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Sample records for cervical polyetheretherketone peek

  1. Comparison of allograft and polyetheretherketone (PEEK) cage subsidence rates in anterior cervical discectomy and fusion (ACDF).

    PubMed

    Yson, Sharon C; Sembrano, Jonathan N; Santos, Edward Rainier G

    2017-04-01

    Structural allografts and PEEK cages are commonly used interbody fusion devices in ACDF. The subsidence rates of these two spacers have not yet been directly compared. The primary aim of this study was to compare the subsidence rate of allograft and PEEK cage in ACDF. The secondary aim was to determine if the presence of subsidence affects the clinical outcome. We reviewed 67 cases (117 levels) of ACDF with either structural allograft or PEEK cages. There were 85 levels (48 cases) with PEEK and 32 levels (19 cases) with allograft spacers. Anterior and posterior disc heights at each operative level were measured at immediate and 6months post-op. Subsidence was defined as a decrease in anterior or posterior disc heights >2mm. NDI of the subsidence (SG) and non-subsidence group (NSG) were recorded. Chi-square test was used to analyze subsidence rates. T-test was used to analyze clinical outcomes (α=0.05). There was no statistically significant difference between subsidence rates of the PEEK (29%; 25/85) and allograft group (28%; 9/32) (p=0.69). Overall mean subsidence was 2.3±1.7mm anteriorly and 2.6±1.2mm posteriorly. Mean NDI improvement was 11.7 (from 47.1 to 35.4; average follow-up: 12mos) for the SG and 14.0 (from 45.8 to 31.8; average follow-up: 13mos) for the NSG (p=0.74). Subsidence rate does not seem to be affected by the use of either PEEK or allograft as spacers in ACDF. Furthermore, subsidence alone does not seem to be predictive of clinical outcomes of ACDF.

  2. SESAME equation of state number 8020: Polyetheretherketone (PEEK)

    SciTech Connect

    Boettger, J.C.; Johnson, J.D.

    1993-12-01

    A new SESAME equation of state (EOS) for the polymer polyetheretherketone (PEEK) has been generated using the computer program GRIZZLY. This new EOS has been added to the SESAME EOS library as material number 8020. A few general guidelines for estimating the thermodynamic parameters for polymers needed to generate an EOS with GRIZZLY are suggested.

  3. [Polyetheretherketone (PEEK). Part II: application in clinical practice].

    PubMed

    Pokorný, D; Fulín, P; Slouf, M; Jahoda, D; Landor, I; Sosna, A

    2010-01-01

    Polyetheretherketone (PEEK) is one of the up-to-date organic polymer thermoplastics with applications in orthopaedics and trauma medicine. This study presents a detailed analysis of its tests and applications in clinical medicine. A wide range of PEEK modifications and composites are commercially available, e.g., PEEK-Classix, PEEK-Optima, Endolign and Motis. They differ in their physical properties, which makes them suitable for different applications. Other forms, so-called PEEK bioactive composites, contain beta-tricalcium phosphate and hydroxyapatite. Research in this field is also concerned with the surface finish of this polymer thermoplastic and involves macroporous titanium and hydroxyapatite layers, or treatment with laser for an exactly defined surface structure. The clinical applications of PEEK and its composites include, in addition to components for spinal surgery, osteosynthesis plates, screws, intramedullary nails or external fixators, which are implants still at the stage of prototypes. In this review, attention is paid to the use of PEEK thermoplastics for joint replacement. Mid-term studies involving hundreds of patients have shown that, for instance, the VerSys Epoch Fullcoat Hip System (Zimmer) has a markedly lower stress-shielding effect. Carbon fibre-reinforced (CFR-PEEK) composites are used to make articulating components for total hip replacement. Their convenient properties allow for production of much thinner liners and an enlargement of the femoral head diameter, thus reducing the wear of joint implants. CFR-PEEK composites are particularly effective for hip resurfacing in which the Mitch PCR (Stryker) acetabular component has been used with good results. The MOTIS polymer acetabular cup (Invibio Ltd.) is another example. Further PEEK applications include the construction of finger-joint prostheses (Mathys AG), suture anchors (Stryker) and various kinds of augmentations (Medin). Based on the information obtained, the authors suggest

  4. A constitutive model of polyether-ether-ketone (PEEK).

    PubMed

    Chen, Fei; Ou, Hengan; Lu, Bin; Long, Hui

    2016-01-01

    A modified Johnson-Cook (JC) model was proposed to describe the flow behaviour of polyether-ether-ketone (PEEK) with the consideration of coupled effects of strain, strain rate and temperature. As compared to traditional JC model, the modified one has better ability to predict the flow behaviour at elevated temperature conditions. In particular, the yield stress was found to be inversely proportional to temperature from the predictions of the proposed model.

  5. Investigation of the dynamic mechanical behavior of polyetheretherketone (PEEK) in the high stress tensile regime

    NASA Astrophysics Data System (ADS)

    Berer, M.; Major, Z.; Pinter, G.; Constantinescu, D. M.; Marsavina, L.

    2014-11-01

    Due to its outstanding mechanical performance both in static and dynamic loading and its resistance up to very high temperatures, Polyetheretherketone (PEEK) has attracted many practical applications. The loaded contact state for the application of PEEK rolls as bearing elements was recently analyzed by the corresponding author. High irreversible deformations on the mantle side were caused by the rolling contact and thus the rolling performance is supposed to be strongly affected by the dynamic mechanical properties of this irreversibly deformed material. Tensile fatigue tests at various stress levels up to the thermally dominated fatigue regime were conducted in order to get information regarding the dynamic mechanical material behavior at high stress regimes. Two types of PEEK (annealed and untreated) were investigated and two load ratios, R, were used (0.1 and 0.5). During the fatigue tests extensometer strain, load and surface temperature were recorded and a quantitative hysteresis loop analysis with calculated secant modulus and dynamic modulus was performed. Furthermore, the concept of isocyclic stress-strain diagrams was applied to enlarge and confirm the results obtained from the hysteresis loop analysis. A sharp transition between thermally dominated and mechanically dominated fatigue regimes was found for both PEEK types (annealed and untreated) and for both load ratios. Moreover, the annealed PEEK was stiffer in the tensile fatigue tests than the untreated material. Both examined PEEK types showed distinct hardening throughout the fatigue tests which made them "more elastic" (higher stiffness and less damping).

  6. Anterior cervical discectomy and fusion: Comparison of titanium and polyetheretherketone cages

    PubMed Central

    2012-01-01

    Background Titanium (TTN) cages have a higher modulus of elasticity when compared with polyetheretherketone (PEEK) cages. This suggests that TTN-cages could show more frequent cage subsidence after anterior cervical discectomy and fusion (ACDF) and therefore might lead to a higher loss of correction. We compared the long term results of stand-alone PEEK- and TTN-cages in a comparable patient collective that was operated under identical operative settings. Methods From 2002 to 2007 154 patients underwent single-level ACDF for degenerative disc disease (DDD). Clinical and radiological outcome were assessed in 86 eligible patients after a mean of 28.4 months. 44 patients received a TTN- and 42 patients a PEEK-cage. Results Solid arthrodesis was found in 93.2% of the TTN-group and 88.1% of the PEEK-group. Cage subsidence was observed in 20.5% of the TTN- and 14.3% of the PEEK-group. A significant segmental lordotic correction was achieved by both cage-types. Even though a loss of correction was found at the last follow-up in both groups, it did not reach the level of statistical significance. Statistical analysis of these results revealed no differences between the TTN- and PEEK-group. When assessed with the neck disability index (NDI), the visual analogue scale (VAS) of neck and arm pain and Odom’s criteria the clinical data showed no significant differences between the groups. Conclusions Clinical and radiological outcomes of ACDF with TTN- or PEEK-cages do not appear to be influenced by the chosen synthetic graft. The modulus of elasticity represents only one of many physical properties of a cage. Design, shape, size, surface architecture of a cage as well as bone density, endplate preparation and applied distraction during surgery need to be considered as further important factors. PMID:22978810

  7. In vitro and in vivo evaluation of bone morphogenetic protein-2 (BMP-2) immobilized collagen-coated polyetheretherketone (PEEK)

    NASA Astrophysics Data System (ADS)

    Du, Ya-Wei; Zhang, Li-Nan; Ye, Xin; Nie, He-Min; Hou, Zeng-Tao; Zeng, Teng-Hui; Yan, Guo-Ping; Shang, Peng

    2015-03-01

    Polyetheretherketone (PEEK) is regarded as one of the most potential candidates of biomaterials in spinal implant applications. However, as a bioinert material, PEEK plays a limited role in osteoconduction and osseointegration. In this study, recombinant human bone morphogenetic protein-2 (rhBMP-2) was immobilized onto the surface of collagen-coated PEEK in order to prepare a multi-functional material. After adsorbed onto the PEEK surface by hydrophobic interaction, collagen was cross-linked with N-(3-dimethylaminopropyl)-N'-ethyl carbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS). EDC/NHS system also contributed to the immobilization of rhBMP-2. Water contact angle tests, XPS and SEM clearly demonstrated the surface changes. ELISA tests quantified the amount of rhBMP-2 immobilized and the release over a period of 30 d. In vitro evaluation proved that the osteogenesis differentiation rate was higher when cells were cultured on modified PEEK discs than on regular ones. In vivo tests were conducted and positive changes of major parameters were presented. This report demonstrates that the rhBMP-2 immobilized method for PEEK modification increase bioactivity in vitro and in vivo, suggesting its practicability in orthopedic and spinal clinical applications.

  8. Study on the Tribological Behaviors of Different PEEK Composite Coatings for Use as Artificial Cervical Disk Materials

    NASA Astrophysics Data System (ADS)

    Song, Jian; Liao, Zhenhua; Wang, Song; Liu, Yuhong; Liu, Weiqiang; Tyagi, Rajnesh

    2016-01-01

    Poly(ether-ether-ketone) (PEEK) is a type of biomaterial which may be used for modifying the surface of materials used in implants. Hence, in the present investigation, the potentiality of PEEK and its composites coatings has been explored for improving the friction and wear behavior of the Ti6Al4V to be used for cervical disks. The structural characteristics, micro-hardness, friction, and wear characteristics of PEEK/Al2O3 and PEEK/SiO2 composite coatings have been investigated and compared with pure PEEK coating and bare titanium alloy sample. According to the XRD analysis results, these coated samples were mainly orthorhombic crystalline form. The contact angle values of PEEK and its composite coatings were higher, while micro-hardness values of these samples decreased significantly. The thickness values of the three coated samples were all above 70 μm on average. The average friction coefficients with a counterface of ZrO2 ball decreased significantly, especially under NCS (newborn calf serum) lubricated condition. After comprehensive evaluation, the PEEK/Al2O3 coating demonstrated optimum tribological properties and could be applied as bearing materials for artificial cervical disk.

  9. Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries

    PubMed Central

    Kim, Soo-Han; Lee, Jung-Kil; Jang, Jae-Won; Park, Hyun-Woong; Hur, Hyuk

    2017-01-01

    Objective This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2–7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries. PMID:28264242

  10. Comparison between Two Different Cervical Interbody Fusion Cages in One Level Stand-alone ACDF: Carbon Fiber Composite Frame Cage Versus Polyetheretherketone Cage

    PubMed Central

    Yoo, Minwook; Kim, Wook-Ha; Hyun, Seung-Jae; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2014-01-01

    Objective The authors conducted a retrospective study to compare the implantation of carbon fiber composite frame cages (CFCFCs) to the implantation of polyetheretherketone (PEEK) cages after anterior cervical discectomy for cervical degenerative disc disease. In addition, the predictive factors that influenced fusion or subsidence were investigated. Methods A total of 58 patients with single-level degenerative disc disease were treated with anterior cervical discectomy and implantation of stand-alone cages; CFCFCs were used in 35 patients, and PEEK cages were used in 23 patients. Preoperative and postoperative radiological and clinical assessments were performed. Results During the mean follow-up period of 41 months, fusion occurred in 43 patients (74.1%), and subsidence developed in 18 patients (31.0%). Pain decreased in all patients, and the patients' satisfaction rate was 75.9%. Neither fusion nor subsidence was related to the clinical outcome. There were no significant differences in the clinical and radiological outcomes between the CFCFC and the PEEK cage groups. Smoking history (p=0.023) was significantly associated with pseudarthrosis, and cage height (≥7mm) (p=0.037) were significantly associated with subsidence. Conclusion The clinical and radiological results were similar between the CFCFC and the PEEK cage groups. Fusion or subsidence did not affect the clinical outcomes. Smoking history and cage height (≥7mm) were predictive factors for pseudarthrosis or subsidence in anterior cervical discectomy and fusion with stand-alone cages. PMID:25346758

  11. Four-corner arthrodesis with a locking, dorsal circular polyether-ether-ketone (PEEK-Optima) plate.

    PubMed

    Rhee, Peter C; Kakar, Sanjeev; Shin, Alexander Y

    2012-12-01

    Scaphoidectomy and 4-corner arthrodesis can be a successful salvage procedure for scaphoid nonunion advanced collapse and scapholunate advanced collapse. Traditional methods of fixation include Kirschner wires, staples, and/or headless compression screws. Nonlocking, dorsal circular plates, manufactured from stainless steel, have been advocated to allow early wrist range of motion and improved union rates. However, the reported union rates have been variable and inconsistent. This wide results have been attributed to the difficulty in assessing union with plain film radiograph due to the radio-opaque plate. Recently, a locking, dorsal circular plate, comprised of a radiolucent polyether-ether-ketone (PEEK-Optima), has been introduced with the additional benefit of providing a fixed-angle construct and allowing a more accurate assessment of bone union with plain film imaging studies.

  12. The influence of nominal stress on wear factors of carbon fibre-reinforced polyetheretherketone (PEEK-OPTIMA® Wear Performance) against zirconia toughened alumina (Biolox® delta ceramic).

    PubMed

    Evans, Andrew; Horton, Henrietta; Unsworth, Anthony; Briscoe, Adam

    2014-06-01

    Carbon fibre-reinforced polyetheretherketone is an attractive alternative to ultra-high-molecular-weight polyethylene in artificial joints, but little has been published on the influence of stress on the wear factor. We know that in ultra-high-molecular-weight polyethylene, the wear factor reduces as the normal stress increases, which is counter-intuitive but very helpful in the case of non-conforming contacts. In this study, carbon fibre-reinforced polyetheretherketone (PEEK-OPTIMA(®) Wear Performance) has been investigated in a pin-on-plate machine under steady loads and under stresses typical of hip and knee joints. At stresses below about 6 MPa, wear factors are between 10 and a 100 times lower than for ultra-high-molecular-weight polyethylene but at higher stresses the wear factors increase substantially.

  13. The Use of a Modified Poly-Ether-Ether-Ketone (PEEK) as an Alternative Framework Material for Removable Dental Prostheses. A Clinical Report.

    PubMed

    Zoidis, Panagiotis; Papathanasiou, Ioannis; Polyzois, Gregory

    2016-10-01

    This clinical report presents a modified poly-ether-ether-ketone (PEEK) as an alternative material for the fabrication of distal extension removable dental prosthesis (RDP) frameworks. This material can be used for patients allergic to metals, or who dislike the metallic taste, the weight, and the unpleasant metal display of the denture framework and retentive clasps. This modified PEEK material, known as BioHPP, is a biocompatible, nonallergic, rigid material, with flexibility comparable to bone, high polishing and low absorption properties, low plaque affinity, and good wear resistance. It has been used for years in orthopedics and medical technology. BioHPP frameworks can be constructed either via CAD/CAM manufacturing or via the conventional lost wax technique. The clinical use of a BioHPP RDP framework is presented as an alternative for the treatment of a distal extension case.

  14. [Use of the PEEK cage in cervical spondylosis treatment].

    PubMed

    Joachin-Hernández, Pedro; Alpízar-Aguirre, Armando; Zárate-Kalfópulus, Barón; Rosales-Olivares, Luis Miguel; Sánchez-Bringas, Guadalupe; Reyes-Sánchez, Alejandro Antonio

    2013-01-01

    Antecedentes: la descompresión y artrodesis con auto-injerto es el patrón de referencia para el tratamiento del conducto cervical estrecho. El uso de cajas de PEEK polímero no reabsorbible, con elasticidad similar al hueso, radiolúcido, y mismo grado de fusión reduce la morbilidad. aterial y métodos: estudio de serie de casos, prospectivo, longitudinal, de intervención deliberada, evaluación en grupol antes y después, seguimiento a dos años. Discoidectomía y colocación de caja de PEEK con injerto autólogo. Se evaluaron artrodesis, lordosis cervical, altura del espacio intervertebral, dolor mediante escala visual análoga, índice de discapacidad cervical, tiempo quirúrgico, sangrado transoperatorio, estancia intrahospitalaria y complicaciones. Análisis estadístico con t de Student, Wilcoxon y exacta de Fisher. Resultados: de 17 pacientes estudiados, 9 (53%) eran del sexo femenino. La edad promedio 62 años. Sangrado promedio de 187 mL. El nivel más afectado fue C5-C6, C6-C7 en cinco pacientes. Se encontró fusión al 100% sin hundimiento ni migración de la caja, altura del espacio conservada, pero no se conservó la lordosis segmentaria. Mejoría clínica en todos los pacientes, y del índice de discapacidad. Conclusión: la disminución de los síntomas, la conservación de la altura del espacio anterior y posterior, la no conservación de la lordosis segmentaria y la fusión con caja de PEEK fueron congruentes con lo reportado en la bibliografía. Se sugiere utilizar la placa anterior para mantener la lordosis cervical. El índice de fusión encontrado fue de 100%, con disminución de los síntomas de dolor y discapacidad. Pérdida de lordosis cervical global.

  15. SU-E-J-38: Improved DRR Image Quality Using Polyetheretherketone (PEEK) Fiducial in Image Guided Radiotherapy (IGRT)

    SciTech Connect

    Shen, S; Jacob, R; Popple, R; Duan, J; Wu, X; Cardan, R; Brezovich, I

    2015-06-15

    Purpose Fiducial-based imaging is often used in IGRT. Traditional gold fiducial marker often has substantial reconstruction artifacts. These artifacts Result in poor image quality of DRR for online kV-to-DRR matching. This study evaluated the image quality of PEEK in DRR in static and moving phantom. Methods CT scan of the Gold and PEEK fiducial (both 1×3 mm) was acquired in a 22 cm cylindrical phantom filled with water. Image artifacts was evaluated with maximum CT value deviated from water due to artifacts; volume of artifacts in 10×10 cm in the center slice; maximum length of streak artifacts from the fiducial. DRR resolution were measured using FWHM and FWTM. 4DCT of PEEK fiducial was acquired with the phantom moving sinusoidally in superior-inferior direction. Motion artifacts were assessed for various 4D phase angles. Results The maximum CT value deviation was −174 for Gold and −24 for PEEK. The volume of artifacts in a 10x10 cm 3 mm slice was 0.369 for Gold and 0.074 cm3 for PEEK. The maximum length of streak artifact was 80mm for Gold and 7 mm for PEEK. PEEK in DRR, FWHM was close to actual (1.0 mm for Gold and 1.1 mm for PEEK). FWTM was 1.8 mm for Gold and 1.3 mm for PEEK in DRR. Barrel motion artifact of PEEK fiducial was noticeable for free-breathing scan. The apparent PEEK length due to residual motion was in close agreement with the calculated length (13 mm for 30–70 phase, 10 mm in 40–60 phase). Conclusion Streak artifacts on planning CT associated with use of gold fiducial can be significantly reduced by PEEK fiducial, while having adequate kV image contrast. DRR image resolution at FWTM was improved from 1.8 mm to 1.3 mm. Because of this improvement, we have been routinely use PEEK for liver IGRT.

  16. Wear studies on ZrO2-filled PEEK as coating bearing materials for artificial cervical discs of Ti6Al4V.

    PubMed

    Song, Jian; Liu, Yuhong; Liao, Zhenhua; Wang, Song; Tyagi, Rajnesh; Liu, Weiqiang

    2016-12-01

    Polyetheretherketone (PEEK) and its composite coatings are believed to be the potential candidates' bio-implant materials. However, these coatings have not yet been used on the surface of titanium-based orthopedics and joint products and very few investigations on the tribological characteristics could be found in the published literature till date. In this study, the wettabilities, composition and micro-hardness were characterized using contact angle measurement, scanning electron microscopy (SEM) and hardness tester. The tribological tests were conducted using a ball-on-disc contact pair under 25% newborn calf serum (NCS) lubricated condition. For comparison, bare Ti6Al4V was studied. The obtained results revealed that those PEEK/ZrO2 composite coatings could improve the tribological properties of Ti6Al4V significantly. Adhesive wear and mild abrasive wear might be the dominant wear and failure mechanisms for PEEK/ZrO2 composite coatings in NCS lubricated condition. After comprehensive evaluation in the present study, 5wt.% ZrO2 nanoparticles filled PEEK coating displayed the optimum tribological characteristics and could be taken as a potential candidate for the bearing material of artificial cervical disc.

  17. Adhesion bonding techniques for highly loaded parts of continuous carbon-fiber reinforced polyetheretherketone (CF-PEEK/APC2)

    NASA Astrophysics Data System (ADS)

    Kempe, G.; Krauss, H.

    It is shown that the adhesion technology is applicable to the bonding of continuous fiber reinforced thermplastics. The influences and conditions under which an enhancement of the bonding strength can be achieved are described. Attention is focused on the applicability of the adhesion method to continuous fiber reinforced PEEK, acknowledging that PEEK is very resistant to chemicals and thereby, a poor candidate for the technique.

  18. Isothermal physical aging characterization of Polyether-ether-ketone (PEEK) and Polyphenylene sulfide (PPS) films by creep and stress relaxation

    NASA Astrophysics Data System (ADS)

    Guo, Yunlong; Bradshaw, Roger D.

    2007-03-01

    This paper considers the experimental characterization of isothermal physical aging of PEEK and PPS films using a dynamic mechanical analyzer. Using the short-term test method established by Struik, momentary creep and stress relaxation curves were measured at several temperatures within 15-35°C below the glass transition temperature ( T g ) at various aging times. Stress and strain levels were such that the materials remained in the linear viscoelastic regime. These curves were then shifted together to determine momentary master curves and shift rates using the PHYAGE program. In order to validate the obtained isothermal physical aging behavior, the results of creep and stress relaxation testing were compared and shown to be consistent with one another using appropriate interconversion of the viscoelastic material functions. Time-temperature superposition of the master curves was also performed. The temperature shift factors and aging shift rates for both PEEK and PPS were consistent for both creep and stress relaxation test results.

  19. Anterior cervical discectomy with fusion in patients with cervical disc degeneration: a prospective outcome study of 258 patients (181 fused with autologous bone graft and 77 fused with a PEEK cage)

    PubMed Central

    2010-01-01

    Background Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure. The aim of this study was to evaluate the clinical outcome of ACDF, with respect to both patient selection and choice of surgical procedure: fusion with an autologous iliac crest graft (AICG) versus fusion with an artificial cage made of polyetheretherketone (PEEK). Methods This was a non-randomized prospective single-center outcome study of 258 patients who underwent ACDF for cervical disc degeneration (CDD). Fusion was attained with either tricortical AICG or PEEK cages without additional anterior plating, with treatment selected at surgeon's discretion. Radicular pain, neck-pain, headache and patient satisfaction with the treatment were scored using the visual analogue scale (VAS). Results The median age was 47.5 (28.3-82.8) years, and 44% of patients were female. 59% had single-level ACDF, 40% had two level ACDF and 1% had three-level ACDF. Of the patients, 181 were fused with AICG and 77 with a PEEK-cage. After surgery, the patients showed a significant reduction in radicular pain (ΔVAS = 3.05), neck pain (ΔVAS = 2.30) and headache (ΔVAS = 0.55). Six months after surgery, 48% of patients had returned to work: however 24% were still receiving workers' compensation. Using univariate and multivariate analyses we found that high preoperative pain intensity was significantly associated with a decrease in pain intensity after surgery, for all three pain categories. There were no significant correlations between pain relief and the following patient characteristics: fusion method (AICG or PEEK-cage), sex, age, number of levels fused, disc level fused, previous neck surgery (except for neck pain), previous neck trauma, or preoperative symptom duration. Two hundred out of the 256 (78%) patients evaluated the surgical result as successful. Only 27/256 (11%) classified the surgical result as a failure. Patient satisfaction

  20. Correction of a mandibular asymmetry after fibula reconstruction using a custom-made polyetheretherketone (PEEK) onlay after implant supported occlusal rehabilitation.

    PubMed

    Berrone, M; Aldiano, C; Pentenero, M; Berrone, S

    2015-10-01

    This study describes an unusual case of mandibular asymmetry after fibula free flap reconstruction in a young man following major facial trauma that was corrected using a custom-made polyetheretherketone prosthesis. There is little information in the literature on the use of alloplasts to correct mandibular asymmetry as interest in 'aesthetic re-modelling' has traditionally focused on nasal, zygomatic and chin regions. This report demonstrates that this technique can be used successfully to address selected cases of mandibular asymmetry.

  1. The rate of successful four-corner arthrodesis with a locking, dorsal circular polyether-ether-ketone (PEEK-Optima) plate.

    PubMed

    Rhee, P C; Shin, A Y

    2013-09-01

    The purpose of this study is to evaluate the rate of union after four-corner arthrodesis with a locking, dorsal circular plate comprised of polyether-ether-ketone. A retrospective review was conducted of all patients who underwent four-corner arthrodesis with a locking, dorsal circular plate at our institution from January 2005 to May 2009. The primary outcome measure was radiographic and clinical union. During the study period, 26 consecutive wrists underwent four-corner arthrodesis with a locking, dorsal circular plate. Twenty-three wrists were included. The mean clinical follow-up was 16 months (range 3-37). Union was achieved in 22 of 23 wrists at a mean time of 3 months (range 1-12). There was one partial union that underwent successful revision arthrodesis. In summary, four-corner fusion with a polyether-ether-ketone locking, dorsal circular plate results in high union rates. The use of a radiolucent plate allows for more accurate assessment of union with the biomechanical advantages of a fixed angle construct.

  2. Fracture resistance of abutment screws made of titanium, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone.

    PubMed

    Neumann, Eduardo Aloisio Fleck; Villar, Cristina Cunha; França, Fabiana Mantovani Gomes

    2014-01-01

    Fractured abutment screws may be replaced; however, sometimes, the screw cannot be removed and the entire implant must be surgically removed and replaced. The aim of this study was to compare the fracture resistance of abutment retention screws made of titanium, polyetheretherketone (PEEK) and 30% carbon fiber-reinforced PEEK, using an external hexagonal implant/UCLA-type abutment interface assembly. UCLA-type abutments were fixed to implants using titanium screws (Group 1), polyetheretherketone (PEEK) screws (Group 2), and 30% carbon fiber-reinforced PEEK screws (Group 3). The assemblies were placed on a stainless steel holding apparatus to allow for loading at 45o off-axis, in a universal testing machine. A 200 N load (static load) was applied at the central point of the abutment extremity, at a crosshead speed of 5 mm/minute, until failure. Data was analyzed by ANOVA and Tukey's range test. The titanium screws had higher fracture resistance, compared with PEEK and 30% carbon fiber-reinforced PEEK screws (p < 0.05). In contrast, no statistically significant difference was observed between the fracture resistance of the PEEK and the 30% carbon fiber-reinforced PEEK screws (p> 0.05). Finally, visual analysis of the fractions revealed that 100% of them occurred at the neck of the abutment screw, suggesting that this is the weakest point of this unit. PEEK abutment screws have lower fracture resistance, in comparison with titanium abutment screws.

  3. PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

    PubMed Central

    Krüger, Marie T.; Sircar, Ronen; Kogias, Evangelos; Scholz, Christoph; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

    2014-01-01

    Purpose. To compare radiographic and clinical outcomes after anterior cervical discectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up. Methods. Anterior cervical discectomy was performed in 107 patients in one or two levels using empty PEEK cages (51 levels), Sulcem PMMA spacers (49 levels) or Palacos PMMA spacers (41 levels) between January, 2005 and February, 2009. Bony fusion, subsidence, and sagittal alignment were retrospectively assessed in CT scans and radiographs at follow-up. Clinical outcome was measured using the VAS, NDI, and SF-36. Results. Bony fusion was assessed in 65% (PEEK cage), 57% (Sulcem), and 46% (Palacos) after a mean follow-up of 2.5 years. Mean subsidence was 2.3–2.6 mm without significant differences between the groups. The most pronounced loss of lordosis was found in PEEK cages (−4.1°). VAS was 3.1 (PEEK cage), 3.6 (Sulcem), and 2.7 (Palacos) without significant differences. Functional outcome in the PEEK cage and Palacos group was superior to the Sulcem group. Conclusions. The substitute groups showed differing fusion rates. Clinical outcome, however, appears to be generally not correlated with fusion status or subsidence. We could not specify a superior disc substitute for anterior cervical discectomy. This trial is registered with DRKS00003591. PMID:25110734

  4. [After titanium, peek ?].

    PubMed

    Meningaud, J-P; Spahn, F; Donsimoni, J-M

    2012-11-01

    The PEEK-Optima(®), composite mixture of polyetheretherketon and inert materials, is used in orthopedics, spinal surgery and cranio-facial surgery. It could be used in dental implantology because of its biological and mechanical properties. The results of an experimental and finite element study made on basal implant prototypes, on basal implantology show that PEEK, contrary to titanium, has a compound structure that allows to optimize the distribution of masticatory forces around the implant. These results should be confirmed by a clinical study according to research regulation.

  5. Current Strategies to Improve the Bioactivity of PEEK

    PubMed Central

    Ma, Rui; Tang, Tingting

    2014-01-01

    The synthetic thermoplastic polymer polyetheretherketone (PEEK) is becoming a popular component of clinical orthopedic and spinal applications, but its practical use suffers from several limitations. Although PEEK is biocompatible, chemically stable, radiolucent and has an elastic modulus similar to that of normal human bone, it is biologically inert, preventing good integration with adjacent bone tissues upon implantation. Recent efforts have focused on increasing the bioactivity of PEEK to improve the bone-implant interface. Two main strategies have been used to overcome the inert character of PEEK. One approach is surface modification to activate PEEK through surface treatment alone or in combination with a surface coating. Another strategy is to prepare bioactive PEEK composites by impregnating bioactive materials into PEEK substrate. Researchers believe that modified bioactive PEEK will have a wide range of orthopedic applications. PMID:24686515

  6. Polyetheretherketone/nano-fluorohydroxyapatite composite with antimicrobial activity and osseointegration properties.

    PubMed

    Wang, Lixin; He, Shu; Wu, Xiaomian; Liang, Shanshan; Mu, Zhonglin; Wei, Jie; Deng, Feng; Deng, Yi; Wei, Shicheng

    2014-08-01

    Lack of antibacterial activity and binding ability to natural bone tissue has significantly limited polyetheretherketone (PEEK) for many challenging dental implant applications. Here, we have developed a polyetheretherketone/nano-fluorohydroxyapatite (PEEK/nano-FHA) biocomposite with enhanced antibacterial activity and osseointegration through blending method. Smooth and rough surfaces of PEEK/nano-FHA biocomposites were also prepared. Our results showed that in vitro initial cell adhesion and proliferation on the nano-FHA reinforced PEEK composite were improved. In addition, higher alkaline phosphatase activity and cell mineralization were also detected in cells cultured on PEEK/nano-FHA biocomposites, especially for rough PEEK/nano-FHA surfaces. More importantly, the as-prepared PEEK/nano-FHA biocomposite could effectively prevent the proliferation and biofilm formation of bacterial. For in vivo test, the newly formed bone volume of PEEK/nano-FHA group was higher than that of bare PEEK group based on 3D microcomputed tomography and 2D histomorphometric analysis. These reports demonstrate that the developed PEEK/nano-FHA biocomposite has increased biocompatibility and antibacterial activity in vitro, and promoted osseointegration in vivo, which suggests that it holds potential to be applied as dental implant material in dental tissue engineering applications.

  7. Bioactive carbon-PEEK composites prepared by chemical surface treatment.

    PubMed

    Miyazaki, Toshiki; Matsunami, Chisato; Shirosaki, Yuki

    2017-01-01

    Polyetheretherketone (PEEK) has attracted much attention as an artificial intervertebral spacer for spinal reconstruction. Furthermore, PEEK plastic reinforced with carbon fiber has twice the bending strength of pure PEEK. However, the PEEK-based materials do not show ability for direct bone bonding, i.e., bioactivity. Although several trials have been conducted for enabling PEEK with bioactivity, few studies have reported on bioactive surface modification of carbon-PEEK composites. In the present study, we attempted the preparation of bioactive carbon-PEEK composites by chemical treatments with H2SO4 and CaCl2. Bioactivity was evaluated by in vitro apatite formation in simulated body fluid (SBF). The apatite formation on the carbon-PEEK composite was compared with that of pure PEEK. Both pure PEEK and carbon-PEEK composite formed the apatite in SBF when they were treated with H2SO4 and CaCl2; the latter showed higher apatite-forming ability than the former. It is conjectured that many functional groups able to induce the apatite nucleation, such as sulfo and carboxyl groups, are incorporated into the dispersed carbon phase in the carbon-PEEK composites.

  8. PEEK dental implants: a review of the literature.

    PubMed

    Schwitalla, Andreas; Müller, Wolf-Dieter

    2013-12-01

    The insertion of dental implants containing titanium can be associated with various complications (eg, hypersensitivity to titanium). The aim of this article is to evaluate whether there are existing studies reporting on PEEK (polyetheretherketone) as an alternative material for dental implants. A systematic literature search of PubMed until December 2010 yielded 3 articles reporting on dental implants made from PEEK. One article analyzed stress distribution in carbon fiber-reinforced PEEK (CFR-PEEK) dental implants by the 3-dimensional finite element method, demonstrating higher stress peaks due to a reduced stiffness compared to titanium. Two articles reported on investigations in mongrel dogs. The first article compared CFR-PEEK to titanium-coated CFR-PEEK implants, which were inserted into the femurs and evaluated after 4 and 8 weeks. The titanium-coated implants showed significantly higher bone-implant contact (BIC) rates. In a second study, implants of pure PEEK were inserted into the mandibles beside implants made from titanium and zirconia and evaluated after 4 months, where PEEK presented the lowest BIC. The existing articles reporting on PEEK dental implants indicate that PEEK could represent a viable alternative material for dental implants. However, further experimental studies on the chemical modulation of PEEK seem to be necessary, mainly to increase the BIC ratio and to minimize the stress distribution to the peri-implant bone.

  9. Outcomes Evaluation of Zero-Profile Devices Compared to Stand-Alone PEEK Cages for the Treatment of Three- and Four-Level Cervical Disc Disease

    PubMed Central

    Paschel, Erin; Mashaly, Hazem; Sabry, Hatem; Jalalod'din, Hasan; Saoud, Khaled

    2016-01-01

    Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF. Methods: Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B). Results: In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia.  Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three- and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery. PMID:27738574

  10. Notch Sensitivity of PEEK in Monotonic Tension

    PubMed Central

    Sobieraj, MC; Kurtz, SM; Rimnac, CM

    2009-01-01

    Poly(ether-ether-ketone) (PEEK) has been used as a load bearing orthopaedic implant material with clinical success. All of the orthpaedic applications contain stress concentrations (notches) in their design; however, little work has been done to examine the stress-strain behavior of PEEK in the presence of a notch. This work examines both the stress-strain behavior and the fracture behavior of neat PEEK in a uniaxial loaded condition, and in circumferentially grooved round bar specimens with different elastic stress concentration factors. It was found that the material shows ductile necking in the smooth condition and that this is almost completely suppressed in the notched conditions. Additionally, the deformation and fracture micromechanisms changed drastically, from one of plastic deformation and void coalescence to one dominated by crazing and brittle fast fracture. This change in mechanism was explained via Neuber's theory of stresses at a notch. PMID:19733391

  11. Research on Tribological Behavior of PEEK and Glass Fiber Reinforced PEEK Composite

    NASA Astrophysics Data System (ADS)

    Li, E. Z.; Guo, W. L.; Wang, H. D.; Xu, B. S.; Liu, X. T.

    The tribological behaviors of pure polyetheretherketone (PEEK) and PEEK composites reinforced by 30wt% short glass fibers (GF) were comparatively evaluated on a ball-on-disc configuration at room temperature. The effects of applied load and sliding time on the friction coefficient and wear loss of the GF/PEEK were examined. The mechanical property, morphology and thermal performance of the composite were studied. The results indicated that the friction coefficient and wear loss of the composite increased gradually and tended to be a stable state as the increase of applied load and sliding time. The GF/PEEK has an excellent wear resistance, compared with PEEK. The SEM and EDS indicated that the short glass-fibers were extruded from the composite rather than pulverized into the composite. Compared with that of pure PEEK, the thermal decomposition temperature of GF/PEEK composite had an increase of 75 °C. The tensile strength and flexural strength of the composite were increased by 64% and 66%, respectively.

  12. Osseointegration of nanohydroxyapatite- or nano-calcium silicate-incorporated polyetheretherketone bioactive composites in vivo.

    PubMed

    Ma, Rui; Yu, Zhifeng; Tang, Songchao; Pan, Yongkang; Wei, Jie; Tang, Tingting

    Polyetheretherketone (PEEK) exhibits appropriate biomechanical strength as well as good biocompatibility and stable chemical properties but lacks bioactivity and cannot achieve highly efficient osseointegration after implantation. Incorporating bioceramics into the PEEK matrix is a feasible approach for improving its bioactivity. In this study, nanohydroxyapatite (n-HA) and nano-calcium silicate (n-CS) were separately incorporated into PEEK to prepare n-HA/PEEK and n-CS/PEEK biocomposites, respectively, using a compounding and injection-molding technique, and the in vitro degradation characteristics were evaluated. Discs with a diameter of 8 mm were inserted in 8 mm full-thickness cranial defects in rabbits for 4 and 8 weeks, and implantation of pure PEEK was used as the control. Three-dimensional microcomputed tomography, histological analysis, fluorescence microscopy of new bone formation, and scanning electron microscopy were used to evaluate the osseointegration performance at the bone/implant interface. The results of the in vitro degradation study demonstrated that degradation of n-CS on the surface of n-CS/PEEK could release Ca and Si ions and form a porous structure. In vivo tests revealed that both n-CS/PEEK and n-HA/PEEK promoted osseointegration at the bone/implant interface compared to PEEK, and n-CS/PEEK exhibited higher bone contact ratio and more new bone formation compared with those of n-HA/PEEK, implying that n-CS/PEEK possessed a stronger ability to promote osseointegration. These two PEEK biocomposites are promising materials for the preparation of orthopedic or craniofacial implants.

  13. Osseointegration of nanohydroxyapatite- or nano-calcium silicate-incorporated polyetheretherketone bioactive composites in vivo

    PubMed Central

    Ma, Rui; Yu, Zhifeng; Tang, Songchao; Pan, Yongkang; Wei, Jie; Tang, Tingting

    2016-01-01

    Polyetheretherketone (PEEK) exhibits appropriate biomechanical strength as well as good biocompatibility and stable chemical properties but lacks bioactivity and cannot achieve highly efficient osseointegration after implantation. Incorporating bioceramics into the PEEK matrix is a feasible approach for improving its bioactivity. In this study, nanohydroxyapatite (n-HA) and nano-calcium silicate (n-CS) were separately incorporated into PEEK to prepare n-HA/PEEK and n-CS/PEEK biocomposites, respectively, using a compounding and injection-molding technique, and the in vitro degradation characteristics were evaluated. Discs with a diameter of 8 mm were inserted in 8 mm full-thickness cranial defects in rabbits for 4 and 8 weeks, and implantation of pure PEEK was used as the control. Three-dimensional microcomputed tomography, histological analysis, fluorescence microscopy of new bone formation, and scanning electron microscopy were used to evaluate the osseointegration performance at the bone/implant interface. The results of the in vitro degradation study demonstrated that degradation of n-CS on the surface of n-CS/PEEK could release Ca and Si ions and form a porous structure. In vivo tests revealed that both n-CS/PEEK and n-HA/PEEK promoted osseointegration at the bone/implant interface compared to PEEK, and n-CS/PEEK exhibited higher bone contact ratio and more new bone formation compared with those of n-HA/PEEK, implying that n-CS/PEEK possessed a stronger ability to promote osseointegration. These two PEEK biocomposites are promising materials for the preparation of orthopedic or craniofacial implants. PMID:27881916

  14. Investigation on polyetheretherketone composite for long term storage of nuclear waste

    NASA Astrophysics Data System (ADS)

    Ajeesh, G.; Bhowmik, Shantanu; Sivakumar, Venugopal; Varshney, Lalit; Kumar, Virendra; Abraham, Mathew

    2015-12-01

    This investigation highlights the effect of radiation, chemical and thermal environments on mechanical and thermal properties of Polyetheretherketone (PEEK) composites, which could prove to be an alternative material for long term storage of nuclear wastes. The tests are conducted on specimens made from PEEK and PEEK reinforced with carbon short fiber. The specimens are subjected to radiation doses, equivalent to the cumulative dosage for 500 years followed by exposure under highly corrosive and thermal environments. Studies under optical microscopy reveal that the dispersion of carbon short fiber in the PEEK Composites is significantly uniform. Differential scanning calorimeter (DSC) and thermo gravimetric analysis (TGA) indicates that there are no significant changes in thermal properties of PEEK composite when exposed to aggressive environments. It is further observed that there are no significant changes in mechanical properties of the composite after exposure to radiation and thermo-chemical environment.

  15. Notched Fatigue Behavior of PEEK

    PubMed Central

    Murphy, JE; Brinkman, JG; Kurtz, SM; Rimnac, CM

    2013-01-01

    Poly(ether-ether-ketone) (PEEK) has been used as a load bearing orthopaedic implant material with clinical success. All of the orthopaedic applications contain stress concentrations (notches) in their design; however, little work has been done to examine the fatigue behavior of PEEK in the presence of a notch. This work examines both stress-life (SN) fatigue behavior and the fracture behavior of unfilled PEEK under tension tension loading in circumferentially grooved round bar specimens with different elastic stress concentration factors. It was found that the majority of the loading was elastic in nature, and that there was only a small portion on the lifetime where there was a detectable change in structural behavior prior to gross fracture. Fractographic analysis via SEM further elucidated the potential fracture micromechanisms. Additional analysis was conducted to estimate the percent of the lifetime spent in crack initiation vs propagation, and it was found that the specimens spent the majority of the time in the crack initiation phase. PMID:20864160

  16. Evaluation of fatigue strength of plain and notched specimens of short carbon-fiber reinforced polyetheretherketone in comparison with polyetheretherketone

    NASA Astrophysics Data System (ADS)

    Nisitani, H.; Noguchi, H.; Kim, Y.-H.

    1992-11-01

    Rotating-bending fatigue tests of short carbon-fiber reinforced polyetheretherketone (CFRPEEK) and polyetheretherketone (PEEK) were carried out to investigate the fatigue characteristics of plain and notched specimens at room temperature. The fatigue mechanisms in the matrix and composite were clarified through successive surface observations using the replica method. The results were discussed using linear notch mechanics. In the plain specimen of PEEK, fracture always occurs from defects and the fatigue crack initiation is of the point-initiation type. Furthermore, the fatigue crack growth rate is very high and the fatigue strength is very sensitive to a notch. The fatigue strength of the composite is much more insensitive to a notch than that of PEEK. In general the fatigue crack initiates from near the fiber end, and propagates to the circumferential direction after it grows to some extent along the fiber. The fatigue strength of an arbitrary notched specimen of these two materials will be estimated from the present results rearranged based on 'linear notch mechanics'.

  17. Preparation, characterization, and in vitro osteoblast functions of a nano-hydroxyapatite/polyetheretherketone biocomposite as orthopedic implant material

    PubMed Central

    Ma, Rui; Tang, Songchao; Tan, Honglue; Lin, Wentao; Wang, Yugang; Wei, Jie; Zhao, Liming; Tang, Tingting

    2014-01-01

    A bioactive composite was prepared by incorporating 40 wt% nano-hydroxyapatite (nHA) into polyetheretherketone (PEEK) through a process of compounding, injection, and molding. The mechanical and surface properties of the nHA/PEEK composite were characterized, and the in vitro osteoblast functions in the composite were investigated. The mechanical properties (elastic modulus and compressive strength) of the nHA/PEEK composite increased significantly, while the tensile strength decreased slightly as compared with PEEK. Further, the addition of nHA into PEEK increased the surface roughness and hydrophilicity of the nHA/PEEK composite. In cell tests, compared with PEEK and ultra-high-molecular-weight polyethylene, it was found that the nHA/PEEK composite could promote the functions of MC3T3-E1 cells, including cell attachment, spreading, proliferation, alkaline phosphatase activity, calcium nodule formation, and expression of osteogenic differentiation-related genes. Incorporation of nHA into PEEK greatly improved the bioperformance of PEEK. The nHA/PEEK composite might be a promising orthopedic implant material. PMID:25170265

  18. Bioactivity and Osseointegration of PEEK Are Inferior to Those of Titanium: A Systematic Review.

    PubMed

    Najeeb, Shariq; Bds, Zohaib Khurshid; Bds, Sana Zohaib; Bds, Muhammad Sohail Zafar

    2016-12-01

    Polyetheretherketone (PEEK) has been suggested as an alternative to replace titanium as a dental implant material. However, PEEK's bioactivity and osseointegration are debatable. This review has systematically analyzed studies that have compared PEEK (or PEEK-based) implants with titanium implants so that its feasibility as a possible replacement for titanium can be determined. The focused question was: "Are the bioactivity and osseointegration of PEEK implants comparable to or better than titanium implants?" Using the key words "dental implant," "implant," "polyetheretherketone," "PEEK," and "titanium" in various combinations, the following databases were searched electronically: PubMED/MEDLINE, Embase, Google Scholar, ISI Web of Knowledge, and Cochrane Database. 5 in vitro and 4 animal studies were included in the review. In 4 out of 5 in vitro studies, titanium exhibited more cellular proliferation, angiogenesis, osteoblast maturation, and osteogenesis compared to PEEK; one in vitro study observed comparable outcomes regardless of the implant material. In all animal studies, uncoated and coated titanium exhibited a more osteogenic behavior than did uncoated PEEK, while comparable bone-implant contact was observed in HA-coated PEEK and coated titanium implants. Unmodified PEEK is less osseoconductive and bioactive than titanium. Furthermore, the majority of studies had multiple sources of bias; hence, in its unmodified form, PEEK is unsuitable to be used as dental implant. Significantly more research and long-term trials must focus on improving the bioactivity of PEEK before it can be used as dental implant. More comparative animal and clinical studies are warranted to ascertain the potential of PEEK as a viable alternative to titanium.

  19. A combination of CO2 laser and plasma surface modification of poly(etheretherketone) to enhance osteoblast response

    NASA Astrophysics Data System (ADS)

    Zheng, Yanyan; Xiong, Chengdong; Wang, Zhecun; Li, Xiaoyu; Zhang, Lifang

    2015-07-01

    Poly(etheretherketone) (PEEK) is a rigid semicrystalline polymer that combines excellent mechanical properties, broad chemical resistance and bone-like stiffness and is widely used in biomedical fields. However, the bio-inert surface of PEEK tends to hinder its biomedical applications when direct osteointegration between the implants and the host tissue is desired. In this work, we demonstrate a dual modification method, which combines the laser and plasma surface treatment to combine advantages of both chemical states and microstructures for osteoblasts responses. While the plasma treatment introduces surface carboxyl groups (sbnd COOH) onto PEEK surface, the laser treatment constructs microstructures over the PEEK surface. Our results indicated that sbnd COOH as well as microgrooves containing micropores or microcraters structure are constructed on PEEK surface and plasma treatment has no apparent effect on the morphology of microstructures produced by laser micromachining. Unexpectedly, the superior mechanical properties of PEEK were maintained irrespective of the treatment used. Compared to native PEEK and single treated PEEK, dual modified PEEK is more favorable for pre-osteoblasts (MC3T3-E1) adhesion, spreading and proliferation. Moreover, cell pseudopodia protrude into the micropores or microcraters, in favor of forming firmer bone-implant integration. Our study illustrates enhanced osteoblasts responses to dual treated PEEK surface, which gives beneficial information of its potential use in orthopedic or dental implants.

  20. Fabrication and characterization of modified-hydroxyapatite/polyetheretherketone coating materials

    NASA Astrophysics Data System (ADS)

    Ma, Rui; Fang, Lin; Luo, Zhongkuan; Zheng, Ruisheng; Song, Shenhua; Weng, Luqian; Lei, JinPing

    2014-09-01

    45 wt%-Hydroxyaptite/polyetheretherketone (HA/PEEK) coating materials modified by silane coupling agent (KH560) on PEEK substrate were successfully fabricated by solution casting method and characterized by Fourier transform infrared spectroscopy (FTIR), X-Ray Diffraction (XRD), scanning electron microscopy (SEM), and tensile testing. The modified HA fillers were obtained to be uniformly distributed in the HA/PEEK coating, which has better properties of tensile strength and fracture toughness than those of the unmodified specimen. A good bonding between the composite coating and the PEEK substrate was achieved by solution casting method, resulting in integral-fracture without falling apart or delaminating during tensile loading. The modified specimens dipped into simulated body fluid (SBF) were characterized by SEM, XRD and FTIR, indicating that the bioactivity of the dipped materials was demonstrated more apparent with extending the dipping time. Therefore, the coating materials may become the substitutes for the hard tissues of the human body in the future, which could realize the balance between the mechanical properties and the bioactivity by modifying the structural design of the coating.

  1. Bone-like apatite coating on functionalized poly(etheretherketone) surface via tailored silanization layers technique.

    PubMed

    Zheng, Yanyan; Xiong, Chengdong; Zhang, Shenglan; Li, Xiaoyu; Zhang, Lifang

    2015-10-01

    Poly(etheretherketone) (PEEK) is a rigid semi-crystalline polymer with outstanding mechanical properties, bone-like stiffness and suitable biocompatibility that has attracted much interest as a biomaterial for orthopedic and dental implants. However, the bio-inert surface of PEEK limits its biomedical applications when direct osteointegration between the implants and the host tissue is desired. In this work, -PO4H2, -COOH and -OH groups were introduced on the PEEK surface by further chemical treatments of the vinyl-terminated silanization layers formed on the hydroxylation-pretreated PEEK surface. Both the surface-functionalized and pristine specimens were characterized by X-ray photoelectron spectroscopy (XPS), attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy and water contact angle measurements. When placed in 1.5 strength simulated body fluid (SBF) solution, apatite was observed to form uniformly on the functionalized PEEK surface and firmly attach to the substrate. The characterized results demonstrated that the coating was constituted by poorly crystallized bone-like apatite and the effect of surface functional groups on coating formation was also discussed in detail. In addition, in vitro biocompatibility of PEEK, in terms of pre-osteoblast cell (MC3T3-E1) attachment, spreading and proliferation, was remarkably enhanced by the bone-like apatite coating. Thus, this study provides a method to enhance the bioactivity of PEEK and expand its applications in orthopedic and dental implants.

  2. In Vivo Osseointegration Performance of Titanium Dioxide Coating Modified Polyetheretherketone Using Arc Ion Plating for Spinal Implant Application

    PubMed Central

    Tsou, Hsi-Kai; Chi, Meng-Hui; Hung, Yi-Wen; Chung, Chi-Jen; He, Ju-Liang

    2015-01-01

    Polyetheretherketone (PEEK), which has biomechanical performance similar to that of human cancellous bone, is used widely as a spinal implant material. However, its bioinertness and hydrophobic surface properties result in poor osseointegration. This study applies a novel modification method, arc ion plating (AIP), that produces a highly osteoblast compatible titanium dioxide (TiO2) coatings on a PEEK substrate. This PEEK with TiO2 coating (TiO2/PEEK) was implanted into the femurs of New Zealand white male rabbits to evaluate its in vivo performance by the push-out test and histological observation. Analytical results show that AIP can prepare TiO2 coatings on bullet-shaped PEEK substrates as implant materials. After prolonged implantation in rabbits, no signs of inflammation existed. Newly regenerated bone formed more prominently with the TiO2/PEEK implant by histological observation. The shear strength of the bone/implant interface increases as implantation period increases. Most importantly, bone bonding performance of the TiO2/PEEK implant was superior to that of bare PEEK. The rutile-TiO2 coatings achieved better osseointegration than the anatase-TiO2 coatings. Therefore, AIP-TiO2 can serve as a novel surface modification method on PEEK for spinal interbody fusion cages. PMID:26504800

  3. Degradation in Thermal Properties and Morphology of Polyetheretherketone-Alumina Composites Exposed to Gamma Radiation

    NASA Astrophysics Data System (ADS)

    Lawrence, Falix; Mishra, Satyabrata; Mallika, C.; Kamachi Mudali, U.; Natarajan, R.; Ponraju, D.; Seshadri, S. K.; Sampath Kumar, T. S.

    2012-07-01

    Sheets of polyetheretherketone (PEEK) and PEEK-alumina composites with micron-sized alumina powder with 5, 10, 15, 20, and 25% by weight were fabricated, irradiated with gamma rays up to 10 MGy and the degradation in their thermal properties and morphology were evaluated. The radicals generated during irradiation get stabilized by chain scission and crosslinking. Chain scission is predominant on the surface and crosslinking is predominant in the bulk of the samples. Owing to radiation damage, the glass transition temperature, T g increased for pure PEEK from 136 to 140.5 °C, whereas the shift in T g for the composites decreased with increase in alumina content and for PEEK-25% alumina, the change in T g was insignificant, as alumina acts as an excitation energy sink and reduces the crosslinking density, which in turn decreased the shift in T g towards higher temperature. Similarly, the melting temperature, T m and enthalpy of melting, Δ H m of PEEK and PEEK-alumina composites decreased on account of radiation owing to the restriction of chain mobility and disordering of structures caused by crosslinks. The decrease in T m and Δ H m was more pronounced in pure PEEK and the extent of decrease in T m and Δ H m was less for composites. SEM images revealed the formation of micro-cracks and micro-pores in PEEK due to radiation. The SEM image of irradiated PEEK-alumina (25%) composite showed negligible micro-cracks and micro-pores, because of the reinforcing effect of high alumina content in the PEEK matrix which helps in reducing the degradation in the properties of the polymer. Though alumina reduces the degradation of the polymer matrix during irradiation, an optimum level of ceramic fillers only have to be loaded to the polymer to avoid the reduction in toughness.

  4. Two-level contiguous cervical disc disease treated with peek cages packed with demineralized bone matrix: results of 3-year follow-up

    PubMed Central

    Topuz, Kıvanç; Çolak, Ahmet; Şimşek, Hakan; Kutlay, Murat; Demircan, Mehmet Nusret; Velioğlu, Murat

    2009-01-01

    Interbody cages are widely used instruments for cervical fusion operations. Long-term follow-up studies are needed to clarify if these devices are dependable. In this prospective study, 79 patients (42 women and 37 men) with a mean age of 51 years operated between January 2000 and December 2005 for treatment of degenerative cervical disc disease and spondylosis associated with radiculopathy or myelopathy were evaluated. Patients underwent two-level contiguous anterior cervical discectomy and fusion operations with standard anterior Smith–Robinson approach. To achieve fusion PEEK cages packed with demineralized bone matrix mixed with autologous blood were used. Clinical outcome was evaluated with Odom’s criteria and results were evaluated as ‘excellent’, ‘good’, ‘fair’ and ‘poor’. Spinal curves, mobility and fusion status were assessed with anterior–posterior and lateral (neutral, flexion and extension) radiographs obtained before surgery and at 3, 12, 24 and 36 months postoperatively. The Ishihara curvature index (ICI) was used for spinal curve evaluation. Lateral dynamic (flexion and extension) radiographs at postoperative 12th month revealed the fusion status classified as 1A, 1B, 2A and 2B. The radiological outcomes were classified as ‘non-fusion’ when 2B healing was observed, and as ‘fusion’ when 1A, 1B or 2A healing was observed at the levels subjected to surgery. According to Odom’s criteria, clinical outcomes were classified as ‘excellent’ or ‘good’ in 69 patients (success rate: 87.3%). Eight patients were graded as ‘fair’ and two as ‘poor’. Preoperative mean ICI was 10.4 ± 3.72 and postoperative mean ICI was 10.1 ± 3.14. The difference was statistically insignificant (P > 0.05); therefore, preoperative lordosis was said to be preserved at final follow-up. Final fusion rate (Types 1A, 1B, and 2A) was 91.7% (145/158 levels). Radiological imaging showed no cage failure or dislodgement and reoperation

  5. Preparation and characterization of bio-composite PEEK/nHA

    NASA Astrophysics Data System (ADS)

    Jin, Y. S.; Bian, C. C.; Zhang, Z. Q.; Zhao, Y.; Yang, L.

    2017-01-01

    PEEK/nHA composite material, with excellent mechanical property as polyetheretherketone (PEEK) and biological activity as hydroxyapatite (HA), has attracted wide attention of medical experts and materials science experts. The addition of hydroxyapatite was the decisive factor for biological activity in PEEK/nHA composite. In this paper, acicular nanohydroxyapatite was prepared by chemical precipitation method with Ca(NO3)2, (NH4)2HPO4 as raw material; PEEK/nHA composite was prepared by solution blending and vacuum sintering method. The composite was characterized with FT-IR, XRD, DSC, TG and mechanical property test. Results showed that the composite has good thermal stability and compressive property when the mass ratio of PEEK to nHA is 10:3; and high nHA content can improve the biological activity of the composite, which can meet the basic requirements for bone tissue engineering scaffold.

  6. Neutral atom beam technique enhances bioactivity of PEEK

    NASA Astrophysics Data System (ADS)

    Khoury, Joseph; Kirkpatrick, Sean R.; Maxwell, Melissa; Cherian, Raymond E.; Kirkpatrick, Allen; Svrluga, Richard C.

    2013-07-01

    Polyetheretherketone (PEEK) is currently gaining popularity in orthopedic and spinal applications but has potential drawbacks in use. PEEK is biocompatible, similar in elasticity to bone, and radiolucent; however, it has been shown to be inert and does not integrate well with bone. Recent efforts have focused on increasing the bioactivity of PEEK by modifying the surface to improve the bone-implant interface. We have employed a novel Accelerated Neutral Atom Beam technique (ANAB) to enhance the bioactivity of PEEK. ANAB employs an intense beam of cluster-like packets of accelerated unbonded neutral argon (Ar) gas atoms. These beams are created by first producing a highly energetic Gas Cluster Ion Beam (GCIB) comprised of van der Waals bonded Ar atoms, then transferring energy to the clusters so as to cause release of most of the interatomic bonds, and finally deflecting away the remaining electrically charged cluster cores of still bonded atoms. We identified that ANAB treatment of PEEK results in nanometer scale surface modifications as well as increased surface hydrophilicity. Human osteoblasts seeded onto the surface of ANAB-treated PEEK exhibited enhanced growth as compared to control PEEK as evidenced by cell proliferation assays and microscopy. This increase in bioactivity resulted in cell proliferation levels comparable to native titanium. An in vivo study using a rat calvarial critical size defect model revealed enhanced osseointegration where bone tissue formation was evident only on the ANAB treated PEEK. Taken together, these data suggest that ANAB treatment of PEEK has the potential to enhance its bioactivity, resulting in bone formation and significantly decreasing osseointegration time of orthopedic and spinal implants.

  7. Osteoconductive hydroxyapatite coated PEEK for spinal fusion surgery

    NASA Astrophysics Data System (ADS)

    Hahn, Byung-Dong; Park, Dong-Soo; Choi, Jong-Jin; Ryu, Jungho; Yoon, Woon-Ha; Choi, Joon-Hwan; Kim, Jong-Woo; Ahn, Cheol-Woo; Kim, Hyoun-Ee; Yoon, Byung-Ho; Jung, In-Kwon

    2013-10-01

    Polyetheretherketone (PEEK) has attracted much interest as biomaterial for interbody fusion cages due to its similar stiffness to bone and good radio-transparency for post-op visualization. Hydroxyapatite (HA) coating stimulates bone growth to the medical implant. The objective of this work is to make an implant consisting of biocompatible PEEK with an osteoconductive HA surface for spinal or orthopedic applications. Highly dense and well-adhered HA coating was developed on medical-grade PEEK using aerosol deposition (AD) without thermal degradation of the PEEK. The HA coating had a dense microstructure with no cracks or pores, and showed good adhesion to PEEK at adhesion strengths above 14.3 MPa. The crystallinity of the HA coating was remarkably enhanced by hydrothermal annealing as post-deposition heat-treatment. In addition, in vitro and in vivo biocompatibility of PEEK, in terms of cell adhesion morphology, cell proliferation, differentiation, and bone-to-implant contact ratio, were remarkably enhanced by the HA coating through AD.

  8. Wear of PEEK-OPTIMA® and PEEK-OPTIMA®-Wear Performance articulating against highly cross-linked polyethylene.

    PubMed

    East, Rebecca H; Briscoe, Adam; Unsworth, Anthony

    2015-03-01

    The idea of all polymer artificial joints, particularly for the knee and finger, has been raised several times in the past 20 years. This is partly because of weight but also to reduce stress shielding in the bone when stiffer materials such as metals or ceramics are used. With this in mind, pin-on-plate studies of various polyetheretherketone preparations against highly cross-linked polyethylene were conducted to investigate the possibility of using such a combination in the design of a new generation of artificial joints. PEEK-OPTIMA(®) (no fibre) against highly cross-linked polyethylene gave very low wear factors of 0.0384 × 10(-6) mm(3)/N m for the polyetheretherketone pins and -0.025 × 10(-6) mm(3)/N m for the highly cross-linked polyethylene plates. The carbon-fibre-reinforced polyetheretherketone (PEEK-OPTIMA(®)-Wear Performance) also produced very low wear rates in the polyetheretherketone pins but produced very high wear in the highly cross-linked polyethylene, as might have been predicted since the carbon fibres are quite abrasive. When the fibres were predominantly tangential to the sliding plane, the mean wear factor was 0.052 × 10(-6) mm(3)/N m for the pins and 49.3 × 10(-6) mm(3)/N m for the highly cross-linked polyethylene plates; a half of that when the fibres ran axially in the pins (0.138 × 10(-6) mm(3)/N m for the pins and 97.5 × 10(-6) mm/ N m for the cross-linked polyethylene plates). PEEK-OPTIMA(®) against highly cross-linked polyethylene merits further investigation.

  9. Self-tapping ability of carbon fibre reinforced polyetheretherketone suture anchors.

    PubMed

    Feerick, Emer M; Wilson, Joanne; Jarman-Smith, Marcus; Ó'Brádaigh, Conchur M; McGarry, J Patrick

    2014-10-01

    An experimental and computational investigation of the self-tapping ability of carbon fibre reinforced polyetheretherketone (CFR-PEEK) has been conducted. Six CFR-PEEK suture anchor designs were investigated using PEEK-OPTIMA® Reinforced, a medical grade of CFR-PEEK. Experimental tests were conducted to investigate the maximum axial force and torque required for self-taping insertion of each anchor design. Additional experimental tests were conducted for some anchor designs using pilot holes. Computational simulations were conducted to determine the maximum stress in each anchor design at various stages of insertion. Simulations also were performed to investigate the effect of wall thickness in the anchor head. The maximum axial force required to insert a self-tapping CFR-PEEK suture anchor did not exceed 150 N for any anchor design. The maximum torque required to insert a self-tapping CFR-PEEK suture anchor did not exceed 0.8 Nm. Computational simulations reveal significant stress concentrations in the region of the anchor tip, demonstrating that a re-design of the tip geometry should be performed to avoid fracture during self-tapping, as observed in the experimental component of this study. This study demonstrates the ability of PEEK-OPTIMA Reinforced suture anchors to self-tap polyurethane foam bone analogue. This provides motivation to further investigate the self-tapping ability of CFR-PEEK suture anchors in animal/cadaveric bone. An optimised design for CFR-PEEK suture anchors offers the advantages of radiolucency, and mechanical properties similar to bone with the ability to self-tap. This may have positive implications for reducing surgery times and the associated costs with the procedure.

  10. Surface modification of nanodiamond and its incorporation in nanodiamond/peek nanocomposites

    NASA Astrophysics Data System (ADS)

    Wahab, Zahidul

    The continued miniaturization of electronic device components requires new lightweight polymers with high thermal stability, high thermal conductivity, low electrical conductivity, and low dielectric constant. Composites of nanodiamond (ND) and poly-ether-ether-ketone (PEEK) are candidates for these applications due their unique combination of properties. The objectives of this research are to explore new routes for surface functionalization of nanodiamond (ND), develop methods for maximizing dispersion of ND as a nano-scale filler in PEEK, and characterize the effect of dispersed ND on the mechanical, thermal and dielectric properties of ND/PEEK composites. Initial attempts to disperse different kinds of commercially available, as-received ND in PEEK were yielded low quality composites due to ND agglomeration and low thermal stability. Thus we began to explore chemical grafting of phenylphosphonate (PPA) onto oxidized ND (OND) and carboxylated ND (CND), hypothesizing that the phenyl functional group would render the NDs more compatible with aromatic PEEK. Detailed characterization results, including 31P NMR, FTIR, and XPS, indicate successful grafting, resulting in arylation of ND, increased ND thermal stability, and better compatibility with organic solvents. Sonication during the grafting promotes more complete exposure of the ND surface to PPA grafting, resulting in even better ND dispersion in organic solvents. PPA-modified OND and CND were then melt-blended with PEEK to produce ND/PEEK composites. Surface tomography results suggest that all PPA-modified NDs were adequately dispersed in PEEK, with OND showing better dispersion due to its higher PPA graft density. The presence of PPA-modified ND has minor impact on PEEK crystallinity based on XRD and DSC data. Tensile testing and DMA results suggest that ND/PEEK composites generally retain the mechanical properties of PEEK with some sacrifice of ductility. TGA data indicate that all ND/PEEK composites have

  11. Fatigue limits of different PEEK materials for dental implants.

    PubMed

    Schwitalla, Andreas Dominik; Zimmermann, Tycho; Spintig, Tobias; Kallage, Ilona; Müller, Wolf-Dieter

    2016-12-23

    The increasing use of PEEK (poly-ether-ether-ketone) as a substitute for metal implant components has led to the suggestion that it could also be used as an alternative to titanium in the field of dental implants. A major requirement for dental implant materials is their resistance to cyclic loading due to mastication. A special fatigue test was designed to evaluate the elastic behavior and long-term form stability of cylindrically shaped PEEK specimens of 4, 5 and 6mm in diameter, using 11 different PEEK materials of various grades: unfilled, filled with titanium dioxide or barium sulfate powder, reinforced with short carbon fibers or short glass fibers, and reinforced with continuous carbon fibers. The samples were exposed to cyclic loads of up to 2000N. The elastic limits ranged between 46.57±6.44MPa for short carbon fiber reinforced specimens of 6mm diameter and 107.62±8.23MPa for samples of a different short carbon fiber reinforced PEEK compound of 4mm diameter. The elastic limits of the two PEEK grades containing continuous carbon fibers could not be observed because they exceeded the limits of the test specification. The elastic moduli ranged between 2.06±0.18GPa for barium sulfate powder filled PEEK-specimens of 6 mm diameter and 57.53±14.3GPa for continuous carbon fibers reinforced PEEK-specimens of 4 mm diameter. In terms of the elastic limit all the PEEK materials in consideration were able to resist the pressure caused by maximum masticatory forces.

  12. Bacterial adhesion to orthopaedic implant materials and a novel oxygen plasma modified PEEK surface.

    PubMed

    Rochford, E T J; Poulsson, A H C; Salavarrieta Varela, J; Lezuo, P; Richards, R G; Moriarty, T F

    2014-01-01

    Despite extensive use of polyetheretherketone (PEEK) in biomedical applications, information about bacterial adhesion to this biomaterial is limited. This study investigated Staphylococcus aureus and Staphylococcus epidermidis adhesion to injection moulded and machined PEEK OPTIMA(®) using a custom-built adhesion chamber with medical grade titanium and Thermanox for comparison. Additionally, bacterial adhesion to a novel oxygen plasma modified PEEK was also investigated in both a pre-operative model in physiological saline, and additionally in a post-operative model in human blood plasma. In the pre-operative model, the rougher machined PEEK had a significantly greater number of adherent bacteria compared to injection moulded PEEK. Bacterial adhesion to titanium and Thermanox was similar. Oxygen plasma surface modification of PEEK did not lead to a significant change in bacterial adhesion in the pre-operative contamination model, despite observed changes in surface characteristics. In the post-operative contamination model, S. aureus adhesion was increased from 5×10(5) CFU cm(-2) to approximately 1.3×10(7) CFU cm(-2) on the modified surfaces due to differential protein adhesion during the conditioning period. However, S. epidermidis adhesion to modified PEEK was less than to unmodified PEEK in the post-operative model. These results illustrate the importance of testing bacterial adhesion of several strains in both a pre-operative and post-operative, clinically relevant bacterial contamination model.

  13. Influence of polyetheretherketone coatings on the Ti-13Nb-13Zr titanium alloy's bio-tribological properties and corrosion resistance.

    PubMed

    Sak, Anita; Moskalewicz, Tomasz; Zimowski, Sławomir; Cieniek, Łukasz; Dubiel, Beata; Radziszewska, Agnieszka; Kot, Marcin; Łukaszczyk, Alicja

    2016-06-01

    Polyetheretherketone (PEEK) coatings of 70-90μm thick were electrophoretically deposited from a suspension of PEEK powder in ethanol on near-β Ti-13Nb-13Zr titanium alloy. In order to produce good quality coatings, the composition of the suspension (pH) and optimized deposition parameters (applied voltage and time) were experimentally selected. The as-deposited coatings exhibited the uniform distribution of PEEK powders on the substrate. The subsequent annealing at a temperature above the PEEK melting point enabled homogeneous, semi-crystalline coatings with spherulitic morphology to be produced. A micro-scratch test showed that the coatings exhibited very good adhesion to the titanium alloy substrate. Coating delamination was not observed even up to a maximal load of 30N. The PEEK coatings significantly improved the tribological properties of the Ti-13Nb-13Zr alloy. The coefficient of friction was reduced from 0.55 for an uncoated alloy to 0.40 and 0.12 for a coated alloy in a dry sliding and sliding in Ringer's solution, respectively. The PEEK coatings exhibited excellent wear resistance in both contact conditions. Their wear rate was more than 200 times smaller compared with the wear rate of the uncoated Ti-13Nb-13Zr alloy. The obtained results indicate that electrophoretically deposited PEEK coatings on the near-β titanium alloy exhibit very useful properties for their prospective tribological applications in medicine.

  14. Enhanced osteointegration on tantalum-implanted polyetheretherketone surface with bone-like elastic modulus.

    PubMed

    Lu, Tao; Wen, Jin; Qian, Shi; Cao, Huiliang; Ning, Congqin; Pan, Xiaoxia; Jiang, Xinquan; Liu, Xuanyong; Chu, Paul K

    2015-05-01

    Polyetheretherketone (PEEK) possesses a similar elastic modulus as bones but yet suffers from bio-inertness and poor osteogenesis. In this work, tantalum ions are implanted energetically into PEEK by plasma immersion ion implantation (PIII) to form Ta2O5 nanoparticles in the near surface. Nanoindentation reveals that the surface elastic modulus of the Ta ion implanted PEEK is closer to that of human cortical bones. In vitro cell adhesion, alkaline phosphatase activity, collagen secretion, extracellular matrix mineralization, and real-time PCR analyses disclose enhanced adhesion, proliferation, and osteogenic differentiation of rat bone mesenchymal stem cells (bMSCs) on the Ta-PIII modified PEEK. In vivo evaluation of the cortico-cancellous rat femur model by means of micro-CT, sequential fluorescent labeling, and histological analysis after 8 weeks confirms significantly improved osteointegration. The bone-like elastic modulus and modified surface topography of the Ta-PIII modified PEEK synergistically induce osteogenic differentiation of bMSCs and the surface-modified materials have large potential in dental and orthopedic implants.

  15. Hydroxyapatite coating on PEEK implants: Biomechanical and histological study in a rabbit model.

    PubMed

    Durham, John W; Montelongo, Sergio A; Ong, Joo L; Guda, Teja; Allen, Matthew J; Rabiei, Afsaneh

    2016-11-01

    A bioactive two-layer coating consisting of hydroxyapatite (HA) and yttria-stabilized zirconia (YSZ) was investigated on cylindrical polyetheretherketone (PEEK) implants using ion beam assisted deposition (IBAD). Post-deposition heat treatments via variable frequency microwave annealing with and without subsequent autoclaving were used to crystallize the as-deposited amorphous HA layer. Microstructural analysis, performed by TEM and EDS, showed that these methods were capable of crystallizing HA coating on PEEK. The in vivo response to cylindrical PEEK samples with and without coating was studied by implanting uncoated PEEK and coated PEEK implants in the lateral femoral condyle of 18 rabbits. Animals were studied in two groups of 9 for observation at 6 or 18weeks post surgery. Micro-CT analysis, histology, and mechanical pull-out tests were performed to determine the effect of the coating on osseointegration. The heat-treated HA/YSZ coatings showed improved implant fixation as well as higher bone regeneration and bone-implant contact area compared to uncoated PEEK. The study offers a novel method to coat PEEK implants with improved osseointegration.

  16. Fine grained osseointegrative coating improves biocompatibility of PEEK in heterotopic sheep model

    PubMed Central

    Verleye, Gino B.M.; Smeets, Dirk; Van Hauwermeiren, Hadewych Y.R.; Loeckx, Dirk; Willems, Karel; Siau, Vincent G.M.G.G.B.; Lauweryns, Philippe J.M.E.

    2015-01-01

    Background and aim Polyetheretherketone (PEEK) materials already have been used successfully in orthopedic and especially spine surgery. PEEK is radiolucent and comparable with bone regarding elasticity. However, PEEK is inert and the adhesion of PEEK implants to bone tissue proceeds slowly because of their relatively low biocompatibility. The aim of the study is to evaluate the effect of titanium and CaP coating on the adhesion of bone tissue. Material and Methods Six adult sheep (body weight 57.6 ± 3.9 kg) were included in this study. Three different types of cylindrical dowels (12 mm length x 8 mm diameter) were implanted in long bones (tibia and femur): PEEK dowels without coating (the control group), and PEEK dowels with a nanocoating of calcium phosphate (CaP group) or titanium (titanium group). Animals were sacrificed after 6, 12 and 26 weeks. Dowels were explanted for micro CT and histology. Results Bone implant contact (BIC) ratio was significantly higher in the titanium versus control groups in the 6 to 12 weeks period (p = 0.03). The ratio between bone volume and tissue volume (BV/TV) was significantly higher in titanium versus control in the 6 to 12 weeks period (p = 0.02). A significant correlation between BIC and BV/TV was seen (r = 0.85, p < 0.05). Conclusion Coating of PEEK dowels with a nanocoating of titanium has beneficial effects on adhesion of bone tissue. PMID:26273553

  17. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods.

    PubMed

    Benezech, Jacques; Garlenq, Bruno; Larroque, Gilles

    2016-01-01

    Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently, semirigid instrumentation systems using rods made of polyetheretherketone (PEEK) have been introduced. This clinical study of 21 patients focuses on the clinical and radiological outcomes of patients with lumbar degenerative disease treated with Initial VEOS PEEK(®)-Optima system (Innov'Spine, France) composed of rods made from PEEK-OPTIMA(®) polymer (Invibio Biomaterial Solutions, UK) without arthrodesis. With an average follow-up of 2 years and half, the chances of reoperation were significantly reduced (4.8%), quality of life was improved (ODI = 16%), and the adjacent disc was preserved in more than 70% of cases. Based on these results, combined with the biomechanical and clinical data already published, PEEK rods systems can be considered as a safe and effective alternative solution to rigid ones.

  18. Poly(ether-ether-ketone) orthopedic bearing surface modified by self-initiated surface grafting of poly(2-methacryloyloxyethyl phosphorylcholine).

    PubMed

    Kyomoto, Masayuki; Moro, Toru; Yamane, Shihori; Hashimoto, Masami; Takatori, Yoshio; Ishihara, Kazuhiko

    2013-10-01

    We investigated the production of free radicals on a poly(ether-ether-ketone) (PEEK) substrate under ultraviolet (UV) irradiation. The amount of the ketyl radicals produced from the benzophenone (BP) units in the PEEK molecular structure initially increased rapidly and then became almost constant. Our observations revealed that the BP units in PEEK acted as photoinitiators, and that it was possible to use them to control the graft polymerization of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC). This "self-initiated surface graft polymerization" method is very convenient in the absence of external photoinitiator. We also investigated the effects of the monomer concentration and UV irradiation time on the extent of the grafted PMPC layer. Furthermore, as an application to improving the durability of artificial hips, we demonstrated the nanometer-scale photoinduced grafting of PMPC onto PEEK and carbon fiber-reinforced PEEK (CFR-PEEK) orthopedic bearing surfaces and interfaces. A variety of test revealed significant improvements in the water wettability, frictional properties, and wear resistance of the surfaces and interfaces.

  19. Covalent attachment of cell-adhesive peptide Gly-Arg-Gly-Asp (GRGD) to poly(etheretherketone) surface by tailored silanization layers technique

    NASA Astrophysics Data System (ADS)

    Zheng, Yanyan; Xiong, Chengdong; Li, Xiaoyu; Zhang, Lifang

    2014-11-01

    Poly(etheretherketone) (PEEK) is a rigid semicrystalline polymer that combines excellent mechanical properties, broad chemical resistance and bone-like stiffness and is widely used in biomedical fields. However, PEEK is naturally bioinert, leading to limited biomedical applications, especially when a direct bone-implant osteointegration is desired. In this study, a three-step reaction procedure was employed to immobilize the cell-adhesive peptide Gly-Arg-Gly-Asp (GRGD) on the surface of PEEK sheet by covalent chemical attachment to favor cell adhesion and proliferation. First, hydroxylation-pretreated PEEK surfaces were silanized with 7-Oct-1-enyltrichlorosilane (OETS) in dry cyclohexane, resulting in a silanization layer with terminal ethenyl. Second, the terminal ethylenic double bonds of the silanization layer on PEEK surface were converted to carboxyl groups through acidic potassium manganate oxidation. Finally, GRGD was covalently attached by carbodiimide mediated condensation between the carboxyl on PEEK surface and amine presents in GRGD. X-ray photoelectron spectroscopy (XPS), attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy, surface profiler and water contact angle measurements were applied to characterize the modified surfaces. The effect of cells attachment and proliferation on each specimen was investigated. Pre-osteoblast cells (MC3T3-E1) attachment, spreading and proliferation were improved effectively on GRGD-modified PEEK surface. PEEK modified with GRGD on its surface has potential use in orthopedic or dental implants.

  20. Enhancement of osteogenesis on micro/nano-topographical carbon fiber-reinforced polyetheretherketone-nanohydroxyapatite biocomposite.

    PubMed

    Xu, Anxiu; Liu, Xiaochen; Gao, Xiang; Deng, Feng; Deng, Yi; Wei, Shicheng

    2015-03-01

    As an FDA-approved implantable material, carbon fiber-reinforced polyetheretherketone (CFRPEEK) possesses excellent mechanical properties similar to those of human cortical bone and is a prime candidate to replace conventional metallic implants. The bioinertness and inferior osteogenic properties of CFRPEEK, however, limit its clinical application as orthopedic/dental implants. The present work aimed at developing a novel carbon fiber-reinforced polyetheretherketone-nanohydroxyapatite (PEEK/CF/n-HA) ternary biocomposite with micro/nano-topographical surface for the enhancement of the osteogenesis as a potential bioactive material for bone grafting and bone tissue-engineering applications. The combined modification of oxygen plasma and sand-blasting could improve the hydrophily and generate micro/nano-topographical structures on the surface of the CFRPEEK-based ternary biocomposite. The results clearly showcased that the micro-/nano-topographical PEEK/n-HA/CF ternary biocomposite demonstrated the outstanding ability to promote the proliferation and differentiation of MG-63 cells in vitro as well as to boost the osseointegration between implant and bone in vivo, thereby boding well application to bone tissue engineering.

  1. Elevated cytokine expression of different PEEK wear particles compared to UHMWPE in vivo.

    PubMed

    Lorber, V; Paulus, A C; Buschmann, A; Schmitt, B; Grupp, T M; Jansson, V; Utzschneider, Sandra

    2014-01-01

    Due to their mechanical properties, there has been growing interest in poly-ether-ether-ketone (PEEK) and its composites as bearing material in total and unicompartmental knee arthroplasty. The aim of this study was to analyze the biological activity of wear particles of two different (pitch and PAN) carbon-fiber-reinforced- (CFR-) PEEK varieties in comparison to ultra-high-molecular-weight-polyethylene (UHMWPE) in vivo. The authors hypothesized no difference between the used biomaterials. Wear particle suspensions of the particulate biomaterials were injected into knee joints of Balb/c mice, which were sacrificed after seven days. The cytokine expression (IL-1β, IL-6, TNF-α) was analyzed immunohistochemically in the synovial layer, the adjacent bone marrow and the articular cartilage. Especially in the bone marrow of the two CFR-PEEK varieties there were increased cytokine expressions compared to the control and UHMWPE group. Furthermore, in the articular cartilage the CFR-PEEK pitch group showed an enhanced cytokine expression, which could be a negative predictor for the use in unicondylar knee systems. As these data suggest an increased proinflammatory potential of CFR-PEEK and its composites in vivo, the initial hypothesis had to be refuted. Summarizing these results, CFR-PEEK seems not to be an attractive alternative to UHMWPE as a bearing material, especially in unicompartmental knee arthroplasty.

  2. Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion

    PubMed Central

    Kwon, O Ik; Lee, Sang Weon; Song, Geun Sung

    2016-01-01

    Objective Anterior cervical discectomy and fusion (ACDF) is a choice of surgical procedure for cervical degenerative diseases associated with radiculopathy or myelopathy. However, the patients undergoing ACDF still have problems. The purpose of the present study is to evaluate the radiologic results of 3 different methods in single-level ACDF. Methods We conducted a retrospective collection of radiological data from January 2011 to December 2014. A total of 67 patients were included in this study. The patients were divided into 3 groups by operation procedure: using stand-alone cage (group cage, n=20); polyether-ether-ketone (PEEK)-titanium combined anchored cage (group AC, n=21); and anterior cervical cage-plate (group CP, n=26). Global cervical lordosis (C2-C7 Cobb angle), fused segment height, fusion rate, and cervical range of motion (ROM) were measured and analyzed at serial preoperative, postoperative, 6-month, and final 1-year follow-up. Results Successful bone fusion was achieved in all patients at the final follow-up examination; however, the loss of disc height over 3 mm at the surgical level was observed in 6 patients in group cage. Groups AC and CP yielded significantly better outcomes than group cage in fused segment height and cervical ROM(p=0.01 and p=0.02, respectively). Furthermore, group AC had similar radiologic outcomes to those of group CP. Conclusion The PEEK-titanium combined anchored cage may be a good alternative procedure in terms of reducing complications induced by plate after ACDF. PMID:27799985

  3. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods

    PubMed Central

    Benezech, Jacques; Garlenq, Bruno; Larroque, Gilles

    2016-01-01

    Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently, semirigid instrumentation systems using rods made of polyetheretherketone (PEEK) have been introduced. This clinical study of 21 patients focuses on the clinical and radiological outcomes of patients with lumbar degenerative disease treated with Initial VEOS PEEK®-Optima system (Innov'Spine, France) composed of rods made from PEEK-OPTIMA® polymer (Invibio Biomaterial Solutions, UK) without arthrodesis. With an average follow-up of 2 years and half, the chances of reoperation were significantly reduced (4.8%), quality of life was improved (ODI = 16%), and the adjacent disc was preserved in more than 70% of cases. Based on these results, combined with the biomechanical and clinical data already published, PEEK rods systems can be considered as a safe and effective alternative solution to rigid ones. PMID:26981285

  4. Subsidence after single-level anterior cervical fusion with a stand-alone cage.

    PubMed

    Park, Jae-Young; Choi, Ki-Young; Moon, Bong Ju; Hur, Hyuk; Jang, Jae-Won; Lee, Jung-Kil

    2016-11-01

    To investigate the risk factors for subsidence in patients treated with stand-alone anterior cervical discectomy and fusion (ACDF) using polyetheretherketone (PEEK) cages for single-level degenerative cervical disease. Seventy-seven consecutive patients who underwent single-level stand-alone ACDF with a PEEK cage between 2005 and 2012 were included. Subsidence was defined as a decrease in the interbody height of more than 3mm on radiographs at the 1-year follow-up compared with that in the immediate post-operative image. Patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, pre-operative overall cervical sagittal angle, segmental angle of the operated level, interbody height, cage height, cage devices and cage location (distance between anterior margin of the body endplate and that of the cage). The clinical outcomes were assessed with visual analog scale, modified Japanese Orthopedic Association score and neck disability index. Twenty-six out of the 77 (33.8%) patients had radiological signs of cage subsidence. Solid fusion was achieved in 25 out of the 26 patients (96.2%) in the subsidence group and in 47 out of the 51 patients (92.2%) in the non-subsidence group. More than 3mm distance between anterior margin of the vertebral body and that of the cage was significantly associated with subsidence (p<0.05). However, subsidence did not correlate with fusion rate or clinical outcomes. Cage location was the only significant risk factor. Therefore, cage location should be taken into consideration during stand-alone ACDF using PEEK cages.

  5. Wear studies on the likely performance of CFR-PEEK/CoCrMo for use as artificial joint bearing materials.

    PubMed

    Scholes, S C; Unsworth, A

    2009-01-01

    It is well known that a reduction in the volume of wear produced by articulating surfaces in artificial joints is likely to result in a lower incidence of failure due to wear particle induced osteolysis. Therefore, new materials have been introduced in an effort to produce bearing surfaces with lower, more biologically acceptable wear. Polyetheretherketone (PEEK-OPTIMA) has been successfully used in a number of implant applications due to its combination of mechanical strength and biocompatibility. Pin-on-plate wear tests were performed on various combinations of PEEK-OPTIMA and carbon fibre reinforced PEEK-OPTIMA (CFR-PEEK) against various CoCrMo alloys to assess the potential of this material combination for use in orthopaedic implants. The PEEK/low carbon CoCrMo produced the highest wear. CFR-PEEK against high carbon or low carbon CoCrMo provided low wear factors. Pin-on-plate tests performed on ultra-high molecular weight polyethylene (UHMWPE) against CoCrMo (using comparable test conditions) have shown similar or higher wear than that found for CFR-PEEK/CoCrMo. This study gives confidence in the likelihood of this material combination performing well in orthopaedic applications.

  6. In vivo implant fixation of carbon fiber-reinforced PEEK hip prostheses in an ovine model.

    PubMed

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

    2013-03-01

    Carbon fiber-reinforced polyetheretherketone (CFR/PEEK) is theoretically suitable as a material for use in hip prostheses, offering excellent biocompatibility, mechanical properties, and the absence of metal ions. To evaluate in vivo fixation methods of CFR/PEEK hip prostheses in bone, we examined radiographic and histological results for cementless or cemented CFR/PEEK hip prostheses in an ovine model with implantation up to 52 weeks. CFR/PEEK cups and stems with rough-textured surfaces plus hydroxyapatite (HA) coatings for cementless fixation and CFR/PEEK cups and stems without HA coating for cement fixation were manufactured based on ovine computed tomography (CT) data. Unilateral total hip arthroplasty was performed using cementless or cemented CFR/PEEK hip prostheses. Five cementless cups and stems and six cemented cups and stems were evaluated. On the femoral side, all cementless stems demonstrated bony ongrowth fixation and all cemented stems demonstrated stable fixation without any gaps at both the bone-cement and cement-stem interfaces. All cementless cases and four of the six cemented cases showed minimal stress shielding. On the acetabular side, two of the five cementless cups demonstrated bony ongrowth fixation. Our results suggest that both cementless and cemented CFR/PEEK stems work well for fixation. Cup fixation may be difficult for both cementless and cemented types in this ovine model, but bone ongrowth fixation on the cup was first seen in two cementless cases. Cementless fixation can be achieved using HA-coated CFR/PEEK implants, even under load-bearing conditions.

  7. PEEK (polyether-ether-ketone)-coated nitinol wire: Film stability for biocompatibility applications

    NASA Astrophysics Data System (ADS)

    Sheiko, Nataliia; Kékicheff, Patrick; Marie, Pascal; Schmutz, Marc; Jacomine, Leandro; Perrin-Schmitt, Fabienne

    2016-12-01

    High quality biocompatible poly-ether-ether-ketone (PEEK) coatings were produced on NiTi shape memory alloy wires using dipping deposition from colloidal aqueous PEEK dispersions after substrate surface treatment. The surface morphology and microstructure were investigated by Scanning Electron Microscopy at every step of the process from the as-received Nitinol substrate to the ultimate PEEK-coated NiTi wire. Nanoscratch tests were carried out to access the adhesive behavior of the polymer coated film to the NiTi. The results indicate that the optimum process conditions in cleaning, chemical etching, and electropolishing the NiTi, were the most important and determining parameters to be achieved. Thus, high quality PEEK coatings were obtained on NiTi wires, straight or curved (even with a U-shape) with a homogeneous microstructure along the wire length and a uniform thickness of 12 μm without any development of cracks or the presence of large voids. The biocompatibility of the PEEK coating film was checked in fibrobast cultured cells. The coating remains stable in biological environment with negligible Ni ion release, no cytotoxicity, and no delamination observed with time.

  8. The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review

    PubMed Central

    Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

    2015-01-01

    Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK’s potential benefits. PMID:25780341

  9. Tribocorrosion behavior of veneering biomedical PEEK to Ti6Al4V structures.

    PubMed

    Sampaio, Miguel; Buciumeanu, Mihaela; Henriques, Bruno; Silva, Filipe S; Souza, Júlio C M; Gomes, José R

    2016-02-01

    In dentistry, prosthetic structures must be able to support masticatory loads combined with a high biocompatibility and wear resistance in the presence of a corrosive environment. In order to improve the simultaneous wear and corrosion response of highly biocompatible prosthetic structures, a veneering poly-ether-ether-ketone (PEEK) to Ti6Al4V substrate was assessed by tribocorrosion analyses under conditions mimicking the oral environment. Samples were synthesized by hot pressing the PEEK veneer onto Ti6Al4V cylinders. The tribocorrosion tests on Ti6Al4V or PEEK/Ti6Al4V samples were performed on a reciprocating ball-on-plate tribometer at 30N normal load, 1Hz and stroke length of 3mm. The tests were carried out in artificial saliva at 37°C. Open circuit potential (OCP) was measured before, during and after reciprocating sliding tests. The worn surfaces were characterized by scanning electron microscopy. The results revealed a lower wear rate on PEEK combined with a lower coefficient of friction (COF), when compared to Ti6Al4V. In fact, PEEK protected Ti6Al4V substrate against the corrosive environment and wear avoiding the release of metallic ions to the surrounding environment.

  10. Cross-sectional examination of the damage zone in impacted specimens of carbon/epoxy and carbon/PEEK composites

    NASA Technical Reports Server (NTRS)

    Nettles, A. T.; Magold, N. J.

    1990-01-01

    Drop weight impact testing was utilized to inflict damage on eight-ply bidirectional and unidirectional samples of carbon/epoxy and carbon/PEEK (polyetheretherketone) test specimens with impact energies ranging from 0.80 J to 1.76 J. The impacting tip was of a smaller diameter (4.2-mm) than those used in most previous studies, and the specimens were placed with a diamond wheel wafering saw through the impacted area perpendicular to the outer fibers. Photographs at 12 x magnification were taken of these cross-sections and examined. The results on the bidirectional samples show little damage until 1.13 J, at which point delaminations were seen in the epoxy specimens. The PEEK specimens showed less delamination than the epoxy specimens for a given impact energy level. The unidirectional specimens displayed more damage than the bidirectional samples for a given impact energy, with the PEEK specimens showing much less damage than the epoxy material.

  11. Effects of bioactive glass and beta-TCP containing three-dimensional laser sintered polyetheretherketone composites on osteoblasts in vitro.

    PubMed

    von Wilmowsky, Cornelius; Vairaktaris, Eleftherios; Pohle, Dirk; Rechtenwald, Thomas; Lutz, Rainer; Münstedt, Helmut; Koller, Garrit; Schmidt, M; Neukam, Friedrich Wilhelm; Schlegel, Karl Andreas; Nkenke, Emeka

    2008-12-15

    Because of their excellent physical properties nonresorbable thermoplastic polymers have become more important for the field of reconstructive surgery. Aim of the present study was to investigate the effects of laser sintered polyetheretherketone (PEEK) with incorporated osteoconductive and bioactive bone substitution materials on osteoblasts in vitro. Human osteoblasts (hFOB 1.19) were seeded onto laser sintered PEEK samples containing nano-sized carbon black, beta-tricalciumphosphate (beta-TCP), and bioactive glass 45S5. Osteoblasts were investigated for cell viability, cell proliferation and cell morphology. A constant proliferation of osteoblasts could be observed on all samples with the highest values for bioactive glass containing samples at day 7 (OD 1.76 +/- 0.22) and day 14 (OD 3.75 +/- 0.31) and lowest values for beta-TCP containing probes throughout the study compared with the PEEK pure control group. Highest cell viability was observed for Bioglass containing probes (95.5 +/- 3.32)% whereas osteoblasts seeded on beta-TCP containing probes showed reduced viability (84.4 +/- 4.32)%. Laser sintered PEEK implants seem to be attractive candidates for use as bone substitutes for reconstructive surgery because of their biocompatibility, individual shape, and the possibility of compounding bioinert polymer powder with osteoconductive and bioactive materials which might benefit bone formation in vivo.

  12. Improved osteoblast compatibility of medical-grade polyetheretherketone using arc ionplated rutile/anatase titanium dioxide films for spinal implants.

    PubMed

    Tsou, Hsi-Kai; Hsieh, Ping-Yen; Chi, Meng-Hui; Chung, Chi-Jen; He, Ju-Liang

    2012-10-01

    Titanium dioxide (TiO(2)), known to exhibit good biocompatibility, is applied in this study as a thin film formed onto polyetheretherketone (PEEK) substrate, which has been widely used in spinal interbody fusion cages. For successful deposition, an arc ionplating (AIP) technique was applied to deposit TiO(2) at low deposition temperature without damaging PEEK substrate, while providing satisfactory film adhesion. This study systematically investigates the effects of TiO(2) thin film phase composition and surface characteristics, controlled by using different target current and substrate bias, on osteoblast compatibility. Experimental results showed that anatase phase (A-TiO(2)) and/or rutile phase (R-TiO(2) ) TiO(2) coatings, respectively, can be prepared in appropriate deposition conditions. Overall, the TiO(2)-coated PEEK presented better osteoblast compatibility than the bare PEEK material in terms of cell adhesion, cell proliferation, and cell differentiation abilities, as well as osteogenesis performance (as determined by levels of osteopontin, osteocalcin, and calcium content). Surface roughness and hydrophilicity of the AIP-TiO(2) films were found to be responsible for significant osteoblast cell growth. It is also noticeable that the R-TiO(2) exhibited better osteoblast compatibility than the A-TiO(2) due to the presence of negatively charged hydroxyl groups on R-TiO(2) (110) surface in nature.

  13. Fabrication of hydroxyapatite thin films on polyetheretherketone substrates using a sputtering technique.

    PubMed

    Ozeki, K; Masuzawa, T; Aoki, H

    2017-03-01

    Hydroxyapatite (HA) thin films were coated on a polyetheretherketone (PEEK) substrate using a sputtering technique. A thin titanium (Ti) intermediate layer was formed between the HA and the PEEK surface to improve adhesion of the HA film to the PEEK substrate. The coated films were recrystallized using a hydrothermal treatment to reduce the dissolution of the HA film. The films were then characterized by X-ray diffractometry (XRD), scanning electron microscopy (SEM), and a UV-Vis spectrophotometer. A pull-out test was performed to measure the film-to-substrate adhesion strength, and an immersion test was performed in ultra-pure water. In the XRD patterns of the sputtered film with the Ti intermediate layer on the PEEK substrate, small HA peaks and large Ti peaks were observed. After the hydrothermal treatment, the intensity of the HA peaks increased. The transmittance of the HA films with 5 and 10nm Ti intermediate layers was >79% and 68%, respectively, in the visible light wavelength region (400-700nm) after the hydrothermal treatment. The adhesion strength of the hydrothermally treated HA films increased with decreasing thickness of the Ti intermediate layer, and the strength reached 2.7MPa with the 5-nm-thick Ti intermediate layer. In the immersion test, the HA film with a 5-nm-thick Ti intermediate layer without hydrothermal treatment exhibited a released Ti concentration of 42.0±2.4ppb. After hydrothermal treatment, the released Ti concentration decreased to 17.3±1.1ppb.

  14. PEEK-Halo effect in interbody fusion.

    PubMed

    Phan, Kevin; Hogan, Jarred A; Assem, Yusuf; Mobbs, Ralph J

    2016-02-01

    Recent developments have seen poly[aryl-ether-ether-ketone] (PEEK) being increasingly used in vertebral body fusion. More novel approaches to improve PEEK have included the introduction of titanium-PEEK (Ti-PEEK) composites and coatings. This paper aims to describe a potential complication of PEEK based implants relating to poorer integration with the surrounding bone, producing a "PEEK-Halo" effect which is not seen in Ti-PEEK composite implants. We present images from two patients undergoing anterior lumbar interbody fusion (ALIF). The first patient underwent an L5/S1 ALIF using a PEEK implant whilst the second patient underwent L4/L5 ALIF using a Ti-PEEK composite implant. Evidence of osseointegration was sought using CT imaging and confirmed using histological preparations of a sheep tibia model. The PEEK-Halo effect is demonstrated by a halo effect between the PEEK implant and the bone graft on CT imaging. This phenomenon is secondary to poor osseointegration of PEEK implants. The PEEK-Halo effect was not demonstrated in the second patient who received a Ti-PEEK composite graft. Histological analysis of graft/bone interface surfaces in PEEK versus Ti-PEEK implants in a sheep model further confirmed poorer osseointegration of the PEEK implant. In conclusion, the PEEK-Halo effect is seen secondary to minimal osseointegration of PEEK at the adjacent vertebral endplate following a PEEK implant insertion. This effect is not seen with Ti-PEEK implants, and may support the role of titanium in improving the bone-implant interface of PEEK substrates.

  15. Tribological properties of polymers PI, PTFE and PEEK at cryogenic temperature in vacuum

    NASA Astrophysics Data System (ADS)

    Wang, Qihua; Zheng, Fei; Wang, Tingmei

    2016-04-01

    The effects of temperature, sliding speed and load on the tribological properties of polyimide (PI), polytetrafluoroethylene (PTFE) and polyetheretherketone (PEEK) at cryogenic temperature in vacuum were investigated using a ball-on-disk tribometer. At cryogenic temperature, polymers show higher hardness which results in decreasing contact area between the friction pairs. Moreover, the real surface area in contact between steel ball and polymer disk determines the friction coefficient instead of the formation and adhesion of the transfer film. Thus, the friction coefficients at cryogenic temperatures are lower than at room temperature. On the other hand, wear rates of the three polymers decrease as temperature decreases since molecular mobility and migration are limited at cryogenic temperatures. For the visco-elasticity of PI, PTFE and PEEK, the friction coefficients fall as the load increases.

  16. Improvement of mechanical properties by additive assisted laser sintering of PEEK

    SciTech Connect

    Kroh, M. Bonten, C.; Eyerer, P.

    2014-05-15

    The additive assisted laser sintering was recently developed at IKT: A carbon black (CB) additive is used to adjust the polymer's laser absorption behavior with the aim to improve the interconnection of sintered powder layers. In this paper a parameter study, Polyetheretherketone (PEEK) samples were prepared with different contents of carbon black and were laser sintered with varying thermal treatment. The samples were mechanically tested and investigated by optical light and transmission electron microscopy. An influence on the morphology at the border areas of particles and intersections of laser sintered layers was found. Depending on the viscosity of the raw material and CB content, different shapes of lamellae were observed. These (trans-) crystalline or polymorph structures, respectively, influence the thermal and mechanical behavior of the virgin PEEK. Moreover, the thermal treatment during the sintering process caused an improvement of mechanical properties like tensile strength and elongation at break.

  17. Bonding and nondestructive evaluation of graphite/PEEK composite and titanium adherends with thermoplastic adhesives

    NASA Technical Reports Server (NTRS)

    Hodges, W. T.; Tyeryar, J. R.; Berry, M.

    1985-01-01

    Bonded single overlap shear specimens were fabricated from Graphite/PEEK (Polyetheretherketone) composite adherends and titanium adherends. Six advanced thermoplastic adhesives were used for the bonding. The specimens were bonded by an electromagnetic induction technique producing high heating rates and high-strength bonds in a few minutes. This contrasts with conventionally heated presses or autoclaves that take hours to process comparable quality bonds. The Graphite/PEEK composites were highly resistant to delamination during the testing. This allowed the specimen to fail exclusively through the bondline, even at very high shear loads. Nondestructive evaluation of bonded specimens was performed ultrasonically by energizing the entire thickness of the material through the bondline and measuring acoustic impedance parameters. Destructive testing confirmed the unique ultrasonic profiles of strong and weak bonds, establishing a standard for predicting relative bond strength in subsequent specimens.

  18. Response of Human Osteoblast to n-HA/PEEK--Quantitative Proteomic Study of Bio-effects of Nano-Hydroxyapatite Composite.

    PubMed

    Zhao, Minzhi; Li, Haiyun; Liu, Xiaochen; Wei, Jie; Ji, Jianguo; Yang, Shu; Hu, Zhiyuan; Wei, Shicheng

    2016-03-09

    Nano-sized hydroxyapatite (n-HA) is considered as a bio-active material, which is often mixed into bone implant material, polyetheretherketone (PEEK). To reveal the global protein expression modulations of osteoblast in response to direct contact with the PEEK composite containing high level (40%) nano-sized hydroxyapatite (n-HA/PEEK) and explain its comprehensive bio-effects, quantitative proteomic analysis was conducted on human osteoblast-like cells MG-63 cultured on n-HA/PEEK in comparison with pure PEEK. Results from quantitative proteomic analysis showed that the most enriched categories in the up-regulated proteins were related to calcium ion processes and associated functions while the most enriched categories in the down-regulated proteins were related to RNA process. This enhanced our understanding to the molecular mechanism of the promotion of the cell adhesion and differentiation with the inhibition of the cell proliferation on n-HA/PEEK composite. It also exhibited that although the calcium ion level of incubate environment hadn't increased, merely the calcium fixed on the surface of material had influence to intracellular calcium related processes, which was also reflect by the higher intracellular Ca(2+) concentration of n-HA/PEEK. This study could lead to more comprehensive cognition to the versatile biocompatibility of composite materials. It further proves that proteomics is useful in new bio-effect discovery.

  19. Microstructure and properties of composite polyetheretherketone/Bioglass® coatings deposited on Ti-6Al-7Nb alloy for medical applications

    NASA Astrophysics Data System (ADS)

    Moskalewicz, Tomasz; Seuss, Sigrid; Boccaccini, Aldo R.

    2013-05-01

    Composite polyetheretherketone (PEEK)/Bioglass® coatings were electrophoretically deposited on two phase α + β Ti-6Al-7Nb titanium alloy substrates. A heat treatment was performed to improve the adhesion of the coatings to the substrate. The microstructure of the coatings and substrate was examined by light microscopy, scanning- and transmission electron microscopy methods as well as by X-ray diffractometry. Coatings deposited from suspensions with PEEK/Bioglass® weight ratio of 0.3 showed the best quality. Coatings of 40 μm thickness, exhibiting uniform porosity, without any cracks or presence of large voids were produced. The microstructure of the coatings was observed to be composed of Bioglass® particles fairly homogeneously embedded in a PEEK matrix. STEM-EDX line analysis revealed diffusion of Na from the glass to the PEEK matrix after heat-treatment. The results demonstrate that electrophoretic deposition (EPD) is a very useful method to deposit uniform and reproducible microporous composite PEEK/Bioglass® coatings on titanium alloy substrate for biomedical applications.

  20. Pressure behavior of different PEEK materials for dental implants.

    PubMed

    Schwitalla, Andreas Dominik; Spintig, Tobias; Kallage, Ilona; Müller, Wolf-Dieter

    2016-02-01

    Due to its mechanical properties, the biocompatible high-performance material PEEK (polyetheretherketone) and PEEK-based compounds may represent viable alternatives to titanium in the field of dental implantology. Therefore we performed static pressure tests with 11 PEEK materials (two unfilled grades, two grades filled with titanium-dioxide-powder, two grades filled with barium-sulfate-powder, two grades reinforced with short carbon fibers, one grade reinforced with glass fibers and two grades reinforced with continuous carbon fibers) in the form of cylindrical specimens with a diameter of 4, 5 and 6mm. The specimens had a height to diameter ratio of 2:1 and were therefore 8, 10 and 12mm high. The parameters elastic modulus, elastic limit and pressure strength were evaluated. The elastic moduli ranged between 2.65±0.03GPa for specimens of a titanium-dioxide-filled grade and 106.71±14.83GPa for specimens reinforced with continuous carbon fibers. The elastic limits ranged between 808.1±42.44N for specimens of a barium-sulfate-filled grade and 7256.4±519.86N for specimens reinforced with continuous carbon fibers. The lowest pressure strength of 122.77MPa was observed for specimens of an unfilled grade, whereas the highest pressure strength of 712.67±66.02MPa could be evaluated for specimens containing continuous carbon fibers. Regarding the maximum bite force of a first molar, all tested materials seem to be suitable for the use as dental implants.

  1. Apatite-forming PEEK with TiO2 surface layer coating.

    PubMed

    Kizuki, Takashi; Matsushita, Tomiharu; Kokubo, Tadashi

    2015-01-01

    Polyetheretherketone (PEEK) is widely used in orthopedic implants, such as spinal fusion devices, because of its moderate elastic modulus, as well as relatively high mechanical strength. However, it does not bond to living bone, and hence it needs autograft to be fixed to the bone. In this study, we attempted to add bone-bonding properties to PEEK by coating with TiO2 synthesized by the sol-gel process. When a TiO2 sol solution consisting of titanium isopropoxide, water, ethanol, and nitric acid was deposited on a PEEK substrate without any pretreatment, the formed TiO2 gel layer was easily peeled off after subsequent treatments. However, when the same solution was deposited on PEEK that was preliminarily subjected to UV or O2 plasma treatment, the deposited TiO2 gel layer strongly adhered to the substrate even after subsequent treatments. The strong adhesion was attributed to the interaction among the C-O, C=O, and O-C=O groups on the PEEK owing to the UV or O2 plasma treatment and the Ti-O bond of the TiO2 gel. Apatite did not form on the as-formed TiO2 gel layer in a simulated body fluid (SBF) even within 3 days; however, apatite formed after soaking in 0.1 M HCl solution at 80 °C for 24 h. This apatite formation was attributed to positive surface charge of the TiO2 gel layer induced by the acid treatment. The PEEK with the TiO2 gel layer coating formed by the proposed process is expected to bond to living bone, because a positively charged titanium oxide which facilitates the formation of apatite in SBF within a short period is known to bond to living bone.

  2. Plasma Surface Functionalized Polyetheretherketone for Enhanced Osseo-Integration at Bone-Implant Interface.

    PubMed

    Zhao, Ying; Wong, Hoi Man; Lui, So Ching; Chong, Eva Y W; Wu, Guosong; Zhao, Xiaoli; Wang, Chong; Pan, Haobo; Cheung, Kenneth M C; Wu, Shuilin; Chu, Paul K; Yeung, Kelvin W K

    2016-02-17

    This study aims at improving osseo-integration at the bone-implant interface of polyetheretherketone (PEEK) by water (H2O) and ammonia (NH3) plasma immersion ion implantation (PIII). The pertinent surface characteristics including surface energy, roughness, morphology, and chemical composition are investigated systematically and the in vitro biological performance is evaluated by cell adhesion and proliferation, alkaline phosphatase (ALP) activity, real-time RT-PCR evaluation, and mineralization tests. In vivo osseo-integration is examined via implanting samples into the distal femur of the rats. The hydrophilicity, surface roughness, cell adhesion, and proliferation, ALP activity, and osteogenic differentiation after H2O PIII or NH3 PIII are improved significantly. Furthermore, substantially enhanced osseo-integration is achieved in vivo. Nonline-of-sight plasma surface functionalization, which is particularly suitable for biomedical implants with an irregular geometry, does not alter the bulk compressive yield strength and elastic modulus of the materials. Consequently, the favorable bulk attributes of PEEK are preserved while the surface biological properties are enhanced thus boding well for wider orthopedic application of the biopolymer.

  3. Novel surface modifications of carbon fiber-reinforced polyetheretherketone hip stem in an ovine model.

    PubMed

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

    2012-01-01

    A carbon fiber-reinforced polymer (CFRP) is theoretically a suitable material for use in an uncemented hip prosthesis considering it can provide isoelastic environment with the surrounding bone, adequate fatigue strength, and a metal-free radiographic evaluation. To date, the selection of polymer material and optimization of both design and surface finish of the prostheses for osseointegration has not been accomplished. This study examined radiographic and histologic results of an uncemented CFRP stem manufactured from carbon fiber-reinforced polyetheretherketone (CFR/PEEK) with a roughened surface and a bioactive treatment in an adult ovine model following a 12-month implantation period. A unilateral hemiarthroplasty of the hip was performed using the CFRP stem or a titanium stem as a control. Four cases with the CFRP stem and five cases with titanium stem were evaluated. Bone on-growth fixation was achieved in two cases with the CFRP stem and in all the cases with the titanium stem. The CFRP cases showed minimal stress shielding while three of five cases with the titanium stem demonstrated typical osteopenia associated with stiff metal stems. Bone on-growth to the uncemented CFRP stem was achieved by using the CFR/PEEK for the material and modifying the surface design and the bioactive surface finish. Bone resorption and osteopenia observed with the Ti stems was not found with the CFRP design.

  4. A nano-sandwich construct built with graphene nanosheets and carbon nanotubes enhances mechanical properties of hydroxyapatite–polyetheretherketone scaffolds

    PubMed Central

    Feng, Pei; Peng, Shuping; Wu, Ping; Gao, Chengde; Huang, Wei; Deng, Youwen; Xiao, Tao; Shuai, Cijun

    2016-01-01

    A nano-sandwich construct was built by combining two-dimensional graphene nanosheets (GNSs) and one-dimensional carbon nanotubes (CNTs) to improve the mechanical properties of hydroxyapatite–polyetheretherketone (HAP–PEEK) scaffolds for bone tissue engineering. In this nano-sandwich construct, the long tubular CNTs penetrated the interlayers of graphene and prevented their aggregation, increasing the effective contact area between the construct and matrix. The combination of GNSs and CNTs in a weight ratio of 2:8 facilitated the dispersion of each other and provided a synergetic effect in enhancing the mechanical properties. The compressive strength and modulus of the scaffolds were increased by 63.58% and 56.54% at this time compared with those of HAP–PEEK scaffolds, respectively. The carbon-based fillers, pulling out and bridging, were also clearly observed in the matrix. Moreover, the dangling of CNTs and their entangling with GNSs further reinforced the mechanical properties. Furthermore, apatite layer formed on the scaffold surface after immersing in simulated body fluid, and the cells attached and spread well on the surface of the scaffolds and displayed good viability, proliferation, and differentiation. These evidence indicate that the HAP–PEEK scaffolds enhanced by GNSs and CNTs are a promising alternative for bone tissue engineering. PMID:27555770

  5. Preparation of three-dimensional braided carbon fiber-reinforced PEEK composites for potential load-bearing bone fixations. Part I. Mechanical properties and cytocompatibility.

    PubMed

    Luo, Honglin; Xiong, Guangyao; Yang, Zhiwei; Raman, Sudha R; Li, Qiuping; Ma, Chunying; Li, Deying; Wang, Zheren; Wan, Yizao

    2014-01-01

    In this study, we focused on fabrication and characterization of three-dimensional carbon fiber-reinforced polyetheretherketone (C3-D/PEEK) composites for orthopedic applications. We found that pre-heating of 3-D fabrics before hot-pressing could eliminate pores in the composites prepared by 3-D co-braiding and hot-pressing techniques. The manufacturing process and the processing variables were studied and optimum parameters were obtained. Moreover, the carbon fibers were surface treated by the anodic oxidization and its effect on mechanical properties of the composites was determined. Preliminary cell studies with mouse osteoblast cells were also performed to examine the cytocompatibility of the composites. Feasibility of the C3-D/PEEK composites as load-bearing bone fixation materials was evaluated. Results suggest that the C3-D/PEEK composites show good promising as load-bearing bone fixations.

  6. Applying the Mini-Open Anterolateral Lumbar Interbody Fusion with Self-Anchored Stand-Alone Polyetheretherketone Cage in Lumbar Revision Surgery

    PubMed Central

    Kuang, Lei; Chen, Yuqiao; Li, Lei; Lü, Guohua

    2016-01-01

    The author retrospectively studied twenty-two patients who underwent revision lumbar surgeries using ALLIF with a self-anchored stand-alone polyetheretherketone (PEEK) cage. The operation time, blood loss, and perioperative complications were evaluated. Oswestry disability index (ODI) scores and visual analog scale (VAS) scores of leg and back pain were analyzed preoperatively and at each time point of postoperative follow-up. Radiological evaluation including fusion, disc height, foraminal height, and subsidence was assessed. The results showed that the ALLIF with a self-anchored stand-alone PEEK cage is safe and effective in revision lumbar surgery with minor surgical trauma, low access-related complication rates, and satisfactory clinical and radiological results. PMID:27885355

  7. The long-term mechanical integrity of non-reinforced PEEK-OPTIMA polymer for demanding spinal applications: experimental and finite-element analysis.

    PubMed

    Ferguson, Stephen J; Visser, Judith M A; Polikeit, Anne

    2006-02-01

    Polyetheretherketone (PEEK) is a novel polymer with potential advantages for its use in demanding orthopaedic applications (e.g. intervertebral cages). However, the influence of a physiological environment on the mechanical stability of PEEK has not been reported. Furthermore, the suitability of the polymer for use in highly stressed spinal implants such as intervertebral cages has not been investigated. Therefore, a combined experimental and analytical study was performed to address these open questions. A quasi-static mechanical compression test was performed to compare the initial mechanical properties of PEEK-OPTIMA polymer in a dry, room-temperature and in an aqueous, 37 degrees C environment (n=10 per group). The creep behaviour of cylindrical PEEK polymer specimens (n=6) was measured in a simulated physiological environment at an applied stress level of 10 MPa for a loading duration of 2000 hours (12 weeks). To compare the biomechanical performance of different intervertebral cage types made from PEEK and titanium under complex loading conditions, a three-dimensional finite element model of a functional spinal unit was created. The elastic modulus of PEEK polymer specimens in a physiological environment was 1.8% lower than that of specimens tested at dry, room temperature conditions (P<0.001). The results from the creep test showed an average creep strain of less than 0.1% after 2000 hours of loading. The finite element analysis demonstrated high strain and stress concentrations at the bone/implant interface, emphasizing the importance of cage geometry for load distribution. The stress and strain maxima in the implants were well below the material strength limits of PEEK. In summary, the experimental results verified the mechanical stability of the PEEK-OPTIMA polymer in a simulated physiological environment, and over extended loading periods. Finite element analysis supported the use of PEEK-OPTIMA for load-bearing intervertebral implants.

  8. Decreased bacteria activity on Si3N4 surfaces compared with PEEK or titanium

    PubMed Central

    Gorth, Deborah J; Puckett, Sabrina; Ercan, Batur; Webster, Thomas J; Rahaman, Mohamed; Bal, B Sonny

    2012-01-01

    A significant need exists for orthopedic implants that can intrinsically resist bacterial colonization. In this study, three biomaterials that are used in spinal implants – titanium (Ti), polyether-ether-ketone (PEEK), and silicon nitride (Si3N4) – were tested to understand their respective susceptibility to bacterial infection with Staphylococcus epidermidis, Staphlococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus. Specifically, the surface chemistry, wettability, and nanostructured topography of respective biomaterials, and the effects on bacterial biofilm formation, colonization, and growth were investigated. Ti and PEEK were received with as-machined surfaces; both materials are hydrophobic, with net negative surface charges. Two surface finishes of Si3N4 were examined: as-fired and polished. In contrast to Ti and PEEK, the surface of Si3N4 is hydrophilic, with a net positive charge. A decreased biofilm formation was found, as well as fewer live bacteria on both the as-fired and polished Si3N4. These differences may reflect differential surface chemistry and surface nanostructure properties between the biomaterials tested. Because protein adsorption on material surfaces affects bacterial adhesion, the adsorption of fibronectin, vitronectin, and laminin on Ti, PEEK, and Si3N4 were also examined. Significantly greater amounts of these proteins adhered to Si3N4 than to Ti or PEEK. The findings of this study suggest that surface properties of biomaterials lead to differential adsorption of physiologic proteins, and that this phenomenon could explain the observed in-vitro differences in bacterial affinity for the respective biomaterials. Intrinsic biomaterial properties as they relate to resistance to bacterial colonization may reflect a novel strategy toward designing future orthopedic implants. PMID:22973102

  9. Electrophoretic Deposition, Microstructure, and Corrosion Resistance of Porous Sol-Gel Glass/Polyetheretherketone Coatings on the Ti-13Nb-13Zr Alloy

    NASA Astrophysics Data System (ADS)

    Moskalewicz, Tomasz; Zych, Anita; Łukaszczyk, Alicja; Cholewa-Kowalska, Katarzyna; Kruk, Adam; Dubiel, Beata; Radziszewska, Agnieszka; Berent, Katarzyna; Gajewska, Marta

    2017-02-01

    In this study, microporous composite sol-gel glass/polyetheretherketone (SGG/PEEK) coatings were produced on the Ti-13Nb-13Zr titanium alloy by electrophoretic deposition. Coatings with different levels of high open porosity were developed by introducing SGG particles of varying diameters into the PEEK matrix. The microstructure of the coatings was characterized by electron microscopy and X-ray diffractometry. The coatings with 40-50 µm thickness were composed of semicrystalline SGG particles consisting of hydroxyapatite, CaSiO3, some Ca2SiO4, and an amorphous phase containing Ca, Si, P, and O, homogeneously embedded in a semicrystalline PEEK matrix. The size of SGG particles present in the coatings strongly influenced the formation of microcracks and their adhesion to the underlying substrate. Microscratch tests showed that the coating containing SGG particles with a diameter smaller than 45 µm and open porosity of 45 pct exhibited good adhesion to the titanium alloy substrate, much better than the coating containing particles with a diameter smaller than 85 µm and total open porosity equal to 48 pct. The corrosion resistance was investigated in Ringer's solution at a temperature of 310 K (37 °C) for a pH equal to 7.4 and in deaerated solutions with the use of open-circuit potential, potentiodynamic polarization, and electrochemical impedance spectroscopy. The SGG/PEEK-coated alloy indicated better electrochemical corrosion resistance compared with the uncoated alloy.

  10. Antibacterial polyetheretherketone implants immobilized with silver ions based on chelate-bonding ability of inositol phosphate: processing, material characterization, cytotoxicity, and antibacterial properties.

    PubMed

    Kakinuma, H; Ishii, K; Ishihama, H; Honda, M; Toyama, Y; Matsumoto, M; Aizawa, M

    2015-01-01

    We developed a novel antibacterial implant by forming a hydroxyapatite (HAp) film on polyetheretherketone (PEEK) substrate, and then immobilizing silver ions (Ag(+) ) on the HAp film based on the chelate-bonding ability of inositol phosphate (IP6). First, the PEEK surface was modified by immersion into concentrated sulfuric acid for 10 min. HAp film was formed on the acid-treated PEEK via the soft-solution process using simulated body fluid (SBF), urea, and urease. After HAp coating, specimens were immersed into IP6 solution, and followed by immersion into silver nitrite solution at concentrations of 0, 0.5, 1, 5 or 10 mM. Ag(+) ions were immobilized on the resulting HAp film due to the chelate-bonding ability of IP6. On cell-culture tests under indirect conditions by Transwell, MC3T3-E1 cells on the specimens derived from the 0.5 and 1 mM Ag(+) solutions showed high relative growth when compared with controls. Furthermore, on evaluation of antibacterial activity in halo test, elution of Ag(+) ions from Ag(+) -immobilized HAp film inhibited bacterial growth. Therefore, the above-mentioned results demonstrated that specimens had both biocompatibility and strong antibacterial activity. The present coating therefore provides bone bonding ability to the implant surface and prevents the formation of biofilms in the early postoperative period.

  11. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    PubMed Central

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  12. Cervicitis

    MedlinePlus

    ... results from a sexually transmitted infection, such as chlamydia or gonorrhea. Cervicitis can develop from noninfectious causes, ... from common sexually transmitted infections (STIs), including gonorrhea, chlamydia, trichomoniasis and genital herpes. Allergic reactions. An allergy, ...

  13. Cervicitis

    MedlinePlus

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  14. A modified CDC biofilm reactor to produce mature biofilms on the surface of peek membranes for an in vivo animal model application.

    PubMed

    Williams, Dustin L; Woodbury, Kassie L; Haymond, Bryan S; Parker, Albert E; Bloebaum, Roy D

    2011-06-01

    Biofilm-related infections have become a major clinical concern. Typically, animal models that involve inoculation with planktonic bacteria have been used to create positive infection signals and examine antimicrobial strategies for eradicating or preventing biofilm-related infection. However, it is estimated that 99.9% of bacteria in nature dwell in established biofilms. As such, open wounds have significant potential to become contaminated with bacteria that reside in a well-established biofilm. In this study, a modified CDC biofilm reactor was developed to repeatably grow mature biofilms of Staphylococcus aureus on the surface of polyetheretherketone (PEEK) membranes for inoculation in a future animal model of orthopaedic implant biofilm-related infection. Results indicated that uniform, mature biofilms repeatably grew on the surface of the PEEK membranes.

  15. The wear properties of CFR-PEEK-OPTIMA articulating against ceramic assessed on a multidirectional pin-on-plate machine.

    PubMed

    Scholes, S C; Unsworth, A

    2007-04-01

    In an attempt to prolong the lives of rubbing implantable devices, several 'new' materials have been examined to determine their suitability as joint couplings. Tests were performed on a multidirectional pin-on-plate machine to determine the wear of both pitch and PAN (polyacrylonitrile)-based carbon fibre reinforced-polyetheretherketone (CFR-PEEK-OPTIMA) pins articulating against both BioLox Delta and BioLox Forte plates (ceramic materials). Both reciprocation and rotational motion were applied to the samples. The tests were conducted using 24.5 per cent bovine serum as the lubricant (protein concentration 15 g/l). Although all four material combinations gave similar low wear with no statistically significant difference (p > 0.25), the lowest average total wear of these pin-on-plate tests was provided by CFR-PEEK-OPTIMA pitch pins versus BioLox Forte plates. This was much lower than the wear produced by conventional joint materials (metal-on-polyethylene) and metal-on-metal combinations when tested on the pin-on-plate machine. This therefore indicates optimism that these PEEK-OPTIMA-based material combinations may perform well in joint applications.

  16. Macrophage reactivity to different polymers demonstrates particle size- and material-specific reactivity: PEEK-OPTIMA(®) particles versus UHMWPE particles in the submicron, micron, and 10 micron size ranges.

    PubMed

    Hallab, Nadim James; McAllister, Kyron; Brady, Mark; Jarman-Smith, Marcus

    2012-02-01

    Biologic reactivity to orthopedic implant debris is generally the main determinant of long-term clinical performance where released polymeric particles of Ultra-high molecular weight polyethylene (UHMWPE) remain the most prevalent debris generated from metal-on-polymer bearing total joint arthroplasties. Polymeric alternatives to UHMWPE such as polyetherether-ketone (PEEK) may have increased wear resistance but the bioreactivity of PEEK-OPTIMA particles on peri-implant inflammation remains largely uncharacterized. We evaluated human monocyte/macrophage responses (THP-1s and primary human) when challenged by PEEK-OPTIMA, UHMWPE, and X-UHMWPE particles of three particle sizes (0.7 um, 2 um, and 10 um) at a dose of 20 particles-per-cell at 24- and 48-h time points. Macrophage responses were measured using cytotoxicity assays, viability assays, proliferation assays and cytokine analysis (IL-1b, IL-6, IL-8, MCP-1, and TNF-α). In general, there were no significant differences between PEEK-OPTIMA, UHMWPE, and X-UHMWPE particles on macrophage viability or proliferation. However, macrophages demonstrated greater cytotoxicity responses to UHMWPE and X-UHMWPE than to PEEK-OPTIMA at 24 and 48 h, where 0.7 μm-UHMWPE particles produced the highest amount of cytotoxicity. Particles of X-UHMWPE more than PEEK-OPTIMA and UHMWPE induced IL-1β, IL-6, MCP-1, and TNF-α at 24 h, p < 0.05 (no significant differences at 48 h). On average, cytokine production was more adversely affected by larger 10 μm particles than by 0.7 and 2 μm sized particles. While limitations of in vitro analysis apply to this study, PEEK-OPTIMA particles were more biocompatible than UHMWPE particles, in that they induced less inflammatory cytokine responses and thus, in part, demonstrates that PEEK-OPTIMA implant debris does not represent an increased inflammatory risk over that of UHMWPE.

  17. Assessment of a polyelectrolyte multilayer film coating loaded with BMP-2 on titanium and PEEK implants in the rabbit femoral condyle

    PubMed Central

    Guillot, R.; Pignot-Paintrand, I.; Lavaud, J.; Decambron, A.; Bourgeois, E.; Josserand, V.; Logeart-Avramoglou, D.; Viguier, E.; Picart, C.

    2016-01-01

    The aim of this study was to evaluate the osseointegration of titanium implants (Ti-6Al-4V, noted here TA6V) and poly(etheretherketone) PEEK implants induced by a BMP-2-delivering surface coating made of polyelectrolyte multilayer films. The in vitro bioactivity of the polyelectrolyte film-coated implants was assessed using the alkaline phosphatase assay. BMP-2-coated TA6V and PEEK implants with a total dose of 9.3 µg of BMP-2 were inserted into the femoral condyles of New Zealand white rabbits and compared to uncoated implants. Rabbits were sacrificed 4 and 8 weeks after implantation. Histomorphometric analyses on TA6V and PEEK implants and microcomputed tomography on PEEK implants revealed that the bone-to-implant contact and bone area around the implants were significantly lower for the BMP-2-coated implants than for the bare implants. This was confirmed by scanning electron microscopy imaging. This difference was more pronounced at 4 weeks in comparison to the 8-week time point. However, bone growth inside the hexagonal upper hollow cavity of the screws was higher in the case of the BMP-2 coated implants. Overall, this study shows that a high dose of BMP-2 leads to localized and temporary bone impairment, and that the dose of BMP-2 delivered at the surface of an implant needs to be carefully optimized. PMID:26965394

  18. Mechanical strength of additive manufactured carbon fiber reinforced polyetheretherketone

    NASA Astrophysics Data System (ADS)

    Chumaevskii, A. V.; Tarasov, S. Yu.; Filippov, A. V.; Kolubaev, E. A.; Rubtsov, V. E.; Eliseev, A. A.

    2016-11-01

    Mechanical properties of both pure and chopped carbon fiber reinforced polyetheretherketone samples have been carried out. It was shown that the reinforcement resulted in increasing the elasticity modulus, compression and tensile ultimate strength by a factor of 3.5, 2.9 and 2.8, respectively. The fracture surfaces have been examined using both optical and scanning electron microscopy.

  19. The influence of metal artifacts on navigation and the reduction of artifacts by the use of polyether-ether-ketone.

    PubMed

    Citak, M; Kendoff, D; Wanich, T; Look, V; Stuber, V; Geerling, J; Krettek, C; Hüfner, T

    2008-07-01

    Registration is a crucial step in navigation assisted surgery. When performing anatomical pair-point registration, there are several potential sources of error, including inadequate data acquisition, improper segmentation, and distortion resulting from metal artifacts. The aim of this study was to evaluate the influence of metal artifacts on the precision of Iso-C(3D) and fluoroscopy-based navigation, and to assess any changes in precision from the use of a newly developed Schanz screw composed of polyether-ether-ketone (PEEK OPTIMA). A T-shaped test specimen was manufactured from synthetic bone material. It was then scanned with a Siremobil Iso-C(3D) while different types of implant were present in the specimen. Five Iso-C(3D) scans were acquired: one with a steel Schanz screw in the specimen, one with a titanium screw, one with a PEEK screw, one with a 5-hole plate, and one with no screw or plate present. The registration was analyzed by "reverse verification" with a pointer in a purpose-built, manipulable 3D holder. All experiments were then repeated using fluoroscopy-based navigation. Increasing presence of metal in the scan area resulted in an increase in mean error (0.55 mm with the steel Schanz screw, 0.7 mm with the 5-hole plate). Artifacts resulting from the titanium Schanz screw were less than those caused by the stainless steel Schanz screw. While this study demonstrates that metallic artifacts do have an influence on the precision of Iso-C(3D) navigation, such artifacts were not found to be a factor when performing fluoroscopy-based navigation.

  20. A rare case of pharyngeal perforation and expectoration of an entire anterior cervical fixation construct.

    PubMed

    Quadri, Syed A; Capua, John; Ramakrishnan, Vivek; Sweiss, Raed; Cabanne, Marc; Noel, Jerry; Fiani, Brian; Siddiqi, Javed

    2017-02-03

    Anterior cervical discectomy and fusion (ACDF) is a very common surgery performed globally. Although a few cases of expectorating screws or extrusion of screws into the gastrointestinal tract through esophageal perforations have previously been reported, there has not been a case reporting pharyngeal perforation and entire cervical construct extrusion in the literature to date. In this report the authors present the first case involving the extrusion of an entire cervical construct via a tear in the posterior pharyngeal wall. An 81-year-old woman presented to the emergency department (ED) with a complaint of significant cervical pain 5 days after a fall due to a syncopal event. Radiological findings showed severe anterior subluxation of C-2 on C-3 with no spinal cord signal change noted. She underwent ACDF at the C2-3 level utilizing a polyetheretherketone (PEEK) cage, allograft, autograft, and a nontranslational plate with a locking apparatus and expanding screws. The screw placement was satisfactory on postoperative radiography and the Grade II spondylolisthesis of C-2 on C-3 was reduced appropriately with the surgery. The postoperative radiographs obtained demonstrated good instrumentation placement. Three and a half years later the patient returned to the ED having expectorated the entire anterior cervical construct. A CT scan demonstrated the C-2 and C-3 vertebral bodies to be fused posteriorly with an anterior erosive defect within the vertebral bodies and the anterior fusion hardware at the C2-3 level no longer identified. The fiberoptic laryngoscopy demonstrated a 1 × 1 cm area over the importation of the hypopharynx, above the glotic area. The Gastrografin swallowing test ruled out any esophageal tear or fistula and confirmed the presence of a large ulcer on the posterior wall of the oropharynx. To the best of the authors' knowledge, this is the first ever reported case of a tear in the posterior pharyngeal wall along with extrusion of the entire cervical

  1. Tribological assessment of a flexible carbon-fibre-reinforced poly(ether-ether-ketone) acetabular cup articulating against an alumina femoral head.

    PubMed

    Scholes, S C; Inman, I A; Unsworth, A; Jones, E

    2008-04-01

    New material combinations have been introduced as the bearing surfaces of hip prostheses in an attempt to prolong their life by overcoming the problems of failure due to wear-particle-induced osteolysis. This will hopefully reduce the need for revision surgery. The study detailed here used a hip simulator to assess the volumetric wear rates of large-diameter carbon-fibre-reinforced pitch-based poly(ether-ether-ketone) (CFR-PEEK) acetabular cups articulating against alumina femoral heads. The joints were tested for 25 x 10(6) cycles. Friction tests were also performed on these joints to determine the lubrication regime under which they operate. The average volumetric wear rate of the CFR-PEEK acetabular component of 54 mm diameter was 1.16 mm(3)/10(6) cycles, compared with 38.6 mm(3)/10(6) cycles for an ultra-high-molecular-weight polyethylene acetabular component of 28 mm diameter worn against a ceramic head. This extremely low wear rate was sustained over 25 x 10(6) cycles (the equivalent of up to approximately 25 years in vivo). The frictional studies showed that the joints worked under the mixed-boundary lubrication regime. The low wear produced by these joints showed that this novel joint couple offers low wear rates and therefore may be an alternative material choice for the reduction of osteolysis.

  2. Adjacent-Level Hypermobility and Instrumented-Level Fatigue Loosening With Titanium and PEEK Rods for a Pedicle Screw System: An In Vitro Study.

    PubMed

    Agarwal, Aakas; Ingels, Marcel; Kodigudla, Manoj; Momeni, Narjes; Goel, Vijay; Agarwal, Anand K

    2016-05-01

    Adjacent-level disease is a common iatrogenic complication seen among patients undergoing spinal fusion for low back pain. This is attributed to the postsurgical differences in stiffness between the spinal levels, which result in abnormal forces, stress shielding, and hypermobility at the adjacent levels. In addition, as most patients undergoing these surgeries are osteoporotic, screw loosening at the index level is a complication that commonly accompanies adjacent-level disease. Recent studies indicate that a rod with lower rigidity than that of titanium may help to overcome these detrimental effects at the adjacent level. The present study was conducted in vitro using 12 L1-S1 specimens divided into groups of six, with each group instrumented with either titanium rods or PEEK (polyetheretherketone) rods. The test protocol included subjecting intact specimens to pure moments of 10 Nm in extension and flexion using an FS20 Biomechanical Spine Test System (Applied Test Systems) followed by hybrid moments on the instrumented specimens to achieve the same L1-S1 motion as that of the intact specimens. During the protocol's later phase, the L4-L5 units from each specimen were segmented for cyclic loading followed by postfatigue kinematic analysis to highlight the differences in motion pre- and postfatigue. The objectives included the in vitro comparison of (1) the adjacent-level motion before and after instrumentation with PEEK and titanium rods and (2) the pre- and postfatigue motion at the instrumented level with PEEK and titanium rods. The results showed that the adjacent levels above the instrumentation caused increased flexion and extension with both PEEK and titanium rods. The postfatigue kinematic data showed that the motion at the instrumented level (L4-L5) increased significantly in both flexion and extension compared to prefatigue motion in titanium groups. However, there was no significant difference in motion between the pre- and postfatigue data in the PEEK

  3. Effects of Melt Processing on Evolution of Structure in PEEK

    NASA Technical Reports Server (NTRS)

    Georgiev, Georgi; Dai, Patrick Shuanghua; Oyebode, Elizabeth; Cebe, Peggy; Capel, Malcolm

    1999-01-01

    We report on the effects of melt processing temperature on structure formation in Poly(ether-ether-ketone), PEEK. Real time Small Angle X-ray Scattering, SAXS, and thermal analysis are used to follow the melting behavior after various stages of processing. Assignment of peaks to structural entities within the material, the relative perfection of the crystals, and the possibility of their reorganization, are all influenced by the melt processing history. With the advent of high intensity synchrotron sources of X-radiation, polymer scientists gain a research tool which, when used along with thermal analysis, provides additional structural information about the crystals during growth and subsequent melting. PEEK is an engineering thermoplastic polymer with a very high glass transition temperature (145 C) and crystal melting point (337 C). PEEK has been the subject of recent studies by X-ray scattering in which melt and cold crystallization were followed in real-time. X-ray scattering and thermal studies have been used to address the formation of dual endothermic response which has been variously ascribed to lamellar insertion, dual crystal populations, or melting followed by re-crystallization. Another important issue is whether all of the amorphous phase is located in interlamellar regions, or alternatively whether some is located in "pockets" away from the crystalline lamellar stacks. The interpretation of scattering from lamellar stacks varies depending upon whether such amorphous pockets are formed. Some groups believe all of the amorphous phase is interlamellar. This leads to selection of a smaller thickness for the crystals. Other groups suggest that most amorphous phase is not interlamellar, and this leads to the suggestion that the crystal thickness is larger than the amorphous layer within the stacks. To investigate these ideas, we used SAXS and Differential Scanning Calorimetry to compare results of single and dual stage melt crystallization of PEEK using a

  4. Effects of Melt Processing on Evolution of Structure in PEEK

    NASA Technical Reports Server (NTRS)

    Georgiev, Georgi; Dai, Patrick Shuanghua; Oyebode, Elizabeth; Cebe, Peggy; Capel, Malcolm

    1999-01-01

    We report on the effects of melt processing temperature on structure formation in Poly(ether-ether-ketone), PEEK. Real time Small Angle X-ray Scattering, SAXS, and thermal analysis are used to follow the melting behavior after various stages of processing. Assignment of peaks to structural entities within the material, the relative perfection of the crystals, and the possibility of their reorganization, are all influenced by the melt processing history. With the advent of high intensity synchrotron sources of X-radiation, polymer scientists gain a research tool which, when used along with thermal analysis, provides additional structural information about the crystals during growth and subsequent melting. PEEK is an engineering thermoplastic polymer with a very high glass transition temperature (145 C) and crystal melting point (337 C). PEEK has been the subject of recent studies by X-ray scattering in which melt and cold crystallization were followed in real-time. X-ray scattering and thermal studies have been used to address the formation of dual endothermic response which has been variously ascribed to lamellar insertion, dual crystal populations, or melting followed by re-crystallization. Another important issue is whether all of the amorphous phase is located in interlamellar regions, or alternatively whether some is located in "pockets" away from the crystalline lamellar stacks. The interpretation of scattering from lamellar stacks varies depending upon whether such amorphous pockets are formed. Some groups believe all of the amorphous phase is interlamellar. This leads to selection of a smaller thickness for the crystals. Other groups suggest that most amorphous phase is not interlamellar, and this leads to the suggestion that the crystal thickness is larger than the amorphous layer within the stacks. To investigate these ideas, we used SAXS and Differential Scanning Calorimetry to compare results of single and dual stage melt crystallization of PEEK using a

  5. First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept

    SciTech Connect

    Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H.; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M.; Borm, Paul J. A.; Jacob, Augustinus L.; Bilecen, Deniz

    2009-05-15

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  6. First magnetic resonance imaging-guided aortic stenting and cava filter placement using a polyetheretherketone-based magnetic resonance imaging-compatible guidewire in swine: proof of concept.

    PubMed

    Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M; Borm, Paul J A; Jacob, Augustinus L; Bilecen, Deniz

    2009-05-01

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  7. Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

    PubMed Central

    Giurea, Alexander; Pfaff, Andreas M.; Tozzi, Gianluca

    2016-01-01

    Carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) represents a promising alternative material for bushings in total knee replacements, after early clinical failures of polyethylene in this application. The objective of the present study was to evaluate the damage modes and the extent of damage observed on CFR-PEEK hinge mechanism articulation components after in vivo service in a rotating hinge knee (RHK) system and to compare the results with corresponding components subjected to in vitro wear tests. Key question was if there were any similarities or differences between in vivo and in vitro damage characteristics. Twelve retrieved RHK systems after an average of 34.9 months in vivo underwent wear damage analysis with focus on the four integrated CFR-PEEK components and distinction between different damage modes and classification with a scoring system. The analysis included visual examination, scanning electron microscopy, and energy dispersive X-ray spectroscopy, as well as surface roughness and profile measurements. The main wear damage modes were comparable between retrieved and in vitro specimens (n = 3), whereby the size of affected area on the retrieved components showed a higher variation. Overall, the retrieved specimens seemed to be slightly heavier damaged which was probably attributable to the more complex loading and kinematic conditions in vivo. PMID:28101512

  8. Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings.

    PubMed

    Schierjott, Ronja A; Giurea, Alexander; Neuhaus, Hans-Joachim; Schwiesau, Jens; Pfaff, Andreas M; Utzschneider, Sandra; Tozzi, Gianluca; Grupp, Thomas M

    2016-01-01

    Carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) represents a promising alternative material for bushings in total knee replacements, after early clinical failures of polyethylene in this application. The objective of the present study was to evaluate the damage modes and the extent of damage observed on CFR-PEEK hinge mechanism articulation components after in vivo service in a rotating hinge knee (RHK) system and to compare the results with corresponding components subjected to in vitro wear tests. Key question was if there were any similarities or differences between in vivo and in vitro damage characteristics. Twelve retrieved RHK systems after an average of 34.9 months in vivo underwent wear damage analysis with focus on the four integrated CFR-PEEK components and distinction between different damage modes and classification with a scoring system. The analysis included visual examination, scanning electron microscopy, and energy dispersive X-ray spectroscopy, as well as surface roughness and profile measurements. The main wear damage modes were comparable between retrieved and in vitro specimens (n = 3), whereby the size of affected area on the retrieved components showed a higher variation. Overall, the retrieved specimens seemed to be slightly heavier damaged which was probably attributable to the more complex loading and kinematic conditions in vivo.

  9. The influence of sterilization processes on the micromechanical properties of carbon fiber-reinforced PEEK composites for bone implant applications.

    PubMed

    Godara, A; Raabe, D; Green, S

    2007-03-01

    The effect of sterilization on the structural integrity of the thermoplastic matrix composite polyetheretherketone (PEEK) reinforced with carbon fibers (CF) is investigated by nanoindentation and nanoscratch tests. The use of the material as a medical implant grade requires a detailed understanding of the micromechanical properties which primarily define its in vivo behavior. Sterilization is a mandatory process for such materials used in medical applications like bone implants. The steam and gamma radiation sterilization processes employed in this study are at sufficient levels to affect the micromechanical properties of some polymer materials, particularly in the interphase region between the polymer matrix and the reinforcing fibers. Nanoindentation and nanoscratch tests are used in this work to reveal local gradients in the hardness and the elastic properties of the interphase regions. Both methods help to explore microscopic changes in the hardness, reduced stiffness and scratch resistance in the interphase region and in the bulk polymer matrix due to the different sterilization processes employed. The results reveal that neither steam nor gamma radiation sterilization entails significant changes of the reduced elastic modulus, hardness or coefficient of friction in the bulk polymer matrix. However, minor material changes of the PEEK matrix were observed in the interphase region. Of the two sterilization methods used, the steam treatment has a more significant influence on these small changes in this region and appears to increase slightly the thickness of the interphase zone.

  10. Anterior cervical discectomy and fusion (ACDF) autograft versus graft substitutes: what do patients prefer?—A clinical study

    PubMed Central

    Maharaj, Monish M.; Phan, Kevin

    2016-01-01

    Background Patient dissatisfaction with donor site morbidity has led to the search for alternative grafting options and techniques. This report compares patient satisfaction rates between autograft and graft substitutes for anterior cervical discectomy and fusion (ACDF). Methods This study was performed with the approval of the local area health network ethics committee. Over a 9-year period, the author performed 574 ACDF procedures (697 levels). Of these, 22 patients had previous surgery with autograft, with a subsequent ACDF procedure performed using a graft substitute. Patients rated their satisfaction with pain, recovery, and preference of autograft versus a bone graft substitute. Graft substitutes used include: tricalcium phosphate/hydroxyapatite (TCP/HA) composite and iFactor placed within a polyetheretherketone (PEEK) cage. Results Results demonstrated that 21/22 patients achieved a solid fusion with the graft substitute. A total of 20/22 patients rated the autograft incision more painful than the anterior cervical incision, and 21/22 preferred the graft substitute. Three patients had adjacent segment disc replacement performed after autograft/ACDF. All patients reported preference for the total disc replacement (TDR) procedure in terms of recovery and postoperative pain. Conclusions Patient satisfaction with bone graft substitutes is very high compared with autograft with all but one (21/22) preferring the graft substitute option. The author questions the traditional recommendation that autograft is the “gold standard” for ACDF. In modern age of graft substitutes, autograft should not be considered the gold standard, but an index option between other options for comparison. PMID:27683706

  11. A new alternative to expandable pedicle screws: Expandable poly-ether-ether-ketone shell.

    PubMed

    Demir, Teyfik

    2015-05-01

    Screw pullout is a very common problem in the fixation of sacrum with pedicle screws. The principal cause of this problem is that the cyclic micro motions in the fixation of sacrum are higher than the other regions of the vertebrae that limit the osteo-integration between bone and screw. In addition to that, the bone quality is very poor at sacrum region. This study investigated a possible solution to the pullout problem without the expandable screws' handicaps. Newly designed poly-ether-ether-ketone expandable shell and classical pedicle screws were biomechanically compared. Torsion test, pullout tests, fatigue tests, flexion/extension moment test, axial gripping capacity tests and torsional gripping capacity tests were conducted in accordance with ASTM F543, F1798 and F1717. Standard polyurethane foam and calf vertebrae were used as embedding medium for pullout tests. Classical pedicle screw pullout load on polyurethane foam was 564.8 N compared to the failure load for calf vertebrae's 1264 N. Under the same test conditions, expandable poly-ether-ether-ketone shell system's pullout loads from polyurethane foam and calf vertebrae were 1196.3 and 1890 N, respectively. The pullout values for expandable poly-ether-ether-ketone shell were 33% and 53% higher than classical pedicle screw on polyurethane foam and calf vertebrae, respectively. The expandable poly-ether-ether-ketone shell exhibited endurance on its 90% of yield load. Contrary to poly-ether-ether-ketone shell, classical pedicle screw exhibited endurance on 70% of its yield load. Expandable poly-ether-ether-ketone shell exhibited much higher pullout performance than classical pedicle screw. Fatigue performance of expandable poly-ether-ether-ketone shell is also higher than classical pedicle screw due to damping the micro motion capacity of the poly-ether-ether-ketone. Expandable poly-ether-ether-ketone shell is a safe alternative to all other expandable pedicle screw systems on mechanical perspective.

  12. Mechanical properties and in vivo study of modified-hydroxyapatite/polyetheretherketone biocomposites.

    PubMed

    Ma, Rui; Li, Qiankuan; Wang, Lin; Zhang, Xianghua; Fang, Lin; Luo, Zhongkuan; Xue, Bai; Ma, Lei

    2017-04-01

    Polyether ether ketone (PEEK) has received much attention for its excellent mechanical properties and biocompatibility. Here, the silane coupling agent KH560 [γ-(2,3-epoxypropoxy)propyltrimethoxysilane] is used for graft modification of bioactive HA (hydroxyapatite) particles and for preparing HA/PEEK composites via a hot-press molding method. The prepared HA/PEEK composites were tested for their mechanical properties with SEM (scanning electron microscopy), infrared spectroscopy, and thermo-analysis. The results show that silane coupling KH-560 modifies HA successfully and that the tensile strengths of HA/PEEK and m-HA/PEEK composites indicate an increasing and then a decreasing tendency with increasing HA contents. The non-modified HA/PEEK composites display the same trend as the modified specimens with lower tensile strength and consist of sharp points. When the HA content is 5wt.%, the tensile strength of m-HA/PEEK composite reaches its maximum, which is 23% higher than that of pure PEEK specimens. The in vivo experiments of m-HA/PEEK used a biomechanical push-out test, SEM, optical microscopy, and an Image-Pro Express C image analysis system. The growth of the bone tissues around the m-HA/PEEK composites with an HA content of 5wt.% is better than that of specimens with different HA contents. This finding shows the nano-scale effect of the bioactive filler HA in PEEK substrates, which obviously contributes to the growth of the surrounding bone issues in vivo. This study could provide theoretical support for the further promotion and application of high-performance engineering plastics such as PEEK in biomedical fields.

  13. UV curable lens production using molecular weight controlled PEEK based acrylic oligomer (Ac-PEEK).

    PubMed

    İnan, Tulay Y; Yıldız, Emel; Karaca, Birsen; Dogan, Hacer; Vatansever, Alican; Nalbant, Muhammed; Eken, Koray

    2014-08-01

    We produced UV curable lenses with properties blocking short wave UV light. In the UV-curable formulations, we used an oligomer (Ac-PEEK) with another urethan oligomer (Mw = 2000). Radically active, molecular weight controlled Ac-PEEK was obtained by reacting 2-hydroxyl ethyl methacrylate with molecular- weight- controlled and isocyanate terminated PEEK (Mn = 4500). We characterized all synthesized monomer, oligomer and optical materials with UV/Vis spectrophotometer with interferogram, elemental analyser, mass spectrophotometer, proton nuclear magnetic resonance, Fourier transform infrared spectroscopy, thermal gravimetric analyzer, differential scanning calorimeter, scanning electron microscopy and gas chromatography. Results suggested that newly synthesized oligomer with the structure of PEEK absorbs short wave UV-light. Ageing tests [ISO 11979-5, Ophthalmic implants-intraocular lenses (IOL)-Part 5: Biocompatibility] performed on the IOL materials were successful. High contact angle of the obtained lenses suggests that all lenses were hydrophobic and SEM results revealed that lenses are morphologically homogeneous. Based on all positive properties just mentioned, we safely conclude that the lenses produced in this study are very promising for IOL production.

  14. PEEK Biomaterials in Trauma, Orthopedic, and Spinal Implants

    PubMed Central

    Kurtz, S. M.; Devine, J. N.

    2007-01-01

    Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

  15. Crystalline ha coating on peek via chemical deposition

    NASA Astrophysics Data System (ADS)

    Almasi, D.; Izman, S.; Assadian, M.; Ghanbari, M.; Abdul Kadir, M. R.

    2014-09-01

    Polyether ether ketone (PEEK) has a similar elastic modulus to bone and can be a suitable alternative to metallic implants. However, PEEK is bioinert and does not integrate well with the surrounding tissues. The current commercial method for solving this problem is by coating PEEK substrates with calcium phosphates via plasma spraying. However, this method produces a low bonding strength between the substrate and the coating layer, as well as non-uniform density of the coating. In this study, chemical deposition was used to deposit HA crystalline particles on PEEK substrate without any subsequent crystallisation process therefore producing crystalline treated layer. EDX results confirmed the deposition of HA, and the XRD results confirmed that the treated layer was crystalline HA. FT-IR analysis confirmed the chemical bonding between HA and the substrate. Surface roughness increased from 24.27 nm to 34.08 nm for 3 min immersion time. The water contact angle showed an increase in wettability of the treated sample from 71.6 to 36.4 degrees, which in turn increased its bioactivity. The proposed method is a suitable alternative to other conventional methods as high temperature was not involved in the process which could damage the surface of the substrate.

  16. Peek-a-What? Infants' Response to the Still-Face Task after Normal and Interrupted Peek-a-Boo

    ERIC Educational Resources Information Center

    Bigelow, Ann E.; Best, Caitlin

    2013-01-01

    Infants' sensitivity to the vitality or tension envelope within dyadic social exchanges was investigated by examining their responses following normal and interrupted games of peek-a-boo embedded in a Still-Face Task. Infants 5-6 months old engaged in two modified Still-Face Tasks with their mothers. In one task, the initial interaction ended with…

  17. An Investigation of Graphite Peek Composite under Compression with a Centrally Located Circular Discontinuity

    DTIC Science & Technology

    1993-03-01

    body of research conducted on Gr/PEEK exists and includes the investigation of Gr/PEEK under both tension and compression with a centrally located cutout...Some of this research has discussed a need to include the nonlinear stress-strain behavior of the materials in the evaluation of the composite. This... research will investigate the nonlinear properties of Gr/PEEK using the nonlinear finite element program, PLNRS, and validate the results both with a

  18. Red selenium nanoparticles and gray selenium nanorods as antibacterial coatings for PEEK medical devices.

    PubMed

    Wang, Qi; Mejía Jaramillo, Alejandra; Pavon, Juan J; Webster, Thomas J

    2016-10-01

    Bacterial infections are commonly found on various poly(ether ether ketone) (PEEK) medical devices (such as orthopedic instruments, spinal fusion devices, and segments in dialysis equipment), and thus, there is a significant need for introducing antibacterial properties to such materials. The objective of this in vitro study was to introduce antibacterial properties to PEEK medical devices by coating them with nanosized selenium. In this study, red selenium (an elemental form of selenium) nanoparticles were coated on PEEK medical devices through a quick precipitation method. Furthermore, with heat treatment at 100°C for 6 days, red selenium nanoparticles were transferred into gray selenium nanorods on the PEEK surfaces. Bacteria test results showed that both red and gray selenium-coated PEEK medical devices significantly inhibited the growth of Pseudomonas aeruginosa compared with uncoated PEEK after either 1, 2, or 3 days. Red selenium nanoparticle-coated PEEK showed less bacteria growth on its surface than gray selenium nanorod-coated PEEK after 3 days. This study demonstrated that red, and to a lesser extent gray, nanosized selenium could be used as potential antibacterial coatings to prevent bacteria function on PEEK medical devices. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1352-1358, 2016.

  19. Rolling contact fatigue testing of peek based composites

    NASA Astrophysics Data System (ADS)

    Avanzini, A.; Donzella, G.; Gallina, D.; Pandini, S.; Petrogalli, C.

    2010-06-01

    Rolling contact fatigue phenomenon was investigated on unfilled PEEK and on three different PEEK composites: 10% carbon micro-fiber, graphite and PTFE filled matrix, 30% carbon micro-fiber filled matrix, 30% glass micro-fiber filled matrix. For this aim, roller-shaped specimens were machined from extruded bars of these materials and subjected to rolling contact tests at different contact pressure levels by means of a four roller machine. Contact pressure-life diagrams and wear rates were so obtained and compared, highlighting a relationship with monotonic and hardness materials properties. Microscopic observations of contact surfaces and transversal section of the specimens also allowed observing the damage mechanisms occurred in the materials tested and the effects of the filler. In particular way, deep radial cracks appeared on unfilled PEEK, while spalling and delamination phenomena where found on composites. Diffuse microcracks were found at the filler-matrix interface of the composites specimens, confirming that the fatigue life of these materials is essentially determined by the crack propagation phase, also under rolling contact loading.

  20. Histopathological Analysis of PEEK Wear Particle Effects on the Synovial Tissue of Patients

    PubMed Central

    Jansson, V.; Giurea, A.

    2016-01-01

    Introduction. Increasing interest developed in the use of carbon-fiber-reinforced-poly-ether-ether-ketones (CFR-PEEK) as an alternative bearing material in knee arthroplasty. The effects of CFR-PEEK wear in in vitro and animal studies are controversially discussed, as there are no data available concerning human tissue. The aim of this study was to analyze human tissue containing CFR-PEEK as well as UHMWPE wear debris. The authors hypothesized no difference between the used biomaterials. Methods and Materials. In 10 patients during knee revision surgery of a rotating-hinge-knee-implant-design, synovial tissue samples were achieved (tibial inserts: UHMWPE; bushings and flanges: CFR-PEEK). One additional patient received revision surgery without any PEEK components as a control. The tissue was paraffin-embedded, sliced into 2 μm thick sections, and stained with hematoxylin and eosin in a standard process. A modified panoptical staining was also done. Results. A “wear-type” reaction was seen in the testing and the control group. In all samples, the UHMWPE particles were scattered in the tissue or incorporated in giant cells. CFR-PEEK particles were seen as conglomerates and only could be found next to vessels. CFR-PEEK particles showed no giant-cell reactions. In conclusion, the hypothesis has to be rejected. UHMWPE and PEEK showed a different scatter-behavior in human synovial tissue. PMID:27766256

  1. Bioactive composites consisting of PEEK and calcium silicate powders.

    PubMed

    Kim, Ill Yong; Sugino, Atsushi; Kikuta, Koichi; Ohtsuki, Chikara; Cho, Sung Baek

    2009-08-01

    Bioactive bone-repairing materials with mechanical properties analogous to those of natural bone can be obtained through the combination of bioactive ceramic fillers with organic polymers. Previously, we developed novel bioactive microspheres in a binary CaO-SiO2 system produced through a sol-gel process as filler for the fabrication of composites. In this study, we fabricate bioactive composites in which polyetheretherketone is reinforced with 0-50 vol% 30CaO x 70SiO2 (CS) microspheres. The prepared composites reinforced with CS particles form hydroxyapatite on their surfaces in simulated body fluid. The induction periods of hydroxyapatite formation on the composites decrease with increasing amount of CS particles. The mechanical properties of the composites are evaluated by three-point bending test. The composites reinforced with 20 vol% CS particles show 123.5 MPa and 6.43 GPa in bending strength and Young's modulus, respectively.

  2. Preparation Methods for Improving PEEK's Bioactivity for Orthopedic and Dental Application: A Review

    PubMed Central

    Almasi, Davood; Iqbal, Nida; Sadeghi, Maliheh; Sudin, Izman; Abdul Kadir, Mohammed Rafiq; Kamarul, Tunku

    2016-01-01

    There is an increased interest in the use of polyether ether ketone (PEEK) for orthopedic and dental implant applications due to its elastic modulus close to that of bone, biocompatibility, and its radiolucent properties. However, PEEK is still categorized as bioinert due to its low integration with surrounding tissues. Many studies have reported on methods to increase the bioactivity of PEEK, but there is still one-preparation method for preparing bioactive PEEK implant where the produced implant with desirable mechanical and bioactivity properties is required. The aim of this review is to present the progress of the preparation methods for improvement of the bioactivity of PEEK and to discuss the strengths and weaknesses of the existing methods. PMID:27127513

  3. Cervical Cerclage

    MedlinePlus

    ... or more second trimester pregnancy losses related to painless cervical dilation and in the absence of labor ... history-indicated cervical cerclage) Prior cerclage due to painless cervical dilation in the second trimester Upon physical ...

  4. Cervical disk arthroplasty versus ACDF for preoperative reducible kyphosis.

    PubMed

    Chen, Yu; Wang, Xinwei; Lu, Xuhua; Yang, Haisong; Chen, Deyu

    2013-07-01

    Cervical total disk arthroplasty has proven to be an effective and safe alternative for anterior cervical diskectomy and fusion (ACDF) for the treatment of cervical disk degenerative disease. However, whether and when cervical disk arthroplasty is indicated for preoperative cervical spine kyphosis is unclear. In the authors' clinical experiences, preoperative kyphosis can generally be divided into reducible and irreducible forms according to the results of dynamic flexion-extension lateral radiographs. Reducible kyphosis is mostly related to local disk prolapse, clinical symptoms, and musculature weakness, but irreducible kyphosis is always associated with significant cervical degeneration or congenital bone malformation. In this study, 32 patients with preoperative reducible kyphosis were randomized in a 1:1 ratio to either single-level total cervical arthroplasty with the Discover cervical disk prosthesis (DePuy Spine, Raynham, Massachusetts) (arthroplasty group) or single-level ACDF with a polyetheretherketone cage and plate (ACDF group). No significant differences existed in clinical and radiological results at 2-year follow-up between the arthroplasty and ACDF groups. The global and functional spinal unit angles of the arthroplasty group were significantly lower than those of the ACDF group 6 months postoperatively, which was consistent with the result of the comparison in Neck Disability Index score. However, the sagittal alignment of the overall cervical spine and the treated segment and the Neck Disability Index score significantly improved after 6 months in the arthroplasty group but not in the ACDF group. Therefore, preoperative reducible kyphosis is not a contraindication for cervical total disk arthroplasty. However, neck strength-building exercises should be emphasized for the postoperative rehabilitation after cervical total disk arthroplasty.

  5. Study on the Wettability and Tribological Behavior of Different Polymers as Bearing Materials for Cervical Prosthesis

    NASA Astrophysics Data System (ADS)

    Wang, Song; Song, Jian; Liao, Zhenhua; Liu, Yuhong; Zhang, Caixia; Liu, Weiqiang

    2015-06-01

    Tribological behaviors of four polymers (conventional and cross-linked UHMWPE, conventional and glass fiber-reinforced PEEK) articulated with Ti6Al4V ball were studied under both dry sliding and 25% bovine serum lubrication. The hardness, static contact angle, surface damage topography, and wear parameter of wear scar were tested. Both cross-linked process of UHMWPE and glass fiber-reinforced treatment of PEEK improved wettability while they did not increase hardness. PEEK revealed higher surface hardness and better wettability than UHMWPE. The dominant wear mechanisms for UHMWPE were plastic deformation and fatigue wear while the failure mechanisms were severe adhesive and abrasive wear for PEEK. Cross-linked process of UHMWPE could form multi-molecular arrangement and reduce stratification, also decreasing friction coefficient and wear rate in both dry sliding and lubrication conditions. However, glass fiber-reinforced treatment of PEEK only decreased its friction coefficient and wear rate in dry condition, which was closely related to the function and wear mechanism of glass fiber. Cross-linked UHMWPE revealed the lowest friction coefficient and wear rate under lubrication condition, which was attributed to the cross-linked treatment and the formation of both protein adsorption film and lubrication film. Hence, cross-linked UHMWPE may be an alternative polymer for use as artificial cervical disc bearing material when it articulated with Ti6Al4V.

  6. Debris of carbon-fibers originated from a CFRP (pEEK) wrist-plate triggered a destruent synovitis in human.

    PubMed

    Merolli, Antonio; Rocchi, Lorenzo; De Spirito, Marco; Federico, Francesco; Morini, Alessandro; Mingarelli, Luigi; Fanfani, Francesco

    2016-03-01

    Application of carbon-fiber-reinforced-polymer (CFRP) artifacts in humans has been promoted in Orthopedic and Trauma Surgery. Literature documents the biocompatibility of materials used, namely carbon fibers (CF) and poly-ether thermoplastics, like poly-ether-ether-ketone (PEEK). A properly designed and accurately implanted composite artifact should not expose its fibers during or after surgery: however this may happen. A white Caucasian woman came to our attention 11 months after surgery for a wrist fracture. She had a severe impairment, being unable to flex the thumb; index finger and distal phalanx of third finger. We retrieved a correctly positioned plate and documented an aggressive erosive flexor tendons synovitis with eroded stumps of flexor tendons. The plate and soft tissues were analyzed by Visible Light and Scanning Electron Microscopy. Histopathology showed granulomatous fibrogenic process with CF engulfed inside multinucleated giant cells. Fibers were unmasked and disrupted inside the holes where screws were tightened and corrugation of the polymer coating led to further unmasking. The mechanism of foreign-body reaction to CF has not been studied in depth yet, particularly at the ultrastructural level and in Humans. This case documents a damage occurred in a clinical application and which was theoretically possible. Our opinion is that a proper way to promote the use of CRFP in the Clinic in the short term is to direct Research towards finding a better way to prevent CF debris to be exposed and released. In the longer term, the biological response to CF deserves a deeper understanding.

  7. Suitability of carbon fiber-reinforced polyetheretherketone cages for use as anterior struts following corpectomy.

    PubMed

    Heary, Robert F; Parvathreddy, Naresh K; Qayumi, Zainab S; Ali, Naiim S; Agarwal, Nitin

    2016-08-01

    OBJECTIVE Fibular allograft remains a widely used strut for corpectomy surgeries. The amount of graft material that can be packed into an allograft strut has not been quantified. Cages are an alternative to fibular allograft for fusion surgeries. The authors of this study assessed the suitability of carbon fiber-reinforced polyetheretherketone (CFRP) cages for anterior corpectomy surgeries. They further explored the parameters known to affect fusion rates in clinical practice. METHODS Six fibular allografts were tested at standard lengths. Three sets of carbon fiber cages (Bengal, DePuy Spine), each with a different footprint size but the same lengths, were tested. The allografts and cages were wrapped in adhesive, fluid-tight transparent barriers and filled with oil. The volume and weight of the oil instilled as well as the implant footprints were measured. The fibular allografts and cages were tested at 20-, 40-, and 50-mm lengths. Two investigators independently performed all measurements 5 times. Five CFRP cubes (1 × 1 × 1 cm) were tested under pure compression, and load versus displacement curves were plotted to determine the modulus of elasticity. RESULTS Significantly more oil fit in the CFRP cages than in the fibular allografts (p < 0.0001). The weight and volume of oil was 4-6 times greater in the cages. Interobserver (r = 0.991) and intraobserver (r = 0.993) reliability was excellent. The modulus of elasticity for CFRP was 16.44 ± 2.07 GPa. CONCLUSIONS Carbon fiber-reinforced polyetheretherketone cages can accommodate much more graft material than can fibular allografts. In clinical practice, the ability to deliver greater amounts of graft material following a corpectomy may improve fusion rates.

  8. Cold-spray coating of hydroxyapatite on a three-dimensional polyetheretherketone implant and its biocompatibility evaluated by in vitro and in vivo minipig model.

    PubMed

    Lee, Jae Hyup; Jang, Hae Lin; Lee, Kyung Mee; Baek, Hae-Ri; Jin, Kyoungsuk; Noh, Jun Hong

    2017-04-01

    PEEK is a bioinert material that does not chemically bind to native bone tissue and thus formation of natural bone-like hydroxyapatite (HA) coating layer on PEEK has been an important challenge to improve biocompatibility and to preserve mechanical property of PEEK. Among various coating techniques, cold-spray coating method is suitable to form stable HA coating layer on PEEK while maintaining their chemical properties, because it can be conducted in relatively low-temperature range. Therefore, in this research, we used cold-spray coating method to form a thick layer of HA on the topographically complex PEEK substrates with periodic ridges on the surface and implanted in iliac bone defects of minipigs which is known to be similar with human body system. In addition, PEEK cage for clinical usage was coated with HA and inserted in the lumbar intervertebral disc space of minipig. We observed higher ALP activity, calcium production, and BSP production of human bone marrow mesenchymal stem cells on the HA-coated PEEK implants than the bare PEEK group in in vitro test. In addition, two-dimensional histological analysis and three-dimensional micro CT analysis demonstrated that implantation of complex shape of HA-PEEK hybrid implant in in vivo minipig model resulted sufficient biocompatibility and osseointegration for further clinical applications. Notably, due to the enhanced stability of PEEK cage induced from HA coating layer, osseointegration rate of the small HA blocks loaded inside the PEEK cage was also significantly improved which indicates overall increased fusion rate and adherence of the HA-coated PEEK cage. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 647-657, 2017.

  9. Heat splicing of plastic fibers using a PEEK tube

    NASA Astrophysics Data System (ADS)

    Hara, K.; Horiuchi, K.; Kim, S.; Nakano, I.; Takebayashi, T.; Takikawa, K.; Yasuoka, K.; Koyano, M.; Matsui, S.; Takeuchi, H.

    1994-08-01

    We have developed a device to splice plastic optical fibers by thermal fusion. The device heats the joint of fibers inserted in a PEEK tube, which can help align the fiber axes and protects the fused joint mechanically. We have tuned the device to produce splices with good light transmission and mechanical strength. Light transmission of nearly 95% with an rms variation of 1.5% has been achieved. The joint supports 1.2 kgf in tension and the bending radius can be as small as 3 cm. The mechanical strength can be improved easily by adding epoxy. We describe the optimization of the device and measurement results of 28000 fiber splices for the CDF plug-upgrade tile/fiber calorimeter.

  10. On compression and damage evolution in PTFE and PEEK

    NASA Astrophysics Data System (ADS)

    Rau, C.; Parry, S.; Garcea, S. C.; Bourne, N. K.; McDonald, S. A.; Eastwood, D. S.; Brown, E. N.; Withers, P. J.

    2017-01-01

    The well-known Taylor cylinder impact test, that follows the impact of a flat-ended cylindrical rod onto a rigid stationary anvil, is conducted over a range of impact speeds for two polymers, PTFE and PEEK. In previous work experiments and a model were developed to capture the deformation behaviour of the rod after impact. A distinctive feature of these works was that a region in which both spatial and temporal variation of both longitudinal and radial deformation showed evidence of changes in phase within the material. This region is X-ray imaged in a range of impacted targets at the I13 Imaging and Coherence beam line at the Diamond synchrotron. Further techniques were fielded to resolve compressed regions within the recovered polymer cylinders that showed a fracture zone in the impact region. This shows the transit of damage from ductile to brittle failure results from previously undetected internal failure.

  11. Comparison of energy absorption of carbon/epoxy and carbon/PEEK composite tubes

    NASA Astrophysics Data System (ADS)

    Hamada, H.; Coppola, J. C.; Hull, D.; Maekawa, Z.; Sato, H.

    1992-07-01

    Axial compressive tests have been carried out on carbon fiber/epoxy and carbon fiber/PEEK tubes made from unidirectional prepreg materials. Three fiber architectures were investigated: unidirectional fibers parallel (0 deg) to the axis of the tube, +/- 30 deg, and +/- 45 deg. One set of tubes was machined with a 45-deg chamfer at one end in an attempt to trigger progressive crushing, and the other set had square ends to determine the compressive strength of the material. Stable progressive crushing occurred in +/- 45 deg carbon fiber/epoxy tubes and 0-deg carbon fiber/PEEK tubes where the crush stress was significantly lower than the compressive fracture strength. The 0-deg carbon fiber/PEEK tubes had a specific energy absorption of 180 kJ/kg, which is the highest value recorded for any material. This high value is interpreted in terms of the high interlaminar toughness of PEEK-matrix composites.

  12. New method in experimental damage study of AS4/PEEK composite laminates

    NASA Astrophysics Data System (ADS)

    Wang, Shibin; Tong, Jingwei; Yue, C.; Li, Linan; Shen, Min

    2002-06-01

    AS4/PEEK [0/+/- 45/90]7s composite laminates were subjected to a bending moment. We have obtained the displacement fields by moire interferometry with the aid of Long Distance Microscope. Based on wavelet analysis, the digital moire images were processed and analyzed. The special algorithms of unconstrained nonlinear minimization and the scale parameter were used to eliminate the influence of the noise in the digital image processing. Tension tests were carried out on AS4/PEEK [ 0/+/- 45/90 ]2s composites. When AS4/PEEK composite laminates were deformed, the images of natural surface of the AS4/PEEK specimen were recorded to study the damage initiation and growth. The experimental results show that the considerable interlaminal stresses between different plies, and these places were more prone to delaminate. The paper presents the microscopic damages and matrix crack growth observed by an optical microscope and the CCD camera.

  13. Cervical Cap

    MedlinePlus

    ... check the cervical cap's position before sex. Squat, bear down, insert your finger into your vagina and ... two days. To remove the cervical cap, squat, bear down and rotate the cap. Relax your muscles ...

  14. Cervical polyps

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001494.htm Cervical polyps To use the sharing features on this page, please enable JavaScript. Cervical polyps are fingerlike growths on the lower part ...

  15. Cervical Cancer

    MedlinePlus

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

  16. Cervical Cancer

    MedlinePlus

    ... cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer is the easiest gynecological cancer to prevent with ... HPV on a woman's cervix. Certain types of HPV can lead to cervical cancer. Your doctor will swab the cervix for cells. ...

  17. Multilevel surface engineering of nanostructured TiO2 on carbon-fiber-reinforced polyetheretherketone.

    PubMed

    Lu, Tao; Liu, Xuanyong; Qian, Shi; Cao, Huiliang; Qiao, Yuqin; Mei, Yongfeng; Chu, Paul K; Ding, Chuanxian

    2014-07-01

    As an implantable material, carbon-fiber-reinforced polyetheretherketone (CFRPEEK) possesses an adjustable elastic modulus similar to that of cortical bone and is a prime candidate to replace metallic surgical implants. However, the bioinertness and poor osteogenic properties of CFRPEEK limit its clinical application as orthopedic implants. In this work, titanium ions are introduced energetically into CFRPEEK by plasma immersion ion implantation (PIII). Scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS) reveal the formation of nanopores with the side wall and bottom embedded with ∼20 nm TiO2 nanoparticles on the CFRPEEK surface. Nanoindentation measurements confirm the stability and improved elastic resistance of the structured surfaces. In vitro cell adhesion, viability assay, and real-time PCR analyses disclose enhanced adhesion, proliferation, and osteo-differentiation of rat bone mesenchymal stem cells (bMSCs). The multilevel structures on CFRPEEK also exhibit partial antibacterial activity to Staphylococcus aureus and Escherichia coli. Our results indicate that a surface with multifunctional biological properties can be produced by multilevel surface engineering and application of CFRPEEK to orthopedic and dental implants can be broadened and expedited based on this scheme.

  18. Wear rate control of peek surfaces modified by femtosecond laser

    NASA Astrophysics Data System (ADS)

    Hammouti, S.; Pascale-Hamri, A.; Faure, N.; Beaugiraud, B.; Guibert, M.; Mauclair, C.; Benayoun, S.; Valette, S.

    2015-12-01

    This paper presents the effect of laser texturing on the tribological properties of PEEK surfaces under a ball-on-flat contact configuration. Thus, surfaces with circular dimples of various diameters and depth were created. Tests were conducted with a normal load of 5 N and a sliding velocity of 0.01 m s-1, using bovine calf serum at 37.5 °C as a lubricant. The tribological conditions including the sliding frequency and the lubricant viscosity indicate that tests were performed under boundary lubrication regime. Results showed that discs with higher dimple depth exhibited higher friction coefficient and caused more abrasive wear on the ball specimen. Nevertheless, tribosystems (ball and disc) with dimpled disc surfaces showed a higher wear resistance. In the frame of our experiments, wear rates obtained for tribosystems including dimpled surfaces were 10 times lower than tribosystems including limited patterned or untextured surfaces. Applications such as design of spinal implants may be concerned by such a surface treatment to increase wear resistance of components.

  19. Mechanical property characterization and impact resistance of selected graphite/PEEK composite materials

    NASA Technical Reports Server (NTRS)

    Baker, Donald J.

    1991-01-01

    To use graphite/PEEK material on highly curved surfaces requires that the material be drapable and easily conformable to the surface. The mechanical property characterization and impact resistance results are presented for laminates made from two types of graphite/PEEK materials that will conform to a curved surface. These laminates were made from two different material forms. These forms are: (1) a fabric where each yarn is a co-mingled Celion G30-500 3K graphite fiber and PEEK fiber; and (2) an interleaved material of Celion G30-500 3K graphite fiber interleaved with PEEK film. The experimental results from the fabric laminates are compared with results for laminates made from AS4/PEEK unidirectional tape. The results indicate that the tension and compression moduli for quasi-isotropic and orthotropic laminates made from fabric materials are at least 98 pct. of the modulus of equivalent laminates made from tape materials. The strength of fabric material laminates is at least 80 pct. of laminates made from tape material. The evaluation of the fabric material for shear stiffness indicates that a tape material laminate could be replaced by a fabric material laminate and still maintain 89 pct. of the shear stiffness of the tape material laminate.

  20. Feasibility of Carbon Fiber/PEEK Composites for Cryogenic Fuel Tank Applications

    NASA Astrophysics Data System (ADS)

    Doyle, K.; Doyle, A.; O Bradaigh, C. M.; Jaredson, D.

    2012-07-01

    This paper investigates the feasibility of CF/PEEK composites for manufacture of cryogenic fuel tanks for Next Generation Space Launchers. The material considered is CF/PEEK tape from Suprem SA and the proposed manufacturing process for the fuel tank is Automated Tape Placement. Material characterization was carried out on test laminates manufactured in an autoclave and also by Automated Tape Placement with in-situ consolidation. The results of the two processes were compared to establish if there is any knock down in properties for the automated tape placement process. A permeability test rig was setup with a helium leak detector and the effect of thermal cycling on the permeability properties of CF/PEEK was measured. A 1/10th scale demonstrator was designed and manufactured consisting of a cylinder manufactured by automated tape placement and an upper dome manufactured by autoclave processing. The assembly was achieved by Amorphous Interlayer Bonding with PEI.

  1. Cervical Angina

    PubMed Central

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

    2015-01-01

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

  2. A comparative study of radiation effects in medical-grade polymers: UHMWPE, PCU and PEEK

    NASA Astrophysics Data System (ADS)

    Jahan, Muhammad S.; Walters, Benjamin M.; Riahinasab, Tayebeh; Gnawali, Rudra; Adhikari, Dipendra; Trieu, Hai

    2016-01-01

    In this study, three medical-grade polymers, ultra-high molecular weight polyethylene (UHMWPE), polycarbonate urethane (PCU) and poly (ether ether ketone) PEEK, were tested immediately after x-irradiation. The primary purpose of this study was to provide a qualitative comparison of the radiation-sensitivity of these polymers. To evaluate radiation-induced defects or trapped charges, radiation dosimetry method, known as thermally stimulated luminescence (TSL) or thermoluminescence (TL), was employed, and for free radical comparison, electron spin resonance (ESR) was used. When these polymers were x-irradiated at room temperature and subsequently heated, broad luminescence was detected as a function of temperature (known as a glow curve) in the temperature region of 75 °C to 250 °C. In particular, TSL of PCU exhibited glow peaks near 140 °C and 225 °C, that of PEEK near 100 °C and 150 °C, and of UHMWPE near 100 °C and 140 °C. In each case, totalTSL was found to increase as a function of x-ray exposure, suggesting the production of radiation-induced species in the respective polymer matrix. Compared to PCU or PEEK, UHMWPE was found to form more than one order of magnitude of free radicals per unit mass per unit x-ray exposure. In two hours in air at room temperature after irradiation, UHMWPE lost 42% of its initial radical concentration, while PCU lost 75%. X-ray induced PEEK radicals (peroxy/phenoxy) decayed in about one week. Unlike UHMWPE or PCU, non-irradiated (as-received) PEEK was found to contain residual radicals. In UHMWPE, primary radicals reportedly decay to oxygen-centered polyenyl radicals in about three months. In all the results did find significant radical formation via ESR and supporting radiation sensitivity measurements via TSL, warranting further investigation into the effects of radiation on PEEK and PCU.

  3. Processing-structure-property relations in PEEK/carbon composites made from comingled fabric and prepreg

    SciTech Connect

    Vu-khanh, T.; Denault, J. )

    1991-10-01

    The effects of the conditions of the processing of PEEK/carbon prepregs and comingled fabric on the microstructure and mechanical characteristics of the resulting composites were investigated. Results showed that, in the comingled fabric system, the fiber/matrix adhesion depends on the molding temperature, the residence time at the melt temperature, and the cooling rate. Too high molding temperature resulted in degradation of the PEEK matrix, which affected the crystallization behavior of the composites, the fiber/matrix adhesion, and the matrix properties. This effect was most important in the case of comingled systems containing sized carbon fibers. 17 refs.

  4. Inflammatory response against different carbon fiber-reinforced PEEK wear particles compared with UHMWPE in vivo.

    PubMed

    Utzschneider, Sandra; Becker, Fabian; Grupp, Thomas M; Sievers, Birte; Paulus, Alexander; Gottschalk, Oliver; Jansson, Volkmar

    2010-11-01

    Poly(ether ether ketone) (PEEK) and its composites are recognized as alternative bearing materials for use in arthroplasty because of their mechanical properties. The objective of this project was to evaluate the biological response of two different kinds of carbon fiber-reinforced (CFR) PEEK compared with ultra-high molecular weight polyethylene (UHMWPE) in vivo as a standard bearing material. Wear particles of the particulate biomaterials were injected into the left knee joint of female BALB/c mice. Assessment of the synovial microcirculation using intravital fluorescence microscopy as well as histological evaluation of the synovial layer were performed 7 days after particle injection. Enhanced leukocyte-endothelial cell interactions and an increase in functional capillary density as well as histological investigations revealed that all tested biomaterials caused significantly (P < 0.05) increased inflammatory reactions compared with control animals (injected with sterile phosphate-buffered saline), without any difference between the tested biomaterials (P > 0.05). These data suggest that wear debris of CFR-PEEK is comparable with UHMWPE in its biological activity. Therefore, CFR-PEEK represents an alternative bearing material because of its superior mechanical and chemical behavior without any increased biological activity of the wear particles, compared with a standard bearing material.

  5. MushyPeek: A Framework for Online Investigation of Audiovisual Dialogue Phenomena

    ERIC Educational Resources Information Center

    Edlund, Jens; Beskow, Jonas

    2009-01-01

    Evaluation of methods and techniques for conversational and multimodal spoken dialogue systems is complex, as is gathering data for the modeling and tuning of such techniques. This article describes MushyPeek, an experiment framework that allows us to manipulate the audiovisual behavior of interlocutors in a setting similar to face-to-face…

  6. Real time SAXS studies of lamellar level morphological development in PEEK

    SciTech Connect

    Verma, R.K.; Marand, H.; Chu, B.

    1995-12-01

    The double endotherm melting behavior of poly(aryl ether ether ketone) PEEK has been the subject of considerable debate during the last few years. Most authors are of the opinion that this behavior is caused either by a melting-recrystallization phenomenon or by the presence of two populations of lamellar thicknesses. In this paper, the double endothermic behavior of PEEK is studied using real time small angle X-ray scattering (SAXS). The correlation and interface distribution functions were used to analyze SAXS data. Calculations presented in this paper suggest that the semi-crystalline morphology of PEEK consists of two type of lamellar stacks consistent with primary and secondary crystallization. The lamellar thickness within these 2 stacks are observed to be about 70 A and 120 A (secondary and primary lamellae respectively) for PEEK crystallized at 307{degrees}C. Based on these observations, we speculate the that double endotherm melting behavior might be related to the melting of these dual stacks of lamellae.

  7. Deposition, Heat Treatment And Characterization of Two Layer Bioactive Coatings on Cylindrical PEEK.

    PubMed

    Durham, John W; Rabiei, Afsaneh

    2016-09-15

    Polyether ether ketone (PEEK) rods were coated via ion beam asssited deposition (IBAD) at room temperature. The coating consists of a two-layer design of yttria-stabilized zirconia (YSZ) as a heat-protection layer, and hydroxyapatite (HA) as a top layer to increase bioactivity. A rotating substrate holder was designed to deposit an even coating on the cylindrical surface of PEEK rods; the uniformity is verified by cross-sectional measurements using scanning electron microscopy (SEM). Deposition is followed by heat treatment of the coating using microwave annealing and autoclaving. Transmission electron microscopy (TEM) showed a dense, uniform columnar grain structure in the YSZ layer that is well bonded to the PEEK substrate, while the calcium phosphate layer was amorphous and pore-free in its as-deposited state. Subsequent heat treatment via microwave energy introduced HA crystallization in the calcium phosphate layer and additional autoclaving further expanded the crystallization of the HA layer. Chemical composition evaluation of the coating indicated the Ca/P ratios of the HA layer to be near that of stoichiometric HA, with minor variations through the HA layer thickness. The adhesion strength of as-deposited HA/YSZ coatings on smooth, polished PEEK surfaces was mostly unaffected by microwave heat treatment, but decreased with additional autoclave treatment. Increasing surface roughness showed improvement of bond strength.

  8. Cervical pneumatocyst.

    PubMed

    Hoover, Jason M; Wenger, Doris E; Eckel, Laurence J; Krauss, William E

    2011-09-01

    The authors present the case of a 56-year-old right hand-dominant woman who was referred for chronic neck pain and a second opinion regarding a cervical lesion. The patient's pain was localized to the subaxial spine in the midline. She reported a subjective sense of intermittent left arm weakness manifesting as difficulty manipulating small objects with her hands and fingers. She also reported paresthesias and numbness in the left hand. Physical and neurological examinations demonstrated no abnormal findings except for a positive Tinel sign over the left median nerve at the wrist. Electromyography demonstrated bilateral carpal tunnel syndrome with no cervical radiculopathy. Cervical spine imaging demonstrated multilevel degenerative disc disease and a pneumatocyst of the C-5 vertebral body. The alignment of the cervical spine was normal. A review of the patient's cervical imaging studies obtained in 1995, 2007, 2008, and 2010 demonstrated that the pneumatocyst was not present in 1995 but was present in 2007. The lesion had not changed in appearance since 2007. At an outside institution, multilevel fusion of the cervical spine was recommended to treat the pneumatocyst prior to evaluation at the authors' institution. The authors, however, did not think that the pneumatocyst was the cause of the patient's neck pain, and cervical pneumatocysts typically have a benign course. As such, the authors recommended conservative management and repeated MR imaging in 6 months. Splinting was used to treat the patient's carpal tunnel syndrome.

  9. The improvement of adhesive properties of PEEK through different pre-treatments

    NASA Astrophysics Data System (ADS)

    Hallmann, Lubica; Mehl, Albert; Sereno, Nuno; Hämmerle, Christoph H. F.

    2012-07-01

    The purpose of this in vitro study was the evaluation of the bond strength of the adhesives/composite resin to Poly Ether Ether Ketone (PEEK) based dental polymer after using different surface conditioning methods. PEEK blanks were cut into discs. All disc specimens were polished with 800 grit SiC paper and divided into 6 main groups. Main groups were divided into 2 subgroups. The main groups of 32 specimens each were treated as follow: (1) control specimens (no treatment), (2) piranha solution etching, (3) abraded with 50 μm alumina particles and chemical etching, (4) abraded with 110 μm alumina particles and chemical etching, (5) abraded with 30 μm silica-coated alumina particles and chemical etching, (6) abraded with 110 μm silica-coated alumina particles and chemical etching. Plexiglas tubes filled with a composite resin (RelyX Unicem) were bonded to the specimens. The adhesives used were Heliobond and Clearfil Ceramic Primer. Each specimen was stored in distilled water (37 °C) for 3 days. Tensile bond strength was measured in a universal testing machine and failure methods were evaluated. Abraded surface with 50 μm alumina particles followed by etching with piranha solution lead to the highest bond strength of 21.4 MPa when Heliobond like adhesive was used. Tribochemical silica coated/etched PEEK surfaces did not have an effect on the bond strength. Non-treated PEEK surface was not able to establish a bond with composite resin. The proper choice of adhesive/composite resin system leads to a strong bond. ConclusionAirborne particle abrasion in combination with piranha solution etching improves the adhesive properties of PEEK.

  10. Cervical Cancer Screening

    MedlinePlus

    ... cases of cervical cancer and the number of deaths due to cervical cancer since 1950. Cervical dysplasia ... for cervical cancer helps decrease the number of deaths from the disease. Regular screening of women between ...

  11. Cervical Stenosis

    MedlinePlus

    ... Interest (Quiz) Breast Cancer (Video) Overview of the Female Reproductive System (News) Study: Plenty of IV Fluids May Make Childbirth Safer, Easier (News) Zejula Approved for Certain Female Cancers Additional Content Medical News Cervical Stenosis By S. ...

  12. Cervical Myomas

    MedlinePlus

    ... Interest (Quiz) Breast Cancer (Video) Overview of the Female Reproductive System (News) Study: Plenty of IV Fluids May Make Childbirth Safer, Easier (News) Zejula Approved for Certain Female Cancers Additional Content Medical News Cervical Myomas By S. ...

  13. Cervical Cancer

    MedlinePlus

    ... Pap test results are not normal. • Get the HPV vaccine. It protects against the types of HPV that ... for cervical cancer. To learn more about the HPV vaccine visit www. cdc. gov/ hpv . • D on’t ...

  14. Cervical dysplasia

    MedlinePlus

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine ... Ask your provider about the HPV vaccine . Girls who receive this ... their chance of getting cervical cancer. You can reduce your ...

  15. Cervical cancer

    MedlinePlus

    ... factors for cervical cancer include: Not getting the HPV vaccine Being economically disadvantaged Having a mother who took ... be prevented by doing the following: Get the HPV vaccine . The vaccine prevents most types of HPV infection ...

  16. Cervical spondylosis

    MedlinePlus

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... nonsteroidal anti-inflammatory medicines (NSAIDs) for long-term pain control. Opioids may be prescribed if the pain is severe ...

  17. HUBBLE PEEKS INTO A STELLAR NURSERY IN A NEARBY GALAXY

    NASA Technical Reports Server (NTRS)

    2002-01-01

    HUBBLE PEEKS INTO A STELLAR NURSERY IN A NEARBY GALAXY NASA's Hubble Space Telescope has peered deep into a neighboring galaxy to reveal details of the formation of new stars. Hubble's target was a newborn star cluster within the Small Magellanic Cloud, a small galaxy that is a satellite of our own Milky Way. The new images show young, brilliant stars cradled within a nebula, or glowing cloud of gas, cataloged as N 81. These massive, recently formed stars inside N 81 are losing material at a high rate, sending out strong stellar winds and shock waves and hollowing out a cocoon within the surrounding nebula. The two most luminous stars, seen in the Hubble image as a very close pair near the center of N 81, emit copious ultraviolet radiation, causing the nebula to glow through fluorescence. Outside the hot, glowing gas is cooler material consisting of hydrogen molecules and dust. Normally this material is invisible, but some of it can be seen in silhouette against the nebular background, as long dust lanes and a small, dark, elliptical-shaped knot. It is believed that the young stars have formed from this cold matter through gravitational contraction. Few features can be seen in N 81 from ground-based telescopes, earning it the informal nick-name 'The Blob.' Astronomers were not sure if just one or a few hot stars were embedded in the cloud, or if it was a stellar nursery containing a large number of less massive stars. Hubble's high-resolution imaging shows the latter to be the case, revealing that numerous young, white-hot stars---easily visible in the color picture---are contained within N 81. This crucial information bears strongly on theories of star formation, and N 81 offers a singular opportunity for a close-up look at the turbulent conditions accompanying the birth of massive stars. The brightest stars in the cluster have a luminosity equal to 300,000 stars like our own Sun. Astronomers are especially keen to study star formation in the Small Magellanic

  18. Get Tested for Cervical Cancer

    MedlinePlus

    ... Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview Cervical Cancer ... Cervical Cancer 1 of 5 sections The Basics: Cervical Cancer What is cervical cancer? Cervical cancer is ...

  19. Influence of PEEK Coating on Hip Implant Stress Shielding: A Finite Element Analysis

    PubMed Central

    Anguiano-Sanchez, Jesica; Martinez-Romero, Oscar; Siller, Hector R.; Diaz-Elizondo, Jose A.; Flores-Villalba, Eduardo

    2016-01-01

    Stress shielding is a well-known failure factor in hip implants. This work proposes a design concept for hip implants, using a combination of metallic stem with a polymer coating (polyether ether ketone (PEEK)). The proposed design concept is simulated using titanium alloy stems and PEEK coatings with thicknesses varying from 100 to 400 μm. The Finite Element analysis of the cancellous bone surrounding the implant shows promising results. The effective von Mises stress increases between 81 and 92% for the complete volume of cancellous bone. When focusing on the proximal zone of the implant, the increased stress transmission to the cancellous bone reaches between 47 and 60%. This increment in load transferred to the bone can influence mineral bone loss due to stress shielding, minimizing such effect, and thus prolonging implant lifespan. PMID:27051460

  20. Improving adhesion of powder coating on PEEK composite: Influence of atmospheric plasma parameters

    NASA Astrophysics Data System (ADS)

    Dupuis, Aurélie; Ho, Thu Huong; Fahs, Ahmad; Lafabrier, Aurore; Louarn, Guy; Bacharouche, Jalal; Airoudj, Aissam; Aragon, Emmanuel; Chailan, Jean-François

    2015-12-01

    In aeronautic industries, powder coatings are increasingly used because of environmental considerations. During the deposition of such a coating on a substrate piece, the main objective is to obtain a good coating/substrate adhesion. In this study, the targeted substrate is a Poly-(Ether EtherKetone)-(PEEK) based composite material. Due to the poor surface energy of PEEK, a surface treatment is necessary in order to enhance its adhesion with the coating. In this purpose, atmospheric plasma treatment has been chosen and the influence of plasma parameters has been studied. Four scan speed nozzles and three gases (Air, N2 and Argon) plasma has been tested. The increase of adhesion with increasing wettability, polarity and nanoroughness has been evidenced. A particular study of the type of grafted polar functionalities according to gas nature allowed to better understand the plasma mechanism and the cross-impact of polarity and nanoroughness in adhesion enhancement.

  1. Covalent attachment of polymeric monolith to polyether ether ketone (PEEK) tubing.

    PubMed

    Lv, Chunguang; Heiter, Jaana; Haljasorg, Tõiv; Leito, Ivo

    2016-08-17

    A new method of reproducible preparation of vinylic polymeric monolithic columns with a key step of covalently anchoring the monolith to PEEK surface is described. In order to chemically attach the polymer monolith to the tube wall, methacrylate functional groups were introduced onto PEEK surface by a three-step procedure, including surface etching, surface reduction and surface methacryloylation. The chemical state of the modified tubing surface was characterized by attenuated total reflectance infrared (ATR-IR) spectroscopy. It was found that the etching step is the key to successfully modifying the PEEK tubing surface. Poly(styrene-co-divinylbenzene) monoliths were in situ synthesized by thermally initiated free radical copolymerization within the confines of surface-vinylized PEEK tubings of dimensions close to ones conventionally used in HPLC and UHPLC (1.6 mm internal diameter, 10.0-12.5 cm length). Adhesion test was done by measuring the operating pressure drop, which the prepared stationary phases can withstand. Good pressure resistance, up to 140 bar/10 cm (flow rate 0.5 mL min(-1), acetonitrile as a mobile phase), indicates strong bonding of monolith to the tubing wall. The monolithic material was proven to have a permeability of 1.7 × 10 (-14) m(2), applying acetonitrile-water 70:30 (v/v) as a mobile phase. The column performance was reproducible from column to column and was evaluated via the isocratic separation of a series of alkylbenzenes in the reversed-phase mode (acetonitrile-water 70:30, v/v). The numbers of plates per meter at optimal flow rate were found to be between 26 000 and 32 000 for the different analytes.

  2. Automated Fiber Placement of PEEK/IM7 Composites with Film Interleaf Layers

    NASA Technical Reports Server (NTRS)

    Hulcher, A. Bruce; Banks, William I., III; Pipes, R. Byron; Tiwari, Surendra N.; Cano, Roberto J.; Johnston, Norman J.; Clinton, R. G., Jr. (Technical Monitor)

    2001-01-01

    The incorporation of thin discrete layers of resin between plies (interleafing) has been shown to improve fatigue and impact properties of structural composite materials. Furthermore, interleafing could be used to increase the barrier properties of composites used as structural materials for cryogenic propellant storage. In this work, robotic heated-head tape placement of PEEK/IM7 composites containing a PEEK polymer film interleaf was investigated. These experiments were carried out at the NASA Langley Research Center automated fiber placement facility. Using the robotic equipment, an optimal fabrication process was developed for the composite without the interleaf. Preliminary interleaf processing trials indicated that a two-stage process was necessary; the film had to be tacked to the partially-placed laminate then fully melted in a separate operation. Screening experiments determined the relative influence of the various robotic process variables on the peel strength of the film-composite interface. Optimization studies were performed in which peel specimens were fabricated at various compaction loads and roller temperatures at each of three film melt processing rates. The resulting data were fitted with quadratic response surfaces. Additional specimens were fabricated at placement parameters predicted by the response surface models to yield high peel strength in an attempt to gage the accuracy of the predicted response and assess the repeatability of the process. The overall results indicate that quality PEEK/lM7 laminates having film interleaves can be successfully and repeatability fabricated by heated head automated fiber placement.

  3. Cranioplasty with customized titanium and PEEK implants in a mechanical stress model.

    PubMed

    Lethaus, Bernd; Safi, Yara; ter Laak-Poort, Mariel; Kloss-Brandstätter, Anita; Banki, Frans; Robbenmenke, Christian; Steinseifer, Ulrich; Kessler, Peter

    2012-04-10

    Large skull defects as a result of craniectomies due to cerebral insults, trauma, or tumors create functional and aesthetic disturbances for the patient. Cranioplasty with implants in these cases are an alternative to autogenous bone transplantation. In our clinic, customized titanium or optima poly-ether-ether ketone (PEEK) implants are used to reconstruct craniectomy defects. To compare the two materials we investigated the structural changes of the implants fixed to a sintered polyamide skull model under mechanical stress in four simplified models. In a standard testing machine, the models were subjected to a load under a quasi-static loading rate of 1.925 mm/min. Fractures of the PEEK implants occurred at a force of 24.2 and 24.5 kN with a displacement of 8.4 and 8 mm. The titanium implants showed no deformation, but extensive damage was seen in the polyamide skull models. The highest pressures achieved were 45.8 and 50.9 kN. In a simplified model with quasi-static loading, both implants withstood forces that were higher than those capable of causing skull fractures. It seems that the mechanical properties of PEEK could provide better protection when used for cranioplasty in patients after craniectomy if reconstruction with autogenous bone is not possible.

  4. Biomechanical evaluation and surface characterization of a nano-modified surface on PEEK implants: a study in the rabbit tibia

    PubMed Central

    Johansson, Pär; Jimbo, Ryo; Kjellin, Per; Currie, Fredrik; Chrcanovic, Bruno Ramos; Wennerberg, Ann

    2014-01-01

    Polyether ether ketone (PEEK) is today frequently used as a biomaterial in different medical operations due to its excellent mechanical and chemical properties. However, the untreated surface of PEEK is bioinert and hydrophobic, and it does not osseointegrate in its pure form. The aim of this study was to evaluate a unique nano-modified surface of PEEK with respect to osseointegration. Forty-eight threaded, non-cutting PEEK implants were inserted bilaterally in the tibia of 24 rabbits. Half of the implants (n=24) were coated with nanocrystalline hydroxyapatite (test) and the remaining implants (n=24) were left uncoated (control). Half of the animals (n=12) were euthanized after 3 weeks of healing and the remaining (n=12) after 12 weeks. The implant retention was measured with a removal torque apparatus. Surface analysis was performed with interferometry, scanning electron microscopy, and X-ray photon spectroscopy to relate the removal torque to the applied surface. The test implants revealed a significantly higher retention after 3 weeks (P=0.05) and 12 weeks (P=0.028) compared to controls. The result of the present study proves that the addition of nanocrystalline hydroxyapatite coating to PEEK surfaces significantly increases its removal torque and biocompatibility. PMID:25152620

  5. Cervical Cancer Stage IIIA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View / ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; ...

  6. Cervical Cancer Stage IIIB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIB Add to My Pictures View / ... 1425x1326 View Download Large: 2850x2651 View Download Title: Cervical Cancer Stage IIIB Description: Stage IIIB cervical cancer; ...

  7. Cervical Cancer Stage IVB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View / ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; ...

  8. Cervical Cancer Stage IVA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View / ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; ...

  9. Cervical Spondylosis and Hypertension

    PubMed Central

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

    2015-01-01

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

  10. Cervicitis associated with lateral cervical displacement.

    PubMed

    Gjoni, Indira; Muneyyirci-Delale, Ozgul

    2012-01-01

    Lateral cervical displacement has been recognized as a sign of endometriosis; however, other causes of the finding have not been explored. In our experience, patients without endometriosis are presenting with lateral cervical displacement, mainly towards the left of midline. The common finding in these cases is the presence of cervicitis leading us to hypothesize the role of cervicitis in causing lateral displacement of the cervix. Future research into this area will provide us with a stronger understanding of the role that lateral cervical displacement plays in the development of pelvic pathology and the development of cervical cancer.

  11. Cervical cancer.

    PubMed

    Shepherd, John H

    2012-06-01

    Standard treatment for invasive cervical cancer involves either radical surgery or radiotherapy. Childbearing is therefore impossible after either of these treatments. A fertility-sparing option, however, by radical trachelectomy has been shown to be effective, provided that strict criteria for selection are followed. Fertility rates are high, whereas recurrence is low, indicating that a more conservative approach to dealing with early small cervical tumours is feasible. Careful preoperative assessment by magnetic resonance imaging scans allows accurate measurement of the tumour with precise definition to plan surgery. This will ensure an adequate clear margin by wide excision of the tumour excising the cervix by radical vaginal trachelectomy with surrounding para-cervical and upper vaginal tissues. An isthmic cerclage is inserted to provide competence at the level of the internal orifice. A primary vagino-isthmic anastomosis is conducted to restore continuity of the lower genital tract. Subsequent pregnancies require careful monitoring in view of the high risk of spontaneous premature rupture of the membranes. Delivery by classical caesarean section is necessary at the onset of labour or electively before term. Over 1100 such procedures have been carried out vaginally or abdominally, resulting in 240 live births. Radical vaginal trachelectomy with a laparoscopic pelvic-node dissection offers the least morbid and invasive route for surgery, provided that adequate surgical skills have been obtained.

  12. Rate-dependent mode I interlaminar crack growth mechanisms in graphite/epoxy and graphite/PEEK

    NASA Technical Reports Server (NTRS)

    Gillespie, J. W., Jr.; Carlsson, L. A.; Smiley, A. J.

    1987-01-01

    In this paper the mode I fracture behavior of graphite/epoxy and graphite/PEEK composites is examined over four decades of crosshead rates (0.25-250 mm/min). Straight-sided double-cantilever-beam specimens consisting of unidirectional laminates were tested at room temperature. For graphite/epoxy the load-deflection response was linear to fracture, and stable slow crack growth initiating at the highest load level was observed for all rates tested. In contrast, mode I crack growth in the graphite/PEEK material was often unstable and showed stick-slip behavior. Subcritical crack growth occurring prior to the onset of fracture was observed at intermediate displacement rates. A mechanism for the fracture behavior of the graphite/PEEK material (based on viscoelastic, plastic, and microcrack coalescence in the process zone) is proposed and related to the observed rate-dependent phenomena.

  13. Selective responses of human gingival fibroblasts and bacteria on carbon fiber reinforced polyetheretherketone with multilevel nanostructured TiO2.

    PubMed

    Wang, Xiao; Lu, Tao; Wen, Jin; Xu, Lianyi; Zeng, Deliang; Wu, Qianju; Cao, Lingyan; Lin, Shuxian; Liu, Xuanyong; Jiang, Xinquan

    2016-03-01

    The long-term success of dental implants relies not only on stable osseointegration but also on the integration of implant surfaces with surrounding soft tissues. In our previous work, titanium plasma immersion ion implantation (PIII) technique was applied to modify the carbon-fiber-reinforced polyetheretherketone (CFRPEEK) surface, constructing a unique multilevel TiO2 nanostructure thus enhancing certain osteogenic properties. However, the interactions between the modified surface and soft-tissue cells are still not clear. Here, we fully investigate the biological behaviors of human gingival fibroblasts (HGFs) and oral pathogens on the structured surface, which determine the early peri-implant soft tissue integration. Scanning electron microscopy (SEM) shows the formation of nanopores with TiO2 nanoparticles embedded on both the sidewall and bottom. In vitro studies including cell adhesion, viability assay, wound healing assay, real-time PCR, western blot and enzyme-linked immunosorbent assay (ELISA) disclose improved adhesion, migration, proliferation, and collagen secretion ability of HGFs on the modified CFRPEEK. Moreover, the structured surface exhibits sustainable antibacterial properties towards Streptococcus mutans, Fusobacterium nucleatum and Porphyromonas gingivalis. Our results reveal that the multilevel TiO2 nanostructures can selectively enhance soft tissue integration and inhibit bacterial reproduction, which will further support and broaden the adoption of CFRPEEK materials in dental fields.

  14. SILICOMB PEEK Kirigami cellular structures: mechanical response and energy dissipation through zero and negative stiffness

    NASA Astrophysics Data System (ADS)

    Virk, K.; Monti, A.; Trehard, T.; Marsh, M.; Hazra, K.; Boba, K.; Remillat, C. D. L.; Scarpa, F.; Farrow, I. R.

    2013-08-01

    The work describes the manufacturing, testing and parametric analysis of cellular structures exhibiting zero Poisson’s ratio-type behaviour, together with zero and negative stiffness effects. The cellular structures are produced in flat panels and curved configurations, using a combination of rapid prototyping techniques and Kirigami (Origami and cutting) procedures for PEEK (Polyether Ether Ketone) thermoplastic composites. The curved cellular configurations show remarkable large deformation behaviours, with zero and negative stiffness regimes depending also on the strain rate applied. These unusual stiffness characteristics lead to a large increase of energy absorption during cyclic tests.

  15. Characterization of elastic-viscoplastic properties of an AS4/PEEK thermoplastic composite

    NASA Technical Reports Server (NTRS)

    Yoon, K. J.; Sun, C. T.

    1991-01-01

    The elastic-viscoplastic properties of an AS4/PEEK (APC-2) thermoplastic composite were characterized at 24 C (75 F) and 121 C (250 F) by using a one-parameter viscoplasticity model. To determine the strain-rate effects, uniaxial tension tests were performed on unidirectional off-axis coupon specimens with different monotonic strain rates. A modified Bodner and Partom's model was also used to describe the viscoplasticity of the thermoplastic composite. The experimental results showed that viscoplastic behavior can be characterized quite well using the one-parameter overstress viscoplasticity model.

  16. Dissipation of mechanical work and temperature rise in AS4/PEEK thermoplastic composite

    NASA Technical Reports Server (NTRS)

    Georgiou, I.; Sun, C. T.

    1990-01-01

    The dissipated mechanical work per cycle of sinusoidal stress in the thermoplastic composite material AS4/PEEK was measured as a function of stress amplitude for fixed frequency and fiber orientation. The experimental result shows that the dissipated work per cycle is proportional to the square of the stress amplitude. Using the concept of the equivalent isotropic material, it is shown that the relaxation modulus satisfies a proportionality condition. Also, the rate of temperature rise due to sinusoidal stresses has been measured as a function of stress amplitude. The result shows that the rate of temperature rise is not proportional to the square of the stress amplitude.

  17. Accelerated simulations of aromatic polymers: application to polyether ether ketone (PEEK)

    NASA Astrophysics Data System (ADS)

    Broadbent, Richard J.; Spencer, James S.; Mostofi, Arash A.; Sutton, Adrian P.

    2014-10-01

    For aromatic polymers, the out-of-plane oscillations of aromatic groups limit the maximum accessible time step in a molecular dynamics simulation. We present a systematic approach to removing such high-frequency oscillations from planar groups along aromatic polymer backbones, while preserving the dynamical properties of the system. We consider, as an example, the industrially important polymer, polyether ether ketone (PEEK), and show that this coarse graining technique maintains excellent agreement with the fully flexible all-atom and all-atom rigid bond models whilst allowing the time step to increase fivefold to 5 fs.

  18. MoS2-Filled PEEK Composite as a Self-Lubricating Material for Aerospace Applications

    NASA Technical Reports Server (NTRS)

    Theiler, Geraldine; Gradt, Thomas

    2010-01-01

    At BAM, several projects were conducted in the past years dealing with the tribological properties of friction couples at cryogenic temperature and in vacuum environment. Promising candidates for vacuum application are MoS2-filled PEEK/PTFE composites, which showed a friction coefficient as low as 0.03 in high vacuum. To complete the tribological profile of these composites, further tests were performed in ultra-high vacuum (UHV) at room temperature. In this paper, friction and stick slip behavior, as well as outgassing characteristics during the test are presented.

  19. Clinical Validation of Smartphone Based Adapter: Peek Retina for Optic Disc Imaging in Kenya

    PubMed Central

    Bastawrous, Andrew; Giardini, Mario Ettore; Bolster, Nigel M; Peto, Tunde; Shah, Nisha; Livingstone, Iain AT; Weiss, Helen A.; Hu, Sen; Rono, Hillary; Kuper, Hannah; Burton, Matthew

    2017-01-01

    Importance Visualization and interpretation of the optic nerve and retina is an essential part of most physical examinations. Objectives To design and validate a smartphone-based retinal adapter enabling image capture and remote grading of the retina Design, setting and participants Validation study comparing the grading of optic nerves from smartphones images with those of a Digital Fundus Camera. Both image sets were independently graded at Moorfields Eye Hospital Reading Centre. Nested within the six-year follow-up of the Nakuru Eye Disease Cohort in Kenya: 1,460adults (2,920eyes) aged 55years and above were recruited consecutively from the Study. A sub-set of 100 optic disc images from both methods were further used to validate a grading app for the optic nerves. Main outcome(s) and measure(s) Vertical cup-to-disc-ratio (VCDR) for each test was compared, in terms of agreement (Bland-Altman & weighted Kappa) and test-retest variability (TRV). Results 2,152 optic nerve images were available from both methods (additionally 371 from reference but not Peek, 170 from Peek but not the reference and 227 from neither the reference camera or Peek). Bland-Altman analysis demonstrated a difference of the average of 0.02 with 95% limits of agreement between -0.21 and 0.17 and a weighted Kappa coefficient of 0.69 (excellent agreement). An experienced retinal photographer was compared to a lay photographer (no health care experience prior to the study) with no observable difference in image acquisition quality between them. Conclusions and relevance Non-clinical photographers using the low-cost Peek Retina adapter and smartphone were able to acquire optic nerve images at a standard that enabled comparable independent remote grading of the images to those acquired using a desktop retinal camera operated by an ophthalmic assistant. The potential for task-shifting and the detection of avoidable causes of blindness in the most at risk communities makes this an attractive public

  20. Cervical Laminoplasty for Multilevel Cervical Myelopathy

    PubMed Central

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

    2011-01-01

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

  1. Feasibility of knitted carbon/PEEK composites for orthopedic bone plates.

    PubMed

    Fujihara, K; Huang, Zheng-Ming; Ramakrishna, S; Satknanantham, K; Hamada, H

    2004-08-01

    This paper focuses on fabrication and characterization of knitted carbon/PEEK fabric composites for orthopedic bone plate application. Bending performance of the knitted carbon/PEEK composite bone plates was investigated with respect to two principal knitting directions (wale- and course-directions). As a result, the wale-direction knitted composite bone plates had much scattering in bending stiffness and maximum bending moment although they exhibited the same bending behavior as that of the course-direction specimens. In comparison with our previously developed braided composite bone plates, the knitted composite bone plates had 55-59% bending stiffness, 40-63% yield bending moment, and 54-77% maximum bending moment. However, the knitted composite bone plates showed higher deformability. Based on the results of the braided composite bone plates, it is considered that the knitted composite plate with 3.2mm thickness can be suitable for forearm or humerus treatment especially when damaged bones need higher deformation to encourage bone ossification.

  2. Damage profile examination on ion irradiated PEEK by 6Li doping and neutron depth profiling technique

    NASA Astrophysics Data System (ADS)

    Vacík, J.; Červená, J.; Hnatowicz, V.; Švorčík, V.; Kobayashi, Y.; Fink, D.; Klett, R.

    1998-05-01

    Depth structure of radiation damaged surface layer of poly(aryl-ether-ether ketone) (PEEK) a polymer was studied using doping with 6Li atoms combined with nondestructive neutron depth profiling (NDP) method. The PEEK foils were irradiated with 2 MeV O + ions up to a fluence of 6 × 10 14 ions/cm 2. The damage profiles in the samples were visualized by doping of the samples with 5 M LiCl water solution at room temperature (RT) for 22.5 h. The Li ions are trapped on ion-produced radiation defects and the Li depth profiles are determined by the NDP method. NDP experiments were performed before and after leaching of excess of lithium atoms from the samples in distilled water at RT for 2 h. The leaching leads to dramatic changes in the Li depth distribution which, at low ion fluences, is similar in shape to the electronic energy loss profile of 2 MeV O + ions. For the higher fluences double-peaked profile occurs, which indicates a competition between different degradation processes in ion irradiated polymer.

  3. Radiological survey results for the Peek Street site properties, Schenectady, New York

    SciTech Connect

    Foley, R.D.; Cottrell, W.D.; Carrier, R.F.

    1992-08-01

    The Peek Street Industrial Facility, located at 425 Peek Street, Schenectady, New York, was operated by the General Electric Company for the Atomic Energy Commission (AEC) between 1947 and 1955. A variety of operations using radioactive materials were conducted at the site, but the main activities were to design an intermediate breeder reactor and to develop a chemical process for the recovery of uranium and plutonium from spent reactor fuel. Nonradioactive beryllium metal was machined on the site for breeder reactor application. The 4.5-acre site was decommissioned and released in October 1955. A radiological survey was conducted by Oak Ridge National Laboratory in November 1989. The survey included scan and grid point measurements of direct radiation levels outdoors on the five properties and inside the factory building, and radionuclide analysis of samples collected from each property. Radionuclide concentrations were determined in outdoor surface and subsurface soil samples from each property and in dust, debris, and structural materials from inside the factory building. Auger holes were logged to assess location and extent of possible subsurface residual soil radioactivity. Radionuclide concentrations were deter-mined in both indoor and outdoor water samples and in selected samples of vegetation. The presence of fixed and transferable surface residual radioactivity was investigated inside the factory building and on discarded materials outdoors on the property. High-volume air samples as well as additional selected indoor and outdoor soil samples were analyzed to determine levels of elemental beryllium.

  4. On the thermally-induced residual stresses in thick fiber-thermoplastic matrix (PEEK) cross-ply laminated plates

    NASA Technical Reports Server (NTRS)

    Hu, Shoufeng; Nairn, John A.

    1992-01-01

    An analytical method for calculating thermally-induced residual stresses in laminated plates is applied to cross-ply PEEK laminates. We considered three cooling procedures: slow cooling (uniform temperature distribution); convective and radiative cooling; and rapid cooling by quenching (constant surface temperature). Some of the calculated stresses are of sufficient magnitude to effect failure properties such as matrix microcracking.

  5. Prediction and Control of Processing-Induced Residual Stresses in Composites. Part 2. AS4/PEEK Composite

    DTIC Science & Technology

    1989-10-01

    model was used to predict dimensionless curvatures. The model underestimates the residual stresses at high temperatures near the onset of crystallization...Crystallization (Thermal-Elastic Model ) ................... 63 Figure 46 Tensile Creep Compliance Master Curve for 33% Crystalline Neat PEEK for Testing...Curvature by Viscoelastic Analysis (VE Model ) as a Function of Cool Down Temperature .......................................... 68 V LIST OF TABLES Page

  6. PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of total knee replacement: A preliminary study

    PubMed Central

    Cowie, Raelene M; Briscoe, Adam; Fisher, John; Jennings, Louise M

    2016-01-01

    PEEK-OPTIMA™ (Invibio Ltd, UK) has been considered as an alternative joint arthroplasty bearing material due to its favourable mechanical properties and the biocompatibility of its wear debris. In this study, the potential to use injection moulded PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of a total knee replacement was investigated in terms of its wear performance. Experimental wear simulation of three cobalt chrome and three PEEK-OPTIMA™ femoral components articulating against all-polyethylene tibial components was carried out under two kinematic conditions: 3 million cycles under intermediate kinematics (maximum anterior-posterior displacement of 5 mm) followed by 3 million cycles under high kinematic conditions (anterior-posterior displacement 10 mm). The wear of the GUR1020 ultra-high-molecular-weight polyethylene tibial components was assessed by gravimetric analysis; for both material combinations under each kinematic condition, the mean wear rates were low, that is, below 5 mm3/million cycles. Specifically, under intermediate kinematic conditions, the wear rate of the ultra-high-molecular-weight polyethylene tibial components was 0.96 ± 2.26 mm3/million cycles and 2.44 ± 0.78 mm3/million cycle against cobalt chrome and PEEK-OPTIMA™ implants, respectively (p = 0.06); under high kinematic conditions, the wear rates were 2.23 ± 1.85 mm3/million cycles and 4.44 ± 2.35 mm3/million cycles, respectively (p = 0.03). Following wear simulation, scratches were apparent on the surface of the PEEK-OPTIMA™ femoral components. The surface topography of the femoral components was assessed using contacting profilometry and showed a statistically significant increase in measured surface roughness of the PEEK-OPTIMA™ femoral components compared to the cobalt chrome implants. However, this did not appear to influence the wear rate, which remained linear over the duration of the study. These

  7. Risks of Cervical Cancer Screening

    MedlinePlus

    ... cases of cervical cancer and the number of deaths due to cervical cancer since 1950. Cervical dysplasia ... for cervical cancer helps decrease the number of deaths from the disease. Regular screening of women between ...

  8. Master plot analysis of microcracking in graphite/epoxy and graphite/PEEK laminates

    NASA Technical Reports Server (NTRS)

    Nairn, John A.; Hu, Shoufeng; Bark, Jong Song

    1993-01-01

    We used a variational stress analysis and an energy release rate failure criterion to construct a master plot analysis of matrix microcracking. In the master plot, the results for all laminates of a single material are predicted to fall on a single line whose slope gives the microcracking toughness of the material. Experimental results from 18 different layups of AS4/3501-6 laminates show that the master plot analysis can explain all observations. In particular, it can explain the differences between microcracking of central 90 deg plies and of free-surface 90 deg plies. Experimental results from two different AS4/PEEK laminates tested at different temperatures can be explained by a modified master plot that accounts for changes in the residual thermal stresses. Finally, we constructed similar master plot analyses for previous literature microcracking models. All microcracking theories that ignore the thickness dependence of the stresses gave poor results.

  9. Prevent Cervical Cancer

    MedlinePlus

    ... Links Inside Knowledge Campaign What CDC Is Doing Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed ... Prevent Cervical Cancer with the Right Test at the Right Time Screening tests can find abnormal cells so they ...

  10. Cervical spondylosis (image)

    MedlinePlus

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

  11. Cervical dysplasia - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100080.htm Cervical dysplasia - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Cervical Cancer Cervix Disorders A.D.A.M., Inc. ...

  12. Cervical Dystonia (Spasmodic Torticollis)

    MedlinePlus

    Cervical dystonia Overview By Mayo Clinic Staff Cervical dystonia, also called spasmodic torticollis, is a painful condition in which your neck muscles contract involuntarily, causing your head to twist or turn ...

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

    ClinicalTrials.gov

    2016-12-07

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

  14. Novel melt-processable poly(ether ether ketone)(PEEK)/inorganic fullerene-like WS(2) nanoparticles for critical applications.

    PubMed

    Naffakh, Mohammed; Díez-Pascual, Ana M; Marco, Carlos; Gómez, Marián A; Jiménez, Ignacio

    2010-09-09

    The combination of high-performance thermoplastic poly(ether ether ketone) (PEEK) with inorganic fullerene-like tungsten disulfide (IF-WS(2)) nanoparticles offers an attractive way to combine the merits of organic and inorganic materials into novel polymer nanocomposite materials. Here, we report the processing of novel PEEK/IF-WS(2) nanocomposites, which overcome the nanoparticle agglomerate formation and provide PEEK-particle interactions. The IF-WS(2) nanoparticles do not require exfoliation or modification, making it possible to obtain stronger, lighter materials without the complexity and processing cost associated with these treatments. The nanocomposites were fabricated by melt blending, after a predispersion step based on ball milling and mechanical treatments in organic solvent, which leads to the dispersion of individually IF-WS(2) nanoparticles in the PEEK matrix as confirmed by scanning electron microscopy. In order to determine the performance of the PEEK/IF-WS(2) nanocomposites for potential critical applications, particularly for the aircraft industry, we have extensively investigated these materials with a wide range of structural, thermal, and mechanical techniques using time-resolved synchrotron X-ray diffraction, thermogravimetric analysis, differential scanning calorimetry, dynamic-mechanical analysis, and tensile and impact tests as well as thermal measurements. Modulus, tensile strengh, thermal stability, and thermal conductivity of PEEK exhibited remarkable improvement with the addition of IF-WS(2).

  15. Experimental determination of Grüneisen gamma for polyether ether ketone (PEEK) using the shock-reverberation technique

    NASA Astrophysics Data System (ADS)

    Roberts, Andrew; Appleby-Thomas, Gareth James; Hazell, Paul

    2012-03-01

    Following multiple loading events the resultant shock state of a material will lie away from the principle Hugoniot. Prediction of such states requires knowledge of a materials equation-of-state. The material-specific variable Grüneisen gamma, γ(v), defines the shape of "off-Hugoniot" points in energy-volume-pressure space. Here, the shock response of the important temperature-resistant polymer polyether ether ketone (PEEK) was compared to ANSYS Autodyn® simulations in an attempt to estimate a value of γ1. However, inconsistencies between experimental and computational results were found, highlighting the importance of full knowledge of material properties for such analyses. In particular, this approach led to revision of the established equation-of-state for PEEK, with a new nonlinear form identified.

  16. ADXS11-001 High Dose HPV+ Cervical Cancer

    ClinicalTrials.gov

    2016-06-17

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

  17. Carbon/PEEK composite materials as an alternative for stainless steel/titanium hip prosthesis: a finite element study.

    PubMed

    Rezaei, Farshid; Hassani, Kamran; Solhjoei, Nosratollah; Karimi, Alireza

    2015-12-01

    Total hip replacement (THR) has been ranked within the most typical surgical processes in the world. The durability of the prosthesis and loosening of prosthesis are the main concerns that mostly reported after THR surgeries. In THR, the femoral prosthesis can be fixed by either cement or cementless methods in the patient's bones. In both procedures, the stability of the prosthesis in the hosted bone has a key asset in its long-term durability and performance. This study aimed to execute a comparative finite element simulation to assess the load transfer between the prosthesis, which is made of carbon/PEEK composite and stainless steel/titanium, and the femur bone. The mechanical behavior of the cortical bone was assumed as a linear transverse isotropic while the spongy bone was modeled like a linear isotropic material. The implants were made of stainless steel (316L) and titanium alloy as they are common materials for implants. The results showed that the carbon/PEEK composites provide a flatter load transfer from the upper body to the leg compared to the stainless steel/titanium prosthesis. Furthermore, the results showed that the von Mises stress, principal stress, and the strain in the carbon/PEEK composites prosthesis were significantly lower than that made of the stainless steel/titanium. The results also imply that the carbon/PEEK composites can be applied to introduce a new optimum design for femoral prosthesis with adjustable stiffness, which can decrease the stress shielding and interface stress. These findings will help clinicians and biomedical experts to increase their knowledge about the hip replacement.

  18. Vaccines against cervical cancer.

    PubMed

    Jansen, Kathrin U

    2004-11-01

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

  19. Acceptability, Usability, and Views on Deployment of Peek, a Mobile Phone mHealth Intervention for Eye Care in Kenya: Qualitative Study

    PubMed Central

    Karanja, Sarah; Lees, Shelley; Bastawrous, Andrew

    2016-01-01

    Background The Portable Eye Examination Kit (Peek) is a mobile phone–based ophthalmic testing system that has been developed to perform comprehensive eye examinations. Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools. Objective This qualitative study evaluated the acceptability and usability of Peek in addition to perceptions regarding its adoption and nationwide deployment. Methods Semistructured interviews were conducted with patients and analyzed using a framework approach. This included analysis of interviews from 20 patients, 8 health care providers (HCPs), and 4 key decision makers in ophthalmic health care provision in Kenya. The participants were purposefully sampled. The coding structure involved predefined themes for assessing the following: (1) the context, that is, environment, user, task, and technology; (2) patient acceptability, that is, patients' perceived benefits, patient preference, and patient satisfaction; (3) usability, that is, efficiency, effectiveness, learnability, and flexibility and operability of Peek; and (4) the benefits of Peek in strengthening eye care provision, that is, capabilities enhancer, opportunity creator, social enabler, and knowledge generator. Emerging themes relating to the objectives were explored from the data using thematic analysis. Results Patients found Peek to be acceptable because of its benefits in overcoming the barriers to accessing ophthalmic services. Most thought it to be fast, convenient, and able to reach a large population. All patients expressed being satisfied with Peek. The HCPs perceived it to satisfy the criteria for usability and found Peek to be acceptable based on the

  20. Pullout performance comparison of novel expandable pedicle screw with expandable poly-ether-ether-ketone shells and cement-augmented pedicle screws.

    PubMed

    Aycan, Mehmet Fatih; Tolunay, Tolga; Demir, Teyfik; Yaman, Mesut Emre; Usta, Yusuf

    2017-02-01

    Aim of this study is to assess the pullout performance of various pedicle screws in different test materials. Polyurethane foams (Grade 10 and Grade 40) produced in laboratory and bovine vertebrae were instrumented with normal, cannulated (cemented), novel expandable and normal (cemented) pedicle screws. Test samples were prepared according to the ASTM F543 standard testing protocols and surgical guidelines. To examine the screw placement and cement distribution, anteriosuperior and oblique radiographs were taken from each sample after insertion process was completed. Pullout tests were performed in an Instron 3369 testing device. Load versus displacement graphs were recorded and the ultimate pullout force was defined as the maximum load (pullout strength) sustained before failure of screw. Student's t-test was performed on each group whether the differences between pullout strength of pedicle screws were significant or not. While normal pedicle screws have the lowest pullout strength in all test materials, normal pedicle screws cemented with polymethylmethacrylate exhibit significantly higher pullout performance than others. For all test materials, there is a significant improvement in pullout strength of normal screws by augmentation. While novel expandable pedicle screws with expandable poly-ether-ether-ketone shells exhibited lower pullout performance than normal screws cemented with polymethylmethacrylate, their pullout performances in all groups were higher than the ones of normal and cannulated pedicle screws. For all test materials, although cannulated pedicle screws exhibit higher pullout strength than normal pedicle screws, there are no significant differences between the two groups. The novel expandable pedicle screws with expandable poly-ether-ether-ketone shells may be used instead of normal and cannulated pedicle screws cemented with polymethylmethacrylate due to their good performances.

  1. Signs and Symptoms of Cervical Cancer

    MedlinePlus

    ... Detection, Diagnosis, and Staging Signs and Symptoms of Cervical Cancer Women with early cervical cancers and pre- ... Ask Your Doctor About Cervical Cancer? More In Cervical Cancer About Cervical Cancer Causes, Risk Factors, and ...

  2. Cervical cancer - screening and prevention

    MedlinePlus

    ... cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... A vaccine is available to protect against the HPV types that cause most cervical cancer in women. The vaccine is: Given as a series of 2 shots. ...

  3. Reflectance measurements of PTFE, Kapton, and PEEK for xenon scintillation light for the LZ detector.

    NASA Astrophysics Data System (ADS)

    Arthurs, M.; Batista, E.; Haefner, J.; Lorenzon, W.; Morton, D.; Neff, A.; Okunawo, M.; Pushkin, K.; Sander, A.; Stephenson, S.; Wang, Y.; LZ Collaboration

    2017-01-01

    LZ (LUX-Zeplin) is an international collaboration that will look for dark matter candidates, WIMPs (Weakly Interacting Massive Particles), through direct detection by dual-phase time projection chamber (TPC) using liquid xenon. The LZ detector will be located nearly a mile underground at SURF, South Dakota, shielded from cosmic background radiation. Seven tons active mass of liquid xenon will be used for detecting the weak interaction of WIMPs with ordinary matter. Over three years of operation it is expected to reach the ultimate sensitivity of 2x10-48 cm2 for a WIMP mass of 50 GeV. As for many other rare event searches, high light collection efficiency is essential for LZ detector. Moreover, in order to achieve greater active volume for detection as well as reduce potential backgrounds, thinner detector walls without significant loss in reflectance are desired. Reflectance measurements of polytetrafluoroethylene (PTFE), Kapton, and PEEK for xenon scintillation light (178 nm), conducted at the University of Michigan using the Michigan Xenon Detector (MiX) will be presented. The University of Michigan, LZ Collaboration, The US Department of Energy.

  4. Characterization of Mode I and Mode II delamination growth and thresholds in AS4/PEEK composites

    NASA Technical Reports Server (NTRS)

    Martin, Roderick H.; Murri, Gretchen Bostaph

    1990-01-01

    Composite materials often fail by delamination. The onset and growth of delamination in AS4/PEEK, a tough thermoplastic matrix composite, was characterized for mode 1 and mode 2 loadings, using the Double Cantilever Beam (DCB) and the End Notched Flexure (ENF) test specimens. Delamination growth per fatigue cycle, da/dN, was related to strain energy release rate, G, by means of a power law. However, the exponents of these power laws were too large for them to be adequately used as a life prediction tool. A small error in the estimated applied loads could lead to large errors in the delamination growth rates. Hence strain energy release rate thresholds, G sub th, below which no delamination would occur were also measured. Mode 1 and 2 threshold G values for no delamination growth were found by monitoring the number of cycles to delamination onset in the DCB and ENF specimens. The maximum applied G for which no delamination growth had occurred until at least 1,000,000 cycles was considered the threshold strain energy release rate. Comments are given on how testing effects, facial interference or delamination front damage, may invalidate the experimental determination of the constants in the expression.

  5. Characterization of Mode 1 and Mode 2 delamination growth and thresholds in graphite/peek composites

    NASA Technical Reports Server (NTRS)

    Martin, Roderick H.; Murri, Gretchen B.

    1988-01-01

    Composite materials often fail by delamination. The onset and growth of delamination in AS4/PEEK, a tough thermoplastic matrix composite, was characterized for mode 1 and mode 2 loadings, using the Double Cantilever Beam (DCB) and the End Notched Flexure (ENF) test specimens. Delamination growth per fatigue cycle, da/dN, was related to strain energy release rate, G, by means of a power law. However, the exponents of these power laws were too large for them to be adequately used as a life prediction tool. A small error in the estimated applied loads could lead to large errors in the delamination growth rates. Hence strain energy release rate thresholds, G sub th, below which no delamination would occur were also measured. Mode 1 and 2 threshold G values for no delamination growth were found by monitoring the number of cycles to delamination onset in the DCB and ENF specimens. The maximum applied G for which no delamination growth had occurred until at least 1,000,000 cycles was considered the threshold strain energy release rate. Comments are given on how testing effects, facial interference or delamination front damage, may invalidate the experimental determination of the constants in the expression.

  6. Processing parameters for filament winding thick-section PEEK/carbon fiber composites

    NASA Astrophysics Data System (ADS)

    Colton, J.; Leach, D.

    1992-12-01

    The consolidation pressure and winding speed for thermoplastic filament winding were studied. Thermoplastic composite parts were manufactured from tape prepreg (APC-2); powder-coated, semi-consolidated towpreg; and commingled fiber towpreg. The material used was carbon fiber (AS-4) (60 vol pct) in a PEEK matrix. The parts made were open-ended cylinders of the three materials, 177.8-mm ID, 228.6 mm long, 17 plies thick with a 0 deg lay-up angle; and rings, 50 plies of APC-2 thick, 6.35 mm wide (one strip wide), 177.8-mm ID, and a lay-up of 0 deg. Their quality was determined by surface finish and void percentage. The tubes made from APC-2 appeared to have the best quality of the three prepregs. For the rings, the speed of lay-down had a significant effect on both the final width of the parts and on the percentage of voids. The pressure of the roller had a significant effect on the final widths at a 99 percent confidence level, but a significant effect on the percentage of voids at only a 95 percent confidence level.

  7. High temperature dielectric properties of Apical, Kapton, Peek, Teflon AF, and Upilex polymers

    NASA Technical Reports Server (NTRS)

    Hammoud, A. N.; Baumann, E. D.; Overton, E.; Myers, I. T.; Suthar, J. L.; Khachen, W.; Laghari, J. R.

    1992-01-01

    Reliable lightweight systems capable of providing electrical power at the magawatt level are a requirement for future manned space exploration missions. This can be achieved by the development of high temperature insulating materials which are not only capable of surviving the hostile space environment but can contribute to reducing the mass and weight of the heat rejection system. In this work, Apical, Upilex, Kapton, Teflon AF, and Peek polymers are characterized for AC and DC dielectric breakdown in air and in silicone oil at temperatures up to 250 C. The materials are also tested in terms of their dielectric constant and dissipation factor at high temperatures with an electrical stress of 60 Hz, 200 V/mil present. The effects of thermal aging on the properties of the films are determined after 15 hours of exposure to 200 and 250 C, each. The results obtained are discussed and conclusions are made concerning the suitability of these dielectrics for use in capacitors and cable insulations in high temperature environments.

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

    ClinicalTrials.gov

    2014-09-22

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

  9. Cervical Cancer Stage IB

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View / ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 ...

  10. Cervical Cancer Stage IA

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View / ... 1500x1200 View Download Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 ...

  11. Peeking into Saturn's Atmosphere: the HST Low-Phase Angle View

    NASA Astrophysics Data System (ADS)

    Perez-Hoyos, S.; Sanz-Requena, J. F.; Sanchez-Lavega, A.; Hueso, R.; del Rio-Gaztelurrutia, T.; Rojas, J. F.; Simon, A. A.; Wong, M. H.; De Pater, I.; Irwin, P. G.

    2015-12-01

    Recent Hubble Space Telescope WFC3 observations of Saturn have provided a low-phase angle view of the planet that complements the higher phase angles and increased spatial resolution view from the Cassini spacecraft. HST orbits were perfectly timed for observing an atmospheric perturbation at polar latitudes that has been conspicuous on ground-based observations of the planet since May 2015. The observations serendipitously captured other interesting features at the Equatorial Zone (EZ) with Voyager-era fast speeds (see Sánchez-Lavega et al. abstract, this meeting). In this presentation we will discuss how the synergy between the Cassini/ISS and HST/WFC3 observations provides an excellent way for peeking into Saturn's atmosphere and analyze the vertical distribution and properties of the particles and aerosols located in the lower stratosphere and upper troposphere of the planet. We first discuss how Cassini/ISS observations at a variety of phase angles constrain particle properties and phase functions, in particular at the Equatorial Zone where they resemble 100 micron ammonia ice crystals. With this information, it is possible to use the HST/WFC3 observations at 10 filters from near-ultraviolet to the near-infrared provide substantial information on the vertical cloud structure and composition: the filters in and out of the intermediate and deep methane bands at the near infrared give information on particle number density around the tropopause level and down to the ammonia condensation level, while near-ultraviolet and blue filters characterize the absorption of unknown chromophores in Saturn's atmosphere. Fast-moving features in the EZ are found to be located deeper (> 2 bar) than the features used for cloud-tracking since the pre-Cassini era (< 1 bar). This provides an unprecedented view of the EZ vertical wind shear by sounding simultaneously three separate atmospheric levels. Finally, results for Saturn's Northern hemisphere will also be showed.

  12. SAXS Study and Thermal Analysis of Two-Stage Melt Crystallization of PEEK

    NASA Astrophysics Data System (ADS)

    Georgiev, Georgi; Dai, Patrick; Oyebode, Elizabeth; Cebe, Peggy; Capel, Malcolm

    1998-03-01

    We have been studying dual stage melt crystalization of PEEK using a treatment scheme involving annealing/crystallization at Ta1 followed by annealing/crystallization at Ta2, where either Ta1Ta2. We compare single and double stages of melt crystallization using differential scanning calorimetry (DSC) and small angle X-ray scattering (SAXS). Double stage crystallization was used to study the relative perfection of the crystals formed from the melt. The samples were heated to 375 C in a Mettler hot stage and were held there for three minutes so as to erase the crystals from previous treatments before cooling to 280 C. Crystallization occurred rapidly during cooling below 300 C. The samples were held for ten minutes at Ta1=280 C before being heated to the annealing temperature, Ta2=295 C, where they were held at for a period of time, t( t = 0, 1, 3.5, or 10 min. ),and then immediately heated to 360 C. We observe a double peak in SAXS intensity. During the isothermal periods, the intensity of the major peak at lower scattering vector, s, stays constant. A shoulder grows up on the high side of the major peak, and increases in intensity with the holding time at 280 C. During heating from below to above of the minor melting endotherm, the intensity in the high s shoulder decreases. After the sample is annealed at 295 C, the shoulder intensity is restored once again. The population scattering at higher s remains longer before it disappears in the sample treated to the second stage of melt crystallization, compare to the sample crystallized with a single stage. Research was supported by the National Aeronautics and Space Administration, Grant NAG8

  13. Derivation of beryllium guidelines for use in establishing cleanup levels at the Peek Street and Sacandaga sites, New York

    SciTech Connect

    Hartmann, H.M.; Avci, H.I.; Ditmars, J.D.

    1992-02-01

    Guideline levels are derived for beryllium in soil and on indoor surfaces at the Peek Street and Sacandaga sites in the state of New York. On the basis of highly conservative assumptions, the soil beryllium concentration that corresponds to a 10{sup {minus} 4} carcinogenic risk level is estimated to be 13 mg/kg at both sites. Calculations indicate that the proposed US Department of Energy guideline of 2 {mu}g/ft{sup 2} for beryllium in dust on indoor surfaces would be sufficiently protective of human health. For occupational protection of workers during cleanup operations, Office of Safety and Health Administration standards for beryllium are referenced and restated.

  14. [Isolated anterior cervical hypertrichosis].

    PubMed

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

    2009-01-01

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

  15. Nanostructured-silver-coated polyetheretherketone tube for online in-tube solid-phase microextraction coupled with high-performance liquid chromatography.

    PubMed

    Sun, Min; Feng, Juanjuan; Bu, Yanan; Luo, Chuannan

    2015-07-14

    Polyetheretherketone tube is a better substrate for in-tube solid-phase microextraction than fused-silica capillary and metal tube because of its resistance to high pressure and good flexibility. It was modified with a nanostructured silver coating, and characterized by scanning electron microscopy and energy dispersive X-ray spectroscopy. It was connected into high-performance liquid chromatography equipment to build the online analysis system by replacing the sample loop of a six-port injection valve. To get the highest extraction capacity, the preparation conditions of the coating was investigated. Important extraction conditions including length of tube, sample volume, and desorption time were optimized using eight polycyclic aromatic hydrocarbons as model analytes. The tube exhibits excellent extraction efficiency toward them, with enrichment factors from 52 to 363. The online analysis method provides good linearity (0.5-100 or 1.0-100 μg/L) and low detection limits (0.15-0.30 μg/L). It has been used to determine polycyclic aromatic hydrocarbons in water samples, with relative recoveries in the range of 92.3-120%. The tube showed highest extraction ability for polycyclic aromatic hydrocarbons, higher extraction ability for hydrophobic phthalates and anilines, and almost no extraction ability for low hydrophobic phenols, due to the possible extraction mechanism including hydrophobic and electron-rich element-metal interactions.

  16. Cervical Radiculopathy (Pinched Nerve)

    MedlinePlus

    ... help relieve pain, strengthen neck muscles, and improve range of motion. In some cases, traction can be used to ... Learn more about surgery for radiculopathy online at Cervical ... a wide range of musculoskeletal conditions and injuries. All articles are ...

  17. [Cervical pregnancy. Three cases].

    PubMed

    Plascencia Moncayo, Norberto; Hernández, María de la Paz; Guadarrama Sánchez, Rafael; Guerra Becerra, Leticia; Salmón Vélez, J Fernando G; Galván Aguilera, Alejandro

    2008-12-01

    We describe cervical pregnancy concept and its rareness. Its frequency is one in 2,550 to 98,000 intrauterine pregnancies. Predisposing factors are related with endometrial damage due to uterine curettages and previous cesarian section. Clinical picture was nonspecific and diagnosis was based in endovaginal ultrasonography. It can cause massive bleeding and put life in risk. During 2007 we attend 829 intrauterine pregnancies at Hospital San José de Querétaro: 11 tubal, and 3 cervical, this represents an extraordinarily high frequency of cervical pregnancy. Here we report three cases of cervical pregnancies treated with total hysterectomy, two as urgency and one elective. We remark early diagnosis importance to perform conservative treatment and maintain reproductive function.

  18. Immunotherapy for Cervical Cancer

    Cancer.gov

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  19. Cervical Cancer Screening

    MedlinePlus

    ... cervical cancer in women aged 30–65 years. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Human Papillomavirus ( ...

  20. Sexually Transmitted Cervicitis

    PubMed Central

    Romanowski, Barbara

    1989-01-01

    Cervical infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and Herpes simplex virus are some of the most common sexually transmitted infections. They are often asymptomatic, and therefore the patient is at risk of developing complications, such as pelvic inflammatory disease. It is important to recognize cervicitis, investigate it appropriately, and provide early treatment. Sexual partners must also be located and offered therapy to prevent re-infection in the index patient. PMID:21248969

  1. PEEK-OPTIMA(™) as an alternative to cobalt chrome in the femoral component of total knee replacement: A preliminary study.

    PubMed

    Cowie, Raelene M; Briscoe, Adam; Fisher, John; Jennings, Louise M

    2016-11-01

    PEEK-OPTIMA(™) (Invibio Ltd, UK) has been considered as an alternative joint arthroplasty bearing material due to its favourable mechanical properties and the biocompatibility of its wear debris. In this study, the potential to use injection moulded PEEK-OPTIMA(™) as an alternative to cobalt chrome in the femoral component of a total knee replacement was investigated in terms of its wear performance. Experimental wear simulation of three cobalt chrome and three PEEK-OPTIMA(™) femoral components articulating against all-polyethylene tibial components was carried out under two kinematic conditions: 3 million cycles under intermediate kinematics (maximum anterior-posterior displacement of 5 mm) followed by 3 million cycles under high kinematic conditions (anterior-posterior displacement 10 mm). The wear of the GUR1020 ultra-high-molecular-weight polyethylene tibial components was assessed by gravimetric analysis; for both material combinations under each kinematic condition, the mean wear rates were low, that is, below 5 mm(3)/million cycles. Specifically, under intermediate kinematic conditions, the wear rate of the ultra-high-molecular-weight polyethylene tibial components was 0.96 ± 2.26 mm(3)/million cycles and 2.44 ± 0.78 mm(3)/million cycle against cobalt chrome and PEEK-OPTIMA(™) implants, respectively (p = 0.06); under high kinematic conditions, the wear rates were 2.23 ± 1.85 mm(3)/million cycles and 4.44 ± 2.35 mm(3)/million cycles, respectively (p = 0.03). Following wear simulation, scratches were apparent on the surface of the PEEK-OPTIMA(™) femoral components. The surface topography of the femoral components was assessed using contacting profilometry and showed a statistically significant increase in measured surface roughness of the PEEK-OPTIMA(™) femoral components compared to the cobalt chrome implants. However, this did not appear to influence the wear rate, which remained linear over the

  2. What Are the Key Statistics about Cervical Cancer?

    MedlinePlus

    ... Cervical Cancer What Are the Key Statistics About Cervical Cancer? The American Cancer Society's estimates for cervical ... in Cervical Cancer Research and Treatment? More In Cervical Cancer About Cervical Cancer Causes, Risk Factors, and ...

  3. Atezolizumab and Bevacizumab in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer

    ClinicalTrials.gov

    2017-03-08

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Recurrent Cervical Carcinoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  4. Severe cervical spondylotic myelopathy with complete neurological and neuroradiological recovery within a month after surgery

    PubMed Central

    Marios, Th.; Dimitrios, Zevgaridis; Theologos, Th.; Christos, Tsonidis

    2016-01-01

    Cervical spondylotic myelopathy is a complex syndrome evolving in the presence of degenerative changes. The choice of care and prognostic factors are controversial. The use of appropriate surgical technique is very important. Posterior approach may be chosen when pathology is present dorsally and/or in the presence of neutral to lordotic alignment. Anterior approach is the golden standard in patients with kyphosis and/or stenosis due to ventral lesions, even with three or more affected levels. A 67-year-old man presented with progressive weakness and clumsiness (mJOA: 5; Nurick: 4). An anterior discectomy, osteophytectomy and bilateral foraminotomy of the C4–C5; C5–C6; C6–C7 were performed. Polyether-Ether-Ketone spacers and a titanium plate were placed. The patient was mobilized 3-hour post-surgery and was released the following day. Medicament therapy and a neck-conditioning program were prescribed. Clinical examinations were normal within a month. Magnetic resonance imaging showed no traces of the preoperatively registered intramedullary focal T2 hyper-intensity. PMID:27887013

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

    PubMed

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

    2014-04-01

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

  6. Cervical Perineural Cyst Masquerading as a Cervical Spinal Tumor

    PubMed Central

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

    2014-01-01

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

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

    MedlinePlus

    The cervical spinal column is made up of vertebral bodies which protect the spinal cord. ... spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine ...

  8. Cervical Stenosis, Myelopathy and Radiculopathy

    MedlinePlus

    ... cervical spine refers to that portion of the spinal column that is within our neck. This portion of ... spinal nerves that travel through it. The cervical spinal column is made up of seven vertebrae and the ...

  9. Cervical Spinal Motion During Intubation.

    DTIC Science & Technology

    2000-01-01

    Ten fresh human cadavers were intubated while recording cervical motion using a cinefluoroscopic technique. Segmental cervical motion from the...performed using no external stabilization, Gardner-Wells traction and manual in-line cervical immobilization. The data are currently being analyzed. A...paper entitled Segmental cervical spine motion during orotracheal intubation of the intact and injured spine with and without external stabilization was published in the Journal of Neurosurgery.

  10. Data Analysis in Cervical Trauma

    DTIC Science & Technology

    1989-04-01

    The cervical spine in lateral view is discussed and a method based on digital statistical analysis is used to reproduce quantitative data of the... cervical lordosis. (2) Marked straightening of the cervical spine. (3) Segmental straightening with reversal of the curve. Part II discusses the use of...the digital analysis to determine the displacement in subjects that have sustained ligamentous injuries of the cervical spine following whiplash injury.

  11. Cervical ectopic pregnancy.

    PubMed

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

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

  12. Experimental determination of Grunieisen gamma for two dissimilar materials (PEEK and Al 5083) via the shock-reverberation technique

    NASA Astrophysics Data System (ADS)

    Roberts, Andrew; Appleby-Thomas, Gareth; Hazell, Paul

    2011-06-01

    Following multiple loading events the resultant shock state of a material will lie away from the principle Hugoniot. Prediction of such states requires knowledge of a materials equation-of-state. The material-specific variable Grunieisen gamma (Γ) defines the shape of ``off-Hugoniot'' points in energy-volume-pressure space. Experimentally the shock-reverberation technique (based on the principle of impedance-matching) has previously allowed estimation of the first-order Grunieisen gamma term (Γ1) for a silicone elastomer. Here, this approach was employed to calculate Γ1 for two dissimilar materials, Polyether ether ketone (PEEK) and the armour-grade aluminium alloy 5083 (H32); thereby allowing discussion of limitations of this technique in the context of plate-impact experiments employing Manganin stress gauges. Finally, the experimentally determined values for Γ1 were further refined by comparison between experimental records and numerical simulations carried out using the commercial code ANYSYS Autodyn®.

  13. Graphene oxide as a dual-function conductive binder for PEEK-derived microporous carbons in high performance supercapacitors

    NASA Astrophysics Data System (ADS)

    Kim, Christine H. J.; Zhang, Hongbo; Liu, Jie

    2015-06-01

    Microporous carbons (MPCs) are promising electrode materials for supercapacitors because of their high surface area and accessible pores. However, their low electrical conductivity and mechanical instability result in limited power density and poor cycle life. This work proposes a unique two-layered film made of polyetheretherketone-derived MPCs and reduced graphene oxide (rGO) as an electrode for supercapacitors. Electrochemical characterizations of films show that such a layered structure is more effective in increasing the accessibility of ions to the hydrophilic MPCs and establishing conductive paths through the rGO network than a simple mixed composite film. The two-layered structure increases the capacitance by ˜124% (237 F g-1) with excellent cycling stability (˜93% after 6000 cycles). More importantly, we demonstrate that such performance improvements result from an optimal balance between electrical conductivity and ion accessibility, which maximizes the synergistic effects of MPC and rGO. The MPCs, which are exposed to the surface, provide a highly accessible surface area for ion adsorption. The rGO serves a dual function as a conductive filler to increase the electrical conductivity and as a binder to interconnect individual MPC particles into a robust and flexible film. These findings provide a rational basis for the design of MPC-based electrodes in high performance supercapacitors.

  14. The degenerative cervical spine.

    PubMed

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management.

  15. Cervical Total Disc Arthroplasty

    PubMed Central

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

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

  16. Arthrodesis Rate and Patient Reported Outcomes After Anterior Lumbar Interbody Fusion Utilizing a Plasma-Sprayed Titanium Coated PEEK Interbody Implant: A Retrospective, Observational Analysis

    PubMed Central

    Bergen, Sophea R.; Staples, Miranda; Liang, Kevin; Raiszadeh, Ramin

    2017-01-01

    Background Anterior lumbar interbody fusion (ALIF) is utilized in symptomatic spinal disc destabilization due to degenerative lumbar disc disease, isthmic and degenerative spondylolisthesis, internal disc disruption, or pseudarthrosis after non-operative treatments fail. The addition of a plasma-sprayed titanium coating (PTC) to polyether ether ketone spacers (PEEK) may reduce the rate of implant subsidence or non-union secondary to poor osseous-integration of non-coated PEEK or metal interbody systems. Methods A retrospective, non-randomized, single-center chart review, evaluated the post-surgical follow-up data of patients receiving a PTC PEEK implant during single or multi-level ALIF procedures to determine the clinical efficacy and rate of arthrodesis after utilization of a coated spacer. Standard roentgenographs or computed tomography were used to identify successful arthrodesis following the ALIF procedure and longitudinal clinical improvements were determined by scores on the Visual Analog Scale (VAS) for low back and leg pain. Results Forty-four subjects (48% male, mean=53 years) were included in this chart review. Follow-up radiology demonstrated radiographic union with bridging bone formation across the interbody space for 42/44 (96%) individuals with solid arthrodesis occurring at an average of 7.3 ± 2.3 months. Subjects demonstrated significant improvement in VAS low back pain (4.5 ± 2.4 point improvement, p=0.0001) and VAS leg pain (4.1 ± 3.3 point improvement, p=0.0001). While there was a significant reduction in the improvement of VAS low back pain of Worker's Compensation claimants as compared to other patients (3.9 ± 2.4 vs. 5.3 ± 2.1), there was no difference in VAS low back pain or leg pain when the data was stratified by gender, age, tobacco use, comorbidities, prior surgery, fusion construct length, use of supplemental posterior instrumentation, BMI, or diagnosis. Conclusions This study provides support that the addition of a PTC coating

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

    ClinicalTrials.gov

    2014-06-18

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

  18. Screening for Cervical Cancer

    MedlinePlus

    ... causes cervical cancer. To learn more about these tests and what happens during them, visit the Web sites listed at the end of this fact ... evidence about the benefits and harms of the test. The grades are explained in the box at ... Web site to read the full recommendation statement on ...

  19. Cervical Neoplasia Probe Control

    SciTech Connect

    Vargo, Timothy D.

    1997-01-24

    This software, which consists of a main executive and several subroutines, performs control of the optics, image acquisition, and Digital Signal Processing (DSP) of this image, of an optical based medical instrument that performs fluoresence detection of precancerous lesions (neoplasia) of the human cervix. The hardware portion of this medical instrument is known by the same name Cervical Neoplasia Probe (CNP)

  20. Cervical ectopic pregnancy

    PubMed Central

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

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

  1. PEEK tube-based online solid-phase microextraction-high-performance liquid chromatography for the determination of yohimbine in rat plasma and its application in pharmacokinetics study.

    PubMed

    Xiang, Xiaowei; Shang, Bing; Wang, Xiaozheng; Chen, Qinhua

    2017-04-01

    Yohimbine is a novel compound for the treatment of erectile dysfunction derived from natural products, and pharmacokinetic study is important for its further development as a new medicine. In this work, we developed a novel PEEK tube-based solid-phase microextraction (SPME)-HPLC method for analysis of yohimbine in plasma and further for pharmacokinetic study. Poly (AA-EGDMA) was synthesized inside a PEEK tube as the sorbent for microextraction of yohimbine, and parameters that could influence extraction efficiency were systematically investigated. Under optimum conditions, the PEEK tube-based SPME method exhibits excellent enrichment efficiency towards yohimbine. By using berberine as internal standard, an online SPME-HPLC method was developed for analysis of yohimbine in human plasma sample. The method has wide linear range (2-1000 ng/mL) with an R(2) of 0.9962; the limit of detection was determined and was as low as 0.1 ng/mL using UV detection. Finally, a pharmacokinetic study of yohimbine was carried out by the online SPME-HPLC method and the results have been compared with those of reported methods.

  2. Porous poly-ether ether ketone (PEEK) manufactured by a novel powder route using near-spherical salt bead porogens: characterisation and mechanical properties.

    PubMed

    Siddiq, Abdur R; Kennedy, Andrew R

    2015-02-01

    Porous PEEK structures with approximately 85% open porosity have been made using PEEK-OPTIMA® powder and a particulate leaching technique using porous, near-spherical, sodium chloride beads. A novel manufacturing approach is presented and compared with a traditional dry mixing method. Irrespective of the method used, the use of near-spherical beads with a fairly narrow size range results in uniform pore structures. However the integration, by tapping, of fine PEEK into a pre-existing network salt beads, followed by compaction and "sintering", produces porous structures with excellent repeatability and homogeneity of density; more uniform pore and strut sizes; an improved and predictable level of connectivity via the formation of "windows" between the cells; faster salt removal rates and lower levels of residual salt. Although tapped samples show a compressive yield stress >1 MPa and stiffness >30 MPa for samples with 84% porosity, the presence of windows in the cell walls means that tapped structures show lower strengths and lower stiffnesses than equivalent structures made by mixing.

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

    ClinicalTrials.gov

    2014-12-29

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

  4. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage IB-IVA Cervical Cancer

    ClinicalTrials.gov

    2016-03-16

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

  5. Os Odontoideum: Rare Cervical Lesion

    DTIC Science & Technology

    2011-11-01

    the articulation between C1 and the os odontoideum on flexion imaging. The remainder of his cervical vertebral bodies had normal alignment with no...appears normal. Figure 3. Flexion view of plain cervical spine. This image shows abnormal translation of the articulation between C1 and the C2 os...worldwide. Peer Reviewed Title: Os Odontoideum: Rare Cervical Lesion Journal Issue: Western Journal of Emergency Medicine, 12(4) Author: Robson

  6. Chronic Pseudomonas aeruginosa cervical osteomyelitis

    PubMed Central

    Meher, Sujeet Kumar; Jain, Harsh; Tripathy, Laxmi Narayan; Basu, Sunandan

    2016-01-01

    Pseudomonas aeruginosa is a rare cause of osteomyelitis of the cervical spine and is usually seen in the background of intravenous drug use and immunocompromised state. Very few cases of osteomyelitis of the cervical spine caused by pseudomonas aeruginosa have been reported in otherwise healthy patients. This is a case presentation of a young female, who in the absence of known risk factors for cervical osteomyelitis presented with progressively worsening neurological signs and symptoms. PMID:27891039

  7. [Primary cervical cancer screening].

    PubMed

    Vargas-Hernández, Víctor Manuel; Vargas-Aguilar, Víctor Manuel; Tovar-Rodríguez, José María

    2015-01-01

    Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis.

  8. Osteotomies in the Cervical Spine

    PubMed Central

    Nemani, Venu M.; Derman, Peter B.

    2016-01-01

    Rigid cervical deformities are difficult problems to treat. The goals of surgical treatment include deformity correction, achieving a rigid fusion, and performing a thorough neural decompression. In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance. In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment. We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications. PMID:26949476

  9. Cervical split: A pseudofracture

    SciTech Connect

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

    1982-01-01

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

  10. Preinduction cervical ripening.

    PubMed

    Thiery, M

    1983-01-01

    This work reviews the evolution of cervical ripening procedures and discusses the most effective current techniques. Current knowledge of the process of spontaneous ripening of the cervix is briefly assessed, but the review concentrates on methodological aspects and the clinical results of preinduction cervical ripening. The historical development of mechanical and pharmacologic ripening procedures is examined, including enzymes, oxytocin, relaxin, corticosteriods, estrogens administered parenterally or locally, and prostaglandins (PGs) administered intravenously, orally, locally, and intravaginally. 3 effective procedures for preinduction cervical ripening are identified and described in greater detail: the catheter technique and local and vaginal administration of PGs. The extraamniotic catheter technique is simple, effective, and safe and is recommended for patients with not totally unripe cervixes and for whom PGs are unavailable or contraindicated. Single-dose extraamniotic instillation of PGE2 in Tylose gel was found to be highly effective for priming the unfavorable cervix before conventional labor induction. In some patients the procedure induces labor. The technique is easy to use, well accepted by the woman, and safe when applied appropriately to carefully selected patients. PGF2alpha gel has been less thoroughly studied. Electronic monitoring at the ripening stage is recommended for patients at risk, and even in low-risk cases much larger series will require study before conclusions can be reached about safety. Injection of PG gel into the cervical canal is less invasive than extraamniotic instillation, but no definite conclusions about its safety are possible due to small series and dissimilar clinical protocols. Pericervical administration of PGE2 and PGF2 alpha and intracervical and intraamniotic tablets of PGE2 are briefly assessed. Adoption of the intravaginal route has been a major step in the development of ripening techniques. 3 types of media

  11. Hybrid cervical disc arthroplasty.

    PubMed

    Tu, Tsung-Hsi; Wu, Jau-Ching; Cheng, Henrich; Mummaneni, Praveen V

    2017-01-01

    For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6. After nonoperative treatment failed, she underwent a single-level ACDF at C3-4 and single-level arthroplasty at C5-6, which successfully relieved her symptoms. No intervention was performed at the normal intervening C4-5 segment. By using ACDF combined with arthroplasty, the authors have avoided a 3-level fusion for this patient and maintained the range of motion of 2 disc levels. The video can be found here: https://youtu.be/OrxcPUBvqLk .

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

    ClinicalTrials.gov

    2014-12-29

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

  13. The influence of a compatibilizer on the thermal and dynamic mechanical properties of PEEK/carbon nanotube composites.

    PubMed

    Díez-Pascual, A M; Naffakh, M; Gómez, M A; Marco, C; Ellis, G; González-Domínguez, J M; Ansón, A; Martínez, M T; Martínez-Rubi, Y; Simard, B; Ashrafi, B

    2009-08-05

    The effect of polyetherimide (PEI) as a compatibilizing agent on the morphology, thermal, electrical and dynamic mechanical properties of poly(ether ether ketone) (PEEK)/single-walled carbon nanotube (SWCNT) nanocomposites, has been investigated for different CNT loadings. After a pre-processing step based on ball milling and pre-mixing under mechanical treatment in ethanol, the samples were prepared by melt extrusion. A more homogeneous distribution of the CNTs throughout the matrix is found for composites containing PEI, as revealed by scanning electron microscopy. Thermogravimetric analysis demonstrates an increase in the matrix degradation temperatures under dry air and nitrogen atmospheres with the addition of SWCNTs; the level of thermal stability of these nanocomposites is maintained when PEI is incorporated. Both differential scanning calorimetry and synchrotron x-ray scattering studies indicate a slight decrease in the crystallization temperatures of the compatibilized samples, and suggest the existence of reorganization phenomena during the heating, which are favoured in the composites incorporating the compatibilizer, due to their smaller crystal size. Dynamic mechanical studies show an increase in the glass transition temperature of the nanocomposites upon the addition of PEI. Furthermore, the presence of PEI causes an enhancement in the storage modulus, and hence in the rigidity of these systems, attributed to an improved interfacial adhesion between the reinforcement and the matrix. The electrical and thermal conductivities of these composites decrease with the incorporation of PEI. Overall, the compatibilized samples exhibit improved properties and are promising for their use in industrial applications.

  14. Water absorption in PEEK and PEI matrices. Contribution to the understanding of water-polar group interactions

    NASA Astrophysics Data System (ADS)

    Courvoisier, E.; Bicaba, Y.; Colin, X.

    2016-05-01

    The water absorption in two aromatic linear polymers (PEEK and PEI) was studied between 10% and 90% RH at 30, 50 and 70°C. It was found that these polymers display classical Henry and Fick's behaviors. Moreover, they have very close values of equilibrium water concentration C∞ and water diffusivity D presumably because their respective polar groups establish molecular interactions of the same nature with water. This assumption was checked from a literature compilation of values of C∞ and D for a large variety of linear and tridimensional polymers containing a single type of polar group. It was then evidenced that almost all types of carbonyl group (in particular, those belonging to imides, amides and ketones) have the same molar contribution to water absorption, except those belonging to esters which are much less hydrophilic. Furthermore, hydroxyl and sulfone groups are much more hydrophilic than carbonyl groups so that their molar contribution is located on another master curve. On this basis, semi-empirical structure/water transport property relationships were proposed. It was found that C∞ increases exponentially with the concentration of polar groups (presumably because water is doubly bonded), but also with the intensity of their molecular interactions with water. In contrast, D is inversely proportional to C∞, which means that polar group-water interactions slow down the rate of water diffusion.

  15. Cervical Cancer Working Group report.

    PubMed

    Konno, Ryo; Sagae, Satoru; Yoshikawa, Hiroyuki; Basu, Partha Sarathi; Hanley, Sharon J B; Tan, Jeffrey H J; Shin, Hai-Rim

    2010-09-01

    Disease burden of cervical cancer in Asia was summarized. Human papillomavirus 16 is the most oncogenic human papillomavirus type. Korea's national cervical cancer screening program targets women aged 30 or over, with coverage of almost 80%. Japan has a long history (50 years) of cervical cancer screening, and cytological screening programs have reduced the incidence/mortality of cervical cancer by 70%. But, recent cervical cancer screening coverage is ∼24%. Modeling suggested that vaccination of all 12-year-old girls would reduce cervical cancer cases by 73% in Japan. India has no cervical cancer screening program, as well as a serious lack of awareness in the general population, medical professionals and policy-makers. A realistic, affordable approach would be a low-volume, once-in-a-lifetime human papillomavirus-based screening program. In Australia, the national cervical cancer program has been very successful in reducing the incidence and mortality of cervical cancer. Australia was the first country to implement free, national human papillomavirus immunization (April 2007), expected to reduce human papillomavirus 16 infections by 56% in 2010 and 92% in 2050. A comparison of the UK and Japan was demonstrated that in the UK, cervical cancer screening and human papillomavirus vaccination uptakes are high because the government provides adequate education/funding. The Japanese government needs to put more emphasis on women's health and preventative medicine. Our conclusion and recommendations are that heightened public awareness of cervical cancer prevention, focusing on screening and vaccination will lead to improved survival and a better quality of life.

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

    ClinicalTrials.gov

    2017-02-08

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage II Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  17. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  18. Cervical carcinoma: an experimental approach.

    PubMed

    Cowan, M E; Skinner, G R

    1988-01-01

    A mouse model system was used to investigate the preventive efficacy of a subunit herpes simplex virus (HSV) vaccine on the development of HSV induced cervical carcinoma. Ten groups of mice were vaccinated before receiving repeated intravaginal exposure to HSV-type 2 inactivated by ultraviolet irradiation. At 20 months postvaccination, neutralizing antibody activity to herpes simplex viruses was detected in the sera of the mice which had received the highest vaccine dose. Although three experimental mice and one control mouse developed cervical tumours and five mice developed preinvasive malignant changes, 87% of cervices were of normal or koilocytotic appearance on histological examination. There was therefore no evidence from this study that repeated exposure of mouse cervices to inactivated HSV-2 induced a significant incidence of preinvasive or invasive cervical carcinoma.

  19. Fractures of the cervical spine

    PubMed Central

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

    2013-01-01

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

  20. The cervical cap.

    PubMed

    1988-10-07

    The US Food and Drug Administration has approved marketing of the Prentif cavity-rim cervical cap. This contraceptive device is being distributed in the US and Canada by Cervical Cap Ltd, Los Gatos, California. The Prentif cap is available in 4 sizes: 22, 25, 28, and 31 mm inside diameter, with a length of 1 1/4-1 1/2 inches. In a multicenter trial involving 522 diaphragm users and 581 cap users followed for 2 years, the cap was 82.6% effective and the diaphragm was 83.3% effective in preventing pregnancy. When pregnancies attributable to user failure were excluded, these rates were increased to 93.6% for the cap and 95.4% for the diaphragm. 4% of cap users compared with only 1.7% of diaphragm users in this study developed abnormal Pap smears after 3 months of use; in addition, a higher proportion of cap users became infected with Gardnerella vaginalis and Monilia. Theoretical hazards include toxic shock syndrome and endometriosis due to backflow of menstrual fluids. Cap users are advised to undergo a Pap test after 3 months of use and discontinue cap use if the results are abnormal. The cap should not be used during menstruation. Although the cap can be left in place for up to 48 hours, its position should be checked before and after each episode of intercourse. The cervical cap requires less spermicide than the diaphragm and is not as messy. In addition, it can be left in the vagina twice as long as the diaphragm, without additional spermicide. Since the cap is smaller than the diaphragm and does not cover the vaginal wall, some women find intercourse more pleasurable with this device.

  1. X-Ray Exam: Cervical Spine

    MedlinePlus

    ... to 2-Year-Old X-Ray Exam: Cervical Spine KidsHealth > For Parents > X-Ray Exam: Cervical Spine A A A What's in this article? What ... Radiografía: columna cervical What It Is A cervical spine X-ray is a safe and painless test ...

  2. [Subcutaneous cervical emphysema secondary to tooth extraction].

    PubMed

    Calvo Boizas, E; Sancipriano Hernández, J A; Rincón Esteban, L; Diego Pérez, C; Santiago Andrés, J; Hermosa Finamor, P; Gómez Toranzo, F

    1997-01-01

    Cervical emphysema is rare and its diagnosis involves the ENT specialist. A case of cervical subcutaneous emphysema secondary to lower molar extraction is reported. The patient had no signs or symptoms other than cervical emphysema. Simple radiography and CT are recommended for early diagnosis. The etiopathogenic mechanisms of subcutaneous cervical emphysema are reviewed. Recent literature contains few cases of dental origin.

  3. X-Ray Exam: Cervical Spine

    MedlinePlus

    ... to 2-Year-Old X-Ray Exam: Cervical Spine KidsHealth > For Parents > X-Ray Exam: Cervical Spine Print A A A What's in this article? ... Radiografía: columna cervical What It Is A cervical spine X-ray is a safe and painless test ...

  4. Surgical Outcomes of Anterior Cervical Fusion Using Deminaralized Bone Matrix as Stand-Alone Graft Material: Single Arm, Pilot Study

    PubMed Central

    Chung, Ho-Jung; Ryu, Kyeong-Sik; Kim, Jin-Sung; Seong, Ji-Hoon

    2016-01-01

    Objective To investigate the safety and efficacy of demineralized bone matrix (DBM) as a bone graft substitute for anterior cervical discectomy and fusion (ACDF) surgery. Methods Twenty consecutive patients treated with ACDF using stand-alone polyestheretherketone (PEEK) cages (Zero-P) with DBM(CGDBM100) were prospectively evaluated with a minimum of 6 months of follow-up. Radiologic efficacy was evaluated with a 6-point scoring method for osseous fusion using plain radiograph and computed tomogrpahy scans. Clinical efficacy was evaluated using the visual analogue scale (VAS), Owestry disability index (ODI), and short-form health questionnaire-36. The safety of the bone graft substitute was assessed with vital sign monitoring and a survey measuring complications at each follow-up visit. Results There were significant improvements in VAS and ODI scores at a mean 6-month follow-up. Six months after surgery, solid fusion was achieved in all patients. Mean score on the 6-point scoring system was 5.1, and bony formation was found to score at least 4 points in all patients. There was no case with implant-related complications such as cage failure or migration, and no complications associated with the use of CGDBM100. Conclusion ACDF using CGDBM100 demonstrated good clinical and radiologic outcomes. The fusion rate was comparable with the published results of traditional ACDF. Therefore, the results of this study suggest that the use of a PEEK cage packed with DBM for ACDF is a safe and effective alternative to the gold standard of autologous iliac bone graft. PMID:27799989

  5. [Cervical spine instability in the surgical patient].

    PubMed

    Barbeito, A; Guerri-Guttenberg, R A

    2014-03-01

    Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.

  6. Characterization of impact damage resistance of CF/PEEK and CF/toughened epoxy laminates under low and high velocity impact tests

    SciTech Connect

    Morita, Hideo; Adachi, Tadaharu; Tateishi, Yasuhiro; Matsumoto, Hiroyuki

    1995-12-31

    In order to use composite materials in aeronautical turbo engines, their resistance to impact damage must be understood. In this work the subperforation flat-wise impact resistance of three kinds of high resistance material systems were evaluated under low and high velocity impact tests. Tested systems were AS4/PEEK (APC-2/AS4, ICI-Fiberite), AS4/PEEK+IL, which consists of APC-2 prepreg and PEEK film inserted between layers as an interleave, and toughened epoxy system T800/{number_sign}3900 (Toray). To investigate the effects of stacking sequence on resistance, three lay-ups -- (0/+30/0/{minus}30)s, (0/+60/0/{minus}60)s, and (0/+45/90/{minus}45)s -- were tested. A drop weight system was used for the low velocity tests, where the velocity ranged from 1.5 to 3.1 m/s. An air gun system was used for the high velocity tests, where the velocity range was between 50 and 100 m/s. The relation between damage area (DA) and impact energy (IE) was linear, and the ratio of the DA/IE quantified the impact resistance of each specimen. The value of DA/IE for the high velocity tests was larger than the value for low velocity tests. To estimate the lay-up effect, a stacking parameter {beta}, which indicates the difference of the inplane stiffness between the adjacent laminae, was proposed. A proportional relation between the DA/IE and the {beta} was obtained. The value of (DA/IE)/{beta}, which was independent of stacking sequence, indicated the impact resistance of the tested material systems for both velocity levels. The ratio of (DA/IE)/{beta} for the high velocity to the value for the low velocity changed with material systems.

  7. Cervical extravasation of bevacizumab.

    PubMed

    Dréanic, Johann; Coriat, Romain; Mir, Olivier; Perkins, Géraldine; Boudou-Rouquette, Pascaline; Brezault, Catherine; Dhooge, Marion; Goldwasser, François; Chaussade, Stanislas

    2013-04-01

    Monoclonal antibodies such as bevacizumab are widely used in medical oncology, either alone or in combination with chemotherapy. No specific recommendations on the management of monoclonal antibodies extravasation exist. Incidence rates vary considerably. Estimates of 0.5-6% have been reported in the literature. Also, patient-associated and procedure-associated risk factors of extravasation are multiple, such as bolus injections or poorly implanted central venous access. We report on an 86-year-old woman with colon cancer with liver metastasis who was treated with 5-fluorouracil, folinic acid, and bevacizumab. Extravasation occurred during chemotherapy infusion because of a catheter migration of the port outside of the superior vena cava, causing cervical pain without skin modifications. Diagnosis was confirmed with the appearance of clinical right cervical tumefaction and cervicothoracic computed tomography scan indicated a perijugular hypodense collection, corresponding to the extravasation. Conservative management was proposed. The patient recovered within 3 weeks from all symptoms. Physicians should be aware that in cases of bevacizumab extravasation, a nonsurgical approach might be effective.

  8. Dysphagia due to cervical osteophytes.

    PubMed

    Khan, Mohammad Saeed; Bansal, Meghana; Agarwal, Abhishek

    2012-05-01

    Cervical bony outgrowths or osteophytes are common and usually asymptomatic. In some cases, they may be associated with dysphagia, dysphonia, dyspnea and pulmonary aspiration. The most common causes of cervical osteophytes are osteoarthritis, ankylosing spondylitis and ankylosing hyperostosis or Diffuse Idiopathic Spinal Hyperostosis (DISH), also known as Forestier's Disease. Other causes are hypoparathyroidism, trauma, acromegaly, ochronosis and flourosis. However, while dysphagia due to osteophytes is reported in the setting of DISH, it is very rare with osteoarthritis. We report a case of a patient who developed dysphagia due to anterior cervical osteophytes in the setting of osteoarthritis.

  9. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    ClinicalTrials.gov

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  10. Airway management for cervical spine surgery.

    PubMed

    Farag, Ehab

    2016-03-01

    Cervical spine surgery is one of the most commonly performed spine surgeries in the United States, and 90% of the cases are related to degenerative cervical spine disease (the rest to cervical spine trauma and/or instability). The airway management for cervical spine surgery represents a crucial step in the anesthetic management to avoid injury to the cervical cord. The crux for upper airway management for cervical spine surgery is maintaining the neck in a neutral position with minimal neck movement during endotracheal intubation. Therefore, the conventional direct laryngoscopy (DL) can be unsuitable for securing the upper airway in cervical spine surgery, especially in cases of cervical spine instability and myelopathy. This review discusses the most recent evidence-based facts of the main advantages and limitations of different techniques available for upper airway management for cervical spine surgery.

  11. Cervical Dysplasia: Is It Cancer?

    MedlinePlus

    ... showed cervical dysplasia. What does that mean? Is it cancer? Answers from Shannon K. Laughlin-Tommaso, M. ... the abnormal cells. Dysplasia could go away on its own or, rarely, it could develop into cancer. ...

  12. Advocating for cervical cancer prevention.

    PubMed

    Sherris, J; Agurto, I; Arrossi, S; Dzuba, I; Gaffikin, L; Herdman, C; Limpaphayom, K; Luciani, S

    2005-05-01

    Cervical cancer is a significant health problem among women in developing countries. Contributing to the cervical cancer health burden in many countries is a lack of understanding and political will to address the problem. Broad-based advocacy efforts that draw on research and program findings from developing-country settings are key to gaining program and policy support, as are cost-effectiveness analyses based on these findings. The Alliance for Cervical Cancer Prevention (ACCP) has undertaken advocacy efforts at the international, regional, national, and local levels to raise awareness and understanding of the problem (and workable solutions), galvanize funders and governments to take action, and engage local stakeholders in ensuring program success. ACCP experience demonstrates the role that evidence-based advocacy efforts play in the ultimate success of cervical cancer prevention programs, particularly when new screening and treatment approaches-and, ultimately, radically new approaches such as a human papillomavirus vaccine-are available.

  13. Cervical spine injuries in football.

    PubMed

    Breslow, M J; Rosen, J E

    2000-01-01

    The game of football, as it is played today, poses serious risk of injury for players of all ages. Injury may occur to any structure of the spinal column, including its bony, ligamentous and soft tissue components. The majority of cervical spine injuries occurring in football are self limited, and a full recovery can be expected. While these injuries are relatively uncommon, cervical spine injuries represent a significant proportion of athletic injuries that can produce permanent disability. The low incidence of cervical spine injuries has lead to a lack of emergency management experience of on-site medical staff. This paper will review the numerous injuries sustained by the cervical spine in football players and provide insights into prevention and guidelines for return to play.

  14. Cervical Vagal Schwannoma: Anesthetic Concerns

    PubMed Central

    Saini, Suman; Sabharwal, Nikki; Agrawal, Nidhi; Singh, Bhupender

    2017-01-01

    Schwannomas arising from cervical vagus nerve is an extremely rare benign neoplasm. The majority of patients present with insidiously growing lateral neck mass without neurological deficit. We report a case of symptomatic cervical vagal nerve schwannoma in a 32-year-old female. Complete surgical resection is the treatment of choice. However, anesthetic management of these tumors can be challenging. We describe here the complications experienced during the management of the patient.

  15. [Pregnancy and invasive cervical cancer].

    PubMed

    Kornovski, Ia; Gorchev, G; Trendafilova

    2008-01-01

    A case of 27-year old woman with spinocellular cervical cancer stage IB1 (FIGO) associated with pregnancy (36 g.w.) was reported. Authors performed cesarean radical hysterectomy with pelvic lymphadenectomy and transposition of the ovaries. The review of the literature revealed an algorithm and and practical recommendations in terms of management of cervical cancer during pregnancy, depending on the stage of the pregnancy and the tumor.

  16. Cervical total disk replacement: complications and avoidance.

    PubMed

    Salari, Behnam; McAfee, Paul C

    2012-01-01

    Anterior cervical diskectomy and fusion for neurologic deficits, radicular arm pain, and neck pain refractory to conservative management are successful. The approach and procedure were first described in 1955 and have become the anterior cervical standard of care for orthopedic surgeons and neurosurgeons. Advancements and innovations have addressed disease processes of the cervical spine with motion-preserving technology. The possibility of obtaining anterior cervical decompression while maintaining adjacent segment motion led to the advent of cervical total disk replacement. The Food and Drug Administration has approved 3 cervical devices with other investigational device exemption trials under way.

  17. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo.

    PubMed

    Li, Yongchao; Peng, Baogan

    2015-01-01

    Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients' subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with Barré-Liéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment.

  18. Analysis of digitized cervical images to detect cervical neoplasia

    NASA Astrophysics Data System (ADS)

    Ferris, Daron G.

    2004-05-01

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

  19. Preventing Cervical Cancer with HPV Vaccines

    Cancer.gov

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

  20. Internet-Based Cervical Cytology Screening System

    DTIC Science & Technology

    2007-04-01

    telecytology, cytopathology, telemedicine, cancer screening, health care information systems, cervical cancer 16. SECURITY CLASSIFICATION OF......approaches to cervical cancer screening possible. In addition, advances in information technology have facilitated the Internet transmission and archival

  1. Cervical Spinal Motion During Orotracheal Intubation.

    DTIC Science & Technology

    1998-01-01

    Sixteen fresh human cadavers were intubated while recording cervical motion using a cine fluoroscopic technique. Segmental cervical motion from the...intubation was performed using no external stabilization, Gardner-Wells traction and manual in-line cervical immobilization. The cadaveric spine motion...immobilization reduced motion at the destabilize C4-5 level. Four patients without significant cervical pathology and normal motion of flexion

  2. Cervical cancer screening.

    PubMed Central

    Katz, A.

    1998-01-01

    OBJECTIVE: To review the role of family physicians in screening for cancer of the cervix, to review the evidence for screening, in particular, frequency and technique for screening, and to review the reasons cervical cancer has not been prevented and the role of family physicians in addressing these failures. QUALITY OF EVIDENCE: The value of screening has been established with level II evidence. Many of the unresolved issues are not supported either way by good evidence; level II and III evidence predominates. MAIN FINDINGS: In Canada, 1350 women were predicted to be diagnosed with cancer of the cervix in 1996. Most of these women had not been screened. Minority, rural, low-income, and older women face important barriers to screening. Family physicians have a role in reaching out to these women to provide effective health care, including cancer screening. When cancer screening is performed, it should conform to recommended techniques with appropriate follow up of abnormal test results. CONCLUSIONS: Family physicians have an important role in preventing cancer of the cervix. Efforts should be concentrated on encouraging a greater proportion of eligible women to be screened. Criteria are suggested for effective screening. PMID:9721422

  3. Human Papillomavirus and Cervical Cancer

    PubMed Central

    Burd, Eileen M.

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Identification of precancerous lesions has been primarily by cytologic screening of cervical cells. Cellular abnormalities, however, may be missed or may not be sufficiently distinct, and a portion of patients with borderline or mildly dyskaryotic cytomorphology will have higher-grade disease identified by subsequent colposcopy and biopsy. Sensitive and specific molecular techniques that detect HPV DNA and distinguish high-risk HPV types from low-risk HPV types have been introduced as an adjunct to cytology. Earlier detection of high-risk HPV types may improve triage, treatment, and follow-up in infected patients. Currently, the clearest role for HPV DNA testing is to improve diagnostic accuracy and limit unnecessary colposcopy in patients with borderline or mildly abnormal cytologic test results. PMID:12525422

  4. Cervical vertebral bone age in girls.

    PubMed

    Mito, Toshinori; Sato, Koshi; Mitani, Hideo

    2002-10-01

    The purpose of this study was to establish cervical vertebral bone age as a new index for objectively evaluating skeletal maturation on cephalometric radiographs. Using cephalometric radiographs of 176 girls (ages 7.0-14.9 years), we measured cervical vertebral bodies and determined a regression formula to obtain cervical vertebral bone age. Next, using cephalometric and hand-wrist radiographs of another 66 girls (ages 8.0-13.9 years), we determined the correlation between cervical vertebral bone age and bone age using the Tanner-Whitehouse 2 method. The following results were obtained: (1) a regression formula was determined to obtain cervical vertebral bone age based on ratios of measurements in the third and fourth cervical vertebral bodies; (2) the correlation coefficient for the relationship between cervical vertebral bone age and bone age (0.869) was significantly (P <.05) higher than that for the relationship between cervical vertebral bone age and chronological age (0.705); and (3) the difference (absolute value) between the cervical vertebral bone age and bone age (0.75 years) was significantly (P <.001) smaller than that between cervical vertebral bone age and chronological age (1.17 years). These results suggest that cervical vertebral bone age reflects skeletal maturity because it approximates bone age, which is considered to be the most reliable method for evaluating skeletal maturation. Using cervical vertebral bone age, it might be possible to evaluate maturity in a detailed and objective manner on cephalometric radiographs.

  5. Internet-Based Cervical Cytology Screening Program

    DTIC Science & Technology

    2005-04-01

    cancer is theoretically completely preventable by effective screening using cervical cytology methods (the Pap test). The process of preparing and...preparation and computerized primary screening make automated approaches to cervical cancer screening possible. In addition, advances in information technology... cervical cancer screening results - completed f) Adapt commercial software (Wellogic) to integrate screening results reporting with medical decision

  6. 21 CFR 884.5250 - Cervical cap.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cervical cap. 884.5250 Section 884.5250 Food and... OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices § 884.5250 Cervical cap. (a) Identification. A cervical cap is a flexible cuplike receptacle that fits over the cervix...

  7. 21 CFR 884.3200 - Cervical drain.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cervical drain. 884.3200 Section 884.3200 Food and... OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3200 Cervical drain. (a) Identification. A cervical drain is a device designed to provide an exit channel for...

  8. Use of Cervical Pessary in the Management of Cervical Insufficiency.

    PubMed

    Timofeev, Julia

    2016-06-01

    Prevention of spontaneous preterm birth is an important public health priority. Pessary may be a potential therapy in cases of cervical insufficiency, in singleton and multiple gestations. Availability of transvaginal sonography for accurate assessment of cervical length is allowing for the tailoring of therapy to a more specific subset of patients who may benefit from this treatment. Pessary therapy is attractive given the favorable side effect profile, low cost, and ease of placement and removal. Large randomized trials are ongoing to validate initial favorable findings.

  9. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  10. No carious cervical lesions: abfraction.

    PubMed

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-10-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5.

  11. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy

    PubMed Central

    Zambrano, Nabila; Reilly, James; Moretti, Michael

    2017-01-01

    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a “cervical sandwich.” We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate. PMID:28261511

  12. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy.

    PubMed

    Zambrano, Nabila; Reilly, James; Moretti, Michael; Lakhi, Nisha

    2017-01-01

    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a "cervical sandwich." We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate.

  13. Biomarker discovery for neuroendocrine cervical cancer.

    PubMed

    Lin, Li-Hsun; Chang, Shing-Jyh; Hu, Ren-Yu; Lin, Meng-Wei; Lin, Szu-Ting; Huang, Shun-Hong; Lyu, Ping-Chiang; Chou, Hsiu-Chuan; Lai, Zih-Yin; Chuang, Yung-Jen; Chan, Hong-Lin

    2014-07-01

    Neuroendocrine cervical cancer is an aggressive but rare form of cervical cancer. The majority of neuroendocrine cervical cancer patients present with advanced-stage diseases. However, the limited numbers of neuroendocrine tumor markers are insufficient for clinical purposes. Thus, we used a proteomic approach combining lysine labeling 2D-DIGE and MALDI-TOF MS to investigate the biomarkers for neuroendocrine cervical cancer. By analyzing the global proteome alteration between the neuroendocrine cervical cancer line (HM-1) and non-neuroendocrine cervical cancer lines (CaSki cells, ME-180 cells, and Hela cells), we identified 82 proteins exhibiting marked changes between HM-1 and CaSki cells, and between ME-180 and Hela cells. Several proteins involved in protein folding, cytoskeleton, transcription control, signal transduction, glycolysis, and redox regulation exhibited significant changes in abundance. Proteomic and immunoblot analyses indicated respective 49.88-fold and 25-fold increased levels of transgelin in HM-1 cells compared with that in other non-neuroendocrine cervical cancer cell lines, implying that transgelin is a biomarker for neuroendocrine cervical cancer. In summary, we used a comprehensive neuroendocrine/non-neuroendocrine cervical cancer model based proteomic approach for identifying neuroendocrine cervical cancer markers, which might contribute to the prognosis and diagnosis of neuroendocrine cervical cancer.

  14. ‘Abnormal’ cervical imaging?: Cervical pneumatocysts – A case report of a cervical spine pneumatocyst

    PubMed Central

    Renshaw, Hanna; Patel, Amit; Boctor, Daniel Sherif Zakaria Matta; Hakmi, Mohamed Atef

    2015-01-01

    To our knowledge there are only 15 reported cases of pneumatocysts in the cervical spine, but awareness of their existence should help the clinician when diagnosing abnormalities in radiological images. When faced with intravertebral gas, in addition to considering more sinister causes, one should consider the differentials including pneumatocysts. Despite our relative lack of understanding of these benign lesions the knowledge that they can change over time should prevent unnecessary testing or treating. We present a patient who fell down stairs and was found to have cervical intravertebral gas, on computed tomography imaging, with the typical appearance of a pneumatocyst. PMID:26719615

  15. Nonoperative Management of Cervical Radiculopathy.

    PubMed

    Childress, Marc A; Becker, Blair A

    2016-05-01

    Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 to 54 years of age. Cervical radiculopathy most often stems from degenerative disease in the cervical spine. The most common examination findings are painful neck movements and muscle spasm. Diminished deep tendon reflexes, particularly of the triceps, are the most common neurologic finding. The Spurling test, shoulder abduction test, and upper limb tension test can be used to confirm the diagnosis. Imaging is not required unless there is a history of trauma, persistent symptoms, or red flags for malignancy, myelopathy, or abscess. Electrodiagnostic testing is not needed if the diagnosis is clear, but has clinical utility when peripheral neuropathy of the upper extremity is a likely alternate diagnosis. Patients should be reassured that most cases will resolve regardless of the type of treatment. Nonoperative treatment includes physical therapy involving strengthening, stretching, and potentially traction, as well as nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. Epidural steroid injections may be helpful but have higher risks of serious complications. In patients with red flag symptoms or persistent symptoms after four to six weeks of treatment, magnetic resonance imaging can identify pathology amenable to epidural steroid injections or surgery.

  16. Cervical Cancer Risk Prediction Models

    Cancer.gov

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  17. CNP. Cervical Neoplasia Probe Control

    SciTech Connect

    Vargo, T.

    1995-05-17

    This software, which consists of a main executive and several subroutines, performs control of the optics, image acquisition, and Digital Signal Processing (DSP) of this image, of an optical based medical instrument that performs fluoresence detection of precancerous lesions (neoplasia) of the human cervix. The hardware portion of this medical instrument is known by the same name Cervical Neoplasia Probe (CNP)

  18. Drugs Approved for Cervical Cancer

    Cancer.gov

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

  19. [Disphagia secondary to cervical osteophytes].

    PubMed

    Torres Muros, B; Serrano, J A; Meschian Coretti, S

    2006-01-01

    Disphagia is a common cause of medical query in the ENT field, in which could be involved a variety of medical reason. One of those is the extrinsic compression of the digestive tract due to a tumoral process, or as the case we report, secundary to a large osteophyte at the anterior side of the cervical spine, after a surgical intervention in this area.

  20. Genetic events in cervical carcinoma

    SciTech Connect

    Sarkar, S.; Tai, C.C.; Mowatt, J.

    1994-09-01

    Cervical carcinoma is the fifth most common cancer world-wide and the second major cause of cancer related death in women. Recent studies have suggested that chromosome 10, particularly the short arm, may be significant in the pathogenesis of the disease. The relationship has not, however, been investigated directly in cervical tumor material. We analyzed 21 paired blood and tumor samples from patients with cervical carcinoma for allele loss on chromosome 10. Ten polymorphic loci spanning the length of chromosome 10 were used including 4 RFLPs and 4 microsatellite markers. Tumor samples were carefully dissected to remove the majority of contaminating normal tissue. Twenty of the 21 pairs were heterozygous for at least one locus. Loss of heterozygosity for one or more chromosome 10 loci was observed in 5 out of the 20 informative cases (25%). One sample showed the apparent loss of an entire copy of chromosome 10. In 3 cases allele loss was confined to loci on the short arm of chromosome 10. We are currently using further markers mapped to chromosome 10p to define the shortest consistent region of allele loss. We suggest that this region may contain one or more tumor suppressor genes involved in the development and/or progression of cervical carcinoma.

  1. Cervical cancer in Latin America.

    PubMed

    Eluf-Neto, J; Nascimento, C M

    2001-04-01

    Cervical cancer is a common cause of morbidity and mortality in developing countries. In Latin America, the incidence rates in several cities are among the highest worldwide, probably due to a high frequency of risk factors and/or a low screening coverage for cervical cancer. Epidemiologic studies conducted in Latin America (and some in the Caribbean), that have investigated the main risk factors for the disease, as well as screening coverage by Papanicolaou (Pap) smear, were reviewed. The prevalence of human papillomavirus (HPV) infection among women with negative Pap smears does not seem to explain the risk observed in Latin American countries. Results of some studies have suggested that reproductive factors and male sexual behavior might be responsible, at least partially, for the high occurrence of cervical cancer in Latin America. Concerning cytology screening, many women have a smear taken regularly (some every year). However, a significant proportion of women, probably those with a high risk of cancer of the cervix, have never had a Pap test. To reduce cervical cancer in these countries, screening programs in Latin America should have a wider coverage, especially reaching those women at higher risk. Semin Oncol 28:188-197.

  2. Nanomechanical clues from morphologically normal cervical squamous cells could improve cervical cancer screening

    NASA Astrophysics Data System (ADS)

    Geng, Li; Feng, Jiantao; Sun, Quanmei; Liu, Jing; Hua, Wenda; Li, Jing; Ao, Zhuo; You, Ke; Guo, Yanli; Liao, Fulong; Zhang, Youyi; Guo, Hongyan; Han, Jinsong; Xiong, Guangwu; Zhang, Lufang; Han, Dong

    2015-09-01

    Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis.Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03662c

  3. 21 CFR 884.4260 - Hygroscopic Laminaria cervical dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hygroscopic Laminaria cervical dilator. 884.4260... Devices § 884.4260 Hygroscopic Laminaria cervical dilator. (a) Identification. A hygroscopic Laminaria cervical dilator is a device designed to dilate (stretch open) the cervical os by cervical insertion of...

  4. Is cervical disc arthroplasty good for congenital cervical stenosis?

    PubMed

    Chang, Peng-Yuan; Chang, Hsuan-Kan; Wu, Jau-Ching; Huang, Wen-Cheng; Fay, Li-Yu; Tu, Tsung-Hsi; Wu, Ching-Lan; Cheng, Henrich

    2017-03-10

    OBJECTIVE Cervical disc arthroplasty (CDA) has been demonstrated to be as safe and effective as anterior cervical discectomy and fusion (ACDF) in the management of 1- and 2-level degenerative disc disease (DDD). However, there has been a lack of data to address the fundamental discrepancy between the two surgeries (CDA vs ACDF), and preservation versus elimination of motion, in the management of cervical myelopathy associated with congenital cervical stenosis (CCS). Although younger patients tend to benefit more from motion preservation, it is uncertain if CCS caused by multilevel DDD can be treated safely with CDA. METHODS Consecutive patients who underwent 3-level anterior cervical discectomy were retrospectively reviewed. Inclusion criteria were age less than 50 years, CCS (Pavlov ratio ≤ 0.82), symptomatic myelopathy correlated with DDD, and stenosis limited to 3 levels of the subaxial cervical (C3-7) spine. Exclusion criteria were ossification of the posterior longitudinal ligament, previous posterior decompression surgery (e.g., laminoplasty or laminectomy), osteoporosis, previous trauma, or other rheumatic diseases that might have caused the cervical myelopathy. All these patients who underwent 3-level discectomy were divided into 2 groups according to the strategies of management: preservation or elimination of motion (the hybrid-CDA group and the ACDF group). The hybrid-CDA group underwent 2-level CDA plus 1-level ACDF, whereas the ACDF group underwent 3-level ACDF. Clinical assessment was measured by the visual analog scales (VAS) for neck and arm pain, Japanese Orthopaedic Association (JOA) scores, and Nurick grades. Radiographic outcomes were measured using dynamic radiographs for evaluation of range of motion (ROM). RESULTS Thirty-seven patients, with a mean (± SD) age of 44.57 ± 5.10 years, were included in the final analysis. There was a male predominance in this series (78.4%, 29 male patients), and the mean follow-up duration was 2.37 ± 1

  5. [Injury of upper cervical spine].

    PubMed

    Ryba, Luděk; Cienciala, Jan; Chaloupka, Richard; Repko, Martin; Vyskočil, Robert

    2016-01-01

    Injuries of the upper cervical spine represent 1/3 of all cervical spine injuries and approximately 40 % result by the death. Every level of the cervical spine can be injured - fractures of condyles of the occipital bone (CO), atlantooccipital dislocation (AOD), fractures of the Atlas (C1), atlantoaxial dislocation (AAD) and fractures of the axis (C2). Most of cases in younger patients are caused by high-energy trauma, while by elderly people, because of the osteoporosis, is needed much less energy and even simple falls can cause the injury of the cervical spine. That´s why the etiology of injuries can be different. In younger patients are caused mainly by car accidents, motorcycle and bicycle accidents and pedestrian crashes by car and in elderly populations are the main reason falls. The mechanism of the injury is axial force, hyperflexion, hyperextension, latero-flexion, rotation and combination of all. The basic diagnostic examination is X ray in AP, lateral and transoral projection. But in the most of cases is CT examination necessary and in the suspicion of the ligamentous injury and neurological deterioration must be MRI examination added. Every injury of the upper cervical spine has its own classification. Clinical symptoms can vary from the neck pain, restricted range of motion, antalgic position of the head, injury of the cranial nerves and different neurologic symptoms from the irritation of nerves to quadriplegia. A large percentage of deaths is at the time of the injury. Therapy is divided to conservative treatment, which is indicated in bone injuries with minimal dislocation. In more severe cases, with the dislocation and ligamentous injury, when is high chance of the instability, is indicated the surgical treatment. We can use anterior or posterior approach, make the osteosynthesis, stabilisation and fusion of the spine. Complex fractures and combination of different types of injuries are often present in this part of the spine. Correct and early

  6. Cervical disc arthroplasty: Pros and cons

    PubMed Central

    Moatz, Bradley; Tortolani, P. Justin

    2012-01-01

    Background: Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. Methods: This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Results: Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Conclusion: Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing. PMID:22905327

  7. Cervical vertebral fusion with anterior meningocele

    PubMed Central

    Chavredakis, Emmanuel; Carter, David; Bhojak, Manesh; Jenkinson, Michael D; Clark, Simon R

    2015-01-01

    We present the first described case of cervical vertebral fusion associated with anterior meningocele and syringomyelia. A 45-year-old woman presented with minor trauma, and plain cervical spine radiographs highlighted a congenital deformity of the cervical vertebral bodies. She had a normal neurological examination; however, further imaging revealed a meningocele and syringomyelia. This case highlights the importance of thorough imaging investigation when presented with a congenital deformity in order to detect and prevent development of degenerative spinal cord pathologies. PMID:25923673

  8. Internet-Based Cervical Cytology Screening Program

    DTIC Science & Technology

    2006-04-01

    Appendices……………………………………………………………………………14 Introduction Cervical cancer is theoretically completely preventable by effective...approaches to cervical cancer screening possible. In addition, advances in information technology have facilitated the Internet transmission and archival...to allow secure, automated reporting of cervical cancer screening results - completed f) Adapt commercial software (Wellogic) to integrate

  9. Internet-Based Cervical Cancer Screening Program

    DTIC Science & Technology

    2008-05-01

    AD_________________ Award Number: W81XWH-04-C-0083 TITLE: Internet-Based Cervical Cancer Screening...DEC 2007 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Internet-Based Cervical Cancer Screening Program 5b. GRANT NUMBER W81XWH-04-C-0083 5c...care information systems, cervical cancer 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF

  10. Working capacity and cervical dystonia.

    PubMed

    Martikainen, Kirsti K; Luukkaala, Tiina H; Marttila, Reijo J

    2010-03-01

    The objective of this questionnaire study was to assess the effect of cervical dystonia on patients' working capacity. Of the 303 working-aged members of the Finnish Dystonia Association (N = 433) who participated in the study 247 (82%) had cervical dystonia. Their median age was 50 years, the median duration of CD symptoms was 12.3 years. Most (78%) subjects were on botulinum toxin treatment. Ninety-seven (39%) had retired because of CD at a median age of 48 years; 96 (39%) of the subjects were working: 87 full-time and 9 part-time. The remaining participants were on sick leave, unemployed, studying or retired of other reasons. Retirement occurred more than ten years earlier compared with the general Finnish population. All possibilities to help CD patients to continue longer in work should be considered early.

  11. [Inequalities in cervical screening practices].

    PubMed

    Döbrőssy, Lajos; Kovács, Attila; Budai, András

    2015-06-14

    Theoretically, the cytology-based cervical screening is capable of early detection of precancerous epithelial lesions of cervix uteri and its cancer, and of early referral to treatment. In this way, screening can inmprove the quality of life of the patients and reduce mortality from the target disease. Unfortunately, this often remains unexploited, because there might be inequalities on both "supply" and "demand" side of screening. In addition to the geopolitical situation of a country, inequalities might result from differences in the health care systems, and heavy access to the screening services. On the other hand, the socioeconomic status, the health-conciousness of the target population, and their knowledge and information of the benefits and potential harms of screening examination might have a bearing on the acceptance or refusal of the offered screening. Efforts need to be made to increase the uptake of cervical screening programmes.

  12. Schwannomatosis of Cervical Vagus Nerve

    PubMed Central

    Sasi, M. P.

    2016-01-01

    Cervical vagal schwannoma is a rare entity among lesions presenting as a neck mass. They are usually slow-growing benign lesions closely associated with the vagus nerve. They are usually solitary and asymptomatic. Multiple schwannomas occurring in patients without neurofibromatosis (NF) are rare and have recently been referred to as schwannomatosis. Here, we present a case of a neck mass that had imaging features suggestive of vagal schwannoma and was operated upon. Intraoperatively, it was discovered to be a case of multiple vagal cervical schwannoma, all directly related to the right vagus nerve, and could be resected from the nerve in toto preserving the function of the vagus nerve. Final HPR confirmed our pre-op suspicion of vagal schwannomatosis. PMID:27807496

  13. Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

    ClinicalTrials.gov

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer; Stage IA2 Cervical Cancer; Stage IB1 Cervical Cancer

  14. Cervical angina caused by atlantoaxial instability.

    PubMed

    Ito, Yoshiyuki; Tanaka, Nobuhiro; Fujimoto, Yoshinori; Yasunaga, Yuji; Ishida, Osamu; Ochi, Mitsuo

    2004-10-01

    Cervical angina is defined as a paroxysmal precordialgia that resembles true cardiac angina caused by cervical spondylosis. Cervical angina most commonly results from compression of the C7 ventral root. We present here a case of cervical angina caused by atlantoaxial instability. This case had marked atlantoaxial instability but no flexibility of the middle to lower levels of the cervical spine. Although there was mild C7 root compression on the radiologic findings, the chest pain was induced by neck motion, and the precordialgia disappeared after posterior atlantoaxial fusion without C7 root decompression. Therefore, we diagnosed this case as cervical angina caused by spinal cord compression at the C1-C2 level. It was speculated that a perturbation of the sympathetic nervous system or a hypofunction of the pain suppression pathway in the posterior horn of the spinal cord caused the pectoralgia. Although cervical angina is a rare disease, physicians should be aware of it; if there are no abnormal findings on cardiac examinations for angina pectoris, they should examine the cervical spine. Cervical angina due to atlantoaxial instability is one of the differential diagnoses of precordialgia.

  15. Nanotechnology in the management of cervical cancer.

    PubMed

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

    2015-03-01

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

  16. Human papilloma virus and cervical preinvasive disease

    PubMed Central

    Bari, M; Iancu, G; Popa, F

    2009-01-01

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

  17. Surgery for cervical intraepithelial neoplasia

    PubMed Central

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

    2014-01-01

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

  18. Survival from Cervical Necrotizing Fasciitis

    PubMed Central

    Gausepohl, Jeniffer S.; Wagner, Jonathan G.

    2015-01-01

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

  19. Cervical accelerometry in preterm infants.

    PubMed

    Reynolds, Eric W; Vice, Frank L; Bosma, James F; Gewolb, Ira H

    2002-09-01

    The objective of this study was to develop a method to use digital signal processing (DSP) technology to describe quantitatively and statistically swallow-associated sounds in preterm infants and to use this method to analyze changes as infants mature. Twelve recordings of accelerometric and physiological data on bottle-feeding preterm infants between 32 and 39 weeks' postmenstrual age (PMA) were analyzed. Cervical auscultation was performed using an accelerometer attached over the larynx. Acoustic data were recorded and graphically displayed using DSP software. Initial discrete sounds (IDSs) were identified and used to construct an average waveform from which a 'variance index' (VI) was calculated for each infant. The shape of the IDS waveforms became progressively more uniform with advancing PMA, as indicated by a significant inverse correlation between VI and PMA (r=0.739; p=0.006). DSP technology facilitated the development of a new method to quantitatively analyze feeding in preterm infants. This method provides an elegant tool to track maturation of infant feeding and assessing feeding readiness. This technique makes the interpretation of cervical auscultation data less subjective by replacing the verbal description of the sounds of feeding with quantitative numeric values. It is anticipated that this method can be automated to facilitate further the analysis of cervical accelerometry data.

  20. [Cervical cancer prevention: an update].

    PubMed

    Irico, G; Escobar, H; Marinelli, B

    2005-01-01

    It has been seen an increase of the cervical cancer and of intraepithelial cancer in the last years. The most important risk factors for cervical cancer are sexual conduct, early of sexual relationships, number of partners, cigarettes, oral anticonceptive, pregnancy, immunosuppression, sexually transmitted illness. And an important role of the Human Papilloma Virus. The HPV has been classified in 3 groups; low risk, the most frequents are 11 and 6, middle risk, tipe 31, 33 and 35, and high risk, 16 and 18, that have frequent association with cervical cancer and with high grade intraepithelial lesions. The cervicovaginal citology is still the most accurate diagnosis method to detect SIL or CIN and invasive cancer in early stages, it is discussed the periodicity and group of women to whom the method must point. There are different options depending if it is a SIL of low or high grade or and cancer. With the possibility of doing follow up or treatment, such as. LLETZ, Laser, Criotraphy, cone and interferon for the preneoplastic lesions. The achievement of a vaccine for HPV could have a significant impact on these pathology.

  1. Amyotrophic cervical myelopathy in adolescence.

    PubMed Central

    Toma, S; Shiozawa, Z

    1995-01-01

    The clinical and radiological features in seven patients who had asymmetric muscular atrophy of the hand and forearm when young are reported and a new hypothesis for its aetiology is proposed. Investigation of body growth curves (a surrogate for velocity of arm growth) showed close relation between (a) the age when the body height increased most rapidly and the onset age of this disorder, and (b) the age when the rapid body growth period ended and the age when symptom progression ceased. Cervical radiological evidence is provided showing asymmetric anterior cord atrophy, disappearance of slackness of dorsal roots in neck extension, and anterior and lateral displacement of the lower cervical cord against the posterior aspects of the vertebral bodies during neck flexion. These results suggest that disproportionate shortening of the dorsal roots is further accentuated during the juvenile growth spurt, which determines the onset and self limited course of the condition, and that repeated neck flexion causes micro-trauma and relative ischaemia of anterior horn cells, which finally results in atrophy of the muscles innervated by motoneurons with long axons. Predisposing anatomical factors are a straight neck due to lack of physiological cervical lordosis and the presence of foreshortened dorsal roots. Images PMID:7823068

  2. Anterior cervical discectomy with arthroplasty versus anterior cervical discectomy and fusion for cervical spondylosis.

    PubMed

    Li, Gao-Ling; Hu, Jian-Zhong; Lu, Hong-Bin; Qu, Jin; Guo, Li-Yun; Zai, Feng-Lei

    2015-03-01

    This meta-analysis aims to estimate the benefits and drawbacks associated with anterior cervical discectomy with arthroplasty (ACDA) versus anterior cervical discectomy and fusion (ACDF) for cervical spondylosis. Of 3651 identified citations, 10 randomised controlled studies involving 2380 participants were included. Moderate quality evidence supports that patients in the ACDA group had: (1) a higher Neck Disability Index (NDI) success rate at 3 month (relative risk [RR]=0.85, 95% confidence interval [CI] 0.78 to 0.93, p=0.0002) and 2 year follow-up (RR=0.95, 95%CI 0.91 to 1.00, p=0.04); (2) greater neurological success at 2 year follow-up (RR=0.95, 95%CI 0.92 to 0.98); and (3) were more likely to be employed within 6 weeks after surgery (RR=0.80 95%CI 0.66 to 0.96). In summary, the current evidence indicates that ACDA is associated with a higher NDI success rate in the short and long-term as well as a higher neurological success rate. Patients who undergo ACDA may also have a greater likelihood of being employed in the short-term. However, all of the evidence reviewed is of moderate or low quality and the clinical significance often marginal or unclear. Additional data are needed to compare the benefits and limitations of ACDA and ACDF.

  3. Relationship of Specific Bacteria in the Cervical and Vaginal Microbiotas with Cervicitis

    PubMed Central

    Srinivasan, Sujatha; Fiedler, Tina L.; Morgan, Martin T.; Balkus, Jennifer E.; McClelland, R. Scott; Fredricks, David N.; Marrazzo, Jeanne M.

    2015-01-01

    Background Cervicitis is an inflammatory condition of the cervix associated with upper genital tract infection and reproductive complications. Although cervicitis can be caused by several known pathogens, the etiology frequently remains obscure. Here we investigate vaginal bacteria associated with bacterial vaginosis as potential causes of cervicitis. Methods Associations between vaginal bacteria and cervicitis were assessed in a retrospective case control study of women attending a Seattle STD clinic. Individual bacterial species were detected using two molecular methods: quantitative PCR (qPCR) and broad range 16S rRNA gene PCR with pyrosequencing. The primary finding from this initial study was evaluated using qPCR in a second cohort of Kenyan women. Results The presence of Mageeibacillus indolicus, formerly BVAB3, in the cervix was associated with cervicitis, while the presence of Lactobacillus jensenii was inversely associated. Quantities of these bacteria did not differ between cervicitis cases and controls, though in a model inclusive of presence and abundance, M. indolicus remained significantly associated with cervicitis after adjustment for other cervicitis-causing pathogens. M. indolicus was not associated with cervicitis in our study of Kenyan women, possibly due to differences in the clinical definition of cervicitis. Conclusions Colonization of the endocervix with M. indolicus may contribute to the clinical manifestations of cervicitis, but further study is needed to determine whether this finding is repeatable and applicable to diverse groups of women. Colonization of the cervix with L. jensenii could be a marker of health, perhaps reducing inflammation or inhibiting pathogenic infection. PMID:26267872

  4. Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis

    PubMed Central

    Fedorchuk, Curtis A; McCoy, Matthew; Lightstone, Douglas F; Bak, David A; Moser, Jacque; Kubricht, Brett; Packer, John; Walton, Dustin; Binongo, Jose

    2016-01-01

    Objective This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis. Methods 29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion. Results Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain’s to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01). Conclusion This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis. PMID:27761195

  5. Chemoradiation Therapy and Ipilimumab in Treating Patients With Stages IB2-IIB or IIIB-IVA Cervical Cancer

    ClinicalTrials.gov

    2017-03-08

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Positive Para-Aortic Lymph Node; Positive Pelvic Lymph Node; Stage IB2 Cervical Cancer; Stage II Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  6. Skeletal maturation evaluation using cervical vertebrae.

    PubMed

    Hassel, B; Farman, A G

    1995-01-01

    Lateral cephalometric and left hand-wrist radiographs from the Bolton-Brush Growth Center at Case Western Reserve University were reviewed a posteriori to develop a cervical vertebrae maturation index (CVMI). By using the lateral profiles of the second, third and fourth cervical vertebrae, it was possible to develop a reliable ranking of patients according to the potential for future adolescent growth potential.

  7. Bilateral cervical ribs in a Dobermann Pinscher.

    PubMed

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

    2015-01-01

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

  8. Infection and Cervical Neoplasia: Facts and Fiction

    PubMed Central

    Al-Daraji, Wael I; Smith, John HF

    2009-01-01

    Whilst there is strong evidence that human papillomavirus (HPV) is the principal aetiological agent in cervical neoplasia, some other sexually transmitted agents may either contribute or protect against cervical carcinogenesis, such as the herpes virus family (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human immunodeficiency virus (HIV) or Chlamydia trachomatis (CT). Epidemiological studies suggest that HSV may have a role in cervical neoplasia, but there is no clear supportive experimental evidence. Serological studies have also failed to reveal a difference in the prevalence of antibodies to CMV and EBV between patients with cervical cancer and controls. However, longitudinal seroepidemiological studies have provided evidence that CT is an independent risk factor for the development of cervical squamous carcinoma and this association is serotype specific. The increased risk of cervical neoplasia in patients infected with HIV has been recognised for over a decade and HIV may interact with HPV either by alternating HPV gene transcription or by immunosuppression. Finally extensive experimental and limited epidemiological evidence suggests that adeno-associated viruses (AAV) may have antioncogenic activity in man and may protect against the development of cervical cancer. At present the mechanism of this action is unclear but may relate to AAV-induced regulation of HPV gene expression and the HPV life cycle. In this review we summarize the current literature relating to the associations and mechanisms of cervical carcinogenesis by each of these infectious microorganisms. PMID:18830380

  9. Cervical Spine MRI in Abused Infants.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1997-01-01

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

  10. Cervical venous reflux in dynamic brain scintigraphy.

    PubMed

    Hayt, D B; Perez, L A

    1976-01-01

    Cervical venous reflux, shown by dynamic brain scintigraphy, was investigated through three avenues of approach: (A) by reviewing 371 randomly chosen routine dynamic intracerebral bloodflow studies to estimate its incidence; (B) by correlative positive-contrast superior venacavography in patients with characteristic cervical venous reflux; and (C) by performing dynamic brain scintigraphy while utilizing various positional and physiologic maneuvers to attempt to produce cervical venous reflux in patients who did not exhibit this phenomenon on earlier examination. Although any obstruction of the superior vena cava or a properly timed Valsalva maneuver in selected patients can produce the scintigraphic picture of cervical venous reflux, in most cases it is a normal phenomenon due to incompetent or absent cervical venous valves.

  11. Brachioradial pruritus and cervical spine manipulation.

    PubMed

    Tait, C P; Grigg, E; Quirk, C J

    1998-08-01

    Brachioradial pruritus (BRP) causes significant morbidity in the majority of patients for whom no effective treatment is found. Chronic ultraviolet radiation exposure has usually been cited as the cause, but nerve damage from cervical spine disease has also been implicated. We report on a small retrospective exploratory study, conducted by questionnaire, of a group of patients who were treated with a specific cervical spine manipulation. Ten of 14 patients reported resolution of symptoms following manipulative treatment. All six patients who had had previous cervical spine disease responded to manipulation, as did half the remaining eight patients who had no previous history of neck symptoms. Although patients with BRP, by definition, share similar symptoms, the aetiology is almost certainly multifactorial. Prospective studies looking for cervical spine disease, as well as assessment of this particular method of cervical spine manipulation as a treatment modality for BRP, should be considered.

  12. Mechanical and cellular processes driving cervical myelopathy

    PubMed Central

    Dolan, Roisin T; Butler, Joseph S; O’Byrne, John M; Poynton, Ashley R

    2016-01-01

    Cervical myelopathy is a well-described clinical syndrome that may evolve from a combination of etiological mechanisms. It is traditionally classified by cervical spinal cord and/or nerve root compression which varies in severity and number of levels involved. The vast array of clinical manifestations of cervical myelopathy cannot fully be explained by the simple concept that a narrowed spinal canal causes compression of the cord, local tissue ischemia, injury and neurological impairment. Despite advances in surgical technology and treatment innovations, there are limited neuro-protective treatments for cervical myelopathy, which reflects an incomplete understanding of the pathophysiological processes involved in this disease. The aim of this review is to provide a comprehensive overview of the key pathophysiological processes at play in the development of cervical myelopathy. PMID:26807352

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

    ClinicalTrials.gov

    2014-04-21

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

  14. Giant anterior cervical osteophyte leading to Dysphagia.

    PubMed

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

    2013-09-01

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

  15. Past, present, and future of cervical arthroplasty.

    PubMed

    Hyun Oh, Chang; Hwan Yoon, Seung

    2013-01-01

    Cervical arthroplasty was developed in an attempt to maintain cervical motion and potentially to avoid or minimize adjacent-segment degeneration. If cervical arthroplasty is successful, the long-term results of surgery for cervical disc disease should improve. However, problems associated with cervical arthroplasty have been reported: these include kyphosis, heterotopic ossification-induced motion limitation, no motion preservation even at the index level, and a higher revision rate in a limited number of cases compared with anterior cervical discectomy and fusion (ACDF). In addition, for degenerative cervical disc disorders, the risk of developing adjacent segment degeneration more than 2 years after surgery is reportedly similar for ACDF and cervical arthroplasty. Cervical disc arthroplasty is an emerging motion-sparing technology and is currently undergoing evaluation in many countries as an alternative to arthrodesis for the treatment of cervical radiculopathy and myelopathy. The decision whether to use arthrodesis or arthroplasty is a difficult one. The achievement of good prosthetic performance demands exacting implantation techniques to ensure correct placement. This fact underlines the increasing importance of special instrumentation and surgical skills that involve an understanding of prosthetic lubrication, wear, and biologic effects and familiarity with currently available information regarding kinematics, basic science, testing, and early clinical results. Fortunately, a number of devices are at the late preclinical study stage or at the early clinical trial stage, and results in many cases are promising. In the near future, it is likely that new designs will be produced to replace spinal discs totally or partially in a pathologic entity-specific manner.

  16. Cervical disc hernia operations through posterior laminoforaminotomy

    PubMed Central

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis. PMID:27217655

  17. Reoperations Following Cervical Disc Replacement

    PubMed Central

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

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential complications associated with CDR. The published rates of reoperation (mean, 1.0%; range, 0%-3.1%), revision (mean, 0.2%; range, 0%-0.5%), and removal (mean, 1.2%; range, 0%-1.9%) following CDR are low and comparable to the published rates of reoperation (mean, 1.7%; range; 0%-3.4%), revision (mean, 1.5%; range, 0%-4.7%), and removal (mean, 2.0%; range, 0%-3.4%) following cervical arthrodesis. The surgical interventions following CDR range from the repositioning to explantation followed by fusion or the reimplantation to posterior foraminotomy or fusion. Strict patient selection, careful preoperative radiographic review and surgical planning, as well as surgical technique may reduce adverse events and the need for future intervention. Minimal literature and no guidelines exist for the approaches and techniques in revision and for the removal of implants following CDR. Adherence to strict indications and precise surgical technique may reduce the number of reoperations, revisions, and removals following CDR. Long-term follow-up studies are needed, assessing the implant survivorship and its effect on the revision and removal rates. PMID:26097667

  18. 21 CFR 884.4250 - Expandable cervical dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Expandable cervical dilator. 884.4250 Section 884....4250 Expandable cervical dilator. (a) Identification. An expandable cervical dilator is an instrument with two handles and two opposing blades used manually to dilate (stretch open) the cervical os....

  19. 21 CFR 884.1040 - Viscometer for cervical mucus.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Viscometer for cervical mucus. 884.1040 Section... Devices § 884.1040 Viscometer for cervical mucus. (a) Identification. A viscometer for cervical mucus is a device that is intended to measure the relative viscoelasticity of cervical mucus collected from a...

  20. 21 CFR 884.4270 - Vibratory cervical dilators.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vibratory cervical dilators. 884.4270 Section 884....4270 Vibratory cervical dilators. (a) Identification. A vibratory cervical dilator is a device designed to dilate the cervical os by stretching it with a power-driven vibrating probe head. The device...

  1. Anterior Cervical Spine Surgery for Degenerative Disease: A Review

    PubMed Central

    SUGAWARA, Taku

    Anterior cervical spine surgery is an established surgical intervention for cervical degenerative disease and high success rate with excellent long-term outcomes have been reported. However, indications of surgical procedures for certain conditions are still controversial and severe complications to cause neurological dysfunction or deaths may occur. This review is focused mainly on five widely performed procedures by anterior approach for cervical degenerative disease; anterior cervical discectomy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical foraminotomy, and arthroplasty. Indications, procedures, outcomes, and complications of these surgeries are discussed. PMID:26119899

  2. Network Topologies Decoding Cervical Cancer

    PubMed Central

    Jalan, Sarika; Kanhaiya, Krishna; Rai, Aparna; Bandapalli, Obul Reddy; Yadav, Alok

    2015-01-01

    According to the GLOBOCAN statistics, cervical cancer is one of the leading causes of death among women worldwide. It is found to be gradually increasing in the younger population, specifically in the developing countries. We analyzed the protein-protein interaction networks of the uterine cervix cells for the normal and disease states. It was found that the disease network was less random than the normal one, providing an insight into the change in complexity of the underlying network in disease state. The study also portrayed that, the disease state has faster signal processing as the diameter of the underlying network was very close to its corresponding random control. This may be a reason for the normal cells to change into malignant state. Further, the analysis revealed VEGFA and IL-6 proteins as the distinctly high degree nodes in the disease network, which are known to manifest a major contribution in promoting cervical cancer. Our analysis, being time proficient and cost effective, provides a direction for developing novel drugs, therapeutic targets and biomarkers by identifying specific interaction patterns, that have structural importance. PMID:26308848

  3. Cervical characteristics of Noonan syndrome.

    PubMed

    Miyamoto, Jun J; Yabunaka, Tomoe; Moriyama, Keiji

    2014-04-01

    BACKGROUND/OBJECTIVES A short neck and low posterior hairline are characteristics of Noonan syndrome (NS) and are hallmarks of basilar invagination/impression. However, it is seldom that NS has been directly linked with this symptom. Thus, this study aimed to investigate basilar impression in NS subjects compared with control subjects and individuals exhibiting Turner Syndrome (TS). SUBJECTS/METHODS The degree of basilar impression and vertical positional differences of the third and fourth cervical vertebrae and hyoid bone in NS (n = 9, mean age: 12.1 years), TS (n = 9, mean age: 12.1 years), and control subjects (n = 9, mean age: 12.0 years) were investigated using lateral cephalometric radiographs. Differences between the three groups were compared using the Steel-Dwass test. Vertical positional differences in the anatomical structures within each group were compared using the Wilcoxon signed-rank test accompanied by a Bonferroni-Holm correction. RESULTS The distance by which the odontoid tip extended past McGregor's line in subjects with NS was significantly greater compared with TS and control subjects. The third and fourth cervical vertebrae were positioned significantly superiorly in subjects with NS compared with TS and control subjects and, in NS, were also significantly superior to the hyoid bone. There was no difference in the position of the hyoid bone itself between the groups. CONCLUSION/IMPLICATION These results suggest that basilar impression may be a frequently found symptom of NS.

  4. Invasive Cervical Resorption: A Review

    PubMed Central

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

    2013-01-01

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

  5. Cervical lymphadenopathy: Unwinding the hidden truth

    PubMed Central

    Ramadas, Athira Aruna; Jose, Renju; Varma, Beena; Chandy, Marina Lazar

    2017-01-01

    Lymphadenopathy is a common clinical finding in a patient seeking oral health care. It may be in a localized, limited, or generalized form. Malignancies, infections, autoimmune disorders, iatrogenic, and other miscellaneous conditions are considered as the causes for cervical lymphadenopathy. Unexplained cervical lymphadenopathy is a cause of concern for physician and patient because sometimes it could be the manifestation of an underlying malignancy. However, a methodological approach to lymphadenopathy can disclose the accurate diagnosis causing minimal discomfort for the patient and in a short time. This paper reports the significance of cervical lymph node examination and ensuing investigations, which led to a diagnosis of non-Hodgkins lymphoma. PMID:28348622

  6. Invasive cervical resorption--a periodontist's perspective.

    PubMed

    Evans, R I

    2000-10-01

    Invasive cervical resorption (ICR) is a relatively uncommon, insidious, resorptive lesion starting subgingivally at the cervical root surface of a tooth. ICR is of uncertain aetiology, although damage to the cervical periodontal attachment to the tooth appears to be a prerequisite. For the most part the lesion is asymptomatic so early detection can be difficult. Nevertheless, if less than a third of the root of the tooth is affected by an ICR lesion treatment of the resorptive tissue using the chemical escharotic agent trichloracetic acid, with or without surgical access, followed by curettage of the lesion and restoration of the defect with glass ionomer cement, is generally successful.

  7. Cervical cancer: is vaccination necessary in India?

    PubMed

    Farhath, Seema; Vijaya, P P; Mumtaj, P

    2013-01-01

    In India, cervical cancer is the most common woman-related cancer, followed by breast cancer. The rate of cervical cancer in India is fourth worldwide. Two vaccines, Gardasil and Cervarix, both targeting HPV-16 and 18 which account for 70% of invasive cervical carcinomas, are licensed in the United States and numerous countries worldwide. Both vaccine formulations have shown excellent efficacy with minimal toxicity in active female population but numerous questions arise in vaccinating like cost effectiveness, lack of proven efficacy against other HPV strains, social acceptance of HPV vaccination and other ethical issues. The main objective of this study is to emphasis the advantages and disadvantages of the vaccination in India.

  8. [Chemoradiotherapy for locally advanced cervical cancer].

    PubMed

    Bazaeva, I Ia; Gorbunova, V A; Kravets, O A; Khokhlova, S V; Limareva, S V; Panov, V O; Strel'tsova, O N; Tarachkova, E V

    2014-01-01

    Cervical cancer takes second place in morbidity and third place in mortality from gynecological cancer. Advanced stages among newly diagnosed cases is still large. The "gold standard" of treatment for locally advanced cervical cancer is chemoradiotherapy with cisplatin that results in a lower risk of death. Improvement of radiotherapy methods allowed to bring optimal dose to the primary tumor with the inclusion of regional metastasis areas with less risk of damage to surrounding healthy tissue and organs. The search for alternative combinations of cytostatics, modes of drug administration, adjuvant chemotherapy after chemoradiotherapy showed an increase in survival of patients with locally advanced cervical cancer.

  9. Increased risk of death with cervical spine immobilisation in penetrating cervical trauma.

    PubMed

    Vanderlan, Wesley B; Tew, Beverly E; McSwain, Norman E

    2009-08-01

    The purpose of this study was to determine if cervical spine immobilisation was related to patient mortality in penetrating cervical trauma. One hundred and ninety-nine patient charts from the Louisiana State University Health Sciences Center New Orleans (Charity Hospital, New Orleans) were examined. Charts were identified by searching the Charity Hospital Trauma Registry from 01/01/1994 to 04/17/2003 for all cases of penetrating cervical trauma. Thirty-five patient deaths were identified. Cervical spine immobilisation was associated with an increased risk of death (p<0.02, odds ratio 2.77, 95% CI 1.18-6.49).

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

    ClinicalTrials.gov

    2016-10-26

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

  11. Comparison of cervical disc arthroplasty with anterior cervical discectomy and fusion for the treatment of cervical spondylotic myelopathy.

    PubMed

    Ding, Chen; Hong, Ying; Liu, Hao; Shi, Rui; Song, Yueming; Li, Tao

    2013-06-01

    The clinical outcome of cervical disc arthroplasty for cervical spondylotic myelopathy (CSM) is still controversial. The authors retrospectively compared the intermediate term clinical outcome of cervical disc arthroplasty and traditional anterior cervical discectomy and fusion (ACDF). Seventy-six cases of single-level CSM with a minimum follow-up of two years were retrospectively analyzed. Thirty-seven patients underwent single-level cervical disc arthroplasty (Bryan disc: 12 cases; Prestige LP disc: 25 cases), while the other 39 patients underwent single-level ACDF. Significant improvement in SF-36 physical/ mental component scores and NDI score was found in both groups (p < 0.05); however, the arthroplasty group had significantly greater score improvement at each follow-up time point (p < 0.05). The JOA score and Nurick grade improved significantly at each time point in both groups (p < 0.05), but there were no significant differences between the groups (p > 0.05). The range of motion (surgical level and C2C7) remained unchanged in the arthroplasty group (p > 0.05), whereas it decreased significantly in the ACDF group (p < 0.05). The arthroplasty group had a lower incidence of complications than the ACDF group. The intermediate outcomes of cervical disc arthroplasty compared favourably to those of ACDF. Arthroplasty avoids complications from spinal fusion by preserving mobility.

  12. NIH Research Leads to Cervical Cancer Vaccine

    MedlinePlus

    ... Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents For ... Douglas Lowy (left) and John Schiller developed the vaccine to prevent HPV infection in women, the cause ...

  13. CDC Vital Signs: Cervical Cancer is Preventable

    MedlinePlus

    ... No woman should die of cervical cancer. Doctors, nurses, and health systems can: Help women understand what ... Early Detection Program , Title X Family Planning Doctors, nurses, and health systems can Help women understand which ...

  14. Cervical Spondylosis: Recognition, Differential Diagnosis, and Management

    PubMed Central

    Voorhies, Rand M.

    2001-01-01

    In contemporary clinical practice, the prevalence of neck pain in the general population is approximately 15%. The challenge for the primary care specialist is to be able to recognize the more serious disorders that require early referral. Additionally, it is important to have the confidence to institute specific treatment for nonurgent conditions in order to avoid unnecessary referral of patients with generally self-limiting conditions. Cervical spondylosis is a general and nonspecific term that encompasses a broad spectrum of afflictions but, for purposes of clarity, can be organized into three clinical syndromes: Type I Syndrome (Cervical Radiculopathy); Type II Syndrome (Cervical Myelopathy); and Type III Syndrome (Axial Joint Pain). It is important to remember that shoulder problems can masquerade as cervical problems, and vice versa (e.g. adhesive capsulitis, recurrent anterior subluxation, impingement syndrome, rotator cuff tear, etc.). A number of management options, including pharmaceutical, physical therapy, and psychological therapies, are available once a diagnosis has been made. PMID:21765723

  15. Congenital narrowing of the cervical spinal canal.

    PubMed Central

    Kessler, J T

    1975-01-01

    The clinical and laboratory findings in six patients with congenital narrowing of the cervical spinal canal and neurological symptoms are described. A variable age of onset and an entirely male occurrence were found. Signs and symptoms of spinal cord dysfunction predominated in all but one patient. Symptoms were produced in five patients by increased physical activity alone. Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes. The clinical features may be distinguishable from those found in cervical spondylosis without congenital narrowing. Intermittent claudication of the cervical spinal cord appears to be an important feature of this syndrome. Surgery improved four out of five people. PMID:1219087

  16. American Society for Colposcopy and Cervical Pathology

    MedlinePlus

    ... Join/Renew Member Resources Careers About History Bylaws Society Leadership Awards CME Mission and Goals Annual Report ... 7227 Toll-Free (240) 575-9880 Fax © American Society for Colposcopy and Cervical Pathology * Required * First Name: * ...

  17. Palliative care in cervical cancer.

    PubMed

    Suhatno

    2000-05-01

    1. Cervical cancer is the most frequent cancer in females and also the most frequent among female genital cancers. 2. Ever though the modality of diagnostic procedures for early detection has improved, in fact most of the patients present in the late stages, so the disease is already incurable, and palliative care is really needed. 3. Palliative care is needed not only for the terminally ill patients, but can be started at the time the cancer is diagnosed. 4. Palliative care is a multidisciplinary approach requiring teamwork. 5. Palliative care in Indonesia, especially in Dr. Soetomo Hospital, is a new modality in the fight against cancer, so we suffer many disadvantages, e.g., disability, limitation, lack of experience. However, such problems will stimulate the team to learn more.

  18. Cervical cancer screening in England.

    PubMed

    Patnick, J

    2000-11-01

    Cervical screening in England is provided free of charge by the National Health Service to all women aged 20-64 years. Computerised call and recall was introduced in 1988 and women receive an invitation every 3-5 years. Smears are taken by the local family doctor, by his/her nurse or at community clinics. Approximately 85% of English women have had a smear in the last 5 years. Quality assurance programmes have recently been established for laboratories and colposcopy clinics and lessons have been learned from previous failures of the service. The incidence has fallen from 16 per 100000 in 1986 to 9.3 per 100000 in 1997. Mortality is currently falling by 7% per year.

  19. Cervical tuberculous adenitis: CT manifestations

    SciTech Connect

    Reede, D.L.; Bergeron, R.T.

    1985-03-01

    Cervical tuberculous adenitis is being seen with increasing frequency in the United States; in the appropriate clinical setting it should be included in the differential diagnosis of an asymptomatic neck mass. Patients are typically young adults who are recent arrivals from Southeast Asia. A history of tuberculosis is not always elicited nor is the chest radiograph always abnormal. All of these patients have positive purified protein derivative tests unless they are anergic. The CT findings may lead to the diagnosis. Several CT patterns of nodal disease can be seen in tuberculous adenitis; some may mimic benign and neoplastic disease. The presence of a multiloculated or multichambered (conglomerate nodal) mass with central lucency and thick rims of enhancement and minimally effaced fascial planes is highly suggestive of tuberculous adenitis, especially if the patient has a strongly positive tuberculosis skin test.

  20. Cervical spine injuries in American football.

    PubMed

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

    2009-01-01

    American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of

  1. Cervical cancer in India and HPV vaccination.

    PubMed

    Kaarthigeyan, K

    2012-01-01

    Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine's efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context.

  2. Cervical balloon for dysfunctional labor following amniotomy.

    PubMed

    Lurie, S; Rabinerson, D; Feinstein, M; Mamet, Y

    1998-01-01

    The conventional treatment for arrest of protracted active phase dilatation is amniotomy and oxitocin. This kind of labor dystocia is associated with an increased incidence in Cesarean delivery. We describe the use of cervical balloon after amniotomy for protracted active phase dilatation. We have used this approach in five parturients. All five patients had a spontaneous vaginal delivery. Intrapartum cervical balloon in patients with dysfunctional labor may reduce the need for Cesarean delivery.

  3. Cervical dystonia and quality of life.

    PubMed

    Tomic, Svetlana; Petkovic, Ivana; Pucic, Tomislav; Resan, Bojan; Juric, Stjepan; Rotim, Tatjana

    2016-12-01

    Cervical dystonia is focal dystonia characterized by involuntary movement of the neck muscle, which leads to abnormal head posture. It can be accompanied with pain and tremor. In this study, we evaluated the presence of depression and anxiety in patients with cervical dystonia and the influence of dystonia symptoms on the quality of life. Psychiatric symptoms were evaluated by use of the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to evaluate the cervical dystonia symptoms. Quality of life was assessed by the craniocervical dystonia questionnaire (CDQ-24) and short form 36 health survey (SF-36). Nineteen patients were analyzed. Most of the patients had mild cervical dystonia (mean TWSTRS 23.89). Depression was present in 42.1 % and anxiety in 57.9 % of the patients. Disability due to cervical dystonia correlated with the occurrence of depression (ρ = 0.534) and anxiety (r = 0.652). Disability was found to significantly influence the stigma, emotional state, pain, daily activity, social life, physical function, and physical and mental disability. Pain influenced some aspects of body pain, physical function, and physical and mental disability. Being associated with disability and pain, cervical dystonia decreases the quality of life in many aspects. Disability also influenced depression and anxiety, which were present in half of study patients. In addition to follow up for cervical dystonia symptoms, patients with cervical dystonia should also be assessed for psychiatric symptoms on routine clinical check-ups. In addition to botulinum toxin, psychopharmaceuticals should be considered as a treatment option in these patients.

  4. Anterior cervical hypertrichosis: a sporadic case

    PubMed Central

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-01-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  5. Multimodal entity coreference for cervical dysplasia diagnosis.

    PubMed

    Song, Dezhao; Kim, Edward; Huang, Xiaolei; Patruno, Joseph; Munoz-Avila, Hector; Heflin, Jeff; Long, L Rodney; Antani, Sameer

    2015-01-01

    Cervical cancer is the second most common type of cancer for women. Existing screening programs for cervical cancer, such as Pap Smear, suffer from low sensitivity. Thus, many patients who are ill are not detected in the screening process. Using images of the cervix as an aid in cervical cancer screening has the potential to greatly improve sensitivity, and can be especially useful in resource-poor regions of the world. In this paper, we develop a data-driven computer algorithm for interpreting cervical images based on color and texture. We are able to obtain 74% sensitivity and 90% specificity when differentiating high-grade cervical lesions from low-grade lesions and normal tissue. On the same dataset, using Pap tests alone yields a sensitivity of 37% and specificity of 96%, and using HPV test alone gives a 57% sensitivity and 93% specificity. Furthermore, we develop a comprehensive algorithmic framework based on Multimodal Entity Coreference for combining various tests to perform disease classification and diagnosis. When integrating multiple tests, we adopt information gain and gradient-based approaches for learning the relative weights of different tests. In our evaluation, we present a novel algorithm that integrates cervical images, Pap, HPV, and patient age, which yields 83.21% sensitivity and 94.79% specificity, a statistically significant improvement over using any single source of information alone.

  6. Automated image analysis of uterine cervical images

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

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

  7. Anterior cervical hypertrichosis: a sporadic case.

    PubMed

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature.

  8. Simple trachelectomy during pregnancy for cervical cancer

    PubMed Central

    Moreno-Luna, Estefania; Alonso, Patricia; Santiago, Javier De; Zapardiel, Ignacio

    2016-01-01

    Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70–80% of cases. We present here the case of a patient with initial diagnosis of cervical cancer made around 20th week of pregnancy. It was then treated by a simple trachelectomy and cerclage during week 24. The pregnant woman gave birth to a healthy baby at the end of her pregnancy. Definitive treatment was completed three months after giving birth with a total hysterectomy and laparoscopic bilateral salpingectomy while preserving both ovaries. After 17 months of monitoring the patient showed no signs of reoccurrence. In conclusion, during the early stage of cervical cancer conservative management may be a reasonable option to preserve the current pregnancy. PMID:27610199

  9. Cervical cancer: screening and therapeutic perspectives.

    PubMed

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

    2008-01-01

    Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia, Africa and Latin America, despite the fact that it is an eminently preventable cancer. While cytology screening programmes have resulted in a substantial reduction of cervical cancer mortality in developed countries, they have been shown to have a wide range of sensitivity in most routine settings including in developing countries. Although liquid-based cytology improves sample adequacy, claims on improved sensitivity remain controversial. Human papillomavirus testing is more sensitive than cytology, but whether this gain represents protection against future cervical cancer is not clear. Recently, in a randomized trial, the use of visual inspection with 4% acetic acid was shown to reduce cervical cancer incidence and mortality. Cryotherapy and large loop excision of the transformation zone are effective and safe treatment methods for cervical intraepithelial neoplasia. The clinical stage of cancer is the single most important prognostic factor and should be carefully evaluated in choosing optimal treatment between surgery and radiotherapy, with or without chemotherapy. At the public health level, health care infrastructure, affordability and capacity for initiating and sustaining vaccination and screening programmes are critical factors in cervical cancer control. On the other hand, an informed practitioner can utilize the multiple opportunities in routine primary care interactions for prevention, screening, early detection and prompt referral for treatment.

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

    PubMed Central

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

    2012-01-01

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

  11. Triapine With Chemotherapy and Radiation Therapy in Treating Patients With IB2-IVA Cervical or Vulvar Cancer

    ClinicalTrials.gov

    2017-01-31

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Vulvar Cancer; Stage IB2 Cervical Cancer; Stage II Vulvar Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Cervical Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vulvar Cancer; Vulvar Adenocarcinoma; Vulvar Squamous Cell Carcinoma

  12. Epidemiology of cervical cancer in Colombia

    PubMed Central

    Muñoz, Nubia

    2012-01-01

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

  13. Epidemiology of cervical cancer in Colombia.

    PubMed

    Muñoz, Nubia; Bravo, Luis Eduardo

    2012-10-01

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

  14. Immunoglobulin concentrations in cervical mucus in patients with normal and abnormal cervical cytology.

    PubMed

    Coughlan, B M; Skinner, G R

    1977-02-01

    The cervical mucus of 31 patients with normal and 16 patients with abnormal cervical cytology was investigated at each stage of the menstrual cycle for immunoglobulin IgG, IgA and IgM. IgG and IgA were present in every mucus sample, while IgM was only occasionally found in trace amounts. IgG and IgA increased towards the last week of the menstrual cycle, the increase being in general more marked for IgA. Patients with abnormal cervical cytology showed increased IgG and, more strikingly, IgA concentrations in their cervical mucus, but there was no correlation between the IgG and IgA concentrations at any stage of the menstrual cycle. Whereas in patients with normal cervical cytology the IgG and IgA concentrations correlated throughout the menstrual cycle.

  15. Innovations in understanding the biology of cervical cancer.

    PubMed

    Wolf, Judith K; Franco, Eduardo L; Arbeit, Jeffery M; Shroyer, Kenneth R; Wu, Tzyy-Choou; Runowicz, Carolyn D; Tortolero-Luna, Guillermo; Herrero, Rolando; Crum, Christopher P

    2003-11-01

    Revelation of the connection between the human papillomavirus (HPV) and cervical neoplasia and invasive cervical cancer is prompting new investigations to expand that understanding and promote vaccines, gene therapy, and other interventions. At the Second International Conference on Cervical Cancer (Houston, TX, April 11-14, 2002), laboratory and clinical researchers reported advances in new studies meant to increase understanding of the natural history of HPV and cervical intraepithelial neoplasia, to evaluate new cervical cancer screening techniques, and to promote new therapies. Using K14-HPV type 16 transgenic mice, researchers are investigating the effects of estrogen on cervical cancer carcinogenesis, and results are lending support to epidemiological theories showing a difference in HPV infection rates and the development of cervical lesions in women using oral contraceptives. Other work involves investigating genes that are up-regulated by HPV infection and the role of the p53 homologue, p63, in cervical neoplasia evolution. Telomerase also is under investigation as a biomarker in high-risk populations. Gene therapy that replaced p53 in cervical cancer cell lines in vitro and a nude mouse model inhibited cell and tumor growth, confirming previous findings in squamous epithelial carcinomas of the head and neck. Furthermore, research in intracellular targeting of antigens to subcellular locations shows promise for treating cervical cancer preclinically. Identification of molecular changes in cervical cancer and knowledge about the importance of HPV infection in cervical cancer can lead to new therapies to treat existing cervical cancer and, in the long term, prevent the disease.

  16. The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing.

    PubMed

    Mekata, Kojiro; Takigawa, Tomoyuki; Matsubayashi, Jun; Toda, Kazukiyo; Hasegawa, Yasuhiro; Ito, Yasuo

    2016-02-01

    Cervical orthosis is used to immobilize the neck in various disorders such as trauma and post-operation. However, it is still uncertain how cervical orthosis restricts the degree of movement of the cervical spine during swallowing and how they affect swallowing physiology. The purpose of this study was to evaluate these issues using the Philadelphia(®) Collar. We conducted videofluorography of swallowing in 39 healthy subjects (23 men, 16 women; mean age of 34.3 years) with and without cervical orthosis. To compare the two conditions regarding the cervical spine motion, we determined the angular and positional changes of the occipital bone (C0) and each cervical vertebra (C1-C7) from the oral phase to the pharyngeal phase. Similarly, to compare swallowing physiology, we assessed the start and end times and the durations of soft palate elevation, rapid hyoid anterosuperior movement, epiglottis inversion, closure of the laryngeal vestibule, and pharyngoesophageal segment (PES) opening. Finally, we compared the transit times of contrast agent in the two conditions. The respective extensions of C1, C2, and C3 were 0.31°, 0.07°, and 0.05° (mean) with cervical orthosis, and the respective flexions of C1, C2, and C3 were 0.98°, 1.42°, and 0.85° (mean) without. These results suggested that cervical orthosis restricted the flexion of C1-C3. Analysis of swallowing physiology revealed that the average durations of hyoid anterosuperior elevation, epiglottic inversion, and PES opening were prolonged by 0.09, 0.19, and 0.05 s, respectively. In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology.

  17. The cervical spine of Australopithecus sediba.

    PubMed

    Meyer, Marc R; Williams, Scott A; Schmid, Peter; Churchill, Steven E; Berger, Lee R

    2017-03-01

    Cervical vertebrae are rare in the early hominin fossil record, presenting a challenge for understanding the evolution of the neck and head carriage in hominin evolution. Here, we examine the cervical vertebrae of Australopithecus sediba, which unlike other South African taxa is known from associated cervical vertebrae. The A. sediba cervical vertebrae exhibit human-like values for wedging, pedicle cross-sectional areas, and articular facet heights, indicating reduced ventral loading relative to African apes. These features combine with a pattern of vertebral body bone distribution and caudally progressive size expansion suggesting a mode of cervical lordosis, load mitigation, and head carriage similar to humans and distinct from the cantilevered mode of head carriage of the extant African great apes. Yet these derived features in A. sediba are accompanied by ape-like vertebral body and dorsal pillar sizes, articular facet orientation, and uncinate process morphology signaling reduced lateral and rotational coupled movements between vertebral elements and indicate a considerably stiffer neck than in humans. A primitively long and horizontally-oriented C7 spinous process is likely related to a prognathic viscerocranium, although the complimentary C3 spinous process is short, implying large moments emanating from scapular and shoulder elevators rather than large muscles of head stabilization. Cross-sectional spinous process shape and robust anterior tubercles similarly signal increased arm elevation consistent with climbing behavior in corroboration with arboreal signatures previously observed in the shoulder, arms, and hand of A. sediba. Spinal canal shape and size suggests that A. sediba lacked the cervical spinal cord enlargement of Homo that confers humans with enhanced motor control to the upper limbs. The cervical spine of A. sediba thus presents a mosaic of primitive and derived characters, with anatomical features relating to neck posture and head

  18. Cervical radiographic parameters in 1- and 2-level anterior cervical discectomy and fusion.

    PubMed

    Gillis, Christopher C; Kaszuba, Megan C; Traynelis, Vincent C

    2016-10-01

    OBJECTIVE Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spine procedures. It can be used to correct cervical kyphotic deformity, which is the most common cervical deformity, and is often performed using lordotic interbody devices. Worsening of the cervical sagittal parameters is associated with decreased health-related quality of life. The study hypothesis is that through the use of machined lordotic allografts in ACDF, segmental and overall cervical lordosis can be maintained or increased, which will have a positive impact on overall cervical sagittal alignment. METHODS Seventy-four cases of 1-level ACDF (ACDF1) and 2-level ACDF (ACDF2) (40 ACDF1 and 34 ACDF2 procedures) were retrospectively reviewed. Upright neutral lateral radiographs were assessed preoperatively and at 6 weeks and 1 year postoperatively. The measured radiographic parameters included focal lordosis, disc height, C2-7 lordosis, C1-7 lordosis, T-1 slope, and C2-7 sagittal vertical axis. Correlation coefficients were calculated to determine the relationships between these radiographic measurements. RESULTS The mean values were as follows: preoperative focal lordosis was 0.574°, disc height was 4.48 mm, C2-7 lordosis was 9.66°, C1-7 lordosis was 42.5°, cervical sagittal vertebral axis (SVA) was 26.9 mm, and the T-1 slope was 33.2°. Cervical segmental lordosis significantly increased by 6.31° at 6 weeks and 6.45° at 1 year. C2-7 lordosis significantly improved by 1 year with a mean improvement of 3.46°. There was a significant positive correlation between the improvement in segmental lordosis and overall cervical lordosis. Overall cervical lordosis was significantly negatively correlated with cervical SVA. Improved segmental lordosis was not correlated with cervical SVA in ACDF1 patients but was significantly negatively correlated in ACDF2 patients. There was also a significant positive correlation between the T-1 slope and cervical SVA. CONCLUSIONS In

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

    Cancer.gov

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

  20. Understanding Cervical Changes: A Health Guide for Women

    Cancer.gov

    Explains HPV Infection; cervical cancer screening tests including Pap test, HPV test, and Pap/HPV cotesting; new cervical cancer screening guidelines; possible Pap test results and Pap/HPV cotest results; follow-up testing; treatment; and HPV vaccination.

  1. Cervical Length: Why Does It Matter during Pregnancy?

    MedlinePlus

    Healthy Lifestyle Pregnancy week by week During pregnancy, what's the significance of cervical length? Answers from Shannon K. Laughlin-Tommaso, ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/cervical-length/faq- ...

  2. Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in Multilevel Cervical Disc Diseases

    PubMed Central

    Zhang, Jianfeng; Meng, Fanxin; Ding, Yan; Li, Jie; Han, Jian; Zhang, Xintao; Dong, Wei

    2016-01-01

    Abstract To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases. Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF. To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched. Studies were included when they compared HS with ACDF and reported at least one of the following outcomes: functionality, neck pain, arm pain, cervical range of motion (ROM), quality of life, and incidence of complications. No language restrictions were used. Two authors independently assessed the methodological quality of included studies and extracted the relevant data. Seven clinical controlled trials were included in this study. Two trials were prospective and the other 5 were retrospective. The results of the meta-analysis indicated that HS achieved better recovery of NDI score (P = 0.038) and similar recovery of VAS score (P = 0.058) compared with ACDF at 2 years follow-up. Moreover, the total cervical ROM (C2–C7) after HS was preserved significantly more than the cervical ROM after ACDF (P = 0.000) at 2 years follow-up. Notably, the compensatory increase of the ROM of superior and inferior adjacent segments was significant in ACDF groups at 2-year follow-up (P < 0.01), compared with HS. The results demonstrate that HS provides equivalent outcomes and functional recovery for cervical disc diseases, and significantly better preservation of cervical ROM compared with ACDF in 2-year follow-up. This suggests the HS is an effective alternative invention for the treatment of multilevel cervical

  3. Adjacent-level arthroplasty following cervical fusion.

    PubMed

    Rajakumar, Deshpande V; Hari, Akshay; Krishna, Murali; Konar, Subhas; Sharma, Ankit

    2017-02-01

    OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1-3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2-7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow

  4. [Cervical neuroblastoma in an infant].

    PubMed

    Arvai, Krisztina; Tóth, Judit; Németh, Tamás; Kiss, Csongor; Molnár, Péter; Oláh, Eva

    2004-01-01

    The case of a one-month-old patient admitted to the Department of Pediatrics (Medical and Health Science Center, Debrecen University) because of respiratory distress caused by a cervical mass compressing the upper respiratory pathways is presented. The mass could only be partially removed, the histological diagnosis proved to be neuroblastoma (SBCT: "small blue cell tumor"). Despite the fact that the DNA index of tumor cells (ploidy measurements) and the age of the patient suggested a favourable prognosis, the tumor continued to grow and metastases appeared. Because of symptoms of compression exerted on the respiratory system by the tumor, chemotherapy had to be applied. Since a standard OPEC/OJEC chemotherapeutic protocol proved to be not entirely effective and a residual tumor was still present, retinoic acid and interferon treatment was introduced. Presently, 4 years after the diagnosis, the patient is in complete remission and can be considered to be cured. The case presented here demonstrates that despite the favorable prognosis of the majority of infant neuroblastomas, in some cases the anatomic location of the tumor, leading to disturbance of vital functions, may serve as indication of chemotherapy. Our experience also proved the efficacy of retinoic acid and interferon treatment in relapsed neuroblastoma.

  5. [Monitoring cervical dilatation by impedance].

    PubMed

    Salvat, J; Lassen, M; Sauze, C; Baud, S; Salvat, F

    1992-01-01

    Several different physics procedures have been tried to mechanize the recording of partograms. Can a measure of impedance of tissue Z using potential difference V, according to Ohm's law V = Z1, and 1 is a constant, be correlated with a measure of cervical dilatation using vaginal examination? This was our hypothesis. The tissue impedance meter was made to our design and applied according to a bipolar procedure. Our work was carried out on 28 patients. 10 patients were registered before labour started in order to test the apparatus and to record the impedance variations without labour taking place, and 18 patients were registered in labour to see whether there was any correlation. The level of impedance in the cervix without labour was 302.7 Ohms with a deviation of 8.2. Using student's t tests it was found that there was a significant correlation (p less than 0.001) in four measurements between the impedance measure and measures obtained by extrapolating the degrees of dilatation calculated from vaginal examination. This is a preliminary study in which we have defined the conditions that are necessary to confirm these first results and to further develop the method.

  6. Human papillomavirus and cervical cancer.

    PubMed

    Crosbie, Emma J; Einstein, Mark H; Franceschi, Silvia; Kitchener, Henry C

    2013-09-07

    Cervical cancer is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and clears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16, 18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved.

  7. Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in multilevel cervical spondylotic myelopathy

    PubMed Central

    Wang, Tao; Wang, Hui; Liu, Sen; An, Huang-Da; Liu, Huan; Ding, Wen-Yuan

    2016-01-01

    Abstract Background: Both anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are used to treat multilevel cervical spondylotic myelopathy (mCSM); however, which one is better treatment for mCSM remains considerable controversy. A meta-analysis was performed to compare clinical outcomes, radiographic outcomes, and surgical outcomes between ACDF and ACCF in treatment for mCSM. Methods: An extensive search of literature was performed in Pubmed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on ACDF versus ACCF treatment for mCSM from January 2011 to August 2016. The following variables were extracted: length of hospital stay, blood loss, operation time, Japanese Orthopedic Association (JOA) scores, Neck Disability Index (NDI) score, fusion rate, Cobb angles of C2 to C7, dysphagia, hoarseness, C5 palsy, infection, cerebral fluid leakage, donor site pain, epidural hematoma, graft subsidence, graft dislodgment, pseudoarthrosis, and total complications. Data analysis was conducted with RevMan 5.3 and STATA 12.0. Results: A total of 8 studies containing 878 patients were included in our study. The results showed that ACDF is better than ACCF in the angle of C2 to C7 at the final follow-up (P < 0.00001, standardized mean difference = 4.76 [3.48, 6.03]; heterogeneity: P = 0.17, I2 = 43%), C5 plasy (P = 0.02, odds ratio [OR] 0.42, 95% confidence interval [CI] 0.21, 0.86; heterogeneity: P = 0.52, I2 = 0%), blood loss (P < 0.00001, standardized mean difference = −53.12, 95% CI −64.61, −41.64; heterogeneity: P = 0.29, I2 = 20%), fusion rate (P = 0.04, OR 2.54, 95% CI 1.05, 6.11; heterogeneity: P = 0.29, I2 = 20%), graft subsidence (P = 0.004, OR 0.11, 95% CI 0.02, 0.48; heterogeneity: P = 0.94, I2 = 0%), and total complications (P = 0.0009, OR 0.56, 95% CI 0.40, 0.79; heterogeneity: P = 0.29, I2 = 18%).However, there are no significant differences in length of hospital stay, operation time, JOA

  8. Correlation between cervical infection and preterm labor.

    PubMed

    Mešić Ðogić, Larisa; Lučić, Nenad; Mićić, Dragana; Omeragić, Feđa; Hodžić, Enes; Fazlagić, Seid; Kovač, Refka; Pavlović, Nevenka

    2017-02-01

    Aim To investigate a correlation between cervical canal infection and imminent preterm labor and to identify most frequent pathogens. Methods A prospective study was conducted in obstetrics/gynecology departments of Health Center and the University Clinical Center Tuzla, and General Hospital Tešanj (Bosnia and Herzegovina, B&H) between October 2013 and May 2014. An examined group included 50 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week, with cervical changes that are related to imminent preterm labor. Changes were detected by ultrasound biometry of cervix and modified Bishop score. A control group included 30 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week of pregnancy without signs of imminent preterm labor. Cervical mucus was microbiologically analyzed for identification of pathogens. Results The infection in cervical canal was proven in 35 (70%) examinees and four (13%) patients from the control group (p=0.015). In seven (20%) cases each Ureaplasma and Mycoplasma were detected followed by E. coli in five (14%) cases (p=0.001). Conclusion Cervical canal infection is associated with changes on cervix and premature rupture of fetal membranes, i.e. preterm labor and imminent preterm labor. Screening for infection before pregnancy should be the main task of family doctors as well as gynecologists.

  9. [Chromosomal instability in carcinogenesis of cervical cancer.

    PubMed

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

    2013-01-01

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

  10. [Epigenetic alterations in cervical cancer progression].

    PubMed

    Ríos-Romero, Magdalena; Soto-Valladares, Ana Guadalupe; Piña-Sánchez, Patricia

    2015-01-01

    Despite the use of the screening test, such as Papanicolaou, and the detection of human papillomavirus (HPV), cervical cancer remains as a public health problem in México and it is the second leading cause of death for malignant neoplasias among women. High-risk HPV infection is the main risk factor for the development of premalignant lesions and cervical cancer; however, HPV infection is not the only factor; there are various genetic and epigenetic alterations required for the development of neoplasias; some of them have been described and even in some cases they have been suggested as biomarkers for prognosis. However, in contrast with other cancer types, such as breast cancer, in cervical cancer the use of biomarkers has not been established for clinical applications. Unlike genetic alterations, epigenetic alterations are potentially reversible; in this sense, their characterization is important, since they have not only a potential use as biomarkers, but they also could represent new therapeutic targets for treatment of cervical cancer. This review describes some of the more common epigenetic alterations in cervical cancer and its potential use in routine clinical practice.

  11. Curcumin Nanoformulation for Cervical Cancer Treatment

    PubMed Central

    Zaman, Mohd S.; Chauhan, Neeraj; Yallapu, Murali M.; Gara, Rishi K.; Maher, Diane M.; Kumari, Sonam; Sikander, Mohammed; Khan, Sheema; Zafar, Nadeem; Jaggi, Meena; Chauhan, Subhash C.

    2016-01-01

    Cervical cancer is one of the most common cancers among women worldwide. Current standards of care for cervical cancer includes surgery, radiation, and chemotherapy. Conventional chemotherapy fails to elicit therapeutic responses and causes severe systemic toxicity. Thus, developing a natural product based, safe treatment modality would be a highly viable option. Curcumin (CUR) is a well-known natural compound, which exhibits excellent anti-cancer potential by regulating many proliferative, oncogenic, and chemo-resistance associated genes/proteins. However, due to rapid degradation and poor bioavailability, its translational and clinical use has been limited. To improve these clinically relevant parameters, we report a poly(lactic-co-glycolic acid) based curcumin nanoparticle formulation (Nano-CUR). This study demonstrates that in comparison to free CUR, Nano-CUR effectively inhibits cell growth, induces apoptosis, and arrests the cell cycle in cervical cancer cell lines. Nano-CUR treatment modulated entities such as miRNAs, transcription factors, and proteins associated with carcinogenesis. Moreover, Nano-CUR effectively reduced the tumor burden in a pre-clinical orthotopic mouse model of cervical cancer by decreasing oncogenic miRNA-21, suppressing nuclear β-catenin, and abrogating expression of E6/E7 HPV oncoproteins including smoking compound benzo[a]pyrene (BaP) induced E6/E7 and IL-6 expression. These superior pre-clinical data suggest that Nano-CUR may be an effective therapeutic modality for cervical cancer. PMID:26837852

  12. Importance of cervical length in dysmenorrhoea aetiology.

    PubMed

    Zebitay, Ali G; Verit, Fatma F; Sakar, M Nafi; Keskin, Seda; Cetin, Orkun; Ulusoy, A Ibrahim

    2016-05-01

    The objective of this prospective case-control study was to determine whether uterine corpus and cervical length measurements have a role in dysmenorrhoea aetiology in virgins. Patients with severe primary dysmenorrhoea with visual analog scale scores of ≥7 composed the dysmenorrhoea group (n = 51), while the control group (n = 51) was of women with painless menstrual cycles or with mild pain. Longitudinal and transverse axes of the uterine cervix and uterine corpus were measured. Correlation between severity of dysmenorrhoea and uterine cervix and corpus axes was calculated. Longitudinal and transverse axes of uterine cervix as well as uterine cervix volume were significantly higher in the dysmenorrhoea group compared to the controls. There was a significant positive correlation between severity of dysmenorrhoea and the length of cervical longitudinal and transverse axes and uterine cervical volume. Our findings reveal longer cervical length and greater cervical volume in young virgin patients with dysmenorrhoea and severe pain compared to those with no or less pain.

  13. Comparison of upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain.

    PubMed

    Yoo, Won-Gyu

    2014-02-01

    [Purpose] In this study, we compared upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain. [Subject] Eight male computer workers with upper trapezius muscle pain and eight others with levator scapular muscle pain participated. [Methods] Each subject was assessed in terms of upper cervical flexion angle and total cervical flexion angles using a cervical range of motion instrument after one hour of computer work. [Results] The upper cervical flexion angle of the group with levator scapular pain was significantly lower than that of the group with upper trapezius pain after computer work. The total cervical flexion angle of the group with upper trapezius pain was significantly lower than that of the group with levator scapular pain after computer work. [Conclusion] For selective and effective intervention for neck pain, therapists should evaluate upper and lower cervical motion individually.

  14. Sperm counts in enzymatically liquefied cervical mucus: quantitative validation using donor cervical mucus.

    PubMed

    de Agostini, A; Campana, A

    1996-02-01

    The post-coital test evaluates the penetration of spermatozoa into cervical mucus; it relies on subjective measurements and therefore lacks precision. Enzymatic liquefaction of cervical mucus allows sperm concentration to be measured in post-coital test samples, but the reliability of such measurements is not known. Donor cervical mucus was used as a model to test the accuracy and sensitivity of sperm quantification in liquefied cervical mucus. Donor cervical mucus was dissolved by enzymatic treatments in the presence of known numbers of spermatozoa and the recovery of sperm cells was assessed after liquefaction of the samples. Enzymatic treatment of cervical mucus with a combination of bromelin and glycosidases resulted in reliable and fast liquefaction of the samples. The accuracy of sperm concentration measurements was 89 +/- 10% (mean +/- SD, n = 50), and the sensitivity limits were 1 x 10(6) and 0.2 x 10(6) spermatozoa/ml for quantitative concentration measurement and qualitative sperm detection respectively. This study demonstrates that liquefaction of cervical mucus by combined protease and glycosidases allows accurate and sensitive determination of sperm concentration in the sample. Therefore we believe that valuable data can be obtained for sperm concentration and total sperm counts in post-coital tests, that should help to improve the reliability of the post-coital test.

  15. Cervical Shedding of Human T Cell Lymphotropic Virus Type I Is Associated with Cervicitis

    PubMed Central

    Zunt, Joseph R.; Dezzutti, Charlene S.; Montano, Silvia M.; Thomas, Katherine K.; Alarcón, Jorge O. V.; Quijano, Eberth; Courtois, Barry N.; Sánchez, Jorge L.; Campos, Pablo; Gotuzzo, Eduardo; Guenthner, Patricia C.; Lal, Renu B.; Holmes, King K.

    2009-01-01

    Human T cell lymphotropic virus type I (HTLV-I) is sexually transmitted. The purpose of this study was to determine the prevalence and risk factors for cervical shedding of HTLV-I DNA among Peruvian sex workers. HTLV tax DNA was detected in cervical specimens from 43 (68%) of 63 HTLV-I–infected sex workers and in samples obtained during 113 (52%) of 216 clinic visits between 1993 and 1997. Detection of HTLV DNA was associated with the presence of ≥30 polymorphonuclear cells (PMNs) within cervical mucus per 100×microscopic field (odds ratio [OR], 4.3, 95% confidence interval [CI], 1.8–10.1) and with the presence of cervical secretions (OR, 2.0; 95% CI 1.2–3.4). Hormonal contraceptive use (OR 1.7; 95% CI, 0.8–3.6) and concomitant cervical infection by Chlamydia trachomatis (OR, 1.5; 95% CI, 0.3–4.3) or Neisseria gonorrhoeae (OR, 1.1; 95% CI, 0.6–3.7) were not significantly associated with HTLV-I shedding. Our results suggest that cervicitis may increase cervical HTLV-I shedding and the sexual transmission of this virus. PMID:12447745

  16. Cervical shedding of human T cell lymphotropic virus type I is associated with cervicitis.

    PubMed

    Zunt, Joseph R; Dezzutti, Charlene S; Montano, Silvia M; Thomas, Katherine K; Alarcón, Jorge O V; Quijano, Eberth; Courtois, Barry N; Sánchez, Jorge L; Campos, Pablo; Gotuzzo, Eduardo; Guenthner, Patricia C; Lal, Renu B; Holmes, King K

    2002-12-01

    Human T cell lymphotropic virus type I (HTLV-I) is sexually transmitted. The purpose of this study was to determine the prevalence and risk factors for cervical shedding of HTLV-I DNA among Peruvian sex workers. HTLV tax DNA was detected in cervical specimens from 43 (68%) of 63 HTLV-I-infected sex workers and in samples obtained during 113 (52%) of 216 clinic visits between 1993 and 1997. Detection of HTLV DNA was associated with the presence of > or =30 polymorphonuclear cells (PMNs) within cervical mucus per 100x microscopic field (odds ratio [OR], 4.3, 95% confidence interval [CI], 1.8-10.1) and with the presence of cervical secretions (OR, 2.0; 95% CI 1.2-3.4). Hormonal contraceptive use (OR 1.7; 95% CI, 0.8-3.6) and concomitant cervical infection by Chlamydia trachomatis (OR, 1.5; 95% CI, 0.3-4.3) or Neisseria gonorrhoeae (OR, 1.1; 95% CI, 0.6-3.7) were not significantly associated with HTLV-I shedding. Our results suggest that cervicitis may increase cervical HTLV-I shedding and the sexual transmission of this virus.

  17. Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study

    PubMed Central

    Nie, Lin; Zhang, Li; Hou, Yong

    2008-01-01

    In this prospective study, our aim was to compare the functional results and radiographic outcomes of fusion and Bryan Cervical Disc replacement in the treatment of two-level cervical disc disease. A total of 65 patients with two-level cervical disc disease were randomly assigned to two groups, those operated on with Bryan Cervical Disc replacement (31) and those operated on with anterior cervical fusion with an iliac crest autograft and plate (34). Clinical evaluation was carried out using the visual analogue scale (VAS), the Short Form 36 (SF-36) and the neck disability index (NDI) during a two year follow-up. Radiological evaluation sought evidence of range of motion, stability and subsidence of the prosthesis. Substantial reduction in NDI scores occurred in both groups, with greater percent improvement in the Bryan group (P = 0.023). The arm pain VAS score improvement was substantial in both groups. Bryan artificial cervical disc replacement seems reliable and safe in the treatment of patients with two-level cervical disc disease. PMID:18956190

  18. To Your Health: NLM update transcript - Reassessing cervical cancer

    MedlinePlus

    ... here' section of MedlinePlus.gov's cervical cancer health topic page . The National Cancer Institute provides additional information about ... factors' section of MedlinePlus.gov's cervical cancer health topic page. MedlinePlus.gov's cervical cancer health topic page also ...

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

    ERIC Educational Resources Information Center

    Zimmet, Judy A.; Reagan, Patricia A.

    1986-01-01

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

  20. Laparoscopic uterine artery occlusion before cervical curettage in cervical ectopic pregnancy: Safe and effective for preventing massive bleeding

    PubMed Central

    Choi, Hong-Seok; Kim, Na-Young

    2015-01-01

    Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions. Cervical ectopic pregnancy can usually be treated by methotrexate injection or surgery. We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods. By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding. PMID:26430673

  1. Preoperative Embolization of Cervical Spine Tumors

    SciTech Connect

    Vetter, Sylvia C.; Strecker, Ernst-Peter; Ackermann, Ludwig W.; Harms, Juergen

    1997-09-15

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

  2. Material Science in Cervical Total Disc Replacement

    PubMed Central

    Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  3. [Wnt signalling pathway and cervical cancer].

    PubMed

    Ramos-Solano, Moisés; Álvarez-Zavala, Monserrat; García-Castro, Beatriz; Jave-Suárez, Luis Felipe; Aguilar-Lemarroy, Adriana

    2015-01-01

    Cervical cancer (CC) is a pathology that arises in the cervical epithelium, whose major cause of risk is human papillomavirus (HPV) infection. Due to the fact that HPV infection per se is not enough to generate a carcinogenic process, it has been proposed that alterations in the Wnt signaling pathway are involved in cervical carcinogenesis. The Wnt family consists of 13 receptors and 19 ligands, and it is highly conserved phylogenetically due to its contribution in different biological processes, such as embryogenesis and tissue regeneration. Additionally, this signaling pathway modulates various cellular functions, for instance: cell proliferation, differentiation, migration and cell polarity. This paper describes the Wnt signaling pathways and alterations that have been found in members of this family in different cancer types and, especially, in CC.

  4. Cervical Meningomyelitis After Lumbar Epidural Steroid Injection

    PubMed Central

    Kim, Joon-Sung; Kim, Ji Yeon

    2015-01-01

    Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement. PMID:26161360

  5. Cigarette smoking and invasive cervical cancer

    SciTech Connect

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

    1986-06-20

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

  6. Cervical spine injuries in football players.

    PubMed

    Thomas, B E; McCullen, G M; Yuan, H A

    1999-01-01

    Cervical spine injuries have been estimated to occur in 10% to 15% of football players, most commonly in linemen, defensive ends, and linebackers. The overwhelming majority of such injuries are self-limited, and full recovery can be expected. However, the presenting symptoms of serious cervical spine injuries may closely resemble those of minor injuries. The orthopaedic surgeon frequently must make a judgment, on the field or later in the office, about the advisability of returning the athlete to the game. These decisions can have an enormous impact on the player and his family. Most severe cervical spine injuries share the common mechanism of application of an axial load to the straightened spine. Avoiding techniques that employ head-down "spear" tackling and wearing properly fitted equipment markedly reduce the risk of serious injury.

  7. 75 FR 24711 - Food and Drug Administration Modernization Act of 1997: Modifications to the List of Recognized...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ...:2001 4-99 4-181 ISO 4049:2009 Dentistry-Polymer-Based Withdrawn and replaced Filling, Restorative and... Polymers:2002 4-119 ADA/ANSI Specification No. 82 - Dental Reaffirmation Reversible/Irreversible... 2026-08 Polyetheretherketone (PEEK) Polymers for Surgical Implant Applications D. Physical Medicine...

  8. Cervicogenic headache alleviation after cervical coblation nucleoplasty

    PubMed Central

    He, Liangliang; Yue, Jianning; Yang, Liqiang; Wu, Baishan; Cao, Guoqing; Guo, Yuna; Lai, Guanghui; Tang, Yuanzhang; Ni, Jiaxiang

    2016-01-01

    Abstract A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty. The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches. In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L. Cervicogenic pain was diagnosed according to the International Headache Society criteria. During the 24-month follow-up, pain visual analog scale (VAS) scores were collected as the primary outcomes, and significant pain relief rate, Neck Disability Index (NDI) headache scores, and Patients Satisfaction Index (PSI) scores were recorded as secondary outcomes to evaluate headache severity and physical function postoperatively. During the 24-month follow-up, a significant decrease in headache VAS scores was observed in group C but not in group L. NDI and PSI scores in group C were better than those in group L. In comparison with the final follow-up, no significant differences in the NDI and PSI scores were found in all observations after surgery. In comparison to group L, ≥50% pain relief was significantly better in group C. No serious complications were observed except for ≤20% of ecchymoma at the needle insertion site. This prospective study indicated that cervicogenic headaches may benefit from nucleoplasty. PMID:27684803

  9. Descriptive Epidemiology of Cervical Dystonia

    PubMed Central

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

    2013-01-01

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

  10. The "shirt collar sign" of cervical dystonia.

    PubMed

    Silver, Michael R; Hanfelt, John; Factor, Stewart A

    2017-05-01

    The diagnosis of cervical dystonia (CD) is clinical. We describe a physical examination observation that has been noted in CD patients. There is a tendency for their shirt collars to be shifted to one side. We validated this apparently consistent finding by having blinded evaluators rating the symmetry of the shirt collars in CD and non-cervical dystonia control subjects. A high correlation was found between the physical finding which we call "shirt collar sign" and the diagnosis. "Shirt collar sign" may be a helpful sign in diagnosing CD.

  11. Cervical cancer in India and HPV vaccination

    PubMed Central

    Kaarthigeyan, K.

    2012-01-01

    Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine's efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context. PMID:22754202

  12. Cervical ribs: identification on MRI and clinical relevance.

    PubMed

    Walden, Michael J; Adin, Mehmet E; Visagan, Ravindran; Viertel, Valentina G; Intrapiromkul, Jarunee; Maluf, Fernando; Patel, Neil V; Alluwaimi, Fatma; Lin, Doris; Yousem, David M

    2013-01-01

    To determine the prevalence of cervical ribs on cervical spine MRI and clinical relevance, we reviewed 2500 studies for cervical ribs and compression of neurovascular structures and compared to CT, when available. Brachial plexus or subclavian artery contact by cervical rib was identified on MRI and/or CT in 12 cases with diagnosis of thoracic outlet syndrome in one. Cervical ribs were identified on 1.2% (25/2083) of examinations, lower than on CT (2%), but MRI may offer equivalent anatomic explanation for patient symptoms.

  13. Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

    PubMed Central

    Shangguan, Lei; Ning, Guang-Zhi; Tang, Yu; Wang, Zhe; Luo, Zhuo-Jing; Zhou, Yue

    2017-01-01

    Objective Symptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD. Methods An exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval. Results Of 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P < 0.0001), and better range of motion (ROM) at the operative level (P < 0.00001). But no significant differences were observed in blood loss, neck disability index (NDI) scores, neck and arm pain scores, Japanese orthopaedic association (JOA) scores, secondary surgery procedures and adverse events (P > 0.05). Subgroup analyses did not demonstrated significant differences. Conclusion In conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future. PMID:28358860

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

    PubMed

    Gong, Wontae

    2015-05-01

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

  15. Cervical cytology in serous and endometrioid endometrial cancer.

    PubMed

    Roelofsen, Thijs; Geels, Yvette P; Pijnenborg, Johanna M A; van Ham, Maaike A P C; Zomer, Saskia F; van Tilburg, Johanna M Wiersma; Snijders, Marc P M L; Siebers, Albert G; Bulten, Johan; Massuger, Leon F A G

    2013-07-01

    The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and clinicopathologic factors were evaluated. In this multicentre study, EEC patients diagnosed at two hospitals from 1999 to 2009 and UPSC patients diagnosed at five hospitals from 1992 to 2009, were included. Revision of the histologic slides was performed systematically and independently by 3 gynecopathologists. Cervical cytology within six months before histopathologic diagnosis of endometrial carcinoma was available for 267 EEC and 80 UPSC patients. Cervical cytology with atypical, malignant, or normal endometrial cells in postmenopausal women was considered as abnormal cytology, specific for endometrial pathology. Abnormal cervical cytology was found in 87.5% of UPSC patients, compared with 37.8% in EEC patients. In UPSC, abnormal cytology was associated with extrauterine spread of disease (P=0.043). In EEC, abnormal cytology was associated with cervical involvement (P=0.034). In both EEC and UPSC patients, abnormal cervical cytology was not associated with survival. In conclusion, abnormal cervical cytology was more frequently found in UPSC patients. It was associated with extrauterine disease in UPSC patients, and with cervical involvement in EEC patients. More prospective research should be performed to assess the true clinical value of preoperative cervical cytology in endometrial cancer patients.

  16. An overview of prevention and early detection of cervical cancers

    PubMed Central

    Mishra, Gauravi A.; Pimple, Sharmila A.; Shastri, Surendra S.

    2011-01-01

    Cervical cancer still remains the most common cancer affecting the Indian women. India alone contributes 25.41% and 26.48% of the global burden of cervical cancer cases and mortality, respectively. Ironically, unlike most other cancers, cervical cancer can be prevented through screening by identifying and treating the precancerous lesions, any time during the course of its long natural history, thus preventing the potential progression to cervical carcinoma. Several screening methods, both traditional and newer technologies, are available to screen women for cervical precancers and cancers. No screening test is perfect and hence the choice of screening test will depend on the setting where it is to be used. Similarly, various methods are available for treatment of cervical precancers and the selection will depend on the cost, morbidity, requirement of reliable biopsy specimens, resources available, etc. The recommendations of screening for cervical cancer in the Indian scenario are discussed. PMID:22557777

  17. Dropped head syndrome associated with cervical spondylotic myelopathy.

    PubMed

    Kawaguchi, Atsushi; Miyamoto, Kei; Sakaguchi, Yasumichi; Nishimoto, Hirofumi; Kodama, Hirotaka; Ohara, Akira; Hosoe, Hideo; Shimizu, Katsuji

    2004-12-01

    We report a case of an 80-year-old woman with dropped head syndrome associated with cervical spondylotic myelopathy. She could not keep her cervical spine in a neutral position for >1 minute. She had a disturbed gait and severe kyphotic deformity in her thoracic spine. Magnetic resonance imaging revealed severe compression of the spinal cord due to cervical spondylotic change. Laminoplasty from C2 through C6 levels was performed. One year after operation, she could keep her cervical spine in a neutral position easily. Her gait was also improved. The symptoms did not recur during 4 years of follow-up. We surmise that to maintain daily activities, she had to extend her cervical spine owing to the thoracic kyphotic deformity, resulting in compression of the spinal cord. The compression led to weakening of the cervical extensor muscles. Cervical laminoplasty was effective.

  18. Cervical Carcinogenesis and Immune Response Gene Polymorphisms: A Review

    PubMed Central

    Mooij, Merel

    2017-01-01

    The local immune response is considered a key determinant in cervical carcinogenesis after persistent infection with oncogenic, high-risk human papillomavirus (HPV) infections. Genetic variation in various immune response genes has been shown to influence risk of developing cervical cancer, as well as progression and survival among cervical cancer patients. We reviewed the literature on associations of immunogenetic single nucleotide polymorphism, allele, genotype, and haplotype distributions with risk and progression of cervical cancer. Studies on HLA and KIR gene polymorphisms were excluded due to the abundance on literature on that subject. We show that multiple genes and loci are associated with variation in risk of cervical cancer. Rather than one single gene being responsible for cervical carcinogenesis, we postulate that variations in the different immune response genes lead to subtle differences in the effectiveness of the antiviral and antitumour immune responses, ultimately leading to differences in risk of developing cervical cancer and progressive disease after HPV infection. PMID:28280748

  19. Pediatric cervical spine: normal anatomy, variants, and trauma.

    PubMed

    Lustrin, Elizabeth Susan; Karakas, Sabiha Pinar; Ortiz, A Orlando; Cinnamon, Jay; Castillo, Mauricio; Vaheesan, Kirubahara; Brown, James H; Diamond, Alan S; Black, Karen; Singh, Sudha

    2003-01-01

    Emergency radiologic evaluation of the pediatric cervical spine can be challenging because of the confusing appearance of synchondroses, normal anatomic variants, and injuries that are unique to children. Cervical spine injuries in children are usually seen in the upper cervical region owing to the unique biomechanics and anatomy of the pediatric cervical spine. Knowledge of the normal embryologic development and anatomy of the cervical spine is important to avoid mistaking synchondroses for fractures in the setting of trauma. Familiarity with anatomic variants is also important for correct image interpretation. These variants include pseudosubluxation, absence of cervical lordosis, wedging of the C3 vertebra, widening of the predental space, prevertebral soft-tissue widening, intervertebral widening, and "pseudo-Jefferson fracture." In addition, familiarity with mechanisms of injury and appropriate imaging modalities will aid in the correct interpretation of radiologic images of the pediatric cervical spine.

  20. Effect of Anterior Cervical Discectomy and Fusion on Patients with Atypical Symptoms Related to Cervical Spondylosis.

    PubMed

    Muheremu, Aikeremujiang; Sun, Yuqing; Yan, Kai; Yu, Jie; Zheng, Shan; Tian, Wei

    2016-09-01

    Background A considerable number of patients with cervical spondylosis complain about one or multiple atypical symptoms such as vertigo, palpitations, headache, blurred vision, hypomnesia, and/or nausea. It remains unclear whether surgical intervention for cervical spondylosis can also effectively alleviate those symptoms. The current study was performed to see if anterior cervical diskectomy and fusion (ACDF) offers such an extra benefit for patients with cervical spondylosis. Objective To investigate if patients who received ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy can also achieve alleviation of certain atypical symptoms associated with cervical spondylosis after the surgery in the long run. Methods Sixty-seven patients who underwent ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy were involved in this study. All these patients also complained about various associated atypical symptoms. They were followed up for 26 to 145 months after the surgery. Severity and frequency scores of the atypical symptoms before the surgery and at last follow-up were compared by paired t tests. Results Most patients reported significantly alleviated symptoms at the last follow-up compared with before the surgery. The severity of vertigo, headache, nausea, and palpitations were significantly alleviated at the last follow-up (with p values of p < 0.001, p = 0.001, p = 0.022, p = 0.004, respectively). There were no significant changes in the severity of tinnitus (p = 0.182), blurred vision (p = 0.260), and hypomnesia (p = 0.821). Conclusion ACDF can significantly alleviate vertigo, headache, nausea, and palpitations in most patients with cervical spondylotic myelopathy and/or radiculopathy, but it is not effective in alleviating symptoms such as tinnitus, blurred vision, and hypomnesia. It can be considered for alleviating atypical symptoms when other treatment options prove

  1. Cervical Microbiome and Cytokine Profile at Various Stages of Cervical Cancer: A Pilot Study

    PubMed Central

    Bahena-Román, Margarita; Téllez-Sosa, Juan; Martínez-Barnetche, Jesús; Cortina-Ceballos, Bernardo; López-Estrada, Guillermina; Delgado-Romero, Karina; Burguete-García, Ana I.; Cantú, David; García-Carrancá, Alejandro; Madrid-Marina, Vicente

    2016-01-01

    Cervical cancer (CC) is caused by high-risk human papillomavirus persistence due to the immunosuppressive tumor microenvironment mediated by cytokines. Vaginal microbiota determines the presence of certain cytokines locally. We assessed the association between cervical microbiota diversity and the histopathological diagnosis of each stage of CC, and we evaluated mRNA cervical expression levels of IL-4, IL-6, IL-10, TGF-β1, TNF-α and IFN-γ across the histopathological diagnosis and specific bacterial clusters. We determined the cervical microbiota by high throughput sequencing of 16S rDNA amplicons and classified it in community state types (CST). Mean difference analyses between alpha-diversity and histopathological diagnosis were carried out, as well as a β-diversity analysis within the histological diagnosis. Cervical cytokine mRNA expression was analyzed across the CSTs and the histopathological diagnoses. We found a significant difference in microbiota's diversity in NCL-HPV negative women vs those with squamous intraepithelial lesions (SIL) and CC(p = 0.006, p = 0.036).When β-diversity was evaluated, the CC samples showed the highest variation within groups (p<0.0006) and the largest distance compared to NCL-HPV negative ones (p<0.00001). The predominant bacteria in women with normal cytology were L. crispatus and L. iners, whereas for SIL, it was Sneathia spp. and for CC, Fusobacterium spp. We found higher median cervical levels of IL-4 and TGF-β1 mRNA in the CST dominated by Fusobacterium spp. These results suggest that the cervical microbiota may be implicated in cervical cancer pathology. Further cohort studies are needed to validate these findings. PMID:27115350

  2. Cervical spine surgery in professional athletes: a systematic review.

    PubMed

    Joaquim, Andrei F; Hsu, Wellington K; Patel, Alpesh A

    2016-04-01

    Cervical surgery is one of the most common surgical spinal procedures performed around the world. The authors performed a systematic review of the literature reporting the outcomes of cervical spine surgery in high-level athletes in order to better understand the nuances of cervical spine pathology in this population. A search of the MEDLINE database using the search terms "cervical spine" AND "surgery" AND "athletes" yielded 54 abstracts. After exclusion of publications that did not meet the criteria for inclusion, a total of 8 papers reporting the outcome of cervical spine surgery in professional or elite athletes treated for symptoms secondary to cervical spine pathology (focusing in degenerative conditions) remained for analysis. Five of these involved the management of cervical disc herniation, 3 were specifically about traumatic neurapraxia. The majority of the patients included in this review were American football players. Anterior cervical discectomy and fusion (ACDF) was commonly performed in high-level athletes for the treatment of cervical disc herniation. Most of the studies suggested that return to play is safe for athletes who are asymptomatic after ACDF for cervical radiculopathy due to disc herniation. Surgical treatment may provide a higher rate of return to play for these athletes than nonsurgical treatment. Return to play after cervical spinal cord contusion may be possible in asymptomatic patients. Cervical cord signal changes on MRI may not be an absolute contraindication for return to play in neurologically intact patients, according to some authors. Cervical contusions secondary to cervical stenosis may be associated with a worse outcome and a higher recurrence rate than those those secondary to disc herniation. The evidence is low (Level IV) and individualized treatment must be recommended.

  3. Review of the Cervical Cancer Burden and Population-Based Cervical Cancer Screening in China.

    PubMed

    Di, Jiangli; Rutherford, Shannon; Chu, Cordia

    2015-01-01

    Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

  4. Skeletal maturation determined by cervical vertebrae development.

    PubMed

    San Román, Paloma; Palma, Juan Carlos; Oteo, M Dolores; Nevado, Esther

    2002-06-01

    The aim of this study was to determine the validity of cervical vertebrae radiographic assessment to predict skeletal maturation. Left hand-wrist and lateral cephalometric radiographs of 958 Spanish children from 5 to 18 years of age were measured. On the left hand-wrist radiographs the classification of Grave and Brown was used to assess skeletal maturation. Cervical vertebrae maturation was evaluated with lateral cephalometric radiographs using the stages described by Lamparski and by Hassel and Farman. A new method to evaluate the cervical maturation by studying the changes in the concavity of the lower border, height, and shape of the vertebral body was created. Correlation coefficients were calculated to establish the relationship between skeletal maturation values obtained by the three classifications of vertebral and skeletal maturation measured at the wrist. All correlation values obtained were statistically significant (P < 0.001). The results suggest that this new method to determine skeletal maturation is very reliable. A simple method based on morphological characteristics of the cervical vertebral bodies to evaluate the maturation stage has been designed. In the population investigated, this method is as accurate as the Hassel and Farman classification and superior to the Lamparski classification. The morphological vertebral parameter best able to estimate the maturation is the concavity of the lower border of the body.

  5. Childhood cervical enterogenous cyst presenting with hemiparesis

    PubMed Central

    Woo, P. Y. C.; Sharr, M. M.

    1982-01-01

    The clinical features of a cervical enterogenous cyst in a one-year-old boy mimicked those of an intracranial mass. Following removal of the cyst the neurological signs rapidly disappeared. The literature is reviewed from histological and clinical aspects and a classification of these cysts is proposed. ImagesFig. 1Fig. 2 PMID:7122385

  6. Cervical Cancer: paradigms at home and abroad

    Cancer.gov

    NCI funded a clinical trial that will have an impact on the treatment of late-stage cervical cancer, and also supported a screening trial in India using a network of community outreach workers offering low tech-screening by direct visualization of the cer

  7. Facial nerve paralysis after cervical traction.

    PubMed

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  8. Cervical Cancer Screening and Perceived Information Needs

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  9. Cervical epidural hematoma after chiropractic spinal manipulation.

    PubMed

    Heiner, Jason D

    2009-10-01

    Spinal epidural hematoma is a rare but potentially devastating complication of spinal manipulation therapy. This is a case report of a healthy pregnant female who presented to the emergency department with a cervical epidural hematoma resulting from chiropractic spinal manipulation therapy that responded to conservative treatment rather than the more common route of surgical management.

  10. Carotid artery disease following external cervical irradiation

    SciTech Connect

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

    1981-01-01

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

  11. Carotid artery disease following external cervical irradiation

    SciTech Connect

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

    1981-11-01

    A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head and neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. This represents a trend toward an increased risk for this population over the expected incidence of 38 strokes for a matched population observed over the same period of time (p = 0.39). A prospective study of 118 similar patients currently living five years after cervical radiotherapy was performed to determine the incidence of carotid artery disease occurring as a consequence of neck irradiation. Abnormal carotid phonoangiograms (CPA) were found in 25% of the patients and abnormal oculoplethysmographs (OPG) were found in 17%. These studies represent significant carotid lesions that are not expected in such a population. It is concluded that the carotid stenoses demonstrated are most likely a consequence of prior irradiation. Patients that are five-year survivors of cervical irradiation should have noninvasive vascular laboratory studies performed as part of their routine follow-up examinations in order to detect these carotid lesions while they are occult.

  12. Two cases of isolated anterior cervical hypertrichosis.

    PubMed

    Reddy, Swapna; Antaya, Richard J

    2010-01-01

    Two unrelated Hispanic females, ages 4 and 3 years, respectively, each presented with a solitary patch of excessive terminal hair growth in the midline of the neck. This rare form of congenital localized hypertrichosis, known as anterior cervical hypertrichosis, is reported here as an isolated defect with no other underlying abnormalities.

  13. Cervical spondylitis due to Neisseria meningitidis.

    PubMed

    Mendes, Stéphanie; Bémer, Pascale; Corvec, Stéphane; Faure, Alexis; Redon, Hervé; Drugeon, Henri B

    2006-05-01

    The diverse clinical spectrum of meningococcal infections includes frequent clinical forms, such as meningitis or septicemia, and uncommon manifestations, such as septic arthritis. Neisseria meningitidis is not generally considered to be a causative agent of osteoarticular infections. We report the first case of acute primary cervical spondylitis in a 48-year-old man.

  14. Problems in the cultivation of cervical bacteria.

    PubMed

    Brown, E R; Keith, L G; Rosen, G F

    1985-03-01

    Multiple variations in the types, species and prevalence of cervical bacteria are described in the literature. A review of the literature was undertaken to determine the effect of delay on the ability to identify bacteria. Experiments were initiated to elaborate on those observations. The rate of organism isolation was related to the delay in transport to the laboratory.

  15. The molecular genetics of cervical carcinoma

    PubMed Central

    Lazo, P A

    1999-01-01

    In the pathogenesis of cervical carcinoma there are three major components, two of them related to the role of human papillomaviruses (HPV). First, the effect of viral E6 and E7 proteins. Second, the integration of viral DNA in chromosomal regions associated with well known tumour phenotypes. Some of these viral integrations occur recurrently at specific chromosomal locations, such as 8q24 and 12q15, both harbouring HPV18 and HPV16. And third, there are other recurrent genetic alterations not linked to HPV. Recurrent losses of heterozygosity (LOH) have been detected in chromosome regions 3p14–22, 4p16, 5p15, 6p21–22, 11q23, 17p13.3 without effect on p53, 18q12–22 and 19q13, all of them suggesting the alteration of putative tumour suppressor genes not yet identified. Recurrent amplification has been mapped to 3q+ arm, with the common region in 3q24–28 in 90% of invasive carcinomas. The mutator phenotype, microsatellite instability, plays a minor role and is detected in only 7% of cervical carcinomas. The development of cervical carcinoma requires the sequential occurrence and selection of several genetic alterations. The identification of the specific genes involved, and their correlation with specific tumour properties and stages could improve the understanding and perhaps the management of cervical carcinoma. © 1999 Cancer Research Campaign PMID:10471054

  16. Adjacent Segment Pathology after Anterior Cervical Fusion

    PubMed Central

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon

    2016-01-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion. PMID:27340541

  17. External cervical resorption: diagnostic and treatment tips

    PubMed Central

    Consolaro, Alberto

    2016-01-01

    ABSTRACT External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature. PMID:27901225

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

    PubMed Central

    Ransone, Jack; Kersey, Robert; Walsh, Katie

    2000-01-01

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

  19. Cervical cancer: Can it be prevented?

    PubMed Central

    Aggarwal, Pakhee

    2014-01-01

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

  20. Developmental biomechanics of the human cervical spine.

    PubMed

    Nuckley, David J; Linders, David R; Ching, Randal P

    2013-04-05

    Head and neck injuries, the leading cause of death for children in the U.S., are difficult to diagnose, treat, and prevent because of a critical void in our understanding of the biomechanical response of the immature cervical spine. The objective of this study was to investigate the functional and failure biomechanics of the cervical spine across multiple axes of loading throughout maturation. A correlational study design was used to examine the relationships governing spinal maturation and biomechanical flexibility curves and tolerance data using a cadaver human in vitro model. Eleven human cadaver cervical spines from across the developmental spectrum (2-28 years) were dissected into segments (C1-C2, C3-C5, and C6-C7) for biomechanical testing. Non-destructive flexibility tests were performed in tension, compression, flexion, extension, lateral bending, and axial rotation. After measuring their intact biomechanical responses, each segment group was failed in different modes to measure the tissue tolerance in tension (C1-C2), compression (C3-C5), and extension (C5-C6). Classical injury patterns were observed in all of the specimens tested. Both the functional (p<0.014) and failure (p<0.0001) mechanics exhibited significant relationships with age. Nonlinear flexibility curves described the functional response of the cervical spine throughout maturation and elucidated age, spinal level, and mode of loading specificity. These data support our understanding of the child cervical spine from a developmental perspective and facilitate the generation of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.

  1. Cervical cancer: Can it be prevented?

    PubMed

    Aggarwal, Pakhee

    2014-10-10

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

  2. Effects of occlusal load on cervical lesions.

    PubMed

    Litonjua, L A; Bush, P J; Andreana, S; Tobias, T S; Cohen, R E

    2004-03-01

    Toothbrush abrasion has been considered to cause cervical lesions. However, some investigators have proposed that occlusal loading factors direct tensile stresses at the cervical area, resulting in wedge-shaped abfraction defects. The purpose of this study is to investigate the role of axial and non-axial load on the development of cervical lesions. Matched paired premolars, extracted for orthodontic purposes, were used in a custom-fabricated toothbrushing apparatus. A periodontal sulcus width of 0b1 mm with 1 mm gingival recession was simulated with denture base resin. In phase 1, eight matched premolar pairs were subjected to 80 h (1b4 million strokes) of brushing and 300 g of toothbrush force. Toothpaste slurry was applied continuously through the toothbrush. One specimen in each pair was subjected to 250 h and 45 kg of continuous axial load, while the other unloaded tooth served as a negative control. In phase 2, 10 matched premolar pairs were subjected to the same conditions; however, the experimental teeth were subjected to 250 h and 45 kg of intermittent non-axial load, directed at a 45 degrees angle to the buccal cusp. Rubber impressions were made of the cervical lesions, then trimmed, weighed, and compared to determine the amount of tooth material lost. When teeth were loaded axially, there was significantly less tooth material loss (P < 0b02); however, when teeth were loaded non-axially, there was no significant difference (P =0b80) when compared with controls. Optical and scanning electron microscopy did not reveal any significant differences in the morphology between pairs. Our data suggest that the application of occlusal load may not necessarily play a significant role in the progression of cervical tooth wear commonly referred to as abfraction.

  3. Addressing Stretch Myelopathy in Multilevel Cervical Kyphosis with Posterior Surgery Using Cervical Pedicle Screws

    PubMed Central

    Mahesh, Bijjawara; Vijay, Shekarappa; Arun, Kumar; Srinivasa, Reddy

    2016-01-01

    Study Design Technique description and retrospective data analysis. Purpose To describe the technique of cervical kyphosis correction with partial facetectomies and evaluate the outcome of single-stage posterior decompression and kyphosis correction in multilevel cervical myelopathy. Overview of Literature Kyphosis correction in multilevel cervical myelopathy involves anterior and posterior surgery. With the advent of cervical pedicle screw-rod instrumentation, single-stage posterior kyphosis correction is feasible and can address stretch myelopathy by posterior shortening. Methods Nine patients underwent single-stage posterior decompression and kyphosis correction for multilevel cervical myelopathy using cervical pedicle screw instrumentation from March 2011 to February 2014 and were evaluated preoperatively and postoperatively with modified Japanese Orthopaedic Association (mJOA) scoring and computed tomography scans for radiological measurements. Kyphosis assessment was made with Ishihara curvature index and C2–C7 Cobb's angle. The linear length of the spinal canal and the actual spinal canal length were also evaluated. The average follow-up was 40.56 months (range, 20 to 53 months). Results The average preoperative C2–7 Cobb's angle of 6.3° (1° to 12°) improved to 2° (10° to −9°). Ishihara index improved from −15.8% (−30.5% to −4.7%) to −3.66% (−14.5% to +12.6%). The actual spinal canal length decreased from 83.64 mm (range, 76.8 to 91.82 mm) to 82.68 mm (range, 75.85 to 90.78 mm). The preoperative mJOA score of 7.8 (range, 3 to 11) improved to 15.0 (range, 13 to 17). Conclusions Single-stage posterior decompression and kyphosis correction using cervical pedicle screws for multilevel cervical myelopathy may address stretch myelopathy, in addition to decompression in the transverse plane. However, cervical lordosis was not achieved with this method as predictably as by the anterior approach. The present study shows evidence of mild

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

    PubMed Central

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

    2014-01-01

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

  5. Recommendations for a national agenda to substantially reduce cervical cancer

    PubMed Central

    Brewer, Noel T.; Saslow, Debbie; Alexander, Kenneth; Chernofsky, Mildred R.; Crosby, Richard; Derting, Libby; Devlin, Leah; Dunton, Charles J.; Engle, Jeffrey; Fernandez, Maria; Fouad, Mona; Huh, Warner; Kinney, Walter; Pierce, Jennifer; Rios, Elena; Rothholz, Mitchel C.; Shlay, Judith C.; Shedd-Steele, Rivienne; Vernon, Sally W.; Walker, Joan; Wynn, Theresa; Zimet, Gregory D.; Casey, Baretta R.

    2016-01-01

    Purpose Prophylactic human papillomavirus (HPV) vaccines and new HPV screening tests, combined with traditional Pap test screening, provide an unprecedented opportunity to greatly reduce cervical cancer in the USA. Despite these advances, thousands of women continue to be diagnosed with and die of this highly preventable disease each year. This paper describes the initiatives and recommendations of national cervical cancer experts toward preventing and possibly eliminating this disease. Methods In May 2011, Cervical Cancer-Free America, a national initiative, convened a cervical cancer summit in Washington, DC. Over 120 experts from the public and private sector met to develop a national agenda for reducing cervical cancer morbidity and mortality in the USA. Results Summit participants evaluated four broad challenges to reducing cervical cancer: (1) low use of HPV vaccines, (2) low use of cervical cancer screening, (3) screening errors, and (4) lack of continuity of care for women diagnosed with cervical cancer. The summit offered 12 concrete recommendations to guide future national and local efforts toward this goal. Conclusions Cervical cancer incidence and mortality can be greatly reduced by better deploying existing methods and systems. The challenge lies in ensuring that the array of available prevention options are accessible and utilized by all age-appropriate women—particularly minority and underserved women who are disproportionately affected by this disease. The consensus was that cervical cancer can be greatly reduced and that prevention efforts can lead the way towards a dramatic reduction in this preventable disease in our country. PMID:23828553

  6. Risk of invasive cervical cancer after atypical glandular cells in cervical screening: nationwide cohort study

    PubMed Central

    Andrae, Bengt; Sundström, Karin; Ström, Peter; Ploner, Alexander; Elfström, K Miriam; Arnheim-Dahlström, Lisen; Dillner, Joakim; Sparén, Pär

    2016-01-01

    Objectives To investigate the risks of invasive cervical cancer after detection of atypical glandular cells (AGC) during cervical screening. Design Nationwide population based cohort study. Setting Cancer and population registries in Sweden. Participants 3 054 328 women living in Sweden at any time between 1 January 1980 and 1 July 2011 who had any record of cervical cytological testing at ages 23-59. Of these, 2 899 968 women had normal cytology results at the first screening record. The first recorded abnormal result was atypical glandular cells (AGC) in 14 625, high grade squamous intraepithelial lesion (HSIL) in 65 633, and low grade squamous intraepithelial lesions (LSIL) in 244 168. Main outcome measures Cumulative incidence of invasive cervical cancer over 15.5 years; proportion of invasive cervical cancer within six months of abnormality (prevalence); crude incidence rates for invasive cervical cancer over 0.5-15.5 years of follow-up; incidence rate ratios compared with women with normal cytology, estimated with Poisson regression adjusted for age and stratified by histopathology of cancer; distribution of clinical assessment within six months after the abnormality. Results The prevalence of cervical cancer was 1.4% for women with AGC, which was lower than for women with HSIL (2.5%) but higher than for women with LSIL (0.2%); adenocarcinoma accounted for 73.2% of the prevalent cases associated with AGC. The incidence rate of invasive cervical cancer after AGC was significantly higher than for women with normal results on cytology for up to 15.5 years and higher than HSIL and LSIL for up to 6.5 years. The incidence rate of adenocarcinoma was 61 times higher than for women with normal results on cytology in the first screening round after AGC, and remained nine times higher for up to 15.5 years. Incidence and prevalence of invasive cervical cancer was highest when AGC was found at ages 30-39. Only 54% of women with AGC underwent histology assessment

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

    PubMed

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

    2015-07-01

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

  8. Nuclear expression of Rac1 in cervical premalignant lesions and cervical cancer cells

    PubMed Central

    2012-01-01

    Background Abnormal expression of Rho-GTPases has been reported in several human cancers. However, the expression of these proteins in cervical cancer has been poorly investigated. In this study we analyzed the expression of the GTPases Rac1, RhoA, Cdc42, and the Rho-GEFs, Tiam1 and beta-Pix, in cervical pre-malignant lesions and cervical cancer cell lines. Methods Protein expression was analyzed by immunochemistry on 102 cervical paraffin-embedded biopsies: 20 without Squamous Intraepithelial Lesions (SIL), 51 Low- grade SIL, and 31 High-grade SIL; and in cervical cancer cell lines C33A and SiHa, and non-tumorigenic HaCat cells. Nuclear localization of Rac1 in HaCat, C33A and SiHa cells was assessed by cellular fractionation and Western blotting, in the presence or not of a chemical Rac1 inhibitor (NSC23766). Results Immunoreacivity for Rac1, RhoA, Tiam1 and beta-Pix was stronger in L-SIL and H-SIL, compared to samples without SIL, and it was significantly associated with the histological diagnosis. Nuclear expression of Rac1 was observed in 52.9% L-SIL and 48.4% H-SIL, but not in samples without SIL. Rac1 was found in the nucleus of C33A and SiHa cells but not in HaCat cells. Chemical inhibition of Rac1 resulted in reduced cell proliferation in HaCat, C33A and SiHa cells. Conclusion Rac1 is expressed in the nucleus of epithelial cells in SILs and cervical cancer cell lines, and chemical inhibition of Rac1 reduces cellular proliferation. Further studies are needed to better understand the role of Rho-GTPases in cervical cancer progression. PMID:22443139

  9. Aetiology, pathogenesis, and pathology of cervical neoplasia.

    PubMed Central

    Arends, M J; Buckley, C H; Wells, M

    1998-01-01

    Early epidemiological studies of cervical neoplasia suggested a causal relation with sexual activity and human papillomaviruses (HPVs) have emerged as prime suspects as venerally transmitted carcinogens. HPVs fall into two broad camps: low risk types, associated with cervical condylomas and CIN 1; and high risk types (mostly 16 and 18), found in 50-80% of CIN 2 and CIN 3 lesions, and 90% of cancers. This association with cancer is very strong, with odds ratios of > 15 (often much higher) in case-control studies that are methodologically sound. An infrequently detected third group of intermediate risk type HPVs is associated with all grades of CIN and occasionally with cancers. HPVs have also been detected in a wide range of asymptomatic controls, indicating that other events are required for development of neoplasia such as viral persistence and/or altered expression of viral genes, often following integration of the viral genome. This leaves the two major viral oncogenes, E6 and E7, directly coupled to viral enhancers and promoters, allowing their continued expression after integration. High risk HPV E7 proteins bind and inactivate the Rb protein, whereas E6 proteins bind p53 and direct its rapid degradation. A range of putative cofactors has been implicated in progression: HLA type, immunosuppression, sex steroid hormones, and smoking; most of these cofactors appear to influence progression to CIN 3. The natural history includes progression to CIN 3 in 10% of CIN 1 and 20% of CIN 2 cases, whereas at least 12% of CIN 3 cases progress to invasive carcinoma. Cervical glandular intraepithelial neoplasia (CGIN) often coexists with squamous CIN, and the premalignant potential of high grade CGIN is not in doubt, but the natural history of low grade CGIN remains uncertain. A high proportion of CGIN lesions and adenocarcinomas are HPV positive, and HPV18 has been implicated more in glandular than in squamous lesions. A strong clinical case for the application of HPV

  10. 78 FR 65451 - Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... AFFAIRS Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire... oira_submission@omb.eop.gov . Please refer to ``OMB Control No. 2900-- NEW (Neck (Cervical Spine...- ] NEW (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire).'' SUPPLEMENTARY...

  11. 78 FR 36306 - Proposed Information Collection (Neck (Cervical Spine) Conditions Disability Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... AFFAIRS Proposed Information Collection (Neck (Cervical Spine) Conditions Disability Benefits... needed to adjudicate the claim for VA disability benefits related to a claimant's diagnosis of a cervical... (Cervical Spine) Conditions Disability Benefits Questionnaire)'' in any correspondence. During the...

  12. Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test.

    PubMed

    Lluch, Enrique; Schomacher, Jochen; Gizzi, Leonardo; Petzke, Frank; Seegar, Dagmar; Falla, Deborah

    2014-02-01

    This study compared the immediate effects of an assisted plus active cranio-cervical flexion exercise (exercise group) versus a passive mobilisation plus assisted cranio-cervical flexion (mobilisation group) on performance of the cranio-cervical flexion test (CCFT), cervical range of motion (ROM) and pain in patients with chronic neck pain. Eighteen volunteers with chronic idiopathic neck pain participated in the study and were randomised to one of the two intervention groups. Current level of pain, cervical ROM and pain perceived during movement, pressure pain threshold (PPT) and surface electromyography (EMG) during performance of the CCFT were measured before and immediately after the intervention. A significant reduction in resting pain and PPT measured over cervical sites was observed immediately following both interventions, although a greater change was observed for the exercise group. No change in cervical ROM was observed after either intervention. Reduced sternocleidomastoid and anterior scalene EMG amplitude were observed during stages of the CCFT but only for the participants in the active exercise group. Although both active and passive interventions offered pain relief, only the exercise group improved on a task of motor function highlighting the importance of specific active treatment for improved motor control of the cervical spine.

  13. Effects of cervical self-stretching on slow vital capacity.

    PubMed

    Han, Dongwook; Yoon, Nayoon; Jeong, Yeongran; Ha, Misook; Nam, Kunwoo

    2015-07-01

    [Purpose] This study investigated the effects of self-stretching of cervical muscles, because the accessory inspiratory muscle is considered to improve pulmonary function. [Subjects] The subjects were 30 healthy university students 19-21 years old who did not have any lung disease, respiratory dysfunction, cervical injury, or any problems upon cervical stretching. [Methods] Spirometry was used as a pulmonary function test to measure the slow vital capacity before and after stretching. The slow vital capacity of the experimental group was measured before and after cervical self-stretching. Meanwhile, the slow vital capacity of the control group, which did not perform stretching, was also measured before and after the intervention. [Results] The expiratory vital capacity, inspiratory reserve volume, and expiratory reserve volume of the experimental group increased significantly after the cervical self-stretching. [Conclusion] Self-stretching of the cervical muscle (i.e., the inspiratory accessory muscle) improves slow vital capacity.

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

    SciTech Connect

    Merz, B.

    1988-11-18

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

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

    PubMed

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

    2015-03-01

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

  16. Diagnostic challenges in cervical tuberculous lymphadenitis: A review

    PubMed Central

    Deveci, Hande Senem; Kule, Mustafa; Kule, Zeynep Altin; Habesoglu, Tulay Erden

    2016-01-01

    Tuberculosis is a very serious disease and incidence is once again on the rise. Lymph node tuberculosis is one of the most common extrapulmonary manifestations of tuberculosis. In differential diagnosis of chronic, painless cervical lymphadenopathy, cervical tuberculous lymphadenitis should be kept in mind. A high index of suspicion is needed for diagnosis of tuberculous lymphadenitis, which is known to mimic a number of pathological conditions. This article reviews epidemiology, clinical manifestations, and diagnostic techniques for cervical tuberculous lymphadenitis. PMID:28058405

  17. Cervical angina: an overlooked source of noncardiac chest pain.

    PubMed

    Sussman, Walter I; Makovitch, Steven A; Merchant, Shabbir Hussain I; Phadke, Jayant

    2015-01-01

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

  18. MR imaging of the acutely injured patient with cervical traction.

    PubMed

    McArdle, C B; Wright, J W; Prevost, W J; Dornfest, D J; Amparo, E G

    1986-04-01

    Magnetic resonance (MR) imaging of the patient with acute cervical injury is important because of the potential prognostic significance of the appearance of the spinal cord at the time of injury. However, cervical traction may involve equipment incompatible with the magnetic environment, and transferring the patient to the imaging table may make it difficult to maintain traction. The authors describe a simple, inexpensive, and reliable method for providing cervical traction within the magnet room.

  19. Clinical Characteristics of Cervical Migraine (Klinicheskie Osobennosti Sheinoi Migreni),

    DTIC Science & Technology

    Headaches are one of the leading complaints in cervical migraine. Along with a careful anamnesis, these characteristic pains should suggest the...presence of cervical migraine. They start in the cervicooccipital area, most often on one side, and spread to the sinciput, the ipsilateral temple and...the brain. An analysis of the evolutionary course of cervical migraine is useful. Thus, headaches over a long period of time were the only symptoms

  20. A Ventromedian Cervical Sclerite of Mosquito Larvae (Diptera: Culicidae)

    DTIC Science & Technology

    1976-01-01

    Mosquito Sys tematics VOL. 8(2) 1976 205 A Ventromedian Cervical Sclerite oflMosquito Larvae (Diptera: Culicidae) John F. Rein& Department of...aegypt; (Linnaeus) by Hochman and Reinert (1974). The ventromedian cervical sclerite has a frag- mented appearance in a number of species of the...Dyar and Knab and dupreei (Coquillett)). Seventy-four species in 19 subgenera of Aedes examined possessed a ven- tromedian cervical sclerite. These

  1. X-Ray Diagnosis of Cervical Migraine (Rentgenodiagnostica Sheinoi Migreni),

    DTIC Science & Technology

    In recent years, interest in diseases of the nervous system resulting from cervical osteochondrosis has increased markedly. The wide range of...frequently simulate severe disorders of the nervous system. These cerebral disorders have come to be called cervical migraine. (Bartschi-Rochaix). They...arise as a result of the pressure of osteophytes of the cervical vertebrae on the vertebral artery and the vertebral nerve which is entwined with it in

  2. Why Do We Put Cervical Collars On Conscious Trauma Patients?

    PubMed Central

    Benger, Jonathan; Blackham, Julian

    2009-01-01

    In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful. Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials. PMID:19765308

  3. Mycobacterium Xenopi Found Incidentally on MRI of the Cervical Spine

    DTIC Science & Technology

    2010-01-01

    Mycobacterium Xenopi Found Incidentally on MRI of the Cervical Spine Military Medicine Radiology Corner, Vol. 175. January, 2010 Radiology Corner...Mycobacterium Xenopi Found Incidentally on MRI of the Cervical Spine Guarantor: Chris Walker1 Contributors: Chris Walker; 1 Col Les Folio...Mycobacterium xenopi in her lung. A mass was incidentally noted in the right upper apex on an MRI ordered to evaluate a subluxation seen in her cervical

  4. Why do we put cervical collars on conscious trauma patients?

    PubMed

    Benger, Jonathan; Blackham, Julian

    2009-09-18

    In this commentary we argue that fully alert, stable and co-operative trauma patients do not require the application of a semi-rigid cervical collar, even if they are suspected of underlying cervical spine fracture, unless their conscious level deteriorates or they find the short-term support of a cervical collar helpful. Despite the historical and cultural barriers that exist, the potential benefits are such that this hypothesis merits rigorous testing in well-designed research trials.

  5. Cervical cancer prevention and treatment in Latin America.

    PubMed

    Lopez, Melissa S; Baker, Ellen S; Maza, Mauricio; Fontes-Cintra, Georgia; Lopez, Aldo; Carvajal, Juan M; Nozar, Fernanda; Fiol, Veronica; Schmeler, Kathleen M

    2017-02-07

    Cervical cancer is a preventable disease with a known etiology (human papillomavirus), effective preventive vaccines, excellent screening methods, and a treatable pre-invasive phase. Surgery is the primary treatment for pre-invasive and early-stage disease and can safely be performed in many low-resource settings. However, cervical cancer rates remain high in many areas of Latin America. This article presents a number of evidence-based strategies being implemented to improve cervical cancer outcomes in Latin America.

  6. A Dynamic Model of the Cervical Spine and Head

    DTIC Science & Technology

    1981-11-01

    neck associated with each motion segment and multiplying by a uniform density. Preliminary simulations have been made of Ox (frontal) and (lateral...Vertebral Column 18 Cervical Spine 23 Vertebrae 23 Ligaments of the Cervical Spine 31 Movement of the Cervical Spine 34 Muscles of the Neck 39 III...GEOMETRIC DATA 62 Vertebral Local and Global Data 62 Ligaments - Geometry 74 Geometry of Muscles 76 Inertial Properties of the Neck 80 APPENDIX B

  7. Head and Cervical Spine Evaluation for the Pediatric Surgeon.

    PubMed

    Arbuthnot, Mary K; Mooney, David P; Glenn, Ian C

    2017-02-01

    This article is designed to guide pediatric surgeons in the evaluation and stabilization of blunt head and cervical spine injuries in pediatric patients. Trauma remains the number one cause of morbidity and mortality among children, and the incidence of head injuries continues to rise. Cervical spine injuries, on the other hand, are unusual but can be devastating if missed. This article highlights the pathophysiology unique to pediatric head and cervical spine trauma as well as keys to clinical and diagnostic evaluation.

  8. Epidemiology of cervical cancer in Latin America

    PubMed Central

    Capote Negrin, Luis G

    2015-01-01

    The basic aspects of the descriptive epidemiology of cervical cancer in Latin America are presented. A decrease in the incidence and mortality rates has been observed in the period from 2000 to 2012 in all countries across the region, this has not occurred at the same proportions, and in many countries, observed figures of incidence and mortality are among the highest levels in the world. In Latin America, calculating a mean measure of the numbers from the GLOBOCAN data from 2000 to 2012, we can observe a difference of up to fivefold of the incidence (Puerto Rico 9,73 Vs Bolivia 50,73) and almost seven times for mortality (Puerto Rico 3,3 Vs Nicaragua 21,67). A report of the epidemiology, risk factors, and evaluation of screening procedures regarding the possible impact of the human papillomavirus (HPV) vaccine I in the prevention of cervical cancer is presented. PMID:26557875

  9. Controlled Cervical Laceration Injury in Mice

    PubMed Central

    Zhang, Yi Ping; Walker, Melissa J.; Shields, Lisa B. E.; Wang, Xiaofei; Walker, Chandler L.; Xu, Xiao-Ming; Shields, Christopher B.

    2013-01-01

    Use of genetically modified mice enhances our understanding of molecular mechanisms underlying several neurological disorders such as a spinal cord injury (SCI). Freehand manual control used to produce a laceration model of SCI creates inconsistent injuries often associated with a crush or contusion component and, therefore, a novel technique was developed. Our model of cervical laceration SCI has resolved inherent difficulties with the freehand method by incorporating 1) cervical vertebral stabilization by vertebral facet fixation, 2) enhanced spinal cord exposure, and 3) creation of a reproducible laceration of the spinal cord using an oscillating blade with an accuracy of ±0.01 mm in depth without associated contusion. Compared to the standard methods of creating a SCI laceration such as freehand use of a scalpel or scissors, our method has produced a consistent lesion. This method is useful for studies on axonal regeneration of corticospinal, rubrospinal, and dorsal ascending tracts. PMID:23685551

  10. Intramedullary cervical neurenteric cyst mimicking an abscess.

    PubMed

    Muzumdar, D; Bhatt, Y; Sheth, J

    2008-01-01

    We describe a cervical intramedullary neurenteric cyst in a 12-year-old male patient who presented with gradual onset and progressively worsening neck pain, spastic quadriparesis and impaired sensation in the C(2) dermatome. MR imaging revealed a well-defined peripherally enhancing cystic intramedullary lesion with a posteroinferior enhancing nodule at the C(2)-C(3) level mimicking an abscess. There was no evidence of spinal dysraphism. The lesion was completely resected through a posterior approach and the patient showed radical improvement in his symptomatology. At follow-up after 3 years, he was asymptomatic and the MR imaging showed no evidence of any residual or recurrent cyst. The case presented here is unique, since a spinal neurenteric cyst showing intense peripheral contrast enhancement mimicking an abscess is unusual. The radiological features, pathogenesis and surgical considerations in cervical intramedullary neurenteric cysts are discussed and the relevant literature is briefly reviewed.

  11. Late prevertebral abscess following anterior cervical plating: the missing screw.

    PubMed

    Martínez-Lage, J F; Felipe-Murcia, M; Martínez-Lage Azorín, L

    2007-04-01

    A 51-year-old man underwent a C5-C7 anterior decompression and fusion. Six years later the patient complained of dysphagia caused by displacement of the cervical plate. One week after the scheduled removal of the implanted material, the patient developed a painful cervical swelling and fever. His cervical radiographs showed that a screw was missing compared to previous studies. Computerized tomography showed a large prevertebral abscess anterior to C4-C7. He underwent emergency surgical drainage of the abscess that was followed by total recovery. This report is aimed at describing this unusual complication of cervical instrumentation and to briefly review its pathogenesis and management options.

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

    PubMed

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

    2015-01-01

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

  13. Sagittal alignment of the cervical spine after neck injury.

    PubMed

    Beltsios, Michail; Savvidou, Olga; Mitsiokapa, Evanthia A; Mavrogenis, Andreas F; Kaspiris, Angelos; Efstathopoulos, Nikolaos; Papagelopoulos, Panayiotis J

    2013-07-01

    The normal sagittal alignment of the cervical spine is lordotic and is affected by the posture of the head and neck. The question of whether loss of cervical lordosis is the result of muscle spasm after injury or a normal variation, and the clinical significance of such changes in sagittal profile of the cervical spine has been an issue of several studies. The purpose of this paper is to study the incidence of normal cervical lordosis and its changes after neck injury compared to the healthy population. We studied the lateral radiographs of the cervical spine of 60 patients with neck injury compared to 100 patients without a neck injury. Lateral radiographs were obtained in the standing or sitting position, and the curvature of the cervical spine was measured using the angle formed between the inferior end plates of the C2 and C7 vertebrae. In the patients without neck injury, lordotic and straight cervical spine sagittal alignment was observed in 36.5% each, double curvature in 17%, and kyphotic in 10%. In the patients with neck injury, lordotic sagittal alignment was observed in 36%, straight in 34%, double curvature in 26% and kyphotic in 4%. No significant difference between the two groups regarding all types of sagittal alignment of the cervical spine was found (p > 0.100). The alterations in normal cervical lordosis in patients with neck injury must be considered coincidental. These alterations should not be associated with muscle spasm caused by neck pain.

  14. Cervical biomechanics and neck pain of "head-spinning" breakdancers.

    PubMed

    Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

    2014-05-01

    The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (p<0.05) and increased cervical torque in all planes (p<0.001). The CROM showed a negative moderate to strong correlation with NDI, pain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers.

  15. Primary Health Care and Cervical Cancer Mortality Rates in Brazil

    PubMed Central

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thomaz, Erika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; de Souza, Marta Rovery; Lein, Adriana; Alvares, Viviane; de Almeida, Dante Grapiuna; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-01-01

    Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized. PMID:28252500

  16. Inhibitory action of relaxin on human cervical smooth muscle.

    PubMed

    Norström, A; Bryman, I; Wiqvist, N; Sahni, S; Lindblom, B

    1984-09-01

    The influence of purified porcine relaxin on contractility of human cervical smooth muscle was investigated in vitro. Strips of cervical tissue were obtained by needle biopsy from pregnant and nonpregnant women and were mounted in a superfused organ chamber for isometric measurement of contractile activity. Relaxin (0.005-25 micrograms/ml) inhibited the spontaneous contractions in cervical strips from 18% of nonpregnant, 68% of early pregnant, and in 100% of term pregnant women. These results indicate that relaxin has an inhibitory action on cervical smooth muscle and that this effect is more constantly detected as pregnancy proceeds.

  17. Molecular mechanisms of cisplatin resistance in cervical cancer

    PubMed Central

    Zhu, Haiyan; Luo, Hui; Zhang, Wenwen; Shen, Zhaojun; Hu, Xiaoli; Zhu, Xueqiong

    2016-01-01

    Patients with advanced or recurrent cervical cancer have poor prognosis, and their 1-year survival is only 10%–20%. Chemotherapy is considered as the standard treatment for patients with advanced or recurrent cervical cancer, and cisplatin appears to treat the disease effectively. However, resistance to cisplatin may develop, thus substantially compromising the efficacy of cisplatin to treat advanced or recurrent cervical cancer. In this article, we systematically review the recent literature and summarize the recent advances in our understanding of the molecular mechanisms underlying cisplatin resistance in cervical cancer. PMID:27354763

  18. Evaluation of Candidate Methylation Markers to Detect Cervical Neoplasia

    PubMed Central

    Shivapurkar, Narayan; Sherman, Mark E.; Stastny, Victor; Echebiri, Chinyere; Rader, Janet S.; Nayar, Ritu; Bonfiglio, Thomas A.; Gazdar, Adi F.; Wang, Sophia S.

    2009-01-01

    Objective Studies of cervical cancer and its immediate precursor, cervical intraepithelial neoplasia 3 (CIN3), have identified genes that often show aberrant DNA methylation and therefore, represent candidate early detection markers. We used quantitative PCR assays to evaluate methylation in five candidate genes (TNFRSF10C, DAPK1, SOCS3, HS3ST2 and CDH1) previously demonstrated as methylated in cervical cancer. Methods In this analysis, we performed methylation assays for the five candidate genes in 45 invasive cervical cancers, 12 histologically normal cervical specimens, and 23 liquid-based cervical cytology specimens confirmed by expert review as unequivocal demonstrating cytologic high-grade squamous intraepithelial lesions, thus representing the counterparts of histologic CIN3. Results We found hypermethylation of HS3ST2 in 93% of cancer tissues and 70% of cytology specimens interpreted as CIN3; hypermethylation of CDH1 was found in 89% of cancers and 26% of CIN3 cytology specimens. Methylation of either HS3ST2 or CDH1 was observed in 100% of cervical cancer tissues and 83% of CIN3 cytology specimens. None of the five genes showed detectable methylation in normal cervical tissues. Conclusion Our data support further evaluation of HS3ST2 and CDH1 methylation as potential markers of cervical cancer and its precursor lesions. PMID:17894941

  19. Cervical cancer screening in low- and middle-income countries.

    PubMed

    Ditzian, Lauren R; David-West, Gizelka; Maza, Mauricio; Hartmann, Beatrix; Shirazian, Taraneh; Cremer, Miriam

    2011-01-01

    Cervical cancer is a leading cause of death among women in the developing world. Conventional cytology-based cervical cancer screening programs have been largely ineffectual at reducing the cervical cancer burden in low-resource settings. In response, alternative strategies have been tested, such as visual inspection with acetic acid (VIA) screening and human papillomavirus (HPV) DNA-based testing. This manuscript reviews literature addressing the programmatic approaches to implementing cervical cancer screening programs in low-resource settings, highlighting the challenges, barriers, and successes related to the use of cytology, VIA, and HPV-DNA based screening programs.

  20. Giant Cervical Osteophyte: An Unusual Cause of Dysphagia

    PubMed Central

    Srivastava, Sudhir Kumar; Bhosale, Sunil Krishna; Aggarwal, Rishi Anil

    2016-01-01

    Dysphagia due to skeletal causes is a rare entity. A large cervical osteophyte can cause mechanical compression of the pharyngo-oesophageal segment leading to dysphagia. Large cervical osteophytes can occur in cervical spondylosis, ankylosing spondylitis or Diffuse Idiopathic Skeletal Hyperostosis (DISH). A 60-year-old female came with progressive dysphagia due to a giant cervical osteophyte anterior to C4 and C5 vertebral bodies causing compression of the pharyngo-oesophageal segment. The patient was treated by surgical excision of the osteophyte by orthopaedic surgeons. The patient had complete relief of dysphagia following excision of the osteophyte. PMID:27891363

  1. Evaluation of dynamic formation of cervical spine column based on functional radiological studies in patients after cervical spine injury.

    PubMed

    Martynkiewicz, Jacek; Dragan, Szymon Feliks; Płocieniak, Katarzyna; Krawczyk, Artur; Kulej, Mirosław; Dragan, Szymon Łukasz

    2011-01-01

    The purpose of this study was to evaluate cervical spine function, based on our own functional method of roentgenometric analysis in patients who suffered from cervical spine sprain injury. Study involved 72 patients who suffered from cervical spine whiplash injury. Conventional plain radiographs in all patients included three lateral views: maximum flexion, neutral (resting) and maximum extension. All views allowed roentgenometric evaluation of ligament instability of the lower cervical spine C5-C7 according to the White and Panjabi criteria. Furthermore, based on literature analysis and their own clinical observations, the authors proposed new classification of dynamic formation of cervical spine column. The dynamic formation of cervical column is evaluated based on pathomechanical chain of being between normal and unstable. Authors' own evaluation system in flexion views can be useful in diagnosis and treatment of this type of injury.

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

    PubMed Central

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

    2014-01-01

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

  3. Cervical Cystic Hygroma in an Adult

    PubMed Central

    Derin, Serhan; Şahan, Murat; Dere, Yelda; Çullu, Neşat; Şahan, Leyla

    2014-01-01

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

  4. Predicting skeletal maturation using cervical vertebrae.

    PubMed

    Minars, Michael; Burch, James; Masella, Richard; Meister, Malcolm

    2003-10-01

    This study's objective was to familiarize the profession with determining skeletal maturation and skeletal age, and predicting growth potential by using cervical vertebrae images of lateral cephalograms. The investigation was done through repeated evaluations of 30 randomly selected, pretreatment lateral cepaholometric radiographs. The accuracy of determining skeletal age and growth potential with lateral cephalograms was found to be R=0.98 (highly accurate) by statistical analysis.

  5. January is Cervical Cancer Awareness Month

    Cancer.gov

    The Center for Global Health supports global activities to advance global cancer research, build expertise, and leverage resources across nations to address the challenges of cancer and reduce cancer deaths worldwide. Towards these aims, NCI has partnered with Pink Ribbon Red Ribbon, a global organization founded on public-private partnerships dedicated to saving women’s lives by advancing prevention, screening, and treatment for breast and cervical cancer in sub-Saharan Africa and Latin America.

  6. [Papillomavirus and cervical cancer in Chile].

    PubMed

    O'Ryan, Miguel; Valenzuela, María Teresa

    2008-11-01

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

  7. [Anterior spinal artery syndrome due to cervical spondylosis presenting as cervical angina].

    PubMed

    Odaka, Masaaki; Hirata, Koichi

    2004-11-01

    A 54-year-old woman developed acute progressive paraparesis after repeated precordial pain. Neurological examination revealed bilateral four-limb weakness predominant in the distal part of the upper limbs, upper limbs brisk tendon reflexes, superficial sensory impairment below the C8 level, and atonic bladder. T2-weighted cervical MRI disclosed hyperintense lesion with disc herniation in gray matter of spinal cord between C5 and C7. No vertebral artery abnormalities were detected. We hypothesized that she developed anterior spinal artery syndrome after cervical angina caused by cervical spondylosis. We conclude that physicians need to be aware of patients who experience chest pain without evidence of cardiac disease and that they take into consideration spinal cord infarction.

  8. Cervical chondrosarcoma- rare malignancy: a case report.

    PubMed

    Merchant, Shuaib; Mohiyuddin, S M Azeem; Rudrappa, Satish; Deo, R P; A, Sagayaraj; Menon, Lakshmi R

    2014-12-01

    To highlight an uncommon bone malignancy, which presented to our institute, as a neck swelling in the supraclavicular region. A 30 year old man presented with history of swelling on the left side of neck since 1 year and numbness of left upper limb since 6 months. Magnetic Resonance Imaging of the Cervical spine & MR Angiography showed a 7.4 × 4.6 cm expansile lesion involving transverse process of C5-C7 vertebrae. As the tumour was found to be deep to the phrenic nerve & brachial plexus, a dual approach was used, anteriorly via neck incision and posteriorly via the spine. The tumour was resected & iliac crest grafted along with stabilization of the cervical spine. Patient is disease free and the cervical spine stabilized with normal movements at two and half years follow up. We need to consider tumour arising from the vertebra as a differential diagnosis for any deep seated hard neck swelling in the supraclavicular region. Even low grade malignancy of this region when resected en-bloc will have a good prognosis.

  9. Chlamydia trachomatis cervicitis in gynecologic outpatients.

    PubMed

    Ripa, K T; Svensson, L; Mårdh, P A; Weström, L

    1978-12-01

    Symptoms suggestive of a lower genital tract infection (LGTI) are common complaints in women who consult gynecologists. Sexually transmitted microorganisms, such as Chlamydia trachomatis. Neisseria gonorrhoeae, and Trichomonas vaginalis, are responsible for a substantial proportion of LGTI. This study was performed to establish the frequency of LGTI caused by C trachomatis in women attending a gynecologic outpatient clinic. Of 170 women with LGTI, 32.9% harbored one or more of these organisms: C trachomatis was found in 19.3%, N gonorrhoeae in 4.7%, and T vaginalis in 25.9%. The results of the isolation studies were correlated with clinical signs and symptoms. In women under 25 years of age, chlamydial cervicitis was found significantly more often in users of oral contraceptives than in nonusers. In women not taking such drugs, cervical erosion was found more often in Chlamydia-positive than Chlamydia-negative women. Since clinical examination failed to reveal any characteristic signs in cases of chlamydial infection, it was not possible to distinguish a chlamydial from a gonococcal infection. This study also reports the successful treatment of 15 women affected by chlamydial cervicitis with doxycycline or trimethoprim sulphamethoxazole.

  10. Anaplastic extramedullary cervical ependymoma with leptomeningeal metastasis.

    PubMed

    Pomeraniec, I J; Dallapiazza, R F; Sumner, H M; Lopes, M B; Shaffrey, C I; Smith, J S

    2015-12-01

    We present a rare extramedullary ependymoma with diffuse spinal metastatic disease, and review the previous reports of extramedullary spinal ependymomas. Ependymomas are the most common intramedullary spinal cord tumor in adults. These tumors rarely present as extramedullary masses. We treated a 23-year-old man with a history of progressive neck, shoulder and arm pain, with sensory and motor symptoms in the C7 dermatome. MRI of the cervical spine demonstrated a ventral contrast-enhancing lesion with evidence of enhancement along the dura and spinal cord of the upper cervical spine, thoracic spine, and cauda equina. He underwent a tumor debulking procedure without complications. Following surgery, he received craniospinal radiation to treat the remaining tumor and diffuse leptomeningeal disease. The final pathology of the tumor revealed that is was a World Health Organization Grade III anaplastic ependymoma. At the 1 year follow-up, the patient had stable imaging and had returned to his preoperative functional status. Of the 19 reported patients with primary intradural, extramedullary spinal ependymomas, two had extradural components and seven had anaplastic grades. Only one tumor with an anaplastic grade resulted in metastatic disease, but without spinal recurrence. To our knowledge, this is the first report of an intradural, extramedullary spinal ependymoma with an anaplastic grade, presenting with concomitant diffuse, nodular leptomeningeal metastasis involving the upper cervical spine, thoracic spine, conus medullaris, and cauda equina. Similar to the treatment of intramedullary ependymomas with metastasis, this patient underwent an aggressive debulking procedure followed by radiation therapy to the entire neuroaxis.

  11. Cervical Necrotizing Fasciitis Caused by Dental Extraction

    PubMed Central

    Figueiredo, Eugênia; Álvares, Pâmella; Silva, Luciano; Silva, Leorik; Caubi, Antônio; Silveira, Marcia; Sobral, Ana Paula

    2016-01-01

    Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections. PMID:27375905

  12. Biology and treatment of cervical adenocarcinoma

    PubMed Central

    Takeuchi, Satoshi

    2016-01-01

    Uterine cervical adenocarcinoma (ADC) has been increasing in its prevalence world widely despite the decrease of squamous cell carcinoma (SCC). It comprises nearly 20-25% of the all cervical malignancy in developed countries. The worse biological behavior had been reported in patients with intermediate- and high risk factors after surgery, and in advanced stage over Ⅲ, radiotherapy (RT) alone and concurrent chemo-radiotherapy (CCRT) with cisplatin was not always effective. As for chemotherapy (CT), the induction CT has not established, as well. Further molecular targeted therapy (MTT) has been studied. The targets of oncogenic driver mutations were vascular endothelial growth factor (VEGF) in SCC, or tyrosine kinase (TK) of endothelial growth factor receptor 2 (EGFR2, Her2/neu)-Ras-MAPK-ERK pathway. Bevacizumab (Bev, anti-VEGF monoclonal antibody) is considered as one of key agent with paclitaxel and carboplatin in SCC, but not for ADC. This article focuses on up-to-date knowledge of biology and possible specific therapeutic directions to explore in the management of cervical ADC. PMID:27198186

  13. Cervical Necrotizing Fasciitis Caused by Dental Extraction.

    PubMed

    Arruda, José Alcides; Figueiredo, Eugênia; Álvares, Pâmella; Silva, Luciano; Silva, Leorik; Caubi, Antônio; Silveira, Marcia; Sobral, Ana Paula

    2016-01-01

    Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections.

  14. Is the cervical fascia an anatomical proteus?

    PubMed

    Natale, Gianfranco; Condino, Sara; Stecco, Antonio; Soldani, Paola; Belmonte, Monica Mattioli; Gesi, Marco

    2015-11-01

    The cervical fasciae have always represented a matter of debate. Indeed, in the literature, it is quite impossible to find two authors reporting the same description of the neck fascia. In the present review, a historical background was outlined, confirming that the Malgaigne's definition of the cervical fascia as an anatomical Proteus is widely justified. In an attempt to provide an essential and a more comprehensive classification, a fixed pattern of description of cervical fasciae is proposed. Based on the morphogenetic criteria, two fascial groups have been recognized: (1) fasciae which derive from primitive fibro-muscular laminae (muscular fasciae or myofasciae); (2) fasciae which derive from connective thickening (visceral fasciae). Topographic and comparative approaches allowed to distinguish three different types of fasciae in the neck: the superficial, the deep and the visceral fasciae. The first is most connected to the skin, the second to the muscles and the third to the viscera. The muscular fascia could be further divided into three layers according to the relationship with the different muscles.

  15. Detection of Human Papillomavirus in Chronic Cervicitis, Cervical Adenocarcinoma, Intraepithelial Neoplasia and Squamus Cell Carcinoma

    PubMed Central

    Mirzaie-Kashani, Elahe; Bouzari, Majid; Talebi, Ardeshir; Arbabzadeh-Zavareh, Farahnaz

    2014-01-01

    Background: Cervical cancer is the second most common cancer in women worldwide. Recent studies show that human papillomavirus (HPV) DNA is present in all cervical carcinomas and in some cervicitis cases, with some geographical variation in viral subtypes. Therefore determination of the presence of HPV in the general population of each region can help reveal the role of these viruses in tumors. Objectives: This study aimed to estimate the frequency of infection with HPV in cervicitis, cervical adenocarcinoma, intraepithelial neoplasia and squamus cell carcinoma samples from the Isfahan Province, Iran. Patients and Methods: One hundred and twenty two formalin fixed paraffin embedded tissue samples of crevicitis cases and different cervix tumors including cervical intraepithelial neoplasia (CIN) (I, II, III), squamus cell carcinoma (SCC) and adenocarcinoma were collected from histopathological files of Al-Zahra Hospital in Isfahan. Data about histopathological changes were collected by reexamination of the hematoxylin and eosin stained sections. DNA was extracted and subjected to Nested PCR using consensus primers, MY09/MY11 and GP5+/GP6+, designed for amplification of a conserved region of the genome coding for L1 protein. Results: In total 74.5% of the tested samples were positive for HPV. Amongst the tested tumors 8 out of 20 (40%) of CIN (I, II, III), 5 out of 21 (23.8%) of adenocarcinoma cases and 78 out of 79 chronic cervicitis cases were positive for HPV. Conclusions: The rate of different carcinomas and also the rate of HPV infection in each case were lower than other reports from different countries. This could be correlated with the social behavior of women in the area, where they mostly have only one partner throughout their life, and also the rate of smoking behavior of women in the studied population. On the other hand the rate of HPV infection in chronic cervicitis cases was much higher than cases reported by previous studies. This necessitates more

  16. Molecular diagnostic assays for cervical neoplasia: emerging markers for the detection of high-grade cervical disease.

    PubMed

    Malinowski, Douglas P

    2005-04-01

    The accurate detection and diagnosis of cervical carcinoma and its malignant precursors (collectively referred to as high-grade cervical disease) represents one of the current challenges in clinical medicine and cytopathology. The advent of molecular diagnostics and the use of whole-genome profiling using DNA microarrays promises to yield improved understanding of the disease process with the subsequent development of more accurate diagnostic procedures based upon these discoveries. Recent reports describing a variety of experimental approaches have identified a series of candidate genes that are overexpressed in cervical carcinoma. In this article, representative examples of these markers and the resulting translational research will be reviewed within the context of improved cervical disease detection. An emerging class of markers, the minichromosome maintenance protein family of DNA licensing factors (MCM-2, MCM-6, MCM-7), shows promise for the specific detection of high-grade cervical disease using simple antibody-based immunochemistry formats. These proteins are overexpressed in cervical disease as a result of infection by oncogenic strains of human papillomavirus (HPV) and subsequent uncontrolled activation of gene transcription and aberrant S-phase induction, mediated through the E2F transcription factor pathway. This behavior appears to be a hallmark of high-grade cervical disease and provides the link between oncogenic HPV infections and the molecular behavior of cervical neoplasia (CN). The use of these molecular descriptors of CN in simple immunochemistry formats compatible with conventional cytology preparations is anticipated to improve the screening and detection of cervical disease within the healthcare system.

  17. Effect of Acupressure on Cervical Ripening

    PubMed Central

    Torkzahrani, Shahnaz; Ghobadi, Khadighe; Heshmat, Reza; Shakeri, Nezhat; Jalali Aria, Katayoun

    2015-01-01

    Background: Cervical ripening is one of the main stages of initiation labor. Acupressure in Chinese medicine is considered as an invasive technique, which through reliving oxytocin ripens the cervix. Acupoint Sanyinjiao (SP6) was selected in this study because it is the acupoint selected in gynecology and it is easy for women to locate and apply pressure without medical assistance. Objectives: The aim of this study was to determine the effect of acupressure on cervical ripening. Patients and Methods: In this randomized clinical trial, 150 primigravida with term pregnancy who had referred to Deziani hospital in Gorgan were chosen and divided to three groups: in the first group acupressure was done by the researcher while in the second groups this was performed by the mother her self, and the third group served as a control and only received routine care. For both intervention groups the pressure was applied on Sp6 for about 20 minutes during one to five days. Elements were checked from cervical ripening at 48 and 96 hours after intervention and at the time of hospitalization. The tools for gathering information included demographic characteristics and midwifery history questionnaire, daily records and follow up forms. Content validity was used for validity of tools. Reliability of the observation check-list and physical examination was confirmed by inter-rater scores (inter observer), and daily records by test-re-test. Data was analyzed by analysis of variance (ANOVA), Kruskal-Wallis and Chi-squared tests (P ≤ 0.05). Results: There was a significant difference between mothers’ educations in the three groups. Most of the mothers (59.5%) in the researcher-performed acupressure group had secondary education. Cervical ripening was significantly different between the three groups after 48 hours (P ≤ 0.05), yet there was no significant difference after 96 hours and at the time of admission. Mean Bishop score was enhanced after 48 hours in the researcher

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

    PubMed

    Breitenecker, G

    2009-12-01

    Despite the undisputed and impressive success which has been achieved since the 1960s by cervical cytology in the fight against cervical cancer and its precursor stages, during which the mortality rate in industrialized countries over the last 40 years has been reduced by two-thirds to three-quarters, a perfect and error-free screening procedure is still a long way off and will probably never be reached. There are two main reasons for this, the lack of adequate coverage and suboptimal quality and assessment of smears. Two screening procedures are in use Europe, an opportunistic and an organized system. Both systems have many advantages but also disadvantages. In organized programs the coverage is higher (up to 80%), although similar numbers are also achieved by non-organized programs over a 3-year cycle, even if they cannot be so exactly documented. The decision on which system is used depends on the health system of the country, public or non-public, and many other national circumstances. However, in both systems prerequisites for a satisfactory result is a high quality in the sampling technique, the processing and the assessment. Therefore, several guidelines have been introduced by state and medical societies for internal and external quality assurance. New technologies, such as thin-layer cytology or automation for replacement or support of conventional cytology liquid-based cytology proved not to be superior enough to justify the high costs of these systems. The recognition of the strong causal relationship between persistent infection with high-risk human papillomavirus (HPV) types and cervical cancer and its precursors has resulted in the development of comparably simple tests. Primary screening using HPV typing alone is not recommended in opportunistic screening due to the low specificity but high sensitivity because it leads to many clinically irrelevant results which place women under stress. In organized screening HPV testing is always and only possible

  19. Wnt-11 overexpression promoting the invasion of cervical cancer cells.

    PubMed

    Wei, Heng; Wang, Ning; Zhang, Yao; Wang, Shizhuo; Pang, Xiaoao; Zhang, Shulan

    2016-09-01

    Wnt-11 is a positive regulator of the Wnt signaling pathway, which plays a crucial role in carcinogenesis. However, Wnt-11 expression in cervical cancer has not been well investigated. The aim of this study was to investigate the role of Wnt-11 in cervical tumor proliferation and invasion. This study examined 24 normal cervical squamous epithelia, 29 cervical intraepithelial neoplasia (CIN), and 78 cervical cancer samples. The expression of Wnt-11 was investigated by immunohistochemistry and quantitative reverse transcription-polymerase chain reaction analysis. The expression of the high-risk human papilloma virus (HR-HPV) E6 oncoprotein was also investigated by immunohistochemistry. In addition, the expression of Wnt-11, HR-HPV E6, JNK-1, phosphorylated JNK-1(P-JNK1), and β-catenin was examined by western blot analysis following Wnt-11 knockdown or overexpression in HeLa or SiHa cells, respectively. The promotion of cervical cancer cell proliferation and invasion was investigated using the cell counting kit-8 and Matrigel invasion assay, respectively. Wnt-11 and HR-HPV E6 expression increased in a manner that corresponded with the progression of cervical cancer and was significantly correlated with the International Federation of Gynecology and Obstetrics cancer stage, lymph node metastasis, tumor size, and HPV infection. Wnt-11 protein expression was positively associated with HR-HPV E6 protein expression in all 78 cervical cancer samples (P < 0.001). Furthermore, Wnt-11 was positively associated with P-JNK1 expression and promoted cervical cancer cell proliferation and invasion. These observations suggest that the increased Wnt-11 expression observed in cervical cancer cells may lead to the phosphorylation and activation of JNK-1 and significantly promote tumor cell proliferation and cell migration/invasion through activation of the Wnt/JNK pathway. Consequently, Wnt-11 may serve as a novel target for cervical cancer therapy.

  20. Association between war and cervical cancer among Vietnamese women.

    PubMed

    Huynh, My Linh D; Raab, Stephen S; Suba, Eric J

    2004-07-10

    Decades ago, cervical cancer was the leading form of cancer among women in both North Vietnam and South Vietnam. Currently, cervical cancer rates are considerably lower in the northern region of the country. We performed a case-control study to measure factors associated with the development of cervical cancer among Vietnamese women. Questionnaire-based interviews were conducted with 202 women in southern Vietnam and 97 women in northern Vietnam. Case subjects were women hospitalized with cervical cancer. Control subjects were women hospitalized with extrauterine neoplasms. Data were analyzed using logistic regression, and odds ratios for the development of invasive cervical cancer were measured. The development of invasive cervical cancer was significantly associated with military service by husbands during the Second Indochinese War and with parity status. Odds ratio for the development of cervical cancer among southern Vietnamese women whose husbands had served in the armed forces was 2.6 (95% CI = 1.2-5.5). Odds ratio for the development of cervical cancer among northern women whose husbands had served in the armed forces was 3.9 (95% CI = 1.5-10.4) if their husbands had been stationed in South Vietnam during the war years. Northern women whose husbands had served in the military experienced no significant increase in cervical cancer risk if their husbands had been stationed in North Vietnam during the war years. Geographic and temporal variation in cervical cancer rates among Vietnamese women was associated with the movement of soldiers. These findings may be useful for cervical cancer prevention efforts in Vietnam and in other countries.