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Noriyoshi Yashiki, Tsuyoshi Yachi, Keiichi Kimura
A 40-year-old female was injured in a car accident while driving. Computed tomography confirmed a dissection localized to the distal aortic arch and hematoma around the area. Severe liver damage with surrounding extravasation was also confirmed. Furthermore, multiple rib fractures and lumbar spine fracture were apparent. Thoracic endovascular aortic repair( TEVAR) was performed after transcatheter arterial embolization to treat the liver injury. As both the iliac and femoral arteries were narrow, the internal iliac artery was transected peripherally and used as an access route...
February 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
R Michalik, H Siebers, T Claßen, M Gatz, B Rohof, J Eschweiler, V Quack, M Betsch
BACKGROUND: The purpose of forefoot off-loader shoes (FOS) is to unload the operated region of the foot in order to allow early mobilization and rehabilitation. However, little is known about the actual biomechanical effects of different designs of FOS on gait, pelvis and spine. RESEARCH QUESTION: Aim of this study was to analyse and compare the effects of two different designs of forefoot unloader shoes. METHODS: Ortho-Wedge (FOS A) and Relief-Dual® (FOS B) were evaluated in this study during standing and while walking...
February 10, 2019: Gait & Posture
Yoji Ogura, Yoshio Shinozaki, Yoshiomi Kobayashi, Takahiro Kitagawa, Yoshiro Yonezawa, Yohei Takahashi, Kodai Yoshida, Akimasa Yasuda, Jun Ogawa
OBJECTIVEThe importance of global sagittal alignment is well known. Patients with lumbar spinal stenosis (LSS) generally tend to bend forward to relieve their neurological symptoms, i.e., they have a positive sagittal vertical axis (SVA). We hypothesized that the positive SVA associated with LSS is symptom related and should improve after surgery. However, little is known about the changes in sagittal alignment in LSS patients after decompression surgery. In this study the authors aimed to evaluate midterm radiographical changes in sagittal spinopelvic alignment after decompression surgery for LSS and to determine the factors influencing the improvement in sagittal spinopelvic alignment...
February 15, 2019: Journal of Neurosurgery. Spine
Garrett K Berger, Peyton L Nisson, Whitney S James, Kristen N Kaiser, R John Hurlbert
OBJECTIVEEwing sarcoma (ES) is among the most prevalent of bone sarcomas in young people. Less often, it presents as a primary lesion of the spine (5%-15% of patients with ES).METHODSA systematic literature search was performed, querying several scientific databases per PRISMA guidelines. Inclusion criteria specified all studies of patients with surgically treated ES located in the spine. Patient age was categorized into three groups: 0-13 years (age group 1), 14-20 years (age group 2), and > 21 (age group 3)...
February 15, 2019: Journal of Neurosurgery. Spine
Karthik Madhavan, Lee Onn Chieng, Valerie L Armstrong, Michael Y Wang
OBJECTIVEDiscitis and osteomyelitis are seen in end-stage renal disease (ESRD) patients due to repeated vascular access for hemodialysis and urinary tract infections leading to recurrent bacteremia. Discitis and osteomyelitis are underdiagnosed due to the nonspecific initial presentation of back pain. In this article, we review the literature for better understanding of the problem and the importance of early diagnosis by primary care physicians and nephrologists. In addition, we discuss the decision-making, follow-up, management, and neurological outcomes...
February 15, 2019: Journal of Neurosurgery. Spine
Hesham Mostafa Zakaria, Michael Bazydlo, Lonni Schultz, Markian A Pahuta, Jason M Schwalb, Paul Park, Ilyas Aleem, David R Nerenz, Victor Chang
OBJECTIVEThe Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide, multicenter quality improvement initiative. Using MSSIC data, the authors sought to identify 90-day adverse events and their associated risk factors (RFs) after cervical spine surgery.METHODSA total of 8236 cervical spine surgery cases were analyzed. Multivariable generalized estimating equation regression models were constructed to identify RFs for adverse events; variables tested included age, sex, diabetes mellitus, disc herniation, foraminal stenosis, central stenosis, American Society of Anesthesiologists Physical Classification System (ASA) class > II, myelopathy, private insurance, anterior versus posterior approach, revision procedures, number of surgical levels, length of procedure, blood loss, preoperative ambulation, ambulation day of surgery, length of hospital stay, and discharge disposition...
February 15, 2019: Journal of Neurosurgery. Spine
Nikolas Lessmann, Bram van Ginneken, Pim A de Jong, Ivana Išgum
Precise segmentation and anatomical identification of the vertebrae provides the basis for automatic analysis of the spine, such as detection of vertebral compression fractures or other abnormalities. Most dedicated spine CT and MR scans as well as scans of the chest, abdomen or neck cover only part of the spine. Segmentation and identification should therefore not rely on the visibility of certain vertebrae or a certain number of vertebrae. We propose an iterative instance segmentation approach that uses a fully convolutional neural network to segment and label vertebrae one after the other, independently of the number of visible vertebrae...
February 12, 2019: Medical Image Analysis
G Lakshmi Prasad, S Divya
PURPOSE: Spinal eosinophilic granulomas(EGs) are uncommon tumors, constituting <1% of all bone tumors. They are mostly seen in the pediatric age group while adult onset is rare. Cervical spine is an infrequent location for involvement by EG. Available literature remains sparse regarding the clinical and management aspects of these lesions, especially in adults. MATERIALS AND METHODS: Literature review was performed by searching online databases to analyze all the reported cases of adult onset cervical EG...
February 13, 2019: World Neurosurgery
Thibault P Bittar, Betina B Nair, Joon S Kim, Dhananjie Chandrasekera, Aidan Sherrington, Karl J Iremonger
Corticosteroid stress hormones drive a multitude of adaptations in the brain. Hypothalamic corticotropin-releasing hormone (CRH) neurons control the circulating levels of corticosteroid stress hormones in the body and are themselves highly sensitive to corticosteroids. CRH neurons have been shown to undergo various adaptions in response to acute stress hormone elevations. However, their structural and physiological changes under chronically elevated corticosterone are less clear. To address this, we determined the structural and functional changes in CRH neurons in the paraventricular nucleus of the hypothalamus following 14 days of corticosterone treatment...
February 13, 2019: Neuropharmacology
Jason M Nagata, Jennifer L Carlson, Neville H Golden, Jin Long, Stuart B Murray, Rebecka Peebles
OBJECTIVE: To compare bone mineral density (BMD) and body composition among adolescents: (a) with atypical anorexia nervosa (AAN) versus anorexia nervosa (AN) and (b) those with and without a prior history of overweight. METHOD: Electronic medical records of patients 9-20 years with AN or AAN who underwent dual-energy x-ray absorptiometry scans were retrospectively reviewed and analyzed. RESULTS: A total of 286 adolescents with AN or AAN were included...
February 16, 2019: International Journal of Eating Disorders
Andrew S Moon, Carly A Cignetti, Jonathan A Isbell, Chong Weng, Sakthivel Rajan Rajaram Manoharan
PURPOSE: Hyperextension-distraction type injury of the thoracolumbar spine is an unstable fracture pattern that generally necessitates surgical stabilization by posterior instrumentation. Care must be taken when positioning these patients from supine to prone due to the unstable nature of their injury. The study objectives were (1) to describe a novel modification of the Jackson table turn technique, which may be safer and more effective than the conventional log-roll method and traditional Jackson table technique for positioning patients with hyperextension-distraction injuries of the thoracolumbar spine from supine to prone in the operating room and (2) to present two cases in which this technique was successfully performed...
February 15, 2019: European Spine Journal
Takayoshi Shimizu, Suthipas Pongmanee, K Daniel Riew
PURPOSE: To investigate the normative value of distance between the spinous processes (inter-spinous process distance, ISPD), correlations between patients' demographics and ISPD, and determine cutoff ISPD values that result in segmental lordosis in posterior cervical-thoracic arthrodesis with instrumentation. METHODS: We reviewed patients with visible lower cervical and cervicothoracic spinous processes (C5-T2) on dynamic X-rays. Radiographic measurements included segmental Cobb angles (S-Cobb) and ISPD, defined as the distance between midpoints of the spinous processes...
February 15, 2019: European Spine Journal
Rekhapalli Rajasekhar, Madhivanan Karthigeyan, Pravin Salunke, Kirti Gupta
PURPOSE: Juvenile xanthogranuloma (JXG) presenting as solitary vertebral body lesion is infrequently seen and usually limited to one or two levels. We report a case of an isolated JXG with extensive cervical spinal (bony and extradural) involvement in a 6-year-old child. There was a diagnostic dilemma as the radiologic and intraoperative picture resembled tuberculosis. The spinal reconstruction was also challenging due to involvement of multiple vertebral levels and necessitated an anterior C1 screw...
February 15, 2019: European Spine Journal
Antonio Klasan, Thomas Neri, Sven Edward Putnis, Philipp Dworschak, Karl Friedrich Schüttler, Susanne Fuchs-Winkelmann, Markus D Schofer, Thomas J Heyse
INTRODUCTION: Impingement of the prominent anterior inferior iliac spine (AIIS) against the femoral neck has recently been described as another type of impingement. The purpose of this study is to provide a distribution of AIIS types using the classification proposed by Hetsroni and thus report on the prevalence of prominent types. MATERIALS AND METHODS: A total of 400 patients were included in the study with an average age 27.3 ± 6.9 years (range 18-40). All patients received a whole-body polytrauma computer tomography (CT) scan in the emergency room (ER) upon arrival...
February 15, 2019: Archives of Orthopaedic and Trauma Surgery
M López Picazo, L Humbert, S Di Gregorio, M A González Ballester, L M Del Río Barquero
A retrospective case-control study assessing the association of DXA-derived 3D measurements with osteoporosis-related vertebral fractures was performed. Trabecular volumetric bone mineral density was the measurement that best discriminates between fracture and control groups. INTRODUCTION: The aim of the present study was to evaluate the association of DXA-derived 3D measurements at the lumbar spine with osteoporosis-related vertebral fractures. METHODS: We retrospectively analyzed a database of 74 postmenopausal women: 37 subjects with incident vertebral fractures and 37 age-matched controls without any type of fracture...
February 15, 2019: Osteoporosis International
Yang Du, Yun Yu, Yang Hu, Xiao-Wan Li, Ze-Xu Wei, Rui-Yuan Pan, Xue-Song Li, Guang-En Zheng, Xiao-Yan Qin, Qing-Shan Liu, Yong Cheng
Genetic variants conferring risk for schizophrenia (SCZ) have been extensively studied, but the role of posttranscriptional mechanisms in SCZ is not well studied. Here we performed the first genome-wide microRNA (miRNA) expression profiling in serum-derived exosome from 49 first-episode, drug-free SCZ patients and 46 controls and identified miRNAs and co-regulated modules that were perturbed in SCZ. Putative targets of these SCZ-affected miRNAs were enriched strongly for genes that have been implicated in protein glycosylation and were also related to neurotransmitter receptor and dendrite (spine) development...
February 16, 2019: Schizophrenia Bulletin
Wei Zhu, Jian Liu, Mingyue Zhu, Qin Shao, Yu Yan
OBJECTIVE: In order to obtain more decision information from Digital Radiography(DR) images, an improved image enhancement algorithm is proposed based on the algorithm of Gauss-Laplacian pyramid. METHODS: The original algorithm is improved on the basis of the human visual characteristics and better enhancements, the low frequency components of the image is histogram equalized to make the image gray scale more balanced, and the high frequency component is enhanced by a hierarchical exponential enhancement to make the details of the image clearer...
January 30, 2019: Zhongguo Yi Liao Qi Xie za Zhi, Chinese Journal of Medical Instrumentation
V Donadio, K Doppler, A Incensi, A Kuzkina, A Janzen, G Mayer, J Volkmann, G Rizzo, E Antelmi, G Plazzi, C Sommer, R Liguori, W H Oertel
BACKGROUND: Visualization of phosphorylated α-synuclein at serine 129 (p-syn) in skin nerves is a promising test for the in vivo diagnosis of synucleinopathies. Here we aimed to establish the intra- and inter-laboratory reproducibility of quantification of intraneural p-syn immunoreactivity in two laboratories with a major expertise (Würzburg and Bologna). METHODS: We enrolled 43 patients affected by Parkinson's disease (PD: 21 patients), Dementia with Lewy Body (DLB: 1), REM sleep behavior disorder (RBD: 11), Multiple System Atrophy (MSA-P: 4) and small fiber neuropathy (SFN: 6)...
February 15, 2019: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Reza Akhavan-Sigari, Walter Schulz-Schaeffer, Amanda Angelika Harcej, Veit Rohde
Chordomas is rare malignant bone tumors thought to arise from remnants of embryonic notochord along the spine, frequently at the skull base and sacrum. Although chordoma is slow growing tumors, while are extremely recurrent, and aggressive, as well as the rate of prognosis remains poorly. Radical surgery and high-dose radiation are the most used treatments. Currently, there is no effective chemotherapeutic standard for chordomas. The Hedgehog (HH) pathway adjusts various processes included in expansion and differentiation of tissues and organs throughout the fetus's life, furthermore cell growth and differentiation in the adult organism, of the cell in an adult organism, in which acute anesthesia is involved in multiple cancers...
February 15, 2019: Journal of Clinical Medicine
Jeong Hee Cho, Yoonseon Park, Naeun Woo
There have been reports of central nervous systemic inflammatory disease associated with vaccination. We describe a female patient who developed longitudinally extensive transverse myelitis following seasonal influenza vaccination. A 38-year-old woman had severe neck and back pain with urinary retention. She received influenza vaccine 3 days before symptom onset. Examination revealed mild quadriparesis with diffuse hyperreflexia. Magnetic resonance imaging (MRI) of the spine showed a T2 hyperintense lesion with gadolinium enhancement in the spinal cord extending from the cervicomedullary junction to the level of T10...
February 5, 2019: Multiple Sclerosis and related Disorders
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