JOURNAL OF FORENSIC SCIENCES, Issue 2 2010
Midori Albert Ph.D.
Abstract:, Union of the vertebral centra or "ring" epiphyses occurs during adolescence and early adulthood, providing valuable age at death information. We present a system for estimating age based on the timing and pattern of vertebral ring union. Data from 57 known individuals aged 14,27 years were used to establish age ranges for various patterns of union in females and males. Female age ranges were more well defined with less overlap in patterns of union than male age ranges. The age ranges are accompanied by descriptions of the stages of union observed that aid in applying this method. A test of interobserver error in scoring stages of union demonstrated strong consistency among three observers (r = 0.91,0.97). Estimating age by observing all stages documented resulted in 78%, 88%, and 100% accuracies using vertebral data alone. We encourage the continued use of this method, in conjunction with other age indicators. [source]

Micro-computed tomography evaluation of vertebral end-plate trabecular bone changes in a porcine asymmetric vertebral tether

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2010
Jean-Michel Laffosse
Abstract We conducted a micro-CT analysis of subchondral bone of the vertebral end-plates after application of compressive stress. Thoracic and lumbar vertebral units were instrumented by carrying out left asymmetric tether in eleven 4-week-old pigs. After 3 months of growth, instrumented units and control units were harvested. Micro-CT study of subchondral bone was performed on one central and two lateral specimens (fixated side and non-fixated side). In control units, bone volume fraction (BV/TV), number of trabeculae (Tb.N), trabecular thickness (Tb.Th), and degree of anisotropy (DA) were significantly higher, whereas intertrabecular space (Tb.Sp) was significantly lower in center than in periphery. No significant difference between the fixated and non-fixated sides was found. In instrumented units, BV/TV, Tb.N, Tb.Th, and DA were significantly higher in center than in periphery. BV/TV, Tb.N, and Conn.D were significantly higher in fixated than in non-fixated side, while Tb.Sp was significantly lower. We noted BV/TV, Tb.N, and Tb.Th significantly lower, and Tb.Sp significantly higher, in the instrumented levels. This study showed, in instrumented units, two opposing processes generating a reorganization of the trabecular network. First, an osteolytic process (decrease in BV/TV, Tb.N, Tb.Th) by stress-shielding, greater in center and on non-fixated side. Second, an osteogenic process (higher BV/TV, Tb.N, Conn.D, and lower Tb.Sp) due to the compressive loading induced by growth on the fixated side. This study demonstrates the densification of the trabecular bone tissue of the vertebral end-plates after compressive loading, and illustrates the potential risks of excessively rigid spinal instrumentation which may induce premature osteopenia. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:232,240, 2010 [source]

Heritability and physiological correlates of migratory tendency in the grasshopper Melanoplus sanguinipes

PHYSIOLOGICAL ENTOMOLOGY, Issue 4 2001
Jack W. Kent JR
Abstract. Durations of tethered flights by the North American migratory grasshopper Melanoplus sanguinipes Fabricius are bimodally distributed: most individuals either will not fly, or else will fly for many hours. This observation suggests a simple measure (the ,one-hour rule') for distinguishing migrants from non-migrants. This measure is repeatable (repeatability = 0.6,0.7). Using laboratory-reared offspring of grasshoppers from an Arizona population of mixed migratory tendency, a breeding experiment was conducted to determine the heritability of migratory tendency and possible correlated responses to selection on migratory behaviour. When migratory tendency is considered as a threshold trait, the heritability of liability is in the range 0.5,0.6. Most families in the breeding experiment had at least some migrants among their offspring; selection on migratory incidence had a correlated effect on the durations of flights by these individuals. The magnitude of thoracic lipid reserves showed a modest correlated response to selection on migratory behaviour. Thoracic and abdominal lipid reserves in identified migrants are reduced by flight, indicating that lipid is mobilized and consumed during flight in this species. [source]

Swiss Society of Surgery

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue S3 2010
Article first published online: 4 MAY 2010
The following abstracts will be presented at the 97th Annual Congress of the Swiss Society of Surgery. The meeting, held in Interlaken, 26-28 May 2010, is organized for the eighth time in collaboration with the Swiss Society of Thoracic, Heart and Vascular Surgery. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Swiss Society of Surgery

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue S3 2009
Article first published online: 29 APR 200
The following abstracts will be presented at the 96th Annual Congress of the Swiss Society of Surgery. The meeting, held in Montreux, 10,12 June 2009, is organized for the seventh time in collaboration with the Swiss Society of Thoracic, Heart and Vascular Surgery. To view the abstracts from this meeting, please click the pdf link on this page. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Swiss Society of Surgery

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue S2 2008
Article first published online: 2 MAY 200
The following abstracts were presented at the 95th Annual Congress of the Swiss Society of Surgery. The meeting, held in Basel 28,30 May 2008, is organized for the sixth time in collaboration with the Swiss Society of Thoracic, Heart and Vascular Surgery. To view the abstracts from this meeting, please click the pdf link on this page. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Cells of all somitic compartments are determined with respect to segmental identity

DEVELOPMENTAL DYNAMICS, Issue 4 2005
Marlyse Dieuguie Fomenou
Abstract Development of somite cells is orchestrated by two regulatory processes. Differentiation of cells from the various somitic compartments into different anlagen and tissues is regulated by extrinsic signals from neighboring structures such as the notochord, neural tube, and surface ectoderm. Morphogenesis of these anlagen to form specific structures according to the segmental identity of each somite is specified by segment-specific positional information, based on the Hox -code. It has been shown that following experimental rotation of presomitic mesoderm or newly formed somites, paraxial mesodermal cells adapt to the altered signaling environment and differentiate according to their new orientation. In contrast, presomitic mesoderm or newly formed somites transplanted to different segmental levels keep their primordial segmental identity and form ectopic structures according to their original position. To determine whether all cells of a segment, including the dorsal and ventral compartment, share the same segmental identity, presomitic mesoderm or newly formed somites were rotated and transplanted from thoracic to cervical level. These experiments show that cells from all compartments of a segment are able to interpret extrinsic local signals correctly, but form structures according to their original positional information and maintain their original Hox expression in the new environment. Developmental Dynamics 233:1386,1393, 2005. © 2005 Wiley-Liss, Inc. [source]

Selective dose escalation of chemoradiotherapy for locally advanced esophageal cancer

DISEASES OF THE ESOPHAGUS, Issue 7 2008
S. K. Seung
SUMMARY., This phase II study assessed the use of concurrent continuous infusion of 5-fluorouracil and weekly carboplatin plus paclitaxel with selective radiation dose escalation for patients with localized esophageal cancer. Patients with esophageal carcinoma were staged by thoracic and abdominal computed tomography, endoscopic ultrasound, and positron emission tomography scans. Patients received a continuous infusion of 5-fluorouracil 225 mg/m2 on days 1 to 38 and intravenous paclitaxel 45 mg/m2 and carboplatin AUC 2 on days 1, 8, 15, 22, 29, and 36. Radiotherapy was delivered in 1.8-Gy fractions, 5 d/wk for 5.5 weeks. Six to 8 weeks after initial therapy, patients without metastatic progression but with a positive biopsy, or less than partial response received a 9-Gy boost with the same concurrent chemotherapy. Twenty-four patients were enrolled: 18 patients were enrolled initially; 6 additional patients were enrolled following a protocol amendment designed to reduce the esophagitis by adding the radioprotectant amifostine. Median follow-up was 30 months. Twenty (83%) patients had adenocarcinomas of the lower esophagus/gastroesophageal junction. Seventeen patients (81%) attained at least a partial response. Six patients received boost treatment. At 4 years, overall survival was 28%, cause-specific survival was 38%, locoregional control was 61%, and distant metastasis-free survival was 52%. Radiation delays ranged from 0 to 62 days (median, 8 d), primarily owing to esophagitis. In total, 28% of patients developed esophageal strictures requiring dilatations. There were no differences in esophageal strictures, local control, or survival with the addition of amifostine. [source]

Levels of evidence available for techniques in antireflux surgery

DISEASES OF THE ESOPHAGUS, Issue 2 2007
M. Neufeld
SUMMARY., The objective of this study was to determine the levels of evidence and grades of recommendations available for techniques in antireflux surgery. Areas of technical controversy in antireflux surgery were identified and developed into eight answerable questions. The external evidence was surveyed using the databases Medline and EMBASE. Abstracts and appropriate articles were identified from January 1966 to December 2005. A set of search strategies was systematically employed to determine the levels of evidence available for each clinical question. Primary outcome measures included the determination of levels of evidence and grade of recommendation based on The Oxford Center for Evidence-Based Medicine. Secondary outcome measures included for randomized controlled trials were Jadad scores, noting the presence of a sample size calculation, and the determination of an effect estimate and the reporting of a confidence interval. Higher quality randomized controlled trials (mostly level 2b, occasional level 1b) existed to answer three questions: whether to complete a 360° or partial wrap; whether or not to divide the short gastric vessels; and whether to perform laparoscopic or open surgery. Lower quality randomized controlled trials were available to determine whether the use of mesh was helpful, whether or not to use a bougie catheter for calibration of the wrap, and whether an anterior or posterior wrap results in a superior outcome. This was deemed to be of inferior grade of recommendation due to the lack (< 2) of trials available and the sole presence of level 2b evidence. The final two questions: whether to complete fundoplication using a thoracic or abdominal approach and whether to use intraoperative manometry relied exclusively upon level 4 evidence and thus received a lower grade of recommendation. A higher Jadad score seemed to be associated with studies having a higher level of evidence available to answer the question. Sample size calculations were given to answer three questions. Effect estimate was difficult to interpret given inconsistent findings, composite outcomes and lack of reported confidence intervals. In conclusion, antireflux surgery has many randomized controlled trials available upon which to base clinical practice. Unfortunately, these are generally of poor quality. We recommend that esophageal surgeons determine consistent outcome measures and endeavor to improve the quality of randomized controlled trials they perform. [source]

Surgery in thoracic esophageal perforation: primary repair is feasible

DISEASES OF THE ESOPHAGUS, Issue 3 2002
S. W. Sung
SUMMARY. Prompt diagnosis and effective treatment are important for thoracic esophageal perforations. The decision for proper management is difficult especially when diagnosed late. However, there is an increasing consensus that primary repair provides good results for repair of thoracic esophageal perforations, which are not diagnosed on time. Primary repair for thoracic esophageal perforations was applied in 20 out of 25 consecutive patients. The time interval between perforation and repair was less than 24 h in six patients (group I), and more than 24 h in 14 patients (group II). The remaining five patients underwent esophagectomy with simultaneous or staged reconstruction because of incorrectable underlying esophageal pathology. Group I had much more iatrogenic causes (P < 0.05). Preoperative sepsis occurred only in group II (P=0.05) and was highly associated with Boerhaave syndrome (P=0.001). Regional viable tissue was used to reinforce the sites of primary repair (n=15, 75%). All of the postoperative morbidity (n=9, 45%) including esophageal leaks (n=6, 30%) and operative death (n=1, 5%) occurred in group II. In patients with postoperative leaks, five eventually healed, but one became a fistula that required reoperation. Primary healing with preservation of the native esophagus was achieved in all 19 patients except one operative death. In addition, the increased incidence of leak and morbidity did not lead to an increase in mortality. In the esophagectomy group, there was no mortality, but one minor suture leak. Regardless of the time interval between the injury and the operation, primary repair is recommended for non-malignant, thoracic, esophageal perforations, but not for anastomotic leaks. Reinforcement that may change the nature of a possible leak is also useful. For incorrectable underlying esophageal pathology, esophagectomy with simultaneous or staged reconstruction is indicated. [source]

State of play: Clearing the thoracolumbar spine in blunt trauma victims

EMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2006
Marten C Howes
Abstract Introduction:, The present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies. Methods:, A comprehensive literature search was performed, and articles identified were critically appraised Results:, Twenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols are presented. The evolution of imaging strategies in response to new technology is described. Conclusions:, Thoracolumbar spine screening is best done using reformatted images acquired when scanning the chest and abdomen of high-risk multi-trauma patients. If computed tomography is not clinically indicated for investigation of other injuries then plain films are the first line investigation. [source]

Thoracic trauma in foals: post mortem findings

EQUINE VETERINARY JOURNAL, Issue 1 2003
M. A. SCHAMBOURG
Summary Reasons for performing study: Thoracic trauma occurs in newborn foals and may cause associated clinical signs; this condition remains poorly documented. Objectives: The purpose of this study was to describe the pathological features of thoracic trauma in newborn foals presented for necropsy examination between 1990 and 2000. Methods: Necropsy reports of foals with thoracic trauma from 1990,2000 were reviewed. Subject details, clinical signs, thoracic and abdominal lesions were noted and analysed statistically. Results: Sixty-seven (9%) of 760 necropsied foals had thoracic trauma. In 19 foals, fractured ribs were considered to be the cause of death (Group A). The remaining foals had fractured ribs (Group B, n = 20) or rib contusions (Group C, n = 28) that were incidental findings. Ribs 3 to 8 accounted for 86% of the traumatised bones. The most common site of injury was the costochondral junction and an area immediately above it (94%). In Group A, all but 2 foals died within the first 8 days post partum. Haemothorax and subsequent pulmonary collapse was cited most commonly as the cause of death (53%). Diaphragmatic rupture and hernia (n = 2) also occurred. Conclusions: The focal site, consistent location and presence of lesions during the first week post partum, all suggest that thoracic trauma in newborn foals probably occurs during parturition. Potential relevance: The description of lesions and site of occurrence of thoracic trauma in foals will increase awareness and improve the diagnosis and treatment of this life threatening condition. [source]

Neuronal nitric oxide synthase (nNOS) mRNA is down-regulated, and constitutive NOS enzymatic activity decreased, in thoracic dorsal root ganglia and spinal cord of the rat by a substance P N-terminal metabolite

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 4 2001
Katalin J. Kovacs
Abstract Nitric oxide (NO) in the spinal cord plays a role in sensory and autonomic activity. Pain induced by acetic acid in the abdominal stretch (writhing) assay and hyperalgesia associated with chronic pain are highly sensitive to NO synthase (NOS) inhibitors. Because substance P (SP) is released and up-regulated in some models of chronic pain, we hypothesized that an accumulation of SP metabolites may influence NOS expression and activity. To test this hypothesis, we examined the effect of intrathecally (i.t.) injected substance P (1-7) [SP(1-7)], the major metabolite of SP in the rat, on neuronal NOS (nNOS) mRNA in the thoracic and lumbar spinal cord, dorsal root ganglia (DRG) and on the corresponding constitutive NOS (cNOS) enzyme activity. Detected using quantitative RT-PCR, nNOS mRNA content in the thoracic spinal cord was decreased 6 h after injection of 5 µmol of SP(1-7) and returned to control 2 days later. In thoracic DRG, nNOS mRNA was reduced 48 h after SP(1-7). The cNOS enzymatic activity in thoracic spinal tissue was gradually decreased to a minimum at 72 h. Down-regulation of NOS by SP(1-7) in the thoracic area appears to be highly associated with capsaicin-sensitive primary afferent neurons. No similar changes in either parameter were measured in the lumbar area after SP(1-7). These data suggest that N-terminal SP fragments, which are known to cause long-term antinociception in the writhing assay, may do so by their ability to down-regulate NO synthesis along nociceptive pathways. [source]

Beetle horns are regulated by the Hox gene, Sex combs reduced, in a species- and sex-specific manner

EVOLUTION AND DEVELOPMENT, Issue 4 2010
Bethany R. Wasik
SUMMARY Discovering the mechanisms that underlie the origin of novel features represents a major frontier in developmental and evolutionary biology. Here we begin to characterize the role of the Hox gene Sex combs reduced (Scr) during the development and evolution of a morphologically novel trait: beetle horns. Beetle horns develop as epidermal outgrowths from the prothorax and/or head, and size and location vary dramatically across species and between sexes. Using both comparative gene expression and larval RNA interference in two species of the horned beetle genus Onthophagus, we show that Scr functions in patterning adult labial mouthpart identity and suppressing wing development in the prothorax. At the same time, however, our results illustrate that Scr has acquired, within its ancestral domain of expression, additional new functions including the regulation of prepupal growth and pupal remodeling of pronotal horn primordia. Furthermore, comparative analyses of our results across both Onthophagus species, which differ in location of horn development (thoracic horns vs. thoracic and head horns) as well as patterns of sexual dimorphism (traditional vs. reversed sexual dimorphism), reveal surprising differences in exactly when, where, and to what degree Scr regulates horn formation in different sexes. These observations suggest that the interactions between Scr and its targets in the regulation of horn development can diversify quickly over remarkably short phylogenetic distances. More generally, our results suggest that the Hox complex can play an integral role in the development and evolution of novel complex traits while maintaining traditional patterning responsibilities. [source]

A new body mass estimation of Brachiosaurus brancai Janensch, 1914 mounted and exhibited at the Museum of Natural History (Berlin, Germany)

FOSSIL RECORD-MITTEILUNGEN AUS DEM MUSEUM FUER NATURKUNDE, Issue 1 2008
Hanns-Christian Gunga
Abstract Body mass and surface areas are important in several aspects for an organism living today. Therefore, mass and surface determinations for extinct dinosaurs could be important for paleo-biological aspects as well. Based on photogrammetrical measurement the body mass and body surface area of the Late Jurassic Brachiosaurus brancai Janensch, 1914 from Tendaguru (East Africa), a skeleton mounted and exhibited at the Museum of Natural History in Berlin (Germany), has been re-evaluated. We determined for a slim type of 3D reconstruction of Brachiosaurus brancai a total volume of 47.9 m3 which represents, assuming a mean tissue density of 0.8 kg per 1,000 cm3, a total body mass of 38,000 kg. The volume distributions from the head to the tail were as follows: 0.2 m3 for the head, neck 7.3 m3, fore limbs 2.9 m3, hind limbs 2.6 m3, thoracic-abdominal cavity 32.4 m3, tail 2.2 m3. The total body surface area was calculated to be 119.1 m2, specifically 1.5 m2 for the head, 26 m2 neck, fore limbs 18.8 m2, hind limbs 16.4 m2, 44.2 m2 thoracic-abdominal cavity, and finally the tail 12.2 m2. Finally, allometric equations were used to estimate presumable organ sizes of this extinct dinosaur and to test whether their dimensions really fit into the thoracic and abdominal cavity of Brachiosaurus brancai if a slim body shape of this sauropod is assumed. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

Chemokine expression in the white matter spinal cord precursor niche after force-defined spinal cord contusion injuries in adult rats

GLIA, Issue 8 2010
Friederike Knerlich-Lukoschus
Abstract Inflammatory cascades induced by spinal cord injuries (SCI) are localized in the white matter, a recognized neural stem- and progenitor-cell (NSPC) niche of the adult spinal cord. Chemokines, as integrators of these processes, might also be important determinants of this NSPC niche. CCL3/CCR1, CCL2/CCR2, and SDF-1,/CXCR4 were analyzed in the ventrolateral white matter after force defined thoracic SCI: Immunoreactivity (IR) density levels were measured 2 d, 7 d, 14 d, and 42 d on cervical (C 5), thoracic (T 5), and lumbar (L 5) levels. On day post operation (DPO) 42, chemokine inductions were further evaluated by real-time RT-PCR and Western blot analyses. Cellular phenotypes were confirmed by double labeling with markers for major cell types and NSPCs (nestin, Musashi-1, NG2, 3CB2, BLBP). Mitotic profiles were investigated in parallel by BrdU labeling. After lesion, chemokines were induced in the ventrolateral white matter on IR-, mRNA-, and protein-level. IR was generally more pronounced after severe lesions, with soaring increases of CCL2/CCR2 and continuous elevations of CCL3/CCR1. SDF-1, and CXCR4 IR induction was focused on thoracic levels. Chemokines/-receptors were co-expressed with astroglial, oligodendroglial markers, nestin, 3CB2 and BLBP by cells morphologically resembling radial glia on DPO 7 to DPO 42, and NG2 or Musashi-1 on DPO 2 and 7. In the white matter BrdU positive cells were significantly elevated after lesion compared with sham controls on all investigated time points peaking in the early time course on thoracic level: Here, chemokines were co-expressed by subsets of BrdU-labeled cells. These findings suggest an important role of chemokines/-receptors in the subpial white matter NSPC niche after SCI. © 2010 Wiley-Liss, Inc. [source]

Spinal pathological findings in ancient Egyptians of the Greco-Roman period living in Bahriyah Oasis

INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2009
F. H. Hussien
Abstract The spine can provide a large amount of information about an individual's physical condition and possible lifestyle through palaeopathological investigations. The aim of this research was to study spinal diseases among Greco-Roman ancient Egyptians from Bahriyah Oasis, and to compare them with those from Giza of the Old Kingdom. The material used in the study included 809 single vertebrae and 77 adult sacra of ancient Egyptians from the Greco-Roman period (332,30 BC) that were excavated from Bahriyah Oasis. The spinal elements were examined for pathological conditions, degenerative diseases, trauma, congenital abnormalities, infectious diseases and neoplasms. The most common lesions of the spine were those due to degenerative processes. The articular facets were more affected than the vertebral bodies. Compression fractures of the bodies, mostly due to osteoporosis, were found in 1.44% and 5.07% of thoracic and lumbar vertebrae respectively. The percentage of spina bifida occulta among ancient Egyptians from Bahriyah Oasis was 62.33%, while among those from Giza was only 3.33%. Few cases of lumbar spondylolysis and one case of DISH were recorded. No cases of infectious or neoplastic diseases were found. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Endoscopic investigation of the internal organs of a 15th-century child mummy from Yangju, Korea

JOURNAL OF ANATOMY, Issue 5 2006
Seok Bae Kim
Abstract Our previous reports on medieval mummies in Korea have provided information on their preservation status. Because invasive techniques cannot easily be applied when investigating such mummies, the need for non-invasive techniques incurring minimal damage has increased among researchers. Therefore, we wished to confirm whether endoscopy, which has been used in non-invasive and minimally invasive studies of mummies around the world, is an effective tool for study of Korean mummies as well. In conducting an endoscopic investigation on a 15th-century child mummy, we found that well-preserved internal organs remained within the thoracic, abdominal and cranial cavities. The internal organs , including the brain, spinal cord, lung, muscles, liver, heart, intestine, diaphragm and mesentery , were easily investigated by endoscopy. Even the stool of the mummy, which accidentally leaked into the abdominal cavity during an endoscopic biopsy, was clearly observed. In addition, unusual nodules were found on the surface of the intestines and liver. Our current study therefore showed that endoscopic observation could provide an invaluable tool for the palaeo-pathological study of Korean mummies. This technique will continue to be used in the study of medieval mummy cases in the future. [source]

Irreversible Perforations in Vertebral Trabeculae?,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 7 2003
X Banse
In human cancellous bone, osteoclastic perforations resulting from normal remodeling were generally considered irreversible. In human vertebral samples, examined by backscatter electron microscopy, there was clear evidence of bridging of perforation defects by new bone formation. Hence trabecular perforations may not be irreversible. Introduction: Preservation of the trabecular bone microarchitecture is essential to maintain its load-bearing capacity and prevent fractures. However, during bone remodeling, the osteoclasts may perforate the platelike trabeculae and disconnect the structure. Large perforations (>100 ,m) are generally considered irreversible because there is no surface on which new bone can be laid down. In this work, we investigated the outcome of these perforations on human vertebral cancellous bone. Materials and Methods: Using backscatter electron microscopy, we analyzed 264 vertebral bone samples from the thoracic and lumbar spine of nine subjects (44,88 years old). Nine fields (2 × 1.5 mm) were observed on each block. Several bone structural units (BSUs) were visible on a single trabecula, illustrating a dynamic, historical aspect of bone remodeling. A bridge was defined as a single and recent BSU connecting two segments of trabeculae previously separated by osteoclastic resorption. They were counted and measured (length and breadth, ,m). Results and Conclusion: We observed 396 bridges over 2376 images. By comparison, we found only 15 microcalluses on the same material. The median length of the bridge was 165 ,m (range, 29,869 ,m); 86% being longer than 100 ,m and 35% longer than 200 ,m. Their breadth was 56 ,m (range, 6,255 ,m), but the thinnest were still in construction. Bridges were found in all nine subjects included in the study, suggesting that it is a common feature of normal vertebral bone remodeling. These observations support the hypothesis that perforation could be repaired by new bone formation. and hence, might not be systematically irreversible. [source]

Slowed Progression or Elimination of Atherosclerosis by Low-Frequency Electrical Impulses

JOURNAL OF CARDIAC SURGERY, Issue 1 2003
Ph.D., Valeri Chekanov M.D.
In this investigation we demonstrated the slow progression or elimination of atherosclerosis by low-frequency EI in case of moderate atherosclerosis (after eight weeks of HCD). Methods: Series I rabbits (control group) were fed HCD for eight weeks. Series II rabbits were fed HCD for eight weeks and were then switched to normal diet for eight weeks (no EI). Series III rabbits were fed HCD for eight weeks and then switched to a normal diet with simultaneous EI (applied near the abdominal aorta) for eight weeks (3 V, 30 single impulses per minute, 24 hours/day). After euthanization, the level of atherosclerosis, percentage of surface area involved in the atherosclerosis process, and an atherosclerosis score were calculated in the aortic arch, thoracic and abdominal aorta. Results: Statistically significant differences were seen in the level of atherosclerosis in the abdominal aorta between series III animals (0.4 ± 0.2) and the other two groups: 1.5 ± 0.4 in series I (HCD only), 1.2 ± 0.3 in series II (HCD then normal diet). Gross examination of the surface also revealed statistically significant differences (p < 0.05) in the percentage of atherosclerosis between the control series I (30.1 ± 4.1%) and series II (21.3 ± 3.6%), compared with series III (5.5 ± 5.4%). In addition, the atherosclerosis score was also significantly different: 45.8 ± 3.9 in series I, 25.2 ± 6.9 in series II, and 2.2 ± 2.0 in series III (p < 0.05). Conclusion: Our study showed that, when applied near the abdominal aorta, low-frequency electrical impulses decrease atherosclerotic deposition in the abdominal aorta. (J Card Surg 2003; 18:47-58) [source]

Aortic Dissection and Third-Degree Atrioventricular Block in a Patient With a Hypertensive Crisis

JOURNAL OF CLINICAL HYPERTENSION, Issue 1 2008
Nikolaos Lionakis MD
A 55-year-old man with a history of uncontrolled hypertension was admitted because of an episode of severely elevated blood pressure. An electrocardiogram revealed complete atrioventricular block while imaging showed a dissecting aneurysm of the descending thoracic and abdominal aorta, type B according to the Stanford classification. Laboratory tests revealed significant increases in serum C-reactive protein. Coronary arteriography was performed and was negative for coronary artery disease. A VDD pacemaker was placed, and a combination of 4 antihypertensive agents was used as treatment. Type B aortic dissection may present with a wide range of manifestations. The authors suggest that measurement of C-reactive protein may be used in hypertensive patients to help reflect vascular injury and its degree, progression, and prognosis. Disorders of intraventricular conductivity are rarely seen in both types of dissection of the aorta (type A, B). Atrioventricular conductivity disorders that result in complete atrioventricular block have been reported only in patients with type A dissection (before the bifurcation of the subclavian artery). In this particular case, however, the authors diagnosed an atrioventricular conductivity disorder causing atrioventricular block in a patient with type B dissection. Consequently, the authors speculate that myocardial fibrosis, as a result of long-standing hypertension, could be the main pathogenetic mechanism leading to the development of such phenomena, resulting from a potential expanding of the fibrotic process to the atrioventricular conduction system. [source]

Three-dimensional sonography in the prenatal diagnosis of aortic arch abnormalities

JOURNAL OF CLINICAL ULTRASOUND, Issue 5 2009
RDMS, Sifa Turan MD
Abstract Purpose To assess the added value of 3-dimensional (3D) echocardiography with spatiotemporal image correlation (STIC) in the diagnosis of aortic arch abnormalities in fetuses with isolated abnormal upper thoracic 3-vessel view (3VV). Method A total of 3,420 women underwent a targeted anatomic survey at 18,22 weeks' gestation in a 1-year period. An isolated abnormal upper thoracic 3VV detected on 2-dimensional (2D) imaging was followed up by conventional 2D echocardiography and 3D fetal echocardiography with STIC. Offline reconstruction by a second operator blinded to the suspected diagnosis was performed. Neonatal echocardiography and MRI with 3D reconstruction were performed to verify the prenatal diagnosis. Result Of the 3,420 patients referred, 4 had an isolated abnormal 3VV (0.09%). A right-sided aortic arch (RAA, n = 3) and double aortic arch (DAA, n = 1) were suspected. In all aortic arch abnormalities, 3D fetal echocardiography and STIC correctly identified RAA with aberrant left subclavian artery in 3 cases and DAA in 1 case with a degree of definition that was equal to the confirmatory postnatal echocardiography and 3D MRI. Conclusion Although the 2D upper 3VV is a powerful screening tool for isolated aortic arch abnormalities, 3D fetal echocardiography with STIC allows an accurate prenatal characterization of the abnormality to a degree that is typically attainable only by post partum imaging. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source]

Electromyography of scoliotic patients treated with a brace

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2003
Daniel Odermatt
Abstract When a brace is used to correct spinal deviation, patients may seek to ease the discomfort from the pressure exerted by the orthosis by actively recruiting specific trunk muscles. The effect of bracing on trunk electromyography (EMG) has been reported in only one study where a limited number of electrodes were placed mainly in the thoracic region. Our hypothesis was that a multi-electrode mapping of the activity of the thoracic, lumbar, and abdominal trunk muscles would provide a more representative picture of the muscular reaction in response to bracing. With a larger number of EMG measuring sites, the presence of any brace-induced trunk muscle activity should be detected. Therefore, EMG signals of 11 adolescent idiopathic scoliosis patients who had been undergoing Boston brace treatment for 0.7-3 years were collected during four isometric tasks to evaluate the response of trunk muscles in the minutes following the application of the brace. Twenty-two pairs of bipolar electrodes were used to measure the EMG signals of the main superficial trunk muscles during four isometric tasks. EMG signals of trunk muscles were compared in braced and unbraced conditions. Brace-induced increases in EMG activity were significant in 43% of the individual measurements and in three of the four tasks for the group mean values. Increases were greater in the lumbar area, especially on the convex side of the secondary (lumbar) curve. These results thus suggest that immediately following the application of the brace, significant muscular responses can be observed in some patients. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

Cervical epidural analgesia via a thoracic approach using nerve-stimulation guidance in adult patients undergoing total shoulder replacement surgery

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2007
B. C. H. Tsui
Background:, Continuous cervical epidural anesthesia can provide excellent peri- and post-operative analgesia, although several factors prevent its widespread use. Advancing catheters from thoracic levels to the cervical region may circumvent these barriers, provided they are accurately positioned. We hypothesize that guiding catheters from thoracic to cervical regions using low-current epidural stimulation will have a high success rate and enable excellent analgesia in adults undergoing total shoulder arthroplasty. Methods:, After Institutional Review Board approval, adult patients were studied consecutively. A 17-G Tuohy needle was inserted into the thoracic epidural space using a right paramedian approach with loss of resistance. A 20-G styletted epidural catheter, with an attached nerve stimulator, was primed with saline and a 1,10 mA current was applied as it advanced in a cephalad direction towards the cervical spine. Muscle twitch responses were observed and post-operative X-ray confirmed final placement. After a test dose, an infusion (2,8 ml/h) of ropivacaine 2 mg/ml and morphine 0.05 mg/ml (or equivalent) was initiated. Verbal analog pain scale scores were collected over 72 h. Results:, Cervical epidural anesthesia was performed on 10 patients. Average current required to elicit a motor response was 4.8 ± 2.0mA. Post-operative X-ray of catheter positions confirmed all catheter tips reached the desired region (C4,7). The technical success rate for catheter placement was 100% and excellent pain control was achieved. Catheters were positioned two to the left, four to the right and four to the midline. Conclusion:, This epidural technique provided highly effective post-operative analgesia in a patient group that traditionally experiences severe post-operative pain and can benefit from early mobilization. [source]

Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 36

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2003
F Logullo
Diabetic lumbosacral radiculoplexus neuropathy (DLRPN) is a well-recognized subacute painful asymmetric proximal and distal lower limb neuropathy. DLRPN may be associated with thoracic and upper limb involvement. The latter may appear as compression mononeuropathies and as a more diffuse disorder consistent with cervicobrachial radiculoplexus neuropathy (DCRPN). We performed a multiperspective study of patients, seen between 1999,2002, with diabetes and acute or subacute onset and progression of unilateral or asymmetric bilateral proximal and/or distal weakness in lower and/or upper limbs. We excluded patients who had compression mononeuropathies or radiculopathies, multineuropathies or asymmetric poly(radiculo)neuropathies, motor neuron disease as suggested by clinical, electrophysiological, laboratory or MRI findings. During the study period we observed 18 patients with diabetic radiculoplexus neuropathy. Most patients were middle-aged or elderly and male preponderance was noted. Ten patients had DLPRN, 6 both DLPRN and DCRPN, 2 isolated DCRPN. DCRPN affected prevalently hands and forearms, unilaterally in 3 patients, bilaterally in 5, and improved spontaneously but incompletely in most patients in several months. Pain was not a prominent feature except for one patient. We conclude that diabetic radiculoplexus neuropathy may involve the cervicobrachial regions not only in association with DLRPN but also alone. [source]

CLINICAL, MRI, AND SKIN BIOPSY FINDINGS IN SENSORY GANGLIONOPATHIES

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2000
A. Sghirlanzoni
Unlike peripheral motor disorders, sensory disturbances are rarely diagnosed by the probable site of pathology. This approach is useful in the differential diagnosis between chronic sensory axonal neuropathies and ganglionopathies, in which routine clinical and neurophysiological evaluation alone often do not provide definite clues. Methods: Thirty patients with peripheral sensory disturbances were investigated. MRI was performed at cervical level in all cases. Four patients also underwent thoracic and lumbar MRI. Seventeen patients underwent skin biopsy at the proximal thigh and the distal leg. In 4 of them, further skin biopsies were taken at C5 dermatome and at the hand. Density of intra-epidermal nerve fibers (IENF) was quantified. Results: In 22 patients, sensory ganglionopathy was suspected. Disease was idiopathic in 7 cases; paraneoplastic in 3 cases; and associated with Sjögren, AIDS, autoimmune chronic hepatitis, and cisplatin neurotoxicity in 4 cases. One patient had a hereditary sensory autonomic neuropathy. Four patients had vitamin E deficiency and 3 patients a spinocerebellar syndrome. In 8 patients, sensory axonal neuropathy related to diabetes, alcoholism, and AIDS on antiretroviral treatment, and monoclonal gammopathy of undetermined significance was diagnosed. MRI findings: All ganglionopathy patients showed posterior columns hyperintensity on T2-weighted MRI. Conversely, MRI was negative in all axonal sensory neuropathy patients. Skin biopsy findings: In neuropathies, IENF density was significantly lower at the distal leg than at the proximal thigh, while ganglionopathies did not show any change with respect to the rostral:caudal orientation. A similar pattern of epidermal denervation was observed in the arm. Discussion: The degeneration of both central and peripheral sensory pathway in a fashion that is not length-dependent localizes the disease to T-shaped sensory neurons Early ataxia and cutaneous sensory symptoms involving the proximal regions of the body reflect this pattern of denervation and should prompt the diagnosis of ganglionopathy. This can be confirmed by T2-weighted hyperintensity in the posterior columns and a distinct pattern of IENF loss. [source]

Contribution of indirect computed tomographic venography to the diagnosis of postpartum venous thromboembolism

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 9 2008
M. P. REVEL
Summary.,Background:,The diagnostic value of indirect computed tomographic venography (CTV), following thoracic computed tomographic angiography (CTA), has not been specifically evaluated in postpartum patients with suspected pulmonary embolism. Objectives: To assess the diagnostic value of CTV in postpartum venous thromboembolism. Methods: We reviewed all CTA and CTV procedures performed during the last 7 years in our institution for suspected pulmonary embolism during the postpartum period. We focused on the quality of CTA, the rates of positive CTA and isolated positive CTV findings, and alternative diagnoses provided by CTV. Results: Fifty-five CTA and 33 CTV procedures were performed for suspected pulmonary embolism in 47 patients referred between 24 h and 2 months after Cesarean (34 patients) or vaginal (13 patients) delivery. Of the 33 patients who had both CTA and CTV, seven had positive CTA findings and four had isolated positive CTV findings. Thus, the absolute increase in the venous thromboembolism detection rate following CTV was 12.1% [95% confidence interval (CI) 4.0,29.1]. Subcapsular hematoma of the liver or spleen was found on CTV in another two patients without venous thromboembolism. Consequently, CTV had a direct impact on clinical management in six of 33 patients (18%). Conclusion: Our results suggest that postpartum patients with suspected pulmonary embolism have a significant rate of pelvic vein thrombosis and that the use of CTV leads to a 31% relative increase in the detection rate of venous thromboembolism as compared to CTA alone in these patients. [source]

Hemorrhagic bile pleuritis and peritonitis secondary to traumatic common bile duct rupture, diaphragmatic tear, and rupture of the spleen in a dog

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 6 2008
Gordon D. Peddle VMD
Abstract Objective, To describe the diagnosis and successful treatment of bile pleuritis and peritonitis secondary to traumatic rupture of the common bile duct and a diaphragmatic tear in a young dog. Case Summary, A 1-year-old German Shepherd dog was referred for evaluation of vomiting and icterus 4 days after being hit by a car. Thoracic radiographs, thoracic and abdominal ultrasonographic examinations, thoraco- and abdominocentesis, and positive contrast celiogram indicated hemorrhagic pleuritis and peritonitis, left dorsal diaphragmatic tear, and rupture and infarct of the spleen. Surgical exploration of the abdomen confirmed these findings in addition to a circumferential tear of the common bile duct, leading to a diagnosis of hemorrhagic bile pleuritis and peritonitis. Aerobic and anaerobic bacterial culture of the abdominal fluid yielded no growth. Surgical correction of the traumatic injuries was achieved via common bile duct anastomosis, cholecystojejunostomy, repair of the diaphragm, and splenectomy. The dog developed postoperative signs consistent with aspiration pneumonia but was successfully treated and discharged from the hospital. Clinical signs and laboratory abnormalities resolved and the dog was alive and healthy 8 months after discharge. New or Unique Information Provided, Bile pleuritis is rare in dogs and cats and is usually associated with penetrating, not blunt, abdominal trauma. Multiple organ injury in cases of traumatic bile duct rupture is uncommon; in this dog, rupture of the common bile duct was accompanied by rupture of the diaphragm and spleen. [source]

Stage Migration in Dogs with Lymphoma

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2007
Andrea B. Flory
Background: Various diagnostic tests have been used to assign a clinical stage to dogs with lymphoma. As more sensitive staging methods are introduced, dogs are reclassified as having a higher disease stage, thereby affecting comparisons of dogs across differently staged clinical trials, and possibly, prognosis. Hypothesis: The addition of more sensitive staging tests causes stage migration in dogs with lymphoma. Animals: Fifty-nine client-owned dogs with previously untreated cytologically or histologically confirmed lymphoma Methods: For every dog, the World Health Organization stage classification (I-V) was based on 5 groupings of various diagnostic tests: A (physical examination [PE] and quantitative blood count [QBC]), B (PE, QBC, thoracic and abdominal radiographs), C (PE, complete blood count with blood-smear evaluation [CBC], thoracic and abdominal radiographs), D (PE, CBC, thoracic radiographs, abdominal ultrasound), and E (PE, CBC, thoracic radiographs, abdominal ultrasound, and bone-marrow cytology). Dogs were treated with doxorubicin-based protocols. Results: There was migration between all of the staging methods except D to E. However, the stage was not a predictor of remission rate, remission duration, or survival, regardless of staging method used. Conclusions and Clinical Importance: These data emphasized the need for standardized methods to determine the clinical stage in dogs with lymphoma. [source]