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Sample records for low-grade isthmic spondylolisthesis

  1. Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique

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    Amoretti, Nicolas; Huwart, Laurent; Browaeys, Patrick; Nouri, Yasir; Ibba, Caroline [Hopital Archet 2, Centre Hospitalo-Universitaire de Nice, Department of Radiology, Nice (France); Hauger, Olivier [Hopital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Department of Radiology, Bordeaux (France); Marcy, Pierre-Yves [Antoine Lacassagne Cancer Research Institute, Department of Radiology, Nice (France); Boileau, Pascal [Hopital Archet 2, Centre Hospitalo-Universitaire de Nice, Department of Orthopedic Surgery, Nice (France)

    2012-12-15

    To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults. Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44-78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores. The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24-32 mm). The VAS and ODI measurements {+-} SD decreased from 7.8 {+-} 0.9 preoperatively to 1.5 {+-} 1.1 at the last 2-year follow-up, and from 62.3 {+-} 17.2 to 15.1 {+-} 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted. This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis. (orig.)

  2. Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis.

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    Bourghli, A; Aunoble, S; Reebye, O; Le Huec, J C

    2011-09-01

    The aim of this prospective study was to assess the sagittal alignment of the spine and pelvis before and after surgical treatment of isthmic spondylolisthesis with flat sacrum. At the same time, the functional outcome was analyzed and correlation examined. This study comprises analysis of 30 subjects (mean age 43 years) with isthmic spondylolisthesis and an average follow-up of 2.5 years after posterior spinal fusion. Radiological spinopelvic parameters were measured and functional evaluation was made using the Oswestry Disability Index. Significant improvement toward more normal values for PT and SS in relation to PI was observed after surgery. Pelvic incidence was unaffected by surgery. Correction of the spinosacral angle shows that the anterior tilt with anterior sagittal imbalance due to spondylolisthesis may be corrected by reduction and fusion of the slipped level. Functional outcome was satisfactory with a statistically significant difference between preoperative values and final follow-up values. The sub-group of patients with insufficient restoration of sagittal balance parameters had less good outcomes than the others. Surgical management of low- and mid-grade isthmic spondylolisthesis showed good clinical outcome with restoration of correct values for the pelvic position-dependent parameters, i.e., pelvis tilt, sacral slope, C7 plumb line position and SSA.

  3. CT findings of isthmic spondylolisthesis and degenerative spondylolisthesis

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    Chang, Suk Kyeong; Cho, Seong II; Chung, Gyung Ho; Lee, Sang Yong; Han, Young Min; Sohn, Myung Hee; Kim, Chong Soo; Choi, Ki Chul [Chonbuk National Univ. College of Medicine, Chonju (Korea, Republic of)

    1996-01-01

    CT evaluate the finding useful for differential diagnosis and associated abnormalities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. We reviewed retrospectively the CT images of 164 patients who were diagnosed spondylolisthesis. One hundred twelve patients had isthmic spondylolisthesis and 52 patients had degenerative spondylolisthesis. Isthmic spondylolisthesis most frequently occurred at L5. The degree of anterior displacement was grade I and II. The defect had a horizontal plane, an irregular surface, a sclerotic margin, and protruding hypertrophic bony spur in the spinal canal. The most frequently associated structural abnormality was a herniated nucleus pulposus at the upper level of the defect. Degenerative spondylolisthesis most frequently occurred at L4-5 and were grade I. The degenerative facet joint had a vertical plane, a hypertrophic bony spur, and a vacuum facet phenomenon. We frequently detected a pseudobulging disk. The most frequently associated structural abnormality was a herniated nucleus pulposus at the level of the displacement. In spondylolisthesis, the findings in CT were valuable for differential diagnosis of isthmic and degenerative types and the detection of associated symptomatic abnormalities.

  4. Surgical treatment of double-level isthmic spondylolisthesis.

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    Song, Deyong; Chen, Zhong; Song, Dewei

    2014-04-01

    Isthmic spondylolisthesis, which is demonstrated in 4%-6% of the general population, is one of the most common types of spondylolisthesis. However, double-level isthmic spondylolisthesis is extremely rare. Only a few reports have examined the outcomes of surgical treatment of double-level spondylolisthesis. The authors present an unusual case of double-level isthmic spondylolisthesis of the lumbar spine. The patient had low-back pain for 20 years and did not respond to conservative treatment. Radiographs revealed bilateral pars defects at L-4 and L-5. Grade 2 isthmic spondylolisthesis was present, both at L4-5 and at L5-S1. The patient underwent decompression, reduction, and posterior lumbar interbody fusion with autogenous bone chips from posterior decompression. At follow-up after 12 months, the patient was free of pain, slippage was corrected, and fusion was achieved. Posterior lumbar interbody fusion with posterior instrumentation and reduction may yield good functional short-term results for double-level spondylolisthesis.

  5. The effects of a global postural reeducation program on an adolescent handball player with isthmic spondylolisthesis.

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    Barroqueiro, Carlos; Morais, Nuno Valente

    2014-04-01

    This report describes and evaluates a physical therapy intervention in a 15-year-old male handball player with low grade isthmic spondylolisthesis and associated spinopelvic misalignment (shear-stress type). Upon examination, increased lumbar lordosis, horizontal sacrum and anterior pelvic tilting were mainly associated with altered resting length and extensibility of the iliopsoas, hip adductors and erector spinae muscles. The intervention was directed at improving the muscles resting length and extensibility balance within a global postural alignment perspective (global postural reeducation). After the treatment period, lumbar lordosis, sacral slope and anterior pelvic tilting decreased 17.2°, 16.5° and 15.1° respectively. Global postural reeducation was effective in changing spinopelvic alignment related to low grade isthmic spondylolisthesis. This treatment option should be considered as a potential nonsurgical alternative for this condition.

  6. Biomechanical evaluation of predictive parameters of progression in adolescent isthmic spondylolisthesis: a computer modeling and simulation study

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    Sevrain Amandine

    2012-01-01

    Full Text Available Abstract Background Pelvic incidence, sacral slope and slip percentage have been shown to be important predicting factors for assessing the risk of progression of low- and high-grade spondylolisthesis. Biomechanical factors, which affect the stress distribution and the mechanisms involved in the vertebral slippage, may also influence the risk of progression, but they are still not well known. The objective was to biomechanically evaluate how geometric sacral parameters influence shear and normal stress at the lumbosacral junction in spondylolisthesis. Methods A finite element model of a low-grade L5-S1 spondylolisthesis was constructed, including the morphology of the spine, pelvis and rib cage based on measurements from biplanar radiographs of a patient. Variations provided on this model aimed to study the effects on low grade spondylolisthesis as well as reproduce high grade spondylolisthesis. Normal and shear stresses at the lumbosacral junction were analyzed under various pelvic incidences, sacral slopes and slip percentages. Their influence on progression risk was statistically analyzed using a one-way analysis of variance. Results Stresses were mainly concentrated on the growth plate of S1, on the intervertebral disc of L5-S1, and ahead the sacral dome for low grade spondylolisthesis. For high grade spondylolisthesis, more important compression and shear stresses were seen in the anterior part of the growth plate and disc as compared to the lateral and posterior areas. Stress magnitudes over this area increased with slip percentage, sacral slope and pelvic incidence. Strong correlations were found between pelvic incidence and the resulting compression and shear stresses in the growth plate and intervertebral disc at the L5-S1 junction. Conclusions Progression of the slippage is mostly affected by a movement and an increase of stresses at the lumbosacral junction in accordance with spino-pelvic parameters. The statistical results provide

  7. Asymptomatic Cervical Isthmic Spondylolisthesis and Associated Occult Spinal Bifida: A Case Report

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    Lim, Jeong-Wook; Kang, Sang-Kuk; Jeon, Su-Gi; Lim, Byeong-Chul

    2013-01-01

    We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she wa...

  8. Isthmic lumbar spondylolisthesis with sciatica; MR imaging vs myelography

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    Annertz, M.; Holtaas, S.; Cronqvist, S.; Joensson, B.; Stroemqvist, B. (Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology Lund Univ. Hospital (Sweden). Dept. of Orthopedics)

    1990-09-01

    Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: Normal nerve (n=8), II: Compressed nerve (n=16); III: Disappearance of fat, nerve not possible to identify (n=9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information. (orig.).

  9. Asymptomatic cervical isthmic spondylolisthesis and associated occult spinal bifida: a case report.

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    Lim, Jeong-Wook; Kang, Sang-Kuk; Jeon, Su-Gi; Lim, Byeong-Chul

    2013-03-01

    We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6(th) cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.

  10. Posterior epidural fat on sagittal MR images: can it heIp in distinguishing between isthmic and degenerative lumbar spondylolisthesis?

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    Youn, Byung Jae; Choi, Jung Ah; Kim, Jung Eun; Choi, Ja Young; Hong, Sung Hwan; Kang, Heung Sik [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-11-01

    We tried to assess the value of posterior epidural fat for distinguishing isthmic spondylolisthesis from degenerative lumbar spondylolisthesis on midline sagittal MR images. The midline sagittal MR images of the lumbar spines were retrospectively studied for 50 patients without spondylolisthesis, for 78 patients with isthmic spondylolisthesis and for 43 patients with degenerative spondylolisthesis. The anteroposterior diameter of the posterior epidural fat (ADEF) was measured at each intervertebral disc level by two radiologists and these values were then compared between each group. To normalize for difference of body size, the posterior epidural fat ratio (PEFR) at each level of spondylolisthesis and at L1-2 were also determined for each level of spondylolisthesis, and the PERF was compared between each group. Statistical analysis was performed by the chi-square method. For the patients with isthmic spondylolisthesis, the ADEFs at the spinal levels with spondylolisthesis were significantly greater than those ADEFs in the control group that were measured at the corresponding disc levels (p<0.05). For the patients with degenerative spondylolisthesis, the ADEFs at the spinal level with spondylolisthesis were significantly less than the ADEFs in the control group that were measured at the corresponding disc levels (p<0.05). The PEFRs obtained at L4-5 were 1.37{+-}0.12 for the control group, 2.61{+-}1.31 for the patients with isthmic spondylolisthesis, and 0.60{+-}0.05 for the patients with degenerative spondylolisthesis. The PEFRs obtained at L5-S1 were 2.25{+-}1.32 for the control group, 3.47{+-}1.69 for the patients with isthmic spondylolisthesis and 1.65{+-}0.18 for the patients with degenerative spondylolisthesis. At both levels, the PEFRs were greatest for the isthmic spondylolisthesis group and smallest for the degenerative spondylolisthesis group, and all the differences were statistically significant. The posterior epidural fat, which is easily seen structure

  11. L5 pedicle subtraction osteotomy for high-grade isthmic spondylolisthesis.

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    Radcliff, Kristen E; Jakoi, Andre M

    2015-04-01

    To the authors' knowledge, this is the first article to present a pedicle subtraction osteotomy in the lumbar spine to correct and stabilize a high-grade isthmic spondylolisthesis, which poses many challenges with regard to treatment options and outcomes. The optimal surgical treatment for high-grade spondylolisthesis is controversial, but the goals of treatment are to stabilize the affected spinal levels and to decompress the neural elements. A pedicle subtraction osteotomy is a reconstructive procedure that addresses fixed sagittal imbalance by increasing lumbar lordosis through posterior spinal column shortening. The authors report a 46-year-old patient with chronic, progressively worsening back and leg radiculopathy accompanied by sagittal plane malalignment and for which a pedicle subtraction osteotomy was performed. The procedure yielded stabilization of the patient's lumbar spondylolisthesis and sagittal plane alignment was restoration. At 3 months postoperatively, the patient's pain had fully resolved and her motor and neurologic examination exhibited no deficits. At 24 months postoperatively, she was still symptom-free and ambulating without assistance. This report is the first documented successful pedicle subtraction osteotomy in the treatment of high-grade spondylolisthesis. This report indicates that certain patient populations may be amenable to pedicle subtraction osteotomy as a treatment option for pathology involving high-grade isthmic spondylolisthesis.

  12. Unilateral Pedicle Stress Fracture in a Long-Term Hemodialysis Patient with Isthmic Spondylolisthesis

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    Keishi Maruo

    2015-01-01

    Full Text Available Most unilateral pedicle stress fractures occur on the contralateral side of patients with unilateral spondylolysis. However, there are few reports of unilateral pedicle stress fractures in patients with bilateral spondylolysis and spondylolisthesis. We report a unique case of unilateral pedicle stress fracture in a long-term hemodialysis patient with isthmic spondylolisthesis. A 65-year-old man who had undergone hemodialysis presented with lower back pain that had persisted for several years. The patient experienced severe right lower extremity pain with no history of trauma. Computed tomography revealed unilateral pedicle fracture with bilateral L5 spondylolysis and spondylolisthesis with progression of scoliosis. The patient underwent Gill laminectomy of L5 with pedicle screw fixation at L4-S1 and interbody fusion at L5-S1. The patient’s leg pain ceased immediately, and he began walking without leg pain. In our present patient, development of scoliosis caused by destructive spondyloarthropathy may have contributed to a unilateral pedicle fracture.

  13. FUNCTIONAL RESULTS OF SURGICAL TREATMENT FOR ISTHMIC SPONDYLOLISTHESIS USING ANTERIOR AND POSTERIOR EXPOSURES

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    V. V. Rudenko

    2013-01-01

    Full Text Available Objective - to compare results of spondylolisthesis treatment using different surgical technologies. Material and methods: 84 patients (aged from 19 till 67 with spondylolisthesis of 1-3 degree (H.W Meyerding were operated. Two methods of surgical exposures were used for decompression and stabilization. Anterior decompression and stabilization exposures from retroperitoneal access were used for the first group of patients. The second group was operated using posteriolateral interbody fusion with transpedicular screw fixation. The following results were estimated after operation: the level of patients’ postoperative adaptation period and the rate of neurological and orthopedic rehabilitation during the postoperative period. Conclusions. The obtained functional results show no difference for both groups where posterior and anterior exposures were used for spondylolisthesis surgical treatment of 1-3 degree.

  14. 峡部裂性与退变性腰椎滑脱 MSCT扫描解剖学因素的对照研究%Anatomical Factors for Isthmic Spondylolisthesis and Degenerative Spondylolisthesis:a Comparison with MSCT

    Institute of Scientific and Technical Information of China (English)

    王志军; 洪波; 杨冬生

    2015-01-01

    ABSTRACT:Objective To compare the anatomical factors for isthmic spondylolisthesis and de-generative spondylolisthesis using multi-slice spiral CT(MSCT).Methods A total of 108 patients with L4 lumbar spondylolisthesis were divided into two groups:isthmic spondylolisthesis group and degenerative spondylolisthesis group,with 54 patients in each group.All be confirmed by MSCT examination.The sacral inclination angle,lumbar lordosis angle,intervertebral joint angle, vertebral arch isthmus width,slippage distance and slippage index were measured in both groups. Results Compared with degenerative spondylolisthesis group,the age,lumbar lordosis angle and vertebral arch isthmus width decreased and the facet and sagittal angles and slippage index in-creased in isthmic spondylolisthesis group(P 0.05).Conclusion Isthmic spon-dylolisthesis is associated with an earlier age of onset and a higher slippage index than degenera-tive spondylolisthesis.Isthmus hypoplasia or changes in morphology (slender)are important fac-tors for the pathogenesis of isthmic spondylolisthesis.The decrease in intervertebral joint facet and sagittal angles and the increase in lumbar lordosis angle are involved in the degenerative spon-dylolisthesis.%目的:利用多层螺旋 CT(multi-slice spiral CT,MSCT)对峡部裂性与退变性腰椎滑脱解剖学因素进行对比分析。方法选取108例腰椎滑脱患者,滑脱椎体均为 L4,其中峡部裂性腰椎滑脱(峡部裂组)54例,退变性腰椎滑脱(退变组)54例,均经 MSCT 检查确诊。分别测量2组病例的骶骨倾斜角、腰椎前凸角、椎间关节角度、椎弓峡部宽度、滑脱距离、滑脱指数。结果峡部裂组年龄、腰椎前凸角、椎弓峡部宽度小于退变组,关节突关节面与矢状面夹角、滑脱指数大于退变组(P <0.05或 P <0.01);2组骶骨倾斜角差异无统计学意义(P >0.05)。结论峡部裂性腰椎滑脱患者发病年龄早于、

  15. Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.

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    Joelson, Anders; Hedlund, Rune; Frennered, Karin

    2014-06-18

    The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis. Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years. The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population. Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high

  16. Spondylolisthesis

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    ... cause spondylolisthesis. Certain sports activities, such as gymnastics, weightlifting, and football, greatly stress the bones in the ... A person with spondylolisthesis may have no symptoms. Children may not show symptoms until they're 18 ...

  17. 成人脊柱滑脱后外侧融合术远期疗效随机对照研究%The long-term effect of posterolateral fusion in adult isthmic spondylolisthesis: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Ekman P; Moller H; Hedlund R

    2005-01-01

    BACKGROUND: Today there is some evidence-based medicine support for a positive shortterm treatment effect of fusion in chronic low back pain in spondylolisthesis and in nonspecific degenerative lumbar spine disorders. The long-term effect is, however, unknown. PURPOSE: To determine the long-term outcome of lumbar fusion in adult isthmic spondylolisthesis. STUDY DESIGN:Prospective, randomized controlled study comparing a 1-year exercise program with instrumented an dnon-instrumented posterolateral fusion with average long-term follow-up of 9 years (range,5-13)。

  18. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    NARCIS (Netherlands)

    M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker (Elske); W.C. Peul (Wilco)

    2008-01-01

    textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, i

  19. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    NARCIS (Netherlands)

    M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker (Elske); W.C. Peul (Wilco)

    2008-01-01

    textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, i

  20. Transforaminal endoscopic discectomy to relieve sciatica and delay fusion in a 31-year-old man with pars defects and low-grade spondylolisthesis.

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    Madhavan, Karthik; Chieng, Lee Onn; Hofstetter, Christoph P; Wang, Michael Y

    2016-02-01

    Isthmic spondylolisthesis due to pars defects resulting from trauma or spondylolysis is not uncommon. Symptomatic patients with such pars defects are traditionally treated with a variety of fusion surgeries. The authors present a unique case in which such a patient was successfully treated with endoscopic discectomy without iatrogenic destabilization. A 31-year-old man presented with a history of left radicular leg pain along the distribution of the sciatic nerve. He had a disc herniation at L5/S1 and bilateral pars defects with a Grade I spondylolisthesis. Dynamic radiographic studies did not show significant movement of L-5 over S-1. The patient did not desire to have a fusion. After induction of local anesthesia, the patient underwent an awake transforaminal endoscopic discectomy via the extraforaminal approach, with decompression of the L-5 and S-1 nerve roots. His preoperative pain resolved immediately, and he was discharged home the same day. His preoperative Oswestry Disability Index score was 74, and postoperatively it was noted to be 8. At 2-year follow-up he continued to be symptom free, and no radiographic progression of the listhesis was noted. In this case preservation of stabilizing structures, including the supraspinous and interspinous ligaments and the facet capsule, may have reduced the likelihood of iatrogenic instability while at the same time achieving symptom control. This may be a reasonable option for select patient symptoms confined to lumbosacral radiculopathy.

  1. Spinopelvic sagittal alignment in isthmic lumbar spondylolisthesis patients%腰椎峡部裂滑脱患者脊柱-骨盆矢状位的平衡

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    隋海涛; 李亮; 马晓春; 于学忠; 王涛

    2015-01-01

    Objective To explore the change of the sagittal alignment of the spine and pelvis before and after surgery for isthmic lumbar spondylolisthesis. Methods Spondylolisthesis patients,who underwent surgical posterior interver-tebral fusion combined with pedicle screw fixation,were retrospectively reviewed. The pre-and post-operative radio-graphic parameters,such as thoracic kyphosis(TK),thoracolumbar junction angle(TLJ)sagittal vertical axis(SVA), spino-sacral angle(SSA),lumbar lordosis(LL),sacral slope (SS),pelvic incidence(PI) and pelvic tilt (PT) were measured. Changes of preoperative and postoperative radiographic parameters were evaluated. Pearson′s correlation coeffieients were used to investigate the association of all parameters. Results PI,TLJ and TK were unaffected by surgery. The alteration of SSA showed significant correlation with the change of PT,PI,LL,SS and SVA. Conclusions Surgical posterior intervertebral fusion combined with pedicle screw fixation of spondylolisthesis can effectively im-prove and maintain the spinal sagittal parameters. SSA is closely related with good clinical outcome,which can be a reference for evaluating spinopelvic sagittal alignment balance and operation strategy.%目的:研究腰椎峡部裂滑脱症患者手术治疗前后脊柱骨盆矢状位影像学参数变化。方法回顾分析54例施行单节段腰椎椎间 cage 融合术治疗的腰椎峡部裂滑脱患者资料,术前及随访时拍摄站立位脊柱全长正、侧位 X 线片,测量手术前后胸椎后凸(TK)、胸腰联合角(TLJ)、C7矢状面平衡(SVA)、脊柱-骨盆角(SSA)、腰椎前凸角(LL)、骶骨倾斜角(SS)、骨盆倾斜角(PT)和骨盆入射角(PI),并应用 Pearson 相关系数对影像学结果进行相关分析。结果脊柱-骨盆相关参数中,除 PI、TLJ 和 TK 外,其余参数手术前后比较差异均有统计学意义(P <0.05,P <0.01)。 SSA 的变化与 PT、PI、LL、SS 及 SVA 的变化存在线性关系。结论腰椎

  2. Lumbar paraspinal muscle morphometry and its correlations with demographic and radiological factors in adult isthmic spondylolisthesis: a retrospective review of 120 surgically managed cases.

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    Thakar, Sumit; Sivaraju, Laxminadh; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

    2016-05-01

    OBJECTIVE The objective of this study was to assess the cross-sectional areas (CSAs) of lumbar paraspinal muscles in adults with isthmic spondylolisthesis (IS), to compare them with those in the normative population, and to evaluate their correlations with demographic factors and MRI changes in various spinal elements. METHODS The authors conducted a retrospective study of patients who had undergone posterior lumbar interbody fusion for IS, and 2 of the authors acting as independent observers calculated the CSAs of various lumbar paraspinal muscles (psoas, erector spinae [ES], multifidus [MF]) on preoperative axial T2-weighted MR images from the L-3 to L-5 vertebral levels and computed the CSAs as ratios with respect to the corresponding vertebral body areas. These values were then compared with those in an age- and sex-matched normative population and were analyzed with respect to age, sex, duration of symptoms, grade of listhesis, and various MRI changes at the level of the listhesis (pedicle signal change, disc degeneration, and facetal arthropathy). RESULTS Compared with values in normative controls, the mean CSA value for the ES muscle was significantly higher in the study cohort of 120 patients (p = 0.002), whereas that for the MF muscle was significantly lower (p = 0.009), and more so in the patients with PSC (p = 0.002). Magnetic resonance imaging signal change in the pedicle was seen in half of the patients, all of whom demonstrated a Type 2 change. Of the variables tested in a multivariate analysis, age independently predicted lower area values for all 3 muscles (p ≤ 0.001), whereas female sex predicted a lower mean psoas area value (p < 0.001). None of the other variables significantly predicted any of the muscle area values. A decrease in the mean MF muscle area value alone was associated with a significantly increased likelihood of a PSC (p = 0.039). CONCLUSIONS Compared with normative controls, patients with IS suffer selective atrophy of their MF

  3. MR findings of spondylolisthesis: assessment of associated spinal and neural foraminal stenosis

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    Kim, Jae Seung; Kang, Heung Sik; Yoon, Hye Kyung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    To assess the spinal canal and neural foraminal stenosis associated with spondylolisthesis on MR imaging. We retrospectively analysed MR findings of 63 cases of spondylolisthesis(degenerative type: 23 cases, isthmic type: 40 cases) regarding the type and grade of spondylolisthesis, presence or absence of associated spinal canal stenosis, and the severity of associated neural foraminal stenosis. Central canal stenosis were more frequent in degenerative type(91%) than isthmic type(33%), and more frequent in grade II spondylolisthesis of degenerative type(100%) and isthmic type(89%) than in grade I spondylolisthesis of degenerative type(45%) and isthmic type(20%). There was positive correlation between the severity of neural foraminal stenosis and the grade of spondylolisthesis, whereas there was no significant difference between degenerative and isthmic types. Degenerative spondylolisthesis were frequently associated with central canal stenosis more than isthmic type. When the grade of spondylolisthesis was higher, it was more frequently associated with central canal stenosis and severe neural foraminal stenosis.

  4. 宽管征在MR I诊断腰椎双侧椎弓峡部不连中的意义%Importance of wide canal sign in the MR diagnosis of lumbar isthmic spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    张联合; 杨岗; 张士良

    2014-01-01

    目的:探讨第5腰椎水平椎管前后径增宽(宽管征)在 MRI诊断椎弓峡部不连中的意义。方法随机收集经 X线平片和/或CT证实的 L5双侧椎弓峡部不连100例,同时收集年龄、性别匹配的无椎弓峡部不连组100例作为对照组,在 T1 WI 正中矢状位 MRI图像上测量 L1、L5椎体的正中水平椎管矢状径,并计算 L5椎体平面的椎管正中矢状径与 L1椎体平面正中矢状径的比率,比较不连组和对照组的 L5/L1椎体平面椎管矢状径率,并进行 ROC曲线分析。结果椎弓峡部不连组 L5椎体平面的平均正中矢状径为(22.3±1.34)mm,平均正中椎管矢状径比率平均为1.32;而对照组平均正中椎管矢状径为(18.8±1.57)mm,平均正中椎管矢状径比率平均为1.12;经统计学检验,两者有显著差异(P 值为0.000);ROC曲线下面积为0.964,当截断点选择为1.25时,灵敏度为88%,特异度为90%,两者之和值最大(1.78)。结论正中椎管矢状比率超过1.25定义为宽管征阳性,是诊断 L5双侧椎弓峡部不连的特异性征象,且直观、容易掌握,能有效地减少断椎弓峡部不连的漏误诊。%Objective To evaluate the importance of wide canal sign (increased anteroposterior diameter of the spinal canal at L5) in the MR diagnosis of lumbar isthmic spondylolisthesis.Methods One hundred cases of bilateral isthmic spondylolisthesis at L5 confirmed with conventional radiography and/or CT were randomly collected.Another age and sex matched 100 cases without spon-dylolisthesis were collected as control group.The sagittal canal diameters at the L1 and L5 levels were measured and analyzed for all 100 cases of bilateral isthmic spondylolisthesis and 100 control subjects.For each group,the sagittal canal ratio(defined as the maxi-mum anteroposterior diameter of the canal at L5 level divided by the diameter of the canal at L1 )was calculated and compared be-tween the two groups ,and anylyzed with ROC curve.Results The mean

  5. Conservative treatment with spontaneous stabilization of Grade II isthmic spondylolisthesis L5/S1 in a forty-four-year old woman, with a six-year follow-up: a case report.

    Science.gov (United States)

    Ferrari, S; Costa, F; Fornari, M

    2012-06-01

    Spondylolisthesis is a pathological condition caused by the slipping of a vertebral body, compared to the underlying structure, following structural and/or degenerative changes to the spine. Studies have attempted evidence to the connection between the natural history of spondylolisthesis, the degree and progression of the slip factor, as well as the pain and disability. Studies have reported a high level of heterogeneity of these factors in different patients as well as difficulty in predicting behaviour. It has been suggested that vertebral instability, independent of the slip factor, could be considered the most important factor to be treated conservatively or surgically. Furthermore, it appears that some patients may manifest complete disk degeneration over time, with vertebral bodies shifting closer and spontaneous stabilisation. This case study reports a forty-four-year old woman, with isthmic spondylolisthesis, where the spine surgeon recommended physiotherapy for conservative treatment, with a prognosis of possible spontaneous stabilization. The case was followed for six years, both clinically and radiologically. Treatment was based on a specific stabilising training program (motor control), immediately aimed to improve the disability and pain factors while waiting for a possible spontaneous stabilisation, that the latest radiological exams revealed with an attempt of arthrodesis. The Oswestry Disability Index (ODI) and the Roland Morris Disability Questionnaire (RMDQ) to measure disability, and the Numeric Rating Scale (NRS) to measure pain, were carried out at the beginning, during and at the end of treatment. They were compared with the radiographic material documenting the evolution of the spondylolisthesis over time. This case study appears to confirm that the hypothesis that a specific aimed approach of rehabilitation may improve the disability and pain levels without compromising the process of spontaneous arthrodesis. The evolution was documented

  6. Comparison of the surgical results in the patients with degenerative spondylolisthesis and isthmic spondylolisthesis%退行性腰椎滑脱症与峡部裂性腰椎滑脱症患者的手术疗效比较

    Institute of Scientific and Technical Information of China (English)

    黄卫国; 海涌

    2014-01-01

    Objective To compare the clinical results in the surgical treatment of degenerative spondylolisthesis and isthmic spondylolisthesis, regarding the safety, curative effects and fusion rate at 2 years after the operation.Methods A retrospective study was performed on 72 adult patients with grade II-III spondylolisthesis who underwent posterior lumbar interbody fusion ( PLIF ) from January 2005 to June 2011. All the patients were divided into 2 groups based on the pathological changes of lumbar spondylolisthesis, including the degenerative spondylolisthesis group (n=48 ) and the isthmic spondylolisthesis group (n=24 ). According to the Meyerding grading system for spondylolisthesis, there were 48 cases of grade II in the degenerative spondylolisthesis group and 10 cases of grade II and 14 cases of grade III in the isthmic spondylolisthesis group. All the patients underwent decompression, reduction, pedicle screw ifxation and spinal fusion. The differences in the preoperative general data between the 2 groups were not statistically significant (P>0.05 ). The operation time, intraoperative blood loss, postoperative ambulation time, postoperative average length of stay and average age were compared between the 2 groups. The curative outcomes were evaluated based on the Visual Analogue Scale ( VAS ) and Japanese Orthopedic Association ( JOA ) assessment criteria for back pain at 1 day before the surgery and 1 month and 2 years after the surgery. The lumbar fusion was observed by the X-ray and 3-dimensional reconstruction of CT scan at 1 year after the surgery.Results The average age of the isthmic spondylolisthesis group was ( 48.6±6.9 ) years old, who was younger than ( 59.5±9.9 ) years old of the degenerative spondylolisthesis group. The intraoperative blood loss, postoperative ambulation time and postoperative average length of stay were ( 343.3±62.4 ) ml, 5.3±2.7d and ( 8.6±2.4 ) d in the degenerative spondylolisthesis group, which were all less than ( 383.8±50

  7. POSTERIOR LUMBAR INTERBODY FUSION AND INSTRUMENTED POSTEROLATERAL FUSION IN ADULT SPONDYLOLISTHESIS: ASSESSMENT AND CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Rajarajan

    2015-11-01

    Full Text Available OBJECTIVE: Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF and posterolateral fusion (PLF in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients had decompression and posterolateral fusion (PLF with a pedicle screw system; other group (16 patients was treated by decompression, posterior lumbar interbody fusion (PLIF and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF and 68 percent with posterolateral fusion (PLF. However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF and 68% with (PLF, but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.

  8. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

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    Brand Ronald

    2008-09-01

    Full Text Available Abstract Background Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. Methods/design All patients (age between 18 and 70 years with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Discussion Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best

  9. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: a prospective randomised controlled trial [NTR1300].

    Science.gov (United States)

    Arts, Mark P; Verstegen, Marco J T; Brand, Ronald; Koes, Bart W; van den Akker, M Elske; Peul, Wilco C

    2008-09-28

    Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. All patients (age between 18 and 70 years) with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best surgical treatment of symptomatic patients with low-grade

  10. 重度腰椎滑脱患者脊柱-骨盆参数改变与症状的关系%Relationship between variations of severe isthmic spondylolisthesis spinopelvic parameters and clinical symptoms

    Institute of Scientific and Technical Information of China (English)

    吕国华; 王正光; 王冰; 尹邦良; 马泽民; 刘伟东; 李磊; 邝磊; 杨帆

    2013-01-01

    Objective To explore the relationship between variations of severe isthmic spondylolisthesis spinopelvic parameters and clinical symptoms.Methods A retrospective study of spinopelvic parameters was conducted for 45 patients with L5 severe isthmic spondylolisthesis.Their spinopelvic parameters were analyzed on preoperative full spinal radiography:grade of spondylolisthesis,pelvic incidence (PI),sacral slope (SS),pelvic tilt (PT),lumbar lordosis (LL),thoracic kyphosis (TK),SFHD,SFVD,SC7D and T9 tilting angle.According to the Oswestry score,the patients with low back pain were divided into light and severe groups.T-tests were used to compare their parameters.The analyses of multiple factor correlation,linear regression and stepwise regression were used to examine the associations between all parameters and Oswestry score.Results Grade of spondylolisthesis,PT,LL,T9 tilting angle,SFHD,SC7D,PT/SS,SFHD/SFVD,LL/TK were significantly greater and SS,SFVD were significantly smaller for patients with severe low back pain versus light low back pain (P < 0.05).PI or TK had no statistically significant difference between two groups.Multiple factor correlation,linear regression and stepwise regression:Grade of spondylolisthesis,PT,SC7D,LL and SFHD had significant positive correlations with Oswestry score.Degree of positive correlation:Grade of spondylolisthesis > SC7D > PT > LL > SFHD.And PI,TK or T9 tilting angle had no significant correlation with Oswestry score.SS and SFVD had significant negative correlations with Oswestry score.Degree of negative correlation:SS > SFVD.PT/SS,SFHD/SFVD and LL/TK had significant positive correlation with Oswestry score.Degree of positive correlation:PT/SS > SFHD/SFVD > LL/TK.Conclusion Clinical symptoms of severe isthmic spondylolisthesis have significant positive correlations with grade of spondylolisthesis,PT,SC7D,LL,SFHD,PT/SS,SFHD/SFVD,LL/TK and significant negative correlations with SS and SFVD.Low back pain symptom has no

  11. Posterolateral instrumented fusion with and without transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis: A randomized clinical trial with 2-year follow-up

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    Mohammad Reza Etemadifar

    2016-01-01

    Full Text Available Background: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although posterolateral fusion and pedicle screw fixation are a relatively common treatment method for the treatment of spondylolisthesis, controversy exists about the necessity of adding interbody fusion to posterolateral fusion. The aim of our study was to assess the functional disability, pain, and complications in patients with spondylolisthesis treated by posterolateral instrumented fusion (PLF with and without transforaminal lumbar interbody fusion (TLIF in a randomized clinical trial. Materials and Methods: From February 2007 to February 2011, 50 adult patients with spondylolisthesis were randomly assigned to be treated with PLF or PLF+TLIF techniques (25 patients in each group by a single surgeon. Back pain, leg pain, and disability were assessed before treatment and until 2 years after surgical treatment using visual analog scale (VAS and oswestry disability index (ODI. Patients were also evaluated for postoperative complications such as infection, neurological complications, and instrument failure. Results: All patients completed the 24 months of follow-up. Twenty patients were females and 30 were males. Average age of the patients was 53 ± 11 years for the PLF group and 51 ± 13 for the PLF + TLIF group. Back pain, leg pain, and disability score were significantly improved postoperatively compared to preoperative scores (P < 0.001. At 3 months of follow-up, there was no statistically significant difference in VAS score for back pain and leg pain in both groups; however, after 6 months and 1 year and 2 years follow-up, the reported scores for back pain and leg pain were significantly lower in the PLF+TLIF group (P < 0.05. The ODI score was also significantly lower in the PLF+TLIF group at 1 year and 2 years of follow-up (P < 0.05. One screw breakage and one superficial infection occurred in the PLF+TLIF group, which had no statistical

  12. Progress in treating isthmic spondylolisthesis in adults%成人腰椎峡部裂椎体滑脱的进展

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    谭俊铭; 李家顺; 贾连顺

    2004-01-01

    腰椎峡部是指上下关节突之间的部分及相应部位的椎板,是神经弓最薄弱之处,如果脊柱功能单位(functional spinal unit,FSU)之间无移位,则关节突间峡部的缺损称为峡部裂;峡部裂可发生于一侧或双侧,双侧峡部裂可能产生患椎及以上脊柱的向前滑移,即为峡部裂性椎体滑脱(isthmic spondylolisthesis,ISS),

  13. 内固定等方法对腰椎峡部不连合并滑脱致下腰痛的缓解作用%Effect of internal fixation and other methods alleviating low back pain caused by isthmic spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    袁岱军; 靳安民; 吴广森

    2003-01-01

    AIM: To explore the long-term therapeutic effects of surgical treatmeut foristhnic spondylolisthesis. METHODS: 42 cases of isthunic spondylolisthesiswere analyzed retrospectively among which 13 cases underwent simple lum-bar interlaminar bone implant and 29 cases underwent transpecdicular fixationcombined with bone implantation. Assessment was made according to JOAstandards before and after treatment. RESULTS: At a 3 years of follow-upassessment, the functional outcome in transpedicular fixation assessed byJOA was excellent and good in 79.3% as compared with the group withoutfixation in which the excellent and good result was 76. 9%. The level of painand functional disability were similar in the two groups, but fusion rate in thegroup with transpedicular fixation was higher than that in group withoutit. CONCLUSION: Surgical treatment for isthmic spondylolisthesis improvesfunction and relieves pain.

  14. Radiological assessment of lumbosacral dystrophic changes in high-grade spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Vialle, Raphael [Armand Trousseau Hospital, Department of Paediatric Orthopaedics, Paris Cedex 12 (France); Schmit, Pierre [Necker-Enfants Malades Hospital, Department of Paediatric Radiology, Paris (France); Dauzac, Cyril; Guigui, Pierre [Beaujon Hospital, Department of Orthopaedic Surgery, Clichy Cedex (France); Wicart, Philippe [Saint-Vincent de Paul Hospital, Department of Paediatric Orthopaedics, Paris (France); Glorion, Christophe [Necker-Enfants Malades Hospital, Department of Paediatric Orthopaedics, Paris (France)

    2005-09-01

    To analyse radiographic correlates for the clinical status of patients and the deformation reducibility of high-grade lumbosacral spondylolisthesis. We also clarify the clinical and radiographic correlates of a new parameter for S1 dystrophy, the ''S1 index''. One hundred cases of high-grade isthmic lumbosacral spondylolisthesis were reviewed. We noted the dystrophic changes in the cranial sacral endplate, and the caudal endplate of L5. The severity of the spondylolisthesis was evaluated by measuring the lumbosacral kyphosis. The clinical status and the deformation reducibility (dependent on the stiffness of the deformation) were compared with these dystrophic patterns, the sagittal slope of S1 and S2 endplates and a sacral morphological marker, the S1 index. Lumbosacral kyphosis was less severe in cases with dystrophic changes of the posterior cranial edge of S1 and/or of the posterior caudal edge of L5 but its reducibility was worse. These patients were more functionally impaired. We describe and analyse this situation as a partial lumbosacral disc failure responsible for the less severe L5 slipping. The S1 index was strongly correlated with the grade of slipping, the lumbosacral kyphosis and its reducibility. We noted the same configuration among patients with a smaller S1 index, i.e. vertical S1 and S2 vertebral bodies associated with more severe but more reducible lumbosacral kyphosis. Analysing specific criteria, we think it is possible to note progressive dystrophic changes according to the natural history of lumbosacral spondylolisthesis. We think that repeated measurements of these morphological parameters in patients diagnosed with a low-grade lumbosacral spondylolisthesis could be helpful in the early detection of evolving lumbosacral kyphosis and L5 slipping. (orig.)

  15. Extensive segment fixation with short segment fusion in the treatment of moderate or severe isthmic spondylolisthesis%延长固定节段结合短节段融合在中重度腰椎滑脱治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    刘世伟; 林旭; 谭伦; 郭勇

    2014-01-01

    目的:探讨延长固定节段结合短节段融合在中重度峡部裂型腰椎滑脱治疗中的手术技巧及疗效。方法对36例中重度峡部裂型腰椎滑脱患者行后路减压复位、椎间植骨融合,并包括滑脱椎近端相邻椎的延长节段钉棒系统固定术。通过影像学资料评估复位及植骨融合情况;采用JOA及VAS评分评价治疗效果。结果患者均获得随访,时间16~39个月。滑脱复位率91.8%~95.2%;椎间隙高度由术前4.7 mm ±2.1 mm恢复至术后10.5 mm ±2.4 mm;植骨融合率100%;JOA评分:术前7.9分±2.1分,术后3个月17.3分±3.9分,末次随访时24.5分±2.0分;VAS评分:术前7.5分±2.0分,术后3个月3.1分±1.4分,末次随访时1.8分±0.9分。参照JOA和VAS评分评价疗效,优20例,良13例,可2例,差1例,优良率91.7%。随访期间滑脱复位率及椎间隙高度无明显丢失。均无滑脱畸形加重,内固定松动,断钉断棒,感染及神经损害加重等现象。结论延长节段固定结合短节段融合治疗中重度峡部裂型腰椎滑脱症,可以达到理想的复位固定效果和可靠的骨性融合,临床疗效满意。%Objective To investigate the effect of extensive segment fixation with short segment fusion in the treat-ment of moderate or severe isthmic spondylolisthesis. Methods 36 patients with isthmic spondylolisthesis were trea-ted by extensive segment fixation and posteriolateral interbody fusion ( PLIF) . The redution and fusion were investiga-ted by imaging data. JOA and VAS scores were used to access the therapeutic effect. Results All patients were fol-lowed up for 16~39 months. The reduction rate of spondylolisthesis was 91. 8% ~95. 2%, the intervertebral disc height improved from 4. 7 mm ± 2. 1 mm to 10. 5 mm ± 2. 4 mm. The rate of bony fusion was 100%. JOA scores im-proved from 7. 9 ± 2. 1 ( preoperative) to 17. 3 ± 3. 9 ( postoperative 3 months

  16. Lytic spondylolisthesis in helicopter pilots.

    Science.gov (United States)

    Froom, P; Froom, J; Van Dyk, D; Caine, Y; Ribak, J; Margaliot, S; Floman, Y

    1984-06-01

    Trauma to the back from the force of chronic stress is thought to be an etiologic factor in isthmic spondylolisthesis (SLL). The relationship of first degree spondylolisthesis to low back pain (LBP) is controversial. We compare the prevalence of SLL in helicopter pilots who are subject to strong vibrational forces, with other airforce personnel. Helicopter pilots had more than a four times higher prevalence of SLL (4.5%) than did cadets (1.0%) and transport pilots (0.9%). Low back pain was more frequent in pilots with SLL than in those without this lesion but in no case was the pain disabling or the defect progressive. We conclude that SLL may be induced by vibrational forces and although SLL is associated with LBP, the pain was little clinical significance.

  17. Application of short-tail multiaxial and long-tail uniaxial pedicle screw spinal system for treatment of lumbar isthmic spondylolisthesis%短尾万向联合长尾单向椎弓根螺钉在峡部裂性腰椎滑脱症中的应用

    Institute of Scientific and Technical Information of China (English)

    潘玉林; 焦云龙; 张华; 郭小伟; 李宝田; 张猛

    2014-01-01

    目的:探讨短尾万向及长尾单向椎弓根螺钉复位内固定系统结合椎体间植骨融合治疗峡部裂性腰椎滑脱症的临床效果。方法2010年6月至2012年1月郑州市骨科医院采用短尾万向及长尾单向椎弓根螺钉复位内固定系统结合椎体间植骨融合治疗74例峡部裂型腰椎滑脱症患者,术后3、6个月行腰椎CT平扫+二维重建检查,评价滑脱复位、椎间隙高度和植骨融合情况;术后6个月采用Beaujon功能评分(BFS)进行疗效评估。结果手术时间90~135 min(平均112 min),出血量300~750 mL(平均420 mL)。术中未发生马尾、神经根损伤,1例出现硬脊膜撕裂继发脑脊液漏。所有患者获有效随访,随访时间6~12个月,平均随访时间8.1个月。术后3、6个月滑脱椎体复位率和植骨融合率分别为(93±5)%、(91±4)%和81%、100%;术后6个月BFS较术前明显改善(P <0.05),BFS好转率为(79±4)%,优51例、良16例、中6例、差1例,优良率为91%(67/74)。随访期间滑脱复位程度和椎间隙高度无明显丢失。结论短尾万向及长尾单向椎弓根螺钉复位内固定系统结合椎体间植骨融合治疗峡部裂性腰椎滑脱症,植骨融合率高,并发症少,滑脱复位满意。%Objective To discuss the clinical effects of operative treatment of lumbar isthmic spondylolisthesis (LIS) with short-tail multiaxial and long-tail uniaxial pedicle screw system combined with intervertebral bone grafting. Methods Clinical data of 74 LIS patients were collected, who were treated in Zhengzhou Orthopedic Hospital by posterior decompressive laminectomy, short-tail multiaxial and long-tail uniaxial pedicle screw fixation combined with intervertebral bone grafting from June 2010 to January 2012. Lumbar CT scanning + 2D reconstruction were performed at 3, 6 months postoperatively to evaluate intervertebral height, the effects of spondylolisthesis reduction

  18. Espondilolistesis ístmica lumbosacra del adulto: laminoartrectomía y fusión in situ Espondilolistese ístmica lombossacral do adulto: lâmino-artrectomia e fusão in situ Adult lumbosacral isthmic spondylolisthesis: laminectomy/arthrectomy and in situ fusion

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    Patricio Manzone

    2012-06-01

    objetivo foi avaliar os resultados a médio prazo da descompressão e fusão in situ em pacientes submetidos a tratamento cirúrgico por um só cirurgião. MÉTODO: Critérios de inclusão: 1 Espondilolistese ístmica L5-S1. 2 Cirurgia depois da maturidade esquelética. 3 Lâmino-artrectomia e artrodese póstero-lateral instrumentada em L5 sem redução. 4 Mais de três anos de acompanhamento. 5 Ausência de pseudoartrose no acompanhamento. 6 Avaliação funcional e radiológica por observadores independentes. Comparação com a literatura. Análise estatística por teste "t", qui quadrado e ANOVA. RESULTADOS: Foram avaliados 16 pacientes (12 ♀ e 4 ♂. Média de idade: 40,6 anos (17-66, acompanhamento médio: 10,3 anos (3,3-18. Média do deslizamento: 42,9%. Nove tinham dor radicular, 3 lombar, 4 dor radicular e lombar. Pontuação de dor pré-operatória média (segundo SRS: 1,38, sem diferenças entre baixo e alto grau (p=0,887. Quinze em 16 pacientes tiveram melhora dos sintomas (pontuação final média: 4,44. Treze em 16 pacientes retornaram à atividade anterior (81%. Houve duas infecções, mas nenhuma complicação neurológica. Os parâmetros espino-pélvicos no final do acompanhamento não apresentaram diferenças estatísticas em relação com os valores encontrados na literatura. A comparação entre deslizamentos de baixo e alto grau da série não mostrou diferença significante nesses parâmetros nem em tempo de acompanhamento, níveis com artrodese, sintomas ou retorno ao trabalho. CONCLUSÃO: A descompressão póstero-lateral e fusão instrumentada in situ permitem 80% de bons resultados na espondilolistese ístmica lombossacral em adultos, independentemente do grau de deslizamento.OBJECTIVE: Adult isthmic spondylolisthesis can be treated with direct repair of the defect, decompression (alone or with posterolateral fusion, circumferential fusion, and reduction with posterior fixation. The aim of this work is to assess the mid-term results of

  19. A universal pedicle screw and V-rod system for lumbar isthmic spondylolysis: a retrospective analysis of 21 cases.

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    Xiong-sheng Chen

    Full Text Available OBJECTIVE: To investigate the surgical outcome of a universal pedicle screw-V rod system and isthmic bone grafting for isthmic spondylolysis. METHODS: Twenty-four patients with isthmic spondylolysis at L5 and grade 0-I spondylolisthesis (Meyerding classification received isthmic bone graft and stabilization using the universal pedicle screw-V rod system. Back pain was evaluated using the visual analog scale (VAS and time to bone healing, improvement in spondylolisthesis and intervertebral space height at L5/S1 and L4/L5 were assessed. RESULTS: Twenty-one patients were followed up for 24 months and included in the analysis. Back pain was markedly improved at 3 months postoperatively with a statistical difference in VAS scores compared with preoperative VAS scores (P<0.001. The VAS scores were 0 to 3 at 6 months postoperatively in all patients and no back pain was reported in all patients except 2 patients who complained of back pain after prolonged sitting. X-ray examination showed a bone graft healing time of 3 to 12 months. Grade I spondylolisthesis improved to grade 0 in 4 patients and no noticeable change was observed in the remaining 17 cases. The intervertebral space height at L5/S1 was statistically increased (P<0.05 while no statistically significant change was seen at L4/L5. There was no statistically significant difference in the ROM of the intervertebral disks of L5/S1 and L4/5 before and after surgery. CONCLUSIONS: The universal pedicle screw-V rod system and isthmic bone grafting directly repairs isthmic spondylolysis and reduces back pain, prevents anterior displacement of the diseased segment and maintains intervertebral space height, thus offering a promising alternative to current approaches for isthmic spondylolysis.

  20. 生理载荷下腰椎峡部裂滑脱与退变滑脱的三维瞬时运动特征%Comparison of three-dimensional transient motion characteristics under physiological load between isthmic and degen-erative lumbar spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    夏群; 胥鸿达; 苗军; 白剑强; 张继东; Shaobai Wang; Guoan Li

    2014-01-01

    ) patients and L4 degenerative spondylolisthesis (DS) patients during functional weight⁃bearing activities. Methods Fifteen symptomatic L4 IS patients and fifteen symptomatic L4 DS patients were recruited. Fifteen asymptomatic volunteers were en⁃rolled as the control group. The L4,5 vertebral segment motion of each subject was reconstructed using three⁃dimensional computed tomography and a solid modeling software. In vivo, lumbar vertebral motion during functional postures (flexion⁃extension, left⁃right twisting and left⁃right bending) was observed using a dual fluoroscopic imaging technique. The spinal function unit was divided in⁃to anterior and posterior segments by the isthmic cleft. Local coordinate systems were established at the vertebral body, to obtain the 6 degree⁃of⁃freedom (DOF) intervertebral range of motion (ROM) at L4,5 and the ROM between the anterior and the posterior segments of L4 IS. Results The motion of IS at L4,5 was found to be increased. The migrations along both sagittal and vertical axis were significantly larger than control group (P<0.05). During left⁃right twisting, the migration along sagittal axis was significantly larger than control group (P<0.05);the rotation along vertical axis was significantly larger than DS and control group (P<0.05). During left⁃right bending, the migration along frontal axis was significantly larger than DS and control group ( P<0.05). The inter⁃vertebral ROM at L4,5 showed no significant difference between DS and control group. The migration between anterior and posteri⁃or segments of IS L4 was larger in standing than supine (P<0.05). The relative migration along sagittal axis between anterior and posterior segments of IS L4 was significantly larger in flexion than standing (P<0.05). Conclusion A spondylolytic defect does lead to detectable instability or hypermobility in the lumbar spine compared with degenerative spondylolisthesis and normal group. From supine to standing posture

  1. Characterization of radiographic features of consecutive lumbar spondylolisthesis

    Science.gov (United States)

    Sun, Yapeng; Wang, Hui; Yang, Dalong; Zhang, Nan; Yang, Sidong; Zhang, Wei; Ding, Wenyuan

    2016-01-01

    Abstract Radiographic features of consecutive lumbar spondylolisthesis were retrospectively analyzed in a total of 17 patients treated for this condition at the Third Hospital of Hebei Medical University from June 2005 to March 2012. To investigate the radiographic features, pelvic compensatory mechanisms, and possible underlying etiologies of consecutive lumbar spondylolisthesis. To the best of our knowledge, there is no previous report concerning the characteristics of consecutive lumbar spondylolisthesis. The Taillard index and the lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), and pelvic tilt (PT) were determined on lateral X-ray images, and the angular displacement was analyzed on flexion–extension X-ray images. Correlation between LL and various pelvic parameters and correlation between Taillard index and angular displacement were assessed by Pearson correlation analysis. A total of 20 cases of isthmic spondylolisthesis and 14 of degenerative spondylolisthesis were retrospectively studied in 17 patients. The Taillard index and the angular displacement in the lower vertebrae were both larger than those in the upper vertebrae. Statistical analysis revealed that LL was correlated with PI and PT, whereas PI was correlated with PT and SS. However, no correlation was identified between Taillard index and angular displacement. In consecutive lumbar spondylolisthesis, the degree of vertebral slip and the angular displacement of the lower vertebrae were both greater than those of the upper vertebrae, indicating that the compensatory mechanism of the pelvis plays an important role in maintaining sagittal balance. PMID:27861359

  2. Posterior lumbar interbody fusion for the management of spondylolisthesis.

    Science.gov (United States)

    Devkota, P; Shrestha, S K; Krishnakumar, R; Renjithkumar, J

    2011-03-01

    The ideal surgical treatment of spondylolisthesis still remains controversial. There are several methods of treatment and posterior lumbar interbody fusion (PLIF) is one of them. We analyze the results of spondylolisthesis treated by PLIF in term of radiological union, improvement of pre-operative symptoms like back pain, radiating pain and return to normal activities including that of employment, by the review of the medical records. Total of 72 patients, 20 male and 52 female and the age ranges from 15 to 68 years with the mean age being 44.38 years were included in the study. Thirty (41.66%) patients had isthmic spondylolisthesis, 26 (36.12%) had congenital spondylolisthesis, and 16 (22.22%) cases had degenerative spondylolisthesis. There were 38 (52.77%) cases of grade I, 14 (19.44%) cases of grade II and 20 (27.77%) cases of grade III according to the grading criteria of Meyerding. According to the evaluation criteria used by Stauffer and Coventry, 59 patients (81.94%) got good results, eight patients (11.11%) belonged to the fair group and five cases (6.94%) had the poor results. This study showed that PLIF is one of the effective and reliable techniques for the management of spondylolisthesis.

  3. MR imaging of spondylolisthesis

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    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sang Un; Choi, Woo Suk; Lee, Sun Wha [Kyunghee University Hospital, Seoul (Korea, Republic of)

    1993-07-15

    We evaluated MR imaging of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30 cm FOV and 5mm/0.5 mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relative variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in generative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7 mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthsis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 case of true disk lesions were onserved in case of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II nerual foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR images is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.

  4. Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis.

    Science.gov (United States)

    Rao, Prashanth J; Ghent, Finn; Phan, Kevin; Lee, Keegan; Reddy, Rajesh; Mobbs, Ralph J

    2015-10-01

    We sought to evaluate the clinical and radiologic efficacy of stand-alone anterior lumbar interbody fusion (ALIF) for low grade degenerative spondylolisthesis, the favoured surgical management approach at our institution. The optimal approach for surgical management of spondylolisthesis remains contentious. We performed a prospective analysis of all consecutive patients with low grade lumbar spondylolisthesis who underwent ALIF between 2009 and 2013 by a single surgeon (n=27). The mean age was 64.9 years with a male to female ratio of 14:13. There were 32 levels operated and the average preoperative spondylolisthesis was 14.8%, which reduced to 6.4% postoperatively and 9.4% at the latest follow-up (p=0001). Postoperative disc height was increased to 175% of preoperative values and was statistically significant (plumbar degenerative spondylolisthesis. Future studies should include adequately powered, prospective, multicentre registry studies with long term follow-up to allow a better assessment of the relative benefits and risks.

  5. HIGH DEGREE SPONDYLOLISTHESIS IN ADULTS: MONOSEGMENTAL REDUCTION AND FIXATION

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    Eduardo Henrique Chiovato Abdala

    2015-09-01

    Full Text Available Objective:To evaluate a method to reduce high degree spondylolisthesis in adults with monosegmental fixing preserving the adjacent level and the improvement of sagittal balance.Methods:A prospective study, with 12 adult patients with high degree spondylolisthesis (III and IV in adults who underwent surgery by the same team. We included 7 women and 5 men with a mean age of 37 years and lombosciatalgy that had no improvement with conservative treatment. The surgical technique used was total or partial reduction by Spondylolisthesis Reduction Instrument (SRI system, with instrumentation only in the affected level, thus sparing the adjacent level, associated with 360ofusion.Results:The L5-S1 level was involved in nine patients, L4-L5 in two, and VT-S1 in one patient. The isthmic type predominated in nine patients, followed by dysplastic type in two, and one iatrogenic spondylolisthesis. These patients were assessed by the Oswestry scale, which showed a preoperative average of 59% and postoperative average of 12.4% (P<0.05. A significant improvement in the average slip angle from 54.66% to 9.5% (35% to 0% was found. No major complications such as infection, neurological damage or material breaks were observed.Conclusion:The reduction of high degree listhesis instrumenting only the affected level produces good results, with good control of pain and functional improvement of patients. However, a larger follow-up is required to better evaluation.

  6. 峡部裂性与退变性腰椎滑脱性别、年龄及发病部位的分析%Comparison of Gender,Age and Diseased Part between Patients with Isthmic Spondylolisthesis and Patients with Degenerative Lumber Spondylylisthesis

    Institute of Scientific and Technical Information of China (English)

    洪波; 赵鹤亮; 崔颖; 杨冬生; 史继国

    2014-01-01

    Objective To investigate the relationships of diseased part to the gender and age in patients with spondylolysis of lumbar spondylolisthesis(SLS)or degenerative lumbar spondylylis-thesis(DLS).Methods The gender,age and diseased part were analyzed in 178 patients with CT-confirmed lumbar spondylolisthesis(94 patients with SLS and 84 patients with DLS).Results The male-to-female ratio was 4351 in SLS group and 417 in DLS group.Compared with DLS group,the mean age of patients significantly decreased in SLS group[(55.31 ± 11.33)years vs (64.00±10.89)years,u=5.21,P<0.01].There was a significant difference in the incidence of lumbar spondylolisthesis in different diseased parts between the two groups(χ2=39.666,P=0.000).The difference in diseased part between males and females was significant in DLS group (χ2=3.878,P=0.049),but not significant in SLS group(χ2=3.156,P=0.076).Conclusion The SLS usually occurs at L5 ,and there is no significant difference between males and females. DLS usually occurs at L4 ,and females have a higher incidence of L4 DLS than males.In addition, SLS occurs at an earlier age than DLS.%目的:初步探讨峡部裂性腰椎滑脱(spondylolysis of lumbar spondylolisthesis,SLS)和退变性腰椎滑脱(de-generative lumber spondylylisthesis,DLS)发病部位与性别、年龄的关系。方法选取178例经 CT确诊的腰椎滑脱患者,其中峡部裂性腰椎滑脱患者94例(SLS组),DLS患者84例(DLS组),分别整理、分析2组患者性别、年龄、发病部位等资料。结果 SLS组男女比4351;DLS组男女比417。SLS组的年龄小于 DLS组[(55.31±11.33)岁比(64.00±10.89)岁,u=5.21,P<0.01)]。SLS和 DLS在不同部位患病率差异有统计学意义(χ2=39.666,P=0.000);SLS发病部位与性别差异无统计学意义(χ2=3.156,P=0.076),DLS发病部位与性别差异有统计学意义(χ2=3.878,P=0.049)。

  7. Vertebral contour in spondylolisthesis

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    Lee, J. S.; Rho, J. C.; Park, J. H.; Choi, H. Y.; Kim, B. K. [Wallace memorial Baptist Hospital, Busan (Korea, Republic of)

    1981-09-15

    The defect in the pars interarticularis of spondylolisthesis may be dependent on contributing factors related to trauma and stress to which the neural arch is subjected, superimposed on a hereditary diasthesis. Posterior wedging of 5th lumber vertebral body in lumbosacral spondylolisthesis together with the degree of slip have been measured. The average wedging in spondylolisthesis is significantly greater than patient without this condition, and forms a characteristic radiological sign. The degree of wedging and slip show a statistically valid correlation. The diagnosis of spondylolisthesis is becoming more prevalent as the complexity of our society result in the increasing use of roentgenography of the lumbar spine. Isolated lateral deviation and rotation of spinous process seen in anteroposterior radiographs of the lumbar spine seems to be associated with pathology in the pars interarticularis.

  8. Case Report: Pycnodysostosis Associated with Spondylolysis and Spondylolisthesis Mimicking Rickets

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    Hidayet Sarı

    2011-04-01

    Full Text Available Pycnodysostosis is a skeletal dysplasia, which is mainly characterized by short stature, increased bone density, separated cranial sutures with open fontanel, bone fragility, small hands and feets. We present a female patient, with pycnodysostosis has been misdiagnosed as rickets for a long period. Patient also had spondylolysis and spondylolisthesis at L5 vertebra. Patient was undergone the external fixation and patient were spent external fixation surgery due to spondylolysis and spondylolisthesis at L4-5 level and right femoral neck fracture. In conclusion, genetical skeletal dysplasia such as pycnodysostosis should be considered out of rickets if exists short stature, bone fragility and open fontanel. In patient with pycnodysostosis occurs bone fragility at an earlier age appears despite the increase in bone mineral density. Also, the development of spondylolysis and isthmic type of spondylolisthesis as well as bone fragility must be considered in the pycnodysostosis. Therefore, we emphasize to prevent high-impact trauma such as falling and crash in patients with pycnodysostosis. (Turkish Journal of Osteoporosis 2011;17:26-9

  9. Epidurography in lumbar spondylolisthesis

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    Johansen, J.G.; Hauge, O.

    1982-04-01

    Seventeen patients with lytic lumbar spondylolisthesis (Meyerding grade I-II) and radicular symptoms were examined by epidurography in addition to radiculomyelography before surgical treatment. Epidurography is considered more suitble than radiculomyelogrphy for assessing this condition because narrowing of the epidural space and compression of the nerve roots, due to osteofibrous changes at the lysis, are more consistently demonstrated.

  10. TRANSFORAMINAL L U MBAR INTERBODY FUSION IN LOW GRADE COMBINED LYTIC AND DEGENERATIVE SPONDYLOLIDTHESIS : FUNCTIONAL OUTCOME OF 21 CASES

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    Suresh

    2015-10-01

    Full Text Available BACKGROUND: Spondylolisthesis is a heterogenous disorder characterised by subluxation of a vertebral body in sagittal plane occuring frequently at l4 - 5 and l5 - S1commonest being isthmic and degenerative variety. While majority are asymptomatic, a subset do produce pain with neurology. Complete decompression of roots is essential, as is the need for solid stabi lization. Several fusion techniques were reported in literature like PLF, TLIF, PLF, ALIF On theoretical grounds, TLIF has been suggested to be safe and result in an improved outcome compared to other techniques. Data to support this view, are lacking. M ETHODS: A total of 21 patients (age range, 27 - 62 years with adult isthmic and degenerative spondylolisthesis were operated. There were 8 males and 13 females with mean age of 46.8 pre - op and 2 - year follow - up, pain (VAS and functional disability were quan tified by Oswestry Disability Index (ODI.Radiological union assessed with xrays by Brantigen and Steffee criteria. The global outcome was excellent in 90%.and 92% fusion. 2 patients presented motor deficit which did not recover. RESULTS: The follow - up was for 2 years. The mean VAS score for low back pain improved from 7.0 preoperatively to 2.1, as did the mean VAS score for leg pain from 6.7 to 1.4 and the mean ODI from 59.5% to 11.3%. CONCLUSION: TLIF does affect the 2 - year outcome of surgical treatment of spondylolisthesis with decreased back pain and ODI’s, with advantages of minimal thecal retraction, restored segmental lordosis and preserved posterior tension band.

  11. The imaging of lumbar spondylolisthesis

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    Butt, S. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom); Saifuddin, A. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom) and Institute of Orthopaedics and Musculo-Skeletal Sciences, University College, London (United Kingdom)]. E-mail: asaifuddin@aol.com

    2005-05-01

    Lumbar spondylolisthesis is a common finding on plain radiographs. The condition has a variety of causes which can be differentiated on the basis of imaging findings. As the treatment is dependent upon the type of spondylolisthesis, it is important for the radiologist to be aware of these features. We present a pictorial review of the imaging features of lumbar spondylolisthesis and explain the differentiating points between different groups of this disorder. The relative merits of the different imaging techniques in assessing lumbar spondylolisthesis are discussed.

  12. Spondylolisthesis and Posterior Instability

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    Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D. (Privatpraxis fuer Upright MRT, Koeln (Germany)); Simons, P.; Kuchta, J. (Media Park Klinik, Koeln (Germany))

    2009-04-15

    We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI.

  13. Spondylolysis and spondylolisthesis

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    Weiss, T.; Treisch, J.; Koehler, D.; Claussen, C.

    1985-07-01

    Spinal CT scans of 680 patients with suspected disc herniation were reviewed to detect lumbar spondylolysis. In this group of patients, 3.23% (n=22) had pars interarticularis defects at L4 or L5. Disc herniation at the interspace of the pars defect was seen in 27.27% (6/22) of patients with spondylolysis. Using Meyerding's method, which measures the degree of vertebral forward dislocation, grade 2 and grade 3 spondylolisthesis were most often seen. While moderate and severe spondylolisthesis can be already detected via lateral localiser image (scout view), pars defects with only little forward dislocation can be easily underdiagnosed. Sources of diagnostic error are: 1. an atypically posterior disc margin which extends beyond only one vertebral body and presents the appearance of disc herniation, 2. pars defects simulating the adjacent facet joints involve the risk of overlooking spondylolysis, 3. CT sections made through the intervertebral discs and facet joints only, may fail to show up the pars defect 10 or 15 mm above the disc plane.

  14. Rotary deformity in degenerative spondylolisthesis

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    Kang, Sung Gwon; Kim, Jeong; Kho, Hyen Sim; Yun, Sung Su; Oh, Jae Hee; Byen, Ju Nam; Kim, Young Chul [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    1994-05-15

    We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. We have made analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom, statistically. We also reviewed CT findings in 15 study groups. The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p < 0.01). The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.

  15. Extrauterine Low-Grade Endometrial Stromal Sarcoma

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    Yu-Ju Chen

    2005-12-01

    Conclusions: Low-grade endometrial stromal sarcoma typically has an indolent clinical course and favorable prognosis. Surgical resection is the primary therapeutic approach, and adjuvant therapy with radiotherapy, chemotherapy, or progesterone therapy should be considered for the management of residual or recurrent low-grade endometrial stromal sarcomas.

  16. Reliability and development of a new classification of lumbosacral spondylolisthesis

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    Parent Stefan

    2008-12-01

    Full Text Available Abstract Background A classification of lumbosacral spondylolisthesis has been proposed recently. This classification describes eight distinct types of spondylolisthesis based on the slip grade, the degree of dysplasia, and the sagittal sacro-pelvic balance. The objectives of this study are to assess the reliability of this classification and to propose a new and refined classification. Methods Standing posteroanterior and lateral radiographs of the spine and pelvis of 40 subjects (22 low-grade, 18 high-grade with lumbosacral spondylolisthesis were reviewed twice by six spine surgeons. Each radiograph was classified based on the slip grade, the degree of dysplasia, and the sagittal sacro-pelvic balance. No measurements from the radiographs were allowed. Intra- and inter-observer reliability was assessed using kappa coefficients. A refined classification is proposed based on the reliability study. Results All eight types of spondylolisthesis described in the original classification were identified. Overall intra- and inter-observer agreement was respectively 76.7% (kappa: 0.72 and 57.0% (kappa: 0.49. The specific intra-observer agreement was 97.1% (kappa: 0.94, 85.0% (kappa: 0.69 and 88.8% (kappa: 0.85 with respect to the slip grade, the degree of dysplasia, and the sacro-pelvic balance, respectively. The specific inter-observer agreement was 95.2% (kappa: 0.90, 72.2% (kappa: 0.43 and 77.2% (kappa: 0.69 with respect to the slip grade, the degree of dysplasia, and the sacro-pelvic balance, respectively. Conclusion This study confirmed that surgeons can classify radiographic findings into all eight types of spondylolisthesis. The intra-observer reliability was substantial, while the inter-observer reliability was moderate mainly due to the difficulty in distinguishing between low- and high-dysplasia. A refined classification excluding the assessment of dysplasia, while incorporating the assessment of the slip grade, sacro-pelvic balance and global

  17. Posterolateral fusion in spondylolisthesis of the lumbosacral segment.

    Directory of Open Access Journals (Sweden)

    Jorge A. Jerez Labrada

    2006-12-01

    Full Text Available Background: Since centuries ago it has been written about lumbar pain, still its treatment remains enigmatic. At present, all developed spinal surgery institutions use the transpedicular fixation methods, but we lack the right technology for what we use the posterolateral fusion. Objetive: to evaluate the results in the aplicate of the posterolateral fusion in spondylolisthesis of the lumbosacral segment. Methods: A Retrospective-descriptive, correlational, and of a series of cases study, carried out in traumatology and orthopaedics service of the Universitarian Provincial Hospital ¨Dr. Gustavo Aldereguía Lima¨ of Cienfuegos, in which were included the 33 patients with spondylisthesis of the lumbosacral segment, who received inter-transversal posterolateral fusion. All the patients got plain anteroposterior and lateral radiography, including right and left slanting sights, to the doubtful cases dynamic sights with flexion and extension of the trunk were applied. To the patients with signs of radicular irritation, a digitalized axial tomography was applied. Results: The main etiological causes in these patients were the isthmic one, followed by degenerative and dysplastic ones. The posterolateral function was carried out alone or combined with other surgical techniques; to the patients with lumbar pain that also had associated signs of radicular irritation were applied exeresis of posterior arch with release of the endangered roots. The more frequent complication was the recurrent pain, present in 6 patients, followed by granuloma of the surgical wound. Conclusions: In spite of lacking a modern instrumentation system, the problem of spondylolisthesis can be solved with only dominating this traditional technique consistent in posterolateral fixation.

  18. The effects of anterior vacuum disc on surgical outcomes of degenerative versus spondylolytic spondylolisthesis: at a minimum two-year follow-up.

    Science.gov (United States)

    Lin, Tung-Yi; Liao, Jen-Chung; Tsai, Tsung-Ting; Lu, Meng-Ling; Niu, Chi-Chien; Chen, Wen-Jer; Chen, Lih-Hui

    2014-10-02

    The vacuum phenomenon within the intervertebral disc usually represents disc degeneration. There are no reports in the English literature that focus on the effect of an anterior vacuum disc on surgical outcome of same-segment spondylolisthesis. Patients with degenerative spondylolisthesis (DS) or isthmic spondylolisthesis (IS) who underwent a spinal surgery between January 2005 and December 2006 were reviewed. Patients who met certain criteria, including (1) only mono-segment spondylolisthesis, (2) gas air within the disc space of the spondylolisthesis segment on preoperative radiographs, (3) having received posterior decompression, posterior pedicle screw fixation, and posterolateral fusion, and (4) at least 12 months of follow-up radiographs available to define the posterolateral fusion rate, were enrolled into the study. Four radiographic parameters (disc height, translation, intradiscal angle, segmental angle) were assessed. Two-year postoperative radiographs were used to determine whether the posterolateral segment was fused or not. Clinical outcome and complications during the follow-up period were documented. Incidence of the disc vacuum phenomenon was significantly higher in the IS group than in the DS group (p vacuum phenomenon is not equal to anterior instability absolutely. Determination of stability or instability in a vacuum disc should be considered by a combination of dynamic radiographs. In the present study, vacuum discs in the DS group showed more instability and a higher posterolateral pseudoarthrosis rate.

  19. MR imaging of spondylolytic spondylolisthesis: changes of intervertebral foramen and nerve root compression

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyung [Ajou Univ. College of Medicine, Seoul (Korea, Republic of); Chung, Tae Sub; Kim, Young Soo [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    To evaluate the factors affecting intervertebral foramen stenosis and nerve root compression in spondylolytic spondylolisthesis. We investigated 120 intervertebral foramina of 60 patients with spondylolytic spondylolisthesis who had undergone lumbar MRI. A retrospective review of their MR images revealed the degree of intervertebral foramen stenosis and causes of nerve root compression. The relationship between disk height diminution following spondylolysis and degree of intervertebral foramen stenosis was also evaluated. Forty eight of 60 patients showed a similar degree of intervertebral foramen stenosis, and in 12 patients the degree of stenosis was different. In 110 intervertebral foramina, stenosis of both the superior and inferior compartments of intervertebral foramina was demonstrated. In 37 of 120 cases (30.8%), stenosis was mild ; in 44 of 120 (36.7%) it was modcrate, and in 29 of 120 (24.2%) it was severe. Stenosis of the inferior compartment was demonstrated in ten of 120 intervertebral foramina (8.3%). Nerve root compression was caused by posterior bulging of the intervertebral disk (65/120), descent of the pedicle (51/120), an isthmic bony segment above the site of spondylolytic (44/120), a bony spur formed at a spondylolytic site (11/120), and fibrocartilaginous callus at a spondylolytic site (5/48). In all cases there was degenerative change of the intervertebral disk at the affected level. There was no relationship between degree of disk height diminution and degree of intervertebral foramen stenosis (p > 0.05). The degree of intervertebral foramen stenosis and causes of nerve root compression in spondylolytic spondylolisthesis are variable, and MRI demonstrates them precisely. There was no positive relationship between degree of nerve root compression at an intervertebral foramen and degree of spondylolysis and degeneration of an intervertebral foramen. The degree of nerve root compression is believed to be another criterion for describing

  20. Thoracolumbar kyphoscoliosis with unilateral subluxation of the spine and postoperative lumbar spondylolisthesis in Hunter syndrome.

    Science.gov (United States)

    Roberts, Simon B; Tsirikos, Athanasios I

    2016-03-01

    Surgical correction for kyphoscoliosis is increasingly being performed for patients with mucopolysaccharidosis (MPS). Reported case series have predominantly included patients with Type I (Hurler) and Type IV (Morquio) MPS. To their knowledge, the authors describe the first case report of surgical management of thoracolumbar kyphoscoliosis in Hunter syndrome (MPS Type II) and the rare occurrence of lumbar spondylolisthesis following surgical stabilization. A 12-year-old boy with Hunter syndrome presented with severe thoracolumbar kyphoscoliosis and no associated symptoms. Spinal radiographs demonstrated kyphosis of 48° (T11-L3) and scoliosis of 22° (T11-L3) with an anteriorly hypoplastic L-1 vertebra. The deformity progressed to kyphosis of 60° and scoliosis of 42° prior to surgical intervention. Spinal CT scans identified left T12-L1 facet subluxation, causing anterior rotatory displacement of the spine proximal to L-1 and bilateral L-5 isthmic spondylolysis with no spondylolisthesis. A combined single-stage anterior and posterior instrumented spinal arthrodesis from T-9 to L-4 was performed. Kyphosis and scoliosis were corrected to 4° and 0°, respectively. Prolonged ventilator support and nasogastric feedings were required for 3 months postoperatively. At 2.5 years following surgery, the patient was asymptomatic, mobilizing independently, and had achieved a solid spinal fusion. However, he had also developed a Grade II spondylolisthesis at L4-5; this was managed nonoperatively in the absence of symptoms or further deterioration of the spondylolisthesis to the 3.5-year postoperative follow-up visit. Satisfactory correction of thoracolumbar kyphoscoliosis in Hunter syndrome can be achieved by combined anterior/posterior instrumented arthrodesis. The risk of developing deformity or instability in motion segments adjacent to an instrumented fusion may be greater in patients with MPS related to the underlying connective tissue disorder.

  1. Ongoing trials in low-grade lymphoma

    Directory of Open Access Journals (Sweden)

    Alexander Burchardt

    2011-10-01

    Full Text Available There are many therapies available for the management of low-grade lymphoma. With follicular lymphoma, for example, combination of chemotherapy and rituximab (immuno-chemo - therapy and consecutive maintenance therapy for 2 years is the current standard of care. To date, the most widely used regimen seems to be rituximab combined with cyclo phosphamide, doxorubicin, vincristine, and prednisone (RCHOP. Substitution of liposomal doxorubicin in place of conventional doxorubicin may improve outcomes in this indication, although evidence for its use in low-grade lymphoma is not as relevant as in aggressive lymphoma. Bendamustine, in combination with rituximab, has shown very good efficacy and tolerability in several lymphoma types, particularly follicular lymphoma and other low-grade lymphomas. Other combinations, such as those including bortezomib and lenalidomide, are under investigation in low-grade lymphoma, and the duration of rituximab maintenance therapy following bendamustine−rituximab-containing induction is being researched by the German Study Group for Indolent Lymphoma (StiL.

  2. Current treatment of low grade gliomas

    NARCIS (Netherlands)

    M.J. van den Bent (Martin); T.A.B. Snijders (Tom); J.E.C. Bromberg (Jacolien)

    2012-01-01

    textabstractLow grade gliomas affect predominantly young adults, and have a relatively favorable prognosis compared to grade III and grade IV gliomas. The challenge for an optimal management of these patients is to find the balance between an optimal survival and the preservation of neurological fun

  3. The association between sacralization and spondylolisthesis.

    Science.gov (United States)

    Dar, Gali; Peled, Nathan

    2014-06-01

    The role of transitional vertebra in spondylolisthesis is still an enigma. Theoretically, obstruction of movements in the L5-S1 joint should provoke hypermobility at the L4-L5 vertebrae, thus leading to the development of spondylolisthesis. The aim of this study was to inquire whether a positive association exists between sacralization and spondylolisthesis. For this purpose, CT images of 436 consecutive patients were examined for the presence of sacralization and spondylolisthesis. The sample was divided into two groups: a sacralization group and non-sacralization group. Independent variables considered were age, sex and degree of lordosis. Sacralization was found in 13.1% of the individuals examined. It was found to be gender- and age-independent (P>0.05), Spondylolisthesis was identified in 7.3% of the individuals examined and found to be gender independent (P>0.05), and age dependent (Pspondylolisthesis was found. The mean lordosis angle in the spondylolisthesis group was 60.41° compared with 50.84° in patients without spondylolisthesis. No association was found between sacralization and the angle of lordosis (P>0.05). The current study did not reveal an association between sacralization and spondylolisthesis and as such sacralization should not be considered an etiology for the development of degenerative spondylolisthesis.

  4. Distribution of Modic changes of endplate in lumber spondylolisthesis and its ralted factors%腰椎滑脱椎体终板Modic改变的分布情况及影响因素

    Institute of Scientific and Technical Information of China (English)

    马铮; 丁文元; 申勇; 杨大龙; 徐佳欣; 王辉; 谢东晓; 胡彬欣

    2012-01-01

    目的 探讨腰椎滑脱椎体终板Modic改变的分布情况,分析峡部裂性滑脱与退变性滑脱终板Modic改变相关影响因素.方法 回顾性分析2005年10月~2011年10月收治的264例腰椎滑脱症患者的影像学资料.比较不同类型腰椎滑脱Modic改变的类型,分析不同类型腰椎滑脱中Modic改变与腰椎滑脱程度、椎间盘退变、体重指数、劳动量的相关性.结果 退变性滑脱113例,其中Modic Ⅰ型7例(6.2%),ModicⅡ型38例(33.6%);峡部断裂性滑脱151例,其中Modic Ⅰ型12例(7.9%),ModicⅡ型23例(15.2%),Modic Ⅲ型28例(18.5%).腰椎滑脱伴Modic改变的患者中,滑脱节段Modic改变发生率显著高于非滑脱节段.不同类型腰椎滑脱中Modic改变与滑脱程度、椎间盘退变、体重指数、劳动量存在明显相关性(P<0.05).结论 腰椎滑脱中Modic改变与滑脱程度、椎间盘退变、体重指数、劳动量存在相关性;Modic改变在退变性滑脱中Ⅱ型较多,在峡部裂性滑脱中以Ⅲ型多见,并且Modic改变易发生在滑脱节段.%Objective To evaluate the distribution of Modic changes of endplate in lumber spondylolisthesis and its raited factors. Methods The imaging data of 264 patients with lumber spondylolisthesis treated in our hospital from October 2005 to October 2011 were reviewed retrospectively. The incidence and the type of Modic changes was compared between isthmic spondylolisthesis and degenerative spondylolisthesis. The correlation between Modic changes and slipping degree of spondylolisthesis, disc degenerations,body mass index and physical activity were analyzed. Results Of all patients, 113 patients diagnosed to be degenerative spondylolisthesis,7 patients(6. 2% ) were classified as type I and 38 patients(33. 6% ) as type II ; and 151 patients diagnosed to be isthmic spondylolisthesis, 12 patients(7.9% )were classified as type I , 23 patients(15.2% ) as type II , and 28 patients(18.5% )were classified as type H

  5. Effect of low-level pulsed laser 890-nm on lumbar spondylolisthesis: a case report

    Science.gov (United States)

    Mortazavi, Seyed M. J.; Afsharpad, Mitra; Djavid, Gholam-reza E.

    2002-10-01

    Objective: Evaluating the effectiveness of low-level laser therapy (LLLT) in alleviating the symptoms of lumbar spondylolisthesis. Materials and Methods: Laser was irradiated for 2 mm at six symmetric points along the lumbosacral spine and 5 points along the referred point ofpain, six times a week for 2 weeks (890 nm; 8 J/cm2; pulsed at 1500 Hz). Perception of benefit, level of function was assessed by the Oswestry disability index, lumbar mobility range of motion and low back pain intensity. Results and Discussion: Results showed a complete reduction in pain and improvement in function in the patient. This case report suggests that low-level laser therapy (LLLT) could play a role in conservative management of low-grade lumbar spondylolisthesis.

  6. Case report 541: Low grade chrondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G.; Wagner, L.D.; Klein, M.J.; Faye-Peterson, O.M.; Lewis, M.M.

    1989-05-01

    A case of low grade chondrosarcoma of the femur in a 15-year-old female is presented. Although chondrosarcoma is a relatively common primary malignant bone tumor in adults, its incidence in the pediatric age group is low. If it does occur in the very young the lesion usually is a high grade tumor. The atypical radiological pattern and the differential diagnosis are discussed. (orig.).

  7. Low grade metamorphism of mafic rocks

    Science.gov (United States)

    Schiffman, Peter

    1995-07-01

    Through most of this past century, metamorphic petrologists in the United States have paid their greatest attention to high grade rocks, especially those which constitute the core zones of exhumed, mountain belts. The pioneering studies of the 50's through the 80's, those which applied the principles of thermodynamics to metamorphic rocks, focused almost exclusively on high temperature systems, for which equilibrium processes could be demonstrated. By the 1980's, metamorphic petrologists had developed the methodologies for deciphering the thermal and baric histories of mountain belts through the study of high grade rocks. Of course, low grade metamorphic rocks - here defined as those which form at pressures and temperatures up to and including the greenschist facies - had been well known and described as well, initially through the efforts of Alpine and Circum-Pacific geologists who recognized that they constituted an integral and contiguous portion of mountain belts, and that they underlay large portions of accreted terranes, many of oceanic origins. But until the mid 80's, much of the effort in studying low grade rocks - for a comprehensive review of the literature to that point see Frey (1987) - had been concentrated on mudstones, volcanoclastic rocks, and associated lithologies common to continental mountain belts and arcs. In the mid 80's, results of the Deep Sea Drilling Project (DSDP) rather dramatically mitigated a shift in the study of low grade metamorphic rocks.

  8. Dynamics of the ampullary-isthmic junction in rabbit oviduct.

    Science.gov (United States)

    Anand, S; Guha, S K

    1982-01-01

    A delay in the ovum transport at the ampullary-isthmic junction (AIJ) has been confirmed by various investigators, but the mechanism of retention and release at this junction is not yet well understood. Using a technique for monitoring unobstructed Fallopian tube motility with an impedance plethysmograph, an increase in luminal diameter was observed at the time when the ova are released from the AIJ. This enlargement persists till all ova emerge from the AIJ. Hence, it seems likely that the AU relaxation is a dominant factor contributing to ova release from the AIJ.

  9. 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.

  10. Current imaging of spondylolytic spondylolisthesis; Imagerie actuelle du spondylolisthesis par lyse isthmique

    Energy Technology Data Exchange (ETDEWEB)

    Wybier, M.; Champsaur, P.; Hamze, B. [Hopital Lariboisiere, 75 - Paris (France)

    1995-12-31

    Unilateral spondylolytic spondylolisthesis may cause lateral tilt of the overlying spinous processes towards the normal isthmus on PA views. Bilateral spondylolytic spondylolisthesis is generally located at the L5-S1 level. The vertebral shift is usually moderate. Instability at the level of spondylolisthesis may be demonstrated by stress lateral views but is uneasy to quantify. In case of sciatica associated to spondylolisthesis, foramen stenosis is probably the most frequent cause but foramen compression of the spinal ganglion is difficult to assess on imaging. (authors). 15 refs., 8 figs.

  11. FUNCTIONAL OUTCOME OF LUMBO-SACRAL SPONDYLOLISTHESIS-POSTERIOR STABILISATION WITH MOSS-MIAMI INSTRUMENTATION AND SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Shivakumar

    2015-11-01

    Full Text Available Spondylolisthesis is derived from the Greek words–spondyl (Vertebra and olisthesis (To slip. The prevalence of spondylolisthesis in general population is approximately 5% and is about equal in men and women. Spondylolysis is a descriptive term referring to a defect in the pars interarticularis. Few studies have investigated the long term effect of posterior lumbar interbody fusion on functional outcome. OBJECTIVES: Objectives of the study are to evaluate the safety, efficacy and functional outcome of surgical management of spondylolisthesis with Moss-Miami instrumentation and posterior spinal fusion. METHODOLOGY: From November 2012 to April 2014, a total of 20 patients, operated with Moss-Miami instrumentation and posterior spinal fusion were followed up and evaluated based on ODI score. RESULTS: There were 20 patients with spondylolisthesis at L4-L5 and L5-S1, who were managed with Moss-Miami instrumentation and posterior spinal fusion; 70% of patients had spondylolisthesis at L5–S1. Most of the patients were in 3rd and 4th decade of life with a female predominance of 18 cases (90%. In this study 55% of patients had Grade I listhesis and 45% had Grade II listhesis. Bony fusion was achieved for all the patients. In this study 12(60% patients had excellent, 5(25% had good, 2(10% fair and 1(5% had poor results based on ODI scoring. CONCLUSION: Surgical fixation of spondylolisthesis using Moss–Miami instrumentation and posterior lumbar interbody graft is still a safe, promising and appealing technique especially in low-grade listhesis.

  12. Current treatment of low grade astrocytoma

    DEFF Research Database (Denmark)

    Pedersen, Christina Louise; Romner, Bertil

    2013-01-01

    Through a comprehensive review of the current literature, the present article investigates several aspects of low grade astrocytomas (LGA), including prognostic factors, treatment strategies and follow-up regimes. LGA are in general relatively slow-growing primary brain tumours, but they have...... as the course of disease. The current literature seems to support the idea that treatment with radical tumour resection, where possible, yields better long term outcome for patients with LGA. However, adjuvant therapy is often necessary. Administering early postoperative radiotherapy to patients with partially...... effective in discriminating between tumour progression and radiation necrosis. The research into biomarkers is currently limited with regards to their applications in LGA diagnostics, and therefore further studies including larger patient populations are needed....

  13. SURGICAL TREATMENT OF SPONDYLOLISTHESIS WITH SOCON INSTRUMENTATION

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To observe the clinical outcomes of using a new instrumentation SOCON system in the treatment of degenerative spondylolisthesis.Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system.Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post- operative satisfactory rate was 90.5%. Pain relief was 90.5%. Neither infection nor neurologic complication occurred in this series.Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.

  14. SURGICAL TREATMENT OF SPONDYLOLISTHESIS WITH SOCON INSTRUMENTATION

    Institute of Scientific and Technical Information of China (English)

    金今; 沈建雄; 邱贵兴; 赵宏; 翁习生; 王以朋

    2000-01-01

    Objective. To observe the clinical outcomes of using a new imtnunentafion SOCON system in the treatment of degenerative spondylolisthesis. Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system. Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post-operative satisfactory rate was 90.5%. Pain relief was 90.5%.Neither infection nor neurologic complication occurred in this series. Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.

  15. GUIDELINES FOR TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    CARMEN YOSSALETH BRICEÑO-GONZÁLEZ

    Full Text Available ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft. Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

  16. Imaging of spondylolysis and spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Hession, P.R. [Dept. of Diagnostic Imaging, St. James Univ. Hospital NHS Trust, Leeds (United Kingdom); Butt, W.P. [Dept. of Diagnostic Imaging, St. James Univ. Hospital NHS Trust, Leeds (United Kingdom)

    1996-06-01

    Given the indolent natural history of a large number of spondylolyses, care should be taken not to attribute symptoms to the defect unnecessarily, but due regard must be given to complications. Therefore, a spondylolisthesis in conjunction with deformity, symptoms of radiculopathy, disc prolapse or canal stenosis should be investigated beyond diagnostic plane radiographs. Magnetic resonance imaging is most useful, but appreciation of full bony detail is not obtained without CT. Evaluation of progression is still performed with lateral radiographs, and appreciation of the inherent inaccuracies of the various techniques used is necessary to avoid precipitating unnecessary surgery. As the resolution of modern imaging equipment improves, smaller and smaller abnormalities are identified which may alter the apparant prevalence rates and are probably more likely to be less clinically relevant. (orig.)

  17. Bioleaching of low-grade copper sulphides

    Institute of Scientific and Technical Information of China (English)

    YIN Sheng-hua; WU Ai-xiang; QIU Guan-zhou

    2008-01-01

    The bioleaching behavior of low-grade copper sulphides under the condition of preferential solution flow was investigated through experiments.The experiment of bioleaching was conducted within the multifunction autocontrol bioleaching apparatus.The results show that the concentrations of Cu2+ and total Fe increase slowly at the beginning.The recovery rate decreases with the increase of depth of dump.The preferential solution happens within the fine region when the application rate is low,and the recovery rate of the fine region is higher than that of the coarse region.The content of fine ore particles within both fine and coarse regions increases during the leaching period,and the preferential solution flow shifts from fine region to coarse region.The surface of the ores at the top of dump is attacked seriously,and the ores in the middle is attacked slightly.There are plenty of crackles on the surface of bottom ores because of the precipitation layer on the surface.

  18. Beneficiation of a low grade limestone sample

    Institute of Scientific and Technical Information of China (English)

    Rao Danda Srinivas; Vijayakumar Tadiparthi Venkata; Subba Rao Sripada; Bhaskar Raju Guntamadugu; Prabhakar Swarna

    2011-01-01

    Pilot scale column flotation studies were conducted on a low grade siliceous limestone ore.Silica content was reduced to less than 1% in the concentrate so that it became satisfactory for use in the paper or rubber industries.The limestone sample was crystalline and constituted primarily of calcite that contained quartz,feldspar,pyroxene,and biotite as gangue minerals.Quartz is the major silicate gangue whereas feldspar,pyroxene,and biotite exist in minor to trace quantities.Traces of pyrite were also observed within the sample.A reverse flotation process was adopted where the silicate gangue minerals were floated using two different commercial cationic collectors:Chem-750 F or Floatamine-D.The studies clearly suggest it is possible to produce a limestone concentrate assaying around 96-97% CaCO3 containing less than 1 % SiO2.The effect of feed flow rate,percent solids,froth depth,and wash water on the grade and recovery of the CaCO3 concentrate is discussed.

  19. Low-grade and anaplastic oligodendroglioma.

    Science.gov (United States)

    Van Den Bent, Martin J; Bromberg, Jacolien E C; Buckner, Jan

    2016-01-01

    Anaplastic oligodendrogliomas have long attracted interest because of their sensitivity to chemotherapy, in particular in the subset of 1p/19q co-deleted tumors. Recent molecular studies have shown that all 1p/19q co-deleted tumors have IDH mutations and most of them also have TERT mutations. Because of the presence of similar typical genetic alterations in astrocytoma and glioblastoma, the current trend is to diagnose these tumors on the basis of their molecular profile. Further long-term follow-up analysis of both EORTC and RTOG randomized studies on (neo)adjuvant procarbazine, lomustine, vincristine (PCV) chemotherapy have shown that adjuvant chemotherapy indeed improves outcome, and this is now standard of care. It is also equally clear that benefit to PCV chemotherapy is not limited to the 1p/19q co-deleted cases; potential other predictive factors are IDH mutations and MGMT promoter methylation. Moreover, a recent RTOG study on low-grade glioma also noted an improved outcome after adjuvant PCV chemotherapy, thus making (PCV) chemotherapy now standard of care for all 1p/19q co-deleted tumors regardless of grade. It remains unclear whether temozolomide provides the same survival benefit, as no data from well-designed clinical trials on adjuvant temozolomide in this tumor type are available. Another question that remains is whether one can safely leave out radiotherapy as part of initial treatment to avoid cognitive side-effects of radiotherapy. The current data suggest that delaying radiotherapy and treatment with chemotherapy only may be detrimental for overall survival.

  20. Compararison analysis of lumber isthmic spondylolysis and its related factors%峡部裂性腰椎滑脱相关影响因素对照分析

    Institute of Scientific and Technical Information of China (English)

    洪波; 赵鹤亮; 赵新斌; 杨冬生; 崔颖

    2014-01-01

    Objective To investigate and study the lumber isthmic spondylolisthesis and its related factors. Methods Sixty-two patients with lumbar spondylolisthesis in our department from 2010 April to 2013 December were selected as research object (spondylolisthesis group), including 28 males and 34 females;the control group from the same gender, age matched 62 cases. L5 is the common site of pathological changes of two groups. Analysis of two cases of vertebral arch isthmus width, facet and sagittal angle, degeneration, lumbosacral angle of lumbar spondylolis-thesis. The data was analyzed by SPSS13.0 software. T-test was used for two groups of quantitative data and chi square test for count data. The resuce of P<0.05 was statistically significant. Results T test of spondylolisthesis group and control group were compared:(1) isthmus width showed statistically significant difference between the two groups (t=-6.553, P<0.001); (2) facet and sagittal angle showed statistically significant difference between the two groups (t=2.381, P<0.01);(3) lumbosacral angle showed statistically significant difference between the two groups (t=2.304, P<0.05). Intervertebral joint degenerationby showed statistically significant difference between two grops (χ2=16.160, P<0.01). Conclusion Vertebral arch isthmus dysplasia or morphological changes (slender) is an important factor in isthmic spondylolisthesis, and intervertebral joint angle, degeneration and lumbosacral angle play a role in the isthmic spondylolisthesis or act as the secondary changes of the isthmic spondylolisthesis, which have a synergis-tic effect.%目的:探讨峡部裂性腰椎滑脱与相关影响因素的关系。方法选取我科2010年4月至2013年12月共62例峡部裂性腰椎滑脱患者,其中男性28例,女性34例;对照组选取同期性别、年龄相匹配的病例62例,两组病例发病部位均为L5。对两组病例椎弓峡部宽度、关节突关节面与矢状面夹角、退变程度、腰

  1. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series

    Directory of Open Access Journals (Sweden)

    Miller Larry E

    2011-09-01

    Full Text Available Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men (ages 46 and 50-were Caucasian. Under fluoroscopic guidance, spondylolisthesis was reduced with a percutaneous pedicle screw system, resulting in interspace distraction. Then, an axial presacral approach with the AxiaLIF System (TranS1, Inc., Wilmington, NC, USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body, further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps, advancing the AxiaLIF rod to its final position in the vertebrae, and retightening the screw caps. The operative time ranged from 173 to 323 minutes, and blood loss was minimal (50 mL. Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative complications were reported, and patients were discharged in two to three days. Fusion was demonstrated radiographically in all patients at one-year follow-up. Conclusions Percutaneous pedicle screw reduction combined with axial presacral lumbar interbody fusion offers a promising and minimally invasive alternative for the management

  2. Desalination using low grade heat sources

    Science.gov (United States)

    Gude, Veera Gnaneswar

    A new, low temperature, energy-efficient and sustainable desalination system has been developed in this research. This system operates under near-vacuum conditions created by exploiting natural means of gravity and barometric pressure head. The system can be driven by low grade heat sources such as solar energy or waste heat streams. Both theoretical and experimental studies were conducted under this research to evaluate and demonstrate the feasibility of the proposed process. Theoretical studies included thermodynamic analysis and process modeling to evaluate the performance of the process using the following alternate energy sources for driving the process: solar thermal energy, solar photovoltaic/thermal energy, geothermal energy, and process waste heat emissions. Experimental studies included prototype scale demonstration of the process using grid power as well as solar photovoltaic/thermal sources. Finally, the feasibility of the process in reclaiming potable-quality water from the effluent of the city wastewater treatment plant was studied. The following results have been obtained from theoretical analysis and modeling: (1) The proposed process can produce up to 8 L/d of freshwater for 1 m2 area of solar collector and evaporation chamber respectively with a specific energy requirement of 3122 kJ for 1 kg of freshwater production. (2) Photovoltaic/thermal (PV/T) energy can produce up to 200 L/d of freshwater with a 25 m2 PV/T module which meets the electricity needs of 21 kWh/d of a typical household as well. This configuration requires a specific energy of 3122 kJ for 1 kg of freshwater production. (3) 100 kg/hr of geothermal water at 60°C as heat source can produce up to 60 L/d of freshwater with a specific energy requirement of 3078 kJ for 1 kg of freshwater production. (4) Waste heat released from an air conditioning system rated at 3.25 kW cooling, can produce up to 125 L/d of freshwater. This configuration requires an additional energy of 208 kJ/kg of

  3. Low-grade oligodendroglioma: current treatments and future hopes.

    Science.gov (United States)

    Lwin, Zarnie; Gan, Hui K; Mason, Warren P

    2009-11-01

    Current treatment modalities for low-grade gliomas include surgery, radiotherapy and chemotherapy. Management of these ultimately incurable tumors remains controversial, particularly the timing and extent of surgery, and the optimal sequence of radiotherapy and chemotherapy thereafter. Two ongoing Phase III trials should provide definitive answers to some of these controversial issues in the treatment of low-grade gliomas and confirm the impact of molecular predictors of response and outcome. This review will discuss recent progress and topical issues in the treatment of low-grade gliomas.

  4. EVALUATION OF POSTERIOR SPINAL FUSION WITH PEDICLE SCREWS AND RODS WITH BONE SUBSTITUTES IN GRADE I AND II SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Chaitanya Reddy

    2016-04-01

    Full Text Available BACKGROUND Low-back pain is the commonest condition encountered day in and day out of an orthopaedic practice. Incidence of spondylolisthesis in normal population is around 5-7%. No matter what the aetiology is, patient has significant functional disability. OBJECTIVES To study the efficacy of pedicular screw rod system and posterolateral fusion with bone substitutes in spondylolisthesis, and to study the complications associated with this treatment modality. METHODOLOGY From July 2012 to September 2014, a total of 30 patients operated with posterolateral fusion were followed up and evaluated based on VAS for low back pain and Japanese orthopaedic association scoring system. RESULTS The mean difference between pre-operative and post-operative VAS score is 3SD with a p value of <0.001, which is strongly significant. The pre-operative and post-operative JOA score has an improvement of 73.4% with a p value of <0.001, which is strongly significant. Rate of improvement was excellent in 16.7%, good in 53.3%, fair in 23.3% and poor in 6.3% of patients; 82% of patients had bone fusion by the end of 8 months. CONCLUSION Pedicular screw rod system with postero-lumbar fusion with bone substitute is safe, promising and appealing technique for low-grade spondylolisthesis with early post-operative pain relief.

  5. Low-grade osteosarcoma of the ethmoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Vlychou, M.; Ostlere, S.J. [Nuffield Orthopaedic Centre, Department of Musculoskeletal Radiology, Oxford (United Kingdom); Kerr, R. [Radcliffe Infirmary, Department of Neurosurgery, Oxford (United Kingdom); Athanasou, N.A. [Nuffield Orthopaedic Centre, Department of Pathology, Nuffield Department of Orthopaedic Surgery, Oxford (United Kingdom)

    2007-05-15

    Osteosarcoma uncommonly arises in craniofacial bones and has only rarely been reported to arise in the ethmoid sinus. Most primary osteosarcomas arising in paranasal sinuses are high-grade malignancies. A low-grade osteosarcoma arising in the ethmoid sinus has not previously been described. We report the clinical, radiological and histological findings of a case of low-grade (parosteal osteosarcoma-like) osteosarcoma which arose in the ethmoid sinus. (orig.)

  6. 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.

  7. Cervico-isthmic pregnancy: early diagnostic imaging and successful dual therapy for uterine-sparing treatment.

    Science.gov (United States)

    Takeda, Akihiro; Koike, Wataru; Hayashi, Shotaro; Imoto, Sanae; Nakamura, Hiromi

    2015-01-01

    Cervico-isthmic pregnancy is a rare and potentially life-threatening form of ectopic gestation in which the blastocyst implants in the uterine cervico-isthmus between the histological and anatomical internal os, followed by subsequent extension to the lower uterine segment. Early diagnosis may allow a conservative therapeutic approach that avoids catastrophic hemorrhage requiring hysterectomy. Here we report the case of a 43-year-old primigravida woman whose cervico-isthmic pregnancy complicated by massive hematometra was diagnosed at 6 weeks gestation by multimodal imaging and successfully treated by hysteroscopic resection, securing adequate hemostasis, after transcatheter arterial chemoembolization.

  8. Results of instrumented posterolateral fusion in treatment of lumbar spondylolisthesis with and without segmental kyphosis: A retrospective investigation

    Directory of Open Access Journals (Sweden)

    Szu-Yuan Chen

    2015-06-01

    Full Text Available Background: Treatment by posterolateral fusion (PLF with pedicle-screw instrumentation can be unsuccessful in one-segment and low-grade lumbar spondylolisthesis. Segmental kyphosis, either rigid or dynamic, was hypothesized to be one of the factors interfering with the fusion results. Methods: From 2004 to 2005, 239 patients with single-segment and low-grade spondylolisthesis were recruited and divided into two groups: Group 1 consisting of 129 patients without segmental kyphosis and group 2 consisting of 110 patients with segmental kyphosis. All patients underwent instrumented PLF at the same medical institute, and the average follow-up period was 31 ± 19 months. We obtained plain radiographs of the lumbosacral spine with the anteroposterior view, the lateral view, and the dynamic flexion-extension views before the operation and during the follow-ups. The results of PLF in the two groups were then compared. Results: There was no significant difference in the demographic data of the two groups, except for gender distribution. The osseous fusion rates were 90.7% in group 1 and 68.2% in group 2 (p < 0.001. Conclusion: Instrumented PLF resulted in significantly higher osseous fusion rate in patients without segmental kyphosis than in the patients with segmental kyphosis. For the patients with sagittal imbalance, such as rigid or dynamic kyphosis, pedicle-screw fixation cannot ensure successful PLF. Interbody fusion by the posterior lumbar interbody fusion or transforaminal lumbar interbody fusion technique might help overcome this problem.

  9. CT findings of spondylolysis and spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Jae Chul; Kim, Hyung Jin; Kim, Jae Hyoung; Shin, Hyung Jin; Ha, Choong Kun; Lim, Byeong Hoon; Chung, Sung Hoon [Gyeong Sang National University College of Medicine, Chinju (Korea, Republic of); Kim, Dong Kyu [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1990-12-15

    Spondylolysis is a common condition, but CT findings have been paid relatively scanty attention in journal publication. The authors reviewed lumbar spine CT of 42 patients who were diagnosed as spondylosis and/or spondylolisthesis in Gyeong Sang National University Hospital. The results were as follows. 1. In 27 cases of spondylolysis, it most frequently occurred at L5 (55.5%) with 88.3% of bilaterality. The defeat of the pars interarticularis was most clearly visible on the slice at or just above the neural foramen. The appearance of the defect had a horizontal plane(88.9%), an irregular surface(85.1%), a non sclerotic margin(88.9%), and a medial proturbance of the medial aspect of the bone just anterior to the defect(77.8%). Spondylolisthesis was associated in 20 of 27 cases(74%), which was demonstrated as an elongation of the anteroposterior diameter of the spinal canal and a pseudobulging disk at defect level in all cases. The degree of the anterior displacement was Grade I in fourteen(55.6%) and Grade II in five(18.7%). 2. Degenerative spondylolisthesis was found in 18 cases and most frequently occurred at L4-5 level(83.3%). The characteristic findings were a vertically-oriented joint plane(66.7%), a posterior displacement of the anterior facet with reference to the posterior facet(50%), bony spurs in the anterior facet(94.1%), a vacuum facet joint(55.6%), and an increased facet joint distance(50%). 3. Spinal stenosis and disk herniation were two most frequent associated abnormalities. They were found at a rate 44.4% and 14.8% in spondylolysis and at a rate 72.2% and 33.3% in degenerative spondylolisthesis. In cases of disk herniation, it frequently occurred just above the level of the defect(2/4) in spondylolysis, in contrast to degenerative spondylolisthesis in which it was most frequent at the same level(4/6). In conclusion, CT must be the highly accurate method for diagnosing and evaluating spondylolysis and all types of spondylolisthesis.

  10. Low-grade proteinuria and microalbuminuria in renal transplantation.

    Science.gov (United States)

    Halimi, Jean-Michel

    2013-07-27

    Nephrotic-range proteinuria has been known for years to be associated with poor renal outcome. Newer evidence indicates that early (1-3 months after transplantation) low-grade proteinuria and microalbuminuria (1) provide information on the graft in terms of donor characteristics and ischemia/reperfusion injury, (2) may occur before the development of donor-specific antibodies, (3) predict the development of diabetes and cardiovascular events, and (4) are associated with reduced long-term graft and patient survivals. Low-grade proteinuria and microalbuminuria are also predictive of diabetes, cardiovascular morbidity, and death in nontransplanted populations, which may help us to understand the pathophysiology of low-grade proteinuria or microalbuminuria in renal transplantation. The impact of immunosuppressive medications, including mammalian target of rapamycin inhibitors, on graft survival is still discussed, and the effect on proteinuria is crucial to the debate. The fact that chronic allograft rejection may exist as early as 3 months after renal transplantation indicates that optimal management of low-grade proteinuria or microalbuminuria should occur very early after transplantation to improve long-term renal function and the overall outcome of renal transplant recipients. The presence of low-grade proteinuria or microalbuminuria early after transplantation must be taken into account to choose adequate immunosuppressive and antihypertensive medications. Limited information exists regarding the benefit of therapeutic interventions to reduce low-grade proteinuria or microalbuminuria. Whether renin angiotensin blockade results in optimal nephroprotection in patients with low-grade proteinuria or microalbuminuria is not proven, especially in the absence of chronic allograft nephropathy. Observational studies and randomized clinical trials yield conflicting results. Finally, randomized clinical trials are urgently needed.

  11. A Change in Lumbar Sagittal Alignment After Single-level Anterior Lumbar Interbody Fusion for Lumbar Degenerative Spondylolisthesis With Normal Sagittal Balance.

    Science.gov (United States)

    Kim, Chi Heon; Chung, Chun Kee; Park, Sung Bae; Yang, Seung Heon; Kim, Jung-Hee

    2017-08-01

    Retrospective analysis. The object is to assess the correlation between whole lumbar lordosis (LL) and the segmental angle (SA) after single-level anterior lumbar interbody fusion for degenerative lumbar spondylolisthesis. The restoration of the SA at lower lumbar spine is meaningful, considering it contributes approximately 60% of LL, and revision surgery due to flat back or adjacent segment pathology was necessary decades after the initial surgery. However, little is known about the change of whole lumbar curvature after single-level lower lumbar fusion surgery, especially for balanced spine. We included 41 consecutive patients (M:F=9:32; mean age, 59.8±9.3 y) with a single-level anterior lumbar interbody fusion surgery for low-grade degenerative spinal spondylolisthesis, with C7 plumb line of sagittal alignment was influenced by single SA. Therefore, obtaining adequate segmental lordosis is desirable considering the effect on the whole spine for a long time.

  12. [Spondylolysis and spondylolisthesis in children and adolescents].

    Science.gov (United States)

    Mora-de Sambricio, A; Garrido-Stratenwerth, E

    2014-01-01

    Low back pain is a common cause of lost playing time in young athletes, and spondylolysis is its most common identifiable cause. Despite technological advances in radiology, which can lead to an early diagnosis with better prognosis, progression to spondylolisthesis is sometimes asymptomatic and may not be detected until late stages. There are wide variations, suggesting lack of consensus as regards the objective of treatment, which consists of clinical, radiological, biomechanical or functional improvement. There is also a lack of agreement regarding the ideal conservative treatment, surgical indications and need of slip reduction, and most of the established recommendations are not evidence based. We present a review of literature, which summarizes the current knowledge of spondylolysis and spondylolisthesis in children and adolescents.

  13. Residual gait abnormalities in surgically treated spondylolisthesis.

    Science.gov (United States)

    Shelokov, A; Haideri, N; Roach, J

    1993-11-01

    The authors retrospectively studied seven patients who had in situ fusion as adolescents for high-grade (IV, V) spondylolisthesis unresponsive to more conservative means. All patients achieved solid bony union; their pain was relieved; and hamstring spasm had resolved. The authors sought to determine whether crouch gait or any other abnormalities could be demonstrated in patients exhibiting clinical parameters of success. Each patient underwent gait analysis, radiographic analysis, and a physical examination. Four of seven patients demonstrated slight degrees of forward trunk lean during varying phases of gait accompanied by increased hip flexion. One patient demonstrated increased trunk extension accompanied by limited hip flexion. Two patients were essentially normal. The authors were unable to quantify residual crouch in these patients with solidly fused high-grade spondylolisthesis.

  14. Cervical myelopathy due to degenerative spondylolisthesis

    OpenAIRE

    Koakutsu, Tomoaki; Nakajo, Junko; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin

    2011-01-01

    Objective To investigate clinical-radiological features of cervical myelopathy due to degenerative spondylolisthesis (DSL). Methods A total of 448 patients were operated for cervical myelopathy at Nishitaga National Hospital between 2000 and 2003. Of these patients, DSL at the symptomatic disc level was observed in 22 (4.9%) patients. Clinical features were investigated by medical records, and radiological features were investigated by radiographs. Results Disc levels of DSL were C3/4 in 6 ca...

  15. Low-Grade Oligodendroglioma of the Pineal Region: Case Report.

    Science.gov (United States)

    Lamis, Fabricio Correa; de Paiva Neto, Manoel Antonio; Stavale, João Norberto; Cavalheiro, Sergio

    2015-07-01

    Background Although germ cell tumors and pineal cell tumors account for most of the histologic tumor subtypes, > 17 different tumors can arise in this location. We report a rare case of a low-grade oligodendroglioma that arose in the pineal region. Clinical Presentation A young woman complaining of a headache underwent magnetic resonance imaging that showed a mass in the pineal region and mild hydrocephalus. A ventriculoperitoneal shunt was performed followed by a near-total tumor removal, due to tumor invasion of the tectal plate and thalamus. The histologic examination confirmed the diagnosis of a low-grade oligodendroglioma. The patient then underwent chemotherapy and radiotherapy as adjuvant therapies. Conclusion Although the pineal region is a common place for a large number of tumoral lesions, low-grade oligodendrogliomas are extremely rare in this location. This case is only the second account of a benign oligodendroglioma of the pineal region reported in the literature.

  16. Low-grade leiomyosarcoma of renal vein: A case report

    Directory of Open Access Journals (Sweden)

    Nalan NEŞE

    2008-01-01

    Full Text Available Leiomyosarcomas originating from renal vein are quite rare malignant tumors since only 30 cases have been reported in the literature. Clinical symptoms which are due to a renal mass along with radiological findings, usually mislead to a preoperative diagnosis of renal cell carcinoma. The correct diagnosis is frequently made on nephrectomy specimens. Low-grade leiomyosarcomas need to be differentiated from leiomyomas. Increased mitotic activity and necrosis are known to be gold standards for differential diagnosis. In this report, we present a case of a 62 year old woman whose tumor in the left kidney diagnosed as low-grade leiomyosarcoma together with a brief review of the literature.

  17. An unusual cystic appearance of disseminated low-grade gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Huang, T.; Zimmerman, R.A. [Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States); Perilongo, G. [Dipt. di Pediatria, Univ. di Padova (Italy); Kaufman, B.A. [Dept. of Neurosurgery, St Louis Children' s Hospital, St Louis, MO (United States); Holden, K.R. [Division of Pediatric Neurology, Room 511, Children' s Hospital, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425-2232 (United States); Carollo, C. [Division of Neuroradiology, Regione Veneto, Azienda Ospedalieri di Padova, Universita di Padova, Via Giustiniani 3, 35 128 Padua (Italy); Kling Chong, W.K. [Dept. of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)

    2001-10-01

    We report five cases of pediatric disseminated low-grade gliomas of the brainstem or spinal cord that exhibited an unusual, cystic pattern. Leptomeningeal disease was present in three of these at diagnosis, and was detected shortly afterwards in the other two. Four patients are alive up to 5 years later, following minimal to no intervention, while one is dead. (orig.)

  18. Deformation of chlorite in naturally deformed low-grade rocks

    NARCIS (Netherlands)

    Bons, A.J.

    1988-01-01

    The intracrystalline deformation of chlorite in naturally deformed low-grade rocks was investigated with transmission electron microscopy (TEM). As in other phyllosilicates, the deformation of chlorite is dominated by the (001) slip plane. Slip along this plane is very easy through the generation an

  19. Polymorphous low-grade adenocarcinoma of the nasal fossa.

    Science.gov (United States)

    González-Lagunas, Javier; Alasà-Caparrós, Cristian; Vendrell-Escofet, Gerard; Huguet-Redecilla, Pere; Raspall-Martin, Guillermo

    2005-01-01

    An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient.

  20. Gamma Knife treatment of low-grade gliomas in children.

    Science.gov (United States)

    Ekşi, Murat Şakir; Yılmaz, Baran; Akakın, Akın; Toktaş, Zafer Orkun; Kaur, Ahmet Cemil; Demir, Mustafa Kemal; Kılıç, Türker

    2015-11-01

    Low-grade gliomas have good overall survival rates in pediatric patients compared to adults. There are some case series that reported the effectiveness and safety of Gamma Knife radiosurgery, yet they are limited in number of patients. We aimed to review the relevant literature for pediatric low-grade glial tumors treated with stereotactic radiosurgery, specifically Gamma Knife radiosurgery, and to present an exemplary case. A 6-year-old boy was admitted to clinic due to head trauma. He was alert, cooperative, and had no obvious motor or sensorial deficit. A head CT scan depicted a hypodense zone at the right caudate nucleus. The brain magnetic resonance imaging (MRI) depicted a mass lesion at the same location. A stereotactic biopsy was performed. Histopathological diagnosis was low-grade astrocytoma (grade II, World Health Organization (WHO) classification, 2007). Gamma Knife radiosurgery was applied to the tumor bed. Tumor volume was 21.85 cm(3). Fourteen gray was given to 50% isodose segment of the lesion (maximal dose of 28 Gy). The tumor has disappeared totally in 4 months, and the patient was tumor-free 21 months after the initial treatment. The presented literature review represents mostly single-center experiences with different patient and treatment characteristics. Accordingly, a mean/median margin dose of 11.3-15 Gy with Gamma Knife radiosurgery (GKRS) is successful in treatment of pediatric and adult low-grade glial tumor patients. However, prospective studies with a large cohort of pediatric patients should be conducted to make a more comprehensive conclusion for effectiveness and safety of GKRS in pediatric low-grade glial tumors.

  1. Direct SX of uranium from low-grade leach solutions

    Energy Technology Data Exchange (ETDEWEB)

    Grinbaum, B., E-mail: baruchgr@bateman.co.il [Bateman Advanced Technologies, Yokneam (Israel)

    2010-07-01

    Historically, recovery of uranium from high-grade (>400 ppm U) pregnant leach solutions (PLS) was done by solvent extraction (SX), while low-grade feed was treated by ion exchange (IX). Significant improvement in the SX technology, especially application of large pulsed columns instead of mixer-settlers (MS), have now made the SX more attractive for PLS with U below 100 ppm. Recently Bateman carried out three test work programs for direct SX of low-grade (<100 ppm) U PLS, using BPC pulsed columns for extraction and MS for stripping and scrubbing. In all 3 cases the results prove that the direct SX is overall more economical that any combination of IX and SX. Based on these results, two industrial plants, in South Africa and Australia, were erected. (author)

  2. Interventricular low-grade oligodendroglioma with multiple parenchymal relapse.

    Science.gov (United States)

    Akhavan, Ali; Binesh, Fariba; Rakhsha, Afshin; Navabii, Hossein

    2012-06-08

    Oligodendrogliomas can be found anywhere oligodendrocytes exist; however, they mostly occur in frontal lobes. Although intra- and extra central nervous system dissemination of anaplastic oligodendroglioma is a well-known property of this tumour, low-grade oligodendroglioma with intracranial relapse is a very uncommon finding. In this case report, a 37-year-old man with grade II oligodendroglioma relapsed after 18 months with multiple parenchymal masses is presented.

  3. Bioprocessing low grade copper ores - a promising alternative

    OpenAIRE

    Guezennec, Anne-Gwenaëlle; d'Hugues, Patrick

    2015-01-01

    International audience; This paper presents an overview of the work performed by the BRGM team in the last 10 years on the development of bio-hydrometallurgy dedicated to the processing of low-grade copper ores from the Kupferschiefer deposits. It covers selection and adaptation of microbial consortia, optimization of process operating parameters such as solid contents, the relationship between bioleaching performance and mineralogy, testing operating parameters to overcome chalcopyrite recal...

  4. [Low grade parosteal osteosarcoma. Clinical and oncological outcomes].

    Science.gov (United States)

    Albergo, José I; Farfalli, Germán L; Ayerza, Miguel A; Muscolo, Domingo L; Aponte-Tinao, Luis A

    2015-01-01

    The objective of the study was to analyze a group of patients with low grade parosteal osteosarcoma treated with limb salvage surgery and reconstructed with bone allograft. A retrospective review from our oncologic data base between 1980 and 2010 was done and all patients with diagnosis of low grade parosteal osteosarcoma, treated with limb salvage surgery and reconstructed with allograft were included. Twenty-two patients were included for the analysis. The mean age was 32±11 years (10-59) y the mean follow-up 93±69 months (8-237). Ten year overall survival of the series was 91% (95% CI: 79-100). Four patients developed local recurrence, 2 of them histological classified after the resection dedifferentiated parosteal osteosarcoma. Two patients developed distant recurrence, being the lung the only site of metastasis. Ten year limb salvage reconstruction survival was 65% (95% CI: 44-86). Long term survival rate in low grade parosteal osteosarcoma is over 90%. Surgical resection wide margin should be the elective treatment and biological limb salvage reconstruction is a good alternative.

  5. Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lefkowitz, D.M.; Quencer, D.M.

    1982-08-01

    A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed.

  6. Traumatic Spondylolisthesis of the Axis Vertebra in Adults

    OpenAIRE

    Schleicher, Philipp; Scholz, Matti; Pingel, Andreas; Kandziora, Frank

    2015-01-01

    Study Design Narrative review. Objective To elucidate the current concepts in diagnosis and treatment of traumatic spondylolisthesis of the axis. Methods Literature review using PubMed, Google Scholar, and Cochrane databases. Results The traumatic spondylolisthesis of the axis accounts to 5% of all cervical spine injuries and is defined by a bilateral separation of the C2 vertebral body from the neural arch. The precise location of the fracture line may vary widely. For understanding the path...

  7. Seizure prognosis of patients with low-grade tumors.

    Science.gov (United States)

    Kahlenberg, Cynthia A; Fadul, Camilo E; Roberts, David W; Thadani, Vijay M; Bujarski, Krzysztof A; Scott, Rod C; Jobst, Barbara C

    2012-09-01

    Seizures frequently impact the quality of life of patients with low grade tumors. Management is often based on best clinical judgment. We examined factors that correlate with seizure outcome to optimize seizure management. Patients with supratentorial low-grade tumors evaluated at a single institution were retrospectively reviewed. Using multiple regression analysis the patient characteristics and treatments were correlated with seizure outcome using Engel's classification. Of the 73 patients with low grade tumors and median follow up of 3.8 years (range 1-20 years), 54 (74%) patients had a seizure ever and 46 (63%) had at least one seizure before tumor surgery. The only factor significantly associated with pre-surgical seizures was tumor histology. Of the 54 patients with seizures ever, 25 (46.3%) had a class I outcome at last follow up. There was no difference in seizure outcome between grade II gliomas (astrocytoma grade II, oligodendroglioma grade II, mixed oligo-astrocytoma grade II) and other pathologies (pilocytic astrocytoma, ependymomas, DNET, gangliocytoma and ganglioglioma). Once seizures were established seizure prognosis was similar between different pathologies. Chemotherapy (p=0.03) and radiation therapy (p=0.02) had a positive effect on seizure outcome. No other parameter including significant tumor growth during the follow up period predicted seizure outcome. Only three patients developed new-onset seizures after tumor surgery that were non-perioperative. Anticonvulsant medication was tapered in 14 patients with seizures and 10 had no further seizures. Five patients underwent additional epilepsy surgery with a class I outcome in four. Two patients received a vagal nerve stimulator with >50% seizure reduction. Seizures at presentation are the most important factor associated with continued seizures after tumor surgery. Pathology does not influence seizure outcome. Use of long term prophylactic anticonvulsants is unwarranted. Chemotherapy and

  8. Experimental Study on Purification of Low Grade Diatomite

    Science.gov (United States)

    Xiao, Liguang; Pang, Bo

    2017-04-01

    This paper presented an innovation for purification of low grade diatomite(DE) by grinding, ultrasonic pretreatment, acid leaching of closed stirring and calcination. The optimum process parameters of DE purification were obtained, the characterizations of original and purified DE were determined by SEM and BET. The results showed that the specific surface area of DE increased from 12.65m2/g to 23.23m2/g, which increased by 45.54%. SEM analysis revealed that the pore structure of purified DE was dredged highly.

  9. Persistent low-grade inflammation and regular exercise

    DEFF Research Database (Denmark)

    Astrom, Maj-Briit; Feigh, Michael; Pedersen, Bente Klarlund

    2010-01-01

    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection...... against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2...

  10. Histopathological spectrum of polymorphous low-grade adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Varun Surya

    2015-01-01

    Full Text Available Polymorphous low-grade adenocarcinomas (PLGA are distinctive salivary gland neoplasms, with an almost exclusive propensity to arise from the minor salivary glands. PLGA frequently manifests as an asymptomatic, slow-growing mass within the oral cavity, which must be separated from adenoid cystic carcinoma and benign mixed tumor for therapeutic and prognostic considerations. We report a case of a 67-year-old male, who presented with a long-standing mass in the palate. This lesion was diagnosed as PLGA based on histopathological findings, which was further confirmed by the immunohistochemical marker.

  11. Magnetic resonance imaging of low-grade fibromyxoid sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Torriani, Martin; Ouellette, Hugue [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States). Dept. of Radiology. Div. of Musculoskeletal Radiology; Etchebehere, Mauricio [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Ortopedia; Amstalden, Eliane M.I. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Patologia

    2006-06-15

    Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue tumor with a deceptively benign histologic appearance affecting predominantly young adults during the fourth decade of life. (MR) imaging features of a surgically confirmed case of LGFMS, affecting the shoulder is presented. A 30-year-old man presented with a 20-year history of a painless slow-growing mass in the right shoulder. Magnetic resonance images were obtained on a 2.0T scanner (Elscint, Haifa, Israel), demonstrating a well-defined soft tissue mass measuring 12.0 x 7.0 x 9.0 cm located between the deltoid muscle, rotator-cuff muscles, and proximal humerus. The differential diagnosis of LGFMS includes several benign and malignant neoplasms containing variable amounts of myxoid and fibrous tissue. Histologically, the most important differential diagnosis is with myxofibrosarcoma. Low-grade fibromyxoid sarcoma is a rare soft tissue tumor with slow growth and deceptively benign histologic appearance. The possibility of LGFMS must be considered when elaborating differential diagnostic possibilities for young adults with a large soft tissue mass exhibiting MR imaging characteristics of intermixed fibrous and myxoid tissue.

  12. Bioleaching of low grade nickel sulfide mineral in column reactor

    Institute of Scientific and Technical Information of China (English)

    ZHEN Shi-jie; QIN Wen-qing; YAN Zhong-qiang; ZHANG Yan-sheng; WANG Jun; REN Liu-yi

    2008-01-01

    Jinchuan low grade nickel (0.4%-0.6% Ni,mass fraction) sulfide mineral ore contains a remarkably high content of magnesia (30%-35% MgO,mass fraction) present in the main gangue minerals.Bioleaching was performed to investigate the feasibility to process the mineral due to its relative simplicity,eco-friendly operation and low capital cost requirements.The mixed mesophiles were enriched from acid mine drainage samples collected from several acid mines in China.Considering that the magnesia is easily extracted by acid solution and the excessive Mg2+ will exceed the tolerance of the mixed mesophiles,three effective means were used to reduce the disadvantage of magnesia during the bioleaching operation.They were adaptation of the mixed mesophiles to improve the tolerance; pre-leaching to remove most leachable magnesia and periodic bleeds of a portion of the pregnant leaching solution to control the level of Mg2+ based on the tolerance of the mixed mesophiles.An extraction of nickel (90.3%) and cobalt (88.6%) was successfully achieved within a 300 d leaching process from the Jinchuan low grade nickel sulfide mineral ore using a column reactor at ambient temperature.

  13. Flotation technology of refractory low-grade molybdenum ore

    Institute of Scientific and Technical Information of China (English)

    Du Shuhua; Luo Zhenfu

    2013-01-01

    Because of the low grade,high oxidation rate and the accumulation of little associated metal sulfide ore in the molybdenum concentrate during flotation,the Qingyang molybdenum ore is difficult to beneflciate.The experimental studies of grinding fineness,the amount of roughing modifier,depressant and collector were completed.In the cleaning process,the contrast experiments of one regrinding.the regrinding and scrubbing,two-stage regrinding was carried.The result shows that the grade of molybdenum ore concentrate is 45.31%,the recovery is 65.98% and the rich ore ratio reaches 20.59% by the regrinding and scrubbing seven cleaning,the regrinding of concentrations from middling of molybdenum-sulfur separation.The regularly-concentrated material from the apparatus was as the middling products.Hence,ideal beneficiation index can be obtained with a rational mineral processing,which offers new beneficiating technology for the refractory low-grade molybdenum ore in China.

  14. Stimulation of systemic low-grade inflammation by psychosocial stress.

    Science.gov (United States)

    Rohleder, Nicolas

    2014-04-01

    Psychosocial stress is an important precursor of disease and reduced quality of life in humans. The biological pathways between stress exposure and pathophysiological processes underlying disease have received substantial scientific attention, although the roles of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system remain insufficiently understood. Recent attention has focused on chronic systemic low-grade inflammation as a promising pathway because elevated inflammation often accompanies chronic psychosocial distress. These alterations of inflammatory activity play a key role in the pathophysiology of diseases that are adversely affected by chronic distress, such as cardiovascular disease. Transient increases in systemic inflammation are observed in response to acute psychosocial stress, with larger responses among individuals reporting adverse psychosocial states or conditions such as depression, lower self-esteem, or lower self-compassion. Recent evidence shows that lower subjective social status and perceived purpose in life are associated with sensitization of inflammatory stress responses to repeated stress exposure. The aims of this selective review article are to summarize current knowledge of the role of acute and chronic psychosocial stress on low-grade inflammation in humans and to discuss potential relationships between inflammatory responses to acute psychosocial stress and long-term development of disease.

  15. Ethanol and other oxygenateds from low grade carbonaceous resources

    Energy Technology Data Exchange (ETDEWEB)

    Joo, O.S.; Jung, K.D.; Han, S.H. [Korea Institute of Science and Technology, Seoul (Korea, Democratic People`s Republic of)] [and others

    1995-12-31

    Anhydrous ethanol and other oxygenates of C2 up can be produced quite competitively from low grade carbonaceous resources in high yield via gasification, methanol synthesis, carbonylation of methanol an hydrogenation consecutively. Gas phase carbonylation of methanol to form methyl acetate is the key step for the whole process. Methyl acetate can be produced very selectively in one step gas phase reaction on a fixed bed column reactor with GHSV over 5,000. The consecutive hydrogenation of methyl or ethyl acetate produce anhydrous ethanol in high purity. It is also attempted to co-produce methanol and DME in IGCC, in which low grade carbonaceous resources are used as energy sources, and the surplus power and pre-power gas can be stored in liquid form of methanol and DME during base load time. Further integration of C2 up oxygenate production with IGCC can improve its economics. The attempt of above extensive technology integration can generate significant industrial profitability as well as reduce the environmental complication related with massive energy consumption.

  16. Low-grade energy of the ground for civil engineering

    Directory of Open Access Journals (Sweden)

    Potienko Natalia

    2017-01-01

    Full Text Available The article researches issues related to the relevance of applying renewable energy sources for civil engineering. The aim of the work is the study of modern approaches to designing buildings, using low-grade energy of the ground. The research methodology is based on the complex analysis of international design experience and on identifying the strengths and weaknesses of objects that use low-grade heat. We have identified the prospects of applying it for domestic construction practice. The state policy in the field of the efficient use of energy resources has been analyzed, and the vector of energy-saving programs development for the Samara Region has been defined. The research describes the impact of using geothermal energy on the architectural and planning solutions of buildings, as well as the peculiar features of the latter’s design, which are related primarily to the increase of energy efficiency. As a result, in the article a conclusion is made that the objects under investigation may be considered as one of the vectors of sustainable architecture development.

  17. Low-grade serous carcinoma: new concepts and emerging therapies.

    Science.gov (United States)

    Romero, Ignacio; Sun, Charlotte C; Wong, Kwong K; Bast, Robert C; Gershenson, David M

    2013-09-01

    For the past several years, all women with epithelial ovarian cancer have been treated identically, whether in a clinical trial or off protocol. Over the past decade, we have come to appreciate the magnitude of the heterogeneity of ovarian cancer. The development of the binary grading system for serous carcinoma was a major advance leading to separate clinical trials for patients with this subtype originating from the Gynecologic Oncology Group's Rare Tumor Committee. The mitogen-activated protein kinase (MAPK) pathway appears to play a prominent role in the pathogenesis of this subtype. Approximately 20-40% of low-grade serous carcinomas have a KRAS mutation, while BRAF mutations are rare - about 5%. Primary treatment of low-grade serous carcinoma includes surgery+platinum-based chemotherapy (either adjuvant or neoadjuvant). Clinical behavior is characterized by young age at diagnosis, relative chemoresistance, and prolonged overall survival. Current options for treatment of relapsed disease include secondary cytoreduction in selected patients, salvage chemotherapy, or hormonal therapy. A recently completed trial of a MEK inhibitor for women with recurrent disease demonstrated promising activity. Future directions will include further investigations of the molecular biology and biomarker-driven clinical trials with targeted agent monotherapy and combinations. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Polymorphous low grade adenocarcinoma: review and case report.

    Science.gov (United States)

    Pintor, María Fernanda; Figueroa, Liberto; Martínez, Benjamín

    2007-12-01

    Polymorphous Low-Grade Adenocarcinoma is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands. It is more frequent in the age range from 30 to 70, with a clear female predilection in a 2:1 ratio. It is usually located in the hard or soft palate, although it may be found in the rest of the oral cavity too. It is rare in major salivary glands. In general it has good prognosis, with recurrence rates in the range of 17% - 24%. Although rare, metastasis to regional lymph nodes may occur in 9% of the cases. This report describes the case of a patient that consulted at the Military Odontological Center (Central Odontológica del Ejército) due to an esthetic alteration of her dental prosthesis, which had been made 8 years before. The patient was sent to the Maxillofacial Surgery Service, where the intraoral examination showed a big mass compromising the hard palate and the alveolar ridge. During examination, a dent in her prosthesis was found to correspond to the tumor mass; it was therefore concluded that the tumor had at least an eight-year-old evolution. An incisional biopsy was carried out, and once the polymorphous low-grade adenocarcinoma diagnosis had been stated, the patient was sent to the Head and Neck Surgery Service of the Military Hospital, where the lesion was treated by wide surgical excision followed by radiation therapy.

  19. Fertility following microsurgical removal of the ampullary-isthmic junction in rabbits.

    Science.gov (United States)

    Eddy, C A; Antonini, R; Pauerstein, C J

    1977-10-01

    The role of the ampullary-isthmic junction (AIJ) in fertility was investigated in the rabbit by using microsurgical tuboplastic techniques. Microsurgical transection or resection of the AIJ failed to alter fertility significantly. Nine of ten rabbits which underwent unilateral transection of the AIJ became pregnant on the operated side and eight of the ten became pregnant on the unoperated control side. Of the ten rabbits which underwent unilateral AIJ resection, all became pregnant bilaterally. The results of this study indicate that the AIJ is not necessary for normal fertility in the rabbit.

  20. Persistent low-grade inflammation and regular exercise.

    Science.gov (United States)

    Astrom, Maj-Briit; Feigh, Michael; Pedersen, Bente Klarlund

    2010-01-01

    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2 diabetes and dementia. We suggest that the anti-inflammatory effects of exercise may be mediated via a long-term effect of exercise leading to a reduction in visceral fat mass and/or by induction of anti-inflammatory cytokines with each bout of exercise.

  1. Beneficiation of low-grade diasporic bauxite with hydrocyclone

    Institute of Scientific and Technical Information of China (English)

    GAO Shu-ling; LI Xia-an; WEI De-zhou; FANG Ping; JIA Chun-yun; LIU Wen-gang; HAN Cong

    2008-01-01

    Low-grade diasporic bauxite was treated with hydrocyclone of small cone-angle. The effects of apex diameter, feed pressure and feed concentration on separation indexes were tested, and then the separation process was discussed by hydrokinetics tentatively. The results show that the increase of apex diameter changes the spacial locality of the envelope of zero vertical velocity, resulting in decrease of the ratio of Al2O3/SiO2 in overflow and increase of the recovery of Al2O3 in underflow, while feed pressure and feed concentration have no remarkable effect on the spacial locality of the envelope of zero vertical velocity, however, the separation indexes are improved by the increase of feed pressure, but are worsened by the increase of feed concentration.

  2. Persistent low-grade inflammation and regular exercise

    DEFF Research Database (Denmark)

    Åström, Maj-brit; Feigh, Michael; Pedersen, Bente Klarlund

    2010-01-01

    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection...... against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2...... diabetes and dementia. We suggest that the anti-inflammatory effects of exercise may be mediated via a long-term effect of exercise leading to a reduction in visceral fat mass and/or by induction of anti-inflammatory cytokines with each bout of exercise....

  3. Optimal management of biopsy-proven low-grade gastricdysplasia

    Institute of Scientific and Technical Information of China (English)

    Jung-Wook Kim; Jae Young Jang

    2015-01-01

    Gastric adenocarcinoma generally culminates via theinflammation-metaplasia-dysplasia-carcinoma sequenceprogression. The prevalence of gastric adenomasshows marked geographic variation. Recently, therate of diagnosis of low-grade dysplasia (LGD) hasincreased due to increased use of upper endoscopy.Many investigators have reported that gastric highgradedysplasia has high potential for malignancy andshould be removed; however, the treatment for gastricLGD remains controversial. Although the risk of LGDprogression to invasive carcinoma has been reported tobe inconsistent, progression has been observed duringfollow-up. Additionally, the rate of upgraded diagnosisin biopsy-proven LGD is high. Therefore, endoscopicresection (ER) may be useful in the treatment anddiagnosis of LGD, especially if lesions are found to haverisk factors for upgraded histology after ER, such aslarge size, surface erythema or depressed morphology.Fatal complications in endoscopic submucosal dissection(ESD) are extremely low and its therapeutic and diagnosticoutcomes are excellent. Therefore, ESD shouldbe applied preferentially instead of endoscopic mucosalresection.

  4. Flotation studies on low grade graphite ore from eastern India

    Institute of Scientific and Technical Information of China (English)

    Vasumathi N.; Vijaya Kumar T.V.; Ratchambigai S.; Subba Rao S.; Bhaskar Raju G

    2015-01-01

    A low grade graphite ore from eastern India was beneficiated by flotation to improve its quality. The ore was composed of 87.80%ash and 8.59%fixed carbon. Primary coarse wet grinding (d80:186 lm) followed by rougher flotation in Denver flotation cell using diesel as collector and pine oil as frother yielded a rougher concentrate. Regrinding (d80:144 lm) of this rougher concentrate was opted for further libera-tion of graphite. It was followed by cleaning in laboratory flotation column. This combined process of relatively coarse primary grinding followed by regrinding and cleaning in flotation column resulted in final concentrate of 7.44% yield with 89.65% fixed carbon and 6.00% ash. This approach of two-stage grinding to recover the flake graphite at the coarsest possible grind can help to minimize grinding energy costs. A conceptual flow sheet which is cost effective was developed based on this methodology.

  5. Development of low grade waste heat thermoelectric power generator

    Directory of Open Access Journals (Sweden)

    Suvit Punnachaiya

    2010-07-01

    Full Text Available This research aimed to develop a 50 watt thermoelectric power generator using low grade waste heat as a heat source,in order to recover and utilize the excess heat in cooling systems of industrial processes and high activity radioisotope sources. Electricity generation was based on the reverse operation of a thermoelectric cooling (TEC device. The TEC devices weremodified and assembled into a set of thermal cell modules operating at a temperature less than 100°C. The developed powergenerator consisted of 4 modules, each generating 15 watts. Two cascade modules were connected in parallel. Each modulecomprised of 96 TEC devices, which were connected in series. The hot side of each module was mounted on an aluminumheat transfer pipe with dimensions 12.212.250 cm. Heat sinks were installed on the cold side with cooling fans to provideforced air cooling.To test electricity generation in the experiment, water steam was used as a heat source instead of low grade waste heat.The open-circuit direct current (DC of 250 V and the short-circuit current of 1.2 A was achieved with the following operatingconditions: a hot side temperature of 96°C and a temperature difference between the hot and cold sides of 25°C. The DC poweroutput was inverted to an AC power source of 220 V with 50 Hz frequency, which can continuously supply more than 50 wattsof power to a resistive load as long as the heat source was applied to the system. The system achieved an electrical conversionefficiency of about 0.47 percent with the capital cost of 70 US$/W.

  6. Low grade epithelial stromal tumour of the seminal vesicle

    Directory of Open Access Journals (Sweden)

    Pozzoli Gianluigi

    2008-09-01

    Full Text Available Abstract Background The mixed epithelial stromal tumour is morphologically characterised by a mixture of solid and cystic areas consisting of a biphasic proliferation of glands admixed with solid areas of spindle cells with variable cellularity and growth patterns. In previous reports the seminal vesicle cystoadenoma was either considered a synonym of or misdiagnosed as mixed epithelial stromal tumour. The recent World Health Organisation Classification of Tumours considered the two lesions as two distinct neoplasms. This work is aimed to present the low-grade epithelial stromal tumour case and the review of the literature to the extent of establishing the true frequency of the neoplasm. Case presentation We describe a low-grade epithelial stromal tumour of the seminal vesicle in a 50-year-old man. Computed tomography showed a 9 × 4.5 cm pelvic mass in the side of the seminal vesicle displacing the prostate and the urinary bladder. Magnetic resonance was able to define tissue planes between the lesion and the adjacent structures and provided useful information for an accurate conservative laparotomic surgical approach. The histology revealed biphasic proliferation of benign glands admixed with stromal cellularity, with focal atypia. After 26 months after the excision the patient is still alive with no evidence of disease. Conclusion Cystoadenoma and mixed epithelial stromal tumour of seminal vesicle are two distinct pathological entities with different histological features and clinical outcome. Due to the unavailability of accurate prognostic parameters, the prediction of the potential biological evolution of mixed epithelial stromal tumour is still difficult. In our case magnetic resonance imaging was able to avoid an exploratory laparotomy and to establish an accurate conservative surgical treatment of the tumour.

  7. Isthmic-vaginal smear cytology in the follow-up after radical vaginal trachelectomy for early stage cervical cancer: is it safe?

    Science.gov (United States)

    Lanowska, Malgorzata; Mangler, Mandy; Grittner, Ulrike; Akbar, Gerta Rose; Speiser, Dorothee; von Tucher, Elisabeth; Köhler, Christhardt; Schneider, Achim; Kühn, Wolfgang

    2014-05-01

    Isthmic-vaginal cytology is a follow-up method in patients who have undergone radical vaginal trachelectomy (RVT) for early cervical cancer. However, to the authors' knowledge, little is known regarding its ability to monitor patients and diagnose disease recurrence. Herein, the authors report their experience with cytology after RVT compared with cytology in patients after cone biopsy and women undergoing screening. A database of 563 specimens from 303 patients was analyzed retrospectively (RVT in 361 specimens, conization in 102 specimens, and screening in 100 specimens). The following criteria were applied: Bethesda system, the presence of endocervical and metaplasia cells, regeneration criteria, vaginal flora, and morphological signs of human papillomavirus. The analysis was performed by 2 cytopathologists. Differences between the groups and correlation between the cytopathologists were analyzed. Smears without endocervical and metaplasia cells were significantly less frequent among the patients who underwent RVT. There was no difference in regeneration signs, vaginal flora, and morphologic signs of human papillomavirus between the groups. After RVT, 26/23 smears (cytopathologist 1/cytopathologist 2) smears were diagnosed as abnormal. Biopsies revealed 7 cases of dysplasia and 1 case of disease recurrence. After conization, 1 patient was diagnosed with a low-grade lesion on cytology; follow-up cytology was normal. In the screening, 10/13 smears were diagnosed with lesions on cytology; biopsy revealed dysplasia in 2 cases. The correlation between both cytopathologists was high. After RVT, histological verification of cytology is frequently needed. The reasons might include alterations of anatomy, regeneration, and inflammation process after RVT. Cytopathologists should become familiar with the spectrum of changes in post-RVT cytology and communication between cytopathologists and clinicians should be improved. This might reduce false-positive results. © 2014

  8. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans;

    2007-01-01

    STUDY DESIGN: A cross-sectional epidemiological survey of 4151 participants of the Copenhagen Osteoarthritis Study. OBJECTIVE: To identify prevalences and individual risk factors for degenerative lumbar spondylolisthesis. SUMMARY OF BACKGROUND DATA: The Copenhagen Osteoarthritis Study has...... registered health parameters since 1976. In 1993, standardized, lateral radiographs of the lumbar spine were recorded. There were 1533 men and 2618 women. METHODS: Statistical correlations were made between degenerative spondylolisthesis, and physical, occupational, and general epidemiological data. RESULTS......: A total of 254 cases of lumbar slip were found (males 2.7%, females 8.4%). In females, no significant relationship between age at menopause or childbirths and the presence of degenerative spondylolisthesis were found. In women, relationships between body mass index (BMI) in 1976 and L4 olisthesis (P = 0...

  9. Spondylolysis/spondylolisthesis: A new thesis of its aetiology

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W.

    1988-01-01

    Attention is drawn to the mode of development of spondylolysis/spondylolisthesis and to the fact that the articular processes of the small vertebrae can exercise an action on the pars interarticularis only if the latter are in oblique position. It is pointed out that the requisite obliqueness of the pars interarticularis is only possible in conjunction with lordosis, so that the latter is an essential condition for the pathogenesis of spondylolysis/spondylolisthesis. It is also pointed out that excessive load due to upright position of the subject is the triggering factor for spondylolysis/spondylolisthesis, because it is only from this position that the articular processes of the small vertebrae can exercise an action on the pars interarticularis. (orig./MBC).

  10. Conformal proton radiation therapy for pediatric low-grade astrocytomas

    Energy Technology Data Exchange (ETDEWEB)

    Hug, E.B. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Radiation Medicine; Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Pediatrics and Dept. of Pathology; Darthmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States). Section of Radiation Oncology; Muenter, M.W.; Archambeau, J.O.; DeVries, A.; Loredo, L.N.; Grove, R.I.; Slater, J.D. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Radiation Medicine; Liwnicz, B. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Pathology

    2002-01-01

    Background: To evaluate the safety and efficacy of proton radiation therapy (PRT) for intracranial low-grade astrocytomas, the authors analyzed the first 27 pediatric patients treated at Loma Linda University Medical Center (LLUMC). Patients and Method: Between September 1991 and August 1997, 27 patients (13 female, 14 male) underwent fractionated proton radiation therapy for progressive or recurrent low-grade astrocytoma. Age at time of treatment ranged from 2 to 18 years (mean: 8.7 years). Tumors were located centrally (diencephatic) in 15 patients, in the cerebral and cerebellar hemispheres in seven patients, and in the brainstem in five patients. 25/27 patients (92%) were treated for progressive, unresectable, or residual disease following subtotal resection. Tissue diagnosis was available in 23/27 patients (85%). Four patients with optic pathway tumors were treated without histologic confirmation. Target doses between 50.4 and 63.0 CGE (cobalt gray equivalent, mean: 55.2 CGE) were prescribed at 1.8 CGE per fraction, five treatments per week. Results: At a mean follow-up period of 3.3 years (0.6-6.8 years), 6/27 patients experienced local failure (all located within the irradiated field), and 4/27 patients had died. By anatomic site these data translated into rates of local control and survival of 87% (13/15 patients) and 93% (14/15 patients) for central tumors, 71% (5/7 patients) and 86% (6/7 patients) for hemispheric tumors, and 60% (3/5 patients) and 60% (3/5 patients) for tumors located in the brainstem. Proton radiation therapy was generally well tolerated. All children with local control maintained their performance status. One child with associated neurofibromatosis, Type 1, developed Moyamoya disease. All six patients with optic pathway tumors and useful vision maintained or improved their visual status. Conclusions: This report on pediatric low-grade astrocytomas confirms proton radiation therapy as a safe and efficacious 3-D conformal treatment

  11. Outcomes of Multidisciplinary Management in Pediatric Low-Grade Gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kevin S., E-mail: koh2@partners.org [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Hung, Jonathan [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Robertson, Patricia L. [Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI (United States); Department of Neurology, University of Michigan Health System, Ann Arbor, MI (United States); Garton, Hugh J.; Muraszko, Karin M. [Department of Neurosurgery, University of Michigan Health System, Ann Arbor, MI (United States); Sandler, Howard M. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Hamstra, Daniel A. [Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI (United States)

    2011-11-15

    Purpose: To evaluate the outcomes in pediatric low-grade gliomas managed in a multidisciplinary setting. Methods and Materials: We conducted a single-institution retrospective study of 181 children with Grade I-II gliomas. Log-rank and stepwise Cox proportional hazards models were used to analyze freedom from progression (FFP) and overall survival (OS). Results: Median follow-up was 6.4 years. Thirty-four (19%) of patients had neurofibromatosis Type 1 (NF1) and because of their favorable prognosis were evaluated separately. In the 147 (81%) of patients without NF1, actuarial 7-year FFP and OS were 67 {+-} 4% (standard error) and 94 {+-} 2%, respectively. In this population, tumor location in the optic pathway/hypothalamus was associated with worse FFP (39% vs. 76%, p < 0.0003), but there was no difference in OS. Age {<=}5 years was associated with worse FFP (52% vs. 75%, p < 0.02) but improved OS (97% vs. 92%, p < 0.05). In those with tissue diagnosis, gross total resection (GTR) was associated with improved 7-year FFP (81% vs. 56%, p < 0.02) and OS (100% vs. 90%, p < 0.03). In a multivariate model, only location in the optic pathway/hypothalamus predicted worse FFP (p < 0.01). Fifty patients received radiation therapy (RT). For those with less than GTR, adjuvant RT improved FFP (89% vs. 49%, p < 0.003) but not OS. There was no difference in OS between patient groups given RT as adjuvant vs. salvage therapy. In NF1 patients, 94% of tumors were located in the optic pathway/hypothalamus. With a conservative treatment strategy in this population, actuarial 7-year FFP and OS were 73 {+-} 9% and 100%, respectively. Conclusions: Low-grade gliomas in children {<=}5 years old with tumors in the optic pathway/hypothalamus are more likely to progress, but this does not confer worse OS because of the success of salvage therapy. When GTR is not achieved, adjuvant RT improves FFP but not OS. Routine adjuvant RT can be avoided and instead reserved as salvage.

  12. Roentgenologic assessment of spondylolisthesis. Pt. 2. An evaluation of progression

    Energy Technology Data Exchange (ETDEWEB)

    Danielson, B.; Frennered, K.; Selvik, G.; Irstam, L.

    Different degrees of artificial L5-S1 spondylolisthesis were created using a lumbar specimen. Lateral radiographs were obtained of each, with the specimen tilted and/or rotated. The true spondylolisthesis was determined stereophotogrammetrically. The slip, measured on the radiographs, was calculated according to two methods modified from BOXALL et coll. (2). No significant difference in accuracy was found between these two methods. The difference in calculated slip between examinations needs to be at least 20 per cent of the sagittal length of L5 to be regarded as a true progression. A true progress of slip of less than 20 per cent is difficult to detect with statistical certainty.

  13. Second Surgery in Insular Low-Grade Gliomas

    Directory of Open Access Journals (Sweden)

    Tamara Ius

    2015-01-01

    Full Text Available Background. Given the technical difficulties, a limited number of works have been published on insular gliomas surgery and risk factors for tumor recurrence (TR are poorly documented. Objective. The aim of the study was to determine TR in adult patients with initial diagnosis of insular Low-Grade Gliomas (LGGs that subsequently underwent second surgery. Methods. A consecutive series of 53 patients with insular LGGs was retrospectively reviewed; 23 patients had two operations for TR. Results. At the time of second surgery, almost half of the patients had experienced progression into high-grade gliomas (HGGs. Univariate analysis showed that TR is influenced by the following: extent of resection (EOR (P<0.002, ΔVT2T1 value (P<0.001, histological diagnosis of oligodendroglioma (P=0.017, and mutation of IDH1 (P=0.022. The multivariate analysis showed that EOR at first surgery was the independent predictor for TR (P<0.001. Conclusions. In patients with insular LGG the EOR at first surgery represents the major predictive factor for TR. At time of TR, more than 50% of cases had progressed in HGG, raising the question of the oncological management after the first surgery.

  14. Recovery of nickel from low grade laterite by electrochemical leaching

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung-Gyu; Lee, Hwa-Young; Oh, Jong-Kee [Korea Institute of Science and Technology, Seoul (Korea)

    1999-06-30

    A study on the recovery of nickel from low-grade laterite is carried out by the electrochemical leaching. The results show that the leaching reaction of Ni and Fe increases with time until 60 minutes, after which the leaching rate decreases. The leaching efficiencies of Ni and Fe are 73% and 64% at 2 hr. reaction, respectively. And current density plays an important role in the leaching rate of nickel, but power consumption increases with increase of current density which proportionally corresponds to nickel leaching. Also, the leaching efficiency of nickel appears to decrease in a small amount with increasing solid density. However, so as to reduce power consumption solid density has to be raised so long as the stirring intensity is not restricted due to heavy load. When the pH of the leaching solution is increased to 6.0, iron and nickel are remaining about 10% and 90% of initial concentrations in the leaching solution, respectively. (author). 11 refs., 2 tabs., 10 figs.

  15. Advances in the management of low-grade gliomas.

    Science.gov (United States)

    Nageswara Rao, Amulya A; Packer, Roger J

    2014-01-01

    Low-grade gliomas (LGGs) represent the most common childhood brain tumors and are a histologically heterogenous group of tumors. Most LGGs are surgically resectable with excellent 10-year overall survival outcomes of more than 90 % with surgery alone. Tumors not amenable to surgical resection and those with an aggressive biology are more challenging to treat. Conventional radiotherapy is a more efficacious method of long-term tumor control than chemotherapy. However, radiation is associated with significant cognitive, endocrine, and cerebrovascular late effects, making chemotherapy an often-preferred modality over radiotherapy, especially in younger children. Multiple chemotherapy regimens have been evaluated over the past few decades with comparable survival outcomes and differing toxicity profiles. Newer regimens containing antiangiogenic agents also show promise. Recent molecular studies have implicated the BRAF oncogene, a key regulator of the MAPK pathway, and the AKT/mTOR pathway in pediatric LGG tumorigenesis. This has opened up promising new avenues for targeted therapy, with many agents currently under investigation.

  16. The evaluation of curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation%椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症疗效评价

    Institute of Scientific and Technical Information of China (English)

    黄久勤; 王传文

    2009-01-01

    Objective To investigate the curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation.Method All 39 cases with lumbar spondylolisthesis accepted treatment during January 2003 to October 2007.There were cataplasia spondylolisthesis in 14 cases and isthmic spondylolisthesis in 25 cases.Twenty-two cases had spondylolisthesis in L4 and 17 cases had spondylolisthesis in L5.According to Meyerding grading,11 patients were classified as degree Ⅰ lesion.27 patients as degree Ⅱ lesion and 1 patient as degree Ⅲ lesion.By the help of X-ray machine,pedicle screw Was embedded in the vertebral spondylolisthesis and it Was lower vertebra.Laminectomy decompress was administered in vertebral spondylolisthesis and hold-down bars was placed to open intervertebral space.Then restored the vertebral spondylolisthesis and fixed it temporary.Next,intervertebral compression bone graft fusion was finished and was adjusted.Results Follow-up period was 5 months to 4 years.Clinical outcomes were measured with Prolo evaluation scale,35 cases were cured,4 cases were good effect.Conclusions This operation has been found to be asafe,rapid and effective method for lumbar spondylolisthesis and it produces a high fusion rate and lower expense.%目的 评价椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症的临床疗效.方法 2003年1月至2007年10月收治的腰椎滑脱症患者39例,其中退变性滑脱14例,峡部裂性滑脱25例.L4椎体滑脱22例,L5k椎体滑脱17例.按Meyerding滑脱程度分级标准:Ⅰ度滑脱11例,Ⅱ度滑脱27例,Ⅲ度滑脱1例.C型臂X线机透视定位下在滑脱椎体及其下位椎体间植入椎弓根螺钉,行滑脱椎体全椎板减压术,安放固定棒并撑开椎间隙,进行滑脱椎体复位及临时固定,处理椎间隙,行椎间打压植骨融合术,调整钉棒进行椎间适度加压,以植骨块稳定为度.结果 本组患者

  17. Low-grade Prehnite-Pumpellyite facies metamorphism in the Bamble sector, SE-Norway

    OpenAIRE

    Velo, Mari Roen

    2014-01-01

    Low-grade metamorphic minerals have been found within the high-grade terrain in the Bamble sector, SE-Norway. The minerals prehnite and pumpellyite indicative of prehnite-pumpellyite facies conditions have been confirmed around the Kragerø area. The formation of analcime, thomsonite, hydrogarnet, albite and clay minerals is also a part of the low-grade metamorphism. The occurrence of these low-grade minerals is constricted to pseudomorph replacement of earlier mineral phases, hydrothermal vei...

  18. Disc displacement patterns in lumbar anterior spondylolisthesis: Contribution to foraminal stenosis

    Energy Technology Data Exchange (ETDEWEB)

    MacMahon, P.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11 (Ireland)], E-mail: petermacmahon@yahoo.com; Taylor, D.H.; Duke, D.; Brennan, D.D.; Eustace, S.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11 (Ireland)

    2009-04-15

    Purpose: To describe the particular disc displacement pattern seen at MRI in patients with spondylolisthesis, and its potential contribution to foraminal stenosis. Methods: 38 patients with symptomatic lumbar anterior spondylolisthesis and 38 sex and aged matched control patients with herniated disc disease, at corresponding disc space levels, were included for study. In each case note was made of the presence, absence and direction of disc displacement and also the presence and location of neural contact with the displaced disc. Results: In 33 of 38 (86.8%) patients in the spondylolisthesis group, the vertical disc displacement was upward. In the control group only 3 patients (7.8%) had upward vertical disc displacement. 19 patients (53%) from the spondylolisthesis group had exit foraminal nerve root contact, compared to 7 patients (18.4%) from the control group. 27 control patients (71%) had contact within the lateral recess, compared to only 6 patients (17%) with spondylolisthesis. Differences for upward displacement were significant (p < 0.05). Conclusion: Disc displacement in patients with spondylolisthesis is predominately in a cephalad and lateral direction. Although this disc displacement pattern can occur in patients without spondylolisthesis, its incidence is much greater in the subset of patients with concomitant spondylolisthesis. In the setting of acquired osseous narrowing of the exit foramen, this described pattern of disc displacement superiorly and laterally in spondylolisthesis increases the susceptibility of spondylolisthesis patients to radicular symptoms and accounts for the exiting nerve root being more commonly affected than the traversing nerve root.

  19. Minimally invasive surgery for lumbar synovial cysts with coexisting degenerative spondylolisthesis.

    Science.gov (United States)

    Denis, Daniel R; Hirt, Daniel; Shah, Saumya; Lu, Daniel C; Holly, Langston T

    2016-01-01

    About one third of lumbar synovial cysts are associated with degenerative spondylolisthesis. Segmental instability is thought to contribute to the pathogenesis and recurrence of synovial cysts and lumbar fusion has been advocated as a treatment of choice in the presence of spondylolisthesis. In patients with spondylolisthesis, minimally invasive resection of lumbar synovial cysts, without fusion, could minimize surgically induced segmental instability while providing good pain relief. Clinical and radiological outcomes of lumbar synovial cyst patients with and without spondylolisthesis were retrospectively compared. Pain outcomes were assessed with modified Macnab criteria. Fifty-three patients (18 with grade 1 spondylolisthesis) underwent minimally invasive synovial cyst resection and all had either excellent or good pain outcome at ≤ 8 post- operative weeks (P = 1.000, n = 53). At > 8 post-operative weeks (mean (SD) follow-up of 200 (175) weeks), excellent or good outcomes were noted in 89% of patients without spondylolisthesis and in 75% of patients with spondylolisthesis (P = 0.425, n = 40). Four patients developed a new grade 1 spondylolisthesis at a mean follow-up of 2.6 ± 2.1 years. Nine patients were assessed for spondylolisthesis measurements at 1.2 ± 1.3 years of follow up and no significant difference was observed (5 ± 0 vs 5 ± 1 mm; P = 0.791). Two patients without spondylolisthesis and none of the patients with spondylolisthesis had a synovial cyst recurrence. Patients with concomitant lumbar degenerative spondylolisthesis and synovial cyst can have good short- and long-term clinical outcomes with minimally invasive surgery without fusion. Post-operative segmental instability does not appear to be significant in patients with spondylolisthesis. All patients included in this article signed an informed consent for the use of their medical information for research.

  20. Minimally invasive surgery for lumbar synovial cysts with coexisting degenerative spondylolisthesis

    Science.gov (United States)

    Hirt, Daniel; Shah, Saumya; Lu, Daniel C.; Holly, Langston T.

    2016-01-01

    Background About one third of lumbar synovial cysts are associated with degenerative spondylolisthesis. Segmental instability is thought to contribute to the pathogenesis and recurrence of synovial cysts and lumbar fusion has been advocated as a treatment of choice in the presence of spondylolisthesis. In patients with spondylolisthesis, minimally invasive resection of lumbar synovial cysts, without fusion, could minimize surgically induced segmental instability while providing good pain relief. Methods Clinical and radiological outcomes of lumbar synovial cyst patients with and without spondylolisthesis were retrospectively compared. Pain outcomes were assessed with modified Macnab criteria. Results Fifty-three patients (18 with grade 1 spondylolisthesis) underwent minimally invasive synovial cyst resection and all had either excellent or good pain outcome at ≤ 8 post- operative weeks (P = 1.000, n = 53). At > 8 post-operative weeks (mean (SD) follow-up of 200 (175) weeks), excellent or good outcomes were noted in 89% of patients without spondylolisthesis and in 75% of patients with spondylolisthesis (P = 0.425, n = 40). Four patients developed a new grade 1 spondylolisthesis at a mean follow-up of 2.6 ± 2.1 years. Nine patients were assessed for spondylolisthesis measurements at 1.2 ± 1.3 years of follow up and no significant difference was observed (5 ± 0 vs 5 ± 1 mm; P = 0.791). Two patients without spondylolisthesis and none of the patients with spondylolisthesis had a synovial cyst recurrence. Conclusion Patients with concomitant lumbar degenerative spondylolisthesis and synovial cyst can have good short- and long-term clinical outcomes with minimally invasive surgery without fusion. Post-operative segmental instability does not appear to be significant in patients with spondylolisthesis. All patients included in this article signed an informed consent for the use of their medical information for research. PMID:27909658

  1. Biomechanics of high-grade spondylolisthesis with and without reduction.

    Science.gov (United States)

    Wang, Wenhai; Aubin, Carl-Eric; Cahill, Patrick; Baran, George; Arnoux, Pierre-Jean; Parent, Stefan; Labelle, Hubert

    2016-04-01

    The clinical advantages of reducing spondylolisthesis over fusion in situ have several intuitive reasons such as restore the spinal column into a more anatomic relationship and alignment. However, there is only little evidence in the literature supporting the theoretical advantages of reduction, and its effect on spinopelvic alignment remains poorly defined. In this study, a comprehensive finite element model was developed to analyze the biomechanics of the spine after spinal fusion at L5-S1 in both types of high-grade spondylolisthesis (balanced and unbalanced pelvis). The relevant clinical indices (i.e. spondylolisthesis grade and Dubousset lumbosacral angle), the displacement of L4-L5, pressure within the annulus and nucleus, and stress at L4-L5 were evaluated and compared. The model can well predict the changes of the important clinical indices during the surgery. For a balanced pelvis, the reduction has a minimal effect on the biomechanical conditions at the adjacent level during postsurgical activities. In the unbalanced case, reduction induced larger deformation in the lumbosacral region and a higher stress concentration at adjacent level. Whether such a stress concentration can lead to long-term disc degeneration is not known. The results provide additional information for the clinician considering reduction of high-grade spondylolisthesis.

  2. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans

    2007-01-01

    : A total of 254 cases of lumbar slip were found (males 2.7%, females 8.4%). In females, no significant relationship between age at menopause or childbirths and the presence of degenerative spondylolisthesis were found. In women, relationships between body mass index (BMI) in 1976 and L4 olisthesis (P = 0...

  3. Degenerative spondylolisthesis is associated with low spinal bone density

    DEFF Research Database (Denmark)

    Andersen, Thomas; Christensen, Finn B; Langdahl, Bente Lomholt

    2013-01-01

    Spinal stenosis and degenerative spondylolisthesis share many symptoms and the same treatment, but their causes remain unclear. Bone mineral density has been suggested to play a role. The aim of this study was to investigate differences in spinal bone density between spinal stenosis and degenerat...

  4. Sexuality after surgery for diffuse low-grade glioma

    Science.gov (United States)

    Surbeck, Werner; Herbet, Guillaume; Duffau, Hugues

    2015-01-01

    Background Although neurological and neurocognitive outcomes have previously been studied after resection of diffuse low-grade glioma (DLGG), the impact of surgery on sexual life has not been investigated. Our aim was to assess whether DLGG surgery could have consequences on sexual experience. Methods Anonymous standardized questionnaires concerning sexual functioning, including the Arizona Sexual Experiences Scale (ASEX) and a subjective statement, were completed by 32 patients who underwent surgery for DLGG. All patients returned to a normal social and professional life following resection, with neither neurological deficits nor depression. No radiotherapy was administered, and patients who received chemotherapy were without treatment for at least 1 year. Results Seventeen patients (53%) reported a postoperative sexual change, with subjective deterioration in 15 (88%) and improvement in 2 (12%). Sexual dysfunction according to ASEX affected 9 of 15 women (60%) and 5 of 17 men (29%). Right-sided resections were associated with more difficulties in reaching orgasm than left-sided resections (P < .02). Men with temporal lobe resection displayed more reduction in sexual drive (P < .003) and sexual arousal (P < .004) than women, resulting in significant higher overall ASEX scores for temporal lobe resections in men (P = .01). Men remaining on antiepileptic drugs who underwent right-sided resection displayed higher overall ASEX scores than women (P = .031). Conclusions This first evaluation of sexual life after surgery for DLGG suggests that sexual dysfunction is common in this population. Therefore, we suggest that sexual health should consistently be addressed during routine pre- and postoperative examination of patients with DLGG. PMID:25699682

  5. PDGFRA gain in low-grade diffuse gliomas.

    Science.gov (United States)

    Motomura, Kazuya; Mittelbronn, Michel; Paulus, Werner; Brokinkel, Benjamin; Keyvani, Kathy; Sure, Ulrich; Wrede, Karsten; Nakazato, Yoichi; Tanaka, Yuko; Nonoguchi, Naosuke; Pierscianek, Daniela; Kim, Young-Ho; Mariani, Luigi; Vital, Anne; Perry, Arie; Ohgaki, Hiroko

    2013-01-01

    Glioblastomas with a proneural expression signature are characterized by frequent IDH1 mutations (i.e. genetic hallmarks of secondary glioblastomas) and PDGFRA (platelet-derived growth factor receptor-α) amplification. Mutations in IDH1/2 are frequent and early genetic events in diffuse astrocytomas (World Health Organization grade II), precursor to secondary glioblastomas, but little is known about the role and timing of PDGFRA amplification in these tumors. We assessed PDGFRA gain in 342 low-grade diffuse gliomas by quantitative polymerase chain reaction. Gain in PDGFRA was detected in 27 (16.3%) of 166 diffuse astrocytomas, significantly more frequent than in oligodendrogliomas (3 [2.6%] of 115, p < 0.0001). Analyses using previously published data from our laboratory showed an inverse correlation between PDGFRA gain and IDH1/2 mutations (p = 0.018) or 1p/19q loss (p < 0.0001). The vast majority of diffuse astrocytomas showed IDH1/2 mutations and/or PDGFRA gain (154 [93%] of 166). Mean survival of diffuse astrocytoma patients with PDGFRA gain was 8.8 ± 1.6 years, similar to that with IDH1/2 mutations (7.8 ± 0.5 years) or TP53 mutations (7.6 ± 0.6 years) but significantly longer than those with MET gain (4.4 ± 0.7 years). Dual-color fluorescence in situ hybridization in 6 diffuse astrocytomas with PDGFRA/MET co-gain identified by quantitative polymerase chain reaction revealed that PDGFRA and MET were typically amplified in different tumor cell populations. Tumor cells with coamplification were also focally observed, suggesting intratumoral heterogeneity, even in diffuse astrocytomas.

  6. Gut microbiota, low-grade inflammation, and metabolic syndrome.

    Science.gov (United States)

    Chassaing, Benoit; Gewirtz, Andrew T

    2014-01-01

    The intestinal tract is inhabited by a large diverse community of bacteria collectively referred to as the gut microbiota. Alterations in gut microbiota composition are associated with a variety of disease states including obesity, diabetes, and inflammatory bowel disease (IBD). Transplant of microbiota from diseased persons (or mice) to germfree mice transfers some aspects of disease phenotype, indicating that altered microbiota plays a role in disease establishment and manifestation. There are myriad potential mechanisms by which alterations in gut microbiota might promote disease, including increasing energy harvest, production of toxic metabolites, and molecular mimicry of host proteins. However, our research indicates that an overarching mechanism by which an aberrant microbiota negatively impacts health is by driving chronic inflammation. More specifically, we hypothesize that the histopathologically evident gut inflammation that defines IBD is a severe but relatively rare outcome of an altered host-microbiota relationship, while a much more common consequence of such disturbances is "low-grade" inflammation characterized by elevated proinflammatory gene expression that associates with, and may promote, metabolic syndrome. In this context, a variety of chronic inflammatory diseases may stem from inability of the mucosal immune system to properly manage a stable healthy relationship with the gut microbiota. While one's ability to manage their gut microbiota is dictated in part by genetics, it can be markedly influenced by the composition of the microbiota one inherits from their early environment. Moreover, the host-microbiota relationship can be perturbed by instigator bacteria or dietary components, which may prove to play a role in promoting chronic inflammatory disease states.

  7. Non-interbody fusion and internal fixation lumbar spondylolysis mild spondylolisthesis Progress%非椎间融合内固定治疗峡部裂性腰椎轻度滑脱进展

    Institute of Scientific and Technical Information of China (English)

    许旻鸣; 潘汉升

    2015-01-01

    Isthmic spondylolisthesis is a common orthopedic spine disease. Mostly due to the driving force of the impact of body weight and lumbar hyperextension repeatedly, thereby increasing lumbar fracture stress and fatigue, so spondylolisthesis, spinal cause instability in the state. For more than three months of non-surgical treatment had no significant effect or symptoms of nerve compression taken to surgery, so oppressed nerves decompression release, and correct spinal spondylolisthesis restore stability. Simple fusion of traditional and supplemented by a variety of bone fixation treatment after fusion lumbar spondylolysisⅠ-Ⅱ ° spondylolisthesis, lumbar prone to reduction or loss of mobility and accelerate degeneration near the vertebral segments, etc. complications. However, non-interbody fusion activity in making isthmus on the basis of bone healing and to some extent, to retain the spine.%峡部裂性腰椎滑脱是一种常见的骨科脊柱疾病。多是由于受驱体重力影响以及腰椎反复过伸,因此增加腰椎峡部应力而发生疲劳骨折,使椎体滑脱,致脊柱处于失稳状态。对于非手术治疗3月以上无明显疗效或有神经压迫症状采取手术治疗,使被压迫的神经得到减压松解,并纠正滑脱恢复脊柱稳定。以往传统的单纯植骨融合并辅以内固定的各种植骨融合术的治疗峡部裂性腰椎Ⅰ-Ⅱ°滑脱后,容易出现腰椎活动度减少或丧失以及加快临近椎体节段退行性变等并发症。然而非椎间融合术在使椎弓峡部骨性愈合的基础上并在一定程度上保留脊柱的活动度。

  8. Two-Year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis: Part II: Radiographic Findings.

    Science.gov (United States)

    Isaacs, Robert E; Sembrano, Jonathan N; Tohmeh, Antoine G

    2016-04-01

    Prospective, multicenter, institutional review board approved study with randomized and observational study arms. The purpose of this study was to compare radiographic outcomes between minimally invasive transforaminal (MIS TLIF) or MIS lateral interbody fusion (XLIF) in the treatment of patients with low-grade degenerative spondylolisthesis with stenosis through 2-year postoperative. Few reports exist comparing different MIS approaches directly in the treatment of similar pathology, as most studies report differences between MIS and open procedures. A total of 55 patients undergoing surgical treatment for degenerative spondylolisthesis with spinal stenosis at one or two contiguous levels between L1 and L5 were enrolled. Twenty-nine patients were treated with XLIF and 26 patients were treated with MIS TLIF. Disc height was significantly improved from preoperative at all postoperative time points in both groups, though the XLIF group experienced less subsidence and resultant loss of disc height than the MIS TLIF group by 24-month postoperative (P = 0.002). Postoperative change in central canal area was statistically greater in the MIS TLIF compared with the XLIF group (43.1 mmvs. 4.1 mm, P = 0.028). At several postoperative time points, foraminal height and area on the ipsilateral side and foraminal height on the contralateral side to the approach were significantly increased postoperatively in the XLIF group, and the magnitude of ipsilateral height increase was greater than in the MIS TLIF cohort (P MIS TLIF levels were solidly bridged (P = 0.448). Different mechanisms of stenosis correction (direct vs. indirect) between the MIS TLIF and XLIF groups studied resulted in several significantly different radiographic characteristics. Despite these differences, both groups of patients experienced significant and maintained clinical improvements with high fusion rates at 2-year follow-up, suggesting that the mechanism of correction may not be critical and

  9. Cumulative irritancy in the guinea pig from low grade irritant vehicles and the angry skin syndrome

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Maibach, H I

    1980-01-01

    A 4-week open cumulative irritancy test in guinea pigs discriminated between two low grade irritant vehicles, nonionic base (anhydrous) and hydrophilic ointment. The procedure might be useful as a predictive test for low grade irritants. The angry skin syndrome was established in the guinea pigs...

  10. DNA methylation signatures of chronic low-grade inflammation are associated with complex diseases

    NARCIS (Netherlands)

    S. Ligthart (Symen); Marzi, C. (Carola); Aslibekyan, S. (Stella); Mendelson, M.M. (Michael M.); K.N. Conneely (Karen N.); T. Tanaka (Toshiko); Colicino, E. (Elena); L. Waite (Lindsay); R. Joehanes (Roby); W. Guan (Weihua); J. Brody (Jennifer); C.E. Elks (Cathy); R.E. Marioni (Riccardo); M.A. Jhun (Min A.); Agha, G. (Golareh); J. Bressler (Jan); C.K. Ward-Caviness (Cavin K.); B.H. Chen (Brian); T. Huan (Tianxiao); K.M. Bakulski (Kelly M.); E. Salfati (Elias); Fiorito, G. (Giovanni); S. Wahl (Simone); K. Schramm (Katharina); Sha, J. (Jin); D.G. Hernandez (Dena); Just, A.C. (Allan C.); J.A. Smith (Jennifer A); N. Sotoodehnia (Nona); L.C. Pilling (Luke); J.S. Pankow (James); Tsao, P.S. (Phil S.); Liu, C. (Chunyu); W. Zhao (Wei); S. Guarrera (Simonetta); Michopoulos, V.J. (Vasiliki J.); Smith, A.K. (Alicia K.); M.J. Peters (Marjolein); D. Melzer (David); Vokonas, P. (Pantel); M. Fornage (Myriam); H. Prokisch (Holger); J.C. Bis (Joshua); A.Y. Chu (Audrey); C. Herder (Christian); H. Grallert (Harald); C. Yao (Chen); S. Shah (Sonia); A.F. McRae (Allan F.); H. Lin; S. Horvath (Steve); Fallin, D. (Daniele); A. Hofman (Albert); N.J. Wareham (Nick); K.L. Wiggins (Kerri); A.P. Feinberg (Andrew P.); J.M. Starr (John); P.M. Visscher (Peter); J. Murabito (Joanne); Kardia, S.L.R. (Sharon L.R.); D. Absher (Devin); E.B. Binder (Elisabeth); A. Singleton (Andrew); S. Bandinelli (Stefania); A. Peters (Annette); M. Waldenberger (Melanie); G. Matullo; Schwartz, J.D. (Joel D.); E.W. Demerath (Ellen); A.G. Uitterlinden (André); Meurs, J.B.J. (Joyce B.J.); O.H. Franco (Oscar); Y.D. Chen (Y.); D. Levy (Daniel); S.T. Turner (Stephen); I.J. Deary (Ian J.); K.J. Ressler (Kerry); J. Dupuis (Josée); L. Ferrucci (Luigi); Ong, K.K. (Ken K.); T.L. Assimes (Themistocles); E.A. Boerwinkle (Eric); W. Koenig (Wolfgang); D.K. Arnett (Donna); A.A. Baccarelli (Andrea A.); E.J. Benjamin (Emelia); A. Dehghan (Abbas)

    2016-01-01

    textabstractBackground: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for infl

  11. Allergic sensitization at school age is a systemic low-grade inflammatory disorder

    DEFF Research Database (Denmark)

    Chawes, B. L. K.; Stokholm, J.; Malby-Schoos, A.-M.;

    2015-01-01

    Systemic low-grade inflammation has been demonstrated in a range of the frequent noncommunicable diseases (NCDs) as a possible shared mechanism, but is largely unexplored in relation to allergic sensitization. Therefore, we aimed to investigate the possible association between systemic low-grade...

  12. Synchronous Low-grade Appendiceal Mucinous Neoplasm and Primary Peritoneal Low-grade Serous Carcinoma: A First Description of These 2 Neoplasms Presenting Together as Suspected Peritoneal Carcinomatosis.

    Science.gov (United States)

    Sekulic, Miroslav; Pichler Sekulic, Simona; Movahedi-Lankarani, Saeid

    2016-09-28

    Low-grade appendiceal mucinous neoplasm is a neoplasm typically of appendiceal origin, which is characterized by diffuse peritoneal involvement by pools of mucin with mucinous epithelium lacking high-grade cytologic atypia, and clinically presents as suspected peritoneal carcinomatosis. A similar clinical presentation can sometimes be seen with disseminated low-grade serous carcinomas of the peritoneum, fallopian tubes, or ovaries; however, this neoplasm is histologically characterized by tubal-type epithelium and invasive or confluent growth. In this case report, we describe a patient presenting with a clinical examination and radiologic features suggestive of peritoneal carcinomatosis and a prominent pelvic mass; however, after pathologic review, the patient was proven to have peritoneal involvement by both low-grade appendiceal mucinous neoplasm of appendiceal origin and a low-grade peritoneal primary serous carcinoma. In short, we present the first description of low-grade appendiceal mucinous neoplasm and serous carcinoma of the peritoneum presenting synchronously, providing morphologic characterization and immunohistochemical studies supporting the diagnosis, and illustrating a rare instance in which 2 neoplastic processes are underlying clinically suspected peritoneal carcinomatosis.

  13. BRAF Mutation Is Rare in Advanced-Stage Low-Grade Ovarian Serous Carcinomas

    Science.gov (United States)

    Wong, Kwong-Kwok; Tsang, Yvonne T.M.; Deavers, Michael T.; Mok, Samuel C.; Zu, Zhifei; Sun, Charlotte; Malpica, Anais; Wolf, Judith K.; Lu, Karen H.; Gershenson, David M.

    2010-01-01

    Low-grade ovarian serous carcinomas are believed to arise via an adenoma-serous borderline tumor-serous carcinoma sequence. In this study, we found that advanced-stage, low-grade ovarian serous carcinomas both with and without adjacent serous borderline tumor shared similar regions of loss of heterozygosity. We then analyzed 91 ovarian tumor samples for mutations in TP53, BRAF, and KRAS. TP53 mutations were not detected in any serous borderline tumors (n = 30) or low-grade serous carcinomas (n = 43) but were found in 73% of high-grade serous carcinomas (n = 18). BRAF (n = 9) or KRAS (n = 5) mutation was detected in 47% of serous borderline tumors, but among the low-grade serous carcinomas (39 stage III, 2 stage II, and 2 stage I), only one (2%) had a BRAF mutation and eight (19%) had a KRAS mutation. The low frequency of BRAF mutations in advanced-stage, low-grade serous carcinomas, which contrasts with previous findings, suggests that aggressive, low-grade serous carcinomas are more likely derived from serous borderline tumors without BRAF mutation. In addition, advanced-stage, low-grade carcinoma patients with BRAF or KRAS mutation have a better apparent clinical outcome. However, further investigation is needed. PMID:20802181

  14. Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case.

    Science.gov (United States)

    Androulaki, A; Papathomas, T G; Alexandrou, P; Lazaris, A C

    2007-01-01

    Low-grade endometrial stromal sarcoma (ESS) is an uncommon neoplasm, which has a highly recurrent nature. A review of the literature revealed that only one case of low-grade ESS, arising within the vulva from a focus of endometriosis, has been previously published. We describe an additional case of low-grade ESS arising within the vulva and to the best of our knowledge the first report of low-grade ESS metastasized to clitoris. A 46-year-old woman was admitted to our hospital due to a heavy uterine bleeding. A physical examination revealed a lesion in clitoris, which exhibited a densely cellular mesenchymal neoplasm on microscopy. On the basis of the pathologic features alone, a differential diagnosis of a low-grade ESS and cellular leiomyoma was considered. Seven months later, the patient presented again with excessive uterine bleeding and a total hysterectomy was performed. A tumor of white-tan, whorled appearance was found. Its features were suggestive of low-grade ESS. Taking into account the possible extrauterine location of an ESS and reviewing the first case, a diagnosis of rare low-grade ESS metastasized to clitoris was made.

  15. [Sagittal balance of the spine and degenerative spondylolisthesis].

    Science.gov (United States)

    Morel, E; Ilharreborde, B; Lenoir, T; Hoffmann, E; Vialle, R; Rillardon, L; Guigui, P

    2005-11-01

    Several reports have examined the pathophysiology of degenerative spondylolisthesis. Very little work has however been devoted to the influence of spinal balance in the sagittal plane in its pathogenesis. The purpose of this work was to present a descriptive analysis of pelvic and spinal sagittal balance in a cohort of seventy patients treated for degenerative spondylolisthesis and to compare findings with those established in a population of 250 volunteers. The goal was to deduct pathophysiological hypotheses and identify therapeutic implications. Seventy patients were included in this study. The following variables were noted: pelvic incidence and version, sacral slope, lumbar lordosis, thoracic kyphosis, T9 sagittal tilt and S1-S2 angle. These variables were measured on digitalized lateral views of the spine using a dedicated software (SpineView). Univariate analysis of the values obtained was performed to identify the variable distributions. Multivariate analysis was applied to study the relationships between these variables and to better define perturbations of spinal balance in the anteroposterior plane. The findings were compared with those obtained in a control population. One of the essential characteristics of the cohort of patients with degenerative spondylolisthesis was the presence of an exaggerated pelvic incidence (62.6 degrees versus 54.7 degrees in the control population). The most significant determinants of T9 sagittal tilt (which reflects sagittal balance) were: pelvic version, pelvic incidence, lumbar lordosis, and L4-S1 local lordosis. One-third of our patients presented posterior tilt due to exaggerated thoracic kyphosis. The high pelvic incidence, via hyperlordosis and increased pelvic version, could be one of the factors favoring degenerative disease of the spinal unit. This work enabled us to better describe sagittal balance in patients with degenerative spondylolisthesis and to propose hypotheses concerning the underlying mechanism of

  16. Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma

    Institute of Scientific and Technical Information of China (English)

    Hyung; Soon; Park; Yu; Jin; Kim; Woo; Ick; Yang; Chang; Ok; Suh; Yong; Chan; Lee

    2010-01-01

    AIM: To investigate treatment outcome of Helicobacter pylori (H.pylori )-negative low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma.METHODS: In this study,we retrospectively reviewed the clinical outcome and clinicopathologic factors of stage Ⅰ E H.pylori -negative low-grade gastric MALT lymphoma cases from August 1998 to June 2009.RESULTS: A total of eleven patients with H.pylori -negative low-grade gastric MALT lymphoma were enrolled in the study and received anti-H.pylori eradication tre...

  17. THE DISTRACTION REDUCTION FIXATION SYSTEM AND ITS APPLICATION IN SPONDYLOLISTHESIS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. An internal fixation apparatus— — distraction reduction fixation system(DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenosis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture. The average age was 53.6 years old (ranged 24~ 72yrs). The mean time for follow-up was 30.6 months (16 ~ 44 months). Results. The slip rate was 0.15± 0.10 before operation, and decreased to 0.09± 0.07 after operation. Entire slip reposition was achieved in 19 cases (54.3% ). The change in height of the intervertebral space within the fixation segments was 0.7± 0.17. Conclusion. DRFS achieved better results for spondylolisthesis less II degree and no other adverse effects were found. Compared with other foreign and domestic techniques, it had advantages in less implants, less operation gears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.

  18. THE DISTRACTION REDUCTION FIXATION SYSTEM AND ITS APPLICATION IN SPONDYLOLISTHESIS

    Institute of Scientific and Technical Information of China (English)

    王以朋; 叶启彬; 邱贵兴; 林进; 张嘉

    2001-01-01

    Objective. An internal fiLxation apparatus ——distraction reduction fixation system (DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenesis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture.The average age was 53.6 years old (ranged 24 -72yrs). The mean time for follow-up was 30. 6 months (16 -44 months). Results. The slip rate was 0. 15 ±0. 10 before operation, and decreased to 0. 09 ± 0. 07 after operation. Entireslip reposition was achieved in 19 cases (54. 3% ). The change in height of the intervertebral space within the fixation segments was 0. 7 ± 0. 17. Conclusion. DRFS achieved better results for spondylolisthesis less Ⅱ degree and no other adverse effects werefound. Compared with other foreign and domestic techniques, it had advantages in less implants, less operationgears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.

  19. NONOPERATIVE VERSUS OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Jose Alfredo Corredor

    2016-03-01

    Full Text Available ABSTRACT Objective: To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively. Methods: Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS, Fischgrund criteria, Short Form-36 (SF-36 function score, and the modified Oswestry Disability Index (ODI. Results: 43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72 for the nonoperative group and 36 months (range 6-80 for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 versus 8, p = 0.000, leg VAS (mean 3 versus 6, p = 0.0015, SF-36 function score (mean 77 versus 35, p = 0.000, and ODI (mean 17 versus 46, p = 0.000. On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000. Conclusion: In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.

  20. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  1. Laryngeal lymphoma: the high and low grades of rare lymphoma involvement sites.

    Science.gov (United States)

    Azzopardi, Charles Paul; Degaetano, James; Betts, Alexandra; Farrugia, Eric; Magri, Claude; Refalo, Nicholas; Gatt, Alexander; Camilleri, David J

    2014-01-01

    The larynx is an extremely rare site of involvement by lymphomatous disease. We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management.

  2. The Cancer Genome Atlas expression profiles of low-grade gliomas.

    Science.gov (United States)

    Gonda, David D; Cheung, Vincent J; Muller, Karra A; Goyal, Amit; Carter, Bob S; Chen, Clark C

    2014-04-01

    Differentiating between low-grade gliomas (LGGs) of astrocytic and oligodendroglial origin remains a major challenge in neurooncology. Here the authors analyzed The Cancer Genome Atlas (TCGA) profiles of LGGs with the goal of identifying distinct molecular characteristics that would afford accurate and reliable discrimination of astrocytic and oligodendroglial tumors. They found that 1) oligodendrogliomas are more likely to exhibit the glioma-CpG island methylator phenotype (G-CIMP), relative to low-grade astrocytomas; 2) relative to oligodendrogliomas, low-grade astrocytomas exhibit a higher expression of genes related to mitosis, replication, and inflammation; and 3) low-grade astrocytic tumors harbor microRNA profiles similar to those previously described for glioblastoma tumors. Orthogonal intersection of these molecular characteristics with existing molecular markers, such as IDH1 mutation, TP53 mutation, and 1p19q status, should facilitate accurate and reliable pathological diagnosis of LGGs.

  3. Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery

    NARCIS (Netherlands)

    M.L.C. van Veelen; C.J.J. Avezaat (Cees); J.M. Kros (Johan); W.L.J. van Putten (Wim); C. Vecht

    1998-01-01

    textabstractBACKGROUND: A retrospective study of patients with low grade astrocytoma was carried out because the best management of such patients remains controversial. Prognostic factors were identified by multivariate analysis. Special attention was paid to the effect

  4. Synchronized brain activity and neurocognitive function in patients with low-grade glioma : a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, Ingeborg; Douw, Linda; Bartolomei, Fabrice; Heimans, Jan J.; van Dijk, Bob W.; Postma, Tjeerd J.; Stam, Cornelis J.; Reijneveld, Jaap C.; Klein, Martin

    2008-01-01

    We investigated the mechanisms underlying neurocognitive dysfunction in patients with low-grade glioma (LGG) by relating functional connectivity revealed by magnetoencephalography to neurocognitive function. We administered a battery of standardized neurocognitive tests measuring six neurocognitive

  5. Low-grade fibromyxoid sarcoma of the transverse colon: A case report

    Directory of Open Access Journals (Sweden)

    I.S. Farrell

    2014-01-01

    This is only the second reported case of low-grade fibromyxoid sarcoma of the colon and would potentially have been missed had not the sample been sent for second opinion at a regional specialist centre.

  6. Prospects for production of synthetic liquid fuel from low-grade coal

    Science.gov (United States)

    Shevyrev, Sergei; Bogomolov, Aleksandr; Alekssev, Maksim

    2015-01-01

    In the paper, we compare the energy costs of steam and steam-oxygen gasification technologies for production of synthetic liquid fuel. Results of mathematic simulation and experimental studies on gasification of low-grade coal are presented.

  7. Intramedullary spinal cord and leptomeningeal metastases from intracranial low-grade oligodendroglioma.

    Science.gov (United States)

    Verma, Nipun; Nolan, Craig; Hirano, Miki; Young, Robert J

    2014-01-01

    We present an unusual case of a patient with an intracranial low-grade oligodendroglioma who developed recurrence with an intramedullary spinal cord metastasis and multiple spinal leptomeningeal metastases. The intramedullary spinal cord metastasis showed mild enhancement similar to the original intracranial primary, while the multiple spinal leptomeningeal metastases revealed no enhancement. This is the seventh reported case of symptomatic intramedullary spinal cord metastasis from a low-grade oligodendroglioma.

  8. Plasma-enhanced gasification of low-grade coals for compact power plants

    Science.gov (United States)

    Uhm, Han S.; Hong, Yong C.; Shin, Dong H.; Lee, Bong J.

    2011-10-01

    A high temperature of a steam torch ensures an efficient gasification of low-grade coals, which is comparable to that of high-grade coals. Therefore, the coal gasification system energized by microwaves can serve as a moderately sized power plant due to its compact and lightweight design. This plasma power plant of low-grade coals would be useful in rural or sparsely populated areas without access to a national power grid.

  9. Neonates with reduced neonatal lung function have systemic low-grade inflammation

    OpenAIRE

    Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus; Pedersen, Susanne Brix; Bisgaard, Hans Flinker

    2015-01-01

    Background: Children and adults with asthma and impaired lung function have been reported to have low-grade systemic inflammation, but it is unknown whether this inflammation starts before symptoms and in particular whether low-grade inflammation is present in asymptomatic neonates with reduced lung function. ObjectiveWe sought to investigate the possible association between neonatal lung function and biomarkers of systemic inflammation. Methods: Plasma levels of high-sensitivity C-reactive p...

  10. Mechanisms of traumatic rupture of the aorta and associated peri-isthmic motion and deformation.

    Science.gov (United States)

    Hardy, Warren N; Shah, Chirag S; Mason, Matthew J; Kopacz, James M; Yang, King H; King, Albert I; Van Ee, Chris A; Bishop, Jennifer L; Banglmaier, Richard F; Bey, Michael J; Morgan, Richard M; Digges, Kennerly H

    2008-11-01

    This study investigated the mechanisms of traumatic rupture of the aorta (TRA). Eight unembalmed human cadavers were tested using various dynamic blunt loading modes. Impacts were conducted using a 32-kg impactor with a 152-mm face, and high-speed seatbelt pretensioners. High-speed biplane x-ray was used to visualize aortic motion within the mediastinum, and to measure deformation of the aorta. An axillary thoracotomy approach was used to access the peri-isthmic region to place radiopaque markers on the aorta. The cadavers were inverted for testing. Clinically relevant TRA was observed in seven of the tests. Peak average longitudinal Lagrange strain was 0.644, with the average peak for all tests being 0.208 +/- 0.216. Peak intraluminal pressure of 165 kPa was recorded. Longitudinal stretch of the aorta was found to be a principal component of injury causation. Stretch of the aorta was generated by thoracic deformation, which is required for injury to occur. The presence of atherosclerosis was demonstrated to promote injury. The isthmus of the aorta moved dorsocranially during frontal impact and submarining loading modes. The aortic isthmus moved medially and anteriorly during impact to the left side. The results of this study provide a better understanding of the mechanisms associated with TRA, and can be used for the validation of finite element models developed for the examination and prediction of TRA.

  11. Radiation-Associated Low-Grade Extraskeletal Osteosarcoma of the Neck Following Treatment for Thyroid Cancer.

    Science.gov (United States)

    Jones, Martin; Chebib, Ivan; Deshpande, Vikram; Nielsen, G Petur

    2015-08-01

    Low-grade extraskeletal osteosarcoma is a rare tumor that may arise de novo or following radiation therapy. Because of the low-grade histology, it may be misdiagnosed as a benign lesion. We present a case of a 59-year-old man with a past history of radiotherapy for papillary carcinoma of the thyroid, presenting 16 years later with a low-grade extraskeletal osteosarcoma of the neck. The patient was treated with surgical excision and is disease free after 12 months of follow-up. The prognosis for patients with low-grade extraskeletal osteosarcoma is relatively good when compared with high-grade sarcomas. While there is a report of a low-grade extraskeletal osteosarcoma arising following radiotherapy for a benign condition, to the best of our knowledge this is the first reported case of a low-grade extraskeletal osteosarcoma occurring following radiotherapy for thyroid cancer, and the only case reported in the soft tissue of the head and neck region. © The Author(s) 2015.

  12. Workers' Compensation, Return to Work, and Lumbar Fusion for Spondylolisthesis.

    Science.gov (United States)

    Anderson, Joshua T; Haas, Arnold R; Percy, Rick; Woods, Stephen T; Ahn, Uri M; Ahn, Nicholas U

    2016-01-01

    Lumbar fusion for spondylolisthesis is associated with consistent outcomes in the general population. However, workers' compensation is a risk factor for worse outcomes. Few studies have evaluated prognostic factors within this clinically distinct population. The goal of this study was to identify prognostic factors for return to work among patients with workers' compensation claims after fusion for spondylolisthesis. The authors used International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes to identify 686 subjects from the Ohio Bureau of Workers' Compensation who underwent fusion for spondylolisthesis from 1993 to 2013. Positive return to work status was recorded in patients who returned to work within 2 years of fusion and remained working for longer than 6 months. The criteria for return to work were met by 29.9% (n=205) of subjects. The authors used multivariate logistic regression analysis to identify prognostic factors for return to work. Negative preoperative prognostic factors for postoperative return to work included: out of work for longer than 1 year before fusion (PReturn to work rates associated with these factors were 9.7%, 0.0%, 10.0%, 29.2%, and 25.0%, respectively. If these subjects were excluded, the return to work rate increased to 60.4%. The 70.1% (n=481) of subjects who did not return to work had markedly worse outcomes, shown by higher medical costs, chronic opioid dependence, and higher rates of failed back syndrome, total disability, and additional surgery. Psychiatric comorbidity increased after fusion but was much higher in those who did not return to work. Future studies are needed to identify how to better facilitate return to work among similar patients with workers' compensation claims.

  13. Dynamic stabilization for degenerative spondylolisthesis and lumbar spinal instability.

    Science.gov (United States)

    Ohtonari, Tatsuya; Nishihara, Nobuharu; Suwa, Katsuyasu; Ota, Taisei; Koyama, Tsunemaro

    2014-01-01

    Lumbar interbody fusion is a widely accepted surgical procedure for patients with lumbar degenerative spondylolisthesis and lumbar spinal instability in the active age group. However, in elderly patients, it is often questionable whether it is truly necessary to construct rigid fixation for a short period of time. In recent years, we have been occasionally performing posterior dynamic stabilization in elderly patients with such lumbar disorders. Posterior dynamic stabilization was performed in 12 patients (6 women, 70.9 ± 5.6 years old at the time of operation) with lumbar degenerative spondylolisthesis in whom % slip was less than 20% or instability associated with lumbar disc herniation between March 2011 and March 2013. Movement occurs through the connector linked to the pedicle screw. In practice, 9 pairs of D connector system where the rod moves in the perpendicular direction alone and 8 pairs of Dynamic connector system where the connector linked to the pedicle screw rotates in the sagittal direction were installed. The observation period was 77-479 days, and the mean recovery rate of lumbar Japanese Orthopedic Association (JOA) score was 65.6 ± 20.8%. There was progression of slippage due to slight loosening in a case with lumbar degenerative spondylolisthesis, but this did not lead to exacerbation of the symptoms. Although follow-up was short, there were no symptomatic adjacent vertebral and disc disorders during this period. Posterior dynamic stabilization may diminish the development of adjacent vertebral or disc disorders due to lumbar interbody fusion, especially in elderly patients, and it may be a useful procedure that facilitates decompression and ensures a certain degree of spinal stabilization.

  14. Degenerative spondylolisthesis: contemporary review of the role of interbody fusion.

    Science.gov (United States)

    Baker, Joseph F; Errico, Thomas J; Kim, Yong; Razi, Afshin

    2017-02-01

    Degenerative spondylolisthesis is a common presentation, yet the best surgical treatment continues to be a matter of debate. Interbody fusion is one of a number of options, but its exact role remains ill defined. The aim of this study was to provide a contemporary review of the literature to help determine the role, if any, of interbody fusion in the surgical treatment of degenerative spondylolisthesis. A systematic review of the literature since 2005 was performed. Details on study size, patient age, surgical treatments, levels of slip, patient reported outcome measures, radiographic outcomes, complications and selected utility measures were recorded. Studies that compared a cohort treated with interbody fusion and at least one other surgical intervention for comparison were included for review. Only studies examining the effect in degenerative spondylolisthesis were included. Two authors independently reviewed the manuscripts and extracted key data. Thirteen studies were included in the final analysis. A total of 565 underwent interbody fusion and 761 underwent other procedures including decompression alone, interspinous stabilisation and posterolateral fusion with or without instrumentation. Most studies were graded Level III evidence. Heterogeneous reporting of outcomes prevented formal statistical analysis. However, in general, studies reviewed concluded no significant clinical or radiographic difference in outcome between interbody fusion and other treatments. Two small studies suggested interbody fusion is a better option in cases of definite instability. Interbody fusion only provided outcomes as good as instrumented posterolateral fusion. However, most studies were Level III, and hence, we remain limited in defining the exact role of interbody fusion-cases with clear instability appear to be most appropriate. Future work should use agreed-upon common outcome measures and definitions.

  15. PAX2 Expression in Low Malignant Potential Ovarian Tumors and Low-Grade Ovarian Serous Carcinomas

    Science.gov (United States)

    Tung, Celestine S.; Mok, Samuel C.; Tsang, Yvonne T.M.; Zu, Zhifei; Song, Huijuan; Liu, Jinsong; Deavers, Michael; Malpica, Anais; Wolf, Judith K.; Lu, Karen H.; Gershenson, David M.; Wong, Kwong-Kwok

    2009-01-01

    Ovarian tumors of low-malignant potential and low-grade ovarian serous carcinomas are thought to represent different stages on a tumorigenic continuum and to develop along pathways distinct from high-grade ovarian serous carcinoma. We performed gene expression profiling on 3 normal human ovarian surface epithelia samples, and 10 low-grade and 10 high-grade ovarian serous carcinomas. Analysis of gene expression profiles of these samples has identified 80 genes up-regulated and 232 genes down-regulated in low-grade ovarian serous carcinomas. PAX2 was found to be one of the most up-regulated genes in low-grade ovarian serous carcinoma. The up-regulation of PAX2 was validated by real-time quantitative RT-PCR, Western blot and immunohistochemical analyses. Real-time RT-PCR demonstrated a statistically significant difference in PAX2 mRNA expression (expressed as fold change in comparison to normal human ovarian surface epithelia) among ovarian tumors of low-malignant potential (1837.38, N=8), low-grade (183.12, N=17), and high-grade (3.72, N=23) carcinoma samples (p=0.015). Western blot analysis revealed strong PAX2 expression in ovarian tumors of low-malignant potential (67%, N=3) and low-grade carcinoma samples (50%, N=10) but no PAX2 protein expression in high-grade carcinomas (0%, N=10). Using immunohistochemistry, tumors of low-malignant potential (59%, N=17) and low-grade carcinoma (63%, N=16) samples expressed significantly stronger nuclear staining than high-grade ovarian carcinoma samples (9.1%, N=263). Furthermore, consistent with previous immunohistochemical findings, PAX2 expression was found to be expressed in the epithelial cells of fallopian tubes but not in normal ovarian surface epithelial cells. Our findings further support the two-tiered hypothesis that tumors of low-malignant potential and low-grade ovarian serous carcinoma are on a continuum and are distinct from high-grade ovarian carcinomas. Additionally, the absence of PAX2 expression in normal

  16. Concentrations and contractile effects of substance P in the human ampullary-isthmic junction.

    Science.gov (United States)

    Forman, A; Andersson, K E; Maigaard, S; Ulmsten, U

    1985-05-01

    From 20 women undergoing hysterectomy, strip preparations were isolated from the outer, longitudinal and the inner, circular smooth muscle layer of the ampullary-isthmic junction (AIJ), together with small arterial segments dissected as ring preparations from the root of the mesosalpinx. The specimens were mounted in organ baths and isometric tension was recorded. In addition, tissue concentrations of substance P (SP) in the ampulla, AIJ and utero-tubal junction were determined by radioimmunoassay. Tissue concentrations of SP expressed as pmol X g tissue-1 (wet weight, +/- SE) amounted to 3.09 +/- 1.40 in the utero-tubal junction, 1.08 +/- 0.299 in the AIJ and 0.742 +/- 0.299 in the ampulla. In strips of circular muscle, SP at concentrations of 10(-7) -3 X 10(-6) mol X l-1 elicited a combined phasic and tonic response and in longitudinal muscle a mainly tonic contraction was produced. In both tissues, contractions elicited by SP were rapidly abolished in calcium-free medium. Nifedipine abolished the phasic contraction elicited in circular muscle by SP while the tonic response was resistant. The contraction in longitudinal muscle was reduced by 20-30%. Vasoactive intestinal polypeptide (VIP) decreased tension in preparations contracted by SP, prostaglandin F2 alpha and K+-depolarization (124 mmol X l(-1). In unstimulated oviductal arterial preparations, SP had no effect, while the peptide induced a transient relaxation of noradrenaline contracted preparations, and slightly decreased tension of K+-depolarized vessels. The results suggest that SP may be involved in the control of motility of the human AIJ.

  17. Stress induces endotoxemia and low-grade inflammation by increasing barrier permeability

    Directory of Open Access Journals (Sweden)

    Karin ede Punder

    2015-05-01

    Full Text Available Chronic non-communicable diseases (NCDs are the leading causes of work absence, disability and mortality worldwide. Most of these diseases are associated with low-grade inflammation. Here we hypothesize that stresses (defined as homeostatic disturbances can induce low-grade inflammation by increasing the availability of water, sodium and energy-rich substances to meet the increased metabolic demand induced by the stressor. One way of triggering low-grade inflammation is by increasing intestinal barrier permeability through activation of various components of the stress system. Although beneficial to meet the demands necessary during stress, increased intestinal barrier permeability also raises the possibility of the translocation of bacteria and their toxins across the intestinal lumen into the blood circulation. In combination with modern life-style factors, the increase in bacteria/bacterial toxin translocation arising from a more permeable intestinal wall causes a low-grade inflammatory state. We support this hypothesis with numerous studies finding associations with NCDs and markers of endotoxemia, suggesting that this process plays a pivotal and perhaps even a causal role in the development of low-grade inflammation and its related diseases.

  18. Painful spondylolysis or spondylolisthesis studied by radiography and single-photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Collier, B.D.; Johnson, R.P.; Carrera, G.F.; Meyer, G.A.; Schwab, J.P.; Flatley, T.J.; Isitman, A.T.; Hellman, R.S.; Zielonka, J.S.; Knobel, J.

    1985-01-01

    Planar bone scintigraphy (PBS) and single-photon emission computed tomography (SPECT) were compared in 19 adults with radiographic evidence of spondylolysis and/or spondylolisthesis. SPECT was more sensitive than PBS when used to identify symptomatic patients and sites of painful defects in the pars interarticularis. In addition, SPECT allowed more accurate localization than PBS. In 6 patients, spondylolysis or spondylolisthesis was unrealted to low back pain, and SPECT images of the posterior neural arch were normal. The authors conclude that when spondylolysis or spondylolisthesis is the cause of low back pain, pars defects are frequently heralded by increased scintigraphic activity which is best detected and localized by SPECT.

  19. Richter syndrome and brain involvement: low-grade lymphoma relapsing as cerebral high-grade lymphoma.

    Science.gov (United States)

    Stuplich, Moritz; Mayer, Karin; Kim, Young; Thanendrarajan, Sharmilan; Simon, Matthias; Schäfer, Niklas; Glas, Martin; Schmidt-Wolf, Ingo G H; Herrlinger, Ulrich

    2012-01-01

    Richter syndrome (RS) describes the development of high-grade non-Hodgkin's lymphoma (NHL) from low-grade NHL. RS isolated to the brain is very rare and has a poor prognosis. We describe the cases of high-grade large B-cell diffuse NHL in a 56-year-old male with chronic lymphocytic leukemia and in a 71-year-old female with previously unknown low-grade NHL, both with initial appearance of neurological symptoms. This report extends the literature of central nervous system RS and particularly highlights the importance of a thorough diagnostic evaluation of patients with low-grade NHL presenting with neurological symptoms. Copyright © 2011 S. Karger AG, Basel.

  20. Extraction of Copper from Malanjkhand Low-Grade Ore by Bacillus stearothermophilus.

    Science.gov (United States)

    Singh, Sradhanjali; Sukla, Lala Behari; Mishra, Baroda Kanta

    2011-10-01

    Thermophilic bacteria are actively prevalent in hot water springs. Their potential to grow and sustain at higher temperatures makes them exceptional compare to other microorganism. The present study was initiated to isolate, identify and determine the feasibility of extraction of copper using thermophilic heterotrophic bacterial strain. Bacillus stearothermophilus is a thermophilic heterotrophic bacterium isolated from hot water spring, Atri, Orissa, India. This bacterium was adapted to low-grade chalcopyrite ore and its efficiency to solubilize copper from Malanjkhand low-grade ore was determined. The low-grade copper ore contains 0.27% Cu, in which the major copper-bearing mineral is chalcopyrite associated with other minerals present as minor phase. Variation in parameters such as pulp-density and temperatures were studied. After 30 days of incubation, it was found that Bacillus stearothermophilus solubilize copper up to 81.25% at pH 6.8 at 60°C.

  1. Low-grade glioma: supratentorial astrocytoma, oligodendroglioma, and oligoastrocytoma in adults.

    Science.gov (United States)

    Ashby, Lynn S; Shapiro, William R

    2004-05-01

    Low-grade glioma is not a single diagnosis but a category of biologically diverse neoplasms. They are indolent, progressive, and, following anaplastic transformation, invariably fatal. Neuro-oncologists have not established a treatment standard for these tumors. However, it is clear that "low-grade" is not synonymous with "benign," and treatment is required sometime in the course of the disease. Previously, achieving a consensus had been limited by a lack of class I evidence. Physicians treated patients based on retrospective series and personal experience. Currently, results from prospective clinical trials are becoming available. These studies have provided data that may serve as treatment guidelines. Additional results regarding the identification of prognostic variables have raised more questions to be answered. Attention is now directed to the importance of translational research to better define these neoplasms. In the future, it will be necessary to distinguish among low-grade gliomas and identify therapies that may differ between them.

  2. Statistical evaluation of manual segmentation of a diffuse low-grade glioma MRI dataset.

    Science.gov (United States)

    Ben Abdallah, Meriem; Blonski, Marie; Wantz-Mezieres, Sophie; Gaudeau, Yann; Taillandier, Luc; Moureaux, Jean-Marie

    2016-08-01

    Software-based manual segmentation is critical to the supervision of diffuse low-grade glioma patients and to the optimal treatment's choice. However, manual segmentation being time-consuming, it is difficult to include it in the clinical routine. An alternative to circumvent the time cost of manual segmentation could be to share the task among different practitioners, providing it can be reproduced. The goal of our work is to assess diffuse low-grade gliomas' manual segmentation's reproducibility on MRI scans, with regard to practitioners, their experience and field of expertise. A panel of 13 experts manually segmented 12 diffuse low-grade glioma clinical MRI datasets using the OSIRIX software. A statistical analysis gave promising results, as the practitioner factor, the medical specialty and the years of experience seem to have no significant impact on the average values of the tumor volume variable.

  3. Thermophysical properties of the products of low-grade fuels thermal recycling

    Directory of Open Access Journals (Sweden)

    Tabakaev Roman B.

    2015-01-01

    Full Text Available The relevance of the work is caused by reorientation of the modern power engineering to use of local low grade fuel resources. Some types of low grade fuels (peat, brown coal, sapropel, wood chips are considered in this work. Thermotechnical characteristics of the investigated fuels and products of their thermal recycling are determined. Thermal recycling process is accompanied by release of fuel dissociation heat (0.33-3.69 MJ/kg. The results of thermal low grade fuel recycling are solid carbonaceous product (semi-coke with a calorific value higher in 1.5-7 times than the value of natural fuels; pyrolysis resin with calorific value 29.4-36.8 MJ/kg; combustible gas with calorific value 15.16-19.06 MJ/m3.

  4. Persistent Depressive Symptoms are Independent Predictors of Low-Grade Inflammation Onset Among Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Fábio Gazelato de Mello Franco

    Full Text Available Abstract Background: Depressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD. Objectives: This study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation. Methods: From a database of 1,508 young (mean age: 41 years individuals with no CVD diagnosis who underwent at least two routine health evaluations, 134 had persistent depressive symptoms (Beck Depression Inventory - BDI ≥ 10, BDI+ and 1,374 had negative symptoms at both time points (BDI-. All participants had been submitted to repeated clinical and laboratory evaluations at a regular follow-up with an average of 26 months from baseline. Low-grade inflammation was defined as plasma high-sensitivity C-Reactive Protein (CRP concentrations > 3 mg/L. The outcome was the incidence of low-grade inflammation evaluated by the time of the second clinical evaluation. Results: The incidence of low-grade inflammation was more frequently observed in the BDI+ group compared to the BDI- group (20.9% vs. 11.4%; p = 0.001. After adjusting for sex, age, waist circumference, body mass index, levels of physical activity, smoking, and prevalence of metabolic syndrome, persistent depressive symptoms remained an independent predictor of low-grade inflammation onset (OR = 1.76; 95% CI: 1.03-3.02; p = 0.04. Conclusions: Persistent depressive symptoms were independently associated with low-grade inflammation onset among healthy individuals.

  5. A radiological study on lumbar spondylolisthesis with intact neural arch

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Myung Ju; Suh, Young Jun; Joe, Seong Jeh; Yoon, Jong Sup [Han-Gang Sung-Shim Hospital, Seoul (Korea, Republic of)

    1980-12-15

    The purpose of this paper is to evaluate and analyze the radiological findings of 13 cases of lumbar spondylolisthesis with intact neural arch at Han-Gang Sung- Shim Hospital during period from Jan. 1975 to June 1980. 1. The age distribution of the patients varied from 31 to 83 years old. The average of the age was 53 years old. 12 patients were female and only one patient was male. 2. All cases revealed anterior slipping of the L4 body on the L5 body, of which degree was classified by Meyerding's method, first degree in 12 patients and second degree in one patient. 3. The angle between the pedicle and inferior articular facet of affected vertebra was measured by Junghann's method. The average of angle was 123 degree. 4. Of 13 cases, 2 cases who had neural compression caused by dislocation of the vertebral bodies and intrusion of lamina and arthritic facets into stenotic spinal canal treated by laminar decompression including foraminotomy. Good results were obtained. 5. The secondary degenerative change of the vertebra was considered to be the cause of the spondylolisthesis with intact neural arch.

  6. Screening of various low-grade biomass materials for low temperature gasification: Method development and application

    DEFF Research Database (Denmark)

    Thomsen, Tobias Pape; Ravenni, Giulia; Holm, Jens Kai;

    2015-01-01

    method and the subsequent use of the method to identify promising e but currently unproven, low-grade biomass resources for conversion in Pyroneer systems. The technical assessment is conducted by comparing the results from a series of physical-mechanical and thermochemical experiments to a set of proven...... references. The technical assessment is supplemented by an evaluation of practical application and overall energy balance. Applying the developed method to 4 references and 18 unproven low-grade potential fuels, indicated that one of these unproven candidates was most likely unsuited for Pyroneer...

  7. Neonates with reduced neonatal lung function have systemic low-grade inflammation

    DEFF Research Database (Denmark)

    Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus;

    2015-01-01

    Background: Children and adults with asthma and impaired lung function have been reported to have low-grade systemic inflammation, but it is unknown whether this inflammation starts before symptoms and in particular whether low-grade inflammation is present in asymptomatic neonates with reduced...... lung function. ObjectiveWe sought to investigate the possible association between neonatal lung function and biomarkers of systemic inflammation.  Methods: Plasma levels of high-sensitivity C-reactive protein (hs-CRP), IL-1β, IL-6, TNF-α, and CXCL8 (IL-8) were measured at age 6 months in 300 children...

  8. Two-year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis: Part I: Clinical Findings.

    Science.gov (United States)

    Sembrano, Jonathan N; Tohmeh, Antoine; Isaacs, Robert

    2016-04-01

    A prospective, multicenter, institutional review board (IRB) approved study with randomized and observational study arms. The purpose of this study was to compare clinical outcomes between minimally invasive transforaminal (MIS TLIF) and MIS lateral interbody fusion (XLIF) in the treatment of patients with low-grade degenerative spondylolisthesis with stenosis through two years postoperative. Few reports exist comparing different MIS approaches directly in the treatment of similar pathology, as most studies report differences between MIS and open procedures. A total of 55 patients undergoing surgical treatment for degenerative spondylolisthesis with spinal stenosis at one or two contiguous levels between L1 and L5 were enrolled. Twenty-nine patients were treated with XLIF and 26 patients were treated with MIS TLIF. Operative time and length of stay were similar between the XLIF and MIS TLIF groups (171 vs 186 minutes; two days for each group). Blood loss was significantly lower in the XLIF group, with 79% of XLIF cases and 27% of MIS TLIF cases resulting in MIS TLIF group (0%). One patient in the XLIF group had a new distal motor weakness and three patients in the XLIF group and two patients in the MIS TLIF group had new sensory changes postoperatively, all of which resolved by 12 months postoperative. Back and leg pain for both XLIF and MIS TLIF groups improved significantly from baseline to 24 months postoperative, with 73% improvement in the XLIF and 64% in the MIS TLIF group. Worst leg pain showed similar improvements through two years postoperative, with a 79% decrease seen in the XLIF group and 74% in the MIS TLIF group. Disability (ODI) improved 53% in the XLIF group and 57% in the MIS TLIF group. Despite different mechanisms of action (indirect vs direct decompression), mid-term clinical outcomes between XLIF and MIS TLIF were similar. These two-year results suggest that both XLIF and MIS TLIF are reasonable MIS approaches for the treatment of lumbar

  9. EFFECTIVENESS OF COMBINED TREATMENT OF LUMBAR SPONDYLOLISTHESIS WITH MED, Quadrant,AND Sextant-R SYSTEMS%MED、Quadrant、Sextant-R系统联合治疗腰椎滑脱症的临床研究

    Institute of Scientific and Technical Information of China (English)

    康辉; 蔡贤华; 徐峰; 黄勇

    2013-01-01

    Objective To analyze the effectiveness of combined treatment of lumbar spondylolisthesis with MED, Quadrant, and Sextant-R systems. Methods Between August 2006 and June 2011, 35 patients with lumbar spondylolisthesis were treated, including 11 cases of isthmic spondylolisthesis and 24 cases of degenerative spondylolisthesis. There were 25 males and 10 females, with a mean age of 55 years (range, 33-71 years). The mean disease duration was 37 months (range, 8-75 months). Spondylolisthesis occurred at L4,5 level in 21 patients and at Ls, S1 level in 14 patients. According to Meyerding classification, 35 cases were rated as dergee I. The minimally invasive surgeries were performed by paraspinal muscle approach; Quadrant system was used for decompression and fusion at severe side, MED system for windowing of lamina at mild side, and Sextant-R system for fixation and reduction. Visual analogue scale (VAS) score was used to evaluate pain, Oswestry disability index (ODI) to evaluate clinical outcomes, spondylolishesis ratio and intervertebral height to evaluate spondylolisthesis reduction. Results Lumbar continuous thin layer CT at postoperation showed that no pedicle screw invaded spinal canal and intervertebral fusion device was at good position. Incisions healed by first intention. All patients were followed up 18-38 months (mean, 26 months). All patients got bone fusion and had no internal fixation failure by radiologic examination at 1 year after operation. Low back pain was relieved, lumbar function improved obviously, and satisfactory reduction of spondylolisthesis was obtained. At 2 weeks and 1 year after operation, the VAS score, ODI score, spondylolisthesis ratio, and intervertebral height were significantly improved when compared with preoperative ones (P 0.05) between at 2 weeks and at 1 year after operation. Conclusion Minimally invasive surgical management for lumbar spondylolisthesis via MED, Quadrant, and Sextant-R systems is a safe and effective surgical

  10. [The history of spondylolisthesis. The nineteenth century: early case reports, terminology, etiology and pathogenesis].

    Science.gov (United States)

    Schlenzka, D

    2015-12-01

    The author describes the history of research and development of knowledge on lumbar spondylolisthesis. Based on the available literature, early case reports, creation of the terminology and etiological concepts are presented.

  11. Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis.

    Science.gov (United States)

    Modi, H N; Srinivasalu, S; Suh, S W; Yang, J H

    2009-08-01

    Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.

  12. Measurement Properties of the Scoliosis Research Society Outcomes Questionnaire in Adolescent Patients With Spondylolisthesis.

    Science.gov (United States)

    Gutman, Gabriel; Joncas, Julie; Mac-Thiong, Jean-Marc; Beauséjour, Marie; Roy-Beaudry, Marjolaine; Labelle, Hubert; Parent, Stefan

    2017-09-01

    Prospective validation of the Scoliosis Research Society Outcomes Questionnaire French-Canadian version (SRS-22fv) in adolescent patients with spondylolisthesis. To determine the measurement properties of the SRS-22fv. The SRS-22 is widely used for the assessment of health-related quality of life in adolescent idiopathic scoliosis (AIS) and other spinal deformities. Spondylolisthesis has an important effect on quality of life. The instrument was previously used in this population, although its measurement properties remained unknown. We aim to determine its reliability, factorial, concurrent validity, and its discriminant capacity in an adolescent spondylolisthesis population. The SRS-22fv was tested in 479 subjects (272 patients with spondylolisthesis, 143 with AIS, and 64 controls) at a single institution. Its reliability was measured using the coefficient of internal consistency, concurrent validity by the short form-12 (SF-12v2 French version) and discriminant validity using multivariate analysis of variance, analysis of covariance, and multivariate linear regression. The SRS-22fv showed a good global internal consistency (spondylolisthesis: Cronbach α = 0.91, AIS: 0.86, and controls: 0.78) in all its domains for spondylolisthesis patients. It showed a factorial structure consistent with the original questionnaire, with 60% of explained variance under four factors. Moderate to high correlation coefficients were found for specifically corresponding domains between SRS-22fv and SF-12v2. Boys had higher scores than do girls, scores worsened with increasing age and body mass index. Analysis of covariance showed statistically significant differences between patients with spondylolisthesis, patients with AIS, and controls when controlling for age, sex, body mass index, pain, function, and self-image scores. In the spondylolisthesis group, scores on all domains and mean total scores were significantly lower in surgical candidates and in patients with high

  13. Inter-hemispheric language functional reorganization in low-grade glioma patients after tumour surgery

    NARCIS (Netherlands)

    Kristo, Gert; Raemaekers, Mathijs; Rutten, Geert Jan; de Gelder, Beatrice; Ramsey, Nick F.

    2015-01-01

    Despite many claims of functional reorganization following tumour surgery, empirical studies that investigate changes in functional activation patterns are rare. This study investigates whether functional recovery following surgical treatment in patients with a low-grade glioma in the left hemispher

  14. Low-grade and high-grade endometrial stromal sarcoma: A National Cancer Database study.

    Science.gov (United States)

    Seagle, Brandon-Luke L; Shilpi, Arunima; Buchanan, Samuel; Goodman, Chelain; Shahabi, Shohreh

    2017-08-01

    To provide refined prognostic information from large cohorts of women with low-grade or high-grade endometrial stromal sarcoma (ESS). We performed an observational retrospective cohort analysis of women diagnosed with low-grade or high-grade ESS from the 1998-2013 National Cancer Database. Kaplan-Meier and multivariable accelerated failure time survival analyses were performed to identify prognostic factors after multiple imputation of missing data. Recursive partitioning methods were used to rank prognostic factors in high-grade ESS. Matched cohort analyses were performed to hypothesis-test effects of adjuvant treatments. We identified 2414 and 1383 women with low-grade or high-grade ESS, respectively. Women with high-grade ESS had markedly decreased survival compared to women with low-grade ESS (five-year survival (95% CI): 32.6 (30.1-35.3%) versus 90.5% (89.3-91.8%), Pradiotherapy (TR (95% CI): 1.57 (1.32-1.87), Pradiotherapy may increase survival of women with high-grade ESS. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. A new power generation method utilizing a low grade heat source

    Institute of Scientific and Technical Information of China (English)

    Wei-feng WU; Kin-ping LONG; Xiao-ling YU; Quan-ke FENG

    2012-01-01

    Energy crisis make the effective use of low grade energy more and more urgent.It is still a worldwide difficult conundrum.To efficiently recover low grade heat,this paper deals with a theoretical analysis of a new power generation method driven by a low grade heat source.When the temperature of the low grade heat source exceeds the saturated temperature,it can heat the liquid into steam.If the steam is sealed and cooled in a container,it will lead to a negative pressure condition.The proposed power generation method utilizes the negative pressure condition in the sealed container,called as a condensator.When the condensator is connected to a liquid pool,the liquid will be pumped into it by the negative pressure condition.After the condensator is filled by liquid,the liquid flows back into the pool and drives the turbine to generate electricity.According to our analysis,for water,the head pressure of water pumped into the condensator could reach 9.5 m when the temperature of water in the pool is 25 ℃,and the steam temperature is 105 ℃.Theoretical thermal efficiency of this power generation system could reach 3.2% to 5.8% varying with the altitude of the condensator to the water level,ignoring steam leakage loss.

  16. Diagnostic value of fine motor deficits in patients with low-grade hepatic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    Sergei Mechtcheriakov; Ivo W. Graziadei; Maria Rettenbacher; Ingrid Schuster; Hartmann Hinterhuber; Wolfgang Vogel; Joser Marksteiner

    2005-01-01

    AIM: The role of motor dysfunction in early diagnosis of low-grade hepatic encephalopathy remains uncertain. We performed a pilot study to comparatively investigate the kinematic characteristics of small and large rapid alternating movements in patients with liver cirrhosis and low-grade hepatic encephalopathy.METHODS: A kinematic analysis of alternating handwriting (7.5 mm) and large drawing movements (DM, 175 mm) was performed in 30 patients with liver cirrhosis (no hepatic encephalopathy: n = 10; minimal hepatic encephalopathy: n = 9; grade I hepatic encephalopathy: n = 11; healthy controls: n = 12). The correlation between kinematic parameters, clinical neuro-psychiatric symptoms of cerebral dysfunction and the grade of encephalopathy was investigated.RESULTS: Both movement types, handwriting and drawing, were significantly slower in cirrhotic patients. In contrast to large DM, the deterioration of handwriting movements significantly correlated with the increase of symptoms of motor dysfunction and differentiated significantly within the group of cirrhosis patients corresponding to the degree of hepatic encephalopathy. CONCLUSION: The deterioration of fine motor control is an important symptom of low-grade hepatic encephalopathy. The kinematic analysis of handwriting allows the quantitative analysis of alterations of motor function and is a possible tool for diagnostics and monitoring of motor dysfunction in patients with low-grade hepatic encephalopathy.

  17. Low-Grade Inflammation Is Associated with Susceptibility to Infection in Healthy Men

    DEFF Research Database (Denmark)

    Kaspersen, Kathrine Agergård; Dinh, Khoa Manh; Erikstrup, Lise Tornvig

    2016-01-01

    INTRODUCTION: The aim of this study was to examine whether low-grade inflammation (LGI) is associated with a subsequently increased risk of infection. METHODS: We included 15,754 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. LGI was...

  18. IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide.

    NARCIS (Netherlands)

    Dubbink, H.J.; Taal, W.; Marion, R. van; Kros, J.M.; Heuvel, I. van; Bromberg, J.E.; Zonnenberg, B.A.; Zonnenberg, C.B.; Postma, T.J.; Gijtenbeek, J.M.M.; Boogerd, W.; Groenendijk, F.H.; Smitt, P.A.; Dinjens, W.N.; Bent, M.J. van den

    2009-01-01

    BACKGROUND: Mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) have been implicated in tumorigenesis of gliomas. Patients with high-grade astrocytomas with IDH1 or IDH2 mutations were reported to have a better survival, but it is unknown if this improved survival also holds for low-grade

  19. IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide

    NARCIS (Netherlands)

    Dubbink, H. J.; Taal, W.; van Marion, R.; Kros, J. M.; van Heuvel, I.; Bromberg, J. E.; Zonnenberg, B. A.; Zonnenberg, C. B. L.; Postma, T. J.; Gijtenbeek, J. M. M.; Boogerd, W.; Groenendijk, F. H.; Smitt, P. A. E. Sillevis; Dinjens, W. N. M.; van den Bent, M. J.

    2009-01-01

    Background: Mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) have been implicated in tumorigenesis of gliomas. Patients with high-grade astrocytomas with IDH1 or IDH2 mutations were reported to have a better survival, but it is unknown if this improved survival also holds for low-grade

  20. Prospects for production of synthetic liquid fuel from low-grade coal

    Directory of Open Access Journals (Sweden)

    Shevyrev Sergei

    2015-01-01

    Full Text Available In the paper, we compare the energy costs of steam and steam-oxygen gasification technologies for production of synthetic liquid fuel. Results of mathematic simulation and experimental studies on gasification of low-grade coal are presented.

  1. Aerobic Training Improved Low-Grade Inflammation in Obese Women with Intellectual Disability

    Science.gov (United States)

    Ordonez, F. J.; Rosety, M. A.; Camacho, A.; Rosety, I.; Diaz, A. J.; Fornieles, G.; Garcia, N.; Rosety-Rodriguez, M.

    2014-01-01

    Background: Obesity is a major health problem in people with intellectual disabilities. It is also widely accepted that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. Fortunately, physical activity has shown to improve inflammation in people with metabolic syndrome and type…

  2. Evolution of DNA repair defects during malignant progression of low-grade gliomas after temozolomide treatment

    NARCIS (Netherlands)

    Thuijl, H.F. van; Mazor, T.; Johnson, B.E.; Fouse, S.D.; Aihara, K.; Hong, C.; Malmstrom, A.; Hallbeck, M.; Heimans, J.J.; Kloezeman, J.J.; Stenmark-Askmalm, M.; Lamfers, M.L.; Saito, N.; Aburatani, H.; Mukasa, A.; Berger, M.S.; Soderkvist, P.; Taylor, B.S.; Molinaro, A.M.; Wesseling, P.; Reijneveld, J.C.; Chang, S.M.; Ylstra, B.; Costello, J. F.

    2015-01-01

    Temozolomide (TMZ) increases the overall survival of patients with glioblastoma (GBM), but its role in the clinical management of diffuse low-grade gliomas (LGG) is still being defined. DNA hypermethylation of the O (6) -methylguanine-DNA methyltransferase (MGMT) promoter is associated with an impro

  3. Primary pulmonary amyloidosis due to low-grade B cell lymphoma.

    Science.gov (United States)

    Georghiou, Georgios P; Boikov, Olga; Vidne, Bernardo A; Saute, Milton

    2007-01-01

    Pulmonary involvement is not an infrequent complication of systemic amyloidosis, although affected patients rarely have significant pulmonary symptoms. In contrast, localized (primary) pulmonary amyloidosis is rare. We report a case of pulmonary low-grade B cell lymphoma with amyloid production, causing localized pulmonary amyloidosis.

  4. Heat-to-current conversion of low-grade heat from a thermocapacitive cycle by supercapacitors

    NARCIS (Netherlands)

    Härtel, Andreas; Janssen, Mathijs; Weingarth, Daniel; Presser, Volker; van Roij, Rene

    2015-01-01

    Thermal energy is abundantly available, and especially low-grade heat is often wasted in industrial processes as a by-product. Tapping into this vast energy reservoir with cost-attractive technologies may become a key element for the transition to an energy-sustainable economy and society. We propos

  5. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    NARCIS (Netherlands)

    Spijkerman, A.M.W.; Gall, M.A.; Tarnow, L.; Twisk, J.W.R.; Lauritzen, E.; Lund-Andersen, H.; Emeis, J.; Parving, H.H.; Stehouwer, C.D.A.

    2007-01-01

    Aims: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. Methods: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually during t

  6. The influence of low-grade glioma on resting state oscillatory brain activity: a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, I.; Stam, C.; Douw, L.; Bartolomei, F.; Heimans, J.; Dijk, van B.; Postma, T.; Klein, M.; Reijneveld, J.

    2008-01-01

    Purpose: In the present MEG-study, power spectral analysis of oscillatory brain activity was used to compare resting state brain activity in both low-grade glioma (LGG) patients and healthy controls. We hypothesized that LGG patients show local as well as diffuse slowing of resting state brain activ

  7. Using low-grade hardwoods for CLT production: a yield analysis

    Science.gov (United States)

    R. Edward Thomas; Urs. Buehlmann

    2017-01-01

    Low-grade hardwood logs are the by-product of logging operations and, more frequently today, urban tree removals. The market prices for these logs is low, as is the value recovered from their logs when producing traditional forest products such as pallet parts, railroad ties, landscaping mulch, or chips for pulp. However, the emergence of cross-laminated timber (CLT)...

  8. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    DEFF Research Database (Denmark)

    Spijkerman, Annemieke M W; Gall, Mari-Anne; Tarnow, L

    2007-01-01

    AIMS: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. METHODS: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually durin...

  9. Radiotherapy-induced cerebral abnormalities in patients with low-grade glioma

    NARCIS (Netherlands)

    Postma, TJ; Klein, M; Verstappen, CCP; Bromberg, JEC; Swennen, M; Langendijk, JA; Taphoorn, MJB; Scheltens, P; Slotman, BJ; van der Ploeg, HM; Aaronson, NK; Heimans, JJ

    2002-01-01

    Abnormalities on CT or MRI and neuropsychological performance in patients with low-grade glioma, with (n = 23) or without (n = 16) prior cerebral radiotherapy, were evaluated. Cerebral atrophy was observed in 14 of 23 patients (61%) treated with prior radiotherapy, and in 1 of 16 patients (6%) witho

  10. Biological formation of caproate and caprylate from acetate: fuel and chemical production from low grade biomass

    NARCIS (Netherlands)

    Steinbusch, K.J.J.; Hamelers, H.V.M.; Plugge, C.M.; Buisman, C.J.N.

    2011-01-01

    This research introduces an alternative mixed culture fermentation technology for anaerobic digestion to recover valuable products from low grade biomass. In this mixed culture fermentation, organic waste streams are converted to caproate and caprylate as precursors for biodiesel or chemicals. It wa

  11. Low-grade inflammation, diet composition and health: Current research evidence and its translation

    NARCIS (Netherlands)

    Minihane, A.M.; Vinoy, S.; Russell, W.R.; Baka, A.; Roche, H.M.; Tuohy, K.M.; Teeling, J.L.; Blaak, E.E.; Fenech, M.; Vauzour, D.; McArdle, H.J.; Kremer, B.H.A.; Sterkman, L.; Vafeiadou, K.; Benedetti, M.M.; Williams, C.M.; Calder, P.C.

    2015-01-01

    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by

  12. The influence of low-grade glioma on resting state oscillatory brain activity : a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, I; Stam, C J; Douw, L; Bartolomei, F; Heimans, J J; van Dijk, B W; Postma, T J; Klein, M; Reijneveld, J C

    2008-01-01

    PURPOSE: In the present MEG-study, power spectral analysis of oscillatory brain activity was used to compare resting state brain activity in both low-grade glioma (LGG) patients and healthy controls. We hypothesized that LGG patients show local as well as diffuse slowing of resting state brain activ

  13. Effect of basicity on ferromanganese production from beneficiated low-grade manganese ore

    Science.gov (United States)

    Suharno, Bambang; Noegroho, Adi; Ferdian, Deni; Nurjaman, Fajar

    2017-01-01

    Indonesia is known to have a large low-grade manganese ore reserve. Nevertheless, it could not be used optimally in producing ferromanganese due to their low Mn/Fe ratio. In this present study, the beneficiation process had been applied to the low-grade manganese ore. Reduction roasting was conducted to this manganese ore at 700°C for an hour and then continued with low-intensity magnetic separation. This process had improved the Mn/Fe ratio from 1.39 to 6.11. The effect of basicity on ferromanganese production from this beneficiated low-grade manganese ore had been investigated clearly in this experiment by using mini submerged arc furnace (SAF). Several basicities for 0.7 and 1.0, was used and it was controlled by the addition of limestone in this smelting process. From this experiment, the ferromanganese containing 60% Mn was obtained from smelting the beneficiated low-grade manganese ore with the optimum basicity 0.7.

  14. Catalytic effect of activated carbon on bioleaching of low-grade primary copper sulfide ores

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The catalytic effect of activated carbon on the bioleaching of low-grade primary copper sulfide ores using mixture of Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans was investigated. The results show that the addition of activated carbon can greatly accelerate the rate and efficiency of copper dissolution from low-grade primary copper sulfide ores. The solution with the concentration of 3.0 g/L activated carbon is most beneficial to the dissolution of copper. The resting time of the mixture of activated carbon and ores has an impact on the bioleaching of low-grade primary copper sulfide ores. The 2 d resting time is most favorable to the dissolution of copper. The enhanced dissolution rate and efficiency of copper can be attributed to the galvanic interaction between activated carbon and chalcopyrite. The addition of activated carbon obviously depresses the dissolution of iron and the bacterial oxidation of ferrous ions in solution. The lower redox potentials are more favorable to the copper dissolution than the higher potentials for low-grade primary copper sulfide ores in the presence of activated carbon.

  15. Efficacy of traditional treatment regimen on Kati Shoola with special reference to lumbar spondylolisthesis

    OpenAIRE

    Ediriweera, E. R. H. S. S.; Gunathilka, H. D. P.; Weerasinghe, K. D. C. M.; Kalawana, O. T. M. R. K. S. B.

    2013-01-01

    According to Ayurveda, Kati Shoola is a disease with pain in lumbar region. Lumbar spondylolisthesis, anterior displacement of a vertebra or the vertebral column in relation to the vertebrae below, is one of the common causes. Current case study was carried out at Ayurveda Teaching hospital, Borella, to evaluate the efficacy of a treatment regimen used by Sri Lankan traditional physician family “Weerasinghe.” A 59-year-old female with a 9-month history of lumbar spondylolisthesis was treated ...

  16. {sup 1}H magnetic resonance spectroscopy in the diagnosis of paediatric low grade brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Orphanidou-Vlachou, E., E-mail: eleni.orphanidou@googlemail.com [School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT (United Kingdom); Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Auer, D., E-mail: dorothee.auer@nottingham.ac.uk [Division of Academic Radiology, School of Medical and Surgical Sciences, The University of Nottingham, University Park, Nottingham, NG7 2RD (United Kingdom); Children' s Brain Tumour Research Centre, Queens Medical Centre, University of Nottingham (United Kingdom); Brundler, M.A., E-mail: marie-anne.brundler@bch.nhs.uk [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Davies, N.P., E-mail: nigel.davies@nhs.net [School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT (United Kingdom); Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); Jaspan, T., E-mail: tim.jaspan@nuh.nhs.uk [Children' s Brain Tumour Research Centre, Queens Medical Centre, University of Nottingham (United Kingdom); MacPherson, L., E-mail: Lesley.MacPherson@bch.nhs.uk [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Natarajan, K., E-mail: Kal.Natarajan@uhb.nhs.uk [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); and others

    2013-06-15

    Introduction: Low grade gliomas are the commonest brain tumours in children but present in a myriad of ways, each with its own treatment challenges. Conventional MRI scans play an important role in their management but have limited ability to identify likely clinical behaviour. The aim of this study is to investigate {sup 1}H magnetic resonance spectroscopy (MRS) as a method for detecting differences between the various low grade gliomas and related tumours in children. Patients and methods: Short echo time single voxel {sup 1}H MRS at 1.5 or 3.0 T was performed prior to treatment on children with low grade brain tumours at two centres and five MR scanners, 69 cases had data which passed quality control. MRS data was processed using LCModel to give mean spectra and metabolite concentrations which were compared using T-tests, ANOVA, Receiver Operator Characteristic curves and logistic regression in SPSS. Results: Significant differences were found in concentrations of key metabolites between glioneuronal and glial tumours (T-test p < 0.05) and between most of the individual histological subtypes of low grade gliomas. The discriminatory metabolites identified, such as choline and myoinositol, are known tumour biomarkers. In the set of pilocytic astrocytomas and unbiopsied optic pathway gliomas, significant differences (p < 0.05, ANOVA) were found in metabolite profiles of tumours depending on location and patient neurofibromatosis type 1 status. Logistic regression analyses yielded equations which could be used to assess the probability of a tumour being of a specific type. Conclusions: MRS can detect subtle differences between low grade brain tumours in children and should form part of the clinical assessment of these tumours.

  17. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    Directory of Open Access Journals (Sweden)

    Julian Arista-Nasr

    2016-04-01

    Full Text Available ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Results Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. Conclusions The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

  18. SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH

    Directory of Open Access Journals (Sweden)

    Сергей Валентинович Виссарионов

    2014-09-01

    Full Text Available Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the main clinical manifestations. During surgery the anatomy of the vertebral canal and the normal interposition in the pathological segment were reconstructed. It resulted in normalization of the body balance and regression of neurological symptoms. Results: in spondylolisthesis grade 2 and 3 full reduction was achieved. In patients with grade 4 spondylolisthesis deformity was reduced to grade 2-3. Pain and radicular syndromes regressed in 2-3 days after surgery. In patients with monoparesis and contractures regression of neurological deficit took 1-1,5 months. Conclusions: The method of surgical treatment in patients with spondylolisthesis of L5 vertebrae depends on the degree of vertebrae shifting presence of segmental instability and neurological sighns.

  19. Defining the inherent stability of degenerative spondylolisthesis: a systematic review.

    Science.gov (United States)

    Simmonds, Andrea M; Rampersaud, Y Raja; Dvorak, Marcel F; Dea, Nicolas; Melnyk, Angela D; Fisher, Charles G

    2015-08-01

    OBJECT A range of surgical options exists for the treatment of degenerative lumbar spondylolisthesis (DLS). The chosen technique inherently depends on the stability of the DLS. Despite a substantial body of literature dedicated to the outcome analysis of numerous DLS procedures, no consensus has been reached on defining or classifying the disorder with respect to stability or the role that instability should play in a treatment algorithm. The purpose of this study was to define grades of stability and to develop a guide for deciding on the optimal approach in surgically managing patients with DLS. METHODS The authors conducted a qualitative systematic review of clinical or biomechanical analyses evaluating the stability of and surgical outcomes for DLS for the period from 1990 to 2013. Research focused on nondegenerative forms of spondylolisthesis or spinal stenosis without associated DLS was excluded. The primary extracted results were clinical and radiographic parameters indicative of DLS instability. RESULTS The following preoperative parameters are predictors of stability in DLS: restabilization signs (disc height loss, osteophyte formation, vertebral endplate sclerosis, and ligament ossification), no disc angle change or less than 3 mm of translation on dynamic radiographs, and the absence of low-back pain. The validity and magnitude of each parameter's contribution can only be determined through appropriately powered prospective evaluation in the future. Identifying these parameters has allowed for the creation of a preliminary DLS instability classification (DSIC) scheme based on the preoperative assessment of DLS stability. CONCLUSIONS Spinal stability is an important factor to consider in the evaluation and treatment of patients with DLS. Qualitative assessment of the best available evidence revealed clinical and radiographic parameters for the creation of the DSIC, a decision aid to help surgeons develop a method of preoperative evaluation to better

  20. Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul;

    2003-01-01

    We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp...... Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux......, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but...

  1. The association between low-grade inflammation, iron status and nucleic acid oxidation in the elderly

    DEFF Research Database (Denmark)

    Broedbaek, Kasper; Siersma, Volkert Dirk; Andersen, Jon T

    2011-01-01

    This study applied a case-control approach to investigate the association between low-grade inflammation, defined by high values within the normal range of C-reactive protein (CRP) and interleukin-6 (IL-6), and urinary markers of nucleic acid oxidation. No differences in excretion of urinary...... markers of nucleic acid oxidation between cases and controls were found and multivariable linear regression analysis showed no association between urinary markers of nucleic acid oxidation and inflammatory markers. Post-hoc multivariable linear regression analysis showed significant associations between...... nucleic acid oxidation and various iron status markers and especially a close relationship between nucleic acid oxidation and ferritin. This study shows no association between low-grade inflammation and urinary markers of nucleic acid oxidation in a population of elderly Italian people. The results...

  2. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?

    Directory of Open Access Journals (Sweden)

    Eduardo da Silva Alves

    2013-01-01

    Full Text Available An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury.

  3. Monitoring temozolomide treatment of low-grade glioma with proton magnetic resonance spectroscopy

    DEFF Research Database (Denmark)

    Murphy, P. S.; Viviers, L; Abson, C;

    2004-01-01

    Assessment of low-grade glioma treatment response remains as much of a challenge as the treatment itself. Proton magnetic resonance spectroscopy ((1)H-MRS) and imaging were incorporated into a study of patients receiving temozolomide therapy for low-grade glioma in order to evaluate and monitor...... tumour metabolite and volume changes during treatment. Patients (n=12) received oral temozolomide (200 mg m(-2) day(-1)) over 5 days on a 28-day cycle for 12 cycles. Response assessment included baseline and three-monthly magnetic resonance imaging studies (pretreatment, 3, 6, 9 and 12 months) assessing...... months, a significant reduction in the mean choline signal was observed compared with the pretreatment (P=0.035) and 3-month scan (P=0.021). The reduction in the tumour choline/water signal paralleled tumour volume change and may reflect the therapeutic effect of temozolomide...

  4. Immunoblastic follicular lymphoma: a very unusual transformation of low-grade follicular lymphoma.

    Science.gov (United States)

    Gheith, Shereen; Cornfield, Dennis; Chen, Weiyi; Singh-Kahlon, Pal; Ahmed, Basil

    2014-11-01

    A 73-year-old man, in clinical remission 17 years after radiation therapy for a localized low-grade follicular lymphoma (FL), developed extensive lymphadenopathy, ascites, and splenomegaly with splenic masses. Axillary lymph node biopsy showed FL composed of nodules of centrocytes side by side with nodules of immunoblasts rather than centroblasts. Immunophenotyping revealed conventional FL markers (BCL-2, BCL-6, and CD10) as well as MUM-1 in the immunoblastic component, suggesting postgerminal center differentiation. Fluorescence in situ hybridization showed t(14;18) in both centrocytic and immunoblastic components and a copy gain of BCL-6 predominantly in the immunoblastic component. Areas of centrocytic and of immunoblastic nodules were macrodissected separately and underwent molecular evaluation for immunoglobulin heavy chain gene rearrangement. Identical base-pair peaks were found, attesting to their clonal identity. This case represents a very unusual example of transformation of a low-grade FL to a nodular immunoblastic FL.

  5. Emerging role of functional brain MRI in low-grade glioma surgery

    DEFF Research Database (Denmark)

    Friismose, Ancuta; Traise, Peter; Markovic, Ljubo

    Learning objectives 1. To describe the use of functional MRI (fMRI) in cranial surgery planning for patients with low-grade gliomas (LGG). 2. To show the increasing importance of fMRI in the clinical setting. Background LGG include brain tumors classified by the World Health Organization as grade I....... Language comprehension and visual tasks can be added to visualize Wernicke’s area or the visual cortex. Diffusion tensor imaging (DTI) is used to map nerve tract course relative to the tumour. Conclusion FMRI has proven its clinical utility in locating eloquent brain areas with relation to tumor site...... be used to map eloquent cortex areas, thus minimizing postoperative deficits and improving surgical performance. Findings and procedure details Patients diagnosed with low-grade gliomas located in eloquent brain areas undergo fMRI prior to surgery. The exams are performed on a 3T MR system (Achieva TX...

  6. Dominance of Acidithiobacillus at ore surface of Zijinshan commercial low-grade copper bioleaching heap

    Institute of Scientific and Technical Information of China (English)

    LIU Xing-yu; CHEN Bo-wei; WEN Jian-kang

    2008-01-01

    The microbial community structure in the ore surface of Zijinshan commercial low-grade copper bioleaching heap was investigated by 16S rRNA gene clone library.For both bacteria and Archaea,105 clones were sequenced.The dominant bacteria species present in the ore surface were Acidithiobacillus and Leptospirillum,accounting for 51.42% and 48.57%,respectively.However,for the Archaea,only one operational taxonomic unit (OUT) belonged to Ferroplasma acidiphilum.These results indicate that function of genus Acidithiobacillus in the commercial low-grade copper bioleaching heap may be underestimated.More detailed and quantitative information on microbial community structure over time are now under investigation.

  7. Low-grade sarcoma in classical seminoma - the first case reported

    Science.gov (United States)

    Petersson, Fredrik; Michal, Michal; Grossmann, Petr; Franco, Marcello; Zámečník, Michal; Hes, Ondrej

    2010-01-01

    A 30-year-old male with no previous history of neoplastic disease presented with a 5 cm large testicular tumor. Routine histopathological examination and immunohistochemical investigation showed a classical seminoma with a contiguous 8 mm large nodule. The nodule was separated from the tunica albuginea by tubuli seminiferi showing intratesticular germ cell neoplasi not otherwise specified (NOS). The nodule was composed of spindle cells with low-grade nuclear atypia, nuclear and cytoplasmic S100 protein immunoreactivity in 15% of the cells and a proliferative activity of up to 20%. No other germ cell tumor components were found. To the best of our knowledge, we herein present the first tumor of a pure classical seminoma with an associated low-grade sarcomatous component. PMID:20126588

  8. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?

    Science.gov (United States)

    da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury. PMID:23533315

  9. A CASE REPORT OF LOW GRADE MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR

    Directory of Open Access Journals (Sweden)

    Sampath Kumar

    2015-01-01

    Full Text Available Malignant nerve sheath tumours [syn : Neurogenic sarcoma , Neuro fibro sarcoma] comprise approximately 5% of all soft tissue sarcomas. Only 8to15% of these tumours arises in Head and neck region. Commonest sites in head and neck region a re lateral skull base or along the course of cranial nerves. These tumours in sino nasal region are extreme rare. In this article we report a rare case of low grade MPNST. The tumour was resected by medial maxillectomy via modified Denker extended maxillar y anterior antrostomy , resected tumour Histopathological examination and immunohistochemistry study reported as low grade MPNST and negative for s - 100 protein. Patient was relieved from symptoms and followed for 18 months.

  10. Low-grade osteosarcoma arising from cemento-ossifying fibroma: a case report.

    Science.gov (United States)

    Lee, Yong Bin; Kim, Nam-Kyoo; Kim, Jae-Young; Kim, Hyung Jun

    2015-02-01

    Cemento-ossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibroma transforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma, treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteosarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibula free flap. The aim of this report is to raise awareness of the possibility that cemento-ossifying fibroma can transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.

  11. Low-grade fibromatosis-like spindle cell carcinoma of the breast.

    Science.gov (United States)

    Dwyer, Jessica B; Clark, Beth Z

    2015-04-01

    Low-grade fibromatosis-like spindle cell carcinoma is a rare tumor in the breast, and represents a variant of the very heterogeneous group of metaplastic carcinomas of the breast. These tumors warrant distinction because of their resemblance to pure fibromatosis, their propensity for local recurrence, and their favorable prognosis among the metaplastic carcinomas of the breast. The diagnosis is potentially challenging, particularly on core needle biopsies, because of the morphologic overlap with other low-grade spindle cell lesions. Recognition of a proliferation of cytologically bland spindle cells with areas of epithelial differentiation in combination with immunohistochemistry using antibodies against cytokeratins and myoepithelial markers should aid in producing a definitive diagnosis. These tumors can be locally aggressive with an increased incidence of local recurrence, but the potential for lymph node or distant metastasis is low. Complete excision with adequate margins is considered curative in the majority of cases.

  12. Collection of low-grade waste heat for enhanced energy harvesting

    Science.gov (United States)

    Dede, Ercan M.; Schmalenberg, Paul; Wang, Chi-Ming; Zhou, Feng; Nomura, Tsuyoshi

    2016-05-01

    Enhanced energy harvesting through the collection of low-grade waste heat is experimentally demonstrated. A structural optimization technique is exploited in the design of a thermal-composite substrate to guide and gather the heat emanating from multiple sources to a predetermined location. A thermoelectric generator is then applied at the selected focusing region to convert the resulting low-grade waste heat to electrical power. The thermal characteristics of the device are experimentally verified by direct temperature measurements of the system and numerically validated via heat conduction simulations. Electrical performance under natural and forced convection is measured, and in both cases, the device with optimized heat flow control plus energy harvesting demonstrates increased power generation when compared with a baseline waste heat recovery system. Electronics applications include energy scavenging for autonomously powered sensor networks or self-actuated devices.

  13. Intraosseous polymorphous low-grade adenocarcinoma of mandible: A rare entity

    Directory of Open Access Journals (Sweden)

    Gayathri Ramesh

    2012-01-01

    Full Text Available Polymorphous low-grade adenocarcinoma is a rare type of minor salivary gland malignancy. The characteristic features of these tumors are the varied histomorphology and the malignant, albeit indolent behavior. It occurs commonly in the minor salivary glands, with the palate (58.5% being the most common intra oral site. Maxillary area (2%, mandibular mucosal area (1.5% and posterior trigone region (0.5% are the least affected areas. An occasional case has been reported arising from an intraosseous location i.e the maxilla, and only two cases have been reported in the English literature originating from the mandible. One such very rare case of polymorphous low-grade adenocarcinoma of the mandible, which radiographically has a soap bubble appearance, is reported here.

  14. Challenges in Drug Discovery for Neurofibromatosis Type 1-Associated Low-Grade Glioma

    Directory of Open Access Journals (Sweden)

    Cora Antoinette Ricker

    2016-12-01

    Full Text Available Neurofibromatosis type 1 (NF1 is an autosomal dominant disorder that results from germline mutations of the NF1 gene, creating a predisposition to low-grade gliomas (pilocytic astrocytoma; PA in young children. Insufficient data and resources represent major challenges to identifying the best possible drug therapies for children with this tumor. Herein, we summarize the currently-available cell lines, genetically-engineered mouse models, and therapeutic targets for these low-grade gliomas (LGGs. Conspicuously absent are human tumor-derived cell lines or patient-derived xenograft models for NF1-LGG. New collaborative initiatives between patients and their families, research groups and pharmaceutical companies are needed to create transformative resources and broaden the knowledge base relevant to identifying cooperating genetic drivers and possible drug therapeutics for this common pediatric brain tumor.

  15. [MALT-type low-grade B-cell lymphomas of the stomach and Helicobacter pylori].

    Science.gov (United States)

    Binek, J; Morant, R; Weber, A; Schmid, U; Hammer, B

    1996-05-11

    From January 1 1994 to March 1 1995 we observed 6 patients with gastric low-grade B-cell lymphoma of MALT type in association with Helicobacter pylori infection. Endoscopically only 3 of the 6 patients presented with pathological findings. All but one patient with metastatic carcinoma received antibiotic therapy for Helicobacter pylori. Follow-up was not possible in one patient who died unexpectedly. In all 4 patients followed-up, eradication of Helicobacter pylori resulted in regression of the malignant lymphoma. During the median follow-up time of 7 months (2-13 months) no relapse of lymphoma was observed. Our results confirm that gastric low-grade B-cell lymphoma of MALT type can regress after eradication of Helicobacter pylori.

  16. Low-grade inflammation and spinal cord injury: exercise as therapy?

    Science.gov (United States)

    da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; Dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury.

  17. Is male factor infertility associated with midlife low-grade inflammation?

    DEFF Research Database (Denmark)

    Hærvig, Katia Keglberg; Kierkegaard, Lene; Lund, Rikke

    2017-01-01

    Male factor infertility is associated with an increased risk of disease and mortality, which has been related to markers of chronic systemic inflammation. The objective of this study was to investigate the association between male factor infertility and low-grade inflammation and furthermore...... to examine the lifetime prevalence of male factor infertility and overall infertility (also including female and couple infertility). The study population consisted of 2140 members of the Metropolit 1953 Danish Male Birth Cohort who had participated in the Copenhagen Aging and Midlife Biobank data collection...... in 2009-2011. Information on male factor infertility and overall infertility was obtained from a questionnaire, and low-grade inflammation was evaluated as the highest plasma levels of C-reactive protein, interleukin-6 and tumour necrosis factor-alpha in the population. The level of interleukin-6...

  18. Exercise as a Mean to Control Low-Grade Systemic Inflammation

    Directory of Open Access Journals (Sweden)

    Neha Mathur

    2008-01-01

    Full Text Available Chronic noncommunicable diseases (CNCDs, which include cardiovascular disease, some cancers, for example, colon cancer, breast cancer, and type 2 diabetes, are reaching epidemic proportions worldwide. It has now become clear that low-grade chronic inflammation is a key player in the pathogenesis of most CNCDs. Given that regular exercise offers protection against all causes of mortality, primarily by protection against atherosclerosis and insulin resistance, we suggest that exercise may exert some of its beneficial health effects by inducing anti-inflammatory actions. Recently, IL-6 was introduced as the first myokine, defined as a cytokine, which is produced and released by contracting skeletal muscle fibres, exerting its effects in other organs of the body. We suggest that skeletal muscle is an endocrine organ and that myokines may be involved in mediating the beneficial effects against CNCDs associated with low-grade inflammation.

  19. Exploiting molecular biology for diagnosis and targeted management of pediatric low-grade gliomas.

    Science.gov (United States)

    Garcia, Michael A; Solomon, David A; Haas-Kogan, Daphne A

    2016-06-01

    The majority of brain tumors arising in children are low-grade gliomas. Although historically categorized together as pediatric low-grade gliomas (PLGGs), there is significant histologic and genetic diversity within this group. In general, prognosis for PLGGs is excellent, and limitation of sequelae from tumor and treatment is paramount. Advances in high-throughput genetic sequencing and gene expression profiling are fundamentally changing the way PLGGs are classified and managed. Here, we review the histologic subtypes and highlight how recent advances in elucidating the molecular pathogenesis of these tumors have refined diagnosis and prognostication. Additionally, we discuss how characterizing specific genetic alterations has paved the way for the rational use of targeted therapies that are currently in various phase clinical trials.

  20. Magnetic separation studies for a low grade siliceous iron ore sample

    Institute of Scientific and Technical Information of China (English)

    Dwari Ranjan Kumar; Rao Danda Srinivas; Reddy Palli Sita Ram

    2013-01-01

    Investigations were carried out,on a low grade siliceous iron ore sample by magnetic separation,to establish its amenability for physical beneficiation.Mineralogical studies revealed that the sample consists of magnetite,hematite and goethite as major opaque oxide minerals where as silicates as well as carbonates form the gangue minerals in the sample.Processes involving combination of classification,dry magnetic separation and wet magnetic separation were carried out to upgrade the low grade siliceous iron ore sample to make it suitable as a marketable product.The sample was first ground and each closed size sieve fractions were subjected to dry magnetic separation and it was observed that limited upgradation is possible.The ground sample was subjected to different finer sizes and separated by wet low intensity magnetic separator.It was possible to obtain a magnetic concentrate of 67% Fe by recovering 90% of iron values at below 200 μm size.

  1. Collection of low-grade waste heat for enhanced energy harvesting

    Directory of Open Access Journals (Sweden)

    Ercan M. Dede

    2016-05-01

    Full Text Available Enhanced energy harvesting through the collection of low-grade waste heat is experimentally demonstrated. A structural optimization technique is exploited in the design of a thermal-composite substrate to guide and gather the heat emanating from multiple sources to a predetermined location. A thermoelectric generator is then applied at the selected focusing region to convert the resulting low-grade waste heat to electrical power. The thermal characteristics of the device are experimentally verified by direct temperature measurements of the system and numerically validated via heat conduction simulations. Electrical performance under natural and forced convection is measured, and in both cases, the device with optimized heat flow control plus energy harvesting demonstrates increased power generation when compared with a baseline waste heat recovery system. Electronics applications include energy scavenging for autonomously powered sensor networks or self-actuated devices.

  2. Isocitrate dehydrogenase 1 Gene Mutation Is Associated with Prognosis in Clinical Low-Grade Gliomas.

    Directory of Open Access Journals (Sweden)

    Ming-Yang Li

    Full Text Available Isocitrate dehydrogenase 1 gene mutations are found in most World Health Organization grade II and III gliomas and secondary glioblastomas. Isocitrate dehydrogenase 1 mutations are known to have prognostic value in high-grade gliomas. However, their prognostic significance in low-grade gliomas remains controversial. We determined the predictive and prognostic value of isocitrate dehydrogenase 1 status in low-grade gliomas. The association of isocitrate dehydrogenase 1 status with clinicopathological and genetic factors was also evaluated. Clinical information and genetic data including isocitrate dehydrogenase 1 mutation, O 6-methylguanine DNA methyltransferase promoter methylation, 1p/19q chromosome loss, and TP53 mutation of 417 low-grade gliomas were collected from the Chinese Glioma Genome Atlas database. Kaplan-Meier and Cox proportional hazards regression analyses were performed to evaluate the prognostic effect of clinical characteristics and molecular biomarkers. Isocitrate dehydrogenase 1 mutation was identified as an independent prognostic factor for overall, but not progression-free, survival. Notably, isocitrate dehydrogenase 1 mutation was found to be a significant prognostic factor in patients with oligodendrogliomas, but not in patients with astrocytomas. Furthermore, O 6-methylguanine DNA methyltransferase promoter methylation (p = 0.017 and TP53 mutation (p < 0.001, but not 1p/19q loss (p = 0.834, occurred at a higher frequency in isocitrate dehydrogenase 1-mutated tumors than in isocitrate dehydrogenase 1 wild-type tumors. Younger patient age (p = 0.041 and frontal lobe location (p = 0.010 were significantly correlated with isocitrate dehydrogenase 1 mutation. Chemotherapy did not provide a survival benefit in patients with isocitrate dehydrogenase 1-mutated tumors. Isocitrate dehydrogenase 1 mutation was an independent prognostic factor in low-grade gliomas, whereas it showed no predictive value for chemotherapy response

  3. Isocitrate dehydrogenase 1 Gene Mutation Is Associated with Prognosis in Clinical Low-Grade Gliomas.

    Science.gov (United States)

    Li, Ming-Yang; Wang, Yin-Yan; Cai, Jin-Quan; Zhang, Chuan-Bao; Wang, Kuan-Yu; Cheng, Wen; Liu, Yan-Wei; Zhang, Wei; Jiang, Tao

    2015-01-01

    Isocitrate dehydrogenase 1 gene mutations are found in most World Health Organization grade II and III gliomas and secondary glioblastomas. Isocitrate dehydrogenase 1 mutations are known to have prognostic value in high-grade gliomas. However, their prognostic significance in low-grade gliomas remains controversial. We determined the predictive and prognostic value of isocitrate dehydrogenase 1 status in low-grade gliomas. The association of isocitrate dehydrogenase 1 status with clinicopathological and genetic factors was also evaluated. Clinical information and genetic data including isocitrate dehydrogenase 1 mutation, O 6-methylguanine DNA methyltransferase promoter methylation, 1p/19q chromosome loss, and TP53 mutation of 417 low-grade gliomas were collected from the Chinese Glioma Genome Atlas database. Kaplan-Meier and Cox proportional hazards regression analyses were performed to evaluate the prognostic effect of clinical characteristics and molecular biomarkers. Isocitrate dehydrogenase 1 mutation was identified as an independent prognostic factor for overall, but not progression-free, survival. Notably, isocitrate dehydrogenase 1 mutation was found to be a significant prognostic factor in patients with oligodendrogliomas, but not in patients with astrocytomas. Furthermore, O 6-methylguanine DNA methyltransferase promoter methylation (p = 0.017) and TP53 mutation (p isocitrate dehydrogenase 1-mutated tumors than in isocitrate dehydrogenase 1 wild-type tumors. Younger patient age (p = 0.041) and frontal lobe location (p = 0.010) were significantly correlated with isocitrate dehydrogenase 1 mutation. Chemotherapy did not provide a survival benefit in patients with isocitrate dehydrogenase 1-mutated tumors. Isocitrate dehydrogenase 1 mutation was an independent prognostic factor in low-grade gliomas, whereas it showed no predictive value for chemotherapy response. Isocitrate dehydrogenase 1 mutation was highly associated with O 6-methylguanine DNA

  4. Fatty acids and chronic low grade inflammation associated with obesity and the metabolic syndrome.

    Science.gov (United States)

    Cooke, Aoife A; Connaughton, Ruth M; Lyons, Claire L; McMorrow, Aoibheann M; Roche, Helen M

    2016-08-15

    The metabolic syndrome is a group of obesity associated metabolic conditions that result in increased risk of cardiovascular disease and type 2 diabetes. Global increases in obesity rates have led to an increase in metabolic syndrome resulting in a demand for increased understanding of the mechanisms involved. This review examines the relationship between adipose tissue biology, lipid metabolism and chronic low grade inflammation relating to obesity and insulin resistance. Copyright © 2016. Published by Elsevier B.V.

  5. Platelet turnover in stable coronary artery disease - influence of thrombopoietin and low-grade inflammation.

    Directory of Open Access Journals (Sweden)

    Sanne Bøjet Larsen

    Full Text Available BACKGROUND: Newly formed platelets are associated with increased aggregation and adverse outcomes in patients with coronary artery disease (CAD. The mechanisms involved in the regulation of platelet turnover in patients with CAD are largely unknown. AIM: To investigate associations between platelet turnover parameters, thrombopoietin and markers of low-grade inflammation in patients with stable CAD. Furthermore, to explore the relationship between platelet turnover parameters and type 2 diabetes, prior myocardial infarction, smoking, age, gender and renal insufficiency. METHODS: We studied 581 stable CAD patients. Platelet turnover parameters (immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell-ratio were determined using automated flow cytometry (Sysmex XE-2100. Furthermore, we measured thrombopoietin and evaluated low-grade inflammation by measurement of high-sensitive CRP and interleukin-6. RESULTS: We found strong associations between the immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell ratio (r = 0.61-0.99, p<0.0001. Thrombopoietin levels were inversely related to all of the platelet turnover parameters (r = -0.17--0.25, p<0.0001. Moreover, thrombopoietin levels were significantly increased in patients with diabetes (p = 0.03 and in smokers (p = 0.003. Low-grade inflammation evaluated by high-sensitive CRP correlated significantly, yet weakly, with immature platelet count (r = 0.10, p = 0.03 and thrombopoietin (r = 0.16, p<0.001. Also interleukin-6 correlated with thrombopoietin (r = 0.10, p = 0.02. CONCLUSION: In stable CAD patients, thrombopoietin was inversely associated with platelet turnover parameters. Furthermore, thrombopoietin levels were increased in patients with diabetes and in smokers. However, low-grade inflammation did not seem to have a

  6. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

    OpenAIRE

    Copeland, William E.; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E. Jane

    2014-01-01

    Bullying is a common childhood experience that affects children at all income levels and racial/ethnic groups. Being a bully victim has long-term adverse consequences on physical and mental health and financial functioning, but bullies themselves display few ill effects. Here, we show that victims suffer from greater increases in low-grade systemic inflammation from childhood to young adulthood than are seen in others. In contrast, bullies showed lower increases in inflammation into adulthood...

  7. Low-grade inflammation in young adults exposed to intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Kelstrup, L.; Clausen, T. D.; Mathiesen, E. R.;

    2012-01-01

    Aim: To investigate associations between fetal exposure to intrauterine hyperglycemia and plasma concentrations of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in adult offspring. Method: We studied 597 offspring, aged 18-27 years, from four different groups concerning...... overweight but not exposure to intrauterine hyperglycemia was associated with low-grade inflammation in adult offspring. (C) 2012 Elsevier Ireland Ltd. All rights reserved....

  8. Adsorption refrigeration-green cooling driven by low grade thermal energy

    Institute of Scientific and Technical Information of China (English)

    WANG Ruzhu; WANG Liwei

    2005-01-01

    As a type of environmental benign refrigeration technology powered by low grade thermal energy, adsorption refrigeration have aroused more and more attention in recent years. In this paper, the research frontiers of adsorption refrigeration, including adsorbent, adsorption theory, heat recovery process, technology of adsorber, the research achievements, and the development achievements, are summarized. Typical systems for adsorption refrigeration research facing to applications in the recent years are presented. Future applications of adsorption refrigeration are analysed.

  9. Fragmentation mechanism of low-grade hematite ore in a high pressure grinding roll

    Institute of Scientific and Technical Information of China (English)

    袁致涛; 李丽匣; 韩跃新; 刘磊; 刘廷

    2016-01-01

    The fragmentation mechanism of low-grade hematite ore in a high pressure grinding roll (HPGR) was studied based on the characteristics of comminuted products at different specific pressure levels. The major properties included the reduction ratio, liberation, specific surface energy, and specific surface area. The results showed that the fracture of low-grade hematite ore in HPGR was an interactive dynamic process in which the interaction between coarse particles of gangue minerals and fine particles of valuable minerals was alternately continuous with increased compactness and compacting strength of materials. Within a range of 2.8–4.4 N/mm2, valuable minerals were crushed after preferentially absorbing energy, whereas gangue minerals were not completely crushed and only acted as an energy transfer medium. Within a range of 4.4–5.2 N/mm2, gangue minerals were adequately crushed after absorbing the remaining energy, whereas preferentially crushed valuable minerals acted as an energy transfer medium. Within a range of 5.2–6.0 N/mm2 range, the low-grade hematite ore was not further comminuted because of the “size effect” on the strength of materials, and the comminution effect of materials became stable.

  10. Low-grade oligodendroglioma of the pineal gland: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Levidou Georgia

    2010-09-01

    Full Text Available Abstract Background Gliomas are a very rare subtype of pineal region tumours, whereas oligodendrogliomas of the pineal region are exceedingly rare, since there have been only 3 cases of anaplastic oligodedrogliomas reported this far. Methods-Results We present a case of a low-grade oligodendroglioma arising in the pineal gland of a 37 year-old woman. The patient presented with diplopia associated with a cystic pineal region mass demonstrated on MRI. Total resection was performed and histological examination showed that the cystic wall consisted of tumour cells with a central nucleus a perinuclear halo and minimal pleomorphism. Immnunohistochemical analysis showed that these cells were diffusely positive for CD57, and negative for GFAP, CD10, CD99, cytokeratins, neurofilaments and synaptophysin. FISH analysis was performed in a small number of neoplastic cells, which were not exhausted after immunohistochemistry and did not reveal deletion of 1p and 19q chromosome arms. However, the diagnosis of a low grade oligodendroglioma of the pineal gland was assigned. Conclusion Although the spectrum of tumours arising in the pineal gland is broad, the reports of oligodendrogliomas confined to this location are exceedingly rare, and to the best of our knowledge there is no report of a low-grade oligodendroglioma. However, they should be added in the long list of tumours arising in the pineal gland.

  11. Dedifferentiated high-grade osteosarcoma originating from low-grade central osteosarcoma of the fibula

    Energy Technology Data Exchange (ETDEWEB)

    Kenan, Samuel [New York University-Hospital for Joint Diseases, Department of Orthopedic Surgery, New York, NY (United States); Ginat, Daniel T. [New York University, School of Medicine, New York, NY (United States); Steiner, German C. [New York University-Hospital for Joint Diseases, Department of Orthopedic Pathology, New York, NY (United States); Department of Pathology, New York, NY (United States)

    2007-04-15

    Low grade central osteosarcoma is a distinct, rare low grade malignant neoplasm characterized histologically by a spindle cell proliferation associated with trabecular bone formation. This tumor usually carries a good prognosis. However, it has the potential to recur, dedifferentiate, and metastasize subsequent to surgical treatment. In extremely rare occasions, LGCOS presents with areas of dedifferentiation upon initial patient evaluation. In this report we describe one such case affecting the fibula of a 39-year-old female, presenting with pain. Initial biopsy demonstrated a high-grade osteosarcoma. No areas of LGCOS were seen histologically. Following biopsy the patient received 3 months of chemotherapy at a different institution. However, the patient continued to exhibit symptoms. X-rays indicated a very aggressive tumor in the diaphysis of the proximal fibula, MRI revealed soft tissue involvement. The tumor and surrounding soft-tissues were excised en bloc at our institution. Microscopically, the lesion consisted of high-grade osteosarcoma as well as an underlying LGCOS that involved the cortex and medullary cavity of the fibula. The two histological components of the tumor were sharply delineated from one another. No chemotherapy effect was appreciated histologically or clinically. Eight months following the surgery, the patient died from lung metastases. This is the third documented case of dedifferentiated LGCOS at initial presentation. This case reveals that the low-grade component was also evident on preoperative radiographs. (orig.)

  12. Putamen involvement and survival outcomes in patients with insular low-grade gliomas.

    Science.gov (United States)

    Wang, Yongheng; Wang, Yinyan; Fan, Xing; Li, Shaowu; Liu, Xing; Wang, Jiangfei; Jiang, Tao

    2016-08-26

    OBJECTIVE Insular glioma has a unique origin and biological behavior; however, the associations between its anatomical features and prognosis have not been well established. The object of this study was to propose a classification system of insular low-grade gliomas based on preoperative MRI findings and to assess the system's association with survival outcome. METHODS A total of 211 consecutively collected patients diagnosed with low-grade insular gliomas was analyzed. All patients were classified according to whether tumor involved the putamen on MR images. The prognostic role of this novel putaminal classification, as well as that of Yaşargil's classification, was examined using multivariate analyses. RESULTS Ninety-nine cases (46.9%) of insular gliomas involved the putamen. Those tumors involving the putamen, as compared with nonputaminal tumors, were larger (p putamen classification (p = 0.014), and IDH1 mutation (p = 0.026) were independent predictors of overall survival. No prognostic role was found for Yaşargil's classification. CONCLUSIONS The current study's findings suggest that the putamen classification is an independent predictor of survival outcome in patients with insular low-grade gliomas. This newly proposed classification allows preoperative survival prediction for patients with insular gliomas.

  13. MRI differentiation of low-grade from high-grade appendicular chondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Douis, Hassan; Singh, Leanne; Saifuddin, Asif [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2014-01-15

    To identify magnetic resonance imaging (MRI) features which differentiate low-grade chondral lesions (atypical cartilaginous tumours/grade 1 chondrosarcoma) from high-grade chondrosarcomas (grade 2, grade 3 and dedifferentiated chondrosarcoma) of the major long bones. We identified all patients treated for central atypical cartilaginous tumours and central chondrosarcoma of major long bones (humerus, femur, tibia) over a 13-year period. The MRI studies were assessed for the following features: bone marrow oedema, soft tissue oedema, bone expansion, cortical thickening, cortical destruction, active periostitis, soft tissue mass and tumour length. The MRI-features were compared with the histopathological tumour grading using univariate, multivariate logistic regression and receiver operating characteristic curve (ROC) analyses. One hundred and seventy-nine tumours were included in this retrospective study. There were 28 atypical cartilaginous tumours, 79 grade 1 chondrosarcomas, 36 grade 2 chondrosarcomas, 13 grade 3 chondrosarcomas and 23 dedifferentiated chondrosarcomas. Multivariate analysis demonstrated that bone expansion (P = 0.001), active periostitis (P = 0.001), soft tissue mass (P < 0.001) and tumour length (P < 0.001) were statistically significant differentiating factors between low-grade and high-grade chondral lesions with an area under the ROC curve of 0.956. On MRI, bone expansion, active periostitis, soft tissue mass and tumour length can reliably differentiate high-grade chondrosarcomas from low-grade chondral lesions of the major long bones. (orig.)

  14. A 31-year-old woman with a transformed low-grade glioma.

    Science.gov (United States)

    Warnke, Peter C

    2010-03-10

    Low-grade gliomas in adults have an incidence of 0.8 to 1.2 per 100,000, and their causes are unknown. Despite their histological classification as low-grade, they cannot be cured by any current treatment mode, and no class I evidence exists to guide initial treatment of these tumors. Median survival ranges between 7.5 years and 10 years, with a 5-year survival probability between 55% and 86%. The prognosis depends on age, World Health Organization (WHO) tumor grade, Karnofsky performance score, cytological type (oligodendroglioma vs astrocytoma), and, potentially, the extent of resection. Oligodendrogliomas with loss of heterozygosity on chromosomes 1p and 19q have a distinctly more favorable prognosis and therapeutic response rate. Low-grade tumors progress to high-grade gliomas with aggressive biological behavior at increasing frequency with advancing age. Ms P is a young woman with a previously treated oligodendroglioma, WHO grade II, with loss of heterozygosity on chromosomes 1p and 19q, which at a third resection had transformed into an oligodendroglioma of WHO grade III. She wants to know her current and future therapeutic options.

  15. Histopathological-molecular genetic correlations in referral pathologist-diagnosed low-grade "oligodendroglioma".

    Science.gov (United States)

    Sasaki, Hikaru; Zlatescu, Magdalena C; Betensky, Rebecca A; Johnk, Loki B; Cutone, Andrea N; Cairncross, J Gregory; Louis, David N

    2002-01-01

    Allelic loss of chromosome 1p predicts increased chemosensitivity and better survival in oligodendroglial tumors. Clinical testing for 1p loss in oligodendroglial tumors at our hospital has allowed us to postulate that certain histological appearances are associated with 1p allelic status. Forty-four cases received for genetic testing were diagnosed by referring pathologists as pure low-grade oligodendroglioma. Central neuropathological review divided the series equally into 22 cases with classical oligodendroglioma histology and 22 with more astrocytic features. Molecular genetic analyses demonstrated 1p loss in 19 of 22 classic oligodendrogliomas (86%) and maintenance of both 1p alleles in 16 of 22 gliomas with astrocytic features (73%). No glial fibrillary acidic protein-positive cell type (gliofibrillary oligodendrocyte, minigemistocyte, cellular processes) was associated with 1p allelic status. Fourteen of the 44 cases were treated with chemotherapy at tumor progression: 3 "astrocytic" gliomas with 1p loss responded to PCV chemotherapy and 2 classic oligodendrogliomas that maintained both 1p alleles included a responder and a non-responder. These results suggest that histological appearance correctly predicts genotype in approximately 80% of low-grade gliomas, but that tumor genotype more closely predicts chemosensitivity. As a result, such objective molecular genetic analyses should be incorporated into patient management and into clinical trials of low-grade diffuse gliomas.

  16. Low-grade Schwann cell neoplasms with leptomeningeal dissemination: clinicopathologic and autopsy findings.

    Science.gov (United States)

    Rodriguez, Erika F; Blakeley, Jaishri; Langmead, Shannon; Olivi, Alessandro; Tufaro, Anthony; Tabbarah, Abeer; Berkenblit, Gail; Sacks, Justin M; Newsome, Scott D; Montgomery, Elizabeth; Rodriguez, Fausto J

    2017-02-01

    Leptomeningeal dissemination of low-grade Schwann cell neoplasms is an exceptionally rare occurrence and has not been well documented in the literature. We encountered 2 cases of leptomeningeal dissemination of low-grade Schwann cell neoplasms. Patient 1 was a 63-year-old woman with neurofibromatosis type 1 and a progressive low-grade malignant peripheral nerve sheath tumor developing from a diffuse/plexiform orbital neurofibroma that arose in childhood. The neoplasm demonstrated local and leptomeningeal dissemination intracranially leading to the patient's death. There was partial loss of H3K27 tri-methylation, p16 and collagen IV. Patient 2 was a 60-year-old man without neurofibromatosis type 1 who presented with cranial nerve symptoms and a disseminated neoplasm with a Schwann cell phenotype. The neoplasm stabilized after irradiation and chemotherapy, but the patient died of medical complications. Autopsy findings documented disseminated leptomeningeal disease in the intracranial and spinal compartment. H3K27M tri-methylation was preserved. The clinicopathologic and autopsy findings are studied and presented, and the literature is reviewed.

  17. Low-grade extraskeletal osteosarcoma of the chest wall: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Chetaille Bruno

    2010-11-01

    Full Text Available Abstract Background Low-grade extraskeletal osteosarcomas (ESOS are extremely rare. Case presentation We present the first case of low-grade ESOS of the chest wall, which occurred in a 30-year-old man. Because of initial misdiagnosis and patient's refusal of surgery, the diagnosis was done after a 4-year history of a slowly growing mass in soft tissues, leading to a huge (30-cm diameter calcified mass locally extended over the left chest wall. Final diagnosis was helped by molecular analysis of MDM2 and CDK4 oncogenes. Unfortunately, at this time, no surgical treatment was possible due to loco-regional extension, and despite chemotherapy, the patient died one year after diagnosis, five years after the first symptoms. Conclusion We describe the clinical, radiological and bio-pathological features of this unique case, and review the literature concerning low-grade ESOS. Our case highlights the diagnostic difficulties for such very rare tumours and the interest of molecular analysis in ambiguous cases.

  18. Simulation of NOx emission in circulating fluidized beds burning low-grade fuels

    Energy Technology Data Exchange (ETDEWEB)

    Afsin Gungor [Nigde University, Nigde (Turkey). Faculty of Engineering and Architecture

    2009-05-15

    Nitrogen oxides are a major environmental pollutant resulting from combustion. This paper presents a modeling study of pollutant NOx emission resulting from low-grade fuel combustion in a circulating fluidized bed. The simulation model accounts for the axial and radial distribution of NOx emission in a circulating fluidized bed (CFB). The model results are compared with and validated against experimental data both for small-size and industrial-size CFBs that use different types of low-grade fuels given in the literature. The present study proves that CFB combustion demonstrated by both experimental data and model predictions produces low and acceptable levels of NOx emissions resulting from the combustion of low-grade fuels. Developed model can also investigate the effects of different operational parameters on overall NOx emission. As a result of this investigation, both experimental data and model predictions show that NOx emission increases with the bed temperature but decreases with excess air if other parameters are kept unchanged. 37 refs., 5 figs., 5 tabs.

  19. The insulin-like growth factor 1 pathway is a potential therapeutic target for low-grade serous ovarian carcinoma

    Science.gov (United States)

    King, Erin R.; Zu, Zhifei; Tsang, Yvonne T.M.; Deavers, Michael T.; Malpica, Anais; Mok, Samuel C.; Gershenson, David M.; Wong, Kwong-Kwok

    2011-01-01

    Objective To validate the overexpression of insulin-like growth factor 1 (IGF-1) and its receptor (IGF-1R) in low-grade serous ovarian carcinoma (SOC), and to investigate whether the IGF-1 pathway is a potential therapeutic target for low-grade SOC. Methods Gene expression profiling was performed on serous borderline ovarian tumors (SBOTs) and low-grade SOC, and overexpression of IGF-1 in low-grade SOC was validated by RT-PCR and immunohistochemistry. The effect of exogenous IGF-1 on cell proliferation was determined in cell lines by cell proliferation assays, cell migration assays, and Western blot. Signaling pathways downstream of IGF-1 and the effects of the AKT inhibitor MK-2206 were investigated by Western blot analysis and by generating IGF-1R short hairpin RNA stable knockdown cell lines. Low- and high-grade cell lines were treated with the dual IGF-1R- and insulin receptor-directed tyrosine kinase inhibitor OSI-906, and cellular proliferation was measured. Results mRNA analysis and immunostaining revealed significantly higher IGF-1 expression in low-grade SOCs than in SBOTs or high-grade SOCs. In response to exogenous treatment with IGF-1, low-grade cell lines exhibited more intense upregulation of phosphorylated AKT than did high-grade cell lines, an effect that was diminished with IGF-1R knockdown and MK-2206 treatment. Low-grade SOC cell lines were more sensitive to growth inhibition with OSI-906 than were high-grade cell lines. Conclusions IGF-1 is overexpressed in low-grade SOCs compared with SBOTs and high-grade SOCs. Additionally, low-grade SOC cell lines were more responsive to IGF-1 stimulation and IGF-1R inhibition than were high-grade lines. The IGF-1 pathway is therefore a potential therapeutic target in low-grade SOC. PMID:21726895

  20. Radiological observation of the spondylolisthesis: The comparison between L4-L5 and L5-S1 spondylolisthesis in plain film and myelographic of findings

    Energy Technology Data Exchange (ETDEWEB)

    Bae, K. S.; Jo, H. G.; Chung, M. C.; Choi, D. L.; Kim, K. J. [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Spondylolisthesis is displacement of one vertebra upon the other with bony defect of neural arch or elongation of the pars interarticularis. Radiological findings of 35 confirmed cases of spondylolisthesis on plain film and myelogram were reviewed. We also compared the size and contour of slipped vertebra, and myelographic findings between L4-L5 (12 cases) and L5-S1 (23 cases) listhesis. The results were as follows: 1. Average of posterior wedging index of the body, foreward displacement, narrowing of intervertebral disc space and the degenerative changes are more severe in L5-S1 spondylolisthesis. 2. Hyperplastic changes of slipped vertebra are more severe in L5-S1 listhesis. 3. Incidence of spina bifida is not co-related between L4-L5 and L5-SI listhesis. 4. Arthrosis of the intervertebral joint appears both below and above the level of L5-S1 listhesis, but rare in L4-L5 listhesis. 5. The L5 root seems to be the one most often affected in lumber spondylolisthesis on myelogram. 6. The diagnosis of intervertebral disc herniation is less relable in patient with listhesis than in patients without listhesis.

  1. 探讨退变性与峡部裂性两组腰椎滑脱症患者的CT诊断特点%To Investigate the CT Diagnosis of Spondylolysis and Degenerative Features of Two Groups of Patients with Lumbar Spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    祖亮

    2016-01-01

    battle". In the isthmic group, 26 cases were bilateral spondylolysis, 13 cases were unilateral spondyloly-sis, 3 cases were incomplete isthmus spondylolysis. Crack group was significantly worse than the degenerative lumbar spondylolisthesis group (P < 0.05), the difference was statistically significant. For degenerative spondylolysis group and calcification of joint capsule group, the articular surface by biochemical, intervertebral joint dislocation or subluxation and facet joint sagittal change The numbers were 37, 50, 26, 41 cases and 3, 13, 0, 4 cases of degenerative joint disease. Obviously than isthmic group serious results (P<0.05). There was statistically significant difference of degenerative spondylolysis group and intervertebral stenosis group intervertebral disc degeneration, intervertebral disc prolapse and empty syndrome there were 43, 37, 21 cases and 4, 9, 2 cases of degenerative disc dis-ease. Spondylolysis group was significantly more than the serious results (P<0.05) there was statistically significant difference. Con-clusion CT diagnosis of spondylolysis in patients with degenerative lumbar spondylolisthesis was significantly higher than that of pa-tients, patients with degenerative intervertebral joint and intervertebral disc lesions than in patients with severe isthmic. Through the observation of CT diagnosis and related characteristics, can be diagnosed with lumbar spondylolisthesis and specific types.

  2. Clinical tests to diagnose lumbar spondylolysis and spondylolisthesis: A systematic review.

    Science.gov (United States)

    Alqarni, Abdullah M; Schneiders, Anthony G; Cook, Chad E; Hendrick, Paul A

    2015-08-01

    The aim of this paper was to systematically review the diagnostic ability of clinical tests to detect lumbar spondylolysis and spondylolisthesis. A systematic literature search of six databases, with no language restrictions, from 1950 to 2014 was concluded on February 1, 2014. Clinical tests were required to be compared against imaging reference standards and report, or allow computation, of common diagnostic values. The systematic search yielded a total of 5164 articles with 57 retained for full-text examination, from which 4 met the full inclusion criteria for the review. Study heterogeneity precluded a meta-analysis of included studies. Fifteen different clinical tests were evaluated for their ability to diagnose lumbar spondylolisthesis and one test for its ability to diagnose lumbar spondylolysis. The one-legged hyperextension test demonstrated low to moderate sensitivity (50%-73%) and low specificity (17%-32%) to diagnose lumbar spondylolysis, while the lumbar spinous process palpation test was the optimal diagnostic test for lumbar spondylolisthesis; returning high specificity (87%-100%) and moderate to high sensitivity (60-88) values. Lumbar spondylolysis and spondylolisthesis are identifiable causes of LBP in athletes. There appears to be utility to lumbar spinous process palpation for the diagnosis of lumbar spondylolisthesis, however the one-legged hyperextension test has virtually no value in diagnosing patients with spondylolysis.

  3. Outcome and Complications in Surgical Treatment of Lumbar Stenosis or Spondylolisthesis in Geriatric Patients.

    Science.gov (United States)

    Lee, Jin-Young; Moon, Seong-Hwan; Suh, Bo-Kyung; Yang, Myung Ho; Park, Moon Soo

    2015-09-01

    Development of anesthesiology and improvement of surgical instruments enabled aggressive surgical treatment even in elderly patients, who require more active physical activities than they were in the past. However, there are controversies about the clinical outcome of spinal surgery in elderly patients with spinal stenosis or spondylolisthesis. The purpose of this study is to review the clinical outcome of spinal surgery in elderly patients with spinal stenosis or spondylolisthesis. MEDLINE search on English-language articles was performed. There were 39685 articles from 1967 to 2013 regarding spinal disease, among which 70 dealt with geriatric lumbar surgery. Eighteen out of 70 articles dealt with geriatric lumbar surgery under the diagnosis of spinal stenosis or spondylolisthesis. One was non-randomized prospective, and other seventeen reports were retrospective. One non-randomized prospective and twelve out of seventeen retrospective studies showed that old ages did not affect the clinical outcomes. One non-randomized prospective and ten of seventeen retrospective studies elucidated postoperative complications: some reports showed that postoperative complications increased in elderly patients, whereas the other reports showed that they did not increase. Nevertheless, most complications were minor. There were two retrospective studies regarding the mortality. Mortality which was unrelated to surgical procedure increased, but surgical procedure-related mortality did not increase. Surgery as a treatment option in the elderly patients with the spinal stenosis or spondylolisthesis may be reasonable. However, there is insufficient evidence to make strong recommendations regarding spinal surgery for geriatric patients with spinal stenosis and spondylolisthesis.

  4. KRAS/BRAF Analysis in Ovarian Low-Grade Serous Carcinoma Having Synchronous All Pathological Precursor Regions

    Directory of Open Access Journals (Sweden)

    Kohei Nakamura

    2016-04-01

    Full Text Available Ovarian low-grade serous carcinoma is thought to begin as a serous cystadenoma or adenofibroma that progresses in a slow stepwise fashion. Among the low-grade serous carcinomas, there is a high frequency of activating mutations in the KRAS or BRAF genes; however, it remains unclear as to how these mutations contribute to tumor progression. This is the first report to track the histopathological progression of serous adenofibroma to low-grade serous carcinoma. Each stage was individually analyzed by pathological and molecular genetic methods to determine what differences occur between the distinct stages of progression.

  5. Radiographical analysis concernig the etiology of degenerative spondylolisthesis of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Ihara, Koichiro (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1989-12-01

    The purpose of this article is to evaluate radiographically degenerative spondylolisthesis of the lumbar spine, with the main focus on the configuration of posterior elements. A comparative study between 49 cases of degenerative spondylolisthesis and 99 cases of other lumbar disorders was performed, using 13 radiographical parameters. The results clearly indicate the posterior elements of degenerative spondylolisthesis shifted horizontally and sagittally to allow slipping. This was due to the weak bony hook mechanism. Furthermore, almost all facet joints were morphologically classified as sagittal or intermediate type. Another meaningful difference was the alignment of the lumbar spine which showed an increase in both lordosis and lumbosacral angle. On the other hand, the level of Jacoby's line was almost the same in both groups. These characteristic configurations could be the cause of listhesis, although further study should be carried out to elucidate whether they are present at the non-listhetic stage. (author).

  6. Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors.

    Science.gov (United States)

    Englot, Dario J; Han, Seunggu J; Berger, Mitchel S; Barbaro, Nicholas M; Chang, Edward F

    2012-04-01

    Achieving seizure control in patients with low-grade temporal lobe gliomas or glioneuronal tumors remains highly underappreciated, because seizures are the most frequent presenting symptom and significantly impact patient quality-of-life. To assess how the extent of temporal lobe resection influences seizure outcome. We performed a quantitative, comprehensive systematic literature review of seizure control outcomes in 1181 patients with epilepsy across 41 studies after surgical resection of low-grade temporal lobe gliomas and glioneuronal tumors. We measured seizure-freedom rates after subtotal resection vs gross-total lesionectomy alone vs tailored resection, including gross-total lesionectomy with hippocampectomy and/or anterior temporal lobe corticectomy. Included studies were observational case series, and no randomized, controlled trials were identified. Although only 43% of patients were seizure-free after subtotal tumor resection, 79% of individuals were seizure-free after gross-total lesionectomy (OR = 5.00, 95% confidence interval [CI]: 3.33-7.14). Furthermore, tailored resection with hippocampectomy plus corticectomy conferred additional benefit over gross-total lesionectomy alone, with 87% of patients achieving seizure freedom (OR = 1.82, 95% CI: 1.23-2.70). Overall, extended resection with hippocampectomy and/or corticectomy over gross-total lesionectomy alone significantly predicted seizure freedom (OR = 1.18, 95% CI: 1.11-1.26). Age seizure outcome. Gross-total lesionectomy of low-grade temporal lobe tumors results in significantly improved seizure control over subtotal resection. Additional tailored resection including the hippocampus and/or adjacent cortex may further improve seizure control, suggesting dual pathology may sometimes allow continued seizures after lesional excision.

  7. ENabling Reduction of Low-grade Inflammation in SEniors Pilot Study: Concept, Rationale, and Design.

    Science.gov (United States)

    Manini, Todd M; Anton, Stephen D; Beavers, Daniel P; Cauley, Jane A; Espeland, Mark A; Fielding, Roger A; Kritchevsky, Stephen B; Leeuwenburgh, Christiaan; Lewis, Kristina H; Liu, Christine; McDermott, Mary M; Miller, Michael E; Tracy, Russell P; Walston, Jeremy D; Radziszewska, Barbara; Lu, Jane; Stowe, Cindy; Wu, Samuel; Newman, Anne B; Ambrosius, Walter T; Pahor, Marco

    2017-09-01

    To test two interventions to reduce interleukin (IL)-6 levels, an indicator of low-grade chronic inflammation and an independent risk factor for impaired mobility and slow walking speed in older adults. The ENabling Reduction of low-Grade Inflammation in SEniors (ENRGISE) Pilot Study was a multicenter, double-blind, placebo-controlled randomized pilot trial of two interventions to reduce IL-6 levels. Five university-based research centers. Target enrollment was 300 men and women aged 70 and older with an average plasma IL-6 level between 2.5 and 30 pg/mL measured twice at least 1 week apart. Participants had low to moderate physical function, defined as self-reported difficulty walking one-quarter of a mile or climbing a flight of stairs and usual walk speed of less than 1 m/s on a 4-m usual-pace walk. Participants were randomized to losartan, omega-3 fish oil (ω-3), combined losartan and ω-3, or placebo. Randomization was stratified depending on eligibility for each group. A titration schedule was implemented to reach a dose that was safe and effective for IL-6 reduction. Maximal doses were 100 mg/d for losartan and 2.8 g/d for ω-3. IL-6, walking speed over 400 m, physical function (Short Physical Performance Battery), other inflammatory markers, safety, tolerability, frailty domains, and maximal leg strength were measured. Results from the ENRGISE Pilot Study will provide recruitment yields, feasibility, medication tolerance and adherence, and preliminary data to help justify a sample size for a more definitive randomized trial. The ENRGISE Pilot Study will inform a larger subsequent trial that is expected to have important clinical and public health implications for the growing population of older adults with low-grade chronic inflammation and mobility limitations. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  8. A Novel Nonpedicular Screw-Based Fixation in Lumbar Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Ming-Hong Chen

    2017-01-01

    Full Text Available Objective. The authors present the clinical results obtained in patients who underwent interspinous fusion device (IFD implantation following posterior lumbar interbody fusion (PLIF. The purpose of this study is investigating the feasibility of IFD with PLIF in the treatment of lumbar spondylolisthesis. Methods. Between September 2013 and November 2014, 39 patients underwent PLIF and subsequent IFD (Romeo®2 PAD, Spineart, Geneva, Switzerland implantation. Medical records of these patients were retrospectively reviewed to collect relevant data such as blood loss, operative time, and length of hospital stay. Radiographs and clinical outcome were evaluated 6 weeks and 12 months after surgery. Results. All 39 patients were followed up for more than one year. There were no major complications such as dura tear, nerve injuries, cerebrospinal fluid leakage, or deep infection. Both interbody and interspinous fusion could be observed on radiographs one year after surgery. However, there were 5 patients having early retropulsion of interbody fusion devices. Conclusion. The interspinous fusion device appears to achieve posterior fixation and facilitate lumbar fusion in selected patients. However, further study is mandatory for proposing a novel anatomic and radiological scoring system to identify patients suitable for this treatment modality and prevent postoperative complications.

  9. A Novel Nonpedicular Screw-Based Fixation in Lumbar Spondylolisthesis

    Science.gov (United States)

    2017-01-01

    Objective. The authors present the clinical results obtained in patients who underwent interspinous fusion device (IFD) implantation following posterior lumbar interbody fusion (PLIF). The purpose of this study is investigating the feasibility of IFD with PLIF in the treatment of lumbar spondylolisthesis. Methods. Between September 2013 and November 2014, 39 patients underwent PLIF and subsequent IFD (Romeo®2 PAD, Spineart, Geneva, Switzerland) implantation. Medical records of these patients were retrospectively reviewed to collect relevant data such as blood loss, operative time, and length of hospital stay. Radiographs and clinical outcome were evaluated 6 weeks and 12 months after surgery. Results. All 39 patients were followed up for more than one year. There were no major complications such as dura tear, nerve injuries, cerebrospinal fluid leakage, or deep infection. Both interbody and interspinous fusion could be observed on radiographs one year after surgery. However, there were 5 patients having early retropulsion of interbody fusion devices. Conclusion. The interspinous fusion device appears to achieve posterior fixation and facilitate lumbar fusion in selected patients. However, further study is mandatory for proposing a novel anatomic and radiological scoring system to identify patients suitable for this treatment modality and prevent postoperative complications. PMID:28164125

  10. Low-Grade Uterine Epithelioid Hemangioendothelioma Presented as a Submucosal Leiomyoma during Labor

    Directory of Open Access Journals (Sweden)

    Anastasios V. Koutsopoulos

    2013-01-01

    Full Text Available With the exception of leiomyomas, soft tissue tumors of the uterine corpus are not common. This is particularly true for vascular neoplasms, with the epithelioid hemangioendothelioma being a curiosity; not more than twenty-two cases of malignant hemangioendotheliomas have been reported in the literature so far, all of which were high-grade hemangioendotheliomas (hemangiosarcomas. We present herewith a unique case of low-grade epithelioid hemangioendothelioma of the uterus in a pregnant woman aged 29 years. The clinical, histological, and immunohistochemical characteristics of this entity, together with its differential diagnosis, are discussed.

  11. Low-grade meningioma showing nearly equal density with spinal fluid on radiographic images.

    Science.gov (United States)

    Tamura, Ryota; Tomita, Hideyuki; Shimizu, Kazuhiko; Sugiyama, Kazutoshi

    2013-06-21

    A 61-year-old woman had an intracranial tumour that was located on the falx. Meningioma was suspected and the tumour rapidly grew over 1 year. It showed nearly equal density with spinal fluid showing almost no enhancement on radiographic images, like microcystic meningioma. Successful removal of the tumour was achieved. Histopathologically, the tumour was diagnosed as low-grade meningioma. The meningioma had variable sized microcysts and the appearance of solid area was meningothelial meningioma. This is a rare radiographic image for meningothelial meningioma.

  12. Exercise as a mean to control low-grade systemic inflammation

    DEFF Research Database (Denmark)

    Mathur, Neha; Pedersen, Bente Klarlund

    2008-01-01

    Chronic noncommunicable diseases (CNCDs), which include cardiovascular disease, some cancers, for example, colon cancer, breast cancer, and type 2 diabetes, are reaching epidemic proportions worldwide. It has now become clear that low-grade chronic inflammation is a key player in the pathogenesis...... of most CNCDs. Given that regular exercise offers protection against all causes of mortality, primarily by protection against atherosclerosis and insulin resistance, we suggest that exercise may exert some of its beneficial health effects by inducing anti-inflammatory actions. Recently, IL-6...

  13. Low-grade mucinous neoplasm of the appendix managed with laparoscopic appendectomy

    Directory of Open Access Journals (Sweden)

    Jonas P DeMuro

    2013-01-01

    Full Text Available Mucocele of the appendix is uncommon and caused by a variety of pathologies. While the gold standard approach to these lesions has historically been exploratory laparotomy and right hemicolectomy, there is increasing experience with a minimally invasive approach and the resection limited to an appendectomy. A case is presented of an appendiceal mucocele diagnosed preoperatively and managed with a laparoscopic appendectomy. The pathology showed a low-grade mucinous neoplasm, with no evidence of recurrence on 30 month follow-up.

  14. Investigating depression-like and metabolic parameters in a chronic low-grade inflammation model

    DEFF Research Database (Denmark)

    Fischer, C. W.; Elfving, B.; Lund, S.

    2012-01-01

    (registered trademark) 2ML4, infusion rate 2.5l/day), which delivers LPS through a catheter into the abdomen. Depression-like behavior was assessed as increased time spent immobile in the forced swim test (FST). Peripheral markers of a low-grade inflammation was measured using a high sensitivity ELISA kit and central...... disturbances or sickness behavior. Thus, this model might help elucidating some of the mechanisms underlying inflammation-associated depression, in order to assist in developing more effective treatment strategies for this group of patients....

  15. A decomposing technique for scheelite concentrate and low-grade scheelite concentrate

    Institute of Scientific and Technical Information of China (English)

    HUO Guangsheng; SUN Peimei; LI Honggui; LI Yunjiao; ZHAO Zhongwei; SUN Zhaoming; LIU Maosheng

    2004-01-01

    The effect of different decomposition conditions on tungsten recovery for scheelite concentrate has been examined. The results show that tungsten recovery can be more than 98% under decomposing conditions as follows: the amount of caustic soda is 2.2 and 3.2 times of theoretical respectively, ratio of water and ore is 0.7-0.8, temperature is 160℃, and preservation time is 2.0 h for scheelite concentrate (63.21% WO3) and low grade scheelite concentrate (55.17% WO3).

  16. Polymorphous low-grade adenocarcinoma of parotid gland: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Arathi N

    2009-01-01

    Full Text Available Polymorphous low-grade adenocarcinoma (PLGA is a rare salivary gland malignant tumor of low aggressiveness, commonly occurring in minor salivary glands. Its occurrence in major salivary gland has been documented albeit rarely. The striking histological feature is architectural diversity combined with benign cytologic features. We report a case of PLGA arising from left parotid in a 25-year-old male patient. On light microscopy, varied patterns were seen .The cells were uniform with bland nuclei. Neural invasion was noted.

  17. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Lynge, E; Rebolj, M

    2012-01-01

    cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management......Please cite this paper as: Frederiksen M, Lynge E, Rebolj M. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03130.x. Background If human papillomavirus (HPV) testing will replace....... Selection criteria Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests. Data collection and analysis Information on study design, participants and outcomes was retrieved using a prespecified form...

  18. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report.

    Science.gov (United States)

    Nomura, Tadashi; Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto

    2017-01-01

    Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

  19. Mucinous cystic neoplasm of the liver with low grade dysplasia of the liver.

    Science.gov (United States)

    Pirdopska, T; Terziev, I; Taneva, I; Dimitrova, V

    2014-01-01

    Mucinous cystic neoplasm (MCN) with low grade dysplasia of the liver is rare. It had been previously called hepatobiliary cystadenoma and is seen almost exclusively in women without an associated invasive carcinoma. There are different theories for development of MCN of the liver. One of these is developing from endodermal immature stroma or primary yolk cells implanted during embryogenesis. Another theory refers to the prevalence of hepatic mucinous cystic neoplasm in segment IV, which may support an implant origin because hamartomatous lesions commonly develop in segment IV. The third theory concerns the expression of oestrogen receptor or progesterone receptor in ovarian-like stroma, which also supports a putative role for female hormones in the tumorogenesis. MCN of the liver is a cystic-forming epithelial neoplasm, usually showing no communication with the bile ducts, composed of cuboidal to columnar, variably mucin-producing epithelium, associated with ovarian-type subepithelial stroma. We present a case of MCN with low grade dysplasia of the liver in a young woman whose working surgical diagnosis was Echinococcus cyst. The MCN diagnosis was confirmed with Immunohistochemical study.

  20. Enchondroma versus Low-Grade Chondrosarcoma in Appendicular Skeleton: Clinical and Radiological Criteria

    Directory of Open Access Journals (Sweden)

    Eugenio M. Ferrer-Santacreu

    2012-01-01

    Full Text Available Objectives. To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. Material and Method. The study included 96 patients with cartilage type lesions suggestive of an enchondroma (E or an low grade chondrosarcoma (LGC according to the clinical and imaging data. The hypotheses were contrasted with the biopsy. Results. Of the 82 patients studied completely, 56 were considered E (68.29%, 8 as LGC (8.33% and in 18 (18.75% were doubtful cases and considered as suspected LGC. Of these, the biopsy showed 4 E (25%, 10 LGC (50% and 4 were not definitive. On the other hand, of the 56 cases diagnosed as E, 15 were biopsied, 5 of these biopsies turned out to be LGC (33.3%. The 8 cases diagnosed as LGC, were also biopsied and only 4 biopsies (50% confirmed the initial diagnosis. Features analyzed in the study showed no statistically significant difference. Correlation analysis between the diagnosis issued initially and the biopsy result gave a value of 0.69 (kappa coefficient, which was considered a good correlation. Conclusion. Features analyzed did not have any statistical significance. However, there was a good correlation between initial diagnosis and biopsy's result.

  1. Harvesting low-grade heat energy using thermo-osmotic vapour transport through nanoporous membranes

    Science.gov (United States)

    Straub, Anthony P.; Yip, Ngai Yin; Lin, Shihong; Lee, Jongho; Elimelech, Menachem

    2016-07-01

    Low-grade heat from sources below 100 ∘C offers a vast quantity of energy. The ability to extract this energy, however, is limited with existing technologies as they are not well-suited to harvest energy from sources with variable heat output or with a small temperature difference between the source and the environment. Here, we present a process for extracting energy from low-grade heat sources utilizing hydrophobic, nanoporous membranes that trap air within their pores when submerged in a liquid. By driving a thermo-osmotic vapour flux across the membrane from a hot reservoir to a pressurized cold reservoir, heat energy can be converted to mechanical work. We demonstrate operation of air-trapping membranes under hydraulic pressures up to 13 bar, show that power densities as high as 3.53 ± 0.29 W m-2 are achievable with a 60 ∘C heat source and a 20 ∘C heat sink, and estimate the efficiency of a full-scale system. The results demonstrate a promising process to harvest energy from low-temperature differences (<40 ∘C) and fluctuating heat sources.

  2. Low-grade myofibroblastic sarcoma arising in fibroadenoma of the breast-A case report.

    Science.gov (United States)

    Myong, Na-Hye; Min, Jun-Won

    2016-03-25

    Myofibroblastic sarcoma or myofibrosarcoma is a malignant tumor of myofibroblasts and known to develop rarely in the breast, but its underlying lesion and tumor cell origin have never been reported yet. A 61-year-old female presented with a gradually growing breast mass with well-demarcated ovoid nodular shape. The tumor was histologically characterized by fascicular-growing spindle cell proliferation with large areas of hyalinized fibrosis and focally ductal epithelial remnants embedded in myxoid stroma, mimicking a fibroadenomatous lesion. It had frequent mitoses of 5-16/10 high-power fields, hemorrhagic necrosis, and focally pericapsular invasion. The spindle cells were diffusely immunoreactive for fibronectin, smooth muscle actin, and calponin, which suggest a myofibroblastic origin. Multiple irregularly thickened vessels with medial or pericytic cell proliferation were found to be merged with the intrinsic tumor cells. The tumor could be diagnosed low-grade myofibroblastic sarcoma arising in an old fibroadenoma. We report a case of a low-grade mammary myofibrosarcoma that showed a background lesion of fibroadenoma first in the worldwide literature and suggest the pericytes or medial muscle cells of the intratumoral vessels as the cell origin of the myofibroblastic sarcoma.

  3. Simultaneous Purification and Perforation of Low-Grade Si Sources for Lithium-Ion Battery Anode.

    Science.gov (United States)

    Jin, Yan; Zhang, Su; Zhu, Bin; Tan, Yingling; Hu, Xiaozhen; Zong, Linqi; Zhu, Jia

    2015-11-11

    Silicon is regarded as one of the most promising candidates for lithium-ion battery anodes because of its abundance and high theoretical capacity. Various silicon nanostructures have been heavily investigated to improve electrochemical performance by addressing issues related to structure fracture and unstable solid-electrolyte interphase (SEI). However, to further enable widespread applications, scalable and cost-effective processes need to be developed to produce these nanostructures at large quantity with finely controlled structures and morphologies. In this study, we develop a scalable and low cost process to produce porous silicon directly from low grade silicon through ball-milling and modified metal-assisted chemical etching. The morphology of porous silicon can be drastically changed from porous-network to nanowire-array by adjusting the component in reaction solutions. Meanwhile, this perforation process can also effectively remove the impurities and, therefore, increase Si purity (up to 99.4%) significantly from low-grade and low-cost ferrosilicon (purity of 83.4%) sources. The electrochemical examinations indicate that these porous silicon structures with carbon treatment can deliver a stable capacity of 1287 mAh g(-1) over 100 cycles at a current density of 2 A g(-1). This type of purified porous silicon with finely controlled morphology, produced by a scalable and cost-effective fabrication process, can also serve as promising candidates for many other energy applications, such as thermoelectrics and solar energy conversion devices.

  4. Scalable Production of Si Nanoparticles Directly from Low Grade Sources for Lithium-Ion Battery Anode.

    Science.gov (United States)

    Zhu, Bin; Jin, Yan; Tan, Yingling; Zong, Linqi; Hu, Yue; Chen, Lei; Chen, Yanbin; Zhang, Qiao; Zhu, Jia

    2015-09-09

    Silicon, one of the most promising candidates as lithium-ion battery anode, has attracted much attention due to its high theoretical capacity, abundant existence, and mature infrastructure. Recently, Si nanostructures-based lithium-ion battery anode, with sophisticated structure designs and process development, has made significant progress. However, low cost and scalable processes to produce these Si nanostructures remained as a challenge, which limits the widespread applications. Herein, we demonstrate that Si nanoparticles with controlled size can be massively produced directly from low grade Si sources through a scalable high energy mechanical milling process. In addition, we systematically studied Si nanoparticles produced from two major low grade Si sources, metallurgical silicon (∼99 wt % Si, $1/kg) and ferrosilicon (∼83 wt % Si, $0.6/kg). It is found that nanoparticles produced from ferrosilicon sources contain FeSi2, which can serve as a buffer layer to alleviate the mechanical fractures of volume expansion, whereas nanoparticles from metallurgical Si sources have higher capacity and better kinetic properties because of higher purity and better electronic transport properties. Ferrosilicon nanoparticles and metallurgical Si nanoparticles demonstrate over 100 stable deep cycling after carbon coating with the reversible capacities of 1360 mAh g(-1) and 1205 mAh g(-1), respectively. Therefore, our approach provides a new strategy for cost-effective, energy-efficient, large scale synthesis of functional Si electrode materials.

  5. Obesity and Low-Grade Inflammation Increase Plasma Follistatin-Like 3 in Humans

    Directory of Open Access Journals (Sweden)

    Claus Brandt

    2014-01-01

    Full Text Available Background. Rodent models suggest that follistatin-like 3 (fstl3 is associated with diabetes and obesity. In humans, plasma fstl3 is reduced with gestational diabetes. In vitro, TNF-α induces fstl3 secretion, which suggests a link to inflammation. Objective. To elucidate the association between plasma fstl3 and obesity, insulin resistance, and low-grade inflammation in humans. Study Design. Plasma fstl3 levels were determined in a cross-sectional study including three groups: patients with type 2 diabetes, impaired glucose tolerance, and healthy controls. In addition, lipopolysaccharide (LPS, TNF-α, or interleukin-6 (IL-6 as well as a hyperinsulinemic euglycemic clamp were used to examine if plasma fstl3 was acutely regulated in humans. Results. Plasma fstl3 was increased in obese subjects independent of glycemic state. Moreover, plasma fstl3 was positively correlated with fat mass, plasma leptin, fasting insulin, and HOMA B and negatively with HOMA S. Furthermore plasma fstl3 correlated positively with plasma TNF-α and IL-6 levels. Infusion of LPS and TNF-α, but not IL-6 and insulin, increased plasma fstl3 in humans. Conclusion. Plasma fstl3 is increased in obese subjects and associated with fat mass and low-grade inflammation. Furthermore, TNF-α increased plasma fstl3, suggesting that TNF-α is one of the inflammatory drivers of increased systemic levels of fstl3.

  6. Frontal brain asymmetry, childhood maltreatment, and low-grade inflammation at midlife.

    Science.gov (United States)

    Hostinar, Camelia E; Davidson, Richard J; Graham, Eileen K; Mroczek, Daniel K; Lachman, Margie E; Seeman, Teresa E; van Reekum, Carien M; Miller, Gregory E

    2017-01-01

    Frontal EEG asymmetry is thought to reflect variations in affective style, such that greater relative right frontal activity at rest predicts enhanced emotional responding to threatening or negative stimuli, and risk of depression and anxiety disorders. A diathesis-stress model has been proposed to explain how this neuro-affective style might predispose to psychopathology, with greater right frontal activity being a vulnerability factor especially under stressful conditions. Less is known about the extent to which greater relative right frontal activity at rest might be associated with or be a diathesis for deleterious physical health outcomes. The present study examined the association between resting frontal EEG asymmetry and systemic, low-grade inflammation and tested the diathesis-stress model by examining whether childhood maltreatment exposure interacts with resting frontal asymmetry in explaining inflammation. Resting EEG, serum inflammatory biomarkers (interleukin-6, C-reactive protein, and fibrinogen) and self-reported psychological measures were available for 314 middle-aged adults (age M=55.3years, SD=11.2, 55.7% female). Analyses supported the diathesis-stress model and revealed that resting frontal EEG asymmetry was significantly associated with inflammation, but only in individuals who had experienced moderate to severe levels of childhood maltreatment. These findings suggest that, in the context of severe adversity, a trait-like tendency towards greater relative right prefrontal activity may predispose to low-grade inflammation, a risk factor for conditions with inflammatory underpinnings such as coronary heart disease.

  7. Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; vaginal versus other sites.

    Science.gov (United States)

    Moschiano, Elizabeth J; Barbuto, Denise A; Walsh, Christine; Singh, Kanwaljit; Euscher, Elizabeth D; Roma, Andres A; Ali-Fehmi, Rouba; Frauenhoffer, Elizabeth E; Montiel, Delia P; Kim, Insun; Djordjevic, Bojana; Malpica, Anais; Hong, Sung Ran; Silva, Elvio G

    2014-05-01

    Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

  8. Polymorphous Low-Grade Adenocarcinoma of the Tongue Base Treated by Transoral Robotic Surgery

    Directory of Open Access Journals (Sweden)

    Jeong Hong Kim

    2015-01-01

    Full Text Available Polymorphous low-grade adenocarcinoma is a rare malignancy arising from the minor salivary glands in the aerodigestive system, most frequently the hard palate. The treatment of choice is wide surgical resection, and the efficacy of radiotherapy has not been confirmed. A 54-year-old male presenting with a mass at the base of the tongue performed transoral laser microsurgery. The pathologic diagnosis was polymorphous low-grade adenocarcinoma. Complete surgical excision was performed via transoral robotic surgery without a flap reconstruction of the surgical defect. Without complications of bleeding or injury to the hypoglossal nerve, proper surgical margins were obtained, and no recurrence was found after 6 months after surgery. The patient did not complain of dysphagia or aspiration. We conclude that, in surgery for tongue base tumors with unknown malignant potential, transoral robotic surgery can be considered for achieving a definite resection avoiding a mandibulotomy without complications of dysphagia or aspiration after confirmation of malignancy with a frozen biopsy.

  9. Mouse Low-Grade Gliomas Contain Cancer Stem Cells with Unique Molecular and Functional Properties

    Directory of Open Access Journals (Sweden)

    Yi-Hsien Chen

    2015-03-01

    Full Text Available The availability of adult malignant glioma stem cells (GSCs has provided unprecedented opportunities to identify the mechanisms underlying treatment resistance. Unfortunately, there is a lack of comparable reagents for the study of pediatric low-grade glioma (LGG. Leveraging a neurofibromatosis 1 (Nf1 genetically engineered mouse LGG model, we report the isolation of CD133+ multi-potent low-grade glioma stem cells (LG-GSCs, which generate glioma-like lesions histologically similar to the parent tumor following injection into immunocompetent hosts. In addition, we demonstrate that these LG-GSCs harbor selective resistance to currently employed conventional and biologically targeted anti-cancer agents, which reflect the acquisition of new targetable signaling pathway abnormalities. Using transcriptomic analysis to identify additional molecular properties, we discovered that mouse and human LG-GSCs harbor high levels of Abcg1 expression critical for protecting against ER-stress-induced mouse LG-GSC apoptosis. Collectively, these findings establish that LGG cancer stem cells have unique molecular and functional properties relevant to brain cancer treatment.

  10. Low-grade inflammation disrupts structural plasticity in the human brain.

    Science.gov (United States)

    Szabó, C; Kelemen, O; Kéri, S

    2014-09-05

    Increased low-grade inflammation is thought to be associated with several neuropsychiatric disorders characterized by decreased neuronal plasticity. The purpose of the present study was to investigate the relationship between structural changes in the human brain during cognitive training and the intensity of low-grade peripheral inflammation in healthy individuals (n=56). A two-month training (30 min/day) with a platformer video game resulted in a significantly increased volume of the right hippocampal formation. The number of stressful life events experienced during the past year was associated with less pronounced enlargement of the hippocampus. However, the main predictor of hippocampal volume expansion was the relative peripheral expression of Nuclear Factor-κB (NF-κB), a transcription factor playing a central role in the effect of pro-inflammatory cytokines. Interleukin-6 (IL-6) and C-reactive protein levels were not related to hippocampal plasticity when NF-κB was taken into consideration. These results suggest that more intensive peripheral inflammation is associated with weaker neuronal plasticity during cognitive training. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  11. Low-grade inflammation, diet composition and health: current research evidence and its translation.

    Science.gov (United States)

    Minihane, Anne M; Vinoy, Sophie; Russell, Wendy R; Baka, Athanasia; Roche, Helen M; Tuohy, Kieran M; Teeling, Jessica L; Blaak, Ellen E; Fenech, Michael; Vauzour, David; McArdle, Harry J; Kremer, Bas H A; Sterkman, Luc; Vafeiadou, Katerina; Benedetti, Massimo Massi; Williams, Christine M; Calder, Philip C

    2015-10-14

    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by the International Life Sciences Institute's European Branch (ILSI Europe). It is co-authored by the speakers from a 2013 workshop led by the Obesity and Diabetes Task Force entitled 'Low-grade inflammation, a high-grade challenge: biomarkers and modulation by dietary strategies'. The latest research in the areas of acute and chronic inflammation and cardiometabolic, gut and cognitive health is presented along with the cellular and molecular mechanisms underlying inflammation-health/disease associations. The evidence relating diet composition and early-life nutrition to inflammatory status is reviewed. Human epidemiological and intervention data are thus far heavily reliant on the measurement of inflammatory markers in the circulation, and in particular cytokines in the fasting state, which are recognised as an insensitive and highly variable index of tissue inflammation. Potential novel kinetic and integrated approaches to capture inflammatory status in humans are discussed. Such approaches are likely to provide a more discriminating means of quantifying inflammation-health/disease associations, and the ability of diet to positively modulate inflammation and provide the much needed evidence to develop research portfolios that will inform new product development and associated health claims.

  12. An electrochemical system for efficiently harvesting low-grade heat energy

    Science.gov (United States)

    Lee, Seok Woo; Yang, Yuan; Lee, Hyun-Wook; Ghasemi, Hadi; Kraemer, Daniel; Chen, Gang; Cui, Yi

    2014-05-01

    Efficient and low-cost thermal energy-harvesting systems are needed to utilize the tremendous low-grade heat sources. Although thermoelectric devices are attractive, its efficiency is limited by the relatively low figure-of-merit and low-temperature differential. An alternative approach is to explore thermodynamic cycles. Thermogalvanic effect, the dependence of electrode potential on temperature, can construct such cycles. In one cycle, an electrochemical cell is charged at a temperature and then discharged at a different temperature with higher cell voltage, thereby converting heat to electricity. Here we report an electrochemical system using a copper hexacyanoferrate cathode and a Cu/Cu2+ anode to convert heat into electricity. The electrode materials have low polarization, high charge capacity, moderate temperature coefficients and low specific heat. These features lead to a high heat-to-electricity energy conversion efficiency of 5.7% when cycled between 10 and 60 °C, opening a promising way to utilize low-grade heat.

  13. Extracapsular dissection as sole therapy for small low-grade malignant tumors of the parotid gland.

    Science.gov (United States)

    Mantsopoulos, Konstantinos; Koch, Michael; Iro, Heinrich

    2017-08-01

    The aim of the study was to investigate whether extracapsular dissection of a primarily unsuspected lesion in the parotid gland could be oncologically sufficient for carefully selected cases of parotid gland malignomas. Retrospective clinical study. The records of all patients treated for primary malignant tumors of the parotid gland solely by means of extracapsular dissection between 2006 and 2013 were studied retrospectively. Patients with manifestation of malignant tumors in the parotid gland that were not of primary salivary gland origin (squamous cell carcinomas, lymphomas, melanomas) or who had had revision surgery or other malignant tumors in their history, as well as patients with insufficient data, were excluded from our study sample. Nine patients, all with low-grade parotid malignancies, were detected. Our study showed acceptable oncologic and functional outcomes throughout. Our study was able to show very encouraging preliminary results following primary extracapsular dissection as sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance. 4. Laryngoscope, 127:1804-1807, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  14. The Outlook for Low-Grade Fuels in Tomsk Region: Research Experience at Tomsk Polytechnic University

    Directory of Open Access Journals (Sweden)

    Khaustov Sergei A.

    2016-01-01

    Full Text Available The urgency of the discussed issue is caused by the need to substitute in the regional fuel-energy balances imported energy resources with local low-grade fuels. The main aim of the study is to estimate thermal properties of local fuels in Tomsk region and evaluate its energy use viability. The methods used in the study were based standard GOST 52911-2008, 11022-95 and 6382-2001, by means of a bomb calorimeter ABK-1 and Vario micro cube analyzer. The mineral ash of researched fuels was studied agreeing with GOST 10538-87. The results state the fact that discussed low-grade fuels of Tomsk region in the unprepared form are not able to replace imported coal in regional energy balance, because of the high moisture and ash content values. A promosing direction of a low-temperature fue processing is a catalytic converter, which allows receiving hydrogen-enriched syngas from the initial solid raw.

  15. An electrochemical system for efficiently harvesting low-grade heat energy.

    Science.gov (United States)

    Lee, Seok Woo; Yang, Yuan; Lee, Hyun-Wook; Ghasemi, Hadi; Kraemer, Daniel; Chen, Gang; Cui, Yi

    2014-05-21

    Efficient and low-cost thermal energy-harvesting systems are needed to utilize the tremendous low-grade heat sources. Although thermoelectric devices are attractive, its efficiency is limited by the relatively low figure-of-merit and low-temperature differential. An alternative approach is to explore thermodynamic cycles. Thermogalvanic effect, the dependence of electrode potential on temperature, can construct such cycles. In one cycle, an electrochemical cell is charged at a temperature and then discharged at a different temperature with higher cell voltage, thereby converting heat to electricity. Here we report an electrochemical system using a copper hexacyanoferrate cathode and a Cu/Cu(2+) anode to convert heat into electricity. The electrode materials have low polarization, high charge capacity, moderate temperature coefficients and low specific heat. These features lead to a high heat-to-electricity energy conversion efficiency of 5.7% when cycled between 10 and 60 °C, opening a promising way to utilize low-grade heat.

  16. Supratentorial low-grade glioma: results and prognostic factors following postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Grabenbauer, G.G.; Roedel, C.M.; Schuchardt, U.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Radiation Oncology; Paulus, W. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neuropathology; Ganslandt, O.; Buchfelder, M.; Schrell, U.; Fahlbusch, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Neurochirurgische Klinik mit Poliklinik; Huk, W.J. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neuroradiology

    2000-06-01

    Background and Purpose: To assess treatment outcome and prognostic factors following postoperative external radiotherapy in 77 patients with low-grade glioma. Patients and Methods: Between 1977 and 1996, 45 patients with astrocytoma, 14 with oligodendroglioma and 18 with mixed glioma received postoperative radiotherapy with a median total dose of 52 Gy (range, 45 to 61 Gy). Sixty-seven patients were treated immediately following surgery, 10 patients with tumor progression. The influence of various factors including histology, gender, age, seizures, duration of symptoms ({<=}6 weeks vs >6 weeks), CT pattern (enhancement vs no enhancement), type of surgery, total radiotherapy dose and timing of radiotherapy on relapse-free survival and overall survival was investigated. Results: The median overall survival time was 81 months, the 5- and 10-year survival rates were 54% and 31%, respectively. The median time to progression was 56 months, while the 5- and 10-year progression-free survival rates were 45% and 24%. Univariate analyses identified the total radiotherapy dose (p=0.01), duration of symptoms (p=0.05), the presence of seizures (p=0.04), and the CT pattern following intravenous contrast (p=0.005) as significant prognostic factors for overall survival. Progression-free survival rates were influenced by the total dose (p=0.04), the duration of symptoms (p=0.01) and CT pattern (p=0.006). On multivariate analysis, only the CT pattern (enhancement vs no enhancement) remained as independent prognostic factors for both progession-free survival and overall survival. Conclusion: A minimum total dose of 52 Gy is recommended for the postoperative radiotherapy in low-grade glioma. Tumors with CT enhancement seem to need further intensification of treatment. (orig.) [German] Hintergrund: Es sollten Ergebnisse und Prognosefaktoren nach postoperativer Radiotherapie bei 77 Patienten mit Low-grade-Gliomen evaluiert werden. Patienten und Methoden: Zwischen 1977 und 1996 wurden 45

  17. Posterolateral fusion in spondylolisthesis of the lumbosacral segment. Fusión posterolateral en la espondilolistesis del segmento lumbosacro.

    Directory of Open Access Journals (Sweden)

    Dania Zúñiga Estrada

    Full Text Available Background: Since centuries ago it has been written about lumbar pain, still its treatment remains enigmatic. At present, all developed spinal surgery institutions use the transpedicular fixation methods, but we lack the right technology for what we use the posterolateral fusion. Objetive: to evaluate the results in the aplicate of the posterolateral fusion in spondylolisthesis of the lumbosacral segment. Methods: A Retrospective-descriptive, correlational, and of a series of cases study, carried out in traumatology and orthopaedics service of the Universitarian Provincial Hospital ¨Dr. Gustavo Aldereguía Lima¨ of Cienfuegos, in which were included the 33 patients with spondylisthesis of the lumbosacral segment, who received inter-transversal posterolateral fusion. All the patients got plain anteroposterior and lateral radiography, including right and left slanting sights, to the doubtful cases dynamic sights with flexion and extension of the trunk were applied. To the patients with signs of radicular irritation, a digitalized axial tomography was applied. Results: The main etiological causes in these patients were the isthmic one, followed by degenerative and dysplastic ones. The posterolateral function was carried out alone or combined with other surgical techniques; to the patients with lumbar pain that also had associated signs of radicular irritation were applied exeresis of posterior arch with release of the endangered roots. The more frequent complication was the recurrent pain, present in 6 patients, followed by granuloma of the surgical wound. Conclusions: In spite of lacking a modern instrumentation system, the problem of spondylolisthesis can be solved with only dominating this traditional technique consistent in posterolateral fixation.
    Fundamento: Del dolor lumbar se ha escrito durante siglos y aún su

  18. Cytologic diagnosis of low-grade papillary urothelial neoplasms (low malignant potential and low-grade carcinoma) in the context of the 1998 WHO/ISUP classification.

    Science.gov (United States)

    Whisnant, Richard E; Bastacky, Sheldon I; Ohori, N Paul

    2003-04-01

    The 1998 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification of urothelial neoplasms introduced a category called papillary neoplasm of low malignant potential (LMP) and separated it from low-grade papillary urothelial carcinoma (LGPUC), which was thought to yield abnormal cells in cytology specimens. The objective of our study was to evaluate the effectiveness of urine cytology in diagnosing these lesions. Eighty-six paired transurethral surgical biopsy and corresponding urine cytology specimens representing the spectrum of urothelial papillary lesions were examined. Consensus diagnosis on each biopsy was made, and the distribution was as follows: 16 benign urothelium, 27 LMP, 28 LGPUC, and 15 high-grade papillary urothelial carcinoma (HGPUC). This was followed by a blinded independent review of the urine cytology specimens by three observers. Each cytology case was marked as negative, atypical, suspicious, or positive for malignant cells by using previously published cytologic criteria. When the negative and atypical diagnoses were grouped together as "benign" and the suspicious and malignant diagnoses as "malignant," the detection rate of "malignancy" of the lesions was as follows: LMP, 37%; LGPUC, 25%; and HGPUC, 53%. The false positive rate was 6%, and the positive predictive value (PPV) was 94%. Detection rates of cells that were at least "atypical" were as follows: LMP, 74%; LGPUC, 79%; and HGPUC, 100%. While most of the LMP and LGPUC cases yielded cells that were at least "atypical," there was no significant difference in the distribution of cytologic diagnoses for LMP and LGPUC cases (P > 0.05). Urine cytology in the context of the 1998 WHO/ISUP classification appears to be useful as a screening tool but does not appear to discriminate LMP effectively from LGPUC. Copyright 2003 Wiley-Liss, Inc.

  19. Sagittal spinopelvic parameters in 2-level lumbar degenerative spondylolisthesis

    Science.gov (United States)

    Wang, Tao; Wang, Hui; Liu, Huan; Ma, Lei; Liu, Feng-Yu; Ding, Wen-Yuan

    2016-01-01

    Abstract The purpose of our study is to evaluate sagittal parameters in 2-level lumbar degenerative spondylolisthesis (DS) (TLDS). A total of 15 patients with TLDS, 40 patients with single-level DS (SLDS), and 30 normal volunteers as control were included in our study. All subjects performed on full spine X-ray. Two categorized data were analyzed: patient characteristics—age, sex, body mass index, radiographic parameters-pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), sacral slope (SS), PI–LL, Cobb between the fifth thoracic vertebral and 12th thoracic vertebral (T5–T12), sagittal vertical axis (SVA) Cobb angle of spondylolisthesis level (CSL), ratio of PT to SS (PT/SS), CSL/LL, variation trend of SS over PI, and LL over PI. The PI (73.1° vs 52.9°), SS (50.8° vs 32.2°), LL (53.1° vs 46.9°), SVA (66.1 vs 22.0 mm), PI–LL (20.0° vs 6.0°), and CSL (23.6° vs 20.0°) in TLDS were significantly larger than these in SLDS. The PI (73.1° vs 40.6°), PT (22.3° vs 17.1°), SS (50.8° vs 23.5°), LL (53.1° vs 32.5°), PI–LL (20.0° vs 8.1°), and SVA (66.1 vs 17.0 mm) in TLDS were significantly larger than those in the normal group (NG). The PI (52.9° vs 40.6°), PT (21.0° vs 17.1°), SS (32.2° vs 23.5°), LL (46.9° vs 32.5°), and SVA (22.0 vs 17.0 mm) in SLDS were significantly higher than those in NG. However, PT/SS (44.0%), LL over PI (y = 0.39x + 24.25), SS over PI (y = 10.79 + 0.55x) were lower in TLDS than these in SLDS (63.8%, y = 0.41x + 25, y = 0.65x − 2.09, respectively), and the similar tend between SLDS and NG (74.0%, y = 0.49x + 13.09, y = 0.67x − 3.9, respectively). Our results showed that 2-level lumbar DS, which was caused by multiple-factors, has a severe sagittal imbalance, but single-level has not any. When we plan for surgical selection for 2-level lumbar DS, global sagittal balance must be considered. PMID:27977581

  20. Investigation of denitrifying microbial communities within an agricultural drainage system fitted with low-grade weirs.

    Science.gov (United States)

    Baker, Beth H; Kröger, Robert; Brooks, John P; Smith, Renotta K; Czarnecki, Joby M Prince

    2015-12-15

    Enhancing wetland characteristics in agricultural drainage ditches with the use of low-grade weirs, has been identified as a best management practice (BMP) to mitigate nutrient runoff from agriculture landscapes. A major objective of utilizing low-grade weirs as a BMP includes fostering environments suitable for the biogeochemical removal of nitrogen via denitrification. This study examined the spatial resolution of microbial communities involved in denitrification in agricultural drainage systems fitted with low-grade weirs. Appropriate sampling scales of microbial communities were investigated using 16S rRNA and denitrification functional genes nosZ, nirS, and nirK via quantitative polymerase chain reaction (qPCR) and terminal-restriction fragment length polymorphism (T-RFLP) analysis. Genes 16S rRNA, nosZ, and nirS were all successfully detected in soil samples, while nirK was below the detection limit throughout the study. Utilizing a combination of three sampling regimes (management, reach, catchment) was found to be effective in capturing microbial community patterns, as ANOVA results revealed nosZ gene abundance was significantly greater at the management rather than reach scale (p = 0.045; F = 3.311), although, no significant differences were observed in 16S rRNA or nirS between sampling scales (p > 0.05). A Pearson correlation matrix confirmed that 16S rRNA and nosZ gene abundances were positively correlated with soil carbon (C), nitrogen (N), and moisture, while nirS abundance was only positively correlated with soil C and soil moisture. This highlights the potential for wetland-like characteristics to be recovered in agricultural drainage systems, as weir proximity is observed to enhance soil moisture and conditions for N remediation. This study provides the basis for additional investigations of these unique environments in the Mississippi Alluvial Valley and a starting point for adaptive management to enhance agricultural drainage systems for microbial

  1. A novel technique to repair a transverse sacral fracture in a previously fused lumbosacral spondylolisthesis

    Science.gov (United States)

    Noh, Thomas; Chedid, Mokbel K.

    2016-01-01

    Background: Transverse fractures of the sacrum are rare, and surgical treatment for these fractures ranges from conservative to challenging. Transverse stress fractures of the sacrum after placement of lumbar-to-sacral instrumentation have been previously described. We report a new technique to repair a transverse Type-2 Roy-Camille fracture with spondylolisthesis of S1 over S2 in a previously fused instrumented high-grade L4-L5, L5-S1 spondylolisthesis. Case Description: A 64-year-old female who previously had an L4-L5, L5-S1 fusion for spondylolisthesis presented with excruciating lower back pain and radiculopathy for over 6 months. She was found to have an S1-S2 transverse fracture caused by previous implantation of pedicle screws. She underwent repositioning of several failed right lumbar and sacral screws and then had bilateral S1-S2 screws placed directly across the fracture line. The patient had an unremarkable postoperative course. She discontinued most of her pain medications within 6 weeks postoperatively. In the months following surgery, she reported only minimal lower back pain and no radiculopathy with the last appointment 5 years postoperatively. Conclusions: We describe a novel technique to reduce an iatrogenic transverse type-2 Roy-Camille fracture at S1-S2 in a previously instrumented high-grade L4-L5, L5-S1 spondylolisthesis. The patient's fracture achieved adequate reduction and fusion with symptomatic relief. PMID:28028448

  2. Grade 1 spondylolisthesis and interspinous device placement: removal in six patients and analysis of current data

    Directory of Open Access Journals (Sweden)

    Parker E Bohm

    2015-01-01

    Conclusions: Regarding patients receiving interspinous devices for symptomatic lumbar spinal stenosis, several high-quality studies have failed to demonstrate a statistical difference in outcomes between patients with or without Grade 1 spondylolisthesis. Nevertheless, surgeons should have a high degree of suspicion when considering use of interspinous devices in this patient population.

  3. A novel technique to repair a transverse sacral fracture in a previously fused lumbosacral spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Thomas Noh

    2016-01-01

    Conclusions: We describe a novel technique to reduce an iatrogenic transverse type-2 Roy-Camille fracture at S1-S2 in a previously instrumented high-grade L4-L5, L5-S1 spondylolisthesis. The patient′s fracture achieved adequate reduction and fusion with symptomatic relief.

  4. Disk hernia and spondylolisthesis diagnosis using biomechanical features and neural network.

    Science.gov (United States)

    Oyedotun, Oyebade K; Olaniyi, Ebenezer O; Khashman, Adnan

    2016-01-01

    Artificial neural networks have found applications in various areas of medical diagnosis. The capability of neural networks to learn medical data, mining useful and complex relationships that exist between attributes has earned it a major domain in decision support systems. This paper proposes a fast automatic system for the diagnosis of disk hernia and spondylolisthesis using biomechanical features and neural network. Such systems as described within this work allow the diagnosis of new cases using trained neural networks; patients are classified as either having disk hernia, spondylolisthesis, or normal. Generally, both disk hernia and spondylolisthesis present similar symptoms; hence, diagnosis is prone to inter-misclassification error. This work is significant in that the proposed systems are capable of making fast decisions on such somewhat difficult diagnoses with reasonable accuracies. Feedforward neural network and radial basis function networks are trained on data obtained from a public database. The results obtained within this research are promising and show that neural networks can find applications as efficient and effective expert systems for the diagnosis of disk hernia and spondylolisthesis.

  5. [Spondylolisthesis and pseudospondylolisthesis. Treatment by segmental reposition and interbody fusion with fixateur interne].

    Science.gov (United States)

    Kluger, P; Weidt, F; Puhl, W

    1997-09-01

    In spondylolisthesis with an indication for fusion and with a slipping of more than 50% at least a partial reposition should be reached in general because the incidence of pseudarthrosis would increase with a fusion in situ and a large disturbance of the spinal statics would persist. Hereby with almost all methods an enlarged operative morbidity and often a longer fusion range has to be taken in account compared to the fusion in situ. Therefore, in smaller slippages the fusion in situ will be favoured because the disturbance of the statics is not so important, that such an effort combined with such methods is necessary. If the operation method with small spondylolisthesis and pseudospondylolisthesis allows the reposition without much effort and if the operative morbidity in comparison with the fusion in situ is not higher, then it is reasonable to fuse the cases with a spondylolisthesis Meyerding grade 1 and 2 in the anatomic corrected position too. Because the spinal fixator we use fills out these criteria we combine the correction of the position with the fusion also in cases of small spondylolisthesis. The incidence of neurologic complications correlates with the amount of the reposition distance and can be caused by preforaminal or extraforaminal lesions. The reduction of small malpositions could only produce preforaminal lesions. Using the spine fixator with its reposition instruments linked outside the wound and with it's un-inhibited access to the segment and to the preforaminal neural structures during the whole repositioning these lesions can be avoided.

  6. Patient Outcomes in the Operative and Nonoperative Management of High-Grade Spondylolisthesis in Children

    DEFF Research Database (Denmark)

    Lundine, K. M.; Lewis, S. J.; Al-Aubaidi, Zaid

    2014-01-01

    with slip reduction maneuvers. There is a paucity of literature regarding nonoperative management in this setting. This study sought to obtain outcome measures in pediatric patients with high-grade spondylolisthesis managed either operatively or nonoperatively.Methods:Database review was performed...

  7. Low-Grade Esthesioneuroblastoma Presenting as SIADH: A Review of Atypical Manifestations

    Directory of Open Access Journals (Sweden)

    Andrew Senchak

    2012-01-01

    Full Text Available Esthesioneuroblastoma (ENB is a neuroendocrine tumor that typically manifests as advanced stage malignancy in the superior nasal cavity. The hallmark symptoms include nasal obstruction and epistaxis, which result from local tissue invasion. Atypical clinical features can also arise and must be considered when diagnosing and treating ENB. These can include origin in an ectopic location, unusual presenting symptoms, and associated paraneoplastic syndromes. The case described here reports a nasal cavity ENB with atypical clinical features that occurred in a young female. Her tumor was low grade, appeared to arise primarily from the middle nasal cavity, and presented as syndrome of inappropriate antidiuretic hormone (SIADH. She also became pregnant shortly after diagnosis, which had implications on her surgical management. We review the atypical features that uncommonly occur with ENB and the clinical considerations that arise from these unusual characteristics.

  8. High Efficient Enrichment and Activated Dissolution of Refractory Low Grade Rh-containing Material

    Institute of Scientific and Technical Information of China (English)

    WU Xiaofeng; DONG Haigang; TONG Weifeng; ZHAO Jiachun; ZENG Rui

    2012-01-01

    Aiming to the low-grade rhodium-containing waste materials,a new process was proposed to enrich and activate rhodium by smelting using iron oxide as a trapping agent and activator.A rhodium concentrate was obtained by the separation of base metals and precious metals.The concentrate was reacted with dilute aqua regia to obtain rhodium solution.The factors influencing the enrichment and activation effects were discussed in this paper.The results showed that the dissolution rate is greater than 99% under the optimum conditions.In this process,the activation of rhodium was finished in the enrichment process.The iron oxide is both a trapping agent and activator,which simplifies the process and reduce the cost.

  9. Principles of Treatment for Borderline, Micropapillary Serous, and Low-Grade Ovarian Cancer.

    Science.gov (United States)

    Hacker, Kari E; Uppal, Shitanshu; Johnston, Carolyn

    2016-09-01

    Borderline ovarian tumors (BOTs) are less common than epithelial ovarian cancers (EOCs). Low-grade EOCs (LG-EOCs) occur even less frequently than BOTs. After primary therapy, recurrence rates of BOTs and LG-EOCs are significantly lower and the stage-adjusted survival is higher than for high-grade EOCs. Thus, determining the best management in terms of traditional ovarian cancer staging and debulking procedures is more challenging and has been recently brought to question. This article reviews the particulars of BOTs and LG-EOCs, their similarities and differences, and how they are best managed and treated, and emphasizes the major role of surgery and the controversial role of chemotherapy. Because these tumors disproportionately affect younger women, this review addresses ovarian preservation in circumstances when fertility or hormonal preservation is desired.

  10. Combined Oral Contraception and Obesity Are Strong Predictors of Low-Grade Inflammation in Healthy Individuals

    DEFF Research Database (Denmark)

    Sørensen, Cecilie J; Pedersen, Ole B; Petersen, Mikkel S

    2014-01-01

    BACKGROUND: C-reactive protein (CRP) is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI), is associated with increased risk of several diseases, especially cardiovascular...... disease. The aim of this study was to identify predictors of increased CRP levels in healthy individuals. We therefore assessed CRP in a large cohort of blood donors. METHODS: We measured plasma CRP levels in 15,684 participants from the Danish Blood Donor Study. CRP was measured by a commercial assay...... and abdominal obesity strongly predicted LGI among healthy individuals. However, the most striking finding was the high prevalence of LGI among premenopausal women who used combined oral contraception. Although the significance of CRP as a marker of inflammation is well known, the role of CRP in pathogenesis...

  11. Diagnostic Challenges of Low-Grade Central Osteosarcoma of Jaw: a Literature Review

    Directory of Open Access Journals (Sweden)

    Seyd Hosein Tabatabaei

    2015-06-01

    Full Text Available Low Grade Central Osteosarcoma (LGCO is a rare subtype of osteosarcoma that is less aggressive than conventional osteosarcoma. The importance of LGCO lies in the fact that regarding microscopic and radiographic features, it occasionally simulates some benign jaw lesions and would consequently be misdiagnosed in many patients. The present study was conducted to collect the information and descriptive analyses related to ten cases reported between 1987 and 2010, including a sample reported by the authors emphasizing on diagnostic errors and the prevailing misdiagnosis. The aforementioned reports were gathered in full-texts through Google and PubMed search engines. Conclusion: The results of this study showed that the pathologists should exactly evaluate the clinical, radiographic, and histopathologic features in order to observe the evidence of invasion.

  12. Effect of technological factors on bacterial leaching of low-grade Ni-Cu sulfide ore

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The bioleaching of a low-grade Ni-Cu sulfide ore from Jinchuan Mine with Thiobacillus ferrooxidans (TF5) and Thiobaxillus thiooxxidlans (TT) was investigated. The effect of pH, the initial cell numbers of bacteria, the pulp den sity and the ratio of TF5 and TT on leaching was described, and the favorable bioleaching conditions for the ore were ex perimentally confirmed. The aeration leaching, agitation leaching with air bubbling, and column leaching were respective ly tested. The highest recovery was achieved in the aeration leaching. After leaching for 20 d with pulp density of 15 %, the extractions of Ni, Cu and Co were respectively 95.4 %, 48.6 % and 82.6 %.

  13. Associations of low grade inflammation and endothelial dysfunction with depression - The Maastricht Study

    DEFF Research Database (Denmark)

    van Dooren, Fleur E P; Schram, Miranda T; Schalkwijk, Casper G

    2016-01-01

    in this association. METHODS: In The Maastricht Study, a population-based cohort study (n=852, 55% men, m=59.8±8.5years), depressive symptoms were assessed with the Patient Health Questionnaire-9 and (major and minor) depressive disorder with the Mini-International Neuropsychiatric Interview. Plasma biomarkers......BACKGROUND: The pathogenesis of depression may involve low-grade inflammation and endothelial dysfunction. We aimed to evaluate the independent associations of inflammation and endothelial dysfunction with depressive symptoms and depressive disorder, and the role of lifestyle factors......E-Selectin) were univariately associated with depressive symptoms and depressive disorder. The sum scores of inflammation and endothelial dysfunction were associated with depressive disorder after adjustment for age, sex, type 2 diabetes, kidney function and prior cardiovascular disease (OR 1.54, p=0.001 and 1...

  14. Waist circumference is related to low-grade inflammation in youth

    DEFF Research Database (Denmark)

    Steene-Johannessen, Jostein; Kolle, Elin; Resaland, GK

    2010-01-01

    included as controls. Inflammatory markers included C-reactive protein (CRP), leptin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor-alpha (TNF-alpha), hepatocyte growth factor (HGF), resistin and interleukin-6 (IL-6). The CVD risk factors included blood pressure, glucose......Abstract Objectives. To examine markers of inflammation in 9- and 15-year-olds with high waist circumference and compare these with controls, and to examine the relationships between inflammatory markers and cardiovascular disease (CVD) risk factors. Methods. Cross-sectional analysis of data from 2.......51) compared with controls. All CVD risk factors differed between the HW group and controls. The CVD risk factors were not associated with TNFalpha or IL-6, but CRP, HGF and PAI-1 were related to the metabolic risk score. Conclusions. Low grade systemic inflammation is already present in youth with high waist...

  15. Neutral Leaching of Low-Grade Pyrolusite with High Silica Content

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Leaching studies of low-grade pyrolusite, containing 11.84% Mn with high silicon, were carried out using sodium sulfite as a reductant in ammonium sulfate medium. Various process parameters including temperature, leaching time, solid-liquid ratio, quantity of ammonium sulfate, as well as the amount of reducing agent were studied in detail. The manganese extraction yield was the response of the process. Temperature and reagent concentration exerted the most important positive effect on the manganese extraction. The optimized conditions showed that when the amount of reducing agent was a stoichonmetric amount, over 90% manganese extraction and the lowest impurities were achieved, the amount of heavy metal impurities in the manganese leaching liquid was less than 5 mg/L, and almost no iron and aluminum were extracted in 3 mol/L ammonium sulfate concentration at 100 ℃ in 45 min.

  16. Experimental study on preferential solution flow during dump leaching of low-grade ores

    Institute of Scientific and Technical Information of China (English)

    YIN Sheng-hua; WU Ai-xiang; SU Yong-ding; ZHANG Jie

    2007-01-01

    The phenomenon of preferential solution flow during dump leaching of low-grade ores was studied. The formative mechanism of preferential solution flow was investigated through analyzing the relationship between permeability and ore diameter,and the relationship between surface tension and ore diameter. The preferential solution flow happened within the fine ore area when the dump was unsaturated. And it could happen within the coarse ore area when the dump became saturated. The results of experiment show that the outflow of coarse ore area increases sharply with higher applied rate. The outflow of fine ore area is greater than that of coarse ore area when the applied rate is below 3.2 L/min, and the preferential solution flow happens in fine ore area. But the preferential solution flow happens in coarse ore area when the applied rate is higher than 3.2 L/min. The result of the experiment is consistent with the mechanism analyzing.

  17. Investigating depression-like and metabolic parameters in a chronic low-grade inflammation model

    DEFF Research Database (Denmark)

    Fischer, C. W.; Elfving, B.; Lund, S.

    2012-01-01

    that elevated markers of inflammation predict a poor response to treatment. Furthermore, increasing evidences show that metabolic abnormalities such as obesity and diabetes mellitus type 2 are associated with a low-grade inflammation. Objectives: The aim of this study is to investigate the effects of a systemic...... levels of pro-inflammatory cytokines (TNF-alpha, IL-1, IL-6) together with the expression of enzymes involved in the tryptophan-kynurenine pathway, will be analyzed in specific brain regions using real-time qPCR. Body weight and food intake was measured once a week, while fasting glucose and insulin...... disturbances or sickness behavior. Thus, this model might help elucidating some of the mechanisms underlying inflammation-associated depression, in order to assist in developing more effective treatment strategies for this group of patients....

  18. Silver-catalyzed bioleaching for raw low-grade copper sulphide ores

    Institute of Scientific and Technical Information of China (English)

    Tianlong DENG; Yafei GUO; Mengxia LIAO; Dongchan LI

    2009-01-01

    This research was conducted to investigate the biooxidation and copper dissolution from raw low-grade refractory copper sulphide ores located in the Xinjiang Autonomous Region of China using adapted Thiobacillus ferrooxidans bacteria. In order to accelerate the bioleach-ing rate, the adapted mixed bacteria and silver ion catalyst were tested in the leach columns at laboratory scale. The overall acid consumption was 4.3 kg sulphuric acid per kg of dissolved copper and was linearly related to the percent copper dissolution. The calculated copper dissolution rates obey the Shrinking Core Model. The relative activation energy of the whole biooxidative leaching stages was calculated to be 48.58 kJ/mol.

  19. Giant Sporadic Low Grade Malignant Peripheral Nerve Sheath (MPNST) of Left Thigh.

    Science.gov (United States)

    Nikumbh, Dhiraj B; Suryawanshi, K H; Dravid, N V; Patil, T B; Rokade, C M

    2013-06-01

    Malignant Peripheral Nerve Sheath Tumours (MPNST) are rare spindle- cell sarcomas which are derived from the schwann cells or the pleuripotent cells of the neural crest. MPNSTs are usually located in the peripheral nerve trunk roots, extremities and in the head and neck region. These tumours may arise as sporadic variants or in patients with neurofibromatosis1 (NF1). The estimated incidence of MPNSTs in the patients with NF1is 2-5% as compared to a 0.001% incidence in the general population. Herein, we are reporting a case of a giant sporadic (NF1 independent) low grade MPNST of the left thigh in 65 year female patient, which had a good prognosis.

  20. Assessment of quality of life in patients treated for low-grade glioma: a preliminary report.

    Science.gov (United States)

    Taphoorn, M J; Heimans, J J; Snoek, F J; Lindeboom, J; Oosterink, B; Wolbers, J G; Karim, A B

    1992-01-01

    In this pilot study quality of life was assessed in fourteen adult patients who were treated for a low-grade glioma with surgery and radiotherapy at least one year previously. Apart from widely used parameters, such as the neurological and functional status, the patients' cognitive functioning and actual affective status were determined. In addition the patients were interviewed to evaluate various aspects of quality of life. Generally no serious focal neurological deficits were found, although psychological examination showed serious cognitive and affective disturbances in most cases. Self report measures concerning cognitive functioning were not in all cases in accordance with objective test results. When the results of treatment in glioma patients are evaluated assessment of quality of life, including neuropsychological functioning, should be performed, especially as new therapeutic strategies are being developed. PMID:1602310

  1. Plantar fibromatosis may adopt the brain gyriform pattern of a low-grade fibromyxoid sarcoma.

    Science.gov (United States)

    Touraine, Sébastien; Bousson, Valérie; Kaci, Rachid; Parlier-Cuau, Caroline; Haddad, Samuel; Laouisset, Liess; Petrover, David; Laredo, Jean-Denis

    2013-01-01

    We report the case of a 42-year-old man with histologically proven plantar fibromatosis (Ledderhose disease) demonstrating an uncommon brain gyriform pattern at MRI, so far exclusively described in the low-grade fibromyxoid sarcoma (LGFMS). An acoustic posterior enhancement at ultrasound, a high intensity on T2w and post-contrast T1wMR images were unusual and related to a high tumor cellularity at histology with no myxoid tissue. The juxtaposition of areas of high and low cellularity (with more fibrous material) in a multilobulated mass built a brain gyriform pattern at MR, similar to what was so far described exclusively in LGFMS. This case demonstrates that the brain gyriform pattern may also be observed in other soft tissue fibrous tumors with no myxoid material but with high cellularity areas alternating with fibrous zones of low cellularity. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Rapid Multiorgan Dissemination of Low-Grade Myxofibrosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yasutaka Murahashi

    2012-01-01

    Full Text Available Myxofibrosarcoma is one of the most common sarcomas in the extremities of elderly people. It is characterized by a high frequency of local recurrence due to an infiltrative growth property. In contrast, the overall risk of distant metastases is generally low. This makes the prognosis for the patients with myxofibrosarcoma definitely good. In this paper, we will report the case of a 79-year-old female with very aggressive metastatic low-grade myxofibrosarcoma. The disease progression was really unexpected and misled every possible medical interpretation, leading to rapid worsening of the patient's clinical conditions and no chance for therapy. The tumor developed diffuse infiltration in lung, spine, skeletal bone, abdomen, paravertebral muscles, and liver. The patient died 8 months after the diagnosis of remote metastases due to rapid tumor progression.

  3. Adaptability of language-related brain network in a low-grade glioma patient

    Institute of Scientific and Technical Information of China (English)

    Olivera Sveljo; Katarina Koprivsek; Milos Lucic

    2011-01-01

    Because functional magnetic resonance imaging can be used for dynamic observation of functional cortical changes after brain injuries, we followed up functional magnetic resonance imaging manifestationsof a language-related brain network in a low -grade glioma patient. Disease progressionand therapy during a 3-year period were followed up at different time points: before and after reoperation,after radiation therapy, and 1 year after irradiation. During the whole 3-year follow -up period,the patient exhibited no neurological deficits while functional magnetic resonance imaging revealeddifferent topologies of the language-related brain network. During disease progression and after irradiation,the language-related brain network was extended or completely transferred to the nondominant(right) hemisphere. In addition, after reoperation and 1 year after irradiation, languageareas were primarily found in the language dominant (left) hemisphere. Our results suggest a highlevel of adaptability of the language-related cortical network of the bilateral hemispheres in thislow -grade glioma patient.

  4. Low-Grade Astrocytoma Associated with Abscess Formation: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tai-Hsin Tsai

    2008-05-01

    Full Text Available A rare case of low-grade astrocytoma associated with abscess formation occurred in a 52-year-old man presenting with Broca's aphasia. He underwent craniotomy and tumor removal under the impression of brain tumor with necrotic cystic change. Abscess accumulation within the intra-axial tumor was found intraoperatively. Literature related to brain abscess with brain tumor is reviewed, with an emphasis on abscesses with astrocytoma. We discuss the common brain tumors that are associated with abscess, pathogens that coexist with brain tumor, and the pathogeneses of coexisting brain abscess and tumor. It is very important to know how to differentiate between and diagnose a brain abscess and tumor, or brain abscess with tumor, preoperatively from clinical presentation and through the use of computed tomography, conventional magnetic resonance imaging, diffusion-weighted imaging or magnetic resonance spectroscopy.

  5. Role of immune cells in obesity induced low grade inflammation and insulin resistance.

    Science.gov (United States)

    Asghar, Ambreen; Sheikh, Nadeem

    2017-05-01

    The frequency of obesity is enormously growing worldwide. Obesity results when energy intake exceeds, energy expenditure. Excess adiposity is a major risk factor in the progress of various metabolic disorders accounting insulin resistance, hypertension, Type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovarian disease and several types of cancers. Obesity is characterized by pro-inflammatory condition in which hypertrophied adipose tissue along with immune cells contribute to increase the level of pro-inflammatory cytokines. Immune cells are the key players in inducing low grade chronic inflammation in obesity and are main factor responsible for pathogenesis of insulin resistance resulting Type 2 diabetes. The current review is aimed to investigate the mechanism of pro-inflammatory responses and insulin resistance involving immune cells and their products in obesity. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Sodium sulfide leaching of low-grade jamesonite concentrate in production of sodium pyroantimoniate

    Institute of Scientific and Technical Information of China (English)

    YANG Tian-zu; JIANG Ming-xi; LAI Qiong-lin; CHEN Jin-zhong

    2005-01-01

    Sodium sulfide leaching of a low-grade jamesonite concentrate in the production of sodium pyroantimoniate through the air oxidation process and the influencing factors on the leaching rate of antimony were investigated.In order to decrease the consumption of sodium sulfide and increase the concentration of antimony in the leaching solution, two-stage leaching of jamesonite concentrate and combination leaching of high-grade stibnite concentrate and jamesonite concentrate were used. The experimental results showthat the consumptions of sodium sulfide for the two-stage leaching process and the combination leaching process are decreased by 20% and 60% compared to those of one-stage leaching process respectively. The final concentrations of antimony in the leaching solutions of both processes are above 100 g/L.

  7. Combustion of low grade fractions of Lubnica coal in fluidized bed

    Directory of Open Access Journals (Sweden)

    Mladenović Milica R.

    2012-01-01

    Full Text Available In this paper a method of examination of fuel suitability for fluidized bed combustion is presented. The research of combustion characteristics of low grade fractions of Lubnica brown coal in the fluidized bed by the aforementioned methodology has been carried out on a laboratory semi-industrial apparatus of 200 kWt. Description of the experimental fluidized bed combustion facility is given, as well as experimental results, with the focus on furnace temperature distribution, in order to determine the location of the zone of intensive combustion. Based on investigation results, which are focused on combustion quality (combustion completion as well as on satisfying the environmental protection criteria, it can be stated that the investigated coal is suitable for burning in bubbling, as well as in circulating fluidized bed.

  8. Recovery of zinc from low-grade zinc oxide ores by solvent extraction

    Institute of Scientific and Technical Information of China (English)

    覃文庆; 蓝卓越; 黎维中

    2003-01-01

    The recovery of zinc from low-grade zinc oxide ores with solvent extraction-electrowinning technique was investigated by using D2EHPA as extractant and 260# kerosene as diluent. The results show that it is possible to selectively leach zinc from the ores by heap leaching. The zinc concentration of leach solution in the first leaching cycle is 32.57 g/L, and in the sixteenth cycle the zinc concentration is 8.27g/L after solvent extraction. The leaching solution is subjected to solvent extraction, scrubbing and selective stripping for enrichment of zinc and removal of impurities. The pregnant zinc sulfate solution produced from the stripping cycle is suitable for zinc electrowinning.Extra-pure zinc metal was obtained in the electrowinning test under conventional conditions.

  9. Low grade dysplasia in Barrett’s esophagus:Should we worry?

    Institute of Scientific and Technical Information of China (English)

    Vamshi; P; Jagadesham; Clive; J; Kelty

    2014-01-01

    The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endoscopic surveillance is a management option but is plagued by sampling error and issues of suboptimal endoscopy.Furthermore endoscopic surveillance has not been demonstrated to be cost-effective or to reduce cancer mortality.The emergence of endoluminal therapy over the past decade has resulted in a paradigm shift in the management of LGD.Ablative therapy,including radiofrequency ablation,has demonstrated promising results in the management of LGD with regards to safety,cost-effectiveness,durability and reduction in cancer risk.It is,however,vital that a shareddecision making process occurs between the physician and the patient as to the preferred management of LGD.As such the management of LGD should be"individualised."

  10. High-efficient thermochemical sorption refrigeration driven by low-grade thermal energy

    Institute of Scientific and Technical Information of China (English)

    LI TingXian; WANG RuZhu; WANG LiWei

    2009-01-01

    Thermochemical sorption refrigeration powered by low-grade thermal energy is one of the en ergy-saving and environment friendly green refrigeration technologies. The operation principle of sorption refrigeration system is based on the thermal effects of reversible physicochemical reaction processes between sorbents and refrigerants. This paper presents the developing study on the differ ent thermochemical sorption refrigeration cycles, and some representative high-efficient thermo chemical sorption refrigeration cycles were evaluated and analyzed based on the conventional single-effect sorption cycle. These advanced sorption refrigeration cycles mainly include the heat and mass recovery sorption cycle, double-effect sorption cycle, multi-effect sorption cycle, combined douhie-way sorption cycle, and double-effect and double-way sorption cycle with internal heat recovery.Moreover, the developing tendency of the thermochemical sorption refrigeration is also predicted in this paper.

  11. Roles of Chronic Low-Grade Inflammation in the Development of Ectopic Fat Deposition

    Directory of Open Access Journals (Sweden)

    Lulu Liu

    2014-01-01

    Full Text Available Pattern of fat distribution is a major determinant for metabolic homeostasis. As a depot of energy, the storage of triglycerides in adipose tissue contributes to the normal fat distribution. Decreased capacity of fat storage in adipose tissue may result in ectopic fat deposition in nonadipose tissues such as liver, pancreas, and kidney. As a critical biomarker of metabolic complications, chronic low-grade inflammation may have the ability to affect the process of lipid accumulation and further lead to the disorder of fat distribution. In this review, we have collected the evidence linking inflammation with ectopic fat deposition to get a better understanding of the underlying mechanism, which may provide us with novel therapeutic strategies for metabolic disorders.

  12. Membrane-free battery for harvesting low-grade thermal energy.

    Science.gov (United States)

    Yang, Yuan; Loomis, James; Ghasemi, Hadi; Lee, Seok Woo; Wang, Yi Jenny; Cui, Yi; Chen, Gang

    2014-11-12

    Efficient and low-cost systems are desired to harvest the tremendous amount of energy stored in low-grade heat sources (membrane in this system raises concerns about the overall cost, which is crucial for waste heat harvesting. Here, we report on a new membrane-free battery with a nickel hexacyanoferrate (NiHCF) cathode and a silver/silver chloride anode. The system has a temperature coefficient of -0.74 mV K(-1). When the battery is discharged at 15 °C and recharged at 55 °C, thermal-to-electricity conversion efficiencies of 2.6% and 3.5% are achieved with assumed heat recuperation of 50% and 70%, respctively. This work opens new opportunities for using membrane-free electrochemical systems to harvest waste heat.

  13. Role of PGC-1α in acute and low-grade inflammation

    DEFF Research Database (Denmark)

    Olesen, Jesper

    inflammation as well as in the inflammatory response in mouse skeletal muscle. 2) Long-term exercise training and/or resveratrol supplementation prevents age-associated low-grade- and skeletal muscle inflammation in mice with PGC-1α being required for these improvements. 3) Exercise training and/or resveratrol....... However, PGC-1α was not mandatory for the exercise training-induced reductions in systemic IL-6 in mice, suggesting that additional factors contribute to the systemic anti-inflammatory effects of exercise training. Study II and III demonstrated that while resveratrol increased the protein content...... of the anti-oxidant enzyme GPX1 and appeared to reduce oxidative stress in mouse skeletal muscle, resveratrol did not elicit any antiinflammatory effects neither in mice nor in human subjects. In contrast, resveratrol even impaired the exercise training-induced reduction in protein carbonylation and TNFα m...

  14. Dedifferentiated liposarcoma of the retro-peritoneum: Histologically low-grade type

    Directory of Open Access Journals (Sweden)

    Parakh Rugvedita

    2010-04-01

    Full Text Available A dedifferentiated liposarcoma of the retro-peritoneum of a 45-year-old female is described in this case report. It showed dedifferentiation into a histological low-grade type and thus defies the traditional definition of dedifferentiated liposarcoma. The excised specimen was a huge, multi-nodular encapsulated mass surrounding the kidney and infiltrating into it. The mass showed a dedifferentiated focus different in color from the surrounding tumor and containing areas of necrosis and hemorrhage. The sections from the dedifferentiated part of the tumor appeared predominantly as benign spindle cell component on histology but the tumor was infiltrating into the kidney. Hence, a close and long-term follow-up is expected in such cases though they look benign. In the retro-peritoneum, a lipoma-like well-differentiated liposarcoma with spindle cell component, like the present tumor, which shows dedifferentiation, should not be overlooked.

  15. Obesity and Low-Grade Inflammation Increase Plasma Follistatin-Like 3 in Humans

    DEFF Research Database (Denmark)

    Brandt, Claus; Pedersen, Maria; Rinnov, Anders;

    2014-01-01

    BACKGROUND: Rodent models suggest that follistatin-like 3 (fstl3) is associated with diabetes and obesity. In humans, plasma fstl3 is reduced with gestational diabetes. In vitro, TNF-α induces fstl3 secretion, which suggests a link to inflammation. OBJECTIVE: To elucidate the association between...... plasma fstl3 and obesity, insulin resistance, and low-grade inflammation in humans. STUDY DESIGN: Plasma fstl3 levels were determined in a cross-sectional study including three groups: patients with type 2 diabetes, impaired glucose tolerance, and healthy controls. In addition, lipopolysaccharide (LPS......), TNF-α, or interleukin-6 (IL-6) as well as a hyperinsulinemic euglycemic clamp were used to examine if plasma fstl3 was acutely regulated in humans. RESULTS: Plasma fstl3 was increased in obese subjects independent of glycemic state. Moreover, plasma fstl3 was positively correlated with fat mass...

  16. Thermomagnetic conversion of low-grade waste heat into electrical power

    Science.gov (United States)

    El Achkar, G.; Dianoux, A.; Kheiri, A.; Maillet, D.; Mazet, T.; Colasson, S.; Feidt, M.; Rado, C.; Servant, F.; Paul-Boncour, V.

    2016-09-01

    A theoretical study relying on the thermal modelling of a Curie wheel, used for the conversion of low-grade waste heat into electrical power, is presented in this paper. It allows understanding the thermal behaviour of a Curie wheel operating in steady state in order to optimise its design. To this end, a stationary one-dimensional analytical thermal model, based on a Lagrangian approach, was developed. It allows determining the local distribution over time of the temperature in the magnetocaloric material exposed to a periodic sinusoidal heat source. Thanks to this model, the effects of different parameters (nature of the magnetocaloric material, nature and temperature of the fluid) were highlighted and studied.

  17. Predictors of seizure freedom after resection of supratentorial low-grade gliomas. A review.

    Science.gov (United States)

    Englot, Dario J; Berger, Mitchel S; Barbaro, Nicholas M; Chang, Edward F

    2011-08-01

    Seizures are the most frequent presenting symptom in patients with low-grade gliomas (LGGs), and significantly influence quality of life if they are uncontrolled. Achieving freedom from seizures is of utmost importance in surgical planning, but the factors associated with seizure control remain incompletely understood. The authors performed a systematic literature review of seizure outcomes after resection of LGGs causing seizures, examining 773 patients across 20 published series. Rates of seizure freedom were stratified across 7 variables: patient age, tumor location, preoperative seizure control with medication, seizure semiology, epilepsy duration, extent of resection, and the use of intraoperative electrocorticography (ECoG). Gross-total resection was most predictive of complete seizure freedom, when compared with subtotal resection (OR 3.41, 95% CI 2.36-4.93). Other predictors of seizure freedom included preoperative seizure control on antiepileptic medication (OR 2.12, 95% CI 1.33-3.38) and duration of seizures of ≤ 1 year (OR 1.85, 95% CI 1.22-2.79). Patients with simple partial seizure semiology achieved seizure freedom less often than those with complex partial, generalized, or mixed seizure types (OR 0.46, 95% CI 0.26-0.80). No significant differences in seizure outcome were observed between adults versus children, patients with temporal lobe versus extratemporal tumors, or with the use of intraoperative ECoG. Seizure control is one of the most important considerations in planning surgery for low-grade brain tumors. Gross-total resection is a critical factor in achieving seizure freedom.

  18. The significance of "geothermal microzonation" for the correct planning of low-grade source geothermal systems

    Science.gov (United States)

    Viccaro, Marco; Pezzino, Antonino; Belfiore, Giuseppe Maria; Campisano, Carlo

    2016-04-01

    Despite the environmental-friendly energy systems are solar thermal technologies, photovoltaic and wind power, other advantageous technologies exist, although they have not found wide development in countries such as Italy. Given the almost absent environmental impact and the rather favorable cost/benefit ratio, low-enthalpy geothermal systems are, however, likely to be of strategic importance also in Italy during the next years. The importance of geology for a sustainable exploitation of the ground through geothermal systems from low-grade sources is becoming paramount. Specifically, understanding of the lithological characteristics of the subsurface along with structures and textures of rocks is essential for a correct planning of the probe/geo-exchanger field and their associated ground source heat pumps. The complex geology of Eastern Sicily (Southern Italy), which includes volcanic, sedimentary and metamorphic units over limited extension, poses the question of how thermal conductivity of rocks is variable at the scale of restricted areas (even within the same municipality). This is the innovative concept of geothermal microzonation, i.e., how variable is the geothermal potential as a function of geology at the microscale. Some pilot areas have been therefore chosen to test how the geological features of the subsurface can influence the low-enthalpy geothermal potential of an area. Our geologically based evaluation and micro-zonation of the low-grade source geothermal potential of the selected areas have been verified to be fundamental for optimization of all the main components of a low-enthalpy geothermal system. Saving realization costs and limiting the energy consumption through correct sizing of the system are main ambitions to have sustainable development of this technology with intensive utilization of the subsurface. The variegated territory of countries such as Italy implies that these goals can be only reached if, primarily, the geological features

  19. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.

    Science.gov (United States)

    Copeland, William E; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E Jane

    2014-05-27

    Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one's status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9-16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child's role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health.

  20. Diagnostic utility of flow cytometry in low-grade myelodysplastic syndromes: a prospective validation study

    Science.gov (United States)

    Ogata, Kiyoyuki; Della Porta, Matteo G.; Malcovati, Luca; Picone, Cristina; Yokose, Norio; Matsuda, Akira; Yamashita, Taishi; Tamura, Hideto; Tsukada, Junichi; Dan, Kazuo

    2009-01-01

    Background The diagnosis of myelodysplastic syndromes is not always straightforward when patients lack specific diagnostic markers, such as blast excess, karyotype abnormality, and ringed sideroblasts. Design and Methods We designed a flow cytometry protocol applicable in many laboratories and verified its diagnostic utility in patients without those diagnostic markers. The cardinal parameters, analyzable from one cell aliquot, were myeloblasts (%), B-cell progenitors (%), myeloblast CD45 expression, and channel number of side scatter where the maximum number of granulocytes occurs. The adjunctive parameters were CD11b, CD15, and CD56 expression (%) on myeloblasts. Marrow samples from 106 control patients with cytopenia and 134 low-grade myelodysplastic syndromes patients, including 81 lacking both ringed sideroblasts and cytogenetic aberrations, were prospectively analyzed in Japan and Italy. Results Data outside the predetermined reference range in 2 or more parameters (multiple abnormalities) were common in myelodysplastic syndromes patients. In those lacking ringed sideroblasts and cytogenetic aberrations, multiple abnormalities were observed in 8/26 Japanese (30.8%) and 37/55 Italians (67.3%) when the cardinal parameters alone were considered, and in 17/26 Japanese (65.4%) and 42/47 Italians (89.4%) when all parameters were taken into account. Multiple abnormalities were rare in controls. When data from all parameters were used, the diagnostic sensitivities were 65% and 89%, specificities were 98% and 90%, and likelihood ratios were 28.1 and 8.5 for the Japanese and Italian cohorts, respectively. Conclusions This protocol can be used in the diagnostic work-up of low-grade myelodysplastic syndromes patients who lack specific diagnostic markers, although further improvement in diagnostic power is desirable. PMID:19546439

  1. Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

    Directory of Open Access Journals (Sweden)

    Grgov Saša

    2015-01-01

    Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

  2. MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET?

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Nathalie L.; Graute, Vera; Cumming, Paul; Bartenstein, Peter; Fougere, Christian la [Ludwig-Maximilians-University Munich, Department of Nuclear Medicine, Munich (Germany); Armbruster, Lena; Suchorska, Bogdana; Tonn, Joerg-Christian; Kreth, Friedrich Wilhelm [Ludwig-Maximilians-University Munich, Department of Neurosurgery, Munich (Germany); Lutz, Juergen [Ludwig-Maximilians-University Munich, Department of Neuroradiology, Munich (Germany); Eigenbrod, Sabina [Ludwig-Maximilians-University Munich, Department of Neuropathology, Munich (Germany)

    2012-06-15

    Since differentiation between low-grade glioma (LGG) and high-grade glioma (HGG) remains challenging according to MRI criteria alone, we investigated the discriminative value of additional dynamic FET PET in patients with MRI-suspected LGG. Included in this retrospective study were 127 patients with newly diagnosed MRI-suspected LGG and dynamic FET PET prior to histopathological assessment. FET PET lesions were visually classified as having reduced, normal, or increased tracer uptake. Maximal tumour uptake scaled to the mean background uptake (SUV{sub max}/BG), mean tumour uptake (SUV{sub mean}/BG), biological tumour volume and kinetics were evaluated and correlated with individual histopathological findings. Histopathological analysis revealed 71 patients with LGG, 47 patients with HGG (including 5 glioblastoma multiforme), 2 patients with low-grade ganglioglioma and 7 patients with non-neoplastic lesions. Of the 127 patients, 97 had lesions with increased FET uptake, of which 93 were neoplastic. Increased uptake was found in 49/71 LGG (69 %) and 42/47 HGG (89 %). None of the conventional uptake parameters differed significantly between the HGG and LGG groups. Kinetic analysis reliably identified HGG (sensitivity 95 %, specificity 72 %, PPV 74 %, NPV 95 %). Normal tracer uptake was observed in 19 patients (15 with LGG, 1 with HGG and 3 with non-neoplastic lesions) and reduced uptake in 11 patients (7 with LGG and 4 with HGG). Among the MRI-suspected LGG, kinetic but not conventional analysis of FET uptake enabled remarkably high sensitivity for detection of HGG. This held true even for lesions with low or diffuse tracer uptake. Lesions with reduced tracer uptake must be interpreted with caution, as they can also harbour HGG tissue. (orig.)

  3. Behavior of Low Grade Steel Fiber Reinforced Concrete Made with Fresh and Recycled Brick Aggregates

    Directory of Open Access Journals (Sweden)

    Md. Shariful Islam

    2017-01-01

    Full Text Available In recent years, recycled aggregates from construction and demolition waste (CDW have been widely accepted in construction sectors as the replacement of coarse aggregate in order to minimize the excessive use of natural resources. In this paper, an experimental investigation is carried out to observe the influence of low grade steel fiber reinforcements on the stress-strain behavior of concrete made with recycled and fresh brick aggregates. In addition, compressive strength by destructive and nondestructive tests, splitting tensile strength, and Young’s modulus are determined. Hooked end steel wires with 50 mm of length and an aspect ratio of 55.6 are used as fiber reinforcements in a volume fraction of 0% (control case, 0.50%, and 1.00% in concrete mixes. The same gradation of aggregates and water-cement ratio (w/c=0.44 were used to assess the effect of steel fiber in all these concrete mixes. All tests were conducted at 7, 14, and 28 days to perceive the effect of age on different mechanical properties. The experimental results show that around 10%~15% and 40%~60% increase in 28 days compressive strength and tensile strength of steel fiber reinforced concrete, respectively, compared to those of the control case. It is observed that the effect of addition of 1% fiber on the concrete compressive strength is little compared to that of 0.5% steel fiber addition. On the other hand, strain of concrete at failure of steel fiber reinforced concrete has increased almost twice compared to the control case. A simple analytical model is also proposed to generate the ascending portions of the stress-strain curve of concrete. There exists a good correlation between the experimental results and the analytical model. A relatively ductile failure is observed for the concrete made with low grade steel fibers.

  4. Hypnosis for Awake Surgery of Low-grade Gliomas: Description of the Method and Psychological Assessment.

    Science.gov (United States)

    Zemmoura, Ilyess; Fournier, Eric; El-Hage, Wissam; Jolly, Virginie; Destrieux, Christophe; Velut, Stéphane

    2016-01-01

    Awake craniotomy with intraoperative electric stimulation is a reliable method for extensive removal of low-grade gliomas while preserving the functional integrity of eloquent surrounding brain structures. Although fully awake procedures have been proposed, asleep-awake-asleep remains the standard technique. Anesthetic contraindications are the only limitation of this method, which is therefore not reliable for older patients with high-grade gliomas. To describe and assess a novel method for awake craniotomy based on hypnosis. We proposed a novel hypnosedation procedure to patients undergoing awake surgery for low-grade gliomas in our institution between May 2011 and April 2015. Surgical data were retrospectively recorded. The subjective experience of hypnosis was assessed by 3 standardized questionnaires: the Cohen Perceived Stress Scale, the Posttraumatic Stress Disorder Checklist Scale, the Peritraumatic Dissociative Experience Questionnaire, and a fourth questionnaire designed specifically for this study. Twenty-eight questionnaires were retrieved from 43 procedures performed on 37 patients. The Peritraumatic Dissociative Experience Questionnaire revealed a dissociation state in 17 cases. The Perceived Stress Scale was pathological in 8 patients. Two patients in this group stated that they would not accept a second hypnosedation procedure. The Posttraumatic Stress Disorder Checklist Scale revealed 1 case of posttraumatic stress disorder. Burr hole and bone flap procedures were the most frequently reported unpleasant events during opening (15 of 52 events). The main findings of our study are the effectiveness of the technique, which in all cases allowed resection of the tumor up to functional boundaries, and the positive psychological impact of the technique in most of the patients.

  5. Molecular profiling of low grade serous ovarian tumours identifies novel candidate driver genes.

    Science.gov (United States)

    Hunter, Sally M; Anglesio, Michael S; Ryland, Georgina L; Sharma, Raghwa; Chiew, Yoke-Eng; Rowley, Simone M; Doyle, Maria A; Li, Jason; Gilks, C Blake; Moss, Phillip; Allan, Prue E; Stephens, Andrew N; Huntsman, David G; deFazio, Anna; Bowtell, David D; Gorringe, Kylie L; Campbell, Ian G

    2015-11-10

    Low grade serous ovarian tumours are a rare and under-characterised histological subtype of epithelial ovarian tumours, with little known of the molecular drivers and facilitators of tumorigenesis beyond classic oncogenic RAS/RAF mutations. With a move towards targeted therapies due to the chemoresistant nature of this subtype, it is pertinent to more fully characterise the genetic events driving this tumour type, some of which may influence response to therapy and/or development of drug resistance. We performed genome-wide high-resolution genomic copy number analysis (Affymetrix SNP6.0) and mutation hotspot screening (KRAS, BRAF, NRAS, HRAS, ERBB2 and TP53) to compare a large cohort of ovarian serous borderline tumours (SBTs, n = 57) with low grade serous carcinomas (LGSCs, n = 19). Whole exome sequencing was performed for 13 SBTs, nine LGSCs and one mixed low/high grade carcinoma. Copy number aberrations were detected in 61% (35/57) of SBTs, compared to 100% (19/19) of LGSCs. Oncogenic RAS/RAF/ERBB2 mutations were detected in 82.5% (47/57) of SBTs compared to 63% (12/19) of LGSCs, with NRAS mutations detected only in LGSC. Some copy number aberrations appeared to be enriched in LGSC, most significantly loss of 9p and homozygous deletions of the CDKN2A/2B locus. Exome sequencing identified BRAF, KRAS, NRAS, USP9X and EIF1AX as the most frequently mutated genes. We have identified markers of progression from borderline to LGSC and novel drivers of LGSC. USP9X and EIF1AX have both been linked to regulation of mTOR, suggesting that mTOR inhibitors may be a key companion treatment for targeted therapy trials of MEK and RAF inhibitors.

  6. 腰椎融合及植入物内固定后滑脱腰椎的椎体稳定性%Stability of lumbar vertebrae with lumbar spondylolisthesis after lumbar fusion and implant internal fixation

    Institute of Scientific and Technical Information of China (English)

    朱瑜琪; 王金荣

    2013-01-01

      背景:腰椎滑脱症的治疗目的是重建脊柱序列和椎体稳定性,解除神经压迫,达到永久腰椎融合的作用。目的:探讨腰椎滑脱症患者腰椎融合及植入物内固定后椎体稳定性的恢复。  方法:腰椎滑脱症最常采用Wiltse分型将其分为发育不良性、峡部裂性、退变性、创伤性以及病理性,将腰椎侧位X射线片的上位椎体相对于下位椎体的滑移程度分为5级,根据腰椎滑脱症患者的分型和分级以及患者具体情况选择适宜的治疗方式。  结果与结论:坚强融合内固定,植入物与椎体间是刚性连接,常用来稳定脊柱、矫正畸形,骨融合率较高,减少了假关节形成。动态融合内固定是用弹性材质或微动装置分散坚强内固定负荷传导,减少应力遮挡效应及邻近节段的应力集中。动态非融合内固定能改变脊柱运动节段的负荷传递方式,阻止脊柱运动,预防邻近节段退变,使失稳的腰椎达到其正常状态的活动特性,实现动态重建腰椎序列。峡部关节缺损部位直接修复植骨,适用于青壮年有症状不伴有退行性椎间盘疾病的滑脱患者。腰椎滑脱症选择哪种材料植骨和植骨部位以及哪种入路方法融合和植入物内固定可以得到理想的融合内固定效果一直是学者们争论的焦点,目前尚未达成统一。%BACKGROUND:The purpose of the treatment of lumbar spondylolisthesis is to reconstruct the spine sequence and vertebral stability, relieve nerve compression, and achieve permanent lumbar fusion. OBJECTIVE:To explore the restore of vertebral stability of the lumbar spondylolisthesis patients after lumbar fusion and implant internal fixation. METHODS:The lumbar spondylolisthesis was often divided into dysplastic, isthmic, degenerative, traumatic and pathological with Wiltse classification. The slip degree of upper vertebra relative to lower vertebra on the

  7. Low-grade and anaplastic oligodendrogliomas: differences in tumour microvascular permeability evaluated with dynamic contrast-enhanced magnetic resonance imaging.

    Science.gov (United States)

    Jia, Zhongzheng; Geng, Daoying; Liu, Ying; Chen, Xingrong; Zhang, Jun

    2013-08-01

    This study was designed to quantitatively assess the microvascular permeability of oligodendroglioma using the volume transfer constant (K(trans)) and the volume of the extravascular extracellular space per unit volume of tissue (V(e)) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). We aimed to evaluate the effectiveness of K(trans) and V(e) in distinguishing between low-grade and anaplastic oligodendroglioma. The maximal values of K(trans) and V(e) for 65 patients with oligodendroglioma (27 grade II, 38 grade III) were obtained. Differences in K(trans) and V(e) between the two groups were analysed using the Mann-Whitney rank-sum test. Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for the K(trans) and Ve that could differentiate between low-grade and anaplastic oligodendrogliomas. Values for K(trans) and Ve in low-grade oligodendrogliomas were significantly lower than those in anaplastic oligodendrogliomas (p low-grade and anaplastic oligodendrogliomas in a statistically significant manner. Our results suggest that DCE-MRI can distinguish the differences in microvascular permeability between low-grade and anaplastic oligodendrogliomas.

  8. Catalytic decomposition of tar derived from wood waste pyrolysis using Indonesian low grade iron ore as catalyst

    Energy Technology Data Exchange (ETDEWEB)

    Wicakso, Doni Rahmat [Chemical Engineering Department, Faculty of Engineering, Lambung Mangkurat University, Jalan A. Yani KM. 36 Banjarbaru, 70714, South Kalimantan (Indonesia); Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Sutijan; Rochmadi [Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Budiman, Arief, E-mail: abudiman@ugm.ac.id [Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Center for Energy Studies, Gadjah Mada University, Sekip K1A, Yogyakarta, 55281 (Indonesia)

    2016-06-03

    Low grade iron ore can be used as an alternative catalyst for bio-tar decomposition. Compared to other catalysts, such as Ni, Rd, Ru, Pd and Pt, iron ore is cheaper. The objective of this research was to investigate the effect of using low grade iron ore as catalyst for tar catalytic decomposition in fixed bed reactor. Tar used in this experiment was pyrolysis product of wood waste while the catalyst was Indonesian low grade iron ore. The variables studied were temperatures between 500 – 600 °C and catalyst weight between 0 – 40 gram. The first step, tar was evaporated at 450 °C to produce tar vapor. Then, tar vapor was flowed to fixed bed reactor filled low grade iron ore. Gas and tar vapor from reactor was cooled, then the liquid and uncondensable gas were analyzed by GC/MS. The catalyst, after experiment, was weighed to calculate total carbon deposited into catalyst pores. The results showed that the tar components that were heavy and light hydrocarbon were decomposed and cracked within the iron ore pores to from gases, light hydrocarbon (bio-oil) and carbon, thus decreasing content tar in bio-oil and increasing the total gas product. In conclusion, the more low grade iron ore used as catalyst, the tar content in the liquid decrease, the H{sup 2} productivity increased and calorimetric value of bio-oil increased.

  9. Catalytic decomposition of tar derived from wood waste pyrolysis using Indonesian low grade iron ore as catalyst

    Science.gov (United States)

    Wicakso, Doni Rahmat; Sutijan, Rochmadi, Budiman, Arief

    2016-06-01

    Low grade iron ore can be used as an alternative catalyst for bio-tar decomposition. Compared to other catalysts, such as Ni, Rd, Ru, Pd and Pt, iron ore is cheaper. The objective of this research was to investigate the effect of using low grade iron ore as catalyst for tar catalytic decomposition in fixed bed reactor. Tar used in this experiment was pyrolysis product of wood waste while the catalyst was Indonesian low grade iron ore. The variables studied were temperatures between 500 - 600 °C and catalyst weight between 0 - 40 gram. The first step, tar was evaporated at 450 °C to produce tar vapor. Then, tar vapor was flowed to fixed bed reactor filled low grade iron ore. Gas and tar vapor from reactor was cooled, then the liquid and uncondensable gas were analyzed by GC/MS. The catalyst, after experiment, was weighed to calculate total carbon deposited into catalyst pores. The results showed that the tar components that were heavy and light hydrocarbon were decomposed and cracked within the iron ore pores to from gases, light hydrocarbon (bio-oil) and carbon, thus decreasing content tar in bio-oil and increasing the total gas product. In conclusion, the more low grade iron ore used as catalyst, the tar content in the liquid decrease, the H2 productivity increased and calorimetric value of bio-oil increased.

  10. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Eun; Rha, Sung Eun; Oh, Soon Nam; Lee, Ah Won; Lee, Keun Ho; Kim, Mee Ran [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to perform a retrospective analysis of the ultrasonographic findings associated with low-grade endometrial stromal sarcoma. Ten pathologically confirmed cases of low-grade endometrial stromal sarcoma at our institution from January 2007 to April 2014 were retrospectively reviewed. All patients underwent a preoperative transvaginal ultrasound. Two radiologists came to a consensus regarding the location, size, margin, and echogenicity of the tumor, as well as the presence of intratumoral cystic degeneration and its extent and configuration. Low-grade endometrial stromal sarcoma manifested as an intramural mass protruding into the endometrial cavity (n=6) or as a purely intramural mass (n=4). The maximal diameter of the lesion ranged from 4 to 9.1 cm (mean, 6.2 cm). The imaging features of low-grade endometrial stromal sarcoma were variable: six cases involved predominantly solid masses containing cystic degeneration, one was a predominantly unilocular cystic mass, two were ill-defined infiltrative solid masses, and one was a well-defined solid mass. Among the seven cases with internal cystic degeneration, five patients showed a multiseptated cystic area or a cystic area with multiple small clusters, while a unilocular cystic area within the tumor was found in two patients. Low-grade endometrial stromal sarcoma is associated with variable ultrasonographic findings with regard to the location, margin, and configuration of the lesion. Multiseptated cystic areas and multiple small areas of cystic degeneration are common.

  11. Traumatic lumbar spondylolisthesis without facet fracture at L4/L5. A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Dominique N’Dri-Oka; Souleymane Issa Sarki; Landry Konan; Yacouba Haro

    2016-01-01

    L4–L5 traumatic spondylolisthesis has been rarely reported in the literature. At lumbar spine level traumatic dislocation lesion realizes“traumatic spondylolisthesis or traumatic bilateral lumbar facet locked syndrome”. The aim of the present paper is to report this rare lesion and discuss its mechanism and management. A case report is followed by Literature review made on Medline and scholar google database from 2000 to 2015. The case report concerned a 33-year-old man, who refused to wear a seat belt, injured his lumbar spine following a motor vehicle accident. L4-L5 spondylolisthesis occurred after the vehicle rolled over several times. Sixteen months after the accident the patient had a favorable outcome. Literature review on Medline and scholar google database from 2000 to 2015 was carried out and five cases of traumatic spondylolisthesis were found. The Sex ratio was 3/2. Surgical treatment consisted of posterolateral interbody fusion. Traumatic lumbar spine spondylolisthesis is rare. When it occurs, it is always associated with vertebral lumbar fracture. L4-L5 traumatic spondylolisthesis was caused by a high-energy mechanism and improper use of seat belt.

  12. Production of alcohol by simultaneous saccharification and fermentation of low-grade wheat flour

    Directory of Open Access Journals (Sweden)

    Marcos Antonio das Neves

    2006-05-01

    Full Text Available Two samples of low-grade wheat flour, namely low-grade 1 (LG1 and low-grade 2 (LG2, with different carbohydrate and fibrous content, were used as substrates. The samples were liquefied using various concentrations of alpha- or beta-amylase, in order to optimize the production of fermentable sugars; the enzyme alpha-amylase revealed higher performance. After liquefaction, the simultaneous saccharification and fermentation was conducted in a jar fermentor. Amyloglucosidase was used for saccharification, and dry baker's yeast, S. cerevisiae, for fermentation simultaneously. Glucose was consumed promptly in both cases, LG1 and LG2; ethanol production was considerably higher in LG1 (38.6 g/L, compared to LG2 (24.9 g/L. The maximum ATP production was observed early in the SSF process. LG1 revealed higher potential as substrate for ethanol production.Dois lotes de amostras de resíduo de farinha de trigo com teor reduzido de amido, especificamente designadas como amostra 1 (LG1 e amostra 2 (LG2, foram utilizados como substrato para fermentação alcoólica. Inicialmente as amostras foram hidrolisadas utilizando-se diferentes concentrações de alfa- ou beta-amilase, com o objetivo de otimizar a produção de açúcares fermentáveis; a enzima alfa-amilase apresentou melhor desempenho. O processo simultâneo de sacarificação e fermentação foi conduzido logo após a hidrólise do amido, em um fermentador com volume de 2 L; o meio contendo amido hidrolisado foi inoculado com amiloglucosidase (enzima utilizada para sacarificação e levedura de panificação desidratada (para fermentação, simultaneamente. Amostras do meio de fermentação foram retiradas regularmente para análise dos teores de glucose, maltose, açúcares redutores e etanol. O teor de Adenosina Tri-Fosfato (ATP também foi analisado. O açúcar glucose foi completamente consumido no início da fermentação, tanto no caso da amostra LG1, quanto LG2, sendo que a produção de etanol

  13. First experiences in treatment of low-grade glioma grade I and II with proton therapy

    Science.gov (United States)

    2012-01-01

    Background To retrospectively assess feasibility and toxicity of proton therapy in patients with low-grade glioma (WHO °I/II). Patients and methods Proton beam therapy only administered in 19 patients (median age 29 years; 9 female, 10 male) for low-grade glioma between 2010 and 2011 was reviewed. In 6 cases proton therapy was performed due to tumor progression after biopsy, in 8 cases each due to tumor progression after (partial-) resection, and in 5 cases due to tumor progression after chemotherapy. Median total dose applied was 54 GyE (range, 48,6-54 GyE) in single fractions of median 1.8 GyE. Median clinical target volume was 99 cc (range, 6–463 cc) and treated using median 2 beams (range, 1–2). Results Proton therapy was finished as planned in all cases. At end of proton therapy, 13 patients showed focal alopecia, 6 patients reported mild fatigue, one patient with temporal tumor localization concentration deficits and speech errors and one more patient deficits in short-term memory. Four patients did not report any side effects. During follow-up, one patient presented with pseudo-progression showing worsening of general condition and brain edema 1–2 months after last irradiation and restitution after 6 months. In the present MR imaging (median follow-up 5 months; range 0–22 months) 12 patients had stable disease, 2 (1) patients partial (complete) remission, one more patient pseudo-progression (differential diagnosis: tumor progression) 4 weeks after irradiation without having had further follow-up imaging so far, and one patient tumor progression approximately 9 months after irradiation. Conclusion Regarding early side effects, mild alopecia was the predominant finding. The rate of alopecia seems to be due to large treatment volumes as well as the anatomical locations of the target volumes and might be avoided by using multiple beams and the gantry in the future. Further evaluations including neuropsychological testing are in preparation. PMID

  14. Cognitive impairments in patients with low grade gliomas and high grade gliomas

    Directory of Open Access Journals (Sweden)

    Eliane C. Miotto

    2011-08-01

    Full Text Available OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19 and high-grade glioma (G2, n=8 patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

  15. Fast Thermal Calibration of Low-Grade Inertial Sensors and Inertial Measurement Units

    Directory of Open Access Journals (Sweden)

    Yalong Ban

    2013-09-01

    Full Text Available The errors of low-cost inertial sensors, especially Micro-Electro Mechanical Systems (MEMS ones, are highly dependent on environmental conditions such as the temperature. Thus, there is a need for the development of accurate and reliable thermal compensation models to reduce the impact of such thermal drift of the sensors. Since the conventional thermal calibration methods are typically time-consuming and costly, an efficient thermal calibration method to investigate the thermal drift of a full set of gyroscope and accelerometer errors (i.e., biases, scale factor errors and non-orthogonalities over the entire temperature range in a few hours is proposed. The proposed method uses the idea of the Ramp method, which removes the time-consuming process of stabilizing the sensor temperature, and addresses its inherent problems with several improvements. We change the temperature linearly for a complete cycle and take a balanced strategy by making comprehensive use of the sensor measurements during both heating and cooling processes. Besides, an efficient 8-step rotate-and-static scheme is designed to further improve the calibration accuracy and efficiency. Real calibration tests showed that the proposed method is suitable for low-grade IMUs and for both lab and factory calibration due to its efficiency and sufficient accuracy.

  16. Fast thermal calibration of low-grade inertial sensors and inertial measurement units.

    Science.gov (United States)

    Niu, Xiaoji; Li, You; Zhang, Hongping; Wang, Qingjiang; Ban, Yalong

    2013-09-12

    The errors of low-cost inertial sensors, especially Micro-Electro Mechanical Systems (MEMS) ones, are highly dependent on environmental conditions such as the temperature. Thus, there is a need for the development of accurate and reliable thermal compensation models to reduce the impact of such thermal drift of the sensors. Since the conventional thermal calibration methods are typically time-consuming and costly, an efficient thermal calibration method to investigate the thermal drift of a full set of gyroscope and accelerometer errors (i.e., biases, scale factor errors and non-orthogonalities) over the entire temperature range in a few hours is proposed. The proposed method uses the idea of the Ramp method, which removes the time-consuming process of stabilizing the sensor temperature, and addresses its inherent problems with several improvements. We change the temperature linearly for a complete cycle and take a balanced strategy by making comprehensive use of the sensor measurements during both heating and cooling processes. Besides, an efficient 8-step rotate-and-static scheme is designed to further improve the calibration accuracy and efficiency. Real calibration tests showed that the proposed method is suitable for low-grade IMUs and for both lab and factory calibration due to its efficiency and sufficient accuracy.

  17. Low grade bioethanol for fuel mixing on gasoline engine using distillation process

    Science.gov (United States)

    Abikusna, Setia; Sugiarto, Bambang; Suntoro, Dedi; Azami

    2017-03-01

    Utilization of renewable energy in Indonesia is still low, compared to 34% oil, 20% coal and 20% gas, utilization of energy sources for water 3%, geothermal 1%, 2% biofuels, and biomass 20%. Whereas renewable energy sources dwindling due to the increasing consumption of gasoline as a fuel. It makes us have to look for alternative renewable energy, one of which is bio ethanol. Several studies on the use of ethanol was done to the researchers. Our studies using low grade bio ethanol which begins with the disitillation independently utilize flue gas heat at compact distillator, produces high grade bio ethanol and ready to be mixed with gasoline. Stages of our study is the compact distillator design of the motor dynamic continued with good performance and emission testing and ethanol distilled. Some improvement is made is through the flue gas heat control mechanism in compact distillator using gate valve, at low, medium, and high speed engine. Compact distillator used is kind of a batch distillation column. Column design process using the shortcut method, then carried the tray design to determine the overall geometry. The distillation is done by comparing the separator with a tray of different distances. As well as by varying the volume of the feed and ethanol levels that will feed distilled. In this study, we analyzed the mixing of ethanol through variation between main jet and pilot jet in the carburetor separately interchangeably with gasoline. And finally mixing mechanism bio ethanol with gasoline improved with fuel mixer for performance.

  18. Network Plasticity and Intraoperative Mapping for Personalized Multimodal Management of Diffuse Low-Grade Gliomas

    Science.gov (United States)

    Ghinda, Cristina Diana; Duffau, Hugues

    2017-01-01

    Gliomas are the most frequent primary brain tumors and include a variety of different histological tumor types and malignancy grades. Recent achievements in terms of molecular and imaging fields have created an unprecedented opportunity to perform a comprehensive interdisciplinary assessment of the glioma pathophysiology, with direct implications in terms of the medical and surgical treatment strategies available for patients. The current paradigm shift considers glioma management in a comprehensive perspective that takes into account the intricate connectivity of the cerebral networks. This allowed significant improvement in the outcome of patients with lesions previously considered inoperable. The current review summarizes the current theoretical framework integrating the adult human brain plasticity and functional reorganization within a dynamic individualized treatment strategy for patients affected by diffuse low-grade gliomas. The concept of neuro-oncology as a brain network surgery has major implications in terms of the clinical management and ensuing outcomes, as indexed by the increased survival and quality of life of patients managed using such an approach.

  19. Selective Removal of Iron from Low-Grade Ti Ore by Reacting with Calcium Chloride

    Science.gov (United States)

    Kang, Jungshin; Okabe, Toru H.

    2017-02-01

    Recently, titanium metal production by molten salt electrolysis using CaCl2 as molten salt and TiO2 or rutile (94 to 96 pct TiO2) as feedstock has been drawing attention. However, when a low-grade Ti ore (mainly FeTiO3) is used as feedstock, removal of iron (Fe) from the ore is indispensable. In this study, the influence of reaction temperature, reaction time, particle size of the ore, and source country for the ore on the removal of iron by selective chlorination using CaCl2 was assessed. Experimental results showed that the mass percent of iron in the ore decreased from 49.7 to 1.79 pct under certain conditions by selective removal of iron as FeCl2. As a result, high-grade CaTiO3 was produced when the ore particles smaller than 74 µm reacted with CaCl2 at 1240 K (967 °C) for 8 to 10 hours. Therefore, this study demonstrates that the removal of iron from the ore is feasible through the selective chlorination process using CaCl2 by optimizing the variables.

  20. Enhancing Low-Grade Thermal Energy Recovery in a Thermally Regenerative Ammonia Battery Using Elevated Temperatures

    KAUST Repository

    Zhang, Fang

    2015-02-13

    © 2015 WILEY-VCH Verlag GmbH & Co. KGaA. A thermally regenerative ammonia battery (TRAB) is a new approach for converting low-grade thermal energy into electricity by using an ammonia electrolyte and copper electrodes. TRAB operation at 72°C produced a power density of 236±8 Wm-2, with a linear decrease in power to 95±5 Wm-2 at 23°C. The improved power at higher temperatures was due to reduced electrode overpotentials and more favorable thermodynamics for the anode reaction (copper oxidation). The energy density varied with temperature and discharge rates, with a maximum of 650 Whm-3 at a discharge energy efficiency of 54% and a temperature of 37°C. The energy efficiency calculated with chemical process simulation software indicated a Carnot-based efficiency of up to 13% and an overall thermal energy recovery of 0.5%. It should be possible to substantially improve these energy recoveries through optimization of electrolyte concentrations and by using improved ion-selective membranes and energy recovery systems such as heat exchangers.

  1. A New Heterotrophic Strain for Bioleaching of Low Grade Complex Copper Ore

    Directory of Open Access Journals (Sweden)

    Kaijian Hu

    2016-02-01

    Full Text Available A new heterotrophic strain, named Providencia sp. JAT-1, was isolated and used in bioleaching of low-grade complex copper ore. The strain uses sodium citrate as a carbon source and urea as a nitrogen source to produce ammonia. The optimal growth condition of the strain is 30 C, initial pH 8, sodium citrate 10 g/L and urea 20 g/L, under which the cell density and ammonia concentration in the medium reached a maximum of 4.83 × 108 cells/mL and 14 g/L, respectively. Ammonia produced by the strain is used as the main lixiviant in bioleaching. Bioleaching results revealed that higher strain growth led to a higher copper recovery, while higher pulp density will cause a greater inhibitory effect on strain growth and ammonia production. The copper extraction reached the highest value of 54.5% at the pulp density of 1%. Malachite, chrysocolla and chalcocite are easy to leach out in this bioleaching system while chalcopyrite is difficult. Results of comparative leaching experiments show that bioleaching using JAT-1 is superior to ammonia leaching at the same condition. The metabolites produced by the strain other than ammonia are also involved in bioleaching.

  2. Current understanding of BRAF alterations in diagnosis, prognosis and therapeutic targeting in paediatric low grade gliomas

    Directory of Open Access Journals (Sweden)

    Catherine Louise Penman

    2015-03-01

    Full Text Available The mitogen-activated protein kinase (MAPK pathway is known to play a key role in the initiation and maintenance of many tumours as well as normal development. This often occurs through mutation of the genes encoding RAS and RAF proteins which are involved in signal transduction in this pathway. BRAF is one of three RAF kinases which act as downstream effectors of growth factor signalling leading to cell cycle progression, proliferation and survival. Initially reported as a point mutation (V600E in the majority of metastatic melanomas, other alterations in the BRAF gene have now been reported in a variety of human cancers including papillary thyroid cancer, colon carcinomas, hairy cell leukaemia and more recently in gliomas. The identification of oncogenic mutations in the BRAF gene have led to a revolution in the treatment of metastatic melanoma using targeted molecular therapies that affect the MAPK pathway either directly through BRAF inhibition or downstream through inhibition of MEK. This review describes the molecular biology of BRAF in the context of paediatric low grade gliomas, the role of BRAF as a diagnostic marker, the prognostic implications of BRAF and evidence for therapeutic targeting of BRAF.

  3. Updated therapeutic strategy for adult low-grade glioma stratified by resection and tumor subtype.

    Science.gov (United States)

    Nitta, Masayuki; Muragaki, Yoshihiro; Maruyama, Takashi; Iseki, Hiroshi; Ikuta, Soko; Konishi, Yoshiyuki; Saito, Taichi; Tamura, Manabu; Chernov, Michael; Watanabe, Atsushi; Okamoto, Saori; Maebayashi, Katsuya; Mitsuhashi, Norio; Okada, Yoshikazu

    2013-01-01

    The importance of surgical resection for patients with supratentorial low-grade glioma (LGG) remains controversial. This retrospective study of patients (n = 153) treated between 2000 to 2010 at a single institution assessed whether increasing the extent of resection (EOR) was associated with improved progression-free survival (PFS) and overall survival (OS). Histological subtypes of World Health Organization grade II tumors were as follows: diffuse astrocytoma in 49 patients (32.0%), oligoastrocytoma in 45 patients (29.4%), and oligodendroglioma in 59 patients (38.6%). Median pre- and postoperative tumor volumes and median EOR were 29.0 cm(3) (range 0.7-162 cm(3)) and 1.7 cm(3) (range 0-135.7 cm(3)) and 95%, respectively. Five- and 10-year OS for all LGG patients were 95.1% and 85.4%, respectively. Eight-year OS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 70.7%, 91.2%, and 98.3%, respectively. Five-year PFS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 42.6%, 71.3%, and 62.7%, respectively. Patients were divided into two groups by EOR ≥90% and oligodendroglioma. Multivariate analysis identified age and EOR as parameters significantly associated with OS. The only parameter associated with PFS was EOR. Based on these findings, we established updated therapeutic strategies for LGG. If surgery resulted in EOR oligodendroglioma or oligoastrocytoma, which are sensitive to chemotherapy, will be treated with chemotherapy.

  4. Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome?

    Science.gov (United States)

    Piscaglia, Anna Chiara; Laterza, Lucrezia; Cesario, Valentina; Gerardi, Viviana; Landi, Rosario; Lopetuso, Loris Riccardo; Calò, Giovanni; Fabbretti, Giovanna; Brisigotti, Massimo; Stefanelli, Maria Loredana; Gasbarrini, Antonio

    2016-12-14

    To evaluate the prevalence of nodular lymphoid hyperplasia (NLH) in adult patients undergoing colonoscopy and its association with known diseases. We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome (IBS)-type symptoms or suspected inflammatory bowel disease (IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening. Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period. One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals (only 3%), while it was significantly more prevalent in symptomatic cases (32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients.

  5. Surgery of insular and paralimbic diffuse low-grade gliomas: technical considerations.

    Science.gov (United States)

    Michaud, Karine; Duffau, Hugues

    2016-11-01

    Once considered a "no man's land" especially when invaded by a diffuse low grade glioma (DLGG), the insula remains to this day a surgical challenge. Surgery for insular DLGG involves consideration of its hidden location under the potentially eloquent operculae, the proximity to vascular tree and high density of functions not only in the insular cortex but also in the white fiber pathways passing under the insular lobe. The natural history of DLGG and the potential benefits and consequences of the surgical approach also need a close look. In the last decade, a better knowledge of the functional anatomy and connectivity of this region, as well as an improvement in surgical techniques as direct stimulation mapping, combined with an increasing literature showing a favorable impact of maximal resection for DLGG, were deciding factors in the paradigmatic shift from expectative treatment to early surgical management. Here, our goal is to discuss the structural and functional aspects of the insula, the specificities of insular and paralimbic DLGG by emphasizing the technical considerations of surgery in this region, as well as its oncological and functional outcomes. In summary, this new strategy based upon early maximal safe surgical resection showed both oncological benefit and preservation of quality of life-or even an improvement thanks to epilepsy relief.

  6. A disconnection account of subjective empathy impairments in diffuse low-grade glioma patients.

    Science.gov (United States)

    Herbet, Guillaume; Lafargue, Gilles; Moritz-Gasser, Sylvie; Menjot de Champfleur, Nicolas; Costi, Emanuele; Bonnetblanc, François; Duffau, Hugues

    2015-04-01

    Human empathic experience is a multifaceted psychological construct which arises from functional integration of multiple neural networks. Despite accumulating knowledge about the cortical circuitry of empathy, almost nothing is known about the connectivity that may be concerned in conveying empathy-related neural information. To bridge this gap in knowledge, we studied dispositional empathy in a large-sized cohort of 107 patients who had undergone surgery for a diffuse low-grade glioma. The self-report questionnaire used enabled us to obtain a global measure of subjective empathy but also, importantly, to assess the two main components of empathy (cognitive and emotional). Data were processed by combining voxelwise and tractwise lesion-symptom analyses. Several major findings emerged from our analyses. First of all, topological voxelwise analyses were inconclusive. Conversely, tractwise multiple regression analyses, including all major associative white matter pathways as potential predictors, yielded to significant models explaining substantial part of the behavioural variance. Among the main results, we found that disconnection of the left cingulum bundle was a strong predictor of a low cognitive empathy (pempathy. Finally, although we failed to relate emotional empathy to disruption of a specific tract, correlation analyses indicated a positive association between this component of empathy and the volumes of residual lesion infiltration in the right hemisphere (pempathy. They may help to better understand the pathophysiology of empathy impairments in pathological conditions characterized by abnormalities of long-range anatomical connectivity, such as autism spectrum disorders, schizophrenia and fronto-temporal dementia.

  7. Beneficiation of low grade graphite ore of eastern India by two-stage grinding and flotation

    Directory of Open Access Journals (Sweden)

    Vasumathi N.

    2014-01-01

    Full Text Available A low grade graphite run-of-mine (r.o.m ore from eastern India was studied for its amenability to beneficiation by flotation technique. The petrography studies indicate that the ore primarily consists of quartz and graphite with minor quantity of mica. It analyzed 89.89% ash and 8.59% fixed carbon. The ore was crushed in stages followed by primary coarse wet grinding to 212 μm (d80. Rougher flotation was carried out in Denver flotation cell to eliminate gangue as much as possible in the form of primary tailings with minimal loss of carbon. Diesel & pine oil were used as collector and frother respectively. Regrinding of rougher concentrate to150 μm (d80 was resorted to further liberate the graphite values and was followed by multi-stage cleaning. This two-stage grinding approach involving a primary coarse grinding and regrinding of rougher float followed by its multi-stage cleaning was found to yield required grade of concentrate for applications such as refractories, batteries and high temperature lubricants. This approach is supposed to retain the flake size of coarse, free and liberated graphite, if available, during primary coarse grinding and rougher flotation stage with minimal grinding energy costs as against the usual practice of single stage grinding in the case of many ores. A final concentrate of 8.97% weight recovery with 5.80% ash and 92.13% fixed carbon could be achieved.

  8. Melatonin ameliorates low-grade inflammation and oxidative stress in young Zucker diabetic fatty rats.

    Science.gov (United States)

    Agil, Ahmad; Reiter, Russel J; Jiménez-Aranda, Aroa; Ibán-Arias, Ruth; Navarro-Alarcón, Miguel; Marchal, Juan Antonio; Adem, Abdu; Fernández-Vázquez, Gumersindo

    2013-05-01

    The aim of this study was to investigate the effects of melatonin on low-grade inflammation and oxidative stress in young male Zucker diabetic fatty (ZDF) rats, an experimental model of metabolic syndrome and type 2 diabetes mellitus (T2DM). ZDF rats (n = 30) and lean littermates (ZL) (n = 30) were used. At 6 wk of age, both lean and fatty animals were subdivided into three groups, each composed of 10 rats: naive (N), vehicle treated (V), and melatonin treated (M) (10 mg/kg/day) for 6 wk. Vehicle and melatonin were added to the drinking water. Pro-inflammatory state was evaluated by plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Also, oxidative stress was assessed by plasma lipid peroxidation (LPO), both basal and after Fe(2+)/H2O2 inducement. ZDF rats exhibited higher levels of IL-6 (112.4 ± 1.5 pg/mL), TNF-α (11.0 ± 0.1 pg/mL) and CRP (828 ± 16.0 µg/mL) compared with lean rats (IL-6, 89.9 ± 1.0, P Melatonin lowered IL-6 (10%, P Melatonin improved basal LPO (15%, P melatonin administration ameliorates the pro-inflammatory state and oxidative stress, which underlie the development of insulin resistance and their consequences, metabolic syndrome, diabetes, and cardiovascular disease.

  9. Preparation of manganese sulfate from low-grade manganese carbonate ores by sulfuric acid leaching

    Institute of Scientific and Technical Information of China (English)

    Qing-quan Lin; Guo-hua Gu; Hui Wang; Ren-feng Zhu; You-cai Liu; and Jian-gang Fu

    2016-01-01

    In this study, a method for preparing pure manganese sulfate from low-grade ores with a granule mean size of 0.47 mm by direct acid leaching was developed. The effects of the types of leaching agents, sulfuric acid concentration, reaction temperature, and agitation rate on the leaching efficiency of manganese were investigated. We observed that sulfuric acid used as a leaching agent provides a similar leach-ing efficiency of manganese and superior selectivity against calcium compared to hydrochloric acid. The optimal leaching conditions in sul-furic acid media were determined; under the optimal conditions, the leaching efficiencies of Mn and Ca were 92.42% and 9.61%, respec-tively. Moreover, the kinetics of manganese leaching indicated that the leaching follows the diffusion-controlled model with an apparent ac-tivation energy of 12.28 kJ·mol−1. The purification conditions of the leaching solution were also discussed. The results show that manganese dioxide is a suitable oxidant of ferrous ions and sodium dimethyldithiocarbamate is an effective precipitant of heavy metals. Finally, through chemical analysis and X-ray diffraction analysis, the obtained product was determined to contain 98% of MnSO4·H2O.

  10. Low-grade fibromatosis-like spindle cell carcinomas of the breast are molecularly exiguous.

    Science.gov (United States)

    Takano, Elena A; Hunter, Sally M; Campbell, Ian G; Fox, Stephen B

    2015-05-01

    Low-grade fibromatosis-like spindle cell carcinomas are very rare breast carcinomas comprising <0.5% of all breast cancers. They demonstrate immunohistochemical (IHC) features of basal-like/metaplastic breast carcinomas, but the underlying molecular characteristics are unknown. We hypothesised that, as with IHC similarities, there may be common genomic alterations between spindle cell and basal-like/metaplastic carcinomas. Genomic mutational profile and genomic copy number aberration (CNA) analyses were performed on three cases of this unusual entity, and findings were compared with that reported for basal-like/metaplastic breast carcinomas. Copy number analyses by molecular inversion probe assays of the three spindle cell carcinoma samples revealed little overall genomic CNAs with only minor changes identified (fraction of the genome altered; 1.3%-6.4%), but with a common 9p21.3 loss in 2 out of 3 samples, with CDKN2A (p16) being a likely candidate. No areas of commonality were identified in an in silico analysis compared with publically available basal-like/metaplastic carcinoma copy number data. These tumours are characterised by low genomic instability, and share no CNAs with other metaplastic carcinomas. These findings favour this entity being a unique group genotype and belie their apparent homogeneous morphology and phenotype. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Low-grade fibromyxoid sarcoma versus fibromatosis: a comparative study of clinicopathological and immunohistochemical features.

    Science.gov (United States)

    Meng, Guo-Zhao; Zhang, Hong-Ying; Bu, Hong; Geng, Jian-Guo

    2009-02-01

    We have studied 11 cases of low-grade fibromyxoid sarcoma (LGFMS) and 15 cases of fibromatosis with respect to clinicopathological features and immunohistochemical expression of Ki-67, nm23, cyclinD1, and p53, in order to investigate the differential diagnosis between this two groups. Formalin-fixed, paraffin-embedded sections from 11 cases of LGFMS and 15 cases of fibromatosis were studied histologically and immunohistochemically. The immunostainings were semiquantitatively evaluated using the Allred score system. Microscopically, LGFMS was composed of bland spindle cells arranged in a whorled pattern showing alternating myxoid zones and fibrous stroma zones with prominent arcade curvilinear capillaries. Cytological atypia, mitotic figures, and tumor necrosis were absent in all 11 cases of LGFMS. In contrast, fibromatosis was less cellular and more fascicular, containing more collagen and showing no alternating fibrous and myxoid zones as compared with LGFMS. The immunostaining scores of nm23 in LGFMS were significantly lower than that in fibromatosis. The immunostaining scores of Ki-67, p53, and cyclinD1 in LGFMS were significantly higher than that in fibromatosis. Thus, we consider that LGFMS can be distinguished from fibromatosis by clinicopathological features, and assessments of the immunohistochemical expression level of cyclinD1, p53, nm23, and Ki-67 are helpful in the differential diagnosis.

  12. A visfatin promoter polymorphism is associated with low-grade inflammation and type 2 diabetes.

    Science.gov (United States)

    Zhang, Yuan-Yuan; Gottardo, Lucia; Thompson, Ryan; Powers, Christine; Nolan, David; Duffy, Jill; Marescotti, Maria Cristina; Avogaro, Angelo; Doria, Alessandro

    2006-12-01

    Visfatin (also known as pre-B cell colony-enhancing factor, or PBEF) is a pro-inflammatory adipokine expressed predominantly in visceral fat. We investigated whether polymorphisms at the visfatin/PBEF locus influence the risk of type 2 diabetes (T2D). Linkage disequilibrium analysis of 52 single nucleotide polymorphisms spanning the entire gene (34.7 kb) plus 20.5 kb of the upstream region and 25.5 kb of the downstream region revealed a single haplotype block that could be tagged by seven single nucleotide polymorphisms. These seven tags were typed in a group of T2D patients (n = 814) and a group of non-diabetic controls (n = 320) of white origin. A significant association was observed at -948C>A, with minor allele frequencies of 0.157 in T2D cases and 0.119 in non-diabetic controls (p = 0.021). In a non-diabetic population (n = 630), the same -948 allele that conferred increased risk of T2D was significantly associated with higher plasma levels of fibrinogen and C-reactive protein (p = 0.0022 and 0.0038, respectively). However, no significant associations were observed with BMI, waist circumference, serum glucose levels, or fasting insulin levels. Our findings suggest that the visfatin/PBEF gene may play a role in determining T2D susceptibility, possibly by modulating chronic, low-grade inflammatory responses.

  13. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case report and literature review.

    Science.gov (United States)

    Oishi, Naoki; Kondo, Tetsuo; Nakazawa, Tadao; Mochizuki, Kunio; Kasai, Kazunari; Inoue, Tomohiro; Yamamoto, Takanori; Watanabe, Hiroyuki; Hatsushika, Kyousuke; Masuyama, Keisuke; Katoh, Ryohei

    2014-12-01

    Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and abnormal expression of thyroid transcription factor-1 (TTF-1). Here we report a novel case of TL-LGNPPA with literature review. The patient was a 43-year-old woman complaining of nasal obstruction. Laryngoscopic study and computed tomography identified a pedunculated mass located on the posterior edge of the left nasal septum. Histologically, the tumor consisted of papillary growth of cuboidal or columnar epithelium. Tubular architecture and a spindle cell component were also observed focally. Some tumor cells exhibited intra-nuclear cytoplasmic inclusions. Immunohistochemically, the neoplastic cells were positive for pancytokeratin (AE1/AE3), CK7, CK19, TTF-1, vimentin and HBME1, but negative for thyroglobulin, Pax8 and CK5/6. Ki67-labeling index reached 5% in the most concentrated spot. Despite the morphological and immunohistochemical similarity to papillary thyroid carcinoma, no BRAF V600E mutation was detected by mutation-specific immunohistochemistry. The patient had neither local recurrence nor distant metastasis 19 months after removal of the tumor.

  14. Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Wataru Kudaka

    2016-01-01

    Full Text Available Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS extending to inferior vena cava (IVC and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

  15. Co-pyrolysis of a Ukrainian low-grade coal (brown) with plastics

    Energy Technology Data Exchange (ETDEWEB)

    V.N. Shevkoplyas [National Academy of Sciences of Ukraine, Donetsk (Ukraine)

    2003-07-01

    An effective pathway of the wastes plastics utilization can be its co-pyrolysis with a low-grade (brown) coal. The Dneprovsky deposit brown coal (Ukraine) and waste plastics as a polyethyleneterephthalate in this investigation were taken. The brown coal-plastics mixed used: 19:1; 9:1 and 4:1 ratio that was as 5, 10 and 20 % plastics additive to the brown coal. The co-pyrolysis mix prepared in the temperature region 450-800{sup o}C in a fixed bed reactor has been carried out. The process time was 0, 60 and 120 min., heating rate - 25{sup o}C/min. The influence plastics additive on the co-pyrolysis yield has been estimated. The influence of the co-pyrolysis isothermal time on the yield and properties of the tars produced has been studied. The mass balances of co-pyrolysis brown coal with plastics have been calculated. It was concluded that the co-pyrolysis brown coal with plastics is a way to utilize organic pollutants. 3 refs., 1 fig., 6 tabs.

  16. Dry Separation of Iron Minerals from Low-Grade Coal-series Kaolin

    Institute of Scientific and Technical Information of China (English)

    HUANG Teng; LEI Shaomin; LIU Mochou; JI Mengjiao; LIU Yuanyuan; YIN Xudong; PENG Yongjun

    2015-01-01

    Dry separation of iron mineral from low-grade coal-series kaolin in Hubei Province of China was investigated. The structure and chemical composition of the kaolin ore were determined by X-ray diffraction (XRD) and X-ray Fluorescence (XRF) analyses. The narrow particle size range classiifcation, dry magnetic separation and calcination were carried out to evaluate the particle size distribution, and the relation between the content of iron and the whiteness. Experimental results revealed that the highest content of iron (3.70%) in kaolin ore was in the particle size range from 60 to 74 μm, and pyrite was the main occurrence of iron in the kaolin ore. Dry magnetic separation showed that the removal rate of iron in kaolin ore could be increased obviously after calcination, and the rate of iron removal was 60% in the particle size range from 60 to 74 μm. As pyrite can be transformed into hematite through calcination, thermodynamic studies and XRD analysis showed that the maximum content of hematite was obtained at 900℃, which would be more beneifcial to magnetic separation.

  17. Ubiquitous Burgess Shale-style "clay templates" in low-grade metamorphic mudrocks

    Science.gov (United States)

    Page, Alex; Gabbott, Sarah E.; Wilby, Philip R.; Zalasiewicz, Jan A.

    2008-11-01

    Despite the Burgess Shale's (British Columbia, Canada) paleobiologicalimportance, there is little consensus regarding its taphonomy.Its organic fossils are preserved as compressions associatedwith phyllosilicate films ("clay templates"). Debate focuseson whether these templates were fundamental in exceptional preservationor if they formed in metamorphism, meaning that it is importantto establish the timing of their formation relative to decay.An early diagenetic origin has been proposed based on anatomy-specificvariations in their composition, purportedly reflecting contrastsin decay. However, we demonstrate that these films bear a remarkablesimilarity to those that occur on organic fossils in graptoliticmudrocks and form as a normal product of low-grade metamorphism.Such phyllosilicates may also occur within voids created byvolume loss in maturation, a process that may have aided theirformation. In bedding-plane assemblages from graptolitic mudrocks,different taxa are associated with distinct phyllosilicates.This likely reflects stepwise maturation of their constituentkerogens in an evolving hydrothermal fluid, with different phyllosilicatesforming as each taxon progressively underwent maturation. Theseobservations provide an analogue for the distribution and compositionof phyllosilicates on Burgess Shale fossils, which we interpretas reflecting variations in the maturation of their constituenttissues. Thus, their clay templates seem unremarkable, formingtoo late to account for exceptional preservation.

  18. Transportation of low-grade thermal energy over long distance by ammonia-water absorption

    Institute of Scientific and Technical Information of China (English)

    MA Qiang; WANG RuZhui; LUO LinGai; XIA ZaiZhong; LIN Peng

    2009-01-01

    This paper presents the importance and the cycle choice for long-distance transportation of low-grade thermal energy, and the thermodynamic and hydrodynamic feasibility of single-effect ammonia-water absorption system for heat or cold transportation over long distance are also involved. A model of a long-distance thermal energy transportation system is built and analyzed, which shows satisfactory and attractive results. When a steam heat source at 12012 is available, the user site can get hot water output at about 55℃ with the thermal COP of about 0.6 and the electric COP of about 100 in winter, and cold water output at about 10~C with the thermal COP of about 0.5 and the electric COP of 50 in summer.A small-size prototype is built to verify the performance analysis. Basically the experimental data show good accordance with the analysis results. The ammonia-water absorption system is a potential prospective solution for the heat or cold transportation over long distance.

  19. Selective Removal of Iron from Low-Grade Ti Ore by Reacting with Calcium Chloride

    Science.gov (United States)

    Kang, Jungshin; Okabe, Toru H.

    2016-09-01

    Recently, titanium metal production by molten salt electrolysis using CaCl2 as molten salt and TiO2 or rutile (94 to 96 pct TiO2) as feedstock has been drawing attention. However, when a low-grade Ti ore (mainly FeTiO3) is used as feedstock, removal of iron (Fe) from the ore is indispensable. In this study, the influence of reaction temperature, reaction time, particle size of the ore, and source country for the ore on the removal of iron by selective chlorination using CaCl2 was assessed. Experimental results showed that the mass percent of iron in the ore decreased from 49.7 to 1.79 pct under certain conditions by selective removal of iron as FeCl2. As a result, high-grade CaTiO3 was produced when the ore particles smaller than 74 µm reacted with CaCl2 at 1240 K (967 °C) for 8 to 10 hours. Therefore, this study demonstrates that the removal of iron from the ore is feasible through the selective chlorination process using CaCl2 by optimizing the variables.

  20. Integrated utilization of low-grade thermal energy in hot coal mine

    Institute of Scientific and Technical Information of China (English)

    Wei-min CHENG; Yu-dong QI; Yan-bin YU; Gang PAN

    2013-01-01

    This paper explores the integrated utilization of low-grade thermal energy in hot coal mines,based on analysis of original heating,refrigerating,mine draining,bath draining and air exhaust systems,and in combination with the actual conditions of Tangkou Coal Mine in Shandong Province.It presents a set of comprehensive and integrated utilization schemes for the various different kinds of low quality heat energy.With heat pumps,the recycling of the low quality heat energy from the drainage,bathing water and the exhaust air can occur in winter,and in summer,there exists condensed heat of the refrigerating system.When in conjunction with solar collectors,the thermal utilization of solar power can be realized for the whole year.The system achieves mine drainage and bathing water purification and recycling,as well as purifying exhaust air by water spraying.It also satisfies the demands of a whole year's bathing heat for the coal mine,with refrigeration in summer,and heating for the ground house and shaft house in winter.It is able to integrate different kinds of low quality heat energy and low emission drainage and dust,and can replace the traditional boiler heating system.Finally,the system reduces conventional energy consumption and the amount of mine water drainage.

  1. The association between obesity and fluid intelligence impairment is mediated by chronic low-grade inflammation.

    Science.gov (United States)

    Spyridaki, Eirini C; Simos, Panagiotis; Avgoustinaki, Pavlina D; Dermitzaki, Eirini; Venihaki, Maria; Bardos, Achilles N; Margioris, Andrew N

    2014-11-28

    Published evidence suggests that obesity impairs cognition. Development of chronic low-grade inflammation (CLGI) represents the earliest consequence of obesity. The present study investigated the association between obesity and fluid intelligence impairment and assessed the potential mediating role of CLGI and psychological (depression/anxiety symptoms), lifestyle (exercise) and physiological (metabolic dysfunction indices) factors in this association. Clinically healthy participants (n 188), grouped as per BMI, underwent cognitive (General Ability Measure for Adults), psychological (Beck Depression Inventory-II and State-Trait Anxiety Inventory) and activity (Godin leisure-time physical activity) measurements. Biochemical parameters included the following: (a) indices of CLGI (high-sensitivity C-reactive protein, erythrocyte sedimentation rate and fibrinogen); (b) insulin resistance (Homeostasis Model Assessment of Insulin Resistance index); (c) adiposity (plasma adiponectin). An inverse association between elevated BMI and fluid intelligence was observed, with obese participants displaying significantly poorer performance compared with age-matched normal-weight peers. Structural equation modelling results were consistent with a negative impact of obesity on cognition that was mediated by CLGI. The results of the present study support the hypothesis that reduced general cognitive ability is associated with obesity, an adverse effect mainly mediated by obesity-associated activation of innate immunity.

  2. Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas

    Directory of Open Access Journals (Sweden)

    André de Macedo Bianco

    2013-01-01

    Full Text Available A retrospective study of 81 patients with low-grade astrocytoma (LGA comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS and progression- free survival (PFS. Degree of tumor resection was classified as gross total resection (GTR, subtotal resection (STR or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013, whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33. Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.

  3. [Presence of high risk human papilomaviruses (HPV) in the low grade cervical lesion].

    Science.gov (United States)

    Iljazović, Ermina; Mustadenagić-Mujanović, Jasminka; Karasalihović, Zinaida; Cickusić, E; Avdić, S

    2006-01-01

    Low grade squamous intraepithelial lesion (LGSIL) and atypical squamous cells undetermined significance (ASCUS) are the most frequent verified cellular abnormalities. Their management are still highly controversial mostly caused by uncertainty about their histology and nature of originate. Detection of HPV DNA in the absence of cytological abnormalities can also indicate presence of high-grade cervical intraepithelial neoplasia (CIN). The aim of this study was to show the association of the benign cellular changes, ASCUS and LGSIL with oncogenic types of HPV and to prove the necessity of more intensive screening of this group of patients. Cytology and pathomorphology analyses were performed first. Identification of the presence of human papiloma virus was carried out by the Digene Hybride Capture II test for all patients. Identification of different HPV types for the particular number of patients was carried out by RFLP (Rsetriction Fragments Length of Polymorphism). Out of the 101 patients in the first group 92 (91,08%) were HPV positive, and 41, 58% had no cellular abnormalities, ASCUS or LGSIL. Out of 509 patients of the second group 26.92% were positive for HRHPV, and 78,97% of them had no cellular abnormalities, ASCUS or LGSIL. HPV 16 was detected in 27.36% (ASCUS/LGSIL) of low risk cervical lesion of the first examined period. The combination of smears with the detection of high risk HPV types increases the triage sensitivity especially at patients with mild.

  4. Reduction of Low-grade Manganese Dioxide Ore Pellets by Biomass Wheat Stalk

    Institute of Scientific and Technical Information of China (English)

    Honglei ZHANG; Guocai ZHU; Hong YAN; Yuna ZHAO; Tiancheng LI; Xiujuan FENG

    2013-01-01

    An investigation on reducing low-grade manganese dioxide ore pellets was carried out by using wheat stalk as reductant.The main impact factors of reduction percent such as particle size,biomass/ore ratio,heating rate,nitrogen flow rate,temperature and time in reduction process were discussed.The morphology and component of manganese dioxide ore particle at different stages were also analyzed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS).The results show the increase of the reduction temperature and time,biomass/ore ratio,and the decrease of particle size,heating rate and nitrogen flow rate can significantly enhance reduction efficiency.The reduction kinetic of the manganese ore is controlled by three-dimensional mass diffusion of gaseous reductive volatiles passing from the surface to the core of the ore particles.The activation energy E and frequency factor A were calculated to be 24.15 kJ.mol-1 and 166 min-1,respectively.Biomass pyrolysis volatiles adsorbed onto the surface of the ore particle leads to serious variation of the microstructures and chemical composition of the manganese ore particles.

  5. Inhibition of Low-Grade Inflammation by Anthocyanins after Microbial Fermentation in Vitro

    Directory of Open Access Journals (Sweden)

    Sabine Kuntz

    2016-07-01

    Full Text Available The anti-inflammatory effects of anthocyanins (ACNs on vascular functions are discussed controversially because of their low bioavailability. This study was performed to determine whether microorganism (MO-fermented ACNs influence vascular inflammation in vitro. Therefore, MO growth media were supplemented with an ACN-rich grape/berry extract and growth responses of Escherichia coli, E. faecalis and H. alvei, as well as ACN fermentation were observed. MO supernatants were used for measuring the anti-inflammatory effect of MO-fermented ACNs in an epithelial-endothelial co-culture transwell system. After basolateral enrichment (240 min, endothelial cells were stimulated immediately or after 20 h with TNF-α. Afterwards, leukocyte adhesion, expression of adhesion molecules and cytokine release were measured. Results indicate that E. coli, E. faecalis and H. alvei utilized ACNs differentially concomitant with different anti-inflammatory effects. Whereas E. coli utilized ACNs completely, no anti-inflammatory effects of fermented ACNs were observed on activated endothelial cells. In contrast, ACN metabolites generated by E. faecalis and H. alvei significantly attenuated low-grade stimulated leukocyte adhesion, the expression of adhesion molecules E-selectin, VCAM-1 and ICAM-1 and cytokine secretion (IL-8 and IL-6, as well as NF-κB mRNA expression with a more pronounced effect of E. faecalis than H. alvei. Thus, MO-fermented ACNs have the potential to reduce inflammation.

  6. Fractionated resection on low grade gliomas involving Broca's area and insights to brain plasticity

    Institute of Scientific and Technical Information of China (English)

    WU Chen-xing; PU Song; LIN Yi; WANG Yong-zhi; JIANG Tao; XIE Jian; WEI Miao; YI Xiao-li; WANG Xiao-yi

    2008-01-01

    Background Resent advances on functional mapping have enabled us to conduct surgery on gliomas within the eloquent area. The objective of the article is to discuss the feasibility of a planned fractionated strategy of resection on low-grade gliomas (LGGs) involving Broca's area. We report the first surgical series of planned fractionated resections on LGGs within Broca's area, focusing on language functional reshaping.Methods Four patients were treated with fractionated operations for LGGs involving Broca's area. All cases underwent conventional magnetic resonance (MR) scanning, language functional MR and diffusion tensor imaging (DTI) before operation. The resections were then performed on patients under awake anesthesia using intraoperative electrical stimulation (IES) for functional mapping. Pre- and post-operative neuro-psychological examinations were evaluated. Results Total resections were achieved in all cases as confirmed by the postoperative control MR. After transient language worsening, all patients recovered to normal3-6 months later.Language functional MR scannings have shown the operation.All patients retumed to a normal socioprofessional life.Conclusions By utilizing the dynamic interaction between brain plasticity and fractionated resections,we can totally remove the tumor involving Broca'S structure without inducing permanent postoperative deficits and even improve the qualityof life.

  7. Multiphoton imaging of low grade, high grade intraepithelial neoplasia and intramucosal invasive cancer of esophagus

    Science.gov (United States)

    Xu, Jian; Jiang, Liwei; Kang, Deyong; Wu, Xuejing; Xu, Meifang; Zhuo, Shuangmu; Zhu, Xiaoqin; Lin, Jiangbo; Chen, Jianxin

    2017-04-01

    Esophageal squamous cell carcinoma (ESCC) is devastating because of its aggressive lymphatic spread and clinical course. It is believed to occur through low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and intramucosal invasive cancer (IMC) before transforming to submucosal cancer. In particular, these early lesions (LGIN, HGIN and IMC), which involve no lymph node nor distant metastasis, can be cured by endoscopic treatment. Therefore, early identification of these lesions is important so as to offer a curative endoscopic resection, thus slowing down the development of ESCC. In this work, spectral information and morphological features of the normal esophageal mucosa are first studied. Then, the morphological changes of LGIN, HGIN and IMC are described. Lastly, quantitative parameters are also extracted by calculating the nuclear-to-cytoplasmic ratio of epithelial cells and the pixel density of collagen in the lamina propria. These results show that multiphoton microscopy (MPM) has the ability to identify normal esophageal mucosa, LGIN, HGIN and IMC. With the development of multiphoton endoscope systems for in vivo imaging, combined with a laser ablation system, MPM has the potential to provide immediate pathologic diagnosis and curative treatment of ESCC before the transformation to submucosal cancer in the future.

  8. Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome?

    Science.gov (United States)

    Piscaglia, Anna Chiara; Laterza, Lucrezia; Cesario, Valentina; Gerardi, Viviana; Landi, Rosario; Lopetuso, Loris Riccardo; Calò, Giovanni; Fabbretti, Giovanna; Brisigotti, Massimo; Stefanelli, Maria Loredana; Gasbarrini, Antonio

    2016-01-01

    AIM To evaluate the prevalence of nodular lymphoid hyperplasia (NLH) in adult patients undergoing colonoscopy and its association with known diseases. METHODS We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome (IBS)-type symptoms or suspected inflammatory bowel disease (IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening. Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period. RESULTS One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals (only 3%), while it was significantly more prevalent in symptomatic cases (32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. CONCLUSION About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients. PMID:28028368

  9. The macrophage low-grade inflammation marker sCD163 is modulated by exogenous sex steroids

    DEFF Research Database (Denmark)

    Thomsen, Henrik Holm; Møller, Holger Jon; Trolle, Christian

    2013-01-01

    Soluble CD163 (sCD163) is a novel marker linked to states of low grade inflammation such as diabetes, obesity, liver disease and atherosclerosis, all prevalent in subjects with Turner and Klinefelter Syndromes. We aimed to assess the levels of sCD163 and the regulation of sCD163 in regards...

  10. Polyphenol intake is associated with low-grade inflammation, using a novel data analysis from the Moli-sani study.

    Science.gov (United States)

    Pounis, George; Bonaccio, Marialaura; Di Castelnuovo, Augusto; Costanzo, Simona; de Curtis, Amalia; Persichillo, Mariarosaria; Sieri, Sabina; Donati, Maria Benedetta; Cerletti, Chiara; de Gaetano, Giovanni; Iacoviello, Licia

    2016-01-01

    The association of polyphenol content of human diet with low-grade inflammation is not yet fully understood. It was the objective of this study to evaluate the association of flavonoid and lignan intake with frequently used and easily applicable in clinical practice low-grade inflammation biomarkers, in a novel holistic approach. A total of 5,948 women and 5,965 men (aged ≥ 35 years) were analysed from the Moli-sani cohort, randomly recruited from the general population. The EPIC-FFQ was used for dietary assessment. Flavonol, flavone, flavanone, flavanol, anthocyanin, isoflavone and lignan intakes were calculated using Eurofir eBASIS and the polyphenol antioxidant content (PAC)-score was constructed to assess the total content of diet in these nutrients. CRP levels, WBC and PLT count and granulocyte to lymphocyte ratio were conceived as low-grade inflammation biomarkers. INFLA-score was constructed summarizing synergistic effects of these biomarkers. The INFLA-score was negatively associated with PAC-score in different levels of adjustment, in both genders (for all β-coefinflammation status (i.e. higher quartile of INFLA-score) in men and women (odds ratio [ORs] 0.92 to 0.95, pinflammation biomarkers in a large population based study. For the first time low-grade inflammation was evaluated in a holistic way through INFLA-score and was associated with polyphenol content of diet.

  11. The role of low-grade inflammation and metabolic flexibility in aging and nutritional modulation thereof: A systems biology approach

    NARCIS (Netherlands)

    Calçada, D.; Vianello, D.; Giampieri, E.; Sala, C.; Castellani, G.; Graaf, A.A. de; Kremer, S.H.A.; Ommen, B. van; Feskens, E.; Santoro, A.; Franceschi, C.; Bouwman, J.

    2014-01-01

    Aging is a biological process characterized by the progressive functional decline of many interrelated physiological systems. In particular, aging is associated with the development of a systemic state of low-grade chronic inflammation (inflammaging), and with progressive deterioration of metabolic

  12. The role of low-grade inflammation and metabolic flexibility in aging and nutritional modulation thereof: a systems biology approach

    NARCIS (Netherlands)

    Viegas Calcada, D.I.; Vianello, D.; Giampieri, E.; Sala, C.; Castellani, G.; Graaf, de A.; Kremer, B.; Ommen, van B.; Feskens, E.J.M.; Santoro, A.; Franceschi, C.; Bouwman, J.

    2014-01-01

    Aging is a biological process characterized by the progressive functional decline of many interrelated physiological systems. In particular, aging is associated with the development of a systemic state of low-grade chronic inflammation (inflammaging), and with progressive deterioration of metabolic

  13. Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage

    Science.gov (United States)

    Lin, Pei-Yi; Hagan, Katherine; Fenoglio, Angela; Grant, P. Ellen; Franceschini, Maria Angela

    2016-05-01

    Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.

  14. First-line temozolomide chemotherapy in progressive low-grade astrocytomas after radiotherapy: molecular characteristics in relation to response

    NARCIS (Netherlands)

    Taal, W.; Dubbink, H.J.; Zonnenberg, C.B.; Zonnenberg, B.A.; Postma, T.J.; Gijtenbeek, J.M.M.; Boogerd, W.; Groenendijk, F.H.; Kros, J.M.; Kouwenhoven, M.C.; Marion, R. van; Heuvel, I. van; Holt, B. van der; Bromberg, J.E.; Sillevis Smitt, P.A.; Dinjens, W.N.; Bent, M.J. van den

    2011-01-01

    Only a few studies examined the effect of temozolomide (TMZ) in recurrent low-grade astrocytoma (LGA) after surgery, none of which included a homogeneous and sufficiently sized group of patients with progression after radiotherapy (RT). We evaluated a cohort of 58 patients treated with TMZ for progr

  15. First-line temozolomide chemotherapy in progressive low-grade astrocytomas after radiotherapy: Molecular characteristics in relation to response

    NARCIS (Netherlands)

    W. Taal (Walter); H.J. Dubbink (Erik Jan); B.A. Zonnenberg; T.J. Postma (Tjeerd); J. Gijtenbeek (Johanna); W. Boogerd (Willem); F.H. Groenendijk (Floris); J.M. Kros (Johan); M.C.M. Kouwenhoven (Mathilde); R. van Marion (Ronald); I. van Heuvel (Irene); B. van der Holt (Bronno); J.E.C. Bromberg (Jacolien); P.A. Smitt (Peter); W.N.M. Dinjens (Winand); M.J. van den Bent (Martin)

    2011-01-01

    textabstractOnly a few studies examined the effect of temozolomide (TMZ) in recurrent low-grade astrocytoma (LGA) after surgery, none of which included a homogeneous and sufficiently sized group of patients with progression after radiotherapy (RT). We evaluated a cohort of 58 patients treated with T

  16. Health-related quality of life in stable, long-term survivors of low-grade glioma

    NARCIS (Netherlands)

    F.W. Boele; L. Douw; J.C. Reijneveld; R. Robben; M.J.B. Taphoorn; N.K. Aaronson; J.J. Heimans; M. Klein

    2015-01-01

    Purpose: Patients with low-grade glioma (LGG) often experience long periods of stable disease, emphasizing the importance of maintaining good health-related quality of life (HRQOL). We assessed the changes in HRQOL in long-term survivors of WHO grade I or II astrocytoma, oligodendroglioma, or oligoa

  17. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma : long-term follow-up

    NARCIS (Netherlands)

    Douw, Linda; Klein, Martin; Fagel, Selene S. A. A.; van den Heuvel, Josje; Taphoorn, Martin J. B.; Aaronson, Neil K.; Postma, Tjeerd J.; Vandertop, W. Peter; Mooij, Jacob J.; Boerman, Rudolf H.; Beute, Guus N.; Sluimer, Jasper D.; Slotman, Ben J.; Reijneveld, Jaap C.; Heimans, Jan J.

    2009-01-01

    Background Our previous study on cognitive functioning among 195 patients with low-grade glioma (LGG) a mean of 6 years after diagnosis suggested that the tumour itself, rather than the radiotherapy used to treat it, has the most deleterious effect on cognitive functioning; only high fraction dose r

  18. Successful treatment of low-grade oligodendroglial tumors with a chemotherapy regimen of procarbazine, lomustine, and vincristine

    NARCIS (Netherlands)

    Stege, Elize M Biemond-ter; Kros, Johan M; de Bruin, Hein G; Enting, R H; van Heuvel, Irene; Looijenga, Leendert H J; van der Rijt, Carin D D; Smitt, Peter A E Sillevis; van den Bent, Martin J

    2005-01-01

    BACKGROUND: Anaplastic oligodendroglioma (OD) tumors, especially those with the combined loss of the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q), are sensitive to chemotherapy. Only limited data are available on the role of chemotherapy in low-grade OD. The authors retrosp

  19. Health-related quality of life in stable, long-term survivors of low-grade glioma

    NARCIS (Netherlands)

    Boele, F.W.; Douw, L.; Reijneveld, J.C.; Robben, R.; Taphoorn, M.J.B.; Aaronson, N.K.; Heimans, J.J.; Klein, M.

    2015-01-01

    Purpose: Patients with low-grade glioma (LGG) often experience long periods of stable disease, emphasizing the importance of maintaining good health-related quality of life (HRQOL). We assessed the changes in HRQOL in long-term survivors of WHO grade I or II astrocytoma, oligodendroglioma, or

  20. Low grade astrocytoma transformating primitive neuroectodermal tumour in an adult? A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Xiaofeng Wang; Yuqiang Sun; Zeshi Tan; Anlong Ji; Xu Sun; Xinyu Li; Ningwei Che

    2016-01-01

    Background:Supratentorial primitive neuroectodermal tumors (sPNET) are rarely occurred in adults.Only 39 cases have been reported in the past decade.The transformation from low grade to aggressive astrocytoma is well known.However,such convert from a low-grade astrocytoma (LGA) into a sPNET between two completely different tumors is rarer.Case Presentation:This report discussed a 36-year-old male,who presented with the chief complaint of partial seizures and left limbs dysfunction and Magnetic resonance imaging (MRI) of whom revealed right frontal lesions which was operated to resect accompanied by the histological diagnosis of sPNET.The patient underwent operation 2.5 years ago because of seizures and was diagnosed with right frontal astrocytoma confirmed by pathology.However,radiotherapy was not preformed on him after the primary surgery.Histology now revealed high grade PNET.Conclusion:It is exactly uncertain that reports revelant to transformation from low-grade astrocytoma to a new kind of tumor or neoplasm induced by radiotation have been published.This case report is accompanied by a review of 39 cases of adult sPNET in the past decade,especially discussing about the transformation of low grade glioma into sPNET.

  1. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Max Schmulson

    2014-04-01

    Conclusions: Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non PI-IBS. Rifaximin has shown itself to be an effective treatment for IBS, regardless of prior factors.

  2. Low-grade intraventricular hemorrhage disrupts cerebellar white matter in preterm infants: evidence from diffusion tensor imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Takashi; Morimoto, Masafumi; Hasegawa, Tatsuji; Morioka, Shigemi; Kidowaki, Satoshi; Moroto, Masaharu; Yamashita, Satoshi; Maeda, Hiroshi; Chiyonobu, Tomohiro; Tokuda, Sachiko; Hosoi, Hajime [Kyoto Prefectural University of Medicine, Department of Pediatrics, Graduate School of Medical Science, Kyoto (Japan); Yamada, Kei [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2015-05-01

    Recent diffusion tensor imaging (DTI) studies have demonstrated that leakage of hemosiderin into cerebrospinal fluid (CSF), which is caused by high-grade intraventricular hemorrhage (IVH), can affect cerebellar development in preterm born infants. However, a direct effect of low-grade IVH on cerebellar development is unknown. Thus, we evaluated the cerebellar and cerebral white matter (WM) of preterm infants with low-grade IVH. Using DTI tractography performed at term-equivalent age, we analyzed 42 infants who were born less than 30 weeks gestational age (GA) at birth (22 with low-grade IVH, 20 without). These infants were divided into two birth groups depending on GA, and we then compared the presence and absence of IVH which was diagnosed by cerebral ultrasound (CUS) within 10 days after birth or conventional magnetic resonance imaging (MRI) at term-equivalent age in each group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP), motor tract, and sensory tract were measured. In the SCP, preterm born infants with IVH had lower FA values compared with infants without IVH. In particular, younger preterm birth with IVH had lower FA values in the SCP and motor tract and higher ADC values in the MCP. Low-grade IVH impaired cerebellar and cerebral WM, especially in the SCP. Moreover, younger preterm infants exhibited greater disruptions to cerebellar WM and the motor tract than infants of older preterm birth. (orig.)

  3. Research on Experimental and Application for the High Efficient Enrichment of the Low-grade Precious Metal Materials

    Institute of Scientific and Technical Information of China (English)

    FAN Xingxiang; FU Guangqiang; DONG Haigang; WU Yuedong; LIU Yang; ZHAO Jiachun; WU Xiaofeng; LI Bojie; TONG Weifeng

    2012-01-01

    On the basis of reviewing the progress in the high efficient enrichment from secondary resources of low-grade precious metals at home and abroad,a process route of the high efficient enrichment precious metals from secondary resources of low-grade metals by adding iron oxide as the trapping agent,reducing agent,additive,mixing uniformly and grinding,pelletizing,reduction,grinding and separation,and selectively acid leaching iron has been put forward in this paper.The experiments of reduction,grinding and separation,and selectively acid leaching iron were carried out mainly.Under the decided experiment parameters and conditions,iron generated during the reduction can trap precious metals during reduction,high active alloy powders were obtained from the reduced products by grinding and separation,the concentration of precious metals was obtained by acid leaching high active alloy powders.The better enrichment effect was obtained by adopting the technical route of processing.Other low grade noble metal materials and enrichment ratio of precious metals from the materials to acid products was high through acid leaching.This process has the advantages of simple process,environmental-friendly,strong adaptability of raw materials,high concentration ratio,which was regarded as a kind of the general efficient enrichment technology of low grade precious metal materials.

  4. Effects of low-grade weirs on soil microbial communities to advance agricultural best management practices for nitrate remediation

    Science.gov (United States)

    Agricultural activities throughout the Mississippi River Basin have been identified as a major source of nutrient pollution, particularly nitrogen from fertilizer application, to downstream waters including the Gulf of Mexico. Utilizing best management practices, such as low-grade weirs have been id...

  5. Central low-grade osteosarcoma with an unusual localization in the diaphysis of a 12-year old patient.

    Science.gov (United States)

    Gilg, Magdalena Maria; Liegl, Bernadette; Wibmer, Christine; Maurer-Ertl, Werner; Leithner, Andreas

    2013-06-01

    Low-grade central osteosarcoma is a very rare subtype of osteosarcoma with a predilection for the metaphysis of long bones and a peak incidence in the 3(rd) decade of life. Absence of specific clinical symptoms and a good prognosis after wide resection are the characteristics of this entity. Chemotherapy is not indicated in this highly differentiated tumour. A 12-year old girl presented with limping, swelling and pain in the mid of the left femur. Radiography showed a 12 cm long intraosseous expansion with lamellated periosteal reaction and contrast medium enhancement in MRI. Although radiology led to the differential diagnoses of Ewing's sarcoma, osteomyelitis and fibrous dysplasia, the histological specimen showed a hyopocellular spindle-cell proliferation arranged in fascicles with mild cytologic atypia and only single mitotic figures. In synopsis with radiology the diagnosis of low-grade central osteosarcoma was made and confirmed by reference pathology. The tumour was resected with wide margins and reconstruction was performed with a vascularized fibula, a homologous allograft and a plate. Staging was negative for recurrence and metastasis at a follow-up of 16 months. Low-grade osteosarcoma accounts for only 1% of all osteosarcomas with a peak incidence in the 3(rd) decade. The diaphyseal localization and the young age make this case special. To achieve the correct diagnosis of this rare low-grade entity and thereby the adequate treatment, despite a wide range of differential diagnoses, a multidisciplinary approach is essential.

  6. Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts.

    Science.gov (United States)

    Guha, Daipayan; Heary, Robert F; Shamji, Mohammed F

    2015-10-01

    OBJECT Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability. METHODS A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed. RESULTS A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%). CONCLUSIONS Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.

  7. Espondilolistese em frango de corte no Brasil Spondylolisthesis ("Kinky Back" in broiler chickens in Brazil

    Directory of Open Access Journals (Sweden)

    T.A. Paixão

    2007-04-01

    Full Text Available Eight 28-day-old broiler chickens of both sexes were examined. Clinical signs, gross findings, radiological, and histopathological changes were described. Spondylolisthesis was characterized by dorsal displacement of the sixth and seventh thoracic vertebrae, resulting in compression of the spinal cord. The major clinical manifestation was paraplegia. Risk factors such as genetics, nutrition, stress, rate of growth, and age were discussed.

  8. STUDY OF VARIATION OF THE DIAMETER OF THE SPINAL CANAL AND THE FORAMINA IN SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Enguer Beraldo Garcia

    2016-03-01

    Full Text Available ABSTRACT Objective: To define and quantify the degree of change of the spinal canal diameter in patients with degenerative and spondylolytic spondylolisthesis. Methods: We studied CT scans of 54 patients. Of this total, 37 (29 women and 8 men had degenerative type and 17 (7 women and 10 men had spondylolytic type. Results: In the degenerative spondylolisthesis group, the average diameter of the spinal canal at the injured vertebra level was 17.35 mm and 17.64 mm for the upper vertebra level. The average diameter of the foramen at the level of the affected vertebra was 14.61 mm to left side and 15.00 mm to the right side. The average diameter of the foramen at the upper vertebra level was 16.82 mm to the left side and 16.51 mm to the right side. In the spondylolytic group, the average diameter of the spinal canal at the level of the affected vertebra was 23.25 mm and at the upper vertebra level was 18.66 mm. The average diameter of the foramen at the level of the affected vertebra was 11.98 mm to the left side and 12.34 mm to the right side. The average diameter of the foramen at the level of the upper vertebra was 16.97 mm to the left side and 15.58 mm to the right side. Conclusion: The diameter of the spinal canal in the sagittal plane showed no statistically significant increase in the spondylolytic spondylolisthesis group, in contrast to what is found in the degenerative spondylolisthesis group. It was also observed a reduction in vertebral foramina of the injured level in both groups.

  9. Operative management of a non-traumatic cervico-thoracic spondylolisthesis: a case report

    Directory of Open Access Journals (Sweden)

    Zwingenberger Stefan

    2012-06-01

    Full Text Available Abstract Introduction In contrast to spondylolisthesis of the lumbar spine, non-traumatic cervico-thoracic spondylolisthesis is a very rare lesion. Even minor changes in the displacement of the vertebrae or the cord can lead to cervical myelopathy and paralysis. Since only a few cases have been well-documented, there is currently no clear preference between operative techniques. Case presentation We describe the case of a 63-year-old Caucasian man with a 13 mm spondylolisthesis between C7 and T1. Within a few months, a progressive cervical myelopathy developed as he began to suffer pain and loss of function of his digits and was no longer able to walk unassisted. In an interdisciplinary collaboration between neurological and orthopedic surgeons, a ventral-dorsal-ventral approach was performed on one vertebral section. The ventral removal of the intervertebral disc was followed by laminectomy and dorsal instrumentation. A new application technique was established by inserting bicortical screws into the transverse processes of T2 and T3. The structure was subsequently stabilized by the ventral insertion of a Harms basket. The procedure was successful as it halted progression of the myelopathy. The patient demonstrated improved sensitivity and recovered the ability to walk unassisted. He has now been able to walk unassisted for two years postoperatively. Conclusion This paper describes a successful treatment for a very rare case of cervico-thoracic spondylolisthesis. The technique of inserting bicortical screws into the transverse processes is a fast, safe and successful method that does not require the use of intraoperative radiographs for placement of the bicortical screws into the transverse processes.

  10. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification.

    Science.gov (United States)

    Labelle, Hubert; Mac-Thiong, Jean-Marc; Roussouly, Pierre

    2011-09-01

    In L5-S1 spondylolisthesis, it has been clearly demonstrated over the past decade that sacro-pelvic morphology is abnormal and that it can be associated to an abnormal sacro-pelvic orientation as well as to a disturbed global sagittal balance of the spine. The purpose of this article is to review the work done within the Spinal Deformity Study Group (SDSG) over the past decade, which has led to a classification incorporating this recent knowledge. The evidence presented has been derived from the analysis of the SDSG database, a multi-center radiological database of patients with L5-S1 spondylolisthesis, collected from 43 spine surgeons in North America and Europe. The classification defines 6 types of spondylolisthesis based on features that can be assessed on sagittal radiographs of the spine and pelvis: (1) grade of slip, (2) pelvic incidence, and (3) spino-pelvic alignment. A reliability study has demonstrated substantial intra- and inter-observer reliability similar to other currently used classifications for spinal deformity. Furthermore, health-related quality of life measures were found to be significantly different between the 6 types, thus supporting the value of a classification based on spino-pelvic alignment. The clinical relevance is that clinicians need to keep in mind when planning treatment that subjects with L5-S1 spondylolisthesis are a heterogeneous group with various adaptations of their posture. In the current controversy on whether high-grade deformities should or should not be reduced, it is suggested that reduction techniques should preferably be used in subjects with evidence of abnormal posture, in order to restore global spino-pelvic balance and improve the biomechanical environment for fusion.

  11. Triple-negative breast cancer: the importance of molecular and histologic subtyping, and recognition of low-grade variants.

    Science.gov (United States)

    Pareja, Fresia; Geyer, Felipe C; Marchiò, Caterina; Burke, Kathleen A; Weigelt, Britta; Reis-Filho, Jorge S

    2016-01-01

    Triple-negative breast cancers (TNBCs), defined by lack of expression of estrogen receptor, progesterone receptor and HER2, account for 12-17% of breast cancers and are clinically perceived as a discrete breast cancer subgroup. Nonetheless, TNBC has been shown to constitute a vastly heterogeneous disease encompassing a wide spectrum of entities with marked genetic, transcriptional, histological and clinical differences. Although most TNBCs are high-grade tumors, there are well-characterized low-grade TNBCs that have an indolent clinical course, whose natural history, molecular features and optimal therapy vastly differ from those of high-grade TNBCs. Secretory and adenoid cystic carcinomas are two histologic types of TNBCs underpinned by specific fusion genes; these tumors have an indolent clinical behavior and lack all of the cardinal molecular features of high-grade triple-negative disease. Recent studies of rare entities, including lesions once believed to constitute mere benign breast disease (e.g., microglandular adenosis), have resulted in the identification of potential precursors of TNBC and suggested the existence of a family of low-grade triple-negative lesions that, despite having low-grade morphology and indolent clinical behavior, have been shown to harbor the complex genomic landscape of common forms of TNBC, and may progress to high-grade disease. In this review, we describe the heterogeneity of TNBC and focus on the histologic and molecular features of low-grade forms of TNBC. Germane to addressing the challenges posed by the so-called triple-negative disease is the realization that TNBC is merely a descriptive term, and that low-grade types of TNBC may be driven by distinct sets of genetic alterations.

  12. [Low-grade systemic inflammation and the development of metabolic diseases: from the molecular evidence to the clinical practice].

    Science.gov (United States)

    León-Pedroza, José Israel; González-Tapia, Luis Alonso; del Olmo-Gil, Esteban; Castellanos-Rodríguez, Diana; Escobedo, Galileo; González-Chávez, Antonio

    2015-01-01

    Systemic inflammation is characterised by high circulating levels of inflammatory cytokines and increased macrophage infiltration in peripheral tissues. Most importantly, this inflammatory state does not involve damage or loss of function of the infiltrated tissue, which is a distinctive feature of the low-grade systemic inflammation. The term "meta-inflammation" has also been used to refer to the low-grade systemic inflammation due to its strong relationship with the development of cardio-metabolic diseases in obesity. A review is presented on the recent clinical and experimental evidence concerning the role of adipose tissue inflammation as a key mediator of low-grade systemic inflammation. Furthermore, the main molecular mechanisms involved in the inflammatory polarization of macrophages with the ability to infiltrate both the adipose tissue and the vascular endothelium via activation of toll-like receptors by metabolic damage-associated molecular patterns, such as advanced glycation-end products and oxidized lipoproteins, is discussed. Finally, a review is made of the pathogenic mechanisms through which the low-grade systemic inflammation contributes to develop insulin resistance, dyslipidaemia, atherogenesis, type 2 diabetes, and hypertension in obese individuals. A better understanding of the molecular mechanisms of low-grade systemic inflammation in promoting cardio-metabolic diseases is necessary, in order to further design novel anti-inflammatory therapies that take into consideration clinical data, as well as the circulating levels of cytokines, immune cells, and metabolic damage-associated molecular patterns in each patient. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  13. Morphometric substantiation of a fixation method choice at surgical correction of spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Anisimova Е.А.

    2010-09-01

    Full Text Available The purpose was to reveal patterns of morphometric characteristics variability of lumbar vertebrae and sacrum for a choice of more adequate selection of standard sizes and introduction orientation of corrigent metalware at surgical treatment of spondylolisthesis. Preparations of lumbar vertebrae and sacrum of 60 skeletons, 110 Kt-grams of men and women of the first and second periods of mature age without visible pathology of a backbone and 300 Kt-grams of patients with spondylolisthesis. The data on age variability and sexual dimorphism of lumbar vertebrae and sacrum were obtained. The analysis of results of surgical treatment of 288 patients with spondylolisthesis during 1995-2008 was carried out. 160 patients were managed with preoperative planning, taking into account morphometric characteristics of vertebrae and sacrum since 2003. It is necessary to install and arrange metalware at reduction taking into account features of back structures and forward basic complex of lumbar vertebrae and sacrum; that allows to receive adequate decompression of neurovascu-lar structures in 85-90% cases, reliable correction and stabilization of damaged lumbosacral segments

  14. Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Leonor Garbin Savarese

    2014-10-01

    Full Text Available To evaluate the association of redundant nerve roots of cauda equina (RNRCE with the degree of lumbar spinal stenosis (LSS and with spondylolisthesis. Method After Institutional Board approval, 171 consecutive patients were retrospectively enrolled, 105 LSS patients and 66 patients without stenosis. The dural sac cross-sectional area (CSA was measured on T2w axial MRI at the level of L2-3, L3-4 and L4-5 intervertebral discs. Two blinded radiologists classified cases as exhibiting or not RNRCE in MRI. Intra- and inter-observer reproducibility was assessed. Results RNRCE were associated with LSS. RRNCE was more frequent when maximum stenosis<55 mm2. Substantial intra- observer agreement and moderate inter-observer agreement were obtained in the classification of RNRCE. Spondylolisthesis was identified in 27 patients and represented increased risk for RRNCE. Conclusion LSS is a risk factor for RNRCE, especially for dural sac CSA<55 mm2. LSS and spondylolisthesis are independent risk factors for RNRCE.

  15. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  16. Longitudinal Investigation of Adaptive Functioning Following Conformal Irradiation for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Netson, Kelli L. [Department of Psychiatry and Behavioral Sciences, Kansas University School of Medicine—Wichita, Kansas (United States); Conklin, Heather M. [Department of Psychology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu, Shengjie; Xiong, Xiaoping [Department of Biostatistics, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [Division of Radiation Oncology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2013-04-01

    Purpose: Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Methods and Materials: Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Results: Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. Conclusions: There was relative sparing of postirradiation functional outcomes over time in this sample

  17. The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease.

    Science.gov (United States)

    Ruiz-Núñez, Begoña; Dijck-Brouwer, D A Janneke; Muskiet, Frits A J

    2016-10-01

    The mantra that dietary (saturated) fat must be minimized to reduce cardiovascular disease (CVD) risk has dominated nutritional guidelines for decades. Parallel to decreasing intakes of fat and saturated fatty acids (SFA), there have been increases in carbohydrate and sugar intakes, overweight, obesity and type 2 diabetes mellitus. The "lipid hypothesis" coined the concept that fat, especially SFA, raises blood low-density lipoprotein-cholesterol and thereby CVD risk. In view of current controversies regarding their adequate intakes and effects, this review aims to summarize research regarding this heterogenic group of fatty acids and the mechanisms relating them to (chronic) systemic low-grade inflammation, insulin resistance, metabolic syndrome and notably CVD. The intimate relationship between inflammation and metabolism, including glucose, fat and cholesterol metabolism, revealed that the dyslipidemia in Western societies, notably increased triglycerides, "small dense" low-density lipoprotein and "dysfunctional" high-density lipoprotein, is influenced by many unfavorable lifestyle factors. Dietary SFA is only one of these, not necessarily the most important, in healthy, insulin-sensitive people. The environment provides us not only with many other proinflammatory stimuli than SFA but also with many antiinflammatory counterparts. Resolution of the conflict between our self-designed environment and ancient genome may rather rely on returning to the proinflammatory/antiinflammatory balance of the Paleolithic era in consonance with the 21st century culture. Accordingly, dietary guidelines might reconsider recommendations for SFA replacement and investigate diet in a broader context, together with nondietary lifestyle factors. This should be a clear priority, opposed to the reductionist approach of studying the effects of single nutrients, such as SFA. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Solidification/stabilisation of electric arc furnace waste using low grade MgO.

    Science.gov (United States)

    Cubukcuoglu, B; Ouki, S K

    2012-02-01

    This study aims to evaluate the potential of low grade MgO (LGMgO) for the stabilisation/solidification (S/S) of heavy metals in steel electric arc furnace wastes. Relevant characteristics such as setting time, unconfined compressive strength (UCS) and leaching behaviour assessed by acid neutralisation capacity (ANC), monolithic and granular leaching tests were examined in light of the UK landfill Waste Acceptance Criteria (WAC) for disposal. The results demonstrated that all studied mix designs with Portland cement type 1 (CEM1) and LGMgO, CEM1-LGMgO 1:2 and 1:4 at 40% and 70% waste addition met the WAC requirements by means of UCS, initial and final setting times and consistence. Most of the ANC results met the WAC limits where the threshold pH values without acid additions were stable and between 11.9 and 12.2 at 28d. Granular leaching results indicate fixation of most of the metals at all mix ratios. An optimum ratio was obtained at CEM1-LGMgO 1:4 at 40% waste additions where none of the metals leaching exceeded the WAC limits and hence may be considered for landfill disposal. The monolithic leaching test results showed that LGMgO performed satisfactorily with respect to S/S of Zn, as the metal component present at the highest concentration level in the waste exhibited very little leaching and passed the leaching test requirement at all mix ratios studied. However, its performance with respect to Pb, Cd and Cr was less effective in reducing their leaching suggesting a higher cumulative rate under those leaching regimes.

  19. Quality of life in low-grade glioma patients receiving temozolomide

    Science.gov (United States)

    Liu, Raymond; Solheim, Karla; Polley, Mei-Yin; Lamborn, Kathleen R.; Page, Margaretta; Fedoroff, Anne; Rabbitt, Jane; Butowski, Nicholas; Prados, Michael; Chang, Susan M.

    2009-01-01

    The purpose of this study was to describe the quality of life (QOL) of low-grade glioma (LGG) patients at baseline prior to chemotherapy and through 12 cycles of temozolomide (TMZ) chemotherapy. Patients with histologically confirmed LGG with only prior surgery were given TMZ for 12 cycles. QOL assessments by the Functional Assessment of Cancer Therapy–Brain (FACT-Br) were obtained at baseline prior to chemotherapy and at 2-month intervals while receiving TMZ. Patients with LGG at baseline prior to chemotherapy had higher reported social well-being scores (mean difference = 5.0; p < 0.01) but had lower reported emotional well-being scores (mean difference = 2.2; p < 0.01) compared to a normal population. Compared to patients with left hemisphere tumors, patients with right hemisphere tumors reported higher physical well-being scores (p = 0.01): 44% could not drive, 26% did not feel independent, and 26% were afraid of having a seizure. Difficulty with work was noted in 24%. Mean change scores at each chemotherapy cycle compared to baseline for all QOL subscales showed either no significant change or were significantly positive (p < 0.01). Patients with LGG on TMZ at baseline prior to chemotherapy reported QOL comparable to a normal population with the exception of social and emotional well-being, and those with right hemisphere tumors reported higher physical well-being scores compared to those with left hemisphere tumors. While remaining on therapy, LGG patients were able to maintain their QOL in all realms. LGG patients’ QOL may be further improved by addressing their emotional well-being and their loss of independence in terms of driving or working. PMID:18713953

  20. Phase II TPDCV protocol for pediatric low-grade hypothalamic/chiasmatic gliomas: 15-year update

    Science.gov (United States)

    Mishra, Kavita K.; Squire, Sarah; Lamborn, Kathleen; Banerjee, Anuradha; Gupta, Nalin; Wara, William M.; Prados, Michael D.; Berger, Mitchel S.

    2010-01-01

    To report long-term results for children with low-grade hypothalamic/chiasmatic gliomas treated on a phase II chemotherapy protocol. Between 1984 and 1992, 33 children with hypothalamic/chiasmatic LGGs received TPDCV chemotherapy on a phase II prospective trial. Median age was 3.0 years (range 0.3–16.2). Twelve patients (36%) underwent STRs, 14 (42%) biopsy only, and seven (21%) no surgery. Twenty patients (61%) had pathologic JPAs, nine (27%) grade II gliomas, and four (12%) no surgical sampling. Median f/u for surviving patients was 15.2 years (range 5.3–20.7); 20 of the 23 surviving patients had 14 or more years of follow-up. Fifteen-year PFS and OS were 23.4 and 71.2%, respectively. Twenty-five patients progressed, of whom 13 are NED, two are AWD, and 10 have died. All children who died were diagnosed and first treated at age three or younger. Age at diagnosis was significantly associated with relapse and survival (P = 0.004 for PFS and P = 0.037 for OS). No PFS or OS benefit was seen with STR versus biopsy/no sampling (P = 0.58 for PFS, P = 0.59 for OS). For patients with JPAs and WHO grade II tumors, the 15-year PFS was 18.8 and 22.2% (P = 0.95) and 15-year OS was 73.7 and 55.6% (P = 0.17), respectively. Upfront TPDCV for children with hypothalamic/chiasmatic LGGs resulted in 15-year OS of 71.2% and 15-year PFS of 23.4%. No survival benefit is demonstrated for greater extent of resection. Age is a significant prognostic factor for progression and survival. PMID:20221671

  1. Evidence for low-grade metamorphism, hydrothermal alteration, and diagenesis on mars from phyllosilicate mineral assemblages

    Science.gov (United States)

    Ehlmann, B.L.; Mustard, J.F.; Clark, R.N.; Swayze, G.A.; Murchie, S.L.

    2011-01-01

    The enhanced spatial and spectral resolution provided by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) on the Mars Reconnaissance Orbiter (MRO) has led to the discovery of numerous hydrated silicate minerals on Mars, particularly in the ancient, cratered crust comprising the southern highlands. Phases recently identified using visible/near-infrared spectra include: smectite, chlorite, prehnite, high-charge phyllosilicates (illite or muscovite), the zeolite analcime, opaline silica, and serpentine. Some mineral assemblages represent the products of aqueous alteration at elevated temperatures. Geologic occurrences of these mineral assemblages are described using examples from west of the Isidis basin near the Nili Fossae and with reference to differences in implied temperature, fluid composition, and starting materials during alteration. The alteration minerals are not distributed homogeneously. Rather, certain craters host distinctive alteration assemblages: (1) prehnite-chlorite-silica, (2) analcime-silica-Fe,Mg-smectite-chlorite, (3) chlorite-illite (muscovite), and (4) serpentine, which furthermore has been found in bedrock units. These assemblages contrast with the prevalence of solely Fe,Mg-smectites in most phyllosilicate-bearing terrains on Mars, and they represent materials altered at depth then exposed by cratering. Of the minerals found to date, prehnite provides the clearest evidence for subsurface, hydrothermal/metamorphic alteration, as it forms only under highly restricted conditions (T = 200 400??C). Multiple mechanisms exist for forming the other individual minerals; however, the most likely formation mechanisms for the characteristic mineralogic assemblages observed are, for (1) and (2), low- grade metamorphism or hydrothermal (400??C has not been found.

  2. Value added products with popular low grade rice varieties of Andhra Pradesh.

    Science.gov (United States)

    Anitha, G; Rajyalakshmi, P

    2014-12-01

    Eight Popular Low Grade Rice Varieties (PLRVs) MTU 3626, MTU 1001, MTU 1010, MTU 4870 and NLR 145, NLR 34242, NLR 30491, NLR 34449, (developed and released by ANGR agricultural University, Andhra Pradesh) having poor cooking quality were selected for the study. ANGRAU variety BPT 5204 popularly consumed as staple rice was used as check. Eight products of traditional/commercial importance were standardized incorporating PLRVs as a major ingredient in the form of rice flour (burfi, noodles and extruded snack product and vennaundalu (butter coated balls), palathalikalu (dough rolled into strips, steamed/cooked in milk); rice semolina (instant kheer mix and instant upma mix), and flaked rice (nutritious bar). The products were evaluated for nutritional, cooking quality characteristics, consumer acceptability and shelf-life. Consumer acceptability of the PLR products was carried out with 60 farm women based on 9 point hedonic scale. Shelf-life of the products (packed in both metalized PP and PE pouches) was evaluated monthly for chemical, microbiological and sensory parameters. Energy values of control and PLR products showed no significant difference. Upon cooking, PLR Noodles showed no significant difference with water absorption and volume but more (p control. The percent total solids and suspended solids were more (though not significant) in PLR kheer and palathalikalu. Extruded product (control and PLR) showed no significant difference with length, diameter, weight and volume expansion ratio and water absorption index (WAI). Consumer acceptability was high for PLR products palathalikalu (95%), instant kheer mix (92%) and extruded product (88%). As per sensory scores, all the PLR products were well accepted with no observable changes in flavor or taste upon storage. PLR products showed increased (P control and PLR) showed no microbial growth during the entire storage period. Considering the poor marketability of PLRVs for consumption as staple rice, the study

  3. The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases

    Science.gov (United States)

    Casas, Rosa; Sacanella, Emilio; Estruch, Ramon

    2016-01-01

    Dietary patterns high in refined starches, sugar, and saturated and trans-fatty acids, poor in natural antioxidants and fiber from fruits, vegetables, and whole grains, and poor in omega-3 fatty acids may cause an activation of the innate immune system, most likely by excessive production of proinflammatory cytokines associated with a reduced production of anti-inflammatory cytokines. The Mediterranean Diet (MedDiet) is a nutritional model inspired by the traditional dietary pattern of some of the countries of the Mediterranean basin. This dietary pattern is characterized by the abundant consumption of olive oil, high consumption of plant foods (fruits, vegetables, pulses, cereals, nuts and seeds); frequent and moderate intake of wine (mainly with meals); moderate consumption of fish, seafood, yogurt, cheese, poultry and eggs; and low consumption of red meat, processed meat products and seeds. Several epidemiological studies have evaluated the effects of a Mediterranean pattern as protective against several diseases associated with chronic low-grade inflammation such as cancer, diabetes, obesity, atherosclerosis, metabolic syndrome and cognition disorders. The adoption of this dietary pattern could counter the effects of several inflammatory markers, decreasing, for example, the secretion of circulating and cellular biomarkers involved in the atherosclerotic process. Thus, the aim of this review was to consider the current evidence about the effectiveness of the MedDiet in these chronic inflammatory diseases due to its antioxidant and anti-inflammatory properties, which may not only act on classical risk factors but also on inflammatory biomarkers such as adhesion molecules, cytokines or molecules related to the stability of atheromatic plaque. PMID:25244229

  4. Cost-Effectiveness of Radiation and Chemotherapy for High-Risk Low-Grade Glioma.

    Science.gov (United States)

    Qian, Yushen; Maruyama, Satoshi; Kim, Haju; Pollom, Erqi L; Kumar, Kiran A; Chin, Alexander L; Harris, Jeremy P; Chang, Daniel T; Pitt, Allison; Bendavid, Eran; Owens, Douglas K; Durkee, Ben Y; Soltys, Scott G

    2017-06-28

    The addition of PCV (procarbazine, lomustine, vincristine) chemotherapy to radiotherapy (RT) for patients with high-risk (≥ 40 years old or sub-totally resected) low-grade glioma (LGG) results in an absolute median survival benefit of over 5 years. We evaluated the cost-effectiveness of this treatment strategy. A decision tree with an integrated three-state Markov model was created to follow patients with high risk LGG after surgery treated with RT vs. RT+PCV. Patients existed in one of 3 health states: stable, progressive, and dead. Survival and freedom from progression were modeled to reflect the results of RTOG 9802 using time-dependent transition probabilities. Health utility values and costs of care were derived from the literature and national registry databases. Analysis was conducted from the healthcare perspective. Deterministic and probabilistic sensitivity analysis explored uncertainty in model parameters. Modeled outcomes demonstrated agreement with clinical data in expected benefit of addition of PCV to RT. The addition of PCV to RT yielded an incremental benefit of 4.77 quality-adjusted life-years (QALYs) (9.94 for RT+PCV vs. 5.17 for RT alone) at an incremental cost of $48,635 ($188,234 for RT+PCV vs. $139,598 for RT alone), resulting in an incremental cost-effectiveness ratio of $10,186 per QALY gained. Probabilistic sensitivity analysis demonstrates that within modeled distributions of parameters, RT+PCV has 99.96% probability of being cost-effectiveness at a willingness-to-pay threshold of $100,000 per QALY. The addition of PCV to RT is a cost-effective treatment strategy for patients with high-risk LGG.

  5. Longitudinal investigation of adaptive functioning following conformal irradiation for pediatric craniopharyngioma and low-grade glioma.

    Science.gov (United States)

    Netson, Kelli L; Conklin, Heather M; Wu, Shengjie; Xiong, Xiaoping; Merchant, Thomas E

    2013-04-01

    Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (PVABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (PVABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (PVABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. There was relative sparing of postirradiation functional outcomes over time in this sample. Baseline differences in functional abilities before the initiation of irradiation suggested that other factors influence functional outcomes

  6. Direct reduction of low grade nickel laterite ore to produce ferronickel using isothermal - temperature gradient

    Science.gov (United States)

    Zulhan, Zulfiadi; Gibranata, Ian

    2017-01-01

    In this study, low grade nickel laterite ore was processed by means of isothermal-temperature gradient method to produce ferronickel nugget. The ore and coal as reductant were ground to obtain the grain size of less than 0.25 mm and 0.425 mm, respectively. Both ground laterite ore and coal were mixed, agglomerated in the form of cylindrical pellet by using press machine and then reduced at temperature of 1000°C to 1400°C in a muffle furnace. The experiments were conducted at three stages each at different temperature profile: the first stage was isothermal at 1000°C; the second stage was temperature gradient at certain heating rate from 1000 to 1400°C; and the third stage was isothermal at 1400°C. The heating rate during temperature gradient stage was varied: 6.67, 8.33 and 10°C/minute. No fluxes were added in these experiments. By addition of 10 wt% of coal into the laterite nikel ore, product of ferronickel nugget was formed with the size varies from 1-2 mm. However, by increasing the coal content, the size of ferronickel nugget was decreased to less than 0.2 mm. The observation of the samples during the heating stage showed that ferronickel nugget grew and separated from the gangue during temperature gradient stage as it achieved the temperature of 1380°C. Furthermore, the experiment results indicated that the recovery of ferronickel can be increased at lower heating rate during temperature gradient stage and longer holding time for final isothermal stage. The highest nickel recovery was obtained at a heating rate of 6.67°C/minute.

  7. Learning and Memory Following Conformal Radiation Therapy for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Di Pinto, Marcos [Department of Pediatric Psychology, Children' s Hospital of Orange County, Orange, California (United States); Conklin, Heather M. [Department of Psychology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Li, Chenghong [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [Division of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2012-11-01

    Purpose: The primary objective of this study was to examine whether children with low-grade glioma (LGG) or craniopharyngioma had impaired learning and memory after conformal radiation therapy (CRT). A secondary objective was to determine whether children who received chemotherapy before CRT, a treatment often used to delay radiation therapy in younger children with LGG, received any protective benefit with respect to learning. Methods and Materials: Learning and memory in 57 children with LGG and 44 children with craniopharyngioma were assessed with the California Verbal Learning Test-Children's Version and the Visual-Auditory Learning tests. Learning measures were administered before CRT, 6 months later, and then yearly for a total of 5 years. Results: No decline in learning scores after CRT was observed when patients were grouped by diagnosis. For children with LGG, chemotherapy before CRT did not provide a protective effect on learning. Multiple regression analyses, which accounted for age and tumor volume and location, found that children treated with chemotherapy before CRT were at greater risk of decline on learning measures than those treated with CRT alone. Variables predictive of learning and memory decline included hydrocephalus, shunt insertion, younger age at time of treatment, female gender, and pre-CRT chemotherapy. Conclusions: This study did not reveal any impairment or decline in learning after CRT in overall aggregate learning scores. However, several important variables were found to have a significant effect on neurocognitive outcome. Specifically, chemotherapy before CRT was predictive of worse outcome on verbal learning in LGG patients. In addition, hydrocephalus and shunt insertion in craniopharyngioma were found to be predictive of worse neurocognitive outcome, suggesting a more aggressive natural history for those patients.

  8. The Mechanism on Biomass Reduction of Low-Grade Manganese Dioxide Ore

    Science.gov (United States)

    Zhang, Honglei; Zhu, Guocai; Yan, Hong; Li, Tiancheng; Zhao, Yuna

    2013-08-01

    The mechanism on biomass reduction of low-grade manganese dioxide ore was studied by investigating influence factors on manganese recovery degree, such as the reaction temperature, time, biomass/ore ratio, compositions of biomass, nitrogen flow rate, and particle size of raw materials, and it was further identified through analysis of gas composition in the outlet gas, X-ray powder diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) for the reduced sample. The results show that the reduction process involved mainly two steps: (1) The biomass was first pyrolyzed to release reductive volatiles and (2) manganese oxide ore was reacted with the reductive volatiles. By an analysis of gas composition in the outlet gas, it was also found that the ratio of biomass/ore had an important effect on the reduction mechanism. With a low biomass/ore ratio of 0.5:10, the reducing reaction of the reductive volatiles with manganese dioxide ore proceeded mainly in two stages: (1) The condensable volatiles (tar) released from biomass pyrolysis reacted with manganese oxide ore to produce reductive noncondensable gases such as hydrogen, carbon monoxide, and some light hydrocarbons; and (2) the small molecule gases further participated in the reduction. XRD pattern analysis on the reduced manganese dioxide ore revealed that the process of biomass reduction of manganese ore underwent in phases (MnO2 → Mn3O4 → MnO). The kinetics study showed the reduction process was controlled by a gas-solid reaction between biomass volatiles and manganese oxide ore with activation energy E of 53.64 kJ mol-1 and frequency factor A of 5.45 × 103 minutes-1.

  9. Revisiting the prognostic role of gallium scintigraphy in low-grade Non-Hodgkin`s lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Gallamini, A.; Cavallero, G.; Pregno, P.; Grasso, M.; Gallo, E. [Division of Haematology, S. Croce Hospital, Cuneo (Italy); Biggi, A.; Farinelli, C. [Department of Nuclear Medicine, S. Croce Hospital, Cuneo (Italy); Fruttero, A.; Pugno, F. [Department of Pathology, S. Croce Hospital, Cuneo (Italy); Leone, A. [Department of Radiology, S. Croce Hospital, Cuneo (Italy)

    1997-12-01

    The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin`s lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the {sup 67}Ga uptake by the tumour, and to establish the contribution of {sup 67}Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic {sup 67}Ga score at diagnosis. In addition to {sup 67}Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. {sup 67}Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1-146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%{+-}14.9% (mean {+-}SD) in the former and 8.9%{+-}7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that {sup 67}Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables. (orig.) With 2 figs., 3 tabs., 43 refs.

  10. Obesity phenotypes and resorption percentage after breast autologous fat grafting: Rule of low-grade inflammation

    Science.gov (United States)

    Gentile, Pietro; Sarlo, Francesca; De Angelis, Barbara; De Lorenzo, Antonio; Cervelli, Valerio

    2016-01-01

    Background: One of the main reasons why the breast fat grafting was questioned is that there may be lipofilling resorption. In the literature, the resorption rate reported over the 1st year is highly variable (20–90%). Objective: The aim of this work was to identify the biochemical and clinical parameters, which increase fat graft maintenance in breast reconstruction. Materials and Methods: A sample of 19 patients was treated with fat grafting mixed with platelet-rich plasma. A complete screening of anthropometry, body composition, and blood biochemical parameters was assessed using the standardized equipment. Pre- and post-operative evaluation was performed, which included a complete clinical examination, photographic assessment, nuclear magnetic resonance imaging of the soft tissue, and ultrasound. The follow-up period was 2 years. Results: The authors divided the results into two types of patients: “responder” and “not a responder.” In the “responder” group patients with normal weight, gynoid fat distribution, obese, with normal blood biochemical parameters, and atherogenic indices but with high preoperative values of platelet-to-lymphocyte ratio (PLR) (174.49) and neutrophil-lymphocyte ratio (NLR) (2.65) showed a greater increase of fat graft maintenance at 6 and 12 months after the last lipofilling session. In the “not responder group” patients with overweight, android fat distribution, obese, high values of atherogenic indices, but with normal preoperative NLR and PLR ratios showed a lower fat graft maintenance at 6 and 12 months. Conclusion: We assume, the problem of fat resorption may be resolved by analysis of body composition and by examine the predictive role of preoperative markers of low-grade inflammation. PMID:27656603

  11. Exploratory Visual Analysis of Statistical Results from Microarray Experiments Comparing High and Low Grade Glioma

    Directory of Open Access Journals (Sweden)

    Jason H. Moore

    2007-01-01

    Full Text Available The biological interpretation of gene expression microarray results is a daunting challenge. For complex diseases such as cancer, wherein the body of published research is extensive, the incorporation of expert knowledge provides a useful analytical framework. We have previously developed the Exploratory Visual Analysis (EVA software for exploring data analysis results in the context of annotation information about each gene, as well as biologically relevant groups of genes. We present EVA as a fl exible combination of statistics and biological annotation that provides a straightforward visual interface for the interpretation of microarray analyses of gene expression in the most commonly occurring class of brain tumors, glioma. We demonstrate the utility of EVA for the biological interpretation of statistical results by analyzing publicly available gene expression profi les of two important glial tumors. The results of a statistical comparison between 21 malignant, high-grade glioblastoma multiforme (GBM tumors and 19 indolent, low-grade pilocytic astrocytomas were analyzed using EVA. By using EVA to examine the results of a relatively simple statistical analysis, we were able to identify tumor class-specifi c gene expression patterns having both statistical and biological signifi cance. Our interactive analysis highlighted the potential importance of genes involved in cell cycle progression, proliferation, signaling, adhesion, migration, motility, and structure, as well as candidate gene loci on a region of Chromosome 7 that has been implicated in glioma. Because EVA does not require statistical or computational expertise and has the fl exibility to accommodate any type of statistical analysis, we anticipate EVA will prove a useful addition to the repertoire of computational methods used for microarray data analysis. EVA is available at no charge to academic users and can be found at http://www.epistasis.org.

  12. Effect of dietary Schizochytrium microalga oil on selected markers of low-grade inflammation in rats.

    Science.gov (United States)

    Komprda, T; Sládek, Z; Škultéty, O; Křížková, S; Rozíková, V; Němcová, B; Šustrová, T; Valová, M

    2016-12-01

    The objective of the present study was to evaluate a potential of Schizochytrium microalga oil to alleviate possible negative effects of high-fat-high-energy diets. Forty adult male rats (Wistar Albino) were fed 7 weeks the diet containing beef tallow + evaporated sweetened milk (diet T) intended to cause mild obesity and low-grade systemic inflammation. Consequently, the animals were divided into four groups by 10 animals each and fed either the T-diet (control) or the diet containing 6% of safflower oil (S), 6% of fish oil (F) and 6% of Schizochytrium microalga oil (A), respectively, for another 7 weeks. The A-diet decreased (p  0.05). In comparison with control, higher (p  0.05) on cellular adiponectin content in the EAT. Higher (p < 0.05) EPA+DHA deposition in the liver of the A-rats correlated with higher expression (149% of control; p < 0.05) of the gene coding for peroxisome proliferator-activated receptor gamma, and with lower expression (82% and 66%; p < 0.05) of the genes coding for adiponectin receptors AdipoR1 and AdipoR2; no relationship to the expression of receptor GPR120 was found. The A-diet did not affect amount of the nuclear fraction of the nuclear factor kappa B in the liver, but increased plasma level of anti-inflammatory cytokine TGF-β1 (p < 0.05). The presented data agree with results of other in vivo rodent and human studies, but not with literature data regarding in vitro experiments: it can be concluded that the effects of dietary oils on inflammatory markers need further investigation.

  13. Cortical mapping with navigated transcranial magnetic stimulation in low-grade glioma surgery

    Directory of Open Access Journals (Sweden)

    Paiva WS

    2012-05-01

    Full Text Available Wellingson S Paiva1, Erich T Fonoff1, Marco A Marcolin2, Hector N Cabrera1, Manoel J Teixeira11Division of Functional Neurosurgery, Hospital das Clinicas, 2TMS Laboratory of the Psychiatry Institute, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Transcranial magnetic stimulation (TMS is a promising method for both investigation and therapeutic treatment of psychiatric and neurologic disorders and, more recently, for brain mapping. This study describes the application of navigated TMS for motor cortex mapping in patients with a brain tumor located close to the precentral gyrus.Materials and methods: In this prospective study, six patients with low-grade gliomas in or near the precentral gyrus underwent TMS, and their motor responses were correlated to locations in the cortex around the lesion, generating a functional map overlaid on three-dimensional magnetic resonance imaging (MRI scans of the brain. To determine the accuracy of this new method, we compared TMS mapping with the gold standard mapping with direct cortical electrical stimulation in surgery. The same navigation system and TMS-generated map were used during the surgical resection procedure.Results: The motor cortex could be clearly mapped using both methods. The locations corresponding to the hand and forearm, found during intraoperative mapping, showed a close spatial relationship to the homotopic areas identified by TMS mapping. The mean distance between TMS and direct cortical electrical stimulation (DES was 4.16 ± 1.02 mm (range: 2.56–5.27 mm.Conclusion: Preoperative mapping of the motor cortex with navigated TMS prior to brain tumor resection is a useful presurgical planning tool with good accuracy.Keywords: transcranial magnetic stimulation, cortical mapping, brain tumor, motor cortex

  14. Efficacy and safety of hexaminolevulinate photodynamic therapy in patients with low-grade cervical intraepithelial neoplasia.

    Science.gov (United States)

    Hillemanns, Peter; Petry, Karl-Ulrich; Soergel, Philipp; Collinet, Pierre; Ardaens, Katty; Gallwas, Julia; Luyten, Alexander; Dannecker, Christian

    2014-08-01

    Non-surgical therapies are needed to reduce the rate of progression of low-grade cervical intraepithelial neoplasia (CIN 1) to high grade CIN (CIN 2/3). The aim of this study was to assess the efficacy and safety of hexaminolevulinate (HAL) photodynamic therapy (PDT) in the treatment of patients with CIN 1. This phase IIa prospective double-blind study randomized patients with CIN 1 into three groups: HAL vaginal suppository, placebo vaginal suppository or follow-up only. Patients in the first two groups received HAL or placebo suppositories 5 hours before illumination with 50 J/cm(2) red coherent light (633 nm) using a special light catheter. All patients had a follow up including colposcopy, cytology and human papilloma virus (HPV) testing 3 and 6 months and additional biopsy 6 months after PDT. The main outcome measure was efficacy, defined as complete histologic remission 6 months after PDT. Secondary outcomes were histologic remission 3 months and HPV eradication 6 months after first PDT. Seventy patients were randomized: 47 to HAL, 12 to placebo, 11 to follow up only. After 6 months CIN lesions had cleared in 57% of patients in the HAL-PDT group compared to 25% in the combined control group (per protocol population, P = 0.04). Twenty-six patients (37%) reported 44 adverse events (AEs), of which 40 were mild or moderate. Nineteen treatment-related AEs were reported by 15 patients (32%) in the HAL PDT group, one in the placebo PDT group (8%), and none in the follow-up group. The most common adverse events were local discomfort including mild pain/cramping (11) and leucorrhoea (2). HAL PDT shows a favorable efficacy and safety profile and represents a promising alternative to observation and surgical procedures in patients with CIN 1. © 2014 Wiley Periodicals, Inc.

  15. Human papillomavirus testing for triage of women with low-grade squamous intraepithelial lesions.

    Science.gov (United States)

    Cuzick, Jack; Thomas Cox, J; Zhang, Guili; Einstein, Mark H; Stoler, Mark; Trupin, Suzanne; Behrens, Catherine M

    2013-02-15

    Low-grade squamous intraepithelial lesion (LSIL) is a common cytologic finding in cervical screening, yet only about 10-20% have significant histologic abnormalities and these are almost always positive for high-risk human papillomavirus (hrHPV). This analysis aims to clarify the role of hrHPV DNA testing in the triage of women with LSIL cytology. In the ATHENA screening trial, we examined 1,084 cases of LSIL, of which 925 had an evaluable biopsy, to determine the extent to which hrHPV testing can identify those patients who have precursor lesions in need of immediate clinical referral and those who have changes more likely to regress spontaneously. Overall, 71.2% of LSIL cases were hrHPV positive, but the prevalence was age dependent, with only 56.1% in women ≥ 40 years. Among women with LSIL, 11.6% (107/925) had a cervical intraepithelial neoplasia grade 2 or worse (CIN2+) histologic diagnosis and, of these, only nine were hrHPV negative. For CIN3+, 91.7% (44/48) of women with LSIL were hrHPV positive. The negative predictive value of hrHPV testing for CIN3+ in LSIL was 100% for women aged ≥ 40 years. Women who were HPV16 positive had a higher positive predictive value for CIN2+ (25.4%) than those who were positive for 12 other pooled hrHPV types (11.5%). Testing for hrHPV in women with LSIL is effective in identifying high-grade cervical lesions, thereby avoiding unnecessary referrals to colposcopy and potential over-treatment of non-progressive lesions, especially for women aged ≥ 40 years. Copyright © 2012 UICC.

  16. p16 Expression and Biological Behavior of Flat Vulvar Low-grade Squamous Intraepithelial Lesions (LSIL).

    Science.gov (United States)

    Lewis, Natasha; Blanco, Luis Z; Maniar, Kruti P

    2017-09-01

    Flat low-grade squamous intraepithelial lesion (LSIL) of the vulva [vulvar intraepithelial neoplasia (VIN) 1, flat condyloma] is an uncommon entity with poorly understood biological behavior. We aimed to determine the risk of subsequent vulvar high-grade squamous intraepithelial lesion (HSIL) or carcinoma following a diagnosis of vulvar LSIL/VIN 1, as well as the frequency and predictive value of p16 immunohistochemical expression in this setting. Of the 51 included cases, p16 positivity (diffuse block staining) was identified in 2 (4%). Follow-up data were available in 34 cases, of which 2 (5.9%) developed subsequent vulvar HSIL, including 1/2 p16-positive cases and 1/32 p16-negative cases. The difference in HSIL frequency between p16-positive and p16-negative cases was not statistically significant (P=0.116 for VIN 2+, P=0.061 for VIN 3). For the 18 patients with treatment information available, 10 (56%) received medical or surgical treatment after biopsy. Our results indicate that flat vulvar LSIL is infrequently p16 positive, and that few patients with vulvar LSIL develop subsequent vulvar HSIL. Despite the use of destructive treatment in some cases, the data provide support for the nonpreneoplastic nature of the entity. Immunohistochemical expression of p16 may not be a predictor of HSIL risk in vulvar LSIL, although this result may also be related to the very low rates of both p16 positivity and subsequent vulvar HSIL in our sample. It is clear that vulvar LSIL is distinct from LSIL in other lower anogenital sites in terms of its behavior and p16 expression frequency.

  17. 腰椎滑脱的X线诊断价值%Value of X Ray Diagnosis for Lumbar Spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    王立侠; 李龙鹏; 李涛; 陈宜新

    2015-01-01

    目的:进一步提高对腰椎滑脱X诊断的认识.方法:回归性分析102例腰椎滑脱的图片资料.结果:本组资料,病变多累计L3~5椎体,51例累及L4椎体,前滑脱42例(86%),30例为多发,后滑脱26例(87%),椎体互相前后滑脱4例(13%);崩裂性滑脱12例(12%),退变性滑脱90例(88%);Ⅰ度93例(91%),Ⅱ度6例(6%),Ⅲ度3例(3%).所用患者均有不同程度的退行性变.结论:常规X线检查不仅可以对腰椎滑脱能够明确诊断,还可以准确显示椎体、椎间盘改变及椎小关节的间接征象.必要时加做站立过伸过屈位片,更能真实的反映腰椎滑脱的程度与稳定性.%Objective: To furthering improve the understanding of X ray in the diagnosis of lumbar spondylolisthesis.Methods:102 cases of lumbar spondylolisthesis images were regressively analyzed.Results:The data showed, the cumulative L3~5 vertebral body lesions, 51 cases involved vertebral body of L4, spondylolisthesis was 42 cases (86%), 30 cases were multiple, retrolisthesis was 26 cases (87%),vertebral spondylolisthesis with spondylolisthesis and retrolisthesis was 4 cases (13%), spondylolytic spondylolisthesis was 12cases (12%), degenerative spondylolisthesis was 90 cases(88%) ,Ⅰgrade was 93 cases (91%), Ⅱ grade was 6 cases(6%),Ⅲ grade was 3 cases (3%). The degrees of degenerative change were varying.Conclusion: routine X-ray examination can make a definite diagnosis for lumbar spondylolisthesis; indirect signs can also display vertebral body and intervertebral disc, facet joint change. When necessary, doing hyperextension curved stand pieces can reflect the degree and the stability of lumbar spondylolisthesis.

  18. Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

    Energy Technology Data Exchange (ETDEWEB)

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid [Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of); Fouladi, Daniel F., E-mail: medicorelax@yahoo.com [Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of)

    2015-05-15

    Highlights: • MR imaging with straightened lower extremities was tested in spondylolisthesis. • This technique is more accurate than conventional MR imaging in detecting slip. • Level of spondylolisthesis is the only independent predictor of severity of slip. - Abstract: Objectives: To compare the degree of slip in spondylolisthesis on supine magnetic resonance (MR) images obtained with flexed and straightened lower extremities. Methods: Supine spinal MR studies were performed in 100 cases of symptomatic spondylolisthesis with flexed and then straightened lower extremities. The angle of lumbar lordosis (by Cobb's method) and the degree of slip (by Taillard's method) were compared between the two sets of images. Results: The mean angle of lumbar lordosis increased from 51.65 ± 8.57° on MR images with flexed lower limbs to 57.39 ± 9.05° on MR images with straightened lower limbs (p < 0.001; mean percent increase: 11.51%). Similar change was also observed for the mean degree of slip (from 25.80 ± 7.74% to 28.68 ± 7.93%, p < 0.001; mean percent increase: 12.60%). After MR imaging with straightened lower extremities 22 out of 54 initially grade I cases had grade II disease (p < 0.001). Conclusions: Supine magnetic resonance imaging with straightened lower extremities detects higher degree of slippage in symptomatic patients with spondylolisthesis compared to conventional MRI with flexed lower extremities.

  19. Disturbed small-world networks and neurocognitive function in frontal lobe low-grade glioma patients.

    Directory of Open Access Journals (Sweden)

    Qingling Huang

    Full Text Available BACKGROUND: Brain tumor patients often associated with losses of the small-world configuration and neurocognitive functions before operations. However, few studies were performed on the impairments of frontal lobe low-grade gliomas (LGG after tumor resection using small-world network features. METHODOLOGY/PRINCIPAL FINDINGS: To detect differences in the whole brain topology among LGG patients before and after operation, a combined study of neurocognitive assessment and graph theoretical network analysis of fMRI data was performed. We collected resting-state fMRI data of 12 carefully selected frontal lobe LGG patients before and after operation. We calculated the topological properties of brain functional networks in the 12 LGG, and compared with 12 healthy controls (HCs. We also applied Montreal Cognitive Assessment (MoCA in a subset of patients (n = 12, including before and after operation groups and HCs (n = 12. The resulting functional connectivity matrices were constructed for all 12 patients, and binary network analysis was performed. In the range of 0.05 ≤ Kcos t ≤ 0.35, the functional networks in preoperative LGG and postoperative one both fitted the definition of small-worldness. We proposed Knet = 0.20 as small-world network interval, and the results showed that the topological properties were found to be disrupted in the two LGG groups, meanwhile the global efficiency increased and the local efficiency decreased. Lnet in the two LGG groups both were longer than HCs. Cnet in the LGG groups were smaller than HCs. Compared with the Hcs, MoCA in the two LGG groups were lower than HCs with significant difference, and the disturbed networks in the LGG were negatively related to worse MoCA scores. CONCLUSIONS: Disturbed small-worldness preperty in the two LGG groups was found and widely spread in the strength and spatial organization of brain networks, and the alterated small-world network may be responsible for cognitive

  20. Bacterial bioleaching of low grade nickel limonite and saprolite ores by mixotrophic bacteria

    Directory of Open Access Journals (Sweden)

    Chaerun Siti Khodijah

    2016-01-01

    Full Text Available Utilization of indigenous bacteria should be considered to establish a successful biohydrometallurgical process. In this study, mixrotrophic iron-oxidizing bacterial consortia consisting of Comamonas testosteroni, Alicyclobacillus ferrooxydans and Pantoea septic which were isolated from Indonesian mineral ores were examined to determine their abilities to recover nickel from limonite and saprolite ores in the bioleaching experiments using stirred tank reactors. The nickel bioleaching experiments inoculated with the bacterial consortia were carried out using coarse limonite ores and weathered saprolite ores with pulp density of 10% w/v. Abiotic controls were also carried out replacing the inocula by the sterile medium. The bioleaching processes were monitored by measuring Ni and Fe contents and pH of the leaching solution as well as the total bacterial enzymatic activity measured as FDA hydrolytic activity. The effect of leaching on the mineralogy of laterite ores was investigated by the scanning electron microscope equipped with energy-dispersive spectroscopy (SEM-EDS and X-ray powder diffraction (XRD. After 28 days of incubation, the FDA hydrolytic activity was observed in both bioleaching experiments containing limonite (17.2 μg fluorescein/mL and saprolite ores (16.9 μg fluorescein/mL. The leached Ni and Fe in the bioleaching experiments containing limonite ores (30% Ni and 5.6% Fe was greater than that in abiotic controls (1% Ni and 0.1% Fe with the pH range of 2.5 to 3.5. However, the bacterial consortia were less capable of bioleaching of Ni (2.5% with the similar leached Fe (6% from the saprolite ores. In abiotic controls, the medium pH remained relatively constant (pH 6. It was concluded that these bacterial isolated as the consortium were capable of nickel bioleaching (precious metal more effectively than iron (gangue metal, thus being applicable to the commercial processing of the difficult-to-process low-grade nickel laterite ores

  1. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata).......To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  2. Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033) : a randomised, open-label, phase 3 intergroup study

    NARCIS (Netherlands)

    Baumert, Brigitta G; Hegi, Monika E; van den Bent, Martin J; von Deimling, Andreas; Gorlia, Thierry; Hoang-Xuan, Khê; Brandes, Alba A; Kantor, Guy; Taphoorn, Martin J B; Hassel, Mohamed Ben; Hartmann, Christian; Ryan, Gail; Capper, David; Kros, Johan M; Kurscheid, Sebastian; Wick, Wolfgang; Enting, Roelien; Reni, Michele; Thiessen, Brian; Dhermain, Frederic; Bromberg, Jacoline E; Feuvret, Loic; Reijneveld, Jaap C; Chinot, Olivier; Gijtenbeek, Johanna M M; Rossiter, John P; Dif, Nicolas; Balana, Carmen; Bravo-Marques, Jose; Clement, Paul M; Marosi, Christine; Tzuk-Shina, Tzahala; Nordal, Robert A; Rees, Jeremy; Lacombe, Denis; Mason, Warren P; Stupp, Roger

    2016-01-01

    BACKGROUND: Outcome of low-grade glioma (WHO grade II) is highly variable, reflecting molecular heterogeneity of the disease. We compared two different, single-modality treatment strategies of standard radiotherapy versus primary temozolomide chemotherapy in patients with low-grade glioma, and asses

  3. COMPARISON OF THE CONCENTRIC TORQUE OF KNEE MUSCLES AND TIMED-WALKING TEST IN HEALTHY AND LOW GRADE TIBIOFEMORAL OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    H. Bagheri

    2007-07-01

    Full Text Available The aim of study was to investigate and compare the concentric torque of Quadriceps and Hamstring muscles and Timed-Walking test in two groups. Thus, one group of healthy subjects and one group of patients with low grade of tibiofemoral osteoarthritis (OA were selected. Concentric torque of Quadriceps and Hamstring were measured in both groups. Besides, pain measurement, Timed-Walking test, range of motion and the muscle bulk of thigh were assessed in both groups. The independent t-test revealed significant differences between the two groups with regard to concentric torques and Timed-Walking test. However, no significant difference in range of motion and the muscle bulk was seen. In conclusion, patients with low grade of osteoarthritis and minimum clinical signs had weaker muscles and functional limitation in comparison with the matched healthy individuals.

  4. Office-Based Transurethral Devascularisation of Low Grade Non-Invasive Urothelial Cancer Using Diode Laser. A Feasibility Study

    DEFF Research Database (Denmark)

    Hermann, Gregers G.; Mogensen, Karin; Lindvold, Lars René

    2015-01-01

    Frequent recurrence of non‐muscle invasive bladder tumours (NMIBC) requiring transurethral resection of bladder tumour (TUR‐BT) and lifelong monitoring makes the lifetime cost per patient the highest of all cancers. A new method is proposed for the removal of low grade NMIBCs in an office......‐based setting, without the need for sedation and pain control and where the patient can leave immediately after treatment. An in vitro model was developed to examine the dose/response relationship between laser power, treatment time, and distance between laser fibre and target, using a 980 nm diode laser...... and chicken meat. The relationship between depth and extent of tissue destruction and the laser settings was measured using microscopy and non‐parametric statistical analysis. A patient with low grade stage Ta tumour and multiple comorbidity, and therefore not fit for general anaesthesia, had a tumour...

  5. Analysis of KIAA1549-BRAF fusion gene expression and IDH1/IDH2 mutations in low grade pediatric astrocytomas.

    Science.gov (United States)

    Cruz, Gabriela Rampazzo; Dias Oliveira, Indhira; Moraes, Laís; Del Giudice Paniago, Mário; de Seixas Alves, Maria Teresa; Capellano, Andrea Maria; Saba-Silva, Nasjla; Cavalheiro, Sérgio; Cerutti, Janete Maria; Toledo, Silvia Regina Caminada

    2014-04-01

    Low-grade astrocytomas comprise about 30 % of the central nervous system tumors in children. Several investigations have searched a correlation between the BRAF gene fusions alterations and mutations at IDH1 and IDH2 genes in low grade pediatric astrocytomas. This study identified the expression of KIAA1549-BRAF fusion gene and BRAF V600E mutation, mutations at exon 4 of the IDH1 and IDH2 genes in samples of pilocytic astrocytomas (PA) and grade-II astrocytomas (A-II) pediatric patients. The correlation between these alterations and the clinical profile of the patients was also evaluated. Eighty-two samples of low-grade astrocytomas (65 PA and 17 A-II) were analyzed by PCR and sequencing for each of the targets identified. We identified the KIAA1549-BRAF fusion transcript in 45 % of the samples. BRAF V600E and BRAFins598T mutations were detected in 7 and 1 % of the samples, respectively. Mutations in the R132/R172 residues of the IDH1/IDH2 genes were detected in only two samples, and the G105G polymorphism (rs11554137:C>T) was identified in ten patients. Additionally, we observed two mutations out of the usual hotspots at IDH1 and IDH2 genes. We observed a smaller frequency of mutations in IDHs genes than previously described, but since the prior studies were composed of adult or mixed (adults and children) samples, we believe that our results represent a relevant contribution to the growing knowledge in low grade childhood astrocytomas.

  6. Upgrading of consumer characteristics of granulated solid fuel from mixture of low-grade coal and biomass

    Science.gov (United States)

    Kuzmina, J. S.; Milovanov, O. Yu; Sinelshchikov, V. A.; Sytchev, G. A.; Zaichenko, V. M.

    2015-11-01

    Effect of torrefaction on consumer characteristics of fuel pellets made of low-grade and agricultural waste is shown. Data on the volatile content, ash content, calorific value and hygroscopicity for initial pellets and pellets, heat-treated at various temperatures are presented. The experimental study of the combustion process of initial and heat-treated pellets showed that torrefaction of pellets leads to a decreasing of the ignition temperature and an increasing of the efficiency of boiler plant.

  7. Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis.

    Science.gov (United States)

    Savranlar, Ahmet; Altin, Remzi; Mahmutyazicioğlu, Kamran; Ozdemir, Hüseyin; Kart, Levent; Ozer, Tülay; Gündoğdu, Sadi

    2004-08-01

    High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP). 71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis. Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT. Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.

  8. Transsacral transdiscal L5-S1 screws for the management of high-grade spondylolisthesis in an adolescent.

    Science.gov (United States)

    Palejwala, Ali; Fridley, Jared; Jea, Andrew

    2016-06-01

    The surgical management of high-grade spondylolisthesis in adolescents remains a controversial issue. Because the basic procedure, posterolateral fusion, is associated with a significant rate of pseudarthrosis and listhesis progression, there is a pressing need for alternative surgical techniques. In the present report, the authors describe the case of an adolescent patient with significant low-back pain who was found to have Grade IV spondylolisthesis at L5-S1 that was treated with transsacral transdiscal screw fixation. Bilateral pedicle screws were placed starting from the top of the S-1 pedicle, across the L5-S1 intervertebral disc space, and into the L-5 body. At 14 months after surgery, the patient had considerable improvement in his pain and radiographic fusion across L5-S1. The authors conclude that transsacral transdiscal pedicle screws may serve as an efficacious and safe option for the correction of high-grade spondylolisthesis in adolescent patients.

  9. Effect of Modified Atmosphere Packaging and Vacuum Packaging on Quality Characteristics of Low Grade Beef during Cold Storage.

    Science.gov (United States)

    Hur, S J; Jin, S K; Park, J H; Jung, S W; Lyu, H J

    2013-12-01

    Many studies have been carried out with respect to packaging methods and temperature conditions of beef. However, the effects of packaging methods and temperature conditions on the quality characteristics have not been extensively studied in low-grade beef. Low-grade beef samples were divided into 3 groups (C: ziplock bag packaging, T1: vacuum packaging, and T2: modified atmosphere packaging (MAP), CO2/N2 = 3:7) and samples were stored at 4°C for 21 days. The water-holding capacity (WHC) was significantly lower in T1 than in the other samples up to 14 days of storage. The thiobarbituric acid reactive substances and volatile basic nitrogen values were significantly lower in T1 and T2 than in C after 7 to 14 days of storage. The total bacterial counts were significantly lower in T1 and T2 than in C after 14 days of storage. In a sensory evaluation, tenderness and overall acceptability were significantly higher in T1 and T2 than in C at the end of the storage period (21 days). We propose that the MAP method can improve beef quality characteristics of low-grade beef during cold storage. However, the beneficial effects did not outweigh the cost increase to implement MAP.

  10. Contribution of nuclear morphometric features to differentiation of atypical complex type endometrial hyperplasia and low grade endometrial carcinoma

    Directory of Open Access Journals (Sweden)

    Onder Onguru

    2011-08-01

    Full Text Available Objective: The differentiation of atypical complex type endometrial hyperplasia (ACEH and low grade endometrial carcinoma (EC may be problematic in endometrial biopsy materials. Desmoplasia and stromal invasion are diagnostic for EC but they are not always demonstrated in endometrial biopsies. In this study, we investigated the contribution of nuclear morphometry to distinction of ACEH and low grade EC. Methods: Ten low grade EC and eight ACEH cases retrieved from the archives of the Department of Pathology. For each case at least 100 nuclei (totally 1000 for both groups were selected using hematoxylen-eosine stained sections and evaluated by a computer assisted system. Measured nuclear morphometric features were nuclear area, nuclear perimeter, circular form factor, diameter equivalent circle, minimum feret, maximum feret, area convex hull, perimeter convex hull. Results: There was no significant differences between these two groups for circular form factor (P=0.871. But all other morphometric features were statistically significant (P<0.05. Conclusion: Our findings suggest that nuclear morphometric features may be used as an ancillary diagnostic tool in addition to conventional histopathological findings in borderline lesion. These findings should be confirmed with expanded case series. [J Exp Integr Med 2011; 1(4.000: 277-280

  11. Research on curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection.

    Science.gov (United States)

    Li, Xiangyun

    2015-07-01

    This study aims to explore the curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection. Sixty children who suffered low-grade fever caused by respiratory system infection were selected and divided into treatment group and control group randomly, each with 30 cases. Control group was treated with conventional methods including oxygen uptake, nebulization and anti-infection, etc, while treatment group was given boil-free granules of traditional Chinese medicine besides the treatment which control group received. Then clinical curative effect of two groups was compared. Results showed that 28 cases (93.3%) were cured in treatment group; while 21 cases (70.0%) were cured in control group. Compared with control group, the treatment group showed up better treatment efficiency and the difference between groups was of statistical significance (Pfever of children caused by respiratory system infection; characterized by short treatment cycle and effective treatment effect, Chinese medicine granules in the combination with oxygen atomization inhalation is proved to be able to efficiently remit symptoms such as coughing, gasp and labored breathing, with outstanding curative effect in the treatment of low-grade fever of children caused by respiratory system infection, thus it is worthy of popularization and application clinically.

  12. Impact of Early Low-Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients.

    Science.gov (United States)

    López, V; Cabello, M; Ruíz-Esteban, P; Sola, E; Gutiérrez, C; Jironda, C; Burgos, D; González-Molina, M; Hernández, D

    2015-11-01

    Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients. The aim of this study was to assess whether the combination of early low-grade proteinuria (proteinuria (300 mg/d) and median creatinine (Cr; 1.7 mg/dL; interquartile range, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr proteinuria proteinuria ≥300 mg/24 h; n = 38), Group C (Cr ≥1.7 mg/dL and proteinuria proteinuria ≥300 mg/24 h; n = 55). Death-censored graft survival was significantly lower in Group D compared with the rest (P proteinuria and a lower estimated glomerular filtration rate (eGFR) as associated with graft failure (hazard rate [HR] 2.5, 95% confidence interval [CI], 1.09-5.97; P = .03). The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials.

    Science.gov (United States)

    Avila, Edward K; Chamberlain, Marc; Schiff, David; Reijneveld, Jaap C; Armstrong, Terri S; Ruda, Roberta; Wen, Patrick Y; Weller, Michael; Koekkoek, Johan A F; Mittal, Sandeep; Arakawa, Yoshiki; Choucair, Ali; Gonzalez-Martinez, Jorge; MacDonald, David R; Nishikawa, Ryo; Shah, Aashit; Vecht, Charles J; Warren, Paula; van den Bent, Martin J; DeAngelis, Lisa M

    2017-01-01

    Patients with low-grade glioma frequently have brain tumor-related epilepsy, which is more common than in patients with high-grade glioma. Treatment for tumor-associated epilepsy usually comprises a combination of surgery, anti-epileptic drugs (AEDs), chemotherapy, and radiotherapy. Response to tumor-directed treatment is measured primarily by overall survival and progression-free survival. However, seizure frequency has been observed to respond to tumor-directed treatment with chemotherapy or radiotherapy. A review of the current literature regarding seizure assessment for low-grade glioma patients reveals a heterogeneous manner in which seizure response has been reported. There is a need for a systematic approach to seizure assessment and its influence on health-related quality-of-life outcomes in patients enrolled in low-grade glioma therapeutic trials. In view of the need to have an adjunctive metric of tumor response in these patients, a method of seizure assessment as a metric in brain tumor treatment trials is proposed. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Deep sequencing detects very-low-grade somatic mosaicism in the unaffected mother of siblings with nemaline myopathy.

    Science.gov (United States)

    Miyatake, Satoko; Koshimizu, Eriko; Hayashi, Yukiko K; Miya, Kazushi; Shiina, Masaaki; Nakashima, Mitsuko; Tsurusaki, Yoshinori; Miyake, Noriko; Saitsu, Hirotomo; Ogata, Kazuhiro; Nishino, Ichizo; Matsumoto, Naomichi

    2014-07-01

    When an expected mutation in a particular disease-causing gene is not identified in a suspected carrier, it is usually assumed to be due to germline mosaicism. We report here very-low-grade somatic mosaicism in ACTA1 in an unaffected mother of two siblings affected with a neonatal form of nemaline myopathy. The mosaicism was detected by deep resequencing using a next-generation sequencer. We identified a novel heterozygous mutation in ACTA1, c.448A>G (p.Thr150Ala), in the affected siblings. Three-dimensional structural modeling suggested that this mutation may affect polymerization and/or actin's interactions with other proteins. In this family, we expected autosomal dominant inheritance with either parent demonstrating germline or somatic mosaicism. Sanger sequencing identified no mutation. However, further deep resequencing of this mutation on a next-generation sequencer identified very-low-grade somatic mosaicism in the mother: 0.4%, 1.1%, and 8.3% in the saliva, blood leukocytes, and nails, respectively. Our study demonstrates the possibility of very-low-grade somatic mosaicism in suspected carriers, rather than germline mosaicism. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Chronic Low-Grade Inflammation in Childhood Obesity Is Associated with Decreased IL-10 Expression by Monocyte Subsets

    Science.gov (United States)

    Mattos, Rafael T.; Medeiros, Nayara I.; Menezes, Carlos A.; Fares, Rafaelle C. G.; Franco, Eliza P.; Dutra, Walderez O.; Rios-Santos, Fabrício; Correa-Oliveira, Rodrigo; Gomes, Juliana A. S.

    2016-01-01

    Chronic low-grade inflammation is related to the development of comorbidities and poor prognosis in obesity. Monocytes are main sources of cytokines and play a pivotal role in inflammation. We evaluated monocyte frequency, phenotype and cytokine profile of monocyte subsets, to determine their association with the pathogenesis of childhood obesity. Children with obesity were evaluated for biochemical and anthropometric parameters. Monocyte subsets were characterized by flow cytometry, considering cytokine production and activation/recognition molecules. Correlation analysis between clinical parameters and immunological data delineated the monocytes contribution for low-grade inflammation. We observed a higher frequency of non-classical monocytes in the childhood obesity group (CO) than normal-weight group (NW). All subsets displayed higher TLR4 expression in CO, but their recognition and antigen presentation functions seem to be diminished due to lower expression of CD40, CD80/86 and HLA-DR. All subsets showed a lower expression of IL-10 in CO and correlation analyses showed changes in IL-10 expression profile. The lower expression of IL-10 may be decisive for the maintenance of the low-grade inflammation status in CO, especially for alterations in non-classical monocytes profile. These cells may contribute to supporting inflammation and loss of regulation in the immune response of children with obesity. PMID:27977792

  16. The relationship between sacral slope and symptomatic isthmic spondylolysis in a cohort of high school athletes: a retrospective analysis.

    Science.gov (United States)

    Hanke, Leigh F; Tuakli-Wosornu, Yetsa A; Harrison, Julian; Moley, Peter J

    2017-10-06

    Spondylolysis with and without anterolisthesis are the most common causes of structural back pain in children and adolescents, but few predictive factors have been confirmed. An association between abnormal sacro-pelvic orientation and both spondylolysis and spondylolisthesis has been supported in the literature. Sacral slope and other sacro-pelvic measurements are easily accessible variables that could aid clinicians in assessing active adolescents with low back pain, particularly when the diagnosis of spondylolysis is suspected. To examine the relationship between sacral slope and symptomatic spondylolysis in a cohort of active adolescents. Case-control retrospective study. Academic outpatient Physiatry practice. Seventy-four patients of primarily adolescent age (between 12-22 years old) with a chief complaint of low back pain and presence of lateral radiographs of the lumbar spine were enrolled. Cases (n=37) were defined as subjects with evidence of spondylolysis on both radiograph and magnetic resonance imaging of the lumbar spine. Controls (n=37) were defined as subjects without spondylolysis. Using a single sagittal radiograph, taken with the patient standing, a fellowship-trained interventional spine Physiatrist measured the sacral slope of each subject (angle between the superior plate of S1 and a horizontal reference on sagittal imaging of the lumbosacral spine). Ages and genders were collected from medical records. The primary outcome was mean sacral slope. Mean sacral slope of cases was compared to mean sacral slope of controls using the Student's t-test. Ages ranged from 12 to 22 for both groups, with no significant differences in age between the groups (cases: 16.8 ± 2.3 years; controls: 17.7 ± 2.7 years). The patients with spondylolysis (cases) consisted of 29 male and 8 female patients, whereas those without spondylolysis (controls) consisted of 15 male and 21 female patients. The mean sacral slope among cases was 42.4°, whereas the mean sacral

  17. Advanced Energy and Water Recovery Technology from Low Grade Waste Heat

    Energy Technology Data Exchange (ETDEWEB)

    Dexin Wang

    2011-12-19

    The project has developed a nanoporous membrane based water vapor separation technology that can be used for recovering energy and water from low-temperature industrial waste gas streams with high moisture contents. This kind of exhaust stream is widely present in many industrial processes including the forest products and paper industry, food industry, chemical industry, cement industry, metal industry, and petroleum industry. The technology can recover not only the sensible heat but also high-purity water along with its considerable latent heat. Waste heats from such streams are considered very difficult to recover by conventional technology because of poor heat transfer performance of heat-exchanger type equipment at low temperature and moisture-related corrosion issues. During the one-year Concept Definition stage of the project, the goal was to prove the concept and technology in the laboratory and identify any issues that need to be addressed in future development of this technology. In this project, computational modeling and simulation have been conducted to investigate the performance of a nanoporous material based technology, transport membrane condenser (TMC), for waste heat and water recovery from low grade industrial flue gases. A series of theoretical and computational analyses have provided insight and support in advanced TMC design and experiments. Experimental study revealed condensation and convection through the porous membrane bundle was greatly improved over an impermeable tube bundle, because of the membrane capillary condensation mechanism and the continuous evacuation of the condensate film or droplets through the membrane pores. Convection Nusselt number in flue gas side for the porous membrane tube bundle is 50% to 80% higher than those for the impermeable stainless steel tube bundle. The condensation rates for the porous membrane tube bundle also increase 60% to 80%. Parametric study for the porous membrane tube bundle heat transfer

  18. Chronic low-grade inflammation, lipid risk factors and mortality in functionally dependent elderly

    Directory of Open Access Journals (Sweden)

    Vasović Olga

    2010-01-01

    Full Text Available Background/Aim. It has been proved that a highly sensitive C-reactive protein (hsCRP can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C and high-density lipoprotein cholesterol (HDL-C decrease during aging, the knowledge that increased hsCRP concentration predicts mortality (Mt would influence therapy and treatment outcome. The aim of this study was to examine importance of chronic low grade inflammation and its association with lipid risk factors for all-cause Mt in functionally dependent elderly. Methods. The participants of this longitudinal prospective study were 257 functionally dependent elderly aged 65-99 years. Baseline measurements: anthropometric measurements, blood pressure, fasting plasma total cholesterol (TC, triglyceride (TG, HDL-C, LDL-C, non- HDL-C, hemoglobin A1c (HbA1c were recorded and different lipid ratios were calculated. Inflammation was assessed by the levels of white blood cells, fibrinogen and hsCRP. The participants with hsCRP grater than 10 mg/L were excluded from the study. The residual participants (77.4% women were divided into three groups according to their hsCRP levels: a low (< 1 mg/L, n = 70, average (1 to 3 mg/L, n = 69, and high (3-10 mg/L, n = 69 hsCRP group. Associations of all-cause Mt with different risk factors were examined using logistic regression analysis. Results. The hsCRP level showed a significant positive correlation with waist (r = 0.199, p = 0.004 and hip (r = 0.187, p = 0.007 circumferences, body mass index (r = 0.143, p = 0.040 and serum triglyceride level (r = 0.139, p = 0.045 and significant negative correlation with HDL-C (r = -0.164, p = 0.018. Ratios TC/HDL-C and TG/HDL-C were significantly smaller in the low hsCRP group compared to the average hsCRP group (p = 0.019, p = 0.045, respectively and without significant differences compared with the high hsCRP group. Two years after the

  19. 飞行人员腰椎滑脱症DR分析%DR Analysis of Lumbar Spondylolisthesis of Flight Crew

    Institute of Scientific and Technical Information of China (English)

    罗久伟; 苑青龙; 苏衍峰

    2011-01-01

    目的:分析飞行人员腰椎滑脱症DR特征,提高对飞行人员腰椎滑脱症的认识.方法:回顾性分析29例飞行人员腰椎滑脱症患者的临床及影像学资料,29例均摄取DR正侧位片,部分加摄双斜位片.结果:单个椎体滑脱25例(86.21%),阶梯状滑脱3例(10.34%),交错状滑脱1例(3.44%),发生椎弓峡部裂5例.发生滑脱的椎体共32个.椎体向前移位20个,向后移位6个,向左移位3个,向右移位3个.结论:DR对飞行人员腰椎滑脱移位的程度及预后评估有重要意义.%Objective To analyze DR feature of flight crew with lumbar spondylolisthesis and improve recognition of flight crew with lumbar spondylolisthesis. Methods Clinical and radiological data of 29 cases with lumbar spondylolisthesis of flight crew were analyzed. All cases used anteroposterior and lateral projection of DR, and a part of these cases were examined with double incline radiographs. Results There were 25 cases (86.21%) of single spondylolisthesis, 3 cases (10.34%) of ladder-shaped spondylolisthesis, 1 cases (3.44%) of cross-shaped spondylolisthesis, 5 cases of spondylolysis in 29. There were 32 cases of spondylolisthesis, including 20 cases forward shift, 6 cases backward shift, 3 cases leftward shift, 3 cases rightward shift. Conclusion DR examination has an important value in evaluating the degree and future of flight crew with lumbar spondylolisthesis.[Chinese Medical Equipment Journal,2011,32(10):82-83

  20. Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolisthesis

    Science.gov (United States)

    Shi, Houyin; Ou, Yunsheng; Jiang, Dianming; Quan, Zhengxue; Zhao, Zenghui; Zhu, Yong

    2017-01-01

    Abstract Background: A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis. Methods: 100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i.v, a maintenance dosage of 2 mg/kg/h TA, or an equivalent volume of normal saline. The pedicle screw system was used for fixing in all the patients, followed by decompression and posterior lumbar interbody fusion. The primary outcomes were intraoperative estimated blood loss and total blood loss. The secondary outcomes were receiving packed red blood cells and postoperative hemoglobin and hematocrit levels. Results: In total, 4 patients were excluded from the analyses, 50 patients were in the TA group, and 46 in the placebo group. The demographic and baseline data between the groups were not statistically different. The intraoperative estimated blood loss and the total blood loss were 33% and 41% lower in the TA group than the placebo group, respectively. The blood transfusion rate did not vary significantly (P = 0.191). Except a patient with a dural tear in the placebo group, no other complications were observed. Conclusion: TA significantly reduced the perioperative blood loss in patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis. PMID:28072709

  1. The results of decompressive surgery and instrumented posterolateral fusion in refractory degenerative spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Behtash H

    2009-02-01

    Full Text Available "nBackground: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients. "nMethods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw instrumentation with mean follow-up of 29 months (range, 13-73 months. Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively. "nResults: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%, good in 7 (30.4%, fair in 2 (8.7% cases. ODI decreased from 72.2% (50-88% preoperatively to 14.4% (0-54% at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05. "nConclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.

  2. Extent of preoperative depression is associated with return to work after lumbar fusion for spondylolisthesis.

    Science.gov (United States)

    Parker, Scott L; Godil, Saniya S; Zuckerman, Scott L; Mendenhall, Stephen K; Devin, Clinton J; McGirt, Matthew J

    2015-04-01

    The ability to understand factors associated with an increased duration of missed work postoperatively could be used to more effectively select patients with the greatest opportunity for a successful outcome. We set out to determine the effect of preoperative depression on postoperative return to work in patients undergoing transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis. Fifty-eight patients undergoing TLIF for symptomatic grade I degenerative lumbar spondylolisthesis were included in this analysis. Patient demographics, clinical presentation, indications for surgery, radiologic studies, and operative variables were assessed for each case. Patient-assessed outcome measures were obtained prospectively at baseline and 2 years postoperatively. To understand the factors associated with prolonged return to work, univariate linear regression analysis and stepwise multivariate Cox proportional hazards model was used. All patient-reported outcomes assessed were significantly improved 2 years after TLIF (P working preoperatively, 26 (81%) returned to work postoperatively. Median time to return to work was 56 days (range, 10-150 days). Independent of patient age; preoperative pain, disability, and quality of life; and extent of postoperative improvement, increased preoperative Zung depression score remained associated with prolonged return to work (P = 0.02). Independent of postoperative improvement in pain, disability, and quality of life, the extent of preoperative depression was an independent predictor of time to return to work in patients undergoing TLIF for spondylolisthesis, suggesting that regardless of how successful TLIF surgery may be at improving a patient's pain, disability, or quality of life, greater depression will delay or prohibit their ability to return to work postoperatively. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Study of sagittal spinopelvic parameters of elderly patients with degenerative spondylolisthesis%老年退变性腰椎滑脱症患者脊柱骨盆矢状面参数研究

    Institute of Scientific and Technical Information of China (English)

    李威; 钟招明; 杨德鸿; 蒋晖; 陈建庭

    2014-01-01

    Objective To compare sagittal spinopelvic parameters between elderly degenerative lumbar spondylolisthesis (DLS) patients and age-matched non-DLS people.Methods A total of 50 elderly DLS patients(≥65 years),and 50 age-and sex-matched non-DLS patients hospitalized in department from January 2004 to January 2014 were included as DLS group and non-DLS group, respectively, after excluding patients with isthmic spondylolisthesis , spinal tumor or tuberculosis , vertebrae compressive fracture, severe arthritis in lower extremities and history of spine surgery .Mean slip angle(SA) and slippage (Slip%) of DLS group were calculated, lumbar lordosis(LL), pelvic incidence(PI), pelvic tilt(PT), sacral slope(SS)were compared between DLS and non-DLS group.In DLS group, all parameters were further compared by gender .Correlations between all parameters in both group were also calculated .Results SA and slip%were 7.4°±5.2°and (22.5 ±9.5)%, respectively.Significantly greater LL、PI、PT、SS were found in elderly DLS patients than age-matched non-DLS people. Comparison of SA, Slip%, LL, PI, PT, SS by gender in DLS group showed no significance .Conclusion Elderly DLS patients have greater sagittal spinopelvic parameters , such as LL, PI, PT, SS, than age-matched non-DLS people.In elderly DLS patients,gender factor may not be a influential factor of spondylolisthesis and main sagittal spinopelvic parameters .%目的:分析比较≥65岁老年退变性腰椎滑脱症( degenerative lumbar spondylolisthesis , DLS)患者与同年龄段无滑脱人群的脊柱骨盆矢状面参数。方法选择2004年1月~2014年1月间于本院就诊,影像学资料完整,无峡部裂、椎体肿瘤,椎体结核、椎体压缩性骨折等疾病,且无腰椎手术史的≥65岁的DLS患者50例为滑脱组。以相同纳入标准选择50例年龄性别匹配的无腰椎滑脱的老年人为对照组。测量滑脱组患者腰椎滑脱椎间盘角和滑脱

  4. Pharmacokinetic MRI of the prostate. Parameters for differentiating low-grade and high-grade prostate cancer; Pharmakokinetische MRT der Prostata. Parameter zur Unterscheidung von low-grade- und high-grade-Prostatakarzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Franiel, T.; Taupitz, M.; Asbach, P.; Beyersdorff, D. [Inst. fuer Radiologie CCM, Charite - Universitaetsmedizin Berlin (Germany); Luedemann, L. [Inst. fuer Strahlentherapie CVK, Charite - Universitaetsmedizin Berlin (Germany); Rost, J. [Klinik fuer Gynaekologie und Geburtshilfe, Ernst-von-Bergmann-Klinikum, Potsdam (Germany)

    2009-06-15

    Purpose: to investigate whether pharmacokinetic MRI parameters ''perfusion, blood volume, mean transit time (MTT), interstitial volume, permeability, extraction coefficient, delay, and dispersion'' allow the differentiation of low-grade (Gleason score {<=} 6) and high-grade (Gleason score {>=} 7) prostate cancer. Materials and method: forty-two patients with prostate cancer verified by biopsy (PSA 2.7 to 31.4ng/ml) and scheduled for prostatectomy underwent MRI at 1.5 Tesla using the dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence (temporal resolution, 1.65 s) and a combined endorectal body phased array coil. Parametric maps were computed using a sequential 3-compartment model and the corresponding post-processing algorithms. A total of 41 areas of prostate cancer (15 low-grade, 26 high-grade cancers) in 32 patients were able to be correlated with the prostatectomy specimens and were included in the analysis. Results: low-grade prostate cancers had a higher mean blood volume (1.76% vs. 1.64%, p = 0.039), longer MTT (6.39 s vs. 3.25 s, p < 0.001), and lower mean permeability (2.57 min{sup -1} vs. 3.86 min{sup -1}, p = 0.011) than high-grade cancers. No statistically significant difference was found for perfusion (p = 0.069), interstitial volume (p = 0.849), extraction coefficient (p = 0.615), delay (p = 0.489), and dispersion (p = 0.306). (orig.)

  5. Radiological and clinical outcomes of posterolateral fusion versus posterior lumbar interbody fusion for spondylolisthesis%两种融合手术治疗腰椎滑脱症的影像学及临床疗效比较

    Institute of Scientific and Technical Information of China (English)

    田海军; 陈德玉; 卢旭华; 袁文; 王新伟; 何志敏; 陈宇; 杨海松

    2009-01-01

    Objective To compare two different kinds of operation: instrumented posterolateral lumbar fusion (PLF) and instrumented posterior lumbar interbody fusion (PLIF) in the treatment of low grade spondylolisthesis. Methods We retrospectively analyzed patients who received these two kinds of operation for low grade spondylolisthesis between June 2004 and December 2006, including PLF in 53 and PLIF in 60. Disc height, Boxall index, segment angle and area of intervertebral foramen were compared both before and after the operation and during the follow-ups as radiological measurement. The Oswestry disability index(OPI) and visual analogue scale (VAS) were measured to compare low back pain, leg pain, and disability. Anatomical reduction rate and fusion rate were also calculated. The radiological measurements and the clinical indexes were compared at the last follow-up. Results The average operation time and blood loss was: PLIF, (194.3±54.7) min, (402.2±123.9) ml; PLF, (179.3±45.7) min, (367.2±102.3) mi, which were of no statistical significance. PLIF group turned up better results in all the post operation radiological measurements, which was statistically significant. The fusion rate was 96.7% and 86.8% respectively, which was not statistically different. The VAS for both lumbar and leg pain as well as the ODI were improved either post operation or in the one year follow-up. The excellent rate for subjective evaluation was 56.7% in PLIF group and 37.7% in PLF group. Conclusion Instrumented PLIF is an effective treatment for low grade spondylolisthesis. It has yield superiority over PLF in correction of spondylolisthesis, maintenance of disc height, regaining of lumbar lordosis and enlargement of intervertebral foramen area, and contributes to a higher rate of excellent results.%目的 比较腰椎后路椎体间融合术(posterior lumbar interbody fusion,PLIF)和腰椎后外侧融合术(posterolateral lumbar fusion,PLF)治疗腰椎滑脱症患者手术前后及随访

  6. Cyclin D1 (Bcl-1, PRAD1) protein expression in low-grade B-cell lymphomas and reactive hyperplasia.

    Science.gov (United States)

    Yang, W. I.; Zukerberg, L. R.; Motokura, T.; Arnold, A.; Harris, N. L.

    1994-01-01

    Mantle cell (centrocytic) lymphoma (MCL) and occasional cases of B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (B-SLL/CLL) show a characteristic translocation, t(11:14)(q13;q32) involving rearrangement of the Bcl-1 region. Recently it was shown that the key Bcl-1 region oncogene is cyclin D1/PRAD1; cyclin D1 mRNA was shown to be overexpressed in cases of MCL. We examined cyclin D1 protein expression in low-grade B-cell lymphomas and reactive lymphoid hyperplasias using polyclonal and monoclonal antibodies to cyclin D1 protein. Definite nuclear staining was seen in 15 of 15 MCLs, 1 of 7 B-SLL/CLLs, 0 of 7 reactive hyperplasias, 0 of 10 follicular lymphomas, and 0 of 4 lymphomas of mucosa-associated lymphoid tissue using immunoperoxidase stains on paraffin-embedded sections. Best results were obtained with the affinity-purified polyclonal antibody on microwave-treated, formalin-fixed, paraffin-embedded tissue. MCLs showed diffuse nuclear staining, whereas the one positive B-SLL/CLL showed dot-like or globular nuclear staining. Nuclear cyclin D1 protein can be detected in all cases of MCL and in rare cases of B-SLL/CLL using an immunohistochemical technique on formalin-fixed, paraffin-embedded tissue, and it does not appear to be detectable in reactive hyperplasias and other low-grade B-cell lymphomas. This protein may be useful in subclassification of low-grade B-cell lymphomas. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:7518196

  7. Hypofractionated stereotactic radiotherapy for low grade glioma at McGill University: long-term follow-up.

    Science.gov (United States)

    Roberge, D; Souhami, L; Olivier, A; Leblanc, R; Podgorsak, E

    2006-02-01

    Small, well-defined, unresectable low-grade gliomas are attractive targets for stereotactic irradiation. Fractionated stereotactic irradiation of these targets has the theoretical benefit of increased normal tissue sparing beyond that provided by the physical characteristics of stereotactic radiosurgery. From July 1987 to November 1992, 21 patients were treated for low-grade glioma at our institution using a hypofractionated regimen of stereotactic radiotherapy. All patients had well-circumscribed, < 40 mm tumors. No patient had had prior radiotherapy. All lesions were histologically proven WHO grade I or II glial tumors. Lesions involved sensitive brain structures and were deemed unresectable. A typical dose of 42 Gy was delivered in 6 fractions over a two-week period using rigid immobilization and a linac-based dynamic stereotactic radiosurgical technique. Patients had a median age of 23 years (9-74) and were predominantly female (60%). Median tumor diameter was 20 mm. With a median follow-up for living patients of 13.3 years, the actuarial 5, 10, and 15-year overall survival rates are 76%, 71%, and 63%, respectively. Treatment was acutely well tolerated although three patients experienced late post-therapy complications. Our results and those of 241 patients treated in nine other institutional series are reviewed. Despite some examples of favorable short-term outcomes, all reported series are highly selected and thus likely biased. The data regarding the use of SRS is limited and, in our opinion, insufficient to claim a clear therapeutic advantage to SRS in the initial management of low-grade glioma. Our own results with hypofractionated stereotactic radiotherapy are similar to those expected with standard therapy.

  8. Lingonberries alter the gut microbiota and prevent low-grade inflammation in high-fat diet fed mice

    Directory of Open Access Journals (Sweden)

    Lovisa Heyman-Lindén

    2016-04-01

    Full Text Available Background: The gut microbiota plays an important role in the development of obesity and obesity-associated impairments such as low-grade inflammation. Lingonberries have been shown to prevent diet-induced obesity and low-grade inflammation. However, it is not known whether the effect of lingonberry supplementation is related to modifications of the gut microbiota. The aim of the present study was to describe whether consumption of different batches of lingonberries alters the composition of the gut microbiota, which could be relevant for the protective effect against high fat (HF-induced metabolic alterations. Methods: Three groups of C57BL/6J mice were fed HF diet with or without a supplement of 20% lingonberries from two different batches (Lingon1 and Lingon2 during 11 weeks. The composition and functionality of the cecal microbiota were assessed by 16S rRNA sequencing and PICRUSt. In addition, parameters related to obesity, insulin sensitivity, hepatic steatosis, inflammation and gut barrier function were examined. Results: HF-induced obesity was only prevented by the Lingon1 diet, whereas both batches of lingonberries reduced plasma levels of markers of inflammation and endotoxemia (SAA and LBP as well as modified the composition and functionality of the gut microbiota, compared to the HF control group. The relative abundance of Akkermansia and Faecalibacterium, genera associated with healthy gut mucosa and anti-inflammation, was found to increase in response to lingonberry intake. Conclusions: Our results show that supplementation with lingonberries to an HF diet prevents low-grade inflammation and is associated with significant changes of the microbiota composition. Notably, the anti-inflammatory properties of lingonberries seem to be independent of effects on body weight gain.

  9. Oral Echinacea purpurea extract in low-grade, steroid-dependent, autoimmune idiopathic uveitis: a pilot study.

    Science.gov (United States)

    Neri, Pier Giorgio; Stagni, Edoardo; Filippello, Massimo; Camillieri, Giovanni; Giovannini, Alfonso; Leggio, Gian Marco; Drago, Filippo

    2006-12-01

    The aim of to test efficacy and safety of Echinacea purpurea (echinacea) extract in the control of low-grade uveitis. Fifty-one (51) patients with low-grade, steroid dependent, autoimmune uveitis were recruited; posterior uveitis was excluded. The start therapy was represented by topical desamethazone for anterior uveitis and oral prednisone, rapidly tapered, for anterior uveitis with inflammatory scores equal to +2 and in all cases of intermediate uveitis. Best-corrected visual acuity (BCVA) decrease or improvement was defined as a reduction or increase of 2 or more letters seen from the initial BCVA; ETDRS chart was used. Thirty-two (32) patients (21 with anterior uveitis and 11 with intermediate uveitis) received Echinacea (150 mg twice/day) as add-on therapy, whereas 20 patients (10 with anterior uveitis and 9 with intermediate uveitis) were treated with the conventional steroid therapy alone. Thirty-one (31) patients showed anterior uveitis and 20 intermediate uveitis. The follow-up duration was 9 months. At the last follow-up, 19/21 patients with anterior uveitis and 9/11 with intermediate uveitis treated with echinacea presented uveitis settled, with a steroid-off time of 209 and 146 days, respectively. BCVA was stable or improved in 19/21 of anterior uveitis and 9/11 of intermediate uveitis. No adverse reactions supposed to be resulting from commercial-grade echinacea were recorded. Patients who did not receive echinacea required a longer treatment period with steroids with a steroid-off time of 121 and 87 days. Systemic echinacea appears safe and effective in the control of low-grade autoimmune idiopathic uveitis.

  10. Cyclin D1 (Bcl-1, PRAD1) protein expression in low-grade B-cell lymphomas and reactive hyperplasia.

    OpenAIRE

    Yang, W. I.; Zukerberg, L R; Motokura, T.; Arnold, A.; Harris, N. L.

    1994-01-01

    Mantle cell (centrocytic) lymphoma (MCL) and occasional cases of B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (B-SLL/CLL) show a characteristic translocation, t(11:14)(q13;q32) involving rearrangement of the Bcl-1 region. Recently it was shown that the key Bcl-1 region oncogene is cyclin D1/PRAD1; cyclin D1 mRNA was shown to be overexpressed in cases of MCL. We examined cyclin D1 protein expression in low-grade B-cell lymphomas and reactive lymphoid hyperplasias using polycl...

  11. The method for Determining the Effectiveness of Low-Grade Geothermal Heat Usage under the Conditions of the Russian Climate

    Directory of Open Access Journals (Sweden)

    Vasilyev G.P.

    2015-01-01

    Full Text Available This paper reports the results of study on the effectiveness of using low-grade ground heat in heat pump systems under the climatic conditions of Russia. The study was performed to collect data for using the software package "INSOLAR.GSHP.12", which simulates the non-stationary thermal conditions of ground source heat pumps (GSHPs over several years of operation.The described study was performed with the financial support of the Ministry of Education and Science of Russia. Contract ID RFMEFI57914X0026.

  12. 1{sup 25I} brachytherapy seeds implantation for inoperable low-grade leiomyosarcoma of inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yuliang; Wang, Yongzheng; Liu, Bin; Li, Zheng; Wang, Wujie [The Second Hospital of Shandong Univ., Jinan (China)

    2013-04-15

    A 60-year-old female presented with abdominal pain and tenderness of five-day duration. Contrast enhanced CT showed a mass of 9 x 6 x 5.5 cm in size with almost complete obliteration of the inferior vena cava and massive extension to the extravascular space. CT-guided biopsy demonstrated a low-grade leiomyosarcoma. The patient underwent 1{sup 25I}odine seeds implantation in two sessions, and another balloon cavoplasty. Abdominal pain and tenderness gradually improved and the patient continues to remain as disease free state for three years after the procedures.

  13. Combined lowering of low grade systemic inflammation and insulin resistance in metabolic syndrome patients treated with Ginkgo biloba.

    Science.gov (United States)

    Siegel, G; Ermilov, E; Knes, O; Rodríguez, M

    2014-12-01

    In a clinical pilot study with eleven metabolic syndrome patients, a simultaneous decrease in hs-CRP from 8.85 ± 4.09 to 4.92 ± 2.51 mg/L (-44.4%) (p Ginkgo biloba. Furthermore, both IL-6 (-12.9%, p < 0.0407) and nanoplaque formation (-14.3%, p < 0.0077) were additionally reduced. According to a large clinical trial elucidating the importance of insulin resistance and low-grade systemic inflammation for cardiovascular disease and overall mortality risk, these data might indicate a CVD/total mortality risk reduction.

  14. SWELLING ON THE HARD PALATE PRESENTING AS POLYMORPHOUS LOW GRADE ADENOCARCINOMA: A CASE REPORT AND REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Swapnil D

    2014-08-01

    Full Text Available Polymorphous Low Grade Adenocarcinoma (PLGA is a relatively newer entity under the sub-classification of adenocarcinoma, which arises mainly from the minor salivary glands. PLGA is difficult to diagnose both clinically and histopathologically due to its indolent presentation and its morphological diversity that includes several microscopic patterns. It is an uncommon malignant neoplasm with low aggressiveness accounting for about 2% of all salivary gland tumours. We are reporting this case of PLGA which arose from the minor salivary gland over the hard palate.

  15. Incidence, diagnosis and management of adult cases presenting with symptomatic lumbar spondylolisthesis in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Masroor Alam

    2016-01-01

    Conclusions: Incidence of symptomatic lumbar spondylolisthesis was high. Sex ratio among presenting cases was observed to be higher in males. Cases were clinically examined and diagnosed radiologically. Most cases were managed conservatively. [Int J Res Med Sci 2016; 4(1.000: 38-41

  16. Surgical Outcome of Reduction and Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

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    Farzad Omidi-Kashani

    2016-02-01

    Full Text Available Background: Lumbar degenerative spondylolisthesis (LDS is a degenerative slippage of the lumbar vertebrae. We aimed to evaluate the surgical outcome of degenerative spondylolisthesis with neural decompression, pedicular screw fixation, reduction, and posterolateral fusion. Methods: This before-after study was carried out on 45 patients (37 female and 8 male with LDS operated from August 2008 to January 2011. The patients’ pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaire. In surgery, we applied distraction force to facilitate slip reduction. All the intra- and postoperative complications were recorded. The paired t-test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of patients and mean follow-up period were 58.3±3.5 years and 31.2±4.8 months, respectively. The mean slip correction rate was 52.2% with a mean correction loss of 4.8%. Preoperative VAS and ODI improved from 8.8 and 71.6 to postoperative 2.1 and 28.7, respectively. Clinical improvement was more prominent in more reduced patients, but Pearson coefficient could not find a significant correlation. Conclusion: Although spinal decompression with fusion and posterior instrumentation in surgical treatment of the patients with LDS result in satisfactory outcome, vertebral reduction cannot significantly enhance the clinical improvement.

  17. Vertebral Artery Caught in the Fracture Gap after Traumatic C2/3 Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Ralf Henkelmann

    2017-01-01

    Full Text Available Background Context. Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap. Purpose. Presentation of a case with follow-up until end of treatment. Study Design. Case report. Methods. A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment. Radiological diagnostics revealed a traumatic C2/3 spondylolisthesis. A computer tomography (CT angiographic scan showed a dislocation of the right vertebral artery into the fracture gap without injury to the artery. Open reduction and osteosynthesis were considered of too high risk. Therefore, we conducted fracture treatment with closed reduction and halo fixation. After removal of the halo fixator, the patient was given a soft cervical collar and was advised to rest for additional 6 weeks before beginning gradual activity. Results. Conventional follow-up revealed osseous consolidation and a CT angiographic scan showed consistent blood flow to the artery. Conclusion. Halo fixation was a safe and effective therapy strategy in the case of vertebral artery entrapment after traumatic C2 spondylolisthesis.

  18. Degenerative lumbar spondylolisthesis: cohort of 670 patients, and proposal of a new classification.

    Science.gov (United States)

    Gille, O; Challier, V; Parent, H; Cavagna, R; Poignard, A; Faline, A; Fuentes, S; Ricart, O; Ferrero, E; Ould Slimane, M

    2014-10-01

    Degenerative spondylolisthesis is common in adults. No consensus is available about the analysis or surgical treatment of degenerative spondylolisthesis. In 2013, the French Society for Spine Surgery (Societe francaise de chirurgie du rachis) held a round table discussion to develop a classification system and assess the outcomes of the main surgical treatments. A multicentre study was conducted in nine centres located throughout France and Luxembourg. We established a database on a prospective cohort of 260 patients included between July 2011 and July 2012 and a retrospective cohort of 410 patients included in personal databases between 2009 and 2013. For patients in the prospective cohort clinical assessments were performed before and after surgery using the self-administered functional impact questionnaire AQS, SF12, and Oswestry Disability Index (ODI). Type of treatment and complications were recorded. Antero-posterior and lateral full-length radiographs were used to measure lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence (PI), pelvic tilt (PT), sagittal vertical axis (SVA), and percentage of vertebral slippage. Mean follow-up was 10 months. We started a randomised clinical trial comparing posterior fusion of degenerative spondylolisthesis with versus without an inter-body cage. 60 patients were included, 30 underwent 180° fusion and 30 underwent 360° fusion using an inter-body cage implanted via a transforaminal approach. We evaluated the quality of neural decompression achieved by minimally invasive fusion technique. In a subgroup of 24 patients computed tomography (CT) was performed before and after the procedure and then compared. Mean age was 67 years and 73% of degenerative spondylolisthesis were located at L4-L5 level. The many surgical procedures performed in the prospective cohort were posterior fusion (39%), posterior fusion combined with inter-body fusion (36%), dynamic stabilization (15%), anterior lumbar fusion (8%), and postero

  19. Research of Mechanical Treatment Influence on Rheological Properties of Coal-Water Fuel Based on Low-Grade 3B Coal

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    Tolokolnikov A. A.

    2017-01-01

    Full Text Available Experimental study of mechanical treatment effect of rotary flow modulation device on coal-water fuel rheological properties were conducted. The slurry was prepared on the basis of low-grade 3B coal from Balakhtinskoe deposit.

  20. Elevated Remnant Cholesterol Causes Both Low-Grade Inflammation and Ischemic Heart Disease, Whereas Elevated Low-Density Lipoprotein Cholesterol Causes Ischemic Heart Disease Without Inflammation

    DEFF Research Database (Denmark)

    Varbo, Anette; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2013-01-01

    Elevated nonfasting remnant cholesterol and low-density lipoprotein (LDL) cholesterol are causally associated with ischemic heart disease (IHD), but whether elevated nonfasting remnant cholesterol and LDL cholesterol both cause low-grade inflammation is currently unknown....

  1. Multidimensional assessment of neuro-psychiatric symptoms in patients with low-grade hepatic encephalopathy: A clinical rating scale

    Institute of Scientific and Technical Information of China (English)

    Sergei Mechtcheriakov; Ivo W Graziadei; André Kugener; Julia Wiedemann; Chantal Galbavy; Hartmann Hinterhuber; Josef Marksteiner; Wolfgang Vogel

    2005-01-01

    AIM: To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms.METHODS: Forty patients with liver cirrhosis (LC, with or without low-grade hepatic encephalopathy) were invest-igated using a clinical neuro-psychiatric rating scale based on a comprehensive list of neurological, psychomotor,cognitive, affective, behavioral symptoms, and symptoms of disturbed bioregulation.RESULTS: The analysis revealed that the majority of cirrhotic patients showed, besides characteristic neurological symptoms of hepatic encephalopathy, various psychomotor,affective and bioregulatory symptoms (disturbed sleep and sexual dysfunction). Patients were impaired in the following subscales: sleep and biorhythm disorder (75.0% of patients), Parkinsonoid symptoms (25.0%), affective symptoms (17.5%), and psychomotor retardation (12.5%).The increase of total neuro-psychiatric clinical score was significantly associated with the degree of hepatic enceph-alopathy.CONCLUSION: This study suggests that a substantial number of patients with LC and low-grade hepatic encephalopathy manifest various clinical neuro-psychiatric symptoms. The use of a rating scale, which explores clinical dimensions of hepatic encephalopathy, would improve the management of patients with LC.

  2. Influence of microwaves on the leaching kinetics of uraninite from a low grade ore in dilute sulfuric acid

    Energy Technology Data Exchange (ETDEWEB)

    Madakkaruppan, V. [Atomic Minerals Directorate for Exploration and Research, Begumpet, Hyderabad 500016 (India); Pius, Anitha, E-mail: dranithapius@gmail.com [Department of Chemistry, Gandhigram Rural Institute, Gandhigram, Dindigul District, Tamil Nadu 624302 (India); Sreenivas, T.; Giri, Nitai [Mineral Processing Division, Bhabha Atomic Research Center, AMD Complex, Begumpet, Hyderabad 500016 (India); Sarbajna, Chanchal [Atomic Minerals Directorate for Exploration and Research, Begumpet, Hyderabad 500016 (India)

    2016-08-05

    Highlights: • U leaching from a low-grade Si-rich ore studied in H{sub 2}SO{sub 4} medium with (MW) irradiation. • MW heating is more efficient in terms of U recovery, kinetics and purity of liquor. • U leachability of 84% obtained in 90 min at 95 °C with 0.38 M H{sub 2}SO{sub 4} at 450 mVwith MW heating • Conventional conductive heating gave about 74% leachability with less purity liquor. • U leaching was found follow product layer diffusion as controlling mechanism. - Abstract: This paper describes a study on microwave assisted leaching of uranium from a low-grade ore of Indian origin. The host rock for uranium mineralization is chlorite-biotite-muscovite-quartzo-feldspathic schist. The dominant presence of siliceous minerals determined leaching of uranium values in sulfuric acid medium under oxidizing conditions. Process parametric studies like the effect of sulfuric acid concentration (0.12–0.50 M), redox potential (400–500 mV), particle size (600–300 μm) and temperature (35°–95 °C) indicated that microwave assisted leaching is more efficient in terms of overall uranium dissolution, kinetics and provide relatively less impurities (Si, Al, Mg and Fe) in the leach liquor compared to conventional conductive leaching. The kinetics of leaching followed shrinking core model with product layer diffusion as controlling mechanism.

  3. Gross-total resection of temporal low grade gliomas is a critically important factor in achieving seizure-freedom

    Directory of Open Access Journals (Sweden)

    Lucas Crociati Meguins

    2015-11-01

    Full Text Available Objective To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome.Method A retrospective study was conducted with patients with temporal low-grade gliomas (LGG.Results Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years. The mean age at seizure onset was 25.7 ± 9.2 (11-66 years. Seizure outcome was classified according with Engel classification. After one year of follow up, forty two patients (64.6% were Engel I; seventeen (26.2% Engel II; four (6.2% Engel III and two (3.1% Engel IV. Statistically significant difference in seizure outcome was obtained when comparing the extension of resection. Engel I was observed in 39 patients (69.6% with total resection and in only 3 (33.3% patients with partial resection.Conclusion Gross-total resection of temporal LGGs is a critically important factor in achieving seizure-freedom.

  4. Gross-total resection of temporal low grade gliomas is a critically important factor in achieving seizure-freedom.

    Science.gov (United States)

    Meguins, Lucas Crociati; Adry, Rodrigo Antônio Rocha da Cruz; Silva Júnior, Sebastião Carlos da; Pereira, Carlos Umberto; Oliveira, Jean Gonçalves de; Morais, Dionei Freitas de; Araújo Filho, Gerardo Maria de; Marques, Lúcia Helena Neves

    2015-11-01

    To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome. A retrospective study was conducted with patients with temporal low-grade gliomas (LGG). Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years). The mean age at seizure onset was 25.7 ± 9.2 (11-66 years). Seizure outcome was classified according with Engel classification. After one year of follow up, forty two patients (64.6%) were Engel I; seventeen (26.2%) Engel II; four (6.2%) Engel III and two (3.1%) Engel IV. Statistically significant difference in seizure outcome was obtained when comparing the extension of resection. Engel I was observed in 39 patients (69.6%) with total resection and in only 3 (33.3%) patients with partial resection. Gross-total resection of temporal LGGs is a critically important factor in achieving seizure-freedom.

  5. A population-based study of low-grade gliomas and mutated isocitrate dehydrogenase 1 (IDH1)

    DEFF Research Database (Denmark)

    Dahlrot, Rikke H; Kristensen, Bjarne W; Hjelmborg, Jacob

    2013-01-01

    Low-grade gliomas (LGG) have a slow growth rate, but transformations into malignant gliomas with a rapid deterioration occur in many patients. The aim of this study was to evaluate clinical prognostic factors in a population-based cohort of patients with LGG. In addition we investigated the expre......Low-grade gliomas (LGG) have a slow growth rate, but transformations into malignant gliomas with a rapid deterioration occur in many patients. The aim of this study was to evaluate clinical prognostic factors in a population-based cohort of patients with LGG. In addition we investigated...... the expression and prognostic value of the isocitrate dehydrogenase 1 (IDH1) R132H mutation. Seventy-four patients diagnosed between 2005 and 2009 in the Region of Southern Denmark were identified using the Danish Cancer Register and The Danish Pathology Databank. Survival analysis using Cox regression......) was identified in 46 % of the patients and was significantly correlated to a good survival in both univariate (HR 0.24, 95 % CI 0.11-0.53) and in multivariate analysis (HR 0.40, 95 % CI 0.17-0.91). The other clinical variables were not significant when adjusted for the effect of mIDH1 status. We find that young...

  6. On a minimal model for hemodynamics and metabolism of lactate: application to low grade glioma and therapeutic strategies.

    Science.gov (United States)

    Lahutte-Auboin, Marion; Guillevin, Rémy; Françoise, Jean-Pierre; Vallée, Jean-Noël; Costalat, Robert

    2013-03-01

    WHO II low grade glioma evolves inevitably to anaplastic transformation. Magnetic resonance imaging is a good non-invasive way to watch it, by hemodynamic and metabolic modifications, thanks to multinuclear spectroscopy (1)H/(31)P. In this work we study a multi-scale minimal model of hemodynamics and metabolism applied to the study of gliomas. This mathematical analysis leads us to a fast-slow system. The control of the position of the stationary point brings to the concept of domain of viability. Starting from this system, the equations bring to light the parameters that push glioma cells out of their domain of viability. Four fundamental factors are highlighted. The first two are cerebral blood flow and the rate of lactate transport through monocarboxylate transporters, which must be reduced in order to push glioma out of its domain of viability. Another factor is the intra arterial lactate, which must be increased. The last factor is pH, indeed a decrease of intra cellular pH could interfere with glioma growth. These reflections suggest that these four parameters could lead to new therapeutic strategies for the management of low grade gliomas.

  7. Key parameters for low-grade fine-grained iron ore valorization: lower environmental impact through reduced waste.

    Science.gov (United States)

    Wagner, Christiane; Orberger, Beate; Tudryn, Alina; Baptiste, Benoît; Wirth, Richard; Morgan, Rachel; Miska, Serge

    2016-04-01

    In low-grade banded iron formations (BIFs), a large part of the iron is related to micro- and nano- metric iron-bearing inclusions within quartz and/or carbonates, mainly dolomite (~ 20 to 50 μm). Low-grade fine grained iron ore present two types of environmental risks: a) they are often stocked as tailings. For example, the recent disaster (5th of November 2015) in the Minas Gerais district, Brazil, was caused by the collapse of the Fundão tailings dam at an open cast mine; b) during beneficiation significant amounts of dust are generated also leading to metal loss. A laminated BIF studied from a drill core at Àguas Claras Mine, Quadrilátero Ferrífero, Brazil, contains 26.71 wt. % total iron, 0.2 wt. % SiO2, 0.32 wt.% MnO, 15.46 wt. % MgO, 22.32 wt.% CaO, 0.09 wt. % P2O5, risk factors.

  8. Multiple low-grade sarcomas of fibroblastic type in the setting of HIV and acquired epidermodysplasia verruciformis.

    Science.gov (United States)

    Dosal, Jacquelyn; Nelson, Ann M; Shelling, Michael; Romaguera, Rita; Poulos, Evangelos; Alonso-Llamazares, Javier

    2014-10-01

    A 46-year-old white male with a history of HIV (CD4 245), acquired epidermodysplasia verruciformis, anal carcinoma in situ, hepatitis B and C presented with 3 asymptomatic, nontender, firm pink/skin-colored nodules involving the arm, left lateral leg, and right third finger. One year later, he developed a similar lesion on his right medial lower leg. Excisional biopsy of one of the lesions showed an atypical spindle cell neoplasm of the dermis compatible with a low-grade sarcoma of fibroblastic origin. Testing for human herpes virus-8, 23 human papillomavirus types, Epstein-Barr virus, and FUS fusion protein were negative. The patient underwent diagnostic imaging with computed tomography scans of the chest, abdomen, and pelvis along with positron emission tomography scan to ensure that there was no other occult primary tumor, all of which were negative. The lesions were excised and have not recurred with 3 years of follow-up. The best histopathologic term for these lesions is multiple low-grade sarcomas of fibroblastic phenotype. They have been proven to be nonaggressive, with little or no metastatic potential. This is a neoplastic process that has not been well defined in the literature. To our knowledge, there are no previous reports of these lesions occurring in multiple sites or in an HIV-positive patient.

  9. Effects of Sodium Citrate on the Ammonium Sulfate Recycled Leaching of Low-Grade Zinc Oxide Ores

    Science.gov (United States)

    Yang, Kun; Li, Shi-wei; Zhang, Li-bo; Peng, Jin-hui; Ma, Ai-yuan; Wang, Bao-bao

    2016-03-01

    The effects of sodium citrate on ammonium sulfate recycled leaching of low-grade zinc oxide ores were studied. By applying various kinds of detection and analysis techniques such as chemical composition analysis, chemical phase method, scanning electron microscopy and energy dispersive spectrum (SEM/EDS), X-ray diffraction (XRD) and Fourier-transforming infrared spectrum (FT-IR), zinc raw ore, its leaching slag and the functional mechanism of sodium citrate were investigated. Based on a comprehensive analysis, it can be concluded that in contrast to hemimorphite (Zn4Si2O7(OH)2 · H2O), amorphous smithsonite (ZnCO3) and zinc silicate (Zn2SiO4) prove to be refractory phases under ammonium sulfate leaching, while sodium citrate has a better chelating action with the refractory phases, resulting in a higher zinc leaching rate. Under conditions of [NH3]/[NH3]T molar ratio being 0.5, [NH3]T being 7.5 mol/L, [Na3C6H5O7] being 0.2 mol/L, S/L ratio being 1:5, temperature being 303 K, holding time being 1 h in each of the two stages, and stirring rate being 300 rpm, the leaching rate of zinc reached 93.4%. In this article, sulfate ammonium recycled technology also reveals its unique advantage in processing low-grade zinc oxide ores accompanied by high silicon and high alkaline gangue.

  10. Computer-based image analysis system designed to differentiate between low-grade and high-grade laryngeal cancer cases.

    Science.gov (United States)

    Ninos, Konstantinos; Kostopoulos, Spiros; Sidiropoulos, Konstantinos; Kalatzis, Ioannis; Glotsos, Dimitris; Athanasiadis, Emmanouil; Ravazoula, Panagiota; Panayiotakis, George; Economou, George; Cavouras, Dionisis

    2013-10-01

    To design a pattern recognition (PR) system for discriminating between low- and high-grade laryngeal cancer cases, employing immunohistochemically stained, for p63 expression, histopathology images. The PR system was designed to assist in the physician's diagnosis for improving patient survival. The material comprised 55 verified cases of laryngeal cancer, 21 of low-grade and 34 of high-grade malignancy. Histopathology images were first processed for automatically segmenting p63 expressed nuclei. Fifty-two features were next extracted from the segmented nuclei, concerning nuclei texture, shape, and physical topology in the image. Those features and the Probabilistic Neural Network classifier were used to design the PR system on the multiprocessors of the Nvidia 580 GTX graphics processing unit (GPU) card using the Compute Unified Device Architecture parallel programming model and C++ programming language. PR system performance in classifying laryngeal cancer cases as low grade and high grade was 85.7% and 94.1%, respectively. The system's overall accuracy was 90.9%, using 7 features, and its estimated accuracy to "unseen" by the system cases was 80%. Optimum system design was feasible after employing parallel processing techniques and GPU technology. The proposed system was structured so as to function in a clinical environment, as a research tool, and with the capability of being redesigned on site when new verified cases are added to its repository.

  11. Leaching kinetics of low grade zinc oxide ore in NH3-NH4Cl-H2O system

    Institute of Scientific and Technical Information of China (English)

    WANG Rui-xiang; TANG Mo-tang; YANG Sheng-hai; ZHAGN Wen-hai; TANG Chao-bo; HE Jing; YANG Jian-guang

    2008-01-01

    The leaching kinetics of low grade zinc oxide ore in NH3-NH4Cl-H2O system was studied. The effects of ore particle size,reaction temperature and the sum concentration of ammonium ion and ammonia on the leaching efficiency of zinc were examined.The leaching kinetics of low-grade zinc oxide ore in NH3-NH4Cl-H2O system follows the kinetic law of shrinking-core model. The results show that diffusion through the inert particle pores is the leaching kinetics rate controlling step. The calculated apparent activation energy of the process is about 7.057kJ/mol. The leaching efficiency of zinc is 92.1% under the conditions of ore particle size of 69μm, holding at 80℃ for 60min, sum ammonia concentration of 7.5mol/L, the molar ratio of ammonium to ammonia being 2:1, and the ratio (g/mL) of solid to liquid being 1:10.

  12. Role of microRNAs on adipogenesis, chronic low-grade inflammation, and insulin resistance in obesity.

    Science.gov (United States)

    Cruz, Kyria Jayanne Clímaco; de Oliveira, Ana Raquel Soares; Morais, Jennifer Beatriz Silva; Severo, Juliana Soares; Marreiro PhD, Dilina do Nascimento

    2017-03-01

    The aim of this review was to convey updated information on the role of microRNAs in adipogenesis, chronic low-grade inflammation, and insulin resistance in obesity. Obesity is a chronic disease characterized by the presence of metabolic disorders (e.g., low-grade chronic inflammation), which contributes to the manifestation of insulin resistance. Diverse molecular mechanisms have been implicated in the development of these disorders, and microRNAs stand out as a contributing factor. They are a class of noncoding RNAs that regulate the expression of genes by inducing cleavage of mRNAs or via inhibition of protein translation. It is important to point out that obese individuals show alterations in the expression of microRNAs favoring manifestation of the metabolic disorders present in these patients, and these alterations may be reversed by the loss of weight. Therefore, microRNAs may be regarded as potential biomarkers of obesity-related disorders. Further studies on this topic may advance the understanding of the molecular basis of obesity, including the participation of microRNAs in the pathogenesis of this disease.

  13. Experimental Analysis of Thermoelectric Heat Exchanger for Power Generation from Salinity Gradient Solar Pond Using Low-Grade Heat

    Science.gov (United States)

    Singh, Baljit; Baharin, Nuraida `Aadilia; Remeli, Muhammad Fairuz; Oberoi, Amandeep; Date, Abhijit; Akbarzadeh, Aliakbar

    2016-10-01

    Salinity gradient solar ponds act as an integrated thermal solar energy collector and storage system. The temperature difference between the upper convective zone and the lower convective zone of a salinity gradient solar pond can be in the range of 40-60°C. The temperature at the bottom of the pond can reach up to 90°C. Low-grade heat (solar ponds is currently converted into electricity by organic Rankine cycle engines. Thermoelectric generators can operate at very low temperature differences and can be a good candidate to replace organic Rankine cycle engines for power generation from salinity gradient solar ponds. The temperature difference in a solar pond can be used to power thermoelectric generators for electricity production. This paper presents an experimental investigation of a thermoelectric generators heat exchanger system designed to be powered by the hot water from the lower convective zone of a solar pond, and cold water from the upper convective zone of a solar pond. The results obtained have indicated significant prospects of such a system to generate power from low-grade heat for remote area power supply systems.

  14. Age-Related Macular Degeneration in the Aspect of Chronic Low-Grade Inflammation (Pathophysiological ParaInflammation

    Directory of Open Access Journals (Sweden)

    Małgorzata Nita

    2014-01-01

    Full Text Available The products of oxidative stress trigger chronic low-grade inflammation (pathophysiological parainflammation process in AMD patients. In early AMD, soft drusen contain many mediators of chronic low-grade inflammation such as C-reactive protein, adducts of the carboxyethylpyrrole protein, immunoglobulins, and acute phase molecules, as well as the complement-related proteins C3a, C5a, C5, C5b-9, CFH, CD35, and CD46. The complement system, mainly alternative pathway, mediates chronic autologous pathophysiological parainflammation in dry and exudative AMD, especially in the Y402H gene polymorphism, which causes hypofunction/lack of the protective complement factor H (CFH and facilitates chronic inflammation mediated by C-reactive protein (CRP. Microglial activation induces photoreceptor cells injury and leads to the development of dry AMD. Many autoantibodies (antibodies against alpha beta crystallin, alpha-actinin, amyloid, C1q, chondroitin, collagen I, collagen III, collagen IV, elastin, fibronectin, heparan sulfate, histone H2A, histone H2B, hyaluronic acid, laminin, proteoglycan, vimentin, vitronectin, and aldolase C and pyruvate kinase M2 and overexpression of Fcc receptors play role in immune-mediated inflammation in AMD patients and in animal model. Macrophages infiltration of retinal/choroidal interface acts as protective factor in early AMD (M2 phenotype macrophages; however it acts as proinflammatory and proangiogenic factor in advanced AMD (M1 and M2 phenotype macrophages.

  15. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

    Directory of Open Access Journals (Sweden)

    Viviane Regina Hernandez Nunes

    Full Text Available ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  16. Espondilólise e espondilolistese em ginastas jovens Spondylolysis and spondylolisthesis in young gymnasts

    Directory of Open Access Journals (Sweden)

    Rafael Mohriak

    2010-01-01

    Full Text Available OBJETIVO: Determinar a presença de espondilólise e espondilolistese em atletas de ginástica artística feminina e correlacionar com dor lombar, história de trauma e carga de treinamento. MÉTODO: Avaliação voluntária de 18 atletas de ginástica olímpica em nível competitivo de oito a 17 anos, com média de 11,3 anos. As ginastas responderam a um questionário em relação às suas atividades esportivas e foram submetidas a exame clínico e radiográfico da coluna lombar. RESULTADOS: A análise das radiografias foi realizada por ortopedistas especialistas em cirurgia de coluna vertebral, obtendo prevalência de 5,56% para espondilólise e não havendo casos de espondilolistese. CONCLUSÃO: A incidência das alterações radiográficas identificadas é semelhante à relatada na literatura para indivíduos não atletas e a lombalgia apontada pelas atletas não apresentou relação direta com a espondilólise ou espondilolistese.OBJECTIVE: To determine the incidence of spondylolysis and spondylolisthesis in young, female gymnasts, and to correlate these with lumbar pain, history of trauma and training load. METHOD: A total of 18 would-be Olympic gymnasts, aged 8-17, with an average age of 11.3, were voluntarily evaluated. The Gymnasts were asked to complete a questionnaire about their sports activities, and were submitted to a clinical examination and lumbar spine radiography. RESULTS: The radiographies were analyzed by experienced specialists in surgery of the vertebral column, who found a 5.56% incidence of spondylolysis and no cases of spondylolisthesis. CONCLUSION: The incidence of radiographic alterations identified remained close to those reported in the literature for non-athletic individuals, and the lumbalgia indicated by the athletes showed no direct relation with spondylolysis and spondylolisthesis.

  17. Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3-4 fixation.

    Science.gov (United States)

    Kwon, Yoon-Kwang; Jang, Ju-Hee; Lee, Choon-Dae; Lee, Sang-Ho

    2014-06-01

    Many studies attest to the excellent results achieved using anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. The purpose of this report is to document a rare instance of L-4 vertebral body fracture following use of a stand-alone interbody fusion device for L3-4 ALIF. The patient, a 55-year-old man, had suffered intractable pain of the back, right buttock, and left leg for several weeks. Initial radiographs showed Grade I degenerative spondylolisthesis, with instability in the sagittal plane (upon 15° rotation) and stenosis of central and both lateral recesses at the L3-4 level. Anterior lumbar interbody fusion of the affected vertebrae was subsequently conducted using a stand-alone cage/plate system. Postoperatively, the severity of spondylolisthesis diminished, with resolution of symptoms. However, the patient returned 2 months later with both leg weakness and back pain. Plain radiographs and CT indicated device failure due to anterior fracture of the L-4 vertebral body, and the spondylolisthesis had recurred. At this point, bilateral facetectomies were performed, with reduction/fixation of L3-4 by pedicle screws. Again, degenerative spondylolisthesis improved postsurgically and symptoms eased, with eventual healing of the vertebral body fracture. This report documents a rare instance of L-4 vertebral body fracture following use of a stand-alone device for ALIF at L3-4, likely as a consequence of angular instability in degenerative spondylolisthesis. Under such conditions, additional pedicle screw fixation is advised.

  18. CTNNB1 (beta-catenin) mutation identifies low grade, early stage endometrial cancer patients at increased risk of recurrence.

    Science.gov (United States)

    Kurnit, Katherine C; Kim, Grace N; Fellman, Bryan M; Urbauer, Diana L; Mills, Gordon B; Zhang, Wei; Broaddus, Russell R

    2017-03-10

    Although the majority of low grade, early stage endometrial cancer patients will have good survival outcomes with surgery alone, those patients who do recur tend to do poorly. Optimal identification of the subset of patients who are at high risk of recurrence and would benefit from adjuvant treatment has been difficult. The purpose of this study was to evaluate the impact of somatic tumor mutation on survival outcomes in this patient population. For this study, low grade was defined as endometrioid FIGO grades 1 or 2, while early stage was defined as endometrioid stages I or II (disease confined to the uterus). Next-generation sequencing was performed using panels comprised of 46-200 genes. Recurrence-free and overall survival was compared across gene mutational status in both univariate and multivariate analyses. In all, 342 patients were identified, 245 of which had endometrioid histology. For grades 1-2, stages I-II endometrioid endometrial cancer patients, age (HR 1.07, 95% CI 1.03-1.10), CTNNB1 mutation (HR 5.97, 95% CI 2.69-13.21), and TP53 mutation (HR 4.07, 95% CI 1.57-10.54) were associated with worse recurrence-free survival on multivariate analysis. When considering endometrioid tumors of all grades and stages, CTNNB1 mutant tumors were associated with significantly higher rates of grades 1-2 disease, lower rates of deep myometrial invasion, and lower rates of lymphatic/vascular space invasion. When both TP53 and CTNNB1 mutations were considered, presence of either TP53 mutation or CTNNB1 mutation remained a statistically significant predictor of recurrence-free survival on multivariate analysis and was associated with a more precise confidence interval (HR 4.69, 95% CI 2.38-9.24). Th