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Sample records for sacral radiation ulcer-report

  1. The surgical treatment of sacral radiation ulcer-report of 5 patients

    International Nuclear Information System (INIS)

    Fukuzumi, Satoshi; Ootaka, Hitoshi; Suzuki, Fumio; Nishimoto, Kazumasa; Hayashi, Satoru; Fujioka, Toshio; Minabe, Toshiharu

    2007-01-01

    We have treated 5 cases of sacral radiation ulcer surgically. All patients with cervical or vulval cancer were treated with external radiotherapy more than 20 years ago. Three patients have rectovaginal fistulas and four patients have osteoradionecrosis of the sacrum. Fecal and/or urinary diversion were accomplished preoperatively in four patients. After debridement of ulcers, these defects were covered by pedicled musculocutaneous flaps. In two of five, marginal necrosis was seen in a great saphenous veno-neuro accompanying artery fasciocutaneous flap and an inferior gluteus maximus musculocutaneous flap. In two of five, seroma was seen. One patient died of the sepsis from pelvic infection with rectal fistula. Among the other four patients, there was no recurrence during the follow up period. The principle for surgically treating radiation ulcer is to completely resect all radionecrotic tissues and cover these defects with well vascularized tissues. It is useful to distinguish damaged tissue from health tissue by MRI. In a case having a rectovaginal fistula, it is recommended that fecal and urinary diversion will be done at first and debridement of ulcer and reconstructive surgery will be done later. (author)

  2. Radiation therapy for pre-sacral recurrence of rectal carcinoma following primary surgery

    International Nuclear Information System (INIS)

    Yamanashi, Shunji; Yokoyama, Suguru; Kirita, Maruyuki; Katou, Yasuharu; Takeuchi, Kazuo; Kumamoto, Yoshikazu

    2006-01-01

    Between April 2002 and December 2005, we treated 15 patients who were suffering from pre-sacral recurrence of rectal cancer with or without liver metastases, using multi-portal irradiation and oral intake of tegafur-uracil (UFT) (300 mg/day), to assess pain relief and local control. Radiation therapy was given 2.1 to 2.4 Gy daily fractions, and total tumor dose was set up at a landmark of 66 Gy/30 fractions/6 weeks (time-dose-fractionation (TDF)=115, corresponding to 70 Gy), varying by recurrent tumor volume. The follow-up time was ranged from 3 to 37 months (median=14.7 months), and median survival was 14.8 months. Pain remission time was 3 to 36 months (median=10.4 months). No severe morbidity which induced by radiation therapy was observed in follow-up duration. The median survival has become unfavorite, but the multi-portal irradiation of high dose delivery is useful for improvement of quality of life (QOL) and beneficial as a palliative therapy. To improvement of local control and prognosis, combined modality with more effective regimen of chemotherapy is expected. (author)

  3. Sacral Neuromodulation

    DEFF Research Database (Denmark)

    Matzel, Klaus E; Chartier-Kastler, Emmanuel; Knowles, Charles H

    2017-01-01

    INTRODUCTION: Sacral neuromodulation (SNM) (sacral nerve stimulation SNS) has become an established therapy for functional disorders of the pelvic organs. Despite its overall success, the therapy fails in a proportion of patients. This may be partially due to inadequate electrode placement...... with suboptimal coupling of the electrode and nerve. Based on these assumptions the technique of sacral spinal neuromodulation has been redefined. All descriptions relate to the only currently available system licensed for all pelvic indications (Medtronic Interstim(®) ). METHOD: An international...

  4. Carbon Ion Radiation Therapy for Unresectable Sacral Chordoma: An Analysis of 188 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Reiko, E-mail: r_imai@nirs.go.jp [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Kamada, Tadashi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Araki, Nobuhito [Department of Orthopedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Abe, Satoshi; Iwamoto, Yukihide; Ozaki, Toshifumi; Kanehira, Chihiro; Kaya, Mitsunori; Takahashi, Kazuhisa; Chuman, Hirokazu; Tsujii, Hirohiko; Tsuneyoshi, Masazumi; Nishida, Yoshihiro; Hiraga, Hiroaki; Hiruma, Toru; Machinami, Rikuo; Matsumine, Akihiko; Matsumoto, Seiichi; Morioka, Hideo; Yamaguchi, Takehiko; and others

    2016-05-01

    Purpose: To evaluate the results of carbon ion radiation therapy administered to 188 patients with unresectable primary sacral chordomas. Patients and Methods: One hundred eighty-eight patients were treated with carbon ion radiation therapy at a single institute between 1996 and 2013 and retrospectively analyzed. The median age was 66 years. The highest proximal invasion reached past S2 level in 137 patients. The median clinical target volume was 345 cm{sup 3}. One hundred six patients received 67.2 gray equivalents (GyE)/16 fractions (fr), 74 patients received 70.4 GyE/16 fr, 7 patients received 73.6 GyE/16 fr, and 1 patient received 64.0 GyE/16 fr. Results: The median follow-up period was 62 months (range, 6.8-147.5 months). Seventy percent of patients were followed for 5 years or until death. The 5-year local control, overall survival, and disease-free survival rates were 77.2%, 81.1%, and 50.3%, respectively. Forty-one patients had a local recurrence. Sex, tumor volume, level of proximal invasion, and irradiated dose were unrelated to local control. There was grade 3 toxicity of the peripheral nerves in 6 patients and grade 4 toxicity of the skin in 2 patients. Ambulation remained in 97% of patients. Conclusions: Carbon ion radiation therapy was safe and effective for unresectable chordoma and provided good local control and survival while preserving ambulation.

  5. Three cases of lumbo-sacral neuropathy due to radiation for uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Yoshikazu; Hokezu, Yoichi; Kanehisa, Yoshihide; Nagamatsu, Keiji; Onishi, Akio

    1985-01-01

    Case 1: The 61-year-old woman developed uterine cancer at age 50. Radiation therapy was initiated to the pelvic lumen from both anterior and posterior sides with a total dose of 21,000 rads. Radiation ulcerative enterocolitis and dermatitis revealed at the end of the therapy. At age 52 (2 years after radiation), she noticed muscle weakness and dysesthesia of the lower legs. These symptoms progressed and amyotrophy of the legs appeared. At age 54 (4 years after radiation), she became unable to walk. Case 2: The 51-year-old woman developed uterine cancer at age 40. Postoperative radiation was initiated by the same dose and the same way as in Case 1 and she suffered from radiation dermatitis. At age 49 (9 years after radiation), she noticed dysesthesia of the right toe, which gradually spread to another side. Ten years after radiation, she began to note weakness in dorsiflexion of feet. Case 3: The 69-year-old woman developed uterine cancer at age 67. Radiation (Linac 4,000 rads, Ralstron 2,000 rads) was performed for 3 months into the pelvic lumen. Two years later, she noted dysesthesia and weakness of her legs. These symptoms progressed gradually. In these 3 cases, EMG showed neurogenic changes, suggesting peripheral nerve lesions. Nerve conduction velocities were decreased. Nerve and muscle biopsies revealed neurogenic changes. No abnormal findings were detected by spinal X-rays and myelography. The neurological findings of these patients were compatible with the lumbo-sacrol plexus injuries apparently due to late radiation effect. (J.P.N.).

  6. Three cases of lumbo-sacral neuropathy due to radiation for uterine cancer

    International Nuclear Information System (INIS)

    Maruyama, Yoshikazu; Hokezu, Yoichi; Kanehisa, Yoshihide; Nagamatsu, Keiji; Onishi, Akio.

    1985-01-01

    Case 1: The 61-year-old woman developed uterine cancer at age 50. Radiation therapy was initiated to the pelvic lumen from both anterior and posterior sides with a total dose of 21,000 rads. Radiation ulcerative neterocolitis and dermatitis revealed at the end of the therapy. At age 52 (2 years after radiation), she noticed muscle weakness and dysesthesia of the lower legs. These symptoms progressed and amyotrophy of the legs appeared. At age 54 (4 years after radiation), she became unable to walk. Case 2: The 51-year-old woman developed uterine cancer at age 40. Postoperative radiation was initiated by the same dose and the same way as in Case 1 and she suffered from radiation dermatitis. At age 49 (9 years after radiation), she noticed dysesthesia of the right toe, which gradually spread to another side. Ten years after radiation, she began to note weakness in dorsiflexion of feet. Case 3: The 69-year-old woman developed uterine cancer at age 67. Radiation (Linac 4,000 rads, Ralstron 2,000 rads) was performed for 3 months into the pelvic lumen. Two years later, she noted dysesthesia and weakness of her legs. These symptoms progressed gradually. In these 3 cases, EMG showed neurogenic changes, suggesting peripheral nerve lesions. Nerve conduction velocities were decreased. Nerve and muscle biopsies revealed neurogenic changes. No abnormal findings were detected by spinal X-rays and myelography. The neurological findings of these patients were compatible with the lumbo-sacrol plexus injuries apparently due to late radiation effect. (J.P.N.)

  7. Sacral chordomas: Impact of high-dose proton/photon-beam radiation therapy combined with or without surgery for primary versus recurrent tumor

    International Nuclear Information System (INIS)

    Park, Lily; De Laney, Thomas F.; Liebsch, Norbert J.; Hornicek, Francis J.; Goldberg, Saveli; Mankin, Henry; Rosenberg, Andrew E.; Rosenthal, Daniel I.; Suit, Herman D.

    2006-01-01

    Purpose: To assess the efficacy of definitive treatment of sacral chordoma by high-dose proton/photon-beam radiation therapy alone or combined with surgery. Methods and Materials: The records of 16 primary and 11 recurrent sacral chordoma patients treated from November 1982 to November 2002 by proton/photon radiation therapy alone (6 patients) or combined with surgery (21 patients) have been analyzed for local control, survival, and treatment-related morbidity. The outcome analysis is based on follow-up information as of 2005. Results: Outcome results show a large difference in local failure rate between patients treated for primary and recurrent chordomas. Local control results by surgery and radiation were 12/14 vs. 1/7 for primary and recurrent lesions. For margin-positive patients, local control results were 10 of 11 and 0 of 5 in the primary and recurrent groups, respectively; the mean follow-up on these locally controlled patients was 8.8 years (4 at 10.3, 12.8, 17, and 21 years). Radiation alone was used in 6 patients, 4 of whom received ≥73.0 Gy (E); local control was observed in 3 of these 4 patients for 2.9, 4.9, and 7.6 years. Conclusion: These data indicate a high local control rate for surgical and radiation treatment of primary (12 of 14) as distinct from recurrent (1 of 7) sacral chordomas. Three of 4 chordomas treated by ≥73.0 Gy (E) of radiation alone had local control; 1 is at 91 months. This indicates that high-dose proton/photon therapy offers an effective treatment option

  8. Updated Outcome and Analysis of Tumor Response in Mobile Spine and Sacral Chordoma Treated With Definitive High-Dose Photon/Proton Radiation Therapy

    International Nuclear Information System (INIS)

    Kabolizadeh, Peyman; Chen, Yen-Lin; Liebsch, Norbert; Hornicek, Francis J.; Schwab, Joseph H.; Choy, Edwin; Rosenthal, Daniel I.; Niemierko, Andrzej; DeLaney, Thomas F.

    2017-01-01

    Purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy. In certain circumstances where resection may result in significant neurologic or organ dysfunction, patients can be treated definitively with radiation therapy alone. Herein, we report the outcome and the assessment of tumor response to definitive radiation therapy. Methods and Materials: A retrospective analysis was performed on 40 patients with unresected chordoma treated with photon/proton radiation therapy. Nineteen patients had complete sets of imaging scans. The soft tissue and bone compartments of the tumor were defined separately. Tumor response was evaluated by the modified Response Evaluation Criteria in Solid Tumors (RECIST) and volumetric analysis. Results: With a median follow-up time of 50.3 months, the rates of 5-year local control, overall survival, disease-specific survival, and distant failure were 85.4%, 81.9%, 89.4%, and 20.2%, respectively. Eighty-four computed tomographic and magnetic resonance imaging scans were reviewed. Among the 19 patients, only 4 local failures occurred, and the median tumor dose was 77.4 GyRBE. Analysis at a median follow-up time of 18 months showed significant volumetric reduction of the total target volume (TTV) and the soft tissue target volume (STTV) within the first 24 months after treatment initiation, followed by further gradual reduction throughout the rest of the follow-up period. The median maximum percentage volumetric regressions of TTV and STTV were 43.2% and 70.4%, respectively. There was only a small reduction in bone target volume over time. In comparison with the modified RECIST, volumetric analysis was more reliable, more reproducible, and could help in measuring minimal changes in the tumor volume. Conclusion: These results continue to support the use of high-dose definitive radiation therapy for selected patients with unresected spine and sacral chordomas

  9. Updated Outcome and Analysis of Tumor Response in Mobile Spine and Sacral Chordoma Treated With Definitive High-Dose Photon/Proton Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kabolizadeh, Peyman, E-mail: peyman.kabolizadeh@beaumont.org [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Chen, Yen-Lin; Liebsch, Norbert [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hornicek, Francis J.; Schwab, Joseph H. [Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Choy, Edwin [Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Rosenthal, Daniel I. [Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Niemierko, Andrzej; DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2017-02-01

    Purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy. In certain circumstances where resection may result in significant neurologic or organ dysfunction, patients can be treated definitively with radiation therapy alone. Herein, we report the outcome and the assessment of tumor response to definitive radiation therapy. Methods and Materials: A retrospective analysis was performed on 40 patients with unresected chordoma treated with photon/proton radiation therapy. Nineteen patients had complete sets of imaging scans. The soft tissue and bone compartments of the tumor were defined separately. Tumor response was evaluated by the modified Response Evaluation Criteria in Solid Tumors (RECIST) and volumetric analysis. Results: With a median follow-up time of 50.3 months, the rates of 5-year local control, overall survival, disease-specific survival, and distant failure were 85.4%, 81.9%, 89.4%, and 20.2%, respectively. Eighty-four computed tomographic and magnetic resonance imaging scans were reviewed. Among the 19 patients, only 4 local failures occurred, and the median tumor dose was 77.4 GyRBE. Analysis at a median follow-up time of 18 months showed significant volumetric reduction of the total target volume (TTV) and the soft tissue target volume (STTV) within the first 24 months after treatment initiation, followed by further gradual reduction throughout the rest of the follow-up period. The median maximum percentage volumetric regressions of TTV and STTV were 43.2% and 70.4%, respectively. There was only a small reduction in bone target volume over time. In comparison with the modified RECIST, volumetric analysis was more reliable, more reproducible, and could help in measuring minimal changes in the tumor volume. Conclusion: These results continue to support the use of high-dose definitive radiation therapy for selected patients with unresected spine and sacral chordomas

  10. The sacral foramina

    International Nuclear Information System (INIS)

    Jackson, H.; Burke, J.T.

    1984-01-01

    The sacral foramina, particularly the first three, are not simple fenestrations. Each foramen is a Y-shaped complex of canals, all with indefinite margins. The complexes lie obliquely at approximately 45 0 to the coronal plane. An appreciation of these facts facilitates the recognition of the anatomy of plain films, tomographs, and computerized scans. (orig.)

  11. Sacral-neuromodulation CT-guided

    International Nuclear Information System (INIS)

    Amoroso, Lamberto; Ricci, Stefano; Pelliccioni, Giuseppe; Scarpino, Osvaldo; Ghiselli, Roberto; Saba, Vittorio

    2005-01-01

    total of 38 centering. Eight patients underwent the PNE procedure on both the S3 foramina. The sacral foramen was centred at the first attempt in 36 out of 38 cases. Two cases required several attempts to centre correctly the foramen. In 4 patients out of 30 a second electrode was implanted. In one patient who had a non consolidated sacral fracture, CT guidance enabled insertion of the electrode inside the only practicable foramen, a manoeuvre that would have been impossible with fluoroscopic guidance. Only once was repositioned after a CT control. During the whole trial period we had a positive response to the PNE test in 18 out of 30 patients (60%), a partial response in 4 out of 30 patients and a negative response in the remaining 8 patients. None of the patients who underwent the PNE test had infectious complications and the procedure was well tolerated by all. The procedure lasted about 45 minutes. Conclusions: The PNE test under Ct guidance proved to be more efficient compared with the traditional technique as the direct view of the electrode position helped to define with greater reliability the patients who were non-responsive to sacral stimulation. Moreover, this method was particularly efficient in patients with sacral anomalies where the traditional guide might fail. The operators' reduced exposure to radiation is an advantage to be taken into consideration. Finally, the usage of mobile CT apparatus in an operating theatre can improve the technique for permanent implantations [it

  12. L5 radiculopathy due to sacral stress fracture

    International Nuclear Information System (INIS)

    Aylwin, Anthony; Saifuddin, Asif; Tucker, Stuart

    2003-01-01

    We report the case of a 70-year-old man who presented with a history of left buttock pain with radiation into the left leg in an L5 distribution. MRI of the lumbar spine revealed a left sacral stress fracture with periosteal reaction involving the left L5 nerve root anterior to the sacral ala. With spontaneous healing of the fracture, the patient's symptoms resolved completely. (orig.)

  13. Two cases of sacral agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, J Y; Bae, Y K; Hahm, C K; Kang, S R [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Sacral agenesis is a central component in the spectrum of anomalies comprising the caudal regression syndrome. Sacral agenesis occurs more frequently in an infant born to mother of diabetes, rubella infection in first trimester than normal mothers. In a patient of sacral agenesis, it is important to recognize the neurologic deficit, neurogenic bladder dysfunction and other congenital anomalies. A case of partial sacral agenesis of 10 years old girl and another case of complete total agenesis associated with multiple anomalies in autopsied newborn are reported.

  14. Two cases of sacral agenesis

    International Nuclear Information System (INIS)

    Choi, J. Y.; Bae, Y. K.; Hahm, C. K.; Kang, S. R.

    1979-01-01

    Sacral agenesis is a central component in the spectrum of anomalies comprising the caudal regression syndrome. Sacral agenesis occurs more frequently in an infant born to mother of diabetes, rubella infection in first trimester than normal mothers. In a patient of sacral agenesis, it is important to recognize the neurologic deficit, neurogenic bladder dysfunction and other congenital anomalies. A case of partial sacral agenesis of 10 years old girl and another case of complete total agenesis associated with multiple anomalies in autopsied newborn are reported.

  15. Imaging findings of sacral tumors

    International Nuclear Information System (INIS)

    Kim, Seung Ho; Hong, Sung Hwan; Choi, Ja Young; Koh, Sung Hye; Chung, Hye Won; Choi, Jung Ah; Kang, Heung Sik

    2003-01-01

    The various pathologic conditions detected at CT and MRI and subsumed by the term 'sacral tumor' include primary bone tumors, sacral canal tumors and metastases. Among these, metastases are much more common than primary bone tumors, of which chordoma is the most common. Although the imaging findings of sacral tumors are nonspecific, a patient's age and sex, and specific findings such as calcification or fluid-fluid levels, can help radiologists in their differential diagnosis. We describe the imaging findings of primary sacral tumors, emphasizing the MRI findings

  16. Cytodiagnosis of Sacral Chordoma

    Directory of Open Access Journals (Sweden)

    Saumya Shukla

    2014-12-01

    Full Text Available We report the cytological findings of a sacro-coccygeal chordoma in a 53 year male diagnosed preoperatively by guided fine needle aspiration cytology. The smears shows characteristic Physalliphorous cells in a metachromatic background of myxoid material entrapping cords of cuboidal cells. Differential diagnosis in cytology include conventional and myxoid chondrosarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, metastatic mucinous carcinoma and myxo-papillary ependymoma. The distinguishing features between these neoplasms are discussed. Preoperative diagnosis of chordoma permits optimum planned surgery. Keywords: chordoma; myxoid; sacral.

  17. Imaging of sacral tumours

    International Nuclear Information System (INIS)

    Gerber, S.; Ollivier, L.; Brisse, H.; Neuenschwander, S.; Leclere, J.; Vanel, D.; Missenard, G.; Pinieux, G. de

    2008-01-01

    All components of the sacrum (bone, cartilage, bone marrow, meninges, nerves, notochord remnants, etc.) can give rise to benign or malignant tumours. Bone metastases and intraosseous sites of haematological malignancies, lymphoma and multiple myeloma are the most frequent aetiologies, while primary bone tumours and meningeal or nerve tumours are less common. Some histological types have a predilection for the sacrum, especially chordoma and giant cell tumour. Clinical signs are usually minor, and sacral tumours are often discovered in the context of nerve root or pelvic organ compression. The roles of conventional radiology, CT and MRI are described and compared with the histological features of the main tumours. The impact of imaging on treatment decisions and follow-up is also reviewed. (orig.)

  18. Imaging of sacral tumours

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, S.; Ollivier, L.; Brisse, H.; Neuenschwander, S. [Institut Curie, Department of Radiology, Paris (France); Leclere, J. [Institut Gustave Roussy, Department of Radiology, Villejuif (France); Vanel, D. [The Rizzoli Institute, Department of Radiology, Bologna (Italy); Missenard, G. [Institut Gustave Roussy, Comite de pathologie tumorale de l' appareil locomoteur, Villejuif (France); Pinieux, G. de [CHRU de Tours, Department of Pathology, Hopital Trousseau, Tours (France)

    2008-04-15

    All components of the sacrum (bone, cartilage, bone marrow, meninges, nerves, notochord remnants, etc.) can give rise to benign or malignant tumours. Bone metastases and intraosseous sites of haematological malignancies, lymphoma and multiple myeloma are the most frequent aetiologies, while primary bone tumours and meningeal or nerve tumours are less common. Some histological types have a predilection for the sacrum, especially chordoma and giant cell tumour. Clinical signs are usually minor, and sacral tumours are often discovered in the context of nerve root or pelvic organ compression. The roles of conventional radiology, CT and MRI are described and compared with the histological features of the main tumours. The impact of imaging on treatment decisions and follow-up is also reviewed. (orig.)

  19. Sacral orientation and spondylolysis.

    Science.gov (United States)

    Peleg, Smadar; Dar, Gali; Steinberg, Nili; Masharawi, Youssef; Been, Ella; Abbas, Janan; Hershkovitz, Israel

    2009-12-01

    A descriptive study (based on skeletal material) was designed to measure sacral anatomic orientation (SAO) in individuals with and without spondylolysis. To test whether a relationship between SAO and spondylolysis exists. Spondylolysis is a stress fracture in the pars interarticularis (mainly of L5). The natural history of the phenomenon has been debated for years with opinions divided, i.e., is it a developmental condition or a stress fracture phenomenon. There is some evidence to suggest that sacral orientation can be a "key player" in revealing the etiology of spondylolysis. The pelvis was anatomically reconstructed and SAO was measured as the angle created between the intersection of a line running parallel to the superior surface of the sacrum and a line running between the anterior superior iliac spine (ASIS) and the anterior-superior edge of the symphysis pubis (PUBIS).SAO was measured in 99 adult males with spondylolysis and 125 adult males without spondylolysis. The difference between the groups was tested using an unpaired t test. Spondylolysis prevalence is significantly higher in African-Americans compared to European-Americans: 5.4% versus 2.04% in males (P < 0.001) and 2.31% versus 0.4%, P < 0.001 in females. SAO was significantly lower in the spondylolytic group (44.07 degrees +/- 11.46 degrees) compared to the control group (51.07 degrees +/- 8.46 degrees, P < 0.001). A more horizontally oriented sacrum leads to direct impingement on L5 pars interarticularis by both L4 inferior articular facet superiorly and S1 superior articular facet inferiorly. Repetitive stress due to standing (daily activities) or sitting increases the "pincer effect" on this area, and eventually may lead to incomplete synostosis of the neural arch.

  20. Landmarks for Sacral Debridement in Sacral Pressure Sores.

    Science.gov (United States)

    Choo, Joshua H; Wilhelmi, Bradon J

    2016-03-01

    Most cases of sacral osteomyelitis arising in the setting of sacral pressure ulcers require minimal cortical debridement. When faced with advanced bony involvement, the surgeon is often unclear about how much can safely be resected. Unfamiliarity with sacral anatomy can lead to concerns of inadvertent entry into the dural space and compromise of future flap options. A cadaveric study (n = 6), in which a wide posterior dissection of the sacrum, was performed. Relationships of the dural sac to bony landmarks of the posterior pelvis were noted. The termination of the dural sac was found in our study to occur at the junction of S2/S3 vertebral bodies, which was located at a mean distance of 0.38 ± 0.16 cm distal to the inferior-most extent of the posterior superior iliac spine (PSIS). The mean thickness of the posterior table of sacrum at this level was 1.7 cm at the midline and 0.5 cm at the sacral foramina. The PSIS is a reliable landmark for localizing the S2/S3 junction and the termination of the dural sac. Sacral debridement medial to the sacral foramina above the level of PSIS must be conservative whenever possible. If aggressive debridement is necessary above this level, the surgeon must be alert to the possibility of dural involvement.

  1. Radiation induced esophageal ulcer; Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Tatsuyuki; Endo, Mitsuo; Yamazaki, Shigeru (Tokyo Medical and Dental Univ. (Japan). School of Medicine) (and others)

    1990-04-01

    A 77-year-old woman was referred to us on Dec. 22, 1986 because of dysphagia and esophageal ulcer. She had a previous history of left radical mastectomy for breast cancer, followed by postoperative {sup 60}Co irradiation to parasternal and supraclavicular regions with 50 Gy about 15 years before. UGIs and endoscopy showed a small ulcer surrounded by submucosal tumor-like protrusion in the esophagus at the thoracic inlet. Examination one month later revealed the ulcer which became larger despite medical treatment, now measuring 1 cm in diameter. Severe dysphagia continued. Right thoractomy and subtotal esophagectomy were performed on Jan 13, 1987. Histological examination revealed nonspecific ulcer, 5 cm in diameter, surrounded by fibrous granulation tissue. Proliferation of dilated capillary vessels was also seen in the bottom of the ulcer, the surrounding wall of which was free from remarkable infiltration of inflammatory cells. Based on these findings and previous medical history, the patient was diagnosed as having a postirradiation ulcer which appeared 15 years after irradiation. Dysphagia was considered due to esophageal dysfunction caused by severe fibrosis of the proper muscle layer. (author).

  2. Osteolytic extra-axial sacral myxopapillary ependymoma.

    Science.gov (United States)

    Biagini, R; Demitri, S; Orsini, U; Bibiloni, J; Briccoli, A; Bertoni, F

    1999-10-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed.

  3. Osteolytic extra-axial sacral myxopapillary ependymoma

    Energy Technology Data Exchange (ETDEWEB)

    Biagini, R.; Demitri, S.; Orsini, U. [Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna (Italy); Bibiloni, J. [Medical Sciences Campus San Juan, University of Puerto Rico (Puerto Rico); Briccoli, A. [Istituto di Patologia Chirurgica, University of Modena (Italy); Bertoni, F. [Servizio di Anatomia Patologica, Istituto Ortopedico Rizzoli Bologna (Italy)

    1999-10-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed. (orig.)

  4. Osteolytic extra-axial sacral myxopapillary ependymoma

    International Nuclear Information System (INIS)

    Biagini, R.; Demitri, S.; Orsini, U.; Bibiloni, J.; Briccoli, A.; Bertoni, F.

    1999-01-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed. (orig.)

  5. Sacral-neuromodulation CT-guided; Nuova tecnica di centraggio TC-assistista nella neuromodulazione sacrale

    Energy Technology Data Exchange (ETDEWEB)

    Amoroso, Lamberto; Ricci, Stefano [INRCA, Ancona (Italy). Dipartimento di radiologia e medicina nucleare; Pelliccioni, Giuseppe; Scarpino, Osvaldo [INRCA, Ancona (Italy). Unita' operativa di radiologia; Ghiselli, Roberto; Saba, Vittorio [INRCA, Ancona (Italy). Dipartimento di chirurgia

    2005-04-01

    total of 38 centering. Eight patients underwent the PNE procedure on both the S3 foramina. The sacral foramen was centred at the first attempt in 36 out of 38 cases. Two cases required several attempts to centre correctly the foramen. In 4 patients out of 30 a second electrode was implanted. In one patient who had a non consolidated sacral fracture, CT guidance enabled insertion of the electrode inside the only practicable foramen, a manoeuvre that would have been impossible with fluoroscopic guidance. Only once was repositioned after a CT control. During the whole trial period we had a positive response to the PNE test in 18 out of 30 patients (60%), a partial response in 4 out of 30 patients and a negative response in the remaining 8 patients. None of the patients who underwent the PNE test had infectious complications and the procedure was well tolerated by all. The procedure lasted about 45 minutes. Conclusions: The PNE test under Ct guidance proved to be more efficient compared with the traditional technique as the direct view of the electrode position helped to define with greater reliability the patients who were non-responsive to sacral stimulation. Moreover, this method was particularly efficient in patients with sacral anomalies where the traditional guide might fail. The operators' reduced exposure to radiation is an advantage to be taken into consideration. Finally, the usage of mobile CT apparatus in an operating theatre can improve the technique for permanent implantations. [Italian] Scopo: La neuromodulazione sacrale ? una nuova procedura diagnostico-terapeutica pe ri disturbi funzionali del basso tratto urinario come l'incontinenza urinaria da urgenza, la ritenzione urinaria non ostruttiva, la sindrome urgenza/frequenza, il dolore pelvico cronico intrattabile e, di recente, anche per il trattamento della stipsi e dell'incontinemza fecale. Il trattamento prevede una prima fase definita PNE test (Percutaneous Nerve Evaluation) che consiste

  6. Sacrality and worldmaking: new categorial perspectives

    OpenAIRE

    William E. Paden

    1999-01-01

    The category of the sacred in particular and the role of transcultural concept-formation in general have undergone an obvious crisis. For the most part, "the sacred," if not an empty label, has been linked with theologism, and transcultural concepts have been condemned for their general non-comparability and colonialist intent. The author approaches the matter of transcultural templates through an analysis of certain concepts of sacrality. With some exceptions, the discourse of sacrality has ...

  7. Storytelling: Performance, Presentations and Sacral Communication

    Directory of Open Access Journals (Sweden)

    Zoltán Bódis

    2013-12-01

    Full Text Available Various schools of tale research manifested the relationship of tales of the sacred based on their ideological preconceptions: the relationship between tales and the sacred is refused or accepted. In this article tales are investigated not from the perspective of the possible sacral referent(s but rather it looks at them as a kind of communicational subsystem that is part of human culture. The focus is on revealing the specific features of sacral communication in the communication system of tales. Sacral communication is a special form of communication in which the elements of the communication model are transformed. The goal of sacral communication is exactly this kind of identity creation. This may be oriented towards creating a personal or a communal self-identity. Among its characteristics we may find the special type of language forms in which the predominance of linguistic elements pushes the sense conveying possibilities more into the background than usual, and those linguistic forms that restructure consciousness become emphasized. In this communication the tale telling is transformed by a language use characteristic of sacral communication (rhythm, repetition and rhetorical forms. Various examples explain that traditional tale telling creates a complex effect related to the visual, auditory, and kinetic senses: a modification and transformation of the self-understanding and self-identity that connect the world of tale telling to sacral communication.

  8. MR imaging of sacral and perisacral lesions

    International Nuclear Information System (INIS)

    Wetzel, L.H.; Levine, E.; Murphey, M.D.

    1987-01-01

    This exhibit demonstrates the utility of MR imaging in evaluating sacral and perisacral lesions. Thirty-two lesions were studied using a superconducting 1.0-T MR imager. Eleven primary and 13 metastatic tumors, four congenital lesions, and four arachnoid cysts were evaluated. MR did not usually enable a more specific histologic diagnosis than other imaging techniques. However, extraosseous and proximal spinal extent of tumors was well defined without use of oral or intravenous contrast material. MR imaging is an excellent noninvasive technique for evaluating most sacral and perisacral lesions and is particularly helpful when precise tumor extent must be determined for treatment planning

  9. Surgical techniques for lumbo-sacral fusion.

    Science.gov (United States)

    Tropiano, P; Giorgi, H; Faure, A; Blondel, B

    2017-02-01

    Lumbo-sacral (L5-S1) fusion is a widely performed procedure that has become the reference standard treatment for refractory low back pain. L5-S1 is a complex transition zone between the mobile lordotic distal lumbar spine and the fixed sacral region. The goal is to immobilise the lumbo-sacral junction in order to relieve pain originating from this site. Apart from achieving inter-vertebral fusion, the main challenge lies in the preoperative determination of the fixed L5-S1 position that will be optimal for the patient. Many lumbo-sacral fusion techniques are available. Stabilisation can be achieved using various methods. An anterior, posterior, or combined approach may be used. Recently developed minimally invasive techniques are gaining in popularity based on their good clinical outcomes and high fusion rates. The objective of this conference is to resolve the main issues faced by spinal surgeons in their everyday practice. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Surgically Treated Symptomatic Prolapsed Lumbar and Sacral ...

    African Journals Online (AJOL)

    Background and Objective: There are various postulated possible causes of surgically symptomatic prolapsed intervertebral discs in the lumbar and sacral regions. They may be acting singularly or collectively. Yet, these factors, which could vary in different environments, have not been satisfactorily confirmed. The intention ...

  11. MRI of occult sacral insufficiency fractures following radiotherapy

    International Nuclear Information System (INIS)

    Mammone, J.F.; Schweitzer, M.E.

    1995-01-01

    Following radiation therapy, marrow abnormalities noted on magnetic resonance imaging (MRI) are frequent and may mimic metastases. Specific radiotherapy changes are usually easily identifiable; however, traumatic lesions cause more interpretive difficulties. We assessed the incidence and MRI characteristics of insufficiency fractures in this population. During a 5-year span (1987-1991), 546 patients received pelvic radiotherapy for primary malignancies. MRI was performed in 25 of these patients at least 3 months after treatment. The mean dose in this group was 53 Gy. These MRI scans were retrospectively reviewed for the appearance of the sacrum with particular attention to the presence of insufficiency fractures. This was correlated with clinical course and scintigraphic findings. Presumed insufficiency fractures on MRI paralleled the sacral side of the sacroiliac joint, enhanced with Gd-DTPA, were most prominent or initially seen anteriorly, and had ill-defined margins on all imaging sequences. The incidence of occult sacral insufficiency fractures was at least 20%. Insufficiency fractures of the sacrum in the post-radiotherapy patient are a relatively frequent occurrence which can mimic metastases. Consideration of this phenomenon and knowledge of differential features may avoid overdiagnosis of osseous metastases. (orig.)

  12. MR myelography of sacral meningeal cysts

    International Nuclear Information System (INIS)

    Tsuchiya, K.; Katase, S.; Hachiya, J.

    1999-01-01

    Purpose: To describe the findings of sacral meningeal cysts (SMCs) on MR myelography and assess its value for the diagnosis of SMCs. Material and Methods: We evaluated the MR images and MR myelograms obtained from 10 patients with SMC. MR myelograms were obtained using a 2D or 3D single-shot fast spin-echo sequence. In 5 patients, X-ray myelograms and postmyelographic CT images were compared with the MR myelograms. Results: A total of 33 SMCs were diagnosed within the spinal canal and/or sacral foramen. MR myelograms clearly revealed each cyst as a well-defined mass showing hyperintensity (10 cysts) or isointensity (23 cysts) compared to cerebrospinal fluid. MR myelograms demonstrated SMCs better than X-ray myelograms and postmyelographic CT images in 3 of the 5 patients. Conclusion: MR myelography can be an adjunct to conventional imaging techniques when surgical treatment is indicated, because it can precisely delineate the extent of SMCs. (orig.)

  13. Sacrality and worldmaking: new categorial perspectives

    Directory of Open Access Journals (Sweden)

    William E. Paden

    1999-01-01

    Full Text Available The category of the sacred in particular and the role of transcultural concept-formation in general have undergone an obvious crisis. For the most part, "the sacred," if not an empty label, has been linked with theologism, and transcultural concepts have been condemned for their general non-comparability and colonialist intent. The author approaches the matter of transcultural templates through an analysis of certain concepts of sacrality. With some exceptions, the discourse of sacrality has indeed been dominated by a single model, where "the sacred" became a reified noun—a substantive term for a supernatural reality, a label for the transcendent, or even an epithet for divinity, mystery, the wholly other. As such, the expression has functioned to bestow a sense of unity to the diversity of cultures, link that unity with a transcendent reality, and offer a simple way of making sense of otherwise foreign beliefs and practices by giving them a familiar, generic referent.

  14. Pneumorrhachis Secondary From Sacral Decubitus Ulcer

    OpenAIRE

    Moayedi, Siamak; Babin, Lisa

    2016-01-01

    An elderly woman with a chronic decubitus sacral ulcer presented to the emergency department with sepsis. A computed tomography of her abdomen showed diffuse gas extending throughout the thoracolumbar spinal canal. Pneumorrhachis is a rare radiographic finding defined as gas within the spinal canal. There are many causes of pneumorrhachis ranging from trauma to infection. In this case the pneumorrhachis was caused by direct spread of gas-forming organisms from vertebral osteomyelitis. Emergen...

  15. [Sacral pressure sores and their treatment].

    Science.gov (United States)

    Bielecki, Marek; Skowroński, Rafał; Skowroński, Jan

    2006-01-01

    Sacral bed sores still present a serious problem in most surgery departments. They occur mainly in elderly patients of limited mobility. The treatment of such sores extends over long periods of time and therefore involves considerable costs. The material consisted of 11 sacral pressure ulcers treated surgically. The sores occurred in 4 severely disabled patients suffering from proximal third femur fractures, 4 patients with traumatic brain injury (treated in the Intensive Care Unit), and 3 patients suffering from bed sores after spinal cord injury. In 6 patients a fasciocutaneous flap was applied to the sores and in 5 cases a pedicled musculocutaneous gluteus maximus flap. The end results were assessed using Seiler's criteria. Complications of the "seroma" type were observed in 3 patients, and in 2 marginal necrosis. In all our patients complete healing was achieved within 2-4 weeks. On analysing our experience to date in surgical treatment of bed sores we are of the opinion that even extensive sacral sores can be covered with unilateral pedicled flaps provided that they are appropriately planned. Deep sores of the 4th degree sometimes with concomitant osteomyelitis require pedicled muscle flaps or in some cases musculocutaneous flaps to improve local circulation. The preparation of the patient for reconstruction surgery is just as important as the operation itself and therefore such preparation should never be neglected.

  16. Transcutaneous sacral neurostimulation for irritative voiding dysfunction.

    Science.gov (United States)

    Walsh, I K; Johnston, R S; Keane, P F

    1999-01-01

    Patients with irritative voiding dysfunction are often unresponsive to standard clinical treatment. We evaluated the response of such individuals to transcutaneous electrical stimulation of the third sacral nerve. 32 patients with refractory irritative voiding dysfunction (31 female and 1 male; mean age 47 years) were recruited to the study. Ambulatory transcutaneous electrical neurostimulation was applied bilaterally to the third sacral dermatomes for 1 week. Symptoms of frequency, nocturia, urgency, and bladder pain were scored by each patient throughout and up to 6 months following treatment. The mean daytime frequency was reduced from 11.3 to 7.96 (p = 0.01). Nocturia episodes were reduced from a mean of 2.6 to 1.8 (p = 0.01). Urgency and bladder pain mean symptom scores were reduced from 5.97 to 4.89 and from 1.48 to 0.64, respectively. After stopping therapy, symptoms returned to pretreatment levels within 2 weeks in 40% of the patients and within 6 months in 100%. Three patients who continued with neurostimulation remained satisfied with this treatment modality at 6 months. Transcutaneous third sacral nerve stimulation may be an effective and noninvasive ambulatory technique for the treatment of patients with refractory irritative voiding dysfunction. Following an initial response, patients may successfully apply this treatment themselves to ensure long-term relief.

  17. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh.

    Science.gov (United States)

    Roth, Ted M; Reight, Ian

    2012-07-01

    Sacral colpopexy may be complicated by mesh exposure, and the surgical treatment of mesh exposure typically results in minor postoperative morbidity and few delayed complications. A 75-year-old woman presented 7 years after a laparoscopic sacral colpopexy, with Mersilene mesh, with an apical mesh exposure. She underwent an uncomplicated transvaginal excision and was asymptomatic until 8 months later when she presented with vaginal drainage and a sacral abscess. This was successfully treated with laparoscopic enterolysis, drainage of the abscess, and explantation of the remaining mesh. Incomplete excision of exposed colpopexy mesh can lead to ascending infection and sacral abscess. Laparoscopic drainage and mesh removal may be considered in these patients.

  18. Bladder compliance after posterior sacral root rhizotomies and anterior sacral root stimulation

    NARCIS (Netherlands)

    Koldewijn, E. L.; van Kerrebroeck, P. E.; Rosier, P. F.; Wijkstra, H.; Debruyne, F. M.

    1994-01-01

    To evaluate the effects of central detrusor denervation on bladder compliance, we studied 27 patients with complete suprasacral spinal cord injury in whom intradural posterior sacral root rhizotomies from S2 to S5 in combination with implantation of an intradural Finetech-Brindley bladder stimulator

  19. Pneumorrhachis Secondary to a Sacral Decubitus Ulcer

    Directory of Open Access Journals (Sweden)

    Siamak Moayedi

    2016-06-01

    Full Text Available An elderly woman with a chronic decubitus sacral ulcer presented to the emergency department with sepsis. A computed tomography of her abdomen showed diffuse gas extending throughout the thoracolumbar spinal canal. Pneumorrhachis is a rare radiographic finding defined as gas within the spinal canal. There are many causes of pneumorrhachis ranging from trauma to infection. In this case the pneumorrhachis was caused by direct spread of gas-forming organisms from vertebral osteomyelitis. Emergency physicians should know about the implication of gas in the spinal canal in the setting of sepsis. [West J Emerg Med. 2016;17(4:466-468.

  20. [Primary genital herpes with sacral meningoradiculitis].

    Science.gov (United States)

    Carron, P-N; Anguenot, J-L; Dubuisson, J-B

    2004-02-01

    Herpetic genital infection is a common sexually transmitted disease, caused in most cases by type 2 Herpes simplex virus (HSV2). This virus is characterized by its neurotropic properties and its ability to establish latency in sacral sensory ganglions. Some cases of genital primo-infection are complicated by viral replication dissemination to neigbhoring nerve structures like meninges and radicular terminations. In such cases muco-cutaneous manifestations are associated with peripheral neurological impairment in the form of meningo-radiculitis. Physicians should be familiar with these neurological symptoms knowing that they always regress completely. The present report illustrates these complications and reviews the potential neurological implications described in the literature.

  1. Postpartum Sacral Stress Fracture: An Atypical Case Report

    Directory of Open Access Journals (Sweden)

    Andrea Speziali

    2015-01-01

    Full Text Available Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9 Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range.

  2. Recurrent meningitis in a case of congenital anterior sacral meningocele and agenesis of sacral and coccygeal vertebrae Meningite recorrente em um paciente com meningocele sacral anterior e agenesia sacral e coccigea

    Directory of Open Access Journals (Sweden)

    Carolina A. R. Funayama

    1995-12-01

    Full Text Available A rare case of recurrent meningitis due to congenital anterior sacral meningocele and agenesis of the sacral and coccygeal vertebrae is described. An autosomal dominant inheritance is demonstrated for lower cord malformation, and environmental factors (chromic acid or fumes are discussed.Um caso raro de meningite recorrente devido a meningocele sacral anterior e agenesia das vértebras sacras coccígeas é descrito. Herança autossômica dominante para malformação medular caudal é demonstrada e, possíveis fatores ambientais (ligados ao cromo, são discutidos.

  3. Four Cases of Urinary Dysfunction Associated with Sacral Herpes Zoster

    OpenAIRE

    松尾, 朋博; 大庭, 康司郎; 宮田, 康好; 井川, 掌; 酒井, 英樹

    2014-01-01

    Herpes zoster is caused by the infection of Varicella-Zoster virus. The anatomical distribution of herpes zoster in the sacral area is only6. 9%1). Moreover, the onset rate of herpes zoster with urinary dysfunction is 0.6%1). The lesion sites of herpes zoster which cause urinary dysfunction are almost lumber and sacral areas. We describe four cases of sacral herpes zoster with urinary dysfunction in this report. All patients were elderly people (66-84 years old), and all patients were adminis...

  4. Primary atypical sacral meningioma- not always benign

    International Nuclear Information System (INIS)

    Bhadra, A.K.; Casey, A.T.H.; Saifuddin, A.; Briggs, T.W.

    2007-01-01

    We present a case of an atypical recurrent meningioma of the sacrum with pulmonary metastasis in a 31-year-old man. He presented with deep-seated buttock pain and urinary hesitancy for 3 months. MRI revealed a lesion occupying the central and left side of the sacral canal at the S1-S2 level. Surgical excision of the lesion via a posterior approach was undertaken, and the patient became symptom-free post-operatively. Histology confirmed atypical meningioma. Eight months later he re-presented with similar symptoms, and MRI confirmed local recurrence. The patient underwent left hemisacrectomy. Six months later he again presented with low back pain and MRI confirmed a second local recurrence. A CT scan of the chest showed multiple lung metastases. The patient died of a severe chest infection 18 months later. (orig.)

  5. Primary atypical sacral meningioma- not always benign

    Energy Technology Data Exchange (ETDEWEB)

    Bhadra, A.K.; Casey, A.T.H.; Saifuddin, A.; Briggs, T.W. [Royal National Orthopaedic Hospital, Stanmore, London (United Kingdom)

    2007-06-15

    We present a case of an atypical recurrent meningioma of the sacrum with pulmonary metastasis in a 31-year-old man. He presented with deep-seated buttock pain and urinary hesitancy for 3 months. MRI revealed a lesion occupying the central and left side of the sacral canal at the S1-S2 level. Surgical excision of the lesion via a posterior approach was undertaken, and the patient became symptom-free post-operatively. Histology confirmed atypical meningioma. Eight months later he re-presented with similar symptoms, and MRI confirmed local recurrence. The patient underwent left hemisacrectomy. Six months later he again presented with low back pain and MRI confirmed a second local recurrence. A CT scan of the chest showed multiple lung metastases. The patient died of a severe chest infection 18 months later. (orig.)

  6. Developmental identity versus typology: Lucy has only four sacral segments.

    Science.gov (United States)

    Machnicki, Allison L; Lovejoy, C Owen; Reno, Philip L

    2016-08-01

    Both interspecific and intraspecific variation in vertebral counts reflect the action of patterning control mechanisms such as Hox. The preserved A.L. 288-1 ("Lucy") sacrum contains five fused elements. However, the transverse processes of the most caudal element do not contact those of the segment immediately craniad to it, leaving incomplete sacral foramina on both sides. This conforms to the traditional definition of four-segmented sacra, which are very rare in humans and African apes. It was recently suggested that fossilization damage precludes interpretation of this specimen and that additional sacral-like features of its last segment (e.g., the extent of the sacral hiatus) suggest a general Australopithecus pattern of five sacral vertebrae. We provide updated descriptions of the original Lucy sacrum. We evaluate sacral/coccygeal variation in a large sample of extant hominoids and place it within the context of developmental variation in the mammalian vertebral column. We report that fossilization damage did not shorten the transverse processes of the fifth segment of Lucy's sacrum. In addition, we find that the extent of the sacral hiatus is too variable in apes and hominids to provide meaningful information on segment identity. Most importantly, a combination of sacral and coccygeal features is to be expected in vertebrae at regional boundaries. The sacral/caudal boundary appears to be displaced cranially in early hominids relative to extant African apes and humans, a condition consistent with the likely ancestral condition for Miocene hominoids. While not definitive in itself, a four-segmented sacrum accords well with the "long-back" model for the Pan/Homo last common ancestor. Am J Phys Anthropol 160:729-739, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Sacral Variability in Tailless Species: Homo sapiens and Ochotona princeps.

    Science.gov (United States)

    Tague, Robert G

    2017-05-01

    Homo sapiens is variable in number of sacral vertebrae, and this variability can lead to obstetrical complication. This study uses the comparative method to test the hypothesis that sacral variability in H. sapiens is associated with absence of a tail. Three species of lagomorphs are studied: Ochotona princeps (N = 271), which is tailless, and Lepus californicus (N = 212) and Sylvilagus audubonii (N = 206), which have tails. Results show that O. princeps has (1) higher diversity index for number of sacral vertebrae (0.49) compared to L. californicus (0.25) and S. audubonii (0.26) and (2) significantly higher percentage of individuals with the species-specific nonmodal number of sacral vertebrae (43.9%) compared to L. californicus (14.2%) and S. audubonii (15.5%). Comparison of H. sapiens (N = 1,030; individuals of age 20-39 years) with O. princeps shows similarities between the species in diversity index (also 0.49 in H. sapiens) and percentage of individuals with nonmodal number of sacral vertebrae (37.3% in H. sapiens). Homeotic transformation best explains the results. H. sapiens and O. princeps show propensity for caudal shift at the sacral-caudal border (i.e., homeotic transformation of the first caudal vertebra to a sacral vertebra). Caudal and cranial shift among presacral vertebrae increases or decreases this propensity, respectively. Increase in number of sacral vertebrae in H. sapiens by homeotic transformation reduces pelvic outlet capacity and can be obstetrically hazardous. Anat Rec, 300:798-809, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Introduction of laparoscopic sacral colpopexy to a fellowship training program.

    Science.gov (United States)

    Kantartzis, Kelly; Sutkin, Gary; Winger, Dan; Wang, Li; Shepherd, Jonathan

    2013-11-01

    Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of laparoscopic sacral colpopexy to an academic urogynecology service that was not performing minimally invasive sacral colpopexies, and it also defines a surgical learning curve. The first 180 laparoscopic sacral colpopexies done by four attending urogynecologists from January 2009 to December 2011 were retrospectively analyzed. The primary outcome was operative time. Secondary outcomes included conversion to laparotomy, estimated blood loss, and intra- and postoperative complications. Linear regression was used to analyze trends in operative times. Fisher's exact test compared surgical complications and counts of categorical variables. Mean total operative time was 250 ± 52 min (range 146-452) with hysterectomy and 222 ± 45 (range 146-353) for sacral colpopexy alone. When compared with the first ten cases performed by each surgeon, operative times in subsequent groups decreased significantly, with a 6-16.3% reduction in overall times. There was no significant difference in the rate of overall complications regardless of the number of prior procedures performed (p = 0.262). Introduction of laparoscopic sacral colpopexy in a training program is safe and efficient. Reduction in operative time is similar to published learning curves in teaching and nonteaching settings. Introducing this technique does not add additional surgical risk as these skills are acquired.

  9. Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

    Directory of Open Access Journals (Sweden)

    Tatsuro Sasaji

    2016-01-01

    Full Text Available While 22 articles have reported on sacral stress fractures, it is a rare injury and its etiology is not well known. We present the case of a 16-year-old male who presented with low back pain in 2015. He was a high school soccer player with a previous history of a bilateral L5 lumbar spondylolysis in 2014. The patient refrained from soccer and wore a brace for six months. Two months after restarting soccer, he again complained of low back pain. After 1 year, a lumbar spine computed tomography revealed the bone union of the spondylolysis. At his first visit to our hospital, his general and neurological conditions were normal and laboratory data were within the normal range. Sacral coronal magnetic resonance imaging (MRI of the left sacral ala revealed an oblique lineal signal void surrounding bone marrow edema. Based on his symptoms, sports history, and MRI, he was diagnosed with a sacral stress fracture. He again refrained from soccer; his low back pain soon improved, and, after 1 year, the abnormal signal change had disappeared on sacral MRI. Recurrent low back pain case caused by a sacral stress fracture occurring after the bone union of lumbar spondylolysis is uncommon.

  10. Incidence, treatment, and survival patterns for sacral chordoma in the United States, 1974-2011

    Directory of Open Access Journals (Sweden)

    Esther Yu

    2016-09-01

    Full Text Available IntroductionSacral chordomas represent one half of all chordomas, a rare neoplasm of notochordal remnants. Current NCCN guidelines recommend surgical resection with or without adjuvant radiotherapy, or definitive radiation for unresectable cases. Recent advances in radiation for chordomas include conformal photon and proton beam radiation. We investigated incidence, treatment, and survival outcomes to observe any trends in response to improvements in surgical and radiation techniques over a near 40 year time period.Materials and Methods345 microscopically confirmed cases of sacral chordoma were identified between 1974 and 2011 from the Surveillance, Epidemiology, and End Results (SEER program of the National Cancer Institute. Cases were divided into three cohorts by calendar year, 1974-1989, 1990-1999, and 2000-2011, as well as into two groups by age less than or equal to 65 versus greater than 65 to investigate trends over time and age via Chi-square analysis. Kaplan-Meier analyses were performed to determine effects of treatment on survival. Multivariate Cox regression analysis was performed to determine predictors of overall survival.Results5-year overall survival for the entire cohort was 60.0%. Overall survival correlated significantly with treatment modality, with 44% surviving at 5 years with no treatment, 52% with radiation alone, 82% surgery alone, and 78% surgery and radiation (p<.001. Age greater than 65 was significantly associated with non-surgical management with radiation alone or no treatment (p<.001. Relatively fewer patients received radiation between 2000 and 2011 compared to prior time periods (p=.03 versus surgery, for which rates which did not vary significantly over time (p=.55. However, 5-year overall survival was not significantly different by time period. Age group and treatment modality were predictive for overall survival on multivariate analysis (p<.001. ConclusionSurgery remains an important component in the

  11. Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

    Science.gov (United States)

    Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

    2015-07-01

    Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

  12. Cost of dressings for prevention of sacral pressure ulcers.

    Science.gov (United States)

    Inoue, Kelly Cristina; Matsuda, Laura Misue

    2016-01-01

    to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil. secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00). the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment. the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.

  13. [Four cases of urinary dysfunction associated with sacral herpes zoster].

    Science.gov (United States)

    Matsuo, Tomohiro; Oba, Kojiro; Miyata, Yasuyoshi; Igawa, Tsukasa; Sakai, Hideki

    2014-02-01

    Herpes zoster is caused by the infection of Varicella-Zoster virus. The anatomical distribution of herpes zoster in the sacral area is only 6. 9%1). Moreover, the onset rate of herpes zoster with urinary dysfunction is 0.6%1). The lesion sites of herpes zoster which cause urinary dysfunction are almost lumber and sacral areas. We describe four cases of sacral herpes zoster with urinary dysfunction in this report. All patients were elderly people (66-84 years old), and all patients were administered anti-virus drugs and alpha 1-adrenergic receptor blockers. Because of urinary retention, three patients have performed clean intermittent self-catheterization (CIC) for several weeks. As the lesions of herpes zoster healed, each patient recovered from urinary dysfunction.

  14. Sacral Nerve Stimulation for Constipation: Suboptimal Outcome and Adverse Events

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Lundby, Lilli; Buntzen, Steen

    2010-01-01

    Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events.......Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events....

  15. Giant Sacral Chondrosarcoma in an Elderly Male : A Case Report

    Directory of Open Access Journals (Sweden)

    HZ Chan

    2014-03-01

    Full Text Available Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.

  16. Sacral neuromodulation in the treatment of the unstable bladder.

    Science.gov (United States)

    Bosch, J L

    1998-07-01

    Sacral neuromodulation as a treatment for urge incontinence in patients with an unstable bladder is the subject of ongoing clinical studies. Although approximately 75% of the patients treated with a permanent sacral foramen electrode implant have experienced significant improvements, it is now also clear that there is an initial failure rate of about 25%. Recent studies have pointed out the importance of improved patient selection on the basis of sex differences, urodynamic parameters and psychological factors. Also, newer forms of test stimulation and permanent electrode implantation are being explored in an effort to improve on the present results.

  17. Sacral Ewing's Sarcoma and Challenges in it's Diagnosis on MRI

    Directory of Open Access Journals (Sweden)

    Albert D'Souza

    2009-01-01

    Full Text Available A 15-yr old boy presented with low backache for 4 months associated with weakness of left lower limb. MRI of lumbosacral spine showed a sacral lesion with intraspinal and presacral soft tissue extension with neural compression. A diagnosis of tuberculosis was considered in the view of high prevalence in this part of the world, however biopsy revealed Ewing's sarcoma. Ewing's tumor of sacrum is rare, but should be suspected in low backache in children. Differential diagnosis for a sacral lesion includes tuberculosis, pyogenic osteomyelitis, lymphoma, chordoma, osteosarcoma and Ewing's sarcoma. MRI is sensitive in detecting these lesions but is nonspecific requiring histopathological examination for confirmation.

  18. Lumbosacral osteomyelitis after robot-assisted total laparoscopic hysterectomy and sacral colpopexy.

    Science.gov (United States)

    Muffly, Tyler M; Diwadkar, Gouri B; Paraiso, Marie Fidela R

    2010-12-01

    We report on the transabdominal resection of infected lumbosacral bone, synthetic mesh, and sinus tract following sacral colpopexy. A 45-year-old nulliparous patient who had undergone transvaginal mesh followed by robot-assisted sacral colpopexy presented with increasing back pain and foul-smelling vaginal drainage. An epidural abscess required surgical intervention, including diskectomy, sacral debridement, and mesh removal to drain the abscess and vaginal sinus tract. Recognized complications of open prolapse procedures also manifest following minimally invasive approaches. Osteomyelitis of the sacral promontory following sacral colpopexy may require gynecologic and neurosurgical management.

  19. The application of sacral block anesthesia in pediatric interventional therapy

    International Nuclear Information System (INIS)

    Zhong Liang; Qin Zenghui

    2009-01-01

    Objective: To discuss the management and feasibility of sacral block anesthesia in pediatric interventional therapy. Methods: A total of 80 pediatric patients were randomly and equally divided into two groups. Patients in group A received sacral block anesthesia together with basic anesthesia with propofol, while patients in group B received intravenous anesthesia with propofol. Small amount of ketamine as maintaining dose was used in both groups when needed. Results: The interventional management was successfully completed in all patients. A marked decrease in blood pressure occurred in three patients of group A receiving sacral block anesthesia. In group B receiving intravenous anesthesia, a decrease of SpO 2 to below 90 percent was seen in 8 cases, and obvious bradycardia developed in 12 cases. All these patients were treated with intravenous medication or by reducing the dose of propofol. Additional small dose of ketamine was needed in 4 patients during the procedure. Conclusion: Sacral block anesthesia combined with intravenous anesthesia is one of the effective anesthesia management schemes for pediatric interventional therapy. (authors)

  20. Perineal colostomy prolapse: a novel application of mesh sacral pexy.

    Science.gov (United States)

    Landen, S; Ursaru, D; Delugeau, V; Landen, C

    2018-01-01

    Full thickness colonic prolapse following pseudocontinent perineal colostomy has not been previously reported. Possible contributing factors include a large skin aperture at the site of the perineal stoma, the absence of anal sphincters and mesorectal attachments and the presence of a perineal hernia. A novel application of sacral pexy combined with perineal hernia repair using two prosthetic meshes is described.

  1. Sacral pressure sore reconstruction – the pedicled superior gluteal ...

    African Journals Online (AJOL)

    Pressure sore reconstruction has always been challenging. Immobile patients are prone to develop pressure sores from unre- lieved pressure on tissue over the sacral area, with shear, friction, moisture and malnutrition as contributing factors. Up to one-third of immobilised patients in long-term care facilities will develop.

  2. Acute urinary retention attributable to sacral herpes zoster.

    Science.gov (United States)

    Acheson, J; Mudd, D

    2004-11-01

    Acute urinary retention in women is uncommon. A 63 year old woman presented with suprapubic pain, a palpable bladder, and multiple grouped vesicles on the right buttock. Catheterisation showed a residual of 2000 ml. A case is reported of acute urinary retention secondary to herpes zoster infection of the sacral nerves (S2-4).

  3. Clinical results of sacral neuromodulation for chronic voiding dysfunction using unilateral sacral foramen electrodes.

    Science.gov (United States)

    Weil, E H; Ruiz-Cerdá, J L; Eerdmans, P H; Janknegt, R A; Van Kerrebroeck, P E

    1998-01-01

    The aim of this study was to determine the long-term clinical efficacy and complications of neuromodulation with a unilateral sacral foramen electrode in 36 patients with chronic voiding dysfunction. Following a positive effect of a percutaneous nerve evaluation test, patients underwent open surgery. A permanent electrode was implanted in 24 patients with urge incontinence, in 6 with urgency-frequency syndrome, and in 6 with nonobstructive urinary retention. After an average follow-up period of 37.8 months, 19 patients (52.8%) continue to benefit from the neuromodulation with a significant improvement of symptoms and urodynamic parameters. The median duration of the therapeutic effect for the total study population was longer than 60 months. No significant difference in the median duration of therapeutic effect with regard to sex, the type of voiding disorder, or the implant pulse generator was found. However, in patients with previous psychological disorders the median duration of therapeutic effect was only 12 months (P = 0.008). Complications were mild. In the group of patients in whom the therapeutic effect remains, 37 reoperations have had to be performed. We conclude that although reoperations were needed to overcome technical problems, patients can achieve lasting symptomatic improvement. Since technical changes in the equipment have reduced the number of complications, even better results can be expected in terms of the reoperation rate.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-08-01

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

  5. Combined Therapy for Distant Metastasis of Sacral Chordoma

    Directory of Open Access Journals (Sweden)

    Birol Özkal

    2015-01-01

    Full Text Available Chordomas are known as rare primary malign tumours that have formed from primitive notochord remains. Sacral chordomas grow slowly but locally and aggressively. Chordomas are locally invasive and have low tendency to metastasis and have a poor prognosis in long-term follow-up. Metastasis may be seen in a rate of 5–40% of the chordomas. Metastasis of chordomas is common in liver, lung, lymph nodes, peritoneum, and brain. The treatment approaches, including surgery, have been discussed in the literature before. Susceptibility to radiotherapy and chemotherapy is controversial in these tumours. The success of surgical treatment affects survival directly. In this report, we will report a sacral chordoma case in which an intraperitoneal distant metastasis occurred and discuss the surgical approach.

  6. Sacral Stress Fracture in an Amateur Badminton Player

    Directory of Open Access Journals (Sweden)

    Yusuke Yuasa

    2017-01-01

    Full Text Available Sacral stress fractures are rare among athletes but have been reported most frequently in long distance runners. We report herein the first case of a sacral stress fracture in an amateur badminton player. A 16-year-old, left-handed adolescent girl, who had just started to play badminton 3 months previously, complained of acute left buttock pain when she received a shuttlecock. Magnetic resonance imaging revealed a linear lesion of the left sacrum with low signal intensity on T1- and high signal intensity on T2-weighted images, which was consistent with a stress fracture. Conservative treatment with rest relieved her symptoms. Her fracture was considered to have occurred due to repetition of an exercise that caused excessive vertical power.

  7. Esqueleto pré-sacral e sacral dos lagartos teiêdeos (Squamata, Teiidae Pressacral and sacral skeleton of teiids lizards (Squamata, Teiidae

    Directory of Open Access Journals (Sweden)

    Lauren Betina Veronese

    1997-01-01

    Full Text Available The morphology of the axial skeleton -pressacral and sacral regions - of the nine genera of Teiidae Boulenger, 1885 comprising Ameiva Meyer, 1795, Callopistes Gravenhorst, 1838, Cnemidophorus Wagler, 1830, Crocodilurus Spix, 1825, Dicrodon Duméril & Bibron, 1839, Dracaena Daudin, 1802, Kenlropyx Spix, 1825, Teius Merrem, 1820 and Tupinambis Daudin, 1803 is here analysed under a comparative approach. The study is in a generic levei, and the principal conclusions reter to differences on the total number of vertebrae and some aspects of the ribs, especially their insertion and presence.

  8. Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention.

    Science.gov (United States)

    Shaker, H S; Hassouna, M

    1998-05-01

    Sacral root neuromodulation is becoming a superior alternative to the standard treatment of idiopathic nonobstructive urinary retention. We report results in 20 successive patients who underwent sacral foramen implantation to restore bladder function. After an initial, thorough baseline assessment 20 patients 19.43 to 55.66 years old with idiopathic nonobstructive urinary retention underwent percutaneous nerve evaluation. Response was assessed by a detailed voiding diary. Responders underwent implantation with an S3 foramen implant, and were followed 1, 3 and 6 months postoperatively, and every 6 months thereafter. Sacral root neuromodulation restored voiding capability in these patients. Bladders were emptied with minimal post-void residual urine, which decreased from 78.3 to 5.5 to 10.2% of the total voided volume from baseline to postoperative followup. These results were reflected in uroflowmetry and pressure-flow studies, which were almost normal after implantation. Furthermore, the urinary tract infection rate decreased significantly and associated pelvic pain improved substantially. The Beck depression inventory and SF-36 quality of life questionnaire indicated some improvement but reached significance in only 1 item. In addition, cystometrography showed no significant difference after 6 months of implantation compared with baseline values. Complications were minimal and within expectations. Sacral root neuromodulation is an appealing, successful modality for nonobstructive urinary retention. Only patients who have a good response to percutaneous nerve evaluation are candidates for implantation. The high efficacy in patients who undergo implantation, relative simplicity of the procedure and low complication rate make this a treatment breakthrough in this difficult group.

  9. Computer Navigation-aided Resection of Sacral Chordomas

    Directory of Open Access Journals (Sweden)

    Yong-Kun Yang

    2016-01-01

    Full Text Available Background: Resection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas. Methods: Between 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old (range: 35-84 years old. Tumors were located above the level of the S3 neural foramen in 23 patients and below the level of the S3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months (range: 18-84 months. Results: Mean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 mm. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 (7.7% exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 (range: 19-30. Conclusions: Computer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.

  10. [PELVIS/SACRAL syndrome with livedoid haemangioma and amniotic band].

    Science.gov (United States)

    Bourrat, E; Lemarchand-Venencie, F; Jacquemont, M-L; El Ghoneimi, A; Wassef, M; Leger, J; Morel, P

    2008-12-01

    PELVIS or SACRAL syndrome denotes the association of local haemangioma and malformation in the pelvic region. In this paper, we report a case noteworthy on account of the initially livedoid appearance of the haemangioma as well as associated amniotic banding of an upper limb. A newborn male infant underwent left colostomy on the day of birth due to anal imperforation and anomalies of the external genital organs with sexual ambiguity. Examination of the skin and appendages revealed poorly delineated hypopigmentation in the sacrolumbar region and a fibrous groove around the right arm characteristic of amniotic band syndrome. Sacrolumbar and pelvic MRI scans revealed deviation towards the left of the last three sacral vertebrae with no medullary anomalies. Retrograde cystography showed a recto-uretral fistula. Progression of the infant's condition was marked by the appearance during the first month of a flat, violaceous, angiomatous, livedoid lesion in the middle of the buttocks and the perineum and a linear lesion on the rear aspect of the right lower limb. The skin biopsy of this lesion revealed a single capillary lobule at the dermal-hypodermal junction of non-specific appearance but with marked Glut1 expression by endothelial cells highly evocative of infantile haemangioma. Segmented haemangiomas are commonly associated with extracutaneous abnormalities. By analogy with PHACE syndrome, defined as association of segmented facial haemangioma with cerebral, ocular and cardio-aortic abnormalities, PELVIS/SACRAL syndrome denotes the association of segmented haemangioma of the loins (sacrolumbar region, buttocks or perineum=napkin haemangioma) with spinal dysraphia affecting the sacrolumbar spine, the terminal medullary cone, the genitourinary organs and the anal region to different degrees. Diagnosis of haemangioma associated with PELVIS/SACRAL syndrome may be delayed or complicated due to the macular, telangiectasic or livedoid appearance commonly seen. To our

  11. Ligament-induced sacral fractures of the pelvis are possible.

    Science.gov (United States)

    Steinke, Hanno; Hammer, Niels; Lingslebe, Uwe; Höch, Andreas; Klink, Thomas; Böhme, Jörg

    2014-07-01

    Pelvic ring stability is maintained passively by both the osseous and the ligamentous apparatus. Therapeutic approaches focus mainly on fracture patterns, so ligaments are often neglected. When they rupture along with the bone after pelvic ring fractures, disrupting stability, ligaments need to be considered during reconstruction and rehabilitation. Our aim was to determine the influence of ligaments on open-book injury using two experimental models with body donors. Mechanisms of bone avulsion related to open-book injury were investigated. Open-book injuries were induced in human pelves and subsequently investigated by anatomical dissection and endoscopy. The findings were compared to CT and MRI scans of open-book injuries. Relevant structures were further analyzed using plastinated cross-sections of the posterior pelvic ring. A fragment of the distal sacrum was observed, related to open-book injury. Two ligaments were found to be responsible for this avulsion phenomenon: the caudal portion of the anterior sacroiliac ligament and another ligament running along the ventral surface of the third sacral vertebra. The sacral fragment remained attached to the coxal bone by this second ligament after open-book injury. These results were validated using plastination and the structures were identified. Pelvic ligaments are probably involved in sacral avulsion caused by lateral traction. Therefore, ligaments should to be taken into account in diagnosis of open-book injury and subsequent therapy. Copyright © 2014 Wiley Periodicals, Inc.

  12. Sacral Neuromodulation in Patients With a Cardiac Pacemaker

    Directory of Open Access Journals (Sweden)

    Abdullah A. Gahzi

    2016-09-01

    Full Text Available The objective of this study was to describe our experience using sacral neuromodulation to treat urinary urgency, frequency, urge incontinence, and chronic urinary retention in patients with cardiac pacemakers. With the increasingly widespread use of InterStim for bladder function restoration, we are seeing more complex patients with multiple comorbidities, including cardiac conditions. Herein, we report 3 cases of individuals with cardiac pacemakers who underwent InterStim implantation to treat urinary conditions. This study is a case series of 3 patients with cardiac pacemakers who underwent sacral neuromodulation to treat refractory voiding dysfunction. The initial patient screening for InterStim therapy involved percutaneous nerve evaluation (PNE, in which a temporary untined lead wire was placed through the S3 foramen. Patients who did not respond to PNE proceeded to a staged implant. All patients in this study had a greater than 50% improvement of their urinary symptoms during the initial trial and underwent placement of the InterStim implantable pulse generator (IPG. Postoperative programming was done under electrocardiogram monitoring by a cardiologist. No interference was observed between the Inter-Stim IPG and the cardiac pacemaker. In this group of patients, sacral neuromodulation in the presence of a cardiac pacemaker appears to have been safe.

  13. Comparison of Aorta-sacral Promontory Distance with Age and BMI in Female Patients Undergoing CT

    OpenAIRE

    Sneha Mary Varghese; Suresh Sukumar; Abhimanyu Pradhan

    2017-01-01

    Introduction: Sacral colpopexy is the gold standard procedure for pelvic organ prolapse. During sacral colpopexy, various complications such as haemorrhage can occur. Careful dissection of presacral space is essential to minimize complications. Aim: The aim of the study was to compare patient age and Body Mass Index (BMI) with Computed Tomography (CT) measured aorta-sacral promontory distance. Materials and Methods: From 172 samples data such as age and BMI of female patients aged 18 ye...

  14. Rectal motility after sacral nerve stimulation for faecal incontinence

    DEFF Research Database (Denmark)

    Michelsen, H B; Worsøe, J; Krogh, K

    2010-01-01

    Sacral nerve stimulation (SNS) is effective against faecal incontinence, but the mode of action is obscure. The aim of this study was to describe the effects of SNS on fasting and postprandial rectal motility. Sixteen patients, 14 women age 33-73 (mean 58), with faecal incontinence of various...... contractions, total time with cyclic rectal contractions, the number of aborally and orally propagating contractions, the number of anal sampling reflexes or rectal wall tension during contractions. Postprandial changes in rectal tone were significantly reduced during SNS (P

  15. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    International Nuclear Information System (INIS)

    Scheck, R.J.; Schramm, T.; Gloning, K.P.; Vogl, T.; Ostermayer, E.

    1995-01-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  16. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Scheck, R J [Dept. of Radiology, Univ. Muenchen (Germany); Schramm, T [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Gloning, K P [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Vogl, T [Dept. of Radiology, Univ. Muenchen (Germany); Ostermayer, E [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany)

    1995-08-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  17. Relief of fecal incontinence by sacral nerve stimulation linked to focal brain activation

    DEFF Research Database (Denmark)

    Lundby, Lilli; Møller, Arne; Buntzen, Steen

    2011-01-01

    This study aimed to test the hypothesis that sacral nerve stimulation affects afferent vagal projections to the central nervous system associated with frontal cortex activation in patients with fecal incontinence.......This study aimed to test the hypothesis that sacral nerve stimulation affects afferent vagal projections to the central nervous system associated with frontal cortex activation in patients with fecal incontinence....

  18. Extraosseous Ewing's sarcoma / primitive neuroectodermal tumor of the sacral nerve plexus

    International Nuclear Information System (INIS)

    Narula, MK; Gupta, Nishant; Anand, Rama; Kapoor, Sudhir

    2009-01-01

    We report an unusual case of Ewing's sarcoma / primitive neuroectodermal tumor (PNET) of the sacral nerve plexus in a 9-year-old boy who presented with a soft tissue swelling and severe piercing pain in the lower back region. MRI of the lumbosacral spine showed a lobulated soft tissue mass with clubbed finger-like projections along the path of the sacral nerves, which had caused widening of the spinal canal and the sacral foramina (S2–S4 level). There was presacral extension and posterior scalloping of the sacral vertebrae. Histopathology of the lesion confirmed Ewing's sarcoma / PNET of the sacral spinal nerve plexus. The patient responded favorably to chemotherapy and radiotherapy, showing clinical and radiological improvement

  19. Clinical results of a brindley procedure: sacral anterior root stimulation in combination with a rhizotomy of the dorsal roots

    NARCIS (Netherlands)

    Martens, F.M.J.; Heesakkers, J.P.F.A.

    2011-01-01

    The Brindley procedure consists of a stimulator for sacral anterior-root stimulation and a rhizotomy of the dorsal sacral roots to abolish neurogenic detrusor overactivity. Stimulation of the sacral anterior roots enables micturition, defecation, and erections. This overview discusses the technique,

  20. Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex.

    Science.gov (United States)

    Lockwood, Michael D; Kondrashova, Tatyana; Johnson, Jane C

    2015-11-01

    Identifying relationships among anatomical structures is key in diagnosing somatic dysfunction. Ultrasonography can be used to visualize anatomical structures, identify sacroiliac landmarks, and validate anatomical findings and measurements in relation to somatic dysfunction. As part of the osteopathic manipulative medicine course at A.T. Still University-Kirksville College of Osteopathic Medicine, first-year students are trained to use ultrasonography to establish relationships among musculoskeletal structures. To determine the ability of first-year osteopathic medical students to establish sacral base position (SBP) and sacral sulcus depth (SSD) using ultrasonography and to identify the relationship of SBP and SSD to body mass index (BMI) and sex. Students used ultrasonography to obtain the distance between the skin and the sacral base (the SBP) and the distance between the skin and the tip of the posterior superior iliac spine bilaterally. Next, students calculated the SSD (the distance between the tip of the posterior superior iliac spine and the SBP). Data were analyzed with respect to side of the body, BMI, sex, and age. The BMI data were subdivided into normal (18-25 mg/kg) and overweight (25-30 mg/kg) groups. Ultrasound images of 211 students were included in the study. The SBP was not significantly different between the left and right sides (36.5 mm vs 36.5 mm; P=.95) but was significantly different between normal and overweight BMI categories (33.0 mm vs 40.0 mm; Psex may point to more soft tissue overlaying the sacrum in these groups. Further research is needed on the use of ultrasonography to establish criteria for somatic dysfunction.

  1. [Sacral neuromodulation in urology - development and current status].

    Science.gov (United States)

    Schwalenberg, T; Stolzenburg, J-U; Kriegel, C; Gonsior, A

    2012-01-01

    Sacral neuromodulation (SNM) in urology is employed to treat refractory lower urinary tract dysfunction as well as chronic pelvic pain. Electrical stimulation of the sacral afferents (S2 - S4) causes activation and conditioning of higher autonomic and somatic neural structures and thereby influences the efferents controlling the urinary bladder, the rectum and their related sphincter systems. It is therefore possible to treat overactivity as well as hypocontractility and functional bladder neck obstruction. SNM treatment is conducted biphasically. Initially, test electrodes are placed to evaluate changes in micturition and pain parameters. If, in this first phase - called peripheral nerve evaluation (PNE test) - sufficient improvements are observed, the patient progresses to phase two which involves implantation of the permanent electrodes and impulse generator system. In recent years, the "two stage approach" with initial implantation of the permanent electrodes has been favoured as it increases treatment success rates. Long-term success rates of SNM vary significantly in the literature (50 - 80 %) due to heterogeneous patient populations as well as improved surgical approaches. With the introduction of "tined lead electrodes" (2002), tissue damage is reduced to a minimum. Technical innovation, financial feasibility (reimbursed in Germany since 2004) and wider application, especially in otherwise therapy-refractory patients or complex dysfunctions of the pelvis, have established SNM as a potent treatment option in urology. © Georg Thieme Verlag KG Stuttgart · New York.

  2. The sacral autonomic outflow is parasympathetic: Langley got it right.

    Science.gov (United States)

    Horn, John P

    2018-04-01

    A recent developmental study of gene expression by Espinosa-Medina, Brunet and colleagues sparked controversy by asserting a revised nomenclature for divisions of the autonomic motor system. Should we re-classify the sacral autonomic outflow as sympathetic, as now suggested, or does it rightly belong to the parasympathetic system, as defined by Langley nearly 100 years ago? Arguments for rejecting Espinosa-Medina, Brunet et al.'s scheme subsequently appeared in e-letters and brief reviews. A more recent commentary in this journal by Brunet and colleagues responded to these criticisms by labeling Langley's scheme as a historical myth perpetuated by ignorance. In reaction to this heated exchange, I now examine both sides to the controversy, together with purported errors by the pioneers in the field. I then explain, once more, why the sacral outflow should remain known as parasympathetic, and outline suggestions for future experimentation to advance the understanding of cellular identity in the autonomic motor system.

  3. CT-guided screw fixation of vertical sacral fractures in local anaesthesia using a standard CT; CT-kontrollierte Schraubenosteosynthese von vertikalen Frakturen des hinteren Beckenringes in Lokalanaesthesie

    Energy Technology Data Exchange (ETDEWEB)

    Reuther, G.; Dehne, I. [Thueringen-Klinik, Saalfeld (Germany). Radiologische Klinik; Roehner, U.; Will, T.; Petereit, U. [Thueringen-Klinik, Saalfeld (Germany). Orthopaedics and Trauma Surgery

    2014-12-15

    To evaluate time efficiency, radiation dose, precision and complications of percutaneous iliosacral screw placement under CT-guidance in local anaesthesia. Retrospective analysis of 143 interventions in 135 patients during a period of 42 months. Implant failures could be evaluated in 85/182 screws and bony healing or refracturing in 46/182 screws. A total of 182 iliosacral screw placements in 179 vertical sacral fractures (105 unilateral, 37 bilateral) took place in 135 patients. 166/179 of the sacral fractures were detected in Denis zone 1, 10 in Denis zone 2 and 3 in Denis zone 3. No screw misplacements including the simultaneous bilateral procedures were noted. The average time for a unilateral screw placement was 23 minutes (range: 14-52 minutes) and 35 minutes (range: 21-60 minutes) for simultaneous bilateral screwing. The dose length product was 365 mGy x cm (range: 162-1014 mGy x cm) for the unilateral and 470 mGy x cm (range: 270-1271 mGy x cm) for the bilateral procedure. 1 gluteal bleeding occurred as the only acute minor complication (0.7%). Fracture healing was verified with follow-up CTs in 42/46 sacral fractures after screw placement. Backing out occurred in 12/85 screws between 6 and 69 days after intervention. In 8 patients contralateral stress fractures were detected after unilateral screw placement between day 10 and 127 (average: 48 days). CT-guided iliosacral screw placement in sacral fractures is a safe tool providing a very high precision. The radiation dose is in the order of a diagnostic CT of the pelvis for both unilateral and bilateral screws. Contralateral stress fractures in unilateral screw placements have to be considered during the first weeks after intervention.

  4. The predictive value of the sacral base pressure test in detecting specific types of sacroiliac dysfunction

    Science.gov (United States)

    Mitchell, Travis D.; Urli, Kristina E.; Breitenbach, Jacques; Yelverton, Chris

    2007-01-01

    Abstract Objective This study aimed to evaluate the validity of the sacral base pressure test in diagnosing sacroiliac joint dysfunction. It also determined the predictive powers of the test in determining which type of sacroiliac joint dysfunction was present. Methods This was a double-blind experimental study with 62 participants. The results from the sacral base pressure test were compared against a cluster of previously validated tests of sacroiliac joint dysfunction to determine its validity and predictive powers. The external rotation of the feet, occurring during the sacral base pressure test, was measured using a digital inclinometer. Results There was no statistically significant difference in the results of the sacral base pressure test between the types of sacroiliac joint dysfunction. In terms of the results of validity, the sacral base pressure test was useful in identifying positive values of sacroiliac joint dysfunction. It was fairly helpful in correctly diagnosing patients with negative test results; however, it had only a “slight” agreement with the diagnosis for κ interpretation. Conclusions In this study, the sacral base pressure test was not a valid test for determining the presence of sacroiliac joint dysfunction or the type of dysfunction present. Further research comparing the agreement of the sacral base pressure test or other sacroiliac joint dysfunction tests with a criterion standard of diagnosis is necessary. PMID:19674694

  5. Bilateral chronic sacral neuromodulation for treatment of lower urinary tract dysfunction.

    Science.gov (United States)

    Hohenfellner, M; Schultz-Lampel, D; Dahms, S; Matzel, K; Thüroff, J W

    1998-09-01

    Chronic sacral neuromodulation aims at functional restoration of selected forms of nonneurogenic and neurogenic bladder dysfunction. The original technique, as described by Tanagho and Schmidt, provides unilateral sacral nerve stimulation via an implanted stimulator powering an electrode inserted into a sacral foramen. Its drawback was that the implant failed unpredictably in some patients despite previous successful percutaneous test stimulation. Therefore, we modified the stimulation technique to improve the efficacy of chronic sacral neuromodulation. Guarded bipolar electrodes powered by an implantable neurostimulator were attached bilaterally directly to the S3 nerves through a sacral laminectomy in 9 women and 2 men (mean age 43.4 years). Of the patients 5 had urinary incontinence due to detrusor hyperactivity and 6 had urinary retention from detrusor hypocontractility. Mean followup with repeated urodynamics was 13 months (range 9 to 28). Four significant complications were encountered in 4 patients. In 10 patients the urological sequelae of the neurological disorder were alleviated significantly (50% or more), including 5 who experienced complete relief of symptoms. The efficacy of chronic sacral neuromodulation can be improved by bilateral attachment of electrodes directly to the sacral nerves.

  6. MRI findings of type II sacral agenesis: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang A; Kim, Myung Soon; Kwon, Woo Cheol [Dept. of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju (Korea, Republic of)

    2016-07-15

    Sacral agenesis (or caudal regression syndrome) is a rare congenital anomaly involving various levels of coccygeal, sacral, and even lumbar or lower thoracic vertebral dysgenesis, as well as spinal cord abnormalities. A few cases have been previously reported in Korea, especially based upon MRI findings. We describe a case of a 4-year-old girl with partially bilateral agenesis of the sacrum (type II), and club-shaped (chisel-shaped) spinal cord disruption. We also review MRI findings of sacral agenesis, focused on classification and radiological findings.

  7. Medium-Term Outcome of Sacral Nerve Modulation for Constipation

    DEFF Research Database (Denmark)

    Govaert, Bastiaan; Maeda, Yasuko; Alberga, Job

    2012-01-01

    was percutaneous nerve evaluation. If this was successful, patients underwent sacral nerve modulation therapy with an implanted device (tined-lead and implantable pulse generator). MAIN OUTCOME MEASURE: Follow-up was performed at 1, 3, 6, and 12 months, and yearly thereafter. Outcome was assessed with the Wexner...... constipation score. RESULTS: A total of 117 patients (13 men, 104 women) with a mean age of 45.6 (SD, 13.0) years underwent percutaneous nerve evaluation. Of these, 68 patients (58%) had successful percutaneous nerve evaluation and underwent implantation of a device. The mean Wexner score was 17.0 (SD, 3.......8) at baseline and 10.2 (SD 5.3) after percutaneous nerve evaluation (p latest follow-up (median, 37 months; range, 4–92) was only 61 (52% of all patients who...

  8. Spatial Narrative As Feature Of Singularity In Sacral Architecture

    Directory of Open Access Journals (Sweden)

    Gytis Oržikauskas

    2014-05-01

    Full Text Available The paper analyses architectural compositions of various religious complexes – historical and contemporary – apart from their stylistic features. The most prominent ensembles under analysis have one noticeably common feature – spatial narrative. The foreseen sequence of forms of experience and spatial structure tell different religious narratives depending on which different aspects of faith were actualized in a given period. The analyzed examples stand in proof that suggestibility of religious aspects in sacral architecture are inseparable from their artistic suggestibility aspects. In some cases, these aspects are less related to architectural stylistic means, but have a direct connection to such components of architectural compositions as foreseen sequence of a visitor’s experience and semantics of particular forms, i.e. architectural narrative, which is achieved not only through the means of perception of space, but also by the relationship to social and cultural meanings and subtext of architecture.

  9. Sacral herpes-zoster infection presenting as sciatic pain.

    Science.gov (United States)

    Ablin, J; Symon, Z; Mevorach, D

    1996-06-01

    Acute herpes-zoster infection is a painful dermatomal lesion that can be manifested by a wide array of neurologic symptoms. We present a 55-year-old female with non-Hodgkin's lymphoma, who developed a left sciatic pain involving the S roots. Two weeks later, the patient developed fever and vesicular rash over the left gluteal area. Herpes-zoster infection was diagnosed and confirmed by the presence of immunoglobulin M (IgM) antibodies against varicella-zoster. The pain and rash resolved, after treatment with acyclovir. In the appropriate clinical setting, sacral herpes-zoster infection ought to be considered in the differential diagnosis of new-onset sciatic pain.

  10. Doença de Paget com acometimento sacral: relato de caso Paget's disease with sacral involvement: a case report

    Directory of Open Access Journals (Sweden)

    Fernanda Nogueira Holanda Ferreira Braga

    2010-10-01

    Full Text Available Os autores relatam o caso de um paciente do sexo masculino, 71 anos de idade, com diagnóstico de doença de Paget óssea sacral. Foi realizado estudo com radiografia, cintilografia, tomografia computadorizada e ressonância magnética, e o diagnóstico foi confirmado por análise histopatológica. O paciente evoluiu com boa resposta ao uso de ibandronato 150 mg, mensalmente, com redução significativa dos marcadores bioquímicos da doença.The authors report a case of a 71-year-old male patient diagnosed with Paget's disease of sacrum. Imaging study was performed with radiography, scintigraphy, computed tomography and magnetic resonance imaging, and the diagnosis was confirmed by biopsy. The patient progressed with a good response to monthly treatment with ibandronate 150 mg, presenting a significant reduction in biochemical markers of disease.

  11. CT-guided fixation of sacral fractures and sacrolilac joint disruptions

    International Nuclear Information System (INIS)

    Nelson, D.W.; Duwelius, P.

    1990-01-01

    Placement of sacral fixation screws at surgery is performed blindly (ie, by palpation). The authors of this paper employed CT to localize the screw between the neutral foramina and anterior sacral cortex and to decrease the morbidity associated with general anesthesia and surgery. Six patients underwent CT-guided sacral fixation performed by means of the 7.0 mm A0 cannulated screw system. All patients had reducible vertical sacral fractures or sacroiliac joint disruptions. Following placement of an epidural catheter for anesthesia, patients were scanned in the prone or decubitus position. Measurements for placement of the guide pin were made from the preliminary scans. Following CT confirmation of satisfactory guide pin placement across the fracture, the screw track was drilled, the screw length was determined, and the fixation screw was placed in position. A CT scan was obtained to evaluate the final position of the screw

  12. Selective detrusor activation by electrical sacral nerve root stimulation in spinal cord injury

    NARCIS (Netherlands)

    Rijkhoff, N. J.; Wijkstra, H.; van Kerrebroeck, P. E.; Debruyne, F. M.

    1997-01-01

    Electrical sacral nerve root stimulation can be used in spinal cord injury patients to induce urinary bladder contraction. However, existing stimulation methods activate simultaneously both the detrusor muscle and the urethral sphincter. Urine evacuation is therefore only possible using poststimulus

  13. Sacral root neuromodulation in the treatment of various voiding and storage problems.

    Science.gov (United States)

    Shaker, H; Hassouna, M M

    1999-01-01

    This paper reviews the use of sacral neuromodulation as a treatment modality for patients with bladder dysfunction. The dual functions of the urinary bladder are to act as a reservoir and to evacuate under voluntary control. Bladder dysfunction is a descriptive term describing the loss or the impairment of one or both of these functions. In the first part of the manuscript we describe the different components of sacral neuromodulation: the screening test known as percutaneous nerve evaluation (PNE), which involves screening patients who could potentially benefit from the therapy. Those who show a satisfactory response will have a permanent neuroprosthesis implanted. The technical aspects of both components of neuromodulation are described in detail, as well as the technical difficulties encountered. In the second part we present our long-term results in patients with sacral neuromodulation. Sacral neuromodulation is a safe and efficient therapeutic modality that helps patients with refractory voiding dysfunction restore their bladder function.

  14. Improving patient knowledge about sacral nerve stimulation using a patient based educational video.

    Science.gov (United States)

    Jeppson, Peter Clegg; Clark, Melissa A; Hampton, Brittany Star; Raker, Christina A; Sung, Vivian W

    2013-10-01

    We developed a patient based educational video to address the information needs of women considering sacral nerve stimulation for overactive bladder. Five semistructured focus groups were used to identify patient knowledge gaps, information needs, patient acceptable terminology and video content preferences for a patient based sacral nerve stimulation educational video. Each session was transcribed, independently coded by 2 coders and examined using an iterative method. A 16-minute educational video was created to address previously identified knowledge gaps and information needs using patient footage, 3-dimensional animation and peer reviewed literature. We developed a questionnaire to evaluate participant sacral nerve stimulation knowledge and therapy attitudes. We then performed a randomized trial to assess the effect of the educational video vs the manufacturer video on patient knowledge and attitudes using our questionnaire. We identified 10 patient important domains, including 1) anatomy, 2) expectations, 3) sacral nerve stimulation device efficacy, 4) surgical procedure, 5) surgical/device complications, 6) post-procedure recovery, 7) sacral nerve stimulation side effects, 8) postoperative restrictions, 9) device maintenance and 10) general sacral nerve stimulation information. A total of 40 women with overactive bladder were randomized to watch the educational (20) or manufacturer (20) video. Knowledge scores improved in each group but the educational video group had a greater score improvement (76.6 vs 24.2 points, p <0.0001). Women who watched the educational video reported more favorable attitudes and expectations about sacral nerve stimulation therapy. Women with overactive bladder considering sacral nerve stimulation therapy have specific information needs. The video that we developed to address these needs was associated with improved short-term patient knowledge. Copyright © 2013 American Urological Association Education and Research, Inc

  15. Distribution pattern of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males.

    Science.gov (United States)

    Nnamdi, Ibe Michael Onwuzuruike

    2013-09-01

    The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published. We treated 88 locations of this lesion in 68 males. The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthesia in knee-chest position (MECCA position). The patients were followed up for 3-6 months post-operatively. There were 88 locations in 68 males of 21-70 years of age, with 29 prolapses occurring during the age range 31-40 years, while 54 locations were on the left and 48 at L4/5. The procedures were well tolerated by all patients and there were no post-operative complications. This lesion in our series occurred mostly on the left, at the L4/5 level and peaked at 31-40 years age range. The predictability of occurrence of this disease, using side, level and age is still not feasible in males from our series.

  16. Presacral abscess as a rare complication of sacral nerve stimulator implantation.

    Science.gov (United States)

    Gumber, A; Ayyar, S; Varia, H; Pettit, S

    2017-03-01

    A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

  17. Restoration of bladder function in spastic neuropathic bladder using sacral deafferentation and different techniques of neurostimulation.

    Science.gov (United States)

    Schumacher, S; Bross, S; Scheepe, J R; Alken, P; Jünemann, K P

    1999-01-01

    Conventional sacral anterior root stimulation (SARS) results in simultaneous activation of both the detrusor muscle and the external urethral sphincter. We evaluated the possibilities of different neurostimulation techniques to overcome stimulation induced detrusor-sphincter-dyssynergia and to achieve a physiological voiding. The literature was reviewed on different techniques of sacral anterior root stimulation of the bladder and the significance of posterior rhizotomy in patients with supraconal spinal cord injury suffering from the loss of voluntary bladder control, detrusor hyperreflexia and sphincter spasm. The achievement of selective detrusor activation would improve current sacral neurostimulation of the bladder, including the principle of "poststimulus voiding". This is possible with the application of selective neurostimulation in techniques of anodal block, high frequency block, depolarizing prepulses and cold block. Nowadays, sacral deafferentation is a standard therapy in combination with neurostimulation of the bladder because in conclusion advantages of complete rhizotomy predominate. The combination of sacral anterior root stimulation and sacral deafferentation is a successful procedure for restoration of bladder function in patients with supraconal spinal cord injury. Anodal block technique and cryotechnique are excellent methods for selective bladder activation to avoid detrusor-sphincter-dyssynergia and thus improve stimulation induced voiding.

  18. Sacral neuromodulation effects on periurethral sensation and urethral sphincter activity.

    Science.gov (United States)

    Gleason, Jonathan L; Kenton, Kimberly; Greer, W Jerod; Ramm, Olga; Szychowski, Jeff M; Wilson, Tracey; Richter, Holly E

    2013-06-01

    To characterize the effect of sacral neuromodulation (SNM) on urethral neuromuscular function. Following IRB approval, women with refractory overactive bladder (OAB) underwent standardized urethral testing prior to and after Stage 1 SNM implantation. Periurethral sensation was measured using current perception thresholds (CPT). Striated urethral sphincter activity was quantified using concentric needle electromyography (CNE) and Multi-Motor Unit Action Potential (MUP) analysis software. Nonparametric analyses were used to characterize pre/post changes with intervention. Baseline CPT and CNE findings were compared between SNM responders and non-responders. Twenty-seven women were enrolled in this pilot study with a mean age of 61 ± 13 years. Twenty of 26 women (76.9%) responded to SNM and went to Stage 2 permanent implantation. Four (14.8%) withdrew after Stage 1 implantation; three of the four withdrawals had not had therapeutic responses to SNM. CPT and CNE parameters did not significantly differ from baseline 2 weeks after SNM. Pre-SNM urethral sensation was not significantly different between responders and non-responders. However, responders had larger amplitude, longer duration and more turns and phases at baseline approaching significance, reflecting more successful urethral reinnervation, than non-responders. SNM does not alter urethral neuromuscular function 2 weeks post Stage 1 implantation. Copyright © 2012 Wiley Periodicals, Inc.

  19. Pregnancy in women with Fowler's syndrome treated with sacral neuromodulation.

    Science.gov (United States)

    Khunda, Azar; Karmarkar, Roopali; Abtahi, Bahareh; Gonzales, Gwen; Elneil, Sohier

    2013-07-01

    Our aim was to determine the impact of pregnancy on sacral neuromodulation (SNM) and vice versa in patients with Fowler's syndrome (FS), which is typified by chronic urinary retention (CUR). We performed a retrospective study of pregnancy in patients with FS who underwent a two-stage SNM implantation. Data were obtained using a standard questionnaire and clinical interview. There were a total of ten patients with 13 pregnancies. The SNM was switched off in ten of the 13 pregnancies, with CUR recurring in nine of the ten pregnancies and recurrent urinary tract infections (UTI) occurring in four of these pregnancies (more than three UTI in the pregnancy). Those in whom the device was left on continued to void normally. One woman had a first trimester miscarriage, eight pregnancies went to term, and four deliveries were premature. Caesarean section was performed in eight pregnancies for obstetric reasons. Four pregnancies resulted in a vaginal delivery. There were no congenital anomalies reported. Following delivery, four of nine women experienced dysfunction of their SNM device when it was switched back on. Turing off the SNM during pregnancy results in recurrence of CUR, with an increased risk of recurrent UTI associated with preterm delivery. This did not impact foetal well-being. The option of keeping the SNM on during pregnancy should therefore be considered, and as caesarean section affects the SNM device, we advise that caesarean section should only be performed for obstetric reasons.

  20. Sacral colpopexy versus transvaginal mesh colpopexy in obese patients.

    Science.gov (United States)

    McDermott, Colleen D; Park, Jean; Terry, Colin L; Woodman, Patrick J; Hale, Douglass S

    2013-05-01

    Obesity can predispose women to pelvic organ prolapse and can also affect the success of pelvic organ prolapse surgery. The purpose of this study was to compare the postoperative anatomical outcomes following sacral colpopexy (SC) and transvaginal mesh colpopexy in a group of obese women with pelvic organ prolapse. We conducted a retrospective cohort study of obese women who underwent SC (n = 56) or transvaginal mesh colpopexy (n = 35). Follow-up ranged from 6 to 12 months. Preoperative, perioperative, and postoperative variables were compared using Student t, Mann-Whitney U, and Fisher exact tests, and by analysis of covariance. The women in the SC group had significantly higher mean apical vaginal measurements (P transvaginal mesh colpopexy group. There were no significant differences between the groups for other postoperative outcomes, including mesh erosion, recurrent prolapse symptoms, dyspareunia, and surgical satisfaction (P > 0.05). In these 91 obese patients with pelvic organ prolapse, SC resulted in better anatomical outcomes than transvaginal mesh colpopexy. However, the two procedures had similar outcomes with regard to recurrent symptoms and surgical satisfaction.

  1. [An adult case of intradural lumbo-sacral lipoma].

    Science.gov (United States)

    Hatayama, T; Sakoda, K; Tokuda, Y; Uozumi, T

    1992-10-01

    A rare case of lumbo-sacral lipoma in an adult case is reported. A 55-year-old male was admitted to the Department of Neurosurgery, Mazda Hospital, after a history of one year of urinary incontinence. Neurologically, no motor or sensory disturbance of the lower extremities was found in this patient. MRI showed a mass with high signal intensity on T2-weighted image, located between L3 to S2 vertebral segments. Metrizamide-CT scan demonstrated the outline of this hypodense mass at the same location as shown on MRI image. A L3 through L5 laminectomy was performed and the tumor was subtotally removed. Microscopic examination revealed that the tumor mass was made up of mature lipoma cells. Postoperative course of the patient was uneventful. The urinary incontinence was improved slightly. No motor or sensory deficit was found. We thought that MRI was useful for the correct diagnosis of lumbosacral lipoma. And it is best managed by operative removal of the tumor as early as possible after it is diagnosed.

  2. Clinical outcome of trans-sacral interbody fusion after partial reduction for high-grade l5-s1 spondylolisthesis.

    Science.gov (United States)

    Smith, J A; Deviren, V; Berven, S; Kleinstueck, F; Bradford, D S

    2001-10-15

    A clinical retrospective study was conducted. To evaluate the clinical and radiographic outcome of reduction followed by trans-sacral interbody fusion for high-grade spondylolisthesis. In situ posterior interbody fusion with fibula allograft has improved the fusion rates for patients with high-grade spondylolisthesis. The use of this technique in conjunction with partial reduction has not been reported. Nine consecutive patients underwent treatment of high-grade (Grade 3 or 4) spondylolisthesis with partial reduction followed by posterior interbody fusion using cortical allograft. The average age at the time of surgery was 27 years (range, 8-51 years), and the average follow-up period was 43 months (range, 24-72 months). Before surgery, eight patients had low back pain, seven patients had radiating leg pain, and five patients had hamstring tightness. The average grade of spondylolisthesis by Meyerding grading was 3.9 (range, 3-5). Charts and radiographs were evaluated, and outcomes were collected by use of the modified SRS outcomes instrument. Radiographic indexes demonstrated significant improvement with partial reduction and fusion. The slip angle, as measured from the inferior endplate of L5, improved from 41.2 degrees (range, 24-82 degrees ) before surgery to 21 degrees (range, 5-40 degrees ) after surgery. All the patients were extremely or somewhat satisfied with surgery. The two patients who underwent this operation without initial instrumentation experienced fractures of their interbody grafts. Both of these patients underwent repair of the pseudarthrosis with placement of trans-sacral pedicle screw instrumentation and subsequent fusion. Partial reduction followed by posterior interbody fusion is an effective technique for the management of high-grade spondylolisthesis in pediatric and adult patient populations, as assessed by radiographic and clinical criteria. Pedicle screw instrumentation with the sacral screws capturing L5 is recommended when this

  3. Safe Zone Quantification of the Third Sacral Segment in Normal and Dysmorphic Sacra.

    Science.gov (United States)

    Hwang, John S; Reilly, Mark C; Shaath, Mohammad K; Changoor, Stuart; Eastman, Jonathan; Routt, Milton Lee Chip; Sirkin, Michael S; Adams, Mark R

    2018-04-01

    To quantify the osseous anatomy of the dysmorphic third sacral segment and assess its ability to accommodate internal fixation. Retrospective chart review of a trauma database. University Level 1 Trauma Center. Fifty-nine patients over the age of 18 with computed tomography scans of the pelvis separated into 2 groups: a group with normal pelvic anatomy and a group with sacral dysmorphism. The sacral osseous area was measured on computed tomography scans in the axial, coronal, and sagittal planes in normal and dysmorphic pelves. These measurements were used to determine the possibility of accommodating a transiliac transsacral screw in the third sacral segment. In the normal group, the S3 coronal transverse width averaged 7.71 mm and the S3 axial transverse width averaged 7.12 mm. The mean S3 cross-sectional area of the normal group was 55.8 mm. The dysmorphic group was found to have a mean S3 coronal transverse width of 9.49 mm, an average S3 axial transverse width of 9.14 mm, and an S3 cross-sectional area of 77.9 mm. The third sacral segment of dysmorphic sacra has a larger osseous pathway available to safely accommodate a transiliac transsacral screw when compared with normal sacra. The S3 segment of dysmorphic sacra can serve as an additional site for screw placement when treating unstable posterior pelvic ring fractures.

  4. Critical Anatomy Relative to the Sacral Suture: A Postoperative Imaging Study After Robotic Sacrocolpopexy.

    Science.gov (United States)

    Crisp, Catrina C; Herfel, Charles V; Pauls, Rachel N; Westermann, Lauren B; Kleeman, Steven D

    2016-01-01

    This study aimed to characterize pertinent anatomy relative to the sacral suture placed at time of robotic sacrocolpopexy using postoperative computed tomography and magnetic resonance imaging. A vascular clip was placed at the base of the sacral suture at the time of robotic sacrocolpopexy. Six weeks postoperatively, subjects returned for a computed tomography scan and magnetic resonance imaging. Ten subjects completed the study. The middle sacral artery and vein coursed midline or to the left of midline in all the subjects. The left common iliac vein was an average of 26 mm from the sacral suture. To the right of the suture, the right common iliac artery was 18 mm away. Following the right common iliac artery to its bifurcation, the right internal iliac was on average 10 mm from the suture. The bifurcations of the inferior vena cava and the aorta were 33 mm and 54 mm further cephalad, respectively.The right ureter, on average, was 18 mm from the suture. The thickness of the anterior longitudinal ligament was 2 mm.The mean angle of descent of the sacrum was 70 degrees. Lastly, we found that 70% of the time, a vertebral body was directly below the suture; the disc was noted in 30%. We describe critical anatomy surrounding the sacral suture placed during robotic sacrocolpopexy. Proximity of both vascular and urologic structures within 10 to 18 mm, as well as anterior ligament thickness of only 2 mm highlights the importance of adequate exposure, careful dissection, and surgeon expertise.

  5. The analysis of the effective of preserving sacral nerve root during surgical treatment of chordoma

    International Nuclear Information System (INIS)

    Ji Yiming; Chen Kangwu; Yang Huilin; Zhu Lifan

    2010-01-01

    Objective: To analyze the effective of preserving sacral nerve root during surgical treatment of sacral chordoma. Methods: This retrospective study included 30 cases of sacral chordomas. All the cases were operated with posterior approach. The blood loss and blood transfusion during operation, the drainged blood after operation were reviewed. The sphincter muscle function of bladder and bowl were observed. Results: Tremendous reduction of blood loss during surgery was found in all cases, the blood loss was 1280 ml in average, the blood transfusion was 1080 ml in average, the drainged blood after ope-ration was 650 ml. Nine patients whose sacral nerve roots had been reserved bilaterally at and above S 3 level, the sphincter muscle function of bladder and bowl was good, whereas the function of sphincter muscle impaired in the other 21 patients and in one case colostomy and ureterocutaneostomy were used. Conclusion: Preoperative arterial embolization is effective method and can lead to excellent results. Even if the tumor is relatively huge and the upper resection margin is as high as at S 1 or S 2 level, the tumor can be removed successfully by posterior approach. Sacral nerve should be preserved as possible. (authors)

  6. Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome.

    Science.gov (United States)

    Eftaiha, S M; Balachandran, B; Marecik, S J; Mellgren, A; Nordenstam, J; Melich, G; Prasad, L M; Park, J J

    2017-10-01

    Sacral nerve stimulation has become a preferred method for the treatment of faecal incontinence in patients who fail conservative (non-operative) therapy. In previous small studies, sacral nerve stimulation has demonstrated improvement of faecal incontinence and quality of life in a majority of patients with low anterior resection syndrome. We evaluated the efficacy of sacral nerve stimulation in the treatment of low anterior resection syndrome using a recently developed and validated low anterior resection syndrome instrument to quantify symptoms. A retrospective review of consecutive patients undergoing sacral nerve stimulation for the treatment of low anterior resection syndrome was performed. Procedures took place in the Division of Colon and Rectal Surgery at two academic tertiary medical centres. Pre- and post-treatment Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores were assessed. Twelve patients (50% men) suffering from low anterior resection syndrome with a mean age of 67.8 (±10.8) years underwent sacral nerve test stimulation. Ten patients (83%) proceeded to permanent implantation. Median time from anterior resection to stimulator implant was 16 (range 5-108) months. At a median follow-up of 19.5 (range 4-42) months, there were significant improvements in Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores (P syndrome and may therefore be a viable treatment option. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  7. Intrapartum sacral stress fracture due to pregnancy-related osteoporosis: a case report.

    Science.gov (United States)

    Oztürk, Gülcan; Külcü, Duygu Geler; Aydoğ, Ece

    2013-01-01

    Low back pain (LBP) and hip pain frequently occur during pregnancy and postpartum period. Although pelvic and mechanic lesions of the soft tissues are most responsible for the etiology, sacral fracture is also one of the rare causes. A 32-year-old primigravid patient presented with LBP and right hip pain which started 3 days after vaginal delivery. Although direct radiographic examination was normal, magnetic resonance imaging of the sacrum revealed sacral stress fracture. Lumbar spine and femoral bone mineral density showed osteoporosis as a risk factor. There were no other risk factors such as trauma, excessive weight gain, and strenuous physical activity. It is considered that the patient had sacral fatigue and insufficiency fracture in intrapartum period. The patient's symptoms subsided in 3 months after physical therapy and rest. In conclusion, sacral fractures during pregnancy and postpartum period, especially resulting from childbirth, are very rare. To date, there are two cases in the literature. In cases who even do not have risk factors related to vaginal delivery such as high birth weight infant and the use of forceps, exc., sacral fracture should be considered in the differential diagnosis of LBP and hip pain started soon after child birth. Pregnancy-related osteoporosis may lead to fracture during vaginal delivery.

  8. Transsacral colon fistula: late complication after resection, irradiation and free flap transfer of sacral chondrosarcoma

    Directory of Open Access Journals (Sweden)

    Schildhauer Thomas A

    2008-11-01

    Full Text Available Abstract Background Primary sacral tumors are rare and experience related to accompanying effects of these tumors is therefore limited to observations on a small number of patients. Case presentation In this case report we present a patient with a history of primary sacral chondrosarcoma, an infection of an implanted spinal stabilization device and discuss the challenges that resulted from a colonic fistula associated with large, life threatening abscesses as late complications of radiotherapy. Conclusion In patients with sacral tumors enterocutaneous fistulas after free musculotaneous free flaps transfer are rare and can occur in the setting of surgical damage followed by radiotherapy or advanced disease. They are associated with prolonged morbidity and high mortality. Identification of high-risk patients and management of fistulas at an early stage may delay the need for subsequent therapy and decrease morbidity.

  9. Retention of urine and sacral paraesthesia in anogenital herpes simplex infection.

    Science.gov (United States)

    Edis, R H

    1981-01-01

    Two definite and 2 probable cases of anogenital herpes simplex and sacral radiculitis are described. Symptoms were typical and consisted of paraesthesia and neuralgic pain in the perineum and legs, urinary retention and constipation occurring within several days to a week after an anogenital herpetic eruption. However, at presentation only 1 case had an obvious history of anogenital herpes simplex. Neurological signs were not striking and consisted of a reduced appreciation of light touch and pin prick over the sacral dermatomes and in 2 cases reduced anal sphincter tone. CSF examination in 3 patients showed a lymphocytosis. Bladder catheterisation was required for up to 2 weeks in 2 patients. The paraesthesia persisted for weeks to months. It should be more widely recognised that anogenital herpes simplex, with sacral radiculitis, is probably the commonest cause of acute retention of urine in young sexually active people.

  10. Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury

    DEFF Research Database (Denmark)

    Zaer, Hamed; Rasmussen, Mikkel Mylius

    2018-01-01

    Spinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual d...

  11. Detection of neurological deficits by computed tomography in sacral fracture patients

    International Nuclear Information System (INIS)

    Nakai, Daisuke; Numazaki, Shin; Katsumura, Tetsu; Tamaru, Tomohiko; Sugiyama, Mitsugi; Nakamura, Jun-ichiro; Saitoh, Tomoyuki

    2006-01-01

    The purpose of this study is to evaluate the correlation between sacral fractures and neurological deficits as complications. From November 2002 to February 2005, 12 patients (15 fractures) were found to have sacral fractures without other spinal injuries or brain injuries and were evaluated by plain CT scans immediately after trauma. This group included 6 males and 6 females, whose age ranged from 17 to 67 years with mean of 39.9±17.4. All patients were classified according to AO (Arbeitsgemeinschaft fuer Osteosynthesefragen) classification (pelvic ring fracture) and Denis's classification. Displacements of sacral fractures were evaluated by plain CT scans for all patients. We defined displacements using the key slice in CT scans that included the first foramen in the sacrum. Five cases, including 2 with bi-lateral sacral fractures, were complicated with neurological deficits. There was one case with a neurological deficit of 7 Type B fractures (14%) and 4 cases with neurological deficits of 5 Type C fractures (80%) in the AO classification. There were 6 fractures with neurological deficits of 12 Zone II fractures (50%) and one fracture with neurological deficits of one Zone III fractures (100%) in Denis's classification. There was a significant correlation between the extent in the displacement of the sacral fractures and neurological deficits. For more than 3 mm displacements in the medial or lateral or anterior directions, neurological deficits increased significantly. In emergency medicine, it is difficult to evaluate the neurological findings of patients with impaired consciousness. Our evaluation using CT scan is valuable as a predictor of neurological deficits and for an optimal reduction in sacral fractures in patients with in impaired consciousness. (author)

  12. Jogger's fracture and other stress fractures of the lumbo-sacral spine

    International Nuclear Information System (INIS)

    Abel, M.S.

    1985-01-01

    The posterior rings of the lower lumbo-sacral vertebrae are subject to stress fractures at any part - pedicle, pars, or lamina. The site of fracture is apparently determined by the axis of weight bearing. The three illustrative clinical examples cited include a jogger with a laminar fracture, a ballet dancer with pedicle fractures, and a nine-year-old boy with fractures of pars and lamina. Chronic low back pain is the typical complaint with stress fractures of the lower lumbo-sacral spine. Special imaging techniques are usually needed to demonstrate these lesions, including vertebral arch views, multi-directional tomography, and computed tomography (CT). (orig.)

  13. Sacral insufficiency fractures: an easily overlooked cause of back pain in the ED.

    LENUS (Irish Health Repository)

    Galbraith, John G

    2011-03-01

    Sacral insufficiency fractures are an important and treatable cause of severe back pain. Despite publication of several case reports since its original description in 1982, awareness of these injuries remains inadequate in emergency medicine. Most patients are elderly women presenting with intractable lower back pain. Postmenopausal osteoporosis is the most significant risk factor. Marked sacral tenderness is common. Neurologic impairment is rarely detectable. Routine radiography of the spine and pelvis is usually inconclusive. Computed tomography remains the diagnostic modality of choice. Treatment is usually conservative.

  14. Diffusion tensor MRI and fiber tractography of the sacral plexus in children with spina bifida

    DEFF Research Database (Denmark)

    Haakma, Wieke; Dik, Pieter; ten Haken, Bennie

    2014-01-01

    anatomical and microstructural properties of the sacral plexus of patients with spina bifida using diffusion tensor imaging and fiber tractography. MATERIALS AND METHODS: Ten patients 8 to 16 years old with spina bifida underwent diffusion tensor imaging on a 3 Tesla magnetic resonance imaging system...... diffusivity values at S1-S3 were significantly lower in patients. CONCLUSIONS: To our knowledge this 3 Tesla magnetic resonance imaging study showed for the first time sacral plexus asymmetry and disorganization in 10 patients with spina bifida using diffusion tensor imaging and fiber tractography...

  15. Rectal ulcer in a patient with VZV sacral meningoradiculitis (Elsberg syndrome).

    Science.gov (United States)

    Matsumoto, Hideyuki; Shimizu, Takahiro; Tokushige, Shin-ichi; Mizuno, Hideo; Igeta, Yukifusa; Hashida, Hideji

    2012-01-01

    This report describes the case of a 55-year-old woman with varicella-zoster virus (VZV) sacral meningoradiculitis (Elsberg syndrome) who presented with herpes zoster in the left S2 dermatome area, urinary retention, and constipation. Lumbar magnetic resonance imaging showed the left sacral nerve root swelling with enhancement. Thereafter, she suddenly showed massive hematochezia and hemorrhagic shock because of a rectal ulcer. To elucidate the relation between Elsberg syndrome and rectal ulcer, accumulation of similar cases is necessary. To avoid severe complications, attention must be devoted to the possibility of rectal bleeding in the early stage of Elsberg syndrome.

  16. U-shaped sacral fractures: Surgical treatment and quality of life

    NARCIS (Netherlands)

    Gribnau, A. J. G.; Boele van Hensbroek, P.; Haverlag, R.; Ponsen, K. J.; Been, H. D.; Goslings, J. C.

    2009-01-01

    Background: U-shaped sacral fractures are rare and highly unstable pelvic ring fractures. They are not recognised in the standard classification systems of these fractures. The fracture pattern is associated with significant neurological injury and can lead to progressive deformity and chronic pain

  17. The influence of sacral nerve stimulation on gastrointestinal motor function in patients with fecal incontinence

    DEFF Research Database (Denmark)

    Damgaard, M; Thomsen, F G; Sørensen, Michael

    2011-01-01

    Sacral nerve stimulation (SNS) is a well-established treatment for fecal incontinence of various etiologies. However, the mechanism of action remains unclear. The aim of the present study was to determine whether SNS affects gastric emptying, small intestinal transit or colonic transit times....

  18. Sacral pseudotumor complicating iliac bone harvest: radiographic, CT and MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.; Roth, C.; O' Connell, M.; Eustace, S. [Dept. of Radiology, Mater Misericordiae Hospital, Dublin (Ireland)

    2003-12-01

    We present the imaging appearances of a lytic pseudotumor in the right sacral ala presenting with referred pain to the right thigh. Subsequent imaging revealed the presence of a cystic lesion arising at the site of previous bone graft harvest; CT-guided aspiration yielded synovial fluid presumed to arise from the contiguous sacroiliac joint. (orig.)

  19. Subarachnoid and basal cistern navigation through the sacral hiatus with guide wire assistance.

    Science.gov (United States)

    Layer, Lauren; Riascos, Roy; Firouzbakht, Farhood; Amole, Adewumi; Von Ritschl, Rudiger; Dipatre, Pier; Cuellar, Hugo

    2011-07-01

    Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis and treatment of intraspinal and intracranial lesions. The most common approach, lumbar puncture, has allowed access to the spinal cord, however, coming with the difficulties of fiberscope damage and decreased torque for guidance. Our objective in this study is to allow an alternate access, the sacral hiatus, with guide wire assistance into the subarachnoid and intracranial structures, while easing the angle of entry and increasing torque. We advanced catheters with guide wire and fluoroscopy assistance into the sacral hiatus of three cadavers. After entry, the thecal sac was punctured and the catheter with guide wire was advanced rostrally until positioned in the basal cisterns of the brain. We confirmed catheter placement with contrast injection, autopsy, and dissection. In our study, the sacral hiatus was easily accessed, but resistance was found when attempting to puncture the thecal sac. The advancement of the catheter with guide wire assistance glided easily rostrally until some mild resistance was discovered at entry into the foramen magnum. With redirection, all catheters passed with ease into the basal cisterns. Positioning was confirmed with contrast injection with fluoroscopy evidence, autopsy, and dissection. There was no macroscopic or microscopic evidence of damage to the spinal roots, spinal cord, or cranial nerves. The sacral hiatus with guide wire assistance is an accessible conduit for uncomplicated entry into the subarachnoid and basal cistern space without damaging surrounding structures.

  20. Selective stimulation of sacral nerve roots for bladder control: a study by computer modeling

    NARCIS (Netherlands)

    Rijkhoff, N. J.; Holsheimer, J.; Koldewijn, E. L.; Struijk, J. J.; van Kerrebroeck, P. E.; Debruyne, F. M.; Wijkstra, H.

    1994-01-01

    The aim of this study was to investigate theoretically the conditions for the activation of the detrusor muscle without activation of the urethral sphincter and afferent fibers, when stimulating the related sacral roots. Therefore, the sensitivity of excitation and blocking thresholds of nerve

  1. Dual-dermal-barrier fashion flaps for the treatment of sacral pressure sores.

    Science.gov (United States)

    Hsiao, Yen-Chang; Chuang, Shiow-Shuh

    2015-02-01

    The sacral region is one of the most vulnerable sites for the development of pressure sores. Even when surgical reconstruction is performed, there is a high chance of recurrence. Therefore, the concept of dual-dermal-barrier fashion flaps for sacral pressure sore reconstruction was proposed. From September 2007 to June 2010, nine patients with grade IV sacral pressures were enrolled. Four patients received bilateral myocutaneous V-Y flaps, four patients received bilateral fasciocutaneous V-Y flaps, and one patient received bilateral rotation-advanced flaps for sacral pressure reconstruction. The flaps were designed based on the perforators of the superior gluteal artery in one patient's reconstructive procedure. All flaps' designs were based on dual-dermal-barrier fashion. The mean follow-up time was 16 months (range = 12-25). No recurrence was noted. Only one patient had a complication of mild dehiscence at the middle suture line, occurring 2 weeks after the reconstructive surgery. The dual-dermal fashion flaps are easily duplicated and versatile. The study has shown minimal morbidity and a reasonable outcome.

  2. Surface localization of sacral foramina for neuromodulation of bladder function. An anatomical study.

    Science.gov (United States)

    Hasan, S T; Shanahan, D A; Pridie, A K; Neal, D E

    1996-01-01

    A method is described for percutaneous localization of the sacral foramina, for neuromodulation of bladder function. We carried out an anatomical study of 5 male and 5 female human cadaver pelves. Using the described surface markings, needles were placed percutaneously into all sacral foramina from nine different angles. Paths of needle entry were studied by subsequent dissection. We observed that although it was possible to enter any sacral foramen at a wide range of insertion angles, the incidence of nerve root/vascular penetration increased with increasing angle of needle entry. Also, the incidence of nerve root penetration was higher with the medial approach compared with lateral entry. The insertion of a needle into the S1 foramen was associated with a higher incidence of nerve root penetration and presents a potential for arterial haemorrhage. On the other hand the smaller S3 and S4 nerve roots were surrounded by venous plexuses, presenting a potential source of venous haemorrhage during procedures. Our study suggests a new method for identifying the surface markings of sacral foramina and it describes the paths of inserted needles into the respective foramina. In addition, it has highlighted some potential risk factors secondary to needle insertion.

  3. Sacral electrical neuromodulation as an alternative treatment option for lower urinary tract dysfunction.

    Science.gov (United States)

    Grünewald, Volker; Höfner, Klaus; Thon, Walter F.; Kuczyk, Markus A.; Jonas, Udo

    1999-01-01

    Temporary electrical stimulation using anal or vaginal electrodes and an external pulse generator has been a treatment modality for urinary urge incontinence for nearly three decades. In 1981 Tanagho and Schmidt introduced chronic electrical stimulation of the sacral spinal nerves using a permanently implanted sacral foramen electrode and a battery powered pulse generator for treatment of different kinds of lower urinary tract dysfunction, refractory to conservative treatment. At our department chronic unilateral electrical stimulation of the S3 sacral spinal nerve has been used for treatment of vesi-courethral dysfunction in 43 patients with a mean postoperative follow up of 43,6 months. Lasting symptomatic improvement by more than 50 % could be achieved in 13 of 18 patients with motor urge incontinence (72,2 %) and in 18 of the 21 patients with urinary retention (85,7 %). Implants offer a sustained therapeutic effect to treatment responders, which is not achieved by temporary neuromodulation. Chronic neuromodulation should be predominantly considered in patients with urinary retention. Furthermore in patients with motor urge incontinence, refusing temporary techniques or in those requiring too much effort to achieve a sustained clinical effect. Despite high initial costs chronic sacral neuromodulation is an economically reasonable treatment option in the long run, when comparing it to the more invasive remaining therapeutic alternatives.

  4. Neurological presentations, imaging, and associated anomalies in 50 patients with sacral agenesis.

    Science.gov (United States)

    Emami-Naeini, Parisa; Rahbar, Ziba; Nejat, Farideh; Kajbafzadeh, Abdolmohammad; El Khashab, Mostafa

    2010-10-01

    Sacral agenesis is an uncommon congenital disorder that involves multiple organs. We studied neurological manifestations of the disease, common associated disorders, and their relation with extent of bony malformation. We investigated neurological manifestations of 50 patients with sacral agenesis. Patients were evaluated for previous procedures, ambulation, limb abnormalities, vertebral alignment, recurrent urinary tract infection, urinary incontinence, dribbling, dimple, lower extremities weakness, myelomeningocele (MMC), and lipomyelomenangocele. Weakness of lower extremities was seen in 37 (74%) patients. Concurrent weakness of proximal and distal muscles of the lower limb was statistically associated with a type of bony aplasia (P = .001). However, paraplegia was seen in only 2 of 44 children over the age of 1, and the rest could walk. Myelodysplastic syndromes were seen in 21 patients. Sacral agenesis is diagnosed in children with concomitant MMC at younger ages and reveals more severe symptoms. Progression of neurological disorders was seen in 19 patients, in all of whom MRI showed tethering of the spinal cord. Urinary disorders including diurnal urinary incontinence (in 30 of 35 children over age 4) and recurrent urinary tract infections (in 37) were also common. Imperforate anus was seen in 11 patients. Twelve children over age 4 reported fecal incontinence, a problem that had statistically significant association with imperforate anus (P = .013). Different disorders can concurrently affect patients with sacral agenesis that may have profound impressions on patients and their families. Early diagnosis, thorough evaluation, and proper intervention are of utmost importance as they can prevent or lessen future complications.

  5. Postoperative Issues of Sacral Nerve Stimulation for Fecal Incontinence and Constipation: A Systematic Literature Review and Treatment Guideline

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Matzel, Klaus; Lundby, Lilli

    2011-01-01

    BACKGROUND: There is a lack of knowledge on the incidence and management of suboptimal therapeutic effect and the complications associated with sacral nerve stimulation for fecal incontinence and constipation. OBJECTIVE: This study aimed to review current literature on postoperative issues...... and to propose a treatment algorithm. DATA SOURCE: PubMed, MEDLINE, and EMBASE were searched using the keywords “sacral nerve stimulation,” “sacral neuromodulation,” “fecal incontinence,” and “constipation” for English-language articles published from January 1980 to August 2010. A further search was conducted...

  6. 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

  7. Evaluation of Partial Cut-out of Sacroiliac Screws From the Sacral Ala Slope via Pelvic Inlet and Outlet View.

    Science.gov (United States)

    Zhang, Jingwei; Hamilton, Ryan; Li, Ming; Ebraheim, Nabil A; He, Xianfeng; Liu, Jiayong; Zhu, Limei

    2015-12-01

    An anatomic and radiographic study of placement of sacroiliac screws. The aim of this study was to quantitatively assess the risk of partial cut-out of sacroiliac screws from the sacral ala slope via inlet and outlet view. The partial cut-out of sacroiliac screws from the superior surface of sacral ala can jeopardize the L5 nerve root, which is difficult to identify on the pelvic inlet and outlet views. Computed tomography images of 60 patients without pelvic ring deformity or injury were used to measure the width (on inlet view) and height (on outlet view) of the sacral ala. The angle of the sacral ala slope was measured on lateral view. According to the measured parameters, the theoretical safe trajectories of screw placement were calculated using inverse trigonometric functions. Under fluoroscopic guidance, a sacroiliac screw was placed close to the midline on both inlet and outlet views, including posterosuperior, posteroinferior, anterosuperior, and anteroinferior regions to the midline. The incidence of screw partial cut-out from the superior surface of sacral ala was identified. The measured widths and heights of the sacral alas were 28.1 ± 2.8 and 29.8 ± 3.1 mm, respectively. The average angle between the superior aspect of the S1 vertebral body and the superior aspect of the sacral ala was 37.2 ± 2.5 degrees. The rate of partial cut-out of the screws from the superior surface of sacral ala slope was 12.5% (5/40) in posterosuperior, 0% (0/40) in posteroinferior, 70% (28/40) in anterosuperior, and 20% (8/40) in anteroinferior. To avoid the risk of partial cut-out from sacroiliac screw placement, more precise description should be added to the conventional description: the sacroiliac screws should be placed at the inferior half portion on outlet view and at the posterior half portion on inlet view. 4.

  8. Imaging Findings of Pelvic Tumor Thrombosis Extending from Sacral Bone Metastasis of Adrenocortical Carcinoma

    Directory of Open Access Journals (Sweden)

    Kenichiro Ishida

    2012-01-01

    Full Text Available We report the imaging findings of a patient with adrenocortical carcinoma who showed pelvic tumor thrombosis extending from sacral bone metastasis. Contrast-enhanced computed tomography demonstrated extensive intraluminal filling defects in the pelvic veins. A lytic lesion in the sacrum was also noted and continuity between the sacral lesion and the filling defect in the branch of pelvic veins was indicated. The filling defects showed increased uptake on positron emission tomography with 18F-fluorodeoxyglucose and single-photon emission computed tomography with 131I-iodomethylnorcholesterol, and fusion images with computed tomography aided the localization of the increased uptake areas. Multimodality imaging may be beneficial for the characterization and localization of lesions in patients suspected of having metastatic adrenocortical carcinoma.

  9. Rare location of spondylitis tuberculosis;atlanto-axial, sacral and cervico-thoracic junction

    Science.gov (United States)

    Victorio; Nasution, M. D.; Ibrahim, S.; Dharmajaya, R.

    2018-03-01

    Three cases of rare location spondylitis tuberculosis are reported, each in atlantoaxial, cervico-thoracic junction,and sacral. The complaints were aweakness of motoric strength and local back pain. Patients’thoracal x-ray was normal, there was no complaint of acough, PCR forTB was early diagnostic and positive in all three cases, HIV negative, intraoperative tissue samplings were sent for histopathology examination and the results showed thespecific inflammatory process. Lesions were evaluated with computer tomography and/or MRI imaging.Preoperative TB regimens therapy were given for 2 weeks and continued for nine months. The surgical procedurewas done in all cases with excellent improvement of symptoms and motoric strength. In our institution,25 cases of total TB spondylitis were performed in 2 years, only 1 case eachwas found in atlanto-axial, cervico-thoracic and sacral.

  10. Sacral myeloradiculitis complicating genital herpes in a HIV-infected patient.

    Science.gov (United States)

    Corral, I; Quereda, C; Navas, E; Pérez-Elias, M J; Jover, F; Moreno, S

    2005-02-01

    Myeloradiculitis is a rare neurological complication of herpes simplex type 2 (HSV-2) infection, frequently associated with a fatal outcome. Among patients with HIV infection, HSV-2 myeloradiculitis has occasionally been reported, always associated with advanced immunosuppression and AIDS. We report a patient with HIV infection but no history of previous opportunistic infections, who developed sacral myeloradiculitis immediately after an episode of genital herpes. Magnetic resonance imaging with gadolinium showed necrotizing myelitis in the conus medullaris and enhancement of sacral roots. CD4 lymphocyte count was 530/mm3. Other possible causes of myeloradiculitis in HIV-infected patients were appropriately excluded. Acyclovir therapy resulted in partial clinical improvement. This report shows that myeloradiculitis as a complication of genital herpes may occur in the early stages of HIV infection and may have a favourable outcome with antiviral treatment.

  11. Descrição do esqueleto axial de Liolaemus arambarensis Verrastro, Veronese, Bujes & Dias Filho (Iguania, Liolaemidae: regiões pré-sacral e sacral Description of the axial skeleton of Liolaemus arambarensis Verrastro et al. (Iguania, Liolaemidae: pre-sacral and sacral regions

    Directory of Open Access Journals (Sweden)

    Caroline M. da Silva

    2007-03-01

    Full Text Available Liolaemus arambarensis Verrastro, Veronese, Bujes & Dias Filho, 2003 (Iguania, Liolaemidae é um pequeno lagarto de areia, que vive nos ambientes de restingas da Laguna dos Patos. A descrição do esqueleto desta espécie pode elucidar algumas relações filogenéticas em relação a outras espécies do gênero. Tendo por objetivo a descrição das regiões pré-sacral e sacral do esqueleto axial de L. arambarensis, foram analisados sete exemplares da espécie. Observou-se que a maior estrutura axial é a coluna vertebral, que é dividida nas regiões: cervical, dorsal, sacral e caudal. A região cervical possui oito vértebras, e as costelas aparecem a partir da quarta vértebra. A região dorsal é dividida em: torácica, com cinco vértebras portando costelas unidas ao esterno; e pós-torácica, com 11 vértebras portando costelas livres. Segue-se a região sacral com duas vértebras fusionadas, que portam processos transversos fortemente expandidos lateralmente. O esterno de L. arambarensis constitui-se de uma placa cartilaginosa calcificada que se comunica com a região torácica da coluna vertebral e com a cintura escapular. Em vista do descrito anteriormente, pode-se dizer que L. arambarensis apresenta os padrões de esqueleto axial descritos para espécies de sua família e gênero.Liolaemus arambarensis Verrastro, Veronese, Bujes & Dias Filho, 2003 (Iguania: Liolaemidae is a small sand lizard that inhabits restingas in the Patos Lagoon, Southern Brazil. The description of the skeleton in this species could give some insights about the phylogenetic relationships with other species of the genus. With the main goal of describing the pre-sacral and sacral regions of the axial skeleton of L. arambarensis, a total of seven individuals were analyzed. It was observed that the largest axial structure is the vertebral column that is divided into four regions: cervical, dorsal, sacral and caudal. The cervical region presents eight vertebra and the

  12. Evidence to justify retention of transvaginal mesh: comparison between laparoscopic sacral colpopexy and transvaginal Elevate™ mesh.

    Science.gov (United States)

    To, Valérie; Hengrasmee, Pattaya; Lam, Alan; Luscombe, Georgina; Lawless, Anna; Lam, Justin

    2017-12-01

    To determine if laparoscopic sacral colpopexy (LSC) offers better apical support with a lower exposure rate than transvaginal mesh surgery with Elevate™. This was a retrospective cohort study comparing patients with apical prolapse (POP-Q point C ≥ -1) who underwent Elevate™ mesh repair (n = 146) with patients who underwent laparoscopic sacral colpopexy (n = 267). The sacral colpopexy group had a mean age of 59 years and a BMI of 25.7. Patients in the Elevate™ group were older, with a mean age of 63 and a BMI of 26.3. Most of the patients of both groups presented with pelvic organ prolapse stage III (LSC 73.8% and Elevate™ 87.0%) and their mean POP-Q point C were not significantly different (LSC 1.4 vs Elevate™ 1.2 cm). Operative time was longer in the LSC group (113 vs 91 min, p < 0.001), but estimated blood loss was lower (75 cm 3 vs 137 cm 3 , p < 0.001). No difference in mesh exposure rate could be found between the two groups at one year (Elevate™ 0.7% vs LSC 2.6%, OR 0.26, 95% CI 0.03 to 2.10, p = 0.21). One-year objective cure rate, defined as no descent beyond the hymen, was 97.0% in the LSC group and 96.6% in the Elevate™ group (p = .81). The overall recurrence (objective, subjective recurrence or reoperation) was also not different between the groups (LSC 4.5% vs Elevate 4.8%, p = 0.89). Transvaginal Elevate™ mesh delivers comparable apical support with a low exposure rate similar to that of laparoscopic sacral colpopexy.

  13. Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies.

    Science.gov (United States)

    König, M A; Jehan, S; Boszczyk, A A; Boszczyk, B M

    2012-05-01

    U-shaped sacral fractures usually result from axial loading of the spine with simultaneous sacral pivoting due to a horizontal fracture which leads to a highly unstable spino-pelvic dissociation. Due to the rarity of these fractures, there is lack of an agreed treatment strategy. A thorough literature search was carried out to identify current treatment concepts. The studies were analysed for mechanism of injury, diagnostic imaging, associated injuries, type of surgery, follow-up times, complications, neurological, clinical and radiological outcome. Sixty-three cases were found in 12 articles. No Class I, II or III evidence was found in the literature. The most common mechanism of injury was a fall or jump from height. Pre-operative neurological deficit was noted in 50 (94.3%) out of 53 cases (not available in 10 patients). The most used surgical options were spino-pelvic fixation with or without decompression and ilio-sacral screws. Post-operative complications occurred in 24 (38.1%) patients. Average follow-up time was 18.6 months (range 2-34 months). Full neurological recovery was noted in 20 cases, partial recovery in 14 and 9 patients had no neurological recovery (5 patients were lost in follow-up). Fracture healing was mentioned in 7 articles with only 1 case of fracture reduction loss. From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.

  14. First experience using navigation-guided radiofrequency kyphoplasty for sacroplasty in sacral insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Klingler, J.H.; Kluge, P.; Sircar, R.; Kogias, E.; Scholz, C.; Krueger, M.T.; Scheiwe, C.; Hubbe, U. [Freiburg Univ. Medical Center, Freiburg (Germany). Dept. of Neurosurgery

    2013-08-15

    Purpose: To evaluate the efficacy and safety of navigation-guided radiofrequency kyphoplasty for sacroplasty in patients with sacral insufficiency fractures. Methods: In this single-center retrospective observational study, four consecutive patients with sacral insufficiency fractures were treated with navigation-guided radiofrequency kyphoplasty for sacroplasty between April 2010 and May 2012. Symptom characteristics, pain duration and pain intensity were recorded for each patient. Cement extravasation was evaluated in thin-sliced and triplanar reconstructed CT scans of the sacrum. Results: Four female patients with painful sacral insufficiency fractures and extensive osteopenic areas significantly improved from an average pre-treatment VAS score of 8.3 {+-} 0.5 to 2.3 {+-} 1.0 (p < 0.001) on the first postoperative day and to 1.3 {+-} 1.9 (p < 0.004) at follow-up (mean, 20.1 weeks). Slight cement extravasations were observed without evidence of being symptomatic. No major complications or procedure-related morbidity were noted. Conclusion: From the limited experience in four patients, navigation-guided radiofrequency kyphoplasty appears to be a safe and effective treatment option for sacral insufficiency fractures even though asymptomatic cement extravasation was noted. The use of navigation based on intraoperative 3 D images simplifies the positioning of the navigated bone needles via the long axis approach. The radiofrequency kyphoplasty system provides the possibility to administer a sufficient amount of bone cement with a well-defined viscosity over the entire period of the procedure leading to high security and low cement extravasation. Sacroplasty provides rapid and enduring pain relief and facilitates prompt mobilization. (orig.)

  15. Comparison of gluteal perforator flaps and gluteal fasciocutaneous rotation flaps for reconstruction of sacral pressure sores.

    Science.gov (United States)

    Chen, Yen-Chou; Huang, Eng-Yen; Lin, Pao-Yuan

    2014-03-01

    The gluteus maximus myocutaneous flap was considered the workhorse that reconstructed sacral pressure sores, but was gradually replaced by fasciocutaneous flap because of several disadvantages. With the advent of the perforator flap technique, gluteal perforator (GP) flap has gained popularity nowadays. The aim of this study was to compare the complications and outcomes between GP flaps and gluteal fasciocutaneous rotation (FR) flaps in the treatment of sacral pressure sores. Between April 2007 and June 2012, 63 patients underwent sacral pressure sore reconstructions, with a GP flap used in 31 cases and an FR flap used in 32 cases. Data collected on the patients included patient age, gender, co-morbidity for being bedridden and follow-up time. Surgical details collected included the defect size, operative time and estimated blood loss. Complications recorded included re-operation, dehiscence, flap necrosis, wound infection, sinus formation, donor-site morbidity and recurrence. The complications and clinical outcomes were compared between these two groups. We found that there was no significant difference in patient demographics, surgical complications and recurrence between these two groups. In gluteal FR flap group, all recurrent cases (five) were treated by reuse of previous flaps. Both methods are comparable, good and safe in treating sacral pressure sores. Gluteal FR flap can be performed without microsurgical dissection, and re-rotation is feasible in recurrent cases. The authors suggest using gluteal FR flaps in patients with a high risk of sore recurrence. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2016-01-01

    . DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

  17. National trends in the usage and success of sacral nerve test stimulation.

    Science.gov (United States)

    Cameron, Anne P; Anger, Jennifer T; Madison, Rodger; Saigal, Christopher S; Clemens, J Quentin

    2011-03-01

    Little is known about outcomes of sacral neuromodulation in the general community, with published reports to date limited to case series or randomized, controlled trials. The goal of this analysis was to identify the national sacral neuromodulation test phase success rate and patient factors that contribute to success. Medical claims data were obtained from a 5% sample of Medicare beneficiaries (1997 to 2007) and from employees of 25 large (Fortune 500) companies (Ingenix®, 2002 to 2007). Using billing codes for the sacral neuromodulation procedure, success was defined as progressing from test phase (percutaneous or staged) to battery implantation. The rate of success was compared based on age, race, gender and diagnosis. In the Medicare sample 358 patients received percutaneous test stimulation and 1,132 underwent 2-stage lead placement, of whom 45.8% and 35.4%, respectively, underwent subsequent battery implantation. In the privately insured sample there were 266 percutaneous procedures and 794, 2-stage procedures. Percutaneous procedures were followed by battery placement in 24.1% of cases, whereas 50.9% of staged procedures resulted in battery implantation. Gender was the only consistent predictor of success, with female patients demonstrating higher success rates in each data set. The sacral neuromodulation success rates in these data sets are inferior to those published in case series and small randomized, controlled trials. Women had significantly better results than men and privately insured individuals had better results than those with Medicare, indicating a potential age effect. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Effect of surgical approach on physical activity and pain control after sacral colpopexy.

    Science.gov (United States)

    Collins, Sarah A; Tulikangas, Paul K; O'Sullivan, David M

    2012-05-01

    We sought to compare recovery of activity and pain control after robotic (ROB) vs abdominal (ABD) sacral colpopexy. Women undergoing ROB and ABD sacral colpopexy wore accelerometers for 7 days preoperatively and the first 10 days postoperatively. They completed postoperative pain diaries and Short Form-36 questionnaires before and after surgery. At 5 days postoperatively, none of the 14 subjects in the ABD group and 4 of 28 (14.3%) in the ROB group achieved 50% total baseline activity counts (P = .283). At 10 days, 5 of 14 (35.7%) in the ABD group and 8 of 26 (30.8%) in the ROB group (P = .972) achieved 50%. Postoperative pain was similar in both groups. Short Form-36 vitality scores were lower (P = .017) after surgery in the ABD group, but not in the ROB group. Women undergoing ROB vs ABD sacral colpopexy do not recover physical activity faster, and pain control is not improved. Copyright © 2012 Mosby, Inc. All rights reserved.

  19. Specific Changes in Brain Activity During Urgency in Women with Overactive Bladder after Successful Sacral Neuromodulation: An fMRI Study.

    Science.gov (United States)

    Weissbart, Steven J; Bhavsar, Rupal; Rao, Hengyi; Wein, Alan J; Detre, John A; Arya, Lily A; Smith, Ariana L

    2018-04-06

    The mechanism of sacral neuromodulation is poorly understood. We compared brain activity during urgency before and after sacral neuromodulation in women with overactive bladder and according to response to treatment. Women with refractory overactive bladder who elected for sacral neuromodulation were invited to undergo a functional magnetic resonance imaging exam before and after treatment. During the imaging exams, the bladder was filled until urgency was experienced. Regions of interest were identified a priori, and brain activity in these regions of interest was compared before and after treatment as well as according to treatment response. A whole brain exploratory analysis with an uncorrected voxel level threshold of pbrain regions that changed after sacral neuromodulation. Among 12 women who underwent a pretreatment functional magnetic resonance imaging exam, seven were successfully treated with sacral neuromodulation and underwent a posttreatment exam. After sacral neuromodulation, brain activity decreased in the left anterior cingulate cortex, bilateral insula, left dorsolateral prefrontal cortex and bilateral orbitofrontal cortex (all pbrain regions with increased activity after sacral neuromodulation. Pretreatment brain activity levels in the bilateral anterior cingulate cortex, right insula, bilateral dorsolateral prefrontal cortex, right orbitofrontal cortex, right supplementary motor area, and right sensorimotor cortex were higher in women who underwent successful treatment (all pBrain activity during urgency changes after successful sacral neuromodulation. Sacral neuromodulation may be more effective in women with higher levels of pretreatment brain activity during urgency. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: single center experience in treating posterior pelvic instability.

    Science.gov (United States)

    Fischer, Sebastian; Vogl, Thomas J; Marzi, Ingo; Zangos, Stephan; Wichmann, Julian L; Scholtz, Jan-Erik; Mack, Martin G; Schmidt, Sven; Eichler, Katrin

    2015-02-01

    The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. 100 guidewires and hollow titan screws were inserted in 38 patients (49.6±19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. The mean minimal distance between guidewire and adjacent neural foramina was 4.5±2.01mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6±0.53mm to 1.2±0.54mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7mGycm). The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: Single center experience in treating posterior pelvic instability

    International Nuclear Information System (INIS)

    Fischer, Sebastian; Vogl, Thomas J.; Marzi, Ingo; Zangos, Stephan; Wichmann, Julian L.; Scholtz, Jan-Erik; Mack, Martin G.; Schmidt, Sven; Eichler, Katrin

    2015-01-01

    Highlights: • Minimally invasive sacroiliac screw fixation can be performed under CT-imaging. • Guidewires help in precise placement of cannulated sacroiliac screw. • Only a diminishing rate of misplacements can be seen. • The method appears to be a safe and very accurate procedure. - Abstract: Objective: The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. Methods: 100 guidewires and hollow titan screws were inserted in 38 patients (49.6 ± 19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. Results: The mean minimal distance between guidewire and adjacent neural foramina was 4.5 ± 2.01 mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6 ± 0.53 mm to 1.2 ± 0.54 mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5 mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0 min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7 mGy cm). Conclusions: The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels

  2. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: Single center experience in treating posterior pelvic instability

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Sebastian, E-mail: sebastian.fischer@kgu.de [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Zangos, Stephan; Wichmann, Julian L.; Scholtz, Jan-Erik; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schmidt, Sven [Orthopaedic University Hospital Friedrichsheim, Marienburgstraße, 260528 Frankfurt (Germany); Eichler, Katrin [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany)

    2015-02-15

    Highlights: • Minimally invasive sacroiliac screw fixation can be performed under CT-imaging. • Guidewires help in precise placement of cannulated sacroiliac screw. • Only a diminishing rate of misplacements can be seen. • The method appears to be a safe and very accurate procedure. - Abstract: Objective: The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. Methods: 100 guidewires and hollow titan screws were inserted in 38 patients (49.6 ± 19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. Results: The mean minimal distance between guidewire and adjacent neural foramina was 4.5 ± 2.01 mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6 ± 0.53 mm to 1.2 ± 0.54 mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5 mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0 min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7 mGy cm). Conclusions: The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels.

  3. The Effect of Early Complications on Flap Selection on Sacral Pressure Sores

    Directory of Open Access Journals (Sweden)

    Musa Kemal Keleş

    2017-06-01

    Full Text Available Objective: Pressure sores occur in bedridden patients in intensive care units, clinics, and even at their own places. Care for sick relatives and working with doctors to address treatment options and ensure proper follow-up are some of the problems associated with these types of wounds. Surgical therapy in the treatment of pressure ulcers is associated with significant complications. In comparison to non-surgical treatment, surgical treatment has a low complication rate and is more cost-effective. The surgical treatment enables the patients to return to their social life sooner than non-surgical treatment. Patient's ability to early return to their social life is advantageous in terms of reducing morbidity and the need for additional operations. This study is aimed to review the flap choices used to treat sacral pressure sores and the resulting acute complications rates retrospectively. Material and Methods: Patients treated for stage 3 and stage 4 sacral pressure sores in our clinic in the past 5 years were included in the study. Patient records were analyzed retrospectively. Patients' demographic data and surgical treatment they received were documented. Surgical method and surgical outcomes were evaluated and early complication rates were determined. Result: Fifty patients were included in the study; 10 of them were female, 40 of were male cases. The most common causative agent was paraplegia after traffic accident. Conclusion: A significant difference was not observed between the type of flap used in the surgical treatment and the rate of complications. Consequently, the surgical treatment of pressure ulcers in the sacral region depends on the patient's individual situation, the cooperation of the family, and previously applied treatments

  4. Does cortical bone thickness in the last sacral vertebra differ among tail types in primates?

    Science.gov (United States)

    Nishimura, Abigail C; Russo, Gabrielle A

    2017-04-01

    The external morphology of the sacrum is demonstrably informative regarding tail type (i.e., tail presence/absence, length, and prehensility) in living and extinct primates. However, little research has focused on the relationship between tail type and internal sacral morphology, a potentially important source of functional information when fossil sacra are incomplete. Here, we determine if cortical bone cross-sectional thickness of the last sacral vertebral body differs among tail types in extant primates and can be used to reconstruct tail types in extinct primates. Cortical bone cross-sectional thickness in the last sacral vertebral body was measured from high-resolution CT scans belonging to 20 extant primate species (N = 72) assigned to tail type categories ("tailless," "nonprehensile short-tailed," "nonprehensile long-tailed," and "prehensile-tailed"). The extant dataset was then used to reconstruct the tail types for four extinct primate species. Tailless primates had significantly thinner cortical bone than tail-bearing primates. Nonprehensile short-tailed primates had significantly thinner cortical bone than nonprehensile long-tailed primates. Cortical bone cross-sectional thickness did not distinguish between prehensile-tailed and nonprehensile long-tailed taxa. Results are strongly influenced by phylogeny. Corroborating previous studies, Epipliopithecus vindobonensis was reconstructed as tailless, Archaeolemur edwardsi as long-tailed, Megaladapis grandidieri as nonprehensile short-tailed, and Palaeopropithecus kelyus as nonprehensile short-tailed or tailless. Results indicate that, in the context of phylogenetic clade, measures of cortical bone cross-sectional thickness can be used to allocate extinct primate species to tail type categories. © 2017 Wiley Periodicals, Inc.

  5. The Thoracic Lordosis Correction Improves Sacral Slope and Walking Ability in Neuromuscular Scoliosis.

    Science.gov (United States)

    Kim, Do Yeon; Moon, Eun Su; Park, Jin Oh; Chong, Hyon Su; Lee, Hwan Mo; Moon, Seong Hwan; Kim, Sung Hoon; Kim, Hak Sun

    2016-10-01

    Retrospective study. To report on neuromuscular patients with preserved walking ability, but forward bending of the body due to thoracic lordosis, and to suggest thoracic lordosis correction as the surgical treatment. It is an established fact that lumbar lordosis or pelvic parameter is directly related to thoracic sagittal balance. However, the reverse relationship has not been fully defined yet. Loss of thoracic kyphosis results in positive sagittal balance, which causes walking difficulty. Neuromuscular patients with thoracic lordosis have not been reported yet, and there have been no reports on their surgical treatments. This study analyzed 8 patients treated with thoracic lordosis correction surgery. Every patient was diagnosed with muscular dystrophy. In thoracic lordosis correction surgery, anterior release was performed in the first stage and posterior segmental instrumentation was performed in the second stage. Radiographic parameters were compared and walking ability was evaluated with gait analysis. All patients were classified according to the modified Rancho Los Amigos Hospital system preoperatively and 2 years postoperatively to evaluate functional ability. The average follow-up period was 2.9 years. Before surgery, the mean thoracic sagittal alignment was -2.1-degree lordosis, the mean Cobb angle and sacral slope increased to 36.3 and 56.6 degrees, respectively. The anterior pelvic tilt in gait analysis was 29.3 degrees. At last follow-up after surgery, the mean thoracic sagittal alignment changed to 12.6-degree kyphosis, and the Cobb angle and sacral slope decreased to 18.9 and 39.5 degrees, respectively. Lumbar lordosis and the sacral slope showed significant positive correlation (Plordosis showed a significant correlation to the preoperative flexibility of the major curve (P=0.028). The anterior pelvic tilt in gait analysis improved to 15.4 degrees. The functional ability improved in 2 (50%) of 4 patients in class 2 and maintained in remaining 6

  6. Effects of Low-frequency Current Sacral Dermatome Stimulation on Idiopathic Slow Transit Constipation.

    Science.gov (United States)

    Kim, Jin-Seop; Yi, Seung-Ju

    2014-06-01

    [Purpose] This study aimed to determine whether low-frequency current therapy can be used to reduce the symptoms of idiopathic slow transit constipation (ISTC). [Subjects] Fifteen patients (ten male and five female) with idiopathic slow transit constipation were enrolled in the present study. [Results] Bowel movements per day, bowel movements per week, and constipation assessment scale scores significantly improved after low-frequency current simulation of S2-S3. [Conclusion] Our results show that stimulation with low-frequency current of the sacral dermatomes may offer therapeutic benefits for a subject of patients with ISTC.

  7. Sacral nerve root neuromodulation: an effective treatment for refractory urge incontinence.

    Science.gov (United States)

    Shaker, H S; Hassouna, M

    1998-05-01

    Sacral foramina implants have been recognized recently as a method for treatment of refractory urinary urge incontinence. We study the outcome of the procedure with in-depth analysis of the results of 18 implanted cases. Patients with urinary urge incontinence were subjected to percutaneous nerve evaluation of the S3 roots as a temporary screening test to determine response to neuromodulation. Satisfactory responders were implanted with permanent sacral root neuroprosthesis. The study design included comprehensive voiding diaries for 4 consecutive days twice as a baseline, 1 with percutaneous nerve evaluation screening, 1 after the percutaneous nerve evaluation, 1 at the 1, 3 and 6 post-implantation visits, and every 6 months thereafter. Uroflowmetry and quality of life questionnaires were performed at the same intervals. Urodynamic study was done as a baseline and 6 months after implantation of the neuroprosthesis. All 18 patients (16 women and 2 men) with refractory urge incontinence received a sacral foramina neuroprosthesis after demonstrating a good response to the percutaneous nerve evaluation. Average patient age at presentation was 42.3+/-3.3 years (range 22 to 67) and duration of urinary symptoms was 6.6+/-1.3 years (range 1.2 to 18.8). Average followup was 18.8 months (range 3 to 83). Neuromodulation in these patients showed a marked reduction in leakage episodes from 6.49 to 1.98 times per 24 hours and in the leakage severity score. Eight patients became completely dry and 4 had average leakage episodes of 1 or less daily. Patients showed as well a decrease in urinary frequency with an increase in functional bladder capacity. Associated pelvic pain improved substantially. Cystometrograms demonstrated increased volume at first sensation by 50% and increased cystometric capacity by 15% with the disappearance of uninhibited contractions in 1 of the 4 patients who presented with it preoperatively. There was also noticeable improvement in the quality of life

  8. Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus

    OpenAIRE

    Hur, Jian

    2015-01-01

    When a patient presents with acute voiding dysfunction without a typical skin rash, it may be difficult to make a diagnosis of herpes zoster. Here, we present a case of scrub typhus in a 25-year-old man with the complication of urinary dysfunction. The patient complained of loss of urinary voiding sensation and constipation. After eight days, he had typical herpes zoster eruptions on the sacral dermatomes and hypalgesia of the S1-S5 dermatomes. No cases of dual infection with varicella zoster...

  9. Development and validation of a bowel-routine-based self-report questionnaire for sacral sparing after spinal cord injury

    DEFF Research Database (Denmark)

    Liu, N; Xing, H; Zhou, M-W

    2017-01-01

    -report questionnaire was developed based on several events that most patients might experience during bowel routine. 102 participants who sustained SCI within 12 months were asked to complete the questionnaire followed by an anorectal examination. Agreements of answers to the questionnaire and the physical examination......STUDY DESIGN: An observational study. OBJECTIVE: To develop a self-administered tool for assessment of sacral sparing after spinal cord injury (SCI) and to test its validity in individuals with SCI. SETTING: Peking University Third Hospital, Beijing, China. METHODS: A 5-item SCI sacral sparing self......: The validity of this questionnaire for the assessment of sacral sparing in up to 12 months post injury is good except for the motor function when there was increased AST. In some situations it could be considered as an alternative tool for digital rectal examination, especially when repeated examinations...

  10. Evaluation of the rostral projection of the sacral lamina as a component of degenerative lumbosacral stenosis in German shepherd dogs.

    Science.gov (United States)

    Saunders, Harvey; Worth, Andrew J; Bridges, Janis P; Hartman, Angela

    2018-05-20

    To determine the association between a greater rostral projection of the sacral lamina and clinical signs of cauda equina syndrome (CES) in German shepherd dogs (GSD) with presumptive degenerative lumbosacral disease (DLSS). Retrospective cohort study. One hundred forty-three GSD (125 police dogs and 18 pet dogs) presenting for either CES or prebreeding evaluation. Fifty-five were classified as affected by CES and diagnosed with DLSS, and 88 were classified as unaffected on the basis of clinical and imaging findings. The position of the rostral edge of the sacral lamina was measured from radiographs and/or computed tomography (CT) scans. This position was compared between affected and unaffected dogs. In dogs that underwent both radiography and CT scanning, the agreement between sacral lamina localization using each imaging modality was determined. Owners/handlers were contacted to determine whether dogs subsequently developed clinical signs compatible with CES at a mean of 29 months (unaffected). The sacral lamina did not extend as far rostrally in affected dogs, compared to unaffected dogs (P = .04). Among the 88 dogs unaffected by CES at initial evaluation, 2 developed clinical signs consistent with CES at follow-up. Rostral projection of the sacral lamina, previously proposed as a potential risk factor in dogs with CES due to lumbosacral degeneration, was not associated with a diagnosis of DLSS in this study; the opposite was true. Rostral projection of the sacral lamina may not be a predisposing factor in the development of CES due to DLSS in GSD. © 2018 The American College of Veterinary Surgeons.

  11. Diffusion tensor magnetic resonance imaging and fiber tractography of the sacral plexus in children with spina bifida

    DEFF Research Database (Denmark)

    Haakma, Wieke; Dik, Pieter; ten Haken, Bennie

    2014-01-01

    anatomical and microstructural properties of the sacral plexus of patients with spina bifida using diffusion tensor imaging and fiber tractography. MATERIALS AND METHODS: Ten patients 8 to 16 years old with spina bifida underwent diffusion tensor imaging on a 3 Tesla magnetic resonance imaging system...... diffusivity values at S1-S3 were significantly lower in patients. CONCLUSIONS: To our knowledge this 3 Tesla magnetic resonance imaging study showed for the first time sacral plexus asymmetry and disorganization in 10 patients with spina bifida using diffusion tensor imaging and fiber tractography...

  12. Ipsilateral Hip Dysplasia in Patients with Sacral Hemiagenesis: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tadatsugu Morimoto

    2015-01-01

    Full Text Available Sacral agenesis (SA is a rare condition consisting of the imperfect development of any part of the sacrum. This paper describes two cases of the rare cooccurrence of ipsilateral SA and developmental dysplasia of the hip (DDH and analyzes possible contributory factors for SA and DDH. Each of a 16-year-old female and 13-year-old female visited our hospital for left hip pain and limping. The findings of physical examinations showed a lower limb length discrepancy (left side in both cases, as well as left hip pain without limitations of the range of motion or neurological deficits. Initial radiographs demonstrated left subluxation of the left hip with associated acetabular dysplasia and partial left sacral agenesis. MRI revealed a tethering cord with a fatty filum terminale, and periacetabular osteotomy combined with allogeneic bone grafting was performed. After the surgery, the patients experienced no further pain, with no leg length discrepancy and were able to walk without a limp, being neurologically normal with a normal left hip range of motion. The cooccurrence of SA and DDH suggests a plausible hypothesis to explain the embryogenic relationship between malformation of the sacrum and hip.

  13. Combined V-Y Fasciocutaneous Advancement and Gluteus Maximus Muscle Rotational Flaps for Treating Sacral Sores

    Directory of Open Access Journals (Sweden)

    Hyun Ho Han

    2016-01-01

    Full Text Available The sacral area is the most common site of pressure sore in bed-ridden patients. Though many treatment methods have been proposed, a musculocutaneous flap using the gluteus muscles or a fasciocutaneous flap is the most popular surgical option. Here, we propose a new method that combines the benefits of these 2 methods: combined V-Y fasciocutaneous advancement and gluteus maximus muscle rotational flaps. A retrospective review was performed for 13 patients who underwent this new procedure from March 2011 to December 2013. Patients’ age, sex, accompanying diseases, follow-up duration, surgical details, complications, and recurrence were documented. Computed tomography was performed postoperatively at 2 to 4 weeks and again at 4 to 6 months to identify the thickness and volume of the rotational muscle portion. After surgery, all patients healed within 1 month; 3 patients experienced minor complications. The average follow-up period was 13.6 months, during which time 1 patient had a recurrence (recurrence rate, 7.7%. Average thickness of the rotated muscle was 9.43 mm at 2 to 4 weeks postoperatively and 9.22 mm at 4 to 6 months postoperatively (p=0.087. Muscle thickness had not decreased, and muscle volume was relatively maintained. This modified method is relatively simple and easy for reconstructing sacral sores, provides sufficient padding, and has little muscle donor-site morbidity.

  14. Effects of acute urinary bladder overdistension on bladder response during sacral neurostimulation.

    Science.gov (United States)

    Bross, S; Schumacher, S; Scheepe, J R; Zendler, S; Braun, P M; Alken, P; Jünemann, K

    1999-10-01

    Urinary retention and micturition disorders after overdistension are clinically well-known complications of subvesical obstruction. We attempted to evaluate whether bladder overdistension influences bladder response and whether overdistension supports detrusor decompensation. Following lumbal laminectomy in 9 male foxhounds, the sacral anterior roots S2 and S3 were placed into a modified Brindley electrode for reproducible and controlled detrusor activation. The bladder was filled in stages of 50 ml from 0 to 700 ml, corresponding to an overdistension. At each volume, the bladder response during sacral anterior root stimulation was registered. After overdistension, the bladder was refilled stepwise from 0 to 300 ml and stimulated. In all dogs, the bladder response was influenced by the intravesical volume. The maximum pressure (mean 69.1 cm H(2)O) was observed at mean volume of 100 ml. During overdistension, a significant reduction in bladder response of more than 80% was seen. After overdistension, a significant reduction in intravesical pressure of 19.0% was observed. In 2 cases, reduction in bladder response was more than 50% after a single overdistension. We conclude that motoric bladder function is influenced during and after overdistension. A single bladder overdistension can support acute and long-lasting detrusor decompensation. In order to protect motoric bladder function, bladder overdistension must be prevented.

  15. Neurostimulation for bladder evacuation: is sacral root stimulation a substitute for microstimulation?

    Science.gov (United States)

    Probst, M; Piechota, H J; Hohenfellner, M; Gleason, C A; Tanagho, E A

    1997-04-01

    To determine by anatomical and functional studies whether stimulation of sacral rootlets might permit selective stimulation of autonomic fibres, thus avoiding the detrusor/sphincter dyssynergia characteristic of current techniques of neurostimulation for bladder evacuation. In 10 male mongrel dogs, the S2 root was isolated and its constituent rootlets followed from their origin in the spinal cord to the point of exit from the dura. The entire root and the individual rootlets were then stimulated, including intra- and extra-dural stimulation and at proximal, mid and distal levels. Neuroanatomical and histological findings showed that rootlets of ventral S2 maintain their identity throughout their intradural course; some carry predominantly autonomic fibres, some predominantly somatic and some a mixture of the two. It appears surgically feasible to identify, isolate and sever the predominantly somatic rootlets intradurally, sparing the predominantly autonomic rootlets for inclusion in extradural electrode placement around the entire sacral root, thus eliminating sphincteric interference with detrusor contraction for voiding at low pressure.

  16. A new technique for long time catheterization of sacral epidural canal in rabbits.

    Science.gov (United States)

    Erkin, Yüksel; Aydın, Zeynep; Taşdöğen, Aydın; Karcı, Ayşe

    2013-01-01

    In this study we aimed to develop a simple and practical technique for chronic sacral epidural catheterization of rabbits. We included ten rabbits weighing 2-2.5 kg in the study. After anesthesia and analgesia, we placed an epidural catheter by a 2 cm longitudinal skin incision in the tail above the sacral hiatus region. We confirmed localization by giving 1% lidocaine (leveling sensory loss and motor function loss of the lower extremity). The catheter was carried forward through a subcutaneous tunnel and fixed at the neck. Chronic caudal epidural catheter placement was succesful in all rabbits. The catheters stayed in place effectively for ten days. We encountered no catheter complications during this period. The localization of the catheter was reconfirmed by 1% lidocaine on the last day. After animals killing, we performed a laminectomy and verified localization of the catheter in the epidural space. Various methods for catheterization of the epidural space in animal models exist in the literature. Epidural catheterization of rabbits can be accomplished by atlanto-occipital, lumbar or caudal routes by amputation of the tail. Intrathecal and epidural catheterization techniques defined in the literature necessitate surgical skill and knowledge of surgical procedures like laminectomy and tail amputation. Our technique does not require substantial surgical skill, anatomical integrity is preserved and malposition of the catheter is not encountered. In conclusion, we suggest that our simple and easily applicable new epidural catheterization technique can be used as a model in experimental animal studies.

  17. Hypointensity on postcontrast MR imaging from compression of the sacral promontory in enlarged uterus with huge leiomyoma and adenomyosis

    International Nuclear Information System (INIS)

    Uotani, Kensuke; Monzawa, Shuichi; Adachi, Shuji; Takemori, Masayuki; Kaji, Yasushi; Sugimura, Kazuro

    2007-01-01

    In patients with huge leiomyoma and with adenomyosis of the uterus, a peculiar area of hypointensity was occasionally observed on postcontrast magnetic resonance (MR) imaging in the dorsal portion of the enlarged uterus near the sacral promontory. We describe the imaging characteristics of these MR findings and correlate them with histopathological findings to examine whether the areas represent specific pathological changes. Ten patients with huge leiomyomas and two with huge adenomyotic lesions whose imaging revealed the hypointensity were enrolled. All had enlarged uteri that extended beyond the sacral promontory. MR findings of the hypointense areas were evaluated and correlated with histopathological findings in 5 patients with leiomyoma and two with adenomyosis who had hysterectomy. The ten patients with leiomyoma showed flare-shaped hypointensity arising from the dorsal surface of the uterine body that extended deep into the tumor. The base of the hypointense areas was narrow in 5 patients with intramural leiomyoma and broad in five with subserosal leiomyoma. Two patients with adenomyosis showed nodular-shaped areas of hypointensity in front of the sacral promontory. Precontrast T 1 - and T 2 -weighted MR images showed no signal abnormalities in the portions corresponding to the hypointensity in any of the 12 patients. Pathological examinations showed no specific findings in the portions corresponding to the hypointensity in the 7 patients who had hysterectomy. The areas of hypointensity may represent functional changes, such as decreased localized blood flow caused by compression of the sacral promontory. (author)

  18. Sacral nerve stimulation increases activation of the primary somatosensory cortex by anal canal stimulation in an experimental model.

    LENUS (Irish Health Repository)

    Griffin, K M

    2011-08-01

    Sacral and posterior tibial nerve stimulation may be used to treat faecal incontinence; however, the mechanism of action is unknown. The aim of this study was to establish whether sensory activation of the cerebral cortex by anal canal stimulation was increased by peripheral neuromodulation.

  19. Radiations

    International Nuclear Information System (INIS)

    Pujol Mora, J.

    1999-01-01

    The exposition to ionizing radiations is a constant fact in the life of the human being and its utilization as diagnostic and therapeutic method is generalized. However, it is notorious how as years go on, the fear to the ionizing radiation seems to persist too, and this fact is not limited to the common individual, but to the technical personnel and professional personnel that labors with them same. (S. Grainger) [es

  20. Radiation

    International Nuclear Information System (INIS)

    Davidson, J.H.

    1986-01-01

    The basic facts about radiation are explained, along with some simple and natural ways of combating its ill-effects, based on ancient healing wisdom as well as the latest biochemical and technological research. Details are also given of the diet that saved thousands of lives in Nagasaki after the Atomic bomb attack. Special comment is made on the use of radiation for food processing. (U.K.)

  1. Mechanical comparison between lengthened and short sacroiliac screws in sacral fracture fixation: a finite element analysis.

    Science.gov (United States)

    Zhao, Y; Zhang, S; Sun, T; Wang, D; Lian, W; Tan, J; Zou, D; Zhao, Y

    2013-09-01

    To compare the stability of lengthened sacroiliac screw and standard sacroiliac screw for the treatment of unilateral vertical sacral fractures; to provide reference for clinical applications. A finite element model of Tile type C pelvic ring injury (unilateral Denis type II fracture of the sacrum) was produced. The unilateral sacral fractures were fixed with lengthened sacroiliac screw and sacroiliac screw in six different types of models respectively. The translation and angle displacement of the superior surface of the sacrum (in standing position on both feet) were measured and compared. The stability of one lengthened sacroiliac screw fixation in S1 or S2 segment is superior to that of one sacroiliac screw fixation in the same sacral segment. The stability of one lengthened sacroiliac screw fixation in S1 and S2 segments respectively is superior to that of one sacroiliac screw fixation in S1 and S2 segments respectively. The stability of one lengthened sacroiliac screw fixation in S1 and S2 segments respectively is superior to that of one lengthened sacroiliac screw fixation in S1 or S2 segment. The stability of one sacroiliac screw fixation in S1 and S2 segments respectively is markedly superior to that of one sacroiliac screw fixation in S1 or S2 segment. The vertical and rotational stability of lengthened sacroiliac screw fixation and sacroiliac screw fixation in S2 is superior to that of S1. In a finite element model of type C pelvic ring disruption, S1 and S2 lengthened sacroiliac screws should be utilized for the fixation as regularly as possible and the most stable fixation is the combination of the lengthened sacroiliac screws of S1 and S2 segments. Even if lengthened sacroiliac screws cannot be systematically used due to specific conditions, one sacroiliac screw fixation in S1 and S2 segments respectively is recommended. No matter which kind of sacroiliac screw is used, if only one screw can be implanted, the fixation in S2 segment is more recommended

  2. A Randomized Comparison Between Ultrasound- and Fluoroscopy-Guided Sacral Lateral Branch Blocks.

    Science.gov (United States)

    Finlayson, Roderick J; Etheridge, John-Paul B; Elgueta, Maria Francisca; Thonnagith, Atikun; De Villiers, Frederick; Nelems, Bill; Tran, De Q

    This randomized trial compared ultrasound (US)- and fluoroscopy-guided sacral lateral branch (SLB) blocks. We hypothesized that US would require a shorter performance time. Forty patients who required unilateral sacral lateral branch blocks for chronic low back pain were randomized to US or fluoroscopy guidance. Before the performance of the assigned block, an investigator who was not involved in patient care carried out baseline analgesic testing. With US, the dorsal sacroiliac ligament, the sacroiliac joint, and the interosseous ligament were probed with a 22-gauge block needle. The patient was asked to rate the level of discomfort using an 11-point numerical rating scale.After the analgesic test, attending anesthesiologists or supervised trainees carried out the SLB blocks. The local anesthetic agent (lidocaine 2%) was identical in all subjects. In the US group, local anesthetic (1.5 mL) was first injected on the lateral crest at the mid-point between S2 and S3. Subsequently, 2 more injections of 0.5 mL were carried out on the lateral crest, immediately cephalad to S2 and at the S1 level. In the fluoroscopy group, SLB blocks were performed according to a previously described 17-injection technique, which involves 9 skin entry sites and the targeting of the L5 posterior root and S1-S3 sacral lateral branches. A 0.4-mL volume of local anesthetic was deposited at each target point. The performance time, number of needle passes, and the incidence of vascular breach were recorded during the performance of the block.Twenty minutes after the end of local anesthetic injection, the same investigator who performed preblock analgesic testing carried out postblock testing in an identical manner. Compared with fluoroscopy, the US technique was associated with a shorter performance time (267.5 ± 99.3 vs 628.7 ± 120.3 seconds; P < 0.001), fewer needle passes and a lower incidence of vascular breach (0 vs 10 occurrences; P = 0.001). However, the block effect (ie, the

  3. 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

  4. [Association of intercalary cervical bone and occult lumbar and sacral spina bifida. Case report].

    Science.gov (United States)

    Ruiz-Osuna, César; Avila-Zamorano, Myrna Lizeth; Suárez-Ahedo, Carlos; Trueba-Davalillo, Cesáreo

    2009-01-01

    The defects of the spinal cord enclose diverse malformations that go from spina bifida to myelomeningocele but there is also a rare variant that is the intercalary bone. The incidence of this phenomenon may vary in 1 to 1,000 to 5,000. At our knowledge, there are no cases reported where it can be an association of intercalary bone and a bifid spine in different levels. In this article we report the case of one patient that coincide with an intercalary cervical bone, bifid spine in lumbar column and bifid spine in sacral column. The objective of this article is also to comment how the clinical symptoms are unspecific, the chronic pain is the frequent symptom, and how the physiotherapy and anti-inflammatory drugs can provide excellent results in a short and medium term.

  5. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  6. The anatomy of the first sacral nerve root sheath shown by computed tomography.

    Science.gov (United States)

    Moore, N R; Dixon, A K; Freer, C E

    1989-08-01

    Analysis of 25 patients with normal computed tomographic appearances at the lumbosacral junction revealed wide variation in the anatomical level at which the first sacral nerve root sheaths were seen emerging from the theca. In nine patients (36%), the S1 nerve root sheaths were first recognized at the level of the lumbosacral disc. In 14 patients (56%), the sheaths emerged cranial to the disc; it is possible that these patients may be more prone to neurological complications related to disc or facet joint disease, especially if the sheath is laterally sited within the lateral recess. Conversely, that minority of patients (two, 8%) in whom the root sheaths emerge caudal to the disc level may be relatively protected from neurological complications.

  7. Development of Marjolin's ulcer following successful surgical treatment of chronic sacral pressure sore

    DEFF Research Database (Denmark)

    Knudsen, M.A.; Biering-Sørensen, Fin

    2008-01-01

    of surgical excision and successful closure of the wound, the patient developed Marjolin's ulcer 2.5 years later. Yet it illustrates the primary importance of preventing the development pressure sores, of aggressive (surgical) therapy with healing when they do arise and of taking frequent biopsies......STUDY DESIGN: Case report. OBJECTIVE: Report of an unusual case, where a Marjolin's ulcer that developed 2.5 years after surgical excision and successful closure. SETTING: Department of Plastic and Reconstructive Surgery and Burn Unit and the Clinic for Spinal Cord Injuries, Copenhagen University...... Hospital, Rigshospitalet, Copenhagen, Denmark. METHODS AND RESULTS: A 22-year-old man sustained a fracture with luxation of the 5th and 6th cervical vertebrae and loss of sensory and motor function after a diving accident (complete C8 lesion). During initial hospitalization, he developed a sacral ulcer...

  8. Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus.

    Science.gov (United States)

    Hur, Jian

    2015-06-01

    When a patient presents with acute voiding dysfunction without a typical skin rash, it may be difficult to make a diagnosis of herpes zoster. Here, we present a case of scrub typhus in a 25-year-old man with the complication of urinary dysfunction. The patient complained of loss of urinary voiding sensation and constipation. After eight days, he had typical herpes zoster eruptions on the sacral dermatomes and hypalgesia of the S1-S5 dermatomes. No cases of dual infection with varicella zoster virus and Orientia tsutsugamushi were found in the literature. In the described case, scrub typhus probably induced sufficient stress to reactivate the varicella zoster virus. Early recognition of this problem is imperative for prompt and appropriate management, as misdiagnosis can lead to long-term urinary dysfunction. It is important that a diagnosis of herpes zoster be considered, especially in patients with sudden onset urinary retention.

  9. Psoas compartment and sacral plexus block via electrostimulation for pelvic limb amputation in dogs.

    Science.gov (United States)

    Congdon, Jonathon M; Boscan, Pedro; Goh, Clara S S; Rezende, Marlis

    2017-07-01

    To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. Prospective clinical study. A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). Dogs were administered morphine (0.5 mg kg -1 ) and atropine (0.02 mg kg -1 ); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2.2 mg kg -1 ) and eight dogs were administered an equivalent volume of saline. The lumbar plexus within the psoas compartment was identified using electrolocation lateral to the lumbar vertebrae at the fourth-fifth, fifth-sixth and sixth-seventh vertebral interspaces. The sacral plexus, ventrolateral to the sacrum, was identified using electrolocation. Anesthesia was monitored using heart rate (HR), invasive blood pressure, electrocardiography, expired gases, respiratory frequency and esophageal temperature by an investigator unaware of the group allocation. Pelvic limb amputation by coxofemoral disarticulation was performed. Dogs that responded to surgical stimulation (>10% increase in HR or arterial pressure) were administered fentanyl (2 μg kg -1 ) intravenously for rescue analgesia. Postoperative pain was assessed at extubation; 30, 60 and 120 minutes; and the morning after surgery using a visual analog scale (VAS). The number of intraoperative fentanyl doses was fewer in the bupivacaine group (2.7±1.1 versus 6.0±2.2; pdogs at extubation (0.8±1.9 versus 3.8±2.5) and at 30 minutes (1.0±1.4 versus 4.3±2.1; pdogs. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

  10. Imaging appearances and clinical outcome following sacrectomy and ilio-lumbar reconstruction for sacral neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Marianna; Davies, A.M.; James, Steven L.J. [Department of Radiology, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom); Stirling, A.J.; Grainger, M. [Department of Spinal Surgery, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom); Grimer, R.J. [Department of Orthopaedic Oncology, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom)

    2014-02-15

    Sacrectomy and ilio-lumbar reconstruction is an uncommonly performed complex surgical procedure for the treatment of sacral neoplasia. There are many challenges in the post-operative period including the potential for tumor recurrence, infection, and construct failure. We present our experience of this patient cohort and describe the complications and imaging appearances that can be encountered during the follow-up period. Retrospective review of our Orthopaedic Oncology database was undertaken which has been collected over a 30-year period to identify patients that had undergone sacrectomy and ilio-lumbar reconstruction. Pre and post-operative imaging including radiographs, CT, and MRI was reviewed. These were viewed by two experienced musculoskeletal radiologists with consensus opinion if there was disagreement over the imaging findings. Data regarding patient demographics, tumor type, and dimensions was collected. Serial review of radiographs, CT, and MRI was performed to assess implant position and integrity, strut graft position and union, and for the presence of recurrence within the surgical bed. Five male and two female patients (mean age 36 years, age range 15-54 years) were treated with this procedure. Histological diagnoses included chordoma, chondrosarcoma, osteosarcoma, and spindle cell sarcoma. Mean maximal tumor size on pre-operative imaging was 10.7 cm (range, 6-16 cm). Post-operative follow-up ranged from 10-46 months. A total of 76 imaging studies were reviewed. Commonly identified complications included vertical rod and cross-connector fracture and screw loosening. Fibula strut graft non-union and fracture was also evident on imaging review. Two patients demonstrated disease recurrence during the follow-up period. This study demonstrates the spectrum and frequency of complications that can occur following sacrectomy and ilio-lumbar reconstruction for sacral neoplasia. (orig.)

  11. An audit of the physiotherapy management of paraplegic patients with sacral pressure sores

    Directory of Open Access Journals (Sweden)

    D. Pather

    2013-01-01

    Full Text Available Introduction: Pressure sores are the most common complication post spinal cord injury that requires patients to be on bed rest. Patient bed rest delay rehabilitation and may lead to other complications associated with immobility. This study sought to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they consider when deciding whether the patient should receive physiotherapy in the ward or gym. Methods: This was a questionnaire based survey of physiotherapists working in spinal cord injury rehabilitation units in South Africa. The self-designed questionnaire was sent to all the main spinal rehabilitation units in the country (14 located in Gauteng, Kwa-Zulu Natal, Western Cape, Eastern Cape and Free State provinces. Results: Thirty-nine physiotherapists from a total of 51 completed the questionnaires (76% response rate. The most common treatment practice for patients with sacral pressure sores was bed rest (98%. The most common physio-therapy practices (70% included were upper limb muscle strengthening, upper and lower limb passive movements, positioning into prone and side lying and passive stretching. The choice of treatment environment was influenced by doctors’ orders and the size, grade and duration of the pressure sores. Conclusion: Direct involvement in pressure sore management in South Africa seem to be less than in other parts of the world. If we are to minimise the pressure sore impact, it appears like we need more focus on gait re-education and standardised ADL programmes and patient treatment in the gym to possibly maximise healing and rehabilitation.

  12. The Unresolved Case of Sacral Chordoma: From Misdiagnosis to Challenging Surgery and Medical Therapy Resistance

    Science.gov (United States)

    Garofalo, Fabio; Christoforidis, Dimitrios; di Summa, Pietro G.; Gay, Béatrice; Cherix, Stéphane; Raffoul, Wassim; Matter, Maurice

    2014-01-01

    Purpose A sacral chordoma is a rare, slow-growing, primary bone tumor, arising from embryonic notochordal remnants. Radical surgery is the only hope for cure. The aim of our present study is to analyse our experience with the challenging treatment of this rare tumor, to review current treatment modalities and to assess the outcome based on R status. Methods Eight patients were treated in our institution between 2001 and 2011. All patients were discussed by a multidisciplinary tumor board, and an en bloc surgical resection by posterior perineal access only or by combined anterior/posterior accesses was planned based on tumor extension. Results Seven patients underwent radical surgery, and one was treated by using local cryotherapy alone due to low performance status. Three misdiagnosed patients had primary surgery at another hospital with R1 margins. Reresection margins in our institution were R1 in two and R0 in one, and all three recurred. Four patients were primarily operated on at our institution and had en bloc surgery with R0 resection margins. One had local recurrence after 18 months. The overall morbidity rate was 86% (6/7 patients) and was mostly related to the perineal wound. Overall, 3 out of 7 resected patients were disease-free at a median follow-up of 2.9 years (range, 1.6-8.0 years). Conclusion Our experience confirms the importance of early correct diagnosis and of an R0 resection for a sacral chordoma invading pelvic structures. It is a rare disease that requires a challenging multidisciplinary treatment, which should ideally be performed in a tertiary referral center. PMID:24999463

  13. Clinical Outcome of Sacral Chordoma With Carbon Ion Radiotherapy Compared With Surgery

    International Nuclear Information System (INIS)

    Nishida, Yoshihiro; Kamada, Tadashi; Imai, Reiko; Tsukushi, Satoshi; Yamada, Yoshihisa; Sugiura, Hideshi; Shido, Yoji; Wasa, Junji; Ishiguro, Naoki

    2011-01-01

    Purpose: To evaluate the efficacy, post-treatment function, toxicity, and complications of carbon ion radiotherapy (RT) for sacral chordoma compared with surgery. Methods and Materials: The records of 17 primary sacral chordoma patients treated since 1990 with surgery (n = 10) or carbon ion RT (n = 7) were retrospectively analyzed for disease-specific survival, local recurrence-free survival, complications, and functional outcome. The applied carbon ion dose ranged from 54.0 Gray equivalent (GyE) to 73.6 GyE (median 70.4). Results: The mean age at treatment was 55 years for the surgery group and 65 years for the carbon ion RT group. The median duration of follow-up was 76 months for the surgery group and 49 months for the carbon ion RT group. The local recurrence-free survival rate at 5 years was 62.5% for the surgery and 100% for the carbon ion RT group, and the disease-specific survival rate at 5 years was 85.7% and 53.3%, respectively. Urinary-anorectal function worsened in 6 patients (60%) in the surgery group, but it was unchanged in all the patients who had undergone carbon ion RT. Postoperative wound complications requiring reoperation occurred in 3 patients (30%) after surgery and in 1 patient (14%) after carbon ion RT. The functional outcome evaluated using the Musculoskeletal Tumor Society scoring system revealed 55% in the surgery group and 75% in the carbon ion RT group. Of the six factors in this scoring system, the carbon ion RT group had significantly greater scores in emotional acceptance than did the surgery group. Conclusion: Carbon ion RT results in a high local control rate and preservation of urinary-anorectal function compared with surgery.

  14. SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, S; Bhatia, S; Sun, W; Menda, Y; Ponto, L; Gross, B; Buatti, J [University Of Iowa, Iowa City, IA (United States)

    2015-06-15

    Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bones from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.

  15. Imperfuração anal associada à agenesia parcial do sacro e lipoma pré-sacral: síndrome de Currarino Imperforate anus associated with partial sacral agenesis and presacral lipoma: Currarino syndrome

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo G. Zen

    2010-09-01

    Full Text Available OBJETIVO: Relatar o caso de uma criança com síndrome de Currarino diagnosticada após avaliação por episódios recorrentes de infecção urinária. DESCRIÇÃO DE CASO: Menina branca de dois anos, única filha de pais hígidos e sem história familiar de defeitos congênitos. A criança nasceu com imperfuração anal e com fístula retovestibular diagnosticadas no primeiro dia de vida. Por volta dos sete meses, começou a apresentar episódios recorrentes de infecção urinária, estabelecendo-se o diagnóstico de bexiga neurogênica. Na mesma ocasião, foi constatada a presença de agenesia parcial do sacro. A avaliação pela tomografia computadorizada e ressonância nuclear magnética de coluna identificou presença de fístula coincidente com a fosseta da transição lombo-sacral, observada ao exame físico; amputação da porção inferior da medula, com diminuição do número de raízes nervosas da cauda equina e massa pré-sacral de aspecto lipomatoso. Esta foi confirmada durante a cirurgia de correção do ânus imperfurado. A criança não apresentava outras dismorfias e a avaliação radiológica dos pais não identificou anormalidades sacrais. COMENTÁRIOS: A síndrome de Currarino é uma doença genética autossômica, dominante e rara caracterizada pela tríade formada por atresia anal, agenesia parcial do sacro e tumoração pré-sacral. Inclui teratomas, meningoceles, cistos entéricos e lipomas, como observado em nossa paciente. Crianças apresentando anormalidades anorretais deveriam ser sempre cuidadosamente avaliadas quanto à presença da síndrome de Currarino. A agenesia parcial do sacro é um forte indicativo da doença.OBJECTIVE: To report a patient with Currarino syndrome diagnosed after evaluation for recurrent urinary infections. CASE DESCRIPTION: This is a Caucasian two-year-old girl, the only daughter of healthy unrelated parents with no family history of congenital defects. The patient was born with imperforate

  16. Prevalence of sacral dysmorphia in a prospective trauma population: Implications for a "safe" surgical corridor for sacro-iliac screw placement.

    Science.gov (United States)

    Hasenboehler, Erik A; Stahel, Philip F; Williams, Allison; Smith, Wade R; Newman, Justin T; Symonds, David L; Morgan, Steven J

    2011-05-10

    Percutaneous sacro-iliac (SI) screw fixation represents a widely used technique in the management of unstable posterior pelvic ring injuries and sacral fractures. The misplacement of SI-screws under fluoroscopic guidance represents a critical complication for these patients. This study was designed to determine the prevalence of sacral dysmorphia and the radiographic anatomy of surgical S1 and S2 corridors in a representative trauma population. Prospective observational cohort study on a consecutive series of 344 skeletally mature trauma patients of both genders enrolled between January 1, 2007, to September 30, 2007, at a single academic level 1 trauma center. Inclusion criteria included a pelvic CT scan as part of the initial diagnostic trauma work-up. The prevalence of sacral dysmorphia was determined by plain radiographic pelvic films and CT scan analysis. The anatomy of sacral corridors was analyzed on 3 mm reconstruction sections derived from multislice CT scan, in the axial, coronal, and sagittal plane. "Safe" potential surgical corridors at S1 and S2 were calculated based on these measurements. Radiographic evidence of sacral dysmorphia was detected in 49 patients (14.5%). The prevalence of sacral dysmorphia was not significantly different between male and female patients (12.2% vs. 19.2%; P = 0.069). In contrast, significant gender-related differences were detected with regard to radiographic analysis of surgical corridors for SI-screw placement, with female trauma patients (n = 99) having significantly narrower corridors at S1 and S2 in all evaluated planes (axial, coronal, sagittal), compared to male counterparts (n = 245; P dysmorphia. These findings emphasize a high prevalence of sacral dysmorphia in a representative trauma population and imply a higher risk of SI-screw misplacement in female patients. Preoperative planning for percutaneous SI-screw fixation for unstable pelvic and sacral fractures must include a detailed CT scan analysis to determine

  17. Unraveling the rapid radiation of crested newts, Triturus cristatus superspecies, using complete mitogenomic sequences

    NARCIS (Netherlands)

    Wielstra, B.M.; Arntzen, J.W.

    2011-01-01

    Background - The rapid radiation of crested newts (Triturus cristatus superspecies) comprises four morphotypes: 1) the T. karelinii group, 2) T. carnifex - T. macedonicus, 3) T. cristatus and 4) T. dobrogicus. These vary in body build and the number of rib-bearing pre-sacral vertebrae (NRBV). The

  18. Treatment of Recurrent Chordomas by Percutaneous Ethanol Injection Therapy and Radiation Therapy

    International Nuclear Information System (INIS)

    Nakajo, M.; Ohkubo, K.; Fukukura, Y.; Nandate, T.; Nakajo, M.

    2006-01-01

    We report a case of recurrent sacral chordomas that have been successfully controlled by the combination therapy of percutaneous ethanol injection therapy (PEIT) and radiation therapy in a 71-year-old man. PEIT may be one of the adjuvant therapies for recurrent chordomas

  19. Evaluation of the diagnostic accuracy of four-view radiography and conventional computed tomography analysing sacral and pelvic fractures in dogs.

    Science.gov (United States)

    Stieger-Vanegas, S M; Senthirajah, S K J; Nemanic, S; Baltzer, W; Warnock, J; Bobe, G

    2015-01-01

    The purpose of our study was (1) to determine whether four-view radiography of the pelvis is as reliable and accurate as computed tomography (CT) in diagnosing sacral and pelvic fractures, in addition to coxofemoral and sacroiliac joint subluxation or luxation, and (2) to evaluate the effect of the amount of training in reading diagnostic imaging studies on the accuracy of diagnosing sacral and pelvic fractures in dogs. Sacral and pelvic fractures were created in 11 canine cadavers using a lateral impactor. In all cadavers, frog-legged ventro-dorsal, lateral, right and left ventro-45°-medial to dorsolateral oblique frog leg ("rollover 45-degree view") radiographs and a CT of the pelvis were obtained. Two radiologists, two surgeons and two veterinary students classified fractures using a confidence scale and noted the duration of evaluation for each imaging modality and case. The imaging results were compared to gross dissection. All evaluators required significantly more time to analyse CT images compared to radiographic images. Sacral and pelvic fractures, specifically those of the sacral body, ischiatic table, and the pubic bone, were more accurately diagnosed using CT compared to radiography. Fractures of the acetabulum and iliac body were diagnosed with similar accuracy (at least 86%) using either modality. Computed tomography is a better method for detecting canine sacral and some pelvic fractures compared to radiography. Computed tomography provided an accuracy of close to 100% in persons trained in evaluating CT images.

  20. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    International Nuclear Information System (INIS)

    Hald, J.K.; Nakstad, P.H.; Hauglum, B.E.

    1991-01-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.)

  1. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    Energy Technology Data Exchange (ETDEWEB)

    Hald, J K; Nakstad, P H; Hauglum, B E [National Hospital, Oslo (Norway). Dept. of Radiology

    1991-05-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.).

  2. Sacral Myeloid Sarcoma Manifesting as Radiculopathy in a Pediatric Patient: An Unusual Form of Myeloid Leukemia Relapse

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    Joana Ruivo Rodrigues

    2018-01-01

    Full Text Available Myeloid sarcoma (MS, granulocytic sarcoma or chloroma, is defined as a localized extramedullary mass of blasts of granulocytic lineage with or without maturation, occurring outside the bone marrow. MS can be diagnosed concurrently with acute myeloid leukemia (AML or myelodysplastic syndrome (MDS. The authors report a case of sacral MS occurring as a relapse of myeloid leukemia in a 5-year-old girl who was taken to the emergency department with radiculopathy symptoms.

  3. VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV—Can Be an Alternative to Flap Reconstruction?

    OpenAIRE

    Batra, R. K.; Aseeja, Veena

    2012-01-01

    Vacuum-assisted closure (VAC) therapy is a new entrant in wound care after growth factors and alginate or hydrocolloid dressing, in the treatment of pressure ulcers. We have been using this technique for diabetic foot ulcers. A young nondiabetic man presented with a large sacral bed sore after high doses of ionotropes in an intensive care unit for treating severe hypotension. His wound was debrided, and instead of flap surgery in such infected wound, he was treated with VAC therapy. The compl...

  4. Shrines and relics between Late Antiquity and Middle Ages: Christianization of the space or sacralization of the Christianity?

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    Luigi Canetti

    2002-12-01

    Full Text Available This essay analyzes the importance of relics and sanctuaries against the backdrop of the sacralization of Christianity and the latter’s re-elaboration into a religious system that occurred in urban milieux in the late ancient times. The main steps of this process, which came to a climax in the 4th century, are the Christianization of time and space as well as the reinterpretation of Christ’s death in terms of a sacrifice.

  5. Urinary retention, erectile dysfunction and meningitis due to sacral herpes zoster: a case report and review of the literature.

    Science.gov (United States)

    Erol, B; Avci, A; Eken, C; Ozgok, Y

    2009-01-01

    Zona zoster infection is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Varicella zoster virus which stays latent in the sensorial root ganglia causes zona zoster infection. The most recognized feature of zona zoster is the dermatomal distribution of vesicular rashes. In the present case report, we state an unusual presentation of sacral zona zoster with urinary retention, erectile dysfunction and meningitis. Copyright 2009 S. Karger AG, Basel.

  6. Accessing 3D Location of Standing Pelvis: Relative Position of Sacral Plateau and Acetabular Cavities versus Pelvis

    International Nuclear Information System (INIS)

    Berthonnaud, E.; Hilmi, R.; Berthonnaud, E.; Berthonnaud, E.; Dimnet, J.

    2012-01-01

    The goal of this paper is to access to pelvis position and morphology in standing posture and to determine the relative locations of their articular surfaces. This is obtained from coupling bi planar radiography and bone modeling. The technique involves different successive steps. Punctual landmarks are first reconstructed, in space, from their projected images, identified on two orthogonal standing X-rays. Geometric models, of global pelvis and articular surfaces, are determined from punctual landmarks. The global pelvis is represented as a triangle of summits: the two femoral head centers and the sacral plateau center. The two acetabular cavities are modeled as hemispheres. The anterior sacral plateau edge is represented by an hemi-ellipsis. The modeled articular surfaces are projected on each X-ray. Their optimal location is obtained when the projected contours of their models best fit real outlines identified from landmark images. Linear and angular parameters characterizing the position of global pelvis and articular surfaces are calculated from the corresponding sets of axis. Relative positions of sacral plateau, and acetabular cavities, are then calculated. Two hundred standing pelvis, of subjects and scoliotic patients, have been studied. Examples are presented. They focus upon pelvis orientations, relative positions of articular surfaces, and pelvis asymmetries.

  7. Treatment of intractable chronic pelvic pain syndrome by injecting a compound of Bupivacaine and Fentanyl into sacral spinal space

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zhan-song; SONG Bo; NIE Fa-chuan; CHEN Jin-mei

    2006-01-01

    Objective:To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome (CPPS). Methods: A total of 36 men with recalcitrant CPPS refractory to multiple prior therapies were treated with the injection of a compound of Bupivacaine and Fentanyl (10 ml of 0. 125% upivacaine, .05 mg Fentanyl, 5 mg Dexamethasone, 100 mg Vitamin B1 and 1 mg Vitamin B12) into sacral space once a week for 4 weeks. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), maximum and average flow rate were performed at the start and the end of 4 weeks' therapy. Results :Mean NIH-CPSI total score was decreased from 26.5±.6 to 13.4±2.0 (P<0. 001). Significant improvement was seen in each subscore domain. A total of 32 patients (89%) had at least 25% improvement on NIH-CPSI and 22 (61%) had at least 50% improvement. Maximal and average flow rate were increased from 19. 5±3.8 to 23. 6±4. 2 and 10. 9±2.6 to 14.3± 2.4 respectively. Conclusion: Injection of this compound of Bupivacaine, Fentanyl and Dexamethasone into sacral spinal space is an effective and safe approach for recalcitrant CPPS. Further study of the mechanisms and prospective placebo controlled trials are warranted.

  8. Morphological evaluation of the thoracic, lumbar and sacral column of the giant anteater (Myrmecophaga tridactyla Linnaeus, 1758

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    Naida C. Borges

    Full Text Available ABSTRACT: This study aimed to describe the number of thoracic, lumbar and sacral vertebrae in tridactyla through radiographic examinations associated with gross anatomy determination. For this purpose, 12 adult specimens of M. tridactyla were analyzed, assigned to the Screening Center of Wild Animals (CETAS, IBAMA-GO, and approved by the Ethics Committee on the Use of Animals (Process CEUA-UFG nr 018/2014. In the radiographic examinations the following numbers of thoracic (T and lumbar (L vertebrae were observed: 16Tx2L (n=7, 15Tx2L (n=3, and 15Tx3L (n=2. In contrast, the numbers of vertebrae identified by anatomical dissection were as follows: 16Tx2L (n=4, 15Tx2L (n=3, and 15Tx3L (n=5. This difference occurred in cases of lumbarization of thoracic vertebrae, as seen in three specimens, and was explained by changes in regional innervations identified by anatomical dissection and the presence of floating ribs (right unilateral=1, left unilateral=1 and bilateral=1, which were not identified by radiographic exams. Regarding the sacral vertebrae there was no variation depending on the methods used, which allowed the identification of 4 (n=1 or 5 (n=11 vertebrae. Thus, we concluded that there is variation in the number of thoracic, lumbar and sacral vertebrae, in addition to lumbarization, which must be considered based on the presence of floating ribs, in this species.

  9. Characterization of herpes simplex virus type 2 latency-associated transcription in human sacral ganglia and in cell culture.

    Science.gov (United States)

    Croen, K D; Ostrove, J M; Dragovic, L; Straus, S E

    1991-01-01

    The ability of herpes simplex virus type 2 (HSV-2) to establish latency in and reactivate from sacral dorsal root sensory ganglia is the basis for recurrent genital herpes. The expression of HSV-2 genes in latently infected human sacral ganglia was investigated by in situ hybridization. Hybridizations with a probe from the long repeat region of HSV-2 revealed strong nuclear signals overlying neurons in sacral ganglia from five of nine individuals. The RNA detected overlaps with the transcript for infected cell protein O but in the opposite, or "anti-sense," orientation. These observations mimic those made previously with HSV-1 in human trigeminal ganglia and confirm the recent findings during latency in HSV-2-infected mice and guinea pigs. Northern hybridization of RNA from infected Vero cells showed that an HSV-2 latency-associated transcript was similar in size to the larger (1.85 kb) latency transcript of HSV-1. Thus, HSV-1 and HSV-2 latency in human sensory ganglia are similar, if not identical, in terms of their cellular localization and pattern of transcription.

  10. Transcutaneous spinal direct current stimulation of the lumbar and sacral spinal cord: a modelling study

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    Fernandes, Sofia R.; Salvador, Ricardo; Wenger, Cornelia; de Carvalho, Mamede; Miranda, Pedro C.

    2018-06-01

    Objective. Our aim was to perform a computational study of the electric field (E-field) generated by transcutaneous spinal direct current stimulation (tsDCS) applied over the thoracic, lumbar and sacral spinal cord, in order to assess possible neuromodulatory effects on spinal cord circuitry related with lower limb functions. Approach. A realistic volume conductor model of the human body consisting of 14 tissues was obtained from available databases. Rubber pad electrodes with a metallic connector and a conductive gel layer were modelled. The finite element (FE) method was used to calculate the E-field when a current of 2.5 mA was passed between two electrodes. The main characteristics of the E-field distributions in the spinal grey matter (spinal-GM) and spinal white matter (spinal-WM) were compared for seven montages, with the anode placed either over T10, T8 or L2 spinous processes (s.p.), and the cathode placed over right deltoid (rD), umbilicus (U) and right iliac crest (rIC) areas or T8 s.p. Anisotropic conductivity of spinal-WM and of a group of dorsal muscles near the vertebral column was considered. Main results. The average E-field magnitude was predicted to be above 0.15 V m-1 in spinal cord regions located between the electrodes. L2-T8 and T8-rIC montages resulted in the highest E-field magnitudes in lumbar and sacral spinal segments (>0.30 V m-1). E-field longitudinal component is 3 to 6 times higher than the ventral-dorsal and right-left components in both the spinal-GM and WM. Anatomical features such as CSF narrowing due to vertebrae bony edges or disks intrusions in the spinal canal correlate with local maxima positions. Significance. Computational modelling studies can provide detailed information regarding the electric field in the spinal cord during tsDCS. They are important to guide the design of clinical tsDCS protocols that optimize stimulation of application-specific spinal targets.

  11. Cancer of the breast and anterior sacral meningeal in a patient with Marfan syndrome

    International Nuclear Information System (INIS)

    Cataldi, S.; Laureiro, E.; Musetti, C.; Vázquez, A.; Cabovianco, A.

    2004-01-01

    Introduction. Breast cancer is the most common malignancy of women in the world Western. It is rare below 30 years. Marfan syndrome (MS) is an entity clinically characterized by cardiovascular, ocular and skeletal genetic base. Its prevalence is estimated at 4-6 per 100,000 births. In the literature there are few reports of cancers diagnosed in association with SM, and after a thorough review, we found only two communications association with malformations such as dural sac meningocele. Objective. The aim of this study was to review the literature from communication A case report of a patient with SM in which the age of 24 he diagnosed with breast cancer and a previous sacral meningocele. Case. Female patient 24 years old, with SM, who consulted a tumor of right breast. Was studied with mammography and cytological puncture were positive for malignancy. Local treatment consisted of modified radical mastectomy and chest wall radiotherapy. The pathology corresponded to ductal carcinoma Infiltrating (CDI) NOS 27mm diameter greater final histologic grade II carcinoma in situ solid and cribriform intermediate grade without necrosis greater than 30%; 10 axillary lymph resected, all free of metastases. The dosage of hormone receptors was frankly positive for both estrogen and progesterone. In sum CDI NOS stage IIA. the chest radiograph and bone scan showed no abnormalities and abdominal ultrasound He requested postoperatively revealed an abdominopelvic image 13 x 16 cm. positron abdomen and pelvis confirmed a predominantly cystic mass in the pelvis and abdomen lower. Exploratory laparotomy revealed that the tumor corresponded to a meningocele before and proceeded to peritoneal cyst resection and closure of the sacral gap. At the time of writing, the patient is free and without neurological deficit disease, low adjuvant Tamoxifen for 3 years. Conclusions. The SM as breast cancer in younger women is uncommon. Few cancers have been reported in association with SM. Some of

  12. The feasibility and radiological features of sacral alar iliac fixation in an adult population: a 3D imaging study

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    Ai-Min Wu

    2016-01-01

    Full Text Available Background: Surgical treatments for adult spinal deformities often include pelvic fixation, and the feasibility of sacral-2 alar iliac (S2AI screw fixation has been shown previously. However, sometimes S2AI screw fixation cannot be applied due to the presence of an osteolytic lesion or trauma or because the biomechanical properties of only an S2AI screw is insufficient. Therefore, we questioned the feasibility of using sacral AI screws in other segments and determined whether S3AI and S4AI screws have the potential to be used for sacral fractures. The aim of this study was to investigate the feasibility and radiological features of sacral AI fixation in S1–S4 in an adult population using 3D imaging techniques. Methods: Computed tomography (CT scans were taken of 45 patients and were imported into Mimics (Version 10.01, Materialise, Belgium software to reconstruct the 3D digital images. Next, a cylinder (radius of 3.5 mm was drawn to imitate the screw trajectory of a S1–4 AI screw, and every imitated screw in each segment was adjusted to a maximum upward and downward angle to acquire the feasible region. The parameters of the S1–4AI screw trajectories were measured. Results: Sacral AI screws could be successfully imitated using 3D digital imaging. The S4AI screw trajectory could be obtained in 19 of 45 patient images (42.2%, while the feasibility rates of S1AI, S2AI, and S3AI screw fixation were 100%, 100%, and 91.1% (41/45, respectively. The feasible regions of S1AI, S2AI, and S3AI screw trajectories were wide enough, while the adjustable angle of S4AI screws was very small. Conclusion: It is feasible to place S1–2AI screws in the entire adult population and S3–4AI screws in some of the adult population. Furthermore, our study suggested that 3D digital images are suitable to study the feasibility of new screw fixation.

  13. CT-guided percutaneous injection of the fibrin glue by 'double needle' technique for the treatment of sacral cysts

    International Nuclear Information System (INIS)

    Wang Ganggang; Chen Long; Yang Chao; Ni Caifang

    2013-01-01

    Objective: To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue by 'double needle' technique to treat sacral cyst. Methods: Clinical data of 20 cases with 'double-needle' injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed. All patients had varying degrees of sacral nerve root compression symptoms. The treatment for sacral cyst was carried out after clear diagnosis was made. On the basis of CT-guided percutaneous injection of fibrin glue, the improved CT-guided percutaneous injection of fibrin glue by 'double-needle' technique was used to treat these patients. The average dose of fibrin glue was (5.9 ± 2.4) ml. The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months. The assessment criteria were as follows: excellent, complete resolution of signs and symptoms, with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up, good, symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region, which did not interfere with the patient's regular work (the cysts did not recur for 6 months during follow-up), fair, no improvement in clinical symptoms, but a decrease in cyst size on the imaging study, poor, no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence. Results: Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy, with most experiencing complete or marked resolution of clinical symptoms. Nine patients reported excellent recovery, 8 reported good recovery, 2 reported fair recovery, and 1 reported poor recovery. The overall percentage of positive outcomes (excellent and good recovery) was 85%. No serious postoperative complications were discovered. Conclusions: CT guided percutaneous injection of the fibrin glue by

  14. Chronic monitoring of lower urinary tract activity via a sacral dorsal root ganglia interface

    Science.gov (United States)

    Khurram, Abeer; Ross, Shani E.; Sperry, Zachariah J.; Ouyang, Aileen; Stephan, Christopher; Jiman, Ahmad A.; Bruns, Tim M.

    2017-06-01

    Objective. Our goal is to develop an interface that integrates chronic monitoring of lower urinary tract (LUT) activity with stimulation of peripheral pathways. Approach. Penetrating microelectrodes were implanted in sacral dorsal root ganglia (DRG) of adult male felines. Peripheral electrodes were placed on or in the pudendal nerve, bladder neck and near the external urethral sphincter. Supra-pubic bladder catheters were implanted for saline infusion and pressure monitoring. Electrode and catheter leads were enclosed in an external housing on the back. Neural signals from microelectrodes and bladder pressure of sedated or awake-behaving felines were recorded under various test conditions in weekly sessions. Electrodes were also stimulated to drive activity. Main results. LUT single- and multi-unit activity was recorded for 4-11 weeks in four felines. As many as 18 unique bladder pressure single-units were identified in each experiment. Some channels consistently recorded bladder afferent activity for up to 41 d, and we tracked individual single-units for up to 23 d continuously. Distension-evoked and stimulation-driven (DRG and pudendal) bladder emptying was observed, during which LUT sensory activity was recorded. Significance. This chronic implant animal model allows for behavioral studies of LUT neurophysiology and will allow for continued development of a closed-loop neuroprosthesis for bladder control.

  15. A case of von Willebrand disease discovered during treatment of a sacral pressure ulcer.

    Science.gov (United States)

    Murakami, Masahiro; Fukaya, Sumiko; Furuya, Masaichi; Hyakusoku, Hiko

    2010-12-01

    A sacral pressure ulcer developed in a patient hospitalized for cerebral infarction. Each time necrotic tissue was debrided from the ulcer, pressure hemostasis was necessary to stop the bleeding. As treatment continued, the pressure required to stop the bleeding caused the ulcer to worsen, leading to a downward spiral in the patient's condition. While trying to determine the cause of this problem, we discovered that the patient had von Willebrand disease. Medication controlled the bleeding, and the pressure ulcer began to heal at the same time. It was clear to us that conservative treatment would lead to a complete cure but that the healing process would take a long time and require continued administration of an expensive drug. We decided, therefore, to close the wound with a fasciocutaneous flap so that the patient could be quickly transferred to a rehabilitation hospital. About 1 month after surgery, epithelialization was complete, we were able to discontinue medication, and the patient was discharged. This experience demonstrates the importance of determining the cause of any deviation from the normal course of healing in pressure ulcers. It also indicates that the use of fasciocutaneous flaps, which involve little intraoperative bleeding in short surgeries, is appropriate in cases like this one.

  16. Disabling Orthostatic Headache after Penetrating Stonemason Pencil Injury to the Sacral Region

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    Carlo Brembilla

    2015-01-01

    Full Text Available Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.

  17. Sexual response in patients treated with sacral neuromodulation for lower urinary tract symptoms or fecal incontinence.

    Science.gov (United States)

    van Voskuilen, A C; Oerlemans, D J; Gielen, N; Lansen-Koch, S M P; Weil, E H J; van Lankveld, J J D M; van den Hombergh, U; Baeten, C G M I; van Kerrenbroeck, P E V

    2012-01-01

    To determine whether sacral neuromodulation (SNM) for urinary symptoms or fecal incontinence gives improvement of female sexual function and whether improvement is due to physiological or psychological factors. Between 2002 and 2008, 8 patients had an array of questionnaires before and after SNM implantation. The questionnaires were: the Questionnaire for Screening for Sexual Dysfunctions, the Golombok Rust Inventory of Sexual Satisfaction, the Symptom Checklist-90, the Maudsley Marital Questionnaire and the McGill-Mah Orgasm Questionnaire. Three of these 8 patients underwent vaginal plethysmography before and after implantation. No statistically significant changes were found, although there seems to be a trend toward improvement in orgasm scores. In plethysmography all 3 patients showed increased vaginal pulse amplitude with the stimulator turned on with both erotic and non-erotic stimuli. This study does not show a clear effect of SNM on sexual function, although there seems to be an improvement in orgasm scores. The lack of response on psychological questionnaires and the increase in vaginal pulse amplitude after SNM implantation indicate that there might be a physiological response. Copyright © 2012 S. Karger AG, Basel.

  18. Neuromodulation of detrusor hyper-reflexia by functional magnetic stimulation of the sacral roots.

    Science.gov (United States)

    Sheriff, M K; Shah, P J; Fowler, C; Mundy, A R; Craggs, M D

    1996-07-01

    To investigate the acute effects of functional magnetic stimulation (FMS) on detrusor hyper-reflexia using a multi-pulse magnetic stimulator. Seven male patients with established and intractable detrusor hyper-reflexia following spinal cord injury were studied. No patient was on medication and none had had previous surgery for detrusor hyper-reflexia. After optimization of magnetic stimulation of S2-S4 sacral anterior roots by recording toe flexor electromyograms, unstable detrusor activity was provoked during cystometry by rapid infusion of fluid into the bladder. The provocation test produced consistent and predictable detrusor hyper-reflexia. On some provocations, supramaximal FMS at 20 pulses/s for 5 s was applied at detrusor pressures which were > 15 cmH2O. Following FMS there was an obvious acute suppression of detrusor hyper-reflexia. There was a profound reduction in detrusor contraction, as assessed by the area under the curves of detrusor pressure with time. Functional magnetic stimulation applied over the sacrum can profoundly suppress detrusor hyper-reflexia in man. It may provide a non-invasive method of assessing patients for implantable electrical neuromodulation devices and as a therapeutic option in its own right.

  19. Effects of Acute Sacral Neuromodulation at Different Frequencies on Bladder Overactivity in Pigs

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    Xing Li

    2017-06-01

    Full Text Available Purpose We investigated the effects of different stimulation frequencies on the inhibition of bladder overactivity by sacral neuromodulation (SNM in pigs. Methods Implant-driven stimulators were used to stimulate the S3 spinal nerve in 13 pigs. Cystometry was performed by infusing normal saline (NS or acetic acid (AA. SNM (pulse width, 210 µsec at frequencies ranging from 5 to 50 Hz was conducted at the intensity threshold at which observable perianal and/or tail movement was induced. Multiple cystometrograms were performed to determine the effects of different frequencies on the micturition reflex. Results AA-induced bladder overactivity significantly reduced the bladder capacity (BC to 34.4%±4.7% of the NS control level (354.4±35.9 mL (P0.05, but SNM at 15, 30, and 50 Hz significantly increased the BC to 54.5%±7.1%, 55.2%±6.5%, and 57.2%±6.1% of the NS control level (P0.05. Conclusions This study demonstrated that 15 Hz was an appropriate frequency for SNM and that frequencies higher than 15 Hz did not lead to better surgical outcomes.

  20. Sacral nerve stimulation for constipation: do we still miss something? Role of psychological evaluation.

    Science.gov (United States)

    Carriero, Alfonso; Martellucci, Jacopo; Talento, Pasquale; Ferrari, Carlo Andrea

    2010-08-01

    The aim of this study was to try to understand if psychological evaluation of patients candidate to sacral nerve stimulation (SNS) could be a potential selection criterion to identify those patients who could successfully respond to this treatment. From 2005 to 2007, 68 patients with slow transit constipation were identified, and all of them fulfill the selection criteria for the SNS treatment. The MMPI-2 test was purposed to all the patients. Wexner score, bowel movements, and SF36 were recorded in all the patients. Twenty-three patients (33.8%) refused the psychological evaluation. Forty-five patients completed the test: only 13 patients (19.1%) had a score in the normal range of the scales of the MMPI-2 and were implanted with the temporary test for SNS. After the screening period, 11 patients (84.6%) reported more than 50% improvement of bowel movements per week and no need of laxatives, so they were definitively implanted. The mean follow-up period was 22 months (range 12-36). The mean number of bowel movements per week and Wexner score were significantly improved after 1 year (p < 0.001). A complete and accurate psychological evaluation could be very important in the selection of the patients with STC that could benefit from SNS.

  1. Sacral Nerve Stimulation For Urinary Urge Incontinence, Urgency-Frequency, Urinary Retention, and Fecal Incontinence

    Science.gov (United States)

    2005-01-01

    Executive Summary Objective The aim of this review was to assess the effectiveness, safety, and cost of sacral nerve stimulation (SNS) to treat urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence. Background: Condition and Target Population Urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence are prevalent, yet rarely discussed, conditions. They are rarely discussed because patients may be uncomfortable disclosing their symptoms to a health professional or may be unaware that there are treatment options for these conditions. Briefly, urge incontinence is an involuntary loss of urine upon a sudden urge. Urgency-frequency is an uncontrollable urge to void, which results in frequent, small-volume voids. People with urgency-frequency may or may not also experience chronic pelvic pain. Urinary retention refers to the inability to void despite having the urge to void. It can be caused by a hypocontractile detrusor (weak or no bladder muscle contraction) or obstruction due to urethral overactivity. Fecal incontinence is a loss of voluntary bowel control. The prevalence of urge incontinence, urgency-frequency, and urinary retention in the general population is 3.3% to 8.2%, and the prevalence of fecal incontinence is 1.4% to 1.9%. About three-quarters of these people will be successfully treated by behaviour and/or drug therapy. For those who do not respond to these therapies, the options for treatment are management with diapers or pads, or surgery. The surgical procedures are generally quite invasive, permanent, and are associated with complications. Pads and/or diapers are used throughout the course of treatment as different therapies are tried. Patients who respond successfully to treatment may still require pads or diapers, but to a lesser extent. The Technology Being Reviewed: Sacral Nerve Stimulation Sacral nerve stimulation is a procedure where a small device attached to an electrode is

  2. Prevalence of sacral dysmorphia in a prospective trauma population: Implications for a "safe" surgical corridor for sacro-iliac screw placement

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    Newman Justin T

    2011-05-01

    Full Text Available Abstract Background Percutaneous sacro-iliac (SI screw fixation represents a widely used technique in the management of unstable posterior pelvic ring injuries and sacral fractures. The misplacement of SI-screws under fluoroscopic guidance represents a critical complication for these patients. This study was designed to determine the prevalence of sacral dysmorphia and the radiographic anatomy of surgical S1 and S2 corridors in a representative trauma population. Methods Prospective observational cohort study on a consecutive series of 344 skeletally mature trauma patients of both genders enrolled between January 1, 2007, to September 30, 2007, at a single academic level 1 trauma center. Inclusion criteria included a pelvic CT scan as part of the initial diagnostic trauma work-up. The prevalence of sacral dysmorphia was determined by plain radiographic pelvic films and CT scan analysis. The anatomy of sacral corridors was analyzed on 3 mm reconstruction sections derived from multislice CT scan, in the axial, coronal, and sagittal plane. "Safe" potential surgical corridors at S1 and S2 were calculated based on these measurements. Results Radiographic evidence of sacral dysmorphia was detected in 49 patients (14.5%. The prevalence of sacral dysmorphia was not significantly different between male and female patients (12.2% vs. 19.2%; P = 0.069. In contrast, significant gender-related differences were detected with regard to radiographic analysis of surgical corridors for SI-screw placement, with female trauma patients (n = 99 having significantly narrower corridors at S1 and S2 in all evaluated planes (axial, coronal, sagittal, compared to male counterparts (n = 245; P P = 0.06, implying S2 as a safe surgical corridor of choice in patients with sacral dysmorphia. Conclusions These findings emphasize a high prevalence of sacral dysmorphia in a representative trauma population and imply a higher risk of SI-screw misplacement in female patients

  3. Clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in the resection of sacral tumors

    International Nuclear Information System (INIS)

    Chen Wenhua; Wang Qi; He Zhongming; Zhou Jian; Wang Yimin; Wang Jie

    2012-01-01

    Objective: To investigate the clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in performing the surgical resection of sacral tumors. Methods: Conventional surgical excision of sacral tumors was employed in 24 patients with sacral tumors (control group), while preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta was carried out in 32 patients with sacral tumors (study group). The operation time, blood loss during the surgery and the one-year recurrence rate of both groups were documented, and the results were statistically analyzed. Results: Angiography showed that in the study group the sacral tumors were supplied by several vessels, and these feeding arteries were occluded separately. The tumors were successfully removed in all patients with the help of intraoperative balloon occlusion of the abdominal aorta. During the surgery, the surgical area was clearly exposed and the blood loss wa remarkably reduced. After the surgery, no ectopic vascular embolization, renal ischemia, limb ischemia or other complications occurred. Statistically significant difference in the operation time, blood loss during the surgery and the one-year recurrence rate existed between the two groups (P<0.05). Conclusion: Preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta can effectively shorten the operation time, reduce the blood loss during the surgery and provide a clear surgical field, and thus the surgical safety can be significantly ensured. (authors)

  4. Pühaduse performatiivsus ja kristlik teater / The Performativity of Sacrality and Christian Theatre

    Directory of Open Access Journals (Sweden)

    Madis Kolk

    2015-06-01

    Full Text Available Teesid: 20. sajandil on esile kerkinud mitmeid teatrisuundi, mis on kritiseerinud ja püüdnud ületada Lääne traditsioonilise teatri väidetavat sõnakesksust ning samuti selle võimetust täita n-ö püha kunsti funktsioone. Kuigi seda pühadusedefitsiiti on püütud leevendada ennekõike orientaalsetest teatrivormidest inspiratsiooni ammutades, aitab selle võimalikku tekkelugu mõista ka katoliikliku kultuuri mõjuväljas võrsunud teatrikunsti ning teatrivaenulikuma ortodoksi teoloogia kontekstis välja töötatud ikooniteoloogia võrdlus. Kõrvutades nende kahe konfessiooni teoloogilis-esteetilisi arusaamu, saame analüüsida ka performatiivsuse esteetika seisukohast olulisi kunstiteose loome- ja tajutingimuste vormilisi ja meelelisi aspekte ning nende toimet sakraalse kunsti sihtide seisukohast. SU M M A R Y In the 21st century Western society has seen an increasing interest in topics related to religion. In this context, the connection between the concept of sacrality in Western culture and freedom of verbal and artistic expression has been reconsidered; the very possibility of so-called sacred art within Western culture has been called into question. Already in the 20th century several theatrical movements in the West have expressed the need to strive for religious (or at least quasi-religious goals by means of the stage. This can already be seen in the work of the symbolists, but such experiments accelerated and became more forceful under the influence of Antonin Artaud’s visions and under the aegis of intercultural theatre. In all of these different quests one can find common elements: discontent with the discursivity of the theatrical canon, a need for a metaphysical dimension in the theatre, and the belief that channels of perception can be opened through contact with exotic ritual cultures. In his book Sacred Theatre Ralph Yarrow has attempted to define the criteria of sacrality in the theatre, drawing upon William S. Haney

  5. Lumbar lordosis and sacral slope in lumbar spinal stenosis: standard values and measurement accuracy.

    Science.gov (United States)

    Bredow, J; Oppermann, J; Scheyerer, M J; Gundlfinger, K; Neiss, W F; Budde, S; Floerkemeier, T; Eysel, P; Beyer, F

    2015-05-01

    Radiological study. To asses standard values, intra- and interobserver reliability and reproducibility of sacral slope (SS) and lumbar lordosis (LL) and the correlation of these parameters in patients with lumbar spinal stenosis (LSS). Anteroposterior and lateral X-rays of the lumbar spine of 102 patients with LSS were included in this retrospective, radiologic study. Measurements of SS and LL were carried out by five examiners. Intraobserver correlation and correlation between LL and SS were calculated with Pearson's r linear correlation coefficient and intraclass correlation coefficients (ICC) were calculated for inter- and intraobserver reliability. In addition, patients were examined in subgroups with respect to previous surgery and the current therapy. Lumbar lordosis averaged 45.6° (range 2.5°-74.9°; SD 14.2°), intraobserver correlation was between Pearson r = 0.93 and 0.98. The measurement of SS averaged 35.3° (range 13.8°-66.9°; SD 9.6°), intraobserver correlation was between Pearson r = 0.89 and 0.96. Intraobserver reliability ranged from 0.966 to 0.992 ICC in LL measurements and 0.944-0.983 ICC in SS measurements. There was an interobserver reliability ICC of 0.944 in LL and 0.990 in SS. Correlation between LL and SS averaged r = 0.79. No statistically significant differences were observed between the analyzed subgroups. Manual measurement of LL and SS in patients with LSS on lateral radiographs is easily performed with excellent intra- and interobserver reliability. Correlation between LL and SS is very high. Differences between patients with and without previous decompression were not statistically significant.

  6. Value of MRI in the diagnosis of non-clival, non-sacral chordoma

    Energy Technology Data Exchange (ETDEWEB)

    Smolders, D.; Wang, X.; Vanhoenacker, F.; De Schepper, A.M. [Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem (Belgium); Drevelengas, A. [Department of Radiology, University of Thessaloniki, Thessaloniki (Greece)

    2003-06-01

    To determine the MR features of non-sacral, non-clival chordoma and to describe a MR prototype of the lesion.Design and patients We reviewed the MR findings of 10 patients with a histologically proven chordoma (6 cervical spine, 1 thoracic spine, 3 lumbar spine). There were three female and seven male patients. Age ranged from 12 to 66 years with a mean age of 44.6 years. The MR images were reviewed for signal intensity (SI) and morphology. All lesions showed a soft tissue extension spanning several vertebral segments. Most of the lesions exhibited a so-called collar button appearance (sagittal images). Two cases of cervical chordoma displayed a ''dumbbell morphology'' (axial images) or ''mushroom'' appearance without bone involvement and with enlargement of the neuroforamen mimicking a neurogenic tumor. Although the region of the nucleus pulposus is the last part of the fetal notochord in the adult to involute, disks were surprisingly spared in all patients. Eight of 10 patients showed heterogeneous SI on all sequences. The overall SI of all lesions was isointense or slightly higher than that of muscle on T1-weighted images. All lesions exhibited high SI on T2-weighted images. After gadolinium contrast administration there was a moderate enhancement in most cases. Although the SI on MR imaging is not specific, chordoma should be considered when a destructive lesion of a vertebral body is associated with a soft tissue mass with a collar button or mushroom appearance and dumbbell morphology, spanning several vertebral segments and sparing the disk(s). (orig.)

  7. Value of MRI in the diagnosis of non-clival, non-sacral chordoma

    International Nuclear Information System (INIS)

    Smolders, D.; Wang, X.; Vanhoenacker, F.; De Schepper, A.M.; Drevelengas, A.

    2003-01-01

    To determine the MR features of non-sacral, non-clival chordoma and to describe a MR prototype of the lesion.Design and patients We reviewed the MR findings of 10 patients with a histologically proven chordoma (6 cervical spine, 1 thoracic spine, 3 lumbar spine). There were three female and seven male patients. Age ranged from 12 to 66 years with a mean age of 44.6 years. The MR images were reviewed for signal intensity (SI) and morphology. All lesions showed a soft tissue extension spanning several vertebral segments. Most of the lesions exhibited a so-called collar button appearance (sagittal images). Two cases of cervical chordoma displayed a ''dumbbell morphology'' (axial images) or ''mushroom'' appearance without bone involvement and with enlargement of the neuroforamen mimicking a neurogenic tumor. Although the region of the nucleus pulposus is the last part of the fetal notochord in the adult to involute, disks were surprisingly spared in all patients. Eight of 10 patients showed heterogeneous SI on all sequences. The overall SI of all lesions was isointense or slightly higher than that of muscle on T1-weighted images. All lesions exhibited high SI on T2-weighted images. After gadolinium contrast administration there was a moderate enhancement in most cases. Although the SI on MR imaging is not specific, chordoma should be considered when a destructive lesion of a vertebral body is associated with a soft tissue mass with a collar button or mushroom appearance and dumbbell morphology, spanning several vertebral segments and sparing the disk(s). (orig.)

  8. Preoperative embolization of hypervascular thoracic, lumbar, and sacral spinal column tumors: technique and outcomes from a single center.

    Science.gov (United States)

    Nair, Sreejit; Gobin, Y Pierre; Leng, Lewis Z; Marcus, Joshua D; Bilsky, Mark; Laufer, Ilya; Patsalides, Athos

    2013-09-01

    The existing literature on preoperative spine tumor embolization is limited in size of patient cohorts and diversity of tumor histologies. This report presents our experience with preoperative embolization of hypervascular thoracic, lumbar, and sacral spinal column tumors in the largest series to date. We conducted a retrospective review of 228 angiograms and 188 pre-operative embolizations for tumors involving thoracic, lumbar and sacral spinal column. Tumor vascularity was evaluated with conventional spinal angiography and was graded from 0 (same as normal adjacent vertebral body) to 3 (severe tumor blush with arteriovenous shunting). Embolic materials included poly vinyl alcohol (PVA) particles and detachable platinum coils and rarely, liquid embolics. The degree of embolization was graded as complete, near-complete, or partial. Anesthesia records were reviewed to document blood loss during surgery. Renal cell carcinoma (44.2%), thyroid carcinoma (9.2%), and leiomyosarcoma (6.6%) were the most common tumors out of a total of 40 tumor histologies. Hemangiopericytoma had the highest mean vascularity (2.6) of all tumor types with at least five representative cases followed by renal cell carcinoma (2.0) and thyroid carcinoma (2.0). PVA particles were used in 100% of cases. Detachable platinum coils were used in 51.6% of cases. Complete, near-complete, and partial embolizations were achieved in 86.1%, 12.7%, and 1.2% of all cases, respectively. There were no new post-procedure neurologic deficits or other complications with long-term morbidity. The mean intra-operative blood loss for the hypervascular tumors treated with pre-operative embolization was 1745 cc. Preoperative embolization of hypervascular thoracic, lumbar, and sacral spine tumors can be performed with high success rates and a high degree of safety at high volume centers.

  9. Comparison of lumbar lordosis in lateral radiographs in standing position with supine MR imaging in consideration of the sacral slope

    International Nuclear Information System (INIS)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Grifka, Joachim; Voellner, Florian; Zeman, Florian

    2017-01-01

    To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Global lumbar lordosis (L1-S1) was 44.99 (± 10754) on radiographs and 47.91 (±9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p < 0.01). Measurements of single level lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9 . Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3 ) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71 ) was lower than L4 / L5 lordosis (27.63 ) compared to the other groups. Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9 . MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs.

  10. Comparison of lumbar lordosis in lateral radiographs in standing position with supine MR imaging in consideration of the sacral slope

    Energy Technology Data Exchange (ETDEWEB)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Grifka, Joachim; Voellner, Florian [Regensburg Univ. Medical Center (Germany). Orthopedic Surgery; Zeman, Florian [Regensburg Univ. Medical Center (Germany). Center for Clinical Studies

    2017-03-15

    To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Global lumbar lordosis (L1-S1) was 44.99 (± 10754) on radiographs and 47.91 (±9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p < 0.01). Measurements of single level lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9 . Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3 ) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71 ) was lower than L4 / L5 lordosis (27.63 ) compared to the other groups. Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9 . MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs.

  11. Median Sacral Artery, Sympathetic Nerves, and the Coccygeal Body: A Study Using Serial Sections of Human Embryos and Fetuses.

    Science.gov (United States)

    Jin, Zhe Wu; Cho, Kwang Ho; Jang, Hyung Suk; Murakami, Gen; Rodríguez-Vázquez, Jose Francisco

    2016-07-01

    To examine how the median sacral artery (MSA) is involved with the coccygeal body or glomus coccygeum, we studied serial frontal or sagittal sections of 14 embryos (approximately 5-6 weeks of gestation) and 12 fetuses (10-18 weeks). At five weeks, the caudal end of the dorsal aorta (i.e., MSA) accompanied putative sympathetic ganglion cells in front of the upper coccygeal and lower sacral vertebrae. At six weeks, a candidate for the initial coccygeal body was identified as a longitudinal arterial plexus involving nerve fibers and sympathetic ganglion cells between arteries. At 10-18 weeks, the MSA exhibited a highly tortuous course at the lower sacral and coccygeal levels, and was attached to and surrounded by veins, nerve fibers, and sympathetic ganglion cells near and between the bilateral origins of the levator ani muscle. Immunohistochemistry demonstrated expression of tyrosine hydroxylase and chromogranin A in the nerves. However, throughout the stages examined, we found no evidence suggestive of an arteriovenous anastomosis, such as well-developed smooth muscle. An acute anterior flexure of the vertebrae at the lower sacrum, as well as regression of the secondary neural tube, seemed to induce arterial plexus formation from an initial straight MSA. Nerves and ganglion cells were likely to be secondarily involved with the plexus because of the close topographical relationship. However, these nerves might play a major role in the extreme change into adult morphology. An arteriovenous anastomosis along the MSA might be an overinterpretation, at least in the prenatal human. Anat Rec, 299:819-827, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Comparative study between fasciocutaneous and myocutaneous flaps in the surgical treatment of pressure ulcers of the sacral region

    Directory of Open Access Journals (Sweden)

    D. Oksman

    2018-06-01

    Full Text Available Introduction: Decubitus ulcers of the sacral region are common conditions in bedridden patients. Deep lesions (Stages III and IV often require surgical treatment for closure. Flaps of the region are the first choice for treatment. We present our experience in the treatment of these lesions and compare two different approaches: local fasciocutaneous flap and gluteus maximus myocutaneous flap with V-Y advancement. Method: From March 2009 to May 2014, 32 patients underwent closure of sacral pressure ulcers by flaps, 17 of them with rotational local fasciocutaneous flaps and 15 with myocutaneous flaps of the gluteus maximus muscle with V-Y advancement. Evolution regarding complications and rate of success after two months was compared between the groups. Results: Out of the 32 operated patients we obtained resolution of lesions after two months in 23 (71.8%, 10 patients in the fasciocutaneous flap group (58.8% and 13 cases in the myocutaneous flap group (86.6%. The most common complication was partial dehiscence of sutures in 12 patients (37.5%, 8 patients in the fasciocutaneous flap group (47% and 4 patients in the myocutaneous flap group (26.6%. The group of patients reconstructed with local fasciocutaneous flaps presented 3 cases with seroma, one with hematoma and 6 with partial cutaneous necrosis; these patients also required more drainage time. Conclusions: Both the local rotational fasciocutaneous flap and the myocutaneous flap of the gluteus maximus muscle in V-Y flap can be used in the surgical treatment of sacral ulcers. In our experience, a reduced success rate and more complications were found in the local fasciocutaneous reconstructive method. Keywords: Pressure ulcer, Fasciocutaneous flap, Myocutaneous flap, Gluteus maximus muscle

  13. VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV-Can Be an Alternative to Flap Reconstruction?

    Science.gov (United States)

    Batra, R K; Aseeja, Veena

    2014-04-01

    Vacuum-assisted closure (VAC) therapy is a new entrant in wound care after growth factors and alginate or hydrocolloid dressing, in the treatment of pressure ulcers. We have been using this technique for diabetic foot ulcers. A young nondiabetic man presented with a large sacral bed sore after high doses of ionotropes in an intensive care unit for treating severe hypotension. His wound was debrided, and instead of flap surgery in such infected wound, he was treated with VAC therapy. The complete wound healing was achieved in 6 weeks and at half the cost of flap surgery. Moreover, the chances of flap failure and its related complications were eliminated.

  14. Sacral Theater, a code to simulate the propagation of the superconducting magnet LHC atlas barrel toroid transition

    International Nuclear Information System (INIS)

    Gastineau, B.

    2000-06-01

    Sacral Theater has been developed for the toroid magnet Atlas of the CERN LHC project. This three dimensional calculations code calculates the propagation of the transition of a superconducting coil in 25 m long hippodrome. Procedures to study low currents have been included. This work is a part of the magnet safety system because the coils protection is made by warmers activating the quench propagation in case of default detection. This allows the complete dissipation of storage energy that can reach 1080 MJ on Atlas. (N.C.)

  15. Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope.

    Science.gov (United States)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Zeman, Florian; Grifka, Joachim; Völlner, Florian

    2017-03-01

    Purpose  To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. Methods  MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Results  Global lumbar lordosis (L1-S1) was 44.99° (± 10 754) on radiographs and 47.91° (± 9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9°. Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3°) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71°) was lower than L4 / L5 lordosis (27.63°) compared to the other groups. Conclusions  Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9°. MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs. Key Points   · Large

  16. Exhausted implanted pulse generator in sacral nerve stimulation for faecal incontinence: What next in daily practice for patients?

    Science.gov (United States)

    Duchalais, Emilie; Meurette, Guillaume; Perrot, Bastien; Wyart, Vincent; Kubis, Caroline; Lehur, Paul-Antoine

    2016-02-01

    The efficacy of sacral nerve stimulation in faecal incontinence relies on an implanted pulse generator known to have a limited lifespan. The long-term use of sacral nerve stimulation raises concerns about the true lifespan of generators. The aim of the study was to assess the lifespan of sacral nerve stimulation implanted pulse generators in daily practice, and the outcome of exhausted generator replacement, in faecal incontinent patients. Faecal incontinent patients with pulse generators (Medtronic Interstim™ or InterstimII™) implanted in a single centre from 2001 to 2014 were prospectively followed up. Generator lifespan was measured according to the Kaplan-Meier method. Patients with a generator explanted/turned off before exhaustion were excluded. Morbidity of exhausted generator replacement and the outcome (Cleveland Clinic Florida Faecal Incontinence (CCF-FI) and Faecal Incontinence Quality of Life (FIQL) scores) were recorded. Of 135 patients with an implanted pulse generator, 112 (InterstimII 66) were included. Mean follow-up was 4.9 ± 2.8 years. The generator reached exhaustion in 29 (26%) cases. Overall median lifespan of an implanted pulse generator was approximately 9 years (95% CI 8-9.2). Interstim and InterstimII 25th percentile lifespan was 7.2 (CI 6.4-8.3) and 5 (CI 4-not reached) years, respectively. After exhaustion, generators were replaced, left in place or explanted in 23, 2 and 4 patients, respectively. Generator replacement was virtually uneventful. CCF-FI/FIQL scores remained unchanged after generator replacement (CCF-FI 8 ± 2 vs 7 ± 3; FIQL 3 ± 0.6 vs 3 ± 0.5; p = ns). In this study, the implanted pulse generator observed median lifespan was 9 years. After exhaustion, generators were safely and efficiently replaced. The study also gives insight into long-term needs and costs of sacral nerve stimulation (SNS) therapy.

  17. Surgical anesthesia with a combination of T12 paravertebral block and lumbar plexus, sacral plexus block for hip replacement in ankylosing spondylitis: CARE-compliant 4 case reports.

    Science.gov (United States)

    Ke, Xijian; Li, Ji; Liu, Yong; Wu, Xi; Mei, Wei

    2017-06-26

    Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints. A combination of T12 paravertebral block, lumbar plexus and sacral plexus block was successfully used for the surgery without any additional intravenous anesthetic or local anesthetics infiltration to the incision, and none of the patients complained of discomfort during the operations. The combination of T12 paravertebral block, lumbar plexus and sacral plexus block, which may block all nerves innervating the articular capsule, surrounding muscles and the skin involved in total hip arthroplasty, might be a promising alternative for total hip arthroplasty in ankylosing spondylitis.

  18. Morphometric study of the true S1 and S2 of the normal and dysmorphic sacralized sacra.

    Science.gov (United States)

    Firat, Ayşegül; Alemdaroğlu, Kadir Bahadır; Özmeriç, Ahmet; Yücens, Mehmet; Göksülük, Dinçer

    2017-06-12

    This study aimed to generate data for the S1 and S2 alar pedicle and body and the alar orientations for both dysmorphic and normal sacra. The study comprised two groups: Group N consisted of 53 normal sacra and Group D included 10 dysmorphic sacra. Various features such as alar pedicle circumference; anterior, middle, and posterior axis of the sacral ala; sacral body height and width; and sagittal thickness were measured. In group N, the median anterior axis of the alae was observed to be 30° on the right and 25° on the left, the median midline axis was found to be 20° on the right and 15° on the left, and the median posterior alar axis was -15° on the right and -20° on the left. The true S1 and S2 alar pedicle circumferences were observed to be significantly smaller in group D, which demonstrated a shorter S1 alar pedicle mean circumference, significantly narrower S1 body mean width, and considerably tapered sagittal thickness. Our analysis indicated that dysmorphic sacra have a lower sagittal thickness and width of bodies and smaller alar pedicles, which explains the difficulties in their percutaneous fixation.

  19. Magnetic resonance imaging of morphological and functional changes of the uterus induced by sacral surface electrical stimulation

    International Nuclear Information System (INIS)

    Ogura, Takahide; Murakami, Takashi; Ozawa, Yuka; Seki, Kazunori; Handa, Yasunobu

    2006-01-01

    The purpose of this study is to examine the morphological and kinematical changes of the uterus induced by electrical stimulation applied to the skin just above the second and fourth posterior sacral foramens (sacral surface electrical stimulation [ssES]) in 26 healthy subjects. Out of them, eight subjects who had severe pain subjectively during every menstruation received ssES just in menstruation. Morphological and functional changes of the uterus were examined by using T2-weighted magnetic resonance (MR) imaging and T1-weighted MR cinematography, respectively. Cyclic electrical stimulation for 15 min with 5 sec ON and 5 sec OFF was applied just before MR scanning. A decrease in thickness of the muscular layer of the uterus was observed in every subject after ssES for 15 min and was significant as compared with the thickness before ssES. Periodic uterine movement during menstruation was observed in the subjects with severe menstrual pain in MR cine and the power spectrum analysis of the movement showed a marked decrease in peak power and frequency after ssES treatment. We conclude that ssES causes a reduction of static muscle tension of the uterus in all menstrual cycle periods and suppression of uterine peristalsis during menstruation in the subjects with severe menstrual pain. Possible neural mechanisms for these static and dynamic effects of ssES on the uterus at spinal level are discussed. (author)

  20. Formation of the sacrum requires down-regulation of sonic hedgehog signaling in the sacral intervertebral discs.

    Science.gov (United States)

    Bonavita, Raffaella; Vincent, Kathleen; Pinelli, Robert; Dahia, Chitra Lekha

    2018-05-21

    In humans, the sacrum forms an important component of the pelvic arch, and it transfers the weight of the body to the lower limbs. The sacrum is formed by collapse of the intervertebral discs (IVDs) between the five sacral vertebrae during childhood, and their fusion to form a single bone. We show that collapse of the sacral discs in the mouse is associated with the down-regulation of sonic hedgehog (SHH) signaling in the nucleus pulposus (NP) of the disc, and many aspects of this phenotype can be reversed by experimental postnatal activation of HH signaling. We have previously shown that SHH signaling is essential for the normal postnatal growth and differentiation of intervertebral discs elsewhere in the spine, and that loss of SHH signaling leads to pathological disc degeneration, a very common disorder of aging. Thus, loss of SHH is pathological in one region of the spine but part of normal development in another. © 2018. Published by The Company of Biologists Ltd.

  1. Sacral insufficiency fractures: a report of three cases; Fracturas por insuficiencia del sacro: a proposito de tres casos

    Energy Technology Data Exchange (ETDEWEB)

    Armesto, V.; Pulpeiro, J. R.; Lauda Corchon, M. [Clinica Nosa Senora dos Ollos Grandes. Lugo (Spain)

    2000-07-01

    Sacral insufficiency fractures pose a diagnostic problem because of the nonspecific clinical signs and the absence of distinguishing features in standard radiological studies. The main causes are osteoporosis, making women reaching the age of menopause among the populations most commonly affected, and a history of radiotherapy, leading to the inclusion of neoplastic disease in the differential diagnosis. The characteristic site is ala sacralis, usually bilateral, and the fracture is vertical, running parallel to the sacroiliac joints. The sacral bone may also be involved (H pattern), as well as the medial region of the ilium. It is frequently associated with fractures of the supraacetabular region and the pubic symphysis. Computed tomography is the technique of choice for detecting the fracture line and/or sclerosis, although it is less sensitive than magnetic resonance (MR) imaging or scintigraphy during acute phases. MR of the above regions shows nonspecific edema, contrasting with hypointense signals indicating the general path of the fracture line in T2-weighted images. The use of gadolinium or fat suppression greatly increases the sensitivity. Bone scintigraphy is a highly sensitive diagnostic tool, although the H pattern occurs in less than 50% of cases. (Author) 24 refs.

  2. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts

    Directory of Open Access Journals (Sweden)

    Irwin Goldstein, MD

    2017-09-01

    Goldstein I, Komisaruk BR, Rubin RS, et al. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts. Sex Med 2017;5:e203–e211.

  3. Comparison of fasciocutaneous V-Y and rotational flaps for defect coverage of sacral pressure sores: a critical single-centre appraisal.

    Science.gov (United States)

    Djedovic, Gabriel; Metzler, Julia; Morandi, Evi M; Wachter, Tanja; Kühn, Shafreena; Pierer, Gerhard; Rieger, Ulrich M

    2017-12-01

    Pressure sore rates remain high in both nursing homes as well as in hospitals. Numerous surgical options are available for defect coverage in the sacral region. However, objective data is scarce as to whether a specific flap design is superior to another. Here, we aim to compare two fasciocutaneous flap designs for sacral defect coverage: the gluteal rotation flap and the gluteal V-Y flap. All primary sacral pressure sores of grades III-IV that were being covered with gluteal fasciocutaneous rotational or V-Y flaps between January 2008 and December 2014 at our institution were analysed. A total of 41 patients received a total of 52 flaps. Of these, 18 patients received 20 gluteal rotational flaps, and 23 patients received 32 V-Y flaps. Both groups were comparable with regards to demographics, comorbidities and complications. Significantly more V-Y flaps were needed to cover smaller defects. Mean length of hospital stay was significantly prolonged when surgical revision had to be carried out. Both flap designs have proven safe and reliable for defect coverage after sacral pressure sores. Gluteal rotational flaps appear to be more useful for larger defects. Both flap designs facilitate their reuse in case of pressure sore recurrence. Complication rates appear to be comparable in both designs and to the current literature. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  4. Quantitative assessment of bone marrow attenuation values at MDCT: An objective tool for the detection of bone bruise related to occult sacral insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Henes, F.O.; Groth, M.; Bley, T.A.; Regier, M.; Ittrich, H.; Adam, G.; Bannas, P. [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Nuechtern, J.V. [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Treszl, A. [University Medical Center Hamburg-Eppendorf, Center for Experimental Medicine, Department of Medical Biometry and Epidemiology, Hamburg (Germany)

    2012-10-15

    To prove the feasibility of using Hounsfield attenuation values at MDCT to detect bone bruises related to sacral insufficiency fractures. Twenty-two patients with acute sacrum trauma and no fracture findings at MDCT were included in our prospective study. Two observers independently reviewed CTs regarding visual signs of bone bruises in 132 defined regions of the sacral alae. Interobserver agreement was tested by {kappa} statistics. Subsequently, HU values were obtained in the same regions, and attenuation differences between the two sides were calculated. Validity and reliability were assessed by intraclass correlation coefficient and Bland-Altman analysis. HU differences were subjected to ROC curve analysis to determine sensitivity, specificity, PPV and NPV. MRI served as standard reference. MRI revealed 19 regions with bone bruises and associated sacral insufficiency fractures. HU measurements demonstrated good validity and reliability (r = 0.989). ROC curve analysis exhibited an ideal cutoff value of 35.7 HU density difference between affected and non-affected regions. Visual evaluation revealed moderate agreement ({kappa} = 0.48); diagnostic accuracy was inferior to objective evaluation. Assessment of differences in bone marrow density by HU measurements is an objective and reliable tool for detection of bone bruises associated with occult sacral insufficiency fractures. (orig.)

  5. The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups.

    Science.gov (United States)

    Jeon, Ji Young; Jeong, Yu Mi; Lee, Sheen-Woo; Kim, Jeong Ho; Choi, Hye-Young; Ahn, Yong

    2018-01-01

    Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups. A retrospective evaluation. A university hospital with inpatient and outpatient LSTV cases presenting low back pain. Four hundred ninety-four LSTV patients were included and categorized into sacralization (n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV patients were reviewed to determine the level of DS termination, the shortest distance between the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and lower thirds). The MRI findings in both of the groups were compared and analyzed. The distribution frequency of the levels of DS termination demonstrated a significant difference between the 2 groups. The mean caudal DS level in the lumbarization group was significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients] vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than 19% of the lumbarization group, whereas in only one case of the sacralization group. Although the incidence of perineural cysts was not significantly different between the 2 groups, the mean level of caudal margin of perineural cysts in the lumbarization group was significantly lower than the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2 [11 {44%} of 25 cases]). This study reveals several limitations including the

  6. Osteoporotic compression fracture of the thoracolumbar spine and sacral insufficiency fracture: incidence and analysis of the relationship according to the clinical factors

    International Nuclear Information System (INIS)

    Kong, Jeong Hwa; Park, Ji Sun; Ryu, Kyung Nam

    2006-01-01

    To evaluate the incidence of sacral insufficiency fracture in osteoporotic patient with compression fracture of the thoracolumbar (T-L) spine on magnetic resonance image (MRI), and to analyze the correlation of variable clinical factors and the incidence of sacral insufficiency fracture. We retrospectively reviewed 160 patients (27 men, 133 women; age range of 50 to 89 years) who underwent spinal MRI and had compression fracture of the T-L spine. Compression fractures due to trauma or tumor were excluded. We evaluated the incidence of sacral insufficiency fracture according to the patients' age, sex, number of compression fractures, and the existence of bone marrow edema pattern of compression fracture. During the same period, we evaluated the incidence of spinal compression fracture in the patients of pelvic insufficiency fracture. Out of the 160 patients who had compression fracture in the T-L spine, 17 (10.6%) had insufficiency fracture of the sacrum. Compression fracture occurred almost 5 times more frequently in women (27:133), but the incidence of sacral insufficiency fracture was 2/27 for men (7.4%) and 15/133 for women (11.3%), with no statistically significant difference (ρ = 0.80). According to age, the ratio of insufficiency fracture to compression fracture was 0% (0/23) in the 50's, 10.6% (7/66) in the 60's, 12.5% (7/56) in the 70's, and 20.0% (3/15) in the 80's. In respect of single and multiple compression fracture, the incidence of sacral insufficiency fracture was 8/65 for men (12.3%) and 9/95 for women (9.5%), showing no significant difference (ρ = 0.37). In the patients with and without compression fracture with bone marrow edema, insufficiency fracture occurred in 5/76 (6.6%) and 12/84 (14.3%), respectively. On the other hand, of the 67 patients who had pelvic insufficiency fracture, 27 (40.3%) also had spinal compression fracture. About 10% of the patients with osteoporotic compression fracture in the T/L spine also had pelvic sacral

  7. Comparative sacral morphology and the reconstructed tail lengths of five extinct primates: Proconsul heseloni, Epipliopithecus vindobonensis, Archaeolemur edwardsi, Megaladapis grandidieri, and Palaeopropithecus kelyus.

    Science.gov (United States)

    Russo, Gabrielle A

    2016-01-01

    This study evaluated the relationship between the morphology of the sacrum-the sole bony link between the tail or coccyx and the rest of the body-and tail length (including presence/absence) and function using a comparative sample of extant mammals spanning six orders (Primates, Carnivora, Rodentia, Diprotodontia, Pilosa, Scandentia; N = 472). Phylogenetically-informed regression methods were used to assess how tail length varied with respect to 11 external and internal (i.e., trabecular) bony sacral variables with known or suspected biomechanical significance across all mammals, only primates, and only non-primates. Sacral variables were also evaluated for primates assigned to tail categories ('tailless,' 'nonprehensile short-tailed,' 'nonprehensile long-tailed,' and 'prehensile-tailed'). Compared to primates with reduced tail lengths, primates with longer tails generally exhibited sacra having larger caudal neural openings than cranial neural openings, and last sacral vertebrae with more mediolaterally-expanded caudal articular surfaces than cranial articular surfaces, more laterally-expanded transverse processes, more dorsally-projecting spinous processes, and larger caudal articular surface areas. Observations were corroborated by the comparative sample, which showed that shorter-tailed (e.g., Lynx rufus [bobcat]) and longer-tailed (e.g., Acinonyx jubatus [cheetah]) non-primate mammals morphologically converge with shorter-tailed (e.g., Macaca nemestrina) and longer-tailed (e.g., Macaca fascicularis) primates, respectively. 'Prehensile-tailed' primates exhibited last sacral vertebrae with more laterally-expanded transverse processes and greater caudal articular surface areas than 'nonprehensile long-tailed' primates. Internal sacral variables performed poorly compared to external sacral variables in analyses of extant primates, and were thus deemed less useful for making inferences concerning tail length and function in extinct primates. The tails lengths of

  8. Effectiveness and Value of Prophylactic 5-Layer Foam Sacral Dressings to Prevent Hospital-Acquired Pressure Injuries in Acute Care Hospitals: An Observational Cohort Study.

    Science.gov (United States)

    Padula, William V

    The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. Retrospective observational cohort. We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03). All facilities are located in the United States. We collected longitudinal data pertaining to prophylactic 5-layer foam sacral dressings purchased by hospital-quarter for 38 academic medical centers between 2010 and 2015. Longitudinal data on acute care, hospital-level patient outcomes (eg, admissions and PSI-03 and pressure injury rate) were queried through the UHC clinical database/resource manager from the Johns Hopkins Medicine portal. Data on volumes of dressings purchased per UHC hospital were merged with UHC data. Mixed-effects negative binomial regression was used to test the longitudinal association of prophylactic foam sacral dressings on pressure injury rates, adjusted for hospital case-mix and Medicare payments rules. Significant pressure injury rate reductions in US acute care hospitals between 2010 and 2015 were associated with the adoption of prophylactic 5-layer foam sacral dressings within a prevention protocol (-1.0 cases/quarter; P = .002) and changes to Medicare payment rules in 2014 (-1.13 cases/quarter; P = .035). Prophylactic 5-layer foam sacral dressings are an effective component of a pressure injury prevention protocol. Hospitals adopting these technologies should expect good value for use of these products.

  9. Intraoperative indocyanine green fluorescent angiography-assisted modified superior gluteal artery perforator flap for reconstruction of sacral pressure sores.

    Science.gov (United States)

    Chang, Chun-Kai; Wu, Chien-Ju; Chen, Chun-Yu; Wang, Chi-Yu; Chu, Tzi-Shiang; Hsu, Kuo-Feng; Chiu, Han-Ting; Liu, Hung-Hui; Chou, Chang-Yi; Wang, Chih-Hsin; Lin, Chin-Ta; Dai, Niann-Tzyy; Tzeng, Yuan-Sheng

    2017-12-01

    Pressure sores are often observed in patients who are bedridden. They can be a severe problem not only for patients and their caregivers but also for plastic surgeons. Here, we describe a new method of superior gluteal artery perforator flap harvesting and anchoring with the assistance of intraoperative indocyanine green fluorescent angiography. In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016. All flaps survived, and two experienced wound-edge partial dehiscence. With the assistance of this imaging device, we were able to acquire a reliable superior gluteal artery perforator flap and perform modified operations with it that are safe, easy to learn and associated with fewer complications than are traditional. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  10. Neuromodulation: urodynamic effects of sacral (S3) spinal nerve stimulation in patients with detrusor instability or detrusor hyperflexia.

    Science.gov (United States)

    Bosch, J L; Groen, J

    1998-05-01

    The aim of this study was to determine the urodynamic effects of sacral (S3) nerve stimulation in patients with urge incontinence due to detrusor overactivity which has been refractory to conservative treatment. A total of 24 patients with idiopathic detrusor instability and five with neurogenic hyperreflexia were studied urodynamically before and 6 months after a permanent S3 foramen electrode implant. The urodynamic studies at follow-up were done with the stimulus on. Clinically, the average voiding frequency, the number of leakage episodes and pad use per 24 h decreased significantly. Improvement in several urodynamic parameters was noted. In the idiopathic as well as in the neurogenic group, the correlation between symptomatic and urodynamic improvement was incomplete. Neuromodulation leads to improvement of several urodynamic parameters in patients with urge incontinence due to detrusor overactivity which has been refractory to conservative treatment and appears to be a valuable treatment option in these patients.

  11. F-18 FDG PET/CT findings of a case of sacral nerve root neurolymphomatosis that occurred during chemotherapy.

    Science.gov (United States)

    Suga, Kazuyoshi; Yasuhiko, Kawakami; Matsunaga, Naofumi; Yujiri, Toshiaki; Nakazora, Tatsuki; Ariyoshi, Kouichi

    2011-01-01

    Neurolymphomatosis (NL) is a rare, unique subtype of lymphomatous infiltration of peripheral nerves. Clinical/radiologic diagnosis of NL is challenging. We report F-18 FDG PET/CT findings of a case of breast diffuse large B-cell lymphoma, in which NL developed regardless of regression of systemic lesions during induction chemotherapy. FDG PET/CT showed characteristic findings of well-demarcated, linear abnormal FDG uptake along a sacral vertebral foramen, leading to diagnosis of NL, with the finding of thickened nerve roots on magnetic resonance imaging. Altered chemotherapeutic regimen resulted in disappearance of these abnormal FDG uptake, with recovery of neurologic symptoms. Peripheral nerve NL may occur during chemotherapy, and FDG PET/CT can be a useful imaging modality in diagnosis and monitoring of therapeutic response of this disease.

  12. Techniques of lumbar-sacral spine fusion in spondylosis: systematic literature review and meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Umeta, Ricardo S G; Avanzi, Osmar

    2011-07-01

    Spine fusions can be performed through different techniques and are used to treat a number of vertebral pathologies. However, there seems to be no consensus regarding which technique of fusion is best suited to treat each distinct spinal disease or group of diseases. To study the effectiveness and complications of the different techniques used for spinal fusion in patients with lumbar spondylosis. Systematic literature review and meta-analysis. Randomized clinical studies comparing the most commonly performed surgical techniques for spine fusion in lumbar-sacral spondylosis, as well as those reporting patient outcome were selected. Identify which technique, if any, presents the best clinical, functional, and radiographic outcome. Systematic literature review and meta-analysis based on scientific articles published and indexed to the following databases: PubMed (1966-2009), Cochrane Collaboration-CENTRAL, EMBASE (1980-2009), and LILACS (1982-2009). The general search strategy focused on the surgical treatment of patients with lumbar-sacral spondylosis. Eight studies met the inclusion criteria and were selected with a total of 1,136 patients. Meta-analysis showed that patients who underwent interbody fusion presented a significantly smaller blood loss (p=.001) and a greater rate of bone fusion (p=.02). Patients submitted to fusion using the posterolateral approach had a significantly shorter operative time (p=.007) and less perioperative complications (p=.03). No statistically significant difference was found for the other studied variables (pain, functional impairment, and return to work). The most commonly used techniques for lumbar spine fusion in patients with spondylosis were interbody fusion and posterolateral approach. Both techniques were comparable in final outcome, but the former presented better rates of fusion and the latter the less complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. GFAP and Fos immunoreactivity in lumbo-sacral spinal cord and medulla oblongata after chronic colonic inflammation in rats

    Science.gov (United States)

    Sun, Yi-Ning; Luo, Jin-Yan; Rao, Zhi-Ren; Lan, Li; Duan, Li

    2005-01-01

    AIM: To investigate the response of astrocytes and neurons in rat lumbo-sacral spinal cord and medulla oblongata induced by chronic colonic inflammation, and the relationship between them. METHODS: Thirty-three male Sprague-Dawley rats were randomly divided into two groups: experimental group (n = 17), colonic inflammation was induced by intra-luminal administration of trinitrobenzenesulfonic acid (TNBS); control group (n = 16), saline was administered intra-luminally. After 3, 7, 14, and 28 d of administration, the lumbo-sacral spinal cord and medulla oblongata were removed and processed for anti-glial fibrillary acidic protein (GFAP), Fos and GFAP/Fos immunohistochemistry. RESULTS: Activated astrocytes positive for GFAP were mainly distributed in the superficial laminae (laminae I-II) of dorsal horn, intermediolateral nucleus (laminae V), posterior commissural nucleus (laminae X) and anterolateral nucleus (laminae IX). Fos-IR (Fos-immunoreactive) neurons were mainly distributed in the deeper laminae of the spinal cord (laminae III-IV, V-VI). In the medulla oblongata, both GFAP-IR astrocytes and Fos-IR neurons were mainly distributed in the medullary visceral zone (MVZ). The density of GFAP in the spinal cord of experimental rats was significantly higher after 3, 7, and 14 d of TNBS administration compared with the controls (50.4±16.8, 29.2±6.5, 24.1±5.6, P0.05). CONCLUSION: Astrocytes in spinal cord and medulla oblongata can be activated by colonic inflammation. The activated astrocytes are closely related to Fos-IR neurons. With the recovery of colonic inflammation, the activity of astrocytes in the spinal cord and medulla oblongata is reduced. PMID:16097052

  14. Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury.

    Science.gov (United States)

    Zaer, Hamed; Rasmussen, Mikkel Mylius; Zepke, Franko; Bodin, Charlotte; Domurath, Burkhard; Kutzenberger, Johannes

    2018-05-10

    Spinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual dysfunction in a large well-defined spinal cord injury cohort. In the manner of cross-sectional study, subjects undergone SARS-SDAF between September 1986 and July 2011 answered a questionnaire concerning conditions before and after surgery in the department of Neuro-Urology, Bad Wildungen, Germany. In total 287 of 587 subjects were analyzed. Median age was 49 years (range 19-80), median time from SCI to surgery was 10 years (range 0-49), and from surgery to follow-up 13 years (range 1-25). Of the analyzed subjects, 100% of both gender used SARS for bladder emptying. On the visual analogue scale (VAS) ranging from 0 to 10 (best), satisfaction with SARS-SDAF was 10 concerning bladder emptying, however 5 and 8 regarding sexual performance, for female and male users, respectively. Baseline and follow-up comparison showed a decline in self-intermittent catheterization (p < 0.0001), partial catheterization by attendant (p = 0.0125), complete catheterization and suprapubic catheterization (p < 0.0001), transurethral catheterization (p < 0.0011), and fewer cases of involuntary urine leakage (p < 0.0001). The SARS-SDAF is a beneficial multi-potential treatment method with simultaneous positive effect on multi-organ dysfunction among SCI subjects.

  15. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts.

    Science.gov (United States)

    Goldstein, Irwin; Komisaruk, Barry R; Rubin, Rachel S; Goldstein, Sue W; Elliott, Stacy; Kissee, Jennifer; Kim, Choll W

    2017-09-01

    Since 14 years of age, the patient had experienced extreme penile pain within seconds of initial sexual arousal through masturbation. Penile pain was so severe that he rarely proceeded to orgasm or ejaculation. After 7 years of undergoing multiple unsuccessful treatments, he was concerned for his long-term mental health and for his future ability to have relationships. To describe a novel collaboration among specialists in sexual medicine, neurophysiology, and spine surgery that led to successful management. Collaborating health care providers conferred with the referring physician, patient, and parents and included a review of all medical records. Elimination of postpubertal intense penile pain during sexual arousal. The patient presented to our sexual medicine facility at 21 years of age. The sexual medicine physician identifying the sexual health complaint noted a pelvic magnetic resonance imaging report of an incidental sacral Tarlov cyst. A subsequent sacral magnetic resonance image showed four sacral Tarlov cysts, with the largest measuring 18 mm. Neuro-genital testing result were abnormal. The neurophysiologist hypothesized the patient's pain at erection was produced by Tarlov cyst-induced neuropathic irritation of sensory fibers that course within the pelvic nerve. The spine surgeon directed a diagnostic injection of bupivacaine to the sacral nerve roots and subsequently morphine to the conus medullaris of the spinal cord. The bupivacaine produced general penile numbness; the morphine selectively decreased penile pain symptoms during sexual arousal without blocking penile skin sensation. The collaboration among specialties led to the conclusion that the Tarlov cysts were pathophysiologically mediating the penile pain symptoms during arousal. Long-term follow-up after surgical repair showed complete symptom elimination at 18 months after treatment. This case provides evidence that (i) Tarlov cysts can cause sacral spinal nerve root radiculitis through

  16. Uterine carcinosarcoma associated with pelvic radiotherapy for sacral chordoma: A case report

    Directory of Open Access Journals (Sweden)

    Korhan Kahraman

    2012-03-01

    Conclusion: In uterine masses seen in patients with history of irradiation to the pelvic field, the probability of uterine sarcomas should always be kept in mind. These tumors may occur simultaneously with recurrence of primary tumor previously treated by adjuvant radiation therapy.

  17. Pelvic X-ray misses out on detecting sacral fractures in the elderly - Importance of CT imaging in blunt pelvic trauma.

    Science.gov (United States)

    Schicho, Andreas; Schmidt, Stefan A; Seeber, Kevin; Olivier, Alain; Richter, Peter H; Gebhard, Florian

    2016-03-01

    Patients aged 75 years and older with blunt pelvic trauma are frequently seen in the ER. The standard diagnostic tool in these patients is the plain a.p.-radiograph of the pelvis. Especially lesions of the posterior pelvic ring are often missed due to e.g. bowel gas projection and enteric overlay. With a retrospective study covering these patients over a 3 year period in our level I trauma centre, we were able to evaluate the rate of missed injuries in the a.p.-radiograph whenever a corresponding CT scan was performed. Age, gender, and accompanying fractures of the pelvic ring were recorded. The intrinsic test characteristics and the performance in the population were calculated according to standard formulas. Thus, 233 consecutive patients with blunt pelvic trauma with both conventional radiographic examination and computed tomography (CT) were included. Thereof, 56 (23%) showed a sacral fracture in the CT scan. Of 233 pelvic X-ray-images taken, 227 showed no sacral fracture. 51 (21.7%) of these were false negative, yielding a sensitivity of just 10.5%. Average age of patients with sacral fractures was 85.1±6.1 years, with 88% being female. Sacral fractures were often accompanied by lesions of the anterior pelvic ring with pubic bone fractures in 75% of sacrum fracture cases. Second most concomitant fractures are found at the acetabulum (23.3%). Plain radiographic imaging is especially likely to miss out fractures of the posterior pelvic ring, which nowadays can be of therapeutic consequence. Besides the physicians experience in the ED, profound knowledge of insensitivity of plain radiographs in finding posterior pelvic ring lesions is crucial for a reliable diagnostic routine. Since the high mortality caused by prolonged immobilisation due to pelvic ring injuries, all fractures should be identified. We therefore provide a diagnostic algorithm for blunt pelvic trauma in the elderly. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. A multi-level rapid prototyping drill guide template reduces the perforation risk of pedicle screw placement in the lumbar and sacral spine.

    Science.gov (United States)

    Merc, Matjaz; Drstvensek, Igor; Vogrin, Matjaz; Brajlih, Tomaz; Recnik, Gregor

    2013-07-01

    The method of free-hand pedicle screw placement is generally safe although it carries potential risks. For this reason, several highly accurate computer-assisted systems were developed and are currently on the market. However, these devices have certain disadvantages. We have developed a method of pedicle screw placement in the lumbar and sacral region using a multi-level drill guide template, created with the rapid prototyping technology and have validated it in a clinical study. The aim of the study was to manufacture and evaluate the accuracy of a multi-level drill guide template for lumbar and first sacral pedicle screw placement and to compare it with the free-hand technique under fluoroscopy supervision. In 2011 and 2012, a randomized clinical trial was performed on 20 patients. 54 screws were implanted in the trial group using templates and 54 in the control group using the fluoroscopy-supervised free-hand technique. Furthermore, applicability for the first sacral level was tested. Preoperative CT-scans were taken and templates were designed using the selective laser sintering method. Postoperative evaluation and statistical analysis of pedicle violation, displacement, screw length and deviation were performed for both groups. The incidence of cortex perforation was significantly reduced in the template group; likewise, the deviation and displacement level of screws in the sagittal plane. In both groups there was no significantly important difference in deviation and displacement level in the transversal plane as not in pedicle screw length. The results for the first sacral level resembled the main investigated group. The method significantly lowers the incidence of cortex perforation and is therefore potentially applicable in clinical practice, especially in some selected cases. The applied method, however, carries a potential for errors during manufacturing and practical usage and therefore still requires further improvements.

  19. Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures with a radiofrequency-induced, high-viscosity bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Eichler, Katrin [University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); J. W. Goethe University of Frankfurt, Institute for Diagnostic and Interventional Radiology, Frankfurt (Germany); Zangos, Stephan; Vogl, Thomas J. [University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Mack, Martin G. [Radiology Munich, Munich (Germany); Marzi, Ingo [University of Frankfurt, Department of Trauma, Hand and Reconstructive Surgery, Frankfurt (Germany)

    2014-04-15

    Our goal was to assess the technical results in patients who underwent long-axis sacroplasty for the treatment of sacral insufficiency fractures (SIF) by radiofrequency-induced high-viscosity bone cement augmentation. Twelve patients with bilateral sacral fractures were treated by augmentation with radiofrequency-activated, high-viscosity polymethylmethacrylate (PMMA) bone cement under local anesthesia. CT-guided sacroplasty was performed by using a long-axis approach through a single entry point. Thirty-six vertebrae were treated in 12 sessions under a combination of CT and fluoroscopic guidance using a bilateral access and a cavity-creating osteotome prior to remote-controlled, hydraulically driven cement injection. The visual analogue scale (VAS) score before sacroplasty and at 1 and 3 months after the treatment was obtained. PMMA leaks were evaluated retrospectively using the post-interventional CT. The mean amount of high-viscosity PMMA injected per patient was 7.8 ml. No major adverse events were observed. In the first 4 days after the procedure, the mean VAS score decreased from 8.1 ± 1.9 to mean 3.1 ± 1.2 and was followed by a gradual but continuous decrease throughout the rest of the follow-up period at 24 weeks (mean 2.2 ± 1.1) and 48 weeks (mean 2.1 ± 1.4). CT fluoroscopy-guided sacral augmentation was safe and effective in all 12 patients with osteoporotic SIF. (orig.)

  20. MAdCAM-1 expressing sacral lymph node in the lymphotoxin beta-deficient mouse provides a site for immune generation following vaginal herpes simplex virus-2 infection.

    Science.gov (United States)

    Soderberg, Kelly A; Linehan, Melissa M; Ruddle, Nancy H; Iwasaki, Akiko

    2004-08-01

    The members of the lymphotoxin (LT) family of molecules play a critical role in lymphoid organogenesis. Whereas LT alpha-deficient mice lack all lymph nodes and Peyer's patches, mice deficient in LT beta retain mesenteric lymph nodes and cervical lymph nodes, suggesting that an LT beta-independent pathway exists for the generation of mucosal lymph nodes. In this study, we describe the presence of a lymph node in LT beta-deficient mice responsible for draining the genital mucosa. In the majority of LT beta-deficient mice, a lymph node was found near the iliac artery, slightly misplaced from the site of the sacral lymph node in wild-type mice. The sacral lymph node of the LT beta-deficient mice, as well as that of the wild-type mice, expressed the mucosal addressin cell adhesion molecule-1 similar to the mesenteric lymph node. Following intravaginal infection with HSV type 2, activated dendritic cells capable of stimulating a Th1 response were found in this sacral lymph node. Furthermore, normal HSV-2-specific IgG responses were generated in the LT beta-deficient mice following intravaginal HSV-2 infection even in the absence of the spleen. Therefore, an LT beta-independent pathway exists for the development of a lymph node associated with the genital mucosa, and such a lymph node serves to generate potent immune responses against viral challenge.

  1. An economic appraisal of the Australian Medical Sheepskin for the prevention of sacral pressure ulcers from a nursing home perspective

    Science.gov (United States)

    2010-01-01

    Background Many devices are in use to prevent pressure ulcers, but from most little is known about their effects and costs. One such preventive device is the Australian Medical Sheepskin that has been proven effective in three randomized trials. In this study the costs and savings from the use of the Australian Medical Sheepskin were investigated from the perspective of a nursing home. Methods An economic model was developed in which monetary costs and monetary savings in respect of the sheepskin were balanced against each other. The model was applied to a fictional (Dutch) nursing home with 100 beds for rehabilitation patients and a time horizon of one year. Input variables for the model consisted of investment costs for using the sheepskin (purchase and laundry), and savings through the prevented cases of pressure ulcers. The input values for the investment costs and for the effectiveness were empirically based on a trial with newly admitted rehabilitation patients from eight nursing homes. The input values for the costs of pressure ulcer treatment were estimated by means of four different approaches. Results Investment costs for using the Australian Medical Sheepskin were larger than the monetary savings obtained by preventing pressure ulcers. Use of the Australian Medical Sheepskin involves an additional cost of approximately €2 per patient per day. Preventing one case of a sacral pressure ulcer by means of the Australian Medical Sheepskin involves an investment of €2,974 when the sheepskin is given to all patients. When the sheepskin is selectively used for more critical patients only, the investment to prevent one case of sacral pressure ulcers decreases to €2,479 (pressure ulcer risk patients) or €1,847 (ADL-severely impaired patients). The factors with the strongest influence on the balance are the frequency of changing the sheepskin and the costs of washing related to this. The economic model was hampered by considerable uncertainty in the

  2. An economic appraisal of the Australian Medical Sheepskin for the prevention of sacral pressure ulcers from a nursing home perspective

    Directory of Open Access Journals (Sweden)

    Achterberg Wilco

    2010-08-01

    Full Text Available Abstract Background Many devices are in use to prevent pressure ulcers, but from most little is known about their effects and costs. One such preventive device is the Australian Medical Sheepskin that has been proven effective in three randomized trials. In this study the costs and savings from the use of the Australian Medical Sheepskin were investigated from the perspective of a nursing home. Methods An economic model was developed in which monetary costs and monetary savings in respect of the sheepskin were balanced against each other. The model was applied to a fictional (Dutch nursing home with 100 beds for rehabilitation patients and a time horizon of one year. Input variables for the model consisted of investment costs for using the sheepskin (purchase and laundry, and savings through the prevented cases of pressure ulcers. The input values for the investment costs and for the effectiveness were empirically based on a trial with newly admitted rehabilitation patients from eight nursing homes. The input values for the costs of pressure ulcer treatment were estimated by means of four different approaches. Results Investment costs for using the Australian Medical Sheepskin were larger than the monetary savings obtained by preventing pressure ulcers. Use of the Australian Medical Sheepskin involves an additional cost of approximately €2 per patient per day. Preventing one case of a sacral pressure ulcer by means of the Australian Medical Sheepskin involves an investment of €2,974 when the sheepskin is given to all patients. When the sheepskin is selectively used for more critical patients only, the investment to prevent one case of sacral pressure ulcers decreases to €2,479 (pressure ulcer risk patients or €1,847 (ADL-severely impaired patients. The factors with the strongest influence on the balance are the frequency of changing the sheepskin and the costs of washing related to this. The economic model was hampered by considerable

  3. Ten-year experience of superior gluteal artery perforator flap for reconstruction of sacral defects in Tri-Service General Hospital

    Directory of Open Access Journals (Sweden)

    Chin-Ta Lin

    2014-01-01

    Full Text Available Background: Despite advances in reconstruction techniques, sacral sores continue to present a challenge to the plastic surgeon. The superior gluteal artery perforator (SGAP flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. However, the dissection of the perforator is tedious and carries a risk of compromising the perforator vessels. Patients and Methods: During the period between April 2003 and March 2013, 30 patients presented to our section with sacral wounds causing by pressure sores or infected pilonidal cysts. Of a total of 30 patients, 13 were female and 17 were male. Their ages ranged from 22 to 92 years old (mean 79.8 years old. Surgical intervention was performed electively with immediate or delayed reconstruction using a SGAP flap. The characteristics of patients′ age, and sex, and cause of sacral defect, co-morbidities, wound culture, flap size, perforator number, hospital stay, and outcome were reviewed. Results: For all operations, the length of the pedicle dissection will not exceed 1 cm because of the vascular anatomy of the SGAP, which lies adjacent to the sacral region. Due to short pedicle dissection, all SGAP flap were elevated around an hour. All flaps survived except two, which had partial flap necrosis and were finally treated by contralateral V-Y advancement flaps coverage. The mean follow-up period was 14.8 months (range 3-24. No flap surgery-related mortality was found. Conclusion: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor site morbidity and good preservation of muscle. Our study shows that deep pedicle dissection is unnecessary when the surgery involves an accurate indicating perforator, adequate flap size design, and correct selection of flap utilization between tunnel and rotation. The

  4. The impact of office chair features on lumbar lordosis, intervertebral joint and sacral tilt angles: a radiographic assessment.

    Science.gov (United States)

    De Carvalho, Diana; Grondin, Diane; Callaghan, Jack

    2017-10-01

    The purpose of this study was to determine which office chair feature is better at improving spine posture in sitting. Participants (n = 28) were radiographed in standing, maximum flexion and seated in four chair conditions: control, lumbar support, seat pan tilt and backrest with scapular relief. Measures of lumbar lordosis, intervertebral joint angles and sacral tilt were compared between conditions and sex. Sitting consisted of approximately 70% of maximum range of spine flexion. No differences in lumbar flexion were found between the chair features or control. Significantly more anterior pelvic rotation was found with the lumbar support (p = 0.0028) and seat pan tilt (p < 0.0001). Males had significantly more anterior pelvic rotation and extended intervertebral joint angles through L1-L3 in all conditions (p < 0.0001). No one feature was statistically superior with respect to minimising spine flexion, however, seat pan tilt resulted in significantly improved pelvic posture. Practitioner Summary: Seat pan tilt, and to some extent lumbar supports, appear to improve seated postures. However, sitting, regardless of chair features used, still involves near end range flexion of the spine. This will increase stresses to the spine and could be a potential injury generator during prolonged seated exposures.

  5. Identification of viral microRNAs expressed in human sacral ganglia latently infected with herpes simplex virus 2.

    Science.gov (United States)

    Umbach, Jennifer L; Wang, Kening; Tang, Shuang; Krause, Philip R; Mont, Erik K; Cohen, Jeffrey I; Cullen, Bryan R

    2010-01-01

    Deep sequencing of small RNAs isolated from human sacral ganglia latently infected with herpes simplex virus 2 (HSV-2) was used to identify HSV-2 microRNAs (miRNAs) expressed during latent infection. This effort resulted in the identification of five distinct HSV-2 miRNA species, two of which, miR-H3/miR-I and miR-H4/miR-II, have been previously reported. Three novel HSV-2 miRNAs were also identified, and two of these, miR-H7 and miR-H9, are derived from the latency-associated transcript (LAT) and are located antisense to the viral transcript encoding transactivator ICP0. A third novel HSV-2 miRNA, miR-H10, is encoded within the unique long (U(L)) region of the genome, 3' to the U(L)15 open reading frame, and is presumably excised from a novel, latent HSV-2 transcript distinct from LAT.

  6. Identification of Viral MicroRNAs Expressed in Human Sacral Ganglia Latently Infected with Herpes Simplex Virus 2▿

    Science.gov (United States)

    Umbach, Jennifer L.; Wang, Kening; Tang, Shuang; Krause, Philip R.; Mont, Erik K.; Cohen, Jeffrey I.; Cullen, Bryan R.

    2010-01-01

    Deep sequencing of small RNAs isolated from human sacral ganglia latently infected with herpes simplex virus 2 (HSV-2) was used to identify HSV-2 microRNAs (miRNAs) expressed during latent infection. This effort resulted in the identification of five distinct HSV-2 miRNA species, two of which, miR-H3/miR-I and miR-H4/miR-II, have been previously reported. Three novel HSV-2 miRNAs were also identified, and two of these, miR-H7 and miR-H9, are derived from the latency-associated transcript (LAT) and are located antisense to the viral transcript encoding transactivator ICP0. A third novel HSV-2 miRNA, miR-H10, is encoded within the unique long (UL) region of the genome, 3′ to the UL15 open reading frame, and is presumably excised from a novel, latent HSV-2 transcript distinct from LAT. PMID:19889786

  7. SaFaRI: sacral nerve stimulation versus the FENIX magnetic sphincter augmentation for adult faecal incontinence: a randomised investigation.

    Science.gov (United States)

    Williams, Annabelle E; Croft, Julie; Napp, Vicky; Corrigan, Neil; Brown, Julia M; Hulme, Claire; Brown, Steven R; Lodge, Jen; Protheroe, David; Jayne, David G

    2016-02-01

    Faecal incontinence is a physically, psychologically and socially disabling condition. NICE guidance (2007) recommends surgical intervention, including sacral nerve stimulation (SNS), after failed conservative therapies. The FENIX magnetic sphincter augmentation (MSA) device is a novel continence device consisting of a flexible band of interlinked titanium beads with magnetic cores that is placed around the anal canal to augment anal sphincter tone through passive attraction of the beads. Preliminary studies suggest the FENIX MSA is safe, but efficacy data is limited. Rigorous evaluation is required prior to widespread adoption. The SaFaRI trial is a National Institute of Health Research (NIHR) Health Technology Assessment (HTA)-funded UK multi-site, parallel group, randomised controlled, unblinded trial that will investigate the use of the FENIX MSA, as compared to SNS, for adult faecal incontinence resistant to conservative management. Twenty sites across the UK, experienced in the treatment of faecal incontinence, will recruit 350 patients randomised equally to receive either SNS or FENIX MSA. Participants will be followed-up at 2 weeks post-surgery and at 6, 12 and 18 months post-randomisation. The primary endpoint is success, as defined by device in use and ≥50 % improvement in the Cleveland Clinic Incontinence Score (CCIS) at 18 months post-randomisation. Secondary endpoints include complications, quality of life and cost effectiveness. SaFaRI will rigorously evaluate a new technology for faecal incontinence, the FENIX™ MSA, allowing its safe and controlled introduction into current clinical practice. These results will inform the future surgical management of adult faecal incontinence.

  8. Percutaneous tibial nerve stimulation vs sacral nerve stimulation for faecal incontinence: a comparative case-matched study.

    Science.gov (United States)

    Al Asari, S; Meurette, G; Mantoo, S; Kubis, C; Wyart, V; Lehur, P-A

    2014-11-01

    The study assessed the initial experience with posterior tibial nerve stimulation (PTNS) for faecal incontinence and compared it with sacral nerve stimulation (SNS) performed in a single centre during the same timespan. A retrospective review of a prospectively collected database was conducted at the colorectal unit, University Hospital, Nantes, France, from May 2009 to December 2010. Seventy-eight patients diagnosed with chronic severe faecal incontinence underwent neurostimulation including PTNS in 21 and SNS in 57. The main outcome measures were faecal incontinence (Wexner score) and quality of life (Fecal Incontinence Quality of Life, FIQL) scores in a short-term follow-up. No significant differences were observed in patients' characteristics. Of 57 patients having SNS, 18 (32%) failed peripheral nerve evaluation and 39 (68%) received a permanent implant. Two (5%) developed a wound infection. No adverse effects were recorded in the PTNS group. There was no significant difference in the mean Wexner and FIQL scores between patients having PTNS and SNS at 6 (P = 0.39 and 0.09) and 12 months (P = 0.79 and 0.37). A 50% or more improvement in Wexner score was seen at 6 and 12 months in 47% and 30% of PTNS patients and in 50% and 58% of SNS patients with no significant difference between the groups. Posterior tibial nerve stimulation is a valid method of treating faecal incontinence in the short term when conservative treatment has failed. It is easier, simpler, cheaper and less invasive than SNS with a similar short-term outcome. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  9. Spinal cord anomalies in patients with anorectal malformations without severe sacral abnormalities or meningomyelocele: outcomes after expectant, conservative management.

    Science.gov (United States)

    Kyrklund, Kristiina; Pakarinen, Mikko P; Taskinen, Seppo; Kivisaari, Reetta; Rintala, Risto J

    2016-12-01

    OBJECTIVE The goal of this study was to determine the significance of spinal cord anomalies (SCAs) in patients with anorectal malformations (ARMs) by comparing the outcomes for bowel function, lower urinary tract symptoms (LUTS), and lower-limb neurological abnormalities to these outcomes in patients with similar ARMs and a normal spinal cord. METHODS The spinal cord MRI records of female patients treated for vestibular and perineal fistula (VF/PF) and male patients with rectourethral fistula (RUF) at a single center between 1983 and 2006 were reviewed. Bowel function and LUTS were assessed by questionnaire. Patients with extensive sacral anomalies or meningomyelocele were excluded. RESULTS Of 89 patients (median age 15 years, range 5-29 years), MRI was available in 90% (n = 80; 40 male patients with RUF), and 80% of patients returned the questionnaire (n = 64; 31 male patients with RUF). Spinal cord anomalies were found in 34%, comprising a filum terminale lipoma in 30%, low conus medullaris in 10%, and thoracolumbar syrinx in 6%. Bowel functional outcomes between patients with SCAs (n = 23) and those with a normal spinal cord (n = 41) were not significantly different for soiling (70% vs 63%), fecal accidents (43% vs 34%), and constipation (57% vs 39%; p = not significant for all). The LUTS, including urge (65% vs 54%), urge incontinence (39% vs 24%), stress incontinence (17% vs 22%), and straining (32% vs 29%) were also comparable between groups (p = not significant for all). No patients developed lower-limb neurological abnormalities. CONCLUSIONS The results suggest that the long-term functional outcomes for patients with SCAs who had VF/PF and RUF may not differ significantly from patients with the same type of ARMs and a normal spinal cord. The results favor a conservative approach to their management in the absence of abnormal neurological findings in the lower limbs.

  10. Turning off sacral nerve stimulation does not affect gastric and small intestinal motility in patients treated for faecal incontinence.

    Science.gov (United States)

    Worsøe, J; Fassov, J; Schlageter, V; Rijkhoff, N J M; Laurberg, S; Krogh, K

    2012-10-01

    Sacral nerve stimulation (SNS) reduces symptoms in up to 80% of patients with faecal incontinence (FI). Its effects are not limited to the distal colon and the pelvic floor. Accordingly, spinal or supraspinal neuromodulation have been suggested as part of the mode of action. The effect of SNS on gastric and small-intestinal motility was studied. Using the magnet tracking system, MTS-1, a small magnetic pill was tracked twice through the upper gastrointestinal tract of eight patients with FI successfully treated with SNS. Following a randomized double-blind crossover design, the stimulator was either left active or was turned off for 1 week before investigations with MTS-1. The median (range) frequency of gastric con-tractions was 3.05 (2.83-3.40) per min during SNS and 3.04 (2.79?-3.76) per min without (P=NS). The median (range) frequency of contractions in the small intestine during the first 2h after pyloric passage was 10.005 (9.68-10.70) per min during SNS and 10.09 (9.79-10.29) per min without SNS (P=NS). The median (range) velocity of the magnetic pill during the first 2h in the small intestine was 1.6 (1.2-2.8) cm/min during SNS and 1.7 (0.8-3.7) cm/min without SNS (P=NS). Small-intestinal propagation mainly occurred during very fast movements (>15cm/min), accounting for 51% (42-60%) of the distance 3% (2-4%) of the time during SNS and for 53% (18-73%) of the distance 3% (1-8%) of the time without SNS (P=NS). Turning off SNS for 1week did not affect gastric or small-intestinal motility patterns. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  11. Application of posterior pelvic tilt taping for the treatment of chronic low back pain with sacroiliac joint dysfunction and increased sacral horizontal angle.

    Science.gov (United States)

    Lee, Jung-hoon; Yoo, Won-gyu

    2012-11-01

    Kinesio Taping (KT) is a therapeutic method used by physical therapists and athletic trainers in combination with other treatment techniques for various musculoskeletal and neuromuscular problems. However, no research has evaluated the effect of KT in patients with low back pain (LBP). The purpose of this case was to describe the application of posterior pelvic tilt taping (PPTT) with Kinesio tape as a treatment for chronic LBP and to reduce the anterior pelvic tilt angle. Case report. The patien was a 20-year-old female amateur swimmer with a Cobb's angle (L1-S1) of 68°, a sacral horizontal angle of 45°, and pain in both medial buttock areas and sacroiliac joints. We performed PPTT with Kinesio tape for 2 weeks (six times per week for an average of 9 h each time). The patient’s radiographs showed that the Cobb's angle (L1-S1) had decreased from 68° to 47° and that the sacral horizontal angle had decreased from 45° to 31°. Reductions in hypomobility or motion asymmetry, as assessed by the motion palpation test, and in pain, as measured by the pain-provocation tests, were observed. On palpation for both medial buttock areas in the prone position, the patient felt no pain. The patient experienced no pain or stiffness in the low back area while performing forward flexion in the standing position with knees fully extended when washing dishes in the sink. The case study demonstrated that PPTT intervention favourably affected the pelvic inclination and sacral horizontal angle, leading to beneficial effects on sacroiliac joint dysfunction (SIJD) and medial buttock pain. Additional research on the clinical effects of this taping procedure requires greater numbers of athletes with SIJD or LBP who have inappropriate anterior pelvic tilt angles and hyperlordosis.

  12. Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.

    Science.gov (United States)

    Sterner, Eila; Fossum, Bjöörn; Berg, Elisabeth; Lindholm, Christina; Stark, André

    2014-08-01

    Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  13. Dynamics of indicators of a metabolic exchange and condition of blood circulation of the bottom extremities after traction extension at patients with lumbar and sacral dorsopathy

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to study influence of traction therapy in a pulse mode in a complex with electrotherapy on a condition of blood circulation of the bottom extremities and level of a metabolic exchange. Material and methods. There had been examined 120 patients with a lumbar and sacral dorsopathy aged from 22 to 69 years (middle age of 49,5 years with prescription of a disease from 1 to 5 years, among them men of 34,2%, women of 65,8%. Results. The analysis of effects of various medical methods on a condition of local blood circulation in the bottom extremities showed that the most expressed its compensation is noted at complex application of mechanical pulse traction influence and electrotherapy for patients with a dorsopathy of lumbar and sacral department of a backbone that is confirmed by restoration to normal values of all indicators rheovasogramm. Conclusion. High clinical results of application of the combined medical and rehabilitation complex are based on compensation of local blood circulation that is shown in elimination of deficiency of blood supply due to improvement of a tone of arterial vessels and elimination of venous stagnation, and also due to increase of linear speed of a blood-groove and development of collateral blood circulation. Application of electrical impulse and mechanical traction influences, more at their combination promotes fermentative activity of the systems responsible for a protein exchange that is important for prevention of degenerate and dystrophic process progressing.

  14. Sacralizing Reality Digitally

    DEFF Research Database (Denmark)

    Damgaard, Mads

    2014-01-01

    authenticity derived from scientific sources is analysed. The case is made that through hyperlinks, YouTube videos and discussion forums, religious communities such as the online Asatrú groups strategically assemble religious authority on a foundation of science, tapping into non-religious ecologies...

  15. The sacralization of information

    Directory of Open Access Journals (Sweden)

    Philippe BRETON

    2011-01-01

    Full Text Available The objective of the article is to describe some parts of the process of " regarding as sacred of the information " which was set up in the middle of the XXth century, within the cybernetics. It is also a question of showing that this original marking strongly influenced the speech which accompagnies the new technologies.

  16. Frankincense and myrrh essential oils and burn incense fume against micro-inhabitants of sacral ambients. Wisdom of the ancients?

    Science.gov (United States)

    Ljaljević Grbić, Milica; Unković, Nikola; Dimkić, Ivica; Janaćković, Peđa; Gavrilović, Milan; Stanojević, Olja; Stupar, Miloš; Vujisić, Ljubodrag; Jelikić, Aleksa; Stanković, Slaviša; Vukojević, Jelena

    2018-03-09

    (12.97%), β-elemene (12.70%), and germacrene B (12.15%). Burn incense fume and soot had α-pinene (68.6%) and incensole (28.6%) as the most dominant compounds, respectively. In vitro antimicrobial assays demonstrated high bacterial and fungal sensitivity to the liquid and vapour phases of EOs, and burn incense fume. In situ application of B. carteri EO vapour and incense fume resulted in reduction of air-borne viable microbial counts by up to 45.39 ± 2.83% for fungi and 67.56 ± 3.12% for bacteria (EO); and by up to 80.43 ± 2.07% for fungi and 91.43 ± 1.26% for bacteria (incense fume). The antimicrobial properties of essential oil derived from frankincense, a compound with well-known traditional use, showed that it possesses a clear potential as a natural antimicrobial agent. Moreover, the results suggest possible application of B. carteri EO vapour and incense fume as occasional air purifiers in sacral ambients, apart from daily church rituals. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Effect of Sacral Neuromodulation on Outcome Measures and Urine Chemokines in Interstitial Cystitis/Painful Bladder Syndrome Patients.

    Science.gov (United States)

    Peters, Kenneth M; Jayabalan, Nirmal; Bui, Don; Killinger, Kim; Chancellor, Michael; Tyagi, Pradeep

    2015-05-01

    Sacral neuromodulation (SNM) may improve interstitial cystitis/painful bladder syndrome (IC/BPS) symptoms of urinary frequency, urgency and perhaps even pain, but objective measures of improvement are lacking. We evaluated the potential for urinary chemokines to serve as measures of treatment response over time to SNM. Women with IC/BPS undergoing SNM consented for this study. Three-day bladder/pain diaries were collected at baseline and validated Interstitial Cystitis Symptom Problem Index (ICSPI) scores and mid-stream urine specimens were collected at baseline and at 24 weeks after successful implant. Collected urine was screened for infection by dipstick and analyzed for chemokines by luminex xMAP analysis. At baseline (n = 16), urine levels of CXCL-1 positively correlated with pain score (r = 0.63, P = 0.009), urgency (r = 0.61, P = 0.01), ICSPI (r = 0.43, P = 0.09) and daily voids (r = 0.44, P = 0.08). ICSPI and pain scores also positively correlated with sIL-1ra (r = 0.50, P = 0.04) and monocyte chemotactic protein-1 (MCP-1) or CCL2 positively correlated with daily voids (r = 0.45, P = 0.07) only. At 24 weeks, the median ICSPI index fell from 28 to 15 (n = 7, P = 0.008). Urine levels of sIL-1ra (633.8 ± 188.2 vs. 149.9 ± 41.62 pg/mL) and MCP-1 (448.3 ± 11.6 vs. 176.9 ± 46.16 pg/mL) and CCL5 (20.78 ± 4.09 vs. 11.21 ± 4.12 pg/mL) were also significantly reduced at the follow-up relative to baseline values (P = 0.04). Multivariable analysis of data revealed that sIL-1ra and MCP-1 together explained the majority of variance in data. Levels of CXCL-1, CXCL-10, interleukin (IL)-8, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) were also reduced at 24 weeks, but differences were not significant. Concomitant decrease in urine levels of chemokines especially MCP-1 was associated with treatment response of SNM. These results

  18. Functional Outcome With Percutaneous Ilio-sacral Screw Fixation For Posterior Pelvic Ring Injuries In Patients Involved In Heavy Manual Laboring

    Directory of Open Access Journals (Sweden)

    Abhishek SM

    2015-11-01

    Full Text Available Introduction: Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients. Materials & Methods: Forty one patients who were treated with percutaneous sacroiliac screw fixation under fluoroscopic guidance and were followed-up for at least one year were analyzed retrospectively for functional outcome using the Majeed score. Results: Twenty one (51.22% and thirteen (31.70% patients were found to be in excellent and good categories respectively and majority of the patients (thirty/73.17% were able to return to their original occupation with or without minor adjustments. Conclusion: Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring.

  19. A median sacral artery anterior to the iliocaval junction: a case report-anatomical considerations and clinical relevance for spine surgery.

    Science.gov (United States)

    Chenin, Louis; Tandabany, Sharmila; Foulon, Pascal; Havet, Eric; Peltier, Johann

    2018-01-01

    The median sacral artery (MSA) is a relatively small vessel that always arises from the posterior, terminal part of the infrarenal aorta. In most cases, the MSA runs behind the iliocaval junction. Here, we describe a very rare case of an MSA running in front of this junction. During a human cadaveric dissection of the retroperitoneal area, we unexpectedly observed that the MSA passed in front of the left common iliac vein. The anatomy of the MSA has been extensively described and variations are quite rare. On the basis of this specific case, knowledge of the anatomic interactions between the MSA and other lumbar retroperitoneal vessels may help to avoid potential complications during surgery.

  20. S3 Dorsal Root Ganglion/Nerve Root Stimulation for Refractory Postsurgical Perineal Pain: Technical Aspects of Anchorless Sacral Transforaminal Lead Placement

    Directory of Open Access Journals (Sweden)

    X. Zuidema

    2016-01-01

    Full Text Available Chronic perineal pain limits patients in physical and sexual activities, leading to social and psychological distress. In most cases, this pain develops after surgery in the urogenital area or as a consequence of trauma. Neuromodulation is one of the options in chronic postsurgical perineal pain treatment. We present a case of refractory perineal pain after right sided surgical resection of a Bartholin’s cyst which was treated with third sacral nerve root/dorsal root ganglion stimulation using the transforaminal approach. We describe a new anchorless lead placement technique using a unique curved lead delivery sheath. We postulate that this new posterior foraminal technique of lead placement is simple, safe, and reversible and may lower the occurrence of lead related complications.

  1. Muscle-splitting approach to superior and inferior gluteal vessels: versatile source of recipient vessels for free-tissue transfer to sacral, gluteal, and ischial regions.

    Science.gov (United States)

    Park, S

    2000-07-01

    The superior gluteal vessel has been reported as a recipient in free-tissue transfer for the coverage of complex soft-tissue defects in the lumbosacral region, where a suitable recipient vessel is difficult to find. The characteristics of proximity, vessel caliber, and constancy make the superior gluteal vessel preferable to previously reported recipient vessels. However, there are technical difficulties in microsurgery (e.g., short pedicle length and deep location) and muscle injury (transection of the muscle) associated with use of the superior gluteal vessel. The purpose of this article is to present a modification of an approach to the gluteal vessel to alleviate technical difficulties and minimize muscle injury. From August of 1997 to January of 1999, six patients received microvascular transfer of the latissimus dorsi muscle or myocutaneous flap to the sacral (4) and ischial (2) regions. The causes of defects were tumor (1), trauma (1), and pressure sores (4). A muscle-splitting approach was used on the superior gluteal vessel and was later applied to the inferior gluteal vessel. The gluteus maximus muscle was split as needed in the direction of its fibers, and the perforators were dissected down to the superior or inferior gluteal artery and vein deep into the muscle. The follow-up period ranged from 6 to 22 months, and all of the flaps survived with complete recovery of the lesion. The major drawbacks of using the superior and inferior gluteal vessels can be overcome with the muscle-splitting approach, which provides increased accessibility and additional length to the vascular pedicle while causing minimal injury to the muscle itself. It also proves to be an easy, safe, and reliable method of dissection. When free-tissue transfer to sacral, gluteal, and ischial regions is indicated, the muscle-splitting approach to the superior and inferior gluteal vessels is a recommended option in the selection of a recipient vessel.

  2. Peripheral injury of pelvic visceral sensory nerves alters GFRa (GDNF family receptor alpha localization in sensory and autonomic pathways of the sacral spinal cord

    Directory of Open Access Journals (Sweden)

    Shelley Lynne Forrest

    2015-04-01

    Full Text Available GDNF (glial cell line-derived neurotrophic factor, neurturin and artemin use their co-receptors (GFRα1, GFRα2 and GFRα3, respectively and the tyrosine kinase Ret for downstream signalling. In rodent dorsal root ganglia (DRG most of the unmyelinated and some myelinated sensory afferents express at least one GFRα. The adult function of these receptors is not completely elucidated but their activity after peripheral nerve injury can facilitate peripheral and central axonal regeneration, recovery of sensation, and sensory hypersensitivity that contributes to pain. Our previous immunohistochemical studies of spinal cord and sciatic nerve injuries in adult rodents have identified characteristic changes in GFRα1, GFRα2 or GFRα3 in central spinal cord axons of sensory neurons located in dorsal root ganglia. Here we extend and contrast this analysis by studying injuries of the pelvic and hypogastric nerves that contain the majority of sensory axons projecting to the pelvic viscera (e.g., bladder and lower bowel. At 7 d, we detected some effects of pelvic but not hypogastric nerve transection on the ipsilateral spinal cord. In sacral (L6-S1 cord ipsilateral to nerve injury, GFRα1-immunoreactivity (IR was increased in medial dorsal horn and CGRP-IR was decreased in lateral dorsal horn. Pelvic nerve injury also upregulated GFRα1- and GFRα3-IR terminals and GFRα1-IR neuronal cell bodies in the sacral parasympathetic nucleus that provides the spinal parasympathetic preganglionic output to the pelvic nerve. This evidence suggests peripheral axotomy has different effects on somatic and visceral sensory input to the spinal cord, and identifies sensory-autonomic interactions as a possible site of post-injury regulation.

  3. Insufficiency fractures following radiation therapy for gynecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Ikushima, Hitoshi; Takegawa, Yoshihiro; Matsuki, Hirokazu; Yasuda, Hiroaki; Kawanaka, Takashi; Shiba, Atsushi; Kishida, Yoshiomi; Iwamoto, Seiji; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

    2002-12-01

    The purpose of this study was to investigate the incidence, clinical and radiological findings of insufficiency fractures (IF) of the female pelvis following radiation therapy. We retrospectively reviewed the radiation oncology records of 108 patients with gynecologic malignancies who underwent external beam radiation therapy of the whole pelvis. All patients underwent conventional radiography and computed tomography (CT) scan every 6 months in follow-up after radiation therapy and magnetic resonance imaging (MRI) and radionuclide bone scan were added when the patients complained of pelvic pain. Thirteen of 108 patients (12%) developed IF in the irradiated field with a median interval of 6 months (range 3-51) from the completion of external beam radiation therapy. All patients who developed IF were postmenopausal women. Age of the patients who developed IF was significantly higher than that of the other patients. The parts of IF were sacroiliac joints, pubis, sacral body and 5th lumbar vertebra and six of 14 patients had multiple lesions. Treatment with rest and nonsteroidal anti-inflammatory drugs lead to symptomatic relief in all patients, although symptoms lasted from 3 to 20 months. Radiation-induced pelvic IF following radiation therapy for gynecologic malignancies were frequently observed in the post-menopausal patients within 1 year after external beam radiation therapy. Symmetrical fractures of the bilateral sacroiliac joint and pubis were the characteristic pattern of pelvic IF. All patients healed with conservative treatment, and nobody became non-ambulant. (author)

  4. 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

  5. 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

  6. 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.

  7. Can the possibility of transverse iliosacral screw fixation for first sacral segment be predicted preoperatively? Results of a computational cadaveric study.

    Science.gov (United States)

    Jeong, Jin-Hoon; Jin, Jin Woo; Kang, Byoung Youl; Jung, Gu-Hee

    2017-10-01

    The purpose of this study was to predict the possibility of transverse iliosacral (TIS) screw fixation into the first sacral segment (S 1 ) and introduce practical anatomical variables using conventional computed tomography (CT) scans. A total of 82 cadaveric sacra (42 males and 40 females) were used for continuous 1.0-mm slice CT scans, which were imported into Mimics ® software to produce a three-dimensional pelvis model. The anterior height (BH) and superior width (BW) of the elevated sacral segment was measured, followed by verification of the safe zone (SZ S1 and SZ S2 ) in a true lateral view. Their vertical (VD S1 and VD S2 ) and horizontal (HD S1 and HD S2 ) distances were measured. VD S1 less than 7mm was classified as impossible sacrum, since the transverse fixation of 7.0 mm-sized IS screw could not be done safely. Fourteen models (16.7%; six females, eight males) were assigned as the impossible sacrum. There was no statistical significance regarding gender (p=0.626) and height (p=0.419). The average values were as follows: BW, 31.4mm (SD 2.9); BH, 16.7mm (SD 6.8); VD S1 , 13.4mm (SD 6.1); HD S1 , 22.5mm (SD 4.5); SZ S1 , 239.5mm 2 (SD 137.1); VD S2 , 15.5mm (SD 3.0); HD S2 , 18.3mm (SD 2.9); and SZ S2 , 221.1mm 2 (SD 68.5). Logistic regression analysis identified BH (p=0.001) and HD S1 (p=0.02) as the only statistically significant variables to predict the possibility. Receiver operating characteristic curve analysis established a cut-off value for BH and HD S1 of impossible sacrum of 20.6mm and 18.6mm, respectively. BH and HD S1 could be used to predict the possibility of TIS screw fixation. If the BH exceeds 20.6mm or HD S1 is less than 18.6mm, TIS screw fixation for S 1 should not be undertaken because of narrowed SZ. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. 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

  9. A Prospective, Descriptive, Quality Improvement Study to Investigate the Impact of a Turn-and-Position Device on the Incidence of Hospital-acquired Sacral Pressure Ulcers and Nursing Staff Time Needed for Repositioning Patients.

    Science.gov (United States)

    Hall, Kimberly D; Clark, Rebecca C

    2016-11-01

    Patients in critical care areas are at risk for developing hospital-acquired pressure ulcers (HAPUs) due to their physical conditions and limited ability to reposition themselves. A prospective, 2-phase quality improvement study was conducted from September to November 2011 and from February to April 2012 in 1 medical and 1 surgical ICU to investigate the impact of a turn-and-assist device on the incidence of HAPUs and the time and personnel required to reposition patients reported as person/minutes (staff x minutes). A consecutive, convenience sample of patients was selected from newly admitted ICU patients who were at least 18 years old, nonambulatory, and required 2 or more people to assist with turning and repositioning. Sociodemographic data (patient age, gender, height, weight, body mass index, incontinence status); total Braden score and subscores for Activity, Mobility, and Moisture on admission; length of ICU stay and ventilator days; and sacral pressure ulcer incidence and stage and turn-and-assist data were collected. Fifty (50) patients participated in each phase. In phase 1, standard care for positioning included pillows, underpads, standard low-air-loss beds and additional staff as required for turning. In phase 2, the study product replaced standard care repositioning products including pillows; and a larger disposable moisture-wicking underpad (included as part of the turn study project kit) was substituted for the smaller, standard moisture-wicking disposable underpad. Turning procedures were timed with a stopwatch. Data were collected for a total of 32 hours during the observation periods; all patients were followed from admission until discharge from the ICU for a maximum of 14 days. T-tests were used to compare patient characteristics and person-minutes needed for repositioning differences, and Fisher's exact test was used to compare the incidence of sacral HAPUs during phase 1 and phase 2 of the study. No statistically significant

  10. Radiation diagnosis of pelvic ring damages in acute injury

    International Nuclear Information System (INIS)

    Dytalov, M.M.

    2000-01-01

    Data on 58 victims with multifocal damages to the pelvic ring were used to examine the diagnostic potentialities of different radiation diagnostic techniques and to compare their resolving power. The later was 65.1, 83.3 and 94.7% in plain and multidimensional X-ray studies, and computed tomography, respectively. Complex of signs is described closed sacral fractures on the plain and oblique pelvic inlet (caudal) radiograms proposed, which could improve the diagnosis of fractures by 8.8 times, and an original orthopedic gauze-plate for the detection and estimation of invisible pelvic bone displacement, and an original procedure for pelvic X-ray study with target load in acute injury. This all can improve the quality of examination of casualties substantially and define indications for different treatments more precise [ru

  11. 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

  12. The validity of compliance monitors to assess wearing time of thoracic-lumbar-sacral orthoses in children with spinal cord injury.

    Science.gov (United States)

    Hunter, Louis N; Sison-Williamson, Mitell; Mendoza, Melissa M; McDonald, Craig M; Molitor, Fred; Mulcahey, M J; Betz, Randal R; Vogel, Lawrence C; Bagley, Anita

    2008-06-15

    Prospective multicenter observation. To determine the validity of 3 commercially available at recording thoracic-lumbar-sacral orthosis (TLSO) wearing time of children with spinal cord injury (SCI) and to assess each monitor's function during daily activities. A major limitation to studies assessing the effectiveness of spinal prophylactic bracing is the patient's compliance with the prescribed wearing time. Although some studies have begun to use objective compliance monitors, there is little documentation of the validity of the monitors during activities of daily life and no comparisons of available monitors. Fifteen children with SCI who wore a TLSO for paralytic scoliosis were observed for 4 days during their rehabilitation stay. Three compliance monitors (2 temperature and 1 pressure sensitive) were mounted onto each TLSO. Time of brace wear from the monitors was compared with the wear time per day recorded in diaries. Observed versus monitored duration of brace wear found the HOBO (temperature sensitive) to be the most valid compliance monitor. The HOBO had the lowest average of difference and variance of difference scores. The correlation between the recorded daily entries and monitored brace wear time was also highest for the HOBO in analysis of dependent and independent scores. Bland-Altman plots showed that the pressure sensitive monitor underestimated wear time whereas the temperature monitors overestimated wear time. Compliance to prescribed wearing schedule has been a barrier to studying TLSO efficacy. All 3 monitors were found to measure TLSO compliance, but the 2 temperature monitors were more in agreement with the daily diaries. Based on its functional advantages compared with the HOBO, the StowAway TidbiT will be used to further investigate the long-term compliance of TLSO bracing in children with SCI.

  13. Impact of Local Management on Long-Term Outcomes in Ewing Tumors of the Pelvis and Sacral Bones: University of Florida Experience

    International Nuclear Information System (INIS)

    Indelicato, Daniel J.; Keole, Sameer R.; Shahlaee, Amir H.; Shi Wenyin; Morris, Christopher G.; Gibbs, C. Parker; Scarborough, Mark T.; Marcus, Robert B.

    2008-01-01

    Purpose: This retrospective analysis describes our 35-year experience with respect to disease control and functional status. Patients and Methods: Thirty-five patients with localized Ewing tumors of the pelvis and sacral bones were treated from 1970 to 2005. Twenty-six patients were treated with definitive radiotherapy (RT), and 9 patients were treated with combined local therapy in the form of surgery + RT. The median RT dose was 55.2 Gy. The patients who received RT alone were more likely to be older men with larger tumors exhibiting soft-tissue extension. Patients in the definitive RT group were more likely to receive etoposide and ifosfamide or undergo bone marrow transplant. Median potential follow-up was 19.4 years. Results: The 15-year actuarial cause-specific survival, freedom from relapse rate, and local control rates were 26% vs. 76% (p = 0.016), 28% vs. 78% (p = 0.015), and 64% vs. 100% (p = 0.087), respectively, for patients treated with definitive RT and combined therapy. Overall, tumors <8 cm had significantly better cause-specific survival, but this was unrelated to local control. The median Toronto Extremity Salvage Score for the definitive RT and combined therapy groups were 99 and 94, respectively (p = 0.19). Seven definitive RT patients (27%) had serious complications. Conclusion: Combined modality local therapy should be considered if pelvic Ewing tumors are resectable. However, because of the extent of local disease, most patients have unresectable or partially resectable tumors and therefore require RT in some capacity. For this reason, innovative RT strategies are needed to improve long-term disease outcomes and minimize side effects while maintaining an acceptable functional result

  14. Sacral neuromodulation and Botulinum toxin A for refractory idiopathic overactive bladder: a cost-utility analysis in the perspective of Italian Healthcare System.

    Science.gov (United States)

    Bertapelle, Maria Paola; Vottero, Mario; Popolo, Giulio Del; Mencarini, Marco; Ostardo, Edoardo; Spinelli, Michele; Giannantoni, Antonella; D'Ausilio, Anna

    2015-08-01

    To assess the relative cost-effectiveness of two therapeutic strategies: one starting with sacral neuromodulation (SNM) versus one starting with Botulinum toxin A (BTX-A) for the management of refractory incontinent idiopathic overactive bladder (OAB) patients, from the perspective of the Italian National Health Service (INHS). Direct medical costs (2011) and benefits (quality-adjusted life years-QALYs) were assessed over a ten-year time frame adapting to the Italian practice a published Markov model. Clinical inputs were based on the published literature and on the expert opinion. Resource consumption rates were provided by clinical experts; unit costs were collected from a single hospital accounting and from standard tariff lists and public prices. Interventional procedures and management of adverse events were costed through a micro-costing approach. The primary outcome was incremental costs per QALYs gained (i.e. differential costs divided by differential benefits). Deterministic (DSA) and probabilistic (PSA) sensitivity analyses were conducted to assess the robustness of the model. Starting with SNM appears to be cost effective (i.e. under 40.000/QALY) from year three (21,259/QALY) onwards and becomes dominant (i.e. more effective and less costly) at year ten: cumulative costs were 32,975 for early SNM and 33,309 for early BTX-A, while cumulative QALYs were 7.52 and 6.93, respectively. At year ten, DSA suggests the results robustness and 99.8 % of the PSA iterations fell within the cost-effectiveness threshold. A therapeutic strategy starting with SNM may be considered cost effective in the midterm and cost saving in the long-term treatment of idiopathic OAB from the INHS perspective.

  15. 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

  16. 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

  17. Osteonecrosis due to radiation given for uterus cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, Kazuo; Ugai, Kazuhiro; Hasegawa, Kazuo; Hirota, Saeko [Hyogo Medical Center for Adults, Akashi (Japan)

    1992-04-01

    During a period 1984-1991, 18 patients were diagnosed as developing osteonecrosis after radiation therapy for uterine cervical cancer. The patients had Stage I-III. Acute pain occurred in the lumbar spine, pelvis, and/or limbs. There was no correlation between osteonecrosis and either clinical staging or the associated surgery. The most common site of osteonecrosis was lumbar spine (n=13), followed by sacroiliacal joint and head and neck of femur (5 each) and pubic bone (3). The duration from radiation therapy to occurrence of osteonecrosis varied from one to 8 years: the latency period tended to be longer for younger patients. There was correlation between radiation doses and site of osteonecrosis: 60 Gy caused more extensive osteonecrosis, involving the pelvis and head of femur, although 40 Gy confined it to the lumbo-sacral region. Osteonecrosis was sometimes difficult to diagnose: needle biopsy, in addition to imaging modalities, was necessary in 4 patients. It is recommended that patients with uterus cervical cancer treated with radiation be followed up carefully. (N.K.).

  18. 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.)

  19. 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

  20. 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

  1. 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. ...

  2. 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

  3. 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

  4. Use of computed tomography to define a sacral safe corridor for placement of 2.7 mm cortical screws in feline sacroiliac luxation.

    Science.gov (United States)

    Philp, Helen; Durand, Alexane; De Vicente, Felipe

    2018-06-01

    Objectives This study aimed to define a safe corridor for 2.7 mm cortical sacroiliac screw insertion in the dorsal plane (craniocaudal direction) using radiography and CT, and in the transverse plane (dorsoventral direction) using CT in feline cadavers. A further aim was to compare the values obtained by CT with those previously reported by radiography in the transverse plane. Methods Thirteen pelvises were retrieved from feline cadavers and dissected to expose one of the articular surfaces of the sacrum. A 2.7 mm screw was placed in the sacrum to a depth of approximately 1 cm in each exposed articular surface. Dorsoventral radiography and CT scanning of each specimen were performed. Multiplanar reconstructions were performed to allow CT evaluation in both the dorsal and transverse planes. Calculations were made to find the maximum, minimum and optimum angles for screw placement in craniocaudal (radiography and CT) and dorsoventral (CT) directions when using a 2.7 mm cortical screw. Results Radiographic measurement showed a mean optimum craniocaudal angle of 106° (range 97-112°). The mean minimum angle was 95° (range 87-107°), whereas the mean maximum angle was 117° (108-124°). Measurement of the dorsal CT scan images showed a mean optimum craniocaudal angle of 101° (range 94-110°). The mean minimum angle was 90° (range 83-99°), whereas the mean maximum angle was 113° (104-125°). The transverse CT scan images showed a mean dorsoventral minimum angle of 103° (range 95-113°), mean maximum angle of 115° (104-125°) and mean optimum dorsoventral angle of 111° (102-119°). Conclusions and relevance An optimum craniocaudal angle of 101° is recommended for 2.7 mm cortical screw placement in the feline sacral body, with a safety margin between 99° and 104°. No single angle can be recommended in the dorsoventral direction and therefore preoperative measuring on individual cats using CT images is recommended to establish the ideal individual angle in the

  5. Sakralaus ir demoniško miesto vaizdiniai lietuvių dramaturgijoje | The Images of a Sacral and Demonic City in Lithuanian Dramaturgy

    Directory of Open Access Journals (Sweden)

    Aušra Martišiūtė

    2006-01-01

    Full Text Available The article explores the dramas where the city is depicted as a special place determining the dramatization of a piece of work. The city symbolism is analyzed according to the criteria of the archetypal city images formulated by M. Eliade, and J. Lotman. The first part of the article ”A sacral city – Vilnius” deals with historical dramas (“Gediminas’ Dream” by A. Fromas Gužutis, “Kęstutis’ Death” by Maironis, “Radvila the Thunder”, “The Fate of Twilight ”, and “Barbora Radvilaite” by B. Sruoga, “Živilė” by A. Škėma, “Barbora Radvilaitė” by J. Grušas, “The Cathedral” by J. Marcinkevičius, “The Crown and the Sand” by R. Samulevičius, and etc.. In Lithuanian dramaturgy, Vilnius meets all the criteria of an ideal, sacred city. In poetic dramas, Vilnius is described as a superb creation embodying the plenitude of human existence. The second part of the article “The Demonic City” deals with the dramas in which the city symbolism conveys the opposite of a sacred, ideal city – an eccentric and demonic city localized in the “outskirts” of cultural space. This aspect of the city symbolism is analyzed in separate subsections: “The Doomed City” (“The Sea Bells” by Vydūnas, and “The Shackles” by M. Pečkauskaitė, “The Profane City” (the comedy “Vain Attempts” by P. Vaičiūnas, “Julijana” by A. Škėma, “A Spring Song” by B. Sruoga, “The Mammoth Hunt” by K. Saja and etc., “The Reflections of Identity” (“Liučė is skating” by L. S. Černiauskaitė, “A Neighbour”, “Madagascar”, and “A Close City” by M. Ivaškevičius.

  6. A Combination of Gestalt Therapy, Rosen Body Work, and Cranio Sacral Therapy did not help in Chronic Whiplash-Associated Disorders (WAD - Results of a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2004-01-01

    Full Text Available The chronic state of whiplash-associated disorder (WAD might be understood as a somatization of existential pain. Intervention aimed to improve quality of life (QOL seemed to be a solution for such situations. The basic idea behind the intervention was holistic, restoring quality of life and relationship with self, in order to diminish tension in the locomotion system, especially the neck. A psychosomatic theory for WAD is proposed. Our treatment was a short 2-day course with teachings in philosophy of life, followed by 6 to 10 individual sessions in gestalt psychotherapy and body therapy (Rosen therapy and Cranio Sacral therapy, followed by a 1-day course approximately 2 months later, closing the intervention. Two independent institutions did the intervention and the assessments. In a randomized, clinically controlled setting, 87 chronic WAD patients were included with a median duration of 37 months from their whiplash accidents. One patient never started. Forty-three had the above intervention (female/male = 36/7, ages 22–49, median 37 years and another 43 were assigned to a nontreated control group (female/male = 35/8, ages 1848, median 38. Six had disability pension and 27 had pending medicolegal issues in each group. Effect variables were pain in neck, arm, and/or head; measures of quality of life and daily activities; as well as general physical or mental health. Wilcoxon test for between-groups comparisons with intention-to-treat analyses was conducted; the square curve paradigm testing for immediate improvements of health and quality of life was also used. The groups were comparable at baseline. From the intervention group, 11 dropped out during the intervention (4 of those later joined the follow-up investigation, 22 of the remaining 32 graduated the course, and 35 of the 43 controls did as well. Approximately 3 months later, we found no clinically relevant or significant increase in any effect measure. The above version of a quality

  7. The cost-benefit of using soft silicone multilayered foam dressings to prevent sacral and heel pressure ulcers in trauma and critically ill patients: a within-trial analysis of the Border Trial.

    Science.gov (United States)

    Santamaria, Nick; Liu, Wei; Gerdtz, Marie; Sage, Sarah; McCann, Jane; Freeman, Amy; Vassiliou, Theresa; DeVincentis, Stephanie; Ng, Ai W; Manias, Elizabeth; Knott, Jonathan; Liew, Danny

    2015-06-01

    Little is known about the cost-benefit of soft silicone foam dressings in pressure ulcer (PU) prevention among critically ill patients in the emergency department (ED) and intensive care unit (ICU). A randomised controlled trial to assess the efficacy of soft silicone foam dressings in preventing sacral and heel PUs was undertaken among 440 critically ill patients in an acute care hospital. Participants were randomly allocated either to an intervention group with prophylactic dressings applied to the sacrum and heels in the ED and changed every 3 days in the ICU or to a control group with standard PU prevention care provided during their ED and ICU stay. The results showed a significant reduction of PU incidence rates in the intervention group (P = 0·001). The intervention cost was estimated to be AU$36·61 per person based on an intention-to-treat analysis, but this was offset by lower downstream costs associated with PU treatment (AU$1103·52). Therefore, the average net cost of the intervention was lower than that of the control (AU$70·82 versus AU$144·56). We conclude that the use of soft silicone multilayered foam dressings to prevent sacral and heel PUs among critically ill patients results in cost savings in the acute care hospital. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  8. 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

  9. 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...

  10. 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)

  11. Radiation safety

    International Nuclear Information System (INIS)

    Woods, D.A.

    1982-01-01

    Sections include: dose units, dose limits, dose rate, potential hazards of ionizing radiations, control of internal and external radiation exposure, personal dosemeters, monitoring programs and transport of radioactive material (packaging and shielding)

  12. Synchrotron radiation

    International Nuclear Information System (INIS)

    Hallmeier, K.H.; Meisel, A.; Ranft, J.

    1982-01-01

    The physical background and the properties of synchrotron radiation are described. The radiation offers many useful applications in the fields of spectroscopy and structural investigations. Some examples are given

  13. 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

  14. 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)

  15. 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.)

  16. 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

  17. 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

  18. Stereotactic Body Radiation Therapy in Spinal Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Kamran A. [Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN (United States); Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Rose, Peter S. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Olivier, Kenneth R. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Brinkmann, Debra H. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Laack, Nadia N., E-mail: laack.nadia@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    2012-04-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  19. Stereotactic Body Radiation Therapy in Spinal Metastases

    International Nuclear Information System (INIS)

    Ahmed, Kamran A.; Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J.; Rose, Peter S.; Olivier, Kenneth R.; Brown, Paul D.; Brinkmann, Debra H.; Laack, Nadia N.

    2012-01-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 ± 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10–40 Gy) in a median of three fractions (range, 1–5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18–30 Gy) in a median of three fractions (range, 1–5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  20. 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.)

  1. 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.

  2. 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)

  3. Treatment of unstable sacral fractures with percutaneous reconstruction plate internal fixation Tratamento de fraturas sacrais instáveis com reconstrução percutânea com fixação de placa interna

    Directory of Open Access Journals (Sweden)

    Hong-Wei Chen

    2012-05-01

    Full Text Available PURPOSE: To study the effects of percutaneous reconstruction plate internal fixation in the treatment of unstable sacral fractures. METHODS: Percutaneous reconstruction plate internal fixation was applied on 21 cases of unstable sacral fracture (15 males and six females, at age range of 16-65 years, mean 38.3 years including four cases of Denis Zone I, 14 cases of Zone II and three cases of Zone III. In operation, an arc incision (about 3-5 cm long was made along the iliac crest on the outside border of posterior superior iliac spine (PSIS on both sides, and then the plate was transported from the wounded side to the opposite one through the subcutaneous tunnel. RESULTS: The mean incision length, operation time, intraoperative blood loss was 4.3cm, 45.2min, and 160.8ml respectively. All these patients were followed up for 12-33 months (average 16.3 months, which showed no incision infection, intraoperative neurovascular injury, internal fixation loose or breakage, disunion, or obvious lower limb length inequality. The function result was rated as excellent in six cases, good in 12 and fair in 3, with excellence rate of 85.7%, according to the Majeed scoring system. CONCLUSION: Percutaneous reconstruction plate internal fixation is an ideal surgical approach to unstable sacral fractures, as it is easy, safe, causing less trauma and fewer complications, and conducive to quicker recovery.OBJETIVO: Estudar os efeitos da reconstrução percutânea com fixação de placa interna no tratamento de fraturas sacrais instáveis. MÉTODOS: A reconstrução percutânea com fixação de placa interna foi aplicada em 21 casos de fratura sacral instável (15 homens e seis mulheres, com idade variando entre 16 e 65 anos, média de 38,3 anos incluindo quatro casos de Zona I de Denis, 14 casos de Zona II e três casos de Zona III. No ato operatório, uma incisão arqueada (cerca de 3 a 5cm de comprimento foi feita ao longo da crista ilíaca na borda externa da

  4. Oral-facial-digital syndrome with mesoaxial polysyndactyly, common AV canal, hirschsprung disease and sacral dysgenesis: Probably a transitional type between II, VI, variant of type VI or a new type

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2014-07-01

    Full Text Available We report a 4 month old male infant, the first in order of birth of healthy first cousin consanguineous parents who has many typical features of oral-facial-digital syndrome type VI (OFDS VI including hypertelorism, bilateral convergent squint, depressed nasal bridge, and wide upturned nares, low set posteriorly rotated ears, long philtrum, gum hyperplasia with notches of the alveolar borders, high arched palate, and hyperplastic oral frenula. He has mesoaxial and postaxial, polysyndactyly which is the specific feature of OFDS VI, however the cerebellum is normal on MRI brain. He has also some rare congenital anomalies including common atrioventricular canal, hirschsprung disease, and sacral dysgenesis. This patient may have a transitional type between II and VI, a variant of type VI or a new type.

  5. Sacral Rituality and Mysticism in the Service of the Awakening of National Identity. Baltic-Balkan Parallels in the Works of B. Kutavičius, L. Lebič and V. Tormis

    Directory of Open Access Journals (Sweden)

    Gregor Pompe

    2015-04-01

    Full Text Available In the works of all B. Kutavičius, L. Lebič and V. Tormis, one can find a pronounced inclination towards the ritual, the use of folk instruments, the idea of the circulation of life, and some sort of simulation of folk music of unidentifiable prehistoric times. These parallels raise the questions about the causes for such similarities which are connected to the socio-political situations of countries in which the composers lived and created. Therefore, it is not possible to disconnect the stylistic changes of the seventies and eighties from the desire for political and ideological liberation. All three composers responded to those trends with similar artistic solutions: they searched for mystical and sacral music of prehistoric tribes which functioned as trigger for the awakening of strong national feelings. 

  6. Telehealth-based model of care redesign to facilitate local fitting and management of patients with a spinal fracture requiring a thoracic lumbar sacral orthosis in rural hospitals in New South Wales.

    Science.gov (United States)

    Gallagher, Ryan; Giles, Michelle; Morison, Jane; Henderson, Judith

    2018-03-23

    To develop and implement a telehealth-based model of care for spinal fractures requiring management with thoracic lumbar sacral orthoses that eliminates the need for transfer to a metropolitan tertiary referral hospital. Pre-post design observational study evaluating model of care implementation. Rural referral hospitals in a large NSW region covering metropolitan, rural and remote hospitals. Patients presenting with a thoracic or lumbar spine fracture requiring thoracic lumbar sacral orthoses management and rural clinicians caring for them. Number of patients managed in rural hospitals without transfer to a metropolitan tertiary referral hospital; length of stay and related cost efficiencies; clinicians' perceived skills, knowledge and confidence levels. Model of care was implemented with clinical and system governance processes; and educational workshops across eight rural hospitals. A total of 81 patients managed in rural hospitals under this model between July 2013 and June 2016 without transfer were included in this study. Mean length of stay reduced from nine to four days. Hospital transfers were eliminated from the patient journey, totalling 24 324 km. Workshops were attended by 71 clinicians from nine rural hospitals and survey findings indicated a significant increase in staff knowledge, skill and confidence post education. Cost efficiencies were gained by eliminating 162 inter-hospital transfers and 405 patient bed days. This model has streamlined patient journeys and reduced transfers and travel, enabling rural clinicians to provide specialised services in local communities and facilitating timely evidence-based care in local communities without any adverse events. © 2018 National Rural Health Alliance Ltd.

  7. 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

  8. 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

  9. 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

  10. 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

  11. [Evaluation of radiation exposure of personnel in an orthopaedic and trauma operation theatre using the new real-time dosimetry system "dose aware"].

    Science.gov (United States)

    Müller, M C; Strauss, A; Pflugmacher, R; Nähle, C P; Pennekamp, P H; Burger, C; Wirtz, D C

    2014-08-01

    There is a positive correlation between operation time and staff exposure to radiation during intraoperative use of C-arm fluoroscopy. Due to harmful effects of exposure to long-term low-dose radiation for both the patient and the operating team it should be kept to a minimum. AIM of this study was to evaluate a novel dosimeter system called Dose Aware® (DA) enabling radiation exposure feedback of the personal in an orthopaedic and trauma operation theatre in real-time. Within a prospective study over a period of four month, DA was applied by the operation team during 104 orthopaedic and trauma operations in which the C-arm fluoroscope was used in 2D-mode. During ten operation techniques, radiation exposure of the surgeon, the first assistant, the theatre nurse and the anaesthesiologist was evaluated. Seventy-three operations were analysed. The surgeon achieved the highest radiation exposure during dorsolumbar spinal osteosynthesis, kyphoplasty and screw fixation of sacral fractures. The first assistant received a higher radiation exposure compared to the surgeon during plate osteosynthesis of distal radius fractures (157 %), intramedullary nailing of pertrochanteric fractures (143 %) and dorsolumbar spinal osteosynthesis (240 %). During external fixation of ankle fractures (68 %) and screw fixation of sacral fractures (66 %) radiation exposure of the theatre nurse exceeded 50 % of the surgeon's radiation exposure. During plate osteosynthesis of distal radius fractures (157 %) and intramedullary splinting of clavicular fractures (115 %), the anaesthesiologist received a higher radiation exposure than the surgeon. The novel dosimeter system DA provides real-time radiation exposure feedback of the personnel in an orthopaedic and trauma operation theatre for the first time. Data of this study demonstrate that radiation exposure of the personnel depends on the operation type. The first assistant, the theatre nurse and the anaesthesiologist might be

  12. 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

  13. 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.

  14. 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

  15. Hawking radiation

    Science.gov (United States)

    Parentani, Renaud; Spindel, Philippe

    2011-12-01

    Hawking radiation is the thermal radiation predicted to be spontaneously emitted by black holes. It arises from the steady conversion of quantum vacuum fluctuations into pairs of particles, one of which escaping at infinity while the other is trapped inside the black hole horizon. It is named after the physicist Stephen Hawking who derived its existence in 1974. This radiation reduces the mass of black holes and is therefore also known as black hole evaporation.

  16. Radiation meter

    Energy Technology Data Exchange (ETDEWEB)

    Burgess, P H

    1990-05-30

    Measuring means comprising first and second silicon PIN diode detectors both being covered with a thin layer of conducting material and the second detector being additionally covered with a relatively thick layer of material, the thickness being chosen such that beta radiation dose rate can be measured in beta radiation fields of high or medium energy, and in the presence of X and gamma radiation. (author). 2 figs.

  17. Radiation regulation

    International Nuclear Information System (INIS)

    Braithwaite, J.; Grabosky, P.

    1985-01-01

    The five main areas of radiation regulation considered are radiation exposure in the mining of uranium and other minerals, exposure in the use of uranium in nuclear reactors, risks in the transport of radioactive materials and hazards associated with the disposal of used materials. In Australia these problems are regulated by mines departments, the Australian Atomic Energy Commission and radiation control branches in state health departments. Each of these instutional areas of regulation is examined

  18. Radiation chemistry

    Energy Technology Data Exchange (ETDEWEB)

    None

    1973-07-01

    Research progress is reported on radiation chemistry of heavy elements that includes the following topics: radiation chemistry of plutonium in nitric acid solutions (spectrophotometric analysis and gamma radiolysis of Pu(IV) and Pu(VI) in nitric acid solution); EPR studies of intermediates formed in radiolytic reactions with aqueous medium; two-phase radiolysis and its effect on the distribution coefficient of plutonium; and radiation chemistry of nitric acid. (DHM)

  19. 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)

  20. Radiation medicine

    International Nuclear Information System (INIS)

    1991-01-01

    This booklet has been produced by UKAEA and the Marie Curie Memorial Foundation to give some basic information about what radiation is and how it is used in day to day diagnosis and treatment. It will be of interest to people undergoing treatment, their relatives and friends, and anyone who wants to know more about this important area. After a brief historical introduction the booklet explains what radiation is, the natural and man-made sources of radiation, how it is produced and how X-rays are used in medical diagnosis and treatment. The radiation protection measures taken and safety standards followed are mentioned. (author)

  1. 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.

  2. 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

  3. 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.

  4. Radiation myelopathy

    International Nuclear Information System (INIS)

    Berlit, P.

    1987-01-01

    After a review of the world literature, the case histories of 43 patients with radiation myelopathy are analyzed. In 1 patient there was a radiation injury of the medulla oblongata, in 2, cervical, in 28, thoracic, and in 12, lumbosacral. In the medulla oblongata lesion an alternans syndrome resulted. The patients with cervical and thoracic radiation myelopathies presented with a Brown-Sequard syndrome, a spinalis anterior syndrome or a transversal syndrome with pyramidal and spinothalamic tract involvement as the most prominent signs. For this group the term 'pyramidal-spinothalamic radiation myelopathy' is proposed. In lumbosacral radiation lesions a pure anterior horn syndrome may lead to spinothalamic tract involvement and the development of a cauda conus syndrome. The clinical presentation of these cases suggests that the location of the radiation lesion is most likely the region of the conus medullaris. The most frequent initial symptom was dysesthesia; the patients complained of burning pain or a feeling of coldness. Usually the neurological deficits were progressive, in pyramidal-spinothalamic radiation myelopathy over 12 months in average, in lumbosacral radiation lesions up to 10 years. The latent period between the finish of radiation therapy and the first neurological signs was 8 months (median) in cervical and thoracic myelopathy and 33 months in lumbosacral lesions. For the entire group of 43 patients there was an inverse relationship between the radiation dose (ret) and the latent period. A positive relation could be demonstrated between the age of patients at the time of radiation therapy and the latent period. Patients simultaneously receiving cytostatic drugs presented after a longer latent period than the remaining group. (orig./MG)

  5. 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

  6. 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

  7. 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)

  8. Background radiation

    International Nuclear Information System (INIS)

    Arnott, D.

    1985-01-01

    The effects of background radiation, whether natural or caused by man's activities, are discussed. The known biological effects of radiation in causing cancers or genetic mutations are explained. The statement that there is a threshold below which there is no risk is examined critically. (U.K.)

  9. Ionizing radiations

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    This is an update about the radiological monitoring in base nuclear installations. A departmental order of the 23. march 1999 (J.O.28. april, p.6309) determines the enabling rules by the Office of Protection against Ionizing Radiations of person having at one's disposal the results with names of individual exposure of workers put through ionizing radiations. (N.C.)

  10. Radiation hematology

    International Nuclear Information System (INIS)

    Zherbin, E.A.; Chukhlovin, A.B.

    1989-01-01

    State-of-the-Art ofl radiation hematology and review of the problems now facing this brauch of radiobiology and nuclear medicine are presented. Distortion of division and maturation of hemopoiesis parent cells is considered as main factor of radiopathology for hematopoetic system. Problems of radiation injury and functional variation of hematopoetic microenvironment cell populations are discussed. 176 figs.; 23 figs.; 18 tabs

  11. 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

  12. Synchrotron radiation

    International Nuclear Information System (INIS)

    Nave, C.; Quinn, P.; Blake, R.J.

    1988-01-01

    The paper on Synchrotron Radiation contains the appendix to the Daresbury Annual Report 1987/88. The appendix is mainly devoted to the scientific progress reports on the work at the Synchrotron Radiation Source in 1987/8. The parameters of the Experimental Stations and the index to the Scientific Reports are also included in the appendix. (U.K.)

  13. Radiation Protection

    International Nuclear Information System (INIS)

    Loos, M.

    2002-01-01

    Major achievements of SCK-CEN's Radiation Protection Department in 2001 are described. The main areas for R and D of the department are enviromnental remediation, emergency planning, radiation protection research, low-level radioactvity measurements, safeguards and physics measurements, decision strategy research and policy support and social sciences in nuclear research. Main achievements for 2001 in these areas are reported

  14. Ionizing radiation

    Science.gov (United States)

    Tobias, C. A.; Grigoryev, Y. G.

    1975-01-01

    The biological effects of ionizing radiation encountered in space are considered. Biological experiments conducted in space and some experiences of astronauts during space flight are described. The effects of various levels of radiation exposure and the determination of permissible dosages are discussed.

  15. 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

  16. 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

  17. 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)

  18. The use of free musculocutaneous flaps to cover chronic radiation ulcers

    International Nuclear Information System (INIS)

    Tsujiguchi, Kounosuke; Tajima, Sadao; Tanaka, Yoshio; Hira, Michiya; Imai, Keisuke; Fukae, Eiichi; Omiya, Yuka.

    1992-01-01

    Three patients with chronic radiation ulcer treated with free musculocutaneous flap transfer are described. The first patient was a 66-year-old woman who developed sacral ulcer 7 years after radiation combined with surgery for uterine cancer. After debridement of this ulcer, interpositional vein grafts 30 cm in length was used to reconstruct an 'extended' latissimus dorsi musculocutaneous flap. The second patient was a 62-year-old woman. She developed ulcer on her chest 15 years after postoperative irradiation for breast cancer. Radiation damage extended to the myocardium and pulmonary parenchyma. After careful debridement, reconstruction was performed by using the free rectus abdominis musculocutaneous flap. The last patient was a 72-year-old woman. Ulcer of the right axilla developed 19 years after postoperative irradiation for breast cancer. Reconstruction was performed by using a free rectus abdominis musculocutaneous flap. In these patients in whom radiation-damaged tissue was not completely excised, favorable results could be attained by using the transfer of the free musculocutaneous flaps. (N.K.)

  19. 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

  20. 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

  1. 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

  2. Radiation physics

    International Nuclear Information System (INIS)

    Nam, Sang Hui

    1991-02-01

    This book deals with radiation physics, which introduces atomic theory and an atomic nucleus of materials, conception of an atom and materials, wave and particle, X ray generation and character, a radioactive element and change law, nature of radioactivity, neutron rays, fission, alpha collapse and beta collage and a neutrino collapse of artificial radioactivity such as collapse of artificial nucleus and artificial radioactivity and radiative capture, interaction with materials like interaction between a charged particle and materials and interaction among X-ray, r-ray and materials, radiation of quantity and unit and a charged particle accelerator.

  3. Synchrotron radiation

    CERN Document Server

    Kunz, C

    1974-01-01

    The production of synchrotron radiation as a by-product of circular high-energy electron (positron) accelerators or storage rings is briefly discussed. A listing of existing or planned synchrotron radiation laboratories is included. The following properties are discussed: spectrum, collimation, polarization, and intensity; a short comparison with other sources (lasers and X-ray tubes) is also given. The remainder of the paper describes the experimental installations at the Deutsches Elektronen-Synchrotron (DESY) and DORIS storage rings, presents a few typical examples out of the fields of atomic, molecular, and solid-state spectroscopy, and finishes with an outlook on the use of synchrotron radiation in molecular biology. (21 refs).

  4. Ionizing radiation

    International Nuclear Information System (INIS)

    Passchier, W.F.

    1988-01-01

    This report is part two from the series 'Future explorations' of the Dutch Counsil for Public Health. It contains contributions on biological effects of radiation in which information is presented on research into the occurrence of cancer in patients treated with radiotherapy and irradiated laboratory animals, on the effects of prenatal irradiation, and on the possibile, only in laboratory-animal research demonstrated, effects of irradiation in offspring of irradiated parents. In other contributions, which put the 'link' between the radiology and the practical radiation hygienics, it appears that the increased scientific knowledge does not make it easier to design radiation-hygienic standards and rules. (H.W.). refs.; figs.; tabs

  5. Radiation safety

    International Nuclear Information System (INIS)

    1996-04-01

    Most of the ionizing radiation that people are exposed to in day-to-day activities comes from natural, rather than manmade, sources. The health effects of radiation - both natural and artificial - are relatively well understood and can be effectively minimized through careful safety measures and practices. The IAEA, together with other international and expert organizations, is helping to promote and institute Basic Safety Standards on an international basis to ensure that radiation sources and radioactive materials are managed for both maximum safety and human benefit

  6. Synchrotron Radiation

    International Nuclear Information System (INIS)

    Asfour, F.I

    2000-01-01

    Synchrotron light is produced by electron accelerators combined with storage rings. This light is generated over a wide spectral region; from infra-red (IR) through the visible and vacuum ultraviolet (VUV), and into the X-ray region. For relativistic electrons (moving nearly with the speed of light), most radiation is concentrated in a small cone with an opening angle of 1/gamma(some 0.1 to 1 milliradian),where gamma is the electron energy in units of rest energy (typically 10 3 -10 4 ). In synchrotron radiation sources (storage rings) highly relativistic electrons are stored to travel along a circular path for many hours. Radiation is caused by transverse acceleration due to magnetic forces(bending magnets). The radiation is emitted in pulses of 10-20 picosecond, separated by some 2 nanosecond or longer separation

  7. Radiating confidence

    International Nuclear Information System (INIS)

    Rush, P.

    1988-01-01

    Radiation monitoring systems for operators handling radioactive wastes are described. These include a personnel monitoring system which is suitable for small groups (ie as few as 50) of personnel. The use of microelectronics enable facilities such as automatic personal dose recording with three accumulative registers and automatic reporting of exceeded dose limits. At a controlled entrance the user is identified with a personal identification number. Exit is then also monitored. The use of pocket dosimeters increase the flexibility of this system. In another system a 'rotary man lock' only allows exit from the radiation controlled zone when satisfactory radiation checks have been made. The radiation and security checks available with this system are described. A 'sack monitor' for low level wastes contained in plastic bags is illustrated. (U.K.)

  8. Radiation damage

    CERN Document Server

    Heijne, Erik H M; CERN. Geneva

    1998-01-01

    a) Radiation damage in organic materials. This series of lectures will give an overview of radiation effects on materials and components frequently used in accelerator engineering and experiments. Basic degradation phenomena will be presented for organic materials with comprehensive damage threshold doses for commonly used rubbers, thermoplastics, thermosets and composite materials. Some indications will be given for glass, scintillators and optical fibres. b) Radiation effects in semiconductor materials and devices. The major part of the time will be devoted to treat radiation effects in semiconductor sensors and the associated electronics, in particular displacement damage, interface and single event phenomena. Evaluation methods and practical aspects will be shown. Strategies will be developed for the survival of the materials under the expected environmental conditions of the LHC machine and detectors. I will describe profound revolution in our understanding of black holes and their relation to quantum me...

  9. Synchrotron radiation

    International Nuclear Information System (INIS)

    Helliwell, J.R.; Walker, R.P.

    1985-01-01

    A detailed account of the research work associated with the Synchrotron Radiation Source at Daresbury Laboratory, United Kingdom, in 1984/85, is presented in the Appendix to the Laboratory's Annual Report. (U.K.)

  10. Radiation curing

    International Nuclear Information System (INIS)

    Wendrinsky, J.

    1987-04-01

    In the beginning of the seventies the two types of radiation sources applied in industrial processes, electron radiation and UV, had been given rather optimistic forecasts. While UV could succeed in the field of panel and film coating, electron radiation curing seems to gain success in quite new fields of manufacturing. The listing of the suggested applications of radiation curing and a comparison of both advantages and disadvantages of this technology are followed by a number of case studies emphasizing the features of these processes and giving some examplary calculations. The data used for the calculations should provide an easy calculation of individual manufacturing costs if special production parameters, investment or energy costs are employed. (Author)

  11. Infrared radiation

    International Nuclear Information System (INIS)

    Moss, C.E.; Ellis, R.J.; Murray, W.E.; Parr, W.H.

    1989-01-01

    All people are exposed to IR radiation from sunlight, artificial light and radiant heating. Exposures to IR are quantified by irradiance and radiant exposure to characterize biological effects on the skin and cornea. However, near-IR exposure to the retina requires knowledge of the radiance of the IR source. With most IR sources in everyday use the health risks are considered minimal; only in certain high radiant work environments are individuals exposed to excessive levels. The interaction of IR radiation with biological tissues is mainly thermal. IR radiation may augment the biological response to other agents. The major health hazards are thermal injury to the eye and skin, including corneal burns from far-IR, heat stress, and retinal and lenticular injury from near-IR radiation. 59 refs, 13 figs, 2 tabs

  12. Radiation enteritis

    Science.gov (United States)

    ... and tobacco Almost all milk products Coffee, tea, chocolate, and sodas with caffeine Foods containing whole bran ... Call your provider if you are having radiation therapy or have had it in the past and ...

  13. Synchrotron radiation

    International Nuclear Information System (INIS)

    Poole, M.W.; Lea, K.R.

    1982-01-01

    A report is given on the work involving the Synchrotron Radiation Division of the Daresbury Laboratory during the period January 1981 - March 1982. Development of the source, beamlines and experimental stations is described. Progress reports from individual investigators are presented which reveal the general diversity and interdisciplinary nature of the research which benefits from access to synchrotron radiation and the associated facilities. Information is given on the organisation of the Division and publications written by the staff are listed. (U.K.)

  14. Radiation safety

    International Nuclear Information System (INIS)

    Goetz, B.B.; Murphy, C.H.

    1987-01-01

    In medicine, as in other fields of scientific endeavor, the development of advanced and specialized techniques has resulted in increased hazards for employees. However, by possessing both an appreciation of the proper use of factors that regulate radiation exposure around radiology equipment and a knowledge of the biologic effects of radiation, which can include possible genetic and somatic consequences, it is possible to maximize the usefulness of these valuable procedures while minimizing the risk to medical personnel involved with patient care

  15. Radiation shielding

    International Nuclear Information System (INIS)

    Yue, D.D.

    1979-01-01

    Details are given of a cylindrical electric penetration assembly for carrying instrumentation leads, used in monitoring the performance of a nuclear reactor, through the containment wall of the reactor. Effective yet economical shielding protection against both fast neutron and high-energy gamma radiation is provided. Adequate spacing within the assembly allows excessive heat to be efficiently dissipated and means of monitoring all potential radiation and gas leakage paths are provided. (UK)

  16. Radiation protection

    International Nuclear Information System (INIS)

    Koelzer, W.

    1976-01-01

    The lecture is divided into five sections. The introduction deals with the physical and radiological terms, quantities and units. Then the basic principles of radiological protection are discussed. In the third section attention is paid to the biological effects of ionizing radiation. The fourth section deals with the objectives of practical radiological protection. Finally the emergency measures are discussed to be taken in radiation accidents. (HP) [de

  17. Synchrotron radiation

    International Nuclear Information System (INIS)

    Norman, D.; Walker, R.P.; Durham, P.J.; Ridley, P.A.

    1986-01-01

    The paper on synchrotron radiation is the appendix to the Daresbury (United Kingdom) annual report, 1985/86. The bulk of the volume is made up of the progress reports for the work carried out during the year under review using the Synchrotron Radiation Source (SRS) at Daresbury. The Appendix also contains: the scientific programmes at the the SRS, progress on beamlines, instrumentation and computing developments, and activities connected with accelerator development. (U.K.)

  18. Radiation Transport

    Energy Technology Data Exchange (ETDEWEB)

    Urbatsch, Todd James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-15

    We present an overview of radiation transport, covering terminology, blackbody raditation, opacities, Boltzmann transport theory, approximations to the transport equation. Next we introduce several transport methods. We present a section on Caseology, observing transport boundary layers. We briefly broach topics of software development, including verification and validation, and we close with a section on high energy-density experiments that highlight and support radiation transport.

  19. Radiation myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Howell, D A [Derbyshire Royal Infirmary, Derby (UK)

    1979-10-01

    Following high-dose radiotherapy treatment of tumours, there is a risk of destructive radiation myelopathy developing a few months later as a result of spinal cord irradiation. The emphasis of the present article is on the mechanism of the development of radiation myelopathy. It is suggested that, in the irradiated segments, the normal endothelial cells lining the penetrating arteries and capillaries are replaced by abnormal cells during the latent period. Radiation-induced mutations or chromosomal aberrations are contained in these cells, thus provoking an immunological response. During the attempted rejection of these cells, protein-rich plasma filtrate is leaked into the artery walls and nervous tissue, causing the destructive myelopathy. The signs of paralysis of spinal cord function may be caused either by infarcts or by oedema of the white matter. Since both diagnosis and treatment are difficult, it is necessary to concentrate on prevention by, whenever possible, reducing radiation doses to below tolerance limits during radiotherapy. As regards radiotherapy in children, it is currently believed that there is little or no difference in radiation tolerance between the child and the adult nervous system. Some early benign forms of radiation myelopathy are also briefly discussed.

  20. Radiation myelopathy

    International Nuclear Information System (INIS)

    Howell, D.A.

    1979-01-01

    Following high-dose radiotherapy treatment of tumours, there is a risk of destructive radiation myelopathy developing a few months later as a result of spinal cord irradiation. The emphasis of the present article is on the mechanism of the development of radiation myelopathy. It is suggested that, in the irradiated segments, the normal endothelial cells lining the penetrating arteries and capillaries are replaced by abnormal cells during the latent period. Radiation-induced mutations or chromosomal aberrations are contained in these cells, thus provoking an immunological response. During the attempted rejection of these cells, protein-rich plasma filtrate is leaked into the artery walls and nervous tissue, causing the destructive myelopathy. The signs of paralysis of spinal cord function may be caused either by infarcts or by oedema of the white matter. Since both diagnosis and treatment are difficult, it is necessary to concentrate on prevention by, whenever possible, reducing radiation doses to below tolerance limits during radiotherapy. As regards radiotherapy in children, it is currently believed that there is little or no difference in radiation tolerance between the child and the adult nervous system. Some early benign forms of radiation myelopathy are also briefly discussed. (UK)

  1. 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

  2. Rectal cancer: The radiation basis of radiotherapy, target volume

    International Nuclear Information System (INIS)

    Bosset, J.F.; Servagi-Vernat, S.; Crehange, G.; Azria, D.; Gerard, J.P.; Hennequin, C.

    2011-01-01

    Since the implementation of preoperative chemo-radiotherapy and meso-rectal excision, the 5-year rates of locoregional failures in T3-T4 N0-N1M0 rectal cancer fell from 25-30% thirty years ago to 5-8% nowadays. A critical analysis of the locoregional failures sites and mechanisms, as well as the identification of nodal extension, helps the radiation oncologist to optimize the radiotherapy target definition. The upper limit of the clinical target volume is usually set at the top of the third sacral vertebra. The lateral pelvic nodes should be included when the tumor is located in the distal part of the rectum. The anal sphincter and the levator muscles should be spared when a conservative surgery is planned. In case of abdomino-perineal excision, the ischio-rectal fossa and the sphincters should be included in the clinical target volume. A confrontation with radiologist and surgeon is mandatory to improve the definition of the target volumes to be treated. (authors)

  3. Ileal perforation induced by acute radiation injury under gefitinib treatment

    International Nuclear Information System (INIS)

    Muraoka, Takayuki; Tsukuda, Kazunori; Toyooka, Shinichi

    2011-01-01

    Enteritis is one of the side effects of radiotherapy to the abdominal cavity. Radiation enteritis involves damage to mucous membranes in the acute phase and to stromal tissues in the late phase. Perforation of the intestine tends to occur in the late phase, and rarely in the acute phase. However, we describe here a case of intestinal perforation occurring in the acute phase after irradiation in a patient who received gefitinib treatment. Gefitinib, one of the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), is widely used to treat non-small cell lung cancer (NSCLC) patients, but is simultaneously known to inhibit wound healing. We suspect that gefitinib may affect regeneration of the small intestinal mucosa injured by irradiation. A 76-year-old woman had NSCLC with metastases to the 5th lumbar, sacral, and right iliac bones. To control the pain from bone metastasis, anterior-posterior opposing portal irradiation (total 35 Gy) was started, and was completed over 22 days. On day 25 after starting radiotherapy, the patient began to take gefitinib. On day 35, she presented with acute peritonitis, and an emergency laparotomy was performed. The terminal ileum was affected by radiation enteritis and there were two pin-hole perforations. In the surgical specimen, no cancerous lesions were detected, and immunohistochemical staining of phosphorylated EGFR (pEGFR) was negative. pEGFR has an important role in mucous membrane repair after irradiation. Intestinal perforation in the acute phase of radiation enteritis may be associated with impaired mucosal repair mechanisms due to the use of an EGFR-TKI such as gefitinib, as evidenced by the absence of pEGFR. (author)

  4. 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 ...

  5. The effect of radiation therapy for bone metastasis in urinary organ cancer

    International Nuclear Information System (INIS)

    Chikazawa, Ippei; Inoue, Shinya; Nakazawa, Yusuke

    2016-01-01

    Bone metastasis symptoms are complications that greatly reduce the quality of life (QOL) of cancer patients. We report a retrospective study on the efficacy of radiation therapy for patients with bone metastasis in urinary organ cancer. (Subjects and methods) Subjects are comprised of 17 patients; total irradiated areas consist of 25 sites. There are 5 patients diagnosed with renal cell carcinoma, 1 patient with bladder cancer and 11 patients with prostatic cancer. All of them have undergone radiation therapy for bone metastasis in urinary organ cancer between April 2007 and March 2014 in the Department of Urology, Kanazawa Medical University. The mean age of the patients was 66.7 years old. We looked at irradiated areas, exposure dose and changes of symptom in all patients. Irradiated areas are thoracolumbar vertebrae (14 sites), cranial base (2 sites), pubic bone (1 site), ilium bone (2 sites), sacral bone (1 site), rib bone (1 site) and hip joint (1 site). The mean exposure dose of one area is 37.5 Gy (13.5-60). 19 irradiated sites which were previously reported to have sharp pain have gained improvement at 16 sites. These 16 sites have comparatively lesser pain or no pain. 8 cases in acknowledgment of walk difficulty, it was with 7 cases walking alone possibility again. This study showed that radiation therapy have significant improvement in terms of symptoms and QOL for the patients with bone metastasis in urinary organ cancer. (author)

  6. Radiofrequency radiation

    International Nuclear Information System (INIS)

    Elder, J.A.; Czerski, P.A.; Stuchly, M.A.; Mild, K.H.; Sheppard, A.R.

    1989-01-01

    High-level radiofrequency radiation is a source of thermal energy that carries all of the known implications of heating for biological systems, including burns, temporary and permanent changes in reproduction, cataracts, and death. In general, no changes in chromosomes, DNA or the reproductive potential of animals exposed to RF radiation have been reported in the absence of significant rises in temperature, though there are limited data on DNA and chromosomal changes at non-thermal levels. Human data are currently limited and do not provide adequate information about the relationship between prolonged low-level RF radiation exposure and increased mortality or morbidity, including cancer incidence. In epidemiological studies and clinical reports of RF effects in man, the problems of quantification are numerous and include uncertainties about ''dose'', health effects, latent periods, dose-response relationships, and interactions with other physical or chemical agents. 228 refs, 6 figs, 2 tabs

  7. Ionizing radiations

    International Nuclear Information System (INIS)

    2009-01-01

    After having recalled some fundamental notions and measurement units related to ionizing radiations, this document describes various aspects of natural and occupational exposures: exposure modes and sources, exposure levels, biological effects, health impacts. Then, it presents prevention principles aimed at, in an occupational context of use of radiation sources (nuclear industry excluded), reducing and managing these exposures: risk assessment, implementation of safety from the front end. Some practical cases illustrate the radiation protection approach. The legal and regulatory framework is presented: general notions, worker exposure, measures specific to some worker categories (pregnant and breast feeding women, young workers, temporary workers). A last part describes what is to be done in case of incident or accident (dissemination of radioactive substances from unsealed sources, anomaly occurring when using a generator or a sealed source, post-accident situation)

  8. Radiation sensor

    International Nuclear Information System (INIS)

    Brown, W.L.; Geronime, R.L.

    1977-01-01

    Radiation sensor and thermocouple, respectively, which can be used for reactor in-core instrumentation. The radiation sensor consists of an inconel conductor wire and rhodium emitter wire, the thermocouple of two intertwined alumel or chromel wires. Both are arranged in the center of a metal tube relative to which they are separated by an insulator made of SiO 2 fibers. This insulator is first introduced as a loose fabric between the radiation sensor and the thermocouple, respectively, and the metal tube and then compacted to a density of 35-73% of pure SiO 2 by drawing the tube. There is no need for soldering or welding. The insulation resistivity at room temperature ist between 10 14 and 10 15 ohms. (ORU) [de

  9. Tidal radiation

    International Nuclear Information System (INIS)

    Mashhoon, B.

    1977-01-01

    The general theory of tides is developed within the framework of Einstein's theory of gravitation. It is based on the concept of Fermi frame and the associated notion of tidal frame along an open curve in spacetime. Following the previous work of the author an approximate scheme for the evaluation of tidal gravitational radiation is presented which is valid for weak gravitational fields. The emission of gravitational radiation from a body in the field of a black hole is discussed, and for some cases of astrophysical interest estimates are given for the contributions of radiation due to center-of-mass motion, purely tidal deformation, and the interference between the center of mass and tidal motions

  10. Cherenkov radiation

    International Nuclear Information System (INIS)

    Hubert, P.

    1955-01-01

    When the radioactivity has been discovered, it was observed by researchers that different materials as mineral salts or solutions were emitting a weak light when submitted to radioactivity beams. At the beginning it has been thought that it was fluorescent light. In 1934, Cherenkov, a russian physicist, worked on the luminescence of uranyl salts solutions caused by gamma radiation and observed a very weak light was emitted by pure liquid. After further studies, he concluded that this phenomena was different from fluorescence. Since then, it has been called Cherenkov effect. This blue light emission is produced when charged particles are going through a transparent medium with an upper velocity than light velocity. This can happen only in medium with large refractive index as water or glass. It also presents its different properties discovered afterwards. The different applications of the Cherenkov radiation are discussed as counting techniques for radiation detectors or comic ray detectors. (M.P.)

  11. Synchrotron radiation

    International Nuclear Information System (INIS)

    Knotek, M.L.

    1987-01-01

    Synchrotron radiation has had a revolutionary effect on a broad range of scientific studies, from physics, chemistry and metallurgy to biology, medicine and geoscience. The situation during the last decade has been one of very rapid growth, there is a great vitality to the field and a capability has been given to a very broad range of scientific disciplines which was undreamed of just a decade or so ago. Here we will discuss some of the properties of synchrotron radiation that makes it so interesting and something of the sources in existence today including the National Synchrotron Light Source (NSLS). The NSLS is one of the new facilities built specifically for synchrotron radiation research and the model that was developed there for involvement of the scientific community is a good one which provides some good lessons for these facilities and others

  12. Radiation control

    International Nuclear Information System (INIS)

    Uchida, Akira

    1981-01-01

    This paper describes on how the condition of radiation level in the ring (storage ring) experimentation room changes corresponding to the operating stage of SOR-ring (synchrotron radiation storage ring), and does not describe on the present radiation control in the SOR facility. The operating stage of SOR is divided into the following five: (1) 307 MeV electron injection, (2) 307 MeV electron storage (used for SOR experiments), (3) energy increase from 307 to 380 MeV, (4) 380 MeV electron storage, (5) re-injection and completion of operation. Gamma and X ray levels are shown when electron beam is injected from the electron synchrotron to the SOR-ring. Two main causes of the high level are reported. Spatial dose rate in storing 307 MeV electrons in also illustrated. This is sufficiently lower than that at electron incidence. The measurement of radiation level at the time of energy increase from 307 to 380 MeV has just started. Since the radiation level in 380 MeV storage, measured at the points about 20 cm apart from the electron orbit, showed several mR/h, the level seems to be negligible at the points where experiments are carried out, 1 m away from the measurement points. The radiation level in electron reinjection and completion of operation may be large during a short period (a few Roentgen) like the time of energy increase. Therefore, the beam shall be re-injected or decreased after confirming that all experimenters have retreated into the predetermined place. (Wakatsuki, Y.)

  13. Radiation toxicology

    International Nuclear Information System (INIS)

    Fry, R.J.M.; Storer, J.B.; Ullrich, R.L.

    1979-01-01

    Extensive studies on both human and experimental animal populations have provided information that allow radiation protection standards to be set with greater confidence than for most if not all other carcinogenic agents. Furthermore, both international and national advisory bodies are continually updating the risk estimates and the standards as new information is available. However, it is clear that models are needed that take into account the multistage nature of carcinogenesis. Studies in both ionizing and ultraviolet radiation carcinogenesis are more valuable to the general problem of elucidating the mechanisms involved in cancer than is indicated by the amount of work or support for this field of research

  14. Radiation therapy

    International Nuclear Information System (INIS)

    Peschel, R.E; Fisher, J.J.

    1986-01-01

    The new insights and controversies concerning the radiobiological properties of malignant melanoma and how these relate to new clinical approaches are reviewed. The recent clinical experience with large individual fraction sizes is analyzed. The treatment of malignant melanoma in certain specialized sites is also described. An attempt is made to place in perspective the usefulness of radiation therapy in the treatment of this complex disease. Finally, certain new applications for radiation therapy both alone and in combustion with other treatment modalities are proposed that may ultimately prove appropriate for clinical trials

  15. Radiation physics

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    The radiation physics program is directed toward understanding the basic mechanism by which charged particles lose energy in traversing matter, and presenting this information in a way meaningful to the study of radiation dosimetry and biological damage. Measurements of the absolute cross sections for the ejection of electrons from ionization by fast charged particles, measurements of optical fluorescence from liquid systems, preliminary analyses of electron emission cross sections for proton bombardment of carbon foils, and nonexponential decay of fluorescence in both polar and nonpolar solutions are covered

  16. Radiation retinopathy

    International Nuclear Information System (INIS)

    Lumbroso, L.; Desjardins, L.; Dendale, R.; Fourquet, A.

    2002-01-01

    Radiation retinopathy is a retinal micro-angiopathy, observed after irradiation of the eye. It can rarely lead to neo-vascular glaucoma and enucleation due to pain. It is due to a progressive retinal capillary then vascular occlusion. Total irradiation dose, dose fraction, and surface of the irradiated retina seem to be strong predictive factors for radiation retinopathy. Patients who underwent an irradiation near the eye (skull base tumors, nasal and paranasal tumors, or brain tumors) should be followed by periodic ophthalmologic examination to detect and treat when necessary the non perfusion areas. (authors)

  17. Radiation epidemiology

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Lyman, J.T.; Alpen, E.L.

    1983-01-01

    The effect of latency periods on cancer risk estimation is under study in our laboratory. Insofar as cancer incidences and radiation doses are concerned, effort is made to ascertain these with the greatest reliability, although problems arise, particularly in attempts to reconstruct the events of exposure many years prevously. The matter of the long latent periods begs the important issue of how to project into the future the risk of cancer induced in individuals exposed at the present time, or depriving a projection model appropriate for predicting how induced cancers will express themselves in time following exposure. Two risk-projection models which are generally used by radiation epidemiologists are discussed

  18. Radiation toxicology

    International Nuclear Information System (INIS)

    Fry, R.J.M.; Storer, J.B.; Ullrich, R.L.

    1979-01-01

    The extensive studies on both human and experimental animal populations have provided information that allows radiation protection standards to be set with greater confidence than for most if not all other carcinogenic agents. Furthermore, both international and national advisory bodies are continually updating the risk estimates and the standards as new information is available. However, it is clear that we need models that take into account the multistage nature of carcinogenesis. Studies in both ionizing and ultraviolet radiation carcinogenesis are more valuable to the general problem of elucidating the mechanisms involved in cancer than is indicated by the amount of work or support for this field of research

  19. Radiation chemistry

    International Nuclear Information System (INIS)

    Swallow, A.J.

    1983-01-01

    The subject is covered in chapters, entitled: introduction (defines scope of article as dealing with the chemistry of reactive species, (e.g. excess electrons, excited states, free radicals and inorganic ions in unusual valency states) as studied using radiation with radiation chemistry in its traditional sense and with biological and industrial applications); gases; water and simple inorganic systems; aqueous metallo-organic compounds and metalloproteins; small organic molecules in aqueous solution; microheterogeneous systems; non-aqueous liquids and solutions; solids; biological macromolecules; synthetic polymers. (U.K.)

  20. Radiation shielding

    International Nuclear Information System (INIS)

    Aitken, D.

    1979-01-01

    Shields for equipment in which ionising radiation is associated with high electrical gradients, for example X-ray tubes and particle accelerators, incorporate a radiation-absorbing metal, as such or as a compound, and are electrically non-conducting and can be placed in the high electrical gradient region of the equipment. Substances disclosed include dispersions of lead, tungsten, uranium or oxides of these in acrylics polyesters, PVC, ABS, polyamides, PTFE, epoxy resins, glass or ceramics. The material used may constitute an evacuable enclosure of the equipment or may be an external shield thereof. (U.K.)

  1. Radiation induced fractures of sacrum: CT diagnosis

    International Nuclear Information System (INIS)

    Rafii, M.; Firooznia, H.; Golimbu, C.; Horner, N.

    1988-01-01

    Sacral insufficiency fracture due to bone atrophy may develop as a complication of irradiation of pelvic malignancies. Pain is the presenting symptom and the clinical diagnoses most often considered are recurrence of the original malignancy and metastatic disease. Computed tomography provides the most specific information helpful for the detection of these fractures and for exclusion of recurrent malignancy

  2. Cherenkov radiation; La radiation Cerenkov

    Energy Technology Data Exchange (ETDEWEB)

    Hubert, P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1955-07-01

    When the radioactivity has been discovered, it was observed by researchers that different materials as mineral salts or solutions were emitting a weak light when submitted to radioactivity beams. At the beginning it has been thought that it was fluorescent light. In 1934, Cherenkov, a russian physicist, worked on the luminescence of uranyl salts solutions caused by gamma radiation and observed a very weak light was emitted by pure liquid. After further studies, he concluded that this phenomena was different from fluorescence. Since then, it has been called Cherenkov effect. This blue light emission is produced when charged particles are going through a transparent medium with an upper velocity than light velocity. This can happen only in medium with large refractive index as water or glass. It also presents its different properties discovered afterwards. The different applications of the Cherenkov radiation are discussed as counting techniques for radiation detectors or comic ray detectors. (M.P.)

  3. Radiation dosage

    Energy Technology Data Exchange (ETDEWEB)

    Finston, Roland [Health Physics, Stanford University, Stanford, CA (United States)

    1986-07-01

    Radiation dosage at Bikini Atoll is the result of current soil contamination, a relic of the nuclear weapons testing program of some 30 years ago. The principal contaminants today and some of their physical properties are listed: cesium-137, strontium-90, plutonium -239, 240 and americium-241. Cobalt-60 contributes less than 1 to the dose and is not considered significant. A resident of the atoll would accumulate radiation dose (rem) in two ways -- by exposure to radiation emanating from the ground and vegetation, and by exposure to radiation released in the spontaneous decay of radionuclides that have entered his body during the ingestion of locally grown foods. The latter process would account for some 90% of the dose; cesium-137 would be responsible for 0 90% of it. Since BARC's method of estimating dosage differs in some respects from that employed by the Lawrence Livermore National Laboratory (LLNL), (Ref.1, LLNL 1982) we are presenting our method in detail. The differences have two sources. First, the numbers used by BARC for the daily ingestion of radionuclides via the diet are higher than LLNL's. Second, BARC's calculation of dose from radionuclide intake utilizes the ICRP system. The net result is that BARC doses are consistently higher than LLNL doses, and in this respect are more conservative.

  4. Radiation dosage

    International Nuclear Information System (INIS)

    Finston, Roland

    1986-01-01

    Radiation dosage at Bikini Atoll is the result of current soil contamination, a relic of the nuclear weapons testing program of some 30 years ago. The principal contaminants today and some of their physical properties are listed: cesium-137, strontium-90, plutonium -239, 240 and americium-241. Cobalt-60 contributes less than 1 to the dose and is not considered significant. A resident of the atoll would accumulate radiation dose (rem) in two ways -- by exposure to radiation emanating from the ground and vegetation, and by exposure to radiation released in the spontaneous decay of radionuclides that have entered his body during the ingestion of locally grown foods. The latter process would account for some 90% of the dose; cesium-137 would be responsible for 0 90% of it. Since BARC's method of estimating dosage differs in some respects from that employed by the Lawrence Livermore National Laboratory (LLNL), (Ref.1, LLNL 1982) we are presenting our method in detail. The differences have two sources. First, the numbers used by BARC for the daily ingestion of radionuclides via the diet are higher than LLNL's. Second, BARC's calculation of dose from radionuclide intake utilizes the ICRP system. The net result is that BARC doses are consistently higher than LLNL doses, and in this respect are more conservative

  5. Radiation dosimetry

    International Nuclear Information System (INIS)

    Aymar A, J.; Medina G, H.

    1988-01-01

    Film is one of the most simple ways to detect radiation although for film as dosimeters a careful attention is required in many aspects, such as emulsion characteristics, film response capacity processing techniques and interpretation of the exposition. Surpassing these factors the film dosimeter is the most reliable

  6. Radiation accidents

    International Nuclear Information System (INIS)

    Saenger, E.L.

    1986-01-01

    It is essential that emergency physicians understand ways to manage patients contaminated by radioactive materials and/or exposed to external radiation sources. Contamination accidents require careful surveys to identify the metabolic pathway of the radionuclides to guide prognosis and treatment. The level of treatment required will depend on careful surveys and meticulous decontamination. There is no specific therapy for the acute radiation syndrome. Prophylactic antibodies are desirable. For severely exposed patients treatment is similar to the supportive care given to patients undergoing organ transplantation. For high-dose extremity injury, no methods have been developed to reverse the fibrosing endarteritis that eventually leads to tissue death so frequently found with this type of injury. Although the Three Mile Island episode of March 1979 created tremendous public concern, there were no radiation injuries. The contamination outside the reactor building and the release of radioiodine were negligible. The accidental fuel element meltdown at Chernobyl, USSR, resulted in many cases of acute radiation syndrome. More than 100,000 people were exposed to high levels of radioactive fallout. The general principles outlined here are applicable to accidents of that degree of severity

  7. Radiation Technology

    International Nuclear Information System (INIS)

    1990-01-01

    The conference was organized to evaluate the application directions of radiation technology in Vietnam and to utilize the Irradiation Centre in Hanoi with the Co-60 source of 110 kCi. The investigation and study of technico-economic feasibility for technology development to various items of food and non-food objects was reported. (N.H.A)

  8. Radiation detectors

    International Nuclear Information System (INIS)

    2013-01-01

    This sixth chapter presents the operational principles of the radiation detectors; detection using photographic emulsions; thermoluminescent detectors; gas detectors; scintillation detectors; liquid scintillation detectors; detectors using semiconductor materials; calibration of detectors; Bragg-Gray theory; measurement chain and uncertainties associated to measurements

  9. Radiation processing

    International Nuclear Information System (INIS)

    Noriah Mod Ali

    2005-01-01

    This chapter covers the basic principle and application of radiation technology. The topic titled specific application discussed briefly the following subtopics: 1) Polymer modification - crosslinking, polymerisation, degradation, grafting; 2) Medical sterilisation; 3) Food irradiation; 4) Environmental protection - waste processing, pollutants treatment

  10. Radiation retinopathy

    International Nuclear Information System (INIS)

    Parker, R.G.; Withers, H.R.

    1988-01-01

    A letter to the editor discusses the effectiveness and risk of radiation treatment of Grave's ophthalmopathy. The authors are unable to document a single instance in which retinopathy can be attributed to therapy with a total dose of 2000 cGy when delivered in daily increments of 180 to 200 cGy

  11. Radiation enteropathy

    Energy Technology Data Exchange (ETDEWEB)

    Farthmann, E.H. (Chirurgische Universitaetsklinik, Freiburg im Breisgau (Germany)); Imdahl, A. (Chirurgische Universitaetsklinik, Freiburg im Breisgau (Germany)); Eggstein, S. (Chirurgische Universitaetsklinik, Freiburg im Breisgau (Germany))

    1994-08-01

    The pathogenesis, clinical picture, diagnosis and treatment of radiation damage to the gut are described. The progress of 90 patients operated on in the Chirurgische Universitaetsklinik Freiburg is retrospectively evaluated. Haemorrhage, vomiting, diarrhoea and, occasionally, perforation are the signs of acute radiation enteropathy, which appears weeks or months after radiotherapy. Expect for perforations, these can usually be treated conservatively. Chronic radiation enteropathy does not manifest itself until years after irradiation, with diarrhoea, obstruction and the development of fistulae. The acute ileus can often be relieved with decompression tubes. After localising the stenosis radiologically with a contrast medium, and improvement in the general condition, many cases require operative intervention. This usually consists of resection, the establishment of a bypass anastomosis or enterostomy. In 44% of the patients postoperative complications followed, with a mortality of 22%. The cause of the high complication rate is partly the poor general condition of the patient, and partly the radiation induced impairment in wound healing, which may lead to insufficiency of the anastomosis and the development of fistulae. (orig./MG)

  12. 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

  13. Radiation effects and radiation risks

    International Nuclear Information System (INIS)

    Lengfelder, E.; Forst, D.; Feist, H.; Pratzel, H.

    1988-01-01

    The book presents the facts and the principles of assessment and evaluation of biological radiation effects in general and also with particular reference to the reactor accident of Chernobyl, reviewing the consequences and the environmental situation on the basis of current national and international literature, including research work by the authors. The material compiled in this book is intended especially for physicians, but will also prove useful for persons working in the public health services, in administration, or other services taking care of people. The authors tried to find an easily comprehensible way of presenting and explaining the very complex processes and mechanisms of biological radiation effects and carcinogenesis, displaying the physical primary processes and the mechanisms of the molecular radiation effects up to the effects of low-level radiation, and present results of comparative epidemiologic studies. This section has been given considerable space, in proportion to its significance. It also contains literature references for further reading, offering more insight and knowledge of aspects of special subject fields. The authors also present less known results and data and discuss them against the background of well-known research results and approaches. Apart from the purpose of presenting comprehensive information, the authors intend to give an impact for further thinking about the problems, and helpful tools for independent decisions and action on the basis of improved insight and assessment, and in this context particularly point to the problems induced by the Chernobyl reactor accident. (orig./MG) With 8 maps in appendix [de

  14. Radiation preservation of maize

    International Nuclear Information System (INIS)

    Wasito.

    1980-01-01

    Radiation preservation of maize was carried out. Radiation doses and sources, shielding materials, packaging materials, chemical radiation effects, biological radiation effects, were discussed. Experimental methods, samples and accessories were also presented. (SMN)

  15. 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.

  16. Radiation effects

    International Nuclear Information System (INIS)

    Collings, E.W.

    1986-01-01

    An important cause of deterioration in superconducting magnets intended for high-energy physics and fusion-reactor applications is radiation damage. The present chapter deals chiefly with the effects of electron, proton, gamma and neutron irradiation on the properties of stabilized Ti-Nb-base composite superconductors. The authors examine the particle-accelerator environment, electron irradiation of Ti-Nb superconductor, proton irradiation of Ti-Nb superconductor and its stabilizer, and deuteron irradiation of Ti-Nb superconductor. A section discussing the fusion reactor environment in general is presented, and the two principal classes of fusion reactor based on the magnetic-confinement concept, namely the tokamak and the mirrormachine are examined. Also discussed is neutron irradiation of Cu/TiNb composite superconductors and critical current density of neutronirradiated Ti-Nb. Finally, radiation damage to stabilizer and insulating materials is described

  17. Radiation teratogenesis

    International Nuclear Information System (INIS)

    Miller, R.W.

    1987-01-01

    Although small head size and metal retardation (MR) were first recognized as teratogenic effects of ionizing radiation in the 1920s, new information continues to emerge about these effects. Early studies of the Japanese atomic-bomb survivors showed that small head size was induced by doses as low as 10-19 rad in air. The next steps are to relate the effects to the new (1985) dosimetry, and to seek lesser effects on the brain by new tests to detect such clinical deficits as inability to sequence ideas, comprehend complex syntax, or pay attention. Although an array of congenital anomalies has been induced by prenatal radiation exposures of animals, only small head size and MR have occured excessively in the human

  18. Radiation enteritis

    International Nuclear Information System (INIS)

    Sato, Makoto; Sano, Masanori; Minakuchi, Naoki; Narisawa, Tomio; Takahashi, Toshio

    1981-01-01

    Radiation enteritis with severe complications including intestinal bleeding, fistula, and stenosis were treated surgically in 9 cases. These 9 cases included 7 cases of cancer of the uterine cervix and 2 single cases of seminoma and melanoma. The patients received 60 Co or Linac x-ray external irradiation with or without intracavitary irradiation by a radium needle. Radiation injury began with melena, vaginorectal fistula, and intestinal obstruction 3 to 18 months after irradiation. One patient with melena underwent colostomy and survived 2 years. One of the three patients with vaginorectal fistula who had colostomy survived 1.5 years. In intestinal obstruction, one patients had bypass operation and three patients had resection of the intestine and the other had both. Leakage was noted in one patient, but the others had favorable prognosis. (Ueda, J.)

  19. Radiation sterilization

    International Nuclear Information System (INIS)

    Jacobs, G.P.

    1989-01-01

    In view of the application of ionizing radiation to sterilize pharmaceutical products, and the particular advantages of using this mode of sterilization for powders for injection, which cannot be sterilized by more conventional methods, it is important to recognise the possibility of modification of radiation response of bacteria when in close contact with various drug powders. For this study, bacterial spores, which lend themselves to dessication, and which can be dried onto an inert powder matrix, were chosen as the test system. The results of this work indicate that the additives tested have a modest protective effect on the spores. However, when considering a bacterial inactivation for sterilization purposes of between six and ten orders of magnitude, that is, a desired sterility assurance level of an expected maximum probability of a product item being non-sterile of 10 -6 , then the slight protective effect observed in this study approaches insignificance

  20. Radiation smog

    International Nuclear Information System (INIS)

    Spurny, Z.

    1988-01-01

    The principle is described of the production of radiation smog resulting from radioactive emisions. The differences are discussed in the contamination over the territory of Czechoslovakia following the Chernobyl accident. The higher surface contamination of industrial areas recorded after the accident can be explained by electroprecipitation of industrial impurities with the radicals and ions of the radioactive cloud. (E.S.). 3 figs., 16 refs

  1. Radiation detector

    International Nuclear Information System (INIS)

    Gillies, W.

    1980-01-01

    The radiation detector for measuring e.g. a neutron flux consists of a central emitter, an insulating shell arranged around it, and a tube-shaped collector enclosing both. The emitter itself is composed of a great number of stranded, spiral wires of small diameter giving a defined flexibility to the detector. For emitter material Pt, Rh, V, Co, Ce, Os or Ta may be used. (DG) [de

  2. Radiation retinopathy

    International Nuclear Information System (INIS)

    Wara, W.M.; Irvine, A.R.; Neger, R.E.; Howes, E.L. Jr.; Phillips, T.L.

    1979-01-01

    The records were reviewed of all patients treated with irradiation to the eye at the University of California, San Francisco, between 1960 and 1975. Eight patients were identified who had developed radiation retinopathy 1 to 3 years postrirradiation. Lesions included retinal vascular occlusions, hemorrhages, microaneurysms, exudates, neovascularization, vitreous hemorrhage, retinal detachments, and optic atrophy with blindness. Four patients had received less than 5000 rad in 6 weeks to the retina, a dose usually considered within normal tissue tolerance

  3. Radiation accidents

    International Nuclear Information System (INIS)

    Poplavskij, K.K.; Smorodintseva, G.I.

    1978-01-01

    On the basis of a critical analysis of the available data on causes and consequences of radiation accidents (RA), a classification of RA by severity (five groups of accidents) according to biomedical consequences and categories of exposed personnel is proposed. A RA is defined and its main characteristics are described. Methods of RA prevention are proposed, as is a plan of specific measures to deal with RA in accordance with the proposed classification

  4. Ionising radiation

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    The law covering ionising radiation in Luxembourg is summarised under the headings: introduction (the outline law of 25 March 1963, and the Grand-Ducal Decree of 8 February 1967); the control of establishments (the authorisation procedure; emergency measures, suspension and withdrawal of the authorisation; alterations to the establishment); the importation, distribution and transit of radioactive substances; the transport of radioactive substances; the protection and safety of the population as a whole; sanctions; international conventions. (U.K.)

  5. Radiation shelter

    International Nuclear Information System (INIS)

    Crookes, T.A.

    1982-01-01

    This patent application describes a shelter comprising a cavity for receiving life to be sheltered; a roof for covering at least a portion of said cavity, and at least one aqueous, protective barrier layer adapted to prevent transmission through said roof and into said cavity of at least a portion of radiation in a predetermined spectrum. The cavity walls may be impregnated with an oil suitable for dressing burns. (author)

  6. Space Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Corliss, William R.

    1968-01-01

    This booklet discusses three kinds of space radiation, cosmic rays, Van Allen Belts, and solar plasma. Cosmic rays are penetrating particles that we cannot see, hear or feel, which come from distant stars. Van Allen Belts, named after their discoverer are great belts of protons and electrons that the earth has captured in its magnetic trap. Solar plasma is a gaseous, electrically neutral mixture of positive and negative ions that the sun spews out from convulsed regions on its surface.

  7. Radiating paradise

    Energy Technology Data Exchange (ETDEWEB)

    Heuseler, H.

    1981-05-06

    Decades after the a-bomb experiments in the desert of Nevada, cases of illness occur more frequently: many former soldiers who had to observe the tests as spectators suffer from leukemia, skin and thyroid ulcers. Even worse are the late results of the nuclear weapon tests in the Pacific: on Bikini and Eniwetok, once paradise-like atolls, the death from radiation is waiting, an attempt to recultivate the bombed Bikini Atoll failed.

  8. Radiation dosimeter

    International Nuclear Information System (INIS)

    Lowe, D.

    1980-01-01

    A radiation dosimeter is described, comprising a thermoluminescent phosphor incorporated in matrix of polyethersulphone. The dosimeter is preferably a thin film formed by spreading a suspension of a powdered phosphor in a solution of polyethersulphone onto a flat surface. The solvent for the polyethersulphone is a mixture of a n-methyl-2-pyrrolidone and xylene in equal proportions. A thin, inert film of polyethersulphone can be cemented to one surface of the dosimeter so as to provide a skin dosimeter. (author)

  9. Radiation detector

    Energy Technology Data Exchange (ETDEWEB)

    Ohata, Shuichi; Takeuchi, Yoji

    1968-10-30

    Herein disclosed is an ionization chamber the airtightness of which can be readily tested. The ionization chamber is characterized in that a small amount of helium gas is filled in the chamber in combination with other ionization gases such as argon gas, xenon gas and the like. Helium leakage from the chamber is measured by a known helium gas sensor in a vacuum vessel. Hence the long term drift of the radiation detector sensitivity may be determined.

  10. Radiation hormesis

    International Nuclear Information System (INIS)

    Hattori, Sadao; Nemoto, Kazuyasu; Ishida, Kenzi; Misonoo, Jun; Suganuma, Hirotoshi; Ishi, Keiichirou; Yamaoka, Kiyonori

    1990-01-01

    Greater attention has recently been drawn to the hormesis effect of radiations on living things. An agent is said to show hormesis when it gives a favorable physiological stimulation to living things and activated their biological functions if used in slight amounts, though it has an adverse effect on them if used in large amount. Recently many reports have been published which insist that radiations in a certain low dose range can have favorable biological effects, such as stimulation and activation, on living things including humans, animals and plants. Thus hormesis can be seen very widely in the biological field. The report first describes recent trends in research in this field, including the background behind the proposal of the radiation hormesis hypothesis, and major studies presented at the Oakland and Frankfurt Conferences. Then it outlines major research efforts that have been made at Denryoku Chuo Kenkyusho in Japan, focusing on animal tests (superoxidedismutase activity, thymidinekinase activity, etc.), immunological surveys, and plant tests. Discussion is also made concerning important issues and study subjects to be covered in future research. (N.K.)

  11. Radiation pager

    International Nuclear Information System (INIS)

    Warren, J.L.; Vadnais, K.G.

    1998-01-01

    Methods of interdicting nuclear materials to date have favored the use of large portal detectors at choke points, or hand carried instruments used by trained personnel for conducting spot searches. Although these methods are effective in some instances, it is often impractical to insert choke points at busy traffic areas, and it is not cost effective to maintain a force of skilled operators whose focus is nuclear interdiction. Recent technology developments are causing profound changes in the philosophy and methods employed for interdicting nuclear materials. Breakthrough advances in the miniaturization of detectors and low power electronics have made possible a new class of small gamma-ray radiation detectors, roughly the size of a message pager, with unprecedented sensitivity for their size. These instruments, named Radiation Pagers TM , are ideally suited for use by untrained individual law enforcement personnel and emergency responders in the course of their regular duties. New tactics that utilize a radiation detector worn by every officer are creating a moving curtain of detection with a significantly higher likelihood of locating illicit nuclear contraband. These individual detectors also provide each officer with a high level of confidence that they are not being unknowingly irradiated in the course of their work. (author)

  12. Ultraviolet radiation

    International Nuclear Information System (INIS)

    Faber, M.

    1989-01-01

    Although UV radiation can arise from a large number of man-made sources, the sun is the main source and both the general public and people working out of doors will be exposed to it. This natural background radiation and the variations in its magnitude must be taken into account when exposure limits are discussed. The full extent to which UV affects human well-being is difficult to quantify. Artificially produced UV has, however, been used in mines and cellars and in far northern latitudes as a supplement to combat functional impairment among people. Many of the observed effects, such as a decrease in the incidence of infectious diseases and in absenteeism, may be due to the bactericidal nature of the radiation. On the other hand, large doses of UV have an acute destructive effect on the skin and eye. Doses so low that they give rise only to normally acceptable or even desirable acute effects can, if repeated, induce changes resulting in late effects such as elastosis of the skin, keratosis and skin cancers. These effects will be of greater significance in people with lightly pigmented skin. 130 refs, 13 figs, 2 tabs

  13. Radiation protection

    International Nuclear Information System (INIS)

    Kamalaksh Shenoy, K.

    2013-01-01

    Three main pillars underpin the IAEA's mission: Safety and Security - The IAEA helps countries to upgrade their infrastructure for nuclear and radiation safety and security, and to prepare for and respond to emergencies. Work is keyed to international conventions, the development of international standards and the application of these standards. The aim is to protect people and the environment from the harmful effects of exposure to ionizing radiation. Science and Technology - The IAEA is the world's focal point for mobilizing peaceful applications of nuclear science and technology for critical needs in developing countries. The work contributes to alleviating poverty, combating disease and pollution of the environment and to other goals of sustainable development. Safeguards and Verification - The IAEA is the nuclear inspectorate, with more than four decades of verification experience. Inspectors work to verify that nuclear material and activities are not diverted towards military purposes. Quantities and Units: Dose equivalent is the product of absorbed dose of radiation and quality factor (Q). For absorbed dose in rads, dose equivalent is in rems. If absorbed dose is in gray, the dose equivalent is in sievert. Quality factor is defined without reference to any particular biological end point. Quality factors are recommended by committees such as the International Commission on Radiological Protection (ICRP) or the National Council on Radiation Protection and Measurements (NCRP), based on experimental RBE values but with some judgment exercised. Effective Dose Equivalent: It is the sum of the weighted dose equivalents for all irradiated tissues, in which the weighting factors represent the different risks of each tissue to mortality from cancer and hereditary effects. Committed dose equivalent: It is the integral over 50 years of dose equivalent following the intake of a radionuclide. Collective effective dose equivalent: It is a quantity for a population and is

  14. Perspective of radiation processing

    International Nuclear Information System (INIS)

    Zhang Manwei

    1987-01-01

    The area of the applications of radiation techniques is very wide. This paper only relates to the applications of radiation techniques in industries including radiation chemical industry, radiation processing of foods and environmental protection by radiation, but the nuclear instruments and the instrumentations of radiation are out-side of our study. (author)

  15. Radiation protection and radiation fear

    International Nuclear Information System (INIS)

    Czeizel, E.

    1982-01-01

    Some data are cited from Japanese statistics analyzing the genetic injuries stemming from the nuclear explosion in Hiroshima. It is shown that neither the number of the unsuccesful pregnancies nor the mortality of the born offsprings increased in those cases there the mother or the father had been exposed to 1-100 rad radiation. There was no significant difference in the chromosomal aberrations amoung the children of irradiated and control parents. (L.E.)

  16. Radiation biology and radiation therapy

    International Nuclear Information System (INIS)

    Wideroee, R.

    1975-01-01

    Radiation biology and radiation therapy can be compared with investigations in different layers of earth. Radiation biology works upwards from the elementary foundations, therapy works downwards with roots to secure and improve the clinical 'surface work'. The Ellis formula (Strandquist), which is a collection of clinical experience, is suited to form connections with radiobiology in the middle layers, and cooperation can give impulses for research. The structure and conditions of tumours and the complicated problems met with are discussed, based on the Carmel symposium of 1969. The oxygen problem in anoxic tumours is not yet solved. Experimental investigations of the effect itself give partly contradictory results. From a clinical viewpoint reoxygenation is of the utmost significance for obtaining control over the primary tumour, and advanced irradiation programmes will here give better results than the traditional ones. New chemicals, e.g. R 0 -07-0582, appear to reduce the OER value to 1.5, thereby making neutron therapy superfluous. Finally a problem from fundamental research is dealt with, wherein two hypotheses explaining the β-effect are described. The repair hypothesis gives a simple explanation but leaves many questions unanswered. The other hypothesis explains the β-effect as two neighbouring single breaks of the DNA molecule. It still presents difficulties, and is scarcely the correct explanation. (JIW)

  17. Radiation danger

    International Nuclear Information System (INIS)

    Gergely, S.M.

    1986-01-01

    The author is a journalist and has written the book 4 weeks after the Chernobyl accident because 'the experts have failed in informing on the consequences of Chernobyl in a way to keep the insecurity in the population within tolerable limits'. It is aimed at the interested layman. First the events as seen through the Austria media and the measures taken by the authorities during the 4 weeks are reviewed. In the rest of the books there is elementary information on some aspects of radioactivity, reactors and radiation limits although 'the connection between radioactivity and health is very complex'. (G.Q.)

  18. Radiation sickness

    International Nuclear Information System (INIS)

    Chin, A.; Leer, J.W.H.; Craandijk, M.; Feenstra, W.F.F.

    1990-01-01

    In a prospective inventory analysis of 169 irradiated patients concerning the incidence and course of Acute Radiation Sickness (fatigue, loss of appetite, nausea and vomiting), it was found that 2/3 of the patients had these complaints. The complaints started during the first week of treatment and mostly even within a few hours after each radiotherapy session. All complaints were progressive during the radiotherapy course, but disappeared spontaneously within one week after completion of the treatment. The possible occurrence of these symptoms soon after the start of radiotherapy should be kept in mind, especially since they can be reduced by simple retimens. (author). 14 refs.; 2 tabs

  19. Radiation Hazards

    Science.gov (United States)

    1975-08-01

    persons having worked more than five years under conditions of low and medium microwave exposure. Three groups of leukocytot changes occur In persons...Medical Publis!Iers (0974) 189-195. 32. Baranski, S., P. Czer-,ki and S. Szinglgilski. Microwave effects on mitosis In vivo and in vitro. Genetica ...effect of 3-cm microwave radiation. Amer. J. Ph-ysiol. 20. (1961) 192- 194. 72. 0sipov2 Yu.A. The effect of VHF-HF under industrial conditions . Gig

  20. 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

  1. Ultraviolet radiation

    International Nuclear Information System (INIS)

    Hawk, J.

    1986-01-01

    Ultraviolet radiation (UVR) from the sun or artificial sources is reflected or transmitted at the surface of the skin, about 5% of normally incident rays being directly reflected. The transmitted fraction is scattered, photochemically absorbed or dissipated as heat within the skin, or passes from it to contribute to the variable total amount of reflected and transmitted radiation. The UVR absorbers in skin are not definitely known, but DNA is a definite target and probably lipoprotein membranes, RNA, proteins, mucopolysaccharides, elastin and collagen. Photochemical or free radical damage to absorber or nearby organelles leads to pharmacological, ultrastructural, histological and clinical changes. Most frequent DNA damage is pyrimidine dimer formation, apparently inhibiting cell function and replication. This is largely enzymatically repaired in man in the dark by excision repair, post-replication repair and possible other enzymatic mechanisms, and at least in some organisms by light-induced photoreactivation repair. UVR exposure causes well recognized acute and chronic clinical syndromes in man. These are discussed in this paper

  2. Radiating matter

    International Nuclear Information System (INIS)

    Zimen, K.E.

    1987-01-01

    The author describes the history and uses of radioactivity. The narration is completed by bibliographic notes on Otto Hahn with a number of so far unpublished letters and documents and on Leo Szilard, the most far-sighted among the nuclear researchers actively engaged during the war. The first part deals with the discovery of radioactivity and the discovery of uranium fission in 1938 with its military consequences, up to the short-lived euphoria on the 'atomic age' (Geneva conference 1955). This is followed by an account of natural radioactivity in our environment, a brief of useful information on radiation effects and radiation protection, and of typical applications of radioactive beams in science, engineering, and medicine. The final part is concerned with the most important instances of insight into nature triggered by the discovery of radioactivity: From cosmological to chemical evolution, from Democrit's atom theory to modern nuclear physics' particle zoo, from the contest of ideas between acausalists and determinists on what is commonly termed 'coincidence' to the limits of graphic views on nature. (orig./HP) [de

  3. Radiating matter

    International Nuclear Information System (INIS)

    Zimen, K.E.

    1990-01-01

    The author describes the history and uses of radioactivity. The narration is completed by bibliographic notes on Otto Hahn with a number of so far unpublished letters and documents and on Leo Szilard, the most far-sighted among the nuclear researchers actively engaged during the war. The first part deals with the discovery of radioactivity and the discovery of uranium fission in 1938 with its military consequences, up to the short-lived euphoria on the 'atomic age' (Geneva conference 1955). This is followed by an account of natural radioactivity in our environment, a brief of useful information on radiation effects and radiation protection, and of typical applications of radioactive beams in science, engineering, and medicine. The final part is concerned with the most important instances of insight into nature triggered by the discovery of radioactivity: From cosmological to chemical evolution, from Democrit's atom theory to modern nuclear physics' particle zoo, from the contest of ideas between acausalists and determinists on what is commonly termed 'coincidence' to the limits of graphic views on nature. (orig.) With 40 figs [de

  4. Synchrotron radiation

    International Nuclear Information System (INIS)

    Pattison, P.; Quinn, P.

    1990-01-01

    This report details the activities in synchrotron radiation and related areas at Daresbury Laboratory during 1989/90. The number and scope of the scientific reports submitted by external users and in-house staff is a reflection of the large amount of scheduled beamtime and high operating efficiency achieved at the Synchrotron Radiation Source (SRS) during the past year. Over 4000 hours of user beam were available, equivalent to about 80% of the total scheduled time. Many of the reports collected here illustrate the increasing technical complexity of the experiments now being carried out at Daresbury. Provision of the appropriate technical and scientific infrastructure and support is a continuing challenge. The development of the Materials Science Laboratory together with the existing Biological Support Laboratory will extend the range of experiments which can be carried out on the SRS. This will particularly facilitate work in which the sample must be prepared or characterised immediately before or during an experiment. The year 1989/90 has also seen a substantial upgrade of several stations, especially in the area of x-ray optics. Many of the advantages of the High Brightness Lattice can only be exploited effectively with the use of focusing optics. As the performance of these stations improves, the range of experiments which are feasible on the SRS will be extended significantly. (author)

  5. Radiation. Protection. Health. Proceedings

    International Nuclear Information System (INIS)

    Hajek, Michael; Maringer, Franz Josef; Steurer, Andreas; Schwaiger, Martina; Timal, Guenter

    2015-01-01

    The topics of the meeting are the diagnostic and therapeutic application of ionizing radiations, the application of radiation in research, industry and engineering and radiation protection. The volume includes the following chapters: Radiation protection and society, radiation protection infrastructure, population and environment, metrology and measuring techniques, 1. Workshop on population and environment, NORM and radon, 2. Update: dose - extent of damage - limiting value definition, radiation protection for personnel (except medicine), radiation protection in medicine.

  6. 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)

  7. 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.)

  8. Radiation detector

    International Nuclear Information System (INIS)

    Conrad, B.; Finkenzeller, J.; Kiiehn, G.; Lichtenberg, W.

    1984-01-01

    In an exemplary embodiment, a flat radiation beam is detected having a common electrode disposed parallel to the beam plane at one side and a common support with a series of individual conductors providing electrodes opposite successive portions of the common electrode and lying in a plane also parallel to the beam plane. The beam may be fan-shaped and the individual electrodes may be aligned with respective ray paths separated by uniform angular increments in the beam plane. The individual conductors and the connection thereof to the exterior of the detector housing may be formed on an insulator which can be folded into a T-shape for leading the supply conductors for alternate individual conductors toward terminals at opposite sides of the chamber

  9. Radiation biophysics

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Summaries of research projects conducted during 1978 and 1979 are presented. The overall thrust of the research is aimed at understanding the effects of radiation on organisms. Specific subject areas include: the effects of heavy-particle beam nuclear interactions in tissue on dosimetry; tracer studies with radioactive fragments of heavy-ion beams; the effects of heavy/ions on human kidney cells and Chinese hamster cells; the response of a rhabdomyosarcoma tumor system in rats to heavy-ion beams; the use of heavy charged particles in radiotherapy of human cancer; heavy-ion radiography; the biological effects of high magnetic fields; central nervous system neurotoxicity; and biophysical studies on cell membranes

  10. Radiation dosimetry

    International Nuclear Information System (INIS)

    Harper, M.W.; Thomas, B.; Conway, J.

    1977-01-01

    A dosemeter is described that is based on the TSCD principle (thermally stimulated current dosimetry). Basically this involves irradiating a responsive material and then heating it,whereby an electric current is produced. If the material is heated in an electric field the peak value of the thermally stimulated current or alternatively the total charge released by heating, can be related to the radiation dose received. The instrument described utilises a sheet coated with a thermoplastic polymer, such as a poly4-methylpent-l-ene. The polymer should have a softening point not lower than 150 0 C with an electrical resistivity of at least 10 16 chms/cm at 150 0 C. The polymer may also be PTFE. Heating should be in the range 150 0 C to 200 0 C and the electric field in the range 50 to 10,000V/mm. (U.K.)

  11. Radiation accidents

    International Nuclear Information System (INIS)

    Nenot, J.C.

    1996-01-01

    Analysis of radiation accidents over a 50 year period shows that simple cases, where the initiating events were immediately recognised, the source identified and under control, the medical input confined to current handling, were exceptional. In many cases, the accidents were only diagnosed when some injuries presented by the victims suggested the radiological nature of the cause. After large-scale accidents, the situation becomes more complicated, either because of management or medical problems, or both. The review of selected accidents which resulted in severe consequences shows that most of them could have been avoided; lack of regulations, contempt for rules, human failure and insufficient training have been identified as frequent initiating parameters. In addition, the situation was worsened because of unpreparedness, insufficient planning, unadapted resources, and underestimation of psychosociological aspects. (author)

  12. Radiation effects at ISABELLE

    International Nuclear Information System (INIS)

    Sanger, P.A.; Danby, G.T.

    1975-01-01

    Shielding, radiation damage, and radiation heating at the planned ISABELLE storage rings were considered. Radiation shielding studies were reviewed and were found to be adequate for present day dosage limits. Radiation damage could be encountered in some extreme cases, but is not expected to limit the performance of the superconducting magnets. Experiments to study the effect of radiation heating on actual magnets are recommended

  13. 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.)

  14. Environmental radiation

    International Nuclear Information System (INIS)

    2008-01-01

    The types of ionizing radiations from the atomic nucleus are explained, such as the beams alpha, beta and gamma. The definitions of spectrometry and nuclear traces have been included.The study presents two researches realized in Costa Rica on the radioactive nuclear and artificial elements in the environment. The first shown is the analysis of coastal sediments where explains which are radioactive artificial isotopes and the pollution that occurs in food, coastal sediments, fertilizers, the soil, the water and the air. Within the analysis techniques are the gamma spectrometry, alpha spectrometry and nuclear strokes. Among the conclusions of this initial investigation is shown that at Punta Leona descendants of Uranium and Thorium present lower concentrations in relation to the gulf and its variations are not important. In the following study the radon gas is analyzed in the human environment where is determined that it is the second generator that causes cancer in lungs after the tobacco. This work indicates that the doses come from natural and artificial sources of radiation for the public are a whole of 2.7 mSv/year, information provided by the UNSCEAR, 2000. The radon gas is inert and radioactive of atomic number 86, includes 23 isotopes and 3 natural isotopes. The radon is everywhere, as are houses and buildings, in Costa Rica it is located in old homes with little ventilation. It describes the equipment used for the detection of radon gas in the environment. Within the conclusions radon gas is concentrated in confined spaces which can be harmful to health. It is determined that enough ventilation in places of high concentrations of radon is important. Finally it is recommended to monitor the sites where can be detected high concentrations of radon and that they have important influx of people [es

  15. Struniak w okolicy kości krzyżowej u 47 – letniej pacjentki – opis przypadku = Chordoma in the sacral spine in an 47-year-old woman – case report

    Directory of Open Access Journals (Sweden)

    Kamila Woźniak

    2016-09-01

    • 2.        Katedra i Klinika Rehabilitacji, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu     Streszczenie   Struniaki (łac. chordoma są rzadkimi, histologicznie łagodnymi, lecz klinicznie złośliwymi nowotworami szkieletu osiowego. Mogą powstać w dowolnym miejscu w linii środkowej ciała, gdzie istniała struna grzbietowa (np. stok, nosogardziel, siodło i okolica okołosiodłowa, otwór wielki kręgi i okolica krzyżowo-ogonowa. Struniaki to wolno rosnące nowotwory, wykazujące miejscową agresywność w stosunku do kości i tkanek miękkich. Struniaka po raz pierwszy opisał w 1856 roku Virchow i Luschke. Z kolei w 1858 roku Muller stwierdził, że nowotwór może pochodzić z pozostałości embrionalnych prymitywnej struny grzbietowej tzw. chorda dorsalis. Autorzy przedstawiają opis przypadku klinicznego leczonego operacyjne w Klinice Neurochirurgii, Neurotraumatologii i Neurochirurgii Dziecięcej Szpitala Uniwersyteckiego nr 1 im. dr A. Jurasza w Bydgoszczy z rozpoznanym w badaniu histopatologicznym struniakiem.   Słowa kluczowe: struniak, chrodoma, nowotwór, szkielet osiowy, neurochirurgia.     Abstract   Chordomas are rare, histologically benign but clinically malignant tumors of the axial skeleton. They can occur anywhere in the midline of the body where there notochord (clivus, nasopharynx, saddle and surroundings parasellar, the foramen vertebrae and surroundings sacral area. Chordomas are slow-growing cancer, showing local aggressiveness relative to bone and soft tissue. Chordoma was first described in 1856 by Virchow and Luschke. In turn, in 1858 Muller found that the cancer can come from embryonic remnants of the primitive notochord called chorda dorsalis. The authors present a clinical case operating treated in the Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery, Dr Antoni Jurasz University Hospital No.1 in Bydgoszcz histopathological diagnosed

  16. A combination of gestalt therapy, Rosen Body Work, and Cranio Sacral therapy did not help in chronic whiplash-associated disorders (WAD)--results of a randomized clinical trial.

    Science.gov (United States)

    Ventegodt, Søren; Merrick, Joav; Andersen, Niels Jørgen; Bendix, Tom

    2004-12-10

    The chronic state of whiplash-associated disorder (WAD) might be understood as a somatization of existential pain. Intervention aimed to improve quality of life (QOL) seemed to be a solution for such situations. The basic idea behind the intervention was holistic, restoring quality of life and relationship with self, in order to diminish tension in the locomotion system, especially the neck. A psychosomatic theory for WAD is proposed. Our treatment was a short 2-day course with teachings in philosophy of life, followed by 6-10 individual sessions in gestalt psychotherapy and body therapy (Rosen therapy and Cranio Sacral therapy), followed by a 1-day course approximately 2 months later, closing the intervention. Two independent institutions did the intervention and the assessments. In a randomized, clinically controlled setting, 87 chronic WAD patients were included with a median duration of 37 months from their whiplash accidents. One patient never started. Forty-three had the above intervention (female/male = 36/7, ages 22-49, median 37 years) and another 43 were assigned to a nontreated control group (female/male = 35/8, ages 18-48, median 38). Six had disability pension and 27 had pending medicolegal issues in each group. Effect variables were pain in neck, arm, and/or head; measures of quality of life and daily activities; as well as general physical or mental health. Wilcoxon test for between-groups comparisons with intention-to-treat analyses was conducted; the square curve paradigm testing for immediate improvements of health and quality of life was also used. The groups were comparable at baseline. From the intervention group, 11 dropped out during the intervention (4 of those later joined the follow-up investigation), 22 of the remaining 32 graduated the course, and 35 of the 43 controls did as well. Approximately 3 months later, we found no clinically relevant or significant increase in any effect measure. The above version of a quality of life

  17. Radiation protection principles

    International Nuclear Information System (INIS)

    Ismail Bahari

    2007-01-01

    The presentation outlines the aspects of radiation protection principles. It discussed the following subjects; radiation hazards and risk, the objectives of radiation protection, three principles of the system - justification of practice, optimization of protection and safety, dose limit

  18. Radiation protection; Proteccion Radiologica

    Energy Technology Data Exchange (ETDEWEB)

    Ures Pantazi, M [Universidad de la Republica, Facultad de Quimica (Uruguay)

    1994-12-31

    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.

  19. Radiation Exposure and Pregnancy

    Science.gov (United States)

    Fact Sheet Adopted: June 2010 Updated: June 2017 Health Physics Society Specialists in Radiation Safety Radiation Exposure and ... radiation and pregnancy can be found on the Health Physics Society " Ask the Experts" Web site. she should ...

  20. 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

  1. 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.)

  2. Radiation Therapy for Cancer

    Science.gov (United States)

    Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Learn about the types of radiation, why side effects happen, which ones you might have, and more.

  3. Radiation modification of materials

    International Nuclear Information System (INIS)

    Pikaev, A.K.

    1987-01-01

    Industrial and radiation chemical processes of material modification based on cross-linking of polymers as a result of radiation are considered. Among them are production of cables and rods with irradiated modified insulation, production of hardened and thermo-shrinkaging polymer products (films, tubes, fashioned products), production of radiation cross-linked polyethylene foam, technology of radiation vulcanization of elastomers. Attention is paid to radiation plants on the basis of γ-sources and electron acceleratos as well as to radiation conditions

  4. 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.)

  5. 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.)

  6. Radiation therapy

    International Nuclear Information System (INIS)

    Matsuura, Keiichi; Miyoshi, Makoto; Jinguu, Ken-ichi

    1982-01-01

    Of the cases of lung cancer in which radiation therapy was given between 1961 and November 1981, 399 cases for which histological type was confirmed, and irradiated as follows were reviewed. The cases of squamous cell carcinoma and adenocarcinoma irradiated with more than 5,000 rad or more, those of undifferentiated carcinoma irradiated with 3,000 rad or more, and those irradiated pre- and post-operatively with 3,000 rad or more. The actual 5 year survival rate for stages I, II, III and IV were 29.6, 9.3, 7.5 and 1.9% respectively, and the survival rate tended to be better for adenocarcinoma than squamous cell carcinoma at stages I, II and III, but not different at stage IV. There was no difference between large cell, small cell and squamous cell carcinomas. Irradiation with 200 rad every other day or 150 rad daily was better than that with 200 rad, and daily irradiation with 150 rad was used since 1976. The therapy of stage III small cell carcinoma at the age of up to 80 years was improved with the combination of anticancer agents, maintenance therapy and immunotherapy, but these combined therapies were not significantly effective for the cancers with other histological types or at other stages. Although there was no significant difference in statistics for resectable cases, clinically, the results were experienced to be better after resection, and surgery was done in combination as much as possible. (Kaihara, S.)

  7. Radiating water

    International Nuclear Information System (INIS)

    Bakker, J.; Harle, N.; Heijkers, H.; Schoene, S.

    1987-04-01

    From a nuclear power plant in operation radioactivity is continuously effusing into the environment, through the chimney, cooling waters and the loss of solid waste. In this account attention is concentrated on tritium which enters, in the form of gas and tritiated water from nuclear power plants under 'normal' operation, the aquatic environment and which, because it can not be purified from the water and because its effluences in surface waters are larger than those of other radioactive waste products, forms the largest threat for the drinking-water supply. In ch. 1 the health risks of tritium are outlined. In particular the genetic risks are insufficiently known until now. In ch. 2 the amount of tritium effluences are estimated, which appears to be many times higher than was generally accepted until now. What does this imply for the Dutch surface waters? In ch. 3 the question of the source term is discussed and in ch. 4 the source term is translated into the effects upon the aquatic environment and especially upon the drinking-water supply. In ch. 5 advisements for policies are formulated. The policy of the Dutch government until now is viewed and nuclear power is judged on the base of three starting points of radiation policy. Therein the demands are included which are inevitable in order to protect the Dutch aquatic environment from a too large radioactivity burden. 91 refs.; 5 figs.; 1 table

  8. Radiation physics

    International Nuclear Information System (INIS)

    Sorenson, J.A.

    1987-01-01

    As in other technologically based field, progress in medical imaging occurs both by ''breakthroughs,'' such as completely new concepts, and by evolutionary advances, such as incremental improvements in existing technology. Both types of advances are of fundamental importance to the field. The new kinestatic charge detection technique, which represents a fundamentally new concept in image recording, qualifies as a ''breakthrough.'' This and several other articles describe new approaches to digital radiography, focusing in particular on the formidable problems of trying to match the excellent image recording and display capabilities of x-ray film. An example of an incremental improvement is a new design for x-ray tube filaments. The modified filament design can provide a significant reduction in focal-spot size, without loss of tube-loading capacity. Because spatial resolution is limited in many practical situations by focal-spot blurring, this incremental improvement in the design of an existing piece of hardware is as important a contribution to improving image quality as a new type of digital detector with a two-fold improvement in spatial resolution. The author has included a few articles dealing with practical issues in radiation protection and quality assurance of x-ray imaging systems

  9. Synchrotron radiation

    International Nuclear Information System (INIS)

    Seddon, E.A.; Reid, R.J.

    1992-01-01

    Work at the Daresbury SRS has of necessity been interrupted this year (1991/92) due to the incorporation of Wiggler II. However, considerable beamtime was awarded before the shutdown and the major part of this appendix is concerned with the progress reports of the research undertaken then. The reports have been organised under the following broad headings: Molecular Science (19 papers), Surface and Materials Science (169 papers), Biological Science (85 papers), Instrumental and Technique Developments (13 papers) and Accelerator Physics (3 papers). It is hoped that in time the number of contributions on accelerator physics will grow to reflect the in-house activity on, for example, accelerator improvement and design. The research reports are preceded by the Annual Report of the Synchrotron Radiation Facilities Committee, which outlines the research highlights identified by that Committee (also included are details of the current membership of the SRFC and the chairmen of the Beamtime Allocation Panels). Following the reports are the specifications for the beamlines and stations. This year Section 3 contains 289 reports (nearly 100 more than last year) and the number of publications, generated by scientists and engineers who have used or are associated with Daresbury Laboratory facilities, has topped 500 for the first time. (author)

  10. Applying radiation

    International Nuclear Information System (INIS)

    Mallozzi, P.J.; Epstein, H.M.; Jung, R.G.; Applebaum, D.C.; Fairand, B.P.; Gallagher, W.J.; Uecker, R.L.; Muckerheide, M.C.

    1979-01-01

    The invention discloses a method and apparatus for applying radiation by producing X-rays of a selected spectrum and intensity and directing them to a desired location. Radiant energy is directed from a laser onto a target to produce such X-rays at the target, which is so positioned adjacent to the desired location as to emit the X-rays toward the desired location; or such X-rays are produced in a region away from the desired location, and are channeled to the desired location. The radiant energy directing means may be shaped (as with bends; adjustable, if desired) to circumvent any obstruction between the laser and the target. Similarly, the X-ray channeling means may be shaped (as with fixed or adjustable bends) to circumvent any obstruction between the region where the X-rays are produced and the desired location. For producing a radiograph in a living organism the X-rays are provided in a short pulse to avoid any blurring of the radiograph from movement of or in the organism. For altering tissue in a living organism the selected spectrum and intensity are such as to affect substantially the tissue in a preselected volume without injuring nearby tissue. Typically, the selected spectrum comprises the range of about 0.1 to 100 keV, and the intensity is selected to provide about 100 to 1000 rads at the desired location. The X-rays may be produced by stimulated emission thereof, typically in a single direction

  11. Counterbalanced radiation detection device

    International Nuclear Information System (INIS)

    Platz, W.

    1986-01-01

    A counterbalanced radiation detection device is described which consists of: (a) a base; (b) a radiation detector having a known weight; (c) means connected with the radiation detector and the base for positioning the radiation detector in different heights with respect to the base; (d) electronic component means movably mounted on the base for counterbalancing the weight of the radiation detector; (e) means connected with the electronic component means and the radiation detector positioning means for positioning the electronic component means in different heights with respect to the base opposite to the heights of the radiation detector; (f) means connected with the radiation detector and the base for shifting the radiation detector horizontally with respect to the base; and (g) means connected with the electronic component means and the radiation detector shifting means for shifting the electronic component means horizontally with respect to the base in opposite direction to shifting of the radiation detector

  12. 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.

  13. 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

  14. 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)

  15. Meningeal cysts in the sacral canal

    International Nuclear Information System (INIS)

    Salatkova, A.; Matejka, J.

    1996-01-01

    Meningeal cysts develop from the meningeal cover, contain liquor, are localised in the spinal canal. Clinical demonstration are different, often with no clinical manifestation, or with manifestation from compression surrounding structures. Meningeal cysts is possible diagnostic imaging with perimyelography, CT and MRI. In the paper it was discussed different feature in the diagnosis meningeal cysts with perimyelography and CT of the spine, position and time of the examination.(authors). 7 figs., 11 refs

  16. Radiation biology and radiation protection

    International Nuclear Information System (INIS)

    Hendry, J.H.

    2012-01-01

    For protection purposes, the biological effects of radiation are separated into stochastic effects (cancer, hereditary effects) presumed to be unicellular in origin, and tissue reactions due to injury in populations of cells. The latter are deterministic effects, renamed ‘tissue reactions’ in the 2007 Recommendations of the International Commission on Radiological Protection because of the increasing evidence of the ability to modify responses after irradiation. Tissue reactions become manifest either early or late after doses above a threshold dose, which is the basis for recommended dose limits for avoiding such effects. Latency time before manifestation is related to cell turnover rates, and tissue proliferative and structural organisation. Threshold doses have been defined for practical purposes at 1% incidence of an effect. In general, threshold doses are lower for longer follow-up times because of the slow progression of injury before manifestation. Radiosensitive individuals in the population may contribute to low threshold doses, and in the future, threshold doses may be increased by the use of various biological response modifiers post irradiation for reducing injury. Threshold doses would be expected to be higher for fractionated or protracted doses, unless doses below the threshold dose only cause single-hit-type events that are not modified by repair/recovery phenomena, or if different mechanisms of injury are involved at low and high doses.

  17. Working safely with ionising radiation

    International Nuclear Information System (INIS)

    McDowell, D.J.

    1990-01-01

    A small leaflet provides information on working safely with ionizing radiation. Topics covered include the types of radiation, radiological units, external radiation, contamination and internal radiation, methods of protection form radiation, radiation monitors, protective clothing for contamination, personal dosemeters, radiation dose limits for classified workers and finally the Ionising Radiations Regulations 1985. (UK)

  18. 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.

  19. Radiation protection to firemen

    International Nuclear Information System (INIS)

    Almeida, E.S. de.

    1985-01-01

    The basic Knowledge about ionizing radiation oriented for firemen, are presented. The mainly damage and effects caused by radiation exposure as well as the method of radiation protection are described in simple words. The action to be taken in case of fire involving radiation such as vehicles transporting radioactive materials are emphasized. (author)

  20. Biological radiation effects

    International Nuclear Information System (INIS)

    Koggl, D.; Dedenkov, A.N.

    1986-01-01

    All nowadays problems of radio biology are considered: types of ionizing radiations, their interaction with material; damage of molecular structures and their reparation; reaction of cells and their recovery from radiation damage; reaction of the whole organism and its separate systems. Particular attention is given to the problems of radiation carcinogenesis and radiation hazard for man

  1. Physics of radiation

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    This chapter discusses the following topics: concept of atom and elements; molecules and compounds; basic principles of radiation; types of radiations; radioactivity, unit of radioactivity, specific activity, radioactive decay, ionisation and ions, interaction of radiation with matters, modes of interaction: photoelectric absorption: Compton scattering, pair-production; attenuation of x and gamma radiation; build-up factors

  2. Radiation detection and measurement

    International Nuclear Information System (INIS)

    Knoll, G.F.

    1979-01-01

    Introductory material covers radiation sources, radiation interactions, general properties of radiation detectors, and counting statistics and error prediction. This is followed by detailed sections on gas-filled detectors, scintillation counters, semiconductor detectors, neutron detectors and spectroscopy, detector electronics and pulse processing, and miscellaneous radiation detectors and applications

  3. Detection of Terahertz Radiation

    DEFF Research Database (Denmark)

    2015-01-01

    The present invention relates to a system for detecting terahertz radiation, a camera device, and a method for detecting terahertz radiation.......The present invention relates to a system for detecting terahertz radiation, a camera device, and a method for detecting terahertz radiation....

  4. Radiation treatment of foodstuffs

    International Nuclear Information System (INIS)

    Luther, T.; Huebner, G.

    1990-10-01

    In addition to fundamental demands on radiation and safety engineering of irradiation facilities, the necessity arises to optimize irradiation conditions by using facilities to capacity and thus reducing irradiation costs. The following subjects are dealt with in detail: rehabilitation of a pilot plant for radiation treatment of onions; examination of radiation resistance of components and equipment parts of food irradiation facilities; chemical dosimetry; relative measurement of the intensity of radioactive sources; thermo- and chemiluminescence to prove irradiation of foodstuffs; radiation induced sprout inhibition of potatoes; laboratory tests of delayed maturation of tomatoes; radiation treatment of strawberries; radiation treatment of forage; radiation induced sprout inhibition of acid-treated onions; radiation treatment of starch and potatoe products; radiation treatment of cosmetics; the universal radiation source UNI 88/26 for gamma irradiation facilities; microbiological aspects of food irradiation, and introduction of chicken irradiation on an industrial scale. (BBR) [de

  5. Introduction to radiation biology

    International Nuclear Information System (INIS)

    Uma Devi, P.; Satish Rao, B.S.; Nagarathnam, A.

    2000-01-01

    This book is arranged in a logical sequence, starting from radiation physics and radiation chemistry, followed by molecular, subcellular and cellular effects and going on to the level of organism. Topics covered include applied radiobiology like modifiers of radiosensitivity, predictive assay, health physics, human genetics and radiopharmaceuticals. The topics covered are : 1. Radiation Physics, 2. Detection and Measurement of Radiation, 3. Radiation Chemistry, 4. DNA Damage and Repair, 5. Chromosomal Aberrations and Gene Mutations, 6. Cellular Radiobiology 7. Acute Radiation Effects, 8. Delayed Effects of Radiation, 9. Biological Basis of Radiotherapy, 10. Chemical Modifiers of Radiosensitivity, 11. Hyperthermia, 12. High LET Radiations in Cancer, Therapy, 13. Predictive Assays, 14. Radiation Effects on Embryos, 15. Human Radiation Genetics, 16. Radiolabelled Compounds in Biology and Medicine and 17. Radiological Health

  6. Chemical and radiation injuries

    International Nuclear Information System (INIS)

    Hugo, M.J.

    1981-01-01

    The paper is a discussion of radiation injuries and the treatment thereof. Radiation injuries are mainly caused as a result of nuclear leaks or nuclear bomb explosions. Such an explosion is usually accompanied by a light flash, noise, heat radiation and nuclear radiation which can all caurse various types of injuries. The general effect of radioactive radiation is discussed. The seriousness of the situation where the whole body was exposed to nuclear radiation, depends on the total radiation dose received and varies from person to person. The progress of radiation sickness is described. Mention is also made of long term radiation effects. The emergency treatment of the injured before specialised aid is available, is discussed. The primary aim of treatment is to save life and to prevent further injuries and complications. Injured people must be removed as far as possible from the point of maximum radiation. Attention must also be given to decontamination

  7. 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

  8. Radiation amorphization of materials

    International Nuclear Information System (INIS)

    Neklyudov, I.M.; Chernyaeva, T.P.

    1993-01-01

    The results of experimental and theoretical research on radiation amorphization are presented in this analytical review. Mechanism and driving forces of radiation amorphization are described, kinetic and thermodynamic conditions of amorphization are formulated. Compositional criteria of radiation amorphization are presented, that allow to predict irradiation behaviour of materials, their tendency to radiation amorphization. Mechanism of transition from crystalline state to amorphous state are considered depending on dose, temperature, structure of primary radiation damage and flux level. (author). 134 refs., 4 tab., 25 fig

  9. 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.

  10. Radiation protection instrument 1993

    International Nuclear Information System (INIS)

    1993-04-01

    The Radiation Protection Instrument, 1993 (Legislative Instrument 1559) prescribes the powers and functions of the Radiation Protection Board established under the Ghana Atomic Energy Commission by the Atomic Energy Commission (Amendment) Law, 1993 (P.N.D.C. Law 308). Also included in the Legislative Instrument are schedules on control and use of ionising radiation and radiation sources as well as procedures for notification, licensing and inspection of ionising radiation facilities. (EAA)

  11. Radiation and toxix materials

    International Nuclear Information System (INIS)

    Antipov, V.V.; Belkin, V.I.; Davydov, B.I.; Kustov, V.V.; Ushakov, I.B.

    1986-01-01

    General radiobiological concepts in aviation medicine related to the biological effect of ionizing radiation on flying factors are presented. Principles of standartization, permissible doses, general principles of radiation protection and prophylaxis of aviation personnel are described. Characteristics of radio emission, microwaves, procedure of their measurements are given. Pathophysiology of electromagnetic radiation is presented. Problems on radiation protection, technical and organization problems on electromagnetic radiation protection, as well as technology in aviation are discussed

  12. 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.

  13. 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

  14. 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)

  15. 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

  16. 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.

  17. 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

  18. Hazards of radiation exposure

    International Nuclear Information System (INIS)

    Solomon, S.B.

    1982-01-01

    Radiation induced carcinogenesis and mutagenesis form the main risks to health from exposure to low levels of radiation. There is scant data on somatic and genetic risks at environmental and occupational levels of radiation exposure. The available data on radiation induced carcinogenesis and mutagenesis are for high doses and high dose rates of radiation. Risk assessments for low level radiation are obtained using these data, assuming a linear dose-response relationship. During uranium mining the chief source of radiation hazard is inhalation of radon daughters. The correlation between radon daughter exposure and the increased incidence of lung cancer has been well documented. For radiation exposures at and below occupational limits, the associated risk of radiation induced cancers and genetic abnormalities is small and should not lead to a detectable increase over naturally occurring rates

  19. New Finnish radiation law

    International Nuclear Information System (INIS)

    Niittyla, A.

    1992-01-01

    The new Finnish Radiation Act will enter into force on 1.1.1992. The Act aims to protect man's health against the harmful effects of radiation. The Act applies to the utilization of ionising radiation and natural radiation as well as non-ionising radiation. It emphasises the fact that a licensed organization or entrepreneur carrying out a practice which causes radiation exposure is responsible for the safety of the activity. The organization or entrepreneur in question is also obliged to take care of radioactive waste. The provisions of the Radiation Act which apply to monitoring of worker exposure are also applied to the use of nuclear energy. Activities involving the use of radiation and the use of nuclear energy are regulated by one authority, the Finnish Centre for Radiation and Nuclear Safety. (author)

  20. 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

  1. Photodetector of ultraviolet radiation

    International Nuclear Information System (INIS)

    Dorogan, V.; Branzari, V.; Vieru, T.; Manole, M.; Canter, V.

    2000-01-01

    The invention relates to photodetectors on base of semiconductors of ultraviolet radiation and may be used in optoelectronic system for determining the intensity and the dose of ultraviolet radiation emitted by the Sun or other sources. Summary of the invention consists in the fact that in the photodetector of ultraviolet radiation the superficial potential barrier is divided into two identical elements, electrically isolated each of the other, one of them being covered with a layer of transparent material for visible and infrared radiation and absorption the ultra violet radiation. The technical result consists in mutual compensation of visible and infrared components of the radiation spectrum

  2. 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)

  3. Radiation protection in Bolivia

    International Nuclear Information System (INIS)

    Miranda Cuadros, A.A.

    2001-01-01

    Radiation protection in Bolivia has gone through a number of stages. Initially, in the 1970s, the focus was mainly on the analysis of environmental sources resulting from the nuclear tests carried out by France in the Pacific Ocean. Subsequently, the focus switched somewhat to radiation protection in connection with the mining of uranium and in the area of public health. During the third stage, radiation protection in other areas became important as the use of radiation sources was introduced. Finally, during the present -- fourth -- stage, radiation protection regulations are being introduced and mechanisms for the control of radiation sources are being established. (author)

  4. Radiation Control Regulation 1993

    International Nuclear Information System (INIS)

    1993-01-01

    This Regulation (No. 434-1993) was made in pursuance of the Radiation Control Act 1990 and replaces the Active Substances Regulations 1959 repealed by the Act. It entered into force on 1 September 1993. The Regulation specifies that the technical radiation protection definitions have the same meaning as in the 1990 recommendations. The Regulation provides for the licensing of persons to use radioactive substances and radiation apparatus. It prescribes activities which may only be carried out by an accredited radiation expert and regulates the use of radiation apparatus and radioactive substances as well as the disposal and transport of radiation apparatus and radioactive substances. (NEA)

  5. Personnel ionizing radiation dosimeter

    International Nuclear Information System (INIS)

    Williams, R.A.

    1975-01-01

    A dosimeter and method for use by personnel working in an area of mixed ionizing radiation fields for measuring and/or determining the effective energy of x- and gamma radiation; beta, x-, and gamma radiation dose equivalent to the surface of the body; beta, x-, and gamma radiation dose equivalent at a depth in the body; the presence of slow neutron, fast neutron dose equivalent; and orientation of the person wearing the dosimeter to the source of radiation is disclosed. Optionally integrated into this device and method are improved means for determining neutron energy spectrum and absorbed dose from fission gamma and neutron radiation resulting from accidental criticality

  6. 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.

  7. Introduction to radiation transport

    International Nuclear Information System (INIS)

    Olson, G.L.

    1998-01-01

    This lecture will present time-dependent radiation transport where the radiation is coupled to a static medium, i.e., the material is not in motion. In reality, radiation exerts a pressure on the materials it propagates through and will accelerate the material in the direction of the radiation flow. This fully coupled problem with radiation transport and materials in motion is referred to as radiation-hydrodynamics (or in a shorthand notation: rad-hydro) and is beyond the scope of this lecture

  8. Introduction to radiation hygiene

    International Nuclear Information System (INIS)

    Huyskens, Ch.J.

    1978-08-01

    This document is to introduce personnel who come into contact with any radiological activities to different aspects of radiation hygiene. The basic theory of radiation physics is given and units and dose equivalents are discussed. The biological effects of ionizing radiations are described and risk analysis is introduced. The various sources of radiation to which the population is exposed are outlined. Saftey standards and legislation regarding radiation hygiene are described and the various methods and instruments for measuring radiation are given. Dosimetry and safety precautions and measures are finally discussed. (C.F.)

  9. The technique on handling radiation

    International Nuclear Information System (INIS)

    1997-11-01

    This book describes measurement of radiation and handling radiation. The first part deals with measurement of radiation. The contents of this part are characteristic on measurement technique of radiation, radiation detector, measurement of energy spectrum, measurement of radioactivity, measurement for a level of radiation and county's statistics on radiation. The second parts explains handling radiation with treating of sealed radioisotope, treating unsealed source and radiation shield.

  10. Radiation protection in radionuclide investigations

    International Nuclear Information System (INIS)

    Taylor, D.M.

    1985-01-01

    The subject is covered in sections: introduction; radiation and radioactivity; alpha particles; beta particles; neutrons; electromagnetic radiation; units of radioactivity and radiation; biological effects of radiation; the philosophy of radiation protection (ALARA principle); practical aspects of radiation protection; work with unsealed radiation sources; radionuclide studies in experimental animals; radiation safety during clinical investigations; legislative control of radiation work; radioactive waste disposal; emergency procedures; conclusion. (U.K.)

  11. Space radiation effects

    International Nuclear Information System (INIS)

    Li Shiqing; Yan Heping

    1995-01-01

    The authors briefly discusses the radiation environment in near-earth space and it's influences on material, and electronic devices using in space airship, also, the research developments in space radiation effects are introduced

  12. Radiation protection standards

    International Nuclear Information System (INIS)

    Koelzer, W.

    1980-01-01

    The present paper deals with: Objectives and basic concepts of radiation protection, basic radiobiological considerations, the ICRP system of dose limitation and with operational radiation protection (limits, reference levels, occupational exposure). (RW)

  13. Prostate radiation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000399.htm Prostate radiation - discharge To use the sharing features on ... keeping or getting an erection may occur after prostate radiation therapy. You may not notice this problem ...

  14. Versatile radiation gaging system

    International Nuclear Information System (INIS)

    Long, P.J.

    1978-01-01

    The attributes of computerized versatile radiation gaging systems are described. The gages are used to measure plating thicknesses and material characteristics that can be determined from radiation attenuation and/or x-ray fluorescence measurements

  15. Radiation camera exposure control

    International Nuclear Information System (INIS)

    Martone, R.J.; Yarsawich, M.; Wolczek, W.

    1976-01-01

    A system and method for governing the exposure of an image generated by a radiation camera to an image sensing camera is disclosed. The exposure is terminated in response to the accumulation of a predetermined quantity of radiation, defining a radiation density, occurring in a predetermined area. An index is produced which represents the value of that quantity of radiation whose accumulation causes the exposure termination. The value of the predetermined radiation quantity represented by the index is sensed so that the radiation camera image intensity can be calibrated to compensate for changes in exposure amounts due to desired variations in radiation density of the exposure, to maintain the detectability of the image by the image sensing camera notwithstanding such variations. Provision is also made for calibrating the image intensity in accordance with the sensitivity of the image sensing camera, and for locating the index for maintaining its detectability and causing the proper centering of the radiation camera image

  16. Industrial processing with radiation

    International Nuclear Information System (INIS)

    Du Plessis, T.A.

    1976-01-01

    The use of large isotopic radiation sources and accelerators in industry is reviewed. The advantages of various sources of ionizing radiation are indicated, and the development and present status of radiation technology are briefly described. Attention is given to the role played by radiation processing in the cross-linking of polymers as applied to cable insulation, artificial limbs and packaging materials, as well as for improving natural rubber. In addition, attention is given to radiation as a possible means of synthesizing polymers, of hardening non-conventional coatings and of manufacturing polymer-wood composites, thereby improving the properties of softwoods. The possibility of improving natural fibres by means of radiation is discussed, and attention is given to the important role already played by radiation in the sterilization of medical products. Finally, reference is made to the role which radiation can play in reducing food spoilage, as well as in making sewage sludge suitable for agricultural purposes [af

  17. Radiation effects in space

    International Nuclear Information System (INIS)

    Fry, R.J.M.

    1986-01-01

    The paper discusses the radiation environment in space that astronauts are likely to be exposed to. Emphasis is on proton and HZE particle effects. Recommendations for radiation protection guidelines are presented

  18. Radiation exposure management

    International Nuclear Information System (INIS)

    Snihs, J.O.

    1985-01-01

    Radiation exposure management includes administrative control, education and training, monitoring and dose assessments and planning of work and radiation protection. The information and discussion given in the paper are based on experiences in Sweden mainly from nuclear power installations. (Author)

  19. Working with radiation

    International Nuclear Information System (INIS)

    1984-01-01

    This simple booklet is written primarily to supply information about radiation, its potential dangers and radiation protection, to those working for, or considering taking up employment with, British Nuclear Fuels plc. (U.K.)

  20. Radiation processing in Japan

    International Nuclear Information System (INIS)

    Makuuchi, Keizo

    2001-01-01

    Economic scale of radiation application in the field of industry, agriculture and medicine in Japan in 1997 was investigated to compare its economic impacts with that of nuclear energy industry. Total production value of radiation application accounted for 54% of nuclear industry including nuclear energy industry and radiation applications in three fields above. Industrial radiation applications were further divided into five groups, namely nondestructive test, RI instruments, radiation facilities, radiation processing and ion beam processing. More than 70% of the total production value was brought about by ion beam processing for use with IC and semiconductors. Future economic prospect of radiation processing of polymers, for example cross-linking, EB curing, graft polymerization and degradation, is reviewed. Particular attention was paid to radiation vulcanization of natural rubber latex and also to degradation of natural polymers. (S. Ohno)