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Sample records for coexisting spine lesions

  1. Coexistence of pheochromocytoma with uncommon vascular lesions

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    Sunil Kumar Kota

    2012-01-01

    Full Text Available Background: Pheochromocytoma/paragangliomas have been described to be associated with rare vascular abnormalities like renal artery stenosis. Coexistence of physiologically significant renal artery lesions is a compounding factor that alters management and prognosis of pheochromocytoma patients. Apart from individual case reports, data on such association in Indian population is not available. The aim of this study is to find the nature and prevalence of associated vascular abnormalities. Materials and Methods: From 1990 to 2010, a total of 50 patients were diagnosed with pheochromocytoma/paragangliomas. Hospital charts of these patients were reviewed retrospectively to identify those with unusual vascular abnormalities. Available literature was also reviewed. Results: Of the 50 patients with pheochromocytoma, 7 (14% had coexisting vascular lesions including renal artery stenosis in 4, aortoarteritis in 1, aortic aneurysm in 1 and inferior vena cava thrombosis in 1. Pheochromocytoma was adrenal in 42 and extra adrenal in 8. Laparoscopic adrenalectomy was done in the patients. One patient with renal artery stenosis due to intimal fibrosis was subjected to percutaneous balloon angioplasty; the other three improved after adrenalectomy and lysis of fibrous adhesive bands. The patient with aortoarteritos was treated with oral steroids. Inferior vena cava thrombosis was reversed with anticoagulants. The patient with abdominal aortic aneurysm was advised for annual follow-up on account of its size of 4.5 cm and asymptomatic presentation. Conclusion: There are multiple mechanisms that can lead to renal artery stenosis and other vascular abnormalities in a case of pheochromocytoma. A high index of suspicion is necessary to enable both entities to be diagnosed preoperatively and allow proper planning of surgical therapy. Incomplete diagnosis may lead to persistent hypertension postoperatively in a case of associated renal artery stenosis.

  2. Multisegmental pneumatocysts of the lumbar spine mimic osteolytic lesions

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    Steingruber, I.E.; Buchberger, W. [Dept. of Radiology, University of Innsbruck (Austria); Bach, C.M.; Wimmer, C.; Nogler, M. [Dept. of Orthopedic Surgery, University of Innsbruck (Austria)

    2001-05-01

    Circumscribed radiolucencies within the vertebral bones can be due to a variety of changes including benign and malignant tumours or tumour-like lesions. Radiolucencies due to degenerative intraosseous pneumatocyst are very uncommon but have to be taken into the differential diagnosis in well-circumscribed lytic lesions of the vertebral bodies. We describe the first case of multisegmental pneumatocysts in the lumbar spine mimicking osteolytic lesions. On computed tomography, the air-equivalent attenuation values of the lesions and the close vicinity to the degenerated vertebral endplates with vacuum phenomenon led to the correct diagnosis. (orig.)

  3. Coexistence of neurofibroma and meningioma at exactly the same level of the cervical spine.

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    Chen, Kai-Yuan; Wu, Jau-Ching; Lin, Shih-Cheih; Huang, Wen-Cheng; Cheng, Henrich

    2014-11-01

    We report a case of the coexistence of different spinal tumors at the same level of the cervical spine, without neurofibromatosis (NF), which was successfully treated with surgery. A 72-year-old female presented with right upper-limb clumsiness and weakness. Magnetic resonance imaging revealed an intradural, extramedullary tumor mass at the right C3-4 level with extradural extension into the intervertebral foramen. The extradural tumor was removed, and the pathology showed neurofibroma. After incision of the dura, the intradural tumor was removed, and was identified as meningioma in the pathological report. The patient did not meet the criteria of NF. Coexistence of neurofibroma and meningioma at exactly the same level of the spine without NF is extremely rare. Exploration of the intradural space may be necessary after resection of an extradural tumor if the surgical finding does not correlate well with the preoperative images. Copyright © 2014. Published by Elsevier Taiwan.

  4. Coexistence of neurofibroma and meningioma at exactly the same level of the cervical spine

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    Kai-Yuan Chen

    2014-11-01

    Full Text Available We report a case of the coexistence of different spinal tumors at the same level of the cervical spine, without neurofibromatosis (NF, which was successfully treated with surgery. A 72-year-old female presented with right upper-limb clumsiness and weakness. Magnetic resonance imaging revealed an intradural, extramedullary tumor mass at the right C3–4 level with extradural extension into the intervertebral foramen. The extradural tumor was removed, and the pathology showed neurofibroma. After incision of the dura, the intradural tumor was removed, and was identified as meningioma in the pathological report. The patient did not meet the criteria of NF. Coexistence of neurofibroma and meningioma at exactly the same level of the spine without NF is extremely rare. Exploration of the intradural space may be necessary after resection of an extradural tumor if the surgical finding does not correlate well with the preoperative images.

  5. Tarlov cysts: a controversial lesion of the sacral spine.

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    Lucantoni, Corrado; Than, Khoi D; Wang, Anthony C; Valdivia-Valdivia, Juan M; Maher, Cormac O; La Marca, Frank; Park, Paul

    2011-12-01

    The primary aim of our study was to provide a comprehensive review of the clinical, imaging, and histopathological features of Tarlov cysts (TCs) and to report operative and nonoperative management strategies in patients with sacral TCs. A literature review was performed to identify articles that reported surgical and nonsurgical management of TCs over the last 10 years. Tarlov cysts are often incidental lesions found in the spine and do not require surgical intervention in the great majority of cases. When TCs are symptomatic, the typical clinical presentation includes back pain, coccyx pain, low radicular pain, bowel/bladder dysfunction, leg weakness, and sexual dysfunction. Tarlov cysts may be revealed by MR and CT imaging of the lumbosacral spine and must be meticulously differentiated from other overlapping spinal pathological entities. They are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated. The authors report and discuss various surgical strategies including posterior decompression, cyst wall resection, CT-guided needle aspiration with intralesional fibrin injection, and shunting. In operative patients, the rates of short-term and long-term improvement in clinical symptoms are not clear. Although neurological deficit frequently improves after surgical treatment of TC, pain is less likely to do so.

  6. Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine

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    Douis, H. [University Hospital Birmingham, Department of Radiology, Birmingham (United Kingdom); Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Davies, A.M. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Jeys, L. [Royal Orthopaedic Hospital, Department of Orthopaedic Oncology, Birmingham (United Kingdom); Sian, P. [Royal Orthopaedic Hospital, Department of Spinal Surgery and Spinal Oncology, Birmingham (United Kingdom)

    2016-04-15

    To evaluate the role of chemical shift MRI in the characterisation of indeterminate skeletal lesions of the spine as benign or malignant. Fifty-five patients (mean age 54.7 years) with 57 indeterminate skeletal lesions of the spine were included in this retrospective study. In addition to conventional MRI at 3 T which included at least sagittal T1WI and T2WI/STIR sequences, patients underwent chemical shift MRI. A cut-off value with a signal drop-out of 20 % was used to differentiate benign lesions from malignant lesions (signal drop-out <20 % being malignant). There were 45 benign lesions and 12 malignant lesions. Chemical shift imaging correctly diagnosed 33 of 45 lesions as benign and 11 of 12 lesions as malignant. In contrast, there were 12 false positive cases and 1 false negative case based on chemical shift MRI. This yielded a sensitivity of 91.7 %, a specificity of 73.3 %, a negative predictive value of 97.1 %, a positive predictive value of 47.8 % and a diagnostic accuracy of 82.5 %. Chemical shift MRI can aid in the characterisation of indeterminate skeletal lesions of the spine in view of its high sensitivity in diagnosing malignant lesions. Chemical shift MRI can potentially avoid biopsy in a considerable percentage of patients with benign skeletal lesions of the spine. (orig.)

  7. Andersson lesions of whole spine magnetic resonance imaging compared with plain radiography in ankylosing spondylitis.

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    Kim, Seong-Kyu; Shin, Kichul; Song, Yoonah; Lee, Seunghun; Kim, Tae-Hwan

    2016-12-01

    The objective of this study was to identify the characteristics of Andersson lesions using whole spine magnetic resonance imaging (MRI) compared with plain radiography in ankylosing spondylitis (AS). A total of 62 patients with AS who had undergone whole spine MRI and plain radiography were retrospectively enrolled in this study. We compared the number of discovertebral units (DVUs) with Andersson lesions with clinical and radiographic indices such as erythrocyte sediment rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Fifty-three patients (85.5 %) by whole spine MRI and 23 patients (37.1 %) by plain radiography had at least one Andersson lesion. We found 129 DVUs with Andersson lesions (11.1 %) by MRI and 35 DVUs by plain radiography over all the spine levels. Andersson lesions by MRI were most commonly detected at the lower thoracic spine (from T7-8 to T12-L1). Among the 151 total Andersson lesions by whole spine MRI, 41 were identified as central disc type, 26 as anterior peripheral disc type, 44 as posterior peripheral disc type, and 40 as diffuse disc type. However, the number of Andersson lesions did not correlate with ESR, CRP, BASDAI, BASFI, or mSASSS (p > 0.05 for all). Our study indicates that the presence of Andersson lesions in patients with AS is clearly underestimated. MRI is a superior technique for detecting early Andersson lesions compared with plain radiography.

  8. Coexistence of two types of clinical lesions in childhood-onset mastocytosis.

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    Pérez-Pérez, Lidia; Allegue, Francisco; Caeiro, José Luis; Fabeiro, José María; Pérez Rodríguez, Alberto; Zulaica, Ander

    2011-01-01

    The vast majority of mastocytosis appear in childhood, urticaria pigmentosa (UP) and mastocytomas being the most common types. Terms such as "xanthelasmoid mastocytosis", "pseudoxanthomatous mastocytosis" or "nodular mastocytosis" have been introduced in the literature to describe the presence of yellowish papular or nodular lesions. We describe two children with cutaneous mastocytosis showing yellowish lesions in combination with other skin lesions. A 10-year-old girl presented with asymptomatic lesions in her vulva at birth, and developed brownish macules on her trunk years after. An eight-year-old boy presented with multiple yellowish papular lesions on his trunk, neck and limbs coexisting with a few clinically anetodermic lesions. No systemic involvement was found and the skin biopsy confirmed a cutaneous mastocytosis in both cases. The two patients are currently asymptomatic and are being periodically followed up. Mastocytoses may show a variety of clinical lesions, sometimes leading to misdiagnosis. Although there are previous reports, involvement of the mucosae and secondary anetoderma are not common findings in cutaneous mastocytoses. We consider that cutaneous manifestations of mastocytoses compose a clinical spectrum, thus explaining the coexistence of different clinical lesions and the development of uncommon presentations.

  9. Coexistence of two types of clinical lesions in childhood-onset mastocytosis

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    Lidia Pérez-Pérez

    2011-01-01

    Full Text Available The vast majority of mastocytosis appear in childhood, urticaria pigmentosa (UP and mastocytomas being the most common types. Terms such as "xanthelasmoid mastocytosis", "pseudoxanthomatous mastocytosis" or "nodular mastocytosis" have been introduced in the literature to describe the presence of yellowish papular or nodular lesions. We describe two children with cutaneous mastocytosis showing yellowish lesions in combination with other skin lesions. A 10-year-old girl presented with asymptomatic lesions in her vulva at birth, and developed brownish macules on her trunk years after. An eight- year-old boy presented with multiple yellowish papular lesions on his trunk, neck and limbs coexisting with a few clinically anetodermic lesions. No systemic involvement was found and the skin biopsy confirmed a cutaneous mastocytosis in both cases. The two patients are currently asymptomatic and are being periodically followed up. Mastocytoses may show a variety of clinical lesions, sometimes leading to misdiagnosis. Although there are previous reports, involvement of the mucosae and secondary anetoderma are not common findings in cutaneous mastocytoses. We consider that cutaneous manifestations of mastocytoses compose a clinical spectrum, thus explaining the coexistence of different clinical lesions and the development of uncommon presentations.

  10. Percutaneous anterolateral balloon kyphoplasty for metastatic lytic lesions of the cervical spine.

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    Lykomitros, Vasilis; Anagnostidis, Kleovoulos S; Alzeer, Ziad; Kapetanos, George A

    2010-11-01

    The purpose of our report is to describe a new application of kyphoplasty, the percutaneous anterolateral balloon kyphoplasty that we performed in two cases of metastatic osteolytic lesions in cervical spine. The first patient, aged 48 years, with primary malignancy in lungs had two metastatic lesions in C2 and C6 vertebrae. Patient's complaints were about pain and restriction of movements (due to the pain) in the cervical spine. The second patient, aged 70 years, with primary malignancy in stomach, had multiple metastatic lesions in thoracolumbar spine and C3, C4 and C5 vertebrae without neurological symptoms. The main symptoms were from cervical spine with severe pain even in bed rest and systematic use of opiate-base analgesic. The preoperative status was evaluated with X-rays, CT scan, MRI scan and with Karnofsky score and visual analogue pain (VAS) scale. Both patients underwent percutaneous anterolateral balloon kyphoplasty via the anterolateral approach in cervical spine under general anaesthesia. No clinical complications occurred during or after the procedure. Both patients experienced pain relief immediately after balloon kyphoplasty and during the following days. The stiffness also resolved rapidly and cervical collars were removed. VAS score significantly improved from 85 and 95 preoperatively to 30 in both patients. Karnofsky score showed also improvement from 40 and 30 preoperatively to 80 and 70, respectively, at the final follow-up (7 months after the procedure). Fluoroscopy-guided percutaneous anterolateral balloon kyphoplasty proved to be safe and effective minimally invasive procedure for metastatic osteolytic lesions of the cervical spine, reducing pain and avoiding vertebral collapse. Experience and attention are necessary in order to avoid complications.

  11. Effect of biological agents on cervical spine lesions in rheumatoid arthritis.

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    Kaito, Takashi; Hosono, Noboru; Ohshima, Shirou; Ohwaki, Hajime; Takenaka, Shota; Fujiwara, Hiroyasu; Makino, Takahiro; Yonenobu, Kazuo

    2012-09-15

    A retrospective cohort analysis. To determine the effect of biological agents (BAs) on the development and progression of cervical spine lesions and identify predictors of lesion progression. The introduction of BAs has facilitated advances in the treatment of rheumatoid arthritis (RA). BAs reduce disease activity and limit structural joint damage. However, the effect of BAs on cervical spine lesions remains unclear. Thirty-eight subjects who received more than 2 years of continuous BA treatment were enrolled. The mean x-ray interval was 4.4 years. RA activity was evaluated by disease activity score (DAS)-C reactive protein (CRP) and matrix metalloproteinase (MMP)-3. Radiographical definitions of cervical lesions were atlanto-dental interval (ADI) more than 3 mm for atlanto-axial subluxation (AAS), Ranawat value less than 13 mm for vertical subluxation (VS), and anterior or posterior listhesis more than 2 mm for subaxial subluxation (SS). Definitions of radiographical progression were an increase of ADI more than 2 mm for AAS, a decrease of both Ranawat and Redlund-Johnell values more than 2 mm for VS, and an increase of listhesis more than 2 mm for SS. RA activity responded dramatically to BA therapy (DAS-CRP from 4.3 to 2.3, P < 0.01; MMP-3 from 207.9 ng/mL to 105.6 ng/mL, P < 0.01). Baseline radiographical evaluation showed no pre-existing cervical spine lesions in 12 cases, AAS in 15 cases, and VS in 11 cases. Radiological progression was found in 1 (8%) patient in the no lesion group, 12 patients (80%) in the AAS group, and 9 patients (80%) in the VS group. The incidence of progression was significantly lower in the no lesion group compared with the other groups. Multivariate regression analysis showed that the presence of pre-existing cervical lesions was the single greatest predictor of progression. BAs prevented the development of de novo cervical spine lesions in patients with RA, but failed to inhibit progression of pre-existing RA lesions.

  12. Transthoracic approach for lesions involving the anterior dorsal spine: A multidisciplinary approach with good outcomes

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    Srikant Balasubramaniam

    2016-01-01

    Materials and Methods: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach. The study was for a period of 5 years from January 2011 to December 2015. Patients age ranged from 25 to 61 years with an average of 36.4 yrs. There were 7 males and 9 females. In our series 9 patients had Kochs spine, 4 patients were traumatic fracture spine and 3 had neoplastic lesion. Majority of patients had multiple symptoms with backache being present in all patients. Results: There was one post operative mortality which was unrelated to surgery. One patient had post operative delayed kyphosis. Remaining patients improved in their symptoms following surgery. Conclusion: With careful coordination by thoracic surgeons, neurospinal surgeons and anaesthetists, the anterior spine approach for dorsal spine is safe and effective. Adequate preoperative evaluation should stratify the risk and institute measures to reduce it. Accurate surgical planning and careful surgical technique are the key to yield a good outcome and to reduce the risk of complications.

  13. Percutaneous aspiration biopsy in cervical spine lytic lesions. Indications and technique

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    Tampieri, D.; Weill, A.; Melanson, D.; Ethier, R. (Montreal Neurological Inst. and Hospital, PQ (Canada). Dept. of Neuroradiology)

    1991-02-01

    We describe the technique and the results of the percutaneous aspiration biopsy (PAB) in a series of 9 patients presenting with neck pain and different degrees of myelopathy, in whom the cervical spine X-ray demonstrated lytic lesions of unknown origin. PAB is a useful, relatively safe technique, and leads to histological diagnosis between metastatic and inflammatory processes. Furthermore, in inflammatory lesions with negative hemoculture, PAB may help in detecting the micro-organism responsible and therefore allow a better antibiotic treatment. (orig.).

  14. Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting.

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    Kuo-Lun Huang

    Full Text Available BACKGROUND: Coronary artery disease (CAD may coexist with extracranial carotid artery stenosis (ECAS, but the influence of CAD on procedure-related complications after carotid artery stenting (CAS has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI scanning. METHODS: Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. RESULTS: Among 126 patients (69.5±9.0 years recruited for unilateral protected CAS, 33 (26% patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33 and 48% (45 in 93 of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6-10.0; P = .0018, and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032. In patients with no CAD (n = 55, asymptomatic CAD (n = 41 and symptomatic CAD (n = 30, the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048, and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120. CONCLUSIONS: The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.

  15. A simple rule for dendritic spine and axonal bouton formation can account for cortical reorganization after focal retinal lesions.

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    Markus Butz

    Full Text Available Lasting alterations in sensory input trigger massive structural and functional adaptations in cortical networks. The principles governing these experience-dependent changes are, however, poorly understood. Here, we examine whether a simple rule based on the neurons' need for homeostasis in electrical activity may serve as driving force for cortical reorganization. According to this rule, a neuron creates new spines and boutons when its level of electrical activity is below a homeostatic set-point and decreases the number of spines and boutons when its activity exceeds this set-point. In addition, neurons need a minimum level of activity to form spines and boutons. Spine and bouton formation depends solely on the neuron's own activity level, and synapses are formed by merging spines and boutons independently of activity. Using a novel computational model, we show that this simple growth rule produces neuron and network changes as observed in the visual cortex after focal retinal lesions. In the model, as in the cortex, the turnover of dendritic spines was increased strongest in the center of the lesion projection zone, while axonal boutons displayed a marked overshoot followed by pruning. Moreover, the decrease in external input was compensated for by the formation of new horizontal connections, which caused a retinotopic remapping. Homeostatic regulation may provide a unifying framework for understanding cortical reorganization, including network repair in degenerative diseases or following focal stroke.

  16. Histopathology of space-occupying lesions of the spine; Histopathologie spinaler Raumforderungen

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    Feiden, W.; Feiden, S. [Universitaetsklinikum des Saarlandes, Institut fuer Neuropathologie, Homburg (Germany)

    2006-12-15

    The first step in diagnosing spinal lesions is to define the anatomical location, especially via magnetic resonance tomography, which is also helpful for histopathologists. However, definite diagnosis is based on histologic and cytologic examinations especially in the case of fine-needle biopsies. In this short review the principal histopathologic diagnoses of primary and secondary tumors and tumor-like lesions of the spine itself, the epidural space, the spinal meninges and nerve roots, and the spinal cord are addressed. The significance of immunohistochemistry for differential diagnosis or, in cases of spinal metastasis, for determination of the primary is discussed. (orig.) Die anatomische Zuordnung einer raumfordernden spinalen Laesion, v. a. mit Hilfe der Magnetresonanztomographie in hervorragender Weise moeglich, ist ein erster Schritt der diagnostischen Eroerterung und auch fuer den Histopathologen diagnostisch hilfreich. Die definitive Diagnose ist letztlich nur an histologischen Schnittpraeparaten von Biopsien oder zytologisch moeglich, letzteres v. a. an Feinnadelpunktaten insbesondere im Falle von Karzinomzellen. In dieser kurzen Uebersicht werden die prinzipiell moeglichen pathologischen Diagnosen eroertert, die bei primaeren und sekundaeren Tumoren und tumorartigen nichtneoplastischen Laesionen der Wirbelsaeule selbst, des spinalen Epiduralraums, der Meningen und Wurzeln sowie des Rueckenmarks vorkommen. Die Bedeutung immunhistochemischer Untersuchungen wird diskutiert, insbesondere hinsichtlich der differenzialdiagnostischen Abgrenzung maligner Tumoren und - im Falle von Metastasen - mit Blick auf deren Herkunft bzw. den Sitz des Primaertumors. (orig.)

  17. Patients with chronic back pain of short duration from the SPACE cohort: which MRI structural lesions in the sacroiliac joints and inflammatory and structural lesions in the spine are most specific for axial spondyloarthritis?

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    de Hooge, Manouk; van den Berg, Rosaline; Navarro-Compán, Victoria; Reijnierse, Monique; van Gaalen, Floris; Fagerli, Karen; Landewé, Robert; van Oosterhout, Maikel; Ramonda, Roberta; Huizinga, Tom; van der Heijde, Désirée

    2016-07-01

    To investigate the extent and performance of MRI lesions in the sacroiliac joint (MRI-SI) and spine (MRI-spine) in patients with suspected axial spondyloarthritis (axSpA). MRI-SI/spine of patients with chronic back pain (onset 95% specificity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Structural lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis - definitions, assessment system, and reference image set

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    Østergaard, Mikkel; Maksymowych, Walter P; Pedersen, Susanne J;

    2009-01-01

    are assessed at each vertebral endplate at all 23 spinal levels from C2/3 to L5/S1, whereas facet joint lesions are to be assessed by segmental level (cervical, thoracic, and lumbar). CONCLUSION: An anatomy-based set of definitions and an assessment system for structural lesions in the spine of patients......OBJECTIVE: There is no reliable and sensitive magnetic resonance imaging (MRI) assessment system for structural lesions in patients with spondyloarthritis (SpA). We sought to develop and illustrate a detailed anatomy-based set of MRI definitions and an assessment system for structural lesions...... in the spine of patients with SpA. METHODS: MRI definitions of different structural ("chronic") lesions at various anatomical locations in the spine, and an accompanying assessment system, were agreed by consensus within the Canada-Denmark MRI working group. Subsequently, a reference image set...

  19. Spinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion.

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    Martínez-Pérez, R; Paredes, I; Cepeda, S; Ramos, A; Castaño-León, A M; García-Fuentes, C; Lobato, R D; Gómez, P A; Lagares, A

    2014-05-01

    In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. We retrospectively reviewed 108 patients diagnosed with traumatic spinal cord injury after cervical trauma between 1990-2011. Plain films, CT, and MR imaging were performed on patients and then reviewed for this study. MR imaging was performed within 96 hours after cervical trauma for all patients. Data regarding ligamentous injury, disk injury, and the extent of the spinal cord injury were collected from an adequate number of MR images. We evaluated anterior longitudinal ligaments, posterior longitudinal ligaments, and the ligamentum flavum. Length of lesion, disk disruption, and ligamentous injury association, as well as the extent of the spinal cord injury were statistically assessed by means of univariate analysis, with the use of nonparametric tests and multivariate analysis along with linear regression. There were significant differences in lesion length on T2-weighted images for anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum in the univariate analysis; however, when this was adjusted by age, level of injury, sex, and disruption of the soft tissue evaluated (disk, anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum) in a multivariable analysis, only ligamentum flavum showed a statistically significant association with lesion length. Furthermore, the number of ligaments affected had a positive correlation with the extension of the lesion. In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies

  20. Intramedullary non-specific inflammatory lesion of thoracic spine: A case report

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    Antonelli Manila

    2010-01-01

    Full Text Available Abstract Background There are several non-neoplastic lesions which mimick intramedullary spinal cord neoplasm in their radiographic and clinical presentation. These can be classified as either infectious (TB, fungal, bacterial, parasytic, syphilis, CMV, HSV and non-infectious (sarcoid, MS, myelitis, ADEM, SLE inflammatory lesions, idiopathic necrotizing myelopathy, unusual vascular lesions and radiation myelopathy. Although biopsy may be indicated in many cases, an erroneous diagnosis of intramedullary neoplasm can often be eliminated pre-operatively. Case description the authors report a very rare case of intramedullary non-specific inflammatory lesion of unknown origin, without signs of infection or demyelinization, in a woman who showed no other evidence of systemic disease. Conclusions Intramedullary lesions that mimick a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis. In our case the final histological examination and the specific tests that we performed have not cleared our doubts regarding the nature of the lesion that remains controversial.

  1. Evaluation of different laser wavelengths on ablation lesion and residual thermal injury in intervertebral discs of the lumbar spine.

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    Plapler, Hélio; Mancini, Marília W; Sella, Valéria R G; Bomfim, Fernando R C

    2016-04-01

    Laser discectomy or nucleotomy is an increasingly important method for less invasive procedures of column, but the ideal kind of laser is still not established. As the wavelength is an important parameter for water absorption, this study was performed to investigate the action of the laser emission in the near infrared (808 to 1908 nm) region in the context of surgical procedures for percutaneous intervertebral disc decompression (nucleotomy). Forty intervertebral discs from pigs lumbar spines were irradiated with laser (λ = 808, 980, 1470 and 1908 nm), 1-s on/off time cycles, for 120 cycles and 10 W of power (808, 980, and 1470 nm) or 240 cycles and 5 W of power (1908 nm), with total power of 1200 J, and subjected to microscopic evaluation through hematoxylin-eosin (HE) staining in order to measure the ablation lesions and the residual thermal injury. Ten other discs were not irradiated and worked as controls. The ablation lesions were measured (in mm) at 1.08 ± 1.25, 1.70 ± 0.63, 2.23 ± 1.02, 1.37 ± 0.39, and 0.94 ± 0.41 (median ± SD) for the control, 808, 980, 1470, and 1908 nm groups, respectively. The difference between 1908 nm and all the other groups was statistically significant (p < 0.05). The residual thermal injury was less evident in 1908 nm laser and sharper in 980 nm laser wavelengths. The laser at a wavelength of 1908 nm was considered the most efficient for the vaporization of the nucleus pulposus, followed by the laser wavelengths of 1470, 808, and 980 nm, and proved to be useful for laser nucleotomy procedure.

  2. Frontal dermoid cyst coexisting with suprasellar craniopharyngioma: a spectrum of ectodermally derived epithelial-lined cystic lesions?

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    Abou-Al-Shaar, Hussam; Abd-El-Barr, Muhammad M; Zaidi, Hasan A; Russell-Goldman, Eleanor; Folkerth, Rebecca D; Laws, Edward R; Antonio Chiocca, E

    2016-12-01

    There is a wide group of lesions that may exist in the sellar and suprasellar regions. Embryologically, there is varying evidence that many of these entities may in fact represent a continuum of pathology deriving from a common ectodermal origin. The authors report a case of a concomitant suprasellar craniopharyngioma invading the third ventricle with a concurrent frontal lobe cystic dermoid tumor. A 21-year-old man presented to the authors' service with a 3-day history of worsening headache, nausea, vomiting, and blurry vision. Magnetic resonance imaging depicted a right frontal lobe lesion associated with a separate suprasellar cystic lesion invading the third ventricle. The patient underwent a right pterional craniotomy for resection of both lesions. Gross-total resection of the right frontal lesion was achieved, and subtotal resection of the suprasellar lesion was accomplished with some residual tumor adherent to the walls of the third ventricle. Histopathological examination of the resected right frontal lesion documented a diagnosis of dermoid cyst and, for the suprasellar lesion, a diagnosis of adamantinomatous craniopharyngioma. The occurrence of craniopharyngioma with dermoid cyst has not been reported in the literature before. Such an association might indeed suggest the previously reported hypothesis that these lesions represent a spectrum of ectodermally derived epithelial-lined cystic lesions.

  3. Vitiligo-like lesions of mycosis fungoides coexisting with large plaque parapsoriasis: An association or a spectrum?

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    Das Jayanta

    2006-01-01

    Full Text Available Mycosis fungoides is the commonest type of primary cutaneous T cell lymphoma. Hypopigmented mycosis fungoides is an uncommon variant usually observed in dark-skinned individuals, especially children. Large plaque parapsoriasis, a disease of the middle-aged, and with no racial and geographical predilection, can be regarded as the clinically benign end of the mycosis fungoides disease spectrum. Case of a 24-year-old male, with asymptomatic hypopigmented lesions with characteristics of large plaque parapsoriasis, and vitiligo-like skin lesions with characteristics of mycosis fungoides developing over pre-existing hypopigmented lesions, with no systemic features, is presented for its unusual clinical features and conspicuous histopathological findings.

  4. Dieulafoy Lesion in the Ascending Colon Presenting with Gastrointestinal Bleeding and Severe Anemia Complicated by a Coexisting Severe Resistant Chronic Idiopathic Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Sherif Ali Eltawansy

    2014-01-01

    Full Text Available Background. GI (gastrointestinal bleeding can be due to a variety of etiologies ranging from being common like bleeding peptic ulcer disease or esophageal varices. One of the rarely documented causes is the Dieulafoy lesion which is known as an abnormally large ectatic artery that penetrates the gut wall, occasionally eroding through the mucosa causing massive bleeding. In addition to that, we refer to the uncommon presentation of Dieulafoy lesion itself as it is well known to be found in the stomach, esophagus, duodenum, and jejunum but not the ascending colon as in our case. The patient had a coexisting ITP (idiopathic thrombocytopenic purpura that was resistant to different therapies. Case Report. We report a case of a 48-year-old Egyptian female known for chronic ITP resistant to treatment. The patient presented with bright red bleeding per rectum and severe life threatening anemia. Endoscopic study showed a Dieulafoy lesion. Endoscopic clipping was successful in controlling the bleeding. Conclusion. Dieulafoy lesion is a rare reason for GI bleeding and can present in common or unexpected places. Also extreme caution should be used in patients with bleeding tendency due to different reasons, like ITP in our case.

  5. Co-existence of integumentary lesions and lung x-ray abnormalities in patients with paracoccidioidomycosis (PCM).

    Science.gov (United States)

    Restrepo, Angela; Tobón, Angela M; Agudelo, Carlos A; Ochoa, Juan E; Rosero, David S; Osorio, Marta L; Cano, Luz E; Alvarez, Diego L

    2008-08-01

    In paracoccidioidomycosis (PCM), the primary lung infection remains silent. In this study, attempts were done to define the primary target organ by correlating lung radiographic abnormalities with the time course of mucosal/skin lesions concurrently exhibited at diagnosis by 63 patients in whom microscopy and/or isolation of Paracoccidioides brasiliensis from respiratory secretions had been positive. Mucosal and skin lesions were found in 65.1% and 12.7% of the patients, respectively. Odynophagia and dysphagia were present in 38.1% each. All patients had lung interstitial infiltrates, and 31.7% had also alveolar lesions; fibrosis was recorded in 46% of them. An inverse correlation was shown for fibrosis and presence of either odynophagia or dysphagia. Cluster analyzes strongly supported two sets of patients: those with mucosal damage, odynophagia/dysphagia, and alveolo-interstitial infiltrates and those with dermal lesions, dyspnea, and lung fibrosis. These groups may represent novel stages in the natural course of PCM.

  6. Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis

    DEFF Research Database (Denmark)

    Hermann, Kay-Geert A; Baraliakos, Xenofon; van der Heijde, Désirée M F M

    2012-01-01

    The aim of this study was to define characteristic MRI findings in the spine of patients with axial spondyloarthritis (SpA) and provide a definition of a positive spinal MRI for inflammation and structural changes.......The aim of this study was to define characteristic MRI findings in the spine of patients with axial spondyloarthritis (SpA) and provide a definition of a positive spinal MRI for inflammation and structural changes....

  7. Vitiligo-like lesions of mycosis fungoides coexisting with large plaque parapsoriasis: An association or a spectrum?

    OpenAIRE

    Das Jayanta; Sengupta Sujata; Gangopadhyay Asok

    2006-01-01

    Mycosis fungoides is the commonest type of primary cutaneous T cell lymphoma. Hypopigmented mycosis fungoides is an uncommon variant usually observed in dark-skinned individuals, especially children. Large plaque parapsoriasis, a disease of the middle-aged, and with no racial and geographical predilection, can be regarded as the clinically benign end of the mycosis fungoides disease spectrum. Case of a 24-year-old male, with asymptomatic hypopigmented lesions with characteristics of large pla...

  8. OMERACT magnetic resonance imaging initiative on structural and inflammatory lesions in ankylosing spondylitis--report of a special interest group at OMERACT 10 on sacroiliac joint and spine lesions.

    Science.gov (United States)

    Baraliakos, Xenofon; van der Heijde, Desirée; Braun, Jurgen; Landewé, Robert B M

    2011-09-01

    The ASAS/OMERACT MRI group recently described and defined magnetic resonance imaging (MRI) findings in sacroiliac joints (SIJ) that are essential for the diagnosis of sacroiliitis in patients with axial spondyloarthritis, including ankylosing spondylitis (AS). At the Outcome Measures in Rheumatology Clinical Trials (OMERACT) 2010 meeting, a special interest group (SIG) was formed to design a research agenda for the definition and description of structural lesions in the SIJ and the spine in patients with established AS. During the SIG, a summary of the previous work of the group was presented to all participants, containing: (1) a description of the current definitions of structural SIJ changes; (2) available scoring methods for SIJ changes; (3) data from a previous pilot MRI exercise on chronic SIJ changes performed by members of the group; and (4) a proposal for a research agenda for OMERACT 11. The group agreed on the project's scientific merits and the need to evaluate all available scoring methods and to have clear definitions for all possible abnormalities that can be seen on MRI, prior to the start of the exercise. It was also agreed that the exercise should include scoring of both structural and inflammatory lesions, due to lack of agreement about the best scoring method for assessing both types of lesions in AS. Participants agreed that longitudinal MRI over a certain period are needed to learn about the time sequence of pathologic changes and to understand the course of the disease. Finally, participants asked the group to add the development of a scoring method for structural changes in the spine in a subsequent exercise. Further to these objectives, all experts who agreed to contribute in the exercise will collaborate to achieve consensus on definitions and to organize training in the different scoring systems prior to the start of the project, with the aim to finalize the multiple reader exercise by the end of 2011, in time for OMERACT 11.

  9. Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine.

    Science.gov (United States)

    Kaale, Bertel Rune; Krakenes, Jostein; Albrektsen, Grethe; Wester, Knut

    2005-11-01

    In the present study, we compared magnetic resonance imaging (MRI) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder (WAD) patients and population-based control persons, and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury. A total of 92 whiplash patients and 30 control persons, randomly drawn, were included. Information on the accident-related factors (i.e., head position and impact direction) was obtained by a questionnaire that was answered within 1 week after the accident. The MRI examination was performed 2-9 (mean 6) years after the accident. Focus was on MRI abnormalities of the alar and the transverse ligaments, and the tectorial and posterior atlanto-occipital membranes, graded 0-3. For all neck structures, the whiplash patients had more high-grade lesions (grade 2 or 3) than the control persons (Chi-square test, p Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high-grade lesions of the alar and transverse ligaments (p whiplash trauma.

  10. Anesthetic Considerations for Neuraxial Anesthesia in Pregnant Patients With Pityriasis Rosea With Skin Lesions Covering the Lumbar Spine.

    Science.gov (United States)

    Werntz, Megan; Chun, Carlene; Togioka, Brandon Michael

    2016-10-15

    Pityriasis rosea (PR) is an acute exanthematous skin disease that is likely due to reactivation of human herpesviruses (HHVs) 6b and 7. In contrast to herpes simplex and zoster (alphaherpesviruses), HHV-6b and -7 (betaherpesviruses) are not found predominantly in skin lesions. This difference in virion location may decrease the possibility of causing central nervous system infection through skin contamination, but the risk for hematogenous spread likely remains the same. This article uses the first-known epidural placement through active PR to illustrate risk-benefit considerations when deciding between neuraxial and general anesthesia for obstetric patients with PR.

  11. Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

    Directory of Open Access Journals (Sweden)

    M. Lorenzin

    2016-09-01

    Full Text Available Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ lesions on magnetic resonance imaging (MRI in patients with early axial spondyloarthritis (axSpA and their correlation with disease activity indices. Sixty patients with low back pain (LBP (≥3 months, ≤2 years, onset ≤45 years, attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA, patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+, patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-. The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

  12. The FAt Spondyloarthritis Spine Score (FASSS)

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw

    2013-01-01

    Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...

  13. Fast STIR (Short TI Inversion Recovery) imaging of the spine. The assessment of the role for the depiction of intramedullary spinal cord lesions and the usefulness of the additional transverse images

    Energy Technology Data Exchange (ETDEWEB)

    Okumura, Ryosuke; Kan, Tomoko; Hirose, Tomohiro; Hara, Tadashi; Shibata, Toyomichi; Ueno, Makoto; Takagi, Takehisa; Kohno, Shigene [Tazuke Kofukai Medical Research Inst., Osaka (Japan). Kitano Hospital

    2002-05-01

    It is known that the fast STIR images of the spine achieve more excellent lesion contrast than the usual fast spin echo (FSE) T2-weighted images, because the elongation of T1 and T2 relaxation time of the lesion additively contribute to the contrast. The fast STIR images showed advantages in the depiction of acute and chronic lesion of multiple sclerosis and tolerable disadvantages in the depiction of other lesions, such as spondylotic myelopathy or syringomyelia. Transverse images showed less usefulness than sagittal images except for their superior gray-to-white matter contrast. Fast STIR imaging can replace FSE T2-weighted imaging in the study of restricted patients' population. (author)

  14. Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements

    Science.gov (United States)

    Ansari, Sajid; Amanullah, Md. Farid; Ahmad, Kaleem; Rauniyar, Raj Kumar

    2013-01-01

    Spinal tuberculosis (TB) or Pott's spine is the commonest extrapulmonary manifestation of TB. It spreads through hematogenous route. Clinically, it presents with constitutional symptoms, back pain, tenderness, paraplegia or paraparesis, and kyphotic or scoliotic deformities. Pott's spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Plain radiographs are usually the initial investigation in spinal TB. For a radiolucent lesion to be apparent on a plain radiograph there should be 30% of bone mineral loss. Computed tomographic scanning provides much better bony detail of irregular lytic lesions, sclerosis, disc collapse, and disruption of bone circumference than plain radiograph. Magnetic resonance imaging (MRI) is the best diagnostic modality for Pott's spine and is more sensitive than other modalities. MRI frequently demonstrates disc collapse/destruction, cold abscess, vertebral wedging/collapse, marrow edema, and spinal deformities. Ultrasound and computed tomographic guided needle aspiration or biopsy is the technique for early histopathological diagnosis. Recently, the coexistence of human immunodeficiency virus infections and TB has been increased globally. In recent years, diffusion-weighted MRI (DW-MRI) and apparent diffusion coefficient values in combination with MRI are used to some extent in the diagnosis of spinal TB. We have reviewed related literature through internet. The terms searched on Google scholar and PubMed are TB, extrapulmonary TB, skeletal TB, spinal TB, Pott's spine, Pott's paraplegia, MRI, and computed tomography (CT). PMID:24020048

  15. Development and Validation of Web-based Training Modules for Systematic Evaluation of Active Inflammatory Lesions in the Spine and Sacroiliac Joints in Spondyloarthritis

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Dhillon, Suhkvinder S; Chiowchanwisawakit, Praveena

    2009-01-01

    OBJECTIVE: Reliable assessment of spinal and sacroiliac joint (SIJ) inflammation on magnetic resonance imaging (MRI) is difficult. We developed 2 Web-based training modules for scoring inflammation by MRI in the spine and SIJ using the SPARCC method. These provide explicit details on methodology...

  16. 18 F-FDG avid lesion due to coexistent fibrous dysplasia in a child of embryonal rhabdomyosarcoma: Source of false positive FDG-PET

    Directory of Open Access Journals (Sweden)

    Basu Sandip

    2010-01-01

    Full Text Available With increasing use of 18 F-fluorodeoxyglucose (FDG-positron emission tomography (PET in the current oncological practice, there is a growing body of evidence of false positive scans due to various benign conditions. In this communication we present intensely avid 18 F-FDG uptake in fibrous dysplasia of right tibia in a 12-year-old child suffering from embryonal rhabdomyosarcoma (ERMS that could have been easily mistaken to be a metastatic focus if not carefully correlated. The patient was a case of ERMS (presenting with left cervical mass with intrathoracic extension who was treated successfully with chemotherapy and was referred for FDG-PET to evaluate the disease status. His whole body survey was unremarkable except for an intensely avid FDG uptake (SUV max 8.5 in shaft of right tibia. The scan was extended up to foot in view of the fact that a prior bone scan had shown a focal uptake in the similar location. Efforts were undertaken to elucidate the exact etiopathology of the aforementioned 18 F-FDG uptake because the rest of the whole body survey was unremarkable. A plain radiograph (both anteroposterior and lateral views of the right tibia showed patchy sclerosis involving the middle diaphysis of the right tibia suggesting a fibrous defect. The computed tomography (CT scan of the same region showed cortical thickening and increased density within the medullary cavity in the shaft of the tibia. A histopathological diagnosis was sought for and the lesion was subsequently proven to be fibrous dysplasia by histopathology of the bone piece obtained from the right tibial lesion by J needle biopsy. The present case is a useful addition to the current body of literature of false positive 18 F-FDG-PET study due to a benign skeletal pathology and underscores the importance of high index of suspicion and careful clinicoradiopathologic correlation, whenever one comes across such an unusual PET finding.

  17. THORACIC SPINE FRACTURES

    Institute of Scientific and Technical Information of China (English)

    戴力扬

    2001-01-01

    Objective. To investigate the unique characteristics and treatment of thoracic spine fractures.Methods. Severty-seven patients with thoracic spine fractures were retrospectively reviewed. Of these, therewere 37 compressior fractures, 34 fracture-dislocations, 3 burst fractures and 3 burst-dislocations. Twenty-six pa-tients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 wereneurologically intact. Fifty-three patients were treated nonoperatively and 24 treated operatively.Results. All patients were followed up for 2 ~ 15 years. None of the 26 patients with a complete lesion recov-ered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them re-mained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some func-tion and 5 did not recovered.Conclusions. E ecause of the unique anatomy and biomechanics of the thoracic spine, the classification common-ly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicat-ed when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidatesfor supplemented decompression.

  18. Fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raphael Martus Marcon

    2013-11-01

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

  19. Fractures of the cervical spine

    Science.gov (United States)

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  20. High Grade Infective Spondylolisthesis of Cervical Spine Secondary to Tuberculosis.

    Science.gov (United States)

    Hadgaonkar, Shailesh; Shah, Kunal; Shyam, Ashok; Sancheti, Parag

    2015-12-01

    Spondylolisthesis coexisting with tuberculosis is rarely reported. There is a controversy whether spondylolisthesis coexists or precedes tuberculosis. Few cases of pathological spondylolisthesis secondary to tuberculous spondylodiscitis have been reported in the lumbar and lumbosacral spine. All cases in the literature presented as anterolisthesis, except one which presented as posterolisthesis of lumbar spine. Spondylolisthesis in the cervical spine is mainly degenerative and traumatic. Spondylolisthesis due to tuberculosis is not reported in the lower cervical spine. The exact mechanism of such an occurrence of spondylolisthesis with tuberculosis is sparsely reported in the literature and inadequately understood. We report a rare case of high grade pathological posterolisthesis of the lower cervical spine due to tubercular spondylodiscitis in a 67-year-old woman managed surgically with a three-year follow-up period. This case highlights the varied and complex presentation of tuberculosis of the lower cervical spine and gives insight into its pathogenesis, diagnosis, and management.

  1. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: evidence of a relationship between inflammation and new bone formation

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Chiowchanwisawakit, Praveena; Clare, Tracey

    2009-01-01

    OBJECTIVE: To determine whether a vertebral corner that demonstrates an active corner inflammatory lesion (CIL) on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) is more likely to evolve into a de novo syndesmophyte visible on plain radiography than is a vertebral c...

  2. Risk factors of neurological lesions in low cervical spine fractures and dislocations Fatores de risco de lesão neurológica nas fraturas e luxações da coluna cervical baixa

    Directory of Open Access Journals (Sweden)

    DANILO GONÇALVES COELHO

    2000-12-01

    Full Text Available Eighty-nine patients with lower cervical spine fractures or dislocations were evaluated for risk factors of neurological lesion. The age, sex, level and pattern of fracture and sagittal diameter of the spinal canal were analysed. There were no significant differences on the age, gender, level and Torg's ratio between intact patients and those with nerve root injury, incomplete or complete spinal cord injuries. Bilateral facet dislocations and burst fractures are a significant risk factor of spinal cord injury.O risco de lesão neurológica foi avaliado em 89 pacientes com fraturas ou luxações da coluna cervical baixa. Foram analisados o sexo, a idade, o diâmetro sagital do canal vertebral, o nível e o tipo de fratura ou luxação. Não foram encontradas diferenças significativas para a idade, sexo, nível da fratura ou luxação e razão de Torg entre os pacientes intactos e aqueles com lesão radicular, lesão medular incompleta e lesão medular completa. Luxações bilaterais de facetas articulares e fraturas em explosão são um fator de risco significativo de lesão neurológica.

  3. Giant cell tumor of the spine.

    Science.gov (United States)

    Ozaki, Toshifumi; Liljenqvist, Ulf; Halm, Henry; Hillmann, Axel; Gosheger, Georg; Winkelmann, Winfried

    2002-08-01

    Six patients with giant cell tumor of the spine had surgery between 1981 and 1995. Three lesions were located in the scrum, two lesions were in the thoracic spine, and one lesion was in the lumbar spine. Preoperatively, all patients had local pain and neurologic symptoms. Two patients had cement implanted after curettage or intralesional excision of the sacral tumor; one patient had a local relapse. After the second curettage and cement implantation, the tumor was controlled. One patient with a sacral lesion had marginal excision and spondylodesis; no relapse developed. Two patients with thoracic lesions had planned marginal excision and spondylodesis; the margins finally became intralesional, but no relapse developed. One patient with a lumbar lesion had incomplete removal of the tumor and received postoperative irradiation. At the final followup (median, 69 months), five of six patients were disease-free and one patient died of disease progression. Two of the five surviving patients had pain after standing or neurologic problems. Although some contamination occurred, planning a marginal excision of the lesion seems beneficial for vertebral lesions above the sacrum. Total sacrectomy of a sacral lesion seems to be too invasive when cement implantation can control the lesion.

  4. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you need ...

  5. Lumbar spine CT scan

    Science.gov (United States)

    CAT scan - lumbar spine; Computed axial tomography scan - lumbar spine; Computed tomography scan - lumbar spine; CT - lower back ... your breath for short periods of time. The scan should take only 10 to 15 minutes.

  6. Signaling in dendritic spines and spine microdomains

    OpenAIRE

    2012-01-01

    The specialized morphology of dendritic spines creates an isolated compartment that allows for localized biochemical signaling. Recent studies have revealed complexity in the function of the spine head as a signaling domain and indicate that (1) the spine is functionally subdivided into multiple independent microdomains and (2) not all biochemical signals are equally compartmentalized within the spine. Here we review these findings as well as the developments in fluorescence microscopy that a...

  7. Clearing the Cervical Spine in a War Zone: What Other Injuries Matter?

    Science.gov (United States)

    2015-07-01

    NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) USAF School of Aerospace Medicine...negative clinical examination of the cervical spine. Coexisting injuries identified in patients with negative physical examination included...injuries in proximity to the neck (head, thoracic spine, chest, or humerus) in 17 (85%) patients. In 3 patients(15%), coexisting injuries were not in

  8. Clinical radiology of the spine and spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Banna, M.

    1985-01-01

    This book is a source of information about aspects of radiology of the spine and spinal column. It presents coverage of both normal and abnormal conditions. Contents: Spinal fractures and dislocations. Degenerative diseases of the spine. Gross anatomy of the spinal cord and meninges. Intraspinal mass lesions. Spinal dysraphism. Congenital anomalies. Tumors of the vertebral column, and more.

  9. Pigmented villonodular synovitis of the spine: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Su Ok; Lee, Joo Hyuk; Yi, Jeong Geun [Cheongju St. Mary' s Hospital, Cheongju (Korea, Republic of)

    2000-10-01

    Pigmented villonodular synovitis (PVNS) is a synovial lesion of joints or tendon sheaths, characterized by villous and nodular overgrowth of the synovial membrane. It commonly occurs in synovial joints of the appendicular skeleton, particularly those of the knee and hip, but rarely affecting those of the spine. We report a case of PVNS of the lumbar spine mimicking epidural mass.

  10. Spine injuries in the sport of gymnastics.

    Science.gov (United States)

    Kruse, David; Lemmen, Brooke

    2009-01-01

    Injury in gymnastics is not an uncommon occurrence, and an injury of the spine frequently is a source of pain in a gymnast. Because of the unique demands of this sport, which repetitively place significant forces across the spine, it becomes clear why the spine commonly is injured. Potential causes of back pain in a gymnast include spondylolysis, Scheuermann's disease, intervertebral disc pathology, and mechanical sources of pain. Much of the diagnostic workup and management of spondylolysis lesions remains controversial, but a successful management strategy can be developed for the safe return of a gymnast to the mat. Mechanical sources of pain are common and should be addressed. Psychosocial etiologies of back pain also exist in these athletes. Rehabilitation strategies should focus on improvement in the strength and function of the trunk and lumbar spine and the correction of biomechanical deficits with a goal of pain-free transition back to gymnastic-specific activities.

  11. Traumatic plexus lesion.

    NARCIS (Netherlands)

    Dongen, R.T.M. van; Cohen, S.P.; Kleef, M. van; Mekhail, N.; Huygen, F.

    2011-01-01

    Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co-exist that require immediate surgical attention. Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be

  12. Osteoid Osteoma of Cervical Spine in two adjacent Vertebrae

    Directory of Open Access Journals (Sweden)

    MR Etemadifar

    2005-09-01

    Full Text Available Osteoid osteoma is a benign bone tumor, mainly seen in 10-30 years male. Spine is a relatively common site and almost always, posterior elements are involved. Plain X-Ray-, CT scan and Isotope scan help to identify and localize spine lesions. We described one 18 years old boy with 3 years low neck pain. Isotope scan, MRI and CT scan showed two lesions in C7 and T1. Gross inspection and histopathology examination confirmed osteoid osteoma in two adjacent vertebrae which has not been reported elsewhere in the literature. Key words: Osteoid Osteoma, Spine, Multifocal

  13. China and Coexistence

    DEFF Research Database (Denmark)

    Odgaard, Liselotte

    “Peaceful coexistence,” long a key phrase in China’s strategic thinking, is a constructive doctrine that offers China a path for influencing the international system. So argues Liselotte Odgaard in this timely analysis of China's national security strategy in the context of its foreign policy...... practice. China’s program of peaceful coexistence emphasizes absolute sovereignty and non-interference in the internal affairs of other states. Odgaard suggests that China’s policy of working within the international community and with non-state actors such as the UN aims to win for China greater power...... and influence without requiring widespread exercise of military or economic pressure. Odgaard examines the origins of peaceful coexistence in early Soviet doctrine, its midcentury development by China and India, and its ongoing appeal to developing countries. She reveals what this foreign policy offers China...

  14. Pigmented villonodular synovitis of the thoracic spine.

    Science.gov (United States)

    Roguski, Marie; Safain, Mina G; Zerris, Vasilios A; Kryzanski, James T; Thomas, Christine B; Magge, Subu N; Riesenburger, Ron I

    2014-10-01

    Pigmented villonodular synovitis (PVNS) is a proliferative lesion of the synovial membranes. Knees, hips, and other large weight-bearing joints are most commonly affected. PVNS rarely presents in the spine, in particular the thoracic segments. We present a patient with PVNS in the thoracic spine and describe its clinical presentation, radiographic findings, pathologic features, and treatment as well as providing the first comprehensive meta-analysis and review of the literature on this topic, to our knowledge. A total of 28 publications reporting 56 patients were found. The lumbar and cervical spine were most frequently involved (40% and 36% of patients, respectively) with infrequent involvement of the thoracic spine (24% of patients). PVNS affects a wide range of ages, but has a particular predilection for the thoracic spine in younger patients. The mean age in the thoracic group was 22.8 years and was significantly lower than the cervical and lumbar groups (42.4 and 48.6 years, respectively; p=0.0001). PVNS should be included in the differential diagnosis of osteodestructive lesions of the spine, especially because of its potential for local recurrence. The goal of treatment should be complete surgical excision. Although the pathogenesis is not clear, mechanical strain may play an important role, especially in cervical and lumbar PVNS. The association of thoracic lesions and younger age suggests that other factors, such as neoplasia, derangement of lipid metabolism, perturbations of humoral and cellular immunity, and other undefined patient factors, play a role in the development of thoracic PVNS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Neuroimaging for spine and spinal cord surgery

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-01-01

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

  16. The coexistence of SAPHO syndrome and rheumatoid arthritis

    Science.gov (United States)

    Xu, Wenrui; Li, Chen; Zhang, Weihong

    2017-01-01

    Abstract Rational: SAPHO (Synovitis-Acne-Pustulosis-Hyperstosis-Osteitis) syndrome is a rare disease featured by its dermatological and osteoarthritic disorders, the latter of which mainly affecting the anterior chest wall, spine, and sacroiliac joint. However, rheumatoid arthritis (RA) is a chronic autoimmune disease, mainly affecting the synovial tissue of small joints in hands and feet. Here, we present an extremely rare case diagnosed with both SAPHO syndrome and RA, with an onset interval of 10 years. So far, only 1 similar case has been reported in the English literature. Patient Concerns: In Sep 2015, a 59-year-old female patient presented to our hospital, complaining of refractory low back pain, left sternoclavicular joint pain, and palmoplanar pustulosis (PPP). In addition, RA had been diagnosed 10 years earlier in the patient, manifested as pain and swelling in bilateral hands and wrists, accompanied by morning stiffness, as well as positive serologic tests. Interventions: In our hospital, laboratory tests revealed elevated inflammatory markers, and imaging examinations of relevant sites showed specific osteoarthritic lesions for SAPHO syndrome. Diagnoses: These findings lead us to make an easy diagnosis of the coexistence of SAPHO syndrome and RA in this petient. Outcomes: Treatment with tripterygium wilfordii polyglycosidium and prednisone was introduced. Both dermatological and osteoarthritic symptoms improved during a 3-month follow-up. Symptoms of RA were successfully controlled with prednisone and leflunomide since 2005. Lessons: We present an extremely rare case diagnosed with both SAPHO syndrome and RA, with an onset interval of 10 years. With this case report, we want to draw attention to the diverse features of SAPHO syndrome. PMID:28072711

  17. Cervical spine involvements in Reiter's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Moilanen, A.; Yli-Kerrtula, U.; Vippula, A.

    1984-07-01

    Cervical spine radiographs of 38 patients orginating from 145 consecutive cases with Reiter's syndrome (RS) were reviewed. Five of these 145 patients (3.4%) had cervical spine manifestations: anterior atlanto-axial dislocation 2, craniovertebral lesions typical for rhreumatoid arthritis (RA), spondylitis typical for ankylosing spondylitis (AS) and anterior ossification, one each. Four of these patients were males. Cervical lesions in RS turned out to be rare. These lesions are alone indistinguisable from those of other chronic rheumatic inflammatory diseases.

  18. Fibrous dysplasia localized to spine: a diagnostic dilemma

    Energy Technology Data Exchange (ETDEWEB)

    Gogia, Nidhi; Gulati, Manpreet [All India Institute of Medical Sciences, Department of Radiology, New Delhi (India); Marwaha, V. [All India Institute of Medical Sciences, Department of Radiology, New Delhi (India); All India Institute of Medical Sciences, Department of Medicine, New Delhi (India); Atri, S. [All India Institute of Medical Sciences, Department of Pathology, New Delhi (India); Gupta, Rajiva [All India Institute of Medical Sciences Ansari Nagar, Department of Medicine, Division of Rheumatology and Clinical Immunology, New Delhi (India)

    2007-06-15

    Fibrous dysplasia of the spine is uncommon, especially in monostotic form. Isolated vertebral involvement in polyostotic form is very rare. We report a case of polyostotic fibrous dysplasia with lesions localized to dorso-lumbar spine in a 45-year-old rheumatoid arthritis patient. No associated appendicular lesions, cutaneous manifestations or endocrinopathies were seen. The extreme rarity of this type of lesion can pose a diagnostic dilemma, and biopsy is required for diagnosis. The association with rheumatoid arthritis in our case seems to be a chance occurrence. (orig.)

  19. Multiplanner spine computed tomography

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-06-15

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

  20. Osteoporosis and Your Spine

    Science.gov (United States)

    ... Store Shopping Cart Home › Patients › Fractures/Fall Prevention › Exercise/Safe Movement › Osteoporosis and Your Spine Osteoporosis and Your Spine Your ... osteoporosis experts. Become a Member ... Patients ... Prevention Exercise/Safe Movement Safe Movement & Exercise Videos Communication with ...

  1. Traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    J. Siebenga (Jan)

    2013-01-01

    textabstractTraumatic spinal fractures have the lowest functional outcomes and the lowest rates of return to work after injury of all major organ systems.1 This thesis will cover traumatic thoracolumbar spine fractures and not osteoporotic spine fractures because of the difference in fracture

  2. Thoracic spine pain

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2013-01-01

    Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

  3. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  4. Destructive discovertebral degenerative disease of the lumbar spine.

    Science.gov (United States)

    Charran, A K; Tony, G; Lalam, R; Tyrrell, P N M; Tins, B; Singh, J; Eisenstein, S M; Balain, B; Trivedi, J M; Cassar-Pullicino, V N

    2012-09-01

    The uncommon variant of degenerative hip joint disease, termed rapidly progressive osteoarthritis, and highlighted by severe joint space loss and osteochondral disintegration, is well established. We present a similar unusual subset in the lumbar spine termed destructive discovertebral degenerative disease (DDDD) with radiological features of vertebral malalignment, severe disc resorption, and "bone sand" formation secondary to vertebral fragmentation. Co-existing metabolic bone disease is likely to promote the development of DDDD of the lumbar spine, which presents with back pain and sciatica due to nerve root compression by the "bone sand" in the epidural space. MRI and CT play a complimentary role in making the diagnosis.

  5. Coexistence of Sarcoidosis and Gouty Arthritis.

    Science.gov (United States)

    Semiz, Hüseyin; Kobak, Senol

    2017-08-21

    Sarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, the involvement of eye and symptoms on the locomotor system. Gouty arthritis is an autoinflammatory disease characterized by hyperuricemia, recurrent arthritis attacks and the deposition of monosodium urate crystals in the joints and the surrounding tissues. We reported the coexistence of sarcoidosis and gouty arthritis in this paper. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  6. Differentiation between focal malignant marrow-replacing lesions and benign red marrow deposition of the spine with T2{sup *}-corrected fat-signal fraction map using a three -echo volume interpolated breath-hold gradient echo dixon sequence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Pyo; Kim, Sung Jun; Chung, Tae Sub; Yoo, Yeon Hwa; Yoon, Choon Sik [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kanneengiesser, Stephan [MR Applications Development, Siemens AG, Healthcare Sector, Erlangen (Germany); Paek, Moon Young [Siemens Ltd., Seoul (Korea, Republic of); Song, Ho Taek; Lee, Young Han; Suh, Jin Suck [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    To assess the feasibility of T2{sup *}-corrected fat-signal fraction (FF) map by using the three-echo volume interpolated breath-hold gradient echo (VIBE) Dixon sequence to differentiate between malignant marrow-replacing lesions and benign red marrow deposition of vertebrae. We assessed 32 lesions from 32 patients who underwent magnetic resonance imaging after being referred for assessment of a known or possible vertebral marrow abnormality. The lesions were divided into 21 malignant marrow-replacing lesions and 11 benign red marrow depositions. Three sequences for the parameter measurements were obtained by using a 1.5-T MR imaging scanner as follows: three-echo VIBE Dixon sequence for FF; conventional T1-weighted imaging for the lesion-disc ratio (LDR); pre- and post-gadolinium enhanced fat-suppressed T1-weighted images for the contrast-enhancement ratio (CER). A region of interest was drawn for each lesion for parameter measurements. The areas under the curve (AUC) of the parameters and their sensitivities and specificities at the most ideal cutoff values from receiver operating characteristic curve analysis were obtained. AUC, sensitivity, and specificity were respectively compared between FF and CER. The AUCs of FF, LDR, and CER were 0.96, 0.80, and 0.72, respectively. In the comparison of diagnostic performance between the FF and CER, the FF showed a significantly larger AUC as compared to the CER (p = 0.030), although the difference of sensitivity (p = 0.157) and specificity (p = 0.157) were not significant. Fat-signal fraction measurement using T2{sup *}-corrected three-echo VIBE Dixon sequence is feasible and has a more accurate diagnostic performance, than the CER, in distinguishing benign red marrow deposition from malignant bone marrow-replacing lesions.

  7. Changes in the cervical spine in chronic polyarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Miehle, W.; Schattenkirchner, M.; Lattermann, K.

    1985-02-01

    In 93 patients with classical chronic polyarthritis (rheumatoid arthritis) (at least five ARA-criterias) there were inflammatory lesions of dens epistropheus in 48.4%, ventral atlantoaxial subluxations in 25.8%, lateral atlantoaxial dislocations in 14% and pseudobasilary invagination in 5.4%. Step-ladder-subluxation between C 2/C 7 was found in 31.2%, discitis in 12.5% and spondylarthritis in 38% of cases. Inflammatory signs of the cervical spine were correlated to the Steinbrocker-Grade IV, ANA level 1 : 40 and the degree of Waaler-Rose. The correlation between long standing steroid-therapy and signs of cervical involvement during c.p. - specially in C/sub 1//C/sub 2/ - is found to be proven. There are connections between the duration of c.p. (more than 10 years) and manifestation of cervical spine lesions, further, in a protective sense between longstanding gold therapy and cervical spine lesions.

  8. Increased detection rate of syringomyelia by whole spine sagittal magnetic resonance images: Based on the data from military conscription of Korean young males

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Seok; Oh, Chang Hyun [Seoul Regional Military Manpower Administration, Seoul (Korea, Republic of); Yoon, Seung Hwan; Park, Hyeong Chun; Park, Chong Oon; Kim, Yeo Ju [Inha Univ. Hospital/College of Medicine/Inha Univ., Incheon (Korea, Republic of)

    2012-09-15

    We compared the detection rate of syringomyelia according to the type of magnetic resonance (MR) images among the Korean military conscription. Among the total of 238910 examinees (males aged 18 to 32 years old) from January 2008 to December 2011, the examinees with conventional single lesion MR images (cervical, thoracic, and lumbar) with and without whole spine sagittal T2 weighted MR images (WSST2I) totaled 1206 cases, and syringomyelia was observed in 24 cases. The detection rate of syringomyelia according to the MR protocol (the presence of WSST2I or not) was done through analysis by annually and the clinical characters of syringomyelia was reviewed. The estimated prevalence of syringomyelia was approximately 10.0 cases per 100000 people. The detection rate was increased annually when the WSST2I proportion was increased (from 3.4 to 14.9 cases per 100000 persons, r = 0.939, p = 0.018). Clinical character of syringomyelia was ambiguous with other spinal diseases. The most affected spinal level was C5 to C7 (83%), and most cases were non communicating syringomyelia with benign central canal widening (79%). Whole spine sagittal MR image is useful to detect coexisting spinal diseases such as syringomyelia, and most syringomyelia in young males was benign hydromyelia. A whole spine sagittal MR image is recommended to increase the detection of syringomyelia.

  9. North American Spine Society

    Science.gov (United States)

    ... Advertise Press Room Press Releases Resources Find a Spokesperson In the News More Member Resources Blog NASS ... 3671 PRESS ROOM Press Releases Resources Find a Spokesperson In The News Blog NASS on Spine EXPLORE ...

  10. Cervical spine CT scan

    Science.gov (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  11. Microtubules in Dendritic Spine Development

    OpenAIRE

    2008-01-01

    It is generally believed that only the actin cytoskeleton resides in dendritic spines and controls spine morphology and plasticity. Here we report that microtubules (MTs) are present in spines and that shRNA knockdown of the MT-plus end binding protein EB3 significantly reduces spine formation. Furthermore, stabilization and inhibition of MTs by low doses of taxol and nocodazole enhance and impair spine formation elicited by BDNF, respectively. Therefore, MTs play an important role in the con...

  12. [Reduction and positioning of cervical spine injuries].

    Science.gov (United States)

    Blauth, M; Knop, C; Bastian, L; Schmidt, U

    1998-01-01

    Prerequisites for successful reduction of cervical spine injuries are an exact analysis and classification of every lesion. In locked dislocations disc protrusion should be excluded prior to reduction by MRI or CT-scan. For manual reduction and closed manipulation by the trauma surgeon we use a halo-ring which is applied in local anaesthesia and fluoroscopic control. The anatomic position is maintained by a halo-fixator until surgery. Skeletal traction is used mainly for locked dislocations and late malalignements. Traction is provided by a halo-ring and weights up to 20 kg. Repeated clinical and neurological examinations are necessary to rule out overdistraction of the spine or neurologic deterioration. The weight may be reduced after reduction to 2 kg. For intraoperative positioning and reduction of cervical spine injuries we designed a special device which is connected to the halo ring and allows to fix the head and spine in any desired position. It may be used in prone or supine position of the patient. Operative reductions are rarely necessary on the cervical spine. Typical indication are fractures of posterior elements of the spine preventing closed reduction. Reduction manoeuvers depend on the kind of injury and are mainly composed of traction and a reversal of the trauma mechanism. The most severe complication is a neurologic deterioration. Reports in literature about 13 patients having sustained such a fate are showing the following: In most cases disc material dislocated in the spinal canal during reduction could be made responsible for the catastrophic course. Especially at risk are patients with open reduction from a posterior approach.

  13. Coexistence between neighbours

    DEFF Research Database (Denmark)

    Shenge, K.C.; Mabagala, R.B.; Mortensen, C A Nieves Paulino

    2008-01-01

    Experiments were conducted under laboratory and screenhouse conditions to study the coexistence between Pseudomonas syringae pv. tomato and Xanthomonas campestris pv. vesicatoria, incitants of bacterial speck and bacterial spot diseases of tomato. Results of in vitro studies showed that when mixed...... cultures of the pathogens were grown together in nutrient yeast dextrose broth over a period of 96 h, colonies of P. s. pv. tomato grossly out-numbered those of X. c. pv. vesicatoria, regardless of the ratio in which they were combined. Results of studies with mixed cultures in planta, under screenhouse...... conditions showed similar results. Results of experiments with heat-killed cells of the pathogens showed that heat-killed cells of either of the pathogens were unable to offer cross protection from infection by the other pathogen in susceptible tomato plants...

  14. The "addicted" spine.

    Science.gov (United States)

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

    2014-01-01

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

  15. The international spine registry SPINE TANGO: status quo and first results.

    Science.gov (United States)

    Melloh, Markus; Staub, Lukas; Aghayev, Emin; Zweig, Thomas; Barz, Thomas; Theis, Jean-Claude; Chavanne, Albert; Grob, Dieter; Aebi, Max; Roeder, Christoph

    2008-09-01

    With an official life time of over 5 years, Spine Tango can meanwhile be considered the first international spine registry. In this paper we present an overview of frequency statistics of Spine Tango for demonstrating the genesis of questionnaire development and the constantly increasing activity in the registry. Results from two exemplar studies serve for showing concepts of data analysis applied to a spine registry. Between 2002 and 2006, about 6,000 datasets were submitted by 25 centres. Descriptive analyses were performed for demographic, surgical and follow-up data of three generations of the Spine Tango surgery and follow-up forms. The two exemplar studies used multiple linear regression models to identify potential predictor variables for the occurrence of dura lesions in posterior spinal fusion, and to evaluate which covariates influenced the length of hospital stay. Over the study period there was a rise in median patient age from 52.3 to 58.6 years in the Spine Tango data pool and an increasing percentage of degenerative diseases as main pathology from 59.9 to 71.4%. Posterior decompression was the most frequent surgical measure. About one-third of all patients had documented follow-ups. The complication rate remained below 10%. The exemplar studies identified "centre of intervention" and "number of segments of fusion" as predictors of the occurrence of dura lesions in posterior spinal fusion surgery. Length of hospital stay among patients with posterior fusion was significantly influenced by "centre of intervention", "surgeon credentials", "number of segments of fusion", "age group" and "sex". Data analysis from Spine Tango is possible but complicated by the incompatibility of questionnaire generations 1 and 2 with the more recent generation 3. Although descriptive and also analytic studies at evidence level 2++ can be performed, findings cannot yet be generalised to any specific country or patient population. Current limitations of Spine Tango include

  16. An unexpected lumbar lesion

    Directory of Open Access Journals (Sweden)

    Laura Beard

    2016-01-01

    Full Text Available This case report details an interesting case of suspected spinal bifida in an obstetric patient who presented for an elective cesarean section. A large scarred/dimpled area, surrounded by significant hair growth in the region of the lumbar spine had been missed in multiple antenatal and preoperative assessments and was recognized on the day of the surgery as the patient was being prepared for spinal anesthesia. The patient was uncertain regarding the pathology of the lesion, and all investigations relating to this had been undertaken in Pakistan where she lived as a child. General anesthesia was undertaken because magnetic resonance imaging had not been performed and tethering of the spinal cord could not be ruled out clinically. The patient suffered from significant blood loss intra and postoperatively, requiring a two unit blood transfusion. She was discharged after 5 days in the hospital. This case highlights the need for thorough examination in all obstetric patients presenting to the preoperative clinic, focusing on the airway, vascular access, and lumbar spine. Patients may not always disclose certain information due to a lack of understanding, embarrassment, forgetfulness, or language barriers. Significant aspects of their care may have been undertaken abroad and access to these notes is often limited. Preoperative detection of the lesion would have allowed further investigation and imaging of the lesion and enabled more comprehensive discussions with the patient regarding anesthetic options and risk.

  17. Villonodular synovitis (PVNS) of the spine

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-01

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

  18. Villonodular synovitis (PVNS) of the spine.

    Science.gov (United States)

    Motamedi, Kambiz; Murphey, Mark D; Fetsch, John F; Furlong, Mary A; Vinh, Tinhoa N; Laskin, William B; Sweet, Donald E

    2005-04-01

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

  19. Function of the spine.

    Science.gov (United States)

    Gracovetsky, S

    1986-07-01

    In spite of the considerable effort which has been invested in attempts to understand the mechanism of human spines, substantial controversy remains, particularly in connection with assumptions which have to be made by those engaged in biological modelling. The hypothesis presented here is that the living joint has stress sensors driving a feedback mechanism, an arrangement which could react to imposed loads by modifying muscular action in such a way as to minimize stress at the joints and therefore the risk of injury. A theory of this kind gives an image of the spine not in terms of a spatial picture, as would a CAT scan, but in terms of stresses, forces and moments acting at the intervertebral joints. Calculations show that the erectores spinae alone cannot support more than about 50 kg; there must be some other mechanism to explain man's ability substantially to exceed that load. It is suggested that the interaction between the erectores spinae and the abdominals are of fundamental importance in the function of the spine; how they are co-ordinated during the lifting of weights is examined in detail. The theory resulting from this hypothesis is used to relate spinal injury and an injured subject's posture and behaviour. A mathematical formulation permits an objective evaluation of the spine, and a procedure for determining an automatic diagnosis of lumbar spine disabilities is proposed.

  20. 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.

  1. Primary bone tumors of the spine.

    Science.gov (United States)

    Cañete, A Navas; Bloem, H L; Kroon, H M

    2016-04-01

    Primary bone tumors of the spine are less common than metastases or multiple myeloma. Based on the patient's age and the radiologic pattern and topography of the tumor, a very approximate differential diagnosis can be established for an osseous vertebral lesion. This article shows the radiologic manifestations of the principal primary bone tumors of the spine from a practical point of view, based on our personal experience and a review of the literature. If bone metastases, multiple myeloma, lymphomas, hemangiomas, and enostoses are excluded, only eight types of tumors account for 80% of all vertebral tumors. These are chordomas, osteoblastomas, chondrosarcomas, giant-cell tumors, osteoid osteomas, Ewing's sarcomas, osteosarcomas, and aneurysmal bone cysts.

  2. COEXISTENCE OF OSTEOARTHRITIS AND OSTEOPOROSIS INFEMORAL HEAD: A SCANNING ELECTRONMICROSCOPIC STUDY

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To ascertain the coexistence of osteoarthritis and osteoporosis in the femoral head . Methods During total hip replacement for osteoarthritis of hip joint in 12 female patients with an average age of 56 years, the femoral heads were procured. After processing the femoral head, specimens were studied under scanning electron microscope. Results Different degrees of osteoarthritic lesions (characterized by degeneration of articular cartilage and hyperplasia of subchondral bone tissues) could coexist with osteoporotic lesions (characterized by icicle-like trabeculae ) in the femoral head. The hyperplas tic bone tissues of osteoarthritis lay in the vicinity of icicle-like trabeculae. However, they did not come into contact, nor did they exert influence on each other. Coexistence of these two different lesions covered a broad territory extending from the deep surface of subchondral bone plate to the head-neck junction of femoral head. Conclusion The results suggest that os teoarthritis and osteoporosis do coexist in the femoral head.

  3. Interpretando as experiências da hospitalização de pacientes com lesão medular Interpretando las experiencias de la hospitalización de pacientes con lesión medular Interpreting the hospitalization experiences of patients with spine lesion

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Pereira de Albuquerque

    2009-08-01

    Full Text Available Estudo qualitativo com eixo teórico no interacionismo simbólico interpretativo de Norman Denzin que teve como objetivo compreender os significados das experiências vivenciadas pelo ser vítima de lesão medular no contexto hospitalar e descrever as narrativas no âmbito das experiências vividas. Os sujeitos da pesquisa foram sete pacientes vítimas de lesão medular traumática hospitalizados em unidade de neurologia do Instituto Dr. José Frota, localizado em Fortaleza - Ce. Interpretamos difícil enfrentamento para o equilíbrio de si, dado ao rompimento repentino do percurso de suas vidas, as alterações orgânicas adquiridas que passam a ser motivos de medos, incertezas, desconforto e ameaça a vida que possuíam junto as suas famílias.Estudio cualitativo con eje teórico en el interaccionismo simbólico interpretativo de Norman Denzin que tuvo como objetivo comprender los significados de las experiencias vivenciadas por ser víctima de lesión medular en el contexto hospitalario y describir las narraciones en el ámbito de las experiencias vividas. Los sujetos de la investigación fueron siete pacientes víctimas de lesión medular traumática hospitalizados en la unidad de neurología do Instituto Dr. José Frota, localizado en Fortaleza - Ce. Percibimos la dificultad de enfrentar la situación y mantener el equilibro, debido al rompimiento repentino del transcurso de sus vidas, las alteraciones orgánicas adquiridas que pasan a ser motivos de miedos, incertidumbres, incomodidad y amenaza a la vida que poseían junto a sus familias.Qualitative study with theoretical axis in symbolic interactionism interpretative of Norman Denzin that had as objective to comprehend the meanings of experiences lived by being victim of spine lesion in context hospital and to describe the narratives in range of experiences lived. The subjects of research were seven patient victims of spine lesion traumatic hospitalized in unity of neurology of Institute

  4. SpineData

    DEFF Research Database (Denmark)

    Kent, Peter; Kongsted, Alice; Jensen, Tue Secher;

    2015-01-01

    % with mid-back pain, and 15% with neck pain. Collectively, across the body regions and measurement time points, there are approximately 1,980 patient-related variables in the database across a broad range of biopsychosocial factors. To date, 36 research projects have used data from the SpineData registry......, including collaborations with researchers from Denmark, Australia, the United Kingdom, and Brazil. Conclusion: We described the aims, development, structure, and content of the SpineData registry, and what is known about any attrition bias and cluster effects in the data. For epidemiology research...

  5. Coexistence of neuropeptides in hydra

    DEFF Research Database (Denmark)

    Grimmelikhuijzen, C J

    1983-01-01

    Using a technique for simultaneous visualisation of two antigens in one section, oxytocin-like immunoreactivity has been found to coexist with bombesin-like immunoreactivity in neurons of the basal disk, gastric region and tentacles of hydra. Neurons with oxytocin-like immunoreactivity in peduncle...... and hypostome, on the other hand, have little or no bombesin-like material. Oxytocin-like immunoreactivity never coexists with FMRFamide-immunoreactivity. The neurons with oxytocin- and FMRFamide-like immunoreactivity, however, are often found to be closely intermingled. The results show that coexistence...

  6. MRI of degenerative cysts of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Khalatbari, K. [Department of MRI, Iran Gamma Knife Centre, Iran University of Medial Sciences-Kamrani Charity Foundation, Tehran (Iran, Islamic Republic of)], E-mail: khalatbarik@yahoo.com; Ansari, H. [Department of Orthopaedics, Rassoul Akram University Hospital, Tehran (Iran, Islamic Republic of)

    2008-03-15

    Degenerative cysts of the lumbar spine encompass a heterogeneous group of cystic lesions that are presumed to share a common aetiology. Some of these cysts may be incidental findings, whereas others may produce acute or chronic symptoms. These cysts have been categorized using various combinations of topographic and pathological characteristics and by their attachment to or communication with a specific spinal structure.

  7. Phenotypic Plasticity and Species Coexistence.

    Science.gov (United States)

    Turcotte, Martin M; Levine, Jonathan M

    2016-10-01

    Ecologists are increasingly interested in predicting how intraspecific variation and changing trait values impact species interactions and community composition. For many traits, much of this variation is caused by phenotypic plasticity, and thus the impact of plasticity on species coexistence deserves robust quantification. Partly due to a lack of sound theoretical expectations, empirical studies make contradictory claims regarding plasticity effects on coexistence. Our critical review of this literature, framed in modern coexistence theory, reveals that plasticity affects species interactions in ways that could impact stabilizing niche differences and competitive asymmetries. However, almost no study integrates these measures to quantify the net effect of plasticity on species coexistence. To address this challenge, we outline novel empirical approaches grounded in modern theory.

  8. Beyond the spine

    DEFF Research Database (Denmark)

    Donovan, James; Cassidy, J David; Cancelliere, Carol;

    2015-01-01

    Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from...

  9. Os Odontoideum: Rare Cervical Lesion

    Science.gov (United States)

    2011-11-01

    the articulation between C1 and the os odontoideum on flexion imaging. The remainder of his cervical vertebral bodies had normal alignment with no...appears normal. Figure 3. Flexion view of plain cervical spine. This image shows abnormal translation of the articulation between C1 and the C2 os...worldwide. Peer Reviewed Title: Os Odontoideum: Rare Cervical Lesion Journal Issue: Western Journal of Emergency Medicine, 12(4) Author: Robson

  10. Aspergilloma coexisting with idiopathic pulmonary fibrosis: A rare occurrence

    Directory of Open Access Journals (Sweden)

    N Kumar

    2013-01-01

    Full Text Available Fungal ball (mycetoma/aspergilloma is a saprophytic fungal infection that colonizes pre-existing lung cavities. Reported literature suggests its development in cystic lesions/cavitation associated with tuberculosis, sarcoidosis, bronchiectasis, lung abscess, and cavitating neoplasm to name a few. Coexistence of aspergilloma with idiopathic pulmonary fibrosis (IPF has not been reported in literature so far, to the best of our knowledge. We hereby report the case of a 55-year-old female with IPF having fungal ball.

  11. Neurenteric cysts of the spine

    Directory of Open Access Journals (Sweden)

    J J Savage

    2010-01-01

    Full Text Available Neurenteric cysts account for 0.7-1.3% of spinal axis tumors. These rare lesions result from the inappropriate partitioning of the embryonic notochordal plate and presumptive endoderm during the third week of human development. Heterotopic rests of epithelium reminiscent of gastrointestinal and respiratory tissue lead to eventual formation of compressive cystic lesions of the pediatric and adult spine. Histopathological analysis of neurenteric tissue reveals a highly characteristic structure of columnar or cuboidal epithelium with or without cilia and mucus globules. Patients with symptomatic neurenteric cysts typically present in the second and third decades of life with size-dependent myelopathic and/or radicular signs. Magnetic resonance imaging and computed tomography are essential diagnostic tools for the delineation of cyst form and overlying osseous architecture. A variety of approaches have been employed in the treatment of neurenteric cysts each with a goal of total surgical resection. Although long-term outcome analyses are limited, data available indicate that surgical intervention in the case of neurenteric cysts results in a high frequency of resolution of neurological deficit with minimal morbidity. However, recurrence rates as high as 37% have been reported with incomplete resection secondary to factors such as cyst adhesion to surrounding structure and unclear dissection planes. Here we present a systematic review of English language literature from January 1966 to December 2009 utilizing MEDLINE with the following search terminology: neurenteric cyst, enterogenous cyst, spinal cord tumor, spinal dysraphism, intraspinal cyst, intramedullary cyst, and intradural cyst. In addition, the references of publications returned from the MEDLINE search criteria were surveyed in order to examine other pertinent reports.

  12. Contextual Learning Induces Dendritic Spine Clustering in Retrosplenial Cortex

    Directory of Open Access Journals (Sweden)

    Adam C Frank

    2014-03-01

    Full Text Available Molecular and electrophysiological studies find convergent evidence suggesting that plasticity within a dendritic tree is not randomly dispersed, but rather clustered into functional groups. Further, results from in silico neuronal modeling show that clustered plasticity is able to increase storage capacity 45 times compared to dispersed plasticity. Recent in vivo work utilizing chronic 2-photon microscopy tested the clustering hypothesis and showed that repetitive motor learning is able to induce clustered addition of new dendritic spines on apical dendrites of L5 neurons in primary motor cortex; moreover, clustered spines were found to be more stable than non-clustered spines, suggesting a physiological role for spine clustering. To further test this hypothesis we used in vivo 2-photon imaging in Thy1-YFP-H mice to chronically examine dendritic spine dynamics in retrosplenial cortex (RSC during spatial learning. RSC is a key component of an extended spatial learning and memory circuit that includes hippocampus and entorhinal cortex. Importantly, RSC is known from both lesion and immediate early gene studies to be critically involved in spatial learning and more specifically in contextual fear conditioning. We utilized a modified contextual fear conditioning protocol wherein animals received a mild foot shock each day for five days; this protocol induces gradual increases in context freezing over several days before the animals reach a behavioral plateau. We coupled behavioral training with four separate in vivo imaging sessions, two before training begins, one early in training, and a final session after training is complete. This allowed us to image spine dynamics before training as well as early in learning and after animals had reached behavioral asymptote. We find that this contextual learning protocol induces a statistically significant increase in the formation of clusters of new dendritic spines in trained animals when compared to home

  13. Phase coexistence in nuclei

    Science.gov (United States)

    Gulminelli, F.

    2004-11-01

    In this work the general theory of first order phase transitions in finite systems is discussed, with a special emphasis to the conceptual problems linked to a thermodynamic description for small, short-lived systems de-exciting in the vacuum as nuclear samples coming from heavy ion collisions. After a short review of the general theory of phase transitions in the framework of information theory, we will present the different possible extensions to the field of finite systems. The concept of negative heat capacity, developed in the early seventies in the context of self-gravitating systems, will be reinterpreted in the general framework of convexity anomalies of thermostatistical potentials. The connection with the distribution of the order parameter will lead us to a definition of first order phase transitions in finite systems based on topology anomalies of the event distribution in the space of observations. A careful study of the thermodynamic limit will provide a bridge with the standard theory of phase transitions and show that in a wide class of physical situations the different statistical ensembles are irreducibly inequivalent. In the second part of the paper we will apply the theoretical ideas developed in the first part to the possible observation of a liquid-to-gas-like phase transition in heavy ion collisions. The applicability of equilibrium concepts in a dynamical collisional process without boundary conditions will first be critically discussed. The observation of abnormally large partial energy fluctuations in carefully selected samples of collisions detected with the MULTICS-Miniball and INDRA array will then be reported as a strong evidence of a first order phase transition with negative heat capacity in the nuclear equation of state. Coexistence de phase dans les noyaux Ce papier présente une revue de la théorie générale des transitions de phase du premier ordre dans les petits systèmes, avec une attention particulière aux probl

  14. Diagnostic value of high resolutional computed tomography of spine

    Energy Technology Data Exchange (ETDEWEB)

    Yang, S. M.; Im, S. K.; Sohn, M. H.; Lim, K. Y.; Kim, J. K.; Choi, K. C. [Jeonbug National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

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

  15. On the collagen criss-cross angles in the annuli fibrosi of lumbar spine finite element models

    OpenAIRE

    2011-01-01

    In the human lumbar spine, annulus fibrosus fibres largely contribute to intervertebral disc stability. Detailed annulus models are therefore necessary to obtain reliable predictions of lumbar spine mechanics by finite element modelling. However, different definitions of collagen orientations coexist in the literature for healthy human lumbar annuli. Therefore, four annulus fibre-induced anisotropy models were built from reported anatomical descriptions, and inserted in a L3–L5 lumba...

  16. Rendering the Topological Spines

    Energy Technology Data Exchange (ETDEWEB)

    Nieves-Rivera, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-05-05

    Many tools to analyze and represent high dimensional data already exits yet most of them are not flexible, informative and intuitive enough to help the scientists make the corresponding analysis and predictions, understand the structure and complexity of scientific data, get a complete picture of it and explore a greater number of hypotheses. With this in mind, N-Dimensional Data Analysis and Visualization (ND²AV) is being developed to serve as an interactive visual analysis platform with the purpose of coupling together a number of these existing tools that range from statistics, machine learning, and data mining, with new techniques, in particular with new visualization approaches. My task is to create the rendering and implementation of a new concept called topological spines in order to extend ND²AV's scope. Other existing visualization tools create a representation preserving either the topological properties or the structural (geometric) ones because it is challenging to preserve them both simultaneously. Overcoming such challenge by creating a balance in between them, the topological spines are introduced as a new approach that aims to preserve them both. Its render using OpenGL and C++ and is currently being tested to further on be implemented on ND²AV. In this paper I will present what are the Topological Spines and how they are rendered.

  17. Complex Spine Pathology Simulator: An Innovative Tool for Advanced Spine Surgery Training.

    Science.gov (United States)

    Gragnaniello, Cristian; Abou-Hamden, Amal; Mortini, Pietro; Colombo, Elena V; Bailo, Michele; Seex, Kevin A; Litvack, Zachary; Caputy, Anthony J; Gagliardi, Filippo

    2016-11-01

    Background Technical advancements in spine surgery have made possible the treatment of increasingly complex pathologies with less morbidity. Time constraints in surgeons' training have made it necessary to develop new training models for spine pathology. Objective To describe the application of a novel compound, Stratathane resin ST-504 derived polymer (SRSDP), that can be injected at different spinal target locations to mimic spinal epidural, subdural extra-axial, and intra-axial pathologies for the use in advanced surgical training. Material and Methods Fresh-frozen thoracolumbar and cervical spine segments of human and sheep cadavers were used to study the model. SRSDP is initially liquid after mixing, allowing it to be injected into target areas where it expands and solidifies, mimicking the entire spectrum of spinal pathologies. Results Different polymer concentrations have been codified to vary adhesiveness, texture, spread capability, deformability, and radiologic visibility. Polymer injection was performed under fluoroscopic guidance through pathology-specific injection sites that avoided compromising the surgical approach for subsequent excision of the artificial lesion. Inflation of a balloon catheter of the desired size was used to displace stiff cadaveric neurovascular structures to mimic pathology-related mass effect. Conclusion The traditional cadaveric training models principally only allow surgeons to practice the surgical approach. The complex spine pathology simulator is a novel educational tool that in a user-friendly, low-cost fashion allows trainees to practice advanced technical skills in the removal of complex spine pathology, potentially shortening some of the aspects of the learning curve of operative skills that may otherwise take many years to acquire.

  18. Neuromechanical control of the spine

    OpenAIRE

    Hodges, Paul

    2003-01-01

    Control of the spine is complex. The spine is inherently unstable and dependent on the contribution of muscles. Yet there is considerable redundancy in the motor system with many muscles that act on the trunk. This is further complicated by the indirect effects of trunk muscle contraction on the spine, such as increased intraabdominal pressure (IAP), and the multiple functions that must be performed by the trunk muscles such as respiration, in addition to control and movemen...

  19. An occult cervical spine fracture.

    Science.gov (United States)

    Khosla, R

    1997-12-01

    A 16-year-old athlete developed neck pain after being dropped on his head with his neck flexed while recreationally wrestling. Initial cervical spine radiographs were negative, but he continued to have neck and arm pain, especially after heading a wet soccer ball. Two months after the initial injury, he had a positive Spurling test; cervical spine CT then revealed a parasagittal linear fracture through the body of C-7. The patient avoided contact and collision activities and had no further physical problems. For patients who suffer cervical spine trauma, adequate visualization of the cervical spine can help prevent catastrophic outcomes.

  20. Tophaceous gout of the lumbar spine mimicking a spinal meningioma.

    Science.gov (United States)

    Ribeiro da Cunha, Pedro; Peliz, António Judice; Barbosa, Marcos

    2016-11-05

    Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal. The differential diagnosis was thought to be straightforward favoring a spinal meningioma. Tophaceous gout was never considered. The presence of a dural tail associated with the lesion is an interesting detail of this case, that strongly misguided it and to the best of our knowledge it is the first one reported in the literature. The patient underwent surgery and intra-operative findings were surprisingly different from those expected, revealing a chalky white mass lesion firmly adherent and compressing the dural sac. It was completely excised, leaving the dura intact. Histopathology confirmed the diagnosis of tophaceous gout. The patient was sent to physical therapy and had a complete remission of pain and neurological deficit, regaining his walking capacity. Although spinal gout is rare, it should be considered in the differential diagnosis for patients presenting with symptoms of spinal stenosis, a suspicion of neoplastic lesion of the spine, and a previous history of gout. Early diagnosis can ensure proper and timely medical management, perhaps avoiding neurological compromise and the need for surgery.

  1. Welfare and Co-existence

    NARCIS (Netherlands)

    Zilberman, David; Wesseler, J.H.H.

    2016-01-01

    The backlash against the introduction of genetically modified (GM) crops and the concern about contamination of non-GM crops by genetic material originating from GM crops has resulted in a complex and costly legal and physical arrangement for coexistence of GM and non-GM agricultural product systems

  2. Spinal CT scan, 2. Lumbar and sacral spines

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Hiroshi (Aichi Medical Univ., Aichi (Japan))

    1982-08-01

    Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival.

  3. Cortical regulation of dopamine depletion-induced dendritic spine loss in striatal medium spiny neurons.

    Science.gov (United States)

    Neely, M D; Schmidt, D E; Deutch, A Y

    2007-10-26

    The proximate cause of Parkinson's disease is striatal dopamine depletion. Although no overt toxicity to striatal neurons has been reported in Parkinson's disease, one of the consequences of striatal dopamine loss is a decrease in the number of dendritic spines on striatal medium spiny neurons (MSNs). Dendrites of these neurons receive cortical glutamatergic inputs onto the dendritic spine head and dopaminergic inputs from the substantia nigra onto the spine neck. This synaptic arrangement suggests that dopamine gates corticostriatal glutamatergic drive onto spines. Using triple organotypic slice cultures composed of ventral mesencephalon, striatum, and cortex of the neonatal rat, we examined the role of the cortex in dopamine depletion-induced dendritic spine loss in MSNs. The striatal dopamine innervation was lesioned by treatment of the cultures with the dopaminergic neurotoxin 1-methyl-4-phenylpyridinium (MPP+) or by removing the mesencephalon. Both MPP+ and mesencephalic ablation decreased MSN dendritic spine density. Analysis of spine morphology revealed that thin spines were preferentially lost after dopamine depletion. Removal of the cortex completely prevented dopamine depletion-induced spine loss. These data indicate that the dendritic remodeling of MSNs seen in parkinsonism occurs secondary to increases in corticostriatal glutamatergic drive, and suggest that modulation of cortical activity may be a useful therapeutic strategy in Parkinson's disease.

  4. Electrical advantages of dendritic spines.

    Directory of Open Access Journals (Sweden)

    Allan T Gulledge

    Full Text Available Many neurons receive excitatory glutamatergic input almost exclusively onto dendritic spines. In the absence of spines, the amplitudes and kinetics of excitatory postsynaptic potentials (EPSPs at the site of synaptic input are highly variable and depend on dendritic location. We hypothesized that dendritic spines standardize the local geometry at the site of synaptic input, thereby reducing location-dependent variability of local EPSP properties. We tested this hypothesis using computational models of simplified and morphologically realistic spiny neurons that allow direct comparison of EPSPs generated on spine heads with EPSPs generated on dendritic shafts at the same dendritic locations. In all morphologies tested, spines greatly reduced location-dependent variability of local EPSP amplitude and kinetics, while having minimal impact on EPSPs measured at the soma. Spine-dependent standardization of local EPSP properties persisted across a range of physiologically relevant spine neck resistances, and in models with variable neck resistances. By reducing the variability of local EPSPs, spines standardized synaptic activation of NMDA receptors and voltage-gated calcium channels. Furthermore, spines enhanced activation of NMDA receptors and facilitated the generation of NMDA spikes and axonal action potentials in response to synaptic input. Finally, we show that dynamic regulation of spine neck geometry can preserve local EPSP properties following plasticity-driven changes in synaptic strength, but is inefficient in modifying the amplitude of EPSPs in other cellular compartments. These observations suggest that one function of dendritic spines is to standardize local EPSP properties throughout the dendritic tree, thereby allowing neurons to use similar voltage-sensitive postsynaptic mechanisms at all dendritic locations.

  5. 'Serpent in the spine': a case of giant spinal ependymoma of cervicothoracic spine.

    Science.gov (United States)

    Arrifin, Arlizan; Kaliaperumal, Chandrasekaran; Keohane, Catherine; O'Sullivan, Michael

    2012-06-27

    We describe a case of giant spinal ependymoma of cervicothoracic spine in a 30-year-old lady who presented with progressive spastic paraparesis and significant combined upper and lower motor neuron signs in her lower limbs over a 1-year period. She also had upper limb small muscle wasting with absent reflexes and diminished sensation. She was wheel chair bound with involvement of sphincters. Neuroimaging revealed a uniformly enhancing intramedullary lesion from C2-T3 level with associated syringomyelia. She underwent a complete excision of this World Health Organisation (WHO) II cellular ependymoma, resulting in significant clinical outcome and improvement in bladder and bowel function.

  6. Co-existence of Pulmonary, Tonsillar and Laryngeal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Erkan Ceylan

    2013-10-01

    Full Text Available    A 56-year old man applied to otorhinolaryngology clinic with sore throat, dysphagia. During direct examination, left palatine tonsil and tonsil plicas ulcerovegetative lesions were found. In the indirect laryngoscopy, in some regions of the larynx and epiglottis, ulcerovegetative lesions were observed too. Because of suspicion of laryngeal carcinoma and metastasis, punch biopsy of the left palatine tonsil was performed. Chest x-ray and computerized tomography of the thorax revealed two adjacent cavitations in the apicoposterior segment of the left upper lobe. In the histopathologic examination of biopsies, granulomatous structures that proved tuberculosis were observed. In the fiberoptic bronchoscopic analysis, endobronchial lesion was not detected. Acid-fast bacilli were determined in sputum and bronchial lavage in microscopy and culture. The case of this middle aged male patient with co-existence of tonsillar, laryngeal and pulmonary tuberculosis presents the clinical significance of upper airway tuberculosis in terms of its infectiousness and rare occurrence.

  7. Degenerative disease of the spine.

    Science.gov (United States)

    Gallucci, Massimo; Limbucci, Nicola; Paonessa, Amalia; Splendiani, Alessandra

    2007-02-01

    Degenerative disease of the spine is a definition that includes a wide spectrum of degenerative abnormalities. Degeneration involves bony structures and the intervertebral disk, although many aspects of spine degeneration are strictly linked because the main common pathogenic factor is identified in chronic overload. During life the spine undergoes continuous changes as a response to physiologic axial load. These age-related changes are similar to pathologic degenerative changes and are a common asymptomatic finding in adults and elderly persons. A mild degree of degenerative changes is paraphysiologic and should be considered pathologic only if abnormalities determine symptoms. Imaging allows complete evaluation of static and dynamic factors related to degenerative disease of the spine and is useful in diagnosing the different aspects of spine degeneration.

  8. Micromechanics of Sea Urchin spines.

    Directory of Open Access Journals (Sweden)

    Naomi Tsafnat

    Full Text Available The endoskeletal structure of the Sea Urchin, Centrostephanus rodgersii, has numerous long spines whose known functions include locomotion, sensing, and protection against predators. These spines have a remarkable internal microstructure and are made of single-crystal calcite. A finite-element model of the spine's unique porous structure, based on micro-computed tomography (microCT and incorporating anisotropic material properties, was developed to study its response to mechanical loading. Simulations show that high stress concentrations occur at certain points in the spine's architecture; brittle cracking would likely initiate in these regions. These analyses demonstrate that the organization of single-crystal calcite in the unique, intricate morphology of the sea urchin spine results in a strong, stiff and lightweight structure that enhances its strength despite the brittleness of its constituent material.

  9. Lipid dynamics at dendritic spines.

    Science.gov (United States)

    Dotti, Carlos Gerardo; Esteban, Jose Antonio; Ledesma, María Dolores

    2014-01-01

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

  10. Baastrup's disease: The kissing spine.

    Science.gov (United States)

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

    2014-02-16

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

  11. Syndromes with chronic non-bacterial osteomyelitis in the spine.

    Science.gov (United States)

    Kubaszewski, Łukasz; Wojdasiewicz, Piotr; Rożek, Marcin; Słowińska, Iwona E; Romanowska-Próchnicka, Katarzyna; Słowiński, Radosław; Poniatowski, Łukasz A; Gasik, Robert

    2015-01-01

    Chronic non-bacterial osteomyelitis (CNO) has been known for over of 40 years. It is an underrecognized entity due to the low number of described cases and poor propagation awareness of the problem. Chronic non-bacterial osteomyelitis is usually confused with infectious spondylodiscitis or malignant lesions, both primary and metastatic. Failing to consider CNO as one of possible lesions of the spine among an array of differential diagnoses may lead to a prolonged ineffective treatment increasing treatment-related morbidity. In this paper the authors describe these two syndromes, with a possible autoimmune background - chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO syndrome - that include CNO being among the manifestations. The authors present the spinal symptomatology of CNO for both syndromes published so far to help spine clinicians organize the information for better usage in everyday clinical practice.

  12. Syndromes with chronic non-bacterial osteomyelitis in the spine

    Science.gov (United States)

    Kubaszewski, Łukasz; Wojdasiewicz, Piotr; Rożek, Marcin; Romanowska-Próchnicka, Katarzyna; Słowiński, Radosław; Poniatowski, Łukasz A.; Gasik, Robert

    2016-01-01

    Chronic non-bacterial osteomyelitis (CNO) has been known for over of 40 years. It is an underrecognized entity due to the low number of described cases and poor propagation awareness of the problem. Chronic non-bacterial osteomyelitis is usually confused with infectious spondylodiscitis or malignant lesions, both primary and metastatic. Failing to consider CNO as one of possible lesions of the spine among an array of differential diagnoses may lead to a prolonged ineffective treatment increasing treatment-related morbidity. In this paper the authors describe these two syndromes, with a possible autoimmune background – chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO syndrome – that include CNO being among the manifestations. The authors present the spinal symptomatology of CNO for both syndromes published so far to help spine clinicians organize the information for better usage in everyday clinical practice. PMID:27407266

  13. Shape coexistence in 153Ho

    CERN Document Server

    Pramanik, Dibyadyuti; Sarkar, M Saha; Bisoi, Abhijit; Ray, Sudatta; Dasgupta, Shinjinee; Chakraborty, A; Krishichayan,; Kshetri, Ritesh; Ray, Indrani; Ganguly, S; Pradhan, M K; Basu, M Ray; Raut, R; Ganguly, G; Ghugre, S S; Sinha, A K; Basu, S K; Bhattacharya, S; Mukherjee, A; Banerjee, P; Goswami, A

    2016-01-01

    The high-spin states in 153Ho, have been studied by 139 57 La(20Ne, 6n) reaction at a projectile energy of 139 MeV at Variable Energy Cyclotron Centre (VECC), Kolkata, India, utilizing an earlier campaign of Indian National Gamma Array (INGA) setup. Data from gamma-gamma coincidence, directional correlation and polarization measurements have been analyzed to assign and confirm the spins and parities of the levels. We have suggested a few additions and revisions of the reported level scheme of 153Ho. The RF-gamma time difference spectra have been useful to confirm the half-life of an isomer in this nucleus. From the comparison of experimental and theoretical results, it is found that there are definite indications of shape coexistence in this nucleus. The experimental and calculated lifetimes of several isomers have been compared to follow the coexistence and evolution of shape with increasing spin.

  14. The spine problem: finding a function for dendritic spines.

    Science.gov (United States)

    Malanowski, Sarah; Craver, Carl F

    2014-01-01

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

  15. The spine problem: Finding a function for dendritic spines

    Directory of Open Access Journals (Sweden)

    Sarah eMalanowski

    2014-09-01

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

  16. High cervical spine spondylodiscitis management and literature review

    Directory of Open Access Journals (Sweden)

    André Luis Sebben

    Full Text Available Summary Spondylodiscitis affecting the cervical spine is the most unusual type. Disease progression can be dramatic, even causing quadriplegia and death. We present an unusual case that progressed with osteolytic lesions between C2 and C3, causing cord compression and epidural abscess. The patient was treated surgically by a double approach and improved without neurological deficits and with better inflammatory markers. We reviewed the current literature on the subject.

  17. MR findings of desmoplastic fibroma of the spine. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kong, K.Y.; Kang, H.S.; Jung, H.W.; Kim, J.J.; Lee, C.K. [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2000-07-01

    We report on the MR imaging findings in a case of spinal desmoplastic fibroma (DF). DF of the bone is a rare, locally aggressive tumor. It is commonly located in long bones, pelvis or mandible. DF involving the spine is extremely rare and difficult to distinguish from other bony lesions such as giant cell tumor, chordoma and fibrous dysplasia of the spine. This case of DF of the spine showed MR findings similar to those of DF arising in the metaphysis of a long bone.

  18. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  19. Spine injuries in dancers.

    Science.gov (United States)

    Gottschlich, Laura M; Young, Craig C

    2011-01-01

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

  20. Physiopathology of Spine Metastasis

    Directory of Open Access Journals (Sweden)

    Giulio Maccauro

    2011-01-01

    Full Text Available The metastasis is the spread of cancer from one part of the body to another. Two-thirds of patients with cancer will develop bone metastasis. Breast, prostate and lung cancer are responsible for more than 80% of cases of metastatic bone disease. The spine is the most common site of bone metastasis. A spinal metastasis may cause pain, instability and neurological injuries. The diffusion through Batson venous system is the principal process of spinal metastasis, but the dissemination is possible also through arterial and lymphatic system or by contiguity. Once cancer cells have invaded the bone, they produce growth factors that stimulate osteoblastic or osteolytic activity resulting in bone remodeling with release of other growth factors that lead to a vicious cycle of bone destruction and growth of local tumour.

  1. MRI cervical spine findings in asymptomatic fighter pilots.

    Science.gov (United States)

    Petrén-Mallmin, M; Linder, J

    1999-12-01

    MRI of the cervical spine for evaluation concerning degenerative lesions was performed on asymptomatic experienced military high performance aircraft pilots (mean age 42 yr with mean accumulated flying time of 2600 h), and for comparison on age-matched controls without military flying experience. Young military high performance aircraft pilots (mean age 23 yr with 220 h of flying per person) were also examined. There were significantly more osteophytes, disk protrusions, compressions of the spinal cord and foraminal stenoses in the experienced pilots than in the age-matched controls. Low frequency of low grade degenerative lesions was found in the young and inexperienced pilots.

  2. [Aneurysmal bone cyst of the spine. Case report].

    Science.gov (United States)

    Rosales-Olivares, Luis Miguel; Baena-Ocampo, Leticia del Carmen; Miramontes-Martínez, Victor Paul; Alpízar-Aguirre, Armando; Reyes-Sánchez, Alejandro

    2006-01-01

    The aneurysmal bone cyst (ABC) is a fast-growing tumor of undefined neoplastic nature. It is occasionally an aggressive benign lesion whose treatment of choice is a complete resection, even though the risk of profuse transoperative bleeding exists. We present a female patient with thoracic spine deformity, with progressive paresthesias and muscle weakness of lower extremities that evolved to paralysis of both lower extremities and sphincter incontinence. Based on radiographic films, lytic lesions were identified at T7 to T9 vertebrae as well as medullary space invasion. In electrophysiologic tests, a complete somatosensorial pathway block was reported. Prior to resection of the neoplastic lesion and thoracolumbar stabilization, an incisional biopsy was performed. There was no postoperative medullary functional improvement. Morphological findings corresponded to an aneurysmal bone cyst at T8. This lesion is mainly located in the long bones and less frequently of the spine, where instability and medullary compression may occur. It is possible to confuse this neoplasia with other lesions. Hence, definite diagnosis with biopsy is necessary for determining an adequate therapeutic plan to eradicate recurrence risk or associated neurologic sequelae, as well as to gain proper stability at the involved vertebral segments.

  3. Synovial cysts of the lumbar spine.

    Science.gov (United States)

    Jankowski, Roman; Szymaś, Janusz; Nowak, Stanisław; Zukiel, Ryszard; Sokół, Bartosz; Paprzycki, Włodzmierz

    2012-01-01

    Synovial cysts of the spine occur most frequently in the lumbosacral region. Methods of treatment vary, but in cases of chronic pain or neurological deficits surgical intervention is undertaken. The aim of this paper is to present indications, surgical technique and efficacy of surgical treatment in patients with synovial cyst of the spinal canal. The retrospective analysis included 11 patients, aged from 47 to 72 years, treated at the Department of Neurosurgery and Neurotraumatology, Poznan University of Medical Sciences, between 2004 and 2009. The length of medical history ranged from 2 months to 6 years. Conservative treatment applied before surgery was not effective. Neurological examination revealed unilateral or bilateral sciatica, superficial sensory disturbance or lower limb paresis. Synovial cysts were located mainly at the L4-L5 level (9 cases). Magnetic resonance imaging (MRI) of the spine was performed in all patients and showed the cystic lesion attached to the intervertebral joint. Surgical treatment consisted of a unilateral fenestration using microsurgical techniques in most cases. Back pain relief was observed in 9 cases. In 10 patients, symptoms of sciatica disappeared. Neurological deficits disappeared in 5 patients. Surgical treatment of spinal synovial cysts is safe, effective and ensures a long-lasting effect. Surgical treatment is indicated in patients in whom the clinical symptoms correlate with the presence of synovial cyst in imaging studies and do not resolve after conservative treatment.

  4. Tophaceous gout of spine causing neural compression

    Directory of Open Access Journals (Sweden)

    Zhuo LI

    2016-11-01

    Full Text Available Objective To investigate the imaging and clinicopathological features of spinal tophaceous gout in thoracic vertebra and the key points of its diagnosis and treatment, in order to improve the recognition of this disease.  Methods and Results A 36-year-old male was admitted because of weakness and numbness of both lower extremities for 2 months with progressive aggravation for 2 weeks. MRI revealed an extradural mass compressing the spinal cord at T9-10. The tumor was totally removed by piecemeal resection. Histopathological examination of the fresh specimen by light microscope demonstrated brown linear crystals, which showed strong birefringence in polarized light microscope, located in fibrous connective tissue, with local bone invasion and foreign body granuloma. However, histopathological examination of the removed specimen demonstrated white amorphous materials, with scatteredly distributed remaining brown linear crystals, which showed single refraction in polarized light microscope. The final pathological diagnosis was tophaceous gout. The patient was followed-up for 6 months. He stopped taking anti-uric acid drugs by himself and could walk with crutch.  Conclusions Tophaceous gout of spine is caused by uratic deposition in spinal joints, which needs to be differentiated from other intraspinal extradural space-occupying lesions like tuberculosis, central nervous system lymphoma, metastatic tumors and lipomyoma. A definite diagnosis of tophaceous gout of spine requires histopathological examination detecting uratic crystals. DOI: 10.3969/j.issn.1672-6731.2016.11.013

  5. [Cervical spine instability in the surgical patient].

    Science.gov (United States)

    Barbeito, A; Guerri-Guttenberg, R A

    2014-03-01

    Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.

  6. Usefulness of F-18 FDG PET/CT in a case of Kaposi sarcoma with an unexpected bone lesion.

    Science.gov (United States)

    Morooka, Miyako; Ito, Kimiteru; Kubota, Kazuo; Yanagisawa, Kunio; Teruya, Katsuji; Hasuo, Kahehiro; Shida, Yoshitaka; Minamimoto, Rhogo; Kikuchi, Yoshimi; Oka, Shinichi

    2011-03-01

    Bone lesions of Kaposi sarcoma are rare. A 56-year-old man who was HIV positive and was diagnosed with Kaposi sarcoma on the basis of the results of a biopsy of skin lesions, underwent F-18 FDG PET/CT scan for detecting Kaposi sarcoma lesions and other AIDS-related diseases. An abnormal uptake was observed in the lumbar spine. MRI showed a diffuse enhanced spine lesion, and Ga-67 and ²⁰¹Tl scanning were negative. As a result, the lesion was considered to be a Kaposi sarcoma, and the shrinkage of the lesion was noted after the therapy for Kaposi sarcoma.

  7. Typhoid spine - A case report

    Directory of Open Access Journals (Sweden)

    Rajesh P

    2004-01-01

    Full Text Available A case of Salmonella typhi isolated from L4-L5 spine is reported here. The causative organism was not suspected preoperatively. The patient responded favourably to surgical drainage and appropriate antibiotic therapy.

  8. The “addicted” spine

    OpenAIRE

    Saturnino eSpiga; Giovanna eMulas; Francesca ePiras; Marco eDiana

    2014-01-01

    Units of dendritic branches called dendritic spines represent more than simply decorative appendages of the neuron and actively participate in integrative functions of “spinous” nerve cells thereby contributing to the general phenomenon of synaptic plasticity. In animal models of drug addiction, spines are profoundly affected by treatments with drugs of abuse and represent important sub cellular markers which interfere deeply into the physiology of the neuron thereby providing an example of t...

  9. Coexistence in preferential attachment networks

    CERN Document Server

    Antunović, Tonći; Racz, Miklos Z

    2013-01-01

    Competition in markets is ubiquitous: cell-phone providers, computer manufacturers, and sport gear brands all vie for customers. Though several coexisting competitors are often observed in empirical data, many current theoretical models of competition on small-world networks predict a single winner taking over the majority of the network. We introduce a new model of product adoption that focuses on word-of-mouth recommendations to provide an explanation for this coexistence of competitors. The key property of our model is that customer choices evolve simultaneously with the network of customers. When a new node joins the network, it chooses neighbors according to preferential attachment, and then chooses its type based on the number of initial neighbors of each type. This can model a new cell-phone user choosing a cell-phone provider, a new student choosing a laptop, or a new athletic team member choosing a gear provider. We provide a detailed analysis of the new model; in particular, we determine the possibl...

  10. The ‘addicted’ spine.

    Directory of Open Access Journals (Sweden)

    Saturnino eSpiga

    2014-10-01

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

  11. Radiology illustrated. Spine

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Heung Sik; Lee, Joon Woo [Seoul National Univ. Bundang Hospital, Seongnam, Kyonggi-do (Korea, Republic of). Dept. of Radiology; Kwon, Jong Won [Samsung Medical Center, Seoul (Korea, Republic of). Dept. of Radiology

    2014-04-01

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

  12. The postsurgical spine.

    Science.gov (United States)

    Santos Armentia, E; Prada González, R; Silva Priegue, N

    2016-04-01

    Failed back surgery syndrome is the persistence or reappearance of pain after surgery on the spine. This term encompasses both mechanical and nonmechanical causes. Imaging techniques are essential in postoperative follow-up and in the evaluation of potential complications responsible for failed back surgery syndrome. This review aims to familiarize radiologists with normal postoperative changes and to help them identify the pathological imaging findings that reflect failed back surgery syndrome. To interpret the imaging findings, it is necessary to know the type of surgery performed in each case and the time elapsed since the intervention. In techniques used to fuse the vertebrae, it is essential to evaluate the degree of bone fusion, the material used (both its position and its integrity), the bone over which it lies, the interface between the implant and bone, and the vertebral segments that are adjacent to metal implants. In decompressive techniques it is important to know what changes can be expected after the intervention and to be able to distinguish them from peridural fibrosis and the recurrence of a hernia. It is also crucial to know the imaging findings for postoperative infections. Other complications are also reviewed, including arachnoiditis, postoperative fluid collections, and changes in the soft tissues adjacent to the surgical site.

  13. Postoperative spine; Postoperative Wirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Schlaeger, R. [Universitaetsspital Basel, Neurologische Klinik und Poliklinik, Basel (Switzerland); Lieb, J.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Shariat, K. [Neurochirurgie Koeln-Merheim, Koeln (Germany); Ahlhelm, F.J. [Kantonsspital Baden AG, Abteilung Neuroradiologie, Institut fuer Radiologie, Baden (Switzerland)

    2014-11-15

    Approximately 15-30 % of surgical procedures involving the lumbar spine are associated with complications that require further diagnostic work-up. The choice of imaging modality for postoperative complications depends on the extent, pattern and temporal evolution of the postoperative neurological signs and symptoms as well as on the preoperative clinical status, the surgical procedure itself and the underlying pathology. The interpretation of imaging findings, in particular the distinction between postoperative complications and normally expected nonspecific postoperative imaging alterations can be challenging and requires the integration of clinical neurological information and the results of laboratory tests. The combination of different imaging techniques might help in cases of equivocal imaging results. (orig.) [German] Etwa 15-30 % der operativen Eingriffe im Bereich der lumbalen Wirbelsaeule verlaufen nicht komplikationsfrei und erfordern weiterfuehrende Abklaerungen. Die Auswahl des bildgebenden Verfahrens im Rahmen postoperativer Komplikationen haengt dabei wesentlich von der zeitlichen Entwicklung, dem Ausmass und Verteilungsmuster der neuaufgetretenen klinisch-neurologischen bzw. orthopaedischen Symptome sowie von den Ausfaellen vor dem Eingriff, der zugrundeliegenden Pathologie und der Lokalisation und Art des Eingriffs ab. Die Interpretation der bildgebenden Befunde, insbesondere die Abgrenzung postoperativer Komplikationen von natuerlicherweise zu erwartenden postoperativen Veraenderungen kann dabei eine Herausforderung darstellen. Bei unklaren Befunden kann ergaenzend zur eingehend klinisch-neurologischen und laborchemischen Bestandsaufnahme auch der kombinierte Einsatz mehrerer bildgebender Modalitaeten diagnostisch weiterhelfen. (orig.)

  14. Postoperative Spine Infections

    Science.gov (United States)

    Evangelisti, Gisberto; Andreani, Lorenzo; Girardi, Federico; Darren, Lebl; Sama, Andrew; Lisanti, Michele

    2015-01-01

    Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of postoperative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication. PMID:26605028

  15. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  16. MRI of the spine in cobalamin deficiency: the value of examining both spinal cord and bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Duprez, T.P. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Gille, M. [Clinique Sainte-Elisabeth, Brussels (Belgium). Dept. of Neurology; Vande Berg, B.C. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Malghem, J. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Grandin, C.B. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Michel, P. [Dept. of Pathology, Brussels (Belgium); Ghariani, S. [Clinique Sainte-Elisabeth, Brussels (Belgium). Dept. of Neurology; Maldague, B.E. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium)

    1996-08-01

    We observed a case of pernicious anaemia in which MRI of the spine demonstrated both intrinsic lesions of the spinal cord and abnormal signal in the bone marrow. The latter resolved with replacement therapy. Only partial recovery of the cord lesions was observed. (orig.)

  17. Coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms

    Science.gov (United States)

    Yao, Pei-Sen; Lin, Zhang-Ya; Zheng, Shu-Fa; Lin, Yuan-Xiang; Yu, Liang-Hong; Jiang, Chang-Zhen; Kang, De-Zhi

    2017-01-01

    Abstract Rationale: There were a few case reports concerning epidermoid tumor coexisted with multiple cerebral aneurysms. Here, we present one case of coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms and performed a literature review. Patient concerns: A 42 years old male patient was admitted to our institution with complaints of headache and dizziness. Interventions: The radiological examinations showed a hypointense lesion in the right parasellar and petrous apex region and an ipsilateral saccular aneurysm originated from the M2–M3 junction of the right middle cerebral artery (MCA) and a saccular aneurysm of the clinoid segment of right internal carotid artery (ICA). Interventions: The patients underwent a right frontotemporal approach for removal of the epidermoid tumor and clipping of the MCA aneurysm in one stage. The aneurysm located at the clinoid segment of ICA was invisible and untreated during operation. Outcomes: No postoperative complications were found in the patient. The patient's follow up after 5 years of surgical treatment was uneventful, and the untreated aneurysm remains stable. Lessons: The coexistence of intracranial epidermoid tumor and cerebral aneurysm is a rare event. The secondly inflammation in cerebral arterial wall may be responsible for the aneurysm formation. Surgical treatment of the intracranial epidermoid tumor and cerebral aneurysm repair may be an optimal scheme in one stage. PMID:28151901

  18. EPIDEMIOLOGY OF SPINE FRACTURES IN MOTORCYCLE ACCIDENT VICTIMS

    Directory of Open Access Journals (Sweden)

    Tiago Argolo Bittencourt de Oliveira

    2016-03-01

    Full Text Available ABSTRACT Objective: To analyze the incidence of spinal injuries between 2000-2010 due to motorcycle accidents and the relation to the increase in motorcycle sales in the same period, as well as the anatomical distribution of these spinal injuries. Methods: Data were collected from 1,295 records of patients who have suffered spinal injury resulting from motorcycle accidents admitted to the ward TRM (Spinal Cord Trauma of the Hospital Geral do Estado da Bahia from 2000 to 2010 in this retrospective study. We selected 110 medical records and collected information on sex, age, neurological deficit on admission (according to Frankel scale, diagnosis, and level of injury. Results: Between 2000 and 2010 there was an increase of almost five times in the incidence of patients who have suffered spinal injury due to motorcycle accidents. More than half (51.4% had cervical spine injury, 37.2% thoracic spine injury and 11.34% had lumbar spine injury. Only 34.3% of patients had no neurological deficit on admission and patients with thoracic spine fracture had a higher incidence and severity of lesion. The average age of patients was 30 years. Conclusions: The increased incidence of spinal injuries due motorcycle accidents occurred in the same period in which there was an increase in motorcycle sales in the country. Patients who have suffered those injuries were young, with higher incidence in the cervical and thoracic spinal levels and high rates of neurological deficit.

  19. Shape coexistence along N = 40

    Energy Technology Data Exchange (ETDEWEB)

    Liddick, S. N. [Michigan State University, East Lansing; Suchyta, S. [Michigan State University, East Lansing; Abromeit, B. [Michigan State University, East Lansing; Ayres, A [University of Tennessee, Knoxville (UTK); Bey, A. [University of Tennessee Medical Center, Knoxville; Bingham, C. R. [University of Tennessee, Knoxville (UTK); Bolla, M [Michigan State University, East Lansing; Carpenter, M. P. [Argonne National Laboratory (ANL); Cartegni, L. [University of Tennessee, Knoxville (UTK); Chiara, C. J. [University of Maryland & Argonne National Laboratory; Crawford, H. L. [Lawrence Berkeley National Laboratory (LBNL); Darby, I. G. [Katholieke University Leuven, Belgium; Grzywacz, R. [University of Tennessee, Knoxville (UTK); Gurdal, G. [Argonne National Laboratory (ANL); Ilyushkin, S. [Mississippi State University (MSU); Larson, N. [Michigan State University, East Lansing; Madurga, M [University of Tennessee, Knoxville (UTK); McCutchan, E. A. [Argonne National Laboratory (ANL); Miller, D [University of Tennessee, Knoxville (UTK); Padgett, Stephen [University of Tennessee, Knoxville (UTK); Paulauskas, S. [University of Tennessee, Knoxville (UTK); Pereira, J. [National Superconducting Cyclotron Laboratory (NSCL); Rajabali, M. M. [Katholieke University Leuven, Belgium; Rykaczewski, Krzysztof Piotr [ORNL; Vinnikova, S. [Michigan State University, East Lansing; Walters, W. B. [University of Maryland; Zhu, S. [Argonne National Laboratory (ANL)

    2011-01-01

    The low-energy level structures of 64 25Mn39 and 66 25Mn41 were investigated through both the decay of Mn metastable states and the population of levels following the decay of 64Cr and 66Cr. The deduced level schemes and tentatively assigned spins and parities suggest the coexistence of spherical and deformed configurations above and below N = 40 for the odd-odd Mn isotopes. The low-energy deformed configurations are attributed to the coupling between a proton in a K = 1/2 level with neutrons in either the K = 1/2 or K = 3/2+ levels originating from the p3/2, p1/2, and g9/2 single-particle states, respectively.

  20. Robotic systems in spine surgery.

    Science.gov (United States)

    Onen, Mehmet Resid; Naderi, Sait

    2014-01-01

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

  1. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  2. Multiplanar CT of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Rothman, S.L.G.; Glenn, W.V. Jr.

    1986-01-01

    This is an illustrated text on computed tomography (CT) of the lumbar spine with an emphasis on the role and value of multiplanar imaging for helping determine diagnoses. The book has adequate discussion of scanning techniques for the different regions, interpretations of various abnormalities, degenerative disk disease, and different diagnoses. There is a 50-page chapter on detailed sectional anatomy of the spine and useful chapters on the postoperative spine and the planning and performing of spinal surgery with CT multiplanar reconstruction. There are comprehensive chapters on spinal tumors and trauma. The final two chapters of the book are devoted to CT image processing using digital networks and CT applications of medical computer graphics.

  3. Voice Deviations and Coexisting Communication Disorders.

    Science.gov (United States)

    St. Louis, Kenneth O.; And Others

    1992-01-01

    This study examined the coexistence of other communicative disorders with voice disorders in about 3,400 children in grades 1-12 at 100 sites throughout the United States. The majority of voice-disordered children had coexisting articulation deviations and also differed from controls on two language measures and mean pure-tone hearing thresholds.…

  4. Degenerative disorders of the spine

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-03-01

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

  5. COEXISTENCE OF CARCINOMAS OF THYROID WITH MULTINODULAR GOITRES OF THYROID – A TWO-YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Kiran Kumar Epari

    2016-08-01

    Full Text Available BACKGROUND Multinodular goitre or nodular hyperplasia or adenomatoid goitre is the most common thyroid disease, which occurs due to deficient iodine intake. Initial hyperthyroid states, followed by follicular atrophy and secondary changes like haemorrhage, calcification and cystic degeneration occurs in most of the cases. Longstanding cases of nodular goitre can be associated with carcinomas, usually follicular carcinomas, and rarely papillary carcinomas.[1] This study was done to know the incidence of coexisting malignancies, follicular and papillary carcinomas of thyroid, in longstanding nodular goitres of thyroid. METHODS All the cases of nodular goitres examined in the last two years were studied, including the thyroidectomy specimens and FNAC slides whichever was done. Extensive grossing of the thyroidectomy specimens was done to detect the possibility of malignancy in longstanding cases of nodular goitre of thyroid. Review of FNAC slides was done in cases where cytodiagnosis of coexisting malignancy was missed and detected in histopathological examination. RESULTS In the present study, conducted over a two-year period, out of 50 cases of thyroidectomy specimens of multinodular goitres studied, six cases were diagnosed to be having coexisting malignancy of thyroid, of which four were follicular carcinomas of thyroid and two were papillary carcinomas of thyroid. FNAC diagnosis of coexisting malignancy was initially missed in FNAC in two cases, i.e. one case each of follicular carcinoma and papillary carcinoma. These FNAC slides were reviewed and the foci of malignancies detected. CONCLUSION There is a possibility of malignancy of thyroid coexisting with longstanding multinodular goitre of thyroid, which should be kept in mind, while performing the needle biopsy and thorough examination of FNAC slides is needed to avoid missing the possible detection of the coexisting malignant lesion. Thyroidectomy specimens should be extensively grossed to

  6. Learning rules and persistence of dendritic spines.

    Science.gov (United States)

    Kasai, Haruo; Hayama, Tatsuya; Ishikawa, Motoko; Watanabe, Satoshi; Yagishita, Sho; Noguchi, Jun

    2010-07-01

    Structural plasticity of dendritic spines underlies learning, memory and cognition in the cerebral cortex. We here summarize fifteen rules of spine structural plasticity, or 'spine learning rules.' Together, they suggest how the spontaneous generation, selection and strengthening (SGSS) of spines represents the physical basis for learning and memory. This SGSS mechanism is consistent with Hebb's learning rule but suggests new relations between synaptic plasticity and memory. We describe the cellular and molecular bases of the spine learning rules, such as the persistence of spine structures and the fundamental role of actin, which polymerizes to form a 'memory gel' required for the selection and strengthening of spine synapses. We also discuss the possible link between transcriptional and translational regulation of structural plasticity. The SGSS mechanism and spine learning rules elucidate the integral nature of synaptic plasticity in neuronal network operations within the actual brain tissue.

  7. Spine neck plasticity regulates compartmentalization of synapses.

    Science.gov (United States)

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

    2014-05-01

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

  8. Langerhans cell histiocytosis of the cervical spine: case report of an unusual location

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Brys, P.; Ghekiere, J.; Baert, A.L. [Department of Radiology, University Hospital Gasthuisberg KU Leuven (Belgium); Samson, I. [Department of Orthopedic Surgery, University Hospitals, Leuven (Belgium); Sciot, R. [Department of Pathology II, University Hospitals, Leuven (Belgium); Brock, P. [Department of Pediatrics, University Hospitals, Leuven (Belgium)

    1998-09-01

    An unusual location for Langerhans cell histiocytosis of the cervical spine is presented. The osteolytic lesion, instead of being located in the vertebral body, was visualised in the left lateral mass of the fifth cervical vertebra, extending into the vertebral body and through the interapophyseal joint into the lateral mass of the fourth cervical vertebra. (orig.) With 3 figs., 7 refs.

  9. Machine Learning-Based Classification of 38 Years of Spine-Related Literature Into 100 Research Topics.

    Science.gov (United States)

    Sing, David C; Metz, Lionel N; Dudli, Stefan

    2017-06-01

    Retrospective review. To identify the top 100 spine research topics. Recent advances in "machine learning," or computers learning without explicit instructions, have yielded broad technological advances. Topic modeling algorithms can be applied to large volumes of text to discover quantifiable themes and trends. Abstracts were extracted from the National Library of Medicine PubMed database from five prominent peer-reviewed spine journals (European Spine Journal [ESJ], The Spine Journal [SpineJ], Spine, Journal of Spinal Disorders and Techniques [JSDT], Journal of Neurosurgery: Spine [JNS]). Each abstract was entered into a latent Dirichlet allocation model specified to discover 100 topics, resulting in each abstract being assigned a probability of belonging in a topic. Topics were named using the five most frequently appearing terms within that topic. Significance of increasing ("hot") or decreasing ("cold") topic popularity over time was evaluated with simple linear regression. From 1978 to 2015, 25,805 spine-related research articles were extracted and classified into 100 topics. Top two most published topics included "clinical, surgeons, guidelines, information, care" (n = 496 articles) and "pain, back, low, treatment, chronic" (424). Top two hot trends included "disc, cervical, replacement, level, arthroplasty" (+0.05%/yr, P topics were ESJ-"operative, surgery, postoperative, underwent, preoperative"; SpineJ-"clinical, surgeons, guidelines, information, care"; Spine-"pain, back, low, treatment, chronic"; JNS- "tumor, lesions, rare, present, diagnosis"; JSDT-"cervical, anterior, plate, fusion, ACDF." Topics discovered through latent Dirichlet allocation modeling represent unbiased meaningful themes relevant to spine care. Topic dynamics can provide historical context and direction for future research for aspiring investigators and trainees interested in spine careers. Please explore https://singdc.shinyapps.io/spinetopics. N A.

  10. Intermittent control of coexisting attractors.

    Science.gov (United States)

    Liu, Yang; Wiercigroch, Marian; Ing, James; Pavlovskaia, Ekaterina

    2013-06-28

    This paper proposes a new control method applicable for a class of non-autonomous dynamical systems that naturally exhibit coexisting attractors. The central idea is based on knowledge of a system's basins of attraction, with control actions being applied intermittently in the time domain when the actual trajectory satisfies a proximity constraint with regards to the desired trajectory. This intermittent control uses an impulsive force to perturb one of the system attractors in order to switch the system response onto another attractor. This is carried out by bringing the perturbed state into the desired basin of attraction. The method has been applied to control both smooth and non-smooth systems, with the Duffing and impact oscillators used as examples. The strength of the intermittent control force is also considered, and a constrained intermittent control law is introduced to investigate the effect of limited control force on the efficiency of the controller. It is shown that increasing the duration of the control action and/or the number of control actuations allows one to successfully switch between the stable attractors using a lower control force. Numerical and experimental results are presented to demonstrate the effectiveness of the proposed method.

  11. Solitary plasmacytoma of spine with amyloidosis

    Directory of Open Access Journals (Sweden)

    Cui-yun SUN

    2017-01-01

    Full Text Available Objective To report the diagnosis and treatment of one case of solitary plasmacytoma of spine with amyloidosis and investigate the clinicopathological features combined with literatures. Methods and Results The patient was a 46-year-old woman. She suffered from weakness of both lower limbs, unsteady gait and numbness of toes for 20 d. MRI examination revealed an irregular mass behind the spinal cord at T5-7 level and T6-7 vertebral body accessory. The enhanced MRI showed obvious heterogeneous enhancement. The border was clear and spinal dura mater was compressed to shift forward. During operation, T5-7 processus spinosus and vertebral laminae were eroded, and the cortex of bone showed "moth-eaten" erosion. The intraspinal and extradural lesion had rich blood supply, loose bone structure and intact spinal dura mater. Histologically, tumor cells were composed of intensive small cells, and focal plasmacytoid cells were seen. Flake pink staining substance was among them. Artificial cracks were common and multinuclear giant tumor cells were scatteredly distributed. Immunohistochemical analysis showed the cytoplasm of tumor cells were diffusely positive for CD138, CD38 and vimentin (Vim,scatteredly positive for leukocyte common antigen (LCA, and negative for immune globulin κ light chain(IgGκ and λ light chain (IgGλ, CD99, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, HMB45 and CD34. The Ki-67 labeling index was 1.25%. Congo red staining showed the pink staining substance was brownish red. Hybridization in situ examination showed the DNA content of IgGκ was more than that of IgGλ. The final pathological diagnosis was solitary plasmacytoma of spine with amyloidosis. The patient was treated with postoperative chemotherapy, and there was no recurrence or metastasis during 18-month follow-up period. Conclusions Solitary plasmacytoma of spine with amyloidosis is a rare tumor. The imaging features can offer a few

  12. Vitamin D and spine surgery

    Science.gov (United States)

    Mabey, Thomas; Singhatanadgige, Weerasak; Yingsakmongkol, Wicharn; Limthongkul, Worawat; Honsawek, Sittisak

    2016-01-01

    Vitamin D is crucial for musculoskeletal health, maintenance, and function. Vitamin D insufficiency is common among patients undergoing spine surgery and the ideal vitamin D level for spine surgery has yet to be investigated. There is a high prevalence of hypovitaminosis D in patients with musculoskeletal pain regardless of surgical intervention. With the frequency and costs of spine surgery increasing, it is imperative that efforts are continued to reduce the impact on patients and healthcare services. Studies into vitamin D and its associations with orthopaedic surgery have yielded alarming findings with regards to the prevalence of vitamin D deficiency. Importantly, altered vitamin D status also contributes to a wide range of disease conditions. Therefore, future investigations are still essential for better understanding the relationship between vitamin D and spine surgery outcomes. Whilst further research is required to fully elucidate the extent of the effects of hypovitaminosis D has on surgical outcomes, it is strongly advisable to reduce the impacts by appropriate vitamin D supplementation of deficient and at-risk patients. PMID:27900269

  13. Cervical spine movement during intubation

    Directory of Open Access Journals (Sweden)

    Amlan Swain

    2017-01-01

    Full Text Available There have been growing concerns following documented instances of neurological deterioration in patients with cervical spine injury as a result of intubation. A significant body of evidence has since evolved with the primary objective of ascertaining the safest way of securing the endotracheal tube in patients with suspected and proven cervical injury. The search for a mode of intubation producing the least movement at the cervical spine is an ongoing process and is limited by logistic and ethical issues. The ensuing review is an attempt to review available evidence on cervical movements during intubation and to comprehensively outline the movement at the cervical spine with a wide plethora of intubation aids. Literature search was sourced from digital libraries including PubMed, Medline and Google Scholar in addition to the standard textbooks of Anaesthesiology. The keywords used in literature search included 'cervical spine motion,' 'neurological deterioration,' 'intubation biomechanics,' 'direct laryngoscopy,' 'flexible fibreoptic intubation,' 'video laryngoscopes' and 'craniocervical motion.' The scientific information in this review is expected to assist neuroanaesthesiologists for planning airway management in patients with neurological injury as well as to direct further research into this topic which has significant clinical and patient safety implications.

  14. Magnetic resonance of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Enzmann, D.R.; De La Paz, R.L.; Rubin, J.R.

    1990-01-01

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

  15. Spine Injuries in Child Abuse.

    Science.gov (United States)

    Jauregui, Julio J; Perfetti, Dean C; Cautela, Frank S; Frumberg, David B; Naziri, Qais; Paulino, Carl B

    2016-09-22

    Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries. Patients with a documented diagnosis of abuse were identified using ICD-9-CM diagnosis codes. Our statistical models consisted of multivariate linear regressions that were adjusted for age, race, and sex. There were 22,192 pediatric patients with a diagnosis of spinal cord or vertebral column injury during the study period, 116 (0.5%) of whom also had a documented diagnosis of abuse. The most common type of abuse was physical (75.9%). Compared with nonabused patients, abused patients were more likely to be below 2 years of age (OR=133.4; 95% CI, 89.5-198.8), female (OR=1.67; 95% CI, 1.16-2.41), and nonwhite (black: OR=3.86; 95% CI, 2.31-6.45; Hispanic: OR=2.86; 95% CI, 1.68-4.86; other: OR=2.33; 95% CI, 1.11-4.86). Abused patients also presented with an increased risk of thoracic (OR=2.57; 95% CI, 1.67-3.97) and lumbar (OR=1.67; 95% CI, 1.03-2.72) vertebral column fractures and had a multivariate-adjusted mean length of stay that was 62.2% longer (P<0.001) and mean total charges that were 52.9% higher (P<0.001) compared with nonabused patients. Furthermore, 19.7% of all pediatric spine patients under 2 years of age admitted during the study period belonged to the abused cohort. Spine injuries are rare but can be found in the pediatric population. With an additional documented diagnosis of abuse, these injuries affect younger patients in the thoracolumbar region of the spine

  16. Male Spine Motion During Coitus

    Science.gov (United States)

    Sidorkewicz, Natalie

    2014-01-01

    Study Design. Repeated measures design. Objective. To describe male spine movement and posture characteristics during coitus and compare these characteristics across 5 common coital positions. Summary of Background Data. Exacerbation of pain during coitus due to coital movements and positions is a prevalent issue reported by low back pain patients. A biomechanical analysis of spine movements and postures during coitus has never been conducted. Methods. Ten healthy males and females engaged in coitus in the following preselected positions and variations: QUADRUPED, MISSIONARY, and SIDELYING. An optoelectronic motion capture system was used to measure 3-dimensional lumbar spine angles that were normalized to upright standing. To determine whether each coital position had distinct spine kinematic profiles, separate univariate general linear models, followed by Tukey's honestly significant difference post hoc analysis were used. The presentation of coital positions was randomized. Results. Both variations of QUADRUPED, mQUAD1 and mQUAD2, were found to have a significantly higher cycle speed than mSIDE (P = 0.043 and P = 0.034, respectively), mMISS1 (P = 0.003 and P = 0.002, respectively), and mMISS2 (P = 0.001 and P spine movement varied depending on the coital position; however, across all positions, the majority of the range of motion used was in flexion. Based on range of motion, the least-to-most recommended positions for a male flexion-intolerant patient are mSIDE, mMISS2, mQUAD2, mMISS1, and mQUAD1. Conclusion. Initial recommendations—which include specific coital positions to avoid, movement strategies, and role of the partner—were developed for male patients whose low back pain is exacerbated by specific motions and postures. Level of Evidence: N/A PMID:25208042

  17. Pott's spine and paraplegia.

    Science.gov (United States)

    Gautam, M P; Karki, P; Rijal, S; Singh, R

    2005-01-01

    Spinal tuberculosis is usually secondary to lung or abdominal involvement and may also be the first manifestation of tuberculosis. Spinal tuberculosis (often called Pott's disease) is by definition, an advanced disease, requiring meticulous assessment and aggressive systemic therapy. Physicians should keep the diagnosis in mind, especially in a patient from a group with a high rate of tuberculosis infection. This review aims on updating the knowledge on spinal tuberculosis and its management. Skeletal involvement has been reported to occur in approximately 10% of all patents with extrapulmonary tuberculosis, and half of these patients develop infection within the spinal column. Symptoms of spinal tuberculosis are back pain, weakness, weight loss, fever, fatigue, and malaise. It is much more prone to develop neurological manifestation, paraplegia of varying degree. The palpation of spinous process in routine clinical examination is the most rewarding clinical method and is an invaluable measure for early recognition. Diagnosis of spinal tuberculosis is made on the basis of typical clinical presentation along with systemic constitutional manifestation and the evidence of past exposure to tuberculosis or concomitant visceral tuberculosis. Magnetic resonance imaging can define the extent of abscess formation and spinal cord compression. The diagnosis is confirmed through percutaneous or open biopsy of the spinal lesion. Surgery is necessary as an adjunct to antibiotic therapy if the vertebral infection produces an abscess, vertebral collapse, or neurologic compression. Some patents need aggressive supportive care owing to tuberculous meningitis or encephalopathy. Moreover, the importance of immediate commencement of appropriate treatment and its continuation for adequate duration along with the proper counseling of the patient and family members should not be underestimated for successful and desired outcome.

  18. [FEATURES OF THE TREATMENT OF THE SPINE IN RHEUMATOID ARTHRITIS].

    Science.gov (United States)

    Selezneva, S; Sinyachenko, O; Zabara, А

    2017-01-01

    Rheumatoid arthritis (RA) refers to the most common inflammatory joint disease, which can lead to persistent disability and early mortality of patients, and one of the manifestations of RA is a frequent lesion of the spine, which significantly affects the quality of life of these patients. To evaluate spine lesion in patients with different types of current RA and factors that determine it. Under the supervision of the RA patient 131 was aged 18 to 79 years (mean 45 years) among them was 18% male and 82% female. Duration of disease was 10 years, I radiographic arthritis stage is set to 8% of cases, II - 38%, III - 35%, IV - 19%, by rheumatoid factor seropositivity was observed in 77% of patients studied, and by the presence of antibodies against cyclic citrullin peptide - y ¾. Extra-articular (systemic) form of the disease occurred in 43% of cases, systemic osteoporosis - 67%. lesions of the spine in the form of osteochondrosis and spondyloarthrosis observed at ½ of the number of RA patients, and clinically overt occurs in 35% of cases, which is directly related to patient age, involving in the process of wrist, elbow and hip joints, the presence of systemic osteoporosis and tendovaginitis, sensory and motor disorders due to peripheral neuropathy. Frequency ratio of mechanical, disfixtional, disgemic and inflammatory pain in the spine in RA is a 1: 2: 6: 14. Radiographs revealed ossification of the outer layers of the intervertebral discs and the formation sindesmofitov and spondylodiscitis. Involvement of joints is characterized by vagueness of the articular surfaces and narrowing gaps. Vertebral pathology affects heart disease symptoms (changes in electrical conductivity, the size of cameras, the left ventricular diastolic function), autonomic changes and severity of neuropathy and predictors are blood levels of rheumatoid factor and C-reactive protein. Due to the nature of spinal lesions in rheumatoid arthritis has been proposed a scheme of treatment with

  19. [Chronic recurrent multifocal osteomyelitis of the spine : Children and adolescent].

    Science.gov (United States)

    von der Höh, N H; Völker, A; Jeszenszky, D; Heyde, C-E

    2016-06-01

    Chronic non-bacterial osteomyelitis (CNO) in childhood and adolescence is a non-infectious autoinflammatory disease of the bone with partial involvement of adjacent joints and soft tissue. The etiology is unknown. The disease can occur singular or recurrent. Individual bones can be affected and multiple lesions can occur. Chronic recurrent multifocal osteomyelitis (CRMO) shows the whole picture of CNO. Accompanying but temporally independent of the bouts of osteomyelitis, some patients show manifestations in the skin, eyes, lungs and the gastrointestinal tract. The article gives an overview of the clinical manifestations, diagnostic procedures, and treatment options for CRMO involvement of the spine based on the current literature and our own cases.

  20. Cervical spine and crystal-associated diseases: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Feydy, Antoine; Chevrot, Alain; Drape, Jean-Luc [Hopital Cochin, Service de Radiologie B, Paris Cedex 14 (France); Liote, Frederic [Hopital Lariboisiere, Federation de Rhumatologie, Paris (France); Carlier, Robert [Hopital Raymond Poincare, Radiologie, Garches (France)

    2006-02-01

    The cervical spine may be specifically involved in crystal-associated arthropathies. In this article, we focus on the three common crystals and diseases: hydroxyapatite crystal deposition disease, calcium pyrophosphate dihydrate (CPPD) deposition disease, and monosodium urate crystals (gout). The cervical involvement in crystal-associated diseases may provoke a misleading clinical presentation with acute neck pain, fever, or neurological symptoms. Imaging allows an accurate diagnosis in typical cases with calcific deposits and destructive lesions of the discs and joints. Most of the cases are related to CPPD or hydroxyapatite crystal deposition; gout is much less common. (orig.)

  1. 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.)

  2. Cervical spine in Treacher Collins syndrome.

    Science.gov (United States)

    Pun, Amy Hoi-Ying; Clark, Bruce Eric; David, David John; Anderson, Peter John

    2012-05-01

    Treacher Collins syndrome is a congenital syndrome with characteristic craniofacial malformations, which are well described in the literature. However, the presence of cervical spine dysmorphology in this syndrome has been minimally described. This study reviews cervical spine radiographs of 40 patients with Treacher Collins syndrome. In this sample, 7 of 40 patients displayed cervical spine anomalies, with 3 of these patients displaying multiple cervical spine anomalies. The patterns of spinal anomalies were variable, suggesting that the underlying genetic mutation has variable expressivity in cervical spine development as it does elsewhere in the craniofacial skeleton.

  3. Findings on magnetic resonance imaging of the spine and femur in a case of McCune-Albright syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Inamo, Y. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Hanawa, Y. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Kin, H. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Okuni, M. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan))

    1993-03-01

    Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright syndrome, is seen in the cranium, facial bones, of the extremeties, and ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8-year-old girl with this syndrome, but [sup 99m]Tc-methylene diphosphonate bone scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae. Multiple well-circumscribed areas of low signal intensity were seen on T1-weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans in this disease have never been reported, our findings in this case proved for evaluating osseous lesions. MRI made it possible to differentiate between fibrous lesions (low signal intensity on T1- und T2- weighted MRI) and cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI). (orig.)

  4. Altered lumbar spine structure, biochemistry and biomechanical properties in a canine model of mucopolysaccharidosis type VII

    Science.gov (United States)

    Smith, Lachlan J; Martin, John T; Szczesny, Spencer E; Ponder, Katherine P; Haskins, Mark E; Elliott, Dawn M

    2010-01-01

    Mucopolysaccharidosis VII (MPS VII) is a lysosomal storage disorder characterized by a deficiency in β-glucuronidase activity, leading to systemic accumulation of poorly degraded glycosaminoglycans (GAG). Along with other morbidities, MPS VII is associated with paediatric spinal deformity. The objective of this study was to examine potential associations between abnormal lumbar spine matrix structure and composition in MPS VII, and spine segment and tissue-level mechanical properties, using a naturally occurring canine model with a similar clinical phenotype to the human form of the disorder. Segments from juvenile MPS VII and unaffected dogs were allocated to: radiography, gross morphology, histology, biochemistry, and mechanical testing. MPS VII spines had radiolucent lesions in the vertebral body epiphyses. Histologically, this corresponded to a GAG-rich cartilaginous region in place of bone, and elevated GAG staining was seen in the annulus fibrosus. Biochemically, MPS VII samples had elevated GAG in the outer annulus fibrosus and epiphyses, low calcium in the epiphyses, and high water content in all regions except the nucleus pulposus. MPS VII spine segments had higher range of motion and lower stiffness than controls. Endplate indentation stiffness and failure loads were significantly lower in MPS VII samples, while annulus fibrosus tensile mechanical properties were normal. Vertebral body lesions in MPS VII spines suggest a failure to convert cartilage to bone during development. Low stiffness in these regions likely contributes to mechanical weakness in motion segments and is a potential factor in the progression of spinal deformity. PMID:19918911

  5. Global minimizers of coexistence for competing species

    OpenAIRE

    2010-01-01

    A class of variational models describing ecological systems of k species competing for the same resources is investigated. The occurrence of coexistence in minimal energy solutions is discussed and positive results are proven for suitably differentiated internal dynamics.

  6. [Thyroid cancer metastasis to the lumbar spine successfully treated by embolization and radioiodine. A case report].

    Science.gov (United States)

    Sumimura, J; Nakagawa, K; Kawamura, J; Tayama, M; Takahashi, E; Moritomo, T; Miyata, M

    1990-07-01

    A 82-year-old woman suffered from a metastatic lesion of follicular carcinoma of the thyroid to the fourth lumbar spine, which compressed the spinal nerves and caused lumbar pain and paresthesis of the lower limb. External irradiation, 5200 RAD, was carried out. Total thyroidectomy was done for the preparation of radioiodine(131I) therapy. Two weeks later, embolization of lumbar arteries was performed to prevent the progression of the spinal cord damage during a period waiting for 131I administration. The size of the lumbar lesion decreased, and lumbal pain and spinal cord symptoms disappeared. After administration of 131I, the metastatic lesion became further smaller.

  7. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  8. Diagnostic usefulness of CT-guided percutaneous biopsy of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Kyung Jin; Kim, Won Hong; Byun, Joon Soo; Cho, Young Kook; Cho, Kyu Jung; Moon, Kyung Ho; Seok, Eul Hye; Shin, Seok Hwan; Han, Heon [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    1999-12-01

    To evaluate the diagnostic value of CT-guided percutaneous biopsy of inflammatory and tumorous lesions of the spine and paraspinal soft tissue. Twenty-three patients underwent CT-guided percutaneous biopsy of the spine and paraspinal soft tissue. Tentative clinical diagnoses determined before biopsy were tuberculous spondylitis(n=5), pyogenic spondylitis (n=4), butterfly vertebra (n=1), old compression fracture (n=3), discitis (n=1), hemangioma (n=1), metastasis (n=7) and multiple myeloma (n=1). Biopsy was performed at the following levels: cervical-(n=1), thoracic-(n=9), and lumbar-spine(n=13). The approach to biopsy of the spine and paraspinal soft tissue lesions was posterolateral (n=11), posterior (n=2), or transpedicular (n=10). Tissue considered adequate by the pathologist involved was obtained in 21 (91%) of the 23 cases. In 19 cases, pathologic findings supported the clinical diagnoses determined before biopsy. In two cases, pathologic and clinical diagnoses differed. Complications such as severe pain, bleeding, infection, neurologic deficit or damage to internal organs were detected neither during or after the procedure. CT-guided percutaneous biopsy is a safe and reliable method of obtaining a diagnosis in many cases involving different spinal and paraspinal lesions.

  9. Fetal evaluation of spine dysraphism

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

  10. Multilevel noncontiguous cervical spine injury

    Directory of Open Access Journals (Sweden)

    Adetunji Mapaderun Toluse

    2017-01-01

    Full Text Available This case report highlights the successful combination of operative and nonoperative management of a patient with noncontiguous cervical spine fractures and incomplete spinal cord injury. A case report of a 40-year-old male victim of a motor vehicular accident who presented with noncontiguous cervical spine fractures (Anderson and D'Alonzo Type III odontoid fracture and traumatic spondylolisthesis of C4/C5 and incomplete spinal cord injury. The odontoid fracture was managed nonoperatively, whereas anterior cervical discectomy and fusion were done at the C4/C5 vertebral level. The patient made full neurologic recovery with radiologic evidence of successful fusion and fracture healing at 12 weeks postoperation in both levels of injuries. Operative and nonoperative modalities can be utilized to manage selected patients.

  11. Coexistence of Major Complications in Pancreatic Pseudocyst: Case report

    Directory of Open Access Journals (Sweden)

    Ömer Fatih Nas

    2016-06-01

    Full Text Available Pancreatic pseudocyst is the most common cystic lesion of the pancreas seen following acute and chronic pancreatitis in 2-10% and 10-30%, respectively. Imaging findings vary depending on the age and severity of the attack. Infection, hemorrhage and rupture are the most frightening complications. The possibility of spontaneous recovery is consider­ably low. A 63-year old male patient who has history of longstanding alcohol consumption presented to the emer­gency department with complaints of abdominal pain. On computerized tomography (CT, an encapsulated and round peripancreatic collection with a size of approximately 8.5x7.5 cm was detected in pancreatic head. In the literature, no article is published mentioning coexistence of complication such as infection, hemorrhage and rupture. We present the association of these three complications observed in our case. J Clin Exp Invest 2016; 7 (2: 203-206

  12. Computed tomography of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Haughton, V.M.; Williams, A.L.

    1982-01-01

    The book describes the computed tomographic (CT) techniques for imaging the different elements comprising the spinal column and canal. The use of intravenous and intrathecal contrast enhancement and of xenon enhancement is briefly mentioned. Reconstruction techniques and special problems regarding CT of the spine are presented. CT of the spinal cord, meninges and subarachnoid space, epidural space, intervertebral discs, facet joints, and vertebrae present normal anatomy, and several common pathologic conditions. (KRM)

  13. MRI of the fetal spine

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-09-01

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

  14. Associated intracranial lesions: meningioma and anterior communicating aneurysm

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2016-09-01

    Full Text Available Asymptomatic associated intracranial lesions are more frequently diagnosed with the utilization of high-resolution imaging. The occurrence of brain tumors together with intracranial aneurysms are a very rare situation. This coexistence is still a diagnostic and therapeutic challenge as no consensus concerning imaging that may cover both type of intracranial lesion was established. We report a case of a 62 years old patient with a meningioma and aneurysm treated in one session with good outcome.

  15. Associated intracranial lesions: meningioma and anterior communicating aneurysm

    OpenAIRE

    Chiriac A.; Ion Georgiana; Faiyad Z.; Poeata I.

    2016-01-01

    Asymptomatic associated intracranial lesions are more frequently diagnosed with the utilization of high-resolution imaging. The occurrence of brain tumors together with intracranial aneurysms are a very rare situation. This coexistence is still a diagnostic and therapeutic challenge as no consensus concerning imaging that may cover both type of intracranial lesion was established. We report a case of a 62 years old patient with a meningioma and aneurysm treated in one session with good outcome.

  16. Linking metacommunity paradigms to spatial coexistence mechanisms.

    Science.gov (United States)

    Shoemaker, Lauren G; Melbourne, Brett A

    2016-09-01

    Four metacommunity paradigms-usually called neutral, species sorting, mass effects, and patch dynamics, respectively-are widely used for empirical and theoretical studies of spatial community dynamics. The paradigm framework highlights key ecological mechanisms operating in metacommunities, such as dispersal limitation, competition-colonization tradeoffs, or species equivalencies. However, differences in coexistence mechanisms between the paradigms and in situations with combined influences of multiple paradigms are not well understood. Here, we create a common model for competitive metacommunities, with unique parameterizations for each metacommunity paradigm and for scenarios with multiple paradigms operating simultaneously. We derive analytical expressions for the strength of Chesson's spatial coexistence mechanisms and quantify these for each paradigm via simulation. For our model, fitness-density covariance, a concentration effect measuring the importance of intraspecific aggregation of individuals, is the dominant coexistence mechanism in all three niche-based metacommunity paradigms. Increased dispersal between patches erodes intraspecific aggregation, leading to lower coexistence strength in the mass effects paradigm compared to species sorting. Our analysis demonstrates the potential importance of aggregation of individuals (fitness-density covariance) over co-variation in abiotic environments and competition between species (the storage effect), as fitness-density covariance can be stronger than the storage effect and is the sole stabilizing mechanism in the patch dynamics paradigm. As expected, stable coexistence does not occur in the neutral paradigm, which requires species to be equal and emphasizes the role of stochasticity. We show that stochasticity also plays an important role in niche-structured metacommunities by altering coexistence strength. We conclude that Chesson's spatial coexistence mechanisms provide a flexible framework for comparing

  17. A Rare Case of Coexistence of Borderline Lepromatous Leprosy with Tuberculosis Verrucosa Cutis

    Science.gov (United States)

    Prabhakaran, Nagendran; Chandrashekar, Laxmisha; Behera, Biswanath

    2016-01-01

    Occurrence of pulmonary tuberculosis with leprosy is known but association of cutaneous tuberculosis with leprosy is rare. We report a case of borderline lepromatous leprosy coexistent with tuberculosis verrucosa cutis in a 29-year-old male, who presented with multiple skin coloured nodules and hyperkeratotic scaly lesions of 3-month duration. Dual infections are associated with high mortality and morbidity. Therefore early diagnosis and management helps to reduce mortality and to mitigate the effects of morbidity. PMID:28003920

  18. Microscope sterility during spine surgery.

    Science.gov (United States)

    Bible, Jesse E; O'Neill, Kevin R; Crosby, Colin G; Schoenecker, Jonathan G; McGirt, Matthew J; Devin, Clinton J

    2012-04-01

    Prospective study. Assess the contamination rates of sterile microscope drapes after spine surgery. The use of the operating microscope has become more prevalent in certain spine procedures, providing superior magnification, visualization, and illumination of the operative field. However, it may represent an additional source of bacterial contamination and increase the risk of developing a postoperative infection. This study included 25 surgical spine cases performed by a single spine surgeon that required the use of the operative microscope. Sterile culture swabs were used to obtain samples from 7 defined locations on the microscope drape after its use during the operation. The undraped technician's console was sampled in each case as a positive control, and an additional 25 microscope drapes were swabbed immediately after they were applied to the microscope to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates using a semiquantitative technique. No growth was observed on any of the 25 negative control drapes. In contrast, 100% of preoperative and 96% of postoperative positive controls demonstrated obvious contamination. In the postoperative group, all 7 sites of evaluation were found to be contaminated with rates of 12% to 44%. Four of the 7 evaluated locations were found to have significant contamination rates compared with negative controls, including the shafts of the optic eyepieces on the main surgeon side (24%, P = 0.022), "forehead" portion on both the main surgeon (24%, P = 0.022) and assistant sides (28%, P = 0.010), and "overhead" portion of the drape (44%, P = 0.0002). Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact

  19. Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report

    Directory of Open Access Journals (Sweden)

    Neto Guerino

    2012-04-01

    Full Text Available Abstract This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. The patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional.

  20. Incidence and functional evolution of traumatic injuries of the spine

    Directory of Open Access Journals (Sweden)

    Francisco Alberto Trinidad Ovalle

    2014-09-01

    Full Text Available OBJECTIVE: To determine the incidence and functional outcome of traumatic injuries of the spine in the period from January 1, 2013 to December 31, 2013, at the General Hospital "Dr. Rafael Pascacio Gamboa", state of Chiapas, México. METHODS: A retrospective, cross-sectional, descriptive, observational study, where all patients seeking medical and surgical care in the emergency department and inpatient unit for a traumatic spinal injury were included, regardless of age or sex. RESULTS: A sample of 60 patients, of whom 43 were male (71.7% and 17 females (28.3%, with an average age of 35 was obtained. As for the cause of the injury, falls were the leading cause (61.7% followed by motor vehicle accidents (35% and finally, assaults (3.3%. In this sample, 21% had associated injuries being the most common (7.3% the thoracic trauma. The most common site of injury was the thoracic spine, followed by the lower cervical and finally the thoracolumbar ones. We found that 70% of patients had partial or complete neurological injury, with complete spinal cord transection (Frankel A being the most frequent lesion in 53%. CONCLUSION: The incidence in our series is similar that the reported in developing countries which have sociocultural problems similar to ours. The same applies to the etiology of these lesions, which is closely linked to social and economic activity in each country or region.

  1. Synovis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: A case of spine, pelvis, and anterior chest wall involvement, with overlooked plantar pustulosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Jeong, Soh Yong; Lee, Sujin; Baek, In Woon; Park, Jeongmi [Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2017-05-15

    Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an inflammatory clinical condition with aseptic bone lesions and characteristic skin manifestations. A 63-year-old woman presented with vague musculoskeletal symptoms including chronic buttock pain. The clinical work-up revealed multiple spine and osteoarticular involvement. Multilevel bone marrow edema and cortical erosions involving the spine, asymmetric sacroiliitis, and osteosclerosis of the sternoclavicular joint were consistent with a diagnosis of SAPHO syndrome. Considering SAPHO syndrome in the differential diagnosis, subsequent skin inspection revealed plantar pustulosis. Despite the unique feature of accompanying skin and skeletal lesions, skin lesions could be overlooked if not suspected.

  2. Charcot Spine and Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Philippe Loriaut

    2014-01-01

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

  3. Coexistence of esophageal superficial carcinoma and multiple leiomyomas: A case report

    Institute of Scientific and Technical Information of China (English)

    Takeshi Iwaya; Go Wakabayashi; Chihaya Maesawa; Noriyuki Uesugi; Toshimoto Kimura; Kenichiro Ikeda; Yusuke Kimura; Shingo Mitomo; Kaoru Ishida; Nobuhiro Sato

    2006-01-01

    Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient's severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas (20 lesions, up to 3 cm in diameter), and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma.This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be misdiagnosed as tumor invasion.The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.

  4. Selective Loss of Smaller Spines in Schizophrenia.

    Science.gov (United States)

    MacDonald, Matthew L; Alhassan, Jamil; Newman, Jason T; Richard, Michelle; Gu, Hong; Kelly, Ryan M; Sampson, Alan R; Fish, Kenneth N; Penzes, Peter; Wills, Zachary P; Lewis, David A; Sweet, Robert A

    2017-06-01

    Decreased density of dendritic spines in adult schizophrenia subjects has been hypothesized to result from increased pruning of excess synapses in adolescence. In vivo imaging studies have confirmed that synaptic pruning is largely driven by the loss of large or mature synapses. Thus, increased pruning throughout adolescence would likely result in a deficit of large spines in adulthood. Here, the authors examined the density and volume of dendritic spines in deep layer 3 of the auditory cortex of 20 schizophrenia and 20 matched comparison subjects as well as aberrant voltage-gated calcium channel subunit protein expression linked to spine loss. Primary auditory cortex deep layer 3 spine density and volume was assessed in 20 pairs of schizophrenia and matched comparison subjects in an initial and replication cohort (12 and eight pairs) by immunohistochemistry-confocal microscopy. Targeted mass spectrometry was used to quantify postsynaptic density and voltage-gated calcium channel protein expression. The effect of increased voltage-gated calcium channel subunit protein expression on spine density and volume was assessed in primary rat neuronal culture. Only the smallest spines are lost in deep layer 3 of the primary auditory cortex in subjects with schizophrenia, while larger spines are retained. Levels of the tryptic peptide ALFDFLK, found in the schizophrenia risk gene CACNB4, are inversely correlated with the density of smaller, but not larger, spines in schizophrenia subjects. Consistent with this observation, CACNB4 overexpression resulted in a lower density of smaller spines in primary neuronal cultures. These findings require a rethinking of the overpruning hypothesis, demonstrate a link between small spine loss and a schizophrenia risk gene, and should spur more in-depth investigations of the mechanisms that govern new or small spine generation and stabilization under normal conditions as well as how this process is impaired in schizophrenia.

  5. Diagnostic Approach to Pediatric Spine Disorders.

    Science.gov (United States)

    Rossi, Andrea; Martinetti, Carola; Morana, Giovanni; Severino, Mariasavina; Tortora, Domenico

    2016-08-01

    Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.

  6. Chondrosarcoma of the Mobile Spine and Sacrum

    Directory of Open Access Journals (Sweden)

    Ryan M. Stuckey

    2011-01-01

    Full Text Available Chondrosarcoma is a rare malignant tumor of bone. This family of tumors can be primary malignant tumors or a secondary malignant transformation of an underlying benign cartilage tumor. Pain is often the initial presenting complaint when chondrosarcoma involves the spine. In the mobile spine, chondrosarcoma commonly presents within the vertebral body and shows a predilection for the thoracic spine. Due to the resistance of chondrosarcoma to both radiation and chemotherapy, treatment is focused on surgery. With en bloc excision of chondrosarcoma of the mobile spine and sacrum patients can have local recurrence rates as low as 20%.

  7. Coexistence of competing stage-structured populations.

    KAUST Repository

    Fujiwara, Masami

    2011-10-05

    This paper analyzes the stability of a coexistence equilibrium point of a model for competition between two stage-structured populations. In this model, for each population, competition for resources may affect any one of the following population parameters: reproduction, juvenile survival, maturation rate, or adult survival. The results show that the competitive strength of a population is affected by (1) the ratio of the population parameter influenced by competition under no resource limitation (maximum compensatory capacity) over the same parameter under a resource limitation due to competition (equilibrium rate) and (2) the ratio of interspecific competition over intraspecific competition; this ratio was previously shown to depend on resource-use overlap. The former ratio, which we define as fitness, can be equalized by adjusting organisms\\' life history strategies, thereby promoting coexistence. We conclude that in addition to niche differentiation among populations, the life history strategies of organisms play an important role in coexistence.

  8. Solvable model for template coexistence in protocells

    CERN Document Server

    Fontanari, J F

    2012-01-01

    Compartmentalization of self-replicating molecules (templates) in protocells is a necessary step towards the evolution of modern cells. However, coexistence between distinct template types inside a protocell can be achieved only if there is a selective pressure favoring protocells with a mixed template composition. Here we study analytically a group selection model for the coexistence between two template types using the diffusion approximation of population genetics. The model combines competition at the template and protocell levels as well as genetic drift inside protocells. At the steady state, we find a continuous phase transition separating the coexistence and segregation regimes, with the order parameter vanishing linearly with the distance to the critical point. In addition, we derive explicit analytical expressions for the critical steady-state probability density of protocell compositions.

  9. Solvable model for template coexistence in protocells

    Science.gov (United States)

    Fontanari, J. F.; Serva, M.

    2013-02-01

    Compartmentalization of self-replicating molecules (templates) in protocells is a necessary step towards the evolution of modern cells. However, coexistence between distinct template types inside a protocell can be achieved only if there is a selective pressure favoring protocells with a mixed template composition. Here we study analytically a group selection model for the coexistence between two template types using the diffusion approximation of population genetics. The model combines competition at the template and protocell levels as well as genetic drift inside protocells. At the steady state, we find a continuous phase transition separating the coexistence and segregation regimes, with the order parameter vanishing linearly with the distance to the critical point. In addition, we derive explicit analytical expressions for the critical steady-state probability density of protocell compositions.

  10. Four-Rod Stabilization of Severely Destabilized Lumbar Spine Caused by Metastatic Tumor

    Directory of Open Access Journals (Sweden)

    Isao Shibuya

    2013-01-01

    Full Text Available We report a case of a 67-year-old female with severely destabilized lumbar spine caused by metastatic malignant tumor. The primary lesion was a thyroid follicular adenocarcinoma. Complete destruction of the L3, L4, and L5 vertebrae had resulted in severe instability, which left the patient with severe back pain and bed-ridden. Since the vertebrae were so severely damaged at 3 levels, 4 rods were used to stabilize the spine. Following stabilization, the pain was alleviated and the patient’s quality of life improved. We introduce here the 4-rod technique to stabilize the spine over 3 vertebral levels following severe destruction by metastatic tumor.

  11. Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.

    Science.gov (United States)

    Kobayashi, Hiroshi; Shinoda, Yusuke; Ohki, Takahiro; Kawano, Hirotaka

    2015-07-02

    An osteoblastoma is a benign bone lesion most commonly affecting the spine; it is frequently found in the posterior elements of the vertebra. When an osteoblastoma originates in the spine, it usually causes dull and localised dorsal pain, but the period between symptom development and diagnosis can be long. MRI shows intense peritumoural oedema accompanying the osteoblastoma. We present a case of a 15-year-old boy with osteoblastoma at the level of the T8-9 left laminae causing intercostal neuralgia without direct invasion to the intercostal nerve. Immediately after surgery, intercostal neuralgia was diminished. To our knowledge, this is the first case of an osteoblastoma with intercostal neuralgia, which is possibly the key symptom for diagnosing an osteoblastoma in the thoracic spine. 2015 BMJ Publishing Group Ltd.

  12. [Death of an infant following 'craniosacral' manipulation of the neck and spine].

    Science.gov (United States)

    Holla, Micha; Ijland, Marloes M; van der Vliet, A M; Edwards, Michael; Verlaat, Carin W M

    2009-04-25

    A healthy 3-month-old girl died after manipulation of the cervical and thoracolumbar spine by a so-called craniosacral therapist. During persistent forced deep flexion of the neck and spine, the infant developed faecal incontinence, atonia and apnoea followed by an asystole. A physical examination, additional MRI studies and an autopsy indicated that the infant probably died as a consequence of local neurovascular lesions of the cervical spine or a mechanically-induced respiratory problem. This is the second reported case of an infant dying after forced manipulations of the neck. Until there is scientific evidence for the effectiveness and safety of forced manipulations of the vertebral column, we advise against this treatment in neonates and infants.

  13. Print vs digital the future of coexistence

    CERN Document Server

    Lee, Sul H

    2013-01-01

    Libraries are currently confronted by the challenges of managing increasing amounts of electronic information. Print vs. Digital: The Future of Coexistence presents the expert perspectives of eight of America's leading library administrators on ways to effectively manage digital flow and offers strategies to provide a level of coexistence between digital and print information. This excellent overview explores how to best balance print and electronic resources, and explores important issues such as the selection of electronic resources, improving access to digital information for a larger user

  14. Coexistence of Strategic Vertical Separation and Integration

    DEFF Research Database (Denmark)

    Jansen, Jos

    2003-01-01

    This paper gives conditions under which vertical separation is chosen by some upstream firms, while vertical integration is chosen by others in the equilibrium of a symmetric model. A vertically separating firm trades off fixed contracting costs against the strategic benefit of writing a (two......-part tariff, exclusive dealing) contract with its retailer. Coexistence emerges when more than two vertical Cournot oligopolists supply close substitutes. When vertical integration and separation coexist, welfare could be improved by reducing the number of vertically separating firms. The scope...

  15. ROBOTIC ASSISTANCE IN SPINE SURGERY

    Directory of Open Access Journals (Sweden)

    N. A. Konovalov

    2010-01-01

    Full Text Available Robotic assistance recently gains increasing popularity in spinal surgery. Robotic assistance provides higher effectiveness and safety especially in complex anatomy environment. 16 patients with degenerative disc disease were operated with robotic assistance device («SpineAssist»; MAZOR Surgical Technologies, Caesarea, Israel. The robot was used for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity. No implant-related complications were recorded.

  16. Absent cervical spine pedicle and associated congenital spinal abnormalities - a diagnostic trap in a setting of acute trauma: case report

    Directory of Open Access Journals (Sweden)

    Wildermuth Simon

    2010-11-01

    Full Text Available Abstract Background Congenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma. Case Presentation This patient presented at the emergency unit of our university hospital after a motor vehicle accident and was sent to our radiology department for imaging of the cervical spine. Initial clinical examination and plain radiographs of the cervical spine were performed but not conclusive. Additional CT of the neck helped establish the right diagnosis. Conclusion CT as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma.

  17. Absent cervical spine pedicle and associated congenital spinal abnormalities - a diagnostic trap in a setting of acute trauma: case report.

    Science.gov (United States)

    Guggenberger, Roman; Andreisek, Gustav; Scheffel, Hans; Wildermuth, Simon; Leschka, Sebastian; Stolzmann, Paul

    2010-11-09

    Congenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma. This patient presented at the emergency unit of our university hospital after a motor vehicle accident and was sent to our radiology department for imaging of the cervical spine. Initial clinical examination and plain radiographs of the cervical spine were performed but not conclusive. Additional CT of the neck helped establish the right diagnosis. CT as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma.

  18. Retropharyngeal cold abscess without Pott's spine | Singh | South ...

    African Journals Online (AJOL)

    Retropharyngeal cold abscess without Pott's spine. ... pyogenic osteomyelitis, tube‚rculosis of the spine, or external injuries caused by endoscopes ... in an adult woman without tuberculosis of the cervical spine who was managed surgically by ...

  19. Reproducibility analysis of the stability and treatment of vertebral metastatic lesions

    Directory of Open Access Journals (Sweden)

    Raphael de Rezende Pratali

    2014-09-01

    Full Text Available OBJECTIVES: To investigate the reproducibility among spine surgeons in defining the treatment of vertebral metastatic lesions, taking into account the mechanical stability of injuries. METHODS: Twenty cases of isolated vertebral metastatic lesions were presented to ten experts. Their opinion was then asked about the stability of the lesion, as well as their treatment option. RESULTS: The interobserver Kappa coefficient obtained both for stability analysis as to the decision of the treatment was poor (0.334 and 0.248, respectively. CONCLUSIONS: Poor interobserver reproducibility was observed in deciding the treatment of vertebral metastatic lesions when considering the stability of the lesions.

  20. Rare case of dual lesion: nonossifying fibroma and osteochondroma.

    Science.gov (United States)

    Grimshaw, Charles S; Zawin, Joan; Brink, David S; Greenberg, David D

    2014-05-01

    In this paper, we offer radiographic and pathologic evidence of a unique coexisting dual lesion. A 14-year-old boy presented for evaluation of a painful right knee after sustaining a twisting injury. The patient was found to have a torn anterior cruciate ligament, in addition to incidental finding of distal femoral dual lesion composed of tissue consistent with a nonossifying fibroma and an osteochondroma. To our knowledge, this is the first report in the medical literature of a dual lesion containing both an osteochondroma and nonossifying fibroma.

  1. Hospital for joint diseases participates in international spine registry Spine Tango after successful pilot study.

    Science.gov (United States)

    Röder, Christoph; Errico, Thomas J; Spivak, Jeffrey M; Murray, M; Protopsaltis, T; Lis, A; Nordin, Margareta; Bendo, John

    2012-01-01

    Spine Tango is currently the only international spine registry in existence. It was developed under the auspices of Eurospine, the Spine Society of Europe, and is hosted at the University of Bern, Switzerland. The HJD Spine Center successfully tested Spine Tango during a 3-month pilot study and has since expanded documentation activities to more surgeons. Workflow integration and dedicated research staff are key factors for such an endeavor. Participation enables benchmarking against national and international peers and outcome research and quality assurance of surgical and non-surgical treatments.

  2. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  3. The Spine of the Cosmic Web

    NARCIS (Netherlands)

    Aragón-Calvo, Miguel A.; Platen, Erwin; van de Weijgaert, Rien; Szalay, Alexander S.

    2010-01-01

    We present the SpineWeb framework for the topological analysis of the Cosmic Web and the identification of its walls, filaments, and cluster nodes. Based on the watershed segmentation of the cosmic density field, the SpineWeb method invokes the local adjacency properties of the boundaries between th

  4. Introduction to the Issue of Coexistence

    NARCIS (Netherlands)

    Kalaitzandonakes, N.; Philips, P.C.; Smyth, S.; Wesseler, J.H.H.

    2016-01-01

    In many ways, the debate about coexistence is about the future of the global food system and its capacity to meet the rapidly growing demand for food and nutrition. Since their commercial introduction in 1995 and 1996, genetically modified (GM) crops have been adopted by farmers around the world at

  5. Introduction to the Issue of Coexistence

    NARCIS (Netherlands)

    Kalaitzandonakes, N.; Philips, P.C.; Smyth, S.; Wesseler, J.H.H.

    2016-01-01

    In many ways, the debate about coexistence is about the future of the global food system and its capacity to meet the rapidly growing demand for food and nutrition. Since their commercial introduction in 1995 and 1996, genetically modified (GM) crops have been adopted by farmers around the world at

  6. Trait-based tests of coexistence mechanisms.

    Science.gov (United States)

    Adler, Peter B; Fajardo, Alex; Kleinhesselink, Andrew R; Kraft, Nathan J B

    2013-10-01

    Recent functional trait studies have shown that trait differences may favour certain species (environmental filtering) while simultaneously preventing competitive exclusion (niche partitioning). However, phenomenological trait-dispersion analyses do not identify the mechanisms that generate niche partitioning, preventing trait-based prediction of future changes in biodiversity. We argue that such predictions require linking functional traits with recognised coexistence mechanisms involving spatial or temporal environmental heterogeneity, resource partitioning and natural enemies. We first demonstrate the limitations of phenomenological approaches using simulations, and then (1) propose trait-based tests of coexistence, (2) generate hypotheses about which plant functional traits are likely to interact with particular mechanisms and (3) review the literature for evidence for these hypotheses. Theory and data suggest that all four classes of coexistence mechanisms could act on functional trait variation, but some mechanisms will be stronger and more widespread than others. The highest priority for future research is studies of interactions between environmental heterogeneity and trait variation that measure environmental variables at within-community scales and quantify species' responses to the environment in the absence of competition. Evidence that similar trait-based coexistence mechanisms operate in many ecosystems would simplify biodiversity forecasting and represent a rare victory for generality over contingency in community ecology.

  7. How variation between individuals affects species coexistence.

    Science.gov (United States)

    Hart, Simon P; Schreiber, Sebastian J; Levine, Jonathan M

    2016-08-01

    Although the effects of variation between individuals within species are traditionally ignored in studies of species coexistence, the magnitude of intraspecific variation in nature is forcing ecologists to reconsider. Compelling intuitive arguments suggest that individual variation may provide a previously unrecognised route to diversity maintenance by blurring species-level competitive differences or substituting for species-level niche differences. These arguments, which are motivating a large body of empirical work, have rarely been evaluated with quantitative theory. Here we incorporate intraspecific variation into a common model of competition and identify three pathways by which this variation affects coexistence: (1) changes in competitive dynamics because of nonlinear averaging, (2) changes in species' mean interaction strengths because of variation in underlying traits (also via nonlinear averaging) and (3) effects on stochastic demography. As a consequence of the first two mechanisms, we find that intraspecific variation in competitive ability increases the dominance of superior competitors, and intraspecific niche variation reduces species-level niche differentiation, both of which make coexistence more difficult. In addition, individual variation can exacerbate the effects of demographic stochasticity, and this further destabilises coexistence. Our work provides a theoretical foundation for emerging empirical interests in the effects of intraspecific variation on species diversity.

  8. Evidence against the use of lumbar spine radiography for low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Bosch, M.A.A.J. van den E-mail: m.a.vandenbosch@azu.nl; Hollingworth, W.; Kinmonth, A.L.; Dixon, A.K

    2004-01-01

    AIM: To review abnormalities reported on plain radiographic examination of the lumbar spine in patients referred with low back pain by general practitioners. Additionally, we evaluated and stratified the prevalence of these abnormalities by age. Finally, the diagnostic impact of lumbar spine radiography for the diagnosis of degenerative change, fracture, infection and possible tumour, was modelled. MATERIALS AND METHODS: A retrospective review of 2007 radiographic reports of patients referred with low back pain for lumbar spine radiography to a large radiology department was performed. The reports were classified into different diagnostic groups and subsequently stratified according to age. The potential diagnostic impact of lumbar spine radiography was modelled by using the prevalence of conditions studied as pre-test probabilities of disease. RESULTS: The prevalence of reported lumbar spine degeneration increased with age to 71% in patients aged 65-74 years. The overall prevalence of fracture, possible infection, possible tumour was low in our study population: 4, 0.8 and 0.7%, respectively. Fracture and possible infection showed no association with age. Possible tumour was only reported in patients older than 55 years of age. CONCLUSION: Although the prevalence of degenerative changes was high in older patients, the therapeutic consequences of diagnosing this abnormality are minor. The prevalence of possible serious conditions was very low in all age categories, which implies radiation exposure in many patients with no significant lesions.

  9. Pathophysiology of regression of synovial cysts of the lumbar spine: the 'anti-inflammatory hypothesis'.

    Science.gov (United States)

    Mattei, Tobias A; Goulart, Carlos R; McCall, Todd D

    2012-12-01

    The term 'synovial cysts' of the lumbar spine refers to cysts that arise from the zygapophyseal joint capsule of the lumbar spine. Although several cases of regression of lumbar spine synovial cysts after oral anti-inflammatory therapy as well as local steroid injection have already been reported in the literature, no study up to now has addressed the role of 'inflammation suppression' in the regression of such lesions. In fact most of the previous studies have regarded 'spontaneous rupture' as well as 'instability resolution' as the most probable explanations for such phenomenon. In this article the authors review the current experimental data about the role of cytokines and inflammation in the development of synovial cysts of the lumbar spine. Additionally with basis on both our clinical experience of regression of a synovial cyst after conservative treatment with a non-steroidal anti-inflammatory drug (Cox-2 inhibitor) as well as on the experimental data supporting the multi-factorial effects of such drugs on the lumbar facet joints, the authors hypothesize that inhibition of inflammation might play a significant role in the pathophysiology of lumbar spine synovial cysts' regression. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Sport injuries of the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Bargon, G.

    1981-03-01

    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.

  11. Accessory spine of the foramen ovale.

    Science.gov (United States)

    Skrzat, J; Walocha, J; Zawiliński, J

    2012-11-01

    The objective of this study was to provide morphometric analysis of an accessory spine that was found within the lumen of the foramen ovale, as well as to find out whether this structure could mechanically irritate the mandibular nerve. A bifid spine was perceived in the macerated skull of an adult individual. It was located in the anterior part of the left foramen ovale. The overall length of the spine was found to be 1.8 mm. The spine had a homogenous structure, and showed high levels of mineralisation. We conclude that the accessory spine did not compress the mandibular nerve, and that the foramen ovale provided enough space for passage of the nerve. In all likelihood, these structures remained in anatomical accordance without causing any neurological symptoms.

  12. Hemangiopericytomas of the spine: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Chad D. Cole

    2009-10-01

    Full Text Available We describe a rare case of a primary intracranial meningeal hemangiopericytoma (HPC with late metastasis to the cervical spine. A 36-year-old woman had a left occipital lesion that was histopathologically identified as HPC. Fourteen years after resection, the tumor recurred and was treated with radiotherapy. Three years later, CT imaging showed a large mass in the liver consistent with metastatic HPC, and MRI of the cervical spine showed an extensive lesion of the C3 vertebral body. The patient underwent C3 corpectomy with en-bloc tumor removal and follow-up radiation with no local recurrence or other spinal metastasis for the following 4 years. Regardless of the subtype of spinal HPC, complete surgical removal and radiotherapy appear to be treatment of choice.

  13. Intraosseous malignant peripheral nerve sheath tumor with focal epithelioid differentiation of the thoracic spine

    Directory of Open Access Journals (Sweden)

    Miyakoshi Naohisa

    2007-01-01

    Full Text Available The authors describe an extremely rare case with malignant peripheral nerve sheath tumor (MPNST with focal epithelioid differentiation presenting as an intraosseous lesion of the spine. A 75-year-old woman presented with progressive paraplegia caused by epidural mass arising from the posterior element of the T7 vertebra. At surgery, the lesion was noted to originate from the T7 vertebra and separate from the dura and spinal nerve roots. The patient died of tumor metastases to the lungs six months after the initial presentation. Histological diagnosis was MPNST. However, the tumor also contained cystic structures lined by epithelioid cells, requiring differentiation from synovial sarcoma. From the histological and immunohistochemical features, as well as the absence of SYT-SSX fusion gene expression, the diagnosis of MPNST with focal epithelioid differentiation was made. This is the first case report of intraosseous MPNST of the spine with a peculiar biphasic appearance.

  14. Clinical analysis of bone scanning in solitary lesion

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A rational analysis procedure for solitary lesions on whole bone scan-ning was offered. This study was undertaken to analyze retrospectively solitary le-sions which obtained final diagnose through the following aspects: (1) diagnosis ofbone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the mostpossible lesion sites indicating bone metastasis, (4) morphological analysis of solitarylesions. The results are: (1) The incidence of solitary lesions in 2465 cases on wholebone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patientswith primary malignancy. The rate of bone metastasis is 6.3% in 64 patients withoutprimary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346patients. (3) In patients with primary malignancy, the incidence of bone metastasis ofsolitary lesions is as follows respectively: bronchi cancer 36.1%(22/61); breast cancer23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18):G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant differ-ence in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) ofsolitary lesions are benign. (5) From anatomical point of view, we found the diagnos-tic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull;10.8% in other bones. There are significant differences in four groups. It is concludedthat: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) Themost possible solitary lesions indicating osseous tumor spread are at spine, pelvic andskull. (3) Special attention to "cold" and streak like lesions should be paid. (4) Aclinical analysis procedure for diagnosis of solitary lesions has been summarized outhere.``

  15. FIREARM INJURIES IN THE SPINE. EFFECTIVE STRATEGY FOR DIAGNOSIS AND TREATMENT

    OpenAIRE

    José María Jiménez-Avila; Andres Enrique Cobar-Bustamante; Mario Alberto Cahueque-Lemus; Elsa Armida Gutiérrez-Roman; Jaime Eduardo Guzmán-Pantoja

    2015-01-01

    The incidence of gunshot wounds to the spine on civilians has increased alarmingly and accounts for 13% to 17% of all traumatic spinal injuries, placing them in third place among the most frequent mechanisms. However, the management of these injuries is still controversial. At present there is little information on the management of these lesions, conservative treatment (non-surgical) being recommended in most publications. Based on the current literature, we propose a procedural protocol aim...

  16. Pigmented villonodular synovitis of the thoracic spine: case report and review of the literature

    OpenAIRE

    Arnold, Paul M.; Dunlay,Ryan P.; Haynes,Neal G.; Ossama Tawfik; Jacob Hodges

    2009-01-01

    Pigmented Villonodular Synovitis (PVNS), a lesion of the synovial tissues, is rarely found in the spine. We present a 73-year-old male with increasing lower extremity weakness and paresthesias. MRI scans revealed disc herniation and spinal cord compression at the T11-T12 and T12- L1 levels. Intraoperative exploration revealed an epidural mass originating in the T12 lamina, compressing the spinal cord at T11-T12. Pathologic examination was consistent with pigmented villonodular synovitis.Sinov...

  17. Bone tumors of the spine and sacral bone; Primaere Tumoren der Wirbelsaeule und des Sakrums

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, Juergen [Klinikum Bremen-Mitte gGmbH, Bremen (Germany). Beratungsstelle und Referenzzentrum fuer Osteoradiologie

    2010-12-15

    Bone tumors and tumorlike lesions of the spine are rare entities and may harbour diagnostic problems. In this article we discuss the epidemiology, topographic aspects, clinical and radiologic features as well as the diagnostic management of vertebral bone tumors. Entities that should be more familiar to the radiologist (i.e. osteoid osteoma, osteoblastoma, hemangioma, giant cell tumor, chordoma, aneurysmal bone cyst) are considered in more detail. (orig.)

  18. Co-existence of cutaneous leishmaniasis with pleural effusion: a case report from Iran.

    Directory of Open Access Journals (Sweden)

    Hossein Mortazavi

    2014-03-01

    Full Text Available Herein, a 12-year-old Afghan boy with chronic cutaneous leishmaniasis on the face and verrucous lesions on the body and pleural effusion suspected of having co-existent tuberculosis has been presented. The cutaneous lesions were appeared for five years before his admission. Leishman-Donovan bodies were seen in H&E (Hematoxylin and eosin slide of skin lesion specimens. The pathogenic species was proved to be Leishmania tropica using Polymerase Chain Reaction (PCR method. Purified Protein Derivative (PPD and Leishmanin Skin Test (LST were strongly positive. The patient was treated with systemic and intralesional meglumine antimoniate (Glucantime for cutaneous leishmaniasis and then with anti-tuberculosis drugs for pleural effusion. Afterwards, pleural effusion was disappeared and cutaneous leishmaniasis cured.

  19. Hemangiopericytoma of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raghvendra V Ramdasi

    2014-01-01

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

  20. Bamboo spine – X-ray findings of ankylosing spondylitis revisited

    Directory of Open Access Journals (Sweden)

    Antoinette Reinders

    2012-09-01

    Full Text Available Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine ankylosis. Typical X-ray findings are florid spondylitis (Romanus lesions, florid diskitis (Andersson lesions, early axial ankylosis, enthesitis, syndesmophytes and insufficiency fractures. Typical radiological abnormalities are pointed out on conventional X-rays and reviewed for early diagnosis and prompt treatment of patients at risk.

  1. Kinematics of the scoliotic spine as related to the normal spine.

    Science.gov (United States)

    Veldhuizen, A G; Scholten, P J

    1987-11-01

    A coupling between the lateral flexion and axial rotation as a result of the geometric arrangement of the motion segments is well known in a normal spine. The kinematic behavior of idiopathic scoliotic spines has been analyzed by means of a biomechanical model study and a radiologic study. The anteroposterior and lateral flexion radiographs of 40 patients with progressive adolescent idiopathic scoliosis were studied. In five of these patients, anteroposterior radiographs were also made with the spine in a ventrally flexed position. The kinematic behavior of a nonpathologic spine was examined by means of a three-dimensional, nonlinear geometric mathematical model of the spine. The frontal plane inclination of the facet joints in conjunction with the vertebral orientation in the sagittal plane influence the kinematic behavior in the normal spine. In a scoliotic spine, there is an axially rotated position and, in most cases, a dorsal inclination (lordotic) of the motion segments. Nevertheless, the direction of the axial rotation during lateral flexion does not differ from the direction of the axial rotation during lateral flexion in a normal spine. The existing axial rotation in idiopathic scoliosis cannot be explained on the basis of spinal kinematics. In contrast to normal spines, in scoliotic spines exists a coupling between ventral flexion or extension and axial rotation. This may be essential in the management of idiopathic scoliosis.

  2. Spatial and Working Memory Is Linked to Spine Density and Mushroom Spines.

    Directory of Open Access Journals (Sweden)

    Rasha Refaat Mahmmoud

    Full Text Available Changes in synaptic structure and efficacy including dendritic spine number and morphology have been shown to underlie neuronal activity and size. Moreover, the shapes of individual dendritic spines were proposed to correlate with their capacity for structural change. Spine numbers and morphology were reported to parallel memory formation in the rat using a water maze but, so far, there is no information on spine counts or shape in the radial arm maze (RAM, a frequently used paradigm for the evaluation of complex memory formation in the rodent.24 male Sprague-Dawley rats were divided into three groups, 8 were trained, 8 remained untrained in the RAM and 8 rats served as cage controls. Dendritic spine numbers and individual spine forms were counted in CA1, CA3 areas and dentate gyrus of hippocampus using a DIL dye method with subsequent quantification by the Neuronstudio software and the image J program.Working memory errors (WME and latency in the RAM were decreased along the training period indicating that animals performed the task. Total spine density was significantly increased following training in the RAM as compared to untrained rats and cage controls. The number of mushroom spines was significantly increased in the trained as compared to untrained and cage controls. Negative significant correlations between spine density and WME were observed in CA1 basal dendrites and in CA3 apical and basal dendrites. In addition, there was a significant negative correlation between spine density and latency in CA3 basal dendrites.The study shows that spine numbers are significantly increased in the trained group, an observation that may suggest the use of this method representing a morphological parameter for memory formation studies in the RAM. Herein, correlations between WME and latency in the RAM and spine density revealed a link between spine numbers and performance in the RAM.

  3. Thoracic spine disc-related abnormalities: longitudinal MR imaging assessment

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Charles J.; Schweitzer, Mark E.; Morrison, William B.; Parellada, Joan A. [TJUH Radiology, Philadelphia, Pennsylvania (United States); Carrino, J.A. [Department of Radiology ASB-1, Harvard Medical School, Brigham and Women' s Hospital, L1, Room 002B, 75 Francis Street, MA 02115, Boston (United States)

    2004-04-01

    To describe and characterize the temporal changes in disc-related disorders of the thoracic spine using MR imaging. A retrospective longitudinal cohort study was carried out of 40 patients with two sequential thoracic spine MR images at variable intervals. The images were assessed for baseline presence of, new incidence of and changes in disc herniation, degenerative disc disease, endplate marrow signal alteration and Schmorl nodes. The range of follow-up was 4-149 weeks. Baseline presence was: disc herniation, 10% (49/480); degenerative disc disease, 14% (66/480); endplate marrow signal alteration, 2.3% (11/480); Schmorl nodes 9.6% (46/480). Most pre-existing lesions tended to remain unchanged. Herniations showed the most change, tending to improve in 27%. New incidence was: disc herniation, 1.5% (7/480), degenerative disc disease, 2% (10/480); endplate marrow signal alteration, 1.6% (8/480); Schmorl nodes, 2.1% (10/480). Disc degeneration was first visible at an 11-week interval and once established almost never changed over many weeks to months. Endplate signal alterations (Modic changes) were uncommon. Schmorl nodes show no change from baseline for up to 2 1/2 years. All findings predominated in the lower intervertebral levels from T6 to T10. The most prevalent thoracic spine disc-related findings are degeneration and herniation. Disc herniations predominate in the lower segments and are a dynamic phenomenon. Disc degeneration can be rapidly evolving but tends to remain unchanged after occurrence. Endplate marrow signal changes were an uncommon manifestation of thoracic disc disease. Schmorl nodes showed the least change over time. (orig.)

  4. OUTCOME ANALYSIS OF POSTERIOR STABILIZATION OF THOR ACO- LUMBAR SPINE FRACTURES IN A RURAL TERTIARY CARE CEN TRE –AN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Prasanta Kumar

    2013-05-01

    Full Text Available ABSTRACT: Thirty five patient with unstable fractures of the lower thoracic and lumbar spine managed uniformly with Hartshill fixation and subla minar wiring were analyzed. On admission, 18 patients had complete neurologic deficit and 17 had incomplete lesions. The neurologic recovery and functional activities were assessed after an averag e follow up for 20.4 months. Improvement of neural function was seen in 71 % patients. Positive correlation was found between the level of injury and Frankel grades. The cord lesions tended to demo nstrate more severe neurologic deficit than cauda equina lesions. A component of dislocation to the injury also resulted in a more severe neural deficit. The complications were minor. Stable fixat ion of thoracolumbar spine fractures was helpful in decreasing hospital stay and recumbency period, the reby facilitating early rehabilitation of the spine injured patients.

  5. Coexistence and sport: the Israeli case

    Directory of Open Access Journals (Sweden)

    Yair Galily

    2013-12-01

    Full Text Available Utilizing sports and other recreational activities to foster peaceful relations and coexistence is an idea that has gained popularity in recent years, particularly in Israel. The aim of the current research is to fill a gap in the research literature on the subject of coexistence programming. The Mifalot organization conducts a program called “Get to Know Your Neighbor” in which Palestinian, Jordanian, and Israeli youth play soccer together. The program, based mainly on the participants’ love for football, is a series of activities and lessons designed to prepare children to meet and interact with youth from neighboring communities. The study examines the effects of participation in this program on the attitudes of the Palestinians, Jordanians, and Israelis toward each other.

  6. Phase coexistence in a forecasting game

    CERN Document Server

    Curty, P; Curty, Philippe; Marsili, Matteo

    2005-01-01

    Individual choices are either based on personal experience or on information provided by peers. The latter case, causes individuals to conform to the majority in their neighborhood. Such herding behavior may be very efficient in aggregating disperse private information, thereby revealing the optimal choice. However if the majority relies on herding, this mechanism may dramatically fail to aggregate correctly the information, causing the majority adopting the wrong choice. We address these issues in a simple model of interacting agents who aim at giving a correct forecast of a public variable, either seeking private information or resorting to herding. As the fraction of herders increases, the model features a phase transition beyond which a state where most agents make the correct forecast coexists with one where most of them are wrong. Simple strategic considerations suggest that indeed such a system of agents self-organizes deep in the coexistence region. There, agents tend to agree much more among themselv...

  7. Co-existence of agricultural production systems.

    Science.gov (United States)

    Jank, Bernhard; Rath, Johannes; Gaugitsch, Helmut

    2006-05-01

    Strategies and best practices for the co-existence of GM and non-GM crops need to be developed and implemented with the participation of farmers and other stakeholders. According to the principle of 'subsidiarity', decisions should be made by the lowest authority possible. When applying this concept to the case of GM crops, the affected society should determine their use and management in a regional decision-making process. Public participation is better accomplished at a lower level, and democratic deficits in decision-making on GMOs are better resolved, enabling farmers to manage or avoid GM crops. Ultimately, voluntary GMO-free zones might be a tool for sustainable co-existence and GM-free production and GMO-free zones might create a specific image for marketing regional products and services, such as tourism.

  8. Gastric schwannoma coexists with peptic ulcer perforation

    Directory of Open Access Journals (Sweden)

    Volkan İnce

    2011-09-01

    Full Text Available Gastric schwannoma is a benign neoplasm that originates from sheet of nerve cell in stomach. Differential diagnosis of gastrointestinal stromal tumors, (GISTs which have malign potential, than these tumors, which definite diagnosis is determined by histopathological and immunohistochemical methods have clinical significance due to gastric schwannomas have excellent progress after surgical resection. We presented a case of gastric schwannoma coexists with peptic ulcer perforation with guide of literature in this study.

  9. On the coexistence of reciprocity and materialism

    OpenAIRE

    Akiko Maruyama

    2007-01-01

    This paper studies the problem of the long-run preferences distribution in a large population using an evolutionary approach. Special attention is given to the investigation of the property of the mixed population equilibria, in which materialists and reciprocators coexist. Some of the players with reciprocal preference care about not only their own material payoffs but also about those of others, while the remaining ones are materialists who maximize their own material payoffs.

  10. Coexisting typical migraine in familial hemiplegic migraine.

    Science.gov (United States)

    Hansen, Jakob Møller; Thomsen, Lise Lykke; Olesen, Jes; Ashina, Messoud

    2010-02-16

    In contrast to patients with migraine with aura (MA) and migraine without aura (MO), most patients with familial hemiplegic migraine (FHM) do not report migraine-like attacks after pharmacologic provocation with glyceryl trinitrate (GTN), a donor of nitric oxide. In the present study, we examined patients with FHM without known gene mutations and hypothesized that 1) GTN would cause more migraine-like attacks in patients with FHM compared to controls, and 2) GTN would cause more migraine attacks in patients with FHM with coexisting MA or MO compared to the pure FHM phenotype. The study design was a balanced provocation study. Twenty-three patients with FHM and 11 healthy controls received a continuous IV infusion of 0.5 mug/kg/min GTN over 20 minutes. We found no difference in the incidence of migraine-like attacks comparing all patients with FHM (30%) to controls (9%) (p = 0.15). Patients with FHM with coexisting MA or MO reported more migraine attacks after GTN (55%) than patients with the pure FHM phenotype (8.3%) (p = 0.02). Compared to healthy controls, more patients with FHM with coexisting MA or MO reported migraine-like attacks than controls (p = 0.03), whereas the FHM group with the pure FHM phenotype did not (p > 0.05). Compared to patients with migraine with aura (MA) and migraine without aura (MO), patients with familial hemiplegic migraine (FHM) without known gene mutations display a reduced sensitivity to nitric oxide. A subset of patients with FHM with coexisting nonhemiplegic migraine is more sensitive than controls. These data extend our previous findings that pathophysiologic pathways in FHM may differ from those of MO and MA.

  11. Coexisting chondroblastoma and osteochondroma: a case report.

    Directory of Open Access Journals (Sweden)

    Pardiwala D

    2002-04-01

    Full Text Available The coexistence of two different types of benign cartilaginous tumours of bone in the same patient has not been reported in literature. We report a case in which a sixteen-year-old male had a benign chondroblastoma of the proximal left humerus and an osteochondroma of the distal left femur. Both originated at the same time and had a progressive increase in size with growth.

  12. The "fixateur interne" as a versatile implant for spine surgery.

    Science.gov (United States)

    Dick, W

    1987-11-01

    The "fixateur interne" is a new device for posterior spine surgery. It consists of long Schanz screws which are inserted from a posterior approach through the pedicles into the vertebral bodies, and of connecting threaded longitudinal rods, carrying mobile clamps which can be fixed in every position by nuts. The long leverarms of the Schanz screws facilitate manual reduction. They are removed at the end of operation. As the device is stable against flexion and rotation by itself, it does not act on the four-point bending principle. Thus, the fixation can be restricted to the immediately adjacent vertebrae of a lesion, leaving the rest of the spine mobile. In fracture treatment instrumentation is combined with a direct repair of the anterior loss of bone stock by a transpedicular bone grafting procedure from the same dorsal approach. This report presents and discusses 183 instrumentations in fresh fractures, posttraumatic deformities, degenerative diseases, tumors, and severe spondylolistheses. The main advantage is the short fixation area and the ease of after treatment.

  13. Primary Dural Repair in Minimally Invasive Spine Surgery

    Directory of Open Access Journals (Sweden)

    Raqeeb M. Haque

    2013-01-01

    Full Text Available We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS. Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is necessary. However, primary dural closure can be difficult due to the restricted space of MIS retractors and the availability of appropriate surgical instrumentation. Methods. We describe the use of a needle already used in the pediatric neurosurgical arena that can facilitate easier and safer closure of spinal dura through MISS retractors in two illustrative intradural cases. Results and Discussion. The primary dural closure technique is described and patient demographics are included. The instruments specifically used for the intradural closure through MIS retractor systems include (1 4-0 Surgilon braided nylon (Covidien, Dublin, Ireland with a CV-20 taper 1/2 circle, 10 mm diameter needle; (2 Scanlan (Saint Paul, MN, USA dura closure set. Conclusion. Successful primary dural repair can be performed on primary and incidental durotomies during minimally invasive spinal surgery. We describe the novel use of a 10 mm diameter needle to help surgeons safely and efficiently close the dura with more ease than previously described.

  14. Buckling collapse of the spine in childhood spinal tuberculosis.

    Science.gov (United States)

    Rajasekaran, S

    2007-07-01

    We prospectively followed 61 children under 15 years of age at the time of diagnosis to identify the risk factors for deformity progression. The children had 63 lesions and a minimum of 15 years followup. All exhibited an increase in deformity during the active disease phase, but 26 of 63 (41%) continued to progress during the quiescent phase until the growth was complete. In 21 of those 26, there was an increase in angular kyphosis with a final deformity column; the deformity was more than 100 degrees and associated with facet dislocation at multiple levels. These patients' vertebral segments above the level of destruction underwent severe sagittal rotation resulting in horizontal vertebrae with vertical growth plates, which resulted in longitudinal overgrowth of the vertebral segments. Risk factors for buckling collapse included an age of less than 7 years at the time of the disease, thoracolumbar involvement, loss of more than two vertebral bodies, and presence of radiographic spine-at-risk signs. Children at risk for buckling collapse must be carefully watched and the spine stabilized to avoid a massive increase in deformity.

  15. Emergent neutrality drives phytoplankton species coexistence

    Science.gov (United States)

    Segura, Angel M.; Calliari, Danilo; Kruk, Carla; Conde, Daniel; Bonilla, Sylvia; Fort, Hugo

    2011-01-01

    The mechanisms that drive species coexistence and community dynamics have long puzzled ecologists. Here, we explain species coexistence, size structure and diversity patterns in a phytoplankton community using a combination of four fundamental factors: organism traits, size-based constraints, hydrology and species competition. Using a ‘microscopic’ Lotka–Volterra competition (MLVC) model (i.e. with explicit recipes to compute its parameters), we provide a mechanistic explanation of species coexistence along a niche axis (i.e. organismic volume). We based our model on empirically measured quantities, minimal ecological assumptions and stochastic processes. In nature, we found aggregated patterns of species biovolume (i.e. clumps) along the volume axis and a peak in species richness. Both patterns were reproduced by the MLVC model. Observed clumps corresponded to niche zones (volumes) where species fitness was highest, or where fitness was equal among competing species. The latter implies the action of equalizing processes, which would suggest emergent neutrality as a plausible mechanism to explain community patterns. PMID:21177680

  16. Tuberous sclerosis complex coexistent with hippocampal sclerosis.

    Science.gov (United States)

    Lang, Min; Prayson, Richard A

    2016-02-01

    Tuberous sclerosis and hippocampal sclerosis are both well-defined entities associated with medically intractable epilepsy. To our knowledge, there has been only one prior case of these two pathologies being co-existent. We report a 7-month-old boy who presented with intractable seizures at 2 months of age. MRI studies showed diffuse volume loss in the brain with bilateral, multiple cortical tubers and subcortical migration abnormalities. Subependymal nodules were noted without subependymal giant cell astrocytoma. Genetic testing revealed TSC2 and PRD gene deletions. Histopathology of the hippocampus showed CA1 sclerosis marked by loss of neurons in the CA1 region. Sections from the temporal, parietal and occipital lobes showed multiple cortical tubers characterized by cortical architectural disorganization, gliosis, calcifications and increased number of large balloon cells. Focal white matter balloon cells and spongiform changes were also present. The patient underwent resection of the right fronto-parietal lobe and a subsequent resection of the right temporal, parietal and occipital lobes. The patient is free of seizures on anti-epileptic medication 69 months after surgery. Although hippocampal sclerosis is well documented to be associated with coexistent focal cortical dysplasia, the specific co-existence of cortical tubers and hippocampal sclerosis appears to be rare.

  17. Species coexistence in a changing world

    Directory of Open Access Journals (Sweden)

    Fernando eValladares

    2015-10-01

    Full Text Available The consequences of global change for the maintenance of species diversity will depend on the sum of each species responses to the environment and on the interactions among them. A wide ecological literature supports that these species-specific responses can arise from factors related to life strategies, evolutionary history and intraspecific variation, and also from environmental variation in space and time. In the light of recent advances from coexistence theory combined with mechanistic explanations of diversity maintenance, we discuss how global change drivers can influence species coexistence. We revise the importance of both competition and facilitation for understanding coexistence in different ecosystems, address the influence of phylogenetic relatedness, functional traits, phenotypic plasticity and intraspecific variability, and discuss lessons learnt from invasion ecology. While most previous studies have focused their efforts on disentangling the mechanisms that maintain the biological diversity in species-rich ecosystems such as tropical forests, grasslands and coral reefs, we argue that much can be learnt from pauci-specific communities where functional variability within each species, together with demographic and stochastic processes becomes key to understand species interactions and eventually community responses to global change.

  18. Histochemical and ultrastructural study of an elastofibroma dorsi coexisting with a high grade spindle cell sarcoma

    Directory of Open Access Journals (Sweden)

    M Alberghini

    2009-06-01

    Full Text Available Elastofibroma dorsi is a pseudotumoral fibroproliferative lesion characterized by polymorphic fiber-like deposits of elastinophilic material. Several theories have been reported explaining the pathogenesis of elastofibroma. Recent cytogenetic studies have demonstrated chromosomal instability in elastofibromas, not normally observed in non-neoplastic tissues. These chromosomal defects are commonly observed in aggressive fibromatosis too. Such clinical observations suggest a multistage pathogenetic mechanism for the onset of elastofibroma. This study, using histochemical, immunohistochemical staining techniques, and ultrastructural examination, describes the detection of an otherwise typical elastofibroma contextual to a high grade sarcoma. Hence, the coexistence of elastofibroma and high-grade sarcoma may suggest a causal link between the two pathological entities. The results obtained suggest that the coexistence of the two pathological entities is conceivably coincidental.

  19. The beneficial effect of plasmapheresis in mixed connective tissue disease with coexisting antiphospholipid syndrome.

    Science.gov (United States)

    Szodoray, P; Hajas, A; Toth, L; Szakall, S; Nakken, B; Soltesz, P; Bodolay, E

    2014-09-01

    The authors report a rare case of a female patient with mixed connective tissue disease (MCTD) with coexisting antiphospholipid syndrome (APS). Five years after the diagnosis of MCTD high concentrations of anticardiolipin (anti-CL) and anti-β2-glycoprotein (anti-β2GPI) autoantibodies were present in the patient's serum without thrombotic events. Epstein-Barr virus (EBV) reactivation provoked APS, with the clinical manifestations of livedo reticularis, digital gangrene and leg ulcers. Skin biopsy from the necrotic area showed multiple fibrin microthrombi in the superficial vessels. Corticosteroid pulse therapy, and plasma exchange in combination with synchronized cyclophosphamide was administered, which led to improvement of the digital gangrenes, while no new lesions developed. The number of CD27high plasma cells decreased, and the previous high levels of autoantibodies also normalized in the peripheral blood. In the case of MCTD with coexisting APS combination therapy, including plasmapheresis has beneficial effects.

  20. Decreased dendritic spine density and abnormal spine morphology in Fyn knockout mice

    OpenAIRE

    2011-01-01

    Fyn is a Src-family tyrosine kinase that affects long term potentiation (LTP), synapse formation, and learning and memory. Fyn is also implicated in dendritic spine formation both in vitro and in vivo. However, whether Fyn’s regulation of dendritic spine formation is brain-region specific and age-dependent is unknown. In the present study, we systematically examined whether Fyn altered dendritic spine density and morphology in the cortex and hippocampus and if these effects were age-dependent...

  1. Multi-Level 3D Printing Implant For Reconstructing Cervical Spine With Metastatic Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Li, Xiucan; Wang, Yiguo; Zhao, Yongfei; Liu, Jianheng; Xiao, Songhua; Mao, Keya

    2017-05-11

    A unique case report. A three-dimensional (3D) printing technology is proposed for reconstructing multi-level cervical spine (C2-C4) after resection of metastatic papillary thyroid carcinoma in a middle-age female patient. Papillary thyroid carcinoma is a malignant neoplasm with a relatively favorable prognosis. A metastatic lesion in multi-level cervical spine (C2-C4) destroys neurological functions and causes local instability. Radical excision of the metastasis and reconstruction of the cervical vertebrae sequence conforms with therapeutic principles, while the special-shaped multi-level upper-cervical spine requires personalized implants. 3D printing is an additive manufacturing technology that produces personalized products by accurately layering material under digital model control via a computer. Reporting of this recent technology for reconstructing multi-level cervical spine (C2-C4) is rare in the literature. Anterior-posterior surgery was performed in one stage. Radical resection of the metastatic lesion (C2-C4) and thyroid gland, along with insertion of a personalized implant manufactured by 3D printing technology, were performed to rebuild the cervical spine sequences. The porous implant was printed in Ti6AL4 V with perfect physicochemical properties and biological performance, such as biocompatibility and osteogenic activity. Finally, lateral mass screw fixation was performed via a posterior approach. Patient neurological function gradually improved after the surgery. The patient received 11/17 on the Japanese Orthopedic Association scale and ambulated with a personalized skull-neck-thorax orthosis on postoperative day 11. She received radioiodine I therapy. The plane X-rays and computed tomography revealed no implant displacement or subsidence at the 12-month follow-up mark. The presented case substantiates the use of 3D printing technology, which enables the personalization of products to solve unconventional problems in spinal surgery. 5.

  2. Dendritic spine detection using curvilinear structure detector and LDA classifier.

    Science.gov (United States)

    Zhang, Yong; Zhou, Xiaobo; Witt, Rochelle M; Sabatini, Bernardo L; Adjeroh, Donald; Wong, Stephen T C

    2007-06-01

    Dendritic spines are small, bulbous cellular compartments that carry synapses. Biologists have been studying the biochemical pathways by examining the morphological and statistical changes of the dendritic spines at the intracellular level. In this paper a novel approach is presented for automated detection of dendritic spines in neuron images. The dendritic spines are recognized as small objects of variable shape attached or detached to multiple dendritic backbones in the 2D projection of the image stack along the optical direction. We extend the curvilinear structure detector to extract the boundaries as well as the centerlines for the dendritic backbones and spines. We further build a classifier using Linear Discriminate Analysis (LDA) to classify the attached spines into valid and invalid types to improve the accuracy of the spine detection. We evaluate the proposed approach by comparing with the manual results in terms of backbone length, spine number, spine length, and spine density.

  3. Image-guided Spine Stabilization for Traumatic or Osteoporotic Spine Injury: Radiological Accuracy and Neurological Outcome

    Science.gov (United States)

    SHIMOKAWA, Nobuyuki; ABE, Junya; SATOH, Hidetoshi; ARIMA, Hironori; TAKAMI, Toshihiro

    2016-01-01

    Significant progress has been made in image-guided surgery (IGS) over the last few decades. IGS can be effectively applied to spinal instrumentation surgery. In the present study, we focused our attention on the feasibility and safety of image-guided spine stabilization for traumatic or osteoporotic spine injury. The IGS spine fixation with or without minimally invasive surgery (MIS) techniques such as percutaneous screw placement, balloon kyphoplasty (BKP), or vertebroplasty (VP) were accomplished in 80 patients with traumatic or osteoprotic spine injury between 2007 and 2015. The injured vertebral levels included the following: cervical spine, 41; thoracic spine, 22; and lumbar spine, 17. Neurological condition before and after surgery was assessed using the American Spinal Injury Association Impairment Scale (AIS). A total of 419 pedicle, lateral mass, or laminar screws were placed, and 399 screws (95.2%) were found to be placed correctly based on postoperative computed tomography scan. Although 20 screws (4.8%) were found to be unexpectedly placed incorrectly, no neural or vascular complications closely associated with screw placement were encountered. Neurological outcomes appeared to be acceptable or successful based on AIS. The IGS is a promising technique that can improve the accuracy of screw placement and reduce potential injury to critical neurovascular structures. The integration of MIS and IGS has proved feasible and safe in the treatment of traumatic or osteoporotic spine injury, although a thorough knowledge of surgical anatomy, spine biomechanics, and basic technique remain the most essential aspects for a successful surgery. PMID:27063144

  4. Research articles published by Korean spine surgeons: Scientific progress and the increase in spine surgery.

    Science.gov (United States)

    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun Jib; Kawaguchi, Yoshiharu

    2017-02-01

    There has been a marked increase in spine surgery in the 21st century, but there are no reports providing quantitative and qualitative analyses of research by Korean spine surgeons. The study goal was to assess the status of Korean spinal surgery and research. The number of spine surgeries was obtained from the Korean National Health Insurance Service. Research articles published by Korean spine surgeons were reviewed by using the Medline/PubMed online database. The number of spine surgeries in Korea increased markedly from 92,390 in 2004 to 164,291 in 2013. During the 2000-2014 period, 1982 articles were published by Korean spine surgeons. The annual number of articles increased from 20 articles in 2000 to 293 articles in 2014. There was a positive correlation between the annual spine surgery and article numbers (particles with Oxford levels of evidence 1, 2, and 3. The mean five-year impact factor (IF) for article quality was 1.79. There was no positive correlation between the annual IF and article numbers. Most articles (65.9%) were authored by neurosurgical spine surgeons. But spinal deformity-related topics were dominant among articles authored by orthopedics. The results show a clear quantitative increase in Korean spinal surgery and research over the last 15years. The lack of a correlation between annual IF and published article numbers indicate that Korean spine surgeons should endeavor to increase research value.

  5. Exercise: The Backbone of Spine Treatment

    Medline Plus

    Full Text Available Exercise: The Backbone of Spine Treatment | View Video Back About Video Struggling with Low Back Pain? Many people are surprised to learn that carefully selected exercise can actually reduce back pain. Some exercises can ...

  6. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

    Directory of Open Access Journals (Sweden)

    Şenol Kobak

    2013-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  7. A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

    Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

  8. Actin remodeling and polymerization forces control dendritic spine morphology

    OpenAIRE

    2015-01-01

    Dendritic spines are small membranous structures that protrude from the neuronal dendrite. Each spine contains a synaptic contact site that may connect its parent dendrite to the axons of neighboring neurons. Dendritic spines are markedly distinct in shape and size, and certain types of stimulation prompt spines to evolve, in fairly predictable fashion, from thin nascent morphologies to the mushroom-like shapes associated with mature spines. This striking progression is coincident with the (r...

  9. Barriers in the brain: resolving dendritic spine morphology and compartmentalization

    OpenAIRE

    2014-01-01

    Dendritic spines are micron-sized protrusions that harbor the majority of excitatory synapses in the central nervous system. The head of the spine is connected to the dendritic shaft by a 50–400 nm thin membrane tube, called the spine neck, which has been hypothesized to confine biochemical and electric signals within the spine compartment. Such compartmentalization could minimize interspinal crosstalk and thereby support spine-specific synapse plasticity. However, to what extent compartmenta...

  10. Trichotillomania and Dermatitis Artefacta: A Rare Coexistence

    Directory of Open Access Journals (Sweden)

    Neeraj Varyani

    2012-01-01

    Full Text Available A 24-year-old pregnant female patient presented with complains of bilateral lower limb swelling and fever for 1 month. On examination, blood pressure was 144/94 mmHg along with pitting pedal edema. She had bizarre skin lesions, aligned longitudinally and distributed over the approachable site of the body with tapering ends and in various stages of healing. Lower limbs examination also revealed similar lesions with signs of cellulitis. Her scalp had short and distorted hair suggesting pulling and plucking. These skin lesions and the denial of self-infliction by the patient made us reach the diagnosis of dermatitis artefacta with trichotillomania. Psychotherapy was advocated along with conservative management of skin lesions. The patient improved and is under our follow up.

  11. Aneurysms of Peripancreatic Arterial Arcades Coexisting with Celiac Trunk Stenosis or Occlusion: Single Institution Experience.

    Science.gov (United States)

    Antoniak, Robert; Grabowska-Derlatka, Laretta; Nawrot, Ireneusz; Cieszanowski, Andrzej; Rowiński, Olgierd

    2017-01-01

    Introduction. True aneurysms of peripancreatic arterial arcades (PAAAs) are rare. Most of them coexist with celiac axis stenosis/occlusion due to median arcuate ligament (MAL) compression or atherosclerosis. The aim of this study was to evaluate the cause of celiac axis lesion and characterize the anatomy of the aneurysms. These findings may have important management implications. Material and Methods. A retrospective analysis of 15 patients with true PAAAs was performed. The diagnosis was established by contrast-enhanced CT, using a 64-MDCT scanner. We evaluated the most probable cause of celiac axis lesion. Aneurysms were characterized by their number, location, size, and morphology. Location of the aneurysms was classified either as pancreaticoduodenal arteries (PDA) or as dorsal pancreatic arteries (DPA) as they may represent different collateral pathways between superior mesenteric artery and celiac trunk. Results. A total of 32 true PAAAs were identified. Celiac trunk was occluded in 12 patients and critically narrowed in 3 patients. Celiac axis lesion was categorized as secondary to MAL compression in 14 cases and due to atherosclerosis in 1 case. The most common location of the aneurysms was inferior pancreaticoduodenal arteries. Only in 1 case aneurysms involved both PDA and DPA. Conclusions. Coexistence of PAAAs with celiac axis compression as well as involvement of either PDAs or DPAs has important therapeutic implications. The uninvolved collateral pathway may be sufficient to preserve effective circulation in celiac trunk branches in case of resection or embolization of the aneurysms. However, further studies are crucial to confirm our findings.

  12. Optimized imaging of the postoperative spine.

    Science.gov (United States)

    McLellan, Anne Marie; Daniel, Simon; Corcuera-Solano, Idoia; Joshi, Vivek; Tanenbaum, Lawrence N

    2014-05-01

    Few tasks in imaging are more challenging than that of optimizing evaluations of the instrumented spine. The authors describe how applying fundamental and more advanced principles to postoperative spine computed tomography and magnetic resonance examinations mitigates the challenges associated with metal implants and significantly improves image quality and consistency. Newer and soon-to-be-available enhancements should provide improved visualization of tissues and hardware as multispectral imaging sequences continue to develop.

  13. Fine structure of synapses on dendritic spines

    Directory of Open Access Journals (Sweden)

    Michael eFrotscher

    2014-09-01

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

  14. Vertigo in patients with cervical spine dysfunction

    OpenAIRE

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

    1998-01-01

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

  15. Posteroanterior versus anteroposterior lumbar spine radiology

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-03-01

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

  16. Tophaceous gout in the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Cabot, Jonathan [Royal Adelaide Hospital, Department of Orthopaedic Surgery, Adelaide, South Australia (Australia); Mosel, Leigh; Kong, Andrew; Hayward, Mike [Flinders Medical Centre, Department of Medical Imaging, Bedford Park, South Australia (Australia)

    2005-12-01

    Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. (orig.)

  17. Computed tomography of the sellar spine

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Bonneville, J.F.; Cattin, F.; Poulignot, D.

    1983-01-01

    The authors report the CT scan findings in a case of sellar spine. This osseous spine which arises on the midline of the anterior aspect of the dorsum sellae and is directed toward the center of the sella turcica has already been described on specimens and on plain films but never on CT scans. The CT scan findings confirm the normal appearance of the surrounding structures.

  18. Tuberculous retropharyngeal abscess without cervical spine TB

    Institute of Scientific and Technical Information of China (English)

    ChandrakantPatil; RashmiKharatPatil; PrasadDeshmukh; SameerSinghal; BlendaDSouza

    2011-01-01

    Tuberculous retropharyngeal abscess is a rare presentation. It is present in adults usually due to involvement of cervical spine by tuberculosis. Retropharyngeal space usually gets involved in children due to pyogenic organisms or secondary to trauma. Here is a case of tuberculous retropharyngeal abscess in an adult female, with pulmonary tuberculosis. The patient was not having tuberculous involvement of cervical spine and was managed surgically by aspirating the retropharyngeal abscess transorally and AKT Category I.

  19. MDCT of acute subaxial cervical spine trauma: a mechanism-based approach.

    Science.gov (United States)

    Raniga, Sameer B; Menon, Venugopal; Al Muzahmi, Khamis S; Butt, Sajid

    2014-06-01

    Injuries to the spinal column are common and road traffic accidents are the commonest cause. Subaxial cervical spine (C3-C7) trauma encompasses a wide spectrum of osseous and ligamentous injuries, in addition to being frequently associated with neurological injury. Multidetector computed tomography (MDCT) is routinely performed to evaluate acute cervical spine trauma, very often as first-line imaging. MDCT provides an insight into the injury morphology, which in turn reflects the mechanics of injury. This article will review the fundamental biomechanical forces underlying the common subaxial spine injuries and resultant injury patterns or "fingerprints" on MDCT. This systematic and focused analysis enables a more accurate and rapid interpretation of cervical spine CT examinations. Mechanical considerations are important in most clinical and surgical decisions to adequately realign the spine, to prevent neurological deterioration and to facilitate appropriate stabilisation. This review will emphasise the variables on CT that affect the surgical management, as well as imaging "pearls" in differentiating "look-alike" lesions with different surgical implications. It will also enable the radiologist in writing clinically relevant CT reports of cervical spine trauma. Teaching Points • Vertebral bodies and disc bear the axial compression forces, while the ligaments bear the distraction forces.• Compressive forces result in fracture and distractive forces result in ligamentous disruption.• Bilateral facet dislocation is the most severe injury of the flexion-distraction spectrum.• Biomechanics-based CT reading will help to rapidly and accurately identify the entire spectrum of injury.• This approach also helps to differentiate look-alike injuries with different clinical implications.

  20. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  1. BIOTECHNOLOGIES AND BIOMATERIALS IN SPINE SURGERY.

    Science.gov (United States)

    Vadala', G; Russo, F; Ambrosio, L; Di Martino, A; Papalia, R; Denaro, V

    2015-01-01

    Over the past few decades, spine disorders have become a major health concern and the number of spinal surgical procedures has been rising significantly. Several biotechnologies and biomaterials are often used in spine surgery to increase the effectiveness of the treatment. In the degenerative spine, when conservative treatment is ineffective the most recommended surgical procedure is decompression followed by spinal fusion. Success rates of spine fusion extensively rely on bone grafts peculiar properties. Autograft has been considered the gold standard to achieve a solid fusion but current research is focused on the development of new biomaterials. Osteoporosis is the main cause of vertebral compression fractures that are significantly associated with pain and disability, especially in the aging population. Vertebral augmentation is a minimally invasive approach in which cement is injected into the vertebral body to stabilize the fracture. New cements are being developed in the clinical scenario with reabsorbable properties and biomechanical features more similar to the native bone. The development of disc regeneration strategies such as nucleus pulposus restoration and annulus fibrosus repair may represent a minimally invasive procedure towards regeneration rather than fusion. Therefore, biomaterials and tissue engineering are fields of growing interest among both surgeons and manufacturing companies, with a major involvement in spine surgery. This review discusses current and novel biotechnologies and biomaterial used in spine surgery employing fusion, augmentation and regeneration.

  2. The 100 most cited spine articles.

    Science.gov (United States)

    Murray, Michael R; Wang, Tianyi; Schroeder, Gregory D; Hsu, Wellington K

    2012-10-01

    Spine-related research has evolved dramatically during the last century. Significant contributions have been made by thousands of authors. A citation rank list has historically been used within a particular field to measure the importance of an article. The purpose of this article is to report on the 100 most cited articles in the field of spine. Science Citation Index Expanded was searched for citations in 27 different journals (as of 30 November 2010) chosen based on the relevance for all cited spine publications. The top 100 most cited articles were identified. Important information such as journal, date, country of origin, author, subspecialty, and level of evidence (for clinical research) were compiled. The top 100 publications ranged from 1,695 to 240 citations. Fifty-three articles were of the lumbar, 17 were of the thoracolumbar, and 15 of the cervical spine. Eighty-one of the articles were clinical and 19 were basic science in nature. Level of evidence varied for the clinical papers, however, was most commonly level IV (34 of 81 articles). Notably, the 1990-1999 decade was the most productive period with 43 of the top 100 articles published during this time. Identification of the most cited articles within the field of spine recognizes some of the most important contributions in the peer-reviewed literature. Current investigators may utilize the aspects of their work to guide and direct future spine-related research.

  3. Developmental biomechanics of the human cervical spine.

    Science.gov (United States)

    Nuckley, David J; Linders, David R; Ching, Randal P

    2013-04-05

    Head and neck injuries, the leading cause of death for children in the U.S., are difficult to diagnose, treat, and prevent because of a critical void in our understanding of the biomechanical response of the immature cervical spine. The objective of this study was to investigate the functional and failure biomechanics of the cervical spine across multiple axes of loading throughout maturation. A correlational study design was used to examine the relationships governing spinal maturation and biomechanical flexibility curves and tolerance data using a cadaver human in vitro model. Eleven human cadaver cervical spines from across the developmental spectrum (2-28 years) were dissected into segments (C1-C2, C3-C5, and C6-C7) for biomechanical testing. Non-destructive flexibility tests were performed in tension, compression, flexion, extension, lateral bending, and axial rotation. After measuring their intact biomechanical responses, each segment group was failed in different modes to measure the tissue tolerance in tension (C1-C2), compression (C3-C5), and extension (C5-C6). Classical injury patterns were observed in all of the specimens tested. Both the functional (pcervical spine throughout maturation and elucidated age, spinal level, and mode of loading specificity. These data support our understanding of the child cervical spine from a developmental perspective and facilitate the generation of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.

  4. Coexisting cranial and multiple spinal meningioma in a child-report of a case.

    Science.gov (United States)

    Shukla, Sujeet Kumar; Trivedi, Adarsh; Sharma, Vivek; Singh, Kulwant

    2011-03-01

    Von Ricklinghausen's disease is commonly associated with simultaneous cranial and spinal meningioma but these are not true meningiomas. Craniospinal meningiomas without Von Ricklinghausen's disease are very rare. We report a 13-year-old girl who presented with two episodes of right focal seizure with secondary generalisation of three year's duration, weakness of both lower limbs for 6 months, and retention of urine of three month's duration. MRI brain showed enhancing lesion in the left fronto-parietal region. MRI spine revealed enhancing intradural extramedullary lesion at D(4-5), D(9-10), and L(1-2). The tumours were excised completely in a single stage, first by craniotomy then by multi level laminectomy. On histology the spinal meningioma had predominant meningothiliomatous. We followed up for 6 months and the patient recovered with power grade 4/5 both lower limb.

  5. Spine inflammatory changes in patients with ankylosing spondylitis assessed by magnetic resonance image

    Directory of Open Access Journals (Sweden)

    A G Bochkova

    2008-01-01

    Full Text Available Objective. To develop the optimal mode of spine evaluation with magnetic resonance image (MRl in pts with ankylosing spondylitis (AS and to study relationship between MR! signs of spinal inflammatory lesions (IL, spondylitis duration and clinical features of AS activity. Material and methods. MRl was performed in 36 pts (22 male, 14 female fulfilling the modified NY criteria of AS. Median age of pis was 26 years (range 19 - 55, Median AS duration - 8 years (range 1,8 - 24. 34 (97% pts were HLA-B27 positive. 21 (64% pts had high AS activity - median BASDAI 40 (range 10 - 77. 92% of pts had inflammatory spine pain (VAS>20 mm and 61% of pts had night pain. Median inflammatory pain duration had been defined separately for every part of the spine assessed by MRl. Median duration of axial pain was 36 months (range: 1-240. MR-scanning (Magnetom Symphony, Siemens, 1.5 T was performed inTl, T2 and T2-FS (fat signal suppression modes. IL scoring was done only in 29 pts evaluated in both sagittal and axial planes. We used two scoring methods: 1 individual IL score of the each spine element (vertebral bodies, processes, arches, zygapophyseai, costovertebral and costotransverse joints, ligaments, and 2 separate IL scoring in the vertebral bodies and posterior spinal elements in order "yes/no”. Results. 50 MRl images of different parts of the spine (8 cervical, 30 thoracic and 12 lumbar have been obtained in 36 pts. Spine IL were found in 35 pts. 26% of all IL were revealed in axial planes. 3 pts with short AS duration had IL only on axial slices (zygapophyseai lumbar joints, costotransverse joints, processes. IL were revealed more often in thoracic (average score: 7.1, than in lumbar (3.7 and cervical (2.1 spine. In most (26 from 29 pts, 90% pts IL were found in painful parts of spine. There was no IL score difference between pts(n=12 with low (BASDAI <40 and high (BASDAI>40; n=17 AS activity. Me and range were 4 (1.8-10.3 and 6 (4-16, respectively; p=0

  6. Surgical treatment of brain tumor coexisted with intracranial aneurysm--case series and review of the literature.

    Science.gov (United States)

    Zhong, Zhihong; Sun, Yuhao; Lin, Dong; Sun, Qingfang; Bian, Liuguan

    2013-10-01

    Coexistence of brain tumor and intracranial aneurysm was previously considered as an uncommon phenomenon. Actually it is not rare in neurosurgical procedures, and its incidence rate may be underestimated. Furthermore, there remains a lack of consensus regarding numerous aspects of its clinical management. We performed a retrospective study of 12 cases of coexistent brain tumor and intracranial aneurysm in our database. Then a systematic PubMed search of English-language literature published between 1970 and 2012 was carried out using the keywords: "brain tumor" and "intracranial aneurysm" in combination with "associate" or "coexist." A consensus panel of neurosurgeons, anesthetists, interventional neurologists, and intensivests reviewed this information and proposed a treatment strategy. In the majority of patients, clinical symptoms were caused by tumor growth, whereas aneurysm rupture was seen only in a few cases. Meningioma was the commonest tumor associated with aneurysm. In most patients, both lesions occurred within the adjacent area. Treatment of both pathologies in one session was performed in most patients. All of our patients were alive within the period of follow-up. Coexistence of brain tumor and intracranial aneurysm may be a coincidence. The treatment strategy should be designed according to the conditions of tumor and aneurysm, locations of both lesions, and pathologic nature of tumor.

  7. Inter-WBAN Coexistence and Interference Mitigation

    Institute of Scientific and Technical Information of China (English)

    Bin Liu; Xiaosong Zhao; Lei Zou; Chang Wen Chen

    2015-01-01

    With promising applications in e⁃health and entertainment, wireless body area networks (WBANs) have attracted the in⁃terest of both academia and industry. If WBANs are densely deployed within a small area, serious problems may arise be⁃tween the WBANs. In this paper, we discuss issues related to the coexistence of WBANs and investigate the main fac⁃tors that cause inter⁃WBAN interference. We survey inter⁃WBAN interference mitigation strategies and track recent re⁃search developments. We also discuss unresolved issues re⁃lated to inter⁃WBAN interference mitigation and propose fu⁃ture research directions.

  8. Evidence for shape coexistence in $^{98}$Mo

    CERN Document Server

    Thomas, T; Werner, V; Ahn, T; Cooper, N; Duckwitz, H; Hinton, M; Ilie, G; Jolie, J; Petkov, P; Radeck, D

    2013-01-01

    A $\\gamma\\gamma$ angular correlation experiment has been performed to investigate the low-energy states of the nucleus $^{98}$Mo. The new data, including spin assignments, multipole mixing ratios and lifetimes reveal evidence for shape coexistence and mixing in $^{98}$Mo, arising from a proton intruder configuration. This result is reproduced by a theoretical calculation within the proton-neutron interacting boson model with configuration mixing, based on microscopic energy density functional theory. The microscopic calculation indicates the importance of the proton particle-hole excitation across the Z=40 sub-shell closure and the subsequent mixing between spherical vibrational and the $\\gamma$-soft equilibrium shapes in $^{98}$Mo.

  9. Interfaces in coexisting metals and Mott insulators

    Science.gov (United States)

    Lee, Juho; Yee, Chuck-Hou

    2017-05-01

    Motivated by the direct observation of electronic phase separation in first-order Mott transitions, we model the interface between thermodynamically coexisting metals and Mott insulators. We show how to model the required slab geometry and extract the electronic spectra. We construct an effective Landau free energy and compute the variation of its parameters across the phase diagram. Finally, using a linear mixture of the density and double occupancy, we identify a natural Ising order parameter which unifies the treatment of the bandwidth and filling controlled Mott transitions.

  10. Coexisting typical migraine in familial hemiplegic migraine

    DEFF Research Database (Denmark)

    Hansen, Jakob Møller; Olesen, Jes; Ashina, Messoud

    2010-01-01

    In contrast to patients with migraine with aura (MA) and migraine without aura (MO), most patients with familial hemiplegic migraine (FHM) do not report migraine-like attacks after pharmacologic provocation with glyceryl trinitrate (GTN), a donor of nitric oxide. In the present study, we examined...... patients with FHM without known gene mutations and hypothesized that 1) GTN would cause more migraine-like attacks in patients with FHM compared to controls, and 2) GTN would cause more migraine attacks in patients with FHM with coexisting MA or MO compared to the pure FHM phenotype....

  11. Coexisting typical migraine in familial hemiplegic migraine

    DEFF Research Database (Denmark)

    Hansen, Jakob Møller; Thomsen, Lise Lykke; Olesen, Jes

    2010-01-01

    In contrast to patients with migraine with aura (MA) and migraine without aura (MO), most patients with familial hemiplegic migraine (FHM) do not report migraine-like attacks after pharmacologic provocation with glyceryl trinitrate (GTN), a donor of nitric oxide. In the present study, we examined...... patients with FHM without known gene mutations and hypothesized that 1) GTN would cause more migraine-like attacks in patients with FHM compared to controls, and 2) GTN would cause more migraine attacks in patients with FHM with coexisting MA or MO compared to the pure FHM phenotype....

  12. Frontal Fibrosing Alopecia Coexisting with Lupus Erythematosus: Poor Response to Hydroxychloroquine.

    Science.gov (United States)

    Contin, Letícia Arsie; Martins da Costa Marques, Elisa Raquel; Noriega, Leandro

    2017-01-01

    Lupus erythematosus, especially the discoid form, and lichen planopilaris may be associated and can occur in different topographies (coexistence) or in the same lesion (lupus eythematosus/lichen planus overlap syndrome). Frontal fibrosing alopecia is considered a variant form of lichen planopilaris and is characterized by frontotemporal hairline and eyebrow involvement. Of the association with lupus erythematosus we have only a few descriptions. Hydroxychloroquine and chloroquine diphosphate are antimalarial drugs described as viable treatment options for both diseases, due to an antilymphocytic effect. The association between frontal fibrosing alopecia and lupus erythematosus (discoid or systemic) is reported in this article, showing a progressive alopecia in the frontotemporal hairline despite treatment with hydroxychloroquine.

  13. Extratemporal Malignant Nerve Sheath Tumor of Facial Nerve with Coexistent Intratemporal Neurofibroma Mimicking Malignant Intratemporal Extension

    Directory of Open Access Journals (Sweden)

    Mitsuhiko Nakahira

    2015-01-01

    Full Text Available We present an extremely unusual case of an extratemporal facial nerve malignant peripheral nerve sheath tumor (MPNST arising from preexistent intratemporal neurofibroma, illustrating a difficulty in discriminating between perineural spread of the MPNST and the preexistent intratemporal neurofibroma on preoperative radiographic images. The most interesting point was that preoperative CT scan and MR images led to misinterpretation that MPNST extended proximally along the facial nerve canal. It is important to recognize that the intratemporal perineural spread of neurofibromas and MPNST share common imaging characteristics. This is the first report (to our knowledge of these 2 lesions coexisting in the facial nerve, leading to misinterpretation on preoperative images.

  14. Coexistence of esophageal blue nevus, hair follicles and basaloid sqamous carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    We present the case of a 57-year-old man who underwent esophagectomy for esophageal carcinoma found at barium meal and gastroscopic examination. He was diagnosed as esophageal basaloid squamous carcinoma (BSC) and gastric stromal tumor, which were associated with focal proliferation of melanocytes/ pigmentophages and hair follicles in esophageal mucosa. Melanocytic hyperplasia (melanocytosis) has previously been recognized as an occasional reactive lesion, which can accompany esophageal inflammation and invasive squamous carcinoma. The present case is unusual because of its hyperplasia of not only melanocytes but also hair follicles. To our knowledge, this is the first report of esophageal blue nevus and hair follicle coexisting with BSC.

  15. Minimally invasive treatment of the thoracic spine disease: completely percutaneous and hybrid approaches.

    Science.gov (United States)

    Tamburrelli, Francesco Ciro; Francesco Ciro, Tamburrelli; Scaramuzzo, Laura; Laura, Scaramuzzo; Genitiempo, Maurizio; Maurizio, Genitiempo; Proietti, Luca; Luca, Proietti

    2013-01-01

    The aim of the study was to evaluate the feasibility of a limited invasive approach for the treatment of upper thoracic spine disease. Seven patients with type-A thoracic fractures and three with tumors underwent long thoracic stabilization through a minimally invasive approach. Four patients underwent a completely percutaneous approach while the other three underwent a modified hybrid technique, a combination of percutaneous and open approach. The hybrid constructs were realized using a percutaneous approach to the spine distally to the spinal lesion and by open approach proximally. In two patients, the stabilization was extended proximally up to the cervical spine. Clinical and radiographic assessment was performed during the first year after the operation at 3, 6, and 12 months. No technically related complications were seen. The postoperative recovery was rapid even in the tumor patients with neurologic impairment. Blood loss was irrelevant. At one-year follow-up there was no loosening or breakage of the screws or failure of the implants. When technically feasible a completely percutaneous approach has to be taken in consideration; otherwise, a combined open-percutaneous approach could be planned to minimize the invasivity of a completely open approach to the thoracic spine.

  16. Right thoracic curvature in the normal spine

    Directory of Open Access Journals (Sweden)

    Masuda Keigo

    2011-01-01

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

  17. Gunshot injuries of the spine.

    Science.gov (United States)

    Jakoi, Andre; Iorio, Justin; Howell, Richard; Zampini, Jay M

    2015-09-01

    Spinal gunshot injuries (spinal GSIs) are a major cause of morbidity and mortality in both military and civilian populations. These injuries are likely to be encountered by spine care professionals in many treatment settings. A paucity of resources is available to summarize current knowledge of spinal GSI evaluation and management. The aim was to summarize the ballistics, epidemiology, evaluation, treatment, and outcomes of spinal GSI among civilian and military populations. This was a review of the current literature reporting spinal GSI management. MEDLINE (PubMed) was queried for recent studies and case reports of spinal GSI evaluation and management. Spinal GSI now comprise the third most common cause of spinal injury. Firearms that produce spinal GSI can be divided into categories of high- and low-energy depending on the initial velocity of the projectile. Neural and mechanical spinal damage varies with these types and results from several factors including direct impact, concussion waves, tissue cavitation, and thermal energy. Management of spinal GSI also depends on several factors including neurologic function and change over time, spinal stability, missile tract through the body, and concomitant injury. Surgical treatment is typically indicated for progressive neurologic changes, spinal instability, persistent cerebrospinal fluid leak, and infection. Surgical treatment for GSI affecting T12 and caudal often has a better outcome than for those cranial to T12. Surgical exploration and removal of missile fragments in the spinal canal are typically indicated for incomplete or worsening neurologic injury. Treatment of spinal GSI requires a multidisciplinary approach with the goal of maintaining or restoring spinal stability and neurologic function and minimizing complications. Concomitant injuries and complications after spinal GSI can present immediate and ongoing challenges to the medical, surgical and rehabilitative care of the patient. Copyright © 2015

  18. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    Energy Technology Data Exchange (ETDEWEB)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A. [Heidelberg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Akbar, M. [Heidelberg Univ. (Germany). Dept. of Orthopaedic Surgery and Rehabilitation Medicine

    2016-12-15

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  19. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Rimondi, Eugenio; Rossi, Giuseppe [Istituto Ortopedico Rizzoli, University of Bologna, Department of Radiology and Interventional Angiographic Radiology, Bologna (Italy); Mavrogenis, Andreas F. [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Orthopaedic Oncology Service, Bologna (Italy); Ussia, Giuseppe; Angelini, Andrea [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Ruggieri, Pietro [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Bologna (Italy)

    2011-06-15

    To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy. Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3-43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5-19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment. Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure. In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate. (orig.)

  20. Primary pleomorphic liposarcoma of the spine. Case report and review of the literature.

    Science.gov (United States)

    Morales-Codina, A M; Martín-Benlloch, J A; Corbellas Aparicio, M

    2016-01-01

    To describe a single case, the fourth ever reported, of pleomorphic liposarcoma of the spine and to undertake a review of the literature. A 60 year old male patient had a bilateral lumbosciatica over a 3 month period. Imaging tests revealed a tumor mass in L1-L3 and a fracture in L2. Also, he had a mural thrombus both in the inferior vena cava and the left renal vein. The biopsy revealed a well-differentiated liposarcoma. En bloc resection of the lesion and stabilization was carried out. Due to the condition of the patient (hemodynamic instability, wound dehiscence and infection, and hypoproteinemia), a decision was made not to subject the patient to either radiation therapy or chemotherapy. The patient was subsequently found to suffer from myopathic paraparesis and a surgical wound infection. At three months, liver metastases were evident, as well as a recurrence of the lesion. A venous thrombosis that extended from the lower iliac vein to the right atrium was observed. The patient died from type I hepatorenal syndrome. Pleomorphic liposarcoma of the spine is a rare occurrence. En bloc resection with wide margins is the treatment of choice. The use of radiotherapy in the spine is controversial. The role that should be played by chemotherapy is still unclear, although it has been employed in treatments. In spite of treatment, these tumors lead to a poor prognosis, with high rates of recurrence, metastasis, and mortality. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  1. MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, M.M. [Neuroradiology Section, Department of Radiology, University Hospital Vienna (Austria); Post, M.J.D. [Department of Radiology, Neuroradiology Section, University of Miami School of Medicine, Miami, FL (United States); Jinkins, J.R. [Neuroimaging Research, Department of Radiology, Nebraska Medical Center, Omaha, NE (United States)

    2000-08-01

    Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment. (orig.)

  2. Coexistence of primary adenocarcinoma of the lung and Tsukamurella infection: a case report and review of the literature.

    Science.gov (United States)

    Perez, Vinicio A de Jesus; Swigris, Jeffrey; Ruoss, Stephen J

    2008-06-14

    A major diagnostic challenge in the evaluation of a cavitary lung lesion is to distinguish between infectious and malignant etiologies. We present the case of an elderly man presenting with fever, hemoptysis and a left upper lobe cavitary lesion. Serial sputum cultures grew Tsukamurella pulmonis, a rare pathogen associated with cavitary pneumonia in immunocompromised patients. However, despite clinical improvement with antibiotic therapy targeted to the organism, concomitant discovery of a papillary thyroid carcinoma led to a needle biopsy of the cavitary lesion, which showed evidence of primary lung adenocarcinoma. This is the first description of Tsukamurella infection in the setting of primary lung carcinoma. The report also illustrates the potential complex nature of cavitary lesions and emphasizes the need to consider the coexistence of malignant and infectious processes in all patients, especially those with risk factors for malignancy that fail to improve on antibiotic therapy.

  3. Coexistence of primary adenocarcinoma of the lung and Tsukamurella infection: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Perez Vinicio

    2008-06-01

    Full Text Available Abstract Introduction A major diagnostic challenge in the evaluation of a cavitary lung lesion is to distinguish between infectious and malignant etiologies. Case presentation We present the case of an elderly man presenting with fever, hemoptysis and a left upper lobe cavitary lesion. Serial sputum cultures grew Tsukamurella pulmonis, a rare pathogen associated with cavitary pneumonia in immunocompromised patients. However, despite clinical improvement with antibiotic therapy targeted to the organism, concomitant discovery of a papillary thyroid carcinoma led to a needle biopsy of the cavitary lesion, which showed evidence of primary lung adenocarcinoma. Conclusion This is the first description of Tsukamurella infection in the setting of primary lung carcinoma. The report also illustrates the potential complex nature of cavitary lesions and emphasizes the need to consider the coexistence of malignant and infectious processes in all patients, especially those with risk factors for malignancy that fail to improve on antibiotic therapy.

  4. Coexistence of papillary carcinoma and Hashimoto's thyroiditis.

    Science.gov (United States)

    Matesa-Anić, Dubravka; Matesa, Neven; Dabelić, Nina; Kusić, Zvonko

    2009-03-01

    The aim of the study was to determine the incidence of coexistence of papillary carcinoma and Hashimoto's thyroiditis in cytologic material. Cytologic findings were collected from 10508 patients that underwent ultrasound-guided fine needle aspiration cytology (FNAC) of the thyroid. Hashimoto's thyroiditis was found in 2156 (20.5%) and papillary carcinoma in 269 (2.6%) of 10508 patients with FNAC, whereas both Hashimoto's thyroiditis and papillary carcinoma were present in 42 (0.4%) patients. Among patients with FNAC diagnosis of Hashimoto's thyroiditis, the prevalence of papillary carcinoma was 1.9%. Among patients with FNAC diagnosis of papillary carcinoma, the prevalence of Hashimoto's thyroiditis was 15.6%. There was no statistically significant association between the presence of papillary carcinoma and Hashimoto's thyroiditis in patients undergoing FNAC (p=0.0522). In conclusion, in a large series of patients, the incidence of Hashimoto's thyroiditis and papillary carcinoma coexistence in cytologic material was 0.4%. There was no statistically significant relationship between Hashimoto's thyroiditis and papillary carcinoma in cytologic material.

  5. Coexistence of papulonecrotic tuberculide with lichen scrofulosorum

    Directory of Open Access Journals (Sweden)

    Das Jayanta

    2010-01-01

    Full Text Available Tuberculides, the supposedly immunologic reactions to the products of dead Mycobacterium tuberculosis bacilli deposited in the skin from distant foci of tubercular infection, are presently considered to be of two types-papulonecrotic tuberculide and lichen scrofulosorum. Simultaneous occurrence of both the types in the same patient is very rare. We report the case of an adult male without any known internal tubercular focus who showed two types of skin lesions, clinically typical and histopathologically consistent with the diagnoses of papulonecrotic tuberculide and lichen scrofulosorum, occurring simultaneously. Polymerase chain reaction showed the presence of Mycobacterium tuberculosis DNA in papulonecrotic tuberculide type of lesion, and both types of lesions responded promptly to anti-tubercular drugs.

  6. Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance.

    Science.gov (United States)

    Monserrate, Andrés; Zussman, Benjamin; Ozpinar, Alp; Niranjan, Ajay; Flickinger, John C; Gerszten, Peter C

    2017-01-01

    OBJECTIVE Cone-beam CT (CBCT) image guidance technology has been widely adopted for spine radiosurgery delivery. There is relatively little experience with spine radiosurgery for intradural tumors using CBCT image guidance. This study prospectively evaluated a series of intradural spine tumors treated with radiosurgery. Patient setup accuracy for spine radiosurgery delivery using CBCT image guidance for intradural spine tumors was determined. METHODS Eighty-two patients with intradural tumors were treated and prospectively evaluated. The positioning deviations of the spine radiosurgery treatments in patients were recorded. Radiosurgery was delivered using a linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality assurance CBCTs were performed and recorded in 30 patients: before, halfway, and after the radiosurgery treatment. The positioning data and fused images of planning CT and CBCT from the treatments were analyzed to determine intrafraction patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained. RESULTS The radiosurgery procedure was successfully completed for all patients. Lesion locations included cervical (22), thoracic (17), lumbar (38), and sacral (5). Tumor histologies included schwannoma (27), neurofibromas (18), meningioma (16), hemangioblastoma (8), and ependymoma (5). The mean prescription dose was 17 Gy (range 12-27 Gy) delivered in 1-3 fractions. At the halfway point of the radiation, the translational variations and standard deviations were 0.4 ± 0.5, 0.5 ± 0.8, and 0.4 ± 0.5 mm in the lateral (x), longitudinal (y), and anteroposterior (z) directions, respectively. Similarly, the variations immediately after treatment were 0.5 ± 0.4, 0.5 ± 0.6, and 0.6 ± 0.5 mm along x, y, and z directions, respectively. The mean rotational angles were 0

  7. Dwarf with dual spinal kyphotic deformity at the cervical and dorsal spine unassociated with odontoid hypoplasia: Surgical management

    Directory of Open Access Journals (Sweden)

    Guru Dutta Satyarthee

    2016-01-01

    Full Text Available Morquio's syndrome is associated with systemic skeletal hypoplasia leading to generalized skeletal deformation. The hypoplasia of odontoid process is frequent association, which is responsible for atlantoaxial dislocation causing compressive myelopathy. However, development of sub-axial cervical kyphotic deformity unassociated with odontoid hypoplasia is extremely rare, and coexistence of dorsal kyphotic deformity is not reported in the western literature till date and represents first case. Current case is 16-year-old boy, who presented with severe kyphotic deformity of cervical spine with spastic quadriparesis. Interestingly, he also had additional asymptomatic kyphotic deformity of dorsal spine; however, odontoid proves hypoplasia was not observed. He was only symptomatic for cervical compression, accordingly surgery was planned. The patient was planned for correction of cervical kyphotic deformity under general anesthesia, underwent fourth cervical corpectomy with resection of posterior longitudinal ligament and fusion with autologous bone graft derived from right fibula, which was refashioned approximating to the width of the corpectomy size after harvesting and fixed between C3 and C5 vertebral bodies and further secured with anterior cervical plating. He tolerated surgical procedure well with improvement in power with significant reduction in spasticity. Postoperative X-ray, cervical spine revealed complete correction of kyphotic deformity cervical spine. At follow-up 6 months following surgery, he is doing well. Successful surgical correction of symptomatic cervical kyphotic deformity can be achieved utilizing anterior cervical corpectomy, autologous fibular bone graft, and anterior cervical plating.

  8. Dwarf with dual spinal kyphotic deformity at the cervical and dorsal spine unassociated with odontoid hypoplasia: Surgical management

    Science.gov (United States)

    Satyarthee, Guru Dutta; Mankotia, Dipanker Singh

    2016-01-01

    Morquio's syndrome is associated with systemic skeletal hypoplasia leading to generalized skeletal deformation. The hypoplasia of odontoid process is frequent association, which is responsible for atlantoaxial dislocation causing compressive myelopathy. However, development of sub-axial cervical kyphotic deformity unassociated with odontoid hypoplasia is extremely rare, and coexistence of dorsal kyphotic deformity is not reported in the western literature till date and represents first case. Current case is 16-year-old boy, who presented with severe kyphotic deformity of cervical spine with spastic quadriparesis. Interestingly, he also had additional asymptomatic kyphotic deformity of dorsal spine; however, odontoid proves hypoplasia was not observed. He was only symptomatic for cervical compression, accordingly surgery was planned. The patient was planned for correction of cervical kyphotic deformity under general anesthesia, underwent fourth cervical corpectomy with resection of posterior longitudinal ligament and fusion with autologous bone graft derived from right fibula, which was refashioned approximating to the width of the corpectomy size after harvesting and fixed between C3 and C5 vertebral bodies and further secured with anterior cervical plating. He tolerated surgical procedure well with improvement in power with significant reduction in spasticity. Postoperative X-ray, cervical spine revealed complete correction of kyphotic deformity cervical spine. At follow-up 6 months following surgery, he is doing well. Successful surgical correction of symptomatic cervical kyphotic deformity can be achieved utilizing anterior cervical corpectomy, autologous fibular bone graft, and anterior cervical plating. PMID:27857796

  9. Management of thoracolumbar spine trauma An overview

    Directory of Open Access Journals (Sweden)

    S Rajasekaran

    2015-01-01

    Full Text Available Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. This review provides an overview of the epidemiology, biomechanical principles, radiological and clinical evaluation, classification and management principles. Literature review of all relevant articles published in PubMed covering thoracolumbar spine fractures with or without neurologic deficit was performed. The search terms used were thoracolumbar, thoracic, lumbar, fracture, trauma and management. All relevant articles and abstracts covering thoracolumbar spine fractures with and without neurologic deficit were reviewed. Biomechanically the thoracolumbar spine is predisposed to a higher incidence of spinal injuries. Computed tomography provides adequate bony detail for assessing spinal stability while magnetic resonance imaging shows injuries to soft tissues (posterior ligamentous complex [PLC] and neurological structures. Different classification systems exist and the most recent is the AO spine knowledge forum classification of thoracolumbar trauma. Treatment includes both nonoperative and operative methods and selected based on the degree of bony injury, neurological involvement, presence of associated injuries and the integrity of the PLC. Significant advances in imaging have helped in the better understanding of thoracolumbar fractures, including information on canal morphology and injury to soft tissue structures. The ideal classification that is simple, comprehensive and guides management is still elusive. Involvement of three columns, progressive neurological deficit, significant kyphosis and canal compromise with neurological deficit are accepted indications for surgical stabilization through anterior, posterior or combined approaches.

  10. Diagnostic utility of candidate definitions for demonstrating axial spondyloarthritis on magnetic resonance imaging of the spine

    DEFF Research Database (Denmark)

    Weber, Ulrich; Zhao, Zheng; Rufibach, Kaspar

    2015-01-01

    OBJECTIVE: A recent consensus statement has suggested ≥3 corner inflammatory lesions (CILs) or several corner fatty lesions (CFLs) as candidate criteria indicative of axial spondyloarthritis (SpA) on magnetic resonance imaging (MRI) of the spine. The aim of this study was to evaluate the diagnostic...... recorded CILs and CFLs in 23 discovertebral units. We tested the diagnostic utility (mean sensitivity and specificity over 4 readers) of the cutoff for the number of lesions on spinal MRI as proposed in the literature (≥2 or ≥3 CILs and ≥6 CFLs), and we tested for possible thresholds (from ≥1 CIL or CFL...... to ≥10 CILs or CFLs) for nonradiographic axial SpA and AS patients in both cohorts. RESULTS: None of the spinal thresholds (≥2 or ≥3 CILs and ≥6 CFLs) showed clinically relevant diagnostic utility (positive likelihood ratio [LR] range 1.38-2.36) when comparing patients with nonradiographic axial Sp...

  11. The challenges of managing coexistent disorders with phenylketonuria

    DEFF Research Database (Denmark)

    MacDonald, A; Ahring, K; Almeida, M F

    2015-01-01

    INTRODUCTION: The few published case reports of co-existent disease with phenylketonuria (PKU) are mainly genetic and familial conditions from consanguineous marriages. The clinical and demographic features of 30 subjects with PKU and co-existent conditions were described in this multi-centre, re...... investigation for co-existent disorders when the clinical history is not completely consistent with PKU is essential. Integrating care of a second condition with PKU management is challenging....

  12. Physical rehabilitation in scoliotic spine injuries in children suffering from cerebral palsy

    Directory of Open Access Journals (Sweden)

    Kalogerova V.G.

    2013-06-01

    Full Text Available The results of the effectiveness of physical rehabilitation programs for children with cerebral palsy with scoliosis spinal lesion. The study involved 20 children aged 5-6 years. Diagnosis of motor function of children assessed to determine the strength endurance of back muscles and abdominals. The angle of curvature of the spine was measured on a scale Chaklin. The reaction of the cardiovascular system load was determined using a sample Shalkova and oxygen supply of the body - the breakdown of the Stange and Genchi. For improvement of lung function and cardio-respiratory systems of children are used with breath exercises and training of diving in the pool. It is established that the introduction of a game program "In the world of animals" and holding corrective exercises in the pool has a positive effect on the functional state of the spine, the cardiorespiratory system and the physical development of children.

  13. OCCULT MANUBRIOSTERNAL JOINT INJURY ASSOCIATED WITH FRACTURE OF THE THORACIC SPINE.

    Science.gov (United States)

    da Silva Herrero, Carlos Fernando Pereira; Porto, Maximiliano Aguiar; Nogueira-Barbosa, Marcello Henrique; Defino, Helton Luiz Aparecido

    2011-01-01

    The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9). This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal luxation was diagnosed. Because of recurrence of the luxation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the arthrodesis on the T7-T11 vertebral segment and maintenance of the reduction of the manubriosternal joint, which was asymptomatic during daily activities.

  14. Low cost augmented reality for training of MRI-guided needle biopsy of the spine.

    Science.gov (United States)

    George, Sandeep; Kesavadas, Thenkurussi

    2008-01-01

    In needle biopsy of the spine, an Augmented Reality (AR) image guidance system can be very effective in ensuring that while targeting the lesion with the biopsy needle, vital organs near the spine are not damaged and that the approach path is accurate. This procedure requires skill that is hard to master on patients. In this paper, we present a low cost AR based training set-up which consists of a software that uses one static single-camera tracking mechanism to locate the biopsy needle in the patient and which then augments the camera feed of the patient with virtual data providing real-time guidance to the surgeon for insertion of the biopsy needle. The setup is implemented using a phantom model consisting of a set of carefully modeled holes to simulate the needle insertion task. The lack of requirement of elaborate infrared tracking systems and high computing power makes this system very effective for educational and training purposes.

  15. Primary epidural liposarcoma of the cervical spine: Technical case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hamid Borghei-Razavi

    2015-03-01

    Full Text Available Liposarcoma is the most common soft tissue sarcoma in adults. These tumors have a high incidence of osseous metastases, with a propensity to the spine; however, primary spinal involvement is very rare. A 56-year-old female patient presented with a 4 month history of cervical pain, including radiation to both upper limbs, without radicular distribution. Magnetic resonance imaging (MRI showed an epidural lesion with gadolinium enhancement and bilateral extension into the intervertebral neural foramina (C5–C7, with spreading on the right side of the tumor into paravertebral tissue. The histopathological diagnosis was myxoid liposarcoma. To our knowledge it is the first case of primary myxoid liposarcoma of the cervical spine in the literature. Although rare, our case demonstrates that liposarcoma should be considered in the differential diagnosis of cervical tumors.

  16. Embryonic development of fin spines in Callorhinchus milii (Holocephali); implications for chondrichthyan fin spine evolution.

    Science.gov (United States)

    Jerve, Anna; Johanson, Zerina; Ahlberg, Per; Boisvert, Catherine

    2014-01-01

    Fin spines are commonly known from fossil gnathostomes (jawed vertebrates) and are usually associated with paired and unpaired fins. They are less common among extant gnathostomes, being restricted to the median fins of certain chondrichthyans (cartilaginous fish), including chimaerids (elephant sharks) and neoselachians (sharks, skates, and rays). Fin spine growth is of great interest and relevance but few studies have considered their evolution and development. We investigated the development of the fin spine of the chimaerid Callorhinchus milii using stained histological sections from a series of larval, hatchling, and adult individuals. The lamellar trunk dentine of the Callorhinchus spine first condenses within the mesenchyme, rather than at the contact surface between mesenchyme and epithelium, in a manner more comparable to dermal bone formation than to normal odontode development. Trabecular dentine forms a small component of the spine under the keel; it is covered externally with a thin layer of lamellar trunk dentine, which is difficult to distinguish in sectioned adult spines. We suggest that the distinctive characteristics of the trunk dentine may reflect an origin through co-option of developmental processes involved in dermal bone formation. Comparison with extant Squalus and a range of fossil chondrichthyans shows that Callorhinchus is more representative than Squalus of generalized chondrichthyan fin-spine architecture, highlighting its value as a developmental model organism. © 2014 Wiley Periodicals, Inc.

  17. Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns.

    Science.gov (United States)

    Nairn, Brian C; Drake, Janessa D M

    2014-10-01

    Complex motion during standing is typical in daily living and requires movement of both the thoracic and lumbar spine; however, the effects of lumbar spine posture on thoracic spine motion patterns remain unclear. Thirteen males moved to six positions involving different lumbar (neutral and flexed) and thoracic (flexed and twisted) posture combinations. The thoracic spine was partitioned into three segments and the range of motion from each posture was calculated. Electromyographical data were collected from eight muscles bilaterally. Results showed that with a flexed lumbar spine, the lower-thoracic region had 14.83 ° and 15.6 1 ° more flexion than the upper- and mid-thoracic regions, respectively. A flexed lumbar spine significantly reduced the mid-thoracic axial twist angle by 5.21 ° compared to maximum twist in the mid-thoracic region. Functional differences emerged across muscles, as low back musculature was greatest in maintaining flexed lumbar postures, while thoracic erector spinae and abdominals showed bilateral differences with greater activations to the ipsilateral side. Combined postures have been previously identified as potential injury modulators and bilateral muscle patterns can have an effect on loading pathways. Overall, changes in thoracic motion were modified by lumbar spine posture, highlighting the importance of considering a multi-segmented approach when analyzing trunk motion. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Tunable two-phase coexistence in half-doped manganites

    Indian Academy of Sciences (India)

    P Chaddah; A Banerjee

    2008-02-01

    We discuss our very interesting experimental observation that the low-temperature two-phase coexistence in half-doped manganites is multi-valued (at any field) in that we can tune the coexisting antiferromagnetic-insulating (AF-I) and the ferromagnetic-metallic (FM-M) phase fractions by following different paths in (; ) space. We have shown experimentally that the phase fraction, in this two-phase coexistence, can take continuous infinity of values. All but one of these are metastable, and two-phase coexistence is not an equilibrium state.

  19. Ghost cell lesions

    Directory of Open Access Journals (Sweden)

    E Rajesh

    2015-01-01

    Full Text Available Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.

  20. Vertebral lesion distribution in multiple myeloma - assessed by reduced-dose whole-body MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Bier, Georg; Kloth, Christopher; Schabel, Christoph; Bongers, Malte; Nikolaou, Konstantin; Horger, Marius [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-01-15

    To observe the distribution and potential distribution patterns of osteolytic and sclerotic vertebral involvement in a representative collective of multiple myeloma patients. A total of 66 consecutive patients with a diagnosis of multiple myeloma at initial diagnosis or during follow-up were examined by multidetector reduced-dose computed tomography to evaluate the distribution of bone lesions along the spine with focus on size, location, and lesion character. Confirmation of diagnosis was performed by comparison to follow-up computed tomography or magnetic resonance tomography. If >50 % of all detected malignant lesions occurred in one spinal segment, the distribution pattern was called cervical, thoracic, lumbar, or sacral, otherwise a ''mixed'' pattern was classified. Of a total number of 933 osseous spine lesions, 632 (67.7 %) were classified as malignant (98.9 % of them osteolytic) and 293 (31.5 %) as benign. The distribution pattern analysis yielded two patients (3.8 %) with a cervical, 26 (50 %) with a thoracic, 4 (7.7 %) with a lumbar, one (1.9 %) with a sacral pattern, and 19 cases (36.6 %) showed a mixed distribution pattern. Segment-wise, the mean lesion size was 6.52 ± 2.76 mm (cervical), 8.97 ± 5.43 mm (thoracic), 11.97 ± 7.11 mm (lumbar), and 17.5 ± 16.465 (sacral), whilst, related to the vertebra size, the lesion/vertebra size ratio is decreasing through the whole spine beginning from the top. Multiple myeloma bone lesions occur preferably and are larger in the thoracic and lumbar spine. Moreover, a specific distribution pattern is present in about 60 %. (orig.)

  1. Thermophysical properties of coexistent phases of plutonium

    Energy Technology Data Exchange (ETDEWEB)

    Freibert, Franz J [Los Alamos National Laboratory; Mitchell, Jeremy N [Los Alamos National Laboratory; Saleh, Tarik A [Los Alamos National Laboratory; Schwartz, Dan S [Los Alamos National Laboratory

    2009-01-01

    Plutonium is the element with the greatest number of allotropic phases. Thermally induced transformations between these phases are typically characterized by thermal hysteresis and incomplete phase reversion. With Ga substitutal in the lattice, low symmetry phases are replaced by a higher symmetry phase. However, the low temperature Martensitic phase transformation ({delta} {yields} {alpha}{prime}) in Ga stabilized {delta}-phase Pu is characterized by a region of thermal hysteresis which can reach 200 C in extent. These regions of thermal hysteresis offer a unique opportunity to study thermodynamics in inhomogeneous systems of coexistent phases. The results of thermophysical properties measured for samples of inhomogeneous unalloyed and Ga alloyed Pu will be discussed and compared with similar measurements of their single phase constituents.

  2. Thermophysical properties of coexistent phases of plutonium

    Energy Technology Data Exchange (ETDEWEB)

    Freibert, F J; Mitchell, J N; Saleh, T A; Schwartz, D S, E-mail: freibert@lanl.gov, E-mail: jeremy@lanl.gov, E-mail: tsaleh@lanl.gov, E-mail: dschwartz@lanl.gov [Nuclear Materials Science Group, Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM 87545 (United States)

    2010-03-15

    Plutonium is the element with the greatest number of allotropic phases. Thermally induced transformations between these phases are typically characterized by thermal hysteresis and incomplete phase reversion. With Ga substitutional in the lattice, low symmetry phases are replaced by a higher symmetry phase. However, the low temperature martensitic phase transformation ({delta}{yields}{alpha}') in Ga stabilized {delta}-phase Pu is characterized by a region of thermal hysteresis which can reach 200 deg. C in extent. These regions of thermal hysteresis offer a unique opportunity to study thermodynamics in inhomogeneous systems of coexistent phases. The results of thermophysical properties measured for samples of inhomogeneous unalloyed and Ga alloyed Pu will be discussed and compared with similar measurements of their single phase constituents.

  3. Limits on new forces coexisting with electromagnetism

    Energy Technology Data Exchange (ETDEWEB)

    Kloor, H.; Fischbach, E.; Talmadge, C. (Physics Department, Purdue University, West Lafayette, Indiana 47907 (United States)); Greene, G.L. (National Institute of Standards and Technology, Gaithersburg, Maryland 20899 (United States))

    1994-02-15

    We consider the limits arising from different electromagnetic systems on the existence of a possible new electromagnetic analogue of the fifth force. Although such a force may have no intrinsic connection to electromagnetism (or gravity), its effects could be manifested through various anomalies in electromagnetic systems, for appropriate values of the coupling strength and range. Our work generalizes that of Bartlett and Loegl (who considered the case of a massive vector field coexisting with massless electrodynamics) to encompass a broad class of phenomenological interactions mediated by both scalar and vector exchanges. By combining data from both gravitational and electromagnetic systems, one can eventually set limits on a new force whose range [lambda] extends from the subatomic scale ([lambda][approx]10[sup [minus]15] m) to the astrophysical scale ([lambda][approx]10[sup 12] m).

  4. Coexistence of rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Barczyńska, Tacjana Anna; Węgierska, Małgorzata; Żuchowski, Paweł; Dura, Marta; Zalewska, Joanna; Waszczak, Marzena; Jeka, Sławomir

    2015-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS - according to our best knowledge - are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

  5. Fixation-coexistence transition in spatial populations

    Science.gov (United States)

    Dall'Asta, Luca; Caccioli, Fabio; Beghè, Deborah

    2013-01-01

    Balancing selection is a special case of frequency-dependent selection that is known to be the major force for the maintenance of biodiversity and polymorphism in natural populations. In finite populations, genetic drift eventually drives the population to fixation to the detriment of biodiversity. The interplay between selection and genetic drift is much richer in spatially extended populations, where the local density of individuals can be low even in the limit of infinitely large systems. We consider the limit of low local density of individuals (strong genetic drift) that is well represented by a modified voter model. We show analytically the existence of a non-equilibrium phase transition between a region in which fixation always occurs and a coexistence phase for a one-dimensional system. We also provide a characterization of the dynamical properties of the system, in particular for what concerns the coarsening behavior and the speed of propagation of heterozygosity above the threshold.

  6. Shape coexistence: the shell model view

    Science.gov (United States)

    Poves, A.

    2016-02-01

    We shall discuss the meaning of the ‘nuclear shape’ in the laboratory frame proper to the spherical shell model. A brief historical promenade will bring us from Elliott’s SU3 breakthrough to today’s large scale shell model calculations. A section is devoted to the algebraic model which extends drastically the field of applicability of Elliot’s SU3, providing a precious heuristic guidance for the exploration of collectivity in the nuclear chart. Shape coexistence and shape mixing will be shown to occur as the result of the competition between the main actors in the nuclear dynamics; the spherical mean field, and the pairing and quadrupole-quadrupole interactions. These ideas will be illustrated with examples in magic nuclei (40Ca and 68Ni); neutron rich semi-magic (32Mg, and 64Cr); and in proton rich N = Z (72Kr).

  7. Competitive exclusion and coexistence of universal grammars.

    Science.gov (United States)

    Mitchener, W Garrett; Nowak, Martin A

    2003-01-01

    Universal grammar (UG) is a list of innate constraints that specify the set of grammars that can be learned by the child during primary language acquisition. UG of the human brain has been shaped by evolution. Evolution requires variation. Hence, we have to postulate and study variation of UG. We investigate evolutionary dynamics and language acquisition in the context of multiple UGs. We provide examples for competitive exclusion and stable coexistence of different UGs. More specific UGs admit fewer candidate grammars, and less specific UGs admit more candidate grammars. We will analyze conditions for more specific UGs to outcompete less specific UGs and vice versa. An interesting finding is that less specific UGs can resist invasion by more specific UGs if learning is more accurate. In other words, accurate learning stabilizes UGs that admit large numbers of candidate grammars.

  8. Novel trophic cascades: apex predators enable coexistence.

    Science.gov (United States)

    Wallach, Arian D; Ripple, William J; Carroll, Scott P

    2015-03-01

    Novel assemblages of native and introduced species characterize a growing proportion of ecosystems worldwide. Some introduced species have contributed to extinctions, even extinction waves, spurring widespread efforts to eradicate or control them. We propose that trophic cascade theory offers insights into why introduced species sometimes become harmful, but in other cases stably coexist with natives and offer net benefits. Large predators commonly limit populations of potentially irruptive prey and mesopredators, both native and introduced. This top-down force influences a wide range of ecosystem processes that often enhance biodiversity. We argue that many species, regardless of their origin or priors, are allies for the retention and restoration of biodiversity in top-down regulated ecosystems.

  9. Co-existence in multispecies biofilm communities

    DEFF Research Database (Denmark)

    Røder, Henriette Lyng

    each other and in understanding the key mechanisms and interactions involved. In the introduction of this thesis the most important concepts of multi-species interactions and biofilm development are explained. After this the topic changes to the various ways of examining community interactions...... of member species increases. After this, various approaches taken by different studies when investigating multispecies communities are discussed, and different techniques for studying multispecies biofilm are described. In manuscript 2, a diverse group of bacteria was co-isolated from a meat processing...... the community. The increased biofilm biomass produced by the new wrinkled variant of X. retroflexus lead to a more positive or neutral co-existence with P. amylolyticus compared to the wild type X. retroflexus. Manuscript 6 investigated how a multispecies biofilm was affected from grazing by the heterotrophic...

  10. Coexisting principles and logics of elder care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene; Eskelinen, Leena; Boll Hansen, Eigil

    2015-01-01

    Healthy and active ageing has become an ideal in Western societies. In the Nordic countries, this ideal has been supported through a policy of help to self-help in elder care since the 1980s. However, reforms inspired by New Public Management (NPM) have introduced a new policy principle of consumer......-oriented service that stresses the wishes and priorities of older people. We have studied how these two principles are applied by care workers in Denmark. Is one principle or logic replacing the other, or do they coexist? Do they create tensions between professional knowledge and the autonomy of older people......? Using neo-institutional theory and feminist care theory, we analysed the articulation of the two policy principles in interviews and their logics in observations in four local authorities. We conclude that help to self-help is the dominant principle, that it is deeply entrenched in the identity...

  11. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...... the activity of primary coronal and root lesions reliably and accurately at one examination by using the combined information obtained from a range of indicators--such as visual appearance, location of the lesion, tactile sensation during probing and gingival health....

  12. Early mesozoic coexistence of amniotes and hepadnaviridae.

    Directory of Open Access Journals (Sweden)

    Alexander Suh

    2014-12-01

    Full Text Available Hepadnaviridae are double-stranded DNA viruses that infect some species of birds and mammals. This includes humans, where hepatitis B viruses (HBVs are prevalent pathogens in considerable parts of the global population. Recently, endogenized sequences of HBVs (eHBVs have been discovered in bird genomes where they constitute direct evidence for the coexistence of these viruses and their hosts from the late Mesozoic until present. Nevertheless, virtually nothing is known about the ancient host range of this virus family in other animals. Here we report the first eHBVs from crocodilian, snake, and turtle genomes, including a turtle eHBV that endogenized >207 million years ago. This genomic "fossil" is >125 million years older than the oldest avian eHBV and provides the first direct evidence that Hepadnaviridae already existed during the Early Mesozoic. This implies that the Mesozoic fossil record of HBV infection spans three of the five major groups of land vertebrates, namely birds, crocodilians, and turtles. We show that the deep phylogenetic relationships of HBVs are largely congruent with the deep phylogeny of their amniote hosts, which suggests an ancient amniote-HBV coexistence and codivergence, at least since the Early Mesozoic. Notably, the organization of overlapping genes as well as the structure of elements involved in viral replication has remained highly conserved among HBVs along that time span, except for the presence of the X gene. We provide multiple lines of evidence that the tumor-promoting X protein of mammalian HBVs lacks a homolog in all other hepadnaviruses and propose a novel scenario for the emergence of X via segmental duplication and overprinting of pre-existing reading frames in the ancestor of mammalian HBVs. Our study reveals an unforeseen host range of prehistoric HBVs and provides novel insights into the genome evolution of hepadnaviruses throughout their long-lasting association with amniote hosts.

  13. Axial loaded MRI of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

  14. Philosophy and concepts of modern spine surgery.

    Science.gov (United States)

    José-Antonio, Soriano-Sánchez; Baabor-Aqueveque, Marcos; Silva-Morales, Francisco

    2011-01-01

    The main goal of improving pain and neurological deficit in the practice of spine surgery is changing for a more ambitious goal, namely to improve the overall quality of life and the future of patients through three major actions (1) preserving the vertebral anatomical structures; (2) preserving the paravertebral anatomical structures; and (3) preserving the functionality of the segment. Thus, three new concepts have emerged (a) minimal surgery; (b) minimal access surgery; and (c) motion preservation surgery. These concepts are covered in a new term, minimally invasive spine surgery (MISS) The term "MISS" is not about one or several particular surgical techniques, but a new way of thinking, a new philosophy. Although the development of minimally invasive spine surgery is recent, its application includes all spine segments and almost all the existing conditions, including deformities.Evidence-based medicine (EBM), a term coined by Alvan Feinstein in the 1960s (Feinstein A (1964) Annals of Internal Medicine 61: 564-579; Feinstein A (1964) Annals of Internal Medicine 61: 757-781; Feinstein A (1964) Annals of Internal Medicine 61: 944-965; Feinstein A (1964) Annals of Internal Medicine 61: 1162-1193.), emphasizes the possibility of combining art and science following the strict application of scientific methods in the treatment of patients (Feinstein A (1964) Annals of Internal Medicine 61: 944-965; Feinstein A (1964) Annals of Internal Medicine 61: 1162-1193.), which may represent the advantages of objectivity and rationality in the use of different treatments (Fig. 11). However, EBM has many obvious defects, especially in spine surgery it is almost impossible to develop double-blind protocols (Andersson G, Bridwell K, Danielsson A, et al (2007) Spine 32: S64-S65.). In most cases, the only evidence one can find in the literature is the lack of evidence (Resnick D (2007) Spine 32:S15-S19.), however, the lack of evidence does not mean its absence. Only then, with a

  15. Intrawound Vancomycin Powder for Spine Tumor Surgery.

    Science.gov (United States)

    Okafor, Richard; Molinari, William; Molinari, Robert; Mesfin, Addisu

    2016-05-01

    Study Design Retrospective evaluation of prospectively collected data. Objective To evaluate infection rates following intrawound vancomycin powder application during spine tumor surgery. Methods Patients ≥18 years old undergoing spine tumor surgery and receiving intrawound vancomycin powder at a single center between January 2008 and January 2015 were enrolled. Patient demographics (age, sex, body mass index [BMI]), tumor type (metastatic, primary) and location, surgical data (estimated blood loss [EBL], levels fused, type of decompression, length of surgery and hospitalization, discharge status from hospital), radiation therapy use, and infection rates (surgery to a minimum of 30 days postoperative) were evaluated. Results Forty patients (46 procedures) undergoing spine tumor surgery and intrawound vancomycin powder application were identified. Five were excluded because of death less than 30 days postoperatively, and 35 patients (41 procedures) were enrolled: 11 women and 24 men with an average age of 61.4 years (range 19 to 92) and average BMI of 27.3 (range 17.4 to 36.8). Three cases were primary spine tumors. Five were hematologic malignancies, and 27 were metastatic cancers. Twenty-one tumors were in the thoracic spine, 12 in the lumbar spine, and 8 in the cervical spine. Average EBL was 899 mL (range 25 to 3,500), average length of surgery was 241 minutes (range 78 to 495), and average hospital stay was 15.1 days (range 3 to 49). Two culture-proven infections (Staphylococcus aureus, Enterobacter cloacae) were noted in 41 procedures (4.9%). Ten patients (28.6%) had preoperative radiation only; 14 (40%) had postoperative radiation only, 5 (14.3%) had both preoperative and postoperative radiation, and 6 (17.1%) had no radiation. There were no associations between radiation treatment and postsurgical infections (p = 0.19). Conclusion In this first study evaluating intrawound vancomycin powder for spine tumor surgery, we report an infection rate

  16. Cervical Spine Axial Rotation Goniometer Design

    Directory of Open Access Journals (Sweden)

    Emin Ulaş Erdem

    2012-06-01

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

  17. A brain-spine interface alleviating gait deficits after spinal cord injury in primates.

    Science.gov (United States)

    Capogrosso, Marco; Milekovic, Tomislav; Borton, David; Wagner, Fabien; Moraud, Eduardo Martin; Mignardot, Jean-Baptiste; Buse, Nicolas; Gandar, Jerome; Barraud, Quentin; Xing, David; Rey, Elodie; Duis, Simone; Jianzhong, Yang; Ko, Wai Kin D; Li, Qin; Detemple, Peter; Denison, Tim; Micera, Silvestro; Bezard, Erwan; Bloch, Jocelyne; Courtine, Grégoire

    2016-11-10

    Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis. Theoretically, this strategy could also restore control over leg muscle activity for walking. However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges. Recently, it was shown in rats that epidural electrical stimulation of the lumbar spinal cord can reproduce the natural activation of synergistic muscle groups producing locomotion. Here we interface leg motor cortex activity with epidural electrical stimulation protocols to establish a brain-spine interface that alleviated gait deficits after a spinal cord injury in non-human primates. Rhesus monkeys (Macaca mulatta) were implanted with an intracortical microelectrode array in the leg area of the motor cortex and with a spinal cord stimulation system composed of a spatially selective epidural implant and a pulse generator with real-time triggering capabilities. We designed and implemented wireless control systems that linked online neural decoding of extension and flexion motor states with stimulation protocols promoting these movements. These systems allowed the monkeys to behave freely without any restrictions or constraining tethered electronics. After validation of the brain-spine interface in intact (uninjured) monkeys, we performed a unilateral corticospinal tract lesion at the thoracic level. As early as six days post-injury and without prior training of the monkeys, the brain-spine interface restored weight-bearing locomotion of the paralysed leg on a treadmill and overground. The implantable components integrated in the brain-spine interface have all been approved for

  18. Multifocal hemangioendothelioma of the lumbar spine and response to surgical resection and radiation.

    Science.gov (United States)

    Kelahan, Linda C; Sandhu, Faheem A; Sayah, Anousheh

    2015-11-01

    Epithelioid hemangioendothelioma rarely occurs in the lumbosacral spine, with very few case reports of spinal hemangioendothelioma in the literature. There is variability in aggressiveness of these lesions without established treatment guidelines. The aim was to present a case of epithelioid hemangioendothelioma in the lumbar spine, including magnetic resonance imaging (MRI) findings, which rapidly progressed over a 2-month period as regional multifocal lumbosacral spinal lesions with epidural extension causing severe spinal canal stenosis. This was a case report in a university hospital setting. The sample included an otherwise healthy adult male with low back pain. Multimodality imaging was performed to help with diagnosis and management including computed tomography, MRI, and positron emission tomography (PET). The patient was treated by embolization, L5 corpectomy and L4-S1 stabilization, and radiation therapy. The diagnosis was confirmed by tissue biopsy. The patient initially presented with severe back and leg pain after a vertebroplasty for an L5 compression fracture at an outside hospital where biopsy was negative for malignancy. Magnetic resonance imaging showed diffuse abnormality of L5 with several smaller lesions in the sacrum. Due to progressive pain 2 weeks after the vertebroplasty, the patient underwent an L5 laminectomy, L4-S1 instrumented posterior fusion, and attempted partial corpectomy for stenosis. At this surgery, the L5 corpectomy was aborted owing to profound bleeding. Pathology was again negative for malignancy. Presumed to be an atypical hemangioma, the lesion was embolized before repeat surgery where the thecal sac was decompressed by partial L5 corpectomy. Biopsy at this time revealed a vascular neoplasm, with hemangioendothelioma not excluded. Approximately 2 months after the stabilization procedure, the patient had increasing pain and bilateral lower extremity weakness. Magnetic resonance imaging was performed and demonstrated marked

  19. Actin Remodeling and Polymerization Forces Control Dendritic Spine Morphology

    CERN Document Server

    Miermans, Karsten; Storm, Cornelis; Hoogenraad, Casper

    2015-01-01

    Dendritic spines are small membranous structures that protrude from the neuronal dendrite. Each spine contains a synaptic contact site that may connect its parent dendrite to the axons of neighboring neurons. Dendritic spines are markedly distinct in shape and size, and certain types of stimulation prompt spines to evolve, in fairly predictable fashion, from thin nascent morphologies to the mushroom-like shapes associated with mature spines. This striking progression is coincident with the (re)configuration of the neuronal network during early development, learning and memory formation, and has been conjectured to be part of the machinery that encodes these processes at the scale of individual neuronal connections. It is well established that the structural plasticity of spines is strongly dependent upon the actin cytoskeleton inside the spine. A general framework that details the precise role of actin in directing the transitions between the various spine shapes is lacking. We address this issue, and present...

  20. Degenerative Changes in the Spine: Is This Arthritis?

    Science.gov (United States)

    ... in my spine. Does this mean I have arthritis? Answers from April Chang-Miller, M.D. Yes. ... spine. Osteoarthritis is the most common form of arthritis. Doctors may also refer to it as degenerative ...

  1. Conspicuous carotenoid-based pelvic spine ornament in three-spined stickleback populations—occurrence and inheritance

    Directory of Open Access Journals (Sweden)

    CR Amundsen

    2015-04-01

    Full Text Available Reports on reddish carotenoid-based ornaments in female three-spined sticklebacks (Gasterosteus aculeatus are few, despite the large interest in the species’ behaviour, ornamentation, morphology and evolution. We sampled sticklebacks from 17 sites in north-western Europe in this first extensive study on the occurrence of carotenoid-based female pelvic spines and throat ornaments. The field results showed that females, and males, with reddish spines were found in all 17 populations. Specimens of both sexes with conspicuous red spines were found in several of the sites. The pelvic spines of males were more intensely red compared to the females’ spines, and large specimens were more red than small ones. Fish infected with the tapeworm (Schistocephalus solidus had drabber spines than uninfected fish. Both sexes had red spines both during and after the spawning period, but the intensity of the red colour was more exaggerated during the spawning period. As opposed to pelvic spines, no sign of red colour at the throat was observed in any female from any of the 17 populations. A rearing experiment was carried out to estimate a potential genetic component of the pelvic spine ornament by artificial crossing and rearing of 15 family groups during a 12 months period. The results indicated that the genetic component of the red colour at the spines was low or close to zero. Although reddish pelvic spines seem common in populations of stickleback, the potential adaptive function of the reddish pelvic spines remains largely unexplained.

  2. Coexistence of meningioma and schwannoma in the same cerebellopontine angle in a patients with NF2.

    Science.gov (United States)

    Matyja, Ewa; Kunert, Przemysław; Grajkowska, Wiesława; Marchel, Andrzej

    2012-01-01

    The coexistence of schwannoma and meningioma in the same cerebellopontine angle (CPA) is uncommon. Especially, the presence of a single mixed tumour composed of demarcated or intermingled components of schwannoma and meningioma tissue is extremely rare. Such a phenomenon is mainly reported in a patient with NF2 or with history of previous irradiation. We present two cases of simultaneous occurrence of schwannoma and meningioma in the same cerebellopontine angle in young adult patients with clinical manifestation of NF2. The first patient was a 18-year-old young man who presented with bilateral CPA tumours, spinal mass lesion and multiple, small, schwannoma-like lesions of the cauda equina. Both CPA tumours was initially diagnosed as schwannomas based on preoperative MR imagings, however right CPA tumour appeared to be composed of a well-circumscribed transitional meningioma located inside schwannoma of Antoni A and B type. The second patient, a young 16-year-old boy, presented bilaterall CPA tumours as well as many meningeal tumours supratentorially and infratentorially. Two adjacent tumours in the left CPA proved to be schwannoma and meningioma. In both cases, the different neoplastic components were confirmed by histopathological and immunohistochemical studies. The possible mechanism underlying the occurrence of such coexisting tumors of different histogenesis remains unclear.

  3. Unusual cause of generalized osteolytic vertebral lesions: a case report

    Directory of Open Access Journals (Sweden)

    Nanda Sudip

    2007-06-01

    Full Text Available Abstract Background Vertebral sarcoidosis is an extremely rare form of osseous sarcoidosis. Although osseous sarcoidosis is almost always an incidental finding of sarcoidosis elsewhere in the body, vertebrae may be the primary disease site. Involvement of vertebrae is usually localized and sclerotic or lytic. Case presentation We describe a case of extensive asymptomatic vertebral involvement by sarcoid with osteolytic lesions. Making the diagnosis requires biopsy and ruling out other commoner causes of osteolytic vertebral lesions. Conclusion We report this case in the hope of expanding the knowledge of osseous sarcoidosis. Our patient was unique in that all involvement was axial with sparing of the peripheral skeleton, near absence of any other organ involvement, diffuse involvement of the whole spine and osteolytic bone lesions.

  4. 'Do not touch' lesions of the skull base.

    Science.gov (United States)

    Dobre, Mircea C; Fischbein, Nancy

    2014-08-01

    Imaging of the skull base presents many challenges due to its anatomical complexity, numerous normal variants and lack of familiarity to many radiologists. As the skull base is a region which is not amenable to physical examination and as lesions of the skull base are generally difficult to biopsy and even more difficult to operate on, the radiologist plays a major role in directing patient management via accurate image interpretation. Knowledge of the skull base should not be limited to neuroradiologists and head and neck radiologists, however, as the central skull base is routinely included in the field of view when imaging the brain, cervical spine, or head and neck with computed tomography or magnetic resonance imaging, and hence, its nuances should be familiar to general radiologists as well. We herein review the imaging findings of a subcategory of lesions of the central skull base, the 'do not touch' lesions.

  5. Spine stereotactic body radiation therapy plans: Achieving dose coverage, conformity, and dose falloff

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Linda X., E-mail: lhong0812@gmail.com [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY (United States); Shankar, Viswanathan [Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (United States); Shen, Jin [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Kuo, Hsiang-Chi [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY (United States); Mynampati, Dinesh [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Yaparpalvi, Ravindra [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY (United States); Goddard, Lee [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Basavatia, Amar; Fox, Jana; Garg, Madhur; Kalnicki, Shalom; Tomé, Wolfgang A. [Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY (United States); Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY (United States)

    2015-10-01

    We report our experience of establishing planning objectives to achieve dose coverage, conformity, and dose falloff for spine stereotactic body radiation therapy (SBRT) plans. Patients with spine lesions were treated using SBRT in our institution since September 2009. Since September 2011, we established the following planning objectives for our SBRT spine plans in addition to the cord dose constraints: (1) dose coverage—prescription dose (PD) to cover at least 95% planning target volume (PTV) and 90% PD to cover at least 99% PTV; (2) conformity index (CI)—ratio of prescription isodose volume (PIV) to the PTV < 1.2; (3) dose falloff—ratio of 50% PIV to the PTV (R{sub 50%}); (4) and maximum dose in percentage of PD at 2 cm from PTV in any direction (D{sub 2cm}) to follow Radiation Therapy Oncology Group (RTOG) 0915. We have retrospectively reviewed 66 separate spine lesions treated between September 2009 and December 2012 (31 treated before September 2011 [group 1] and 35 treated after [group 2]). The χ{sup 2} test was used to examine the difference in parameters between groups. The PTV V{sub 100%} {sub PD} ≥ 95% objective was met in 29.0% of group 1 vs 91.4% of group 2 (p < 0.01) plans. The PTV V{sub 90%} {sub PD} ≥ 99% objective was met in 38.7% of group 1 vs 88.6% of group 2 (p < 0.01) plans. Overall, 4 plans in group 1 had CI > 1.2 vs none in group 2 (p = 0.04). For D{sub 2cm}, 48.3% plans yielded a minor violation of the objectives and 16.1% a major violation for group 1, whereas 17.1% exhibited a minor violation and 2.9% a major violation for group 2 (p < 0.01). Spine SBRT plans can be improved on dose coverage, conformity, and dose falloff employing a combination of RTOG spine and lung SBRT protocol planning objectives.

  6. Paradoxical signaling regulates structural plasticity in dendritic spines

    OpenAIRE

    2016-01-01

    Transient spine enlargement (3- to 5-min timescale) is an important event associated with the structural plasticity of dendritic spines. Many of the molecular mechanisms associated with transient spine enlargement have been identified experimentally. Here, we use a systems biology approach to construct a mathematical model of biochemical signaling and actin-mediated transient spine expansion in response to calcium influx caused by NMDA receptor activation. We have identified that a key featur...

  7. 49 CFR 572.115 - Lumbar spine and pelvis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that...

  8. Low-grade osteosarcoma of the spine: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chul; Suh, Jin Suck; Kim, Myung In; Choo, Hye Jung; Huh, Yong Min [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    Low-grade osteosarcoma is not typically found in the long bone and pelvis. Most primary osteosarcomas that arise in the spine are high-grade malignancies. A low-grade osteosarcoma arising in the spine has not been previously described. We report here the clinical, radiological, and histological findings of a case of low-grade osteosarcoma that arose in the spine.

  9. Upper spine morphology in hypophosphatemic rickets and healthy controls

    DEFF Research Database (Denmark)

    Gjørup, Hans; Sonnesen, Liselotte; Beck-Nielsen, Signe S

    2014-01-01

    BACKGROUND/OBJECTIVES: The aim of this study was to describe upper spine morphology in adult patients with hypophosphatemic rickets (HR) compared with controls to assess differences in spine morphology in terms of severity of skeletal impact and to study associations between spine morphology and ...

  10. 49 CFR 572.9 - Lumbar spine, abdomen, and pelvis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis. 572.9 Section... Percentile Male § 572.9 Lumbar spine, abdomen, and pelvis. (a) The lumbar spine, abdomen, and pelvis consist... minutes after the release. (d) When the abdomen is subjected to continuously applied force in accordance...

  11. 49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section 572.19 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY...-Year-Old Child § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and pelvis...

  12. Barriers in the brain : resolving dendritic spine morphology and compartmentalization

    NARCIS (Netherlands)

    Adrian, Max; Kusters, Remy; Wierenga, Corette J; Storm, Cornelis; Hoogenraad, Casper C; Kapitein, Lukas C

    2014-01-01

    Dendritic spines are micron-sized protrusions that harbor the majority of excitatory synapses in the central nervous system. The head of the spine is connected to the dendritic shaft by a 50-400 nm thin membrane tube, called the spine neck, which has been hypothesized to confine biochemical and elec

  13. Dynamic microtubules regulate dendritic spine morphology and synaptic plasticity

    NARCIS (Netherlands)

    Jaworski, J.; Kapitein, L.C.; Montenegro Gouveia, S.; Dortland, B.R.; Wulf, P.S.; Grigoriev, I.; Camera, P.; Spangler, S.A.; Di Stefano, P.; Demmers, J.; Krugers, H.; Defilippi, P.; Akhmanova, A.; Hoogenraad, C.C.

    2009-01-01

    Dendritic spines are the major sites of excitatory synaptic input, and their morphological changes have been linked to learning and memory processes. Here, we report that growing microtubule plus ends decorated by the microtubule tip-tracking protein EB3 enter spines and can modulate spine morpholog

  14. Variation of neck muscle strength along the human cervical spine.

    Science.gov (United States)

    Oi, Nelson; Pandy, Marcus G; Myers, Barry S; Nightingale, Roger W; Chancey, Valeta Carol

    2004-11-01

    The aim of this study was to describe and explain the variation of neck muscle strength along the cervical spine. A three-dimensional model of the head-neck complex was developed to test the hypothesis that the moment-generating capacity of the neck musculature is lower in the upper cervical spine than in the lower cervical spine. The model calculations suggest that the neck muscles can protect the lower cervical spine from injury during extension and lateral bending. The maximum flexor moment developed in the lower cervical spine was 2 times higher than that developed in the upper spine. The model also predicted that the neck musculature is 30% stronger in the lower cervical spine during lateral bending. Peak compressive forces (up to 3 times body weight) were higher in the lower cervical spine. These results are consistent with the clinical finding that extension loading of the neck often leads to injuries in the upper cervical spine. Analysis of the model results showed that neck flexor strength was greater in the lower cervical spine because of the relatively large size of the sternocleidomastoid muscle. The hyoid muscles developed significant flexor moments about the joints of the upper cervical spine, as these muscles had relatively large flexor moment arms; however, this effect was offset by the action of the sternocleidomastoid, which exerted a large extensor moment in the upper spine. Lateral bending strength of the neck muscles was governed by geometry (i.e., moment arms) rather than by muscle size.

  15. Coexisting Sclerosing Angiomatoid Nodular Transformation of the Spleen with Multiple Calcifying Fibrous Pseudotumors in a Patient

    Directory of Open Access Journals (Sweden)

    Jen-Chieh Lee

    2007-01-01

    Full Text Available Primary tumor or tumor-like lesions of the spleen are rare. Among them, vascular lesions are the most common. Vascular tumor of the spleen is different from the usual hemangioma of soft tissue because the vascular structure of the spleen is unique. Sclerosing angiomatoid nodular transformation (SANT is a recently described vascular lesion of the spleen. Grossly, it is a multinodular, well-circumscribed tumor containing a hypervascular core. Microscopically, it comprises three types of vessels, and each type recapitulates the immunohistochemical characteristics of the normal vascular elements of the splenic red pulp, i.e. capillaries, sinusoids, and small veins, respectively. Because of the rarity of this entity, its actual pathogenesis is still unknown. In this study, we report a case of SANT occurring in a 43-year-old woman, in whom there were also multiple calcifying fibrous pseudotumors (CFPTs in the abdominal cavity. Both SANT and CFPT are thought to be variants of inflammatory pseudotumor. Coexistence of these two rare entities in a patient has never been reported, and this fact suggests that there might be a common mechanism contributing to the formation of these two types of lesions. [J Formos Med Assoc 2007;106(3:234-239

  16. Tumefactive Fibroinflammatory Lesion: A Diagnostic Dilemma

    Science.gov (United States)

    Jain, Promil; Sen, Rajeev; Sharma, Nisha; Bhargava, Shilpi; Singh, Virender

    2017-01-01

    Tumefactive fibroinflammatory lesions (TFLs) are rare idiopathic benign fibrosclerosing lesions that clinically simulate a malignancy. TFLs are seen more frequently in males between 10 and 74 years of age. The usual site of involvement is the head and neck region, but rarely the extremities may be involved. Coexisting fibrosclerotic processes have been reported including retroperitoneal fibrosis, sclerosing cholangitis, sclerosing mediastinal fibrosis, and orbital pseudotumors. The etiology of this poorly understood entity remains unknown. Possible suggestions include exaggerated responses or autoimmune reactions to any chronic infection. The clinical and radiological appearance of TFLs is that of malignancy, but histopathology reveals them to be a benign process broadly classified under non-neoplastic, fibroinflammatory proliferations. The treatment strategies for these lesions are not well defined and variable and include steroids, surgery, and radiotherapy either alone or in combination. TFLs, albeit not fatal, have a high recurrence rate; patients should, therefore, be kept on long-term follow-up. We describe a young female patient presenting with a rapidly developing cheek swelling, which was diagnosed histopathologically as a TFLs.

  17. Primary Langerhans cell histiocytosis (LCH in the adult cervical spine: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sang-Deok Kim, M.D.

    2017-03-01

    Full Text Available Langerhans cell histiocytosis (LCH of the spine is a common benign disease in children and adolescents that rarely affects adults. Main management of single lesion (unifocal vertebral LCH is conservative method, unless there is neurological deficit due to mass effect, surgery must be considered. This is an interesting and rare case report of the patient with LCH at C5 vertebral body who underwent fusion surgery.

  18. Two-staged operation on C2 neoplastic lesions: anterior excision and posterior stabilization.

    Science.gov (United States)

    Colak, Ahmet; Kutlay, Murat; Kibici, Kenan; Demircan, M Nusret; Akin, Osman N

    2004-07-01

    This retrospective study included eight consecutive cases with C2 vertebral body neoplastic lesions. The anterior retropharyngeal approach was used to remove the lesions and decompress the spinal cord. Spinal stabilization with occipitocervical plating in a second-stage operation makes the treatment more tolerable for patients. The object of this study was to determine the effectiveness of a two-stage operation strategy for these lesions. Eight patients were operated on via anterior retropharyngeal approach and then stabilized with occipitocervical plates posteriorly in a second sitting. All neck pain and all dysphagia problems resolved. Partial neurologic improvement was achieved in three out of four patients. No postoperative infection was seen. The retropharyngeal approach to the upper cervical spine and anterior foramen magnum lesions is an effective alternative to transoral surgery because of low complication rates. Neoplastic lesions in the upper cervical spine can safely and effectively be operated with this technique. The general medical status of patients with malignancies does not permit too long, time-consuming operations. Stabilization of the spine in a separate operation increases patient tolerability without any morbidity.

  19. Surgical site infection in posterior spine surgery

    African Journals Online (AJOL)

    2016-03-20

    Mar 20, 2016 ... Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of ... before postoperative day 5 were associated with an increase in the rate of SSI. .... Table 1: Patient characteristics and associated wound .... patients with superficial or deep surgical site infection after spinal surgery.

  20. On the controversies of spine surgery research

    NARCIS (Netherlands)

    Jacobs, W.C.H.

    1974-01-01

    This thesis is about effectiveness of surgical interventions in the spine and the value of different methodologies for providing a valid answer. In the first part five systematic reviews were performed. One reviewed cervical degenerative disc disease comparing the different anterior fusion techniqu

  1. Minimally invasive procedures on the lumbar spine

    Science.gov (United States)

    Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A

    2015-01-01

    Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

  2. Congenital spine anomalies: the closed spinal dysraphisms

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, Erin Simon [University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, PA (United States); Rossi, Andrea [G. Gaslini Children' s Hospital, Department of Radiology, Genoa (Italy)

    2015-09-15

    The term congenital spinal anomalies encompasses a wide variety of dysmorphology that occurs during early development. Familiarity with current terminology and a practical, clinico-radiologic classification system allows the radiologist to have a more complete understanding of malformations of the spine and improves accuracy of diagnosis when these entities are encountered in practice. (orig.)

  3. X-Ray parameters of lumbar spine

    Directory of Open Access Journals (Sweden)

    Otabek Ablyazov

    2012-05-01

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

  4. AOSpine subaxial cervical spine injury classification system

    NARCIS (Netherlands)

    Vaccaro, Alexander R.; Koerner, John D.; Radcliff, Kris E.; Oner, F. Cumhur; Reinhold, Maximilian; Schnake, Klaus J.; Kandziora, Frank; Fehlings, Michael G.; Dvorak, Marcel F.; Aarabi, Bizhan; Rajasekaran, Shanmuganathan; Schroeder, Gregory D.; Kepler, Christopher K.; Vialle, Luiz R.

    2016-01-01

    Purpose: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used

  5. Cervical human spine loads during traumatomechanical investigations

    NARCIS (Netherlands)

    Kallieris, D.; Rizzetti, A.; Mattern. R.; Thunnissen, J.G.M.; Philippens, M.M.G.M.

    1996-01-01

    The last decade's improvements in automotive safety resulted into a significant decrease of fatal injuries. However, due to the use of belts and airbags it can be observed that cervical spine injuries, non-severe and severe, have become more important. It seems that inertial loading of the neck by

  6. A musculoskeletal model for the lumbar spine.

    Science.gov (United States)

    Christophy, Miguel; Faruk Senan, Nur Adila; Lotz, Jeffrey C; O'Reilly, Oliver M

    2012-01-01

    A new musculoskeletal model for the lumbar spine is described in this paper. This model features a rigid pelvis and sacrum, the five lumbar vertebrae, and a rigid torso consisting of a lumped thoracic spine and ribcage. The motion of the individual lumbar vertebrae was defined as a fraction of the net lumbar movement about the three rotational degrees of freedom: flexion-extension lateral bending, and axial rotation. Additionally, the eight main muscle groups of the lumbar spine were incorporated using 238 muscle fascicles with prescriptions for the parameters in the Hill-type muscle models obtained with the help of an extensive literature survey. The features of the model include the abilities to predict joint reactions, muscle forces, and muscle activation patterns. To illustrate the capabilities of the model and validate its physiological similarity, the model's predictions for the moment arms of the muscles are shown for a range of flexion-extension motions of the lower back. The model uses the OpenSim platform and is freely available on https://www.simtk.org/home/lumbarspine to other spinal researchers interested in analyzing the kinematics of the spine. The model can also be integrated with existing OpenSim models to build more comprehensive models of the human body.

  7. Adult idiopathic scoliosis: the tethered spine.

    Science.gov (United States)

    Whyte Ferguson, Lucy

    2014-01-01

    This article reports on an observational and treatment study using three case histories to describe common patterns of muscle and fascial asymmetry in adults with idiopathic scoliosis (IS) who have significant scoliotic curvatures that were not surgically corrected and who have chronic pain. Rather than being located in the paraspinal muscles, the myofascial trigger points (TrPs) apparently responsible for the pain were located at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine. Asymmetries in these muscles appear to tether the spine in such a way that they contribute to scoliotic curvatures. Evaluation also showed that each of these individuals had major ligamentous laxity and this may also have contributed to development of scoliotic curvatures. Treatment focused on release of TrPs found to refer pain into the spine, release of related fascia, and correction of related joint dysfunction. Treatment resulted in substantial relief of longstanding chronic pain. Treatment thus validated the diagnostic hypothesis that myofascial and fascial asymmetries were to some extent responsible for pain in adults with significant scoliotic curvatures. Treatment of these patterns of TrPs and muscle and fascial asymmetries and related joint dysfunction was also effective in relieving pain in each of these individuals after they were injured in auto accidents. Treatment of myofascial TrPs and asymmetrical fascial tension along with treatment of accompanying joint dysfunction is proposed as an effective approach to treating both chronic and acute pain in adults with scoliosis that has not been surgically corrected.

  8. Cervical human spine loads during traumatomechanical investigations

    NARCIS (Netherlands)

    Kallieris, D.; Rizzetti, A.; Mattern. R.; Thunnissen, J.G.M.; Philippens, M.M.G.M.

    1996-01-01

    The last decade's improvements in automotive safety resulted into a significant decrease of fatal injuries. However, due to the use of belts and airbags it can be observed that cervical spine injuries, non-severe and severe, have become more important. It seems that inertial loading of the neck by t

  9. AOSpine subaxial cervical spine injury classification system

    NARCIS (Netherlands)

    Vaccaro, Alexander R.; Koerner, John D.; Radcliff, Kris E.; Oner, F. Cumhur|info:eu-repo/dai/nl/188615326; Reinhold, Maximilian; Schnake, Klaus J.; Kandziora, Frank; Fehlings, Michael G.; Dvorak, Marcel F.; Aarabi, Bizhan; Rajasekaran, Shanmuganathan; Schroeder, Gregory D.; Kepler, Christopher K.; Vialle, Luiz R.

    2016-01-01

    Purpose: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used f

  10. Cervical human spine loads during traumatomechanical investigations

    NARCIS (Netherlands)

    Kallieris, D.; Rizzetti, A.; Mattern. R.; Thunnissen, J.G.M.; Philippens, M.M.G.M.

    1996-01-01

    The last decade's improvements in automotive safety resulted into a significant decrease of fatal injuries. However, due to the use of belts and airbags it can be observed that cervical spine injuries, non-severe and severe, have become more important. It seems that inertial loading of the neck by t

  11. POSTERIOR STABILISATION OF BURST FRACTURES OF DORSOLUMBAR SPINE

    Directory of Open Access Journals (Sweden)

    Mukharjee

    2016-05-01

    Full Text Available BACKGROUND Injury to spinal cord and spinal column are serious injuries causing death and disability in the young adult population. Spinal injuries have the lowest functional outcomes and lowest rates of return to work after injury of all major organ system. Although the incidence is relatively small, the impact is enormous as measured in terms of catastrophic physical disability, psychological consequences, and the tremendous cost and the demands on the health care system. With advances in medical technology and the increased experience with large number of spinal injuries, the impetus for the development of programmatic approaches in the management of these devastated victims was provided. The management of spinal injuries is continuously evolving. Many different approaches exist in the treatment of these patients; the comprehensive of spinal cord injuries, multidisciplinary speciality approaches which include orthopaedic surgeon, neurosurgeon, urologist, improvement and better quality of life. METHODS Pre-Operative Evaluation: Mode of injury, fracture level, Magerl’s type, preoperative neurologic status, pain experience, sagittal index, post-operative neurologic recovery, vertebral body compression ratio, Cobb’s angle, complications and rehabilitation were studied and compared with the other studies. Pre-operative MRI was done mandatorily in each case. Surgical Procedure: Under general anaesthesia through posterior midline approach to the spine, we exposed posterior elements of vertebrae one above and one below the fractured vertebra under image intensifier control, we inserted pedicle screws into the pedicles of normal vertebra above and below the fractured vertebra. [1] By compression and distraction manoeuvres, also by gentle manipulative manoeuvres we reduced the retropulsed, translated vertebrae, to achieve near anatomical restoration. We used Cotrel-Dubousset pedicle screw instrumentation for posterior spinal fusion one level above

  12. CT imaging of coexisting pulmonary tuberculosis and lung cancer

    Institute of Scientific and Technical Information of China (English)

    吕岩

    2013-01-01

    Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer. Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination. All patients were divided into two groups,group

  13. The costs of coexistence on farms in Germany

    DEFF Research Database (Denmark)

    Punt, Maarten J.; Venus, Thomas J.; Wesseler, Justus H H

    2017-01-01

    In the European Union, freedom of choice between genetically modified (GM) and conventional or organic crops, for both producers and consumers, should be provided through coexistence measures. Coexistence measures at the farm level differ in costs and effectiveness and should not tip the balance ...

  14. Double Jeopardy for Children Who Stutter: Race and Coexisting Disorders

    Science.gov (United States)

    Blood, Gordon W.; Blood, Ingrid; Kreiger, Jennifer; O'Connor, Shelah; Qualls, Constance Dean

    2009-01-01

    The primary purpose of this study was to examine the influence of racial and ethnic backgrounds in children who stutter (CWS) with 18 specific coexisting disorders. A sample of 1,184 speech-language pathologists responded to a detailed questionnaire designed to answer questions about the type and prevalence of coexisting disorders in 2,535 CWS.…

  15. Trophic position of coexisting krill species: a stable isotope approach

    DEFF Research Database (Denmark)

    Agersted, Mette Dalgaard; Bode, Antonio; Nielsen, Torkel Gissel

    2014-01-01

    Four krill species with overlapping functional biology coexist in Greenland waters. Here, we used stable isotopes to investigate and discuss their trophic role and mode of coexistence. Bulk carbon (δ13C) and nitrogen (δ15N) stable isotope analyses of Thysanoessa longicaudata, T. inermis, T. rasch...

  16. Laser triangulation measurements of scoliotic spine curvatures.

    Science.gov (United States)

    Čelan, Dušan; Jesenšek Papež, Breda; Poredoš, Primož; Možina, Janez

    2015-01-01

    The main purpose of this research was to develop a new method for differentiating between scoliotic and healthy subjects by analysing the curvatures of their spines in the cranio-caudal view. The study included 247 subjects with physiological curvatures of the spine and 28 subjects with clinically confirmed scoliosis. The curvature of the spine was determined by a computer analysis of the surface of the back, measured with a non-invasive, 3D, laser-triangulation system. The determined spinal curve was represented in the transversal plane, which is perpendicular to the line segment that was defined by the initial point and the end point of the spinal curve. This was achieved using a rotation matrix. The distances between the extreme points in the antero-posterior (AP) and left-right (LR) views were calculated in relation to the length of the spine as well as the quotient of these two values LR/AP. All the measured parameters were compared between the scoliotic and control groups using the Student's t-Test in case of normal data and Kruskal-Wallis test in case of non-normal data. Besides, a comprehensive diagram representing the distances between the extreme points in the AP and LR views was introduced, which clearly demonstrated the direction and the size of the thoracic and lumbar spinal curvatures for each individual subject. While the distances between the extreme points of the spine in the AP view were found to differ only slightly between the groups (p = 0.1), the distances between the LR extreme points were found to be significantly greater in the scoliosis group, compared to the control group (p < 0.001). The quotient LR/AP was statistically significantly different in both groups (p < 0.001). The main innovation of the presented method is the ability to differentiate a scoliotic subject from a healthy subject by assessing the curvature of the spine in the cranio-caudal view. Therefore, the proposed method could be useful for human posture

  17. Hip-spine syndrome: A cadaveric analysis between osteoarthritis of the lumbar spine and hip joints.

    Science.gov (United States)

    Weinberg, D S; Gebhart, J J; Liu, R W

    2017-09-01

    Authors have recently proposed the concept of "hip-spine syndrome", however there exists limited evidence available to differentiate whether these concomitant arthritides are due to anatomic/structural causes, or systemic/metabolic effects. Exploring this relationship has important implications during the evaluation and treatment of both spine and hip disorders-a common clinical presentation of many patients. The purpose of this experiment was to investigate the individual contribution of hip arthritis towards the development of spine arthritis, with knee arthritis also being analyzed as a negative (systemic) control. Hip and spine arthritis are caused by both metabolic and anatomic causes. A large, well-organized osteological database was queried, and osteoarthritis of the spine, hip, and knee joints was quantified using a validated scoring criteria. Six hundred and twenty-five specimens were chosen for analysis. Multivariate linear regression models were created to quantify the independent contributions of age, gender, race, height, and arthritis of the spine and hip joints. Age was the strongest predictor of arthritis at each site (standardized betas>0.281, P<0.001 for all). Hip arthritis was a stronger predictor of spine arthritis than was knee arthritis (standardized betas 0.215 and 0.155, respectively, P<0.001 for both). Spine arthritis was also a stronger predictor of hip arthritis than was knee arthritis (standardized betas 0.232 and 0.173, P<0.001 for both). Anatomic/structural influences about the lumbosacral-pelvic junction contribute towards the development of arthritis that is separate from any systemic/metabolic effects. Surgeons performing total hip arthroplasty should remain aware of these relationships, although future research is necessary regarding optimal surgical treatment of these patients. N/A (cadaveric study). Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Estimating the probability of coexistence in cross-feeding communities.

    Science.gov (United States)

    Vessman, Björn; Gerlee, Philip; Lundh, Torbjörn

    2016-11-07

    The dynamics of many microbial ecosystems are driven by cross-feeding interactions, in which metabolites excreted by some species are metabolised further by others. The population dynamics of such ecosystems are governed by frequency-dependent selection, which allows for stable coexistence of two or more species. We have analysed a model of cross-feeding based on the replicator equation, with the aim of establishing criteria for coexistence in ecosystems containing three species, given the information of the three species' ability to coexist in their three separate pairs, i.e. the long term dynamics in the three two-species component systems. The triple-system is studied statistically and the probability of coexistence in the species triplet is computed for two models of species interactions. The interaction parameters are modelled either as stochastically independent or organised in a hierarchy where any derived metabolite carries less energy than previous nutrients in the metabolic chain. We differentiate between different modes of coexistence with respect to the pair-wise dynamics of the species, and find that the probability of coexistence is close to 12 for triplet systems with three pair-wise coexistent pairs and for the so-called intransitive systems. Systems with two and one pair-wise coexistent pairs are more likely to exist for random interaction parameters, but are on the other hand much less likely to exhibit triplet coexistence. Hence we conclude that certain species triplets are, from a statistical point of view, rare, but if allowed to interact are likely to coexist. This knowledge might be helpful when constructing synthetic microbial communities for industrial purposes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. ‘Serpent in the spine’: a case of giant spinal ependymoma of cervicothoracic spine

    Science.gov (United States)

    Arrifin, Arlizan; Kaliaperumal, Chandrasekaran; Keohane, Catherine; O'Sullivan, Michael

    2012-01-01

    We describe a case of giant spinal ependymoma of cervicothoracic spine in a 30-year-old lady who presented with progressive spastic paraparesis and significant combined upper and lower motor neuron signs in her lower limbs over a 1-year period. She also had upper limb small muscle wasting with absent reflexes and diminished sensation. She was wheel chair bound with involvement of sphincters. Neuroimaging revealed a uniformly enhancing intramedullary lesion from C2–T3 level with associated syringomyelia. She underwent a complete excision of this World Health Organisation (WHO) II cellular ependymoma, resulting in significant clinical outcome and improvement in bladder and bowel function. PMID:22739334

  20. Cervical spine osteoblastoma presenting as mechanical neck pain: a case report

    OpenAIRE

    1994-01-01

    Osteoblastoma is a benign bone-forming tumor that represents approximately 1% of all primary bone tumors. It occurs 40% of the time in the spine, most commonly in the posterior elements. The clinical presentation in this case is of chronic neck pain and stiffness. Although most lesions are well visualized on plain films, a bone scan or CT scan may be of better diagnostic value. Treatment is via surgical excision. In this report we present a case of cervical osteoblastoma mistaken for mechanic...

  1. Papillary thyroid carcinoma metastasis to the lumbar spine masquerading as a schmorl's node

    Energy Technology Data Exchange (ETDEWEB)

    Daignault, Cory P.; Palmer, Edwin L.; Scott, James A.; Swan, John S. [Dept. of Radiology, Massachusetts General Hospital, Boston (United States); Daniels, Gilbert H. [Dept. of Radiology, Division of Nuclear Medicine, UMass Memorial Medical Center, Worcester (United States)

    2015-09-15

    A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.

  2. Spine curve modeling for quantitative analysis of spinal curvature.

    Science.gov (United States)

    Hay, Ori; Hershkovitz, Israel; Rivlin, Ehud

    2009-01-01

    Spine curvature and posture are important to sustain healthy back. Incorrect spine configuration can add strain to muscles and put stress on the spine, leading to low back pain (LBP). We propose new method for analyzing spine curvature in 3D, using CT imaging. The proposed method is based on two novel concepts: the spine curvature is derived from spinal canal centerline, and evaluation of the curve is carried out against a model based on healthy individuals. We show results of curvature analysis of healthy population, pathological (scoliosis) patients, and patients having nonspecific chronic LBP.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

    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. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  5. Aggression and coexistence in female caribou

    Science.gov (United States)

    Weckerly, Floyd W.; Ricca, Mark A.

    2014-01-01

    Female caribou (Rangifer tarandus) are highly gregarious, yet there has been little study of the behavioral mechanisms that foster coexistence. Quantifying patterns of aggression between male and female, particularly in the only cervid taxa where both sexes grow antlers, should provide insight into these mechanisms. We asked if patterns of aggression by male and female caribou followed the pattern typically noted in other polygynous cervids, in which males display higher frequencies and intensity of aggression. From June to August in 2011 and 2012, we measured the frequency and intensity of aggression across a range of group sizes through focal animal sampling of 170 caribou (64 males and 106 females) on Adak Island in the Aleutian Archipelago, Alaska. Males in same-sex and mixed-sex groups and females in mixed-sex groups had higher frequencies of aggression than females in same-sex groups. Group size did not influence frequency of aggression. Males displayed more intense aggression than females. Frequent aggression in mixed-sex groups probably reflects lower tolerance of males for animals in close proximity. Female caribou were less aggressive and more gregarious than males, as in other polygynous cervid species.

  6. Evaluation and management of 2 ferocactus spines in the orbit.

    Science.gov (United States)

    Russell, David J; Kim, Tim I; Kubis, Kenneth

    2013-01-01

    A 49-year-old woman, who had fallen face first in a cactus 1 week earlier, presented with a small, mobile, noninflamed subcutaneous nodule at the rim of her right lateral orbit with no other functional deficits. A CT scan was obtained, which revealed a 4-cm intraorbital tubular-shaped foreign body resembling a large cactus spine. A second preoperative CT scan, obtained for an intraoperative guidance system, demonstrated a second cactus spine, which was initially not seen on the first CT scan. Both spines were removed surgically without complication. The authors discuss factors that can cause diagnosis delay, review the radiographic features of cactus spines, and discuss the often times benign clinical course of retained cactus spine foreign bodies. To the authors' knowledge, this is the first case report of cactus spines in the orbit. Health-care professionals should have a low threshold for imaging in cases of traumatic injuries involving cactus spines.

  7. Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Yesupalan Rajam

    2008-06-01

    Full Text Available Abstract Background A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries. Methods This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed. Results 28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4% would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied. Conclusion Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.

  8. Common conjunctival lesions

    African Journals Online (AJOL)

    ocular appearance. is discussion does not attempt to classify lesions, but only highlights ... magnifying glass. Examine what you can see and evert the upper ... look at the cornea and feel for pre-auricular and submandibular lymph nodes.

  9. Oropharynx lesion biopsy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003850.htm Oropharynx lesion biopsy To use the sharing features on this ... Department of Otolaryngology - Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. ...

  10. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal...... or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal...... health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health...

  11. Unusual benign breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G.J.R. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)]. E-mail: gporter@ncht.trent.nhs.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Lee, A.H.S. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Hamilton, L.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); James, J.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)

    2006-07-15

    The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathological appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological-pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management.

  12. Andersson Lesion in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  13. Upper gastrointestinal hemorrhage after nonresponsive thoracic spine pain: a case report

    Science.gov (United States)

    George, James W.; Skaggs, Clayton D.

    2009-01-01

    Abstract Objective This case study reports the findings of an upper gastrointestinal hemorrhage in a patient with thoracic spine pain reporting to a chiropractic clinic. The purpose of this article is to highlight the importance of identifying a patient's medication history as well as reviewing the signs and symptoms of gastrointestinal bleeding from a nonvariceal lesion. Clinical Features A 61-year–old woman presented with worsening middle thoracic spine pain of 3 months' duration along with recent abdominal pain. Medications, physical therapy, and spinal manipulation did not provide considerable improvement. The patient was taking ibuprofen daily to cope with her back pain. Intervention and Outcome The initial physical examination demonstrated mild increased tissue tension in the thoracic paraspinal muscles with mild restriction of thoracic spine range of motion secondary to the patient's pain. There was pain on palpation of the T4-5 and T7-8 spinal segments. The physical examination findings did not correlate to the patient's pain presentation, and she was referred back to her primary care physician. Two days after the initial examination, the patient experienced an upper gastrointestinal hemorrhage and underwent emergency surgery. It was determined postoperatively that she had a medication-induced duodenal ulcer that subsequently ruptured. Conclusion An upper gastrointestinal bleed should be considered in the differential diagnosis of a patient with a history of prolonged aspirin or nonsteroidal anti-inflammatory drug use with nonspecific abdominal symptoms. PMID:19646391

  14. A new device for internal fixation of thoracolumbar and lumbar spine fractures: the 'fixateur interne'.

    Science.gov (United States)

    Dick, W; Kluger, P; Magerl, F; Woersdörfer, O; Zäch, G

    1985-08-01

    A new system of operative fixation of thoracolumbar and lumbar spine fractures is presented: the 'fixateur interne' (F.I.). From a posterior approach long Schanz screws are inserted through the pedicles into the body of the two vertebrae just adjacent to the lesion and connected by th threaded F.I. rods. By tightening the nuts the Schanz screws are fixed in all directions. The advantages of the F.I. system are: excellent reposition by the long lever-arm of the Schanz screws, immobilization of only two segments and therefore good mobility of the residual spine, stability against flexion forces better than is obtained with Harrington distraction rods, additional rotational stability, and fixation in lordosis or kyphosis as is desired. The F.I. does not act as a four point bending system like all other dorsal spine instrumentation systems, but provides stability in flexion by itself. Therefore it can be Used independently of the condition of all ligaments (including the anterior longitudinal ligament) and of the posterior wall of the fractured vertebrae, and there is no need to fix more than the two immediately adjacent vertebrae, thus avoiding the often painful and cumbersome iatrogenic loss of lumbar lordosis and of mobility and permitting early mobilization of the patient. Experience with the first 45 patients is very promising.

  15. Evaluation of the role of magnetic resonance myelography in lumbar spine imaging

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, M.J.; Lee, M.J.; Pender, S.; McGrath, F.P.; Brennan, R.P.; Varghese, J.C. [Department of Radiology, Beaumont Hospital, Dublin (Ireland)]|[Royal College of Surgeons in Ireland Medical School, Dublin (Ireland)

    1999-06-01

    The purpose of our study was to evaluate the accuracy of MR myelography in depicting disc herniation in the lumbar spine when compared with conventional MRI in patients presenting with clinical evidence of disc herniation. One hundred patients referred for conventional MR imaging of the lumbar spine also had coronal MR (TR 9000 ms, TE 272 ms eff, NEX 3, echo train length 32) myelography performed. Three experienced observers compared magnetic resonance myelography (MRM) with conventional lumbar spine MR using the following variables: visibility of thecal sac and nerve roots, and the presence, location and severity of disc herniation. Disc protrusions were seen at 110 disc space levels on conventional MR images as opposed to 93 on MRM. However, only 72 % of lesions seen on conventional MR were diagnosed by MRM. Similarly, only 63.8 % of nerve root compression abnormalities seen at conventional MR were visualized when compared with conventional MRM. The sensitivity, specificity and accuracy of MRM when compared with conventional MR was 72, 93 and 85 %, respectively. The MRM technique yields images that resemble conventional myelography and may be used to help confirm abnormalities seen on conventional MR in selected cases; however, the large number of false-positive and false-negative examinations indicates that caution should be used in interpreting MRM images. (orig.) With 5 figs., 1 tab., 25 refs.

  16. ASSESSMENT OF SCORES IN DECISION MAKING IN METASTASES OF THE SPINE

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius de Oliveira Ferreira

    2015-12-01

    Full Text Available Objective : The aim of this study is to assess the intra- and interobserver concordance of SINS, Harrington, Tokuhashi and Tomita scores among general orthopedic surgeons and spine surgeons with experience above 5 and 10 years in the evaluation of patients with spinal metastasis. Methods : Twenty cases of patients with metastatic lesion of the spine were presented to 10 examiners and the scores aforementioned have been applied. After six weeks, the cases were reintroduced in a different order and data were analyzed. Results : The intraobserver reliability showed better agreement in SINS score among examiners with less experience and Harrington and Tomita scores among those who had more than 10-year experience. The interobserver reliability of the examiners of the group with over 10-year experience showed higher precision when using these scores, especially Harrington and Tomita. The SINS score was the choice for daily practice and was able to modify the management more often. Conclusions : This study demonstrated that the use of predictive scores of instability, Harrington, and prognosis, Tomita, had a higher intra- and interobserver reliability particularly among spine surgeons with experience above 10 years.

  17. Coexistence of fisheries with river dolphin conservation.

    Science.gov (United States)

    Kelkar, Nachiket; Krishnaswamy, Jagdish; Choudhary, Sunil; Sutaria, Dipani

    2010-08-01

    Freshwater biodiversity conservation is generally perceived to conflict with human use and extraction (e.g., fisheries). Overexploited fisheries upset the balance between local economic needs and endangered species' conservation. We investigated resource competition between fisheries and Ganges river dolphins (Platanista gangetica gangetica) in a human-dominated river system in India to assess the potential for their coexistence. We surveyed a 65-km stretch of the lower Ganga River to assess habitat use by dolphins (encounter rates) and fishing activity (habitat preferences of fishers, intensity of net and boat use). Dolphin abundance in the main channel increased from 179 (SE 7) (mid dry season) to 270 (SE 8) (peak dry season), probably as a result of immigration from upstream tributaries. Dolphins preferred river channels with muddy, rocky substrates, and deep midchannel waters. These areas overlapped considerably with fishing areas. Sites with 2-6 boats/km (moderately fished) were more preferred by dolphins than sites with 8-55 boats/km (heavily fished). Estimated spatial (85%) and prey-resource overlap (75%) between fisheries and dolphins (chiefly predators of small fish) suggests a high level of competition between the two groups. A decrease in abundance of larger fish, indicated by the fact that small fish comprised 74% of the total caught, may have intensified the present competition. Dolphins seem resilient to changes in fish community structure and may persist in overfished rivers. Regulated fishing in dolphin hotspots and maintenance of adequate dry season flows can sustain dolphins in tributaries and reduce competition in the main river. Fish-stock restoration and management, effective monitoring, curbing destructive fishing practices, secure tenure rights, and provision of alternative livelihoods for fishers may help reconcile conservation and local needs in overexploited river systems.

  18. Coexistence of competitors mediated by nonlinear noise

    Science.gov (United States)

    Siekmann, Ivo; Bengfort, Michael; Malchow, Horst

    2017-06-01

    Stochastic reaction-diffusion equations are a popular modelling approach for studying interacting populations in a heterogeneous environment under the influence of environmental fluctuations. Although the theoretical basis of alternative models such as Fokker-Planck diffusion is not less convincing, movement of populations is most commonly modelled using the diffusion law due to Fick. An interesting feature of Fokker-Planck diffusion is the fact that for spatially varying diffusion coefficients the stationary solution is not a homogeneous distribution - in contrast to Fick's law of diffusion. Instead, concentration accumulates in regions of low diffusivity and tends to lower levels for areas of high diffusivity. Thus, we may interpret the stationary distribution of the Fokker-Planck diffusion as a reflection of different levels of habitat quality. Moreover, the most common model for environmental fluctuations, linear multiplicative noise, is based on the assumption that individuals respond independently to stochastic environmental fluctuations. For large population densities the assumption of independence is debatable and the model further implies that noise intensities can increase to arbitrarily high levels. Therefore, instead of the commonly used linear multiplicative noise model, we implement environmental variability by an alternative nonlinear noise term which never exceeds a certain maximum noise intensity. With Fokker-Planck diffusion and the nonlinear noise model replacing the classical approaches we investigate a simple invasive system based on the Lotka-Volterra competition model. We observe that the heterogeneous stationary distribution generated by Fokker-Planck diffusion generally facilitates the formation of segregated habitats of resident and invader. However, this segregation can be broken by nonlinear noise leading to coexistence of resident and invader across the whole spatial domain, an effect that would not be possible in the non

  19. COEXISTING PERIODIC ORBITS IN VIBRO-IMPACTING DYNAMICAL SYSTEMS

    Institute of Scientific and Technical Information of China (English)

    李群宏; 陆启韶

    2003-01-01

    A method is presented to seek for coexisting periodic orbits which may be stable or unstable in piecewise-linear vibro-impacting systems. The conditions for coexistence of single impact periodic orbits are derived, and in particular, it is investigated in details how to assure that no other impacts will happen in an evolution period of a single impact periodic motion. Furthermore, some criteria for nonexistence of single impact periodic orbits with specific periods are also established. Finally, the stability of coexisting periodic orbits is discussed, and the corresponding computation formula is given. Examples of numerical simulation are in good agreement with the theoretic analysis.

  20. Visualization of the network of primo vessels and primo nodes above the pia mater of the brain and spine of rats by using Alcian blue.

    Science.gov (United States)

    Lee, Ho-Sung; Lee, Byung-Cheon

    2012-10-01

    By spraying and injecting Alcian blue into the lateral ventricle, we were able to visualize the network of the nerve primo vascular system above the pia mater of the brain and spine of rats. Staining these novel structures above the pia mater with 4',6-diamidino-2-phenylindole demonstrated that they coexisted in cellular and extracellular DNA forms. The cellular primo node consisted of many cells surrounded by rod-shaped nuclei while the extracellular primo node had a different morphology from that of a general cell in terms of DNA signals, showing granular DNA in a threadlike network of extracellular DNA. Also, differently from F-actin in general cells, the F-actin in the primo vessel was short and rod-shaped. Light and transmission electron microscopic images of the PN showed that the nerve primo vascular system above the pia mater of the brain and spine was a novel dynamic network, suggesting the coexistence of DNA and extracellular DNA. Based on these data, we suggest that a novel dynamic system with a certain function exists above the pia mater of the central nerve system. We also discuss the potential of this novel network system in the brain and spine as related to acupuncture meridians and neural regeneration.

  1. Morbidity and mortality of complex spine surgery

    DEFF Research Database (Denmark)

    Karstensen, Sven; Bari, Tanvir; Gehrchen, Martin

    2016-01-01

    adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population. STUDY DESIGN: A prospective, consecutive cohort study......BACKGROUND CONTEXT: Most literature on complications in spine surgery has been retrospective or based on national databases with few variables. The Spine AdVerse Events Severity (SAVES) system has been found reliable and valid in two Canadian centers, providing precise information regarding all...... was conducted using the SAVES version 2010 in the period from January 1, 2013 until December 31, 2013. A retrospective analysis was performed on all patients operated from November 1, 2011 until October 31, 2012 for comparison. PATIENT SAMPLE: Patients undergoing spinal surgery at a tertiary referral center...

  2. Palpation of the upper thoracic spine

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Vach, Kirstin;

    2002-01-01

    procedure. RESULTS: Using an "expanded" definition of agreement that accepts small inaccuracies (+/-1 segment) in the numbering of spinal segments, we found--based on the pooled data from the thoracic spine--kappa values of 0.59 to 0.77 for the hour-to-hour and the day-to-day intraobserver reliability......OBJECTIVE: To assess the intraobserver reliability (in terms of hour-to-hour and day-to-day reliability) and the interobserver reliability with 3 palpation procedures for the detection of spinal biomechanic dysfunction in the upper 8 segments of the thoracic spine. DESIGN: A repeated....... INTERVENTION: Three types of palpation were performed: Sitting motion palpation and prone motion palpation for biomechanic dysfunction and paraspinal palpation for tenderness. Each dimension was rated as "absent" or "present" for each segment. All examinations were performed according to a standard written...

  3. Branched standard spines of 3-manifolds

    CERN Document Server

    Benedetti, Riccardo

    1997-01-01

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

  4. Sagittal parameters of the spine: biomechanical approach.

    Science.gov (United States)

    Roussouly, Pierre; Pinheiro-Franco, João Luiz

    2011-09-01

    According to the anatomical segmentation, spine curves are the sacral kyphosis (sacrum), lumbar lordosis (L1 to L5), thoracic kyphosis (T1 to T12) and cervical lordosis (C1 to C7). From the morphological point of view the vertebrae of a curve are not identical: from cranial to caudal and vice versa there is a progressive anatomical modification. Both curves of the thoraco-lumbar spine may be divided at the Inflexion Point where lordosis turns into kyphosis. A geometrical construct of each curve by two tangent arcs of circle allows understanding the reciprocal changes between both curves. Lumbar Lordosis is mainly dependent on SS orientation, and the top of thoracic curve on C7 is very stable over the sacrum. Thoracic curve is dependent on lumbar lordosis orientation and C7 positioning. On a reverse effect, structural changing of thoracic kyphosis may affect the shape of the lumbar lordosis and the orientation of the pelvis.

  5. Development of the Young Spine Questionnaire

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Hestbæk, Lise

    Title Development of the Young Spine Questionnaire Authors & Affiliations Henrik Hein Lauridsen1, Lise Hestbæk1,2 1. Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Clinical Locomotion Network, Campusvej 55, DK-5230...... and adolescents are absent. The purpose of this study was to develop an instrument for children aged 9-12 years which could fill this gap in the literature. Methods The Young Spine Questionnaire (YSQ) was developed in three phases – the conceptualisation, development and testing phase. We used the conceptual...... model of Wilson and Cleary (1995) and divided the YSQ into two parts: part one included spinal prevalence estimates (including pictures of spinal area) and part two questions regarding pain, activity restrictions, care seeking behaviour and influence of parental back trouble. During the developing phase...

  6. The local immune response in ulcerative lesions of Buruli disease

    Science.gov (United States)

    Kiszewski, A E; Becerril, E; Aguilar, L D; Kader, I T A; Myers, W; Portaels, F; Hernàndez Pando, R

    2006-01-01

    Buruli disease (BU) is a progressive necrotic and ulcerative disease of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. BU is considered the third most common mycobacterial disease after tuberculosis and leprosy. Three clinical stages of the cutaneous lesions have been described in BU: pre-ulcerative, ulcerative and healed lesions. In this study we used immunohistochemistry and automated morphometry to determine the percentage of macrophages and of CD4/CD8 lymphocytes and their expression of interferon (IFN)-γ, interleukin (IL)-10, tumour necrosis factor (TNF)-α and transforming growth factor (TGF)-β. Expression of these cytokines was correlated with the inflammatory response evaluated by histopathology. All the studied BU ulcerative cases showed extensive necrosis and chronic inflammation. The most important feature was the presence or absence of granulomas co-existing with a mixed pro-inflammatory/anti-inflammatory cytokine balance. When granulomas were present significantly higher expression of IFN-γ was seen, whereas in ulcerative lesions without granulomas there was increased expression of IL-10 and significantly higher bacillary counts. These features correlated with the chronicity of the lesions; longer-lasting lesions showed granulomas. Thus, granulomas were absent from relatively early ulcerative lesions, which contained more bacilli and little IFN-γ, suggesting that at this stage of the disease strong suppression of the protective cellular immune response facilitates proliferation of bacilli. PMID:16487243

  7. Surgical management of Juxtafacet cysts in the lumbar spine.

    Science.gov (United States)

    Yurt, Alaattin; Seçer, Mehmet; Aydın, Murat; Akçay, Emrah; Ertürk, Ali Rıza; Akkol, İsmail; Yılmaz, Hakan; Palaz, Mahmut Necdet

    2016-05-01

    Juxtafacet cysts of the lumbar spine are extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. The aim of this study is to evaluate the efficacy of surgery and address controversial issues in the treatment of symptomatic juxta facet cysts in the Neurosurgical Department of our hospital and review of the literature. Data from seven patients (age range 58-68 years, mean age 63 years) with low back and radicular leg pain due to a lumbar facet joint cyst were retrospectively analyzed. Demographic data, cyst level, presence of concominant local pathology, treatment and results of treatment were recorded. After surgery there was no case of a recurrent cyst during the follow-up period. The mean follow-up period of patients at the time of this study was 4 years. All patients had back pain, while five also experienced unilateral radicular leg pain and two had bilateral leg pain. Four patients had neurogenic claudication. MRI identified the cyst and highlighted underlying pathology in all cases. All patients underwent surgical cyst excision. Post-operatively, all patients showed a total resolution of symptoms with sustained benefit at final evaluation. Surgery is a safe and effective treatment for lumbar juxtafacet cysts. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  8. MR imaging of the spine: trauma and degenerative disease

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, J.T. [Department of Radiology, University Hospital Maastricht (Netherlands)

    1999-09-01

    The purpose of this paper is to discuss the capabilities and drawbacks of MR imaging in patients with trauma to the spine and degenerative spinal conditions. In spinal trauma MR imaging is secondary to plain X-ray films and CT because of the greater availability and ease of performance of these techniques and their superior capability for detecting vertebral fractures. Magnetic resonance imaging is useful for detecting ligamentous ruptures and intraspinal mass lesions such as hematoma, and for assessing the state of the spinal cord and prognosis of a cord injury. In degenerative spinal disease the necessity is emphasized of critically evaluating the clinical relevance of any abnormal feature detected, as findings of degenerative pathology are common in individuals without symptoms. Magnetic resonance myelography permits rapid and accurate assessment of the state of the lumbar nerve roots (compressed or not). In the cervical region the quality of the myelographic picture is often degraded in patients with a narrow spinal canal. (orig.) With 10 figs., 14 refs.

  9. Heritability of Thoracic Spine Curvature and Genetic Correlations With Other Spine Traits: The Framingham Study

    Science.gov (United States)

    Yau, Michelle S; Demissie, Serkalem; Zhou, Yanhua; Anderson, Dennis E; Lorbergs, Amanda L; Kiel, Douglas P; Allaire, Brett T; Yang, Laiji; Cupples, L Adrienne; Travison, Thomas G; Bouxsein, Mary L; Karasik, David; Samelson, Elizabeth J

    2017-01-01

    Hyperkyphosis is a common spinal disorder in older adults, characterized by excessive forward curvature of the thoracic spine and adverse health outcomes. The etiology of hyperkyphosis has not been firmly established, but may be related to changes that occur with aging in the vertebrae, discs, joints, and muscles, which function as a unit to support the spine. Determining the contribution of genetics to thoracic spine curvature and the degree of genetic sharing among co-occurring measures of spine health may provide insight into the etiology of hyperkyphosis. The purpose of our study was to estimate heritability of thoracic spine curvature using T4–T12 kyphosis (Cobb) angle and genetic correlations between thoracic spine curvature and vertebral fracture, intervertebral disc height narrowing, facet joint osteoarthritis (OA), lumbar spine volumetric bone mineral density (vBMD), and paraspinal muscle area and density, which were all assessed from computed tomography (CT) images. Participants included 2063 women and men in the second and third generation offspring of the original cohort of the Framingham Study. Heritability of kyphosis angle, adjusted for age, sex, and weight, was 54% (95% confidence interval [CI], 43% to 64%). We found moderate genetic correlations between kyphosis angle and paraspinal muscle area ( ρ^G, −0.46; 95% CI, −0.67 to −0.26), vertebral fracture ( ρ^G, 0.39; 95% CI, 0.18 to 0.61), vBMD ( ρ^G,−0.23; 95% CI, −0.41 to −0.04), and paraspinal muscle density ( ρ^G,−0.22; 95% CI, −0.48 to 0.03). Genetic correlations between kyphosis angle and disc height narrowing ( ρ^G, 0.17; 95% CI, −0.05 to 0.38) and facet joint OA ( ρ^G, 0.05; 95% CI, −0.15 to 0.24) were low. Thoracic spine curvature may be heritable and share genetic factors with other age-related spine traits including trunk muscle size, vertebral fracture, and bone mineral density. PMID:27455046

  10. Pedicular stress fracture in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Chong, V.F.H.; Htoo, M.M. [Singapore General Hospital, Singapore, (Singapore). Department of Diagnostic Radiology

    1997-08-01

    Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle (`pediculolysis`) is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal. (authors). 10 refs., 2 figs.

  11. Rigid Spine Syndrome among Children in Oman

    Directory of Open Access Journals (Sweden)

    Roshan Koul

    2015-08-01

    Full Text Available Objectives: Rigidity of the spine is common in adults but is rarely observed in children. The aim of this study was to report on rigid spine syndrome (RSS among children in Oman. Methods: Data on children diagnosed with RSS were collected consecutively at presentation between 1996 and 2014 at the Sultan Qaboos University Hospital (SQUH in Muscat, Oman. A diagnosis of RSS was based on the patient’s history, clinical examination, biochemical investigations, electrophysiological findings, neuro-imaging and muscle biopsy. Atrophy of the paraspinal muscles, particularly the erector spinae, was the diagnostic feature; this was noted using magnetic resonance imaging of the spine. Children with disease onset in the paraspinal muscles were labelled as having primary RSS or rigid spinal muscular dystrophy. Secondary RSS was classified as RSS due to the late involvement of other muscle diseases. Results: Over the 18-year period, 12 children were included in the study, with a maleto- female ratio of 9:3. A total of 10 children were found to have primary RSS or rigid spinal muscular dystrophy syndrome while two had secondary RSS. Onset of the disease ranged from birth to 18 months of age. A family history was noted, with two siblings from one family and three siblings from another (n = 5. On examination, children with primary RSS had typical features of severe spine rigidity at onset, with the rest of the neurological examination being normal. Conclusion: RSS is a rare disease with only 12 reported cases found at SQUH during the study period. Cases of primary RSS should be differentiated from the secondary type.

  12. Spine revisited: Principles and parlance redefined

    Directory of Open Access Journals (Sweden)

    Kothari M

    2005-01-01

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

  13. Biomechanical Comparison Of Intact Lumbar Lamp Spine And Endoscopic Discectomized Lamp Spine

    Directory of Open Access Journals (Sweden)

    Ahmet Karakasli

    2012-06-01

    Full Text Available Objectives: Purpose of current study was biomechanical comparison of changes wrought on motion segments after minimally invasive percutan endoscopic discectomized and intact spine. Materials and Methods: We prepared ten fresh-frozen lamb spines were used for this study. The spine of each specimen was dissected between L4-L5. The biomechanical tests for both intact spine and discectomized spine were performed by using axial compression testing machine (AG-I 10 kN, Shimadzu, Japanese. The axial compression was applied to all specimens with the loading speed of 5 mm/min. 8400 N/mm moment was applied to each specimen to achieve flexion and extension motions, right and left bending by a specially designed fixture. Results: In axial compression and flexion tests, the specimens were more stable according to displacement values. The displacement values of sectioned specimens were closer to intact specimens. Only displacement values of left-bending anteroposterior test for both situations were significant (0.05 ;#8805; P. Conclusion: PTED hasn't biomechanical and cilinical disadvantages. Endoscopic discectomy hadn't any disadvantages in stability. Only anterior-posterior displacement values of left bending test were statistically significant. We consider that cause of these results were due to the fact that all specimens had percutan transforaminal endoscopic discectomy (PTED from left side.

  14. Intrapartum Ultrasound Assessment of Fetal Spine Position

    Directory of Open Access Journals (Sweden)

    Salvatore Gizzo

    2014-01-01

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

  15. Perioperative visual loss after spine surgery.

    Science.gov (United States)

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

    2014-04-18

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

  16. Ambulatory spine surgery: a survey study.

    Science.gov (United States)

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

    2014-08-01

    Study Design Cross-sectional study. Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039). Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety.

  17. ATLS® and damage control in spine trauma

    Directory of Open Access Journals (Sweden)

    Gosse Andreas

    2009-03-01

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

  18. Hippocampal Dendritic Spines Are Segregated Depending on Their Actin Polymerization

    Directory of Open Access Journals (Sweden)

    Nuria Domínguez-Iturza

    2016-01-01

    Full Text Available Dendritic spines are mushroom-shaped protrusions of the postsynaptic membrane. Spines receive the majority of glutamatergic synaptic inputs. Their morphology, dynamics, and density have been related to synaptic plasticity and learning. The main determinant of spine shape is filamentous actin. Using FRAP, we have reexamined the actin dynamics of individual spines from pyramidal hippocampal neurons, both in cultures and in hippocampal organotypic slices. Our results indicate that, in cultures, the actin mobile fraction is independently regulated at the individual spine level, and mobile fraction values do not correlate with either age or distance from the soma. The most significant factor regulating actin mobile fraction was the presence of astrocytes in the culture substrate. Spines from neurons growing in the virtual absence of astrocytes have a more stable actin cytoskeleton, while spines from neurons growing in close contact with astrocytes show a more dynamic cytoskeleton. According to their recovery time, spines were distributed into two populations with slower and faster recovery times, while spines from slice cultures were grouped into one population. Finally, employing fast lineal acquisition protocols, we confirmed the existence of loci with high polymerization rates within the spine.

  19. Barriers in the brain: resolving dendritic spine morphology and compartmentalization.

    Science.gov (United States)

    Adrian, Max; Kusters, Remy; Wierenga, Corette J; Storm, Cornelis; Hoogenraad, Casper C; Kapitein, Lukas C

    2014-01-01

    Dendritic spines are micron-sized protrusions that harbor the majority of excitatory synapses in the central nervous system. The head of the spine is connected to the dendritic shaft by a 50-400 nm thin membrane tube, called the spine neck, which has been hypothesized to confine biochemical and electric signals within the spine compartment. Such compartmentalization could minimize interspinal crosstalk and thereby support spine-specific synapse plasticity. However, to what extent compartmentalization is governed by spine morphology, and in particular the diameter of the spine neck, has remained unresolved. Here, we review recent advances in tool development - both experimental and theoretical - that facilitate studying the role of the spine neck in compartmentalization. Special emphasis is given to recent advances in microscopy methods and quantitative modeling applications as we discuss compartmentalization of biochemical signals, membrane receptors and electrical signals in spines. Multidisciplinary approaches should help to answer how dendritic spine architecture affects the cellular and molecular processes required for synapse maintenance and modulation.

  20. New computed radiography processing condition for whole-spine radiography.

    Science.gov (United States)

    Sasagawa, Takeshi; Kunogi, Junichi; Masuyama, Shigeru; Ogihara, Satoshi; Takeuchi, Yosuke; Takeshita, Yujiro; Kamiya, Naokazu; Murakami, Hideki; Tsuchiya, Hiroyuki

    2011-12-06

    Computed radiography (CR) has many advantages compared with conventional radiographs, especially in image processing. Although CR is being used in chest radiography and mammography, it has not been applied to spine imaging. The purposes of this study were to formulate a set of new CR processing parameters and to test whether the resultant whole-spine radiographs visualized the spine more clearly than conventional images. This study included 29 patients who underwent whole-spine radiographs. We used 3 image processing methods to improve the clarity of whole-spine radiographs: gradation processing, dynamic range control processing, and multi-objective frequency processing. Radiograph definition was evaluated using vertebrae sampled from each region of the whole spine, specifically C4, C7, T8, T12, and L3; evaluation of the lateral view also included the sacral spine and femoral head. Image definition was assessed using a 3-point grading system. The conventional and processed CR images (both frontal and lateral views) were evaluated by 5 spine surgeons. In all spinal regions on both frontal and lateral views, the processed images showed statistically significantly better clarity than the corresponding conventional images, especially at T12, L3, the sacral spine, and the femoral head on the lateral view. Our set of new CR processing parameters can improve the clarity of whole-spine radiographs compared with conventional images. The greatest advantage of image processing was that it enabled clear depiction of the thoracolumbar junction, lumbar vertebrae, sacrum, and femoral head in the lateral view.

  1. Barriers in the Brain: Resolving Dendritic Spine Morphology and Compartmentalization

    Directory of Open Access Journals (Sweden)

    Max eAdrian

    2014-12-01

    Full Text Available Dendritic spines are micron-sized protrusions that harbor the majority of excitatory synapses in the central nervous system. The head of the spine is connected to the dendritic shaft by a 50-400 nm thin membrane tube, called the spine neck, which has been hypothesized to confine biochemical and electric signals within the spine compartment. Such compartmentalization could minimize interspinal crosstalk and thereby support spine-specific synapse plasticity. However, to what extent compartmentalization is governed by spine morphology, and in particular the diameter of the spine neck, has remained unresolved. Here, we review recent advances in tool development - both experimental and theoretical - that facilitate studying the role of the spine neck in compartmentalization. Special emphasis is given to recent advances in microscopy methods and quantitative modeling applications as we discuss compartmentalization of biochemical signals, membrane receptors and electrical signals in spines. Multidisciplinary approaches should help to answer how dendritic spine architecture affects the cellular and molecular processes required for synapse maintenance and modulation.

  2. Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.

    Directory of Open Access Journals (Sweden)

    Maria A Cantu

    Full Text Available BACKGROUND: There is little data on treatment of Langerhans cell histiocytosis (LCH in adults. Available data is on small numbers of patients with short follow-up times and no comparison of results from different treatment regimens. We analyzed the responses of adult LCH patients with bone lesions to three primary chemotherapy treatments to define the optimal one. METHODS AND FINDINGS: Fifty-eight adult patients with bone lesions, either as a solitary site or as a component of multisystem disease, were analyzed for disease location and response to surgery, curettage, steroids, radiation, vinblastine/prednisone, 2-Chlorodeoxyadenosine (2-CdA, or cytosine arabinoside (ARA-C. The mean age of patients was 32 years, with equal gender distribution. Twenty-nine patients had 1 lesion; 16, 2 lesions; 5, 3 lesions; and 8 had 4 or more. Most bone lesions were in the skull, spine, or jaw. Chemotherapy, surgery, curettage, or radiation, but not steroids alone, achieved improvement or resolution of lesions in a majority of patients. Comparison of the three chemotherapy regimens revealed 84% of patients treated with vinblastine/prednisone either did not respond or relapsed within a year, whereas 59% of patients treated with 2-CdA and 21% treated with ARA-C failed. Toxicity was worse with the vinblastine/prednisone group as 75% had grade 3-4 neuropathy. Grade 3-4 cytopenias occurred in 37% of the 2-CdA -treated patients and 20% of the ARA-C-treated patients. The major limitation of this study is it is retrospective and not a clinical trial. CONCLUSIONS: ARA-C is an effective and minimally toxic treatment for LCH bone lesions in adults. In contrast, vinblastine/prednisone results in poor overall responses and excessive toxicity.

  3. Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases.

    Science.gov (United States)

    Atallah, Marwan; Joag, Madhura; Galor, Anat; Amescua, Guillermo; Nanji, Afshan; Wang, Jianhua; Perez, Victor L; Dubovy, Sander; Karp, Carol L

    2017-10-01

    Coexistence of an ocular surface disease can mask the typical features of ocular surface squamous neoplasia (OSSN). The purpose of this study was to evaluate high resolution optical coherence tomography (HR-OCT) as an adjunct in the detection and differentiation of OSSN within coexisting ocular surface pathologies. Retrospective study of 16 patients with ocular surface disease and lesions suspicious for OSSN that were evaluated with HR-OCT. HR-OCT images of the lesions were taken to look for evidence of OSSN. Biopsies were performed in all cases, and the HR-OCT findings were compared to the histological results. Of the 16 patients with OSSN and a coexisting ocular surface disease, 12 were found to have OSSN by HR-OCT and all were subsequently confirmed by biopsy. Two patients had OSSN with rosacea, one with pingueculum, two within pterygia, one with Salzmann' nodular degeneration, six with limbal stem cell deficiency (LSCD)/scarring. In all 12 cases HR-OCT images revealed classical findings of hyper-reflective, thickened epithelium and an abrupt transition from normal to abnormal epithelium. OSSN was ruled out by HR-OCT in four cases (2 Salzmann's, 1 mucous membrane pemphigoid, and 1 LSCD). Negative findings were confirmed by biopsy. HR-OCT was used to follow resolution of the OSSN in positive cases, and it detected recurrence in 1 case. While histopathology is the gold standard in the diagnosis of OSSN, HR-OCT can be used to noninvasively detect the presence of OSSN in patients with coexisting ocular conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Opting out against defection leads to stable coexistence with cooperation

    Science.gov (United States)

    Zhang, Bo-Yu; Fan, Song-Jia; Li, Cong; Zheng, Xiu-Deng; Bao, Jian-Zhang; Cressman, Ross; Tao, Yi

    2016-01-01

    Cooperation coexisting with defection is a common phenomenon in nature and human society. Previous studies for promoting cooperation based on kin selection, direct and indirect reciprocity, graph selection and group selection have provided conditions that cooperators outcompete defectors. However, a simple mechanism of the long-term stable coexistence of cooperation and defection is still lacking. To reveal the effect of direct reciprocity on the coexistence of cooperation and defection, we conducted a simple experiment based on the Prisoner’s Dilemma (PD) game, where the basic idea behind our experiment is that all players in a PD game should prefer a cooperator as an opponent. Our experimental and theoretical results show clearly that the strategies allowing opting out against defection are able to maintain this stable coexistence. PMID:27775099

  5. Ethnic Struggle, Coexistence, and Democratization in Eastern Europe

    OpenAIRE

    Cianetti, Licia

    2013-01-01

    Ethnic Struggle, Coexistence, and Democratization in Eastern Europe. By Sherrill Stroschein. Pp. 289. Cambridge: Cambridge University Press. 2012. £60.00. Hardback. ISBN: 9781107005242. Click here to read the review

  6. Coexistent adenocarcinoma and microcystic adenoma of the pancreas.

    Science.gov (United States)

    Posniak, H V; Olson, M C; Demos, T C

    1991-01-01

    A case with coexistent pancreatic adenocarcinoma and microcystic adenoma is presented. These diagnoses were suspected on the basis of their computed tomography (CT) appearances and confirmed with CT-guided fine-needle aspiration.

  7. Uterine didelphys coexisting with term pregnancy, an incidental ...

    African Journals Online (AJOL)

    Uterine didelphys coexisting with term pregnancy, an incidental finding during an ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... carry their pregnancies to term with live deliveries without any complication, some ...

  8. Cervical spine injuries in American football.

    Science.gov (United States)

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

    2009-01-01

    American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of

  9. Meniscal Ramp Lesions

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  10. Coexistence of pulmonary tuberculosis and sarcoidosis: a diagnostic dilemma.

    Science.gov (United States)

    Mandal, Sanjay Kumar; Ghosh, Sudip; Mondal, Soumya Sarathi; Chatterjee, Sumanta

    2014-12-19

    Tuberculosis and sarcoidosis are multisystem diseases having different aetiology and management; however, they have similar clinical and histological characteristics. Very rarely they may coexist. We report a rare case of a 38-year-old woman who presented with chronic cough, low-grade fever and respiratory distress that was initially diagnosed as miliary tuberculosis. Diagnosis was supported by positive mycobacterial culture and initially responded to antitubercular treatment, but later recurrences led to further investigations and the diagnosis of coexisting sarcoidosis.

  11. An Analysis of Clinico-Radiological and Histopathological Correlation in Tuberculosis of Spine

    Directory of Open Access Journals (Sweden)

    Sadik I Shaikh

    2013-06-01

    Full Text Available Background: In the recent past, the use of computerized axial tomography and magnetic resonance imaging has helped to differentiate spinal tuberculosis from radiologically similar lesions. Objective: The objectives of the study was to assess how dependable clinical and radiological features are in estab-lishing a diagnosis of spinal tuberculosis; and to identify other conditions which may have clinical and radiological features similar to those seen in patients with spinal tuberculosis. Methodology: Two hundred and sixty-seven consecutive patients with clinical and radiological features suggestive of tuberculosis of the spine treated over a period of five years were analysed. This retrospective case series analysis was done in a tertiary care hospital. The clinical presentation, radiological features and the erythrocyte sedimentation rate were correlated with the histopathological diagnosis on tissue obtained by open biopsy in 130 cases during surgery and in 137 cases by closed vertebral biopsy. Results: One hundred sixty-six cases were histologically proved as tuberculosis and 74 proved to be non-tuberculous lesions. Twenty-seven cases in which the biopsy was inconclusive were excluded from the study. The study demonstrated that tuberculous lesions were commoner in younger patients and the lesion was more often in the paradiscal region as compared to non-tuberculous lesions. However, all other clinical and radiological variables were not significantly different to enable reliable identification of tuberculous lesions on the basis of clinical and radiological features alone. Conclusion: It is recommended that all vertebral lesions suspected to be of tuberculous origin not responding to empirical antituberculosis therapy should have a definitive histopathological diagnosis and radiological investigation to facilitate appropriate treatment. [Natl J Med Res 2013; 3(3.000: 198-202

  12. Gout in the spine and sacri-iliac joints: radiological manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Jajic, I.

    1982-06-01

    It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke (8), and in two patients vertebral lesions corresponded to those described by Jaffe (5). Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-05-01

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

  14. Results of cement augmentation and curettage in aneurysmal bone cyst of spine

    Directory of Open Access Journals (Sweden)

    Saumyajit Basu

    2016-01-01

    Full Text Available Aneurysmal bone cyst (ABC is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal

  15. Treatments for primary aneurysmal bone cysts of the cervical spine: experience of 14 cases

    Institute of Scientific and Technical Information of China (English)

    Wang Chao; Liu Xiaoguang; Jiang Liang; Yang Shaomin; Wei Feng; Wu Fengliang; Liu Zhongjun

    2014-01-01

    Background Aneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive.The optimal treatment of cervical spine lesions remains controversial.This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.Methods This series included eight men and six women diagnosed between 2002 and 2012.A retrospective review of the hospital charts,operating room reports,office charts,and radiographs was performed.The data collected included patient age,sex,radiological features,pathology,treatment method,outcomes,and complications from biopsies and treatments.The mean age at diagnosis was 17.5 years old with a range of 6-35 years.All patients had experienced local pain for a mean of 7.3 months (range,0.5-18.0 months),and three patients had neurological deficits (one with radiculopathy and two with myelopathy).The Frankel classification before treatment was E in 12 cases,D in one case,and C in one case.Results Four patients received radiotherapy alone.Ten patients underwent surgery,including five total spondyiectomies,two local resections,and three curettages.Three patients received preoperative selective arterial embolization,and four received adjuvant radiotherapy.The mean follow-up time was 44.5 months (range 12-96 months),and no recurrence was identified.Three patients with neurological deficits achieved complete recovery,as noted at the final follow-up examination.One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy.He refused further treatment.Conclusions The results can be achieved by different treatments (surgical resection/curettage,selective arterial embolization,and radiotherapy) for ABC of the cervical spine.Reconstruction of stability is also important for the treatment of cervical ABC.

  16. Tradeoffs, competition, and coexistence in eastern deciduous forest ant communities.

    Science.gov (United States)

    Stuble, Katharine L; Rodriguez-Cabal, Mariano A; McCormick, Gail L; Jurić, Ivan; Dunn, Robert R; Sanders, Nathan J

    2013-04-01

    Ecologists have long sought to explain the coexistence of multiple potentially competing species in local assemblages. This is especially challenging in species-rich assemblages in which interspecific competition is intense, as it often is in ant assemblages. As a result, a suite of mechanisms has been proposed to explain coexistence among potentially competing ant species: the dominance-discovery tradeoff, the dominance-thermal tolerance tradeoff, spatial segregation, temperature-based niche partitioning, and temporal niche partitioning. Through a series of observations and experiments, we examined a deciduous forest ant assemblage in eastern North America for the signature of each of these coexistence mechanisms. We failed to detect evidence for any of the commonly suggested mechanisms of coexistence, with one notable exception: ant species appear to temporally partition foraging times such that behaviourally dominant species foraged more intensely at night, while foraging by subdominant species peaked during the day. Our work, though focused on a single assemblage, indicates that many of the commonly cited mechanisms of coexistence may not be general to all ant assemblages. However, temporal segregation may play a role in promoting coexistence among ant species in at least some ecosystems, as it does in many other organisms.

  17. Persistent coexistence of cyclically competing species in spatially extended ecosystems

    Science.gov (United States)

    Park, Junpyo; Do, Younghae; Huang, Zi-Gang; Lai, Ying-Cheng

    2013-06-01

    A fundamental result in the evolutionary-game paradigm of cyclic competition in spatially extended ecological systems, as represented by the classic Reichenbach-Mobilia-Frey (RMF) model, is that high mobility tends to hamper or even exclude species coexistence. This result was obtained under the hypothesis that individuals move randomly without taking into account the suitability of their local environment. We incorporate local habitat suitability into the RMF model and investigate its effect on coexistence. In particular, we hypothesize the use of "basic instinct" of an individual to determine its movement at any time step. That is, an individual is more likely to move when the local habitat becomes hostile and is no longer favorable for survival and growth. We show that, when such local habitat suitability is taken into account, robust coexistence can emerge even in the high-mobility regime where extinction is certain in the RMF model. A surprising finding is that coexistence is accompanied by the occurrence of substantial empty space in the system. Reexamination of the RMF model confirms the necessity and the important role of empty space in coexistence. Our study implies that adaptation/movements according to local habitat suitability are a fundamental factor to promote species coexistence and, consequently, biodiversity.

  18. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Innes, N P T; Frencken, J E; Bjørndal, L

    2016-01-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current...... managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical...... manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...

  19. Dry needling for the management of thoracic spine pain.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Layton, Michelle; Dommerholt, Jan

    2015-07-01

    Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars.

  20. Anatomy of large animal spines and its comparison to the human spine: a systematic review.

    Science.gov (United States)

    Sheng, Sun-Ren; Wang, Xiang-Yang; Xu, Hua-Zi; Zhu, Guo-Qing; Zhou, Yi-Fei

    2010-01-01

    Animal models have been commonly used for in vivo and in vitro spinal research. However, the extent to which animal models resemble the human spine has not been well known. We conducted a systematic review to compare the morphometric features of vertebrae between human and animal species, so as to give some suggestions on how to choose an appropriate animal model in spine research. A literature search of all English language peer-reviewed publications was conducted using PubMed, OVID, Springer and Elsevier (Science Direct) for the years 1980-2008. Two reviewers extracted data on the anatomy of large animal spines from the identified articles. Each anatomical study of animals had to include at least three vertebral levels. The anatomical data from all animal studies were compared with the existing data of the human spine in the literature. Of the papers retrieved, seven were included in the review. The animals in the studies involved baboon, sheep, porcine, calf and deer. Distinct anatomical differences of vertebrae were found between the human and each large animal spine. In cervical region, spines of the baboon and human are more similar as compared to other animals. In thoracic and lumbar regions, the mean pedicle height of all animals was greater than the human pedicles. There was similar mean pedicle width between animal and the human specimens, except in thoracic segments of sheep. The human spinal canal was wider and deeper in the anteroposterior plane than any of the animals. The mean human vertebral body width and depth were greater than that of the animals except in upper thoracic segments of the deer. However, the mean vertebral body height was lower than that of all animals. This paper provides a comprehensive review to compare vertebrae geometries of experimental animal models to the human vertebrae, and will help for choosing animal model in vivo and in vitro spine research. When the animal selected for spine research, the structural similarities and

  1. Lesiones deportivas Sports injuries

    OpenAIRE

    2007-01-01

    El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participa...

  2. Flexible Robotic Spine Actuated by Shape Memory Alloy

    OpenAIRE

    2014-01-01

    A flexible robotic spine actuated by shape memory alloy (SMA) can achieve both bending motion and impact absorption, which will allow robots to realize a variety of postures. In this paper, the robotic spine is designed and simplified into a multi-segment dynamic model based on several verified assumptions. The SMA wire is modelled using the Seelecke-Muller-Acenbach theory. An iterative algorithm is developed to address the external forces distributed along the spine and compute the spine’s b...

  3. Coexistence of a single cerebral arteriovenous malformation and spinal arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Wang Yabing

    2009-01-01

    Full Text Available The coexistence of a cerebral and a spinal arteriovenous malformation (AVM together is extremely rare. We present a 31-year-old woman, who suffered from severe root pains in the left upper extremity. Magnetic resonance imaging (MRI revealed the abnormal vessels in the left occipital lobe and upper cervical segment of spinal cord. Cerebral angiography and spinal angiogram revealed two AVMs: One was in the right occipital lobe and the other was located in the C1-C2 segments of cervical cord. She had no other vascular lesions, and nor did her other family members. As the primary problem in her was left upper extremity root pains, which we considered was related to the spinal AVM, the first therapeutic treatment was focused on spinal AVM. The cerebral AVM of the right occipital lobe was surgically resected after part embolization.

  4. Perivascular epithelioid cell tumor of the liver coexisting with a gastrointestinal stromal tumor

    DEFF Research Database (Denmark)

    Paiva, Carlos Eduardo; Moraes Neto, Francisco Alves; Agaimy, Abbas

    2008-01-01

    Approximately 10% of patients with gastrointestinal stromal tumors (GIST) develop other neoplasms, either synchronously or metachronously. In this report we describe coexistence of a gastrointestinal stromal tumor and a hepatic perivascular epithelioid cell tumor (PEComa) in a 51-year-old woman...... with no evidence of tuberous sclerosis. A subcapsular hepatic nodule (0.8 cm in diameter) was found during surgery for symptomatic gastric neoplasm (15 cm in diameter) arising from the lesser curvature. Both tumors revealed histomorphological and immunohistochemical features confirming a diagnosis of a small...... incidental hepatic PEComa and a high risky extramural gastric GIST, respectively. The patient remained disease-free 25 mo after surgery with no evidence of tumor recurrence or new neoplasms. To our knowledge, this is the first report of PEComa in a patient with GIST. Hepatic lesions detected synchronously...

  5. The coexistence of oral lichen planus and psoriasis vulgaris – a case report

    Directory of Open Access Journals (Sweden)

    Paulina Kiluk

    2016-05-01

    Full Text Available Introduction . Psoriasis and lichen planus are common dermatological conditions, whose coexistence is rarely described. Although the exact etiopathogenesis of both diseases is still unknown, autoimmune factors play an important role in their development. A common feature is also the occurrence of the Köbner phenomenon. The principal differences concern the clinical, histological and immunological events. Objective. To present a patient with oral lichen planus, in whom psoriasis developed. Case report. A 75-year-old patient, with a 3-year history of oral lichen planus, presented itchy erythematous skin lesions initially located in the intertriginous area. Outpatient treatment consisting of topical and oral antifungal medications did not bring significant improvement. Skin biopsy confirmed the diagnosis of psoriasis. Treatment with tar ointment and topical tacrolimus was carried out, resulting in gradual improvement. Conclusions . A review of the literature indicates the existence of possible, but still unexplained, linkages between these two diseases.

  6. Computational Approach to Dendritic Spine Taxonomy and Shape Transition Analysis

    Science.gov (United States)

    Bokota, Grzegorz; Magnowska, Marta; Kuśmierczyk, Tomasz; Łukasik, Michał; Roszkowska, Matylda; Plewczynski, Dariusz

    2016-01-01

    The common approach in morphological analysis of dendritic spines of mammalian neuronal cells is to categorize spines into subpopulations based on whether they are stubby, mushroom, thin, or filopodia shaped. The corresponding cellular models of synaptic plasticity, long-term potentiation, and long-term depression associate the synaptic strength with either spine enlargement or spine shrinkage. Although a variety of automatic spine segmentation and feature extraction methods were developed recently, no approaches allowing for an automatic and unbiased distinction between dendritic spine subpopulations and detailed computational models of spine behavior exist. We propose an automatic and statistically based method for the unsupervised construction of spine shape taxonomy based on arbitrary features. The taxonomy is then utilized in the newly introduced computational model of behavior, which relies on transitions between shapes. Models of different populations are compared using supplied bootstrap-based statistical tests. We compared two populations of spines at two time points. The first population was stimulated with long-term potentiation, and the other in the resting state was used as a control. The comparison of shape transition characteristics allowed us to identify the differences between population behaviors. Although some extreme changes were observed in the stimulated population, statistically significant differences were found only when whole models were compared. The source code of our software is freely available for non-commercial use1. Contact: d.plewczynski@cent.uw.edu.pl. PMID:28066226

  7. 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.

  8. A Retrospective Study on Cholesteatoma Otitis Media Coexisting with Cholesterol Granuloma

    Institute of Scientific and Technical Information of China (English)

    罗凌惠; 龚树生; 白广平; 汪吉宝

    2002-01-01

    Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cas-es of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cas-es of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and blood-y otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Tem poral bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases,enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplas-ty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological e-tiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location,extension and severity of the lesion, The purpose of surgery is to remove the lesion and create an

  9. Arthroscopic guided biopsy and radiofrequency thermoablation of a benign neoplasm of the tibial spines area: a treatment option

    Directory of Open Access Journals (Sweden)

    Zoccali Carmine

    2012-04-01

    Full Text Available Abstract Background Lesions located in the area of the tibial spines are rare. In most cases, treatment follows histological diagnosis, but when imaging and clinical data are considered to be "very" characteristic for benign lesions, such as chondroblastoma or osteoid osteoma, treatment may be performed without biopsy. Traditional curettage requires opening the joint, which presents a high risk of contamination of the joint itself and surrounding structures, such as the popliteal area, with possible contamination of the neurovascular bundle when performing curettage with the posterior approach. In this case, the re-excision of a local recurrence would be extremely difficult. Results We describe a technique using arthroscopic guidance for radiofrequency thermoablation of a benign lesion in the tibial spines area. We report on an illustrative case. The patient so treated, reported immediate relief from the pain, and after two weeks, was free of pain. The biopsy performed before the treatment confirmed the radiological diagnosis of chondroblastoma. At one year of follow-up, the patient is without pain, with a 0-130°range of motion, has no activity limitations and is apparently free of disease. Conclusion This technique allows a radiofrequency thermoablation of a lesion in the tibial spines area and in the posterior tibial surface to be performed without opening the joint, monitoring the tibial plateau surface, probably decreasing the risk of cartilage damage. Unfortunately, in the case presented, the high pressure from the arthroscopy's pump broke the tibial plateau surface creating a communication to the tibial tunnel used for thermoablation.

  10. Immunopathology of skin lesions

    Directory of Open Access Journals (Sweden)

    Khan Nazoora

    2001-09-01

    Full Text Available A study was conducted on 130 patients suffering from skin lesions which included psoriasis, lichen planus, DLE, pemphigus, vitiligo and alopecia areata. Forty age-and-sex-matched healthy individuals served as control. Serum IgG, IgM, and circulating immune complexes (CIC were estimated. Significant increase in serum IgG (1937.2 ± 1030.43 mg% and IgM (232.12 ± 136.98 mg% was observed in all the skin lesions when compared with controls except in lichen planus where they were significantly lowered, values being 580.61± 77.35 mg% and 66.88 ± 6.59mg% respectively. CIC levels were significantly raised (P<0.00 1 in various skin lesions (40.49±23.29 when compared with controls (17.68± 3.21, but no significance was observed in lichen planus( 17.72 ± 4.28. Serum IgG, IgM and CIC were statistically significantly altered depending on the extent of the lesion and lowered significantly to almost normal values following treatment, thereby confirming the role of immunity in the pathogenesis of these skin disorders.

  11. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

    Full Text Available A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

  12. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C;

    2015-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants...

  13. Biomechanical in vitro evaluation of the complete porcine spine in comparison with data of the human spine.

    Science.gov (United States)

    Wilke, Hans-Joachim; Geppert, Jürgen; Kienle, Annette

    2011-11-01

    The purpose of this study was to provide quantitative biomechanical properties of the whole porcine spine and compare them with data from the literature on the human spine. Complete spines were sectioned into single joint segments and tested in a spine tester with pure moments in the three main anatomical planes. Range of motion, neutral zone and stiffness parameters of the spine were determined in flexion/extension, right/left lateral bending and left/right axial rotation. Comparison with data of the human spine reported in the literature showed that certain regions of the porcine spine exhibit greater similarities than others. The cervical area of C1-C2 and the upper and middle thoracic sections exhibited the most similarities. The lower thoracic and the lumbar area are qualitatively similar to the human spine. The remaining cervical section from C3 to C7 appears to be less suitable as a model. Based on the biomechanical similarities of certain regions of the porcine and human spines demonstrated by this study results, it appears that the use of the porcine spine could be an alternative to human specimens in the field of in vitro research. However, it has to be emphasized that the porcine spine is not a suitable biomechanics surrogate for all regions of the human spinal column, and it should be carefully considered whether other specimens, for example from the calf or sheep spine, represent a better alternative for a specific scientific question. It should be noted that compared with human specimens each animal model always only represents a compromise.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

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

  15. Augmented reality visualization for thoracoscopic spine surgery

    Science.gov (United States)

    Sauer, Frank; Vogt, Sebastian; Khamene, Ali; Heining, Sandro; Euler, Ekkehard; Schneberger, Marc; Zuerl, Konrad; Mutschler, Wolf

    2006-03-01

    We are developing an augmented reality (AR) image guidance system in which information derived from medical images is overlaid onto a video view of the patient. The centerpiece of the system is a head-mounted display custom fitted with two miniature color video cameras that capture the stereo view of the scene. Medical graphics is overlaid onto the video view and appears firmly anchored in the scene, without perceivable time lag or jitter. We have been testing the system for different clinical applications. In this paper we discuss minimally invasive thoracoscopic spine surgery as a promising new orthopedic application. In the standard approach, the thoracoscope - a rigid endoscope - provides visual feedback for the minimally invasive procedure of removing a damaged disc and fusing the two neighboring vertebrae. The navigation challenges are twofold. From a global perspective, the correct vertebrae on the spine have to be located with the inserted instruments. From a local perspective, the actual spine procedure has to be performed precisely. Visual feedback from the thoracoscope provides only limited support for both of these tasks. In the augmented reality approach, we give the surgeon additional anatomical context for the navigation. Before the surgery, we derive a model of the patient's anatomy from a CT scan, and during surgery we track the location of the surgical instruments in relation to patient and model. With this information, we can help the surgeon in both the global and local navigation, providing a global map and 3D information beyond the local 2D view of the thoracoscope. Augmented reality visualization is a particularly intuitive method of displaying this information to the surgeon. To adapt our augmented reality system to this application, we had to add an external optical tracking system, which works now in combination with our head-mounted tracking camera. The surgeon's feedback to the initial phantom experiments is very positive.

  16. A newborn with grouped facial skin lesions and subsequent seizures

    Science.gov (United States)

    2014-01-01

    Background Congenital grouped skin lesions are alarming signs of a variety of threatening diagnoses of quite different origin. The present case report shows an impressive clinical pattern of a neonate and illustrates the difficulty in differential diagnosis of mixed connective tissue disease and neonatal lupus erythematosus in newborns. This reported case is to our knowledge the first description of an unrecognized mixed connective tissue disease in the mother with an unusual clinical manifestation in the newborn, comprising skin lesions, neurological damage and non-typical antibody constellation. Case presentation We report on a Caucasian female neonate from a perinatally asymptomatic mother, who presented with grouped facial pustular-like skin lesions, followed by focal clonic seizures caused by multiple ischemic brain lesions. Herpes simplex virus infection was excluded and both the mother and her infant had the antibody pattern of systemic lupus erythematosus and neonatal lupus erythematosus, respectively. However, clinical signs in the mother showed overlapping features of mixed connective tissue disease. Conclusion This case report emphasizes congenital Lupus erythematosus and mixed connective tissue disease as important differential diagnoses of grouped skin lesions in addition to Herpes simplex virus-infection. The coexistence of different criteria for mixed connective tissue disease makes it difficult to allocate precisely maternal and congenital infantile disease. PMID:24884686

  17. Evaluation of Spine Health and Spine Mechanics in Servicemembers with Traumatic Lower Extremity Amputation or Injury

    Science.gov (United States)

    2015-10-01

    procedures to reduce long-term incidence and recurrence of low back pain. 15. SUBJECT TERMS Low Back Pain; Intervertebral Disc; Inter -Segmental Motion...Specific Aim 1: Quantify lumbar spinal alignment and inter -segmental vertebral motions with traumatic lower...injury (with and without LBP) and uninjured controls. Low Back Pain; Intervertebral Disc; Inter -Segmental Motion; Spine Load; Spinal Alignment

  18. [Plain radiographs of the spine: static and relationships between spine and pelvis].

    Science.gov (United States)

    Morvan, G; Wybier, M; Mathieu, P; Vuillemin, V; Guerini, H

    2008-05-01

    Man, with his erect posture, evolves in a world subject to the laws of gravity. His spine reflects these constraints. The morphology and static of human spine and biomechanical relationships between spine and pelvis are in direct relation with bipedia. Owing to this position the pelvis widened and straightened, characteristic sagittal spinal curves appeared and the perispinal muscles were deeply reorganized. Each pelvis is characterized by an important anatomical landmark: the pelvic incidence that reflects the sagittal morphology of the pelvis. Based on this anatomical characteristic, a chain of reactions determines the more efficient equilibrium of the whole body in the sagittal plane in term of energy consumption. Incidence affects the sacral slope, which determines lumbar lordosis, which itself influences pelvic tilt, thoracic kyphosis, and even hip and knee position. All these landmarks can easily be studied on a sagittal radiograph. Knowledge of these functional relationships is essential to understand the origin of low back pain, sagittal imbalance and above all before surgical treatment of spine disorders especially when arthrodesis is considered.

  19. Acupuncture: a potential modality for the treatment of auricular pruritus in Ramsay Hunt Syndrome with multiple cranial nerve lesions.

    Science.gov (United States)

    Liu, Lan Ying; Wang, He Sheng; Sun, Jian Hua

    2015-03-01

    Auricular pruritus coexisted with multiple cranial nerve lesions in Ramsay Hunt syndrome has been rarely reported in the literature especially its treatment. However, auricular pruritus cannot be better improved along with the improvement of multiple cranial nerve lesions. We tried to solve the problem with acupuncture and got experience from it. The following 2 cases of Ramsay Hunt syndrome show a potential modality for the treatment of auricular pruritus with acupuncture.

  20. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  1. Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping.

    Science.gov (United States)

    Clavero, Omar; McCloskey, Jenny; Molina, Vicente Marco; Quirós, Beatriz; Bravo, Ignacio G; de Sanjosé, Silvia; Bosch, F Xavier; Pimenoff, Ville N

    2017-06-01

    Human papillomavirus (HPV)-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ). We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and -positive patients. Histopathology identified 47 squamous intraepithelial lesions (SILs) adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Sixteen (16/47) of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47) were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM); Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Respiratory Disorders in Complicated Cervical Spine Injury

    Directory of Open Access Journals (Sweden)

    S. A. Pervukhin

    2016-01-01

    Full Text Available Objective. Evaluating the results of respiratory therapy in patients with complicated traumatic injury of the cervical spine.Materials and methods. A retrospective comparative analysis of the clinical course was carried out in 52 patients with complicated traumatic injury of the cervical spine: group A: complete spinal cord injury (ASIA A, 37 patients and group B: incomplete injury (ASIA B, 15 patients. The severity of patients' status on integral scales, parameters of the respiratory pattern and thoracopulmonary compliance, gas composition, and acidbase status of the blood were assessed. Data on patients who required prolonged mechanical ventilation, duration of mechanical ventilation, incidence of nosocomial pneumonia, duration of stay in the ICU, time of hospital treatment, and mortality were included in the analysis. Results. The average APACHE II and SOFA scores were higher in group A patients. The development of the acute respiratory failure required longterm mechanical ventilation (more than 48 hours in 91.4% of group A patients and in 53.3% of group B patients. Ventilatorassociated pneumonia complicated the disease in 81.3% of group A patients and 62.5% of group B patients and was accompanied by sepsis in 25% and 12.5% of cases, respectively. Statistically significant deterioration of biomechanical properties and gas exchange function of the lungs was observed in patients complicated with septic pneumonia.Conclusion. Patients with complicated ASIA A and ASIA B cervical spine injuries demonstrate the presence of respiratory failure of neurogenic origin. In addition, the infectious bronchopulmonary complications aggravated respiratory failure in patients with ASIA A injury in 70.3% versus 33.3% in patients with ASIA B. Developmentof pulmonogenic sepsis led to deterioration of the biomechanical and gas exchange functions of the lungs and increased the likelihood of unfavorable outcome of the disease in 77.8% of cases. The high

  3. Novalis radiosurgery for metastatic spine tumors.

    Science.gov (United States)

    Rock, Jack P; Ryu, Samuel; Yin, Fang-Fang

    2004-10-01

    It is logical to anticipate that the field of spinal radiosurgery will evolve in a fashion similar to that seen for intracranial radiosurgery. Given the frequency of various pathologic entities that affect the spine, including those that have proven to be largely intractable to surgery, radiation, and chemotherapy (eg, sarcomas), and the serious clinical, economic and quality-of-life consequences of paraplegia, radiosurgery offers new hope as an adjuvant or primary therapy. The meticulous application of well-designed investigations of relevant clinical outcomes will be critical to the appropriate and effective use of this technology.

  4. Posterior approach to the degenerative cervical spine.

    Science.gov (United States)

    Yonenobu, Kazuo; Oda, Takenori

    2003-10-01

    Laminoplasty has been gradually accepted as a treatment for choice for cervical compression myelopathy. The historical perspective of laminoplasty is described. The aims of laminoplasty are to expand the spinal canal, to secure spinal stability, to preserve the protective function of the spine, and to preserve spinal mobility. Laminoplasty is indicated in myelopathic patients with a developmentally narrow spinal canal or multiple-level involvement combined with a relatively narrow canal. Several laminoplasty techniques and supplementary techniques are described, together with expected outcomes and complications of surgery.

  5. Morphometric study of distance between posterior inferior iliac spine and ischial spine of the human hip bone for sex determination

    OpenAIRE

    2014-01-01

    Background: Objective of current study was to study the distance between Posterior Inferior Iliac Spine and Ischial Spine (PIIS-IS) of human hip bone for determination of sex. Methods: The study comprised unpaired 149 adult human hip bones of known sex. The posterior inferior iliac spine and ischial spine were identified in all the hip bones and a vernier calliper was used to measure the distance between the PIIS-IS. Results: It was observed that the mean distance of PIIS-IS in males a...

  6. Is a pelvic fracture a predictor for thoracolumbar spine fractures after blunt trauma?

    NARCIS (Netherlands)

    Pouw, M.H.; Deunk, J.; Brink, M.; Dekker, H.M.; Kool, D.R.; Vugt, A.B. van; Edwards, M.J.R.

    2009-01-01

    BACKGROUND: Discussion still remains which polytraumatized patients require radiologic thoracolumbar spine (TL spine) screening. The purpose of this study is to determine whether pelvic fractures are associated with TL spine fractures after a blunt trauma. Additionally, the sensitivity of

  7. Thromboembolic Complications Following Spine Surgery Assessed with Spiral CT Scans: DVT/PE Following Spine Surgery.

    Science.gov (United States)

    Kim, Han Jo; Walcott-Sapp, Sarah; Adler, Ronald S; Pavlov, Helene; Boachie-Adjei, Oheneba; Westrich, Geoffrey H

    2011-02-01

    Spine surgery is associated with a significant risk of postoperative pulmonary embolism (PE) and/or deep vein thrombosis (DVT). The goal of this study was to determine which symptoms and risk factors were associated with spiral CT scans positive for PE and/or DVT in the postoperative spine surgery patient. We conducted a retrospective review of all spine patients who underwent a postoperative CT to rule out PE during the period of March 2004-February 2006. The type of surgical procedure, risk factors, symptoms prompting scan ordering, anticoagulation, and treatment were recorded. Logistic regression models were used to determine significant predictors of a positive CT in this patient population. Of the 3,331 patients that had spine surgery during the study period, 130 (3.9%) had a spiral CT scan to rule out PE and/or proximal DVT. Thirty-three of the 130 (25.4%) CT scans were positive for PE only, five (3.8%) for PE and DVT, and three (2.3%) for DVT only. Only 24.5% (32) patients had risk factors for thromboembolic disease, and of these, a history of PE and/or DVT was the only significant risk factor for a positive scan (p = 0.03). No presenting symptoms or demographic variables were noted to have a significant association with PE and/or DVT. The type of surgical procedure (i.e., anterior, posterior, and percutaneous) was not associated with an increased risk for PE and/or DVT. Patients who are undergoing spine surgery with a history of thromboembolic disease should be carefully monitored postoperatively and may benefit from more aggressive prophylaxis.

  8. Atypical course oferysipelas and coexisting infections. Case study and literature review

    Directory of Open Access Journals (Sweden)

    Anna Martyniuk

    2015-12-01

    Full Text Available Erysipelas is  an acute, erythematous, rapidly spreading skin infection, usually caused by beta-haemolytic group A Streptococcus bacteria. The disease is usually located on the legs and toes, less frequently on the face. One of the predisposing factors for the development of erysipelas are coexisting infections. The aim of the work was to attempt to determine whether there was any connection between the atypical course of erysipelas and Helicobacter pylori infection in a 47-year-old female patient. The patient had a history of treatment for chronic otitis media with effusion and recurring abdominal pain. The current disease started abruptly with fever, erythematous skin lesion located on the right cheek and severe pain in the right ear. After a few days, the facial erythema got worse, oedema appeared on the right side of the face and redness, oedema and pain in the auricle could be observed. After examinations by an ENT specialist and a dermatologist, erysipelas of the face, auricle and external auditory meatus was diagnosed. The diagnosis was confirmed by bacteriological examination. As a result of antibiotic therapy skin lesions subsided and the patient’s general condition improved. As the dyspeptic symptoms exacerbated, a diagnostic test was performed and a coexisting Helicobacter pylori infection was diagnosed. The overall clinical picture and data obtained from medical literature suggest that the coexisting Helicobacter pylori infection could have contributed to both the chronic otitis media with effusion and atypical course of erysipelas. According to medical literature, in the case of patients with dyspeptic symptoms, Helicobacter pylori bacteria can be transferred from the lining of the stomach upwards to the oral cavity, middle ear and paranasal sinuses. Kariya et al. in their review of original work suggested that Helicobacter pylori may contribute to the exacerbation of an existing inflammation in

  9. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review

    DEFF Research Database (Denmark)

    Hestbaek, L; Leboeuf-Yde, C

    2000-01-01

    was searched for the years 1976 to 1995 with the following index terms: "chiropractic tests," "chiropractic adjusting technique," "motion palpation," "movement palpation," "leg length," "applied kinesiology," and "sacrooccipital technique." In addition, a manual search was performed at the libraries....... Documentation of applied kinesiology was not available. Palpation for muscle tension, palpation for misalignment, and visual inspection were either undocumented, unreliable, or not valid. CONCLUSION: The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because......OBJECTIVE: To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies. DATA SOURCES: The CHIROLARS database...

  10. [Stress fracture of the scapular spine associated with rotator cuff dysfunction: Report of 3 cases and review of the literature].

    Science.gov (United States)

    García-Coiradas, J; Lópiz, Y; Marco, F

    2014-01-01

    Scapular spine stress fractures have been scarcely reported in the literature. Their pathomechanics, clinical course and treatment are not well established. We review 3 cases in 2 patients that were associated with cuff dysfunction. On follow-up, none of these fractures progressed to healing. Two of them needed osteosynthesis and bone grafting, and the third one became a painless non-union. The authors propose the combination of 3 factors as a reason for this lesion: a functionally impaired cuff, a greater activation of the muscles with origin and insertion in the spine-acromion and a fragile bone. As we believe that these fractures are unstable, and non-union would be expected, their surgical management is recommended. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  11. Competitive intransitivity, population interaction structure, and strategy coexistence.

    Science.gov (United States)

    Laird, Robert A; Schamp, Brandon S

    2015-01-21

    Intransitive competition occurs when competing strategies cannot be listed in a hierarchy, but rather form loops-as in the game rock-paper-scissors. Due to its cyclic competitive replacement, competitive intransitivity promotes strategy coexistence, both in rock-paper-scissors and in higher-richness communities. Previous work has shown that this intransitivity-mediated coexistence is strongly influenced by spatially explicit interactions, compared to when populations are well mixed. Here, we extend and broaden this line of research and examine the impact on coexistence of intransitive competition taking place on a continuum of small-world networks linking spatial lattices and regular random graphs. We use simulations to show that the positive effect of competitive intransitivity on strategy coexistence holds when competition occurs on networks toward the spatial end of the continuum. However, in networks that are sufficiently disordered, increasingly violent fluctuations in strategy frequencies can lead to extinctions and the prevalence of monocultures. We further show that the degree of disorder that leads to the transition between these two regimes is positively dependent on population size; indeed for very large populations, intransitivity-mediated strategy coexistence may even be possible in regular graphs with completely random connections. Our results emphasize the importance of interaction structure in determining strategy dynamics and diversity.

  12. Coexistence of competing metabolic pathways in well-mixed populations

    Science.gov (United States)

    Fernández, Lenin; Amado, André; Campos, Paulo R. A.; Ferreira, Fernando Fagundes

    2016-05-01

    Understanding why strains with different metabolic pathways that compete for a single limiting resource coexist is a challenging issue within a theoretical perspective. Previous investigations rely on mechanisms such as group or spatial structuring to achieve a stable coexistence between competing metabolic strategies. Nevertheless, coexistence has been experimentally reported even in situations where it cannot be attributed to spatial effects [Heredity 100, 471 (2008), 10.1038/sj.hdy.6801073]. According to that study a toxin expelled by one of the strains can be responsible for the stable maintenance of the two strain types. We propose a resource-based model in which an efficient strain with a slow metabolic rate competes with a second strain type which presents a fast but inefficient metabolism. Moreover, the model assumes that the inefficient strain produces a toxin as a by-product. This toxin affects the growth rate of both strains with different strength. Through an extensive exploration of the parameter space we determine the situations at which the coexistence of the two strains is possible. Interestingly, we observe that the resource influx rate plays a key role in the maintenance of the two strain types. In a scenario of resource scarcity the inefficient is favored, though as the resource influx rate is augmented the coexistence becomes possible and its domain is enlarged.

  13. Hydatid disease of spine: Multiple meticulous surgeries and a long term followup

    Directory of Open Access Journals (Sweden)

    Akshay Jain

    2014-01-01

    Full Text Available We present a long term followup (13 years of spinal hydatid disease with multiple recurrences and intradural dissemination of the disease at the last followup. Intradural extension of the disease in our case was supposedly through the dural rent which has not been reported in English literature. An early followup of the same case has been reported previously by the authors. A 53 year-old female came with progressive left leg pain and difficulty in walking since 2 months. On examination, she had grade four power of ankle and digit dorsiflexors (L4 and L5 myotomes on the left side (Medical Research Council grade. There was no sensory loss, no myelopathy and sphincters were intact. Plain radiographs showed consolidation at D10-D11 (old operated levels with stable anterior column and there were no implant related problems. Magnetic resonance imaging showed a cystic lesion at L3-L4, signal intensity same as of cerebrospinal fluid in T2 and T1, displacing the cauda equina roots. The proximal extent of the lesion could not be identified because of artifacts from previous stainless steel instrumentation. Computed tomography myelogram showed complete block at L3-L4 junction with "meniscus sign". This is the longest followup of hydatid disease of the spine that has ever been reported. Hydatid disease should always be included in the differential diagnosis of destructive or infectious lesions of the spine. Aggressive radical resection whenever possible and chemotherapy is the key to good results. Recurrence is known to occur even after that. Disease can have long remission periods. Possibility of intradural dissemination through dural injury is highly likely. Hence, it should always be repaired whenever possible.

  14. Hydatid disease of spine: Multiple meticulous surgeries and a long term followup.

    Science.gov (United States)

    Jain, Akshay; Prasad, Gautam; Rustagi, Tarush; Bhojraj, Shekhar Y

    2014-09-01

    We present a long term followup (13 years) of spinal hydatid disease with multiple recurrences and intradural dissemination of the disease at the last followup. Intradural extension of the disease in our case was supposedly through the dural rent which has not been reported in English literature. An early followup of the same case has been reported previously by the authors. A 53 year-old female came with progressive left leg pain and difficulty in walking since 2 months. On examination, she had grade four power of ankle and digit dorsiflexors (L4 and L5 myotomes) on the left side (Medical Research Council grade). There was no sensory loss, no myelopathy and sphincters were intact. Plain radiographs showed consolidation at D10-D11 (old operated levels) with stable anterior column and there were no implant related problems. Magnetic resonance imaging showed a cystic lesion at L3-L4, signal intensity same as of cerebrospinal fluid in T2 and T1, displacing the cauda equina roots. The proximal extent of the lesion could not be identified because of artifacts from previous stainless steel instrumentation. Computed tomography myelogram showed complete block at L3-L4 junction with "meniscus sign". This is the longest followup of hydatid disease of the spine that has ever been reported. Hydatid disease should always be included in the differential diagnosis of destructive or infectious lesions of the spine. Aggressive radical resection whenever possible and chemotherapy is the key to good results. Recurrence is known to occur even after that. Disease can have long remission periods. Possibility of intradural dissemination through dural injury is highly likely. Hence, it should always be repaired whenever possible.

  15. Hydatid disease of spine: Multiple meticulous surgeries and a long term followup

    Science.gov (United States)

    Jain, Akshay; Prasad, Gautam; Rustagi, Tarush; Bhojraj, Shekhar Y

    2014-01-01

    We present a long term followup (13 years) of spinal hydatid disease with multiple recurrences and intradural dissemination of the disease at the last followup. Intradural extension of the disease in our case was supposedly through the dural rent which has not been reported in English literature. An early followup of the same case has been reported previously by the authors. A 53 year-old female came with progressive left leg pain and difficulty in walking since 2 months. On examination, she had grade four power of ankle and digit dorsiflexors (L4 and L5 myotomes) on the left side (Medical Research Council grade). There was no sensory loss, no myelopathy and sphincters were intact. Plain radiographs showed consolidation at D10-D11 (old operated levels) with stable anterior column and there were no implant related problems. Magnetic resonance imaging showed a cystic lesion at L3-L4, signal intensity same as of cerebrospinal fluid in T2 and T1, displacing the cauda equina roots. The proximal extent of the lesion could not be identified because of artifacts from previous stainless steel instrumentation. Computed tomography myelogram showed complete block at L3-L4 junction with “meniscus sign”. This is the longest followup of hydatid disease of the spine that has ever been reported. Hydatid disease should always be included in the differential diagnosis of destructive or infectious lesions of the spine. Aggressive radical resection whenever possible and chemotherapy is the key to good results. Recurrence is known to occur even after that. Disease can have long remission periods. Possibility of intradural dissemination through dural injury is highly likely. Hence, it should always be repaired whenever possible. PMID:25298565

  16. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  17. Micromechanics of Minor Cervical Spine Injuries

    Science.gov (United States)

    Niederer, Peter F.; Schmitt, Kai-Uwe; Muser, Markus H.; Walz, Felix H.

    Minor soft tissue injuries of the cervical spine are of increasing significance in public health. They may in particular be associated with long-term impairment. Such injuries are observed primarily in rear-end automobile collisions at low impact speeds and are attributed to a “whiplash”-type event. The question with respect to injury mechanisms of the cervical spine in cases of impacts of a low severity have raised controversial views in the past. Among proposed injury mechanisms, interactions between fluid and solid structures have been postulated: Viscous shear stresses or pressure gradients which arise in the deforming anatomical structures may have an adverse influence, e. g., on cellular membranes. In this communication, mathematical modeling approaches are presented which allow for a quantification of fluid/solid interactions under typical loading conditions of interest here. It is found, that the shear stresses caused by fluids and acting on accelerated surfaces of fluid-filled bodies depend largely on the size of the fluid space under consideration. Accelerations exhibit a stronger influence than their duration. It cannot be excluded that critical levels are reached even in a low speed impact scenario.

  18. Dendritic spine changes associated with normal aging.

    Science.gov (United States)

    Dickstein, D L; Weaver, C M; Luebke, J I; Hof, P R

    2013-10-22

    Given the rapid rate of population aging and the increased incidence of cognitive decline and neurodegenerative diseases with advanced age, it is important to ascertain the determinants that result in cognitive impairment. It is also important to note that much of the aged population exhibit 'successful' cognitive aging, in which cognitive impairment is minimal. One main goal of normal aging studies is to distinguish the neural changes that occur in unsuccessful (functionally impaired) subjects from those of successful (functionally unimpaired) subjects. In this review, we present some of the structural adaptations that neurons and spines undergo throughout normal aging and discuss their likely contributions to electrophysiological properties and cognition. Structural changes of neurons and dendritic spines during aging, and the functional consequences of such changes, remain poorly understood. Elucidating the structural and functional synaptic age-related changes that lead to cognitive impairment may lead to the development of drug treatments that can restore or protect neural circuits and mediate cognition and successful aging.

  19. Research of Spined Heat-Exchanging Pipes

    Directory of Open Access Journals (Sweden)

    Akulov Kirill

    2016-01-01

    Full Text Available Work is devoted to a research of spined heat-exchanging pipes that are assumed to use in air-cooler exchangers (ACE. The proposed new geometry of finning allows intensifying heat exchange and improving the efficiency of air coolers. It is caused by the increased area of finned surface with a value of finning ratio (the ratio of the area of the smooth pipe to a finned one to 42.7, while in the commercially available ACE, the figure is 22. Besides, the geometrical arrangement of the pin fins turbulizes the airflow. It should be mentioned that an easier method of manufacturing of heat exchanging pipes is proposed to use, which will reduce their costs. The proposed heat exchange pipes are made by winding cut aluminum strip to the supporting pipe or stretching stamped blanks on it. To increase the efficiency of the heat exchange surface pin fins should be as thin and long as possible; however, their strength should be sufficient for deformation-free operation. Fins should be staggered to maximize the distance between them. Spined heat-exchange pipes are designed to operate in a commercially produced ACE and their service is carried out similarly to commercially produced transversely finned pipes.

  20. [Tumours of the upper cervical spine].

    Science.gov (United States)

    Hernández García, Borja Jesús; Isla Guerrero, Alberto; Castaño, Ana; Alvarez Ruiz, Fernando; Gómez de la Riva, Alvaro

    2013-01-01

    Vertebral tumours arising in the upper cervical spine are rare. We present our experience in managing these neoplasms. We retrospectively reviewed the case histories of patients treated at our institution between January 2000 and June 2011. There were 9 patients with tumours in C1-C2-C3: 2metastases, 3chordomas, 2plasmocytomas, 1chondrosarcoma and 1osteochondroma. All patients complained of neck pain at the time of diagnosis. Three patients underwent an anterior and posterior approach, 3 an exclusively posterior approach and 3 an exclusively anterior surgical approach. Tumour resection was intralesional in 7 cases. Chemo-radiotherapy was used as adjuvant therapy in patients with malignant tumours. Vertebral tumours in the upper cervical spine are usually malignant. Achieving en bloc resection is particularly challenging and is technically unfeasible in many cases. This worsens the prognosis and makes adjuvant treatment very important. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  1. Unicystic ameloblastoma with diverse mural proliferation - a hybrid lesion.

    Science.gov (United States)

    Mahadesh, Jyothi; Rayapati, Dilip Kumar; Maligi, Prathima M; Ramachandra, Prashanth

    2011-03-01

    A 46-year-old man was referred to our hospital for treatment, complaining of swelling on the right mandibular molar region. Radiographic examination revealed a well defined multilocular radiolucent lesion with root resorption of right lower anteriors and molars. Following biopsy, a diagnosis of unicystic ameloblastoma of mural type was made and hemimandibulectomy was performed under general anesthesia. Histopathological examination of the surgical specimen exhibited a unicystic ameloblastoma of luminal, intraluminal, and mural type. Intraluminal proliferation was of plexiform pattern and mural proliferation showed unusual histopathological findings, which revealed follicular, acanthomatous areas coexisted with desmoplastic areas. This mural picture was similar to the so-called 'hybrid lesion of ameloblastoma', whose biological profile is not elicited due to the lack of adequate published reports. Two years follow up till date has not revealed any signs of recurrence.

  2. Unicystic ameloblastoma with diverse mural proliferation - a hybrid lesion

    Energy Technology Data Exchange (ETDEWEB)

    Mahadesh, Jyothi [Sri Siddhartha Dental College and Hospital, (India); Rayapati, Dilip Kumar; Maligi, Prathima M; Ramachandra, Prashanth [Dayananda Sagar College of Dental Sciences, Bengaluru (India)

    2011-03-15

    A 46-year-old man was referred to our hospital for treatment, complaining of swelling on the right mandibular molar region. Radiographic examination revealed a well defined multilocular radiolucent lesion with root resorption of right lower anteriors and molars. Following biopsy, a diagnosis of unicystic ameloblastoma of mural type was made and hemimandibulectomy was performed under general anesthesia. Histopathological examination of the surgical specimen exhibited a unicystic ameloblastoma of luminal, intraluminal, and mural type. Intraluminal proliferation was of plexiform pattern and mural proliferation showed unusual histopathological findings, which revealed follicular, acanthomatous areas coexisted with desmoplastic areas. This mural picture was similar to the so-called 'hybrid lesion of ameloblastoma', whose biological profile is not elicited due to the lack of adequate published reports. Two years follow up till date has not revealed any signs of recurrence.

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

    Directory of Open Access Journals (Sweden)

    Swanger Sharon A

    2011-10-01

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

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

    OpenAIRE

    2011-01-01

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

  5. Systemic transthyretin amyloidosis in a patient with bent spine syndrome.

    Science.gov (United States)

    Rezania, Kourosh; Pytel, Peter; Smit, Laurel J; Mastrianni, James; Dina, Michelle A; Highsmith, W Edward; Dogan, Ahmet

    2013-06-01

    Wild-type and mutant transthyretin (TTR) are implicated in systemic amyloidosis (ATTR). Myopathy is a rare complication of ATTR amyloidosis, however no patient with bent spine syndrome secondary to ATTR amyloidosis has been reported so far. We present the first case of bent spine syndrome in a patient with wild-type ATTR amyloidosis who also had concomitant Alzheimer's disease.

  6. Stability of the Scoliotic Spine: Effect of Scoliosis Braces.

    Science.gov (United States)

    Havey, Robert M; Gavin, Thomas M; Patwardhan, Avinash G

    2016-04-01

    Orthotic treatment (braces) for scoliosis is best understood in light of the natural history of idiopathic scoliosis and the mechanics of spine stability. Idiopathic scoliosis is a spinal deformity confronted often by spine surgeons. With prompt recognition, treatment can be effective.

  7. An Injectable Method for Posterior Lateral Spine Fusion

    Science.gov (United States)

    2013-09-01

    West, and E. A. Olmsted-Davis, “An injectable method for noninvasive spine fusion,” Spine J. 11(6), 545–556 (2011). 15. R. Y. Tsien , “Constructing...Lev-Ram, P. A. Steinbach, and R. Y. Tsien , “Mammalian expression of infrared fluorescent proteins engineered from a bacterial phytochrome,” Science

  8. Links between the mechanics of ventilation and spine stability.

    Science.gov (United States)

    Wang, Simon; McGill, Stuart M

    2008-05-01

    Spine stability is ensured through isometric coactivation of the torso muscles; however, these same muscles are used cyclically to assist ventilation. Our objective was to investigate this apparent paradoxical role (isometric contraction for stability or rhythmic contraction for ventilation) of some selected torso muscles that are involved in both ventilation and support of the spine. Eight, asymptomatic, male subjects provided data on low back moments, motion, muscle activation, and hand force. These data were input to an anatomically detailed, biologically driven model from which spine load and a lumbar spine stability index was obtained. Results revealed that subjects entrained their torso stabilization muscles to breathe during demanding ventilation tasks. Increases in lung volume and back extensor muscle activation coincided with increases in spine stability, whereas declines in spine stability were observed during periods of low lung inflation volume and simultaneously low levels of torso muscle activation. As a case study, aberrant ventilation motor patterns (poor muscle entrainment), seen in one subject, compromised spine stability. Those interested in rehabilitation of patients with lung compromise and concomitant back troubles would be assisted with knowledge of the mechanical links between ventilation during tasks that impose spine loading.

  9. An Injectable Method for Posterior Lateral Spine Fusion

    Science.gov (United States)

    2014-09-01

    types of spine fusion and is useful for the treatment of scoliosis , instability and painful degenerative conditions of the spine. We recently...taken 4 weeks after the initial injection of AdBMP2 transduced cells. INTRODUCTION: The treatment of many spinal problems involves stabilization of

  10. Following Scoliosis Progression in the Spine using Ultrasound Imaging

    NARCIS (Netherlands)

    Purnama, Ketut; Wilkinson, M.H.F.; Veldhuizen, A.G.; Ooijen, P.M.A. van; Sardjono, T.A.; Lubbers, Jacob; Verkerke, G.J.; Dossel, O; Schlegel, WC

    2009-01-01

    Scoliosis is a three-dimensional deformation of the spine which is characterized by a lateral deviation of the spine and axial rotation of the vertebrae. It must be monitored frequently to be in time to start the treatment in case of progression. Nowadays, X-ray is used, but has a detrimental effect

  11. Comparative anatomical dimensions of the complete human and porcine spine

    NARCIS (Netherlands)

    Busscher, Iris; Ploegmakers, Joris J. W.; Verkerke, Gijsbertus J.; Veldhuizen, Albert G.

    2010-01-01

    New spinal implants and surgical procedures are often tested pre-clinically on human cadaver spines. However, the availability of fresh frozen human cadaver material is very limited and alternative animal spines are more easily available in all desired age groups, and have more uniform geometrical a

  12. Comparative anatomical dimensions of the complete human and porcine spine

    NARCIS (Netherlands)

    Busscher, Iris; Ploegmakers, Joris J. W.; Verkerke, Gijsbertus J.; Veldhuizen, Albert G.

    New spinal implants and surgical procedures are often tested pre-clinically on human cadaver spines. However, the availability of fresh frozen human cadaver material is very limited and alternative animal spines are more easily available in all desired age groups, and have more uniform geometrical

  13. Lesiones en el deporte

    Directory of Open Access Journals (Sweden)

    Rubio Gimeno, Silvio

    2000-02-01

    Full Text Available Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmente del sistema músculo- esquelético.
    Se exponen en este trabajo consideraciones históricas, la epidemiología de la lesión deportiva y se describen, concisamente, algunas de las lesiones más habituales y significativas que afectan a músculos, tendones y sistema esquelético.

  14. Mobile spine chordoma: results of 166 patients from the AOSpine Knowledge Forum Tumor database

    Science.gov (United States)

    Gokaslan, Ziya L.; Zadnik, Patricia L.; Sciubba, Daniel M.; Germscheid, Niccole; Goodwin, C. Rory; Wolinsky, Jean-Paul; Bettegowda, Chetan; Groves, Mari L.; Luzzati, Alessandro; Rhines, Laurence D.; Fisher, Charles G.; Varga, Peter Pal; Dekutoski, Mark B.; Clarke, Michelle J.; Fehlings, Michael G.; Quraishi, Nasir A.; Chou, Dean; Reynolds, Jeremy J.; Williams, Richard P.; Kawahara, Norio; Boriani, Stefano

    2016-01-01

    Object A chordoma is an indolent primary spinal tumor that has devastating effects on the patient’s life. These lesions are chemoresistant, resistant to conventional radiotherapy, and moderately sensitive to proton therapy; however, en bloc resection remains the preferred treatment for optimizing patient outcomes. While multiple small and largely retrospective studies have investigated the outcomes following en bloc resection of chordomas in the sacrum, there have been few large-scale studies on patients with chordomas of the mobile spine. The goal of this study was to review the outcomes of surgically treated patients with mobile spine chordomas at multiple international centers with respect to local recurrence and survival. This multiinstitutional retrospective study collected data between 1988 and 2012 about prognosis-predicting factors, including various clinical characteristics and surgical techniques for mobile spine chordoma. Tumors were classified according to the Enneking principles and analyzed in 2 treatment cohorts: Enneking-appropriate (EA) and Enneking-inappropriate (EI) cohorts. Patients were categorized as EA when the final pathological assessment of the margin matched the Enneking recommendation; otherwise, they were categorized as EI. Methods Descriptive statistics were used to summarize the data (Student t-test, chi-square, and Fisher exact tests). Recurrence and survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariate Cox proportional hazard modeling. Results A total of 166 patients (55 female and 111 male patients) with mobile spine chordoma were included. The median patient follow-up was 2.6 years (range 1 day to 22.5 years). Fifty-eight (41%) patients were EA and 84 (59%) patients were EI. The type of biopsy (p < 0.001), spinal location (p = 0.018), and if the patient received adjuvant therapy (p < 0.001) were significantly different between the 2 cohorts. Overall, 58 (35%) patients developed local

  15. [Coexistence of coeliac disease and inflammatory bowel disease in children].

    Science.gov (United States)

    Krawiec, Paulina; Pawłowska-Kamieniak, Agnieszka; Pac-Kożuchowska, Elżbieta; Mroczkowska-Juchkiewcz, Agnieszka; Kominek, Katarzyna

    2016-01-01

    Coeliac disease and inflammatory bowel disease are chronic inflammatory conditions of gastrointestinal tract with complex aetiology with genetic, environmental and immunological factors contributing to its pathogenesis. It was noted that immune-mediated disorders often coexist. There is well-known association between coeliac disease and type 1 diabetes and ulcerative colitis and primary sclerosing cholangitis. However, growing body of literature suggests the association between coeliac disease and inflammatory bowel disease, particularly ulcerative colitis. This is an extremely rare problem in paediatric gastroenterology. To date there have been reported several cases of children with coexisting coeliac disease and inflammatory bowel disease. Herewith we present review of current literature on coexistence of coeliac disease and inflammatory bowel disease in children. © 2016 MEDPRESS.

  16. A Case of hereditary spherocytosis coexisting with Gilbert's syndrome.

    Science.gov (United States)

    Lee, Min Jae; Chang, Yoon Hwan; Kang, Seung Hwa; Mun, Se Kwon; Kim, Heyjin; Han, Chul Ju; Kim, Jin; Kang, Hye Jin

    2013-03-25

    We recently encountered a case of hereditary spherocytosis coexisting with Gilbert's syndrome. Patient was initially diagnosed with Gilbert's syndrome and observed, but other findings suggestive of concurrent hemolysis, such as splenomegaly and gallstones were noted during the follow-up period. Therefore, further evaluations, including a peripheral blood smear, osmotic fragility test, autohemolysis test, and red blood cell membrane protein test were performed, and coexisting hereditary spherocytosis was diagnosed. Genotyping of the conjugation enzyme uridine diphosphate-glucuronosyltransferase was used to confirm Gilbert's syndrome. Because of the high prevalence rates and similar symptoms of these 2 diseases, hereditary spherocytosis can be masked in patients with Gilbert's syndrome. In review of a case and other article, the possibility of the coexistence of these 2 diseases should be considered, especially in patients with unconjugated hyperbilirubinemia who also have splenomegaly and gallstones.

  17. Endometrial Adenocarcinoma and Mucocele of the Appendix: An Unusual Coexistence

    Directory of Open Access Journals (Sweden)

    Ioannis Kalogiannidis

    2013-01-01

    Full Text Available Appendiceal mucocele is a rare clinical entity, which is however quite often associated with mucinous ovarian tumor. The coexistence of mucinous cystadenoma of the appendix and endometrial adenocarcinoma has not been reported before. A 49-year-old woman presented to our clinic with postmenopausal bleeding and no other symptom. Endometrial biopsy revealed endometrial adenocarcinoma of endometrioid type (grade I. Preoperative CT scanning revealed an appendiceal mucocele, and a colonoscopy confirmed the diagnosis. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and appendectomy. The final histopathological examination showed a mucinous cystadenoma of the appendix and confirmed the diagnosis of endometrioid endometrial adenocarcinoma. The coexistence of appendiceal mucocele and female genital tract pathology is rare. However, gynecologists should keep a high level of suspicion for such possible coexistence. Both the diagnostic approach and the therapeutic management should be multidisciplinary, most importantly with the involvement of general surgeons.

  18. Beyond peaceful coexistence the emergence of space, time and quantum

    CERN Document Server

    2016-01-01

    Beyond Peaceful Coexistence: The Emergence of Space, Time and Quantum brings together leading academics in mathematics and physics to address going beyond the 'peaceful coexistence' of space-time descriptions (local and continuous ones) and quantum events (discrete and non-commutative ones). Formidable challenges waiting beyond the Standard Model require a new semantic consistency within the theories in order to build new ways of understanding, working and relating to them. The original A. Shimony meaning of the peaceful coexistence (the collapse postulate and non-locality) appear to be just the tip of the iceberg in relation to more serious fundamental issues across physics as a whole.Chapters in this book present perspectives on emergent, discrete, geometrodynamic and topological approaches, as well as a new interpretative spectrum of quantum theories after Copenhagen, discrete time theories, time-less approaches and 'super-fluid' pictures of space-time.As well as stimulating further research among establis...

  19. Interdisciplinary and Cross-Cultural Perspectives on Explanatory Coexistence.

    Science.gov (United States)

    Watson-Jones, Rachel E; Busch, Justin T A; Legare, Cristine H

    2015-10-01

    Natural and supernatural explanations are used to interpret the same events in a number of predictable and universal ways. Yet little is known about how variation in diverse cultural ecologies influences how people integrate natural and supernatural explanations. Here, we examine explanatory coexistence in three existentially arousing domains of human thought: illness, death, and human origins using qualitative data from interviews conducted in Tanna, Vanuatu. Vanuatu, a Melanesian archipelago, provides a cultural context ideal for examining variation in explanatory coexistence due to the lack of industrialization and the relatively recent introduction of Christianity and Western education. We argue for the integration of interdisciplinary methodologies from cognitive science and anthropology to inform research on explanatory coexistence. Copyright © 2015 Cognitive Science Society, Inc.

  20. Performance Analysis on the Coexistence of Multiple Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Lijun Qian

    2015-05-01

    Full Text Available The demand for wireless services is growing on a daily basis while spectral resources to support this growth are static. Therefore, there is need for the adoption of a new spectrum sharing paradigm. Cognitive Radio (CR is a revolutionary technology aiming to increase spectrum utilization through dynamic spectrum access, as well as mitigating interference among multiple coexisting wireless networks. In many practical scenarios, multiple CR networks may coexist in the same geographical area, and they may interfere with each other and also have to yield to the primary user (PU. In this study, we investigate how much throughput a node in a CR network can achieve in the presence of another CR network and a PU. The results of this study illustrate how the transmission probability and sensing performance affect the achievable throughput of a node in coexisting CR networks. In addition, these results may serve as guidance for the deployment of multiple CR networks.

  1. Meniscal Ramp Lesions

    OpenAIRE

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, ...

  2. Pediatric cervical spine: normal anatomy, variants, and trauma.

    Science.gov (United States)

    Lustrin, Elizabeth Susan; Karakas, Sabiha Pinar; Ortiz, A Orlando; Cinnamon, Jay; Castillo, Mauricio; Vaheesan, Kirubahara; Brown, James H; Diamond, Alan S; Black, Karen; Singh, Sudha

    2003-01-01

    Emergency radiologic evaluation of the pediatric cervical spine can be challenging because of the confusing appearance of synchondroses, normal anatomic variants, and injuries that are unique to children. Cervical spine injuries in children are usually seen in the upper cervical region owing to the unique biomechanics and anatomy of the pediatric cervical spine. Knowledge of the normal embryologic development and anatomy of the cervical spine is important to avoid mistaking synchondroses for fractures in the setting of trauma. Familiarity with anatomic variants is also important for correct image interpretation. These variants include pseudosubluxation, absence of cervical lordosis, wedging of the C3 vertebra, widening of the predental space, prevertebral soft-tissue widening, intervertebral widening, and "pseudo-Jefferson fracture." In addition, familiarity with mechanisms of injury and appropriate imaging modalities will aid in the correct interpretation of radiologic images of the pediatric cervical spine.

  3. Dysphagia associated with cervical spine and postural disorders.

    Science.gov (United States)

    Papadopoulou, Soultana; Exarchakos, Georgios; Beris, Alexander; Ploumis, Avraam

    2013-12-01

    Difficulties with swallowing may be both persistent and life threatening for the majority of those who experience it irrespective of age, gender, and race. The purpose of this review is to define oropharyngeal dysphagia and describe its relationship to cervical spine disorders and postural disturbances due to either congenital or acquired disorders. The etiology and diagnosis of dysphagia are analyzed, focusing on cervical spine pathology associated with dysphagia as severe cervical spine disorders and postural disturbances largely have been held accountable for deglutition disorders. Scoliosis, kyphosis–lordosis, and osteophytes are the primary focus of this review in an attempt to elucidate the link between cervical spine disorders and dysphagia. It is important for physicians to be knowledgeable about what triggers oropharyngeal dysphagia in cases of cervical spine and postural disorders. Moreover, the optimum treatment for dysphagia, including the use of therapeutic maneuvers during deglutition, neck exercises, and surgical treatment, is discussed.

  4. Dendritic spine actin dynamics in neuronal maturation and synaptic plasticity.

    Science.gov (United States)

    Hlushchenko, Iryna; Koskinen, Mikko; Hotulainen, Pirta

    2016-09-01

    The majority of the postsynaptic terminals of excitatory synapses in the central nervous system exist on small bulbous structures on dendrites known as dendritic spines. The actin cytoskeleton is a structural element underlying the proper development and morphology of dendritic spines. Synaptic activity patterns rapidly change actin dynamics, leading to morphological changes in dendritic spines. In this mini-review, we will discuss recent findings on neuronal maturation and synaptic plasticity-induced changes in the dendritic spine actin cytoskeleton. We propose that actin dynamics in dendritic spines decrease through actin filament crosslinking during neuronal maturation. In long-term potentiation, we evaluate the model of fast breakdown of actin filaments through severing and rebuilding through polymerization and later stabilization through crosslinking. We will discuss the role of Ca(2+) in long-term depression, and suggest that actin filaments are dissolved through actin filament severing. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Sensitivity of lumbar spine loading to anatomical parameters

    DEFF Research Database (Denmark)

    Putzer, Michael; Ehrlich, Ingo; Rasmussen, John

    2016-01-01

    models for four different postures. The in uence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine were studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force......Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the in uence of dened geometrical parameters on lumbar spine loading utilizing ve parametrized musculoskeletal lumbar spine...... were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most in uential. The results indicated that measuring these parameters from X-rays would be most important to morph an existing musculoskeletal...

  6. Wi-Fi Coexistence with Duty Cycled LTE-U

    OpenAIRE

    Pang, Yimin; Babaei, Alireza; Andreoli-Fang, Jennifer; Hamzeh, Belal

    2016-01-01

    Coexistence of Wi-Fi and LTE-Unlicensed (LTE-U) technologies has drawn significant concern in industry. In this paper, we investigate the Wi-Fi performance in the presence of duty cycle based LTE-U transmission on the same channel. More specifically, one LTE-U cell and one Wi-Fi basic service set (BSS) coexist by allowing LTE-U devices transmit their signals only in predetermined duty cycles. Wi-Fi stations, on the other hand, simply contend the shared channel using the distributed coordinati...

  7. Coexistence and Survival in Conservative Lotka-Volterra Networks

    Science.gov (United States)

    Knebel, Johannes; Krüger, Torben; Weber, Markus F.; Frey, Erwin

    2013-04-01

    Analyzing coexistence and survival scenarios of Lotka-Volterra (LV) networks in which the total biomass is conserved is of vital importance for the characterization of long-term dynamics of ecological communities. Here, we introduce a classification scheme for coexistence scenarios in these conservative LV models and quantify the extinction process by employing the Pfaffian of the network’s interaction matrix. We illustrate our findings on global stability properties for general systems of four and five species and find a generalized scaling law for the extinction time.

  8. Phase Coexistence in Gallium Nanoparticles Controlled by Electron Excitation

    Science.gov (United States)

    Pochon, S.; MacDonald, K. F.; Knize, R. J.; Zheludev, N. I.

    2004-04-01

    In gallium nanoparticles 100nm in diameter grown on the tip of an optical fiber from an atomic beam we observed equilibrium coexistence of γ, β, and liquid structural phases that can be controlled by e-beam excitation in a highly reversible and reproducible fashion. With 2keV electrons only 1pJ of excitation energy per nanoparticle is needed to exercise control, with the equilibrium phase achieved in less than a few tenths of a microsecond. The transformations between coexisting phases are accompanied by a continuous change in the nanoparticle film's reflectivity.

  9. Coexistence and survival in conservative Lotka-Volterra networks.

    Science.gov (United States)

    Knebel, Johannes; Krüger, Torben; Weber, Markus F; Frey, Erwin

    2013-04-19

    Analyzing coexistence and survival scenarios of Lotka-Volterra (LV) networks in which the total biomass is conserved is of vital importance for the characterization of long-term dynamics of ecological communities. Here, we introduce a classification scheme for coexistence scenarios in these conservative LV models and quantify the extinction process by employing the Pfaffian of the network's interaction matrix. We illustrate our findings on global stability properties for general systems of four and five species and find a generalized scaling law for the extinction time.

  10. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  11. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  12. Effect of Spine Motion on Mobility in Quadruped Running

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qun

    2014-01-01

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

  13. Effect of spine motion on mobility in quadruped running

    Science.gov (United States)

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

    2014-11-01

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

  14. Evaluation of coronary arterial stenotic lesion with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Handa, Satoshi [Wakayama Medical Coll. (Japan)

    2002-09-01

    Although coronary arteriography (CAG) is an invasive method, it is widely used to diagnose the ischemic heart disease (IHD). Magnetic resonance imaging (MRI) is a noninvasive method and could be useful as a screening method for IHD. As coronary artery (CA) can be depicted as high intensity with a new pulse sequence of MRI, segmented k-space turboFLASH (STFL), we contrived a means to visualize CA and investigated the usefulness of this method to diagnose the stenotic lesion of CA. We compared the image quality of CA with body coil and spine surface coil in 24 normal volunteers using MRI. The quality was better with surface coil than with body coil. With surface coil, the segment no.1, no.2, no.5, no.6 of CA were visualized in all cases and the segment no.3, no.7, no.11 were in more than 70% of the cases. We investigated the figure of depicting the stenotic lesion with STFL method in 33 angina pectoris patients with more than 50% stenosis of CA in segment no.1, no.2, no.3, no.5, no.6, no.7, no.11 (41 lesions). The figures of depicting the stenotic lesion of CA were divided into three patterns as follows, the abruption of signal intensity of CA, the narrowing of signal intensity, the focal decreased signal intensity. The severe stenotic lesion (more than 90% stenosis) was showed as an abruption of signal intensity, and mild stenotic lesion (50% stenosis) was showed as a narrowing of signal intensity or focal decreased signal intensity. The sensitivity and specificity of MRI in diagnosing the stenotic lesions were calculated in consequent 27 angina pectoris patients having more than 25% stenosis in the segment no.1, no.2, no.3, no.5, no.6, no.7, no.11 of CA. The CAG study was analyzed accordingly to the American Heart Association CA stenosis classification, and in MRI the segments were classified into normal, abruption of signal intensity, narrowing of signal intensity and focal decreased signal intensity. When the abruption of signal intensity was recognized in MRI

  15. Perivascular epithelioid cell tumor of the liver coexisting with a gastrointestinal stromal tumor

    Institute of Scientific and Technical Information of China (English)

    Carlos Eduardo Paiva; Francisco Alves Moraes Neto; Abbas Agaimy; Maria Aparecida Custódio Domingues; Silvia Regina Rogatto

    2008-01-01

    Approximately 10% of patients with gastrointestinal stromal tumors (GIST) develop other neoplasms,either synchronously or metachronously.In this report we describe coexistence of a gastrointestinal stromal tumor and a hepatic perivascular epithelioid cell tumor (PEComa) in a 51-year-old woman with no evidence of tuberous sclerosis.A subcapsular hepatic nodule (0.8 cm in diameter) was found during surgery for symptomatic gastric neoplasm (15 cm in diameter) arising from the lesser curvature.Both tumors revealed histomorphological and immunohistochemical features confirming a diagnosis of a small incidental hepatic PEComa and a high risky extramural gastric GIST,respectively.The patient remained disease-free 25 mo after surgery with no evidence of tumor recurrence or new neoplasms.To our knowledge,this is the first report of PEComa in a patient with GIST.Hepatic lesions detected synchronously or metachronously in patients with GISTs may represent histogenetically distinct lesions and should be sampled to confirm or exclude metastatic GISTs.

  16. Significance of sagittal reformations in routine thoracic and abdominal multislice CT studies for detecting osteoporotic fractures and other spine abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Dirk; Bauer, Jan S.; Zeile, Martin; Rummeny, Ernst J. [Klinikum Rechts der Isar, TU Muenchen, Department of Radiology, Muenchen (Germany); Link, Thomas M. [Musculoskeletal and Quantitative Imaging Research, UCSF, Department of Radiology, San Francisco, CA (United States)

    2008-08-15

    The purpose was to assess osteoporotic vertebral fractures and other spinal lesions in sagittal reformations obtained from routine multidetector computed tomography (MDCT) studies of the thorax and abdomen, to compare sagittal reformations with axial images in detecting these lesions and to investigate how frequently they were missed in the official radiology report. Routine abdominal or thoracoabdominal MDCT using a standard protocol was performed in 112 postmenopausal women. Axial images and sagittal reformations were analyzed separately by two radiologists in consensus and were compared in order to evaluate how often spinal lesions could be detected. In addition the official radiology reports were assessed to determine how many of those abnormalities were identified. Spine abnormalities were visualized in 101/112 postmenopausal women. In 27 patients osteoporotic vertebral deformities were found; 6 of these were shown in the axial images, but none of these were diagnosed in the official radiology report. Additional abnormalities included degenerative disc disease, osteoarthritis of the facet joints, scoliosis, hemangiomas and bone metastases. In only 9/101 patients spine abnormalities were mentioned in the radiology report. Sagittal reformations of standard MDCT images provide important additional information on spinal abnormalities; in particular, osteoporotic vertebral deformities are substantially better detected. (orig.)

  17. Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root: a case report and literature review.

    Science.gov (United States)

    Moscovici, Samuel; Ramirez-DeNoriega, Fernando; Fellig, Yakov; Rosenthal, Guy; Cohen, José E; Itshayek, Eyal

    2011-11-01

    Review the presentation and diagnosis of an intradural extramedullary hemangiopericytoma of the thoracic spine. To present a rare case of intradural, subpial hemangiopericytoma in the thoracic spine, with a brief overview of the literature. Spinal intradural extramedullary hemangiopericytoma is rare entity that radiographically mimics nerve-sheath tumors. These lesions are typically diagnosed at surgery performed due to suspicion of tumor. A 20-year-old man who presented with back pain, leg weakness, and sphincter incontinence. MR imaging demonstrated an intradural extramedullary lesion at the T9-T10 level that was isointense on T1- and T2-weighted images and homogeneously enhancing after administration of gadolinium, with cystic components seen on T2-weighted images. The preoperative diagnosis was meningioma or schwannoma. At surgery, the lesion was bluish and completely subpial, with apparent nerve root invasion. Pathological examination revealed a neoplasm adjacent to a nerve root with possible focal infiltration. Abundant reticulin fibers and widened, branching vascular channels imparting a staghorn appearance were seen. Up to five mitotic figures were counted in one high-power field. On immunostaining, the neoplastic cells were diffusely immunoreactive for CD99 and immunonegative for EMA, CD34, and S-100 protein. The pathological diagnosis was consistent with anaplastic hemangiopericytoma, WHO grade III. This is the ninth report of spinal intradural hemangiopericytoma. The location of the neoplasm supports the hypothesis that hemangiopericytoma may arise from the spinal pial capillaries.

  18. Benign versus malignant osseous lesions in the lumbar vertebrae: differentiation by means of bone SPET

    Energy Technology Data Exchange (ETDEWEB)

    Reinartz, P.; Sabri, O.; Zimny, M.; Nowak, B.; Ostwald, E.; Cremerius, U.; Buell, U. [Department of Nuclear Medicine, Aachen University of Technology, Aachen (Germany); Schaffeldt, J. [Department of Radiology, Hospital Bardenberg, Aachen (Germany)

    2000-06-01

    Bone scanning is a well-accepted and frequently performed diagnostic procedure with a high sensitivity, especially when single-photon emission tomography (SPET) acquisitions are added. However, the differentiation of benign from malignant osseous lesions often poses difficulty. The purpose of this study was to find out whether the particular localisation of an intraosseous lesion in a lumbar vertebra is an indicator of its aetiology. Bone scintigraphy including planar whole-body scans as well as SPET imaging of the lumbar spine was performed in 109 patients. The diagnoses of osseous lesions in the lumbar vertebrae were made strictly on the basis of the findings of magnetic resonance imaging, computed tomography or plain radiography. Sixteen patients had to be excluded from the study because they did not undergo adequate radiological examination. To determine the particular localisation of vertebral lesions in the bone scan, two experienced nuclear medicine physicians examined the studies independently while blinded to the radiological results. Four anatomical regions were differentiated within the vertebra: the vertebral body, the pedicle, the facet joints and the spinous process. Clopper-Pearson analysis, which takes into account the number of examinations, yielded the following probability intervals for the malignancy of intraosseous lesions in the lumbar spine: vertebral body 36.8%-57.3%, pedicle 87.7%- 100%, facet joints 0.8%-21.4% and spinous process 18.7%-81.3%. It was concluded that lesions affecting the pedicle are a strong indicator for malignancy, whereas involvement of the facet joints is usually related to benign disease. Lesions affecting the vertebral body or the spinous process do not show a clear tendency towards either malignancy or benignity. In contrast to other studies, a significant probability of malignancy (35.6%) was observed in lesions affecting exclusively the vertebral body. (orig.)

  19. Anterior cervical fusion and osteosynthetic stabilization according to Caspar: a prospective study of 41 patients with fractures and/or dislocations of the cervical spine.

    Science.gov (United States)

    Goffin, J; Plets, C; Van den Bergh, R

    1989-12-01

    Between June 1984 and April 1988, 41 patients with severe posttraumatic lesions of the cervical spine between the C2-C3 and the C7-T1 level seen consecutively were treated by an anterior cervical fusion and osteosynthetic stabilization according to Caspar. These patients were prospectively studied. Seven patients had a bilateral facet dislocation, 5 a unilateral facet dislocation, 9 an anterior subluxation, 9 an anterior compression fracture, 5 a hangman's fracture, and 6 a hyperextension injury at a lower cervical level. From a neurological point of view, there were 12 patients with an initial complete transverse lesion and 14 with an incomplete transverse lesion, and the remaining 15 patients did not have any deficit initially. Four patients died during the first 3 months after the operation. In 38 patients good anatomical position was obtained, generally by the intraoperative use of the vertebral distractor of Caspar. In all patients excellent immediate postoperative stability of the spine was obtained, although in 2 patients a second operation was necessary a few days after the first one. Postoperatively all patients were "immobilized" by a soft collar for 3 months. Four patients with an initial complete transverse lesion showed some neurological recovery in the postoperative period, and all patients with an incomplete transverse lesion improved. There were no postoperative neurological disturbances in the group of patients who were neurologically normal from the beginning. The mean postoperative hospitalization time was 13.6 days. These results were compared to the results from the literature, concerning other conservative and operative treatments for posttraumatic lesions of the cervical spine.

  20. Musculoskeletal support of lumbar spine stability.

    Science.gov (United States)

    Wagner, H; Anders, Ch; Puta, Ch; Petrovitch, A; Mörl, F; Schilling, N; Witte, H; Blickhan, R

    2005-12-01

    Using a biomechanical model and experimental data the self-stabilising behaviour of antagonistic trunk muscles was analyzed. The biomechanical model is constituted of a pair of antagonistic Hill-type muscles, their geometric arrangement with respect to the spine, and the instantaneous centre of rotation in frontal plane. Using Ljapunov's theory, the stability of certain motion and loading situations was analyzed. Applying a sensitivity analysis, the influence of different muscle properties and the geometric arrangement on stability was investigated. The simulations revealed that the stability of spinal movements depended primarily on the geometrical arrangement of muscles and the position of the centre of rotation of the spine, the latter was affected in turn by the activities of the profound muscles. To stabilize the situations simulated oblique muscle arrangements were necessary. In order to define an instantaneous centre of rotation in the lower region of the spine negative attachment angles (medio-lateral decline) of muscles were necessary, corresponding to the real anatomy of obliquus externus muscles. More cranially located instantaneous centres of rotation required positive attachment angles for stability, corresponding to obliquus internus or multifidus muscles. Furthermore, the fibre-type distribution of muscles influenced the stability of the system, i.e. a high percentage of fast-twitch-fibres supported the stabilisation. Conclusions drawn from the simulations were supported by experimental data. Sudden loads and quick-release perturbations with two different amplitudes were applied to the upper body of ten male subjects. In comparison to sudden load situations preactivation of muscles due to an external load, i.e. quick-release perturbation, led to significantly less dependency of the amplitude of deflection on the amplitude of the perturbation. This observation relates to the self-stabilising properties of the musculoskeletal system. In conclusion