Sample records for cervical spondylotic myelopathy

  1. Pathogenesis of cervical spondylotic myelopathy.

    PubMed Central

    Levine, D N

    1997-01-01

    OBJECTIVE: To determine whether either of two mechanical theories predicts the topographic pattern of neuropathology in cervical spondylotic myelopathy (CSM). The compression theory states that the spinal cord is compressed between a spondylotic bar anteriorly and the ligamenta flava posteriorly. The dentate tension theory states that the spinal cord is pulled laterally by the dentate ligaments, which are tensed by an anterior spondylotic bar. METHODS: The spinal cord cross section, at the level of a spondylotic bar, is modelled as a circular disc subject to forces applied at its circumference. These forces differ for the two theories. From the pattern of forces at the circumference the distribution of shear stresses in the interior of the disc-that is, over the transverse section of the spinal cord-is calculated. With the assumption that highly stressed areas are most subject to damage, the stress pattern predicted by each theory can be compared to the topographic neuropathology of CSM. RESULTS: The predicted stress pattern of the dentate tension theory corresponds to the reported neuropathology, whereas the predicted stress pattern of the compression theory does not. CONCLUSIONS: The results strongly favour the theory that CSM is caused by tensile stresses transmitted to the spinal cord from the dura via the dentate ligaments. A spondylotic bar can increase dentate tension by displacing the spinal cord dorsally, while the dural attachments of the dentate, anchored by the dural root sleeves and dural ligaments, are displaced less. The spondylotic bar may also increase dentate tension by interfering locally with dural stretch during neck flexion, the resultant increase in dural stress being transmitted to the spinal cord via the dentate ligaments. Flexion of the neck increases dural tension and should be avoided in the conservative treatment of CSM. Both anterior and posterior extradural surgical operations can diminish dentate tension, which may explain their usefulness in CSM. The generality of these results must be tempered by the simplifying assumptions required for the mathematical model. Images PMID:9120444

  2. Cervical spondylotic myelopathy and radiculopathy.

    PubMed

    Truumees, E; Herkowitz, H N

    2000-01-01

    Appropriate management of degenerative cervical spine conditions requires careful elucidation of the presenting clinical syndrome. Because of the pervasiveness of degenerative changes in asymptomatic patients, a clear correlation of symptoms, physical signs, and imaging findings is required before any specific diagnosis can be made. At this time, surgery is not recommended for prophylactic decompression in asymptomatic patients or in those patients with neck pain in the absence of extremity symptoms. In most patients with radiculopathy or mild myelopathy, a trial of nonsurgical management is recommended. Ultimately, patients with neurologic complaints and in whom nonsurgical measures have failed, as well as those with more pronounced myelopathy, should be offered surgical intervention. Selection of the safest, yet sufficient, approach requires a clear understanding of the benefits and expected outcomes. The outlook for patients with both cervical radiculopathy and early myelopathy is good. Radicular symptoms usually improve, but gait and hand changes may not. LF is preferred in younger patients with posterolateral or lateral soft disk herniations, or focal foraminal osteophyte impingement and predominance of upper extremity symptoms. More central 1- or 2-level pathology should be treated with ACDF. Anterior cervical corpectomy should be entertained in patients with nondisk level encroachment and in those with 3 contiguous levels of pathology. This approach is also required in cases of kyphosis and instability. Laminoplasty is indicated in patients with 4 or more levels of stenosis, particularly in those with global conditions such as continuous OPLL or congenital stenosis. In these patients, kyphosis or severe deformity may be addressed with a circumferential approach. PMID:10829188

  3. Gait Analysis in Cervical Spondylotic Myelopathy

    PubMed Central

    Endo, Kenji; Suzuki, Hidekazu; Tanaka, Hidetoshi; Shishido, Takaaki; Yamamoto, Kengo

    2015-01-01

    Study Design Gait analysis of patients with cervical spondylotic myelopathy (CSM) by using a sheet-type gait analysis system. Purpose The aim of this study was to compare the gait patterns of patients with CSM, evaluated by the Nurick grades, and to determine the threshold values of gait parameters predicting the occurrence of a fall by using a gait recorder. Overview of Literature Gait disorder due to CSM may progress to severe paraplegia, following even a minor trauma such as a fall. The indications for the surgery of CSM without severe paralysis remain controversial. The quantitative gait analysis and the decision for decompressive surgery in patients with CSM are important in order to prevent severe paraplegia from a fall. Methods One hundred thirty-two subjects (normal, 34; CSM, 98) underwent gait analysis by using a sensor sheet. Measurements of gait cycle parameters included the step and stride length, step width, foot angle, swing phase, and stance phase. CSM was assessed by Nurick grade. Results Although the clinical symptoms were lacking, Nurick grade 1 had significant abnormalities in the parameters of velocity, step length, and step angle (p<0.05). Regarding the Nurick grade and walking phase, the length of the stance phase was increased to more than 70% of the entire walking cycle in Nurick grade 4. Conclusions Gait analysis was an objective tool for evaluating the gait stability. Our results suggested that when the percentage of the stance phase in the gait cycle increases to above 70%, the CSM patients have an increased fall risk. PMID:26097646

  4. Neurological recovery after surgical decompression in patients with cervical spondylotic myelopathy - a prospective study

    Microsoft Academic Search

    W. Y. Cheung; D. Arvinte; Y. W. Wong; K. D. K. Luk; K. M. C. Cheung

    2008-01-01

    Cervical spondylotic myelopathy is a common clinical problem. No study has examined the pattern of neurological recovery after\\u000a surgical decompression. We conducted a prospective study on the pattern of neurological recovery after surgical decompression\\u000a in patients with cervical spondylotic myelopathy. Patients suffering from cervical spondylotic myelopathy and requiring surgical\\u000a decompression from January 1995 to December 2000 were prospectively included. Upper

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

    Microsoft Academic Search

    Motohiro Kawasaki; Toshikazu Tani; Takahiro Ushida; Kenji Ishida

    2007-01-01

    Background  Degenerative spondylolisthesis of the cervical spine has received insufficient attention in contrast to that of the lumbar\\u000a spine. The authors analyzed the functional significance of anterior and posterior degenerative spondylolisthesis (anterolisthesis\\u000a and retrolisthesis) of the cervical spine to elucidate its role in the development of cervical spondylotic myelopathy (CSM)\\u000a in the elderly.\\u000a \\u000a \\u000a \\u000a Methods  A total of 79 patients aged 65 or

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

    PubMed

    Hoshimaru, Minoru

    2010-01-01

    Patients with cervical spondylotic myelopathy sometimes complain of cognitive dysfunction, which may be coincidence. However, cognitive dysfunction may be related to disorders of the cervical spine and/or spinal cord. This study investigated cognitive dysfunction in patients with cervical spinal disorders. A total of 79 patients with cervical spondylotic myelopathy (40 women and 39 men, mean age 61.2 years) underwent cervical laminoplasty between January 2006 and July 2007. Ten of these 79 patients (7 women and 3 men, mean age 65.2 years) complained of moderate to severe memory disturbances. These 10 patients underwent neuroimaging studies and a battery of neuropsychological tests consisting of the mini-mental state examination, Kohs Block Design Test, Miyake Memory Test, Benton Visual Retention Test (BVRT), and "kana-hiroi" test before and 3 months after surgery. Brain magnetic resonance imaging showed no organic brain lesions in the 10 patients, but single photon emission computed tomography demonstrated reduced regional cerebral blood flow in the posterior cortical areas in eight patients before surgery. Neuropsychological test scores showed statistically significant improvement after surgery in the Kohs Block Design Test and the BVRT, which measure visuospatial perception and reflect the function of the parietal and/or occipital lobes (p < 0.05). The practice effect may have contributed to the neuropsychological improvements, but this study suggests that cervical spinal disorders may affect cognitive functions and that surgical treatment can ameliorate such effects. PMID:20671380

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

    Microsoft Academic Search

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

    2010-01-01

    Surgical treatment of cervical spondylotic myelopathy (CSM) aims to prevent or delay the progression of the disease. Many\\u000a patients are diagnosed in advanced stages of the disease, presenting severe functional disability and extensive radiologic\\u000a changes, which suggests clinical irreversibility. There are doubts about the real benefit of surgery in patients who are seriously\\u000a ill, bedridden or in a wheelchair. The

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

    PubMed Central

    Jia, Wen-yu; Wang, Xia; Chen, Bin; Shahbaz, Muhammad; Nie, Lin; Cheng, Lei

    2015-01-01

    Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM) is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6%) of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6%) patients turned back to normal. Blood pressure of another 37(25.7%) patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics. PMID:26193469

  9. Characterizing Thalamocortical Disturbances in Cervical Spondylotic Myelopathy: Revealed by Functional Connectivity under Two Slow Frequency Bands

    PubMed Central

    Zhou, Fuqing; Wu, Lin; Liu, Xiaojia; Gong, Honghan; Luk, Keith Dip-Kei; Hu, Yong

    2015-01-01

    Background and Purpose Recent advanced MRI studies on cervical spondylotic myelopathy (CSM) revealed alterations of sensorimotor cortex, but the disturbances of large-scale thalamocortical systems remains elusive. The purpose of this study was to characterizing the CSM-related thalamocortical disturbances, which were associated with spinal cord structural injury, and clinical measures. Methods A total of 17 patients with degenerative CSM and well-matched control subjects participated. Thalamocortical disturbances were quantified using thalamus seed-based functional connectivity in two distinct low frequencies bands (slow-5 and slow-4), with different neural manifestations. The clinical measures were evaluated by Japanese Orthopaedic Association (JOA) score system and Neck Disability Index (NDI) questionnaires. Results Decreased functional connectivity was found in the thalamo-motor, -somatosensory, and -temporal circuits in the slow-5 band, indicating impairment of thalamo-cortical circuit degeneration or axon/synaptic impairment. By contrast, increased functional connectivity between thalami and the bilateral primary motor (M1), primary and secondary somatosensory (S1/S2), premotor cortex (PMC), and right temporal cortex was detected in the slow-4 band, and were associated with higher fractional anisotropy values in the cervical cord, corresponding to mild spinal cord structural injury. Conclusions These thalamocortical disturbances revealed by two slow frequency bands inform basic understanding and vital clues about the sensorimotor dysfunction in CSM. Further work is needed to evaluate its contribution in central functional reorganization during spinal cord degeneration. PMID:26053316

  10. Perioperative Risks Associated with Cervical Spondylotic Myelopathy Based on Surgical Treatment Strategies

    PubMed Central

    Macagno, Angel; Liu, Shian; Marascalchi, Bryan J; Yang, Sun; Boniello, Anthony J; Bendo, John A; Lafage, Virginie C

    2015-01-01

    Background Few studies have provided nationwide estimates of patient characteristics and procedure-related complications, or examined postsurgical outcomes for patients with cervical spondylotic myelopathy (CSM) comparatively with respect to surgical approach. The objective of this study is to identify patients at risk for morbidity and mortality directly related with the selected approach, report an overall nation-wide complication rate for each approach against which surgeons can compare themselves, and direct future research to improve patient outcomes. Methods Patients surgically treated for CSM were retrospectively identified using ICD-9-CM codes from the Nationwide Inpatient Sample (NIS) database. Four cohorts were compared for demographics and hospital system-related data: anterior (ACDF, ACCF), posterior decompression without fusion, decompression with posterior fusion, and combined anterior-posterior. Multivariate analysis was also used to determine the odds ratio of morbidity and mortality among the cohorts. Results 54,416 discharges were identified between 2001 and 2010: 34,400 anterior, 9,014 decompression procedures without fusion, 8,741 decompression procedures with posterior fusion, and 2,261 combined anterior-posterior. Groups were statistically different with respect to age, length of hospital stay, mortality, and complications. Groups were statistically different for Deyo score except between posterior decompression only and combined approaches. Using multivariate analysis and adjusting for covariates, the combined (2.74[2.18-3.44]) and laminectomy (1.22[1.04-1.44]) cohorts had an increased risk of mortality when compared to anterior alone. Conclusion These findings are the first to determine the rates and odds of perioperative risks directly related to combined anterior-posterior procedures. This study provides clinically useful data for surgeons to educate patients and direct future research to improve patient outcomes. PMID:26196031

  11. The role of smoking status and collagen IX polymorphisms in the susceptibility to cervical spondylotic myelopathy.

    PubMed

    Wang, Z C; Shi, J G; Chen, X S; Xu, G H; Li, L J; Jia, L S

    2012-01-01

    We investigated a possible association of collagen IX tryptophan (Trp) alleles (Trp2 and Trp3) and smoking with cervical spondylotic myelopathy (CSM) in 172 Chinese patients and 176 age- and gender-matched controls. The smoking status was evaluated by smoking index (SI). The CSM cases had a significantly higher prevalence of Trp2 alleles (Trp2+) than controls (19.8 vs 6.2%, P = 0.002), but the prevalence of Trp3 alleles (Trp3+) was similar between the two groups (23.3 vs 21.6%, P = 0.713). Logistic regression analyses showed that the subjects with Trp2+ had a higher risk for CSM. We thus analyzed whether smoking status influenced the association between Trp2 alleles and CSM risk. Among Trp2+ subjects with an SI less than 100, the smoking status did not influence the effect of risk for SCM [odds ratio (OR) = 1.34, 95% confidential interval (95%CI) = 0.85-2.18, P > 0.05]. When SI increased from 101 to 300, the OR for CSM reached 3.34 (95%CI = 2.11-5.67, P = 0.011); when SI was more than 300, the OR for CSM reached 5.56 (95%CI = 3.62-7.36, P < 0.001). Among Trp2- subjects with SI more than 300, the OR for CSM increased 2.14 (95%CI = 1.15-4.07, P = 0.024). We found a significant association between the Trp2 alleles and CSM risk and smoking amplifies this risk, suggesting that smoking abstinence is important for reducing CSM occurrence in subjects with high genetic risk. PMID:22614351

  12. Cervical spondylotic amyotrophy

    Microsoft Academic Search

    Sheng-Dan Jiang; Lei-Sheng Jiang; Li-Yang Dai

    2011-01-01

    Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower\\u000a limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One\\u000a is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn\\u000a cell. Cervical spondylotic amyotrophy is classified

  13. Use of electrical stimulation and exercise to increase muscle strength in a patient after surgery for cervical spondylotic myelopathy.

    PubMed

    Pastor, Donna

    2010-02-01

    Current literature offers little research on the restoration of function in patients following anterior decompression surgery for cervical spondylotic myelopathy. This case report describes the functional outcomes for a physical therapy program using a protocol of alternate day electrical stimulation to hip and knee extensor muscles along with exercise. The protocol, designed to increase lower extremity strength necessary for ambulation in a patient who was status post anterior cervical decompression and fusion surgery, consisted of treatment sessions five times per week for 6 weeks and included electrical stimulation [medium frequency alternating current (MFAC)] in conjunction with active range of motion exercises, followed by functional mobility training and gait training. Outcome measures included Manual Muscle testing, the Functional Independence Measure (FIM), and the Walking Index for Spinal Cord Injuries (WISCI). Improvement was demonstrated in all three measures following the use of the treatment regimen, suggesting there may be a benefit to the use of electrical stimulation and exercise to increase lower extremity strength and improve gait outcomes in this population. Definitive conclusions regarding the correlation between this treatment protocol and the outcomes achieved are limited by the case report design. Carefully designed research studies are needed to demonstrate the effectiveness of the protocol. PMID:20067363

  14. Operative Outcomes for Cervical Myelopathy and Radiculopathy

    PubMed Central

    Galbraith, J. G.; Butler, J. S.; Dolan, A. M.; O'Byrne, J. M.

    2012-01-01

    Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications. PMID:22046575

  15. Evaluation of Anterior Cervical Reconstruction with Titanium Mesh Cages versus Nano-Hydroxyapatite/Polyamide66 Cages after 1- or 2-Level Corpectomy for Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 117 Patients

    PubMed Central

    Zhang, Yuan; Quan, Zhengxue; Zhao, Zenghui; Luo, Xiaoji; Tang, Ke; Li, Jie; Zhou, Xu; Jiang, Dianming

    2014-01-01

    Objective To retrospectively compare the efficacy of the titanium mesh cage (TMC) and the nano-hydroxyapatite/polyamide66 cage (n-HA/PA66 cage) for 1- or 2-level anterior cervical corpectomy and fusion (ACCF) to treat multilevel cervical spondylotic myelopathy (MCSM). Methods A total of 117 consecutive patients with MCSM who underwent 1- or 2-level ACCF using a TMC or an n-HA/PA66 cage were studied retrospectively at a mean follow-up of 45.28±12.83 months. The patients were divided into four groups according to the level of corpectomy (1- or 2-level corpectomy) and cage type used (TMC or n-HA/PA66 cage). Clinical and radiological parameters were used to evaluate outcomes. Results At the one-year follow-up, the fusion rate in the n-HA/PA66 group was higher, albeit non-significantly, than that in the TMC group for both 1- and 2-level ACCF, but the fusion rates of the procedures were almost equal at the final follow-up. The incidence of cage subsidence at the final follow-up was significantly higher in the TMC group than in the n-HA/PA66 group for the 1-level ACCF (24% vs. 4%, p?=?0.01), and the difference was greater for the 2-level ACCF between the TMC group and the n-HA/PA66 group (38% vs. 5%, p?=?0.01). Meanwhile, a much greater loss of fused height was observed in the TMC group compared with the n-HA/PA66 group for both the 1- and 2-level ACCF. All four groups demonstrated increases in C2-C7 Cobb angle and JOA scores and decreases in VAS at the final follow-up compared with preoperative values. Conclusion The lower incidence of cage subsidence, better maintenance of the height of the fused segment and similar excellent bony fusion indicate that the n-HA/PA66 cage may be a superior alternative to the TMC for cervical reconstruction after cervical corpectomy, in particular for 2-level ACCF. PMID:24789144

  16. Cervical Myelopathy in Rheumatoid Arthritis

    PubMed Central

    Mukerji, N.; Todd, N. V.

    2011-01-01

    Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common. PMID:22203899

  17. Correlation between degree of subvoxel spinal cord compression measured with super-resolution tract density imaging and neurological impairment in cervical spondylotic myelopathy.

    PubMed

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

    2015-06-01

    OBJECT The purpose of this study was to explore the use of super-resolution tract density images derived from probabilistic diffusion tensor imaging (DTI) tractography of the spinal cord as an imaging surrogate for microstructural integrity and functional impairment in patients with cervical spondylosis. METHODS Structural MRI and DTI images were collected for 27 patients with cervical spondylosis with (n= 21) and without (n= 6) functional impairment as defined by the modified Japanese Orthopaedic Association Scale (mJOA). DTI was performed axially through the site of compression in a total of 20 directions with 10 averages. Probabilistic tractography was performed at 0.5-mm isotropic spatial resolution using the streamline technique combined with constrained spherical deconvolution. The following measurements were calculated for each patient: maximum tract density at the site of compression, average tract density in rostral normal-appearing spinal cord, and the ratio of maximum density to normal density. RESULTS Compared with normal tissue, the site of compression exhibited elevated fiber tract density in all patients, and a higher fiber tract density was also noted in focal areas at the site of compression in patients with functional impairment. There was a strong negative correlation between maximum tract density and mJOA score (R(2)= 0.6324, p < 0.0001) and the ratio of maximum tract density to normal tract density (R(2)= 0.6647, p < 0.0001). When grouped according to severity of neurological impairment (asymptomatic, mJOA score of 18; mild, mJOA score of 15-17; moderate, mJOA score of 11-14; and severe, mJOA score < 11), the results showed a significant difference in the ratio between severe and both no impairment (p= 0.0009) and any impairment (p= 0.036). A ratio of maximum fiber tract density at the site of compression to fiber tract density at C-2 greater than 1.45 had 82% sensitivity and 70% specificity for identifying patients with moderate to severe impairment (ROC AUC= 0.8882, p= 0.0009). CONCLUSIONS These results support the use of DTI as a surrogate for determining spinal cord integrity in patients with cervical spondylosis. Probabilistic tractography provides spinal cord microstructural information that can help discern clinical status in cervical spondylosis patients with varying degrees of neurological impairment. PMID:25746116

  18. Cox Decompression Manipulation and Guided Rehabilitation of a Patient With a Post Surgical C6-C7 Fusion With Spondylotic Myelopathy and Concurrent L5-S1 Radiculopathy

    PubMed Central

    Joachim, George C.

    2014-01-01

    Objective The purpose of this case report is to describe combined treatment utilizing Cox distraction manipulation and guided rehabilitation for a patient with spine pain and post-surgical C6-7 fusion with spondylotic myelopathy and L5-S1 radiculopathy. Clinical features A 38-year-old man presented to a chiropractic clinic with neck pain and a history of an anterior cervical spine plate fusion at C6-7 after a work related accident 4 years earlier. He had signs and symptoms of spondolytic myelopathy and right lower back, right posterior thigh pain and numbness. Intervention and outcome The patient was treated with Cox technique and rehabilitation. The patient experienced a reduction of pain on a numeric pain scale from 8/10 to 3/10. The patient was seen a total of 12 visits over 3 months. No adverse effects were reported. Conclusions A patient with a prior C6-7 fusion with spondylotic myelopathy and concurrent L5-S1 radiculopathy improved after a course of rehabilitation and Cox distraction manipulation. Further research is needed to establish its efficiency. PMID:25685119

  19. Conservative treatment with hyperbaric oxygen therapy for cervical spondylotic amyotrophy

    Microsoft Academic Search

    K Tofuku; H Koga; K Yone; S Komiya

    2011-01-01

    Study design:Small case series of patients with cervical spondylotic amyotrophy (CSA) managed by conservative treatment with hyperbaric oxygen (HBO) therapy.Objective:To study the effects of conservative treatment with HBO therapy of CSA patients.Setting:Department of Orthopaedic Surgery, Imakiire General Hospital, Kagoshima, Japan.Methods:This study included 10 patients with CSA who underwent rehabilitation, including cervical traction and muscle exercise, for some period of time

  20. Cervical Stenosis, Myelopathy and Radiculopathy

    MedlinePLUS

    ... the entire cervical spinal cord through two operations: laminectomy and laminoplasty. In both of these operations, the ... portions of the back of the vertebra. In laminectomy, the back of the vertebra is completely removed. ...

  1. Anterior decompression in the management of unilateral cervical spondylotic amyotrophy.

    PubMed

    Zhang, Jing Tao; Yang, Da Long; Shen, Yong; Zhang, Ying Ze; Wang, Lin Feng; Ding, Wen Yuan

    2012-12-01

    Cervical spondylotic amyotrophy is a rare clinical condition. The purpose of this study was to investigate the effects of anterior decompression in patients with unilateral upper-extremity amyotrophy caused by cervical spondylosis. The authors retrospectively analyzed the records of 31 patients (23 men and 8 women) who underwent anterior decompressive surgery for cervical spondylotic amyotrophy at the authors' institution between 2000 and 2011. Demographic characteristics, pre- and postoperative results of imaging studies, and postoperative muscle power improvement were reviewed at a mean follow-up of 22.2 months (range, 14-36 months). Patients were divided into proximal (n=21) and distal (n=10) types according to the most severely atrophic muscle, and the 2 groups were compared statistically. The most commonly affected intervertebral level in proximal-type patients was C4-C5, whereas that in distal-type patients was C5-C6. Impingements against the ventral nerve root and anterior horn were observed in 22 and 25 cases, respectively, with 16 cases having both impingements. Eighty-one percent of proximal-type patients gained 1 or more grades of muscle power improvement on manual muscle testing, whereas 40% of distal-type patients improved. Within 15 postoperative days, 57% of proximal-type patients attained subjective or objective improvement of muscle power, whereas all distal-type patients failed to improve. Anterior decompression was effective for most patients with unilateral cervical spondylotic amyotrophy, although postoperative muscle power improvement in distal-type patients was inferior to that in proximal-type patients. Furthermore, compared with the proximal type, the distal type showed a slower postoperative recovery. PMID:23218638

  2. Surgical results of anterior corpectomy in the aged patients with cervical myelopathy.

    PubMed

    Lu, Jun; Wu, Xiaotao; Li, Yonggang; Kong, Xiangfei

    2008-01-01

    Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications of anterior corpectomy in aged patients with cervical myelopathy. Twenty patients 70 years of age or older who underwent anterior corpectomy, titanium mesh cage (TMC) reconstruction and anterior plate fixation for the treatment of compressive cervical myelopathy were reviewed. The average age at the time of operation was 75 years. Neurologic deficits before and after surgery were assessed using a scoring system proposed by the Japanese Orthopedic Association (JOA Score). Clinical results and post-operative complications were compared with those of patients 69 years old or younger as a control. Pre-operative Radiologic evaluation of every patient consisted of anterior-posterior, lateral, bilateral oblique, flextion, and extension radiographs, computed tomography and magnetic resonance imaging of the cervical spine. Any factor causing spinal cord compression and the sign of cervical instability were recorded. Surgical-related complications occurred in seven patients in the aged group. The incidence of complications was 35% in the aged patient group and 9.7% in the control group respectively. Although the difference was striking, no statistical significance was found between the two groups. One patient died of respiratory failure resulting from pulmonary infection. The mortality rate was 5%. The pre-operative mean JOA score was 9.3 (from 3 to 14) in the aged patient group. Nineteen patients were followed at least 2 years and the mean JOA score was 13.4 (from 8 to 17). 68.4% of the aged patients achieved a good or excellent result. There was no statistical difference in the recovery rate of JOA score between the aged group (58.1%) and control group (67.0%). In the pre-operative radiographs, the incidence of cervical instability was much higher in the control group (32%) than in the aged group (5%) and multilevel cord compression caused by posterior disc space osteophytes was more common in the aged group. Anterior corpectomy combined with TMC fusion and plate fixation provides favorable neurologic recovery even in the patients over 70 years old. However, the incidence of surgical related complications shows a conspicuous increasing in the aged patients. Overcompensation mechanism for cervical instability is the probable cause of degenerative cervical spondylotic myelopathy in aged patients. PMID:17972117

  3. Influence of laminectomy on the course of cervical myelopathy

    Microsoft Academic Search

    K. Gorter

    1976-01-01

    Summary The pathogenesis of cervical myelopathy resulting from cervical spondylarthrosis seems to be the result of intermittent compression of the cervical cord and its feeding arteries. In the literature proof is given that both factors play an important role. By laminectomy or ventral fusion a regression of the neurological disability can be obtained. In our series of 75 patients there

  4. Posterior Cervical Inclinatory Foraminotomy for Spondylotic Radiculopathy Preliminary

    PubMed Central

    Chang, Jae-Chil; Choi, Soon-Kwan

    2011-01-01

    Posterior cervical foraminotomy is an attractive therapeutic option in selected cases of cervical radiculopathy that maintains cervical range of motion and minimize adjacent-segment degeneration. The focus of this procedure is to preserve as much of the facet as possible with decompression. Posterior cervical inclinatory foraminotomy (PCIF) is a new technique developed to offer excellent results by inclinatory decompression with minimal facet resection. The highlight of our PCIF technique is the use of inclinatory drilling out for preserving more of facet joint. The operative indications are radiculopathy from cervical foraminal stenosis (single or multilevel) with persistent or recurrent root symptoms. The PCIFs were performed between April 2007 and December 2009 on 26 male and 8 female patients with a total of 55 spinal levels. Complete and partial improvement in radiculopathic pain were seen in 26 patients (76%), and 8 patients (24%), respectively, with preserving more of facet joint. We believe that PCIF allows for preserving more of the facet joint and capsule when decompressing cervical foraminal stenosis due to spondylosis. We suggest that our PCIF technique can be an effective alternative surgical approach in the management of cervical spondylotic radiculopathy. PMID:21716632

  5. Clinical outcomes of microendoscopic decompression surgery for cervical myelopathy

    PubMed Central

    Yoshida, Munehito; Yamada, Hiroshi; Nakagawa, Yukihiro; Maio, Kazuhiro; Kawai, Masaki; Iwasaki, Hiroshi

    2009-01-01

    Retrospective study on the results of microendoscopic decompression surgery for the treatment of cervical myelopathy. The purpose of this study was to describe the microendoscopic laminoplasty (MEL) technique as the surgical method in the treatment of cervical myelopathy, and to document the clinical outcomes for MEL surgery. Endoscopic surgery poses several challenges for the aspiring endoscopic surgeons, the most critical of which is mastering hand–eye coordination. With training in live animal and cadaver surgery, the technical progress has reduced the problem of morbidity following surgery. The authors have performed microendoscopic decompression surgery on more than 2,000 patients for lumbar spinal canal stenosis. Fifty-one patients underwent the posterior decompression surgery using microendoscopy for cervical myelopathy at authors’ institute. The average age was 62.9 years. The criteria for exclusion were cervical myelopathy with tumor, trauma, severe ossification of posterior longitudinal ligament, rheumatoid arthritis, pyogenic spondylitises, destructive spondylo-arthropathies, and other combined spinal lesions. The items evaluated were neurological evaluation, recovery rates; these were calculated following examination using the Hirabayashi’s method with the criteria proposed by the Japanese Orthopaedic Association scoring system (JOA score). The mean follow-up period was 20.3 months. The average of JOA score was 10.1 points at the initial examination and 13.6 points at the final follow-up. The average recovery rate was 52.5%. The recovery rate according to surgical levels was, respectively, 56.5% in one level, 46.3% in two levels and 54.1% in more than three levels. The complications were as follows: one patient sustained a pin-hole-like dura mater injury inflicted by a high-speed air-drill during surgery, one patient developed an epidural hematoma 3 days after surgery, and two patients had the C5 nerve root palsy after surgery. The epidural hematoma was removed by the microendoscopy. All two C5 palsy improved with conservative therapy, such as a neck collar. These four patients on complications have returned to work at the final follow-up. This observation suggests that the clinical outcomes of microendoscopic surgery for cervical myelopathy were excellent or showed good results. This minimally invasive technique would be helpful in choosing a surgical method for cervical myelopathy. PMID:19956984

  6. Cervical myelopathy induced by pseudogout in ligamentum flavum and retro-odontoid mass: a case report

    Microsoft Academic Search

    S-H Lin; E-T Hsieh; T-Y Wu; C-W Chang

    2006-01-01

    Study design:Retrospective case study.Objectives:Report a rare case of cervical myelopathy induced by calcium pyrophosphate dehydrate (CPPD) deposition in multiple cervical levels.Setting:An area teaching hospital in Taiwan.Method:A patient with cervical myelopathy was evaluated by computerized tomography (CT) scan and magnetic resonance (MR) image. CPPD deposition known as pseudogout was diagnosed and approved by a polarized microscope.Result:A prominent hypertrophy of ligmentum flavum

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

    PubMed

    Ek?i, Murat ?akir; Özcan Ek?i, Emel Ece; Y?lmaz, Baran; Tokta?, Zafer Orkun; Konya, Deniz

    2015-01-01

    Cervical myelopathy (CM) is mostly a degenerative process ending in myelopathic and/or radiculopathic syndromes. On T2-weighted magnetic resonance imaging (MRI), CM appears as a hyperintense area near the spondylotic spine. This high intensity signal depends on the impact of outer forces and their duration. It also determines the prognosis of the surgical candidate. A 40-year-old male patient admitted to our clinic with right upper extremity weakness and hypoesthesia that had started 2 months earlier. On neurological examination there was 2/5 motor weakness of right biceps brachii, and hypoesthesia over right C6 dermatome. Right upper extremity deep tendon reflexes were hypoactive, but lower ones were hyperactive. After clinical and radiological work-up, preliminary diagnosis was directed to a spinal intramedullary tumor. Total resection of the herniated cervical disc fragment and the mass lesion was managed. Pathology of the mass lesion was compatible with subacute infarct tissue and inflammatory response. Final diagnosis was CM under effect of cervical disc herniation. Contrast-enhanced spinal cord myelopathic lesions are very rare and resemble much more tumors and inflammatory processes. However, the principal treatment approach totally differs depending on pathology. When there are both a disc herniation and a high clinical suspicion; biopsy should be delayed. The most probable solution will be surgery for the disc disease with thorough preoperative scanning of vascular malformations; clinical and radiological close follow-up after surgery. Biopsy or surgical resection can be performed if patient deteriorates despite the primary surgery. PMID:25972718

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

    SciTech Connect

    Modi, Manish, E-mail: modim72@yahoo.co [PGIMER, Department of Neurology (India); Bapuraj, J. Rajiv [University Hospital, Department of Neuroradiology (United States); Lal, Anupam [PGIMER, Department of Radiodiagnosis (India); Prabhakar, S. [PGIMER, Department of Neurology (India); Khandelwal, N. [PGIMER, Department of Radiodiagnosis (India)

    2010-12-15

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

  9. Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

    Microsoft Academic Search

    Jun Lu; Xiaotao Wu; Yonggang Li; Xiangfei Kong

    2008-01-01

    Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years\\u000a old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate\\u000a the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications\\u000a of anterior corpectomy in aged

  10. Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: a meta-analysis of clinical and radiological outcomes.

    PubMed

    Lee, Chang-Hyun; Lee, Jaebong; Kang, James D; Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2015-06-01

    OBJECT Posterior cervical surgery, expansive laminoplasty (EL) or laminectomy followed by fusion (LF), is usually performed in patients with multilevel (? 3) cervical spondylotic myelopathy (CSM). However, the superiority of either of these techniques is still open to debate. The aim of this study was to compare clinical outcomes and postoperative kyphosis in patients undergoing EL versus LF by performing a meta-analysis. METHODS Included in the meta-analysis were all studies of EL versus LF in adults with multilevel CSM in MEDLINE (PubMed), EMBASE, and the Cochrane library. A random-effects model was applied to pool data using the mean difference (MD) for continuous outcomes, such as the Japanese Orthopaedic Association (JOA) grade, the cervical curvature index (CCI), and the visual analog scale (VAS) score for neck pain. RESULTS Seven studies comprising 302 and 290 patients treated with EL and LF, respectively, were included in the final analyses. Both treatment groups showed slight cervical lordosis and moderate neck pain in the baseline state. Both groups were similarly improved in JOA grade (MD 0.09, 95% CI -0.37 to 0.54, p = 0.07) and neck pain VAS score (MD -0.33, 95% CI -1.50 to 0.84, p = 0.58). Both groups evenly lost cervical lordosis. In the LF group lordosis seemed to be preserved in long-term follow-up studies, although the difference between the 2 treatment groups was not statistically significant. CONCLUSIONS Both EL and LF lead to clinical improvement and loss of lordosis evenly. There is no evidence to support EL over LF in the treatment of multilevel CSM. Any superiority between EL and LF remains in question, although the LF group shows favorable long-term results. PMID:25815808

  11. Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies

    Microsoft Academic Search

    Gaizka Bilbao; Melchor Duart; Juan Jose Aurrecoechea; Iñigo Pomposo; Alfonso Igartua; Gregorio Catalán; Maria Luisa Jauregui; Jesus Garibi

    2010-01-01

    Background  Cervical corpectomy is a common procedure in spondylosis. It is normally a well-tolerated surgery and clinical improvement\\u000a is widely described. However, it is associated with potential risky complications (subsidence, clinical deterioration, vertebral\\u000a artery injury...); thus, a judicious surgical indication and a good technique are required.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We revised retrospectively the clinical evolution and complications of 71 spondylotic corpectomies in a series

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

    PubMed Central

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

    2007-01-01

    Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients’ quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screening test for somatization, HADS, MMPI-2 scale 1 (Hypochondriasis), and self reported severity of symptoms 1 year after treatment. There was no significant difference in initial clinical presentation or demographic characteristics between the patients treated by surgical decompression and those treated by non-surgical means. There was a striking and statistically significant improvement in all symptoms attributed to the fibromyalgia syndrome in the surgical patients but not in the non-surgical patients at 1 year following the treatment of cervical myelopathy (P ? 0.018–0.001, Chi-square or Fisher’s exact test). At the 1 year follow-up, there was a statistically significant improvement in both physical and mental quality of life as measured by the SF-36 score for the surgical group as compared to the non-surgical group (Repeated Measures ANOVA P < 0.01). There was a statistically significant improvement in the scores from Scale 1 of the MMPI-2 and the screening test for somatization disorder, and the anxiety and depression scores exclusively in the surgical patients (Wilcoxon signed rank, P < 0.001). The surgical treatment of cervical myelopathy due to spinal cord or caudal brainstem compression in patients carrying the diagnosis of fibromyalgia can result in a significant improvement in a wide array of symptoms usually attributed to fibromyalgia with attendant measurable improvements in the quality of life. We recommend detailed neurological and neuroradiological evaluation of patients with fibromyalgia in order to exclude compressive cervical myelopathy, a potentially treatable condition. PMID:17426987

  13. Intramedullary Sarcoidosis Presenting with Delayed Spinal Cord Swelling after Cervical Laminoplasty for Compressive Cervical Myelopathy

    PubMed Central

    Kwon, Du Ho; Kim, Eun-Sang; Eoh, Whan

    2014-01-01

    Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis. PMID:25535524

  14. [Imaging diagnosis of cervical spondylosis].

    PubMed

    Song, Z Q

    1989-04-01

    Myodil-myelographic manifestations of 60 cases of cervical spondylotic myelopathy and radiculopathy were analyzed. For better understanding the biomechanical disturbances of cervical spondylosis, CT scans of 26 cases of this disease were also investigated. Myelography and/or CT were considered necessary if surgical procedure was to be undertaken with anterior approach. Myodil myelography or CT could fulfill the diagnostic requirements for surgery if Non-ionic water-soluble contrast media or other new techniques were not available. PMID:2758936

  15. Cervical myelopathy in athetoid and dystonic cerebral palsy: retrospective study and literature review

    PubMed Central

    Rech, Celia; Garreau de Loubresse, Christian

    2010-01-01

    The early onset of degenerative cervical lesions has been well described in patients suffering from athetoid or dystonic cerebral palsy. Myelopathy can occur and aggravate of their unstable neurological status. Diagnosis and treatment are delayed and disrupted by the abnormal movements. This retrospective study was implemented to evaluate the symptoms, the anatomical findings, and the surgical management of seven patients from 20 to 56 years old suffering from cervical myelopathy and athetoid or dystonic cerebral palsy. The mean delay in diagnosis was 15 months and the mean follow-up was 33 months. The initial symptoms were spasticity, limbs weakness, paresthesias and vesico-sphinteric dysfunction. In addition to abnormal movements, imaging demonstrated disc herniation, spinal stenosis and instability. All patients were managed surgically by performing simultaneous spinal cord decompression and fusion. Two patients benefited from preoperative botulinum toxin injections, which facilitated postoperative care and immobilization. Strict postoperative immobilization was achieved for 3 months by a Philadelphia collar or a cervico-thoracic orthosis. All patients improved functionally with a mean Japanese Orthopaedic Association score gain of 1.5 points, in spite of the permanent disabilities of the myelopathy. Complications occurred with wound infection, metal failure and relapse of cervical myelopathy at an adjacent level in one case each. All the previous authors advised against isolated laminectomy but no consensus emerged from the literature analysis. Spinal fusion is usually recommended but can be complicated by degenerative adjacent deterioration. Surgical management provides good outcomes but requires a long-term follow-up. PMID:20066444

  16. Hypoplasia of the atlas causing cervical myelopathy with situs inversus totalis

    Microsoft Academic Search

    K Tofuku; H Koga; K Yone; S Komiya

    2007-01-01

    Study design:A case report of myelopathic hypoplasia of the atlas with situs inversus totalis.Objectives:To describe a case of cervical myelopathy caused by hypoplasia of the atlas with situs inversus totalis, and to briefly review the pertinent literature.Setting:Department of Orthopaedic Surgery, Kagoshima, Japan.Methods:The history, results of examination, and findings of radiographic imaging studies for a 56-year-old man with a 10-year history

  17. Contribution of disc degeneration to osteophyte formation in the cervical spine: a biomechanical investigation

    Microsoft Academic Search

    Srirangam Kumaresan; Narayan Yoganandan; Frank A. Pintar; Dennis J. Maiman; Vijay K. Goel

    2001-01-01

    Cervical spine disorders such as spondylotic radiculopathy and myelopathy are often related to osteophyte formation. Bone remodeling experimental–analytical studies have correlated biomechanical responses such as stress and strain energy density to the formation of bony outgrowth. Using these responses of the spinal components, the present study was conducted to investigate the basis for the occurrence of disc-related pathological conditions. An

  18. Cervical myelopathy from retro-odontoid calcium pyrophosphate dihydrate mass: a case report.

    PubMed

    Luksanapruksa, Panya; Chotivichit, Areesak; Wilartratsami, Sirichai

    2013-10-01

    Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is one of the most common forms of crystal-associated arthropathy in the elderly. However, cervical spine is rarely affected, especially in upper cervical area. There have been previous reported cases of symptomatic retro-odontoid CPPD deposition disease in English literature but this case is the first reported in Thai patients. This is a case report of a 67-year-old man who presented with neck pain with progressive myelopathy. Neurologic examination demonstrated a cervical myelopathy with muscle weakness and sensory disturbance of both extremities. Imaging studies showed extradural retro-odontoid mass compressing the spinal cord. The patient underwent occiput to C3 fusion with plating, posterior arch of atlas resection, transoral odontoidectomy, and mass removal. Histological examination of the mass revealed fibrocartilage tissue and rhomboid shaped crystals that showed positive biferingent in polarized light microscopy consistent with CPPD crystals. After surgery, no complication was found, and his neurological function had improved. PMID:24350422

  19. Comparison of one-level microendoscopy laminoforaminotomy and cervical arthroplasty in cervical spondylotic radiculopathy: a minimum 2-year follow-up study

    PubMed Central

    2013-01-01

    Background This study aims to compare the perioperative parameters and clinical results between microendoscopy laminoforaminotomy (MELF) and cervical arthroplasty (CA) in the treatment of one-level cervical spondylotic radiculopathy in a retrospective study. Methods From 2003 to 2007, a total of 97 patients with one-level cervical spondylotic radiculopathy were treated. Forty-five patients underwent CA. Fifty-two patients underwent MELF. Patient demographics and operative data were collected with a minimum 2-year follow-up. Perioperative parameters were compared. Clinical assessment in terms of neck disability index (NDI), short form (SF)-36, and visual analogue scale (VAS) of arm pain and neck pain was performed prior to surgery and at 1.5, 3, 6, 12, and 24 months after surgery. Results Fluoroscopy time (CA, 60.3 s; MELF, 12.1 s; P??0.05). Conclusions As alternatives of anterior cervical decompression and fusion (ACDF), both CA and MELF can produce satisfactory clinical outcomes. MELF has the additional benefits of less blood loss, less surgical time, less X-ray time, and shorter hospital stay. PMID:24341633

  20. MRI findings in Hirayama’s disease: flexion-induced cervical myelopathy or intrinsic motor neuron disease?

    Microsoft Academic Search

    Rolf Schröder; Ewald Keller; Sebastian Flacke; Stephan Schmidt; Christoph Pohl; Thomas Klockgether; Uwe Schlegel

    1999-01-01

    Hirayama’s disease is a benign juvenile form of focal amyotrophy affecting the upper limbs. Previous studies have suggested\\u000a that the disorder is a neck flexion induced cervical myelopathy. We report clinical and magnetic resonance imaging findings\\u000a in nine patients with Hirayama’s disease. Cervical imaging of seven patients revealed spinal cord changes consisting of focal\\u000a atrophy and foci of signal alterations.

  1. Cervical myelopathy due to chronic overshunting in a pediatric patient: case report and review of the literature.

    PubMed

    Ulrich, Nils Harry-Bert; Maier, Matthias; Bernays, Rene-Ludwig; Krayenbuhl, Niklaus; Kollias, Spyros

    2013-01-01

    We present a rare cause of cervical myelopathy produced by an engorged suboccipital epidural venous plexus due to chronic cerebrospinal fluid (CSF) overdrainage. A 17-year-old boy with obstructive hydrocephalus due to a retrocerebellar cyst and secondary implantation of a ventricloperitoneal shunt (VP-shunt) presented with progressive spastic tetraparesis. MRI imaging revealed myelopathy due to significant compression of the cervical spinal cord by engorged epidural veins. Further assessment at a low-pressure setting revealed a broken shunt valve. The VP-shunt valve was changed with an additional anti-siphon device leading to a gradual increase of the intracranial pressure (ICP). After intensive physiotherapy, the patient showed slight clinical improvement. Follow-up imaging within nine days showed distinct regression of the dilated venous plexus at the cranial-cervical junction (CCJ) with the resolution of cord compression. Engorgement of the epidural venous plexus should always be considered in the differential diagnosis of myelopathy in long-term shunt patients even when classical clinical and radiological signs of overshunting are missing. PMID:23756987

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

    PubMed

    Adeleye, A Olufemi; Akinyemi, R Olusola

    2010-09-01

    An otherwise-healthy, active 83-year-old Nigerian man developed reversible central cord myelopathy from a mild fall on a level surface. Cervical spine magnetic resonance imaging (MRI) revealed C5, 6, and 7 block vertebrae and marked disc extrusions only at the immediately adjoining upper and lower non-fused segments of the cervical spine. There was no spinal canal stenosis otherwise. We think that the unique presentation of this case of Klippel-Feil syndrome further supports the impression that following fusion (congenital or acquired) of one segment of the spinal column, hypermobility of the non-fused adjoining segments may strongly predispose to more disc extrusions. PMID:21327144

  3. Dorsal laminectomy for treatment of cervical vertebral stenotic myelopathy in an alpaca.

    PubMed

    Barker, W H J; Witte, T H; Driver, C J; Jull, P; Whitehead, C E; Volk, H A

    2015-05-15

    Case Description-An 11-year-old male breeding alpaca was evaluated for a 2-day history of lowered head carriage and lethargy. Clinical Findings-On initial examination, the alpaca had signs of lethargy and lowered carriage of the head and neck, but no specific neurologic deficits. Medical management improved the clinical signs, but 8 months later, the alpaca developed acute, progressive general proprioceptive ataxia affecting all 4 limbs and was referred for further evaluation and treatment. Magnetic resonance imaging and CT identified disruption of the normal osseous architecture of C7 and T1. Medical management was attempted, but because of a lack of improvement, the patient underwent surgery 14 months after initial examination. Treatment and Outcome-A dorsal laminectomy of C7 and T1 via a dorsal midline approach was performed, and the spinous processes of both vertebrae were removed prior to removal of the overlying lamina. Free dorsal expansion of the spinal cord was ensured by resection of the ligamentum flavum. Six months after surgery, the alpaca had returned to successful breeding with 7 hembra bred in the first year after surgery, producing 6 crias, and 4 crias in the second year. The patient was eventually euthanized 28 months after surgery because of neurologic deterioration but was still ambulatory at that time. Conclusions and Clinical Relevance-A good outcome with adequate alleviation of clinical signs and breeding soundness for > 2 years following dorsal laminectomy was achieved in this camelid patient. The surgical approach was similar to that in other species and was associated with mild postoperative morbidity. Veterinarians treating camelids should be aware of the initial clinical signs and treatment options for cervical vertebral stenotic myelopathy. In acute cases, the signs of reduced cervical mobility and pain on manipulation should prompt investigation including appropriate diagnostic imaging. Timely surgical intervention should be considered in patients that respond poorly to medical treatment to avoid irreversible spinal cord injury and optimize outcome. PMID:25932939

  4. MR Classification System Based on Axial Images for Cervical Compressive Myelopathy.

    PubMed

    You, Ja Yeon; Lee, Joon Woo; Lee, Eugene; Lee, Guen Young; Yeom, Jin S; Kang, Heung Sik

    2015-08-01

    Purpose To propose a new magnetic resonance (MR) classification system based on axial images for cervical compressive myelopathy (CCM) (Ax-CCM system), to assess the interobserver agreement with the Ax-CCM system, and to evaluate the relationship between Ax-CCM patterns and the baseline severity of CCM and the subsequent surgical outcome. Materials and Methods The institutional review board approved this retrospective study. A total of 202 patients (male-to-female ratio, 128:84; mean age ± standard deviation, 56.3 years ± 11.9; age range, 24-83 years) with CCM who underwent preoperative MR imaging and decompression surgery were retrospectively evaluated. The Ax-CCM pattern was based on the margin and extent of intramedullary hyperintensity on axial T2-weighted images, as follows; type 0 = normal, type 1 = diffuse, type 2 = fuzzy focal, and type 3 = discrete focal. Interobserver variability was analyzed by using the intraclass correlation coefficient across three readers. The modified Japanese Orthopedic Association (JOA) score and the postoperative improvement (good vs little improvement) were evaluated according to the Ax-CCM pattern by using one-way analysis of variance, the ?(2) test, and the Fisher exact test. Results The intraclass correlation coefficient for the Ax-CCM system was 0.83. The preoperative JOA score was significantly different according to Ax-CCM pattern across all readers (P < .05), with the type 2 pattern showing the worst preoperative JOA score (mean, 11.6 ± 3.1 for readers A and C and 11.7 ± 2.9 for reader B). The proportion of good improvement was significantly lower with the type 2 pattern (27 of 72 patients, 37%) than with the other patterns (64 of 123 patients, 52%) (P = .034). Conclusion The Ax-CCM system showed good interobserver agreement, and the type 2 pattern was correlated with poor preoperative neurologic status and less postoperative improvement. (©) RSNA, 2015. PMID:25906184

  5. A Comparison of Computed Tomography Measures for Diagnosing Cervical Spinal Stenosis Associated with Myelopathy: A Case-Control Study

    PubMed Central

    Hoffler, C Edward; Cameron, Brian M; Rhee, John M; Bawa, Maneesh; Malone, David G; Bent, Melissa; Yoon, Tim S

    2015-01-01

    Study Design Retrospective comparative study. Purpose To assess differences in computed tomography (CT) imaging parameters between patients with cervical myelopathy and controls. Overview of Literature There is a lack of information regarding the best predictor of symptomatic stenosis based on osseous canal dimensions. We postulate that smaller osseous canal dimensions increase the risk of symptomatic central stenosis. Methods CT images and medical records of patients with cervical myelopathy (19 patients, 8 males; average age, 64.4±13.4 years) and controls (18 patients, 14 males; average age, 60.4±11.0 years) were collected. A new measure called the laminar roof pitch angle (=angle between the lamina) was conducted along with linear measures, ratios and surrogates of canal perimeter and area at each level C2-C7 (222 levels). Receiver-operator curves were used to assess the diagnostic value of each. Rater reliability was assessed for the measures. Results The medial-lateral (ML) diameter (at mid-pedicle level) and calculated canal area (=anterior-posterior.×ML diameters) were the most accurate and highly reliable. ML diameter below 23.5 mm and calculated canal area below 300 mm2 generated 82% to 84% sensitivity and 67% to 68% sensitivity. No significant correlations were identified between age, height, weight, body mass in dex and gender for each of the CT measures. Conclusions CT measures including ML dimensions were most predictive. This study is the first to identify an important role for the ML dimension in cases of slowly progressive compressive myelopathy. A ML reserve may be protective when the canal is progressively compromised in the anterior-posterior dimension. PMID:25705331

  6. Is there any relationship between proinflammatory mediator levels in disc material and myelopathy with cervical disc herniation and spondylosis? A non-randomized, prospective clinical study

    Microsoft Academic Search

    Mehmet Nusret Demircan; Alparslan Asir; Ahmet Cetinkal; Nursal Gedik; Ahmet Murat Kutlay; Ahmet Çolak; Sedat Kurtar; Hakan Simsek

    2007-01-01

    The proinflammatory mediator (PIM) levels were assessed in surgically removed samples of herniated cervical intervertebral\\u000a discs. The objective of this study was to investigate if there is a correlation between the levels of PIMs in disc material\\u000a and myelopathy associated with cervical intervertebral disc herniation and spondylosis. The role of proinflammatory mediators\\u000a in the degeneration of intervertebral disc and the

  7. Cervical Myelopathy Secondary to Atlanto-occipital Assimilation: The Usefulness of the Simple Decompressive Surgery

    PubMed Central

    Kim, Kang Rae; Kim, Young Zoon; Cho, Yong Woon; Kim, Joon Soo; Kim, Kyu Hong; Lee, In Chang

    2013-01-01

    Atlanto-occipital assimilation is one of the most common osseous anomalies observed at the craniocervical junction. Most patients with atlas assimilation show no symptom, but some have neurological problems such as myelopathy that may require surgical treatment. Occipitocervical fusion may be required if atlato-occipital assimilation is accompanied by occipito-axial instability. However, in cases of symptomatic atlas assimilation with minor cord compression without instability, simple decompressive surgery may be the treatment modality. This report describes a case of successful treatment of a patient with myelopathy secondary to atlanto-occipital assimilation without instability, using posterior simple decompressive surgery. PMID:24757486

  8. Cervical Myelopathy Secondary to Atlanto-occipital Assimilation: The Usefulness of the Simple Decompressive Surgery.

    PubMed

    Kim, Kang Rae; Lee, Young Min; Kim, Young Zoon; Cho, Yong Woon; Kim, Joon Soo; Kim, Kyu Hong; Lee, In Chang

    2013-09-01

    Atlanto-occipital assimilation is one of the most common osseous anomalies observed at the craniocervical junction. Most patients with atlas assimilation show no symptom, but some have neurological problems such as myelopathy that may require surgical treatment. Occipitocervical fusion may be required if atlato-occipital assimilation is accompanied by occipito-axial instability. However, in cases of symptomatic atlas assimilation with minor cord compression without instability, simple decompressive surgery may be the treatment modality. This report describes a case of successful treatment of a patient with myelopathy secondary to atlanto-occipital assimilation without instability, using posterior simple decompressive surgery. PMID:24757486

  9. Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI

    PubMed Central

    Evans, Linton T.; Lollis, S. Scott

    2015-01-01

    Introduction. Flexion-extension, or kinematic, MRI has been used to identify dynamic spondylotic spinal cord compression not seen with traditional static MRI. The use of kinematic MRI to diagnose postoperative complications, specifically dynamic compression, is not as well documented. The authors describe a case of dynamic spinal cord compression by the paraspinal muscles causing worsening myelopathy following cervical laminectomy. This was only diagnosed with flexion-extension MRI. Methods. The patient was a 90-year-old male presenting to the neurosurgery clinic with functional decline and cervical spondylotic myelopathy. Results. A multilevel laminectomy was performed. Following surgery the patient had progressive weakness and worsening myelopathy. No active cord compression was seen on multiple MRIs obtained in a neutral position, and flexion-extension X-rays did not show instability. A kinematic MRI demonstrated dynamic compression of the spinal cord only during neck extension, by the paraspinal muscles. To relieve the compression, the patient underwent an instrumented fusion, with cross-links used to buttress the paraspinal muscles away from the cord. This resulted in neurologic improvement. Conclusions. We describe a novel case of spinal cord compression by paraspinal muscles following cervical laminectomy. In individuals with persistent myelopathy or delayed neurologic decline following posterior decompression, flexion-extension MRI may prove useful in diagnosing this potential complication. PMID:25984378

  10. Cervical Myelopathy Caused by Disc Herniation at the Segment of Existing Osteochondroma in a Patient with Hereditary Multiple Exostoses

    PubMed Central

    Tarukado, Kiyoshi; Senba, Hideyuki; Kitamura, Takahiro; Komiya, Norihiro; Shidahara, Satoshi

    2014-01-01

    Hereditary multiple exostoses (HME) is a benign hereditary disorder characterized by multiple osteochondromas. Osteochondroma appears occasionally in the spinal column as a part of HME. A 37-year-old man presented with a history of HME and cervical compressive myelopathy caused by intraspinal osteochondroma arising from the lamina of the C5 and disc herniation at the C5-6. He was treated by open-door laminoplasty at the C5 and C6 with excision of the tumor. The neurological symptoms were immediately relieved after surgery. Magnetic resonance images demonstrated a sufficient decompression of the spinal cord with a spontaneous regression of the herniated disc at one year after surgery. There was no recurrence of the tumor and no appearance of kyphosis and segmental instability of the cervical spine on postoperative imaging studies for three years after surgery. The patient could be successfully treated by laminoplasty with excision of the tumor and without removal of the herniated disc. PMID:25558330

  11. Increased Low-Frequency Oscillation Amplitude of Sensorimotor Cortex Associated with the Severity of Structural Impairment in Cervical Myelopathy

    PubMed Central

    Zhou, Fuqing; Gong, Honghan; Liu, Xiaojia; Wu, Lin; Luk, Keith Dip-Kei; Hu, Yong

    2014-01-01

    Decreases in metabolites and increased motor-related, but decreased sensory-related activation of the sensorimotor cortex (SMC) have been observed in patients with cervical myelopathy (CM) using advanced MRI techniques. However, the nature of intrinsic neuronal activity in the SMC, and the relationship between cerebral function and structural damage of the spinal cord in patients with CM are not fully understood. The purpose of this study was to assess intrinsic neuronal activity by calculating the regional amplitude of low frequency fluctuations (ALFF) using resting-state functional MRI (rs-fMRI), and correlations with clinical and imaging indices. Nineteen patients and 19 age- and sex-matched healthy subjects underwent rs-fMRI scans. ALFF measurements were performed in the SMC, a key brain network likely to impaired or reorganized patients with CM. Compared with healthy subjects, increased amplitude of cortical low-frequency oscillations (LFO) was observed in the right precentral gyrus, right postcentral gyrus, and left supplementary motor area. Furthermore, increased z-ALFF values in the right precentral gyrus and right postcentral gyrus correlated with decreased fractional anisotropy values at the C2 level, which indicated increased intrinsic neuronal activity in the SMC corresponding to the structural impairment in the spinal cord of patients with CM. These findings suggest a complex and diverging relationship of cortical functional reorganization and distal spinal anatomical compression in patients with CM and, thus, add important information in understanding how spinal cord integrity may be a factor in the intrinsic covariance of spontaneous low-frequency fluctuations of BOLD signals involved in cortical plasticity. PMID:25111566

  12. A case of 'tropical' myelopathy.

    PubMed

    Laureys, G; Chaskis, C; Bourgain, C; Stadnik, T; Dielman, C; Ebinger, G

    2007-12-01

    We present a case of lower limb sensory disturbances and weakness in a patient originating from Mali. MRI showed a diffuse myelopathy of the cervical and thoracic spinal cord. Serological evaluation of blood and cerebrospinal fluid pointed towards schistosomiasis as the cause. Histological confirmation was made on bladder-biopsy. Treatment with praziquantel and steroids brought marked clinical improvement. This case illustrates the need to keep in mind more exotic causes of myelopathy in those patients coming from endemic regions. PMID:18416289

  13. Comparison of the Japanese Orthopaedic Association (JOA) Score and Modified JOA (mJOA) Score for the Assessment of Cervical Myelopathy: A Multicenter Observational Study

    PubMed Central

    Kato, So; Oshima, Yasushi; Oka, Hiroyuki; Chikuda, Hirotaka; Takeshita, Yujiro; Miyoshi, Kota; Kawamura, Naohiro; Masuda, Kazuhiro; Kunogi, Junichi; Okazaki, Rentaro; Azuma, Seiichi; Hara, Nobuhiro; Tanaka, Sakae; Takeshita, Katsushi

    2015-01-01

    Objectives The Japanese Orthopaedic Association (JOA) score is widely used to assess the severity of clinical symptoms in patients with cervical compressive myelopathy, particularly in East Asian countries. In contrast, modified versions of the JOA score are currently accepted as the standard tool for assessment in Western countries. The objective of the present study is to compare these scales and clarify their differences and interchangeability and verify their validity by comparing them to other outcome measures. Materials and Methods Five institutions participated in this prospective multicenter observational study. The JOA and modified JOA (mJOA) proposed by Benzel were recorded preoperatively and at three months postoperatively in patients with cervical compressive myelopathy who underwent decompression surgery. Patient reported outcome (PRO) measures, including Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), the Short Form-12 (SF-12) and the Neck Disability Index (NDI), were also recorded. The preoperative JOA score and mJOA score were compared to each other and the PRO values. A Bland-Altman analysis was performed to investigate their limits of agreement. Results A total of ninety-two patients were included. The correlation coefficient (Spearman’s rho) between the JOA and mJOA was 0.87. In contrast, the correlations between JOA/mJOA and the other PRO values were moderate (|rho| = 0.03 – 0.51). The correlation coefficient of the recovery rate between the JOA and mJOA was 0.75. The Bland-Altman analyses showed that limits of agreement were 3.6 to -1.2 for the total score, and 55.1% to -68.8% for the recovery rates. Conclusions In the present study, the JOA score and the mJOA score showed good correlation with each other in terms of their total scores and recovery rates. Previous studies using the JOA can be interpreted based on the mJOA; however it is not ideal to use them interchangeably. The validity of both scores was demonstrated by comparing these values to the PRO values. PMID:25837285

  14. [Cervical myelopathy after low grade distortion of the cervical spine. Possible association with pre-existing spondylosis of the cervical spine].

    PubMed

    Aurich, M; Hofmann, G O; Gras, F M

    2015-04-01

    A patient with spondylosis deformans of the cervical spine with no neurological deficits developed rapidly progressive tetraparesis 1 day after a whiplash injury due to a car accident (rear end collision), although initially there were no clinical symptoms. Surgical decompression and spondylodesis led to relief of the neurological deficits. This case demonstrates that even a low grade whiplash injury (grade 1) can cause severe neurological symptoms later and that a degenerative disease of the spine is a predisposing factor. PMID:25336350

  15. Latent period in clinical radiation myelopathy

    Microsoft Academic Search

    Timothy E. Schultheiss; Elizabeth M. Higgins; Anas M. El-Mahdi

    1984-01-01

    Seventy-seven papers containing data on more than 300 cases of radiation myelopathy have been analyzed. The data suggest that the latent periods are similar in the cervical and thoracic levels of the spinal cord and are bimodally distributed. Myelopathy of lumbar cord apparently has a shorter latent period. As in controlled animal experiments, the latent period decreases with increasing dose.

  16. Cervical spondylosis with spinal cord encroachment: should preventive surgery be recommended?

    PubMed Central

    Murphy, Donald R; Coulis, Christopher M; Gerrard, Jonathan K

    2009-01-01

    Background It has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma. Preventive decompression surgery has been recommended for these individuals. The purpose of this paper is to provide the non-surgical spine specialist with information upon which to base advice to patients. The evidence behind claims of increased risk is investigated as well as the evidence regarding the risk of decompression surgery. Methods A literature search was conducted on the risk of spinal cord injury in individuals with asymptomatic cord encroachment and the risk and benefit of preventive decompression surgery. Results Three studies on the risk of spinal cord injury in this population met the inclusion criteria. All reported increased risk. However, none were prospective cohort studies or case-control studies, so the designs did not allow firm conclusions to be drawn. A number of studies and reviews of the risks and benefits of decompression surgery in patients with cervical myelopathy were found, but no studies were found that addressed surgery in asymptomatic individuals thought to be at risk. The complications of decompression surgery range from transient hoarseness to spinal cord injury, with rates ranging from 0.3% to 60%. Conclusion There is insufficient evidence that individuals with spondylotic spinal cord encroachment are at increased risk of spinal cord injury from minor trauma. Prospective cohort or case-control studies are needed to assess this risk. There is no evidence that prophylactic decompression surgery is helpful in this patient population. Decompression surgery appears to be helpful in patients with cervical myelopathy, but the significant risks may outweigh the unknown benefit in asymptomatic individuals. Thus, broad recommendations for decompression surgery in suspected at-risk individuals cannot be made. Recommendations to individual patients must consider possible unique circumstances. PMID:19703280

  17. Traumatic myelopathy in a seventeen-year-old child with cervical spinal stenosis (without fracture or dislocation) and a C2-C3 Klippel-Feil fusion. A case report.

    PubMed

    Epstein, N E; Epstein, J A; Zilkha, A

    1984-01-01

    A 17-year-old white male patient sustained a cervical hyperextension injury while body surfing. Plain cervical radiographs, tomography, and CAT scan showed neither fracture nor subluxation, but congenital narrowing of the spinal canal and fusion of C2-C3 (Klippel-Feil). Clinically, he had a central cord syndrome, characterized by a motor dominant myelopathy. The conservative management of this patient with a central cord injury in the presence of spinal stenosis and a Klippel-Feil syndrome resulted in almost full recovery although he was quadriplegic initially. This constellation of findings rarely has been reported in adolescence. PMID:6474247

  18. Over-shunting associated myelopathy.

    PubMed

    Howard, Brian M; Sribnick, Eric A; Dhall, Sanjay S

    2014-12-01

    Intracranial hypotension typically presents following cerebrospinal fluid (CSF) leak, but can be induced by CSF diversion. Classically, patients present with positional headache, but less common symptoms include neck pain and cranial nerve palsies. To our knowledge, the neurosurgical literature contains six reports of patients with symptomatic cervical, epidural venous plexus engorgement as the result of CSF shunting. The patient presented herein is a 26-year-old woman with shunt-dependent, congenital hydrocephalus. She presented with rapidly progressive cervical myelopathy following ventriculoperitoneal shunt revision. Imaging revealed engorgement of the cervical epidural venous plexus and mass effect on the cervical spinal cord. "Over-shunting associated myelopathy" is a rare complication of CSF diversion that should be familiar to physicians who routinely evaluate patients with intracranial shunts. PMID:25070631

  19. Boomerang deformity of cervical spinal cord migrating between split laminae after laminoplasty.

    PubMed

    Kimura, S; Gomibuchi, F; Shimoda, H; Ikezawa, Y; Segawa, H; Kaneko, F; Uchiyama, S; Homma, T

    2000-04-01

    Patients with cervical compression myelopathy were studied to elucidate the mechanism underlying boomerang deformity, which results from the migration of the cervical spinal cord between split laminae after laminoplasty with median splitting of the spinous processes (boomerang sign). Thirty-nine cases, comprising 25 patients with cervical spondylotic myelopathy, 8 patients with ossification of the posterior longitudinal ligament, and 6 patients with cervical disc herniation with developmental canal stenosis, were examined. The clinical and radiological findings were retrospectively compared between patients with (B group, 8 cases) and without (C group, 31 cases) boomerang sign. Moderate increase of the grade of this deformity resulted in no clinical recovery, although there was no difference in clinical recovery between the two groups. Most boomerang signs developed at the C4/5 and/or C5/6 level, where maximal posterior movement of the spinal cord was achieved. Widths between lateral hinges and between split laminae in the B group were smaller than in the C group. Flatness of the spinal cord in the B group was more severe than in the C group. In conclusion, the boomerang sign was caused by posterior movement of the spinal cord, narrower enlargement of the spinal canal and flatness of the spinal cord. PMID:10823431

  20. Cervical laminoplasty for cervical myeloradiculopathy

    Microsoft Academic Search

    Richard M. Ozuna; Rick B. Delamarter

    1996-01-01

    The role for treatment of conditions resulting in cervical spondylotic myeloradiculopathy through posterior approaches is discussed. The indications and advantages of a posterior approach andin particular laminoplasty are reviewed. Various techniques of laminoplasty are presented. The senior author's technique and series in expansive open door laminoplasty is also reviewed. The series was a prospective study performed to evaluate the clinical

  1. Clinical and Radiological Outcomes of Anterior Cervical Interbody Fusion Using Hydroxyapatite Spacer

    PubMed Central

    Kim, Sung Chul; Kang, Sung Won; Kim, Se Hyuk; Cho, Ki Hong

    2009-01-01

    Objective This is retrospective study of clinical and radiological outcomes of anterior cervical fusion using Bongros-HA™ (BioAlpha, Seongnam, Korea) which is a type of synthetic hydroxyapatite (HA) spacer to evaluate the efficacy in its clinical application and usefulness as a reliable alternative to autograft bone. Methods Twenty-nine patients were enrolled in this study and 40 segments were involved. All patients were performed anterior cervical interbody fusion using HA spacer and plating system. Indications for surgery were radiculopathy caused by soft-disc herniation or spondylosis in 18 patients, spondylotic myelopathy in 1 patient, and spinal trauma in 10 patients. Cervical spine radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months in all patients to evaluate intervertebral disc height, and the degrees of lordosis. Cervical computed tomography was done at postoperative 12 month in all patients to confirm the fusion status. The mean period of clinical follow-up was 17 months. Results Complete interbody fusion was achieved in 100% of patients. Preoperative kyphotic deformities were corrected in all cases after surgery. Intervertebral disc height was well maintained during follow up period. There were no cases of graft extrusion, graft deterioration and graft fracture. Conclusion HA spacer is very efficient in achieving cervical fusion, maintaining intervertebral disc height, and restoring lordosis. When combined with the placement of a cervical plate, immediate stability can be achieved and graft related complication can be prevented. PMID:19893716

  2. Minimally invasive posterior cervical decompression using tubular retractor: The technical note and early clinical outcome

    PubMed Central

    Hur, Jung-Woo; Kim, Jin-Sung; Shin, Myeong-Hoon; Ryu, Kyeong-Sik

    2014-01-01

    Background: The aim of this work is to present a novel decompression technique that approaches cervical spine posteriorly, but through minimal invasive method using tubular retractor avoiding detachment of posterior musculature. Methods: Six patients underwent minimally invasive posterior cervical decompression using the tubular retractor system and surgical microscope. Minimally invasive access to the posterior cervical spine was performed with exposure through a paramedian muscle-splitting approach. With the assistance of a specialized tubular retraction system and deep soft tissue expansion mechanism, multilevel posterior cervical decompression could be accomplished. This approach also allows safe docking of the retractor system on the lateral mass, thus avoiding the cervical spinal canal during exposure. A standard operating microscope was used with ×10 magnification and 400 mm focal length. The hospital charts, magnetic resonance imaging studies, and follow-up records of all the patients were reviewed. Outcome was assessed by neurological status and visual analog scale (VAS) for neck and arm pain. Results: There was no significant complication related to operation. The follow-up time was 4-12 months (mean, 9 months). Muscle weakness improved in all patients; sensory deficits resolved in four patients and improved in two patients. Analysis of the mean VAS for radicular pain and VAS for neck pain showed significant improvement. Conclusions: The preliminary experiences with good clinical outcome seem to promise that this minimally invasive technique is a valid alternative option for the treatment of cervical spondylotic myelopathy. PMID:24778922

  3. Cervical screw missing secondary to delayed esophageal fistula: case report.

    PubMed

    Cagli, Sedat; Isik, H Serdar; Zileli, Mehmet

    2009-10-01

    Although anterior surgical approaches to the cervical spine have become popular and safe in recent years, they also have some complications. We present a case of loss of an anterior cervical plate screw by the natural tracts. The patient was a 47- year-old woman who was operated on for cervical spondylotic myelopathy at another institution. Surgical interference included two levels of anterior discectomy, iliac graft placement and fixation using plate and screws. Two years later, plate dislocation and partial migration of the upper screws were observed. After 7 years the patient complained of dysphagia and she accepted removal of the osteosynthesis. Radiographical examination showed that one of the upper screws was missing and two lower screws were broken. Esophageal perforation was found during the surgery and repaired. Further progress was favourable. Complications associated with esophageal perforation may range from massive infection and death to spontaneous recovery. Erosion of the esophageal wall due to extruded bulky constructs may lead to a persistent fistula, abscess or septic diffusion. Spontaneous perforation of the esophagus and screw loss via the gastrointestinal tract make this case interesting.. PMID:19847769

  4. Latent period in clinical radiation myelopathy

    SciTech Connect

    Schultheiss, T.E.; Higgins, E.M.; El-Mahdi, A.M.

    1984-07-01

    Seventy-seven papers containing data on more than 300 cases of radiation myelopathy have been analyzed. The data suggest that the latent periods are similar in the cervical and thoracic levels of the spinal cord and are bimodally distributed. Myelopathy of lumbar cord apparently has a shorter latent period. As in controlled animal experiments, the latent period decreases with increasing dose. Furthermore, the variation in latent periods also decreases with dose. It is also seen that retreated patients and pediatric or adolescent patients have greatly reduced latent periods. The implications of these findings as they compare with the animal data are discussed.

  5. The evidence and the possible significance of autophagy in degeneration model of human cervical end-plate cartilage

    PubMed Central

    XU, HONGGUANG; XIONG, SHOULIANG; WANG, HONG; ZHANG, MIN; YU, YUNFEI

    2014-01-01

    The aim of this study was to observe autophagy in chondrocytes from degenerative human cervical vertebral end-plates and to investigate the significance of variations in autophagy in the degeneration of cervical vertebral end-plate chondrocytes. Cartilage end-plates were obtained from 48 inpatients admitted to hospital between February 2011 and August 2012. The patients were divided into the control group (n=17) with cervical vertebral fracture or dislocation and the cervical spondylosis group (n=31) with cervical spondylotic myelopathy. End-plate chondrocytes were isolated via enzyme digestion and then cultured in vitro. The cells were stained with toluidine blue and hematoxylin-eosin (H&E). A laser scanning confocal microscope and monodansylcadaverine (MDC) were used to reveal autophagy in the end-plate chondrocytes. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect mRNA expression of type II collagen and aggrecan. Western blotting was conducted to detect LC3 proteins. The chondrocytes isolated from the degenerative human cervical end-plates were cultured successfully in vitro. The morphology of the cells from the cervical spondylosis group tended to exhibit changes in spindle morphology compared with the control group. Autophagic bodies were stained with MDC. LC3 proteins were visible in the intracellular and perinuclear regions under the laser scanning confocal microscope. The mRNA expression levels (relative to those of ?-actin) of aggrecan (0.715±0.194) and type II collagen (0.628±0.254) in the cervical spondylosis group were markedly decreased compared with those in the control group (0.913±0.254 and 0.845±0.186, respectively; both P<0.05). The LC3-II/LC3-I ratio was observed to be significantly reduced in the cervical spondylosis group by Western blot analysis. Autophagy has an important role in human cervical disc degeneration. The regulation of autophagy may prevent disc degeneration in cartilage end-plate cells. PMID:24520242

  6. FDG-PET SUV can distinguish between spinal sarcoidosis and myelopathy with canal stenosis.

    PubMed

    Sakushima, Ken; Yabe, Ichiro; Shiga, Tohru; Yashima-Yamada, Moemi; Tsuji-Akimoto, Sachiko; Terae, Satoshi; Sasaki, Hidenao

    2011-02-01

    Spinal cord sarcoidosis is a rare manifestation of sarcoidosis. Magnetic resonance imaging (MRI) of spinal cord sarcoidosis sometimes resembles that of the non-inflammatory spinal cord lesion. (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is an effective method to detect both systemic and central nervous system lesions in sarcoidosis. This study compared the standard uptake value (SUV) of FDG-PET between spinal cord sarcoidosis and non-inflammatory spinal cord lesions. We retrospectively reviewed the records of patients who underwent both spinal MRI and FDG-PET scans. We used SUV to evaluate the FDG-PET uptake of the lesion. The region of interest was the center of high-intensity areas on T2-weighted MR images. We included three patients with spinal cord sarcoidosis, five with myelomalacia caused by cervical spondylosis or ossification of the posterior longitudinal ligament, one with spinal cord edema associated with cervical spondylosis, and one with spinal cord edema associated with dural arteriovenous fistula. The spinal cord sarcoidosis group had a significantly higher SUV (mean 4.38, range 3.30-4.93) than patients with the other diseases (mean 1.87, range 1.42-2.74). The SUV of FDG-PET thus may be able to distinguish spinal cord sarcoidosis from other non-inflammatory lesions. FDG-PET can play an important role in the diagnosis of spinal cord sarcoidosis because the gadolinium enhancement in MRI is sometimes seen in spondylotic myelopathy or vascular malformation. FDG-PET is informative for the accurate diagnosis of spinal cord sarcoidosis and may enable clinicians to start treatment at an earlier stage. PMID:20820799

  7. Lumbar and cervical stenosis. Frequency of the association, role of the ankylosing hyperostosis

    Microsoft Academic Search

    M. Laroche; L. Moulinier; J. Arlet; Ph. Arrue; H. Rousseau; A. Cantagrel; B. Mazieres

    1992-01-01

    Summary  The authors report a study of 47 patients admitted for cervical myelopathy (N=17) or symptomatic lumbar spinal stenosis (N=30). Nine patients had clinical evidence of coexisting cervical myelopathy and lumbar spinal stenosis. Ten out of the 17 patients having cervical myelopathy had lumbar spinal stenosis as evidenced by saggital tomography and\\/or computerized tomography. Nine out of the 30 patients admitted

  8. Copper deficiency myelopathy: A report of two cases.

    PubMed

    Plantone, Domenico; Primiano, Guido; Renna, Rosaria; Restuccia, Domenico; Iorio, Raffaele; Patanella, Katia A; Ferilli, Michela N; Servidei, Serenella

    2015-07-01

    Context Copper deficiency myelopathy represents an often underdiagnosed, acquired neurological syndrome, clinically characterized by posterior column dysfunction. The main causes of copper deficiency are bariatric surgery, increased consumption of zinc, and malabsorption. However, even after a careful history taking and extensive laboratory researches, the etiology of copper deficiency remains undetermined in a significant percentage of cases. Patients affected by copper deficiency myelopathy usually present with sensory ataxia due to dorsal column dysfunction and sometimes with mild leg spasticity. In such patients, spinal cord magnetic resonance imaging (MRI) may show hyperintense lesions in T2-weighted sequences involving the posterior columns of cervical and thoracic cord. These MRI findings are not distinguishable from those of subacute combined degeneration associated with vitamin B12 deficiency. Findings Here, we describe two patients with gait ataxia and sensory symptoms in which a diagnosis of copper deficiency myelopathy was made. Both patients showed a significant clinical, neuroradiological, and neurophysiological improvement after proper supplementation therapy. Conclusion The patients herein described underline the importance to include serum copper and ceruloplasmin levels as part of the myelopathy diagnostic workup, especially in the cases of otherwise unexplained subacute myelopathy involving the posterior columns. Since copper deficiency myelopathy is a progressive syndrome, early diagnosis is mandatory in order to promptly provide a proper supplementation therapy and, thus, prevent an irreversible neurological damage. PMID:25343982

  9. Delayed Surgical Intervention in Central Cord Syndrome with Cervical Stenosis

    PubMed Central

    Park, Moon Soo; Moon, Seong-Hwan; Lee, Hwan-Mo; Kim, Tae-Hwan; Oh, Jae Keun; Suh, Bo-Kyung; Lee, Seung Jin; Riew, K. Daniel

    2014-01-01

    Study Design?Review of the literature. Objective?It is generally accepted that surgical treatment is necessary for central cord syndrome (CCS) with an underlying cervical stenosis. However, the surgical timing for decompression is controversial in spondylotic cervical CCS. The purpose of this study is to review the results of early and delayed surgery in patients with spondylotic cervical CCS. Methods?MEDLINE was searched for English-language articles on CCS. There were 1,653 articles from 1940 to 2012 regarding CCS, 5 of which dealt with the timing of surgery for spondylotic cervical CCS. Results?All five reports regarding the surgical timing of spondylotic cervical CCS were retrospective. Motor improvement, functional independence measures, and walking ability showed similar improvement in early and late surgery groups in the studies with follow-up longer than 1 year. However, greater improvement was seen in the early surgery group in the studies with follow-up shorter than 1 year. The complication rates did not show a difference between the early and late surgery groups. However, there are controversies regarding the length of intensive care unit stay or hospital stay for the two groups. Conclusions?There was no difference in motor improvement, functional independence, walking ability, and complication rates between early and late surgery for spondylotic cervical CCS. PMID:25649889

  10. Cervical radiculopathy: Pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar A prospective, controlled study

    Microsoft Academic Search

    L. C. G. Persson; U. Moritz; L. Brandt; C.-A. Carlsson

    1997-01-01

    This prospective, randomised study compares the efficacy of surgery, physiotherapy and cervical collar with respect to pain, motor weakness and sensory loss in 81 patients with long-lasting cervical radiculopathy corresponding to a nerve root that was significantly compressed by spondylotic encroachment, with or without an additional bulging disk, as verified by MRI or CT-myelography. Pain intensity was registered on a

  11. [A case of transverse myelopathy caused by acupuncture].

    PubMed

    Sato, M; Yamane, K; Ezima, M; Sugishita, Y; Nozaki, H

    1991-07-01

    A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with DIC, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a focal infection of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture. PMID:1786654

  12. Cytokine Concentrations in the Cerebrospinal Fluid of Great Danes with Cervical Spondylomyelopathy

    PubMed Central

    Martin-Vaquero, P.; da Costa, R.C.; Moore, S.A.; Gross, A.C.; Eubank, T.D.

    2014-01-01

    Background Chronic inflammation is involved in the pathogenesis of human cervical spondylotic myelopathy and could also play a role in cervical spondylomyelopathy (CSM) in dogs. Hypothesis/Objectives That cerebrospinal fluid (CSF) cytokine concentrations would differ between clinically normal (control) and CSM-affected Great Danes (GDs), with affected GDs showing higher levels of inflammatory cytokines, such as interleukin (IL)-6 and monocyte chemoattractant protein-1/chemokine ligand 2 (MCP-1/CCL2). Animals Client-owned GDs: 15 control, 15 CSM-affected. Methods Prospective study. Dogs underwent cervical vertebral column magnetic resonance imaging and collection of CSF from the cerebellomedullary cistern. Cytokine concentrations were measured using a commercially available canine multiplex immunoassay. Cytokine concentrations were compared between groups. Associations with the administration of anti-inflammatory medications, disease duration and severity, severity of spinal cord (SC) compression, and SC signal changes were investigated in affected GDs. Results Affected GDs had significantly lower MCP-1/CCL2 (mean 138.03 pg/mL, 95% confidence interval [CI] = 114.85–161.20) than control GDs (212.89 pg/mL, 95% CI = 165.68–260.11, P = .028). In affected GDs, MCP-1/CCL2 concentrations correlated inversely with the severity of SC compression. There were no associations with administration of anti-inflammatory medications, disease duration, or disease severity. IL-6 concentrations were significantly higher (2.20 pg/mL, 95% CI = 1.92–2.47, P < .001) in GDs with SC signal changes. Conclusions and Clinical Importance Lower MCP-1/CCL2 in CSM-affected GDs might compromise clearance of axonal and myelin debris, delay axon regeneration, and affect recovery. Higher IL-6 in CSM-affected GDs with SC signal changes suggests more severe inflammation in this group. PMID:24965833

  13. Pectoralis major motor evoked potentials in cervical spondylosis

    Microsoft Academic Search

    Y. L. Lo; L. L. Chan; C. T. Tan; J. L. T. Chen; S. B. Tan

    2005-01-01

    Myelopathy is a severe complication of cervical spondylosis (CS). We studied 27 consecutive patients with CS referred for evaluation for possible myelopathy using transcranial magnetic stimulation. The findings were compared with those from 20 normal controls. Magnetic resonance imaging was utilized to assess the degree of cord compromise. Central motor conduction time (CMCT) abnormalities showed equivalent diagnostic yield with pectoralis

  14. Amyotrophic lateral sclerosis: frequent complications by cervical spondylosis

    Microsoft Academic Search

    Masahito Yamada; Yutaka Furukawa; Mie Hirohata

    2003-01-01

    Cervical spondylosis is associated with myelopathy and radiculopathy, which sometimes mimic clinical manifestations of amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disorder that affects upper and lower motor neurons. Cervical spondylosis may coexist with ALS because both diseases preferentially affect individuals of middle or old age. We investigated 63 patients with ALS to clarify the complications of cervical spondylosis and

  15. Longitudinal length of the spinal cord after cervical laminoplasty

    Microsoft Academic Search

    Toru Yokoyama; Kazumasa Ueyama; Akihiro Okada; Takashi Tomita

    2002-01-01

    Purpose of study: In cases of cervical myelopathy, the relationship between surgical outcome after laminoplasty and the sagittal alignment is controversial. In our cases with OPLL of unexpected poor surgical outcome, we often found a straight, tense spinal cord on postoperative magnetic resonance imaging, (MRI). So we tried to measure a longitudinal length of the cervical spinal cord (LSC) as

  16. Acute transverse myelopathy complicating systemic lupus erythematosus.

    PubMed Central

    Propper, D J; Bucknall, R C

    1989-01-01

    A sixteen year old girl with systemic lupus erythematosus developed acute transverse myelopathy. She was treated with high dose steroids, cyclophosphamide, and plasma exchange and regained partial neurological function. Previous descriptions of transverse myelopathy complicating systemic lupus erythematosus are reviewed, with particular reference to the efficacy of high dose steroid treatment. PMID:2662918

  17. Schistosomal myelopathy in childhood: findings of magnetic resonance imaging in 26 patients.

    PubMed

    Henriques-Souza, Adélia Maria de Miranda; Valença, Marcelo Moraes

    2011-12-01

    We describe magnetic resonance image findings of 26 children (16 boys; average age, 9.4 years) with schistosomal myelopathy. All children lived in Pernambuco State, Brazil, an area of endemic mansoni schistosomiasis. Imaging abnormalities were identified in 92.3% of the children. The most frequent findings included: (1) enlargement of the spinal cord at the thoracic level, usually below T(8), in 23/24 (96%) patients; (2) hypointense signals in T(1)-weighted imaging; (3) hyperintense signals in T(2) imaging; and (4) heterogeneous enhancement with gadolinium. Although enlargement was evident at the thoracic level, abnormal signals frequently extended to the lower cervical level, or inferiorly to the lumbar and sacral cord. Magnetic resonance imaging of the spinal cord can play a strong role in the investigation of children with schistosomal myelopathy. Although imaging abnormalities are not specific, their presence strengthens presumptive diagnoses, to expedite treatment and avoid invasive procedures. PMID:22114998

  18. Phosphorylated neurofilament subunit NF-H becomes elevated in the cerebrospinal fluid of patients with acutely worsening symptoms of compression myelopathy.

    PubMed

    Takahashi, Hiroshi; Aoki, Yasuchika; Nakajima, Arata; Sonobe, Masato; Terajima, Fumiaki; Saito, Masahiko; Taniguchi, Shinji; Yamada, Manabu; Watanabe, Fusako; Furuya, Takeo; Koda, Masao; Yamazaki, Masashi; Takahashi, Kazuhisa; Nakagawa, Koichi

    2014-12-01

    It is known that the severity of compression myelopathy sometimes worsens rapidly and results in poor functional recovery because of limited axonal regeneration. Levels of phosphorylated neurofilament subunit NF-H (pNF-H), which indicate axonal degeneration, are elevated in other neurological disorders. To our knowledge, there has been no examination of pNF-H levels in compression myelopathy. Therefore, we conducted a pilot cross-sectional study to evaluate pNF-H levels in the cerebrospinal fluid (CSF) of patients with worsening symptoms of cervical compression myelopathy. From January 2011 to March 2013, 51 samples of CSF were collected from patients at the time of myelography before spinal surgery. The indications for surgery were acutely worsening compression myelopathy (AM) in eight, chronic compression myelopathy (CM) in six, and lumbar canal stenosis (LCS) in 37 patients. The pNF-H levels were measured using a standard enzyme-linked immunosorbent assay. The mean ± standard deviation pNF-H value was 2127.1 ± 556.8 pg/ml in AM patients, 175.8 ± 67.38 pg/ml in CM patients and 518.7 ± 665.7 pg/ml in LCS patients. A significant increase in pNF-H levels was detected in the CSF of patients with AM compared with those with either CM or LCS. The clinical outcome of surgical treatment for patients with cervical myelopathy was satisfactory in both AM and CM patients. Despite the limitations of small sample size and lack of healthy CSF control data due to ethical considerations, our results suggest that pNF-H in CSF can act as a biomarker that reflects the severity of AM. PMID:25065845

  19. Microsurgical Anterior Cervical Foraminotomy (Uncoforaminotomy) for Unilateral Radiculopathy: Clinical Results of a new Technique

    Microsoft Academic Search

    W. Saringer; I. Nöbauer; M. Reddy; M. Tschabitscher; A. Horaczek

    2002-01-01

    Summary.\\u000a Summary.  \\u000a ?\\u000a \\u000a \\u000a \\u000a \\u000a Background:   The authors report the clinical application of a new microsurgical technique. The cervical anterior foraminotomy (uncoforaminotomy),\\u000a which is used for the surgical treatment of unilateral cervical radiculopathy secondary to posterolateral disc herniations\\u000a or spondylotic foraminal stenoses.\\u000a \\u000a ?\\u000a \\u000a \\u000a \\u000a \\u000a Method:   Between June 2000 and May 2001, 34 patients (16 men and 18 women with a mean age of

  20. From less to maximally invasiveness in cervical spine surgery

    PubMed Central

    Visocchi, M.; Conforti, G.; Roselli, R.; La Rocca, G.; Spallone, A.

    2015-01-01

    Introduction Multilevel cervical myelopathy without surgical treatment is generally poor in the neurological deficit without surgical decompression. The two main surgical strategies used for the treatment of multilevel cervical myelopathy are anterior decompression via anterior corpectomy or posterior decompression via laminctomy/laminoplasty. Presentation of case We present the case of a 62 year-old lady, harboring rheumatoid artritis (RA) with gait disturbances, pain, and weakness in both arms. A C5 and C6 somatectomy, C4–C7 discectomy and, instrumentation and fusion with telescopic distractor “piston like”, anterior plate and expandable screws were performed. Two days later the patient complained dysfagia, and a cervical X-ray showed hardware dislocation. So a C4 somatectomy, telescopic extension of the construct up to C3 with expandible screws was performed. After one week the patient complained again soft dysfagia. New cervical X-ray showed the pull out of the cranial screws (C3). So the third surgery “one stage combined” an anterior decompression with fusion along with posterior instrumentation, and fusion was performed. Discussion There is a considerable controversy over which surgical approach will receive the best clinical outcome for the minimum cost in the compressive cervical myelopathy. However, the most important factors in patient selection for a particular procedure are the clinical symptoms and the radiographic alignment of the spine. the goals of surgery for cervical multilevel stenosis include the restoration of height, alignment, and stability. Conclusion We stress the importance of a careful patients selection, and invocated still the importance for 360° cervical fixation. PMID:25734320

  1. Fibrocartilaginous Embolic Myelopathy in a Dog

    PubMed Central

    Gill, C. W.

    1979-01-01

    This case report gives details concerning fibrocartilaginous arterial embolism leading to an ischemic myelopathy in a dog. Using various histochemical techniques, the material occluding the vessels was found to be similar to that reported for fibrocartilaginous ground substance of the nucleus pulposus. The pathway by which this material enters the arterial vasculature of the spinal cord is not known. ImagesFIGURE 1.FIGURE 2.FIGURE 3.FIGURE 4. PMID:544004

  2. Hyperferritinemia in a woman with systemic lupus erythematosus, severe nephritis and an iron-rich intraspinal schwannoma mimicking lupus myelopathy.

    PubMed

    Conca, W; Al-Hakim, M; Moussa, N; Al-Salam, S; Corr, P

    2009-01-01

    We describe a lupus flare in a 59-year-old woman who presented with pancytopenia, nephritis, severe renal dysfunction and marked hyperferritinemia. The course of the disease was further complicated by an iron-laden, intraspinal ancient schwannoma that compressed the cervical cord mimicking a lupus-related myelopathy and was removed surgically. Treatment with mycophenolate mofetil (MMF) and prednisone induced a gradual decline in levels of serum ferritin with a concomitant improvement in renal function and reduction of proteinuria. Serum ferritin may be a useful marker of the response to treatment with MMF in renal lupus. PMID:19917169

  3. Thoracic spondylosis presenting with spastic paraparesis

    Microsoft Academic Search

    J. S. Chana; F. Afshar

    1996-01-01

    Spondylotic change of the spine is common in the cervical and lumbar regions and may present with compression of the spinal cord and nerve roots. Myelopathy due to degenerative disease in the thoracic spine is exceptional. Only a few cases have been reported in the literature and these reports have described disease in the lower four thoracic segments. We report

  4. Selective posterior decompression of the cervical spine.

    PubMed

    Kim, Kyongsong; Isu, Toyohiko; Sugawara, Atsushi; Matsumoto, Ryoji; Isobe, Masanori; Morimoto, Daijiro; Mishina, Masahiro; Kobayashi, Shiro; Yoshida, Daizo; Teramoto, Akira

    2011-01-01

    Posterior decompression of the cervical spine is an accepted treatment for patients with cervical canal disease, but some patients experience postoperative axial pain and C5 or C6 palsy that affect their quality of life. Here we describe selective posterior decompression using a spinous process-splitting approach to prevent these complications performed in 17 patients with myelopathy treated at median 2.4 levels by selective posterior decompression via the transspinous approach. Clinical symptoms, axial pain, and C5 or C6 palsy were compared before and after treatment. The range of motion of the cervical spine and shift of the cervical cord were studied at the C5 level. All patients experienced symptom improvement and none suffered deterioration or required reoperation. The Japanese Orthopaedic Association score improved from 10.9 to 14.4 points and none of the patients reported C5 or C6 palsy or axial pain at the last follow-up visit. There was no statistically significant change in pre- and postoperative cervical alignment and range of motion. The posterior shift of the spinal cord at the C5 level was 1.7 mm. None of our 17 patients experienced significant postoperative axial pain after selective posterior decompression via the transspinous approach. Minimal spinal cord shift at the C5 level may have contributed to the reduced incidence of postoperative C5 or C6 palsy in our series. Selective posterior decompression is less invasive and effective in some patients with cervical canal disease. PMID:21358151

  5. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment.

    PubMed

    Woods, Barrett I; Hilibrand, Alan S

    2015-06-01

    Cervical radiculopathy is a relatively common neurological disorder resulting from nerve root dysfunction, which is often due to mechanical compression; however, inflammatory cytokines released from damaged intervertebral disks can also result in symptoms. Cervical radiculopathy can often be diagnosed with a thorough history and physical examination, but an magnetic resonance imaging or computed tomographic myelogram should be used to confirm the diagnosis. Because of the ubiquity of degenerative changes found on these imaging modalities, the patient's symptoms must correlate with pathology for a successful diagnosis. In the absence of myelopathy or significant muscle weakness all patients should be treated conservatively for at least 6 weeks. Conservative treatments consist of immobilization, anti-inflammatory medications, physical therapy, cervical traction, and epidural steroid injections. Cervical radiculopathy typically is self-limiting with 75%-90% of patients achieving symptomatic improvement with nonoperative care. For patients who are persistently symptomatic despite conservative treatment, or those who have a significant functional deficit surgical treatment is appropriate. Surgical options include anterior cervical decompression and fusion, cervical disk arthroplasty, and posterior foraminotomy. Patient selection is critical to optimize outcome. PMID:25985461

  6. Intradural tumor and concomitant disc herniation of cervical spine

    PubMed Central

    Bapat, Mihir R; Rathi, Prasanna; Pawar, Uday; Chaudhary, Kshitij

    2011-01-01

    We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies. PMID:21221228

  7. Intradural tumor and concomitant disc herniation of cervical spine.

    PubMed

    Bapat, Mihir R; Rathi, Prasanna; Pawar, Uday; Chaudhary, Kshitij

    2011-01-01

    We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies. PMID:21221228

  8. Surgical treatment of myeloradiculopathy in cervical spondylosis. A report on 438 operations.

    PubMed

    Samii, M; Völkening, D; Sepehrnia, A; Penkert, G; Baumann, H

    1989-01-01

    In the past eleven years we have performed 438 microsurgical ventral discectomies with bilateral foraminotomy followed by fusion with palacos in the cervical spine in our clinic. An analysis of the preoperative symptoms shows a great variability and overlapping of the various segments. To determine the right level for the operation it is crucial that the results of the clinical and the radiological examinations be evaluated. The results of ascending myelography and CT scans are of great value. In cases of cervical myelopathy a multisegmental operation is often necessary to obtain good results. The complication rate was small in our patients and a second operation was only necessary in a few cases. We had very good postoperative results in radicular pain and muscle weakness. In patients with symptoms of cervical myelopathy we achieved considerable improvement. PMID:2594204

  9. Cervical Cancer

    MedlinePLUS

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. ...

  10. Combined Anterior Approach with Transcorporeal Herniotomy for a Huge Migrated Cervical Disc Herniation

    PubMed Central

    Ahn, Yong; Lee, Choon Dae; Lee, Sang-Ho

    2011-01-01

    The report describes the herniation of a huge migrated cervical disc, which was treated by a combined anterior approach. A 50-year-old man presented with radiculopathy and myelopathy. Radiological images revealed the herniation of a huge disc which had migrated superiorly from the C6-7 disc to the C5-6 disc. We tried to combine an anterior cervical discectomy and fusion (ACDF) and transcorporeal herniotomy to avoid corpectomy. Postoperatively, successful clinical and radiological results were obtained. It is therefore possible to remove a huge migrated herniated cervical disc completely by a combined ACDF and trancorporeal approach without corpectomy.

  11. [Cervical teratoma].

    PubMed

    Lindhardt, Christian; Kristensen, Søren

    2003-04-21

    We describe the case of a 3-year-old girl with a cervical teratoma. Cervical teratomas are rare tumors in infancy and childhood, commonly presenting as large cervical masses and often diagnosed before birth. In the actual case the teratoma was present at birth but was very small and had a little pseudoduct, which was mistaken for a median cervical cyst. It is emphasized that knowledge of teratomas although often benign in infants and children is essential since they have a malignant potential. If detected early surgical removal is curative provided it is complete. PMID:12768909

  12. Cervical polyps

    MedlinePLUS

    Cervical polyps are fingerlike growths on the lower part of the uterus that connects with the vagina ( ... The exact cause of cervical polyps is not known. They may occur with: An abnormal response to increased levels of the female hormone estrogen Chronic ...

  13. Aggressive vertebral hemangioma as a rare cause of myelopathy.

    PubMed

    Sari, Hidayet; Uludag, Murat; Akarirmak, Ulku; Ornek, Nurettin Irem; Gun, Kerem; Gulsen, Fatih

    2014-01-01

    Vertebral hemangiomas (VHs) are common lesions in the adult population. They are usually asymptomatic and found incidentally on radiological imaging. New-onset back pain followed by subacute progression of thoracal myelopathy is the most common presentation in patients with neurological deficit. Differential diagnoses would include metastasis, multiple myeloma, lymphoma, Paget disease, osseous tumors such as Ewing sarcoma or hemangioblastoma and blood dyscrasia. We present a 41 year-old-male patient with thoracal VH causing myelopathy that completely improved after rehabilitation program with embolization and vertebroplasty procedures. PMID:23948851

  14. Cervical Cancer

    MedlinePLUS

    ... Centers for Disease Control and Prevention’s (CDC) Inside Knowledge: Get the Facts About Gynecologic Cancer campaign. The ... the facts about gynecologic cancer, providing important “inside knowledge” about their bodies and health. What is cervical ...

  15. Cervical Cancer

    MedlinePLUS

    ... and chlamydia. HPV is the virus that can cause genital warts. It seems to be very closely connected with these changes. Risk factors for cervical cancer Starting to have sex early (before age 18) ...

  16. Use of cylindrical titanium mesh and locking plates in anterior cervical fusion. Technical note.

    PubMed

    Das, K; Couldwell, W T; Sava, G; Taddonio, R F

    2001-01-01

    After performing anterior cervical corpectomy or discectomy for cervical spondolytic myelopathy or radiculopathy, iliac crest bone graft and fibular auto- or allograft is often used to achieve arthrodesis in the cervical spine. The purpose of this study was to evaluate the use of a cylindrical titanium mesh and locking plate system as an alternative technique in achieving anterior cervical fusion and maintaining lordosis. Hospital records and radiographs of 38 patients who underwent anterior cervical discectomies (28 patients) or corpectomies (10 patients) from 1995 to 1997 were reviewed retrospectively. All patients had undergone arthrodesis in which autograft and a cylindrical titanium mesh and anterior locking plate fixation were used after discectomy or corpectomy. There were 20 men and 18 women (mean age 46.1 years; range 34-72 years). Presenting symptoms included radiculopathy (61%), myelopathy (37%), and neck pain (2%). Preoperative and postoperative radiographs were studied, and data were obtained on the following: overall lordosis or kyphosis of the cervical spine, segmental lordosis or kyphosis at each surgically treated level, and evidence of fusion. In all of the patients in whom lordosis was present preoperatively, lordosis was maintained during the follow-up period. The overall fusion rate was 100%. The average change in overall lordosis or kyphosis related to the fixation devices was 1.2 degrees (range 1-5 degrees) the average segmental change was 2.3 degrees (range 0-5 degrees); and the mean follow up was 16 months (range 12-36 months). Anterior cervical fusion with cylindrical titanium mesh and cervical locking plate system is an effective method of achieving arthrodesis and maintaining alignment in the cervical spine. The construct may provide additional load-sharing function, and it avoids the use of cadaveric bone or the need for harvesting tricortical iliac crest autograft. PMID:11147858

  17. Vaginitis, cervicitis, and cervical length in pregnancy

    Microsoft Academic Search

    Jantien J. Boomgaard; Karin S. Dekker; Elsabet van Rensburg; Corlia van den Berg; Illse Niemand; Roosmarie H. Bam; Hendrik S. Cronjé

    1999-01-01

    Objective: We sought to determine the possible association among vaginitis, cervicitis, and cervical length in pregnancy. Study Design: Primigravid volunteers, between 20 and 36 weeks’ gestation (n = 210), were examined. Vaginitis was diagnosed by pH determination and wet mount smear, cervicitis was diagnosed by cervicography, and cervical length was diagnosed by vaginal ultrasonographic measurement. Patients with both vaginitis and

  18. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones.

    PubMed

    Aleman, Monica; Dimock, Abigail N; Wisner, Erik R; Prutton, Jamie W; Madigan, John E

    2014-11-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  19. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones

    PubMed Central

    Aleman, Monica; Dimock, Abigail N.; Wisner, Erik R.; Prutton, Jamie W.; Madigan, John E.

    2014-01-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  20. Progressive Myelopathy in a Dog Caused by Thorium Dioxide

    PubMed Central

    Lord, L. H.; Robinson, G. A.

    1965-01-01

    A study of the use of Thorotrast as a contrast media in myelograms in dogs is presented, indicating that the material introduced into the cerebro-spinal fluid, will become permanently associated with the meninges, leading to the development of myelopathy. ImagesFig. 1 (a)Fig. 1 (b).Fig. 1 (c).Fig. 1 (d).Fig. 2a.FIG. 2b.FIG. 3a.FIG. 3b.FIG. 4.FIG. 5. PMID:4221911

  1. Revision of anterior cervical pseudoarthrosis with anterior allograft fusion and plating.

    PubMed

    Coric, D; Branch, C L; Jenkins, J D

    1997-06-01

    Anterior cervical discectomy and fusion is an efficacious procedure used to treat a variety of cervical spinal disorders, including spondylosis, myelopathy, herniated discs, trauma, and degenerative disc disease. Pseudarthrosis, or failure of fusion, may be the most common complication of spinal fusion procedures. Nineteen consecutive patients with symptomatic pseudarthrosis following failed anterior cervical fusions were treated with anterior cervical revision using iliac crest allografts and either the Cervical Spine Locking Plate system (10 patients) or the Trapezial Osteosynthetic Plate system (nine patients). The mean age of the nine men and 10 women undergoing treatment was 49.1 years (range 25-72 years). Eleven patients (57.9%) exhibited pseudarthrosis at one level, six (31.5%) at two levels, and two (10.5%) at three levels. The indications for revision were intractable neck pain with radiculopathy (17 patients) or myelopathy (two patients), with evidence of pseudarthrosis on plain cervical radiography as well as computerized tomography (CT) or single-photon emission computerized tomography (SPECT) scanning, or both. All eight patients evaluated with SPECT showed increased focal uptake consistent with pseudarthrosis, which was subsequently confirmed intraoperatively in all eight. The average follow-up period was 22.4 months (range 12-42 months). Solid osseous fusion was achieved over all 28 levels in all 18 patients available for follow-up review (100%). One patient died 4 months postoperatively from myocardial infarction related to preexisting coronary artery disease. There were no intraoperative complications; postoperatively, two patients (10.5%) experienced transient hoarseness. Anterior revision of failed cervical fusions using allograft interbody fusion material and anterior plating is a safe and efficacious procedure. In this series, the use of allografts avoided donor site morbidity without adversely affecting fusion rates. Rigid internal fixation was achieved by means of anterior plating without increasing surgical morbidity rates. The SPECT imaging technique has the potential to reliably confirm the diagnosis of pseudarthrosis. PMID:9171175

  2. Cervical spine CT scan

    MedlinePLUS

    ... scan – cervical spine; Computed tomography scan – cervical spine; CT scan - cervical spine; Neck CT scan ... table that slides into the center of the CT scanner. Once you are inside the scanner, the ...

  3. Cervical Cancer Stage IIIA

    MedlinePLUS

    ... My Pictures Browse Search Quick Search Image Details Cervical Cancer Stage IIIA View/Download: Small: 612x612 View Download Add to My Pictures Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; ...

  4. Cervical Cancer Stage IVB

    MedlinePLUS

    ... My Pictures Browse Search Quick Search Image Details Cervical Cancer Stage IVB View/Download: Small: 594x640 View Download Add to My Pictures Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; ...

  5. Cervical Cancer Stage IA

    MedlinePLUS

    Cervical Cancer Stage IA View/Download: Small: 720x576 View Download Add to My Pictures Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing shows a cross-section of the ...

  6. Cervical Cancer Stage IVA

    MedlinePLUS

    ... My Pictures Browse Search Quick Search Image Details Cervical Cancer Stage IVA View/Download: Small: 756x576 View Download Add to My Pictures Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; ...

  7. Cervical dysplasia - series (image)

    MedlinePLUS

    Cervical cancer is one of the most common cancers in women. It is a cancer of the ... smear is the screening procedure used to detect cervical cancer. Limited or early cervical cancer (carcinoma in ...

  8. [Cervical spondylosis].

    PubMed

    Iwanami, Akio; Toyama, Yoshiaki

    2014-10-01

    Japan has now become an aging society. In 2014, people aged more than 65 years old accounted for 25.1% of Japan's entire population. Aging is associated with an increased risk of problems related to the locomotive organs. Deterioration of locomotive ability causes falls or tumbles, which would be a threat to good health and longevity of aged people. To maintain the locomotive ability of the elderly, therefore, the Japanese Orthopaedic Association starts a campaign to promote awareness and prevention of "locomotive syndrome". Cervical spondylosis is a disorder for age-related wear affecting the disks and vertebrae of cervical spine. It would also be a cause of "locomotive syndrome". Here, we give an outline of this disease and introduce its diagnosis and treatment. PMID:25509798

  9. Missed upper cervical spine fracture: clinical and radiological considerations

    PubMed Central

    Hadida, Camille; Lemire, Joe J

    1997-01-01

    Objective: This report presents a case of missed upper cervical spine fracture following a motor vehicle accident and illustrates various clinical and radiographic considerations necessary in the evaluation of post traumatic cervical spine injuries. Specific clinical signs and symptoms, as well as radiographic clues should prompt the astute clinician to suspect a fracture even when plain film radiographs have been reported as normal. Clinical features: A 44-year-old male was referred for an orthopaedic consultation for assessment of headaches following a high speed head-on motor vehicle accident eleven weeks prior to his presentation. Cervical spine radiographs taken at an emergency ward the day of the collision were reported as essentially normal. Subsequent radiographs taken eleven weeks later revealed a fracture through the body of axis with anterior displacement of atlas. A review of the initial radiographs clearly demonstrated signs suggesting an upper cervical fracture. Intervention and outcome: Initially the patient was prescribed a soft collar which he wore daily until an orthopaedic consultation eleven weeks later. Fifteen weeks following trauma, the patient was considered for surgical intervention, due to persistent headaches associated with the development of neurological signs suggestive of early onset of cervical myelopathy. Conclusion: Cervical spine fractures can have disastrous consequences if not detected early. A thorough clinical and radiological evaluation is essential in any patient presenting with a history of neck or head trauma. Repeated plain film radiographs are imperative in the event of inadequate visualization of the cervical vertebrae. When in doubt, further imaging studies such as computed tomography or magnetic resonance imaging are required to rule out a fracture. ImagesFigure 1AFigure 1BFigure 2Figure 3

  10. Resection of an intramedullary high cervical metastasis from a malignant mixed Muellerian tumour.

    PubMed

    Stienen, Martin Nikolaus; Hinkerohe, Daniel; Harders, Albrecht; Lücke, Sebastian

    2013-04-01

    We present a 66-year-old female patient with a high cervical intramedullary metastasis from a malignant mixed Muellerian tumour (MMMT; carcinosarcoma) with concomitant syringomyelia. She was admitted to our clinic with symptoms of cervical myelopathy. MRI revealed an intramedullary tumour of 2.6cm×1.2cm at the cervical vertebral body C2. We performed a laminectomy on C2 followed by a dorsal median myelotomy from C1 to C3 to resect the tumour. The surgical intervention removed the tumour completely and resolved the syringomyelia. During the 36months of follow-up, the patient presented in a stable condition with no evidence of tumour recurrence. To our knowledge, this is the first report of an intramedullary metastasis of a MMMT. PMID:23321628

  11. Cervical orthoses.

    PubMed

    Beavis, A

    1989-04-01

    A biomechanical study is presented to compare the effectiveness of three types of off-the-shelf cervical orthoses and one custom-fit collar in restricting cervical spine motion. A group of 10 normal subjects was studied. The measurements of flexion and extension, lateral side flexion and axial rotation were recorded using various measurement techniques. Interface pressures at the chin and occiput were also measured, along with the warming effect of the collars. The results indicated that all the collars restricted neck movements, for example, the Plastazote collar by 50% of flexion and extension, and that there was no significant difference between off-the-shelf Plastazote and custom-fit collars in restricting movement. Significantly high interface pressures were recorded at the chin, with the subjects wearing the hard and Plastazote orthoses. The warming effect of the soft collar was equal to that of a wool scarf. The study was aimed at improving prescription and although the subjective observations were not validated, the subjects concluded that the custom-fit collars were more comfortable; an important point with such a high rejection rate. PMID:2717386

  12. Drugs Approved for Cervical Cancer

    MedlinePLUS

    ... Questions to Ask Your Doctor about Treatment Research Drugs Approved for Cervical Cancer This page lists cancer ... Cervical Cancer Drug Combinations Used in Cervical Cancer Drugs Approved to Prevent Cervical Cancer Cervarix (Recombinant HPV ...

  13. Unexpected death of a patient with rheumatoid arthritis complicated by a cervical deformity.

    PubMed

    Unuma, Kana; Harada, Kazuki; Nakajima, Makoto; Ito, Takako; Okutsu, Kosuke; Yoshida, Ken-ichi

    2010-09-01

    An elderly female with a 43-year history of rheumatoid arthritis died 2weeks after the onset of chest discomfort, electrolyte disturbance, and interstitial pneumonia. She had frequent premature ventricular contractions, fluctuating heart rate, and hypotension. Ischemic heart disease and interstitial pneumonia were excluded as the cause of death based on clinical course and autopsy findings. A severe cervical deformity with myelopathy likely contributed to circulatory instability, possibly through injury to the intra-spinal sympathetic nervous system, which can induce cardiovascular instability and suppress respiratory function. This likely led to death. PMID:20634116

  14. New titanium spacer for cervical laminoplasty: initial clinical experience. Technical note.

    PubMed

    Tani, Satoshi; Suetsua, Futoshi; Mizuno, Junichi; Uchikado, Hisaaki; Nagashima, Hiroyasu; Akiyama, Masahiko; Isoshima, Akira; Ohashi, Hiroki; Hirano, Yoshitaka; Abe, Toshiaki

    2010-01-01

    Many commercially available hydroxyapatite (HA) spacers for cervical laminoplasty have been introduced but have disadvantages such as lack of plasticity, easy cracking, and occasional difficulty in fixation by sutures. Here we present the short-term results of a newly designed titanium spacer (Laminoplasty Basket) in open-door cervical laminoplasty, and evaluated clinically and radiologically. The titanium box-shaped spacer with two arms for fixation was easily inserted and fixed into the laminoplasty space with 4-mm or 5-mm length screws after the posterior cervical arch was repositioned for the canal expansion. Twenty-one patients with cervical myelopathy due to spondylosis or ossification of the longitudinal ligament or developmental narrow canal observed for more than 6 months postoperatively were enrolled in this study. The neurological condition of these patients improved from 9.4 points on the Japanese Orthopaedic Association scale preoperatively to 13.5 points at 6 months after surgery. Postoperative radiological evaluation showed no laminar closure or implant failure and cervical spine curvature was maintained. These results seemed to have no significant difference compared with those using HA spacers. This titanium spacer is a potential substitute for conventional HA or other similar devices in cervical laminoplasty. PMID:21206196

  15. Transient radiation myelopathy: spinal somatosensory evoked responses following incidental cord exposure during radiotherapy

    Microsoft Academic Search

    B R Lecky; N M Murray; R J Berry

    1980-01-01

    Serial spinal somatosensory evoked potentials were recorded in six patients undergoing radiotherapy involving incidental spinal radiation. Two patients developed transient radiation myelopathy. No abnormality was found in the somatosensory evoked potentials throughout the study.

  16. Hepatic myelopathy: an unusual neurological complication of chronic liver disease presenting as quadriparesis

    PubMed Central

    Kori, Prakash; Sahu, Ritesh; Jaiswal, Anupam; Shukla, Rakesh

    2013-01-01

    Hepatic myelopathy is a rare neurological complication of chronic liver disease, which is usually seen in adults, presenting as pure motor spastic paraparesis. It is almost always associated with portosystemic shunts and hepatic decompensation. We report a rare case of a young adult man presenting as rapidly progressive spastic quadriparesis because of hepatic myelopathy and associated spontaneous splenorenal shunt and early hepatic decompensation. PMID:23749858

  17. Intra-individual variation in lumbar bone mineral density as a measure of spondylotic deformity in the elderly

    Microsoft Academic Search

    Takuo Fujita; Mutsumi Ohue; Yoshio Fujii; Akimitsu Miyauchi; Yasuyuki Takagi

    2003-01-01

    .  ?In an attempt at quantitative assessment of spondylotic deformity, the intra-individual variation in L1–L4 bone mineral density (BMD) was calculated, as the standard deviation (SD) and coefficient of variation (CV), obtained by\\u000a dividing the SD by mean L1–L4 BMD, in 463 subjects. The subjects ranged in age from their second to tenth decades. Dual-energy X-ray absorptiometry (DXA),\\u000a using the Lunar

  18. Smoking and Cervical Cancer

    MedlinePLUS

    ... been found in cervical mucus. These substances, called carcinogens, may damage the genes in cervical cells. Because ... www.smokefree.gov/ American Cancer ... Lung Association: http://www.ffsonline.org/ Centers for Disease ...

  19. Cervical Cancer Screening

    MedlinePLUS

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes ...

  20. Cervical spondylosis (image)

    MedlinePLUS

    Cervical spondylosis is a disorder that results from abnormal growth of the bones of the neck and ... Progressive neck pain is a key indication of cervical spondylosis. It may be the only symptom in ...

  1. [Cervical ranula].

    PubMed

    Geurts, T W; van den Akker, H P; Balm, A J

    2004-02-21

    Three patients, 2 men aged 21 and 39 years, respectively, and 1 woman aged 29 years, presented with a unilateral swelling of the neck, with no accompanying symptoms. In the youngest man the diagnosis of a 'plunging ranula' was made after repeated fine needle aspiration yielded viscous yellowish mucus with a high amylase content. In the oldest man the diagnosis was made during the operation and in the woman the diagnosis was finally made after two surgical explorations in the neck. In all 3, no recurrence occurred after removal of the involved salivary glands. A cervical ranula is an extension of a pseudocyst of the glandula sublingualis. Important clues for the diagnosis of a 'plunging ranula' are: the simultaneous presence of a ranula in the floor of the mouth (or a history of one), a characteristic cystic mass in the submandibular space with an extension into the sublingual space on CT and/or MRI, and the aspiration of amylase-containing mucus. Excision of the sublingual gland as the source of salivary leakage is the therapy of choice in a case of 'plunging ranula', with drainage of mucus from the ranula into the oral cavity. As the 'plunging ranula' represents a pseudocyst without an epithelial lining, excision is not indicated. PMID:15032092

  2. Congenital Stenosis of the Cervical Spine: Diagnosis and Management

    PubMed Central

    Countee, Roger W.; Vijayanathan, Thurairasah

    1979-01-01

    An analysis of 11 cases of congenital stenosis of the cervical spine seen over the past three years is reported. The authors' experiences at an urban community hospital, as well as a large Veterans Administration Hospital, lead them to conclude that this disorder is a neurologically significant anomaly which is probably more common than published reports would imply. It can be clinically and radiographically distinguished from “pure” cervical spondylosis, to which it is related, and its treatment should be appropriately modified. It appears to have a predilection for young adult black males, and cervical myelopathy is the predominant clinical feature. Varying degrees of trauma, a disease endemic to the inner city, plays a major role in precipitating the neurological catastrophes associated with this potentially correctable disorder. Proper management of this entity demands a heightened awareness of its existence as well as a high standard of neurological and roentgenographic diagnosis, and operative performance. A flexible operative strategy which takes into account the specific biomechanical factors involved in this disorder as well as the patient's individual physiological and social status is imperative. Surgery offers a good opportunity for improving neurological function. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:439156

  3. Cervical paravertebral osteolipoma: case report and literature review.

    PubMed

    Guirro, Pau; Saló, Guillem; Molina, Antoni; Lladó, Andreu; Puig-Verdié, Lluís; Ramírez-Valencia, Manuel

    2015-04-01

    Lipomas are the most frequent soft tissue tumors. Osteolipomas are a rare variant that can be difficult to diagnose. We report the case of a 66-year-old man consulting with a tumor of 2 years development in the right paravertebral cervical region. Neurologically, the patient had no sign of myelopathy or neurological focality. Magnetic resonance imaging showed a mass with a lipid component and calcifications inside within the right paravertebral musculature with a possible origin in the right C3 posterior root. A computed tomography scan and guided biopsy were performed, revealing hematic material and small bone spicules with no apparent neoplastic element. The tumor was totally removed, including the right C3 posterior branch, and was confirmed to be an osteolipoma on biopsy. The patient remains asymptomatic at 6-month follow-up. The osteolipoma is a benign tumor of soft tissue, characterized by lipoma areas with mature bone tissue differentiation, and even with hematopoietic marrow. PMID:25901244

  4. Giant Ventral Midline Schwannoma of Cervical Spine : Agonies and Nuances

    PubMed Central

    Chagla, Aadil; Goel, Atul

    2010-01-01

    Pure ventral midline giant schwannoma is an extremely rare entity. Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated giant pan cervical extramedullary schwannoma in an 18-year-old male patient with compressive myelopathy and sphincter involvement is presented. Spinal MR imaging showed a midline ventrally situated extramedullary tumor with severe spinal cord compression extending from clivus to C7 vertebra. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. Post operative MR imaging showed no evidence of the tumor. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed. PMID:20617092

  5. Veliparib, Topotecan Hydrochloride, and Filgrastim or Pegfilgrastim in Treating Patients With Persistent or Recurrent Cervical Cancer

    ClinicalTrials.gov

    2015-07-16

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Recurrent Cervical Carcinoma; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  6. Veliparib, Topotecan Hydrochloride, and Filgrastim or Pegfilgrastim in Treating Patients With Persistent or Recurrent Cervical Cancer

    ClinicalTrials.gov

    2015-06-02

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Recurrent Cervical Carcinoma; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  7. Vaccines against cervical cancer.

    PubMed

    Jansen, Kathrin U

    2004-11-01

    Cervical cancer and precancerous lesions of the genital tract are a major threat to women's health worldwide. Although the introduction of screening tests to detect cervical cancer and its precursor lesions has reduced overall cervical cancer rates in the developed world, the approach was largely unsuccessful for developing countries, primarily due to a lack of appropriate infrastructures and high costs. Annually, 470,000 cervical cancer cases are diagnosed worldwide, of which 80% occur in developing countries. Despite advances in treatment of cervical cancer, approximately half of the women afflicted with the disease will die. Over 20 years of dedicated research has provided conclusive evidence that a subset of human papillomaviruses are the aetiological agents for cervical cancer. Finding a viral origin for this disease provided the basis to fight cervical cancer using prophylactic or therapeutic vaccination. Both vaccine approaches are reviewed here, with an emphasis on recent clinical data. PMID:15500408

  8. Visuo-proprioceptive interactions in degenerative cervical spine diseases requiring surgery.

    PubMed

    Freppel, S; Bisdorff, A; Colnat-Coulbois, S; Ceyte, H; Cian, C; Gauchard, G; Auque, J; Perrin, P

    2013-01-01

    Cervical proprioception plays a key role in postural control, but its specific contribution is controversial. Postural impairment was shown in whiplash injuries without demonstrating the sole involvement of the cervical spine. The consequences of degenerative cervical spine diseases are underreported in posture-related scientific literature in spite of their high prevalence. No report has focused on the two different mechanisms underlying cervicobrachial pain: herniated discs and spondylosis. This study aimed to evaluate postural control of two groups of patients with degenerative cervical spine diseases with or without optokinetic stimulation before and after surgical treatment. Seventeen patients with radiculopathy were recruited and divided into two groups according to the spondylotic or discal origin of the nerve compression. All patients and a control population of 31 healthy individuals underwent a static posturographic test with 12 recordings; the first four recordings with the head in 0° position: eyes closed, eyes open without optokinetic stimulation, with clockwise and counter clockwise optokinetic stimulations. These four sensorial situations were repeated with the head rotated 30° to the left and to the right. Patients repeated these 12 recordings 6weeks postoperatively. None of the patients reported vertigo or balance disorders before or after surgery. Prior to surgery, in the eyes closed condition, the herniated disc group was more stable than the spondylosis group. After surgery, the contribution of visual input to postural control in a dynamic visual environment was reduced in both cervical spine diseases whereas in a stable visual environment visual contribution was reduced only in the spondylosis group. The relative importance of visual and proprioceptive inputs to postural control varies according to the type of pathology and surgery tends to reduce visual contribution mostly in the spondylosis group. PMID:24120556

  9. Single-Level Degenerative Cervical Disc Disease and Driving Disability: Results from a Prospective, Randomized Trial

    PubMed Central

    Kelly, Michael P.; Mitchell, M. David; Hacker, Robert J.; Riew, K. Daniel; Sasso, Rick C.

    2013-01-01

    Study Design?Post hoc analysis of prospective, randomized trial. Objective?To investigate the disability associated with driving and single-level degenerative, cervical disc disease and to investigate the effect of surgery on driving disability. Methods?Post hoc analysis of data obtained from three sites participating in a multicenter, randomized, controlled trial comparing cervical disc arthroplasty (TDA) with anterior cervical discectomy and fusion (ACDF). The driving subscale of the Neck Disability Index (NDI) was analyzed for all patients. A dichotomous severity score was created from the NDI. Statistical comparisons were made within and between groups. Results?Two-year follow-up was available for 118/135 (87%) patients. One half of the study population (49.6%) reported moderate or severe preoperative driving difficulty. This disability associated with driving was similar among the two groups (ACDF: 2.5?±?1.1, TDA: 2.6?±?1.0, p?=?0.646). The majority of patients showed improvement, with no or little driving disability, at the sixth postoperative week (ACDF: 75%, TDA: 90%, p?=?0.073). At no follow-up point did a difference exist between groups according to the severity index. Conclusions?Many patients suffering from radiculopathy or myelopathy from cervical disc disease are limited in their ability to operate an automobile. Following anterior cervical spine surgery, most patients are able to return to comfortable driving at 6 weeks. PMID:24436875

  10. Get Tested for Cervical Cancer

    MedlinePLUS

    ... Get Tested for Cervical Cancer Get Tested for Cervical Cancer The Basics Take Action! Ver en español ... tests) and follow-up care can help prevent cervical cancer. You can get a Pap test (sometimes ...

  11. Pediatric cervical spine instability

    PubMed Central

    El Hage, Samer; Rachkidi, Rami; Kharrat, Khalil; Dagher, Fernand; Kreichati, Gabi

    2008-01-01

    Cervical spine instability in children is rare but not exceptional and may be due to many factors. Although it mostly occurs at the upper cervical spine, all vertebrae from the occiput to T1 may be involved. It may be acute or chronic, occurring secondary to trauma or due to congenital anomaly, skeletal or metabolic dystrophy or rheumatoid arthritis. It can be isolated or associated with other musculoskeletal or visceral anomalies. A thorough knowledge of embryology, anatomy, physiology and physiopathology of the cervical spine in children is essential to avoid pitfalls, recognize normal variants and identify children at risk of developing cervical spine instability and undertake the appropriate treatment. PMID:19308585

  12. Bevacizumab, Radiation Therapy, and Cisplatin in Treating Patients With Previously Untreated Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2014-09-22

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer

  13. Cervical Discitis in Children.

    PubMed

    Scheuerman, Oded; Landau, Daniel; Schwarz, Michael; Hoffer, Vered; Marcus, Nufar; Hoffnung, Liat Ashkenazi; Levy, Itzhak

    2015-07-01

    Cervical discitis, though rare, should be included in the differential diagnosis of torticollis, neck pain and neurodevelopmental regression in motor skills in children and infants. Magnetic resonance imaging is the diagnostic method of choice. Treatment should be conservative with antibiotics only. The aim of this study was to describe the 10-year experience of a tertiary pediatric medical center with cervical discitis. PMID:25886786

  14. Osteoradionecrosis of the cervical vertebrae in patients irradiated for head and neck cancers.

    PubMed

    Kosaka, Yasuhiro; Okuno, Yoshishige; Tagawa, Yumiko; Ueki, Nami; Itoh, Kyo; Shinohara, Shogo; Kikuchi, Masahiro

    2010-06-01

    Osteoradionecrosis (ORN) is one of the common late adverse effects that follow radiation therapy for head and neck cancers. ORN usually develops on the mandible and less frequently on the maxilla. We present three cases of ORN of the cervical vertebrae, which is rarely reported. Two patients suffered from secondary osteomyelitis after neoadjuvant chemotherapy followed by definitive concurrent chemoradiation therapy with a hyperfractionated and an accelerated hyperfractionated regimen, respectively. For these patients, the high intensity of treatment was considered the cause of ORN. The third patient underwent concurrent chemoradiation therapy for upper thoracic esophageal cancer and subsequently underwent endoscopic laser resection and radiation therapy for hypopharyngeal cancer. ORN developed in the area of reirradiation. In this case, an excessive radiation dose was considered the cause. ORN of cervical vertebrae, different from that of the mandible and maxilla, has a risk of radiculopathy and myelopathy. In the future, ORN of cervical vertebrae will increase because metachronous double cancers will increase and opportunities for reirradiation, in turn, will increase. To prevent this, it is necessary to optimize the treatment schedule for radiation therapy, including the total dose, fractionation, and concurrent chemotherapy, and to decrease the volume of cervical vertebrae within the irradiation field. PMID:20585930

  15. Seropositive Neuromyelitis Optica imitating an Intramedullary Cervical Spinal Cord Tumor: Case Report and Brief Review of the Literature

    PubMed Central

    Chiu, Jennifer Hiu-Fung; Leung, Kar-Ming; Chan, Kwong-Yau

    2014-01-01

    A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized. PMID:25346824

  16. Posterior Cervical Foraminotomy and Laminectomy

    Microsoft Academic Search

    John E. O’Toole; Kurt M. Eichholz; Richard G. Fessler

    \\u000a Posterior decompressive procedures are fundamental tools in the surgical treatment of symptomatic cervical degenerative spine\\u000a disease [1–4]. Even as anterior cervical procedures have gained prominence, posterior cervical laminoforaminotomy still provides\\u000a symptomatic relief in 92–97% of patients with radiculopathy from foraminal stenosis or lateral herniated discs [3, 5]. Similarly,\\u000a posterior cervical decompression for cervical stenosis achieves neurological improvement in 62.5–83% of

  17. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    ClinicalTrials.gov

    2015-05-05

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  18. Posterior Epidural Migration of Sequestrated Cervical Disc Fragment: Case Series

    PubMed Central

    Kumar, Gopalan Senthil; Mahesha, Kanthila Bhat

    2011-01-01

    Study Design A retrospective study was undertaken to delineate the characteristics of non-traumatic sequestrated epidurally migrated cervical disc prolapse. Purpose To present first case series of eight such cases diagnosed preoperatively and to discuss their magnetic resonance imaging (MRI) characteristics and their management. Overview of Literature Non-traumatic spontaneous migration of the sequestrated disc fragment epidurally behind cervical vertebral body is rare. Only ten cases have been reported in literature. Methods Detailed clinico-radiological profiles of these 8 cases are presented. In six cases their clinical picture was suggestive of cervical myelopathy. MRI scan showed single level epidural migrated disc behind body of C4, C6, and C7 in six patients and two cases with multiple levels (C5-C6). In six cases, anterior corpectomy with excision of the disc was performed and the seventh patient underwent dorsal laminectomy. The eighth patient chose not to undergo surgery. Results T1 images of the MRI scan showed an isointense signal in all the 8 cases. T2 images revealed a varying intensity. In six cases who underwent anterior corpectomy, there was a rent in the posterior longitudinal ligament. Among those in two cases multiple disc fragments were seen. In the rest four cases, a single large fragment was observed. These patients improved after anterior corpectomy and disc excision. There was no improvement in the patient who had undergone dorsal laminectomy. The eighth patient who refused surgery progressively deteriorated. Conclusions We opine that MRI scan especially T1 images are useful in these cases. We prefer to treat these cases through anterior corpectomy with excision of the sequestrated disc which proved to result in excellent outcome. PMID:22164316

  19. Comparison of in vivo and simulator-retrieved metal-on-metal cervical disc replacements

    PubMed Central

    Kurtz, Steven M.; Ciccarelli, Lauren; Harper, Megan L.; Siskey, Ryan; Shorez, Jacob; Chan, Frank W.

    2012-01-01

    Background Cervical disc arthroplasty is regarded as a promising treatment for myelopathy and radiculopathy as an alternative to cervical spine fusion. On the basis of 2-year clinical data for the PRESTIGE® Cervical Disc (Medtronic, Memphis, Tennessee), the Food and Drug Administration recommended conditional approval in September 2006 and final approval in July 2007; however, relatively little is known about its wear and damage modes in vivo. The main objective was to analyze the tribological findings of the PRESTIGE® Cervical Disc. This study characterized the in vivo wear patterns of retrieved cervical discs and tested the hypothesis that the total disc replacements exhibited similar surface morphology and wear patterns in vitro as in vivo. Methods Ten explanted total disc replacements (PRESTIGE®, PRESTIGE® I, and PRESTIGE® II) from 10 patients retrieved after a mean of 1.8 years (range, 0.3–4.1 years) were analyzed. Wear testing included coupled lateral bending ( ±4.7°) and axial rotation ( ±3.8°) with a 49 N axial load for 5 million cycles followed by 10 million cycles of flexion-extension ( ±9.7°) with 148 N. Implant surfaces were characterized by the use of white-light interferometry, scanning electron microscopy, and energy dispersive spectroscopy. Results The explants generally exhibited a slightly discolored, elliptic wear region of varying dimension centered in the bearing center, with the long axis oriented in the medial-lateral direction. Abrasive wear was the dominant in vivo wear mechanism, with microscopic scratches generally oriented in the medial-lateral direction. Wear testing resulted in severe abrasive wear in a curvilinear fashion oriented primarily in the medial-lateral direction. All retrievals showed evidence of an abrasive wear mechanism. Conclusions This study documented important similarity between the wear mechanisms of components tested in vitro and explanted PRESTIGE® Cervical Discs; however, the severity of wear was much greater during the in vitro test compared with the retrievals. PMID:25694884

  20. Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders

    PubMed Central

    Sakale, Harshal; Dulani, Rajesh; Singh, Pradeep K; Sanrakhia, Manoj

    2014-01-01

    Study Design Prospective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India. Purpose To show the efficacy of decompression in the late presentation of cervical spinal cord disorders. Overview of Literature Studies by various authors have shown that early spinal decompression results in better neurological outcomes. Methods From January 2003 to January 2005, 11 of the 41 patients with cervical spinal cord compression, meeting the inclusion criteria, underwent anterior decompression; interbody graft placement and stabilization by anterior cervical locking plate. The neurologic and functional outcomes were recorded. Results Five patients had spinal cord injury and 6 patients had compressive cervical myelopathy. Complications included 1 death and 1 plate loosening. No patient lost their preoperative neurological status. One patient had no improvement, 2 patients showed full recovery. The mean follow-up is 28.3 month. At the of rehabilitation, 6 were able to walk without support), 2 could walk with support, and 1 needed a wheelchair. The average American Spinal Injury Association motor score on admission to the hospital, 32.8 (standard deviation [SD], 30.5); admission to rehabilitation, 38.6 (SD, 32.4); discharge from rehabilitation, 46.2 (SD, 33.7). The most recent follow-up was 64.0 (SD, 35.3). Conclusions The anterior approach for cervical decompression allows for adequate decompression. This decompression is the best chance offered in even late reported cases, including posttraumatic cases where there is no evidence of cord transactions. The use of anterior cervical plates reduces the chances of graft loosening, extruding, or collapsing. PMID:24761201

  1. [Cervical cerclage in 2008].

    PubMed

    Fuchs, F; Senat, M-V; Gervaise, A; Deffieux, X; Faivre, E; Frydman, R; Fernandez, H

    2008-11-01

    Cervical cerclage is a common surgical technique that has been used for more than 50 years to prevent preterm deliveries and in the management of a threatened second trimester loss. However, it remains one of the most controversial interventions in obstetrics and this is probably due to difficulties in diagnosing cervical insufficiency, which is based on a history of recurrent second trimester loss or early preterm delivery following painless cervical dilatation in the absence of contractions or bleeding. This article reviews in 2008 the current literature regarding the efficacy of elective cerclage, ultrasound-indicated cerclage, emergency cerclage, and cervico-isthmic cerclage for singletons and multiple pregnancies. PMID:18922730

  2. Cervical Cancer Other Characteristics

    Cancer.gov

    Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer: Mortality Rates | Organization

  3. Cervical Cancer Other Characteristics

    Cancer.gov

    Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Other

  4. Screening for Cervical Cancer

    MedlinePLUS

    ... 17 PM You are here: Home Recommendations for Primary Care Practice Published Recommendations Recommendation Summary Cervical Cancer: Screening ... are one-page documents that provide guidance to primary care clinicians for using recommendations in practice. This summary ...

  5. Cervical Cancer Stage IIIB

    MedlinePLUS

    ... Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing shows cancer in the cervix, the vagina, and ... that connect the kidneys to the bladder). The drawing shows the ureter on the right blocked by ...

  6. Radiation Therapy Plus Cisplatin and Gemcitabine in Treating Patients With Cervical Cancer

    ClinicalTrials.gov

    2014-12-23

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  7. Cervical Perineural Cyst Masquerading as a Cervical Spinal Tumor

    PubMed Central

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha

    2014-01-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor. PMID:24761204

  8. Cervical perineural cyst masquerading as a cervical spinal tumor.

    PubMed

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor. PMID:24761204

  9. January Monthly Spotlight: Cervical Health and Cervical Cancer Disparities

    Cancer.gov

    In January, CRCHD joins the nation in raising awareness for Cervical Health and Cervical Cancer Disparities. This month we share a special focus on NCI/CRCHD research programs that are trying to reduce cervical cancer disparities in underserved communities and the people who are spreading the word about the importance of early detection.

  10. Spinal surgery -- cervical - series (image)

    MedlinePLUS

    The cervical spinal column is made up of vertebral bodies which protect the spinal cord. ... Cervical spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the ...

  11. Thoracic Disc Herniation of the Adjacent Segment With Acutely Progressing Myelopathy

    PubMed Central

    Oh, In-Soo; Seo, Jun-Yeong; Kim, Yoon-Chung

    2010-01-01

    We report a case of a 66-year-old woman with progressing myelopathy. Her history revealed instrumented fusion from T10 to S1 for degenerative lumbar kyphosis and spinal stenosis. The plain radiographs showed narrowing of the intervertebral disc space with a gas shadow and sclerotic end-plate changes at T9-T10. Magnetic resonance imaging revealed a posterolateral mass compressing the spinal cord at the T9-T10 level. The patient was treated with a discectomy through the posterior approach combined with posterior instrumentation. The patient's symptoms and myelopathy resolved completely after the discectomy and instrumented fusion. The thoracic disc herniation might have been caused by the increased motion and stress concentration at the adjacent segment. PMID:20622956

  12. Follicular cervicitis: a case report.

    PubMed

    Sethi, Seema; Rajni

    2004-04-01

    Chronic follicular cervicitis (CFC) is a benign inflammatory condition which can be easily diagnosed with a fair degree of assurance on pap stained cervical smears, thus preventing the need for cervical biopsy. We report a case of CFC in a postmenopausal woman. PMID:16295497

  13. Breed Distribution of SOD1 Alleles Previously Associated with Canine Degenerative Myelopathy

    PubMed Central

    Zeng, R; Coates, JR; Johnson, GC; Hansen, L; Awano, T; Kolicheski, A; Ivansson, E; Perloski, M; Lindblad-Toh, K; O'Brien, DP; Guo, J; Katz, ML; Johnson, GS

    2014-01-01

    Background Previous reports associated 2 mutant SOD1 alleles (SOD1:c.118A and SOD1:c.52T) with degenerative myelopathy in 6 canine breeds. The distribution of these alleles in other breeds has not been reported. Objective To describe the distribution of SOD1:c.118A and SOD1:c.52T in 222 breeds. Animals DNA from 33,747 dogs was genotyped at SOD1:c.118, SOD1:c.52, or both. Spinal cord sections from 249 of these dogs were examined. Methods Retrospective analysis of 35,359 previously determined genotypes at SOD1:c.118G>A or SOD1:c.52A>T and prospective survey to update the clinical status of a subset of dogs from which samples were obtained with a relatively low ascertainment bias. Results The SOD1:c.118A allele was found in cross-bred dogs and in 124 different canine breeds whereas the SOD1:c.52T allele was only found in Bernese Mountain Dogs. Most of the dogs with histopathologically confirmed degenerative myelopathy were SOD1:c.118A homozygotes, but 8 dogs with histopathologically confirmed degenerative myelopathy were SOD1:c.118A/G heterozygotes and had no other sequence variants in their SOD1 amino acid coding regions. The updated clinical conditions of dogs from which samples were obtained with a relatively low ascertainment bias suggest that SOD1:c.118A homozygotes are at a much higher risk of developing degenerative myelopathy than are SOD1:c.118A/G heterozygotes. Conclusions and Clinical Importance We conclude that the SOD1:c.118A allele is widespread and common among privately owned dogs whereas the SOD1:c.52T allele is rare and appears to be limited to Bernese Mountain Dogs. We also conclude that breeding to avoid the production of SOD1:c.118A homozygotes is a rational strategy. PMID:24524809

  14. Hypothesis on the pathogenesis of vacuolar myelopathy, dementia, and peripheral neuropathy in AIDS

    PubMed Central

    Tan, S; Guiloff, R

    1998-01-01

    Certain aspects of the clinical syndrome of dementia, cerebral atrophy, predominantly sensory neuropathy, and vacuolar myelopathy in AIDS resemble those seen in vitamin B12 deficiency. Pathologically, there are similarities not only in the changes in the spinal cord, but also in the brain and peripheral nerves. The pathogenesis of vacuolar myelopathy may be secondary to a combination of immune mediated myelin and oligodendrocyte injury, and simultaneous impairment of repair mechanisms due to a deficiency of S-adenosylmethionine (SAM). Products derived from macrophages may interfere directly with the methyl transfer cycle through the generation of reactive oxygen intermediates and reactions involving nitric oxide and peroxynitrite which may limit the supply of methionine for conversion to SAM, both by direct interaction as well as through inhibition of methionine synthase. Macrophage activation with secretion of cytokines and other biologically reactive substances within the nervous system is sustained in the late stages of HIV infection by the general effects of immune depletion, including loss of T cells (with concomitant reduction of macrophage regulatory molecules) and recurrent opportunistic infections, and may be further augmented by the local presence of the virus itself (or its surface glycoprotein gp120). This would account for the common, but not exclusive, occurrence of vacuolar myelopathy in AIDS. The ability of the virus and its products to stimulate macrophage and microglial activation may also explain the association between severity ofvacuolar myelopathy and the presence of HIV encephalitis. A similar mechanism may underlie the pathogenesis of dementia, cerebral atrophy, and peripheral neuropathy. Local factors or differential susceptibility between the central and peripheral nervous system may determine whether myelinotoxic or neurotoxic processes predominate; the prominence of myelin involvement in the spinal cord, and axonal involvement peripherally may reflect both ends of this range, with the brain manifesting a more equal balance of both processes. ?? PMID:9667556

  15. Cervical Total Disc Arthroplasty

    PubMed Central

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc arthroplasty devices have come onto the market and completed Food and Drug Administration Investigational Device Exemption trials. Though some of the early results demonstrate equivalency of arthroplasty to fusion, compelling evidence of benefits in terms of symptomatic adjacent segment degeneration are lacking. In addition, non-industry-sponsored studies indicate that these devices are equivalent to fusion in terms of adjacent segment degeneration. Longer-term studies will eventually provide the definitive answer. PMID:24353955

  16. Clinical presentation of a patient with thoracic myelopathy at a chiropractic clinic

    PubMed Central

    Gay, Charles W.; Bishop, Mark D.; Beres, Jacqueline L.

    2012-01-01

    Introduction The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic. Case Report/Methods After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult. Results Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement. Conclusion It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment. PMID:23204955

  17. Acute motor-sensory axonal neuropathy after cervical spine surgery.

    PubMed

    Miscusi, Massimo; Currà, Antonio; Della Rocca, Carlo; Missori, Paolo; Petrozza, Vincenzo

    2012-07-01

    The authors report the case of a 55-year-old man who presented with acute motor-sensory axonal neuropathy (AMSAN), a variant of Guillain-Barré syndrome with a poor prognosis, immediately after surgery for resection of a cervical chondroma. A misdiagnosis of spinal cord shock due to an acute surgical or vascular postoperative complication was initially made in this patient. Nevertheless, there was continuous transient improvement that was followed by progressive worsening, and further investigation was necessary. The diagnosis of AMSAN, associated with acute colitis caused by Helicobacter pylori, was made based on neurophysiological examinations and colonoscopy. Interestingly, the patient also developed nephrotic syndrome, which was thought to be a further complication of the autoimmune reaction. Delayed administration of immunoglobulins (400 mg/kg/day), mesalazine (800 mg 3×/day), and meropenem (3 g/day) was used to treat the Helicobacter infection and the autoimmune reaction, leading to restoration of renal function and slight neurological improvement. The patient's general condition and neurological status improved slightly, but he remained seriously disabled (Frankel Grade C). This case demonstrates that a new onset of neurological symptoms in the early postoperative period after spine surgery could be related to causes other than iatrogenic myelopathy, and that an early diagnosis can reduce neurological sequelae, leading to a better outcome. PMID:22559275

  18. Chemoradiation Therapy and Ipilimumab in Treating Patients With Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2015-06-10

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  19. Chemoradiation Therapy and Ipilimumab in Treating Patients With Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2015-07-02

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  20. Prevent Cervical Cancer

    MedlinePLUS

    ... PDF [PDF-839KB] High-quality PDF for professional printing [PDF-2.7MB] Cancer Home “Prevent Cervical Cancer” ... PDF [PDF-839KB] High-quality PDF for professional printing [PDF-2.7MB] Language: English Español (Spanish) File ...

  1. Cervical ectopic pregnancy

    PubMed Central

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

    Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Early diagnosis and medical management with systemic or local administration of methotrexate is the treatment of choice. If the pregnancy is disturbed, it may lead to massive hemorrhage, which may require hysterectomy to save the patient. We report three cases of cervical pregnancy managed successfully with different approaches of management. Our first case, 28 years old G3P2L2 with previous two lower segment cesarean sections, presented with bleeding per vaginum following 6 weeks of amenorrhea. Clinical examination followed by transvaginal ultrasound confirmed the diagnosis of cervical pregnancy. Total abdominal hysterectomy was done in view of intractable bleeding to save the patient. The second case, a 26-year-old second gravida with previous normal vaginal delivery presented with pain abdomen and single episode of spotting per vaginum following 7 weeks of amenorrhea. Transvaginal ultrasound revealed empty endometrial cavity, closed internal os with gestational sac containing live fetus of 7 weeks gestational age in cervical canal and she was treated with intra-amniotic potassium chloride followed by systemic methotrexate. Follow up with serum beta human chorionic gonadotropin level revealed successful outcome. Our third case, a 27-year-old primigravida with history of infertility treatment admitted with complaints of bleeding per vaginum for 1 day following 8 weeks amenorrhea. She was diagnosed as cervical pregnancy by clinical examination, confirmed by transvaginal ultrasonography and subsequently managed by dilation and curettage with intracervical Foleys’ ballon tamponade. PMID:25810679

  2. Role of cervical soft tissue lesion in cervical spondylosis and tuina intervention

    Microsoft Academic Search

    Min Fang; Jun-tao Yan; Shu-yun Jiang; Wu-quan Sun; Yu-chao Liu

    2008-01-01

    Cervical spondylosis is markedly characterized by degenerative changes. The studies in recent years on the role of cervical soft tissue lesion in cervical spondylosis indicated that cervical soft tissue lesion runs through the whole process of cervical spondylosis and is dominantly responsible for varieties of clinical symptoms. Cervical osseous lesion can be regarded as a result of soft tissue lesion

  3. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation

    Microsoft Academic Search

    Jian Li; Deng-lu Yan; Zai-Heng Zhang

    2008-01-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous\\u000a discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results\\u000a of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN\\u000a in symptomatic patients who had cervical herniated discs. From July of

  4. Leprotic cervical spondylodiscitis.

    PubMed

    Kim, Sang Jin; Lee, Tae Hoon; Shin, Jun Jae; Chae, Gue Tae

    2010-07-01

    Leprosy is a chronic infectious disease caused by the Mycobacterium leprae that leads to leprotic neuropathy involving the peripheral nerve and several characteristic skin lesions. Skeletal involvement can occur in peripheral joints, such as the wrist and the ankle. However, there is no report of an axial leprotic lesion involving the spine or paraspinal soft tissue. The authors report the first case of a leprotic cervical lesion involving the axial skeletal system. A 48-year-old male presented with neck pain and severe pain in the right suprascapular area and left arm. Preoperative MRI of the cervical spine revealed signal changes in the prevertebral soft tissue at the level of the C3, 4, 5 vertebral bodies. There were a lower signal intensity on T1-weighted image and high signal intensity on T2WI of the bone marrow at the level of the C5 and C6 vertebral bodies, and a C5/6 segmental ossification of the posterior longitudinal ligament. There were herniated cervical disc on the left C5/6 with C6 root and the right side of C6/7 with a C7 root compression. He was previously diagnosed with leprosy when he was 14 years old and received treatment intermittently over the course of 7 years. But patient did not disclose his past history. Surgical intervention was conducted using an anterior cervical approach. An incision was made in the anterior longitudinal ligament at C5/6, and a pinkish gray friable gelatinous material was observed on the C5/6 disc and on the anterior lower one-third surface of the C5 vertebral body. Specimens were obtained and subjected to pathological evaluation and microbiological culture. After C5/6 and C6/7 discectomies, nerve root decompression and autologous iliac bone grafting were performed at the C5/6 and C6/7 levels. The C5-6-7 vertebrae were fixed with an Atlantis cervical locking plate and a screw system. The pathological report indicated chronic inflammation with heavy plasma cell infiltration on the specimen. We sent the specimens to the Institute of Hansen's Disease, and polymerase chain reaction for leprosy tested positive. After surgery, his pain disappeared and he was given a prescription for antileprotic drugs. The authors describe the first case of leprotic cervical spondylodiscitis that was operatively treated in a 48-year-old patient with known leprosy history since his 14 years old. PMID:20372941

  5. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    ClinicalTrials.gov

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  6. 21 CFR 884.5250 - Cervical cap.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 2011-04-01 2011-04-01 false Cervical cap. 884.5250 Section 884.5250 ...Gynecological Therapeutic Devices § 884.5250 Cervical cap. (a) Identification. A cervical cap is a flexible cuplike receptacle...

  7. 21 CFR 884.5250 - Cervical cap.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 2010-04-01 false Cervical cap. 884.5250 Section 884.5250 ...Gynecological Therapeutic Devices § 884.5250 Cervical cap. (a) Identification. A cervical cap is a flexible cuplike receptacle...

  8. Early clinical and radiographical results of keel-less and shallow keel cervical disc replacement

    PubMed Central

    Ling, Ji Min; Tiruchelvarayan, Rajendra

    2015-01-01

    Background: Cervical disc replacements has been shown to be as effective as fusions in the treatment of radiculopathy or myelopathy due to disc prolapse. Newer implants were designed to reduce the difficulty of end-plate preparation. Since 2010, the authors have started using Discocerv (Alphatec Spine, Carlsbad, USA) a keel-less implant and Activ-C (B. Braun, Sheffield, UK), a shallow keel implant. Aim: The aim of this study was to compare the duration of surgery between cervical disc replacement and anterior cervical discectomy and fusion, and also to evaluate the functional outcome, complications, and radiographic outcome of cervical disc replacement. Results: Fifty patients were included (20 disc replacement and 30 fusion). This was a single surgeon retrospective study, with all surgery performed by the senior author (RT). The mean operation duration for single-level disc replacement was 2.6 h, and for single-level fusion was 2.4 h (P = 0.4684). For 2-levels surgery, the result was 3.5 h for 2-level hybrid surgery (one level disc replacement and one level fusion) and 3.4 h for fusion (P = 0.4489). Disc replacement resulted in preservation of an average of 67% of the angle of motion at the sagittal plane (FFflexion-extension). The average range of motion after disc replacement was 6.1°. The median clinical follow-up duration was 2 years (average 1.8 years). There was no incidence of major complications or significant neurovascular injury in this series of patients. A significant improvement in short form-36 scores was seen as early as 3 months postoperative (from 58 preoperative to 92 at 3 months). The improvement was sustained up to the fourth year of follow-up. Conclusion: Cervical arthroplasty with keel-less and shallow keel implants are safe and relatively easy to perform. The surgical time for disc replacement is not significantly longer than standard fusion surgery. There is reasonably good preservation of motion. The short-term functional improvement is good, and we await further long-term outcome results. The authors felt that cervical disc replacement will have an important role in the treatment of cervical degenerative disc disease in the future. PMID:25767568

  9. Myelopathy Caused by Spinal Dural Arterio-Venous Fistula after First Lumbar Vertebral Body Fracture - A Case Report -

    PubMed Central

    Kang, Jin-Woo; Kim, Dong-Kyu; Joo, Young-Jin; Kim, Tae-Hoon; Song, Sun-Hong

    2011-01-01

    Spinal dural arteriovenous fistula is a rare vascular lesion of the spinal cord associated with progressive myelopathy. Symptoms include progressive gait dysfunction, weakness, sensory loss, and bowel and bladder dysfunction. Because these symptoms overlap with other common causes of myelopathy and the disease is rare, spinal dural arteriovenous fistula is often not suspected and the time to diagnosis is long. We report the case of a 60-year-old woman who presented with progressive lower limb weakness and gait disturbance diagnosed as spinal dural arteriovenous fistula involving a fractured L1 vertebral body. PMID:22506198

  10. Cervical cystic hygroma.

    PubMed

    Guruprasad, Yadavalli; Chauhan, Dinesh Singh

    2012-09-01

    Cystic hygroma or cystic lymphangioma is a congenital malformation of the lymphatic system that manifests itself as a soft, benign, and painless mass. It is widely accepted that they arise from the remnants of embryonic lymphatic tissue which retains the potential for proliferation. They grow in the fashion of sprouting and are capable of transgressing anatomical boundaries. They can occur almost at any anatomical site. However, 75-80% cystic hygromas are located in the head and neck region. In the neck, they are typically located within the posterior cervical triangle. The majority of cases (80-90%) are diagnosed under the age of two. We present a case of cervical cystic hygroma in a 6 year old male child which was surgically treated. PMID:23997487

  11. [Measurement and clinical significance of cervical lordosis].

    PubMed

    Zhang, Yu-ting; Wang, Xiang; Zhan, Hong-sheng

    2014-12-01

    Measurement of cervical lordosis is the basic method for evaluating cervical function, and important reference for determine treatment decision. However, how to choose appropriate measurement in accordance with different situation, as well as the relationship among these methods is not clear. An increasing number of studies suggested that different measurements could directly affect the judgment of cervical lordosis. Therefore, comparative study of cervical vertebrae plays an important role in clinical treatment for cervical spondylosis under different cervical curvature conditions. PMID:25638900

  12. Cervical plate fracture: a rare complication

    PubMed Central

    Veli, Citisli; Muhammet, Ibrahimoglu; Serkan, Civlan; Murat, Kocaoglu

    2015-01-01

    In traumatic and degenerative diseases cervical fusion with anterior cervical plate are commonly used. The increase in the use of cervical plate segment level is also increased risk of developing complications. This case report shows that the increase in the use of cervical plate segment level and also the complications in cervical spinal instrumentation, short-segment cervical plate rare case reported to be broken.

  13. Cervical split: A pseudofracture

    SciTech Connect

    Goldberg, R.P.; Vine, H.S.; Sacks, B.A.; Ellison, H.P.

    1982-01-01

    A horizontal lucent line projecting over a cervical vertebral body on lateral radiographs and simulating a fracture is described. This pseudofracture line results from the lucency between contiguous proliferative osteophytes at the uncinate process/vertebral articulation. Associated disc space narrowing was seen in all of our eleven cases. The origin of this pseudofracture line, cases illustrating this phenomenon, and additional projections helpful for clarification are presented.

  14. Cervical Primitive Neuroectodermal Tumor

    Microsoft Academic Search

    Anne S. Tsao; Lawrence M. Roth; Alan Sandler; Jean A. Hurteau

    2001-01-01

    Background.Primitive neuroectodermal tumors (PNETs) are rare and potentially aggressive malignancies.Case. A 24-year-old woman in her eighth week of pregnancy presented with a cervical mass. Tissue biopsy demonstrated poorly differentiated carcinosarcoma with neuroendocrine features. Immunohistochemical studies confirmed the diagnosis of PNET. Treatment included alternating courses of cyclophosphamide, adriamycin, vincristine (CAV) and ifosfamide, etoposide (IE). A radical hysterectomy with bilateral ovarian transposition

  15. Subacute posttraumatic ascending myelopathy in a 15-year-old boy.

    PubMed

    Kovanda, Timothy J; Horn, Eric M

    2014-09-01

    Secondary injury following initial spinal cord trauma is uncommon and frequently attributed to mismanagement of an unprotected cord in the acute time period after injury. Subacute posttraumatic ascending myelopathy (SPAM) is a rare occurrence in the days to weeks following an initial spinal cord injury that is unrelated to manipulation of an unprotected cord and involves 4 or more vertebral levels above the original injury. The authors present a case of SPAM occurring in a 15-year-old boy who sustained a T3-4 fracture-dislocation resulting in a complete spinal cord injury, and they highlight the imaging findings and optimum treatment for this rare event. PMID:24905393

  16. Radiation Therapy and Cisplatin With or Without Epoetin Alfa in Treating Patients With Cervical Cancer and Anemia

    ClinicalTrials.gov

    2014-12-29

    Anemia; Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Drug Toxicity; Radiation Toxicity; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  17. Rehabilitation and long-term course of nontraumatic myelopathy associated with surfing.

    PubMed

    Aoki, Masahiro; Moriizumi, Shigehiro; Toki, Megumi; Murakami, Takanori; Ishiai, Sumio

    2013-09-01

    A nontraumatic spinal cord injury related to surfing is called surfer's myelopathy. The case of a 26-yr-old man who became paraplegic after surfing without apparent traumatic events is described. Physical examination revealed a spinal cord injury at T12 according to the American Spinal Injury Association Impairment Scale A. The initial magnetic resonance image revealed a fusiform swelling of the spinal cord from T7-8 to the conus, which was hyperintense on T2-weighted images. After 6 mos of rehabilitation, the patient was followed for more than 1 yr after onset. He became able to walk with knee-ankle-foot-orthoses without assistance. A magnetic resonance image obtained 1 yr after the onset of paraplegia showed an atrophic spinal cord from T7-8 to the conus. The course of the neurologic findings and the imaging studies suggest that the pathogenesis of surfer's myelopathy may be ischemia of the anterior spinal artery territory induced by the abnormal trunk posture while surfing. PMID:22019977

  18. Fractures of the cervical spine

    PubMed Central

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  19. Upper Cervical Spine Trauma.

    PubMed

    Bransford, Richard J; Alton, Timothy B; Patel, Amit R; Bellabarba, Carlo

    2014-11-01

    Injuries to the upper cervical spine are potentially lethal; thus, full characterization of the injuries requires an accurate history and physical examination, and management requires an in-depth understanding of the radiographic projection of the craniocervical complex. Occipital condyle fractures may represent major ligament avulsions and may be highly unstable, requiring surgery. Craniocervical dissociation results from disruption of the primary osseoligamentous stabilizers between the occiput and C2. Dynamic fluoroscopy can differentiate the subtypes of craniocervical dissociation and help guide treatment. Management of atlas fractures is dictated by transverse alar ligament integrity. Atlantoaxial dislocations are rotated, translated, or distracted and are treated with a rigid cervical orthosis or fusion. Treatment of odontoid fractures is controversial and dictated by fracture characteristics, patient comorbidities, and radiographic findings. Hangman's fractures of the axis are rarely treated surgically, but atypical patterns and displaced fractures may cause neurologic injury and should be reduced and fused. Management of injuries to the craniocervical junction remains challenging, but good outcomes can be achieved with a comprehensive plan that consists of accurate and timely diagnosis and stabilization of the craniocervical junction. PMID:25344597

  20. Trauma-induced myelopathy in patients with retro-odontoid pseudotumour and ossification of the anterior longitudinal ligament: a report of two cases.

    PubMed

    Tobari, Yoshiko; Kimura, Atsushi; Sasaki, Satoru; Tajiri, Yasuhito; Seichi, Atsushi

    2014-12-01

    We report 2 cases of acute, progressive myelopathy after a fall in elderly patients who had a retroodontoid pseudotumour and extensive ossification of the anterior longitudinal ligament. PMID:25550033

  1. Outcome of single level anterior cervical discectomy and fusion using nano-hydroxyapatite/polyamide-66 cage

    PubMed Central

    Yang, Xi; Liu, Limin; Song, Yueming; Kong, Qingquan; Zeng, Jiancheng; Tu, Chongqi

    2014-01-01

    Background: Cages have been widely used for the anterior reconstruction and fusion of cervical spine. Nonmetal cages have become popular due to prominent stress shielding and high rate of subsidence of metallic cages. This study aims to assess fusion with n-HA/PA66 cage following one level anterior cervical discectomy. Materials and Methods: Forty seven consecutive patients with radiculopathy or myelopathy underwent single level ACDF using n-HA/PA66 cage. We measured the segmental lordosis and intervertebral disc height on preoperative radiographs and then calculated the loss of segmental lordosis correction and cage subsidence over followup. Fusion status was evaluated on CT scans. Odom criteria, Japanese Orthopedic Association (JOA) and Visual Analog Pain Scales (VAS) scores were used to assess the clinical results. Statistically quantitative data were analyzed while Categorical data by ?2 test. Results: Mean correction of segmental lordosis from surgery was 6.9 ± 3.0° with a mean loss of correction of 1.7 ± 1.9°. Mean cage subsidence was 1.2 ± 0.6 mm and the rate of cage subsidence (>2 mm) was 2%. The rate of fusion success was 100%. No significant difference was found on clinical or radiographic outcomes between the patients (n=27) who were fused by n-HA/PA66 cage with pure local bone and the ones (n=20) with hybrid bone (local bone associating with bone from iliac crest). Conclusions: The n-HA/PA66 cage is a satisfactory reconstructing implant after anterior cervical discectomy, which can effectively promote bone graft fusion and prevent cage subsidence. PMID:24741136

  2. Percutaneous cervical nucleoplasty and percutaneous cervical discectomy treatments of the contained cervical disc herniation

    Microsoft Academic Search

    Denglu YanJian; Jian Li; Haodong Zhu; Zhi Zhang; Lijun Duan

    2010-01-01

    Background  There were no studies in literature to compare the clinical outcomes of percutaneous nucleoplasty (PCN) and percutaneous cervical\\u000a discectomy (PCD) in contained cervical disc herniation.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective of patients with symptomatic contained cervical disc herniated were operated on with PCN and PCD from June\\u000a 2003 to July 2005. Two-hundred and four patients initially fulfilled the study criteria, and 28 patients

  3. Cervical Cancer HPV Vaccine Use

    Cancer.gov

    Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer: Mortality Rates | Organization

  4. Laparoscopic Placement of Cervical Cerclage

    PubMed Central

    Tusheva, Olga A; Cohen, Sarah L; McElrath, Thomas F; Einarsson, Jon I

    2012-01-01

    Cervical shortening is believed to be a marker for generalized intrauterine inflammation and has a strong association with spontaneous preterm birth. A variety of therapies, including vaginal and intramuscular progesterone, pessary, and cerclage, have been demonstrated to be effective in specific clinical circumstances. Cervical cerclage can be placed via transvaginal, open transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy. A laparoscopic approach may be superior to the transabdominal approach in terms of surgical outcomes, cost, and postoperative morbidity. PMID:23483629

  5. Immunohistochemical screening for viral agents in cheetahs (Acinonyx jubatus) with myelopathy.

    PubMed

    Shibly, S; Schmidt, P; Robert, N; Walzer, C; Url, A

    2006-10-21

    Numerous cases of acute-onset progressive ataxia, hindlimb paresis and paralysis of unknown aetiology occurred during 1993 to 2003 in cheetahs (Acinonyx jubatus) within the European Endangered Species Programme (eep). This study describes the immunohistochemical investigation of a possible viral aetiology of the "cheetah myelopathy". Antibodies to feline herpesvirus type 1, canine distemper virus, canine parvovirus and Borna disease virus were applied to formalin-fixed and paraffin-embedded brain and spinal cord sections from 25 affected cheetahs aged between three-and-a-half months and 13 years. Using the avidin-biotin complex technique, none of the antibodies gave positive immunosignals in either the brain or the spinal cord tissue. PMID:17056652

  6. Human T lymphotropic virus type-1-associated myelopathy manifesting shortly after living-donor renal transplantation.

    PubMed

    Nagamine, Yuito; Hayashi, Takeshi; Kato, Yuji; Horiuchi, Yohsuke; Tanahashi, Norio

    2015-01-01

    A 38-year-old woman experienced numbness in both lower extremities and spastic paralysis a few months after undergoing living-donor renal transplantation. The patient was negative for human T lymphotropic virus type-1 (HTLV-1) antibodies prior to the procedure; however, she was diagnosed with HTLV-1-associated myelopathy (HAM) based on positive serum and cerebrospinal fluid antibody titers after the surgery. Because the donor was also positive for HTLV-1 antibodies, the infection likely originated from the transplanted kidney. Clinical and imaging improvements were noted following the administration of interferon-?. HAM has been reported to occur after living-donor renal transplantation; however, there are no previous reports of onset within such a short period. PMID:25742898

  7. [Combined spinal-epidural anesthesia for a patient with HTLV-1 associated myelopathy].

    PubMed

    Yokomizo, Taishi; Hiraki, Teruyuki; Mishima, Yasunori; Ushijima, Kazuo

    2014-08-01

    An 81-year-old female with HTLV-1 associated myelopathy (HAM) was scheduled for transurethral lithotomy. She had had paresthesia and spastic paresis in the lower extremities for the past 15 years. The preoperative respiratory function test revealed a vital capacity of 1.3 l (58% of the predicted value). We selected combined spinal-epidural anesthesia (CSEA) for her to avoid postoperative respiratory complications due to general anesthesia. After placement of a thoracic epidural catheter, spinal anesthesia was achieved by administration of bupivacaine 7.5 mg, resulting in the sensory block level to T 6, five min later. The intraoperative blood pressure remained high at 150-200 mmHg, in spite of the administration of nicardipine. Postoperatively, neither the deterioration in the neurological findings of HAM nor the exacerbation of respiratory function was observed. The present report suggests that CSEA can be one of the choices of anesthesia for a patient with HAM. PMID:25199333

  8. HTLV-I associated myelopathy: an endemic disease of Canadian aboriginals of the Northwest Pacific coast?

    PubMed

    Oger, J J; Werker, D H; Foti, D J; Dekaban, G A

    1993-11-01

    Human T-cell lymphotropic virus type 1 (HTLV-I) is responsible for HTLV-I associated myelopathy or tropical spastic paraparesis (HAM/TSP) and for adult T-cell leukemia/lymphoma (ATLL). Both diseases have been well described in individuals living in Japan, West Indies, Seychelles Islands and Columbia where infection with HTLV-I is considered endemic and in persons whose descendants originated from these endemic areas. We report here 4 cases of HAM/TSP in 4 natives from 4 different tribal groups from British Columbia (B.C.). These are the first case reports of HTLV-I linked diseases found among North American Aboriginals. Possible routes of infection for HTLV-I infection included sexual transmission, breast feeding, blood transfusions and IV drug use. The seroprevalence of HTLV-I in North American Native population is unknown and we suggest that it is endemic in this ethnic group. PMID:8313245

  9. Risk factors in cervical spondylosis

    PubMed Central

    Singh, Sudhir; Kumar, Dharmendra; Kumar, Sanjeev

    2014-01-01

    Background Cervical spondylosis is essentially a degenerative disorder common after fourth decade. It has been seen that radiological evidence of cervical spondylosis do not necessarily co-relate with clinical findings. This discrepancy has been attributed to the morphometric dimensions of the vertebrae, age, sex, race, occupation, weight and height of the patients. Objective The objective of this study is to co-relate the variables like age, sex, race, occupation, vertebral body diameter, canal diameter, canal body ratio of cervical spine vertebrae with cervical spondylosis cases with normal population. Methods In this hospital based, case control, consent based, cross-sectional, clinico-radiological study 200 individuals (controls-100, cases-100) who were subjected to lateral projection radiographs of cervical spine. Their age, sex, race, occupation, height, weight and mid-sagittal canal diameter (CD), sagittal vertebral body diameter (VBD) and the canal-body ratio (CBR) of the cervical vertebrae was recorded and analyzed statistically. Results There was no relation between vertebral dimensions and clinical groups. In radiculopathy group, age and height showed significance on univariate analysis. While only age remained significant on multivariate analysis. In neck pain group age, sex, and height showed significance on univariate analysis while in multivariate analysis age, sex and occupation were significant risk factors. PMID:25983502

  10. Neurologic manifestations of human immunodeficiency virus-2: dementia, myelopathy, and neuropathy in West Africa

    PubMed Central

    Choi, Youngjee; Townend, John; Vincent, Tim; Zaidi, Irfan; Sarge-Njie, Ramu; Jaye, Assan

    2015-01-01

    While well documented in human immunodeficiency virus (HIV)-1, neurologic sequelae have not been systematically evaluated in HIV-2. After excluding for confounding comorbidities, 67 individuals from a rural cohort in Guinea-Bissau (22 HIV-2 participants, 45 seronegative controls) were evaluated. HIV+individuals were divided into CD4<350 and CD4?350 for analysis. HIV-associated neurocognitive disorders (HAND), assessed by the International HIV Dementia Scale (IHDS), distal sensory polyneuropathy (DSPN), and myelopathy were the main outcome variables. In univariate analysis, there was no difference in IHDS scores among groups. When analyzed by primary education attainment, IHDS scores were nonsignificantly higher (p=0.06) with more education. There was no significant difference in DSPN prevalence among groups; overall, 45% of participants had DSPN. There were no cases of myelopathy. In multivariate linear regression, higher IHDS scores were significantly correlated with older age (coefficient=?0.11, p<0.001). Logistic regression analysis showed that older age (odds ratio (OR) 95% CI 1.04–1.20), lower CD4 count (OR 95% CI 0.996–0.999), and higher BMI (OR 95% CI 1.02–1.43) significantly predicted the presence of DSPN. While a significant increase in cognitive impairment was not observed in HIV-2-infected individuals, the study suggests the IHDS may be a less effective screening tool for HAND in settings of lower educational attainment as encountered in rural Guinea-Bissau. Similar to HIV-1, DSPN seems to occur with lower CD4 counts in HIV-2. Further study of the viral–host interactions in HIV-2 and its consequent neurological diseases may provide an avenue for understanding the epidemic problems of HIV-1. PMID:21424866

  11. Interferon beta-1a treatment in HTLV-1-associated myelopathy/tropical spastic paraparesis: a case report.

    PubMed

    Viana, Graça Maria de Castro; Silva, Marcos Antonio Custódio Neto da; Souza, Victor Lima; Lopes, Natália Barbosa da Silva; Silva, Diego Luz Felipe da; Nascimento, Maria do Desterro Soares Brandão

    2014-01-01

    Here a young patient (< 21 years of age) with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF). Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved. PMID:25229227

  12. Antemortem diagnosis and successful management of noncompressive segmental myelopathy in a Siberian-Bengal mixed breed tiger.

    PubMed

    Flower, Jennifer E; Lynch, Kate; Clark-Price, Stuart C; Welle, Kenneth R; O'Brien, Robert; Whittington, Julia K

    2013-12-01

    A 10-yr-old female spayed mixed breed tiger presented for a 9-day history of acute and nonprogressive paralysis of the pelvic limbs. Magnetic resonance imaging revealed a lesion suggestive of fibrocartilaginous embolic myelopathy with regional spinal cord edema, decreased disk signal intensity at L2-L3, and mild intervertebral disk protrusion at L1-L2 and L2-L3. Cerebral spinal fluid analysis showed no overt evidence of infection or neoplasia. Medical therapy was instituted, including corticosteroids and gastroprotectants as well as nursing care and physical therapy. The tiger began showing clinical improvement 2 wk after initiating treatment, progressing to the point where the animal was standing and intermittently walking. Three months after diagnosis, the tiger had regained muscle strength of its hind limbs and walked regularly with improving coordination. This case is the first report of antemortem diagnosis and successful medical management of suspected fibrocartilaginous embolic myelopathy in a large exotic felid. PMID:24450082

  13. Difficult-to-wean: High index of suspicion

    PubMed Central

    Gelaye, Alehegn; Patel, Brijesh; Farra, Wassim; Kole, Bruce

    2014-01-01

    Patient: Female, 57 Final Diagnosis: Syryngomyelia • cervical Symptoms: Acute respiratory insufficiency Medication: — Clinical Procedure: — Specialty: Pulmonology Objective: Rare disease Background: Failed planned extubation occurs in a minority of patients with acute respiratory failure requiring invasive mechanical ventilation. In patients presenting with acute respiratory failure with no identifiable cardiopulmonary causes, uncommon conditions, such as cervical spondylotic myelopathy, should be considered. In very rare instances, when cervical spondylotic myelopathy and syringomyelia present concomitantly, they can be devastating. Case Report: A 57-year-old woman visited the emergency room (ER) after feeling unwell for several days. She was brought to the ER with acute respiratory distress and obtunded state with GCS of 6/15. She was hypotensive and agonally breathing. Her initial neurologic evaluation was unrevealing. Based on these findings, she was intubated. Over the next several days, she was difficult to wean from the ventilator and had persistent respiratory acidosis. After a short-lived extubation, the patient was again re-intubated. This time the neurologic evaluation showed decreased movements of all muscle groups against gravity and forces, with generalized weakness. An MRI of the brain and cervical spine demonstrated moderate degenerative disc disease and syringomyelia extending from C2 to C7 level. The patient underwent de-compression laminectomy. After failing several weaning trials, she underwent bronchoscopically-assisted tracheotomy. Conclusions: Acute cardiopulmonary and intensive care unit-acquired neuromuscular conditions have been attributed as a major cause of difficult weaning and extubation. Failure to identify and correct other rare combinations (such as cervical degenerative disc disease and syringomyelia) may cause acute respiratory failure and subsequent failure to wean and extubation, resulting in high rates of mortality and morbidity. PMID:24790685

  14. Analysis of digitized cervical images to detect cervical neoplasia

    NASA Astrophysics Data System (ADS)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  15. NIH Research Leads to Cervical Cancer Vaccine

    MedlinePLUS

    ... Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of ... in women, the cause of the majority of cervical cancers. Photo courtesy of Judy Folkenberg, NLM Writer ...

  16. Cervical Cancer Prevention and Screening: Financial Issues

    MedlinePLUS

    ... with lower incomes and those without insurance. Federal law Coverage of cervical cancer screening tests is mandated ... says. They also are not covered by state laws, including those about cervical cancer screening. Women who ...

  17. Cervical Spinal Epidural Hematoma Following Cervical Posterior Laminoforaminotomy

    PubMed Central

    Choi, Jeong Hoon; Lee, Sang-Ho

    2013-01-01

    A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible. PMID:23560180

  18. Corpectomy with Adjacent-Level Kyphoplasty to Treat Metastatic Lung Cancer in Three Contiguous Cervical Vertebrae Causing Focal Neurologic Compromise

    PubMed Central

    Bateman, Antony H.; Way, Adam C.

    2014-01-01

    Study Design?Case report. Objectives?Decompression of metastatic spinal cord compression has been shown to improve quality of life and prolong ambulation in patients undergoing palliative treatment. We report a case of metastatic cervical myelopathy treated with a combined approach using corpectomy and stabilization together with balloon kyphoplasty to allow adequate decompression and immediate stability in a patient with significant destruction of adjacent vertebral bodies. Methods?The cervical spine was approached anteriorly and decompressed with a C7 corpectomy. Subsequent stability was achieved with insertion of a trabecular metal cage. Balloon kyphoplasty was used to treat lytic lesions within the posterior body of the adjacent vertebrae for pain relief and increased stability. Additional stability was achieved through the application of an anterior plate. Results?Full limited decompression and stabilization were successfully achieved. The patient had no further neurologic deterioration and made modest improvements that allowed a return to independent ambulation. Conclusion?This limited approach may be an option for patients with metastatic spinal cord compression, lytic destruction of adjacent vertebral bodies, and limited life expectancy. PMID:25844288

  19. Cervical esophageal hemangioma combined with thyroid cancer.

    PubMed

    Lee, Jong Cheol; Kim, Jeong Won; Lee, Yong Jik; Lee, Seong Rok; Park, Chang-Ryul; Jung, Jong-Pil

    2011-08-01

    Hemangiomas that arise in cervical esophagus are extremely rare, representing 3.3% of all benign esophageal tumors. Although endoscopic mucosal resection (EMR) and potassium titanyl phosphate/yttrium aluminum garnet (KTP/YAG) laser therapy have been used with success for small tumors, the safety and efficacy in the case of large tumors remains uncertain. We report the successful resection of cervical esophageal hemangioma through a cervical esophagotomy in a patient with thyroid cancer who needed a cervical collar incision. PMID:22263178

  20. Cervical Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    Screening methods used to find cervical changes that may lead to cervical cancer include the Pap test and human papillomavirus (HPV) testing. Such screening tests may find cancers early, when they are most treatable. Women who have never been screened or who have not been screened in the past 5 years face a greater risk of developing invasive cervical cancer.

  1. HPV vaccination and cervical cancer.

    PubMed

    Szarewski, Anne

    2012-12-01

    Cervical cancer is the third most common cancer in women worldwide and often affects women under 40 years with young families. Vaccination against the human papillomavirus (HPV) is a major advance, since it offers primary prevention against the infectious agent that is the main cause of the disease. Two prophylactic vaccines have shown great promise in clinical trials. One of these (Gardasil(®)) contains all four HPV types, offering protection against genital warts (types 6 and 11) as well as cervical cancer (types 16 and 18). The other (Cervarix(®)) contains types 16 and 18, targeting cervical cancer alone, but also has a degree of cross-protection against types 31 and 45, which could significantly increase the level of protection. Adolescent girls remain the primary target of vaccination programmes, but the issues of vaccinating boys and older women are increasingly debated. PMID:22890794

  2. Biomarkers of Cervical Dysplasia and Carcinoma

    PubMed Central

    Hwang, Sonya J.; Shroyer, Kenneth R.

    2012-01-01

    Although cervical cytology screening has decreased the incidence of cervical cancer in industrialized countries, HPV-related cervical disease, including premalignant and malignant lesions, continues to represent a major burden on the health care system. Some of the problems include the potential for either under- or overtreatment of women due to decreased specificity of screening tests as well as significant interobserver variability in the diagnosis of cervical dysplastic lesions. Although not completely elucidated, the HPV-driven molecular mechanisms underlying the development of cervical lesions have provided a number of potential biomarkers for both diagnostic and prognostic use in the clinical management of these women. PMID:22131995

  3. Cervical spinal cord injuries in patients with cervical spondylosis.

    PubMed

    Regenbogen, V S; Rogers, L F; Atlas, S W; Kim, K S

    1986-02-01

    Eighty-eight patients over age 40 with traumatic cervical spinal cord injuries were clinically and radiographically evaluated, and comparison was made with 35 spinal cord injury patients under age 36. While most older patients sustained obvious bony and/or ligamentous damage commensurate with their neurologic findings, 25 (28%) of the 88 patients had no demonstrable bony abnormalities and 17 (20%) of the 88 patients had only minimal evidence of bony injury. Of particular interest are the patients with severe cord injuries, yet no bony abnormalities, who seem to form a distinct subgroup of the cervical spinal cord injury patient on the basis of radiographic and clinical features. Of these 25 patients, 24 (96%) had severe cervical spondylosis. Fourteen (56%) of the 25 patients were injured in falls, five (36%) of these 14 being of a seemingly trivial nature. Of the 42 patients with minimal or no demonstrable bony abnormalities, 33 (79%) were evaluated with plain tomography and no occult fractures or other significant pathology was demonstrated. Pantopaque myelography in 27 (64%) of the 42 cases revealed no extruded disk or other surgical lesion in any patient. In large measure, these injuries can be attributed to cervical spondylosis, which narrows the canal and makes the cord more susceptible to compression by the bulging ligamenta flava during hyperextension. PMID:3484576

  4. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.

    PubMed

    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

    2008-12-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no significant difference in stability either preoperatively or postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery. PMID:18830638

  5. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage I, Stage II, Stage III, or Stage IV Cervical Cancer

    ClinicalTrials.gov

    2014-12-23

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  6. Drugs Approved for Cervical Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  7. Embolization followed by surgery for treatment of perimedullary arteriovenous fistula causing acute myelopathy

    PubMed Central

    Hsiao, I-Han; Lee, Han-Chung; Yen, Pao-Sheng; Cho, Der-Yang

    2015-01-01

    Background: Perimedullary arteriovenous fistula (AVF) is rare. There are three subtypes, and the treatment strategies for each are different. Subtype B (multiple fistulas) can be treated by either embolization or surgery. On the basis of a case from our treatment experience, we propose a method for achieving optimal outcome while minimizing nerve injury. Case Description: A 51-year-old female was admitted to our hospital with acute myelopathy caused by a perimedullary AVF. Initially, we treated her by embolization using the chemical agent Onyx. Her symptoms improved immediately but gradually returned beginning 1 week later. Two months later, the symptoms had returned to pretreatment status, so we removed the fistulas surgically. Severe adhesions between nerve and occult venous varices were noted during the operation. Afterward, the patient's symptoms improved significantly. Histopathological sections showed an inflammatory reaction around the varices. Conclusions: We initially considered several possible reasons for the return of symptoms: (a) Hypoperfusion of the spinal cord; (b) mass effect of the occult vein varices; (c) residual AVF or vascular remodeling resulting in recurrent cord hypertension; (d) Onyx-induced perivascular inflammation resulting in nerves adhering to each other and to occult venous varices. Clinical, surgical, and pathological findings ruled out the first three, leaving Onyx-induced perivascular inflammation as the probable reason. Given our treatment experience and the pros and cons of the two methods, we propose that initial embolization followed by surgery after 5 days to remove occult venous varices is the ideal strategy for treating perimedullary AVF of subtype B.

  8. Optic neuropathy, myelopathy, anemia, and neutropenia caused by acquired copper deficiency after gastric bypass surgery.

    PubMed

    Yarandi, Shadi S; Griffith, Daniel P; Sharma, Rahul; Mohan, Arun; Zhao, Vivian M; Ziegler, Thomas R

    2014-01-01

    Malabsorptive bariatric surgery is rapidly becoming a major cause of copper deficiency given the increasing prevalence of these procedures for morbid obesity. Acquired copper deficiency can present with clinically significant hematologic and neurological manifestations. Although hematologic manifestations of copper deficiency are rapidly reversible, significant neurological improvement after copper supplementation therapy is unusual and many patients remain debilitated and may only experience, at best, stabilization of the neurological manifestations. Here we present a case of an undiagnosed copper deficiency several years after bariatric gastric bypass surgery, in a patient who concomitantly used zinc-containing denture cream for several years, associated with anemia, neutropenia, myelopathy, respiratory failure, and bilateral optic neuropathy, which caused major vision loss. This patient was also a heterozygote carrier of the 5,10-methylenetetrahydrofolate reductase A1298C gene polymorphism, which may affect copper metabolism. Intravenous copper repletion resulted in rapid correction of hematologic indices. However, neurological manifestations, including vision loss responded only modestly to copper supplementation, despite achieving normal blood copper concentrations. Clinicians should consider copper deficiency in patients at risk, as in this case, as a delayed diagnosis can lead to irreversible disability due to neurological manifestations. PMID:24583748

  9. Ultrasound-indicated cervical cerclage: Outcome depends on preoperative cervical length and presence of visible membranes at time of cerclage

    Microsoft Academic Search

    Katie M. Groom; Andrew H. Shennan; Phillip R. Bennett

    2002-01-01

    Objective: The purpose of this study was to assess cases of ultrasound-indicated cervical cerclage and to relate preoperative cervical length, operative findings, postoperative cervical length, and pregnancy outcome to establish the appropriate criteria to offer cervical cerclage. Study Design: A prospective observational study comprised 380 women at high risk of preterm labor who underwent serial transvaginal ultrasonographic assessment of cervical

  10. Low-back pain in HTLV-I-associated myelopathy\\/tropical spastic paraparesis: nociceptive or neuropathic?

    Microsoft Academic Search

    Í R Tavares; A C Franzoi; A Q-C Araújo

    2010-01-01

    Study design:Cross-sectional.Objectives:To describe characteristics of low-back pain in human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy\\/tropical spastic paraparesis (HAM\\/TSP) patients and to identify its neuropathic and\\/or non-neuropathic pain components.Setting:A reference center for the care of patients with HAM\\/TSP in Rio de Janeiro, Brazil.Methods:A total of 90 patients with HAM\\/TSP referred by tertiary care centers were consecutively assessed. The patients were

  11. Percutaneous transplantation of human umbilical cord-derived mesenchymal stem cells in a dog suspected to have fibrocartilaginous embolic myelopathy

    PubMed Central

    Chung, Wook-Hun; Park, Seon-Ah; Lee, Jae-Hoon; Chung, Dai-Jung; Yang, Wo-Jong; Kang, Eun-Hee; Choi, Chi-Bong; Chang, Hwa-Seok; Kim, Dae-Hyun; Hwang, Soo-Han; Han, Hoon

    2013-01-01

    The use of human umbilical cord blood-derived mesenchymal stem cells for cell transplantation therapy holds great promise for repairing spinal cord injury. Here we report the first clinical trial transplantation of human umbilical cord (hUCB)-derived mesenchymal stem cells (MSCs) into the spinal cord of a dog suspected to have fibrocartilaginous embolic myelopathy (FCEM) and that experienced a loss of deep pain sensation. Locomotor functions improved following transplantation in a dog. Based on our findings, we suggest that transplantation of hUCB-derived MSCs will have beneficial therapeutic effects on FCEM patients lacking deep pain sensation. PMID:23820160

  12. Solitary extramedullary plasmacytoma of thoracic epidural space presenting with dorsal compressive myelopathy: A case report and review of literature

    PubMed Central

    Kumar, Amandeep; Satyarthee, Guru Dutt; Sable, Mukund; Suri, Vaishali; Sharma, Bhawani S.

    2015-01-01

    Plasma Cell neoplasms result from monoclonal proliferation of plasma cells. Solitary extramedullary plasmacytomas (SEMPs) are rare and constitute 5% of all plasma cell disorders. SEMPs most commonly involve upper aerodigestive tract. Isolated spinal epidural space involvement by SEMPs is extremely rare and to best of our knowledge only 7 such cases have been reported previously in available English literature. We hereby present a rare case of thoracic epidural SEMP in a 32-year-old female who presented with thoracic compressive myelopathy and discuss the pertinent literature.

  13. 21 CFR 884.4250 - Expandable cervical dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 2011-04-01 false Expandable cervical dilator. 884.4250 Section 884...Surgical Devices § 884.4250 Expandable cervical dilator. (a) Identification. An expandable cervical dilator is an instrument with two...

  14. 21 CFR 884.4250 - Expandable cervical dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 false Expandable cervical dilator. 884.4250 Section 884...Surgical Devices § 884.4250 Expandable cervical dilator. (a) Identification. An expandable cervical dilator is an instrument with two...

  15. Cervical varix with placenta previa totalis.

    PubMed

    Kumazawa, Yukiyo; Shimizu, Dai; Hosoya, Naoko; Hirano, Hideto; Ishiyama, Koichi; Tanaka, Toshinobu

    2007-08-01

    A cervical varix during pregnancy is a very rare complication. It can lead to hemorrhage and may result in significant morbidity. Furthermore, appropriate management has not yet been established. We present a case of a cervical varix with placenta previa totalis. A 30-year-old woman with placenta previa totalis also had a cervical varix without bleeding. At 32 weeks' gestation, massive hemorrhage from the cervical varix occurred. A vaginal pack controlled the bleeding, and a cesarean section was subsequently carried out because of uncontrollable uterine contractions. A 1655 g female infant was delivered; the estimated blood loss was 1814 mL. The cervical varix decreased dramatically in size. In conclusion, presented herein is a rare case of a cervical varix, which had a successful outcome. PMID:17688624

  16. Clinical application of a new plate fixation system in open-door laminoplasty.

    PubMed

    Jiang, Liangjun; Chen, Weishan; Chen, Qixin; Xu, Kan; Wu, Qionghua; Li, Fangcai

    2012-02-01

    The purpose of this retrospective clinical series was to evaluate the benefits and complications of plate fixation for open-door laminoplasty in cervical spondylotic myelopathy with multilevel spinal stenosis compared with open-door laminoplasty without fixation. Forty-nine patients underwent open-door laminoplasty for cervical myelopathy with multilevel spinal stenosis with at least 13 months of follow-up. A plate was used as the sole method of fixation between the lateral mass and lamina with 3 screws. Computed tomography scans obtained pre- and postoperatively were assessed for plate complications and spinal canal enlargement. Pre- and postoperative neurological condition was assessed by the Japanese Orthopedic Association (JOA) myelopathy score. Overall cervical spine range of motion (ROM) was measured in full flexion and extension radiographs pre- and postoperatively. No restenosis due to door reclosure was noted, and no plates failed. No screws were backed out or broken. Almost all patients showed neurological improvement. The JOA score increased by 3.9±0.7 points in the suture group and 4.3±0.8 points in the plate group (P>.05). The postoperative increase in mean anteroposterior diameter of the spinal canal from C3 to C7 was 4.5±0.6 mm in the suture group and 5.1±0.5 mm in the plate group. The greater mean anteroposterior diameter increase in the plate group was statistically significant (P<.01). The mean cervical ROM decreased in the plate and suture groups postoperatively (P<.001). No significant difference was found in mean cervical ROM reduction between the groups (P>.05). No difference in axial symptoms was found between the 2 groups. PMID:22310411

  17. Cervical uncinate process: an anatomic study for anterior decompression of the cervical spine

    Microsoft Academic Search

    J. Lu; N. A. Ebraheim; H. Yang; M. Skie; R. A. Yeasting

    1998-01-01

    Morphometric evaluation of 54 dry cervical spines from C3 to C7 (a total of 270 cervical vertebrae) was performed to determine the bony boundaries of the uncinate process for resection of the uncinate process for access to posterolateral osteophytes or herniated disks at the time of anterior cervical diskectomy. The uncinate processes were significantly higher (p < 0.01) at the

  18. Human papillomavirus in false negative archival cervical smears: implications for screening for cervical cancer

    Microsoft Academic Search

    J M Walboomers; A M de Roda Husman; P J Snijders; H V Stel; E K Risse; T J Helmerhorst; F J Voorhorst; C J Meijer

    1995-01-01

    AIM--To assess the value of detecting human papillomavirus (HPV) DNA in false negative archival cervical smears in population based screening programmes for cervical cancer. METHODS--Cytomorphologically classified false negative archival Pap smears (n = 27) taken from 18 women up to six years before cervical cancer was diagnosed were blindly mixed with 89 smears from hospital patients with a variety of

  19. Induction of Aromatase Expression in Cervical Carcinomas: Effects of Endogenous Estrogen on Cervical Cancer Cell Proliferation

    Microsoft Academic Search

    Hareesh B. Nair; Roopa Luthra; Nameer Kirma; Ya-Guang Liu; Lisa Flowers; Dean Evans; Rajeshwar Rao Tekmal

    2005-01-01

    Epidemiologic studies have implicated estrogenic exposure as well as human papilloma virus (HPV) infection in cervical carcinogenesis, and some studies have suggested that estrogen and HPV may play synergistic roles in cervical tumorigenesis. In this study, we report a novel finding that f35% of cervical carcinomas tested (n = 19) express aromatase, the enzyme responsible for converting androgen to estrogen,

  20. Cervical competence as a continuum: A study of ultrasonographic cervical length and obstetric performance

    Microsoft Academic Search

    Jay D. Iams; Francee F. Johnson; Jiri Sonck; Larry Sachs; Cathy Gebauer; Philip Samuels

    1995-01-01

    OBJECTIVE: Our purpose was to investigate the hypothesis that cervical competence is a continuum that is related to cervical length and is reflected by pregnancy history.STUDY DESIGN: A cross-sectional study was performed of cervical length measured by transvaginal ultrasonography in women with prior preterm delivery at ? 26 weeks, 27 to 32 weeks, and 33 to 35 weeks compared with

  1. OXYTOCIN-INDUCED CERVICAL DILATION AND CERVICAL MANIPULATION IN SHEEP: EFFECTS ON LAPAROSCOPIC ARTIFICIAL INSEMINATION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Difficulty of cervical penetration during transcervical artificial insemination (TAI), limits its use in sheep. Trauma of cervical manipulation (CM) may explain low fertility after TAI. We investigated effects of cervical dilation using exogenous oxytocin (OT) to facilitate TAI and its effect on rep...

  2. Multiple noncontiguous fractures of the cervical spine.

    PubMed

    Shear, P; Hugenholtz, H; Richard, M T; Russell, N A; Peterson, E W; Benoit, B G; da Silva, V F

    1988-05-01

    Multiple noncontiguous fracture-subluxations of the cervical spine are fractures and subluxations separated by at least one normal intervening cervical vertebra. A review of all 66 consecutive cervical spine fractures treated by the Division of Neurosurgery at the University of Ottawa during 26 consecutive months revealed six such cases (9%). These injuries are more common than previously recognized. Special consideration is required in their treatment because of the presence of a mobile intermediate segment in some of these patients. PMID:3367408

  3. Human papillomavirus, cervical cancer and women's knowledge

    Microsoft Academic Search

    Azadeh Stark; Lucie Gregoire; Rebecca Pilarski; Allison Zarbo; Arthur Gaba; Wayne D. Lancaster

    2008-01-01

    Background: Human papillomavirus (HPV) is the major risk factor for cervical cancer. Methods: We implemented a retrospective case-series study to discern HPV knowledge accuracy among women diagnosed with and treated for cervical cancer. Cases (n=1174), identified from the Pathology database, were diagnosed and treated for cervical cancer at the same institution. Data were collected using self-administered questionnaires and by reviewing

  4. Cervical spine injury in maxillofacial trauma

    Microsoft Academic Search

    Z. Lalani; K. M. Bonanthaya

    1997-01-01

    Objective—To find out the incidence of associated facial injuries and injuries to the cervical spine. Design—Retrospective study. Setting—Teaching hospital, India. Subjects-536 patients treated for maxillofacial injuries between January 1992 and November 1993. Interventions—Review of hospital case notes and radiographs. Main outcome measures—Coexisting facial and cervical spine injuries, morbidity and mortality. Results—16 patients (3%) had sustained both facial and cervical spine

  5. Probabilities of Radiation Myelopathy Specific to Stereotactic Body Radiation Therapy to Guide Safe Practice

    SciTech Connect

    Sahgal, Arjun, E-mail: arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada) [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States)] [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States); Ma, Lijun [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States); Chang, Eric [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States)] [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States); Chao, Sam [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Muacevic, Alexander [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany)] [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany); Gorgulho, Alessandra [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States)] [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States); Soltys, Scott [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)] [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)] [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Angelov, Lilyana [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Gibbs, Iris [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada)] [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Larson, David A. [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)

    2013-02-01

    Purpose: Dose-volume histogram (DVH) results for 9 cases of post spine stereotactic body radiation therapy (SBRT) radiation myelopathy (RM) are reported and compared with a cohort of 66 spine SBRT patients without RM. Methods and Materials: DVH data were centrally analyzed according to the thecal sac point maximum (Pmax) volume, 0.1- to 1-cc volumes in increments of 0.1 cc, and to the 2 cc volume. 2-Gy biologically equivalent doses (nBED) were calculated using an {alpha}/{beta} = 2 Gy (units = Gy{sub 2/2}). For the 2 cohorts, the nBED means and distributions were compared using the t test and Mann-Whitney test, respectively. Significance (P<.05) was defined as concordance of both tests at each specified volume. A logistic regression model was developed to estimate the probability of RM using the dose distribution for a given volume. Results: Significant differences in both the means and distributions at the Pmax and up to the 0.8-cc volume were observed. Concordant significance was greatest for the Pmax volume. At the Pmax volume the fit of the logistic regression model, summarized by the area under the curve, was 0.87. A risk of RM of 5% or less was observed when limiting the thecal sac Pmax volume doses to 12.4 Gy in a single fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. Conclusion: We report the first logistic regression model yielding estimates for the probability of human RM specific to SBRT.

  6. Survival from Cervical Necrotizing Fasciitis

    PubMed Central

    Gausepohl, Jeniffer S.; Wagner, Jonathan G.

    2015-01-01

    Cervical necrotizing fasciitis (CNF) is an uncommon, yet clinically significant infection that rapidly progresses to involve the deep neck spaces. Early recognition and aggressive surgical intervention and debridement are important, as this disease is associated with a high morbidity and mortality. In this report, we present a case of CNF and descending mediastinitis from a non-odontogenic source in a patient presenting with neck swelling and odynophagia. PMID:25671035

  7. Survival from cervical necrotizing fasciitis.

    PubMed

    Gausepohl, Jeniffer S; Wagner, Jonathan G

    2015-01-01

    Cervical necrotizing fasciitis (CNF) is an uncommon, yet clinically significant infection that rapidly progresses to involve the deep neck spaces. Early recognition and aggressive surgical intervention and debridement are important, as this disease is associated with a high morbidity and mortality. In this report, we present a case of CNF and descending mediastinitis from a non-odontogenic source in a patient presenting with neck swelling and odynophagia. PMID:25671035

  8. Surgery for cervical intraepithelial neoplasia

    PubMed Central

    Martin-Hirsch, Pierre PL; Paraskevaidis, Evangelos; Bryant, Andrew; Dickinson, Heather O; Keep, Sarah L

    2014-01-01

    Background Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2 or 3). Cervical intraepithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the grade and extent of the disease. Objectives To assess the effectiveness and safety of alternative surgical treatments for CIN. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (up to April 2009). We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) of alternative surgical treatments in women with cervical intraepithelial neoplasia. Data collection and analysis Two review authors independently abstracted data and assessed risks of bias. Risk ratios that compared residual disease after the follow-up examination and adverse events in women who received one of either laser ablation, laser conisation, large loop excision of the transformation zone (LLETZ), knife conisation or cryotherapy were pooled in random-effects model meta-analyses. Main results Twenty-nine trials were included. Seven surgical techniques were tested in various comparisons. No significant differences in treatment failures were demonstrated in terms of persistent disease after treatment. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although the trials did not provide data for every outcome measure. There were not enough data to assess the effect on morbidity when compared with laser ablation. Authors’ conclusions The evidence suggests that there is no obvious superior surgical technique for treating cervical intraepithelial neoplasia in terms of treatment failures or operative morbidity. PMID:20556751

  9. Human papilloma virus and cervical preinvasive disease

    PubMed Central

    Bari, M; Iancu, G; Popa, F

    2009-01-01

    Cervical cancer lesions represent a major threat to the health of the women worldwide. Human Papillomavirus (HPV) is responsible for 99.7% of cervical cancer cases, the infectious etiology giving the possibility of preventing cervical cancer by vaccination. The most aggressive HPV types are 16 and 18, which cause about 70% of cases of invasive cancer. The vaccination is recommended to the girls aged 11–12. The diagnosis and the treatment of cervical preinvasive disease allow the doctor to prevent the development of the invasive disease. PMID:20108750

  10. Interdisciplinary treatment of cervical lesions.

    PubMed

    Allen, Edward P; Winter, Robert R

    2011-01-01

    Soft tissue grafting is an integral part of treatment of cervical lesions due to the common lack of adequate attached gingiva and root exposure associated with these lesions. Complete root coverage is a predictable outcome for Miller Class I and II recession defects, and partial root coverage can be achieved in Miller Class III defects. In the esthetic zone, it is desirable to cover as much of the root as possible, and all sites require an adequate zone of attached gingiva, especially adjacent to a restoration. Restorations are required for cervical lesions with excessive depth and significant involvement of the enamel, but they should be avoided where the lesion is shallow and the enamel involvement is minimal. Of course, some sites will require both soft-tissue grafting and placement of a restoration. An interdisciplinary approach to treating cervical lesions will create the most biologically appropriate, stable, and esthetic outcome. Establishing the appropriate tooth form first in treatment planning and sequencing will determine the gingival level and extent of periodontal procedures necessary to achieve the desired outcome. PMID:22439257

  11. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    This study seeks to develop sensitive, specific, and inexpensive approaches to cervical cancer screening as alternatives to the traditional Pap test and cervical human papillomavirus (HPV) DNA testing.

  12. Radiation myelopathy: Estimates of risk in 1048 patients in three randomized trials of palliative radiotherapy for non-small cell lung cancer

    Microsoft Academic Search

    F. R. Macbeth; T. E. Wheldon; D. J. Girling; R. J. Stephens; D. Machin; N. M. Bleehen; A. Lamont; D. J. Radstone; N. S. Reed

    1996-01-01

    Radiation myelopathy (RM) is an uncommon but serious late effect of thoracic radiotherapy (RT), which oncologists try to avoid by careful planning and dose selection. Five patients with RM are described from among 1048 with inoperable non-small cell lung cancer treated with palliative RT in three randomized trials conducted by the Medical Research Council Lung Cancer Working Party. Seven RT

  13. Immunopathogenesis of Human T-Cell Leukemia Virus Type-1-Associated Myelopathy/Tropical Spastic Paraparesis: Recent Perspectives

    PubMed Central

    Saito, Mineki; Bangham, Charles R. M.

    2012-01-01

    Human T-cell leukemia virus type-1 (HTLV-1) is a replication-competent human retrovirus associated with two distinct types of disease only in a minority of infected individuals: the malignancy known as adult T-cell leukemia (ATL) and a chronic inflammatory central nervous system disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP is a chronic progressive myelopathy characterized by spastic paraparesis, sphincter dysfunction, and mild sensory disturbance in the lower extremities. Although the factors that cause these different manifestations of HTLV-1 infection are not fully understood, accumulating evidence from host population genetics, viral genetics, DNA expression microarrays, and assays of lymphocyte function suggests that complex virus-host interactions and the host immune response play an important role in the pathogenesis of HAM/TSP. Especially, the efficiency of an individual's cytotoxic T-cell (CTL) response to HTLV-1 limits the HTLV-1 proviral load and the risk of HAM/TSP. This paper focuses on the recent advances in HAM/TSP research with the aim to identify the precise mechanisms of disease, in order to develop effective treatment and prevention. PMID:23198155

  14. Anatomical and functional perspectives of the cervical spine: Part I: the “normal” cervical spine †

    PubMed Central

    McGregor, Marion; Mior, Silvano

    1989-01-01

    This is the first of a three part series describing the clinical issues surrounding the radiographic assessment of the cervical spine. Defined in this literature review is the working definition of cervical stability. Described are the “normal” anatomical relationships between the cervical vertebrae for both the adult and the child, as portrayed by lateral radiographs. Also presented is a review of available documentation regarding the normal segmental function of the vertebrae in the upper and in the lower cervical spine. The next two parts in this series will deal with the definitions and radiographic evaluation of cervical hypermobility and instability respectively.

  15. Myelopathy mimicking subacute combined degeneration in a Down syndrome patient with methotrexate treatment for B lymphoblastic leukemia: report of an autopsy case.

    PubMed

    Satomi, Kaishi; Yoshida, Mari; Matsuoka, Kentaro; Okita, Hajime; Hosoya, Yosuke; Shioda, Yoko; Kumagai, Masa-Aki; Mori, Tetsuya; Morishita, Yukio; Noguchi, Masayuki; Nakazawa, Atsuko

    2014-08-01

    We report clinicopathological features of a 23-year-old woman with Down syndrome (DS) presenting with subacute myelopathy treated with chemotherapy, including intravenous and intrathecal administration of methotrexate (MTX), and with allogenic bone-marrow transplantation for B lymphoblastic leukemia. Autopsy revealed severe demyelinating vacuolar myelopathy in the posterior and lateral columns of the spinal cord, associated with macrophage infiltration, marked axonal loss and some swollen axons. Pathological changes of posterior and lateral columns were observed from the medulla oblongata to lumbar cord. Proximal anterior and posterior roots were preserved. Cerebral white matter was relatively well preserved. There were no vascular lesions or meningeal dissemination of leukemia. Longitudinal extension of cord lesions was extensive, unlike typical cases of subacute combined degeneration (SACD), but distribution of lesions and histological findings were similar to that of SACD. DS patients show heightened sensitivity to MTX because of their genetic background. Risk factors for toxic myelopathy of DS are discussed, including delayed clearance of MTX despite normal renal function, alterations in MTX polyglutamation and enhanced folic acid depletion due to gene dosage effects of chromosome 21. Alteration of folate metabolism and/or vitamin B12 levels through intravenous or intrathecal administration of MTX might exist, although vitamin B12 and other essential nutrients were managed using intravenous hyperalimentation. To the best of our knowledge, this is the first report of an autopsy case that shows myelopathy mimicking SACD in a DS patient accompanied by B lymphoblastic leukemia. The case suggests a pathophysiological mechanism of MTX-related myelopathy in DS patients with B lymphoblastic leukemia mimicking SACD. PMID:24661121

  16. Evaluation of pediatric cervical spine injuries

    Microsoft Academic Search

    Chris Baker; Howard Kadish; Jeff E Schunk

    1999-01-01

    To compare historical features, clinical examination findings, and radiographic results among pediatric patients with cervical spine injury (CSI), a retrospective review of patients who were diagnosed with CSI was undertaken. Two main groups were identified: radiographically evident cervical spine injury (RESCI), and spinal cord injury without radiographic abnormality (SCIWORA). Demographic, historical, clinical, and radiographic information was obtained from patients' charts

  17. Cervical Cancer: Screening and Therapeutic Perspectives

    Microsoft Academic Search

    Rengaswamy Sankaranarayanan; Somanathan Thara; Pulikottil Okkuru Esmy; Partha Basu

    2008-01-01

    Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia, Africa and Latin America, despite the fact that it is an eminently preventable cancer. While cytology screening programmes have resulted in a substantial reduction of cervical cancer mortality in developed countries, they have been shown

  18. Congenital Disorders of the Cervical Spine

    Microsoft Academic Search

    Robert N. Hensinger

    \\u000a Radiological interpretation of the infant’s spine may be difficult and a clear understanding of its appearance at different\\u000a ages is essential if deformity and malalignment are to be recognized. Normal development of the cervical spine is discussed\\u000a in the section on cervical trauma.

  19. Cervical Spine MRI in Abused Infants.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1997-01-01

    This study attempted to use cervical spine magnetic resonance imaging (MRI) to detect cord injury in 12 dead children with head injury from child abuse. Eighty percent of children autopsied had small cervical spine hemorrhages; MRI did not identify them and did not identify cord injury in any child studied, indicating that MRI scans are probably…

  20. Cervical spine injuries from motor vehicle accidents

    Microsoft Academic Search

    N. Yoganandan; D. J. Maiman; F. A. Pintar

    1989-01-01

    The objective of the study was to delineate the critical regions of the human cervical spine and determine the mechanisms of injury in motor vehicle accidents (MVA). The clinical data were gathered from patient records. Results indicated that while neck injuries in MVA are complex and can occur at any level of the cervical spine, the craniocervical junction (among fatalities)

  1. Spinal cord infarction with cervical angina.

    PubMed

    Nakae, Yoshiharu; Johkura, Ken; Kudo, Yosuke; Kuroiwa, Yoshiyuki

    2013-01-15

    Cervical angina is defined as chest pain resembling true cardiac angina but originating from disorders of the cervical spine. Cervical angina is caused by cervical spondylosis in most cases. A 66-year-old man presented with bilateral arm palsy after chest pain resembling angina pectoris. Neurological examination revealed motor and sensory disturbances of the C7 to T1 level, and magnetic resonance imaging showed a hyperintense spinal cord lesion on T2-weighted imaging. Spinal cord infarction was diagnosed. Severe sinus bradycardia was identified on admission, and improved over the course of 5 weeks. Sympathetic afferent fibers from the heart and coronary arteries generally have their cell bodies in the dorsal root ganglia of the C8 to T9 spinal segments. Electrical stimulation of cardiopulmonary afferent fibers excites spinothalamic tract cells in the T1 to T6 segments of the spinal cord. Spinal cord injury can result in the loss of supraspinal control of the sympathetic system and can cause bradycardia, as commonly seen in patients with severe lesions of the cervical or high-thoracic (T6 or above) spinal cord. Bradycardia in the present case suggested impairment of the sympathetic system at the cervical and thoracic levels. These findings indicated that cervical angina in this case was mediated through the sympathetic nervous system. This represents only the second report of cervical angina caused by spinal cord infarction. PMID:23199591

  2. HPV and the Prevention of Cervical Cancer

    Microsoft Academic Search

    Martin C. Mahoney

    Summary Human papillomavirus (HPV) infection has many significant clinical outcomes, including the development of cervical cancer. The consequences of HPV infec- tion are costly in terms of both direct and indirect costs. A significant advance in the prevention of cervical cancer and other adverse outcomes from HPV has occurred with the introduction of a vaccine to prevent infection with the

  3. How will HPV vaccines affect cervical cancer?

    Microsoft Academic Search

    Richard Roden; T.-C. Wu

    2006-01-01

    Cancer of the uterine cervix is the second largest cause of cancer deaths in women, and its toll is greatest in populations that lack screening programmes to detect precursor lesions. Persistent infection with 'high risk' genotypes of human papillomavirus (HPV) is necessary, although not sufficient, to cause cervical carcinoma. Therefore, HPV vaccination provides an opportunity to profoundly affect cervical cancer

  4. Familial Clusters of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

    PubMed Central

    Nozuma, Satoshi; Matsuura, Eiji; Matsuzaki, Toshio; Watanabe, Osamu; Kubota, Ryuji; Izumo, Shuji; Takashima, Hiroshi

    2014-01-01

    Objective HTLV-1 proviral loads (PVLs) and some genetic factors are reported to be associated with the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). However, there are very few reports on HAM/TSP having family history. We aimed to define the clinical features and laboratory indications associated with HAM/TSP having family history. Methods Records of 784 HAM/TSP patients who were hospitalized in Kagoshima University Hospital and related hospitals from 1987 to 2012 were reviewed. Using an unmatched case-control design, 40 patients of HAM/TSP having family history (f-HAM/TSP) were compared with 124 patients suffering from sporadic HAM/TSP, who were admitted in series over the last 10 years for associated clinical features. Results Of the 784 patients, 40 (5.1%) were f-HAM/TSP cases. Compared with sporadic cases, the age of onset was earlier (41.3 vs. 51.6 years, p<0.001), motor disability grades were lower (4.0 vs. 4.9, p?=?0.043) despite longer duration of illness (14.3 vs. 10.2 years, p?=?0.026), time elapsed between onset and wheelchair use in daily life was longer (18.3 vs. 10.0 years, p?=?0.025), cases with rapid disease progression were fewer (10.0% vs. 28.2%, p?=?0.019), and protein levels in cerebrospinal fluid (CSF) were significantly lower in f-HAM/TSP cases (29.9 vs. 42.5 mg, p<0.001). There was no difference in HTLV-1 PVLs, anti-HTLV-1 antibody titers in serum and CSF, or cell number and neopterin levels in CSF. Furthermore, HTLV-1 PVLs were lower in cases with rapid disease progression than in those with slow progression in both f-HAM/TSP and sporadic cases. Conclusions We demonstrated that HAM/TSP aggregates in the family, with a younger age of onset and a slow rate of progression in f-HAM/TSP cases compared with sporadic cases. These data also suggested that factors other than HTLV-1 PVLs contribute to the disease course of HAM/TSP. PMID:24802839

  5. Reoperations Following Cervical Disc Replacement

    PubMed Central

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential complications associated with CDR. The published rates of reoperation (mean, 1.0%; range, 0%-3.1%), revision (mean, 0.2%; range, 0%-0.5%), and removal (mean, 1.2%; range, 0%-1.9%) following CDR are low and comparable to the published rates of reoperation (mean, 1.7%; range; 0%-3.4%), revision (mean, 1.5%; range, 0%-4.7%), and removal (mean, 2.0%; range, 0%-3.4%) following cervical arthrodesis. The surgical interventions following CDR range from the repositioning to explantation followed by fusion or the reimplantation to posterior foraminotomy or fusion. Strict patient selection, careful preoperative radiographic review and surgical planning, as well as surgical technique may reduce adverse events and the need for future intervention. Minimal literature and no guidelines exist for the approaches and techniques in revision and for the removal of implants following CDR. Adherence to strict indications and precise surgical technique may reduce the number of reoperations, revisions, and removals following CDR. Long-term follow-up studies are needed, assessing the implant survivorship and its effect on the revision and removal rates.

  6. Pathology Case Study: Cervical Lymphadenopathy

    NSDL National Science Digital Library

    Contis, Lydia C.

    This is a hematopathology case study presented by the University of Pittsburgh Department of Pathology in which a 17-year-old female has cervical lymphadenopathy. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.

  7. Invasive Cervical Resorption: A Review

    PubMed Central

    Kandalgaonkar, Shilpa D; Gharat, Leena A; Tupsakhare, Suyog D; Gabhane, Mahesh H

    2013-01-01

    Invasive cervical resorption is a relatively uncommon form of external root resorption exhibiting no external signs. The resorptive condition is often detected by routine radiographic examination. The clinical features vary from a small defect at the gingival margin to a pink coronal discoloration of the tooth crown resulting in ultimate cavitation of the overlying enamel which is painless unless pulpal or periodontal infection supervenes. Radiographic features of lesions vary from well-delineated to irregularly bordered mottled radiolucencies, and these can be confused with dental caries. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal, because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing clastic cells adjacent to the dentin surface. More advanced lesions display fibro-osseous characteristics with deposition of ectopic bonelike calcifications both within the resorbing tissue and directly on the dentin surface. How to cite this article: Kandalgaonkar SD, Gharat LA, Tupsakhare SD, Gabhane MH. Invasive Cervical Resorption: A Review. J Int Oral Health 2013;5(6):124-30 . PMID:24453457

  8. Positron Emission Tomography Using Fluoromisonidazole F 18 and Fludeoxyglucose F 18 to Find Oxygen in Tumor Cells of Patients Undergoing Treatment for Newly Diagnosed Stage IB, Stage II, Stage III, or Stage IV Cervical Cancer

    ClinicalTrials.gov

    2014-06-10

    Cervical Adenocarcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  9. Vertebral artery injuries in cervical spine surgery

    PubMed Central

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least risk. A thorough understanding of the complex anatomy of the vertebral artery is mandatory prior to performing cervical spine surgery, and since the vertebral artery can have a variable course, especially in the upper cervical spine, the surgeon must minimize the possibility of an arterial injury by preoperatively assessing the artery with a computed tomography (CT) scan or magnetic resonance imaging (MRI). Intraoperatively, the surgeon must be aware of when the vertebral artery is most at risk, and take precautions to avoid an injury. In the event of an arterial injury, the surgeon must have a plan of action to (1) Achieve control of the hemorrhage. (2) Prevent acute central nervous system ischemia. (3) Prevent postoperative complications such as embolism and pseudoaneurysm Conclusion: Prior to performing cervical spine surgery, one must understand the four A's of vertebral artery injuries: Anatomy, Assessment, Avoidance, and Action. PMID:24340233

  10. Donor-transmitted HTLV-1-associated myelopathy in a kidney transplant recipient--case report and literature review.

    PubMed

    Ramanan, P; Deziel, P J; Norby, S M; Yao, J D; Garza, I; Razonable, R R

    2014-10-01

    Clinical disease due to human T cell lymphotropic virus type 1 (HTLV-1), a retrovirus endemic in certain regions of the world, is rarely reported after solid organ transplantation. In 2009, universal deceased donor organ screening for HTLV-1 was discontinued in the United States. We report the first case of donor-derived HTLV-1-associated myelopathy in a kidney transplant recipient from the United States. The patient, who was HTLV-1-seronegative prior to transplantation, likely acquired HTLV-1 infection from a seropositive organ donor. In this era when screening of donors and recipients for HTLV infection is not mandatory, clinicians should be vigilant in recognizing the risk and potential occurrence of this donor-derived infection in recipients with epidemiologic exposures. PMID:25138148

  11. Cervical uncinate process: an anatomic study for anterior decompression of the cervical spine

    Microsoft Academic Search

    J. Lu; N. A. Ebraheim; H. Yang; M. Skie; R. A. Yeasting

    1998-01-01

    Summary Morphometric evaluation of 54 dry cervical spines from C3 to C7 (a total of 270 cervical vertebrae) was performed to determine the bony boundaries of the uncinate process for resection of the uncinate process for access to posterolateral osteophytes or herniated disks at the time of anterior cervical diskectomy. The uncinate processes were significantly higher (p<0.01) at the C4

  12. Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results

    Microsoft Academic Search

    Gun Choi; Sang-Ho Lee; Arun Bhanot; Yu Sik Chae; Byungjoo Jung; Seungcheol Lee

    2007-01-01

    A prospective analysis of the first twenty patients operated for cervical radiculopathy by a new modification of transcorporeal\\u000a anterior cervical foraminotomy technique. To evaluate early results of a functional disc surgery in which decompression for\\u000a the cervical radiculopathy is done by drilling a hole in the upper vertebral body and most of the disc tissue is preserved.\\u000a Earlier approaches to

  13. Occipito-Cervical Fusion with the Cervical Cotrel-Dubousset Rod System

    Microsoft Academic Search

    V. Heidecke; N. G. Rainov; W. Burkert

    1998-01-01

    Summary  ?Diseases and conditions which cause instability of the cranio-cervical junction and the adjacent upper cervical spine are\\u000a relatively common and potentially life-threatening. Direct internal occipito-cervical fusion (OCF) is a modern means of surgical\\u000a treatment in such cases, and has some advantages over simple immobilization of the affected segments. The present study was\\u000a designed to evaluate surgical handling, results, and complications

  14. Human Papillomavirus Type 16 Integration in Cervical Carcinoma In Situ and in Invasive Cervical Cancer

    Microsoft Academic Search

    Hugo Arias-Pulido; Cheri L. Peyton; Nancy E. Joste; Hernan Vargas; Cosette M. Wheeler

    2006-01-01

    Integration of human papillomavirus type 16 (HPV-16) into the host DNA has been proposed as a potential marker of cervical neoplastic progression. In this study, a quantitative real-time PCR (qRT-PCR) was used to examine the physical status of HPV-16 in 126 cervical carcinoma in situ and 92 invasive cervical cancers. Based on criteria applied to results from this qRT-PCR assay,

  15. New Technologies for Cervical Cancer Screening

    PubMed Central

    Brown, Alaina J.; Trimble, Cornelia L.

    2013-01-01

    New technologies for cervical cancer screening seek to provide an accurate, efficient, and cost-effective way of identifying women at risk for cervical cancer. Current screening uses HPV DNA testing combined with cytology and requires multiple visits at a great cost to the patient and the society. New methods for screening include HPV diagnostics (detection of either the presence of HPV or integration of the virus into the host cell), proliferation, and detection of epigenetic changes, either in the host or virus. These methods show promise in changing the way that current cervical cancer screening is undertaken in both low and high-resource settings. PMID:22119058

  16. Characterization of the Human Cervical Mucous Proteome

    Microsoft Academic Search

    Gitika Panicker; Yiming Ye; Dongxia Wang; Elizabeth R. Unger

    2010-01-01

    Introduction  Cervical cancer is among the most common cancers in women worldwide. Discovery of biomarkers for the early detection of cervical\\u000a cancer would improve current screening practices and reduce the burden of disease.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  In this study, we report characterization of the human cervical mucous proteome as the first step towards protein biomarker\\u000a discovery.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The protein composition was characterized using one- and

  17. Contribution of Galvanic Vestibular Stimulation for the Diagnosis of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

    PubMed Central

    Matos Cunha, Luciana Cristina; Campelo Tavares, Maurício; Tierra Criollo, Carlos Julio; Labanca, Ludimila; Cardoso dos Santos Couto Paz, Clarissa; Resende Martins, Henrique; de Freitas Carneiro-Proietti, Anna Bárbara

    2013-01-01

    Background and Purpose Galvanic vestibular stimulation (GVS) is a low-cost and safe examination for testing the vestibulospinal pathway. Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a slowly progressive disease that affects the vestibulospinal tract early in its course. This study compared the electromyographic (EMG) responses triggered by GVS of asymptomatic HTLV-1-infected subjects and subjects with HAM/TSP. Methods Bipolar galvanic stimuli (400 ms and 2 mA) were applied to the mastoid processes of 39 subjects (n=120 stimulations per subject, with 60 from each lower limb). Both the short latency (SL) and medium latency (ML) components of the EMG response were recorded from the soleus muscles of 13 healthy, HTLV-1-negative adults (56±5 years, mean±SD), and 26 individuals infected with HTLV-1, of whom 13 were asymptomatic (56±8 years) and 13 had HAM/TSP (60±6 years). Results The SL and ML EMG components were 55±4 and 112±10 ms, respectively, in the group of healthy subjects, 61±6 and 112±10 ms and in the HTLV-1-asymptomatic group, and 67±8 and 130±3 ms in the HAM/TSP group (p=0.001). The SL component was delayed in 4/13 (31%) of the examinations in the HTLV-1-asymptomatic group, while the ML component was normal in all of them. In the HAM/TSP group, the most common alteration was the absence of waves. Conclusions A pattern of abnormal vestibular-evoked EMG responses was found in HTLV-1-neurological disease, ranging from delayed latency among asymptomatic carriers to the absence of a response in HAM/TSP. GVS may contribute to the early diagnosis and monitoring of nontraumatic myelopathies. PMID:24285967

  18. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2015-05-28

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  19. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2015-06-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  20. Cisplatin and Radiation Therapy With or Without Carboplatin and Paclitaxel in Patients With Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2015-03-17

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Chemotherapeutic Agent Toxicity; Cognitive Side Effects of Cancer Therapy; Psychological Impact of Cancer; Radiation Toxicity; Sexual Dysfunction and Infertility; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  1. Indications and techniques for anterior cervical plating.

    PubMed

    Rhee, John M; Park, Jong-Beom; Yang, Jun-Young; Riew, Daniel K

    2005-12-01

    Anterior cervical plating is commonly performed to stabilize anterior cervical fusions. Modern plating options include dynamic plates, with screws that can either toggle within fixed holes or translate within slotted holes. Regardless of the plating system used, paramount to success and avoidance of complications with plated anterior cervical fusions are meticulous plating techniques, exacting graft carpentry, and understanding the biomechanical limitations of plating in certain situations, such as multilevel corpectomies reconstructed with a single-strut graft. In order to prevent graft-related complications associated with long-strut grafts, additional posterior fixation and fusion, or alternative corpectomy constructs, such as multilevel anterior cervical discectomy and fusion, corpectomy-discectomy, and corpectomy-corpectomy, should be considered instead if the pattern of stenosis allows. PMID:16565534

  2. Abnormal Cervical Cancer Screening Test Results

    MedlinePLUS

    ... freeze abnormal cervical tissue, which then sloughs off. • Laser therapy—A focused beam of light is used ... tissue is removed from the cervix. Cryotherapy: A freezing technique used to destroy diseased tissue; also known ...

  3. Cervical Cancer Incidence and Mortality Rates

    Cancer.gov

    Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer: Mortality Rates | Organization

  4. Development of Consensus Educational Materials on HPV & Cervical Cancer for Europe

    Cancer.gov

    1 Development of Development of Consensus Educational Materials Consensus Educational Materials on HPV & Cervical Cancer for Europe on HPV & Cervical Cancer for Europe Philip Davies Philip Davies European Cervical Cancer Association European Cervical

  5. Trampoline Injuries of the Cervical Spine

    Microsoft Academic Search

    Peter G. Brown; Mark Lee

    2000-01-01

    Trampolines were responsible for over 6,500 pediatric cervical spine injuries in 1998. This represents a five-fold increase in just 10 years. While most have been minor, paraplegia, quadriplegia and death are all reported. We present 2 cases of trampoline-related cervical spine injury and review the relevant literature. Additionally, we examine the efforts made to reduce the incidence of trampoline injuries,

  6. Cervical Cancer: paradigms at home and abroad

    Cancer.gov

    NCI funded a clinical trial that will have an impact on the treatment of late-stage cervical cancer, and also supported a screening trial in India using a network of community outreach workers offering low tech-screening by direct visualization of the cervix coated with dilute acetic acid (vinegar), a process known as VIA. Image depicts cervical cancer microvessel density which increases lethality of the cancer.

  7. Polygenic Control of Human T Lymphotropic Virus Type I (HTLV?I) Provirus Load and the Risk of HTLV?I–Associated Myelopathy\\/Tropical Spastic Paraparesis

    Microsoft Academic Search

    Asna Siddiqui; Mike Bunce; Nobutaka Eiraku; Shuji Izumo; Koichiro Usuku; Mitsuhiro Osame

    2002-01-01

    Human T lymphotropic virus type I (HTLV-I)-associated myelopathy\\/tropical spastic para- paresis (HAM\\/TSP) is one outcome of infection with HTLV-I. A population association study of 229 patients with HAM\\/TSP and 202 healthy carriers of HTLV-I in southern Japan showed that this outcome of HTLV-I infection and the HTLV-I provirus load are under polygenic control. Of 58 polymorphic sites studied in 39

  8. Automated image analysis of uterine cervical images

    NASA Astrophysics Data System (ADS)

    Li, Wenjing; Gu, Jia; Ferris, Daron; Poirson, Allen

    2007-03-01

    Cervical Cancer is the second most common cancer among women worldwide and the leading cause of cancer mortality of women in developing countries. If detected early and treated adequately, cervical cancer can be virtually prevented. Cervical precursor lesions and invasive cancer exhibit certain morphologic features that can be identified during a visual inspection exam. Digital imaging technologies allow us to assist the physician with a Computer-Aided Diagnosis (CAD) system. In colposcopy, epithelium that turns white after application of acetic acid is called acetowhite epithelium. Acetowhite epithelium is one of the major diagnostic features observed in detecting cancer and pre-cancerous regions. Automatic extraction of acetowhite regions from cervical images has been a challenging task due to specular reflection, various illumination conditions, and most importantly, large intra-patient variation. This paper presents a multi-step acetowhite region detection system to analyze the acetowhite lesions in cervical images automatically. First, the system calibrates the color of the cervical images to be independent of screening devices. Second, the anatomy of the uterine cervix is analyzed in terms of cervix region, external os region, columnar region, and squamous region. Third, the squamous region is further analyzed and subregions based on three levels of acetowhite are identified. The extracted acetowhite regions are accompanied by color scores to indicate the different levels of acetowhite. The system has been evaluated by 40 human subjects' data and demonstrates high correlation with experts' annotations.

  9. Persistent human papillomavirus infection and cervical neoplasia.

    PubMed

    Ferenczy, Alex; Franco, Eduardo

    2002-01-01

    The development of cervical cancer is preceded by precursor lesions (cervical intraepithelial neoplasia). Evidence-based epidemiological and molecular data suggest that persistent infections with human papillomavirus (HPV) types that carry ahigh oncogenic risk are the intermediate endpoints, leading to both intraepithelial and invasive cervical neoplasia. Integration of highly oncogenic HPVs into host-cell chromosomes is followed by binding of HPV E6 and E7 oncoproteins to tumour-suppressor genes p53 and RB, respectively. This process results in impaired tumour-suppressor-gene function, involving DNA repair, decreased apoptosis, and eventual cell immortalisation. Mutations causing chromosomal alterations, loss of heterozygosity, and proto-oncogene and telomerase activation in immunopermissive individuals have important roles in virus-induced cervical carcinogenesis. The so-called non-European variants of HPV 16 and 18 may increase the degradation potential of p53. HPV 16 is polymorphic and, although the evidence is controversial, the Arg/Arg genotype of p53 could have greater susceptibility to HPV-E6 degradation than the other genotypes. The coincident interplay between the non-European genomic variants of HPV 16/18 and p53 Arg/Arg may explain, at least in part, the persistence of HPV infection and tumour progression in women with cervical neoplasia. Further epidemiological and molecular research is needed, to gain insight into HPV-mediated cervical carcinogenesis. The evidence highlights the need to develop appropriate prophylactic HPV vaccines and diagnostic and screening tests. PMID:11905599

  10. Conservative Treatment in Early Cervical Cancer

    PubMed Central

    Karimi-Zarchi, Mojgan; Mousavi, Azamsadat; Gilani, Mitra Modares; Barooti, Esmat; Miratashi-Yazdi, Ashrafosadat; Dehghani, Atefe

    2013-01-01

    Purpose of review: The aim of this study was to describe fertility preservation methods to improve quality of life of early stages of cervical cancer. Recent finding: Although definite treatment of early stages of cervical cancer including stages IA,IB1 and IIA non-bulky is radial hysterectomy, this method is used in perimenopousal period in which fertility preservation is not important. Whenever fertility preservation is so important, some methods like radical trachelectomy and laparoscopic lymphadenectomy are used to rule out lymphatic metastases. Summary: If any visible lesion on cervix is found, pelvic MRI is helpful and during operation, trachelectomy samples are sent for frozen section and margin study. Radical trachelectomy is done vaginal or abdominal. Overall relapse rate of cervical cancer in radical trachelectomy and radical hysterectomy is the same. Complications of radical trachelectomy include chronic vaginal discharge, abnormal uterine bleeding, dysmenorrhea, inflammation and ulcer due to cercelage, amenorrhea, cervical stenosis and pregnancy complications following trachelectomy including 2nd trimester abortion and premature labor following cervical prematurity.The best and preferred method of labor is cesarean section. Neoadjuant chemotherapy followed by radical trachelectomy in large cervical lesions is a suitable treatment. Ultraconservative operations like large cold knife conization, simple trachelectomy with laparoscopic lymphadenectomy and sentinel lymph node mapping are suitable for very small lesions. PMID:24170987

  11. The Future of Vaccines for Cervical Cancer

    PubMed Central

    Huh, Warner K.; Roden, Richard B.S.

    2015-01-01

    Cervical cancer continues to cause significant morbidity and mortality worldwide, making prophylactic cervical cancer vaccines an important focus for cervical cancer prevention. The increasing accessibility of these vaccines worldwide has the potential to greatly decrease the incidence and burden of disease in the future. However, current prophylactic vaccines offer no therapeutic benefit for persons already infected with human papillomavirus types targeted by vaccines or persons with precancerous lesions or cervical cancer. The protection offered by current vaccines is primarily against human papillomavirus types used to derive the vaccine, although partial cross-protection for related virus types has been observed. Herein, we describe findings from preclinical and clinical studies that employ vaccine strategies that have the potential to shape the future of vaccines against cervical cancer. Modalities include prophylactic strategies to target more oncogenic virus types by using the minor capsid antigen L2 and/or by increasing the number of types used to derive virus-like particle vaccines. Therapeutic strategies include the development of vaccines against human papillomavirus early proteins (targets for cellular immunity) for the resolution of precancerous lesions and cervical cancer. Future applications of existing VLP-based vaccines are also discussed. PMID:18482559

  12. I. Cervical dysplasia = abnormal tissue growth n Cervical cancer develops in the

    E-print Network

    Dever, Jennifer A.

    in flat, scaly surface cells that line the cervix (called squamous cell carcinomas). Approximately 10-15% of cases develop in glandular surface cells (called adenocarcinomas). Types of Cervical Cancer: Squamous Cell Carcinoma Adenocarcinoma Small Cell Carcinoma #12;11/12/12 2 B. Incidence & Prevelance n Cervical

  13. Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy

    PubMed Central

    Rossi, Paolo Giorgi; Ricciardi, Alessandro; Cohet, Catherine; Palazzo, Fabio; Furnari, Giacomo; Valle, Sabrina; Largeron, Nathalie; Federici, Antonio

    2009-01-01

    Background We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities. Methods The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia) was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region. Results An estimated 6.4 million women aged 25–69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively). Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000–17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to €158.5 million for screening and €22.9 million for the management of cervical abnormalities. Conclusion Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately €181.5 million, of which 87% is attributable to screening. PMID:19243586

  14. Increased Fusion Rates With Cervical Plating for Two Level Anterior Cervical Discectomy and Fusion

    Microsoft Academic Search

    Jeffrey C. Wang; Paul W. McDonough; Kevin K. Endow; Rick B. Delamarter

    Study Design. A retrospective review of all patients surgically treated with a two-level anterior cervical disc- ectomy and fusion with and without anterior plate fixa- tion by a single surgeon. Objectives. To compare the clinical and radiographic success of two-level discectomy and the effect of anterior cervical plate fixation. Summary of Background Data. Prior studies of multi- segment fusions have

  15. Palliative Occipito-Cervical Stabilization in Patients with Malignant Tumors of the Occipito-Cervical Junction and the Upper Cervical Spine

    Microsoft Academic Search

    M. Zimmermann; R. Wolff; A. Raabe; D. Stolke; V. Seifert

    2002-01-01

    Summary.\\u000a Summary.  \\u000a ?\\u000a \\u000a \\u000a \\u000a \\u000a Background:   Occipital-cervical stability may be impaired in patients with primary malignant or metastatic tumors of the cranio-cervical\\u000a junction and the upper cervical spine. The purpose of this study was to evaluate occipital-cervical fixation with prebended\\u000a titanium-loops and sublaminar wiring in order to achieve a rigid and safe stabilisation of the occipito-cervical region in\\u000a this group of patients.

  16. Cervical wedge resection for treatment of pyometra secondary to transluminal cervical adhesions in six mares.

    PubMed

    Arnold, Carolyn E; Brinsko, Steven P; Varner, Dickson D

    2015-06-15

    Case Description-6 mares with pyometra secondary to transluminal cervical adhesions were examined. Clinical Findings-Reasons for hospital admission included infertility (5 mares) and acute colic (1 mare). In the 6 mares, palpation per rectum of the reproductive tract revealed uterine distention, and transrectal ultrasonography confirmed the presence of echogenic fluid accumulation within the uterus. Cervical palpation during vaginal speculum examination indicated transluminal cervical adhesions. Three mares had severe distortion of the cervix as a result of diverticula and fibrosis. All 6 mares had a diagnosis of pyometra secondary to transluminal cervical adhesions. Treatment and Outcome-Initially, the cervical adhesions were manually broken down to establish a patent cervical lumen to accommodate a uterine lavage catheter. A sample of the uterine content was obtained for bacteriologic culture and antimicrobial susceptibility testing, and the uterus was lavaged with 0.05% povidone-iodine solution to remove the mucopurulent exudate. Once the uterus was evacuated, cervical surgery was performed in standing mares following sedation and caudal epidural anesthesia. A full-thickness wedge-shaped defect was made in the dorsolateral aspect of the cervix that created a permanent opening to the uterus. Postoperative care included applying topical medication to the cervix to reduce the recurrence of adhesion formation. All 6 mares had patent cervices and resolution of pyometra following surgery. Conclusions and Clinical Relevance-Cervical wedge resection enabled treatment of pyometra in mares with transluminal cervical adhesions, without the need for ovariohysterectomy. (J Am Vet Med Assoc 2015;246:1354-1357). PMID:26043134

  17. How protective is cervical cancer screening against cervical cancer mortality in developing countries? The Colombian case

    PubMed Central

    2010-01-01

    Background Cervical cancer is one of the top causes of cancer morbidity and mortality in Colombia despite the existence of a national preventive program. Screening coverage with cervical cytology does not explain the lack of success of the program in reducing incidence and mortality rates by cervical cancer. To address this problem an ecological analysis, at department level, was carried out in Colombia to assess the relationship between cervical screening characteristics and cervical cancer mortality rates. Methods Mortality rates by cervical cancer were estimated at the department level for the period 2000-2005. Levels of mortality rates were compared to cervical screening coverage and other characteristics of the program. A Poisson regression was used to estimate the effect of different dimensions of program performance on mortality by cervical cancer. Results Screening coverage ranged from 28.7% to 65.6% by department but increases on this variable were not related to decreases in mortality rates. A significant reduction in mortality was found in departments where a higher proportion of women looked for medical advice when abnormal findings were reported in Pap smears. Geographic areas where a higher proportion of women lack health insurance had higher rates of mortality by cervical cancer. Conclusions These results suggest that coverage is not adequate to prevent mortality due to cervical cancer if women with abnormal results are not provided with adequate follow up and treatment. The role of different dimensions of health care such as insurance coverage, quality of care, and barriers for accessing health care needs to be evaluated and addressed in future studies. PMID:20846446

  18. Changes in Cervical Sagittal Alignment after Single-Level Posterior Percutaneous Endoscopic Cervical Diskectomy

    PubMed Central

    Kim, Chi Heon; Shin, Kyung-Hyun; Chung, Chun Kee; Park, Sung Bae; Kim, Jung Hee

    2014-01-01

    Study Design?Case series. Objective?Posterior percutaneous endoscopic cervical diskectomy (PECD) can preserve the disk in patients with a foraminal disk herniation. However, progressive angulation at the operated segment is a concern, especially for patients with cervical lordosis?cervical lordosis after posterior PECD was analyzed. Methods?Medical records were reviewed of 32 consecutive patients (22 men, 10 women; mean age, 49?±?12 years) who had single-level foraminal soft disk herniation. The operation levels were as follows: C4–5 in 1 patient, C5–6 in 12, C6–7 in 18, and C7–T1 in 1. All patients were discharged the day after the operation, and neck motion was encouraged. All patients were followed for 30?±?7 months (range, 24 to 46 months), and 21/32 patients (66%) had radiographs taken at 25?±?11 months (range, 12 to 45 months). Radiologic parameters were assessed, including cervical curvature (C2–7), segmental Cobb's angle (SA), and anterior and posterior disk height (AH and PH, respectively) at the operative level. Results?At the last follow-up, 29/32 patients (91%) had no or minimal pain, and 3/32 patients had occasional pain. SA, AH, and PH were not significantly changed. Cervical lordosis?cervical lordosis?cervical curvature changed from ?2.5?±?8.0 to ?11.3?±?9.3 degrees (p?=?0.01). For patients with cervical lordosis???10 degrees, cervical curvature changed from ?17.5?±?5.8 to ?19.9?±?5.7 degrees (p?=?0.24). Conclusions?Cervical curvature does not worsen after posterior PECD. PMID:25648214

  19. Anesthetic Implications of Chronic Disease of the Cervical Spine

    Microsoft Academic Search

    MICHAEL D. POPITZ

    1998-01-01

    nderstanding the anatomy of the cervical spine and its anatomical relationships to the airway has daily importance to the anesthesiologist. Particularly important considerations include the con- tribution of chronic abnormalities of the cervical spine to the \\

  20. Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED)

    Cancer.gov

    A study to comprehensively assess biomarkers of risk for progressive cervical neoplasia, and thus develop a new set of biomarkers that can distinguish those at highest risk of cervical cancer from those with benign infection

  1. Preventing Cervical Cancer: The Development of HPV Vaccines

    Cancer.gov

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  2. What Are the Key Statistics about Cervical Cancer?

    MedlinePLUS

    ... factors for cervical cancer? What are the key statistics about cervical cancer? The American Cancer Society's estimates ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  3. Raman spectroscopic characterization on cervical neoplasm in biopsy direction

    NASA Astrophysics Data System (ADS)

    Shin, Hsiao Hsin; Tsai, Yan Sheng; Wang, Tao Yuan; Chu, Shou Chia; Chiang, Huihua Kenny

    2007-02-01

    Raman spectroscopy was applied to distinguish the spectroscopic information between normal cervical tissues (14) and cervical neoplasia (17), including low grade squamous intraepithelial lesions (6) and high grade squamous intraepithelial lesions (11). Standard pathological sections of these cervical tissues were measured from superficial to stroma layers. We have normalized significant Raman peaks, 1250 and 1579-1656 cm -1 by taking a ratio over a stationary Raman at 1004 cm -1, and successfully discriminated between normal and neoplasm cervical tissues.

  4. The cervical cap as a barrier contraceptive.

    PubMed

    Cagen, R

    1986-05-01

    This report covers the 1st 4 years (beginning in 1984) of a Food and Drug Administration-approved study of use of the cervical cap as a contraceptive device. The cap used in this study is the Prentif Cavity-Rim Cervical Cap. 620 women were issued cervical caps. They ranged in age from 16 to 43 years. 97.7% had attained a high school diploma and 57.3% had at least an undergraduate college education. Each woman was instructed carefully on proper placement and use of the cervical cap. Terminal problems appear most frequently during the 1st 9 months of cap usage. Terminal problems most frequently mentioned include 1) unplanned pregnancy, 2) partner discomfort, 3) dislodgement and 4) lack of confidence. Out of 620 women, there were 92 unplanned pregnancies during the 4-year period. At least 45 of 86 pregnancies were associated with user failure (6 of the 92 were not sure whether their pregnancies occurred before or after being fitted for the cap.). 4 of the 620 developed an abnormal Papanicolaou smear. This figure is within the expected range of women in any sample who would develop an abnormal Papanicolaou smear. Odor was the most frequently mentioned problem (2.9%). 80.53% of the participants continued to use the cervical cap after 1 year. Comfort and convenience were 2 positive reasons mentioned for continuing use of the cap. Motivation is the most important factor associated with the success of the cap. PMID:3757513

  5. Biomechanical analysis of the anterior cervical fusion.

    PubMed

    Fernandes, P C; Fernandes, P R; Folgado, J O; Levy Melancia, J

    2012-01-01

    This paper presents a biomechanical analysis of the cervical C5-C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine. It was confirmed that the results were very sensitive to intervertebral disc properties. The insertion of an anterior cervical plate influenced the stress distribution at the vertebral level as well as in the bone graft. Additionally, stress values in the graft decreased when it is used together with a cage. PMID:21806410

  6. South Africa project provides cervical cancer screening.

    PubMed

    Kennedy, L

    1997-01-01

    Cervical cancer is one of the five leading causes of death among women aged 45-59 years in the developing world, and the most common type of cancer among South African women, accounting for about 25% of all cancer-related mortality. The Philani Cervical Cancer Prevention Project, located in Site C of Khayelitsha, a settlement outside of Cape Town, is now screening women to prevent development of the disease. The Philani Project is a demonstration study for a larger cervical cancer prevention project. AVSC International is providing technical and management assistance as one of the project's five collaborators. Working out of a mobile clinic parked next to an outpatient treatment center, the project is comparing the use of Pap smears and four other screening approaches in a low-resource situation in order to develop protocols for similar programs. Now in its second year, the Philani project has enrolled 1600 previously unscreened women over age 35 years. Follow-up and treatment are provided. 80% of women identified with a problem through screening and in need of colposcopy return for follow-up and treatment. However, the number of women who return voluntarily for follow-up is continuously increasing due to the staff's attention to providing community education about cervical screening. About 9% of clients were found to have abnormalities of the cervix with the potential to progress to a malignancy, and 8 cases of outright cervical cancer have been detected. Community outreach, innovative programs, and coordinated efforts are discussed. PMID:12293924

  7. Progesterone Signaling Inhibits Cervical Carcinogenesis in Mice

    PubMed Central

    Yoo, Young A; Son, Jieun; Mehta, Fabiola F.; DeMayo, Francesco J.; Lydon, John P.; Chung, Sang-Hyuk

    2014-01-01

    Human papillomavirus is the main cause of cervical cancer, yet other nonviral cofactors are also required for the disease. The uterine cervix is a hormone-responsive tissue, and female hormones have been implicated in cervical carcinogenesis. A transgenic mouse model expressing human papillomavirus oncogenes E6 and/or E7 has proven useful to study a mechanism of hormone actions in the context of this common malignancy. Estrogen and estrogen receptor ? are required for the development of cervical cancer in this mouse model. Estrogen receptor ? is known to up-regulate expression of the progesterone receptor, which, on activation by its ligands, either promotes or inhibits carcinogenesis, depending on the tissue context. Here, we report that progesterone receptor inhibits cervical and vaginal epithelial cell proliferation in a ligand-dependent manner. We also report that synthetic progestin medroxyprogesterone acetate promotes regression of cancers and precancerous lesions in the female lower reproductive tracts (ie, cervix and vagina) in the human papillomavirus transgenic mouse model. Our results provide the first experimental evidence that supports the hypothesis that progesterone signaling is inhibitory for cervical carcinogenesis in vivo. PMID:24012679

  8. Landscape of Genomic Alterations in Cervical Carcinomas

    PubMed Central

    Ojesina, Akinyemi I.; Lichtenstein, Lee; Freeman, Samuel S.; Pedamallu, Chandra Sekhar; Imaz-Rosshandler, Ivan; Pugh, Trevor J.; Cherniack, Andrew D.; Ambrogio, Lauren; Cibulskis, Kristian; Bertelsen, Bjørn; Romero-Cordoba, Sandra; Treviño, Victor; Vazquez-Santillan, Karla; Guadarrama, Alberto Salido; Wright, Alexi A.; Rosenberg, Mara W.; Duke, Fujiko; Kaplan, Bethany; Wang, Rui; Nickerson, Elizabeth; Walline, Heather M.; Lawrence, Michael S.; Stewart, Chip; Carter, Scott L.; McKenna, Aaron; Rodriguez-Sanchez, Iram P.; Espinosa-Castilla, Magali; Woie, Kathrine; Bjorge, Line; Wik, Elisabeth; Halle, Mari K.; Hoivik, Erling A.; Krakstad, Camilla; Gabiño, Nayeli Belem; Gómez-Macías, Gabriela Sofia; Valdez-Chapa, Lezmes D.; Garza-Rodríguez, María Lourdes; Maytorena, German; Vazquez, Jorge; Rodea, Carlos; Cravioto, Adrian; Cortes, Maria L.; Greulich, Heidi; Crum, Christopher P.; Neuberg, Donna S.; Hidalgo-Miranda, Alfredo; Escareno, Claudia Rangel; Akslen, Lars A.; Carey, Thomas E.; Vintermyr, Olav K.; Gabriel, Stacey B.; Barrera-Saldaña, Hugo A.; Melendez-Zajgla, Jorge; Getz, Gad; Salvesen, Helga B.; Meyerson, Matthew

    2014-01-01

    Cervical cancer is responsible for 10–15% of cancer-related deaths in women worldwide1,2. The etiological role of infection with high-risk human papilloma viruses (HPV) in cervical carcinomas is well established3. Previous studies have implicated somatic mutations in PIK3CA, PTEN, TP53, STK11 and KRAS4–7 as well as several copy number alterations in the pathogenesis of cervical carcinomas8,9. Here, we report whole exome sequencing analysis of 115 cervical carcinoma-normal paired samples, transcriptome sequencing of 79 cases and whole genome sequencing of 14 tumor-normal pairs. Novel somatic mutations in 79 primary squamous cell carcinomas include recurrent E322K substitutions in the MAPK1 gene (8%), inactivating mutations in the HLA-B gene (9%), and mutations in EP300 (16%), FBXW7 (15%), NFE2L2 (4%) TP53 (5%) and ERBB2 (6%). We also observed somatic ELF3 (13%) and CBFB (8%) mutations in 24 adenocarcinomas. Squamous cell carcinomas had higher frequencies of somatic mutations in the Tp*C dinucleotide context than adenocarcinomas. Gene expression levels at HPV integration sites were significantly higher in tumors with HPV integration compared with expression of the same genes in tumors without viral integration at the same site. These data demonstrate several recurrent genomic alterations in cervical carcinomas that suggest novel strategies to combat this disease. PMID:24390348

  9. Emerging Biological Treatments for Uterine Cervical Carcinoma

    PubMed Central

    Vici, Patrizia; Mariani, Luciano; Pizzuti, Laura; Sergi, Domenico; Di Lauro, Luigi; Vizza, Enrico; Tomao, Federica; Tomao, Silverio; Mancini, Emanuela; Vincenzoni, Cristina; Barba, Maddalena; Maugeri-Saccà, Marcello; Giovinazzo, Giuseppe; Venuti, Aldo

    2014-01-01

    Cervical cancer is the third most common cancer worldwide, and the development of new diagnosis, prognostic, and treatment strategies is a major interest for public health. Cisplatin, in combination with external beam irradiation for locally advanced disease, or as monotherapy for recurrent/metastatic disease, has been the cornerstone of treatment for more than two decades. Other investigated cytotoxic therapies include paclitaxel, ifosfamide and topotecan, as single agents or in combination, revealing unsatisfactory results. In recent years, much effort has been made towards evaluating new drugs and developing innovative therapies to treat cervical cancer. Among the most investigated molecular targets are epidermal growth factor receptor and vascular endothelial growth factor (VEGF) signaling pathways, both playing a critical role in cervical cancer development. Studies with bevacizumab or VEGF receptor tyrosine kinase have given encouraging results in terms of clinical efficacy, without adding significant toxicity. A great number of other molecular agents targeting critical pathways in cervical malignant transformation are being evaluated in preclinical and clinical trials, reporting preliminary promising data. In the current review, we discuss novel therapeutic strategies which are being investigated for the treatment of advanced cervical cancer. PMID:24494026

  10. Human Papillomavirus type distribution in invasive cervical cancer in Uganda

    Microsoft Academic Search

    Michael Odida; Silvia de Sanjosé; Wim Quint; Xavier F Bosch; Joellen Klaustermeier; Elisabete Weiderpass

    2008-01-01

    BACKGROUND: We conducted a study aiming to describe Human Papillomavirus (HPV) type distribution in invasive cervical carcinoma in Uganda. METHODS: 191 archival cervical carcinoma samples diagnosed in the Department of Pathology, Makerere University in Kampala between 1968 and 1992 were analysed using a sensitive PCR-Reverse Hybridization Line Probe Assay. RESULTS: Out of the 186 cases of confirmed invasive cervical cancer

  11. Neurological and Osteological Definitions of Cervical Vertebrae in Mammals

    Microsoft Academic Search

    E. B. Giffin; M. Gillett

    1996-01-01

    The presence of seven cervical vertebrae is an almost universal mammalian trait. The posterior boundary of the cervical series is traditionally defined osteologically, but its location is also predictable using neurological markers of the brachial plexus. The existence of three living mammalian genera with osteologi-cally defined cervical counts other than seven offers the opportunity to examine the coincidence of osteological

  12. Computed tomography in cervical disc disease when myelography is unsatisfactory.

    PubMed

    Fon, G T; Sage, M R

    1984-01-01

    Water-soluble contrast media have replaced myodil for cervical myelography. In the presence of significant degenerative disease, the normal cervical lordotic curve may be decreased, straightened or even reversed, making it impossible to 'pool' sufficient contrast medium in this region. In such cases, third generation computed tomography is invaluable in confirming or excluding the presence of cervical disc protrusion. PMID:6690181

  13. An Historical Look at a Contemporary Question: The Cervical Cap.

    ERIC Educational Resources Information Center

    Zimmet, Judy A.; Reagan, Patricia A.

    1986-01-01

    The history of the use of cervical caps as a birth control method is recounted in the areas of (1) revival of the cervical cap; (2) repopularization of the cervical cap; (3) empirical research; (4) nonbehavioral factors; (5) behavioral problems; and (6) health problems. (CB)

  14. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    Risk for cervical cancer may depend on human papillomavirus (HPV) subtype, viral load in cervical tissue, and the persistence of infection. The risk of cervical cancer due to HPV infection may be modified by an individual's genetics, specifically, a group of alleles that code for the human leukocyte antigen (HLA).

  15. Analysis of the cervical spine alignment following laminoplasty and laminectomy

    Microsoft Academic Search

    Shunji Matsunaga; Takashi Sakou; Kenji Nakanisi

    1999-01-01

    Very little detailed biomechanical examination of the alignment of the cervical spine following laminoplasty has been reported. We performed a comparative study regarding the buckling-type alignment that follows laminoplasty and laminectomy to know the mechanical changes in the alignment of the cervical spine. Lateral images of plain roentgenograms of the cervical spine were put into a computer and examined using

  16. Evaluation of cervical conization as a definitive treatment for microinvasive cervical carcinoma and cervical intraepithelial neoplasia grade 3

    Microsoft Academic Search

    Noriko Takeda; Takahiro Suzuki; Miwa Suzuki; Motoki Matsuura; Ryoichi Tanaka; Miho Fujii; Eiki Ito; Tsuyoshi Saito

    Purpose  The aim of the study was to evaluate disease persistence after conization of CIN3 and microinvasive cervical carcinoma.\\u000a \\u000a \\u000a \\u000a Methods  Medical records from a total of 231 patients were reviewed. The prevalence of CIN3 and cervical carcinoma diagnosed by means\\u000a of conization were analyzed. All conizations were performed under lumbar anesthesia using a laser technique.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Of the 231 patients, 25 had margin

  17. Cervical Meningomyelitis After Lumbar Epidural Steroid Injection

    PubMed Central

    Kim, Joon-Sung; Kim, Ji Yeon

    2015-01-01

    Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement.

  18. Structural brain abnormalities in cervical dystonia

    PubMed Central

    2013-01-01

    Background Idiopathic cervical dystonia is characterized by involuntary spasms, tremors or jerks. It is not restricted to a disturbance in the basal ganglia system because non-conventional voxel-based MRI morphometry (VBM) and diffusion tensor imaging (DTI) have detected numerous regional changes in the brains of patients. In this study scans of 24 patients with cervical dystonia and 24 age-and sex-matched controls were analysed using VBM, DTI and magnetization transfer imaging (MTI) using a voxel-based approach and a region-of-interest analysis. Results were correlated with UDRS, TWSTRS and disease duration. Results We found structural alterations in the basal ganglia; thalamus; motor cortex; premotor cortex; frontal, temporal and parietal cortices; visual system; cerebellum and brainstem of the patients with dystonia. Conclusions Cervical dystonia is a multisystem disease involving several networks such as the motor, sensory and visual systems. PMID:24131497

  19. Preoperative Embolization of Cervical Spine Tumors

    SciTech Connect

    Vetter, Sylvia C.; Strecker, Ernst-Peter [Department of Radiology and Nuclear Medicine, Diakonissenkrankenhaus, Diakonissenstrasse 28, D-76199 Karlsruhe (Germany); Ackermann, Ludwig W.; Harms, Juergen [Department of Orthopedic Surgery, Klinikum Karlsbad-Langensteinbach Guttmannstrasse 1, D-76307 Karlsbad (Germany)

    1997-09-15

    Purpose: To assess the technical success rate, complications, and effect on intraoperative blood loss of preoperative transarterial embolization of cervical spine tumors. Methods: A retrospective analysis was performed on 38 patients with tumors of the cervical spine; 69 vertebrae were affected. Polyvinyl alcohol particles, coils, gelfoam particles, either alone or in combination, were used for preoperative tumor embolization. After embolization a total of 57 corporectomies with titanium basket implantation were performed. Results: In 36 of 38 patients, complete (n= 27) or partial (n= 9) embolization was achieved. In 23 patients one vertebral artery was completely occluded by coil placement, and in one patient the ipsilateral internal and external carotid arteries were occluded in addition. No neurological complications could be directly related to the embolization, but two postoperative brain stem infarctions occurred. The mean intraoperative blood loss was 2.4 L. Conclusion: Transarterial embolization of cervical spine tumors is a safe and effective procedure to facilitate extensive surgery.

  20. Clinical features of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in northeast Iran.

    PubMed

    Shoeibi, Ali; Rafatpanah, Houshang; Azarpazhooh, Amir; Mokhber, Naghme; Hedayati-Moghaddam, Mohammad Reza; Amiri, Amin; Hashemi, Peyman; Foroghipour, Mohsen; Hoseini, Reza Farid; Bazarbachi, Ali; Azarpazhooh, Mahmoud Reza

    2013-12-01

    This study aimed to introduce clinical manifestations of patients in northeast Iran with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and describe the epidemiological features, as well as risk factors for HTLV-1 infection. This is a cross-sectional study of HTLV-1 infected cases and HAM/TSP patients referred by outpatient neurology clinics as well as Mashhad Blood Transfusion Center from 2005 to 2010. The study comprises 513 cases, including 358 healthy carriers (HCs) and 145 HAM/TSP patients. The majority of carriers were male (73.5%), whereas 67.6% of HAM/TSP sufferers were female (P < 0.001). The mean age of HAM/TSP patients and HCs was 45.9 ± 13.6 and 39.5 ± 11.58 years, respectively (P < 0.001). The history of transfusion, surgery, hospitalization and cupping was observed in a significant greater number of HAM/TSP patients than the HCs (P < 0.001, P < 0.001, P < 0.001 and P = 0.029, respectively). Gait disturbance was the most common complaint in HAM/TSP patients (72.4%). This research develops an HTLV-1 data registry in an endemic area such as Mashhad which can serve useful purposes, including evaluation of clinical and laboratory characteristics of HAM/TSP patients and epidemiological data of HTLV-1-infected cases. PMID:23568138

  1. Tax mutation associated with tropical spastic paraparesis/human T-cell leukemia virus type I-associated myelopathy.

    PubMed Central

    Renjifo, B; Borrero, I; Essex, M

    1995-01-01

    Tumaco, Colombia, is an area with elevated rates of tropical spastic paraparesis/human T-cell leukemia virus type I (HTLV-I)-associated myelopathy (TSP/HAM). We have identified a mutation in nucleotide 7959 of the tax gene of 14 Tumaco HTLV-I isolates (14 positive of 14 tested) that was present in 5 of 14 (35%) TSP/HAM patients from Japan and in 8 of 11 (72%) TSP/HAM patients from other geographic locations. In contrast, this mutation was found in only 2 of 21 (9.5%) HTLV-I-infected subjects outside of Tumaco who did not have TSP/HAM. tax clones with nucleotide mutations including one at nucleotide 7959 showed a greater ability to transactivate the HTLV-I U3 promoter. However, this effect was not observed when two clones that differed only in nucleotide 7959 were compared. These results suggest that HTLV-I-infected individuals carrying isolates with this tax mutation are at higher risk for developing TSP/HAM. PMID:7884912

  2. HTLV-I-associated myelopathy/tropical spastic paraparesis in Brazil: a nationwide survey. HAM/TSP Brazilian Study Group.

    PubMed

    Araújo, A Q; Andrade-Filho, A S; Castro-Costa, C M; Menna-Barreto, M; Almeida, S M

    1998-12-15

    To study the epidemiology of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Brazil, we conducted a nationwide survey between March 1994 and April 1995. Five centers from three regions of the country participated, enrolling 163 patients. Most patients came from the northeastern and southeastern regions (93.2%). Most enrollees were white women, 42.9% and 64.4%, respectively. The most common risk factors for infection included a history of venereal diseases (30.6%) and blood transfusion (21.6%). The median age at the beginning of the disease was 42 years. The main neurologic findings were spastic paraparesis, widespread brisk tendon jerks, bilateral Babinski's sign, and bladder dysfunction. Some interregional differences reached statistical significance. The ratio of females over males increased from south to north. In addition, in both southern and southeastern regions, whites prevailed, whereas in the northeast, mulattos predominated. This follows the normal distribution of the population in these regions. A significantly higher rate of venereal diseases was found in the southeast compared with the other regions studied. A history of intravenous drug use was more frequent among patients as the sample moves south. Finally, a fluctuating course of the disease was proportionally more frequent in the southern region. PMID:9859969

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

    PubMed

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

    2015-01-01

    Human T-lymphotropic virus 1 (HTLV-1) infection may be associated with damage to the spinal cord - HTLV-associated myelopathy/tropical spastic paraparesis - and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions. PMID:25759588

  4. [A case of acute progressive myelopathy due to intravascular large B cell lymphoma diagnosed with only random skin biopsy].

    PubMed

    Yamazaki, Hidekazu; Imai, Keisuke; Hamanaka, Masashi; Yamada, Takehiro; Tsuto, Kazuma; Yamamoto, Atsushi; Tsutumi, Yasuhiko

    2015-01-01

    A 64-year old woman was admitted to our hospital with subacute onset paraparesis and sensory disturbance at a level below Th10. Spinal MRI showed a T2 weighted high-signal intensity lesion at a level from Th5 to Th12, and an abdominal CT showed a mass in the left kidney. Her paraparesis deteriorated rapidly, and administration of high dose methyl prednisolone followed by oral steroid therapy was started before obtaining of a definitive diagnosis. However her symptoms did not improve after the beginning of treatment. At the same time, a bone marrow puncture, and biopsies from kidney and spinal cord were performed. These biopsies demonstrated no clues, diagnostically. Therefore a random skin biopsy was performed at the five sites on the 17th day after the steroid dosage end. From this, pathological evidence of intravascular large B cell lymphoma (IVLBCL) was shown. For rapid diagnosis of acute myelopathy with mass lesion of another organ due to IVLBCL, a biopsy is taken not only from spinal cord or mass lesions, but is also taken of multiple sites in skin randomly. This must be performed without a delay before a sudden deterioration of neurologic symptoms can occur from ischemic events not responsive to steroid therapy. PMID:25746076

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

    PubMed Central

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

    2015-01-01

    Human T-lymphotropic virus 1 (HTLV-1) infection may be associated with damage to the spinal cord – HTLV-associated myelopathy/tropical spastic paraparesis – and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions. PMID:25759588

  6. Descriptive Epidemiology of Cervical Dystonia

    PubMed Central

    Defazio, Giovanni; Jankovic, Joseph; Giel, Jennifer L.; Papapetropoulos, Spyridon

    2013-01-01

    Background Cervical dystonia (CD), the most common form of adult-onset focal dystonia, has a heterogeneous clinical presentation with variable clinical features, leading to difficulties and delays in diagnosis. Owing to the lack of reviews specifically focusing on the frequency of primary CD in the general population, we performed a systematic literature search to examine its prevalence/incidence and analyze methodological differences among studies. Methods We performed a systematic literature search to examine the prevalence data of primary focal CD. Sixteen articles met our methodological criteria. Because the reported prevalence estimates were found to vary widely across studies, we analyzed methodological differences and other factors to determine whether true differences exist in prevalence rates among geographic areas (and by gender and age distributions), as well as to facilitate recommendations for future studies. Results Prevalence estimates ranged from 20–4,100?cases/million. Generally, studies that relied on service-based and record-linkage system data likely underestimated the prevalence of CD, whereas population-based studies suffered from over-ascertainment. The more methodologically robust studies yielded a range of estimates of 28–183?cases/million. Despite the varying prevalence estimates, an approximate 2:1 female:male ratio was consistent among many studies. Three studies estimated incidence, ranging from 8–12 cases/million person-years. Discussion Although several studies have attempted to estimate the prevalence and incidence of CD, there is a need for additional well-designed epidemiological studies on primary CD that include large populations; use defined CD diagnostic criteria; and stratify for factors such as age, gender, and ethnicity. PMID:24255801

  7. Cervical intramedullary schwannoma mimicking a glioma

    PubMed Central

    Gupta, Ankush; Nair, Bijesh Ravindran; Chacko, Geeta; Mani, Sunithi; Joseph, Vivek

    2015-01-01

    We present a case of a cervical intramedullary schwannoma (IS), which resembled a glioma on radiology. Somatic and root pain, the most common presenting complaints of IS, were lacking in our patient, and the characteristic magnetic resonance finding of an enhancing thickened nerve root in IS, was absent in our case. Preoperative diagnosis of a cervical IS is not always possible. Complete tumor resection is the ideal treatment for IS. Intraoperative frozen section can be a useful for decision making though the tumor-cord plane will ultimately decide if the tumor can be radically excised. PMID:25767576

  8. AAC11 Overexpression Induces Invasion and Protects Cervical Cancer Cells from Apoptosis

    Microsoft Academic Search

    Jin Woo Kim; Hyun Suk Cho; Jeong Hyun Kim; Soo Young Hur; Tae Eung Kim; Joon Mo Lee; In-Kyung Kim; Sung Eun Namkoong

    2000-01-01

    To identify the genes involved in cervical carcinogenesis, we applied the mRNA differential display (DD) method to analyze normal cervical tissue, cervical cancer, metastatic lymph node, and cervical cancer cell line. We cloned a 491-bp cDNA fragment, CC231, which was present in metastatic tissue and cervical cancer cell line, but absent in normal cervical and cervical cancer tissues. The 491

  9. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    This study explores the cervical cancer-related knowledge and behaviors of mothers and the potential of the mother-daughter relationship using daughter-initiated cervical cancer prevention in South Africa. The relationship has implications for effecting intergenerational prevention behavior for cervical cancer. This study will contribute formative data towards a better understanding of the potential of daughters to serve as advocates to promote cervical cancer screening with their mothers in order to develop effective and innovative methods to promote screening for cervical cancer.

  10. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine

    PubMed Central

    Gong, Wontae

    2015-01-01

    [Purpose] The aim of this study was to determine the effect of cervical posture manipulation, based on passive motion analysis (MBPMA) and general mobilization, on cervical lordosis, forward head posture (FHP), and cervical ROM in university students with problems in cervical posture and range of motion (ROM). [Subjects] The Subjects were 40 university students in their 20s who displayed problems in cervical posture and ROM; they were divided into an MBPMA group (n=20) and a mobilization group (n=20). [Methods] Each group underwent MBPMA or mobilization three times a week for four weeks. The effects of MBPMA and mobilization on cervical lordosis, FHP, and cervical ROM were analyzed by radiography. [Results] MBPMA was effective in increasing the cervical lordosis, cervical extension ROM (CER), and ranges of flexion and extension motion (RFEM) and in decreasing FHP. Mobilization was effective in increasing CER and decreasing FHP. [Conclusion] MBPMA can be utilized as an effective method for decreasing FHP and improving cervical lordosis and cervical ROM.

  11. Use of C2 spinous process screw for posterior cervical fixation as substitute for laminar screw in a patient with thin laminae

    PubMed Central

    Nagata, Kosei; Baba, Satoshi; Chikuda, Hirotaka; Takeshita, Katsushi

    2013-01-01

    Rigid screw fixation of C2 including transarticular screw and pedicle screw contain the risk of vertebral artery (VA) injury. On the other hand, translaminar screws are considered to be safer for patients with anomalous VA. But C2 translaminar screw placement was limited in patients who have thin laminas and there is marked variation in C2 laminar thickness. Appropriate C2 fixation method for a patient who has thin laminas and high-riding VA together was controversial. Here, we present a case of an elderly Asian woman who had thin laminas and high-riding VA together with progressive myelopathy to report a first case of C2 spinous process screw insertion. Although the stability and safety of C2 spinous process screw was reported in cadaver series, there was no clinical report to our knowledge. Spinous process screw can be an option of C2 fixation for patients with high-riding VA and severe degenerated cervical spines including thin C2 laminas. PMID:23814004

  12. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    ClinicalTrials.gov

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

  13. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial

    Microsoft Academic Search

    Barbara Kuijper; Jos Th J Tans; Anita Beelen; Frans Nollet; Marianne de Visser

    2009-01-01

    Objective To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy.Design Randomised controlled trial.Setting Neurology outpatient clinics in three Dutch hospitals.Participants 205 patients with symptoms and signs of cervical radiculopathy of less than one month’s durationInterventions Treatment with a semi-hard collar and taking rest for three to six

  14. Update on ASCCP consensus guidelines for abnormal cervical screening tests and cervical histology.

    PubMed

    Apgar, Barbara S; Kittendorf, Anne L; Bettcher, Catherine M; Wong, Jean; Kaufman, Amanda J

    2009-07-15

    New data have emerged since publication of the American Society for Colposcopy and Cervical Pathology's 2001 consensus guidelines for management of abnormal cervical cytology and histology. The 2006 guidelines include recommendations for special populations (i.e., adolescents and pregnant women). Human papillomavirus testing is now included for management of atypical glandular cytology, for follow-up after treatment for cervical intraepithelial neoplasia, and in combination with cytologic screening in women 30 years and older. The preferred management of atypical squamous cells of undetermined significance in adult women is reflex human papillomavirus DNA testing. Colposcopy is recommended for adult women with low-grade squamous intraepithelial lesion, atypical glandular cells, high-grade intraepithelial neoplasia, and atypical squamous cells-cannot exclude high-grade intraepithelial neoplasia. Cervical intraepithelial neoplasia, grade 1 can be managed conservatively in adult women, but treatment for cervical intraepithelial neoplasia, grades 2 and 3 is recommended. Immediate treatment is an option for adult women but not for adolescents with high-grade squamous intraepithelial lesion. Conservative management of adolescents with any cytologic or histologic diagnosis except specified cervical intraepithelial neoplasia, grade 3 and adenocarcinoma in situ is recommended. Colposcopy is preferred for pregnant women with low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion, but evaluation of the former may be deferred until no earlier than six weeks postpartum. Treatment during pregnancy is unacceptable unless invasive carcinoma is identified. PMID:19621855

  15. Position of the cervical vertebrae during helmet removal and cervical collar application in football and hockey.

    PubMed

    Prinsen, R K; Syrotuik, D G; Reid, D C

    1995-07-01

    There is lack of consensus among prehospital personnel (athletic therapists, paramedics, sport physiotherapists) concerning specific aspects of initial care and assessment of injured athletes presenting signs and symptoms of a cervical spine injury (CSI). In instances of serious injury involving the head and/or spine, complicated by altered levels of consciousness, protective equipment such as helmets and shoulder pads may provide a hinderance to prompt, safe and efficient management. Specifically, there is disagreement concerning the need or advisability of removing protective head gear, as in the case of football and hockey athletes. Using the technique of fluoroscopy, the cervical spine displacement of 21 male football and hockey athletes was determined while wearing protective shoulder pads and protective head equipment at the following times (a) during helmet removal, (b) during cervical collar application, and (c) as the helmetless head was allowed to rest. Subsequent frame-by-frame video arthokinematic analysis, using computer-assisted digitization, showed significant alterations in the position of adjacent cervical vertebrae during helmet removal, cervical collar application, and head rest. Results suggest that stabilization and transportation of football and hockey athletes with suspected CSI in their respective protective equipment is recommended in order to reduce the risk of further trauma by unnecessary cervical spine motion. PMID:7670970

  16. Anterior plating of unstable cervical spine fractures

    Microsoft Academic Search

    D C Mann; B W Braner; J S Keene; A B Levin; David Mann

    1990-01-01

    Medical records and radiographs of 16 patients who had anterior decompression, bone grafting, and plating of grade III and IV (Allen 1982) unstable cervical spine injuries were reviewed. Surgery was performed within 15 days of injury, reductions were achieved and maintained at follow-up, and fusion occurred in all cases. Neurologic function stabilised or improved in all cases. However, 3 patients

  17. Angiogenesis, Thrombospondin1 and Cervical Carcinogenesis

    Microsoft Academic Search

    Ming-Ping Wu; Cheng-Yang Chou

    2005-01-01

    SUMMARY Angiogenesis, the growth of new vessels from existing vasculature, plays an essential role in tumor development. The process involves interaction among cancer cells, endothelial cells, and components of the extracellular matrix, and is regulated by the balance of angiogenesis activators and angiogenesis inhibitors. This review profiles some fundamental concepts of angiogenesis, the importance of angiogenesis in cervical neoplasm, and

  18. Excessive daytime sleepiness in cervical dystonia

    Microsoft Academic Search

    Lynn Marie Trotti; Christine D. Esper; Paul J. Feustel; Donald L. Bliwise; Stewart A. Factor

    2009-01-01

    Few investigations have examined sleep in cervical dystonia (CD) patients. We assessed 43 consecutive CD patients, 19 patients with other focal movement disorders, and 49 healthy, age- and gender-matched controls for the presence of excessive daytime sleepiness (as measured by the Epworth Sleepiness Scale, ESS). All patients were receiving botulinum toxin. We found that a higher percentage of CD patients

  19. [Castelman disease. Apropos of 2 cervical localizations].

    PubMed

    el Messaoudi, A; el Edghiri, H; Lazrak, A; Jazouli, N; Kzadri, M

    1993-01-01

    The authors report two cases of neck localisations of Castelman's disease. A cervical mass and an inflammatory syndrome are the main clinical and biological symptoms. The diagnosis of the disease is based on histology. Surgery provides a complete recovery. PMID:8191062

  20. Sonographic Evaluation of an Embryonic Cervical Pregnancy

    Microsoft Academic Search

    Cassie J. Alexander

    2007-01-01

    Cervical pregnancy is a rare form of ectopic pregnancy, and early diagnosis and treatment are important when managing this type of emergency. Although rare, if implantation occurs in the endocervical canal, it can pose a serious risk to the patient's future fertility. When an endocervical pregnancy is suspected, transabdominal and endocavity sonography should be performed.

  1. Director's Message 2 Cervical Cancer 4

    E-print Network

    George, Steven C.

    Director's Message 2 Cervical Cancer 4 Laser Eyelid Surgery 5 LASER B E C K M A N L A S E R I N on pg. 8) Rafiki, an iguana, has recovered fully from laser surgery. (Please see Veterinary Update on pg

  2. Cervical Cancer Screening and Perceived Information Needs

    ERIC Educational Resources Information Center

    Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark

    2005-01-01

    Purpose: To identify women's sources of information about cervical cancer screening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression…

  3. Neck Pain (Cervical Strain) COMMON CAUSES

    E-print Network

    Virginia Tech

    , such a sport injury or motor vehicle accident. More common and less dramatic causes include reaching or pulling trauma to head occurred or headache is severe. This side effect will resolve in time. Most injuriesNeck Pain (Cervical Strain) COMMON CAUSES: Neck pain may be triggered by a specific event

  4. X-Ray Exam: Cervical Spine

    MedlinePLUS

    ... or hand. It can detect fractures in the cervical vertebrae or dislocation of the joints between the vertebrae. It's commonly done after someone has been in an automobile or other accident and has had an injury to the head, neck, or back, especially if ...

  5. Cervical spine response in frontal crash

    Microsoft Academic Search

    Matthew B. Panzer; Jason B. Fice; Duane S. Cronin

    2011-01-01

    Predicting neck response and injury resulting from motor vehicle accidents is essential to improving occupant protection. A detailed human cervical spine finite element model has been developed, with material properties and geometry determined a priori of any validation, for the evaluation of global kinematics and tissue-level response. Model validation was based on flexion\\/extension response at the segment level, tension response

  6. HPV - a vaccine against cervical cancer

    Microsoft Academic Search

    N. Desmond; H. Petousis-Harris; N. Turner

    2006-01-01

    Most cervical cancer is caused by Human papillomavirus (HPV). Protection against the major cancer-causing serotypes of this virus by vaccination is now a reality for New Zealand women. Internationally two manufacturers have candidate HPV vaccines: the bivalent Cervarix (GlaxoSmith Kline) and the tetravalent Gardasil (CSL and Merck & Co). This article focuses on Gardasil, as this vaccine is now available

  7. Remote microscope control for cervical cancer telediagnostic

    Microsoft Academic Search

    A. Parra; J. Puentes; A. Herrera

    2003-01-01

    Despite the improvements to conveniently exchange digital cytological images and patient data forms, which facilitate and accelerate cervical cancer telediagnostic, some of the diagnosed cases require the expert cytologist to remotely acquire images of the slide being examined by a less experienced technician. This paper presents an interactive remote microscope control that permits to distantly be in command of the

  8. Cortical and cervical stimulation after hemispheric infarction

    Microsoft Academic Search

    A Berardelli; M Inghilleri; M Manfredi; A Zamponi; V Cecconi; G Dolce

    1987-01-01

    Cortical and cervical stimulation has been performed in 20 patients with hemiparesis or hemiplegia due to hemispheric infarction and in 20 control subjects. The motor action potentials (MAPs) were recorded from biceps and thenar muscles. MAPs evoked by stimulation of the undamaged hemisphere were normal in 18 out of 20 patients and in two there was a slight increase of

  9. Clinical Reversible Myelopathy in T-Cell Lymphoblastic Lymphoma Treated with Nelarabine and Radiotherapy: Report of a Case and Review of Literature of an Increasing Complication

    PubMed Central

    Tisi, Maria Chiara; Ausoni, Giuseppe; Vita, Maria Gabriella; Tartaglione, Tommaso; Balducci, Mario; Laurenti, Luca; Chiusolo, Patrizia; Hohaus, Stefan; Sica, Simona

    2015-01-01

    Eleven cases of neurological defects in T-ALL patients treated with nelarabine have been described in the last 4 years, seven of these after stem cell transplantation (SCT) for T Lymphoblastic Lymphoma (T-LBL). Most of these patients had an unfavorable outcome or irreversible neurological damage. We now report the case of a 41-year-old woman suffering from T-LBL who presented with severe, but reversible myelopathy after receiving nelarabine-based treatment and mediastinal radiotherapy, and we provide a review of the literature on the topic. PMID:25745552

  10. Evaluating societal preferences for human papillomavirus vaccine and cervical smear test screening programme

    Microsoft Academic Search

    Bridgette Oteng; Fawziah Marra; Larry D Lynd; Gina Ogilvie; David Patrick; Carlo A Marra

    2010-01-01

    BackgroundCervical cancer and genital warts are diseases associated with human papillomavirus (HPV) infection. Cervical smear testing is used as a cervical cancer screening tool in most countries worldwide. The newly introduced vaccines that prevent HPV infections are the quadrivalent vaccine (Gardasil), which prevents genital warts and cervical cancer, and the bivalent vaccine (Cervarix), which prevents cervical cancer only. Public preferences

  11. CSF CXCL10, CXCL9, and Neopterin as Candidate Prognostic Biomarkers for HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

    PubMed Central

    Sato, Tomoo; Coler-Reilly, Ariella; Utsunomiya, Atae; Araya, Natsumi; Yagishita, Naoko; Ando, Hitoshi; Yamauchi, Junji; Inoue, Eisuke; Ueno, Takahiko; Hasegawa, Yasuhiro; Nishioka, Kusuki; Nakajima, Toshihiro; Jacobson, Steven; Izumo, Shuji; Yamano, Yoshihisa

    2013-01-01

    Background Human T-lymphotropic virus type 1 (HTLV-1) -associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a rare chronic neuroinflammatory disease. Since the disease course of HAM/TSP varies among patients, there is a dire need for biomarkers capable of predicting the rate of disease progression. However, there have been no studies to date that have compared the prognostic values of multiple potential biomarkers for HAM/TSP. Methodology/Principal Findings Peripheral blood and cerebrospinal fluid (CSF) samples from HAM/TSP patients and HTLV-1-infected control subjects were obtained and tested retrospectively for several potential biomarkers, including chemokines and other cytokines, and nine optimal candidates were selected based on receiver operating characteristic (ROC) analysis. Next, we evaluated the relationship between these candidates and the rate of disease progression in HAM/TSP patients, beginning with a first cohort of 30 patients (Training Set) and proceeding to a second cohort of 23 patients (Test Set). We defined “deteriorating HAM/TSP” as distinctly worsening function (?3 grades on Osame's Motor Disability Score (OMDS)) over four years and “stable HAM/TSP” as unchanged or only slightly worsened function (1 grade on OMDS) over four years, and we compared the levels of the candidate biomarkers in patients divided into these two groups. The CSF levels of chemokine (C-X-C motif) ligand 10 (CXCL10), CXCL9, and neopterin were well-correlated with disease progression, better even than HTLV-1 proviral load in PBMCs. Importantly, these results were validated using the Test Set. Conclusions/Significance As the CSF levels of CXCL10, CXCL9, and neopterin were the most strongly correlated with rate of disease progression, they represent the most viable candidates for HAM/TSP prognostic biomarkers. The identification of effective prognostic biomarkers could lead to earlier detection of high-risk patients, more patient-specific treatment options, and more productive clinical trials. PMID:24130912

  12. The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea.

    PubMed

    Oh, H Y; Kim, B-S; Seo, S-S; Kong, J-S; Lee, J-K; Park, S-Y; Hong, K-M; Kim, H-K; Kim, M K

    2015-07-01

    Recent studies have suggested potential roles of the microbiome in cervicovaginal diseases. However, there has been no report on the cervical microbiome in cervical intraepithelial neoplasia (CIN). We aimed to identify the cervical microbiota of Korean women and assess the association between the cervical microbiota and CIN, and to determine the combined effect of the microbiota and human papillomavirus (HPV) on the risk of CIN. The cervical microbiota of 70 women with CIN and 50 control women was analysed using pyrosequencing based on the 16S rRNA gene. The associations between specific microbial patterns or abundance of specific microbiota and CIN risk were assessed using multivariate logistic regression, and the relative excess risk due to interaction (RERI) and the synergy index (S) were calculated. The phyla Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, Tenericutes, Fusobacteria and TM7 were predominant in the microbiota and four distinct community types were observed in all women. A high score of the pattern characterized by predominance of Atopobium vaginae, Gardnerella vaginalis and Lactobacillus iners with a minority of Lactobacillus crispatus had a higher CIN risk (OR 5.80, 95% CI 1.73?19.4) and abundance of A. vaginae had a higher CIN risk (OR 6.63, 95% CI 1.61?27.2). The synergistic effect of a high score of this microbial pattern and oncogenic HPV was observed (OR 34.1, 95% CI 4.95?284.5; RERI/S, 15.9/1.93). A predominance of A. vaginae, G. vaginalis and L. iners with a concomitant paucity of L. crispatus in the cervical microbiota was associated with CIN risk, suggesting that bacterial dysbiosis and its combination with oncogenic HPV may be a risk factor for cervical neoplasia. PMID:25752224

  13. Congestive Myelopathy due to Intradural Spinal AVM Supplied by Artery of Adamkiewicz: Case Report with Brief Literature Review and Analysis of the Foix-Alajouanine Syndrome Definition

    PubMed Central

    Sood, Dinesh; Mistry, Kewal A.; Khatri, Garvit D.; Chadha, Veenal; Garg, Swati; Suthar, Pokhraj P.; Patel, Dhruv G.; Patel, Ankitkumar

    2015-01-01

    Summary Background Spinal arteriovenous malformations (AVMs) can lead to development of congestive myelopathy (Foix-Alajouanine syndrome). Spinal AVMs are rare and so is this syndrome. Diagnosis is often missed due to its rarity and confusing definitions of the Foix-Alajouanine syndrome. Case Report We report a case of a 47-year-old male patient suffering from this rare syndrome with an AVM arising from the artery of Adamkiewicz, which is another rarity. Our patient was treated by embolization of the lesion with 20% glue, after which he showed mild improvement of symptoms. We also present a brief review of literature on spinal AVMs and elucidate the evolution of the term Foix-Alajouanine syndrome. Conclusions Use of the term “Foix-Alajouanine syndrome” should be restricted to patients with progressive subacute to chronic neurological symptoms due to congestive myelopathy caused by intradural spinal AVMs. CT angiography should supplement DSA as preliminary Imaging modality. Patients may be treated with surgery or endovascular procedures. PMID:26171088

  14. Increased seroreactivity to human T cell lymphoma/leukemia virus-related endogenous sequence-1 Gag peptides in patients with human T cell lymphoma/leukemia virus myelopathy.

    PubMed

    Perzova, Raisa; Graziano, Elliot; Sanghi, Swathi; Welch, Caitlin; Benz, Patricia; Abbott, Lynn; Lalone, Danielle; Glaser, Jordan; Loughran, Thomas; Sheremata, William; Poiesz, Bernard J

    2015-02-01

    Previously, we had shown that although only 8% of patients with large granular lymphocytic leukemia (LGLL) were infected with human T cell lymphoma/leukemia virus (HTLV)-2, almost half had antibodies to HTLV Gag and Env peptides. Herein, we investigated whether this could be due to cross-reactive antibodies to two homologous peptides in the Gag protein of the endogenous retrovirus HTLV-related endogenous sequence-1 (HRES-1). In addition, we had previously shown that patients with HTLV neurodegenerative diseases had increased seroreactivity to homologous HERV-K10 endogenous retrovirus peptides. Hence, in this study we also examined whether these patients had increased seroreactivity to the aforementioned HRES-1 Gag peptides. Sera from 100 volunteer blood donors (VBD), 53 patients with LGLL, 74 subjects with HTLV-1 or 2 infection (58 nonmyelopathy and 16 myelopathy), and 83 patients with multiple sclerosis (MS) were evaluated. The HTLV-positive myelopathy (HAM) patients had a statistically increased prevalence of antibodies to both HRES-1 Gag peptides (81%) vs. the VBD (0%), LGLL patients (13%), and MS patients (1%), and the HTLV-positive nonmyelopathy subjects (21%). The data suggest that cross-reactivity to HRES-1 peptides could be involved in the pathogenesis of HAM. The difference between the VBD and LGLL patients was also statistically significant, also suggesting a possible association in a minority of patients. PMID:25295378

  15. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes...

  16. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes recommendations...Task Force guidelines for breast and cervical cancer screening; Impact of...

  17. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes recommendations...Reform and its impact for breast and cervical cancer screening; updates on...

  18. 78 FR 36306 - Proposed Information Collection (Neck (Cervical Spine) Conditions Disability Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ...Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...a claimant's diagnosis of a cervical spine condition. DATES: Written comments and...Control No. 2900--NEW (Neck (Cervical Spine) Conditions Disability Benefits...

  19. Human papillomavirus prevalence in paired urine and cervical samples in women invited for cervical cancer screening.

    PubMed

    Burroni, Elena; Bonanni, Paolo; Sani, Cristina; Lastrucci, Vieri; Carozzi, Francesca; Iossa, Anna; Andersson, Karin Louise; Brandigi, Livia; Di Pierro, Carmelina; Confortini, Massimo; Levi, Miriam; Boccalini, Sara; Indiani, Laura; Sala, Antonino; Tanini, Tommaso; Bechini, Angela; Azzari, Chiara

    2015-03-01

    With the introduction of Human papillomavirus (HPV) vaccination in young girls in 2007, it is important to monitor HPV infections and epidemiological changes in this target population. The present study has evaluated the detection of human papillomavirus DNA in paired cervical and urine samples to understand if HPV testing in urine could be used as non-invasive method to monitor HPV status in young women. The study enrolled 216 twenty five-year-old women, resident in Florence and invited for the first time to the cervical cancer Screening Program within a project evaluating the impact of HPV vaccination. HPV genotyping was performed on 216 paired urine and cervical samples. The overall concordance between cervix and urine samples, investigated by HPV genotyping (INNO-LiPA HPV Genotyping Extra), was: 85.6% (184/215), 84.6% (182/215), 80% (172/215) when the same HPV, at least the same HR HPV and all HR HPV, respectively, were detected. HPV type specific concordance in paired urine and cervical samples was observed in 85.8% (175/204) of women with normal cytology and in seven out of nine women with abnormal cytology. Urine seems to be a suitable and reliable biological material for HPV DNA detection as evidenced by the high concordance with HPV detected in cervical samples. These results suggest that urine could be a good noninvasive tool to monitor HPV infection in vaccinated women. PMID:25418873

  20. Genomic aberrations in cervical adenocarcinomas in Hong Kong Chinese women.

    PubMed

    Chung, Tony K H; Van Hummelen, Paul; Chan, Paul K S; Cheung, Tak Hong; Yim, So Fan; Yu, Mei Y; Ducar, Matthew D; Thorner, Aaron R; MacConaill, Laura E; Doran, Graeme; Pedamallu, Chandra Sekhar; Ojesina, Akinyemi I; Wong, Raymond R Y; Wang, Vivian W; Freeman, Samuel S; Lau, Tat San; Kwong, Joseph; Chan, Loucia K Y; Fromer, Menachem; May, Taymaa; Worley, Michael J; Esselen, Katharine M; Elias, Kevin M; Lawrence, Michael; Getz, Gad; Smith, David I; Crum, Christopher P; Meyerson, Matthew; Berkowitz, Ross S; Wong, Yick Fu

    2015-08-15

    Although the rates of cervical squamous cell carcinoma have been declining, the rates of cervical adenocarcinoma are increasing in some countries. Outcomes for advanced cervical adenocarcinoma remain poor. Precision mapping of genetic alterations in cervical adenocarcinoma may enable better selection of therapies and deliver improved outcomes when combined with new sequencing diagnostics. We present whole-exome sequencing results from 15 cervical adenocarcinomas and paired normal samples from Hong Kong Chinese women. These data revealed a heterogeneous mutation spectrum and identified several frequently altered genes including FAT1, ARID1A, ERBB2 and PIK3CA. Exome sequencing identified human papillomavirus (HPV) sequences in 13 tumors in which the HPV genome might have integrated into and hence disrupted the functions of certain exons, raising the possibility that HPV integration can alter pathways other than p53 and pRb. Together, these provisionary data suggest the potential for individualized therapies for cervical adenocarcinoma based on genomic information. PMID:25626421

  1. Ewe breed differences in fertility after cervical AI with frozen–thawed semen and associated differences in sperm penetration and physicochemical properties of cervical mucus

    Microsoft Academic Search

    Lorraine Richardson; J. P. Hanrahan; Lydia O’Hara; Anne Donovan; Sean Fair; Michael O'Sullivan; Stephen D. Carrington; Pat Lonergan; A. C. O. Evans

    The objective of this study was to examine sperm penetration through cervical mucus and associated physicochemical properties of cervical mucus from Belclare and Suffolk ewes – two breeds with divergent pregnancy rate following cervical AI using frozen–thawed semen. In Experiment 1, sperm penetration through cervical mucus was assessed in 15 Belclare and 15 Suffolk ewes at 30, 48 and 57h

  2. Flexion-extension cervical spine radiography in pediatric blunt trauma

    Microsoft Academic Search

    William A. Woods; William J. Brady; Gary Pollock; Narendra Kini; Jeffrey S. Young

    1998-01-01

    Ligamentous cervical injury may not be apparent when viewed with static cervical spine radiography (CSR). Dynamic (flexion-extension)\\u000a views of the cervical spine may aid in the identification of such injury. A retrospective descriptive study was carried out\\u000a between July 1, 1990, and June 30, 1994, in an academic emergency department averaging 60,000 patient visits (of which 20%\\u000a are pediatric) per

  3. Placental-type alkaline phosphatase in cervical neoplasia

    Microsoft Academic Search

    PJ McLaughlin; PH Warne; GE Hutchinson; PM Johnson; DF Tucker

    1987-01-01

    Monoclonal antibodies reactive with placental-type alkaline phosphatase have formed the basis of methods for detection of this oncodevelopmental antigen in patients with pre-invasive and invasive cervical neoplasia, with or without evidence of papilloma virus infection. Disease-related elevations of placental-type alkaline phosphatase were not observed in patients' sera. Solubilised cervical smears or biopsy material, and cervical mucus swabs, often contained substantial

  4. Cervical stump cancer: a study of 14 cases

    Microsoft Academic Search

    Cléber S. Silva; Cristina O. Cardoso; Renato A. Menegaz; Sheila J. Adad; Luís F. R. Angotti; Eddie F. C. Murta

    2004-01-01

    Case report.  This is a report on 14 patients with cervical stump cancer, aged 30 to 68 years old (median = 53 years), seen in a public\\u000a university hospital. Over a 15-year period, 363 cases of cervical cancer were treated, of which fourteen (3.85%) were in the\\u000a cervical stump. The time interval between subtotal hysterectomy and the diagnosis of the neoplasm varied from

  5. Cervical muscle area measurements in acute whiplash patients and controls

    Microsoft Academic Search

    Erika J Ulbrich; Suzanne E Anderson; Andre Busato; Susanne Abderhalden; Chris Boesch; Heinz Zimmermann; Paul Heini; Juerg Hodler; Matthias Sturzenegger

    2011-01-01

    Purpose: To quantitatively compare the muscle cross-sectional areas (CSAs) of the cervical muscles in symptomatic acute whiplash patients versus healthy controls. We hypothesized, that symptomatic whiplash patients have smaller cervical muscle CSAs than matched controls and that smaller cervical muscle CSAs in women might explain that women more frequently are symptomatic after whiplash injury than men.\\u000aMaterials and Methods: Prospective

  6. Appropriate use of cervical cancer vaccine.

    PubMed

    Zimet, Gregory D; Shew, Marcia L; Kahn, Jessica A

    2008-01-01

    Human papillomavirus (HPV) is a necessary, though not sufficient, cause of cervical cancer. Two vaccines have been developed that prevent two HPV types associated with 70% of cervical cancers. One of the vaccines (a quadrivalent vaccine) also prevents two HPV types associated with 90% of genital warts. Both HPV vaccines have shown very good efficacy and safety. This review summarizes the guidelines for use of the quadrivalent vaccine published by the Advisory Committee on Immunization Practices, presents data on vaccine efficacy and safety, and gives an overview of the findings of cost-effectiveness studies. In addition, we summarize the research on the attitudes of parents and health care providers toward HPV vaccine and critically evaluate controversial and challenging issues surrounding HPV vaccination, including concerns about sexual disinhibition and potential obstacles to vaccine distribution and uptake. PMID:18186704

  7. Cervical Intervertebral Disc Protrusion in Two Horses

    PubMed Central

    Foss, R. R.; Genetzky, R. M.; Riedesel, E. A.; Graham, C.

    1983-01-01

    Two horses with ataxia of all four limbs were found to have cervical intervertebral disc protrusion. Severe pelvic limb ataxia, proprioceptive deficits and spasticity were present in both horses with similar but less severe signs in the thoracic limbs. Cerebrospinal fluid analysis was within normal limits. Metrizamide myelography allowed definitive diagnosis in one case when a compression of the spinal cord was demonstrated at the level of the second intervertebral space. In the second case, an intervertebral disc protrusion between cervical vertebrae 6 and 7 was found at necropsy. Fiber degeneration with poor myelin staining characterized the spinal cords histologically. ImagesFigure 1.Figure 2a.Figure 2b.Figure 3. PMID:17422269

  8. Horner's Syndrome after Superficial Cervical Plexus Block.

    PubMed

    Flores, Stefan; Riguzzi, Christine; Herring, Andrew A; Nagdev, Arun

    2015-05-01

    Ultrasound-guided nerve blocks are becoming more essential for the management of acute pain in the emergency department (ED). With increased block frequency comes unexpected complications that require prompt recognition and treatment. The superficial cervical plexus block (SCPB) has been recently described as a method for ED management of clavicle fracture pain. Horner's syndrome (HS) is a rare and self-limiting complication of regional anesthesia in neck region such as brachial and cervical plexus blocks. Herein we describe the first reported case of a HS after an ultrasound-guided SCPB performed in the ED and discuss the complex anatomy of the neck that contributes to the occurrence of this complication. PMID:25987922

  9. The role of trachelectomy in cervical cancer

    PubMed Central

    Halaska, MJ; Robova, H; Pluta, M; Rob, L

    2015-01-01

    Cervical cancer is one of the most common cancers in women worldwide. Because it often affects women of childbearing age (19–45 years), fertility-sparing surgery is an important issue. The article reviews current viable fertility-sparing options with a special focus on trachelectomy, including vaginal radical trachelectomy, abdominal radical trachelectomy and simple trachelectomy. Neoadjuvant chemotherapy is also discussed. Finally, the decision to proceed with fertility-sparing treatment should be a patient-driven process. PMID:25729419

  10. Cervical cancer prevention: immunization and screening 2015.

    PubMed

    Thaxton, Lauren; Waxman, Alan G

    2015-05-01

    Both primary and secondary prevention of cervical cancer are now available. Immunizations against human papillomavirus (HPV) types 16 and 18 have the potential to prevent 70% of cancers of the cervix plus a large percentage of other lower anogenital tract cancers. Screening guidelines were recently changed to recommend cotesting with cytology plus an HPV test. The addition of HPV testing increases the sensitivity and negative predictive value of screening over the Papanicolaou (Pap) test alone. PMID:25841595

  11. Ectopic gastric mucosa in the cervical esophagus

    Microsoft Academic Search

    Edwin Ishoo; Nicolas Y. Busaba

    2002-01-01

    This study describes the clinical presentation and management of ectopic gastric mucosa (EGM) in the cervical esophagus. This is a case report of a 53-year-old male who presented with left-sided odynophagia of 3 months' duration. Office examination, including flexible fiberoptic laryngoscopy, was unremarkable. Direct larynogoscopy and rigid esophagoscopy revealed a 2 × 1-cm fleshy, red, and raised lesion in the

  12. Innovations in Cervical and Endometrial Cancer

    PubMed Central

    Mallmann, P.; Beckmann, M. W.; Emons, G.

    2013-01-01

    The S2k guideline “Diagnostics and Therapy for Cervical Cancer” published in 2008 is currently being revised to the S3 level. Current developments in epidemiology, surgical therapy, radiochemotherapy and drug therapy will be presented. The S2k guideline “Diagnostics and Therapy for Endometrial Cancer” will also be up-dated this year. The revised recommendations on early diagnosis and diagnostics, therapy for precursors, surgical therapy, adjuvant therapy and therapy for recurrences and metastases will be presented. PMID:24771941

  13. Pediatric cervical spine injuries: a comprehensive review

    Microsoft Academic Search

    Martin Mortazavi; Pankaj A. Gore; Steve Chang; R. Shane Tubbs; Nicholas Theodore

    2011-01-01

    Introduction  Cervical spine injuries can be life-altering issues in the pediatric population. The aim of the present paper was to review\\u000a this literature.\\u000a \\u000a \\u000a \\u000a \\u000a Conclusions  A comprehensive knowledge of the special anatomy and biomechanics of the spine of children is essential in diagnosis and treating\\u000a issues related to spine injuries.

  14. [Papillomavirus and cervical cancer in Chile].

    PubMed

    O'Ryan, Miguel; Valenzuela, María Teresa

    2008-11-01

    Molecular, clinical and epidemiological studies have established beyond doubt that human papiloma viruses (HPV) cause cervical cancer. The virus is also associated with genital warts and other less common cancers in oropharynx, vulva, vagina and penis. Worldwide, VPH genotypes 16 and 18 are the most common high risk genotypes, detected in near 70% of women with cervical cancer. The discovery of a cause-effect relationship between several carcinogenic microorganisms and cancer open avenues for new diagnostic, treatment and prevention strategies. In this issue of Revista Médica de Chile, two papers on HPV are presented. Guzman and colleagues demonstrate that HPV can be detected in 66% to 77% of healthy male adolescents bypolymerase chain reaction and that positivity depends on the site of the penis that is sampled. These results support the role of male to female transmission of high risk HPVs in Chile and should lead to even more active educational campaigns. The second paper provides recommendations for HPV vaccine use in Chile, generated by the Immunization Advisory Committee of the Chilean Infectious Disease Society. To issue these recommendations, the Committee analyzes the epidemiological information available on HPV infection and cervical cancer in Chile, vaccine safety and effectiveness data, and describes cost-effectiveness studies. Taking into account that universal vaccination is controversial, the Committee favors vaccine use in Chile and it's incorporation into a national program. However, there is an indication that the country requires the implementation of an integrated surveillance approach including cross matching of data obtained from HPV genotype surveillance, monitoring of vaccination coverage, and surveillance of cervical cancer. The final decision of universal vaccine use in Chile should be based on a through analysis of information.ev Mid Chile PMID:19301766

  15. Safety and Efficacy of Bioabsorbable Cervical Spacers and Low-Dose rhBMP-2 in Multi-Level ACDF

    PubMed Central

    Khajavi, Kaveh; Shen, Alessandria

    2014-01-01

    Introduction Many options for interbody spacer and graft biologic exist for multilevel anterior cervical discectomy and fusion (ACDF). The objective of this study is to evaluate the safety and efficacy of a bioabsorbable cervical spacer (BCS) (Cornerstone HSR, Medtronic Sofamor Danek) filled with low-dose rhBMP-2 (INFUSE, Medtronic Sofamor Danek) in multilevel ACDF. Methods 72 consecutive patients treated with a multi-level ACDF using BCS and rhBMP-2 (dosage between 0.5 to 0.7 mg per level) at a single institution were followed in an IRB-approved, prospective registry. A total of 187 levels were treated (mean = 2.6), with 37 (51%) patients undergoing a 2-level procedure and 35 (49%) undergoing a 3- or 4-level procedure. Statistical analysis included frequency and ANOVA tests. Significance was accepted for p < 0.001. Results Average follow-up was 13.8 months. Mean patient age was 55.3 years, 70.8% were female, and 16.7% had undergone a previous cervical procedure. 29 (40%) patients had cervical spondylitic myelopathy, 27 (38%) had radiculopathy, 15 (21%) had a combination of both, and 1 (1%) patient had a previous nonunion. A total of 187 levels were treated with an ACDF, with 37 (51%) 2-level, 27 (38%) 3-level, and 8 (11%) 4-level cases. Average OR time, EBL, and LOS were 144 minutes, 49 mL, and 1.1 days, respectively. Major complications occurred in 5 (7%) patients: 2 returns to OR (1 nonunion, 1 seroma), 1 recurrent laryngeal nerve injury, and 2 hospital readmissions for excessive pre-vertebral swelling/dysphagia treated with steroids and observation. Minor complications occurred in 3 (4%) patients: 2 exacerbations of pre-existing medical conditions (1 atrial fibrillation, 1 COPD), and 1 hospital readmission for nausea/ headache due to narcotics. At last follow-up, NDI improved 43% from 43.6% to 25.0%. VAS neck pain improved 60% from 5.5 to 2.2 and VAS arm pain improved 52% from 5.8 to 2.6. SF-36 PCS improved 24% from 37.5 to 46.3 and MCS improved 18% from 43.2 to 50.9. All clinical improvements were statistically significant (p < 0.001). Patient satisfaction was high, with 97% of patients reported being satisfied with their surgical outcome, and 90% would undergo the procedure again. Conclusion Patients in this series experienced significant clinical improvements, low complication rates, and high patient satisfaction. Symptomatic pseudoarthrosis was rare. BCS filled with low-dose rhBMP-2 appears to be a safe and effective option in multilevel ACDF. Further investigation is warranted. PMID:25694938

  16. Disturbances of dynamic balance in phasic cervical dystonia

    PubMed Central

    Muller, J; Ebersbach, G; Wissel, J; Brenneis, C; Badry, L; Poewe, W

    1999-01-01

    OBJECTIVE—To quantitatively assess control of balance under static and dynamic conditions in patients with tonic and phasic cervical dystonia.?METHODS—Ten patients with purely tonic cervical dystonia with fixed postural deviation and 20 patients with cervical dystonia with phasic head movements were investigated at least 3 months after botulinum toxin injections. Seventeen age matched volunteers served as controls. Static posturography was performed on a force platform; dynamic equilibrium was studied on a stabilometer, which requires the subject to continuously adapt upright posture to an unstable tilting surface. Measurements of maximum amplitude and linear displacement of the pivot were taken with open and closed eyes.?RESULTS—Sway path values in static posturography were not significantly different between patients with cervical dystonia and controls. On dynamic posturography, patients with phasic cervical dystonia showed significantly higher platform measures (maximum amplitude and linear displacement of the pivot) with eyes open and closed By contrast, none of the dynamic platform measures differed significantly between patients with tonic cervical dystonia and controls.?CONCLUSIONS—Normal measures of dynamic equilibrium in tonic cervical dystonia argue against a primary abnormality of balance control in cervical dystonia. Impaired dynamic equilibrium in phasic cervical dystonia is likely to reflect a disruption of vestibular input due to repetitive, involuntary head oscillations.?? PMID:10567505

  17. Cervical mucus: from biochemical structure to clinical implications.

    PubMed

    Curlin, Marija; Bursac, Danijel

    2013-01-01

    Structure of human cervical mucus plays a pivotal role in female fertility and protection of reproductive health. Investigation of biochemical and biophysical structure of cervical mucus remains a challenge due to complex structural proteins, high content of oligosaccharides and cyclic variability of its structure. We present the current knowledge on chemical and biophysical features of cervical mucus and regulation of its secretion, relevant clinical observations and underexplored elements. The latter relates to biochemical background of physical properties and antimicrobial activity of cervical mucus, and regulation of its production. PMID:23277065

  18. Update knowledge on cervical cancer incidence and prevalence in Asia.

    PubMed

    Daniyal, Muhammad; Akhtar, Naheed; Ahmad, Saeed; Fatima, Urooj; Akram, Muhammad; Asif, Hafiz Muhammad

    2015-01-01

    Cervical cancer is the second most common cause of cancer-related death among women worldwide, with over 500,000 new cases diagnosed annually and 50% mortality rate in Asia. In the United States, approximately 10,370 new cases of cervical cancer are diagnosed annually, and estimated 3,710 deaths occur from the disease, making it the sixth most common cause of malignancy among American women. This study aims to provide awareness about cervical cancer as well as an updated knowledge about the prevalence and incidence of cervical cancer in Asia. PMID:25987011

  19. Human Papillomavirus Testing in the Prevention of Cervical Cancer

    PubMed Central

    Wentzensen, Nicolas; Wacholder, Sholom; Kinney, Walter; Gage, Julia C.; Castle, Philip E.

    2011-01-01

    Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening methods. New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test results predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment. PMID:21282563

  20. Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

    PubMed Central

    Kim, Seok-Hee; Jung, Da-Jung; Choi, Yoo-Min; Kim, Jong-Uk; Yook, Tae-Han

    2014-01-01

    Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were ‘pain on cervical spine’, ‘cervical pain’, ‘ruptured cervical disk’, ‘cervical disc disorder’, ‘stiffness of the neck’, ‘cervical disk’, ‘whiplash injury’, ‘cervicalgia’, ‘posterior cervical pain’, ‘neck disability’, ‘Herniated Nucleus Pulposus (HNP)’, and ‘Herniated Intervertebral Disc (HIVD)’. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient’s condition. PMID:25780714

  1. Gankyrin Is Frequently Overexpressed in Cervical High Grade Disease and Is Associated with Cervical Carcinogenesis and Metastasis

    PubMed Central

    Qian, Wenyan; Dong, Yu; Yang, Yongbin; Liu, Zhiqiang; Feng, Youji; Ma, Ding; Zhang, Zhenbo; Wu, Sufang

    2014-01-01

    Our previous studies have showed that Gankyrin expression is correlated with a malignant phenotype in endometrial carcinoma. Here, we investigated the possible role of Gankyrin in cervical disease. The increasing protein level of Gankyrin was observed in high-grade cervical intraepithelial neoplasia and carcinoma compared with benign cervical tissues and low-grade cervical intraepithelial neoplasia. In para-carcinoma tissues, it was found interestingly that there was no lymph node metastasis when nuclei Gankyrin was positively expressed, but lymph node metastasis rate was 30% (6/20) when nuclei Gankyrin was negatively expressed. In vitro, the transfection of Gankyrin resulted in markedly up-regulating of Vimentin, ?-catenin and Twist2, as well as down-regulating of E-cadherin in cervical carcinoma cells. Our results suggested that Gankyrin may be functional in cervical carcinogenesis and metastasis. PMID:24751719

  2. Sperm penetration into cervical mucus in vitro. III. Effect of freezing on estrous bovine cervical mucus

    SciTech Connect

    Lee, W.I.; Gaddum-Rosse, P.; Blandau, R.J.

    1981-08-01

    The influence of the storages period on estrous bovine cervical mucus after it was stored in the freezing compartment of the laboratory refrigerator was evaluated by an in vitro sperm penetration test with human spermatozoa, laser light-scattering, and a spinnbarkeit test. Data obtained from the sperm penetration test were analyzed by a mathematical model that correlates the sperm motility with the sperm transport rate and the penetrability of the mucus. The tests showed that estrous bovine cervical mucus can be stored for up to 4 weeks at -12 degrees C without a change in its physical properties. The results of this study strengthen the suggestion that bovine mucus could be employed as a substitute for human cervical mucus.

  3. Barriers to Cervical Cancer Screening Among Lesbians

    PubMed Central

    Lydecker, Alison D.; Ireland, Lynda

    2010-01-01

    Abstract Objective To evaluate cervical cancer screening practices and barriers to screening in a sample of lesbians. Methods Cross-sectional survey data were collected from 225 self-identified lesbians who completed an online questionnaire. Results Of the respondents, 71% reported receiving a Pap screening test in the past 24 months (routine screeners), and 29% reported receiving a Pap screening test >24 months ago or never (nonroutine screeners). Routine screeners were more likely to be older (p?cervical cancer. Conclusions Many lesbians do not screen for cervical cancer at recommended rates. Nonroutine screeners perceive fewer benefits, more barriers, and more discrimination and are less knowledgeable about screening guidelines than routine screeners. PMID:20095905

  4. HPV infection and cervical disease: a review.

    PubMed

    Carter, Jonathan R; Ding, Zongqun; Rose, Barbara R

    2011-04-01

    Cervical cancer remains a significant problem worldwide particularly in underdeveloped countries. The disease and its financial impact are significant. Infection with the human papilloma virus (HPV) is necessary for the development of cervical cancer and its precursors. HPV also causes precancer and cancer elsewhere in the lower genital tract in women and men, as well as cancers of the aerodigestive tract. Whilst non-sexual transmission has been reported, the usual method of transmission is by sexual intercourse with the virus deposited on the basement membrane of the cervical epithelium. It is then taken up by the basal cells, and viral amplification occurs with the maturation of the squamous epithelium. During this process, it remains hidden from the host immune system, thus not mounting an immune response in many instances. About half of the women infected with HPV do not develop clinically detected serum antibody levels and are thus at risk of re-infection with the same HPV type. HPV vaccination produces sustained levels of serum-neutralising antibodies and has been shown to be effective in reducing disease caused by the vaccine-associated HPV types. Vaccination is considered well tolerated and safe with syncope and venous thromboembolism reported more frequently that would be expected. Vaccination will not protect against pre-existing HPV infection and hence may not provide complete protection in all women, and as the duration of protection is not known, for the time being routine Pap testing screening according to the Australian guidelines should continue. PMID:21466509

  5. Cervical cancer screening among vulnerable women

    PubMed Central

    Wiedmeyer, Mei-ling; Lofters, Aisha; Rashid, Meb

    2012-01-01

    Abstract Objective To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened. Design Chart review. Setting A CHC in downtown Toronto. Participants A total of 357 eligible refugee women attending the CHC. Main outcome measures Papanicolaou test received or documented reason for no Pap test. Results Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration. Conclusion The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population. PMID:22972744

  6. The cervical cap: past and current experience.

    PubMed

    Fairbanks, B; Scharfman, B

    1980-01-01

    In the past several years, a new trend has emerged where women in increasingly growing numbers are becoming hesitant to accept the risks associated with hormonal and invasive methods of birth control. It is as part of this trend that a revival of sorts is occurring with the cervical cap, a form of birth control with roots which precede recorded history and which, in its modern form, was widely advocated in late 19th and early 20th century Europe. Based on the principle of occlusion, the cervical cap appears effective and risk-free, both vital concerns to women of all centuries. Women's health activists and organizations have been in the forefront of this revival. Two of the first organizations to take an active interest in making the cap available were the New Hampshire Feminist Health Center in Concord, New Hampshire, and the Emma Goldman Women's Health Clinic in Iowa City, Iowa. The National Women's Health Network, a national organization based in Washington, D.C., has also been an active advocate on the cervical cap's behalf. PMID:7018094

  7. Functional Analysis of Bladder Cancer-Related Protein Gene: A Putative Cervical Cancer Tumor Suppressor Gene in Cervical Carcinoma

    Microsoft Academic Search

    Zehua Zuo; Min Zhao; Juan Liu; Guifang Gao; Xinxing Wu

    2006-01-01

    Our previous study has suggested thatthe bladder cancer-associated protein gene (BLCAP) was among the differentially expressed genes in cervical cancer. We confirm here that BLCAP is expressed in all noncancerous cervical tissues (10\\/10), but it is greatly lost in primary cervical cancer tissue (31\\/39). In order to further investigate the functional roles of BLCAP, we stably transfected BLCAP cDNA into

  8. Anterior cervical multilevel decompression and fusion using fibular strut as revision surgery for failed cervical laminoplasty

    Microsoft Academic Search

    Shingo Komura; Kei Miyamoto; Hideo Hosoe; Kazunari Fushimi; Chizuo Iwai; Hirofumi Nishimoto; Katsuji Shimizu

    Study design  Retrospective analyses of six cases.\\u000a \\u000a \\u000a \\u000a Objective  To describe six patients with previous failed laminoplasty who were subsequently managed by anterior cervical decompression\\u000a and fusion (ACDF) using fibular strut as revision surgeries.\\u000a \\u000a \\u000a \\u000a \\u000a Summary of background data  While several complications and unsatisfactory results of cervical laminoplasty have been reported, there is no general consensus\\u000a on how to best surgically treat these pathological conditions.

  9. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

    PubMed

    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women. PMID:24685531

  10. [Cervical cancer screening: past--present--future].

    PubMed

    Breitenecker, G

    2009-12-01

    Despite the undisputed and impressive success which has been achieved since the 1960s by cervical cytology in the fight against cervical cancer and its precursor stages, during which the mortality rate in industrialized countries over the last 40 years has been reduced by two-thirds to three-quarters, a perfect and error-free screening procedure is still a long way off and will probably never be reached. There are two main reasons for this, the lack of adequate coverage and suboptimal quality and assessment of smears. Two screening procedures are in use Europe, an opportunistic and an organized system. Both systems have many advantages but also disadvantages. In organized programs the coverage is higher (up to 80%), although similar numbers are also achieved by non-organized programs over a 3-year cycle, even if they cannot be so exactly documented. The decision on which system is used depends on the health system of the country, public or non-public, and many other national circumstances. However, in both systems prerequisites for a satisfactory result is a high quality in the sampling technique, the processing and the assessment. Therefore, several guidelines have been introduced by state and medical societies for internal and external quality assurance. New technologies, such as thin-layer cytology or automation for replacement or support of conventional cytology liquid-based cytology proved not to be superior enough to justify the high costs of these systems. The recognition of the strong causal relationship between persistent infection with high-risk human papillomavirus (HPV) types and cervical cancer and its precursors has resulted in the development of comparably simple tests. Primary screening using HPV typing alone is not recommended in opportunistic screening due to the low specificity but high sensitivity because it leads to many clinically irrelevant results which place women under stress. In organized screening HPV testing is always and only possible in combination with cytology. Various models and approaches are in the testing phase and appear promising. HPV testing is on the other hand well accepted and recommended as a triage test to select women with equivocal smear results (Pap group III, ASCUS) if a biopsy is required or can be followed up and also for follow-up of patients after cone biopsy. However, vaccination of young girls against oncogenic HPV types which has now become widespread still leaves many questions open for the future because the observation period is too short. There is justified hope that this will become a valuable tool in cervical cancer control and may lead to a substantial reduction in the burden of cervical cancer in the future. However, as the current vaccines on the market do not cover all oncogenic virus types and the effects of vaccination will only be observed after many years, the necessity of a cytological screening will remain unrestricted. Therefore, cervical cytology will remain as the trusted, simple to use, economic and proven, like no other method for early cancer detection, efficient procedure even in the foreseeable future. If carried out with the highest quality demands it will play a central role in the early detection of cervical cancer. PMID:19756616

  11. Fludeoxyglucose F 18 PET Scan, CT Scan, and Ferumoxtran-10 MRI Scan Before Chemotherapy and Radiation Therapy in Finding Lymph Node Metastasis in Patients With Locally Advanced Cervical Cancer or High-Risk Endometrial Cancer

    ClinicalTrials.gov

    2014-10-31

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Stage I Endometrial Carcinoma; Stage IB Cervical Cancer; Stage II Endometrial Carcinoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Endometrial Carcinoma; Stage IVA Cervical Cancer

  12. The causal relation between human papillomavirus and cervical cancer

    PubMed Central

    Bosch, F X; Lorincz, A; Muñoz, N; Meijer, C J L M; Shah, K V

    2002-01-01

    The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented. PMID:11919208

  13. A review of californium-252 neutron brachytherapy for cervical cancer

    Microsoft Academic Search

    Yosh Maruyama; John R. van Nagell; Justine Yoneda; Elvis S. Donaldson; Holly H. Gallion; Deborah Powell; Richard J. Kryscio

    1991-01-01

    Since 1976 a clinical trial has been conducted to test the feasibility, the potential, and to develop methods for using the neutron-emitting radioactive isotope, californium-252 (Cf-252), for the treatment of cervical cancer. A total of 218 patients were treated in the initial study period from 1976 until 1983. The trials initially treated advanced cervical cancer patients using different doses and

  14. Cervical cancer screening programmes and policies in 18 European countries

    Microsoft Academic Search

    A Anttila; G Ronco; G Clifford; F Bray; M Hakama; M Arbyn; E Weiderpass

    2004-01-01

    A questionnaire survey was conducted by the Epidemiology Working Group of the European Cervical Cancer Screening Network, and the International Agency for Research on Cancer, IARC, between August and December 2003 in 35 centres in 20 European countries with reliable cervical cancer incidence and\\/or mortality data in databanks held at IARC and WHO. The questionnaire was completed by 28 centres

  15. Clear cell adenocarcinoma of the bladder with intravesical cervical invasion.

    PubMed

    Marchalik, Daniel; Krishnan, Jayashree; Verghese, Mohan; Venkatesan, Krishnan

    2015-01-01

    A 26-year-old woman with a complicated urological and gynecological history with uterine didelphys with bilaterally inserting intravesical cervical oses presented with cyclical haematuria. Work up revealed a mass in the ectopic cervical os and adjacent bladder wall. Subsequent resection confirmed a clear cell adenocarcinoma of urological origin with invasion into neighbouring os. PMID:26109625

  16. THE STRAIGHT CERVICAL SPINE: DOES IT INDICATE MUSCLE SPASM?

    Microsoft Academic Search

    P. S. HELLIWELL; P. F. EVANS; V. WRIGHT

    1994-01-01

    The loss of cervical lordosis in radiographs of patients presenting with neck pain is sometimes ascribed to muscle spasm. We performed a cross-sectional study of the prevalence of 'straight' cervical spines in three populations: 83 patients presenting to an accident department with acute neck pain, 83 referred to a radiology department with chronic neck problems, and 80 radiographs from a

  17. A possible cervical cause of low back pain: pelvic distortion

    Microsoft Academic Search

    Brett M. Carr; Ronald J. Tyszkowski

    2000-01-01

    Objective: to discuss the diagnosis and treatment of pelvic distortion related to cervical spine dysfunction in a patient with low back pain, as well as presenting a theoretical etiology.Clinical features: pelvic distortion is a disorder in which the ilia become counter-rotated on the sacrum. Our clinical experience suggests that it can arise from dysfunction in the cervical spine. It can

  18. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    The progression of human papillomavirus (HPV) infection to cervical neoplasia is likely influenced by the immune response. Toll-like receptors (TLRs) induce secretion of cytokines and activation of T cells that may play an important role in cervical immunity to HPV infection.

  19. Treatment of cervical necrotizing fasciitis with hyperbaric oxygen therapy

    Microsoft Academic Search

    F. P. JOHNS LANGFORD; RICHARD E. MOON; BRYANT W. STOLP; RICHARD L. SCHER

    1995-01-01

    Hyperbaric oxygen therapy has significantly improved the management of necrotizing fasciitis of the extremities and trunk. Its role in cervical necrotizing fasciitis has not been fully evaluated. Historically, necrotizing fasciitis has been associated with considerable morbidity and mortality. This report discusses our experience with cervical necrotizing fasciitis in six patients treated from 1986 to 1993 who received hyperbaric oxygen therapy.

  20. Chronic cervical spinal cord injury and autonomic hyperreflexia in rats

    E-print Network

    Schramm, Lawrence P.

    Chronic cervical spinal cord injury and autonomic hyperreflexia in rats JOHN W. OSBORN, ROBERT F cervical spinal cord injury and autonomic hyperreflexia in rats. Am. J. Physiol. 258(Regulatory Integra spinal cord injury are proneto acute, marked,hypertensive episodes,i.e., autonomic hyperreflexia

  1. Surgical management of cervical and lumbosacral radiculopathies: indications and outcomes

    Microsoft Academic Search

    Phillip B. Storm; Dean Chou; Rafael J. Tamargo

    2002-01-01

    Cervical and lumbosacral radiculopathies are common, but most are transient and rarely require anything more than symptomatic treatment. Although persistent radiculopathies can be caused by serious medical condi- tions, such as demyelinating diseases, cyanocobalamin (vitamin B12) defi- ciency, syphilis, herpes, and others, the subject of this article is limited to cervical and lumbosacral radiculopathies caused by compression, most com- monly

  2. Human Papillomavirus 45 Genetic Variation and Cervical Cancer Risk Worldwide

    PubMed Central

    Chen, Alyce A.; Heideman, Daniëlle A. M.; Boon, Debby; Gheit, Tarik; Snijders, Peter J. F.; Tommasino, Massimo; Franceschi, Silvia

    2014-01-01

    ABSTRACT Human papillomavirus 45 (HPV45) is a member of the HPV18-related alpha-7 species and accounts for approximately 5% of all cervical cancer cases worldwide. This study evaluated the genetic diversity of HPV45 and the association of HPV45 variants with the risk of cervical cancer by sequencing the entire E6 and E7 open reading frames of 300 HPV45-positive cervical samples from 36 countries. A total of 43 HPV45 sequence variants were identified that formed 5 phylogenetic sublineages, A1, A2, A3, B1, and B2, the distribution of which varied by geographical region. Among 192 cases of cervical cancer and 101 controls, the B2 sublineage was significantly overrepresented in cervical cancer, both overall and in Africa and Europe separately. We show that the sequence analysis of E6 and E7 allows the classification of HPV45 variants and that the risk of cervical cancer may differ by HPV45 variant sublineage. IMPORTANCE This work describes the largest study to date of human papillomavirus 45 (HPV45)-positive cervical samples and provides a comprehensive reference for phylogenetic classification for use in epidemiological studies of the carcinogenicity of HPV45 genetic variants, particularly as our findings suggest that the B2 sublineage of HPV45 is associated with a higher risk of cervical cancer. PMID:24501412

  3. Late Sequelae of Whiplash Injury with Dissection of Cervical Arteries

    Microsoft Academic Search

    Vital Hauser; Peter Zangger; Yaroslav Winter; Wolfgang Oertel; Jürg Kesselring

    2010-01-01

    Background\\/Aims: The objective of our study was to estimate the incidence of posttraumatic dissections of cervical arteries in patients with whiplash injury acquired in a car accident. Methods and Patients: We performed a retrospective analysis of medical records of 500 patients with whiplash injury acquired in car accidents between 1996 and 2005 and searched for dissections of cervical arteries occurring

  4. Addressing the myths of cervical spine injury management

    Microsoft Academic Search

    Michael E Ivy; Stephen M Cohn

    1997-01-01

    Every year in the United States about 5,000 people sustain a cervical spinal cord injury. Vastly greater numbers present to hospitals after motor vehicle crashes and falls with potential cervical spine injuries (CSI) for evaluation. This group of patients requires very careful management while undergoing evaluation for potential CSI to minimize the potential for spinal cord injury. It is, therefore,

  5. Genital warts and cervical neoplasia: An epidemiological study

    Microsoft Academic Search

    S Franceschi; R Doll; J Gallwey; C La Vecchia; R Peto; A I Spriggs

    1983-01-01

    Cervical carcinoma and cervical intra-epithelial neoplasia (CIN) are likely to be associated with all sexually transmitted diseases (STDs). To help discover which (if any) of the recognised STDs might actually cause these conditions, a key question is whether one particular such association is much stronger than the others. The present study is therefore only of women newly attending an STD

  6. The Prevalence of Human Papillomavirus in Cervical Cancer in Iran

    Microsoft Academic Search

    SH Mortazavi; M Raoufi; M Nadji; P Kowsarian; A Nowroozi

    2002-01-01

    Background: The human papiloma virus (HPV), which is sexually transmitted, and most commonly causes genital warts, has been linked to cervical intraepithelial neoplasia and invasive carcinoma. Of ninety plus types of HPV, HPV-16 is the most prevalent in cervical cancer, followed by HPV-18, and HPV-33. As HPV's implication has not been assessed in the Middle East the main focus of

  7. Electrical stimulation of the motor tracts in cervical spondylosis

    Microsoft Academic Search

    G Abbruzzese; D DallAgata; M Morena; S Simonetti; L Spadavecchia; P Severi; G C Andrioli; E Favale

    1988-01-01

    Motor action potentials evoked by percutaneous electrical stimulation of the scalp and of the cervical (or lumbar) vertebral region were recorded from the biceps, thenar and tibialis anterior muscles in 30 patients with cervical spondylosis. Twelve normal controls were matched for age and height. Abnormalities of central motor conduction (absence or increased central delay of cortical responses) for at least

  8. Gastric myoelectrical activity in patients with cervical spinal cord injury

    Microsoft Academic Search

    Ching-Liang Lu; Pam Montgomery; Xiaoping Zou; William C Orr; J D Z Chen; F. A. C. G

    1998-01-01

    Objective:Dyspeptic symptoms are common in patients with cervical spinal cord injury (SCI). The supraspinal control of sympathetic innervation to the stomach is interrupted in these patients. Gastric emptying has been reported to be delayed in some patients with cervical SCI. Gastric myoelectrical activity is known to regulate gastric motility and is correlated with gastric emptying. The change in gastric myoelectrical

  9. A panel of regulated proteins in serum from patients with cervical intraepithelial neoplasia and cervical cancer.

    PubMed

    Boichenko, Alexander P; Govorukhina, Natalia; Klip, Harry G; van der Zee, A G J; Güzel, Co?kun; Luider, Theo M; Bischoff, Rainer

    2014-11-01

    We developed a discovery-validation mass-spectrometry-based pipeline to identify a set of proteins that are regulated in serum of patients with cervical intraepithelial neoplasia (CIN) and squamous cell cervical cancer using iTRAQ, label-free shotgun, and targeted mass-spectrometric quantification. In the discovery stage we used a "pooling" strategy for the comparative analysis of immunodepleted serum and revealed 15 up- and 26 down-regulated proteins in patients with early- (CES) and late-stage (CLS) cervical cancer. The analysis of nondepleted serum samples from patients with CIN, CES, an CLS and healthy controls showed significant changes in abundance of alpha-1-acid glycoprotein 1, alpha-1-antitrypsin, serotransferrin, haptoglobin, alpha-2-HS-glycoprotein, and vitamin D-binding protein. We validated our findings using a fast UHPLC/MRM method in an independent set of serum samples from patients with cervical cancer or CIN and healthy controls as well as serum samples from patients with ovarian cancer (more than 400 samples in total). The panel of six proteins showed 67% sensitivity and 88% specificity for discrimination of patients with CIN from healthy controls, a stage of the disease where current protein-based biomarkers, for example, squamous cell carcinoma antigen (SCCA), fail to show any discrimination. Additionally, combining the six-protein panel with SCCA improves the discrimination of patients with CES and CLS from healthy controls. PMID:25232869

  10. Potential of Cervical Electrosurgical Excision Procedure for Diagnosis and Treatment of Cervical Intraepithelial Neoplasia

    Microsoft Academic Search

    Thomas J. Herzog; Sybilann Williams; Lisa M. Adler; Janet S. Rader; Richard T. Kubiniec; H. Marvin Camel; David G. Mutch

    1995-01-01

    The aim of this study was to evaluate the diagnostic potential, treatment efficacy, specimen adequacy, and acute complication rate associated with electrosurgical excision procedure (EEP) of the cervix for the management of cervical intraepithelial neoplasia (CIN). Analysis was performed retrospectively on 153 consecutive patients who underwent EEP under colposcopic guidance. Patients with negative endocervical curettage (ECC), adequate colposcopy, and biopsy-proven

  11. Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance

    Microsoft Academic Search

    Dean H Watson; Patricia H Trott

    1993-01-01

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' headache and a questionnaire was used to establish a profile of the headache population.

  12. Biomechanics of the cervical spine Part 2. Cervical spine soft tissue responses and biomechanical modeling

    Microsoft Academic Search

    Narayan Yoganandan; Srirangam Kumaresan; Frank A Pintar

    2001-01-01

    Objective. The responses and contributions of the soft tissue structures of the human neck are described with a focus on mathematical modeling. Spinal ligaments, intervertebral discs, zygapophysial joints, and uncovertebral joints of the cervical spine are included. Finite element modeling approaches have been emphasized. Representative data relevant to the development and execution of the model are discussed. A brief description

  13. [Anterior cervical fusion on the lower cervical spine: own clinical experience].

    PubMed

    Pazdernyik, Szilárd; Sándor, László; Elek, Péter; Barzó, Pál

    2010-01-30

    Both acute and chronic instability of the cervical spine can be succesfully treated by anterior crevical fusion. The main goal is to create a spondylodesis through which the instable motion segments are fixed in the position defined by the surgeon. The spondylodesis is realised by the bone healing of the intervertebral space. The consolidation itself is facilitated by the operative stabilisation of the segments involved, and also by the implantation/transplantation of the osteoproductive/osteoinductive materials. The sooner consolidation is achieved, the more likely it is to be able to avoid the material dependent complications and/or that of dislocation. So as to support this theory a retrospective clinical/radiological study was performed. During this the length and the safety of the consolidation was measured by applying various anterior cervical plating systems. A total of 485 patients having cervical injuries or degenerative disc disease were treated by anterior cervical plating. For bone transplantation partly pure autolog spongious partly autolog cortico-spongious morsalised bone chips, furthermore autolog tricortical bone block were applied. A standard protocoll was used for data collection, evaluation and also follow-up. The patients treated with plate systems were divided into 3 groups: Group 1: Non-locked H-plate system with autogeneous cancellous bone (155 trauma patients, for a total of 210 cervical motion segments, 1.35 segments/patients). Group 2: Non-locked H-plate system with tricortical autograft (167 patients, for a total of 290 cervical motion segments, 1.73 segments/patients). Group 3: Locked cervical plate system with tricortical autograft (73 patients, for a total of 110 cervical motion segments, 1.5 segments/patients). Patients treated with standalone cage belong to group 4. These cages were filled with autogenous cortico-spongiosus bone chips (90 patients, for a total of 90 cervical motion segments, 1.0 segments/patients). Evaluations included postoperative clinical, X-ray and CT examination, and follow-ups at 6, 16, 52, and 104 weeks. We established three grades, and classified the degree of bony fusion between the graft and vertebra: not-yet-fused, fused or non-union. When evaluating the results the following statements/observations were made: a) There is a fast and safe consolidation in the case of those patients that underwent dinamic disc osteosynthesis (p = 0.00001). b) Whereas performing fixation with non-locked or locked screw plate systems and strutgrafted with tricortical autograft created prolonged healing requiring months and developed non-unions more often (non-locked screw-plate system versus locked screw-plate system) (p > 0.05). c) Using locked screw-plate fixation systems non-union rate in our study was 21%, suggesting that this form of fixation has only a limited use. d) In our study complete consolidation without pseudoarthrosis was achieved by using standalone cages filled with autolog cortico-spongiosus bone chips, but bony healing was delayed due to cage coating and the substitution of pure autogenous spongiosa for cortico-spongiosus bone chips. It is recommended to treat acute/chronic instability of the cervical spine both by using non-fixed plate system with autolog cancellosus bone and by standalone cage filled with cortico-spongiosus bone chips as well. It is worth keeping in mind that by applying this lattest an extra surgery to harvest the graft will be avoided. PMID:20420121

  14. Hysterosalpingographic features of cervical abnormalities: acquired structural anomalies.

    PubMed

    Zafarani, F; Ahmadi, F; Shahrzad, G

    2015-08-01

    Cervical abnormalities may be congenital or acquired. Congenital cervical structural anomalies are relatively uncommon, whereas acquired cervical abnormalities are commonly seen in gynaecology clinics. Acquired abnormalities of the cervix can cause cervical factor infertility and recurrent spontaneous abortion. Various imaging tools have been used for evaluation of the uterine cavity and fallopian tubes. Hysterosalpingography (HSG) is a quick and minimally invasive tool for evaluation of infertility that facilitates visualization of the inner surfaces of the uterine cavity and fallopian tubes, as well as the cervical canal and isthmus. The lesions of the uterine cervix show various imaging manifestations on HSG such as narrowing, dilatation, filling defects, irregularities and diverticular projections. This pictorial review describes and illustrates the hysterosalpingographic appearances of normal variants and acquired structural abnormalities of the cervix. Accurate diagnosis of such cases is considered essential for optimal treatment. The pathological findings and radiopathological correlation will be briefly discussed. PMID:26111269

  15. [Hibernoma and cervical rib: two rare diseases, the same manifestation].

    PubMed

    Antunes, J; Santos, S; Andrade, N; Simões, F; Salgado, C

    2013-07-01

    The hibernoma is a rare benign tumor of soft tissue, derived from remnants of fetal brown adipose tissue. A cervical rib is a supernumerary or accessory rib derived from the 7th cervical vertebra. CLINCAL CASE: 2-year-old girl, previously healthy, referenced to Pediatrics consultation, for left supraclavicular mass. No history of infectious diseases or systemic symptoms. At exam presented mass in supraclavicular left region, 1.5 to 2 cm in diameter, hard, mobile, non-adherent to the deep planes. Laboratory tests exclude an infectious or lymphoproliferative disease. In cervical radiograph we observed bilateral cervical ribs. Cervical ultrasound revealed calcified nodule 0.8 cm, compatible with calcified adenopathy. Biopsy was performed and histology revealed a hibernoma, which was completely removed surgically. This case illustrates the association of two diagnoses, uncommon in children. These were made during the investigation of lymphadenopathies, a frequent reason for pediatrics consultation. PMID:24482907

  16. Return to play after cervical spine injury in sports.

    PubMed

    Cantu, Robert C; Li, Yan Michael; Abdulhamid, Mohamed; Chin, Lawrence S

    2013-01-01

    Spinal cord injuries (SCIs) resulting from sports now represent 8.9% of the total causes of SCI. Regardless of cause, there are bound to be return-to-play decisions to be made for athletes. Since catastrophic cervical spine injuries are among the most devastating injuries in all of sports, returning from a cervical spine injury is one of the most difficult decisions in sports medicine. Axial loading is the primary mechanism for catastrophic cervical spine injuries. Axial loading occurs as a result of intentional or unintentional head-down contact and spearing. Most would agree that the athlete returning to a contact or collision sport after a cervical spine injury must be asymptomatic, have full strength, and have full active range of motion; however, each situation is unique. The following review discusses the pathophysiology of these conditions and suggests guidelines for return to contact sports after traumatic cervical SCI. PMID:23314078

  17. Cervical Spine Involvement: A Rare Manifestation of Reiter's Syndrome

    PubMed Central

    Rastegar, Khodakaram; Ghalaenovi, Hossein; Babashahi, Ali; Shayanfar, Nasrin; Jafari, Mohammad; Jalalian, Mehrdad; Fattahi, Arash

    2014-01-01

    Spine involvement is less common in Reiter's syndrome than in other seronegative spondyloarthropathies. Also, cervical spine involvement rarely occurs in Reiter's syndrome and other spondyloarthropathies. This paper reports a rare case of Reiter's syndrome in which there was cervical spine involvement that presented clinically as an atlanto-axial rotatory subluxation. Reiter's Syndrome (RS) is one of the most common types of seronegative spondyloarthropathies (SSAs) that presents clinically with a triad of symptoms, i.e., conjunctivitis, urethritis, and arthritis. This case highlighted the importance of radiographs of the lateral cervical spine and dynamic cervical imaging for all patients who have Reiter's syndrome with cervical spine symptoms to ensure that this dangerous abnormality is not overlooked. PMID:25360183

  18. Cervical elongation following sacrospinous hysteropexy: a case series.

    PubMed

    Hyakutake, Momoe Tina; Cundiff, Geoffrey William; Geoffrion, Roxana

    2014-06-01

    In recent years, pelvic floor surgeons have increasingly repaired pelvic organ prolapse around an intact uterus. Uterine conservation and hysteropexy have been driven by patient preference, less risk of mesh erosion, shorter operative time, and decreased blood loss and postoperative pain. We present a case series of patients with cervical elongation after vaginal sacrospinous hysteropexy using polypropylene mesh arms, a novel technique developed by the senior author. We defined cervical elongation as greater than or equal to a two-fold increase in cervical length compared with preoperative measurements. Of the 8 patients who underwent this procedure, 5 (62.5 %) had cervical elongation during the first year postoperatively. In the most severe case, the cervix extended to 4 cm beyond the hymenal ring. Most of the patients were mildly symptomatic and chose expectant management. The cases are reviewed in detail. A brief literature review on cervical elongation is presented. PMID:24297063

  19. A prospective uncontrolled trial of fermented milk drink containing viable Lactobacillus casei strain Shirota in the treatment of HTLV-1 associated myelopathy/tropical spastic paraparesis.

    PubMed

    Matsuzaki, Toshio; Saito, Mineki; Usuku, Koichiro; Nose, Hirohisa; Izumo, Shuji; Arimura, Kimiyoshi; Osame, Mitsuhiro

    2005-10-15

    Ten patients with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) were treated in an uncontrolled preliminary trial by oral administration of viable Lactobacillus casei strain Shirota (LcS) containing fermented milk. HTLV-1 provirus load, motor function, neurological findings, and immunological parameters were evaluated after 4 weeks. Although LcS did not change the frequencies or absolute numbers of all the examined cell surface phenotypes of peripheral blood mononuclear cells, NK cell activity was significantly increased after 4 weeks of oral administration of LcS preparation. Improvements in spasticity (modified Ashworth Scale scores) and urinary symptoms were also seen after LcS treatment. No adverse effect was observed in all the 10 patients throughout the study period. Our results indicated that LcS may be a safe and beneficial agent for the treatment of HAM/TSP; therefore randomized controlled studies are warranted. PMID:15961107

  20. Human T-lymphotropic Virus Type-I (HTLV-I)-associated Myelopathy with Bulbar Palsy-type Amyotrophic Lateral Sclerosis-like Symptoms.

    PubMed

    Ando, Rina; Nishikawa, Noriko; Tsujii, Tomoaki; Iwaki, Hirotaka; Yabe, Hayato; Nagai, Masahiro; Nomoto, Masahiro

    2015-01-01

    We herein report a case of Human T-lymphotropic virus type-I (HTLV-I)-associated myelopathy with bulbar palsy-type amyotrophic lateral sclerosis-like symptoms. A 52-year-old woman developed dyslalia at approximately 40 years of age, which slowly progressed. She presented with muscular atrophy and increased tendon reflexes of the extremities as well as bulbar palsy, from which motor neuron disease was suspected. Cerebrospinal fluid (CSF) testing revealed no abnormalities except for an elevated neopterin concentration at 143.17 pmol/mL (normal ?30 pmol/mL). Her serum and CSF anti-HTLV-I antibody titers were also high. Intravenous infusions of methylprednisolone decreased the CSF neopterin concentration to 50.33 pmol/mL. Subsequent oral prednisolone therapy was effective in alleviating the symptoms. PMID:25948358

  1. Dropped Shoulder Syndrome: A Cause of Lower Cervical Radiculopathy

    PubMed Central

    2011-01-01

    Background and Purpose Cervical radiculopathy is a pathological process involving a nerve root of the cervical spine. The most common causes of radiculopathy are cervical disc herniation followed by cervical spondylosis. The aim of this study was to determine the effect of dropped shoulder as a cause of lower cervical radiculopathy. Methods In total, 132 patients, comprising 105 women (79.5%) and 27 men (20.5%; female : male ratio of 4 : 1) and a mean age of 36.7 years (range 18-58 years), were included in this study. All of the patients presented with shoulder pain, and were investigated by cervical X-ray, cervical magnetic resonance imaging, serum muscle enzymes, and electromyography (EMG)/nerve-conduction studies. Results Ninety six patients (72.7%) exhibited visually detectable dropped shoulder. The lateral view X-ray of the cervical region revealed eight or more vertebrae. In 119 patients (90.2%), the EMG revealed a mild-to-moderate or moderate denervation patterns in the abductor digiti minimi, first dorsal interosseous, and flexor carpi ulnaris muscles, while the abductor pollicis brevis, extensor carpi radialis, and triceps brachii were denervated in 102 patients (77.3%). All of the patients had lower cervical paraspinal muscles with a denervation pattern. Conclusions Three criteria for diagnosing dropped shoulder syndrome have been suggested: pain with consistent anatomical distribution, X-ray abnormalities, and EMG abnormalities. Compression of the cervical roots by muscle spasm has been proposed as the cause of dropped shoulder syndrome; this possibility is discussed herein. PMID:21779296

  2. Health Beliefs Associated with Cervical Cancer Screening Among Vietnamese Americans

    PubMed Central

    Gao, Wanzhen; Fang, Carolyn Y.; Tan, Yin; Feng, Ziding; Ge, Shaokui; Nguyen, Joseph An

    2013-01-01

    Abstract Background Vietnamese American women represent one of the ethnic subgroups at great risk for cervical cancer in the United States. The underutilization of cervical cancer screening and the vulnerability of Vietnamese American women to cervical cancer may be compounded by their health beliefs. Objective The objective of this study was to explore the associations between factors of the Health Belief Model (HBM) and cervical cancer screening among Vietnamese American women. Methods Vietnamese American women (n=1,450) were enrolled into the randomized controlled trial (RCT) study who were recruited from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey. Participants completed baseline assessments of demographic and acculturation variables, health care access factors, and constructs of the HBM, as well as health behaviors in either English or Vietnamese. Results The rate of those who had ever undergone cervical cancer screening was 53% (769/1450) among the participants. After adjusting for sociodemographic variables, the significant associated factors from HBM included: believing themselves at risk and more likely than average women to get cervical cancer; believing that cervical cancer changes life; believing a Pap test is important for staying healthy, not understanding what is done during a Pap test, being scared to know having cervical cancer; taking a Pap test is embarrassing; not being available by doctors at convenient times; having too much time for a test; believing no need for a Pap test when feeling well; and being confident in getting a test. Conclusion Understanding how health beliefs may be associated with cervical cancer screening among underserved Vietnamese American women is essential for identifying the subgroup of women who are most at risk for cervical cancer and would benefit from intervention programs to increase screening rates. PMID:23428284

  3. Shanxi Province Cervical Cancer Screening Study: A Cross-Sectional Comparative Trial of Multiple Techniques to Detect Cervical Neoplasia

    Microsoft Academic Search

    J. Belinson; Y. L. Qiao; R. Pretorius; W. H. Zhang; P. Elson; L. Li; Q. J. Pan; C. Fischer; A. Lorincz; D. Zahniser

    2001-01-01

    Objective. The aim of this study was to design a cervical cancer screening algorithm for the developing world that is highly sensitive for cervical intraepithelial neoplasia (CIN) II, III, and cancer and highly specific for CIN II and III, making it possible to ablate the transformation zone without histologic confirmation.Methods. In rural Shanxi Province, China, we examined 1997 women ages

  4. Elective cervical cerclage versus serial ultrasound surveillance of cervical length in a population at high risk for preterm delivery

    Microsoft Academic Search

    Katie M. Groom; Phillip R. Bennett; Monali Golara; Angeli Thalon; Andrew H. Shennan

    2004-01-01

    Objective: To compare pregnancy outcome for women at risk of preterm delivery undergoing elective cervical cerclage in the first trimester or serial transvaginal assessment of cervical length with cerclage only if indicated (control cases). Design: A matched case control study. Setting: Prematurity clinic at two London teaching hospitals. Population: Women at high risk for preterm delivery. Methods: Cases of elective

  5. Diagnosis and treatment of cervical artery dissection.

    PubMed

    Engelter, Stefan T; Traenka, Christopher; Von Hessling, Alexander; Lyrer, Philippe A

    2015-05-01

    Cervical artery dissection (CAD) is a major cause of stroke in the young. A mural hematoma is detected in most CAD patients. The intramural blood accumulation should not be considered a reason to withhold intravenous thrombolysis in patients with CAD-related stroke. Because intravenous-thrombolyzed CAD patients might not recover as well as other stroke patients, acute endovascular treatment is an alternative. Regarding the choice of antithrombotic agents, this article discusses the findings of 4 meta-analyses across observational data, the current status of 3 randomized controlled trials, and arguments and counterarguments favoring anticoagulants over antiplatelets. Furthermore, the role of stenting and surgery is addressed. PMID:25907914

  6. Cervical myelocystocele: prenatal diagnosis and therapeutical considerations

    Microsoft Academic Search

    Olivier Klein; Marie-Alice Coulomb; Jessica Ternier; Gabriel Lena

    2009-01-01

    Background  Cervical myelocystocele (CMC) is a very rare congenital malformation and belongs to the spectrum of skin-covered (occult)\\u000a dysraphisms. Only 15 cases have been so far reported throughout the literature. We report the first case of CMC whose diagnosis\\u000a was established prenatally by ultrasound imaging (US) followed by fetal magnetic resonance imaging (MR).\\u000a \\u000a \\u000a \\u000a Case History  A 35-year-old woman was referred for further

  7. Cervical Spine Surgery: An Historical Perspective

    Microsoft Academic Search

    Vincenzo Denaro; Alberto Di Martino

    2011-01-01

    Background  Continued innovation in surgery requires a knowledge and understanding of historical advances with a recognition of successes\\u000a and failures.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  To identify these successes and failures, we selectively reviewed historical literature on cervical spine surgery with respect\\u000a to the development of (1) surgical approaches, (2) management of degenerative disc disease, and (3) methods to treat segmental\\u000a instability.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We performed a nonsystematic

  8. The impact of interferon-alpha treatment on clinical and immunovirological aspects of HTLV-1-associated myelopathy in northeast of Iran.

    PubMed

    Rafatpanah, Houshang; Rezaee, Abdolrahim; Etemadi, Mohammad Mehdi; Hosseini, Reza Farid; Khorram, Bita; Afsahr, Leila; Taylor, Graham; Mokhber, Naghmeh; Mahmoudi, Mahmoud; Abbaszadegan, Mohammad Reza; Foroghipor, Mohsen; Hashemi, Peyman; Amiri, Amin; Tehrani, Mohsen; Azarpazhooh, Amir; Azarpazhooh, Mahmoud Reza

    2012-09-15

    Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory myelopathy. The pathophysiology of HAM/TSP is not yet fully understood; therefore, effective therapy remains a challenging issue. This study was designed to evaluate the efficacy of interferon-alpha (IFN-?) in HAM/TSP patients in the Northeast of Iran. Forty-nine patients with a definite diagnosis of HAM/TSP were enrolled in this clinical trial. For six months, the patients received three million international units of subcutaneous IFN-?-2b per each injection. The dose regimen was daily injection for the first month, three times administration per week for the months 2 and 3, twice weekly injection for the months 4 and 5 and weekly injection for the sixth month. The clinical and laboratory responses were evaluated based on neurologic examinations and immunovirological markers. IFN-? had significant but temporary effect on the motor and urinary functions of the patients. Comparing to the baseline values, proviral load was significantly decreased one month after treatment in responders (495.20±306.87 to 262.69±219.24 p=0.02) and non-responders (624.86±261.90 to 428.28±259.88 p=0.03). Anti-HTLV-1 antibody titers were significantly decreased among responders (1152.1±200.5 to 511.6±98.2 p=0.009) and non-responders (1280.1±368.1 to 537.6±187 p=0.007). Flow cytometry showed no significant changes in CD4, CD8, CD4CD25 and CD16CD56 counts with IFN-?. The positive impact of IFN-? was observed during the treatment period with significant effects on some clinical aspects of HAM/TSP. PMID:22727800

  9. Efficacy of prosultiamine treatment in patients with human T lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis: results from an open-label clinical trial

    PubMed Central

    2013-01-01

    Background Human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic myelopathy characterized by motor dysfunction of the lower extremities and urinary disturbance. Immunomodulatory treatments are the main strategy for HAM/TSP, but several issues are associated with long-term treatment. We conducted a clinical trial with prosultiamine (which has apoptotic activity against HTLV-I-infected cells) as a novel therapy in HAM/TSP patients. Methods We enrolled 24 HAM/TSP patients in this open-label clinical trial. Prosultiamine (300 mg, orally) was administered once daily for 12 weeks. We monitored changes in the motor function of the lower extremities and urinary function as well as copy numbers of the HTLV-I provirus in peripheral blood mononuclear cells (PBMCs). Results Improvement in the motor function of the lower extremities based on a reduction in spasticity (for example, decrease in time required for walking and descending a flight of stairs) was observed. In an urodynamic study (UDS), bladder capacity and detrusor pressure and then maximum flow rate increased significantly. Detrusor overactivity and detrusor-sphincter dyssynergia improved in 68.8% and 45.5% of patients observed at pretreatment, respectively. Improvement in UDS corresponded with improvements in the score of nocturia-quality of life questionnaire. HTLV-I proviral copy numbers in PBMCs decreased significantly (approximately 15.4%) compared with pretreatment levels. Conclusions These data suggest that prosultiamine can safely improve motor dysfunction of the lower extremities and urinary disturbance as well as reduce HTLV-I provirus levels in peripheral blood. It therefore has potential as a new therapeutic tool for HAM/TSP patients. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) number, UMIN000005969. Please see related commentary: http://www.biomedcentral.com/1741-7015/11/183. PMID:23945290

  10. Building up a computerized follow-up register and information system for cervical cytology

    Microsoft Academic Search

    A. A. Terpos; M. Efstratiadou; H. Symiakaki; A. Tsiveleka; P. Mentzelopoulou; A. Linos; I. Mantas

    1995-01-01

    It is well known that cervical intraepithelial neoplasia (CIN) and human papilloma virus (HPV) infection are closely related to cervical cancer. The cervical cytology examination (pap-test), followed by a colposcopic examination and a biopsy are the common tools for the early detection and the establishment of diagnosis of the cervical precancerous lesions. The monitoring and surveillance of those precancerous lesions

  11. Prediction of high-grade cervical intraepithelial neoplasia in cytologically normal women by human papillomavirus testing

    Microsoft Academic Search

    F Carozzi; G Ronco; M Confortini; D Noferini; C Maddau; S Ciatto; N Segnan

    2000-01-01

    Human papillomavirus (HPV) testing has been suggested for primary screening of cervical cancer. Prediction of future high-grade cervical lesions is crucial for effectiveness and cost. We performed a case control study in a retrospective cohort of women with at least two cervical smears, all but the last one being negative, from the organized cervical screening programme in Florence, Italy. We

  12. Subsidence of stand-alone cervical cages in anterior interbody fusion: warning

    Microsoft Academic Search

    Erol Gercek; Vincent Arlet; Josee Delisle; Dante Marchesi

    2003-01-01

    Anterior cervical decompression and fusion with anterior plating of the cervical spine is a well-accepted treatment for cervical radiculopathy. Recently, to minimise the extent of surgery, anterior interbody fusion with cages has become more common. While there are numerous reports on the primary stabilising effects of the different cervical cages, little is known about the subsidence behaviour of such cages

  13. An Unusual Cervical Tumor as Presentation of a Non-Hodgkin Lymphoma

    PubMed Central

    De Greve, Tom; Vanwalleghem, Lieve; Van Hoof, Achiel; Coenegrachts, Kenneth; Van Trappen, Philippe

    2014-01-01

    Rare cervical cancers are responsible for a minority of cases encountered by a clinician. However, behavioral patterns, management, and prognosis of certain rare cervical cancers differ from either squamous carcinomas or adenocarcinomas. Here we present a case of a locally advanced cervical tumor as a presentation of an extranodal cervical non-Hodgkin lymphoma (NHL), with a review of the current literature. PMID:24782935

  14. 75 FR 54345 - Determination of Regulatory Review Period for Purposes of Patent Extension; BRYAN CERVICAL DISC...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-07

    ...Purposes of Patent Extension; BRYAN CERVICAL DISC SYSTEM AGENCY: Food and Drug Administration...the regulatory review period for BRYAN CERVICAL DISC SYSTEM and is publishing this notice...for marketing the medical device BRYAN CERVICAL DISC SYSTEM. BRYAN CERVICAL DISC...

  15. Correlates of IL10 and IL12 Concentrations in Cervical Secretions

    Microsoft Academic Search

    Patti E. Gravitt; Allan Hildesheim; Rolando Herrero; Mark Schiffman; Mark E. Sherman; M. Concepcion Bratti; Ana C. Rodriguez; Lidia A. Morera; Fernando Cardenas; Frederick P. Bowman; Keerti V. Shah; Peggy A. Crowley-Nowick

    2003-01-01

    Interindividual variations in host immune responses to HPV infection are thought to be important determinants of viral persistence and progression to cervical intraepithelial neoplasia and cancer. However, few studies have measured local immune markers at the site of infection (e.g., the cervical mucosa). We sought to determine biologic correlates of IL-10 and IL-12 concentrations in cervical secretions. Cervical secretions were

  16. The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash

    Microsoft Academic Search

    Julia Treleaven; Gwendolen Jull; Nancy LowChoy

    2006-01-01

    Cervical joint position error (JPE) has been used as a measure of cervical afferent input to detect disturbances in sensori-motor control as a possible contributor to a neck pain syndrome. This study aimed to investigate the relationship between cervical JPE, balance and eye movement control. It was of particular interest whether assessment of cervical JPE alone was sufficient to signal

  17. Comparison of the Symmetry of Right and Left Lateral Cervical Flexion and Rotation and the Cervical FRR in Young Computer Workers

    PubMed Central

    Yoo, Won-gyu

    2014-01-01

    [Purpose] This study compared the symmetry of right and left lateral cervical flexion and rotation, and the cervical flexion-relaxation ratio (FRR) in young computer workers in Korea. [Subjects and Methods] Twenty computer workers (14 males and 6 females) participated in this study. We measured their right and left lateral cervical flexion, rotation, and FRR. [Results] Right and left lateral flexion and right and left rotation showed no significant differences between the sides. The left cervical FRR was significantly lower than the right cervical FRR. [Conclusion] The cervical FRR, expressed as a numerical value, is a more sensitive marker for measuring neuromuscular changes associated with mild asymmetry than CROM. PMID:24926152

  18. Histopathological outcomes of women with abnormal cervical cytology: a review of literature in Thailand.

    PubMed

    Kietpeerakool, Chumnan; Tangjitgamol, Siriwan; Srisomboon, Jatupol

    2014-01-01

    Cervical cytology remains the principal screening method to detect pre-invasive and invasive cervical lesions. Management of abnormal cervical cytology depends on the risk of encountering a significant cervical lesion or high-grade cervical disease. These risks may vary in different areas across the country. Thus, determining the rate of significant cervical lesion associated with each type of abnormal cervical cytology in each area is of critical importance for designing area-specific management approach. This review was conducted to evaluate the rate of high-grade cervical disease among Thai women with abnormal cervical cytology. A relatively high incidence of underlying significant lesions including invasive disease was demonstrated even in those having only minimal smear abnormality. This baseline information is crucial and must be taken into consideration in management of women with abnormal cytological screening to achieve the goals of comprehensive cervical cancer control in Thailand. PMID:25169475

  19. Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

    PubMed

    Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

    2015-07-01

    The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury. PMID:25290103

  20. Cervical lymph node diseases in children

    PubMed Central

    Lang, Stephan; Kansy, Benjamin

    2014-01-01

    The lymph nodes are an essential part of the body’s immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) – a critical aspect especially among children – and can represent an early clinical sign in their exposed position on a child’s slim neck. Involvement of the lymph nodes in multiple conditions is accompanied by a correspondingly large number of available diagnostic procedures. In the interests of time, patient wellbeing and cost, a careful choice of these must be made to permit appropriate treatment. The basis of diagnostic decisions is a detailed anamnesis and clinical examination. Sonography also plays an important role in differential diagnosis of lymph node swelling in children and is useful in answering one of the critical diagnostic questions: is there a suspicion of malignancy? If so, full dissection of the most conspicuous lymph node may be necessary to obtain histological confirmation. Diagnosis and treatment of childhood cervical lymph node disorders present the attending pediatric and ENT physicians with some particular challenges. The spectrum of differential diagnoses and the varying degrees of clinical relevance – from banal infections to malignant diseases – demand a clear and considered approach to the child’s individual clinical presentation. Such an approach is described in the following paper. PMID:25587368

  1. Micromechanics of Minor Cervical Spine Injuries

    NASA Astrophysics Data System (ADS)

    Niederer, Peter F.; Schmitt, Kai-Uwe; Muser, Markus H.; Walz, Felix H.

    Minor soft tissue injuries of the cervical spine are of increasing significance in public health. They may in particular be associated with long-term impairment. Such injuries are observed primarily in rear-end automobile collisions at low impact speeds and are attributed to a “whiplash”-type event. The question with respect to injury mechanisms of the cervical spine in cases of impacts of a low severity have raised controversial views in the past. Among proposed injury mechanisms, interactions between fluid and solid structures have been postulated: Viscous shear stresses or pressure gradients which arise in the deforming anatomical structures may have an adverse influence, e. g., on cellular membranes. In this communication, mathematical modeling approaches are presented which allow for a quantification of fluid/solid interactions under typical loading conditions of interest here. It is found, that the shear stresses caused by fluids and acting on accelerated surfaces of fluid-filled bodies depend largely on the size of the fluid space under consideration. Accelerations exhibit a stronger influence than their duration. It cannot be excluded that critical levels are reached even in a low speed impact scenario.

  2. Remote cerebellar hemorrhage after cervical spinal surgery.

    PubMed

    Huang, Po-Hsien; Wu, Jau-Ching; Cheng, Henrich; Shih, Yang-Hsin; Huang, Wen-Cheng

    2013-10-01

    Remote cerebellar hemorrhage (RCH) is an unpredictable and rare complication of spinal surgery. We report five cases of RCH following cervical spinal surgery, and summarize another seven similar cases from the literature. Dural opening with cerebrospinal fluid (CSF) hypovolemia seems to be an important factor contributing to RCH following cervical spinal surgery. As other authors have proposed, surgical positioning may be another factor contributing to RCH. RCH is thought to be hemorrhagic venous infarction, resulting from the stretching occlusion of the superior cerebellar vein by the cerebellar sag effect. Either intraoperative CSF loss or a postoperative CSF leak from drainage may cause cerebellar sag, further resulting in RCH. RCH is usually self-limiting, and most patients with RCH have an optimal outcome after conservative treatment. Severe cases that involved surgical intervention because of evidence of brainstem compression or hydrocephalus also had acceptable outcomes, compared to spontaneous CH. It has been suggested that one way to prevent RCH is to avoid extensive perioperative loss of CSF, by paying attention to surgical positioning during spinal surgery. We also underline the importance of early diagnosis and CSF expansion in the early treatment of RCH. PMID:23746536

  3. Cervical Mucus Properties Stratify Risk for Preterm Birth

    PubMed Central

    Jaishankar, Aditya; Friedlander, Ronn S.; Lieleg, Oliver; Doyle, Patrick S.; McKinley, Gareth; House, Michael; Ribbeck, Katharina

    2013-01-01

    Background Ascending infection from the colonized vagina to the normally sterile intrauterine cavity is a well-documented cause of preterm birth. The primary physical barrier to microbial ascension is the cervical canal, which is filled with a dense and protective mucus plug. Despite its central role in separating the vaginal from the intrauterine tract, the barrier properties of cervical mucus have not been studied in preterm birth. Methods and Findings To study the protective function of the cervical mucus in preterm birth we performed a pilot case-control study to measure the viscoelasticity and permeability properties of mucus obtained from pregnant women at high-risk and low-risk for preterm birth. Using extensional and shear rheology we found that cervical mucus from women at high-risk for preterm birth was more extensible and forms significantly weaker gels compared to cervical mucus from women at low-risk of preterm birth. Moreover, permeability measurements using fluorescent microbeads show that high-risk mucus was more permeable compared with low-risk mucus. Conclusions Our findings suggest that critical biophysical barrier properties of cervical mucus in women at high-risk for preterm birth are compromised compared to women with healthy pregnancy. We hypothesize that impaired barrier properties of cervical mucus could contribute to increased rates of intrauterine infection seen in women with preterm birth. We furthermore suggest that a robust association of spinnbarkeit and preterm birth could be an effectively exploited biomarker for preterm birth prediction. PMID:23936335

  4. Tetraploidy and chromosomal instability are early events during cervical carcinogenesis.

    PubMed

    Olaharski, Andrew J; Sotelo, Rita; Solorza-Luna, Gilberto; Gonsebatt, Maria E; Guzman, Patricia; Mohar, Alejandro; Eastmond, David A

    2006-02-01

    Chromosomal instability as manifested by increases in aneuploidy and structural chromosome aberrations is believed to play a critical role in the intermediate to late stages in the development of cervical malignancies. The current study was designed to determine the role of tetraploidy in the formation of aneuploidy and ascertain the occurrence of these alterations during the earlier stages of cervical carcinogenesis. Cervical cell samples, with diagnoses ranging from Normal to high-grade lesions, (HSIL) were obtained from 143 women and were evaluated for chromosomal alterations using dual-probe fluorescence in situ hybridization. Cervical cells from a subset of the group were also evaluated for chromosomal instability in the form of micronuclei. The frequencies of cells exhibiting either tetrasomy or aneusomy for Chromosomes 3 and 17 increased significantly with disease progression and displayed distinctive patterns where aneusomy was rarely present in the absence of tetrasomy. The frequencies of micronuclei that formed through either chromosomal loss or breakage increased significantly in both the low-grade and high-grade diagnostic categories and were highly correlated with both the number of tetrasomic and aneusomic cervical cells. In addition, a unique chromosomal alteration involving a significant non-random loss of Chromosome 17 specific to near-tetraploid aneusomic cells (trisomy 17 and tetrasomy 3) was observed. We conclude that tetraploidy and chromosomal instability are related events occurring during the early stages of cervical carcinogenesis that predispose cervical cells to the formation of aneuploidy frequently involving the loss of Chromosome 17. PMID:16123119

  5. Advancing Cervical Cancer Prevention in India: Implementation Science Priorities

    PubMed Central

    Madsen, Emily; Porterfield, Deborah; Varghese, Beena

    2013-01-01

    Cervical cancer is the leading cause of cancer mortality in India, accounting for 17% of all cancer deaths among women aged 30 to 69 years. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025, but there are few large-scale, organized cervical cancer prevention programs in the country. We conducted a review of the cervical cancer prevention research literature and programmatic experiences in India to summarize the current state of knowledge and practices and recommend research priorities to address the gap in services. We found that research and programs in India have demonstrated the feasibility and acceptability of cervical cancer prevention efforts and that screening strategies requiring minimal additional human resources and laboratory infrastructure can reduce morbidity and mortality. However, additional evidence generated through implementation science research is needed to ensure that cervical cancer prevention efforts have the desired impact and are cost-effective. Specifically, implementation science research is needed to understand individual- and community-level barriers to screening and diagnostic and treatment services; to improve health care worker performance; to strengthen links among screening, diagnosis, and treatment; and to determine optimal program design, outcomes, and costs. With a quarter of the global burden of cervical cancer in India, there is no better time than now to translate research findings to practice. Implementation science can help ensure that investments in cervical cancer prevention and control result in the greatest impact. PMID:24217555

  6. A continuous fiber distribution material model for human cervical tissue.

    PubMed

    Myers, Kristin M; Hendon, Christine P; Gan, Yu; Yao, Wang; Yoshida, Kyoko; Fernandez, Michael; Vink, Joy; Wapner, Ronald J

    2015-06-25

    The uterine cervix during pregnancy is the vital mechanical barrier which resists compressive and tensile loads generated from a growing fetus. Premature cervical remodeling and softening is hypothesized to result in the shortening of the cervix, which is known to increase a woman?s risk of preterm birth. To understand the role of cervical material properties in preventing preterm birth, we derive a cervical material model based on previous mechanical, biochemical and histological experiments conducted on nonpregnant and pregnant human hysterectomy cervical tissue samples. In this study we present a three-dimensional fiber composite model that captures the equilibrium material behavior of the tissue in tension and compression. Cervical tissue is modeled as a fibrous composite material, where a single family of preferentially aligned and continuously distributed collagen fibers are embedded in a compressible neo-Hookean ground substance. The total stress in the collagen solid network is calculated by integrating the fiber stresses. The shape of the fiber distribution is described by an ellipsoid where semi-principal axis lengths are fit to optical coherence tomography measurements. The composite material model is fit to averaged mechanical testing data from uni-axial compression and tension experiments, and averaged material parameters are reported for nonpregnant and term pregnant human cervical tissue. The model is then evaluated by investigating the stress and strain state of a uniform thick-walled cylinder under a compressive stress with collagen fibers preferentially aligned in the circumferential direction. This material modeling framework for the equilibrium behavior of human cervical tissue serves as a basis to determine the role of preferentially-aligned cervical collagen fibers in preventing cervical deformation during pregnancy. PMID:25817474

  7. Human Vagus Nerve Branching in the Cervical Region

    PubMed Central

    Hammer, Niels; Glätzner, Juliane; Feja, Christine; Kühne, Christian; Meixensberger, Jürgen; Planitzer, Uwe; Schleifenbaum, Stefan; Tillmann, Bernhard N.; Winkler, Dirk

    2015-01-01

    Background Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation. Materials and Methods Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides) in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections. Results Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally) and proven histologically in all cases. Right-sided branching (22%) was more common than left-sided branching (12%) and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm) and cross-sections (7.24 mm2 vs. 5.28 mm2). Discussion Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation. PMID:25679804

  8. Cervical spine injury in dismounted improvised explosive device trauma

    PubMed Central

    Taddeo, Joseph; Devine, Maj Melissa; McAlister, LCol Vivian C.

    2015-01-01

    Background The injury pattern from improvised explosive device (IED) trauma is different if the target is in a vehicle (mounted) or on foot (dismounted). Combat and civilian first response protocols require the placement of a cervical collar on all victims of a blast injury. Methods We searched the Joint Theatre Trauma Registry (JTTR) and the Role 3 Hospital, Kandahar Airfield (KAF) database from Mar. 1, 2008, to May 31, 2011. We collected data on cervical fracture; head injury; traumatic amputation; initial blood pressure, pulse, injury severity score (ISS), Glasgow Coma Scale (GCS) score and base excess; and patient demographic information. Results The concordance rate between JTTR and KAF databases was 98%. Of the 15 693 admissions in JTTR, 326 patients with dismounted IED injuries were located. The rate of cervical collar prehospital placement was 7.6%. Cervical fractures were found in 19 (5.8%) dismounted IED victims, but only 4 (1.2%) were considered radiographically unstable. None of these 19 patients had prehospital placement of a collar. Patients with cervical spine fractures were more severely injured than those without (ISS 18.2 v. 13.4; GCS 10.1 v. 12.5). Patients with head injuries had significantly higher risk of cervical spine injury than those with no head injury recorded (13.6% v. 3.9%). No differences in frequency of cervical spine injury were found between patients who had associated traumatic amputations and those who did not (5.4% v. 6.0%). Conclusion Dismounted IED is a mechanism of injury associated with a low risk for cervical spine trauma. A selective protocol for cervical collar placement on victims of dismounted IED blasts is possible and may be more amenable to combat situations. PMID:26100769

  9. Detection of human T-lymphotropic virus type I p40 tax protein in cerebrospinal fluid cells from patients with human T-lymphotropic virus type I-associated myelopathy\\/tropical spastic paraparesis

    Microsoft Academic Search

    Takashi Moritoyo; Shuji Izumo; Hiroyoko Moritoyo; Yuetsu Tanaka; Yoshimasa Kiyomatsu; Masahiro Nagai; Koichiro Usuku; Masaru Sorimachi; Mitsuhiro Osame

    1999-01-01

    We investigated the role of viral transcripts of human T-lymphotropic virus type I (HTLV-I) in the cerebrospinal fluid (CSF) cells and peripheral blood mononuclear cells (PBMCs) of patients with human T-lymphotropic virus type I-associated myelopathy (HAM)\\/tropical spastic paraparesis (TSP). To detect the HTLV-I p40tax protein, we developed a new sensitive method of immunohistochemistry combined with tyramide signal amplification and quantitative

  10. Cervical Epidural Abscess Mimicking as Stroke - Report of Two Cases

    PubMed Central

    Velpula, Jagan Mohana Reddy; Gakhar, Harinder; Sigamoney, Kohilavani; Bommireddy, Rajendra

    2014-01-01

    Background: Stroke is a common provisional diagnosis in patients presenting to the emergency department (ED) with unilateral neurological deficit. Cervical epidural abscess (CEA) may also present clinically with a unilateral neurological deficit. Objects: To highlight the inherent problems with diagnosing cervical epidural abscess and possible consequences of delay in diagnosis. Case Report: We would like to highlight two cases provisionally diagnosed as stroke. Both cases turned out to be cervical epidural abscesses. The delay in diagnosis and treatment led to suboptimal outcome in both cases. Summary: Cases with suspected stroke who deteriorate while under treatment or whose diagnosis is doubtful should have MRI whole spine in order to avoid potential complications. PMID:24551026

  11. Primary strategies for HPV infection and cervical cancer prevention.

    PubMed

    Harper, Diane M; Demars, Leslie R

    2014-06-01

    Counseling messages for tobacco cessation, condom use, circumcision, and selective choice in the number of sexual partners can help reduce the risk of cervical cancer. Other sexual behavioral and reproductive risk factors for cervical cancer are a younger age at first intercourse and at first full-term pregnancy as well as increasing duration of combined hormonal oral contraceptive use. Micronutrients and supplements can reduce the risk of human papillomavirus infection, persistence, progression, and regression. Some human papillomavirus infections can be prevented by vaccination. Cervical cancer is best prevented by screening. PMID:24686336

  12. Innovative methods of cervical assessment and potential for novel treatment.

    PubMed

    Feltovich, Helen; House, Michael

    2014-09-01

    A multitude of pathophysiologic pathways culminate in the final common denominator of cervical softening, shortening, and dilation that lead to preterm birth. At present, a variety of emerging technology aims to objectively quantify critical cervical parameters such as microstructural organization and softening of the cervix. If the nature and timing of cervical changes can be precisely identified, it should be possible to identify the causative upstream molecular processes and resultant biomechanical events associated with each unique pathway. This would promote molecular studies, ultimately leading to novel approaches to preterm birth prediction, novel treatments, and prevention. PMID:25084285

  13. Impact of HPV immunization on the detection of cervical disease.

    PubMed

    Munro, Ami J; Cruickshank, Margaret E

    2014-04-01

    Human papillomavirus (HPV) is the primary cause of cervical cancer and genital warts. The development of HPV vaccines has been a major advance in the prevention of these diseases. Recent studies have shown promising early effects of HPV immunization programs on cervical abnormalities and genital warts, with evidence of herd immunity against genital warts also emerging in Australia. Further studies are required to not only continue monitoring the effect of the HPV immunization on the incidence of these diseases, but also to establish the effect the immunization will have on cervical screening programs and the performance of colposcopy. PMID:24606579

  14. A survey of management strategies for noncarious cervical lesions.

    PubMed

    Estafan, Ashraf; Bartlett, David; Goldstein, Gary

    2014-01-01

    Both causation and management of noncarious cervical lesions (NCCLs) (abfractions, wedge-shaped defects, stress-induced cervical lesions, and cervical erosion) remain debatable. A survey of clinicians' perceptions was therefore conducted at a recent professional meeting to determine optimal approaches to NCCL management. Examples of lesions differing in depth (1, 2, and 3 mm) were presented as being either sensitive or nonsensitive, and participants recorded their responses to the presented individual scenarios. This report provides information regarding correlations between increases in lesion depth, lesion sensitivity, and professionals' willingness to restore them. It was also noted that decisions to ensure mechanical retention positively influenced estimates for restoration longevity. PMID:24392484

  15. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    PubMed Central

    Obel, J; McKenzie, J; Buenconsejo-Lum, LE; Durand, AM; Ekeroma, A; Souares, Y; Hoy, D; Baravilala, W; Garland, SM; Kjaer, SK; Roth, A

    2015-01-01

    Objective To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific. PMID:25921158

  16. The Fullendoscopic Anterior Cervical Fusion: A New Horizon for Selective Percutaneous Endoscopic Cervical Decompression

    Microsoft Academic Search

    S. Hellinger

    \\u000a As a bridge between open and percutaneous therapy, endoscopy of the cervical spine started to be used at the beginning of\\u000a the 1990s, following good experiences on the lumbar spine. The principle of microsurgery is combined with the minimally invasive\\u000a principles by bringing the optical level to the forefront of pathology. Access morbidity has been significantly reduced by\\u000a the percutaneous

  17. Anterior cervical fusion using porous hydroxyapatite ceramics for cervical disc herniation

    Microsoft Academic Search

    Futoshi Suetsuna; Toru Yokoyama; Eiji Kenuka; Seiko Harata

    2001-01-01

    Background context: The Smith-Robinson Method (SR), which employs autogenous bone, is the current standard for anterior cervical fusion (AF) surgery. However, autogenous bone has graft-related complications and morbidity, and harvesting it increases trauma and risk to the patient. The use of hydroxyapatite ceramic (HAP) inserts may provide a superior alternative.Purpose: To determine the efficacy of using HAP in AF.Study design\\/setting:

  18. Photodynamic therapy of cervical intraepithelial neoplasia

    NASA Astrophysics Data System (ADS)

    Inada, Natalia M.; Lombardi, Welington; Leite, Marieli F. M.; Trujillo, Jose R.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2014-03-01

    Photodynamic therapy (PDT) is a technique that has been used for the treatment of tumors, especially in Gynecology. The photodynamic reaction is based on the production of reactive oxygen species after the activation of a photosensitizer. Advantages of the PDT in comparison to the surgical resection are: ambulatory treatment and tissue recovery highly satisfactory, through a non-invasive procedure. The cervical intraepithelial neoplasia (CIN) grades I and II presents potential indications for PDT. The aim of the proposed study is to evaluate the safety and efficacy of the PDT for the diagnostics and treatment of CIN I and II. The equipment and the photosensitizer are produced in Brazil with a representative low cost. It is possible to visualize the fluorescence of the cervix and to treat the lesions, without side effects. The proposed clinical protocol shows great potential to become a public health technique.

  19. Primary cervical hydatid cyst: a rare occurrence

    PubMed Central

    2012-01-01

    Hydatid disease, a parasitic infection is caused by Echinococcus granulosus. It has serious impact on health and economy especially in countries where it is endemic. It occurs frequently in liver and lung. The disease is chronic and cyst can localize in different organs. A hydatid cyst occurrence in the head and neck is extremely rare. To know the distribution of disease can help in its control and prevention. We report a case of primary cervical hydatid cyst in 20 year old female. A high index of suspicion is required to diagnose hydatid cyst in rare locations like this. Hydatid cyst should be considered in differential diagnosis of benign swellings of head and neck region, so that it can be managed during surgery to prevent acute anaphylaxis. Virtual slides The virtual slides’ for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4915595218376646 PMID:23157817

  20. Radiation Therapy and Cisplatin With or Without Triapine in Treating Patients With Newly Diagnosed Stage IB2, II, or IIIB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2015-06-05

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Vaginal Cancer

  1. Perceived Risk of Cervical Cancer in Appalachian Women

    PubMed Central

    Kelly, Kimberly M.; Ferketich, Amy K.; Ruffin, Mack T.; Tatum, Cathy; Paskett, Electra D.

    2013-01-01

    Objective To examine perceptions of cervical cancer risk in elevated-risk Appalachians. Methods Appalachian women (n=571) completed interviews examining self-regulation model factors relevant to perceived risk of cervical cancer. Results Women with good/very good knowledge of cervical cancer, greater worry, and history of sexually transmitted infection had higher odds of rating their perceived risk as somewhat/much higher than did other women. Former smokers, compared to never smokers, had lower risk perceptions. Conclusions Self-regulation model factors are important to understanding perceptions of cervical cancer risk in underserved women. The relationship of smoking and worry to perceived risk may be a target for intervention. PMID:23026042

  2. ICSN Biennial Meeting - Copenhagen 2008 - Abstracts - Cervical Cancer Screening

    Cancer.gov

    ICSN Biennial Meeting 2008 Helsingør, Denmark Attendance Rate (2003-2005) of the Hungarian Organized, Nation-Wide Cervical Cancer Screening Program Authors: I Boncz, A Sebestyén Affiliation: Department of Health Economics, Policy & Management, University

  3. Image-Guided Radiotherapy and -Brachytherapy for Cervical Cancer

    PubMed Central

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer. PMID:25853092

  4. Factors Affecting Hispanic Women's Participation in Screening for Cervical Cancer.

    PubMed

    Moore de Peralta, Arelis; Holaday, Bonnie; McDonell, James R

    2015-06-01

    Hispanic women's cervical cancer rates are disproportionately high. The Health Belief Model (HBM) was used as a theoretical framework to explore beliefs, attitudes, socio-economic, and cultural factors influencing Hispanic women's decisions about cervical cancer screening. A cross-sectional survey was conducted among Hispanic women 18-65 years old (n = 205) in the Upstate of South Carolina. Generalized Linear Modeling was used. Across all models, perceived threats (susceptibility and severity), self-efficacy, and the interaction of benefits and barriers were significant predictors. Significant covariates included age, marital status, income, regular medical care, and familism. A modified HBM was a useful model for examining cervical cancer screening in this sample of Hispanic women. The inclusion of external, or social factors increased the strength of the HBM as an explanatory model. The HBM can be used as a framework to design culturally appropriate cervical cancer screening interventions. PMID:24578156

  5. Acute cervical cord injuries in patients with epilepsy.

    PubMed Central

    Allen, J W; Kendall, B E; Kocen, R S; Milligan, N M

    1982-01-01

    Seven cases with acute cervical cord lesions associated with a fit and fall, were found in approximately 500 patients with epilepsy over a period of 7 years. In all patients the epilepsy was refractory to drug therapy and six suffered tonic fits which resulted in falls and frequent head injuries. Notable radiological changes were found in the cervical spine; there was ankylosis in five, hyperostosis in four and the minimum sagittal diameter of the bony canal was less than 11mm in three cases. The findings indicate that repetitive trauma may be a factor in producing bony changes in the cervical spine which put the patient at risk of cervical cord injury, especially when the spinal canal is developmentally narrow. Images PMID:7143009

  6. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer

    Cancer.gov

    Twitter Multimedia Home About Key Initiatives Funding Resources Tools Cancer Control & Population Sciences Home Behavioral Research Program Home Process of Care Research Branch Process of Care Research Branch (PCRB) Key Initiatives HPV and Cervical Cancer HPV

  7. Mechanical and biochemical properties of human cervical tissue

    E-print Network

    Myers, Kristin M

    2005-01-01

    The mechanical integrity of cervical tissue is crucial for maintaining a healthy gestation. Altered tissue biochemistry can cause drastic changes in the mechanical properties of the cervix and contribute to premature ...

  8. Tumoral calcinosis involving the cervical spine

    PubMed Central

    Sasaki, Osamu; Nakamura, Kimihiko; Nashimoto, Takeo; Shibuya, Hiroyuki

    2015-01-01

    Background: Tumoral calcinosis (TC) is a disease of unknown etiology characterized by the presence of calcified masses in the juxta-articular regions of the extremities. Involvement of the cervical spine is very rare. In this report, the characteristics of TC of the cervical spine, including the clinical presentation, radiographic features, and surgical management are discussed. Case Description: A 90-year-old healthy female suffering from numbness of the upper extremities for 3 months presented with a 2-week history of progressive weakness of the lower extremities. A neurological examination revealed mild weakness and sensory impairment of the bilateral upper and lower extremities. Computed tomography (CT) scans demonstrated amorphous calcified masses posterior to the spinous process that extended into the interlaminar spaces of C3/4 and C4/5. The masses involved the posterior elements of C3-C4. Interestingly, CT scans performed 4 years earlier showed subtle calcification of a yellow ligament at C3/4 and C4/5. However, neither calcified masses nor bone erosion were observed. On magnetic resonance (MR) imaging, the mass showed hypointensity on T1- and T2-weighted images. The lesion was compressing the spinal cord and was resected surgically. The pathological findings were consistent with those of TC. The natural history of TC is not understood. However, this case suggests that calcified masses may progress within several years and that the bone around the mass may be involved. Postoperatively, residual masses may disappear spontaneously, while new bone is formed in the erosive lamina and facet. Conclusion: The treatment of choice for TC, if the lesion causes progressive symptoms, is surgical resection.

  9. Occipito-cervical fusion using posterior titanium plates

    Microsoft Academic Search

    I. H. Lieberman; J. K. Webb

    1998-01-01

    Occipito-cervical fusion may be indicated for instability of the occipito-cervical junction or atlanto-axial spine secondary\\u000a to a wide spectrum of pathology. Many techniques exist to stabilize the spine until fusion is achieved. Recent reports of\\u000a plate fixation have been favorable. In this study we set out to determine the effectiveness and advantages of titanium plate\\u000a fixation when used to stabilize

  10. Different cervical cancer screening approaches in a Chinese multicentre study

    Microsoft Academic Search

    N Li; J-F Shi; S Franceschi; W-H Zhang; M Dai; B Liu; Y-Z Zhang; L-K Li; R-F Wu; H De Vuyst; M Plummer; Y-L Qiao; G Clifford

    2009-01-01

    To evaluate alternative cervical cancer screening methods, digital colposcopy and collection of cervical exfoliated cells for liquid-based cytology (LBC) and hybrid capture 2 (HC2) testing were performed among 2562 women aged 15–59 years in three study sites in the People's Republic of China (rural Shanxi province, Shenyang city in Liaoning province and Shenzhen city in Guangdong province). Visual inspection with

  11. Cervical arthroplasty using ProDisc-C Case Report

    PubMed Central

    Nica, DA; Copaciu, R

    2013-01-01

    Cervical disc replacement is an emerging motion-preserving technology in the surgical treatment of the cervical degenerative disc disorders used as an alternative to the classic interbody fusion. We present a case report of a patient diagnosed with C6-7 right disc herniation who underwent anterior discectomy and received a total disc replacement using ProDisc C artificial disc prosthesis. PMID:23599830

  12. Cervical arthroplasty using ProDisc-C case report.

    PubMed

    Nica, D A; Copaciu, R

    2013-03-15

    Cervical disc replacement is an emerging motion-preserving technology in the surgical treatment of the cervical degenerative disc disorders used as an alternative to the classic interbody fusion. We present a case report of a patient diagnosed with C6-7 right disc herniation who underwent anterior discectomy and received a total disc replacement using ProDisc C artificial disc prosthesis. PMID:23599830

  13. Early cervical adenocarcinoma: selection criteria for radical surgery

    Microsoft Academic Search

    John O. Schorge; Kenneth R. Lee; Sandra J. Lee; Cynthia E. Flynn; Annekathryn Goodman; Ellen E. Sheets

    1999-01-01

    Objective: To identify selection criteria for radical surgery in early cervical adenocarcinoma based on pretreatment clinical stage and correlation with high-risk surgical-pathologic factors.Methods: One hundred seventy-five women with International Federation of Gynecology and Obstetrics (FIGO) clinical stage IB1 (n = 132) and IB2-IIA (n = 43) cervical adenocarcinoma were treated primarily at our institutions from 1982 to 1996. Histopathologic sections

  14. HPV types and cofactors causing cervical cancer in Peru

    Microsoft Academic Search

    C Santos; N Muñoz; S Klug; M Almonte; I Guerrero; M Alvarez; C Velarde; O Galdos; M Castillo; J Walboomers; C Meijer; E Caceres

    2001-01-01

    We conducted a hospital-based case-control study in Peru of 198 women with histologically confirmed cervical cancer (173 squamous cell carcinomas and 25 cases of adenocarcinoma\\/adenosquamous carcinoma) and 196 control women. Information on risk factors was obtained by personal interview. Using PCR-based assays on exfoliated cervical cells and biopsy specimens, HPV DNA was detected in 95.3% of women with squamous cell

  15. [Whiplash injury analysis of cervical vertebra by finite element method].

    PubMed

    Wang, Tao; Li, Zheng-Dong; Shao, Yu; Chen, Yi-Jiu

    2015-02-01

    Finite element method (FEM) is an effective mathematical method for stress analysis, and has been gradually applied in the study of biomechanics of human body structures. This paper reviews the construction, development, materials assignment and verification of FEM model of cervical vertebra, and it also states the research results of injury mechanism of whiplash injury and biomechanical response analysis of the cervical vertebra using FEM by researchers at home and abroad. PMID:26058135

  16. Cervical fixation in the pediatric patient: our experience

    Microsoft Academic Search

    Marco Crostelli; Massimo Mariani; Osvaldo Mazza; Elio Ascani

    2009-01-01

    The surgical management of cervical instability in children is a challenging issue. Although the indications for internal\\u000a fixation are similar to those for adults, accurate pre-surgery study and sharp surgical techniques are necessary because of\\u000a the size of such patients’ anatomy, their peculiar tissue biology and the wide spectrum of diseases requiring cervical fusion.\\u000a Our case study is made up

  17. Cystic spinal dysraphism of the cervical and upper thoracic region

    Microsoft Academic Search

    J. Francisco Salomão; Sérgio Cavalheiro; René D. Leibinger; Antonio R. Bellas; Elide Vanazzi; Luiz A. M. de Souza; Andréa G. Nardi

    2006-01-01

    Background  Cystic dysraphic lesions of the cervical and upper thoracic region are rare and only a few series have been published about the topic. These malformations can be divided into categories that include both myelocystoceles and the so-called cervical meningoceles or myelomeningoceles.Methods  A retrospective study of 18 patients was conducted.Results  In 17 patients a squamous or a cicatricial epithelium of variable thickness covered

  18. Anterior discectomy without interbody fusion for cervical disc herniation

    Microsoft Academic Search

    V. Pointillart; A. Cernier; J. M. Vital; J. Senegas

    1995-01-01

    Between 1985 and 1990, 68 patients with cervical radiculopathy due to soft disc herniation were treated by anterior cervical discectomy without interbody fusion. Eleven patients were unavailable for follow-up examination. The mean follow-up was 23 months (range 12–54 months). Both clinical and radiographic follow-ups were done, and 92% of the patients was found to have excellent or good clinical results.

  19. Effect of rigid cervical collar on tracheal intubation using Airtraq®

    PubMed Central

    Durga, Padmaja; Yendrapati, Chiranjeevi; Kaniti, Geeta; Padhy, Narmada; Anne, Kiran Kumar; Ramachandran, Gopinath

    2014-01-01

    Background and Aims: Cervical spine immobilisation with rigid cervical collar imposes difficulty in intubation. Removal of the anterior part of the collar may jeopardize the safety of the cervical spine. The effect of restricted mouth opening and cervical spine immobilisation that result from the application of rigid cervical collar on intubation using Airtraq® was evaluated. Methods: Seventy healthy adults with normal airways included in the study were intubated Using Airtraq® with (group C) and without rigid cervical collar (group NC). The ease of insertion of Airtraq® into the oral cavity, intubation time, intubation difficulty score (IDS) were compared using Wilcoxon sign ranked test and McNemar test, using SPSS version 13. Results: Intubation using Airtraq® was successful in the presence of the cervical collar in 96% which was comparable to group without collar (P = 0.24). The restriction of mouth opening resulted in mild difficulty in insertion of Airtraq®. The median Likert scale for insertion was - 1 in the group C and + 1 in group NC (P < 0.001). The intubation time was longer in group C (30 ± 14.3 s vs. 26.9 ± 14.8 s) compared to group NC. The need for adjusting manoeuvres was 18.5% in group C versus 6.2% in group NC (P = 0.003) and bougie was required in 12 (18.5%) and 4 (6.2%) patients in group C and NC, respectively, to facilitate intubation (P = 0.02). The modified IDS score was higher in group C but there was no difference in the number of patients with IDS < 2. Conclusion: Tracheal intubation using Airtraq® in the presence of rigid cervical collar has equivalent success rate, acceptable difficulty in insertion and mild increase in IDS. PMID:25197109

  20. Theophylline for Bradycardia Secondary to Cervical Spinal Cord Injury

    Microsoft Academic Search

    Farid SadakaSoophia; Soophia Khan Naydenov; John J. Ponzillo

    2010-01-01

    Background  Spinal cord injury (SCI) is a devastating disease process that can occur as a consequence of motor vehicle collisions, falls,\\u000a or other traumatic injuries. Persistent bradycardia was found to be universally present in all high cervical SCI patients.\\u000a Limited data exists to suggest the most effective therapy for the bradycardia associated with high cervical SCI. Treatment\\u000a includes atropine, epinephrine, dopamine,

  1. Primary Radiotherapy of StageIIA\\/B–IIIB Cervical Carcinoma

    Microsoft Academic Search

    Árpád Mayer; Csaba Nemeskéri; Csaba Petneházi; Gábor Borgulya; Szilvia Varga; Attila Naszály

    2004-01-01

    Background: Comprehensive literature on cervical cancer demonstrates, even today, the need for optimization of the timing of external-beam radiotherapy (EBRT) and high-dose-rate brachytherapy (HDR-BT) in the treatment of stage IIA\\/B–IIIB cervical carcinoma. Patients and Methods: 210 patients with carcinoma of the cervix were treated in the Municipal Center of Oncoradiology between January 1991 and December 1996 (FIGO IIA: n =

  2. Minimally Invasive Therapy of Cervical Intraepithelial Neoplasia for Fertility Preservation

    Microsoft Academic Search

    Darko Milinovic; Drzislav Kalafatic; Damir Babic; Lidija Beketic Oreskovic; Helena Lovric Grsic; Slavko Oreskovic

    2009-01-01

    The aim of this study was to determine the extension of cervical intraepithelial neoplasia grade III (CIN III) into endocervical\\u000a canal and depth of endocervical crypts involvement by CIN with the regard to patients’ age and parity. Correlation between\\u000a the area of CIN involvement and the extension into endocervical canal was estimated. A total of 218 cervical cone specimens\\u000a with

  3. The association between Chlamydia cervicitis, chorioamnionitis and neonatal complications

    Microsoft Academic Search

    G. G. G. Donders; P. Moerman; G. H. De Wet; P. Hooft; P. Goubau

    1991-01-01

    Summary  In a prospective study on genital infections, the influence of Chlamydial cervicitis on pregnancy outcome was evaluated. In\\u000a eleven women with Chlamydial cervicitis perinatal outcome was recorded, the placenta was examined and the newborns were screened\\u000a for Chlamydial conjunctivitis. They were compared with 13 women who were negative for Chlamydia and were delivered immediately\\u000a after a Chlamydia positive woman. Compared

  4. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    Although human papillomavirus (HPV) infection is a significant factor in the development of most cervical and vulvar cancers, large population-based studies have implied an inherited predisposition to these cancers. Cell-mediated immune mechanisms, including human leukocyte antigen (HLA) type 1 and 2 cytokines, determine an individual's response to HPV infection. Investigators propose to analyze associations of HLA class I and II alleles with the risk of cervical and vulvar cancers.

  5. Cervical facet joint kinematics during bilateral facet dislocation

    Microsoft Academic Search

    Manohar M. Panjabi; Andrew K. Simpson; Paul C. Ivancic; Adam M. Pearson; Yasuhiro Tominaga; James J. Yue

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual\\u000a ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation\\u000a was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra,\\u000a tilted posteriorly by 42.5°. Average peak

  6. HPV-related cervical disease and oropharyngeal cancer.

    PubMed

    Lozza, Virginia; Pieralli, Annalisa; Corioni, Serena; Longinotti, Manuela; Bianchi, Claudia; Moncini, Daniela; Fallani, Maria Grazia

    2014-08-01

    Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervical and oral cancer. We show the case of a woman affected by HPV-related cervical disease and oropharyngeal squamous cell carcinoma (OPSCC). A 41-year-old woman arrived at our Colposcopy Center following an abnormal Pap smear result (ASC-H) and a diagnosis of moderate cervical dysplasia obtained by a cervical biopsy. She underwent a colposcopy that showed a cervical abnormal transformation zone grade 2. A laser conization was performed in November 2010. Histology reported a moderate/severe dysplasia. The cone resection margins were free. Follow-up colposcopy and cytology were negative. The HPV testing showed an infection by HPV 16. In October 2012, the patient presented to the Head-Neck ER after episodes of hemoptysis; a lesion was found in the left tonsillar lodge. A biopsy was performed with a result of squamous cell carcinoma with low-grade differentiation. The HPV testing detected a high-risk HPV and the immunohistochemical analysis was positive for p16. She was treated by chemotherapy and brachytherapy. She was followed at the head-neck center with monthly visits with oral visual inspection that showed complete absence of mucosal abnormalities. HPV-related OPSCC and cervical precancerous/cancerous lesions have significant similarities in terms of pathogenesis. They are both caused largely by HPV 16, as in the present case. In conclusion, because of this association found in literature and in our case, we think that women with HPV cervical lesions should have regular surveillance for oropharyngeal cancer, whereas women with OPSCC should be encouraged to have diligent cervical screening. PMID:24584479

  7. Stage IA 1 cervical adenocarcinoma: definition and treatment

    Microsoft Academic Search

    John O. Schorge; Kenneth R. Lee; Cynthia E. Flynn; Annekathryn Goodman; Ellen E. Sheets

    1999-01-01

    Objective: To propose a definition for stage IA1 cervical adenocarcinoma, based on the International Federation of Gynecology and Obstetrics (FIGO) staging system, and to determine if patients meeting criteria might be candidates for conservative surgery.Methods: Two hundred women were diagnosed with early-stage cervical adenocarcinoma from 1982 to 1996. Histopathologic sections were reviewed by a gynecologic pathologist. Medical records were reviewed,

  8. Diagnosis and treatment of cervical carcinomas, number 35, May 2002

    Microsoft Academic Search

    2002-01-01

    Invasive cervical carcinoma, once the most common reporductive-tract cancer in the United States, has recently fallen to the rank of third most common. Globally, cervical cancer is a major health problem, with a yearly incidence of 371,000 cases and an annual death rate of 190,000 (1). The International Federation of Gynecology and Obstetrics (FIGO) recently revised its staging criteria. In

  9. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    Conducted in India, this study is evaluating the effectiveness of a well-planned health education breast and cervical cancer program in regions where there are limited resources. By using trained primary health workers to conduct low-cost screening methods, such as a clinical breast examination or visual inspection of the cervix painted with 4% acetic acid, the study hopes to reduce the incidence of cervical cancer and mortality.

  10. DCCPS: BRP: PCRB: Key Initiatives: HPV and Cervical Cancer Research

    Cancer.gov

    The overall goal of this study is to determine the association between serum biomarkers of oxidant load and cervical carcinogenesis among women from the Ludwig-McGill Cohort Study. The Ludgwig-McGill Cohort Study is a large prospective study which collected multiple measurements of relevant risk factors (e.g., smoking, presence of cervical inflammatory cells, dietary and circulatory concentrations of antioxidant nutrients) and endpoints (e.g., type-specific HPV persistence, viral load, and development of SIL).

  11. Injectable silk foams for the treatment of cervical insufficiency

    NASA Astrophysics Data System (ADS)

    Fournier, Eric P.

    Preterm birth is the leading cause of neonatal mortality, resulting in over 4,000 deaths each year. A significant risk factor for preterm birth is cervical insufficiency, the weakening and subsequent deformation of cervical tissue. Cervical insufficiency is both detectable and treatable but current treatments are lacking. The most common approach requires multiple invasive procedures. This work investigates the injection of silk foams, a minimally-invasive method for supporting cervical tissue. Silk offers many advantages for use as a biomaterial including strength, versatility, and biocompatibility. Injectable silk foams will minimize patient discomfort while also providing more targeted and personalized treatment. A battery of mechanical testing was undertaken to determine silk foam response under physiologically relevant loading and environmental conditions. Mechanical testing was paired with analysis of foam morphology and structure that illustrated the effects of injection on pore geometry and size. Biological response to silk foams was evaluated using an in vitro degradation study and subcutaneous in vivo implantation in a mouse model. Results showed that foams exceeded the mechanical requirements for stiffening cervical tissue, although the current injection process limits foam size. Injection was shown to cause measurable but localized foam deformation. This work indicates that silk foams are a feasible treatment option for cervical insufficiency but challenges remain with foam delivery.

  12. In vivo and in vitro hyperspectral imaging of cervical neoplasia

    NASA Astrophysics Data System (ADS)

    Wang, Chaojian; Zheng, Wenli; Bu, Yanggao; Chang, Shufang; Tong, Qingping; Zhang, Shiwu; Xu, Ronald X.

    2014-02-01

    Cervical cancer is a prevalent disease in many developing countries. Colposcopy is the most common approach for screening cervical intraepithelial neoplasia (CIN). However, its clinical efficacy heavily relies on the examiner's experience. Spectroscopy is a potentially effective method for noninvasive diagnosis of cervical neoplasia. In this paper, we introduce a hyperspectral imaging technique for noninvasive detection and quantitative analysis of cervical neoplasia. A hyperspectral camera is used to collect the reflectance images of the entire cervix under xenon lamp illumination, followed by standard colposcopy examination and cervical tissue biopsy at both normal and abnormal sites in different quadrants. The collected reflectance data are calibrated and the hyperspectral signals are extracted. Further spectral analysis and image processing works are carried out to classify tissue into different types based on the spectral characteristics at different stages of cervical intraepithelial neoplasia. The hyperspectral camera is also coupled with a lab microscope to acquire the hyperspectral transmittance images of the pathological slides. The in vivo and the in vitro imaging results are compared with clinical findings to assess the accuracy and efficacy of the method.

  13. Requirement for Stromal Estrogen Receptor Alpha in Cervical Neoplasia

    PubMed Central

    Chung, Sang-Hyuk; Shin, Myeong Kyun; Korach, Kenneth S.; Lambert, Paul F.

    2012-01-01

    The major etiological factor for cervical cancer is the high-risk human papillomavirus (HPV), which encodes E6 and E7 oncogenes. However, HPV is not sufficient and estrogen has been proposed as an etiological cofactor for the disease. Its requirement has been demonstrated in mouse models for HPV-associated cervical cancer (e.g., K14E7 transgenic mice). Although germline knockout of estrogen receptor alpha (ER?) renders mice resistant to cervical cancer, the cell type-specific requirement for ER? is not known. In this study, we demonstrate that temporal deletion of stromal ER? induced complete regression of cervical dysplasia in K14E7 mice. Our results strongly support the hypothesis that stromal ER? is necessary for HPV-induced cervical carcinogenesis and implicate paracrine mechanisms involving ER? signaling in the development of estrogen-dependent cervical cancers. This is the first evidence to support the importance of stromal ER? in estrogen-dependent neoplastic disease of the female reproductive tract. PMID:23065599

  14. Natural history and epidemiology of HPV infection and cervical cancer.

    PubMed

    Castellsagué, Xavier

    2008-09-01

    Cervical cancer is the most common cancer affecting women in developing countries. It has been estimated to have been responsible for almost 260 000 deaths annually, of which about 80% occurred in developing countries. Persistent infection by certain oncogenic HPV types is firmly established as the necessary cause of most premalignant and malignant epithelial lesions of the cervix and of a variable fraction of neoplastic lesions of the vulva, vagina, anus, penis, and oropharynx. There are more than 100 known HPV genotypes, at least 15 of which can cause cancer of the cervix and other sites. HPV 16 and 18, the two most common oncogenic types, cause approximately 70% of all cervical cancers worldwide. HPV, especially genotypes 6 and 11, can also cause genital warts. HPV is highly transmissible and it is now considered the most common sexually transmitted infection in most populations. Although most women infected with the virus become negative within 2 years, women with persistent high-risk HPV infections are at greatest risk for developing cervical cancer. Since the identification of HPV as the necessary cause of cervical cancer, HPV-based technology has become the centre of novel primary and secondary cervical cancer prevention strategies by the introduction of HPV testing in screening and of HPV vaccines in preadolescent girls and young women. If implemented widely and wisely the deployment of these protocols has the potential to complete Papanicolaou's goal of cervical cancer eradication by extending the benefits of prevention to the developing populations of the world. PMID:18760711

  15. Cervical cancer prevention in the human papilloma virus vaccine era.

    PubMed

    Ghazal-Aswad, Saad

    2008-09-01

    Globally, cervical cancer is second only to breast cancer as the leading cause of cancer in women, with a global prevalence of 2.3 million. It is the third most common cause of female cancer-related mortality worldwide, and 82% of new cervical cancer cases occur in developing countries. As stated by WHO, "without screening programs, cervical cancer is detected too late and leads to death in almost all cases." However, even in Europe, the United States, and Canada, where most women have access to routine screening, approximately 30,000 women die each year. Infection with oncogenic types of HPV 16 and 18 is the most significant risk/causative factor in cervical cancer etiology, and worldwide HPV positivity in cervical carcinoma has been documented to be 99.7%. In 2006 Merck's quadrivalent vaccine was approved by FDA. It targets four HPV types (6, 11, 16, and 18) that are involved in cervical cancer, high and low grade squamous intraepithelial lesions, and anogenital warts. Results from combined Phase II/III studies show that the efficacy of vaccine was 95-100% against LGSIL and HGSIL related to HPV 16 and 18 and vaccine use led to a 99% reduction in the incidence of genital warts (related to HPV 6 and 11). Due to morbidity associated with infection with HPV types 6, 11, 16, and 18, a prophylactic quadrivalent HPV vaccine targeting these four HPV types is expected to substantially reduce the burden of HPV-related disease. PMID:18837904

  16. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    ClinicalTrials.gov

    2014-12-23

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  17. Flexitouch® Home Maintenance Therapy or Standard Home Maintenance Therapy in Treating Patients With Lower-Extremity Lymphedema Caused by Treatment for Cervical Cancer, Vulvar Cancer, or Endometrial Cancer

    ClinicalTrials.gov

    2014-12-29

    Lymphedema; Stage 0 Cervical Cancer; Stage 0 Uterine Corpus Cancer; Stage 0 Vulvar Cancer; Stage I Uterine Corpus Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Vulvar Cancer; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer; Stage IVB Vulvar Cancer

  18. A unified sample preparation protocol for proteomic and genomic profiling of cervical swabs to identify biomarkers for cervical cancer screening

    PubMed Central

    Rader, Janet S.; Malone, James P; Gross, Julia; Gilmore, Petra; Brooks, Rebecca A.; Nguyen, Loan; Crimmins, Dan L.; Feng, Sheng; Wright, Jason D.; Taylor, Nicolas; Zighelboim, Israel; Funk, Margo C; Huettner, Phyllis C.; Ladenson, Jack H.; Gius, David; Townsend, R. Reid

    2011-01-01

    Cervical cancer screening is ideally suited for the development of biomarkers due to the ease of tissue acquisition and the well-established histological transitions. Furthermore, cell and biologic fluid obtained from cervix samples undergo specific molecular changes that can be profiled. However, the ideal manner and techniques for preparing cervical samples remains to be determined. To address this critical issue a patient screening protein and nucleic acid collection protocol was established. RNAlater was used to collect the samples followed by proteomic methods to identify proteins that were differentially expressed in normal cervical epithelial versus cervical cancer cells. Three hundred ninety spots were identified via two-dimensional difference gel electrophoresis (2-D DIGE) that were expressed at either higher or lower levels (>3-fold) in cervical cancer samples. These proteomic results were compared to genes in a cDNA microarray analysis of microdissected neoplastic cervical specimens to identify overlapping patterns of expression. The most frequent pathways represented by the combined dataset were: cell cycle: G2/M DNA damage checkpoint regulation; aryl hydrocarbon receptor signaling; p53 signaling; cell cycle: G1/S checkpoint regulation; and the endoplasmic reticulum stress pathway. HNRPA2B1 was identified as a biomarker candidate with increased expression in cancer compared to normal cervix and validated by Western blot. PMID:21136816

  19. Posterolateral microdisectomy for cervical monoradiculopathy caused by posterolateral soft cervical disc sequestration.

    PubMed

    Aldrich, F

    1990-03-01

    The controversy over whether to use a posterior or anterior approach for surgical treatment of soft cervical discs is still largely unsettled. However, although the posterior approach may be underutilized, it has distinct advantages when there are specific indications. Out of a large pool of cases, 53 patients presented with acute monoradiculopathy caused by soft cervical disc herniation. In 36 of these, the disc was sequestered (nonconfined) and was posterolateral to the disc space as seen on computerized tomography-myelography. Distinct motor weakness was a common clinical finding in all 36 cases. These patients were treated by using a 2- to 3-cm skin incision for the posterolateral microsurgical approach. The extent of the lateral facetectomy depended upon the relationship between the nerve root and the disc. All fragments were lateral to the dural sac and were sequestered through the anulus fibrosus and the posterior longitudinal ligament. Sequestrations were removed under direct microscopic vision, but the disc space was not entered. Pain relief and motor-power improvement in the affected radicular distribution were immediate in all patients. Sensory deficit and residual motor loss improved dramatically with normalization at approximately 6 months. No complications occurred and the mean hospital stay was 2 days. The follow-up period varied from 4 to 42 months with a mean of 26 months. Thus far, there have been no recurrences or other associated complications. By using strict selection criteria and a microsurgical posterolateral approach with removal of the sequestered disc fragment, excellent results with normalization of the monoradiculopathy can be obtained. The ease of this technique, low risk, minimal complications, and excellent results make it an attractive alternative to the anterior approach. The clinical presentations, specific indications, surgical technique, and clinical results are discussed; and a prototype of a small cervical self-retaining retractor is described. PMID:2303870

  20. Optimal management of locally advanced cervical carcinoma.

    PubMed

    Keys, H; Gibbons, S K

    1996-01-01

    Locally advanced or recurrent cervical cancer is highly responsive to treatment and at least moderately curable with effective aggressive treatment. Radiation therapy is the mainstay of treatment for patients with this cancer. The roles for surgery and chemotherapy are as yet unproved, and both modalities are currently under investigation for their potential roles in the management of these conditions. Exenterative surgery clearly has an established utility for central pelvic failures after prior radiation therapy. Postsurgical pelvic recurrences are rarely successfully treated for cure, but considerable palliative effect is possible. The roles of intraoperative irradiation, sensitizing chemotherapy, and radical resection with interstitial irradiation are all under investigation at this time. Much has been learned over the past several decades about what parameters are important for successful radiation therapy for cervical cancers of stages IIB-IVA. While the traditional staging work-up for these patients included excretory urography, barium enema, examination under anesthesia, cystoscopy, and proctoscopy, there is now good evidence that computed tomography scan with intravenous contrast and office examination and biopsy are sufficient, with cystoscopy reserved for those few patients in whom clinical or imaging data suggest a higher risk of involvement. Surgical lymph node staging, especially of para-aortic lymph nodes, may be worthwhile in certain settings (e.g., for entry into research protocols), but it has no demonstrated role in routine clinical practice. Evidence is clear and convincing that effective treatment for these disease stages requires the inclusion of intracavitary brachytherapy. The role of interstitial brachytherapy is less clear, although there are some fervent advocates of this procedure. The debate continues about the use of low-dose-rate versus high-dose-rate brachytherapy. Treatment dose, volume, and length of treatment course are all important variables with outcome implications. The central disease requires a total dose of 8000-9000 cGy for maximal control probability, with larger tumors requiring the higher doses. The three-dimensional treatment volume must adequately surround the cancer and its likely routes of spread. Overall treatment time should be kept as short as possible, within the limits of conventional, tolerable fractionation. The potential theoretical advantage of hyperfractionated external-beam irradiation has yet to be verified in this disease but is of interest. It will be tested in an upcoming Gynecologic Oncology Group clinical trial. The negative prognostic significance of hypoxia in cervical cancers in general has been reported recently. While tumor cell hypoxia is almost certainly a problem in this disease, hypoxic cell sensitizers have not yet been found to improve treatment results. In clinical practice, reoxygenation probably occurs in these tumors. The role of paraaortic lymph node elective irradiation has been of interest for more than 20 years and was the subject of two randomized trials with quite different results. The Radiation Therapy Oncology Group trial found significantly improved survival in the treatment group assigned to receive paraaortic irradiation, when compared with the pelvic treatment group. However, a similar study by the European Organization for Research and Treatment of Cancer found no difference. The results of treatment today are substantially improved from those seen two decades ago. About 75% of patients with stage IIB disease and fully 50% of patients with stage IIIB disease are now cured with conventional irradiation alone. Clearly, there is still a need for further improvement. Of patients with urinary bladder involvement, 10%-20% are long-term survivors, as are 25%-30% of patients with para-aortic lymph node metastases. While these improvements are significant, there is clearly room for further progress. (ABSTRACT TRUNCATED) PMID:9023835

  1. Spontaneous cervical haemorrhage of a parathyroid adenoma

    PubMed Central

    Knee, Graham; Todd, Colin

    2015-01-01

    Summary Haemorrhage of a parathyroid adenoma is a rare clinical presentation. This report describes a previously fit and well 54-year-old woman who presented with acute neck swelling and pain with an overlying ecchymosis. Admission laboratory tests revealed a raised parathyroid hormone and hypercalcaemia. A computed tomography (CT) scan showed widespread anterior cervical haemorrhage and a lesion at the inferior pole of the left thyroid gland. A working diagnosis of spontaneous haemorrhage from a parathyroid adenoma was made. As she was haemodynamically stable, she was treated conservatively with a period of observation in hospital to monitor for signs of neck organ compression. Follow-up imaging with CT, ultrasound and sestamibi confirmed the likely source of haemorrhage as a parathyroid nodule with significant vascularity. The diagnosis was confirmed on histopathological analysis after elective surgical exploration of the neck 6 months after her presentation. This revealed a benign parathyroid adenoma with evidence of acute and chronic bleeding. The patient made a full recovery with immediate normalisation of her biochemistry post-operatively. Despite developing a hoarse voice in the immediate post-operative period, this resolved completely within 1 month. This case report provides further evidence to support a minimal delay for elective surgery after conservative management to reduce the risks associated with recurrent bleeding. Learning points Haemorrhage of a parathyroid adenoma should be a differential for all cases of acute cervical swelling or ecchymosis with no precipitating factor.The clerking should identify any risk factors for endocrine disease.Blood tests to screen for abnormal parathyroid biochemistry should be performed on admission.Detailed imaging of the neck is essential to identify the source of haemorrhage and risk of compression to vital neck organs.Conservative management is a suitable option for patients who remain haemodynamically stable but all should undergo a period of observation in hospital.Conservatively managed patients should be considered for definitive surgical exploration within a month of presentation to avoid the risks of recurrent bleeding. PMID:26124955

  2. Epidemiology of cervical cancer with special focus on India

    PubMed Central

    Sreedevi, Aswathy; Javed, Reshma; Dinesh, Avani

    2015-01-01

    Cervical cancer is on the declining trend in India according to the population-based registries; yet it continues to be a major public health problem for women in India. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper. This paper attempts to review the available knowledge regarding the epidemiology and pattern of cervical cancer; types of HPV (human papilloma virus) prevalent among cervical cancer patients and among women in general, high-risk groups such as commercial sex workers, and HIV (human immunodeficiency virus)-positive women; and the role of the national program on cancer in control efforts. The peak age of incidence of cervical cancer is 55–59 years, and a considerable proportion of women report in the late stages of disease. Specific types of oncogenic HPV-16, 18 have been identified in patients with cervical cancer. Other epidemiological risk factors are early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, use of oral contraceptives, and lack of awareness. A multipronged approach is necessary which can target areas of high prevalence identified by registries with a combination of behavior change communication exercises and routine early screening with VIA. Sensitizing the people of the area, including menfolk, is necessary to increase uptake levels. Vaccination against types 16 and 18 can also be undertaken after taking into confidence all stakeholders, including the parents of adolescent girls. Preventing and treating cervical cancer and reducing the burden are possible by targeting resources to the areas with high prevalence. PMID:25931830

  3. An historical look at a contemporary question: the cervical cap.

    PubMed

    Zimmet, J A; Reagan, P A

    1986-01-01

    The cervical cap was most likely invented during the 19th century and was rediscovered in 1908 by a Viennese physician. The cap was always more popular in Europe than in the US, and the introduction of oral contraceptives and the IUD in the 1960s led to a declining interest in barrier methods. In 1977, the US Food and Drug Administration banned distribution of the cervical cap, presumably in reaction to outbreaks of toxic shock syndrome and despite rising interest in the device on the part of the woman's health movement. It is important for health educators to be informed about empirical research about the cervical cap so that they can counsel consumers in the event that the device is reclassified for general use. Acceptor studies have identified convenience, safety, spontaneity, and comfort as reasons for selecting the cervical cap, while difficult insertion and removal, odor, partner discomfort, and uncertainty about contraceptive effectiveness are cited as reasons for disliking this device. Dislodgement has been a major problem, experienced by almost half of cap acceptors at some point. Discontinuation rates after 6 months of use have been in the 25-40% range. No cases of pelvic inflammatory disease or significant cervical pathology have been recorded. The unplanned pregnancy rate associated with the cervical cap has been estimated to be about 8%. Omission of spermicide, dislodgement, faulty technique, and irregular usage account for most of these failures. There is a need for additional research addressing the issues and documenting the limits of safe cervical cap use. PMID:3152361

  4. Epidemiology of cervical cancer with special focus on India.

    PubMed

    Sreedevi, Aswathy; Javed, Reshma; Dinesh, Avani

    2015-01-01

    Cervical cancer is on the declining trend in India according to the population-based registries; yet it continues to be a major public health problem for women in India. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper. This paper attempts to review the available knowledge regarding the epidemiology and pattern of cervical cancer; types of HPV (human papilloma virus) prevalent among cervical cancer patients and among women in general, high-risk groups such as commercial sex workers, and HIV (human immunodeficiency virus)-positive women; and the role of the national program on cancer in control efforts. The peak age of incidence of cervical cancer is 55-59 years, and a considerable proportion of women report in the late stages of disease. Specific types of oncogenic HPV-16, 18 have been identified in patients with cervical cancer. Other epidemiological risk factors are early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, use of oral contraceptives, and lack of awareness. A multipronged approach is necessary which can target areas of high prevalence identified by registries with a combination of behavior change communication exercises and routine early screening with VIA. Sensitizing the people of the area, including menfolk, is necessary to increase uptake levels. Vaccination against types 16 and 18 can also be undertaken after taking into confidence all stakeholders, including the parents of adolescent girls. Preventing and treating cervical cancer and reducing the burden are possible by targeting resources to the areas with high prevalence. PMID:25931830

  5. Screening of cervical cancer in Catalonia 2006–2012

    PubMed Central

    de Sanjosé, Silvia; Ibáñez, Raquel; Rodríguez-Salés, Vanesa; Peris, Mercè; Roura, Esther; Diaz, Mireia; Torné, Aureli; Costa, Dolors; Canet, Yolanda; Falguera, Gemma; Alejo, Maria; Espinàs, Josep Alfons; Bosch, F. Xavier

    2015-01-01

    The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008–2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden. PMID:25987901

  6. Survival rates of cervical cancer patients in Malaysia.

    PubMed

    Muhamad, Nor Asiah; Kamaluddin, Muhammad Amir; Adon, Mohd Yusoff; Noh, Mohamed Asyraf; Bakhtiar, Mohammed Faizal; Ibrahim Tamim, Nor Saleha; Mahmud, Siti Haniza; Aris, Tahir

    2015-01-01

    Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate. PMID:25854407

  7. Screening of cervical cancer in Catalonia 2006-2012.

    PubMed

    de Sanjosé, Silvia; Ibáñez, Raquel; Rodríguez-Salés, Vanesa; Peris, Mercè; Roura, Esther; Diaz, Mireia; Torné, Aureli; Costa, Dolors; Canet, Yolanda; Falguera, Gemma; Alejo, Maria; Espinàs, Josep Alfons; Bosch, F Xavier

    2015-01-01

    The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008-2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden. PMID:25987901

  8. Up-Regulation of miR-21 Is Associated with Cervicitis and Human Papillomavirus Infection in Cervical Tissues

    PubMed Central

    Bumrungthai, Sureewan; Ekalaksananan, Tipaya; Evans, Mark Francis; Chopjitt, Peechanika; Tangsiriwatthana, Thumwadee; Patarapadungkit, Natcha; Kleebkaow, Pilaiwan; Luanratanakorn, Sanguanchoke; Kongyingyoes, Bunkerd; Worawichawong, Suchin; Pientong, Chamsai

    2015-01-01

    MicroRNA-21 (miR-21) is recognized as an oncomir and shows up-regulation in many types of human malignancy. The aim of this study was to investigate the association of miR-21 expression associated with HPV infection in normal and abnormal cervical tissues. Cervical tissue samples with different cytological or histopathological grades were investigated for HPV by PCR and for miR-21 and programmed cell death, protein 4 (PDCD4) expression using quantitative real-time PCR (qRT-PCR). Laser capture microdissection (LCM) of stromal and epithelial tissues and in situ hybridization (ISH) using locked nucleic acid (LNA) probes were performed on a subset of fixed specimens. Cell line experiments were conducted on fibroblasts stimulated in culture media from HeLa cells, which were then assessed for miR-21, PDCD4, IL-6 and ?-SMA expression by qRT-PCR. Twenty normal cervical cell, 12 cervicitis, 14 cervical intraepithelial neoplastic I (CIN I), 22 CIN II-III and 43 cervical squamous cell carcinoma (SCC) specimens were investigated. miR-21 levels were significantly lower in normal than in abnormal tissues. The expression of miR-21 in HPV negative normal cytology was significantly lower than in HPV positive samples in abnormal tissue and SCC. The miR-21 expression was significantly higher in HPV negative cervicitis than HPV negative normal cells. LCM and ISH data showed that miR-21 is primarily expressed in the tumor-associated stromal cell microenvironment. Fibroblasts treated with HeLa cell culture media showed up-regulated expression of miR-21, which correlated with increased expression of ?-SMA and IL-6 and with down-regulation of PDCD4. These results demonstrate that miR-21 is associated with HPV infection and involved in cervical lesions as well as cervicitis and its up-regulation in tumor-stroma might be involved in the inflammation process and cervical cancer progression. PMID:26010154

  9. Visualization of HTLV-1–Specific Cytotoxic T Lymphocytes in the Spinal Cords of Patients With HTLV-1–Associated Myelopathy/Tropical Spastic Paraparesis

    PubMed Central

    Matsuura, Eiji; Kubota, Ryuji; Tanaka, Yuetsu; Takashima, Hiroshi; Izumo, Shuji

    2015-01-01

    Abstract Activated human T-lymphotropic virus type-1 (HTLV-1)–specific CD8-positive cytotoxic T lymphocytes (CTLs) are markedly increased in the periphery of patients with HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP), an HTLV-1–induced inflammatory disease of the CNS. Although virus-specific CTLs play a pivotal role to eliminate virus-infected cells, the potential role of HTLV-1–specific CTLs in the pathogenesis of HAM/TSP remains unclear. To address this issue, we evaluated the infiltration of HTLV-1–specific CTLs and the expression of HTLV-1 proteins in the spinal cords of 3 patients with HAM/TSP. Confocal laser scanning microscopy with our unique staining procedure made it possible to visualize HTLV-1–specific CTLs infiltrating the CNS of the HAM/TSP patients. The frequency of HTLV-1–specific CTLs was more than 20% of CD8-positive cells infiltrating the CNS. In addition, HTLV-1 proteins were detected in CD4-positive infiltrating T lymphocytes but not CNS resident cells. Although neurons were generally preserved, apoptotic oligodendrocytes were frequently in contact with CD8-positive cells; this likely resulted in demyelination. These findings suggest that the immune responses of the CTLs against HTLV-1–infected CD4-positive lymphocytes migrating into the CNS resulted in bystander neural damage. PMID:25470342

  10. Association of IL-10 Gene Polymorphisms and Human T Lymphotropic Virus Type I-Associated Myelopathy/tropical Spastic Paraparesis in North-East of Iran (Mashhad).

    PubMed

    Shirdel, Abbas; Azarpazhooh, Mahmoud Reza; Sahebari, Maryam; Ghanbari, Mohsen; Mirfeizi, Seyedeh Zahra; Hutchinson, Ian; Ziaee, Aghigh; Rafatpanah, Houshang

    2013-03-01

    The underlying mechanisms leading to the development of human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) in HTLV-I infected individuals are not fully understood. Host genetic factors appear to be involved as risk factors for developing HAM/TSP. We investigated the possible contribution of interleukin-10 (IL-10) as a risk factor to HAM/TSP by comparing frequencies of promoter region single nucleotide polymorphisms in HTLV-I infected Iranian patients who either remained asymptomatic or developed HAM/TSP and asymptomatic HTLV-I carriers. Healthy, uninfected individuals from the same region served as healthy controls. Significant differences were observed in the distribution of IL-10 promoter alleles and genotypes at position -819 and -592 between HAM/TSP patients and healthy controls (P=0.01), and between HTLV-I carriers and healthy controls (P=0.02). The frequency of the low IL-10 producer haplotype (-1082*A, -819*T, -592*A) was significantly associated with HTLV-I carriage or HAM/TSP compared with healthy controls (P=0.02 and 0.01, respectively). Our results suggest that IL-10 -819*T and -592*A alleles are significant risk factors for developing HTLLV-I infection but do not appear to convey additional risk for developing HAM/TSP. PMID:24470873

  11. The Impact of Immune Response on HTLV-I in HTLV-I-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP).

    PubMed

    Rafatpanah, Houshang; Farid Hosseini, Reza; Pourseyed, Seyed Hassan

    2013-03-01

    Human T lymphotropic virus type I (HTLV-I) is a retrovirus which is associated with adult T cells leukaemia (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in a minority of HTLV-I-infected individuals. It is not clear why a minority of HTLV-I-infected individuals develop HAM/TSP and majority remains lifelong carriers. It seems that the interaction between the virus and the immune response plays an important role in HTLV-I-associated diseases. Although the role of the immune response in HTLV-I pathogenesis is not fully understood, however it seems that the efficacy of the immune response which is involved in controlling or limiting of viral persistence determines the outcome of HTLV-I-associated diseases. Here we discuss the role of innate and adaptive immune response and also the risk factors contribute to the observed differences between HAM/TSP patients and asymptomatic HTLV-I carriers. PMID:24470869

  12. The Impact of Immune Response on HTLV-I in HTLV-I-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP)

    PubMed Central

    Rafatpanah, Houshang; Farid Hosseini, Reza; Pourseyed, Seyed Hassan

    2013-01-01

    Human T lymphotropic virus type I (HTLV-I) is a retrovirus which is associated with adult T cells leukaemia (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in a minority of HTLV-I-infected individuals. It is not clear why a minority of HTLV-I-infected individuals develop HAM/TSP and majority remains lifelong carriers. It seems that the interaction between the virus and the immune response plays an important role in HTLV-I-associated diseases. Although the role of the immune response in HTLV-I pathogenesis is not fully understood, however it seems that the efficacy of the immune response which is involved in controlling or limiting of viral persistence determines the outcome of HTLV-I-associated diseases. Here we discuss the role of innate and adaptive immune response and also the risk factors contribute to the observed differences between HAM/TSP patients and asymptomatic HTLV-I carriers. PMID:24470869

  13. Association of IL-10 Gene Polymorphisms and Human T Lymphotropic Virus Type I-Associated Myelopathy/tropical Spastic Paraparesis in North-East of Iran (Mashhad)

    PubMed Central

    Shirdel, Abbas; Azarpazhooh, Mahmoud Reza; Sahebari, Maryam; Ghanbari, Mohsen; Mirfeizi, Seyedeh Zahra; Hutchinson, Ian; Ziaee, Aghigh; Rafatpanah, Houshang

    2013-01-01

    The underlying mechanisms leading to the development of human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) in HTLV-I infected individuals are not fully understood. Host genetic factors appear to be involved as risk factors for developing HAM/TSP. We investigated the possible contribution of interleukin-10 (IL-10) as a risk factor to HAM/TSP by comparing frequencies of promoter region single nucleotide polymorphisms in HTLV-I infected Iranian patients who either remained asymptomatic or developed HAM/TSP and asymptomatic HTLV-I carriers. Healthy, uninfected individuals from the same region served as healthy controls. Significant differences were observed in the distribution of IL-10 promoter alleles and genotypes at position -819 and -592 between HAM/TSP patients and healthy controls (P=0.01), and between HTLV-I carriers and healthy controls (P=0.02). The frequency of the low IL-10 producer haplotype (-1082*A, -819*T, -592*A) was significantly associated with HTLV-I carriage or HAM/TSP compared with healthy controls (P=0.02 and 0.01, respectively). Our results suggest that IL-10 -819*T and -592*A alleles are significant risk factors for developing HTLLV-I infection but do not appear to convey additional risk for developing HAM/TSP. PMID:24470873

  14. Characterization of Thoracic Motor and Sensory Neurons and Spinal Nerve Roots in Canine Degenerative Myelopathy, a Potential Disease Model of Amyotrophic Lateral Sclerosis

    PubMed Central

    Morgan, Brandie R.; Coates, Joan R.; Johnson, Gayle C.; Shelton, G. Diane; Katz, Martin L.

    2014-01-01

    Canine Degenerative Myelopathy (DM) is a progressive adult-onset multisystem degenerative disease with many features in common with amyotrophic lateral sclerosis (ALS). As with some forms of ALS, DM is associated with mutations in superoxide dismutase 1 (SOD1). Clinical signs include general proprioceptive ataxia and spastic upper motor neuron paresis in pelvic limbs, which progress to flaccid tetraplegia and dysphagia. The purpose of this study was to characterize DM as a potential disease model for ALS. We previously reported that intercostal muscle atrophy develops in dogs with advanced stage DM. To determine if other components of the thoracic motor unit (MU) also demonstrated morphological changes consistent with dysfunction, histopathologic and morphometric analyses were conducted on thoracic spinal motor neurons (MN) and dorsal root ganglia (DRG), and in motor and sensory nerve root axons from DM-affected Boxers and Pembroke Welsh Corgis (PWCs). No alterations in MNs, or motor root axons were observed in either breed. However, advanced stage PWCs exhibited significant losses of sensory root axons, and numerous DRG sensory neurons displayed evidence of degeneration. These results indicate that intercostal muscle atrophy in DM is not preceded by physical loss of the motor neurons innervating these muscles, or of their axons. Axonal loss in thoracic sensory roots and sensory nerve death suggest sensory involvement may play an important role in DM disease progression. Further analysis of the mechanisms responsible for these morphological findings would aid in the development of therapeutic intervention for DM and some forms of ALS. PMID:24375814

  15. Polygenic control of human T lymphotropic virus type I (HTLV-I) provirus load and the risk of HTLV-I-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Vine, Alison M; Witkover, Aviva D; Lloyd, Alun L; Jeffery, Katie J M; Siddiqui, Asna; Marshall, Sara E F; Bunce, Mike; Eiraku, Nobutaka; Izumo, Shuji; Usuku, Koichiro; Osame, Mitsuhiro; Bangham, Charles R M

    2002-10-01

    Human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is one outcome of infection with HTLV-I. A population association study of 229 patients with HAM/TSP and 202 healthy carriers of HTLV-I in southern Japan showed that this outcome of HTLV-I infection and the HTLV-I provirus load are under polygenic control. Of 58 polymorphic sites studied in 39 non-HLA candidate gene loci, 3 new host genetic factors that influenced the risk of HAM/TSP or the provirus load of HTLV-I were identified. The promoter TNF -863A allele predisposed to HAM/TSP, whereas SDF-1 +801A 3'UTR, and IL-15 191C alleles conferred protection. Knowledge of HTLV-I-infected individuals' ages, sex, provirus load, HTLV-I subgroup, and genotypes at the loci HLA-A, HLA-C, SDF-1, and TNF-alpha allowed for the correct identification of 88% of cases of HAM/TSP in this Japanese cohort. PMID:12232833

  16. Therapeutic benefits of an oral vitamin B1 derivative for human T lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).

    PubMed

    Kira, Jun-Ichi

    2013-01-01

    Prosultiamine, a vitamin B1 derivative, has long been used for beriberi neuropathy and Wernicke's encephalopathy. Based on the finding that prosultiamine induces apoptosis in human T lymphotropic virus type I (HTLV-I)-infected T cells, Nakamura et al. conducted a clinical trial of prosultiamine in patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). In this open-label, single arm study enrolling 24 HAM/TSP patients recently published in BMC Medicine, oral prosultiamine (300 mg/day for 12 weeks) was found to be effective by neurological, urological and virological evaluations. Notably, it increased detrusor pressure, bladder capacity and maximum flow rate, and improved detrusor overactivity and detrusor-sphincter dyssynergia. A significant decrease in HTLV-I copy numbers in peripheral blood following the treatment provided a rationale for using the drug. The trial has some limitations, such as the small numbers of participants, the open-label design, the lack of a placebo arm, and the short trial period. Nevertheless, the observation that such a safe, cheap drug may have excellent therapeutic effects on HAM/TSP, a chronic devastating illness occurring mainly in developing countries, provides support for future large-scale randomized controlled trials.Please see related research: http://www.biomedcentral.com/1741-7015/11/182. PMID:23945332

  17. Therapeutic benefits of an oral vitamin B1 derivative for human T lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

    PubMed Central

    2013-01-01

    Prosultiamine, a vitamin B1 derivative, has long been used for beriberi neuropathy and Wernicke’s encephalopathy. Based on the finding that prosultiamine induces apoptosis in human T lymphotropic virus type I (HTLV-I)-infected T cells, Nakamura et al. conducted a clinical trial of prosultiamine in patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). In this open-label, single arm study enrolling 24 HAM/TSP patients recently published in BMC Medicine, oral prosultiamine (300 mg/day for 12 weeks) was found to be effective by neurological, urological and virological evaluations. Notably, it increased detrusor pressure, bladder capacity and maximum flow rate, and improved detrusor overactivity and detrusor-sphincter dyssynergia. A significant decrease in HTLV-I copy numbers in peripheral blood following the treatment provided a rationale for using the drug. The trial has some limitations, such as the small numbers of participants, the open-label design, the lack of a placebo arm, and the short trial period. Nevertheless, the observation that such a safe, cheap drug may have excellent therapeutic effects on HAM/TSP, a chronic devastating illness occurring mainly in developing countries, provides support for future large-scale randomized controlled trials. Please see related research: http://www.biomedcentral.com/1741-7015/11/182. PMID:23945332

  18. Visualization of HTLV-1-specific cytotoxic T lymphocytes in the spinal cords of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Matsuura, Eiji; Kubota, Ryuji; Tanaka, Yuetsu; Takashima, Hiroshi; Izumo, Shuji

    2015-01-01

    Activated human T-lymphotropic virus type-1 (HTLV-1)-specific CD8-positive cytotoxic T lymphocytes (CTLs) are markedly increased in the periphery of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), an HTLV-1-induced inflammatory disease of the CNS. Although virus-specific CTLs play a pivotal role to eliminate virus-infected cells, the potential role of HTLV-1-specific CTLs in the pathogenesis of HAM/TSP remains unclear. To address this issue, we evaluated the infiltration of HTLV-1-specific CTLs and the expression of HTLV-1 proteins in the spinal cords of 3 patients with HAM/TSP. Confocal laser scanning microscopy with our unique staining procedure made it possible to visualize HTLV-1-specific CTLs infiltrating the CNS of the HAM/TSP patients. The frequency of HTLV-1-specific CTLs was more than 20% of CD8-positive cells infiltrating the CNS. In addition, HTLV-1 proteins were detected in CD4-positive infiltrating T lymphocytes but not CNS resident cells. Although neurons were generally preserved, apoptotic oligodendrocytes were frequently in contact with CD8-positive cells; this likely resulted in demyelination. These findings suggest that the immune responses of the CTLs against HTLV-1-infected CD4-positive lymphocytes migrating into the CNS resulted in bystander neural damage. PMID:25470342

  19. Pharyngoesophageal perforation 3 years after anterior cervical spine surgery: a rare case report and literature review.

    PubMed

    Yin, Dan-Hui; Yang, Xin-Ming; Huang, Qi; Yang, Mi; Tang, Qin-Lai; Wang, Shu-Hui; Wang, Shuang; Liu, Jia-Jia; Yang, Tao; Li, Shi-Sheng

    2015-08-01

    Pharyngoesophageal perforation after anterior cervical spine surgery is rare and the delayed cases were more rarely reported but potentially life-threatening. We report a case of pharyngoesophageal perforation 3 years after anterior cervical spine surgery. The patient presented with dysphagia, fever, left cervical mass and developing dyspnea 3 years after cervical spine surgery for trauma. After careful examinations, he underwent an emergency tracheostomy, neck exploration, hardware removal, abscess drainage and infected tissue debridement. 14 days after surgery, CT of the neck with oral contrast demonstrated no contrast extravasation from the esophagus. Upon review of literature, only 14 cases of pharyngoesophageal perforation more than 1 year after anterior cervical spine surgery were found. We discussed possible etiology, diagnosis and management and concluded that in cases of dysphagia, dyspnea, cervical pain, swelling and edema of the cervical area even long time after anterior cervical spine surgery, potential pharyngoesophageal damage should be considered. PMID:25559465

  20. A comprehensive review on host genetic susceptibility to human papillomavirus infection and progression to cervical cancer

    PubMed Central

    Chattopadhyay, Koushik

    2011-01-01

    Cervical cancer is the second most common cancer in women worldwide. This is caused by oncogenic types of human papillomavirus (HPV) infection. Although large numbers of young sexually active women get HPV-infected, only a small fraction develop cervical cancer. This points to different co-factors for regression of HPV infection or progression to cervical cancer. Host genetic factors play an important role in the outcome of such complex or multifactor diseases such as cervical cancer and are also known to regulate the rate of disease progression. The aim of this review is to compile the advances in the field of host genetics of cervical cancer. MEDLINE database was searched using the terms, ‘HPV’, ‘cervical’, ‘CIN’, ‘polymorphism(s)’, ‘cervical’+ *the name of the gene* and ‘HPV’+ *the name of the gene*. This review focuses on the major host genes reported to affect the progression to cervical cancer in HPV infected individuals. PMID:22345983