Sample records for cervical vertebrae

  1. Vertebroplasty of Cervical Vertebra

    PubMed Central

    Kordecki, Kazimierz; Lewszuk, Andrzej; Pu?awska-Stalmach, Magdalena; Michalak, Pawe?; ?ukasiewicz, Adam; Sackiewicz, Izabela; Polaków, Piotr; Rutka, Katarzyna; ?ebkowski, Wojciech; ?ebkowska, Urszula

    2015-01-01

    Summary Background The first vertebroplasty was performed by Harve Deramond in France in 1984 due to a hemangioma of cervical vertebral body. Procedure technique consisted of inserting a needle through the bony palate of the oral cavity. Bone cement injected under pressure not only fills the areas of bone loss. The heat released in the process of crystallization causes denaturation of pathological tissue proteins (metastasis) and disrupts blood supply (hemangiomas). The aim of this study was to evaluate the method of treatment from anterolateral access. Material/Methods In the years 2007–2012 the procedure was performed in 6 men and 9 women aged from 42 to 71 years (mean age: 56.3 years). In 10 cases the reason for vertebroplasty was the vertebral hemangioma, in another 4 – pathological vertebral fractures due to metastases, and in one case – multiple myeloma. Procedures were performed from anterolateral access, under local anesthesia, under x-ray guidance (fluoroscopy). Bone needle was inserted into the vertebral body, followed by injection of PMMA cement. Results In 100% cases pain relief was observed immediately after the procedure and beneficial therapeutic effect was obtained. No life-threatening complications and clinical symptoms were observed. Average length hospital stay amounted to 2.9 days. Conclusions Cervical spine vertebroplasty from anterolateral access seems to be a safe, effective and beneficial method of treatment. It reduces the risk of infection in comparison to the transoral method. PMID:25674195

  2. Trabecular bone density of male human cervical and lumbar vertebrae

    Microsoft Academic Search

    Narayan Yoganandan; Frank A. Pintar; Brian D. Stemper; Jamie L. Baisden; Recyi Aktay; Barry S. Shender; Glenn Paskoff; Purushottam Laud

    2006-01-01

    The objective of this study was to determine the bone mineral density (BMD) of cervical vertebrae and correlate with the lumbar spine. Fifty-seven young adult healthy male volunteers, ranging from 18 to 41 years of age, underwent quantitative computed tomography (QCT) scanning of C2-T1 and L2–L4 vertebrae. To account for correlations, repeated measures techniques were used to compare data as

  3. Trabecular bone density of male human cervical and lumbar vertebrae.

    PubMed

    Yoganandan, Narayan; Pintar, Frank A; Stemper, Brian D; Baisden, Jamie L; Aktay, Recyi; Shender, Barry S; Paskoff, Glenn; Laud, Purushottam

    2006-08-01

    The objective of this study was to determine the bone mineral density (BMD) of cervical vertebrae and correlate with the lumbar spine. Fifty-seven young adult healthy male volunteers, ranging from 18 to 41 years of age, underwent quantitative computed tomography (QCT) scanning of C2-T1 and L2-L4 vertebrae. To account for correlations, repeated measures techniques were used to compare data as a function of spinal level and region. Linear regression methods were used (+/-95% CI) to compare data as a function of spinal level and region. The mean age and body height were 25.0 +/- 5.8 years and 181.0 +/- 7.6 cm. BMD decreased from the rostral to caudal direction along the spinal column. Grouped data indicated that the neck is the densest followed by the first thoracic vertebra and low back with mean BMD of 256.0 +/- 48.1, 194.3 +/- 44.2, and 172.2 +/- 28.4 mg/cm(3), respectively; differences were statistically significant. While BMD did not vary significantly between the three lumbar bodies, neck vertebrae demonstrated significant trends. The matrix of correlation coefficients between BMD and spinal level indicated that the relationship is strong in the lumbar (r = 0.92-0.96) and cervical (r = 0.73-0.92) spines. Data from the present study show that the trabecular bony architecture of the neck is significantly different from the low back. These quantitative BMD data from a controlled young adult healthy human male volunteer population may be valuable in establishing normative data specifically for the neck. From a trabecular bone density perspective, these results indicate that lumbar vertebrae cannot act as the best surrogates for neck vertebrae. Significant variations in densities among neck vertebrae, unlike the low back counterpart, may underscore the need to treat these bones as different structures. PMID:16580272

  4. [Improvement of stabilization technique of cervical vertebrae using cylindrical implants].

    PubMed

    Barysh, A E; Buznitski?, R I

    2013-04-01

    The algorithm for cervical interbody stabilization with the use of vertical cylindrical mesh implant was improvement. Implementation of the developed method allows to reduce the load per unit area of bone bodies of recorded vertebrae in contact with the terminal part of the implant, which reduces the risk of loss of correction of the deformity after surgery. Results of surgical treatment of 5 patients for diseases and injuries of the cervical spine show the effectiveness of the method and the possibility of its application in clinical practice. PMID:23888724

  5. The Mammalian Cervical Vertebrae Blueprint Depends on the T (brachyury) Gene.

    PubMed

    Kromik, Andreas; Ulrich, Reiner; Kusenda, Marian; Tipold, Andrea; Stein, Veronika M; Hellige, Maren; Dziallas, Peter; Hadlich, Frieder; Widmann, Philipp; Goldammer, Tom; Baumgärtner, Wolfgang; Rehage, Jürgen; Segelke, Dierck; Weikard, Rosemarie; Kühn, Christa

    2015-03-01

    A key common feature all but three known mammalian genera is the strict seven cervical vertebrae blueprint, suggesting the involvement of strong conserving selection forces during mammalian radiation. This is further supported by reports indicating that children with cervical ribs die before they reach reproductive age. Hypotheses were put up, associating cervical ribs (homeotic transformations) to embryonal cancer (e.g., neuroblastoma) or ascribing the constraint in cervical vertebral count to the development of the mammalian diaphragm. Here, we describe a spontaneous mutation c.196A > G in the Bos taurus T gene (also known as brachyury) associated with a cervical vertebral homeotic transformation that violates the fundamental mammalian cervical blueprint, but does not preclude reproduction of the affected individual. Genome-wide mapping, haplotype tracking within a large pedigree, resequencing of target genome regions, and bioinformatic analyses unambiguously confirmed the mutant c.196G allele as causal for this previously unknown defect termed vertebral and spinal dysplasia (VSD) by providing evidence for the mutation event. The nonsynonymous VSD mutation is located within the highly conserved T box of the T gene, which plays a fundamental role in eumetazoan body organization and vertebral development. To our knowledge, VSD is the first unequivocally approved spontaneous mutation decreasing cervical vertebrae number in a large mammal. The spontaneous VSD mutation in the bovine T gene is the first in vivo evidence for the hypothesis that the T protein is directly involved in the maintenance of the mammalian seven-cervical vertebra blueprint. It therefore furthers our knowledge of the T-protein function and early mammalian notochord development. PMID:25614605

  6. CT and MRI in hydatid disease of cervical vertebrae

    Microsoft Academic Search

    A. G. Ö?üt; K. Kanbero?lu; A. Altu?; O. Çokyüksel

    1992-01-01

    Hydatid disease (HD) of the cervical spine is rare. A case investigated by computed tomography (CT) and magnetic resonance imaging (MRI) is presented. While CT shows the bone lesion better, MRI is superior in demonstrating compression of neural structures. The complementary use of CT and MRI in such cases is suggested.

  7. Osseous hemangioma of the seventh cervical vertebra with osteoid formation mimicking metastasis: a case report

    Microsoft Academic Search

    Stefan Lakemeier; Carolin Christina Westhoff; Susanne Fuchs-Winkelmann; Markus Schofer

    2009-01-01

    INTRODUCTION: We report the case of an osseous hemangioma located in the seventh cervical vertebra with reactive osteoid formation and non-typical findings in the radiological and the histopathological examination, mimicking metastasis of a malignant tumor. To our knowledge, this is the first description of such a case in the literature. CASE PRESENTATION: A 44-year-old otherwise healthy Caucasian German woman presented

  8. Sex estimation using the second cervical vertebra: a morphometric analysis in a documented Portuguese skeletal sample.

    PubMed

    Gama, Inês; Navega, David; Cunha, Eugénia

    2015-03-01

    Biological sex estimation is one of the main parameters required in the construction of a biological profile of an unknown deceased person. In corpses in an advanced state of decomposition, skeletonized or severely mutilated, bone analysis may provide the only way to access biological sex. Although the hip bones are the most dimorphic and useful bones for sex estimation, they are often badly preserved and/or fragmented or may not even be present in some cases. For that reason, it is necessary to develop sex estimation methods based on bones less dimorphic. In this study, 13 dimensions of the second cervical vertebra were measured in order to quantify sex-related variation and to generate a simple predictive model based on logistic regression analysis. For logistic regression fitting, 190 individuals from the Coimbra Identified Skeletal Collection were used as a training sample. The resulting model was also evaluated in an independent test sample composed of 47 individuals from the Identified Skeletal Collection of the 21st Century (University of Coimbra). The developed logistic regression model correctly estimated known sex in 86.7 to 89.7 % of the cases. The second cervical vertebra demonstrated to be a useful alternative for sex estimation when other skeletal elements are not available or suitable for analysis. This method seems promising but more reliability studies are required for a more robust validation. PMID:25212127

  9. Stature estimation in Japanese cadavers based on the second cervical vertebra measured using multidetector computed tomography.

    PubMed

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Hayakawa, Mutsumi; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Hoshioka, Yumi; Iwase, Hirotaro

    2015-05-01

    The purpose of this study was to assess correlations between measurements of the second cervical vertebra (C2) and stature using multidetector computed tomography (MDCT) images, and to develop regression equations for estimating stature in a Japanese population. Measurements were performed on 216 Japanese subjects (116 males and 100 females) who underwent postmortem CT between May 2011 and November 2013. Sagittal images through the center of the C2 were used for assessment. The length from the top of the dens to the anteroinferior point of the vertebral body (DA), the length from the anteroinferior point of the vertebral body to the posterior point of the spinous process (AS), and the length from the top of the dens to the posterior point of the spinous process (DS) were measured. The correlation between stature and each parameter (DA, AS, and DS) was assessed using Pearson product-moment correlation coefficients and regression analysis was performed for stature estimation. All measurements of the C2 were positively correlated with stature regardless of sex. The highest correlation was observed for the DA in all cases, and the lowest correlation was observed for AS in all cases. However, the standard errors of estimate were large. Thus, our study concludes that the size of the C2 as measured with MDCT images may be useful for stature estimation only when better predictors, such as long bones, are unavailable. PMID:25466453

  10. Halisaurus sp. (Mosasauridae) from the Upper Cretaceous (?Santonian) of east-central Peru, and the taxonomic utility of mosasaur cervical vertebrae

    Microsoft Academic Search

    Michael W. Caldwell; Gorden L. Bell Jr

    1995-01-01

    A cervical vertebra, collected from Upper Cretaceous (?Santonian) sediments in eastcentral Peru, is described and assigned to the genus Halisaurus. The Peruvian specimen shows the centrum and condyle-cotyle morphology considered to characterize halisaurines. The centrum is elongate and extremely compressed dorsoventrally, as are the cotyle and condyle. The condylar facet also has a dorsally expanded articular surface. The hypapophysis is

  11. DEFECTS IN CERVICAL VERTEBRAE IN BORIC ACID-EXPOSED RAT EMBRYOS ARE ASSOCIATED WITH ANTERIOR SHIFTS OF HOX GENE EXPRESSION DOMAINS

    EPA Science Inventory

    Defects in cervical vertebrae in boric acid-exposed rat embryos are associated with anterior shifts of hox gene expression domains Nathalie Wery,1 Michael G. Narotsky,2 Nathalie Pacico,1 Robert J. Kavlock,2 Jacques J. Picard,1 AND Francoise Gofflot,1* 1Unit of Developme...

  12. The Cervical Spine of the American Barn Owl (Tyto furcata pratincola): I. Anatomy of the Vertebrae and Regionalization in Their S-Shaped Arrangement

    PubMed Central

    Krings, Markus; Nyakatura, John A.; Fischer, Martin S.; Wagner, Hermann

    2014-01-01

    Background Owls possess an extraordinary neck and head mobility. To understand this mobility it is necessary to have an anatomical description of cervical vertebrae with an emphasis on those criteria that are relevant for head positioning. No functional description specific to owls is available. Methodology/Principal findings X-ray films and micro-CT scans were recorded from American barn owls (Tyto furcata pratincola) and used to obtain three-dimensional head movements and three-dimensional models of the 14 cervical vertebrae (C1?C14). The diameter of the vertebral canal, the zygapophyseal protrusion, the distance between joint centers, and the pitching angle were quantified. Whereas the first two variables are purely osteological characteristics of single vertebrae, the latter two take into account interactions between vertebrae. These variables change in characteristic ways from cranial to caudal. The vertebral canal is wide in the cranial and caudal neck regions, but narrow in the middle, where both the zygapophyseal protrusion and the distance between joint centers are large. Pitching angles are more negative in the cranial and caudal neck regions than in the middle region. Cluster analysis suggested a complex regionalization. Whereas the borders (C1 and C13/C14) formed stable clusters, the other cervical vertebrae were sorted into 4 or 5 additional clusters. The borders of the clusters were influenced by the variables analyzed. Conclusions/Significance A statistical analysis was used to evaluate the regionalization of the cervical spine in the barn owl. While earlier measurements have shown that there appear to be three regions of flexibility of the neck, our indicators suggest 3–7 regions. These many regions allow a high degree of flexibility, potentially facilitating the large head turns that barn owls are able to make. The cervical vertebral series of other species should also be investigated using statistical criteria to further characterize morphology and the potential movements associated with it. PMID:24651767

  13. Sex determination from the second cervical vertebra: a test of Wescott's method on a modern American sample.

    PubMed

    Bethard, Jonathan D; Seet, Billie L

    2013-01-01

    Numerous methods for establishing a biological profile exist; however, many of these methods rely on the recovery of several specific bones or on fragile skeletal elements that are sometimes irrecoverable. It is for this reason new methods utilizing other previously under-documented bones should be established and tested by the forensic anthropological community. This study tests the accuracy of Wescott's (J Forensic Sci 2000;45(2)) method for determining sex from the second cervical vertebra. Specimens were drawn from the donated skeletal collection curated at the Hamilton County Forensic Center (n = 57) and the William M. Bass Donated Skeletal Collection (n = 243). Both intra- and inter-observer error rates were low and accurate classifications ranged from 78% (females-Function 1) to 90.6% (males-Function 5). Of the five functions, Function 4 achieved the highest overall accuracy, with 260 individuals (86.7%) falling into the correct category. Overall, this method is an effective classificatory tool for sex estimation. PMID:22563852

  14. Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model

    PubMed Central

    Qin, Jie; He, Xijing; Wang, Dong; Qi, Peng; Guo, Lei; Huang, Sihua; Cai, Xuan; Li, Haopeng; Wang, Rui

    2012-01-01

    This was an in vitro and in vivo study to develop a novel artificial cervical vertebra and intervertebral complex (ACVC) joint in a goat model to provide a new method for treating degenerative disc disease in the cervical spine. The objectives of this study were to test the safety, validity, and effectiveness of ACVC by goat model and to provide preclinical data for a clinical trial in humans in future. We designed the ACVC based on the radiological and anatomical data on goat and human cervical spines, established an animal model by implanting the ACVC into goat cervical spines in vitro prior to in vivo implantation through the anterior approach, and evaluated clinical, radiological, biomechanical parameters after implantation. The X-ray radiological data revealed similarities between goat and human intervertebral angles at the levels of C2-3, C3-4, and C4-5, and between goat and human lordosis angles at the levels of C3-4 and C4-5. In the in vivo implantation, the goats successfully endured the entire experimental procedure and recovered well after the surgery. The radiological results showed that there was no dislocation of the ACVC and that the ACVC successfully restored the intervertebral disc height after the surgery. The biomechanical data showed that there was no significant difference in range of motion (ROM) or neural zone (NZ) between the control group and the ACVC group in flexion-extension and lateral bending before or after the fatigue test. The ROM and NZ of the ACVC group were greater than those of the control group for rotation. In conclusion, the goat provides an excellent animal model for the biomechanical study of the cervical spine. The ACVC is able to provide instant stability after surgery and to preserve normal motion in the cervical spine. PMID:23300816

  15. CT Morphometric Analysis to Determine the Anatomical Basis for the Use of Transpedicular Screws during Reconstruction and Fixations of Anterior Cervical Vertebrae

    PubMed Central

    Chen, Chun; Ruan, Dike; Wu, Changfu; Wu, Weidong; Sun, Peidong; Zhang, Yuanzhi; Wu, Jigong; Lu, Sheng; Ouyang, Jun

    2013-01-01

    Background Accurate placement of pedicle screw during Anterior Transpedicular Screw fixation (ATPS) in cervical spine depends on accurate anatomical knowledge of the vertebrae. However, little is known of the morphometric characteristics of cervical vertebrae in Chinese population. Methods Three-dimensional reconstructions of CT images were performed for 80 cases. The anatomic data and screw fixation parameters for ATPS fixation were measured using the Mimics software. Findings The overall mean OPW, OPH and PAL ranged from 5.81 to 7.49 mm, 7.77 to 8.69 mm, and 33.40 to 31.13 mm separately, and SPA was 93.54 to 109.36 degrees from C3 to C6, 104.99 degrees at C7, whereas, 49.00 to 32.26 degrees from C4 to C7, 46.79 degrees at C3 (TPA). Dl/rSIP had an increasing trend away from upper endplate with mean value from 1.87 to 5.83 mm. Dl/rTIP was located at the lateral portion of the anterior cortex of vertebrae for C3 to C5 and ipsilateral for C6 to C7 with mean value from ?2.70 to ?3.00 mm, and 0.17 to 3.18 mm. The entrance points for pedicular screw insertion for C3 to C5 and C6 to C7 were recommended ?2??3 mm and 0–4 mm from the median sagittal plane, respectively, 1–4 mm and 5–6 mm from the upper endplate, with TPA being 46.79–49.00 degrees and 40.89–32.26 degrees, respectively, and SPA being 93.54–106.69 degrees and 109.36–104.99 degrees, respectively. The pedicle screw insertion diameter was recommended 3.5 mm (C3 and C4), 4.0 mm (C5 to C7), and the pedicle axial length was 21–24 mm for C3 to C7 for both genders. However, the ATPS insertion in C3 should be individualized given its relatively small anatomical dimensions. Conclusions The data provided a morphometric basis for the ATPS fixation technique in lower cervical fixation. It will help in preoperative planning and execution of this surgery. PMID:24349038

  16. Extracranial glioblastoma with synchronous metastases in the lung, pulmonary lymph nodes, vertebrae, cervical muscles and epidural space in a young patient - case report and review of literature

    PubMed Central

    2013-01-01

    Background Extraneural and extracranial metastases of glioblastoma (GB) are very rarely reported in the literature. They occur in only 0.2% of all GB patients. Case presentation We present a 40 year old caucasian male with secondary GB and first diagnosis of an astrocytoma world health organisation (WHO) grade II through stereotactic biopsy in 2006. He presented a new hemiparesis and a progress of the known mass lesion in 2008. Subtotal tumor resection was performed and the histological examination verified a GB. After combined radio- and chemotherapy the adjuvant temozolomide therapy was not started because of non-compliance. In 2011 a second local relapse was resected and 4 month later the patient presented a fast progressing tetraparesis. Cervical CT and MRI scan showed a mass lesion infiltrating the fifth and sixth vertebra with infiltration of the spinal canal and large paravertebral tumor masses. Emergency surgery was performed. By additional screening further metastases were detected in the thoracal and lumbal spine and surprisingly also in the lung and pulmonary lymphnodes. Palliative radio- and chemotherapy of the pulmonal lesions was completed, further antitumor therapy was rejected. The patient died 10 months after diagnosis of the extraneural metastases. Conclusion Especially young “long-term-survivors” seem to have a higher risk of extraneural metastasis from a GB and appropriate staging should be performed in these cases. PMID:23883669

  17. Sagittal evaluation of elemental geometrical dimensions of human vertebrae.

    PubMed Central

    Gilad, I; Nissan, M

    1985-01-01

    Geometrical configuration and dimensions of the human vertebra were investigated using radiographs of 157 normal healthy adult men. Measurements were based on five bony reference points, which can be defined in radiographs. The measurements permit the determination of nine dimensions that can be used for anthropometrical evaluation of the cervical and lumbar vertebrae. A simplified model of the vertebra in the sagittal plane is presented and serves as a basis for the geometrical measurements. In the cervical region, average width exceeded average height of vertebral bodies C3 to C7, while in C2 the average width was smaller than the average height; C7 was the longest and C3 the shortest cervical vertebra. In the lumbar region, average width exceeded average height of the vertebral bodies. Values for width and height did not differ significantly from L1 to L5; L3 was the longest and L5 the shortest lumbar vertebra. Images Fig. 1 PMID:3870717

  18. 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

  19. Pediatric cervical spine instability

    Microsoft Academic Search

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

    2008-01-01

    Cervical spine instability in children is rare but not exceptional and may be due to many factors. Although it mostly occurs\\u000a at the upper cervical spine, all vertebrae from the occiput to T1 may be involved. It may be acute or chronic, occurring secondary\\u000a to trauma or due to congenital anomaly, skeletal or metabolic dystrophy or rheumatoid arthritis. It can

  20. [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

  1. Imaging techniques for radiography of cervical vertebrae using CT images

    Microsoft Academic Search

    Toshinori Maruyama; Hideki Yamamoto

    2009-01-01

    A good positioning technique is essential for obtaining accurate diagnostic information in radiography. In this study, we developed the imaging techniques which produce a plane image using CT images in order to assist the students' positioning practice under the X-ray equipment. First, we scanned the skull phantom by CT (computed tomography) and obtained CT images. Next, we measure the positioning

  2. The Natural History and Clinical Syndromes of Degenerative Cervical Spondylosis

    PubMed Central

    Kelly, John C.; Groarke, Patrick J.; Butler, Joseph S.; Poynton, Ashley R.; O'Byrne, John M.

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy PMID:22162812

  3. Transoral approach to the cervical spine: report of four cases

    Microsoft Academic Search

    SA OLaoire; DGT Thomas

    1982-01-01

    The transoral approach to the upper cervical spine is an established but little used route, offering excellent access with good wound healing, to lesions of the bodies of the atlas, axis and upper part of the third cervical vertebra. The authors report four cases which demonstrate the value of the procedure.

  4. Shape regression for vertebra fracture quantification

    NASA Astrophysics Data System (ADS)

    Lund, Michael Tillge; de Bruijne, Marleen; Tanko, Laszlo B.; Nielsen, Mads

    2005-04-01

    Accurate and reliable identification and quantification of vertebral fractures constitute a challenge both in clinical trials and in diagnosis of osteoporosis. Various efforts have been made to develop reliable, objective, and reproducible methods for assessing vertebral fractures, but at present there is no consensus concerning a universally accepted diagnostic definition of vertebral fractures. In this project we want to investigate whether or not it is possible to accurately reconstruct the shape of a normal vertebra, using a neighbouring vertebra as prior information. The reconstructed shape can then be used to develop a novel vertebra fracture measure, by comparing the segmented vertebra shape with its reconstructed normal shape. The vertebrae in lateral x-rays of the lumbar spine were manually annotated by a medical expert. With this dataset we built a shape model, with equidistant point distribution between the four corner points. Based on the shape model, a multiple linear regression model of a normal vertebra shape was developed for each dataset using leave-one-out cross-validation. The reconstructed shape was calculated for each dataset using these regression models. The average prediction error for the annotated shape was on average 3%.

  5. Dimensional accuracy of 3D printed vertebra

    NASA Astrophysics Data System (ADS)

    Ogden, Kent; Ordway, Nathaniel; Diallo, Dalanda; Tillapaugh-Fay, Gwen; Aslan, Can

    2014-03-01

    3D printer applications in the biomedical sciences and medical imaging are expanding and will have an increasing impact on the practice of medicine. Orthopedic and reconstructive surgery has been an obvious area for development of 3D printer applications as the segmentation of bony anatomy to generate printable models is relatively straightforward. There are important issues that should be addressed when using 3D printed models for applications that may affect patient care; in particular the dimensional accuracy of the printed parts needs to be high to avoid poor decisions being made prior to surgery or therapeutic procedures. In this work, the dimensional accuracy of 3D printed vertebral bodies derived from CT data for a cadaver spine is compared with direct measurements on the ex-vivo vertebra and with measurements made on the 3D rendered vertebra using commercial 3D image processing software. The vertebra was printed on a consumer grade 3D printer using an additive print process using PLA (polylactic acid) filament. Measurements were made for 15 different anatomic features of the vertebral body, including vertebral body height, endplate width and depth, pedicle height and width, and spinal canal width and depth, among others. It is shown that for the segmentation and printing process used, the results of measurements made on the 3D printed vertebral body are substantially the same as those produced by direct measurement on the vertebra and measurements made on the 3D rendered vertebra.

  6. Cervical Spine Loads and Intervertebral Motions During Whiplash

    Microsoft Academic Search

    Paul C. Ivancic; Manohar M. Panjabi; Shigeki Ito

    2006-01-01

    Objective. To quantify the dynamic loads and intervertebral motions throughout the cervical spine during simulated rear impacts.Methods. Using a biofidelic whole cervical spine model with muscle force replication and surrogate head and bench-top mini-sled, impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of the T1 vertebra. Inverse dynamics was used to calculate the dynamic cervical spine

  7. Bizarre tubercles on the vertebrae of Eocene fossil birds indicate an avian disease without modern counterpart.

    PubMed

    Mayr, Gerald

    2007-08-01

    Remains of fossil birds with numerous bony tubercles on the cervical vertebrae are reported from the Middle Eocene of Messel in Germany and the Late Eocene of the Quercy fissure fillings in France. These structures, which are unknown from extant birds and other vertebrates, were previously described for an avian skeleton from Messel but considered a singular feature of this specimen. The new fossils are from a different species of uncertain phylogenetic affinities and show that tuberculated vertebrae have a wider taxonomic, temporal, and geographic distribution. In contrast to previous assumptions, they are no ontogenetic feature and arise from the vertebral surface. It is concluded that they are most likely of pathologic origin and the first record of a Paleogene avian disease. Their regular and symmetrical arrangement over most of the external vertebral surface indicates a systemic disorder caused by factors that do not affect extant birds, such as especially high-dosed phytohormones or extinct pathogens. PMID:17406849

  8. Bizarre tubercles on the vertebrae of Eocene fossil birds indicate an avian disease without modern counterpart

    NASA Astrophysics Data System (ADS)

    Mayr, Gerald

    2007-08-01

    Remains of fossil birds with numerous bony tubercles on the cervical vertebrae are reported from the Middle Eocene of Messel in Germany and the Late Eocene of the Quercy fissure fillings in France. These structures, which are unknown from extant birds and other vertebrates, were previously described for an avian skeleton from Messel but considered a singular feature of this specimen. The new fossils are from a different species of uncertain phylogenetic affinities and show that tuberculated vertebrae have a wider taxonomic, temporal, and geographic distribution. In contrast to previous assumptions, they are no ontogenetic feature and arise from the vertebral surface. It is concluded that they are most likely of pathologic origin and the first record of a Paleogene avian disease. Their regular and symmetrical arrangement over most of the external vertebral surface indicates a systemic disorder caused by factors that do not affect extant birds, such as especially high-dosed phytohormones or extinct pathogens.

  9. Cervical Cancer

    MedlinePLUS

    ... Dictionary Search for Clinical Trials NCI Publications Español Cervical Cancer Definition of cervical cancer : Cancer that forms in tissues of the ... the cervix and looked at under a microscope). Cervical cancer is almost always caused by human papillomavirus ( ...

  10. Benign notochordal cell tumor: a retrospective study of 11 cases with 13 vertebra bodies

    PubMed Central

    Ma, Xiaomei; Xia, Chunyan; Liu, Dong; Liu, Huimin; Wang, Chenguang; Yu, Hongyu

    2014-01-01

    Purpose: To analyze the clinical data, MRI, pathological diagnosis, treatment and long-term effects of benign notochordal cell tumor (BNCT), a newly described novel spine tumor. Methods: We retrospectively studied 11 patients’ clinical data of the above. Results: The ratio of males to females was 4:7, and the average age was 49.2 years (range, 18-74 years). Cervical vertebra (5; 38.5%) and thoracic vertebra (5; 38.5%) were the most frequent site followed by the lumbar vertebra (3; 23%). Pain was the main symptom except case 2 who were diagnosed accidently because of prostate cancer. The mean delay from first clinical symptoms to diagnosis was ranged from 2 months to 20 years. MRI showed all BNCTs were osteolytic lesions with hypointense on T1-weighted sequences, hyperintense on T2-weighted sequences. There were 4 vertebral bodies with wedge fracture. There were two cases that had two noncontiguous vertebral bodies with BNCT. In histology, marrow replacement was noted by multivacuolated physaliphorous cells immunoreactive for CK, EMA and S100 protein. All 10 cases except case 2 had vertebral reconstruction and fixation with different methods. Of the 11 patients, 9 had full follow-up data which showed no evidence of recurrence or metastasis without further treatment. Conclusion: Noncontiguous multi-centricity BNCTs are rare. No specific vertebrae are more frequently involved. Once BNCT is diagnosed by pathology, the surgical intervention is necessary for the patients with obvious clinical symptoms although it is benign. There is no evidence of BNCT recurrence or metastasis. PMID:25120733

  11. Finite element analysis of the cervical spine: a material property sensitivity study

    Microsoft Academic Search

    Srirangam Kumaresan; Narayan Yoganandan; Frank A. Pintar

    1999-01-01

    Objective. The study determined the effect of variations in the material properties of the cervical spinal components on the output of the finite element analysis (external and internal responses of the cervical spine) under physiologic load vectors.Design. A three-dimensional (3D) anatomically accurate finite element model comprising of the C4-C5-C6 cervical spine unit including the three vertebrae, two interconnecting intervertebral discs,

  12. Bilateral cervical ribs in a Dobermann Pinscher.

    PubMed

    Ricciardi, M; De Simone, A; Gernone, F; Giannuzzi, P

    2015-03-17

    An 11-year-old intact female Doberman Pinscher was presented with the complaint of non-ambulatory tetraparesis. Clinical and neurological examination revealed a caudal cervical spinal cord disfunction (C6-T2 spinal cord segments). Magnetic resonance imaging and computed tomographic (CT) findings of the cervical spine were consistent with caudal cervical spondylomyelopathy (CSM). During the diagnostic work-up for the cervical spine, bilateral bone anomalies involving the seventh cervical vertebra and the first ribs were found on radiographs and CT examination. The rib anomalies found in this dog appear similar to cervical ribs widely described in human medicine. In people, cervical ribs are associated with a high rate of stillbirth, early childhood cancer, and can cause the thoracic outlet syndrome, characterized by neurovascular compression at level of superior aperture of the chest. In dogs, only some sporadic anatomopathological descriptions of cervical ribs exist. In this report the radiographic and CT findings of these particular vertebral and rib anomalies along with their relationships with adjacent vasculature and musculature are shown intravitam in a dog. Specific radiographic and CT findings described in this report may help in reaching a presumptive diagnosis of this anomaly. Finally, their clinical and evolutionary significance are discussed. PMID:25650786

  13. Hemophilic pseudotumor of the first lumbar vertebra

    PubMed Central

    Nachimuthu, Gurusamy; Arockiaraj, Justin; Krishnan, Venkatesh; Sundararaj, Gabriel David

    2014-01-01

    Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases. PMID:25404776

  14. 3D Biplanar Reconstruction of Scoliotic Vertebrae Using Statistical Models

    Microsoft Academic Search

    Said Benameur; Max Mignotte; Stefan Parent; Hubert Labelle; Wafa Skalli; Jacques A. De Guise

    2001-01-01

    This paper presents a new 3D reconstruction method of the scoliotic vertebrae of a spine, using two conventional radiographic views (postero-anterior and lateral), and a global prior knowledge on the geometrical structure of each vertebra. This geometrical knowledge is efficiently captured by a statistical deformable template integrating a set of admissible deformations, expressed by the first modes of variation in

  15. Cervical Cancer

    MedlinePLUS

    ... Overview What is cervical cancer? Cervical cancer is cancer of the cervix. The cervix is part of your uterus (womb). ... your doctor does to check for signs of cancer of the cervix. The cells from your cervix are checked for ...

  16. Cervical cancer

    MedlinePLUS

    Cancer - cervix ... Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United ... of the routine use of Pap smears . Cervical cancer starts in the cells on the surface of ...

  17. Lumbosacral Transition Vertebra: Prevalence and Its Significance

    PubMed Central

    Amritanand, Rohit; Krishnan, Venkatesh; David, Kenny Samuel

    2014-01-01

    Study Design Retrospective analysis of radiological images. Purpose To determine the prevalence of lumbosacral transition vertebra (LSTV) and to study its significance with respect to clinically significant spinal symptoms, disc degeneration and herniation. Overview of Literature LSTV is the most common congenital anomaly of the lumbosacral spine. The prevalence has been debated to vary between 7% and 30%, and its relationship to back pain, disc degeneration and herniation has also not been established. Methods The study involved examining the radiological images of 3 groups of patients. Group A consisted of kidney urinary bladder (KUB) X-rays of patients attending urology outpatient clinic. Group B consisted of X-rays with or without magnetic resonance images (MRIs) of patients at-tending a spine outpatient clinic, and group C consisted of X-rays and MRI of patients who had undergone surgery for lumbar disc herniation. One thousand patients meeting the inclusion criteria were selected to be in each group. LSTV was classified by Castellvi's classification and disc degeneration was assessed by Pfirrmann's grading on MRI scans. Results The prevalence of LSTV among urology outpatients, spine outpatients and discectomy patients was 8.1%, 14%, and 16.9% respectively. LSTV patients showed a higher Pfirrmann's grade of degeneration of the last mobile disc. Results were found to be significant statistically. Conclusions The prevalence of LSTV in spinal outpatients and discectomy patients was significantly higher as compared to those attending the urology outpatient clinic. There was a definite causal relationship between the transitional vertebra and the degeneration of the disc immediately cephalad to it. PMID:24596605

  18. Cervical and thoracic vertebral malformation ("weak neck") in Colombia lambs.

    PubMed

    Lakritz, J; Barr, B C; George, L W; Wisner, E R; Glenn, J S; East, N E; Pool, R R

    1995-01-01

    The purpose of this study is to describe a developmental defect of the caudal cervical and cranial thoracic vertebrae in 11 purebred Colombia lambs. The lambs were either affected at birth, or developed the condition within the first 18 days of age. Cervicothoracic kyphosis, with a compensatory cervical lordosis and ataxia were common; 8 lambs had abnormal head posture, characterized by inability to lift the head from the ground. One lamb had rigid head and neck, and had to move the entire body to look to the left or right. Neurological signs included ataxia, tetraparesis, diminished conscious proprioception, and increased patellar and triceps reflexes. One lamb had inspiratory stridor because of compression of the trachea in the area overlying the abnormal vertebrae (cervical vertebrae 6 [C6] and 7 [C7]). Radiographic and pathological abnormalities included malalignment and malarticulation of the caudal cervical and cranial thoracic spine, rounded cranioventral margins in the bodies of vertebrae C7 and T1, wedging of the intervertebral disc spaces between C6 and T1 vertebrae, and hypoplasia of the dens. Pathological changes in the soft tissues included hypoplasia of the cervical epaxial and hypaxial musculature, with associated focal areas of myodegeneration. Mild Wallerian axonal degeneration, compatible with a mild cord compression syndrome, was found in 3 lambs in the cervicothoracic spinal cord adjacent to the vertebral anomalies. The concentrations of copper and selenium in blood, plasma, or tissues were normal in 10 of 11 lambs. All but one of the lambs in which pedigree information was provided were genetically related. Siblings born as twins to 5 of the affected lambs were normal, but both lambs from one twin pregnancy were affected. Owners reported that breeding stock had been shared among the ranches. Because of the close familial relationships of the affected lambs, the condition is suspected to have a hereditary basis. PMID:8558486

  19. Dimensional coordinate measurements: application in characterizing cervical spine motion

    NASA Astrophysics Data System (ADS)

    Zheng, Weilong; Li, Linan; Wang, Shibin; Wang, Zhiyong; Shi, Nianke; Xue, Yuan

    2014-06-01

    Cervical spine as a complicated part in the human body, the form of its movement is diverse. The movements of the segments of vertebrae are three-dimensional, and it is reflected in the changes of the angle between two joint and the displacement in different directions. Under normal conditions, cervical can flex, extend, lateral flex and rotate. For there is no relative motion between measuring marks fixed on one segment of cervical vertebra, the cervical vertebrae with three marked points can be seen as a body. Body's motion in space can be decomposed into translational movement and rotational movement around a base point .This study concerns the calculation of dimensional coordinate of the marked points pasted to the human body's cervical spine by an optical method. Afterward, these measures will allow the calculation of motion parameters for every spine segment. For this study, we choose a three-dimensional measurement method based on binocular stereo vision. The object with marked points is placed in front of the CCD camera. Through each shot, we will get there two parallax images taken from different cameras. According to the principle of binocular vision we can be realized three-dimensional measurements. Cameras are erected parallelly. This paper describes the layout of experimental system and a mathematical model to get the coordinates.

  20. Bertolotti's syndrome revisited. Transitional vertebrae of the lumbar spine.

    PubMed

    Elster, A D

    1989-12-01

    Bertolotti's syndrome refers to the association of back pain with lumbosacral transitional vertebrae. Such vertebrae were observed in 140 of 2,000 adults with back pain over a 4-year period of study. Each patient had radiographic evaluation of the lumbar spine by plain films as well as a sectional imaging modality (magnetic resonance [MR] or computed tomography [CT]). The overall incidence of structural pathology (eg, spinal stenosis and disc protrusion) detected by CT or MR was not apparently higher in patients with transitional vertebrae, but the distribution of these lesions was significantly different. Disc bulge or herniation, when it occurred, was nearly nine times more common at the interspace immediately above the transitional vertebra than at any other level. Spinal stenosis and nerve root canal stenosis were more common at or near the interspace above the transitional vertebra than at any other level. Degenerative change at the articulation between the transverse process of the transitional vertebra and the pelvis was an uncommon occurrence; when seen there was no significant correlation with the reported side of pain. It is postulated that hypermobility and altered stresses become concentrated in the spine at the level immediately above a lumbar transitional vertebra. Accelerated disc and facet joint degeneration at this level may then result. PMID:2533403

  1. Tracking Lumbar Vertebrae in Digital Videofluoroscopic Video Automatically

    E-print Network

    Wong, Kenneth K.Y.

    Tracking Lumbar Vertebrae in Digital Videofluoroscopic Video Automatically Shu-Fai WONG1 , Kwan) shows typical videofluoroscopic image of spine. Thus, a wide range of researches on automatic extraction

  2. Level Set Segmentation of Lumbar Vertebrae Using Appearance Models

    NASA Astrophysics Data System (ADS)

    Fritscher, Karl; Leber, Stefan; Schmölz, Werner; Schubert, Rainer

    For the planning of surgical interventions of the spine exact knowledge about 3D shape and the local bone quality of vertebrae are of great importance in order to estimate the anchorage strength of screws or implants. As a prerequisite for quantitative analysis a method for objective and therefore automated segmentation of vertebrae is needed. In this paper a framework for the automatic segmentation of vertebrae using 3D appearance models in a level set framework is presented. In this framework model information as well as gradient information and probabilities of pixel intensities at object edges in the unseen image are used. The method is tested on 29 lumbar vertebrae leading to accurate results, which can be useful for surgical planning and further analysis of the local bone quality.

  3. Cervical Angina

    PubMed Central

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  4. Quantitative Assessment of Cervical Vertebral Maturation Using Cone Beam Computed Tomography in Korean Girls

    PubMed Central

    Byun, Bo-Ram; Kim, Yong-Il; Maki, Koutaro; Son, Woo-Sung

    2015-01-01

    This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6–18 years of age). CBCT-generated cervical vertebral maturation (CVM) was used to demarcate the odontoid process and the body of the second cervical vertebra, based on the dentocentral synchondrosis. Correlation coefficient analysis and multiple linear regression analysis were used for each parameter of the cervical vertebrae (P < 0.05). Forty-seven of 64 parameters from CBCT-generated CVM (independent variables) exhibited statistically significant correlations (P < 0.05). The multiple regression model with the greatest R2 had six parameters (PH2/W2, UW2/W2, (OH+AH2)/LW2, UW3/LW3, D3, and H4/W4) as independent variables with a variance inflation factor (VIF) of <2. CBCT-generated CVM was able to include parameters from the second cervical vertebral body and odontoid process, respectively, for the multiple regression models. This suggests that quantitative analysis might be used to estimate skeletal maturation status.

  5. Cervical neuroblastoma.

    PubMed

    Singh, Harjitpal; Mohan, C; Mohindroo, N K; Sharma, D R

    2007-09-01

    Cervical neuroblastoma is relatively uncommon. It present, most often as a firm mass in the lateral neck. Primary neuroblastomas of the neck usually arise in the cervical sympathetic ganglia. They are the sixth most common head and neck extracranial neoplasms. Neuroblastoma is the most common malignancy in children under 1 year of age. No known cause of Neuroblastoma has been reported. PMID:23120455

  6. Cervical Cancer

    MedlinePLUS

    ... in the United States get cervical cancer. The human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex. At least half of sexually active people will ...

  7. Automatic labeling and segmentation of vertebrae in CT images

    NASA Astrophysics Data System (ADS)

    Rasoulian, Abtin; Rohling, Robert N.; Abolmaesumi, Purang

    2014-03-01

    Labeling and segmentation of the spinal column from CT images is a pre-processing step for a range of image- guided interventions. State-of-the art techniques have focused either on image feature extraction or template matching for labeling of the vertebrae followed by segmentation of each vertebra. Recently, statistical multi- object models have been introduced to extract common statistical characteristics among several anatomies. In particular, we have created models for segmentation of the lumbar spine which are robust, accurate, and computationally tractable. In this paper, we reconstruct a statistical multi-vertebrae pose+shape model and utilize it in a novel framework for labeling and segmentation of the vertebra in a CT image. We validate our technique in terms of accuracy of the labeling and segmentation of CT images acquired from 56 subjects. The method correctly labels all vertebrae in 70% of patients and is only one level off for the remaining 30%. The mean distance error achieved for the segmentation is 2.1 +/- 0.7 mm.

  8. A biomechanical system for measuring the three dimensional kinematics of the cervical spine during impact

    Microsoft Academic Search

    J. R. Humm; G. F. Harris; Y. N. Yoganandan; T. H. Lim; C. J. Mugnier; R. C. Anderson

    1997-01-01

    Four intact human head-neck complexes were fixed between T1 and T2. Reflective target markers were inserted into the exposed cervical vertebra to document the 3D kinematics of the cervical spine and head. A dynamic pulse was delivered to the specimen using a mini-sled pendulum apparatus. Each specimen was examined in five different orientations and with two different pulses, for a

  9. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths.

    PubMed

    Reumer, Jelle W F; Ten Broek, Clara M A; Galis, Frietson

    2014-01-01

    The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects). Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3%) and approximately 10 times higher than that of extant elephants (3.6%). Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side) and seventh (anterior side) cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene. PMID:24711969

  10. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths

    PubMed Central

    Reumer, Jelle W.F.; ten Broek, Clara M.A.

    2014-01-01

    The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects). Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3%) and approximately 10 times higher than that of extant elephants (3.6%). Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side) and seventh (anterior side) cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene. PMID:24711969

  11. Cervical Cap

    MedlinePLUS

    ... and remove the cap. How Much Does It Cost? A cervical cap costs about $70 and should be replaced every year. In addition, there is also the cost of the doctor's visit. Many health insurance plans ...

  12. Cervical Cryotherapy

    MedlinePLUS

    Cervical Cryotherapy What is cryotherapy? Cryotherapy or a freezing treatment is a safe and effective way to ... similar to menstrual cramps during the treatment. The freezing treatment takes only 10 to 15 minutes and ...

  13. Cervical Adenocarcinoma

    MedlinePLUS

    ... The most common subtype of cervical cancer, called squamous cell carcinoma, arises from the surface lining of the ectocervix, ... successful at decreasing the number of patients with squamous cell carcinoma of the cervix, it has not yet been ...

  14. Design of an occipito-cervical fixation device.

    PubMed

    Shepherd, D E; Bolger, C M; Leahy, J C; Mathias, K J; Hukins, D W

    2000-01-01

    Metal plates may be used to stabilize the cervical spine. The plates are attached to the posterior of the vertebra by placing screws into the lateral masses. The plating may be extended, in the form of rod or plate, to connect with and support the occiput. Several problems, such as screw loosening and the plate obscuring the surgeon's view as a screw is being inserted, have been identified with present plate systems. This paper describes the initial design for a cervical fixation device to overcome these problems, and the design and development that was undertaken to enable a prototype device to be manufactured. PMID:10997060

  15. Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads

    Microsoft Academic Search

    Srirangam Kumaresan; Narayan Yoganandan; Frank A Pintar; Dennis J Maiman

    1999-01-01

    An anatomically accurate, three-dimensional, nonlinear finite element model of the human cervical spine was developed using computed tomography images and cryomicrotome sections. The detailed model included the cortical bone, cancellous core, endplate, lamina, pedicle, transverse processes and spinous processes of the vertebrae; the annulus fibrosus and nucleus pulposus of the intervertebral discs; the uncovertebral joints; the articular cartilage, the synovial

  16. Automated identification of spinal cord and vertebras on sagittal MRI

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Dong, Qian; He, Bo; Wei, Jun; Hadjiiski, Lubomir M.; Couriel, Daniel

    2014-03-01

    We are developing an automated method for the identification of the spinal cord and the vertebras on spinal MR images, which is an essential step for computerized analysis of bone marrow diseases. The spinal cord segment was first enhanced by a newly developed hierarchical multiscale tubular (HMT) filter that utilizes the complementary hyper- and hypo- intensities in the T1-weighted (T1W) and STIR MRI sequences. An Expectation-Maximization (EM) analysis method was then applied to the enhanced tubular structures to extract candidates of the spinal cord. The spinal cord was finally identified by a maximum-likelihood registration method by analysis of the features extracted from the candidate objects in the two MRI sequences. Using the identified spinal cord as a reference, the vertebras were localized based on the intervertebral disc locations extracted by another HMT filter applied to the T1W images. In this study, 5 and 30 MRI scans from 35 patients who were diagnosed with multiple myeloma disease were collected retrospectively with IRB approval as training and test set, respectively. The vertebras manually outlined by a radiologist were used as reference standard. A total of 422 vertebras were marked in the 30 test cases. For the 30 test cases, 100% (30/30) of the spinal cords were correctly segmented with 4 false positives (FPs) mistakenly identified on the back muscles in 4 scans. A sensitivity of 95.0% (401/422) was achieved for the identification of vertebras, and 5 FPs were marked in 4 scans with an average FP rate of 0.17 FPs/scan.

  17. Cervical radiculopathy.

    PubMed

    Polston, David W

    2007-05-01

    Cervical radiculopathy is a condition encountered commonly in the evaluation of neck pain that may result in significant discomfort and functional deficits. Although the long-term prognosis of this condition is favorable, a standardized approach to therapy is important to minimize unnecessary tests and identify patients who require more urgent intervention. Patient education, pain control, and physical therapy are the first line of therapy. Patients who have protracted pain or significant functional deficits may require a more thorough evaluation, including imaging, electrodiagnostic testing, and, possibly, surgical referral. This article outlines the basic clinical, diagnostic, and therapy considerations in the evaluation of cervical radiculopathy. PMID:17445734

  18. Vertebrae in Compression: Mechanical Behavior of Arches and Centra in the Gray Smooth-Hound Shark

    E-print Network

    Long Jr., John H.

    Vertebrae in Compression: Mechanical Behavior of Arches and Centra in the Gray Smooth-Hound Shark, Poughkeepsie, New York 12604 ABSTRACT In swimming sharks, vertebrae are sub- jected, in part, to compressive cartilages in compression, to determine the ma- terial properties of shark vertebrae, and to document

  19. Cervical Stenosis

    MedlinePLUS

    ... the tissues in the cervix thin (atrophy) Cervical stenosis may result in an accumulation of blood in the uterus (hematometra). In women who are still menstruating, menstrual blood mixed with cells from the uterus may flow backward into the pelvis, possibly causing endometriosis (see ...

  20. RELATIONSHIP BETWEEN CRANIAL AND MANDIBULAR GROWTH AND THE STAGES OF MATURATION OF THE CERVICAL VERTEBRAE

    PubMed Central

    Damian, Melissa Feres; Cechinato, Fernando; Molina, Rafael Dagnese; Woitchunas, Fábio Eduardo

    2007-01-01

    Quantification of the expectation of craniofacial growth during the pubertal growth spurt (PGS) is helpful in orthodontic diagnosis and treatment planning. Thus, this study investigated whether the stages of the vertebral maturation index (VMI) would be valid for estimating cranial and mandibular growth during the initial stages of PGS, testing the null hypothesis that these structures do not demonstrate differential growth dependent on the maturation stage. A study population of 45 patients of both genders with 2 lateral cephalometric radiographs, taken at a 12-month interval, was selected from files. All patients should not have been previously submitted to orthodontic treatment and should be before or during the peak stage of PGS. The S-N and Co-Gn cephalometric measurements were traced on both radiographs of each patient, by computed cephalometric tracings, for evaluation of skull and mandible, respectively. The growth of these structures was established by the difference between the measurements obtained on both tracings. The VMI stage was also estimated on the radiographs, determining the position of patients on the PGS curve at two periods, baseline and after 12 months. Cephalometric tracings and VMI estimates were performed by two calibrated examiners. Descriptive statistics revealed that both cephalometric measurements increased during the study period, especially Co-Gn, which demonstrated (ANOVA and Tukey's test; 5% significance level), a statistically significant peak of development (p = 0.001), when the patient was in the VMI stage representing the PGS peak. It was concluded that the VMI stages were valid for the analysis of cranial growth and especially of mandibular growth at the initial stages of PGS, thus rejecting the null hypothesis. PMID:19089113

  1. Cervical Spine Functional Anatomy and the Biomechanics of Injury Due to Compressive Loading

    PubMed Central

    Swartz, Erik E; Floyd, R. T; Cendoma, Mike

    2005-01-01

    Objective: To provide a foundation of knowledge concerning the functional anatomy, kinematic response, and mechanisms involved in axial-compression cervical spine injury as they relate to sport injury. Data Sources: We conducted literature searches through the Index Medicus, SPORT Discus, and PubMed databases and the Library of Congress from 1975–2003 using the key phrases cervical spine injury, biomechanics of cervical spine, football spinal injuries, kinematics of the cervical spine, and axial load. Data Synthesis: Research on normal kinematics and minor and major injury mechanisms to the cervical spine reveals the complex nature of movement in this segment. The movement into a single plane is not the product of equal and summative movement between and among all cervical vertebrae. Instead, individual vertebrae may experience a reversal of motion while traveling through a single plane of movement. Furthermore, vertebral movement in 1 plane often requires contributed movement in 1 or 2 other planes. Injury mechanisms are even more complex. The reaction of the cervical spine to an axial-load impact has been investigated using cadaver specimens and demonstrates a buckling effect. Impact location and head orientation affect the degree and level of resultant injury. Conclusions/Recommendations: As with any joint of the body, our understanding of the mechanisms of cervical spine injury will ultimately serve to reduce their occurrence and increase the likelihood of recognition and immediate care. However, the cervical spine is unique in its normal kinematics compared with joints of the extremities. Injury biomechanics in the cervical spine are complex, and much can still be learned about mechanisms of the cervical spine injury specific to sports. PMID:16284634

  2. Lumbosacral Transitional Vertebrae and Its Prevalence in the Australian Population

    PubMed Central

    French, Heath D.; Somasundaram, Arjuna J.; Schaefer, Nathan R.; Laherty, Richard W.

    2014-01-01

    Study Design?Retrospective cohort study. Objective?Lumbosacral transitional vertebrae (LSTV) are a common congenital anomaly, and they can be accurately identified on anteroposterior (AP) radiographs of the lumbosacral spine. This study attempts to determine the prevalence of this congenital anomaly and to increase awareness among all clinicians to reduce the risk of surgical and procedural errors in patients with LSTV. Methods?A retrospective review of 5,941 AP and lateral lumbar radiographs was performed. Transitional vertebrae were identified and categorized under the Castellvi classification. Results?The prevalence of LSTV in the study population was 9.9%. Lumbarized S1 and sacralized L5 were seen in 5.8 and 4.1% of patients, respectively. Conclusion?LSTV are a common normal variant and can be a factor in spinal surgery at incorrect levels. It is essential that all clinicians are aware of this common congenital anomaly. PMID:25396103

  3. Sex determination by discriminant function analysis of lumbar vertebrae.

    PubMed

    Ostrofsky, Kelly R; Churchill, Steven E

    2015-01-01

    Sex determination is critical for developing the biological profile of unidentified skeletal remains. When more commonly used elements (os coxa, cranium) for sexing are not available, methods utilizing other skeletal elements are needed. This study aims to assess the degree of sexual dimorphism of the lumbar vertebrae and develop discriminant functions for sex determination from them, using a sample of South African blacks from the Raymond A. Dart Collection (47 males, 51 females). Eleven variables at each lumbar level were subjected to univariate and multivariate discriminant function analyses. Univariate equations produced classification rates ranging from 57.7% to 83.5%, with the highest accuracies associated with dimensions of the vertebral body. Multivariate stepwise analysis generated classification rates ranging from 75.9% to 88.7%. These results are comparable to other methods for sexing the skeleton and indicate that measures of the lumbar vertebrae can be used as an effective tool for sex determination. PMID:25382679

  4. Modelling and analysis of vertebra deformations with spherical harmonics.

    PubMed

    Lefaix, Gildas; Haigron, Pascal; Rolland, Yan; Collorec, René

    2002-01-01

    In this paper we present an elaborate and precise geometrical model of the spine structure based on spherical harmonics. We first describe the application of spherical harmonics to the modelling of the vertebra surface, then we study the behaviour of the model under particular deformations. The first results of this study show that we can obtain a realistic model of each vertebra of the spine and that it is possible to estimate particular deformations with a good accuracy from the spherical harmonics coefficients of the deformed surface. Furthermore, this model constitutes an a priori geometrical knowledge for the diagnosis of the spine scoliosis in a three-dimensional approach (reconstruction from 2D images). PMID:15456024

  5. Cervical Squamous Cell Carcinoma

    MedlinePLUS

    ... increased vaginal discharge, pelvic pain, or pain during sexual intercourse. (continued on next page) Cervical Cancer Cervical Squamous Cell Carcinoma Copyright © 2011. College of American Pathologists. For use and reproduction by patients and CAP members only. Normal cervical ...

  6. Multirigid registration of MR and CT images of the cervical spine

    NASA Astrophysics Data System (ADS)

    Hu, Yangqiu; Haynor, David R.

    2004-05-01

    We present our work on fusion of MR and CT images of the cervical spine. To achieve the required registration accuracy of approximately 1mm, the spine is treated as a collection of rigid vertebrae, and a separate rigid body transformation applied to each (Hawkes). This in turn requires segmentation of the CT datasets into separate vertebral images, which is difficult because the narrow planes separating adjacent vertebrae are parallel to the axial plane of the CT scans. We solve this problem by evolving all the vertebral contours simultaneously using a level set method, and use contour competition to estimate the position of the vertebral edges when a clean separation between adjacent vertebrae is not seen. Contour competition is based in turn on the vertical scan principle: no part of a given vertebra is vertically below any part of an inferior vertebra. Once segmentation is complete, the individual rigid body transforms are then estimated using mutual information maximization, and the CT images of the vertebrae superimposed on the MR scans. The resultant fused images contain the bony detail of CT and the soft tissue discrimination of MR and appear to be diagnostically equivalent, or superior, to CT myelograms. A formal test of these conclusions is planned for the next phase of our work.

  7. Cervical spine mobility analysis on radiographs: a fully automatic approach.

    PubMed

    Lecron, Fabian; Benjelloun, Mohammed; Mahmoudi, Saïd

    2012-12-01

    Conventional X-ray radiography remains nowadays the most common method to analyze spinal mobility in two dimensions. Therefore, the objective of this paper is to develop a framework dedicated to the fully automatic cervical spine mobility analysis on X-ray images. To this aim, we propose an approach based on three main steps: fully automatic vertebra detection, vertebra segmentation and angular measurement. The accuracy of the method was assessed for a total of 245 vertebræ. For the vertebra detection, we proposed an adapted version of two descriptors, namely Scale-invariant Feature Transform (SIFT) and Speeded-up Robust Features (SURF), coupled with a multi-class Support Vector Machine (SVM) classifier. Vertebræ are successfully detected in 89.8% of cases and it is demonstrated that SURF slightly outperforms SIFT. The Active Shape Model approach was considered as a segmentation procedure. We observed that a statistical shape model specific to the vertebral level improves the results. Angular errors of cervical spine mobility are presented. We showed that these errors remain within the inter-operator variability of the reference method. PMID:22981777

  8. Cervical Laminoplasty for Multilevel Cervical Myelopathy

    PubMed Central

    Sayana, Murali Krishna; Jamil, Hassan; Poynton, Ashley

    2011-01-01

    Cervical spondylotic myelopathy can result from degenerative cervical spondylosis, herniated disk material, osteophytes, redundant ligamentum flavum, or ossification of the posterior longitudinal ligament. Surgical intervention for multi-level myelopathy aims to decompress the spinal cord and maintain stability of the cervical spine. Laminoplasty was major surgical advancement as laminectomy resulted in kyphosis and unsatisfactory outcomes. Hirabayashi popularised the expansive open door laminoplasty which was later modified several surgeons. Laminoplasty has changed the way surgeons approach multilevel cervical spondylotic myelopathy. PMID:21991408

  9. Effects of cervical deep muscle strengthening in a neck pain: a patient with klippel-feil syndrome.

    PubMed

    Bae, Youngsook

    2014-12-01

    [Purpose] This study aimed to identify the effects of cervical deep muscle strengthening (CDS) on neck pain in a patient with Klippel-Feil syndrome (KFS). [Subjects and Methods] The subjects was a 39?year-old woman with neck pain and KFS that included incomplete block vertebrae in the C2-3 segments and block vertebrae in the C6-7 segments. The subject performed an exercise program including cervical strengthening exercise (level 1) and CDS exercise (level 2) for 6 weeks. Neck pain intensity was measured using the visual analogue scale (VAS) and the pressure pain threshold (PPT). All measurements were obtained before and after the CDS exercise program. [Results] The VAS and PPT measurements decreased; range of motion in the cervical joint increased. [Conclusion] CDS exercises were effective interventions for reducing neck pain in a patient with Klippel-Feil syndrome. PMID:25540517

  10. Effects of Cervical Deep Muscle Strengthening in a Neck Pain: A Patient with Klippel-Feil Syndrome

    PubMed Central

    Bae, Youngsook

    2014-01-01

    [Purpose] This study aimed to identify the effects of cervical deep muscle strengthening (CDS) on neck pain in a patient with Klippel-Feil syndrome (KFS). [Subjects and Methods] The subjects was a 39?year-old woman with neck pain and KFS that included incomplete block vertebrae in the C2–3 segments and block vertebrae in the C6–7 segments. The subject performed an exercise program including cervical strengthening exercise (level 1) and CDS exercise (level 2) for 6 weeks. Neck pain intensity was measured using the visual analogue scale (VAS) and the pressure pain threshold (PPT). All measurements were obtained before and after the CDS exercise program. [Results] The VAS and PPT measurements decreased; range of motion in the cervical joint increased. [Conclusion] CDS exercises were effective interventions for reducing neck pain in a patient with Klippel-Feil syndrome. PMID:25540517

  11. Ossified Ligamentum Longitudinale Anterius in Adult Human Dry Vertebrae

    PubMed Central

    Venumadhav, Nelluri; KS, Siddaraju

    2014-01-01

    Background: The ligamentum longitudinale anterius is a broad and strong band of fibrous tissue that runs along the anterior surfaces of the bodies of the vertebrae. Aim: The study was undertaken to evaluate the incidence of ossified ligamentum longitudinale anterius in adult dry human vertebra. Materials and Methods: This study was carried out on 95 sets of dry human vertebral columns irrespective of age and sex at Mayo Institute of Medical Sciences- Barabanki,-UP, Melaka Manipal Medical College-Manipal University and Department of Anatomy, KMCT Medical College, Manassery- Calicut, India. All the sets of vertebral columns were macroscopically inspected for the ossified ligamentum longitudinale anterius. Results: It was observed that out of 95 sets of vertebral columns, 27 (28.42%) vertebral columns showed ossification. Out of 27 vertebral columns, 17 (17.89%) vertebral columns showed segmental type of ossification, 2 (2.11%) vertebral columns showed continuous type of ossification and 8 (8.42%) vertebral columns showed mixed type of ossification at different vertebral level. Conclusion: Such type of ossification will affect the biomechanics of the spine and may result in stiff neck, low back pain, dysphagia, odynophagia, compression of the brachial plexus, aphonia, immobility or mucosal thickening of larynx. Hence, knowledge of such abnormalities should be kept in mind to minimise serious complications in any surgical intervention or investigative procedures in the region. PMID:25302180

  12. 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

  13. "Lucy" (A.L. 288-1) had five sacral vertebrae.

    PubMed

    Russo, Gabrielle A; Williams, Scott A

    2015-02-01

    A "long-backed" scenario of hominin vertebral evolution posits that early hominins possessed six lumbar vertebrae coupled with a high frequency of four sacral vertebrae (7:12-13:6:4), a configuration acquired from a hominin-panin last common ancestor (PLCA) having a vertebral formula of 7:13:6-7:4. One founding line of evidence for this hypothesis is the recent assertion that the "Lucy" sacrum (A.L. 288-1an, Australopithecus afarensis) consists of four sacral vertebrae and a partially-fused first coccygeal vertebra (Co1), rather than five sacral vertebrae as in modern humans. This study reassesses the number of sacral vertebrae in Lucy by reexamining the distal end of A.L.288-1an in the context of a comparative sample of modern human sacra and Co1 vertebrae, and the sacrum of A. sediba (MH2). Results demonstrate that, similar to S5 in modern humans and A. sediba, the last vertebra in A.L. 288-1an exhibits inferiorly-projecting (right side) cornua and a kidney-shaped inferior body articular surface. This morphology is inconsistent with that of fused or isolated Co1 vertebrae in humans, which either lack cornua or possess only superiorly-projecting cornua, and have more circularly-shaped inferior body articular surfaces. The level at which the hiatus' apex is located is also more compatible with typical five-element modern human sacra and A. sediba than if only four sacral vertebrae are present. Our observations suggest that A.L. 288-1 possessed five sacral vertebrae as in modern humans; thus, sacral number in "Lucy" does not indicate a directional change in vertebral count that can provide information on the PLCA ancestral condition. PMID:25331588

  14. Finite element modeling of the C4–C6 cervical spine unit

    Microsoft Academic Search

    N. Yoganandan; S. C. Kumaresan; Liming Voo; F. A. Pintar; S. J. Larson

    1996-01-01

    This study was conducted to develop a detailed, three-dimensional, anatomically accurate finite element model of the human cervical spine structure using close-up computed tomography scans and to validate against experimental data. The finite element model of the three vertebra segment CA-06 unit consisted of 9178 solid elements and 1193 thin shell elements. The force-displacement response under axial compression correlated well

  15. The relation between the spatial distribution of vertebral artery compromise and exposure to cervical manipulation

    Microsoft Academic Search

    Gregory N. Kawchuk; Gian S. Jhangri; Eric L. Hurwitz; Shari Wynd; S. Haldeman; Michael D. Hill

    2008-01-01

    Background and purpose\\u000a   The vertebral artery is made up of four segments, one of which (V3) is connected to highly mobile cervical vertebrae. This\\u000a connection underlies the common assumption that persons with pre-event histories of mechanical neck movements, such as cervical\\u000a spine manipulation (cSMT), should experience increased V3 dissection.\\u000a \\u000a \\u000a \\u000a \\u000a Methods\\u000a   Two of the largest case series of vertebral artery dissection

  16. Solitary myofibroma of the lumbar vertebra: adult case.

    PubMed

    Konishi, E; Mazaki, T; Urata, Y; Tanaka, K; Kanoe, H; Ikenaga, M; Hayakawa, K; Yanagisawa, A

    2007-06-01

    We present the first known adult case of solitary myofibroma of bone, which affected a lumbar vertebra in a 33-year-old male. Radiography identified a purely lytic lesion with a sclerotic rim in the right pedicle of L1. CT showed an expansile lytic lesion with a sclerotic rim. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneously hyperintense signal on T2-weighted images, and marked enhancement with gadolinium. Pathological study showed a mixed picture of nodular proliferation of spindle-shaped myoid cells and hemangiopericytomatous proliferation of short spindle/small round cells. The tumor cells were immunoreactive for smooth muscle actin and immunonegative for desmin. This case of solitary myofibroma of bone is exceptionally rare because of its occurrence in an adult older than 20 years of age and its location at an extra-craniofacial site. PMID:16649043

  17. Variations in strength of vertebrae with age and their relation to osteoporosis

    Microsoft Academic Search

    G. H. Bell; Olive Dunbar; J. S. Beck; A. Gibb

    1967-01-01

    Fourth and fifth lumbar vertebrae were obtained at post mortem examinations of human subjects in the range 26 to 86 years and at the same time specimens were taken from the iliac crests for histological assessment of trabecular density (iliac crest score). After removal of pedicles and spinous processes the vertebrae were compressed in a testing machine to mechanical failure.

  18. Ivory vertebra on 18F-sodium fluoride scan: an old sign in a new modality.

    PubMed

    Oldan, Jorge Daniel; Kuzminski, Samuel; James, Olga

    2014-11-01

    We report a case of ivory vertebra on 18F-sodium fluoride. A prostate cancer patient had a 18F-sodium fluoride PET scan to evaluate overall spread of disease. In addition to other findings of metastatic disease, the patient had an ivory vertebra. PMID:24566404

  19. Extrication, immobilization and radiologic investigation of patients with cervical spine injuries.

    PubMed Central

    Karbi, O A; Caspari, D A; Tator, C H

    1988-01-01

    Most cervical spine injuries are due to motor vehicle accidents. Proper extrication of the victims is vital; the ideal device should be easily assembled and applied, should facilitate removal of victims from automobile seats without changing the body's position, must not hinder airway access or the performance of cardiopulmonary resuscitation, must accommodate all types of patients, including children and obese or pregnant patients, and must completely immobilize the patient, especially if hyperextension is suspected. Current methods of immobilization, such as the use of a soft collar and sandbags, allow neck extension; the short board protects against extension but interferes with airway access. Newer devices are discussed in this article. Injuries of the upper cervical spine are less common but more serious than those of the lower portion and usually involve the vertebral arch. Radiologic examination of the first and second cervical vertebrae and the seventh cervical and first thoracic vertebrae should be emphasized. If lateral and anteroposterior views do not reveal abnormal findings and injury is still suspected, oblique views and computed or conventional tomography should be used. Cervical spinal cord injuries can be minimized or prevented if proper early management is applied. PMID:3046734

  20. Periosteal structure and development in a rat caudal vertebra.

    PubMed Central

    Ellender, G; Feik, S A; Carach, B J

    1988-01-01

    Female Sprague-Dawley rats from birth to 300 days were used to study the bone/soft tissue interrelationships of the 14th caudal vertebra with particular emphasis on the periosteum throughout growth, development and maturation. The growth of the rats follows a sigmoid curve with three phases, a developmental, a rapid growth and a maturation phase. The width/length ratio of the bone and the thickness of the periosteum are closely concurrent, with a rapid decrease during the developmental phase and a levelling off during the rapid growth phase. SEM studies established that the caudal vertebra has symmetrical lateral sides and a pronounced concavity on the ventral surface where the main vascular plexus is located. Morphological changes in the periosteum cna be described as occurring in three layers and reflect the stages seen in general somatic growth. The inner cambial layer initially contains elongated but functional osteoblasts; these become cuboidal during the rapid growth phase and ultimately are flattened and quiescent. The mid-zone with its vessels, undifferentiated and mononuclear phagocytic cells also attains its maximum development in the rapid growth period and then gradually involutes. The fibrous periosteum consists of a syncytial arrangement of fibroblasts in a collagenous matrix which becomes increasingly dense although reduced in width. Sharpey fibre bundles connect the bone with the fibrous periosteum and these become thicker with age. The mid-zone of the periosteum has not been described previously. Besides having a nutritive role and providing progenitor cells it is thought to act as a buffer modulating the interaction between bone and the covering soft tissues. With age and the deletion of the mid-zone a less sensitive periosteal response to stress can be expected. Images Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 PMID:3225221

  1. Craniofacial and Cervical Morphology Related to Sagittal Spinal Posture in Children and Adolescents

    PubMed Central

    Segatto, Angyalka; Braunitzer, Gábor

    2014-01-01

    Studies on the relationship between body posture and craniofacial parameters often focus on the cervical spine. Thus, less attention has been paid to the morphology of the vertebra C2 that serves as both a structural and functional link between the craniofacial area and the other part of the spine. The objective of this study was to assess the relation of craniofacial features to certain morphological and positional characteristics of the cervical vertebrae and the spine during growth. We determined body posture indices for 69 children and adolescents by means of a radiation-free method (rasterstereography). The morphological and positional analysis of the craniofacial area and the cervical vertebrae was based on standardized lateral X-ray cephalograms. Medium to strong correlations were found between body posture, C2 morphology, and craniofacial parameters. We found significant correlations between the C2 dens axis height and maxillary indices as well as between the C2 dens axis inclination and cephalometrical values of the mandibular area. Similarly the correlation between the C2 dens axis inclination and the postural index flèche cervicale was highly significant (P < 0.05, r = 0.333). These results suggest that morphological features of the odontoid process may serve as valuable predictive markers in interdisciplinary orthopedic-orthodontic diagnostics. PMID:25276804

  2. Severe neurologic manifestations from cervical spine instability in spondylo-megaepiphyseal-metaphyseal dysplasia.

    PubMed

    Simon, Marleen; Campos-Xavier, Ana Belinda; Mittaz-Crettol, Lauréane; Valadares, Eugenia Ribeiro; Carvalho, Daniel; Speck-Martins, Carlos Eduardo; Nampoothiri, Sheela; Alanay, Yasemin; Mihci, Ercan; van Bever, Yolande; Garcia-Segarra, Nuria; Cavalcanti, Denise; Mortier, Geert; Bonafé, Luisa; Superti-Furga, Andrea

    2012-08-15

    Spondylo-megaepiphyseal-metaphyseal dysplasia (SMMD; OMIM 613330) is a dysostosis/dysplasia caused by recessive mutations in the homeobox-containing gene, NKX3-2 (formerly known as BAPX1). Because of the rarity of the condition, its diagnostic features and natural course are not well known. We describe clinical and radiographic findings in six patients (five of which with homozygous mutations in the NKX3-2 gene) and highlight the unusual and severe changes in the cervical spine and the neurologic complications. In individuals with SMMD, the trunk and the neck are short, while the limbs, fingers and toes are disproportionately long. Radiographs show a severe ossification delay of the vertebral bodies with sagittal and coronal clefts, missing ossification of the pubic bones, large round "balloon-like" epiphyses of the long bones, and presence of multiple pseudoepiphyses at all metacarpals and phalanges. Reduced or absent ossification of the cervical vertebrae leads to cervical instability with anterior or posterior kinking of the cervical spine (swan neck-like deformity, kyknodysostosis). As a result of the cervical spine instability or deformation, five of six patients in our series suffered cervical cord injury that manifested clinically as limb spasticity. Although the number of individuals observed is small, the high incidence of cervical spine deformation in SMMD is unique among skeletal dysplasias. Early diagnosis of SMMD by recognition of the radiographic pattern might prevent of the neurologic complications via prophylactic cervical spine stabilization. PMID:22791571

  3. Quantification of the effect of osteolytic metastases on bone strain within whole vertebrae using image registration.

    PubMed

    Hardisty, Michael R; Akens, Margarete K; Hojjat, Seyed-Parsa; Yee, Albert; Whyne, Cari M

    2012-07-01

    The vertebral column is the most frequent site of metastatic involvement of the skeleton with up to 1/3 of all cancer patients developing spinal metastases. Longer survival times for patients, particularly secondary to breast cancer, have increased the need for better understanding the impact of skeletal metastases on structural stability. This study aims to apply image registration to calculate strain distributions in metastatically involved rodent vertebrae utilizing µCT imaging. Osteolytic vertebral lesions were developed in five rnu/rnu rats 2-3 weeks post intracardiac injection with MT-1 human breast cancer cells. An image registration algorithm was used to calculate and compare strain fields due to axial compressive loading in metastatically involved and control vertebrae. Tumor-bearing vertebrae had greatly increased compressive strains, double the magnitude of strain compared to control vertebrae (p=0.01). Qualitatively strain concentrated within the growth plates in both tumor bearing and control vertebrae. Most interesting was the presence of strain concentrations at the dorsal wall in metastatically involved vertebrae, suggesting structural instability. Strain distributions, quantified by image registration were consistent with known consequences of lytic involvement. Metastatically involved vertebrae had greater strain magnitude than control vertebrae. Strain concentrations at the dorsal wall in only the metastatic vertebrae, were consistent with higher incidence of burst fracture secondary to this pathology. Future use of image registration of whole vertebrae will allow focused examination of the efficacy of targeted and systemic treatments in reducing strains and the related risk of fracture in pathologic bones under simple and complex loading. PMID:22213180

  4. Surgical management of multilevel cervical spinal stenosis and spinal cord injury complicated by cervical spine fracture

    PubMed Central

    2014-01-01

    Background There are few reports regarding surgical management of multilevel cervical spinal stenosis with spinal cord injury. Our purpose is to evaluate the safety and feasibility of open-door expansive laminoplasty in combination with transpedicular screw fixation for the treatment of multilevel cervical spinal stenosis and spinal cord injury in the trauma population. Methods This was a retrospective study of 21 patients who had multilevel cervical spinal stenosis and spinal cord injury with unstable fracture. An open-door expansive posterior laminoplasty combined with transpedicular screw fixation was performed under persistent intraoperative skull traction. Outcome measures included postoperative improvement in Japanese Orthopedic Association (JOA) score and incidence of complications. Results The average operation time was 190 min, with an average blood loss of 437 ml. A total of 120 transpedicular screws were implanted into the cervical vertebrae between vertebral C3 and C7, including 20 into C3, 34 into C4, 36 into C5, 20 into C6, and 10 into C7. The mean preoperative JOA score was 3.67?±?0.53. The patients were followed for an average of 17.5 months, and the average JOA score improved to 8.17?±?1.59, significantly higher than the preoperative score (t?=?1.798, P?cervical spinal stenosis and spinal cord injury complicated by unstable fracture. Its advantages include minimum surgical trauma, less intraoperative blood loss, and satisfactory stable supportive effect for reduction of fracture. PMID:25142353

  5. Cervical origin of left subclavian artery: A rare anomaly

    PubMed Central

    Sundaram, Ponnusamy Shunmuga; Sukulal, Kiron; Bijulal, Sasidharan; Tharakan, Jaganmohan A

    2014-01-01

    A 22-year-old lady was referred to our institute for the management of pulmonary atresia with hypoplastic pulmonary arteries. Computed tomographic Angiography (CTA) showed right aortic arch with left brachicephalic artery as the first branch, which trifurcated into internal carotid, external carotid and subclavian artery high up in the neck at the level of third cervical vertebra. The left subclavian artery then travelled back caudally and entered into the arm after giving rise to a large collateral artery. This is the first ever-reported case of cervical origin of left subclavian artery (COLSA) in the literature. This anomaly can be explained by the absence of left fourth aortic arch with left subclavian artery arising from the left third aortic arch. PMID:25298702

  6. Cervical origin of left subclavian artery: A rare anomaly.

    PubMed

    Sundaram, Ponnusamy Shunmuga; Sukulal, Kiron; Bijulal, Sasidharan; Tharakan, Jaganmohan A

    2014-09-01

    A 22-year-old lady was referred to our institute for the management of pulmonary atresia with hypoplastic pulmonary arteries. Computed tomographic Angiography (CTA) showed right aortic arch with left brachicephalic artery as the first branch, which trifurcated into internal carotid, external carotid and subclavian artery high up in the neck at the level of third cervical vertebra. The left subclavian artery then travelled back caudally and entered into the arm after giving rise to a large collateral artery. This is the first ever-reported case of cervical origin of left subclavian artery (COLSA) in the literature. This anomaly can be explained by the absence of left fourth aortic arch with left subclavian artery arising from the left third aortic arch. PMID:25298702

  7. Hipertricosis cervical anterior esporádica

    Microsoft Academic Search

    B. Monteagudo; M. Cabanillas; C. de las Heras; J. M. Cacharrón

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a «tuft» of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair

  8. Isolated Anterior Cervical Hypertrichosis

    Microsoft Academic Search

    B. Monteagudo; M. Cabanillas; C. de las Heras; J. M. Cacharr?n

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a «tuft» of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair

  9. Vaccine Therapy in Treating Patients With Persistent or Recurrent Cervical Cancer

    ClinicalTrials.gov

    2015-02-27

    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

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

    ClinicalTrials.gov

    2015-03-11

    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

  11. Finite element model of human cervical spinal column.

    PubMed

    Wheeldon, J; Khouphongsy, P; Kumaresan, S; Yoganandan, N; Pintar, F A

    2000-01-01

    The purpose of this study was to develop a detailed anatomically accurate finite element model (FEM) of the whole cervical column (C2-T1) using sagittal and coronal computed tomography (CT) scan images and cryomicrotome anatomical sections. The bony vertebrae were defined using CT scan images. The geometrical details of intervertebral discs, uncovertebral joints and ligaments were obtained from cryomicrotome sections. The following steps were used to develop the FEM: wire mesh, surface model and solid model. The wire mesh of each vertebra and disc was generated from the CT and cryomicrotome sections, respectively. The surface model was developed by connecting the wire mesh lines. The solid model was obtained by filling the volume enclosed by the surface model. Finally, the FEM was constructed by discretizing the solid model using the mapped-mesh option. Appropriate finite element types were assigned to each component. For example, the isoparametric eight-noded solid elements were used to define the cancellous bone of a vertebra. The material properties reported in literature were adopted in the model. Commercially available software (IDEAS and ABAQUS) was used to develop the FEM. PMID:10834255

  12. Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability

    PubMed Central

    Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

    2014-01-01

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of excessive motion between two adjacent cervical vertebrae and these associated symptoms is described as cervical instability. Therefore, we propose that in many cases of chronic neck pain, the cause may be underlying joint instability due to capsular ligament laxity. Currently, curative treatment options for this type of cervical instability are inconclusive and inadequate. Based on clinical studies and experience with patients who have visited our chronic pain clinic with complaints of chronic neck pain, we contend that prolotherapy offers a potentially curative treatment option for chronic neck pain related to capsular ligament laxity and underlying cervical instability. PMID:25328557

  13. Lumbosacral Transitional Vertebrae: Association with Low Back Pain

    PubMed Central

    Alizai, Hamza; Virayavanich, Warapat; Liu, Felix; Hernandez, Alexandra; Lynch, John A.; Nevitt, Michael C.; McCulloch, Charles E.; Lane, Nancy E.; Link, Thomas M.

    2012-01-01

    Purpose: To assess the prevalence and degree of lumbosacral transitional vertebrae (LSTV) in the Osteoarthritis Initiative (OAI) cohort, to assess whether LSTV correlates with low back pain (LBP) and buttock pain, and to assess the reproducibility of grading LSTV. Materials & Methods: Institutional review board approval was obtained, and informed consent documentation was approved for the study protocol. Standard standing pelvic radiographs that included the transverse processes of L5 were graded according to Castellvi classification of LSTV in 4636 participants (1992 men and 2804 women; aged 45–80 years) from the OAI cohort. These data were correlated with prevalence and severity of LBP and buttock pain. Results: Prevalence of LSTV was 18.1% (841 of 4636), with a higher rate in men than in women (28.1% vs 11.1%, respectively; P < .001). Of the 841 individuals with LSTV, 41.72% were type I (dysplastic enlarged transverse process), 41.4% were type II (pseudoarticulation), 11.5% were type III (fusion), and 5.2% were type IV (one transverse process fused and one with pseudoarticulation). Of the participants without LSTV, 53.9% reported LBP, while the prevalence of LBP for types I, II, III, and IV was 46%, 73%, 40%, and 66%, respectively (P < .05, ?2 test). Types II and IV had higher prevalence and severity of LBP and buttock pain (P < .001). Conclusion: LSTV types II and IV positively correlate with prevalence and severity of LBP and buttock pain. © RSNA, 2012 PMID:22952380

  14. Cervical pedicles: correcting a common misconception.

    PubMed

    Pitman, Alexander G

    2011-06-01

    To bring to the attention of Australian radiologists in training, directors of training and radiologists in general, a commonly held erroneous misconception, specifically that of the plain radiographic appearance of the cervical spine pedicle and the transverse process in oblique projections. A human C5 vertebra was appropriately marked and radiographed in the oblique projection to demonstrate key anatomical structures and their relations. The rounded cortical contour overlying the vertebral body is commonly misinterpreted as a cervical transverse process but is the plain radiographic outline of the end-on ipsilateral pedicle. Because of the right-angle relationship of the transverse process long axis and the end-on pedicle long axis, the ipsilateral transverse process appears as a faint elongated corticated structure projecting beyond the vertebral body contour. It may also be obscured because of small size, relative osteopaenia and overlying soft tissue bulk. The end-on pedicle has been unequivocally demonstrated, as has the ipsilateral transverse process. The two lie at right angles to each other. The common misconception (amplified by an error in an earlier edition of a popular atlas) should be debunked by radiologists and should not be promulgated to Australian radiology trainees. PMID:21696564

  15. Quantitative Analyses of Pediatric Cervical Spine Ossification Patterns Using Computed Tomography

    PubMed Central

    Yoganandan, Narayan; Pintar, Frank A.; Lew, Sean M.; Rao, Raj D.; Rangarajan, Nagarajan

    2011-01-01

    The objective of the present study was to quantify ossification processes of the human pediatric cervical spine. Computed tomography images were obtained from a high resolution scanner according to clinical protocols. Bone window images were used to identify the presence of the primary synchondroses of the atlas, axis, and C3 vertebrae in 101 children. Principles of logistic regression were used to determine probability distributions as a function of subject age for each synchondrosis for each vertebra. The mean and 95% upper and 95% lower confidence intervals are given for each dataset delineating probability curves. Posterior ossifications preceded bilateral anterior closures of the synchondroses in all vertebrae. However, ossifications occurred at different ages. Logistic regression results for closures of different synchondrosis indicated p-values of <0.001 for the atlas, ranging from 0.002 to <0.001 for the axis, and 0.021 to 0.005 for the C3 vertebra. Fifty percent probability of three, two, and one synchondroses occurred at 2.53, 6.97, and 7.57 years of age for the atlas; 3.59, 4.74, and 5.7 years of age for the axis; and 1.28, 2.22, and 3.17 years of age for the third cervical vertebrae, respectively. Ossifications occurring at different ages indicate non-uniform maturations of bone growth/strength. They provide an anatomical rationale to reexamine dummies, scaling processes, and injury metrics for improved understanding of pediatric neck injuries PMID:22105393

  16. Quantitative analyses of pediatric cervical spine ossification patterns using computed tomography.

    PubMed

    Yoganandan, Narayan; Pintar, Frank A; Lew, Sean M; Rao, Raj D; Rangarajan, Nagarajan

    2011-01-01

    The objective of the present study was to quantify ossification processes of the human pediatric cervical spine. Computed tomography images were obtained from a high resolution scanner according to clinical protocols. Bone window images were used to identify the presence of the primary synchondroses of the atlas, axis, and C3 vertebrae in 101 children. Principles of logistic regression were used to determine probability distributions as a function of subject age for each synchondrosis for each vertebra. The mean and 95% upper and 95% lower confidence intervals are given for each dataset delineating probability curves. Posterior ossifications preceded bilateral anterior closures of the synchondroses in all vertebrae. However, ossifications occurred at different ages. Logistic regression results for closures of different synchondrosis indicated p-values of <0.001 for the atlas, ranging from 0.002 to <0.001 for the axis, and 0.021 to 0.005 for the C3 vertebra. Fifty percent probability of three, two, and one synchondroses occurred at 2.53, 6.97, and 7.57 years of age for the atlas; 3.59, 4.74, and 5.7 years of age for the axis; and 1.28, 2.22, and 3.17 years of age for the third cervical vertebrae, respectively. Ossifications occurring at different ages indicate non-uniform maturations of bone growth/strength. They provide an anatomical rationale to reexamine dummies, scaling processes, and injury metrics for improved understanding of pediatric neck injuries. PMID:22105393

  17. ADXS11-001 High Dose HPV+ Cervical Cancer

    ClinicalTrials.gov

    2015-02-25

    Effects of Immunotherapy; Metastatic/Recurrent Cervical Cancer; Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Small Cell Carcinoma; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  18. [Preliminary application of the fusion cage of biomimetic n-HA/PA66 composites in anterior cervical intervertebral fusion].

    PubMed

    Ou, Yunsheng; Jiang, Dianming; Quan, Zhengxue; An, Hong; Tang, Ke; Li, Jia; Shen, Changhuan

    2010-04-01

    This study was aimed to evaluate the preliminary efficacy and the safety of the fusion cage made of biomimetic nano-hydroxyapatite and polyamide 66 (n-HA/PA66) composites for the structural reconstruction and the restoration of height of vertebral body in the case of cervical spondylosis by anterior surgical procedures. 52 patients with cervical spondylosis, received the therapy by discectomy with or without vertebrae resection and decompression, and the fusion cage of n-HA/PA66 vertebra implant with bone chip, and titanium plate system was fixed. All cases were followed up for 6 to 25 months. All the patients' preoperative symptoms subsided without any serious complication, and no patient complained of lasting soreness. No effusion or flare was found, and no recurrence happened in the follow-up. The preoperative JOA score was 10.4, and post-operative JOA score 15.7. The X-ray films of all cases demonstrated successful fusion with good curvature and height, and there was no sinking or collapse. The stability was satisfactory; the reconstructive height of vertebra was maintained. No complications such as infection and screw broken came into being. The fusion cage of the biomimetic n-HA/PA66 composites can effectively restore the height and structure of vertebra. It may have the potential for use as a satisfactory prosthestic vertebral body replacement. PMID:20481312

  19. 3D\\/2D registration and segmentation of scoliotic vertebrae using statistical models

    Microsoft Academic Search

    Said Benameur; Max Mignotte; Stefan Parent; Hubert Labelle; Wafa Skalli; Jacques de Guise

    2003-01-01

    We propose a new 3D\\/2D registration method for vertebrae of the scoliotic spine, using two conventional radiographic views (postero-anterior and lateral), and a priori global knowledge of the geometric structure of each vertebra. This geometric knowledge is efficiently captured by a statistical deformable template integrating a set of admissible deformations, expressed by the first modes of variation in Karhunen–Loeve expansion,

  20. Automatic lumbar vertebra segmentation from clinical CT for wedge compression fracture diagnosis

    NASA Astrophysics Data System (ADS)

    Ghosh, Subarna; Alomari, Raja'S.; Chaudhary, Vipin; Dhillon, Gurmeet

    2011-03-01

    Lumbar vertebral fractures vary greatly in types and causes and usually result from severe trauma or pathological conditions such as osteoporosis. Lumbar wedge compression fractures are amongst the most common ones where the vertebra is severely compressed forming a wedge shape and causing pain and pressure on the nerve roots and the spine. Since vertebral segmentation is the first step in any automated diagnosis task, we present a fully automated method for robustly localizing and segmenting the vertebrae for preparation of vertebral fracture diagnosis. Our segmentation method consists of five main steps towards the CAD(Computer-Aided Diagnosis) system: 1) Localization of the intervertebral discs. 2) Localization of the vertebral skeleton. 3) Segmentation of the individual vertebra. 4) Detection of the vertebrae center line and 5) Detection of the vertebrae major boundary points. Our segmentation results are promising with an average error of 1.5mm (modified Hausdorff distance metric) on 50 clinical CT cases i.e. a total of 250 lumbar vertebrae. We also present promising preliminary results for automatic wedge compression fracture diagnosis on 15 cases, 7 of which have one or more vertebral compression fracture, and obtain an accuracy of 97.33%.

  1. Bone Lose of the Ancient Mediterranean lumbar vertebrae : Iasos, 6th century ad.

    NASA Astrophysics Data System (ADS)

    Kaya, Serdar; Solmaz, Ilker; Il?ca, A. Turan; Karaçal?o?lu, Özgür; Damla Y?lmaz, Nalan; Ba?o?lu, Ok?an; K?l?c, Selim; Izci, Yusuf

    Evaluation of bone mineral density (BMD) of the ancient peoples has received great interest by anthropologists. The aims of this study are to investigate the lumbar vertebrae of the Iasos people during the Byzantine period, in order to determine the prevalence of bone loss and to interpret dietary conditions of ancient Mediterranean populations. Lumbar vertebrae belonging to twenty eight skeletons of the 6th c AD were analyzed by radiographs and dual energy X-ray absorptiometry. The BMD values for each biologic sex and age group were compared. The correlation between the BMD and radiological features was also analyzed. The mean BMD was 0.940 g/cm2. BMD was decreased by aging in both sexes, but it was not significant. Osteopenia was found in 11 (39%) and osteoporosis in 4 (14.3%) out 28 vertebrae. The BMD was normal in 13 (46%) out of 28 vertebrae. Osteopenia was present in 7 (38%) of 18 male vertebrae and 4 (40%) of 10 female vertebrae. The spine score was high in the male group and there was a strong positive correlation between the BMD and spine score for both sexes. This study revealed that the BMD decreased by aging and that osteopenia was a problem in both sexes of the Iasos people during the 6th c AD. There was no correlation between the BMD and radiological features for age groups and biological sexes.

  2. Solitary juvenile xanthogranuloma of the cervical spine in a child: A case report and review of literature

    PubMed Central

    Bhaisora, Kamlesh Singh; Jaiswal, Awadhesh Kumar; Mehrotra, Anant; Sahu, Rabi Narayan; Srivastava, Arun; Jaiswal, Sushila; Behari, Sanjay

    2015-01-01

    The authors present a case of 15 years male child who presented with neck pain and progressive ascending quadriparesis. Magnetic resonance imaging showed lytic mass involving C5 and C6 vertebra with soft tissue extension. Surgical excision of mass done using anterior cervical approach. Postoperatively, patient showed improvement in spasticity and power. Histopathological examination of mass was suggestive of juvenile xanthogranuloma (JXG). At 6 months follow–up, patient was improving without any evidence of recurrence. Only 12 cases of JXG of spine have been reported till date including only four cases involving the cervical spine and among these four cases only two were of pediatric age group.

  3. Biomechanics of Cervical ‘Skip’ Corpectomy versus Standard Multilevel Corpectomy

    PubMed Central

    Yilmaz, Murat; Yüksel, K. Zafer; Baek, Seungwon; Sawa, Anna G.U.; Dalbayrak, Sedat; Sonntag, Volker K.H.; Crawford, Neil R.

    2012-01-01

    Study Design In vitro biomechanical study of flexibility with finite element simulation to estimate screw stresses. Objective To compare cervical spinal stability after a standard plated three-level corpectomy with stability after a plated three-level “skip” corpectomy where the middle vertebra is left intact (i.e., two one-level corpectomies), and to quantify pullout forces acting on the screws during various loading modes. Summary of Background Data Clinically, three-level cervical plated corpectomy has a high rate of failure, partially because only four contact points affix the plate to the upper and lower intact vertebrae. Leaving the intermediate vertebral body intact for additional fixation points may overcome this problem while still allowing dural sac decompression. Methods Quasistatic nonconstraining torque (maximum 1 Nm) induced flexion, extension, lateral bending, and axial rotation while angular motion was recorded stereophotogrammetrically. Specimens were tested intact and after corpectomy with standard plated and strut-grafted three-level corpectomy (7 specimens) or ‘skip’ corpectomy (7 specimens). Screw stresses were quantified using a validated finite element model of C3–C7 mimicking experimentally tested groups. Skip corpectomy with C5 screws omitted was also simulated. Results Plated skip corpectomy tended to be more stable than plated standard corpectomy, but the difference was not significant. Compared to standard plated corpectomy, plated skip corpectomy reduced peak screw pull-out force during axial rotation (mode of loading of highest peak force) by 15% (4-screw attachment) and 19% (6-screw attachment). Conclusions Skip corpectomy is a good alternative to standard three-level corpectomy to improve stability, especially during lateral bending. Under pure moment loading, the screws of a cervical multilevel plate experience the highest pullout forces during axial rotation. Thus, limiting this movement in patients undergoing plated multilevel corpectomy may be reasonable, especially until solid fusion is achieved. PMID:22801457

  4. Adaptive bone formation in acellular vertebrae of sea bass (Dicentrarchus labrax L.).

    PubMed

    Kranenbarg, Sander; van Cleynenbreugel, Tim; Schipper, Henk; van Leeuwen, Johan

    2005-09-01

    Mammalian bone is an active tissue in which osteoblasts and osteoclasts balance bone mass. This process of adaptive modelling and remodelling is probably regulated by strain-sensing osteocytes. Bone of advanced teleosts is acellular yet, despite the lack of osteocytes, it is capable of an adaptive response to physical stimuli. Strenuous exercise is known to induce lordosis. Lordosis is a ventrad curvature of the vertebral column, and the affected vertebrae show an increase in bone formation. The effects of lordosis on the strain distribution in sea bass (Dicentrarchus labrax L.) vertebrae are assessed using finite element modelling. The response of the local tissue is analyzed spatially and ontogenetically in terms of bone volume. Lordotic vertebrae show a significantly increased strain energy due to the increased load compared with normal vertebrae when loaded in compression. High strain regions are found in the vertebral centrum and parasagittal ridges. The increase in strain energy is attenuated by a change in architecture due to the increased bone formation. The increased bone formation is seen mainly at the articular surfaces of the vertebrae, although some extra bone is formed in the vertebral centrum. Regions in which the highest strains are found do not spatially correlate with regions in which the most extensive bone apposition occurs in lordotic vertebrae of sea bass. Mammalian-like strain-regulated bone modelling is probably not the guiding mechanism in adaptive bone modelling of acellular sea bass vertebrae. Chondroidal ossification is found at the articular surfaces where it mediates a rapid adaptive response, potentially attenuating high stresses on the dorsal zygapophyses. PMID:16155222

  5. Pullout strength of misplaced pedicle screws in the thoracic and lumbar vertebrae - A cadaveric study

    PubMed Central

    Saraf, Shyam K; Singh, Ravindra P; Singh, Vakil; Varma, Ashish

    2013-01-01

    Background: The objective of this cadaveric study was to analyze the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of lower thoracic and lumbar pedicle screws. We also investigated the effect of bone mineral density (BMD), diameter of pedicle screws, and the region of spine on the pullout strength of pedicle screws. Materials and Methods: Sixty fresh human cadaveric vertebrae (D10–L2) were harvested. Dual-energy X-ray absorptiometry (DEXA) scan of vertebrae was done for BMD. Titanium pedicle screws of different diameters (5.2 and 6.2 mm) were inserted in the thoracic and lumbar segments after dividing the specimens into three groups: a) standard pedicle screw (no cortical perforation); b) screw with medial cortical perforation; and c) screw with lateral cortical perforation. Finally, pullout load of pedicle screws was recorded using INSTRON Universal Testing Machine. Results: Compared with standard placement, medially misplaced screws had 9.4% greater mean pullout strength and laterally misplaced screws had 47.3% lesser mean pullout strength. The pullout strength of the 6.2 mm pedicle screws was 33% greater than that of the 5.2 mm pedicle screws. The pullout load of pedicle screws in lumbar vertebra was 13.9% greater than that in the thoracic vertebra (P = 0.105), but it was not statistically significant. There was no significant difference between pullout loads of vertebra with different BMD (P = 0.901). Conclusion: The mean pullout strength was less with lateral misplaced pedicle screws while medial misplaced pedicle screw had more pullout strength. The pullout load of 6.2 mm screws was greater than that of 5.2 mm pedicle screws. No significant correlation was found between bone mineral densities and the pullout strength of vertebra. Similarly, the pullout load of screw placed in thoracic and lumbar vertebrae was not significantly different. PMID:23798753

  6. 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

  7. Changes in Bone Density after Cancer Treatment in Patients with Cervical and Endometrial Cancer

    PubMed Central

    Oh, Young Lim; Yoon, Man Soo; Suh, Dong Soo; Kim, Ari; Kim, Min Joung; Lee, Ji Young; Song, Yong Jung; Ji, Yong Il; Kim, Ki Hyung; Chun, Sungwook

    2015-01-01

    OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer. PMID:25553092

  8. Laminectomy for cervical myelopathy

    Microsoft Academic Search

    N E Epstein

    2003-01-01

    Study design: Cervical laminectomy with or without fusion, or laminoplasty, successfully address congenital or acquired stenosis, multilevel spondylosis, ossification of the posterior longitudinal ligament (OPLL), and ossification of the yellow ligament (OYL). To optimize surgical results, however, these procedures should be applied to carefully selected patients.Objectives: To determine the clinical, neurodiagnostic, appropriate posterior cervical approaches to be employed in patients

  9. Lumbosacral transitional vertebra causing Bertolotti’s syndrome: a case report and review of the literature

    PubMed Central

    Koutras, Georgios; Natsis, Konstantinos

    2009-01-01

    Introduction Lumbosacral transitional vertebra is an anatomical variation of the fifth lumbar vertebra in which an enlarged transverse process can form a joint or fusion with the sacrum or ilium. The association of that variant with low back pain and the change in the biomechanical properties of the lumbar spine is called Bertolotti’s syndrome. Case presentation We report a case of a 40-year-old male patient with chronic low back pain extending to the left buttock, just above the ipsilateral sacroiliac joint. Radiographic investigation revealed an anomalous enlargement of the left transverse process of the fifth lumbar vertebra forming a pseudarthrosis with the infrajacent ala of the sacrum. Conclusion In young patients with back pain the possibility of Bertolotti’s syndrome should always be taken in account. PMID:19830065

  10. Retroperitoneal paraganglioma with metastasis to the abdominal vertebra: a case report

    PubMed Central

    2013-01-01

    Background Extra-adrenal paraganglioma of the retroperitoneum with metastasis to the vertebra is very rare. To our knowledge this is the first report of this kind of disease in the literature. Case presentation Here, we present an oroginal case of paraganglioma of the retroperitoneum with metastasis to the abdominal vertebra in a 42-year-old female patient who was successfully treated by complete removal of the tumor and its metastasis. The patient was followed up for four years and remained disease-free. Conclusion Our case demonstrated the need to consider paraganglioma of the retroperitoneum in the differential diagnosis of retroperitoneal mass, metastatic tumors to the vertebra, and the importance of radical surgery for a successful management of the disease. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1956611954880197 PMID:23537060

  11. Determination of Absorbed Dose of Organs (Thyroid, Sternum, Cervical vertebra) in Thyroid Cancer Patients Following Radioiodine Therapy

    Microsoft Academic Search

    D. Shahbazi-Gahrouei; S. Nikzad; P. Shokrani; Z. Shahi

    Introduction: In patients with thyroid carcinoma, radiation absorbed doses of the thyroid and surrounding tissues is important to weigh risk and benefit considerations. In nuclear medicine, the accuracy of absorbed dose of internally distributed radionuclides is estimated by different methods such as MIRD and direct method using TLD. The aim of this study is using TLD and a phantom to

  12. Cephalometric Investigation of First Cervical Vertebrae Morphology and Hyoid Position in Young Adults with Different Sagittal Skeletal Patterns

    PubMed Central

    Gündüz Arslan, Seher; Dilde?, Neval; Devecioglu Kama, Jalen

    2014-01-01

    The aim of this retrospective study was to examine hyoid bone position and C1 (atlas) morphology in males and females and analyze these parameters with respect to different sagittal skeletal patterns via cephalometry, with the goal of identifying cephalometric norms. Lateral cephalometric radiographs from 120 individuals (average age: 21.1?±?2.9 years) were classified according to their ANB angle (Class I, II, or III) and used to assess 14 parameters. Class I and II patients showed significant differences in Hy-NSL, Hy-PD, Hy-CVT, Lum, and a-p measurements. These parameters were consistently larger in males than in females. Intergroup comparisons among males showed significant differences in the SNA, ANB, Hy-CVT, X, and Z measurements. The hyoid was positioned more inferiorly and anteriorly and was more prominent in males than in females in all groups. Among participants exhibiting a Class I skeletal pattern, C1 was also larger in the anterior-posterior direction in males than in females. In the sagittal plane, the hyoid was positioned similarly in males with either Class I or III skeletal patterns but was positioned posteriorly in males with a Class II skeletal pattern. In addition, the vertical position of C1 varied with sagittal skeletal pattern in males. PMID:25152900

  13. "Hot" vertebra on (18)F-FDG PET scan: a case of vertebral hemangioma.

    PubMed

    Nakayama, Michihiro; Okizaki, Atsutaka; Ishitoya, Shunta; Aburano, Tamio

    2012-12-01

    An F-FDG-PET with CT scan was performed to stage a tongue cancer, revealing the hypermetabolic region in the thoracic vertebra. This corresponded to a benign lesion seen on MRIs and CT.Although these findings suggested a vertebral hemangioma, "hot" vertebra in FDG-PET was atypical. The final diagnosis was confirmed capillary hemangioma by the scopic biopsy and this lesion was no change at 1 year later.Careful interpretation of metabolic (FDG-PET) and anatomic (CT and MRI) images should be performed to accurately characterize the foci of increased FDG uptake. PMID:23154481

  14. [Isolated anterior cervical hypertrichosis].

    PubMed

    Monteagudo, B; Cabanillas, M; de las Heras, C; Cacharrón, J M

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding. PMID:19268113

  15. Cervical Cancer Prevention

    MedlinePLUS

    ... cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. ... might lower your risk of cancer. The following risk factors increase the risk of cervical cancer: HPV Infection ...

  16. 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

  17. Cervical Cancer Screening Programs

    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

  18. Cervical Cancer Screening Programs

    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 Organization

  19. 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

  20. Cervical Cancer Participation 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 (Archived Tables): Home Participation

  1. Smoking and Cervical Cancer

    MedlinePLUS

    Smoking and Cervical Cancer If you smoke, you have an increased chance of developing precancerous lesions of ... returning for follow-up appointments, and to Stop Smoking! Copyright © 2003, 2008 American Society for Colposcopy and ...

  2. Conservative treatment of a comminuted cervical fracture in a racehorse.

    PubMed

    Vos, Nj

    2008-01-01

    The 'classical' or 'Hangman' neck fracture involves the odontoid peg (process) of the second cervical vertebra (C2), and is described as an axial, dens or odontoid peg fracture in both the veterinary and human literature. Possible surgical treatment in both foals and adult horses requires a technique that allows decompression, anatomical alignment and stabilisation of the odontoid fracture. A limited number of surgical cases in foals have been reported in literature, but never in an adult horse. A mature Irish Thoroughbred racehorse was diagnosed with a type 2a odontoid peg fracture. Clinical signs included reluctance to move the head and neck, a left hind limb lameness and a neurological status of grade 2. The horse was treated conservatively and raced successfully five months after the diagnosed injury. PMID:21851712

  3. Conservative treatment of a comminuted cervical fracture in a racehorse

    PubMed Central

    2008-01-01

    The 'classical' or 'Hangman' neck fracture involves the odontoid peg (process) of the second cervical vertebra (C2), and is described as an axial, dens or odontoid peg fracture in both the veterinary and human literature. Possible surgical treatment in both foals and adult horses requires a technique that allows decompression, anatomical alignment and stabilisation of the odontoid fracture. A limited number of surgical cases in foals have been reported in literature, but never in an adult horse. A mature Irish Thoroughbred racehorse was diagnosed with a type 2a odontoid peg fracture. Clinical signs included reluctance to move the head and neck, a left hind limb lameness and a neurological status of grade 2. The horse was treated conservatively and raced successfully five months after the diagnosed injury. PMID:21851712

  4. 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

  5. Revised Vertebral Count in the “Longest-Necked Vertebrate” Elasmosaurus platyurus Cope 1868, and Clarification of the Cervical-Dorsal Transition in Plesiosauria

    PubMed Central

    Sachs, Sven; Kear, Benjamin P.; Everhart, Michael J.

    2013-01-01

    Elasmosaurid plesiosaurians are renowned for their immensely long necks, and indeed, possessed the highest number of cervical vertebrae for any known vertebrate. Historically, the largest count has been attributed to the iconic Elasmosaurus platyurus from the Late Cretaceous of Kansas, but estimates for the total neck series in this taxon have varied between published reports. Accurately determining the number of vertebral centra vis-à-vis the maximum length of the neck in plesiosaurians has significant implications for phylogenetic character designations, as well as the inconsistent terminology applied to some osteological structures. With these issues in mind, we reassessed the holotype of E. platyurus as a model for standardizing the debated cervical-dorsal transition in plesiosaurians, and during this procedure, documented a “lost” cervical centrum. Our revision also advocates retention of the term “pectorals” to describe the usually three or more distinctive vertebrae close to the cranial margin of the forelimb girdle that bear a functional rib facet transected by the neurocentral suture, and thus conjointly formed by both the parapophysis on the centrum body and diapophysis from the neural arch (irrespective of rib length). This morphology is unambiguously distinguishable from standard cervicals, in which the functional rib facet is borne exclusively on the centrum, and dorsals in which the rib articulation is situated above the neurocentral suture and functionally borne only by the transverse process of the neural arch. Given these easily distinguishable definitions, the maximum number of neck vertebrae preserved in E. platyurus is 72; this is only three vertebrae shorter than the recently described Albertonectes, which together with E. platyurus constitute the “longest necked” animals ever to have lived. PMID:23940656

  6. Evaluation of traumatic lateral cervical spine computed radiography images: quality control acceptability of images for clinical diagnosis, hardcopy versus high-resolution monitors

    NASA Astrophysics Data System (ADS)

    Leckie, Robert G.; Sheehy, Monet R.; Cade, Lawrence; Goeringer, Fred; Meyers, Chris A.; Parker, James E.; Smith, Donald V.; Freedman, Matthew T.

    1993-06-01

    The computed radiography images of 100 randomly selected traumatic cervical spine series were evaluated. The studies were reviewed on the laser printed hardcopy and 2K monitor soft copy images. In addition to the cervical vertebrae, the cervico-thoracic vertebral body interface must be recognized for a lateral c-spine image to be acceptable. The level of visualization of the spine was on average, 1/2 vertebral body better on the monitor than the hardcopy image. In 8% of cases, this improve visualization allowed clearance of the lateral cervical spine thereby expediting patient care in this critical area. This presentation will cover the quality of images and techniques to improve the success rate for clearing the cervical spine.

  7. Compressive strength of elderly vertebrae is reduced by disc degeneration and additional flexion.

    PubMed

    Maquer, Ghislain; Schwiedrzik, Jakob; Huber, Gerd; Morlock, Michael M; Zysset, Philippe K

    2015-02-01

    Computer tomography (CT)-based finite element (FE) models assess vertebral strength better than dual energy X-ray absorptiometry. Osteoporotic vertebrae are usually loaded via degenerated intervertebral discs (IVD) and potentially at higher risk under forward bending, but the influences of the IVD and loading conditions are generally overlooked. Accordingly, magnetic resonance imaging was performed on 14 lumbar discs to generate FE models for the healthiest and most degenerated specimens. Compression, torsion, bending, flexion and extension conducted experimentally were used to calibrate both models. They were combined with CT-based FE models of 12 lumbar vertebral bodies to evaluate the effect of disc degeneration compared to a loading via endplates embedded in a stiff resin, the usual experimental paradigm. Compression and lifting were simulated, load and damage pattern were evaluated at failure. Adding flexion to the compression (lifting) and higher disc degeneration reduces the failure load (8-14%, 5-7%) and increases damage in the vertebrae. Under both loading scenarios, decreasing the disc height slightly increases the failure load; embedding and degenerated IVD provides respectively the highest and lowest failure load. Embedded vertebrae are more brittle, but failure loads induced via IVDs correlate highly with vertebral strength. In conclusion, osteoporotic vertebrae with degenerated IVDs are consistently weaker-especially under lifting, but clinical assessment of their strength is possible via FE analysis without extensive disc modelling, by extrapolating measures from the embedded situation. PMID:25460926

  8. New Finds at the Swartkrans Australopithecine Site (contd): Two New Early Hominid Vertebrae from Swartkrans

    Microsoft Academic Search

    J. T. Robinson

    1970-01-01

    Last week Dr C. K. Brain introduced the Swartkrans cave site and described some recent discoveries there. Dr J. T. Robinson now describes two hominid vertebrae which he suggests belonged to a Poranthropus individual ; Mr R. J. Clarke, Dr F. Clark Howell and Dr C. K. Brain present evidence for the view that two different hominids once lived at

  9. 3D/2D registration and segmentation of scoliotic vertebrae using statistical models

    E-print Network

    Mignotte, Max

    3D/2D registration and segmentation of scoliotic vertebrae using statistical models Said Benameura Elsevier Science Ltd. All rights reserved. Keywords: 3D/2D registration; 3D reconstruction model statistical regis- tration model from biplanar radiographic images for the 3D 0895-6111/03/$ - see front

  10. The metamorphic fate of supernumerary caudal vertebrae in South Asian litter frogs (Anura: Megophryidae).

    PubMed

    Handrigan, Gregory R; Wassersug, Richard J

    2007-09-01

    Tadpoles of the Megophryidae, a South Asian family of litter frogs, are unique among anurans by virtue of their expanded caudal skeletons, which include supernumerary vertebral centra. The number of these vertebrae varies widely within the family, with tadpoles of Leptobrachella having as many as 30 and Leptolalax only five. Vertebral morphology is also quite variable, ranging from complete, perichordal centra to fragmentary ossifications. This variation in the caudal osteology of larval megophryids, however, is not manifested in the adult morphology. Post-metamorphic litter frogs have a typical anuran axial skeleton, invariably comprising eight presacral vertebrae, a single sacral vertebra and, postsacrally, the urostyle. To resolve this incongruity between life phases and to determine the precise metamorphic fate of supernumerary caudal vertebrae in megophryids, we examined metamorphic specimens from the genera Leptobrachella, Leptolalax, Ophryophryne and Megophrys. In all four, the caudal larval skeleton undergoes massive reduction, leaving only the coccyx and hypochord untouched. Caudal centra are apparently degraded by osteoclasts, which have not previously been implicated in vertebral remodelling during anuran metamorphosis. In Megophrys and Ophryophryne metamorphs, presacral centra also undergo resorption, consistent with an epichordal mode of centrum formation. The conservation of megophryid adult axial osteology in the face of extensive larval skeletal diversity reveals the role of metamorphosis in constraining anuran morphology. PMID:17559539

  11. Developmental failure of segmentation in a caudal vertebra of Apatosaurus (Sauropoda).

    PubMed

    Lovelace, David M

    2014-07-01

    A vertebral element assigned to an Apatosaurus cf. ajax from the Late Jurassic Morrison Formation is described. The specimen exhibits an unusual morphology where two vertebrae are nearly seamlessly fused together, including the haemal arch that spans them. This morphology is thought be the result of a developmental abnormality. CT scans of the specimen reveal a thin zone of dorsoventral thickening between the two neural arches consistent with cortical bone. Contrast in internal morphology differentiates the anterior and posterior vertebral bodies with the anterior expressing greater porosity, which increased accommodation for barite-rich calcite precipitation. No vacuities are observed to suggest the former presence of an intervertebral disk or intervertebral joints: the absence of an intervertebral disc or intervertebral joints is indicative of a condition known as block vertebra. Block vertebrae occur with the loss, or inhibition, of somitocoele mesenchyme early in embyogenesis (i.e., during resegmentation of the somites responsible for the formation of the affected vertebra). The derivatives of somitocoele mesenchyme include the intervertebral disc and joints. Although vertebral paleopathologies are not uncommon in the fossil record, this specimen is the first recognized congenital malformation within Sauropoda. Anat Rec, 297:1262-1269, 2014. © 2014 Wiley Periodicals, Inc. PMID:24532488

  12. Automatic Lumbar Vertebra Segmentation from clinical CT for Wedge Compression Fracture Diagnosis

    E-print Network

    Chaudhary, Vipin

    compression fracture, and obtain an accuracy of 97.33%. Keywords: Lumbar Spine, Wedge Compression Fracture in mobility.3 #12;Fractures in the lumbar spine occur for a number of reasons. In younger patients, fracturesAutomatic Lumbar Vertebra Segmentation from clinical CT for Wedge Compression Fracture Diagnosis

  13. Pathological fracture of a lumbar vertebra caused by rheumatoid arthritis – a case report

    Microsoft Academic Search

    T. Nakase; K. Fujiwara; J. Kohno; H. Owaki; T. Tomita; K. Yonenobu; T. Ochi

    1998-01-01

    Summary.  ?We describe a case of rheumatoid arthritis (RA) with collapse of the L3 lumbar vertebra for which surgery was performed. The\\u000a pathogenesis of lumbar lesions affected by RA is discussed and the literature reviewed.

  14. Anatomical transformation in mammals: developmental origin of aberrant cervical anatomy in tree sloths.

    PubMed

    Buchholtz, Emily A; Stepien, Courtney C

    2009-01-01

    Mammalian cervical count has been fixed at seven for more than 200 million years. The rare exceptions to this evolutionary constraint have intrigued anatomists since the time of Cuvier, but the developmental processes that generate them are unknown. Here we evaluate competing hypotheses for the evolutionary origin of cervical variants in Bradypus and Choloepus, tree sloths that have broken the seven cervical vertebrae barrier independently and in opposite directions. Transitional and mediolaterally disjunct anatomy characterizes the cervicothoracic vertebral boundary in each genus, although polarities are reversed. The thoracolumbar, lumbosacral, and sacrocaudal boundaries are also disrupted, and are more extreme in individuals with more extreme cervical counts. Hypotheses of homologous, homeotic, meristic, or associational transformations of traditional vertebral column anatomy are not supported by these data. We identify global homeotic repatterning of abaxial relative to primaxial mesodermal derivatives as the origin of the anomalous cervical counts of tree sloths. This interpretation emphasizes the strong resistance of the "rule of seven" to evolutionary change, as morphological stasis has been maintained primaxially coincident with the generation of a functionally longer (Bradypus) or shorter (Choloepus) neck. PMID:19196334

  15. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    NASA Astrophysics Data System (ADS)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  16. Measurement of Intervertebral Cervical Motion by Means of Dynamic X-Ray Image Processing and Data Interpolation

    PubMed Central

    Bifulco, Paolo; Cesarelli, Mario; Romano, Maria; Sansone, Mario

    2013-01-01

    Accurate measurement of intervertebral kinematics of the cervical spine can support the diagnosis of widespread diseases related to neck pain, such as chronic whiplash dysfunction, arthritis, and segmental degeneration. The natural inaccessibility of the spine, its complex anatomy, and the small range of motion only permit concise measurement in vivo. Low dose X-ray fluoroscopy allows time-continuous screening of cervical spine during patient's spontaneous motion. To obtain accurate motion measurements, each vertebra was tracked by means of image processing along a sequence of radiographic images. To obtain a time-continuous representation of motion and to reduce noise in the experimental data, smoothing spline interpolation was used. Estimation of intervertebral motion for cervical segments was obtained by processing patient's fluoroscopic sequence; intervertebral angle and displacement and the instantaneous centre of rotation were computed. The RMS value of fitting errors resulted in about 0.2 degree for rotation and 0.2?mm for displacements. PMID:24288523

  17. 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.

  18. 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

  19. 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

  20. Risks of Cervical Cancer Screening

    MedlinePLUS

    ... Trials NCI Publications Español Cervical Cancer Screening (PDQ®) Risks of Cervical Cancer Screening Key Points for This ... your need for screening tests. Screening tests have risks. Decisions about screening tests can be difficult. Not ...

  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.

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

    ClinicalTrials.gov

    2014-10-09

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

  3. Pure traumatic upper cervical disc herniation causing spinal cord injury: a case report and review of literature

    PubMed Central

    Sharifi, Guive; Mosavi, Seyed Ali; Shafieezad, Misagh; Asgari Nosari, Massoud

    2012-01-01

    Abstract: One third of all spinal injuries involve cervical vertebrae, and the impact of injury to the cervical spinal cord is profound and requires systemic treatment. The role and timing of surgical decompression after an acute spinal cord injury (SCI) remains one of the most controversial topics pertaining to spinal surgery. Lack of controlled, prospective, multicenter clinical studies has contributed to confusion in optimal treatment methods for patients with injuries of the cervical spinal cord. Clinically, the question of whether surgical decompression improves motor recovery following SCI remains surrounded by controversy. Case: Two cases with a 32-year-old man who developed right -sided Brown-Séquard Syndrome Following a motor to car accident with the large right paramedian C3–C4 disc herniation, and ipsilateral spinal cord compression and a 30-year-old man with the syndrome of acute central cervical spinal cord injury with motor impairment involving only upper extremities due to central C2–C3 disc herniation following a pedestrian accident are reported. Discectomy and anterior cervical fusion with the polyetheretherketone (PEEK) cage were performed. A complete motor deficit recovery and a marked sensitive deficit improvement were obtained. The need for and timing of surgical decompression in post traumatic spinal cord injury is controversial. Surgery may expedite neurological recovery in some patients and may provide additional neurological recovery when clinical improvement has plateaued or worsened. In our patient a complete motor deficit recovery was observed. Keywords: Cervical, Disc herniation, Spinal cord injury

  4. Cervical disk injuries in athletes

    Microsoft Academic Search

    K. Kumano; T. Umeyama

    1986-01-01

    Cervical disk injuries are defined as a cervical injury associated with neurological deficits, radicular symptoms, or radiological evidence of disk degeneration, but not with a fracture or a dislocation of the cervical spine. Thirty cases covering the period from July 1982 to June 1984 were analyzed, and the following findings are presented. Fifty percent of the injuries were sustained in

  5. Vulnerability of healthy vertebrae in patients with and without previous vertebral fracture.

    PubMed

    Morosano, Mario E; Menoyo, Inés; Caferra, Digna A; Sánchez, Ariel; Tomat, María F; Bocanera, Roberto; Pezzotto, Stella M; Masoni, Ana M

    2011-04-01

    Vertebral deformities are associated with a marked increase in morbidity, mortality, and burden in terms of sanitary expenditures. Patients with vertebral fractures have a negative impact in their health, less quality of life, and loss of functional capacity and independence. The purpose of this study was to explore the vulnerability of healthy vertebrae in patients who have sustained already a compression fracture and in patients who do not have prevalent fractures in the thoracic spine; and to explore the association of the deformity in healthy vertebrae with different variables, such as bone mineral density (BMD), body mass index, age, loss of height, presence of clinical kyphosis, history of other osteoporotic fractures, and falls occurring during the last year. Clinical data and complementary studies from 175 postmenopausal outpatients were analyzed. These women (age: 69.7±11.1 years) had not received any treatment for osteoporosis. Anteroposterior and lateral radiographs of the thoracic spine and bone densitometry of the hip were obtained; morphometry was performed in 1575 thoracic vertebrae from T4 to T12. The angle of wedging of each vertebral body was calculated using a trigonometric formula. Then, the sum of wedge angles of vertebral bodies (SWA) was determined, and Cobb angle was measured. In patients with vertebral fractures, after excluding the angles of fractured vertebral bodies, the mean wedge angle of the remaining vertebrae (MWAhealthy) was calculated. The same procedure was followed in patients without vertebral fractures. MWAhealthy was considered as an indicator of the structural vulnerability of non-fractured vertebrae. Patients with prevalent fractures had lower BMD, wider Cobb angle, and higher sum of wedge angles than patients without vertebral fractures. The proportion of patients with accentuation of clinical kyphosis was higher in the group with prevalent vertebral fractures. A highly significant difference was found in the MWAhealthy, which was higher in patients with prevalent fractures (4.1±1.3° vs. 3.0±1.1°; p<0.001). Patients showing vertebral fractures had 7.1±4.2 cm height loss in average, significantly superior than that found among non-fractured women (3.6±3.2 cm; p<0.01). In multivariate analysis, the increase of MWAhealthy was associated with advancing age (p<0.02), lower femoral neck BMD (p<0.005), presence of clinical kyphosis (p<0.01) and vertebral fractures (p<0.02). This study presents evidence that a series of factors independently influence the increase in wedging deformity of vertebral bodies that are not fractured yet. These factors could contribute to an increased vulnerability of the vertebrae, making them more susceptible to fracture. PMID:21185414

  6. [Treatment of cervical cancer].

    PubMed

    Touboul, Cyril; Skalli, Dounia; Guillo, Eric; Martin, Michel; Mallaurie, Emmanuelle; Mansouri, Dhouha; Abd Al Samad, Issam; Chabi, Naima; Hospitel, Sylvie; Koskas, Martin; Haddad, Bassam

    2014-06-01

    The treatment of uterine cervical cancer evolved the last past twenty years. The management of early stages cervical cancer is based on surgery +/- after an initial brachytherapy in order to increase loco-regional control. A conservative treatment preserving uterine and ovarian functions is sometimes possible for young patients < 40 years old wishing to conceive. This strategy allows pregnancies with low recurrence rate. Finally, the use of the sentinel lymph node staging should be validated within the next few years. The treatment of locally advanced stages is based on concomitant chemoradiation therapy, which allows obtaining an important complete tumour response rate (90%). Thereafter, the irradiation modalities will depend on the para-aortic lymph nodes status diagnosed by PET-computed tomography +/- staging laparoscopic para-aortic lymphadenectomy. The use of completion surgery may be indicated in case of cervical residual disease and has to be balanced with its specific morbidity. All the decisions are made during a multidisciplinary tumour board. PMID:25090765

  7. Cervical total disc arthroplasty.

    PubMed

    Basho, Rahul; Hood, Kenneth A

    2012-06-01

    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

  8. Thoracic and lumbar vertebrae morphology in Lenke type 1 female adolescent idiopathic scoliosis patients

    PubMed Central

    Hu, Xiaobang; Siemionow, Krzysztof B.

    2014-01-01

    Background Pedicle screws are widely used in adolescent idiopathic scoliosis (AIS) surgeries. Pedicle screw malposition may lead to serious vascular and neurologic complications. Knowledge of the morphometric anatomy of the thoracic and lumbar vertebrae is essential for the surgeon while implanting pedicle screws. It has been reported that there is a reduction of pedicle width at the concavity of the curve in AIS patients. However, it is unclear if gender plays a role in this pedicle width pattern. The goal of this study is to assess the vertebrae morphology in a more homogeneous group of AIS patients - female patients with Lenke type 1 curve. Methods The thoracic and lumbar vertebra and pedicle morphometry of 17 consecutive Lenke type 1 female AIS patients was analyzed based on 1mm fine cut CT scans. Morphometric anatomy of 539 pedicles from T1 to L5 was studied. Measurements included pedicle length, chord length, transverse pedicle width, transverse pedicle angle and vertebral rotation angle. Results The mean age of the patients was 14 years old (range 12-18). The mean Cobb angle was 56° (range 43° -88°) and the mean angle of vertebral rotation varied between 4-13.8°. The apical vertebra was between T7 and T11. The transverse pedicle width was significantly smaller (p < 0.05) on the concave side in the apical region of the thoracic spine (T7 and T8), measuring between 2.1-2.2 mm on the concave side and 2.7-3.1 mm on the convex side. Meanwhile, in some upper thoracic vertebrae (T3, T4, T5), the width was significantly bigger (p < 0.05) on the concave side than on the convex side, measuring between 2.8-4 mm on the concave side and 1.8-2.4 mm on the convex side. In the lumbar spine, the width varied between 4.1-9.9 mm without significant differences between the concave and convex sides (p > 0.05). The pedicle length varied between 15.4-28.7 mm and was significantly smaller (p < 0.05) on the concave side at T4, T5 and L2. The chord length was shortest at T1, measuring 32.4 mm and increased gradually to 54.3 mm at L3 but no statistical difference was found between the concave and convex sides. The transverse pedicle angle varied between 11.8° and 35° and was significantly bigger on the concave side at T7 and on the convex side at L1 (p < 0.05). Conclusions The vertebrae morphology in Lenke type 1 female AIS patients is substantially different from the vertebrae in normal spines especially at the apex and in the upper thoracic region. This is consistent with some previous reports which did not distinguish between male and female patients. Our findings suggest that gender does not play a major role in the vertebrae morphology pattern of AIS patients. Furthermore, recognizing this pattern is critical in order to optimize pedicle screw instrumentation and may allow for some leeway adjustments in the pedicle screw trajectory regardless of the methods of implantation. PMID:25694922

  9. Measurement and Visualization of Three-Dimensional Vertebra Shape by Freehand Ultrasound Scanning

    NASA Astrophysics Data System (ADS)

    Kohyama, Kazuhiro; Yasumuro, Yoshihiro; Imura, Masataka; Manabe, Yoshitsugu; Oshiro, Osamu; Moroi, Keishichiro; Chihara, Kunihiro

    2005-06-01

    Paracentesis is a common operation for pain clinics and spinal anesthetics administration and requires empirical training and flexible skills to cope with the various cases of individual patients. We propose a method of measuring and visualizing three-dimensional vertebra shapes for assisting anesthesiologists, by an ultrasound imaging technique that is prevalent in many hospitals and has no harmful risks to the human body. The proposed system enables anesthesiologists to investigate vertebra shapes by freehand probing. Three-dimensional reconstruction and graphical rendering can be performed by monitoring the motion of the ultrasound probe and registering the scanned echography into the identical three-dimensional space. Considering the echography imaging features, volume rendering of hard tissue surfaces is achieved and interactive measurement is possible. This paper describes the practicability of the proposed method based on experimental measurement of both phantom and real lumbar vertebre and sacra.

  10. Trabecular microfracture precedes cortical shell failure in the rat caudal vertebra under cyclic overloading.

    PubMed

    Kummari, S R; Davis, A J; Vega, L A; Ahn, N; Cassinelli, E H; Hernandez, C J

    2009-08-01

    Microscopic tissue damage has been observed in otherwise healthy cancellous bone in humans and is believed to contribute to bone fragility and increased fracture risk. Animal models to study microscopic tissue damage and repair in cancellous bone would be useful, but it is currently not clear how loads applied to a whole animal bone are related to the amount and type of resulting microdamage in cancellous bone. In the current study we determine the relationship between applied cyclic compressive overloading and the resulting amount of microdamage in isolated rat tail vertebrae, a bone that has been used previously for in vivo loading experiments. Rat caudal vertebrae (C7-C9, n = 22) were potted in bone cement and subjected to cyclic compressive loading from 0 to 260 N. Loading was terminated in the secondary and tertiary phases of the creep-fatigue curve using custom data-monitoring software. In cancellous bone, trabecular microfracture was the primary form of microdamage observed with few microcracks. Trabecular microfracture prevalence increased with the amount of cyclic loading and occurred in nine out of 10 specimens loaded into the tertiary phase. Only small amounts of microdamage were observed in the cortical shell of the vertebrae, demonstrating that, under axial cyclic loading, damage occurs primarily in regions of cancellous bone before overt fracture of the bone (macroscopic cracks in the cortical shell). These experiments in isolated rat tail vertebrae suggest that it may be possible to use an animal model to study the generation and repair of microscopic tissue damage in cancellous bone. PMID:19488669

  11. An experimentally validated micromechanical model of a rat vertebra under compressive loading.

    PubMed

    Tsafnat, Naomi; Wroe, Stephen

    2011-01-01

    In recent years, finite element analysis (FEA) has been increasingly applied to examine and predict the mechanical behaviour of craniofacial and other bony structures. Traditional methods used to determine material properties and validate finite element models (FEMs) have met with variable success, and can be time-consuming. An implicit assumption underlying many FE studies is that relatively high localized stress/strain magnitudes identified in FEMs are likely to predict material failure. Here we present a new approach that may offer some advantages over previous approaches. Recently developed technology now allows us to both image and conduct mechanical tests on samples in situ using a materials testing stage (MTS) fitted inside the microCT scanner. Thus, micro-finite element models can be created and validated using both quantitative and qualitative means. In this study, a rat vertebra was tested under compressive loading until failure using an MTS. MicroCT imaging of the vertebra before mechanical testing was used to create a high resolution finite element model of the vertebra. Load-displacement data recorded during the test were used to calculate the effective Young's modulus of the bone (found to be 128 MPa). The microCT image of the compressed vertebra was used to assess the predictive qualities of the FE model. The model showed the highest stress concentrations in the areas that failed during the test. Clearly, our analyses do not directly address biomechanics of the craniofacial region; however, the methodology adopted here could easily be applied to examine the properties and behaviour of specific craniofacial structures, or whole craniofacial regions of small vertebrates. Experimentally validated micro-FE analyses are a powerful method in the study of materials with complex microstructures such as bone. PMID:20819113

  12. Cervical facet joint kinematics during bilateral facet dislocation.

    PubMed

    Panjabi, Manohar M; Simpson, Andrew K; Ivancic, Paul C; Pearson, Adam M; Tominaga, Yasuhiro; Yue, James J

    2007-10-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5 degrees. Average peak rotations and anterior sliding (displacement of upper articulating facet surface along the lower), separation and compression (displacement of upper facet away from and towards the lower), and lateral shear were determined at the anterior and posterior edges of the right and left facets and statistically compared (P < 0.05). First, peak facet separation occurred, and was significantly greater at the left posterior facet edge, as compared to the anterior edges. Next, peak flexion rotation and anterior facet sliding occurred, followed by peak facet compression. The highest average facet translation peaks were 22.0 mm for anterior sliding, 7.9 mm for separation, 9.9 mm for compression and 3.6 mm for lateral shear. The highest average rotation of 63 degrees occurred in flexion, significantly greater than all other directions. These events occurred, on average, within 0.29 s following impact. During BFD, the main sagittal motions included facet separation, flexion rotation, anterior sliding, followed by compression, however, non-sagittal motions also existed. These motions indicated that unilateral dislocation may precede bilateral dislocation. PMID:17566792

  13. Cervical vertebral strain measurements under axial and eccentric loading.

    PubMed

    Pintar, F A; Yoganandan, N; Pesigan, M; Reinartz, J; Sances, A; Cusick, J F

    1995-11-01

    The mid to lower cervical spine is a common site for compression related injury. In the present study, we determined the patterns of localized strain distribution in the anterior aspect of the vertebral body and in the lateral masses of lower cervical three-segment units. Miniature strain gages were mounted to human cadaveric vertebrae. Each preparation was line-loaded using a knife-edge oriented in the coronal plane that was moved incrementally from anterior to posterior to induce compression-flexion or compression-extension loading. Uniform compressive loading and failure runs were also conducted. Failure tests indicated strain shifting to "restabilize" the preparation after failure of a component. Under these various compressive loading vectors, the location which resulted in the least amount of deformation for a given force application (i.e., stiffest axis) was quantified to be in the region between 0.5- 1.0 cm anterior to the posterior longitudinal ligament. The location in which line-loading produced no rotation (i.e., balance point) was in this region; it was also close to where the vertebral body strains change from compressive to tensile. Strain values from line loading in this region produced similar strains as recorded under uniform compressive loading, and this was also the region of minimum strain. The region of minimum strain was also more pronounced under higher magnitudes of loading, suggesting that as the maximum load carrying capacity is reached the stiffest axis becomes more well defined. PMID:8748531

  14. Mechanical properties of sand tiger shark (Carcharias taurus) vertebrae in relation to spinal deformity.

    PubMed

    Huber, Daniel R; Neveu, Danielle E; Stinson, Charlotte M; Anderson, Paul A; Berzins, Ilze K

    2013-11-15

    Approximately 35% of sand tiger sharks (Carcharias taurus) in public aquaria exhibit spinal deformities ranging from compressed vertebrae and loss of intervertebral space to dislocated spines with vertebral degeneration and massive spondylosis caused by excessive mineralization both within vertebrae and outside the notochordal sheath. To identify the mechanical basis of these deformities, vertebral centra from affected (N=12) and non-affected (N=9) C. taurus were subjected to axial compression tests on an MTS 858 Bionix material testing system, after which mineral content was determined. Vertebral centra from affected sharks had significantly lower mineral content and material behavior in nearly all variables characterizing elasticity, plasticity and failure. These mechanical deficiencies are correlated with size at capture, capture method, vitamin C and zinc deficiency, aquarium size and swimming behavior in public aquaria. Non-affected C. taurus had greater stiffness and toughness even though these properties are generally incompatible in mineralized structures, suggesting that the biphasic (mineralized, unmineralized phases) nature of chondrichthyan vertebrae yields material behavior not otherwise observed in vertebrate skeletons. However, vertebral centra from non-affected sharks had lower mineral content (33%), stiffness (167 MPa), yield strain (14%) and ultimate strength (16 MPa) than other species of sharks and bony vertebrates, indicating that biomechanical precautions must be taken in the husbandry of this species. PMID:23997197

  15. Sensory Neuron Development in Mouse Coccygeal Vertebrae and Its Relationship to Tail Biopsies for Genotyping

    PubMed Central

    Silverman, Jerald; Hendricks, Gregory

    2014-01-01

    A common method of genotyping mice is via tissue obtained from tail biopsies. However, there is no available information on the temporal development of sensory neurons in the tail and how their presence or absence might affect the age for performing tail biopsies. The goals of this study were to determine if afferent sensory neurons, and in particular nociceptive neurons, are present in the coccygeal vertebrae at or near the time of birth and if not, when they first can be visualized on or in those vertebrae. Using toluidine blue neuronal staining, transmission electron microscopy, and calcitonin-related gene peptide immunostaining, we found proximal to distal maturation of coccygeal nerve growth in the C57BL/6J mouse. Single nerve bundles were first seen on postpartum day (PPD) 0. On PPD 3 presumptive nociceptive sensory nerve fibers were seen entering the vertebral perichondrium. Neural development continued through the last time point (PPD 7) but at no time were neural fibers seen entering the body of the vertebrae. The effect of age on the development of pain perception in the neonatal mouse is discussed. PMID:24505409

  16. Correlation between nucleus zone migration within scoliotic intervertebral discs and mechanical properties distribution within scoliotic vertebrae.

    PubMed

    Périé, D; Curnier, D; de Gauzy, J Sales

    2003-11-01

    Correlations between intervertebral disc degeneration and bone mass were investigated previously, but never on scoliotic patients. Using MRI measurements of intervertebral discs behavior and vertebral bone tomodensitometry, correlations between nucleus zone displacement within intervertebral discs and mechanical center migration within vertebral bodies were investigated in vivo on scoliotic patients. The protocol, performed on eleven scoliotic girls, was composed of a CT scan acquisition of apical and adjacent vertebrae followed by a MRI acquisition of the thoracolumbar spine. The displacement between the vertebral body centroid and inertia center was computed from the CT images and called the mechanical migration. The displacement between nucleus zones and vertebral body centroids was quantified from MRI and called the nucleus zone migration. For apical vertebrae, a significant correlation was found in the coronal plane (r = 0.766, p < 0.01), but not in the sagittal plane (r = -0.349, p > 0.05). For adjacent vertebrae, significant correlations were found in both coronal (r = -0.633, p < 0.05) and sagittal (r = -0.797, p < 0.01) planes. The nucleus zone migration occurred in the convexity of the curvature whereas the mechanical migration occurred in the concavity.Known secondary mechanical phenomenon of scoliosis was quantified using new parameters describing intervertebral discs and vertebral bodies. Further investigations should be performed to explain the mechanical evolution of scoliosis and to use these parameters in predictive criteria of scoliosis. PMID:14684195

  17. ‘Monster… -omics’: on segmentation, re-segmentation, and vertebrae formation in amphibians and other vertebrates

    PubMed Central

    2013-01-01

    Background The axial skeleton is one of the defining evolutionary landmarks of vertebrates. How this structure develops and how it has evolved in the different vertebrate lineages is, however, a matter of debate. Vertebrae and vertebral structures are derived from the embryonic somites, although the mechanisms of development are different between lineages. Discussion Using the anecdotal description of a teratological newt (Triturus dobrogicus) with an unusual malformation in its axial skeleton, we review, compare, and discuss the development of vertebral structures and, in particular, the development of centra from somitic cellular domains in different vertebrate groups. Vertebrae development through re-segmentation of the somitic sclerotomal cells is considered the general mechanism among vertebrates, which has been generalized from studies in amniotic model organisms. The prevalence of this mechanism among anamniotes is, however, controversial. We propose alternative developmental mechanisms for vertebrae formation that should be experimentally tested. Summary Research in model organisms, especially amniotes, is laying the foundations for a thorough understanding of the mechanisms of development of the axial skeleton in vertebrates, foundations that should expand the extent of future comparative studies. Although immersed in the ‘-omics’ era, we emphasize the need for an integrative and organismal approach in evolutionary developmental biology for a better understanding of the causal role of development in the evolution of morphological diversity in nature. PMID:23577917

  18. Heterogeneous Computing for Vertebra Detection and Segmentation in X-Ray Images

    PubMed Central

    Lecron, Fabian; Mahmoudi, Sidi Ahmed; Benjelloun, Mohammed; Mahmoudi, Saïd; Manneback, Pierre

    2011-01-01

    The context of this work is related to the vertebra segmentation. The method we propose is based on the active shape model (ASM). An original approach taking advantage of the edge polygonal approximation was developed to locate the vertebra positions in a X-ray image. Despite the fact that segmentation results show good efficiency, the time is a key variable that has always to be optimized in a medical context. Therefore, we present how vertebra extraction can efficiently be performed in exploiting the full computing power of parallel (GPU) and heterogeneous (multi-CPU/multi-GPU) architectures. We propose a parallel hybrid implementation of the most intensive steps enabling to boost performance. Experimentations have been conducted using a set of high-resolution X-ray medical images, showing a global speedup ranging from 3 to 22, by comparison with the CPU implementation. Data transfer times between CPU and GPU memories were included in the execution times of our proposed implementation. PMID:21860613

  19. Enhanced detection of the vertebrae in 2D CT-images

    NASA Astrophysics Data System (ADS)

    Graf, Franz; Greil, Robert; Kriegel, Hans-Peter; Schubert, Matthias; Cavallaro, Alexander

    2012-02-01

    In recent years, a considerable amount of methods have been proposed for detecting and reconstructing the spine and the vertebrae from CT and MR scans. The results are either used for examining the vertebrae or serve as a preprocessing step for further detection and annotation tasks. In this paper, we propose a method for reliably detecting the position of the vertebrae on a single slice of a transversal body CT scan. Thus, our method is not restricted by the available portion of the 3D scan, but even suffices with a single 2D image. A further advantage of our method is that detection does not require adjusting parameters or direct user interaction. Technically, our method is based on an imaging pipeline comprising five steps: The input image is preprocessed. The relevant region of the image is extracted. Then, a set of candidate locations is selected based on bone density. In the next step, image features are extracted from the surrounding of the candidate locations and an instance-based learning approach is used for selecting the best candidate. Finally, a refinement step optimizes the best candidate region. Our proposed method is validated on a large diverse data set of more than 8 000 images and improves the accuracy in terms of area overlap and distance from the true position significantly compared to the only other method being proposed for this task so far.

  20. Finite element modeling of the C4-C6 cervical spine unit.

    PubMed

    Yoganandan, N; Kumaresan, S C; Voo, L; Pintar, F A; Larson, S J

    1996-10-01

    This study was conducted to develop a detailed, three-dimensional, anatomically accurate finite element model of the human cervical spine structure using close-up computed tomography scans and to validate against experimental data. The finite element model of the three vertebra segment C4-C6 unit consisted of 9178 solid elements and 1193 thin shell elements. The force-displacement response under axial compression correlated well with experimental data. Because of the inclusion of three levels in the spinal structure, it was possible to determine the internal mechanics of the various components at each level. The applicability of the model was illustrated by adopting appropriate material properties from literature. Results indicated that, the stresses in the anterior column were higher compared to the posterior column at the inferior level, while the opposite was found to be true at the superior level. The superior and inferior endplate stresses were higher in the middle vertebral body compared to the adjacent vertebrae. In addition, the stresses in the cancellous core of the middle, unconstrained vertebral body were higher. The present three-dimensional finite element model offers an additional facet to a better understanding of the biomechanics of the human cervical spine. PMID:8892241

  1. Cisplatin and Radiation Therapy With or Without Tirapazamine in Treating Patients With Cervical Cancer

    ClinicalTrials.gov

    2014-06-18

    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; Stage IVA Cervical Cancer

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

    ClinicalTrials.gov

    2015-03-23

    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

  3. Morphometrics of the skeleton of Dermophis mexicanus (Amphibia: Gymnophiona). Part I. The vertebrae, with comparisons to other species.

    PubMed

    Wake, M H

    1980-08-01

    Morphometric analysis of vertebral structure in caecilians (Amphibia: Gymnophiona) is presented. Ontogenetic variation in Dermophis mexicanus is analyzed through the 100+ vertebrae composing the column. Vertebral structure in adult D. mexicanus is compared with that in Ichthyophis glutinosus and Typhlonectes compressicauda. Centra of the atlas, second, tenth, 20th, and 50th vertebrae grow at allometrically different rates in D. mexicanus, though the 20th and 50th are not significantly different. Growth appears significantly slower in several dimensions of anterior and posterior vertebrae relative to midtrunk vertebrae in all three species. Mensural patterns throughout the entire column are similar in the terrestrail burrowers D. mexicanus and I. glutinosus; patterns in the aquatic T. compressicauda differ substantially from those of the burrowing species and are strongly influenced by allometry. Of the 112 D. mexicanus examined, 13.4% had vertebral anomalies, usually fusions. PMID:7452726

  4. Cervical Radiculopathy (Pinched Nerve)

    MedlinePLUS

    ... sometimes referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy. Understanding your ... worn for short periods of time, because long-term wear can decrease the strength of neck ... and is not intended to serve as medical advice. Anyone seeking speci? c orthopaedic advice or ...

  5. Changes in Bone Mineral Density in Uterine Cervical Cancer Patients After Radiation Therapy

    SciTech Connect

    Okonogi, Noriyuki; Saitoh, Jun-ichi; Suzuki, Yoshiyuki, E-mail: syoshi@gunma-u.ac.jp; Noda, Shin-ei; Ohno, Tatsuya; Oike, Takahiro; Ohkubo, Yu; Ando, Ken; Sato, Hiro; Nakano, Takashi

    2013-12-01

    Purpose: To prospectively investigate the changes in bone mineral density (BMD) after pelvic radiation therapy in patients with uterine cervical cancer. Methods and Materials: Of 52 cervical cancer patients who received pelvic RT in our university hospital between 2009 and 2011, 46 patients without recurrence and who were followed up for more than 12 months were included in the study. The BMD of the irradiated region and nonirradiated regions, serum estradiol, tartrate-resistant acid phosphatase-5b, and N-terminal cross-linking telopeptide of collagen 1 were measured before, at 3 months after, and at 12 months after RT. The patient cohort was divided into 2 groups according to estradiol level before RT, and the groups were defined as postmenopausal (<40 pg/mL) and premenopausal (?40 pg/mL). Results: The mean BMDs within the irradiation field (lumbar vertebra 5) in the postmenopausal and the premenopausal groups were 0.825 and 0.910 g/cm{sup 2} before RT and 0.746 and 0.841 g/cm{sup 2} 12 months after RT, respectively. Significant decreases were observed in both groups (P<.05 and P<.01, respectively). In addition, in the premenopausal group the mean BMDs of the nonirradiated regions at thoracic vertebrae 9-12 and lumbar vertebrae 2-4 were 0.753 and 0.958 g/cm{sup 2} before RT and were significantly decreased to 0.706 and 0.921 g/cm{sup 2} 12 months after RT (P<.01 and P<.05, respectively). Estradiol significantly decreased 3 months after RT, whereas tartrate-resistant acid phosphatase-5b and N-terminal cross-linking telopeptide of collagen 1 continued to increase over time in the premenopausal group. Conclusions: A decrease in BMD in the irradiated region after RT was observed within 1 year, regardless of menopausal status. Furthermore, in premenopausal patients, pelvic RT caused a decrease in systemic BMD.

  6. The variation of cancellous bones at lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep.

    PubMed

    Zhang, Yongqiang; Li, Yongfeng; Gao, Qi; Shao, Bo; Xiao, Jianrui; Zhou, Hong; Niu, Qiang; Shen, Mingming; Liu, Baolin; Hu, Kaijin; Kong, Liang

    2014-07-01

    This study aimed to compare the variation of cancellous bones at four skeletal sites: lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep. Sixteen adult sheep were randomly divided into two groups: eight sheep were ovariectomized served as experimental group; the other eight untreated sheep were served as control group. Bone mineral density was assessed by dual-energy X-ray absorptiometry on lumbar vertebrae at baseline and twelve months after ovariectomy. After 12 months, lumbar vertebrae L3 and L4, femoral necks, mandibular angles and the fourth ribs were harvested for micro-CT scanning, histological analysis and biomechanical test. The results showed that bone mineral density of lumbar vertebra decreased significantly in twelfth month (p<0.05). The results of micro-CT showed that the bone volume/total volume decreased by 45.6%, 36.1% 21.3% and 18.7% in lumbar vertebrae, femoral necks, mandibular angles and ribs in experimental group (p<0.05) respectively. The trabecular number showed the same downtrend (p<0.05). Histological analysis showed trabecular area/tissue area decreased by 32.1%, 23.2% and 20.7% in lumbar vertebrae, femoral necks and mandibular angles respectively (p<0.05), but no significant difference in ribs. Specimens elastic modulus from lumbar vertebra, femoral neck and mandibular angle were 952±76MPa (628±70MPa), 961±173MPa (610±72MPa) and 595±60MPa (444±31MPa) in control group (experimental group) respectively. These datum indicated that the sensibility of cancellous bones to oestrogen deficiency in ovariectomized sheep was site-specific on a pattern as follows: lumbar vertebra, femoral neck, mandibular angle and rib. PMID:24769217

  7. Three-dimensional assessment of the intervertebral kinematics after Mobi-C total disc replacement at the cervical spine in vivo using the EOS stereoradiography system

    PubMed Central

    Rousseau, Marc-Antoine; Laporte, Sébastien; Dufour, Thierry; Steib, Jean-Paul; Lazennec, Jean-Yves; Skalli, Wafa

    2011-01-01

    Background Because 3-dimensional computed tomography and magnetic resonance imaging analysis of the spinal architecture is done with the patient in the supine position, stereoradiography may be more clinically relevant for the measurement of the relative displacements of the cervical vertebrae in vivo in the upright position. The innovative EOS stereoradiography system was used for measuring the relative angular displacements of the cervical vertebrae in a limited population to determine its feasibility. The precision and accuracy of the method were investigated. Methods In 9 patients with 16 Mobi-C prostheses (LDR Medical, Troyes, France) and 12 healthy subjects, EOS stereoradiography of the lower cervical spine (C3-7) was performed in the neutral upright position of the neck, flexion, extension, left and right lateral bending, and left and right axial rotation. The angular displacements were measured from the neutral position to every other posture. The random error was studied in terms of reproducibility. In addition, an in vitro protocol was performed in 6 specimens to investigate accuracy. Results The reproducibility and the accuracy variables varied similarly between 1.2° and 3.2° depending on the axis and direction of rotation under consideration. The Mobi-C group showed less mobility than the control group, whereas the pattern of coupling was similar. Conclusions Overall, the feasibility of dynamic EOS stereoradiography was shown. The prosthesis replicates the pattern of motion of the normal cervical spine.

  8. 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

  9. 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

  10. Structural and micro-anatomical changes in vertebrae associated with idiopathic-type spinal curvature in the curveback guppy model

    PubMed Central

    2010-01-01

    Background The curveback lineage of guppy is characterized by heritable idiopathic-type spinal curvature that develops during growth. Prior work has revealed several important developmental similarities to the human idiopathic scoliosis (IS) syndrome. In this study we investigate structural and histological aspects of the vertebrae that are associated with spinal curvature in the curveback guppy and test for sexual dimorphism that might explain a female bias for severe curve magnitudes in the population. Methods Vertebrae were studied from whole-mount skeletal specimens of curved and non-curved adult males and females. A series of ratios were used to characterize structural aspects of each vertebra. A three-way analysis of variance tested for effects of sex, curvature, vertebral position along the spine, and all 2-way interactions (i.e., sex and curvature, sex and vertebra position, and vertebra position and curvature). Histological analyses were used to characterize micro-architectural changes in affected vertebrae and the intervertebral region. Results In curveback, vertebrae that are associated with curvature demonstrate asymmetric shape distortion, migration of the intervertebral ligament, and vertebral thickening on the concave side of curvature. There is sexual dimorphism among curved individuals such that for several vertebrae, females have more slender vertebrae than do males. Also, in the region of the spine where lordosis typically occurs, curved and non-curved females have a reduced width at the middle of their vertebrae, relative to males. Conclusions Based on similarities to human spinal curvatures and to animals with induced curves, the concave-convex biases described in the guppy suggest that there is a mechanical component to curve pathogenesis in curveback. Because idiopathic-type curvature in curveback is primarily a sagittal deformity, it is structurally more similar to Scheuermann kyphosis than IS. Anatomical differences between teleosts and humans make direct biomechanical comparisons difficult. However, study of basic biological systems involved in idiopathic-type spinal curvature in curveback may provide insight into the relationship between a predisposing aetiology, growth, and biomechanics. Further work is needed to clarify whether observed sex differences in vertebral characteristics are related to the female bias for severe curves that is observed in the population. PMID:20529276

  11. Adenocarcinoma of the cervical stump

    SciTech Connect

    Goodman, H.M.; Niloff, J.M.; Buttlar, C.A.; Welch, W.R.; Marck, A.; Feuer, E.J.; Lahman, E.A.; Jenison, E.; Knapp, R.C. (Brigham and Women's Hospital, Boston, MA (USA))

    1989-11-01

    Sixteen women with adenocarcinoma of the cervical stump were treated over a 15-year period. The median survivals of 40 months for stage IB and 17 months for stages II and III were significantly worse compared with those for patients treated for cervical adenocarcinoma of the intact uterus or squamous carcinoma of the cervical stump. The poor results were due to both local and distant failure. Implications regarding tumor radiosensitivity and adjuvant therapy in these high-risk patients are discussed.

  12. [Cervical disc herniation].

    PubMed

    Schnake, K J; Hoffmann, C-H; Kandziora, F

    2012-12-01

    The cervical disc herniation is characterized by prolapsed nucleus pulposus material through the annulus into the spinal canal. The local mechanical or chemical irritation of neural structures typically leads to symptoms of radiculopathy, cervicocephalgia or myelopathy. Pronounced sensorimotor deficits or intractable pain constitute surgical treatment. In all other cases conservative treatment is indicated, including pain medication, active and passive physiotherapy, and local injections, respectively. Anterior cervical discectomy and interbody fusion (ACDF) is still the surgical treatment of choice. Predominantly, cages with or without plates are in use to obtain solid fusion. The implantation of a total disc replacement is a viable alternative, if no contraindications exist. Other surgical techniques may be performed in proper selected cases. The overall clinical and radiological results of both surgical and conservative treatment are good. PMID:23296562

  13. Percutaneous cervical disc decompression

    Microsoft Academic Search

    Klaus Birnbaum

    2009-01-01

    Background  Cervical disc nucleoplasty is a significant and clinically demonstrated innovation in percutaneous disc decompression in case\\u000a of non-herniated disc protrusions or prolpase. It allows a percutaneous decompression via a 19-gauge needle under utilization\\u000a of the Coblation® technique and under C-arm control. Until now the patients suffering of a cervicobrachialgia in cause of a disc prolapse had\\u000a only the therapeutical solution

  14. Disparities and Cervical Cancer

    Microsoft Academic Search

    Marcela del Carmen; Teresa Diaz-Montez

    \\u000a Cervical cancer became a preventable disease with the introduction of the Papanicolaou smear (Pap smear) in the 1940s. Trend\\u000a data show that incidence rates have decreased steadily over the past several decades in both white and African American women\\u000a living in the United States (American Cancer Society 2007). Mortality rates have declined steadily over the past several decades\\u000a as well

  15. Group-wise registration of ultrasound to CT images of human vertebrae

    NASA Astrophysics Data System (ADS)

    Gill, Sean; Mousavi, Parvin; Fichtinger, Gabor; Pichora, David; Abolmaesumi, Purang

    2009-02-01

    Automatic registration of ultrasound (US) to computed tomography (CT) datasets is a challenge of considerable interest, particularly in orthopaedic and percutaneous interventions. We propose an algorithm for group-wise volume-to-volume registration of US to CT images of the lumbar spine. Each vertebra in CT is treated as a sub-volume and transformed individually. The sub-volumes are then reconstructed into a single volume. The algorithm dynamically combines simulated US reflections from the vertebrae surfaces and surrounding soft tissue in the reconstructed CT, with scaled CT data to simulate US images of the spine anatomy. The simulated US data is used to register preoperative CT data to intra-operative US images. Covariance Matrix Adaption - Evolution Strategy (CMA-ES) is utilized as the optimization strategy. The registration is tested using a phantom of the lumbar spine (L3-L5). Initial misalignments of up to 8 mm were registered with a mean target registration error of 1.87+/-0.73 mm for L3, 2.79+/-0.93 mm for L4, 1.72+/-0.70 mm for L5, and 2.08+/-0.55 mm across the entire volume. To select an appropriate optimization strategy, we performed a volume-to- volume registration of US to CT of the lumbar spine, allowing no relative motion between vertebrae. We compare the results of this registration using three optimization strategies: simplex, gradient descent and CMA-ES. CMA-ES was found to converge slower than gradient descent and simplex, but was more robust for rigid volume-to-volume registration for initial misalignments up to 20 mm.

  16. Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

    PubMed Central

    Keskin, Fatih; Erdi, Fatih; Nayman, Alaaddin; Babaoglu, Ozan; Erdal, Kalkan; Ozer, Ali Fahir

    2015-01-01

    Context: This study was designed to understand and define the special radio-anatomic morphometry of C7 vertebra by using multidetector computed tomography (MDCT). Aims: The major aim of the study was to detect the gender- and side-related morphometric differences of C7 vertebra among subjects. Setting and design: Our radiology unit database scanned for MDCT sections of the C7 vertebra. Materials and Methods: A total of 214 patients (134 men, 80 women) were selected. A detailed morphometric evaluation of C7 was done. Statistical analysis used: T test, ANOVA. Lamina length (P < 0.001), pedicle length (P < 0.001), outer cortical (P = 0.01) and inner cancellous pedicle (P < 0.001) width, pedicle angle to sagittal plane (P < 0.001) values were statistically significantly different on the right versus left side. When the results were stratified by gender, lamina length, inner cancellous lamina height, pedicle length, inner cancellous pedicle height, outer cortical pedicle width, lateral mass anteroposterior length, anteroposterior length of C7 corpus, height of C7 corpus (P < 0.001), C6-7 (P = 0.013) and C7-T1disc height (P = 0.04), transverse foramina perpendicular width at C7 (P = 0.046) values were found to be statistically significantly different. Vertebral artery most commonly enters into the transverse foramina at C6 level. Conclusions: Gender and side differences are important factors for preoperative planning and showed significant differences among subjects. MDCT is a practical option for investigating the exact anatomical features of osseous structures.

  17. The orientation of the cervical vertebral column in unrestrained awake animals. I. Resting position.

    PubMed

    Vidal, P P; Graf, W; Berthoz, A

    1986-01-01

    The orientation of the cervical vertebral column was studied by X-ray photography of the region containing the head and the neck in nine unrestrained species of vertebrates (man, monkey, cat, rabbit, guinea pig, rat, chicken, frog, lizard). In addition, the orientation of the horizontal semicircular canals was measured in four species using landmarks on the skull. In all vertebrates studied, with the exception of frog and lizard, the general orientation of the cervical vertebral column was vertical when animals were at rest, and not horizontal or oblique as suggested by the macroscopic appearance of the neck. The posture of the animal, whether lying, sitting or standing, had little effect on this general vertical orientation, although some variability was noticed depending on the species. This finding prompted the definition of a resting zone, where the cervical column can take any orientation within a narrow range around a mean position. The cervical vertebral column composes part of the S-shaped structure of the entire vertebral column, with one inflection around the cervico-thoracic (C7/Th1) junction. This feature is already noticable in the lizard. The vertical orientation of the cervical vertebral column is interpreted to provide a stable and energy saving balance of the head. Furthermore, when the head is lowered or raised, the atlanto-occipital and cervico-thoracic junctions are predominantly involved, while the entire cervical column largely preserves its intrinsic configuration. The curved configuration of the cervico-thoracic vertebral column embedded in long spring-like muscles is interpreted to function as a shock absorber. At rest, animals did not hold their heads with the horizontal canals oriented earth horizontally all the time, but often maintained them pitched up by ca. 5 deg, as has been reported for man. At other times, presumably when the vigilance level increased, the horizontal canals were brought into the earth horizontal plane. The vertical orientation of the cervical column results in a vertical positioning of the odontoid process of the axis (second cervical vertebra, C2), which thus provides the axis of rotation for yaw movements of the head. This axis corresponds to that of the horizontal semicircular canals. The vertical organization of the cervical vertebral column in birds and mammals, whether the animal is quadrupedal or bipedal, points to a common organizational principle for eye and head movement systems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3082659

  18. Lower dorsal and lumbar pedicle morphometry in Indian population: a study of four hundred fifty vertebrae.

    PubMed

    Acharya, Shankar; Dorje, Tsewang; Srivastava, Abhishek

    2010-05-01

    STUDY DESIGN.: Prospective, computer aided pedicle morphometric data measurements obtained from computed tomography (CT) scan of lower thoracic (T9-T12) and lumber vertebrae in a large group of Indian population. OBJECTIVES.: Measurement on CT scan of the surgically relevant parameters of transverse pedicle isthmus width, transverse pedicle angle, and depth to anterior cortex along the midline axis and the pedicle axis by Computer software aid in a large sample of Indian population. To compare the results with those of similar studies of Western and Indian population in literature by other methods and to deduce safety parameters for pedicular screw placements in these areas. SUMMARY OF BACKGROUND DATA.: Although differences have been reported in literature between various ethnic groups, most studies reported are for white populations and Indian studies are few. The Indian studies have had small sample size, and been done on patients with preexisting spinal disorder or cadavers and by manual data measurements. To the authors' knowledge, the present study is the largest published for patients from the Indian subcontinent and only using computer software aided measurements. METHODS.: CT scans of the lower thoracic and lumbosacral spine of patients free from spinal disorders from the Indian subcontinent were reviewed. We analyzed a total of 450 vertebrae in 50 consecutive patients. Parameters recorded were transverse pedicle isthmus width, transverse pedicle angle, and depth to anterior cortex along the midline axis and the pedicle axis with help of computer software. RESULTS.: The mean transverse pedicle isthmus width was least at the T9 level (5.65 mm). Majority of pedicles at thoracic level had diameter over 5 mm T9 (94%), T10 (100%), T11 (96%), T12 (100%). At lumber all had diameters over 7 mm with wide range at upper levels. The mean transverse pedicle angle faced laterally at thoracic vertebrae with exception of T9. In lumber area, all were medially directed with maximum at L5 and least at L1. The depth to the anterior cortex was more along the pedicle axis at all levels except T11 and T12. CONCLUSION.: Significant differences exist between the pedicles of Indian and white populations. It is suggested that preoperative software-based morphometric data should be collected if possible for preoperative planning of pedicle implant placement and sizes to avoid inadvertent complications. Further, data from study can be used as a guide for implant size, intraoperative placement trajectory at lower thoracic and lumber vertebrae pedicles. PMID:20431473

  19. 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

  20. Jack-of-all-trades master of all? Snake vertebrae have a generalist inner organization

    NASA Astrophysics Data System (ADS)

    Houssaye, Alexandra; Boistel, Renaud; Böhme, Wolfgang; Herrel, Anthony

    2013-11-01

    Snakes are a very speciose group of squamates that adapted to various habitats and ecological niches. Their ecological diversity is of particular interest and functional demands associated with their various styles of locomotion are expected to result in anatomical specializations. In order to explore the potential adaptation of snakes to their environment we here analyze variation in vertebral structure at the microanatomical level in species with different locomotor adaptations. Vertebrae, being a major element of the snake body, are expected to display adaptations to the physical constraints associated with the different locomotor modes and environments. Our results revealed a rather homogenous vertebral microanatomy in contrast to what has been observed for other squamates and amniotes more generally. We here suggest that the near-absence of microanatomical specializations in snake vertebrae might be correlated to their rather homogeneous overall morphology and reduced range of morphological diversity, as compared to lizards. Thus, snakes appear to retain a generalist inner morphology that allows them to move efficiently in different environments. Only a few ecologically highly specialized taxa appear to display some microanatomical specializations that remain to be studied in greater detail.

  1. Bony-tailed tadpoles: the development of supernumerary caudal vertebrae in larval megophryids (Anura).

    PubMed

    Handrigan, Gregory R; Haas, Alexander; Wassersug, Richard J

    2007-01-01

    The axial skeleton in most anuran families consists of vertebrae, a single sacral vertebra, and the urostyle. Tadpoles from one anuran family, the Megophryidae, deviate, however, from this pattern in bearing supernumerary vertebral centra in their tails. At least 5 of 11 genera from this Asian family share this character: Leptobrachella (approximately 30 caudal centra), Leptolalax (5-6), Megophrys (11-15), Ophryophryne (11-14), and Xenophrys (>or=7). Tadpoles from each genus are typically found in streams, where their extended caudal skeleton anchors muscles that facilitate tadpoles wiggling between plant debris and rocks or even burrowing into the stream bed. The extra centra of megophryids ossify differently in each genus. In Leptobrachella and Ophryophryne, the caudal centra ossify around the entire notochord, whereas in Megophrys and Xenophrys each develops from dorsal and ventral pairs of ossifications that expand to meet each other. The evolutionary loss of caudal centra, an apomorphic anuran trait, is reversed in larval megophryids and confirms that the machinery for caudal vertebral development has been retained in some modern anurans. A likely driving force in the reappearance of the trait in megophryids is the selective pressure associated with a riparian lifestyle. PMID:17371401

  2. A fast, accurate, and reliable reconstruction method of the lumbar spine vertebrae using positional MRI

    PubMed Central

    Simons, Craig J.; Cobb, Loren; Davidson, Bradley S.

    2014-01-01

    In vivo measurement of lumbar spine configuration is useful for constructing quantitative biomechanical models. Positional magnetic resonance imaging (MRI) accommodates a larger range of movement in most joints than conventional MRI and does not require a supine position. However, this is achieved at the expense of image resolution and contrast. As a result, quantitative research using positional MRI have required long reconstruction times and are sensitive to incorrectly identifying the vertebral boundary due to low contrast between bone and surrounding tissue in the images. We present a semi-automated method used to obtain digitized reconstructions of lumbar vertebrae in any posture of interest. This method combines a high-resolution reference scan with a low-resolution postural scan to provide a detailed and accurate representation of the vertebrae in the posture of interest. Compared to a criterion standard, translational reconstruction error ranged from 0.7 mm to 1.6 mm and rotational reconstruction error ranged from 0.3 degrees to 2.6 degrees. Intraclass correlation coefficients indicated high interrater reliability for measurements within the imaging plane (ICC = 0.97?0.99). Computational efficiency indicates that this method may be used to compile data sets large enough to account for population variance, and potentially expand the use of positional MRI as a quantitative biomechanics research tool. PMID:24370942

  3. 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

  4. Electrodiagnosis of cervical radiculopathy.

    PubMed

    Hakimi, Kevin; Spanier, David

    2013-02-01

    Cervical radiculopathy is a common diagnosis with a peak onset in the fifth decade. The most commonly affected nerve root is C7, C6, and C8. The etiology is often compressive, but may arise from noncompressive sources. Patients commonly complain of pain, weakness, numbness, and/or tingling. Examination may reveal sensory or motor disturbance in a dermatomal/myotomal distribution. Neural compression and tension signs may be positive. Diagnostic tests include imaging and electrodiagnostic study. Electrodiagnostic study serves as an extension of the neurologic examination. Electrodiagnostic findings can be useful for patients with atypical symptoms, potential pain-mediated weakness, and nonfocal imaging findings. PMID:23177027

  5. Pseudohemangioma of the Vertebra: An Unusual Radiographic Manifestation of Primary Ewing's Sarcoma

    Microsoft Academic Search

    Joshua A. Bemporad; Gordon Sze; John C. Chaloupka; Charles Duncan

    1999-01-01

    Summary: Primary Ewing's sarcoma (ES) of the spine is uncommon, exhibiting a variety of appearances on plain- film radiographs and cross-sectional images. We report the unusual CT imaging manifestations of a primary ES with a coarse trabecular pattern that mimicked an aggressive hemiangioma of the cervical spine. Ewing's sarcoma (ES) is an aggressive malignant neoplasm accounting for 6% to 8%

  6. Anterior cervical interbody constructs: effect of a repetitive compressive force on the endplate.

    PubMed

    Ordway, Nathaniel R; Rim, Byeong Cheol; Tan, Rong; Hickman, Rebecca; Fayyazi, Amir H

    2012-04-01

    Graft subsidence following anterior cervical reconstruction can result in the loss of sagittal balance and recurring foraminal stenosis. This study examined the implant-endplate interface using a cyclic fatigue loading protocol in an attempt to model the subsidence seen in vivo. The superior endplate from 30 cervical vertebrae (C3 to T1) were harvested and biomechanically tested in axial compression with one of three implants: Fibular allograft; titanium mesh cage packed with cancellous chips; and trabecular metal. Each construct was cyclically loaded from 50 to 250?N for 10,000 cycles. Nondestructive cyclic loading of the cervical endplate-implant construct resulted in a stiffer construct independent of the type of the interbody implant tested. The trabecular metal construct demonstrated significantly more axial stability and significantly less subsidence in comparison to the titanium mesh construct. Although the allograft construct resulted in more subsidence than the trabecular metal construct, the difference was not significant and no difference was found when comparing axial stability. For all constructs, the majority of the subsidence during the cyclic testing occurred during the first 500 cycles and was followed by a more gradual settling in the remaining 9,500 cycles. PMID:22002745

  7. Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads.

    PubMed

    Kumaresan, S; Yoganandan, N; Pintar, F A; Maiman, D J

    1999-12-01

    An anatomically accurate, three-dimensional, nonlinear finite element model of the human cervical spine was developed using computed tomography images and cryomicrotome sections. The detailed model included the cortical bone, cancellous core, endplate, lamina, pedicle, transverse processes and spinous processes of the vertebrae; the annulus fibrosus and nucleus pulposus of the intervertebral discs; the uncovertebral joints; the articular cartilage, the synovial fluid and synovial membrane of the facet joints; and the anterior and posterior longitudinal ligaments, interspinous ligaments, capsular ligaments and ligamentum flavum. The finite element model was validated with experimental results: force-displacement and localized strain responses of the vertebral body and lateral masses under pure compression, and varying eccentric anterior-compression and posterior-compression loading modes. This experimentally validated finite element model was used to study the biomechanics of the cervical spine intervertebral disc by quantifying the internal axial and shear forces resisted by the ventral, middle, and dorsal regions of the disc under the above axial and eccentric loading modes. Results indicated that higher axial forces (compared to shear forces) were transmitted through different regions of the disc under all loading modes. While the ventral region of the disc resisted higher variations in axial force, the dorsal region transmitted higher shear forces under all loading modes. These findings may offer an insight to better understand the biomechanical role of the human cervical spine intervertebral disc. PMID:10717549

  8. 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

  9. History of cervical disc arthroplasty.

    PubMed

    Baaj, Ali A; Uribe, Juan S; Vale, Fernando L; Preul, Mark C; Crawford, Neil R

    2009-09-01

    Enthusiasm for cervical disc arthroplasty is based on the premise that motion-preserving devices attenuate the progression of adjacent-segment disease (ASD) in the cervical spine. Arthrodesis, on the other hand, results in abnormal load transfer on adjacent segments, leading to the acceleration of ASD. It has taken several decades of pioneering work to produce clinically relevant devices that mimic the kinematics of the intervertebral disc. The goal of this work is to trace the origins of cervical arthroplasty technology and highlight the attributes of devices currently available in the market. PMID:19722812

  10. The functional morphology of the superior articular processes of the lumbar vertebrae.

    PubMed Central

    Putz, R

    1985-01-01

    The bony trabeculae in the superior articular processes of the lumbar vertebrae form a series of overlapping pointed arches that correspond to the lines of stress produced during rotation. By using a photoelastic model, it has been possible to demonstrate that this structural arrangement is a functional adaptation to alternate lateral and medial bending movements. The functional significance of the articular processes is obviously to limit rotation, which can take place in the lumbar segment of the vertebral column during any asymmetrical movement of the body. The alternate bending movements of the superior articular processes arise partly from the laterally directed pressure of the corresponding inferior process, and partly from the medially directed pull of the firm 'transverse strengthening ligaments' of the joint capsule. Images Fig. 3 Fig. 4 Fig. 5 PMID:3870725

  11. Correlative analyses of isolated upper lumbar disc herniation and adjacent wedge-shaped vertebrae

    PubMed Central

    Xu, Jia-Xin; Yang, Si-Dong; Wang, Bao-Lin; Yang, Da-Long; Ding, Wen-Yuan; Shen, Yong

    2015-01-01

    Background: Upper lumbar disc herniation (ULDH) is easy to be misdiagnosed due to its special anatomical and atypical clinical features. Few studies have identified the relationship between ULDH and adjacent wedge-shaped vertebrae (WSV). Hypothesis: WSV may have some indicative relations withULDH. Patients and methods: Between January 2003 and October 2013, 47 patients (27 males and 20 females; mean age, 41.2 years) with single-level ULDH (as study group) and 47 sex- and age-matched healthy volunteers (as control group) were studied by radiograph. The two groups were compared with respect to age, sexual proportion, body mass index (BMI), kyphotic angle, and the proportion of WSV. Also, correlative analyses were conducted in the study group to investigate the relation between the kyphotic angle of target vertebrae and other factors including age, BMI, Cobb angle, JOA score and bone mineral density (BMD). Results: The average kyphotic angle in the study group was 11° (4°-22°), while the average kyphotic angle in the control group was 2° (0°-7°). Obviously, the mean kyphotic angle in the study group was statistically larger than that in the control group (t=13.797, P<0.001). The proportion of WSV in the study group was significantly larger than that in the control group (x2=36.380, P<0.0001). The correlations between kyphotic angles and other items (i.e., age, BMI, BMD, Cobb angle and JOA score) in the study group and the control group were low or uncorrelated. Conclusions: WSV are indicatively associated with adjacent ULDH. Thus, ULDH should be alerted when WSV are first found in radiograph and accompanied by clinical symptoms. PMID:25785106

  12. Anterior Cervical Arachnoid Cyst

    PubMed Central

    Sharifi, Give

    2013-01-01

    This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome. PMID:23741550

  13. Age and Growth of Endangered Smalltooth Sawfish (Pristis pectinata) Verified with LA-ICP-MS Analysis of Vertebrae

    PubMed Central

    Scharer, Rachel M.; Patterson III, William F.; Carlson, John K.; Poulakis, Gregg R.

    2012-01-01

    Endangered smalltooth sawfish (Pristis pectinata) were opportunistically sampled in south Florida and aged by counting opaque bands in sectioned vertebrae (n?=?15). Small sample size precluded traditional age verification, but fish collected in spring and summer had translucent vertebrae margins, while fish collected in winter had opaque margins. Trends in Sr:Ca measured across vertebrae with laser ablation-inductively coupled plasma-mass spectrometry corresponded well to annual salinity trends observed in sawfish estuarine nursery habitats in south Florida, thus serve as a chemical marker verifying annual formation of opaque bands. Based on that finding and assumptions about mean birth date and timing of opaque band formation, estimated age ranged from 0.4 y for a 0.60 m total length (TL) male to 14.0 y for a 4.35 m TL female. Von Bertalanffy growth parameters computed from size at age data were 4.48 m for L?, 0.219 y?1for k, and ?0.81 y for t0. Results of this study have important implications for sawfish conservation as well as for inferring habitat residency of euryhaline elasmobranchs via chemical analysis of vertebrae. PMID:23082225

  14. Three-dimensional morphometry of the L6 vertebra in the ovariectomized rat model of osteoporosis: biomechanical implications.

    PubMed

    Kinney, J H; Haupt, D L; Balooch, M; Ladd, A J; Ryaby, J T; Lane, N E

    2000-10-01

    This article summarizes the results of a three-dimensional study of changes in the morphology of the L6 rat vertebra at 120 days after ovariectomy (OVX), with estrogen replacement therapy used as a positive control. Synchrotron radiation microtomography was used to quantify the structural parameters defining trabecular bone architecture, while finite-element methods were used to explore the relationships between these parameters and the compressive elastic behavior of the vertebrae. There was a 22% decrease in trabecular bone volume (TBV) and a 19% decline in mean trabecular thickness (Tb.Th) with OVX. This was accompanied by a 150% increase in trabecular connectivity, a result of the perforation of trabecular plates. Finite-element analysis of the trabecular bone removed from the cortical shell showed a 37% decline in the Young's modulus in compression after OVX with no appreciable change in the estrogen-treated group. The intact vertebrae (containing its trabecular bone) exhibited a 15% decrease in modulus with OVX, but this decline lacked statistical significance. OVX-induced changes in the trabecular architecture were different from those that have been observed in the proximal tibia. This difference was a consequence of the much more platelike structure of the trabecular bone in the vertebra. PMID:11028451

  15. Estimation of out-of-plane vertebra rotations on radiographic projections using CT data: a simulation study.

    PubMed

    Bifulco, Paolo; Sansone, Mario; Cesarelli, Mario; Allen, Robert; Bracale, Marcello

    2002-05-01

    This study extends previous research concerning in vivo intervertebral motion by means of single-plane fluoroscopy in an attempt to overcome 2D analysis limitations. Knowledge of out-of-plane vertebra rotations will extend the results provided by planar kinematic studies, which is particularly important for lateral bending investigation where axial rotation accompanies side bending, but is also valuable in sagittal analysis (e.g. indicating an absence of coupled axial rotation). Combining a fluoroscopic projection of a vertebra with volumetric information provided by CT data, vertebra 3D position can be estimated. Out-of-plane vertebral rotations are estimated by comparing Digitally Reconstructed Radiographs (DRRs) in different orientations with a reference fluoroscopic projection, maximising the image cross-correlation index. DRRs have been computed from CT-data using a ray-casting algorithm. In this work a feasibility study of the method was performed by means of a computer simulation. To this end the CT volume (vertebra L4, segmented) provided by the Visible Human Project was utilised and reference fluoroscopic projections were simulated in different orientations adding various levels of noise. Accuracy and precision of the proposed method was determined. Error analysis reveals that an accuracy of less than 1 degree can be achieved in computation of out-of-plane vertebral angles. PMID:11996848

  16. Drugs Approved for Cervical Cancer

    MedlinePLUS

    Other Drug Resources A to Z List of Cancer Drugs Drugs Approved for Different Types of Cancer Drugs Approved ... NCI Dictionary of Cancer Terms NCI Drug Dictionary Drugs Approved for Cervical Cancer This page lists cancer ...

  17. 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

  18. Hemangiopericytoma of the cervical spine.

    PubMed

    Ramdasi, Raghvendra V; Nadkarni, Trimurti D; Goel, Naina A

    2014-04-01

    A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC). The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented. PMID:25210342

  19. Molecular biology of cervical cancer.

    PubMed

    González Martín, A

    2007-06-01

    Cervical cancer is a virus-induced disease that is caused by the integration of high-risk infecting human papillomaviruses (HPV) in the host genome. For this reason, the carcinogenesis process of cervical cancer is associated to the expression of the viral oncogenic proteins E6 and E7. These proteins are capable of inactivating p53 and pRb, which induces a continuous cell proliferation with the increasing risk of accumulation of DNA damage that eventually leads to cancer. Moreover, cervical cancer can be prevented by prophylactic HPV vaccines; their molecular characteristics and mechanism of action are reviewed. Ultimately, new molecular targets for cervical cancer like proteasome, the EGFR family and IGF family are exposed. PMID:17594948

  20. Hemangiopericytoma of the cervical spine

    PubMed Central

    Ramdasi, Raghvendra V.; Nadkarni, Trimurti D.; Goel, Naina A.

    2014-01-01

    A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC). The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented. PMID:25210342

  1. General Information about Cervical Cancer

    MedlinePLUS

    ... increased risk of cervical cancer. There are two vaccines to prevent HPV in girls and young women ... HPV) test : A laboratory test used to check DNA or RNA for certain types of HPV infection. ...

  2. How Are Cervical Cancers and Pre-Cancers Diagnosed?

    MedlinePLUS

    ... How is cervical cancer staged? How is cervical cancer diagnosed? The first step in finding cervical cancer ... systems. Tests for women with symptoms of cervical cancer or abnormal Pap results Medical history and physical ...

  3. Infections of the Cervical Spine

    Microsoft Academic Search

    Luca Denaro; Umile Giuseppe Longo; Vincenzo Denaro

    \\u000a Spinal infections are relatively rare, accounting for only 2–4% of all osteomyelitis infections, and are located preferentially\\u000a in the thoracic and lumbar segments. Although the cervical segment is the less common spine localization, cervical spinal\\u000a infections present the highest incidence of neurological involvement [6].\\u000a \\u000a \\u000a Recent advances in diagnosis and management — with the introduction of antibiotics and more aggressive surgery

  4. Early Cervical Neoplasia: Treatment Methods

    PubMed Central

    Benedet, J.L.

    1990-01-01

    Cervical cancer screening programs have been one of the most important developments in women's health care during the past 50 years. Sound knowledge of the principles and techniques for taking Papanicolaou smears, interpreting results, and investigating abnormalities detected are essential skills for individuals providing primary health care to women. The author briefly reviews the current investigatory methods and the common treatments for cervical intraepithelial neoplasia and early invasive cancer of the cervix. PMID:21233966

  5. Glycoprotein and Glycan in Patients With Stage I, Stage II, Stage III, or Stage IV Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    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

  6. Compressed vertebrae in Atlantic salmon Salmo salar: evidence for metaplastic chondrogenesis as a skeletogenic response late in ontogeny.

    PubMed

    Witten, P Eckhard; Gil-Martens, Laura; Hall, Brian K; Huysseune, Ann; Obach, Alex

    2005-05-20

    Anterior/posterior (a/p) compression of the vertebral column, referred to as 'short tails', is a recurring event in farmed Atlantic salmon. Like other skeletal deformities, the problem usually becomes evident in a late life phase, too late for preventive measures, making it difficult to understand the aetiology of the disease. We use structural, radiological, histological, and mineral analyses to study 'short tail' adult salmon and to demonstrate that the study of adult fish can provide important insights into earlier developmental processes. 'Short tails' display a/p compressed vertebrae throughout the spine, except for the first post-cranial vertebrae. The vertebral number is unaltered, but the intervertebral space is reduced and the vertebrae are shorter. Compressed vertebrae are characterized by an unchanged central part, altered vertebral end plates (straight instead of funnel-shaped), an atypical inward bending of the vertebral edges, and structural alterations in the intervertebral tissue. The spongiosa is unaffected. The growth zones of adjacent vertebrae fuse and blend towards the intervertebral space into chondrogenic tissue. This tissue produces different types of cartilage, replacing the notochord. The correspondence in location of intervertebral cartilage and deformed vertebral end plates, and the clearly delimited, unaltered, central vertebral parts suggest that the a/p compression of vertebral bodies is a late developmental disorder that may be related to a metaplastic shift of osteogenic tissue into chondrogenic tissue in the vertebral growth zone. Given the lack of evidence for infections, metabolic disorders and/or genetic disorders, we propose that an altered mechanical load could have caused the transformation of the bone growth zones and the concomitant replacement of the intervertebral (notochord) tissue by cartilaginous tissues in the 'short tails' studied here. This hypothesis is supported by the role that notochord cells are known to play in spine development and in maintaining the structure of the intervertebral disk. PMID:15997822

  7. Registration of 2D histological sections with 3D micro-CT datasets from small animal vertebrae and tibiae.

    PubMed

    Museyko, Oleg; Marshall, Robert Percy; Lu, Jing; Hess, Andreas; Schett, Georg; Amling, Michael; Kalender, Willi A; Engelke, Klaus

    2015-11-01

    The aim of this study was the registration of digitized thin 2D sections of mouse vertebrae and tibiae used for histomorphometry of trabecular bone structure into 3D micro computed tomography (?CT) datasets of the samples from which the sections were prepared. Intensity-based and segmentation-based registrations (SegRegs) of 2D sections and 3D ?CT datasets were applied. As the 2D sections were deformed during their preparation, affine registration for the vertebrae was used instead of rigid registration. Tibiae sections were additionally cut on the distal end, which subsequently undergone more deformation so that elastic registration was necessary. The Jaccard distance was used as registration quality measure. The quality of intensity-based registrations and SegRegs was practically equal, although precision errors of the elastic registration of segmentation masks in tibiae were lower, while those in vertebrae were lower for the intensity-based registration. Results of SegReg significantly depended on the segmentation of the ?CT datasets. Accuracy errors were reduced from approximately 64% to 42% when applying affine instead of rigid transformations for the vertebrae and from about 43% to 24% when using B-spline instead of rigid transformations for the tibiae. Accuracy errors can also be caused by the difference in spatial resolution between the thin sections (pixel size: 7.25 ?m) and the ?CT data (voxel size: 15 ?m). In the vertebrae, average deformations amounted to a 6.7% shortening along the direction of sectioning and a 4% extension along the perpendicular direction corresponding to 0.13-0.17 mm. Maximum offsets in the mouse tibiae were 0.16 mm on average. PMID:25136982

  8. Cervical facet injections in the management of cervicogenic headaches.

    PubMed

    Ng, Andrew; Wang, Dajie

    2015-05-01

    Cervicogenic headache is defined as headaches originating from cervical spine structures including cervical facet joints, cervical intervertebral discs, skeletal muscles, connective tissues, and neurovascular structures. Cervical facet injections with steroids have been used to alleviate cervicogenic headache secondary to cervical facet arthropathy. In this article, we will review the cervical spine anatomy, cervical facet injections, and the efficacy of cervical facet injections as a treatment for cervicogenic headache. PMID:25795156

  9. Cervical Cord Decompression Using Extended Anterior Cervical Foraminotomy Technique

    PubMed Central

    Kim, Sung-Duk; Lee, Cheol-Young; Kim, Hyun-Woo; Jung, Chul-Ku; Kim, Jong Hyun

    2014-01-01

    Objective At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. Methods Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. Results In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. Conclusions Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed. PMID:25328648

  10. Age, Gender and Normalization Covariates for Spinal Cord Gray Matter and Total Cross-Sectional Areas at Cervical and Thoracic Levels: A 2D Phase Sensitive Inversion Recovery Imaging Study

    PubMed Central

    Papinutto, Nico; Schlaeger, Regina; Panara, Valentina; Zhu, Alyssa H.; Caverzasi, Eduardo; Stern, William A.; Hauser, Stephen L.; Henry, Roland G.

    2015-01-01

    The source of inter-subject variability and the influence of age and gender on morphometric characteristics of the spinal cord, such as the total cross-sectional area (TCA), the gray matter (GM) and white matter (WM) areas, currently remain under investigation. Understanding the effect of covariates such as age, gender, brain volumes, and skull- and vertebra-derived metrics on cervical and thoracic spinal cord TCA and GM areas in healthy subjects would be fundamental for exploring compartment specific changes in neurological diseases affecting the spinal cord. Using Magnetic Resonance Imaging at 3T we investigated 32 healthy subjects using a 2D phase sensitive inversion recovery sequence and we measured TCA, GM and WM areas at 4 cervical and thoracic levels of the spinal cord. We assessed age and gender relationships of cord measures and explored associations between cord measures and a) brain volumes and b) skull- and vertebra-derived metrics. Age and gender had a significant effect on TCA, WM and GM areas (with women and elderly having smaller values than men and younger people respectively), but not on the GM area/TCA ratio. The total intracranial volume and C3 vertebra dimensions showed the highest correlations with cord measures. When used in multi-regression models, they reduced cord areas group variability by approximately a third. Age and gender influences on cord measures and normalization strategies here presented might be of use in the study of compartment specific changes in various neurological diseases affecting the spinal cord. PMID:25781178

  11. Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks

    Microsoft Academic Search

    Constantine Constantoyannis; Demetres Konstantinou; Harry Kourtopoulos; Nicolas Papadakis

    2002-01-01

    Objective: To describe the use of intermittent cervical traction in managing 4 patients with cervical radiculopathy and large-volume herniated disks. Clinical Features: Four patients had neck pain radiating to the arm. The clinical examination was typical in all cases for radiculopathy of cervical origin. Magnetic resonance imaging (MRI) of the cervical spine revealed large-volume herniated disks in all patients. Intervention

  12. Percolation theory relates corticocancellous architecture to mechanical function in vertebrae of inbred mouse strains

    PubMed Central

    Tommasini, Steven M.; Wearne, Susan L.; Hof, Patrick R.; Jepsen, Karl J.

    2009-01-01

    Complex corticocancellous skeletal sites such as the vertebra or proximal femur are connected networks of bone capable of transferring mechanical loads. Characterizing these structures as networks may allow us to quantify the load transferring behavior of the emergent system as a function of the connected cortical and trabecular components. By defining the relationship between certain physical bone traits and mechanical load transfer pathways, a clearer picture of the genetic determinants of skeletal fragility can be developed. We tested the hypothesis that the measures provided by network percolation theory will reveal that different combinations of cortical, trabecular, and compositional traits lead to significantly different load transfer pathways within the vertebral bodies among inbred mouse strains. Gross morphologic, micro-architectural, and compositional traits of L5 vertebrae from 15 week old A/J (A), C57BL6/J (B6), and C3H/HeJ (C3H) inbred mice (n=10/strain) were determined using micro-computed tomography. Measures included total cross-sectional area, bone volume fraction, trabecular number, thickness, spacing, cortical area, and tissue mineral density. Two-dimensional coronal sections were converted to network graphs with the cortical shell considered as one highly connected node. Percolation parameters including correlation length (average number of connected nodes between superior and inferior surfaces), chemical length (minimum number of connected nodes between surfaces), and backbone mass (strut number) were measured. Analysis of the topology of the connected bone networks showed that A and B6 mice transfer load through trabecular pathways in the middle of the vertebral body in addition to the cortical shell. C3H mice transfer load primarily through the highly mineralized cortical shell. Thus, the measures provided by percolation theory provide a quantitative approach to study how different combinations of cortical and trabecular traits lead to mechanically functional structures. The data further emphasize the interdependent nature of these physical bone traits suggesting similar genetic variants may affect both trabecular and cortical bone. Therefore, developing a network approach to study corticocancellous architecture during growth should further our understanding of the biological basis of skeletal fragility and, thus, provide novel engineering approaches to studying the genetic basis of fracture risk. PMID:18258502

  13. Use of cervical spine manipulation under anesthesia for management of cervical disk herniation, cervical radiculopathy, and associated cervicogenic headache syndrome

    Microsoft Academic Search

    James Herzog

    1999-01-01

    Objective: To demonstrate the benefits of cervical spine manipulation with the patient under anesthesia as an approach to treating a patient with chronic cervical disk herniation, associated cervical radiculopathy, and cervicogenic headache syndrome. Clinical Features: The patient had neck pain with radiating paresthesia into the right upper extremity and incapacitating headaches and had no response to 6 months of conservative

  14. Cervical Cancer Rates by Race and Ethnicity

    MedlinePLUS

    ... Fighting Cervical Cancer Worldwide Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ... Skin Uterine Cancer Home Cervical Cancer Rates by Race and Ethnicity Language: English Español (Spanish) Recommend on ...

  15. 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 ...

  16. 21 CFR 884.3200 - Cervical drain.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3200 Cervical drain. (a) Identification. A cervical drain is a device designed to provide...

  17. Neuropathology of Cervical Dystonia

    PubMed Central

    Prudente, C.N.; Pardo, C.A.; Xiao, J.; Hanfelt, J.; Hess, E.J.; LeDoux, M.S.; Jinnah, H.A.

    2012-01-01

    The aim of this study was to search for neuropathological changes in postmortem brain tissue of individuals with cervical dystonia (CD). Multiple regions of formalin-preserved brains were collected from patients with CD and controls and examined with an extensive battery of histopathological stains in a two-stage study design. In stage one, 4 CD brains underwent a broad screening neuropathological examination. In stage two, these 4 CD brains were combined with 2 additional CD brains, and the subjective findings were quantified and compared to 16 age-matched controls. The initial subjective neuropathological assessment revealed only two regions with relatively consistent changes. The substantia nigra had frequent ubiquitin-positive intranuclear inclusions known as Marinesco bodies. Additionally, the cerebellum showed patchy loss of Purkinje cells, areas of focal gliosis and torpedo bodies. Other brain regions showed minor or inconsistent changes. In the second stage of the analysis, quantitative studies failed to reveal significant differences in the numbers of Marinesco bodies in CD versus controls, but confirmed a significantly lower Purkinje cell density in CD. Molecular investigations revealed 4 of the CD cases and 2 controls to harbor sequence variants in non-coding regions of THAP1, and these cases had lower Purkinje cell densities regardless of whether they had CD. The findings suggest that subtle neuropathological changes such as lower Purkinje cell density may be found in primary CD when relevant brain regions are investigated with appropriate methods. PMID:23195594

  18. Neuropathology of cervical dystonia.

    PubMed

    Prudente, C N; Pardo, C A; Xiao, J; Hanfelt, J; Hess, E J; Ledoux, M S; Jinnah, H A

    2013-03-01

    The aim of this study was to search for neuropathological changes in postmortem brain tissue of individuals with cervical dystonia (CD). Multiple regions of formalin-preserved brains were collected from patients with CD and controls and examined with an extensive battery of histopathological stains in a two-stage study design. In stage one, 4 CD brains underwent a broad screening neuropathological examination. In stage two, these 4 CD brains were combined with 2 additional CD brains, and the subjective findings were quantified and compared to 16 age-matched controls. The initial subjective neuropathological assessment revealed only two regions with relatively consistent changes. The substantia nigra had frequent ubiquitin-positive intranuclear inclusions known as Marinesco bodies. Additionally, the cerebellum showed patchy loss of Purkinje cells, areas of focal gliosis and torpedo bodies. Other brain regions showed minor or inconsistent changes. In the second stage of the analysis, quantitative studies failed to reveal significant differences in the numbers of Marinesco bodies in CD versus controls, but confirmed a significantly lower Purkinje cell density in CD. Molecular investigations revealed 4 of the CD cases and 2 controls to harbor sequence variants in non-coding regions of THAP1, and these cases had lower Purkinje cell densities regardless of whether they had CD. The findings suggest that subtle neuropathological changes such as lower Purkinje cell density may be found in primary CD when relevant brain regions are investigated with appropriate methods. PMID:23195594

  19. Traumatic Disorders of the Cervical Spine

    Microsoft Academic Search

    Robert N. Hensinger

    \\u000a The child’s cervical spine often presents a diagnostic dilemma. The presence of cervical growth plates, lack of complete ossification,\\u000a unique developmental aspects, and hypermobility are causes of confusion in the interpretation of cervical radiographs in children\\u000a with neck pain or stiffness [1]. Cervical spine radiographs in children are notoriously difficult to interpret. Lack of familiarity\\u000a with normal growth and development

  20. Fusion around cervical disc prosthesis: case report

    Microsoft Academic Search

    Ronald H. M. A. Bartels; Roland Donk

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a right-sided anterior cervical discectomy because of pain in the right arm resulting from a herniated disc (C5-C6). INTERVENTION:

  1. Rapid Progression of Solitary Plasmacytoma to Multiple Myeloma in Lumbar Vertebra

    PubMed Central

    Yang, Jin Seo; Kang, Suk Hyung; Choi, Hyuk Jai

    2013-01-01

    The prognosis of solitary plasmacytoma varies greatly, with some patients recovering after surgical removal or local fractional radiation therapy, and others progressing to multiple myeloma years later. Primary detection of progression to multiple myeloma is important in the treatment of solitary plasmacytoma. There have been several analyses of the risk factors involved in the early progression to multiple myeloma. We describe one case of solitary plasmacytoma of the lumbar vertebra that was treated with surgical decompression with stabilization and additional radiotherapy. The patient had no factors associated with rapid progression to multiple myeloma such as age, size, immunologic results, pathological findings, and serum free light chain ratio at the time of diagnosis. However, his condition progressed to multiple myeloma less than two months after the initial diagnosis of solitary plasmacytoma. We suggest that surgeons should be vigilant in watching for rapid progression to multiple myeloma even in case that the patient with solitary plasmacytoma has no risk factors for rapid progression to multiple myeloma. PMID:24379952

  2. Morphometrical dimensions of the sheep thoracolumbar vertebrae as seen on digitised CT images

    PubMed Central

    Berner, Dagmar; Jülke, Henriette; Hohaus, Christian; Brehm, Walter; Gerlach, Kerstin

    2013-01-01

    The sheep spine is widely used as a model for preclinical research in human medicine to test new spinal implants and surgical procedures. Therefore, precise morphometric data are needed. The present study aimed to provide computed tomographic (CT) morphometry of sheep thoracolumbar spine. Five adult normal Merino sheep were included in this study. Sheep were anaesthetised and positioned in sternal recumbency. Subsequently, transverse and sagittal images were obtained using a multi-detector-row helical CT scanner. Measurements of the vertebral bodies, pedicles, intervertebral disc and transverse processes were performed with dedicated software. Vertebral bodies and the spinal canal were wider than they were deep, most obviously in the lumbar vertebrae. The intervertebral discs were as much as 57.4% thicker in the lumbar than in the thoracic spine. The pedicles were higher and longer than they were wide over the entire thoracolumbar spine. In conclusion, the generated data can serve as a CT reference for the ovine thoracolumbar spine and may be helpful in using sheep spine as a model for human spinal research. PMID:24106508

  3. Micro-CT Imaging of Rat Bone and Lumber Vertebra using Synchrotron Radiation

    SciTech Connect

    Rao, Donepudi V. [Department of Physics, Sir. C.R.R. (A) College, Eluru-534007., W.G. Dt., A.P. (India); Cesareo, Roberto; Brunetti, Antonio [Istituto di Matematica e Fisica, Universita di Sassari, Via Vienna 2, 07100 Sassari (Italy); Akatsuka, Takao; Yuasa, Tetsyua [Department of Bio-System Engineering, Faculty of Engineering, Yamagata University, 4-3-16 Jonan, Yonezawa 992-8510 (Japan); Takeda, Tohoru [Institute of Clinical Medicine, University of Tsukuba, Tsukuba (Japan); Tromba, Giuliana [SYRMEP, Elettra, Trieste (Italy); Gigante, Giovanni E. [SDepartimento di Fisica, Universita di Roma ''La Sapienza'' 00185, Roma (Italy)

    2009-03-10

    Micro-tomographic imaging with a spatial resolution on the micrometer scale offers owes a high potential to perform certain types of measurements that were not feasible with other techniques or conventional laboratory methods. The synchrotron X-ray source gives substantial advantages because of its high brilliance and continuous X-ray spectrum. Based on this, visualized the microstructure of rat bone and lumber vertebra was visualized using 20, 25 and 30 keV synchrotron X-rays. We utilized the data which was acquired at different energies for multi-model imaging and to estimate the Ca/P ratio. Up to now there has been no research carried out using these images for the estimation of the calcium content, with synchrotron X-rays. The results are based on the analysis of images and gray values obtained at different energies. We introduce this new method in order to measure the calcium content by means of high resolution synchrotron micro-CT.

  4. Direct visualization of regions with lowered bone mineral density in dual-energy CT images of vertebrae

    NASA Astrophysics Data System (ADS)

    Wesarg, Stefan; Erdt, Marius; Kafchitsas, Konstantinos; Khan, M. Fawad

    2011-03-01

    Dual-energy CT allows for a better material differentiation than conventional CT. For the purpose of osteoporosis diagnosis, a detection of regions with lowered bone mineral density (BMD) is of high clinical interest. Based on an existing biophysical model of the trabecular bone in vertebrae a new method for directly highlighting those low density regions in the image data has been developed. For this, we combine image data acquired at 80 kV and 140 kV with information about the BMD range in different vertebrae and derive a method for computing a color enhanced image which clearly indicates low density regions. An evaluation of our method which compares it with a quantitative method for BMD assessment shows a very good correspondence between both methods. The strength of our method lies in its simplicity and speed.

  5. Nucleus pulposus cells derived IGF-1 and MCP-1 enhance osteoclastogenesis and vertebrae disruption in lumbar disc herniation

    PubMed Central

    Zhu, Zhongjiao; Huang, Peng; Chong, Yanxue; George, Suraj K; Wen, Bingtao; Han, Na; Liu, Zhiqiang; Kang, Lixin; Lin, Nie

    2014-01-01

    Study design: Chronic strained lumbar disc herniation (LDH) cases were classified into bulging LDH, herniated LDH and prolapse LDH types according to imaging examination, and vertebrae disruptions were evaluated. Cytokines derived from the nucleus pulposus cells were detected, and their effects on osteoclastogenesis, as well as the mechanisms involved, were studied via an in vitro osteoclast differentiation system. Objective: To clarify the mechanisms of lumbar vertebrae resorption induced by lumbar herniation. Summary and background data: Chronic strained lumbar disc herniation induced vertebrae erosion exacerbates quality of patients’ life and clinical outcome. Although nucleus pulposus cells derived cytokines were reported to play an important role in this pathogenesis, the fundamental mechanisms underlying this process are still unclear. Methods: Chronic strained lumbar disc herniation patients were diagnosed with CT scan and T2-weighted magnetic resonance imaging. RNA was extracted from 192 surgical specimens of the herniated lumbar disc and 29 surgical excisions of the lumbar disc from spinal injury patients. The expressions of osteoclastogenesis related cytokines and chemokines were examined using real time PCR. Monocytes were induced into osteoclast with M-CSF and RANKL in vitro, while the IGF-1 and MCP-1 were added into the differentiation procedure in order to evaluate the effects and explore the molecular mechanisms. Results: Vertebrae erosion had a positive relationship with lumbar disc herniation severity types. In all of the osteoclastogenesis related cytokines, the IGF-1 and MCP-1 were the most highly expressed in the nucleus pulposus cells. IGF-1 enhances activation of NF-kB signaling directly, but MCP-1 upregulated the expression of RANK, so that enhanced cellular sensitivity to RANKL resulted in increasing osteoclastogenesis and activity. Conclusion: Lumbar herniation induced overexpression of IGF-1 and MCP-1 in nucleus pulposus cells aggravated vertebral erosions. Hence, this study suggests that targeting osteoclastogenesis related cytokines has potential clinical significance in the treatment of lumbar disc herniation patients. PMID:25674216

  6. Fibromatosis of the cervical fascia.

    PubMed

    Kania, Romain E; Hartl, Dana M; Hans, Stéphane; Papon, Jean-François; Carnot, Françoise; Brasnu, Daniel F

    2003-01-01

    Fibromatosis is a rare benign soft-tissue tumor of fibroblastic origin arising from the aponeurotic structures. Preoperative diagnosis of fibromatosis of the deep cervical fascia is difficult from clinical presentation alone. We report a case of a tumor of the cervical fascia space for which the radiologic appearance did not exhibit specific characteristics. Critical analysis of the radiologic images combined with fine-needle aspiration findings were helpful in suggesting preoperatively the diagnosis of fibromatosis, which was confirmed histologically after surgical resection. PMID:12884216

  7. Differential gene expression of bgp and mgp in trabecular and compact bone of Atlantic salmon (Salmo salar L.) vertebrae.

    PubMed

    Krossøy, Christel; Ornsrud, Robin; Wargelius, Anna

    2009-12-01

    The tissue-specific gene expression of the vitamin K-dependent proteins bone gamma-carboxyglutamate-protein (BGP) and matrix gamma-carboxyglutamate-protein (MGP) in Atlantic salmon (Salmo salar L.) was investigated. In previous studies, BGP, the most abundant non-collagenous protein of bone, was almost exclusively associated with bone, whereas the non-structural protein MGP has a more widespread tissue distribution. In-situ hybridization of juvenile Atlantic salmon ( approximately 40 g, fresh water) vertebrae demonstrated expression of bgp and mgp mRNA in osteoblasts lining the trabecular bone, whereas no staining was observed in the compact bone. By separating the trabecular and compact bone of both juvenile ( approximately 40 g, fresh water) and adult ( approximately 1000 g, sea water) Atlantic salmon, we observed that the two vertebral bone compartments displayed different levels of bgp, whereas no such differences were seen for mgp. Measurements of the mineral content and Ca/P molar ratio in adult salmon revealed no significant differences between trabecular and compact bone. In conclusion, the osteoblasts covering the salmon vertebrae have unique gene expression patterns and levels of bgp and mgp. Further, the study confirms the presence of mRNA from the vitamin K-dependent proteins BGP and MGP in the vertebrae, fin and gills of Atlantic salmon. PMID:19811564

  8. Differential gene expression of bgp and mgp in trabecular and compact bone of Atlantic salmon (Salmo salar L.) vertebrae

    PubMed Central

    Krossøy, Christel; Ørnsrud, Robin; Wargelius, Anna

    2009-01-01

    The tissue-specific gene expression of the vitamin K-dependent proteins bone ?-carboxyglutamate-protein (BGP) and matrix ?-carboxyglutamate-protein (MGP) in Atlantic salmon (Salmo salar L.) was investigated. In previous studies, BGP, the most abundant non-collagenous protein of bone, was almost exclusively associated with bone, whereas the non-structural protein MGP has a more widespread tissue distribution. In-situ hybridization of juvenile Atlantic salmon (?40 g, fresh water) vertebrae demonstrated expression of bgp and mgp mRNA in osteoblasts lining the trabecular bone, whereas no staining was observed in the compact bone. By separating the trabecular and compact bone of both juvenile (?40 g, fresh water) and adult (?1000 g, sea water) Atlantic salmon, we observed that the two vertebral bone compartments displayed different levels of bgp, whereas no such differences were seen for mgp. Measurements of the mineral content and Ca/P molar ratio in adult salmon revealed no significant differences between trabecular and compact bone. In conclusion, the osteoblasts covering the salmon vertebrae have unique gene expression patterns and levels of bgp and mgp. Further, the study confirms the presence of mRNA from the vitamin K-dependent proteins BGP and MGP in the vertebrae, fin and gills of Atlantic salmon. PMID:19811564

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

    PubMed Central

    Li, Jian; Zhang, Zai-Heng

    2008-01-01

    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) ?11° or horizontal displacement (HD) ?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

  10. Cervical Remodeling during Pregnancy and Parturition

    PubMed Central

    Timmons, Brenda; Akins, Meredith; Mahendroo, Mala

    2010-01-01

    Appropriate and timely cervical remodeling is key for successful birth. Premature cervical opening can result in preterm birth which occurs in 12.5% of pregnancies. Research focused on the mechanisms of term and preterm cervical remodeling is essential to prevent prematurity. This review highlights recent findings that better define molecular processes driving progressive disorganization of the cervical extracellular matrix. This includes studies that redefine the role of immune cells and identify diverse functions of the cervical epithelia and hyaluronan in remodeling. New investigations proposing that infection-induced premature cervical remodeling is distinct from the normal process are presented. Recent advances in our understanding of term and preterm cervical remodeling provide new directions for investigation and compel investigators to reevaluate currently accepted models. PMID:20172738

  11. 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

  12. Are Spinal or Paraspinal Anatomic Markers Helpful for Vertebral Numbering and Diagnosing Lumbosacral Transitional Vertebrae?

    PubMed Central

    Ucar, Murat; Erdogan, Aylin Billur; Kilic, Koray; Ozcan, Cahide

    2014-01-01

    Objective To evaluate the value of spinal and paraspinal anatomic markers in both the diagnosis of lumbosacral transitional vertebrae (LSTVs) and identification of vertebral levels on lumbar MRI. Materials and Methods Lumbar MRI from 1049 adult patients were studied. By comparing with the whole-spine localizer, the diagnostic errors in numbering vertebral segments on lumbar MRI were evaluated. The morphology of S1-2 disc, L5 and S1 body, and lumbar spinous processes (SPs) were evaluated by using sagittal MRI. The positions of right renal artery (RRA), superior mesenteric artery, aortic bifurcation (AB) and conus medullaris (CM) were described. Results The diagnostic error for evaluation of vertebral segmentation on lumbar MRI alone was 14.1%. In lumbarization, all patients revealed a well-formed S1-2 disc with squared S1 body. A rhombus-shaped L5 body in sacralization and a rectangular-shaped S1 body in lumbarization were found. The L3 had the longest SP. The most common sites of spinal and paraspinal structures were: RRA at L1 body (53.6%) and L1-2 disc (34.1%), superior mesenteric artery at L1 body (55.1%) and T12-L1 disc (31.6%), and AB at L4 body (71.1%). CM had variable locations, changing from the T12-L1 disc to L2 body. They were located at higher sacralization and lower lumbarization. Conclusion The spinal morphologic features and locations of the spinal and paraspinal structures on lumbar MRI are not completely reliable for the diagnosis of LSTVs and identification on the vertebral levels. PMID:24644411

  13. Role of trabecular microfractures in failure of human vertebrae estimated by the finite element method

    NASA Astrophysics Data System (ADS)

    Sidorenko, Irina N.; Bauer, Jan; Monetti, Roberto; Müller, Dirk; Rummeny, Ernst J.; Eckstein, Felix; Matsuura, Maiko; Lochmüller, Eva-Maria; Zysset, Philippe K.; Räth, Christoph W.

    2009-02-01

    Spine fractures are the most frequent complication of osteoporosis, a disease characterized by low bone mass and structural deterioration of bone tissue. In case of the spine, the trabecular network plays the main role in load carrying and distribution. A correct description of mechanical properties of this bone structure helps to differentiate between strong and weak bones and can be useful for fracture prediction and treatment monitoring. By means of the finite element method (FEM), applied to ?CT images, we modelled biomechanical processes in probes during loading and correlated the estimated failure load with the maximum compressive strength (MCS), obtained in real biomechanical tests. We studied a sample of 151 specimens taken from the trabecular part of human vertebrae in vitro, visualised using ?CT imaging at an isotropic resolution of 26?m and tested by uniaxial compression. Besides the standard way of estimating failure load, which takes into account only strong micro-fractures, we also included small micro-fractures, what improved the correlation with MCS (Pearson's correlation coefficient r=0.78 vs. r=0.58). This correlation coefficient was larger than that for both the standard morphometric parameters (r=0.73 for bone volume fraction) and for texture measures defined by the local (an-) isotropic scaling indices method (r=0.55) and Minkowski Functionals (r=0.61). However, the performance of the FEM was different for subsamples selected according to the MCS value. The correlation increased for strong specimens (r=0.88), slightly decreased for weak specimens (r=0.68) and markedly dropped for specimens with medium MCS, e.g. between 60

  14. Spinal deformity in aged zebrafish is accompanied by degenerative changes to their vertebrae that resemble osteoarthritis.

    PubMed

    Hayes, Anthony J; Reynolds, Scott; Nowell, Mari A; Meakin, Lee B; Habicher, Judith; Ledin, Johan; Bashford, Andrew; Caterson, Bruce; Hammond, Chrissy L

    2013-01-01

    Age-related degenerative changes within the vertebral column are a significant cause of morbidity with considerable socio-economic impact worldwide. An improved understanding of these changes through the development of experimental models may lead to improvements in existing clinical treatment options. The zebrafish is a well-established model for the study of skeletogenesis with significant potential in gerontological research. With advancing age, zebrafish frequently develop gross deformities of their vertebral column, previously ascribed to reduced trunk muscle tone. In this study, we assess degenerative changes specifically within the bone and cartilage of the vertebral column of zebrafish at 1, 2 and 3-years of age. We show increased frequency and severity of spinal deformities/curvatures with age. Underlying the most severe phenotypes are partial or complete vertebral dislocations and focal thickening of the vertebral bone at the joint margins. MicroCT examination demonstrates small defects, fractures and morphological evidence suggestive of bone erosion and remodeling (i.e. osteophytes) within the vertebrae during aging, but no significant change in bone density. Light and electron microscopic examination reveal striking age-related changes in cell morphology, suggestive of chondroptosis, and tissue remodelling of the vertebral cartilage, particularly within the pericellular micro-environment. Glycosaminoglycan analysis of the vertebral column by HPLC demonstrates a consistent, age-related increase in the yield of total chondroitin sulfate disaccharide, but no change in sulfation pattern, supported by immunohistochemical analysis. Immunohistochemistry strongly identifies all three chondroitin/dermatan sulphate isoforms (C-0-S, C-4-S/DS and C-6-S) within the vertebral cartilage, particularly within the pericellular micro-environment. In contrast, keratan sulfate immunolocalises specifically with the notochordal tissue of the intervertebral disc, and its labelling diminishes with age. In summary, these observations raise the prospect that zebrafish, in addition to modelling skeletal development, may have utility in modelling age-related degenerative changes that affect the skeleton during senescence. PMID:24086633

  15. Spinal Deformity in Aged Zebrafish Is Accompanied by Degenerative Changes to Their Vertebrae that Resemble Osteoarthritis

    PubMed Central

    Hayes, Anthony J.; Reynolds, Scott; Nowell, Mari A.; Meakin, Lee B.; Habicher, Judith; Ledin, Johan; Bashford, Andrew; Caterson, Bruce; Hammond, Chrissy L.

    2013-01-01

    Age-related degenerative changes within the vertebral column are a significant cause of morbidity with considerable socio-economic impact worldwide. An improved understanding of these changes through the development of experimental models may lead to improvements in existing clinical treatment options. The zebrafish is a well-established model for the study of skeletogenesis with significant potential in gerontological research. With advancing age, zebrafish frequently develop gross deformities of their vertebral column, previously ascribed to reduced trunk muscle tone. In this study, we assess degenerative changes specifically within the bone and cartilage of the vertebral column of zebrafish at 1, 2 and 3-years of age. We show increased frequency and severity of spinal deformities/curvatures with age. Underlying the most severe phenotypes are partial or complete vertebral dislocations and focal thickening of the vertebral bone at the joint margins. MicroCT examination demonstrates small defects, fractures and morphological evidence suggestive of bone erosion and remodeling (i.e. osteophytes) within the vertebrae during aging, but no significant change in bone density. Light and electron microscopic examination reveal striking age-related changes in cell morphology, suggestive of chondroptosis, and tissue remodelling of the vertebral cartilage, particularly within the pericellular micro-environment. Glycosaminoglycan analysis of the vertebral column by HPLC demonstrates a consistent, age-related increase in the yield of total chondroitin sulfate disaccharide, but no change in sulfation pattern, supported by immunohistochemical analysis. Immunohistochemistry strongly identifies all three chondroitin/dermatan sulphate isoforms (C-0-S, C-4-S/DS and C-6-S) within the vertebral cartilage, particularly within the pericellular micro-environment. In contrast, keratan sulfate immunolocalises specifically with the notochordal tissue of the intervertebral disc, and its labelling diminishes with age. In summary, these observations raise the prospect that zebrafish, in addition to modelling skeletal development, may have utility in modelling age-related degenerative changes that affect the skeleton during senescence. PMID:24086633

  16. Get Tested for Cervical Cancer

    MedlinePLUS

    ... Testing for cervical cancer is covered under the Affordable Care Act , the health care reform law passed in 2010. Depending on your insurance plan, you may be able to get tested at no cost to you. If ... about the Affordable Care Act. If you don’t have insurance, find a ...

  17. Cervical traction using EMG biofeedback

    Microsoft Academic Search

    M. Y. Lee; M. K. Wong; F. T. Tang; W. H. Chang; Y. L. Chen

    1996-01-01

    The increase of age-related diseases such as musculoskeletal and neurological dysfunction will require increased use of rehabilitation therapy. The effectiveness of this treatment depends of the skill of the therapist and the functionality inherent in the therapeutic device used. Here, a new EMG biofeedback controlled therapeutic traction machine was developed to relieve neck pain or cervical compression syndrome. Through EMG

  18. ISASS Policy Statement - Cervical Interbody

    PubMed Central

    Singh, Kern; Qureshi, Sheeraz

    2014-01-01

    Morgan Lorio, MD, FACS, Chair, ISASS Task Force on Coding & Reimbursement In 2011, CPT code 22551 was revised to combine or bundle CPT codes 63075 and 22554 when both procedures were performed at the same site/same surgical session. The add on code +22552 is used to report each additional interspace. 2014 heralded a downward pressure on this now prime target code (for non-coverage?) 22551 through an egregious insurer attempt to redefine cervical arthrodesis, effectively removing spine surgeon choice and altering best practice without clinical evidence. Currently, spine surgeons are equally split on the use of allograft versus cages for cervical arthrodesis. Structural allograft, CPT code 20931, is reported once per same surgical session, regardless of the number of allografts used. CPT code 22851 which is designated solely for cage use, has a higher reimbursement than structural allograft, and may be reported for each inner space. Hence, the rationale behind why some payers wrongly consider “spine cages NOT medically necessary for cervical fusion.” A timely consensus paper summarizing spine surgeon purview on the logical progressive evolution of cervical interbody fusion for ISASS/IASP membership was strategically identified as an advocacy focus by the ISASS Task Force. ISASS appreciates the authors’ charge with gratitude. This article has both teeth and transparent clinical real-world merit. PMID:25694945

  19. 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.

  20. ISASS Policy Statement - cervical interbody.

    PubMed

    Singh, Kern; Qureshi, Sheeraz

    2014-01-01

    Morgan Lorio, MD, FACS, Chair, ISASS Task Force on Coding & Reimbursement In 2011, CPT code 22551 was revised to combine or bundle CPT codes 63075 and 22554 when both procedures were performed at the same site/same surgical session. The add on code +22552 is used to report each additional interspace. 2014 heralded a downward pressure on this now prime target code (for non-coverage?) 22551 through an egregious insurer attempt to redefine cervical arthrodesis, effectively removing spine surgeon choice and altering best practice without clinical evidence. Currently, spine surgeons are equally split on the use of allograft versus cages for cervical arthrodesis. Structural allograft, CPT code 20931, is reported once per same surgical session, regardless of the number of allografts used. CPT code 22851 which is designated solely for cage use, has a higher reimbursement than structural allograft, and may be reported for each inner space. Hence, the rationale behind why some payers wrongly consider "spine cages NOT medically necessary for cervical fusion." A timely consensus paper summarizing spine surgeon purview on the logical progressive evolution of cervical interbody fusion for ISASS/IASP membership was strategically identified as an advocacy focus by the ISASS Task Force. ISASS appreciates the authors' charge with gratitude. This article has both teeth and transparent clinical real-world merit. PMID:25694945

  1. Mixed reality simulation of rasping procedure in artificial cervical disc replacement (ACDR) surgery

    PubMed Central

    2010-01-01

    Background Until quite recently spinal disorder problems in the U.S. have been operated by fusing cervical vertebrae instead of replacement of the cervical disc with an artificial disc. Cervical disc replacement is a recently approved procedure in the U.S. It is one of the most challenging surgical procedures in the medical field due to the deficiencies in available diagnostic tools and insufficient number of surgical practices For physicians and surgical instrument developers, it is critical to understand how to successfully deploy the new artificial disc replacement systems. Without proper understanding and practice of the deployment procedure, it is possible to injure the vertebral body. Mixed reality (MR) and virtual reality (VR) surgical simulators are becoming an indispensable part of physicians’ training, since they offer a risk free training environment. In this study, MR simulation framework and intricacies involved in the development of a MR simulator for the rasping procedure in artificial cervical disc replacement (ACDR) surgery are investigated. The major components that make up the MR surgical simulator with motion tracking system are addressed. Findings A mixed reality surgical simulator that targets rasping procedure in the artificial cervical disc replacement surgery with a VICON motion tracking system was developed. There were several challenges in the development of MR surgical simulator. First, the assembly of different hardware components for surgical simulation development that involves knowledge and application of interdisciplinary fields such as signal processing, computer vision and graphics, along with the design and placements of sensors etc . Second challenge was the creation of a physically correct model of the rasping procedure in order to attain critical forces. This challenge was handled with finite element modeling. The third challenge was minimization of error in mapping movements of an actor in real model to a virtual model in a process called registration. This issue was overcome by a two-way (virtual object to real domain and real domain to virtual object) semi-automatic registration method. Conclusions The applicability of the VICON MR setting for the ACDR surgical simulator is demonstrated. The main stream problems encountered in MR surgical simulator development are addressed. First, an effective environment for MR surgical development is constructed. Second, the strain and the stress intensities and critical forces are simulated under the various rasp instrument loadings with impacts that are applied on intervertebral surfaces of the anterior vertebrae throughout the rasping procedure. Third, two approaches are introduced to solve the registration problem in MR setting. Results show that our system creates an effective environment for surgical simulation development and solves tedious and time-consuming registration problems caused by misalignments. Further, the MR ACDR surgery simulator was tested by 5 different physicians who found that the MR simulator is effective enough to teach the anatomical details of cervical discs and to grasp the basics of the ACDR surgery and rasping procedure PMID:20946594

  2. Cervical Spondylotic Myelopathy Caused by Single-Level Vertebral Spontaneous Fusion

    PubMed Central

    Hou, Tiesheng; Gu, Guangfei; Zhang, Hailong; Zhao, Shan; He, Shisheng

    2014-01-01

    Purpose To evaluate the clinical features, imaging characteristics, surgical options, and clinical outcomes of patients with Cervical spondylotic myelopathy (CSM) caused by single-level vertebral spontaneous fusion (SLVSF). Methods Sixteen consecutive patients with SLVSF who underwent anterior surgery were included in this study and 38 patients with CSM caused by spinal degeneration were enrolled as a control group. Demographic features, clinical presentations, imaging characteristics, surgery strategy, Nurick grade, Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and complications were evaluated. Results There were significant differences between the two groups in the mean age and the average duration of neck pain. There was no significant difference between the two groups in length of cervical spine. In the SLVSF group, 13 patients had upper segment translational instability and none had rotational instability. Pre- and postoperative Nurick grades were 2.94±0.77 and 2.19±0.54 in the SLVSF group, and 2.97±0.72 and 2.16±0.64 in the control group. Pre- and postoperative JOA scores were 9.25±2.02 and 11.69±1.62 in the SLVSF group, and 9.87±2.58 and 12.53±2.69 in the control group. Pre- and postoperative NDI values were 28.5±7.75 and 15.56±5.51 in the SLVSF group, and 16±6.13 and 11.29±4.58 in the control group. Conclusions Patients with SLVSF have necks of normal lengths, which can be used to distinguish this disorder from Klippel-Feil syndrome. There are three main features of SLVSF: (1) hypoplasia at both of the spontaneously fused vertebral bodies; (2) a major pathological feature of translational instability of the upper vertebra to the fused level; and (3) severe neck pain. Anterior surgery has a good therapeutic effect for patients with cervical SLVSF. PMID:25380388

  3. Cervical spondylosis and hypertension: a clinical study of 2 cases.

    PubMed

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-03-01

    Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms.Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  4. Defective antioxidant systems in cervical cancer.

    PubMed

    Jiang, Bin; Xiao, Songshu; Khan, Md Asaduzzaman; Xue, Min

    2013-08-01

    Cervical cancer remains a great problem for woman health, as it is the second deadly cancer of females worldwide. The infection of human papilloma virus (HPV) is the major risk factor for this cancer, although several other factors are also associated. Oxidative stress or antioxidant deficiency has been frequently identified to be associated with cervical cancer. Defects in the antioxidant enzyme systems are reported to play important role behind this antioxidant deficiency, which is responsible for the production of reactive oxygen species and ultimately, DNA damage in cervical cells. In response, cells become more vulnerable to HPV infection for cervical cancer development. Recently, antioxidant therapies or dietary supplementation of antioxidants have gained considerable interests in the cervical cancer treatment. In this study, we have reviewed the association of defective antioxidant systems and cervical cancer development. The recent advances in both of the basic and clinical research focusing on possible antioxidant therapy have also been discussed. PMID:23616011

  5. Factors associated with radiosensitivity of cervical cancer.

    PubMed

    Qin, Chenglu; Chen, Xuhui; Bai, Qian; Davis, Matthew R; Fang, Yujiang

    2014-09-01

    Radiation therapy plays a critical role in women with advanced-stage cervical cancer worldwide, particularly in developing countries, and most of the time it may be the only available treatment. The efficacy of radiation largely depends on the radiosensitivity of the tumor. The high radiation dose associated with therapy for cervical cancer may have severe side-effects and low-dose radiation has little effect on cervical cancer. A safe and effective radiosensitizing agent is required to allow reduction of radiation doses used and of side-effects associated with radiation for cervical cancer. In recent years, great knowledge has been gained about the effects of apoptosis, cyclo-oxygenases, angiogenesis, hypoxia and temperature on radiation, making it possible to manipulate the radiation response of cervical cancer to achieve a better treatment outcome. In this mini review, some of these factors associated with the radiosensitivity of cervical cancer are discussed. PMID:25202040

  6. Differentiation between Symptomatic and Asymptomatic Extraforaminal Stenosis in Lumbosacral Transitional Vertebra: Role of Three-Dimensional Magnetic Resonance Lumbosacral Radiculography

    PubMed Central

    Kim, Jae Woon; Lee, Jae Kyo

    2012-01-01

    Objective To investigate the role of lumbosacral radiculography using 3-dimentional (3D) magnetic resonance (MR) rendering for diagnostic information of symptomatic extraforaminal stenosis in lumbosacral transitional vertebra. Materials and Methods The study population consisted of 18 patients with symptomatic (n = 10) and asymptomatic extraforaminal stenosis (n = 8) in lumbosacral transitional vertebra. Each patient underwent 3D coronal fast-field echo sequences with selective water excitation using the principles of the selective excitation technique (Proset imaging). Morphologic changes of the L5 nerve roots at the symptomatic and asymptomatic extraforaminal stenosis were evaluated on 3D MR rendered images of the lumbosacral spine. Results Ten cases with symptomatic extraforaminal stenosis showed hyperplasia and degenerative osteophytes of the sacral ala and/or osteophytes at the lateral margin of the L5 body. On 3D MR lumbosacral radiculography, indentation of the L5 nerve roots was found in two cases, while swelling of the nerve roots was seen in eight cases at the exiting nerve root. Eight cases with asymptomatic extraforaminal stenosis showed hyperplasia and degenerative osteophytes of the sacral ala and/or osteophytes at the lateral margin of the L5 body. Based on 3D MR lumbosacral radiculography, indentation or swelling of the L5 nerve roots was not found in any cases with asymptomatic extraforaminal stenosis. Conclusion Results from 3D MR lumbosacral radiculography Indicate the indentation or swelling of the L5 nerve root in symptomatic extraforaminal stenosis. Based on these findings, 3D MR radiculography may be helpful in the diagnosis of the symptomatic extraforaminal stenosis with lumbosacral transitional vertebra. PMID:22778561

  7. Cryptococcosis of lumbar vertebra in a patient with rheumatoid arthritis and scleroderma: case report and literature review

    PubMed Central

    2013-01-01

    Background Although cryptococcosis mainly occurs in the central nervous system and lungs in immunocompromised hosts, it can involve any body site or structure. Here we report the first case of primary cryptococcosis of a lumbar vertebra without involvement of the central nervous system or lungs in a relatively immunocompromised individual with rheumatoid arthritis and scleroderma. Case presentation A 40-year-old Chinese woman with rheumatoid arthritis diagnosed 1 year beforehand and with a subsequent diagnosis of scleroderma was found to have an isolated cryptococcal infection of the fourth lumbar vertebra. Her main complaints were severe low back and left leg pain. Cryptococcosis was diagnosed by CT-guided needle biopsy and microbiological confirmation; however, serum cryptococcal antigen titer was negative. After 3 months of antifungal therapy with fluconazole the patient developed symptoms and signs of scleroderma, which was confirmed on laboratory tests. After taking fluconazole for 6 months, the progressive destruction of the lumbar vertebral body had halted and the size of an adjacent paravertebral mass had decreased substantially. On discharge symptoms had resolved and at an annual follow-up there was no evidence of recurrence on the basis of symptoms, signs or imaging investigations. Conclusion Although cryptococcosis of the lumbar vertebra is extremely rare, it should be considered in the differential diagnosis for patients with lumbar vertebral masses to avoid missed diagnosis, misdiagnosis and diagnostic delay. Early treatment with antifungals proved to be a satisfactory alternative to surgery in this relatively immunocompromised patient. Any residual spinal instability can be treated later, once the infection has resolved. PMID:23496879

  8. Cervical epidural steroid injections in the management of cervical radiculitis: interlaminar versus transforaminal. A review

    Microsoft Academic Search

    Christopher W. Huston

    2009-01-01

    There has been recent concern regarding the safety of cervical epidural steroid injections. The decision to proceed with treatment\\u000a requires balancing the risk and benefits. This article is an in depth review of the efficacy, complications, and technique\\u000a of both interlaminar and transforaminal cervical epidural steroid injections in the management of cervical radiculitis.

  9. 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...

  10. 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

  11. Chemotherapy for advanced or recurrent cervical cancer.

    PubMed

    Kamura, Toshiharu; Ushijima, Kimio

    2013-06-01

    The primary treatment options for cervical cancer are surgery and radiation for more than a century. However, over the last 40 years chemotherapy has been building up its reputation in the management of cervical cancer in various forms such as chemoradiation, neoadjuvant chemotherapy, and palliative chemotherapy for advanced or recurrent disease. Among these, in this review, chemotherapy for advanced or recurrent cervical cancer will be discussed. PMID:23915846

  12. Isolated Echinococcosis of cervical region

    PubMed Central

    Khare, Pratima; Kala, Pooja; Gupta, Renu; Chauhan, Nidhi

    2014-01-01

    Echinococcosis, commonly called as hydatid disease, is a parasitic infestation caused by the larva of the genus Echinococcus in human. Isolated occurrence of Echinococcosis without any evidence of visceral disease is very rare. A thorough search of the literature revealed only 11 cases of isolated cervical Echinococcosis. We report here a very rare case of isolated hydatid cyst in a 45-year-old female patient, who presented with swelling in right cervical region about 5 cm below the angle of mandible with no evidence of the disease elsewhere in the body. The case was diagnosed on fine needle aspiration cytology. The diagnosis was further supported by histopathology. We propose that the treating physician should also consider the differential diagnosis of Echinococcosis in the presence of an asymptomatic soft tissue mass, especially when the patient lives in an endemic area. PMID:25210241

  13. Human cervical mucus: research update.

    PubMed

    Katz, D F

    1991-12-01

    Evaluation of cervical mucus is a standard for determining the fertile period in natural family planning. Cervical mucus accepts, filters, prepares, and releases sperm for successful transport to the egg and fertilization. Recent scientific advances provide answers to how the mucus regulates fertility as its physical properties change during the menstrual cycle. Transmission electron microscopy reveals small interstices between mucus macromolecules relative to a sperm head. Thus advancing sperm must push aside or cut through the microstructure. The interstices are largest in the periovulatory phase of the cycle. Small magnetic spheres, comparable with the size of a sperm head, are now being used to study the physical properties of the mucus on the scale of individual sperm. PMID:1755453

  14. Os Odontoideum: Rare Cervical Lesion

    PubMed Central

    Robson, Kristie A

    2011-01-01

    We report the case of a 22-year-old Marine who presented to the emergency department, after a martial arts exercise, with transient weakness and numbness in all extremities. Computed tomography cervical spine radiographs revealed os odontoideum. Lateral flexion–extension radiographs identified atlanto-axillary instability. This abnormality is rare and can be career ending for military members who do not undergo surgical fusion. PMID:22224150

  15. 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

  16. MRI of cervical facet dislocation

    Microsoft Academic Search

    C. C. Leite; B. E. Escobar; J. Randy Jinkins

    1997-01-01

    The MRI examinations of eight patients with cervical vertebral dislocation demonstrated by conventional radiography were\\u000a reviewed. All patients had axial and sagittal T 1- and T 2-weighted imaging on a 1.5-T unit. This revealed unilateral partial\\u000a facet dislocation (in two patients), bilateral partial facet dislocation (in two), unilateral complete dislocation (in two)\\u000a and bilateral complete facet dislocation (in two). In

  17. 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

  18. Cervical cerclage: a review of current evidence.

    PubMed

    Abbott, Danielle; To, Meekai; Shennan, Andrew

    2012-06-01

    Cervical cerclage is commonly used in the management of women considered to be at high risk of second-trimester loss and spontaneous preterm birth. Insertion is dictated by factors such as multiple pregnancy, uterine anomalies, a history of cervical trauma through destructive procedures or forced dilatation, and cervical shortening seen on transvaginal ultrasound examination. However, its use and efficacy in these different groups is highly controversial as there is contradiction in the results of individual studies and meta-analyses. This review examines the contemporary evidence on cervical cerclage and its current role in obstetrics. PMID:22335473

  19. Degenerative cervical spondylolisthesis: a systematic review

    Microsoft Academic Search

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

    2011-01-01

    Purpose  Degenerative cervical spondylolisthesis has received insufficient attention, in contrast to degenerative lumbar spondylolisthesis.\\u000a In fact, degenerative cervical spondylolisthesis may be more common than previously thought.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In order to provide appropriate guidelines for the treatment of degenerative cervical spondylolisthesis, a systematic review\\u000a of degenerative cervical spondylolisthesis was performed. An English literature search from January 1947 to November 2010\\u000a was completed with

  20. Nanotechnology in the management of cervical cancer.

    PubMed

    Chen, Jiezhong; Gu, Wenyi; Yang, Lei; Chen, Chen; Shao, Renfu; Xu, Kewei; Xu, Zhi Ping

    2015-03-01

    Cervical cancer is a major disease with high mortality. All cervical cancers are caused by infection with human papillomaviruses (HPV). Although preventive vaccines for cervical cancer are successful, treatment of cervical cancer is far less satisfactory because of multidrug resistance and side effects. In this review, we summarize the recent application of nanotechnology to the diagnosis and treatment of cervical cancer as well as the development of HPV vaccines. Early detection of cervical cancer enables tumours to be efficiently removed by surgical procedures, leading to increased survival rate. The current method of detecting cervical cancer by Pap smear can only achieve 50% sensitivity, whereas nanotechnology has been used to detect HPVs with greatly improved sensitivity. In cervical cancer treatment, nanotechnology has been used for the delivery of anticancer drugs to increase treatment efficacy and decrease side effects. Nanodelivery of HPV preventive and therapeutic vaccines has also been investigated to increase vaccine efficacy. Overall, these developments suggest that nanoparticle-based vaccine may become the most effective way to prevent and treat cervical cancer, assisted or combined with some other nanotechnology-based therapy. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25752817

  1. Laparoscopic Fertility Sparing Management of Cervical Cancer

    PubMed Central

    Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

  2. Management of complex cervical instability.

    PubMed

    König, Stefan Alexander; Ranguis, Sebastian; Spetzger, Uwe

    2015-03-01

    Purpose?Illustrative cases are presented to demonstrate the surgical management of complex instability of the cervical spine. Methods?Six patients with different underlying pathologies are presented along with their clinical and radiologic findings, surgical procedures, complications, and outcomes. Results?Five patients underwent anteroposterior (AP) decompression and stabilization, of which two required secondary posterior stabilization because of dislocation or subsidence of the anterior osteosynthesis. In another case, a patient with a two-level corpectomy, a stable situation was achieved with an anterior approach only. The outcomes, measured according to Odom's criteria, were excellent in one patient, good in three patients, and fair in two patients. Conclusions?In cases of complex cervical instability, combined AP decompression and stabilization minimizes the risk of anterior plate failure or dislocation of the vertebral body prosthesis. However, there may be increased risk of adjacent-level degeneration. Therefore, a combined procedure should be considered in selected patients. Not all patients with cervical instability require circumferential surgery. In two-level corpectomy cases, the decision between the less invasive anterior-only approach and the more stable combined approach can be difficult. However, in patients with proof of poor bone quality or with metabolic disorders, a more stable combined approach should be considered. PMID:23765918

  3. Cranio cervical tuberculous hypertrophic pachymeningitis

    PubMed Central

    Senapati, Satya Bhusan; Mishra, Sudhansu Sekhar; Das, Srikanta; Parida, Deepak Kumar; Satapathy, Mani Charan

    2014-01-01

    Background: Hypertrophic pachymeningitis is a unique clinical entity characterized by fibrosis and thickening of dura mater resulting in neurological dysfunction. It could be idiopathic or due to variety of inflammatory and infectious conditions. Tuberculous hypertrophic pachymeningitis involving cranio cervical region is rarely reported. Case Description: A 50-year-old female presented with history of progressive quadriparesis and stiffness of neck for 2 years, dysphagia to liquid for past 3 months. Her condition rapidly deteriorated when another physician prescribed her corticosteroid. Physical examination revealed high cervical compressive myelo-radiculopathy with lower cranial nerve palsy and neck rigidity. Series of serum analysis, cerebrospinal fluid (CSF) study and contrast magnetic resonance imaging (MRI) clinched the diagnosis. She improved on antitubercular treatment. Conclusion: In case of multilevel cervical compressive myelo-radiculopathy with lower cranial involvement, possibility of hypertrophic pachymeningitis should be kept in mind. Before diagnosing it as idiopathic, infectious causes should be excluded otherwise prescription of corticosteroid will flare up the disease process. PMID:24818059

  4. Multimodality evaluation of cervical tumors

    NASA Astrophysics Data System (ADS)

    Madsen, Mark T.; Mayr, Nina A.; Yuh, William T. C.; Ehrhardt, James C.; Magnotta, Vincent A.; Ponto, Laura L. B.; Vannier, Michael W.; Hichwa, Richard D.

    1997-05-01

    Clinical signs of radiotherapy failure are often not present until well after treatment has been completed. Methods which could predict the response of tumors either before or early into the radiotherapy schedule would have important implications for patient management. Recent studies performed at our institution suggest that MR perfusion imaging maya be useful in distinguishing between individuals who are likely to benefit from radiation therapy and those who are not. Because MR perfusion imaging reflects tissue vascularity as well as perfusion, quantitative positron emission tomographic (PET) blood flow studies were performed to obtain an independent assessment of tumor perfusion. MR perfusion and PET quantitative blood flow studies were acquired on four women diagnosed with advanced cervical cancer. The MR perfusion studies were acquired on a 1 cm sagittal slice through the epicenter of the tumor mass. Quantitative PET blood flow studies were performed using an autoradiographic technique. The PET and MRI were registered using a manual interactive routine and the mean blood flow in the tumor was compared to the relative signal intensity in a corresponding region on the MR image. The mean blood flow in the cervical tumors ranged form 30-48 ml/min/100 grams. The observed blood flow values are consistent with the assumed relationship between MR contrast enhancement and the distribution of tissue perfusion. The information offered by these studies provides an additional window into the evaluation of the response of cervical tumors to radiation therapy.

  5. INCREASING THE CERVICAL LORDOSIS WITH CHIROPRACTIC BIOPHYSICS SEATED COMBINED EXTENSION-COMPRESSION AND TRANSVERSE LOAD CERVICAL TRACTION WITH CERVICAL MANIPULATION: NONRANDOMIZED CLINICAL CONTROL TRIAL

    Microsoft Academic Search

    Deed E. Harrison; Donald D. Harrison; Joeseph J. Betz; Tadeusz J. Janik; Burt Holland; Christopher J. Colloca; Jason W. Haas

    Background: Cervical lordosis has been shown to be an important outcome of care; however, few conservative methods of rehabilitating sagittal cervical alignment have been reported. Objective: To study whether a seated, retracted, extended, and compressed position would cause tension in the anterior cervical ligament, anterior disk, and muscle structures, and thereby restore cervical lordosis or increase the curvature in patients

  6. Metric and morphological study of the upper cervical spine from the Sima de los Huesos site (Sierra de Atapuerca, Burgos, Spain).

    PubMed

    Gómez-Olivencia, Asier; Carretero, José Miguel; Arsuaga, Juan Luis; Rodríguez-García, Laura; García-González, Rebeca; Martínez, Ignacio

    2007-07-01

    In this article, the upper cervical spine remains recovered from the Sima de los Huesos (SH) middle Pleistocene site in the Sierra de Atapuerca (Burgos, Spain) are described and analyzed. To date, this site has yielded more than 5000 human fossils belonging to a minimum of 28 individuals of the species Homo heidelbergensis. At least eleven individuals are represented by the upper cervical (C1 and C2) specimens: six adults and five subadults, one of which could represent an adolescent individual. The most complete adult vertebrae (three atlases and three axes) are described, measured, and compared with other fossil hominins and modern humans. These six specimens are associated with one another and represent three individuals. In addition, one of these sets of cervical vertebrae is associated with Cranium 5 (Individual XXI) from the site. The metric analysis demonstrates that the Sima de los Huesos atlases and axes are metrically more similar to Neandertals than to our modern human comparative sample. The SH atlases share with Neandertals a sagittally elongated canal. The most remarkable feature of the SH (and Neandertal) axes is that they are craniocaudally low and mediolaterally wide compared to our modern male sample. Morphologically, the SH sample shares with Neandertals a higher frequency of caudally projected anterior atlas arch, which could reflect greater development of the longus colli muscle. In other features, such as the frequency of weakly developed tubercles for the attachment of the transverse ligament of the atlas, the Sima de los Huesos fossils show intermediate frequencies between our modern comparative samples and the Neandertals, which could represent the primitive condition. Our results are consistent with the previous phylogenetic interpretation of H. heidelbergensis as an exclusively European species, ancestral only to H. neanderthalensis. PMID:17467038

  7. Recovery Effects of a 180?mT Static Magnetic Field on Bone Mineral Density of Osteoporotic Lumbar Vertebrae in Ovariectomized Rats

    PubMed Central

    Xu, Shenzhi; Okano, Hideyuki; Tomita, Naohide; Ikada, Yoshito

    2011-01-01

    The effects of a moderate-intensity static magnetic field (SMF) on osteoporosis of the lumbar vertebrae were studied in ovariectomized rats. A small disc magnet (maximum magnetic flux density 180?mT) was implanted to the right side of spinous process of the third lumbar vertebra. Female rats in the growth stage (10 weeks old) were randomly divided into 4 groups: (i) ovariectomized and implanted with a disc magnet (SMF); (ii) ovariectomized and implanted with a nonmagnetized disc (sham); (iii) ovariectomized alone (OVX) and (vi) intact, nonoperated cage control (CTL). The blood serum 17-?-estradiol (E2) concentrations were measured by radioimmunoassay, and the bone mineral density (BMD) values of the femurs and the lumbar vertebrae were assessed by dual energy X-ray absorptiometry. The E2 concentrations were statistically significantly lower for all three operated groups than those of the CTL group at the 6th week. Although there was no statistical significant difference in the E2 concentrations between the SMF-exposed and sham-exposed groups, the BMD values of the lumbar vertebrae proximal to the SMF-exposed area statistically significantly increased in the SMF-exposed group than in the sham-exposed group. These results suggest that the SMF increased the BMD values of osteoporotic lumbar vertebrae in the ovariectomized rats. PMID:20953437

  8. Retrospective Cohort Study of the Prevalence of Lumbosacral Transitional Vertebra in a Wide and Well-Represented Population

    PubMed Central

    Uçar, Demet; Uçar, Bekir Yavuz; Co?ar, Yahya; Emrem, Kurtulu?; Gümü?suyu, Gürkan; Mutlu, Serhat; Mutlu, Burcu; Çaçan, Mehmet Akif; Mertsoy, Y?lmaz; Gümü?, Hatice

    2013-01-01

    Purpose. The aim of this study is to determine the prevalence of lumbosacral transitional vertebra (LSTV) in a well-represented general population. Methods. For a retrospective cohort study, abdominal radiographs of adult subjects were queried with clear visibility of the vertebral body articulation of the last rib, all lumbar transverse processes, and complete sacral wings. Exclusion criteria included any radiologic evidence of previous lumbosacral surgery that would block our view. A total of 6200 abdominal films were reviewed, and 3607 were identified as being suitable for the measurement of the desired parameters. Results. A total of 3607 subjects were identified as eligible for the study, and 683 (18.9%) were classified as positive for a lumbosacral transitional vertebra. The prevalence of sacralization and lumbarization was found as 17.2% and 1.7%, respectively. The average age at the time of the study was 39.5 ± 15.2 years (18–86 years). Conclusions. As a result of different opinions, LSTV retains its controversial status. Our prevalence study of the general population will provide assistance for resolution of the controversy. Prevalence studies of the general population with a wide participation will shed light on comparative studies. PMID:23864947

  9. Complexity of neutral zones, lumbar stability and subsystem adaptations: probable alterations in lumbosacral transitional vertebrae (LSTV) subtypes.

    PubMed

    Mahato, Niladri Kumar

    2013-01-01

    Physiological and anatomical ranges of movements at lumbar and lumbo-sacral motion segments are influenced by passive (bones and ligaments) and active (muscles) elements. The movements are visualized in terms of intrinsically unopposed (Neutral Zones) or opposed (Transitional Zones) movement zones. These two zones constitute the absolute ranges of motion for different regions of the spine. Though values of these ranges for flexion, extension, lateral bending and axial rotation at different spinal segments may demonstrate similarities across matched population, these parameters are most likely to show different values in lumbar spines affected with lumbo-sacral transitional vertebrae (LSTV). LSTV is a common variation of the lumbo-sacral junction and present well documented structural changes at the lower spine and L5/S1 vertebrae. This study attempts to (i) delineate and hypothesize relationships between changes in active and passive elements, (ii) understand the possibilities of restriction or augmentation in the values of these 'zones', and (iii) to predict overall LSTV induced physiological lumbar motion changes, in association with these variations. PMID:23159743

  10. Human papillomavirus testing in primary cervical screening

    Microsoft Academic Search

    J. Cuzick; A. Szarewski; G. Terry; A. Hanby; P. Maddox; M. Anderson; S. J. Steele; J. Guillebaud; C. Kocjean

    1995-01-01

    Several studies have examined the role of tests for human papillomavirus (HPV) in screening for cervical cancer but as yet the relevance is unclear. We looked at HPV testing for types 16, 18, 31, and 33 on material taken at the time of a cervical smear in 2009 eligible women having routine screening. Women with any degree of dyskaryosis or

  11. Restoration of non-carious cervical lesions

    Microsoft Academic Search

    I. Ichim; Q. Lib; J. Loughran; M. V. Swain; J. Kieser

    2007-01-01

    ObjectiveAs a typical non-carious cervical lesion, abfraction is a common clinical occurrence which requires restorative treatment in most patients. Nonetheless, the relatively poor clinical longevity of cervical dental used for restoring abfraction lesions has been a major concern of dentists and patients. The continuing loss of hard tissue and, in turn, the low retention of the restorative materials in situ

  12. 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)

  13. 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…

  14. 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

  15. New insights into cervical cancer screening

    PubMed Central

    Boone, Jonathan D.; Erickson, Britt K.

    2012-01-01

    Worldwide, cervical cancer is a leading cause of cancer related morbidity and mortality. For over 50 years, cervical cytology has been the gold standard for cervical cancer screening. Because of its profound effect on cervical cancer mortality in nations that have adopted screening programs, the Pap smear is widely accepted as the model screening test. Since its introduction, many studies have analyzed the Pap smear and found that it is not without its shortcomings including low sensitivity for detection of cervical intraepithelial neoplasia 2/3. Additionally, the discovery of infection with the human papillomavirus (HPV) as a necessary step in the development of cervical cancer has led to the development of HPV testing as an adjunct to cytology screening. More recently, researchers have compared HPV testing and cytology in the primary screening of cervical cancer. In this review, we will discuss cytologic testing limitations, the role of HPV DNA testing as an alternative screening tool, the impact of the HPV vaccine on screening, and future directions in cervical cancer screening. PMID:23094132

  16. Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer

    ClinicalTrials.gov

    2014-04-21

    Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

  17. Giant Anterior Cervical Osteophyte Leading to Dysphagia

    PubMed Central

    Hwang, Jin Seop; Chough, Chung Kee

    2013-01-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5. Radiography showed extensive ossification of anterior longitudinal ligament along the left anterolateral aspect of vertebral bodies from C2 to T1. The ossification was espe cially prominent at the level of C4-5 and linear breakage was noted at same level. Esophagogram revealed a filling defect along the pharynx and lateral displacement of the esophagus. Giant anterior cervical osteophyte was removed through the leftsided anterolateral cervical approach to the spine. Anterior cervical interbody fusion at C4-5 was followed by posterior cervical fixation using lateral mass screws from C3 to C6. After surgery, dysphagia and dysphonia improved immediately. One year later, cervical CT showed bone fusion at C4-5 bodies and no recurrence of osteophyte. DISH is a common cause of anterior cervical osteophyte leading to progressive dysphagia. Keeping this clinical entity in the differential diagnosis is important in patients with progressive neck stiffness, dysphagia or dysphonia. And surgical treatment of symptomatic anterior cervical osteophyte due to DISH should be considered with a solid fusion procedure preventing postoperative instability or osteophyte progress. PMID:24757489

  18. Giant anterior cervical osteophyte leading to Dysphagia.

    PubMed

    Hwang, Jin Seop; Chough, Chung Kee; Joo, Won Il

    2013-09-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5. Radiography showed extensive ossification of anterior longitudinal ligament along the left anterolateral aspect of vertebral bodies from C2 to T1. The ossification was espe cially prominent at the level of C4-5 and linear breakage was noted at same level. Esophagogram revealed a filling defect along the pharynx and lateral displacement of the esophagus. Giant anterior cervical osteophyte was removed through the leftsided anterolateral cervical approach to the spine. Anterior cervical interbody fusion at C4-5 was followed by posterior cervical fixation using lateral mass screws from C3 to C6. After surgery, dysphagia and dysphonia improved immediately. One year later, cervical CT showed bone fusion at C4-5 bodies and no recurrence of osteophyte. DISH is a common cause of anterior cervical osteophyte leading to progressive dysphagia. Keeping this clinical entity in the differential diagnosis is important in patients with progressive neck stiffness, dysphagia or dysphonia. And surgical treatment of symptomatic anterior cervical osteophyte due to DISH should be considered with a solid fusion procedure preventing postoperative instability or osteophyte progress. PMID:24757489

  19. A combined approach for the treatment of cervical vertigo

    Microsoft Academic Search

    Eduardo S. B Bracher; Clemente I. R Almeida; Roberta A Almeida; André C Duprat; Cheri B. B Bracher

    2000-01-01

    Background: Cervical vertigo is a diagnosis commonly made at both otorhinolaringologist and chiropractic offices. Hypothesized nonvascular mechanisms are reviewed. Therapeutic approaches have been suggested in the literature, ranging from cervical immobilization to vertebral manipulation.Objective: To characterize the patient population with cervical vertigo and observe therapeutic results of a treatment protocol by using distinct conservative modalities.Methods: Fifteen subjects with cervical vertigo

  20. Childhood Forced Sex and Cervical Dysplasia Among Women Prison Inmates

    Microsoft Academic Search

    Ann L. Coker; Nilam J. Patel; Shanthi Krishnaswami; Wendy Schmidt; Donna L. Richter

    1998-01-01

    This cross-sectional study is one of the first to investigate an association between childhood forced sex and cervical dysplasia. Cervical dysplasia can be identified through Pap smear screening and indicates precancerous cervical lesions, which if not treated, could become cervical cancer. Of 123 women confined under medium security in a women's correctional facility and surveyed for this study, 31.7% (n

  1. Is 58% sensitivity for detection of cervical intraepithelial neoplasia 3 and invasive cervical cancer optimal for cervical screening?

    PubMed Central

    Austin, R. Marshall; Zhao, Chengquan

    2014-01-01

    Recent Food and Drug Administration (FDA) approval of a Roche cobas human papillomavirus (HPV) test application as a first line primary cervical screening tool in women 25 and older introduces a new era of complex cervical screening choices. Perhaps the most surprising findings in Roche's supporting ATHENA trial data were the unexpectedly low verification bias-adjusted CIN3+ sensitivities documented by the FDA for both the proposed cobas HPV testing algorithm (58.26%) and Pap testing algorithm (42.63%). These unexpectedly low sensitivity estimates suggest intuitively that there is still considerable room for improvement in cervical screening, and available data from large systems point to routine cytology and HPV co-testing as offering the greatest protection against development of cervical cancer. Observational studies of large populations screened over time remain essential to document actual protection from development of cervical cancer with any new cervical screening options, as natural history studies and available data from large systems indicate that most CIN2/3 cases detected in short term clinical trials would not progress to invasive cervical cancer. Interpretation of ATHENA trial data and its application to routine clinical practice is further limited by published studies which document that a significant proportion of CIN2/3 biopsy diagnoses in the ATHENA trial could not be confirmed as accurate when evaluated with p16 immunohistochemistry and that cytology laboratory performance in the trial was notably suboptimal. PMID:24987445

  2. Imaging, clearance, and controversies in pediatric cervical spine trauma.

    PubMed

    Tat, Sonny T; Mejia, Michelle J; Freishtat, Robert J

    2014-12-01

    Diagnosing cervical spine injury in children can be difficult because the clinical examination can be unreliable, and evidence-based consensus guidelines for cervical spine injury evaluation in children have not been established. However, the consequences of cervical spine injuries are significant. Therefore, practitioners should understand common patterns of cervical spine injury in children, the evidence and indications for cervical spine imaging, and which imaging modalities to use. Herein, we review the epidemiology and unique anatomical features of pediatric cervical spine injury. In addition, we will summarize current practice for clearance and imaging of the pediatric cervical spine in trauma. PMID:25469605

  3. Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient.

    PubMed

    McDowell, Michael M; Hanft, Simon J; Greenberg, Sophie A; Rahmati, Rahmatullah; Carrao, Vincent; Eisig, Sidney; Anderson, Richard C E

    2014-06-01

    The authors report on the surgical management of an extensive lesion of the upper cervical spine that required an uncommon transmandibular approach to facilitate exposure, resection, and stabilization in a pediatric patient. A 6-year-old boy with a large aneurysmal bone cyst of the C-2 vertebra presented with progressive weakness and right-sided neck pain. The lesion extended laterally into the soft tissue of the neck, inferiorly to C-4, and posteriorly around the spinal cord. A transmandibular osteotomy was performed to provide adequate exposure for complete resection of the mass and anterior C1-3 instrumentation and fusion. Subsequently, the patient underwent occiput to C-4 posterior instrumentation and fusion. The patient tolerated the operation well and had regained all function at 3 and 11 months' follow-up. No neurological complications or problems of speech, swallowing, or respiration occurred. Even in pediatric patients, the transmandibular approach for the treatment of upper cervical spine lesions is an effective method of maximizing exposure for complex lesions requiring resection and stabilization. PMID:24702619

  4. Cervical screening adjuncts: recent advances.

    PubMed

    Spitzer, M

    1998-08-01

    In an effort to reduce the false-negative rate of cervical cytologic findings, several new technologies have recently evolved. Automated cytologic testing (PapNet, AutoPap 300 QC) proposes to rescreen negative conventional cytologic findings to identify smears likely to be false negative. Fluid-based monolayers (ThinPrep, CytoRich) propose to reduce the false-negative rates by optimizing the collection and preparation of cells. Human papillomavirus deoxyribonucleic acid testing by Hybrid Capture has been proposed for a variety of screening and triage roles. Visual screening after application of acetic acid is done by cervicography by use of a photographic technique, whereas in speculoscopy the screening is done by direct visualization of the cervix by the primary care provider. Polarprobe uses biophysical parameters and a computer algorithm to give an instantaneous prediction of the likelihood of cervical disease. Each of these techniques, as well as the clinical experience with them, is reviewed. Current and possible future uses are discussed with regard to both clinical usefulness and cost-effectiveness. PMID:9731867

  5. 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

  6. 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

  7. Attachment and barriers to cervical screening.

    PubMed

    Hill, Erin M; Gick, Mary L

    2013-05-01

    The present study explored the role of attachment insecurity in cervical screening behaviors and barriers in a sample of 257 female undergraduates. Information on attachment dimensions as well as attachment style was collected. Attachment anxiety and attachment avoidance were associated with decreased likelihood of having participated in cervical screening and positively associated with screening barriers. Screening barriers were elevated among individuals with insecure attachment styles (preoccupied, fearful, and dismissing), and dismissing participants were less likely to have engaged in screening compared to secure participants. Our findings demonstrate that attachment insecurity may be a risk factor for inadequate cervical screening and screening barriers. PMID:22933580

  8. Quantification of Pediatric Cervical Growth: Anatomical Changes in the Sub-Axial Spine

    PubMed Central

    Lee, Jung Jae; Hong, Jae Taek; Kim, Jong Tae

    2015-01-01

    Objective In order to provide normal values of the pediatric sub-axial cervical spinal canal and vertebral body growth pattern using computed tomographic scans, a total of 318 patients less than 10 years old were included. Methods The growth of the vertebral body and canal space was investigated using four different age groups. The Torg ratio (TR) was calculated and all patients were classified into a low TR group and a high TR group according to a cutoff value of 1.0. To account for spinal curvature, the C3-7 angle was measured. Results Very little axial expansion and growth in height were observed (2.9 mm and 3.4 mm, respectively), and the spinal canal increments (1.8 mm) were much smaller than the dimensions of the vertebral body. The mean TR values were 1.03±0.14 at the C3 vertebral level, 1.02±0.13 at C4, 1.05±0.13 at C5, 1.04±0.13 at C6, and 1.02±0.12 at C7 in all patients. The mean sub-axial angle (C3-7) was 7.9±10.6° (range: -17-47°). Conclusion The upper sub-axial spinal canal continuously increased in size compared to the lower sub-axial spine after 8 years of age. Considerable decrements in the TR was found after late childhood compared to younger ages. Generally, there were no significant differences between boys and girls in vertical length of the cervical vertebrae. However, the axial dimension of the vertebral body and the spinal canal space varied according to gender.

  9. Expression of PBK/TOPK in cervical cancer and cervical intraepithelial neoplasia

    PubMed Central

    Luo, Qiong; Lei, Bin; Liu, Shuguang; Chen, Yaowen; Sheng, Wenjie; Lin, Peixin; Li, Wenxia; Zhu, Haili; Shen, Hong

    2014-01-01

    objectives: To evaluate the expression of PBK/TOPK (PDZ-binding kinase/T-LAK cell-originated protein kinase) and its clinical significance in cervical cancer and cervical intraepithelial neoplasia. Methods: PBK/TOPK expression was detected in 28 cases of low-grade cervical intraepithelial neoplasia (CINI), 62 cases of high-grade intraepithelial neoplasia and 80 cases of cervical cancer by immunohistochemistry (IHC). Then, the correlation between PBK/TOPK expression and clinicopathological features was quantitatively analyzed by measuring the positive unit (PU). Results: PBK/TOPK expression was significantly greater in cervical cancer than that in high-grade intraepithelial neoplasia and CINI (P < 0.05). Meanwhile, PBK/TOPK expression in high-grade intraepithelial neoplasia was significantly higher compared with that in CINI (P < 0.05). In addition, PBK/TOPK expression in cervical cancer significantly correlated with histological type, differentiation, lymph node metastasis, vaginal and cervical invasion, TNM stage and tumor size (P < 0.05). Conclusion: PBK/TOPK expression is closely associated with cervical cancer and cervical intraepithelial neoplasia, which may be served as a useful target for tumor diagnosis and immunotherapy. PMID:25550851

  10. Management of cervical premalignant lesions.

    PubMed

    Lindeque, B G

    2005-08-01

    Management of cervical preneoplasia starts with an abnormal smear result. The use of the Bethesda system is recommended. The management of patients with low-grade abnormal smear results varies around the world. Patients with atypical squamous cells on cytology are recommended to be subclassified into atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells where high-grade squamous intra-epithelial lesions (HSIL) cannot be excluded (ASCH) groups. While patients with ASCUS can be followed with cytology or colposcopy, the risk of having cervical intra-epithelial neoplasia (CIN) is higher in patients with ASCH. Such patients, as well as those with low-grade squamous intra-epithelial lesions on cytology, should be referred for colposcopy to ensure that diagnosis and treatment in CIN is detected. Patients with HSIL should be referred promptly for colposcopic assessment. This should, usually at the same clinic visit, be followed by large loop excision of the transformation zone (LLETZ). Although this is effective treatment, around 15% of patients will have persistent/recurrent disease on cytological follow-up. Patients with positive human papillomavirus DNA tests at follow-up seem to have a considerably higher risk of recurrent preneoplasia than those who have negative tests. Patients over 50 years of age have much higher recurrence risks than younger patients. These factors impact on second-line treatment and follow-up schedules. An important benefit of conservative treatment for CIN with LLETZ is retention of fertility. LLETZ is associated with an increased risk of preterm prelabour rupture of membranes and preterm birth, but not with other adverse pregnancy outcome measures. Conservative excisional management of adenocarcinoma in situ by LLETZ or cold knife cone biopsy is not reported to be as effective as that of CIN, with high risk of residual and recurrent disease at follow-up. Conversely, LLETZ may be acceptable treatment for micro-invasive squamous carcinoma if the excision margins are free of disease and there is no evidence of lymphovascular involvement. The ability to detect and treat premalignant lesions on the cervix reversed the natural history of cervical cancer. Methods of conservative treatment that evolved over decades have been proven safe and effective, allowing retention of fertility. Good clinical guidelines have been developed for most clinical scenarios while some uncertainties persist for other scenarios. PMID:16150393

  11. Life history reconstruction of modern and fossil sockeye salmon ( Oncorhynchus nerka) by oxygen isotopic analysis of otoliths, vertebrae, and teeth: Implication for paleoenvironmental reconstructions

    NASA Astrophysics Data System (ADS)

    Zazzo, A.; Smith, G. R.; Patterson, W. P.; Dufour, E.

    2006-09-01

    We evaluate the use of oxygen isotope values of biogenic apatite for tracking freshwater to marine migration in modern and fossil Pacific sockeye salmon. Oxygen isotope analyses of otoliths, vertebrae, and teeth of three anadromous modern sockeye salmon from Alaska establish a basis for the interpretation of fossil vertebrae and tooth apatite from Pleistocene sockeye salmon of the Skokomish River Valley, Washington. High resolution ?18O profiles in salmon otoliths provide, at a monthly resolution, a detailed record of individual history including continental rearing, migration to sea, seasonal variation in sea surface temperatures during marine life, and spawning migration before capture. Pacific salmon teeth are constantly renewed with the last set of teeth forming under the influence of freshwater. Therefore, they do not allow inference concerning sea-run versus landlocked life history in fossil salmon. Salmon vertebrae are also ambiguous indicators of life history regarding fresh versus marine water because centra are minimally ossified in the freshwater stages of life and the outermost layer of vertebral bone might be resorbed to provide nutrients during the non-feeding phase of the spawning migration. Therefore, ?18O values of accretionary growth rings in sea-run salmon vertebrae are dominated by the marine signal only if they are not diagenetically altered in freshwater deposits. In Pleistocene sockeye reported here, neither the teeth nor vertebral apatite present clear marine ?18O values due to the combined effects of tooth replacement and diagenetic alteration of bone and dentine. ?18O(PO 4) values of fossil vertebrae are intermediate between ?18O(PO 4) values of enamel and basal tooth dentin. Assuming a similar rate of isotope exchange of vertebrae and dentine with freshwater during diagenesis, these results are interpreted to reflect formation of the teeth under the influence of freshwater, and formation of the vertebrae under the influence of oceanic water. Our approach demonstrates that when appropriate knowledge of tissue formation is available, isotopic differences between altered and unaltered tissue holds promise of distinguishing between marine and freshwater origin of the tissues.

  12. Differential cytology of cervical neoplasias

    NASA Astrophysics Data System (ADS)

    Koenig, Rainer; Bergander, S.

    1990-11-01

    In the context of the early recognition of cervical cancer the cytology has to detect tumor positive cases among a bulk of un suspicious specimens. Unfortunately there is a group of cases with a vague diaxosis, the so called PAP-ill-group. There are many reasons for the recent impossibility of a safe conclusion from the PAP-Ill-smears to their histological diagnoses (Pig. 1). Today for an exact statement a cone biopsy and a microscopical investigation of its histological sections for such caseS are necessary. That results in a high medical and economical expense and, last not least, that means a higher risk of complications and of future family planning problems for the women affected.

  13. MRI morphometric characterisation of the paediatric cervical spine and spinal cord in children with MPS IVA (Morquio-Brailsford syndrome).

    PubMed

    Solanki, Guirish A; Lo, William B; Hendriksz, Christian J

    2013-03-01

    Nearly all children with MPS IVA develop skeletal deformities affecting the spine. At the atlanto-axial spine, odontoid hypoplasia occurs. GAG deposition around the dens, leads to peri-odontoid infiltration. Transverse/alar ligament incompetence causes instability. Atlanto-axial instability is associated with cord compression and myelopathy, leading to major morbidity and mortality. Intervention is often required. Does the presence of widened bullet shaped vertebra in platyspondily encroach on the spinal canal and cause spinal stenosis in MPS IVA? So far, there have been no standardised morphometric measurements of the paediatric MPS IVA cervical spine to evaluate whether there is pre-existing spinal stenosis predisposing to compressive myelopathy or whether this is purely an acquired process secondary to instability and compression. This study provides the first radiological quantitative analysis of the cervical spine and spinal cord in a series of affected children. MRI morphometry indicates that the MPS IVA spine is narrower at C1-2 level giving an inverted funnel shape. There is no evidence of a reduction in the Torg ratio (canal-body ratio) in the cervical spine. The spinal canal does not exceed 11 mm at any level, significantly smaller than normal historical cohorts (14 mm). The sagittal diameter and axial surface area of both spinal canal and cord are reduced. C1-2 level cord compression was evident in the canal-cord ratio but the Torg ratio was not predictive of cord compression. In MPS IVA the reduction in the space available for the cord (SAC) is multifactorial rather than due to congenital spinal stenosis. PMID:23404316

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

    ClinicalTrials.gov

    2014-12-23

    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

  15. Cervical premalignant lesions and their management

    PubMed Central

    Köse, Faruk M.; Naki, Murat M.

    2014-01-01

    Cervical cancer is the tenth most common cancer in women in developed countries that have national screening programs, while it is in the second line in underdeveloped countries. According to Ministry of Health registry data, cervical cancer is the eighth most common cancer among female cancers in Turkey. Today, the most effective screening for cervical cancer is to obtain smears from the cervix. Therefore, periodic screening programs are of great importance in identifying preinvasive lesions to prevent their progression to invasive cancer. Today, with the use of human papilloma virus (HPV) vaccine, screening programs have brought new insights into the prevention of cervical cancer. Management of preinvasive lesions has to be known by each obstetrics and gynecology specialist. Redundant procedures and treatments can be avoided by directing patients correctly at this step. Cancer phobia should not be created. Ablative or destructive treatments should not be done without histological diagnosis; hysterectomy, which has an equal risk of recurrence, should not be recommended. PMID:24976778

  16. Cervical Exercise: The Backbone of Spine Treatment

    MedlinePLUS

    North American Spine Society Public Education Series Cervical Exercise: The Backbone of Spine Treatment How important is it? What can be ... exercises. The Importance of Exercise for the Neck Spine experts agree that physical activity is important for ...

  17. 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

  18. NIH Research Leads to Cervical Cancer Vaccine

    MedlinePLUS

    Skip Navigation Bar Home Current Issue Past Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents For an enhanced version of this page please turn ...

  19. 21 CFR 884.5250 - Cervical cap.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... A cervical cap is a flexible cuplike receptacle that fits over the cervix to collect menstrual flow or to aid artificial insemination. This generic type of device is not for contraceptive use. (b) Classification. Class II (performance...

  20. Quantitative spectroscopy for detection of cervical dysplasia

    E-print Network

    Mirkovi?, Jelena, Ph. D. Massachusetts Institute of Technology

    2009-01-01

    The current clinical standard for cervical cancer diagnosis is colposcopy, a procedure that involves visual inspection and biopsy of at-risk tissue, followed by histopathology. The major objective of colposcopy is detection ...

  1. Cervical spine injuries in American football.

    PubMed

    Rihn, Jeffrey A; Anderson, David T; Lamb, Kathleen; Deluca, Peter F; Bata, Ahmed; Marchetto, Paul A; Neves, Nuno; Vaccaro, Alexander R

    2009-01-01

    American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of catastrophic injury is felt to be the result of changes in the rules in the mid-1970s that prohibited the use of the head as the initial contact point when blocking and tackling. Evaluation of patients with suspected cervical spine injury includes a complete neurological examination while on the field or the sidelines. Immobilization on a hard board may also be necessary. The decision to obtain radiographs can be made on the basis of the history and physical examination. Treatment depends on severity of diagnosed injury and can range from an individualized cervical spine rehabilitation programme for a 'stinger' to cervical spine decompression and fusion for more serious bony or ligamentous injury. Still under constant debate is the decision to return to play for the athlete. PMID:19691361

  2. Biomechanical evaluation of Caspar cervical screws: comparative stability under cyclical loading.

    PubMed

    Gallagher, M R; Maiman, D J; Reinartz, J; Pintar, F; Yoganandan, N

    1993-12-01

    Anterior cervical instrumentation is used as an adjunct to bone fusion; however, definitive biomechanical data to support some applications and techniques are lacking. In the absence of supportive experimental data, posterior cortical penetration has been recommended with the Caspar system. Previously, we compared the axial pull-out strength of Caspar screws with and without posterior cortical penetration. This study compares the stability of unicortical versus bicortical screw penetration groups under cyclical loading simulating physiological flexion-extension. Caspar screws were placed in human cadaveric vertebrae with or without posterior cortical purchase. Each screw was separately tested, simulating flexion-extension to 200 cycles. Deformation time data allowed a direct comparison of screw "wobble" with and without posterior cortical purchase. The mean deformation differences between subcortical and bicortical groups were statistically significant and increased over time within both groups. Enhanced stability was noted with bicortical purchase throughout most of the examined range, becoming more pronounced over longer periods of cyclical loading. Significant (P < 0.05) increases in deformation over time were noted for both groups, suggesting potentially significant deterioration at the screw-bone interface, despite bicortical purchase. Such deterioration with repeated flexion-extension loading may be of concern in the use of Caspar plates in the presence of multicolumn instability. PMID:8133990

  3. 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

  4. Vertigo in patients with cervical spine dysfunction

    Microsoft Academic Search

    R. Galm; M. Rittmeister; E. Schmitt

    1998-01-01

    To our knowledge, quantitative studies on the significance of disorders of the upper cervical spine as a cause of vertigo\\u000a or impaired hearing do not exist. We examined the cervical spines of 67 patients who presented with symptoms of dizziness.\\u000a Prior to the orthopaedic examination, causes of vertigo relating to the field of ENT and neurology had been ruled out.

  5. Dynamic analysis of pediatric cervical spine

    Microsoft Academic Search

    S. Kumaresan; N. Yoganandan; F. A. Pintar; K. Reichert

    1999-01-01

    The purpose of the study is to quantify the dynamic response of age-specific one, three and six year old human cervical spine structures, and to compare the responses with the skeletally mature adult cervical spine. A three-dimensional nonlinear finite element modeling approach was used. Age-specific pediatric models were developed by incorporating their component-related developmental anatomy features. Eigen value and transient

  6. Circulating Tumor Markers in Cervical Cancer

    Microsoft Academic Search

    P. Benedetti Panici; G. Scambia; G. Baiocchi; C. Sonsini; S. Greggi; F. Battaglia; S. Mancuso

    1989-01-01

    Serum levels of CA 19-9, CA 125 and CA 15-3 were measured in 91 patients with cervical cancer (16 with intraepithelial neoplasia and 75 with invasive cancer). In 35 patients with locally advanced cervical cancer, serum marker levels were measured at monthly intervals during neo-adjuvant chemotherapy. CA 19-9 was found to be abnormally high only in advanced stages with an

  7. Cervical endometriosis: a diagnostic and management dilemma

    Microsoft Academic Search

    Saurabh V Phadnis; Jagruti S Doshi; Oluyemisi Ogunnaike; Andrew Coady; Malcolm Padwick; F. A. Sanusi

    2005-01-01

    Cervical endometriosis is usually a retrospective finding on histology. We describe the diverse symptomatology of the disease,\\u000a wherein a suspicion of diagnosis may be raised. A series of five patients with cervical endometriosis confirmed on histology\\u000a was identified. One patient was asymptomatic but examination revealed a mass arising from the cervix. Two patients presented\\u000a with persistent postcoital bleeding, one patient

  8. 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.

  9. Capillary hemangioma of the cervical intervertebral disc

    Microsoft Academic Search

    Ahmet Cetinkal; Ahmet Colak; Kivanc Topuz; Cem Atabey; Ufuk Berber

    2011-01-01

    An anterior cervical decompression and fusion operation was complicated by extensive bleeding from the disc space. Histopathological\\u000a evaluation of the resected specimen revealed the diagnosis as the very first reported case of capillary hemangioma in intervertebral\\u000a disc space. Retrospective review of the preoperative MRI demonstrated supporting findings of a capillary hemangioma within\\u000a the cervical intervertebral disc.

  10. 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.

  11. Multifactorial Etiology of Cervical Cancer: A Hypothesis

    PubMed Central

    Haverkos, Harry W.

    2005-01-01

    Cancer of the cervix is the second most common life-threatening cancer among women worldwide, with incidence rates ranging from 4.8 per 100,000 women per year in the Middle East to 44.3 per 100,000 in East Africa. Epidemiologic and clinical data demonstrate that human papillomaviruses (HPV), especially HPV-16 and HPV-18, play at least a major if not a necessary role in the etiology of cervical cancer. However, many investigators acknowledge that HPV is not sufficient to induce cervical cancer and that a multifactorial etiology is likely. HPV can be found in a growing proportion of patients with cervical cancer, approaching 100%, but is not yet found in every patient with disease. Other factors, such as herpes simplex virus type 2 infections, cigarette smoking, vaginal douching, nutrition, and use of oral contraceptives, have been proposed as contributing factors. In the first half of the 20th century, Peyton Rous and colleagues demonstrated the joint action of tars and Shope papillomavirus to consistently induce squamous cell carcinomas in rabbits. Using the Rous model as a prototype, one might hypothesize that some cases of cervical cancer arise from an interaction between oncogenic viruses and cervical tar exposures. Cervical tar exposures include cigarette smoking, use of tar-based vaginal douches, and long years of inhaling smoke from wood- and coal-burning stoves in poorly ventilated kitchens. PMID:16614679

  12. Abnormal pap smear and cervical cancer in pregnancy.

    PubMed

    Yang, Kathleen Y

    2012-09-01

    Pregnancy represents a unique opportunity to screen reproductive age women for cervical cancer and abnormal cervical cytology is relatively common in this population. In the absence of large, prospective clinical trials investigating the optimal management strategies for cervical dysplasia in pregnant women, consensus guidelines established by the American Society for Colposcopy and Cervical Pathology is available with considerations to this special patient population. Modalities for evaluation and management algorithms are reviewed and summarized from largely case series of pregnant women with cervical dysplasia and cervical cancer. PMID:22828115

  13. Screening for cervical cancer and human papilloma virus: Indian context.

    PubMed

    Deodhar, Kedar K

    2012-06-01

    Cervical cancer remains the most common fatal cancer in Indian women. The primary underlying cause of cervical cancer is persistent infection with human papilloma virus (HPV); HPV 16 and 18 account for nearly 70% of all cervical cancers worldwide. Cytology-based cervical screening programs have been very effective, but require establishing an infrastructure and quality control mechanisms, which can be a challenge. Cervical screening by visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) are acceptable alternatives for low-resource settings. Primary screening for cervical cancer with HPV testing is attractive but cost could be the limiting factor. A less expensive HPV test holds promise. PMID:22726999

  14. Manual Physical Therapy, Cervical Traction, and Strengthening Exercises in Patients With Cervical Radiculopathy: A Case Series

    Microsoft Academic Search

    Joshua A. Cleland; Julie M. Whitman; Julie M. Fritz; Jessica A. Palmer

    2005-01-01

    Study Design: A case series of consecutive patients with cervical radiculopathy. Background: A multitude of physical therapy interventions have been proposed to be effective in the management of cervical radiculopathy. However, outcome studies using consistent treatment approaches on a well-defined sample of patients are lacking. The purpose of this case series is to describe the outcomes of a consecutive series

  15. Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors

    Microsoft Academic Search

    Ying Chun Zeng; Shirley SY Ching; Alice Y Loke

    2010-01-01

    BACKGROUND: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly

  16. Cervical and mediastinal hematoma: presentation of an asymptomatic cervical parathyroid adenoma: case report and literature review

    Microsoft Academic Search

    Michele Tonerini; Eugenio Orsitto; Luisa Fratini; Alessandra Tozzini; Andrea Chelli; Stefano Santi; Mauro Rossi

    2004-01-01

    The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to emphasize that a failure to consider this diagnosis may result in delayed operative intervention with potentially fatal complications.

  17. Epidemiology of cervical cancer in Colombia

    PubMed Central

    Muñoz, Nubia

    2012-01-01

    Worldwide, cervical cancer is the third most common cancer in women, and the first or second most common in developing countries. Cervical cancer remains in Colombia the first cause of cancer mortality and the second cause of cancer incidence among women, despite the existence of screening programs during the last 3 decades. Bucaramanga, Manizales and Cali reported rates around 20 per 100,000and Pasto 27 per 100,000. The Cali cancer registry has reported a progressive decrease in the age standardized incidence and mortality rates of cervical cancer over the past 40 years. Reasons for the decline in incidence and mortality of cervical cancer are multiple and probably include: improvement in socio-economic conditions, decrease in parity rates and some effect of screening programs. Human papilloma Virus is the main cause of cervical cancer, HPV natural history studies have now revealed that HPVs are the commonest of the sexually transmitted infections in most populations. Most HPV exposures result in spontaneous clearance without clinical manifestations and only a small fraction of the infected persons, known as chronic or persistent carriers, will retain the virus and progress to precancerous and cancer. HPV 16 and 18 account for 70% of cervical cancer and the 8 most common types. (HPV 16, 18, 45, 33, 31, 52, 58 and 35) account for about 90% of cervical cancer. Case-control studies also allowed the identification of the following cofactors that acting together with HPV increase the risk of progression from HPV persistent infection to cervical cancer: tobacco, high parity, long term use of oral contraceptives and past infections with herpes simplex type 2 and Chlamydia trachomatis. The demonstration that infection with certain types of human papillomavirus (HPV) is not only the main cause but also a necessary cause of cervical cancer has led to great advances in the prevention of this disease on two fronts: (i) Primary prevention by the use of prophylactic HPV vaccines; and (ii) secondary prevention by increasing the accuracy of cervical cancer screening. PMID:24893303

  18. Comparison of Expansive Pedicle Screw and Polymethylmethacrylate-Augmented Pedicle Screw in Osteoporotic Sheep Lumbar Vertebrae: Biomechanical and Interfacial Evaluations

    PubMed Central

    Zhang, Bo; Xie, Qing-yun; Wang, Cai-ru; Liu, Jin-biao; Liao, Dong-fa; Jiang, Kai; Lei, Wei; Pan, Xian-ming

    2013-01-01

    Background It was reported that expansive pedicle screw (EPS) and polymethylmethacrylate-augmented pedicle screw (PMMA-PS) could be used to increase screw stability in osteoporosis. However, there are no studies comparing the two kinds of screws in vivo. Thus, we aimed to compare biomechanical and interfacial performances of EPS and PMMA-PS in osteoporotic sheep spine. Methodology/Principal Findings After successful induction of osteoporotic sheep, lumbar vertebrae in each sheep were randomly divided into three groups. The conventional pedicle screw (CPS) was inserted directly into vertebrae in CPS group; PMMA was injected prior to insertion of CPS in PMMA-PS group; and the EPS was inserted in EPS group. Sheep were killed and biomechanical tests, micro-CT analysis and histological observation were performed at both 6 and 12 weeks post-operation. At 6-week and 12-week, screw stabilities in EPS and PMMA-PS groups were significantly higher than that in CPS group, but there were no significant differences between EPS and PMMA-PS groups at two study periods. The screw stability in EPS group at 12-week was significantly higher than that at 6-week. The bone trabeculae around the expanding anterior part of EPS were more and denser than that in CPS group at 6-week and 12-week. PMMA was found without any degradation and absorption forming non-biological “screw-PMMA-bone” interface in PMMA-PS group, however, more and more bone trabeculae surrounded anterior part of EPS improving local bone quality and formed biological “screw-bone” interface. Conclusions/Significance EPS can markedly enhance screw stability with a similar effect to the traditional method of screw augmentation with PMMA in initial surgery in osteoporosis. EPS can form better biological interface between screw and bone than PMMA-PS. In addition, EPS have no risk of thermal injury, leakage and compression caused by PMMA. We propose EPS has a great application potential in augmentation of screw stability in osteoporosis in clinic. PMID:24086381

  19. Can micro-imaging based analysis methods quantify structural integrity of rat vertebrae with and without metastatic involvement?

    PubMed

    Hojjat, Seyed-Parsa; Beek, Maarten; Akens, Margarete K; Whyne, Cari M

    2012-09-21

    This study compares the ability of ?CT image-based registration, 2D structural rigidity analyses and multimodal continuum-level finite element (FE) modeling in evaluating the mechanical stability of healthy, osteolytic, and mixed osteolytic/osteoblastic metastatically involved rat vertebrae. ?MR and ?CT images (loaded and unloaded) were acquired of lumbar spinal motion segments from 15rnu/rnu rats (five per group). Strains were calculated based on image registration of the loaded and unloaded ?CT images and via analysis of FE models created from the ?CT and ?MR data. Predicted yield load was also calculated through 2D structural rigidity analysis of the axial unloaded ?CT slices. Measures from the three techniques were compared to experimental yield loads. The ability of these methods to predict experimental yield loads were evaluated and image registration and FE calculated strains were directly compared. Quantitatively for all samples, only limited weak correlations were found between the image-based measures and experimental yield load. In comparison to the experimental yield load, we observed a trend toward a weak negative correlation with median strain calculated using the image-based strain measurement algorithm (r=-0.405, p=0.067), weak significant correlations (p<0.05) with FE based median and 10th percentile strain values (r=-0.454, -0.637, respectively), and a trend toward a weak significant correlation with FE based mean strain (r=-0.366, p=0.09). Individual group analyses, however, yielded more and stronger correlations with experimental results. Considering the image-based strain measurement algorithm we observed moderate significant correlations with experimental yield load (p<0.05) in the osteolytic group for mean and median strain values (r=-0.840, -0.832, respectively), and in the healthy group for median strain values (r=-0.809). Considering the rigidity-based predicted yield load, we observed a strong significant correlation with the experimental yield load in the mixed osteolytic/osteoblastic group (r=0.946) and trend toward a moderate correlation with the experimental yield load in the osteolytic group (r=0.788). Qualitatively, strain patterns in the vertebral bodies generated using image registration and FEA were well matched, yet quantitatively a significant correlation was found only between mean strains in the healthy group (r=0.934). Large structural differences in metastatic vertebrae and the complexity of motion segment loading may have led to varied modes of failure. Improvements in load characterization, material properties assignments and resolution are necessary to yield a more generalized ability for image-based registration, structural rigidity and FE methods to accurately represent stability in healthy and pathologic scenarios. PMID:22858318

  20. 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

  1. 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

  2. Differential expression of keratins 10, 17, and 19 in normal cervical epithelium, cervical intraepithelial neoplasia, and cervical carcinoma.

    PubMed Central

    Maddox, P; Sasieni, P; Szarewski, A; Anderson, M; Hanby, A

    1999-01-01

    AIM: To examine the value of immunohistochemistry in defining a keratin profile to aid cervical histopathological diagnosis. METHODS: Immunohistochemical localisation of keratins 17, 10, and 19 was studied in 268 cervical biopsies from 216 women including normal epithelia (with and without human papilloma virus), low and high grade cervical intraepithelial neoplasia, and invasive carcinoma. The percentage of positive immunostaining was scored using a Kontron MOP videoplan image analyser. RESULTS: All major categories of cervical epithelia expressed these keratins to varying degrees. The median percentage of immunostaining for keratin 10 was 40% in normal tissue compared with just 1% in invasive carcinoma (p < 0.0001). The medians for keratin 17 were 0% in the normal group and 80% in carcinomas (p < 0.0001). By contrast, there was no significant difference in staining for keratin 19. Using a combination of the keratin 10 and 17 percentages, it was possible to separate the carcinomas from the benign conditions with a sensitivity of 100% and a specificity of 93%. Further analyses within the groups revealed more extensive staining for keratins 10 and 19 in reserve cell hyperplasia, immature squamous metaplasia, and congenital transformation zone. CONCLUSIONS: The morphological variety within the cervix is reflected, in part, by distinct keratin patterns. There are striking differences in the patterns of keratins 10 and 17 between infiltrating squamous carcinoma and normal cervical epithelia. PMID:10343611

  3. 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 \\

  4. Analysis of Senate Bill 1245: Cervical Cancer Screening Test

    E-print Network

    California Health Benefits Review Program (CHBRP)

    2006-01-01

    In California, the age-adjusted death rate for Hispanics inCalifornia, the age-adjusted incidence rate of cervical cancer among HispanicsCalifornia Cervical Cancer Screening, Incidence, and Mortality Race All races White Black Hispanic

  5. Perinatal outcomes following conservative management of cervical dysplasia

    Cancer.gov

    Preterm delivery outcomes following Preterm delivery outcomes following LEEP treatment of cervical LEEP treatment of cervical intraepithelial intraepithelial neoplasia neoplasia (CIN) (CIN) Audrey F. Audrey F. Saftlas Saftlas, PhD, MPH , PhD, MPH Department

  6. 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 ...

  7. University of Arizona researchers report on cervical cancer study

    Cancer.gov

    Dr. Monk is nationally recognized for his expertise in cervical cancer and chairs the Gynecologic Oncology Cervical Cancer Committee for the National Cancer Institute funded Gynecologic Oncology Group for the study published in NEJM.

  8. 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian

    MedlinePLUS

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian Past Issues / Spring 2007 ... of this page please turn Javascript on. Gynecologic Cancers Cervical, Endometrial, and Ovarian NCI estimates that endometrial, ...

  9. 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

  10. 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.

  11. Effects of Acupuncture Knife on Inflammatory Factors and Pain in Third Lumbar Vertebrae Transverse Process Syndrome Model Rats

    PubMed Central

    Yu, Jia Ni; Guo, Chang Qing; Hu, Bo; Liu, Nai Gang; Sun, Hong Mei; Xu, Hong; Wu, Hai Xia; Guo, Yan; Liang, Chu Xi; Chen, Zhan Xia; Li, Xiao Hong

    2014-01-01

    The aim of this paper was to explore the long-term effects and pain relief mechanism of acupuncture knife on third lumbar vertebrae (L3) transverse process syndrome. Forty SD rats were randomized into control, model, electroacupuncture (EA), and acupuncture knife (AK) group. Except control rats, other rats were subjected to an operation to emulate L3 transverse process syndrome. Fourteen days after the operation, EA and AK rats were given electroacupuncture and acupuncture knife treatments, respectively. Fifty-six days after the operation, enzyme-linked immunosorbent assay was used to measure substance P (SP), 5-hydroxytryptamine (5-HT), interleukin-1? (IL-1?), interleukin-10 (IL-10), tumor necrosis factor-? (TNF-?), and transforming growth factor-? (TGF-?) in peripheral blood. The tail flick test was used to observe pain threshold. We found that rats with the simulation operation had significantly higher levels of SP, 5-HT, IL-1, IL-10, TNF-?, and TGF-?, while the AK rats had lower levels. In addition, the pain threshold of AK rats was similar to that of control rats. AK pretreatment could alleviate pain through modulating inflammatory response. PMID:25544854

  12. Pathobiology of cervical spondylotic myelopathy.

    PubMed

    Karadimas, Spyridon K; Gatzounis, Georgios; Fehlings, Michael G

    2015-04-01

    In this narrative review, we aim to outline what is currently known about the pathophysiology of cervical spondylotic myelopathy (CSM), the most common cause of spinal cord dysfunction. In particular, we note the unique factors that distinguish it from acute spinal cord injury. Despite its common occurrence, the reasons why some patients develop severe symptomatology while others have few or no symptoms despite radiographic evidence confirming similar degrees of compression is poorly understood. Neither is there a clear understanding of why certain patients have a stable clinical myelopathy and others present with only mild myelopathy. Moreover, the precise molecular mechanisms which contribute to the pathogenesis of the disease are incompletely understood. The current treatment method is decompression of the spinal cord but a lack of clinically relevant models of CSM have hindered the understanding of the full pathophysiology which would aid the development of new therapeutic avenues of investigation. Further elucidation of the role of ischemia, currently a source of debate, as well as the complex cascade of biomolecular events as a result of the unique pathophysiology in this disease will pave the way for further neuroprotective strategies to be developed to attenuate the physiological consequences of surgical decompression and augment its benefits. PMID:24626958

  13. Subacute Cervical Myelopathy in a Child with Cerebral Palsy

    Microsoft Academic Search

    L. Angelini; G. Broggi; N. Nardocci; M. Savoiardo

    1982-01-01

    A 12-year-old girl with a spastic dystonic tetraparesis due to cerebral palsy showed a subacute cervical myelopathy. X-ray films of the cervical spine demonstrated a subluxation of C4 on C5. Myelography and computerized tomography of the cervical spine performed under general anesthesia demonstrated only a minimal rotation of C3 with respect to C4 and a rather narrow cervical canal. In

  14. 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

  15. Landscape of genomic alterations in cervical carcinomas.

    PubMed

    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

    2014-02-20

    Cervical cancer is responsible for 10-15% of cancer-related deaths in women worldwide. The aetiological role of infection with high-risk human papilloma viruses (HPVs) in cervical carcinomas is well established. Previous studies have also implicated somatic mutations in PIK3CA, PTEN, TP53, STK11 and KRAS as well as several copy-number alterations in the pathogenesis of cervical carcinomas. 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 tumour-normal pairs. Previously unknown 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 observe somatic ELF3 (13%) and CBFB (8%) mutations in 24 adenocarcinomas. Squamous cell carcinomas have higher frequencies of somatic nucleotide substitutions occurring at cytosines preceded by thymines (Tp*C sites) than adenocarcinomas. Gene expression levels at HPV integration sites were statistically significantly higher in tumours with HPV integration compared with expression of the same genes in tumours without viral integration at the same site. These data demonstrate several recurrent genomic alterations in cervical carcinomas that suggest new strategies to combat this disease. PMID:24390348

  16. Aberrant cell cycle regulation in cervical carcinoma.

    PubMed

    Kim, Young Tae; Zhao, Min

    2005-10-31

    Carcinoma of the uterine cervix is one of the most common malignancies among women worldwide. Human papillomaviruses (HPV) have been identified as the major etiological factor in cervical carcinogenesis. However, the time lag between HPV infection and the diagnosis of cancer indicates that multiple steps, as well as multiple factors, may be necessary for the development of cervical cancer. The development and progression of cervical carcinoma have been shown to be dependent on various genetic and epigenetic events, especially alterations in the cell cycle checkpoint machinery. In mammalian cells, control of the cell cycle is regulated by the activity of cyclin-dependent kinases (CDKs) and their essential activating coenzymes, the cyclins. Generally, CDKs, cyclins, and CDK inhibitors function within several pathways, including the p16(INK4A)-cyclin D1-CDK4/6-pRb-E2F, p21(WAF1)- p27(KIP1)-cyclinE-CDK2, and p14(ARF)-MDM2-p53 pathways. The results from several studies showed aberrant regulation of several cell cycle proteins, such as cyclin D, cyclin E, p16(INK4A), p21(WAF1), and p27(KIP1), as characteristic features of HPV- infected and HPV E6/E7 oncogene-expressing cervical carcinomas and their precursors. These data suggested further that interactions of viral proteins with host cellular proteins, particularly cell cycle proteins, are involved in the activation or repression of cell cycle progression in cervical carcinogenesis. PMID:16259056

  17. 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

  18. [Chromosomal instability in carcinogenesis of cervical cancer.

    PubMed

    de Los Santos-Munive, Victoria; Alonso-Avelino, Juan Angel

    2013-01-01

    In order to spot common chromosomal imbalances in early and late lesions of cervical cancer that might be used as progression biomarkers, we made a search of literature in PubMed from 1996 to 2011. The medical subject headings employed were chromosomal alterations, loss of heterozygosis, cervical cancer, cervical tumorigenesis, chromosomal aberrations, cervical intraepithelial neoplasm and low-grade squamous intraepithelial lesion. The common chromosomal imbalances were gains in 8q24 (77.7 %), 20q13 (66.9 %), 3q26 (47.1 %), Xp22 (43.8 %), and 5p15 (60 %), principally. On the other hand, integration of the high-risk human papillomavirus genome into the host chromosome has been associated with the development of neoplasia, but the chromosomal imbalances seem to precede and promote such integration. Chromosomal imbalances in 8q24, 20q13, 3q21-26 and 5p15-Xp22, determined by fluorescent in situ hybridization assay or comparative genomic hybridization assay for early detection of the presence of high-risk human papillomavirus, are promising markers of cervical cancer progression. PMID:24290016

  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

    2015-03-18

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA 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 Squamous Cell Carcinoma

  20. Ovarian squamous cell carcinoma which metastasized 8 years after cervical conization for early microinvasive cervical cancer: a case report.

    PubMed

    Hidaka, Takao; Nakashima, Akitoshi; Hasegawa, Toru; Nomoto, Kazuhiro; Ishizawa, Shin; Tsuneyama, Koichi; Takano, Yasuo; Saito, Shigeru

    2011-06-01

    Squamous cell cervical carcinoma that metastasized to the ovary is common in patients with bulky tumors or locally advanced disease; however, ovarian squamous cell carcinoma that metastasized after cervical conization surgery for early microinvasive uterine cervical carcinoma is very rare. We present a case of ovarian squamous cell carcinoma that metastasized 8 years after cervical conization surgery for early microinvasive cervical carcinoma. She had no sign of recurrence in the uterine cervix. We detected human papillomavirus type 16 DNA in both cervical tissue and ovarian tissue, suggesting that ovarian squamous cell carcinoma is derived from microinvasive cervical cancer. Although there are very few cases of early microinvasive squamous cell carcinoma that metastasized to the ovary with delayed recurrence, we should pay attention strictly not only to the cervical condition but also to the ovarian condition on regular post-operative follow-up. PMID:21467082

  1. Use of Lowest Single Lumbar Spine Vertebra Bone Mineral Density T-Score and Other T-Score Approaches for Diagnosing Osteoporosis and Relationships with Vertebral Fracture Status

    Microsoft Academic Search

    Peiqi Chen; Paul D. Miller; Neil C. Binkley; David L. Kendler; Mayme Wong; Kelly Krohn

    2008-01-01

    For diagnosing osteoporosis, International Society for Clinical Densitometry guidelines suggest using the lowest bone mineral density T-score of the lumbar spine (LS), femoral neck (FN), or total hip (TH). For the LS, use of the total spine (L1–L4) T-score is suggested. Although controversial, some authors have suggested using a single lumbar vertebra of L1–L4 with the lowest T-score to diagnose

  2. Use of single-photon emission computed tomography/low-resolution computed tomography fusion imaging in detecting an unusually presenting osteoid osteoma of the lumbar vertebra.

    PubMed

    Hephzibah, Julie; Theodore, Bernice; Oommen, Regi; David, Kenny; Moses, Vinu; Shah, Sanjeev; Panicker, Jayalakshmi

    2009-03-01

    In this article, we describe an unusual presentation of osteoid osteoma of the lumbar vertebra in a woman in her early 30s. Single-photon emission computed tomography/low-resolution computed tomography (SPECT/CT) fusion imaging was used to detect the osteoma, precisely localize the pathology site, and guide surgical excision of the lesion. In recent years, SPECT/CT fusion imaging has helped make interpretations of scintigraphic images significantly more accurate. PMID:19377642

  3. Clinical presentation of cervical ribs in the pediatric population.

    PubMed

    Chan, Kenny H; Gitomer, Sarah A; Perkins, Jonathan N; Liang, Conan; Strain, John D

    2013-03-01

    Cervical ribs may cause thoracic outlet syndrome in adults, but symptoms are poorly described in children. In our series, 88.8% of the 322 children were asymptomatic. The most common symptoms were neck mass and pain. Useful diagnostic tools were cervical spine and chest radiographs. Differential diagnosis of a supraclavicular mass includes cervical ribs. PMID:23219244

  4. Vaccines Against Human Papillomavirus and Cervical Cancer: Promises and Challenges

    Microsoft Academic Search

    Ali Mahdavi; Bradley J. Monk

    Cervical cancer and precancerous lesions of the genital tract are major threats to the health of women world- wide. The introduction of screening tests to detect cer- vical cancer precursor lesions has reduced cervical cancer rates in the developed world, but not in devel- oping countries. Human papillomavirus (HPV) is the primary etiologic agent of cervical cancer and dyspla- sia.

  5. Radiculopathy and Myelopathy in Patients with Primary Cervical Dystonia

    Microsoft Academic Search

    Johann M. Hagenah; Alexandra Vieregge; Peter Vieregge

    2001-01-01

    In a prospective series of 34 incident patients with primary cervical dystonia (CD), 6 showed clinical or radiological signs of cervical radiculopathy (RP) or myelopathy (MP) during the course of their movement disorder. Age at onset in these patients was in the range reported for pure spondylotic cervical RP without an accompanying movement disorder. Radiologically, spondylosis was mild in 1

  6. Investigation of Motorcyclist Cervical Spine Trauma Using HUMOS Model

    Microsoft Academic Search

    J. Sun; A. Rojas; P. Bertrand; Y. Petit; R. Kraenzler; P. J. Arnoux

    2012-01-01

    With 16% of the total road user fatalities, motorcyclists represent the second largest group in France after car occupants. Regarding transport accidents, they count for a large proportion of the lower cervical spine trauma. According to different clinical studies, it is postulated that the cervical spine fragility areas are located on the upper and the lower cervical spine.Regarding motorcyclists crashes,

  7. Biomechanics of the cervical spine 4: major injuries

    Microsoft Academic Search

    Joseph F Cusick; Narayan Yoganandan

    2002-01-01

    This review presents considerations regarding major cervical spine injury, including some concepts that are presently undergoing evaluation and clarification. Correlation of certain biomechanical parameters and clinical factors associated with the causation and occurrence of traumatic cervical spine injuries assists in clarifying the pathogenesis and treatment of this diverse group of injuries. Instability of the cervical column based on clinical and

  8. Cervical adenocarcinoma identification by testing for chromosomal abnormalities.

    PubMed

    Dittus, Janet L; Dudley, Bunyan S; Upender, Madhvi; Endress, Gregory A

    2013-12-01

    We report on a case of cervical adenocarcinoma in situ in a 42-year-old woman with a history of human papillomavirus infection. Repeat cytology, human papillomavirus testing, and colposcopy failed to identify the lesion. Testing of the cervical cell DNA identified chromosomal abnormalities, prompting a cervical cone biopsy, which identified adenocarcinoma in situ. PMID:24283864

  9. Comparisons of three anterior cervical surgeries in treating cervical spondylotic myelopathy

    PubMed Central

    2014-01-01

    Background Anterior cervical discectomy and fusion (ACDF) was one of the preferred treatments for degenerative cervical spondylosis. However, the motion of adjacent segment was significantly increased after operation. So cervical disc arthroplasty have been suggested to keep the motion of adjacent segment. A new implant named dynamic cervical implant (DCI) has been developed to keep the motion of adjacent segment. Methods We retrospectively reviewed 91 patients treated for single level cervical spondylotic myelopathy with anterior cervical discectomy and fusion (ACDF), dynamic cervical implant (DCI) and cervical total disc replacement (CTDR) between sep 2009 and Mar 2011 in our hospital. They were divided into three groups by surgical methods: ACDF group (group A, 34 cases), DCI group (group B, 25 cases), CTDR group (group C, 32 cases). Operation time, intraoperative blood loss, preoperative and postoperative JOA score and JOA recovery rate were compared among the three groups. Pre-and postoperative hyperextension and hyperflexion radiograms were observed to measure range of motion (ROM) of C2–7, operative and adjacent levels. Results There was no statistical difference in operative time, intraoperative blood loss, and JOA recovery rate (P?>?0.05) among three groups. But the differences of their postoperative JOA scores and preoperative JOA scores were of statistical significance (P??0.05). There was no statistically significant difference between preoperative ROM and postoperative ROM of upper and lower levels in group B (P?>?0.05), but had statistically significance of C2–7 and operative levels (P?cervical spondylotic myelopathy. But each group has respective advantages and disadvantages. PMID:25012927

  10. [Electrosurgery of cervical changes and its place in cervical cancer prophylaxis].

    PubMed

    Rokita, Wojciech; Stanis?awska, Marta; Spaczy?ski, Marek; Nowak-Markwitz, Ewa; Kedzia, Witold

    2009-11-01

    For many years electrosurgical procedures have been used to treat cervical changes. The equipment and the technique of performing these procedures have evolved considerably during the recent years. The Fisher cone and electrocoagulation of the cervix have been replaced with the LLETZ/LEEP procedure. Low cost, the simplicity of performance, high safety and high therapeutic effectiveness in treating precancerous cervical changes make the LLETZ/LEEP procedure a very good method of accomplishing the cervical cancer preventive program. The indications, contra-indications, the technique of performance along with postoperative complications after the LLETZ/LEEP procedure and the physical basics of electrosurgical procedures were thoroughly presented in the article. PMID:20088401

  11. Screening hospital patients for uterine cervical cancer.

    PubMed Central

    Hudson, E; Hewertson, S; Jansz, C; Gordon, H

    1983-01-01

    Women patients admitted to a district general hospital with non-gynaecological conditions were offered a cervical smear test. In three years 2296 women were tested. Serious uterine pathology was detected in 13 patients (5.7 per 1000) and significant cytological abnormalities (dyskaryosis of all grades) in 46 (20.0 per 1000). Of the women screened 963 (41.9%) had never had a smear test before and 1608 (70.0%) were over 39 yr. The results show that cervical screening of non-gynaecological patients in hospital reaches many of the women at risk for cervical cancer who do not otherwise have smears taken and reveals considerable uterine pathology. PMID:6853729

  12. Cigarette smoking and invasive cervical cancer

    SciTech Connect

    Brinton, L.A.; Schairer, C.; Haenszel, W.; Stolley, P.; Lehman, H.F.; Levine, R.; Savitz, D.A.

    1986-06-20

    A case-control study of 480 patients with invasive cervical cancer and 797 population controls, conducted in five geographic areas in the United States, included an evaluation of the relationship of several cigarette smoking variables to cervical cancer risk. Although smoking was correlated with both age at first intercourse and number of sexual partners, a significant smoking-related risk persisted for squamous cell carcinoma after adjustment for these factors (relative risk, 1.5). Twofold excess risks were seen for those smoking 40 or more cigarettes per day and those smoking for 40 or more years. Increased risks, however, were observed only among recent and continuous smokers. In contrast to squamous cell cancer, no relationship was observed between smoking and risk of adenocarcinoma or adenosquamous carcinoma. These results suggest a causal relationship between cigarette smoking and invasive squamous cell cervical cancer, perhaps through a late-stage or promotional event, although the mechanisms of action require further elucidation.

  13. 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

  14. [Implementation status of cervical screening in Europe].

    PubMed

    Döbr?ssy, Lajos; Cornides, Agnes; Kovács, Attila; Budai, András

    2014-12-14

    Following the recommendation of the Council of the European Union, almost all governments made a policy statement on the introduction of cytology-based cervical screening for the health care system. However, the status of implementation is uneven. In the majority of the developed countries an organised model of screening recommended by the relevant international professional organisations are in use, while occasional screening is applied in some other countries. Screening strategies (i.e. age range, screening intervals), coverage of the target population, and compliance rates vary significantly. The screening activities are in a planning phase is some less developed Central-Eastern and South European countries. In Hungary, the transition from the traditional "gynaecological cancer screening" into the recommended organised cervical screening is in progress; the active involvement of the district health visitors in the cervical screening would provide further improvement. PMID:25481500

  15. Odebode-Agaja adult cervical traction device.

    PubMed

    Odebode, T O; Agaja, S B

    2011-01-01

    This technical note describes a new simple, cheap and affordable adult cervical traction device that is especially suitable for use in resource-poor third world countries because of its cost-effectiveness. While the widely used imported Gardner-Wells tongs cost over N250,000 (Nigerian) naira (approximately $1630 USD), the new equally effective, durable and locally readily available Odebode-Agaja traction device sells for N35,000 naira (approximately $220 USD). The device does not require scalp incision or skull drilling. It is designed for bedside application in patients with cervical spine injuries, including subluxation and fracture-dislocation of the cervical spine from the atlanto-occipital joint to T1. PMID:21149570

  16. Cervical spine trauma in the pediatric patient.

    PubMed

    Klimo, Paul; Ware, Marcus L; Gupta, Nalin; Brockmeyer, Douglas

    2007-10-01

    Injuries to the pediatric cervical spine occur infrequently. Numerous unique anatomic and biomechanical features of the pediatric spine render it much more flexible than the adult spine. These features give rise to significant differences in the presentation, diagnosis, treatment, and prognosis of pediatric cervical trauma compared with adults. Younger children more often suffer injury to the upper cervical spine with greater neurologic injury and fewer fractures. Once the child reaches the age of 10 years, he or she develops a more adult-type spine, and injuries are thus more similar to those seen in the adult population. The unique anatomic and biomechanical differences in the pediatric spine are discussed, along with the various common and unique injuries. PMID:17991586

  17. The next steps in cervical screening.

    PubMed

    Sankaranarayanan, Rengaswamy; Qiao, You-Lin; Keita, Namory

    2015-03-01

    Cervical cancer is fourth most common cancer among women with four-fifths of the global burden in low- and middle-income countries (LMICs). Persistent infection with one of the high-risk types of human papillomaviruses (HPV), particularly HPV 16/18, is the central cause of cervical neoplasia. Progress in developing feasible, alternative screening methods in LMICs and HPV vaccines have further improved cervical cancer prevention prospects. While existing screening programs in high-income countries should be re-organized, in view of the downstream effects of national HPV vaccination programs, LMICs should introduce national programs to vaccinate single year cohorts of girls aged 9-13 years with two or three doses and screen 30-35-year-old women with HPV testing to pragmatically decrease their high disease burden. PMID:25776294

  18. Correlation of Cervical Smear and Pathohistological Findings

    PubMed Central

    Asotic, Amir; Taric, Suada; Asotic, Jasmina

    2014-01-01

    ABSTRACT Introduction: In endeavor to suppress the cervical carcinoma there are several possible approaches including measures of primary and secondary prevention. So far effects of these measures on the number of cases and mortality rate of cervical carcinoma were modest. Only exception is organized testing based on cytological exam of the cervical smear – Pap test, which has proven to be highly effective in reducing the number of cases and mortality of cervical carcinoma in countries with this program. Goal: of this research is analysis of correlation between abnormal cytological test results and pathohistological diagnosis of all patients in the analyzed period. ] Material and methods: Research is descriptive, analytical, comparative, and partly epidemiological. Results of cytological and pathohistological diagnostic in the period between January 1, 2009 and December 31, 2011 were used for analysis. All analyzed patients had colposcopy exam and Pap test, and patients with abnormal results of this test underwent cervical biopsy for pathohistological diagnostics. Results: We came to following results and conclusions: total number of L-SIL and H-SIL (PAPA III) results was 395 (6.20%) in comparison to total sample of 5894 (92.44%) patients. There is a statistically significant difference in relation to PHD result of cervical biopsy after L-SIL and H-SIL (PAPA II and IV), and highest statistical margin is in relation of CIN II changes to cytological findings, issued at Clinic of Obstetrics and Gynecology and other health institutions. We come to conclusion that the highest percentage of patients with L-SIL and H-SIL findings is in age group between 0-29 years old. Statistical analysis has shown a positive trend in number of younger patients with L-SIL and H-SIL (PAPA III and IV), with average age of patients in 2011 being 31.12±9.12 years old. PMID:24937933

  19. 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.

  20. Four lateral mass screw fixation techniques in lower cervical spine following laminectomy: a finite element analysis study of stress distribution

    PubMed Central

    2014-01-01

    Background Lateral mass screw fixation (LSF) techniques have been widely used for reconstructing and stabilizing the cervical spine; however, complications may result depending on the choice of surgeon. There are only a few reports related to LSF applications, even though fracture fixation has become a severe complication. This study establishes the three-dimensional finite element model of the lower cervical spine, and compares the stress distribution of the four LSF techniques (Magerl, Roy-Camille, Anderson, and An), following laminectomy -- to explore the risks of rupture after fixation. Method CT scans were performed on a healthy adult female volunteer, and Digital imaging and communication in medicine (Dicom) data was obtained. Mimics 10.01, Geomagic Studio 12.0, Solidworks 2012, HyperMesh 10.1 and Abaqus 6.12 software programs were used to establish the intact model of the lower cervical spines (C3-C7), a postoperative model after laminectomy, and a reconstructive model after applying the LSF techniques. A compressive preload of 74 N combined with a pure moment of 1.8 Nm was applied to the intact and reconstructive model, simulating normal flexion, extension, lateral bending, and axial rotation. The stress distribution of the four LSF techniques was compared by analyzing the maximum von Mises stress. Result The three-dimensional finite element model of the intact C3-C7 vertebrae was successfully established. This model consists of 503,911 elements and 93,390 nodes. During flexion, extension, lateral bending, and axial rotation modes, the intact model’s angular intersegmental range of motion was in good agreement with the results reported from the literature. The postoperative model after the three-segment laminectomy and the reconstructive model after applying the four LSF techniques were established based on the validated intact model. The stress distribution for the Magerl and Roy-Camille groups were more dispersive, and the maximum von Mises stress levels were lower than the other two groups in various conditions. Conclusion The LSF techniques of Magerl and Roy-Camille are safer methods for stabilizing the lower cervical spine. Therefore, these methods potentially have a lower risk of fixation fracture. PMID:25106498

  1. [Primary sterility and cervical pregnancy. A case report].

    PubMed

    Cano López, L M L; Vital Reyes, V S; Alvarado-Cabrero, I; Ferreira Ríos, A; Hinojosa-Cruz, J C

    2002-09-01

    Fortunately cervical pregnancy, an ectopic gestation that frequently represents obstetric urgency, is a rare entity. We present here the case of a woman who developed cervical pregnancy despite no risk factor associated with ectopic pregnancy was identified. The patient came to the office because of primary sterility of 4 years of evolution. Among her background she reported previous cervical surgery due to benign pathology. She reached pregnancy after medical and surgical treatment. In the week eleven of gestation, the patient presented to the hospital with clinical symptoms of abortion. An ultrasound revealed abdominal pregnancy. Laparotomy was "white", cervix was found enlarged with the external orifice closed, suggesting cervical pregnancy. Conservative treatment consisted in cervical evacuation, endometrial curettage and vaginal tampon. She evolved satisfactorily. We do not know about any previous report of cervical-pregnancy associated with cervical surgery and sterility. We also recognize the need to increase the number of similar cases to generalize results. Thus, it is important to highlight in this case the absence of known risk factors for cervical pregnancy and the background of cervical surgery and sterility. Therefore, we recommend to search for antecedents of cervical surgery and sterility when cervical pregnancy is suspected. PMID:12448054

  2. Occult ligamentous injury of the cervical spine associated with cervical spine fracture.

    PubMed

    Seijas, Roberto; Ares, Oscar; Casamitjana, José

    2005-12-01

    We report the case of a 20-year-old patient with a C5 cervical spine fracture and an undetected ligamentous lesion between C1 and C2. Cervical spine lesion protocols and the rates of lesions that are not diagnosed with standard evaluation protocols are reviewed, with particular emphasis on comatose patients. Dynamic studies during the surgical procedure for fixation of the fracture are recommended to increase the detection of ligamentous lesions. PMID:16459871

  3. Traumatic cervical spinal cord injury with “negative” cervical spine CT scan

    PubMed Central

    Kolli, Sreedhar; Schreiber, Adam; Harrop, James; Jallo, Jack

    2010-01-01

    A 46-year-old man fell four steps, striking his neck and having associated neck pain and discomfort. He was evaluated at a local emergency department and reported no neurological deficit but focal mid cervical tenderness. Radiographs and computed tomography (CT) scan were “negative” for cervical spine fracture, dislocation or pre-vertebral soft tissue swelling. He was discharged home in a cervical collar with a scheduled outpatient follow-up. Over the proceeding hours neurologic deterioration occurred, including hand and lower limb weakness with the inability to urinate. The patient returned to the local emergency room and was transferred to a tertiary care hospital where examination revealed C5ASIAB deficits. Repeat high resolution CT scan of the cervical spine with reformatted images was unremarkable for osseous fractures except some loss of definition in the posterior cervical musculature. Emergency magnetic resonance imaging MRI revealed a subluxation of C5/6 right facet (not evident on CT) with disruption of the posterior longitudinal ligament, ligamentum flavum, and disc space with abnormal T2 weighted spinal cord hyperintense signal at C5/6. He underwent emergency C5–C6 anterior and posterior decompression and fusion. One week later an examination showed improved C5ASIAD. This case reveals the difficulty of assessing the cervical spine for instability and potential limitations of current management schemes. PMID:22389654

  4. Decreased cervical cancer cell adhesion on nanotubular titanium for the treatment of cervical cancer

    PubMed Central

    Crear, Jara; Kummer, Kim M; Webster, Thomas J

    2013-01-01

    Cervical cancer can be treated by surgical resection, chemotherapy, and/or radiation. Titanium biomaterials have been suggested as a tool to help in the local delivery of chemotherapeutic agents and/or radiation to cervical cancer sites. However, current titanium medical devices used for treating cervical cancer do not by themselves possess any anticancer properties; such devices act as carriers for pharmaceutical agents or radiation sources and may even allow for the growth of cancer cells. Based on studies, which have demonstrated decreased lung, breast, and bone cancer cell functions on nanostructured compared to nanosmooth polymers, the objective of the present in vitro study was to modify titanium to possess nanotubular surface features and determine cervical cancer cell adhesion after 4 hours. Here, titanium was anodized to possess nanotubular surface features. Results demonstrated the ability to decrease cervical cancer cell adhesion by about a half on nanotubular compared to currently used nanosmooth titanium (without the use of chemotherapeutics or radiation), opening up numerous possibilities for the use of nanotubular titanium in local drug delivery or radiation treatment of cervical cancer. PMID:23493522

  5. New molecular targets against cervical cancer

    PubMed Central

    Duenas-Gonzalez, Alfonso; Serrano-Olvera, Alberto; Cetina, Lucely; Coronel, Jaime

    2014-01-01

    Cervical cancer is the third most commonly diagnosed cancer worldwide and the fourth leading cause of cancer death in women. Major advances but still insufficient achievements in the treatment of locally advanced and high-risk early stage patients have occurred in the last decade with the incorporation of concurrent cisplatin with radiation and, lately, gemcitabine added to cisplatin chemoradiation. Despite a number of clinical studies incorporating molecular-targeted therapy as radiosensitizers being in progress, so far, only antiangiogenic therapy with bevacizumab added to cisplatin chemoradiation has demonstrated safety and shown encouraging results in a Phase II study. In advanced disease, cisplatin doublets do not have a great impact on the natural history of the disease with median survival rates not exceeding 13 months. The first Phase III study of bevacizumab, added to cisplatin or a non-cisplatin-containing doublet, showed significant increase in both overall survival and progression-free survival. Further studies are needed before bevacizumab plus chemotherapy can be considered the standard of care for advanced disease. Characterization of the mutational landscape of cervical cancer has already been initiated, indicating that, for now, few of these targetable alterations match with available agents. Progress in both the mutational landscape knowledge and developments of novel targeted therapies may result in more effective and individualized treatments for cervical cancer. The potential efficacy of knocking down the key alterations in cervical cancer – E6 and E7 human papillomavirus oncoproteins – must not be overlooked. PMID:25525394

  6. Upper cervical instability: are clinical tests reliable?

    Microsoft Academic Search

    E Cattrysse; R. A. H. M Swinkels; R. A. B Oostendorp; W Duquet

    1997-01-01

    SUMMARY. The aim of this preliminary study was to investigate the reliability of a selection of manual tests used for the examination of instability of the upper cervical region.Eleven children with Down's syndrome were examined by four independent examiners with different levels of experience in manual therapy. Three tests as described by Van der El (1992) were used: the lateral

  7. Carotid artery disease following external cervical irradiation

    SciTech Connect

    Elerding, S.C.; Fernandez, R.N.; Grotta, J.C.; Lindberg, R.D.; Causay, L.C.; McMurtrey, M.J.

    1981-01-01

    A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head an neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. This represents a trend toward an increased risk for this population observed over the same period of time (p . 0.39). A prospective study of 118 similar patients currently living five years after cervical radiotherapy was performed to determine the incidence of carotid artery disease occurring as a consequence of neck irradiation. Abnormal carotid phonangiograms (CPA) were found in 25% of the patients and abnormal oculoplethysmographs (OPG) were found in 17%. These studies represent significant carotid lesions that are not expected in such a population. It is concluded that the carotid stenoses demonstrated are most likely a consequence of prior irradiation. Patients that are five-year survivors of cervical irradiation should have noninvasive vascular laboratory studies performed as part of their routine follow-up examinations in order to detect these carotid lesions while they are occult.

  8. Information provision in cervical screening in Australia.

    PubMed

    Williams, Jane H; Carter, Stacy M; Rychetnik, Lucie

    2014-09-01

    The National Cervical Screening Program and associated state and territory organisations are responsible for promoting cervical screening. Communication via multiple media channels encourages women to be screened. However, some communications are not clear about the risk of cervical cancer and the protective capacity and reliability of the Pap test. The potential harms of screening are rarely presented. Women usually receive Pap tests from general practitioners, who often screen opportunistically during appointments. Screening targets and incentive payments encourage high screening rates. Consent is an important ethical principle in the delivery of all health care. Provision of material information is one of the elements of valid consent. The combination of arguably ambiguous communications, screening participation targets and opportunistic testing under time pressure seems likely to undermine opportunities for women to be informed. Of particular concern are women who are less likely to benefit, those who are more likely to experience harm, and some groups of disadvantaged women. Improved communications could include providing patients with information on the absolute risk of cervical cancer, and the morbidity and mortality benefits and harms of screening. Screening programs internationally have begun providing such information. Areas for further research include the appropriate roles of the programs, screeners and individuals in providing and seeking information. Such work would identify the optimum method for informing women in the screening process. PMID:25163384

  9. X-Ray Exam: Cervical Spine

    MedlinePLUS

    KidsHealth > Parents > Doctors & Hospitals > Medical Tests & Exams > X-Ray Exam: Cervical Spine Print A A A Text Size What's in this article? What It Is Why It's Done Preparation Procedure What to Expect Getting the Results Risks Helping Your Child If ...

  10. Neck Pain (Cervical Strain) COMMON CAUSES

    E-print Network

    Virginia Tech

    Neck Pain (Cervical Strain) COMMON CAUSES: Neck pain may be triggered by a specific event discomfort. Long term neck problems are more likely when pain develops gradually or discomfort is recurrent over a period of time. Chronic neck pain is often triggered by prior injuries, especially if original

  11. The electrodiagnosis of cervical and lumbosacral radiculopathy.

    PubMed

    Tsao, Bryan

    2007-05-01

    This article reviews the usefulness of the electrodiagnostic examination in patients who have suspected cervical and lumbosacral radiculopathy. This study can verify the presence and severity of radiculopathy, determine which levels are involved, and provide an electrodiagnostic correlate to imaging abnormalities. A practical approach for conducting the nerve conduction portion and needle electrode examination in these patients is discussed. PMID:17445739

  12. Visual inspection methods for cervical cancer prevention.

    PubMed

    Sankaranarayanan, Rengaswamy; Nessa, Ashrafun; Esmy, Pulikattil Okkuru; Dangou, Jean-Marie

    2012-04-01

    The need for simple, cost-effective screening approaches for cervical cancer prevention in low-resource countries has led to the evaluation of visual screening with 3-5% acetic acid. The low reproducibility and wide variation in accuracy reflect the subjective nature of the test. Pooled sensitivity, specificity, positive and negative predictive values were 80%, 92%, 10% and 99%, respectively, for detecting cervical intraepithelial neoplasia grade 2 or worse lesions. Realistic sensitivity of a quality- assured single visual inspection with acetic acid is around 50%. A single round of visual inspection with acetic acid screening has been associated with a 25-35% reduction in cervical cancer incidence and the frequency of cervical intraepithelial neoplasia grade 2 or worse lesions in randomised-controlled trials. Despite all its limitations, implementing visual inspection with acetic acid screening in low-resource countries may provide a pragmatic approach to building up human resources and infrastructure that may facilitate the highly anticipated low-cost, rapid human papilloma virus testing in the near future. PMID:22075441

  13. Related Resources for Cervical Cancer Screening

    Cancer.gov

    NCI has comprehensive research-based information on cancer prevention, screening, diagnosis, treatment, genetics and supportive care. Our information specialists can answer questions related to cancer, including cervical cancer screening and treatment. You can contact us by phone, online chat, or e-mail.

  14. Cervical cancer: Can it be prevented?

    PubMed

    Aggarwal, Pakhee

    2014-10-10

    Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus (HPV) vaccination. So far, only prophylactic HPV vaccines which prevent HPV infection by one or more subtypes are commercially available. Therapeutic HPV vaccines which aid in clearing established infection are still under trial. Secondary prevention entails early detection of precancerous lesions and its success is determined by the population coverage and the efficacy of the screening technique. A number of techniques are in use, including cytology, visual inspection (using the naked eye, magnivisualizer, acetic acid and Lugol's iodine), HPV testing and a combination of these methods. Updated screening guidelines have been advocated by the American Cancer Society in light of the role of HPV on cervical carcinogenesis. Recent research has also focussed on novel biomarkers that can predict progression to cancer in screen positive women and help to differentiate those who need treatment from those who can be left for follow-up. Last but not the least, effective treatment of precancerous lesions can help to reduce the incidence of invasive cervical cancer and this constitutes tertiary prevention. A combination of these approaches can help to prevent the burden of cervical cancer and its antecedent morbidity and mortality, but all of these are not feasible in all settings due to resource and allocation constraints. Thus, all countries, especially low and middle income ones, have to determine their own cocktail of approaches that work before we can say with certainty that yes, cervical cancer can be prevented. PMID:25302177

  15. Cervical cancer: Can it be prevented?

    PubMed Central

    Aggarwal, Pakhee

    2014-01-01

    Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus (HPV) vaccination. So far, only prophylactic HPV vaccines which prevent HPV infection by one or more subtypes are commercially available. Therapeutic HPV vaccines which aid in clearing established infection are still under trial. Secondary prevention entails early detection of precancerous lesions and its success is determined by the population coverage and the efficacy of the screening technique. A number of techniques are in use, including cytology, visual inspection (using the naked eye, magnivisualizer, acetic acid and Lugol’s iodine), HPV testing and a combination of these methods. Updated screening guidelines have been advocated by the American Cancer Society in light of the role of HPV on cervical carcinogenesis. Recent research has also focussed on novel biomarkers that can predict progression to cancer in screen positive women and help to differentiate those who need treatment from those who can be left for follow-up. Last but not the least, effective treatment of precancerous lesions can help to reduce the incidence of invasive cervical cancer and this constitutes tertiary prevention. A combination of these approaches can help to prevent the burden of cervical cancer and its antecedent morbidity and mortality, but all of these are not feasible in all settings due to resource and allocation constraints. Thus, all countries, especially low and middle income ones, have to determine their own cocktail of approaches that work before we can say with certainty that yes, cervical cancer can be prevented. PMID:25302177

  16. The Efficacy of the Rapid Form Cervical Vacuum Immobilizer in Cervical Spine Immobilization of the Equipped Football Player

    PubMed Central

    Ransone, Jack; Kersey, Robert; Walsh, Katie

    2000-01-01

    Objective: To determine the effectiveness of the Rapid Form Cervical Vacuum Immobilizer in controlling the cervical spine movements of a football player wearing shoulder pads and a helmet. Design and Setting: We used a 1-group, repeated-measures experimental design to radiographically assess cervical spine range of motion with and without the Rapid Form Cervical Vacuum Immobilizer. Two experimental conditions (with and without vacuum splint) were applied to 10 subjects in a repeated-measures design. Each subject was radiographed in cervical forward flexion, extension, and lateral flexion under each experimental condition. Subjects: Ten healthy male subjects without a history of cervical spine pathology or abnormality volunteered for this study. Measurements: Cervical forward flexion, extension, and lateral flexion range of motion were compared under both treatment conditions. Joint angles were determined by straightedge tangential lines drawn on the radiographs along the foramen magnum, inferior ring border of the atlas, and along the inferior tips of the 2nd through 7th vertebral bodies. The total range of motion was determined and compared with the treatment condition by multiple paired t tests. Results: The Cervical Vacuum Immobilizer limited cervical spine range of motion in forward flexion, extension, and lateral flexion. The secondary statistical analysis for the effect size determined that each group had a large effect size, indicating that the power of the experimental or vacuum splint group was high. Conclusions: We found that the Cervical Vacuum Immobilizer limited cervical spine range of motion in forward flexion, extension, and lateral flexion. The Cervical Vacuum Immobilizer can be easily placed on an injured, fully equipped football player and serves to limit cervical spine range of motion while the athlete is immobilized and transported. Future research should determine how the Cervical Vacuum Immobilizer limits range of motion with the athlete immobilized to the spine board. ImagesFigure 1.Figure 2. PMID:16558611

  17. High expression of octamer transcription factor 1 in cervical cancer

    PubMed Central

    XIAO, SONGSHU; LIAO, SHAN; ZHOU, YANHONG; JIANG, BIN; LI, YUERAN; XUE, MIN

    2014-01-01

    Cervical carcinoma is the second most prevalent malignancy in females worldwide. The crucial etiologic factors involved in the development of cervical carcinoma include infection with papillomavirus, and the structural or functional mutation of oncogenes and tumor suppressor genes. The abnormal change of octamer transcription factor 1 (OCT1) is associated with tumor progression and a poor patient survival rate. However, little is known regarding the effect of OCT1 in cervical cancer. In the present study, flow cytometry, western blot analysis and quantitative polymerase chain reaction (qPCR) were peformed to identify differentially expressed OCT1 in cervical cancer tissue and adjacent non-cancerous tissues. The normalized OCT1 gene expression in cervical cancer was 5.98 times higher compared with the adjacent non-cancerous tissues. Western blot analysis and flow cytometry assessed the levels of OCT1 protein. The results of these two differential techniques showed that the protein expression level of OCT1 was greater in cervical cancer tissues, which corresponded with the qPCR results. Finally, as OCT1 is a potential target gene for microRNA (miR)-1467, -1185, -4493 and -3919, their expression levels were analyzed in cervical cancer tissues and adjacent non-cancerous tissues; they were downregulated by ~45% in the cervical cancer samples. The results of the present study showed that OCT1 is highly expressed in cervical cancer tissues and indicated that OCT-1 may be significant in cervical cancer. PMID:24932254

  18. Analysis of cervical injuries in persons with head injuries.

    PubMed

    Hitosugi, Masahito; Maegawa, Mayumi; Motozawa, Yasuki; Kido, Masahito; Kawato, Hitoshi; Nagai, Toshiaki; Tokudome, Shogo

    2008-03-01

    To determine which clinical factors are useful for predicting concomitant injuries of the cervical spine and cervical spinal cord in persons with head injuries, we examined the nature and mechanisms of cervical injuries. For 109 forensic autopsies of persons with head injuries, the cause of injury, mechanism of cervical injury, survival time, and anatomic injury severity (1990 revision of the abbreviated injury scale [AIS] and injury severity score) were determined. Traffic accidents were the most common cause of injuries (41.3%), followed by slips and falls (24.8%), assaults (17.4%), and falls from height (9.2%). The mean maximum AIS scores and the AIS scores of the head or neck were similar in the 4 groups. Cervical spine injuries and epidural or subdural hemorrhages of the cervical spinal cord were more common in persons dying in traffic accidents and falls from height than in persons dying in slips and falls or assaults. Cervical injuries were significantly more common in persons sustaining frontal impacts than lateral or rear impacts. The most common cervical hyperextension injuries were atlanto-occipital and atlantoaxial dislocation and injuries of the 5th intervertebral disc. Our results suggest that persons with injuries of the head due to high-energy frontal impacts should be carefully examined for concomitant cervical injuries. These findings should be helpful for decreasing preventable deaths from undiagnosed cervical injuries in head-injured persons. PMID:19749612

  19. The contralateral lamina: a reliable guide in subaxial, cervical pedicle screw placement.

    PubMed

    Hacker, A G; Molloy, S; Bernard, J

    2008-11-01

    We have assessed the clinical observation that the angle of the contralateral lamina matches the angle required from the sagital plane for the placement of pedicle screws in the subaxial cervical spine. Fifty-four randomly chosen axial CT scans taken between December 2003 and December 2004 were examined. Subjects were excluded if the scan showed signs of fracture, tumour or gross abnormality. The digitised images were analysed on the Philips PACS system using SECTRA software. One hundred and sixty-eight individual vertebrae were assessed between C3 and C7. The following were measured; the angle of the pedicle relative to the sagital plane, the smallest internal and external diameter of the pedicles and the angle of the lamina. Angular measures had a CV% of 3.9%. The re-measurement error for distance was 0.5 mm. Three hundred and thirty-six pedicles were assessed in 25 females and 29 males. Average age was 48.2 years (range 17-85). Our morphologic data from live subjects was comparable to previous cadaveric data. Mean pedicle external diameter was 4.9 mm at C3 and 6.6 mm at C7. Females were marginally smaller than males. Left and right did not significantly differ. In no case was the pedicle narrower than 3.2 mm. Mean pedicle angle was 130 degrees at C3 and 140 degrees at C7. The contralateral laminar angle correlated well at C3, 4, 5 (R (2) = 0.9, C3 P = 0.002, C4 P = 0.06, C5 P = 0.0004) and was within 1 degrees of pedicle angle. At C6, 7 it was within 11 degrees . In all cases a line parallel to the lamina provided a safe corridor of 3 mm for a pedicle implant. The contralateral lamina provides a reliable intraoperative guide to the angle from the sagital plane for subaxial cervical pedicle instrumentation in adults. PMID:18795348

  20. Bone adaptation to cyclic loading in murine caudal vertebrae is maintained with age and directly correlated to the local micromechanical environment.

    PubMed

    Lambers, Floor M; Kuhn, Gisela; Weigt, Claudia; Koch, Kathleen M; Schulte, Friederike A; Müller, Ralph

    2015-04-13

    The ability of the skeleton to adapt to mechanical stimuli (mechanosensitivity) has most often been investigated at the whole-bone level, but less is known about the local mechanoregulation of bone remodeling at the bone surface, especially in context of the aging skeleton. The aim of this study was to determine the local and global mechanosensitivity of the sixth caudal vertebra during cyclic loading (8N, three times per week, for six weeks) in mice aged 15, 52, and 82 weeks at the start of loading. Bone adaptation was monitored with in vivo micro-computed tomography. Strain energy density (SED), assumed as the mechanical stimulus for bone adaptation, was determined with micro-finite element models. Mechanical loading had a beneficial effect on the bone microstructure and bone stiffness in all age groups. Mineralizing surface was on average 13% greater (p<0.05) in loaded than control groups in 15- and 82-week-old mice, but not for 52-week-old mice. SED at the start of loading correlated to the change in bone volume fraction in the following 6 weeks for loaded groups (r(2)=0.69-0.85) but not control groups. At the local level, SED was 14-20% greater (p<0.01) at sites of bone formation, and 15-20% lower (p<0.01) at sites of bone resorption compared to quiescent bone surfaces for all age groups, indicating SED was a stimulus for bone adaptation. Taken together, these results support that mechanosensitivity is maintained with age in caudal vertebrae of mice at a local and global level. Since age-related bone loss was not observed in caudal vertebrae, results from the current study might not be translatable to aged humans. PMID:25543278

  1. Investigations of (Delta)14C, (delta)13C, and (delta)15N in vertebrae of white shark (Carcharodon carcharias) from the eastern North Pacific Ocean

    SciTech Connect

    Kerr, L A; Andrews, A H; Cailliet, G M; Brown, T A; Coale, K H

    2006-06-08

    The white shark (Carcharodon carcharias) has a complex life history that is characterized by large scale movements and a highly variable diet. Estimates of age and growth for the white shark from the eastern North Pacific Ocean indicate they have a slow growth rate and a relatively high longevity. Age, growth, and longevity estimates useful for stock assessment and fishery models, however, require some form of validation. By counting vertebral growth band pairs, ages can be estimated, but because not all sharks deposit annual growth bands and many are not easily discernable, it is necessary to validate growth band periodicity with an independent method. Radiocarbon ({sup 14}C) age validation uses the discrete {sup 14}C signal produced from thermonuclear testing in the 1950s and 1960s that is retained in skeletal structures as a time-specific marker. Growth band pairs in vertebrae, estimated as annual and spanning the 1930s to 1990s, were analyzed for {Delta}{sup 14}C and stable carbon and nitrogen isotopes ({delta}{sup 13}C and {delta}{sup 15}N). The aim of this study was to evaluate the utility of {sup 14}C age validation for a wide-ranging species with a complex life history and to use stable isotope measurements in vertebrae as a means of resolving complexity introduced into the {sup 14}C chronology by ontogenetic shifts in diet and habitat. Stable isotopes provided useful trophic position information; however, validation of age estimates was confounded by what may have been some combination of the dietary source of carbon to the vertebrae, large-scale movement patterns, and steep {sup 14}C gradients with depth in the eastern North Pacific Ocean.

  2. Geometry of coplanar stereoscopic radiographic pairs for analysis of the lateral cervical radiograph: a study using mathematical models

    PubMed Central

    Briggs, Lafayette

    2011-01-01

    Objective This study evaluated 3-dimensional (3D) assessments of points of interest on a phantom replica of the human skull and cervical vertebrae to better understand how structures are represented in space using mathematical methods. Methods Three basic geometric equations derived from the “Law of Similar Triangles” are introduced, and measurements are taken after 4 trials to demonstrate how 3D data extracted from 2-dimensional (2D) digitized radiographic pairs can be used to produce coordinate points associated with 3 areas on the atlas. Results An analysis of variance test for multiple group comparison shows no significant statistical difference between 4 trials (P = 0.995). In addition, 6 strong positive correlations are evident using Pearson product-moment coefficient test (r = 0.9008 through 0.9977, P = 0.002). Conclusion This study suggests that it is possible to use coplanar stereoscopic radiographic pairs to define an object's location in 3D space by taking retrospective measurements directly from 2D digitized radiographs. PMID:22027202

  3. In vivo ultrasonic attenuation slope estimates for detecting cervical ripening in rats: Preliminary results

    E-print Network

    Illinois at Urbana-Champaign, University of

    In vivo ultrasonic attenuation slope estimates for detecting cervical ripening in rats: Preliminary; revised 10 December 2007; accepted 11 December 2007 To effectively postpone preterm birth, cervical means of detecting cervical ripening. Herein, the traditional attenuation slope-estimation algorithm

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. Cervical vertebral canal endoscopy in a horse with cervical vertebral stenotic myelopathy.

    PubMed

    Prange, T; Carr, E A; Stick, J A; Garcia-Pereira, F L; Patterson, J S; Derksen, F J

    2012-01-01

    A 3-year-old Thoroughbred gelding presented with a history of neurological signs, including incoordination in his hindlimbs, of about 7 months' duration. On initial examination, the horse exhibited ataxia and paresis in all limbs with more severe deficits in the hindlimbs. Cervical radiographs displayed severe osteoarthritis of the articular processes between C5 and C6. On subsequent cervical myelography the dorsal contrast column was reduced by 90% at the level of the intervertebral space between C5 and C6. Cervical vertebral canal endoscopy, including epidural (epiduroscopy) and subarachnoid endoscopy (myeloscopy), was performed under general anaesthesia. A substantial narrowing of the subarachnoid space at the level between C6 and C7 was seen during myeloscopy, while no compression was apparent between C5 and C6. Epiduroscopy showed no abnormalities. After completion of the procedure, the horse was subjected to euthanasia and the cervical spinal cord submitted for histopathological examination. Severe myelin and axon degeneration of the white matter was diagnosed at the level of the intervertebral space between C6 and C7, with Wallerian degeneration cranially and caudally, indicating chronic spinal cord compression at this site. Myeloscopy was successfully used to identify the site of spinal cord compression in a horse with cervical vertebral stenotic myelopathy, while myelography results were misleading. PMID:21696435

  9. 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

  10. Large scale study of HPV genotypes in cervical cancer and different cytological cervical specimens in Thailand.

    PubMed

    Chansaenroj, Jira; Junyangdikul, Pairoj; Chinchai, Teeraporn; Swangvaree, Sukumarn; Karalak, Anant; Gemma, Nobuhiro; Poovorawan, Yong

    2014-04-01

    Identification of high-risk HPV genotypes in patients is essential for vaccination and prevention programs while the geographic distribution of cervical cancer varies widely. HPV 16 is the major cause of cervical cancer followed by HPV 18, HPV 31, HPV 52, or HPV 58 depending on geographic area. In this study, the distribution of HPV genotypes in cervical specimens from women living in Thailand was analyzed by HPV testing with electrochemical DNA chip and PCR direct sequencing. The 716 specimens were grouped according to their cytological grades; 100 normal, 100 low-grade squamous intraepithelial lesions, 100 high grade squamous intraepithelial lesions, and 416 specimens of cervical cancer. The results showed that HPV 16, HPV 18, HPV 52, and HPV 58 are the most common HPV genotypes in Thailand, respectively. With respect to age, women below the age of 26 years were almost negative for high-risk HPV DNA exclusively. Conversely, high prevalence of high-risk HPV DNA and abnormal cytology were usually found in women between 26 and 45 years while cervical cancer was detected mainly in women above the age of 45 years. To increase protection efficiency, a vaccine including HPV 52 and HPV 58 should be offered to Asian women, and primary HPV screening should start at 26-30 years of age. PMID:24127280

  11. Use of Fidji cervical cage in the treatment of cervical spinal cord injury without radiographic abnormality.

    PubMed

    Huang, Sheng-Li; Yan, Hong-Wei; Wang, Kun-Zheng

    2013-01-01

    Spinal cord injury without radiographic abnormality (SCIWORA) is a rare condition seen in adults. Many interbody fusion cages have been developed for its treatment, but clinical studies of Fidji cervical cage are still scarce. A total number of five patients (four male and one female) were reviewed. The ages of the patients ranged from 40 to 60 years. All the patients underwent neurological and radiological examinations. Neurological and functional outcomes were assessed on the basis of Frankel's grade. Three of the patients were Frankel B, and the rest two were Frankel C. Magnetic resonance imaging was also performed for the evaluation of spinal cord and intervertebral disc injury. Anterior cervical discectomy and Fidji cervical cage fusion were performed for all. The fusion status was evaluated on the basis of X-rays. After surgical intervention, the clinical symptoms improved for all the patients. The disc interspaces in all the patients achieved solid union at final follow-up. Fidji cervical cage is very efficient in achieving cervical fusion in patients with SCIWORA. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory. PMID:23844369

  12. DNA probes for papillomavirus strains readied for cervical cancer screening

    SciTech Connect

    Merz, B.

    1988-11-18

    New Papillomavirus tests are ready to come to the aid of the standard Papanicolauo test in screening for cervical cancer. The new tests, which detect the strains of human papillomavirus (HPV) most commonly associated with human cervical cancer, are designed to be used as an adjunct to rather than as a replacement for the Papanicolaou smears. Their developers say that they can be used to indicated a risk of developing cancer in women whose Papanicolaou smears indicate mild cervical dysplasia, and, eventually, to detect papillomavirus infection in normal Papanicolaou smears. The rationale for HPV testing is derived from a growing body of evidence that HPV is a major factor in the etiology of cervical cancer. Three HPV tests were described recently in Chicago at the Third International Conference on Human Papillomavirus and Squamous Cervical Cancer. Each relies on DNA probes to detect the presence of papillomavirus in cervical cells and/or to distinguish the strain of papillomavirus present.

  13. Epigenetics and cervical cancer: from pathogenesis to therapy.

    PubMed

    Fang, Jinchuan; Zhang, Hai; Jin, Sufang

    2014-06-01

    Although human papillomavirus (HPV) infection has been found in most of the cervical cancer cases, additional genetic and epigenetic changes are required for disease progression. Previously, it was thought that only genetic mutation plays a key role in cervical cancer development. But recent advances in the biology of cervical cancer revealed that epigenetic alteration is common in cervical carcinogenesis and metastasis. Epigenetic alteration due to aberrant DNA methylation and histone modification has been extensively studied in cervical cancer. Recent research strategies keep insight into noncoding RNAs, especially miRNA and lncRNA. At the same time, interest has been grown to study the utility of these changes as biomarkers to determine disease progression as well as use them as the therapeutic targets. This study has been aimed to review the recent progress of epigenetic study for cervical cancer research including role of these epigenetic changes in disease progression, their prognostic values, and their use in targeted therapy. PMID:24554414

  14. [Falls in the elderly: think about cervical fracture!].

    PubMed

    Morisod, J; Coutaz, M

    2009-11-01

    Cervical spine fractures are not uncommon in the geriatric population. Lower energy injuries could be responsible, like a simple fall. After an injury, a fracture should always be suspected in patients who complain of cervical tenderness, until proven otherwise. Simple and easily applicable guidelines, such as the NEXUS rules that has been validated in the elderly, could help to achieve a correct diagnosis. Most often, cervical immobilization by rigid collars is an adequate therapy and allows a satisfactory functional recovery. PMID:19994667

  15. Chlamydia trachomatis infection and risk of cervical intraepithelial neoplasia

    Microsoft Academic Search

    Matti Lehtinen; Kevin A Ault; Erika Lyytikainen; Joakim Dillner; Suzanne M Garland; Daron G Ferris; Laura A Koutsky; Heather L Sings; Shuang Lu; Richard M Haupt; Jorma Paavonen

    2011-01-01

    ObjectivesHigh-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. As Chlamydia trachomatis is also linked to cervical cancer, its role as a potential co-factor in the development of cervical intraepithelial neoplasia (CIN) grade 2 or higher was examined.MethodsThe placebo arms of two large, multinational, clinical trials of an HPV6\\/11\\/16\\/18 vaccine were combined. A total of 8441 healthy women

  16. Tuberculosis mimicking cervical carcinoma--case report.

    PubMed

    Micha, J P; Brown, J V; Birk, C; Van Horn, D; Rettenmaier, M A; Goldstein, B H

    2007-01-01

    Tuberculosis is a chronic bacterial infection that primarily results in pulmonary disease. Although there are several reported cases of extra-pulmonary tuberculosis, very few reports have described this disease in the female genital tract. We present a case involving a 67-year-old woman who presented with vaginal discharge, abdominal discomfort, and a pelvic mass in 2006. Clinically, cervical carcinoma was suspected, but pathologic diagnosis eventually revealed tuberculosis of the cervix. Tuberculosis is associated with a significant inflammatory reaction, which may mimic a gynecologic malignancy on exam or with diagnostic imaging. Despite the rare incidence, tuberculosis of the cervix should be considered in the differential diagnosis when cervical carcinoma is initially suspected. PMID:17713102

  17. Cervical Symmetric Dumbbell Ganglioneuromas Causing Severe Paresis

    PubMed Central

    Miyamoto, Kei; Hirose, Yoshinobu; Kito, Yusuke; Fushimi, Kazunari; Shimizu, Katsuji

    2014-01-01

    We report an extremely rare case with bilateral and symmetric dumbbell ganglioneuromas of the cervical spine in an elderly patient. A 72-year-old man came by ambulance to our hospital due to progressive incomplete paraplegia. Magnetic resonance imaging demonstrated bilateral symmetric dumbbell tumors at the C1/2 level. We performed total resection of the intracanalar tumor, aiming at complete decompression of the spinal cord, and partial and subtotal resection of foraminal outside portions. Histopathological examination of the surgical specimen indicated the tumor cells to be spindle cells with the presence of ganglion cells and no cellular pleomorphism, suggesting a diagnosis of ganglioneuroma. Although the surgery was not curative, the postoperative course was uneventful and provided a satisfactory outcome. This is the fourth known case of cervical ganglioneuromas of the bilateral symmetric dumbbell type. PMID:24596609

  18. Cervical symmetric dumbbell ganglioneuromas causing severe paresis.

    PubMed

    Hioki, Akira; Miyamoto, Kei; Hirose, Yoshinobu; Kito, Yusuke; Fushimi, Kazunari; Shimizu, Katsuji

    2014-02-01

    We report an extremely rare case with bilateral and symmetric dumbbell ganglioneuromas of the cervical spine in an elderly patient. A 72-year-old man came by ambulance to our hospital due to progressive incomplete paraplegia. Magnetic resonance imaging demonstrated bilateral symmetric dumbbell tumors at the C1/2 level. We performed total resection of the intracanalar tumor, aiming at complete decompression of the spinal cord, and partial and subtotal resection of foraminal outside portions. Histopathological examination of the surgical specimen indicated the tumor cells to be spindle cells with the presence of ganglion cells and no cellular pleomorphism, suggesting a diagnosis of ganglioneuroma. Although the surgery was not curative, the postoperative course was uneventful and provided a satisfactory outcome. This is the fourth known case of cervical ganglioneuromas of the bilateral symmetric dumbbell type. PMID:24596609

  19. Amelanotic melanoma presenting with cervical lymphadenopathy.

    PubMed

    Karnwal, Abhishek; Hadjihannas, Edward; Sherif, Ali; Grumett, Simon; Karnwal, Sudha; Mathews, John

    2009-01-01

    We present a rare case of an amelanotic melanoma of unknown primary presenting with cervical lymphadenopathy. A 20-year-old man presented with large left sided neck lump, associated dysphagia and weight loss. Examination revealed a hard mass in the left posterior triangle of neck and sacral sensory loss. Fine needle aspiration cytology of the mass suggested a poorly differentiated carcinoma. Computed tomography showed a left sided, 8×13 cm cervical mass with liver, lung and bony metastases. Histological examination of the lymph nodal mass confirmed the diagnosis of a metastatic amelanotic melanoma. The patient was treated with glucocorticoids, radiation therapy for the sacral bony deposit, and chemotherapy. Despite an initial reduction of his target lesions, his condition subsequently deteriorated and he died 4 months after diagnosis. PMID:21686931

  20. [Pretreatment diagnostic evaluation of cervical cancer].

    PubMed

    Lemke, U; Hamm, B

    2009-05-01

    Magnetic resonance imaging (MRI) has evolved into an integral component of the pretherapeutic local staging of cervical cancer. Many recent studies have demonstrated the superiority of MRI for this indication. It is the method of choice for therapeutic decision making and planning, monitoring of the response to radiotherapy, excluding of tumor recurrence, and assessing of patients for tumor or therapy-related complications. The superiority of MRI is mainly due to its high soft-tissue contrast that allows depiction of the abdominal and pelvic organs with excellent image quality. This article provides an overview of the diagnostic potential and limitations of MRI in the primary staging of cervical cancer and supplementary imaging modalities - CT, PET, and PET/CT - on the basis of the current scientific literature. Also included is a discussion of state-of-the-art lymph node staging and the limitations of imaging in lymph node assessment. PMID:19373746

  1. Cervical Thymic Cyst in an Adult

    PubMed Central

    Alzahrani, Hassan A.; Iqbal, Javeria M.; Abu Shaheen, Amani K.; Al Harthi, Bandar N.

    2014-01-01

    Cervical thymic cysts (CTCs) are unusual lesions, representing only 1% of cystic cervical masses. Diagnosis of this condition in adults is even rarer. We report a 34-year-old female who presented with asymptomatic progressively growing left-sided neck swelling. Neck ultrasound (US) showed a large cystic lesion with septation, compressing the ipsilateral vessels. Magnetic resonance imaging (MRI) confirmed the US findings. Surgical excision was performed which subsequently showed findings consistent with CTC. CTC in adult is extremely rare, with few reported cases identified in the literature. Thymic gland anomalies in the neck are the consequences of an arrest in the descent of the gland, sequestration of the thymic tissue, or failure of involution. The diagnosis of this condition is rarely done prior to surgical excision. The clinical presentation, radiologic imaging, surgical findings, and histologic appearance are all essential components to make the correct diagnosis of this very rare differential diagnosis of cystic lateral neck swelling. PMID:24876986

  2. Upper cervical trauma in motor vehicle collisions.

    PubMed

    Shkrum, M J; Green, R N; Nowak, E S

    1989-03-01

    Motor vehicle collisions can cause a variety of injuries in pedestrians and vehicle occupants. Fatal and nonfatal trauma to the upper cervical spine, that is, atlanto-occipital junction, atlas and axis, can be part of this spectrum. Certain distinctive injuries (for example, "hangman's fracture") which occur result from the unique anatomic structure of this area and the various disruptive forces such as extension, distraction (tension), compression (axial loading), shear, and inertia generated during collision. Correlation of autopsy findings or radiological information of these cervical injuries or both with scene investigation can be informative not only in the determination of morbidity and mortality, but also in the assessment of injury mechanisms and improvements in occupant protection. PMID:2708956

  3. Management of cervical thorium dioxide granulomas.

    PubMed

    Stanley, R B; Calcaterra, T C

    1981-10-01

    Thorium dioxide (Thorotrast) was used extensively in the United States from the 1930s through the 1950s for contrast radiography, including cerebral angiography. Its use was discontinued after the pathologic consequences of tumor formation and local fibrotic reaction (thorium dioxide granuloma) were recognized. The latency period for the development of these consequences is 20 to 30 years and, thus, has not expired. Radical surgical excision in an attempt to remove cervical thorium dioxide granulomas and their ionizing radiation has been advocated previously. A case prompted reconsideration of this management. Total surgical removal does not seem possible and is extremely hazardous in those cases with a patent carotid artery adjacent to the cervical granuloma. More cases should be expected, and each case should be approached individually as to benefits and risks of attempted surgical removal of the granuloma. Radical surgery is not always the treatment of choice. PMID:7283829

  4. Radiographic evaluation of cervical spine trauma

    Microsoft Academic Search

    C. M. Bach; I. E. Steingruber; S. Peer; R. Peer-Kühberger; W. Jaschke; M. Ogon

    2001-01-01

    Different imaging modalities are available for the diagnosis of cervical spine injuries. There is a controversial discussion\\u000a about whether plain radiography (PR), conventional tomography (CTO) or computed tomography (CT) should primarily be used.\\u000a PR and CTO are more often available and less costly than CT. Especially in second-care hospitals, CT is not always available.\\u000a The diagnostic work-up in these centres

  5. Restoration of non-carious cervical lesions

    Microsoft Academic Search

    I. P. Ichim; P. R. Schmidlin; Q. Lic; J. A. Kieser; M. V. Swain

    2007-01-01

    ObjectiveIt is still largely unknown as to what material parameter requirements would be most suitable to minimise the fracture and maximising the retention rate of the restoration of cervical non-carious lesions (NCCL). The present paper, as a first of its kind, proposes a radical approach to address the problems of material improvement, namely: numerical-based, fracture and damage mechanics materials optimisation

  6. Cervical Cystic Hygroma in an Adult

    PubMed Central

    Derin, Serhan; ?ahan, Murat; Dere, Yelda; Çullu, Ne?at; ?ahan, Leyla

    2014-01-01

    Cystic hygromas/lymphangiomas are extremely rare malformations in adults. They are usually seen in infants and children under 2 years of age. En bloc resection is difficult due to the adhesive characteristics of the tumors. Inadequate surgical intervention often leads to recurrent disease. We report herein the case of a cystic hygroma/lymphangioma that presented as an uncommon mass on the cervical region in an adult, together with its histopathological, radiologic, and operative features. PMID:25548704

  7. Cervical external root resorption in vital teeth.

    PubMed

    Bergmans, L; Van Cleynenbreugel, J; Verbeken, E; Wevers, M; Van Meerbeek, B; Lambrechts, P

    2002-06-01

    External resorptions associated with inflammation in marginal tissues present a difficult clinical situation. Many times, lesions are misdiagnosed and confused with caries and internal resorptions. As a result inappropriate treatment is often initiated. This paper provides three-dimensional representations of cervical external resorption, based on X-ray microfocus-tomographical scanning of a case, which will aid the dental practitioner in recognizing characteristic features during clinical inspection. In addition, histopathological examination reveals the cellular morphology of the adjacent tissues. PMID:12296786

  8. Cervical pain: A comparison of three pillows

    Microsoft Academic Search

    Robert A. Lavin; Marco Pappagallo; Keith V. Kuhlemeier

    1997-01-01

    Objective: To compare three pillows with regard to pain intensity, pain relief, quality of sleep, disability, and overall satisfaction in subjects with benign cervical pain. The three pillows evaluated were the subjects' usual pillow, a roll pillow, and a water-based pillow.Study Design: Subjects used their usual pillows for the first week of this 5-week randomized crossover design study. They were

  9. Modern management of locally advanced cervical carcinoma

    Microsoft Academic Search

    Alfonso Dueñas-Gonzalez; Lucely Cetina; Ignacio Mariscal; Jaime de la Garza

    2003-01-01

    Radiation was until recently the key and only modality for the routine treatment of locally advanced cervical carcinoma. However after years of studying multi-modality treatments as an alternative to radiation alone in randomized phase III trials, the standard treatment has changed to chemo-radiation based on cisplatin. Three recent meta-analyses have confirmed that cisplatin-based chemo-radiation adds an absolute 12% benefit in

  10. 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

  11. 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

  12. 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

  13. Optical coherence tomography in diagnosing cervical cancer

    NASA Astrophysics Data System (ADS)

    Kuznetzova, Irina A.; Shakhova, Natalia M.; Kachalina, Tatiana S.; Gladkova, Natalia D.; Myakov, Alexey V.; Iksanov, Rashid R.; Feldchtein, Felix I.

    2000-05-01

    Cervical cancer remains one of the most significant problem in oncogynecology. It tends towards treatment approaches that provide termination of pathological processes along with preservation of the patient's life quality. There is a need in earlier and more accurate diagnosis of pathological states, objective assessment of physiological processes, and adequate monitoring of the course of treatment. In our previous publications we have reported unique capabilities of the Optical Coherence Tomography (OCT) to image in vivo the mucosa structure of the cervix and to monitor various physiological and pathological alterations. In this report, we present results of OCT application to diagnose different stages of cervical cancer and to control its treatment at early stages. We have performed OCT-colposcopy in 11 female patients with cervical cancer to derive OCT criteria of this disease, to provide exact demarcation of a pathological area, and to determine a real size of a tumor. We have found that, in general, borders of a tumor, defined visually and detected with OCT by violation of the basement membrane in exocervix, do not coincide. The mismatch depends on a stage of cancer and can be as much as several millimeters. This information is especially important for evaluation of linear dimension of tumors with 3 - 5 mm invasion and also for differential diagnosis between the T1 and T2 stages with cancer extension onto vagina.

  14. 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

  15. Cervical paraspinal spontaneous activity in asymptomatic subjects.

    PubMed

    Date, Elaine S; Kim, Byung-Jo; Yoon, Joon Shik; Park, Byung Kyu

    2006-09-01

    Paraspinal fibrillation potentials or positive sharp waves (PSWs) reportedly may be the only electrodiagnostic abnormality in patients with radiculopathies. However, spontaneous activity may be present in muscles of asymptomatic subjects. To determine whether abnormal spontaneous activity in the cervical paraspinal muscles is clinically relevant, we evaluated the prevalence of such activity in asymptomatic individuals and examined its relationship with age. Sixty-six asymptomatic subjects underwent a needle electromyographic examination of the paraspinal muscles bilaterally at the C5/6 and C6/7 levels. All of the recorded potentials were captured and their firing rates and waveforms were evaluated. The potentials were considered to be abnormal if reproducible trains of PSWs or fibrillation potentials were present. Eight of the 66 (12%) subjects showed PSWs, five bilaterally; none showed fibrillation potentials. A statistical analysis for the effect of age could not be performed due to the small sample size. Because electromyographic cervical paraspinal abnormalities can be found in asymptomatic subjects, caution should be exercised when attributing the etiology of neck pain to radiculopathy if the only electrodiagnostic findings are electromyographic cervical paraspinal abnormalities. PMID:16634054

  16. A new 3-point bending traction method for restoring cervical lordosis and cervical manipulation: A nonrandomized clinical controlled trial

    Microsoft Academic Search

    Deed E. Harrison; Rene Cailliet; Donald D. Harrison; Tadeusz J. Janik; Burt Holland

    2002-01-01

    Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. A new 3-point bending traction method for restoring cervical lordosis and cervical manipulation: a nonrandomized clinical controlled trial. Arch Phys Med Rehabil 2002;83:447-53. Objective: To evaluate a new 3-point bending type of cervical traction. Design: Nonrandomized controlled trial of prospective, consecutive patients compared with control subjects. Follow-up patient data were

  17. Treatment of cervical dystonia and focal hand dystonia by high cervical continuously infused intrathecal baclofen: A report of 2 cases

    Microsoft Academic Search

    Dennis D. Dykstra; Alejandro Mendez; Diane Chappuis; Tanya Baxter; Lorie DesLauriers; Mark Stuckey

    2005-01-01

    Dykstra DD, Mendez A, Chappuis D, Baxter T, DesLauriers L, Stuckey M. Treatment of cervical dystonia and focal hand dystonia by high cervical continuously infused intrathecal baclofen: a report of 2 cases. Arch Phys Med Rehabil 2005;86:830–3.We describe 2 patients, one with cervical dystonia (CD) combined with focal hand dystonia (writer’s cramp) and another with idiopathic CD, who were unresponsive

  18. Comparison between anterior cervical discectomy fusion and cervical corpectomy fusion using titanium cages for reconstruction: analysis of outcome and long-term follow-up

    Microsoft Academic Search

    Juan S. Uribe; Jaypal Reddy Sangala; Edward A. M. Duckworth; Fernando L. Vale

    2009-01-01

    Retrospective comparative study of 80 consecutive patients treated with either anterior cervical discectomy fusion (ACDF)\\u000a or anterior cervical corpectomy fusion (ACCF) for multi-level cervical spondylosis. To compare clinical outcome, fusion rates,\\u000a and complications of anterior cervical reconstruction of multi-level ACDF and single-\\/multi-level ACCF performed using titanium\\u000a mesh cages (TMCs) filled with autograft and anterior cervical plates (ACPs). Reconstruction of the

  19. [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

  20. Women's perspectives on illness when being screened for cervical cancer

    PubMed Central

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle; Bradley, Stephen K.; Møller, Suzanne

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide whether to participate in cervical cancer screening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings of vulnerability and an increased need to care for themselves. Later on, an understanding of HPV as the basis for diagnosis and the realization that disease might not be accompanied by symptoms developed. The outcome for participants was a life experience, which they used to encourage others to participate in screening and to suggest ways that information about screening and HPV might reach a wider Greenlandic population. Conclusion Women living through the process of cervical disease, treatment and follow-up develop knowledge about HPV, cervical cell changes, cervical disease and their connection, which, if used to inform cervical screening programmes, will improve the quality of information about HPV, cervical cancer and screening participation. This includes that verbal and written information given at the point of screening and diagnosis needs to be complemented by visual imagery. PMID:23984277

  1. 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

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

    E-print Network

    Dever, Jennifer A.

    is HPV q Evidence of HPV is found in nearly 80% of cervical carcinomas q HPV strains found most system's ability to fight infection (including HPV infection) and increases the likelihood that precancerous cells will progress to cancer. A. HPV ­ carries oncogenes n It is proposed that HPV interferes

  3. Gene expression changes in progression of cervical neoplasia revealed by microarray analysis of cervical neoplastic keratinocytes.

    PubMed

    Rotondo, John Charles; Bosi, Silvia; Bassi, Cristian; Ferracin, Manuela; Lanza, Giovanni; Gafà, Roberta; Magri, Eros; Selvatici, Rita; Torresani, Stefania; Marci, Roberto; Garutti, Paola; Negrini, Massimo; Tognon, Mauro; Martini, Fernanda

    2015-04-01

    To evaluate the gene expression changes involved in neoplastic progression of cervical intraepithelial neoplasia. Using microarray analysis, large-scale gene expression profile was carried out on HPV16-CIN2, HPV16-CIN3, and normal cervical keratinocytes derived from two HPV16-CIN2, two HPV-CIN3 lesions, and two corresponding normal cervical tissues, respectively. Differentially expressed genes were analyzed in normal cervical keratinocytes compared with HPV16-CIN2 keratinocytes and in HPV16-CIN2 keratinocytes compared with HPV16-CIN3 keratinocytes; 37 candidate genes with continuously increasing or decreasing expression during CIN progression were identified. One of these genes, phosphoglycerate dehydrogenase, was chosen for further characterization. Quantitative reverse transcription-polymerase chain reaction and immunohistochemical analysis confirmed that expression of phosphoglycerate dehydrogenase consistently increases during progression of CIN toward cancer. Gene expression changes occurring during CIN progression were investigated using microarray analysis, for the first time, in CIN2 and CIN3 keratinocytes naturally infected with HPV16. Phosphoglycerate dehydrogenase is likely to be associated with tumorigenesis and may be a potential prognostic marker for CIN progression. PMID:25205602

  4. Long latency trigemino-cervical reflex in patients with cervical dystonia.

    PubMed

    Gündüz, Ay?egül; Ergin, Hayal; K?z?ltan, Meral E

    2015-01-01

    Trigemino-cervical reflex (TCR) is elicited by stimulation of face using various modalities. TCR reflects the interaction between trigeminal system and cervical motoneurons. Such a specific interaction is assumed to play role in development of cervical dystonia (CD) through superior colliculus. In this study, we aimed to investigate alterations of the functional relationship between those structures in CD and in a subgroup with dystonic tremor. A total of consecutive 23 patients with primary CD (7 men, 16 women) and 16 age and sex matched control subjects (7 men, 9 women) were included in this study. TCR was obtained after percutaneous electrical stimulation (with duration of 0.5 ms) of infraorbital branch of trigeminal nerve while recording over splenius capitis and sternocleidomastoid muscles. Presence and onset latencies of TCR did not differ significantly between patients with CD and controls, and same pattern of muscle activation occurred in both groups. Responses of patient group seemed to have higher amplitudes and to be more persistent. There were no significant side-to-side differences of TCR probability, latency, amplitude or duration with respect to the side of head deviation in CD. Increased amplitudes and durations of responses probably reflect increased excitability of the reflex circuit. We suggest that similar latencies and response pattern in comparison to healthy individuals decrease the possibility of structural disturbance. TCR is probably under bilateral basal ganglia and dopaminergic control. Alterations of trigemino-cervical pathway are more extensive and are not solely due to local changes of brainstem interneurons. PMID:25056194

  5. 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

  6. Optoelectronic method for detection of cervical intraepithelial neoplasia and cervical cancer

    NASA Astrophysics Data System (ADS)

    Pruski, D.; Przybylski, M.; K?dzia, W.; K?dzia, H.; Jagielska-Pruska, J.; Spaczy?ski, M.

    2011-12-01

    The optoelectronic method is one of the most promising concepts of biophysical program of the diagnostics of CIN and cervical cancer. Objectives of the work are evaluation of sensitivity and specificity of the optoelectronic method in the detection of CIN and cervical cancer. The paper shows correlation between the pNOR number and sensitivity/specificity of the optoelectronic method. The study included 293 patients with abnormal cervical cytology result and the following examinations: examination with the use of the optoelectronic method — Truscreen, colposcopic examination, and histopathologic biopsy. Specificity of the optoelectronic method for LGSIL was estimated at 65.70%, for HGSIL and squamous cell carcinoma of cervix amounted to 90.38%. Specificity of the optoelectronic method used to confirm lack of cervical pathology was estimated at 78.89%. The field under the ROC curve for the optoelectronic method was estimated at 0.88 (95% CI, 0.84-0.92) which shows high diagnostic value of the test in the detection of HGSIL and squamous cell carcinoma. The optoelectronic method is characterised by high usefulness in the detection of CIN, present in the squamous epithelium and squamous cell carcinoma of cervix.

  7. 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

  8. [Uterine cervical cancer screening in kitakyushu city: present and future].

    PubMed

    Matsuura, Yusuke; Oka, Haruko; Yamagata, Kazuhiro; Kikuchi, Joji; Inoue, Isao; Ohkubo, Nobuyuki; Toki, Naoyuki; Kawagoe, Toshinori; Hachisuga, Toru; Kashimura, Masamichi

    2014-09-01

    Uterine cervical cancer is the most common primary gynecologic malignant tumor in Japan. Conventional cervical screening Papanicolaou (Pap) test has been shown to be extremely effective in reducing cervical cancer incidence and mortality, but the consultation rate for cancer screening in Japan is markedly low, at 20% of prescribed subjects, in comparison with other developed countries. In 2001, 15,501 women (6.8%) received a Pap test in Kitakyushu City, and that was less than half of national average. From 2009, free coupons for uterine cervical cancer screening were distributed to Japanese woman who were 20, 25, 30, 35 or 40 years of age as part of the project for women-specific cancer screening. The rate of participation in Pap testing was 22.3% in 2012, with 31,970 women receiving cervical tests. It was almost as high as the national level. It's obvious that high risk human papillomavirus (HPV) is responsible for cervical cancer incidence and HPV mainly infects through sexual practice. The rate of early cervical neoplasms and invasive cancers is currently increasing in young women. Abnormal Pap tests were detected in 2.3% of the women in 2008. To increase the population's participation in this screening process, a cost-effective and efficient system should be established. National and local governments, medical institutions, companies, and educational institutions must have an accurate understanding of the current situation, and take an assertive approach in order to decrease the mortality rate of uterine cervical cancer. PMID:25224713

  9. The role of human papillomavirus in cervical adenocarcinoma carcinogenesis

    Microsoft Academic Search

    S Andersson; E Rylander; B Larsson; A Strand; C Silfversvärd; E Wilander

    2001-01-01

    Human papillomavirus (HPV) is considered the single most important co-factor in the development of cervical squamous cell carcinomas. Adenocarcinomas of the cervix are also related to HPV, but the correlation is reported to be less pronounced. In the present study, 131 cervical adenocarcinomas were identified through the Swedish Cancer Registry, examined morphologically and then analysed with sensitive polymerase chain reaction

  10. 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

  11. Antioxidants in cervical cancer: Chemopreventive and chemotherapeutic effects of polyphenols

    Microsoft Academic Search

    F. Di Domenico; C. Foppoli; R. Coccia; M. Perluigi

    Cervical cancer lesions are a major threat to the health of women, representing the second most common cancer worldwide. The unanimously recognized etiological factor in the causation of cervical cancer is the infection with human papilloma virus (HPV). HPV infection, although necessary, is not per se sufficient to induce cancer. Other factors have to be involved in the progression of

  12. 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

  13. Vertebral Artery Injuries Following Chiropractic Cervical Spine Manipulation —Case Reports

    Microsoft Academic Search

    Robert Raskind; Charles M. North

    1990-01-01

    Four patients undergoing cervical spinal manipulations for nonneurologic diseases and with no previous neurologic signs or symptoms all developed significant neurologic deficits, one fatal, following manipulations of the cervical spine. Both the literature and the authors' series show that a number of patients have a prodrome prior to the onset of neurologic changes. There is no established therapy for the

  14. Biomechanics of the cervical spine Part 3: minor injuries

    Microsoft Academic Search

    Nikolai Bogduk; Narayan Yoganandan

    2001-01-01

    Minor injuries of the cervical spine are essentially defined as injuries that do not involve a fracture. Archetypical of minor cervical injury is the whiplash injury. Among other reasons, neck pain after whiplash has been controversial because critics do not credit that an injury to the neck can occur in a whiplash accident. In pursuit of the injury mechanism, bioengineers

  15. Social Construction of Cervical Cancer Screening among Panamanian Women

    ERIC Educational Resources Information Center

    Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen

    2012-01-01

    Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…

  16. Cervical Subluxation after Surgery and Irradiation of Childhood Ependymoma

    Microsoft Academic Search

    Daniel T. Fletcher; William C. Warner; Michael S. Muhlbauer; Thomas E. Merchant

    2002-01-01

    Aggressive resection followed by postoperative radiation therapy directed at the tumor bed characterizes the treatment of childhood infratentorial ependymoma. Tumor resection often requires access to the upper portion of the cervical spinal canal, which places the patient at risk of complications, including destabilization. Two cases of cervical subluxation after surgery and irradiation for infratentorial ependymoma are presented and discussed to

  17. 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

  18. WHERE WE HAVE TRAVELLED IN CERVICAL CANCER PROTECTION

    Microsoft Academic Search

    Margaret Davy

    Cervical cancer was described in the time of Hippocrates, and it was commented that it had a grim prognosis. Over the centuries, various theories regarding aetiology and also treatments were proposed - in vain in the majority of cases. More and more aggressive treatments were advocated to treat those unfortunate women who were diagnosed with cervical cancer. It is only

  19. 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

  20. Sentinel node procedure in Ib cervical cancer: a preliminary series

    Microsoft Academic Search

    T Lantzsch; M Wolters; J Grimm; T Mende; J Buchmann; G Sliutz; H Koelbl

    2001-01-01

    The aim of this study was to determine the diagnostic accuracy and feasibility of sentinel lymph node (SLN) detection using a gamma probe in patients with Figo IB cervical cancer. Between January 1999 and September 2000, 14 patients with cervical cancer, planned for radical hysterectomy were eligible for the study. The day before radical hysterectomy we injected technetium99m-labelled nanocolloid in

  1. Purification and Characterization of Hexosaminidase from Human Uterine Cervical Carcinoma

    Microsoft Academic Search

    V. Bhuvarahamurthy; S. Govindasamy

    1996-01-01

    Normal human uterine cervical tissue and uterine cervical carcinoma tissue were collected and subjected to fractionation of hexosaminidase isoenzymes Hex A, Hex B, and Hex I using DEAE-cellulose anion-exchange chromatography. Hex A was found to be the major isoenzyme in control tissues, whereas Hex B was the major isoenzyme in carcinoma tissues. These two major isoenzyme fractions were first purified

  2. No difference in delayed hypersensitivity between breast and cervical carcinomas.

    PubMed

    Munzarová, M; Kovarík, J; Ptácková, B; Hlávková, J; Kolcová, V; Nebeský, T

    1984-01-01

    DNCB and PPD skin testing was performed in 130 breast and 110 cervical cancer patients. BATES' instruction with a plea for uniformity was used [1]. Patients were tested while being diagnosed and prior to the treatment. No significant differences either in the frequency of a reactivity or grade of response in corresponding stages of breast and cervical cancer were found. PMID:6700799

  3. Epidemiologic Classification of Human Papillomavirus Types Associated with Cervical Cancer

    Microsoft Academic Search

    Nubia Muñoz; F. Xavier Bosch; Silvia de Sanjosé; Rolando Herrero; Xavier Castellsagué; Keerti V. Shah; Peter J. F. Snijders; Chris J. L. M. Meijer

    2003-01-01

    background Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but the risk associated with the various HPV types has not been adequately assessed. methods We pooled data from 11 case-control studies from nine countries involving 1918 wom- en with histologically confirmed squamous-cell cervical cancer and 1928 control wom- en. A common protocol and questionnaire were

  4. Cervical Cancer Among Hispanic Women: Assessing the Impact on Farmworkers

    Microsoft Academic Search

    Faith Boucher; Marc B. Schenker

    2002-01-01

    The purpose of this paper was to review the literature on Hispanic populations to outline: 1) demographics; 2) general health status; 3) cervical cancer incidence and mortality; 4) Pap smear screening rates; and 5) barriers to preventive care services. The methods: MEDLINE, Med66, Med75, and Med85 files, from 1966 to 1999, were searched for key words Hispanic health, cervical cancer

  5. Mild Obesity, Physical Activity, Calorie Intake, and the Risks of Cervical Intraepithelial Neoplasia and Cervical Cancer

    PubMed Central

    Lee, Jae Kwan; So, Kyeong A.; Piyathilake, Chandrika J.; Kim, Mi Kyung

    2013-01-01

    Objective We investigated whether obesity, physical activity, and calorie intake are associated with the risks of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods We enrolled 1125 women (age, 18–65 years) into a human papillomavirus cohort study established from 2006 to 2012. Multinomial logistic regression models were used to estimate crude and multivariate odds ratios (ORs) and the corresponding 95% confidence intervals (95% CIs), and to assess whether body mass index (BMI), height, weight, total calorie intake, and physical activity were associated with the risks of CIN and cervical cancer. Results Cervical cancer risk was positively associated with BMI and inversely associated with physical activity. When compared with women with a normal BMI (18.5–23 kg/m2), the multivariate ORs (95% CIs) for those overweight (23–25 kg/m2) and mild obesity (?25 kg/m2) were 1.25 (0.79–2.00) and 1.70 (1.10–2.63), respectively. When compared with women with the lowest tertile of physical activity (<38.5 MET-hours/week), the ORs (95% CIs) for cervical cancer were 0.95 (0.61–1.48) and 0.61 (0.38–0.98) for women with medium physical activity (38.5–71.9 MET-hours/week) and those with high physical activity (72 MET-hours/week), respectively (p for linear trend ?=?0.03). The CIN2/3 risk was inversely associated with physical activity after adjustment for confounders. Compared with women with low physical activity (< 38.5 MET-hours/week), the ORs (95% CIs) for CIN2/3 were 0.64 (0.40–1.01) and 0.58 (0.36–0.93) for the medium and high physical activity groups, respectively (p for linear trend ?=?0.02). Total calorie intake was not statistically associated with the risks of CIN and cervical cancer after adjustment for confounders. Conclusion Our results indicate that in addition to screening for and treatment of CIN, recommendations on the maintenance of an appropriate BMI with an emphasis on physical activity could be an important preventive strategy against the development of cervical cancer. PMID:23776686

  6. 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

  7. Cervical Neoplasia and Cigarette Smoking: Are They Linked?

    PubMed

    Runowicz; Lymberis; Tobias

    1997-03-01

    The presence of tobacco-specific carcinogens in the cervical mucus of smokers and their effect on the local immune system strongly suggest that smoking has an etiologic role in the development of cervical neoplasia. However, it remains unclear whether smoking can affect the initiation of high-grade cervical neoplasia independently from human papillomavirus (HPV) infection. Studies that control for HPV infection may not entirely resolve the issue of the role of smoking in cervical neoplasia. Cigarette smoking may be causative through its effect on oncogenic HPV infection or by altering the immune response system. This article reviews the currently available data assessing the relationship between cigarette smoking and cervical neoplasia. PMID:9746684

  8. Regrowth of Cervical Intradural Lipoma without Spinal Dysraphism

    PubMed Central

    Son, Doo Kyung; Choi, Chang Hwa; Song, Geun Sung

    2014-01-01

    A 49 years old male patient who suffered from deterioration of posterior neck pain, left hand numbness, left lower limb pain and gait disturbance for 3 years visited our outpatient department. He had been diagnosed as non-dysraphic cervical intradural lipoma and operated in August 1990. On the radiologic images, we found the regrowth of non-dysraphic cervical intradural lipoma from C2 to C7 level, which surrounds and compresses the cervical spinal cord. Previous subtotal laminectomy from C2 to C7 and severe cervical lordosis were also found. Appropriate debulking of lipoma mass without duroplasty was successfully done with intraoperative neurophysiological monitoring (IONM). We are following up the patient for 24 months via outpatient department, his neurologic symptoms such as hand numbness, gait disturbance, left lower limb pain and posterior neck pain have improved. We describe a rare case of regrowth of non-dysraphic cervical intradural lipoma. PMID:25328656

  9. 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

  10. Is cervical decompression beneficial in patients with coexistent cervical stenosis and multiple sclerosis?

    PubMed

    Tan, Lee A; Kasliwal, Manish K; Muth, Christopher C; Stefoski, Dusan; Traynelis, Vincent C

    2014-12-01

    Cervical stenosis (CS) and multiple sclerosis (MS) are two common conditions with distinctive pathophysiology but overlapping clinical manifestations. The uncertainty involved in attributing worsening symptoms to CS in patients with MS due to extremely high prevalence of asymptomatic radiological CS makes treatment decisions challenging. A retrospective review was performed analyzing the medical records of all patients with confirmed diagnosis of MS who had coexistent CS and underwent surgery for cervical radiculopathy/myeloradiculopathy. Eighteen patients with coexistent CS and MS who had undergone cervical spine decompression and fusion were identified. There were six men and 12 women with an average age of 52.7 years (range 40-72 years). Pre-operative symptoms included progressive myelopathy (14 patients), neck pain (seven patients), radiculopathy (five patients), and bladder dysfunction (seven patients). Thirteen of the 14 patients (92.9%) with myelopathy showed either improvement (4/14, 28.6%) or stabilization (9/14, 64.3%) in their symptoms with neck pain and radiculopathy improving in 100% and 80% of patients, respectively. None of the seven patients with urinary dysfunction had improvement in urinary symptoms after surgery. To conclude, cervical spine decompression and fusion can improve or stabilize myelopathy, and significantly relieve neck pain and radiculopathy in the majority of patients with coexistent CS and MS. Urinary dysfunctions appear unlikely to improve after surgery. The low rate of surgical complications in our cohort demonstrates that cervical spine surgery can be safely performed in carefully selected patients with concomitant CS and MS with a good clinical outcome and also eliminate CS as a confounding factor in the long-term management of MS patients. PMID:25088960

  11. Image-based brachytherapy for cervical cancer.

    PubMed

    Vargo, John A; Beriwal, Sushil

    2014-12-10

    Cervical cancer is the third most common cancer in women worldwide; definitive radiation therapy and concurrent chemotherapy is the accepted standard of care for patients with node positive or locally advanced tumors > 4 cm. Brachytherapy is an important part of definitive radiotherapy shown to improve overall survival. While results for two-dimensional X-ray based brachytherapy have been good in terms of local control especially for early stage disease, unexplained toxicities and treatment failures remain. Improvements in brachytherapy planning have more recently paved the way for three-dimensional image-based brachytherapy with volumetric optimization which increases tumor control, reduces toxicity, and helps predict outcomes. Advantages of image-based brachytherapy include: improved tumor coverage (especially for large volume disease), decreased dose to critical organs (especially for small cervix), confirmation of applicator placement, and accounting for sigmoid colon dose. A number of modalities for image-based brachytherapy have emerged including: magnetic resonance imaging (MRI), computed tomography (CT), CT-MRI hybrid, and ultrasound with respective benefits and outcomes data. For practical application of image-based brachytherapy the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology Working Group and American Brachytherapy Society working group guideline serve as invaluable tools, additionally here-in we outline our institutional clinical integration of these guidelines. While the body of literature supporting image-based brachytherapy continues to evolve a number of uncertainties and challenges remain including: applicator reconstruction, increasing resource/cost demands, mobile four-dimensional targets and organs-at-risk, and accurate contouring of "grey zones" to avoid marginal miss. Ongoing studies, including the prospective EMBRACE (an international study of MRI-guided brachytherapy in locally advanced cervical cancer) trial, along with continued improvements in imaging, contouring, quality assurance, physics, and brachytherapy delivery promise to perpetuate the advancement of image-based brachytherapy to optimize outcomes for cervical cancer patients. PMID:25493230

  12. Eag1 potassium channels as markers of cervical dysplasia.

    PubMed

    Ortiz, Cindy Sharon; Montante-Montes, Daniel; Saqui-Salces, Milena; Hinojosa, Luz María; Gamboa-Dominguez, Armando; Hernández-Gallegos, Elisabeth; Martínez-Benítez, Braulio; Del Rosario Solís-Pancoatl, María; Garcia-Villa, Enrique; Ramírez, Ana; Aguilar-Guadarrama, Ricardo; Gariglio, Patricio; Pardo, Luis A; Stühmer, Walter; Camacho, Javier

    2011-12-01

    Human ether à-go-go 1 (Eag1) potassium channels are potential tumor markers and therapeutic targets for several types of malignancies, including cervical cancer. Estrogens and human papilloma virus oncogenes regulate Eag1 gene expression, suggesting that Eag1 may already be present in pre-malignant lesions. Therefore, Eag1 could be used as an early marker and/or a potential risk indicator for cervical cancer. Consequently, we studied Eag1 protein expression by immunochemistry in cervical cancer cell lines, normal keratinocytes, cervical cytologies from intraepithelial lesions, biopsies from cervical intraepithelial neoplasias (CIN 1, 2 and 3) and in normal smears from patients taking or not taking estrogens. Two hundred and eighty-six samples obtained by liquid-based cytology and fifteen CIN biopsies were studied. We observed Eag1 protein expression in the cervical cancer cell lines, as opposed to normal keratinocytes. Eag1 was found in 67% of the cervical cytologies from low-grade intra-epithelial lesions and in 92% of the samples from high-grade intraepithelial lesions, but only in 27% of the normal samples. Noteworthy, morphologically normal cells obtained from dysplastic samples also exhibited Eag1 expression. In CIN biopsies we found that the higher the grade of the lesion, the broader the Eag1 protein distribution. Almost 50% of the normal patients taking estrogens displayed Eag1 expression. We suggest Eag1 as a potential marker of cervical dysplasia and a risk indicator for developing cervical lesions in patients taking estrogens. Eag1 detection in cervical cancer screening programs should help to improve early diagnosis and decrease mortality rates from this disease. PMID:21887469

  13. A comparison of ultrasonographically detected cervical changes in response to transfundal pressure, coughing, and standing in predicting cervical incompetence

    Microsoft Academic Search

    Edwin R. Guzman; Denise M. Pisatowski; Anthony M. Vintzileos; Carlos W. Benito; Maryellen L. Hanley; Cande V. Ananth

    1997-01-01

    Objective Our purpose was to compare various noninvasive stress techniques for their ability to elicit ultrasonographic cervical changes and to determine their efficacy in detecting ultrasonographic cervical incompetence. Study design Eighty-nine patients at risk for pregnancy loss and preterm birth underwent ultrasonographic evaluation of the cervix at least twice between 15 and 24 weeks of gestation. With use of a

  14. ISASS Policy Statement – Cervical Artificial Disc

    PubMed Central

    2014-01-01

    Morgan Lorio, MD, FACS, Chair, ISASS Task Force on Coding & Reimbursement The ISASS Task Force reached out to Domagoj Coric, MD to provide a timely summation on cervical disc arthroplasty given his special interest and recent IASP championship of this innovative technology to insure enhanced spine patient access. The ISASS Task Force is pleased with this step towards published ISASS societal policy and applauds Dr. Coric's effort; if ISASS is to continue to succeed we must continually harness the voluntary talents and energies of our members with gratitude. PMID:25694944

  15. Intelligent screening systems for cervical cancer.

    PubMed

    Jusman, Yessi; Ng, Siew Cheok; Abu Osman, Noor Azuan

    2014-01-01

    Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data. PMID:24955419

  16. Nonoperative Modalities to Treat Symptomatic Cervical Spondylosis

    PubMed Central

    Hirpara, Kieran Michael; Butler, Joseph S.; Dolan, Roisin T.; O'Byrne, John M.; Poynton, Ashley R.

    2012-01-01

    Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis. PMID:21991426

  17. Amelanotic malignant melanoma of the cervical oesophagus.

    PubMed

    Ramaswamy, Balakrishnan; Bhandarkar, Ajay M; Venkitachalam, Shruti; Trivedi, Shivangi

    2014-01-01

    We report the case of a young woman who presented with progressive dysphagia and swelling in the anterior aspect of the neck of short duration. On evaluation, she was diagnosed with amelanotic malignant melanoma of the cervical oesophagus. She underwent total laryngopharyngo-oesophagectomy with gastric transposition with bilateral modified radical neck dissection with feeding jejunostomy and a permanent tracheostomy with postoperative combined chemoradiation therapy. However, in spite of aggressive treatment, the patient expired 8 months after initial presentation with distant metastasis. PMID:24729119

  18. Intelligent Screening Systems for Cervical Cancer

    PubMed Central

    Ng, Siew Cheok; Abu Osman, Noor Azuan

    2014-01-01

    Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data. PMID:24955419

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

    Microsoft Academic Search

    Hiroshi Kobayashi; Shin-ichi Kikuchi; Koji Otani; Miho Sekiguchi; Yasufumi Sekiguchi; Shin-ichi Konno

    2010-01-01

    BACKGROUND: In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to

  20. Spinal Column

    MedlinePLUS

    ... vertebrae. The first cervical vertebra is called the atlas and is significantly different from the other vertebrae. ... surface that fits within the ring of the atlas. The curve of the neck is described as ...

  1. Non-destructive evaluation of the effects of combined bisphosphonate and photodynamic therapy on bone strain in metastatic vertebrae using image registration.

    PubMed

    Hojjat, Seyed-Parsa; Won, Emily; Hardisty, Michael R; Akens, Margarete K; Wise-Milestone, Lisa M; Whyne, Cari M

    2011-11-01

    Skeletal metastases most frequently affect the vertebral column and may lead to severe consequences including fracture. Clinical management of skeletal metastases often utilizes a multimodal treatment approach, including bisphosphonates (BPs). Previous work has demonstrated the synergistic potential of photodynamic therapy (PDT) in combination with BP in treating osteolytic disease through structural, histologic, and destructive mechanical testing analyses. Recent work has developed and validated image-based methods that may be used to non-destructively determine mechanical stability in whole bones, and enable their use for additional (i.e. histologic) analysis. In this work we use an intensity-based 3D image registration technique to compare the strain patterns throughout untreated control and BP + PDT treated rnu/rnu rat spinal motion segments with osteolytic metastases. It was hypothesized that the combination treatment will reduce average and maximum strain values and restore the pattern of strain to that of healthy vertebrae. Mean, median, and 90th percentile strains in the control group were significantly higher than the treatment group. High strain areas in both groups were observed around the endplates; in the control group, large areas of high strains were also observed around the lesions and adjacent to the dorsal wall. Absence of high strains adjacent to the dorsal wall (similar to healthy vertebrae) may correspond to a reduced risk of burst fracture following BP + PDT therapy. This study demonstrates the application of non-destructive image analysis to quantify the positive mechanical effects of combined BP + PDT treatment in the metastatic spine. PMID:21818534

  2. Comparison of the elemental composition of different hard parts (otoliths, scales, fin rays, vertebrae and eye lenses) of freshwater fish using ICPMS

    NASA Astrophysics Data System (ADS)

    Kirchmaier, Leo; Irrgeher, Johanna; Prohaska, Thomas; Zitek, Andreas

    2013-04-01

    Elemental and isotopic fingerprints of different hard parts of fish are a powerful tool to gain life history information of individual fish. Most of these structures, like otoliths, scales, fin rays and vertebrae show incremental growth, allowing for a time resolved analysis of this information using e.g. laser ablation-inductively coupled plasma mass spectrometry (LA-ICPMS). Scales and fin-rays serve as important non-lethal alternatives to otoliths. Additional structures without incremental growth such as eye lenses might contain complementary information. However, there is a lack of solid matrix-matched reference materials that are needed to quantify elemental concentrations using LA-ICPMS. In this study we determined the elemental composition ("elemental fingerprint") of otoliths, scales, fin rays, vertebrae and eye lenses from freshwater fish of the Danube catchment using microwave-assisted digestion and solution based inductively coupled plasma mass spectrometry in order to gain information on the natural concentration ranges of various elements of interest in such samples. The investigation has focused on macro (Ca, Mg and P), minor and trace elements (Ba, Cu, Mn, Pb, Sr and Zn). Method validation was performed using the following certified reference materials (CRMs): riverine water (NRC SLRS-5), bone ash (NIST SRM 1400), bone meal (NIST SRM 1486) and fish otolith (NRC FEBS-1). Significant differences in elemental concentrations among different hard parts analyzed were found suggesting that different structures might be suited for a particular research purpose e.g. tracing environmental pollution. Based on this work, the preparation of in-house certified matrix-matched reference materials (co-precipitated hydroxyapatite calibration standards pressed to pellets) is established allowing for the quantification of the elemental concentration on a time resolved level in different hard parts by direct solid sampling via laser.

  3. Inertial loading of the human cervical spine.

    PubMed

    Yoganandan, N; Pintar, F A

    1997-08-01

    While the majority of experimental cervical spine biomechanics research has been conducted using slowly applied forces and/or moments, or dynamically applied forces with contact, little research has been performed to delineate the biomechanics of the human neck under inertial "noncontact" type forces. This study was designed to develop a comprehensive methodology to induce these loads. A minisled pendulum experimental setup was designed to test specimens (such as human cadaver neck) at subfailure or failure levels under different loading modalities including flexion, extension, and lateral bending. The system allows acceleration/deceleration input with varying wave form shapes. The test setup dynamically records the input and output strength information such as forces, accelerations, moments, and angular velocities; it also has the flexibility to obtain the temporal overall and local kinematic data of the cervical spine components at every vertebral level. These data will permit a complete biomechanical structural analysis. In this paper, the feasibility of the methodology is demonstrated by subjecting a human cadaver head-neck complex with intact musculature and skin under inertial flexion and extension whiplash loading at two velocities. PMID:9285335

  4. 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

  5. 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

  6. An intradural cervical chordoma mimicking schwannoma

    PubMed Central

    Samadian, Mohammad; Shafizad, Misagh

    2012-01-01

    Abstract: Chordoma is a relatively rare tumor originating from the embryonic remnants of the notochord. This is an aggressive, slow growing and invasive tumor. It occurs mostly at the two ends of neuroaxis which is more frequent in the sacrococcygeal region. Chordoma in vertebral column is very rare. This tumor is extradural in origin and compresses neural tissues and makes the patient symptomatic. This tumor found extremely rare in the spinal region as an intradural tumor. The present study reports a rare case of intradural chordoma tumor as well as its clinical manifestations and treatment options. Case: The patient was a 50-year-old female presented with 9 months history of progressively worsening neck pain, cervical spine chordoma resembling neurinoma and right arm numbness. Physical examination showed no weakness in her limbs, but she had upward plantar reflex and mild hyperreflexia. In a magnetic resonance imaging (MRI) scan of the cervical spine there was an ill-defined enhancing mass in the posterior aspect of C2-C3 body caused cord compression more severe in right side as well as foraminal scalloping. The patient underwent surgery and after midline posterior cervical incision and paravertebral muscle stripping a laminectomy was performed from C1 through C4 using a high speed drill. Needle biopsy revealed chordoma on frozen section and all of accessible parts of tumor were excised. The gross and microscopic histopathological appearance was consistent with chordoma. Chordomas are malignant tumors that arise from remains of embryonic notochord. These ectopic rests of notochord termed “ecchordosis physaliphora “can be found in approximately 2% of autopsies. These are aggressive, slow growing, locally invasive and destructive tumors those occur in the midline of neuroaxis. They generally thought to account for 2% to 4% of all primary bone neoplasms and 1% to 4% malignant bone neoplasms. They are the most frequent primary malignant spinal tumors after plasmacytomas. The incidence has been estimated to be 0.51 cases per million. The most common location is sacrococcygeal region followed by the clivus. These two locations account for approximately 90% of chordomas. Of the tumors that do not arise in the sacrum or clivus, half occur in the cervical region, with the remainder found in the lumbar or thoracic region, in descending order of frequency. Cervical spine chordomas account for 6% of all cases. Distal metastasis most often occurs in young patients, those with sacrococcygeal or vertebral tumors, and those with atypical histological features. These tumors usually spread to contiguous anatomical structures, but they may be found in distant sites (skin, musculoskeletal system, brain, and other internal organs). Seeding of the tumor has also been reported, and the likely mechanism seems to be tumor cell of contamination during the surgical procedures. The usual radiological findings in chordomas of spine are destructive or lytic lesions with occasional sclerotic changes. They tend to lie anterolateral, rather than dorsal towards the cord, and reportedly known to invade the dura. The midline location, destructive nature, soft tissue mass formation and calcification are the radiological hallmarks of chordomas. Computed Tomography (CT) scan is the best imaging modality to delineate areas of osteolytic, osteosclerotic, or mixed areas of bone destruction.Chordoma is usually known as a hypovascular tumor which grows in a lobulated manner. Septal enhancement which reflects a lobulated growth pattern is seen in both CT and MRI and even in gross examination. Other epidural tumors include neurinoma, neurofibroma, meningioma, neuroblastoma, hemangioma, lymphoma and metastases. Their differentiation from chordoma may be difficult due to the same enhancement pattern on CT and MRI. A dumbbell-shaped chordoma is a rare pathogenic condition. The dumbbell shape is a characteristic finding of neurinomas in spine but in spinal neurinomas extention to transverse foramina has not yet been reported. Although our case mimicked a

  7. Comparative effectiveness of different types of cervical laminoplasty.

    PubMed

    Heller, John G; Raich, Annie L; Dettori, Joseph R; Riew, K Daniel

    2013-10-01

    Study Design?Systematic review. Study Rationale?Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions?The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical laminoplasty? KQ2: In adults with cervical myelopathy from OPLL or spondylosis, are postoperative complications, including pain and infection, different for the use of miniplates versus the use of no plates following laminoplasty? KQ3: Do these results vary based on early active postoperative cervical motion? Materials and Methods?A systematic review of the English-language literature was undertaken for articles published between 1970 and March 11, 2013. Electronic databases and reference lists of key articles were searched to identify studies evaluating (1) open door cervical laminoplasty and French door cervical laminoplasty and (2) the use of miniplates or no plates in cervical laminoplasty for the treatment of cervical spondylotic myelopathy or OPLL in adults. Studies involving traumatic onset, cervical fracture, infection, deformity, or neoplasms were excluded, as were noncomparative studies. Two independent reviewers (A.L.R., J.R.D.) assessed the level of evidence quality using the Grades of Recommendations Assessment, Development and Evaluation system, and disagreements were resolved by consensus. Results?We identified three studies (one of class of evidence [CoE] II and two of CoE III) meeting our inclusion criteria comparing open door cervical laminoplasty with French door laminoplasty and two studies (one CoE II and one CoE III) comparing the use of miniplates with no plates. Data from one randomized controlled trial (RCT) and two retrospective cohort studies suggest no difference between treatment groups regarding improvement in myelopathy. One RCT reported significant improvement in axial pain and significantly higher short-form 36 scores in the French door laminoplasty treatment group. Overall, complications appear to be higher in the open door group than the French door group, although complete reporting of complications was poor in all studies. Overall, data from one RCT and one retrospective cohort study suggest that the incidence of complications (including reoperation, radiculopathy, and infection) is higher in the no plate treatment group compared with the miniplate group. One RCT reported greater pain as measured by the visual analog scale score in the no plate treatment group. There was no evidence available to assess the effect of early cervical motion for open door cervical laminoplasty compared with French door laminoplasty. Both studies comparing the use of miniplates and no plates reported early postoperative motion. Evidence from one RCT suggests that earlier postoperative cervical motion might reduce pain. Conclusion?Data from three comparative studies are not sufficient to support the superiority of open door cervical laminoplasty or French door cervical laminoplasty. Data from two comparative studies are not sufficient to support the superiority of the use of miniplates or no plates following cervical laminoplasty. The overall strength of evidence to support any conclusions is low or insufficient. Thus, the debate continues while opportunity exists for the spine surgery community to resolve these issues with appropriately designed clinical studies. PMID:24436708

  8. Comparative Effectiveness of Different Types of Cervical Laminoplasty

    PubMed Central

    Heller, John G.; Raich, Annie L.; Dettori, Joseph R.; Riew, K. Daniel

    2013-01-01

    Study Design?Systematic review. Study Rationale?Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions?The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical laminoplasty? KQ2: In adults with cervical myelopathy from OPLL or spondylosis, are postoperative complications, including pain and infection, different for the use of miniplates versus the use of no plates following laminoplasty? KQ3: Do these results vary based on early active postoperative cervical motion? Materials and Methods?A systematic review of the English-language literature was undertaken for articles published between 1970 and March 11, 2013. Electronic databases and reference lists of key articles were searched to identify studies evaluating (1) open door cervical laminoplasty and French door cervical laminoplasty and (2) the use of miniplates or no plates in cervical laminoplasty for the treatment of cervical spondylotic myelopathy or OPLL in adults. Studies involving traumatic onset, cervical fracture, infection, deformity, or neoplasms were excluded, as were noncomparative studies. Two independent reviewers (A.L.R., J.R.D.) assessed the level of evidence quality using the Grades of Recommendations Assessment, Development and Evaluation system, and disagreements were resolved by consensus. Results?We identified three studies (one of class of evidence [CoE] II and two of CoE III) meeting our inclusion criteria comparing open door cervical laminoplasty with French door laminoplasty and two studies (one CoE II and one CoE III) comparing the use of miniplates with no plates. Data from one randomized controlled trial (RCT) and two retrospective cohort studies suggest no difference between treatment groups regarding improvement in myelopathy. One RCT reported significant improvement in axial pain and significantly higher short-form 36 scores in the French door laminoplasty treatment group. Overall, complications appear to be higher in the open door group than the French door group, although complete reporting of complications was poor in all studies. Overall, data from one RCT and one retrospective cohort study suggest that the incidence of complications (including reoperation, radiculopathy, and infection) is higher in the no plate treatment group compared with the miniplate group. One RCT reported greater pain as measured by the visual analog scale score in the no plate treatment group. There was no evidence available to assess the effect of early cervical motion for open door cervical laminoplasty compared with French door laminoplasty. Both studies comparing the use of miniplates and no plates reported early postoperative motion. Evidence from one RCT suggests that earlier postoperative cervical motion might reduce pain. Conclusion?Data from three comparative studies are not sufficient to support the superiority of open door cervical laminoplasty or French door cervical laminoplasty. Data from two comparative studies are not sufficient to support the superiority of the use of miniplates or no plates following cervical laminoplasty. The overall strength of evidence to support any conclusions is low or insufficient. Thus, the debate continues while opportunity exists for the spine surgery community to resolve these issues with appropriately designed clinical studies. PMID:24436708

  9. 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

  10. Methylation Patterns of the IFN-? Gene in Cervical Cancer Tissues

    PubMed Central

    Ma, Dong; Jiang, Chunyang; Hu, Xiaoli; Li, Qingzhao; Li, Tingting; Yang, Yanyan; Li, Ou

    2014-01-01

    Objective: To explore the relationship between methylation of interferon gamma (IFN-?) gene and tumorigenesis in cervical cancer tissues, the biopsy specimens of cervical cancer and cervical intraepithelial neoplasia (CIN) (I-III) patients as well as normal controls were collected and analyzed. Methods: The methylation of the IFN-? gene was verified by using methylation-specific PCR and DNA sequencing analysis, and the expression levels of IFN-? mRNA were detected using quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). Results: The methylation rates of the IFN-? gene were significantly higher in cervical cancer tissues (15/43, 34.9%) than those in CIN (3/23, 13.0% of CIN I; 6/39, 15.4% of CIN II/III) and normal cervical tissues (2/43, 4.7%) (P < 0.01). Furthermore, the mRNA expression of IFN-? in cervical tumors with methylation (0.71 ± 0.13, n = 8) was lower than that in those without methylation (1.58 ± 0.32, n = 27) (P < 0.05). Likewise, the IFN-? expression levels in CIN II/III tissues with methylation (0.87 ± 0.16, n = 5) were significantly (P < 0.01) lower compared to those without methylation (2.12 ± 0.27, n = 32). Conclusion: The hypermethylation of IFN-? gene may be related with tumorigenesis of cervical cancer. PMID:25208560

  11. Box-Shape Cervical Expansive Laminoplasty: Clinical and Radiological Outcomes

    PubMed Central

    Park, Hae Gi; Zhang, Ho Yeol

    2014-01-01

    Objective Box-shape cervical expansive laminoplasty is a procedure that utilizes a Miniplate® or Maxpacer® to achieve maximal canal expansion. This method is expected to show much larger canal expansion and good clinical outcome. So we investigated the clinical and radiological outcome of Box-shape cervical expansive laminoplasty. Methods Between June 2008 and July 2013, we performed cervical expansive laminoplasty in 87 and 48 patients using the Box-shape cervical expansive laminoplasty, respectively. We analyzed the clinical results of these operations using the Japanese Orthopedic Association (JOA) scoring system and by assessing the position of intralaminar screws with postoperative computed tomography (CT) at POD-6 months. Results A total of 48 patients with ossification of the posterior longitudinal ligament (OPLL) (36 pts), cervical spondylotic myelopathy (CSM) (12 pts) were enrolled. Overall JOA scores improved from 11.49 to 14.22 at POD-6 months (OPLL: 11.32 -->14.3; CSM: 12-->14). Postoperative CT scans were performed in 39 patients at 177 levels for a total of 354 screws. The malpositioning rate of intralaminar screws was 3.4% and hardware-related neurologic complications did not occur. Conclusion Box-shape cervical expansive laminoplasty creates maximal spinal canal expansion and leads to improved cervical myelopathy. The use of intralaminar screws to fix the remodeled lamina-facet does not represent a significant difficulty. PMID:25346761

  12. Chlamydia trachomatis infection: implications for HPV status and cervical cancer.

    PubMed

    Silva, Jani; Cerqueira, Fátima; Medeiros, Rui

    2014-04-01

    Genital Chlamydia trachomatis (CT) infections have been identified as a major health problem concern. CT is associated with adverse effect on women reproduction and also associated with cervical hypertrophy and induction of squamous metaplasia, providing a possible relationship with human papillomavirus (HPV) infection. Infection by high-risk HPV types is crucial to the pathogenesis of invasive cervical cancer (ICC), but other co-variants/cofactors must be present for the development of malignancy. CT biological effect may damage the mucosal barrier, improving HPV infection, or may interfere in immune response and viral clearance supporting the persistence of HPV infection. Moreover, CT-related chronic cervical inflammation, decrease of lower genital tract antigen-presenting cells, inhibition of cell-mediated immunity, and anti-apoptotic capacity may influence the natural history of HPV infection, namely persistence progression or resolution. Although several epidemiological studies have stated a positive association involving CT and HPV-related cervical neoplastic lesions and/or cervical cancer (CC), the specific role of this bacterium in the pathogenesis of cervical neoplasia has not been completely clarified. The present review summarizes several studies on CT role in cervical cancer and suggests future research directions on HPV and CT interaction. PMID:24346121

  13. Update on prevention and screening of cervical cancer

    PubMed Central

    McGraw, Shaniqua L; Ferrante, Jeanne M

    2014-01-01

    Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals. PMID:25302174

  14. Papillomavirus sequences integrate near cellular oncogenes in some cervical carcinomas

    SciTech Connect

    Duerst, M.; Croce, C.M.; Gissmann, L.; Schwarz, E.; Huebner, K.

    1987-02-01

    The chromosomal locations of cellular sequences flanking integrated papillomavirus DNA in four cervical cell lines and a primary cervical carcinoma have been determined. The two human papillomavirus (HPV) 16 flanking sequences derived from the tumor were localized to chromosomes regions 20pter..-->..20q13 and 3p25..-->..3qter, regions that also contain the protooncogenes c-src-1 and c-raf-1, respectively. The HPV 16 integration site in the SiHa cervical carcinoma-derived cell line is in chromosome region 13q14..-->..13q32. The HPV 18 integration site in SW756 cervical carcinoma cells is in chromosome 12 but is not closely linked to the Ki-ras2 gene. Finally, in two cervical carcinoma cell lines, HeLa and C4-I, HPV 18 DNA is integrated in chromosome 8, 5' of the c-myc gene. The HeLaHPV 18 integration site is within 40 kilobases 5' of the c-myc gene, inside the HL60 amplification unit surrounding and including the c-myc gene. Additionally, steady-state levels of c-myc mRNA are elevated in HeLa and C4-I cells relative to other cervical carcinoma cell lines. Thus, in at least some genital tumors, cis-activation of cellular oncogenes by HPV may be involved in malignant transformation of cervical cells.

  15. Application of the Carolina Framework for Cervical Cancer Prevention

    PubMed Central

    Moss, Jennifer L.; McCarthy, Schatzi H.; Gilkey, Melissa B.; Brewer, Noel T.

    2014-01-01

    Objective The Carolina Framework for Cervical Cancer Prevention describes 4 main causes of cervical cancer incidence: human papillomavirus (HPV) infection, lack of screening, screening errors, and not receiving follow-up care. We present 2 applications of the Carolina Framework in which we identify high-need counties in North Carolina and generate recommendations for improving prevention efforts. Methods We created a cervical cancer prevention need index (CCPNI) that ranked counties on cervical cancer mortality, HPV vaccine initiation and completion, Pap smear screening, and provision of Pap tests to rarely- or never-screened women. In addition, we conducted in-depth interviews with 19 key informants from programs and agencies involved in cervical cancer prevention in North Carolina. Results North Carolina’s 100 counties varied widely on individual CCPNI components, including annual cervical cancer mortality (median 2.7/100,000 women; range 0.0–8.0), adolescent girls’ HPV vaccine initiation (median 42%; range 15%–62%), and Pap testing in the previous 3 years among Medicaid-insured adult women (median 59%; range 40%–83%). Counties with the greatest prevention needs formed 2 distinct clusters in the northeast and south-central regions of the state. Interviews generated 9 recommendations to improve cervical cancer prevention in North Carolina, identifying applications to specific programs and policies in the state. Conclusions This study found striking geographic disparities in cervical cancer prevention need in North Carolina. Future prevention efforts in the state should prioritize high-need regions as well as recommended strategies and applications in existing programs. Other states can use the Carolina Framework to increase the impact of their cervical cancer prevention efforts. PMID:24333357

  16. Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

    PubMed Central

    Kim, Sung-Ha; Park, Man-Young; Lee, Sang-Mi; Jung, Ho-Hyun; Kim, Jae-Kyoun; Lee, Jong-Deok; Kim, Dong-Woung; Yeom, Seung-Ryong; Lim, Jin-Young; Park, Min-Jung; Park, Se-Woon; Kim, Sung-Chul

    2012-01-01

    The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment. PMID:25780641

  17. 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

  18. Identification and validation of genes involved in cervical tumourigenesis

    Microsoft Academic Search

    Thangarajan Rajkumar; Kesavan Sabitha; Neelakantan Vijayalakshmi; Sundersingh Shirley; Mayil Vahanan Bose; Gopisetty Gopal; Ganesharaja Selvaluxmy

    2011-01-01

    Background  Cervical cancer is the most common cancer among Indian women. This cancer has well defined pre-cancerous stages and evolves\\u000a over 10-15 years or more. This study was undertaken to identify differentially expressed genes between normal, dysplastic\\u000a and invasive cervical cancer.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  A total of 28 invasive cervical cancers, 4 CIN3\\/CIS, 4 CIN1\\/CIN2 and 5 Normal cervix samples were studied.

  19. Clinical significance of osteopontin expression in cervical cancer

    Microsoft Academic Search

    HanByoul Cho; Soon Won Hong; Youn Jin Oh; Min A Kim; Eun Suk Kang; Jong Min Lee; Sang Wun Kim; Sung Hoon Kim; Jae Hoon Kim; Young Tae Kim; Kook Lee

    2008-01-01

    Purpose  New diagnostic markers, other than squamous cell carcinoma (SCC) antigen, are needed for the detection of cervical cancer.\\u000a Osteopontin (OPN) is a candidate frequently associated with several human malignancies. The purpose of this study was to evaluate\\u000a the clinical significance of OPN expression as a diagnostic and prognostic biomarker for cervical cancer.\\u000a \\u000a \\u000a \\u000a Methods  Immunohistochemical staining of tissue from 97 cervical cancer

  20. The role of phonophoresis in dyshpagia due to cervical osteophytes

    PubMed Central

    Unlu, Zeliha; Orguc, Sebnem; Eskiizmir, Gorkem; Aslan, Asim; Tasci, Saliha

    2008-01-01

    Objective: Treatment of patients with anterior cervical osteophytes causing dysphagia includes conservative treatment with anti-inflammatory drugs, muscle relaxants, antibiotics, and an appropriate soft diet. Physical therapy with its advantages may be an alternative method in the treatment, which was not reported previously. Case description: Phonophoresis therapy is applied in nine patients with dysphagia due to cervical osteophytes. Results: The symptom of dysphagia regressed in various degrees in all patients after phonophoresis therapy. Conclusions: Phonophoresis might be an alternative method for the non-steroidal anti-inflammatory drug (NSAID) treatment in patients with dysphagia due to cervical osteophytes. PMID:20428400

  1. Cervical spondylodiscitis associated with oesophageal perforation: a rare complication after anterior cervical fusion.

    PubMed

    Korovessis, Panagiotis; Repantis, Thomas; Vitsas, Vasilis; Vardakastanis, Konstantinos

    2013-11-01

    Anterior cervical instrumented fusion is a commonly performed spinal surgery with relatively low complication rate. Especially, spinal infections are very rare and often associated with oesophageal perforation secondary to hardware migration. We present a rare complication of cervical spondylodiscitis in a 24-year-old man after an anterior cervical fusion. He had sustained a C5/C6 fracture dislocation associated with incomplete tetraplegia and he was treated by a combined staged posterior (lateral mass screws) and anterior (plate, PEEK) cervical fusion with an uneventful postoperative course with exception of light dysphagia for liquids. Three months after surgery, the patient developed fever and severe dysphagia. A barium-swallow study was indicative for oesophageal perforation, while MRI of the neck demonstrated spondylodiscitis C5/C6 accompanied by a prevertebral and epidural abscess. The treatment consisted of surgical debridement and evacuation of the abscesses, removal of the anterior spinal implants and insertion of a mesh cage with iliac bone graft. The weakened oesophagus posterior wall was enhanced with resorbable interrupted sutures and a 6-week course of antibiotics was administered. Dysphagia improved significantly while interbody fusion occurred 5 months following revision surgery. Five years postoperatively motor and sensor function had returned to normal limits. Dysphagia or deterioration of preexisted dysphagia in the late postoperative setting should be considered carefully and evaluated for oesophageal perforation and complicated spinal infection. In the case of not completed fusion, removal of the implants followed by meticulous debridement and insertion of titanium mesh cage, filled with autogenous bone graft lead to successful fusion and infection eradication. PMID:23412223

  2. A Meta-Analysis Comparing the Results of Cervical Disc Arthroplasty with Anterior Cervical Discectomy and Fusion (ACDF) for the Treatment of Symptomatic Cervical Disc Disease

    PubMed Central

    Gao, Yu; Liu, Ming; Li, Tao; Huang, Fuguo; Tang, Tingting; Xiang, Zhou

    2013-01-01

    Background: Anterior cervical discectomy and fusion is a standard treatment for symptomatic cervical disc disease, but pseudarthrosis and accelerated adjacent-level disc degeneration may develop. Cervical disc arthroplasty was developed to preserve the kinematics of the functional spinal unit. Trials comparing arthroplasty with anterior cervical discectomy and fusion have shown unclear benefits in terms of clinical results, neck motion at the operated level, adverse events, and the need for secondary surgical procedures. Methods: Only randomized clinical trials were included in this meta-analysis, and the search strategy followed the requirements of the Cochrane Library Handbook. Two reviewers independently assessed the methodological quality of each included study and extracted the relevant data. Results: Twenty-seven randomized clinical trials were included; twelve studies were Level I and fifteen were Level II. The results of the meta-analysis indicated longer operative times, more blood loss, lower neck and arm pain scores reported on a visual analog scale, better neurological success, greater motion at the operated level, fewer secondary surgical procedures, and fewer such procedures that involved supplemental fixation or revision in the arthroplasty group compared with the anterior cervical discectomy and fusion group. These differences were significant (p < 0.05). The two groups had similar lengths of hospital stay, Neck Disability Index scores, and rates of adverse events, removals, and reoperations (p > 0.05). Conclusions: The meta-analysis revealed that anterior cervical discectomy and fusion was associated with shorter operative times and less blood loss compared with arthroplasty. Other outcomes after arthroplasty (length of hospital stay, clinical indices, range of motion at the operated level, adverse events, and secondary surgical procedures) were superior or equivalent to the outcomes after anterior cervical discectomy and fusion. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID:23515991

  3. Human papillomavirus types and recurrent cervical warts

    SciTech Connect

    Nuovo, G.J. (Columbia Presbyterian Medical Center, New York, NY (USA)); Pedemonte, B.M. (Harlem Hospital Medical Center, New York, NY (USA))

    1990-03-02

    The authors analyzed cervical intraepithelial neoplasias (CINs) detected after cryotherapy to determine if recurrence is associated with the same human papillomavirus (HPV) type found in the original lesion. Eight women had detectable HPV DNA in CINs that occurred after ablation of another CIN, and for each patient the HPV type in the pretreatment lesion was different from that in the CIN that appeared after cryotherapy. This compares with 12 women who had HPV detected in two or more CINs present at the same time, 11 of whom had the same HPv type noted. they concluded that although multiple, simultaneous CINs in a woman often contain the same HPV type, recurrent CINs that occur after cryotherapy contain an HPV type different from that present in the pretreatment lesion.

  4. [Cervical abscess caused by Capnocytophaga ochracea].

    PubMed

    Henzen, C; Streit, E

    1993-06-01

    Capnocytophaga is a gram-negative capnophilic bacterium which is part of the normal oral flora of humans (C. ochracea, C. gingivalis, C. sputigena) and mammals such as canines, cats, and rodents (C. animorsus and C. cynodegmi). Its role in the pathogenesis of periodontal disease is not well defined, and normally it represents an opportunistic germ of low pathogenicity. Threatening and fulminant infections have been observed in immunodeficient patients, and lately in immunocompetent hosts. We describe an otherwise healthy woman who developed a cervical abscess due to C. ochracea. Recurrent aphthous lesions are suspected to be the port of entrance for the germs. Bacteriological, clinical, epidemiological, and therapeutic aspects of Capnocytophaga infection are discussed. PMID:8322052

  5. 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.

  6. Extensive cervical necrotizing fasciitis of odontogenic origin.

    PubMed

    Antunes, Antonio Azoubel; Avelar, Rafael Linard; de Melo, Willian Morais; Pereira-Santos, Darklilson; Frota, Riedel

    2013-11-01

    Necrotizing fasciitis (NF) is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. The authors report a case of necrotizing fasciitis from odontogenic origin in a patient with uncontrolled diabetes mellitus. The initial diagnosis was based on clinical information, in which multiple necrosis areas in cervical and thoracic regions were observed. Wide antibiotic therapy was applied, followed by surgical drain age and debridement. Culture was positive for methicillin-resistant Staphylococcus aureus. Although the treatment is established, the patient dies after sepsis and failure of vital organs. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done. PMID:24220476

  7. High prevalence of HPV in non-cervical sites of women with abnormal cervical cytology

    PubMed Central

    2011-01-01

    Background Human papillomaviruses (HPV) are causally associated with ano-genital and a subset of head and neck cancers. Rising incidence of HPV+ anal cancers and head and neck cancers have now been demonstrated in the developed world over the last decade. The majority of published data on HPV prevalence at the anal and oro-pharyngeal sites are from studies of higher-risk populations. There is a paucity of data on the prevalence of HPV at non-cervical sites in lower risk, non-HIV+ women and this study was designed to provide initial pilot data on a population of women recalled for colposcopy as part of the UK cervical screening programme. Methods 100 non-HIV+ women with abnormal cervical cytology, attending clinic for colposcopic examination were recruited. Swabs from the oro-pharyngeal, anal and cervical sites were taken and DNA extracted. HPV detection and genotyping were performed using a standardised, commercially available PCR-line blot assay, which is used to genotype 37 HPV subtypes known to infect the ano-genital and oro-pharyngeal areas. Strict sampling and laboratory precautions were taken to prevent cross-contamination. Results There was a very high prevalence of HPV infection at all three sites: 96.0%, 91.4% and 92.4% at the cervix, anus and oro-pharynx, respectively. Multiple HPV subtype infections were dominant at all 3 mucosal sites. At least one or more HR genotype was present at both the cervix/anus in 39/52 (75.0%) patients; both the cervix/oro-pharynx in 48/56 (85.7%) patients; and both the anus/oro-pharynx in 39/52 (75.0%) patients. HPV 16 infection was highly dominant across all mucosal sites, with over a 2-fold increase over the next most prevalent subtype (HPV 31). Conclusions Women with abnormal smears have widespread infection with high-risk HPV at the cervical, anal and oro-pharyngeal mucosal sites and may represent a higher risk population for HPV disease in the future. PMID:22047498

  8. 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.

  9. Bilateral diaphragmatic paralysis due to cervical chiropractic manipulation.

    PubMed

    John, Seby; Tavee, Jinny

    2015-02-01

    Neck pain from cervical spinal disease is a common problem with significant disability, and chiropractic manipulation has emerged as one of the leading forms of alternative treatment for such spinal symptoms. However, more experience with these forms of treatment has revealed associated complications that are far from benign. Complications range from mild symptoms, such as local neck tenderness or stiffness, to more severe injuries involving the spinal cord, peripheral nerve roots, and arteries within the neck. Phrenic nerve injury causing diaphragmatic palsy is a rare complication of cervical chiropractic manipulation. We report a case of bilateral diaphragmatic paralysis in a healthy gentleman who underwent cervical manipulation. Physicians must be aware of this complication and should be cautious when recommending spinal manipulation for the treatment of neck pain, especially in the presence of preexisting degenerative disease of the cervical spine. PMID:25692510

  10. Breast and Cervical Cancer Prevention and Treatment Act of 2000

    MedlinePLUS

    ... or cervical cancer through a federal screening program. Contacts for More Information NBCCEDP contacts can answer questions ... Listen to audio/podcast Follow us on Twitter Contact Us: Centers for Disease Control and Prevention Division ...

  11. Immune-Based Treatment Shows Promise against Metastatic Cervical Cancer

    Cancer.gov

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  12. 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

  13. Cervical Caps or Diaphragms: Answering Your Patients' Questions

    PubMed Central

    Donlevy, Mary J.

    1987-01-01

    Cervical caps and diaphragms offer a plausible contraceptive alternative for some women. Selection of patients, advantages, disadvantages, and fitting techniques are discussed in order to help answer those difficult patient questions. ImagesFigure 1 PMID:21263962

  14. Fractures of the articular processes of the cervical spine

    SciTech Connect

    Woodring, J.H.; Goldstein, S.J.

    1982-08-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

  15. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Measurements of relative viscoelasticity are intended for use as an adjunct in the clinical evaluation of a female with chronic infertility, to determine the time of ovulation and the penetrability of cervical mucus to motile sperm. (b)...

  16. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Measurements of relative viscoelasticity are intended for use as an adjunct in the clinical evaluation of a female with chronic infertility, to determine the time of ovulation and the penetrability of cervical mucus to motile sperm. (b)...

  17. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Measurements of relative viscoelasticity are intended for use as an adjunct in the clinical evaluation of a female with chronic infertility, to determine the time of ovulation and the penetrability of cervical mucus to motile sperm. (b)...

  18. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Measurements of relative viscoelasticity are intended for use as an adjunct in the clinical evaluation of a female with chronic infertility, to determine the time of ovulation and the penetrability of cervical mucus to motile sperm. (b)...

  19. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Measurements of relative viscoelasticity are intended for use as an adjunct in the clinical evaluation of a female with chronic infertility, to determine the time of ovulation and the penetrability of cervical mucus to motile sperm. (b)...

  20. Injury biomechanics of the human cervical column.

    PubMed

    Yoganandan, N; Sances, A; Pintar, F; Maiman, D J; Reinartz, J; Cusick, J F; Larson, S J

    1990-10-01

    In this study, the authors have developed a technique to replicate clinically relevant traumatic cervical spine injuries and determined the injury biomechanics. Because of the importance of compressive forces in neck injuries, this research was conducted using compression as the primary load vector. Six fresh human cadaveric head-neck complexes were prepared by fixing the distal end in methylmethacrylate. Tests were done with varying loading rates to include quasistatic and dynamic conditions. For quasistatic experiments, the proximal end was fixed to the piston of the testing device. In dynamic tests, the cranium was unconstrained, and to maintain stability, the effects of the spinal musculature were simulated by means of pulleys, deadweights, and springs in the anterior and posterior parts of the head-neck complex. Quasistatic tests conducted at a rate of 2.0 mm/sec produced cervical spine trauma at forces ranging from 1.7 to 2.3 kN, with deformations ranging from 2.2 to 3.7 cm. The specimens were deep-frozen at the level of injury, preserving the local deformation of the tissues to enable a detailed evaluation immediately after the injury. Dynamic tests conducted at velocities of 3.2 to 5.7 m/sec resulted in impact injuries at one level of the head-neck complex. The applied forces at the vertex were considerably higher than those recorded at the distal end. The failure deformations for both the quasistatic (2.2-3.7 cm) and dynamic (1.7-3.2 cm) tests, however, were found to be similar, suggesting that the human head-neck complex is a deformation-sensitive structure. PMID:2263968