Case of chronic progressive radiation myelopathy with a CT myelogram simulating intramedullary tumor

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Kanemaru, Kazutomi; Kamo, Hisaki; Yamao, Satoshi; Akiguchi, Ichiro; Kameyama, Masakuni

1985-05-01

A 58-year-old man underwent a right middle lobectomy in June, 1975, for poorly differentiated adenocarcinoma of the lung. Postoperative irradiation was given to the hilus (6100 rads), and to the right supraclavicular area (6000 rads). In 1980, 60 months after completion of irradiation, the patient noticed weakness of his legs particularly on the left side. In 1982, he noticed the girdle sensation in the upper thoracic region, and paresthesia in the lateral side of the right thigh. In Dec 1983, micturition disturbance appeared, and gait disturbance progressed, he was admitted to the Kyoto University Hospital. Neurological examination revealed an incomplete left Brown-Sequard syndrome with diminution of pain and thermal sensation on the right lower limb, and weakness and spasticity particularly on the left lower limb. Conventional myelogram with CT myelogram showed spinal cord swelling from T-2 through T-5. No extramedullary lesion was found. Laminectomy was performed through T-1 to T-6. When the dura was opened, the cord was swollen and necrotic with a cyst formation. Microscopic examination of the thickened part of the cord showed necrosis and gliosis. The lesion was correspond to the cord segments exposed to the radiation, and a diagnosis of radiation myelopathy was made. Several cases of radiation myelopathy with definite swelling of the cord at myelography were reported, but myelography in these cases was performed at most within 11 months after the onset. In this case, myelography was performed three years after the onset, and revealed difinite swelling of the cord due to a cyst formation. (author).

Radiation myelopathy in over-irradiated patients: MR imaging findings

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Alfonso, E.R.; Gregorio, M.A. de; Mateo, P.; Esco, R.; Bascon, N.; Morales, F.; Bellosta, R.; Lopez, P.; Gimeno, M.; Roca, M.; Villavieja, J.L.

1997-01-01

The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the ''open-neck'' (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase (< 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis. (orig.). With 3 figs., 2 tabs

Radiation myelopathy in over-irradiated patients: MR imaging findings

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Alfonso, E.R. [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain); Gregorio, M.A. de [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain); Mateo, P. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Esco, R. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Bascon, N. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Morales, F. [Neurology Service, Hospital Clinico Universitario, Zaragoza (Spain); Bellosta, R. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Lopez, P. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Gimeno, M. [Hospital Miguel Servet, Zaragoza (Spain); Roca, M. [Radiology Service, Hospital Miguel Servet, E-50 009 Zaragoza (Spain); Villavieja, J.L. [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain)

1997-04-01

The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the ``open-neck`` (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase (< 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis. (orig.). With 3 figs., 2 tabs.

A case of chronic progressive radiation myelopathy with a CT myelogram simulating intramedullary tumor

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Kanemaru, Kazutomi; Kamo, Hisaki; Yamao, Satoshi; Akiguchi, Ichiro; Kameyama, Masakuni

1985-01-01

A 58-year-old man underwent a right middle lobectomy in June, 1975, for poorly differentiated adenocarcinoma of the lung. Postoperative irradiation was given to the hilus (6100 rads), and to the right supraclavicular area (6000 rads). In 1980, 60 months after completion of irradiation, the patient noticed weakness of his legs particularly on the left side. In 1982, he noticed the girdle sensation in the upper thoracic region, and paresthesia in the lateral side of the right thigh. In Dec 1983, micturition disturbance appeared, and gait disturbance progressed, he was admitted to the Kyoto University Hospital. Neurological examination revealed an incomplete left Brown-Sequard syndrome with diminution of pain and thermal sensation on the right lower limb, and weakness and spasticity particularly on the left lower limb. Conventional myelogram with CT myelogram showed spinal cord swelling from T-2 through T-5. No extramedullary lesion was found. Laminectomy was performed through T-1 to T-6. When the dura was opened, the cord was swollen and necrotic with a cyst formation. Microscopic examination of the thickened part of the cord showed necrosis and gliosis. The lesion was correspond to the cord segments exposed to the radiation, and a diagnosis of radiation myelopathy was made. Several cases of radiation myelopathy with definite swelling of the cord at myelography were reported, but myelography in these cases was performed at most within 11 months after the onset. In this case, myelography was performed three years after the onset, and revealed difinite swelling of the cord due to a cyst formation. (author)

Thoracic myelopathy with alkaptonuria.

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Akeda, Koji; Kasai, Yuichi; Kawakita, Eiji; Matsumura, Yoshihiro; Kono, Toshibumi; Murata, Tetsuya; Uchida, Atsumasa

2008-01-15

A case of thoracic myelopathy with alkaptonuria (ochronotic spondyloarthropathy) is presented. To present and review the first reported case of an alkaptonuric patient with concomitant thoracic myelopathy. Alkaptonuria, a rare hereditary metabolic disease, is characterized by accumulation of homogentistic acid, ochronosis, and destruction of connective tissue resulting in degenerative spondylosis and arthritis. Despite the high incidence of intervertebral disc diseases among patients with alkaptonuria, neurologic symptoms caused by spinal disease are rare. Thoracic myelopathy in a patient with alkaptonuria has not been previously reported. The clinical course, radiologic features, pathology, and treatment outcome of an alkaptonuria patient with thoracic myelopathy was documented. Myelopathy of the patient was caused by rupture of a thoracic intervertebral disc. The neurologic symptoms of the patient were markedly improved after surgery. We have reported for the first time, that an alkaptonuria patient showed thoracic myelopathy caused by rupture of a thoracic intervertebral disc. Decompression followed by the instrumented fusion of the thoracic spine was effective for improving the neurologic symptoms.

Myelopathy and peripheral neuropathy after X-ray therapy

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Berstad, J.

1986-03-01

Three patients with injury to the spinal cord after X-ray therapy are reported. One patient suffered from a chronic progressive myelopathy, whereas two others were considered to have a peripheral motor neuropathy due to selective damage to the motoneurons. The prognosis of patients with peripheral motor neuropathy is good, in contrast to chronic progressive myelopathy which most often leads to severe disability and death. Characteristically there is a latent interval from months to years between completed radiation therapy and the appearance of neurological symptoms. The mechanism for delayed radiation injury to the cord is at present unknown, but the possibilities of fibrosis, injury to the microcirculation, or direct injury to the nervous tissue are discussed. The importance of a correct diagnosis before further treatment is decided upon is stressed. The most difficult differential diagnosis is intraspinal metastases.

Myelopathy and peripheral neuropathy after X-ray therapy

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Berstad, J.

1986-01-01

Three patients with injury to the spinal cord after X-ray therapy are reported. One patient suffered from a chronic progressive myelopathy, whereas two others were considered to have a peripheral motor neuropathy due to selective damage to the motoneurons. The prognosis of patients with peripheral motor neuropathy is good, in contrast to chronic progressive myelopathy which most often leads to severe disability and death. Characteristically there is a latent interval from months to years between completed radiation therapy and the appearance of neurological symptoms. The mechanism for delayed radiation injury to the cord is at present unknown, but the possibilities of fibrosis, injury to the microcirculation, or direct injury to the nervous tissue are discussed. The importance of a correct diagnosis before further treatment is decided upon is stressed. The most difficult differential diagnosis is intraspinal metastases

A case of acutely developed delayed radiation myelopathy

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Hayashi, Shintaro; Amari, Masakuni; Fukuda, Toshio; Okamoto, Koichi

2002-01-01

A 66-year-old man with a history of hypertension received radiation therapy on his neck at age 61 because of laryngeal cancer (T1bN0M0). Five years after the radiation, he acutely developed dysuria, tetraparesis and dissociated sensory disturbances below bilateral Th4 level. T2 weighted MRI showed a high signal lesion affecting the central area of the spinal cord extending from C1 to C7. On the second clinical day, he developed respiratory arrest and was ventilated. The cerebrospinal fluid contained 20/mm 3 (monocyte 15, neutorophil 5) white cells; protein was 52.5 mg/dl; IgG index 0.54; Q albumin was 9.6; tests for oligoclonal band and myelin basic protein were negative; a culture yielded no microorganism. He was treated with steroids and supportive measures without improvement, and died of a sudden cardiac arrest on the 8th clinical day. postmortem examination confirmed conspicuous focal spongy changes with many axonal swellings, especially in the posterior and lateral columns at cervical and Th1 levels. The pathological findings were considered to be compatible with those of delayed radiation myelopathy (DRM). In the anterior horn of the cervical cord there were lesions of diffuse racification and the proliferation of small vessels. There were no findings of hyaline vascular changes, infarction or metastasis of laryngeal cancer at the spinal cord. It is considered that hyperintensity of signals on T2-weighted may originate from racification and proliferation of small vessels in the gray matter, and these pathological changes would be intimately associated with the severe neurologic morbidity of this patient. Acute development of neurological findings and the pathological changes in the gray matter of the spinal cord are rare manifestations of DRM. (author)

Pathophysiology of cervical myelopathy.

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Baptiste, Darryl C; Fehlings, Michael G

2006-01-01

Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes. Clinicians who treat cervical myelopathy cord injuries should have a basic understanding of the pathophysiology and the processes that are initiated after the spinal cord has been injured. Literature review. Literature review of human cervical myelopathy and clinically relevant animal models to further our understanding of the pathological mechanisms involved. The pathophysiology of cervical myelopathy involves static factors, which result in acquired or developmental stenosis of the cervical canal and dynamic factors, which involve repetitive injury to the cervical cord. These mechanical factors in turn result in direct injury to neurons and glia as well as a secondary cascade of events including ischemia, excitotoxicity, and apoptosis; a pathobiology similar to that occurring in traumatic spinal cord injury. This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.

CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL ...

African Journals Online (AJOL)

CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL DISABILITY. LONG TERM RESULTS CONCERNING 18 PATIENTS OPERATED ON BY ANTERIOR APPROACH IN GABON MYELOPATHIES CERVICARTHROSIQUES INVALIDANTES. RESULTATS A LONG TERME DE 18 PATIENTS OPERES PAR VOIE ...

Two children with chronic progressive radiation myelopathy

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Ohta, Hideaki; Takai, Kenji; Hosoi, Gaku; Okamura, Takayuki; Osugi, Yuko; Ishihara, Shigehiko; Hara, Junichi; Tawa, Akio; Okada, Shintaro

1995-01-01

We report two patients who developed chronic progressive radiation myelopathy (CPRM). Patient 1 was a 16-year-old boy with group IV rhabdomyosarcoma of cervical soft tissue. He underwent partial excision of the tumor and received systemic and intrathecal chemotherapy and 44 Gy of local radiotherapy (C4 through Th3). These therapies were followed by high-dose chemotherapy including thio-TEPA and busulfan with autologous bone marrow rescue. One year after the completion of the therapies, he developed CPRM. Patient 2 was a 15-year-old girl with acute lymphoblastic leukemia on the 3rd complete remission. She received 18 Gy of irradiation to whole brain during the 1st remission and another 18 Gy to whole brain and 9 Gy to spinal cord after her 1st CNS relapse. After successful reinduction therapy for the 2nd relapse in CNS and bone marrow, she underwent an allogeneic bone marrow transplantation (BMT). The preconditioning regimen consisted of 12 Gy total body irradiation, thio-TEPA and cyclophosphamide. Seven months after BMT, she developed CPRM at C0-C1 level, which was included in the area of whole-brain irradiation. In both patients, MR images showed a swelling of the cervical cord and ring-like images by gadolinium enhancement. Their neurological disability transiently responded to the administration of corticosteroid, but they developed progressive quadriplegia. Although it is reported that a dose of 45-50 Gy may be safe, these cases suggest that administration of high-dose chemotherapy combined with intrathecal chemotherapy and radiotherapy to the cord might increase the rink of developing CPRM. (author)

Two children with chronic progressive radiation myelopathy

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Ohta, Hideaki; Takai, Kenji; Hosoi, Gaku; Okamura, Takayuki; Osugi, Yuko; Ishihara, Shigehiko; Hara, Junichi; Tawa, Akio; Okada, Shintaro [Osaka Univ. (Japan). Faculty of Medicine

1995-06-01

We report two patients who developed chronic progressive radiation myelopathy (CPRM). Patient 1 was a 16-year-old boy with group IV rhabdomyosarcoma of cervical soft tissue. He underwent partial excision of the tumor and received systemic and intrathecal chemotherapy and 44 Gy of local radiotherapy (C4 through Th3). These therapies were followed by high-dose chemotherapy including thio-TEPA and busulfan with autologous bone marrow rescue. One year after the completion of the therapies, he developed CPRM. Patient 2 was a 15-year-old girl with acute lymphoblastic leukemia on the 3rd complete remission. She received 18 Gy of irradiation to whole brain during the 1st remission and another 18 Gy to whole brain and 9 Gy to spinal cord after her 1st CNS relapse. After successful reinduction therapy for the 2nd relapse in CNS and bone marrow, she underwent an allogeneic bone marrow transplantation (BMT). The preconditioning regimen consisted of 12 Gy total body irradiation, thio-TEPA and cyclophosphamide. Seven months after BMT, she developed CPRM at C0-C1 level, which was included in the area of whole-brain irradiation. In both patients, MR images showed a swelling of the cervical cord and ring-like images by gadolinium enhancement. Their neurological disability transiently responded to the administration of corticosteroid, but they developed progressive quadriplegia. Although it is reported that a dose of 45-50 Gy may be safe, these cases suggest that administration of high-dose chemotherapy combined with intrathecal chemotherapy and radiotherapy to the cord might increase the rink of developing CPRM. (author).

Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

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Ashok Kumar Kayal

2017-01-01

Full Text Available Background: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. Materials and Methods: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM and chronic myelopathy (CM. In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement. Results: The study had 151 patients (96 ASM and 55 CM with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23, multiple sclerosis (MS (8, systemic lupus erythematosus (1, Hashimoto's disease (1, postinfectious acute disseminated encephalomyelitis (6, postinfectious myelitis (8, infections (9, spinal cord infarct (5, and electrocution (1. The causes of CM were MS (1, probable or possible sarcoidosis (7, mixed connective tissue disease (1, Hashimoto's disease (2, infections (9, Vitamin B12deficiency (4, folate deficiency (2, hepatic myelopathy (2, radiation (11, and paraneoplastic (1. No etiology could be found in 48 (31.8% patients (34 ASM and 14 CM. In 21/96 (21.9% patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria. Conclusion: Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent was found in 68% patients of noncompressive

Acute progressive paraplegia in heroin-associated myelopathy.

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Mahoney, Kyle W; Romba, Meghan; Gailloud, Philippe; Izbudak, Izlem; Saylor, Deanna

2018-05-01

As the opioid epidemic continues, understanding manifestations of abuse, including heroin-associated myelopathy remains essential. Here we describe a young man with a past medical history significant for polysubstance abuse who developed acute-onset, rapidly progressive myelopathy after resumption of intravenous heroin use. He had significant spinal cord involvement with findings suggestive of heroin-associated myelopathy. The salient features of this case include diffusion imaging of the spine and spinal angiography supporting a possible vasculopathy as the pathophysiologic mechanism underlying heroin-associated myelopathy. Additionally, CSF studies showed the transition from a neutrophilic pleocytosis to a lymphocytic pleocytosis suggesting an inflammatory component. Copyright © 2018 Elsevier Ltd. All rights reserved.

Auto-ignition generated combustion. Pt. 2. Thermodynamic fundamentals; Verbrennungssteuerung durch Selbstzuendung. T. 2. Experimentelle Analyse

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Guibert, P. [Paris-6 Univ. (France). Lab. de Mecanique Physique; Morin, C. [Paris-6 Univ. (France); Mokhtari, S.

2004-02-01

The combustion initiation by auto-ignition demonstrates benefits in NO{sub x} reduction and in process stability for both spark-ignited and compression ignited engines. Based on the better thermodynamic particularities of the auto-ignition, which have been presented in the first part, the characteristics of this process are demonstrated in the second part by experimental analysis. For comparison with similar studies, the analyses have been carried out in base of a two stroke loop scavenged spark-ignition single cylinder engine. (orig.) [German] Die Steuerung der Verbrennung durch Selbstzuendung zeigt Vorteile bezueglich Senkung der NO{sub x}-Emission und Prozessstabilitaet, sowohl bei Otto- als auch bei Dieselmotoren. Auf Grundlage der thermodynamischen Besonderheiten der Selbstzuendvorgaenge, die im ersten Teil praesentiert wurden, erfolgt im zweiten Teil eine experimentelle Betrachtung der Prozesscharakteristika. Zur Vergleichbarkeit mit aehnlichen Untersuchungen wird die experimentelle Analyse auf Basis eines Zweitakt-Einzylinder-Ottomotors mit Umkehrspuelung durchgefuehrt. (orig.)

A case of lymphosarcoma complicated with radiation-induced myelopathy and pericarditis, who died of leukoencephalopathy

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Ikuno, Yoshiko; Okamura, Jun; Tasaka, Hideko; Kotoo, Yasunori

1978-01-01

A 14-year-old girl was diagnosed to have lymphosarcoma (Stage I) after needle biopsy of the huge mediastinal mass. By radiation therapy to the mediastinum (5,400 rads) and combination chemotherapy (according to St. Jude protocol by Aur), complete remission was obtained. During the maintenance therapy, she started to complain of weakness and decreased sensation on her lower extremities 8 months after the diagnosis. Central nervous system (CNS) relapse was diagnosed one week later, which was successfully treated with intrathecally administered methotrexate (MTX) and hydrocortisone (HDC) and then, she received cranial radiation (2,000 rads). However, neurological symptoms progressed gradually and she developed loss of pain sensation, absence of deep tendon reflex of the lower extremities, and neulogenic bladder symptoms, which were finally diagnosed as radiation-induced myelopathy. She also developed asymptomatic radiation pericarditis 18 months after diagnosis. She experienced 3 more episodes of CNS relapse which were successfully treated with MTX and HDC. At 26 months after diagnosis, she developed headache, loss of taste and bilateral facial palsy. She had generalized convulsion one hour after intrathecal medication with MTX, HDC and cytosine arabinoside, then became comatous and died 3 days later. Autopsy revealed performation of duodenal ulcers and demyelinisation of the pons, medulla and thoracic spine (leukoencephalopathy). No tumor cell was seen at any place examined. The possible relations between complications, cause of death and treatment were discussed. (author)

Evaluation of idiopathic transverse myelitis revealing specific myelopathy diagnoses.

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Zalewski, Nicholas L; Flanagan, Eoin P; Keegan, B Mark

2018-01-09

To evaluate specific myelopathy diagnoses made in patients with suspected idiopathic transverse myelitis (ITM). A total of 226 patients 18 years and older were referred to Mayo Clinic Neurology for suspected ITM from December 1, 2010, to December 31, 2015. Electronic medical records were reviewed for detailed clinical presentation and course, laboratory and electrophysiologic investigations, and neuroimaging to determine the etiology. Current diagnostic criteria for ITM and alternative myelopathy diagnoses were applied. All cases where any discrepancy was suspected from the final reported clinical diagnosis were reviewed by each author and a consensus final diagnosis was made. The diagnostic criteria for ITM were met in 41 of 226 patients (18.1%). In 158 patients (69.9%), an alternative specific myelopathy diagnosis was made: multiple sclerosis or clinically isolated syndrome, 75; vascular myelopathy, 41; neurosarcoidosis, 12; neuromyelitis optica spectrum disorder, 12; myelin oligodendrocyte glycoprotein myelopathy, 5; neoplastic, 4; compressive, 3; nutritional, 3; infectious, 2; and other, 2. A myelopathy was not confirmed in 27 patients. Time from symptom onset to final clinical diagnosis in patients without ITM was a median of 9 months (range 0-288). Fifty-five patients (24%) required treatment changes according to their final clinical diagnosis. The majority of patients with suspected ITM have an alternative specific myelopathy diagnosis. A presumptive diagnosis of ITM can lead to premature diagnostic conclusions affecting patient treatment. Copyright © 2017 American Academy of Neurology.

Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study.

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Smith, Justin S; Lafage, Virginie; Ryan, Devon J; Shaffrey, Christopher I; Schwab, Frank J; Patel, Alpesh A; Brodke, Darrel S; Arnold, Paul M; Riew, K Daniel; Traynelis, Vincent C; Radcliff, Kris; Vaccaro, Alexander R; Fehlings, Michael G; Ames, Christopher P

2013-10-15

Post hoc analysis of prospectively collected data. Development of methods to determine in vivo spinal cord dimensions and application to correlate preoperative alignment, myelopathy, and health-related quality-of-life scores in patients with cervical spondylotic myelopathy (CSM). CSM is the leading cause of spinal cord dysfunction. The association between cervical alignment, sagittal balance, and myelopathy has not been well characterized. This was a post hoc analysis of the prospective, multicenter AOSpine North America CSM study. Inclusion criteria for this study required preoperative cervical magnetic resonance imaging (MRI) and neutral sagittal cervical radiography. Techniques for MRI assessment of spinal cord dimensions were developed. Correlations between imaging and health-related quality-of-life scores were assessed. Fifty-six patients met inclusion criteria (mean age = 55.4 yr). The modified Japanese Orthopedic Association (mJOA) scores correlated with C2-C7 sagittal vertical axis (SVA) (r = -0.282, P = 0.035). Spinal cord volume correlated with cord length (r = 0.472, P balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the basis of sagittal alignment. It is interesting to note that sagittal balance but not kyphosis is tied to myelopathy score. Future work will correlate alignment changes to cord morphology changes and myelopathy outcomes. SUMMARY STATEMENTS: This is the first study to correlate sagittal balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the

A case of recurrent delayed radiation myelopathy with 5-year remission interval

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Tsukagoshi, Setsuki; Ikeda, Masaki; Tano, Shinobu; Obayashi, Kai; Fujita, Yukio; Okamoto, Koichi

2010-01-01

We report a 47-year-old woman with relapsed delayed radiation myelopathy (DRM), occurring 5 years and 10 years after radiation therapy for nasopharyngeal carcinoma at 37 years old. Sensations of pain and temperature had been disturbed in the right leg since 42 years old. MRI showed Gadolinium-enhanced lesion as a ring-like-enhancement of the spinal cord at C1-2 on T 1 -weighted image (T 1 WI), with high signal area and swelling of the spinal cord at the upper C1 to C6 areas on T 2 -weighted image. We diagnosed her as having DRM after considering the differential diagnosis, e.g., multiple sclerosis, spinal tumor and other neurological diseases. Her sensory symptoms quickly improved following therapy with prednisolone and warfarin. Although she remained healthy for a few years, dysesthesia of the neck on the right side appeared 5 years later after the first clinical occurrence. At this time, MRI demonstrated Gadolinium-enhanced lesion as a ring-like enhancement of the spinal cord at C2 on T 1 WI, but the area also differed from that of previous lesion; a high signal area and swelling of the spinal cord was also seen on fluid attenuated inversion recovery (FLAIR) image of the medulla and upper C1 to C6. For recurrence of DRM, we administered prednisolone and warfarin. Thereafter, the patient recovered and the spinal cord lesion on MRI decreased markedly. The clinical course demonstrated that administration of prednisolone and warfarin might be effective for relapsed DRM. (author)

Mise au point myelopathie cervicarthrosique revelee par un ...

African Journals Online (AJOL)

Degenerative cervical myelopathy is a progressive spinal cord disease caused by mecanical compression from different structure of a spinal stenosis in pathologics conditions which brings histological damade. In addition acut myelopathy is frequently revealed by cervical spine injury with dynamic injury mechanism.

Cervical Myelopathy in Rheumatoid Arthritis

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N. Mukerji

2011-01-01

Full Text Available Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

Development of a self-administered questionnaire to screen patients for cervical myelopathy

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Sekiguchi Yasufumi

2010-11-01

Full Text Available Abstract Background In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy. Methods A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, β-coefficients, and p value, items were chosen and assigned a score. Results Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a

Inadvertent destruction of the spinal cord by radiation therapy

International Nuclear Information System (INIS)

Bhavilai, D.

1974-01-01

A case of radiation myelopathy following cobalt therapy of a carcinoma of the esophagus is presented. A permanent quadriplegia resulted. Radiation myelopathy can result from treatment with x-rays or radioactive cobalt regardless of whether the condition being treated involves the spinal cord. No effective treatment is known. Prevention requires keeping the radiation at low level

Myelopathy: Retrospective Evaluation of Twenty-Eight Cases

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Yüksel Erdal

2017-12-01

Full Text Available Objective: Myelopathy is used to describe any neurologic deficit related to the spinal cord. Determining the etiology is important for detecting emergency situations and treating the cause. Materials and Methods: We evaluated 28 patients who were diagnosed as having and treated for myelopathy between January 2014 and January 2015 in our hospital. The clinical and laboratory findings of the patients and their response to treatment were assessed. Results: Of the 28 patients, 16 were male and 12 were female, the mean age was 48 years (range, 22-77 years. The most common initial symptoms were sensorial deficits and motor weakness. Demyelinating diseases were the most common diseases and multiple sclerosis was the most frequent etiology among demiyelinating diseases. Cervical spinal cord was the most frequent region involved in myelopathy episodes which was detected by magnetic resonance imaging on T2W images. We observed clinical improvement in 15 of the 20 patients who were treated with corticosteroids. In addition, vitamin B12 treatment led to clinical improvement in two patients who were diagnosed as having subacute combined degeneration. Conclusion: The diagnosis and etiology of myelopathy and identification of rare conditions that require emergency surgery or interventional treatments are of utmost importance

Imaging Modalities for Cervical Spondylotic Stenosis and Myelopathy

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C. Green

2012-01-01

Full Text Available Cervical spondylosis is a spectrum of pathology presenting as neck pain, radiculopathy, and myelopathy or all in combination. Diagnostic imaging is essential to diagnosis and preoperative planning. We discuss the modalities of imaging in common practice. We examine the use of imaging to differentiate among central, subarticular, and lateral stenosis and in the assessment of myelopathy.

Research progress of HIV-associated myelopathy

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Kun HONG

2016-08-01

Full Text Available The wide usage of highly active antiretroviral therapy (HAART leads to reduction of the occurence rate of focal or diffuse neurological damage caused by human immunodeficiency virus (HIV infection, which prominently improves the living quality of HIV-infected patients. Despite this progress, about 70% of HIV-infected patients develop neurological complications. Although neurological disease typically occurs in the advanced stage of the disease or after severe damage of immune functions, it may also occur during early stage of the infection. HIV-associated myelopathy is a common complication of immunodeficiency syndrome and its typical pathological appearence is vacuolar degeneration. In many patients the clinical manifestations of vacuolar myelopathy are in fact limited to non-specific sphincter or sexual dysfunction, and may remain completely asymptomatic. Even when motor and sensory symptoms become evident, the diagnosis is often complicated by a concomitant peripheral neuropathy. The purpose of this study is to summarize pathogenesis, clinical manifestations, pathological features, diagnosis and treatment of HIV-associated myelopathy. DOI: 10.3969/j.issn.1672-6731.2016.08.004

Cervical myelopathy: magnetic imaging findings

International Nuclear Information System (INIS)

Kholin, A.V.; Makarov, A.Yu.; Gurevich, D.V.

1996-01-01

69 patients with clinical signs of cervical myelopathy were examined using magnetic imaging (T1- and T2-suspended tomograms of the sagittal and transverse section using a device with 0.04 T field intensity). Vertebral disk hernias were revealed in 35 patients, compression of the spinal cord with metastases into vertebral body in 2, extramedullary tumor in 11, intramedullary tumor in 9, and syringomyelia in 12 patients. T2-suspended tomograms proved to be more informative due to their higher sensitivity to aqueous content. T1-suspended tomograms help assess the degree of spinal cord compression and the direction of the disk protrusion. Magnetic imaging is an informative method used for objective identification of the cases of myelopathy of cervical localization [ru

Motor conduction velocity in the human spinal cord: slowed conduction in multiple sclerosis and radiation myelopathy

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Snooks, S.J.; Swash, M.

1985-01-01

Transcutaneous electrical stimulation of the central nervous system was used to measure motor conduction velocity in the human spinal cord in 21 subjects aged 22 to 75 years (mean 55 years), none of whom had neurological disease. The motor conduction velocity between the sixth cervical (C6) and first lumbar (L1) vertebral levels was 67.4+-9.1 m/s. This probably represents conduction velocity in the corticospinal tracts. In these subjects the motor conduction velocity in the cauda equina, between the first lumbar (L1) and fourth lumbar (L4) vertebral levels, was 57.9+-10.3 m/s. In four of five patients with multiple sclerosis, all with corticospinal signs in the legs, motor conduction velocity between C6 and L1 was slowed (41.8+-16.8 m/s), but cauda equina conduction was normal (55.8+-7.8 m/s). Similar slowing of spinal cord motor conduction was found in a patient with radiation myelopathy. This method should provide a relevant, simple clinical test in patients with spinal cord disease. (author)

Finger-tapping motion analysis in cervical myelopathy by magnetic-sensor tapping device.

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Miwa, Toshitada; Hosono, Noboru; Mukai, Yoshihiro; Makino, Takahiro; Kandori, Akihiko; Fuji, Takeshi

2013-08-01

Case-control study. The purpose of this study is to determine finger motion of patients with cervical myelopathy during finger-tapping cycles. A major symptom of patients with compressive cervical myelopathy is finger clumsiness. Therefore, understanding finger motion is prerequisite in assessing the severity of myelopathy. The popular grip-and-release test evaluates only the number of motion cycles, which is insufficient to fully describe complex finger motion. Forty-three patients with cervical myelopathy and 41 healthy controls tapped their index fingers against their thumbs as rapidly as possible for 30 seconds and the motion was recorded by a magnetic-sensor coil attached to the nail surface. Output signals were stored in a computer, which automatically calculated tapping frequency, distance moved, ratio of opening/closing velocity and the SD of the tapping interval. The SD of the tapping interval was significantly greater and all other measures were significantly smaller in patients with cervical myelopathy, than in healthy controls. All indices significantly improved after surgical decompression of the cervical spine. Distance moved (Pearson correlation coefficient: r=0.590, Ptapping interval (r=-0.451; P=0.002) were significantly correlated with the Japanese Orthopedic Association score (neurological scale). The quantitative evaluation of finger paralysis was performed by this tapping device. Speed and regularity in repetitive motion of fingers were correlated with the severity of cervical myelopathy.

Surgical Management in Cervical Spondylotic Myelopathy Due to Alkaptonuria.

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Karadag, Ali; Sandal, Evren; Middlebrooks, Erik H; Senoglu, Mehmet

2018-05-01

Ochronotic arthropathy related to alkaptonuria is a rare condition. Cervical spine involvement with myelopathic features has been even more rarely described, particularly related to atlantoaxial instability. As such, little is known about the optimal surgical management in these patients. We described the first case, to our knowledge, of a patient with alkaptonuria and related cervical spondylotic myelopathy from pannus formation at the atlantoaxial joint. We describe our choices in surgical management of this rare condition in a patient with an excellent outcome. Ochronotic cervical spondylotic myelopathy is a rare condition and may require additional considerations in surgical treatment compared to more common causes of cervical spondylotic myelopathy. In our case, we elected for decompression with posterior occipitocervical screw fixation and were able to achieve neurologic recovery with no complications, currently at 2-year follow-up. Copyright © 2018 Elsevier Inc. All rights reserved.

Diffusion tensor imaging and fiber tractography in cervical compressive myelopathy: preliminary results

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Lee, Joon Woo; Kim, Jae Hyoung; Park, Jong Bin; Lee, Guen Young; Kang, Heung Sik; Park, Kun Woo; Yeom, Jin S.

2011-01-01

To assess diffusion tensor imaging (DTI) parameters in cervical compressive myelopathy (CCM) patients compared to normal volunteers, to relate them with myelopathy severity, and to relate tractography patterns with postoperative neurologic improvement. Twenty patients suffering from CCM were prospectively enrolled (M:F = 13:7, mean age, 49.6 years; range 22-67 years) from September 2009 to March 2010. Sensitivity encoding (SENSE) single-shot echo-planar imaging (EPI) was used for the sagittal DTI. Twenty sex- and age-matched normal volunteers underwent the same scanning procedure. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the spinal cord were compared between the patients and normal volunteers and were related to myelopathy severity based on Japanese Orthopedic Association (JOA) scores. Tractography patterns were related to myelopathy severity and postoperative improvement. There were significant differences between patients and normal volunteers in terms of FA (0.498 ± 0.114 vs. 0.604 ± 0.057; p = 0.001) and ADC (1.442 ± 0.389 vs. 1.169 ± 0.098; p = 0.001). DTI parameters and tractography patterns were not related to myelopathy severity. In ten patients in the neurologically worse group, postoperative neurologic improvement was seen in four of five patients with intact fiber tracts, but only one of five patients with interrupted fiber tracts exhibited neurologic improvement. DTI parameters in CCM patients were significantly different from those in normal volunteers but were not significantly related to myelopathy severity. The patterns of tractography appear to correlate with postoperative neurologic improvement. (orig.)

ROLE OF MRI IN EVALUATION OF COMPRESSIVE MYELOPATHY

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Raseshkumar Rasiklal Vyas

2017-03-01

Full Text Available BACKGROUND Aim of the study was to find out various causes of compressive myelopathy and to characterise them. MATERIALS AND METHODS Total of 48 cases were analysed over a period of January 2016 to January 2017 and were evaluated using MRI spine studies. RESULTS MRI, because of its exemplary tissue characterisation and high contrast resolution, excellently demonstrates the anatomical details and pathological process. Thus, is a superior modality in diagnosing Spinal cord lesions as well as associated soft tissue injuries, inter-vertebral discs and ligaments. In our study, traumatic injuries (43% were found to be the most common cause of Compressive myelopathy, other were Infections (23%, primary malignancies (17%, and Metastasis (17%. Thoracic spine was found to be the most frequent site in cases of Traumatic injuries. 40 out of total 48 cases had extradural, and the rest 8 had intra-dural compressive lesions. CONCLUSION The study concludes that patients with suspected Compressive myelopathies benefit from evaluation with MRI, which is highly accurate for characterising and identifying the underlying aetiology, as well as associated features. Thus, explicitly helps in stating the long-term prognosis of the patient.

Trends analysis of surgical procedures for cervical degenerative disc disease and myelopathy in patients with tobacco use disorder.

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Grisdela, Phillip; Buser, Zorica; D'Oro, Anthony; Paholpak, Permsak; Liu, John C; Wang, Jeffrey C

2017-09-01

This study defined the incidence and trends of surgeries performed for patients with cervical disc degeneration with and without tobacco use disorder (TUD). This study utilized the Humana Inc. database between 2007 and 2013 to identify patients with cervical disc degeneration with or without myelopathy. International Classification of Diseases, ninth revision (ICD-9) and Current Procedural Terminology (CPT) codes determined the initial diagnosis of disc degeneration, myelopathy status and TUD, whether patients received surgery, and TUD status at surgery. The prevalence of disc degeneration with myelopathy increased by 32.8% between 2007 and 2013, while disc disease with myelopathy and TUD increased by 91.6%. For patients without myelopathy, the prevalence of disc degeneration alone increased by 65.4%, and disc degeneration with myelopathy increased by 148.7%. Of myelopathy patients, 1717 (6.4%) had TUD and 1024 (59.6%) received surgery, compared to 6508 patients without TUD (26.1%). For patients without myelopathy, 11,337 (3.5%) had TUD and 787 (6.9%) underwent surgery, compared to 9716 patients (3%) without TUD. Of surgical patients, 781 (76.3%) with myelopathy and TUD still had a TUD diagnosis at surgery, and 542 (68.9%) of patients without myelopathy still had a TUD diagnosis at surgery. The prevalence of degenerative disc disease and TUD has increased more than disc disease alone. Patients with TUD were more likely to get surgery, and to have surgeries earlier than patients without TUD. Patients with TUD at the time of the diagnosis of their disc degeneration likely still had a TUD diagnosis at the time of surgery.

Treatment of Portosystemic Shunt Myelopathy with a Stent Graft Deployed through a Transjugular Intrahepatic Route

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Jain, Deepak; Arora, Ankur; Deka, Pranjal; Mukund, Amar; Bhatnagar, Shorav; Jindal, Deepti; Kumar, Niteen; Pamecha, Viniyendra

2013-01-01

A case of surgically created splenorenal shunt complicated with shunt myelopathy was successfully managed by placement of a stent graft within the splenic vein to close the portosystemic shunt and alleviate myelopathy. To our knowledge, this is the first report of a case of shunt myelopathy in a patient with noncirrhotic portal fibrosis without cirrhosis treated by a novel technique wherein a transjugular intrahepatic route was adopted to deploy the stent graft

Morphology of the cervical spinal cord with myelopathy on computed myelography

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Iwasaki, Hiroaki; Asano, Masafumi; Yokota, Hidemaro

1984-01-01

The relationship between morphological changes in the spinal cord shown on computer-assisted myelography and symptoms was investigated in 73 patients with cervical spondylotic myelopathy. Flatness of the spinal cord was seen in many of the patients. Symptoms were likely to be severer with increasing the degree of flatness of the spinal cord. The length of the flat spinal cord will help to select the operative method for cervical spondylotic myelopathy. (Namekawa, K.)

Dosimetric analysis of varying cord planning organ at risk volume in spine stereotactic body radiation therapy

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Dawn Owen, MD, PhD

2016-01-01

Conclusion: Current guidelines may overestimate the risk of myelopathy from spine SBRT. The current study's population included both radiation-naïve and retreatment cases, but no myelopathy was observed despite exceeding recommended spine limits.

Asymptomatic HIV positive patient presenting with myelopathy

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Jatin Agrawal

2016-01-01

Full Text Available A wide variety of disorders of diverse pathogenic mechanisms can trigger spinal cord dysfunction in HIV-1-infected patients. The most common such condition is HIV-1-associated myelopathy (HAM which characteristically seen during advanced HIV infection in patients with low CD4 cell counts and previous AIDS-defining diagnoses. Histologically seen in approximately 30% of AIDS patients, but only 10% have clinical symptoms related to the disease. We describe an unusual case of HAM in previously asymptomatic patient with relatively low CD4 cell count (78 cells/mm3. The patient unaware of her seropositive status presented with a clinically slowly progressive myelopathy with difficulty in walking without assistance. We discharged a patient on antiretroviral therapy. We also review the disorders reported to derange spinal cord function in previously asymptomatic HIV-1 infected patients with preserved counts.

Operative Outcomes for Cervical Myelopathy and Radiculopathy

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J. G. Galbraith

2012-01-01

Full Text Available Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

Quadriplegia secondary to cervical spondylotic myelopathy-a rare complication of head and neck surgery.

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Chen, Wei-Fan; Kang, Chung-Jan; Lee, Sai-Cheung; Tsao, Chung-Kan

2013-02-01

Free tissue reconstruction after ablation of head and neck malignancy often requires extensive cervical manipulation, which may exacerbate preexisting cervical spondylosis and result in progression to cervical myelopathy. We present a rare case of postoperative quadriplegia caused by cervical spondylotic myelopathy after head and neck reconstruction. A 63-year-old man without a history of cervical spondylosis underwent resection of a gingivo-buccal squamous cell carcinoma with immediate reconstruction with free fibula osteocutaneous flap. On postoperative day 4, the patient was found to have quadriplegia. MRI demonstrated severe cervical myelopathy. Decompressive laminectomy was performed. The patient underwent an extensive rehabilitation program but only realized moderate improvement. Cervical spondylotic myelopathy is a rare but disastrous complication of head and neck surgery. We hypothesize that it is potentially avoidable with heightened awareness of this disease entity, preoperative identification of patients at risk, and prophylactic interventions Copyright © 2011 Wiley Periodicals, Inc.

Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications

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Ross, Ruth E.; Shade-Zeldow, Yvonne; Kostas, Konstantinos; Morrissey, Mary; Elias, Dean A.; Shepard, Alan

2007-01-01

Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients’ quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screening test for somatization, HADS, MMPI-2 scale 1 (Hypochondriasis), and self reported severity of symptoms 1 year after treatment. There was no significant difference in initial clinical presentation or demographic characteristics between the patients treated by surgical decompression and those treated by non-surgical means. There was a striking and statistically significant improvement in all symptoms attributed to the fibromyalgia syndrome in the surgical patients but not in the non-surgical patients at 1 year following the treatment of cervical myelopathy (P ≤ 0.018–0.001, Chi-square or Fisher’s exact test). At the 1 year follow-up, there was a statistically significant improvement in both physical and mental quality of life as measured by the SF-36 score for the surgical group as compared to the non-surgical group (Repeated Measures ANOVA P somatization disorder, and the anxiety and depression scores exclusively in the surgical patients (Wilcoxon signed rank, P < 0.001). The surgical treatment of cervical myelopathy due to spinal cord or caudal brainstem compression in patients carrying the diagnosis of fibromyalgia can result in a significant improvement in a wide array of symptoms usually attributed to fibromyalgia with attendant measurable improvements in the quality of life. We recommend detailed neurological and neuroradiological evaluation of patients with fibromyalgia in order to exclude compressive cervical myelopathy, a potentially treatable

Surgical results and MRI findings of cervical myelopathy treated with anterior decompression and fusion

International Nuclear Information System (INIS)

Miyazato, Takenari; Teruya, Yoshimitsu; Kinjo, Yukio

1995-01-01

We reviewed 19 patients with cervical myelopathy treated with anterior decompression and fusion. Etiology of cervical myelopathy was cervical disc herniation (CDH) in 13 patients and cervical spondylosis (CSM) in 6. Clinical recovery rate (%) was calculated from preoperative cervical myelopathy score (JOA) and the score at follow-up. Correlation between the clinical recovery rate and MRI findings (area and flatness at the narrowest part of the spinal cord), age at surgery, duration of myelopathy and pre-operative clinical score were analyzed separately in the CDH and CSM groups. Clinical recovery rate averaged 69% in the CDH group and 75% in the CSM group. In the CDH group, average clinical recovery rate in patients younger than 60 years was 80 and in patients over 60 years was 60. There was a significant negative correlation between the clinical recovery rate and age at surgery (p<0.05). No significant correlation was found between the clinical recovery rate and other factors investigated. (author)

The characteristics of chronic pain after non-traumatic, non-compressive myelopathy: Focus on neuropathic pain.

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Eom, Young In; Kim, Min; Joo, In Soo

2017-05-01

The aim of this study was to assess the characteristics of neuropathic pain after non-traumatic, non-compressive (NTNC) myelopathy and find potential predictors for neuropathic pain. We analyzed 54 patients with NTNC myelopathy. The Short Form McGill Pain Questionnaire (SF-MPQ) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were used to assess pain. Health-related QOL was evaluated by the Short Form 36-item (SF-36) health survey. Out of 48 patients with pain, 16 (33.3%) patients experienced neuropathic pain. Mean age was significantly lower in patients with neuropathic pain than in patients with non-neuropathic pain (39.1 ± 12.5 vs. 49.8 ± 9.3, P = 0.002). There were no statistically significant differences in the other variables including sex, etiology of myelopathy, pain and QOL scores between the two groups. A binary logistic regression revealed that onset age under 40, and non-idiopathic etiology were independent predictors of the occurrence of neuropathic pain. Both SF-MPQ and LANSS scores were significantly correlated with SF-36 scores, adjusted by age, sex, presence of diabetes mellitus, and current EDSS scores (r = -0.624, P Neuropathic pain must be one of serious complications in patients with NTNC myelopathy and also affects their quality of life. Onset age and etiology of myelopathy are important factors in the development of neuropathic pain in NTNC myelopathy.

Diagnostic Approach to Myelopathies

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Granados Sanchez, Ana Maria; Garcia Posada, Lina Maria; Ortega Toscano, Cesar Andres; Lopez Lopez, Alejandra

2011-01-01

Myelopathy is a broad term that refers to spinal cord involvement of multiple etiologies. Spinal cord diseases often have devastating consequences, ranging from quadriplegia and paraplegia to severe sensory deficits due to its confinement in a very small area. Many of these diseases are potentially reversible if they are recognized on time, hence the importance of recognizing the significance of magnetic resonance imaging when approaching a multifactorial disease considered as one of the most critical neurological emergencies, where prognosis depends on an early and accurate diagnosis.

Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

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Wenger, Markus; Markwalder, Thomas-Marc

2016-04-01

This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed. Copyright © 2015 Elsevier Ltd. All rights reserved.

MRI findings in acute idiopathic transverse myelopathy in children

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Andronikou, Savvas; Albuquerque-Jonathan, Glenda; Hewlett, Richard; Wilmshurst, Jo

2003-01-01

To describe the clinical and MRI findings in three children with acute idiopathic myelopathy (AIM). Retrospective review of the clinical presentation, MRI findings and outcome of three patients diagnosed with acute idiopathic transverse myelitis. Of note was the swift onset of symptoms in all patients, without any preceding illness or history of vaccination in two of the patients, and the rapid resolution of symptoms on steroid therapy in all the patients. MRI showed T2-weighted hyperintensity and patchy enhancement with gadolinium, but the extensive cord involvement did not correlate with the severity of presentation or outcome. Our findings do not support that MRI evidence alone of diffuse myelopathy is a predictor of poor outcome in childhood AIM. (orig.)

Subacute copper-deficiency myelopathy in a patient with occult celiac disease.

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Cavallieri, Francesco; Fini, Nicola; Contardi, Sara; Fiorini, Massimo; Corradini, Elena; Valzania, Franco

2017-07-01

Acquired copper deficiency represents a rare cause of progressive myelopathy presenting with sensory ataxia and spastic gait. The time interval from neurological symptoms onset to diagnosis of myelopathy ranges from 2 months to several years in almost all cases, mimicking the clinical course of subacute combined degeneration due to vitamin B12 deficiency. A 60-year-old man, without any gastrointestinal symptoms, developed over the course of one week rapidly progressive gait imbalance, tingling and numbness in his feet and ascending lower limb weakness. Spine magnetic resonance imaging revealed hyperintensity involving cervical and dorsal posterior columns of spinal cord. Blood analysis revealed undetectable serum copper levels, low serum ceruloplasmin and positive serum Immunoglobulin A anti-tissue transglutaminase. Upper gastrointestinal endoscopy was performed revealing duodenal villous atrophy consistent with a malabsorption pattern. A gluten-free diet in association with intravenous then oral copper supplementation prompted sustained normalization of serum copper levels and progressive clinical improvement. We report a rare case of myelopathy induced by copper deficiency secondary to undiagnosed celiac disease, peculiarly presenting with a subacute onset. This case expands the neurological presentation and clinical course of myelopathy due to acquired copper deficiency. We suggest investigation of copper deficiency in patients presenting with subacute or even acute sensory ataxia and spastic gait. Detection of hypocupremia in patients without a previous history of gastric surgery should lead to diagnostic testing for celiac disease even in the absence of any obvious gastrointestinal symptoms.

Variation in radiation sensitivity and repair kinetics in different parts of the spinal cord

International Nuclear Information System (INIS)

Adamus-Gorka, Magdalena; Brahme, Anders; Mavroidis, Panayiotis; Lind, Bengt K.

2008-01-01

Background. The spinal cord, known for its strongly serial character and high sensitivity to radiation even when a small segment is irradiated, is one of the most critical organs at risk to be spared during radiation therapy. To compare the sensitivity of different parts of the spinal cord, data for radiation myelopathy have been used. Material and methods. In the present study, the relative seriality model was fitted to two different datasets of clinical radiation myelitis concerning cervical spinal cord after treating 248 patients for head and neck cancer and thoracic spinal cord after treating 43 patients with lung carcinoma. The maximum likelihood method was applied to fit the clinical data. The model parameters and their 68% confidence intervals were calculated for each dataset. The α/β ratio for the thoracic cord was also was also found to be 0.9 (0-3.0) Gy. Results. The dose-response curve for the more sensitive cervical myelopathy is well described by the parameters D 50 =55.9 (54.8-57.1) Gy, γ=6.9 (5.0-9.2), s=0.13 (0.07-0.24), whereas the thoracic myelopathy is described by the parameters D 50 =75.5 (70.5-80.8) Gy, γ=1.1 (0.6-1.6), s=36 (3.3-8). Discussion and conclusions. Large differences in radiation response between the cervical and thoracic region of spinal cord are thus observed: cervical myelopathy seems to be characterized by medium seriality, while thoracic spinal cord is characterized by a highly serial dose-response. The much steeper dose-response curve for cervical spinal cord myelopathy can be interpreted as a higher number of functional subunits consistent with a higher amount of white matter close to the brain

Remission of HIV-associated myelopathy after highly active antiretroviral therapy

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Fernandez-Fernandez F

2004-07-01

Full Text Available HIV-associated myelopathy is the leading cause of spinal cord disease in HIV-infected patients. Typically, it affects individuals with low CD4 T cell counts, presenting with slowly progressive spastic paraparesis associated with dorsal column sensory loss as well as urinary disturbances. Other aetiologies must be first ruled out before establishing the diagnosis. We report here the case of a 37-year-old woman with advanced HIV disease, who developed HIV-associated myelopathy. The patient showed a gradual improvement after beginning with highly active antiretroviral therapy and, finally, she achieved a complete functional recovery. In addition, neuroimaging and neurophysiological tests normalized.

Reevaluation of the Pavlov ratio in patients with cervical myelopathy.

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Suk, Kyung-Soo; Kim, Ki-Tack; Lee, Jung-Hee; Lee, Sang-Hun; Kim, Jin-Soo; Kim, Jin-Young

2009-03-01

This study was designed to reevaluate the effectiveness of the Pavlov ratio in patients with cervical myelopathy. We studied 107 patients who underwent open door laminoplasty for the treatment of cervical myelopathy between the C3 to C7 levels. We determined the Pavlov ratio on preoperative and postoperative cervical spine lateral radiographs, the vertebral body-to-canal ratio on sagittal reconstruction CT scans, and the vertebral body-to-cerebrospinal fluid (CSF) column ratio on T2-weighted sagittal MR images from C3 to C6. The severity of myelopathy was determined using the JOA score on both preoperative and postoperative images. The recovery rate was also calculated. The Pavlov ratio in plain radiographs from patients with myelopathy was compared with the ratio of the vertebral body to the spinal canal on CT and MRI. The average Pavlov ratio between C3 and C6 ranged from 0.71 to 0.76. On CT scan, the average vertebral body-to-canal ratio between C3 and C6 ranged from 0.62 to 0.66. On MRI, the vertebral body-to-CSF column ratio between C3 and C6 ranged between 0.53 and 0.57. A positive correlation was noted between the Pavlov ratio and the vertebral body-to-canal ratio on sagittal-reconstruction CT (correlation coefficient = 0.497-0.627, p = 0.000) and between the Pavlov ratio and the vertebral body-to-CSF column ratio on MRI (correlation coefficient = 0.511-0.649, p = 0.000). We demonstrated a good correlation between the Pavlov ratio and both the vertebral body-to-canal ratio on CT and the vertebral body-to-CSF column ratio on MRI. Therefore, the Pavlov ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane.

[Cervical myelopathy from an aspect of a neurological surgeon].

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Koyama, T

1994-12-01

More than 65 per cent of intramedurally tumors and intradural extramedurally tumors were located in cervical region. They enact a cause of cervical myelopathy. A special attention should be paid to solitaly intramedurally vascular malformations, when the patients show an acute progressive myelopathy. In very rare cases of syringomyelia, intramedurally tumors such as hemangioblastoma or ependymoma could be found, so that enhanced MRI or angiography should be done if necessary. In cases of a herniated disc, cervical spondylosis and OPLL, the distance between articulo-pillar line and spinolaminal line must be measured. If the distance of both lines is near or the same, that means narrow cervical canal. In rare cases the form of the vertebral body is round. This is a rare cause of a type of narrow canal.

Severity score system for progressive myelopathy: development and validation of a new clinical scale

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R.M. Castilhos

2012-07-01

Full Text Available Progressive myelopathies can be secondary to inborn errors of metabolism (IEM such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM, covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS, the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001 and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001 were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

MR findings of subacute necrotizing myelopathy: case report

International Nuclear Information System (INIS)

Na, Dong Gyu; Chang, Kee Hyun; Han, Moon Hee; Kim, Hyun Jip; Kim, Chong Jai; Chi, Je G.

1994-01-01

Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. 1 case of pathologically proved subacute necrotizing myelopathy. The patients was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1-weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of gradual progressive neurologic deterioration may be helpful in the diagnosis of SNM

Case of sensory ataxic ganglionopathy-myelopathy in copper deficiency.

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Zara, Gabriella; Grassivaro, Francesca; Brocadello, Filippo; Manara, Renzo; Pesenti, Francesco Francini

2009-02-15

Spinal cord involvement associated with severe copper deficiency has been reported in the last 8 years. Copper deficiency may produce an ataxic myelopathy. Clinical and neuroimaging findings are similar to the subacute combined degeneration seen in patients with vitamin B12 deficiency. Macrocytic, normocytic and microcytic anemia, leukopenia and, in severe cases, pancytopenia are well known hematologic manifestations. The most patients with copper deficiency myelopathy had unrecognized carency. Some authors suggested that early recognition and copper supplementation may prevent neurologic deterioration but clinical findings do not improve. We present a patient with copper deficiency, dorsal root ganglions and cervical dorsal columns involvement. Clinical status and neuroimaging improved after copper replacement therapy. Sensory neurons of dorsal root ganglia may be the most sensitive nervous pathway. In this case the early copper treatment allowed to improve neurologic lesions and to prevent further involvements.

PROMIS Physical Function Correlation With NDI and mJOA in the Surgical Cervical Myelopathy Patient Population.

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Owen, Robert J; Zebala, Lukas P; Peters, Colleen; McAnany, Steven

2018-04-15

Retrospective review. To determine the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function with Neck Disability Index (NDI) and Modified Japanese Orthopedic Association (mJOA) scores in the surgical cervical myelopathy patient population. Outcome measures such as NDI and mJOA are essential for analyzing treatments for cervical myelopathy. Administrative burdens impose limits on completion of these measures. The PROMIS group developed an outcome measure to improve reporting of patient symptoms and function and to reduce administrative burden. Despite early success, NDI and mJOA have not been compared with PROMIS in patients with cervical myelopathy. This study determines the correlation of NDI and mJOA with PROMIS in surgical patients with cervical myelopathy. A total of 60 patients with cervical myelopathy undergoing surgery were included. PROMIS, NDI, and mJOA were collected preoperatively, and in the first 6 months postoperatively. Correlations between NDI, mJOA, and PROMIS were quantified using Pearson correlation coefficients. Students t tests were used to test significance. All 60 (100%) of patients completed preoperative questionnaires. Fifty-five (92%) of patients completed initial follow-up questionnaires within the first 6 months. PROMIS physical function and NDI demonstrated a strong negative correlation at baseline and in initial follow-up (R = -0.69, -0.76). PROMIS and mJOA demonstrated a strong positive correlation at baseline and in initial follow-up (R = 0.61, 0.72). PROMIS physical function has a strong negative correlation with NDI and a strong positive correlation with mJOA at baseline and in the early postoperative course in patients undergoing surgery for cervical myelopathy. Surgeons may factor these outcomes into the delivery and interpretation of patient-reported outcome measures in this population. Use of PROMIS may improve completion of outcome measures in the office and reduce

Cytokine expression of macrophages in HIV-1-associated vacuolar myelopathy.

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Tyor, W R; Glass, J D; Baumrind, N; McArthur, J C; Griffin, J W; Becker, P S; Griffin, D E

1993-05-01

Macrophages are frequently present within the periaxonal and intramyelinic vacuoles that are located primarily in the posterior and lateral funiculi of the thoracic spinal cord in HIV-associated vacuolar myelopathy. But the role of these macrophages in the formation of the vacuoles is unclear. One hypothesis is that cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF)-alpha, are produced locally by macrophages and have toxic effects on myelin or oligodendrocytes. The resulting myelin damage eventually culminates in the removal of myelin by macrophages and vacuole formation. We studied thoracic spinal cord specimens taken at autopsy from HIV-positive (+) and HIV-negative individuals. The predominant mononuclear cells present in HIV+ spinal cords are macrophages. They are located primarily in the posterior and lateral funiculi regardless of the presence or absence of vacuolar myelopathy. Macrophages and microglia are more frequent in HIV+ than HIV-negative individuals and these cells frequently stain for class I and class II antigens, IL-1, and TNF-alpha. Activated macrophages positive for IL-1 and TNF-alpha are great increased in the posterior and lateral funiculi of HIV+ individuals with and without vacuolar myelopathy, suggesting they are present prior to the development of vacuoles. Cytokines, such as TNF-alpha, may be toxic for myelin or oligodendrocytes, leading to myelin damage and removal by macrophages and vacuole formation.

Recurrent acute transverse myelopathy: association with antiphospholipid antibody syndrome.

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Shaharao, Vijaya; Bartakke, Sandip; Muranjan, Mamta N; Bavdekar, Manisha S; Bavdekar, Sandeep B; Udani, Vrajesh P

2004-06-01

A seven-year-old boy presented with a second episode of acute transverse myelopathy. The first episode had responded dramatically to methylprednisolone. The manifestations of the second episode did not respond to methylprednisolone or IVIG. He showed persistently raised levels of antiphospholipid antibodies in the serum. Primary conditions like collagen vascular diseases, malignancy, exposure to drugs and HIV infection, which are known to be associated with the raised titers of these antibodies were ruled out clinically and by investigations. Recurrent transverse myelopathy is a rare event in childhood and reports of its association with Antiphospholipid Antibody Syndrome (APLAS) are scanty. The etiological role for these antibodies remains to be established. However, once the diagnosis is established, it may be prudent to treat the condition with agents and procedures to bring about a decrease in their titers. Long-term therapy to prevent thromboembolic complications of APLAS may also be instituted.

Laminoplasty and laminectomy for cervical sponydylotic myelopathy: a systematic review

DEFF Research Database (Denmark)

Bartels, R.H.M.A.; van Tulder, M.W.; Moojen, W.A.

2015-01-01

BACKGROUND: Cervical spondylotic myelopathy is frequently encountered in neurosurgical practice. The posterior surgical approach includes laminectomy and laminoplasty.OBJECTIVE: To perform a systematic review evaluating the effectiveness of posterior laminectomy compared with posterior laminoplasty...

Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

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Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

2013-10-15

Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index

Preoperative cervical sagittal alignment parameters and their impacts on myelopathy in patients with cervical spondylotic myelopathy: a retrospective study

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Wei Yuan

2017-11-01

Full Text Available Background Cervical sagittal alignment plays an important role in the pathogenesis of cervical spondylotic myelopathy (CSM, but there are limited studies on the cervical sagittal parameters in CSM patients and their correlations with myelopathy. The aim of this study is to investigate the correlations among the preoperative cervical sagittal alignment parameters and their correlations with the development of myelopathy in patients with CSM. Methods We retrospectively collected 212 patients with CSM who underwent surgical interventions. Gender, age, modified Japanese Orthopedic Association score (mJOA, cervical lordosis (CL, C2–C7 sagittal vertical axis (C2–C7 SVA, T1 slope (T1S, neck tilt (NT and thoracic inlet angle (TIA were collected before operation. Interobserver and intraobserver reliability were calculated for all measurements (intraclass correlation coefficient, ICC. Data were analyzed with Pearson and Spearman correlation tests and multiple linear regression analysis. Results A total of 212 patients with CSM were included in this study (male: 136, female: 76 with an average age of 54.5 ± 10.1 years old. Intraobserver and interobserver reliability for all included radiographic parameters presented good to excellent agreement (ICC > 0.7. No significant differences in demographic and radiological parameters have been observed between males and females (P > 0.05. We found statistically significant correlations among the following parameters: age with CL (r = 0.135, P = 0.049, age with T1S (r = 0.222, P = 0.001, CL with T1S (r = 0.291, P < 0.001, CL with C2-C7 SVA (r =  − 0.395, P < 0.001, mJOA with age (r =  − 0.274, P < 0.001, mJOA with C2–C7 SVA (r =  − 0.219, P < 0.001 and mJOA with T1S(r =  − 0.171, p = 0.013. Linear regression analysis showed that C2–C7 SVA was the predictor of CL (adjusted R2 = 0.152, P < 0.001 and multiple linear regression showed that age combined with C

Surfer's myelopathy: a rare presentation in a non-surfing setting and review of the literature.

Science.gov (United States)

Maharaj, Monish M; Phan, Kevin; Hariswamy, Soumya; Rao, Prashanth J

2016-09-01

Surfers myelopathy can be a rapidly devastating disease and little is known surrounding the pathophysiology of the condition. Although the classical pattern of illness has been well reported, it has never been observed in a non-surfing setting. A 51-year-old demolition worker presented with acute non-traumatic myelopathy. Clinical examination revealed sensory loss to the level of L2. T2-MRI and MRI-DWI revealed a hyperintense signal suggestive of an ischaemic event. A diagnosis of surfer's myelopathy was made and he was commenced on steroid therapy. Following steroid therapy and fluid management the patient was discharged after 6 days with minor anaethesia but significant overall neurological improvement. Diagnosis of SM requires a thorough history, clinical examination and imaging (MRI, MRI-DWI). The patient should be admitted early and investigated. The use of rehabilitation services may be useful if available.

Solitary Osteochondroma of the Thoracic Spine with Compressive Myelopathy; A Rare Presentation

International Nuclear Information System (INIS)

Mehrian, Payam; Karimi, Mohammad Ali; Kahkuee, Shahram; Bakhshayeshkaram, Mehrdad; Ghasemikhah, Reza

2013-01-01

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient’s symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma

Vascular myelopathy: causes and mechanisms, possibilities of diagnosis and treatment

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G. V. Ponomarev

2018-01-01

Full Text Available Vascular myelopathy is a rare severe disease caused by a broad spectrum of causes, among which pathology of the aorta and its branches, aortic surgery, spinal diseases, and spinal trauma occupy the main place. The processes of neuroinflammation and glutamate neurotoxicity play a leading role in the pathogenesis of myeloischemia. The clinical picture of the disease is nonspecific and depends on the location and volume of an ischemic focus. Magnetic resonance imaging is a gold standard for diagnosis. However, this method remains insensitive in the acute period and fails to detect spinal cord ischemia at preclinical stages. The investigation and introduction of specific biochemical markers (glutamate receptors and their antibodies for neurotoxicity, which can identify ischemia in the advanced stage and predetermine its development, are promising. The treatment of vascular myelopathy has not currently been standardized and it is mainly pathogenetic and symptomatic.

Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma

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Hermier, M.; Cotton, F.; Froment, J.C. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Saint-Pierre, G.; Jouvet, A. [Department of Neuropathology, Hopital Neurologique et Neurochirurgical, Lyon (France); Ongolo-Zogo, P. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Department of Radiology, Hopital Central, Yaounde (Cameroon); Fischer, G. [Department of Neurosurgery, Hopital Neurologique et Neurochirurgical, Lyon (France)

2002-06-01

Haemangioblastomas are vascular tumours which mainly involve the central nervous system and retina, often in the setting of von Hippel-Lindau disease. Haemangioblastomas occurring outside the central nervous system are uncommon. Wherever it is, recognising this tumour prior to surgery is desirable, as preoperative embolisation may be considered. We report the clinical, imaging and pathological features of a sporadic sacral root haemangioblastoma in a 58-year-old man with chronic sciatica and myelopathy. The diagnosis was questioned preoperatively because an enlarged sacral foramen, seen to be filled by a highly vascular, enhancing mass and dilated vessels. Myelopathy was attributed to the presumed high venous pressure resulting from increased flow in veins draining the vascular tumour. Microneurosurgical excision was performed after endovascular embolisation and led to persistent clinical improvement. (orig.)

Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma

International Nuclear Information System (INIS)

Hermier, M.; Cotton, F.; Froment, J.C.; Saint-Pierre, G.; Jouvet, A.; Ongolo-Zogo, P.; Fischer, G.

2002-01-01

Haemangioblastomas are vascular tumours which mainly involve the central nervous system and retina, often in the setting of von Hippel-Lindau disease. Haemangioblastomas occurring outside the central nervous system are uncommon. Wherever it is, recognising this tumour prior to surgery is desirable, as preoperative embolisation may be considered. We report the clinical, imaging and pathological features of a sporadic sacral root haemangioblastoma in a 58-year-old man with chronic sciatica and myelopathy. The diagnosis was questioned preoperatively because an enlarged sacral foramen, seen to be filled by a highly vascular, enhancing mass and dilated vessels. Myelopathy was attributed to the presumed high venous pressure resulting from increased flow in veins draining the vascular tumour. Microneurosurgical excision was performed after endovascular embolisation and led to persistent clinical improvement. (orig.)

Venous hypertensive myelopathy associated with cervical spondylosis.

Science.gov (United States)

Okada, Seiji; Chang, Charles; Chang, Geraldine; Yue, James J

2016-11-01

Venous hypertensive myelopathy (VHM) results from spinal vascular malformations of arteriovenous shunting that increases spinal venous pressure, leading to congestive edema and neurologic dysfunction. There has been no report of VHM associated with cervical spondylotic myelopathy (CSM). The aim of this study was to report an extremely rare case of VHM likely due to CSM. This study is a case report and review of the literature. The patient was a 51-year-old man with CSM exhibiting relatively rapid neurologic deterioration with an abnormal expansion of a centromedullary hyperintense lesion on T2-weighted magnetic resonance imaging (MRI) in the absence of traumatic injury. Neurologic examination and radiologic imaging were taken by various means. The patient developed a cervical radiculopathy, followed by gait disturbance and motor weakness. The MRI of the cervical spine demonstrated spinal canal stenosis due to disc bulging and flavum hypertrophy at the C5/C6 and C6/C7 levels as well as hyperintense area over the C5-C7 levels on T2-weighted images. Although decompression surgery was planned, an acute inflammatory process such as transverse myelitis or demyelinating disease other than cord compression was also considered, and the patient received intravenous steroids. His walking improved for several days. However, his symptoms then became significantly worse, and he had difficulty walking. Subsequent MRI demonstrated marked progression of the T2 hyperintense lesion over the C4-T1 vertebral levels. Flow voids were also noted on the dorsal surface of the upper cervical cord on T2-weighted MRI. His lab work, medical history, and the local enhancement on contrast-enhanced MRI indicated low probability of spinal inflammatory diseases. Therefore, the decision was made to perform anterior cervical discectomy and fusion surgery on two levels. Following surgery, his symptoms improved promptly. Our case indicates that VHM could be caused by spondylotic cord compression in the

Surfer’s myelopathy: a rare presentation in a non-surfing setting and review of the literature

Science.gov (United States)

Phan, Kevin; Hariswamy, Soumya; Rao, Prashanth J.

2016-01-01

Background Surfers myelopathy can be a rapidly devastating disease and little is known surrounding the pathophysiology of the condition. Although the classical pattern of illness has been well reported, it has never been observed in a non-surfing setting. Methods A 51-year-old demolition worker presented with acute non-traumatic myelopathy. Clinical examination revealed sensory loss to the level of L2. T2-MRI and MRI-DWI revealed a hyperintense signal suggestive of an ischaemic event. A diagnosis of surfer’s myelopathy was made and he was commenced on steroid therapy. Results Following steroid therapy and fluid management the patient was discharged after 6 days with minor anaethesia but significant overall neurological improvement. Conclusions Diagnosis of SM requires a thorough history, clinical examination and imaging (MRI, MRI-DWI). The patient should be admitted early and investigated. The use of rehabilitation services may be useful if available. PMID:27757436

Iso-effect table for radiation tolerance of the human spinal cord

International Nuclear Information System (INIS)

Cohen, L.; Creditor, M.

1981-01-01

Available literature on radiation injury to the human spinal cord was collected into a comprehensive data set relating the incidence of myelopathy to dosage, number of fractions and total treatment time. The data was analyzed using a search program (RAD3) to derive best-fitting cell kinetic parameters on the assumption that radiation myelopathy arises from cellular depletion in the irradiated tissues. From these parameters iso-effect tables were constructed for a wide range of treatment schedules, including daily treatment as well as fractionation at longer intervals. The tables provide a set of limiting doses, above which the risk of radiation injury to the spinal cord becomes substantial. General application of NSD tolerance limits could lead to systematic overdosage of the spinal cord, especially with large individual fractions or short treatment times. We conclude that the computed iso-effect tables provide a more reliable clinical guide than conventional time-dose equations

Surfer's myelopathy: case report and review.

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Karabegovic, Amna; Strachan-Jackman, Shirley; Carr, David

2011-09-01

Nontraumatic spinal cord injury from surfing is a new entity first described in 2004 and likely of ischemic etiology. We report the case of a 25-year-old man who presented to the emergency department with a 2-week history of lower extremity weakness after surfing in Indonesia. The patient reported developing low back pain, lower extremity weakness, sensory changes, and urinary retention shortly after his first surfing lesson. The patient was subsequently diagnosed with surfer's myelopathy. The purpose of this report is to review the clinical presentation, etiology, risk factors, and management of this increasingly described entity.

Quality of life in symptomatic cervical myelopathy after open-door laminoplasty

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Rodrigo Yuiti Nakao

2015-06-01

Full Text Available OBJECTIVE: To analyze the results obtained by open-door laminoplasty using the Newbridge(r/Blackstone plate, in cases of myelopathy associated with cervical lordosis.METHODS: From December 2010 to October 2012, eight patients between the ages of 49 and 68 underwent open-door laminoplasty with the use of the Newbridge(r fixation system for maintenance and stabilization of the cervical laminoplasty. Minimum follow-up was four months. For the evaluation of quality of life the questionnaire SF-36 was applied at the following times: preoperative, one month and three months after surgery associated with the subjective assessment of the patient regarding satisfaction with the procedure and with the Nurick neurological scale applied prior to surgery and three months later.RESULTS: According to the SF-36, there was significant improvement in the domains functional ability, general health perceptions and emotional aspects over time; regarding physical limitations and social aspects there was no improvement in the first postoperative month, only in the third month. There were no statistically significant changes observed during the period covered by this study related to pain, vitality and mental health. According to Nurick scale, there was evidence of improvement in symptoms of cervical myelopathy. Based on the subjective evaluation of the patients, surprisingly, all patients were satisfied with the surgical procedure and the results.CONCLUSION: The open-door laminoplasty technique with rigid fixation to maintain the opening is useful in improving the symptoms of cervical myelopathy associated with lordosis, leading to improved quality of life and with a high degree of patient satisfaction and fewer complications.

Preoperative and postoperative evaluation of clinical symptoms of cervical myelopathy

International Nuclear Information System (INIS)

Ito, Tomokazu; Oshima, Yoshihiko; Ota, Yoshio

1993-01-01

To evaluate the clinical significance of signal changes on T2-weighted magnetic resonance (MR) images in myelopathy, the relationship between characteristics of clinical symptoms and postoperative recovery was examined. The subjects were a total of 52 patients (37 men and 15 women) with cervical myelopathy (n=44) or ossification of the posterior longitudinal ligament (n=8), who underwent extended surgery of Yamagata University's style. They ranged in age from 33 to 81 years (mean, 60.8). The degree of spinal compression and signal changes in the spinal cord were classified on T1-weighted and T2-weighted sagittal images, respecstively. Hyperintense on T2-weighted images tended to be associated with lower preoperative JOA's scores especially for exercise, legs and bladder or rectum function, as compared with isointense. T2-weighted images seemed to reflect, to some degree, the severity of preoperative clinical symptoms. For the rate of postoperative improvement, however, there was no significant difference between the hyperintense and isointense groups on T2-weighted images. (N.K.)

Sudden onset of cervical spondylotic myelopathy during sleep: a case report.

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Young, Irene A; Burns, Stephen P; Little, James W

2002-03-01

Cervical spondylotic myelopathy is a common cause of compressive spinal cord dysfunction. The typical course involves either a gradual or an episodic increase in symptoms and neurologic deficits, with impairment evolving over a period of months to years. Acute neurologic deterioration in conjunction with cervical spondylosis has been described almost exclusively in traumatic situations such as disk herniation. We report a case of an acute, nontraumatic onset of tetraplegia in association with cervical spondylosis. A 56-year-old man developed tetraplegia during a 1-hour nap, with loss of volitional control of his extremities, impaired sensation below the C3 dermatome, and increased muscle tone. Magnetic resonance imaging of the cervical spine revealed canal stenosis and increased T2 signal within the cord. This case report describes the rehabilitation course for this patient and reviews the clinical spectrum of onset and progression of cervical spondylotic myelopathy. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Predicting surgical outcome in cases of cervical myelopathy with magnetic resonance imaging. Critical parameters

International Nuclear Information System (INIS)

Akiyama, Takashi

1997-01-01

In this study, the author attempted to correlate clinical factors significant in cases of cervical myelopathy with postoperative recovery. It is hoped that the results will aid in the preoperative prediction of surgical outcomes. The factors considered were the transverse area of the spinal cord, the cord compression rate, the presence of a high intensity area in T2-weighted MRI, the duration of symptoms before surgery, and age at surgery. Because there are variations in the transverse area of the spinal cord, 100 normal individuals were selected and the standard transverse area was calculated. The transverse area of the spinal cord and the cord constriction rate in the myelopathy cases was then measured and compared to the standard. The data indicated that the constriction rate was most relevant to recovery rate. Clinical thresholds found to correlate with a better than average rate of recovery in cases of cervical spondylotic myelopathy (CSM) were: a cord constriction rate; under 28.7%, cord compression rate; over 0.38, duration of symptoms before surgery; less than 9.2 months, and age at surgery; under 59.2 yrs. In patients with ossification of the longitudinal ligament (OPLL), cord constriction rate; under 36.2%, cord compression rate; over 0.30, duration of symptoms before surgery; less than 14.2 months, and age at surgery; under 57.6 yrs., all correlated with superior recovery, as did cord constriction rate; under 22.3%, and duration of symptoms before surgery; less than 3.7 months with patients suffering from cervical disc herniation (CDH). Furthermore, the absence of a T2-weighted high intensity area in CSM and OPLL patients also correlated with improved recovery. These results suggest that a favorable postoperative recovery rate can be expected in cases of cervical myelopathy that conform to the above criteria. (author)

Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score

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Rishi Anil Aggarwal

2016-01-01

Full Text Available Context: Preoperative severity of myelopathy, age, and duration of symptoms have been shown to be highly predictive of the outcome in compressive cervical myelopathy (CCM. The role of radiological parameters is still controversial. Aims: Define the prognostic factors in CCM and formulate a prognostic score to predict the outcome following surgery in CCM. Settings and Design: Retrospective. Materials and Methods: This study included 78 consecutive patients with CCM treated surgically. The modified Japanese Orthopaedic Association (mJOA scale was used to quantify severity of myelopathy at admission and at 12-month follow-up. The outcome was defined as "good" if the patient had mJOA score ≥16 and "poor" if the score was <16. Age, sex, duration of symptoms, comorbidities, intrinsic hand muscle wasting (IHMW, diagnosis, surgical technique, Torg ratio, instability on dynamic radiographs, and magnetic resonance imaging (MRI signal intensity changes were assessed. Statistics: Statistical Package for the Social Sciences (SPSS (version 20.0 was used for statistical analysis. The association was assessed amongst variables using logistic regression analysis. Parameters having a statistically significant correlation with the outcome were included in formulating a prognostic score. Results: Severity of myelopathy, IHMW, age, duration, diabetes, and instability on radiographs were predictive of the outcome with a P value <0.01. Genders, diagnosis, surgical procedure, Torg ratio, and intensity changes on MRI were not significantly related to the outcome. A 8-point scoring system was devised incorporating the significant clinicoradiological parameters, and it was found that nearly all patients (97.82% with a score below 5 had good outcome and all patients (100% with a score above 5 had poor outcome. The outcome is difficult to predict with a score of 5. Conclusions: Clinical parameters are better predictors of the outcome as compared to radiological findings

Reliability of three-dimensional gait analysis in cervical spondylotic myelopathy.

LENUS (Irish Health Repository)

McDermott, Ailish

2010-10-01

Gait impairment is one of the primary symptoms of cervical spondylotic myelopathy (CSM). Detailed assessment is possible using three-dimensional gait analysis (3DGA), however the reliability of 3DGA for this population has not been established. The aim of this study was to evaluate the test-retest reliability of temporal-spatial, kinematic and kinetic parameters in a CSM population.

Atlantoaxial subluxation. Radiography and magnetic resonance imaging correlated to myelopathy

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Yamashita, Y.; Takahashi, M.; Sakamoto, Y.; Kojima, R.

Twenty-nine patients with atlantoaxial subluxation (18 with rheumatoid arthritis, 2 due to trauma, 4 with os odontoideum, and one each with polyarteritis nodosa, rheumatic fever, Klippel-Feil syndrome, achondroplasia, and cause unknown) were evaluated using a 0.22 tesla resistive MRI unit. Cord compression was classified into four grades according to the degree on magnetic resonance imaging. There were 7 patients with no thecal sac compression (grade 0), 10 with a minimal degree of subarachnoid space compression without cord compression (grade 1), 7 with mild cord compression (grade 2), and 5 with severe cord compression or cord atrophy (grade 3). Although the severity of myelopathy showed poor correlation with the atlantodental interval on conventional radiography, high correlation was observed between MR grading and the degree of myelopathy. The high signal intensity foci were observed in 7 or 12 patients with cord compression (grades 2 and 3) on T2 weighted images. Other frequently observed findings in rheumatoid arthritis included soft tissue masses of low to intermediate signal intensity in the paraodontoid space, erosions of the odontoid processes, and atlanto-axial impaction on T1 and T2 weighted images.

Radiation-induced myelopathy in long-term surviving metastatic spinal cord compression patients after hypofractionated radiotherapy: a clinical and magnetic resonance imaging analysis

International Nuclear Information System (INIS)

Maranzano, Ernesto; Bellavita, Rita; Floridi, Piero; Celani, Grazia; Righetti, Enrico; Lupattelli, Marco; Panizza, Bianca Moira; Frattegiani, Alessandro; Pelliccioli, Gian Piero; Latini, Paolo

2001-01-01

Background and purpose: Hypofractionated radiotherapy is often administered in metastatic spinal cord compression (MSCC), but no studies have been published on the incidence of radiation-induced myelopathy (RIM) in long-term surviving patients. Our report addresses this topic. Patients and methods: Of 465 consecutive MSCC patients submitted to radiotherapy between 1988 and 1997, 13 live patients (seven females, six males, median age 69 years, median follow-up 69 months) surviving for 2 years or more were retrospectively reviewed to evaluate RIM. All patients underwent radiotherapy. Eight patients underwent a short-course regimen of 8 Gy, with 7 days rest, and then another 8 Gy. Five patients underwent a split-course regimen of 5 Gy x3, 4 days rest, and then 3 Gy x5. Only one patient also underwent laminectomy. Full neurological examination and magnetic resonance imaging (MRI) were performed. Results: Of 12 patients submitted to radiotherapy alone, 11 were ambulant (eight without support and three with support) with good bladder function. In nine of these 11 patients, MRI was negative; in one case MRI evidenced an in-field relapse 30 months after the end of radiotherapy, and in the other, two new MSCC foci outside the irradiated spine. In the remaining patient RIM was suspected at 18 months after radiotherapy when the patient became paraplegic and cystoplegic, and magnetic resonance images evidenced an ischemic injury in the irradiated area. The only patient treated with surgery plus postoperative radiotherapy worsened and remained paraparetic. Magnetic resonance images showed cord atrophy at the surgical level, explained as an ischemic necrosis due to surgery injury. Conclusions: On the grounds of our data regarding RIM in long-term surviving MSCC patients, we believe that a hypofractionated radiotherapy regimen can be used for the majority of patients. For a minority of patients, more protracted radiation regimens could be considered

Cervical Fusion for Absent Pedicle Syndrome Manifesting with Myelopathy.

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Goodwin, C Rory; Desai, Atman; Khattab, Mohamed H; Elder, Benjamin D; Bydon, Ali; Wolinsky, Jean-Paul

2016-02-01

Absent congenital pedicle syndrome is a posterior arch defect characterized by numerous congenital and mechanical abnormalities that result from disconnection of the anterior and posterior columns of the spinal canal. Absent congenital pedicle syndrome is a rare anomaly that is most commonly diagnosed incidentally, after evaluation of minor trauma, or after complaints of chronic neck pain. We report a case of absent congenital pedicle syndrome in a patient who presented with myelopathy and lower extremity weakness and review the literature on the surgical management of this entity. A 32-year-old woman with a history of systemic lupus erythematosus presented to the Neurosurgery Service with progressive weakness in her upper and lower extremities, clonus, and hyperreflexia. Magnetic resonance imaging revealed congenital absence of the pedicles of C2, C3, C4, C5, and C6 with a congenitally narrow canal at C4-5. The patient underwent a staged anterior and posterior cervical decompression and fusion. She was placed in a halo after surgery; at the 1-year follow-up, she was ambulatory with demonstrated improvement in weakness and fusion of her cervical spine. Absent congenital pedicle syndrome is rare, and most reported cases were treated conservatively. Surgical management is reserved for patients with myelopathy or instability. Copyright © 2016 Elsevier Inc. All rights reserved.

3 T magnetic resonance diffusion tensor imaging and fibre tracking in cervical myelopathy

International Nuclear Information System (INIS)

Xiangshui, M.; Xiangjun, C.; Xiaoming, Z.; Qingshi, Z.; Yi, C.; Chuanqiang, Q.; Xiangxing, M.; Chuanfu, L.; Jinwen, H.

2010-01-01

Aim: To analyse the characterization of diffusion tensor imaging (DTI) with 3 T magnetic resonance imaging (MRI) in cervical myelopathy. Methods: A total of 21 healthy controls and 84 patients with cervical myelopathy underwent T2-weighted imaging and DTI. The patients were divided into four groups based on the degree of cord compression and MRI signal intensity of the compressed cord as seen on T2-weighted images. The values of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and eigenvalues (λ i ) were analysed, and fibre tracking (FT) was performed. Results: For healthy controls, the mean values from the DTI of the cervical spinal cord were ADC = 0.784 ± 0.083 x 10 -3 mm 2 /s, FA = 0.721 ± 0.027, λ 1 , λ 2 , and λ 3 = 1.509 ± 0.145 x 10 -3 , 0.416 ± 0.094 x 10 -3 , and 0.411 ± 0.102 x 10 -3 mm 2 /s, respectively. Only values for λ 2 and λ 3 differed significantly between the control and A groups (p 2 and λ 3 of group A were 0.516 ± 0.105 x 10 -3 and 0.525 ± 0.129 x 10 -3 mm 2 /s, respectively. ADC, FA, λ 1 , λ 2 and λ 3 differed significantly between the control and B, C, D groups (p i obtained with DTI could assess subtle structural damage and changes of anisotropy in the cord of cervical myelopathy. Fibre tracking was useful in verifying changes in the compressed cord.

Imaging of Spinal Cord Injury: Acute Cervical Spinal Cord Injury, Cervical Spondylotic Myelopathy, and Cord Herniation.

Science.gov (United States)

Talekar, Kiran; Poplawski, Michael; Hegde, Rahul; Cox, Mougnyan; Flanders, Adam

2016-10-01

We review the pathophysiology and imaging findings of acute traumatic spinal cord injury (SCI), cervical spondylotic myelopathy, and briefly review the much less common cord herniation as a unique cause of myelopathy. Acute traumatic SCI is devastating to the patient and the costs to society are staggering. There are currently no "cures" for SCI and the only accepted pharmacologic treatment regimen for traumatic SCI is currently being questioned. Evaluation and prognostication of SCI is a demanding area with significant deficiencies, including lack of biomarkers. Accurate classification of SCI is heavily dependent on a good clinical examination, the results of which can vary substantially based upon the patient׳s condition or comorbidities and the skills of the examiner. Moreover, the full extent of a patients׳ neurologic injury may not become apparent for days after injury; by then, therapeutic response may be limited. Although magnetic resonance imaging (MRI) is the best imaging modality for the evaluation of spinal cord parenchyma, conventional MR techniques do not appear to differentiate edema from axonal injury. Recently, it is proposed that in addition to characterizing the anatomic extent of injury, metrics derived from conventional MRI and diffusion tensor imaging, in conjunction with the neurological examination, can serve as a reliable objective biomarker for determination of the extent of neurologic injury and early identification of patients who would benefit from treatment. Cervical spondylosis is a common disorder affecting predominantly the elderly with a potential to narrow the spinal canal and thereby impinge or compress upon the neural elements leading to cervical spondylotic myelopathy and radiculopathy. It is the commonest nontraumatic cause of spinal cord disorder in adults. Imaging plays an important role in grading the severity of spondylosis and detecting cord abnormalities suggesting myelopathy. Copyright © 2016 Elsevier Inc. All rights

Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

LENUS (Irish Health Repository)

Ogbonnaya, Ebere Sunny

2011-01-01

Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

Operative techniques for cervical radiculopathy and myelopathy.

LENUS (Irish Health Repository)

Moran, C

2012-02-01

The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970\\'s. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

Radiation response of the central nervous system

International Nuclear Information System (INIS)

Schultheiss, T.E.; Kun, L.E.; Ang, K.K.; Stephens, L.C.

1995-01-01

This report reviews the anatomical, pathophysiological, and clinical aspects of radiation injury to the central nervous system (CNS). Despite the lack of pathognomonic characteristics for CNS radiation lesions, demyelination and malacia are consistently the dominant morphological features of radiation myelopathy. In addition, cerebral atrophy is commonly observed in patients with neurological deficits related to chemotherapy and radiation, and neurocognitive deficits are associated with diffuse white matter changes. Clinical and experimental dose-response information have been evaluated and summarized into specific recommendations for the spinal cord and brain. The common spinal cord dose limit of 45 Gy in 22 to 25 fractions is conservative and can be relaxed if respecting this limit materially reduces the probability of tumor control. It is suggested that the 5% incidence of radiation myelopathy probably lies between 57 and 61 Gy to the spinal cord in the absence of dose modifying chemotherapy. A clinically detectable length effect for the spinal cord has not been observed. The effects of chemotherapy and altered fractionation are also discussed. Brain necrosis in adults is rarely noted below 60 Gy in conventional fractionation, with imaging and clinical changes being observed generally only above 50 Gy. However, neurocognitive effects are observed at lower doses, especially in children. A more pronounced volume effect is believed to exist in the brain than in the spinal cord. Tumor progression may be hard to distinguish from radiation and chemotherapy effects. Diffuse white matter injury can be attributed to radiation and associated with neurological deficits, but leukoencephalopathy is rarely observed in the absence of chemotherapy. Subjective, objective, management, and analytic (SOMA) parameters related to radiation spinal cord and brain injury have been developed and presented on ordinal scales

Radiation response of the central nervous system

International Nuclear Information System (INIS)

Schultheiss, T.E.; Kun, L.E.; Stephens, L.C.

1995-01-01

This report reviews the anatomical, pathophysiological, and clinical aspects of radiation injury to the central nervous system (CNS). Despite the lack of pathoGyomonic characteristics for CNS radiation lesions, demyelination and malacia are consistently the dominant morphological features of radiation myelopathy. In addition, cerebral atrophy is commonly observed in patients with neurological deficits related to chemotherapy and radiation, and neurocognitive deficits are associated with diffuse white matter changes. Clinical and experimental dose-response information have been evaluated and summarized into specific recommendations for the spinal cord and brain. The common spinal cord dose limit of 45 Gn in 22 to 25 fractions is conservative and can be relaxed if respecting this limit materially reduces the probability of tumor control. It is suggested that the 5% incidence of radiation myelopathy probably lies between 57 and 61 Gy to the spinal cord in the absence of dose modifying chemotherapy. A clinically detectable length effect for the spinal cord has not been observed. The effects of chemotherapy and altered fractionation are also discussed. Brain necrosis in adults is rarely noted below 60 Gy in conventional fractionation, with imaging and clinical changes being observed generally only above 50 Gy. However, neurocognitive effects are observed at lower doses, especially in children. A more pronounced volume effect is believed to exist in the brain than in the spinal cord. Tumor progression may be hard to distinguish from radiation and chemotherapy effects. Diffuse white matter injury can be attributed to radiation and associated with neurological deficits, but leukoencephalopathy is rarely observed in the absence of chemotherapy. Subjective, objective, management, and analytic (SOMA) parameters related to radiation spinal cord and brain injury have been developed and presented on ordinal scales. 140 refs., 3 figs., 6 tabs

Fibrocartilaginous embolic myelopathy: demographics, clinical presentation, and functional outcomes.

Science.gov (United States)

Moore, Brittany J; Batterson, Anna M; Luetmer, Marianne T; Reeves, Ronald K

2018-05-25

Retrospective cohort study. To describe the demographics, clinical presentation, and functional outcomes of fibrocartilaginous embolic myelopathy (FCEM). Academic inpatient rehabilitation unit in the midwestern United States. We retrospectively searched our database to identify patients admitted between January 1, 1995 and March 31, 2016, with a high probability of FCEM. Demographic, clinical, and functional outcome measures, including Functional Independence Measure (FIM) information was obtained by chart review. We identified 31 patients with findings suggestive of FCEM (52% male), which was 2% of the nontraumatic spinal cord injury population admitted to inpatient rehabilitation. The age distribution was bimodal, with peaks in the second and sixth-to-seventh decades. The most common clinical presentation was acute pain and rapid progression of neurologic deficits consistent with a vascular myelopathy. Only three patients (10%) had FCEM documented as a diagnostic possibility. Most patients had paraplegia and neurologically incomplete injuries and were discharged to home. Nearly half of the patients required no assistive device for bladder management at discharge, but most were discharged with medications for bowel management. Median FIM walking locomotion score for all patients was 5, but most patients were discharged using a wheelchair for primary mobility. Median motor FIM subscale score was 36 at admission and 69 at discharge, with a median motor efficiency of 1.41. FCEM may be underdiagnosed and should be considered in those with the appropriate clinical presentation, because their functional outcomes may be more favorable than those with other causes of spinal cord infarction.

Relationship between magnetic resonance imaging and clinical results of decompression surgery for cervical myelopathy

International Nuclear Information System (INIS)

Okumura, Hiroshi

1993-01-01

MR imaging was investigated before and after surgery in 60 cases of cervical myelopathy. A preoperative high-signal-intensity area in the spinal cord was thought to be an important indicator of poor prognosis, because the recovery ratio of the preoperative high-signal group was 32±24%, while that of the normal-signal group was 86±15%. But, a high-signal-intensity area had no significant correlation with the morbidity period, preoperative clinical severity and degree of cord compression. There was a significant correlation between postoperative MR imaging and the neurological prognosis. And, atrophy and high-signal-intensity area in the spinal cord were frequently seen in cases of poor neurological postoperative recovery, corresponding to the morbidity period, preoperative clinical severity and degree of cord compression. MR imaging can serve as a useful tool to assess cervical myelopathy and to forecast the postoperative prognosis. (author)

THESEUS - achieving maximum possible road transport tanker safety by means of experimental accident simulation; THESEUS - Tankfahrzeuge mit hoechsterreichbarer Sicherheit durch experimentelle Unfallsimulation

Energy Technology Data Exchange (ETDEWEB)

Rompe, K.; Heuser, G.

1996-03-01

In spring 1990, the Federal German Minister for Education, Science, Research and Technology (BMBF) commissioned the team from the Federal Institute for Materials Research and Testing (BAM), DEKRA, Daimler-Benz, the Federal Road Research Institute (BASt) with the University of Cologne, Ellinghaus and TUeV Rheinland (project leader) to perform the research project `THESEUS` (the acronym THESEUS comes from the German `Tankfahrzeuge mit hoechst erreichbarer Sicherheit durch experimentelle Unfallsimulation`, which translates as `achieving maximum possible road transport tanker safety by means of experimental accident simulation`). Arting from an analysis of road transport tanker accidents, crash tests and overturn tests were performed and supplemented by investigations of road transport tanker components and accompanying complex calculations of the failure processes. Parallel to this, the static side-tilt stability of road transport tankers was determined on a tilting test platform. The causes of and constructive possibilities for avoiding overturning, which is the most common cause of accidents in which hazardous materials escape, wewre analysed in dynamic driving tests with supplementary computer simulation. Various measures for improving the safety of road transport tankers were determined and subjected to a cost-benefit analysis. (orig.) [Deutsch] Das Bundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie hat seit 1990 das Forschungsproject `THESEUS` (Tankfahrzeuge mit hoechst erreichbarer Sicherheit durch experimentelle Unfallsimulation) der Arbeitsgemeinschaft aus TUeV Rheinland (Federfuehrung), Bundesanstalt fuer Materialforschung und -pruefung (BAM), DEKRA, Daimler Benz, Bundesanstalt fuer Strassenwesen (BASt), Universitaet Koeln und Ellinghaus gefoerdert. Ausgehend von der detaillierten Analyse von 231 Tankfahrzeugunfaellen wurden Tankfahrzeug-Crashversuche und Tankfahrzeug-Umsturzversuche durchgefuehrt. Diese Messungen an kompletten Fahrzeugen

The Radiation Dose-Response of the Human Spinal Cord

International Nuclear Information System (INIS)

Schultheiss, Timothy E.

2008-01-01

Purpose: To characterize the radiation dose-response of the human spinal cord. Methods and Materials: Because no single institution has sufficient data to establish a dose-response function for the human spinal cord, published reports were combined. Requisite data were dose and fractionation, number of patients at risk, number of myelopathy cases, and survival experience of the population. Eight data points for cervical myelopathy were obtained from five reports. Using maximum likelihood estimation correcting for the survival experience of the population, estimates were obtained for the median tolerance dose, slope parameter, and α/β ratio in a logistic dose-response function. An adequate fit to thoracic data was not possible. Hyperbaric oxygen treatments involving the cervical cord were also analyzed. Results: The estimate of the median tolerance dose (cervical cord) was 69.4 Gy (95% confidence interval, 66.4-72.6). The α/β = 0.87 Gy. At 45 Gy, the (extrapolated) probability of myelopathy is 0.03%; and at 50 Gy, 0.2%. The dose for a 5% myelopathy rate is 59.3 Gy. Graphical analysis indicates that the sensitivity of the thoracic cord is less than that of the cervical cord. There appears to be a sensitizing effect from hyperbaric oxygen treatment. Conclusions: The estimate of α/β is smaller than usually quoted, but values this small were found in some studies. Using α/β = 0.87 Gy, one would expect a considerable advantage by decreasing the dose/fraction to less than 2 Gy. These results were obtained from only single fractions/day and should not be applied uncritically to hyperfractionation

Vertebral Arteriovenous Fistula Presenting as Cervical Myelopathy: A Rapid Recovery with Balloon Embolization

International Nuclear Information System (INIS)

Modi, Manish; Bapuraj, J. Rajiv; Lal, Anupam; Prabhakar, S.; Khandelwal, N.

2010-01-01

A 24-year-old male presented with progressive cervical myelopathy of 2 months' duration. Magnetic resonance imaging of the cervical spine and angiography revealed a large arteriovenous fistula arising from the left vertebral artery. The present case highlights the clinical features and dramatic recovery following endovascular balloon occlusion of a giant cervical arteriovenous fistula.

Radiation tolerance of the spinal cord previously-damaged by tumor operation: long term neurological improvement and time-dose-volume relationships after irradiation of intraspinal gliomas

International Nuclear Information System (INIS)

Kopelson, G.

1982-01-01

Of 26 patients with intramedullary spinal cord gliomas (9 astrocytomas, 5 glioblastomas, 12 ependymomas) seen at the Massachusetts General Hospital from 1962-1980, 24 were irradiated (21 initially and 3 after post-surgical recurrence). Those 19 patients who survived at least 1 year after completion of irradiation were evaluated for post-irradiation neurological changes.No patient developed radiation myelopathy. Return to a permanently and completely normal neurological status occured for 33/51 (65%) of pre-irradiation neurological deficits. The major cause of post-irradiation neurological deterioration was tumor recurrence. Although 18/19 patients had their thoracic or lumbar spinal cords irradiated, each with field sizes greater than 10 cm, spinal cord doses approaching, equalling, or occasionally exceeding various definitions of spinal cord tolerance were tolerated well without evidence of radiation myelopathy. Spinal cords of patients with intramedullary gliomas, often with major neurological deficits prior to irradiation, may be treated safely to doses approaching or equalling spinal cord tolerance levels. These doses are expected to locally control most ependymomas and astrocytomas without an increased radiation myelopathy. Caution should be observed if doses higher than this are contemplated in an attempt to cure glioblastoma, because the 5% tolerance level of the damaged spinal remains to be defined

Radiation response of the rat cervical spinal cord after irradiation at different ages: Tolerance, latency and pathology

International Nuclear Information System (INIS)

Ruifrok, A.C.C.; Van Der Kogel, A.J.; Stephens, L.C.

1994-01-01

Investigation of the age dependent single-dose radiation tolerance, latency to radiation myelopathy, and the histopathological changes after irradiation of the rat cervical spinal cord is presented. Rats were irradiated with graded single doses of 4 MV photons to the cervical spinal cord. When the rats showed definite signs of paresis of the forelegs, they were killed and processed for histological examination. The radiation dose resulting in paresis due to white matter damage in 50% of the animals (ED 50 ) after single dose irradiation was about 21.5 Gy at all ages ≥ 2 weeks. Only the Ed 50 at 1 week was significantly lower. The latency to the development of paresis clearly changed with the age at irradiation, from about 2 weeks after irradiation at 1 week to 6-8 months after irradiation at age ≥ 8 weeks. The white matter damage was similar in all symptomatic animals studied. The most prominent were areas with diffuse demyelination and swollen axons, often with focal necrosis, accompanied by glial reaction. This was observed in all symptomatic animals, irrespective of the age at irradiation. Expression of vascular damage appeared to depend on the age at irradiation. Although the latency to myelopathy is clearly age dependent, single dose tolerance is not age dependent at age ≥ 2 weeks in the rat cervical spinal cord. The white matter damage is similar in all symptomatic animals studied, but the vasculopathies appear to be influenced by the age at irradiation. It is concluded that white matter damage and vascular damage are separate phenomena contributing to the development of radiation myelopathy, expression of which may depend on the radiation dose applied and the age at irradiation. 28 refs., 5 figs., 3 tabs

Outcomes of conservative treatment for cervical myelopathy caused by soft disc herniation

International Nuclear Information System (INIS)

Matsumoto, Morio; Chiba, Kazuhiro; Ishii, Ken; Ogawa, Yuto; Takaishi, Hironari; Nakamura, Masaya; Toyama, Yoshiaki

2006-01-01

The purposes of this study are to delineate the clinical course and MRI findings of patients with disc hernias which regressed spontaneously and to determine who is eligible for conservative treatment. Twenty-three patients with mild cervical myelopathy (initial Japanese Orthopedic Association (JOA) scores >10) caused by soft disc herniation were treated conservatively for more than two years (13 males, 10 females, mean age 50, mean follow-up 3.6 years). The investigated items included JOA scores and MRI findings (morphology of disc herniation). Morphology of disc herniation was classified into focal type (herniated mass persisting at the intervertebral level) and diffuse type (herniated mass migrating rostrally or caudally) in the sagittal plane and median type or paramedian type in the axial plane. The mean JOA scores were 13.4±1.5 before treatment, and 16.0±1.0 at follow-up. Regression of herniation was observed in 14 patients (Group A), while no regression was seen in 9 patients (Group B). The JOA scores were 13.7±1.5 (Group A) and 14.0±1.6 (Group B) before treatment, and 16.3±1.6 and 15.7±1.2 at follow-up, respectively. On sagittal MR images, diffuse-type herniation was observed in 9 patients (64%) and focal-type in 5 (36%) in Group A, and 3 (33%) and 6 (67%) in Group B, respectively. On axial images, median-type herniation was observed in 10 patients (71%), and paramedian-type in 4 (29%) in Group A, and 6 (67%) and 3 (33%) in Group B, respectively. Spontaneous soft disc regression in patients with cervical myelopathy was observed in more than half of those treated conservatively for longer than 2 years. Conservative treatment can be recommended for patients with mild cervical myelopathy, especially when caused by median-and/or diffuse-type disc hernia, although close observation is mandatory. (author)

Magnetic resonance imaging in patients with progressive myelopathy following spinal surgery.

OpenAIRE

Avrahami, E; Tadmor, R; Cohn, D F

1989-01-01

Thirty one patients with insidious progressive myelopathy 2 to 8 years following surgery of the cervical spine were subjected to magnetic resonance imaging (MRI). In 15 patients operated on for vascular malformations or intramedullary tumours, syringomyelia and cystic lesions of the spinal cord were shown. Seven of these patients also showed a combination of a recurrent tumour and spinal atrophy. Out of 16 patients who had surgery for herniated disc or spinal stenosis of the cervical spine, f...

Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

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Shuhei Ito

2017-01-01

Full Text Available Extramedullary hematopoiesis (EMH occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.

Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera.

Science.gov (United States)

Ito, Shuhei; Fujita, Nobuyuki; Hosogane, Naobumi; Nagoshi, Narihito; Yagi, Mitsuru; Iwanami, Akio; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken

2017-01-01

Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.

Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

OpenAIRE

Ito, Shuhei; Fujita, Nobuyuki; Hosogane, Naobumi; Nagoshi, Narihito; Yagi, Mitsuru; Iwanami, Akio; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken

2017-01-01

Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.

[The modified method registration of kinesthetic evoked potentials and its application for research of proprioceptive sensitivity disorders at spondylogenic cervical myelopathy].

Science.gov (United States)

Gordeev, S A; Voronin, S G

2016-01-01

To analyze the efficacy of modified (passive radiocarpal articulation flexion/extension) and «standard» (passive radiocarpal articulation flexion) methods of kinesthetic evoked potentials for proprioceptive sensitivity assessment in healthy subjects and patients with spondylotic cervical myelopathy. The study included 14 healthy subjects (4 women and 10 men, mean age 54.1±10.5 years) and 8 patients (2 women and 6 men, mean age 55.8±10.9 years) with spondylotic cervical myelopathy. Muscle-joint sensation was examined during the clinical study. A modified method of kinesthetic evoked potentials was developed. This method differed from the "standard" one by the organization of a cycle including several passive movements,where each new movement differed from the preceding one by the direction. The modified method of kinesthetic evoked potentials ensures more reliable kinesthetic sensitivity assessment due to movement variability. Asignificant increaseof the latent periods of the early components of the response was found in patients compared to healthy subjects. The modified method of kinesthetic evoked potentials can be used for objective diagnosis of proprioceptive sensitivity disorders in patients with spondylotic cervical myelopathy.

EFFICACY OF CAGE PLACEMENT WITHOUT PLATE IN PATIENTS WITH CERVICAL MYELOPATHY WITH SINGLE-LEVEL AFFECTION

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CARLOS ALBERTO ZUÑIGA-MAZÓN

Full Text Available ABSTRACT Objective: To determine the efficacy of PEEK (Poly-ether-ether-ketone cage without plate for the treatment of single-level cervical spondylosis. Methods: Ten patients with cervical myelopathy data, with a single-level root condition, seen at the outpatient clinic of the Neurosurgery Service, operated in 2016, mean age 53 years, 6 (60% female, 4 (40% obese, 3 (30% smokers. The Cloward technique was used by anterior approach, discectomy, and PEEK cage placement. Results: At six months of surgery, 100% of the patients had increased intervertebral space, with a 100% reduction in osteophytes; only one patient had dysphagia, no patient had lesion of the adjacent segment and 10% had persistent root pathology. Cervical lordosis was observed in 90% of the patients and arthrodesis in 100% of the cases. Conclusions: Anterior approach arthrodesis using PEEK cage without cervical plate is effective as a treatment of cervical myelopathy in a single level.

Degenerative Cervical Myelopathy: A Spectrum of Related Disorders Affecting the Aging Spine.

Science.gov (United States)

Tetreault, Lindsay; Goldstein, Christina L; Arnold, Paul; Harrop, James; Hilibrand, Alan; Nouri, Aria; Fehlings, Michael G

2015-10-01

Cervical spinal cord dysfunction can result from either traumatic or nontraumatic causes, including tumors, infections, and degenerative changes. In this article, we review the range of degenerative spinal disorders resulting in progressive cervical spinal cord compression and propose the adoption of a new term, degenerative cervical myelopathy (DCM). DCM comprises both osteoarthritic changes to the spine, including spondylosis, disk herniation, and facet arthropathy (collectively referred to as cervical spondylotic myelopathy), and ligamentous aberrations such as ossification of the posterior longitudinal ligament and hypertrophy of the ligamentum flavum. This review summarizes current knowledge of the pathophysiology of DCM and describes the cascade of events that occur after compression of the spinal cord, including ischemia, destruction of the blood-spinal cord barrier, demyelination, and neuronal apoptosis. Important features of the diagnosis of DCM are discussed in detail, and relevant clinical and imaging findings are highlighted. Furthermore, this review outlines valuable assessment tools for evaluating functional status and quality of life in these patients and summarizes the advantages and disadvantages of each. Other topics of this review include epidemiology, the prevalence of degenerative changes in the asymptomatic population, the natural history and rates of progression, risk factors of diagnosis (clinical, imaging and genetic), and management strategies.

Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia.

Science.gov (United States)

Heffez, Dan S; Ross, Ruth E; Shade-Zeldow, Yvonne; Kostas, Konstantinos; Shah, Sagar; Gottschalk, Robert; Elias, Dean A; Shepard, Alan; Leurgans, Sue E; Moore, Charity G

2004-10-01

While patients with fibromyalgia report symptoms consistent with cervical myelopathy, a detailed neurological evaluation is not routine. We sought to determine if patients with fibromyalgia manifest objective neurological signs of cervical myelopathy. Two hundred and seventy patients, 18 years and older, who carried the diagnosis of fibromyalgia but who had no previously recognized neurological disease underwent detailed clinical neurological and neuroradiological evaluation for the prevalence of objective evidence of cervical myelopathy and radiological evidence of cerebellar tonsillar herniation (Chiari 1 malformation) or cervical spinal canal stenosis. Patients were primarily women (87%), of mean age 44 years, who had been symptomatic for 8 years (standard deviation, 6.3 years). The predominant complaints were neck/back pain (95%), fatigue (95%), exertional fatigue (96%), cognitive impairment (92%), instability of gait (85%), grip weakness (83%), paresthesiae (80%), dizziness (71%) and numbness (69%). Eighty-eight percent of patients reported worsening symptoms with neck extension. The neurological examination was consistent with cervical myelopathy: upper thoracic spinothalamic sensory level (83%), hyperreflexia (64%), inversion of the radial periosteal reflex (57%), positive Romberg sign (28%), ankle clonus (25%), positive Hoffman sign (26%), impaired tandem walk (23%), dysmetria (15%) and dysdiadochokinesia (13%). MRI and contrast-enhanced CT imaging of the cervical spine revealed stenosis. The mean antero-posterior (AP) spinal canal diameter at C2/3, C3/4, C4/5, C5/6, C6/7 and C7/T1 was 13.5 mm, 11.8 mm, 11.5 mm, 10.4 mm, 11.3 mm and 14.5 mm respectively, (CT images). In 46% of patients, the AP spinal diameter at C5/6 measured 10 mm, or less, with the neck positioned in mild extension, i.e., clinically significant spinal canal stenosis. MRI of the brain revealed tonsillar ectopia >5 mm in 20% of patients (mean=7.1+/-1.8 mm), i.e., Chiari 1 malformation

Neurorestoratology evidence in an animal model with cervical spondylotic myelopathy

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Li X

2017-01-01

Full Text Available Xiang Li,1,2 Guangsheng Li,1,3 Keith Dip-Kei Luk,1 Yong Hu1–3 1Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, 2Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 3Spinal Division, Department of Orthopaedics, Affiliated Hospital of Guangdong Medical University, Guangdong, People’s Republic of China Background: Cervical spondylotic myelopathy (CSM is a chronic compression injury of the spinal cord, with potentially reversible conditions after surgical decompression, and a unique model of incomplete spinal cord injury. Several animal studies showed pathological changes of demyelination, axon loss and neuron apoptosis in rats with chronic spinal cord compression. However, there is a limited understanding of the neurological change in the spinal cord after surgical decompression. The aim of this study was to validate the neurorestoratology of myelopathic lesions in the spinal cord in a rat model. Materials and methods: A total of 16 adult Sprague-Dawley rats were divided into four groups: sham control (group 1; CSM model with 4-week chronic compression (group 2, 2 weeks (group 3 and 4 weeks (group 4 after surgical decompression of CSM model. The compression and decompression were verified by magnetic resonance imaging (MRI test. Neurological function was evaluated by Basso, Beattie, and Bresnahan (BBB locomotor rating scale, ladder rung walking test and somatosensory-evoked potentials (SEPs. Neuropathological change was evaluated by histological examinations. Results: MRI confirmed the compression of the cervical spinal cord as well as the reshaping of cord morphology after decompression. After decompression, significant changes of neurological function were observed in BBB scores (p < 0.01, F = 10.52, ladder rung walking test (p < 0.05, F = 14.21 and latencies (p < 0.05, F = 5.76 and amplitudes (p < 0.05, F = 3.8 of

Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study.

Science.gov (United States)

Popovic, Milos R; Zivanovic, Vera; Valiante, Taufik A

2016-01-01

Non-traumatic spinal cord pathology is responsible for 25-52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16-21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials, showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function, in people with stroke and traumatic SCI. Motivated by this success, we decided to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61-year-old male who had C3-C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntarily open and close the hand and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study ~22 months following initial surgical intervention. Participant was assessed using Toronto Rehabilitation Institute's Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT), Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre-post differences in scores on all measures clearly demonstrated improvement in voluntary hand function following 15 1-h FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.

INTERFERON BETA-1A TREATMENT IN HTLV-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: A CASE REPORT

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Graça Maria de Castro Viana

2014-09-01

Full Text Available Here a young patient (< 21 years of age with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF. Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

Gait impairment in cervical spondylotic myelopathy: comparison with age- and gender-matched healthy controls.

LENUS (Irish Health Repository)

Malone, Ailish

2012-12-01

Gait impairment is a primary symptom of cervical spondylotic myelopathy (CSM); however, little is known about specific kinetic and kinematic gait parameters. The objectives of the study were: (1) to compare gait patterns of people with untreated CSM to those of age- and gender-matched healthy controls; (2) to examine the effect of gait speed on kinematic and kinetic parameters.

Quality control in radiotherapy treatment: Radiation induced myelopathy

International Nuclear Information System (INIS)

Fernandez-Vicioso, E.; Ruiz-Cruces, R.

2001-01-01

Direct injury of the spinal cord has been reported many times, particularly in cases of overexposures with radiotherapy of neoplasm that occurred outside the Central Nervous System. Permanent damage to the spinal cord is the most feared complication of radiation therapy treatments and one of the relatively common causes of litigation for medical malpractice in the context of cancer treatment. We have learned from clinical experience, data from randomized trials and animal experimentation, the dose tolerance as well as the interfraction interval for hyperfractionation regimes. We are still lacking precious clinical information, in particular the dose tolerance in combined modality treatments that represent the vast majority of modern treatments. (author)

Hepatic Myelopathy in a Patient with Decompensated Alcoholic Cirrhosis and Portal Colopathy

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Madhumita Premkumar

2012-01-01

Full Text Available Cirrhotic or hepatic myelopathy is a rare neurological complication of chronic liver disease usually seen in adults and presents as a progressive pure motor spastic paraparesis which is usually associated with overt liver failure and a surgical or spontaneous systemic portocaval shunt. We describe the development of progressive spastic paraparesis, in a patient with alcoholic cirrhosis with portal hypertension and portal colopathy who presented with the first episode of hepatic encephalopathy. The patient had not undergone any shunt procedure.

Analysis of Patients with Myelopathy due to Benign Intradural Spinal Tumors with Concomitant Lumbar Degenerative Diseases Misdiagnosed and Erroneously Treated with Lumbar Surgery.

Science.gov (United States)

Lu, Kang; Wang, Hao-Kuang; Liliang, Po-Chou; Yang, Chih-Hui; Yen, Cheng-Yo; Tsai, Yu-Duan; Chen, Po-Yuan; Chye, Cien-Leong; Wang, Kuo-Wei; Liang, Cheng-Loong; Chen, Han-Jung

2017-09-01

When a cervical or thoracic benign intradural spinal tumor (BIST) coexists with lumbar degenerative diseases (LDD), diagnosis can be difficult. Symptoms of BIST-myelopathy can be mistaken as being related to LDD. Worse, an unnecessary lumbar surgery could be performed. This study was conducted to analyze cases in which an erroneous lumbar surgery was undertaken in the wake of failure to identify BIST-associated myelopathy. Cases were found in a hospital database. Patients who underwent surgery for LDD first and then another surgery for BIST removal within a short interval were studied. Issues investigated included why the BISTs were missed, how they were found later, and how the patients reacted to the unnecessary lumbar procedures. Over 10 years, 167 patients received both surgeries for LDD and a cervical or thoracic BIST. In 7 patients, lumbar surgery preceded tumor removal by a short interval. Mistakes shared by the physicians included failure to detect myelopathy and a BIST, and a hasty decision for lumbar surgery, which soon turned out to be futile. Although the BISTs were subsequently found and removed, 5 patients believed that the lumbar surgery was unnecessary, with 4 patients expressing regrets and 1 patient threatening to take legal action against the initial surgeon. Concomitant symptomatic LDD and BIST-associated myelopathy pose a diagnostic challenge. Spine specialists should refrain from reflexively linking leg symptoms and impaired ability to walk to LDD. Comprehensive patient evaluation is fundamental to avoid misdiagnosis and wrong lumbar surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Health Economics and the Management of Degenerative Cervical Myelopathy.

Science.gov (United States)

Witiw, Christopher D; Smieliauskas, Fabrice; Fehlings, Michael G

2018-01-01

Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord impairment worldwide. Surgical intervention has been demonstrated to be effective and is becoming standard of care. Spine surgery, however, is costly and value needs to be demonstrated. This review serves to summarize the key health economic concepts as they relate to the assessment of the value of surgery for DCM. This is followed by a discussion of current health economic research on DCM, which suggests that surgery is likely to be cost effective. The review concludes with a summary of future questions that remain unanswered, such as which patient subgroups derive the most value from surgery and which surgical approaches are the most cost effective. Copyright © 2017 Elsevier Inc. All rights reserved.

Thoracic Synovial Cyst at the Th2-3 Level Causing Myelopathy

DEFF Research Database (Denmark)

Sundskarð, Martin M; Gaini, Shahin

2017-01-01

Intraspinal synovial cyst is a rare cause of myelopathy. These cysts present most often in the lumbar and cervical parts of the spine but are more infrequent in the thoracic spine. We present a case of a 73-year-old man with an intraspinal, extradural synovial cyst at the Th2-3 level causing...... paraesthesia and weakness in the legs. A laminectomy and excision of the cyst were performed and the patient recovered fully. In the thoracic spine, synovial cysts are almost exclusively found in the lower part. Laminectomy, with excision, is the treatment of choice, although steroid injections have been...

Pathological investigation of radiation necrosis

International Nuclear Information System (INIS)

Nakamura, Nishio; Yoshimura, Noriaki; Ikuta, Fusahiro

1975-01-01

The brain and spinal cord of an 18-year-old male, who suffered from cerebellar medulloblastoma with subarachnoid spread, had been irradiated by a large amount of Linac X-ray: 14,450 rads to the lower thoracic segments and 7,400 rads to the lumbar segments. The tumor at the roof of the 4th ventricle had disseminated along the ventricular system but was limited to the subarachnoid space of the cervical spinal cord. No remarkable changes were found in the volume or consistency of the thoracic and lumbar cord. Elasticity of the lower thoracic segment was greatly diminished and the cut surfaces were yellowish white and fragile. Microscopically extensive coagulation necrosis was observed with complete disintegration of myelin and axon. Vascular changes were most prominent in the smaller vessels, eg. hyalinous thickening, concentric cleavage, adventitial fibrosis and edema of small artery perivascular spaces, fibrin thrombi occulusion of arterioles and capillaries, and telangiectasia. In the lumbar spinal cord, moderate neuronal degeneration and protoplasmic astrocytosis were observed. Changes in the lumbar posterior white column were considered to be not only secondary degeneration but also a primary lesion caused by irradiation. Liquefactive necrosis in the gray matter of the cervical cord was thought to be a nonspecific circulatory disturbance because of the absence of vascular changes. Vascular changes were thought to be very important in the histological diagnosis of radiation myelopathy and it was supposed that increased permeability of the vessel walls was a factor in coagulation necrosis. They considered this case to have typical histology of radiation myelopathy. (Evans, J.)

Prediction of the recovery rate after surgery for cervical myelopathy from the view of CT-myelography

International Nuclear Information System (INIS)

Koyanagi, Takahiro; Satomi, Kazuhiko; Asazuma, Takahito; Toyama, Yoshiaki; Fujimura, Shoichi; Hirabayashi, Kiyoshi; Hamano, Yasuyuki; Shiraishi, Takeshi.

1991-01-01

This study was designed to prepare a formula for predicting postoperative recovery in cervical myelopathy. Preoperative CT-myelography (CT-M) was performed in a total of 103 patients, consisting of 44 with cervical spinal myelopathy (CSM), 39 with ossification of the posterior longitudinal ligament (OPLL), and 20 with cervical disk herniation (CDH). Multivariate analyses were used to obtain correlations between CT-M findings (spinal cord area and the rate of spinal cord flatness) and clinical items (age, disease duration, preoperative JOA score, and postoperative recovery rate). There was a strong positive correlation between spinal cord area and postoperative recovery rate. Because both spinal cord area and disease duration for the CSM and OPLL groups had a strong positive correlation with the recovery rate, they were found to predict postoperative recovery. In the CDH group, there was no predictive index. Spinal cord area was more potential index than preoperative severity. Disease duration may also serve as an index complementing spinal cord area in the evaluation of postoperative recovery. (N.K.)

Neuropsychological improvement in patients with cervical spondylotic myelopathy after posterior decompression surgery

International Nuclear Information System (INIS)

Hoshimaru, Minoru

2010-01-01

Patients with cervical spondylotic myelopathy sometimes complain of cognitive dysfunction, which may be coincidence. However, cognitive dysfunction may be related to disorders of the cervical spine and/or spinal cord. This study investigated cognitive dysfunction in patients with cervical spinal disorders. A total of 79 patients with cervical spondylotic myelopathy (40 women and 39 men, mean age 61.2 years) underwent cervical laminoplasty between January 2006 and July 2007. Ten of these 79 patients (7 women and 3 men, mean age 65.2 years) complained of moderate to severe memory disturbances. These 10 patients underwent neuroimaging studies and a battery of neuropsychological tests consisting of the mini-mental state examination, Kohs Block Design Test, Miyake Memory Test, Benton Visual Retention Test (BVRT), and 'kana-hiroi' test before and 3 months after surgery. Brain magnetic resonance imaging showed no organic brain lesions in the 10 patients, but single photon emission computed tomography demonstrated reduced regional cerebral blood flow in the posterior cortical areas in eight patients before surgery. Neuropsychological test scores showed statistically significant improvement after surgery in the Kohs Block Design Test and the BVRT, which measure visuospatial perception and reflect the function of the parietal and/or occipital lobes (p<0.05). The practice effect may have contributed to the neuropsychological improvements, but this study suggests that cervical spinal disorders may affect cognitive functions and that surgical treatment can ameliorate such effects. (author)

The efficacy of dynamic MRI in assessing a cervical myelopathy

International Nuclear Information System (INIS)

Morimoto, Tetsuya; Yamada, Tomonori; Okumura, Yoshiya; Hashimoto, Hiroshi; Hiramatsu, Kenichiro; Tsunoda, Shigeru; Sakaki, Toshisuke; Iwasaki, Satoru

1994-01-01

There are problems that are unresolved with regard to the treatment of cases presenting a post-taumatic cervical myelopathy, such as when the surgical indications are not clearly evidence and the proper timing of this surgery. In this regard, the authors have used dynamic MRI to retrospectively analyze the cervical spine of 24 previously treated dynamic MRI cases presenting a subacute myelopathy to determine the efficacy of dynamic MRI as a method of treatment. Dynamic MRI analysis protocol was as follows. For the MR imagings, each patient was placed supine with the neck in the neutral position, after which the neck was set in the extended position. Dynamic changes between the neutral position and extended position images were analyzed by focusing on the following two point: (1) the narrowing of the subarachnoid space in the T2-weighted images and (2) evidence of cord compression in the T1-weighted images. Twelve cases out of 24 were treated conservatively because of a gradual improvement in their myelopathic symptoms. The other 12 cases were treated surgically, because of no improvement in their residual myelopathic symptoms at the time when the dynamic MRI had been performed. In the majority of cases in the surgical group, the narrowing of the subarachnoid space and spinal cord compression were hightened on neck extension, whereas in the conservative group, such findings were minimal. Dynamic MRI also more clearly visualized multiple lesions and the direction of the cord compression. These findings thus provided more detailed information to plan the surgical approach and to estimate the amount of surgical decompression needed. Based on the results of this retrospective study, we thus concluded that surgical treatment appears to benefit subacute cases who show no improvement in their residual myelopathic symptoms and whose dynamic MRI results also demonstrate an increased narrowing of subarachnoid space and a heightened spinal cord compression. (author)

Magnetic resonance imaging for Human T-cell lymphotropic virus type 1 (HTLV1- associated myelopathy/tropical spastic paraparesis patients: a systematic review

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Fariba Zemorshidi

2015-06-01

Full Text Available Introduction: Human T-cell lymphotropic virus type 1 (HTLV-1 associated myelopathy/tropical spastic paraparesis is a chronic progressive neurologic disease which might be associated by brain and spinal cord atrophy and lesions. Here we systematically reviewed the brain and spinal cord abnormalities reported by using magnetic resonance imaging modality on HTLV-1 associated myelopathy/tropical spastic paraparesis patients. Methods: PubMed was searched for all the relevant articles which used magnetic resonance imaging for patients with human HTLV-1 associated myelopathy/tropical spastic paraparesis disease. Included criteria were all the cohort and case series on with at least 10 patients. We had no time limitation for searched articles, but only English language articles were included in our systematic review. Exclusion criteria were none-English articles, case reports, articles with less than 10 patients, spastic paraparesis patients with unknown etiology, and patients with HTLVII. Results: Total of 14 relevant articles were extracted after studying title, abstracts, and full text of the irrelevant articles. Only 2/14 articles, reported brain atrophy incidence. 5/14 articles studied the brain lesions prevalence. Spinal cord atrophy and lesions, each were studied in 6/14 articles.Discussion: According to the extracted data, brain atrophy does not seem to happen frequently in patients with HTLV-1 associated myelopathy/tropical spastic paraparesis. None-specific brain lesions identified in articles are indicative of low specificity of magnetic resonance imaging technique despite its high sensitivity. Conclusion: Prevalence of spinal cord lesions and atrophy in these patients might be due to the degenerative processes associated with aging phenomenon. Further larger studies in endemic areas can more accurately reveal the specificity of magnetic resonance imaging for these patients.

Cervical spine abnormalities and instability with myelopathy in warfarin-related chondrodysplasia: 17-year follow-up

International Nuclear Information System (INIS)

Takano, Hideyuki; Smith, W.L.; Sato, Yutaka; Kao, S.C.S.

1998-01-01

A patient with warfarin embryopathy developed progressive cervical spinal myelopathy owing to bony cervical spinal damage. While there are several descriptions of warfarin embryopathy, the long-term complication of cervical spinal instability has not been reported. This cervical instability may, as in our patient, cause severe neurological dysfunction or even sudden death; therefore, it is important that pediatric radiologists should be alert to this condition. (orig.)

Radiation-induced osteochondroma of the T4 vertebra causing spinal cord compression

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Gorospe, Luis; Madrid-Muniz, Carmen; Royo, Aranzazu; Garcia-Raya, Pilar [Department of Radiology, La Paz University Hospital, Madrid (Spain); Alvarez-Ruiz, Fernando [Department of Neurosurgery, La Paz University Hospital, Madrid (Spain); Lopez-Barea, Fernando [Department of Pathology, La Paz University Hospital, Madrid (Spain)

2002-04-01

A case of a radiation-induced osteochondroma arising from the vertebral body of T4 in an 18-year-old man is reported. The patient presented with a history of progressive left lower extremity weakness. At 7 years of age, he had undergone resection of a cerebellar medulloblastoma and received adjunctive craniospinal irradiation and systemic chemotherapy. Both CT and MR imaging revealed an extradural mass contiguous with the posteroinferior endplate of the T4 vertebral body. This case indicates that radiation-induced osteochondroma should be considered in the differential diagnosis of patients with symptoms of myelopathy or nerve root compression and a history of radiation therapy involving the spine in childhood. (orig.)

Cervical spine abnormalities and instability with myelopathy in warfarin-related chondrodysplasia: 17-year follow-up

Energy Technology Data Exchange (ETDEWEB)

Takano, Hideyuki; Smith, W.L.; Sato, Yutaka; Kao, S.C.S. [Department of Radiology, The University of Iowa Clinics and Hospitals, 200 Hawkins Dr., F3966 JPP, Iowa City, IA 52242-1077 (United States)

1998-07-01

A patient with warfarin embryopathy developed progressive cervical spinal myelopathy owing to bony cervical spinal damage. While there are several descriptions of warfarin embryopathy, the long-term complication of cervical spinal instability has not been reported. This cervical instability may, as in our patient, cause severe neurological dysfunction or even sudden death; therefore, it is important that pediatric radiologists should be alert to this condition. (orig.) With 5 figs., 9 refs.

Negative MRI findings in a case of degenerative myelopathy in a dog : clinical communication

Directory of Open Access Journals (Sweden)

M. Okada

2009-05-01

Full Text Available An 11-year-old male Rough collie was submitted with paraparesis, but did not respond to medical treatment. Clinical signs worsened and the dog displayed paralysis, inability to stand and loss of voluntary bladder control, whereupon magnetic resonance imaging (MRI was performed. No significant abnormalities were identified from MRI, blood tests, cerebrospinal fluid tests or radiography. After MRI, the dog developed dyspnoea and died. Autopsy and subsequent histopathological examination led to a diagnosis of degenerative myelopathy.

The reporting of study and population characteristics in degenerative cervical myelopathy: A systematic review.

Directory of Open Access Journals (Sweden)

Benjamin M Davies

Full Text Available Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent condition. Variable reporting in interventional trials of study design and sample characteristics limits the interpretation of pooled outcomes. This is pertinent in DCM where baseline characteristics are known to influence outcome. The present study aims to assess the reporting of the study design and baseline characteristics in DCM as the premise for the development of a standardised reporting set.A systematic review of MEDLINE and EMBASE databases, registered with PROSPERO (CRD42015025497 was conducted in accordance with PRISMA guidelines. Full text articles in English, with >50 patients (prospective or >200 patients (retrospective, reporting outcomes of DCM were deemed to be eligible.A total of 108 studies involving 23,876 patients, conducted world-wide, were identified. 33 (31% specified a clear primary objective. Study populations often included radiculopathy (51, 47% but excluded patients who had undergone previous surgery (42, 39%. Diagnositic criteria for myelopathy were often uncertain; MRI assessment was specified in only 67 (62% of studies. Patient comorbidities were referenced by 37 (34% studies. Symptom duration was reported by 46 (43% studies. Multivariate analysis was used to control for baseline characteristics in 33 (31% of studies.The reporting of study design and sample characteristics is variable. The development of a consensus minimum dataset for (CODE-DCM will facilitate future research synthesis in the future.

Ciliary derived neurotrophic factor protects oligodendrocytes against radiation induced damage in vitro by a mechanism independent of a proliferative effect

International Nuclear Information System (INIS)

Evans, Andrew J.; Mabie, Peter C.; Kessler, Jack A.; Vikram, Bhadrasain

1997-01-01

Purpose/Objective: Radiation-induced damage to the central nervous system in the from of myelopathy is a dose-limiting complication in the treatment of tumors situated in or close to the spinal cord. The target cell for this damage is not definitively identified, but demyelination due to oligodendrocyte damage is strongly implicated. Multiple neurotrophic factors have recently been identified which demonstrate a survival effect on oligodendrocytes. We investigated the effect of Ciliary Derived Neurotrophic Factor (CNTF), Neurotrophin-3 (NT-3) and Nerve Growth Factor (NGF) on the radiosensitivity of oligodendrocytes in vitro to determine if this may ameliorate radiation damage, as a model for reducing myelopathy in vivo. Materials and Methods: Mature oligodendrocytes were cultured from the cortex of newborn Sprague-Dawley white rats and maintained on poly-d-lysine plates. The experimental arm was exposed to CNTF (0.01-100ng/ml), NGF (100ng/ml) or NT-3 (20ng/ml) for 24 hours prior to radiation, and control and experimental arms radiated using a cobalt 60 irradiator at a dose rate of .87 Gy/min with doses from 2 Gy to 10 Gy. Oligodendrocytes were identified using an O4 antibody, assessed for viability at 5 days using an MTT assay and counted using a phase contrast microscope. Combination studies of CNTF and NT-3 were also performed. BrdU studies were performed to determine if the various neurotrophins induced proliferation, with BrdU added for the 24 hour period prior to radiation only, for the 5 day period following radiation only, or for both periods combined. Results: The proportion of mature oligodendrocytes surviving 5 days after irradiation was not significantly increased by NGF, and was only modestly increased by NT-3. However, CNTF significantly increased the surviving proportion at all doses The addition of NT-3 to CNTF did not further increase the proportion of oligodendrocytes surviving. CNTF dose escalation studies confirmed 20ng/ml as an optimal dose. Brd

A study on the clinical significance of magnetic resonance imaging (MRI) findings in patients with cervical spondylotic myelopathy

International Nuclear Information System (INIS)

Toyooka, Satoshi

1997-01-01

This study was designed to evaluate magnetic resonance (MR) images of the cervical compressive myelopathy. It was also meant to serve as a review of clinical symptoms and an investigation of the usefulness of MRI. Comparative studies were carried out on 110 cases concerning the shape and signal intensity of the spinal cord, anterior epidural venous plexus MR images and clinical symptoms. The shape of the spinal cord and pre- and post-surgical conditions revealed by MRI correlated with clinical symptoms. As for the signal intensity of the spinal cord, in cases in which both high (T2-weighted image) and low (T1-weighted image) signals detected prior to surgery continued after surgery, as well as cases with high and low signals appearing after surgery, had the lower improvement than average. Low signal intensity on T1-weighted images are assumed to indicate irreversible changes of the spinal cord. High signal intensity on T2-weighted images is assumed to indicate both reversible and irreversible changes of the spinal cord. Epidural venous plexus can also be observed in healthy people and is not directly bound to clinical manifestations. Nevertheless, changes in the shape of the epidural venous plexus and signal intensity can reflect venous plexus compression and circulatory changes caused by compression. In the application of MRI to cervical compressive myelopathies, images of changes in the shape and signal intensity of the spinal cord and anterior epidural venous plexus images were considered important observations linked to clinical symptoms. MRI is an essential non-invasive imaging technique for the diagnosis of cervical compressive myelopathy, estimation of prognosis and postoperative follow-up. More investigations of compressive factors, circulatory dynamics of the spinal cord and high quality image are necessary. (author)

Electrophysiological and MRI study on poor outcome after surgery for cervical myelopathy

Energy Technology Data Exchange (ETDEWEB)

Kameyama, Osamu; Kawakita, Hirofumi; Ogawa, Ryokei [Kansai Medical Univ., Moriguchi, Osaka (Japan)

1995-11-01

Occasionally, the outcome from laminoplasty for cervical spondylosis is disappointing despite an adequate operation. Before surgery, it is difficult to diagnose the pathological extent of the involvement of the spinal cord. The purpose of this study is to determine the efficacy of magnetic resonance imaging (MRI) and of the motor evoked potentials (MEPs) for the indication of the surgery and prognosis. Retrospectively, we investigated the MEPs and the MRI of 31 patients in surgery for cervical myelopathy, involving 21 with cervical spondylosis and 10 with ossification of the posterior longitudinal ligamentum, and compared the findings from those with a poor outcome (n=3l) with the findings from those with a good outcome (n=32). The MEPs from the thenar muscle and the tibialis anterior were evoked by transcranial magnetic brain stimulation. In the poor-outcome patients, the spinal canal was narrow and lumbar spinal canal stenosis was seen in 5 cases which required lumbar laminectomy. Before operation, the MEPs from the thenar muscle could not be evoked in 5 cases while there was a remarkably prolonged central motor conduction time in the other 26 cases. MRI revealed the deformed spinal cord in the involved area, and the signal intensity of the involved spinal cord in the T2 weighted image was remarkably high. The signal intensity ratio was significantly higher in the poor-outcome patients than in the good-outcome patients. This study suggested that a high signal intensity in the T2 weighted image and a prolonged conduction time or absence of MEPs largely corresponded to the clinical and other investigative features of myelopathy responsible for a poor outcome. (author).

Electrophysiological and MRI study on poor outcome after surgery for cervical myelopathy

International Nuclear Information System (INIS)

Kameyama, Osamu; Kawakita, Hirofumi; Ogawa, Ryokei

1995-01-01

Occasionally, the outcome from laminoplasty for cervical spondylosis is disappointing despite an adequate operation. Before surgery, it is difficult to diagnose the pathological extent of the involvement of the spinal cord. The purpose of this study is to determine the efficacy of magnetic resonance imaging (MRI) and of the motor evoked potentials (MEPs) for the indication of the surgery and prognosis. Retrospectively, we investigated the MEPs and the MRI of 31 patients in surgery for cervical myelopathy, involving 21 with cervical spondylosis and 10 with ossification of the posterior longitudinal ligamentum, and compared the findings from those with a poor outcome (n=3l) with the findings from those with a good outcome (n=32). The MEPs from the thenar muscle and the tibialis anterior were evoked by transcranial magnetic brain stimulation. In the poor-outcome patients, the spinal canal was narrow and lumbar spinal canal stenosis was seen in 5 cases which required lumbar laminectomy. Before operation, the MEPs from the thenar muscle could not be evoked in 5 cases while there was a remarkably prolonged central motor conduction time in the other 26 cases. MRI revealed the deformed spinal cord in the involved area, and the signal intensity of the involved spinal cord in the T2 weighted image was remarkably high. The signal intensity ratio was significantly higher in the poor-outcome patients than in the good-outcome patients. This study suggested that a high signal intensity in the T2 weighted image and a prolonged conduction time or absence of MEPs largely corresponded to the clinical and other investigative features of myelopathy responsible for a poor outcome. (author)

Cine MRI of patients with cervical myelopathy

International Nuclear Information System (INIS)

Ukita, Yasutaka

1993-01-01

Forty-six patients with cervical myelopathy were examined before and after surgery by cine magnetic resonance imaging (MRI). According to the occurrence site and degree of flow void, cerebrospinal fluid (CSF) flow void was classified into five: anterior type (flow void mainly in the anterior part of subarachnoid space), posterior type (mainly in the posteiror part), anteroposterior type (in the anterior and posterior parts), incomplete block type (flow void limited to the upper and lower parts of the block), and complete block type (no flow void). None of the 46 patients had normal CSF flow void on cine MRI before surgery. CSF flow void was seen in systolic phase on ECG (from 150 to 300 msec from R's wave) in all patients after spinal cord decompression. Postoperative CBF flow void types correlated well with surgical method, disease, and postoperative vertebral alignment. Postoperative outcome was the most excellent in the group of posterior type and the poorest in the group of anteroposterior type, showing a significant difference between the groups. Cine MRI is a useful noninvasive, dynamic method for assessing postoperative decompression effect. (N.K.)

Canine degenerative myelopathy: biochemical characterization of superoxide dismutase 1 in the first naturally occurring non-human amyotrophic lateral sclerosis model.

Science.gov (United States)

Crisp, Matthew J; Beckett, Jeffrey; Coates, Joan R; Miller, Timothy M

2013-10-01

Mutations in canine superoxide dismutase 1 (SOD1) have recently been shown to cause canine degenerative myelopathy, a disabling neurodegenerative disorder affecting specific breeds of dogs characterized by progressive motor neuron loss and paralysis until death, or more common, euthanasia. This discovery makes canine degenerative myelopathy the first and only naturally occurring non-human model of amyotrophic lateral sclerosis (ALS), closely paralleling the clinical, pathological, and genetic presentation of its human counterpart, SOD1-mediated familial ALS. To further understand the biochemical role that canine SOD1 plays in this disease and how it may be similar to human SOD1, we characterized the only two SOD1 mutations described in affected dogs to date, E40K and T18S. We show that a detergent-insoluble species of mutant SOD1 is present in spinal cords of affected dogs that increases with disease progression. Our in vitro results indicate that both canine SOD1 mutants form enzymatically active dimers, arguing against a loss of function in affected homozygous animals. Further studies show that these mutants, like most human SOD1 mutants, have an increased propensity to form aggregates in cell culture, with 10-20% of cells possessing visible aggregates. Creation of the E40K mutation in human SOD1 recapitulates the normal enzymatic activity but not the aggregation propensity seen with the canine mutant. Our findings lend strong biochemical support to the toxic role of SOD1 in canine degenerative myelopathy and establish close parallels for the role mutant SOD1 plays in both canine and human disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods

Science.gov (United States)

2018-01-01

Background Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. Objective To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. Methods An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website’s Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Results Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. Conclusions The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. PMID:29402760

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods.

Science.gov (United States)

Davies, Benjamin; Kotter, Mark

2018-02-05

Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website's Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. ©Benjamin Davies, Mark Kotter. Originally published in JMIR Research Protocols (http

The human dorsal spinocerebellar tract: myelinated fiber spectrum and fiber density in controls, autosomal dominant spinocerebellar atrophy, Huntington's chorea, radiation myelopathy, and diseases with peripheral sensory nerve involvement

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Ringelstein, E.B.; Schroeder, J.M.

1982-01-01

The human dorsal spinocerebellar tract (DSCT) was evaluated morphometrically in 14 control cases of different age and sex using semithin sections of epon-embedded cross sections from the C3, T5, and T10 segments of the spinal cord. A bimodal fiber spectrum was revealed with one peak at 2-3 microns, and a second, broader peak at about 6-8 microns. Fiber density at C3 was 11,188 fibers/mm2 and at T5, 11,156 fibers/mm2. Regression analysis relating fiber density to age disclosed a highly significant loss of myelinated fibers at T5 amounting to about 2.5% per decade. A severe reduction of fiber density and a distinct change in the fiber spectrum with predominant loss of large myelinated fibers were noted in a case of autosomal dominant spinocerebellar atrophy with late onset, and, to a lesser degree, in a case of Huntington's chorea. A subtotal loss of fibers with a persistent normal distribution of fiber sizes was observed rostral to a focus of severe radiation myelopathy, indicating Wallerian degeneration of large numbers of fibers, and a reduction of fiber diameters caudal to the lesion, suggesting retrograde fiber change. By contrast, no primary or transneural changes in the DSCT were detected in six cases of long-term alcoholism, carcinomatous sensory neuropathy, and neurofibromatosis in spite of the involvement of numerous nerve roots.

Wall-eyed bilateral internuclear ophthalmoplegia (webino syndrome and myelopathy in pyoderma gangrenosum

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Marco Aurélio Lana

1990-12-01

Full Text Available A 35-year-old female with pyoderma gangrenosum developed paraparesis with a sensory level at L1. Three months later she complained of diplopia and was found to have bilateral internuclear ophthalmoplegia with exotropia and no ocular convergence. The term Webino syndrome has been coined to design this set of neuro-opthalmologic findings. Although it was initially attributed to lesions affecting the medial longitudinal fasciculus and the medial rectus subnuclei of the oculomotor complex in the midbrain the exact location of the lesion is still disputed. In the present case both myelopathy and Webino syndrome were probably due to vascular occlusive disease resulting from central nervous system vasculitis occurring in concomitance to pyoderma gangrenosum.

Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

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Ze-qun Li

Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013).

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Bartholomew, K A; Stover, K E; Olby, N J; Moore, S A

2016-12-24

Fibrocartilaginous embolic myelopathy (FCE) is common in dogs; however, there is conflicting information in the veterinary literature regarding clinical characteristics and data on recovery in severe cases is sparse. A systematic review of canine FCE was performed to delineate the natural history of this disease. 322 previously reported cases and 71 previously unreported cases were identified for inclusion. Source publications were identified via PubMed central search and by references from review articles. Previously unreported cases were identified via computerised medical records search at two veterinary institutions. FCE was most common in middle-aged large breed dogs (30 per cent); however, the miniature schnauzer was the most frequently reported individual breed and small breeds comprised 24 per cent of all reported cases. The most common neuroanatomical localisation was a T3-L3 myelopathy (33.1 per cent). Prognosis for recovery of ambulation was good to excellent with 85 per cent of cases regaining the ability to walk unassisted, most within 3 weeks. Persistent neurological deficits were common in patients that recovered ambulation (49.1 per cent). When nociception was absent in the affected limbs at initial presentation, rate of recovery was lower (10 per cent); however, this data is likely biased by limited follow-up in more severe cases. Future prospective studies should evaluate prognosis for more severely affected patients. British Veterinary Association.

Analysis of spastic gait in cervical myelopathy: Linking compression ratio to spatiotemporal and pedobarographic parameters.

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Nagai, Taro; Takahashi, Yasuhito; Endo, Kenji; Ikegami, Ryo; Ueno, Ryuichi; Yamamoto, Kengo

2018-01-01

Gait dysfunction associated with spasticity and hyperreflexia is a primary symptom in patients with compression of cervical spinal cord. The objective of this study was to link maximum compression ratio (CR) to spatiotemporal/pedobarographic parameters. Quantitative gait analysis was performed by using a pedobarograph in 75 elderly males with a wide range of cervical compression severity. CR values were characterized on T1-weighted magnetic resonance imaging (MRI). Statistical significances in gait analysis parameters (speed, cadence, stride length, step with, and toe-out angle) were evaluated among different CR groups by the non-parametric Kruskal-Wallis test followed by the Mann-Whitney U test using Bonferroni correction. The Spearman test was performed to verify correlations between CR and gait parameters. The Kruskal-Wallis test revealed significant decline in gait speed and stride length and significant increase in toe-out angle with progression of cervical compression myelopathy. The post-hoc Mann-Whitney U test showed significant differences in these parameters between the control group (0.45test revealed that CR was significantly correlated with speed, cadence, stride length, and toe-out angle. Gait speed, stride length, and toe-out angle can serve as useful indexes for evaluating progressive gait abnormality in cervical myelopathy. Our findings suggest that CR≤0.25 is associated with significantly poorer gait performance. Nevertheless, future prospective studies are needed to determine a potential benefit from decompressive surgery in such severe compression patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Cervical Klippel-Feil syndrome predisposing an elderly African man to central cord myelopathy following minor trauma

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Olufemi Adeleye, A; Olusola Akinyemi, R

2010-01-01

An otherwise-healthy, active 83-year-old Nigerian man developed reversible central cord myelopathy from a mild fall on a level surface. Cervical spine magnetic resonance imaging (MRI) revealed C5, 6, and 7 block vertebrae and marked disc extrusions only at the immediately adjoining upper and lower non-fused segments of the cervical spine. There was no spinal canal stenosis otherwise. We think that the unique presentation of this case of Klippel-Feil syndrome further supports the impression th...

Clinical and Radiographic Outcomes of C1 Laminectomy Without Fusion in Patients With Cervical Myelopathy That Is Associated With a Retro-odontoid Pseudotumor.

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Takemoto, Mitsuru; Neo, Masashi; Fujibayashi, Shunsuke; Sakamoto, Takeshi; Ota, Masato; Otsuki, Bungo; Kaneko, Hiroki; Umebayashi, Takeshi

2016-12-01

A retro-odontoid pseudotumor that is not associated with rheumatoid arthritis or hemodialysis is clinically rare. The majority of surgeons select transoral resection as the surgical treatment, often followed by posterior fusion or posterior decompression and fusion. In contrast, some authors have reported success with simple decompression without posterior stabilization in cases where atlanto-axial instability (AAI) is either absent or minor. In this study, we have evaluated the clinical and radiographic outcomes of C1 laminectomy without fusion as the surgical treatment for patients with cervical myelopathy that is associated with a retro-odontoid pseudotumor. A retrospective chart review was conducted on 10 patients who underwent C1 laminectomy without fusion for cervical myelopathy associated with a retro-odontoid pseudotumor. The average follow-up time was 29 months. All cases were graded as Ranawat grade 3a or 3b. After surgery, myelopathy improved in all of the patients. In 2 patients, the atlas-dens interval increased in the flexed position; however, this did not result in any clinical problems. The size of the retro-odontoid mass (measured on magnetic resonance images at least 12 mo after surgery) decreased in 4 of the 10 cases. AAI progression and mass enlargement were our primary concerns for this surgical option; however, C1 laminectomy did not cause severe AAI progression, no patients showed serious mass enlargement, and all patients demonstrated neurological improvement. This surgical strategy is beneficial especially for elderly patients given the risks of other surgical options that use an anterior transoral approach or posterior fusion.

Radiation therapy and late reactions in normal tissues

International Nuclear Information System (INIS)

Aoyama, Takashi; Kuroda, Yasumasa

1998-01-01

Recent developments in cancer therapy have made us increasingly aware that the quality of life of a patient is as valuable as other benefits received from therapy. This awareness leads to an emphasis on organ and/or function preservation in the course of therapy. In line with this new thinking, greater consideration is placed on radiation therapy as an appropriate modality of cancer therapy. Possible complications in normal tissues, especially those of late reaction type after the therapy must be overcome. This review, therefore, focuses on recent progress of studies on mechanisms of the complications of the late reaction type. An observation of a clinical case concerning a late reaction of spinal cord (radiation myelopathy) and surveys of experimental studies on the mechanisms of late reactions (including radiation pneumonitis and lung fibrosis, and radiation response of vascular endothelial cells) provide a hypothesis that apoptosis through the pathway starting with radiation-induced sphingomyelin hydrolysis may play an important role in causing a variety of late reactions. This insight is based on the fact that radiation also activates protein kinase C which appears to block apoptosis. The mechanisms of late reactions, therefore, may involve a balance between radiation-induced apoptotic death and its down regulation by suppressor mechanisms through protein kinase C. (author)

The efficacy of dynamic MRI in assessing a cervical myelopathy; A retrospective study

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Morimoto, Tetsuya; Yamada, Tomonori; Okumura, Yoshiya; Hashimoto, Hiroshi; Hiramatsu, Kenichiro; Tsunoda, Shigeru; Sakaki, Toshisuke; Iwasaki, Satoru (Nara Medical Univ., Kashihara (Japan))

1994-01-01

There are problems that are unresolved with regard to the treatment of cases presenting a post-taumatic cervical myelopathy, such as when the surgical indications are not clearly evidence and the proper timing of this surgery. In this regard, the authors have used dynamic MRI to retrospectively analyze the cervical spine of 24 previously treated dynamic MRI cases presenting a subacute myelopathy to determine the efficacy of dynamic MRI as a method of treatment. Dynamic MRI analysis protocol was as follows. For the MR imagings, each patient was placed supine with the neck in the neutral position, after which the neck was set in the extended position. Dynamic changes between the neutral position and extended position images were analyzed by focusing on the following two point: (1) the narrowing of the subarachnoid space in the T2-weighted images and (2) evidence of cord compression in the T1-weighted images. Twelve cases out of 24 were treated conservatively because of a gradual improvement in their myelopathic symptoms. The other 12 cases were treated surgically, because of no improvement in their residual myelopathic symptoms at the time when the dynamic MRI had been performed. In the majority of cases in the surgical group, the narrowing of the subarachnoid space and spinal cord compression were hightened on neck extension, whereas in the conservative group, such findings were minimal. Dynamic MRI also more clearly visualized multiple lesions and the direction of the cord compression. These findings thus provided more detailed information to plan the surgical approach and to estimate the amount of surgical decompression needed. Based on the results of this retrospective study, we thus concluded that surgical treatment appears to benefit subacute cases who show no improvement in their residual myelopathic symptoms and whose dynamic MRI results also demonstrate an increased narrowing of subarachnoid space and a heightened spinal cord compression. (author).

Late effects of radiation on the lumbar spinal cord of guinea pigs: Re-treatment tolerance

International Nuclear Information System (INIS)

Mason, K.A.; Withers, H.R.; Chiang, Chi-Shiun

1993-01-01

Using a guinea pig model of lumbar myelopathy, various factors affecting the tolerance of spinal cord to irradiation were assessed: (a) extent of initial injury; (b) time interval between priming and test doses; and (c) animal age at the time of initial radiation treatment. A 3 cm section of lumbar spinal cord of guinea pigs was irradiated with fractionated doses of 4.5 Gy gamma rays given as 9 fractions per week. Guinea pigs were primed with 9 x 4.5 Gy in 7 days which is 60% of the ED 50 for a continuous course of treatment. After 28 or 40 weeks, animal were retreated with 6-14 fractions of 4.5 Gy. Animals were observed for 2 years following the priming dose and both the incidence and latency of myelopathy recorded. Young adult guinea pigs (8 wk old) showed both a decreased radiation tolerance and latency compared to old individuals (40 wk old). At 28 or 40 wk after 9 x 4.5 Gy, only about 8% of the initial injury was remembered in young adult guinea pigs. The amount of residual injury was dependent on the initial damage as a proportion of the tolerance dose. The spinal cord shows a greater capacity for long-term recovery than generally appreciated and re-treatment doses clinically prescribed may be lower than necessary. 8 refs., 3 figs., 2 tabs

The 25-question Geriatric Locomotive Function Scale predicts the risk of recurrent falls in postoperative patients with cervical myelopathy.

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Kimura, Atsushi; Takeshita, Katsushi; Inoue, Hirokazu; Seichi, Atsushi; Kawasaki, Yosuke; Yoshii, Toshitaka; Inose, Hiroyuki; Furuya, Takeo; Takeuchi, Kazuhiro; Matsunaga, Shunji; Seki, Shoji; Tsushima, Mikito; Imagama, Shiro; Koda, Masao; Yamazaki, Masashi; Mori, Kanji; Nishimura, Hirosuke; Endo, Kenji; Yamada, Kei; Sato, Kimiaki; Okawa, Atsushi

2018-01-01

Fall-induced injuries represent a major public health concern for older individuals. The relationship between risk of falling and the severity of locomotive syndrome (LS) remains largely unknown. We conducted a retrospective analysis of patients who had undergone surgery from January 2012 to December 2013 and completed at least 1 year of follow-up at 12 participating institutes. Patients completed a questionnaire survey regarding their fall experience during a routine postoperative follow-up. Questionnaire items included the number of falls during the prior postoperative year and the 25-question Geriatric Locomotive Function Scale (GLFS-25). The severity of cervical myelopathy was assessed using the Japanese Orthopaedic Association (JOA) score. We analyzed the association between the incidence of falling and the severity of LS measured by the GLFS-25. Of 360 patients, 61 (16.9%) experienced 1 fall; 31 (8.6%), 2-3 falls; 4 (1.1%), 4-5 falls; and 6 (1.7%), ≥6 falls during the first postoperative year. Thus, 102 (28%) patients experienced at least 1 fall, and 41 (11%) experienced recurrent falls (2 or more falls) during the time period. The mean GLFS-25 score was 30.2 ± 22.7, and 242 (62%) patients had GLFS-25 scores of 16 or higher, which fulfilled the diagnostic criteria for LS. When subjects were categorized into recurrent fallers and non-recurrent fallers, recurrent fallers had a significantly higher GLFS-25 score and a significantly lower extremity motor function score of the JOA score than non-recurrent fallers. The GLFS-25 and lower extremity motor function score of the JOA score yielded the areas under the receiver operating characteristic curves of 0.674 and 0.607, respectively, to differentiate recurrent fallers from non-recurrent fallers. Postoperative patients with cervical myelopathy had a 62% prevalence of LS. The GLFS-25 may be useful to predict the risk of recurrent falls in patients with cervical myelopathy. Copyright © 2017 The Japanese

MRI of the spinal cord in myelopathy complicating vitamin B12 deficiency: two additional cases and a review of the literature

International Nuclear Information System (INIS)

Bassi, S.S.; Bulundwe, K.K.; Gledhill, R.F.; Labuscagne, J.H.

1999-01-01

Focal spinal cord lesions have been present in all previously reported cases of MRI appearances in myelopathy complicating vitamin B 12 deficiency. We describe two further cases showing mild atrophy only and review the salient features of the previous 11 publications. MRI findings reflect quite closely the known pathological changes in this condition. (orig.)

Synovial chondromatosis of the lumbar spine with compressive myelopathy: a case report with review of the literature

International Nuclear Information System (INIS)

Abdelwahab, Ibrahim Fikry; Contractor, Daniel; Bianchi, Stefano; Hermann, George; Hoch, Benjamin

2008-01-01

Synovial chondromatosis has been rarely reported to occur in the spine with only one case found in the lumbar spine. We describe another case of synovial chondromatosis in the lumbar spine in a 41-year-old man who presented with compressive myelopathy. The tumor was located in the left ventrolateral corner of the epidural space just below the L 4 -L 5 intervertebral space. Besides being extremely rare, our case was unusual in that the juxtaposed facet joint was radiologically normal. (orig.)

Diffusion Tensor Imaging Correlates with Short-Term Myelopathy Outcome in Patients with Cervical Spondylotic Myelopathy.

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Vedantam, Aditya; Rao, Avinash; Kurpad, Shekar N; Jirjis, Michael B; Eckardt, Gerald; Schmit, Brian D; Wang, Marjorie C

2017-01-01

To determine if spinal cord diffusion tensor imaging indexes correlate with short-term clinical outcome in patients undergoing elective cervical spine surgery for cervical spondylotic myelopathy (CSM). A prospective consecutive cohort study was performed in patients undergoing elective cervical spine surgery for CSM. After obtaining informed consent, patients with CSM underwent preoperative T2-weighted magnetic resonance imaging and diffusion tensor imaging of the cervical spine. Fractional anisotropy (FA) values at the level of maximum cord compression and at the noncompressed C1-2 level were calculated on axial images. We recorded the modified Japanese Orthopaedic Association (mJOA) scale, Neck Disability Index, and Short Form-36 physical functioning subscale scores for all patients preoperatively and 3 months postoperatively. Statistical analysis was performed to identify correlations between FA and clinical outcome scores. The study included 27 patients (mean age 54.5 years ± 1.9, 12 men). The mean postoperative changes in mJOA scale, Neck Disability Index, and Short Form-36 physical functioning subscale scores were 0.9 ± 0.3, -6.0 ± 1.9, and 3.4 ± 1.9. The mean FA at the level of maximum compression was significantly lower than the mean FA at the C1-2 level (0.5 vs. 0.55, P = 0.01). FA was significantly correlated with change in mJOA scale score (Pearson r = -0.42, P = 0.02). FA was significantly correlated with the preoperative mJOA scale score (Pearson r = 0.65, P < 0.001). Preoperative FA at the level of maximum cord compression significantly correlates with the 3-month change in mJOA scale score among patients with CSM. FA was also significantly associated with preoperative mJOA scale score and is a potential biomarker for spinal cord dysfunction in CSM. Published by Elsevier Inc.

Direct analysis of viral-specific CD8+ T cells with soluble HLA-A2/Tax11-19 tetramer complexes in patients with human T cell lymphotropic virus-associated myelopathy.

Science.gov (United States)

Bieganowska, K; Höllsberg, P; Buckle, G J; Lim, D G; Greten, T F; Schneck, J; Altman, J D; Jacobson, S; Ledis, S L; Hanchard, B; Chin, J; Morgan, O; Roth, P A; Hafler, D A

1999-02-01

Human T cell lymphotropic virus-I (HTLV-I)-associated myelopathy is a slowly progressive neurologic disease characterized by inflammatory infiltrates in the central nervous system accompanied by clonal expansion of HTLV-I-reactive CD8+ T-cells. In patients carrying the HLA-A2 allele, the immune response is primarily directed to the Tax11-19 peptide. The frequency, activation state, and TCR usage of HLA-A2/Tax11-19 binding T cells in patients with HTLV-I-associated myelopathy was determined using MHC class I tetramers loaded with the Tax11-19 peptide. Circulating Tax11-19-reactive T cells were found at very high frequencies, approaching 1:10 circulating CD8+ T cells. T cells binding HLA-A2/Tax11-19 consisted of heterogeneous populations expressing different chemokine receptors and the IL-2R beta-chain but not the IL-2R alpha-chain. Additionally, Tax11-19-reactive CD8+ T cells used one predominant TCR Vbeta-chain for the recognition of the HLA-A2/Tax11-19 complex. These data provide direct evidence for high frequencies of circulating Tax11-19-reactive CD8+ T cells in patients with HTLV-I-associated myelopathy.

Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

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Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

2009-03-01

Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

Large armored bridging over fractured vertebra with intraspinal tumor mimicking bony mass caused by migrated fragments of burst cervical vertebra presenting with severe cervical myelopathy

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Satyarthee Guru Dutta

2017-06-01

Full Text Available Vertebral body may get displaced anterior or posteror with elements of rotation. However, burst cervical spine vertebral fracture may migrate anteriorly and posteriorly simultaneously. However anterior displaced fragment forming armor like mass is very rare. Similarly, the posteriorly propelled fragments migrating caudally and posterolaterally producing a large osseous mass inside spinal canal mimicking bony tumour causing severe cervical canal stenosis and presenting with marked myelopathy is extremely rare. To the best knowledge of authors, association of such traumatic dual pathology represents first of its kind in western literature, who was neglected early medical advice and presenting with marked compressive cervical myelopathy. She underwent successful surgical decompression with gradual recovery of spastic limb weakness and recovery of sensation. Authors also highlights the importance of early resuscitation and adequate maintainace of mean arterial pressure following acute spinal cord injury. Pertinent literature is briefly reviewed.

The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy.

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Rikita, T; Tanaka, N; Nakanishi, K; Kamei, N; Sumiyoshi, N; Kotaka, S; Adachi, N; Ochi, M

2017-04-01

Retrospective study. Few studies have reported a relationship between central motor conduction time (CMCT), which evaluates corticospinal function, and degree of spinal cord compression in patients with myelopathy. Thus, there is no consensus on predicting the degree of prolonged CMCT on the basis of the degree of spinal cord compression. If a correlation exists between CMCT and spinal cord compression, then spinal cord compression may be a useful noninvasive clinical indicator of corticospinal function. Therefore, this study evaluated the relationship between CMCT and cervical spinal cord compression measured by magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM). Hiroshima University Hospital in Japan. We studied 33 patients undergoing laminoplasty. Patients exhibited significant cervical spinal cord compression on both MRI and intraoperative electrophysiological examination. We assessed transcranial magnetic stimulation measurement of CMCT; spinal cord compression parameters such as area, lateral diameter, anteroposterior diameter and flattening of the spinal cord at the lesion site and C2/3 levels on MRI; and pre- versus postoperative Japanese Orthopaedic Association (JOA) scores. Correlations between CMCT and flattening as well as anteroposterior diameter of the spinal cord at the lesion level were observed. Strong correlations between CMCT and the ratio of the flattening and anteroposterior diameter parameters at the lesion level to that at the C2/3 level were also observed. Measurement of spinal cord compression may be useful for the evaluation of corticospinal function as a proxy for CMCT in patients with CSM.

Correlação clinica entre a mielopatia cervical e o índice de Torg Correlation between the clinic and the index of cervical myelopathy Torg

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Agnaldo Rogério Lozorio

2012-01-01

Full Text Available OBJETIVO: A mielopatia cervical é uma disfunção da medula espinhal relacionada a degeneração típica do envelhecimento, cuja patologia se relaciona com a isquemia e compressão da medula. Muitos são os problemas clínicos apresentados por portadores de mielopatia, nos casos mais graves este acometimento pode levar a para ou tetraplegia quando não tratado. Devido a patologia primária desta doença ser causada por compressão gerando isquemia medular, julgamos poder existir uma correlação entre o grau de compressão e clínica dos pacientes portadores de mielopatia cervical, porém não encontramos nenhum estudo na literatura que realizou esta correlação, por existir esta dúvida na literatura é que objetivamos em nosso estudo analisar a correlação entre o grau do comprometimento clínico dos pacientes com mielopatia cervical e o índice de Torg. MÉTODOS: Estudo prospectivo, de caráter descritivo, avaliados 46 pacientes, realizado mensuração radiográfica do índice de Torg e análise clínica através da escala de JOA e Nurick. RESULTADOS: Dos 46 pacientes, 100% apresentaram Torg OBJECTIVE: Cervical myelopathy is a spinal cord dysfunction related to degeneration typical of aging. Its primary pathology is related to ischemia and spinal cord compression. Patients with myelopathy present many clinical problems; more severe cases may lead to quadriplegia if not treated in a timely manner. Because the primary pathology of this disease is caused by compression, thus generating spinal cord ischemia, we believed there must be a correlation between the degree of compression and the clinical assessment of patients with cervical myelopathy, but we did not find any study in the literature that made this correlation. Because there is doubt the literature we aimed, in our study, to analyze the correlation between the degree of clinical impairment of patients with cervical myelopathy and the Torg index. METHODS: A prospective, descriptive

MRI in the investigation of patients with myelopathy thought to be due to multiple sclerosis

International Nuclear Information System (INIS)

Papadopoulos, A.; Gouliamos, A.; Trakadas, S.; Kalovidouris, A.; Sgouropoulos, P.; Gatzonis, S.; Vlahos, L.

1995-01-01

The role of cerebral and spinal cord MRI was investigated in 65 patients with myelopathy suspected of having demyelinating disease. Cerebral MRI demonstrated lesions compatible with demyelination in 80% and spinal cord MRI in 68.6%. In 28.5% of our patients brain lesions were present with normal spinal cord images, but in 17% spinal cord lesions were depicted with a normal brain MRI. The combination of the two examinations demonstrated lesions in 97% of the patients. The frequency of coexistent cerebral lesions in patients with spinal cord lesions was over 85% in patients with chronic disease but only 28.5% in patients with acute myelitis. (orig.)

MRI in the investigation of patients with myelopathy thought to be due to multiple sclerosis

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Papadopoulos, A. [CT and MRI Unit, X-Ray Dept., `Areteion` Hospital, Univ. Athens (Greece); Gouliamos, A. [CT and MRI Unit, X-Ray Dept., `Areteion` Hospital, Univ. Athens (Greece); Trakadas, S. [CT and MRI Unit, X-Ray Dept., `Areteion` Hospital, Univ. Athens (Greece); Kalovidouris, A. [CT and MRI Unit, X-Ray Dept., `Areteion` Hospital, Univ. Athens (Greece); Sgouropoulos, P. [Neurology Dept., `Eginition` Hospital, Univ. Athens Medical School (Greece); Gatzonis, S. [Neurology Dept., `Eginition` Hospital, Univ. Athens Medical School (Greece); Vlahos, L. [CT and MRI Unit, X-Ray Dept., `Areteion` Hospital, Univ. Athens (Greece)

1995-07-01

The role of cerebral and spinal cord MRI was investigated in 65 patients with myelopathy suspected of having demyelinating disease. Cerebral MRI demonstrated lesions compatible with demyelination in 80% and spinal cord MRI in 68.6%. In 28.5% of our patients brain lesions were present with normal spinal cord images, but in 17% spinal cord lesions were depicted with a normal brain MRI. The combination of the two examinations demonstrated lesions in 97% of the patients. The frequency of coexistent cerebral lesions in patients with spinal cord lesions was over 85% in patients with chronic disease but only 28.5% in patients with acute myelitis. (orig.)

Spinal cord edema with contrast enhancement mimicking intramedullary tumor in patient with cervical myelopathy: A case report and a brief literature review.

Science.gov (United States)

Gkasdaris, Grigorios; Chourmouzi, Danai; Karagiannidis, Apostolos; Kapetanakis, Stylianos

2017-01-01

Cervical myelopathy (CM) is a clinical diagnosis that may be associated with hyperintense areas on T2-weighted magnetic resonance imaging (MRI) scan. The use of contrast enhancement in such areas to differentiate between neoplastic and degenerative disease has rarely been described. We present a 41-year-old female with a 5-month course of progressive CM. The cervical MRI revealed spinal cord swelling, stenosis, and a hyperintense signal at the C5-C6 and C5-C7 levels. Both the neurologic and radiologic examinations were consistent with an intramedullary cervical cord tumor. To decompress the spinal canal, an anterior cervical discectomy and fusion was performed from C5 to C7 level. This resulted in immediate and significant improvement of the myelopathy. Postoperatively, over 1.5 years, the hyperintense, enhancing intramedullary lesion gradually regressed on multiple postoperative MRI scans. Spinal cord edema is occasionally seen on MR studies of the cervical spine in patients with degenerative CM. Contrast-enhanced MR studies may help differentiate hyperintense cord signals due to edema vs. atypical intramedullary tumors. Routine successive postoperative MRI evaluations are crucial to confirm the diagnosis of degenerative vs. neoplastic disease.

Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study

OpenAIRE

Popovic, Milos R.; Zivanovic, Vera; Valiante, Taufik A.

2016-01-01

Non-traumatic spinal cord pathology is responsible for 25–52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16–21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials,...

Comparing the radiosensitivity of cervical and thoracic spinal cord using the relative seriality model

International Nuclear Information System (INIS)

Adamus-Gorka, M.; Lind, B.K.; Brahme, A.

2003-01-01

Spinal cord is one of the most important normal tissues that are aimed to be spared during radiation therapy of cancer. This organ has been known for its strongly serial character and its high sensitivity to radiation. In order to compare the sensitivity of different parts of spinal cord, the early data (1970's) for radiation myelopathy available in the literature could be used. In the present study the relative seriality model (Kallman et al. 1992) has been fitted to two different sets of clinical data for spinal cord irradiation: radiation myelitis of cervical spinal cord after treating 248 patients for malignant disease of head and neck (Abbatucci et al. 1978) and radiation myelitis of thoracic spinal cord after radiation treating 43 patients with lung carcinoma (Reinhold et al. 1976). The maximum likelihood method was applied for the fitting and the corresponding parameters together with their 68% confidence intervals calculated for each of the datasets respectively. The alpha-beta ratio for the thoracic survival was also obtained. On the basis of the present study the following conclusions can be drawn: 1. radiation myelopathy is a strongly serial endpoint, 2. it appears to be differences in radiosensitivity between the cervical and thoracic region of spinal cord, 3. thoracic spinal cord revealed very serial characteristic of dose response, while the cervical myelopathy seems to be a bit less serial endpoint, 4. the dose-response curve is much steeper in case of myelopathy of cervical spinal cord, due to the much higher gamma value for this region. This work compares the fitting of NTCP model to the cervical and thoracic regions of the spinal cord and shows quite different responses. In the future more data should be tested for better understanding the mechanism of spinal cord sensitivity to radiation

Maple Syrup Urine Disease Complicated with Kyphoscoliosis and Myelopathy

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Jia-Woei Hou

2016-10-01

Full Text Available Maple syrup urine disease (MSUD is an autosomal recessive aminoacidopathy secondary to an enzyme defect in the catabolic pathway of the branched-chain amino acids (BCAAs: leucine, isoleucine, and valine. Accumulation of their corresponding keto-acids leads to encephalopathy if not treated in time. A newborn male patient was suspected to have MSUD after tandem mass study when he presented symptoms and signs suggestive neonatal sepsis, anemia, and diarrhea. Food restriction of BCAAs was started; however, acrodermatitis enteropathica-like skin eruptions occurred at age 2 months. The skin rashes resolved after adding BCAAs and adjusting the infant formula. At age 7 months, he suffered from recurrent skin lesions, zinc deficiency, osteoporosis, and kyphosis of the thoracic spine with acute angulation over the T11-T12 level associated with spinal compression and myelopathy. After supplementation of zinc products and pamidronate, skin lesions and osteopenia improved gradually. Direct sequencing of the DBT gene showed a compound heterozygous mutation [4.7 kb deletion and c.650-651insT (L217F or L217fsX223]. It is unusual that neurodegeneration still developed in this patient despite diet restriction. Additionally, brain and spinal magnetic resonance imaging, bone mineral density study, and monitoring of zinc status are suggested in MSUD patients.

Characteristics of spondylotic myelopathy on 3D driven-equilibrium fast spin echo and 2D fast spin echo magnetic resonance imaging: a retrospective cross-sectional study.

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Abdulhadi, Mike A; Perno, Joseph R; Melhem, Elias R; Nucifora, Paolo G P

2014-01-01

In patients with spinal stenosis, magnetic resonance imaging of the cervical spine can be improved by using 3D driven-equilibrium fast spin echo sequences to provide a high-resolution assessment of osseous and ligamentous structures. However, it is not yet clear whether 3D driven-equilibrium fast spin echo sequences adequately evaluate the spinal cord itself. As a result, they are generally supplemented by additional 2D fast spin echo sequences, adding time to the examination and potential discomfort to the patient. Here we investigate the hypothesis that in patients with spinal stenosis and spondylotic myelopathy, 3D driven-equilibrium fast spin echo sequences can characterize cord lesions equally well as 2D fast spin echo sequences. We performed a retrospective analysis of 30 adult patients with spondylotic myelopathy who had been examined with both 3D driven-equilibrium fast spin echo sequences and 2D fast spin echo sequences at the same scanning session. The two sequences were inspected separately for each patient, and visible cord lesions were manually traced. We found no significant differences between 3D driven-equilibrium fast spin echo and 2D fast spin echo sequences in the mean number, mean area, or mean transverse dimensions of spondylotic cord lesions. Nevertheless, the mean contrast-to-noise ratio of cord lesions was decreased on 3D driven-equilibrium fast spin echo sequences compared to 2D fast spin echo sequences. These findings suggest that 3D driven-equilibrium fast spin echo sequences do not need supplemental 2D fast spin echo sequences for the diagnosis of spondylotic myelopathy, but they may be less well suited for quantitative signal measurements in the spinal cord.

Indication for the operative methods in surgical treatment of cervical spondylotic myelopathy

International Nuclear Information System (INIS)

Kobayashi, Akira; Inoue, Shunichi; Watabe, Tsuneo; Nagase, Joji; Harada, Yoshitada

1984-01-01

Indication for the operative methods for cervical spondylotic myelopathy was examined in 16 patients undergoing CT-myelography before and after operation. There was a highly significant correlation between the anteroposterior (A-P) diameter of the spinal cord and clinical symptoms. Patients with shorter A-P diameter of the spinal cord tended to have severer preoperative clinical symptoms. Clinical symptoms improved as the post operative A-P diameter of the spinal cord increased. Fixation with decompression of the anterior spinal cord should be indicated when constriction of 5 mm or less of the spinal cord is seen segmentally at the level of the intervertebral disc. Dilation of the spinal cavity should be indicated when the constriction of the spinal cord is 5 mm or less at all levels of the cervical spinal cord. In performing fixation with anterior decompression, 15 mm is considered to be the most suitable width for complete and safe decompression of the flattened spinal cord with a wide transverse diameter. (Namekawa, K)

Common γ-chain blocking peptide reduces in vitro immune activation markers in HTLV-1-associated myelopathy/tropical spastic paraparesis.

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Massoud, Raya; Enose-Akahata, Yoshimi; Tagaya, Yutaka; Azimi, Nazli; Basheer, Asjad; Jacobson, Steven

2015-09-01

Human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive inflammatory myelopathy occurring in a subset of HTLV-1-infected individuals. Despite advances in understanding its immunopathogenesis, an effective treatment remains to be found. IL-2 and IL-15, members of the gamma chain (γc) family of cytokines, are prominently deregulated in HAM/TSP and underlie many of the characteristic immune abnormalities, such as spontaneous lymphocyte proliferation (SP), increased STAT5 phosphorylation in the lymphocytes, and increased frequency and cytotoxicity of virus-specific cytotoxic CD8(+) T lymphocytes (CTLs). In this study, we describe a novel immunomodulatory strategy consisting of selective blockade of certain γc family cytokines, including IL-2 and IL-15, with a γc antagonistic peptide. In vitro, a PEGylated form of the peptide, named BNZ132-1-40, reduced multiple immune activation markers such as SP, STAT5 phosphorylation, spontaneous degranulation of CD8(+) T cells, and the frequency of transactivator protein (Tax)-specific CD8(+) CTLs, thought to be major players in the immunopathogenesis of the disease. This strategy is thus a promising therapeutic approach to HAM/TSP with the potential of being more effective than single monoclonal antibodies targeting either IL-2 or IL-15 receptors and safer than inhibitors of downstream signaling molecules such as JAK1 inhibitors. Finally, selective cytokine blockade with antagonistic peptides might be applicable to multiple other conditions in which cytokines are pathogenic.

Chronological observation in early radiation myelopathy of the cervical spinal cord

International Nuclear Information System (INIS)

Hirota, Saeko; Yoshida, Shoji; Soejima, Toshinori

1993-01-01

Gd-enhanced MR images of two patients with clinically and histopathologically diagnosed chronic progressive radiation myelitis (CPRM) were observed chronologically. One of them had had nasopharyngeal cancer and received radiotherapy at a dose of 100 Gy to the C1-2 level of the spinal cord. She developed CPRM 25 months after the termination of radiotherapy. The other had had malignant lymphoma originating from the tonsil and received chemoradiotherapy. The dose delivered to her cervical spinal cord was 40 Gy, and she developed CPRM 30 months later. Gd-enhanced MRI in the early phase revealed a small crescent-shaped nidus with or without a very small central nonenhanced area in both cases. Enhancement was not great. At that time, patients noticed only the inability to perceive pain and temperature or paresthesia in the opposite side. In a few months, MRI revealed a much more strongly enhanced and larger nidus with enlargement of a central nonenhanced area accompanied by long segmental cord enlargement. The patients' neurological symptoms had also progressed, with hemiparesis developing, for example. (author)

Canine degenerative myelopathy: a model of human amyotrophic lateral sclerosis.

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Nardone, Raffaele; Höller, Yvonne; Taylor, Alexandra C; Lochner, Piergiorgio; Tezzon, Frediano; Golaszewski, Stefan; Brigo, Francesco; Trinka, Eugen

2016-02-01

Canine degenerative myelopathy (CDM) represents a unique naturally occurring animal model for human amyotrophic lateral sclerosis (ALS) because of similar clinical signs, neuropathologic findings, and involvement of the superoxide dismutase 1 (SOD1) mutation. A definitive diagnosis can only be made postmortem through microscopic detection of axonal degeneration, demyelination and astroglial proliferation, which is more severe in the dorsal columns of the thoracic spinal cord and in the dorsal portion of the lateral funiculus. Interestingly, the muscle acetylcholine receptor complexes are intact in CDM prior to functional impairment, thus suggesting that muscle atrophy in CDM does not result from physical denervation. Moreover, since sensory involvement seems to play an important role in CDM progression, a more careful investigation of the sensory pathology in ALS is also warranted. The importance of SOD1 expression remains unclear, while oxidative stress and denatured ubiquinated proteins appear to play a crucial role in the pathogenesis of CDM. In this updated narrative review we performed a systematic search of the published studies on CDM that may shed light on the pathophysiological mechanisms of human ALS. A better understanding of the factors that determine the disease progression in CDM may be beneficial for the development of effective treatments for ALS. Copyright © 2015 Elsevier GmbH. All rights reserved.

Cervical spondylotic myelopathy caused by violent motor tics in a child with Tourette syndrome.

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Ko, Da-Young; Kim, Seung-Ki; Chae, Jong-Hee; Wang, Kyu-Chang; Phi, Ji Hoon

2013-02-01

We report a case of a 9-year-old boy with Tourette syndrome (TS) who developed progressive quadriparesis that was more severe in the upper extremities. He had experienced frequent and violent motor tics consisting of hyperflexion and hyperextension for years. Magnetic resonance imaging (MRI) revealed a focal high-signal intensity cord lesion and adjacent cervical spondylotic changes. Initially, the patient was observed for several months because of diagnostic uncertainty; his neurological status had improved and later worsened again. Anterior cervical discectomy of C3-4 and fusion immediately followed by posterior fixation were performed. After surgery, the neck collar was applied for 6 months. His neurological signs and symptoms improved dramatically. TS with violent neck motion may cause cervical spondylotic myelopathy at an early age. The optimal management is still unclear and attempts to control tics should be paramount. Circumferential fusion with neck bracing represents a viable treatment option.

A study on the hollow-out radiation technique applied to the protection of the spinal cord

International Nuclear Information System (INIS)

Matsuda, Tadayoshi

1975-01-01

The hollow-out radiation technique to protect the spinal cord in linear accelerator X-ray treatment of malignant diseases has been established in this study. Several kinds of diseases were selected as the subjects of the hollow-out technique to protect the cervical spinal cord, thoracic spinal cord, and dorsolumbar spinal cord from radiation, plus fundamental data, such as the materials, shapes and sizes of absorber, which are most appropriate for each of the diseases, were established. In all the cases receiving this technique, the necessary areas of therapy are covered by 80-90% dose distribution and the radiation dose of the spinal cord is kept below 40%. The fundamental data and irradiation conditions for the hollow-out technique of every part of the spinal cord were arranged from the results of phantom examinations on every part of the human body and from 42 cases actually treated. In the present study, the hollow-out technique for the cervical spinal cord, thoracic spinal cord, and dorsolumbar spinal cord is divided into 5 categories, and a method for the planning of radiation therapy and the actual treatment are described. The hollow-out radiation technique on the spinal cord is useful radiation therapy which can give better results by preventing radiation myelopathy. (auth.)

Impact of Cervical Sagittal Alignment on Axial Neck Pain and Health-related Quality of Life After Cervical Laminoplasty in Patients With Cervical Spondylotic Myelopathy or Ossification of the Posterior Longitudinal Ligament: A Prospective Comparative Study.

Science.gov (United States)

Fujiwara, Hiroyasu; Oda, Takenori; Makino, Takahiro; Moriguchi, Yu; Yonenobu, Kazuo; Kaito, Takashi

2018-05-01

This is prospective observational study. To prospectively investigate the correlation among axial neck pain; a newly developed patient-based quality of life outcome measure, the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ); and cervical sagittal alignment after open-door laminoplasty for cervical myelopathy. Many studies have focused on postoperative axial neck pain after laminoplasty. However, the correlation among cervical sagittal alignment, neck pain, and JOACMEQ has not been investigated. In total, 57 consecutive patients treated by open-door laminoplasty for cervical myelopathy were included (mean age, 63.7 y; 15 women and 42 men) and divided into 2 groups according to diagnosis [cervical spondylotic myelopathy (CSM) group: 35 patients, and ossification of the posterior longitudinal ligament (OPLL) group: 22 patients]. JOA score, a subdomain of cervical spine function (CSF) in the JOACMEQ, and the visual analog scale for axial neck pain were assessed preoperatively and 12 months postoperatively. Radiographic cervical sagittal parameters were measured by C2 sagittal vertical axis (C2 SVA), C2-C7 lordosis, C7 sagittal slope (C7 slope), and range of motion. C2 SVA values in both groups shifted slightly anteriorly between preoperative and 12-month postoperative measurements (CSM: +19.7±10.9 mm; OPLL: +22.1±13.4 mm vs. CSM: +23.2±16.1 mm; OPLL: +28.7±15.4 mm, respectively). Postoperative axial neck pain in the OPLL group showed strong negative correlations with C2 SVA and C7 slope. Strong negative correlations were found between axial neck pain and CSF in both the preoperative CSM and OPLL groups (CSM: r=-0.45, P=0.01; OPLL: r=-0.61, Ppain and CSF in the postoperative OPLL group (r=-0.51, P=0.05). This study demonstrated a significant negative correlation between neck pain and CSF in both the CSM and OPLL groups preoperatively and in the OPLL group postoperatively. Radiographic cervical sagittal alignment

Possible etiologies for tropical spastic paraparesis and human T lymphotropic virus I-associated myelopathy

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V. Zaninovic'

2004-01-01

Full Text Available The epidemiology of tropical spastic paraparesis/human T lymphotropic virus I (HTLV-I-associated myelopathy (TSP/HAM is frequently inconsistent and suggests environmental factors in the etiology of these syndromes. The neuropathology corresponds to a toxometabolic or autoimmune process and possibly not to a viral disease. Some logical hypotheses about the etiology and physiopathology of TSP and HAM are proposed. Glutamate-mediated excitotoxicity, central distal axonopathies, cassava, lathyrism and cycad toxicity may explain most cases of TSP. The damage caused to astrocytes and to the blood-brain barrier by HTLV-I plus xenobiotics may explain most cases of HAM. Analysis of the HTLV-I/xenobiotic ratio clarifies most of the paradoxical epidemiology of TSP and HAM. Modern neurotoxicology, neuroimmunology and molecular biology may explain the neuropathology of TSP and HAM. It is quite possible that there are other xenobiotics implicated in the etiology of some TSP/HAMs. The prevention of these syndromes appears to be possible today.

Biotinidase deficiency presenting as recurrent myelopathy in a 7-year-old boy and a review of the literature.

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Raha, Sarbani; Udani, Vrajesh

2011-10-01

Biotinidase deficiency may produce variable neurologic manifestations. Brainstem and spinal cord disease comprises an uncommon presentation of biotinidase deficiency. We describe a 7-year old boy with subacute progressive quadriplegia and "sighing" respirations. Severe biotinidase deficiency was established, and the patient demonstrated complete recovery with biotin supplementation. Genetic studies revealed presence of homozygous mutation in the BTD gene [c.133C>T (p.H447Y)]. Biotinidase deficiency should be considered in the differential diagnosis for subacute, long segment myelopathy, particularly with brainstem involvement. This entity is treatable; a high index of suspicion can be life-saving. We also review the literature on biotinidase deficiency presenting as spinal cord demyelinating disease. Copyright © 2011 Elsevier Inc. All rights reserved.

A Brazilian Portuguese cross-cultural adaptation of the modified JOA scale for myelopathy.

Science.gov (United States)

Pratali, Raphael R; Smith, Justin S; Motta, Rodrigo L N; Martins, Samuel M; Motta, Marcel M; Rocha, Ricardo D; Herrero, Carlos Fernando P S

2017-02-01

To develop a version of the modified Japanese Orthopaedic Association (mJOA) scale that had been translated into Portuguese and cross-culturally adapted for the Brazilian population. The well-established process of forward-backward translation was employed along with cross-cultural adaptation. Three bilingual translators (English and native Portuguese) performed the forward translation of the mJOA scale from English to Portuguese based on iterative discussions used to reach a consensus translation. The translated version of the mJOA scale was then back-translated into English by a native English-speaking translator unaware of the concepts involved with the mJOA scale. The original mJOA scale and the back-translated version were compared by a native North American neurosurgeon, and as they were considered equivalent, the final version of the mJOA scale that had been translated into Portuguese and cross-culturally adapted was defined. To facilitate global and cross-cultural comparisons of the severity of cervical myelopathy, this study presents a version of the mJOA scale that was translated into Portuguese and cross-culturally adapted for the Brazilian population.

Prediction of myelopathic level in cervical spondylotic myelopathy using diffusion tensor imaging.

Science.gov (United States)

Wang, Shu-Qiang; Li, Xiang; Cui, Jiao-Long; Li, Han-Xiong; Luk, Keith D K; Hu, Yong

2015-06-01

To investigate the use of a newly designed machine learning-based classifier in the automatic identification of myelopathic levels in cervical spondylotic myelopathy (CSM). In all, 58 normal volunteers and 16 subjects with CSM were recruited for diffusion tensor imaging (DTI) acquisition. The eigenvalues were extracted as the selected features from DTI images. Three classifiers, naive Bayesian, support vector machine, and support tensor machine, and fractional anisotropy (FA) were employed to identify myelopathic levels. The results were compared with clinical level diagnosis results and accuracy, sensitivity, and specificity were calculated to evaluate the performance of the developed classifiers. The accuracy by support tensor machine was the highest (93.62%) among the three classifiers. The support tensor machine also showed excellent capacity to identify true positives (sensitivity: 84.62%) and true negatives (specificity: 97.06%). The accuracy by FA value was the lowest (76%) in all the methods. The classifiers-based method using eigenvalues had a better performance in identifying the levels of CSM than the diagnosis using FA values. The support tensor machine was the best among three classifiers. © 2014 Wiley Periodicals, Inc.

Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

International Nuclear Information System (INIS)

Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa

1994-01-01

HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after 131 I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after 131 I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after 131 I therapy.(author)

Anterior cervical discectomy and fusion for the management of axial neck pain in the absence of radiculopathy or myelopathy

Science.gov (United States)

Riew, K Daniel; Ecker, Erika; Dettori, Joseph R.

2010-01-01

Study design: Systematic review Study rationale: Anterior cervical discectomy and fusion (ACDF) is a proven, effective treatment for relieving neck pain due to degenerative conditions of the cervical spine. Since most patients also present with radiculopathy or myelopathy, little is known as to the effectiveness of ACDF to relieve pain and improve function in patients without radicular or myelopathic symptoms. Objective: To examine the clinical outcome in patients undergoing (ACDF) for axial neck pain without radicular or myelopathic symptoms. Methods: A systematic review was undertaken for articles published up to March 2010. Electronic databases and reference lists of key articles were searched to identify studies evaluating ACDF for the treatment of axial neck pain only. Radiculopathy and myelopathy, patients who suffered severe trauma, or with tumor/metastatic disease or infection were excluded. Two independent reviewers assessed the strength of evidence using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus. Results: No comparative studies were identified. Three case series met our inclusion criteria and were evaluated. All studies showed a mean improvement of pain of at least 50% approximately 4-years following surgery. Functional outcomes improved between 32% and 52% from baseline. Most patients reported satisfaction with surgery, 56% in one study and 79% in another. Complications varied among studies ranging from 1% to 10% and included pseudoarthrosis (9%), nonunion and revision (3%) and screw removal (1%). Conclusion: There is low evidence suggesting that patients with axial neck pain without radicular or myelopathic symptoms may receive some improvement in pain and function following ACDF. However, whether this benefit is greater than nontreatment or other treatments cannot be determined with the present literature. PMID:22956927

Laminoplasty Does not Lead to Worsening Axial Neck Pain in the Properly Selected Patient With Cervical Myelopathy: A Comparison With Laminectomy and Fusion.

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Stephens, Byron F; Rhee, John M; Neustein, Thomas M; Arceo, Rafael

2017-12-15

Retrospective cohort study of prospectively collected data. To determine if laminoplasty (LP) is associated with worsening axial neck pain in patients with multilevel cervical myelopathy, and to compare neck pain, clinical outcomes, and radiographic measures in a group undergoing laminectomy and fusion (LF). Postoperative new or worsening axial neck pain is commonly cited as a major disadvantage of laminoplasty. However, there remains a paucity of corroborative data from large series. Following institutional review board approval, we reviewed the medical records, radiographs, and prospective clinical outcomes database of 85 patients undergoing LP and 52 patients undergoing LF for cervical myelopathy with minimum 1-year radiographic follow-up and average clinical follow-up of 18.5 months. LP was performed in those with neutral to lordotic C2-7 alignment and who did not complain of diffuse axial pain. Otherwise, LF was performed. Clinical outcomes included visual analogue score (VAS)-neck pain, VAS-total pain, neck disability index (NDI), short form 36, modified Japanese Orthopaedic Association (mJOA), and several radiographic parameters. VAS-neck did not worsen in LP (-0.2, P = 0.54) and did improve in LF (-2.0, P = 0.0013). VAS-total improved significantly in both groups (LF -1.04 ± 0.52, P = 0.05; LP -1.4 ± 0.51, P = 0.008). NDI improved in both groups, but was significant in only LP (LP decreased 6.79 ± 2.25, P = 0.0032; LF decreased 4.01 ± 3.05, P = 0.19). mJOA scores improved significantly in both groups (LP improved 2.89 ± 0.27, P cervical lordosis in both groups that was significant in LP (LP 2.92° loss, P = 0.0181; LF 1.25° loss, P = 0.53). In a carefully selected group of myelopathic patients without significant diffuse axial pain preoperatively and appropriate sagittal alignment, laminoplasty did not lead to worsening axial neck pain, and it was associated with significant improvements in other

Impact of Cervical Spine Deformity on Preoperative Disease Severity and Postoperative Outcomes Following Fusion Surgery for Degenerative Cervical Myelopathy: Sub-analysis of AOSpine North America and International Studies.

Science.gov (United States)

Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

2018-02-15

Sub-analysis of the prospective AOSpine CSM North America and International studies. The aim of this study was to investigate the impact of cervical spine deformity on pre- and postoperative outcomes in fusion surgeries for degenerative cervical myelopathy. The associations between cervical alignment and patient outcomes have been reported but are not well established in a myelopathy cohort. The impact of deformity correction in this population also needs to be elucidated. A total of 757 patients were enrolled in two prospective international multicenter AOSpine studies. Among those who underwent anterior or posterior fusion surgeries, pre- and 1-year postoperative upright neutral lateral radiographs of cervical spine were investigated to measure C2-7 Cobb angle and C2-7 sagittal vertical axis (SVA). Patient outcome measures included the modified Japanese Orthopedic Association score for myelopathy severity, Neck Disability Index (NDI), and Short-form 36 (SF-36). These scores were compared between patients with and without cervical deformity, which was defined as C2-7 Cobb >10° kyphosis and/or SVA >40 mm. A total of 178 patients were included with complete pre- and postoperative radiographs. SVA significantly increased postoperatively (27.4 vs. 30.7 mm, P = 0.004). All outcome measurement showed significant improvements above minimal clinically important differences. 23.6% of the patients had cervical deformity preoperatively; preoperative deformity was associated with worse preoperative NDI scores (45.7 vs. 38.9, P = 0.04). Postoperatively, those with deformity exhibited significantly lower SF-36 physical component scores (37.2 vs. 41.4, P = 0.048). However, when focusing on the preoperatively deformed cohort, we did not find any significant differences in the postoperative outcome scores between those with and without residual deformity. There was a significant association between cervical deformity and both preoperative disease severity and

Proprioceptive neuromuscular facilitation in HTLV-I-associated myelopathy/tropical spastic paraparesis

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Vera Lúcia Santos de Britto

2014-01-01

Full Text Available Introduction: Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF and to compare two methods of treatment delivery. Methods: Fourteen patients with human T cell lymphotropic virus type I (HTLV-I were randomly allocated into two groups. In group I (seven patients, PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients, PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modified Ashworth scale, the functional independence measure (FIM and the timed up and go test (TUG were assessed before and after the interventions. Results: In the within-group evaluation, low-back pain was significantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I. Conclusions: Both PNF protocols were effective in treating patients with HAM/TSP.

Reliability of surface electromyography timing parameters in gait in cervical spondylotic myelopathy.

LENUS (Irish Health Repository)

Malone, Ailish

2012-02-01

The aims of this study were to validate a computerised method to detect muscle activity from surface electromyography (SEMG) signals in gait in patients with cervical spondylotic myelopathy (CSM), and to evaluate the test-retest reliability of the activation times designated by this method. SEMG signals were recorded from rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and medial gastrocnemius (MG), during gait in 12 participants with CSM on two separate test days. Four computerised activity detection methods, based on the Teager-Kaiser Energy Operator (TKEO), were applied to a subset of signals and compared to visual interpretation of muscle activation. The most accurate method was then applied to all signals for evaluation of test-retest reliability. A detection method based on a combined slope and amplitude threshold showed the highest agreement (87.5%) with visual interpretation. With respect to reliability, the standard error of measurement (SEM) of the timing of RF, TA and MG between test days was 5.5% stride duration or less, while the SEM of BF was 9.4%. The timing parameters of RF, TA and MG designated by this method were considered sufficiently reliable for use in clinical practice, however the reliability of BF was questionable.

A Brazilian Portuguese cross-cultural adaptation of the modified JOA scale for myelopathy

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Raphael R. Pratali

Full Text Available OBJECTIVES: To develop a version of the modified Japanese Orthopaedic Association (mJOA scale that had been translated into Portuguese and cross-culturally adapted for the Brazilian population. METHODS: The well-established process of forward-backward translation was employed along with cross-cultural adaptation. RESULTS: Three bilingual translators (English and native Portuguese performed the forward translation of the mJOA scale from English to Portuguese based on iterative discussions used to reach a consensus translation. The translated version of the mJOA scale was then back-translated into English by a native English-speaking translator unaware of the concepts involved with the mJOA scale. The original mJOA scale and the back-translated version were compared by a native North American neurosurgeon, and as they were considered equivalent, the final version of the mJOA scale that had been translated into Portuguese and cross-culturally adapted was defined. CONCLUSION: To facilitate global and cross-cultural comparisons of the severity of cervical myelopathy, this study presents a version of the mJOA scale that was translated into Portuguese and cross-culturally adapted for the Brazilian population.

Magnetic resonance imaging findings of HTLV-I-associated myelopathy

Energy Technology Data Exchange (ETDEWEB)

Furukawa, Yoshitaka; Une, Humiho; Osame, Mitsuhiro

1989-02-01

Magnetic resonance imaging (MRI) of the brain was evaluated in 12 HAM (HTLV-I-associated myelopathy) patients (4 males and 8 females, mean age of 54 yrs) and compaired with 36 non-HAM controls (16 males and 20 females mean age of 52yrs). MRI of the brain was performed using a 0.5 Tesla superconducting unit. Imaging in all patients was done with the long spin echo (TR=2,000msec, TE=100msec) sequences, and 10mm contiguous axial slices of the entire brain were obtained in all cases. Except for two cases, MRI of the brain was abnormal in 10 (83%) HAM patients, while in controls, 18 (50%) cases were abnormal. The abnormalities were high intensity lesions through SE 2000/100 sequences (T/sub 2/ weighted image), and consisted of small isolated hemisphere lesions in 9 patients, periventricular changes in 9 patients, bilateral thalamic lesions in 2 patients and pontine lesions in 3 patients. We found that the factor of age was very important. In patients with ages below 59 yrs, 6 of 8 HAM patients (75%) had abnormalities, while in control cases, 6 of 23 (23%) had abnormalities in periventricular area. And in isolated hemisphere, 6 of 8 HAM patients (75%) had abnormalities, while in control cases, 3 of 23 (13%) had abnormalities. On the other hand, in patients with ages over 60 yrs, 3 of 4 (75%) HAM patients had abnormalities in periventricular area, while in controls, 10 of 13 cases (77%) had abnormalities, and in isolated hemisphere, 3 of 4 (75%) HAM patients had abnormalities, and in controls, 10 of 13 cases (77%) had abnormalities. Our data suggest that HAM patients with ages below 59 years will show a greater percentage of abnormalities than controls. (author).

Magnetic resonance imaging findings of HTLV-I-associated myelopathy

International Nuclear Information System (INIS)

Furukawa, Yoshitaka; Une, Humiho; Osame, Mitsuhiro

1989-01-01

Magnetic resonance imaging (MRI) of the brain was evaluated in 12 HAM (HTLV-I-associated myelopathy) patients (4 males and 8 females, mean age of 54 yrs) and compaired with 36 non-HAM controls (16 males and 20 females mean age of 52yrs). MRI of the brain was performed using a 0.5 Tesla superconducting unit. Imaging in all patients was done with the long spin echo (TR=2,000msec, TE=100msec) sequences, and 10mm contiguous axial slices of the entire brain were obtained in all cases. Except for two cases, MRI of the brain was abnormal in 10 (83%) HAM patients, while in controls, 18 (50%) cases were abnormal. The abnormalities were high intensity lesions through SE 2000/100 sequences (T 2 weighted image), and consisted of small isolated hemisphere lesions in 9 patients, periventricular changes in 9 patients, bilateral thalamic lesions in 2 patients and pontine lesions in 3 patients. We found that the factor of age was very important. In patients with ages below 59 yrs, 6 of 8 HAM patients (75%) had abnormalities, while in control cases, 6 of 23 (23%) had abnormalities in periventricular area. And in isolated hemisphere, 6 of 8 HAM patients (75%) had abnormalities, while in control cases, 3 of 23 (13%) had abnormalities. On the other hand, in patients with ages over 60 yrs, 3 of 4 (75%) HAM patients had abnormalities in periventricular area, while in controls, 10 of 13 cases (77%) had abnormalities, and in isolated hemisphere, 3 of 4 (75%) HAM patients had abnormalities, and in controls, 10 of 13 cases (77%) had abnormalities. Our data suggest that HAM patients with ages below 59 years will show a greater percentage of abnormalities than controls. (author)

Neurological manifestations in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis in the Amazon.

Science.gov (United States)

Dias, G A S; Yoshikawa, G T; Koyama, R V L; Fujihara, S; Martins, L C S; Medeiros, R; Quaresma, J A S; Fuzii, H T

2016-02-01

A cross-sectional observational study was conducted. The aim was to analyze the clinical-functional profile of patients diagnosed with HTLV-1 (human T-lymphotropic virus type 1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in the Amazon region. Reference center for HTLV in the city of Belém, state of Pará, Brazil. Muscle strength, muscle tone, balance and the need for gait assistance among patients with HAM/TSP were evaluated. Among the 82 patients infected with HTLV-1, 27 (10 men and 17 women) were diagnosed with HAM/TSP. No statistically significant difference in muscle tone or strength was found between the lower limbs. Muscle weakness and spasticity were predominant in the proximal lower limbs. Patients with HAM/TSP are at a high risk of falls (P=0.03), and predominantly use either a cane or a crutch on one side as a gait-assistance device (P=0.02). Patients with HAM/TSP exhibit a similar clinical pattern of muscle weakness and spasticity, with a high risk of falls, requiring gait-assistance devices.

Reshaping of Gait Coordination by Robotic Intervention in Myelopathy Patients After Surgery

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Puentes, Sandra; Kadone, Hideki; Kubota, Shigeki; Abe, Tetsuya; Shimizu, Yukiyo; Marushima, Aiki; Sankai, Yoshiyuki; Yamazaki, Masashi; Suzuki, Kenji

2018-01-01

The Ossification of the Posterior Longitudinal Ligament (OPLL) is an idiopathic degenerative spinal disease which may cause motor deficit. For patients presenting myelopathy or severe stenosis, surgical decompression is the treatment of choice; however, despite adequate decompression residual motor impairment is found in some cases. After surgery, there is no therapeutic approach available for this population. The Hybrid Assistive Limb® (HAL) robot suit is a unique powered exoskeleton designed to predict, support, and enhance the lower extremities performance of patients using their own bioelectric signals. This approach has been used for spinal cord injury and stroke patients where the walking performance improved. However, there is no available data about gait kinematics evaluation after HAL therapy. Here we analyze the effect of HAL therapy in OPLL patients in acute and chronic stages after decompression surgery. We found that HAL therapy improved the walking performance for both groups. Interestingly, kinematics evaluation by the analysis of the elevation angles of the thigh, shank, and foot by using a principal component analysis showed that planar covariation, plane orientation, and movement range evaluation improved for acute patients suggesting an improvement in gait coordination. Being the first study performing kinematics analysis after HAL therapy, our results suggest that HAL improved the gait coordination of acute patients by supporting the relearning process and therefore reshaping their gait pattern. PMID:29551960

The relationship between cervical lordosis and Nurick scores in patients undergoing circumferential vs. posterior alone cervical decompression, instrumentation and fusion for treatment of cervical spondylotic myelopathy.

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Patel, Shalin; Glivar, Phillip; Asgarzadie, Farbod; Cheng, David Juma Wayne; Danisa, Olumide

2017-11-01

The loss of regional cervical sagittal alignment and the progressive development of cervical kyphosis is a factor in the advancement of myelopathy. Adequate decompression of the spinal canal along with reestablishment of cervical lordosis are desired objective with regard to the surgical treatment of patients with cervical spondylotic myelopathy. A retrospective chart review was conducted in which patients who underwent either a combined anterior/posterior instrumentation and decompression or a posterior alone instrumentation and decompression for the treatment of CSM at our institution were identified. Any patient undergoing operative intervention for trauma, infection or tumors were excluded. Similarly, patients undergoing posterior instrumentation with constructs extending beyond the level of C2-C7 were similarly excluded from this study. A total of 67 patients met the inclusion criteria for this study. A total of 32 patients underwent posterior alone surgery and the remaining 35 underwent combined anterior/posterior procedure. Radiographic evaluation of patient's preoperative and postoperative cervical lordosis as measured by the C2-C7 Cobb angle was performed. Each patient's preoperative and postoperative functional disability as enumerated by the Nurick score was also recorded. Statistical analysis was conducted to determine if there was a significant relationship between improvement in cervical lordosis and improvement in patient's clinical outcomes as enumerated by the Nurick Score in patients undergoing posterior alone versus combined anterior/posterior decompression, instrumentation and fusion of the cervical spine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

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Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

1994-09-01

HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

The correlation between evoked spinal cord potentials and magnetic resonance imaging before Surgery in cervical spondylotic myelopathy

International Nuclear Information System (INIS)

Akashi, Kosuke; Kanchiku, Tsukasa; Taguchi, Toshihiko; Kato, Yoshihiko; Imajo, Yasuaki; Suzuki, Hidenori

2010-01-01

The purpose of this study is to clarify the correlation between electrophysiological examination and MRI diagnosis. Twenty-four patients with cervical spondylotic myelopathy were examined with magnetic resonance imaging and evoked spinal cord potentials (ESCPs) before surgery. In all the patients, only the intervertebral level was symptomatic, as shown by ESCPs. ESCPs following median nerve stimulation (MN-ESCPs), transcranial electric stimulation (TCE-ESCPs), and spinal cord stimulation (Spinal-ECSPs) were recorded. The patients were grouped into two groups as follows: group A, all ESCPs were abnormal; group B, normal spinal cord stimulation. Spinal cord transverse area and compression ratio (central and 1/4-lateral anteroposterior diameter divided by transverse diameter) were measured on T1-weighted axial imaging, with abnormal ESCPs as indicators of spinal cord morphology. Central and 1/4-lateral compression ratio was significantly lower in group A. Spinal cord morphology of magnetic resonance imaging is useful for functional diagnosis. (author)

Imaging spinal cord atrophy in progressive myelopathies: HTLV-I-associated neurological disease (HAM/TSP) and multiple sclerosis (MS).

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Azodi, Shila; Nair, Govind; Enose-Akahata, Yoshimi; Charlip, Emily; Vellucci, Ashley; Cortese, Irene; Dwyer, Jenifer; Billioux, B Jeanne; Thomas, Chevaz; Ohayon, Joan; Reich, Daniel S; Jacobson, Steven

2017-11-01

Previous work measures spinal cord thinning in chronic progressive myelopathies, including human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and multiple sclerosis (MS). Quantitative measurements of spinal cord atrophy are important in fully characterizing these and other spinal cord diseases. We aimed to investigate patterns of spinal cord atrophy and correlations with clinical markers. Spinal cord cross-sectional area was measured in individuals (24 healthy controls [HCs], 17 asymptomatic carriers of HTLV-1 (AC), 47 HAM/TSP, 74 relapsing-remitting MS [RRMS], 17 secondary progressive MS [SPMS], and 40 primary progressive MS [PPMS]) from C1 to T10. Clinical disability scores, viral markers, and immunological parameters were obtained for patients and correlated with representative spinal cord cross-sectional area regions at the C2 to C3, C4 to C5, and T4 to T9 levels. In 2 HAM/TSP patients, spinal cord cross-sectional area was measured over 3 years. All spinal cord regions are thinner in HAM/TSP (56 mm 2 [standard deviation, 10], 59 [10], 23 [5]) than in HC (76 [7], 83 [8], 38 [4]) and AC (71 [7], 78 [9], 36 [7]). SPMS (62 [9], 66 [9], 32 [6]) and PPMS (65 [11], 68 [10], 35 [7]) have thinner cervical cords than HC and RRMS (73 [9], 77 [10], 37 [6]). Clinical disability scores (Expanded Disability Status Scale [p = 0.009] and Instituto de Pesquisas de Cananeia [p = 0.03]) and CD8 + T-cell frequency (p = 0.04) correlate with T4 to T9 spinal cord cross-sectional area in HAM/TSP. Higher cerebrospinal fluid HTLV-1 proviral load (p = 0.01) was associated with thinner spinal cord cross-sectional area. Both HAM/TSP patients followed longitudinally showed thoracic thinning followed by cervical thinning. Group average spinal cord cross-sectional area in HAM/TSP and progressive MS show spinal cord atrophy. We further hypothesize in HAM/TSP that is possible that neuroglial loss from a thoracic inflammatory

Cardiovascular risk profile in patients with myelopathy associated with HTLV-1.

Science.gov (United States)

Prado, Fabio Luís Silva do; Prado, Renata; Ladeia, Ana Marice Teixeira

HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis) is a slowly progressive disease, characterized by a chronic spastic paraparesis. It is not known if the disease carries an independent risk for cardiovascular disease. The objective of this study was to evaluate the cardiovascular risk profile related to HAM/TSP and compare it with the general population. This was a cross-sectional study, with a control group. HAM/TSP patients were evaluated using cardiovascular risk scores (ASCVD RISK, SCORE and Framingham) and inflammatory markers (ultrasensitive CRP and IL-6), and compared with a control group of healthy individuals. We also evaluated the correlation between cardiovascular risk and the functional status of patients with HAM/TSP evaluated by the FIM scale. Eighty percent of patients in this study were females, mean age of 51 years (11.3). The control group showed an increased cardiovascular event risk in 10 years when ASCVD was analyzed (cardiovascular risk ≥7.5% in 10 years seen in 43% of patients in the control group vs. 23% of patients with HAM/TSP; p=0.037). There was no difference in ultrasensitive CRP or IL-6 values between the groups, even when groups were stratified into low and high risk. There was no correlation between the functional status of HAM/TSP patients and the cardiovascular risk. In this study, the cardiovascular risk profile of patients with HAM/TSP was better than the risk of the control group. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Essential role of radiation therapy for the treatment of pancreatic cancer. Novel study concepts and established treatment recommendations

Energy Technology Data Exchange (ETDEWEB)

Dobiasch, Sophie [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Goerig, Nicole L.; Fietkau, Rainer [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Universitaetsklinikum Erlangen, Erlangen (Germany); Combs, Stephanie E. [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Neuherberg (Germany)

2018-03-15

Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. (orig.) [German] Das Pankreaskarzinom gehoert zu den aggressivsten menschlichen Tumoren und verzeichnete in den letzten 6 Jahren eine steigende Inzidenz. Die Diagnose wird meist erst im fortgeschrittenen Stadium gestellt; dies schliesst haeufig eine primaer kurative Intervention mithilfe der chirurgischen Resektion aus und bedingt die hohe Mortalitaet. Obwohl die Strahlentherapie im multimodalen Therapieansatz des Pankreaskarzinoms eine zentrale Saeule darstellt, wird die Rolle der Strahlentherapie in der Literatur kontrovers diskutiert. Der vorliegende Beitrag bietet eine Uebersicht moderner Bestrahlungsstrategien im interdisziplinaeren Konzept gemaess der Leitlinien der American Society of Clinical Oncology (ASCO) im Vergleich zu den

Experimental and numerical examination of the unsteady flow in an axial turbine; Experimentelle und numerische Untersuchung der instationaeren Stroemung in einer Axialturbine

Energy Technology Data Exchange (ETDEWEB)

Gentner, C.

2000-07-01

The periodic instationary flow in guidevanes and runner of an axial hydraulic turbine is examined experimentally and numerically. The study is carried out at three different points of operation. The experimental study comprises the measurement of the velocity of the flow at midspan using a single channel Laser Doppler Velocimeter and the acquisition of the ozillating pressure at several locations in the casing. The unsteady numerical examination is carried out in a two dimensional plane at midspan of the runnerblades. The interaction between guidevanes and runner is taken into account by exchanging the flow properties at the adjoining edges of the two calculation grids. Further the influence of the tip clearance flow on the characteristics of the turbine is studied numerically by means of a three dimensional steady state calculation. The comparison of the results of measurement and calculation shows the abilities and the limitations of the applied numerical method. Moreover the results are helpful for the optimisation of the turbine with regard to higher efficiency and reduced cavitation. (orig.) [German] Die periodisch instationaere Stroemung in Leit- und Laufrad einer hydraulischen Axialturbine zur Druckentspannung in Rohrleitungssystemen wird fuer drei Betriebspunkte experimentell und rechnerisch untersucht. Die experimentelle Untersuchung umfasst die zeitaufgeloeste Messung der Stroemungsgeschwindigkeiten mit einem Laser-Doppler-Velozimeter im Mittelschnitt und die Erfassung des periodisch schwankenden Drucks an mehreren Punkten an der Gehaeusewand. Die instationaere numerische Untersuchung erfolgt in einem zweidimensionalen Zylinderschnitt im mittleren Durchmesser der Laufschaufeln. Die Wechselwirkung zwischen Leit- und Laufrad wird druch den Austausch der Stroemungsgroessen mittels eines Kopplungsalgorithmus an der Stossflaeche zwischen den zwei gegeneinander bewegten Berechnungsgittern erfasst. Darueber hinaus wird in einer dreidimensionalen stationaeren

Clinical pathophysiology of human T-lymphotropic virus-type1-associated myelopathy/tropical spastic paraparesis

Directory of Open Access Journals (Sweden)

Yoshihisa eYamano

2012-11-01

Full Text Available Human T-lymphotropic virus type 1 (HTLV-1, a human retrovirus, is the causative agent of a progressive neurological disease termed HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP. HAM/TSP is a chronic inflammatory disease of the central nervous system and is characterized by unremitting myelopathic symptoms such as spastic paraparesis, lower limb sensory disturbance, and bladder/bowel dysfunction. Approximately 0.25%–3.8% of HTLV-1-infected individuals develop HAM/TSP, which is more common in women than in men. Since the discovery of HAM/TSP, significant advances have been made with respect to elucidating the virological, molecular, and immunopathological mechanisms underlying this disease. These findings suggest that spinal cord invasion by HTLV-1-infected T cells triggers a strong virus-specific immune response and increases proinflammatory cytokine and chemokine production, leading to chronic lymphocytic inflammation and tissue damage in spinal cord lesions. However, little progress has been made in the development of an optimal treatment for HAM/TSP, more specifically in the identification of biomarkers for predicting disease progression and of molecular targets for novel therapeutic strategies targeting the underlying pathological mechanisms. This review summarizes current clinical and pathophysiological knowledge on HAM/TSP and discusses future focus areas for research on this disease.

Facetal distraction as treatment for single- and multilevel cervical spondylotic radiculopathy and myelopathy: a preliminary report.

Science.gov (United States)

Goel, Atul; Shah, Abhidha

2011-06-01

The authors discuss their successful preliminary experience with 36 cases of cervical spondylotic disease by performing facetal distraction using specially designed Goel cervical facet spacers. The clinical and radiological results of treatment are analyzed. The mechanism of action of the proposed spacers and the rationale for their use are evaluated. Between 2006 and February 2010, 36 patients were treated using the proposed technique. Of these patients, 18 had multilevel and 18 had single-level cervical spondylotic radiculopathy and/or myelopathy. The average follow-up period was 17 months with a minimum of 6 months. The Japanese Orthopaedic Association classification system, visual analog scale (neck pain and radiculopathy), and Odom criteria were used to monitor the clinical status of the patient. The patients were prospectively analyzed. The technique of surgery involved wide opening of the facet joints, denuding of articular cartilage, distraction of facets, and forced impaction of Goel cervical facet spacers into the articular cavity. Additionally, the interspinous process ligaments were resected, and corticocancellous bone graft from the iliac crest was placed and was stabilized over the adjoining laminae and facets after adequately preparing the host bone. Eighteen patients underwent single-level, 6 patients underwent 2-level, and 12 patients underwent 3-level treatment. The alterations in the physical architecture of spine and canal dimensions were evaluated before and after the placement of intrafacet joint spacers and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of pain, radiculopathy, and myelopathy. Analysis of radiological features suggested that the distraction of facets with the spacers resulted in an increase in the intervertebral foraminal dimension (mean 2.2 mm), an increase in the height of the intervertebral disc space (range 0.4-1.2 mm), and an increase in the interspinous distance (mean 2

CT Chest and pulmonary functional changes in patients with HTLV-associated myelopathy in the Eastern Brazilian Amazon.

Directory of Open Access Journals (Sweden)

Luiz Fábio Magno Falcão

Full Text Available The aim of this study was to compare computed tomography (CT scans of chest and lung function among patients with Human T-Lymphotropic Virus Type 1 (HTLV with and without HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP. In this cross-sectional study performed between January 2013 and June 2016, we included 48 patients with HAM/TSP (19 women and 11 men and without HAM/TSP (12 women and 6 men. We compared CT findings and lung functions of these groups. Patients who had HAM/TSP had abnormal CT findings (P = 0.000, including more frequent bronchiectasis (P = 0.049, parenchymal bands (P = 0.007, interlobular septal thickening (P = 0.035, and pleural thickening (P = 0.009. In addition, neither patients with HAM/TSP (9/30; 30% nor the controls (0/18; 0% had obstructive or restrictive lung disease (P = 0.009. HTLV diagnosis should be considered in all patients with abnormal CT findings in whom no other cause is apparent. It is important to remember that lung disease increases the rates of morbidity and mortality in developing countries.

Experimental radiotherapy and clinical radiobiology. Vol. 16; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 16. Proceedings

Energy Technology Data Exchange (ETDEWEB)

Baumann, M; Dahm-Daphi, J; Dikomey, E; Petersen, C; Rodemann, H P; Zips, D [eds.

2007-07-01

The following topics were dealt with: DNA repair as therapeutical target in radiation therapy, biological imaging and tumor microenvironment, molecular factors of radiation therapy, molecular factors and modulation of the radiation reaction of normal tissues, experimental tumor therapy, EGFR inhibition, the endothel cell as primary target of radiation therapy, molecular and cellular foundations of the radiation biology of protons and ions. (HSI)

Reproducibility, temporal stability, and functional correlation of diffusion MR measurements within the spinal cord in patients with asymptomatic cervical stenosis or cervical myelopathy.

Science.gov (United States)

Ellingson, Benjamin M; Salamon, Noriko; Woodworth, Davis C; Yokota, Hajime; Holly, Langston T

2018-05-01

OBJECTIVE The purpose of this study was to quantify the reproducibility, temporal stability, and functional correlation of diffusion MR characteristics in the spinal cord in patients with cervical stenosis with or without myelopathy. The association between longitudinal diffusion tensor imaging (DTI) measurements and serial neurological function assessment was explored at both the group and individual level. METHODS Sixty-six nonoperatively treated patients with cervical stenosis were prospectively followed (3 months to > 5 years) using synchronous serial MRI and functional outcome assessment. A total of 183 separate MRI examinations were performed, separated by at least 3 months, and each patient had a minimum of 2 MRI scans (range 2-5 scans). Anatomical and DTI measurements were performed within the spinal cord at the C1-2 region as well as at the area of highest compression. Coefficients of variance (COVs) were compared across measurements in both reference tissue and areas of compression for anatomical measurements, fractional anisotropy (FA), and mean diffusivity (MD). The correlation between diffusion MR measures at the site of compression and evaluations of neurological function assessed using the modified Japanese Orthopaedic Association (mJOA) scale at multiple time points was evaluated. RESULTS The COVs for anatomical measurements (Torg ratio and canal diameter) were between 7% and 10%. The median COV for FA measurements at the site of compression was 9%, and for reference tissue at C1-2 it was 6%. The median COV for MD at the site of compression was approximately 12%, and for reference tissue at C1-2 it was 10%. The FA and MD measurements of C1-2 averaged 0.61 and 0.91 μm 2 /msec, respectively, whereas the FA and MD measurements at the site of compression averaged 0.51 and 1.26 μm 2 /msec, respectively. Both FA (slope = 0.037; R 2 = 0.3281, p slope = -0.074; R 2 = 0.1101, p = 0.0084) were significantly correlated with the mJOA score. The FA decreased

[Clinical study on spinal cord decompression combined with traditional Chinese medicine for the treatment of cervical spondylotic myelopathy].

Science.gov (United States)

Yang, Feng; Tan, Ming-Sheng; Yi, Ping; Tang, Xiang-Sheng; Hao, Qing-Ying; Qi, Ying-Na

2018-01-25

To compare the clinical effect between spinal card decompression combined with traditional Chinese medicine and simple spinal card decompression for cervical spondylotic myelopathy. From June 2012 to June 2015, 73 patients with cervical spondylotic myelopathy were treated, including 42 males and 31 females, aged from 29 to 73 years old with a mean of 50.9 years old. The patients were divided into the simple operation group (34 cases) and the operation combined with traditional Chinese medicine group(39 cases) according to the idea of themselves. The anterior discectomy or subtotal corpectomy with internal fixation or posterior simple open-door decompression with lateral mass screw fixation were performed in the patients. Among them, 39 cases were treated with traditional Chinese medicine after surgery. The Japanese orthopedic association (JOA) score of spinal cord function, the improvement rate of neural function, the neck dysfunction index (NDI) score and the governor vessel stasis syndrome score were compared between two groups preoperative and postoperative 1 week, 1 month and the final follow-up respectively. The internal fixation and the condition of spinal cord decompression were observed by CT, MRI and X-rays before and after operation. All the operations were successful, no injuries such as dura mater, spinal cord and nerve root were found. All the wounds were healed without infection except one patient had a superficial infection. It was solved after intermittent debridement and anti-infective therapy. Hematoma occurred in 1 case, complicated with spinal cord compression, caused incomplete paralysis, and promptly performed the re-operation to remove the hematoma without any obvious sequelae. All the patients were followed up from 12 to 24 months, (14.6±0.8) months for simple operation group and (13.5±0.7) months for operation combined with traditional Chinese medicine group, and there was no significant difference( P >0.05). The scores of JOA, NDI and

Physiotherapy for human T-lymphotropic virus 1-associated myelopathy: review of the literature and future perspectives.

Science.gov (United States)

Sá, Katia N; Macêdo, Maíra C; Andrade, Rosana P; Mendes, Selena D; Martins, José V; Baptista, Abrahão F

2015-01-01

Human T-lymphotropic virus 1 (HTLV-1) infection may be associated with damage to the spinal cord - HTLV-associated myelopathy/tropical spastic paraparesis - and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions.

Clinical significance of MRI/18F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

International Nuclear Information System (INIS)

Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi; Okazawa, Hidehiko; Kimura, Hirohiko; Kudo, Takashi

2012-01-01

18 F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/ 18 F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on 18 F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and 18 F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and 18 F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV max ). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV max was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV max with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV max . Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated with a poor postoperative neurological

Predictors of cervical lordosis loss after laminoplasty in patients with cervical spondylotic myelopathy.

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Zhang, Jing Tao; Li, Jia Qi; Niu, Rui Jie; Liu, Zhao; Tong, Tong; Shen, Yong

2017-04-01

To determine whether radiological, clinical, and demographic findings in patients with cervical spondylotic myelopathy (CSM) were independently associated with loss of cervical lordosis (LCL) after laminoplasty. The prospective study included 41 consecutive patients who underwent laminoplasty for CSM. The difference in C2-7 Cobb angle between the postoperative and preoperative films was used to evaluate change in cervical alignment. Age, sex, body mass index (BMI), smoking history, preoperative C2-7 Cobb angle, T1 slope, C2-7 range of motion (C2-7 ROM), C2-7 sagittal vertical axis (C2-7 SVA), and cephalad vertebral level undergoing laminoplasty (CVLL) were assessed. Data were analyzed using Pearson and Spearman correlation test, and univariate and stepwise multivariate linear regression. T1 slope, C2-7 SVA, and CVLL significantly correlated with LCL (P < 0.001), whereas age, BMI, and preoperative C2-7 Cobb angle did not. In multiple linear regression analysis, higher T1 slope (B = 0.351, P = 0.037), greater C2-7 SVA (B = 0.393, P < 0.001), and starting laminoplasty at C4 level (B = - 7.038, P < 0.001) were significantly associated with higher postoperative LCL. Cervical alignment was compromised after laminoplasty in patients with CSM, and the degree of LCL was associated with preoperative T1 slope, C2-7 SVA, and CVLL.

Mielopatia torácica por calcificação do ligamento amarelo cursando com hiperproteinorraquia e resposta à corticoterapia: relato de caso Thoracic myelopathy due to calcification of the ligamentum flavum with hyperproteinorachia and responsive to steroid therapy: case report

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Flávia Yuri Shiguematsu

2012-06-01

Full Text Available Calcificação e ossificação do ligamento amarelo ou do ligamento longitudinal posterior são causas de mielopatia compressiva, mais frequentes nos níveis torácicos inferiores e bastante raras em populações ocidentais. A descompressão cirúrgica é a única terapia proposta, mas a doença costuma ser progressiva e sua recorrência após a cirurgia não é incomum. Mediadores inflamatórios podem ter algum papel na progressão da mielopatia compressiva, mas não se tem notícia de qualquer proposta de abordagem terapêutica envolvendo agentes anti-inflamatórios. Neste contexto, relatamos um caso de mielopatia compressiva por calcificação do ligamento amarelo em que se observou hiperproteinorraquia e resposta à corticoterapia. Tais informações são inéditas e podem fornecer novas ideias para a compreensão da doença.Calcification and ossification of the ligamentum flavum or of the posterior longitudinal ligament are causes of compressive myelopathy, more frequent in the lower thoracic levels, and extremely rare in Western populations. Surgical decompression is the only therapy, but the disease is usually progressive, and its recurrence after surgery is common. Inflammatory mediators might play a role in the progression of compressive myelopathy, but, to our knowledge, the therapeutic approach involving anti-inflammatory agents has never been tried before. We report a case of compressive myelopathy due to calcification of the ligamentum flavum, in which hyperproteinorachia and response to steroid therapy have been observed. Those data have not been published before and might provide new ideas for the disease understanding.

MR imaging of spinal factors and compression of the spinal cord in cervical myelopathy

International Nuclear Information System (INIS)

Kokubun, Shoichi; Ozawa, Hiroshi; Sakurai, Minoru; Ishii, Sukenobu; Tani, Shotaro; Sato, Tetsuaki.

1992-01-01

Magnetic resonance (MR) images of surgical 109 patients with cervical spondylotic myelopathy were retrospectively reviewed to examine whether MR imaging would replace conventional radiological procedures in determining spinal factors and spinal cord compression in this disease. MR imaging was useful in determining spondylotic herniation, continuous type of ossification of posterior longitudinal ligament, and calcification of yellow ligament, probably replacing CT myelography, discography, and CT discography. When total defect of the subarachnoid space on T2-weighted images and block on myelograms were compared in determining spinal cord compression, the spinal cord was affected more extensively by 1.3 intervertebral distance (IVD) on T2-weighted images. When indentation of one third or more in anterior and posterior diameter of the spinal cord was used as spinal cord compression, the difference in the affected extension between myelography and MR imaging was 0.2 IVD on T1-weighted images and 0.6 IVD on T2-weighted images. However, when block was seen in 3 or more IVD on myelograms, the range of spinal cord compression tended to be larger on T1-weighted images. For a small range of spinal cord compression, T1-weighted imaging seems to be helpful in determining the range of decompression. When using T2-weighted imaging, the range of decompression becomes large, frequently including posterior decompression. (N.K.)

Cortical Reorganization Is Associated with Surgical Decompression of Cervical Spondylotic Myelopathy

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Andrew Green

2015-01-01

Full Text Available Background. Cervical spondylotic myelopathy (CSM results in sensorimotor limb deficits, bladder, and bowel dysfunction, but mechanisms underlying motor plasticity changes before and after surgery are unclear. Methods. We studied 24 patients who underwent decompression surgery and 15 healthy controls. Patients with mixed upper and lower limb dysfunction (Group A and only lower limb dysfunction (Group B were then analysed separately. Results. The sum amplitude of motor evoked potentials sMEP (p<0.01 and number of focal points where MEPs were elicited (N (p<0.001 were significantly larger in CSM patients compared with controls. For Group A (16 patients, sMEP (p<0.01 and N (p<0.001 showed similar findings. However, for Group B (8 patients, only N (p=0.03 was significantly larger in patients than controls. Group A had significantly increased grip strength (p=0.02 and reduced sMEP (p=0.001 and N (p=0.003 after surgery. Changes in sMEP (cMEP significantly correlated inversely with improved feeding (p=0.03 and stacking (p=0.04 times as was the change in number of focal points (NDiff with improved writing times (p=0.03. Group B did not show significant reduction in sMEP or N after surgery, or significant correlation of cMEP or NDiff with all hand function tests. No significant differences in H reflex parameters obtained from the flexor carpi radialis, or central motor conduction time changes, were noted after surgery. Discussion. Compensatory expansion of motor cortical representation occurs largely at cortical rather than spinal levels, with a tendency to normalization after surgery. These mirrored improvements in relevant tasks requiring utilization of intrinsic hand muscles.

Comparison of Anterior and Posterior Surgery for Degenerative Cervical Myelopathy: An MRI-Based Propensity-Score-Matched Analysis Using Data from the Prospective Multicenter AOSpine CSM North America and International Studies.

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Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

2017-06-21

Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy. A total of 757 patients were enrolled in 2 prospective multicenter AOSpine studies, which involved 26 international sites. Preoperative MRIs were reviewed to characterize the causes of the cord compression, including single-level disc disease, multilevel disc disease, ossification of the posterior longitudinal ligament, enlargement of the ligamentum flavum, vertebral subluxation/spondylolisthesis, congenital fusion, number of compressed levels, or kyphosis. The propensity to choose anterior decompression was calculated using demographic data, preoperative MRI findings, and the modified Japanese Orthopaedic Association (mJOA) scores in a logistic regression model. We then performed 1-to-1 matching of patients who had received anterior decompression with those who had the same propensity score but had received posterior decompression to compare 2-year postoperative outcomes and 30-day perioperative complication rates between the 2 groups after adjustment for background characteristics. A total of 435 cases were included in the propensity score calculation, and 1-to-1 matching resulted in 80 pairs of anterior and posterior surgical cases; 99% of these matched patients had multilevel compression. The anterior and posterior groups did not differ significantly in terms of the postoperative mJOA score (15.1 versus 15.3, p = 0.53), Neck Disability Index (20.5 versus 24.1, p = 0.44), or Short Form-36 (SF-36

Psychiatric comorbidities in a young man with subacute myelopathy induced by abusive nitrous oxide consumption: a case report.

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Mancke, Falk; Kaklauskaitė, Gintarė; Kollmer, Jennifer; Weiler, Markus

2016-01-01

Nitrous oxide (N 2 O), a long-standing anesthetic, is known for its recreational use, and its consumption is on the rise. Several case studies have reported neurological and psychiatric complications of N 2 O use. To date, however, there has not been a study using standardized diagnostic procedures to assess psychiatric comorbidities in a patient consuming N 2 O. Here, we report about a 35-year-old male with magnetic resonance imaging confirmed subacute myelopathy induced by N 2 O consumption, who suffered from comorbid cannabinoid and nicotine dependence as well as abuse of amphetamines, cocaine, lysergic acid diethylamide, and ketamine. Additionally, there was evidence of a preceding transient psychotic and depressive episode induced by synthetic cannabinoid abuse. In summary, this case raises awareness of an important mechanism of neural toxicity, with which physicians working in the field of substance-related disorders should be familiar. In fact, excluding N 2 O toxicity in patients with recognized substance-related disorders and new neurological deficits is compulsory, as untreated for months the damage to the nervous system is at risk of becoming irreversible.

Evaluation of neck pain by using a visual analog scale before and after laminoplasty in patients with cervical myelopathy: relationship with clinical results.

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Ara, Tsuyoshi; Iizuka, Haku; Sorimachi, Yasunori; Iizuka, Yoichi; Nakajima, Takashi; Nishinome, Masahiro; Tsutsumi, Satoshi; Takagishi, Kenji

2010-06-01

In this study the authors investigated the neck pain of patients with cervical myelopathy by using a visual analog scale (VAS) before and after laminoplasty, and they analyzed the association of amount of neck pain with the clinical results. A retrospective review was conducted in 41 patients with cervical myelopathy who underwent cervical laminoplasty. The patients were assessed using questionnaires to evaluate the neck pain intensity before surgery, and 2 years after surgery, the outcome was assessed using a VAS. The degree of cervical lordosis and range of motion (ROM) of the cervical spine were evaluated before and after laminoplasty. The neurological status was also evaluated before and after surgery. The patients were classified into 2 groups according to their preoperative neck pain: 1) the pain (PA) group, which included patients whose preoperative VAS score was more than 1 mm; and 2) the no pain (NP) group, which included patients whose preoperative VAS score was 0 mm. Inclusion in the PA group indicated a restriction of the cervical ROM before laminoplasty; however, the improvement of neck pain in this group and the deterioration of pain status in the NP group eliminated this difference after laminoplasty. Thereafter, the PA group was classified into 2 subgroups according to the improvement of the preoperative neck pain: 1) the improved group, which included patients whose postoperative VAS score decreased; and 2) the no improvement group, which included patients who were not in the improved group. No significant differences were observed in the average recovery and radiographic results between these 2 subgroups. Neck pain before surgery in the PA group indicated a restriction of the cervical ROM; however, the improvement of neck pain in this group and the deterioration of pain status in the NP group indicated the disappearance of this difference postoperatively. Moreover, improvement of preoperative neck pain was not associated with the radiographic

HTLV-I associated myelopathy with multiple spotty areas in cerebral white matter and brain stem by MRI

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Hara, Yasuo; Takahashi, Mitsuo; Yoshikawa, Hiroo; Yorifuji, Shirou; Tarui, Seiichiro

1988-01-01

A 48-year-old woman was admitted with complaints of urinary incontinence and gait disturbance, both of which had progressed slowly without any sign of remission. Family history was not contributory. Neurologically, extreme spasticity was recoginized in the lower limbs. Babinski sign was positive bilaterally. Flower-like atypical lymphocytes were seen in blood. Positive anti-HTLV-I antibody was confirmed in serum and spinal fluid by western blot. She was diagnosed as having HTLV-I associated myelopathy (HAM). CT reveald calcification in bilateral globus pallidus, and MRI revealed multiple spotty areas in cerebral white matter and brain stem, but no spinal cord lesion was detectable. Electrophysiologically, brain stem auditory evoked potential (BAEP) suggested the presence of bilateral brain stem lesions. Neither median nor posterior tibial nerve somatosensory evoked potentials were evoked, a finding suggesting the existence of spinal cord lesion. In this case, the lesion was not confined to spinal cord, it was also observed in brain stem and cerebral white matter. Such distinct lesions in cerebral white matter and brain stem have not been reported in patients with HAM. It is suggested that HTLV-I is probably associated with cerebral white matter and brain stem.

C3-6 laminoplasty for cervical spondylotic myelopathy maintains satisfactory long-term surgical outcomes.

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Sakaura, Hironobu; Hosono, Noboru; Mukai, Yoshihiro; Iwasaki, Motoki; Yoshikawa, Hideki

2014-08-01

Study Design Prospective cohort study. Objective To clarify long-term surgical outcomes of C3-6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3-6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study. Myelopathic symptoms were assessed using Japanese Orthopaedic Association (JOA) score. Axial neck pain was graded as severe, moderate, or mild. C2-7 angle was measured using lateral radiographs of the cervical spine before surgery and at final follow-up. Results Mean JOA score before surgery (11.7) was significantly improved to 15.2 at the time of maximum recovery (1 year after surgery), declining slightly to 14.9 by the latest follow-up. Late deterioration of JOA score developed in eight patients, but was unrelated to the cervical spine lesions in each case. No patient suffered from prolonged postoperative axial neck pain at final follow-up. The mean C2-7 angle before surgery (13.8 degrees) significantly increased to 19.2 degrees at final follow-up. Conclusions C3-6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with CSM maintained satisfactory long-term neurologic improvement with significantly reduced frequencies of prolonged postoperative axial neck pain and loss of C2-7 angle after surgery.

Beam Attenuators and the Risk of Unrecognized Large-Fraction Irradiation of Critical Tissues

International Nuclear Information System (INIS)

Luka, S.; Marks, J.E.

2015-01-01

The use of radiation beam attenuators led to radiation injury of the spinal cord in one patient and of the peripheral nerve in another due to unsuspected large-fraction irradiation. The anatomic distribution of radiation dose was reconstructed in the sagittal plane for the patient who developed radiation myelopathy and in the axial plane for the patient who developed peripheral neuropathy. The actual dose delivered to the injured structure in each patient was taken from the dose distribution and recorded along with the time, number of fractions, and dose per fraction. The patient who developed radiation myelopathy received a total of 46.5 Gy in twenty-three 2.1 Gy fractions in 31 days to the upper cervical spinal cord where the thickness of the neck was less than the central axis thickness due to cervical lordosis and absence of a posterior compensating filter. The patient who developed peripheral neuropathy received 55 Gy in twenty-five 2.2 Gy fractions in 50 days to the femoral nerve using bolus over the groins and an anterior one-half value layer Cerrobend pelvic block to bias the dose anteriorly. Compensating filters and other beam attenuators should be used with caution because they may result in unsuspected large-fraction irradiation and total doses of radiation that exceed the tolerance of critical structures.

Beam Attenuators and the Risk of Unrecognized Large-Fraction Irradiation of Critical Tissues

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Luka, S.; Marks, J.E.

2015-01-15

The use of radiation beam attenuators led to radiation injury of the spinal cord in one patient and of the peripheral nerve in another due to unsuspected large-fraction irradiation. The anatomic distribution of radiation dose was reconstructed in the sagittal plane for the patient who developed radiation myelopathy and in the axial plane for the patient who developed peripheral neuropathy. The actual dose delivered to the injured structure in each patient was taken from the dose distribution and recorded along with the time, number of fractions, and dose per fraction. The patient who developed radiation myelopathy received a total of 46.5 Gy in twenty-three 2.1 Gy fractions in 31 days to the upper cervical spinal cord where the thickness of the neck was less than the central axis thickness due to cervical lordosis and absence of a posterior compensating filter. The patient who developed peripheral neuropathy received 55 Gy in twenty-five 2.2 Gy fractions in 50 days to the femoral nerve using bolus over the groins and an anterior one-half value layer Cerrobend pelvic block to bias the dose anteriorly. Compensating filters and other beam attenuators should be used with caution because they may result in unsuspected large-fraction irradiation and total doses of radiation that exceed the tolerance of critical structures.

Long term results of anterior corpectomy and fusion for cervical spondylotic myelopathy.

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Rui Gao

Full Text Available BACKGROUND: Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF for patients with cervical spondylotic myelopathy (CSM during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD. METHODS: This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. FINDINGS: Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA and the sagittal alignment of the whole cervical spine (SACS increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8 ± 1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ≤ 9 were important predictors of the fair recovery rate (≤ 50%. Repeated surgery due to ASD was performed in 7 (4.8% cases. CONCLUSIONS: ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory.

Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese

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Lu Ning

2006-11-01

Full Text Available Abstract Objectives To investigate clinical effects and manual operational point of Bryan cervical disc prosthesis in Chinese, to observe the stability and range of movement (ROM post-operatively. Methods and materials From 2003,12 to 2005,12, Bryan disc prosthesis replacement applied in 83 cases (102 levels of cervical spondylotic myelopathy (CSM after anterior decompression in our hospital. Clinical (JOA grade and Odom's scale and radiological (X-ray of flexion, extension; left and right bending position follow-up was performed. Systemic radiographic study about stability and ROM of replaced level post operationally were measured. CT or MRI scans were applied in all cases to evaluate the signs of the prosthesis deflexion and hetero-ossification in the replaced levels. Results At least 12 months follow-up were done in 65/83 of these paients. All of 83 patients were improved according to Odsm's scale. JOA score increased from average 8.7 to 15.5. There was no prosthesis subsidence. Replaced segment achieved stability and restored partial of normal ROM 4.73°(3.7°–5.9° early postoperation and 8.12°(5.8°–13.6° more than 12 months postoperation in flex and extension position. No obvious loss of lordosis was found. CT or MRI follow-up shows position deflexion of the prosthesis metal endplates ( Conclusion Byran cervical disc prosthesis restored motion to the level of the intact segment in flexion-extension and lateral bending in post-operative images. At the same time, it can achieve good anterior decompression treatment effect and immediate stability in replaced 1 or 2 levels, and which is a new choice for the treatment of CSM.

An analysis of cervical myelopathy due to cervical spondylosis or ossification of posterior longitudinal ligament by CT myelography

International Nuclear Information System (INIS)

Fujiwara, Keiju; Yonenobe, Sakuo; Ebara, Sohei; Yamashita, Kazuo; Ono, Keiro

1988-01-01

CT-myelographic (CTM) findings of 20 patients with ossification of posterior longitudinal ligament (OPLL) and 24 patients with cervical spondylotic myelopathy (CSM) were reviewed for the evaluation of (1) contributing factors to preoperative neurologic symptoms and therapeutic prognosis in OPLL, and (2) differences in pathology between OPLL and CSM. In OPLL, the severity of preoperative neurologic symptoms was not related to the degree of deformed spinal cord - as expressed by the transverse area of the spinal cord and the rate of flatness - nor the degree of ossification - as expressed by the rate of stricture, and the transverse areas of the effective spinal canal and ossification. The transverse areas of the spinal cord and effective spinal canal were correlated with both postoperative scores for neurologic symptoms and the recovery rate. Osseous compression to the spinal cord was severer in OPLL than OSM. Regarding other factors, such as size and shape of the spinal cord and therapeutic prognosis, there was no difference between the two diseases. This implied the association of dynamic compression to the spinal cord that resulted from the unstable cervical spine in the case of CSM. (Namekawa, K.)

Theoretical and experimental investigations of an added firing system in cogeneration processes with gas turbines optimizing flame stability and burnout behaviour; Theoretische und experimentelle Untersuchungen einer Zusatzfeuerung in gasturbinengestuetzten KWK-Prozessen fuer eine Optimierung hinsichtlich Flammenstabilitaet und Ausbrandverhalten

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Koesters, M.; Kliemt, C.

2004-07-01

The effects of the key flow, mixing and ignition parameters on the ignition process was investigated in near-practical conditions. It was found that the ignition energy can be minimized by careful selection of the electrode configuration and positioning near the burner. Further, a criterion was developed for developing characteristic fields and design specifications for gas burners. The FLUENT code can calculate the mixing, flow and turbulence situation of a burner. This, and plus the newly established ignition criterion, can support the development of characteristic fields and help to minimize the experimental expenditure. [German] Der Einfluss der wichtigsten Stroemungs-, Mischungs- und Zuendparameter auf die Zuendung wurde mit Hilfe gezielter experimenteller und theoretischer Untersuchungen unter industrienahen Bedingungen getestet. Hierbei konnte eine gute Uebereinstimmung zwischen den Messungen und Rechnungen erzielt werden. Die Ergebnisse haben gezeigt, dass durch eine geeignete Wahl der Elektrodenkonfiguration und der Elektrodenpositionierung im Brennernahbereich eine Zuendenergieminimierung erreicht werden kann. Gleichzeitig wurde ein Kriterium entwickelt, das zur Erarbeitung von Kennfeldern und Auslegungsvorschriften fuer Gasbrenner genutzt werden kann. Mit Hilfe des kommerziellen CFD-Programms FLUENT kann die Mischungs-, Stroemungs- und Turbulenzsituation eines Brenners numerisch berechnet werden. Mittels dieser Ergebnisse und unter Anwendung des ermittelten Zuendkriteriums kann die Erstellung von Arbeits- und Zuendkennfeldern fuer die Neuentwicklung bzw. Verbesserung von Industriegasbrennern unterstuetzt und somit der experimentelle Aufwand minimiert werden. (orig.)

Normal tissue tolerance to external beam radiation therapy: Spinal cord; Tolerance a l'irradiation des tissus sains: moelle epiniere

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Habrand, J.L. [Departement de radiotherapie, institut Gustave-Roussy, 94 - Villejuif (France); Centre de protontherapie, institut Curie, 91 - Orsay (France); Drouet, F. [Departement de radiotherapie, centre Rene-Gauducheau, 44 - Nantes (France)

2010-07-15

Radiation myelopathy is one of the most dreadful complications of radiation therapy. Despite multiple animal experiments and human autopsic series, its pathogenesis remains largely unknown. In most instances, the classical aspect of myelomalacia combines glial and vascular injuries in various sequences. Recent studies point out the role of oligo-dendrocytes and their precursors, as well as of intercellular mediators (cytokines and stress molecules). The clinical presentation comprises a spectrum of non specific neurological symptoms whose evolution is sometimes regressive but more commonly progressive and life-threatening. Usually, it occurs following a latent period of six months to two years after irradiation of the cervical, thoracic or upper lumbar spine to a dose in excess of 50 Gy, conventionally fractionated. Nonetheless, these typical features can be altered by extrinsic factors, such as hypo fractionation/acceleration of the dose, multiple surgical procedures, chemotherapy especially mega therapy, or neurotoxic drugs. Conversely, hyperfractionated regimens that take into account protracted half-time repair of sublethal damages to the CNS, as well as sophisticated estimates of the dose to the cord and QA programs during the treatment course minimize such risks. (authors)

Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder.

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Kalsi-Ryan, Sukhvinder; Karadimas, Spyridon K; Fehlings, Michael G

2013-08-01

Cervical spondylotic myelopathy (CSM) is a common disorder involving chronic progressive compression of the cervical spinal cord due to degenerative disc disease, spondylosis, or other degenerative pathology. CSM is the most common form of spinal cord impairment and causes functional decline leading to reduced independence and quality of life. Despite a sound understanding of the disease process, clinical presentation and management, a universal definition of CSM and a standardized index of severity are not currently used universally. Work is required to develop a definition and establish clinical predictors of progression to improve management of CSM. Despite advances in decompressive and reconstructive surgery, patients are often left with residual disability. Gaps in knowledge of the pathobiology of CSM have limited therapeutic advances to complement surgery. Although the histopathologic and pathophysiologic similarities between CSM and traumatic spinal cord injury have long been acknowledged, the unique pathomechanisms of CSM remain unexplored. Increased efforts to elucidate CSM pathobiology could lead to the discovery of novel therapeutic targets for human CSM and other spinal cord diseases. Here, the natural history of CSM, epidemiology, clinical presentation, and current methods of clinical management are reported, along with the current state of basic scientific research in the field.

The pathogenesis of tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy

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Casseb J.

2000-01-01

Full Text Available Tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy (TSP/HAM is caused by a human T-cell leukemia virus type I (HTLV-I after a long incubation period. TSP/HAM is characterized by a chronic progressive paraparesis with sphincter disturbances, no/mild sensory loss, the absence of spinal cord compression and seropositivity for HTLV-I antibodies. The pathogenesis of this entity is not completely known and involves a multivariable phenomenon of immune system activation against the presence of HTLV-I antigens, leading to an inflammatory process and demyelination, mainly in the thoracic spinal cord. The current hypothesis about the pathogenesis of TSP/HAM is: 1 presence of HTLV-I antigens in the lumbar spinal cord, noted by an increased DNA HTLV-I load; 2 CTL either with their lytic functions or release/production of soluble factors, such as CC-chemokines, cytokines, and adhesion molecules; 3 the presence of Tax gene expression that activates T-cell proliferation or induces an inflammatory process in the spinal cord; 4 the presence of B cells with neutralizing antibody production, or complement activation by an immune complex phenomenon, and 5 lower IL-2 and IFN-gamma production and increased IL-10, indicating drive to a cytokine type 2 pattern in the TSP/HAM subjects and the existence of a genetic background such as some HLA haplotypes. All of these factors should be implicated in TSP/HAM and further studies are necessary to investigate their role in the development of TSP/HAM.

Clinical significance of MRI/{sup 18}F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

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Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi [University of Fukui, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Okazawa, Hidehiko [University of Fukui, Department of Biomedical Imaging Research Center, Eiheiji, Fukui (Japan); Kimura, Hirohiko [University of Fukui, Departments of Radiology, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Kudo, Takashi [Nagasaki University, Department of Radioisotope Medicine, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki (Japan)

2012-10-15

{sup 18}F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/{sup 18}F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on {sup 18}F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and {sup 18}F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and {sup 18}F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV{sub max}). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV{sub max} was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV{sub max} with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV{sub max}. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated

Tract-Specific Diffusion Tensor Imaging Reveals Laterality of Neurological Symptoms in Patients with Cervical Compression Myelopathy.

Science.gov (United States)

Maki, Satoshi; Koda, Masao; Saito, Junya; Takahashi, Sho; Inada, Taigo; Kamiya, Koshiro; Ota, Mitsutoshi; Iijima, Yasushi; Masuda, Yoshitada; Matsumoto, Koji; Kojima, Masatoshi; Takahashi, Kazuhisa; Obata, Takayuki; Yamazaki, Masashi; Furuya, Takeo

2016-12-01

Patients with cervical compression myelopathy (CCM) generally present bilateral neurological symptoms in their extremities. However, a substantial portion of patients with CCM exhibit laterality of neurological symptoms. The aim of this study was to assess the correlation between intrinsic structural damage and laterality of symptoms using spinal cord diffusion tensor imaging (DTI) of the corticospinal tract. We enrolled 10 healthy volunteers and 40 patients with CCM in this study. We evaluated motor function using the American Spinal Injury Association (ASIA) motor score for left and right extremities. For DTI acquisitions, a 3.0-T magnetic resonance imaging system with diffusion-weighted spin-echo sequence was used. Regions-of-interest in the lateral column tracts were determined. We determined the correlations between fractional anisotropy (FA) and ASIA motor scores. An FA asymmetry index was calculated using left and right regions-of-interest. Four patients exhibited laterality of symptoms in their extremities, for which left and right ASIA scores correlated moderately with FA in the left and right lateral columns, respectively (left: ρ = 0.64, P laterality of symptoms. Using tract-specific DTI, we demonstrated that microstructural damages in the left and right corticospinal tracts correlated with corresponding neurological symptoms in the ipsilateral side and the FA asymmetry index could indicate laterality in neurological symptoms of patients with CCM. Copyright © 2016 Elsevier Inc. All rights reserved.

C3–6 Laminoplasty for Cervical Spondylotic Myelopathy Maintains Satisfactory Long-Term Surgical Outcomes

Science.gov (United States)

Sakaura, Hironobu; Hosono, Noboru; Mukai, Yoshihiro; Iwasaki, Motoki; Yoshikawa, Hideki

2014-01-01

Study Design Prospective cohort study. Objective To clarify long-term surgical outcomes of C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3–6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study. Myelopathic symptoms were assessed using Japanese Orthopaedic Association (JOA) score. Axial neck pain was graded as severe, moderate, or mild. C2–7 angle was measured using lateral radiographs of the cervical spine before surgery and at final follow-up. Results Mean JOA score before surgery (11.7) was significantly improved to 15.2 at the time of maximum recovery (1 year after surgery), declining slightly to 14.9 by the latest follow-up. Late deterioration of JOA score developed in eight patients, but was unrelated to the cervical spine lesions in each case. No patient suffered from prolonged postoperative axial neck pain at final follow-up. The mean C2–7 angle before surgery (13.8 degrees) significantly increased to 19.2 degrees at final follow-up. Conclusions C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with CSM maintained satisfactory long-term neurologic improvement with significantly reduced frequencies of prolonged postoperative axial neck pain and loss of C2–7 angle after surgery. PMID:25083358

Experimental radiotherapy and clinical radiobiology. Vol. 19. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 19. Proceedings

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Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemann, H Peter; Zips, Daniel [eds.

2010-12-18

The proceedings include review contributions on radio-oncology, and new radiation technologies and molecular prediction; and poster sessions on the following topics: hypoxia; molecular mechanisms of radiation resistance; molecular targeting; DNA repair; biological imaging; biology of experimental radiations; normal tissue toxicity; modern radiotherapy; tumor hypoxia and metabolic micro milieu; immune system and radiotherapy.

The relationship between electrodiagnosis using spinal cord evoked potential after spinal cord stimulation and MRI evaluation for cervical myelopathy

International Nuclear Information System (INIS)

Kato, Tsuyoshi; Shiba, Keiichiro; Ueta, Takayoshi; Ohta, Hideki; Mori, Eiji; Kaji, Kozo; Yuge, Itaru; Kawano, Osamu

2006-01-01

We studied the correlation between the site of high intensity spinal cord signals on preoperative sagittal T2 MRIs (T2-high signal) and that of intrdaperative electrophysiological abnormalities for 200 cervical myelopathy cases. We recorded the Sp(E)-SCEPs during posterior cervical laminoplasty operations. In the cases with a T2-high signal at single levels, conduction abnormality matched the site of T2-high signal in 50%, and no conduction abnormalities were detected in 44%. In the cases with a T2-high signal at two levels, conduction abnormality matched the site of T2-high signal in only 11%, and no conduction abnormalities were disclosed in 59%. In the cases with a T2-high signal at three or more levels, conduction abnormalities matched the site of T2-high signal in 8% and no conduction abnormalities were disclosed in 72%. Our study showed a higher correspondence between the MRI finding and conduction abnormalities in the cases with T2-high signal at single levels, although our Sp(E)-SCEP study could not disclose conduction abnormalities in nearly half the cases. False negative findings of Sp(E)-SCEPs may result from the simplified recording technique. (author)

Genetic testing of canine degenerative myelopathy in the South African Boxer dog population

Directory of Open Access Journals (Sweden)

Gareth E. Zeiler

2013-10-01

Full Text Available Canine degenerative myelopathy (DM is a progressive disease process that is diagnosed late in life and mainly affects the pelvic limbs. Factors that make an ante-mortem definitive diagnosis of DM include: an insidious onset and clinical manifestation that mimics other disease processes of the pelvic limbs (hip dysplasia, cranial cruciate ligament rupture, etc. or there may even be concurrent disease processes, old-age onset and lack of reliable diagnostic methods. Until recently, South African dog owners had to submit samples to laboratories overseas for genetic testing in order to confirm an affected dog (homozygous A/A and to aid in the ante-mortem diagnosis of DM. Only affected dogs have been confirmed to manifest the clinical signs of DM. This study aimed to verify whether genetic testing by a local genetic laboratory was possible in order to detect a missense mutation of the superoxide dismutase gene (SOD1 that is implicated in causing the clinical signs of DM. The study also aimed to detect and map the inheritance of this disease process in a local Boxer dog population where the pedigree of the sampled population was known. Venous blood collected from Boxer dogs using a simple random sampling technique. The samples were genotyped for the SOD1:c.118G>A polymorphism. Carrier and affected Boxer dogs were detected. A pedigree that demonstrated the significance of inheriting a carrier or affected state in the population was mapped. The present study concludes that genotyping of the missense mutation in Boxer dogs is possible in South Africa. There are carrier and affected Boxer dogs in the local population, making DM a plausible diagnosis in aged dogs presenting with pelvic limb pathology.

Experimental radiotherapy and clinical radiobiology. Vol. 18. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 18. Proceedings

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Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemann, H Peter; Zips, Daniel [eds.

2009-07-15

The proceedings on experimental radiotherapy and clinical radiobiology contain two review articles (prediction of normal tissue reactions after radiotherapy, ?H2AX foci as a marker for DNA double-strand breaks) and 34 contributions to the following topics: Hypoxia and molecular mechanisms of radiation resistance; biological imaging of the tumor micromilieu; DNA repair, genomic instability and carcerogenesis; molecular factors of radiation resistance; actual controversial discussion on possible irradiation caused metastasis risk enhancement; EGFR inhibition and irradiation; biology of experimental radiation/ normal tissue toxicity.

Tropical spastic paraparesis and HTLV-1 associated myelopathy: clinical, epidemiological, virological and therapeutic aspects.

Science.gov (United States)

Gessain, A; Mahieux, R

2012-03-01

In 1980, Human T cell leukemia/lymphoma virus type 1 (HTLV-1) was the first oncogenic human retrovirus to be discovered. HTLV-1 belongs to the Retroviridae family, the Orthoretrovirinae subfamily and to the deltaretrovirus genus. HTLV-1 preferentially infects CD4(+) lymphoid cells in vivo. Three molecules have been identified for binding and/or entry of HTLV-1: heparan sulfate proteoglycans, neuropilin-1, and glucose transporter 1. An efficient transfer of the virus from an infected cell to a target cell can occur through the formation of a viral synapse and/or by virofilm structure. As for all retroviruses, HTLV-1 genome possesses three major ORFs (gag, pol and env) encoding the structural and enzymatic proteins. HTLV-1 encodes also some regulatory and auxillary proteins including the tax protein with transforming activities and the HBZ protein which plays a role in the proliferation and maintenance of the leukemic cells. HTLV-1 is present throughout the world with clusters of high endemicity including mainly Southern Japan, the Caribbean region, areas in South America and in intertropical Africa. The worldwide HTLV-1 infected population is estimated to be around 10-20 million. HTLV-1 has three modes of transmission: (1): mother to child, mainly linked to prolonged breast-feeding; (2): sexual, mainly occurring from male to female and (3): contaminated blood products. HTLV-1 possesses a remarkable genetic stability. HTLV-1 is the etiological agent of mainly two severe diseases: a malignant T CD4(+) cell lymphoproliferation, of very poor prognosis, named Adult T cell Leukemia/Lymphoma (ATLL), and a chronic neuro-myelopathy named Tropical spastic paraparesis/HTLV-1 Associated Myelopathy (TSP/HAM). The lifetime risk among HTLV-1 carriers is estimated to be around 0.25 to 3%. TSP/HAM mainly occurs in adults, with a mean age at onset of 40-50 years and it is more common in women than in men. Blood transfusion is a major risk factor for TSP/HAM development. Clinically

Experimental improvisation practise and notation. Addenda 2000-

DEFF Research Database (Denmark)

Bergstrøm-Nielsen, Carl

Addenda to Experimental improvisation practise and notation (please see this title for more information!) Stichwörter: experimentelle Musik, offenes Werk, grafische Notation, musikalische Notation, musikalische Aufführungspraxis, freie Improvisation, Musikpädagogik, Geschichte der Musik, Musikäst...

A case of radiation myelopathy responded to ACTH therapy

International Nuclear Information System (INIS)

Matsui, Toshiyuki; Kawanami, Sachiko; Nishimaru, Katsuya

1981-01-01

A patient with nasal reticulum-cell sarcoma received 60 Co irradiation in a total dose of 10,000 rad in 25 fractions and intracarotid arterial transfusion of 5-Fu 4,000 mg. The prognosis was favorable without subjective symptoms for about one year before disturbance in walking and abnormal sensation in legs occurred. Metastasis of tumor was ruled out, and diagnosis of acute radiculoneuritis was made for the reason that the region which exposed to irradiation coincided the level of neurological disturbances which rapidly advanced. This patient received ACTH therapy. Administration of dexamethasone in a dose of 4 mg per day relieved subjective pain and lowered the level of impaired sensation, and arrested progress of motor paralysis. However, the symptoms was exacerbated again after 2 weeks and the decrease of the dose caused an highered the level of impaired and resulted in motor paralysis. Total dose was 171 mg. (Ueda, J.)

Dynamic changes in the dural space and spinal cord cross-sectional area during flexion and extension in patients with cervical spondylotic myelopathy

International Nuclear Information System (INIS)

Machino, Masaaki; Yukawa, Yasutsugu; Ito, Keigo; Nakashima, Hiroaki; Kato, Fumihiko

2009-01-01

The number of patients with cervical spondylotic myelopathy (CSM) is increasing with the aging of the population. The patients' during spinal cord tends to be compressed neck extension, because the yellow ligaments and intervertebral discs protrude into the spinal canal during neck extension (pincer mechanism). A total of 100 patients with CSM were prospectively enrolled in this study. After preoperative myelography, multi-detector-row CT (MDCT) scans were acquired in flexion and extension, and the dural space and spinal cord cross-sectional area at each disc level from C2/3 to C7/Th1 were measured by using Scion imaging software. The average dural space and average spinal cord cross-sectional area were smaller in extension than in flexion from the C3/4 to C7/Th1 disc level, and the greatest dynamic changes were seen at the C5/6 level. MDCT demonstrated dynamic factors in patients with CSM. The spinal cord cross-sectional area became narrower during extension in patients with CSM. (author)

Anterolisthesis and retrolisthesis of the cervical spine in cervical spondylotic myelopathy in the elderly

International Nuclear Information System (INIS)

Kawasaki, Motohiro; Tani, Toshikazu; Ushida, Takahiro; Ishida, Kenji

2007-01-01

Degenerative spondylolisthesis of the cervical spine has received insufficient attention in contrast to that of the lumbar spine. The authors analyzed the functional significance of anterior and posterior degenerative spondylolisthesis (anterolisthesis and retrolisthesis) of the cervical spine to elucidate its role in the development of cervical spondylotic myelopathy (CSM) in the elderly. A total of 79 patients aged 65 or older who eventually had surgical treatment for CSM were evaluated radiographically. Altogether, 24 patients (30%) had displacement of 3.5 mm or more (severe spondylolisthesis group), 31 had displacement of 2.0-3.4 mm (moderate spondylolisthesis group), and 24 had less than 2.0 mm displacement (mild spondylolisthesis group). The severe spondylolisthesis group consisted of 14 patients with anterolisthesis (anterolisthesis group) and 10 patients with retrolisthesis (retrolisthesis group). Patients with severe spondylolisthesis had a high incidence (93%) of degenerative spondylolisthesis at C3/4 or C4/5 and significantly greater cervical mobility than those with mild spondylolisthesis. The anterolisthesis group, but not the retrolisthesis group, had a significantly wider spinal canal than the mild spondylolisthesis group, although the degree of horizontal displacement and cervical mobility did not differ significantly between the anterolisthesis and retrolisthesis groups. Severe cord compression seen on T1-weighted magnetic resonance imaging (MRI) scans and high-intensity spinal cord signals seen on T2-weighted MRI scans corresponded significantly to the levels of the spondylolisthesis. Degenerative spondylolisthesis is not a rare radiographic finding in elderly patients with CSM, which tends to cause intense cord compression that is seen on MRI scans. Greater mobility of the upper cervical segments may be a compensatory reaction for advanced disc degeneration of the lower cervical segments, leading to the development of degenerative

Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy.

Science.gov (United States)

Ren, Da-Jiang; Li, Fang; Zhang, Zhi-Cheng; Kai, Guan; Shan, Jian-Lin; Zhao, Guang-Min; Sun, Tian-Sheng

2015-08-05

Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM). Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM. Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L) and hemilaminectomy (Group H). Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA), and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared. Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41%) than in Group H (62.72 ± 3.86%) (P < 0.01). Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.

[Autoimmune syndrome in the tropical spastic paraparesis/myelopathy associated with human T-lymphotropic virus infections].

Science.gov (United States)

Domínguez, Martha C; Torres, Miyerlandi; Tamayo, Oscar; Criollo, William; Quintana, Milton; Sánchez, Adalberto; García, Felipe

2008-12-01

Previous reports have given evidence that in tropical spastic paraparesis (TSP)/human T-lymphotrophic virus (HTLV-I)-associated myelopathy (HAM), an autoimmune process occurs as part of its pathogenesis. The roles of autoimmunity and the molecular mimicry was evaluated in TSP/HAM patients. Plasma samples were characterized from patients in the Pacific coastal region of Colombia. Thirty-seven were identified as TSP/HAM, 10 were diagnosed with adult T-cell leukemia virus, 22 were asymptomatic carriers but seropositive for HTLV-I and 20 were seronegative and served as negative controls. Plasmatic levels of the following were determined: antinuclear antibody (ANA) levels, anticardiolipine-2 (ACL-2), interferon- (IFN-gamma) and interleukin-4 (IL-4). Using Western blot, the crossreactivity of the seropositive and seronegative samples was evaluated against proteins extracted from several central nervous system components of non infected Wistar rats. The HTLV-I seropositive plasmas were crossreacted with a monoclonal tax (LT4 anti-taxp40) from spinal cord neurons of non infected Wistar rats. Of the TSP/HAM patients, 70.2% were reactive against ANA and 83.8% against ACL-2, in contrast with those ATL and asymptomatic seropositives subjects that were not reactive (P<0.001). Moreover, 70.3% had detectable levels of IFN and 43.2% had detectable IL-4. LT4 anti-taxp40 and plasma of TSP/HAM exhibited cross reactivity with a MW 33-35 kDa protein from the rat spinal cord nuclei. Support was provided for the existence of an autoimmune syndrome mediated by molecular mimicry; the syndrome was responsible for some of the axonal degeneration observed in TSP/HAM patients.

Experimental radiotherapy and clinical radiobiology. Vol. 20. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 20. Proceedings

Energy Technology Data Exchange (ETDEWEB)

Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemannn, Hans-Peter; Zips, Daniel (eds.)

2011-07-01

The proceedings include contributions on the following issues: laser driven proton accelerators on the way for radiotherapy, radiobiological evaluation of new radiations; molecular factors of radiation response; biological targeting; EGFR epidermal growth factor receptor/targeting - combined internal and external irradiation, radiobiology of normal tissues; dose-volume histograms for the radiotherapy: curves without radiobiological relevance or important information for the therapy planning; HPV (human papilloma virus) and radiation sensitivity of HNSCC (head and neck squamous cell carcinomas): evidence, radiobiological mechanism, clinical consequences and perspectives; mechanisms of action and intertumoral heterogeneity of response to EGFR inhibition in radiotherapy of solid tumors; evaluation of biomarkers for radiotherapy.

Secondary geochemical reactions in hydrothermal energy harnessing; Geochemische Folgereaktionen bei der hydrogeothermalen Energiegewinnung

Energy Technology Data Exchange (ETDEWEB)

Kuehn, M.

1996-12-01

This thesis is in six parts: description of geothermal energy harnessing, analytics, geochemical-thermodynamic modellings, experimental investigations, discussion of results, summary. (HW) [Deutsch] Die vorliegende Dissertationsschrift gliedert sich in 6 Teile: - Beschreibung der geothermischen Energienutzung - Analytik - geochemische-thermodynamische Modellierungen - experimentelle Untersuchungen - Diskussion der Ergebnisse - Zusammenfassung. (HW)

Mielite transversa como manifestação clínica inicial de linfoma não Hodgkin disseminado e mielopatia vacuolar associada ao HIV: relato de caso Transverse myelitis as initial symptom of disseminated non-Hodgkin lymphoma and HIV-associated vacuolar myelopathy: case report

Directory of Open Access Journals (Sweden)

Leandro P. de Moura

1996-06-01

Full Text Available Linfomas não Hodgkin de alto grau são comumente relatados em pacientes com a síndrome da imunodeficiência adquirida (AIDS. Comprometendo com grande freqüência o sistema nervoso central, particularmente as leptomeninges e os hemisférios cerebrais. O acometimento epidural é pouco freqüente, variando de 3,5% a 8,3% de acordo com os registros da literatura. Os autores relatam o caso de um paciente de 27 anos de idade com AIDS, cuja manifestação clínica inicial da doença linfomatosa disseminada foi a mielite transversa associada à mielopatia vacuolar. Destaca-se a importância do diagnóstico diferencial precoce das mielopatias na AIDS, em virtude da alta malignidade da neoplasia e da evolução extremamente rápida nesses pacientes.Non-Hodgkin lymphoma is frequently seen in AIDS patients usually affecting the central nervous system (CNS, especially the leptomeninges and the cerebral hemispheres. The epidural involvement is rarely described, ranging from 3.5% to 8.3% among the CNS sites. The authors present a case of disseminated non Hodgkin lymphoma associated to vacuolar myelopathy in a 27 years-old male patient with AIDS emphasizing the importance of this differential diagnosis in the myelopathies of AIDS.

Psychiatric comorbidities in a young man with subacute myelopathy induced by abusive nitrous oxide consumption: a case report

Directory of Open Access Journals (Sweden)

Mancke F

2016-09-01

Full Text Available Falk Mancke,1,2,* Gintare Kaklauskaite,1,* Jennifer Kollmer,3 Markus Weiler1 1Department of Neurology, 2Department of General Psychiatry, Center for Psychosocial Medicine, 3Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany *These authors contributed equally to this work Abstract: Nitrous oxide (N2O, a long-standing anesthetic, is known for its recreational use, and its consumption is on the rise. Several case studies have reported neurological and psychiatric complications of N2O use. To date, however, there has not been a study using standardized diagnostic procedures to assess psychiatric comorbidities in a patient consuming N2O. Here, we report about a 35-year-old male with magnetic resonance imaging confirmed subacute myelopathy induced by N2O consumption, who suffered from comorbid cannabinoid and nicotine dependence as well as abuse of amphetamines, cocaine, lysergic acid diethylamide, and ketamine. Additionally, there was evidence of a preceding transient psychotic and depressive episode induced by synthetic cannabinoid abuse. In summary, this case raises awareness of an important mechanism of neural toxicity, with which physicians working in the field of ­substance-related disorders should be familiar. In fact, excluding N2O toxicity in patients with recognized substance-related disorders and new neurological deficits is compulsory, as untreated for months the damage to the nervous system is at risk of becoming irreversible. Keywords: addictive disorders, laughing gas, subacute combined degeneration, substance use disorder, vitamin B12 deficiency

Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy

Directory of Open Access Journals (Sweden)

Da-Jiang Ren

2015-01-01

Full Text Available Background: Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM. Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM. Methods: Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L and hemilaminectomy (Group H. Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA, and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared. Results: Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41% than in Group H (62.72 ± 3.86% (P < 0.01. Conclusions: Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.

A treatable cause of myelopathy and vision loss mimicking neuromyelitis optica spectrum disorder: late-onset biotinidase deficiency.

Science.gov (United States)

Yilmaz, Sanem; Serin, Mine; Canda, Ebru; Eraslan, Cenk; Tekin, Hande; Ucar, Sema Kalkan; Gokben, Sarenur; Tekgul, Hasan; Serdaroglu, Gul

2017-06-01

Biotinidase deficiency is characterized by severe neurological manifestations as hypotonia, lethargy, ataxia, hearing loss, seizures and developmental retardation in its classical form. Late-onset biotinidase deficiency presents distinctly from the classical form such as limb weakness and vision problems. A 14-year-old boy presented with progressive vision loss and upper limb weakness. The patient was initiated steroid therapy with a preliminary diagnosis of neuromyelitis optica spectrum disorder due to the craniospinal imaging findings demonstrating optic nerve, brainstem and longitudinally extensive spinal cord involvement. Although the patient exhibited partial clinical improvement after pulse steroid therapy, craniocervical imaging performed one month after the initiation of steroid therapy did not show any regression. The CSF IgG index was <0.8 (normal: <0.8), oligoclonal band and aquaporin-4 antibodies were negative. Metabolic investigations revealed a low biotinidase enzyme activity 8% (0.58 nmoL/min/mL; normal range: 4.4 to 12). Genetic testing showed c.98-104delinsTCC and p.V457 M mutations in biotinidase (BTD) gene. At the third month of biotin replacement therapy, control craniospinal MRI demonstrated a complete regression of the lesions. The muscle strength of the case returned to normal. His visual acuity was 7/10 in the left eye and 9/10 in the right. The late-onset form of the biotinidase deficiency should be kept in mind in all patients with myelopathy with or without vision loss, particularly in those with inadequate response to steroid therapy. The family screening is important to identify asymptomatic individuals and timely treatment.

Cervical myelopathy due to single level disc herniation presenting as intramedullary mass lesion: What to do first?

Directory of Open Access Journals (Sweden)

Murat Sakir Eksi

2015-01-01

Full Text Available Cervical myelopathy (CM is mostly a degenerative process ending in myelopathic and/or radiculopathic syndromes. On T2-weighted magnetic resonance imaging (MRI, CM appears as a hyperintense area near the spondylotic spine. This high intensity signal depends on the impact of outer forces and their duration. It also determines the prognosis of the surgical candidate. A 40-year-old male patient admitted to our clinic with right upper extremity weakness and hypoesthesia that had started 2 months earlier. On neurological examination there was 2/5 motor weakness of right biceps brachii, and hypoesthesia over right C6 dermatome. Right upper extremity deep tendon reflexes were hypoactive, but lower ones were hyperactive. After clinical and radiological work-up, preliminary diagnosis was directed to a spinal intramedullary tumor. Total resection of the herniated cervical disc fragment and the mass lesion was managed. Pathology of the mass lesion was compatible with subacute infarct tissue and inflammatory response. Final diagnosis was CM under effect of cervical disc herniation. Contrast-enhanced spinal cord myelopathic lesions are very rare and resemble much more tumors and inflammatory processes. However, the principal treatment approach totally differs depending on pathology. When there are both a disc herniation and a high clinical suspicion; biopsy should be delayed. The most probable solution will be surgery for the disc disease with thorough preoperative scanning of vascular malformations; clinical and radiological close follow-up after surgery. Biopsy or surgical resection can be performed if patient deteriorates despite the primary surgery.

Experimental investigation and mathematical modelling of the combustion of brown coal, refuse and mixed fuels in a circulating fluidized bed combustor; Experimentelle Untersuchung und mathematische Modellierung der Verbrennung von Braunkohle, Abfallstoffen und Mischbrennstoffen in einer zirkulierenden Wirbelschichtfeuerung

Energy Technology Data Exchange (ETDEWEB)

Bernstein, W; Brunne, T; Hiller, A [Technische Univ. Dresden (Germany). Inst. fuer Energietechnik; Albrecht, J [Lurgi Umwelt GmbH, Frankfurt am Main (Germany); Quang, N [Polytechnic Inst., Danang (Viet Nam)

1998-09-01

Extensive experiments on combustion of biological materials and residues in fluidized bed combustors and dust combustors have been carried out at the Department of Power Plant Engineering of Dresden University since the early nineties. Particular interest was taken in mixing brown coal with sewage sludge, sugar pulp and waste wood. The experiments were supplemented by modelling in a research project funded jointly by the BMBF and Messrs. Lurgi since early 1997. A combustion cell model designed by Siegen University is being modified for the new mixed fuels, and preliminary investigations were carried out on a batch reactor while the modelling work was continued. (orig.) [Deutsch] An dem Lehrstuhl fuer Kraftwerkstechnik der TU Dresden werden seit Anfang der 90-iger Jahre umfangreiche experimentelle Untersuchungen zur Verbrennung von Bio- und Reststoffen in Wirbelschicht- und Staubfeuerungen durchgefuehrt. Dabei war vor allem die Zufeuerung dieser Stoffe in Waermeerzeugeranlagen auf Braunkohlenbasis von besonderem Interesse. Experimentell konnte nachgewiesen werden, dass sowohl Biobrennstoffe als auch Abfaelle in zirkulierenden Wirbelschichtfeuerungen umweltschonend zur Waermeerzeugung eingesetzt werden koennen. Als Beispiel wird das an Hand von Braunkohle-Klaerschlammgemischen sowie Bagasse- und Holz-Braunkohlegemischen gezeigt. Neben den experimentellen Untersuchungen bietet die Modellierung der Verbrennungsvorgaenge ein geeignetes Mittel um Voraussagen zu anderen Mischungsanteilen sowie anderen geometrischen Abmessungen machen zu koennen. Seit Anfang 1997 wird dazu ein vom BMBF und der Firma Lurgi gefoerdertes Forschungsvorhaben bearbeitet. Ein von der Universitaet Gesamthochschule Siegen fuer die Braunkohleverbrennung konzipiertes Zellenmodell wird auf die neuen Brennstoffgemische erweitert. Da grundsaetzlich andere Stoffzusammensetzungen vorliegen, wurden an einem Batch-Reaktor Voruntersuchungen zum Pyrolyseverhalten der Brennstoffe durchgefuehrt. Erste

Chronological observation in early radiation myelopathy of the cervical spinal cord; Gadolinium-enhanced MRI findings in two cases

Energy Technology Data Exchange (ETDEWEB)

Hirota, Saeko; Yoshida, Shoji; Soejima, Toshinori (Hyogo Medical Center for Adults, Akashi (Japan)) (and others)

Gd-enhanced MR images of two patients with clinically and histopathologically diagnosed chronic progressive radiation myelitis (CPRM) were observed chronologically. One of them had had nasopharyngeal cancer and received radiotherapy at a dose of 100 Gy to the C1-2 level of the spinal cord. She developed CPRM 25 months after the termination of radiotherapy. The other had had malignant lymphoma originating from the tonsil and received chemoradiotherapy. The dose delivered to her cervical spinal cord was 40 Gy, and she developed CPRM 30 months later. Gd-enhanced MRI in the early phase revealed a small crescent-shaped nidus with or without a very small central nonenhanced area in both cases. Enhancement was not great. At that time, patients noticed only the inability to perceive pain and temperature or paresthesia in the opposite side. In a few months, MRI revealed a much more strongly enhanced and larger nidus with enlargement of a central nonenhanced area accompanied by long segmental cord enlargement. The patients' neurological symptoms had also progressed, with hemiparesis developing, for example. (author).

Castor Seed Poisoning in Humans: A Review

Science.gov (United States)

1990-01-18

semillas do ricino. Arch Argon Pad 1961; 56:337-339. 40. Kraszewska Z, Switlik I, Stalewski R, Gest3nberger J. Ostre zatrucie nasionami drzewa...por ingestion de semillas de ricino. A proposito de un caso. Med Clin (Barcelona) 1988; 90:716-717. 54. Ehrlich P. Experimentelle Unterzuchungen

Long-term outcomes and prognostic analysis of modified open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy

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Su N

2016-08-01

Full Text Available Nan Su, Qi Fei, Bingqiang Wang, Dong Li, Jinjun Li, Hai Meng, Yong Yang, Ai Guo Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, People’s Republic of China Objectives: The purpose of the present study was to explore and analyze the long-term outcomes and factors that affect the prognosis of expansive open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy (CSM. Methods: We retrospectively reviewed 49 patients with multilevel CSM who had undergone expansive open-door laminoplasty with lateral mass screws fixation and fusion in our hospital between February 2008 and February 2012. The average follow-up period was 4.6 years. The clinical data of patients, including age, sex, operation records, pre- and postoperation Japanese Orthopedic Association (JOA scores, cervical spine canal stenosis, and cervical curvature, were collected. Increased signal intensity (ISI on T2-weighted magnetic resonance imaging and ossification of the posterior longitudinal ligament were also observed. Paired t-test was used to analyze the treatment effectiveness and recovery of neuronal function. The prognostic factors were analyzed with multivariable linear regression model. Results: Forty-nine patients with CSM with a mean age of 59.44 years were enrolled in this study. The average of preoperative JOA score was 9.14±2.25, and postoperative JOA score was 15.31±1.73. There was significant difference between the pre- and postoperative JOA scores. The clinical improvement rate was 80.27%. On follow-up, five patients had complaints of neck and shoulder pain, but no evidence of C5 nerve palsy was found. Developmental cervical spine canal stenosis was present in all patients before surgery. Before surgery, ISI was observed in eight patients, while ossification of the posterior longitudinal ligament was found in 12 patients. The average of preoperative cervical

Sensitivity of MRI in detecting alveolar infiltrates. Experimental studies; Sensitivitaet der MRT fuer alveolaere Infiltrate. Experimentelle Untersuchungen

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Biederer, J.; Busse, I.; Grimm, J.; Reuter, M.; Heller, M. [Kiel Univ. (Germany). Klinikum fuer Diagnostische Radiologie; Muhle, C. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin; Freitag, S. [Kiel Univ. (Germany). Inst. fuer Medizinische Informatik und Statistik

2002-08-01

detect pneumonia in patients. (orig.) [German] Zielsetzung: Eine experimentelle Studie zur Untersuchung des Signalverhaltens artifizieller alveolaerer Infiltrate mit T{sub 1}- und T{sub 2}-gewichteten MR-Sequenzen. Material und Methoden: 10 Lungen-Explantate von Schweinen wurden tracheal intubiert, in der kuenstlichen Thoraxhoehle eines Phantoms durch Unterdruck entfaltet und an einem klinischen Magnetresonanztomographen bei 1,5 T untersucht. Mit gezielter Instillation von 100-200 ml Gelatineloesung wurden alveolaere Infiltrate erzeugt und mit Gradientenecho- (2D-, 3D-GRE) und schnellen Spinechosequenzen (T{sub 2}-TSE, T{sub 2}-HASTE) dargestellt. Die Signalintensitaet des Lungenparenchyms nativ und mit Infiltrat wurde an repraesentativen Querschnitten erfasst. Zum Vergleich erfolgten Kontrollen mit Spiral-CT. Ergebnisse: Die instillierte Fluessigkeit simulierte alveolaere Infiltrate mit typischem Milchglasmuster im CT, wie es an Patienten mit Pneumonie oder ARDS beobachtet wird. Vor dem Versuch zeigten nur T{sub 2}-HASTE und T{sub 2}-TSE ein Lungenparenchymsignal (Signal/Rausch-Verhaeltnis von 3,62 bzw. 1,39). Nach Instillation von Fluessigkeit fand sich in diesen Sequenzen ein Signalanstieg von ca. 30% bei 100 ml (p<0,01) bzw. 60% bei 200 ml (p<0,01). Bei 2D-GRE betrug die Signalintensitaetszunahme 0,74% (p=0,32) nach 100 ml und 5,6% (p<0,01) nach 200 ml (fuer 3D-GRE 2,2% [p=0,02] bzw. 4,4% [p<0,01]). Die CT-Kontrollen zeigten fuer 100 ml eine Dichtezunahme um durchschnittlich 17 H.E. (p=0,02) und fuer 200 ml um 75 H.E. (p<0,01). Schlussfolgerungen: Mit T{sub 2}-gewichteten Sequenzen ist die MRT zur Darstellung artifizieller alveolaerer Infiltrate geeignet. (orig.)

Physiotherapy for human T-lymphotropic virus 1-associated myelopathy: review of the literature and future perspectives

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Sá KN

2015-02-01

Full Text Available Katia N Sá,1 Maíra C Macêdo,1 Rosana P Andrade,2 Selena D Mendes,1 José V Martins,3 Abrahão F Baptista1,4 1Neuromusculoskeletal Research Group, Bahian School of Medicine and Human Health, Salvador, Brazil; 2Edgard Santos University Hospital, Federal University of Bahia, Salvador, 3Deolindo Couto Institute of Neurology, Federal University of Rio de Janeiro, Rio de Janeiro, 4Biomorphology Department, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil Abstract: Human T-lymphotropic virus 1 (HTLV-1 infection may be associated with damage to the spinal cord – HTLV-associated myelopathy/tropical spastic paraparesis – and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions. Keywords: HTLV-1, HAM/TSP, physical therapy modalities, quality of life, pain, sensory-motor dysfunction, urinary symptoms

Increased low-frequency oscillation amplitude of sensorimotor cortex associated with the severity of structural impairment in cervical myelopathy.

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Fuqing Zhou

Full Text Available Decreases in metabolites and increased motor-related, but decreased sensory-related activation of the sensorimotor cortex (SMC have been observed in patients with cervical myelopathy (CM using advanced MRI techniques. However, the nature of intrinsic neuronal activity in the SMC, and the relationship between cerebral function and structural damage of the spinal cord in patients with CM are not fully understood. The purpose of this study was to assess intrinsic neuronal activity by calculating the regional amplitude of low frequency fluctuations (ALFF using resting-state functional MRI (rs-fMRI, and correlations with clinical and imaging indices. Nineteen patients and 19 age- and sex-matched healthy subjects underwent rs-fMRI scans. ALFF measurements were performed in the SMC, a key brain network likely to impaired or reorganized patients with CM. Compared with healthy subjects, increased amplitude of cortical low-frequency oscillations (LFO was observed in the right precentral gyrus, right postcentral gyrus, and left supplementary motor area. Furthermore, increased z-ALFF values in the right precentral gyrus and right postcentral gyrus correlated with decreased fractional anisotropy values at the C2 level, which indicated increased intrinsic neuronal activity in the SMC corresponding to the structural impairment in the spinal cord of patients with CM. These findings suggest a complex and diverging relationship of cortical functional reorganization and distal spinal anatomical compression in patients with CM and, thus, add important information in understanding how spinal cord integrity may be a factor in the intrinsic covariance of spontaneous low-frequency fluctuations of BOLD signals involved in cortical plasticity.

The functional relevance of diffusion tensor imaging in comparison to conventional MRI in patients with cervical compressive myelopathy

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Yang, Young-Mi; Oh, Jae-Keun; Song, Ji-Sun [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Spine Center, Anyang-si, Gyeonggi-do (Korea, Republic of); Yoo, Woo-Kyoung [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Physical Medicine and Rehabilitation, Anyang-si (Korea, Republic of); Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Hallym Institute for Translational Genomics and Bioinformatics, Anyang-si (Korea, Republic of); Yoo, Je Hyun; Kwak, Yoon Hae [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Orthopaedic surgery, Anyang-si (Korea, Republic of); Kim, Seok Woo [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Spine Center, Anyang-si, Gyeonggi-do (Korea, Republic of); Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Orthopaedic surgery, Anyang-si (Korea, Republic of)

2017-11-15

To determine the functional relevance of diffusion tensor imaging (DTI) metrics and conventional MRI (signal intensity change in T2, compression ratio) by measuring the correlation of these parameters with clinical outcome measured by the modified Japanese Orthopedic Association (mJOA) score. A total of 20 cervical myelopathy (CM) patients participated in this prospective cohort study. The severities of CM were assessed using the mJOA score. Conventional MRIs (T2-weighted images) measuring the signal changes of spinal cords and the degree of compression at the lesion level and DTI metrics [fractional anisotropy (FA), apparent diffusion coefficient (ADC)] at each lesion and below each lesion (C7/T1) level were acquired using a 3-T Achieva MRI. These parameters were correlated with the mJOA scores to determine the functional relevance. Ninety percent of CM patients showed signal changes and 30 % of patients noted a more than 40% canal compression ratio in conventional MRIs at the lesion level; however, these findings were not correlated with the mJOA score (p < 0.05). In contrast, FA values on DTI showed high sensitivity to CM (100%), which was well correlated with the mJOA score (p = 0.034, r = 0.475) below the lesion level (C7/T1). This study showed a meaningful symptomatic correlation between mJOA scores and FA values below the lesion levels in CM patients. It could give us more understanding of the pathological changes in spinal cords matched with various clinical findings in CM patients than the results from conventional MRI. (orig.)

The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI

International Nuclear Information System (INIS)

Kara, Batuhan; Celik, Azim; Karadereler, Selhan; Ulusoy, Levent; Ganiyusufoglu, Kursat; Onat, Levent; Mutlu, Ayhan; Sirvanci, Mustafa; Ornek, Ibrahim; Hamzaoglu, Azmi

2011-01-01

The radiological diagnosis of cervical spondylotic myelopathy (CSM) has to be made as soon as possible, since surgery performed in earlier stages during the course of CSM was reported to be more successful when compared with later stages. We hypothesized that diffusion tensor imaging (DTI) may detect CSM in earlier stages, before the appearance of signal increase in T2-weighted sequences. A total of 16 patients with neurological signs and symptoms of CSM but without hyperintensity in spinal cord on T2-weighted sequences enrolled in the study. The magnetic resonance (MR) examinations were performed on a 3-T MR imaging system. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were generated on axial plane. The ADC and FA measurements in each individual were made at the level of most severe cervical canal stenosis and at a nonstenotic level. Student's t test was used to compare FA and ADC values of the spinal cord in stenotic and nonstenotic segments. We also investigated if there was a correlation between DTI parametrics and duration of clinical symptoms by using Pearson correlation analysis. All patients showed changes in DTI parametrics at stenotic segments. While FA values of the spinal cord at the stenotic level showed a statistically significant reduction, there was a statistically significant increase in the measured ADC values (p < 0.001). There was no statistical correlation between the duration of symptoms and DTI parametrics. Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM. (orig.)

Intravenous methylprednisolone in HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP Metilprednisolona endovenosa na mielopatia associada ao HTLV-I/Paraparesia Espástica Tropical (MAH/PET

Directory of Open Access Journals (Sweden)

Abelardo Q-C Araújo

1993-09-01

Full Text Available HTLV-I (Human T-lymphotropic virus type I associated myelopathy/tropical spastic paraparesis (HAM/TSP is an immunomediated myelopathy induced by the HTLV-I. Some patients, specially those from Japan, seem to have a good response to steroid treatment. However, this has not been found in other regions of the world. High dose intravenous methylprednisolone has been used with success in patients with relapses of multiple sclerosis (MS, another autoimmune disease of the central nervous system. To test the effectiveness of methylprednisolone in patients with HAM/TSP, we devised an open trial in 23 patients. We found a very limited benefit of this form of treatment in these patients. Only one patient, who had the shortest disease duration (five months in the whole group, showed a sustained benefit. We speculate that those patients with a shorter history, with presumably less demye-lination and more inflammatory lesions, would show a better response to immunossupressive treatments.A mielopatia associada ao protovírus T-linfotrópico humano (HTLV-I, também conhecida como paraparesia espástica tropical associada ao HTLV-I (MAH/PET, constitui enfermidade imunomediada desencadeada pela infecção pelo HTLV-I. Nesta condição tem sido demonstrada, particularmente em pacientes japoneses, boa resposta clínica à terapêutica com corticosteróides. Este efeito benéfico todavia não foi encontrado em todas as regiões do mundo. Pulsoterapia com metilprednisolona endovenosa tem sido utilizada com sucesso em pacientes com esclerose múltipla, outro exemplo de doença auto-imune do sistema nervoso central, especialmente durante as fases de exacerbação da doença. Objetivando testar a eficácia da pulsoterapia com metilprednisolona em pacientes com MAH/PET, conduzimos estudo aberto em 23 doentes. Não constatamos efeito benéfico significativo desta forma de tratamento na maioria dos enfermos estudados. Apenas um dos pacientes, o qual exibia o menor tempo de

Limb myokymia

International Nuclear Information System (INIS)

Albers, J.W.; Allen, A.A.; Bastron, J.A.; Daube, J.R.

1981-01-01

Thirty-eight patients with myokymic discharges localized to limb muscles on needle electromyography had various neurologic lesions, both acute and chronic. Of the 38 patients, 27 had had previous radiation therapy and the clinical diagnosis of radiation-induced plexopathy, myelopathy, or both. For the remaining 11 patients, the diagnoses included multiple sclerosis, inflammatory polyradiculoneuropathy, ischemic neuropathy, inflammatory myopathy, and chronic disorders of the spinal cord and peripheral nerves. The clinical presentations and results of local ischemia, peripheral nerve block, and percutaneous stimulation suggest that most limb myokymic discharges arise focally at the site of a chronic peripheral nerve lesion

A Baseline Historical Analysis of Neck and Back-Related Morbidity in the U.S. Army: Occupational Risks Potentially Related to Head-Supported Mass

Science.gov (United States)

2005-09-01

disorder with myelopathy, unspecified region 722.73 Intervertebral disc disorder w/ myelopathy, lumbar region 721.3 Lumbosacral spondylosis without...Disc disorder, lumbar region 721.42 Spondylosis with myelopathy, lumbar region 724.6 Disorders of sacrum 738.4 Acquired spondylolisthesis...particular, increases risk for spondylosis and accentuates age-related decreases in spinal lordosis(20). In addition to the ballistic protection

Defective human T-cell lymphotropic virus type I (HTLV-I) provirus in seronegative tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM) patients.

Science.gov (United States)

Ramirez, E; Fernandez, J; Cartier, L; Villota, C; Rios, M

2003-02-01

Infection with human T-cell lymphotropic virus type I (HTLV-I) have been associated with the development of the tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). We studied the presence of HTLV-I provirus in peripheral blood mononuclear cells (PBMC) from 72 Chilean patients with progressive spastic paraparesis by polymerase chain reaction: 32 seropositive and 40 seronegative cases. We amplified different genomic regions of HTLV-I using primers of 5' ltr, tax, env/tax, pX, pol and env genes. These genes were detected from all seropositive patients. The seronegative patients were negative with 5' ltr, pol, env, and pX primers. However, amplified product of tax and env/tax genes was detected from 16 and four seronegative patients, respectively. Three of them were positive with both genetic regions. The results of this study show that the complete HTLV-I provirus is found in 100% of seropositive cases. In seronegative cases, clinically very similar of seropositive cases, was found only tax gene in 42.5% (17/40) of patients. These results suggest the presence of a defective HTLV-I provirus in some seronegative patients with progressive spastic paraparesis, and suggest a pathogenic role of this truncate provirus for a group of TSP/HAM.

Computed tomography in cervical spondylotic myelopathy and radiculopathy: Visualisation of structures, myelographic comparison, cord measurements and clinical utility

International Nuclear Information System (INIS)

Yu, Y.L.; Du Boulay, G.H.; Stevens, J.M.; Kendall, B.E.

1986-01-01

Sixty-nine patients with cervical spondylotic myelopathy (CSM), radiculopathy (CSR), or both (CSMR) were studied with computed tomography (CT). Computer-assisted myelography (CAM) accurately determines the site and nature of spondylotic protrusions and provides good visualisation of the subarachnoid space and cord deformities even in areas with dilute metrizamide. However, excessive vertebral movement and bulging ligamenta flava with their effects on cord deformity, so easily visualised in myelograms, are completely or partially missed. In the assessment of CSM, metrizamide myelography (MM) followed by CAM should be performed, particularly when the myelographic images are unsatisfactory due to contrast dilution or blockage, when cord compression cannot be ascertained with MM and when cord atrophy is suspected. In CSR, the diagnostic information from MM and CAM is comparable. The diagnostic criteria in CAM are, however, less direct and since MM is adequate in uncomplicated cases, CAM is generally not necessary. The APD, APD/TD ratio, area and circularity are sensitive indices of cord deformity and the first two should be used more often to assist visual assessment of cord deformity. The relation between cord parameters and treatment response is better reflected in CSM cases managed conservatively and the results suggest that the degree of cord deformity is helpful in determining the outcome and hence the choice between surgical and conservative treatment. In plain CT, the osteophytes and calcified discs are adequately visualised and canal dimensions measured with accuracy, but the cervical cord and roots cannot be properly assessed and the diagnosis of CSM or CSR cannot be ascertained. At present, its role in cervical spondylosis is therefore limited. (orig.)

The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI

Energy Technology Data Exchange (ETDEWEB)

Kara, Batuhan [Bakirkoey Dr. Sadi Konuk Teaching Hospital, Department of Radiology, Istanbul (Turkey); Celik, Azim [General Electric Healthcare, Istanbul (Turkey); Karadereler, Selhan [Florence Nightingale Hospital, Department of Neurosurgery, Istanbul (Turkey); Ulusoy, Levent; Ganiyusufoglu, Kursat; Onat, Levent; Mutlu, Ayhan; Sirvanci, Mustafa [Florence Nightingale Hospital, Department of Radiology, Istanbul (Turkey); Ornek, Ibrahim [Florence Nightingale Hospital, Department of Neurology, Istanbul (Turkey); Hamzaoglu, Azmi [Florence Nightingale Hospital, Department of Orthopedic Surgery, Istanbul (Turkey)

2011-08-15

The radiological diagnosis of cervical spondylotic myelopathy (CSM) has to be made as soon as possible, since surgery performed in earlier stages during the course of CSM was reported to be more successful when compared with later stages. We hypothesized that diffusion tensor imaging (DTI) may detect CSM in earlier stages, before the appearance of signal increase in T2-weighted sequences. A total of 16 patients with neurological signs and symptoms of CSM but without hyperintensity in spinal cord on T2-weighted sequences enrolled in the study. The magnetic resonance (MR) examinations were performed on a 3-T MR imaging system. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were generated on axial plane. The ADC and FA measurements in each individual were made at the level of most severe cervical canal stenosis and at a nonstenotic level. Student's t test was used to compare FA and ADC values of the spinal cord in stenotic and nonstenotic segments. We also investigated if there was a correlation between DTI parametrics and duration of clinical symptoms by using Pearson correlation analysis. All patients showed changes in DTI parametrics at stenotic segments. While FA values of the spinal cord at the stenotic level showed a statistically significant reduction, there was a statistically significant increase in the measured ADC values (p < 0.001). There was no statistical correlation between the duration of symptoms and DTI parametrics. Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM. (orig.)

Experimental MR-guided cryotherapy of the brain with almost real-time imaging by radial k-space scanning; Experimentelle MR-gesteuerte Kryotherapie des Gehirns mit nahezu Echtzeitdarstellung durch radiale k-Raum-Abtastung

Energy Technology Data Exchange (ETDEWEB)

Tacke, J.; Schorn, R.; Glowinski, A.; Grosskortenhaus, S.; Adam, G.; Guenther, R.W. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Speetzen, R.; Rau, G. [Helmholtz-Institut fuer Biomedizinische Technik, Aachen (Germany); Rasche, V. [Philips GmbH Forschungslaboratorium, Hamburg (Germany)

1999-02-01

Purpose: To test radial k-space scanning by MR fluoroscopy to guide and control MR-guided interstitial cryotherapy of the healthy pig brain. Methods: After MR tomographic planning of the approach, an MR-compatible experimental cryotherapy probe of 2.7 mm diameter was introduced through a 5 mm burr hole into the right frontal brain of five healthy pigs. The freeze-thaw cycles were imaged using a T{sub 1}-weighted gradient echo sequence with radial k-space scanning in coronal, sagittal, and axial directions. Results: The high temporal resolution of the chosen sequence permits a continuous representation of the freezing process with good image quality and high contrast between ice and unfrozen brain parenchyma. Because of the interactive conception of the sequence the layer plane could be chosen as desired during the measurement. Ice formation was sharply demarcated, spherically configurated, and was free of signals. Its maximum diameter was 13 mm. Conclusions: With use of the novel, interactively controllable gradient echo sequence with radial k-space scanning, guidance of the intervention under fluoroscopic conditions with the advantages of MRT is possible. MR-guided cryotherapy allows a minimally-invasive, precisely dosable focal tissue ablation. (orig.) [Deutsch] Ziel: Erprobung der radialen k-Raum-Abtastung bei der MR-Fluoroskopie zur Steuerung und Kontrolle MR-gesteuerter interstitieller Kryotherapie des gesunden Schweinegehirns. Methoden: Nach MR-tomographischer Planung des Zugangsweges wurde eine MR-kompatible experimentelle Kryotherapiesonde von 2,7 mm Durchmesser ueber ein 5 mm Bohrloch in das rechte Frontalhirn von fuenf gesunden Schweinen eingebracht. Die Frier-/Tauzyklen wurden anhand einer T{sub 1}-gewichteten Gradientenechosequenz mit radialer k-Raum-Abtastung in koronarer, sagittaler und axialer Schichtfuehrung dargestellt. Ergebnisse: Die hohe zeitliche Aufloesung der gewaehlten Sequenz erlaubte eine kontinuierliche Darstellung des Friervorgangs bei

Gas-operated heat pump for monovalent space heating and tap water heating. A seizable contribution to carbon dioxide emission control; Gasbetriebene Waermepumpe zur monovalenten Raumbeheizung und Trinkwassererwaermung. Ein greifbarer Beitrag zur Reduktion der CO{sub 2}-Emissionen

Energy Technology Data Exchange (ETDEWEB)

Heikrodt, K.; Heckt, R. [Viessmann Werke GmbH und Co., Allendorf (Germany)

1999-07-01

The project had the objectives to develop a Vuilleumier heat pump for space heating and make an experimental study testing it as a heat generator for a heating system for one- and multi-family houses. Apart from monovalent operation, the following boundary conditions were defined: provision for connection to existing heating systems, even radiator heatings with 75 C/60 C, tap water heating, and air-source heat. Performance constant, manufacturing cost, freedom from maintenance, and service life were taken into consideration in the design, rating and construction of the unit. (orig.) [German] Ziel des Vorhabens war die Entwicklung einer Vuilleumier-Waermepumpe zur Raumbeheizung und deren experimentelle Untersuchung als Waermeerzeuger fuer ein Heizungssystem in Ein- und Mehrfamilienhaeusern. Als Rahmebedingungen wurden neben einer monovalenten Betriebsweise auch die moegliche Anbindung an bestehende Heizungssysteme, sogar Radiatorheizungen mit 75 C/60 C, Trinkwassererwaermung und Luft als Waermequelle festgelegt. Leistungszahl, Herstellkosten, Wartungsfreiheit und Lebensdauer wurden in Konzeption, Auslegung und Konstruktion beruecksichtigt. (orig.)

Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

Directory of Open Access Journals (Sweden)

Dong C. Lim

2010-01-01

Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

Lesions in nerves and plexus after radiotherapy

International Nuclear Information System (INIS)

Vees, W.

1978-01-01

Apart from the typical, radiation-induced changes in the skin, common secondary findings were oedemas, radiation-induced ulceration, fibroses of the mediastinum and lungs, pleura adhesions, and osteoradionecroses. In one patient with radiogenic paresis of the plexus brachialis, irradiation of the spinal cord because of epidural metastases of a mammary carcinoma resulted in radiation myelopathy which was verified by laminectomy. Observations of radiogenic lesions of the plexus brachialis show that the usual site of the lesion in the vasomotoric nerve bundle is the axilla. The lesion is assumed to be caused mainly by an overlapping of the axillary, infraclavicular and supraclavicular fields of irradiation which results in a dose peak in the axilla. (orig./AJ) 891 AJ/orig.- 892 MKO [de

A study of measurement of the spinal cord of cervical myelopathy with CT-myelography and forecast of operative result from the size of the spinal cord

International Nuclear Information System (INIS)

Oosawa, Yoshimitsu

1985-01-01

The antero-posterior (AP) and transverse (T) diameter and the T area of the spinal canal, dural canal, and spinal cord were measured using CT-myelography (CT-M) in 44 patients with cervical myelopathy (CM) and 20 control subjects. The AP diameter of these canals and cord and the T diameter of the spinal canal were smaller in the CM group than in the control group. Postoperative CT-M showed that the dural canal and spinal cord had an increase in the AP diameter and T area and a decrease in the T diameter. Preoperative symptoms were well correlated with the AP diameter and the T area of the spinal canal, dural canal, and spinal cord, and spinal cord compression. The symptoms tended to be milder with larger AT diameter and T area of the spinal canal, dural canal, and spinal cord and with smaller spinal cord compression and deformity. Functional damage was reversible in patients with slight spinal cord compression. Favorable operative outcome tended to be achieved when the preoperative AP diameter and T area of the spinal cord were ≥ 5 mm and ≥ 50 mm 2 , respectively. (Namekawa, K.)

Theorie und Validierung der Modellbildung bipolarer Leistungshalbleiter im Temperaturbereich von 100K bis 400K

OpenAIRE

Schlögl, Andreas E.

2007-01-01

Theoretische Grundlagen zur temperaturabhängigen Modellbildung bipolarer Leistungshalbleiter wurden untersucht, optimiert und validiert. Basierend auf der neuen Formulierung von Trägerbeweglichkeiten nach Mnatsakanov wurde eine neue Kontinuitätsgleichung zur Beschreibung des bipolaren Stromtransports in schwach dotierten Driftzonen hergeleitet und charakterisiert. Ein vollständiges Leistungsdioden-Modell wurde erstellt. Zur temperaturabhängigen Validierung wurden experimentelle Techniken entw...

Rohstoffliche und verfahrenstechnische Einflussfaktoren der Pyrolyse biogener Rohstoffe

OpenAIRE

Reichel, Denise

2017-01-01

Die vorliegende Arbeit beschäftigt sich mit rohstofflichen und verfahrenstechnischen Einflussfaktoren bei der Biomassepyrolyse. Ausgehend von der Entwicklung einer kleintechnischen Festbettpyrolyseapparatur, erfolgten experimentelle Untersuchungen an 26 biogenen Einsatzstoffen unter verschiedenen Prozessbedingungen. Die Apparatur erlaubt eine vollständige Bilanzierung und Gewinnung aller Produkte, zudem können Einflüsse durch sekundäre Reaktionen in der Gasphase minimiert werden. Die Einsa...

Development of a new assessment tool for cervical myelopathy using hand-tracking sensor: Part 1: validity and reliability.

Science.gov (United States)

Alagha, M Abdulhadi; Alagha, Mahmoud A; Dunstan, Eleanor; Sperwer, Olaf; Timmins, Kate A; Boszczyk, Bronek M

2017-04-01

To assess the reliability and validity of a hand motion sensor, Leap Motion Controller (LMC), in the 15-s hand grip-and-release test, as compared against human inspection of an external digital camera recording. Fifty healthy participants were asked to fully grip-and-release their dominant hand as rapidly as possible for two trials with a 10-min rest in-between, while wearing a non-metal wrist splint. Each test lasted for 15 s, and a digital camera was used to film the anterolateral side of the hand on the first test. Three assessors counted the frequency of grip-and-release (G-R) cycles independently and in a blinded fashion. The average mean of the three was compared with that measured by LMC using the Bland-Altman method. Test-retest reliability was examined by comparing the two 15-s tests. The mean number of G-R cycles recorded was: 47.8 ± 6.4 (test 1, video observer); 47.7 ± 6.5 (test 1, LMC); and 50.2 ± 6.5 (test 2, LMC). Bland-Altman indicated good agreement, with a low bias (0.15 cycles) and narrow limits of agreement. The ICC showed high inter-rater agreement and the coefficient of repeatability for the number of cycles was ±5.393, with a mean bias of 3.63. LMC appears to be valid and reliable in the 15-s grip-and-release test. This serves as a first step towards the development of an objective myelopathy assessment device and platform for the assessment of neuromotor hand function in general. Further assessment in a clinical setting and to gauge healthy benchmark values is warranted.

Upregulation of CB2 receptors in reactive astrocytes in canine degenerative myelopathy, a disease model of amyotrophic lateral sclerosis

Science.gov (United States)

Fernández-Trapero, María; Espejo-Porras, Francisco; Rodríguez-Cueto, Carmen; Coates, Joan R.; Pérez-Díaz, Carmen; de Lago, Eva; Fernández-Ruiz, Javier

2017-01-01

ABSTRACT Targeting of the CB2 receptor results in neuroprotection in the SOD1G93A mutant mouse model of amyotrophic lateral sclerosis (ALS). The neuroprotective effects of CB2 receptors are facilitated by their upregulation in the spinal cord of the mutant mice. Here, we investigated whether similar CB2 receptor upregulation, as well as parallel changes in other endocannabinoid elements, is evident in the spinal cord of dogs with degenerative myelopathy (DM), caused by mutations in the superoxide dismutase 1 gene (SOD1). We used well-characterized post-mortem spinal cords from unaffected and DM-affected dogs. Tissues were used first to confirm the loss of motor neurons using Nissl staining, which was accompanied by glial reactivity (elevated GFAP and Iba-1 immunoreactivity). Next, we investigated possible differences in the expression of endocannabinoid genes measured by qPCR between DM-affected and control dogs. We found no changes in expression of the CB1 receptor (confirmed with CB1 receptor immunostaining) or NAPE-PLD, DAGL, FAAH and MAGL enzymes. In contrast, CB2 receptor levels were significantly elevated in DM-affected dogs determined by qPCR and western blotting, which was confirmed in the grey matter using CB2 receptor immunostaining. Using double-labelling immunofluorescence, CB2 receptor immunolabelling colocalized with GFAP but not Iba-1, indicating upregulation of CB2 receptors on astrocytes in DM-affected dogs. Our results demonstrate a marked upregulation of CB2 receptors in the spinal cord in canine DM, which is concentrated in activated astrocytes. Such receptors could be used as a potential target to enhance the neuroprotective effects exerted by these glial cells. PMID:28069688

Upregulation of CB2 receptors in reactive astrocytes in canine degenerative myelopathy, a disease model of amyotrophic lateral sclerosis

Directory of Open Access Journals (Sweden)

María Fernández-Trapero

2017-05-01

Full Text Available Targeting of the CB2 receptor results in neuroprotection in the SOD1G93A mutant mouse model of amyotrophic lateral sclerosis (ALS. The neuroprotective effects of CB2 receptors are facilitated by their upregulation in the spinal cord of the mutant mice. Here, we investigated whether similar CB2 receptor upregulation, as well as parallel changes in other endocannabinoid elements, is evident in the spinal cord of dogs with degenerative myelopathy (DM, caused by mutations in the superoxide dismutase 1 gene (SOD1. We used well-characterized post-mortem spinal cords from unaffected and DM-affected dogs. Tissues were used first to confirm the loss of motor neurons using Nissl staining, which was accompanied by glial reactivity (elevated GFAP and Iba-1 immunoreactivity. Next, we investigated possible differences in the expression of endocannabinoid genes measured by qPCR between DM-affected and control dogs. We found no changes in expression of the CB1 receptor (confirmed with CB1 receptor immunostaining or NAPE-PLD, DAGL, FAAH and MAGL enzymes. In contrast, CB2 receptor levels were significantly elevated in DM-affected dogs determined by qPCR and western blotting, which was confirmed in the grey matter using CB2 receptor immunostaining. Using double-labelling immunofluorescence, CB2 receptor immunolabelling colocalized with GFAP but not Iba-1, indicating upregulation of CB2 receptors on astrocytes in DM-affected dogs. Our results demonstrate a marked upregulation of CB2 receptors in the spinal cord in canine DM, which is concentrated in activated astrocytes. Such receptors could be used as a potential target to enhance the neuroprotective effects exerted by these glial cells.

Cytoplasmic Localization of HTLV-1 HBZ Protein: A Biomarker of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP).

Science.gov (United States)

Baratella, Marco; Forlani, Greta; Raval, Goutham U; Tedeschi, Alessandra; Gout, Olivier; Gessain, Antoine; Tosi, Giovanna; Accolla, Roberto S

2017-01-01

HTLV-1 is the causative agent of a severe form of adult T cell leukemia/Lymphoma (ATL), and of a chronic progressive neuromyelopathy designated HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Two important HTLV-1-encoded proteins, Tax-1 and HBZ, play crucial roles in the generation and maintenance of the oncogenic process. Less information is instead available on the molecular and cellular mechanisms leading to HAM/TSP. More importantly, no single specific biomarker has been described that unambiguously define the status of HAM/TSP. Here we report for the first time the finding that HBZ, described until now as an exclusive nuclear protein both in chronically infected and in ATL cells, is instead exclusively localized in the cytoplasm of peripheral blood mononuclear cells (PBMC) from patients suffering of HAM/TSP. Interestingly, at the single cell level, HBZ and Tax-1 proteins are never found co-expressed in the same cell, suggesting the existence of mechanisms of expression uncoupling of these two important HTLV-1 viral products in HAM/TSP patients. Cells expressing cytoplasmic HBZ were almost exclusively found in the CD4+ T cell compartment that was not, at least in a representative HAM/TSP patient, expressing the CD25 marker. Less than 1 percent CD8+ T cells were fond positive for HBZ, while B cells and NK cells were found negative for HBZ in HAM/TSP patients. Our results identify the cytoplasmic localization of HBZ in HAM/TSP patient as a possible biomarker of this rather neglected tropical disease, and raise important hypotheses on the role of HBZ in the pathogenesis of the neuromyelopathy associated to HTLV-1 infection.

Cytoplasmic Localization of HTLV-1 HBZ Protein: A Biomarker of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP.

Directory of Open Access Journals (Sweden)

Marco Baratella

2017-01-01

Full Text Available HTLV-1 is the causative agent of a severe form of adult T cell leukemia/Lymphoma (ATL, and of a chronic progressive neuromyelopathy designated HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP. Two important HTLV-1-encoded proteins, Tax-1 and HBZ, play crucial roles in the generation and maintenance of the oncogenic process. Less information is instead available on the molecular and cellular mechanisms leading to HAM/TSP. More importantly, no single specific biomarker has been described that unambiguously define the status of HAM/TSP. Here we report for the first time the finding that HBZ, described until now as an exclusive nuclear protein both in chronically infected and in ATL cells, is instead exclusively localized in the cytoplasm of peripheral blood mononuclear cells (PBMC from patients suffering of HAM/TSP. Interestingly, at the single cell level, HBZ and Tax-1 proteins are never found co-expressed in the same cell, suggesting the existence of mechanisms of expression uncoupling of these two important HTLV-1 viral products in HAM/TSP patients. Cells expressing cytoplasmic HBZ were almost exclusively found in the CD4+ T cell compartment that was not, at least in a representative HAM/TSP patient, expressing the CD25 marker. Less than 1 percent CD8+ T cells were fond positive for HBZ, while B cells and NK cells were found negative for HBZ in HAM/TSP patients. Our results identify the cytoplasmic localization of HBZ in HAM/TSP patient as a possible biomarker of this rather neglected tropical disease, and raise important hypotheses on the role of HBZ in the pathogenesis of the neuromyelopathy associated to HTLV-1 infection.

Image analysis of open-door laminoplasty for cervical spondylotic myelopathy: comparing the influence of cord morphology and spine alignment.

Science.gov (United States)

Lin, Bon-Jour; Lin, Meng-Chi; Lin, Chin; Lee, Meei-Shyuan; Feng, Shao-Wei; Ju, Da-Tong; Ma, Hsin-I; Liu, Ming-Ying; Hueng, Dueng-Yuan

2015-10-01

Previous studies have identified the factors affecting the surgical outcome of cervical spondylotic myelopathy (CSM) following laminoplasty. Nonetheless, the effect of these factors remains controversial. It is unknown about the association between pre-operative cervical spinal cord morphology and post-operative imaging result following laminoplasty. The goal of this study is to analyze the impact of pre-operative cervical spinal cord morphology on post-operative imaging in patients with CSM. Twenty-six patients with CSM undergoing open-door laminoplasty were classified according to pre-operative cervical spine bony alignment and cervical spinal cord morphology, and the results were evaluated in terms of post-operative spinal cord posterior drift, and post-operative expansion of the antero-posterior dura diameter. By the result of study, pre-operative spinal cord morphology was an effective classification in predicting surgical outcome - patients with anterior convexity type, description of cervical spinal cord morphology, had more spinal cord posterior migration than those with neutral or posterior convexity type after open-door laminoplasty. Otherwise, the interesting finding was that cervical spine Cobb's angle had an impact on post-operative spinal cord posterior drift in patients with neutral or posterior convexity type spinal cord morphology - the degree of kyphosis was inversely proportional to the distance of post-operative spinal cord posterior drift, but not in the anterior convexity type. These findings supported that pre-operative cervical spinal cord morphology may be used as screening for patients undergoing laminoplasty. Patients having neutral or posterior convexity type spinal cord morphology accompanied with kyphotic deformity were not suitable candidates for laminoplasty. Copyright © 2015 Elsevier B.V. All rights reserved.

Tabes dorsalis

Science.gov (United States)

Locomotor ataxia; Syphilitic myelopathy; Syphilitic myeloneuropathy; Myelopathy - syphilitic; Tabetic neurosyphilis ... the nervous system. If syphilis infection is suspected, tests may include the following: Cerebrospinal fluid (CSF) examination ...

Long-term safety and efficacy of fractionated stereotactic body radiation therapy for spinal metastases

Energy Technology Data Exchange (ETDEWEB)

Mantel, Frederick; Glatz, Stefan; Toussaint, Andre; Flentje, Michael; Guckenberger, Matthias [University Hospital Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany)

2014-12-15

Patients with long life expectancy despite metastatic status might benefit from long-term local control of spinal metastases. Dose-intensified radiotherapy (RT) is believed to control tumor growth better and thus offers longer pain relief. This single-institution study reports on fractionated stereotactic body radiation therapy (SBRT) for spinal metastases in patients with good life expectancy based on performance status, extent of metastases, histology, and time to metastasis. Between 2004 and 2010, 36 treatment sites in 32 patients (median age 55 years; male 61 %; median Karnofsky performance score 85) were treated with fractionated SBRT. The median treatment dose was 60 Gy (range, 48.5-65 Gy) given in a median of 20 fractions (range, 17-33); the median maximum dose to the planning risk volume for the spinal cord (PRV-SC) was 46.6 Gy. All patients suffering from pain prior to RT reported pain relief after treatment; after a median follow-up of 20.3 months, 61 % of treatment sites were pain-free, another 25 % associated with mild pain. In 86 % of treatments, patients were free from neurological symptoms at the time of the last clinical follow-up. Acute grade 1 toxicities (CTCAE 3.0) were observed in 11 patients. Myelopathy did not occur in any patient. Radiologically controlled freedom from local progression was 92 and 84 % after 12 and 24 months, respectively. Median overall survival (OS) was 19.6 months. Patient selection resulted in long OS despite metastatic disease, and dose-intensified fractionated SBRT for spinal metastases was safe and achieved long-term local tumor control and palliation of pain. (orig.) [German] Patienten mit guter Lebenserwartung trotz metastasierter Erkrankung koennten von einer lang andauernden lokalen Kontrolle von Wirbelsaeulenmetastasen profitieren. Eine dosisintensivierte Radiotherapie (RT) kann vermutlich eine bessere Tumorkontrolle und daher eine laengere Schmerzpalliation erreichen. Ausgewertet wurden die monozentrischen

Spinal Extradural Arachnoid Cyst

OpenAIRE

Choi, Seung Won; Seong, Han Yu; Roh, Sung Woo

2013-01-01

Spinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. The etiology remains still unclear. We experienced 2 cases of SEACs and reviewed the cases and previous literatures. A 59-year-old man complained of both leg radiating pain and paresthesia for 4 years. His MRI showed an extradural cyst from T12 to L3 and we performed cyst fenestration and repaired the dural defect with tailored laminectomy. Another 51-year-old female patient visited our cli...

A Systematic Review of Non-Traumatic Spinal Cord Injuries in Sub-Saharan Africa and a Proposed Diagnostic Algorithm for Resource-Limited Settings

Directory of Open Access Journals (Sweden)

Abdu Kisekka Musubire

2017-12-01

Full Text Available BackgroundNon-traumatic myelopathy is common in Africa and there are geographic differences in etiology. Clinical management is challenging due to the broad differential diagnosis and the lack of diagnostics. The objective of this systematic review is to determine the most common etiologies of non-traumatic myelopathy in sub-Saharan Africa to inform a regionally appropriate diagnostic algorithm.MethodsWe conducted a systemic review searching Medline and Embase databases using the following search terms: “Non traumatic spinal cord injury” or “myelopathy” with limitations to epidemiology or etiologies and Sub-Saharan Africa. We described the frequencies of the different etiologies and proposed a diagnostic algorithm based on the most common diagnoses.ResultsWe identified 19 studies all performed at tertiary institutions; 15 were retrospective and 13 were published in the era of the HIV epidemic. Compressive bone lesions accounted for more than 48% of the cases; a majority were Pott’s disease and metastatic disease. No diagnosis was identified in up to 30% of cases in most studies; in particular, definitive diagnoses of non-compressive lesions were rare and a majority were clinical diagnoses of transverse myelitis and HIV myelopathy. Age and HIV were major determinants of etiology.ConclusionCompressive myelopathies represent a majority of non-traumatic myelopathies in sub-Saharan Africa, and most were due to Pott’s disease. Non-compressive myelopathies have not been well defined and need further research in Africa. We recommend a standardized approach to management of non-traumatic myelopathy focused on identifying treatable conditions with tests widely available in low-resource settings.

Effect of repetitive transcranial magnetic stimulation on reducing spasticity in patients suffering from HTLV-1-associated myelopathy.

Science.gov (United States)

Amiri, Mostafa; Nafissi, Shahriar; Jamal-Omidi, Shirin; Amiri, Motahareh; Fatehi, Farzad

2014-12-01

Human T-lymphotropic virus type 1 has been implicated in human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Regarding its endemicity in Iran and the role of repetitive transcranial magnetic stimulation in reducing spasticity, we decided to evaluate the efficacy of repetitive transcranial magnetic stimulation in reducing spasticity (as primary outcome) and pain, muscle power, and quality of life (as secondary outcomes) in patients suffering from HAM/TSP. In this pretest-posttest study, nine definite patients with HAM/TSP (according to WHO guidelines) were recruited. All patients underwent five consecutive daily sessions of active repetitive transcranial magnetic stimulation (each session consisting of 20 trains of 10 pulses at 5 Hz and an intensity of 90% of resting motor threshold for the biceps brachii muscle). Main outcome measures including spasticity (by modified Ashworth scale), pain (by visual analog scale), muscle power, and quality of life (by SF 36) were measured before the study and days 5, 7, 30 after the termination of the sessions. Seven (77.8%) females and 2 (22.2%) males were recruited with the mean age of 52 ± 12.67 years, and the mean duration of the disease was 5 ± 3.94. Comparison of the repeated measures showed a statistically significant decrease in pain and spasticity in lower limbs. The decrement in spasticity was persistent even 30 days after the intervention; however, the pain reduction was seen only 5 days after the procedure. No change in quality of life, and muscle power was detected. It seems that repetitive transcranial magnetic stimulation could decrease spasticity and pain in patients with HAM/TSP, and this effect could persistently continue by 1 month, but it did not influence patients' muscle power and quality of life, and it could be used as an adjuvant therapy in patients suffering from human T-lymphotropic virus type 1-associated HAM/TSP.

Surgical site infections following operative management of cervical spondylotic myelopathy: prevalence, predictors of occurence, and influence on peri-operative outcomes.

Science.gov (United States)

Jalai, C M; Worley, N; Poorman, G W; Cruz, D L; Vira, S; Passias, P G

2016-06-01

Studies have examined infection rates following spine surgery and their relationship to post-operative complications and increased length of stay. Few studies, however, have investigated predictors of infection, specifically in the setting of operative intervention for cervical spondylotic myelopathy (CSM). This study aims to identify the incidence and factors predictive of infection amongst this cohort. This study performed a retrospective review of the prospectively collected American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Patients included those treated surgically for CSM (ICD-9 code 721.1) from 2010 to 2012. Patient demographics and surgical data were collected with outcome variables including the occurrence of one of the following surgical site infections (SSIs) within 30 days of index operation: superficial SSI, deep incisional SSI, and organ/space SSI. 3057 patients were included in this analysis. Overall infection rate was 1.15 % (35/3057), of which 54.3 % (19/35) were superficial SSIs, 28.6 % (10/35) were deep incisional SSI, and 20 % (7/35) were peri-spinal SSI. Logistic regression revealed factors associated with SSI included: higher BMI [OR 1.162 (CI 1.269-1.064), p = 0.001] and operative time ≥208 min [OR 4.769 (CI 20.220-1.125), p = 0.034]. The overall SSI rate for the examined CSM cohort was 1.15 %. This study identified increased BMI and operative time ≥208 min as predictors of infection in surgical CSM patients. This information should be carefully considered in delivering patient education and future efforts to optimize risk in CSM patients indicated for surgical intervention.

Arginase-1 expressing microglia in close proximity to motor neurons were increased early in disease progression in canine degenerative myelopathy, a model of amyotrophic lateral sclerosis.

Science.gov (United States)

Toedebusch, Christine M; Snyder, John C; Jones, Maria R; Garcia, Virginia B; Johnson, Gayle C; Villalón, Eric L; Coates, Joan R; Garcia, Michael L

2018-04-01

Toxicity within superoxide dismutase-1 (SOD1)-associated familial amyotrophic lateral sclerosis (ALS) is non-cell autonomous with direct contribution from microglia. Microglia exhibit variable expression of neuroprotective and neurotoxic molecules throughout disease progression. The mechanisms regulating microglial phenotype within ALS are not well understood. This work presents a first study to examine the specific microglial phenotypic response in close association to motor neurons in a naturally occurring disease model of ALS, canine degenerative myelopathy (DM). Microglia closely associated with motor neurons were increased in all stages of DM progression, although only DM Late reached statistical significance. Furthermore, the number of arginase-1 expressing microglia per motor neuron were significantly increased in early stages of DM, whereas the number of inducible nitric oxide synthase (iNOS)-expressing microglia per motor neuron was indistinguishable from aged controls at all stages of disease. Fractalkine, a chemotactic molecule for microglia, was expressed in motor neurons, and the fractalkine receptor was specifically localized to microglia. However, we found no correlation between microglial response and lumbar spinal cord fractalkine levels. Taken together, these data suggest that arginase-1-expressing microglia are recruited to the motor neuron early in DM disease through a fractalkine-independent mechanism. Copyright © 2018 Elsevier Inc. All rights reserved.

Influence of Magnetic Resonance Imaging Features on Surgical Decision-Making in Degenerative Cervical Myelopathy: Results from a Global Survey of AOSpine International Members.

Science.gov (United States)

Nouri, Aria; Martin, Allan R; Nater, Anick; Witiw, Christopher D; Kato, So; Tetreault, Lindsay; Reihani-Kermani, Hamed; Santaguida, Carlo; Fehlings, Michael G

2017-09-01

We conducted a survey to understand how specific pathologic features on magnetic resonance imaging (MRI) influence surgeons toward an anterior or posterior surgical approach in degenerative cervical myelopathy (DCM). A questionnaire was sent out to 6179 AOSpine International members via e-mail. This included 18 questions on a 7-point Likert scale regarding how MRI features influence the respondent's decision to perform an anterior or posterior surgical approach. Influence was classified based on the mean and mode. Variations in responses were assessed by region and training. Of 513 respondents, 51.7% were orthopedic surgeons, 36.8% were neurosurgeons, and the remainder were fellows, residents, or other. In ascending order, multilevel bulging disks, cervical kyphosis, and a high degree of anterior cord compression had a moderate to strong influence toward an anterior approach. A high degree of posterior cord compression had a moderate to strong influence, whereas multilevel compression, ossification of the posterior longitudinal ligament, ligamentum flavum enlargement, and congenital stenosis had a moderate influence toward a posterior approach. Neurosurgeons chose anterior approaches more and posterior approaches less in comparison with orthopedic surgeons (P influences the choice for anterior or posterior surgical approach. These data highlight factors based on surgeon experience, training, and region of practice. They will be helpful in defining future areas of investigation in an effort to provide individualized surgical strategies and optimize patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Experimental determination of the electronic properties of application-relevant interfaces of organic semiconductors by means of photoelectron spectroscopy; Experimentelle Bestimmung der elektronischen Eigenschaften anwendungsrelevanter Grenzflaechen organischer Halbleiter mittels Photoelektronenspektroskopie

Energy Technology Data Exchange (ETDEWEB)

Grobosch, Mandy

2009-07-01

This thesis under the titel Experimental Determination of the Electronic Properties of Application-relevant Interfaces of Organic Semiconductors by means of Photoelectron Spectroscopy was drawn up at the Leibniz Institute for Solid-State and Materials Research (IFW) Dresden at the Institute for Solid-State Research (IFF) under the maintenance of Prof. Dr. B. Buechner. To the scientific study hereby came two types of application-relevant interfaces. On the one hand the influence of the electrode preparation under normal conditions by means of ex-situ purification procedures in comparison to in-situ prepared contacts on the electronic behaviour of the organic semiconductor sexithiophene on interfaces to metallic substrates was studied. As substrate materials hereby the metals silver, palladium, gold, and platinum came to application. In a second study the interfaces of the organic semiconductors sexithiophene and copper(II)-phthalocyanine in contact to thin films of the transition-metal oxide La{sub 0.7}Sr{sub 0.3}MnO{sub 3} were studied. Also here a comparing study for ex-situ and in-situ purificated La{sub 0.7}Sr{sub 0.3}MnO{sub 3} contacts was performed. The films applied for this were fabricated in the IWF Dresden at the Institute for Metallic Materials (IMW). Also in the framework of these studies the influence of oxygen on the electronic and chemical behaviour on the interfaces held the spotlight. [German] Diese Dissertation unter dem Titel Experimentelle Bestimmung der elektronischen Eigenschaften anwendungsrelevanter Grenzflaechen organischer Halbleiter mittels Photoelektronenspektroskopie wurde am Leibniz Institut fuer Festkoerper- und Werkstoffforschung (IFW) Dresden am Institut fuer Festkoerperforschung (IFF) unter der Betreuung von Prof. Dr. B. Buechner angefertigt. Zur wissenschaftlichen Untersuchung kamen hierbei zwei Typen anwendungsrelevanter Grenzflaechen. Zum einem wurde der Einfluss einer Elektrodenpraeparation unter Normalbedingungen mittels ex

Mathematical modelling and simulation of solar-assisted drying of bulk farm products; Mathematische Modellierung und Simulation der solar unterstuetzten Trocknung landwirtschaftlicher Schuettgueter

Energy Technology Data Exchange (ETDEWEB)

Maltry, W.; Ziegler, T.; Richter, I.

1997-04-01

The report deals with problems associated with the harnessing of solar energy for drying bulk farm products: technical fundamentals, enthalpy diagrams, models for grain drying, experimental investigations, analysis of drying processes, benefits and applications of drying processes, advances. (HW) [Deutsch] Der Bericht behandelt die Probleme der Solarenergienutzung zur Trockung landwirtschaftlicher Massengueter: - Trocknungstechnische Grundlagen - Enthalpie-Diagramme - Modelle zur Koernertrocknung - experimentelle Untersuchungen - Analyse von Trocknungsprozesse - Nutzen und Verwertbarkeit der Trocknungsprozesse - Fortschritte. (HW)

Symptomatic thoracic spinal cord herniation: case series and technical report.

Science.gov (United States)

Hawasli, Ammar H; Ray, Wilson Z; Wright, Neill M

2014-09-01

Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on the treatment algorithm and surgical technique, and there are few data on clinical outcomes. In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomatology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially because of multiple sclerosis. Finally, compared with compressive myelopathy in the thoracic spine, surgical treatment of ISCH led to rapid improvement despite a long duration of symptoms. Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair.

Role of IL-21 in HTLV-1 infections with emphasis on HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP).

Science.gov (United States)

Rajaei, Taraneh; Farajifard, Hamid; Rafatpanah, Houshang; Bustani, Reza; Valizadeh, Narges; Rajaei, Bahareh; Rezaee, Seyed Abdolrahim

2017-06-01

Interleukin-21 (IL-21) enhances the survival and cytotoxic properties of cytotoxic T cells (CTLs) and exhibits essential roles in controlling chronic viral infections. HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive inflammatory disease of the nervous system. The main determinant of disease progression is efficiency of the CTL response to Human T lymphotropic virus types I (HTLV-1). In this study, the expression of host IL-21 and HTLV-I Tax and proviral load (PVL) was evaluated to understand the role and mechanism of IL-21 in HTLV-1 infections and the subsequent development of HAM/TSP. A cross-sectional study was carried out on 20 HAM/TSP patients, 20 asymptomatic HTLV-1 carriers (ACs) and 20 healthy controls (HCs) to evaluate the expression of IL-21 and Tax and PVL in non-activated and phorbol myristate acetate (PMA)-ionomycin-activated peripheral blood mononuclear cells (PBMCs). The mean mRNA expression of IL-21 in the non-activated and activated PBMCs was higher (by 5-13 times) in the HAM/TSP patients than in ACs and HCs (p Tax and PVL was observed in the HAM/TSP subjects than ACs (p Tax gene expression was positively correlated with PVL (R = 0.595, p = 0.000) and IL-21 gene expression (R = 0.395, p = 0.021) in the HTLV-1-infected subjects. In conclusion, the increase in IL-21 mRNA expression may reflect the attempt of infected T cells to induce an appropriate antiviral response, and the decrease in IL-21 protein expression may reflect the inhibition of IL-21 mRNA translation by viral factors in favour of virus evasion and dissemination.

Modification of the biologic dose to normal tissue by daily fraction

Energy Technology Data Exchange (ETDEWEB)

Wollin, M; Kagan, A R [Southern California Permanente Medical Group, Los Angeles Calif. (USA). Dep. of Radiation Therapy

1976-12-01

A method to predict normal tissue injury is proposed that includes high daily doses and unusual times successfully by calculating a new value called BIR (Biologic Index of Reaction). BIR and NSD were calculated for various normal tissue reactions. With the aid of statistical correlation techniques it is found that the BIR model is better than the NSD model in predicting radiation myelopathy and vocal edema and as good as NSD IN PREDICTING RIB FRACTURE/ Neither model predicts pericardial effusion. In no case were the results of BIR inferior to those of NSD.

Degenerative myelopathy in German Shepherd Dog: comparison of two molecular assays for the identification of the SOD1:c.118G>A mutation.

Science.gov (United States)

Capucchio, Maria Teresa; Spalenza, Veronica; Biasibetti, Elena; Bottero, Maria Teresa; Rasero, Roberto; Dalmasso, Alessandra; Sacchi, Paola

2014-02-01

Degenerative myelopathy (DM) is a late-onset, slowly progressive degeneration of spinal cord white matter which is reported primarily in large breed dogs. The missense mutation SOD1:c.118G>A is associated with this pathology in several dog breeds, including the German Shepherd Dog (GSD). The aims of the present study were to develop a tool for the rapid screening of the SOD1 mutation site in dogs and to evaluate the association of the polymorphism with DM in the German Shepherd breed. Two different techniques were compared: a minisequencing test and a real-time pcr allelic discrimination assay. Both approaches resulted effective and efficient. A sample of 47 dogs were examined. Ten subjects presented the symptoms of the illness; for one of them the diagnosis was confirmed by postmortem investigations and it resulted to be an A/A homozygote. In another clinically suspected dog, heterozygote A/G, the histopathological examination of the medulla showed moderate axon and myelin degenerative changes. GSD shows a frequency of the mutant allele equal to 0.17, quite high being a high-risk allele. Because canine DM has a late onset in adulthood and homozygous mutant dogs are likely as fertile as other genotypes, the natural selection is mild and the mutant allele may reach high frequencies. A diagnostic test, easy to implement, may contribute to control the gene diffusion in populations. The SOD1:c.118G>A mutation could be a useful marker for breeding strategies intending to reduce the incidence of DM.

Ziekten van het ruggenmerg

NARCIS (Netherlands)

Groen, Robertus; Kuks, Joannes; Snoek, Jozef; Kuks, Jan B.M.; Snoek, Jos W.

2016-01-01

Er zijn vele oorzaken voor een myelopathie. Beschadiging van het myelum kan compleet zijn (zoals in het geval van een complete dwarslaesie), maar is vaker incompleet (zoals bij een incomplete traumatische dwarslaesie en de meeste vormen van myelopathie op basis van niet-traumatische oorzaken). Er

Ionizing radiation, radiation sources, radiation exposure, radiation effects. Pt. 2

International Nuclear Information System (INIS)

Schultz, E.

1985-01-01

Part 2 deals with radiation exposure due to artificial radiation sources. The article describes X-ray diagnosis complete with an analysis of major methods, nuclear-medical diagnosis, percutaneous radiation therapy, isotope therapy, radiation from industrial generation of nucler energy and other sources of ionizing radiation. In conclusion, the authors attempt to asses total dose, genetically significant dose and various hazards of total radiation exposure by means of a summation of all radiation impacts. (orig./WU) [de

The value of MR and other methods in evaluation of cervical spondylosis

International Nuclear Information System (INIS)

Konopka, M.; Rejniak, I.; Kluczewska, E.; Baron, J.; Collie, D.

1995-01-01

38 patients with clinical symptoms of myelopathy, radiculopathy and neck pain have undergone X-ray and MR examinations in order to estimate spinal canal and degenerative changes of cervical vertebral column. The correlation between degree of degenerative changes and myelopathy or radiculopathy or neck pain was established on MR. In patients with myelopathy advanced degeneration changes (2. and 3. degree) were observed more often than in radiculopathy and neck pain. Disorders of mobility and cervical spine instability were found in 50%. Focal changes with high signal on T2 images in cervical cord were found in 2 cases. (author)

Adult T-cell leukemia-lymphoma in a patient with HTLV-I/II associated myelopathy Leucemia - linfoma de células T do adulto em um paciente com mielopatia associada a HTLV-I/II

Directory of Open Access Journals (Sweden)

Virgínia Freitas

1997-06-01

Full Text Available Chronic myelopathy associated with T-lymphotropic virus type I (HAM has been described as an endemic disease in several areas of the world, meanwhile there are few papers describing the association between HAM and adult T cell leukemia-lymphoma. We report the case of a man that, after four years of progressive spastic paraparesis and neurogenic bladder, developed a clinical picture of a lymphoproliferative disorder characterized by dermal and systemic envolvement, mimicking mycosis fungoides/Sézary syndrome.Apesar da infecção pelo HTLV-I ser endêmica em várias regiões do mundo, poucos são os relatos da associação entre leucemia-linfoma de células T do adulto (ATLL e encefalomieloneuropatia pelo HTLV-I. No presente artigo é descrito um paciente que no curso do comprometimento neurológico pelo HTLV-I desenvolveu quadro de leucemia com infiltração de tecido dérmico semelhante ao encontrado na micose fungóide/síndrome de Sézary.

Balance, functional mobility, and fall occurrence in patients with human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis: a cross-sectional study.

Science.gov (United States)

Fonseca, Erika Pedreira da; Sá, Katia Nunes; Nunes, Rebeca Freitas Reis; Ribeiro Junior, Antônio Carlos; Lira, Síntia Freitas Bastos; Pinto, Elen Beatriz

2018-01-01

Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS) and functional mobility evaluation based on the timed up and go (TUG) test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC) curve; 5% alpha was considered. We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (prisk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values ​​of 50 points using the BBS and 12.28 seconds using the TUG test.

Maximum likelihood estimation of dose-response parameters for therapeutic operating characteristic (TOC) analysis of carcinoma of the nasopharynx

International Nuclear Information System (INIS)

Metz, C.E.; Tokars, R.P.; Kronman, H.B.; Griem, M.L.

1982-01-01

A Therapeutic Operating Characteristic (TOC) curve for radiation therapy plots, for all possible treatment doses, the probability of tumor ablation as a function of the probability of radiation-induced complication. Application of this analysis to actual therapeutic situation requires that dose-response curves for ablation and for complication be estimated from clinical data. We describe an approach in which ''maximum likelihood estimates'' of these dose-response curves are made, and we apply this approach to data collected on responses to radiotherapy for carcinoma of the nasopharynx. TOC curves constructed from the estimated dose-response curves are subject to moderately large uncertainties because of the limitations of available data.These TOC curves suggest, however, that treatment doses greater than 1800 rem may substantially increase the probability of tumor ablation with little increase in the risk of radiation-induced cervical myelopathy, especially for T1 and T2 tumors

Characterisation of laser induced thermal radiation for the experimental investigation of heavy ion interactions with plasma; Charakterisierung lasererzeugter Hohlraumstrahlung fuer die experimentelle Untersuchung der Wechselwirkung von Schwerionen mit Plasmen

Energy Technology Data Exchange (ETDEWEB)

Hessling, Thomas

2010-02-08

One major area of interest of the plasma physics group at the GSI Helmholtzzentrum fuer Schwerionenforschung GmbH (GSI Helmholtz Centre for Heavy Ion Research) and the laser and plasma physics group at the Institut fuer Kernphysik (Nuclear Physics Institute) of the University of Technology Darmstadt is the determination of the energy loss of heavy ions in plasma. The experimental area Z6 at GSI offers the unique opportunity for this in the combination of the ion accelerator UNILAC with two high energy laser systems: nhelix and PHELIX. In recent experiments a thin carbon foil is probed by regular ion bunches every 9.2 ns. A laser pulse of one or both of the laser systems heats the foil to the plasma state at a certain time. The change in arrival time of each ion bunch at a stop detector allows to determine the energy loss in the plasma. In addition to this experimental scheme with a directly heated foil a different scheme with indirectly heated targets is investigated. The laser is unable to penetrate the foil and thus deposits its energy on the surface, leading to gradients in density and temperature. In the indirectly heated set-up the laser energy is converted into thermal X-Rays in a converter hohlraum. A secondary cavity, containing the interaction target for the ion beam, is attached to the converter and heated homogeneously by the X-Rays. In the present work the thermal radiation from a converter cavity with a diameter of either 750 m or 650 m was investigated. The frequency-doubled nhelix beam (532 nm wavelength) with energies of up to 30 joules in six to seven nanoseconds (FWHM) was used as the heating laser. A new diode spectrometer, specifically designed for the temperature measurement, recorded the absolute radiation intensity at four different wavelengths and resolved the temperature evolution during the heating phase. Maximum values between 32 eV and 38 eV have been determined in various measurements. In addition to the temporal characterisation the

Comparison of a zero-profile anchored spacer (ROI-C) and the polyetheretherketone (PEEK) cages with an anterior plate in anterior cervical discectomy and fusion for multilevel cervical spondylotic myelopathy.

Science.gov (United States)

Liu, Yijie; Wang, Heng; Li, Xuefeng; Chen, Jie; Sun, Han; Wang, Genlin; Yang, Huilin; Jiang, Weimin

2016-06-01

We aimed to analyze the clinical and radiographic efficacy of a new zero-profile anchored spacer called the ROI-C in anterior discectomy and fusion (ACDF) for multilevel cervical spondylotic myelopathy (MCSM). We retrospectively reviewed the clinical, radiological outcomes and complications of multilevel ACDF with the ROI-C or with the polyetheretherketone (PEEK) cages with an anterior plate. From April 2011 to April 2014, 60 patients with MCSM were operated on using ACDF, with the ROI-C in 28 patients and PEEK cages with an anterior plate in 32 patients. The operative time, intraoperative blood loss, and clinical and radiological results were compared between the ROI-C group and the cage-plate group. The mean follow-up time was 23.8 ± 6.6 months, ranging from 12 to 36 months. At the first month and the last follow-up, the neck disability index (NDI) scores were decreased, and the Japanese Orthopedic Association (JOA) scores were significantly increased, compared with the presurgical measurements in both groups. There were no significant differences in NDI scores or JOA scores between the two groups (P > 0.05), but there were significant differences in the operation time, blood loss and the presence of dysphagia (P PEEK cage with an anterior plate.

Morphological study of the axial view of the cervical spinal cord by MR images

International Nuclear Information System (INIS)

Suzuki, Masahiro; Shimamura, Tadashi

1994-01-01

To investigate the morphological changes in the cervical spinal cord in patients with cervical myelopathy, we examined the axial anatomy of the cervical spinal cord and the spinal canal using MRI and CT scans. This study involved 35 patients (mean age=56.8) with cervical myelopathy and 118 adult normal volunteers (mean age=48.1) as controls. The transverse area of the spinal cord was measured on MR images (T 1 images), while the transverse area of the spinal canal was measured on CT. In normal subjects, the transverse area, the sagittal diameter, and the coronal diameter of the spinal cord showed a significant positive correlation with body height, and a significant negative correlation with age. No significant difference was identified between males and females. The transverse area, the sagittal diameter, the coronal diameter, and the ratio of the sagittal/coronal diameter of the spinal cord and the spinal canal showed significant positive correlations among each other in normal subjects, but no significant correlation was noted in the patients with cervical myelopathy. These was no significant difference between the normal subjects and the patients in the transverse area or in the ratio of the sagittal/coronal diameter of the spinal cord at the levels without cord compression. However, the transverse area of the spinal canal in the patients with myelopathy was significantly smaller than that of normal subjects. In conclusion, a poor or no correlation between the size of the spinal cord and the spinal canal is a frequent finding in patients with myelopathy. Furthermore, this study suggests that patients with myelopathy present a narrow spinal canal more frequently than do normal subjects. (author)

The value of MR and other methods in evaluation of cervical spondylosis; Wartosc badania MR i innych metod obrazowania w ocenie stopnia zaawansowania spondylozy szyjnej

Energy Technology Data Exchange (ETDEWEB)

Konopka, M.; Rejniak, I.; Kluczewska, E.; Baron, J.; Collie, D. [Pracownia Rezonansu Magnetycznego, Instytut Pediatrii w Budowie, Katowice (Poland) and Zaklad Diagnostyki Obrazowej, Centrum Medyczne Ksztalcenia Podyplomowego, Centralny Szpital Kliniczny, Warsaw-Miedzylesie (Poland) and Western General Hospital, Edinburgh (United Kingdom)

1995-12-31

38 patients with clinical symptoms of myelopathy, radiculopathy and neck pain have undergone X-ray and MR examinations in order to estimate spinal canal and degenerative changes of cervical vertebral column. The correlation between degree of degenerative changes and myelopathy or radiculopathy or neck pain was established on MR. In patients with myelopathy advanced degeneration changes (2. and 3. degree) were observed more often than in radiculopathy and neck pain. Disorders of mobility and cervical spine instability were found in 50%. Focal changes with high signal on T2 images in cervical cord were found in 2 cases. (author) 17 refs, 4 figs , 7 tabs

Intraoperative computed tomography for cervicomedullary decompression of foramen magnum stenosis in achondroplasia: two case reports.

Science.gov (United States)

Arishima, Hidetaka; Tsunetoshi, Kenzo; Kodera, Toshiaki; Kitai, Ryuhei; Takeuchi, Hiroaki; Kikuta, Ken-Ichiro

2013-01-01

The authors report two cases of cervicomedullary decompression of foramen magnum (FM) stenosis in children with achondroplasia using intraoperative computed tomography (iCT). A 14-month-old girl with myelopathy and retarded motor development, and a 10-year-old girl who had already undergone incomplete FM decompression was presented with myelopathy. Both patients underwent decompressive sub-occipitalcraniectomy and C1 laminectomy without duraplasty using iCT. It clearly showed the extent of FM decompression during surgery, which finally enabled sufficient decompression. After the operation, their myelopathy improved. We think that iCT can provide useful information and guidance for sufficient decompression for FM stenosis in children with achondroplasia.

Increased expression of OX40 is associated with progressive disease in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis.

Science.gov (United States)

Saito, Mineki; Tanaka, Reiko; Arishima, Shiho; Matsuzaki, Toshio; Ishihara, Satoshi; Tokashiki, Takashi; Ohya, Yusuke; Takashima, Hiroshi; Umehara, Fujio; Izumo, Shuji; Tanaka, Yuetsu

2013-05-07

OX40 is a member of the tumor necrosis factor receptor family that is expressed primarily on activated CD4+ T cells and promotes the development of effector and memory T cells. Although OX40 has been reported to be a target gene of human T-cell leukemia virus type-1 (HTLV-1) viral transactivator Tax and is overexpressed in vivo in adult T-cell leukemia (ATL) cells, an association between OX40 and HTLV-1-associated inflammatory disorders, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), has not yet been established. Moreover, because abrogation of OX40 signals ameliorates chronic inflammation in animal models of autoimmune disease, novel monoclonal antibodies against OX40 may offer a potential treatment for HTLV-1-associated diseases such as ATL and HAM/TSP. In this study, we showed that OX40 was specifically expressed in CD4+ T cells naturally infected with HTLV-1 that have the potential to produce pro-inflammatory cytokines along with Tax expression. We also showed that OX40 was overexpressed in spinal cord infiltrating mononuclear cells in a clinically progressive HAM/TSP patient with a short duration of illness. The levels of the soluble form of OX40 (sOX40) in the cerebrospinal fluid (CSF) from chronic progressive HAM/TSP patients or from patients with other inflammatory neurological diseases (OINDs) were not different. In contrast, sOX40 levels in the CSF of rapidly progressing HAM/TSP patients were higher than those in the CSF from patients with OINDs, and these patients showed higher sOX40 levels in the CSF than in the plasma. When our newly produced monoclonal antibody against OX40 was added to peripheral blood mononuclear cells in culture, HTLV-1-infected T cells were specifically removed by a mechanism that depends on antibody-dependent cellular cytotoxicity. Our study identified OX40 as a key molecule and biomarker for rapid progression of HAM/TSP. Furthermore, blocking OX40 may have potential in therapeutic intervention for

Avaliação do tipo de diamante de benzel em pacientes portadores de mielopatia cervical Evaluación del tipo de diamante de benzel en pacientes con mielopatia cervical Evaluation of the type of benzel's diamond in patients with cervical myelopathy

Directory of Open Access Journals (Sweden)

Rodrigo Rezende

2012-12-01

medidas se encontraron 24 pacientes con diamante del tipo A (80%, 2 con tipo B (6,7% y 4 con tipo C (13,3%. CONCLUSIÓN: El diamante de Benzel del tipo "A" se encuentra en el 80% de los pacientes con mielopatía cervical en el período preoperatorio.OBJECTIVE: Diffuse the method of Benzel for calibration of cervical angulation and to assess the prevalence of each type of Benzel's diamond between 30 patients with cervical myelopathy with an indication for surgical treatment. METHODS: A retrospective study of patients with cervical myelopathy treated surgically. We analyzed lateral radiographs of cervical spine where the diamonds were measured using the techniques described by the author himself. We excluded patients who developed disease following trauma, who underwent reoperations or those who have not provided adequate lateral radiographs for measurement. RESULTS: We evaluated 30 patients, of whom 25 were male, aged between 30 and 74 years (mean 52.4 years. After completion of the measures 24 patients were found with diamond type A (80%, 2 with type B (6.7% and 4 with type C (13.3%. CONCLUSION: The Benzel diamond "A" was found in 80% of patients with cervical myelopathy in the preoperative evaluation.

Atoms, radiation, and radiation protection

International Nuclear Information System (INIS)

Turner, J.E.

1986-01-01

This book describes basic atomic and nuclear structure, the physical processes that result in the emission of ionizing radiations, and external and internal radiation protection criteria, standards, and practices from the standpoint of their underlying physical and biological basis. The sources and properties of ionizing radiation-charged particles, photons, and neutrons-and their interactions with matter are discussed in detail. The underlying physical principles of radiation detection and systems for radiation dosimetry are presented. Topics considered include atomic physics and radiation; atomic structure and radiation; the nucleus and nuclear radiation; interaction of heavy charged particles with matter; interaction of beta particles with matter; phenomena associated with charged-particle tracks; interaction of photons with matter; neutrons, fission and criticality; methods of radiation detection; radiation dosimetry; chemical and biological effects of radiation; radiation protection criteria and standards; external radiation protection; and internal dosimetry and radiation protection

Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion.

Directory of Open Access Journals (Sweden)

Sheng Shi

Full Text Available Cervical disc arthroplasty (CDA with Discover prosthesis or anterior cervical discectomy and fusion (ACDF with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM. However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM.A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA score and Neck Disability Index (NDI. For radiographic assessment, the overall sagittal alignment (OSA, functional spinal unit (FSU angle, and range of motion (ROM at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded.Both treatments significantly improved all clinical parameters (P 0.05. Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05. However, significant differences occurred in prosthesis migration in CDA group.The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up.

Experiments and CFD simulations of DTBP pool fires; Experimentelle Untersuchungen und CFD-Simulationen von DTBP-Poolfeuern

Energy Technology Data Exchange (ETDEWEB)

Chun, Hyunjoo

2007-07-01

Flammable liquids are used increasingly often world-wide. Their storage, transport and chemical reactions are a considerable safety problem in industrial plants. Heat release and combustion products of big fires are a high hazard for persons, the immediate vicinity and the environment in general. Investigations of pool fires were carried out for a realistic assessment of the potential hazards to persons and plants in the immediate vicinity. Most of the available data on fire effects, safety distances and other measures relevant to fire protection are for hydrocarbons, alcohols and liquefied gases. LIttle is known on pool fires of liquid organic peroxides, which have quite different combustion characteristics with higher mass burnup rates and higher heat emissions into the vicinity. The dissertation presents experiments to characterize the combustion characteristics of organic peroxides as a function of the pool diameter. Di-tert-butylperoxide (DTBPL) was chosen for the experiments because it has a relatively high thermal stability as compared to other organic peroxides. Mass burnup rates, flame temperatures, the surface emissive power (SEP), the strength of thermal radiation and the flame length were measured as a function of the pool diameter. Further, parameters required for CFD simulations of DTBP pool fires were identified experimentally in order to ensure realistic modelling of real fires as a basis, e.g., for assessing safety distances. Experiments on large pool fires are costly and require much equipment and technical preparations so that fires are limited to pool diameters of only a few meters as a rule. CFD simulations would be capable of improving the prediction of safety-relevant parameters like flame temperature, surface emissive power, radiation strength and flame length without limiting the pool diameter or the fuel volume. Appropriate sub-models were used for modelling pool fires of organic peroxides, and the simulation results were critically

Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up.

Science.gov (United States)

Chen, Yu; Wang, Xinwei; Lu, Xuhua; Yang, Lili; Yang, Haisong; Yuan, Wen; Chen, Deyu

2013-07-01

Anterior cervical discectomy and fusion (ACDF) with titanium- or polyetheretherketone (PEEK)-cage reconstruction is widely used in the treatment of cervical spondylotic myelopathy (CSM). This study was to compare outcomes of titanium and PEEK cages in the treatment of multilevel CSM. Between November 2002 and December 2004, a total of 80 patients with 3-level CSM were randomized in a 1:1 ratio to titanium group and PEEK group. The overall follow-up period of the patients ranged from 86 to 116 months (average 99.7 months). Clinical and radiological results were compared between titanium group and PEEK group. At the final follow-up, the clinical outcomes including JOA score, NDI score, and the excellent and good rates of clinical outcomes in the PEEK group were better than those in the titanium group. More loss of the Cobb angles and the intervertebral height was observed in the titanium group, resulting in the radiological parameters in the titanium group becoming inferior to the PEEK group at the final follow-up. Cage subsidence rates were 34.5 and 5.4% in the titanium and PEEK groups, respectively. Fusion was observed in all patients of two groups at the final follow-up. Two patients presented with cage dislocation without clinical symptoms in the titanium group. In surgical treatment of multilevel CSM, PEEK cage is superior to titanium cage in maintenance of intervertebral height and cervical lordosis, resulting in better clinical outcomes in the long-term follow-up.

C1-C2 transarticular screw fixation for atlantoaxial instability due to rheumatoid arthritis: a seven-year analysis of outcome.

LENUS (Irish Health Repository)

Nagaria, Jabir

2009-12-15

STUDY DESIGN.: Observational study. Retrospective analysis of prospectively collected data. OBJECTIVE.: The purpose of this article was to report long-term (minimum 7 years) clinical and radiologic outcome of our series of patients with Rheumatoid Arthritis who underwent transarticular screw fixation to treat atlantoaxial subluxation. SUMMARY OF BACKGROUND DATA.: The indications for intervention in patients with atlantoaxial instability are pain, myelopathy, and progressive neurologic deficit. The various treatment options available for these patients are isolated C1-C2 fusion, occipitocervical fusion with or without transoral surgery. Review of current literature suggests that C1-C2 transarticular screw fixation has significant functional benefits, although there is discrepancy in this literature regarding improvement in function following surgery. METHODS.: Myelopathy was assessed using Ranawat myelopathy score and Myelopathy Disability Index. Pain scores were assessed using Visual Analogue Scale. The radiologic imaging was assessed and the following data were extracted; atlanto-dens interval, space available for cord, presence of signal change on T2 weighted image, and fusion rates. RESULTS.: Thirty-seven patients, median age 56, were included in the study. Average duration of neck symptoms was 15.8 months. Average duration of rheumatoid arthritis before surgery was 20.6 years. Preoperative symptoms: suboccipital pain in 26 patients; neck pain, 32; myelopathy, 22; and 5 were asymptomatic. After surgery: suboccipital pain, 2; neck pain, 3; and myelopathy, 10. Ninety percent patients with neck and suboccipital pain improved after surgery in their Visual Analogue pain scores, with all of them having >50% improvement in VAS scores (6.94-2.12 [P < 0.05]).Preoperative Ranawat grade was as follows: grade 1 in 15 patients, grade 2 in 7, and grade 3a in 14, grade 3b in 1.After surgery: grade 1 in 27 patients, grade 2 in 7, grade 3a in 1, and grade 3b in 2. The mean

Radiation practices and radiation measurements

International Nuclear Information System (INIS)

2008-03-01

The guide presents the principal requirements on accuracy of radiation measurements and on the approval, calibration and operating condition inspections of radiation meters, together with requirements for dosimetric services measuring the individual radiation doses of workers engaged in radiation work (approved dosimetric services). The Guide also sets out the definitions of quantities and units used in radiation measurements. The radiation protection quantities used for assessing the harmful effects of radiation and for expressing the maximum values for radiation exposure (equivalent dose and effective dose) are set out in Guide ST 7.2. This Guide concerns measurements of ionizing radiation involved in radiation practices, the results of which are used for determining the radiation exposure of workers engaged in radiation work and members of the public, and of patients subject to the use of radiation in health services, or upon the basis of which compliance with safety requirements of appliances currently in use and of their premises of use or of the workplaces of workers is ensured. The Guide also concerns measurements of the radon concentration of inhaled air in both workplaces and dwellings. The Guide does not apply to determining the radiation exposure of aircrews, determination of exposure caused by internal radiation, or measurements made to protect the public in the event of, or in preparation for abnormal radiation conditions

A Detailed Dosimetric Analysis of Spinal Cord Tolerance in High-Dose Spine Radiosurgery.

Science.gov (United States)

Katsoulakis, Evangelia; Jackson, Andrew; Cox, Brett; Lovelock, Michael; Yamada, Yoshiya

2017-11-01

Dose-volume tolerance of the spinal cord (SC) in spinal stereotactic radiosurgery (SRS) is difficult to define because radiation myelitis rates are low, and published reports document cases of myelopathy but do not account for the total number of patients treated at given dose-volume combinations who do not have myelitis. This study reports SC toxicity from single-fraction spinal SRS and presents a comprehensive atlas of the incidence of adverse events to examine dose-volume predictors. A prospective database of all patients undergoing single-fraction spinal SRS at our institution between 2004 and 2011 was reviewed. SC toxicity was defined by clinical myelitis with accompanying magnetic resonance imaging (MRI) signal changes that were not attributable to tumor progression. Dose-volume histogram (DVH) atlases were created for these endpoints. Rates of adverse events with 95% confidence limits and probabilities that rates of adverse events were 13.33 Gy, and minimum doses to the hottest 0.1, 0.2, 0.5, and 1 cc were >10.66, 10.9, and 8 Gy, respectively; however, both myelitis cases occurred below the 34th percentile for Dmax and there were 194 DVHs in total with Dmax >13.33 Gy. A median SC Dmax of 13.85 Gy is safe and supports that a Dmax limit of 14 Gy carries a low <1% rate of myelopathy. No dose-volume thresholds or relationships between SC dose and myelitis were apparent. This is the largest study examining dosimetric data and radiation-induced myelitis in de novo spine SRS. Copyright © 2017 Elsevier Inc. All rights reserved.

Production and Quality Assurance of Modules and Study of optimized Pixel Sensor Designs for the Upgrade of the CMS Pixel Detector

CERN Document Server

Heindl, Stefan; Husemann, Ulrich

In der vorliegenden Dissertation wird die Modulproduktion am Institut für Experimentelle Kernphysik des KIT für das Phase-I-Upgrade des CMS-Pixeldetektors im Jahr 2017 vorgestellt. Dies umfasst die gesamte Produktionskette, an deren Ende die fertigen Module stehen. Ein besonderes Augenmerk wird dabei auf die Qualitätssicherung während der Produktion gelegt. Darüber hinaus werden die Ergebnisse von Teststrahluntersuchungen von optimierten Pixelsensoren für das geplante Phase-II-Upgrade des CMS-Pixeldetektors präsentiert.

[Lightning strike and lesions outside the brain: Clinical cases and a review of the literature].

Science.gov (United States)

Morin, A; Lesourd, A; Cabane, J

2015-01-01

Every year, 240,000 people are struck by lightning worldwide, causing injuries leading to significant handicaps. Most of the symptoms involve brain lesions; neuromuscular sequelae and myelopathy are less common. We describe five cases of patients struck by lightning with various clinical presentations. The first patient presented painful paresthesias in both upper limbs that disappeared 18 months later; the injury was a plexopathy. The second patient developed proximal weakness in the upper-left limb due to a myopathy. Two patients presented with various motor weaknesses in the lower limbs due to motor neuron disease and myelopathy. The last patient had a transient tetraplegy, which resolved in 5minutes; the diagnosis was keraunoparalysis. Lightning injuries can have many consequences depending on the different mechanisms involved. The clinical presentation is often due to a very focal lesion without any secondary extension. Motor neuron disease probably results from post-traumatic myelopathy. We discuss the ALS-electrocution association, frequently described in the literature. Various peripheral nerve and spinal cord lesions can be seen in lightning strike victims involving myelopathy, motor neuron, muscle and plexus. Clinical syndromes are often atypical but outcome is often favorable. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Diagnosis of cervical spinal cord disorders with MRI

International Nuclear Information System (INIS)

Suyama, Naohito; Iizuka, Tadashi

1991-01-01

From September 1987 through May 1989, magnetic resonance imaging (MRI) has been performed in 58 patients with myelopathy and 9 patients with spinal cord injuries. This study was designed to determine the rate of spinal cord stricture and changes of signal intensities. Increased signal intensity on T2-weighted images was more frequently observed than decreased intensity on T1-weighted images in the group of myelopathy (19/58 vs 10/58). In the group of spinal cord injuries, however, there was no significant difference in the incidence between increased intensity on T2-weighted images (4/9) and decreased intensity on T1-weighted images (7/9). Twelve patients with chronic compressive spinal myelopathy tended to have an increased intensity on T2-weighted images. In such cases, although JOA scores were low before surgery, signal intensity returned to that without marked signal changes. In chronic compressive cervical myelopathy, the degree of preoperative compression was the same as the postoperative JOA scores. Regarding cervical spinal injury, there was a good correlation between the size of low signal area and the degree of paralysis. (N.K.)

Radiation and radiation protection; Strahlung und Strahlenschutz

Energy Technology Data Exchange (ETDEWEB)

Bartholomaeus, Melanie (comp.)

2017-04-15

The publication of the Bundesamt fuer Strahlenschutz covers the following issues: (i) Human beings in natural and artificial radiation fields; (ii) ionizing radiation: radioactivity and radiation, radiation exposure and doses; measurement of ionizing radiation, natural radiation sources, artificial radiation sources, ionizing radiation effects on human beings, applied radiation protection, radiation exposure of the German population, radiation doses in comparison; (iii) non-ionizing radiation; low-frequency electric and magnetic fields, high-frequency electromagnetic fields, optical radiation; (iiii) glossary, (iv) units and conversion.

Balance, functional mobility, and fall occurrence in patients with human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis: a cross-sectional study

Directory of Open Access Journals (Sweden)

Erika Pedreira da Fonseca

Full Text Available Abstract INTRODUCTION: Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. METHODS: A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS and functional mobility evaluation based on the timed up and go (TUG test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC curve; 5% alpha was considered. RESULTS: We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (p<0.05. Good accuracy was determined for the BBS (77% and TUG test (70% and the cutoff points for the risk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. CONCLUSIONS: Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values of 50 points using the BBS and 12.28 seconds using the TUG test.

Comparison of plate-cage construct and stand-alone anchored spacer in the surgical treatment of three-level cervical spondylotic myelopathy: a preliminary clinical study.

Science.gov (United States)

Shi, Sheng; Liu, Zu-De; Li, Xin-Feng; Qian, Lie; Zhong, Gui-Bin; Chen, Fang-Jing

2015-09-01

Although stand-alone cages were advocated to be superior to plate-cage construct (PCC) because of comparable clinical outcomes and fewer plate-related complications, cage dislocation and subsidence were frequently mentioned in multilevel fusion. There are some concerns about whether these issues can be effectively prevented in multilevel anterior cervical discectomy and fusion (ACDF) by stand-alone anchored spacer (SAAS). The aim was to compare clinical outcomes, radiologic parameters, and complications of PCC and SAAS in the treatment of three-level cervical spondylotic myelopathy (CSM). This was a retrospective comparative study. A total of 38 consecutive patients with three-level CSM (ACDF with PCC, 20 patients; ACDF with SAAS, 18 patients) were reviewed. Clinical outcomes were assessed using Japanese Orthopaedic Association and Neck Disability Index. The radiologic evaluations included cervical alignment (CA), segmental angle (SA), postoperative curvature loss (PCL), and incidence of subsidence. All the aforementioned parameters were compared before and after surgery between two groups. Besides, the aforementioned results were also compared between the two groups. The complications were also recorded. The mean follow-up period was 30.3 months. No significant differences were observed in clinical outcomes between the two groups (p>.05). Additionally, no significant differences existed in fusion rate between the two groups. There were significant differences in PCL of SA and CA and correction of SA between the two groups (pSAAS group, and the potential of SAAS to reduce the incidence of postoperative dysphagia was not proven. No other complications were observed in this study. In the surgical treatment of three-level CSM, PCC is superior to SAAS in correction and maintenance of SA and avoiding cage subsidence, although the technique of ACDF with SAAS yielded encouraging clinical outcomes and high fusion rate. Copyright © 2015 Elsevier Inc. All rights reserved.

Fluidized-bed gasification of plastics and baking coal; Vergasung von Kunststoffen und backender Steinkohle in der Wirbelschicht

Energy Technology Data Exchange (ETDEWEB)

Scharpff, J.T.

1995-12-31

The applicability of fluidized-bed processes for recycling of plastics is investigated by experiments on a semi-industrial scale, and the particular characteristics and specific problems connected with the use of plastics are gone into. Apart from the technical aspects, the problem of organic pollutants produced in the process is investigated as well. The plastics used in the experiments were all chlorine-free; the report therefore contains an extra chapter on the chlorine problem caused by PVC in plastic fractions. Against the background of the current discussion of dioxin and furan emissions, the problem of efficient chlorine separation from the product gas is of topical interest which warrants a detailed theoretical analysis and experimental investigations in a laboratory system. (orig.) [Deutsch] In dieser Arbeit werden die Eignung des Wirbelschichtverfahrens fuer das Recycling von Kunststoffen durch experimentelle Versuche im Technikumsmassstab untersucht und die Besonderheiten sowie die spezifischen Probleme beim Einsatz von Kunststoffen in der Wirbelschicht behandelt. Neben verfahrenstechnischen Gesichtspunkten wird auch die Problematik der Entstehung organischer Schadstoffe beruecksichtigt. Da bei den in der Technikumsanlage eingesetzten Kunststoffen ausschliesslich chlorfreie Kunststoffkomponenten zum Einsatz kamen, widmet sich diese Arbeit gesondert der Chlorproblematik, die durch den PVC-Anteil in Kunststofffraktionen verursacht wird. Vor dem Hintergrund der aktuellen Diskussionen um Dioxin- und Furanemissionen erhaelt die Frage einer effizienten Chlorabscheidung aus dem Produktgas eine besondere Bedeutung, welcher durch eine ausfuehrliche theoretische Betrachtung sowie experimentelle Versuche in einer Laboranlage Rechnung getragen wird. (orig.)

Infrared Radiation and Blackbody Radiation

OpenAIRE

2005-01-01

tut present graph Tutorial Presentation Graph Interactive Media Element This interactive tutorial covers the following: How infrared radiation was discovered., The regions of infrared radiation and their relations to temperature., The nature of blackbody radiation and Planck's radiation law., The relationship between temperature and the power emitted by radiation.The interactions in this tutorial include clicking to reveal new information, and questions that help students...

A comparative study of human T-cell lymphotropic virus-associated myelopathy in HIV-positive and HIV-negative patients in KwaZulu-Natal

Directory of Open Access Journals (Sweden)

Hoosain F. Paruk

2017-12-01

Full Text Available Background: KwaZulu-Natal is an endemic area for HIV and human T-cell lymphotropic virus (HTLV infection. The main neurological manifestation of HTLV is HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP. The effect of HIV co-infection in patients with HAM/TSP is not well documented. Aims: To determine the prevalence of HIV seropositivity in patients with HAM/TSP and compare the clinical, laboratory and radiological features of patients mono-infected with HTLV and those dually infected with HTLV and HIV. Methods: Adult patients referred to the Neurology Department at Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal, South Africa, for the period 01 January 2004 to 31 December 2015 with a positive HTLV serology were identified from the National Health Laboratory Service database. A retrospective chart review was conducted to identify all patients who had a diagnosis of HAM/TSP and to record their HIV status. Clinical, laboratory and radiological data were compared for HIV-positive and HIV-negative patients. Results: A total of 52 patients with HAM/TSP were identified. HIV results were available in 44 patients of whom 23 (52% patients were HIV co-infected. Patients who were HIV-positive had a younger age of presentation compared to HIV-negative patients (median: 31 vs 50 years, p = 0.002. HIV-positive patients had a median duration of symptoms at presentation of 12 months compared to 16 months for HIV-negative patients, but the difference did not reach statistical significance (p = 0.082. The CD4 cell counts of HIV-positive patients were well preserved with a median count of 781 cells/µL. Conclusions: HIV co-infection is commonly seen in the setting of HAM/TSP in KwaZulu-Natal. An interaction between the viruses may accelerate the development of HAM/TSP, leading to a younger age of presentation. Co-infection may have treatment implications because of CD4 counts being preserved in these patients.

Erectile insufficiency as first symptom of HTLV-I/II associated myelopathy: case report Insuficiência erétil como primeiro sintoma da mielopatia associada ao HTLV I/II: relato de caso

Directory of Open Access Journals (Sweden)

JOSÉ TEOTONIO OLIVEIRA

1998-03-01

Full Text Available A case of HTLV-I/II myelopathy in which the initial complaint was erectile insufficiency (EI is reported. The only abnormalities found on the neurological exam were discrete weakness of the psoas and increased knee jerk reflexes. Diagnosis was made by demonstrating antibodies anti-HTLV I/II in the serum and cerebrospinal fluid (with the techniques of ELISA and Western blot, with confirmation by the polymerase chain reaction (PCR. EI can thus be the first symptom of HTLV-I/II infection and patients with EI of unknown etiology should be tested for HTLV-I/II in endemic areas.É relatado um caso de mielopatia associada ao HTLV I/II cuja primeira manifestação foi insuficiência erétil (IE. O exame neurológico do paciente apresentava somente discreta fraqueza dos psoas e aumento dos reflexos patelares. O diagnóstico foi feito pelo achado de anticorpos anti-HTLV I/II no soro e no líquor (com as técnicas de ELISA e Western blot e confirmado pela reação em cadeia da polimerase (PCR. Insuficiência erétil pode ser a primeira manifestação clínica de infecção pelo HTLV I/II e pacientes com IE de etiologia desconhecida devem ser testados para HTLV-I/II em áreas endêmicas.

Approaches to radiotherapy in metastatic spinal cord compression.

Science.gov (United States)

Suppl, Morten Hiul

2018-04-01

Metastatic spinal cord compression is caused by the progression of metastatic lesions within the vicinity of the spinal cord. The consequences are very severe with loss of neurological function and severe pain. The standard treatment is surgical intervention followed by radiotherapy or radiotherapy alone. However, the majority of patients are treated with radiotherapy only due to contraindications to surgery and technical inoperability. Stereotactic body radiotherapy is a technology to deliver higher radiation dose to the radiotherapy target with the use of spatial coordinates. This modality has shown positive results in treating lesions in brain and lungs. Hence, it could prove beneficial in metastatic spinal cord compression. We designed and planned a trial to investigate this method in patients with metastatic spinal cord compression. The method was usable but the trial was stopped prematurely due to low accrual that made comparison with surgery impossible. Low accrual is a known problem for trials evaluating new approaches in radiotherapy. Target definition in radiotherapy of metastatic spinal cord compression is defined by patient history, examination and imaging. Functional imaging could provide information to guide target definition with the sparring of normal tissue e.g. spinal cord and hematopoietic tissue of the bone marrow. In future trials this may be used for dose escalation of spinal metastases. The trial showed that PET/MRI was feasible in this group of patients but did not change the radiotherapy target in the included patients. Neurological outcome is similar irrespective of course length and therefore single fraction radiotherapy is recommended for the majority of patients. In-field recurrence is a risk factor of both short and long fractionation schemes and re-irradiation have the potential risk of radiation-induced myelopathy. In a retrospective study of re-irradiation, we investigated the incidence of radiation-induced myelopathy. In our study

6. GESA symposium on experimental stress analysis, May 6 and 7, 1982 Stuttgart

Energy Technology Data Exchange (ETDEWEB)

1982-04-01

Under the scientific chairmanship of Dr. H. Wolf, KWU Muehlheim/Ruhr, the 6th Symposium of the Gemeinschaft Experimentelle Spannungsanalyse (GESA = Experimental Stress Analysis Association) takes place in the Schwabenlandhalle at Fellbach near Stuttgart. The meeting will be organized by VDI/VDE-Gesellschaft Mess- und Regelungstechnik (GMR = VDI/VDE Society for Instrumentation and Control Engineering) located at Duesseldorf. It will be associated with an exposition of firms working in the field of experimental mechanics and presenting among other things developments in the fields of measuring transmitters, data acquisition and processing.

6. GESA symposium on experimental stress analysis, May 6 and 7, 1982 Stuttgart

International Nuclear Information System (INIS)

Anon.

1982-01-01

Under the scientific chairmanship of Dr. H. Wolf, KWU Muehlheim/Ruhr the 6th Symposium of the Gemeinschaft Experimentelle Spannungsanalyse (GESA = Experimental Stress Analysis Association) takes place in the Schwabenlandhalle at Fellbach near Stuttgart. The meeting will be organized by VDI/VDE-Gesellschaft Mess- und Regelungstechnik (GMR = VDI/VDE Society for Instrumentation and Control Engineering) located at Duesseldorf. It will be associated with an exposition of firms working in the field of experimental mechanics and presenting among other things developments in the fields of measuring transmitters, data acquisition and processing. (orig./RW) [de

Differential diagnosis of myelitis; Differenzialdiagnostik der Myelitis

Energy Technology Data Exchange (ETDEWEB)

Langner, Soenke [Universitaetsmedizin Greifswald (Germany). Inst. fuer Diagnostische Radiologie und Neuroradiologie

2016-09-15

Acute transverse Myelitis is an inflammatory myelopathy characterized by rapid onset of bilateral neurological symptoms. There is a vast array of differential diagnoses and the underlying pathology often cannot be identified on clinical examination alone. Therefore neuroimaging has a central role in narrowing the differential diagnosis. This review aims to provide a summary of common causes of non-traumatic myelopathies, many of which may have similar radiological appearance.

Neurogenic bladder in Hunter's syndrome.

Science.gov (United States)

Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

1994-01-01

We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

Radiation exposure and radiation protection

International Nuclear Information System (INIS)

Heuck, F.; Scherer, E.

1985-01-01

The present volume is devoted to the radiation hazards and the protective measures which can be taken. It describes the current state of knowledge on the changes which exposure to ionizing rays and other forms of physical energy can induce in organs and tissues, in the functional units and systems of the organism. Special attention is paid to general cellular radiation biology and radiation pathology and to general questions of the biological effects of densely ionizing particle radiation, in order to achieve a better all-round understanding of the effects of radiation on the living organism. Aside from the overviews dealing with the effects of radiation on the abdominal organs, urinary tract, lungs, cerebral and nervous tissue, bones, and skin, the discussion continues with the lymphatic system, the bone marrow as a bloodforming organ, and the various phases of reaction in the reproductive organs, including damage and subsequent regeneration. A special section deals with environmental radiation hazards, including exposure to natural radiation and the dangers of working with radioactive substances, and examines radiation catastrophes from the medical point of view. Not only reactor accidents are covered, but also nuclear explosions, with exhaustive discussion of possible damage and treatment. The state of knowledge on chemical protection against radiation is reviewed in detail. Finally, there is thorough treatment of the mechanism of the substances used for protection against radiation damage in man and of experience concerning this subject to date. In the final section of the book the problems of combined radiotherapy are discussed. The improvement in the efficacy of tumor radiotherapy by means of heavy particles is elucidated, and the significance of the efficacy of tumor therapy using electron-affinitive substances is explained. There is also discussion of the simultaneous use of radiation and pharmaceuticals in the treatment of tumors. (orig./MG) [de

Atoms, Radiation, and Radiation Protection

CERN Document Server

Turner, James E

2007-01-01

Atoms, Radiation, and Radiation Protection offers professionals and advanced students a comprehensive coverage of the major concepts that underlie the origins and transport of ionizing radiation in matter. Understanding atomic structure and the physical mechanisms of radiation interactions is the foundation on which much of the current practice of radiological health protection is based. The work covers the detection and measurement of radiation and the statistical interpretation of the data. The procedures that are used to protect man and the environment from the potential harmful effects of

MRI of the cranio-cervical region in rheumatoid arthritis

International Nuclear Information System (INIS)

Algra, P.R.; Breedveld, F.C.; Vielvoye, G.J.; Doornbos, J.; Roos, A. de

1987-01-01

16 patients suffering from rheumatoid arthritis and suspected compressive cervical myelopathy were studied with a 0.5 T superconducting magnetic resonance imaging (MRI) scanner. MRI findings were compared with those of plain radiography and myelography. Subluxation was detected equally well by MRI and radiography. MRI was able to detect the presence, level and origin of cord compression. MRI was superior in diagnosing the extent of cord compression. Cord distortion detected by MRI correlated better with clinical evidence of myelopathy than did the radiographically established extent of the subluxation. MRI correctly diagnosed the level and cause of cord compression in six patients who were subsequently operated upon because of progressive neurological signs. These findings suggest that MRI has potential in the diagnosis and management of patients with rheumatoid arthritis suspected of compressive cervical myelopathy. 20 refs.; 4 figs.; 1 table

Is there a benefit to operating on patients (bedridden or in wheelchairs) with advanced stage cervical spondylotic myelopathy?

Science.gov (United States)

Scardino, Fabrizio Borges; Rocha, Leonardo Poubel; Barcelos, Alécio Cristino Evangelista Santos; Rotta, José Marcus; Botelho, Ricardo Vieira

2010-05-01

Surgical treatment of cervical spondylotic myelopathy (CSM) aims to prevent or delay the progression of the disease. Many patients are diagnosed in advanced stages of the disease, presenting severe functional disability and extensive radiologic changes, which suggests clinical irreversibility. There are doubts about the real benefit of surgery in patients who are seriously ill, bedridden or in a wheelchair. The objective of the study is to evaluate the effects of surgical treatment in the clinical outcomes of patients severely affected by CSM. We analyzed patients with CSM who received an operation at a single institution between 1996 and 2008. Cases with a preoperative Nurick score equal to 5 were studied. We describe postoperative clinical improvement and compare the demographics and clinical data between the patients who improved and those who had no improvement. Radiological findings were also analyzed. We evaluated 55 patients operated on. Nine presented with preoperative Nurick score of 5 (16.3%). The mean age was 69.77 +/- 6.6 years (95% CI 64.65-79.90). The mean follow-up was 53.44 +/- 35.09 months (CI 26.46-80.42). Six patients (66.6%) achieved functional improvement when assessed by the Nurick scale, regaining the ability to walk. All patients improved on the JOAm scale, except one. The mean preoperative Nurick score was 5, while the mean postoperative Nurick score was 4.11 +/- 0.92 (95% CI 3.39-4.82) (Wilcoxon p = 0.027). The mean preoperative JOAm score was 6.4, and postoperative was 9.88 +/- 2.31 (CI 95% 8.10-11.66) (Wilcoxon p = 0.011). All spinal cords presented high-intensity signal on T2-weighted images. There was no correlation between the number of spinal cord high-intensity signal levels and clinical improvement. Three out of seven patients (whose image was adequate for analysis) had evident spinal cord atrophy, and two of them did not improve clinically. In the whole sample of patients, the mean length of disease for those who improved was 9

Paraspinal muscle morphometry in cervical spondylotic myelopathy and its implications in clinicoradiological outcomes following central corpectomy: clinical article.

Science.gov (United States)

Thakar, Sumit; Mohan, Dilip; Furtado, Sunil V; Sai Kiran, Narayanam Anantha; Dadlani, Ravi; Aryan, Saritha; Rao, Arun S; Hegde, Alangar S

2014-08-01

The objective of this study was to assess the cross-sectional areas (CSAs) of the superficial, deep flexor (DF), and deep extensor (DE) paraspinal muscles in patients with cervical spondylotic myelopathy (CSM), and to evaluate their correlations with functional status and sagittal spinal alignment changes following central corpectomy with fusion and plating. In this retrospective study of 67 patients who underwent central corpectomy with fusion and plating for CSM, the CSAs of the paraspinal muscles were calculated on the preoperative T2-weighted axial MR images and computed as ratios with respect to the corresponding vertebral body areas (VBAs) and as flexor/extensor CSA ratios. These ratios were then compared with those in the normative population and analyzed with respect to various clinicoradiological factors, including pain status, Nurick grade, and segmental angle change at follow-up (SACF). The mean CSA values for all muscle groups and the DF/DE ratio were significantly lower in the study cohort compared with an age- and sex-matched normative study group (p < 0.001). Among various independent variables tested in a multivariate regression analysis, increasing age and female sex significantly predicted a lower total extensor CSA/VBA ratio (p < 0.001), while a longer duration of symptoms significantly predicted a greater total flexor/total extensor CSA ratio (p = 0.02). In patients undergoing single-level corpectomy, graft subsidence had a positive correlation with SACF in all patients (p < 0.05), irrespective of the preoperative segmental angle and curvature, while in patients undergoing 2-level corpectomy, graft subsidence demonstrated such a correlation only in the subgroup with lordotic curvatures (p = 0.02). Among the muscle area ratios, the DF/DE ratio demonstrated a negative correlation with SACF in the subgroup with preoperative straight or kyphotic segmental angles (p = 0.04 in the single corpectomy group, p = 0.01 in the 2-level corpectomy group

The influence of sagittal profile alteration and final lordosis on the clinical outcome of cervical spondylotic myelopathy. A Delta-Omega-analysis.

Directory of Open Access Journals (Sweden)

Daniel Koeppen

Full Text Available Decompression and maintaining or restoring a cervical lordosis are major goals in the surgical treatment of cervical spondylotic myelopathy (CSM. Numerous studies support the assumption that cervical lordosis is a key factor for neurological recovery and pain reduction. However, even kyphotic patients can be asymptomatic. The balance of the spine is subject of an increasing number of publications. The main purpose of the study was to evaluate the validity of lordotic alignment on the course of CSM and to set this parameter in context with well-validated tools, namely the modified Japanese Orthopaedic Association scoring system (mJOAS and the visual analogue scale (VAS, to predict and measure the clinical outcome after surgery.This is a retrospective study with prospectively collected data of a heterogeneous cohort. The authors analyzed the records of 102 patients suffering from CSM that underwent decompressive surgery and instrumentation. Clinical outcome was assessed by using the mJOAS, VAS and Odom's criteria. The radiological analysis involved comparison of pre- and postoperative radiographs. The patients were divided into subgroups to be able to compare the influence of various amounts of correction (3 Delta-groups: 14°. The comparison of Odom's criteria showed that preoperatively kyphotic patients benefitted more from surgery than lordotic patients (p = 0.029, but no differences could be seen comparing neck pain and neurological improvement. The improvement of pain and neurological impairment measured by VAS and mJOAS supports the statistical impact and validity of the data despite comparatively small numbers of patients. The lack of postoperative kyphosis is a major limitation of the study to encompass the impact of sagittal alignment on clinical outcome.Decompression and stabilization appear to be key elements of surgical treatment of CSM. While the achievement of cervical lordosis remains a major goal of surgery, clinical improvement is

Radiation dosimetry and radiation biophysics

International Nuclear Information System (INIS)

Anon.

1981-01-01

Radiation dosimetry and radiation biophysics are two closely integrated programs whose joint purpose is to explore the connections between the primary physical events produced by radiation and their biological consequences in cellular systems. The radiation dosimetry program includes the theoretical description of primary events and their connection with the observable biological effects. This program also is concerned with the design and measurement of physical parameters used in theory or to support biological experiments. The radiation biophysics program tests and uses the theoretical developments for experimental design, and provides information for further theoretical development through experiments on cellular systems

Radiation dosimetry and radiation biophysics

International Nuclear Information System (INIS)

Anon.

1979-01-01

Radiation dosimetry and radiation biophysics are two closely integrated programs whose joint purpose is to explore the connections between the primary physical events produced by radiation and their biological consequences in cellular systems. The radiation dosimetry program includes the theoretical description of primary events and their connection with the observable biological effects. This program also is concerned with design and measurement of those physical parameters used in the theory or to support biological experiments. The radiation biophysics program tests and makes use of the theoretical developments for experimental design. Also, this program provides information for further theoretical development through experiments on cellular systems

Application of radiation-induced apoptosis in radiation oncology and radiation protection

International Nuclear Information System (INIS)

Crompton, N.E.A.; Emery, G.C.; Ozsahin, M.; Menz, R.; Knesplova, L.; Larsson, B.

1997-01-01

A rapid assay of the ability of lymphocytes to respond to radiation-induced damage is presented. Age and genetic dependence of radiation response have been quantified. The assay is sensitive to low doses of radiation. Its ability to assess the cytotoxic response of blood capillaries to radiation has been evaluated. (author)

Foundations of radiation physics and radiation protection. 5. ed.

International Nuclear Information System (INIS)

Krieger, Hanno

2017-01-01

The following topics are dealt with: Types of radiation and radiation fields, the atomic structure, radioactive decays, decay law, natural and artificial radioactivity, interactions of ionizing photon radiation, attenuation of neutral-particle beams, interactions of neutron radiation, interactions of charged particles, ionization and energy transfer, radiation doses, radiation protection phantoms, foundations of the radiation biology of cells, effects and risks of ionizing radiation, radiation expositions of men with ionizing radiation, radiation protection law, practical radiation protection against ionizing radiations, radiation eposures in medical radiology. (HSI)

Radiographic analysis of the correlation between ossification of the nuchal ligament and sagittal alignment and segmental stability of the cervical spine in patients with cervical spondylotic myelopathy.

Science.gov (United States)

Ying, Jinwei; Teng, Honglin; Qian, Yunfan; Hu, Yingying; Wen, Tianyong; Ruan, Dike; Zhu, Minyu

2018-01-01

Background Ossification of the nuchal ligament (ONL) caused by chronic injury to the nuchal ligament (NL) is very common in instability-related cervical disorders. Purpose To determine possible correlations between ONL, sagittal alignment, and segmental stability of the cervical spine. Material and Methods Seventy-three patients with cervical spondylotic myelopathy (CSM) and ONL (ONL group) and 118 patients with CSM only (control group) were recruited. Radiographic data included the characteristics of ONL, sagittal alignment and segmental stability, and ossification of the posterior longitudinal ligament (OPLL). We performed comparisons in terms of radiographic parameters between the ONL and control groups. The correlations between ONL size, cervical sagittal alignment, and segmental stability were analyzed. Multivariate logistic regression was used to identify the independent risk factors of the development of ONL. Results C2-C7 sagittal vertical axis (SVA), T1 slope (T1S), T1S minus cervical lordosis (T1S-CL) on the lateral plain, angular displacement (AD), and horizontal displacement (HD) on the dynamic radiograph increased significantly in the ONL group compared with the control group. The size of ONL significantly correlated with C2-C7 SVA, T1S, AD, and HD. The incidence of ONL was higher in patients with OPLL and segmental instability. Cervical instability, sagittal malalignment, and OPLL were independent predictors of the development of ONL through multivariate analysis. Conclusion Patients with ONL are more likely to have abnormal sagittal alignment and instability of the cervical spine. Thus, increased awareness and appreciation of this often-overlooked radiographic finding is warranted during diagnosis and treatment of instability-related cervical pathologies and injuries.

Radiation

International Nuclear Information System (INIS)

2013-01-01

The chapter one presents the composition of matter and atomic theory; matter structure; transitions; origin of radiation; radioactivity; nuclear radiation; interactions in decay processes; radiation produced by the interaction of radiation with matter

Radiation chemistry

International Nuclear Information System (INIS)

Rodgers, F.; Rodgers, M.A.

1987-01-01

The contents of this book include: Interaction of ionizing radiation with matter; Primary products in radiation chemistry; Theoretical aspects of radiation chemistry; Theories of the solvated electron; The radiation chemistry of gases; Radiation chemistry of colloidal aggregates; Radiation chemistry of the alkali halides; Radiation chemistry of polymers; Radiation chemistry of biopolymers; Radiation processing and sterilization; and Compound index

Experimentelle Untersuchungen zur sonographischen Frakturdiagnostik im Kinderalter

OpenAIRE

Meuser, Stefan Heinrich Peter

2010-01-01

Falsch diagnostiziert und nicht korrekt therapiert können Frakturen im Kindesalter zu Wachstumsstörungen und damit verbundenen lebenslangen Problemen führen. Nach einem Trauma ist die klinische Untersuchung und Bestimmung des Schmerzmaximums gerade bei Kindern oft sehr schwierig. So müssen häufig mehrere Röntgenaufnahmen getätigt werden, ehe eine Fraktur sicher diagnostiziert oder ausgeschlossen werden kann. Die hierbei auftretende ionisierende Strahlung geht jedoch besonder...

Environmental radiation and exposure to radiation

International Nuclear Information System (INIS)

1981-02-01

Compared to 1977 the exposure to radiation of the population of the Federal Republic of Germany from both natural and artificial radiation sources has not greatly charged. The amin part of exposure to natural radiation is caused by environmental radiation and by the absorption of naturally radioactive substances into the body. Artificial exposure to radiation of the population is essentially caused by the use of ionizing rays and radioactive substances in medicine. When radioactive materials are released from nuclear facilities the exposure to radiation of the population is only very slightly increased. The real exposure to radiation of individual people can even in the worst affected places, have been at most fractions of a millirem. The exposure to radiation in the worst afected places in the area of a hard-coal power station is higher than that coming from a nuclear power station of the same capacity. The summation of all contributions to the exposure of radiation by nuclear facilities to the population led in 1978 in the Federal Republic of Germany to a genetically significant dose of clearly less than 1 millerem per year. The medium-ranged exposure to radiation by external radiation effects through professional work was in 1978 at 80 millirems. No difference to 1977. The contribution of radionuclide from the fallout coming from nuclear-weapon tests and which has been deposited in the soil, to the whole-body dose for 1978 applies the same as the genetically significant dose of the population with less than 1 millirem. (orig./HP) [de

Cervical spondylotic myelopathy

African Journals Online (AJOL)

function. Seventy-five per cent of patients with mild symptoms (sensory changes but no functional ... of both motor and sensory function as well as ... pathological and compressive) structures, ... management of cervical degenerative disease:.

Bundled payment reimbursement for anterior and posterior approaches for cervical spondylotic myelopathy: an analysis of private payer and Medicare databases.

Science.gov (United States)

Virk, Sohrab S; Phillips, Frank M; Khan, Safdar N

2018-03-01

OBJECTIVE Cervical spondylotic myelopathy (CSM) is a progressive spinal condition that often requires surgery. Studies have shown the clinical equivalency of anterior versus posterior approaches for CSM surgery. The purpose of this study was to determine the amount and type of resources used for anterior and posterior surgical treatment of CSM by using large national databases of clinical and financial information from patients. METHODS This study consists of 2 large cohorts of patients who underwent either an anterior or posterior approach for treatment of CSM. These patients were selected from the Medicare 5% National Sample Administrative Database (SAF5) and the Humana orthopedic database (HORTHO), which is a database of patients with private payer health insurance. The outcome measures were the cost of a 90-day episode of care, as well as a breakdown of the cost components for each surgical procedure between 2005 and 2014. RESULTS A total of 16,444 patients were included in this analysis. In HORTHO, there were 10,332 and 1556 patients treated with an anterior or posterior approach for CSM, respectively. In SAF5, there were 3851 and 705 patients who were treated by an anterior or posterior approach for CSM, respectively. The mean ± SD reimbursements for anterior and posterior approaches in the HORTHO database were $20,863 ± $2014 and $23,813 ± $4258, respectively (p = 0.048). The mean ± SD reimbursements for anterior and posterior approaches in the SAF5 database were $18,219 ± $1053 and $25,598 ± $1686, respectively (p reimbursements for a rehabilitation/skilled nursing facility and hospital/inpatient care for patients who underwent a posterior approach in both the private payer and Medicare databases. In all cohorts in this study, the hospital-related reimbursement was more than double the surgeon-related reimbursement. CONCLUSIONS This study provides resource utilization information for a 90-day episode of care for both anterior and posterior approaches

Radiation measurement

International Nuclear Information System (INIS)

Go, Sung Jin; Kim, Seung Guk; No, Gyeong Seok; Park, Myeong Hwan; Ann, Bong Seon

1998-03-01

This book explains technical terms about radiation measurement, which are radiation, radiation quantity and unit such as prefix of international unit, unit for defence purposes of radiation, coefficient of radiation and interaction, kinds and principles of radiation detector, ionization chamber, G-M counter, G-M tube, proportional counter, scintillation detector, semiconductor radiation detector, thermoluminescence dosimeter, PLD, others detector, radiation monitor, neutron detector, calibration of radiation detector, statistics of counting value, activation analysis and electronics circuit of radiation detector.

Mielopatia associada ao HTLV-I / paraparesia espástica tropical: relato dos primeiros casos em Sergipe HTLV-I associated myelopathy, tropical spastic paraparesis: report of the first cases in Sergipe-Brazil

Directory of Open Access Journals (Sweden)

HÉLIO ARAUJO OLIVEIRA

1998-03-01

Full Text Available Mielopatia associada ao HTLV-I / paraparesia espástica tropical (MAH/PET, tem sido descrita em quase todas as regiões do Brasil.Os autores apresentam oito casos clinicamente definidos como MAH/PET, os primeiros relatados no Estado de Sergipe .Todos foram positivos para HTLV-I, através do método ELISA, realizado duas vezes; em apenas dois casos foi possível a confirmação por Western Blot. De acordo com protocolo de investigação clínico-laboratorial, todos os pacientes apresentaram acometimento do tracto piramidal, com mínimo comprometimeto da sensibilidade e alterações esfincterianas. Os autores chamam a atenção para a endemicidade do HTLV-I no Estado, cuja prevalência entre doadores de sangue é significativa (0,43%.HTLV-I associated myelopathy/ tropical spastic paraparesis (HAM/TSP has been decribed in practically all regions of Brazil. The authors present eight clinically defined cases of HAM/TSP, as being the first reported in Sergipe (Northeastern Brazil. All of them were confirmed through ELISA in two examinations, although only two were confirmed by Western Blot. According to clinical/laboratorial investigation protocol, all patients presented involvement of the pyramidal tract with minimal sensory loss and sphincter alteration. The authors call the attention for the endemicity of HTLV-I in the region, whose prevalence amongst blood donors is significant (0.43%.

Radiation protection medical care of radiation workers

International Nuclear Information System (INIS)

Walt, H.

1988-01-01

Radiation protection medical care for radiation workers is part of the extensive programme protecting people against dangers emanating from the peaceful application of ionizing radiation. Thus it is a special field of occupational health care and emergency medicine in case of radiation accidents. It has proved helpful in preventing radiation damage as well as in early detection, treatment, after-care, and expert assessment. The medical checks include pre-employment and follow-up examinations, continued long-range medical care as well as specific monitoring of individuals and defined groups of workers. Three levels of action are involved: works medical officers specialized in radiation protection, the Institute of Medicine at the National Board for Atomic Safety and Radiation Protection, and a network of clinical departments specialized in handling cases of acute radiation damage. An account is given of categories, types, and methods of examinations for radiation workers and operators. (author)

Application of theoretical vehicle dynamic results for experimental validation of vehicle characteristics in autonomous vehicle guidance; Aehnlichkeitstheoretische Modelluebertragung zur experimentellen Eigenschaftsabsicherung in der autonomen Fahrzeugfuehrung

Energy Technology Data Exchange (ETDEWEB)

Hilgert, J.; Bertram, T. [Univ. Duisburg (Germany). Fachbereich Maschinenbau

2002-07-01

The validation and verification of theoretical vehicle dynamic results for autonomous driving can be seen as a major challenge. The main reasons are the high cost of driving tests and the risk of damaging or destroying the test vehicle and the involved persons. One possibility for avoiding these problems and simultaneously to ensure good experimental results lies in the use of scaled model vehicles. Of special relevance is the transfer of relevant parameters to the full size vehicle. In this paper a method based on similitude analysis is developed for validation and verification of driving tests for autonomous vehicles. This method is described for a lane change manoeuvre for a 1:5 scaled vehicle belonging to the Institute of Mechatronics and System Dynamics at the Gerhard-Mercator-Universitaet Duisburg. (orig.) [German] In der autonomen Fahrzeugfuehrung stellt die experimentelle Verifikation und Validierung von theoretischen Ergebnissen hinsichtlich fahrdynamischer Eigenschaften eine grosse Herausforderung dar. Die Ursachen hierfuer liegen zum einen in den hohen Kosten, welche bei Fahrversuchen entstehen, und zum anderen im Unfallrisiko fuer den Versuchstraeger und die am Versuch beteiligten Personen. Eine Moeglichkeit diese Nachteile zu umgehen und gleichzeitig experimentelle Ergebnisse zu bekommen, besteht in der Verwendung massstabgetreuer Modellfahrzeuge. Von besonderer Bedeutung ist hier die Uebertragung relevanter Parameter auf das reale Fahrzeug. In diesem Beitrag wird daher mit Hilfe von aehnlichkeitstheoretischen Ueberlegungen ein Konzept zur experimentellen Verifikation und Validierung von Fahrversuchen auf Basis eines am Institut fuer Mechatronik und Systemdynamik der Gerhard-Mercator-Universitaet Duisburg vorhandenen Fahrzeugmodells (Massstab 1:5) anhand eines Spurwechselmanoevers vorgestellt. (orig.)

Radiation measurement practice for understanding statistical fluctuation of radiation count using natural radiation sources

International Nuclear Information System (INIS)

Kawano, Takao

2014-01-01

It is known that radiation is detected at random and the radiation counts fluctuate statistically. In the present study, a radiation measurement experiment was performed to understand the randomness and statistical fluctuation of radiation counts. In the measurement, three natural radiation sources were used. The sources were fabricated from potassium chloride chemicals, chemical fertilizers and kelps. These materials contain naturally occurring potassium-40 that is a radionuclide. From high schools, junior high schools and elementary schools, nine teachers participated to the radiation measurement experiment. Each participant measured the 1-min integration counts of radiation five times using GM survey meters, and 45 sets of data were obtained for the respective natural radiation sources. It was found that the frequency of occurrence of radiation counts was distributed according to a Gaussian distribution curve, although the obtained 45 data sets of radiation counts superficially looked to be fluctuating meaninglessly. (author)

Radiation carcinogenesis

International Nuclear Information System (INIS)

1978-01-01

The Cancergram deals with all aspects of radiation carcinogenesis. The term radiation here includes U-V radiation and the entire electromagnetic spectrum, electron and other charged particle beams, neutrons, and alpha and beta radiation from radioactive substances. Abstracts included concern relationships between radiation and carcinogenesis in humans, experimental induction of tumors in animals by irradiation, studies on the mechanism of radiation carcinogenesis at the cellular level, studies of RBE, dose response or dose threshold in relation to radiation carcinogenesis, and methods and policies for control of radiation exposure in the general population. In general, this Cancergram excludes abstracts on radio-therapy, radiologic diagnosis, radiation pathology, and radiation biology, where these articles have no bearing on radiation carcinogenesis

Radiation risks and radiation protection at CRNL

International Nuclear Information System (INIS)

Myers, D.K.

1986-01-01

Radiation exposure is an occupational hazard at CRNL. The predicted health effects of low levels of radiation are described and compared with other hazards of living. Data related to the health of radiation workers are also considered. Special attention is given to the expected effects of radiation on the unborn child. Measures taken to protect CRNL employees against undue occupational exposure to radiation are noted

Radiation physics, biophysics, and radiation biology

International Nuclear Information System (INIS)

Hall, E.J.; Zaider, M.

1991-05-01

Research at the Radiological Research Laboratory is a blend of physics, chemistry, and biology, involving research at the basic level with the admixture of a small proportion of pragmatic or applied research in support of radiation protection and/or radiotherapy. Current research topics include: oncogenic transformation assays, mutation studies involving interactions between radiation and environmental contaminants, isolation, characterization and sequencing of a human repair gene, characterization of a dominant transforming gene found in C3H 10T1/2 cells, characterize ab initio the interaction of DNA and radiation, refine estimates of the radiation quality factor Q, a new mechanistic model of oncogenesis showing the role of long-term low dose medium LET radiation, and time dependent modeling of radiation induced chromosome damage and subsequent repair or misrepair

From the top-quark to the Higgs-Boson: the search for the heaviest particles of nature

International Nuclear Information System (INIS)

Mueller, T.

2001-01-01

According to our present knowledge the fundamental constituents of matter are quarks and leptons ordered by their mass into three particle families. With the discovery of the top quark about six years age our periodic table of elementary particles has been completed but the origin of its unusually high mass and, more general, of the mass of all particles, still needs to be established. The Institut fuer Experimentelle Kernphysik in Karlsruhe, who researches on the top quark and its properties, also takes part in the world-wide race for the discovery of the widely believed mediator of mass, the Higgs boson. (orig.)

Radiation detection device and a radiation detection method

International Nuclear Information System (INIS)

Blum, A.

1975-01-01

A radiation detection device is described including at least one scintillator in the path of radiation emissions from a distributed radiation source; a plurality of photodetectors for viewing each scintillator; a signal processing means, a storage means, and a data processing means that are interconnected with one another and connected to said photodetectors; and display means connected to the data processing means to locate a plurality of radiation sources in said distributed radiation source and to provide an image of the distributed radiation sources. The storage means includes radiation emission response data and location data from a plurality of known locations for use by the data processing means to derive a more accurate image by comparison of radiation responses from known locations with radiation responses from unknown locations. (auth)

Radiation chemistry in development and research of radiation biology

International Nuclear Information System (INIS)

Min Rui

2010-01-01

During the establishment and development of radiation biology, radiation chemistry acts like bridge which units the spatial and temporal insight coming from radiation physics with radiation biology. The theory, model, and methodology of radiation chemistry play an important role in promoting research and development of radiation biology. Following research development of radiation biology effects towards systems radiation biology the illustration and exploration both diversity of biological responses and complex process of biological effect occurring remain to need the theory, model, and methodology come from radiation chemistry. (authors)

Foam radiators for transition radiation detectors

International Nuclear Information System (INIS)

Chernyatin, V.; Dolgoshein, B.; Gavrilenko, I.; Potekhin, M.; Romaniouk, A.; Sosnovtsev, V.

1993-01-01

A wide variety of foam radiators, potentially useful in the design of a transition radiation detector, the possible particle identification tool in collider experiments, have been tested in the beam. Various characteristics of these radiators are compared, and the conclusion is reached that certain brands of polyethylene foam are best suited for use in the detector. Comparison is made with a 'traditional' radiator, which is a periodic structure of plastic foils. (orig.)

Computed tomography in the evaluation of caudal cervical spondylomyelopathy of the Doberman Pinscher

International Nuclear Information System (INIS)

Sharp, N.J.H.; Cofone, M.; Robertson, I.D.; DeCarlo, A.; Smith, G.K.; Thrall, D.E.

1995-01-01

Caudal cervical spondylomyelopathy is a common neurologic disorder of Doberman pinschers which has a number of striking similarities to cervical spondylotic myelopathy in humans. Diagnosis of this human disease is facilitated considerably by the use of computed tomographic (CT) myelography. Sixteen Doberman pinscher dogs with caudal cervical spondylomyelopathy were studied by conventional myelography followed by CT myelography. A close correlation was noted between the CT myelographic appearance of the cervical spinal cord in these dogs, and that reported for human cervical spondylotic myelopathy. Five dogs had atrophy of the spinal cord, and in another there was an accumulation of contrast medium within the spinal cord. These features are often associated with a poor response to surgical decompression in humans with cervical spondylotic myelopathy. The CT examination provided information that could not be obtained by conventional myelography alone and should be considered as an additional diagnostic procedure in dogs with caudal cervical spondylomyelopathy

Radiation tolerance of the cervical spinal cord: incidence and dose-volume relationship of symptomatic and asymptomatic late effects following high dose irradiation of paraspinal tumors

International Nuclear Information System (INIS)

Liu, Mitchell C.C.; Munzenrider, John E.; Finkelstein, Dianne; Liebsch, Norbert; Adams, Judy; Hug, Eugen B.

1997-01-01

Purpose: Low grade chordomas and chondrosarcomas require high radiation doses for effective, lasting tumor control. Fractionated, 3-D planned, conformal proton radiation therapy has been used for lesions along the base of skull and spine to deliver high target doses, while respecting constraints of critical, normal tissues. In this study, we sought to determine the incidence of myelopathy after high dose radiotherapy to the cervical spine and investigated the influence of various treatment parameters, including dose-volume relationship. Methods and Materials: Between December 1980 and March 1996, 78 patients were treated at the Massachusetts General Hospital and Harvard Cyclotron Laboratory for primary or recurrent chordomas and chondrosarcomas of the cervical spine using combined proton and photon radiation therapy. In general, the tumor dose given was between 64.5 to 79.2 CGE (Cobalt Gray Equivalent). The guidelines for maximum permissible doses to spinal cord were: ≤ 64 CGE to the spinal cord surface and ≤ 53 CGE to the spinal cord center. Dose volume histograms of the spinal cord were analyzed to investigate a possible dose and volume relationship. Results: With a mean follow-up period of 46.6 months (range: 3 - 157 months), 4 of 78 patients (5.1%) developed high-grade (RTOG Grade 3 and 4) late toxicity: 3 patients (3.8%) experienced sensory deficits without motor deficits, none had any limitations of daily activities. One patient (1.2%) developed motor deficit with loss of motor function of one upper extremity. The only patient, who developed permanent motor damage had received additional prior radiation treatment and therefore received a cumulative spinal cord dose higher than the treatment guidelines. No patient treated within the guidelines experienced any motor impairment. Six patients (7.7%) experienced transient Lhermitt's syndrome and 1 patient (1.2%) developed asymptomatic radiographic MR findings only. Time to onset of symptoms of radiographic

Radiation and radiation protection

International Nuclear Information System (INIS)

Landfermann, H.H.; Solbach, C.

1992-11-01

The brochure explains the major types of radiation, the radiation sources, effects, uses, and risks, as well as the regulatory system adopted by the government in order to keep the risks as low as possible. (orig./DG) [de

Effects of radiation-counselling convergence education on radiation awareness

International Nuclear Information System (INIS)

Seoung, Youl Hun

2017-01-01

The purpose of study was to analysis on the effects of radiation-counselling convergence education on radiation awareness. The survey objects were students of radiation-counselling convergence education from 12th May to 22th June in 2016. The questionnaires were education satisfactions and radiation awareness (risk, benefit, control) by Likert-type 5 scales. The analysis results revealed that education satisfactions of men students showed a significant higher female students and correlation coefficient of education satisfactions were the best high in the benefit and control of radiation. Finally radiation-counselling convergence education had a significant effect on radiation benefit. This convergence education influenced positive recognition on radiation benefit and it was indicated that radiation-counselors could treat clients on the basis of radiation benefit

Effects of radiation-counselling convergence education on radiation awareness

Energy Technology Data Exchange (ETDEWEB)

Seoung, Youl Hun [Dept. of Radiological Science, College of Health Science, Cheongju University, Cheongju (Korea, Republic of)

2017-06-15

The purpose of study was to analysis on the effects of radiation-counselling convergence education on radiation awareness. The survey objects were students of radiation-counselling convergence education from 12th May to 22th June in 2016. The questionnaires were education satisfactions and radiation awareness (risk, benefit, control) by Likert-type 5 scales. The analysis results revealed that education satisfactions of men students showed a significant higher female students and correlation coefficient of education satisfactions were the best high in the benefit and control of radiation. Finally radiation-counselling convergence education had a significant effect on radiation benefit. This convergence education influenced positive recognition on radiation benefit and it was indicated that radiation-counselors could treat clients on the basis of radiation benefit.

The influence of sagittal profile alteration and final lordosis on the clinical outcome of cervical spondylotic myelopathy. A Delta-Omega-analysis.

Science.gov (United States)

Koeppen, Daniel; Piepenbrock, Claudia; Kroppenstedt, Stefan; Čabraja, Mario

2017-01-01

Decompression and maintaining or restoring a cervical lordosis are major goals in the surgical treatment of cervical spondylotic myelopathy (CSM). Numerous studies support the assumption that cervical lordosis is a key factor for neurological recovery and pain reduction. However, even kyphotic patients can be asymptomatic. The balance of the spine is subject of an increasing number of publications. The main purpose of the study was to evaluate the validity of lordotic alignment on the course of CSM and to set this parameter in context with well-validated tools, namely the modified Japanese Orthopaedic Association scoring system (mJOAS) and the visual analogue scale (VAS), to predict and measure the clinical outcome after surgery. This is a retrospective study with prospectively collected data of a heterogeneous cohort. The authors analyzed the records of 102 patients suffering from CSM that underwent decompressive surgery and instrumentation. Clinical outcome was assessed by using the mJOAS, VAS and Odom's criteria. The radiological analysis involved comparison of pre- and postoperative radiographs. The patients were divided into subgroups to be able to compare the influence of various amounts of correction (3 Delta-groups: lordosis (4 Omega-groups: 0-7°, 8-14°, 15-21°, ≥22°). 219 levels were fused in 102 patients. Surgery improved the clinical outcome of all groups significantly. A lordotic profile was achieved in all analyzed groups. Patients that showed small lordosis after surgery (lordosis (>14°). The comparison of Odom's criteria showed that preoperatively kyphotic patients benefitted more from surgery than lordotic patients (p = 0.029), but no differences could be seen comparing neck pain and neurological improvement. The improvement of pain and neurological impairment measured by VAS and mJOAS supports the statistical impact and validity of the data despite comparatively small numbers of patients. The lack of postoperative kyphosis is a major

Operational radiation protection and radiation protection training

International Nuclear Information System (INIS)

Kraus, W.

1989-01-01

The radiation protection system in the German Democratic Republic (GDR) is reviewed. The competent authority (the SAAS) and its systems of licensing and supervision are described. Discussion covers the role of the Radiation Protection Officer, the types of radiation monitoring, medical surveillance programs and the classification of workers and work areas. Unusual occurrences in the GDR, 1963-1976, are presented and the occupational radiation protection problems at some specific types of workplaces are discussed. The GDR's system of training in radiation protection and nuclear safety is described. 5 figs., 18 tabs

Interaction of hyperthermia and radiation: radiation quality

International Nuclear Information System (INIS)

Loshek, D.D.; Orr, J.S.; Solomonidis, E.

1981-01-01

Cell-survival data were collected to determine the survival response of asynchronous CHO cells subject to radiation and hyperthermia. The irradiation was at room temperature 100 minutes before exposure to hyperthermia at 42 0 C. The survival response to the combination of these two agents is expressed by means of a survival surface, a three-dimensional concept relating cell survival to heat dose and radiation dose. The survival surface could be approximately described by a survival model comprising three components of cell killing: the unperturbed radiation component, the unperturbed hyperthermia component and the interaction component. The dependence of the radiation component and the interaction component on radiation quality were investigated by irradiating with either 60 Co γ rays, 250 kV X rays or 14.7 MeV neutrons. An analysis suggests that the interaction component and the radiation component exhibit similar dependencies on radiation quality both for the deposition of damage and the repair or accumulation of that damage. (U.K.)

Natural radiation

International Nuclear Information System (INIS)

Feliciano, Vanusa Maria Delage

2016-01-01

Cosmic radiation, as well as cosmogenic radiation, terrestrial radiation, radon and thorium are introduced in this chapter 3. The distribution of natural radiation sources is treated, where the percentage distribution of the contribution relative to exposure to radiation from natural and artificial sources is also included

Radiation safety

International Nuclear Information System (INIS)

Jain, Priyanka

2014-01-01

The use of radiation sources is a privilege; in order to retain the privilege, all persons who use sources of radiation must follow policies and procedures for their safe and legal use. The purpose of this poster is to describe the policies and procedures of the Radiation Protection Program. Specific conditions of radiation safety require the establishment of peer committees to evaluate proposals for the use of radionuclides, the appointment of a radiation safety officer, and the implementation of a radiation safety program. In addition, the University and Medical Centre administrations have determined that the use of radiation producing machines and non-ionizing radiation sources shall be included in the radiation safety program. These Radiation Safety policies are intended to ensure that such use is in accordance with applicable State and Federal regulations and accepted standards as directed towards the protection of health and the minimization of hazard to life or property. It is the policy that all activities involving ionizing radiation or radiation emitting devices be conducted so as to keep hazards from radiation to a minimum. Persons involved in these activities are expected to comply fully with the Canadian Nuclear Safety Act and all it. The risk of prosecution by the Department of Health and Community Services exists if compliance with all applicable legislation is not fulfilled. (author)

The analysis of radiation exposure of hospital radiation workers

International Nuclear Information System (INIS)

Jeong, Tae Sik; Shin, Byung Chul; Moon, Chang Woo; Cho, Yeong Duk; Lee, Yong Hwan; Yum, Ha Yong

2000-01-01

This investigation was performed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyz ed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. The average of yearly radiation exposure of 347 persons was 1.52±1.35 mSv. Though it was less than 5OmSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87±1.01 mSv/year, mean 1.22±0.69 mSv between 31 and 40 year old and mean 0.97±0.43 mSv/year over, 41year old (p<0.001). Men received mean 1.67±1.54 mSv/year were higher than women who received mean 1.13±0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear medicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.69±1.81 mSv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (0<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74±1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17±0.35 mSv/year and upper gastrointestinal room of mean 1.74±1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75±1

Radiation exposure analysis of female nuclear medicine radiation workers

Energy Technology Data Exchange (ETDEWEB)

Lee, Ju Young [Dept. of Biomedical Engineering Graduate School, Chungbuk National University, Cheongju (Korea, Republic of); Park, Hoon Hee [Dept. of Radiological Technologist, Shingu College, Sungnam (Korea, Republic of)

2016-06-15

In this study, radiation workers who work in nuclear medicine department were analyzed to find the cause of differences of radiation exposure from General Characteristic, Knowledge, Recognition and Conduct, especially females working on nuclear medicine radiation, in order to pave the way for positive defense against radiation exposure. The subjects were 106 radiation workers who were divided into two groups of sixty-four males and forty-two females answered questions about their General Characteristic, Knowledge, Recognition, Conduct, and radiation exposure dose which was measured by TLD (Thermo Luminescence Dosimeter). The results of the analysis revealed that as the higher score of knowledge and conduct was shown, the radiation exposure decreased in female groups, and as the higher score of conduct was shown, the radiation exposure decreased in male groups. In the correlation analysis of female groups, the non-experienced in pregnancy showed decreasing amount of radiation exposure as the score of knowledge and conduct was higher and the experienced in pregnancy showed decreasing amount of radiation exposure as the score of recognition and conduct was higher. In the regression analysis on related factors of radiation exposure dose of nuclear medicine radiation workers, the gender caused the meaningful result and the amount of radiation exposure of female groups compared to male groups. In the regression analysis on related factors of radiation exposure dose of female groups, the factor of conduct showed a meaningful result and the amount of radiation exposure of the experienced in pregnancy was lower compared to the non-experienced. The conclusion of this study revealed that radiation exposure of female groups was lower than that of male groups. Therefore, male groups need to more actively defend themselves against radiation exposure. Among the female groups, the experienced in pregnancy who have an active defense tendency showed a lower radiation exposure. Thus

Radiation exposure analysis of female nuclear medicine radiation workers

International Nuclear Information System (INIS)

Lee, Ju Young; Park, Hoon Hee

2016-01-01

In this study, radiation workers who work in nuclear medicine department were analyzed to find the cause of differences of radiation exposure from General Characteristic, Knowledge, Recognition and Conduct, especially females working on nuclear medicine radiation, in order to pave the way for positive defense against radiation exposure. The subjects were 106 radiation workers who were divided into two groups of sixty-four males and forty-two females answered questions about their General Characteristic, Knowledge, Recognition, Conduct, and radiation exposure dose which was measured by TLD (Thermo Luminescence Dosimeter). The results of the analysis revealed that as the higher score of knowledge and conduct was shown, the radiation exposure decreased in female groups, and as the higher score of conduct was shown, the radiation exposure decreased in male groups. In the correlation analysis of female groups, the non-experienced in pregnancy showed decreasing amount of radiation exposure as the score of knowledge and conduct was higher and the experienced in pregnancy showed decreasing amount of radiation exposure as the score of recognition and conduct was higher. In the regression analysis on related factors of radiation exposure dose of nuclear medicine radiation workers, the gender caused the meaningful result and the amount of radiation exposure of female groups compared to male groups. In the regression analysis on related factors of radiation exposure dose of female groups, the factor of conduct showed a meaningful result and the amount of radiation exposure of the experienced in pregnancy was lower compared to the non-experienced. The conclusion of this study revealed that radiation exposure of female groups was lower than that of male groups. Therefore, male groups need to more actively defend themselves against radiation exposure. Among the female groups, the experienced in pregnancy who have an active defense tendency showed a lower radiation exposure. Thus

Sound radiation quantities arising from a resilient circular radiator

NARCIS (Netherlands)

Aarts, R.M.; Janssen, A.J.E.M.

2009-01-01

Power series expansions in ka are derived for the pressure at the edge of a radiator, the reaction force on the radiator, and the total radiated power arising from a harmonically excited, resilient, flat, circular radiator of radius a in an infinite baffle. The velocity profiles on the radiator are

Ionizing radiation

International Nuclear Information System (INIS)

Kruger, J.

1989-01-01

Ionizing radiation results in biological damage that differs from other hazardous substances and is highly dangerous to man. Ionizing radiation cannot be perceived by man's sense organs and the biological damage cannot be detected immediately afterwards (except in very high doses). Every human being is exposed to low doses of radiation. The structure of the atom; sources of ionizing radiation; radiation units; biological effects; norms for radiation protection; and the national control in South Africa are discussed. 1 fig., 5 refs

Radiation injuries/ionizing radiation

International Nuclear Information System (INIS)

Gooden, D.S.

1991-01-01

This book was written to aid trial attorneys involved in radiation litigation. Radiologists and medical physicists will also find it helpful as they prepare for trial, either as a litigant or an expert witness. Two chapters present checklists to guide attorneys for both plaintiffs and defendants. Gooden titles these checklists Elements of Damages and Elements of Proof and leads the reader to conclusions about each of these. One section that will be particularly helpful to attorneys contains sample interrogatories associated with a case of alleged radiation exposure resulting in a late radiation injury. There are interrogatories for the plaintiff to ask the defendant and for the defendant to ask the plaintiff

Radiation exposure and radiation hazards of human population. Pt. 1

International Nuclear Information System (INIS)

Jacobi, W.

1982-01-01

The present Part I provides a survey on the various sources of natural and artificial radiation exposure of human population. Furthermore, biological radiation effects and radiation damages are surveyed. In an appendix, radiation types, radiation doses, and radiation dose units are explained. (orig./GSCH) [de

Proposing a simple radiation scale for the public: Radiation index

Energy Technology Data Exchange (ETDEWEB)

Cho, Gyu Seong; Kim, Jong Hyun [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon (Korea, Republic of); Park, Tae Soon [Center for Ionizing Radiation, Korea Research Institute of Standards and Science (KRISS), Daejeon (Korea, Republic of); Cho, Kunwoo [Dept. of Natural Radiation Safety, Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of)

2017-04-15

A new radiation scale is proposed. With empathy toward the vast majority of people who are not well versed in radiation and related matters, and thus suffering from misunderstanding that breeds unnecessary fear of radiation, the aim of proposing a new radiation scale, radiation index (RAIN), is to put the general public at ease with the concept of radiation. RAIN is defined in dimensionless numbers that relate any specific radiation dose to a properly defined reference level. As RAIN is expressed in plain numbers without an attached scientific unit, the public will feel comfortable with its friendly look, which in turn should help them understand radiation dose levels easily and allay their anxieties about radiation. The expanded awareness and proper understanding of radiation will empower the public to feel that they are not hopeless victims of radiation. The correspondence between RAIN and the specific accumulated dose is established. The equivalence will allow RAIN to serve as a common language of communication for the general public with which they can converse with radiation experts to discuss matters related to radiation safety, radiation diagnosis and therapy, nuclear accidents, and other related matters. Such fruitful dialogues will ultimately enhance public acceptance of radiation and associated technologies.

Proposing a simple radiation scale for the public: Radiation index

International Nuclear Information System (INIS)

Cho, Gyu Seong; Kim, Jong Hyun; Park, Tae Soon; Cho, Kunwoo

2017-01-01

A new radiation scale is proposed. With empathy toward the vast majority of people who are not well versed in radiation and related matters, and thus suffering from misunderstanding that breeds unnecessary fear of radiation, the aim of proposing a new radiation scale, radiation index (RAIN), is to put the general public at ease with the concept of radiation. RAIN is defined in dimensionless numbers that relate any specific radiation dose to a properly defined reference level. As RAIN is expressed in plain numbers without an attached scientific unit, the public will feel comfortable with its friendly look, which in turn should help them understand radiation dose levels easily and allay their anxieties about radiation. The expanded awareness and proper understanding of radiation will empower the public to feel that they are not hopeless victims of radiation. The correspondence between RAIN and the specific accumulated dose is established. The equivalence will allow RAIN to serve as a common language of communication for the general public with which they can converse with radiation experts to discuss matters related to radiation safety, radiation diagnosis and therapy, nuclear accidents, and other related matters. Such fruitful dialogues will ultimately enhance public acceptance of radiation and associated technologies

Radiation versus radiation: nuclear energy in perspective

International Nuclear Information System (INIS)

Gonzalez, A.J.; Anderer, J.

1989-01-01

This paper seeks to provide a proper perspective on radiation exposures from nuclear energy. Instead of comparing these exposures with other pollutants, natural and man-made, it assesses the radiation doses that result from the human environment and from the entire fuel cycle associated with nuclear generated electricity. It explores radiation versus radiation, not only in terms of absolute levels but, more importantly, of the enormous variability characterizing many radiation sources. The quantitative findings and their implications are meant to contribute to a balanced understanding of the radiological impact of nuclear energy, and so to help to bridge the information gap that is perceived to exist on this issue. The 1988 Unscear report and its seven scientific annexes provide an authoritative and dispassionate factual basis for examining radiation levels from all sources, natural and man-made. It is the main source for this paper. (author)

Roles of radiation chemistry in development and research of radiation biology

International Nuclear Information System (INIS)

Min Rui

2009-01-01

Radiation chemistry acts as a bridge connecting radiation physics with radiation biology in spatial and temporal insight. The theory, model, and methodology coming from radiation chemistry play an important role in the research and development of radiation biology. The chemical changes induced by ionizing radiation are involved not only in early event of biological effects caused by ionizing radiation but in function radiation biology, such as DNA damage and repair, sensitive modification, metabolism and function of active oxygen and so on. Following the research development of radiation biology, systems radiation biology, accurate quality and quantity of radiation biology effects need more methods and perfect tools from radiation chemistry. (authors)

Radiation protection guidelines for radiation emergencies

International Nuclear Information System (INIS)

Lessard, E.T.; Meinhold, C.B.

1986-01-01

The system of dose limitation and present guidance for emergency workers and guidance for intervention on behalf of the public are discussed. There are three elements for the system of dose limitation: justification, optimization and dose limits. The first element is basically a political process in this country. Justification is based on a risk-benefit analysis, and justification of the use of radioactive materials or radiation is generally not within the authority of radiation protection managers. Radiation protection managers typically assess detriments or harm caused by radiation exposure and have very little expertise in assessing the benefits of a particular practice involving nuclear material

Radiation and radiation effects; Strahlung und Strahlenwirkung

Energy Technology Data Exchange (ETDEWEB)

Neumaier, S. [Physikalisch-Technische Bundesanstalt, Berlin (Germany). Arbeitsgruppe Strahlenschutz; Janssen, H. [Physikalisch-Technische Bundesanstalt, Berlin (Germany). Abt. Ionisierende Strahlung

2006-12-15

The average dose incurred by the German population is about 4 millisievert p.a., about half of which results from natural radiation sources. The second half is caused nearly completely by medical applications. Only a very small fraction of the annual dose results from technical applications. This special issue of PTB focuses on the measuring problems relating to natural radiation sources and technical applications of ionizing radiation. The current contribution also outlines some important aspects of radiation exposure from medical applications. (orig.)

Use of synchrotron radiation in radiation biology research

International Nuclear Information System (INIS)

Yamada, Takeshi

1981-01-01

Synchrotron radiation (SR) holds great expectation as a new research tool in the new areas of material science, because it has the continuous spectral distribution from visible light to X-ray, and its intensity is 10 2 to 10 3 times as strong as that of conventional radiation sources. In the National Laboratory for High Energy Physics, a synchrotron radiation experimental facility has been constructed, which will start operation in fiscal 1982. With this SR, the photons having the wavelength in undeveloped region from vacuum ultraviolet to soft X-ray are obtained as intense mono-wavelength light. The SR thus should contribute to the elucidation of the fundamentals in the biological action of radiation. The following matters are described: synchrotron radiation, experimental facility using SR, electron storage ring, features of SR, photon factory plan and synchrotron radiation experimental facility, utilization of SR in radiation biology field. (J.P.N.)

Technical sheets of ionizing radiations. 2. Non-ionizing radiations

International Nuclear Information System (INIS)

Anon.

1975-01-01

The biological effects of different non-ionizing radiations are studied: ultra-violet radiation, visible radiation, infrared radiation, micrometric waves, ultrasonics. In spite of their apparent diversity these radiations are similar in their physico-chemical effects, but in view of their widely varying production methods and types of application each type is considered separately. It is pointed out that no organization resembling the CIPR exists in the field of non-ionizing radiations, the result being a great disparity amongst the different legislations in force [fr

Gravitational radiation resistance, radiation damping and field fluctuations

International Nuclear Information System (INIS)

Schaefer, G.

1981-01-01

Application is made of two different generalised fluctuation-dissipation theorems and their derivations to the calculation of the gravitational quadrupole radiation resistance using the radiation-reaction force given by Misner, Thorne and Wheeler (Gravitation (San Francisco: Freeman) ch 36,37 (1973)) and the usual tidal force on one hand and the tidal force and the free gravitational radiation field on the other hand. The quantum-mechanical version (including thermal generalisations) of the well known classical quadrupole radiation damping formula is obtained as a function of the radiation resistance. (author)

Radiation protection and the safety of radiation sources

International Nuclear Information System (INIS)

1996-01-01

These Safety Fundamentals cover the protection of human beings against ionizing radiation (gamma and X rays and alpha, beta and other particles that can induce ionization as they interact with biological materials), referred to herein subsequently as radiation, and the safety of sources that produce ionizing radiation. The Fundamentals do not apply to non-ionizing radiation such as microwave, ultraviolet, visible and infrared radiation. They do not apply either to the control of non-radiological aspects of health and safety. They are, however, part of the overall framework of health and safety

Development of natural radiation model for evaluation of background radiation in radiation portal monitor

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Bum; Lee, Jin Hyung; Moon, Myung Kook [Radioisotope Research and Development Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-11-15

In ports and airports, radiation portal monitors (RPM) are deployed to detect illicit radioactive materials. Detected gamma rays in a RPM include background radiation and radiation from a freight. As a vehicle moves through the RPM, the vehicle causes the fluctuations in the natural background radiation signal, which ranges of up to 30%. The fluctuation increases the uncertainty of detection signal and can be a cause of RPM false alarm. Therefore, it is important to evaluate background radiation as well as radiation from a container. In this paper, a natural background radiation model was developed to evaluate RPM. To develop natural background radiation model, a Monte Carlo simulation was performed and compared with experimental measurements from a RPM for {sup 40}K, {sup 232}Th series, and {sup 235}U series, which are major sources of natural background radiation. For a natural radiation source, we considered a cylindrical soil volume with 300 m radius and 1 m depth, which was estimated as the maximum range affecting the RPM by MCNP6 simulation. The volume source model was converted to surface source by using MCNP SSW card for computational efficiency. The computational efficiency of the surface source model was improved to approximately 200 times better than that of the volume source model. The surface source model is composed of a hemisphere with 20 m radius in which the RPM and container are modelled. The natural radiation spectrum from the simulation was best fitted to the experimental measurement when portions of {sup 40}K, {sup 232}Th series, and {sup 235}U series were 0.75, 0.0636, and 0.0552 Bq·g{sup -1}, respectively. For gross counting results, the difference between simulation and experiment was around 5%. The background radiation model was used to evaluate background suppression from a 40 ft container with 7.2 m·s{sup -1} speed. In further study, background models and freight models for RPM in real container ports will be developed and applied to

From radiation chemistry to radiation engineering

International Nuclear Information System (INIS)

Ballantine, D.S.

1976-01-01

During the past 25 years there has been a steady recognition that radiation in the form of electrons or gamma rays can offer positive advantages as a processing technology. Underlying this process industry, and largely responsible for its success, are significant contributions from the field of basic and applied radiation chemistry. In this paper it is attempted to relate fundamental radiation chemistry studies directly to the practical engineering applications

Radiation and man. From radiology to radiation protection

International Nuclear Information System (INIS)

2005-04-01

Man first became aware of the invisible radiation surrounding him in 1895, when Wilhelm Roentgen showed that a photographic plate could be affected by an invisible radiation capable of passing through matter. He called this radiation 'X-rays' from X, the unknown. Doctors immediately saw the usefulness of this type of radiation and began to use it in medical research. This was the birth of radiology. 'Mankind has been exposed to radiation since his first appearance on Earth. We first became aware of this at the end of the 19. century'. However, it was not long before some of the doctors and radiologists treating their patients with X-rays began to fall ill. It began to be understood that exposure to high doses of radiation was dangerous and protective measures were necessary. From the 1920's onwards, international commissions were established to specify regulations for the use of radiation and for the radiological protection of personnel. (authors)

Solar-aided air conditioning through sorption. Final report. Phase 2; Solar unterstuetzte Klimatisierung ueber Sorption. Endbericht zur Phase 2

Energy Technology Data Exchange (ETDEWEB)

Laevemann, E; Kessling, W; Peltzer, M

1996-09-24

The present article reports on possibilities of using solar energy for cooling buildings. It contains the following chapters: Current state of research and development; room air conditioning; planning and results of the studies; theory; experimental studies on the sorption dehumidifier; development of exchange surfaces; development of solution distributors; cooling of exchange surfaces; construction of a sorption dehumidifier. (HW) [Deutsch] Die Arbeit berichtet ueber Moeglichkeiten der Anwendung von Solarenergie zur Kuehlung von Gebaeuden. Die Arbeit enthaelt folgende Kapitel: - Stand der Forschung und Entwicklung - Raumklimatisierung - Planung und Ergebnis der Untersuchungen - Theorie - Experimentelle Untersuchungen am Sorptionsentfeuchter - Entwicklung von Austauschflaechen - Entwicklung von Loesungsverteilern - Kuehlung von Austauschflaechen - Konstruktion eines Sorptionsentfeuchters. (HW)

Radiation hormesis and its potential to manage radiation injuries

International Nuclear Information System (INIS)

Bala, Madhu; Mathew, Lazar

2000-01-01

The term radiation hormesis explains stimulatory or beneficial effects of low dose radiation exposure, which cannot be predicted by extrapolation of detrimental or lethal effects of high dose radiation exposure. Although beneficial effects of low doses of radiation were observed soon after discovery of x-rays and radioactivity, studies remained inconclusive until recently, due to (i) inadequate statistical planning of experiments conducted in early part of the 20th century; and (ii) poor dose monitoring. Recently (1980s onwards), large scale, systematic epidemiological and experimental studies with a number of diverse systems have demonstrated existence of radiation hormesis beyond doubt. It is pointed out that the hormetic effects of radiation have not been successfully exploited so far for human benefits, primarily because underlying molecular mechanisms are poorly understood. It is argued that with more and more studies, it is becoming evident that radiation hormesis is not merely physiological adaptation, but a genetically regulated phenomenon and involves de novo synthesis of proteins. Role of these proteins in induction of radiation hormesis is the current area of research in a number of world-renowned laboratories. The first part of this review elucidates the shifts in paradigms on radiation effects in the 20th century and the later portion presents a brief on underlying molecular mechanisms of radiation hormesis and their implications towards management of radiation injuries. (author)

Radiation signatures

International Nuclear Information System (INIS)

McGlynn, S.P.; Varma, M.N.

1992-01-01

A new concept for modelling radiation risk is proposed. This concept is based on the proposal that the spectrum of molecular lesions, which we dub ''the radiation signature'', can be used to identify the quality of the causal radiation. If the proposal concerning radiation signatures can be established then, in principle, both prospective and retrospective risk determination can be assessed on an individual basis. A major goal of biophysical modelling is to relate physical events such as ionization, excitation, etc. to the production of radiation carcinogenesis. A description of the physical events is provided by track structure. The track structure is determined by radiation quality, and it can be considered to be the ''physical signature'' of the radiation. Unfortunately, the uniqueness characteristics of this signature are dissipated in biological systems in ∼10 -9 s. Nonetheless, it is our contention that this physical disturbance of the biological system eventuates later, at ∼10 0 s, in molecular lesion spectra which also characterize the causal radiation. (author)

CT and MRI findings in HAM. A report on five cases

Energy Technology Data Exchange (ETDEWEB)

Fukaura, Hikoaki; Tashiro, Kunio; Maruo, Yasunori; Moriwaka, Fumio; Itoh, Kazunori; Matsuura, Tooru; Togashi, Takehiro (Hokkaido Univ., Sapporo (Japan). School of Medicine); Hamada, Takeshi; Matsumoto, Akihisa

1989-02-01

The findings of the spinal MR imagings and the CT myelography of 5 cases with HTLV-I associated myelopathy (HAM) were presented. One case who showed transverse myelopathy with a multiple sclerosis-like abrupt onset showed spinal-cord swelling at the early stage on CT myelography; its disappearance was documented 4 months after corticosteroid therapy. The other 4 cases, all with slowly progressive myelopathy, clinically revealed spinal-cord atrophy, especially at the thoracic level, on MR imagings. The degree of spinal-cord atrophy seemed not have any correlation with the clinical and laboratory data or with the corticosteroid therapy. The clinical entity of HAM has not yet been determined, and its relationship with tropical spastic paraparesis (TSP) as well as that with some form of multiple sclerosis is controversial. The neuroradiological findings of MR imaging and CT myelography, including spinal-cord swelling at the early stage, in a case diagnosed as HAM with atypical clinical features or as spinal-cord atrophy in typical chronic cases might contribute to its resolution. (author).

Radiation protection

International Nuclear Information System (INIS)

Jain, Aman; Sharma, Shivam; Parasher, Abhishek

2014-01-01

Radiation dose measurement, field of radiobiology, is considered to be critical factor for optimizing radiation protection to the health care practitioners, patients and the public. This lead to equipment that has dose - area product meters permanently installed. In many countries and even institution, the range of equipment is vast and with the opportunity for radiation protection and dose recording varies considerably. Practitioners must move with the changed demands of radiation protection but in many cases without assistance of modern advancements in technology Keeping the three basic safety measures Time, Dose and Shielding we can say 'Optimum dose is safe dose' instead of 'No dose is safe dose'. The purpose enclosed within the title 'Radiation Protection'. The use of radiation is expanding widely everyday around the world and crossing boundaries of medical imaging, diagnostic and. The way to get the ''As low as reasonably achievable' is only achievable by using methodology of radiation protection and to bring the concern of general public and practitioners over the hazards of un-necessary radiation dose. Three basic principles of radiation protection are time, distance and shielding. By minimizing the exposure time increasing the distance and including the shielding we can reduce the optimum range of dose. The ability of shielding material to attenuate radiation is generally given as half value layer. This is the thickness of the material which will reduce the amount of radiation by 50%. Lab coat and gloves must be worn when handling radioactive material or when working in a labeled radiation work area. Safety glasses or other appropriate splash shields should be used when handling radioactive material. 1. Reached to low dose level to occupational workers, public as per prescribed dose limit. 2. By mean of ALARA principle we achieved the protection from radiation besides us using the radiation for our benefit

Central nervous system tumors

International Nuclear Information System (INIS)

Gavin, P.R.; Fike, J.R.; Hoopes, P.J.

1995-01-01

Central nervous system (CNS) tumors are relatively common in veterinary medicine, with most diagnoses occurring in the canine and feline species. Numerous tumor types from various cells or origins have been identified with the most common tumors being meningiomas and glial cell tumors. Radiation therapy is often used as an aid to control the clinical signs associated with these neoplasms. In general, these tumors have a very low metastatic potential, such that local control offers substantial benefit. Experience in veterinary radiation oncology would indicate that many patients benefit from radiation treatment. Current practice indicates the need for computed tomography or magnetic resonance imaging studies. These highly beneficial studies are used for diagnosis, treatment planning, and to monitor treatment response. Improvements in treatment planning and radiation delivered to the tumor, while sparing the normal tissues, should improve local control and decrease potential radiation related problems to the CNS. When possible, multiple fractions of 3 Gy or less should be used. The tolerance dose to the normal tissue with this fractionation schedule is 50 to 55 Gy. The most common and serious complications of radiation for CNS tumors is delayed radiation myelopathy and necrosis. Medical management of the patient during radiation therapy requires careful attention to anesthetic protocols, and medications to reduce intracranial pressure that is often elevated in these patients. Canine brain tumors have served as an experimental model to test numerous new treatments. Increased availability of advanced imaging modalities has spawned increased detection of these neoplasms. Early detection of these tumors with appropriate aggressive therapy should prove beneficial to many patients

Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

Directory of Open Access Journals (Sweden)

Dörr Harald

2011-11-01

Full Text Available Abstract Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the absorbed radiation dose and its distribution. Multi-organ-involvement and multi-organ-failure need be taken into account. The most vulnerable organ system to radiation exposure is the hematopoietic system. In addition to hematopoietic syndrome, radiation induced damage to the skin plays an important role in diagnostics and the treatment of radiation accident victims. The most important therapeutic principles with special reference to hematopoietic syndrome and cutaneous radiation syndrome are reviewed.

Radiation analysis devices, radiation analysis methods, and articles of manufacture

Science.gov (United States)

Roybal, Lyle Gene

2010-06-08

Radiation analysis devices include circuitry configured to determine respective radiation count data for a plurality of sections of an area of interest and combine the radiation count data of individual of sections to determine whether a selected radioactive material is present in the area of interest. An amount of the radiation count data for an individual section is insufficient to determine whether the selected radioactive material is present in the individual section. An article of manufacture includes media comprising programming configured to cause processing circuitry to perform processing comprising determining one or more correction factors based on a calibration of a radiation analysis device, measuring radiation received by the radiation analysis device using the one or more correction factors, and presenting information relating to an amount of radiation measured by the radiation analysis device having one of a plurality of specified radiation energy levels of a range of interest.

Identification of Human T-lymphotropic Virus Type I (HTLV-I Subtypes Using Restrited Fragment Length Polymorphism in a Cohort of Asymptomatic Carriers and Patients with HTLV-I-associated Myelopathy/tropical Spastic Paraparesis from São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Segurado Aluisio AC

2002-01-01

Full Text Available Although human T-lymphotropic virus type I (HTLV-I exhibits high genetic stability, as compared to other RNA viruses and particularly to human immunodeficiency virus (HIV, genotypic subtypes of this human retrovirus have been characterized in isolates from diverse geographical areas. These are currently believed not to be associated with different pathogenetic outcomes of infection. The present study aimed at characterizing genotypic subtypes of viral isolates from 70 HTLV-I-infected individuals from São Paulo, Brazil, including 42 asymptomatic carriers and 28 patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, using restricted fragment length polymorphism (RFLP analysis of long terminal repeat (LTR HTLV-I proviral DNA sequences. Peripheral blood mononuclear cell lysates were amplified by nested polymerase chain reaction (PCR and amplicons submitted to enzymatic digestion using a panel of endonucleases. Among HTLV-I asymptomatic carriers, viral cosmopolitan subtypes A, B, C and E were identified in 73.8%, 7.1%, 7.1% and 12% of tested samples, respectively, whereas among HAM/TSP patients, cosmopolitan A (89.3%, cosmopolitan C (7.1% and cosmopolitan E (3.6% subtypes were detected. HTLV-I subtypes were not statistically significant associated with patients' clinical status. We also conclude that RFLP analysis is a suitable tool for descriptive studies on the molecular epidemiology of HTLV-I infections in our environment.

Is anterior cervical discectomy and fusion superior to corpectomy and fusion for treatment of multilevel cervical spondylotic myelopathy? A systemic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Ying-Chao Han

Full Text Available OBJECTIVE: Both anterior cervical discectomy with fusion (ACDF and anterior cervical corpectomy with fusion (ACCF are used to treat cervical spondylotic myelopathy (CSM, however, there is considerable controversy as to whether ACDF or ACCF is the optimal treatment for this condition. To compare the clinical outcomes, complications, and surgical trauma between ACDF and ACCF for the treatment of CSM, we conducted a meta-analysis. METHODS: We conducted a comprehensive search in MEDLINE, EMBASE, PubMed, Google Scholar and Cochrane databases, searching for relevant controlled trials up to July 2013 that compared ACDF and ACCF for the treatment of CSM. We performed title and abstract screening and full-text screening independently and in duplicate. A random effects model was used for heterogeneous data; otherwise, a fixed effect model was used to pool data, using mean difference (MD for continuous outcomes and odds ratio (OR for dichotomous outcomes. RESULTS: Of 2157 citations examined, 15 articles representing 1372 participants were eligible. Overall, there were significant differences between the two treatment groups for hospital stay (M = -5.60, 95% CI = -7.09 to -4.11, blood loss (MD = -151.35, 95% CI = -253.22 to -49.48, complications (OR = 0.50, 95% CI = 0.35 to 0.73 and increased lordosis of C2-C7 (MD = 3.70, 95% CI = 0.96 to 6.45 and fusion segments angles (MD = 3.38, 95% CI = 2.54 to 4.22. However, there were no significant differences in the operation time (MD = -9.34, 95% CI = -42.99 to 24.31, JOA (MD = 0.24, 95% CI = -0.10 to 0.57, VAS (MD = -0.06, 95% CI = -0.81 to 0.70, NDI (MD = -1.37, 95% CI  = -3.17 to 0.43, Odom criteria (OR = 0.88, 95% CI = 0.60 to 1.30 or fusion rate (OR = 1.17, 95% CI = 0.34 to 4.11. CONCLUSIONS: Based on this meta-analysis, although complications and increased lordosis are significantly better in the ACDF group, there is no strong evidence to support the routine use of ACDF over ACCF in

The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based magnetic resonance imaging study: the Wakayama Spine Study.

Science.gov (United States)

Nagata, Keiji; Yoshimura, Noriko; Hashizume, Hiroshi; Muraki, Shigeyuki; Ishimoto, Yuyu; Yamada, Hiroshi; Takiguchi, Noboru; Nakagawa, Yukihiro; Minamide, Akihito; Oka, Hiroyuki; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Yoshida, Munehito

2014-12-01

A narrow cervical spinal canal (CSC) is a well-known risk factor for cervical myelopathy (CM). However, no epidemiologic data of the CSC based on a population-based cohort are available. The purpose of the study was to investigate the age-related differences in CSC diameters on plain radiographs and to examine the associated magnetic resonance imaging (MRI) abnormalities including cervical cord compression and increased signal intensity (ISI) as well as the clinical CM with the narrow CSC. This was a cross-sectional study. Data were obtained from the baseline survey of the Wakayama Spine Study that was performed from 2008 to 2010 in a western part of Japan. Finally, a total of 959 subjects (319 men and 640 women; mean age, 66.4 years) were included. The outcome measures included in the study were the CSC diameter at C5 level on plain radiographs, cervical cord compression and ISI on sagittal T2-weighted MRI, and physical signs related to CM (eg, the Hoffmann reflex, hyperreflexia of the patellar tendon, the Babinski reflex, sensory and motor function, and bowel/bladder symptoms). The age-related differences of CSC diameters in men and women were investigated by descriptive statistics. The prevalence of MRI abnormalities and clinical CM was compared among the groups divided by the CSC diameter (less than 13, 13-15, and 15 mm or more). In addition, a logistic regression analysis was performed to determine the association of the CSC diameter with cervical cord compression/clinical CM after overall adjustment for age, sex, and body mass index. The CSC diameter was narrower with increasing age in both men and women. The prevalence of cervical cord compression, ISI, and the clinical CM was significantly higher in the narrower CSC group. The prevalence of cervical cord compression, ISI, and CM among subjects with CSC diameter less than 13 mm was 38.0%, 5.4%, and 10.1%, respectively. In the logistic model, the CSC diameter was a significant predictive factor for the

Tax secretion from peripheral blood mononuclear cells and Tax detection in plasma of patients with human T-lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis and asymptomatic carriers.

Science.gov (United States)

Medina, Fernando; Quintremil, Sebastián; Alberti, Carolina; Godoy, Fabián; Pando, María E; Bustamante, Andrés; Barriga, Andrés; Cartier, Luis; Puente, Javier; Tanaka, Yuetsu; Valenzuela, María A; Ramírez, Eugenio

2016-03-01

Human T-lymphotropic virus-type 1 (HTLV-1) is the etiologic agent of the neurologic disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Tax viral protein plays a critical role in viral pathogenesis. Previous studies suggested that extracellular Tax might involve cytokine-like extracellular effects. We evaluated Tax secretion in 18 h-ex vivo peripheral blood mononuclear cells (PBMCs) cultures from 15 HAM/TSP patients and 15 asymptomatic carriers. Futhermore, Tax plasma level was evaluated from other 12 HAM/TSP patients and 10 asymptomatic carriers. Proviral load and mRNA encoding Tax were quantified by PCR and real-time RT-PCR, respectively. Intracellular Tax in CD4(+)CD25(+) cells occurred in 100% and 86.7% of HAM/TSP patients and asymptomatic carriers, respectively. Percentage of CD4(+)CD25(+) Tax+, proviral load and mRNA encoding Tax were significantly higher in HAM/TSP patients. Western blot analyses showed higher secretion levels of ubiquitinated Tax in HAM/TSP patients than in asymptomatic carriers. In HTLV-1-infected subjects, Western blot of plasma Tax showed higher levels in HAM/TSP patients than in asymptomatic carriers, whereas no Tax was found in non-infected subjects. Immunoprecipitated plasma Tax resolved on SDS-PAGE gave two major bands of 57 and 48 kDa allowing identification of Tax and Ubiquitin peptides by mass spectrometry. Relative percentage of either CD4(+)CD25(+) Tax+ cells, or Tax protein released from PBMCs, or plasma Tax, correlates neither with tax mRNA nor with proviral load. This fact could be explained by a complex regulation of Tax expression. Tax secreted from PBMCs or present in plasma could potentially become a biomarker to distinguish between HAM/TSP patients and asymptomatic carriers. © 2015 Wiley Periodicals, Inc.

Regulation for radiation protection in applications of radiation sources

International Nuclear Information System (INIS)

Sonawane, Avinash U.

2016-01-01

Applications of ionising radiation in multifarious field are increasing in the country for the societal benefits. The national regulatory body ensures safety and security of radiation sources by enforcing provisions in the national law and other relevant rules issued under the principle law. In addition, the enforcement of detailed requirements contained in practice specific safety codes and standard and issuance of safety directives brings effectiveness in ensuring safe handling and secure management of radiation sources. The regulatory requirements for control over radiation sources throughout their life-cycle have evolved over the years from experience gained. Nevertheless, some of the regulatory activities which require special attention have been identified such as the development of regulation to deal with advance emerging radiation technology in applications of radiation in medicine and industry; sustaining continuity in ensuring human resource development programme; inspections of category 3 and 4 disused sources and their safe disposal; measures for controlling transboundary movement of radiation sources. The regulatory measures have been contemplated and are being enforced to deal with the above issues in an effective manner. The complete involvement of the management of radiation facilities, radiation workers and their commitment in establishing and maintaining safety and security culture is essential to handle the radiation sources safely and efficiently at all times

Brain radiation - discharge

Science.gov (United States)

Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

Radiation-induced Genomic Instability and Radiation Sensitivity

Energy Technology Data Exchange (ETDEWEB)

Varnum, Susan M.; Sowa, Marianne B.; Kim, Grace J.; Morgan, William F.

2013-01-19

The obvious relationships between reactive oxygen and nitrogen species, mitochondrial dysfunction, inflammatory type responses and reactive chemokines and cytokines suggests a general stress response induced by ionizing radiation most likely leads to the non-targeted effects described after radiation exposure. We argue that true bystander effects do not occur in the radiation therapy clinic. But there is no question that effects outside the target volume do occur. These “out of field effects” are considered very low dose effects in the context of therapy. So what are the implications of non-targeted effects on radiation sensitivity? The primary goal of therapy is to eradicate the tumor. Given the genetic diversity of the human population, lifestyle and environment factors it is likely some combination of these will influence patient outcome. Non-targeted effects may contribute to a greater or lesser extent. But consider the potential situation involving a partial body exposure due to a radiation accident or radiological terrorism. Non-targeted effects suggest that the tissue at risk for demonstrating possible detrimental effects of radiation exposure might be greater than the volume actually irradiated.

Diagnosis of cervical intervertebral disc protrusion and the relation between localization of the lesion and the neurological symptoms

International Nuclear Information System (INIS)

Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Miyasaka, Kazuo; Tashiro, Kunio; Tsuru, Mitsuo; Ito, Terufumi.

1985-01-01

In the cervical disc disease, computed tomography (CT) myelographic and conventional myelographic findings were surgically confirmed. The authors classified the disc protrusion into two types, and demonstrated the characteristic features of these two types in CT myelography and conventional myelography. Moreover, the correlation with the localization of the disc protrusion and the laterality of the myelopathy are discussed. All cases were obtained using a late generation scanner and the patient in the supine position with the neck in the neutral position. Using conventional myelography, all examinations were obtained with the neck in a flexion, neutral and extended positions. Twenty-two patients with cervical disc disease operated on by an anterior approach were studied by CT myelography and conventional myelography. According to the style of the compression on the spinal cord, the cervical disc protrusion was classified into two main groups, the subligamentous type and epiligamentous type. This study included 10 patients of the subligamentous type and 12 patients of the epiligamentous type. The localization of the disc protrusion and the laterality of the myelopathy often corresponded with each other. Not only the localization of the lesion, but also the pincer effect, especially the oblique pincer effect, which is reinforced by dynamic factors, are important in the understanding of the manifestations of myelopathy. In the subligamentous type, the main cause of the myelopathy is considered to be the mechanical pressure by the prolapsed nucleus pulposus. In the epiligamentous type, on the other hand, it is believed to be the pincer effect, reinforced by dynamic factors. (author)

New radiobiological, radiation risk and radiation protection paradigms

International Nuclear Information System (INIS)

Goodhead, Dudley T.

2010-01-01

The long-standing conventional paradigm for radiobiology has formed a logical basis for the standard paradigm for radiation risk of cancer and heritable effects and, from these paradigms, has developed the internationally applied system for radiation protection, but with many simplifications, assumptions and generalizations. A variety of additional radiobiological phenomena that do not conform to the standard paradigm for radiobiology may have potential implications for radiation risk and radiation protection. It is suggested, however, that the current state of knowledge is still insufficient for these phenomena, individually or collectively, to be formulated systematically into a new paradigm for radiobiology. Additionally, there is at present lack of direct evidence of their relevance to risk for human health, despite attractive hypotheses as to how they might be involved. Finally, it remains to be shown how incorporation of such phenomena into the paradigm for radiation protection would provide sufficient added value to offset disruption to the present widely applied system. Further research should aim for better mechanistic understanding of processes such as radiation-induced genomic instability (for all radiation types) and bystander effects (particularly for low-fluence high-LET particles) and also priority should be given to confirmation, or negation, of the relevance of the processes to human health risks from radiation.

Radiation injury

International Nuclear Information System (INIS)

Hubner, K.F.

1988-01-01

Radiation accidents and incidents continue to be of great interest and concern to the public. Issues such as the threat of nuclear war, the Chernobyl reactor accident, or reports of sporadic incidences of accidental radiation exposure keep this interest up and maintain a high level of fear among the public. In this climate of real concern and radiation phobia, physicians should not only be prepared to answer questions about acute or late effects of ionizing radiation, but also be able to participate in the initial assessment and management of individuals who have been exposed to ionizing radiation or contaminated with radioactive material. Some of the key facts about radiation injury and its medical treatment are discussed by the author

Perception of low dose radiation risks among radiation researchers in Korea.

Science.gov (United States)

Seong, Ki Moon; Kwon, TaeWoo; Seo, Songwon; Lee, Dalnim; Park, Sunhoo; Jin, Young Woo; Lee, Seung-Sook

2017-01-01

Expert's risk evaluation of radiation exposure strongly influences the public's risk perception. Experts can inform laypersons of significant radiation information including health knowledge based on experimental data. However, some experts' radiation risk perception is often based on non-conclusive scientific evidence (i.e., radiation levels below 100 millisievert), which is currently under debate. Examining perception levels among experts is important for communication with the public since these individual's opinions have often exacerbated the public's confusion. We conducted a survey of Korean radiation researchers to investigate their perceptions of the risks associated with radiation exposure below 100 millisievert. A linear regression analysis revealed that having ≥ 11 years' research experience was a critical factor associated with radiation risk perception, which was inversely correlated with each other. Increased opportunities to understand radiation effects at perception of radiation exposure. In addition, radiation researchers conceived that more scientific evidence reducing the uncertainty for radiation effects perception of radiation exposure.

Perception of low dose radiation risks among radiation researchers in Korea

Science.gov (United States)

Seo, Songwon; Lee, Dalnim; Park, Sunhoo; Jin, Young Woo; Lee, Seung-Sook

2017-01-01

Expert’s risk evaluation of radiation exposure strongly influences the public’s risk perception. Experts can inform laypersons of significant radiation information including health knowledge based on experimental data. However, some experts’ radiation risk perception is often based on non-conclusive scientific evidence (i.e., radiation levels below 100 millisievert), which is currently under debate. Examining perception levels among experts is important for communication with the public since these individual’s opinions have often exacerbated the public’s confusion. We conducted a survey of Korean radiation researchers to investigate their perceptions of the risks associated with radiation exposure below 100 millisievert. A linear regression analysis revealed that having ≥ 11 years’ research experience was a critical factor associated with radiation risk perception, which was inversely correlated with each other. Increased opportunities to understand radiation effects at risk perception of radiation exposure. In addition, radiation researchers conceived that more scientific evidence reducing the uncertainty for radiation effects risk perception of radiation exposure. PMID:28166286

Tax posttranslational modifications and interaction with calreticulin in MT-2 cells and human peripheral blood mononuclear cells of human T cell lymphotropic virus type-I-associated myelopathy/tropical spastic paraparesis patients.

Science.gov (United States)

Medina, Fernando; Quintremil, Sebastian; Alberti, Carolina; Barriga, Andres; Cartier, Luis; Puente, Javier; Ramírez, Eugenio; Ferreira, Arturo; Tanaka, Yuetsu; Valenzuela, Maria Antonieta

2014-04-01

The human retrovirus human T cell lymphotropic virus type-I (HTLV-1) is the etiologic agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Axonal degeneration in HAM/TSP patients occurs without neuron infection, with the secreted viral Tax protein proposed to be involved. We previously found that Tax secreted into the culture medium of MT-2 cells (HTLV-1-infected cell line) produced neurite retraction in neuroblastoma cells differentiated to neuronal type. To assess the relevance of Tax posttranslational modifications on this effect, we addressed the question of whether Tax secreted by MT-2 cells and peripheral blood mononuclear cells (PBMCs) of HTLV-1-infected subjects is modified. The interaction of Tax with calreticulin (CRT) that modulates intracellular Tax localization and secretion has been described. We studied Tax localization and modifications in MT-2 cells and its interaction with CRT. Intracellular Tax in MT-2 cells was assessed by flow cytometry, corresponding mainly to a 71-kDa protein followed by western blot. This protein reported as a chimera with gp21 viral protein-confirmed by mass spectrometry-showed no ubiquitination or SUMOylation. The Tax-CRT interaction was determined by confocal microscopy and coimmunoprecipitation. Extracellular Tax from HAM/TSP PBMCs is ubiquitinated according to western blot, and its interaction with CRT was shown by coimmunoprecipitation. A positive correlation between Tax and CRT secretion was observed in HAM/TSP PBMCs and asymptomatic carriers. For both proteins inhibitors and activators of secretion showed secretion through the endoplasmic reticulum-Golgi complex. Tax, present in PBMC culture medium, produced neurite retraction in differentiated neuroblastoma cells. These results suggest that Tax, whether ubiquitinated or not, is active for neurite retraction.

Grosse Axiallager mit Hybridschmierung - Theoretische und experimentelle Betrachtungen

DEFF Research Database (Denmark)

Santos, Ilmar; Fuerst, Axel

2003-01-01

Der vorliegende Artikel praesentiert die Simulation eines grossen axialen Kippsegmentlagers unter Beruecksichtigung der hybriden Schmierung, d.h. gleichzeitige hydrodynamische und hydrostatische Schmierung. Ein Vergleich mit Messungen zeigt, dass fuer das betrachtete Lager mit 2,2 m Durchmesser die...

Report / Institut für Experimentelle Physik II

OpenAIRE

Grundmann, Marius

2014-01-01

The Institute for Experimental Physics II of Universität Leipzig welcomes you to read its activity report 2001. In the following some statistics about the structure of the institute, the people involved, and the teaching activities are summarized. The core of the report is built by the scientific activity reports - arranged according to the groups making up the institute: solid-state optics and acoustics, semiconductor physics, nuclear solid-state physics, physics of dielectric solids, super...

Experimentelles FMCW-Radar zur hochfrequenten Charakterisierung von Windenergieanlagen

Science.gov (United States)

Schubert, Karsten; Werner, Jens; Schwartau, Fabian

2017-09-01

During the increasing dissemination of renewable energy sources the potential and actual interference effects of wind turbine plants became obvious. Turbines reflect the signals of weather radar and other radar systems. In addition to the static radar echoes, in particular the Doppler echoes are to be mentioned as an undesirable impairment Keränen (2014). As a result, building permit is refused for numerous new wind turbines, as the potential interference can not be reliably predicted. As a contribution to the improvement of this predictability, measurements are planned which aim at the high-frequency characterisation of wind energy installations. In this paper, a cost-effective FMCW radar is presented, which is operated in the same frequency band (C-band) as the weather radars of the German weather service. Here, the focus is on the description of the hardware design including the considerations used for its dimensioning.

Radiation protection

International Nuclear Information System (INIS)

Koelzer, W.

1975-01-01

Physical and radiological terms, quantities, and units. Basic principles of radiation protection (ICRP, IAEA, EURATOM, FRG). Biological effects of ionizing radiation. Objectives of practical radiation protection. (HP) [de

Topics in radiation dosimetry radiation dosimetry

CERN Document Server

1972-01-01

Radiation Dosimetry, Supplement 1: Topics in Radiation Dosimetry covers instruments and techniques in dealing with special dosimetry problems. The book discusses thermoluminescence dosimetry in archeological dating; dosimetric applications of track etching; vacuum chambers of radiation measurement. The text also describes wall-less detectors in microdosimetry; dosimetry of low-energy X-rays; and the theory and general applicability of the gamma-ray theory of track effects to various systems. Dose equivalent determinations in neutron fields by means of moderator techniques; as well as developm

Staff radiation exposure in radiation diagnostics

International Nuclear Information System (INIS)

Khakimova, N.U.; Malisheva, E.Yu.; Shosafarova, Sh.G.

2010-01-01

Present article is devoted to staff radiation exposure in radiation diagnostics. Data on staff radiation exposure obtained during 2005-2008 years was analyzed. It was found that average individual doses of staff of various occupations in Dushanbe city for 2008 year are at 0.29-2.16 mSv range. They are higher than the average health indicators but lower than maximum permissible dose. It was defined that paramedical personnel receives the highest doses among the various categories of staff.

Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

Directory of Open Access Journals (Sweden)

Lance K. Mitsunaga

2012-01-01

Full Text Available Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation and to preserve postoperative cervical stability and alignment. With the right surgical indications, reliable results can be expected with laminoplasty in treating patients with multilevel cervical myelopathy.

The natural history and clinical syndromes of degenerative cervical spondylosis.

LENUS (Irish Health Repository)

Kelly, John C

2012-01-01

Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

Development of radiation dose assessment system for radiation accident (RADARAC)

International Nuclear Information System (INIS)

Takahashi, Fumiaki; Shigemori, Yuji; Seki, Akiyuki

2009-07-01

The possibility of radiation accident is very rare, but cannot be regarded as zero. Medical treatments are quite essential for a heavily exposed person in an occurrence of a radiation accident. Radiation dose distribution in a human body is useful information to carry out effectively the medical treatments. A radiation transport calculation utilizing the Monte Carlo method has an advantageous in the analysis of radiation dose inside of the body, which cannot be measured. An input file, which describes models for the accident condition and quantities of interest, should be prepared to execute the radiation transport calculation. Since the accident situation, however, cannot be prospected, many complicated procedures are needed to make effectively the input file soon after the occurrence of the accident. In addition, the calculated doses are to be given in output files, which usually include much information concerning the radiation transport calculation. Thus, Radiation Dose Assessment system for Radiation Accident (RADARAC) was developed to derive effectively radiation dose by using the MCNPX or MCNP code. RADARAC mainly consists of two parts. One part is RADARAC - INPUT, which involves three programs. A user can interactively set up necessary resources to make input files for the codes, with graphical user interfaces in a personnel computer. The input file includes information concerning the geometric structure of the radiation source and the exposed person, emission of radiations during the accident, physical quantities of interest and so on. The other part is RADARAC - DOSE, which has one program. The results of radiation doses can be effectively indicated with numerical tables, graphs and color figures visibly depicting dose distribution by using this program. These results are obtained from the outputs of the radiation transport calculations. It is confirmed that the system can effectively make input files with a few thousand lines and indicate more than 20

Radiation research contracts: Biological effects of small radiation doses

Energy Technology Data Exchange (ETDEWEB)

Hug, O [International Atomic Energy Agency, Division of Health, Safety and Waste Disposal, Vienna (Austria)

1959-04-15

To establish the maximum permissible radiation doses for occupational and other kinds of radiation exposure, it is necessary to know those biological effects which can be produced by very small radiation doses. This particular field of radiation biology has not yet been sufficiently explored. This holds true for possible delayed damage after occupational radiation exposure over a period of many years as well as for acute reactions of the organism to single low level exposures. We know that irradiation of less than 25 Roentgen units (r) is unlikely to produce symptoms of radiation sickness. We have, however, found indications that even smaller doses may produce certain instantaneous reactions which must not be neglected

Radiation metabolomics : a window to high throughput radiation biodosimetry

International Nuclear Information System (INIS)

Rana, Poonam

2016-01-01

In the event of an intentional or accidental release of ionizing radiation in a densely populated area, timely assessment and triage of the general population for radiation exposure is critical. In particular, a significant number of victims may sustain radiation injury, which increases mortality and worsens the overall prognosis of victims from radiation trauma. Availability of a high-throughput noninvasive in vivo biodosimetry tool for assessing the radiation exposure is of particular importance for timely diagnosis of radiation injury. In this study, we describe the potential NMR techniques in evaluating the radiation injury. NMR is the most versatile technique that has been extensively used in the diverse fields of science since its discovery. NMR and biomedical sciences have been going hand in hand since its application in clinical imaging as MRI and metabolic profiling of biofluids was identified. We have established an NMR based metabonomic and in vivo spectroscopy approach to analyse and identify metabolic profile to measure metabolic fingerprint for radiation exposure. NMR spectroscopy experiments were conducted on urine and serum samples collected from mice irradiated with different doses of radiation. Additionally, in vivo NMR spectroscopy was also performed in different region of brains post irradiation in animal model. A number of metabolites associated with energy metabolism, gut flora metabolites, osmolytes, amino acids and membrane metabolism were identified in serum and urine metabolome. Our results illustrated a metabolic fingerprint for radiation exposure that elucidates perturbed physiological functions. Quantitative as well as multivariate analysis/assessment of these metabolites demonstrated dose and time dependent toxicological effect. In vivo spectroscopy from brain showed radiation induced changes in hippocampus region indicating whole body radiation had striking effect on brain metabolism as well. The results of the present work lay a

Validation of radiation dose estimations in VRdose: comparing estimated radiation doses with observed radiation doses

International Nuclear Information System (INIS)

Nystad, Espen; Sebok, Angelia; Meyer, Geir

2004-04-01

The Halden Virtual Reality Centre has developed work-planning software that predicts the radiation exposure of workers in contaminated areas. To validate the accuracy of the predicted radiation dosages, it is necessary to compare predicted doses to actual dosages. During an experimental study conducted at the Halden Boiling Water Reactor (HBWR) hall, the radiation exposure was measured for all participants throughout the test session, ref. HWR-681 [3]. Data from this experimental study have also been used to model tasks in the work-planning software and gather data for predicted radiation exposure. Two different methods were used to predict radiation dosages; one method used all radiation data from all the floor levels in the HBWR (all-data method). The other used only data from the floor level where the task was conducted (isolated data method). The study showed that the all-data method gave predictions that were on average 2.3 times higher than the actual radiation dosages. The isolated-data method gave predictions on average 0.9 times the actual dosages. (Author)

A case of post-irradiation lumbosacral radioculopathy successfully treated with corticosteroid and warfarin

Energy Technology Data Exchange (ETDEWEB)

Anezaki, Toshiharu; Harada, Takashi; Kawachi, Izumi; Sanpei, Kazuhiro; Soma, Yoshiaki; Tsuji, Shoji [Niigata Univ. (Japan). Brain Research Inst

1999-08-01

A 33-year-old man underwent post-operative radiation therapy for the left testicular anaplastic seminoma. One year later, the patient developed muscle weakness and sensory disturbance in the left lower extremity, and muscle weakness in the right lower extremity. MRI demonstrated linear and focal gadolinium (Gd) enhancement of the anterior portion of the lumbosacral roots within the cauda equina. The neurological symptoms improved after administration of corticosteroid and warfarin. Radiation myelopathy of this type was classified as ''selective anterior horn cell injury or amyotrophy'' by Reagan, and the site of the lesion was considered to be the lower motor neurons. However, based on the clinical and MRI findings, we proposed that the disease process was injury to the spinal nerve roots rather than the lower motor neurons. Recent neuropathological studies of this syndrome have demonstrated degeneration of the proximal spinal nerve roots. We consider that primary lesions of this syndrome occur in spinal nerve roots rather than in lower motor neurons, and ''lumbosacral radiculopathy'' is a more appropriate term for this condition. (author)

A case of post-irradiation lumbosacral radioculopathy successfully treated with corticosteroid and warfarin

International Nuclear Information System (INIS)

Anezaki, Toshiharu; Harada, Takashi; Kawachi, Izumi; Sanpei, Kazuhiro; Soma, Yoshiaki; Tsuji, Shoji

1999-01-01

A 33-year-old man underwent post-operative radiation therapy for the left testicular anaplastic seminoma. One year later, the patient developed muscle weakness and sensory disturbance in the left lower extremity, and muscle weakness in the right lower extremity. MRI demonstrated linear and focal gadolinium (Gd) enhancement of the anterior portion of the lumbosacral roots within the cauda equina. The neurological symptoms improved after administration of corticosteroid and warfarin. Radiation myelopathy of this type was classified as ''selective anterior horn cell injury or amyotrophy'' by Reagan, and the site of the lesion was considered to be the lower motor neurons. However, based on the clinical and MRI findings, we proposed that the disease process was injury to the spinal nerve roots rather than the lower motor neurons. Recent neuropathological studies of this syndrome have demonstrated degeneration of the proximal spinal nerve roots. We consider that primary lesions of this syndrome occur in spinal nerve roots rather than in lower motor neurons, and ''lumbosacral radiculopathy'' is a more appropriate term for this condition. (author)

Radiation protection

International Nuclear Information System (INIS)

Ures Pantazi, M.

1994-01-01

This work define procedures and controls about ionizing radiations. Between some definitions it found the following topics: radiation dose, risk, biological effects, international radioprotection bodies, workers exposure, accidental exposure, emergencies and radiation protection

Radiation physics, biophysics, and radiation biology

International Nuclear Information System (INIS)

Hall, E.J.; Zaider, M.

1993-05-01

Research at the Center for Radiological Research is a multidisciplenary blend of physics, chemistry and biology aimed at understanding the mechanisms involved in the health problems resulting from human exposure to ionizing radiations. The focus is increased on biochemistry and the application of the techniques of molecular biology to the problems of radiation biology. Research highlights of the program from the past year are described. A mathematical model describing the production of single-strand and double-strand breaks in DNA as a function radiation quality has been completed. For the first time Monte Carlo techniques have been used to obtain directly the spatial distribution of DNA moieties altered by radiation. This information was obtained by including the transport codes a realistic description of the electronic structure of DNA. We have investigated structure activity relationships for the potential oncogenicity of a new generation of bioreductive drugs that function as hypoxic cytotoxins. Experimental and theoretical investigation of the inverse dose rate effect, whereby medium LET radiations actually produce an c effect when the dose is protracted, is now at a point where the basic mechanisms are reasonably understood and the complex interplay between dose, dose rate and radiation quality which is necessary for the effect to be present can now be predicted at least in vitro. In terms of early radiobiological damage, a quantitative link has been established between basic energy deposition and locally multiply damaged sites, the radiochemical precursor of DNA double strand breaks; specifically, the spatial and energy deposition requirements necessary to form LMDs have been evaluated. For the first time, a mechanically understood ''biological fingerprint'' of high-LET radiation has been established. Specifically measurement of the ratio of inter-to intra-chromosomal aberrations produces a unique signature from alpha-particles or neutrons

Radiation physics, biophysics, and radiation biology

Energy Technology Data Exchange (ETDEWEB)

Hall, E.J.; Zaider, M.

1993-05-01

Research at the Center for Radiological Research is a multidisciplenary blend of physics, chemistry and biology aimed at understanding the mechanisms involved in the health problems resulting from human exposure to ionizing radiations. The focus is increased on biochemistry and the application of the techniques of molecular biology to the problems of radiation biology. Research highlights of the program from the past year are described. A mathematical model describing the production of single-strand and double-strand breaks in DNA as a function radiation quality has been completed. For the first time Monte Carlo techniques have been used to obtain directly the spatial distribution of DNA moieties altered by radiation. This information was obtained by including the transport codes a realistic description of the electronic structure of DNA. We have investigated structure activity relationships for the potential oncogenicity of a new generation of bioreductive drugs that function as hypoxic cytotoxins. Experimental and theoretical investigation of the inverse dose rate effect, whereby medium LET radiations actually produce an c effect when the dose is protracted, is now at a point where the basic mechanisms are reasonably understood and the complex interplay between dose, dose rate and radiation quality which is necessary for the effect to be present can now be predicted at least in vitro. In terms of early radiobiological damage, a quantitative link has been established between basic energy deposition and locally multiply damaged sites, the radiochemical precursor of DNA double strand breaks; specifically, the spatial and energy deposition requirements necessary to form LMDs have been evaluated. For the first time, a mechanically understood biological fingerprint'' of high-LET radiation has been established. Specifically measurement of the ratio of inter-to intra-chromosomal aberrations produces a unique signature from alpha-particles or neutrons.

Cosmic radiation

Energy Technology Data Exchange (ETDEWEB)

Capdevielle, J N

1984-01-01

First, the different instruments and techniques of cosmic particle detection are presented. Then the passage of the cosmic particles through the atmosphere is studied: electrons, photons, muons. The collective behavior of the different categories is also studied, the electromagnetic cascade is distinguished from the hadron cascade. Through the principal physical properties of the radiation and the medium, the ''mean'' aspects of the radiation are then successively dealt with out of the atmosphere, at different altitudes until the sea level, then at great depths. A chapter is devoted to cosmic radiation of more than 10,000 GeV, studied separately. Then solar radiation in universe is studied through their propagation in solar system and their origin. At last, the cosmic radiation effects are studied in environment (cosmic biophysics) and some applications of cosmic radiation are presented.

Radiation protection - Revision of French radiation protection regulations (1988)

International Nuclear Information System (INIS)

Mayoux, J.C.

1989-01-01

This article analyses the recent amendments to the 1966 and 1975 Decrees on general radiation protection principles and radiation protection of workers in large nuclear installations respectively and also describes national radiation protection law. In particular, the amendments incorporate the revised EURATOM basic radiation protection standards and the new international units (sievert and becquerel replace rem and curie) in the Decrees. (NEA) [fr

Radiation

International Nuclear Information System (INIS)

Winther, J.F.; Ulbak, K.; Dreyer, L.; Pukkala, E.; Oesterlind, A.

1997-01-01

Exposure to solar and ionizing radiation increases the risk for cancer in humans. Some 5% of solar radiation is within the ultraviolet spectrum and may cause both malignant melanoma and non-melanocytic skin cancer; the latter is regarded as a benign disease and is accordingly not included in our estimation of avoidable cancers. Under the assumption that the rate of occurrence of malignant melanoma of the buttocks of both men and women and of the scalp of women would apply to all parts of the body in people completely unexposed to solar radiation, it was estimated that approximately 95% of all malignant melanomas arising in the Nordic populations around the year 2000 will be due to exposure to natural ultraviolet radiation, equivalent to an annual number of about 4700 cases, with 2100 in men and 2600 in women, or some 4% of all cancers notified. Exposure to ionizing radiation in the Nordic countries occurs at an average effective dose per capita per year of about 3 mSv (Iceland, 1.1 mSv) from natural sources, and about 1 mSv from man-made sources. While the natural sources are primarily radon in indoor air, natural radionuclides in food, cosmic radiation and gamma radiation from soil and building materials, the man-made sources are dominated by the diagnostic and therapeutic use of ionizing radiation. On the basis of measured levels of radon in Nordic dwellings and associated risk estimates for lung cancer derived from well-conducted epidemiological studies, we estimated that about 180 cases of lung cancer (1% of all lung cancer cases) per year could be avoided in the Nordic countries around the year 2000 if indoor exposure to radon were eliminated, and that an additional 720 cases (6%) could be avoided annually if either radon or tobacco smoking were eliminated. Similarly, it was estimated that the exposure of the Nordic populations to natural sources of ionizing radiation other than radon and to medical sources will each give rise to an annual total of 2120

Antiradiation Vaccine: Immunological neutralization of Radiation Toxins at Acute Radiation Syndromes.

Science.gov (United States)

Popov, Dmitri; Maliev, Slava

Introduction: Current medical management of the Acute Radiation Syndromes (ARS) does not include immune prophylaxis based on the Antiradiation Vaccine. Existing principles for the treatment of acute radiation syndromes are based on the replacement and supportive therapy. Haemotopoietic cell transplantation is recomended as an important method of treatment of a Haemopoietic form of the ARS. Though in the different hospitals and institutions, 31 pa-tients with a haemopoietic form have previously undergone transplantation with stem cells, in all cases(100%) the transplantants were rejected. Lethality rate was 87%.(N.Daniak et al. 2005). A large amount of biological substances or antigens isolated from bacterias (flagellin and derivates), plants, different types of venom (honeybees, scorpions, snakes) have been studied. This biological active substances can produce a nonspecific stimulation of immune system of mammals and protect against of mild doses of irradiation. But their radioprotection efficacy against high doses of radiation were not sufficient. Relative radioprotection characteristics or adaptive properties of antioxidants were expressed only at mild doses of radiation. However antioxidants demonstrated a very low protective efficacy at high doses of radiation. Some ex-periments demonstrated even a harmful effect of antioxidants administered to animals that had severe forms of the ARS. Only Specific Radiation Toxins roused a specific antigenic stim-ulation of antibody synthesis. An active immunization by non-toxic doses of radiation toxins includes a complex of radiation toxins that we call the Specific Radiation Determinant (SRD). Immunization must be provided not less than 24 days before irradiation and it is effective up to three years and more. Active immunization by radiation toxins significantly reduces the mortality rate (100%) and improves survival rate up to 60% compare with the 0% sur-vival rate among the irradiated animals in control groups

Radiation enteritis

International Nuclear Information System (INIS)

Ochsner, S.F.; Head, L.H.

1973-01-01

A comprehensive review of radiation enteritis is presented. Experience in clinical radiation therapy has indicated that the small bowel is the segment of the alimentary tract that is most susceptible to radiation damage. (U.S.)

Radiation sickness

Science.gov (United States)

... exposure to ionizing radiation. There are two main types of radiation: nonionizing and ionizing. Nonionizing radiation comes in the form of light, radio waves, microwaves and radar. These forms usually don't cause tissue damage. ...

Calculating the diffuse solar radiation in regions without solar radiation measurements

International Nuclear Information System (INIS)

Li, Huashan; Bu, Xianbiao; Long, Zhen; Zhao, Liang; Ma, Weibin

2012-01-01

Correlations for calculating diffuse solar radiation can be classified into models with global solar radiation (H-based method) and without it (Non-H method). The objective of the present study is to compare the performance of H-based and Non-H methods for calculating the diffuse solar radiation in regions without solar radiation measurements. The comparison is carried out at eight meteorological stations in China focusing on the monthly average daily diffuse solar radiation. Based on statistical error tests, the results show that the Non-H method that includes other readily available meteorological elements gives better estimates. Therefore, it can be concluded that the Non-H method is more appropriate than the H-based one for calculating the diffuse solar radiation in regions without solar radiation measurements. -- Highlights: ► Methods for calculating diffuse solar radiation in regions without solar radiation measurements are investigated. ► Diffuse solar radiation models can be classified into two groups according to global solar radiation. ► Two approaches are compared at the eight meteorological stations in China. ► The method without global solar radiation is recommended.

Radiation monitor

International Nuclear Information System (INIS)

Pao, C.T.; Green, W.K.

1978-01-01

A system for indicating radiation from a radioactive fluid such as a gas wherein simultaneous indications of the activity concentration of radioactivity of the gas, the radiation dose rate and average energy of the radiation are provided

Cervical Spondylotic Myelopathy (CSM)

Science.gov (United States)

... of CSM occur over time. They can include: neck pain or stiffness arm pain numbness in your hands ... Health, Men, Seniors, WomenTags: adult, elderly, Neck Disorders, neck pain, Neck Swelling, older adults, Rheumatologic, senior September 1, ...

Radiation safety

International Nuclear Information System (INIS)

Auxier, J.A.

1977-01-01

Data available on the biological effects of radiation on man are reviewed, with emphasis on dose response to low LET and high LET radiation sources, and the effects of dose rate. Existing guides for radiation protection were formulated largely on the basis of tumor induction in the bone of radium dial painters, but the ICRP/NCRP annual dose guides of 5 rem/yr are of the same general magnitude as the doses received in several parts of the world from the natural radiation environment. Because of the greater sensitivity of rapidly dividing cells and the assumption that radiation occupations would not begin before the age of eighteen, maximum exposure levels were set as 5 (N-18) rem/yr, where N is the exposed worker's age in years. However, in the case of the natural radiation environment, exposure commences, in a sense, with the exposure of the ovum of the individual's mother; and the ovum is formed during the fetal development of the mother. In occupational exposures, the professional health physicist has always practiced the as low as practical philosophy, and exposures have generally averaged far below the guidelines. The average annual exposure of the radiation worker in modern plants and laboratories is approximately equal to the average natural radiation environment exposure rate and far lower than the natural radiation environment in many parts of the world. There are numerous complications and uncertainties in quantifying radiation effects on humans, however, the greatest is that due to having to extrapolate from high dose levels at which effects have been measured and quantified, to low levels at which most exposures occur but at which no effects have been observed

Radiation imaging

Energy Technology Data Exchange (ETDEWEB)

Redmayne, I.

1986-05-21

A detector for the detection of radiation such as X-ray radiation comprises an array of scintillation elements embedded in a sheet of radiation absorbing material. The scintillation elements are monitored individually, for example by a corresponding array of photodiodes, to build up a picture of the incident radiation. The front face of the sheet and the inner walls of the bores may be coated with a reflective material. The detector finds particular application in weld radiography. The detector may be stepped relative to the radiation source, the signals produced by the rows of the detector as they pass a predetermined point being summed.

Radiation imaging

International Nuclear Information System (INIS)

Redmayne, Ian.

1986-01-01

A detector for the detection of radiation such as X-ray radiation comprises an array of scintillation elements embedded in a sheet of radiation absorbing material. The scintillation elements are monitored individually, for example by a corresponding array of photodiodes, to build up a picture of the incident radiation. The front face of the sheet and the inner walls of the bores may be coated with a reflective material. The detector finds particular application in weld radiography. The detector may be stepped relative to the radiation source, the signals produced by the rows of the detector as they pass a predetermined point being summed. (author)

Radiation carcinogenesis

International Nuclear Information System (INIS)

Adams, G.E.

1987-01-01

In this contribution about carcinogenesis induced by ionizing radiation some radiation dose-response relationships are discussed. Curves are shown of the relation between cell survival and resp. low and high LET radiation. The difference between both curves can be ascribed to endogenous repair mechanisms in the cell. The relation between single-gen mutation frequency and the surviving fractions of irradiated cells indicates that these repairing mechanisms are not error free. Some examples of reverse dose-response relationships are presented in which decreasing values of dose-rate (LET) correspond with increasing radiation induced cell transformation. Finally some molecular aspects of radiation carcinogenesis are discussed. (H.W.). 22 refs.; 4 figs

Ionizing radiations

International Nuclear Information System (INIS)

Newton, W.

1984-01-01

The purpose of this article is to simplify some of the relevant points of legislation, biological effects and protection for the benefit of the occupational health nurse not familiar with the nuclear industries. The subject is dealt with under the following headings; Understanding atoms. What is meant by ionizing radiation. Types of ionizing radiation. Effects of radiation: long and short term somatic effects, genetic effects. Control of radiation: occupational exposure, women of reproductive age, medical aspects, principles of control. The occupational health nurse's role. Emergency arrangements: national arrangements for incidents involving radiation, action to be taken by the nurse. Decontamination procedures: external and internal contamination. (U.K.)

Medical radiation

International Nuclear Information System (INIS)

1992-01-01

This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

Risk Factors: Radiation

Science.gov (United States)

Radiation of certain wavelengths, called ionizing radiation, has enough energy to damage DNA and cause cancer. Ionizing radiation includes radon, x-rays, gamma rays, and other forms of high-energy radiation.

Ionizing radiation

International Nuclear Information System (INIS)

Dennis, J.A.

1982-01-01

The subject is discussed under the headings: characteristics of ionizing radiations; biological effects; comparison of radiation and other industrial risks; principles of protection; cost-benefit analysis; dose limits; the control and monitoring of radiation; reference levels; emergency reference levels. (U.K.)

Radiation protection in medical imaging and radiation oncology

CERN Document Server

Stoeva, Magdalena S

2016-01-01

Radiation Protection in Medical Imaging and Radiation Oncology focuses on the professional, operational, and regulatory aspects of radiation protection. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This book summarizes evidence supporting changes in consensus recommendations, regulations, and health physics practices associated with these recent advances in radiology, nuclear medicine, and radiation oncology. It supports intelligent and practical methods for protection of personnel, the public, and patients. The book is based on current recommendations by the International Commission on Radiological Protection and is complemented by detailed practical sections and professional discussions by the world’s leading medical and health physics professionals. It also ...

Counterbalanced radiation detection system

International Nuclear Information System (INIS)

Platz, W.

1987-01-01

A counterbalanced radiation detection system is described comprising: (a) a stand; (b) a first radiation detector; (c) a first radiation detector arm means for tiltably connecting the first radiation detector with the stand; (d) a second radiation detector; (e) a second radiation detector arm means for tiltably connecting the second radiation detector with the stand, whereby the tilting angles of the radiation detector arm means define a distance between the radiation detectors; and (f) a torque transforming means connected between the first and second radiation detector arm means for transforming the torque created by one of the radiation detectors in a sense opposed to the torque created by the other radiation detector

Precautions against radiations

International Nuclear Information System (INIS)

Osborn, S.B.

1986-01-01

In this chapter the characteristics of ionizing and non-ionizing radiations likely to cause hazards in a chemical laboratory are considered. Quantities and units of radiation are described. The general principles of radiation protection, precautions against radiation hazards, ICRP standards and recommendations and the legislation relating to the control of radiation hazards in the UK are discussed. (U.K.)

Radiation exposure and radiation risk of the population

International Nuclear Information System (INIS)

Jacobi, W.; Paretzke, H.G.; Ehling, U.H.

1981-02-01

The major scientifically founded results concerning the assessment of the radiation exposure and the analysis and evaluation of the radiationhazards for the population, particularly in the range of low doses, are presented. As to the risk analysis special attention is paid to the rays with low ionization density (X-, γ-, β- and electronrays). Contents: 1) Detailed survey of the results and conclusions; 2) Data on the radiation load of the population; 3) Results to epidemiological questioning on the risk of cancer; 4) Genetical radiation hazards of the population. For quantification purposes of the risk of cancer by γ-radiation the observations with the a-bomb survivors in Japan are taken as a basis, as the available dosimetrical data have to be revised. Appendices: 1) German translation of the UNSCEAR-Report (1977); 2) BEIR-Report (1980); 3) Comments from the SSK on the comparability of the risks of natural-artificial radiation exposure; 4) Comments from the SSK on the importance of synergistical influences for the radiation protection (23.9.1977). (HP) [de

Roentgen's heritage and radiation phobia, a challenge to radiation research and radiation protection

International Nuclear Information System (INIS)

Feinendegen, L.E.

1996-01-01

Present practice of applying linearity to assessing risk even from very low dose exposure of complex tissues to ionising radiation has been evaluated in terms of microdosimetric approach to energy deposition in tissues, nature of radiation and also the magnitudes of conditioning and challenging doses. This paper discusses the probability of radiation risk at quite low doses on the tissues in terms of simple mathematical terms. (author). 13 refs., 2 figs., 1 tab

Occupational radiation exposure monitoring among radiation workers in Nepal

International Nuclear Information System (INIS)

Bhatt, Chhavi Raj; Shrestha, Shanta Lall; Khanal, Tara; Ween, Borgny

2008-01-01

Nepal was accepted as a member of the IAEA in 2007. Nepal is one of the world's least developed countries and is defined in Health Level IV. The population counted 26.4 millions in 2007. The health care sector increases with new hospitals and clinics, however, Nepal has no radiation protection authority or radiation protection regulation in the country until now. The radiation producing equipment in the health sector includes conventional X-ray and dental X-ray equipment, fluoroscopes, mammography, CT, catheterization laboratory equipment, nuclear medicine facilities, a few linear accelerators, Co 60 teletherapy and High Dose Rate brachytherapy sources. The situation regarding dosimetry service for radiation workers is unclear. A survey has been carried out to give an overview of the situation. The data collection of the survey was performed by phone call interviews with responsible staff at the different hospitals and clinics. Data about different occupationally exposed staff, use of personal radiation monitoring and type of dosimetry system were collected. In addition, it was asked if dosimetry reports were compiled in files or databases for further follow-up of staff, if needed. The survey shows that less of 25% of the procedures performed on the surveyed hospitals and clinics are performed by staff with personnel radiation monitoring. Radiation monitoring service for exposed staff is not compulsory or standardized, since there is no radiation protection authority. Nepal has taken a step forward regarding radiation protection, with the IAEA membership, although there are still major problems that have to be solved. An evaluation of the existing practice of staff dosimetry can be the first helpful step for further work in building a national radiation protection authority. (author)

Radiation safety

International Nuclear Information System (INIS)

Van Riessen, A.

2002-01-01

Full text: Experience has shown that modem, fully enclosed, XRF and XRD units are generally safe. This experience may lead to complacency and ultimately a lowering of standards which may lead to accidents. Maintaining awareness of radiation safety issues is thus an important role for all radiation safety officers. With the ongoing progress in technology, a greater number of radiation workers are more likely to use a range of instruments/techniques - eg portable XRF, neutron beam analysis, and synchrotron radiation analysis. The source for each of these types of analyses is different and necessitates an understanding of the associated dangers as well as use of specific radiation badges. The trend of 'suitcase science' is resulting in scientists receiving doses from a range of instruments and facilities with no coordinated approach to obtain an integrated dose reading for an individual. This aspect of radiation safety needs urgent attention. Within Australia a divide is springing up between those who work on Commonwealth property and those who work on State property. For example a university staff member may operate irradiating equipment on a University campus and then go to a CSIRO laboratory to operate similar equipment. While at the University State regulations apply and while at CSIRO Commonwealth regulations apply. Does this individual require two badges? Is there a need to obtain two licences? The application of two sets of regulations causes unnecessary confusion and increases the workload of radiation safety officers. Radiation safety officers need to introduce risk management strategies to ensure that both existing and new procedures result in risk minimisation. A component of this strategy includes ongoing education and revising of regulations. AXAA may choose to contribute to both of these activities as a service to its members as well as raising the level of radiation safety for all radiation workers. Copyright (2002) Australian X-ray Analytical

Radiation exposure

International Nuclear Information System (INIS)

Dalton, L.K.

1991-01-01

The book gives accounts of some social and environmental impacts of the developing radiation industries, including the experiences of affected communities and individuals. Its structure is based on a division which has been made between nuclear and non-nuclear radiation sources, because they create distinctly different problems for environmental protection and so for public health policy. The emissions from electronic and electrical installations - the non-nuclear radiations - are dealt with in Part I. Emissions from radioactive substances - the nuclear radiations - are dealt with in Part II. Part III is for readers who want more detailed information about scientific basis of radiation-related biological changes and their associated health effects. 75 refs., 9 tabs., 7 figs., ills

Radiation sickness

International Nuclear Information System (INIS)

Endoh, Masaru; Ishida, Yusei; Saeki, Mitsuaki

1983-01-01

The frequency of radiation sickness in 1,060 patients treated at our Department was 12.8 percent. It was frequent in patients with brain cancer (12 percent), whole spine cancer (47 percent), uterus cancer (28 percent), lung cancer (22 percent) and esophagus cancer (12 percent). Radiation sickness following X-irradiation was studied in its relation to patient's age, size of radiation fields, dosis and white blood cell count. However, we could not find any definite clinical feature relevant to occurrence. There are many theories published concerning the mechanism of radiation sickness. Clinical experiences have shown that radiation sickness cannot be explained by one theory alone but by several theories such as those based on psychology, stress or histamine. (author)

Current perspectives of radiation therapy. History of radiation therapy

International Nuclear Information System (INIS)

Itami, Jun

2011-01-01

More than 100 years have passed since the discovery of X-Strahlen by Roentgen. The history of radiation therapy has evolved under mutual stimulating relationships of the external beam radiation therapy by X-ray tubes and accelerators, and the internal radiation therapy employing radium and other radionuclides. The currently employed technologies in radiation therapy have its origin already till nineteen sixties and the development of physics and engineering have realized the original concept. (author)

Focus radiation protection

International Nuclear Information System (INIS)

Ebermann, Lutz

2016-01-01

The publication of the Bundesamt fuer Strahlenschutz on radiation protection covers the following issues: (i) exposure from natural sources: health hazard due to radon, radiation protection in residential homes, radon in Germany, natural raw materials in industrial processes; (ii) clearance of radioactive wastes: clearance in the frame of nuclear power plant dismantling, the situation in Germany and Europe; (iii) emergency management: principles of radiation protection, fictive sequence of accident events; (iiii) other actual radiation protection topics: more limits - more protection? radiation protection in medicine, occupational radiation protection.

Radiation studied on the internet. On-line radiation teaching materials

International Nuclear Information System (INIS)

Inoue, Hiroyoshi; Kagoshima, Mayumi; Yamasaki, Mariko

2005-01-01

In order to facilitate scientific understanding of radiation in Japan where social understanding has been already progressed, we developed Internet radiation teaching materials that can be utilized as off-school teaching materials or supplementary materials. The teaching materials of ''atomic structure and radiation'' and ''medical treatment and radiation'' were tried for 160 high school students and 59 junior high school students, respectively. More than 70% of the student answered that these teaching materials were effective when they understand radiation. (author)

Radiation induced sarcomas of bone following therapeutic radiation

International Nuclear Information System (INIS)

Kim, J.H.; Chu, F.C.H.; Woodward, H.Q.; Huvos, A.

1983-01-01

Because of new therapeutic trends of multi-modality and the importance of late effects, we have updated our series of radiation induced bone sarcomas seen at Memorial Sloan-Kettering Cancer Center over the past four decades. A total of 37 cases of bone sarcoma arising from normal bone in the irradiated field was analyzed. The median for latent period from irradiation to diagnosis of bone sarcoma was 11 years with a minimum latent period of four years. The median radiation dose for the bone sarcoma was 6000 rad in 6 weeks with a minimum total radiation dose of 3000 rad in 3 weeks. We have found nine patients who developed bone sarcomas in the radiation field after successful treatment of Hodgkin's disease. Criteria for radiation induced bone sarcomas and the magnitude of the risk of bone sarcomas are briefly discussed

Radiation safety audit

International Nuclear Information System (INIS)

Kadadunna, K.P.I.K.; Mod Ali, Noriah

2008-01-01

Audit has been seen as one of the effective methods to ensure harmonization in radiation protection. A radiation safety audit is a formal safety performance examination of existing or future work activities by an independent team. Regular audit will assist the management in its mission to maintain the facilities environment that is inherently safe for its employees. The audits review the adequacy of facilities for the type of use, training, and competency of workers, supervision by authorized users, availability of survey instruments, security of radioactive materials, minimization of personnel exposure to radiation, safety equipment, and the required record keeping. All approved areas of use are included in these periodic audits. Any deficiency found in the audit shall be corrected as soon as possible after they are reported. Radiation safety audit is a proactive approach to improve radiation safety practices and identify and prevent any potential radiation accident. It is an excellent tool to identify potential problem to radiation users and to assure that safety measures to eliminate or reduce the problems are fully considered. Radiation safety audit will help to develop safety culture of the facility. It is intended to be the cornerstone of a safety program designed to aid the facility, staff and management in maintaining a safe environment in which activities are carried out. The initiative of this work is to evaluate the need of having a proper audit as one of the mechanism to manage the safety using ionizing radiation. This study is focused on the need of having a proper radiation safety audit to identify deviations and deficiencies of radiation protection programmes. It will be based on studies conducted on several institutes/radiation facilities in Malaysia in 2006. Steps will then be formulated towards strengthening radiation safety through proper audit. This will result in a better working situation and confidence in the radiation protection community

Radiation therapy

International Nuclear Information System (INIS)

Bader, J.L.; Glatstein, E.

1987-01-01

The radiation oncologist encounters the critically ill immunosuppressed patient in four settings. First, the newly diagnosed cancer patient presents for initial evaluation and treatment, with immunosuppression from the cancer itself, malnutrition, concomitant infectious disease, prior drug or alcohol abuse or other medical problems. Second, the previously treated cancer patient presents with metastatic or recurrent primary cancer causing local symptoms. Immune dysfunction in this setting may be due to prior chemotherapy and/or radiation as well as any of the original factors. Third, the patient previously treated with radiation presents with a life-threatening problem possibly due to complications of prior therapy. In this setting, the radiation oncologist is asked to evaluate the clinical problem and to suggest whether radiation might be causing part or all of the problem and what can be done to treat these sequelae of radiation. Fourth, the patient with a benign diagnosis (not cancer) is seen with a problem potentially emeliorated by radiation (e.g., kidney transplant rejection, preparation for transplant, or intractable rheumatoid arthritis). This chapter reviews these four issues and presents clinical and radiobiologic principles on which recommendations for therapy are based

Radiation monitoring

International Nuclear Information System (INIS)

Larsson, L.Eh.; B'yuli, D.K.; Karmikel, Dzh.Kh.E.

1985-01-01

Recommendations on radiation monitoring of personnel, used medical ionizing radiation source, are given. The necessity to carry out radiation monitoring of situation at medical personnel's positions and personnel dosimetry is marked. It is convenient to subdivide radiation monitoring into 3 types: usual, surgical and special. Usual monitoring is connected with current work; surgical monitoring is carried out to receive information during a concrete operation; special monitoring is used to detect possible deviation from standard conditions of work or when suspecting them

The world of radiation

International Nuclear Information System (INIS)

Song, Myeong Jae

2000-12-01

This book deals with the world of radiation with the first meeting discovery of the rays, meeting between radiation and human body, illusion and truth of radiation and philosophy of management for radiation. These are the titles of the stories ; predictor, unforgettable Hiroshima, nude photo, radiation and radioactivity, living in the radiation, people make radiation, too, mysteries in human body, gene, DNA and cell, when radiation meets human body, the first victim in the atomic accident in Japan. The fact of Chernobyl accident, is radiation in the plutonium fatal? body without brain and a deformed calf, management on radiation in the nuclear power plant, ideal and reality is really radiation dangerous? and the good news.

Diagnostic radiation risks

Energy Technology Data Exchange (ETDEWEB)

Sherwood, T [Addenbrooke' s Hospital, Cambridge (UK)

1980-04-01

A brief discussion on diagnostic radiation risks is given. First some fundamental facts on the concepts and units of radiation measurement are clarified. Medical diagnostic radiation doses are also compared to the radiation doses received annually by man from natural background radiation. The controversy concerning the '10-day rule' in X-raying women of child-bearing age is discussed; it would appear that the risk of malformation in an unborn child due to X-radiation is very much less than the natural level of risk of malformation. The differences in the radiographic techniques and thus the different X-ray doses needed to make adequate X-ray images of different parts of the body are considered. The radiation burden of nuclear medicine investigations compared to X-ray procedures is also discussed. Finally, the problems of using volunteers in radiation research are aired.

Nuclear radiation in warfare

International Nuclear Information System (INIS)

Rotblat, J.

1986-01-01

The subject is covered in chapters, entitled: introduction; digest of nuclear weaponry (characteristics of nuclear weapons; effects of nuclear weapons other than ionizing radiation (fire-ball, fall-out, thermal radiation, blast wave, electromagnetic pulse); the nuclear arms race; war scenarios; biological effects of radiations on man (radiation doses; natural sources of radiation; acute effects of radiation; long-term somatic effects; genetic effects; factors affecting the biological response to radiation; internal exposure; synergistic effects; protection against radiation effects); radiations from nuclear explosions (initial radiation; fall-out; effects of fall-out on animal and plant life; contamination of water and food supplies by fall-out); radiation casualties in a nuclear war; effectiveness of civil defence; other warlike uses of radiation (attacks on civilian nuclear power installations; radiological warfare; terrorist activities); conclusion. (orig./HP) [de

Nuclear radiation in warfare

International Nuclear Information System (INIS)

Rotblat, J.

1981-01-01

The subject is covered in chapters, entitled: introduction; digest of nuclear weaponry (characteristics of nuclear weapons; effects of nuclear weapons other than ionizing radiation (fire-ball, fall-out, thermal radiation, blast wave, electromagnetic pulse); the nuclear arms race; war scenarios); biological effects of radiations on man (radiation doses; natural sources of radiation; acute effects of radiation; long-term somatic effects; genetic effects; factors affecting the biological response to radiation; internal exposure; synergistic effects; protection against radiation effects); radiations from nuclear explosions (initial radiation; fall-out; effects of fall-out on animal and plant life; contamination of water and food supplies by fall-out); radiation casualties in a nuclear war; effectiveness of civil defence; other warlike uses of radiation (attacks on civilian nuclear power installations; radiological warfare; terrorist activities); conclusion. (U.K.)

Communication skills training for radiation therapists: preparing patients for radiation therapy.

Science.gov (United States)

Halkett, Georgia; O'Connor, Moira; Aranda, Sanchia; Jefford, Michael; Merchant, Susan; York, Debra; Miller, Lisa; Schofield, Penelope

2016-12-01

Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing

Living with radiation

International Nuclear Information System (INIS)

Tymen, G.

1999-01-01

This editorial article discusses the various forms of radiation that we live with. In particular, the general public's lack of knowledge on the subject is mentioned and the concentration of the media on radiation accidents and emissions is looked at critically. The various forms of radiation - ionising and non-ionising - are briefly discussed. Natural ionising radiation sources and in particular radon are described and the increasing proportion of doses attributed to cosmic radiation met in high-flying aircraft and radiation doses resulting from medical examination and treatment are discussed. Non-ionising radiation such as electromagnetic fields generated by power lines, mobile telephones and kitchen equipment and their implications on health are also looked at

Wireless radiation sensor

Science.gov (United States)

Lamberti, Vincent E.; Howell, Jr, Layton N.; Mee, David K.; Kress, Reid L.

2016-08-09

Disclosed is a sensor for detecting radiation. The sensor includes a ferromagnetic metal and a radiation sensitive material coupled to the ferromagnetic metal. The radiation sensitive material is operable to change a tensile stress of the ferromagnetic metal upon exposure to radiation. The radiation is detected based on changes in the magnetic switching characteristics of the ferromagnetic metal caused by the changes in the tensile stress.

[Traumatic spinal complications of cervical arthrosis].

Science.gov (United States)

Verstichel, P; Berthelot, J L; Randriananja, H; Crozier, S; Masson, C

1996-02-17

Cervical spondylotic myelopathy is usually a chronic and progressive disease. In a few cases, however, dramatic tetraplegia sometimes occurs after even minor injury. We report seven patients (6 males, 1 female, aged from 41 to 63), who suffered from acute myelopathy after an injury. In 5 cases, the injury revealed the cervical spondylotic myelopathy. A hyperextension of the cervical spine was found in 5 cases. The injury was severe in only one case, but there was no bony abnormalities, except arthrosis. The most common cause was a fall. In contrast, severe tetraplegia was found in 4 cases. Spontaneous, but incomplete, recuperation occurred in 4 patients. In all 7 cases, CT scan and MRI showed congenital cervical stenosis associated with cervical spondylosis. The level of disco-osteophytic changes was mainly in C4, C5, C6. On T2-weighted spin-echo image, an increased signal intensity was present in the cord of 3 patients, but was not correlated with the severity of the symptoms, nor with improvement. Surgical treatment was performed in 6 cases: 3 laminectomies, 3 anterior or antero-lateral approaches. Improvement after operative decompression was observed in all but one case, even when the motor or sensory deficit persists for more than one year. Motricity of the inferior limbs improved better than the other deficits, perhaps because of the location of non-reversible lesions in the spinal gray matter. The acute medullary syndrome of cervical spondylotic myelopathy is serious and can cause major handicaps. This complication justifies a preventive surgical attitude when medullar signs are moderate, and cervical imagery shows a spondylotic compression of the cord with congenital stenosis.

Clinical, physiological and pathological characterisation of the sensory predominant peripheral neuropathy in copper deficiency.

Science.gov (United States)

Taylor, Sean W; Laughlin, Ruple S; Kumar, Neeraj; Goodman, Brent; Klein, Christopher J; Dyck, Peter J; Dyck, P James B

2017-10-01

Myelopathy is considered the most common neurological complication of copper deficiency. Concurrent peripheral neuropathy has been recognised in association with copper deficiency but has not been well characterised. To characterise the clinical, physiological and pathological features of copper-deficient peripheral neuropathy. Patients with simultaneous copper deficiency (peripheral neuropathy seen at the Mayo Clinic from 1985 to 2005 were identified. 34 patients were identified (median age 55 years, range 36-78) including 24 women and 10 men. Myelopathy was found in 21 patients. Median serum copper level was 0.11 μg/mL (range 0-0.58). The most frequent clinical and electrophysiological pattern of neuropathy was a sensory predominant length-dependent peripheral neuropathy (71%). Somatosensory evoked potentials demonstrated central slowing supporting myelopathy (96%). Quantitative sensory testing demonstrated both small and large fibre involvement (100%). Autonomic reflex screens (77%) and thermoregulatory sweat test (67%) confirmed sudomotor dysfunction. 14 cutaneous nerve biopsies revealed loss of myelinated nerve fibres (86%), increased regenerative clusters (50%), increased rates of axonal degeneration (91%) and increased numbers of empty nerve strands (73%). 71% of biopsies demonstrated epineurial perivascular inflammation. An axonal, length-dependent sensory predominant peripheral neuropathy causing sensory ataxia is characteristic of copper deficiency usually co-occurring with myelopathy. Neurophysiological testing confirms involvement of large, greater than small fibres. The pathological findings suggest axonal degeneration and repair. Inflammatory infiltrates are common but are small and of doubtful pathological significance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Radiation carcinogenesis

International Nuclear Information System (INIS)

Fry, R.J.M.

1976-01-01

The risk of iatrogenic tumors with radiation therapy is so outweighed by the benefit of cure that estimates of risk have not been considered necessary. However, with the introduction of chemotherapy, combined therapy, and particle radiation therapy, the comparative risks should be examined. In the case of radiation, total dose, fractionation, dose rate, dose distribution, and radiation quality should be considered in the estimation of risk. The biological factors that must be considered include incidence of tumors, latent period, degree of malignancy, and multiplicity of tumors. The risk of radiation induction of tumors is influenced by the genotype, sex, and age of the patient, the tissues that will be exposed, and previous therapy. With chemotherapy the number of cells at risk is usually markedly higher than with radiation therapy. Clearly the problem of the estimation of comparative risks is complex. This paper presents the current views on the comparative risks and the importance of the various factors that influence the estimation of risk

Health effects of radiation and the implications for radiation safety

International Nuclear Information System (INIS)

Gonzalez, A.J.; Anderer, J.

1991-01-01

In this Paper two elements of a multiphase analysis of radiation exposures in the living environment - the human health effects of ionizing radiation and the implications for radiation safety policy and practices - are presented. Part 1 draws together the current state of scientific knowledge and insight about the human health effects of radiation, describing these in terms of known cause-related deterministic effects and of the estimated incidence of stochastic effects as defined by biostatistics and biological models. The 1988 UNSCEAR report provides an authoritative basis for such an examination. Part 2 explores some of the major implications that the state-of-the-art of radiation biology has - or should have - for radiation safety policy and practices. (author)

Concepts of radiation protection

International Nuclear Information System (INIS)

2013-01-01

This seventh chapter presents the concepts and principles of safety and radiation protection, emergency situations; NORM and TENORM; radiation protection care; radiation protection plan; activities of the radiation protection service; practical rules of radiation protection and the radiation symbol

GRAVITATIONAL RADIATION

Directory of Open Access Journals (Sweden)

Metin SALTIK

1996-03-01

Full Text Available According to classical electromagnetic theory, an accelerated charge or system of charges radiates electromagnetic waves. In a radio transmitter antenna charges are accelerated along the antenna and release electromagnetic waves, which is radiated at the velocity of light in the surrounding medium. All of the radio transmitters work on this principle today. In this study an analogy is established between the principles by which accelerated charge systems markes radiation and the accelerated mass system, and the systems cousing gravitational radiation are investigated.

Radiation-induced polymerization and radiation effect on polymers

International Nuclear Information System (INIS)

Seguchi, Tadao

1977-12-01

The processes of radiation-induced polymerization of monomers and also radiation effects on polymers have been studied by instrumental analyses of electron spin resonance (ESR), nuclear magnetic resonance (NMR) and electron microscopy. In radiation-induced polymerization, graft-copolymerization and absorbed state polymerization were taken up. For graft-copolymerization, monomers such as methylmethacrylate and butadiene were made to react with irradiated polyethylene, and behaviors of the initiating radicals and propagating radicals were followed under the reaction by ESR. For absorbed state polymerization, acrylonitrile/zeolite and methylmethacrylate/zeolite were chosen. Absorbed monomers were irradiated at 77 0 K and polymerized at room temperature. Active species and the concentrations were measured by ESR and the yields of polymer were observed by NMR. In radiation effect on polymers, polyvinylfluoride, polyvinylidenfluoride and polytetrafluoroethylene were taken up. Active species trapped in the polymer matrixes were identified and decay and reactivity of the species were also studied. On the basis of information from the electron microscopy and x-ray analysis, radiation effects on these polymers are described. In polytetrafluoroethylene produced by radiation polymerization, the relation between morphology and polymerization conditions and also the process of crystallization during polymerization were studied. (auth.)

Radiation treatment and radiation reactions in dermatology. 2. ed.

Energy Technology Data Exchange (ETDEWEB)

Panizzon, Renato G. [Univ. Hospital CHUV, Lausanne (Switzerland). Dept. of Dermatology; Seegenschmiedt, M. Heinrich (ed.) [Strahlenzentrum Hamburg (Germany)

2015-03-01

Explains the use of radiation treatment in the full range of skin cancers and precancerous lesions. Covers physical and radiobiological principles, dose definitions, radiation reactions, and risk assessments. Revised and updated edition that includes new chapters and numerous additional figures. In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies - including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor - as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.

Promoting safety culture in radiation industry through radiation audit

International Nuclear Information System (INIS)

Noriah, M.A.

2007-01-01

This paper illustrates the Malaysian experience in implementing and promoting effective radiation safety program. Current management practice demands that an organization inculcate culture of safety in preventing radiation hazard. The aforementioned objectives of radiation protection can only be met when it is implemented and evaluated continuously. Commitment from the workforce to treat safety as a priority and the ability to turn a requirement into a practical language is also important to implement radiation safety policy efficiently. Maintaining and improving safety culture is a continuous process. There is a need to establish a program to measure, review and audit health and safety performance against predetermined standards. This program is known as radiation safety audit and is able to reveal where and when action is needed to make improvements to the systems of controls. A structured and proper radiation self-auditing system is seen as the sole requirement to meet the current and future needs in sustainability of radiation safety. As a result safety culture, which has been a vital element on safety in many industries can be improved and promote changes, leading to good safety performance and excellence. (author)

Radiation treatment and radiation reactions in dermatology. 2. ed.

International Nuclear Information System (INIS)

Panizzon, Renato G.

2015-01-01

Explains the use of radiation treatment in the full range of skin cancers and precancerous lesions. Covers physical and radiobiological principles, dose definitions, radiation reactions, and risk assessments. Revised and updated edition that includes new chapters and numerous additional figures. In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies - including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor - as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.

Sound radiation quantities arising from a resilient circular radiator.

Science.gov (United States)

Aarts, Ronald M; Janssen, Augustus J E M

2009-10-01

Power series expansions in ka are derived for the pressure at the edge of a radiator, the reaction force on the radiator, and the total radiated power arising from a harmonically excited, resilient, flat, circular radiator of radius a in an infinite baffle. The velocity profiles on the radiator are either Stenzel functions (1-(sigma/a)2)n, with sigma the radial coordinate on the radiator, or linear combinations of Zernike functions Pn(2(sigma/a)2-1), with Pn the Legendre polynomial of degree n. Both sets of functions give rise, via King's integral for the pressure, to integrals for the quantities of interest involving the product of two Bessel functions. These integrals have a power series expansion and allow an expression in terms of Bessel functions of the first kind and Struve functions. Consequently, many of the results in [M. Greenspan, J. Acoust. Soc. Am. 65, 608-621 (1979)] are generalized and treated in a unified manner. A foreseen application is for loudspeakers. The relation between the radiated power in the near-field on one hand and in the far field on the other is highlighted.

Background radiation levels and standards for protection from ionizing radiations

International Nuclear Information System (INIS)

Farai, I.

1999-01-01

Apart from the amount of radiation which a worker may receive while he performs his work, he is also exposed to radiation because of the nature of his environment. In other words, all individuals are subject to some irradiation even though they may not work with radioactive substances. This source of radiation exposure is often referred to as background radiation. In most environments, it is low-level and can be grouped into two natural and man-made. Background radiation provides the basis on which allowable exposure limits for workers are drawn

Radiation watchdog

International Nuclear Information System (INIS)

Manning, R.

1984-01-01

Designated by WHO as a Collaborating Centre, the Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee provides assistance to all countries of the Americas in radiation accidents including human contamination or overexposure. It also conducts courses in radiation emergency response for health professionals from throughout the world

Radiation oncology

International Nuclear Information System (INIS)

Anon.

1977-01-01

The Radiation Oncology Division has had as its main objectives both to operate an academic training program and to carry out research on radiation therapy of cancer. Since fiscal year 1975, following a directive from ERDA, increased effort has been given to research. The research activities have been complemented by the training program, which has been oriented toward producing radiation oncologists, giving physicians short-term experience in radiation oncology, and teaching medical students about clinical cancer and its radiation therapy. The purpose of the research effort is to improve present modalities of radiation therapy of cancer. As in previous years, the Division has operated as the Radiation Oncology Program of the Department of Radiological Sciences of the University of Puerto Rico School of Medicine. It has provided radiation oncology support to patients at the University Hospital and to academic programs of the University of Puerto Rico Medical Sciences Campus. The patients, in turn, have provided the clinical basis for the educational and research projects of the Division. Funding has been primarily from PRNC (approx. 40%) and from National Cancer Institute grants channeled through the School of Medicine (approx. 60%). Special inter-institutional relationships with the San Juan Veterans Administration Hospital and the Metropolitan Hospital in San Juan have permitted inclusion of patients from these institutions in the Division's research projects. Medical physics and radiotherapy consultations have been provided to the Radiotherapy Department of the VA Hospital

Коррекция трофологической недостаточности у больных с синдромом компрессионной миелопатии различной этиологии на уровне верхнешейного отдела позвоночника

Directory of Open Access Journals (Sweden)

Bajanov S.P.

2012-09-01

Full Text Available Objective: To improve the treatment results of patients with traumatic injuries, and neoplastic lesions of the upper cervical spine on the basis of a differentiated algorithm of nutritional-metabolic therapy. Materials and methods: Based on clinical and instrumental methods of examination typical metabolic characteristics have been studied in 21 patients with compressive myelopathy at the level of the upper cervical spine. Results: Due to the received data differentiated algorithm of nutritional-metabolic therapy has been worked out. Conclusion: The use of nutritional-metabolic therapy in patients with compressive myelopathy at the level of the upper cervical spine may improve the treatment.

Ionizing radiation sources. Ionizing radiation interaction with matter

International Nuclear Information System (INIS)

Popits, R.

1976-01-01

Fundamentals of nuclear physics are reviewed under the headings: obtaining of X-rays and their properties; modes of radioactive decay of natural or man-made radionuclides; radioactive neutron sources; nuclear fission as basis for devising nuclear reactors and weapons; thermonuclear reactions; cosmic radiation. Basic aspects of ionizing radiation interactions with matter are considered with regard to charged particles, photon radiation, and neutrons. (A.B.)

Ultraviolet radiation, measurements and safety evaluations for radiation protection purposes

International Nuclear Information System (INIS)

Witew, B.; Fischer, P.G.

1983-01-01

In order to evaluate the effects of ultraviolet radiation, one has to study that photobiologically effective radiation which induces a just measurable threshold reaction. For practical radiation protection, one has to determine the permissible duration of exposure at the end of which the threshold reaction is induced. This time limit is derived by means of spectral measurements and determination of radiation intensity. Detrimental photobiological effects can be avoided, and favourable effects optimized, by observing the time limit. Thus these measurements are used to determine the threshold at which the desired effects of ultraviolet radiation will be accompanied by unwanted effects or damage to persons, as for instance in the use of ultraviolet radiation for operating room sterilization, arc welding work, or cosmetic purposes. (orig.) [de

Flow, simulation and dynamics. Including a contribution of Vienna University (TU Wien); Stroemung, Simulation und Dynamik. Mit einem Beitrag der TU Wien

Energy Technology Data Exchange (ETDEWEB)

Kauder, K. [ed.

1998-12-31

This report covers the following topics: Gas-flow through clearances in screw vacuum pumps - part 1, gas flow research at a plane screw type machine model - part 2, two-phase screw-type engine - problems of the filling process, oil as a design parameter in screw-type engines - use of non-newtonian oils, experimental determination of the dynamic properties of screw compressors, hot gas screw-type engine - simulations as a basis for construction - part 3. [Deutsch] Dieser Bericht hat folgende Inhalte: Gasspaltstroemungen in Schraubenspindel-Vakuumpumpen - Teil 1, Gasspaltstroemungen in einem ebenen Schraubenmaschinenmodell - Teil 2, Zweiphasen-Schraubenmotor-Probleme des Fuellungsvorganges, Oel als Konstruktionselement - Einsatz nicht-newtonscher Oele, die experimentelle Bestimmung der dynamischen Eigenschaften von Schraubenkompressoren, die Heissgasschraubenmaschine - simulationsgestuetzte Auslegung - Teil 3

Module Production for the CMS Phase I Pixel Detector and Study of the expected Detector Performance for the Time of Operation

CERN Document Server

Freund, Benedikt; Muller, Thomas

Diese Dissertation befasst sich mit dem Phase-I-Upgrade des CMS-Pixeldetektors, welches im Jahr 2017 durchgeführt wurde. Im Detail werden zwei Aspekte behandelt. Im ersten Teil wird die Modulproduktion, die am Institut für Experimentelle Kernphysik und Institut für Prozessdatenverarbeitung und Elektronik des KIT stattgefunden hat, vorgestellt. Dabei wird die gesamte Produktionskette, beginnend bei den einzelnen Komponenten bis hin zu den fertigen Pixeldetektormodulen beschrieben mit besonderem Augenmerk auf der Qualitätskontrolle der Halbemodule (einem Zwischenprodukt bestehend aus Siliziumsensor und Auslesechips). Im zweiten Teil wird die Untersuchung der Leistungsfähigkeit des neuen Pixeldetektors vorgestellt. Dabei geht es neben der eigentlichen Bestimmung der Leistungsfähigkeit vor allem um die Optimierung der Betriebsparameter.

Radiation protection

International Nuclear Information System (INIS)

1989-01-01

A NRPB leaflet in the 'At-a-Glance' series explains in a simple but scientifically accurate way what radiation is, the biological effects and the relative sensitivity of different parts of the human body. The leaflet then discusses radiation protection principles, radiation protection in the UK and finally the effectiveness of this radiation protection as judged by a breakdown of the total dose received by an average person in the UK, a heavy consumer of Cumbrian seafood, an average nuclear industry worker and an average person in Cornwall. (UK)

Synchrotron radiation

International Nuclear Information System (INIS)

Farge, Y.

1982-01-01

Synchrotron radiation is produced by electrons accelerated near the velocity of light in storage rings, which are used for high energy Physics experiments. The radiation light exhibits a wide spread continuous spectrum ranging from 01 nanometre to radiofrequency. This radiation is characterized by high power (several kilowatts) and intense brightness. The paper recalls the emission laws and the distinctive properties of the radiation, and gives some of the numerous applications in research, such as molecular spectroscopy, X ray diffraction by heavy proteins and X ray microlithography in LVSI circuit making [fr

Radiation protection in hospitals

International Nuclear Information System (INIS)

MOuld, R.F.

1985-01-01

A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)

Preparative radiation chemistry

International Nuclear Information System (INIS)

Drawe, H.

1978-01-01

Preparative synthesis of compounds with the aid of radiation chemistry is increasingly used in laboratories as well as on a technical scale. A large number of new compounds has been produced with the methods of radiation chemistry. With the increasing number of available radiation sources, also the number of synthesis metods in radiation chemistry has increased. This paper can only briefly mention the many possible ways of synthesis in radiation chemistry. (orig./HK) [de

Gravitation radiation observations

OpenAIRE

Glass, E. N.

2017-01-01

The notion of gravitational radiation begins with electromagnetic radiation. In 1887 Heinrich Hertz, working in one room, generated and received electromagnetic radiation. Maxwell's equations describe the electromagnetic field. The quanta of electromagnetic radiation are spin 1 photons. They are fundamental to atomic physics and quantum electrodynamics.

Radiation control system

International Nuclear Information System (INIS)

Murao, Mitsuo.

1985-01-01

Purpose: To rapidly and suitably performing planning and designation by radiation-working control systems in the radiation controlled area of nuclear power plant. Method: Various informations regarding radiation exposure are arranged and actual exposure data are statistically stored, to thereby perform forecasting calculation for the radiation exposure upon workings in the plurality of working regions in the radiation controlled area. Based on the forecast values and the registered workers' exposure dose in the past workings are alocated successively such that the total exposure does upon conducting the workings is less than the limited value, to prepare working plans in the areas. Further, procedures for preparing a series of documents regarding the workings in the radiation area are automated to rapidly and properly provide the informations serving to the planning and designation for the radiation workings. As a result, the radiation managers' burnden can be mitigated and an efficient working management system can be provided, in view of the exposure management and personal management. (Kamimura, M.)

Radiation hazards

International Nuclear Information System (INIS)

Rausch, L.

1979-01-01

On a scientific basis and with the aid of realistic examples, the author gives a popular introduction to an understanding and judgment of the public discussion over radiation hazards: Uses and hazards of X-ray examinations, biological radiation effects, civilisation risks in comparison, origins and explanation of radiation protection regulations. (orig.) [de

Modeling Radiative Heat Transfer and Turbulence-Radiation Interactions in Engines

Energy Technology Data Exchange (ETDEWEB)

Paul, Chandan [Pennsylvania State Univ., University Park, PA (United States); Sircar, Arpan [Pennsylvania State Univ., University Park, PA (United States); Ferreyro-Fernandez, Sebastian [Pennsylvania State Univ., University Park, PA (United States); Imren, Abdurrahman [Pennsylvania State Univ., University Park, PA (United States); Haworth, Daniel C [Pennsylvania State Univ., University Park, PA (United States); Roy, Somesh P [Marquette University (United States); Ge, Wenjun [University of California Merced (United States); Modest, Michael F [University of California Merced (United States)

2017-04-26

Detailed radiation modelling in piston engines has received relatively little attention to date. Recently, it is being revisited in light of current trends towards higher operating pressures and higher levels of exhaust-gas recirculation, both of which enhance molecular gas radiation. Advanced high-efficiency engines also are expected to function closer to the limits of stable operation, where even small perturbations to the energy balance can have a large influence on system behavior. Here several different spectral radiation property models and radiative transfer equation (RTE) solvers have been implemented in an OpenFOAM-based engine CFD code, and simulations have been performed for a full-load (peak pressure ~200 bar) heavy-duty diesel engine. Differences in computed temperature fields, NO and soot levels, and wall heat transfer rates are shown for different combinations of spectral models and RTE solvers. The relative importance of molecular gas radiation versus soot radiation is examined. And the influence of turbulence-radiation interactions is determined by comparing results obtained using local mean values of composition and temperature to compute radiative emission and absorption with those obtained using a particle-based transported probability density function method.

American Society for Radiation Oncology (ASTRO) Survey of Radiation Biology Educators in U.S. and Canadian Radiation Oncology Residency Programs

International Nuclear Information System (INIS)

Rosenstein, Barry S.; Held, Kathryn D.; Rockwell, Sara; Williams, Jacqueline P.; Zeman, Elaine M.

2009-01-01

Purpose: To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada. Methods and Materials: In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada. Results: The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educators whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs. Conclusions: A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.

Thyroid and radiation

Energy Technology Data Exchange (ETDEWEB)

Yamashita, Shunichi; Namba, Hiroyuki; Nagataki, Shigenobu (Nagasaki Univ. (Japan). School of Medicine)

1993-11-01

The topic 'Thyroid and Radiation' is both an old and new area to be solved by human beings. The thyroid is an organ that is usually susceptible to exposure to ionizing radiation, both by virtue of its ability to concentrate radioiodine (internal radiation) and by routine medical examination: Chest X-ray, Dental X-ray, X-irradiation of cervical lymph nodes etc. (external radiation). Iodine-131 is widely used for the therapy of Graves' disease and thyroid cancers, of which the disadvantage is radiation-induced hypothyroidism but not complications of thyroid tumor. The thyroid gland is comparatively radioresistant, however, the data obtained from Hiroshima, Nagasaki and Marshall islands indicates a high incidence of external radiation-induced thyroid tumors as well as hypothyroidism. The different biological effects of internal and external radiation remains to be further clarified. Interestingly, recent reports demonstrate the increased number of thyroid cancer in children around Chernobyl in Belarus. In this review, we would like to introduce the effect of radiation on the thyroid gland at the molecular, cellular and tissue levels. Furthermore the clinical usefulness of iodine-131, including the safety-control for radiation exposure will be discussed. (author) 50 refs.

Basic radiation oncology

International Nuclear Information System (INIS)

Beyzadeoglu, M. M.; Ebruli, C.

2008-01-01

Basic Radiation Oncology is an all-in-one book. It is an up-to-date bedside oriented book integrating the radiation physics, radiobiology and clinical radiation oncology. It includes the essentials of all aspects of radiation oncology with more than 300 practical illustrations, black and white and color figures. The layout and presentation is very practical and enriched with many pearl boxes. Key studies particularly randomized ones are also included at the end of each clinical chapter. Basic knowledge of all high-tech radiation teletherapy units such as tomotherapy, cyberknife, and proton therapy are also given. The first 2 sections review concepts that are crucial in radiation physics and radiobiology. The remaining 11 chapters describe treatment regimens for main cancer sites and tumor types. Basic Radiation Oncology will greatly help meeting the needs for a practical and bedside oriented oncology book for residents, fellows, and clinicians of Radiation, Medical and Surgical Oncology as well as medical students, physicians and medical physicists interested in Clinical Oncology. English Edition of the book Temel Radyasyon Onkolojisi is being published by Springer Heidelberg this year with updated 2009 AJCC Staging as Basic Radiation Oncology

Radiation protection forum

International Nuclear Information System (INIS)

Cabral, W.

2010-01-01

The National Director of the Nuclear Regulatory Authority and Radiation Protection of Uruguay in the first forum for radiation protection set out the following themes: activity of regulatory body, radiation safety, physical security, safeguards, legal framework, committed substantive program, use of radiation, risks and benefits, major sources of radiation, the national regulatory framework, national inventory of sources, inspections, licensing, import and export of sources control , radioactive transport, materials safety, agreements, information and teaching, radiological emergencies and prompt response.

Toxic properties of specific radiation determinant molecules, derived from radiated species

Science.gov (United States)

Popov, Dmitri; Maliev, Vecheslav; Kedar, Prasad; Casey, Rachael; Jones, Jeffrey

Introduction: High doses of radiation induce the formation of radiation toxins in the organs of irradiated mammals. After whole body irradiation, cellular macromolecules and cell walls are damaged as a result of long-lived radiation-induced free radicals, reactive oxygen species, and fast, charged particles of radiation. High doses of radiation induce breaks in the chemical bonds of macromolecules and cross-linking reactions via chemically active processes. These processes result in the creation of novel modified macromolecules that possess specific toxic and antigenic properties defined by the type and dose of irradiation by which they are generated. Radiation toxins isolated from the lymph of irradiated animals are classified as hematotoxic, neurotoxic, and enteric non-bacterial (GI) radiation toxins, and they play an important role in the development of hematopoietic, cerebrovascular, and gastrointestinal acute radiation syndromes (ARS). Seven distinct toxins derived from post-irradiated animals have been designated as Specific Radiation Determinants (SRD): SRD-1 (neurotoxic radiation toxin generated by the cerebrovascular form of ARS), SRD-3 (enteric non-bacterial radiation toxins generated by the gastrointestinal form of ARS), and SRD-4 (hematotoxic radiation toxins generated by the hematological, bone marrow form of ARS). SRD-4 is further subdivided into four groups depending on the severity of the ARS induced: SRD-4/1, mild ARS; SRD-4/2, moderate ARS; SRD-4/3, severe ARS; and SRD-4/4, extremely severe ARS. The seventh SRD, SRD-2 is a toxic extract derived from animals suffering from a fourth form of ARS, as described in European literature and produces toxicity primarily in the autonimic nervous system. These radiation toxins have been shown to be responsible for the induction of important pathophysiological, immunological, and biochemical reactions in ARS. Materials and Methods: These studies incorporated the use of statistically significant numbers of a

Cerebrovascular Acute Radiation Syndrome : Radiation Neurotoxins, Mechanisms of Toxicity, Neuroimmune Interactions.

Science.gov (United States)

Popov, Dmitri; Maliev, Slava

Introduction: Cerebrovascular Acute Radiation Syndrome (CvARS) is an extremely severe in-jury of Central Nervous System (CNS) and Peripheral Nervous System (PNS). CvARS can be induced by the high doses of neutron, heavy ions, or gamma radiation. The Syndrome clinical picture depends on a type, timing, and the doses of radiation. Four grades of the CvARS were defined: mild, moderate, severe, and extremely severe. Also, four stages of CvARS were developed: prodromal, latent, manifest, outcome -death. Duration of stages depends on the types, doses, and time of radiation. The CvARS clinical symptoms are: respiratory distress, hypotension, cerebral edema, severe disorder of cerebral blood microcirculation, and acute motor weakness. The radiation toxins, Cerebro-Vascular Radiation Neurotoxins (SvARSn), determine development of the acute radiation syndrome. Mechanism of action of the toxins: Though pathogenesis of radiation injury of CNS remains unknown, our concept describes the Cv ARS as a result of Neurotoxicity and Excitotoxicity, cell death through apoptotic necrosis. Neurotoxicity occurs after the high doses radiation exposure, formation of radiation neuro-toxins, possible bioradicals, or group of specific enzymes. Intracerebral hemorrhage can be a consequence of the damage of endothelial cells caused by radiation and the radiation tox-ins. Disruption of blood-brain barrier (BBB)and blood-cerebrospinal fluid barrier (BCFB)is possibly the most significant effect of microcirculation disorder and metabolic insufficiency. NMDA-receptors excitotoxic injury mediated by cerebral ischemia and cerebral hypoxia. Dam-age of the pyramidal cells in layers 3 and 5 and Purkinje cell layer the cerebral cortex , damage of pyramidal cells in the hippocampus occur as a result of cerebral ischemia and intracerebral bleeding. Methods: Radiation Toxins of CV ARS are defined as glycoproteins with the molec-ular weight of RT toxins ranges from 200-250 kDa and with high enzymatic activity

Radiation protection problems with sealed Pu radiation sources

International Nuclear Information System (INIS)

Naumann, M.; Wels, C.

1982-01-01

A brief outline of the production methods and most important properties of Pu-238 and Pu-239 is given, followed by an overview of possibilities for utilizing the different types of radiation emitted, a description of problems involved in the safe handling of Pu radiation sources, and an assessment of the design principles for Pu-containing alpha, photon, neutron and energy sources from the radiation protection point of view. (author)

Radiation monitoring system

International Nuclear Information System (INIS)

Takeuchi, Nobuyoshi; Fujimoto, Toshiaki; Nagama, Hideyo

2007-01-01

A positive outlook toward nuclear power plants and a higher level of technologies for using radiation in the medical field are trends that are spreading throughout the world, and as a consequence, demand is increasing for equipment and systems that measure and control radiation. Equipment ranging from radiation detection and measurement devices to computer-based radiation management systems will be set up in overseas. Products that depend on overseas specifications based on IEC and other international standards are being developed. Fuji Electric is advancing the overseas deployment of radiation monitoring systems by adopting measures that will ensure the reliability and traceability of radiation equipment. (author)