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1

Pathogenesis of sciatic pain: role of herniated nucleus pulposus and deformation of spinal nerve root and dorsal root ganglion  

Microsoft Academic Search

The basic pathophysiologic mechanisms related to disc herniation and sciatica are poorly understood. Recently it was demonstrated that nucleus pulposus from an intervertebral disc could induce structural and functional changes in adjacent nerve roots when applied epidurally, however, it is not known if such changes are painful. In a model for inducing disc herniation in the rat, we found that

Kjell Omarker; Robert R. Myers

1998-01-01

2

Spinal balloon nucleoplasty: a hypothetical minimally invasive treatment for herniated nucleus pulposus.  

PubMed

Low back pain is the most common cause of disability under the age of 45. The annual incidence of back pain is estimated to be 5% and the lifetime prevalence is 80%. Majority of the patients with persistent symptoms are suffering from radiculopathy that is mainly caused by a herniated nucleus pulposus (HNP). HNP can heal spontaneously due to spontaneous resorption. Besides pressure nucleus pulposus, without any compression, may induce similar changes when applied epidurally to the nerve roots. Nevertheless, combination of chronic mechanical compression and application of nucleus pulposus causes a more pronounced nerve injury. When dual pathophysiology (pressure and inflammatory reaction), spontaneous resorption, and natural course of HNP are taken into account, any treatment modality that eliminates both the pressure and contact of the nucleus pulposus with the nerve root via creating extra time for healing to take place might prove beneficial. These requirements can be provided by spinal balloon nucleoplasty (SBN), which can be used in combination with other treatment modalities such as chymopapain injection. In this hypothetical method, epidural access to the subarachnoid space is established via epidural needles, thereafter a specially designed balloon tipped catheter is advanced. When the catheter is ideally placed with the help of CT or MRI, the balloon at the tip is inflated to relieve pressure and to prevent contact of the nerve root with HNP. The answer to the question, will SBN find a place in clinical practice? is obscure. But a homology can be established with uterine fibroid embolization, which has found clinical use in a period of 30 years approximately. PMID:18096323

Basaran, Ahmet; Topatan, Sena

2007-12-21

3

Percutaneous endoscopic transforaminal approach to decompress the lateral recess in an elderly patient with spinal canal stenosis, herniated nucleus pulposus and pulmonary comorbidities.  

PubMed

A 70-year-old man with severe pulmonary comorbidities was referred to our institution for treatment of a right L5 nerve impingement. He had suffered from spinal canal stenosis and herniated nucleus pulposus (HNP) at the level of L4-L5 for more than a year and had been treated conservatively. However, the pain could not be alleviated, and his primary care physician scheduled posterior decompression surgery. During this procedure, the anesthesiologist refused to induce general anesthesia because of the patient's very poor pulmonary condition. Subsequently, the patient was referred to us. We used a transforaminal approach with percutaneous endoscopic discectomy, with the patient under local anesthesia. First, herniated nucleus pulposus fragments at the disc level were removed. With a trephine drill, the upper part of the L5 pedicle was removed, which allowed for the extraction of dorsally migrated fragments. Following complete removal of the herniated nucleus pulposus fragments, osseous decompression was performed. The osseous endplate of L5 (anterior part of the lateral recess) was removed to enlarge the lateral recess so that decompression of the L5 nerve root was possible. The patient's lower back pain and right leg pain subsided following surgery. Percutaneous endoscopic discectomy is useful for patients with severe comorbidities as it can be done with local anesthesia. PMID:23601998

Kitahama, Yoshihiro; Sairyo, Koichi; Dezawa, Akira

2013-05-01

4

Identification of novel nucleus pulposus markers  

PubMed Central

Mesenchymal stem-cell based therapies have been proposed as novel treatments for intervertebral disc degeneration, a prevalent and disabling condition associated with back pain. The development of these treatment strategies, however, has been hindered by the incomplete understanding of the human nucleus pulposus phenotype and by an inaccurate interpretation and translation of animal to human research. This review summarises recent work characterising the nucleus pulposus phenotype in different animal models and in humans and integrates their findings with the anatomical and physiological differences between these species. Understanding this phenotype is paramount to guarantee that implanted cells restore the native functions of the intervertebral disc. Cite this article: Bone Joint Res 2013;2:169–78.

Rodrigues-Pinto, R.; Richardson, S. M.; Hoyland, J. A.

2013-01-01

5

Stem cell regeneration of the nucleus pulposus.  

PubMed

Low back pain due to disc degeneration is one of the largest health problems faced in this nation when judged by lost work time and direct as well as indirect costs. Many experimental methods are being explored to treat or to reverse the effect of disc degeneration. This article reviews the strategy of a tissue engineering approach to disc regeneration. Mesenchymal stem cells (MSC) such as those obtained from marrow stroma when exposed to the appropriate microenvironment (hypoxia, growth factor, three dimensional culture) differentiate into nucleus pulposus-like cells. These then may be candidates for transplantation and nucleus repopulation. While the work is in its infancy, there is significant optimism that next steps will lead to organ culture models of disc degeneration and regeneration, and ultimately to in vivo rescue of degenerating discs with stem cell treatment. PMID:15541688

Risbud, Makarand V; Shapiro, Irving M; Vaccaro, Alexander R; Albert, Todd J

6

Fas ligand plays an important role for the production of pro-inflammatory cytokines in intervertebral disc nucleus pulposus cells.  

PubMed

It is suggested that pro-inflammatory cytokines, which are produced by interaction of the intervertebral nucleus pulposus cells and macrophages, may be linked to the cause of pain of the intervertebral disc herniation. This study carries out the in vitro experiments to examine the mechanism, with the use of the co-culture of an immortalized cell line of nucleus pulposus of the human intervertebral disc and the macrophage cell line. As a result, it is found that the production of pro-inflammatory cytokines is significantly larger at the co-culture group than at the independent culture group. Also, at the co-culture group of macrophages and intervertebral nucleus pulposus cells with over-expression of fas ligand (FasL), the production of pro-inflammatory cytokines is found to be far larger. Furthermore, it is found that these pro-inflammatory cytokines are produced mainly by the intervertebral nucleus pulposus cells with over-expression of FasL, and that the expression of a disintegrin and metalloproteinase (ADAM) 10, which controls the expression of FasL and activates reverse signaling inside cells, also increases. From these findings, it is suggested that FasL and ADAM10 play an important role in the production of pro-inflammatory cytokines coming from interaction of the intervertebral nucleus pulposus cells and macrophages. PMID:23192951

Yamamoto, Junya; Maeno, Koichiro; Takada, Toru; Kakutani, Kenichiro; Yurube, Takashi; Zhang, Zhongying; Hirata, Hiroaki; Kurakawa, Takuto; Sakai, Daisuke; Mochida, Joji; Doita, Minoru; Kurosaka, Masahiro; Nishida, Kotaro

2012-11-28

7

Effects of hypoxias and scaffold architecture on rabbit mesenchymal stem cell differentiation towards a nucleus pulposus-like phenotype  

Microsoft Academic Search

Nucleus pulposus grafts are needed for patients requiring replacement of their degenerated intervertebral discs. Bone marrow-derived mesenchymal stem cells (MSCs) are a potential autologous stem cell source for the nucleus pulposus regeneration. One of the key issues of constructing functional nucleus pulposus using MSCs, however, is to differentiate MSCs into nucleus pulposus phenotype in vitro and to maintain their phenotypic stability

Ganjun Feng; Xiaobing Jin; Jiang Hu; Haiyun Ma; Melanie J. Gupte; Hao Liu; Peter X. Ma

2011-01-01

8

Development of injectable hydrogels for nucleus pulposus replacement  

NASA Astrophysics Data System (ADS)

Intervertebral disc degeneration has been reported as the underlying cause for 75% of cases of lower back pain and is marked by dehydration of the nucleus pulposus within the intervertebral disc. There have been many implant designs to replace the nucleus pulposus. Some researchers have proposed the replacement of the nucleus pulposus with hydrogel materials. The insertion of devices made from these materials further compromises the annulus of the disc. An ideal nucleus replacement could be injected into the disc space and form a solid in vivo. However, injectable replacements using curing elastomers and thermoplastic materials are not ideal because of the potentially harmful exothermic heat evolved from their reactions and the toxicity of the reactants used. We propose a hydrogel system that can be injected as a liquid at 25°C and solidified to yield a hydrogel within the intervertebral disc at 37°C. In aqueous solutions, these polymers have Lower Critical Solution Temperatures (LCST) between 25-37°C, making them unique candidate materials for this application. Poly(N-isopropylacrylamide) (PNIPAAm) is the most widely studied LCST polymer due to its drastic transition near body temperature. However, by itself, pure PNIPAAm forms a hydrogel that has low water content and can readily undergo plastic deformation. To increase the water content and impart elasticity to PNIPAAm hydrogels, grafted and branched hydrogel systems were created that incorporated the thermogelling PNIPAAm and hydrophilic poly(ethylene glycol) (PEG). In this research, the effects of polymer composition and monomer to initiator ratio, which controls polymer MW, on the in vitro swelling properties (mass, chemical, and compressive mechanical stability) of hydrogels formed from aqueous solutions of these polymers were evaluated. Immersion studies were also conducted in solutions to simulate the osmotic environment of the nucleus pulposus. The effects of repeated compression and unloading cycles on the water content and dimensional recovery of hydrogels made from three candidate polymer formulations were also determined. Unlike PNIPAAm and PEG grafted PNIPAAm hydrogels, PEG branched hydrogels have covalently linked networks. Addition of 7 mol% PEG branches to PNIPAAm resulted in a hydrogel with a higher water content and better elastic recovery than hydrogels made from pure PNIPAAm. PEG branched PNIPAAm hydrogels were shown to have mass, chemical, and compressive mechanical stability in vitro. Furthermore, these hydrogels showed superior dimensional recovery after compressive cycling than pure PNIPAAm and PEG grafted PNIPAAm hydrogels. The 7 mol% PEG branched PNIPAAm hydrogels have suitable swelling and mechanical properties to potentially serve as a nucleus pulposus replacement.

Thomas, Jonathan D.

9

Development and characterization of novel hydrogels for nucleus pulposus replacement  

NASA Astrophysics Data System (ADS)

Hydrogels have been proposed as candidates for nucleus pulposus replacement due to their similarity in mechanical behavior to the native tissue when subjected to transient or static loading; however, given the viscoelastic nature of soft biological tissues, the lack of dynamic testing is a significant inadequacy in the studies performed to date. Our goal was to identify hydrogel systems whose viscoelastic behavior, particularly under dynamic torsional shear, mimicked that of the native tissue. Hydrogels were formed via photopolymerization of glycidyl methacrylate and 1,2-epoxy-5-hexene modified poly(vinyl alcohol) and were allowed to equilibrate in Hank's solution prior to analysis. The viscoelastic behavior of all prepared materials was compared with that of sheep nucleus pulposi. Complex shear moduli and phase shift angles were determined from dynamic frequency sweeps in torsional shear. Resistance towards hydrolysis was assessed by evaluation of the viscoelastic behavior of hydrogels submerged in Hank's solution for progressively longer periods of time. For glycidyl methacrylate-PVA hydrogels the viscoelastic parameters could be modulated by varying the molecular weight of PVA and the concentration of polymer prior to photopolymerization. The mechanical behavior of 1,2-epoxy-5-hexene-PVA hydrogels could be regulated in a similar manner by altering the type and percentage of monomer used to induce polymerization. The phase shift angles of all hydrogels were lower than those of the nucleus pulposi; however, the complex shear moduli of both synthetic systems spanned the values observed for the natural system. Over the time frame of the experiment, no change in moduli was observed following submersion in Hank's solution. This study represents the first attempt to successfully mimic the viscoelastic nature of the nucleus pulposus exhibited under dynamic torsional loading with that of materials intended for use in tissue replacement.

Bader, Rebecca Ann

10

Influence of intradiscal medication on nucleus pulposus cells.  

PubMed

BACKGROUND CONTEXT: Eugene Carragee was the first to prove that provocative discography may contribute to intervertebral disc degeneration. Disc degeneration can be induced either by mechanical trauma caused by the puncturing needle or as a pharmacological effect of the drugs instilled into the disc. PURPOSE: The aim of this study was to test the influence of cortisone, lidocaine, and iopamidol on nucleus pulposus cells under an in vitro setting. STUDY DESIGN: Controlled in vitro study is the design type. METHODS: The nucleus pulposus was excised from 12 bovine tail intervertebral discs and monolayer cell cultures were generated. The cultures were divided into four sample groups and incubated in either standard cell culture medium (control group) or medium supplemented with the test substances. The dose rate was adapted based on a total dose of 3 mL iopamidol, 1 mL lidocaine, and 10 mg cortisone per nucleus pulposus. Cell count, viability, proliferation, and differentiation features were analyzed. The study was supported by DePuy. No conflicts of interest arise from this support. RESULTS: After 24 hours, a significant decrease in cell counts was observed in all three test groups. Population doubling time was 16 hours in the control group cultured in standard medium and increased to 21 hours (cortisone), 25 hours (iopamidol), and 38 hours (lidocaine) after incubation in discography medication (p<.001). Cell viability was slightly, but not significantly decreased in all medication groups. Cells incubated in Lidocaine were significantly smaller (p<.01) and showed clearly reduced pseudopodia formation. Incubation in lidocaine and iopamidol also significantly reduced glycosaminoglycan synthesis. CONCLUSION: Although only a small decrease in cell viability was observed in all three substances tested, cell count and proliferation decreased significantly. Incubation in lidocaine inhibited pseudopodia formation and might therefore interfere with intercellular signalling and cell migration. Glycosaminoglycan synthesis was significantly decreased after contact with lidocaine as well as Iopamidol. These observations suggest that all three medications tested might interfere with biological repair mechanisms of the intervertebral disc and therefore contribute to a further degeneration. PMID:23608563

Eder, Claudia; Pinsger, Astrid; Schildboeck, Sabrina; Falkner, Erwin; Becker, Philipp; Ogon, Michael

2013-04-19

11

Differentiation of mesenchymal stem cells into nucleus pulposus cells in vitro  

Microsoft Academic Search

Summary  To find a new source of seed cells for constructing tissue-engineered intervertebral disc, nucleus pulposus (NP) cells and\\u000a mesenchymal stem cells (MSCs) were isolated from New Zealand white rabbits. The nucleus pulposus cells population was fluorescence-laelled\\u000a and co-cultured with MSCs with or without direct contact. Morphological changes were observed every 12 h. Semi-quantitative\\u000a reverse transcriptase-polymerase chain reaction was performed to

Fenghua Tao; Feng Li; Guanghui Li; Feng Pan

2008-01-01

12

Effects of hypoxias and scaffold architecture on rabbit mesenchymal stem cell differentiation towards a nucleus pulposus-like phenotype.  

PubMed

Nucleus pulposus grafts are needed for patients requiring replacement of their degenerated intervertebral discs. Bone marrow-derived mesenchymal stem cells (MSCs) are a potential autologous stem cell source for the nucleus pulposus regeneration. One of the key issues of constructing functional nucleus pulposus using MSCs, however, is to differentiate MSCs into nucleus pulposus phenotype in vitro and to maintain their phenotypic stability in vivo. In this study, three-dimensional (3D) nanofibrous poly(l-lactide) (PLLA) scaffolds were seeded with multi-potent rabbit MSCs and the constructs were induced along nucleus pulposus development routes in a hypoxia chamber (2% O(2)) in the presence of TGF-?1. It was found that nanofibrous scaffold could support the differentiation of rabbit MSCs towards a nucleus pulposus-like phenotype in vitro, as evidenced by upregulated expression of a few important nucleus pulposus-associated genes (aggrecan, type II collagen and Sox-9), abundant deposition of extracellular matrix (glycosaminoglycan (GAG) and type II collagen), and the continuous expression of the nucleus pulposus-specific marker, hypoxia-inducible factor (HIF)-1?. The subcutaneous implantation results confirmed that hypoxic induction before implantation could help the constructs to retain their phenotype and resist calcification in vivo. Therefore, the above data showed the promise of using 3D nanofibrous scaffolds in combination with TGF-?1 and hypoxic induction to regenerate functional nucleus pulposus grafts for intervertebral disc replacement. PMID:21839506

Feng, Ganjun; Jin, Xiaobing; Hu, Jiang; Ma, Haiyun; Gupte, Melanie J; Liu, Hao; Ma, Peter X

2011-08-11

13

The effects of oxygen tension and antiaging factor Klotho on Wnt signaling in nucleus pulposus cells  

PubMed Central

Introduction The goals of this study were to examine the oxemic regulation of Wnt signaling to explore whether Wnt signaling accelerates the age-related degeneration of nucleus pulposus cells, and if so, to define the mechanism underlying this effect. We investigated the expression of Klotho, a newly identified antiaging gene, and whether its regulation is attributable to the suppression of Wnt signaling. Methods Rat nucleus pulposus cells were cultured under normoxic (21% O2) or hypoxic (2% O2) conditions, and the expression and promoter activity of Wnt signaling and Klotho were evaluated. The effect of Klotho protein was examined with transfection experiments, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, senescence-associated ?-galactosidase staining, and cell-cycle analysis. To determine the methylation status of the Klotho promoter region, bisulfite genomic sequencing analysis was performed. Its relation with the activation of Wnt signaling was assessed. We also examined whether the expression of Klotho could block the effects of pathological Wnt expression in nucleus pulposus cells. Results Nucleus pulposus cells exhibited increased ?-catenin mRNA and protein under the hypoxic condition. Klotho protein was expressed in vivo, and protein and messenger RNA expression decreased under the hypoxic condition. Klotho treatment decreased cell proliferation and induced the quiescence of nucleus pulposus cells. In addition, Klotho treatment inhibited expression of ?-catenin gene and protein compared with untreated control cells. Conclusions These data indicate that Wnt signaling and Klotho form a negative-feedback loop in nucleus pulposus cells. These results suggest that the expression of Klotho is regulated by the balance between upregulation and downregulation of Wnt signaling.

2012-01-01

14

Identification of transglutaminase substrates from porcine nucleus pulposus as potential amplifiers in cross-linking cell scaffolds.  

PubMed

Nucleus pulposus from the porcine intervertebral disc was separated chromatographically to discover substrates of microbial transglutaminase. Highly purified proteins were prepared, among them type II collagen, the major protein of the nucleus pulposus. Determination of substrates was performed by transglutaminase-mediated incorporation of biotinylated probes displaying several glutamine and lysine donor proteins. Type II collagen was only labeled if smaller nucleus pulposus proteins were present. One of the modulating proteins was serotransferrin, a lysine donor substrate of bacterial transglutaminase. An additional substrate was the carboxy-terminal propeptide of type II collagen, chondrocalcin. Chondrocalcin, a regulator of type II collagen fibrillogenesis, occurs abundantly in juvenile cartilage and nucleus pulposus. Accordingly, the protein may be regarded as an excellent additive for the preparation of injectable stem cells in nucleus pulposus-like matrices cross-linked by microbial transglutaminase. PMID:23495872

Gebauer, Elke; Goßla, Elke; Kwas, Carolin; Salzig, Denise; Schmiermund, Alexandra; Czermak, Peter; Fuchsbauer, Hans-Lothar

2013-03-29

15

Current Developments in Tissue Engineering of Nucleus Pulposus for the Treatment of Intervertebral Disc Degeneration  

Microsoft Academic Search

The main cause for back pain is considered to be the degenerative changes in the intervertebral disc (IVD). Some evidence indicates that IVD degeneration originates from the nucleus pulposus (NP). The IVD does not possess self repair capacity. Current treatment options range from pain management to invasive procedures. The science of disc cell transplantation is still in its infancy. Advancement

Immanuel M. Sebastine; David J. Williams

2007-01-01

16

MiR-27a Regulates Apoptosis in Nucleus Pulposus Cells by Targeting PI3K  

PubMed Central

The precise role of apoptosis in the pathogenesis of intervertebral disc degeneration (IDD) remains to be elucidated. We analyzed degenerative nucleus pulposus (NP) cells and found that the expression of miR-27a was increased. The overexpression of miR-27a was further verified using real-time RT-PCR. Bioinformatics target prediction identified phosphoinositide-3 kinases (PI3K) as putative targets of miR-27a. Furthermore, miR-27a inhibited PI3K expression by directly targeting their 3’-UTRs, and this inhibition was abolished by mutation of the miR-27a binding sites. Various cellular processes including cell growth, proliferation, migration and adhesion are regulated by activation of the PI3K/AKT signaling pathway, and nucleus pulposus cells are known to strongly express the phosphorylated survival protein AKT. Our results identify PI3K as a novel target of miR-27a. Upregulation of miR-27a thus targets PI3K, initiating apoptosis of nucleus pulposus cells. This present study revealed that downregulated miR-27a might develop a novel intervention for IDD treatment through the prevention of apoptosis in Nucleus pulposus Cells.

Chen, Huajiang; Yuan, Wen; Wang, Jianxi; Tang, Xianye

2013-01-01

17

Notochordal Cells Interact with Nucleus Pulposus Cells: Regulation of Proteoglycan Synthesis  

Microsoft Academic Search

The disappearance of notochordal cells is correlated with early degenerative changes in the intervertebral disc. With increased disc degeneration there is a marked decrease in proteoglycan synthesis, resulting in loss of mechanical function. One possible mechanism for the decrease in proteoglycan synthesis is the loss of notochordal cells from the tissue. In this study, nucleus pulposus cells cocultured with notochordal

Dean J. Aguiar; Sandra L. Johnson; Theodore R. Oegema

1999-01-01

18

Fas/FasL interaction of nucleus pulposus and cancer cells with the activation of caspases.  

PubMed

Spinal metastatic disease is characterised by the preservation of the intervertebral disc structure, even after severe destruction of the vertebral body by neoplastic tissues. Anatomical features of the discs are thought to be the reason for the disc's resistance to metastatic cancer. However, little is known about the biochemical mechanism to prevent or attenuate the local invasion of cancer cells into the discs. The purpose of this study was to investigate the hypothesis that Fas ligand (FasL) produced by nucleus pulposus cells can kill Fas-expressing cancer cells infiltrating into the discs by the activation of caspases. Fas-expressing MCF-7 breast cancer cells were cultured with (experimental group) and without (control group) supernatant of nucleus pulposus cells containing FasL (50 pg/ml) for 48 h. The apoptosis of MCF-7 breast cancer cells was determined by the TUNEL technique. In addition, the activation of caspase-8, -9 and -3 was investigated by Western blot analysis. After treatment with supernatant of the nucleus pulposus cells containing FasL, the apoptosis of MCF-7 breast cancer cells was significantly increased, along with the activation of caspase-8, -9 and -3 compared with those of the control group. Our results suggest that the Fas/FasL interaction of nucleus pulposus and cancer cells might be a potential mechanism of the disc's resistance to metastatic cancer. PMID:17589843

Park, Jong-Beom; Lee, Jin-Kyung; Park, Eun-Young; Riew, K Daniel

2007-06-23

19

Fas/FasL interaction of nucleus pulposus and cancer cells with the activation of caspases  

PubMed Central

Spinal metastatic disease is characterised by the preservation of the intervertebral disc structure, even after severe destruction of the vertebral body by neoplastic tissues. Anatomical features of the discs are thought to be the reason for the disc’s resistance to metastatic cancer. However, little is known about the biochemical mechanism to prevent or attenuate the local invasion of cancer cells into the discs. The purpose of this study was to investigate the hypothesis that Fas ligand (FasL) produced by nucleus pulposus cells can kill Fas-expressing cancer cells infiltrating into the discs by the activation of caspases. Fas-expressing MCF-7 breast cancer cells were cultured with (experimental group) and without (control group) supernatant of nucleus pulposus cells containing FasL (50 pg/ml) for 48 h. The apoptosis of MCF-7 breast cancer cells was determined by the TUNEL technique. In addition, the activation of caspase-8, -9 and -3 was investigated by Western blot analysis. After treatment with supernatant of the nucleus pulposus cells containing FasL, the apoptosis of MCF-7 breast cancer cells was significantly increased, along with the activation of caspase-8, -9 and -3 compared with those of the control group. Our results suggest that the Fas/FasL interaction of nucleus pulposus and cancer cells might be a potential mechanism of the disc’s resistance to metastatic cancer.

Lee, Jin-Kyung; Park, Eun-Young; Riew, K. Daniel

2007-01-01

20

Local application of nucleus pulposus induces expression OF P2X3 in rat dorsal root ganglion cells.  

PubMed

The P2X(3) receptor is a ligand-gated cation channel that is activated by extra cellular adenosine triphosphate (ATP) found in the dorsal root, trigeminal and nodose ganglia. It is one of the receptors transmitting nociceptive information of injuries and inflammation of the periphery by endogenous ATP released from damaged cells. The present study was performed in order to evaluate if there was an increased expression of P2X(3)-immunoreactivity in dorsal root ganglion (DRG) neurons after experimental disc herniation. There were four groups: exposure of the left L4 dorsal root ganglion and incision of the L4-L5 disc, exposure and slight displacement of the left L4 dorsal ganglion, sham exposure of the L4 dorsal root ganglion, and normal. Seven days after surgery, the DRG's were collected, sectioned and stained immunohistochemically for the P2X(3) receptor. The expression of P2X(3) increased significantly following incision of the L4-5 disc compared to the normal group. Sham surgery induced a minor, although statistically significant increase. Mechanical displacement did not induce any increased expression of the receptors. The study demonstrates that expression of the P2X(3)receptors in the DRG may be induced by local application of nucleus pulposus. This may increase our understanding of the pathophysiologic mechanisms related to disc herniation and sciatica. PMID:22790888

Takahashi Sato, Kaoru; Satoh, Koichiro; Sekiguchi, Miho; Kikuchi, Shin-ichi; Konno, Shin-ichi; Murakawa, Masahiro; Rydevik, Björn; Olmarker, Kjell

2012-01-01

21

Differentiation of mesenchymal stem cells towards a nucleus pulposus-like phenotype utilizing simulated microgravity In vitro  

Microsoft Academic Search

Summary  Mesenchymal stem cells (MSCs) were induced into a nucleus pulposus-like phenotype utilizing simulated microgravity in vitro in order to establish a new cell-based tissue engineering treatment for intervertebral disc degeneration. For induction of\\u000a a nucleus pulposus-like phenotype, MSCs were cultured in simulated microgravity in a chemically defined medium supplemented\\u000a with 0 (experimental group) and 10 ng\\/mL (positive control group) of

Wei Luo; Wei Xiong; Min Qiu; Yongwei Lv; Yong Li; Feng Li

2011-01-01

22

Activation of rat nucleus pulposus cells by coculture with whole bone marrow cells collected by the perfusion method.  

PubMed

Cell proliferation and matrix synthesis were compared for rat nucleus pulposus cells cocultured with mesenchymal stem cells (MSCs) or fresh whole bone marrow cells (BMCs), harvested by the perfusion or aspiration methods. Nucleus pulposus cells were isolated from tail intervertebral discs of F344/slc rats, and BMCs were obtained from femora. Proteoglycan synthesis, DNA synthesis, and aggrecan mRNA expression were measured. The level of transforming growth factor-beta in supernatants from the culture system was also measured. Cell number, aggrecan mRNA expression, and uptake of [(35)S]-sulfate and [(3)H]-thymidine by nucleus pulposus cells cocultured with fresh whole BMCs all increased significantly compared with nucleus pulposus cells cocultured with MSCs. TGF-beta secreted by nucleus pulposus cells cocultured with fresh whole BMCs also significantly increased when compared with cocultures with MSCs. The perfusion method was superior to the aspiration method for preventing contamination of BMCs with peripheral red blood cells and lymphocytes, which may cause an autoimmune response in the disc. In conclusion, we suggest that fresh whole BMCs harvested by the perfusion method are more effective for increasing the proliferative and matrix synthesis capacity of nucleus pulposus cells. PMID:18752275

Umeda, Masayuki; Kushida, Taketoshi; Sasai, Kunihiko; Asada, Taku; Oe, Kenichi; Sakai, Daisuke; Mochida, Joji; Ikehara, Susumu; Iida, Hirokazu

2009-02-01

23

Fabrication of a Layered Microstructured Polymeric Microspheres as a Cell Carrier for Nucleus Pulposus Regeneration  

Microsoft Academic Search

This study aimed to investigate the feasibility of nanostructured 3D poly(lactide-co-glycolide) (PLGA) constructs, which are loaded with dexamethasone (DEX) and growth factor embedded hepaiin\\/poly(L-lysine) nanoparticles by a layer-by-layer system, to serve as an effective scaffold for nucleus pulposus (NP) tissue engineering. Our results demonstrated that the microsphere constructs were capable of simultaneously releasing basic fibroblast growth factor and DEX with

Chengzhen Liang; Hao Li; Chan Li; Zhiru Yang; Xiaopeng Zhou; Yiqing Tao; Yuxiang Xiao; Fangcai Li; Qixin Chen

2012-01-01

24

Notochordal cell conditioned medium stimulates mesenchymal stem cell differentiation toward a young nucleus pulposus phenotype  

Microsoft Academic Search

Introduction  Mesenchymal stem cells (MSCs) offer promise for intervertebral disc (IVD) repair and regeneration because they are easily\\u000a isolated and expanded, and can differentiate into several mesenchymal tissues. Notochordal (NC) cells contribute to IVD development,\\u000a incorporate into the nucleus pulposus (NP), and stimulate mature disc cells. However, there have been no studies investigating\\u000a the effects of NC cells on adult stem

Casey L Korecki; Juan M Taboas; Rocky S Tuan; James C Iatridis

2010-01-01

25

Mesenchymal Stem Cell and Nucleus Pulposus Cell Coculture Modulates Cell Profile  

Microsoft Academic Search

Spontaneous cell fusion can occur in cocultured stem cells. We examined whether telomerase activity change and cell fusion\\u000a occurred in mesenchymal stem cell (MSC) and nucleus pulposus cell (NPC) coculture. MSCs and NPCs were labeled with PKH26 and\\u000a PKH67 dyes and cocultured at a 50:50 ratio. An equal number of MSCs or NPCs were used as the control. After 14 days,

Chi-Chien Niu; Li-Jen Yuan; Song-Shu Lin; Lih-Huei Chen; Wen-Jer Chen

2009-01-01

26

Potential of co-culture of nucleus pulposus mesenchymal stem cells and nucleus pulposus cells in hyperosmotic microenvironment for intervertebral disc regeneration.  

PubMed

Nucleus pulposus mesenchymal stem cells (NPMSCs) are a potential cell source for intervertebral disc (IVD) regeneration, but little is known about their response to IVD-like high osmolarity (400 mOsm). This study was to investigate the viability, proliferation and protein biosynthesis of nucleus pulposus cells (NPCs), NPMSCs and co-cultured NPMSCs-NPCs under IVD-like high osmolarity conditions. NPCs and NPMSCs were isolated and cultured under standard and IVD-like high osmolarity conditions for 1 or 2 weeks. Cell viability was measured by annexin V-FITC and PI staining, and cell proliferation measured by MTT assay. The expression of SOX-9, aggrecan and collagen-II was measured by RT-PCR and Western blot analyses. IVD-like high osmolarity condition slightly inhibited cell viability and decreased the expression of SOX-9, aggrecan and collagen-II at the mRNA and protein levels in all groups compared with standard condition. NPMSCs could tolerate IVD-like high osmolarity, and NPCs-NPMSCs co-culture increased cell proliferation and the expression of SOX-9, aggrecan and collagen-II under both culture conditions, suggesting that co-culture of NPMSCs-NPCs has potential application for IVD regeneration. PMID:23554141

Tao, Yi-Qing; Liang, Cheng-Zhen; Li, Hao; Zhang, Yu-Jie; Li, Fang-Cai; Chen, Gang; Chen, Qi-Xin

2013-04-18

27

Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral disc  

PubMed Central

Despite the high prevalence of intervertebral disc disease, little is known about changes in intervertebral disc cells and their regenerative potential with ageing and intervertebral disc degeneration. Here we identify populations of progenitor cells that are Tie2 positive (Tie2+) and disialoganglioside 2 positive (GD2+), in the nucleus pulposus from mice and humans. These cells form spheroid colonies that express type II collagen and aggrecan. They are clonally multipotent and differentiated into mesenchymal lineages and induced reorganization of nucleus pulposus tissue when transplanted into non-obese diabetic/severe combined immunodeficient mice. The frequency of Tie2+ cells in tissues from patients decreases markedly with age and degeneration of the intervertebral disc, suggesting exhaustion of their capacity for regeneration. However, progenitor cells (Tie2+GD2+) can be induced from their precursor cells (Tie2+GD2?) under simple culture conditions. Moreover, angiopoietin-1, a ligand of Tie2, is crucial for the survival of nucleus pulposus cells. Our results offer insights for regenerative therapy and a new diagnostic standard.

Sakai, Daisuke; Nakamura, Yoshihiko; Nakai, Tomoko; Mishima, Taishi; Kato, Shunichi; Grad, Sibylle; Alini, Mauro; Risbud, Makarand V.; Chan, Danny; Cheah, Kathryn S.E.; Yamamura, Ken-ichi; Masuda, Koichi; Okano, Hideyuki; Ando, Kiyoshi; Mochida, Joji

2012-01-01

28

Difference in Energy Metabolism of Annulus Fibrosus and Nucleus Pulposus Cells of the Intervertebral Disc  

PubMed Central

Low back pain is associated with intervertebral disc degeneration. One of the main signs of degeneration is the inability to maintain extracellular matrix integrity. Extracellular matrix synthesis is closely related to production of adenosine triphosphate (i.e. energy) of the cells. The intervertebral disc is composed of two major anatomical regions: annulus fibrosus and nucleus pulposus, which are structurally and compositionally different, indicating that their cellular metabolisms may also be distinct. The objective of this study was to investigate energy metabolism of annulus fibrosus and nucleus pulposus cells with and without dynamic compression, and examine differences between the two cell types. Porcine annulus and nucleus tissues were harvested and enzymatically digested. Cells were isolated and embedded into agarose constructs. Dynamically loaded samples were subjected to a sinusoidal displacement at 2 Hz and 15% strain for 4 h. Energy metabolism of cells was analyzed by measuring adenosine triphosphate content and release, glucose consumption, and lactate/nitric oxide production. A comparison of those measurements between annulus and nucleus cells was conducted. Annulus and nucleus cells exhibited different metabolic pathways. Nucleus cells had higher adenosine triphosphate content with and without dynamic loading, while annulus cells had higher lactate production and glucose consumption. Compression increased adenosine triphosphate release from both cell types and increased energy production of annulus cells. Dynamic loading affected energy metabolism of intervertebral disc cells, with the effect being greater in annulus cells.

Salvatierra, Jessica Czamanski; Yuan, Tai Yi; Fernando, Hanan; Castillo, Andre; Gu, Wei Yong; Cheung, Herman S.; Huant, C.-Y. Charles

2011-01-01

29

Mechanical Compression and Nucleus Pulposus Application on Dorsal Root Ganglia Differentially Modify Evoked Neuronal Activity in the Thalamus  

PubMed Central

Abstract A combination of mechanical compression caused by a protruding disc and leakage of nucleus pulposus (NP) from the disc core is presumed to contribute to intervertebral disc hernia-related pain. Experimental models of disc hernia including both components have resulted in changes in neuronal activity at the level of the dorsal root ganglion (DRG) and spinal cord, but changes within the brain have been less well studied. However, acute application of NP to a DRG without mechanical compression rapidly increases neuronal activity in the thalamus, a major brain relay nucleus processing information from sensory pathways including ascending nociceptive tracts. The combination of mechanical compression and NP might therefore result in further increases in central neuronal activity. Using an experimental disc herniation rat model including both mechanical compression and NP the present study aimed to investigate changes in neuronal activity in the contralateral thalamic ventral posterior lateral nucleus in vivo. Measurements were obtained while electrically stimulating the ipsilateral sciatic nerve at A? fiber intensities. The L4 DRG was subjected to light mechanical compression and NP exposure, and acute changes in evoked thalamic responses were recorded for up to 40?min. In order to compare effects in naïve animals with effects following a longer period of NP exposure, animals that were either disc-punctured or sham-operated 24?h previously were also included. In all animals, light mechanical compression of the DRG depressed the number of evoked neuronal responses. Prior NP exposure resulted in less potent changes following mechanical compression (80% of baseline) than that observed in naïve animals (50%). During the subsequent NP application, the number of evoked responses compared to baseline increased in pre-exposed animals (to 87%) as well as in naïve animals (72%) in which the removal of the mechanical compression resulted in a further increase (106%). The contribution of acute DRG compression and disc material leakage to changes in transmission in central neuronal networks is likely to be complex and to involve both short-term and long-term effects. Since a light mechanical compression may reduce transmission in nociceptive pathways, it is possible that the presence or absence of NP is crucial for pain development in the acute phase of disc herniation.

Nilsson, Elin; Brisby, Helena; Rask, Katarina

2013-01-01

30

Identification of Nucleus Pulposus Precursor Cells and Notochordal Remnants in the Mouse: Implications for Disk Degeneration and Chordoma Formation  

PubMed Central

A classically identified “notochordal” cell population in the nucleus pulposus is thought to regulate disk homeostasis. However, the embryonic origin of these cells has been under dispute for >60 years. Here we provide the first direct evidence that all cell types in the adult mouse nucleus pulposus are derived from the embryonic notochord. Additionally, rare isolated embryonic notochord cells remained in the vertebral column and resembled “notochordal remnants,” which in humans have been proposed to give rise to a rare type of late-onset cancer called chordoma. Previously, this cell type had not been identified in the mouse model system. The development and characterization of a mouse model that can be used to fate map nucleus pulposus precursor cells in any mutant background will be useful for uncovering the cellular and molecular mechanisms of disk degeneration. In addition, the identification of notochordal remnants in mice is the first step towards generating an in vivo model of chordoma.

Choi, Kyung-Suk; Cohn, Martin J.; Harfe, Brian D.

2009-01-01

31

Intradiscal transplantation of synovial mesenchymal stem cells prevents intervertebral disc degeneration through suppression of matrix metalloproteinase-related genes in nucleus pulposus cells in rabbits  

PubMed Central

Introduction Synovial mesenchymal stem cells (MSCs) have high proliferative and chondrogenic potentials, and MSCs transplanted into the articular cartilage defect produce abundant extracellular matrix. Because of similarities between the articular cartilage and the intervertebral disc cartilage, synovial MSCs are a potential cell source for disc regeneration. Here, we examined the effect of intradiscal transplantation of synovial MSCs after aspiration of nucleus pulposus in rabbits. Methods The nucleus pulposus tissues of rabbit's intervertebral discs were aspirated to induce disc degeneration, and allogenic synovial MSCs were transplanted. At 2, 4, 6, 8, 16, 24 weeks postoperatively, we evaluated with imaging analyses such as X-ray and magnetic resonance imaging (MRI), and histological analysis. To investigate interaction between synovial MSCs and nucleus pulposus cells, human synovial MSCs and rat nucleus pulposus cells were co-cultured, and species specific microarray were performed. Results The existence of transplanted cells labeled with DiI or derived from green fluorescent protein (GFP)-expressing transgenic rabbits was confirmed up until 24 weeks. X-ray analyses demonstrated that intervertebral disc height in the MSC group remained higher than that in the degeneration group. T2 weighted MR imaging showed higher signal intensity of nucleus pulposus in the MSC group. Immunohistological analyses revealed higher expression of type II collagen around nucleus pulposus cells in the MSC group compared with even that of the normal group. In co-culture of rat nucleus pulposus cells and human synovial MSCs, species specific microarray revealed that gene profiles of nucleus pulposus were altered markedly with suppression of genes relating matrix degradative enzymes and inflammatory cytokines. Conclusions Synovial MSCs injected into the nucleus pulposus space promoted synthesis of the remaining nucleus pulposus cells to type II collagen and inhibition of expressions of degradative enzymes and inflammatory cytokines, resulting in maintaining the structure of the intervertebral disc being maintained.

2010-01-01

32

Effects of lumbar sympathectomy on pain behavioral changes caused by nucleus pulposus-induced spinal nerve damage in rats  

Microsoft Academic Search

It has been suggested that lumbar sympathectomy can reduce pain behavior, including mechanical allodynia and thermal hyperalgesia, caused by ligation of the spinal nerve. One well-characterized model, which involves application of nucleus pulposus to the spinal nerve and displacement of the adjacent nerve, shows behavioral changes in rats. However, there have been no previous reports regarding sympathectomy performed in this

Yasuaki Murata; Kjell Olmarker; Ichiro Takahashi; Kazuhisa Takahashi; Björn Rydevik

2006-01-01

33

HIF Regulation of ANK Expression in Nucleus Pulposus Cells: Possible Implications in Controlling Dystrophic Mineralization in the Intervertebral Disc  

PubMed Central

Objective Since nucleus pulposus cells reside in hypoxia, we determined if expression of ANK, a pyrophosphate transporter, is regulated by the HIF proteins. Methods Quantitative RT-PCR and Western blot were used to measure ANK expression in nucleus pulposus cells. Transfections were performed to determine the effect of HIF-1/-2 on ANK promoter activity. Results ANK was expressed in embryonic and mature rat disc. Oxygen dependent changes in ANK expression in nucleus pulposus cells were minimal. However, silencing of HIF-1? and HIF-2? resulted in increased ANK expression and upregulation of promoter activity. HIF mediated suppression of ANK was validated by measuring promoter activity in HIF-1? null embryonic fibroblasts. Compared with wild type cells, in hypoxia, there was induction of promoter activity in the null cells. We overexpressed HIF-1? and HIF-2? in nucleus pulposus cells and noted a significant suppression in ANK promoter activity. Since the ANK promoter contains two hypoxia response elements (HRE), we performed site-directed mutagenesis and measured promoter activity. We found that HIF-1 can bind to either of the HRE and suppress promoter activity. In contrast, HIF-2 was required to bind to both HRE to suppress activity. Finally, analysis of human nucleus pulposus tissue showed that while ANK was expressed in normal tissue, there was increased expression of ANK along with alkaline phosphatase in the degenerate state. Conclusion Both HIF-1 and HIF-2 serve as negative regulators of ANK expression in the disc. We propose that baseline ANK expression in the disc serves to prevent mineral formation under physiological conditions.

Skubutyte, Renata; Markova, Dessislava; Freeman, Theresa A.; Anderson, D. Greg; Dion, Arnold S.; Williams, Charlene J.; Shapiro, Irving M.; Risbud, Makarand V.

2011-01-01

34

HIF-1? AND HIF-2? DEGRADATION IS DIFFERENTIALLY REGULATED IN NUCLEUS PULPOSUS CELLS OF THE INTERVERTEBRAL DISC  

PubMed Central

Studies of many cell types show that level of HIF-1? and HIF-2? is primarily controlled by oxygen-dependent proteasomal degradation, catalyzed by HIF prolyl-hydroxylases (PHDs). However, in hypoxic niche of the intervertebral disc, the mechanism of HIF-? turnover in nucleus pulposus cells is not yet known. We show that in nucleus pulposus cells HIF-1? and HIF-2? degradation was mediated through 26S proteasome irrespective of oxygen tension. Noteworthy, HIF-2? degradation through 26S proteasome was more pronounced in hypoxia. Surprisingly, treatment with DMOG, a PHD inhibitor, shows accumulation of only HIF-1? and induction in activity of its target genes but not of HIF-2?. Loss and gain of function analyses using lentiviral knockdown of PHDs and overexpression of individual PHDs show that in nucleus pulposus cells only PHD2 played a limited role in HIF-1? degradation, again HIF-2? degradation was unaffected. We also demonstrate that the treatment with inhibitors of lysosomal proteolysis results in a strong accumulation of HIF-1? and to a much smaller extent of HIF-2? levels. It is thus evident that in addition to PHD2 catalyzed degradation, HIF-1? turnover in nucleus pulposus cells is primarily regulated by oxygen-independent pathways. Importantly, our data clearly suggests that proteasomal degradation of HIF-2? is not mediated by classical oxygen dependent PHD pathway. These results for the first time provide a rationale for the normoxic stabilization as well as the maintenance of steady state levels of HIF-1? and HIF-2? in nucleus pulposus cells.

Fujita, Nobuyuki; Chiba, Kazuhiro; Shapiro, Irving M.; Risbud, Makarand V.

2011-01-01

35

Adult acute calcific discitis confined to the nucleus pulposus in the cervical spine: case report.  

PubMed

Acute calcific discitis is a rare condition in the pediatric population and has been reported in only 2 instances in the adult population. This report describes a case of acute calcific discitis that uniquely presented in the adult cervical spine. A 22-year-old woman presented with the chief complaint of sudden-onset neck pain. Nonsurgical management, including nonsteroidal antiinflammatory drugs, provided moderate symptom relief. Radiography revealed nucleus pulposus calcification at the C2-3 level. Contrast-enhanced MRI did not reveal any additional abnormalities. Further nonsurgical management, including physical therapy and nonsteroidal antiinflammatory drugs, led to complete symptom relief within 6 months. Follow-up imaging demonstrated that the calcification had nearly resolved. Acute calcific discitis should be managed conservatively; the prognosis for a complete recovery is excellent. The pathophysiology of the disorder is yet to be elucidated, and the disorder is not exclusive to the pediatric population. PMID:23746089

Azizaddini, Shahrzad; Arefanian, Saeed; Redjal, Navid; Walcott, Brian P; Mollahoseini, Reza

2013-06-07

36

Determination of the strain-dependent hydraulic permeability of the compressed bovine nucleus pulposus.  

PubMed

The hydraulic permeability, k, of the nucleus pulposus (NP) is crucial, both in withstanding compressive stress and for convective transport of nutrients within the disc. Permeability has previously been determined using biphasic mathematical models, but has not been found by direct permeation experiments, which is the objective of this study. Bovine coccygeal nucleus samples (n=64), phi10mm and thickness 683+/-49microm (mean+/-S.D.) were compressed axially to one of lambda=1.0, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4 or 0.3, where lambda is the stretch ratio. Ringer's solution was permeated through the sample, with an o-ring ensuring axial flow. During stress equilibrium, k was determined and fitted to four permeability-strain equations. Permeability decreased exponentially with compression, and was best described by Values of k were comparable to those arising from mathematical models, lending confidence to permeability being determined from such models. PMID:18164714

Heneghan, Paul; Riches, Philip E

2007-12-31

37

Co-culture of Adult Mesenchymal Stem Cells and Nucleus Pulposus Cells in Bilaminar Pellets for Intervertebral Disc Regeneration  

Microsoft Academic Search

BackgroundOur goal is to optimize stem cell-based tissue engineering strategies in the context of the intervertebral disc environment. We explored the benefits of co-culturing nucleus pulposus cells (NPC) and adult mesenchymal stem cells (MSC) using a novel spherical bilaminar pellet culture system where one cell type is enclosed in a sphere of the other cell type. Our 3D system provides

Aliza A. Allon; Richard A. Schneider; Jeffrey C. Lotz

2009-01-01

38

BiDirectional Exchange of Membrane Components Occurs during Co-Culture of Mesenchymal Stem Cells and Nucleus Pulposus Cells  

Microsoft Academic Search

Mesenchymal stem cell (MSC)-based therapies have been proposed as novel treatments for intervertebral disc (IVD) degeneration. We have previously demonstrated that when MSCs are co-cultured with nucleus pulposus (NP) cells with direct cell-cell contact, they differentiate along the NP lineage and simultaneously stimulate the degenerate NP cell population to regain a normal (non-degenerate) phenotype, an effect which requires cell-cell communication.

Sandra Strassburg; Nigel W. Hodson; Patrick I. Hill; Stephen M. Richardson; Judith A. Hoyland

2012-01-01

39

Silver needle therapy for intractable low-back pain at tender point after removal of nucleus pulposus  

Microsoft Academic Search

Objective: To examine the use of a new silver needle therapy for treating tender points involved in intractable low-back pain after removal of nucleus pulposus.Subjects: The study involved 24 patients (17 men and 7 women) aged 26 to 67 years with a mean age of 54.5 ± 5 years.Settings: The Department of Orthopedics at the First Military Medical University, the

Li Yi-Kai; Ao Xueyan; Wang Fu-Gen

2000-01-01

40

The natural history of lumbar disc herniation and radiculopathy  

Microsoft Academic Search

The majority of patients suffering from a radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery or chemonucleolysis. The clinical course of the radiculopathy varies as well as the efficacy of conservative treatment. In some patients the symptoms decline after a week or two; in others the pain may continue for many months or years. Despite an

Michel Benoist

2002-01-01

41

The expression and role of non-canonical (PKC) signaling in nucleus pulposus cell metabolism.  

PubMed

Canonical Wnt/?-catenin (hereafter Wnt) signaling regulates the proliferation and differentiation of various cell types. However, the role of non-canonical signaling including protein kinase C (PKC) signaling has not been investigated in intervertebral disc (IVD) cells. The aim of this study was to elucidate whether the activation of PKC signaling act to modulate Wnt signaling in IVD cells. We performed several reporter assays, real-time reverse transcription polymerase chain reaction (RT-PCR), immunohistochemical and immunofluorescence analyses, and western blot analyses using rat nucleus pulposus (NP) cells. We also examined the cell proliferation and cell cycle distribution under phorbol 12-myristate 13-acetate (PMA) stimulation, a known activator of PKC signaling. We found that NP cells exhibited decreased ?-catenin mRNA and protein levels upon stimulation with PMA. PMA treatment promoted proliferation and cell cycle progression in a time- and dose-dependent manner. In addition, activation of the PKC signaling also regulated the expression of aggrecan. Finally, activation by PMA induced the expression of several PKC isoforms in NP cells. It is concluded that activation of PKC signaling might lead to an increase in matrix synthesis and cell proliferation, thereby inhibiting IVD degeneration. Crosstalk in these signaling pathways plays an important role in the regulation of IVD homeostasis. PMID:22389031

Arai, Fumiyuki; Hiyama, Akihiko; Sakai, Daisuke; Yokoyama, Katsuya; Mochida, Joji

2012-03-02

42

SIRT1 inhibits apoptosis of degenerative human disc nucleus pulposus cells through activation of Akt pathway.  

PubMed

Many studies have demonstrated that SIRT1, an NAD(+)-dependent deacetylase, reduces apoptosis in several different cells. However, the role of SIRT1 in apoptosis of disc nucleus pulposus (NP) cells remains unclear. The present study was performed to determine whether degenerative human NP would express SIRT1, and to investigate the role of SIRT1 in NP cells apoptosis. The expression of SIRT1 in disc NP of patients (>55 years) with lumbar disc degenerative disease (DDD) and the disc NP of patients (<25 years) with lumbar vertebra fracture (LVF) was assessed by immunohistochemistry, reverse transcription polymerase chain reaction, and Western blot analysis. The results showed that SIRT1 mRNA and protein levels were greater in LVF disc NP than those in DDD disc NP. Degenerative human NP cells were treated in culture with activator or inhibitor of SIRT1, resveratrol or nicotinamide, or SIRT1 small interfering RNA (siRNA), and cell apoptosis was quantified via flow cytometry. The rate of apoptosis was far fewer in resveratrol-treated NP cells than in SIRT1 siRNA-transfected or nicotinamide-treated NP cells. After SIRT1 siRNA was transfected, NP cells decreased phosphorylation of Akt, while resveratrol phosphorylated Akt. Treatment with LY294002 or Akt siRNA increased the rate of apoptosis. Our results suggested that SIRT1 plays a critical role in survival of degenerative human NP cells through the Akt anti-apoptotic signaling pathway. PMID:22990594

Wang, Dawu; Hu, Zhenming; Hao, Jie; He, Bin; Gan, Qiang; Zhong, Xiaoming; Zhang, Xiaojun; Shen, Jieliang; Fang, Ji; Jiang, Wei

2012-09-19

43

The Role of Leptin on the Organization and Expression of Cytoskeleton Elements in Nucleus Pulposus Cells  

PubMed Central

Obesity is an important risk factor for intervertebral disc degeneration and leptin is a biomarker of obesity. However, the expression of leptin receptors has not been determined in disc tissue. It is not known whether leptin has a direct effect on the nucleus pulposus (NP) cells. To determine whether the NP tissues and cells express leptin receptors (OBRa and OBRb) and whether leptin affects the organization and the expression of major cytoskeletal elements in NP cells. Messenger RNA (mRNA) and protein levels of OBRa and OBRb were measured by real-time PCR and Western blot, respectively, in NP tissues and cells. Immunofluorescence and real-time PCR and Western blot were performed to investigate the effect of leptin on cytoskeleton reorganization and expression. Results show that mRNA and proteins of OBRa and OBRb were expressed in all NP tissues and cells, and that OBRb expression was correlated with patients' body weight. Increased expression of ?-actin and reorganization of F-actin were evident in leptin-stimulated NP cells. Leptin also induced vimentin expression but had no effect on ?-tubulin in NP cells. These findings provide novel evidence supporting the possible involvement of leptin in the pathogenesis of intervertebral disc degeneration. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 847–857, 2013

Li, Zheng; Shen, Jianxiong; Wu, William Ka Kei; Yu, Xin; Liang, Jinqian; Qiu, Guixing; Liu, Jiaming

2013-01-01

44

Regenerating Nucleus Pulposus of the Intervertebral Disc Using Biodegradable Nanofibrous Polymer Scaffolds  

PubMed Central

Low back pain is a leading health problem in the United States, which is most often resulted from nucleus pulposus (NP) degeneration. To date, the replacement of degenerated NP relies entirely on mechanical devices. However, a biological NP replacement implant is more desirable. Here, we report the regeneration of NP tissue using a biodegradable nanofibrous (NF) scaffold. Rabbit NP cells were seeded on the NF scaffolds to regenerate NP-like tissue both in vitro and in a subcutaneous implantation model. The NP cells on the NF scaffolds proliferated faster than those on control solid-walled (SW) scaffolds in vitro. Significantly more extracellular matrix (ECM) production (glycosaminoglycan and type II collagen) was found on the NF scaffolds than on the control SW scaffolds. The constructs were then implanted in the caudal spine of athymic rats for up to 12 weeks. The tissue-engineered NP could survive, produce functional ECM, remain in place, and maintain the disc height, which is similar to the native NP tissue.

Feng, Ganjun; Zhang, Zhanpeng; Jin, Xiaobing; Hu, Jiang; Gupte, Melanie J.; Holzwarth, Jeremy M.

2012-01-01

45

Expression of neural and neurotrophic markers in nucleus pulposus cells isolated from degenerated intervertebral disc.  

PubMed

Intervertebral disc (IVD) degeneration is a common disorder of the lower spine. Since it is caused by loss of cellularity, there is interest in the comprehension of the cellular phenotypes. This study aimed to verify if stem cells isolated from nucleus pulposus of intervertebral discs (NPs-IVD), which may express neurogenic properties, may be implicated in IVD disease. NPs-IVD isolated from 14 human pathological discs were cultured under mesenchymal and neural differentiation. An induction of the neural markers GFAP, NF, MAP2, O4, and a decrement of the expression of the immature neural markers ?-tubulin III, Nestin, NG2, occurred within the neural differentiation. The expression of TrkA and p75NGFR, the receptors of NGF, was not correlated with neural induction; in contrast, TrkB, the BDNF receptor, increased and was co-expressed with acid sensing ion channel 3 (ASIC3). In the same condition, neuroinflammatory markers were over-expressed. We confirm our hypothesis that stem cells within IVD degeneration acquire neurogenic phenotype, causing the induction of markers related to inflammatory condition. These cells could promote the enrolment of neurotrophines in adaptation to the acidic microenvironment in degenerative conditions. These data could improve our knowledge about IVD cellularity and eventually lead to the development of pharmacological therapies. PMID:22374745

Navone, Stefania E; Marfia, Giovanni; Canzi, Laura; Ciusani, Emilio; Canazza, Alessandra; Visintini, Sergio; Campanella, Rolando; Parati, Eugenio A

2012-02-28

46

Biocomposite hydrogels with carboxymethylated, nanofibrillated cellulose powder for replacement of the nucleus pulposus.  

PubMed

Biocomposite hydrogels with carboxymethylated, nanofibrillated cellulose (c-NFC) powder were prepared by UV polymerization of N-vinyl-2-pyrrolidone with Tween 20 trimethacrylate as a cross-linking agent for replacement of the native, human nucleus pulposus (NP) in intervertebral disks. The swelling ratios and the moduli of elasticity in compression of neat and biocomposite hydrogels were evaluated in dependence of c-NFC concentration (ranging from 0 to 1.6% v/v) and degree of substitution (DS, ranging from 0 to 0.23). The viscoelastic properties in shear and the material relaxation behavior in compression were measured for neat and biocomposite hydrogels containing 0.4% v/v of fibrils (DS ranging from 0 to 0.23), and their morphologies were characterized by cryo-scanning electron microscopy (cryo-SEM). The obtained results show that the biocomposite hydrogels can successfully mimic the mechanical and swelling behavior of the NP. In addition, the presence of the c-NFC shows lower strain values after cyclic compression tests and consequently creates improved material relaxation properties compared with neat hydrogels. Among the tested samples, the biocomposite hydrogel containing 0.4% v/v of c-NFC with a DS of 0.17 shows the closest behavior to native NP. Further investigation should focus on evaluation and improvement of the long-term relaxation behavior. PMID:21405099

Eyholzer, C; de Couraça, A Borges; Duc, F; Bourban, P E; Tingaut, P; Zimmermann, T; Månson, J A E; Oksman, K

2011-03-25

47

Regulation of CCN2/CTGF Expression in the Nucleus Pulposus of the Intervertebral Disc: Role of Smad and AP1 Signaling  

PubMed Central

Objective To investigate TGF? regulation of CTGF expression in cells of the nucleus pulposus. Methods Real Time RT-PCR and Western blot analysis was used to measure CTGF expression in the nucleus pulposus. Transfections were used to measure the effect of Smad2/3/7 and AP1on TGF? mediated CTGF promoter activity. Results CTGF expression was lower in the neonatal disc compared with the skeletally mature rat disc. An increase in CTGF expression and promoter activity was observed in nucleus pulposus cells after TGF? treatment. Deletion analysis indicated that promoter constructs lacking smad and AP1 motifs were unresponsive to treatment. Analysis showed that full-length Smad3 and the Smad3-MH2 domain alone increased CTGF activity. Further evidence of Smad3 and AP1 involvement was seen when DN-Smad3, SiRNA-Smad3, smad7 and DN-AP1 suppressed TGF? mediated activation of the CTGF promoter. When either Smad3 or AP1 sites were mutated, CTGF promoter induction by TGF? was suppressed. We also observed a decrease in expression of CTGF in discs of Smad3 null mice compared to the wild type. Analysis of human nucleus pulposus indicated a trend of increasing CTGF and TGF? expression in the degenerate state. Conclusion TGF?, through Smad3 and AP1, serves as a positive regulator of CTGF expression in the nucleus pulposus. We propose that CTGF is a part of the limited reparative response of the degenerate disc.

Tran, Cassie M.; Markova, Dessislava; Smith, Harvey E.; Susarla, Bala; Ponnappan, Ravi Kumar; Anderson, D Greg; Symes, Aviva; Shapiro, Irving M.; Risbud, Makarand V.

2011-01-01

48

Pain Behavior Changes Following Disc Puncture Relate to Nucleus Pulposus Rather than to the Disc Injury Per Se: An Experimental Study in Rats  

PubMed Central

It has previously been demonstrated that disc puncture in the rat induced changes in grooming and wet dog shakes, two behavioral changes that may be linked to discomfort and neuropathic pain. In this study the aim was to separate the effects of disc injury and the epidural presence of nucleus pulposus. Following anesthesia, the L4-5 disc was exposed using a dorsal approach. Ten rats received a superficial disc injury without nucleus pulposus leakage and ten rats received nucleus pulposus from a donor rat without disc injury. In ten animals the L4-5 disc was punctured using a ventral approach, with 10 corresponding controls. Spontaneous behavior was assessed after surgery. The data was matched to historical control of dorsal sham surgery and disc puncture. The study showed that the effects of nucleus pulposus were more pronounced than the effects induced by the disc injury. Ventral disc puncture did not induce any behavioral changes different from sham exposure. In conclusion, the data from the study indicate that behavioral changes induced by disc puncture are more likely to relate to the epidural presence of nucleus pulposus than the disc injury per se.

Nilsson, Elin; Nakamae, Toshio; Olmarker, Kjell

2011-01-01

49

Influence of preoperative nucleus pulposus status and radiculopathy on outcomes in mono-segmental lumbar total disc replacement: results from a nationwide registry  

PubMed Central

Background Currently, herniated nucleus pulposus (HNP) with radiculopathy and other preconditions are regarded as relative or absolute contraindications for lumbar total disc replacement (TDR). In Switzerland it is left to the surgeon's discretion when to operate. The present study is based on the dataset of SWISSspine, a governmentally mandated health technology assessment registry. We hypothesized that preoperative nucleus pulposus status and presence or absence of radiculopathy has an influence on clinical outcomes in patients treated with mono-segmental lumbar TDR. Methods Between March 2005 and April 2009, 416 patients underwent mono-segmental lumbar TDR, which was documented in a prospective observational multicenter mode. The data collection consisted of perioperative and follow-up data (physician based) and clinical outcomes (NASS, EQ-5D). Patients were divided into four groups according to their preoperative status: 1) group degenerative disc disease ("DDD"): 160 patients without HNP and no radiculopathy, classic precondition for TDR; 2) group "HNP-No radiculopathy": 68 patients with HNP but without radiculopathy; 3) group "Stenosis": 73 patients without HNP but with radiculopathy, and 4) group "HNP-Radiculopathy": 132 patients with HNP and radiculopathy. The groups were compared regarding preoperative patient characteristics and pre- and postoperative VAS and EQ-5D scores using general linear modeling. Results Demographics in all four groups were comparable. Regarding the improvement of quality of life (EQ-5D) there were no differences across the four groups. For the two main groups DDD and HNP-Radiculopathy no differences were found in the adjusted postoperative back- and leg pain alleviation levels, in the stenosis group back- and leg pain relief were lower. Conclusions Despite higher preoperative leg pain levels, outcomes in lumbar TDR patients with HNP and radiculopathy were similar to outcomes in patients with the classic indication; this because patients with higher preoperative leg pain levels benefit from a relatively greater leg pain alleviation. The group with absence of HNP but presence of radiculopathy showed considerably less benefits from the operation, which is probably related to ongoing degenerative processes of the posterior segmental structures. This observational multicenter study suggests that the diagnoses HNP and radiculopathy, combined or alone, may not have to be considered as absolute or relative contraindications for mono-segmental lumbar TDR anymore, whereas patients without HNP but with radiculopathy seem to be suboptimal candidates for the procedure.

2011-01-01

50

Silk-Fibrin/Hyaluronic Acid Composite Gels for Nucleus Pulposus Tissue Regeneration  

PubMed Central

Scaffold designs are critical for in vitro culture of tissue-engineered cartilage in three-dimensional environments to enhance cellular differentiation for tissue engineering and regenerative medicine. In the present study we demonstrated silk and fibrin/hyaluronic acid (HA) composite gels as scaffolds for nucleus pulposus (NP) cartilage formation, providing both biochemical support for NP outcomes as well as fostering the retention of size of the scaffold during culture due to the combined features of the two proteins. Passage two (P2) human chondrocytes cultured in 10% serum were encapsulated within silk-fibrin/HA gels. Five study groups with fibrin/HA gel culture (F/H) along with varying silk concentrations (2% silk gel only, fibrin/HA gel culture with 1% silk [F/H+1S], 1.5% silk [F/H+1.5S], and 2% silk [F/H+2S]) were cultured in serum-free chondrogenic defined media (CDM) for 4 weeks. Histological examination with alcian blue showed a defined chondrogenic area at 1 week in all groups that widened homogenously until 4 weeks. In particular, chondrogenic differentiation observed in the F/H+1.5S had no reduction in size throughout the culture period. The results of biochemical and molecular biological evaluations supported observations made during histological examination. Mechanical strength measurements showed that the silk mixed gels provided stronger mechanical properties for NP tissue than fibrin/HA composite gels in CDM. This effect could potentially be useful in the study of in vitro NP tissue engineering as well as for clinical implications for NP tissue regeneration.

Park, Sang-Hyug; Cho, Hongsik; Gil, Eun Seok; Mandal, Biman B.; Min, Byoung-Hyun

2011-01-01

51

Nanofibrillated cellulose composite hydrogel for the replacement of the nucleus pulposus.  

PubMed

The swelling and compressive mechanical behavior as well as the morphology and biocompatibility of composite hydrogels based on Tween® 20 trimethacrylate (T3), N-vinyl-2-pyrrolidone (NVP) and nanofibrillated cellulose (NFC) were assessed in the present study. The chemical structure of T3 was verified by Fourier transform infrared spectroscopy and proton nuclear magnetic resonance, and the degree of substitution was found to be around 3. Swelling ratios of neat hydrogels composed of different concentrations of T3 and NVP were found to range from 1.5 to 5.7 with decreasing concentration of T3. Various concentrations of cellulose nanofibrils (0.2-1.6wt.%) were then used to produce composite hydrogels that showed lower swelling ratios than neat ones for a given T3 concentration. Neat and composite hydrogels exhibited a typical nonlinear response under compression. All composite hydrogels showed an increase in elastic modulus compared to neat hydrogel of about 3- to 8-fold, reaching 18kPa at 0% strain and 62kPa at 20% strain for the hydrogel with the highest NFC content. All hydrogels presented a porous and homogeneous structure, with interconnected pore cells of around 100nm in diameter. The hydrogels are biocompatible. The results of this study demonstrate that composite hydrogels reinforced with NFC may be viable as nucleus pulposus implants due to their adequate swelling ratio, which may restore the annulus fibrosus loading, and their increased mechanical properties, which could possibly restore the height of the intervertebral discs. PMID:21651996

Borges, Ana C; Eyholzer, Christian; Duc, Fabien; Bourban, Pierre-Etienne; Tingaut, Philippe; Zimmermann, Tanja; Pioletti, Dominique P; Månson, Jan-Anders E

2011-05-27

52

Effects of TGF-?1 and IGF-1 on proliferation of human nucleus pulposus cells in medium with different serum concentrations  

Microsoft Academic Search

BACKGROUND: The low proliferative viability of human nucleus pulposus(NP) cells is considered as a cause of intervertebral discs degeneration. Growth factors, such as TGF-?1 and IGF-1, have been implicated in cell proliferation and matrix synthesis. OBJECTIVE: To investigate the dose-response and time-course effect of transforming growth factor?1(TGF-?1) and insulin-like growth factor-1(IGF-1) on proliferation of NP cells. STUDY DESIGN: 3-(4,5-dimethylthiazolyl)-2,5-diphenyl-tetrazolium bromide

Rongfeng Zhang; Dike Ruan; Chao Zhang

2006-01-01

53

The three-dimensional architecture of the notochordal nucleus pulposus: novel observations on cell structures in the canine intervertebral disc  

PubMed Central

Cells from the nucleus pulposus of young (< 2 years) and old (> 5 years) non-chondrodystrophoid dogs were studied using routine histology, confocal laser scanning microscopy and transmission electron microscopy. The architecture of cell structures – from the tissue scale down to subcellular scale – was reported. Clusters of notochordal cells were observed in young nuclei pulposi, ranging from 10 to 426 cells each. These clusters resisted mechanical disruption and showed evidence of cell–cell signalling via gap junctions. Cells (30–40 µm in diameter) within the clusters had a physaliferous appearance, containing numerous large inclusions which ranged from 1 to 20 µm in diameter. The inclusions were surrounded by a dense actin cortex but were not contained by a lipid bilayer. The contents of the inclusions were determined not to be predominantly carbohydrate or neutral lipid as assessed by histochemical staining, but the exact composition of the contents remained uncertain. There were striking differences in the cell architecture of young vs. old nuclei pulposi, with a loss of both cell clusters and physaliferous cells during ageing. These observations demonstrate unique cell structures, which may influence our understanding of the differences between notochordal and chondrocytic cells in the nucleus pulposus. Such differences could have substantial impact upon how we think about development, degeneration and repair of the intervertebral disc.

Hunter, Christopher J; Matyas, John R; Duncan, Neil A

2003-01-01

54

Design, synthesis, imaging, and biomechanics of a softness-gradient hydrogel nucleus pulposus prosthesis in a canine lumbar spine model.  

PubMed

A hydrogel nucleus pulposus prosthesis (NPP) was designed to swell in situ, have intrinsic radiopacity, and restore intervertebral disc height and biomechanical functionality. These features were examined using an ex vivo canine lumbar model. Nine NPPs were implanted in five spines and their visibility was assessed on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). The NPPs were visible on all imaging modalities and 8/9 NPPs stayed intact and in situ. Six other NPPs were tested biomechanically in six canine lumbar spines. Removal of the nucleus pulposus (nuclectomy) caused significant changes in biomechanical parameters. After implantation and swelling of the NPP, values were not significantly different from the native state for range of motion (ROM) of flexion-extension (FE) and lateral bending (LB), the neutral zone (NZ) of all motion directions, and the NZ stiffness (NZS) of FE. Biomechanical restoration by the NPP compared with the nuclectomized state was significant for the ROM of FE and axial rotation, the NZ of FE and LB, and the NZS of FE and LB. Disc height was significantly restored and 6/6 NPPs stayed intact and in situ. In conclusion, the NPPs swell in situ, have intrinsic radiopacity and restored disc height and aforementioned biomechanical properties. PMID:22888039

Kranenburg, Hendrik-Jan C; Meij, Björn P; Onis, David; van der Veen, Albert J; Saralidze, Ketie; Smolders, Luc A; Huizinga, Julie G; Knetsch, Menno L W; Luijten, Peter R; Visser, Fredy; Voorhout, George; Dhert, Wouter J A; Hazewinkel, Herman A W; Koole, Leo H

2012-08-09

55

Comparison of neuropathic pain induced by the application of normal and mechanically compressed nucleus pulposus to lumbar nerve roots in the rat  

Microsoft Academic Search

We studied whether applying nucleus pulposus tissue, obtained from tail intervertebral discs that had been subjected to chronic mechanical compression, to the lumbar nerve roots produces hyperalgesia, which is thought to be a pain-related behavior in the rat. An Ilizarov-type apparatus was used for immobilization and chronically applied compression of the rat tail for eight weeks. Three weeks after application

Mamoru Kawakami; Hiroshi Hashizume; Hideto Nishi; Takuji Matsumoto; Tetsuya Tamaki; Koichi Kuribayashi

2003-01-01

56

Effects of selective tumor necrosis factor-alpha inhibition to pain-behavioral changes caused by nucleus pulposus-induced damage to the spinal nerve in rats  

Microsoft Academic Search

Application of nucleus pulposus to the spinal nerve and displacement of the adjacent nerve results in behavioral changes in rats. It has been reported that treatment with the tumor necrosis factor-alpha (TNF?) inhibitor, infliximab, significantly reduces spontaneous pain behavior in this animal model. However, there have been no reports of the effects of infliximab on mechanical or thermal hyperalgesia using

Yasuaki Murata; Kjell Olmarker; Ichiro Takahashi; Kazuhisa Takahashi; Björn Rydevik

2005-01-01

57

Recent advances in biological therapies for disc degeneration: tissue engineering of the annulus fibrosus, nucleus pulposus and whole intervertebral discs.  

PubMed

Advanced intervertebral disc (IVD) degeneration, a major cause of back pain in the United States, is treated using invasive surgical intervention which may cause further degeneration is the future. Because of the limitations of traditional solutions, tissue engineering therapies have become increasingly popular. IVDs have two distinct regions, the inner nucleus pulposus (NP) which is jelly-like and rich in glycosaminoglycans (GAGs) and the outer annulus fibrosus (AF) which is organized into highly collagenous lamellae. Tissue engineered scaffolds, as well as whole organ culture systems have been developed. These culture systems may help elucidate the initial causes of disc degeneration. To create an effective tissue engineered therapy, researchers have focused on designing materials that mimic the properties of these two regions to be used independently or in concert. The few in vivo studies show promise in retaining disc height and MRI T2 signal intensity, the gold standard in determining disc health. PMID:23773764

Hudson, Katherine D; Alimi, Marjan; Grunert, Peter; Härtl, Roger; Bonassar, Lawrence J

2013-06-14

58

Osthole, a herbal compound, alleviates nucleus pulposus-evoked nociceptive responses through the suppression of overexpression of acid-sensing ion channel 3 (ASIC3) in rat dorsal root ganglion  

PubMed Central

Summary Background Osthole (Ost), a natural coumarin derivative, has been shown to inhibit many pro-inflammatory mediators and block voltage-gated Na+ channels. During inflammation, acidosis is an important pain inducer which activates nociceptors by gating depolarizing cationic channels, such as acid-sensing ion channel 3 (ASIC3). The aim of this study was to examine the effects of Ost on nucleus pulposus-evoked nociceptive responses and ASIC3 over-expression in the rat dorsal root ganglion, and to investigate the possible mechanism. Material/Methods Radicular pain was generated with application of nucleus pulposus (NP) to nerve root. Mechanical allodynia was evaluated using von Frey filaments with logarithmically incremental rigidity to calculate the 50% probability thresholds for mechanical paw withdrawal. ASIC3 protein expression in dorsal root ganglions (DRGs) was assessed with Western blot and immunohistochemistry. Membrane potential (MP) shift of DRG neurons induced by ASIC3-sensitive acid (pH6.5) was determined by DiBAC4 (3) fluorescence intensity (F.I.). Results The NP-evoked mechanical hyperalgesia model showed allodynia for 3 weeks, and ASIC3 expression was up-regulated in DRG neurons, reaching peak on Day 7. Epidural administration of Ost induced a remarkable and prolonged antinociceptive effect, accompanied by an inhibition of over-expressed ASIC3 protein and of abnormal shift of MP. Amiloride (Ami), an antagonist of ASIC3, strengthened the antinociceptive effect of Ost. Conclusions Up-regulation of ASIC3 expression may be associated with NP-evoked mechanical hyperalgesia. A single epidural injection of Ost decreased ASIC3 expression in DGR neurons and the pain in the NP-evoked mechanical hyperalgesia model. Osthole may be of great benefit for preventing chronic pain status often seen in lumbar disc herniation (LDH).

He, Qiu-Lan; Chen, Yuling; Qin, Jian; Mo, Sui-Lin; Wei, Ming; Zhang, Jin-Jun; Li, Mei-Na; Zou, Xue-Nong; Zhou, Shu-Feng; Chen, Xiao-Wu; Sun, Lai-Bao

2012-01-01

59

Influence of different commercial scaffolds on the in vitro differentiation of human mesenchymal stem cells to nucleus pulposus-like cells  

Microsoft Academic Search

Introduction  Cell-based therapies for regeneration of the degenerated intervertebral disc (IVD) are an alternative to current surgical\\u000a intervention. Mesenchymal stem cells (MSCs), in combination with a scaffold, might be ideal candidates for regenerating nucleus\\u000a pulposus (NP), the pressure-distributing part of the IVD. While the use of growth factors for MSCs differentiation currently\\u000a receives major attention, in this study we compare the

Alessandro Bertolo; Marco Mehr; Niklaus Aebli; Martin Baur; Stephen J. Ferguson; Jivko V. Stoyanov

60

Herniated lumbar disc  

PubMed Central

Introduction Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30-50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 49 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, advice to stay active, analgesics, antidepressants, bed rest, corticosteroids (epidural injections), cytokine inhibitors (infliximab), discectomy (automated percutaneous, laser, microdisectomy, standard), exercise therapy, heat, ice, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), percutaneous disc decompression, spinal manipulation, and traction.

2009-01-01

61

Variations in gene and protein expression in canine chondrodystrophic nucleus pulposus cells following long-term three-dimensional culture.  

PubMed

Intervertebral disc (IVD) degeneration greatly affects quality of life. The nucleus pulposus (NP) of chondrodystrophic dog breeds (CDBs) is similar to the human NP, because the cells disappear with age and are replaced by fibrochondrocyte-like cells. However, because IVD develops as early as within the first year of life, we used canines as a model to investigate in vitro the mechanisms underlying IVD degeneration. Specifically, we evaluated the potential of a three-dimensional (3D) culture of healthy NP as an in vitro model system to investigate the mechanisms of IVD degeneration. Agarose hydrogels were populated with healthy NP cells from beagles after performing magnetic resonance imaging, and mRNA expression profiles and pericellular extracellular matrix (ECM) protein distribution were determined. After 25 days of 3D culture, there was a tendency for redifferentiation into the native NP phenotype, and mRNA levels of Col2A1, COMP, and CK18 were not significantly different from those of freshly isolated cells. Our findings suggest that long-term 3D culture promoted chondrodystrophic NP redifferentiation through reconstruction of the pericellular microenvironment. Further, lipopolysaccharide (LPS) induced expression of TNF-?, MMP3, MMP13, VEGF, and PGES mRNA in the 3D cultures, creating a molecular milieu that mimics that of degenerated NP. These results suggest that this in vitro model represents a reliable and cost-effective tool for evaluating new therapies for disc degeneration. PMID:23658803

Iwata, Munetaka; Ochi, Hiroki; Asou, Yoshinori; Haro, Hirotaka; Aikawa, Takeshi; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Tagawa, Masahiro; Hara, Yasushi

2013-05-02

62

Shh Signaling from the Nucleus Pulposus Is Required for the Postnatal Growth and Differentiation of the Mouse Intervertebral Disc  

PubMed Central

Intervertebral discs (IVD) are essential components of the vertebral column. They maintain separation, and provide shock absorbing buffers, between adjacent vertebrae, while also allowing movements between them. Each IVD consists of a central semi-liquid nucleus pulposus (NP) surrounded by a multi-layered fibrocartilagenous annulus fibrosus (AF). Although the IVDs grow and differentiate after birth along with the vertebral column, little is known about the mechanism of this. Understanding the signals that control normal IVD growth and differentiation would also provide potential therapies for degenerative disc disease, which is the major cause of lower back pain and affects a large proportion of the population. In this work, we show that during postnatal growth of the mouse, Sonic hedgehog (Shh) signaling from the NP cells controls many aspects of growth and differentiation of both the NP cells themselves and of the surrounding AF, and that it acts, at least partly, by regulating other signaling pathways in the NP and AF. Recent studies have shown that the NP cells arise from the embryonic notochord, which acts as a major signaling center in the embryo. This work shows that this notochord-derived tissue continues to carry out a major signaling function in the postnatal body and that the IVDs are signaling centers, in addition to their already known functions in the mechanics of vertebral column function.

Dahia, Chitra Lekha; Mahoney, Eric; Wylie, Christopher

2012-01-01

63

Variations in Gene and Protein Expression in Canine Chondrodystrophic Nucleus Pulposus Cells following Long-Term Three-Dimensional Culture  

PubMed Central

Intervertebral disc (IVD) degeneration greatly affects quality of life. The nucleus pulposus (NP) of chondrodystrophic dog breeds (CDBs) is similar to the human NP, because the cells disappear with age and are replaced by fibrochondrocyte-like cells. However, because IVD develops as early as within the first year of life, we used canines as a model to investigate in vitro the mechanisms underlying IVD degeneration. Specifically, we evaluated the potential of a three-dimensional (3D) culture of healthy NP as an in vitro model system to investigate the mechanisms of IVD degeneration. Agarose hydrogels were populated with healthy NP cells from beagles after performing magnetic resonance imaging, and mRNA expression profiles and pericellular extracellular matrix (ECM) protein distribution were determined. After 25 days of 3D culture, there was a tendency for redifferentiation into the native NP phenotype, and mRNA levels of Col2A1, COMP, and CK18 were not significantly different from those of freshly isolated cells. Our findings suggest that long-term 3D culture promoted chondrodystrophic NP redifferentiation through reconstruction of the pericellular microenvironment. Further, lipopolysaccharide (LPS) induced expression of TNF-?, MMP3, MMP13, VEGF, and PGES mRNA in the 3D cultures, creating a molecular milieu that mimics that of degenerated NP. These results suggest that this in vitro model represents a reliable and cost-effective tool for evaluating new therapies for disc degeneration.

Iwata, Munetaka; Ochi, Hiroki; Asou, Yoshinori; Haro, Hirotaka; Aikawa, Takeshi; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Tagawa, Masahiro; Hara, Yasushi

2013-01-01

64

In situ forming hydrogels composed of oxidized high molecular weight hyaluronic acid and gelatin for nucleus pulposus regeneration.  

PubMed

Encapsulation of nucleus pulposus (NP) cells within in situ forming hydrogels is a novel biological treatment for early stage intervertebral disc degeneration. The procedure aims to prolong the life of the degenerating discs and to regenerate damaged tissue. In this study we developed an injectable oxidized hyaluronic acid-gelatin-adipic acid dihydrazide (oxi-HAG-ADH) hydrogel. High molecular weight (1900 kDa) hyaluronic acid was crosslinked with various concentrations of gelatin to synthesize the hydrogels and their viscoelastic properties were analyzed. Interactions between the hydrogels, NP cells, and the extracellular matrix (ECM) were also evaluated, as were the effects of the hydrogels on NP cell gene expression. The hydrogels possess several clinical advantages, including sterilizability, low viscosity for injection, and ease of use. The viscoelastic properties of the hydrogels were similar to native tissue, as reflected in the complex shear modulus (?11-14 kPa for hydrogels, 11.3 kPa for native NP). Cultured NP cells not only attached to the hydrogels but also survived, proliferated, and maintained their round morphology. Importantly, we found that hydrogels increased NP cell expression of several crucial ECM-related genes, such as COL2A1, AGN, SOX-9, and HIF-1A. PMID:23041783

Chen, Yu-Chun; Su, Wen-Yu; Yang, Shu-Hua; Gefen, Amit; Lin, Feng-Huei

2012-10-04

65

Distinction between the extracellular matrix of the nucleus pulposus and hyaline cartilage: a requisite for tissue engineering of intervertebral disc.  

PubMed

Tissue engineering of intervertebral discs (IVD) using mesenchymal stem cells (MSCs) induced to differentiate into a disc-cell phenotype has been considered as an alternative treatment for disc degeneration. However, since there is no unique marker characteristic of discs and since hyaline cartilage and immature nucleus pulposus (NP) possess similar macromolecules in their extracellular matrix, it is currently difficult to recognize MSC conversion to a disc cell. This study was performed to compare the proteoglycan to collagen ratio (measured as GAG to hydroxyproline ratio) in the NP of normal disc to that of the hyaline cartilage of the endplate within the same group of individuals and test the hypothesis that this ratio can be used for in vivo studies to distinguish between a normal NP and hyaline cartilage phenotype. Whole human lumbar spine specimens from fresh cadavers, ranging in age from 12 weeks to 79 years, were used to harvest the IVDs and adjacent endplates. The GAG to hydroxyproline ratio within the NP of young adults is approximately 27:1, whereas the ratio within the hyaline cartilage endplate of the same aged individuals is about 2:1. The production of an extracellular matrix with a high proteoglycan to collagen ratio can be used in vivo to distinguish NP cells from chondrocytes, and could help in identifying a NP-like phenotype in vivo as opposed to a chondrocyte when MSCs are induced to differentiate for tissue engineering of a disc. PMID:15602703

Mwale, F; Roughley, P; Antoniou, J

2004-12-15

66

Impact of direct cell co-cultures on human adipose-derived stromal cells and nucleus pulposus cells.  

PubMed

Biologic and cellular treatment strategies aiming for curing intervertebral disc degeneration (IDD) have been proposed recently. Given the convenient availability and expansion potential, adipose-derived stromal cells (ADSCs) might be an ideal cell candidate. However, the interaction between ADSCs and nucleus pulposus (NP) cells still remains ambiguous, especially in direct co-cultures of the two types of cells. Nevertheless, NP markers in ADSCs after co-cultures were unidentified. Here, we addressed the interaction of human ADSCs and NP cells in a direct co-culture system for the first time. As a result, ADSCs could differentiate to the NP cell phenotype with a significant up-regulated expression of multiple genes and proteins in extracellular matrix (ECM) (SOX9, COL2A1, ACAN, and COL6A2), relative NP markers (FOXF1, PAX1, CA12, and HBB) and pertinent growth factors (CDMP-1, TGF-?1, IGF-1, and CTGF). Moreover, the gene expression of COL2A1, ACAN, and COL6A2 of degenerate NP cells was also up-regulated. Collectively, these results suggest that direct co-cultures of ADSCs and NP cells may exert a reciprocal impact, that is, both stimulating ADSCs differentiation to the NP cell phenotype and inducing NP cells to regain functional phenotype. Accordingly, ADSCs might be a potential candidate in the development of cellular treatment strategies for IDD. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1804-1813, 2013. PMID:23913869

Sun, Zhen; Liu, Zhi-Heng; Zhao, Xu-Hong; Sun, Lu; Chen, Yu-Fei; Zhang, Wei-Lin; Gao, Yang; Zhang, Yong-Zhao; Wan, Zhong-Yuan; Samartzis, Dino; Wang, Hai-Qiang; Luo, Zhuo-Jing

2013-08-02

67

Differentiation of Mouse Induced Pluripotent Stem Cells (iPSCs) into Nucleus Pulposus-Like Cells In Vitro  

PubMed Central

A large percentage of the population may be expected to experience painful symptoms or disability associated with intervertebral disc (IVD) degeneration – a condition characterized by diminished integrity of tissue components. Great interest exists in the use of autologous or allogeneic cells delivered to the degenerated IVD to promote matrix regeneration. Induced pluripotent stem cells (iPSCs), derived from a patient’s own somatic cells, have demonstrated their capacity to differentiate into various cell types although their potential to differentiate into an IVD cell has not yet been demonstrated. The overall objective of this study was to assess the possibility of generating iPSC-derived nucleus pulposus (NP) cells in a mouse model, a cell population that is entirely derived from notochord. This study employed magnetic activated cell sorting (MACS) to isolate a CD24+ iPSC subpopulation. Notochordal cell-related gene expression was analyzed in this CD24+ cell fraction via real time RT-PCR. CD24+ iPSCs were then cultured in a laminin-rich culture system for up to 28 days, and the mouse NP phenotype was assessed by immunostaining. This study also focused on producing a more conducive environment for NP differentiation of mouse iPSCs with addition of low oxygen tension and notochordal cell conditioned medium (NCCM) to the culture platform. iPSCs were evaluated for an ability to adopt an NP-like phenotype through a combination of immunostaining and biochemical assays. Results demonstrated that a CD24+ fraction of mouse iPSCs could be retrieved and differentiated into a population that could synthesize matrix components similar to that in native NP. Likewise, the addition of a hypoxic environment and NCCM induced a similar phenotypic result. In conclusion, this study suggests that mouse iPSCs have the potential to differentiate into NP-like cells and suggests the possibility that they may be used as a novel cell source for cellular therapy in the IVD.

Chen, Jun; Lee, Esther J.; Jing, Liufang; Christoforou, Nicolas; Leong, Kam W.; Setton, Lori A.

2013-01-01

68

Differentiation of Mouse Induced Pluripotent Stem Cells (iPSCs) into Nucleus Pulposus-Like Cells In Vitro.  

PubMed

A large percentage of the population may be expected to experience painful symptoms or disability associated with intervertebral disc (IVD) degeneration - a condition characterized by diminished integrity of tissue components. Great interest exists in the use of autologous or allogeneic cells delivered to the degenerated IVD to promote matrix regeneration. Induced pluripotent stem cells (iPSCs), derived from a patient's own somatic cells, have demonstrated their capacity to differentiate into various cell types although their potential to differentiate into an IVD cell has not yet been demonstrated. The overall objective of this study was to assess the possibility of generating iPSC-derived nucleus pulposus (NP) cells in a mouse model, a cell population that is entirely derived from notochord. This study employed magnetic activated cell sorting (MACS) to isolate a CD24(+) iPSC subpopulation. Notochordal cell-related gene expression was analyzed in this CD24(+) cell fraction via real time RT-PCR. CD24(+) iPSCs were then cultured in a laminin-rich culture system for up to 28 days, and the mouse NP phenotype was assessed by immunostaining. This study also focused on producing a more conducive environment for NP differentiation of mouse iPSCs with addition of low oxygen tension and notochordal cell conditioned medium (NCCM) to the culture platform. iPSCs were evaluated for an ability to adopt an NP-like phenotype through a combination of immunostaining and biochemical assays. Results demonstrated that a CD24(+) fraction of mouse iPSCs could be retrieved and differentiated into a population that could synthesize matrix components similar to that in native NP. Likewise, the addition of a hypoxic environment and NCCM induced a similar phenotypic result. In conclusion, this study suggests that mouse iPSCs have the potential to differentiate into NP-like cells and suggests the possibility that they may be used as a novel cell source for cellular therapy in the IVD. PMID:24086564

Chen, Jun; Lee, Esther J; Jing, Liufang; Christoforou, Nicolas; Leong, Kam W; Setton, Lori A

2013-09-25

69

Biological characteristics of adult degenerative nucleus pulposus cells in a three-dimensional microcarrier stirring culture system.  

PubMed

A major problem in reconstructing degenerative intervertebral discs is to obtain sufficient nucleus pulposus (NP) seeding cells with normal physiologic functions. The current study adopted a three-dimensional microcarrier culture system for massive cell expansion and evaluated the biological characteristics and physiological functions of the propagated adult degenerative NP cells. Isolated adult NP cells were cultured in either microcarrier stirring culturing system or traditional monolayer cultivation. The growth characteristics, proliferation, extracellular matrix secretion, and apoptosis potential were examined to evaluate the different features of the two cultivation methods. Compared to the monolayer cultivation system, the adhesion time of NP cells in the three-dimensional microcarrier culture system appeared longer with relatively transient stable growth period. MTT and (3)H-TdR assays suggested significantly elevated proliferation and higher thymidine incorporation rates in cells from microcarrier system compare to cells in the monolayer system at the exponential growth phase (p < 0.05). Western blot data complimented the immunostaining results that the NP cells in the microcarrier system expressed significantly more protein levels of both type collagens at the exponential growth phase than that in the monolayer system (p < 0.05). Further, significantly more (35)S labeled proteoglycan incorporation was noticed in the cells on the microcarriers at both the stable growth and the exponential growth phases (p < 0.05 and p < 0.01). In conclusion, the three-dimensional microcarrier stirring culture system provides a means of fast and massive propagation of NP seeding cells which maintain their normal physiological characteristics and functions. PMID:23335154

Ning, Bin; Liu, Haifei; Gong, Weiming; Jiang, Jianhao; Hu, Yougu; Yang, Shang-You

2013-01-17

70

Expression of Laminin Isoforms, Receptors and Binding Proteins Unique to Nucleus Pulposus Cells of Immature Intervertebral Disc  

PubMed Central

Intervertebral disc (IVD) disorders are believed to be related to aging-related cell loss and phenotypic changes, as well as biochemical and structural changes in the extracellular matrix of the nucleus pulposus (NP) region. Previously, we found that the laminin ?1 chain was more highly expressed in immature NP porcine tissues, in parallel with the expression pattern for a laminin receptor, integrin ?6 subunit, as compared to adjacent anulus fibrosus region; suggesting that cell-matrix interactions may be unique to the immature NP. However, the identity of laminin isoforms specific to immature or mature NP tissues, their associated receptors and functional significance are still poorly understood. In this study, we evaluated the zonal-specific expression of the laminin chains, receptors (i.e. integrins) and other binding proteins in immature tissue and isolated cells of rat, porcine and human intervertebral disc, towards the goal of revealing features of cellular environment and cell-matrix interactions in the immature NP. Results from both immuno-histochemical staining and flow cytometry analysis found that NP cells expressed higher levels of the laminin ?5 chain, laminin receptors (integrin ?3, ?6, ?4 subunit and CD239) and related binding proteins (CD151), as compared to cells from adjacent anulus fibrosus. These differences suggest that laminin interactions with NP cells are distinct from that of the anulus fibrosus, and that laminins may be important contributors to region-specific IVD biology. The revealed laminin isoforms, their receptors and related binding proteins may be used as distinguishing features of these immature NP cells in the intervertebral disc.

Chen, Jun; Jing, Liufang; Gilchrist, Christopher L; Richardson, William J; Fitch, Robert D; Setton, Lori A

2010-01-01

71

An injectable nucleus replacement as an adjunct to microdiscectomy: 2 year follow-up in a pilot clinical study  

Microsoft Academic Search

Literature indicates that loss of disc tissue from herniation and\\/or surgery can accelerate degeneration of the disc. The\\u000a associated loss of disc height may correspond with recurrent back and\\/or leg pain. A novel hydrogel has been developed to\\u000a replace lost nucleus pulposus and potentially restore normal disc biomechanics following herniation and surgery. A single-center,\\u000a non-randomized, prospective feasibility study was undertaken

Ulrich Berlemann; Othmar Schwarzenbach

2009-01-01

72

Differentiation of GFP-Bcl-2-engineered mesenchymal stem cells towards a nucleus pulposus-like phenotype under hypoxia in vitro.  

PubMed

Differentiation of bone marrow-derived mesenchymal stem cells (MSCs) into a nucleus pulposus-like phenotype under hypoxia has been proposed as a potential therapeutic approach for intervertebral disc degeneration. However, limited cell viability under hypoxic conditions has restricted MSC differentiation capacity and thus restricted its clinical application. In this study, we genetically modified MSCs with an anti-apoptotic GFP-Bcl-2 gene and evaluated cell survival and functional improvement under hypoxia in vitro. Rat bone marrow MSCs were transfected by lentiviral vectors with the GFP-Bcl-2 gene (GFP-Bcl-2-MSCs). Cell proliferation and apoptosis were assessed, and semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) was carried out to evaluate phenotypic and biosynthetic activities. In addition, Alcian blue staining was used to detect the formation of sulfated glycosaminoglycans (GAGs) in the differentiated cells. We found that the Bcl-2 gene protected MSCs against apoptosis. We also observed that Bcl-2 over-expression reduced apoptosis by 40.61% in non-transfected MSCs and 38.43% in vector-MSCs to 18.33% in Bcl-2-MSCs. At 3days, the number of viable Bcl-2-MSCs was approximately two times higher than the number of MSCs or vector-MSCs under hypoxic conditions. RT-PCR showed higher expression of chondrocyte-related genes (Sox-9, aggrecan and type II collagen) in GFP-Bcl-2-MSCs cultured under hypoxia. The accumulation of proteoglycans in the pellet was 86% higher in GFP-Bcl-2-MSCs than in the control groups. Furthermore, the ratio of proteoglycans/collagen II in GFP-Bcl-2-MSCs was 6.2-fold higher compared to the MSC and vector-MSC groups, which denoted a nucleus pulposus-like differentiation phenotype. Our findings support the hypothesis that anti-apoptotic gene-modified MSCs can differentiate into cells with a nucleus pulposus-like phenotype in vitro, which may have value for the regeneration of intervertebral discs using cell transplantation therapy. PMID:23416353

Fang, Zhong; Yang, Qin; Luo, Wei; Li, Guang-hui; Xiao, Jun; Li, Feng; Xiong, Wei

2013-02-12

73

The Potential of N-Rich Plasma-Polymerized Ethylene (PPE:N) Films for Regulating the Phenotype of the Nucleus Pulposus.  

PubMed

We recently developed a nitrogen-rich plasma-polymerized biomaterial, designated "PPE:N" (N-doped plasma-polymerized ethylene) that is capable of suppressing cellular hypertrophy while promoting type I collagen and aggrecan expression in mesenchymal stem cells from osteoarthritis patients. We then hypothesized that these surfaces would form an ideal substrate on which the nucleus pulposus (NP) phenotype would be maintained. Recent evidence using microarrays showed that in young rats, the relative mRNA levels of glypican-3 (GPC3) and pleiotrophin binding factor (PTN) were significantly higher in nucleus pulposus (NP) compared to annulus fibrosus (AF) and articular cartilage. Furthermore, vimentin (VIM) mRNA levels were higher in NP versus articular cartilage. In contrast, the levels of expression of cartilage oligomeric matrix protein (COMP) and matrix gla protein precursor (MGP) were lower in NP compared to articular cartilage. The objective of this study was to compare the expression profiles of these genes in NP cells from fetal bovine lumbar discs when cultured on either commercial polystyrene (PS) tissue culture dishes or on PPE:N with time. We found that the expression of these genes varies with the concentration of N ([N]). More specifically, the expression of several genes of NP was sensitive to [N], with a decrease of GPC3, VIM, PTN, and MGP in function of decreasing [N]. The expression of aggrecan, collagen type I, and collagen type II was also studied: no significant differences were observed in the cells on different surfaces with different culture time. The results support the concept that PPE:N may be a suitable scaffold for the culture of NP cells. Further studies are however necessary to better understand their effects on cellular phenotypes. PMID:19478889

Mwale, Fackson; Petit, Alain; Tian Wang, Hong; Epure, Laura M; Girard-Lauriault, Pierre-Luc; Ouellet, Jean A; Wertheimer, Michael R; Antoniou, John

2008-10-24

74

Effect of cryopreservation on canine and human activated nucleus pulposus cells: a feasibility study for cell therapy of the intervertebral disc.  

PubMed

It has been shown that coculture of bone marrow-derived stromal cells (BMSCs) with intervertebral disc (IVD) nucleus pulposus (NP) cells significantly activates the biological characteristics of NP cells in animal models and in humans. We therefore predicted that activated NP cells would be a useful graft source for cellular transplantation therapy in the treatment of degenerative IVDs. However, the activation protocol is based on fresh isolation and activation of NP cells, which limits the timing of clinical application. Cell transplantation therapy could be offered to more patients than is now possible if activated NP cells could be transplanted as and when required by the condition of the patient. No study has investigated the effect of cryopreservation on NP cells after enzymatic isolation. We investigated the effects of cryopreservation of canine and human NP cells in both cell and tissue form before coculture with autologous BMSCs. Cell viability, proliferation, glycosaminoglycan production, aggrecan transcriptional activity, colony generation, and gene expression profile of the cells after cryopreservation and subsequent coculture were analyzed. The influence of cryopreservation on cell chromosomal abnormalities and tumorigenesis was also studied. The results showed that there were no clear differences between the noncryopreserved and cryopreserved cells in terms of cell viability, proliferation capacity, and capacity to synthesize extracellular matrix. Furthermore, the cells showed no apparent chromosomal abnormalities or tumorigenic ability and exhibited similar patterns of gene expression. These findings suggest that by using cryopreservation, it may be possible to transplant activated NP cells upon request for patients' needs. PMID:23914334

Tanaka, Masahiro; Sakai, Daisuke; Hiyama, Akihiko; Arai, Fumiyuki; Nakajima, Daisuke; Nukaga, Tadashi; Nakai, Tomoko; Mochida, Joji

2013-08-01

75

Characterization of injectable hydrogels based on poly(N-isopropylacrylamide)-g-chondroitin sulfate with adhesive properties for nucleus pulposus tissue engineering.  

PubMed

The goal of this work is to develop an injectable nucleus pulposus (NP) tissue engineering scaffold with the ability to form an adhesive interface with surrounding disc tissue. A family of in situ forming hydrogels based on poly(N-isopropylacrylamide)-graft-chondroitin sulfate (PNIPAAm-g-CS) were evaluated for their mechanical properties, bioadhesive strength, and cytocompatibility. It was shown experimentally and computationally with the Neo-hookean hyperelastic model that increasing the crosslink density and decreasing the CS concentration increased mechanical properties at 37 °C, generating several hydrogel formulations with unconfined compressive modulus values similar to what has been reported for the native NP. The adhesive tensile strength of PNIPAAm increased significantly with CS incorporation (p < 0.05), ranging from 0.4 to 1 kPa. Live/Dead and XTT assay results indicate that the copolymer is not cytotoxic to human embryonic kidney (HEK) 293 cells. Taken together, these data indicate the potential of PNIPAAm-g-CS to function as a scaffold for NP regeneration. PMID:23371764

Wiltsey, Craig; Kubinski, Pamela; Christiani, Thomas; Toomer, Katelynn; Sheehan, Joseph; Branda, Amanda; Kadlowec, Jennifer; Iftode, Cristina; Vernengo, Jennifer

2013-01-31

76

FasL Expression on Human Nucleus Pulposus Cells Contributes to the Immune Privilege of Intervertebral Disc by Interacting with Immunocytes  

PubMed Central

The mechanisms of immune privilege in human nucleus pulposus (NP) remain unclear. Accumulating evidence indicates that Fas ligand (FasL) might play an important role in the immune privilege of the disc. We aimed for addressing the role of FasL expression in human intervertebral disc degeneration (IDD) and immune privilege in terms of the interaction between NP cells and immunocytes via the FasL-Fas machinery. We collected NP specimens from 20 patients with IDD as degenerative group and 8 normal cadaveric donors as control. FasL expression was detected by qRT-PCR, western blotting and flow cytometry (FCM). We also collected macrophages and CD8+ T cells from the peripheral blood of patients with IDD for co-cultures with NP cells. And macrophages and CD8+ T cells were harvested for apoptosis analysis by FCM after 2 days of co-cultures. We found that FasL expression in mRNA, protein and cellular resolutions demonstrated a significant decrease in degenerative group compared with normal control (p<0.05). FCM analysis found that human NP cells with increased FasL expression resulted in significantly increased apoptosis ratio of macrophages and CD8+ T cells. Our study demonstrated that FasL expression tends to decrease in degenerated discs and FasL plays an important role in human disc immune privilege, which might provide a novel target for the treatment strategies for IDD.

Liu, Zhi-Heng; Sun, Zhen; Wang, Hai-Qiang; Ge, Jun; Jiang, Ting-Shuai; Chen, Yu-Fei; Ma, Ying; Wang, Chen; Hu, Sheng; Samartzis, Dino; Luo, Zhuo-Jing

2013-01-01

77

Effect of nucleus pulposus cells having different phenotypes on chondrogenic differentiation of adipose-derived stromal cells in a coculture system using porous membranes.  

PubMed

In this study, adipose-derived stem cells (ASCs) were cocultured with nucleus pulposus (NP) cells using a porous membrane to investigate the effect of NP cell phenotype on ASC chondrogenic differentiation. Human NP cells were collected from 14 patients and classified into two groups (normal vs. degenerative) depending on the level of type II collagen, aggrecan (AGG), type I collagen, and bax gene expression. Human ASCs were then cocultured with each group of NP cells on porous membranes in the absence of chondrogenic supplements. After 2 weeks, real-time-polymerase chain reaction results showed that ASCs cocultured with normal NP cells had much higher type II collagen and AGG gene expression than ASCs cocultured with degenerative NP cells. The production of AGG was also observed only in the group cocultured with normal NP cells. Additionally, coculture of ASC pellets with normal NP cells promoted the production of AGG as compared to coculture of ASC monolayer with normal NP cells. These data demonstrate that a coculture system using porous membranes can induce ASC differentiation into NP cells without chondrogenic supplements. Further, the phenotype of cocultured NP cells significantly influences the extent of ASC differentiation. PMID:21599538

Choi, Eun-Hee; Park, Hansoo; Park, Kwang-Sook; Park, Kyung Soon; Kim, Byung-Soo; Han, In-Bo; Shin, Dong-Ah; Lee, Soo-Hong

2011-07-01

78

Hypoxia-inducible factor (HIF)-1? and CCN2 form a regulatory circuit in hypoxic nucleus pulposus cells: CCN2 suppresses HIF-1? level and transcriptional activity.  

PubMed

The objective of the study was to investigate if hypoxia-inducible factor (HIF)-1? and connective tissue growth factor (CCN2) form a regulatory network in hypoxic nucleus pulposus (NP) cells. A decrease in CCN2 expression and proximal promoter activity was observed in NP cells after hypoxic culture. Analysis of both human and mouse CCN2 promoters using the JASPAR core database revealed the presence of putative hypoxia response elements. Transfection experiments showed that both promoter activities and CCN2 expression decreases in hypoxia in a HIF-1?-dependent fashion. Interestingly, deletion analysis and mutation of the hypoxia responsive elements individually or in combination resulted in no change in promoter activity in response to hypoxia or in response to HIF-1?, suggesting an indirect mode of regulation. Notably, silencing of endogenous CCN2 increased HIF-1? levels and its target gene expression, suggesting a role for CCN2 in controlling basal HIF-1? levels. On the other hand, treatment of cells with rCCN2 resulted in a decrease in the ability of HIF-1? transactivating domain to recruit co-activators and diminished target gene expression. Last, knockdown of CCN2 in NP cells results in a significant decrease in GAG synthesis and expression of AGGRECAN and COLLAGEN II. Immunohistochemical staining of intervertebral discs of Ccn2 null embryos shows a decrease in aggrecan. These findings reveal a negative feedback loop between CCN2 and HIF-1? in NP cells and demonstrate a role for CCN2 in maintaining matrix homeostasis in this tissue. PMID:23530034

Tran, Cassie M; Fujita, Nobuyuki; Huang, Bau-Lin; Ong, Jessica R; Lyons, Karen M; Shapiro, Irving M; Risbud, Makarand V

2013-03-24

79

Smad3 Controls ?-1,3-Glucuronosyltransferase 1 Expression in Rat Nucleus Pulposus Cells: Implications of Dysregulated Expression in Disc Disease  

PubMed Central

Objective To study the regulation of expression of ?-1,3-glucuronosyltransferase 1 (GlcAT-1), an important regulator of glycosaminoglycan (GAG) synthesis, by Smad3 in nucleus pulposus (NP) cells. Methods GlcAT-1 expression was examined in rat NP and anulus fibrosus (AF) cells treated with transforming growth factor ? (TGF?). The effects of Smad signaling and Smad suppression on GlcAT-1 were examined in rat NP cells. GlcAT-1 expression was analyzed in the discs of Smad3-null mice and in degenerated human NP tissue. Results TGF? increased the expression of GlcAT-1 in rat NP but not rat AF cells. Suppression of GlcAT-1 promoter activity was evident with dominant-negative ALK-5 (DN-ALK-5). Cotransfection with Smad3 strongly induced promoter activity independent of TGF?. Bioinformatics analysis indicated the presence of several Smad binding sites in the promoter; deletion analysis showed that the region between ?274 and ?123 bp was required for Smad3 response. DN-Smad3, Smad 3 small interfering RNA, and Smad7 strongly suppressed basal as well as TGF?-induced promoter activity. Induction of promoter activity by Smad3 was significantly blocked by DN-Smad3; Smad7 had a very small effect. Lentiviral transduction of NP cells with short hairpin RNA Smad3 resulted in a decrease in GlcAT-1 expression and accumulation of GAG. Compared to wild-type mice, significantly lower expression of GlcAT-1 was seen in the discs of Smad3-null mice. Analysis of degenerated human NP tissue specimens showed no positive correlation between GlcAT-1 and TGF? expression. Moreover, isolated cells from degenerated human tissue showed a lack of induction of GlcAT-1 expression following TGF? treatment, suggesting an altered response. Conclusion Our findings demonstrate that in healthy NP cells, the TGF?–Smad3 axis serves as a regulator of GlcAT-1 expression. However, an altered responsiveness to TGF? during disc degeneration may compromise GAG synthesis.

Wu, Qianghua; Wang, Jianru; Skubutyte, Renata; Kepler, Christopher K.; Huang, Zonggui; Anderson, D. Greg; Shapiro, Irving M.; Risbud, Makarand V.

2013-01-01

80

CT of lumbar spine disk herniation: correlation with surgical findings  

SciTech Connect

Computed tomography (CT) of the lumbar spine was performed with selectively positioned 5-mm-thick axial cross sections to examine each disk level from the top of the neural foramen to the pedicle of the next caudad vertebra. One hundred consecutive patients with 116 surgical disk explorations were reviewed. There was agreement between the CT and surgical findings in 89 patients (104 explorations) in determination of presence or absence of a herniated nucleus pulposus (HNP). Discrepancy occurred in 12 instances (11 patients): two because of incorrect interpretations, five in previously operated patients, three in spondylolisthesis, and two in spinal stenosis. There were 97 true-positives, eight false-negatives, seven true-negatives, and four false-positives. If nine previously operated patients are excluded from the study, then CT was accurate in detection of presence or absence of an HNP in 93% of the disk explorations.

Firooznia, H.; Benjamin, V.; Kricheff, I.I.; Rafii, M.; Golimbu, C.

1984-03-01

81

BMP-2 and TGF-? Stimulate Expression of ?1,3-Glucuronosyl Transferase 1 (GlcAT-1) in Nucleus Pulposus Cells Through AP1, TonEBP, and Sp1: Role of MAPKs  

PubMed Central

The goal of the study was to investigate bone morphogenetic protein 2 (BMP-2) and transforming growth factor ? (TGF-?) control of the expression of ?1,3-glucuronosyl transferase 1 (GlcAT-1), an important regulator of chondroitin sulfate synthesis in cells of the nucleus pulposus. Treatment with both growth factors resulted in induction of GlcAT-1 expression and promoter activity. Deletion analysis indicated that promoter constructs lacking AP1 and TonE sites were unresponsive to growth factor treatment. Experiments using dominant-negative proteins showed that these transcription factors along with Sp1 were required for induction of GlcAT-1 promoter activity. Moreover, when either AP1 or TonE binding sites were mutated, induction was suppressed. Both BMP-2 and TGF-? increased c-Jun and TonEBP expression and phosphorylation of transactivation domains. We investigated the role of the mitogen-activated protein kinase (MAPK) signaling pathway following growth factor treatment; a robust and transient activation of ERK1/2, p38, and JNK was noted. Treatment with MAPK inhibitors blocked BMP-2- and TGF-?-induced AP1 reporter function, GlcAT-1 expression, and GAG accumulation. We found that DN-ERK1 but not DN-ERK2 resulted in suppression of growth factor–mediated induction of GlcAT-1 promoter activity; we also showed that p38? was important in GlcAT-1 activation. Results of these studies demonstrate that BMP-2 and TGF-? regulate GlcAT-1 expression in nucleus pulposus cells through a signaling network comprising MAPK, AP1, Sp1, and TonEBP. It is concluded that by controlling both GAG and aggrecan synthesis, these growth factors positively influence disk cell function. © 2010 American Society for Bone and Mineral Research.

Hiyama, Akihiko; Gogate, Shilpa S; Gajghate, Sachin; Mochida, Joji; Shapiro, Irving M; Risbud, Makarand V

2010-01-01

82

Prolyl hydroxylase 3 (PHD3) modulates catabolic effects of tumor necrosis factor-? (TNF-?) on cells of the nucleus pulposus through co-activation of nuclear factor ?B (NF-?B)/p65 signaling.  

PubMed

Recent studies suggest a differential role of prolyl hydroxylase (PHD) isoforms in controlling hypoxia-inducible factor (HIF)-? degradation and activity in nucleus pulposus (NP) cells. However, the regulation and function of PHDs under inflammatory conditions that characterize disc disease are not yet known. Here, we show that in NP cells, TNF-? and IL-1? induce PHD3 expression through NF-?B. Lentiviral delivery of Sh-p65 and Sh-IKK? confirms that cytokine-mediated PHD3 expression is NF-?B-dependent. It is noteworthy that although both cytokines induce HIF activity, mechanistic studies using Sh-HIF-1? and PHD3 promoter/enhancer constructs harboring well characterized hypoxia response element (HRE) show lack of HIF involvement in cytokine-mediated PHD3 expression. Loss-of-function studies clearly indicate that PHD3 serves as a co-activator of NF-?B signaling activity in NP cells; PHD3 interacts with, and co-localizes with, p65. We observed that when PHD3 is silenced, there is a significant decrease in TNF-?-induced expression of catabolic markers that include ADAMTS5, syndecan4, MMP13, and COX2, and at the same time, there is restoration of aggrecan and collagen type II expression. It is noteworthy that hydroxylase function of PHDs is not required for mediating cytokine-dependent gene expression. These findings show that by enhancing the activity of inflammatory cytokines, PHD3 may serve a critical role in degenerative disc disease. PMID:22948157

Fujita, Nobuyuki; Gogate, Shilpa S; Chiba, Kazuhiro; Toyama, Yoshiaki; Shapiro, Irving M; Risbud, Makarand V

2012-09-04

83

Effect of pathology type and severity on the distribution of MRI signal intensities within the degenerated nucleus pulposus: application to idiopathic scoliosis and spondylolisthesis  

Microsoft Academic Search

BACKGROUND: Disc degeneration is characterized by a loss of cellularity, degradation of the extracellular matrix, and, as a result, morphological changes and biomechanical alterations. We hypothesized that the distribution of the MR signal intensity within the nucleus zone of the intervertebral disc was modified according to the pathology and the severity of the pathology. The objective of this study was

Delphine Périé; Daniel Curnier

2010-01-01

84

Brain herniation  

MedlinePLUS

... blinking, gagging, pupils reacting to light) Loss of consciousness Respiratory arrest (no breathing) Wide (dilated) pupils and ... nervous system (neurological) exam shows changes in alertness (consciousness). Depending on the severity of the herniation and ...

85

Stem cell regeneration of the nucleus pulposus  

Microsoft Academic Search

Low back pain due to disc degeneration is one of the largest health problems faced in this nation when judged by lost work time and direct as well as indirect costs. Many experimental methods are being explored to treat or to reverse the effect of disc degeneration. This article reviews the strategy of a tissue engineering approach to disc regeneration.

Makarand V. Risbud; Irving M. Shapiro; Alexander R. Vaccaro; Todd J. Albert

2004-01-01

86

Spinal nociceptive hyperexcitability induced by experimental disc herniation is associated with enhanced local expression of Csf1 and FasL.  

PubMed

Sciatica after disc herniation may be associated with compression of spinal nerves, but also inflammatory substances released from the nucleus pulposus (NP) leaking into the spinal canal. Here, in an animal model mimicking clinical intervertebral disc herniation, we investigate the effect of NP on neuronal activity. In anaesthetized Lewis rats, extracellular single-unit recordings of spinal dorsal horn neurons were performed, and the C-fibre responses were examined. Moreover, quantitative polymerase chain reaction was used to explore the gene expression of proinflammatory cytokines in the NP tissue exposed to the spinal dorsal nerve roots L3-L5. In accordance with earlier studies, we showed a significant increase in the C-fibre response and an upregulation of the gene expression of interleukin 1? and tumour necrosis factor 180minutes after application of NP onto the nerve roots. Moreover, based on a polymerase chain reaction array of 84 common inflammatory cytokines at the same time point, we demonstrated a highly significant upregulation of colony-stimulating factor 1 also termed macrophage colony-stimulating factor and Fas ligand. The pronounced upregulation of Csf1 and Fas ligand 180minutes after application of NP onto the nerve roots suggests that macrophage activation and apoptosis may be involved in pain hypersensitivity and other sensory abnormalities after disc herniation. PMID:23711477

Egeland, Nina Gran; Moen, Aurora; Pedersen, Linda Margareth; Brisby, Helena; Gjerstad, Johannes

2013-05-24

87

Management of herniated intervertebral disks during saturation dives: a case report.  

PubMed

During research saturation dives at 5.0 and 5.5 atm abs, 2 divers developed an acute herniation of the nucleus pulposus of the L5-S1 intervertebral disk. In both cases the pain was severe enough to require intravenous morphine or intramuscular meperidine. Although the symptoms presented by these divers are frequently considered to be an indication for immediate surgical consultation, we decided that emergency decompression posed an unacceptable risk that decompression sickness (DCS) would develop in the region of acute inflammation. In both cases strict bedrest and medical therapy were performed at depth. In the first case, 12 h was spent at depth before initiating a standard U.S. Navy saturation decompression schedule with the chamber partial pressure of oxygen elevated to 0.50 atm abs. In the second case, a conservative He-N2-O2 trimix decompression schedule was followed to the surface. In both cases, no initial upward excursion was performed. The required decompression time was 57 h 24 min from 5.5 atm abs and 55 h 38 min from 5.0 atm abs. During the course of decompression, the first diver's neurologic exam improved and he required decreasing amounts of intravenous narcotic; we considered both to be evidence against DCS. The second diver continued to have pain and muscle spasm throughout decompression, however he did not develop motor, reflex, or sphincter abnormalities. Both divers have responded well to nonsurgical therapy. PMID:1534427

Stevens, D M; Caras, B G; Flynn, E T; Dutka, A J; Thorp, J W; Thalmann, E D

1992-05-01

88

Herniated Cervical Disc  

MedlinePLUS

... outer layer can also tear. This can allow displacement of the disc's center (called a herniated or ... diagnosed? A thorough clinical evaluation to determine the character and location of the pain plus an examination ...

89

Percutaneous treatment of intervertebral disc herniation.  

PubMed

Interventional radiology plays a major role in the management of symptomatic intervertebral disc herniations. In the absence of significant pain relief with conservative treatment including oral pain killers and anti-inflammatory drugs, selective image-guided periradicular infiltrations are generally indicated. The precise control of needle positioning allows optimal distribution of steroids along the painful nerve root. After 6 weeks of failure of conservative treatment including periradicular infiltration, treatment aiming to decompress or remove the herniation is considered. Conventional open surgery offers suboptimal results and is associated with significant morbidity. To achieve minimally invasive discal decompression, different percutaneous techniques have been developed. Their principle is to remove a small volume of nucleus, which results in an important reduction of intradiscal pressure and subsequently reduction of pressure inside the disc herniation. However, only contained disc herniations determined by computed tomography or magnetic resonance are indicated for these techniques. Thermal techniques such as radiofrequency or laser nucleotomy seem to be more effective than purely mechanical nucleotomy; indeed, they achieve discal decompression but also thermal destruction of intradiscal nociceptors, which may play a major role in the physiopathology of discal pain. The techniques of image-guided spinal periradicular infiltration and percutaneous nucleotomy with laser and radiofrequency are presented with emphasis on their best indications. PMID:21629404

Buy, Xavier; Gangi, Afshin

2010-06-01

90

Can Prevention of a Reherniation Be Investigated? Establishment of a Herniation Model and Experiments With an Anular Closure Device  

PubMed Central

Study Design. Biomechanical in vitro study. Objective. To establish a reliable in vitro herniation model with human cadaver spines that enables evaluation of anular closure devices. Summary of Background Data. Biomechanically, it is desirable to close anulus defects after disc herniation to preserve as much nucleus as possible. Multiple anular closure options exist to prevent reherniation. A reliable test procedure is needed to evaluate the efficacy and reliability of these implants. Methods. Two groups of human lumbar segments (n = 6 per group) were tested under cyclic loading until herniation occurred or 100,000 load cycles were applied. One group contained moderate/severe degenerated discs. A second group had mild degenerated discs. Intradiscal pressure was measured in the intact state to confirm disc quality. If herniation occurred, the extruded material was reinserted into the disc and the anulus defect was treated with the Barricaid anular closure device (Intrinsic Therapeutics, Inc., Woburn, MA). Disc height and 3-dimensional flexibility of the specimens in the intact, defect, and implanted states were measured under pure moments in each principal motion plane. Afterwards, provocation of reherniation was attempted with additional 100,000 load cycles. Results. Likelihood of herniation was strongly linked to disc degeneration and supported by the magnitude of intradiscal pressure. In moderate/severe degenerated discs, only 1 herniation was created. In mild degenerated discs, herniations were reliably created in all specimens. Using this worst-case model, herniation caused a significant reduction of disc height, which was nearly restored with the implant. In no case was reherniation or implant migration visible after 100,000 load cycles after Barricaid implantation. Conclusion. We established a human herniation model that reliably produced nucleus extrusion during cyclic loading by selecting specimens with low disc degeneration. The Barricaid seems to prevent nucleus from reherniating. The reliability of this method suggests the opportunity to investigate other anulus closure devices and nucleus replacement techniques critically.

Wilke, Hans-Joachim; Ressel, Lena; Heuer, Frank; Graf, Nicolas; Rath, Stefan

2013-01-01

91

Ochronosis and lumbar disc herniation  

Microsoft Academic Search

Summary  Alkaptonuria is a rare, autosomal recessive metabolic disorder in which the homogentisic acid oxidase activity is absent.\\u000a Its incidence is as low as 0.001%. Ochronosis is the pigmentation of connective tissues and this pigmentation leads to degenerative\\u000a changes in alkaptonuric patients.\\u000a \\u000a Alkaptonuria most prominently involves the lumbar region, but lumbar disc herniation as the presenting feature of alkaptonuria\\u000a is not

D. Gürkanlar; M. Daneyemez; I. Solmaz; C. Temiz

2006-01-01

92

Endoscopic Discectomy for Extraforaminal Lumbar Disc Herniation  

Microsoft Academic Search

The microendoscopic discectomy (MED) technique has been one of the promising surgeries for lumbar disc herniation in the last few years. The purpose of this study is to report the feasibility of a minimally invasive technique for extraforaminal lumbar disc herniation. Ten patients with extraforaminal lumbar disc herniation (one at L3-4, four at L4-5, and five at L5-S1) underwent MED

Yuichi Takano; Nobuhiro Yuasa

93

Two-Level Thoracic Disc Herniation  

Microsoft Academic Search

We report a rare case of two-level thoracic disc herniation that occurred in a 48-year-old woman. She was referred with a 10-month history of pain on the right side of the thorax. On examination, she had hypoesthesia and hypalgesia in the right T6-T8 dermatomes. An MRI scan revealed a large herniated disc at the T7\\/8 level and a smaller herniated

NIELS LEVI; KJELD DONS

94

Risk factors of recurrent lumbar disk herniation  

PubMed Central

Background: Recurrent lumbar disc herniation (LDH) is a common cause of poor outcomes after lumbar discectomy surgery. Studies focused on risk factors of true recurrent disk herniation at the same level and side, are few. The aim of current study is to evaluate risk factors of recurrent disc herniation in Iranian population. Materials and Methods: We retrospectively reviewed 40 patients with recurrent disc herniation and 120 patients without recurrence to evaluate possible risk factors for herniation recurrence. A clinically significant recurrent herniation was defined as a disc herniation causing leg pain with radiographic (MRI) evidence of disc material at the same side and level of the index surgery causing impingement, compression, or deviation of nerve tissue. A series of patients without recurrence was used for comparison to identify possible risk factors for recurrent LDH. Results: There was significant difference between groups with and without LDH in sex (P = 0.003), smoking habit (P = 0.004), height (P = 0.04), weight (P = 0.006) and occupational characteristic (P < 0.001). By putting these differences in logistic regression analysis, it showed that gender (male), taller height, heavy works and being smoker could predict lumbar disc herniation recurrence. Conclusion: Considering sex, smoking and heavy works as predictors of recurrent LDH, surgeons should advice their patients to limit hard work and put away smoking especially in tall and male ones to prevent LDH recurrence.

Shimia, Mohammad; Babaei-Ghazani, Arash; Sadat, Bina Eftekhar; Habibi, Behnaz; Habibzadeh, Afshin

2013-01-01

95

Traumatic herniation of the buccal fat pad  

Microsoft Academic Search

Two new cases of traumatic herniation of the buccal fat pad are presented. The herniated fat pad was repositioned in case 1 and was excised in case 2. There was no recurrence after surgery in each case. Reviewing the literature, the lesion usually occurred in infants or young children under the age of 4 years as a result of traumatic

Norio Horie

2001-01-01

96

Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation  

PubMed Central

The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for early diagnosis and treatment.

Bae, Jun Seok; Pee, Yong Hun; Lee, Sang-Ho

2012-01-01

97

[Dorsal disc herniation. 13 cases].  

PubMed

Thirteen patients with thoracic disc herniation have been operated on between 1960 and 1984. Nine presented with a progressive cord compression syndrome affecting sensory function more than motor. Four patients presented with acute cord compression. During this period, the authors have abandoned medullary angiography and myelography. The diagnosis is now based on computerised myelotomography. Three cases were treated by laminectomy with two postoperative deteriorations. Two cases were treated by a transthoracic approach which seemed to be too risky. Eight cases were treated through a postero-lateral approach, six being through a transverse arthropediculectomy using a microscope for better dissection of the vessels and Harrington rods to avoid secondary kyphosis. Seven of 9 cord syndromes were improved. Four cases with predominantly radicular syndromes were all improved. PMID:3797727

Lesoin, F; Rousseaux, M; Autricque, A; Villette, L; Clarisse, J; Jomin, M

1986-01-01

98

Disc degeneration after disc herniation: are we accelerating the process?  

PubMed Central

Study design:?Systematic review. Study rationale:?Disc degeneration is a common process starting early in life. Often disc herniation is an early step in disc degeneration, which may cause pain or stenosis. How quickly this subsequent disc degeneration occurs following a disc herniation and subsequent surgical treatment and whether certain spinal procedures increase the rate of degeneration remain unclear. Objectives:?To investigate the risk of subsequent radiographic disc degeneration following discectomy, discography, and conservative care in patients with a first-time diagnosed herniated nucleus pulpous (HNP) and to ascertain whether this risk in these defined groups changes over time. Methods:?A systematic review of pertinent articles published up to June 2012. Key articles were searched to identify studies evaluating the risk of subsequent radiographic disc degeneration following treatment for HNP. Studies that included patients undergoing secondary surgery for disc herniation or that did not use a validated classification system to measure the severity of disc degeneration were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results:?From a total of 147 possible citations, three cohort studies (class of evidence III) met our inclusion criteria and form the basis for this report. The risk of subsequent lumbar disc degeneration following standard discectomy was significantly greater compared with both microdiscectomy (48.7% vs 9.1%) and asymptomatic controls (90% vs 68%) in two studies with mean follow-ups of 5.5 and 25.3 years, respectively. Following conservative care for first-time HNP in the third study, the risk of progression of lumbar disc degeneration was 47.6% over the first 2 years of follow-up and 95.2% over the next 6 years of follow-up. In the same study, the risk of lumbar disc degeneration was shown to increase incrementally over the course of the 8-year follow-up, with all patients showing signs of degeneration at final examination. Conclusion:?Standard discectomy in first-time lumbar HNP may increase the risk of subsequent same-level lumbar disc degeneration compared with microdiscectomy as seen in one low-quality study. However, disc degeneration is likely a natural, temporal consequence following HNP, as demonstrated in a second low-quality study. The overall strength of evidence for the conclusions is very low.

Schroeder, Josh E.; Dettori, Joseph R.; Brodt, Erika D.; Kaplan, Leon

2012-01-01

99

Fas\\/FasL interaction of nucleus pulposus and cancer cells with the activation of caspases  

Microsoft Academic Search

Spinal metastatic disease is characterised by the preservation of the intervertebral disc structure, even after severe destruction\\u000a of the vertebral body by neoplastic tissues. Anatomical features of the discs are thought to be the reason for the disc’s\\u000a resistance to metastatic cancer. However, little is known about the biochemical mechanism to prevent or attenuate the local\\u000a invasion of cancer cells

Jong-Beom Park; Jin-Kyung Lee; Eun-Young Park; K. Daniel Riew

2008-01-01

100

Lumbar disc nucleoplasty using coblation technology: clinical outcome  

Microsoft Academic Search

Background and purposeAlthough the standard treatment for lumbar disc herniation is lumbar microdiscectomy, nucleoplasty offers a new technique with encouraging results in well selected cases. Nucleoplasty is a minimally invasive technique that manages intradiscal herniation through energy based removal of part of the nucleus pulposus. The purpose of this study was to assess the safety and clinical outcome of the

Alaa Azzazi; Sherif AlMekawi; Mostafa Zein

2010-01-01

101

Cardiac herniation following completion pneumonectomy for bronchiectasis.  

PubMed

Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm x 4 cm area of adherent pericardium near the obtuse margin of heart was removed during surgery. During head-end elevation of the bed in postoperative intensive care unit, patient got accidentally tilted to the left side, which resulted in ventricular fibrillation. Chest cavity was re-opened for cardiopulmonary resuscitation. Left ventricle was found herniating through the pericardial deficiency into the left-thoracic cavity with the cardiac apex touching chest wall. During surgical re-exploration, the pericardial deficiency was closed with a synthetic Dacron patch. Hemodynamic condition remained stable in the immediate postoperative period. Patients had infection of the left thoracic cavity after 5 weeks, for which he was subjected to thoracoplasty and omentopexy. Prompt recognition with timely intervention is life saving from cardiac herniation. Strategy of closing the pericardial defect after pneumonectomy should be followed routinely, irrespective of the indication for pneumonectomy. PMID:20826968

Gadhinglajkar, Shrinivas; Siddappa, Shivananda; Sreedhar, Rupa; Madathipat, Unnikrishnan

102

Resorption of thoracic disc herniation. Report of 2 cases.  

PubMed

The authors describe 2 cases of thoracic disc herniation, resulting in acute myelopathy without bladder dysfunction or progressive muscular weakness; the herniated disc apparently resorbed without surgical intervention. Thoracic disc herniations are less frequent than cervical or lumbar disc herniations and are usually associated with severe neurological deficits. In these 2 cases, the herniated discs exhibited marked decreases in size, corresponding to a favorable clinical outcome within a few months after the initiation of conservative treatment with prostaglandin E(1) and/or steroids in conjunction with physical therapy. The authors conclude that thoracic herniated discs are capable of undergoing natural resorption and that conservative treatment could be indicated, even in the presence of moderate myelopathy, when the myelopathy is not accompanied by bladder dysfunction or progressive muscular weakness. PMID:18312085

Haro, Hirotaka; Domoto, Toru; Maekawa, Shingo; Horiuchi, Tadahiro; Komori, Hiromichi; Hamada, Yoshiki

2008-03-01

103

Thoracic disc herniation and spinal cord injury.  

PubMed

A 52-yr-old male developed progressive thoracic myelopathy after a fall. At laminectomy using the standard posterior approach, he was found to have a herniated thoracic disc compressing the spinal cord. Postoperatively, he was paraplegic. We had a series of three such patients. This paper discusses the problems associated with discectomy using the standard posterior approach and reviews the literature about the alternative approaches for surgical treatment available today. PMID:3179014

Hegde, S; Staas, W E

1988-10-01

104

Revision surgery for lumbar disc herniation  

Microsoft Academic Search

We reviewed 45 patients who had undergone repeated open operations for lumbar disc herniation. There were 26 men and 19 women with a mean follow up of 4.3 years. Twenty-four patients had had one previous discectomy, 12 had 2, and 9 had 3 or more; 11 needed a fusion without instrumentation. Residual or re-extruded disc hernias, either sub- or transligamentous,

H. Baba; Q. Chen; K. Kamitani; S. Imura; K. Tomita

1995-01-01

105

Breathing patterns in children with craniofacial dysostosis and hindbrain herniation  

Microsoft Academic Search

In the past few years, hindbrain herniation has become recognized as a frequent feature of the child with syndromic craniofacial dysostosis. The clinical sig- nificance of hindbrain herniation in these disorders is unclear. Abnormalities of respi- ratory control have frequently been reported. The aim of the present study was to document the incidence of obstructive and central respiratory abnormalities during

S. L. Gonsalez; D. Thompson; R. Hayward

1998-01-01

106

Lung herniation: a rare complication in minimally invasive cardiothoracic surgery  

Microsoft Academic Search

Objective: Lung herniation, defined as a protrusion of the lung parenchyma with pleural membranes through a defect of the thoracic wall, is a rare entity. As minimally invasive cardiac procedures evolve, different complications may be evident such as lung herniation. A retrospective review of all patients submitted to minimally invasive cardiac or transplant surgery through anterior mini-thoracotomy at our department

Kalliopi Athanassiadi; Erik Bagaev; Andre Simon; Axel Haverich

2008-01-01

107

Lung herniation: a rare complication in minimally invasive cardiothoracic surgery  

Microsoft Academic Search

Objective: Lung herniation, defined as a protrusion of the lung parenchyma with pleural membranes through a defect of the thoracic wall, is a rare entity. As minimally invasive cardiac procedures evolve, different complications may be evident such as lung herniation. A retrospective review of all patients submitted to minimally invasive cardiac or transplant surgery through anterior mini-thoracotomy at our department

Kalliopi Athanassiadi; Erik Bagaev; Andre Simon; Axel Haverich

2010-01-01

108

Recurrence of sciatica following hemilaminectomy for disc herniation  

Microsoft Academic Search

This retrospective study investigated the causes of ipsilateral sciatica following formal hemilaminectomy and discectomy for disc herniation and analyzed the factors that influence the outcome of revision surgery for recurrence. From a series of 1,016 patients who were operated upon for primary lumbar disc herniation, 64 patients were revised because of persistent or recurrent sciatica and back pain. Successful outcome

Konstantinos Liaropoulos; Paraskevi Spiropoulou; Nikolaos Papadakis; Th Maraziotis; Panagiotis Korovessis

2003-01-01

109

Low-Back Pain Following Surgery for Lumbar Disc Herniation  

Microsoft Academic Search

Background: Lumbar disc herniation often causes sciatica. Although surgery may provide relief of sciatic pain, it is uncertain how surgery affects the relief of low-back pain. The purpose of the present prospective study was to assess the efficacy of discectomy in the treatment of low-back pain associated with lumbar disc herniation. Methods: Between 1998 and 2001, forty consecutive patients with

TOMOAKI TOYONE; TADASHI TANAKA; DAISUKE KATO; RYUTAKU KANEYAMA

110

Diagnosis and prognosis in lumbar disc herniation.  

PubMed

In a prospective 2-year followup study of 160 consecutive patients undergoing primary surgery for suspected lumbar disc herniation, the authors studied the diagnostic and prognostic factors by using stepwise logistic regression analysis. When the different factors were entered in the same order as presented clinically, history and pain analysis contained most of the predictive information available. When all factors were entered simultaneously in the computations, the following factors (in order of relative importance) predicted relief of sciatica after 2 years: rupture of the anulus (as opposed to bulging disc or negative exploration), no preoperative comorbidity, and male gender. The following factors predicted return to work at 2 years: no preoperative comorbidity, duration of sciatica less than 7 months, education or vocational training in addition to compulsory school, age younger than 41 years, male gender, and no previous nonspinal surgery. Return to work does not seem to be a valid result parameter in lumbar disc surgery. The most important physical signs were root tension tests and lumbar range of motion, whereas neurologic signs were of secondary importance. Many people have asymptomatic herniations, and today supersensitive diagnostic imaging is widely available. Thus, the importance of clinical evaluation has increased, and most of the relevant information can be obtained by listening to the patient. A simple anamnesis apparently is a good alternative to psychologic tests in surgical triage. PMID:10212604

Vucetic, N; Astrand, P; Güntner, P; Svensson, O

1999-04-01

111

Sacral Perineural Cyst Accompanying Disc Herniation  

PubMed Central

Although most of sacral perineural cysts are asymptomatic, some may produce symptoms. Specific radicular pain may be due to distortion, compression, or stretching of nerve root by a space occupying cyst. We report a rare case of S1 radiculopathy caused by sacral perineural cyst accompanying disc herniation. The patient underwent a microscopic discectomy at L5-S1 level. However, the patient's symptoms did not improved. The hypesthesia persisted, as did the right leg pain. Cyst-subarachnoid shunt was set to decompress nerve root and to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and cyst. Immediately after surgery, the patient had no leg pain. After 6 months, the patient still remained free of leg pain.

Ju, Chang Il; Shin, Ho; Kim, Hyeun Sung

2009-01-01

112

Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome  

PubMed Central

Summary This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.

Guest, J.D.; Griesdale, D.E.; Marotta, T.

2000-01-01

113

Sagittal spinal alignment in patients with lumbar disc herniation  

Microsoft Academic Search

A retrospective cross-sectional study was designed to evaluate total sagittal spinal alignment in patients with lumbar disc\\u000a herniation (LDH) and healthy subjects. Abnormal sagittal spinal alignment could cause persistent low back pain in lumbar disease.\\u000a Previous studies analyzed sciatic scoliotic list in patients with lumbar disc herniation; but there is little or no information\\u000a on the relationship between sagittal alignment

Kenji Endo; Hidekazu Suzuki; Hidetoshi Tanaka; Yupeng Kang; Kengo Yamamoto

2010-01-01

114

Outcomes of cervical and lumbar disk herniations in Major League Baseball pitchers.  

PubMed

The effects of disk herniations on the career and performance outcomes of Major League Baseball (MLB) pitchers are unknown. The purpose of this study is to determine the outcomes after a cervical or lumbar disk herniation for MLB pitchers. Forty MLB pitchers from 1984 to 2009 with a cervical disk herniation or lumbar disk herniation were identified using a previously established protocol. Cervical disk herniation was identified in 11 pitchers, 8 of which were treated operatively. The majority of pitchers with cervical disk herniation (8/11) returned to play at an average of 11.6 months. Lumbar disk herniation was identified in 29 pitchers, 20 of which were treated operatively. All pitchers with lumbar disk herniation (29/29) returned to play at an average of 7.3 months after diagnosis. PMID:21800814

Roberts, David W; Roc, Gilbert J; Hsu, Wellington K

2011-08-01

115

Clinical Outcomes of Epidural Neuroplasty for Cervical Disc Herniation  

PubMed Central

Cervical disc herniation is a common disorder characterized by neck pain radiating to the arm and fingers as determined by the affected dermatome. This condition has a favorable prognosis, but pain can have a serious detrimental impact on daily activities. Epidural neuroplasty has been applied as a treatment option for cervical disc herniation; however, no study has addressed the clinical outcomes. This retrospective study evaluated the clinical outcomes of epidural neuroplasty on 128 patients for the treatment of cervical disc herniation. To measure pain-related disabilities over time, the changes of pain scores in neck and arm were evaluated using a numerical rating scale (NRS) and the neck disability index (NDI). Compared with preprocedural values, the pain NRS of neck and arm demonstrated significant improvement at day 1, and 1, 3, 6, and 12 months after the procedure (P < 0.001). Likewise, the NDI was significantly reduced at 3, 6, and 12 months after the procedure (P < 0.001). There were no serious complications. Cervical epidural neuroplasty shows good clinical outcomes in the treatment of cervical disc herniation and can be considered a treatment modality for cervical disc herniation refractory to conservative treatment.

Park, Eun Jung; Park, Sun Young; Lee, Se Jin; Koh, Do Yle

2013-01-01

116

[Diaphragmatic herniation after oesophagectomy: a report of two cases].  

PubMed

Diaphragmatic herniation is the protrusion of abdominal structures into the chest through a defect in the diaphragm. It is a rare complication following oesophagectomy. Preoperative diagnosis is important in order to establish both the nature and extent of the diaphragmatic defect. The treatment of choice is surgery. In a series of 574 intrathoracic oesophagogastroplasties performed at our Institution from 1990 to 2004, the prevalence of diaphragmatic herniation was 0.35%. We report two cases of major diaphragmatic herniation after oesophagectomy for cancer performed using a laparotomic-thoracotomic (case 1) and a laparoscopicthoracotomic approach (case 2). The case 1 patient was asymptomatic: hernia repair involved hiatoplasty and mesh positioning. The case 2 patient presented with vomiting and abdominal pain: she underwent emergency laparoscopic surgery and direct closure of the diaphragmatic tear. At 12 months' follow-up, both patients were symptom-free. A barium swallow confirmed that the previously herniated abdominal viscera had returned to the abdomen. Diaphragmatic herniation following oesophagectomy is a rare complication which may be asymptomatic or present as bowel obstruction. Several aetiopathogenetic factors may be responsible for diaphragmatic hernias: enlargement of the diaphragmatic hiatus, a combination of negative pressure in the chest and positive pressure in the abdomen, and small number of adhesions in the case of patients operated on with minimally invasive surgery. Surgical repair is the treatment of choice and is mandatory as emergency treatment in the case of symptomatic hernias. PMID:17663385

Rampado, Sabrina; Zaninotto, Giovanni; Fiore, Davide; Ruol, Albero; Castoro, Carlo; Portale, Giuseppe; Ancona, Ermanno

117

Relationship between Physical Work Load and Lumbar Disc Herniation.  

PubMed

Lumbar disc herniation (LDH) is a disabling problem. This retrospective case control study was done to evaluate the possible relevance of physical work load with Lumbar Disc Herniation. We have performed this study in the Spinal Surgery Unit of Department of Orthopaedic Surgery at BSMMU, Dhaka from July 2007 to June 2010 where 200 cases with Lumbar Disc Herniation and 200 control subjects matched by age, gender and area of residence were taken and analyzed. Chi-square test was computed for sex, area of residence, type of physical work and effort at work, whereas Odds ratio was computed for physical work load, stress at work and daily working period. The highest odds ratio (OR) was with the physical work load (OR: 03.48, CI: 01.84-06.59), hard work (OR: 03.14, CI: 01.74-05.65) and working period of >8 hours (OR: 01.34, CI: 0.75-02.38). Odds ratio for heavy load carrying at work was 03.48 and less job satisfaction or stress at work was 02.45. There was a statistically significant positive association between cumulative exposure of physical work load and lumbar disc herniation indicating an increased occurrence of herniation in heavy physical work load and occupation requiring harder efforts. PMID:23982545

Ahsan, M K; Matin, T; Ali, M I; Ali, M Y; Awwal, M A; Sakeb, N

2013-07-01

118

Intraspinal Extradural Cysts Communicating with Adjacent Herniated Disks: Imaging Characteristics and Possible Pathogenesis  

Microsoft Academic Search

Summary: We report two cases of intraspinal extradural cysts communicating with an adjacent herniated disk that we term ''disk cysts.'' These cysts were well defined and homogeneous, and were present in the ventrolateral ex- tradural space adjacent to a lumbar herniated disk. They had rim enhancement on contrast-enhanced MR images, and communication with a herniated disk was revealed by diskography.

Kinuko Kono; Hiroaki Nakamura; Yuichi Inoue; Terue Okamura; Miyuki Shakudo; Ryusaku Yamada

119

Treatment of a symptomatic forearm muscle herniation with a mesh graft.  

PubMed

Symptomatic muscle herniations are an unusual cause of upper extremity pain in the athlete that is rarely reported in the literature. Out of 18 reported cases of upper extremity herniations, only 3 were caused by strenuous exertion. This article describes a successful repair of a 21-year-old rock climber's ventral forearm herniation with polypropylene mesh. PMID:23016006

Sanders, Brett S; Bruce, Jeremy; Robertson, Jason

2011-03-01

120

Spontaneous Intracranial Hypotension Secondary to Lumbar Disc Herniation  

PubMed Central

Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdural lumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.

Kim, Kyoung-Tae

2010-01-01

121

An in vitro study investigating the survival and phenotype of mesenchymal stem cells following injection into nucleus pulposus tissue  

Microsoft Academic Search

INTRODUCTION: The decreased disc height characteristic of intervertebral disc (IVD) degeneration has often been linked to low back pain, and thus regeneration strategies aimed at restoring the disc extracellular matrix and ultimately disc height have been proposed as potential treatments for IVD degeneration. One such therapy under investigation by a number of groups worldwide is the use of autologous mesenchymal

Christine L Le Maitre; Pauline Baird; Anthony J Freemont; Judith A Hoyland

2009-01-01

122

Childhood intervertebral disc calcification  

Microsoft Academic Search

Two cases of intervertebral disc calcification in children are reported. A 13-year-old boy presented with right subscapular pain radiating into the axilla with radiographic demonstration of multiple calcified intervertebral discs and a herniated fragment of calcified nucleus pulposus at T2–3. His condition improved with conservative therapy, and follow-up radiographic evaluation revealed resolution of the herniated calcified disc material. A second

B. Theo Mellion; John P. Laurent; William C. Watters

1993-01-01

123

Endoscopic Percutaneous Transforaminal Treatment for Herniated Lumbar Discs  

Microsoft Academic Search

Summary.  \\u000a ?Background: The prevailing percutaneous treatment options for herniated non-contained lumbar discs have not reliably achieved the same\\u000a good results as the conventional microsurgical techniques. In this study we evaluated clinical outcome and complication rate\\u000a following endoscopic percutaneous transforaminal treatment of extruded or sequestrated herniated lumbar discs in 122 patients\\u000a with a follow-up period of more than one year.\\u000a \\u000a \\u000a \\u000a ?Method:

S. Eustacchio; G. Flaschka; M. Trummer; I. Fuchs; F. Unger

2002-01-01

124

Intradural tumor and concomitant disc herniation of cervical spine  

PubMed Central

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

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

2011-01-01

125

Lumbar-sacral radiculopathy secondary to intraspinal synovial cyst  

Microsoft Academic Search

Objective:The presentation of a patient with acute low back pain and distal radiation to the lower extremities is often attributed to a herniated nucleus pulposus (NHP). The purpose of this report is to illustrate how an intraspinal lumbar synovial cyst can have a similar presentation.

Philip Jordan Marion; Neil Kahanovitz

1995-01-01

126

Investigation of nano-mechanical properties of annulus fibrosus using atomic force microscopy  

Microsoft Academic Search

We describe the use of atomic force microscopy (AFM) to investigate the nanomechanical properties of annulus fibrosus (AF)—the outer fibrous layer of an intervertebral disc (IVD) encapsulating the inner jelly-like mass known as the nucleus pulposus (NP). Disk disease, degenerated discs, slipped discs, and herniated discs are common terms often linked to back pain and are caused due to degeneration

Naama T. Lewis; Mohammad A. Hussain; Jeremy J. Mao

2008-01-01

127

Standards of Practice: Quality Assurance Guidelines for Percutaneous Treatments of Intervertebral Discs  

SciTech Connect

Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

Kelekis, Alexis D., E-mail: akelekis@med.uoa.gr; Filippiadis, Dimitris K., E-mail: dfilippiadis@yahoo.g [Attikon University Hospital, 2nd Radiology Department (Greece); Martin, Jean-Baptiste, E-mail: jbmartin@cird.c [Geneva University Hospital, Service d'Imagerie Medicale (Switzerland); Brountzos, Elias, E-mail: ebrountz@med.uoa.g [Attikon University Hospital, 2nd Radiology Department (Greece)

2010-10-15

128

Paraesophageal herniation as a complication following laparascopic antireflux surgery  

Microsoft Academic Search

Paraesophageal herniation of the stomach is a rare complication following laparoscopic Nissen fundoplication. We retrospectively reviewed our experience with 720 patients undergoing laparoscopic Nissen fundoplications. Seven patients were found to have postoperative paraesophageal hernias requiring reoperation. The clinical presentation, diagnostic workup, operative treatment, and outcome were evaluated. There were no deaths or procedure-related complications. Clinical presentation was recurrent dysphagia in

Matthias H. Seelig; Ronald A. Hinder; Paul J. Klingler; Neil R. Floch; Susan A. Branton; Stephen L. Smith

1999-01-01

129

Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)  

Microsoft Academic Search

Objectives: To review clinical and radiological findings in patients with Duret hemorrhages and to discuss the pathophysiology and differential diagnosis of these lesions. Patients and methods: We reviewed the case records of four patients with Duret hemorrhages who had been admitted to the neurological intensive care unit with supratentorial mass lesions. Results: Descending transtentorial and subfalcine herniations were present in

Paul M. Parizel; Smitha Makkat; Philippe G. Jorens; Özkan Özsarlak; Patrick Cras; Johan W. Van Goethem; Luc van den Hauwe; Jan Verlooy; Arthur M. De Schepper

2002-01-01

130

Diaphragmatic Laceration, Partial Liver Herniation and Catamenial Pneumothorax  

Microsoft Academic Search

Catamenial pneumothorax is a recurrent pneumothorax temporally associated with menstruation. Pathogenesis remains debated however pleural endometriosis or diaphragmatic abnormalities are almost always present. We report the case of a 35-year-old woman with recurrent right catamenial pneumothorax. At thoracoscopy a large laceration of the diaphragm with partial intrathoracic liver herniation was seen. Treatment involved repair of the diaphragmatic lacerations, and pleurodesis.

Antonio Bobbio; Paolo Carbognani; Luca Ampollini; Michele Rusca

131

Surgical discectomy for lumbar disc herniation: surgical techniques.  

PubMed

Discectomy for lumbar discal herniation is the most commonly performed spinal surgery. The basic principle of the various techniques is to relieve the nerve root compression induced by the herniation. Initially, the approach was a unilateral posterior 5-cm incision: the multifidus was detached from the vertebra, giving access through an interlaminar space in case of posterolateral herniation; an alternative paraspinal approach was used for extraforaminal herniation. Over the past 30 years, many technical improvements have decreased operative trauma by reducing incision size, thereby reducing postoperative pain and hospital stay and time off work, while improving clinical outcome. Magnification and illumination systems by microscope and endoscope have been introduced to enable minimally invasive techniques. Several comparative studies have analyzed the clinical results of these various techniques. Although the methodology of most of these studies is debatable, all approaches seem to provide clinical outcomes of similar quality. At all events, minimally invasive techniques reduce hospital stay. While technical proficiency is essential, the final result depends on strict compliance with a prerequisite for surgical indication: close correlation between clinical symptoms and radiological findings. It is essential to discuss the risk/benefit ratio and explain the pros and cons of the recommended technique to the patient. PMID:23352565

Blamoutier, A

2013-01-24

132

Thoracic venous congestion caused by thoracic disc herniation.  

PubMed

We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix-Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery. PMID:23785652

Roger, Eric P; Chamczuk, Andrea J; Hagan, Marygrace C

2013-02-17

133

Thoracic venous congestion caused by thoracic disc herniation  

PubMed Central

We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix–Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery.

Roger, Eric P; Chamczuk, Andrea J; Hagan, Marygrace C

2013-01-01

134

The role of inflammation in disk herniation-associated radiculopathy  

Microsoft Academic Search

Objective:The causes and physiopathology of low-back pain and acute lumbarradiculopathy remain unclear. A compression of the nerve root by protruded disk has been suggested but explains only partially the physiopathology of radicular pain. This article provides an overview of the role of inflammation in disk herniation-associated radiculopathy.

Philippe Goupille; Malcolm I. V. Jayson; Jean-Pierre Valat; Anthony J. Freemont

1998-01-01

135

Nucleus-nucleus total reaction cross sections  

SciTech Connect

We compare sigma/sub R/(E) for nucleus-nucleus systems (obtained from existing direct measurements and derived from elastic scattering data) with nucleon-nucleon and nucleon-nucleus data. The energy dependence of sigma/sub R/(E) for nucleus-nucleus systems is found to be quite rapid; there appears to be no evidence for an energy independent, geometric sigma/sub R/. Simple parameter free microscopic calculations are able to quantitatively reproduce the data and thus, emphasize the dominance of nucleon-nucleon interactions in medium energy nucleus-nucleus collisions.

DeVries, R.M.; Peng, J.C.

1980-09-01

136

Automatic diagnosis of lumbar disc herniation with shape and appearance features from MRI  

NASA Astrophysics Data System (ADS)

Intervertebral disc herniation is a major reason for lower back pain (LBP), which is the second most common neurological ailment in the United States. Automation of herniated disc diagnosis reduces the large burden on radiologists who have to diagnose hundreds of cases each day using clinical MRI. We present a method for automatic diagnosis of lumbar disc herniation using appearance and shape features. We jointly use the intensity signal for modeling the appearance of herniated disc and the active shape model for modeling the shape of herniated disc. We utilize a Gibbs distribution for classification of discs using appearance and shape features. We use 33 clinical MRI cases of the lumbar area for training and testing both appearance and shape models. We achieve over 91% accuracy in detection of herniation in a cross-validation experiment with specificity of 91% and sensitivity of 94%.

Alomari, Raja's.; Corso, Jason J.; Chaudhary, Vipin; Dhillon, Gurmeet

2010-03-01

137

Posteriorly migrated thoracic disc herniation: a case report  

PubMed Central

Introduction Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine. Case presentation A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery. Conclusions Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass.

2013-01-01

138

Paraesophageal herniation as a complication following laparoscopic antireflux surgery  

Microsoft Academic Search

Paraesophageal herniation of the stomach is a rare complication following laparoscopic Nissen fundoplication. We retrospectively\\u000a reviewed our experience with 720 patients undergoing laparoscopic Nissen fundoplications. Seven patients were found to have\\u000a postoperative paraesophageal hernias requiring reoperation. The clinical presentation, diagnostic workup, operative treatment,\\u000a and outcome were evaluated. There were no deaths or procedure-related complications. Clinical presentation was recurrent dysphagia\\u000a in

Matthias H. Seelig; Ronald A. Hinder; Paul J. Klingler; Neil R. Floch; Susan A. Branton; Stephen L. Smith

1999-01-01

139

Foraminal disc herniation Th9-Th10 mimicking abdominal pain  

Microsoft Academic Search

Thoracic disc herniations (TDH) requiring surgery are rare. They usually present with pain and\\/or myelopathy. Only 6% are wide lateral, either intraforaminal or extraforaminal. A 52-year-old patient presented with chronic mid-thoracic pain, radiating along the left 9th and 10th ribs. After nephrologic and pancreatic diseases had been exclud - ed, a CT-scan showed a far-lateral calcified TDH in the left

Patrick FRANSEN; Frédéric COLLIGNON; Bernard VAN DEN HEULE

2008-01-01

140

Herniation of the bladder after recurrent pubic symphysis diastasis  

Microsoft Academic Search

Bladder and urethral injuries are relatively common complications of pelvic trauma; however, bladder herniation into a pubic\\u000a symphysis diastasis is an unusual sequelae of such trauma. The case reported here is that of a patient in whom the initial\\u000a open-book type fracture of the pelvic ring with a major pubic diastasis was treated with external fixator. Ten weeks after\\u000a satisfactory

William Tabib; Délphine Mitilian; François Pauthier; Eva Ghiles

2010-01-01

141

Herniation through the foramen of Morgagni: early diagnosis and treatment  

Microsoft Academic Search

The majority of congenital diaphragmatic hernias (CDH) occur through the foramen of Bochdalek; herniation through the foramen\\u000a of Morgagni (MH) is rare. Fifteen children (12 males and 3 females) with congenital MH (7 right, 3 left, 5 bilateral) were\\u000a treated over a period of 15 years, comprising 11% of a total of 135 children with different types of CDH. The

Ahmed H. Al-Salem; Akhter Nawaz; Hilal Matta; Alic Jacobsz

2002-01-01

142

A rare complication of aortobifemoral bypass operation: internal herniation.  

PubMed

Intestinal brids are most common cause of postoperative ileus although there are various cause of ileus after abdominal operation. On the other hand internal herniation is a rare cause of ileus after abdominal operations. Diagnosis of this hernias are important because of strangulation and necrosis of its content due to circulatory disturbance. In this case report, we publish a patient with ileus due to a greft which has been used in a previous abdominal surgery for abdominal aort aneurysm. PMID:23599202

Citgez, Bülent; Yetkin, Gürkan; Uluda?, Mehmet; Akgün, Ismail; Ekici, U?ur; Kartal, Abdulcabbar

2013-03-01

143

Management of disc herniations with bi-radicular symptoms via combined lateral and interlaminar approach  

Microsoft Academic Search

Large lumbosacral disc herniations causing bi-radicular symptoms are very rare clinical entities and may present a surgical\\u000a challenge. This study was undertaken to evaluate the effectiveness of the simply modified combined lateral and interlaminar\\u000a approach for the treatment of these unique disc herniations. Between 2000 and 2005, 18 patients with bi-radicular symptoms\\u000a secondary to large disc herniations of the lumbar

Murat Kutlay; K?vanç Topuz; Ahmet Çetinkal; Hakan ?im?ek; Mehmet Nusret Demircan

2010-01-01

144

Mesenteric Defect with Internal Herniation in the Pediatric Emergency Department: An Unusual Presentation of Acute Abdomen.  

PubMed

Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management. PMID:23597540

Hu, Mei-Hua; Huang, Go-Shine; Chen, Jeng-Chang; Wu, Chang-Teng

2013-01-20

145

Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs.  

PubMed

PURPOSE: Lumbar disc degeneration may be associated with intensity of neovascularization in disc herniations. Our study was designed to evaluate how much the severity of histodegeneration is related to the development of neovascularization and to the level of pleiotrophin in the herniated lumbar discs. METHODS: Surgically excised lumbar disc specimens were obtained from 29 patients with noncontained (i.e., extruding through the posterior longitudinal ligament) and 21 patients with contained disc herniations. The histodegeneration scores and levels of neovascularization were estimated according to semiquantitative analysis in lumbar disc and endplate samples. Immunohistochemical staining were performed to identify the newly formed blood vessels and to detect the presence of pleiotrophin in the specimens. RESULTS: Higher levels of disc and endplate neovascularity were registered in noncontained herniations. The level of neovascularization was significantly related to the score of histodegeneration in the herniated disc tissues but not in the endplate specimens. Both contained and noncontained herniations had the highest values of histodegeneration in conjunction with the highest level of neovascularization but the relations between neovascularity and degenerative changes remained to be significant only in the group of noncontained herniations. Registration or frequency of pleiotrophin positive cells did not correlate significantly with histodegeneration or level of neovascularization in the disc samples. CONCLUSION: Severe histodegeneration of the lumbar disc herniations is associated with enhanced neovascularization and potentially also spontaneous regression of the herniated tissue. PMID:23736847

Rätsep, Tõnu; Minajeva, Ave; Asser, Toomas

2013-06-01

146

Treatment of lumbar disc herniation in the second decade of life  

Microsoft Academic Search

Lumbar disc herniation is rare in patients under the age of 20 years. In the department of orthopaedic surgery of the University Hospital of Frankfurt, 33 patients below the age of 20 with lumbar disc herniation were treated over a period of 10 years. Eighteen were managed conservatively and 15 surgically. The purpose of this study is to report on

A. A. Kurth; S. Rau; C. Wang; E. Schmitt

1996-01-01

147

Incarcerated Trocar Site Herniation of the Small Bowel following Laparoscopic Myomectomy  

PubMed Central

Small bowel herniation through the fascial defect created by the entry of trocars is one of the major complications of the laparoscopic surgery. In this paper, we describe a 42-year-old woman developing an incarcerated trocar site herniation of the small bowel following laparoscopic myomectomy and treated by laparoscopic approach.

Zomer, Monica Tessmann; de Azevedo, Rafael Menezes

2013-01-01

148

Incarcerated Trocar Site Herniation of the Small Bowel following Laparoscopic Myomectomy.  

PubMed

Small bowel herniation through the fascial defect created by the entry of trocars is one of the major complications of the laparoscopic surgery. In this paper, we describe a 42-year-old woman developing an incarcerated trocar site herniation of the small bowel following laparoscopic myomectomy and treated by laparoscopic approach. PMID:23956895

Kondo, William; Zomer, Monica Tessmann; Braga-Baiak, Andresa; de Azevedo, Rafael Menezes

2013-07-14

149

Different Expression of Extracellular Matrix Genes : Primary vs. Recurrent Disc Herniation  

PubMed Central

Objective Recurrent lumbar disc herniation has been reported to occur in 5% to 15% of surgically treated primary lumbar disc herniation cases. We investigated the molecular biologic characteristics of primary herniated discs and recurrent discs to see whether the recurrent discs has the similar biological features with primary herniated discs. Methods Primary herniated disc and recurrent disc cells were obtained by discectomy of lumbar disc patients and cells were isolated and then taken through monolayer cultures. We compared chondrogenic and osteogenic mRNA gene expression, and western blot between the two groups. Results The mRNA gene expression of recurrent disc cells were increased 1.47* times for aggrecan, 1.38 times for type I collagen, 2.04 times for type II collagen, 1.22 times for both Sox-9 and osteocalcin, and 1.31 times for alkaline phosphatase, respectively, compared with the primary herniated lumbar disc cells (*indicates p < 0.05). Western blot results for each aggrecan, type I collagen, type II collagen, Sox-9, osteocalcin, and alkaline phosphatase were similar between the primary herniated disc cells and recurrent disc cells. Conclusion These results indicate that the recurrent disc cells have similar chondrogenic and osteogenic gene expression compared to primary herniated disc cells. Therefore, we assumed that the regeneration of remaining discs could fill the previous discectomy space and also it could be one of the factors for disc recurrence especially in the molecular biologic field.

Kuh, Sung-Uk; Kwon, Young-Min; Chin, Dong-Kyu; Jin, Byung-Ho; Cho, Yong-Eun

2010-01-01

150

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

Microsoft Academic Search

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

Constantine Constantoyannis; Demetres Konstantinou; Harry Kourtopoulos; Nicolas Papadakis

2002-01-01

151

Detection of Residual Disc Hernia Material and Confirmation of Nerve Root Decompression at Lumbar Disc Herniation Surgery by Intraoperative Ultrasound  

Microsoft Academic Search

The aim of lumbar disc herniation surgery is the removal of herniated disc material (HDM) and complete decompression of the nerve root. As some patients present with residual HDM, we examined the ability of intraoperative ultrasound (IOUS) to detect this material. Between February 2006 and June 2007, we used IOUS in 30 patients undergoing surgery for lumbar disc herniation. They

Takeshi Aoyama; Kazutoshi Hida; Minoru Akino; Shunsuke Yano; Yoshinobu Iwasaki

2009-01-01

152

Spontaneous Transient Lateral Thoracic Lung Herniation Resulting in Systemic Inflammatory Response Syndrome (SIRS) and Subsequent Contralateral Lung Injury.  

PubMed

Lung herniation is a relatively rare clinical entity that is most commonly either congenital or acquired traumatically. We describe a case of spontaneous lung herniation secondary to acute cough in an obese male smoker complicated by contralateral acute lung injury and systemic inflammatory response syndrome (SIRS). Mechanisms of lung herniation, classification, diagnosis, and management will be discussed. PMID:22084612

Kaliyadan, Antony; Kebede, Amal; Ali, Tabassum; Karchevsky, Michael; Vasseur, Bernard; Patel, Nirav

2011-07-03

153

Spontaneous Transient Lateral Thoracic Lung Herniation Resulting in Systemic Inflammatory Response Syndrome (SIRS) and Subsequent Contralateral Lung Injury  

PubMed Central

Lung herniation is a relatively rare clinical entity that is most commonly either congenital or acquired traumatically. We describe a case of spontaneous lung herniation secondary to acute cough in an obese male smoker complicated by contralateral acute lung injury and systemic inflammatory response syndrome (SIRS). Mechanisms of lung herniation, classification, diagnosis, and management will be discussed.

Kaliyadan, Antony; Kebede, Amal; Ali, Tabassum; Karchevsky, Michael; Vasseur, Bernard; Patel, Nirav

2011-01-01

154

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial  

PubMed Central

Prospective case series studies have shown that plasma disc decompression (PDD) using the COBLATION SpineWand device (ArthroCare Corporation, Austin, TX) is effective for decompressing the disc nucleus in symptomatic contained cervical disc herniations. This prospective, randomized controlled clinical trial was conducted to evaluate the clinical outcomes of percutaneous PDD as compared to conservative care (CC) through 1 year. Patients (n = 115) had neck/arm pain >50 on the visual analog scale (VAS) pain scale and had failed at least 30 days of failed CC. Patients were randomly assigned to receive either PDD (n = 62) or CC (n = 58). Clinical outcome was determined by VAS pain score, neck disability index (NDI) score, and SF-36 health survey, collected at 6 weeks, 3 months, 6 months, and 1 year. The PDD group had significantly lower VAS pain scores at all follow-up time points (PDD vs. CC: 6 weeks, ?46.87 ± 2.71 vs. ?15.26 ± 1.97; 3 months, ?53.16 ± 2.74 vs. ?30.45 ± 2.59; 6 months, ?56.22 ± 2.63 vs. ?40.26 ± 2.56; 1 year, ?65.73 ± 2.24 vs. ?36.45 ± 2.86; GEE, P < 0.0001). PDD patients also had significant NDI score improvement over baseline when compared to CC patients at the 6 weeks (PDD vs. CC: ?9.15 ± 1.06 vs. ?4.61 ± 0.53, P < 0.0001) and 1 year (PDD vs. CC: ?16.70 ± 0.29 vs. ?12.40 ± 1.26, P = 0.005) follow-ups. PDD patients showed statistically significant improvement over baseline in SF-36 physical component summary scores when compared to CC patients at 6 weeks and 1 year (PDD vs. CC: 8.86 + 8.04 vs. 4.24 ± 3.79, P = 0.0004; 17.64 ± 10.37 vs. 10.50 ± 10.6, P = 0.0003, respectively). In patients who had neck/arm pain due to a contained cervical disc herniation, PDD was associated with significantly better clinical outcomes than a CC regimen. At 1 year, CC patients appeared to suffer a “relapse, showing signs of decline in most measurements, whereas PDD patients showed continued stable improvement.

Nardi, Pier Vittorio

2009-01-01

155

Mammoth orbitofrontal neurofibromatosis with herniating meningo-encephalocele.  

PubMed

We are presenting a mammoth orbito-frontal neurofibroma with a herniating meningo-encephalocele in a 23 year old African male. The tumour measured 87cm x 54cm and occupied the right orbito-temporo-facial region and had destroyed the right orbit. A pre operative embolization of the feeding vessels was followed by a one stage near total excision of the tumour and repair of the meningo-encephalocele in hypotensive anaesthesia. The excised tumour weighed 8 Kg and, to the best of our knowledge, is the largest orbito-facial neurofibroma reported in literature. PMID:20924457

Dhanraj, Prema; Paul, Kingsly; Lamba, Shashank; Shetty, Rahul

2010-01-01

156

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.  

PubMed

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

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

2008-10-01

157

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation  

PubMed Central

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.

Li, Jian; Zhang, Zai-Heng

2008-01-01

158

Psychopathological Influence of Lumbar Disc Herniation in Male Adolescent  

PubMed Central

Purpose There is no report about psychopathological effect causing by disc herniation. The disease could impose psychopathological influence on the social life, the treatment period, and response to the treatment. This study was to evaluate retrospectively the psychopathological influence of lumbar disc herniation (LDH) among Korean 19-year-old males. Materials and Methods We compared the Korean military multiphasic personality inventory (KMPI) profiles of 74 LDH cases with the KMPI profiles of 150 controls. The LDH groups were categorized to 2 groups according to the presence of thecal sac compression by disc materials, and evaluated the relation between the KMPI and LDH. Results The decrease of the faking-good response scale and increase of the faking-bad response scale were observed more in the LDH group than in the normal volunteer group (p<0.05). The neurosis set such as anxiety, depression and somatization was markedly increased in the LDH group compared to the normal volunteers group (p<0.05). The scale of personality disorder was also increased more in the LDH group (p=0.002). The differences of KMPI scales were not correlated with the severe pathology of LDH. Conclusion Young male with LDH may tend to have more abnormal results of multiphasic personality inventory test compared to the normal volunteers, suggesting that LDH may be related to the psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate and treat the psychopathological aspects in patients with LDH.

Kim, Tae Woo; Oh, Chang Hyun; Shim, Yu Sik; Park, Hyeong-chun; Park, Chong Oon

2013-01-01

159

Multifractal analysis of nucleus-nucleus interactions  

SciTech Connect

We have performed a multifractal ([ital G]-moment) analysis of 14.6--200 GeV/nucleon nucleus-nucleus and 200--800 GeV proton-nucleus interactions from KLM and Fermilab E-90 and E-508 emulsion data, including explicit corrections for the finite statistical sample. The corrected slopes of the [ital G] moments for protons, [sup 16]O, [sup 28]Si, and [sup 32]S nuclei show only slight evidence for departures from random behavior, while the normalized entropies appear to show a more consistent departure from randomness, particularly for protons. Given the size of the uncertainties, the results of the fractal analysis are not consistent either with results of intermittency analyses for nucleus-nucleus collisions or with the nonrandom behavior previously reported for leptonic and hadronic collisions. However, because of the effects of statistical noise, the fractal analysis is not as sensitive as the intermittency analysis for detecting nonrandom fluctuations.

Sengupta, K.; Cherry, M.L.; Jones, W.V.; Wefel, J.P. (Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803 (United States)); Dabrowska, A.; Holynski, R.; Jurak, A.; Olszewski, A.; Szarska, M.; Trzupek, A.; Wilczynska, B.; Wilczynski, H.; Wolter, W.; Wosiek, B.; Wozniak, K. (Institute of Nuclear Physics, Kawiory 26 A, 30-055, Krakow (Poland)); Freier, P.S.; Waddington, C.J. (School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455 (United States)); (KLM Collaboration)

1993-10-01

160

Imaging the intervertebral disk: age-related changes, herniations, and radicular pain.  

PubMed

The articulations of the spinal motion segment, the intervertebral disk, and the zygapophyseal joints, inevitably undergo age-related changes. This article focuses on the intervertebral disk, specifically when fissures sufficiently weaken the posterior annulus so as to allow herniation of nuclear material into the outer annular structure as a contained protrusion or breach the annulus and pass into the epidural space as an extrusion. This article examines the imaging of the age-related changes of the disk and disk herniation: nomenclature, the reliability and relative merits of imaging modalities, the imaging natural history of disk herniations, and, most importantly, the clinical significance. PMID:22643389

Del Grande, Filippo; Maus, Timothy P; Carrino, John A

2012-07-01

161

Adolescent lumbar disc herniation in a Tae Kwon Do martial artist: a case report  

PubMed Central

Lumbar disc herniations are rare in children. The etiology and clinical picture may be different in children than in adults. Conservative management is the treatment of choice. Tae Kwon Do is a Korean martial art which is notorious for its high fast kicks. Tae Kwon Do will be an official Olympic sport in the year 2000. Low back pain is occasionally reported by Tae Kwon Do athletes but there are no reported cases in the literature on disc herniation in a Tae Kwon Do athlete. A case report is presented to illustrate clinical presentation, diagnosis, radiological assessment and conservative management of lumbar disc herniation in children. ImagesFigure 1Figure 2

Kazemi, Mohsen

1999-01-01

162

Lumbar Disc Herniation Associated with Contralateral Neurological Deficit: Can Venous Congestion Be the Cause?  

PubMed Central

Lumbar disc herniation (LDH) associated with a contralateral neurological deficit is sometimes encountered by surgeons. Compression against the opposite pedicle in case of a large discal herniation and prominent stenotic changes of contralateral side are held responsible for contralateral symptoms and findings. In this study, we report a case of LDH associated with a painless contralateral neurological deficit. Prominent venous engorgement and congestion at the contralateral side of discal herniation were detected during the operation. It's treatment with bipolar coagulation and significant improvement was seen after the operation.

Kizmazoglu, Ceren; Ozer, Ercan; Arda, Mehmet Nuri

2013-01-01

163

Surgical vs Nonoperative Treatment for Lumbar Disk Herniation  

PubMed Central

Context For patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care. Objective To compare the treatment effects of diskectomy and usual care. Design, Setting, and Patients Prospective observational cohort of surgical candidates with imaging-confirmed lumbar intervertebral disk herniation who were treated at 13 spine clinics in 11 US states and who met the SPORT eligibility criteria but declined randomization between March 2000 and March 2003. Interventions Standard open diskectomy vs usual nonoperative care. Main Outcome Measures Changes from baseline in the Medical Outcomes Study Short-Form Health Survey (SF-36) bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons/MODEMS version). Results Of the 743 patients enrolled in the observational cohort, 528 patients received surgery and 191 received usual nonoperative care. At 3 months, patients who chose surgery had greater improvement in the primary outcome measures of bodily pain (mean change: surgery, 40.9 vs nonoperative care, 26.0; treatment effect, 14.8; 95% confidence interval, 10.8-18.9), physical function (mean change: surgery, 40.7 vs nonoperative care, 25.3; treatment effect, 15.4; 95% CI, 11.6-19.2), and Oswestry Disability Index (mean change: surgery, ?36.1 vs nonoperative care, ?20.9; treatment effect, ?15.2; 95% CI, ?18.5. to ?11.8). These differences narrowed somewhat at 2 years: bodily pain (mean change: surgery, 42.6 vs nonoperative care, 32.4; treatment effect, 10.2; 95% CI, 5.9-14.5), physical function (mean change: surgery, 43.9 vs nonoperavtive care 31.9; treatment effect, 12.0; 95% CI; 7.9-16.1), and Oswestry Disability Index (mean change: surgery ?37.6 vs nonoperative care ?24.2; treatment effect, ?13.4; 95% CI, ?17.0 to ?9.7). Conclusions Patients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care. However, nonrandomized comparisons of self-reported outcomes are subject to potential confounding and must be interpreted cautiously. Trial Registration clinicaltrials.gov Identifier: NCT00000410

Weinstein, James N.; Lurie, Jon D.; Tosteson, Tor D.; Skinner, Jonathan S.; Hanscom, Brett; Tosteson, Anna N. A.; Herkowitz, Harry; Fischgrund, Jeffrey; Cammisa, Frank P.; Albert, Todd; Deyo, Richard A.

2008-01-01

164

Traumatic Acute Brain Herniation through the Ear in a Child  

PubMed Central

A seven-year-old girl presented to Sultan Qaboos University Hospital, Oman, with a history of having been hit by a motor vehicle. After this, she had right-sided cerebrospinal fluid otorrhoea, and a week later, brain matter extruded through the right ear. A computed tomography scan of the brain demonstrated a tegmen fracture communicating with the external auditory canal. There was no hearing or facial nerve impairment and an otoscopic examination showed an intact tympanic membrane. She underwent a transcranial repair of the middle cranial fossa base, which revealed a wide dural and bony defect of the tegmen with herniation of the temporal lobe. Repair was made with an intradural patch of artificial dura. The rarity of this type of presentation of temporal bone fracture and its management are discussed.

Kariyattil, Rajeev; Muthukuttiparambil, Unnikrishnan

2012-01-01

165

Surgical vs Nonoperative Treatment for Lumbar Disk Herniation  

PubMed Central

Context Lumbar diskectomy is the most common surgical procedure performed for back and leg symptoms in US patients, but the efficacy of the procedure relative to nonoperative care remains controversial. Objective To assess the efficacy of surgery for lumbar intervertebral disk herniation. Design, Setting, and Patients The Spine Patient Outcomes Research Trial, a randomized clinical trial enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in 11 US states. Patients were 501 surgical candidates (mean age, 42 years; 42% women) with imaging-confirmed lumbar intervertebral disk herniation and persistent signs and symptoms of radiculopathy for at least 6 weeks. Interventions Standard open diskectomy vs nonoperative treatment individualized to the patient. Main Outcome Measures Primary outcomes were changes from baseline for the Medical Outcomes Study 36-item Short-Form Health Survey bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons MODEMS version) at 6 weeks, 3 months, 6 months, and 1 and 2 years from enrollment. Secondary outcomes included sciatica severity as measured by the Sciatica Bothersomeness Index, satisfaction with symptoms, self-reported improvement, and employment status. Results Adherence to assigned treatment was limited: 50% of patients assigned to surgery received surgery within 3 months of enrollment, while 30% of those assigned to nonoperative treatment received surgery in the same period. Intent-to-treat analyses demonstrated substantial improvements for all primary and secondary outcomes in both treatment groups. Between-group differences in improvements were consistently in favor of surgery for all periods but were small and not statistically significant for the primary outcomes. Conclusions Patients in both the surgery and the nonoperative treatment groups improved substantially over a 2-year period. Because of the large numbers of patients who crossed over in both directions, conclusions about the superiority or equivalence of the treatments are not warranted based on the intent-to-treat analysis. Trial Registration clinicaltrials.gov Identifier: NCT00000410

Weinstein, James N.; Tosteson, Tor D.; Lurie, Jon D.; Tosteson, Anna N. A.; Hanscom, Brett; Skinner, Jonathan S.; Abdu, William A.; Hilibrand, Alan S.; Boden, Scott D.; Deyo, Richard A.

2008-01-01

166

Recurrent ventral herniation in Ehlers-Danlos syndrome.  

PubMed

Ehlers-Danlos syndrome is an inherited collagen disorder characterized by skin hyperextensibility, joint laxity, and tissue friability. In this study, it was hypothesized that Ehlers-Danlos syndrome is frequently undiagnosed in patients who present for repair of ventral abdominal wall hernias. A retrospective chart review was conducted, and patients who had presented for elective repair of recurrent abdominal wall herniation were identified. In all patients, one or more prior attempts at repair with either mesh or autologous tissues had failed. Patients in whom abdominal wall components were lost secondary to extirpation or trauma, patients who had required acute closure, and patients with less than 2 months of follow-up were excluded. Twenty patients met these criteria. Twenty cases of recurrent ventral hernia repairs were reviewed, with special attention to identification of the preoperative diagnosis of Ehlers-Danlos syndrome. Patients ranged in age from 29 to 75 years, with a mean age of 54 years. Five patients were male (25 percent), and 15 were female (75 percent). The majority (95 percent) were Caucasian. The most common initial procedures were gynecologic in origin (35 percent). A precise closure technique that minimizes recurrence after ventral hernia repairs was used. With use of this technique, there was only one recurrence over a follow-up period that ranged from 2 to 60 months (mean follow-up duration, 25.7 months). Two patients with Ehlers-Danlos syndrome were identified, and their cases are presented in this article. The "components separation" technique with primary component approximation and mesh overlay was used for defect closure in the two cases presented. The identification of these two patients suggests the possibility of underdiagnosis of Ehlers-Danlos syndrome among patients who undergo repeated ventral hernia repair and who have had previous adverse postoperative outcomes. There are no previous reports in the literature that address recurrent ventral abdominal herniation in patients with Ehlers-Danlos syndrome. PMID:11129180

Girotto, J A; Malaisrie, S C; Bulkely, G; Manson, P N

2000-12-01

167

A quantitative method for comparing the distribution of cerebral trauma in closed-head injuries with and without tentorial herniation.  

PubMed

Damage to the cerebral and cerebellar hemispheres and brain-stem was investigated in forty-seven cases of closed-head injury of which twenty-four had undergone tentorial herniation. The damage was assessed by eye in coronal sections as well as microscopically using celloidin and paraffin techniques. All cases had damage to the hemispheres and brain stem. The types and positions of the damage were plotted on charts and quantified by using a cm2 grid system. The quantity of the haemorrhage and ischaemia in the hemispheres was found by Student's t-test to be statistically greater (P less than 0.001) for cases which had herniated. Haemorrhage and ischaemia were most frequently seen on the ventral aspect of the hemispheres and particularly the frontal lobes. The distribution of the haemorrhage and ischaemia was the same for both the herniated and non-herniated brains. In a subsample of sixteen cases statistically significant differences were found using the X2 test for the positions of brain-stem damage per se in herniated and non-herniated brains. In a second subsample of thirty-two cases a statistical difference in the position of haemorrhage was also found. The greatest damage to the brain-stem was medial and rostral in herniated brains and paralateral and rostral but extending further caudally in non-herniated brains. The variation in quantity of the five types of damage with length of survival was compared for herniated and non-herniated brains. PMID:6866209

Gibson, P H

168

Post-traumatic diaphragmatic herniation of the liver, examined by positron emission tomography: case report  

PubMed Central

We present a case of post-traumatic diaphragmatic herniation of the liver, which mimicked an intrathoracic tumor. After an automobile accident, the patient underwent thoracotomies for hemothorax and lung cancer in the right chest. Seven months later, computed tomography (CT) demonstrated a round tumor in the thorax adjacent to the right diaphragm with a higher density than the liver parenchyma. An intrathoracic tumor including a primary or metastatic lung cancer was suspected. However, positron emission tomography (PET) showed that the uptake of fluorine-18-fluorodeoxyglucose (FDG) was identical to that in the liver, and the tumor appeared to be contiguous with the liver. Thus, we suspected liver herniation. Core needle biopsy revealed liver cells without neoplastic tissue. Upon surgical exploration, herniation of the liver was found and repaired. PET was helpful in providing morphological and functional information leading to accurate diagnosis of liver herniation in this unusual case.

2011-01-01

169

Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations.  

PubMed

Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery. PMID:21386942

Chua, Nicholas H L; Gültuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C

2011-03-02

170

Percutaneous Thoracic Intervertebral Disc Nucleoplasty: Technical Notes from 3 Patients with Painful Thoracic Disc Herniations  

PubMed Central

Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery.

Gultuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C.

2011-01-01

171

Clinical features of conjoined lumbosacral nerve roots versus lumbar intervertebral disc herniations  

Microsoft Academic Search

Unidentified nerve root anomalies, conjoined nerve root (CNR) being the most common, may account for some failed spinal surgical\\u000a procedures as well as intraoperative neural injury. Previous studies have failed to clinically discern CNR from herniated\\u000a discs and found their surgical outcomes as being inferior. A comparative study of CNR and disc herniations was undertaken.\\u000a Between 2002 and 2008, 16

R. Lotan; A. Al-Rashdi; A. Yee; J. Finkelstein

2010-01-01

172

Analysis of hard thoracic herniated discs: review of 18 cases operated by thoracoscopy  

Microsoft Academic Search

The authors retrospectively reviewed a series of 18 hard thoracic herniated discs (HTHD) operated by thoracoscopy. Isolated cases of HTHD have been reported in the literature, but no series describing these lesions has been published. Seventy-two percent of the herniated discs were situated between T8 and T12. Fifty-six percent of the patients had radiographic sequelae of Scheuermanns disease. Postoperatively, 83%

Olivier Gille; Christian Soderlund; Henri J. C. Razafimahandri; Paolo Mangione; Jean-Marc Vital

2006-01-01

173

Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review  

Microsoft Academic Search

The effectiveness of surgery in patients with sciatica due to lumbar disc herniations is not without dispute. The goal of\\u000a this study was to assess the effects of surgery versus conservative therapy (including epidural injections) for patients with\\u000a sciatica due to lumbar disc herniation. A comprehensive search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro\\u000a up to October 2009.

Wilco C. H. JacobsMaurits; Maurits van Tulder; Mark Arts; Sidney M. Rubinstein; Marienke van Middelkoop; Raymond Ostelo; Arianne Verhagen; Bart Koes; Wilco C. Peul

2011-01-01

174

Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.  

PubMed

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

2012-01-22

175

Cervical Disc Herniation Causing Brown-S?quard's Syndrome: A Case Report and Literature Review  

PubMed Central

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

2011-01-01

176

The clinical effect of herbal magnetic corsets on lumbar disc herniation  

Microsoft Academic Search

Objective: To determine the clinical effects of the treatment of lumbar disc herniation with herbal magnetic corsets.Design: A randomized control trial.Setting: The outpatient and inpatient departments of the Rehabilitation Center of the West China Hospital.Patients: Sixty patients with clinically diagnosed lumbar disc herniation were included in the study.Interventions: Both groups received lumbar traction, medium frequency electrotherapy and massage, whereas the

Chengqi He; Peng Chen; Xiaohong Wang; Mingfu Ding; Qun Lan; Mei Han

2006-01-01

177

Spinal cord herniation: a misdiagnosed and treatable cause of thoracic myelopathy  

Microsoft Academic Search

This study is a case report and review of the literature. Spinal cord herniation is a rare, although increasingly recognized,\\u000a cause of spinal cord dysfunction. It is due to an anterior dural defect, through which the spinal cord herniates. The purpose\\u000a of this article is to report the authors’ experience and to provide insight on clinical presentation and radiological signs

Fahed Zairi; Laurent Thines; Philippe Bourgeois; Olivier Dereeper; Richard Assaker

2010-01-01

178

Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica  

Microsoft Academic Search

Proinflammatory cytokines have been identified in herniated intervertebral discs in humans, and such cytokines have experimentally been demonstrated to be important in the pathophysiological mechanisms of disc herniation. Cerebrospinal fluid (CSF) and serum concentrations of interleukin (IL)-1#, IL-6, IL-8, interferon (IFN)-% and tumour necrosis factor (TNF)-! were investigated using the enzyme-linked immunosorbent assay (ELISA) technique in 39 patients with lumbar

H. Brisby; K. Olmarker; K. Larsson; M. Nutu; B. Rydevik

2002-01-01

179

Incisional bowel herniations after operative laparoscopy: A series of nineteen cases and review of the literature  

Microsoft Academic Search

Objectives: The objectives of this report were (1) to identify all cases of incisional bowel herniations noted after operative laparoscopy in 11 participating institutions and (2) to report the clinical details of such patients.Study Design: A retrospective case review was performed.Results: Nineteen cases of incisional bowel herniation were identified. The average age of the patients was 50.5 years. Initial laparoscopic

Guy M. Boike; Charles E. Miller; Nick M. Spirtos; Jeffrey M. Fowler; Robert Summitt; James W. Orr

1995-01-01

180

Reservoir herniation as a complication of three-piece penile prosthesis insertion  

Microsoft Academic Search

Objectives. To obtain data concerning the incidence and management of reservoir herniation in inflatable penile prosthesis surgery in a clinical investigation. Reservoir herniation after scrotal placement of inflatable penile prosthesis is an unusual complication, and a review of the published medical reports reveals only anecdotal reports and no definitive articles.Methods. A multi-item self-addressed questionnaire was mailed to the members of

Hossein Sadeghi-Nejad; Anoop Sharma; Robert J Irwin; Steven K Wilson; John R Delk

2001-01-01

181

Intradural Lumbar Disc Herniation Associated With Degenerative Spine Disease and Rheumatoid Arthritis.  

PubMed

Study Design. A case report by Kara Krajewski and Jan Regelsberger.Objective. To demonstrate a case of intradural lumbar disc herniation including imaging studies, intraoperative imaging and an intraoperative video.Summary of Background Data. The first case of lumbar intradural disc herniation was reported as early as 1942; since then over 150 cases have been reported, mostly in the lumbar spine. Gadolinium-enhanced MRI is considered the gold standard for diagnosing this entity, though it is rarely peformed routinely in lumbar disc disease and diagnosis is often made intraoperatively.Methods. A 70-year-old man presented to the emergency department as a referral complaining of lower back pain, loss of sensation in the right thigh and difficulty walking. On examination, he showed uneven gait, right-sided foot drop (1/5), hypesthesias in the right inguinal area and ventral thigh and a positive straight leg raise test on the right. Anal sphincter tone was within normal limits. An MRI of the lumbar spine showed a large mediolateral herniated disc at L3/4, with caudal displacement and unclear signal changes intradurally.Results. Intraoperatively, the herniated disc was found upon opening the dural sac.Conclusion. Intradural disc herniations are a rare entity. The opening and inspection of the dural sack should be considered when the correct spinal level can be confirmed and insufficient herniated disc material can be visualized extradurally. PMID:23462573

Krajewski, K; Regelsberger, J

2013-03-01

182

Spinal cord herniation into pseudomeningocele after traumatic nerve root avulsion: case report and review of the literature  

Microsoft Academic Search

We present an extremely rare case of traumatic spinal cord herniation due to a brachial plexus avulsion injury and provide\\u000a a review of the literature of spinal cord herniation. Spinal cord herniation is an uncommon condition that can occur spontaneously\\u000a or as a result of surgery or trauma. This condition often presents with symptoms and signs as Brown-Séquard syndrome. Traumatic

Masato Tanaka; Hisanori Ikuma; Kazuo Nakanishi; Yoshihisa Sugimoto; Haruo Misawa; Tomoaki Takigawa; Toshifumi Ozaki

2008-01-01

183

Who should have Surgery for an Intervertebral Disc Herniation?  

PubMed Central

Study Design Combined prospective randomized controlled trial and observational cohort study of intervertebral disc herniation (IDH), an as-treated analysis. Objective To determine modifiers of the treatment effect (TE) of surgery (the difference between surgical and nonoperative outcomes) for intervertebral disc herniation (IDH) using subgroup analysis. Summary of Background Data SPORT demonstrated a positive surgical TE for IDH at the group level. However, individual characteristics may affect TE. No prior studies have evaluated TE modifiers in IDH. Methods IDH patients underwent either discectomy (n=788) or nonoperative care (n=404) and were analyzed according to treatment received. Thirty-seven baseline variables were used to define subgroups for calculating the time-weighted average TE for the Oswestry Disability Index (ODI) over 4 years (TE=?ODIsurgery-?ODInonoperative). Variables with significant subgroup by* treatment interactions (p<0.1) were simultaneously entered into a multivariate model to select independent TE predictors. Results All analyzed subgroups improved significantly more with surgery than with nonoperative treatment (p<0.05). In minimally adjusted univariate analyses: being married, absence of joint problems, worsening symptom trend at baseline, high school education or less, older age, no worker’s compensation, longer duration of symptoms, and an SF-36 mental component score (MCS) less than 35 were associated with greater TEs. Multivariate analysis demonstrated: being married (TE ?15.8 vs. ?7.7 single, p<0.001), absence of joint problems (TE ?14.6 vs. ?10.3 joint problems, p=0.012), and worsening symptoms (TE ?15.9 vs. ?11.8 stable symptoms, p=0.032) were independent TE modifiers. TE’s were greatest in married patients with worsening symptoms (?18.3) vs. single patients with stable symptoms (?7.8). Conclusions IDH patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of specific characteristics. However, being married, without joint problems, and worsening symptom trend at baseline were associated with a greater treatment effect.

Pearson, Adam; Lurie, Jon; Tosteson, Tor; Zhao, Wenyan; Abdu, William; Mirza, Sohail; Weinstein, James

2012-01-01

184

Lumbar intraspinal extradural ganglion cyst  

PubMed Central

A case is presented of an intraspinal extradural ganglion cyst at the L4–5 level. The clinical picture suggested a herniated nucleus pulposus at this level. A myelogram revealed a round lesion almost completely obstructing the flow of Pantopaque at the L4–5 level. A ganglion cyst with a haemorrhage into it and the surrounding tissue was removed, and surgery was followed by complete recovery. Images

Brish, Adam; Payan, Hushong M.

1972-01-01

185

Nucleus-nucleus interaction between boosted nuclei  

SciTech Connect

The nucleus-nucleus interaction potential has been studied within the relativistic mean field theory. The systematics of the relativistic effects have been investigated by analyzing the relation between the potential and the bombarding energy as a function of the impact parameter. It is shown that the potential barriers are noticeably sensitive to the bombarding energy for a given impact parameter. At large bombarding energies, the slope at the potential edge decreases with the impact parameter. Comparisons with a nonrelativistic treatment shows that relativistic effects cannot be ignored at bombarding energies around and larger than 100 MeV/nucleon.

Long Wenhui [School of Nuclear Science and Technology, Lanzhou University, 730000 Lanzhou (China); Department of Physics, Texas AM University, Commerce, Texas 75429 (United States); Bertulani, Carlos A. [Department of Physics, Texas AM University, Commerce, Texas 75429 (United States)

2011-02-15

186

Unusual case of camptocormia triggered by lumbar-disc herniation.  

PubMed

A 21-year-old male patient with low back pain and marked forward bending was presented. The exaggerated lumbar flexion was preventing him to stand in erect posture but disappeared while lying. The symptoms had begun after he had lifted a heavy object. Straight-leg-raising test could not be performed properly because of the exaggerated pain. The light-touch sense was decreased on L5 and S1 dermatomes. There was no loss of muscle strength. The deep-tendon reflexes were normal. Plain graph showed mild narrowing in the L4-5 and L5-S1 intervertebral spaces. Lumbar magnetic resonance imaging revealed disc protrusions in L4-5 and L5-S1 levels. During his stay in the department, the patient was given tizanidine and tramadol, and physical therapy was performed. A paravertebral intramuscular injection with lidocaine was applied. Moreover, the patient was referred to psychiatrist for evaluation regarding his medical history of conversive seizures and possible efforts for secondary gain. No response was obtained from all the treatments. The final diagnosis was camptocormia triggered by lumbar-disc herniation. He was applied supportive psychotherapy, psychoeducation regarding secondary gain, strong suggestions to improve posture, positive reinforcement, and behavioral therapy. His postural abnormality resolved and disappeared completely with mild pain. PMID:18087763

Duman, Iltekin; Baklaci, Korhan; Tan, Arif Kenan; Kalyon, Tunc Alp

2007-12-18

187

[70 patients operated on for sciatica without herniated disk].  

PubMed

Seventy patients suffering from sciatica were operated in whom no disc herniation was found. In 42 instances, compression of bony origin was found. These cases were either due to general narrowing of the spinal canal with signs in the distribution of several roots with neurological intermittent claudication, or to narrowing of the lateral recess or intervertebral foramen with involvement of only one root. Decompressive surgery was always beneficial for pain. In 20 instances a disc was found to be only bulging; disc excision was performed in 17 of these patients. In 8 instances, no abnormality was found. Some patients were nevertheless cured by disc excision, a single laminectomy being useful. The incidence of additional psychological problems is discussed. It is concluded that the clinical signs should guide the surgeon rather than the radiological findings in decisions for surgical treatment. Patients who have been correctly treated by conservative means for an adequate time should be systematically operated on if they have not shown sufficient clinical improvement. PMID:6217517

Richard, J C; Mazas, F

1982-01-01

188

Hemilaminoplasty for the treatment of lumbar disc herniation.  

PubMed

The aim of this study was to evaluate the clinical outcome of the hemilaminoplasty technique for the treatment of lumbar disc herniation (LDH). Forty-three cases of single-level LDH underwent a discectomy and hemilaminoplasty procedure. The preoperative JOA score and VAS of lower back and leg pain were 10.4+/-1.3, 7.8+/-2.1, and 8.6+/-1.7, respectively. The Cobb angle of lumbar sagittal alignment was 10.1+/-2.0. Twenty-five patients who agreed to lumbar discectomy through fenestration were enrolled as the control group. The postoperative JOA score and VAS of low back and leg pain of the hemilaminoplasty group were 19.4+/-1.3, 1.4+/-0.4, and 2.1+/-0.5, respectively. The Cobb angle was 29.2+/-1.9 degrees. There was no epidural scar observed in any of the patients. The Cobb angle of the hemilaminoplasty group was higher than that of the control group (p < 0.05), while the VAS was significantly lower (p < 0.05). Hemilaminoplasty is a useful method to improve clinical outcome, prevent epidural scar, and preserve the normal alignment of lumbar spine. PMID:18636258

Xinyu, Liu; Yanping, Zheng; Jianmin, Li; Liangtai, Gong

2008-07-18

189

Meson-Nucleus Interaction  

Microsoft Academic Search

The total and elastic cross sections for pion-nucleus scattering at medium energies are known for several nuclei. There are mainly two theoretical approaches, the optical model potential and the Glauber approximation, which have been used to analyse the pion-nucleus scattering data. These theoretical calculations use some approximations such as the impulse approximation for the ?N amplitude, the closure or the

Kamlesh Kumar Bajaj

1976-01-01

190

Interference of Detection Rate of Lumbar Disc Herniation by Socioeconomic Status  

PubMed Central

Study Design Retrospective study. Purpose The objective of the study is to evaluate the relationship between the detection rate of lumbar disc herniation and socioeconomic status. Overview of Literature Income is one important determinant of public health. Yet, there are no reports about the relationship between socioeconomic status and the detective rate of disc herniation. Methods In this study, 443 cases were checked for lumbar computed tomography for lumbar disc herniation, and they reviewed questionnaires about their socioeconomic status, the presence of back pain or radiating pain and the presence of a medical certificate (to check the medical or surgical treatment for the pain) during the Korean conscription. Results Without the consideration for the presence of a medical certificate, there was no difference in spinal physical grade according to socioeconomic status (p=0.290). But, with the consideration of the presence of a medical certificate, the significant statistical differences were observed according to socioeconomic status in 249 cases in the presence of a medical certificate (p=0.028). There was a lower detection rate in low economic status individuals than those in the high economic class. The common reason for not submitting a medical certificate is that it is neither necessary for the people of lower socioeconomic status nor is it financially affordable. Conclusions The prevalence of lumbar disc herniation is not different according to socioeconomic status, but the detective rate was affected by socioeconomic status. Socioeconomic status is an important factor for detecting lumbar disc herniation.

Ji, Gyu Yeul; Jung, Nak-Yong; An, Seong Dae; Choi, Won-Seok; Kim, Jung Hoon

2013-01-01

191

Intradiscal transplantation of synovial mesenchymal stem cells prevents intervertebral disc degeneration through suppression of matrix metalloproteinase-related genes in nucleus pulposus cells in rabbits  

Microsoft Academic Search

INTRODUCTION: Synovial mesenchymal stem cells (MSCs) have high proliferative and chondrogenic potentials, and MSCs transplanted into the articular cartilage defect produce abundant extracellular matrix. Because of similarities between the articular cartilage and the intervertebral disc cartilage, synovial MSCs are a potential cell source for disc regeneration. Here, we examined the effect of intradiscal transplantation of synovial MSCs after aspiration of

Takashi Miyamoto; Takeshi Muneta; Takashi Tabuchi; Kenji Matsumoto; Hirohisa Saito; Kunikazu Tsuji; Ichiro Sekiya

2010-01-01

192

Intradural herniation of intervertebral disc at the level of Lumbar 1-Lumbar 2.  

PubMed

Intradural disc herniation is a serious and rare complication of intervertebral disc rupture. The preoperative diagnosis of intradural disc herniation is still difficult despite new neuroradiologic investigation possibilities including computerized tomography and magnetic resonance imaging and it is usually diagnosed by during surgery. Here we present an intradural disc herniation case at the level of L1-L2 with accompanying significant myelopathic neurologic deficits. A 50-year-old female patient was admitted to the hospital with pain and weakness in both legs. Her neurological examination revealed paraparesis. Magnetic resonance imaging showed an extruded disc hernia of central localization at the L1-L2 level. She underwent total laminectomy at the level of L1-L2 and her intradural disc fragment was extirpated by microsurgical methods. PMID:17935031

Oztürk, Adil; Avci, Emel; Yazgan, Pelin; Torun, Fuat; Yüceta?, Seyho; Karaba?, Hamza

2007-04-01

193

Gangrenous small bowel obstruction secondary to congenital internal herniation: a case report.  

PubMed

Congenital internal herniation is a rare condition presenting as recurrent abdominal pain or acute intestinal obstruction. In cases in which bowel incarceration or strangulation develop, rapid progression to bowel ischemia, necrosis or perforation is inevitable. Mortality in such cases has been reported to be as high as 50%. Despite advances in imaging modalities, arriving at a pre-operative diagnosis of a congenital internal herniation remains a challenge. We report such a case where imaging was unsuccessful in determining the cause of intestinal obstruction in a 3 year old child. Congenital internal herniation may result in disastrous consequences if not addressed in a timely fashion due to its rarity. Hence a high index of clinical suspicion is needed to avoid missing this diagnosis in a child presenting with recurrent abdominal pain or acute intestinal obstruction. PMID:22582563

Tan, Y L; Alhagi, Muthu V

2012-02-01

194

Compressive properties of fibrous repair tissue compared to nucleus and annulus.  

PubMed

The wound healing process includes filling the void between implant and tissue edges by collagenous connective repair tissue. This fibrous repair tissue may load share or stabilize implants such as spinal disc replacements. The objective of this study was the biomechanical characterization of human fibrous tissue compared to annulus fibrosus and nucleus pulposus. Human lumbar discs (10 nucleus and annulus) and 10 lumbar deep wound fibrous tissue specimens were sectioned into 12mm diameter×6mm high cylindrical samples. Confined compression testing, after 2h swelling at 0.11MPa, was performed at 5%, 10% and 15% strain over 3.5h. Unconfined dynamic testing (2-0.001Hz) was performed at 5-15% strain. Semi-quantitative histology estimated the proportion of proteoglycan to collagen. Fibrous tissue exhibited a decrease in height during the swelling period whereas annulus and nucleus tissues did not. The aggregate modulus was significantly less for fibrous tissue (p<0.002). Percent stress relaxation was greatest for the fibrous tissue and similar for annulus and nucleus. Dynamic testing found the storage modulus (E') was greater than the loss modulus (E?) for all tissues. Annulus were found to have greater E' and E? than nucleus, whereas E' and E? were similar between annulus and fibrous tissue. Fibrous tissue had the greatest increase in both moduli at greater frequencies, but had the lowest hydration and proteoglycan content. Fibrous tissue would not be a substitute for native tissue within the disc space but if adjacent to a disc prosthesis may impart some degree of intersegmental stability during acute loading activities. PMID:23643028

Freeman, Andrew L; Buttermann, Glenn R; Beaubien, Brian P; Rochefort, Willie E

2013-05-01

195

A germane link between piriformis muscle atrophy and lumbar disc herniation.  

PubMed

This article reports the case of a a 29-year-old girl with a right-sided sciatica. Magnetic resonance imaging of the lumbar vertebrae and the pelvic region detected a right L5-S paracentral disc herniation with descending S1 nerve root compression and atrophy in the right piriformis muscle. Magnetic resonance images of two other subjects -one with a known diagnosis of lumbosacral nerve root compression and one healthy individual without any low back pathology were also used in comparison. To the best knowledge of the authors, piriformis muscle atrophy associated with lumbar disc herniation is discussed for the first time in the Literature. PMID:19156020

Malas, F U; Ozçakar, L; Kerimoõlu, U; Yörübulut, M

2009-03-01

196

Continuous venovenous hemofiltration rapidly lowers toxic metabolites in a patient with MSUD and imminent cerebral herniation.  

PubMed

Maple syrup urine disease (MSUD) is an inborn error of amino acid metabolism. During catabolic stress encephalopathy and brain swelling that can culminate in brain herniation may occur. Beyond the neonatal period, these metabolic decompensations normally can be treated with a conservative dietary emergency regimen. Nevertheless in exceptionally severe cases also older patients may require extracorporeal interventions. We present the case of a 12-year-old patient with cerebral edema and imminent cerebral herniation. Continuous venovenous hemofiltration (CVVH) caused a prompt decrease of the toxic metabolite levels as well as an improvement of the patient's condition. PMID:20309789

Thimm, E; Hadzik, B; Höhn, T

2010-03-22

197

Antiproton-Nucleus Interaction.  

National Technical Information Service (NTIS)

Several facets of antinucleon-nucleus interactions are explored. The topics treated are: coherent interactions, production of unusual states and particles in the nuclear medium, and the creation of extreme states of matter by antimatter annihilation. It i...

W. R. Gibbs

1984-01-01

198

Antiproton-nucleus interaction  

Microsoft Academic Search

The antiproton-nucleus physics is reviewed. On the experimental side, the recent results obtained at the LEAR, BNL and KEK facilities are analyzed. A brief summary of the main pp and pn experimental data is also given. The antiproton-nucleus interaction can lead to elasic, inelastic and charge exchange scattering and to annihilation. The latter is very dominant. The scattering cross-sections are

J. Cugnon; J. Vandermeulen

1989-01-01

199

Genotypic and Antimicrobial Characterisation of Propionibacterium acnes Isolates from Surgically Excised Lumbar Disc Herniations  

PubMed Central

The anaerobic skin commensal Propionibacterium acnes is an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation. P. acnes and other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence of P. acnes in their excised herniated disc tissue. Using recA and mAb typing methods, 52% of the isolates were type II (50% of culture-positive patients), while type IA strains accounted for 28% of isolates (42% patients). Type III (11% isolates; 21% patients) and type IB strains (9% isolates; 17% patients) were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (?1mg/L). The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ?4?mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63%) suggests that the role of P. acnes in lumbar disc herniation should not be readily dismissed.

Rollason, Jess; Albert, Hanne B.; Barnard, Emma; Worthington, Tony; Hilton, Anthony C.; Vernallis, Ann; Patrick, Sheila; Elliott, Tom

2013-01-01

200

Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty  

Microsoft Academic Search

The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and\\/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The

Peter B. Fodor; M. Sachs; S. Bosniak

1987-01-01

201

Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty  

Microsoft Academic Search

The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and\\/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The

Michael Evan Sachs; Stephen L. Bosniak

1986-01-01

202

Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation?  

Microsoft Academic Search

Lumbar disc herniation (LDH) is a common cause of back and sciatic pain. When clinical treat- ment fails, surgery may be indicated in selected patients. Although surgery is effective in most cases, some of these patients may have a poor outcome. Different factors may influence these results and poor adap- tation at work is one well-known cause of treatment failure.

Daniel Benzecry Almeida; Paola Hesse Poletto; Jerônimo Buzetti Milano; André Giacomelli Leal; Ricardo Ramina

2007-01-01

203

Isolation of the Fourth Ventricle Causing Transtentorial Herniation: Neurosonographic Findings in Premature Infants  

Microsoft Academic Search

OBJECTIVE. Significant posthemorrhagic enlargement of the fourth ventricle occurs only in a small minority of patients. Although entrapment or isolation of any ventricle can occur, the fourth ventricle is the most common site. This study was undertaken to better understand enlargement of the fourth ventricle after intraventricular hemorrhage and the neurosonographic features of isolation and transtentorial herniation. MATERIALS AND METHODS.

Theodore R. Hall; Anna Choi; Dieter ScheIlinger; Edward G. Grant

204

Management of Herniated Intervertebral Disks during Saturation Dives: A Case Report. (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Stevens DM, Caras BG, Flynn ET, Dutka AJ, Thorp JW, Thalmann ED. Management of herniated intervertebral disks during saturation dives: a case report. Undersea Biomed Res 1992; 19(3):191-198. During research saturation dives at 5.0 and 5.5 atm abs, 2 diver...

D. M. Stevens B. G. Caras E. T. Flynn A. J. Dutka J. W. Thorp

1992-01-01

205

Tension arachnoid cyst causing uncal herniation in a 60 year old: a rare presentation.  

PubMed

Arachnoid cysts are congenital benign cysts accounting for approximately 1% of all intracranial mass lesions. Uncal herniation due to arachnoid cyst is a rare mode of presentation. It is hypothesized that only tension arachnoid cyst could cause the life-threatening condition that results from a progressive deterioration and worsening of a simple and usually congenital arachnoid cyst, associated with the formation of a "ball valve" at the point of an opening on the cyst wall. To-date only one case of an arachnoid cyst causing Uncal herniation has been reported to the best of our knowledge. We present a rare case of uncal herniation in a 60-year-old lady caused by a giant left temporal arachnoid cyst. She presented to us in emergency room after experiencing headaches since last one week followed by vomiting, seizures, and altered state of consciousness. She was operated immediately and marsupialization of the arachnoid cyst was performed. She showed good recovery. Although arachnoid cyst is a benign slowly growing pathology, it can lead to Uncal herniation as a "tension" arachnoid cyst, possible due to "ball-valve" mechanism. Elective treatment should be considered to prevent progressive significant enlargement of cyst. PMID:22483281

Tahir, Muhammad Zubair; Quadri, S A; Farooqui, Mudassir; Bari, Muhammad Ehsan; Di, Xiao

2012-03-01

206

The plant cell nucleus  

PubMed Central

Communication between the cytoplasm and the nucleus is a fundamental feature shared by both plant and animal cells. Cellular factors involved in the transport of macromolecules through the nuclear envelope, including nucleoporins, importins and Ran-GTP related components, are conserved among a variety of eukaryotic systems. Interestingly, mutations in these nuclear components compromise resistance signaling, illustrating the importance of nucleocytoplasmic trafficking in plant innate immunity. Indeed, spatial restriction of defense regulators by the nuclear envelope and stimulus-induced nuclear translocation constitute an important level of defense-associated gene regulation in plants. A significant number of effectors from different microbial pathogens are targeted to the plant cell nucleus. In addition, key host factors, including resistance proteins, immunity components, transcription factors and transcriptional regulators shuttle between the cytoplasm and the nucleus, and their level of nuclear accumulation determines the output of the defense response, further confirming the crucial role played by the nucleus during the interaction between plants and pathogens. Here, we discuss recent findings that situate the nucleus at the frontline of the mutual recognition between plants and invading microbes.

Deslandes, Laurent

2011-01-01

207

Synapse to Nucleus Signaling  

PubMed Central

Signals generated in distal subcellular compartments of neurons must often travel long distances to the nucleus to trigger changes in gene expression. This retrograde signaling is critical to the development, function and survival of neural circuits, and neurons have evolved multiple mechanisms to transmit signals over long distances. In this review, we briefly summarize the range of mechanisms whereby distally-generated signals are transported to neuronal nuclei. We then focus on the transport of soluble signals from the synapse to the nucleus during neuronal plasticity.

Ch'ng, Toh Hean; Martin, Kelsey C.

2011-01-01

208

Kaon-nucleus scattering  

SciTech Connect

The derivations of the Lippmann-Schwinger equation and Watson multiple scattering are given. A simple optical potential is found to be the first term of that series. The number density distribution models of the nucleus, harmonic well, and Woods-Saxon are used without t-matrix taken from the scattering experiments. The parameterized two-body inputs, which are kaon-nucleon total cross sections, elastic slope parameters, and the ratio of the real to the imaginary part of the forward elastic scattering amplitude, are presented. The eikonal approximation was chosen as our solution method to estimate the total and absorptive cross sections for the kaon-nucleus scattering.

Hong, Byungsik; Maung, K.M.; Wilson, J.W.; Buck, W.W.

1989-01-01

209

The Human Suprachiasmatic Nucleus  

NSDL National Science Digital Library

In mammals, the controlling clock component that generates a 24-hour rhythm is the suprachiasmatic nucleus (SCN), located in a part of the brain called the hypothalamus. The SCN produces a signal that can keep the rest of the body on an approximately 24-hour schedule. This animation illustrates the location of the SCN in the human brain.

Howard Hughes Medical Institute (Howard Hughes Medical Institute;)

2008-04-10

210

Antiproton-nucleus interaction  

SciTech Connect

Several facets of antinucleon-nucleus interactions are explored. The topics treated are: coherent interactions, production of unusual states and particles in the nuclear medium, and the creation of extreme states of matter by antimatter annihilation. It is found that temperatures of the magnitude necessary to achieve the predicted quark-gluon phase transition are obtained. 20 references.

Gibbs, W.R.

1984-01-01

211

Antiproton-nucleus interaction  

SciTech Connect

Several facets of antinucleon-nucleus interactions are explored. The topics treated are: coherent interactions, production of usual states and particles in the nuclear medium, and the creation of extreme states of matter by antimatter annihilation. It is found that temperatures of the magnitude necessary to achieve the predicted quark-gluon phase transition are obtained.

Gibbs, W.R.

1984-11-15

212

Onset of deconfinement in nucleus-nucleus collisions  

SciTech Connect

The energy dependence of hadron production in relativistic nucleus-nucleus collisions reveals anomalies-the kink, horn, and step. They were predicted as signals of the deconfinement phase transition and observed by the NA49 Collaboration in central PbPb collisions at the CERN SPS. This indicates the onset of the deconfinement in nucleus-nucleus collisions at about 30 A GeV.

Gazdzicki, M., E-mail: marek@mail.cern.ch [University of Frankfurt, Institut fuer Kernphysik (Germany); Gorenstein, M. I. [Bogolyubov Institute for Theoretical Physics (Ukraine); Seyboth, P. [Max-Planck-Institut fuer Physik (Germany)

2012-05-15

213

Effects of two types of chairs on stature change and comfort for individuals with healthy and herniated discs  

Microsoft Academic Search

The objective of this study was to determine if stature change and perceived comfort are significantly different for individuals with either healthy or herniated discs when seated in a conventional chair or a sit-stand chair. Sixteen subjects were studied (5 young\\/healthy, 6 old\\/healthy, 5 old\\/herniated). Subjects performed a search task on a computer screen during two 2 h sessions for

DOMINIQUE P. MICHEL; MARTIN G. HELANDER

1994-01-01

214

Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up  

Microsoft Academic Search

Factors as age, sex, smoking, duration of leg pain, working status, type\\/level of disc herniation and psychosocial factors\\u000a have been demonstrated to be of importance for short-term results after lumbar discectomy. There are few studies with long-term\\u000a follow-up. In this prospective study of lumbar disc herniation patients undergoing surgery, the result was evaluated at 2\\u000a and 5–10 (mean 7.3) years

Katarina Silverplats; B. Lind; B. Zoëga; K. Halldin; M. Gellerstedt; H. Brisby; L. Rutberg

2010-01-01

215

Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up  

PubMed Central

Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 virgin lumbar disc herniation patients (mean age 42 years, 57% males) were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected from patient files. Back and leg pain on visual analog scale and employment status were collected by questionnaires. Results The cumulative rate of re-operations for lumbar disc herniation was 10.2% (95% Cl 6.0 to 15.1). The rate of residives at initial site was 7.4% (95% Cl 3.7 to 11.3) and rate of lumbar disc herniations at other sites was 3.1% (95% Cl 0.6 to 6.2). The occurrence of residive lumbar disc herniations was evenly distributed across the 5 years. Neither age, gender, preoperative symptoms, physical activity nor employment had effect on the probability of re-operation. Conclusion Seven percent of the lumbar disc patients had a residive lumbar disc operation within five years of their first operation. No specific factors influencing the risk for re-operation were found.

Hakkinen, Arja; Kiviranta, Ilkka; Neva, Marko H; Kautiainen, Hannu; Ylinen, Jari

2007-01-01

216

Cytoarchitecture of the Supraoptic Nucleus  

Microsoft Academic Search

A Golgi-Cox study of the supraoptic nucleus of the adult rabbit has revealed the presence of three major cell types: (1) large multipolar neurons; (2) large bipolar neurons, and (3) small interneurons. The multipolar and bipolar neurons demonstrated regional variation in the rostral and caudal aspects of this nucleus, while the interneurons appeared identical throughout the nucleus. This study provides

David L. Felten; Kathryn A. Cashner

1979-01-01

217

A Novel Approach to the Surgical Treatment of Lumbar Disc Herniations: Indications of Simple Discectomy and Posterior Transpedicular Dynamic Stabilization Based on Carragee Classification  

PubMed Central

Surgery of lumbar disc herniation is still a problem since Mixter and Barr. Main trouble is dissatisfaction after the operation. Today there is a debate on surgical or conservative treatment despite spending great effort to provide patients with satisfaction. The main problem is segmental instability, and the minimally invasive approach via microscope or endoscope is not necessarily appropriate solution for all cases. Microsurgery or endoscopy would be appropriate for the treatment of Carragee type I and type III herniations. On the other hand in Carragee type II and type IV herniations that are prone to develop recurrent disc herniation and segmental instability, the minimal invasive techniques might be insufficient to achieve satisfactory results. The posterior transpedicular dynamic stabilization method might be a good solution to prevent or diminish the recurrent disc herniation and development of segmental instability. In this study we present our experience in the surgical treatment of disc herniations.

Ozer, A. F.; Keskin, F.; Oktenoglu, T.; Suzer, T.; Ataker, Y.; Gomleksiz, C.; Sasani, M.

2013-01-01

218

Andromeda Galaxy's Double Nucleus  

NASA Video Gallery

This zoom dives deep into the nucleus of the neighboring spiral galaxy M31, also known as the Andromeda galaxy. The sequence begins with a backyard constellation view and ends with the new Hubble Space Telescope image that centers on the 100-million-solar-mass black hole at the core of the galaxy and the young blue stars surrounding the black hole. This is the sharpest visible-light image ever made of the nucleus of an external galaxy. Astronomers are trying to understand how apparently young stars were formed so deep inside the black hole's gravitational grip and how they survive in an extreme environment. Credit: NASA, ESA, and G. Bacon (STScI) TRT: 26 sec.

Lynn Jenner

2012-01-11

219

Effects of lumbar disk herniation on the careers of professional baseball players.  

PubMed

Outcomes after lumbar disk herniation in baseball athletes are currently unknown. It has been postulated that the repetitive torque-producing motions of a baseball player may have negative implications after a disk injury. Sixty-nine lumbar disk herniations (40 treated operatively, 29 nonoperatively) in 64 professional baseball players were identified, and important outcome measures including successful return to play, time to recovery, career longevity, and performance based on vital statistics to each position were documented. Ninety-seven percent of baseball athletes successfully returned to play at an average of 6.6 months after diagnosis. Athletes treated operatively required significantly more time to return to play than those managed nonoperatively (8.7 vs 3.6 months, respectively; P<.0001). PMID:22229920

Earhart, Jeffrey S; Roberts, David; Roc, Gilbert; Gryzlo, Stephen; Hsu, Wellington

2012-01-01

220

Patho-anatomy of Herniation of the Reticulum Through the Diaphragm in the Bovine  

PubMed Central

Dissection of embalmed and untreated water buffalo carcasses (n=10) revealed that hernias had occurred at the musculotendinous junction of the diaphragm, ventral to the foramen venae cavae and slightly lateral to the median plane. The diameter of the hernial ring varied from 7 cm to 20 cm. Herniation was more common in the right thoracic cavity with the reticulum firmly adherent to the hernia ring. Adhesions between the herniated portion of the reticulum and pleura, lung, pericardium or thoracic wall were present, while in a few cases thick fibrous tracts concealing metallic bodies were found. In two cases, involvement of esophageal groove with malalignment of cardia and reticulo-omasal opening was observed. Displacement and compression of the heart was observed in four animals. ImagesFigure 1.Figure 2.Figure 3.

Deshpande, K. S.; Krishnamurthy, D.; Nigam, J. M.; Sharma, D. N.

1981-01-01

221

Intradural disk herniation at L1-L2: report of two cases  

PubMed Central

Context Lumbar intradural disk herniation (IDH) is a rare but serious complication of spinal disk protrusions. Although the pathogenesis of lumbar IDH is still vague, it is believed to be associated with the adhesion of the posterior longitudinal ligament with the ventral wall of the dura. Diagnosis is still difficult despite current neuroradiologic imaging techniques. Findings Two women, ages 63 and 69 years, presented with recent exacerbation of back pain. In each case, imaging studies revealed a ventral herniated disk at L1–L2. Both patients underwent surgery and in both cases a hard mass was palpated through the dura. Both patients experienced immediate postoperative relief of back pain following surgery. One patient required fusion and postoperative rehabilitation; her neurologic deficit returned to baseline. Conclusion/clinical relevance Prompt surgical intervention is indicated for IDH; disk removal allows for symptomatic relief and minimization of neurologic deficit.

Arnold, Paul M.; Wakwaya, Yosafe T.

2011-01-01

222

Histology of herniations through the body wall and cuticle of zooplankton from the Laurentian Great Lakes.  

PubMed

Zooplankton of the Laurentian Great Lakes developed hernial protrusions whose gross appearance matches those on zooplankton described elsewhere in the world. We have carried out a histologic and cytologic analysis of the protrusions and found that they are composed of apparently degenerating or necrotic tissue(s) that has been expressed from the organism through the process of herniation. At their base the protrusions are continuous with viable tissue(s) within the organism through a fissure in the exoskeleton. Our observations lead us to suspect that these hernial protrusions are lethal. The development of such protrusions in zooplankton may be a worldwide phenomenon, but the cause of the herniation remains a mystery. PMID:11273690

Omair, M; Naylor, B; Jude, D J; Quddus, J; Beals, T F; Vanderploeg, H A

2001-02-01

223

Math/Science Nucleus  

NSDL National Science Digital Library

Math/Science Nucleus is a non-profit organization composed of scientists, educators, and community members focused on education and research. It provides a resource center designed to develop problem solving capacity through science for the world's children. A free online reference science curriculum for elementary grades is provided including lesson plans. Additionally, online animated storybooks and slideshows guide educators in how to integrate science content into children's lives.

2004-11-28

224

Neuregulins in the Nucleus  

Microsoft Academic Search

\\u000a The neuregulins are a subset of the ligands for the epidermal growth factor receptor family of receptors. They can bind to\\u000a these receptors and evoke a range of cellular responses. Some of the neuregulins have however been found in the cell nucleus\\u000a associated with nucleoli and intrachromatin granules. This brief review summarises the data for nuclear expression obtained\\u000a from observations

Carol M. McClelland; William J. Gullick

225

Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery  

PubMed Central

Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.

Tuli, Puneet; Parashar, Atul; Nanda, Vipul; Sharma, Ramesh K.

2009-01-01

226

Temporomandibular joint herniation into the external ear canal through foramen of Huschke.  

PubMed

Foramen of Huschke, which is also known as the foramen tympanicum, is an anatomical variation of the tympanic portion of the temporal bone. This foramen is located on the anteroinferior aspect of the external auditory canal, posteromedial to the temporomandibular joint. Herein, a rare case of foramen Huschke with a herniation of the soft tissues around the temporomandibular joint that result in severe otalgia and its treatment are presented. PMID:21316883

Akcam, Timur; Hidir, Yusuf; Ilica, A Turan; Kilic, Erbil; Sencimen, Metin

2011-02-12

227

Spontaneous dural tear leading to intracranial hypotension and tonsillar herniation in Marfan syndrome: a case report  

PubMed Central

Background We describe the case of a 38 year old male with Marfan syndrome who presented with orthostatic headaches and seizures. Case Presentation The patient was diagnosed with Spontaneous Intracranial Hypotension secondary to CSF leaks, objectively demonstrated by MR Myelogram with intrathecal contrast. Epidural autologus blood patch was administered at the leakage site leading to significant improvement. Conclusion Our literature search shows that this is the second reported case of a Marfan patient presenting with symptomatic spontaneous CSF leaks along with tonsillar herniation.

2010-01-01

228

The Impact of Epidural Steroid Injections on the Outcomes of Patients Treated for Lumbar Disc Herniation  

PubMed Central

Background: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment. Methods: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first three months of the study or prior to the study (the No-ESI group). Results: There was a significant difference in the preference for surgery between groups (19% in the ESI group compared with 56% in the No-ESI group, p < 0.001). There was no difference in primary or secondary outcome measures at four years between the groups. A higher percentage of patients changed from surgical to nonsurgical treatment in the ESI group (41% versus 12% in the No-ESI, p < 0.001). Conclusions: Patients with lumbar disc herniation treated with epidural steroid injection had no improvement in short or long-term outcomes compared with patients who were not treated with epidural steroid injection. There was a higher prevalence of crossover to nonsurgical treatment among surgically assigned ESI-group patients, although this was confounded by the increased baseline desire to avoid surgery among patients in the ESI group. Given these data, we concluded that more studies are necessary to establish the value of epidural steroid injection for symptomatic lumbar intervertebral disc herniation. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Radcliff, Kristen; Hilibrand, Alan; Lurie, Jon D.; Tosteson, Tor D.; Delasotta, Lawrence; Rihn, Jeffrey; Zhao, Wenyan; Vaccaro, Alexander; Albert, Todd J.; Weinstein, James N.

2012-01-01

229

Chiropractic rehabilitation of a patient with S1 radiculopathy associated with a large lumbar disk herniation  

Microsoft Academic Search

Objective: To describe the nonsurgical treatment of acute S1 radiculopathy from a large (12 × 12 × 13 mm) L5-S1 disk herniation. Clinical Features: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. His symptoms began 5 days before the initial visit and progressed despite nonsteroidal anti-inflammatory drugs and

Craig E. Morris

1999-01-01

230

Meningococcal Encephalitis associated with cerebellar tonsillar herniation and acute cervicomedullary injury.  

PubMed

A 13-year-old girl presented with a progressive ascending paralysis, bulbar dysfunction and finally respiratory arrest. Magnetic resonance (MR) showed acute cervicomedullary injury and hindbrain herniation. An emergency foramen magnum decompression and external ventricular drainage insertion were performed, and meningococcal infection was diagnosed. The patient recovered completely. Meningococcal encephalitis may have an atypical presentation, and a surgery can optimise the outcome. PMID:23391099

Fayeye, O; Pettorini, B L; Smith, M; Williams, H; Rodrigues, D; Kay, A

2013-02-01

231

A rare case of Brown-Sequard syndrome caused by cervical disc herniation: a case report  

PubMed Central

Abstract: Brown-Sequard syndrome is a rare neurological disorder characterized by ipsilateral motor paralysis caused by a lesion through corticospinal tract and contralateral loss of pain and temperature sensation due to the involvement of spinothalamic tract. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. This paper aims to report a case of Brown-Sequard syndrome that occurred in a patient suffering from CHD. In this case, using a rapid and urgent intervention we could prevent permanent neurologic deficit in the patient. Case: A 56-year-old woman complained about a sudden paresis in her right leg lasting for 4 days. Her pain was progressively worsening until she couldn’t walk without assistance. There was no history of trauma in the neck. Neurological examinations revealed right side spastic hemi-paresis as well as loss of pain and temperature sensation below T4 dermatome in the left side. The case was diagnosed as Brown-Sequard syndrome and cervical magnetic resonance imaging scan showed a disc herniation at C5/C6 and C6/C7 levels. Surgery was performed via anterior cervical microdiscectomy and fusion. After a 2-month period of follow-up, neurological assessments showed that motor and sensory functions of the patient returned to the normal condition. Although cervical disc herniation as a cause of Brown-Sequard syndrome is relatively rare, early diagnosis accompanied by an urgent treatment can prevent neurological complications in such cases. Keywords: Brown-Sequard Syndrome, Cervical Disc Herniation, Surgery, Ipsilateral motor paralysis

Ghasemi, Amir Abbas

2012-01-01

232

Treatment of a symptomatic forearm muscle herniation with a wrap-around fascia lata graft  

Microsoft Academic Search

Muscle herniation in the extremity is a well-recognized cause of symptomatic pain on exertion. Only 17 cases involving the\\u000a upper limb has been previously described, 11 of them involving the anterior compartment of the forearm and only 2 were caused\\u000a by strenuous exertion. Treatment for this condition ranged from nonsurgical, primary closure with palmaris longus interweave,\\u000a formal fasciotomy, to closure

Kamarul A. Khalid; Edward T. Mah

2009-01-01

233

Unilateral inferior temporal lobectomy with hippocampectomy for relief of incisural herniation  

Microsoft Academic Search

Summary 1.The syndrome of incisural hippocampal herniation, accompanied by unilateral and then bilateral fixed pupils, deepening coma, respiratory irregularity (Cheyne-Stokes), contralateral hemiplegia, ipsilateral decerebrate posturing, rising blood pressure, and finally renal shutdown, indicates a terminal state that requires immediate relief.2.Accepted methods of relief by brain shrinkage, dexamethasone, subtemporal decompression, anterior temporal lobectomy, cutting of the tentorium, and even massive uncapping

W. B. Scoville; D. B. Bettis

1979-01-01

234

Reversible propriospinal myoclonus due to thoracic disc herniation: long-term follow-up.  

PubMed

PSM is a rare form of myoclonus of spinal origin. The thoracic level is considered as the myoclonic generator in most cases; however, structural abnormality in conventional magnetic resonance imaging (MRI) related to PSM is more rare. We report the case of a 23-year-old man with PSM with ventral thoracic disc herniation confirmed by conventional MRI, which completely resolved after thoracic discectomy. This case indicates that decompressive surgery might be a valid treatment option. PMID:22014609

Jang, Wooyoung; Kim, Joong-Seok; Ahn, Jin Young; Kim, Hee-Tae

2011-10-20

235

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation  

PubMed Central

Objective To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective nerve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

Eun, Sang Soo; Chang, Won Sok; Bae, Sang Jin; Lee, Sang-Ho

2010-01-01

236

A review of current treatment for lumbar disc herniation in children and adolescents  

Microsoft Academic Search

Lumbar disc herniation (LDH) is a common disorder among adults with degenerated lumbar intervertebral discs. However, its\\u000a occurrence in childhood and adolescence is much less frequent mostly because children and adolescents tend to have a healthier\\u000a lumbar spine as compared with adults. This difference indicates that children and adolescents are far from being just little\\u000a adults. Over the years, there

Lei Dang; Zhongjun Liu

2010-01-01

237

Brain herniation in a patient with apparently normal intracranial pressure: a case report  

PubMed Central

Introduction Intracranial pressure monitoring is commonly implemented in patients with neurologic injury and at high risk of developing intracranial hypertension, to detect changes in intracranial pressure in a timely manner. This enables early and potentially life-saving treatment of intracranial hypertension. Case presentation An intraparenchymal pressure probe was placed in the hemisphere contralateral to a large basal ganglia hemorrhage in a 75-year-old Caucasian man who was mechanically ventilated and sedated because of depressed consciousness. Intracranial pressures were continuously recorded and never exceeded 17 mmHg. After sedation had been stopped, our patient showed clinical signs of transtentorial brain herniation, despite apparently normal intracranial pressures (less than 10 mmHg). Computed tomography revealed that the size of the intracerebral hematoma had increased together with significant unilateral brain edema and transtentorial herniation. The contralateral hemisphere where the intraparenchymal pressure probe was placed appeared normal. Our patient underwent emergency decompressive craniotomy and was tracheotomized early, but did not completely recover. Conclusions Intraparenchymal pressure probes placed in the hemisphere contralateral to an intracerebral hematoma may dramatically underestimate intracranial pressure despite apparently normal values, even in the case of transtentorial brain herniation.

2010-01-01

238

Intraoperative atelectasis due to endotracheal tube cuff herniation: a case report.  

PubMed

Endotracheal tube (ETT) cuff herniation is a rare, and often difficult to diagnose, cause of bronchial obstruction. We present a case of outside cuff herniation of an endotracheal tube that caused pulmonary right lung atelectasis. A 29-year-old man ,a case of car accident with multiple fractures, was admitted to the emergency ward and transferred to the operating room(OR) for open reduction and internal fixation (ORIF) of all fractures .The procedures were done under general anesthesia (G/A). The past medical history of the patient did not indicate any problem. Anesthesia was induced with thiopental, atracurium and then maintained by propofol and remifentanyl infusions and 100% O2 via orally inserted ETT. The patient was positioned in left lateral decubitus position for operation. Two hours after induction of anesthesia, the oxygen saturation level dropped to 85 % and the breath sounds in the right side of the chest were weakened. The chest x-ray images showed right lung atelectasis especially in the upper lobe. The problem was disappeared after removal of the ETT. In this case, we observed that an ETT cuff herniation can be a cause of airway obstruction. If there is a decreased unilateral breath sounds, we recommend replacement or repositioning of ETT. PMID:23165818

Moazeni Bitgani, Mohammad; Madineh, Hossein

2012-01-01

239

[Meningeal herniation associated to chronic otitis media in an otology center in the City of Mexico].  

PubMed

To assess the frequency and clinical characteristics of meningocele and meningoencephalocele into the middle ear, at an otological referral center of Mexico city. After analyzing 586 recordings of middle ear surgery, we identified that 3 (0.5%) had defects of the tegmen timpani, 2 had brain abscesses (0.34%) and 1 had (0.17%) a facial palsy. Two of the patients with defects of the tegmen timpani had herniation of the intracraneal tissue. Case 1. A 38 year old woman with a history of bilateral chronic otitis media, with 2 surgeries in the left ear. She was seeking medical care because of right hearing loss. However, computed tomography and magnetic resonance showed a defect of the tegmen timpani with temporal lobe herniation in the left ear. Case 2 was a 46 year old woman with no history of ear disease, just high blood pressure. She was seeking medical care because of right hearing loss, vertigo and headache. The clinical evaluation suggested tissue in the middle ear and the computed tomography showed a defect of the tegmen timpani, meningocele was confirmed by surgery. In the 2 patients the clinical characteristics did not suggest herniation of intracraneal tissue as the first diagnosis. This show us the importance of an intended evaluation and image studies to make an early diagnosis. PMID:16503034

Esparza Castro, M; Martínez Gutiérrez, N; Jáuregui Renaud, K

2006-01-01

240

Atypical presentation of thoracic disc herniation: case series and review of the literature.  

PubMed

Modern imaging has revealed that thoracic disc herniation (TDH) has a prevalence of 11-37% in asymptomatic patients. Pain, sensory disturbances, myelopathy, and lower extremity weakness are the most common presenting symptoms, but other atypical extraspinal complaints, such as gastrointestinal or cardiopulmonary discomfort, may be reported. Our objective is to make providers familiar with TDH's atypical symptoms to help avoid potential serious consequences created by a delay in diagnosis. We report the cases of two patients who each presented with atypical extraspinal symptoms secondary to a TDH. One patient presented with a chronic history of nausea, emesis, and chest tightness and MRI showed a large right paramedian disc herniation at T7-8. A second patient reported chronic constipation, buttock and leg burning pain, gait instability, and urinary frequency; an MRI of his thoracic spine demonstrated a central disc herniation at T10-11. TDH can present with vague extraspinal symptoms and unfamiliarity with these symptoms can lead to misdiagnosis with progression of the disease and unnecessary diagnostic tests and medical procedures. Therefore, TDH should be included in the differential diagnosis of patients with negative gastrointestinal, genitourinary, and cardiopulmonary system basic studies. PMID:23691393

Shirzadi, Ali; Drazin, Doniel; Jeswani, Sunil; Lovely, Leah; Liu, John

2013-04-04

241

Retrolisthesis and lumbar disc herniation: a postoperative assessment of patient function  

PubMed Central

BACKGROUND CONTEXT The presence of retrolisthesis has been associated with the degenerative changes of the lumbar spine. However, retrolisthesis in patients with L5–S1 disc herniation has not been shown to have a significant relationship with worse baseline pain or function. Whether it can affect the outcomes after discectomy, is yet to be established. PURPOSE The purpose of this study was to determine the relationship between retrolisthesis (alone or in combination with other degenerative conditions) and postoperative low back pain, physical function, and quality of life. This study was intended to be a follow-up to a previous investigation that looked at the preoperative assessment of patient function in those with retrolisthesis and lumbar disc herniation. STUDY DESIGN Cross-sectional study. PATIENT SAMPLE Patients enrolled in SPORT (Spine Patient Outcomes Research Trial) who had undergone L5–S1 discectomy and had a complete magnetic resonance imaging scan available for review (n=125). Individuals with anterolisthesis were excluded. OUTCOME MEASURES Time-weighted averages over 4 years for the Short Form (SF)-36 bodily pain scale, SF-36 physical function scale, Oswestry Disability Index (ODI), and Sciatica Bothersomeness Index (SBI). METHODS Retrolisthesis was defined as a posterior subluxation of 8% or more. Disc degeneration was defined as any loss of disc signal on T2 imaging. Modic changes were graded 1 to 3 and collectively classified as vertebral end plate degenerative changes. The presence of facet arthropathy and ligamentum flavum hypertrophy was classified jointly as posterior degenerative changes. Longitudinal regression models were used to compare the time-weighted outcomes over 4 years. RESULTS Patients with retrolisthesis did significantly worse with regard to bodily pain and physical function over 4 years. However, there were no significant differences in terms of ODI or SBI. Similarly, retrolisthesis was not a significant factor in the operative time, blood loss, lengths of stay, complications, rate of additional spine surgeries, or recurrent disc herniations. Disc degeneration, modic changes, and posterior degenerative changes did not affect the outcomes. CONCLUSIONS Although retrolisthesis in patients with L5–S1 disc herniation did not affect the baseline pain or function, postoperative outcomes appeared to be somewhat worse. It is possible that the contribution of pain or dysfunction related to retrolisthesis became more evident after removal of the disc herniation.

Kang, Kevin K.; Shen, Michael S.; Zhao, Wenyan; Lurie, Jon D.; Razi, Afshin E.

2013-01-01

242

Case-control Study of Risk Factors for Lumbar Intervertebral Disc Herniation in Croatian Island Populations  

PubMed Central

Aim To investigate the risk factors for lumbar intervertebral disc herniation (L4/L5 or L5/S1) severe enough to require surgery of the lower spine among 9 isolated populations of Croatian islands and to evaluate predictive value, sensitivity, and specificity of a simple screening test based on the understanding of the risk factors in this population. Methods In a sample of 1001 examinees from Croatian island populations, we identified all subjects who underwent surgery of the lower spine due to lumbar intervertebral disc herniation L4/L5 or L5/S1 and selected 4 controls matched by age, gender, and village of residence for each of them. Odds ratio was computed for the following variables: body mass index, occupation, intensity of physical labor at work, intensity of physical labor at home, smoking index, claudication index, self-assessed limitation in physical activity, level of education, socio-economic status, and family history of lumbar intervertebral disc herniation requiring surgery. Results Comparison of 67 identified cases with 268 controls revealed the highest odds ratios (OR) for positive family history (OR 4.00; 95% confidence intervals [CI], 1.89-6.11, P<0.001), intensity of physical labor at work defined as “hard” (OR 2.94; 95% CI, 1.07-4.81, P<0.001), and body mass index of 25.7 or more (OR 2.77, 95% CI, 1.05-4.49, P?=?0.002). A simple screening test based on the presence of any two of these three criteria has 74% sensitivity and 82% specificity to detect persons who underwent lower spine surgery due to lumbar intervertebral disc herniation in the population aged 40 years or more. Conclusion Occurrence of lumbar disk herniation severe enough to require surgery of the lower spine can be predicted using a very simple set of criteria. This type of screening could reduce the need for surgery in isolated communities through prevention within primary health care.

Saftic, Robert; Grgic, Matijana; Ebling, Barbara; Splavski, Bruno

2006-01-01

243

Gatekeepers of the Nucleus  

NSDL National Science Digital Library

Nuclear pore complexes (NPCs) form the site for entry and exit from the nucleus. A convergence of studies have defined the physical framework for the nuclear transport mechanism. This includes definition of the soluble transport machinery required for protein and RNA movement, x-ray structure analysis of transport factors, definitive compositional analysis of yeast NPCs, and documentation of the relative steady state arrangement of NPC components within the portal. With this information, researchers are now in the exciting position to examine the dynamic interplay between shuttling transport factors and the static pore complex.

Susan Wente (Washington University School of Medicine;Department of Cell Biology and Physiology)

2000-05-26

244

Higgs-boson production in nucleus-nucleus collisions.  

PubMed

Cross-section calculations are presented for the production of intermediate-mass Higgs bosons produced in ultrarelativistic nucleus-nucleus collisions via two-photon fusion. The calculations are performed in position space using Baur's method for folding together the Weizsacker-Williams virtual-photon spectra of the two colliding nuclei. It is found that two-photon fusion in nucleus-nucleus collisions is a plausible way of finding intermediate-mass Higgs bosons at the Superconducting Super Collider or the CERN Large Hadron Collider. PMID:10012777

Norbury, J W

1990-12-01

245

Distant Comet Nucleus Sizes  

NASA Astrophysics Data System (ADS)

A subset of well-observed dynamically new comets will be between heliocentric distances of 19 to 28 AU during cycle 5 where it should be possible for the first time to detect their nuclei. These comets are part of a long-term ground-based program to search for physical and chemical differences between the comets entering the inner Solar System for the first time and those which have been thermally processed (the periodic comets). The gradual disappearance of their comae has been monitored for several years from the ground, but it has been impossible to observe the nuclei because of the presence of comae. The nucleus properties of these comets are not only essential to thermal sublimation models for the light-curve behavior, but also extremely important to models of the outer Solar System formation, in particular to the mass distribution in the nebula and the sizes of the protoplanetary bodies at large distances. Cycle 5 will be the only opportunity to obtain physical information about these nuclei before they become definitively too faint to be observed. The WFPC2 will be used to detect the nuclei to a limiting magnitude of R = 28. Non-detections are very improbable; however, the corresponding constraints (2.5-5.5 km) would be extremely strong, and equally important to the models. Small nucleus sizes, combined with thermal sublimation models, will rule out the hypothesis that distant, unusually active comets must be large, rather that they must have a

Meech, Karen

1995-07-01

246

Single nucleon emission in relativistic nucleus-nucleus reactions  

Microsoft Academic Search

Significant discrepancies between theory and experiment have previously been noted for nucleon emission via electromagnetic processes in relativistic nucleus-nucleus collisions. The present work investigates the hypothesis that these discrepancies have arisen due to uncertainties about how to deduce the experimental electromagnetic cross section from the total measured cross section. An optical-model calculation of single neutron removal is added to electromagnetic

John W. Norbury; Lawrence W. Townsend

1992-01-01

247

Single nucleon emission in relativistic nucleus-nucleus reactions  

Microsoft Academic Search

Significant discrepancies between theory and experiment have previously been noted for nucleon emission via electromagnetic processes in relativistic nucleus-nucleus collisions. The present work investigates the hypothesis that these discrepancies have arisen due to uncertainties about how to deduce the experimental electromagnetic cross section from the total measured cross section. An optical-model calculation of single neutron removal is added to electromagnetic

John Norbury; Lawrence Townsend

1990-01-01

248

Internal herniation of the anterior gastric wall through an attenuated Nissen Fundoplication wrap: an unusual complication and its laparoscopic management.  

PubMed

Laparoscopic Nissen fundoplication is the treatment of choice for medically refractive gastro-oesophageal reflux disease as it is considered safe, cost efficient and effective. Unusual variants of internal abdominal herniation, however, have been reported after the procedure. Here, we present a case of a 38-year-old woman who presented 3 months after a successful laparoscopic Nissen Rossetti fundoplication, with abdominal pain and persistent vomiting. Abdominal X-ray at the time of admission was normal but CT suggested internal herniation of the stomach. Laparoscopy confirmed internal herniation of the anterior wall of the stomach through an attenuated fundoplication wrap. We show that a prompt diagnosis of this complication, which we have not found reported previously in the English literature, can be achieved by CT, permitting an early laparoscopic intervention to preserve the viability of the obstructed segment of stomach. PMID:20694799

Chattopadhyay, D; Wynne, K S

2010-08-08

249

Use of CT-guided periradicular injection for the treatment of foraminal and extraforaminal disc herniations.  

PubMed

Study design: ?Retrospective case series. Evidence level IV. Objectives: ?To evaluate surgical candidates with foraminal or extraforaminal lumbar disc herniation treated with CT-guided periradicular injection (CTGPI) as a valid treatment option for avoiding surgery. Methods: ?We carried out a retrospective evaluation of 46 consecutive patients with foraminal or extraforaminal disc herniation treated with CTGPI. CTGPI was performed only when radicular pain could not be controlled, or in patients who continued requiring pain medication following an acute episode and whose radicular pain precluded them from resuming their daily activities. Forty-six patients with a minimum 2-year follow-up met the inclusion criteria. There were 21 women and 25 men, with a mean age of 47 years. Results: ?At 1 month after injection, 41 (89%) patients experienced a decrease in radicular pain; 3 experienced no change; and 2 had received surgical treatment. At the final follow-up visit (mean, 74 months) 6 additional patients underwent surgery while 38 (83%) did not require surgery. Pain level comparison between pre-injection and last examination showed that low back pain had decreased a mean of 5 points and radicular pain diminished a mean of 7 points. Twenty-two (58%) of the 38 nonoperated patients had no pain at all and 35 patients had resumed their normal daily activities. No complications were recorded. Conclusion: ?Based on these results, we consider that the use of CTGPI is a reliable alternative before surgery for patients with foraminal or extraforaminal disc herniation without severe motor deficit but with intractable radicular pain. [Table: see text]. PMID:23532378

Gruenberg, Marcelo F; Petracchi, Matías; Valacco, Marcelo; Solá, Carlos

2011-08-01

250

Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature  

PubMed Central

The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy in patients with symptomatic lumbar disc herniations. Transforaminal endoscopic techniques for patients with symptomatic lumbar disc herniations have become increasingly popular. The literature has not yet been systematically reviewed. A comprehensive systematic literature search of the MEDLINE and EMBASE databases was performed up to May 2008. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality and outcomes were extracted by the two reviewers independently. One randomized controlled trial, 7 non-randomized controlled trials and 31 observational studies were identified. Studies were heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures and the methodological quality of these studies was poor. The eight trials did not find any statistically significant differences in leg pain reduction between the transforaminal endoscopic surgery group (89%) and the open microdiscectomy group (87%); overall improvement (84 vs. 78%), re-operation rate (6.8 vs. 4.7%) and complication rate (1.5 vs. 1%), respectively. In conclusion, current evidence on the effectiveness of transforaminal endoscopic surgery is poor and does not provide valid information to either support or refute using this type of surgery in patients with symptomatic lumbar disc herniations. High-quality randomized controlled trials with sufficiently large sample sizes are direly needed to evaluate if transforaminal endoscopic surgery is more effective than open microdiscectomy.

Nellensteijn, Jorm; Bartels, Ronald; Peul, Wilco; van Royen, Barend; van Tulder, Maurits

2009-01-01

251

Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy.  

PubMed

Existing studies on micro-endoscopic lumbar discectomy report similar outcomes to those of open and microdiscectomy and conflicting results on complications. We designed a randomised controlled trial to investigate the hypothesis of different outcomes and complications obtainable with the three techniques. 240 patients aged 18-65 years affected by posterior lumbar disc herniation and symptoms lasting over 6 weeks of conservative management were randomised to micro-endoscopic (group 1), micro (group 2) or open (group 3) discectomy. Exclusion criteria were less than 6 weeks of pain duration, cauda equina compromise, foraminal or extra-foraminal herniations, spinal stenosis, malignancy, previous spinal surgery, spinal deformity, concurrent infection and rheumatic disease. Surgery and follow-up were made at a single Institution. A biomedical researcher independently collected and reviewed the data. ODI, back and leg VAS and SF-36 were the outcome measures used preoperatively, postoperatively and at 6-, 12- and 24-month follow-up. 212/240 (91%) patients completed the 24-month follow-up period. VAS back and leg, ODI and SF36 scores showed clinically and statistically significant improvements within groups without significant difference among groups throughout follow-up. Dural tears, root injuries and recurrent herniations were significantly more common in group 1. Wound infections were similar in group 2 and 3, but did not affect patients in group 1. Overall costs were significantly higher in group 1 and lower in group 3. In conclusion, outcome measures are equivalent 2 years following lumbar discectomy with micro-endoscopy, microscopy or open technique, but severe complications are more likely and costs higher with micro-endoscopy. PMID:20127495

Teli, Marco; Lovi, Alessio; Brayda-Bruno, Marco; Zagra, Antonino; Corriero, Andrea; Giudici, Fabrizio; Minoia, Leone

2010-02-03

252

Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy  

PubMed Central

Existing studies on micro-endoscopic lumbar discectomy report similar outcomes to those of open and microdiscectomy and conflicting results on complications. We designed a randomised controlled trial to investigate the hypothesis of different outcomes and complications obtainable with the three techniques. 240 patients aged 18–65 years affected by posterior lumbar disc herniation and symptoms lasting over 6 weeks of conservative management were randomised to micro-endoscopic (group 1), micro (group 2) or open (group 3) discectomy. Exclusion criteria were less than 6 weeks of pain duration, cauda equina compromise, foraminal or extra-foraminal herniations, spinal stenosis, malignancy, previous spinal surgery, spinal deformity, concurrent infection and rheumatic disease. Surgery and follow-up were made at a single Institution. A biomedical researcher independently collected and reviewed the data. ODI, back and leg VAS and SF-36 were the outcome measures used preoperatively, postoperatively and at 6-, 12- and 24-month follow-up. 212/240 (91%) patients completed the 24-month follow-up period. VAS back and leg, ODI and SF36 scores showed clinically and statistically significant improvements within groups without significant difference among groups throughout follow-up. Dural tears, root injuries and recurrent herniations were significantly more common in group 1. Wound infections were similar in group 2 and 3, but did not affect patients in group 1. Overall costs were significantly higher in group 1 and lower in group 3. In conclusion, outcome measures are equivalent 2 years following lumbar discectomy with micro-endoscopy, microscopy or open technique, but severe complications are more likely and costs higher with micro-endoscopy.

Lovi, Alessio; Brayda-Bruno, Marco; Zagra, Antonino; Corriero, Andrea; Giudici, Fabrizio; Minoia, Leone

2010-01-01

253

Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.  

PubMed

Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. Background: A 23-year-old male collegiate wrestler injured his neck in a wrestling tournament match and experienced pain, weakness, and numbness in his left upper extremity. He completed that match and 1 additional match that day with mild symptoms. Evaluation by a certified athletic trainer 6 days postinjury showed radiculopathy in the C7 distribution of his left upper extremity. He was evaluated further by the team physician, a primary care physician, and a neurosurgeon. Differential Diagnosis: Cervical spine injury, stinger/burner, peripheral nerve injury, spinal cord injury, thoracic outlet syndrome, brachial plexus radiculopathy. Treatment: The patient initially underwent nonoperative management with ice, heat, massage, electrical stimulation, shortwave diathermy, and nonsteroidal anti-inflammatory drugs without symptom resolution. Cervical spine radiographs were negative for bony pathologic conditions. Magnetic resonance imaging showed evidence of T1-T2 disc herniation. The patient underwent surgery to resolve the symptoms and enable him to participate for the remainder of the wrestling season. Uniqueness: Whereas brachial plexus radiculopathy commonly is seen in collision sports, a postfixed brachial plexus in which the T2 nerve root has substantial contribution to the innervation of the upper extremity is a rare anatomic variation with which many health care providers are unfamiliar. Conclusions: The injury sustained by the wrestler appeared to be C7 radiculopathy due to a brachial plexus traction injury. However, it ultimately was diagnosed as radiculopathy due to a T1-T2 thoracic intervertebral disc herniation causing impingement of a postfixed brachial plexus and required surgical intervention. Athletic trainers and physicians need to be aware of the anatomic variations of the brachial plexus when evaluating and caring for patients with suspected brachial plexus radiculopathies. PMID:23952042

Kuzma, Scott A; Doberstein, Scott T; Rushlow, David R

2013-08-16

254

Plastid-to-Nucleus Signaling  

Microsoft Academic Search

The function of the eukaryotic cell depends on the regulated and reciprocal interaction between its different compartments.\\u000a This includes not only the exchange of energy equivalents but also information. Most information exchange flows from the nucleus\\u000a to the organelles, because the large majority of genes encoding proteins with organellar function are encoded in the nucleus.

Åsa Strand; Tatjana Kleine; Joanne Chory

255

Comet Odyssey: Comet Nucleus Orbiter  

Microsoft Academic Search

Comet Odyssey is a comet nucleus orbiter mission, proposed to NASA's Discovery program in 2004. The goal of the mission is to completely characterize a cometary nucleus, both physically and compositionally, as can only be done during an extended rendezvous and not with a fast flyby. Comet Odyssey will launch in October 2009 on a Delta II 7925 and use

P. R. Weissman; W. D. Smythe; S. J. Spitz; D. E. Bernard; R. W. Bailey

2004-01-01

256

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion  

Microsoft Academic Search

Between 2001 and 2005, 43 patients (average age 54.2, range 36–68 years) with recurrent lumbar disc herniation underwent reoperation\\u000a with the transforaminal lumbar interbody fusion (TLIF) technique at our unit. All cases were followed up for 24–72 months\\u000a (mean 45 months) and graded using the Japanese Orthopaedic Association (JOA) score system pre- and post-operation and during\\u000a the follow-up period. The leg pain of

Zhiming Chen; Jie Zhao; AiGang Liu; Jiandong Yuan; Zhonghai Li

2009-01-01

257

Herniation of the gallbladder within a hernia of the abdominal wall associated with Mirizzi Syndrome  

PubMed Central

A gallbladder incarcerated hernia associated with Mirizzi syndrome is a very rare entity and to our knowledge this is the first case ever described in literature. An 85-year-old man presented at the emergency department with a tender right upper quadrant mass. Computed Tomography (CT) revealed the presence of a gallbladder lithiasis with signs of acute cholecystitis, herniated through the abdominal wall with an associated Mirizzi syndrome. Laparoscopic cholecystectomy and repair of the abdominal wall defect were performed. The patient recovered very well and the postoperative period was uneventful.

Paolino, LA; Millan, M; Bossi, M; Champault, G; Barrat, C

2011-01-01

258

Higher preoperative Oswestry Disability Index is associated with better surgical outcome in upper lumbar disc herniations  

Microsoft Academic Search

To evaluate the surgical outcome in terms of functional and subjective recovery, patients who needed discectomies at L1–L2,\\u000a L2–L3 and L3–L4 levels were compared with an age and sex-matched group of patients who required L4–L5 and L5–S1 discectomies.\\u000a We prospectively enrolled 50 consecutive patients, referred to our center, who had L1–L2, L2–L3 and L3–L4 herniations and\\u000a required surgical intervention. Likewise,

Hooshang Saberi; Arash Vatankhahan Isfahani

2008-01-01

259

[Use of glucocorticoids in low back pain due to disc herniation with radicular involvement].  

PubMed

Although systemic glucocorticoids are frequently used for the treatment of radicular pain due to disc herniation, there are only few studies available. No trial has successfully demonstrated the superiority of systemic glucocorticoids compared to placebo. Therefore their use is not recommended. Spinal injection using radiographic guidance appears to provide some beneficial short-term effect on pain. It might be offered when pain treatments according to the WHO steps have failed. Because rare but serious adverse events have been reported, transforaminal periradicular injections should only be used after thorough analysis of risks and benefits with the patient. PMID:22073701

Lazarou, Ilias; Genevay, Stéphane; Nendaz, Mathieu

2011-10-19

260

Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block  

Microsoft Academic Search

Background  In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves.\\u000a We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation\\u000a in a patient undergoing a caudal block.\\u000a \\u000a \\u000a \\u000a \\u000a Clinical features  A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she

Shubada Dugani; De Q. H. Tran; Roderick J. Finlayson

2011-01-01

261

Health-related quality of life in patients with surgically treated lumbar disc herniation  

PubMed Central

Background and purpose Health-related quality of life (HRQoL) instruments have been of increasing interest for evaluation of medical treatments over the past 10–15 years. In this prospective, long-term follow-up study we investigated the influence of preoperative factors and the change in HRQoL over time after lumbar disc herniation surgery. Methods 117 patients surgically treated for lumbar disc herniation (L4-L5 or L5-S1) were evaluated with a self-completion HRQoL instrument (EQ-5D) preoperatively, after 2 years (96 patients) and after 7 years (89 patients). Baseline data (age, sex, duration of leg pain, surgical level) and degree of leg and back pain (VAS) were obtained preoperatively. The mean age was 39 (18–66) years, 54% were men, and the surgical level was L5-S1 in 58% of the patients. The change in EQ-5D score at the 2-year follow-up was analyzed by testing for correlation and by using a multiple regression model including all baseline factors (age, sex, duration of pain, degree of leg and back pain, and baseline EQ-5D score) as potential predictors. Results 85% of the patients reported improvement in EQ-5D two years after surgery and this result remained at the long-term follow-up. The mean difference (change) between the preoperative EQ-5D score and the 2-year and 7-year scores was 0.59 (p < 0.001) and 0.62 (p < 0.001), respectively. However, the HRQoL for this patient group did not reach the mean level of previously reported values for a normal population of the same age range at any of the follow-ups. The changes in EQ-5D score between the 2- and 7-year follow-ups were not statistically significant (mean change 0.03, p = 0.2). There was a correlation between baseline leg pain and the change in EQ-5D at the 2-year (r = 0.33, p = 0.002) and 7-year follow-up (r = 0.23, p = 0.04). However, when using regression analysis the only statistically significant predictor for change in EQ-5D was baseline EQ-5D score. Interpretation Our findings suggest that HRQoL (as measured by EQ-5D) improved 2 years after lumbar disc herniation surgery, but there was no further improvement after 5 more years. Low quality of life and severe leg pain at baseline are important predictors of improvement in quality of life after lumbar disc herniation surgery.

2011-01-01

262

The Budding Yeast Nucleus  

PubMed Central

The budding yeast nucleus, like those of other eukaryotic species, is highly organized with respect to both chromosomal sequences and enzymatic activities. At the nuclear periphery interactions of nuclear pores with chromatin, mRNA, and transport factors promote efficient gene expression, whereas centromeres, telomeres, and silent chromatin are clustered and anchored away from pores. Internal nuclear organization appears to be function-dependent, reflecting localized sites for tRNA transcription, rDNA transcription, ribosome assembly, and DNA repair. Recent advances have identified new proteins involved in the positioning of chromatin and have allowed testing of the functional role of higher-order chromatin organization. The unequal distribution of silent information regulatory factors and histone modifying enzymes, which arises in part from the juxtaposition of telomeric repeats, has been shown to influence chromatin-mediated transcriptional repression. Other localization events suppress unwanted recombination. These findings highlight the contribution budding yeast genetics and cytology have made to dissecting the functional role of nuclear structure.

Taddei, Angela; Schober, Heiko; Gasser, Susan M.

2010-01-01

263

Mechanics of the nucleus.  

PubMed

The nucleus is the distinguishing feature of eukaryotic cells. Until recently, it was often considered simply as a unique compartment containing the genetic information of the cell and associated machinery, without much attention to its structure and mechanical properties. This article provides compelling examples that illustrate how specific nuclear structures are associated with important cellular functions, and how defects in nuclear mechanics can cause a multitude of human diseases. During differentiation, embryonic stem cells modify their nuclear envelope composition and chromatin structure, resulting in stiffer nuclei that reflect decreased transcriptional plasticity. In contrast, neutrophils have evolved characteristic lobulated nuclei that increase their physical plasticity, enabling passage through narrow tissue spaces in their response to inflammation. Research on diverse cell types further demonstrates how induced nuclear deformations during cellular compression or stretch can modulate cellular function. Pathological examples of disturbed nuclear mechanics include the many diseases caused by mutations in the nuclear envelope proteins lamin A/C and associated proteins, as well as cancer cells that are often characterized by abnormal nuclear morphology. In this article, we will focus on determining the functional relationship between nuclear mechanics and cellular (dys-)function, describing the molecular changes associated with physiological and pathological examples, the resulting defects in nuclear mechanics, and the effects on cellular function. New insights into the close relationship between nuclear mechanics and cellular organization and function will yield a better understanding of normal biology and will offer new clues into therapeutic approaches to the various diseases associated with defective nuclear mechanics. PMID:23737203

Lammerding, Jan

2011-04-01

264

Effects of human midkine on spontaneous resorption of herniated intervertebral discs.  

PubMed

This study was performed in 36 rabbits to investigate the role of midkine (MK) in the resorption of herniated intervertebral discs. The L(1-2) disc was excised and immersed in one of three kinds of solution for two hours before relocation into the L4 epidural space. In the MK-treated group, the weight of relocated intervertebral discs decreased more over time than in the control group. Newly formed vessels and inflammatory cells were more frequently observed in the MK-treated group than in the control group two weeks after surgery. The degradation of matrix was more significant in the MK-treated group than in the control group four weeks after surgery. Larger areas were replaced by fibrous tissues in the MK-treated group eight weeks after surgery. Thus, MK can accelerate the resorption of the intervertebral disc relocation to the epidural space. Epidural injection of MK may contribute to the therapy of lumber disc herniation. PMID:19277655

Zhou, Guoshun; Dai, Licheng; Jiang, Xuesheng; Ma, Zhihong; Ping, Jinliang; Li, Jianyou; Li, Xiongfeng

2009-03-11

265

Strangulated intercostal liver herniation subsequent to blunt trauma. First report with review of the world literature.  

PubMed

Traumatic transdiaphragmatic intercostal hernia, defined as an acquired herniation of abdominal contents through disrupted intercostal muscles, is a rarely reported entity. We present the first reported case of a traumatic transdiaphragmatic intercostal hernia complicated by strangulation of the herniated visceral contents.Following blunt trauma, a 61-year old man developed a traumatic transdiaphragmatic intercostal hernia complicated by strangulation of liver segment VI. Due to pre-existing respiratory problems and the presence of multiple other injuries (grade III kidney laceration and lung contusion) the hernia was managed non-operatively for the first 2?weeks.The strangulated liver segment eventually underwent ischemic necrosis. Six weeks later the resulting subcutaneous abscess required surgical drainage. Nine months post injury the large symptomatic intercostal hernia was treated with laparoscopic mesh repair. Twelve months after the initial trauma, a small recurrence of the hernia required laparoscopic re-fixation of the mesh.This paper outlines important steps in managing a rare post traumatic entity. Early liver reduction and hernia repair would have been ideal. The adopted conservative approach caused liver necrosis and required staged procedures to achieve a good outcome. PMID:22800293

Bendinelli, Cino; Martin, Andrew; Nebauer, Shane D; Balogh, Zsolt J

2012-07-16

266

Effects of human midkine on spontaneous resorption of herniated intervertebral discs  

PubMed Central

This study was performed in 36 rabbits to investigate the role of midkine (MK) in the resorption of herniated intervertebral discs. The L1-2 disc was excised and immersed in one of three kinds of solution for two hours before relocation into the L4 epidural space. In the MK-treated group, the weight of relocated intervertebral discs decreased more over time than in the control group. Newly formed vessels and inflammatory cells were more frequently observed in the MK-treated group than in the control group two weeks after surgery. The degradation of matrix was more significant in the MK-treated group than in the control group four weeks after surgery. Larger areas were replaced by fibrous tissues in the MK-treated group eight weeks after surgery. Thus, MK can accelerate the resorption of the intervertebral disc relocation to the epidural space. Epidural injection of MK may contribute to the therapy of lumber disc herniation.

Jiang, Xuesheng; Ma, Zhihong; Ping, Jinliang; Li, Jianyou; Li, Xiongfeng

2009-01-01

267

Case of idiopathic thoracic spinal cord herniation with a chronic history: a case report and review of the literature  

Microsoft Academic Search

Idiopathic spinal cord herniation is a rare disease that presents with slowly progressive myelopathy. This article describes the clinical findings of a patient with a chronic history. A 68-year-old woman initially presented at the age of 32 years with left leg weakness. After slowly progressive neurological deterioration over 34 years, she became completely paraplegic. At the age of 66 years,

Taku Saito; Yorito Anamizu; Kozo Nakamura; Atsushi Seichi

2004-01-01

268

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

Microsoft Academic Search

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

James Herzog

1999-01-01

269

Unexpected doubly-magic nucleus.  

SciTech Connect

Nuclei with a 'magic' number of both protons and neutrons, dubbed doubly magic, are particularly stable. The oxygen isotope {sup 24}O has been found to be one such nucleus - yet it lies just at the limit of stability.

Janssens, R. V. F.; Physics

2009-01-01

270

J/? suppression from hadron-nucleus to nucleus-nucleus collisions  

NASA Astrophysics Data System (ADS)

We explore the combined role of inelastic final-state scattering with nucleons and comoving secondary particles in the suppression of J/? production for hadron-nucleus and nucleus-nucleus collisions, as functions of target mass, beam energy, and transverse energy. Our interpretation of recent data suggests that nuclear scattering dominates the suppression for ? + A collisions at 125 GeV while a comparable contribution from scattering in a dense comover gas emerges for O + U and S + U at 200 AGeV. Formerly: Physics Department, State University of New York, Stony Brook, NY 11794, USA. Present address: Lawrence Livermore Laboratory, PO Box 808, Livermore, CA 94550, USA.

Gavin, S.; Vogt, R.

1990-11-01

271

Use of fracture size and soft tissue herniation on computed tomography to predict diplopia in isolated orbital floor fractures.  

PubMed

PURPOSE: To determine the role of fracture size and soft tissue herniation as measured by computed tomography in predicting the development of persistent diplopia in patients with isolated orbital floor fractures. METHODS: A retrospective chart review identified patients presenting between March 2009 and 2012 with isolated orbital floor fractures. Computed tomographic scans were assessed for transverse fracture size and absence or presence of soft tissue herniation and rectus involvement. Presence of diplopia at 6-10days, decision for surgical repair, and presence of diplopia were recorded. RESULTS: Fifty-six patients fulfilled inclusion criteria. Eighteen of 56 patients (32%) had preoperative diplopia. In Type A fractures, 0/9 (0%) small, 1/8 (12.5%) medium, and 2/14 (14%) large fractures had diplopia. For Type B fractures, 3/4 (75%) small, 9/13 (69%) medium, and 4/8 (50%) large fractures had diplopia. Type B fractures were significantly more likely to cause diplopia than Type A fractures in the small (p=0.003) and medium (p=0.007) size groups but not in the large groups (p=0.07). CONCLUSIONS: Transverse fracture size and presence of soft tissue herniation on CT imaging can predict development of persistent diplopia in isolated orbital floor fractures. Small and medium sized fractures with soft tissue herniation are more likely to cause diplopia than large sized fractures. We recommend early repair or closer observation of small and medium sized orbital floor fractures with soft tissue herniation due to the high risk of diplopia. PMID:23529135

Shah, Hassan A; Shipchandler, Taha Z; Sufyan, Ahmed S; Nunery, William R; Lee, Hui Bae H

2013-03-22

272

Photoproduction of lepton pairs in proton-nucleus and nucleus-nucleus collisions at RHIC and LHC energies  

NASA Astrophysics Data System (ADS)

In this contribution we study coherent interactions as a probe of the nonlinear effects in the Quantum Electrodynamics (QED). In particular, we study the multiphoton effects in the production of leptons pairs for proton-nucleus and nucleus-nucleus collisions for heavy nuclei. In the proton-nucleus we assume the ultrarelativistic proton as a source of photons and estimate the photoproduction of lepton pairs on nuclei at RHIC and LHC energies considering the multiphoton effects associated to multiple rescattering of the projectile photon on the proton of the nucleus. In nucleus - nucleus colllisions we consider the two nuclei as a source of photons. As each scattering contributes with a factor ?Z to the cross section, this contribution must be taken into account for heavy nuclei. We consider the Coulomb corrections to calculate themultiple scatterings and estimate the total cross section for muon and tau pair production in proton-nucleus and nucleus-nucleus collisions at RHIC and LHC energies.

Moreira, B. D.; Gonçalves, V. P.; De Santana Amaral, J. T.

2013-03-01

273

Herniated disk  

MedlinePLUS

... pressure on nearby nerves. See also: Acute low back pain Chronic low back pain Sciatica ... CHANGES Diet and exercise are crucial to improving back pain in overweight patients. Physical therapy is important for ...

274

Herniated Disk  

MedlinePLUS

... Neck As with pain in the lower back, neck pain is also common. When pressure is placed on ... history. Tell him or her if you have neck/back pain with gradually increasing arm/leg pain. Tell the ...

275

Herniated Disk  

MedlinePLUS

... 478. Robinson J, et al. Treatment of cervical radiculopathy. http://www.uptodate.com/home/index.html. Accessed Oct. 7, 2010. Levin K, et al. Lumbosacral radiculopathy: Prognosis and treatment. http://www.uptodate.com/home/ ...

276

Herniated Disc  

MedlinePLUS

... Go Advanced Search Home About AANS Governance and Leadership Annual Reports Executive Office Driving Directions Cyber Museum ... Advertising and Marketing AANS Neurosurgeon Advertising Index Corporate Leadership Council Guidelines Career Center Media 2012 Annual Scientific ...

277

Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges  

PubMed Central

Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed.

Bron, Johannes Leendert; Helder, Marco N.; Meisel, Hans-Jorg; Van Royen, Barend J.

2008-01-01

278

Toward a systematic nucleus-nucleus potential for peripheral collisions  

NASA Astrophysics Data System (ADS)

A systematic nucleus-nucleus potential is proposed based on an optical model analysis of angular distributions of differential cross sections of 6Li and 7Li elastic scattering from targets with A?40 with incident energies between 5 and 40 MeV/nucleon. A single-folding model based on the Bruyères Jeukenne-Lejeune-Mahaux (JLMB) model nucleon-nucleus potentials was used. Systematics in energy dependence of the potential parameters were obtained. This systematics was found to give reasonable account for both elastic scattering and total reaction cross sections for projectiles with mass numbers up to A˜40, including both stable and unstable nuclei, for incident energies from the vicinity of the Coulomb barrier to about 100 MeV/nucleon.

Xu, Y. P.; Pang, D. Y.

2013-04-01

279

Transport of the Influenza Virus Genome from Nucleus to Nucleus  

PubMed Central

The segmented genome of an influenza virus is encapsidated into ribonucleoprotein complexes (RNPs). Unusually among RNA viruses, influenza viruses replicate in the nucleus of an infected cell, and their RNPs must therefore recruit host factors to ensure transport across a number of cellular compartments during the course of an infection. Recent studies have shed new light on many of these processes, including the regulation of nuclear export, genome packaging, mechanisms of virion assembly and viral entry and, in particular, the identification of Rab11 on recycling endosomes as a key mediator of RNP transport and genome assembly. This review uses these recent gains in understanding to describe in detail the journey of an influenza A virus RNP from its synthesis in the nucleus through to its entry into the nucleus of a new host cell.

Hutchinson, Edward C.; Fodor, Ervin

2013-01-01

280

Brain herniation induced by drainage of subdural hematoma in spontaneous intracranial hypotension  

PubMed Central

Spontaneous intracranial hypotension (SIH), typically presents with orthostatic headache, low pressure on lumbar tapping, and diffuse pachymeningeal enhancement on magnetic resonance imaging. SIH is often accompanied by subdural fluid collections, which in most cases responds to conservative treatment or spinal epidural blood patch. Several authors advocate that large subdural hematoma with acute deterioration merits surgical drainage; however, few have reported complications following craniotomy. We describe a complicated case of SIH, which was initially diagnosed as acute subarachnoid hemorrhage with bilateral chronic subdural hematoma (SDH), due to unusual presentation. Burr hole drainage of subdural hematoma was performed due to progressive decrease of consciousness, which then resulted in a huge postoperative epidural hematoma collection. Prompt hematoma evacuation did not restore the patient's consciousness but aggravated downward brain herniation. Trendelenburg position and spinal epidural blood patch achieved a rapid improvement in patient's consciousness. This case indicates that the surgical drainage for chronic SDH in SIH can lead to serious complications and it should be cautiously considered.

Chotai, Silky; Kim, Jong-Hyun; Kim, Joo-Han; Kwon, Taek-Hyun

2013-01-01

281

[Noninvasive magnetic resonance myelography in patients with lumbosacral intervertebral disk herniation].  

PubMed

For many decades X-ray myelography has remained one of the major diagnostic methods for spinal pathology. With the advent of computed tomography (CT), CT myelography using water-soluble contrast agents has been developed. Visualization of the subarachnoidal spaces of the spinal cord and dural sac without an intrathecal contrast agent has become possible with the emergence of magnetic resonance imaging (MRI). Its further development and improvement has brought to existence the new noninvasive technique MR myelography based on the suppression of a signal from the medulla and its enhancement from the cerebrospinal fluid-containing spaces. This paper compares routine X-ray myelography, CT myelography, and MR myelography used in the diagnosis of lumbosacral intervertebral disk herniation and assesses the informative value and benefits of MR myelography as a noninvasive diagnostic method for this pathology. PMID:21866824

Arutiunov, N V; Konovalov, N A; Mel'nikova-Pitskheluri, T V; Fadeeva, L M; Tissen, T P

282

Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations  

PubMed Central

Anterior cervical decompression and fusion (ACDF) is the standard for cervical discectomies. With the full-endoscopic anterior cervical discectomy (FACD) a minimally invasive procedure is available. The objective of this prospective, randomised, controlled study was to compare the results of FACD with those of ACDF in mediolateral soft disc herniations. A total of 103 patients with ACDF or FACD were followed up for two years. In addition to general parameters specific measuring instruments were used. Postoperatively 85.9% of the patients no longer had arm pain, and 10.1% had occasional pain. There were no significant clinical differences between the decompression with or without fusion. The full-endoscopic technique afforded advantages in operation technique, rehabilitation and soft tissue injury. The recorded results show that FACD is a sufficient and safe alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Komp, Martin; Merk, Harry; Godolias, Georgios

2008-01-01

283

Acute Paraplegia Secondary to Thoracic Disc Herniation of the Adjacent Segment Following Thoracolumbar Fusion and Instrumentation  

PubMed Central

Proximal junctional disease is a well-recognized postoperative phenomenon in adults who are undergoing long thoracolumbar fusion and instrumentation, and is attributed to increased a junctional stress concentration. In general, the onset of symptoms in these patients is insidious and the disease progresses slowly. We report on a contrary case of rapidly progressing paraplegia secondary to acute disc herniation at the proximal adjacent segment after long posterior thoracolumbar fusion with cement augmentation at the upper instrumented vertebra and the supra-adjacent vertebra. The patient was treated with a discectomy through the costo-transverse approach combined with extension of the posterior instrumentation. The patient's neurological status improved markedly. Stress concentration at the proximal junction disc space may have caused accelerated disc degeneration which in turn lead to this complication.

Assaker, Richard; Musharrafieh, Ramzi Sharif

2013-01-01

284

Psoas compartment blockade in a laterally herniated disc compressing the psoas muscle -a case report-.  

PubMed

A psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and analgesia for post-operative pain. Currently, this block is advocated for relieving pain in the lower extremity and pelvic area resulting from various origins. We report a case of a 69-year-old male patient who had gait abnormality with posterior pelvic and hip pain, which were both aggravated by hip extension. From the magnetic resonance image, the patient was found to have a laterally herniated intervertebral disc at the L2/3 level, which compressed the right psoas muscle. This was thought to be the origin of the pain, so a psoas compartment block was performed using 0.25% chirocaine with triamcinolone 5mg, and the pain in both the pelvis and hip were relieved. PMID:22514781

Kim, Hye Young; Park, Jin Woo; Park, Soo Young; Moon, Jee Youn; Shin, Jae Hyuck; Park, Sang Hyun

2012-04-04

285

Endoscopic Transforaminal Suprapedicular Approach in High Grade Inferior Migrated Lumbar Disc Herniation  

PubMed Central

Objective Although endoscopic procedures for lumbar disc diseases have improved greatly, the postoperative outcomes for high grade inferior migrated discs are not satisfactory. Because of anatomic limitations, a rigid endoscope cannot reach all lesions effectively. The purpose of this study was to determine the feasibility of endoscopic transforaminal suprapedicular approach to high grade inferior-migrated lumbar disc herniations. Methods Between May 2006 and March 2008, a suprapedicular approach was performed in 53 patients with high grade inferior-migrated lumbar disc herniations using a rigid endoscope and a semi-rigid flexible curved probe. One-to-four hours after surgery, the presence of remnant discs was checked with MRI. The outcomes were evaluated with the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) one week after surgery. Results The L2-3 level was involved in 2 patients and the L3-4 level was involved in 14 patients, while the L4-5 level was involved in 39 patients. There were single piece-type in 34 cases and a multiple piece-type in 19 cases. Satisfactory results were obtained in all cases. The mean preoperative VAS for leg pain was 9.32±0.43 points (range, 7-10 points), whereas the mean ODI was 79.82±4.53 points (range, 68-92 points). At the last follow-up examination, the mean postoperative VAS for leg pain was 1.78±0.71 points and the mean postoperative ODI improved to 15.27±3.82 points. Conclusion A high grade inferior migrated lumbar disc is difficult to remove sufficiently by posterolateral endoscopic lumbar dscectomy using a rigid endoscope. However, a satisfactory result can be obtained by applying a transforaminal suprapedicular approach with a flexible semi-rigid curved probe.

Kim, Hyeun Sung; Kim, Seok Won; Kim, Jong Gue

2009-01-01

286

Produced particle multiplicity dependence on centrality in nucleus - nucleus collisions  

Microsoft Academic Search

An equation is presented, which allows us to calculate the dependence of the multiplicity of the particles produced in nucleus - nucleus collisions, 0954-3899\\/22\\/10\\/010\\/img109, on an experimentally measured value 0954-3899\\/22\\/10\\/010\\/img110, which is strongly correlated to the impact parameter b. The equation combines data from a wide range of projectile masses (0954-3899\\/22\\/10\\/010\\/img111 - 197) over a large momentum region 0954-3899\\/22\\/10\\/010\\/img112. The

M. I. Adamovich; M. M. Aggarwal; Y. A. Alexandrov; R. Amirikas; N. P. Andreeva; Z. V. Anzon; R. Arora; F. A. Avetyan; S. K. Badyal; A. M. Bakich; E. S. Basova; I. K. Bazarov; K. B. Bhalla; A. Bhasin; V. S. Bhatia; V. G. Bogdanov; V. Bradnova; V. I. Bubnov; T. H. Burnett; X. Cai; D. A. Carshiev; I. Y. Chasnikov; L. P. Chernova; M. M. Chernyavsky; S. Dhamija; G. Z. Eligbaeva; L. E. Eremenko; A. S. Gaitinov; E. Ganssauge; S. Garpman; S. G. Gerassimov; C. Graf; J. G. Grote; K. G. Gulamov; S. K. Gupta; V. K. Gupta; U. Henjes; L. Just; S. Kachroo; G. S. Kalyachkina; E. K. Kanygina; M. Karabova; S. Kitroo; S. P. Kharlamov; A. D. Kovalenko; S. A. Krasnov; V. Kumar; V. G. Larionova; Y. D. Li; L. S. Liu; S. Lokanathan; J. J. Lord; N. S. Lukicheva; S. B. Luo; L. K. Mangotra; N. A. Marutyan; A. Y. Mashkov; N. V. Maslennikova; I. S. Mittra; S. Mookerjee; S. Z. Nasyrov; V. S. Navotny; J. Nystrand; M. Ochs; G. I. Orlova; I. Otterlund; L. S. Peak; N. G. Peresadko; N. V. Petrov; V. A. Plyushchev; V. V. Rusokova; W. Y. Qian; Y. M. Quin; R. Raniwala; N. K. Rao; M. Röper; N. Saidkhanov; N. A. Samanova; L. G. Sarkisova; V. R. Sarkisyan; G. S. Shabratova; A. M. Seitimbetov; C. I. Shakhova; S. N. Shpilev; D. Skelding; K. Söderström; Z. I. Solovjeva; E. Stenlund; L. N. Svechnikova; T. Svensson; A. M. Tawfik; M. Tothova; M. I. Tretyakova; T. P. Trofimova; U. I. Tuleeva; B. P. Tursunov; S. Vokal; J. Vrlakova; H. Q. Wang; Z. Q. Weng; R. J. Wilkes; Y. L. Xia; C. B. Yang; D. H. Zhang; P. Y. Zheng; S. I. Zhokhova; D. C. Zhou

1996-01-01

287

Functional MR imaging of submandibular herniation of sublingual tissues through a gap of the mylohyoid muscle in two cases of submandibular "masses".  

PubMed

Except for neoplasms, in symptomatic patients with submandibular swellings, gaps of the mylohyoid muscle may be the cause of herniations of sublingual tissues, such as fat and/or the sublingual gland. In two patients with a submandibular swelling, MRI with standard sequences including contrast enhancement was performed to exclude a neoplastic lesion. In addition, we performed a trueFISP sequence during modified Valsalva's maneuver. In both patients, a neoplasm was excluded. Instead, the trueFISP sequence during the modified Valsalva's maneuver showed submandibular herniation of sublingual tissues. If MRI of the floor of the mouth does not show a neoplasm, an additional functional MR investigation should be performed. Gaps of the mylohyoid muscle can be the cause of herniating sublingual tissues (similar to plunging ranulas). During the modified Valsalva's maneuver, sublingual fat and/or gland can herniate and cause a symptomatic submandibular swelling. A coronal trueFISP sequence is particularly suited to demonstrate this. PMID:15449011

Keberle, M; Eulert, S; Relic, A; Hahn, D

2004-09-24

288

New Diagnostic Tool for Far Lateral Lumbar Disc Herniation : The Clinical Usefulness of 3-Tesla Magnetic Resonance Myelography Comparing with the Discography CT  

PubMed Central

Objective To prospectively assess the diagnostic and clinical value of a new technique (3-tesla magnetic resonance myelography, 3T MRM) as compared to computed tomographic discography (disco-CT) in patients with far lateral disc herniation. Methods We evaluated 3T MRM and disco-CT of 25 patients, whom we suspected of suffering from far lateral disc herniation. Using an assessment scale, 4 observers examined independently both 3T MRM and disco-CT images. We analyzed observer agreement and the accentuation of each image. Results We found complete matching, and observer agreement, between high resolution images of 3T MRM and disco-CT for diagnosing far lateral disc herniation. Conclusion We think noninvasive 3T MRM is an appropriate diagnostic tool for far lateral disc herniation as compared to disco-CT.

Kim, Duk-Gyu; Park, Jung-Soo

2012-01-01

289

Long-term outcome after implantation of prosthetic disc nucleus device (PDN) in lumbar disc disease  

PubMed Central

Background: The prosthetic disc nucleus (PDN) device offers an adjunct treatment for patients with degenerative disc disease and herniation, who necessitate surgical intervention, avoiding total-disc replacement or fusion. This prospective, clinical study aimed to gauge the long-term effectiveness of microdiscectomy followed by PDN implantation in relieving pain and improving functional status in patients with symptomatic degenerative lumbar disc disease and herniation. Methods: Ten patients with a) at least 6 months low back pain and/or sciatica resistant to conservative treatment and b) radiologically documented degenerative lumbar disc disease and herniation have been selected. Follow-up at 6 weeks, 3, 12, 48, and 96 months postoperatively included physical examination, radiological investigation (plain and dynamic radiographs and magnetic resonance imaging), and self-completion of outcome scales (visual analogue, Oswestry, and Prolo functional status). Short Form-36 version 2 Health Survey patient profile at 96 months completed the image of health related quality of life. Results: Patients' mean follow-up was 100.6 months. Significant improvements in Oswestry, Prolo, and VAS scores were documented (p: 0.004 in all scales at 48 months). Generic health status was rated within the average lumbar disease population (46.36.8 for physical component summary and 45.29.6 for mental component summary). Lumbar spine range of motion (20.211.8 at 96 months) was restricted in relation to normal, but maintained considerable mobility. Treated disc height increased postoperatively (p:0.002) and its maintenance could also be documented in all cases. Disc height at the level above did not show any significant modification. All postoperative MRI showed a non-clinically significant high signal of end-plate on T2 sequences. Clinically relevant complications included one case of pulmonary thrombosis and one case of device extrusion, which was subsequently explanted. Conclusions: After implantation, most patients continue to enjoy significant pain relief, a considerable amount of mobility is conserved and the disease specific functional outcome is excellent and remains for long, although it could not be supported that the generic health related quality of life is that of the general population.

Selviaridis, P; Foroglou, N; Tsitlakidis, A; Hatzisotiriou, A; Magras, I; Patsalas, I

2010-01-01

290

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

Microsoft Academic Search

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

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

2007-01-01

291

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study  

Microsoft Academic Search

The aim of this study is to explore the occurrence and the risk factors of back-related loss of working time in patients undergoing\\u000a surgery for lumbar disc herniation. One hundred and fifty-two gainfully employed patients underwent surgery for lumbar disc\\u000a herniation. Two months postoperatively, those patients completed a self-report questionnaire including queries on back and\\u000a leg pain (VAS), functional capacity

K. Puolakka; J. Ylinen; M. H. Neva; H. Kautiainen; A. Häkkinen

2008-01-01

292

Anti p-nucleus interaction  

SciTech Connect

Status and future prospects of antiproton-nucleus scattering experiments are presented. These scattering experiments were conducted at antiproton beam momentums of 300 and 600 MeV/c on target nuclei of /sup 6/Li, /sup 12/C, /sup 16/O, /sup 18/O, /sup 40/Ca, /sup 48/Ca, and /sup 208/Pb. Antiproton-proton reactions investigated antiproton-nucleus bound or resonant states in antiproton reactions with d, /sup 6/Li, /sup 12/C, /sup 63/Cu, and /sup 209/Bi. Inelastic scattering experiments investigated the spin-isospin dependence of the NN interactions. 19 refs., 1 fig., 1 tab. (DWL)

Peng, J.C.

1986-05-01

293

Gyration of Comet Halley's nucleus  

Microsoft Academic Search

Strong observational and theoretical evidences have been found in the past decade that introduce a complex excitation as the generic physical scenario defining the gyration of slowly 'rotating', small bodies (mean period >= 3 d, mean diameter le 20 km) in the solar system. It is generally conjectured that the gyration of Comet Halley's nucleus is complex meaning that the

R. Vanscheidt

1999-01-01

294

Mesencephalic Trigeminal Nucleus in Sharks  

Microsoft Academic Search

In 22 adult sharks representing eight species, the mesencephalic trigeminal nucleus (Mes V) was examined employing the Romanes reduced silver method. Morphological evidence is presented of extensive development of neurites and intranuclear communication among Mes V cells of sharks, as well as their apparent innervation by extranuclear neurons. Species differences and the possible significance of the morphology of the Mes

Malcolm F. MacDonnell

1980-01-01

295

The antiproton-nucleus interaction  

Microsoft Academic Search

Several facets of antinucleon-nucleus interactions are explored. The topics treated are: coherent interactions, production of usual states and particles in the nuclear medium, and the creation of extreme states of matter by antimatter annihilation. It is found that temperatures of the magnitude necessary to achieve the predicted quark-gluon phase transition are obtained.

W. R. Gibbs

1984-01-01

296

Centrosomes: hooked on the nucleus.  

PubMed

A recent study has shown that the Hook protein ZYG-12 of Caenorhabditis elegans is essential for attachment of the centrosome to the nucleus. The results suggest a novel mechanism for the tight coupling between these two organelles, and shed new light on its biological significance. PMID:15062118

Gönczy, Pierre

2004-04-01

297

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy  

Microsoft Academic Search

The aim of our study was twofold: firstly, to compare the preoperative and postoperative results at mid-term follow-up periods\\u000a along with the data of the control group. Secondly, to evaluate the effectiveness among open-discectomy and microdiscectomy\\u000a surgical groups. In the present study, we investigated a cohort of 100 patients with the lumbar disc herniation causing low\\u000a back pain compared to

Kotryna Veresciagina; Bronius Spakauskas; Kazys Vytautas Ambrozaitis

2010-01-01

298

Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation  

Microsoft Academic Search

This single-blind randomised clinical trial compared osteopathic manipulative treatment with chemonucleolysis (used as a\\u000a control of known efficacy) for symptomatic lumbar disc herniation. Forty patients with sciatica due to this diagnosis (confirmed\\u000a by imaging) were treated either by chemonucleolysis or manipulation. Outcomes (leg pain, back pain and self-reported disability)\\u000a were measured at 2 weeks, 6 weeks and 12 months. The

A. Kim Burton; K. Malcolm Tillotson; John Cleary

2000-01-01

299

Comet Odyssey: Comet Nucleus Orbiter  

NASA Astrophysics Data System (ADS)

Comet Odyssey is a comet nucleus orbiter mission, proposed to NASA's Discovery program in 2004. The goal of the mission is to completely characterize a cometary nucleus, both physically and compositionally, as can only be done during an extended rendezvous and not with a fast flyby. Comet Odyssey will launch in October 2009 on a Delta II 7925 and use a solar-electric powered spacecraft to effect a rendezvous with periodic comet 46P/Wirtanen in October 2013. Arrival is 96 days after perihelion at a heliocentric distance of 1.61 AU. Comet Odyssey's science payload includes narrow- and wide-angle CCD cameras, an infrared thermal imager, a gas chromatograph/mass spectrometer, an XRD/XRF dust compositional analyzer, and a dust counter and accumulation sensors. The Comet Odyssey spacecraft implementation uses a high heritage approach of flight proven and redundant hardware. The 3-engine ion propulsion subsystem is derived from that on Dawn but includes the capability for multi-engine thrusting. Comet Odyssey will approach the Wirtanen nucleus and make repeated slow flybys through the active cometary coma for a period of three months. It will then be placed in a ˜100-km radius orbit around the nucleus, with a plan to eventually orbit at 40-km altitude or less. From that altitude the narrow-angle camera will map the entire nucleus surface at 1 meter/pixel and the thermal imager will map at 19 meter/pixel. The orbital portion of the nominal mission will last 4.5 months, following the comet outward from the Sun to 3.3 AU as the comet evolves from an active to a quiescent state. En route to P/Wirtanen, the Comet Odyssey spacecraft will perform a close flyby of the 200-km diameter, G-type, main belt asteroid 19 Fortuna in January 2012 and make appropriate remote sensing observations.

Weissman, P. R.; Smythe, W. D.; Spitz, S. J.; Bernard, D. E.; Bailey, R. W.

2004-11-01

300

Effectiveness of heat-sensitive moxibustion in the treatment of lumbar disc herniation: study protocol for a randomized controlled trial  

PubMed Central

Background Lumbar disc herniation is a common and costly problem. Moxibustion is employed to relieve symptoms and might therefore act as a therapeutic alternative. Many studies have already reported encouraging results in heat-sensitive moxibustion for lumbar disc herniation. Hence, we designed a randomized controlled clinical trial to investigate the effectiveness of heat-sensitive moxibustion compared with conventional moxibustion. Methods This trial is a multicenter, prospective, randomized controlled clinical trial. The 316 eligible patients are randomly allocated to two different groups. The experimental group is treated with heat-sensitive moxibustion (n = 158); while the control group (n = 158) is treated with conventional moxibustion. The moxibustion locations are different for the groups. The experimental group selects heat-sensitization acupoints from the region which consists of bilateral Da Changshu (BL25) and Yao Shu (Du2). Meanwhile, fixed acupoints are used in control group; patients in both groups receive 18 sessions in 2 weeks. Discussion The study design guarantees a high internal validity for the results. It is one large-scale randomized controlled trial to evaluate the efficacy of heat-sensitive moxibustion compared to conventional moxibustion and may provide evidence for this therapy as a treatment for moderate and severe lumbar disc herniation. Moreover, the result may uncover the inherent laws to improve the therapeutic effect with suspended moxibustion. Trial Registration The trial is registered at Chinese Clinical Trials Registry: ChiCTR-TRC-09000604. The application date was 27 November 2009. The first patient was randomized on the 16 June 2011.

2011-01-01

301

Dynamical nucleus-nucleus potential at short distances  

SciTech Connect

The dynamical nucleus-nucleus potentials for fusion reactions {sup 40}Ca+{sup 40}Ca, {sup 48}Ca+{sup 208}Pb, and {sup 126}Sn+{sup 130}Te are studied with the improved quantum molecular dynamics model together with the extended Thomas-Fermi approximation for the kinetic energies of nuclei. The obtained fusion barrier for {sup 40}Ca+{sup 40}Ca is in good agreement with the extracted fusion barrier from the measured fusion excitation function, and the depths of the fusion pockets are close to the results of time-dependent Hartree-Fock calculations. The energy dependence of the fusion barrier is also investigated. The fusion pocket becomes shallow for a heavy fusion system and almost disappears for heavy nearly symmetric systems, and the obtained potential at short distances is higher than the adiabatic potential.

Jiang Yongying; Wang Ning [Department of Physics, Guangxi Normal University, Guilin 541004 (China); Li Zhuxia [China Institute of Atomic Energy, Beijing 102413 (China); Scheid, Werner [Institute for Theoretical Physics, Justus-Liebig-University, D-35392 Giessen (Germany)

2010-04-15

302

Prognostic factors for non-success in patients with sciatica and disc herniation  

PubMed Central

Background Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2?years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine–Seattle Back Questionnaire score of ?5 (0–12) (primary outcome) and Sciatica Bothersomeness Index ?7 (0–24) (secondary outcome). Results Rates of non-success were at 1 and 2?years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1?year was significantly associated with being male (OR 1.70 [95% CI; 1.06???2.73]), smoker (2.06 [1.31???3.25]), more back pain (1.0 [1.01???1.02]), more comorbid subjective health complaints (1.09 [1.03???1.15]), reduced tendon reflex (1.62 [1.03???2.56]), and not treated surgically (2.97 [1.75???5.04]). Further, factors significantly associated with non-success at 2?years were duration of back problems?>;?1?year (1.92 [1.11???3.32]), duration of sciatica?>;?3?months (2.30 [1.40???3.80]), more comorbid subjective health complaints (1.10 [1.03???1.17]) and kinesiophobia (1.04 [1.00???1.08]). For the secondary outcome variable, in the final multivariate model, more comorbid subjective health complaints, more back pain, muscular weakness at clinical examination, and not treated surgically, were independent prognostic factors for non-success at both 1 and 2?years. Conclusions The results indicate that the prognosis for sciatica referred to secondary care is not that good and only slightly better after surgery and that comorbidity should be assessed in patients with sciatica. This calls for a broader assessment of patients with sciatica than the traditional clinical assessment in which mainly the physical symptoms and signs are investigated.

2012-01-01

303

Trend of the incidence of lumbar disc herniation: decreasing with aging in the elderly  

PubMed Central

Background Compelling evidence has shown that the incidence of lumbar disc herniation (LDH) increases with age. In this study, retrospective clinical analysis of 601 cases of LDH has been conducted to investigate the role of age in the incidence of LDH in the elderly. The aim of the study is to investigate the relationship between the process of aging and the occurrence of LDH in old adults. Methods Clinical cases (n = 601) of LDH were retrospectively analyzed. Results The imaging examination with computed tomography and/or magnetic resonance imaging showed the occurrence of degeneration in LDH patients over 65 years of age. The most common site of LDH is toward the bottom of the spine at L4–L5 and/or L5–S1. The incidence of LDH drops with age in the elderly, especially after the age of 80 years. There is an obvious decrease in LDH in the elderly female. Conclusion A decreasing incidence of LDH with aging occurs in the elderly. This investigation indicates that aging is not a contributor to the performance of LDH in the elderly although the incidence of LDH is proportional to age.

Ma, Daoyou; Liang, Yunbiao; Wang, Daoming; Liu, Zejiang; Zhang, Wei; Ma, Tantan; Zhang, Liang; Lu, Xingjun; Cai, Zhiyou

2013-01-01

304

Military Rank and the Symptoms of Lumbar Disc Herniation in Young Korean Soldiers.  

PubMed

OBJECTIVE: There are many factors associated with the symptom presentation of lumbar disc herniation (LDH). However, there are only few reports regarding the clinical feature of LDH in military medicine. The objective of this study is to determine the factors that affected the symptoms of LDH in young Korean soldiers. METHODS: One hundred thirty male soldiers, diagnosed with LDH, were enrolled in this study. They were divided into four groups, according to their military ranks: private, private first class, corporal, and sergeant. The visual analog scale for low back pain (VAS-LBP), the VAS for leg pain (VAS-LP), and the Oswestry Disability Index (ODI) were evaluated. The education level and military rank were also reviewed and their relationship with the degree of symptoms was investigated. RESULTS: The mean age for the male subjects enrolled was 20.7 ± 1.2. The mean VAS-LBP, VAS-LP, and ODI were 6.6% ± 1.7%, 7.1% ± 1.9%, and 46.0% ± 16.3%, respectively. There was no statistically significant relationship between the degree of symptoms and the radiologic findings. However, the military rank had an inverse correlation with the VAS scores and the ODI (P < 0.05). CONCLUSION: Our data showed that the military rank was associated with the symptom presentation of LDH and reflected the characteristics of military life. PMID:23428375

Kang, Suk Hyung; Yang, Jin Seo; Cho, Yong Jun; Park, Seung Won; Ko, Kwang Pil

2013-02-18

305

[Spontaneous regression of lumbar and cervical disc herniations - a well established phenomenon].  

PubMed

Symptomatic lumbar (LDH) and cervical disc herniations (CDH) are highly prevalent diseases that neurosurgeons and orthopaedic surgeons face every day. If symptom control cannot be achieved by nonsurgical means or in cases with severe or progressive neurological deficits, a surgical therapy is generally recommended. Nevertheless, the majority of patients will improve significantly or even completely without surgery over weeks until months after symptom onset. Still, when a recommendation is to be made concerning the further treatment in affected patients, it has to be kept in mind that the nonsurgical therapy may be associated with disabling pain and persisting neurological deficits with influence on the functional capacity, quality of life and ability to work for a variable period. Today, it is almost impossible to predict which patient will profit from nonsurgical therapy and which patient will require surgery during the clinical course because of incomplete alleviation. In this work, we present two current cases of patients with spontaneous regression of a LDH and a CDH. PMID:23692907

Gautschi, Oliver P; Stienen, Martin N; Schaller, Karl

2013-05-22

306

A retrospective study of intervertebral disc herniation in dogs in Japan: 297 cases.  

PubMed

We investigated the epidemiological characteristics of intervertebral disc herniation (IVDH) in Japan in a large population using a retrospective study. The sample population was dogs (n=297) with IVDH in Japan. Medical records were reviewed for breed, sex, age, affected interspace and neurological severity. The dogs were comprised of 132 cases of cervical IVDH (C-IVDH) and 165 cases of thoracolumbar IVDH (TL-IVDH). In Japan, the Dachshund, Beagle and Shih Tzu tended to suffer from both C-IVDH and TL-IVDH. The Shiba Inu, a characteristic Japanese dog breed, suffered from both C-IVDH and TL-IVDH, although there was little data relating to the whole breed. Male dogs tended to suffer from C-IVDH and TL-IVDH at a rate almost twice that of females in Japan. Among the three predominant dog breeds, the Dachshund, Beagle and Shih Tzu, the Dachshund tended to suffer from both C-IVDH and TL-IVDH at an earlier age than the Beagle, and the Beagle tended to suffer from both C-IVDH and TL-IVDH earlier than the Shih Tzu. Among the three predominant breeds, the Shih Tzu, in particular, tended to suffer from both C-IVDH and TL-IVDH at multiple sites. Our data from Japan were in partial agreement with previous data from the U.S.A., and epidemiological characteristics of IVDH peculiar to Japan were also identified. PMID:18685242

Itoh, Hisanori; Hara, Yasushi; Yoshimi, Natsuko; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Ochi, Hiroki; Hasegawa, Daisuke; Orima, Hiromitsu; Tagawa, Masahiro

2008-07-01

307

Surgical Excision of the Lumbar Disc Herniation in Elementary School Age  

PubMed Central

Study Design A retrospective study. Purpose To assess the radiological, clinical features and surgical outcomes of six patients of elementary school age with lumbar disc herniation (LDH). Overview of Literature LDH is common in people in their fourth and fifth decades. However, the condition is extremely rare in children of elementary school age. Moreover, the clinical symptoms and treatments are different from those of adults. Methods We reviewed a series of 6 patients under the age of 12 years, who underwent surgery for LDH at our institution between 1992-2002. Initially, all patients were treated conservatively. The indications for surgery were failure of conservative treatment for 3 months, intractable pain and/or progressive neurological impairment. Results The surgical findings revealed a protruding disc in five cases and a ruptured disc in one. In addition, separation of the vertebral ring apophysis was observed in 3 cases. The symptoms had disappeared completely at the last follow-up. At the last follow-up, the Japanese Orthopaedic Association score was 10 points in 5 cases and 9 points in 1, and the Kirkaldy-Willis criteria was excellent in all patients. No intervertebral disc space narrowing was observed in any patient at last follow up. In addition, there were no degenerative changes in the vertebral endplate and facet joint. Conclusions Patients with symptoms that persist for more than 3 months or those with a progressive neurological deficit must be considered for surgical discectomy.

Kim, Youn-Soo; Park, Il-Jung; Rhyu, Kee-Won; Lee, Sang-Uk

2009-01-01

308

Recovery of the corticospinal tract after injury by transtentorial herniation: a case report.  

PubMed

Little is known about recovery of the corticospinal tract (CST) after injury by transtentorial herniation (TH). We present with a patient who showed recovery of the CST after injury by TH, using diffusion tensor tractography (DTT) and transcranial magnetic stimulation (TMS). A 69-year-old female underwent craniotomy and drainage of an intracerebral hemorrhage in the left corona radiata and basal ganglia. Brain CT showed left TH and brain MRI revealed a leukomalactic lesion at the left cerebral peduncle. The patient presented with complete paralysis of the right extremities at ICH onset, but slowly recovered some function to the point of being able to move the affected extremities against gravity at about 6 months after onset. Three-week DTT showed disruption of the left CST below the cerebral peduncle; however, this disruption was recovered on 1-year DTT. Three-week TMS showed no motor evoked potential for the affected hemisphere; in contrast, motor evoked potentials that were compatible with regenerated CST were obtained from the affected hand muscle at 6 months. Using DTT and TMS in a patient with ICH, we demonstrated recovery of the CST after injury by TH. PMID:22142757

Kwon, Hyeok Gyu; Lee, Dong Gyu; Choi, Byung Yeon; Chang, Chul Hoon; Kim, Seong Ho; Jang, Sung Ho

2011-01-01

309

Checkerboard Theory of the Nucleus.  

NASA Astrophysics Data System (ADS)

The Checker Board Model (CBM) is a 2D model of the nucleus that proposes that the synchronization of the 2 outer rotating quarks in the nucleons accounts for magnetic moment of the nucleons and that the magnetic flux from the nucleons couples (weaves) into the 2D checker board array structures and this magnetic coupling in addition to electrostatic forces of the rotating and stationary quarks accounts for the apparent strong nuclear force. The symmetry of the He nucleus helps explain why this 2D structure is so stable. This model explain the mass of the proton and neutron, along with their magnetic moments and their absolute and relative sizes in terms of the above structure and predict the masses of two newly proposed quarks ^(1): the ``up'' and the ``dn'' quarks. Since the masses of the ``up'' and ``dn'' quark determined by the CBM (237.31 MeV and 42.392 MeV respectively) did not fit within the standard model as candidates for u and d, a new model (New Physics) had to be invented. This new particle physics model predicts that nature has 5 generations not 3. (1). T.M. Lach, Checkerboard Structure of the Nucleus, Infinite Energy, Vol. 5, issue 30, (2000). (2). T.M. Lach, Masses of the Sub-Nuclear Particles, nucl-th/0008026, @http://xxx.lanl.gov/

Lach, Theodore

2006-04-01

310

Nucleus-nucleus reactions above TeV/amu region  

SciTech Connect

Transverse moments of gamma rays and/or {pi}{sup 0} mesons produced in high energy ({approx gt}TeV/amu) cosmic ray nucleus-nucleus collisions have been measured with emulsion chambers. A group of events having large average transverse momenta, have been found, which exceed the apparent limiting behavior of increased with both increasing energy density and rapidity density. A set of heavy-ion collision data have been analysed to examine the photon to hadron production rate in the forward pseudorapidity region, in terms of number ratio, R{sub N} and of momentum flow ratio, R{sub M}. With some photon-rich events, the isospin structures along the pseudorapidity axis were examined. The results implies that in the event-by-event basis, the local isospin conservation does not apparently hold, however the global ratio, by estimating the total number of photons from the momentum distribution could restore the symmetries except for some special events. 34 refs., 12 figs., 2 tabs.

Not Available

1988-01-01

311

Exceptionally bright, compact starburst nucleus  

SciTech Connect

Observations are reported of a remarkably bright (V about 13) starburst nucleus, 0833 + 652, which has been detected at radio, infrared, optical, ultraviolet, and X-ray wavelengths. Despite an observed flux at each of these wavelengths which is comparable to that of NGC 7714, often considered the 'prototypical' example of the starburst phenomenon, 0833 + 652 appears to be a previously uncataloged object. Its ease of detectability throughout the electromagnetic spectrum should make it useful for a variety of problems in the study of compact emission-line galaxies. 30 references.

Margon, B.; Anderson, S.F.; Mateo, M.; Fich, M.; Massey, P.

1988-11-01

312

Minimally invasive surgical procedures for the treatment of lumbar disc herniation  

PubMed Central

Introduction In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy) which could serve as a basis for coverage decisions, has been published in Germany. Objective Against this background the aim of the following assessment is: Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc by a posterolateral or posterior approach are included. Methods In order to assess safety, efficacy and effectiveness of minimally-invasive procedures as well as their economic implications systematic reviews of the literature are performed. A comprehensive search strategy is composed to search 23 electronic databases, among them MEDLINE, EMBASE and the Cochrane Library. Methodological quality of systematic reviews, HTA reports and primary research is assessed using checklists of the German Scientific Working Group for Health Technology Assessment. Quality and transparency of cost analyses are documented using the quality and transparency catalogues of the working group. Study results are summarised in a qualitative manner. Due to the limited number and the low methodological quality of the studies it is not possible to conduct metaanalyses. In addition to the results of controlled trials results of recent case series are introduced and discussed. Results The evidence-base to assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery procedures is rather limited: Percutaneous manual discectomy: Six case series (four after 1998) Automated percutaneous lumbar discectomy: Two RCT (one discontinued), twelve case series (one after 1998) Chemonucleolysis: Five RCT, five non-randomised controlled trials, eleven case series Percutaneous laserdiscectomy: One non-randomised controlled trial, 13 case series (eight after 1998) Endoscopic procedures: Three RCT, 21 case series (17 after 1998) There are two economic analyses each retrieved for chemonucleolysis and automated percutaneous discectomy as well as one cost-minimisation analysis comparing costs of an endoscopic procedure to costs for open discectomy. Among all minimally-invasive procedures chemonucleolysis is the only of which efficacy may be judged on the basis of results from high quality randomised controlled trials (RCT). Study results suggest that the procedure maybe (cost)effectively used as an intermediate therapeutical option between conservative and operative management of small lumbar disc herniations

Luhmann, Dagmar; Burkhardt-Hammer, Tatjana; Borowski, Cathleen; Raspe, Heiner

2005-01-01

313

Density dependent interactions and the consistency of folding estimates of nucleon-nucleus and nucleus-nucleus potentials  

Microsoft Academic Search

It is shown that density dependence in the interaction does effect the consistency of the results obtained in folding calculations of nucleon-nucleus and nucleus-nucleus potentials. A modified density dependent version of the new G matrix interaction of Bertsch et al. gives reasonable results for both. Present address: Bettis Atomic Power Laboratory, Westinghouse Electric Corporation, P.O. Box 79, West Mifflin, Pennsylvania

F. Petrovich; J. J. Bevelacqua

1977-01-01

314

Treating thoracic-disc herniations: Do we always have to go anteriorly?  

PubMed

Study design: ?Retrospective cohort study. Objective: ?To determine if there is a difference in outcome and complications in surgically managed patients with thoracic-disc herniations (TDH) undergoing a modified transfacet pedicle-sparing decompression and fusion (posteriorly) compared to those undergoing anterior transthoracic discectomies (anteriorly). Methods: ?Thirty-five consecutive operatively managed TDH underwent operative management between March 2003 and November 2009. Outcomes and complications were reviewed from patient records and x-rays assessing differences between those treated posteriorly and those treated anteriorly. Results: ?Twenty-four patients underwent posterior management for 35 TDH and ten patients underwent anterior management for twelve TDH. Mean age was 50 years in both groups. Body mass index (BMI) averaged 28.8 in the anterior group and 32.0 in the posterior group. Follow-up averaged 38 weeks with four patients lost to follow-up (all posterior). Major complications secondary to surgery occurred in three patients (30%) in the anterior group (pulmonary embolus, pneumonia, and wrong level surgery) and in seven patients (35%) in the posterior group (seroma, misplaced instrumentation requiring revision, recurrence requiring an additional operation, and four infections). No neurological complications occurred and all patients noted improvement from baseline. Average length of stay was 7.3 days in the anterior group and 4.2 days in the posterior group (P < .003). Final pain as assessed by visual analog scale (VAS) improved from 6.7 to 4.3 in the anterior group and 6.9 to 2.3 in the posterior group (P?=?.05). Conclusions: ?Complication rates are similar between groups and are approach related. Posteriorly managed patients had greater improvement in pain and shorter length of stay. [Table: see text] The definition of the different classes of evidence is available on page 83. PMID:23544020

Bransford, Richard J; Zhang, Fangyi; Bellabarba, Carlo; Lee, Michael J

2010-05-01

315

Idiopathic spinal cord herniation: Clinical review and report of three cases  

PubMed Central

Idiopathic spinal cord herniation (ISCH) is a rare condition, of unknown pathogenesis, that primarily affects the thoracic spinal cord. It is characterized by ventral displacement of the spinal cord through a dural defect. The aim of this study was to review the literature and to present a retrospective single center experience with three cases of ISCH. The literature review analyzed a total of 78 relevant publications on ISCH, which included a total of 171 patients, supplemented with 3 patients treated at our institution. Numerous case reports have demonstrated improvement in clinical outcomes after surgery; however, follow-up is predominantly short, data are incomplete, the condition is frequently misdiagnosed, and it is difficult to predict which patients will benefit from surgery. We identified 159 cases treated with surgical management. The mean symptom duration was 54 months, and the mean follow-up 33 months. The result at follow-up was improved neurological outcome in 74%, unchanged result in 18%, and worse outcome in 8%. There were 15 cases of conservative management, with mean symptom duration 52 months and mean follow-up 33 months. The neurological outcome was unchanged in 100%. ISCH is a rare condition causing progressive thoracic myelopathy, and the natural history is unknown. There is a lack of evidence-based treatment strategies, and the majority of cases are treated with surgical management at diagnosis. Management of ISCH needs to be individualized for each patient, and clinicians should be encouraged to report new cases, standardize case reports, and ensure long-term follow-up.

Summers, Johanne C.; Balasubramani, Yagnesh V.; Chan, Patrick C. H.; Rosenfeld, Jeffrey V.

2013-01-01

316

A PHASED REHABILITATION PROTOCOL FOR ATHLETES WITH LUMBAR INTERVERTEBRAL DISC HERNIATION  

PubMed Central

Conservative non-surgical management of a herniated lumbar intervertebral disc (HLD) in athletes is a complex task due to the dramatic forces imparted on the spine during sport participation. The demands placed upon the athlete during rehabilitation and return to sport are unique not only from a sport specific perspective, but also regarding return to the sport strength and conditioning programs utilized for sport preparation. Many prescriptions fail to address postural and motor control faults specific to athletic development, which may prevent full return to sport after suffering a HLD or predispose the athlete to future exacerbations of a HLD. Strength exercises involving squatting, deadlifting, and Olympic power lifts are large components of the typical athlete's conditioning program, therefore some progressions are provided to address potential underlying problems in the athlete's technique that may have contributed to their HLD in the first place. The purpose of this clinical commentary is to propose a framework for rehabilitation that is built around the phases of healing of the disc. Phase I: Non-Rotational/Non-Flexion Phase (Acute Inflammatory Phase), Phase II: Counter rotation/Flexion Phase (Repair Phase), Phase III: Rotational Phase/Power development (Remodeling Phase), and Phase IV: Full return to sport. This clinical commentary provides a theoretical basis for these phases based on available literature as well as reviewing many popular current practice trends in the management of an HLD. The authors recognize the limits of any general exercise rehabilitation recommendation with regard to return to sport, as well as any general strength and conditioning program. It is vital that an individual assessment and prescription is made for every athlete which reviews and addresses movement in all planes of motion under all necessary extrinsic and intrinsic demands to that athlete. Level of Evidence: 5

VanGelder, Leonard H.; Vaughn, Daniel W.

2013-01-01

317

Nonsurgical Treatment of Lumbar Disk Herniation: Are Outcomes Different in Older Adults?  

PubMed Central

Objectives To determine whether older adults (age?60 years) experience less improvement in disability and pain with nonsurgical treatment of lumbar disk herniation (LDH), as compared to younger adults (age<60 years). Design Prospective longitudinal comparative cohort study. Setting Outpatient specialty spine clinic Participants 133 consecutive patients with radicular pain and MR-confirmed acute LDH (89 younger adults and 44 older adults). Intervention Nonsurgical treatment tailored to the individual patient. Measurements Patient-reported disability on the Oswestry Disability Index (ODI), leg pain intensity, and back pain intensity were recorded at baseline, 1, 3, and 6 months. The primary outcome was the ODI change score at 6 months. Secondary longitudinal analyses examined rates of change over the follow-up period. Results Older adults demonstrated improvements in ODI(range 0-100) and pain intensity(range 0-10) with nonsurgical treatment that were not significantly different from those seen in younger adults at 6 month follow-up, either with or without adjustment for potential confounders. Adjusted mean improvements in older adults as compared to younger adults were 31 vs. 33 (p=0.63) for ODI, 4.5 vs. 4.5 (p=0.99) for leg pain, and 2.4 vs. 2.7 for back pain (p=0.69). A greater amount of the total improvement in leg pain and back pain in older adults was noted in the first month of follow-up, as compared to younger adults. Conclusion These preliminary findings suggest that the outcomes of LDH with nonsurgical treatment were not worse in older adults (age?60 years) as compared to younger adults (age<60 years). Future research is warranted to examine nonsurgical treatment for LDH in older adults.

Suri, Pradeep; Hunter, David J.; Jouve, Cristin; Hartigan, Carol; Limke, Janet; Pena, Enrique; Li, Ling; Luz, Jennifer; Rainville, James

2011-01-01

318

Mechanisms of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management  

PubMed Central

Background The pathogenesis of Chiari malformations is incompletely understood. We tested the hypothesis that different etiologies have different mechanisms of cerebellar tonsil herniation (CTH), as revealed by posterior cranial fossa (PCF) morphology. Methods In 741 patients with Chiari malformation type I (CM-I) and 11 patients with Chiari malformation type II (CM-II), the size of the occipital enchondrium and volume of the PCF (PCFV) were measured on reconstructed 2D-CT and MR images of the skull. Measurements were compared with those in 80 age- and sex-matched healthy control individuals, and the results were correlated with clinical findings. Results Significant reductions of PCF size and volume were present in 388 patients with classical CM-I, 11 patients with CM-II, and five patients with CM-I and craniosynostosis. Occipital bone size and PCFV were normal in 225 patients with CM-I and occipitoatlantoaxial joint instability, 55 patients with CM-I and tethered cord syndrome (TCS), 30 patients with CM-I and intracranial mass lesions, and 28 patients with CM-I and lumboperitoneal shunts. Ten patients had miscellaneous etiologies. The size and area of the foramen magnum were significantly smaller in patients with classical CM-I and CM-I occurring with craniosynostosis and significantly larger in patients with CM-II and CM-I occurring with TCS. Conclusions Important clues concerning the pathogenesis of CTH were provided by morphometric measurements of the PCF. When these assessments were correlated with etiological factors, the following causal mechanisms were suggested: (1) cranial constriction; (2) cranial settling; (3) spinal cord tethering; (4) intracranial hypertension; and (5) intraspinal hypotension.

Nishikawa, Misao; Kula, Roger W.; Dlugacz, Yosef D.

2010-01-01

319

Transforaminal Epidural Clonidine versus Corticosteroid for Acute Lumbosacral Radiculopathy due to Intervertebral Disk Herniation  

PubMed Central

Study Design Randomized, double-blinded trial clinical trial. Objective To compare efficacies of 2 active therapies for chronic low back pain. Summary of Background Data Radicular pain may result from intervertebral disk herniation (IDH). Clonidine has demonstrated analgesic and antiinflammatory activity in animal studies of nerve injury. Extensive clinical experience supports neuraxial clonidine's safety. Methods Patients with ˜3 months of low back and leg pain due to IDH were randomized to transforaminal epidural (TFE) injection(s) of 2% lidocaine and either clonidine (200 or 400mcg) or triamcinolone (40mg). Patients received 1- 3 injections administered about 2 weeks apart. Patients, investigators and study coordinators were blinded to treatment. Primary outcome was 11-point Pain Intensity Numerical Rating Scale (PI-NRS) at 1 month. Other outcomes included Patient Global Impression of Change (PGIC), and functional measures. Results Thirty-three patients were screened and randomized. Twenty-six patients enrolled; 11 received clonidine and 15 triamcinolone. Both groups showed significant improvement in pain score at 2 weeks and 1 month compared to baseline (p< 0.05). The corticosteroid group showed additional functional improvement at 1 month relative to clonidine (p=0.022). There was no difference between groups for primary outcome. However, as target enrollment was not reached, we cannot say with confidence that the 2 treatments would be expected to result in similar short-term pain relief. Side-effects were common in both groups, but there were no serious complications. Conclusions Radicular pain due to IDH improved rapidly with TFE injection of either clonidine or triamcinolone. Corticosteroid resulted in greater functional improvement, with unclear differences in analgesia. Future studies will determine if clonidine is superior to placebo and of particular use in those at risk for corticosteroid complications.

Burgher, Abram H.; Hoelzer, Bryan C.; Schroeder, Darrell R.; Wilson, Gregory A.; Huntoon, Marc A.

2010-01-01

320

Herniation pits in human mummies: a CT investigation in the Capuchin Catacombs of Palermo, Sicily.  

PubMed

Herniation pits (HPs) of the femoral neck were first described in a radiological publication in 1982 as round to oval radiolucencies in the proximal superior quadrant of the femoral neck on anteroposterior radiographs of adults. In following early clinical publications, HPs were generally recognized as an incidental finding. In contrast, in current clinical literature they are mentioned in the context of femoroacetabular impingement (FAI) of the hip joint, which is known to cause osteoarthritis (OA). The significance of HPs in chronic skeletal disorders such as OA is still unclear, but they are discussed as a possible radiological indicator for FAI in a large part of clinical studies.In this paleoradiological study we examined a sample of mummies from the Capuchin Catacombs of Palermo, Sicily, by a mobile computed tomography (CT) scanner. Evaluation of the CT examinations revealed HPs in six out of 16 (37.5%) adult male mummies.The first aim of this study was to compare the characteristics of HPs shown in our mummy collection to the findings described in clinical literature. Thereby CT evaluation revealed that their osseous imaging characteristics are in accordance, consisting of round to oval subcortical lesions at the anterior femoral neck, clearly demarcated by a sclerotic margin.The second aim was to introduce HPs to the paleoradiological and paleopathological methodology as an entity that underwent a renaissance from an incidental finding to a possible radiological indicator of FAI in the clinical situation. As FAI plays an important role in the development of OA of the hip, which is a very common finding in human skeletal remains, HPs should always be considered in paleoradiological evaluation of hip joint diseases. PMID:22567164

Panzer, Stephanie; Piombino-Mascali, Dario; Zink, Albert R

2012-05-02

321

Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain  

PubMed Central

Background Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. Methods A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1) and the other group did (group 2). There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment. Results Significant pain relief and functional status improvement (primary outcome) defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months. Conclusion Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and/or radiculitis.

Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar

2012-01-01

322

Reliability of T2-weighted sagittal magnetic resonance images for determining the location of compressive disk herniation in dogs.  

PubMed

Magnetic resonance imaging is used commonly to diagnose intervertebral disk herniation in dogs. It is common to locate areas of suspected compression on sagittal T2-weighted (T2-W) images and then obtain limited transverse images in these areas to reduce the acquisition time (a step-by-step approach). Our objective was to assess the frequency of correct localization of spinal cord compression due to disk herniation using only the sagittal images. The results from isolated readings of the sagittal T2-W images alone or combined with a single-shot fast spin echo (SSFSE) slab in 118 dogs were compared with a gold standard, based on a consensual reading of all images available, including complete transverse images across the entire spinal segments under study. The sites of compression were localized correctly from the sagittal images in 89.8% of dogs. If only the most significant lesions were accounted for, the percentage increased up to 95.2%. In 54.9% of the readings with incorrect localization, the actual compressive site was immediately adjacent to the one suspected from review of the sagittal images. The frequency of correct localization was higher in the cervical region, and was increased by examination of the SSFSE slab. The most common cause of disagreement was the presence of multiple degenerate bulging disks. Based on these results we recommend obtaining transverse images across the entire segment when multiple bulging disks are present. It is also recommended to obtain transverse images across the spaces immediately adjacent to the suspected site of herniation from review of the sagittal images. PMID:21689199

Guillem Gallach, R; Suran, J; Cáceres, A V; Reetz, J A; Brown, D C; Mai, W

2011-06-20

323

Pedunculated basilar terminus aneurysm with pseudo-septation due to anterior herniation through a perforated membrane of Liliequist.  

PubMed

Septations within cerebral arteries or aneurysms are exceedingly rare in the absence of associated fenestrations. We report an unusual unruptured pedunculated basilar apex aneurysm, with a "pseudoseptation" between the main aneurysmal sac and an anterior compartment, which was, in fact, represented by a perforation in the membrane of Liliequist, permitting anterior aneurysmal herniation into the carotid-chiasmatic cistern. The patient was successfully treated with detachable coils. This case is unusual on 2 accounts: 1) the aneurysm's appearance, and 2) the presence of a large fenestration in the membrane of Liliequist, of which anatomic features are herein reviewed. PMID:19474119

Hacein-Bey, L; Varelas, P N

2009-05-27

324

Combined intra-extracanal approach to lumbosacral disc herniations with bi-radicular involvement. Technical considerations from a surgical series of 15 cases.  

PubMed

Large lumbosacral disc herniations effacing both the paramedian and the foraminal area often cause double radicular compression. Surgical management of these lesions may be difficult. A traditional interlaminar approach usually brings into view only the paramedian portion of the intervertebral disc, unless the lateral bone removal is considerably increased. Conversely, the numerous far-lateral approaches proposed for removing foraminal or extraforaminal disc herniations would decompress the exiting nerve root only. Overall, these approaches share the drawback of controlling the neuroforamen on one side alone. A combined intra-extraforaminal exposure is a useful yet rarely reported approach. Over a 3-year period, 15 patients with bi-radicular symptoms due to large disc herniations of the lumbar spine underwent surgery through a combined intra-extracanal approach. A standard medial exposure with an almost complete hemilaminectomy of the upper vertebra was combined with an extraforaminal exposure, achieved by minimal drilling of the inferior facet joint, the lateral border of the pars interarticularis and the inferior margin of the superior transverse process. The herniated discs were removed using key maneuvers made feasible by working simultaneously on both operative windows. In all cases the disc herniation could be completely removed, thus decompressing both nerve roots. Radicular pain was fully relieved without procedure-related morbidity. The intra-extraforaminal exposure was particularly useful in identifying the extraforaminal nerve root early. Early identification was especially advantageous when periradicular scar tissue hid the nerve root from view, as it did in patients who had undergone previous surgery at the same site or had long-standing radicular symptoms. Controlling the foramen on both sides also reduced the risk of leaving residual disc fragments. A curved probe was used to push the disc material outside the foramen. In conclusion, specific surgical maneuvers made feasible by a simultaneous extraspinal and intraspinal exposure allow quick, safe and complete removal of lumbosacral disc herniations with paramedian and foraminal extension. PMID:15761707

Paolini, Sergio; Ciappetta, Pasquale; Raco, Antonino; Missori, Paolo; Delfini, Roberto

2005-03-11

325

On the rotation of comet Borrelly's nucleus  

NASA Astrophysics Data System (ADS)

We consider the secular effect of outgassing torques on the rotation of a comet nucleus. An averaging method is applied to obtain evolutionary equations which allow us to study the long-term variations in the nucleus spin state. Since the spin axis direction of 19P/Borrelly’s nucleus is close to the line of apsides direction, a simplified version of these equations can be written to analytically study the most important qualitative effects. In particular, a correlation between the drift of the rotation axis direction and the possible spin up/spin down of the nucleus is revealed.

Sidorenko, V. V.; Scheeres, D. J.; Byram, S. M.

2008-09-01

326

Projections from the ventral cochlear nucleus to the dorsal cochlear nucleus in rats  

Microsoft Academic Search

Local circuit interactions between the dorsal and ventral divisions of the cochlear nucleus are known to influence the evoked responses of the resident neurons to sound. In the present study, we examined the projections of neurons in the ventral cochlear nucleus to the dorsal cochlear nucleus by using retrograde transport of biotinylated dextran amine injected into restricted but different regions

John R. Doucet; David K. Ryugo

1997-01-01

327

Treating thoracic-disc herniations: Do we always have to go anteriorly?  

PubMed Central

Study design:?Retrospective cohort study. Objective:?To determine if there is a difference in outcome and complications in surgically managed patients with thoracic-disc herniations (TDH) undergoing a modified transfacet pedicle-sparing decompression and fusion (posteriorly) compared to those undergoing anterior transthoracic discectomies (anteriorly). Methods:?Thirty-five consecutive operatively managed TDH underwent operative management between March 2003 and November 2009. Outcomes and complications were reviewed from patient records and x-rays assessing differences between those treated posteriorly and those treated anteriorly. Results:?Twenty-four patients underwent posterior management for 35 TDH and ten patients underwent anterior management for twelve TDH. Mean age was 50 years in both groups. Body mass index (BMI) averaged 28.8 in the anterior group and 32.0 in the posterior group. Follow-up averaged 38 weeks with four patients lost to follow-up (all posterior). Major complications secondary to surgery occurred in three patients (30%) in the anterior group (pulmonary embolus, pneumonia, and wrong level surgery) and in seven patients (35%) in the posterior group (seroma, misplaced instrumentation requiring revision, recurrence requiring an additional operation, and four infections). No neurological complications occurred and all patients noted improvement from baseline. Average length of stay was 7.3 days in the anterior group and 4.2 days in the posterior group (P < .003). Final pain as assessed by visual analog scale (VAS) improved from 6.7 to 4.3 in the anterior group and 6.9 to 2.3 in the posterior group (P?=?.05). Conclusions:?Complication rates are similar between groups and are approach related. Posteriorly managed patients had greater improvement in pain and shorter length of stay. Methods evaluation and class of evidence (CoE) Methodological principle: Study design:  Randomized controlled trial  Cohort study •  Case control  Case series Statement of concealed allocation* Intent to treat* Independent or blind assessment • Complete follow-up of ?85% Adequate sample size Controlling for possible confounding Evidence class: III *Applies to randomized controlled trials only. The definition of the different classes of evidence is available on page 83.

Bransford, Richard J.; Zhang, Fangyi; Bellabarba, Carlo; Lee, Michael J.

2010-01-01

328

Paying attention to the thalamic reticular nucleus  

Microsoft Academic Search

The thalamic reticular nucleus can be divided into a number of sectors, each concerned with a different function (sight, touch, hearing, movement or `limbic' functions). Each sector is connected to more than one thalamic nucleus and to more than one cortical area, and each sector has topographically mapped connections with the thalamus and the cortex. We consider the known details

R. W. Guillery; S. L. Feig; D. A. Lozsádi

1998-01-01

329

Dynamical evolution of comet nucleus rotation  

Microsoft Academic Search

The rotational dynamics of outgassing cometary nuclei are investigated analytically. We develop a general theory for the evolution of a comet nucleus' rotation state using averaging theory and assuming that the outgassing torques are a function of solar insolation and heliocentric distance. The resulting solutions are a function of the nucleus inertia ellipsoid, its outgassing properties, its heliocentric orbit, and

D. J. Scheeres; V. V. Sidorenko; A. I. Neishtadt; A. A. Vasiliev

2002-01-01

330

Collective Resonances in Pion-Nucleus Scattering  

Microsoft Academic Search

Pion-nucleus scattering is described by the excitation of bound nucleons into the Delta resonance leading to isobaric resonances of the whole nucleus. A few broad collective resonances of different multipolarity are shown to dominate elastic and inelastic pi-12C scattering. From the qualitatively good agreement with the data, we conclude that those giant isobaric resonances are a general feature of the

K. Klingenbeck; M. Dillig; M. G. Huber

1978-01-01

331

Antinucleon and nucleon-nucleus interactions  

Microsoft Academic Search

This book presents the following experimental and theoretic reviews on the application of relativity and the inclusion of quark degrees of freedom; experimental results in nucleon-nucleus physics; theoretical talks on hadronic interactions and collective spin modes of excitation; and talks presenting data for nuclear spin observables. The book contains papers on microscopic relativistic description of nucleon-nucleus scattering, the relativistic nuclear

G. E. Walker; C. D. Goodman; C. Olmer

1985-01-01

332

The target nucleus in relativistic nuclear collisions  

Microsoft Academic Search

Both the fireball model and hydrodynamical model predict, in a central collision, a fast energy dissipation in the early diving stage of the projectile into the target nucleus. In the final state both models show total incident energy largely dispersed over the whole target nucleus. In a quantitative comparison with the data for the intranuclear cascade calculations, however, the 90

H. H. Gutbrod; A. I. Warwick; H. Wieman

1982-01-01

333

Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation: a prospective randomised controlled trial [ISRCTN51857546  

Microsoft Academic Search

BACKGROUND: Open discectomy is the standard surgical procedure in the treatment of patients with long-lasting sciatica caused by lumbar disc herniation. Minimally invasive approaches such as microendoscopic discectomy have gained attention in recent years. Reduced tissue trauma allows early ambulation, short hospital stay and quick resumption of daily activities. A comparative cost-effectiveness study has not been performed yet. We present

Mark P Arts; Wilco C Peul; Ronald Brand; Bart W Koes; Ralph TWM Thomeer

2006-01-01

334

Outcomes of a prospective cohort study on peri-radicular infiltration for radicular pain in patients with lumbar disc herniation and spinal stenosis  

Microsoft Academic Search

The purpose of this study was to assess the outcome of peri-radicular infiltration for radicular pain in patients with spinal stenosis and lumbar disc herniation (LDH). Patients with spinal stenosis ( n=62) or LDH ( n=55) who met our criteria received fluoroscopically guided peri-radicular infiltration of local anaesthetic and steroid at the site of documented pathology. All the patients were

Leslie Chong Lich Ng; Philip Sell

2004-01-01

335

Translaminar Microendoscopic Herniotomy for Cranially Migrated Lumbar Disc Herniations Encroaching on the Exiting Nerve Root in the Preforaminal and Foraminal Zones  

PubMed Central

Study Design Case series. Purpose The aim of this study was to describe translaminar microendoscopic herniotomy (TL-MEH) for cranially migrated lumbar disc herniations encroaching on the exiting nerve root in the preforaminal and foraminal zones and to report preliminary results of the procedure. Overview of Literature Conventional interlaminar approaches for preforaminal and foraminal lumbar disc herniations result in extensive removal of the lamina and facet joint to remove disc fragments safely. More destructive approaches increase the risk of postoperative segmental instability. Methods TL-MEH is a minimally invasive procedure for herniotomy via the translaminar approach using a microendoscopic technique. TL-MEH was performed in seven patients with a cranially migrated lumbar disc herniation encroaching on the exiting nerve root. The disc fragments were located in the preforaminal zone in four patients, and in the preforaminal and foraminal zones in three. Results All patients experienced immediate relief from symptoms after surgery and satisfactory results at the final follow-up. Surgical complications, such as a dural tear, nerve injury, and surgical site infection, were not investigated. Conclusions TL-MEH seemed to be an effective and safe alternative minimally invasive surgical option for patients with a cranially migrated lumbar disc herniation encroaching the exiting nerve root in the preforaminal and foraminal zones.

Tono, Osamu; Senba, Hideyuki; Kitamura, Takahiro; Komiya, Norihiro; Oga, Masayoshi; Shidahara, Satoshi

2013-01-01

336

Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial  

Microsoft Academic Search

BACKGROUND: The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD). This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus

Patrick A Brouwer; Wilco C Peul; Ronald Brand; Mark P Arts; Bart W Koes; A van den Annette Berg; Mark A van Buchem

2009-01-01

337

The classical field created in early stages of high energy nucleus-nucleus collisions  

NASA Astrophysics Data System (ADS)

We show that a special choice of light-cone gauge can greatly simplify the calculation of the classical color field created in the initial stages of nucleus-nucleus collisions. Within this gauge, we can in particular construct explicitly the conserved color current and calculate exactly the gauge field immediately after the collision. This field is used as a boundary condition in an iterative solution of the Yang-Mills equations in the forward light-cone. In leading order, which corresponds to a linearization of the Yang-Mills equation in the forward light-cone, we obtain a simple formula for the spectrum of gluons produced in nucleus-nucleus collisions. This formula reproduces exactly the known formula for proton-nucleus collisions, where k-factorization is recovered, while the latter property apparently breaks down in the case of nucleus-nucleus collisions.

Blaizot, Jean-Paul; Mehtar-Tani, Yacine

2009-02-01

338

Coordinated Spitzer Comet Nucleus Observations  

NASA Astrophysics Data System (ADS)

We have been awarded 104.5 hours of Spitzer telescope time (Fall 2006 and Spring 2007) to make an albedo and radius survey for 100 Jupiter-family comet nuclei using the IRS PU and MIPS imaging. These nuclei have dynamical and evolutionary connections to other Solar System small bodies: TNOs, Centaurs, Trojan asteroids and extinct comet nuclei. The JFCs remain the only group that has not been studied in the mid-IR. Using Spitzer and complementary optical (ground-based) imaging proposed here, we will (1) measure the thermal emission from 100 JFC nuclei and determine their radii, (2) combine the thermal data with optical data to get geometric albedos (for a subset), (3) compare the comet albedo distribution with those of Centaurs, TNOs, Trojans and extinct comet candidates to gauge the effects of surface evolution, (4) test for correlations between cometary albedos and other properties of the nuclei (e.g. composition and dynamical age), (5) resolve the long- standing question of just how safe it is to assume an albedo for a cometary nucleus, and (6) use the radii to derive a new estimate of the size distribution of the JFC comets and verify if a truncation in the sizes is required for small nuclei. This request is for the optical imaging component for those targets best observed from the southern hemisphere.

Meech, Karen; Fernandez, Yanga; Pittichova, Jana; Harrington, David

2007-02-01

339

Matrix metalloprotease-9 activity in the cerebrospinal fluid and spinal injury severity in dogs with intervertebral disc herniation.  

PubMed

We investigated whether matrix metalloproteinase (MMP)-9 expression in the cerebrospinal fluid (CSF) of dogs with intervertebral disc herniation (IVDH) is associated with the severity of neurological signs and prognosis. CSF from the cisterna magna (C-CSF) and the lumbar spine (L-CSF) of 34 dogs with IVDH was analyzed using zymography. Activity of MMP-9 in L-CSF was detected in 6 of 34 dogs with IVDH, often for more than 7 days after injury. MMP-9 activity was not detected from any of the C-CSF samples. Of the six cases that were MMP-9 positive, all four cases with grade V that had loss of deep pain were non-ambulatory 6 months after treatment. The remaining two cases with grade III and IV could recover mobility. In dogs with grade V thoracolumbar IVDH, MMP-9 expression in the CSF may indicate severe spinal cord injury with poor prognosis. PMID:20965533

Nagano, S; Kim, S H; Tokunaga, S; Arai, K; Fujiki, M; Misumi, K

2010-10-20

340

Analysis of cartilage oligomeric matrix protein and matrix metalloproteinase-9 in cerebrospinal fluid of miniature dachshund with intervertebral disc herniation.  

PubMed

We evaluated whether the cerebrospinal fluid (CSF) concentration of cartilage oligomeric matrix protein (COMP) is related to disease severity, prognosis and matrix metalloproteinase (MMP)-9 activity of the CSF in miniature dachshund with intervertebral disc herniation. Samples were obtained from 23 patients and 6 normal dogs, and all patients received hemilaminectomy. Twenty dogs recovered successfully and 3 of 11 dogs without deep nociception had MMP-9 activity in the CSF and an unsuccessful outcome. The COMP levels from patients were significantly higher than those from normal dogs. MMP-9 activity and neurological severity were not related to the COMP levels. However, the COMP levels from 3 unsuccessful cases that had MMP-9 activity were significantly lower than those from all recovered cases and/or successful cases without deep nociception. Concerning severe cases, increased proteolytic activity might affect the COMP concentration and prognosis due to MMP-9 associated deleterious effects. PMID:22440362

Nagano, Shinichi; Fujiki, Makoto; Tokunaga, Satoshi; Misumi, Kazuhiro

2012-03-20

341

Laparoscopic management of a small bowel herniation from an ileal conduit: report of a case and review of the literature.  

PubMed

Bladder carcinoma can be treated with cystectomy and urinary diversion. Ileal conduit is a popular technique, originally performed with closure of all mesenteric and peritoneal defects to minimize internal herniation. Recent advances in laparoscopic and robotic techniques often leave these defects open. We present a case of a 75-year-old gentleman with a small bowel entrapment underneath an intraperitoneal ileal conduit and ureter causing obstruction. This internal hernia occurred 2 months after undergoing a DaVinci robotic-assisted laparoscopic cystoprostatectomy with an ileal conduit. Bowel obstruction is an important complication associated with the need for reoperation and patient mortality. Historical review shows a precedent for closure of the mesenteric defect, obliterating the peritoneal defect in the right lumbar gutter, and suturing the ileal conduit to the posterior peritoneum to prevent potential internal hernias. The literature involving ileal conduits is examined for consensus on the preferred method of treating these potential spaces. PMID:23579536

Coughlin, Lisa M; Orr, Dennis P

2013-04-01

342

Herniated L4-L5 disc after placement of Harrington instrumentation for a fracture of the thoracolumbar spine.  

PubMed

The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated. PMID:1870676

Segal, R; Pollack, I; Segal, E; Hanley, E; Scalbassi, R; Hirsch, W

1991-07-01

343

Herniation of an enlarged middle cerebral artery through a temporal bone defect in association with an arteriovenous malformation.  

PubMed

We present a previously undescribed variant of the middle cerebral artery (MCA) protruding through a defect in the temporal bone, associated with a large arteriovenous malformation (AVM). The patient, a 59-year-old male, presented with a large right frontoparietal AVM with feeding aneurysms and a recent haemorrhage. Preoperative imaging demonstrated a tortuous right MCA feeder abutting the anterosuperior temporal bone in the region of the pterion. An associated temporal bone defect was visible. The patient underwent a pterional craniotomy for surgical clipping of aneurysms associated with the AVM. On reflection of the temporalis muscle, the MCA branch was transected as it coursed through a defect in the temporal bone. This patient demonstrates that the MCA may deviate from its usual anatomy and herniate through a defect in the skull. Because a pterional craniotomy is such a common surgical approach, knowledge and anticipation of such anatomic variants are essential to avoid catastrophic vascular injury during surgery. PMID:22954792

Raley, Darryl Alan; Davidson, Andrew Stewart; Morgan, Michael Kerin

2012-09-03

344

Technical challenges to surgical clipping of aneurysmal regrowth with coil herniation following endovascular treatment - a case report  

PubMed Central

In recent years, technical developments have made endovascular procedures attractive therapeutic options and enabled the endovascular surgeon to redefine the management of cerebral aneurysms. However, as the number of aneurysms undergoing endovascular therapy has grown, so has the number of patients with incompletely treated aneurysms who are presenting for further management. In cases of failure of endovascular treatment caused by either incomplete occlusion or regrowth of the aneurysm, a complementary treatment is often necessary. Surgical treatment of these patients is challenging. We present a case of a ruptured posterior cerebral artery aneurysm treated initially with endovascular coiling that left behind significant residual aneurysmal sac. Regrowth of the aneurysm documented on follow-up was treated surgically. At surgery, the coil was found to have herniated through the aneurysmal sac into the subarachnoid space, and the aneurysm was successfully clipped without removing the coils. We review the regrowth of aneurysms following endovascular therapy and potential problems and challenges of surgically managing these lesions.

Pillai, Promod; Karim, Aftab; Nanda, Anil

2007-01-01

345

Cervical myelopathy due to nuclear herniations in young adults: clinical and radiological profile, results of microdiscectomy without interbody fusion.  

PubMed Central

A study was made of the clinical and radiological characteristics and the results of microsurgical discectomy without interbody fusion, of 26 young adults, who presented with cervical myelopathy due to nuclear herniations. Neck trauma was not a significant aetiological factor. The disease produced moderate to very severe functional disability in most patients (73%), in a relatively short period (mean symptom duration 6.3 months). Radiological assessment revealed the presence of canal stenosis, significant disc protrusions with paucity of spondylotic changes in most patients. At operation, soft disc lesions were found in 85% and sequestrated discs in 31%. Microsurgical discectomy without fusion produced gratifying recovery of functional disability without significant deleterious effects on the cervical spine. Images

Selladurai, B M

1992-01-01

346

Field Theoretic Aspects of Pion Nucleus Physics.  

National Technical Information Service (NTIS)

Field theoretic aspects of pion nucleus physics are illustrated with a discussion of a phenomenological form of the pion nucleon off shell scattering amplitude and with comments on multiple scattering. (ERA citation 02:002077)

M. K. Banerjee

1976-01-01

347

The target nucleus in relativistic nuclear collisions  

NASA Astrophysics Data System (ADS)

Both the fireball model and hydrodynamical model predict, in a central collision, a fast energy dissipation in the early diving stage of the projectile into the target nucleus. In the final state both models show total incident energy largely dispersed over the whole target nucleus. In a quantitative comparison with the data for the intranuclear cascade calculations, however, the 90 deg double differential cross section seems to be flatter than the calculated one. If the slope is reflecting the temperature in the system then the data are having apparently a higher temperature than the cascade would predict. A picture of the reaction mechanism where the light projectile (e.g., Ne) gets stopped very early in the large target nucleus (e.g., AU or U) forming a small fireball at approximately half the beam rapidity, which decays inside the target nucleus, heating it up and causing the whole system to expand is discussed.

Gutbrod, H. H.; Warwick, A. I.; Wieman, H.

1982-03-01

348

The Spring Nucleus: A Microkemel for Objects  

Microsoft Academic Search

The Spring system is a distributed operating system that supports a distributed, object-oriented application framework. Each individual Spring system is based around a microkernel known as the nucleus, which is structured to support fast cross-address-space object invocations. This paper discusses the deign rationale for the nucleus' IPC facilities and how they fit into the overall Spring programming model. We then

Graham Hamilton; Panos Kougiouris

1993-01-01

349

An Ultrafine Aerosol Condensation Nucleus Counter  

Microsoft Academic Search

The development of a condensation nucleus counter (CNC) for detecting ultrafine aerosol (UFA) particles (particle diameter ?20 nm) is described here. This instrument is designed specifically for high-efficiency detection and counting of ultrafine particles. It is a modified version of the TSI model 3020 continuous flow, single-particle-counting condensation nucleus counter with sequential saturator and condenser. Design modifications incorporating aerosol sheathing

Mark R. Stolzenburg; Peter H. McMurry

1991-01-01

350

Nucleon-nucleus scattering and shell model  

Microsoft Academic Search

Nucleon-nucleus scattering is treated in a shell model picture, i.e. as in similar investigations the existence of a selfconsistent nuclear single particle potential is assumed representing the dominating part of the nucleon-nucleus interaction. For this case of reasonable splitting into effective one-body and many-body interactions theS-matrix is calculated by the formal methods ofGell-Mann, Goldberger, Watson et al. yielding a factorization

Heiner Meldner

1966-01-01

351

Dispersive effects in pion-nucleus scattering  

Microsoft Academic Search

The influence of dispersive, medium effects on pion-nucleus elastic scattering is investigated in a simple model. The pion-nucleus interaction in the impulse approximation is represented by an optical potential whose form is motivated by field-theoretic considerations and the properties of the ..delta..ââ resonance. The intermediate ..delta..ââ spectrum is described by a mean spectral energy, E\\/sub ms\\/, where the shift E\\/sub

D. J. Ernst; Mikkel Johnson

1985-01-01

352

Collective resonance in pion-nucleus scattering  

Microsoft Academic Search

Pion-nucleus scattering is described by the excitation of bound nucleons into the ..delta.. resonance leading to isobaric resonances of the whole nucleus. A few broad collective resonances of different multipolarity are shown to dominate elastic and inelastic ..pi..-¹²C scattering. From the qualitatively good agreement with the data, we conclude that those giant isobaric resonances are a general feature of the

K. Klingenbeck; M. Dillig; M. G. Huber

1978-01-01

353

Dispersive effects in pion-nucleus scattering  

Microsoft Academic Search

The influence of dispersive, medium effects on pion-nucleus elastic scattering is investigated in a simple model. The pion-nucleus interaction in the impulse approximation is represented by an optical potential whose form is motivated by field-theoretic considerations and the properties of the Delta33 resonance. The intermediate Delta33 spectrum is described by a mean spectral energy, Ems, where the shift Ems represents

D. J. Ernst; Mikkel B. Johnson

1985-01-01

354

Functional architecture in the cell nucleus.  

PubMed Central

The major functions of the cell nucleus, including transcription, pre-mRNA splicing and ribosome assembly, have been studied extensively by biochemical, genetic and molecular methods. An overwhelming amount of information about their molecular mechanisms is available. In stark contrast, very little is known about how these processes are integrated into the structural framework of the cell nucleus and how they are spatially and temporally co-ordinated within the three-dimensional confines of the nucleus. It is also largely unknown how nuclear architecture affects gene expression. In order to understand how genomes are organized, and how they function, the basic principles that govern nuclear architecture and function must be uncovered. Recent work combining molecular, biochemical and cell biological methods is beginning to shed light on how the nucleus functions and how genes are expressed in vivo. It has become clear that the nucleus contains distinct compartments and that many nuclear components are highly dynamic. Here we describe the major structural compartments of the cell nucleus and discuss their established and proposed functions. We summarize recent observations regarding the dynamic properties of chromatin, mRNA and nuclear proteins, and we consider the implications these findings have for the organization of nuclear processes and gene expression. Finally, we speculate that self-organization might play a substantial role in establishing and maintaining nuclear organization.

Dundr, M; Misteli, T

2001-01-01

355

Commissural axons of the mouse cochlear nucleus.  

PubMed

The axons of commissural neurons that project from one cochlear nucleus to the other were studied after labeling with anterograde tracer. Injections were made into the dorsal subdivision of the cochlear nucleus in order to restrict labeling only to the group of commissural neurons that gave off collaterals to, or were located in, this subdivision. The number of labeled commissural axons in each injection was correlated with the number of labeled radiate multipolar neurons, suggesting radiate neurons as the predominant origin of the axons. The radiate commissural axons are thick and myelinated, and they exit the dorsal acoustic stria of the injected cochlear nucleus to cross the brainstem in the dorsal half, near the crossing position of the olivocochlear bundle. They enter the opposite cochlear nucleus via the dorsal and ventral acoustic stria and at its medial border. Reconstructions of single axons demonstrate that terminations are mostly in the core and typically within a single subdivision of the cochlear nucleus. Extents of termination range from narrow to broad along both the dorsoventral (i.e., tonotopic) and the rostrocaudal dimensions. In the electron microscope, labeled swellings form synapses that are symmetric (in that there is little postsynaptic density), a characteristic of inhibitory synapses. Our labeled axons do not appear to include excitatory commissural axons that end in edge regions of the nucleus. Radiate commissural axons could mediate the broadband inhibition observed in responses to contralateral sound, and they may balance input from the two ears with a quick time course. PMID:23124982

Brown, M Christian; Drottar, Marie; Benson, Thane E; Darrow, Keith

2013-05-01

356

Toward describing one-nucleon exchange in nucleus-nucleus scattering  

SciTech Connect

The effect of one-nucleon exchanges on the potential of nucleus-nucleus interaction is considered on the basis of the resonating-group method. Corrections to the folding-model potential are obtained in the semiclassical approximation. Neutron scattering on {sup 4}He nuclei is considered as a model example.

Fadeev, S. N., E-mail: fsn3@yandex.ru; Gridnev, K. A., E-mail: kgridnev@yahoo.co [St. Petersburg State University (Russian Federation)

2010-12-15

357

An ipsilateral projection from the red nucleus to the lateral reticular nucleus in the cat.  

PubMed

Injections of the wheat germ agglutinin--horseradish peroxidase complex into the lateral reticular nucleus reveal that in addition to the well known contralateral rubroreticular connection, there is also a small but clear cut ipsilateral projection. Cells of various sizes participate in this ipsilateral pathway, and the retrogradely labelled neurons lie dispersed throughout the entire red nucleus. PMID:6524685

Qvist, H; Dietrichs, E; Walberg, F

1984-01-01

358

Gribov?s inelastic screening in high energy nucleus-nucleus interaction  

NASA Astrophysics Data System (ADS)

We show that at LHC energies an accounting for the Gribov's screenings in the framework of the quasi-eikonal approach generalized for nucleus-nucleus interactions leads to a significant (˜19%) decrease in the number of participating nucleons and intra-nuclear collision multiplicity for Pb+Pb interactions. Predictions for other energies and interactions are given also.

Uzhinsky, V.; Galoyan, A.

2013-04-01

359

Estudio fenomenologico de las colisiones nucleo-nucleo. (Phenomenological study of nucleus-nucleus collision).  

National Technical Information Service (NTIS)

Several aspects of high energy nucleus-nucleus collisions are analyzed in the framework of Dual Parton Model and Glauber-Gribov formalism. First of all the leading baryon spectra are calculated and an extensive study of nuclear stopping power are presente...

J. Casado Alvarez

1988-01-01

360

Projections of the lateral reticular nucleus to the cochlear nucleus in rats  

Microsoft Academic Search

The lateral reticular nucleus (LRN) resides in the rostral medulla and caudal pons, is implicated in cardiovascular regulation and cranial nerve reflexes, and gives rise to mossy fibers in the cerebellum. Retrograde tracing data revealed that medium-sized multipolar cells from the magnocellular part of the LRN project to the cochlear nucleus (CN). We sought to characterize the LRN projection to

Xiping Zhan; David K. Ryugo

2007-01-01

361

Toward describing one-nucleon exchange in nucleus-nucleus scattering  

Microsoft Academic Search

The effect of one-nucleon exchanges on the potential of nucleus-nucleus interaction is considered on the basis of the resonating-group\\u000a method. Corrections to the folding-model potential are obtained in the semiclassical approximation. Neutron scattering on\\u000a 4He nuclei is considered as a model example.

S. N. Fadeev; K. A. Gridnev

2010-01-01

362

Toward describing one-nucleon exchange in nucleus-nucleus scattering  

Microsoft Academic Search

The effect of one-nucleon exchanges on the potential of nucleus-nucleus interaction is considered on the basis of the resonating-group method. Corrections to the folding-model potential are obtained in the semiclassical approximation. Neutron scattering on 4He nuclei is considered as a model example.

S. N. Fadeev; K. A. Gridnev

2010-01-01

363

One-nucleon exchange and the effective local potential in nucleus-nucleus scattering  

Microsoft Academic Search

The influence of one-nucleon exchange on the local nucleus-nucleus potential is investigated using the resonating group method.\\u000a Neutron scattering on 4He and 16O nuclei is examined in detail. The results are compared to microscopic calculations.

S. N. Fadeev; K. A. Gridnev

2011-01-01

364

Nucleon Molecular Orbitals and the Transition Mechanism Between Molecular Orbitals in Nucleus-Nucleus Collisions.  

National Technical Information Service (NTIS)

The molecular orbitals of the nucleon(s) in nucleus-nucleus collisions are dynamically defined as a linear combination of nucleon single-particle orbits (LCNO) in a rotating frame by using the coupled-reaction-channel (CRC) theory. Nucleon molecular orbit...

B. Imanishi S. Misono W. von Oertzen H. Voit

1988-01-01

365

Target nucleus in relativistic nuclear collisions  

SciTech Connect

Both the fireball model and hydrodynamical model predict, in a central collision, a fast energy dissipation in the early diving stage of the projectile into the target nucleus. In the final state both models show total incident energy largely dispersed over the whole target nucleus. In a quantitative comparison with the data for the Intranuclear Cascade Calculations, however, the 90/sup 0/ double differential cross section seems to be flatter than the calculated one. If the slope is reflecting the temperature in the system then the data are having apparently a higher temperature than the cascade would predict. This report suggests and discusses a picture of the reaction mechanism where the light projectile (e.g. Ne) gets stopped very early in the large target nucleus (e.g. Au or U) forming a small fireball at approximately half the beam rapidity, which decays inside the target nucleus, heating it up and causing thee whole system to expand. The expansion cools the system and big clusters can condense out if the total energy and thus entropy in the system is not too high to prevent it. Such a qualitative picture of a reaction mechanism emerges when we consider the information obtained about relativistic nuclear collisions from measurements of the remnants of a large target nucleus struck by a smaller projectile (Ne + Au) and relate it to the complementary information from earlier measurements of fast light reaction products. (WHK)

Gutbrod, H.H.; Warwick, A.I.; Wieman, H.

1982-03-01

366

A minimally invasive treatment for lumbar disc herniation: DiscoGel® chemonucleolysis in patients unresponsive to chemonucleolysis with oxygen-ozone.  

PubMed

A multitude of therapies is available to treat disc herniation, ranging from conservative methods (medication and physical therapy) to minimally invasive (percutaneous) treatments and surgery. O?-O? chemonucleolysis (O?-O? therapy) is one of the minimally invasive treatments with the best cost/benefit ratio and lowest complication rate. Another substance recently made available exploiting the chemical properties of pure ethanol is DiscoGel®, a radiopaque gelified ethanol more viscous than absolute alcohol 8,9. The present study aimed to assess the therapeutic outcome of DiscoGel® chemonucleolysis in patients with lumbar disc herniation unresponsive to O?-O? therapy. Thirty-two patients aged between 20 and 79 years were treated by DiscoGel® chemonucleolysis between December 2008 and January 2010. The treatment was successful (improvement in pain) in 24 out of 32 patients. DiscoGel® is safe and easy to handle and there were no complications related to product diffusivity outside the treatment site. The therapeutic success rate of DiscoGel® chemonucleolysis in patients unresponsive to O?-O? therapy was satisfactory. Among other methods used to treat lumbar disc herniation, DiscoGel® chemonucleolysis can be deemed an intermediate procedure bridging conservative medical treatments and surgery. PMID:22440607

Stagni, S; de Santis, F; Cirillo, L; Dall'olio, M; Princiotta, C; Simonetti, L; Stafa, A; Leonardi, M

2012-03-16

367

Chiropractic management using Cox cervical flexion-distraction technique for a disk herniation with left foraminal narrowing in a 64-year-old man  

PubMed Central

Objective The purpose of this case report is to describe chiropractic management of a patient with a C6/C7 left posteromedial disk herniation with foraminal narrowing and concomitant neurological compromise in the form of left upper extremity radiating pain and hypoesthesia/anesthesia using Cox flexion-distraction technique. Clinical Features A 64-year-old man presented to a chiropractic clinic with complaints of neck/left shoulder pain and hypoesthesia/anesthesia into the palmar side of his left hand. Magnetic resonance images of the cervical spine revealed a left posteromedial C6/C7 disk herniation along with foraminal narrowing. In addition, there were other levels of degeneration, most noted at the C3/C4 spinal level, which also had significant left-sided foraminal narrowing. Intervention and Outcome Treatment included Cox flexion-distraction protocols aimed to reduce nerve root compression along with supportive physiological therapeutic interventions to aid with pain reduction and functional improvement. The patient was treated a total of 10 times over a course of 4 weeks. The patient reported being pain-free and fully functional 8 months following the conclusion of care. Conclusion This case study demonstrated the use of Cox flexion-distraction for treatment of a patient with a cervical disk herniation, foraminal narrowing, and associated radiating pain and radiculopathy in the left upper extremity.

Manison, Allen M.

2011-01-01

368

Consistent parametrisation for the production rates of negatively charged hadrons and neutral strange particles in nucleon-nucleon, nucleon-nucleus and nucleus-nucleus collisions.  

National Technical Information Service (NTIS)

A parametrisation of negative hadron and neutral strange particle production was developed which consistently describes presently available data from nucleon-nuceon, nucleon-nucleus, and nucleus-nucleus collisions at a beam energy of 200 GeV per nucleon. ...

K. Kadija I. Derado N. Schmitz P. Seyboth

1994-01-01

369

Compound Nucleus Contributions to the Optical Potential  

SciTech Connect

An ab-initio calculation of the optical potential for neutron-nucleus scattering has been performed by explicitly coupling the elastic channel to all the particle-hole (p-h) excitation states in the target. These p-h states may be regarded as doorway states through which the flux flows to more complicated configurations, and (in the end) to long-lived compound nucleus resonances. The random-phase approximation (RPA) provides the linear combinations of p-h states that include the residual interactions within the target, and we show preliminary results for elastic flux loss using both p-h and RPA descriptions of target excitations.

Thompson, I J; Dietrich, F S; Escher, J E; Dupuis, M

2008-01-28

370

Low energy antiproton-nucleus interactions  

SciTech Connect

The interaction of 175-MeV antiprotons with nuclei is examined within the intranuclear cascade model. The experimental characteristics of nucleon-antinucleon annihilation and scattering are used as input, and the propagation of the resultant pions thru the nucleus is treated realistically. The effect of the antiproton-nucleus strong attraction is also included. Overall characteristics of antiproton annihilation within nuclei, particularly the large, well-defined energy deposition, indicate that such collisions constitute a unique laboratory for the study of nuclei at very high excitations. The calculations also identify promising experimental observables and triggers.

Clover, M.R.; DeVries, R.M.; DiGiacomo, N.J.; Yariv, Y.

1982-11-01

371

The influence of torsion on disc herniation when combined with flexion  

PubMed Central

The role of torsion in the mechanical derangement of intervertebral discs remains largely undefined. The current study sought to investigate if torsion, when applied in combination with flexion, affects the internal failure mechanics of the disc wall when exposed to high nuclear pressure. Thirty ovine lumbar motion segments were each positioned in 2° axial rotation plus 7° flexion. Whilst maintained in this posture, the nucleus of each segment was gradually injected with a viscous radio-opaque gel, via an injection screw placed longitudinally within the inferior vertebra, until failure occurred. Segments were then inspected using micro-CT and optical microscopy in tandem. Five motion segments failed to pressurize correctly. Of the remaining 25 successfully tested motion segments, 17 suffered vertebral endplate rupture and 8 suffered disc failure. Disc failure occurred in mature motion segments significantly more often than immature segments. The most common mode of disc failure was a central posterior radial tear involving a systematic annulus–endplate–annulus failure pattern. The endplate portion of these radial tears often propagated contralateral to the direction of applied axial rotation, and, at the lateral margin, only those fibres inclined in the direction of the applied torque were affected. Apart from the 2° of applied axial rotation, the methods employed in this study replicated those used in a previously published study. Consequently, the different outcome obtained in this study can be directly attributed to the applied axial rotation. These inter-study differences show that when combined with flexion, torsion markedly reduces the nuclear pressure required to form clinically relevant radial tears that involve cartilaginous endplate failure. Conversely, torsion appears to increase the disc wall’s resistance to radial tears that do not involve cartilaginous endplate failure, effectively halving the disc wall’s overall risk of rupture.

Robertson, Peter A.; Broom, Neil D.

2010-01-01

372

A Relativistic Multiple Scattering Theory for Nucleus-Nucleus Collisions with Delta Resonance Coupling  

NASA Astrophysics Data System (ADS)

Non-relativistic multiple scattering theories (NRMST) are formulated by separating the unperturbed Hamiltonian from the interaction and writing the Lippmann-Schwinger equation as an infinite series in the multiple sums of pseudo two-body operators, known as the Watson tau-operators. The advantage of using the multiple scattering theory (MST) is that the pseudo two-body operators are often well approximated by free two-body nucleon-nucleon operators, which are obtained from parameterizations of experimental data. Relativistic theories are needed to properly describe the production of new particles, such as pions, from nucleus-nucleus collisions. Relativistic multiple scattering theories (RMST) have been developed for nucleon-nucleus scattering; however, no RMST for nucleus-nucleus scattering has yet been derived.footnotetextMaung K M, Norbury J W, and Coleman T 2007 J. Phys. G 34 1861. The purpose of this research is to derive an RMST for nucleus-nucleus scattering and to include delta degrees of freedom in the interaction, the minimum requirement for pion production.

Werneth, Charles; Maung Maung, Khin; Norbury, John

2012-10-01

373

TWO-PHOTON PHYSICS IN NUCLEUS-NUCLEUS COLLISIONS AT RHIC.  

SciTech Connect

Ultra-relativistic heavy-ions carry strong electromagnetic and nuclear fields. Interactions between these fields in peripheral nucleus-nucleus collisions can probe many interesting physics topics. This presentation will focus on coherent two-photon and photonuclear processes at RHIC. The rates for these interactions will be high. The coherent coupling of all the protons in the nucleus enhances the equivalent photon flux by a factor Z{sup 2} up to an energy of {approx} 3 GeV. The plans for studying coherent interactions with the STAR experiment will be discussed. Experimental techniques for separating signal from background will be presented.

NYSTRAND,J.

1998-09-10

374

Cytoarchitecture of the rat's supraoptic nucleus  

Microsoft Academic Search

There have been few Golgi studies dealing with the cytoarchitecture of the supraoptic nucleus (SON). This is due in part to resistance of supraoptic neurons to impregnation by Golgi methods. In this study, the structure of the SON was examined in normal S\\/D rats by using both Nissl and Golgi-silver methods. The purpose was to correlate shape, size and location

J. E. Bruni; P. M. Perumal

1984-01-01

375

Intrinsic Firing Dynamics of Vestibular Nucleus Neurons  

Microsoft Academic Search

Individual brainstem neurons involved in vestibular reflexes respond to identical head movements with a wide range of firing responses. This diversity of firing dynamics has been commonly assumed to arise from differences in the types of vestibular nerve inputs to vestibular nucleus neurons. In this study we show that, independent of the nature of inputs, the intrinsic membrane properties of

Chris Sekirnjak

2002-01-01

376

GABAergic control of the subthalamic nucleus  

Microsoft Academic Search

The glutamatergic subthalamic nucleus (STN) is a key component of the basal ganglia, a group of subcortical brain nuclei important for voluntary movement and the site of dysfunction in Parkinson's disease. The rate and pattern of STN activity is precisely regulated by the reciprocally connected GABAergic external globus pallidus (GPe) and glutamatergic afferents from the cortex. Subthalamic neurons possess intrinsic

Mark D. Bevan; Nicholas E. Hallworth; Jérôme Baufreton

2007-01-01

377

Afferents to the Ventrolateral Preoptic Nucleus  

Microsoft Academic Search

Sleep is influenced by diverse factors such as circadian time, affective states, ambient temperature, pain, etc., but pathways mediating these influences are unknown. To identify pathways that may influence sleep, we examined afferents to the ventro- lateral preoptic nucleus (VLPO), an area critically implicated in promoting sleep. Injections of the retrograde tracer cholera toxin B subunit (CTB) into the VLPO

Thomas C. Chou; Alvhild A. Bjorkum; Stephanie E. Gaus; Jun Lu; Thomas E. Scammell; Clifford B. Saper

2002-01-01

378

Macromolecular mobility inside the cell nucleus  

Microsoft Academic Search

The highly organized interior of the living cell imposes major constraints on the dynamic properties of macromolecules and macromolecular complexes in both the cytoplasm and the nucleus. Although there are many examples of cytoplasmic molecular assemblies that can be propelled by molecular motors along microtubules and actin filaments, a view that had emerged during the past few years was that

Maria Carmo-Fonseca; Melpomeni Platani; Jason R. Swedlow

2002-01-01

379

Spatial memory, plasticity and nucleus accumbens.  

PubMed

Research on the function of the nucleus accumbens, the most ventral component of the striatal complex, has traditionally focused on locomotor activity, reward, motivation and addiction. However, based on the existence of projections to the nucleus accumbens from the allocortical regions involved in spatial navigation, it has been suggested that this structure plays a role in spatial learning and memory. Lesion and neuropharmacological studies confirm this view, also revealing the complex dynamics of the receptors involved in these processes. Moreover, the effects of post-training intra-nucleus accumbens drug administrations demonstrate the necessity of off-line neural activity within this structure in order to consolidate spatial memory. Blockade of molecular processes implicated in synaptic plasticity, such as cAMP response element-binding protein (CREB)-induced transcription or extracellular matrix remodeling, provides further experimental support to this hypothesis. These observations imply that experience-dependent synaptic plasticity responsible for long-term stabilization of spatial information might occur within the nucleus accumbens, similarly to what has been observed in the hippocampus. This suggests that a comprehensive understanding of spatial memory processing should be viewed in the context of a wider neural circuit. PMID:23104853

Rinaldi, Arianna; Oliverio, Alberto; Mele, Andrea

2012-01-01

380

Evaporation from a porous cometary nucleus  

SciTech Connect

In a porous cometary nucleus, ice sublimates from the volume of a surface layer rather than just from the upper boundary. Given a model for the porous medium, the equations of mass and heat transfer can be solved for any desired orbit. The temperature profile and the vapor flux as a function of depth in the upper layer of the nucleus may thus be obtained. Calculations are performed for a spherically symmetric icy nucleus in the orbit of Comet P/Halley, assuming different values of porosity and different models for the ice structure. The upper layer may be divided in two zones: in the uppermost zone, whose thickness ranges from 100 microns to about 1 mm, the vapor flux is directed outward, whereas in the lower zone, which is 1000 times thicker, the vapor flows in the opposite direction. The sublimation rate as a function of heliocentric distance depends strongly on the porosity of the nucleus and is little affected by other parameters related to the structure of the ice. This allows the determination of the porosity coefficient of a comet from observation of its water production rates at large heliocentric distances. 18 refs.

Mekler, Y.; Prialnik, D.; Podolak, M. (Tel Aviv Univ. (Israel))

1990-06-01

381

Development of the Human Parvocellular Red Nucleus  

Microsoft Academic Search

Morphology of the human parvocellular red nucleus (RNp) was investigated in 14 fetuses aged from 12 to 39 weeks of gestation (WG). The brains were processed into celloidin-embedded serial sections. At 12 WG, the anlage of RNp was observed as an ovoid mass of immature neurons clustering into some groups. Lobular appearance in cross-sectional images was conspicuous during the early

Katsuyuki Yamaguchi; Noboru Goto

2008-01-01

382

An organism arises from every nucleus.  

PubMed

The fact that, cloning using somatic cell nuclear transfer (SCNT) method has been performed, opened new horizons for cloning, and changed the way of our understanding and approach to cell and nucleus. The progress in cloning technology, brought the anticipation of the ability to clone an organism from each somatic cell nucleus. Therefore, the 'Cell Theory' is about to take the additional statement as "An organism arises from every nucleus". The development of gene targeting procedures which can be applied with SCNT, showed us that it may be possible to obtain different versions of the original genetic constitution of a cell. Because of this opportunity which is provided by SCNT, in reproductive cloning, it would be possible to clone enhanced organisms which can adapt to different environmental conditions and survive. Furthermore, regaining the genetic characteristics of ancestors or reverse herediter variations would be possible. On the other hand, in therapeutic cloning, more precise and easily obtainable alternatives for cell replacement therapy could be presented. However, while producing healthier or different organisms from a nucleus, it is hard to foresee the side effects influencing natural processes in long term is rather difficult. PMID:19995701

Keklikoglu, Nurullah

2009-01-01

383

Binding effects in pion-nucleus scattering  

Microsoft Academic Search

The pion nucleus optical potential is evaluated for a pion scattered by a nucleon bound in a potential well. Total cross sections for pi-16O scattering are computed supposing an S-wave separable two body interaction. The comparison with impulse and static approximations shows that they are not justified in a resonance region.

J. P. Dedonder; C. Schmit

1976-01-01

384

Nucleon-nucleus interactions from JACEE  

NASA Astrophysics Data System (ADS)

Results on hadron-nucleus interactions from the Japanese-American Cooperation Emulsion Experiment experiment are presented. Angular distributions for charged particles, and angular and transverse momentum spectra for photons have been measured for a sample of events with sigma epsilongamma. Results on central rapidity density and transverse energy flow are discussed.

Burnett, T. H.; Dake, S.; Fuki, M.; Gregory, J. C.; Hayashi, T.; Holynski, R.; Iwai, J.; Jones, W. V.; Jurak, A.; Lord, J. J.

1985-08-01

385

Compound nucleus studies withy reverse kinematics  

SciTech Connect

Reverse kinematics reactions are used to demonstrate the compound nucleus origin of intermediate mass particles at low energies and the extension of the same mechanism at higher energies. No evidence has appeared in our energy range for liquid-vapor equilibrium or cold fragmentation mechanisms. 11 refs., 12 figs.

Moretto, L.G.

1985-06-01

386

Evaporation from a porous cometary nucleus  

NASA Astrophysics Data System (ADS)

In a porous cometary nucleus, ice sublimates from the volume of a surface layer rather than just from the upper boundary. Given a model for the porous medium, the equations of mass and heat transfer can be solved for any desired orbit. The temperature profile and the vapor flux as a function of depth in the upper layer of the nucleus may thus be obtained. Calculations are performed for a spherically symmetric icy nucleus in the orbit of Comet P/Halley, assuming different values of porosity and different models for the ice structure. The upper layer may be divided in two zones: in the uppermost zone, whose thickness ranges from 100 microns to about 1 mm, the vapor flux is directed outward, whereas in the lower zone, which is 1000 times thicker, the vapor flows in the opposite direction. The sublimation rate as a function of heliocentric distance depends strongly on the porosity of the nucleus and is little affected by other parameters related to the structure of the ice. This allows the determination of the porosity coefficient of a comet from observation of its water production rates at large heliocentric distances.

Mekler, Y.; Prialnik, D.; Podolak, M.

1990-06-01

387

Target Nucleus in Relativistic Nuclear Collisions.  

National Technical Information Service (NTIS)

Both the fireball model and hydrodynamical model predict, in a central collision, a fast energy dissipation in the early diving stage of the projectile into the target nucleus. In the final state both models show total incident energy largely dispersed ov...

H. H. Gutbrod A. I. Warwick H. Wieman

1982-01-01

388

Receptor tyrosine kinases in the nucleus.  

PubMed

To date, 18 distinct receptor tyrosine kinases (RTKs) are reported to be trafficked from the cell surface to the nucleus in response to ligand binding or heterologous agonist exposure. In most cases, an intracellular domain (ICD) fragment of the receptor is generated at the cell surface and translocated to the nucleus, whereas for a few others the intact receptor is translocated to the nucleus. ICD fragments are generated by several mechanisms, including proteolysis, internal translation initiation, and messenger RNA (mRNA) splicing. The most prevalent mechanism is intramembrane cleavage by ?-secretase. In some cases, more than one mechanism has been reported for the nuclear localization of a specific RTK. The generation and use of RTK ICD fragments to directly communicate with the nucleus and influence gene expression parallels the production of ICD fragments by a number of non-RTK cell-surface molecules that also influence cell proliferation. This review will be focused on the individual RTKs and to a lesser extent on other growth-related cell-surface transmembrane proteins. PMID:24086039

Carpenter, Graham; Liao, Hong-Jun

2013-10-01

389

Paraventricular nucleus, stress response, and cardiovascular disease  

Microsoft Academic Search

The paraventricular nucleus of the hypothalamus (PVN) is a complex effector structure that initiates endocrine and autonomic responses to stress. It receives inputs from visceral receptors, circulating hormones such as angiotensin II, and limbic circuits and contains neurons that release vasopressin, activate the adrenocortical axis, and activate preganglionic sympathetic or parasympathetic outflows. The neurochemical control of the different subgroups of

Eduardo E. Benarroch

2005-01-01

390

Overview of neutrino-nucleus quasielastic scattering  

SciTech Connect

A review of quasielastic neutrino-nucleus scattering will be presented, with emphasis on bringing together the knowledge (and language) of neutrino physics, electron scattering, and nuclear structure communities. Assumptions commonly made which simplify the theoretical calculations will be examined. Finally, an attempt will be made to identify places where improvement from either theoretical or experimental sides would be more significant.

Herraiz, J. L.; Martinez, M. C.; Udias, J. M. [Grupo de Fisica Nuclear, Departamento de Fisica Atomica, Molecular y Nuclear Universidad Complutense de Madrid, E-28040 Madrid (Spain); Caballero, J. A. [Departamento de Fisica Atomica, Molecular y Nuclear Universidad de Sevilla, Apdo. 1065, E-41080 Sevilla (Spain)

2009-11-25

391

Fragmentectomy versus Conventional Microdiscectomy in Single-Level Lumbar Disc Herniations : Comparison of Clinical Results and Recurrence Rates  

PubMed Central

Objective This retrospective study aimed to compare clinical outcomes in terms of pain relief and recurrence rate between fragmentectomies and conventional microdiscectomies in patients with lumbar disc herniation (LDH). Methods Between January 2008 and May 2011, a total of 175 patients met the inclusion criteria of this study. The visual analogue scale (VAS) scores of back and radicular pains were recorded before surgery, 2 and 6 weeks after surgery. Recurrence was defined when a patient had the same pattern of preoperative symptoms and was confirmed with magnetic resonance imaging. Results Seventy-four patients (42.3%) were suitable for fragmentectomy, and 101 patients underwent conventional microdiscectomy. There were no significant differences in VAS scores between the fragmentectomy and conventional microdiscectomy groups 2 and 6 weeks after surgery. During the follow-up period, 3 patients (4.05%) in the fragmentectomy group and 7 patients (6.93%) in the conventional microdiscectomy group relapsed. Conclusion If patients are selected according to well-defined criteria, fragmentectomy can be a good surgical option for LDH, in the physiological aspect of preserving healthy intervertebral disc materials.

Kim, Yeon-Seong; Lee, Min-Cheol; Song, Jae-Wook; Kim, Sang-Kyu; Kim, In-Hwan

2012-01-01

392

Results on ultra-relativistic nucleus-nucleus interactions from balloon-borne emulsion chambers  

NASA Astrophysics Data System (ADS)

The results of balloon-borne emulsion-chamber measurements on high-energy cosmic-ray nuclei (Burnett et al., 1983) are summarized in tables and graphs and briefly characterized. Special consideration is given to seven nucleus-nucleus interaction events at energy in excess of 1 TeV/A with multiplicity greater than 400, and to Fe interactions (53 with CHO, 10 with emulsion, and 14 with Pb) at 20-60 GeV/A.

Burnett, T. H.; Dake, S.; Derrickson, J. H.; Fountain, W.; Meegan, C. A.; Takahashi, Y.; Watts, J. W.; Fuki, M.; Gregory, J. C.; Hayashi, T.

393

Nucleus-nucleus scattering structure using the first order optical potential  

SciTech Connect

First order optical potential is used to calculate the total cross section, differential cross section, and absorption-cross section for nucleus-nucleus scattering. The results are compared to the available Eikonal model and the experimental data in the energy range 100-1000 MeV for several nuclei. The differential and absorption cross sections are calculated using partial wave expansion. The partial waves are obtained by solving the Lippmann-Scwinger equation in momentum space.

Dubey, R.R.; Khandelwal, G.S. [and others

1993-10-01

394

Eta-Mesic Nucleus: A New Form of Nuclear Matter  

Microsoft Academic Search

Formation of eta-mesic nucleus, a bound state of an eta meson in a nucleus, is reviewed in this paper. Three different theoretical approaches are used to calculate the binding energies and widths of such nuclei. The effect of eta-mesic nucleus in pion double-charge-exchange reaction is discussed. Experimental efforts by different groups to detect the nucleus are also discussed. The ramifications

Q. Haider; L. C. Liu

2009-01-01

395

Why do we have a caudate nucleus?  

PubMed

In order to understand the physiological role of the caudate nucleus, we combine here our laboratory data on cats with reports of patients with selective damage to this nucleus. Cats with bilateral removal of the caudate nuclei showed a stereotyped behavior consisting of persistently approaching and then following a person, another cat, or any object, and attempting to contact the target. Simultaneously, the animals exhibited a friendly disposition and persistent docility together with purring and forelimbs treading/kneading. The magnitude and duration of this behavior was proportional to the extent of the removal reaching a maximum after ablations of 65% or more of the caudate tissue. These cats were hyperactive but they had lost the feline elegance of movements. Additional features of acaudate cats were: (1) postural and accuracy deficits (plus perseveration) in paw usage tasks including bar pressing for food reward; (2) cognitive and perceptual impairments on a T-maze battery of tasks and on the bar pressing tasks; (3) blockage or blunting of the species-specific behavioral response to a single injection of morphine; Unilateral caudate nucleus removal did not produce global behavioral effects, but only deficit in the contralateral paw contact placing reaction and paw usage/bar pressing. Moreover and surprisingly, we found hypertrophy of the ipsilateral caudate nucleus following prenatal focal neocortical removal. The findings in human were also behavioral (not neurological) and also occurred with unilateral caudate damage. The main manifestations consisted of loss of drive (apathy), obsessive-compulsive behavior, cognitive deficits, stimulus-bound perseverative behavior, and hyperactivity. Based on all of the above data we propose that the specific function of the caudate nucleus is to control approach-attachment behavior, ranging from plain approach to a target, to romantic love. This putative function would account well for the caudate involvement in the pathophysiology of a number of clinical syndromes that we mention, all of which compromise approach-attachment- affect behaviors. In addition we conclude that the caudate nucleus contributes importantly to body and limbs posture as well as to the accuracy and speed of directed movements. PMID:20407491

Villablanca, Jaime R

2010-01-01

396

Percutaneous laser lumbar disc decompression - mechanism of action, indications and contraindications.  

PubMed

This article describes the development of minimally invasive methods in the treatment of lumbar discopathy, with particular attention to percutaneous laser disc decompression (PLDD). The authors discus the therapeutic operating mechanism of PLDD, emphasizing the importance of the thermal characteristics of laser light, which is responsible for the vaporization and ablation of a small amount of tissue from the nucleus pulposus. This causes a significant reduction in pressure in the closed structure of the disc, and consequently reduced compression exerted by the disk on the dural sac and the nerve roots. Improvement in the flow of cerebro-spinal fluid has also been observed on the level at which the operation is performed. On the basis of our own experience and the reports of other authors, we have specified indications and contra-indications for PLDD. Our conclusion is that PLDD is an effective treatment method for low back pain and ischialgia caused by protrusion or herniation of the nucleus pulposus, with elimination or significant reduction in symptoms in over 75% of those treated; reduction or resolution of neurological deficits that arise in the course of lumbar discopathy has also been observed. This method enables one-stage treatment of multi-level degenerative changes in the intervertebral disc. The only absolute contraindications for PLDD are the presence of sequestration, disturbances in blood coagulation, and bacterial infection. PMID:17675991

Maksymowicz, Wojciech; Barczewska, Monika; Sobieraj, Andrzej

2004-06-30

397

Neurochemical organization of the nucleus paramedianus dorsalis in the human  

Microsoft Academic Search

We have characterized the neurochemical organization of a small brainstem nucleus in the human brain, the nucleus paramedianus dorsalis (PMD). PMD is located adjacent and medial to the nucleus prepositus hypoglossi (PH) in the dorsal medulla and is distinguished by the pattern of immunoreactivity of cells and fibers to several markers including calcium-binding proteins, a synthetic enzyme for nitric oxide

Joan S. Baizer; James F. Baker; Kristin Haas; Raquel Lima

2007-01-01

398

Single ? production in neutrino-nucleus scattering  

NASA Astrophysics Data System (ADS)

We study 1? production in both charged and neutral current neutrino-nucleus scattering for neutrino energies below 2 GeV. We use a theoretical model for one pion production at the nucleon level that we correct for medium effects. The results are incorporated into a cascade program that apart from production also includes the pion final state interaction inside the nucleus. Besides, in some specific channels coherent ? production is also possible and we evaluate its contribution as well. Our results for total and differential cross sections are compared with recent data from the MiniBooNE Collaboration. The model provides an overall acceptable description of the data, better for neutral-current than for charged-current channels, although the theory is systematically below the data. Differential cross sections, folded with the full neutrino flux, show that most of the missing pions lie in the forward direction and at high energies.

Hernández, E.; Nieves, J.; Vacas, M. J. Vicente

2013-06-01

399

Crustal models of the evolving comet nucleus  

NASA Astrophysics Data System (ADS)

Comet missions are shown to validate the two-phase surface model of Shul'man, except that loose grains are consolidated via physico-chemical and gas deposition into a coherent crust. This primarily organic crust is further consolidated by cooking in solar radiation, especially at peak temperatures around perihelion. The two surface phases of sublimating ices and nonvolatile crust are disjoint, the former deepening into crater-like hollows over many apparitions. The transition to nonvolatile crust is unstable, subject to competing consolidation and disruption processes, and sensitive to seasonal changes. While a low density snowball interior is favored, ice sheets or frozen lakes covering liquid or gas pockets might be formed and occasionally erupt. Comets vanish when crustal growth completely covers the surface, but are rejuvenated when a boulder impact starts a new crater. Nucleus splitting is seen as the culmination of irregular erosion, deepening the craters through a substantial fraction of the nucleus or through to a hollow center.

Wallis, M. K.; Wickramasinghe, N. C.

1987-09-01

400

Plasma Membrane-to-Nucleus Calcium Signaling  

Microsoft Academic Search

Calcium is a ubiquitous cellular second messenger that mediates a vast array of cellular processes. Elevation of intracellular\\u000a calcium activates signaling cascades that are able to target the nucleus, where they modify gene transcription. The eukaryotic\\u000a cell is wired up in a sophisticated manner to enable it to respond differently to different calcium signals. In this way a\\u000a single second

Giles E. Hardingham

401

Parity violation in the compound nucleus  

SciTech Connect

Measurements have been performed on the helicity dependence of the neutron resonance cross section for many nuclei by our TRIPLE Collaboration. A large number of parity violations are observed. Generic enhancements amplify the signal for symmetry breaking and the stochastic properties of the compound nucleus permit the strength of the symmetry-breaking interaction to be determined without knowledge of the wave functions of individual states. A total of 15 nuclei have been analyzed with this statistical approach. The results are summarized.

Mitchell, G. E.; Crawford, B. E.; Grossmann, C. A.; Lowie, L. Y. [North Carolina State University, Raleigh, North Carolina 27695 and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708 (United States); Bowman, J. D.; Knudson, J.; Penttilae, S.; Seestrom, S. J.; Smith, D. A.; Yen, Yi-Fen; Yuan, V. W. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Delheij, P. P. J. [TRIUMF, Vancouver, British Columbia, V6T 2A3 (Canada); Haseyama, T.; Masaike, A.; Matsuda, Y. [Department of Physics, Kyoto University, Kyoto 606-8502 (Japan); Postma, H. [University of Technology, Delft, 2600 GA (Netherlands); Roberson, N. R. [Duke University, Durham, North Carolina 27708 and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708 (United States); Sharapov, E. I. [Joint Institute for Nuclear Research, 141980 Dubna (Russian Federation); Stephenson, S. L. [Gettysburg College, Gettysburg, Pennsylvania 17325 (United States)

1999-06-10

402

Regge Trajectory for Nucleon-Nucleus Scattering  

Microsoft Academic Search

The theory of complex angular momentum for nucleon-nucleus scattering is developed in relation to the R-matrix theory of nuclear reactions. As a particular example, the Breit-Wigner multi-level formula in terms of Regge parameters is discussed in a suitable form for practical analysis. The theory is applied to the s- and p-wave elastic proton and neutron scattering by 14C and 14N

Syurei Iwao; Akira Kawakami

1968-01-01

403

Local field corrections in. pi. -nucleus scattering  

Microsoft Academic Search

The local field correction to the ..pi..-nucleus optical potential is calculated taking recoil into account. The correction arises from the triple scattering matrix element <0;k vertical-bartauâGtauâGtauâvertical-bar 0;k'>, where tau\\/sub i\\/ are ..pi..N amplitudes. The recoil energy of nucleon 1 affects the pion Green's function G and the intermediate scattering amplitude tauâ. The recoil of nucleon 2 affects only tauâ and

M. K. Banerjee; S. J. Wallace

1980-01-01

404

Glycine immunoreactivity of multipolar neurons in the ventral cochlear nucleus which project to the dorsal cochlear nucleus  

Microsoft Academic Search

Certain distinct populations of neurons in the dorsal cochlear nucleus are inhibited by a neural source that is responsive to a wide range of acoustic frequencies. In this study, we examined the glycine immunoreactivity of two types of ventral cochlear nucleus neurons (planar and radiate) in the rat which project to the dorsal cochlear nucleus (DCN) and thus, might be

John R. Doucet; Adam T. Ross; M. Boyd Gillespie; David K. Ryugo

1999-01-01

405

Direct Projections from the Central Amygdaloid Nucleus to the Hypothalamic Paraventricular Nucleus: Possible Role in Stress-Induced Adrenocorticotropin Release  

Microsoft Academic Search

The amygdala, particularly the central amygdaloid nucleus, is important for the expression of adrenocorticotropin and corticosterone responses during stress. The aim of the present study was to determine if the central amygdaloid nucleus directly innervated the hypothalamic paraventricular nucleus. To accomplish this aim, the Phaseolus vulgaris leucoagglutinin lectin antero-grade tracing method was used. Injections of the tracer into the medial

Thackery S. Gray; Michael E. Carney; Debra J. Magnuson

1989-01-01

406

COLLI-Monte-Carlo Generator of Soft Hadronic, Hadron-Nucleus and Nucleus Collisions at High Energies.  

National Technical Information Service (NTIS)

The COLLI-program complex for computer simulation of the soft hadronic, hadron-nucleus and nucleus-nucleus collisions at high energies is briefly described. Instead of the physical model of the hadron inelastic interaction the quark-gluon string model has...

N. S. Amelin

1986-01-01

407

A controlled case study of the relationship between environmental risk factors and apoptotic gene polymorphism and lumbar disc herniation.  

PubMed

To explore the etiologic role of apoptosis-related genes, environmental risk factors, and their interaction in the occurrence of lumbar disk herniation (LDH), a controlled case study was performed with 128 LDH patients and 132 age- and sex-matched controls. Matrix-assisted laser desorption/ionization, time-of-flight mass spectrometry assay was used to analyze the genotype of nine polymorphism sites in three genes, including Fas -1377G/A rs2234767, Fas -670G/A rs1800682, Fas rs2147420, Fas rs2296603, Fas rs7901656, Fas rs1571019, Fas ligand (FasL) -844C/T rs763110, caspase 9 (CASP9) -1263A>G rs4645978, and CASP9 -712C>T rs4645981. The patients and controls showed similar age and sex, but had significant differences in lumbar load, bed type, amateur sports, and leisure activities (P < 0.05). The correlation analysis revealed that polymorphism of FasL -844C/T (rs763110) and CASP9 -1263A>G (rs4645978) had a significant correlation with LDH, indicating that the genotypes of FasL -844C/T TT and CASP9 -1263A>G GG are probably high-risk genotypes for LDH. The results of environment-gene interaction analysis revealed that, in LDH, the interaction of the FasL -844TT genotype and level III to IV lumbar load was consistent with the ultramultiplying model, and the interaction of the CASP9 rs4645978 GG genotype and level III to IV lumbar load was consistent with the submultiplicative model. Therefore, the risk of LDH was determined by both environmental and genetic risk factors, and the mechanisms of interactions between different genotypes and environmental factors also differed. PMID:23141929

Zhang, Yin-Gang; Zhang, Feng; Sun, Zhengmin; Guo, Wentao; Liu, Jian; Liu, Miao; Guo, Xiong

2012-11-07

408

The impact of early recovery on long-term outcomes in a cohort of patients undergoing prolonged nonoperative treatment for lumbar disc herniation.  

PubMed

Object The authors comprehensively studied the recovery of individual patients undergoing treatment for lumbar disc herniation. The primary goal was to gain insight into the variability of individual patient utility scores within a treatment cohort. The secondary goal was to determine how the rates and variability of patient recovery over time, represented by improvement in utility scores, affected long-term patient outcomes. Methods EuroQol Group-5 Dimension (EQ-5D) scores were obtained at baseline and at 2, 4, 8, 12, 26, 38, and 52 weeks for 93 patients treated under a prolonged conservative care protocol for lumbar disc herniation. Gaussian kernel densities were used to estimate the distribution of utility scores at each time point. Logistic regression and multistate Markov models were used to characterize individual patient improvement over time. Fisher exact tests were used to compare the distribution of EQ-5D domain scores. Results The distribution of utility scores was bimodal at 1 year and effectively sorted patients into a "higher" utility group (EQ-5D = 1; 43% of cohort) and a "lower" utility group (EQ-5D ? 0.86; 57% of cohort). Fisher exact tests revealed that pain/discomfort, mobility, and usual activities significantly differed between the 2 utility groups (p ? 0.001). The utility groups emerged at 8 weeks and were stable for the remainder of the treatment period. Using utility scores from 8 weeks, regression models predicted 1-year outcomes with 62% accuracy. Conclusions This study is the first to comprehensively consider the utility recovery of individual patients within a treatment cohort for lumbar disc herniation. The results suggest that most utility is recovered during the early treatment period. Moreover, the findings suggest that initial improvement is critical to a patient's long-term outcome: patients who do not experience significant initial recovery appear unlikely to do so at a later time under the same treatment protocol. PMID:23808581

Cowperthwaite, Matthew C; van den Hout, Wilbert B; Webb, K Michael

2013-06-28

409

Surgical versus Non-Operative Treatment for Lumbar Disc Herniation: Four-Year Results for the Spine Patient Outcomes Research Trial (SPORT)  

PubMed Central

Study Design Concurrent prospective randomized and observational cohort study. Objectives To assess the 4-year outcomes of surgery vs. non-operative care. Background Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical to non-operative treatment remain controversial. Methods Surgical candidates with imaging-confirmed lumbar intervertebral disc herniation meeting SPORT eligibility criteria enrolled into prospective randomized (501 participants) and observational cohorts (743 participants) at 13 spine clinics in 11 US states. Interventions were standard open discectomy versus usual non-operative care. Main outcome measures were changes from baseline in the SF-36 Bodily Pain (BP) and Physical Function (PF) scales and the modified Oswestry Disability Index (ODI - AAOS/Modems version) assessed at 6 weeks, 3 and 6 months, and annually thereafter. Results Non-adherence to treatment assignment caused the intent-to-treat analyses to underestimate the treatment effects. In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures (mean change Surgery vs. Non-operative; treatment effect; 95% CI): BP (45.6 vs. 30.7; 15.0; 11.8 to 18.1), PF (44.6 vs. 29.7; 14.9; 12.0 to 17.8) and ODI (?38.1 vs. ?24.9; ?13.2; ?15.6 to ?10.9). The percent working was similar between the surgery and non-operative groups, 84.4% vs. 78.4% respectively. Conclusion In a combined as-treated analysis at 4 years, patients who underwent surgery for a lumbar disc herniation achieved greater improvement than non-operatively treated patients in all primary and secondary outcomes except work status. Trial Registration Spine Patient Outcomes Research Trial (SPORT): Intervertebral Disc Herniation; #NCT00000410; http://www.clinicaltrials.gov/ct/show/NCT00000410?order=2

Weinstein, James N.; Lurie, Jon D.; Tosteson, Tor D.; Tosteson, Anna N. A.; Blood, Emily; Abdu, William A.; Herkowitz, Harry; Hilibrand, Alan; Albert, Todd; Fischgrund, Jeffrey

2009-01-01

410

Afferent connections to the abducent nucleus in the cat.  

PubMed

The afferent connections to the abducent nucleus in the cat were studied by means of retrograde transport of WGA-HRP after implantations of the tracer in crystalline form. Retrogradely labelled cells were found bilaterally in the medial and descending vestibular nuclei, mainly in their ventral and medial portions, in the rostral part of the ipsilateral gigantocellular reticular nucleus, in the medial part of the contralateral caudal pontine reticular nucleus and bilaterally in the oculomotor nucleus, mainly in its dorsolateral division. Some labelled cells were also found bilaterally in the mesencephalic reticular formation, the periaqueductal grey and the nucleus of the trapezoid body. PMID:1707258

Hoddevik, G H; Dietrichs, E; Walberg, F

1991-01-01

411

A consistent parametrisation for the production rates of negatively charged hadrons and neutral strange particles in nucleon-nucleon, nucleon-nucleus and nucleus-nucleus collisions  

Microsoft Academic Search

A parametrisation of negative hadron and neutral strange particle production was developed which consistently describes presently available data from nucleon-nucleon, nucleon-nucleus and nucleus-nucleus collisions at a beam energy of 200 GeV per nucleon. Average multiplicities of negative hadrons are found to be proportional to the number of wounded nucleons, averageKs0 multiplicities proportional to the number of wounded quarks, and average

K. Kadija; I. Derado; N. Schmitz; P. Seyboth

1995-01-01

412

Projections from the vestibular nuclei and nucleus prepositus hypoglossi to dorsal raphe nucleus in rats  

PubMed Central

The serotonergic system regulates processing in components of the vestibular nuclear complex, including the medial vestibular nucleus (MVe) and nucleus prepositus hypoglossi (PH). Recent studies using anterograde and retrograde tracers have shown that vestibular nuclei are targeted by regionally-selective projections from the serotonergic dorsal raphe nucleus. The objective of the present investigation was to determine whether the DRN is targeted by projections from the vestibular nuclear complex in rats, using the anterograde tracer biotinylated dextran amine (BDA). After injection of BDA into PH or the caudal parvicellular division of MVe, labeled fibers and terminals were observed in the ventromedial and lateral subdivisions of DRN. These findings indicate that projections from the vestibular nuclei and PH are organized to modulate processing within specific functional domains of the DRN.

Cuccurazzu, Bruna; Halberstadt, Adam L.

2008-01-01

413

Nuclear radii calculations in various theoretical approaches for nucleus-nucleus interactions  

SciTech Connect

The information about sizes and nuclear density distributions in unstable (radioactive) nuclei is usually extracted from the data on interaction of radioactive nuclear beams with a nuclear target. We show that in the case of nucleus-nucleus collisions the values of the parameters depend somewhat strongly on the considered theoretical approach and on the assumption about the parametrization of the nuclear density distribution. The obtained values of root-mean-square radii (R{sub rms}) for stable nuclei with atomic weights A=12-40 vary by approximately 0.1 fm when calculated in the optical approximation, in the rigid target approximation, and using the exact expression of the Glauber theory. We present several examples of R{sub rms} radii calculations using these three theoretical approaches and compare these results with the data obtained from electron-nucleus scattering.

Merino, C.; Novikov, I. S.; Shabelski, Yu. [Departamento de Fisica de Particulas, Facultade de Fisica, and Instituto Galego de Fisica de Altas Enerxias (IFGAE), Universidade de Santiago de Compostela, E-15782 Santiago de Compostela, Galiza (Spain); Department of Physics and Astronomy, Western Kentucky University, Bowling Green, Kentucky 42101-1077 (United States); Petersburg Nuclear Physics Institute, Gatchina, St. Petersburg 188350 (Russian Federation)

2009-12-15

414

Nuclear radii calculations in various theoretical approaches for nucleus-nucleus interactions  

NASA Astrophysics Data System (ADS)

The information about sizes and nuclear density distributions in unstable (radioactive) nuclei is usually extracted from the data on interaction of radioactive nuclear beams with a nuclear target. We show that in the case of nucleus-nucleus collisions the values of the parameters depend somewhat strongly on the considered theoretical approach and on the assumption about the parametrization of the nuclear density distribution. The obtained values of root-mean-square radii (Rrms) for stable nuclei with atomic weights A=12-40 vary by approximately 0.1 fm when calculated in the optical approximation, in the rigid target approximation, and using the exact expression of the Glauber theory. We present several examples of Rrms radii calculations using these three theoretical approaches and compare these results with the data obtained from electron-nucleus scattering.

Merino, C.; Novikov, I. S.; Shabelski, Yu.

2009-12-01

415

Relations between polarized-proton-nucleus and unpolarized-transverse-electron-nucleus scattering and applications  

SciTech Connect

We calculate the cross section for polarized-proton-nucleus non-spin-flip ({up arrow}{up arrow}) and spin-flip ({down arrow}{up arrow}) inelastic scattering where the polarization is perpendicular to the scattering plane. This cross section is compared with that of unpolarized-electron-nucleus scattering. We note that, in the plane-wave impulse approximation, the non-spin-flip squared form factor is essentially the same, apart from a factor of {ital q}{sup 2}, as one obtained in {ital unpolarized}-electron-nucleus scattering in which only the spin terms are kept and the convection terms dropped. But the spin-flip squared form factor is different.

Zheng, D.C.; Zamick, L. (Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08855 (US))

1989-09-01

416

Chemically defined collateral projections from the pons to the central nucleus of the amygdala and hypothalamic paraventricular nucleus in the rat  

Microsoft Academic Search

Triple fluorescence labelling was employed to reveal the distribution of chemically identified neurons within the pontine laterodorsal tegmental nucleus and dorsal raphe nucleus which supply branching collateral input to the central nucleus of the amygdala and hypothalamic paraventricular nucleus. The chemical identity of neurons in the laterodorsal tegmental nucleus was revealed by immunocytochemical detection of choline-acetyltransferase or substance P; in

Theodor Petrov; Teresa L. Krukoff; Jack H. Jhamandas

1994-01-01

417

Subthreshold pion production from nucleus-nucleus collisions around 100 MeV/nucleon  

NASA Astrophysics Data System (ADS)

Several global variables were tested with the aim to determine the impact parameter in nucleus-nucleus collisions producing pions at incident energies around 100 MeV/nucleon. The experimental set-up includes the MEDEA multidetector, part of which is used as a ? 0 spectrometer, and an additional hodoscope of plastic scintillators to cover very forward angles. A statistical model was used to generate both inclusive and pion-triggered events. Selection of well measured events was made through the measured total parallel momentum. Among the different global variables which were tested, the average parallel velocity was seen to give the best correlation with the impact parameter.

Badalá, A.; Barbera, R.; Palmeri, A.; Pappalardo, G. S.; Riggi, F.; Russo, A. C.

1993-12-01

418

Extraction of nucleus-nucleus potential and energy dissipation from dynamical mean-field theory  

SciTech Connect

Nucleus-nucleus interaction potentials in heavy-ion fusion reactions are extracted from the microscopic time-dependent Hartree-Fock theory. When the center-of-mass energy is much higher than the Coulomb barrier energy, extracted potentials identify with the frozen density approximation. As the center-of-mass energy decreases to the Coulomb barrier energy, potentials become energy dependent. This dependence indicates dynamical reorganization of internal degrees of freedom and leads to a reduction of the ''apparent'' barrier. Including this effect leads to the Coulomb barrier energy very close to experimental one. Aspects of one-body energy dissipation extracted from the mean-field theory are discussed.

Washiyama, Kouhei; Lacroix, Denis [GANIL, BP55027, 14076 Caen (France)

2009-03-04

419

Jet Tomography of High-Energy Nucleus-Nucleus Collisions at Next-to-Leading Order  

SciTech Connect

We demonstrate that jet observables are highly sensitive to the characteristics of the vacuum and the in-medium QCD parton showers and propose techniques that exploit this sensitivity to constrain the mechanism of quark and gluon energy loss in strongly interacting plasmas. As a first example, we calculate the inclusive jet cross section in high-energy nucleus-nucleus collisions to O({alpha}{sub s}{sup 3}). Theoretical predictions for the medium-induced jet broadening and the suppression of the jet production rate due to cold and hot nuclear matter effects in Au+Au and Cu+Cu reactions at RHIC are presented.

Vitev, Ivan [Theoretical Division, Los Alamos National Laboratory, MS B238, Los Alamos, New Mexico 87545 (United States); Zhang Benwei [Key Laboratory of Quark Lepton Physics, Hua-Zhong Normal University, Ministry of Education (China)

2010-04-02

420

Jet tomography of high-energy nucleus-nucleus collisions at next-to-leading order  

SciTech Connect

We demonstrate that jet observables are highly sensitive to the characteristics of the vacuum and the in-medium QCD parton showers and propose techniques that exploit this sensitivity to constrain the mechanism of quark and gluon energy loss in strongly-interacting plasmas. As a first example, we calculate the inclusive jet cross section in high-energy nucleus-nucleus collisions to {Omicron}({alpha}{sub s}{sup 3}). Theoretical predictions for the medium-induced jet broadening and the suppression of the jet production rate due to cold and hot nuclear matter effects in Au+Au and Cu+Cu reactions at RHIC are presented.

Vitev, Ivan [Los Alamos National Laboratory; Zhang, Ben - Wei [Los Alamos National Laboratory

2009-01-01

421

High energy factorization in nucleus-nucleus collisions. II. Multigluon correlations  

SciTech Connect

We extend previous results from the preceding paper on factorization in high energy nucleus-nucleus collisions by computing the inclusive multigluon spectrum to next-to-leading order. The factorization formula is strictly valid for multigluon emission in a slice of rapidity of width {delta}Y{<=}{alpha}{sub s}{sup -1}. Our results shows that often neglected disconnected graphs dominate the inclusive multigluon spectrum, and are crucial in order to achieve factorization for this quantity. These results provide a dynamical framework for the Glasma flux tube picture of the striking ''ridge''-like correlation seen in heavy ion collisions.

Gelis, Francois [Theory Division, PH-TH, Case C01600, CERN, CH-1211, Geneva 23 (Switzerland); Lappi, Tuomas [Institut de Physique Theorique (URA 2306 du CNRS) CEA/DSM/Saclay, Batiment 774 91191, Gif-sur-Yvette Cedex (France); Venugopalan, Raju [Physics Department, Brookhaven National Laboratory Upton, New York 11973 (United States)

2008-09-01

422

Rapidity signatures of phase transition in high energy nucleus-nucleus collisions  

NASA Astrophysics Data System (ADS)

The interaction of a 5-TeV Si nucleus with a Br or Ag target is simulated on the basis of the theoretical calculations of Elbert and Stanev (1983) and the parameterization of Stenlund and Otterlund (1982). The results are compared with observations of such a collision in the balloon-borne high-energy cosmic-ray data of Burnett et al. (1983), and an excess of particles with pseudorapidities greater than 3 is found. It is shown that this excess can be attributed to the formation of a phase-transition fireball in the Si nucleus.

Stanev, T.

423

Paraventricular hypothalamic nucleus: axonal projections to the brainstem  

PubMed Central

The paraventricular hypothalamic nucleus (PVH) contains many neurons that innervate the brainstem, but information regarding their target sites remains incomplete. Here, we labeled neurons in the rat PVH with an anterograde axonal tracer, Phaseolus vulgaris leucoagglutinin (PHAL) and studied their descending projections in reference to specific neuronal subpopulations throughout the brainstem. While many of their target sites were identified previously, numerous new observations were made. Major findings include: (1) In the midbrain, the PVH projects lightly to the ventral tegmental area, Edinger-Westphal nucleus, ventrolateral periaqueductal gray matter, reticular formation, pedunculopontine tegmental nucleus, and dorsal raphe nucleus. (2) In the dorsal pons, the PVH projects heavily to the pre-locus coeruleus, yet very little to the catecholamine neurons in the locus coeruleus, and selectively targets the viscerosensory subregions of the parabrachial nucleus; (3) In the ventral medulla, the superior salivatory nucleus, retrotrapezoid nucleus, compact and external formations of the nucleus ambiguus, A1 and caudal C1 catecholamine neurons, and caudal pressor area receive dense axonal projections, generally exceeding the PVH projection to the rostral C1 region; (4) The medial nucleus of the solitary tract (including A2 noradrenergic and aldosterone-sensitive neurons) receives the most extensive projections of the PVH, substantially more than the dorsal vagal nucleus or area postrema. Our findings suggest that the PVH may modulate a range of homeostatic functions, including cerebral and ocular blood flow, corneal and nasal hydration, ingestive behavior, sodium intake, and glucose metabolism, as well as cardiovascular, gastrointestinal, and respiratory activities.

Geerling, Joel C.; Shin, Jung-Won; Chimenti, Peter C.; Loewy, Arthur D.

2010-01-01

424

Sample of starburst nucleus galaxies (Contini+ 1998)  

NASA Astrophysics Data System (ADS)

This paper presents optical long-slit spectroscopic observations of 105 barred Markarian IRAS galaxies. These observations are used to determine the spectral type (starburst or Seyfert) of emission-line regions in the nucleus and along the bar of the galaxies, in order to define a homogeneous sample of Starburst Nucleus Galaxies (SBNGs). Our selection criteria (ultraviolet excess, far infrared emission and barred morphology) have been very efficient for selecting star-forming galaxies, since our sample of 221 emission-line regions includes 82% nuclear or extranuclear starbursts. The contamination by Seyferts is low (9%). The remaining galaxies (9%) are objects with ambiguous classification (HII or LINER). The dust content and H? luminosity increase towards the nuclei of the galaxies. No significant variation of the electron density is found between nuclear and bar HII regions. However, the mean H? luminosity and electron density in the bar are higher than in typical disk HII regions. We investigate different mechanisms for explaining the excess of nitrogen emission observed in our starburst nuclei. There is no evidence for the presence of a weak hidden active galactic nucleus in our starburst galaxies. The cause of this excess is probably a selective enrichment of nitrogen in the nuclei of the galaxies, following a succession of short and intense bursts of star formation. Our sample of SBNGs, located at a mean redshift of 0.015, has moderate H? (1041erg/s) and far infrared (1010L?) luminosities. The types are distributed equally among early- and late-type giant spirals with a slight preference for Sbc/Sc types because of their barred morphology. The majority (62%) of SBNGs are isolated with no sign of gravitational interaction. In terms of distance, luminosity and level of interaction, SBNGs are intermediate between HII galaxies and luminous infrared galaxies. (5 data files).

Contini, T.; Considere, S.; Davoust, E.

1997-11-01

425

Effect of Interlaminar Epidural Steroid Injection in Acute and Subacute Pain Due to Lumbar Disk Herniation: A Randomized Comparison of 2 Different Protocols  

PubMed Central

In order to assess the efficacy of epidural steroid injections (ESI) in acute and subacute pain due to lumbar spine disk herniation, we conducted a randomized trial, comparing 2 different protocols. Fourty patients with radicular pain due to L4-L5 and L5-S1 disc herniation were assigned to receive either 3 consecutive ESI every 24 hours through a spinal catheter (group A) or 3 consecutive ESI every 10 days with an epidural needle (group B). All patients had improved Oswestry Disabilty Index (ODI) and the Visual Analog Scale (VAS) for pain scores at 1 month of follow-up compared to baseline, while no significant differences were observed between the 2 groups. The scores for group B were statistically significant lower at 2 months of follow-up compared to those of group A. The improvement in the scores of group B was continuous since the mean scores at 2 months of follow up were lower compared to the respective scores at 1 month. Protocol B (3 consecutive ESI every 10 days) was found more effective in the treatment of subacute pain compared to Protocol A (3 consecutive ESI every 24 hours) with statistically significant differences in the ODI and VAS scores at 2 months of follow-up.

Gelalis, I.D; Arnaoutoglou, E; Pakos, E.E; Politis, A.N; Rapti, M; Xenakis, T.A; Papadopoulos, G

2009-01-01

426

Herniation of Duodenum into the Right Ventral Hepatic Peritoneal Cavity with Groove Formation at the Ventral Hepatic Surface in a 2-Week-Old Chicken.  

PubMed

Internal hernia in avian species is very rare. A necropsy of a 2-week-old SPF White Leghorn chicken revealed a loop of the duodenum and associated pancreas (4 × 2 × 1 cm) was protruded through abnormal foramen (2.5 cm in diameter) in the right posthepatic septum into the right ventral hepatic peritoneal cavity. The herniated loop located underneath the ventral hepatic surface leaving a groove on the right hepatic lobe (2 × 1.5 × 0.4 cm). The involved part of pancreas in the hernia was grossly enlarged. Microscopically, a zone of pressure atrophy of hepatic tissue was characterized by crowdedness of hepatocytes with pyknotic nuclei and faint eosinophilic cytoplasm and indistinct narrow sinusoids. The pancreas revealed hypertrophy of the acinar cells with an increase in the secretory granules and basophilic cytoplasm. This the first report of duodenum herniation into the right ventral hepatic peritoneal cavity resulting in groove formation on the ventral hepatic surface in a 2-week-old chicken. PMID:23759688

Haridy, Mohie; Sasaki, Jun; Goryo, Masanobu

2013-06-12

427

Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis  

PubMed Central

Background While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain. Methods A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain. Results One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1) or local anesthetic mixed with nonparticulate betamethasone (group 2). The primary outcome of significant pain relief and improvement in functional status (?50%) was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks. Conclusion Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.

Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh

2012-01-01

428

Analysis of the Volumes of the Posterior Cranial Fossa, Cerebellum, and Herniated Tonsils Using the Stereological Methods in Patients with Chiari Type I Malformation  

PubMed Central

Objective. The aim of this study was to determine the posterior cranial fossa volume, cerebellar volume, and herniated tonsillar volume in patients with chiari type I malformation and control subjects using stereological methods. Material and Methods. These volumes were estimated retrospectively using the Cavalieri principle as a point-counting technique. We used magnetic resonance images taken from 25 control subjects and 30 patients with chiari type I malformation. Results. The posterior cranial fossa volume in patients with chiari type I malformation was significantly smaller than the volume in the control subjects (P < 0.05). In the chiari type I malformation group, the cerebellar volume was smaller than the control group, but this difference was not statistically significant (P > 0.05). In the chiari type I malformation group, the ratio of cerebellar volume to posterior cranial fossa volume was higher than in the control group. We also found a positive correlation between the posterior cranial fossa volume and cerebellar volume for each of the groups (r = 0.865, P < 0.001). The mean (±SD) herniated tonsillar volume and length were 0.89 ± 0.50?cm3 and 9.63 ± 3.37?mm in the chiari type I malformation group, respectively. Conclusion. This study has shown that posterior cranial fossa and cerebellum volumes can be measured by stereological methods, and the ratio of these measurements can contribute to the evaluation of chiari type I malformation cases.

Vurdem, Umit Erkan; Acer, Niyazi; Ertekin, Tolga; Savranlar, Ahmet; Inci, Mehmet Fatih

2012-01-01

429

Parity violation in the compound nucleus  

SciTech Connect

Measurements have been performed on the helicity dependence of the neutron resonance cross section for many nuclei by our TRIPLE Collaboration. A large number of parity violations are observed. Generic enhancements amplify the signal for symmetry breaking and the stochastic properties of the compound nucleus permit the strength of the symmetry-breaking interaction to be determined without knowledge of the wave functions of individual states. A total of 15 nuclei have been analyzed with this statistical approach. The results are summarized. {copyright} {ital 1999 American Institute of Physics.}

Mitchell, G.E.; Crawford, B.E.; Grossmann, C.A.; Lowie, L.Y. [North Carolina State University, Raleigh, North Carolina 27695 and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708 (United States); Bowman, J.D.; Knudson, J.; Penttilae, S.; Seestrom, S.J.; Smith, D.A.; Yen, Y.; Yuan, V.W. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Delheij, P.P. [TRIUMF, Vancouver, British Columbia, V6T 2A3 (Canada); Haseyama, T.; Masaike, A.; Matsuda, Y. [Department of Physics, Kyoto University, Kyoto 606-8502 (Japan); Postma, H. [University of Technology, Delft, 2600 GA (the Netherlands); Roberson, N.R. [Duke University, Durham, North Carolina 27708 and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708 (United States); Sharapov, E.I. [Joint Institute for Nuclear Research, 141980 Dubna (Russia); Stephenson, S.L. [Gettysburg College, Gettysburg, Pennsylvania 17325 (United States)

1999-06-01

430

Spin flip effects in pion nucleus interactions  

SciTech Connect

We investigate the effect of spin flip in the reaction mechanism of pion nucleus interactions, theoretically and experimentally. We construct the microscopic optical potential in configuration space from first principles, summing particle-hole pair contributions. Subsequently, we solve the coupled-channel Klein-Gordon equation including spin flip and Fermi averaging corrections. We calculate the transition matrix elements for elastic, inelastic and charge exchange scattering. We compare and contrast to previous models with the aid of a code, based on the formalism as described. In addition, we analyze the experimental spectra obtained for the double charge exchange reaction [sup 93]Nb([pi][sup +], [pi][sup [minus

Kagarlis, M.A.

1993-03-01

431

Temperature dependence of ice critical nucleus size.  

PubMed

We present a molecular dynamics study of ice growth from supercooled water. By performing a series of simulations with different initial conditions, we have quantitative established the relationship existing between the critical nucleus size and the temperature. The results show that ice embryos containing hundreds or thousands of molecules are needed for the system to crystallize macroscopically, even at high degrees of supercooling. Our findings explain the difficulty in observing spontaneous ice nucleation in atomistic simulations and the relative ease with which water droplets can be supercooled under controlled experiments. PMID:21787014

Pereyra, Rodolfo G; Szleifer, Igal; Carignano, Marcelo A

2011-07-21