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Sample records for radiation myelopathy experimentelle

  1. Radiation myelopathy.

    PubMed Central

    Sanyal, B; Pant, G C; Subrahmaniyam, K; Agrawal, M S; Mohanty, S

    1979-01-01

    Five cases of radiation myelopathy were found in a total of 10,000 cases given radiotherapy from 1968 to 1977. The clinical presentation and treatment details including the total dose, treatment volume, number of fractionations, overall time, and the RET value at the spinal cord were calculated and compared with other reports on this subject. The total number of fractionations ranged from 20 to 26 with an overall time of 32 days to 37 days. The dose received by four patients ranged from 1030 to 1900 RET, a little higher than the tolerance level of the spinal cord as compared to reported values. Two patients in this series had high blood pressure. The incidence of radiation myelopathy, already acceptably low, could possibly be reduced further by meticulous planning of radiation. PMID:448380

  2. Observations on radiation myelopathy.

    PubMed

    Godwin-Austen, R B; Howell, D A; Worthington, B

    1975-12-01

    Three cases of radiation myelopathy are reported. Corticosteroid therapy was associated with worth-while remissions in 2 patients. Two patients showed swelling of the spinal cord in myelograms and in one it extended below the irradiated part of the spinal cord. Demyelination of the dorsal white columns of the spinal cord unaccompanied by vascular abnormality was seen below the irradiated part of the cord. It is suggested that radiation damages the endothelial cell barrier of capillaries and arterioles after a latent interval. Proteinous oedema fluid spreads through the white matter from the capillaries and also into the arteriolar walls narrowing these vessels enough to cause local ischaemia and infarction. It is further suggested that apart from ischaemia and infarction myelin is also damaged by poor nutrition associated with oedema fluid, and that radiation damage to oligodendroglial cells is not the cause of this additional demyelination in patients with radiation myelopathy.

  3. Pathology of radiation myelopathy

    PubMed Central

    Burns, R. J.; Jones, A. N.; Robertson, J. S.

    1972-01-01

    After nothing the rarity of papers describing the pathology of delayed radiation necrosis of the spinal cord, the clinical and pathological findings from four cases are presented. The main pathological features are asymmetric demyelination of the lateral columns and to a lesser degree the posterior and anterior columns of white matter, with coagulative necrosis at the level of irradiation which affected the grey matter to a lesser degree. There is ascending and descending secondary tract degeneration, and poor glial response in the lesions themselves. Vascular changes, mainly hyalilne thickening of arteriolar walls, are present, but not in degree sufficient to explain the primary lesion. The discussion of the pathogenesis of the myelopathy weighs the merits of a primary vascular lesion against those of a primary effect of the radiation on neural tissue. The latter is favoured. Images PMID:4647860

  4. Latent period in clinical radiation myelopathy

    SciTech Connect

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

    1984-07-01

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

  5. Radiation myelopathy of cervical spinal cord simulating intramedullary neoplasm

    PubMed Central

    Fogelholm, R.; Haltia, M.; Andersson, L. C.

    1974-01-01

    Radiation myelopathy is a well-known complication of irradiation therapy of neoplasms in the vicinity of the spinal cord. Most earlier authors have stressed the association of a normal myelogram and normal CSF protein level with this condition. One case of radiation myelopathy with a myelogram simulating intramedullary neoplasm and with extremely high CSF protein concentration is presented. Six months after myelography necropsy revealed severe atrophy of the previously thickened lower cervical spinal cord. The pathogenetic mechanisms are discussed. Images PMID:4443812

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

    SciTech Connect

    Sahgal, Arjun; Weinberg, Vivian; Ma, Lijun; Chang, Eric; Chao, Sam; Muacevic, Alexander; Gorgulho, Alessandra; Soltys, Scott; Gerszten, Peter C.; Ryu, Sam; Angelov, Lilyana; Gibbs, Iris; Wong, C. Shun; Larson, David A.

    2013-02-01

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

  7. HEREDITARY MYELOPATHIES

    PubMed Central

    Fink, John K.

    2009-01-01

    Hereditary myelopathies are a diverse group of disorders in which major aspects of the clinical syndrome involve spinal cord structures. Hereditary myelopathic syndromes can be recognized as four clinical paradigms: (1) spinocerebellar ataxia, (2) motor neuron disorder, (3) leukodystrophy, and (4) distal motor-sensory axonopathy. This review illustrates these hereditary myelopathy paradigms with clinical examples with an emphasis on clinical recognition and differential diagnosis. PMID:20148180

  8. Tropical myelopathies.

    PubMed

    Román, Gustavo C

    2014-01-01

    A large number of causal agents produce spinal cord lesions in the tropics. Most etiologies found in temperate regions also occur in the tropics including trauma, herniated discs, tumors, epidural abscess, and congenital malformations. However, infectious and nutritional disorders occur with higher prevalence in tropical regions. Among the most common infectious etiologies are tuberculous Pott's disease, brucellosis, and neuroborreliosis. Parasitic diseases such as schistosomiasis, neurocysticercosis, and eosinophilic meningitis are frequent causes of nontraumatic paraplegia. The retrovirus HTLV-1 is a cause of tropical spastic paraparesis. Nutritional causes of paraparesis include deficiencies of vitamin B12 and folate; endemic clusters of konzo and tropical ataxic myeloneuropathy are associated in Africa with malnutrition and excessive consumption of cyanide-containing bitter cassava. Other toxic etiologies of tropical paraplegia include lathyrism and fluorosis. Nutritional forms of myelopathy are associated often with optic and sensory neuropathy, hence the name tropical myeloneuropathies. Acute transverse myelopathy is seen in association with vaccination, infections, and fibrocartilaginous embolism of the nucleus pulposus. Multiple sclerosis and optic myelopathy occur in the tropics but with lesser prevalence than in temperate regions. The advent of modern imaging in the tropics, including computed tomography and magnetic resonance imaging, has allowed better diagnosis and treatment of these conditions that are a frequent cause of death and disability.

  9. ACR Appropriateness Criteria Myelopathy.

    PubMed

    Roth, Christopher J; Angevine, Peter D; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fries, Ian Blair; Holly, Langston T; Kendi, Ayse Tuba Karaqulle; Kessler, Marcus M; Kirsch, Claudia F; Luttrull, Michael D; Mechtler, Laszlo L; O'Toole, John E; Sharma, Aseem; Shetty, Vilaas S; West, O Clark; Cornelius, Rebecca S; Bykowski, Julie

    2016-01-01

    Patients presenting with myelopathic symptoms may have a number of causative intradural and extradural etiologies, including disc degenerative diseases, spinal masses, infectious or inflammatory processes, vascular compromise, and vertebral fracture. Patients may present acutely or insidiously and may progress toward long-term paralysis if not treated promptly and effectively. Noncontrast CT is the most appropriate first examination in acute trauma cases to diagnose vertebral fracture as the cause of acute myelopathy. In most nontraumatic cases, MRI is the modality of choice to evaluate the location, severity, and causative etiology of spinal cord myelopathy, and predicts which patients may benefit from surgery. Myelopathy from spinal stenosis and spinal osteoarthritis is best confirmed without MRI intravenous contrast. Many other myelopathic conditions are more easily visualized after contrast administration. Imaging performed should be limited to the appropriate spinal levels, based on history, physical examination, and clinical judgment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  10. Degenerative myelopathy in an adult miniature poodle.

    PubMed

    Matthews, N S; de Lahunta, A

    1985-06-01

    Degenerative myelopathy was diagnosed at necropsy of an adult Miniature Poodle with a 33-month history of progressive pelvic limb ataxia and proprioceptive deficit. Microscopic examination of the cord revealed diffuse degenerative myelopathy. Degenerative myelopathy is usually seen in adult, large-breed dogs and progresses over a period of months. In this case, the myelopathy progressed slowly and the degree of paralysis became more extensive than usually seen.

  11. Alcoholic Myelopathy and Nutritional Deficiency

    PubMed Central

    Koike, Haruki; Nakamura, Tomohiko; Ikeda, Shohei; Takahashi, Mie; Kawagashira, Yuichi; Iijima, Masahiro; Katsuno, Masahisa; Sobue, Gen

    2017-01-01

    A patient with chronic alcoholism presented with myelopathy and low serum folate and cobalamin levels. A 42-year-old alcoholic man had gait disturbance for 4 months. A neurological examination revealed marked spasticity with increased deep tendon reflexes and extensor plantar responses of the lower limbs. His cobalamin level was decreased and his serum folate level was particularly low. His plasma ammonia level was not increased. Abstinence and folic acid and cobalamin supplementation stopped the progression of his neurological deficits. This case indicates that nutritional deficiency should be monitored closely in patients with chronic alcoholism who present with myelopathy. PMID:28049986

  12. 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

  13. Nontraumatic Myelopathy Associated With Surfing

    PubMed Central

    Avilés-Hernández, Israel; García-Zozaya, Inigo; DeVillasante, Jorge M

    2007-01-01

    Background/Objective: Ischemic nontraumatic spinal cord injury associated with surfing is a novel diagnosis believed to be related to prolonged spine hyperextension while lying prone on the surfboard. Only 9 cases have been documented. This report features possible risk factors, etiology, diagnostic imaging, and outcomes of surfer's myelopathy. Design: Case report. Results: A 37-year-old man developed T11 American Spinal Injury Association (ASIA) A paraplegia shortly after surfing. The clinical history and magnetic resonance imaging findings were compatible with an ischemic insult to the distal thoracic spinal cord. Our patient did not have any of the proposed risk factors associated with this condition, and, contrary to most reports, he sustained a complete spinal cord lesion without neurological recovery by 8 weeks post injury. Conclusions: Surfer's myelopathy, because of its proposed mechanism of injury, is amenable to medical intervention. Increased awareness of this condition may lead to early recognition and treatment, which should contribute to improved neurological outcomes. PMID:17684897

  14. Acute transverse myelopathy complicating systemic lupus erythematosus.

    PubMed Central

    Propper, D J; Bucknall, R C

    1989-01-01

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

  15. Complete paraplegia resulting from surfer's myelopathy.

    PubMed

    Takakura, Tomokazu; Yokoyama, Osamu; Sakuma, Fujiko; Itoh, Ryousuke; Romero, Ray R

    2013-09-01

    Three patients with diagnoses of surfer's myelopathy (24-31 yrs old; two men, one woman) were admitted to our rehabilitation hospital. All three patients were novice surfers and had a typical clinical course of onset: rapid progression of paraplegia after back pain while taking surfing lessons. Despite months of rehabilitation at our hospital, in all three patients, complete paraplegia (T9-T12) and bladder-bowel dysfunction remained. Our case profiles suggest that the neurologic outcome of surfer's myelopathy is potentially catastrophic, as has been suggested in previous reports. Surfer's myelopathy has been estimated to be an ischemic thoracic myelopathy. From our case profiles and review of the literature, not only the prolonged prone hyperextended posture of paddling but also the repetitive mechanical stress caused by flexion-extension of the spinal column may be related to its pathogenesis. To prevent surfer's myelopathy and to avoid progressive deterioration of neurologic function, increased education and awareness are essential.

  16. Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

    PubMed Central

    Kayal, Ashok Kumar; Goswami, Munindra; Das, Marami; Basumatary, Lakhshya Jyoti; Bhowmick, Suvorit Subhas; Synmon, Baiakmenlang

    2017-01-01

    Background: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. Materials and Methods: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM) and chronic myelopathy (CM). In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement. Results: The study had 151 patients (96 ASM and 55 CM) with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23), multiple sclerosis (MS) (8), systemic lupus erythematosus (1), Hashimoto's disease (1), postinfectious acute disseminated encephalomyelitis (6), postinfectious myelitis (8), infections (9), spinal cord infarct (5), and electrocution (1). The causes of CM were MS (1), probable or possible sarcoidosis (7), mixed connective tissue disease (1), Hashimoto's disease (2), infections (9), Vitamin B12 deficiency (4), folate deficiency (2), hepatic myelopathy (2), radiation (11), and paraneoplastic (1). No etiology could be found in 48 (31.8%) patients (34 ASM and 14 CM). In 21/96 (21.9%) patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria. Conclusion: Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 68% patients of

  17. Sudden myelopathy secondary to therapeutic total-body hyperthermia after spinal-cord irradiation

    SciTech Connect

    Douglas, M.A.; Parks, L.C.; Bebin, J.

    1981-03-05

    Hyperthermia is a new method of treatment receiving increasing clinical attention in cancer therapy. Its efficacy has been well demonstrated in animals, but its indications, contraindications, and appropriate place in cancer therapy have yet to be defined. We report three cases of acute myelopathy in patients undergoing hyperthermia after spinal-cord irradiation within the preceding two months. Post-mortem examination in one case revealed findings similar to those seen in myelopathy resulting from long-term irradiation. Several neurologic side effects have been reported previously with total-body hyperthermia - most commonly peripheral neuropathy, but not myelopathy. The mechanism of action of hyperthermia in cancer therapy (with or without prior irradiation) is unknown. The experience reported suggests that in some patients hyperthermia may potentiate radiation-induced damage to the spinal cord or otherwise interact to cause acute spinal-cord necrosis.

  18. 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

  19. Motor conduction measurement in myelopathy hand

    PubMed Central

    Shibuya, Ryoichi; Wada, Eiji; Iwasaki, Motoki; Yonenobu, Kazuo; Yoshikawa, Hideki

    2014-01-01

    Summary We studied the relationship between intramedullary high signal intensity (IMHSI) on T2-weighted magnetic resonance images and motor conduction in the spinal cords of cervical spondylotic myelopathy (CSM) patients. There was no significant difference between the biceps or triceps central motor conduction times (CMCTs) of the patients who did and did not exhibit IMHSI, whereas the abductor pollicis brevis CMCT was significantly longer in the patients who exhibited IMHSI (p<0.05) than in those who did not. The CMCT of the abductor pollicis brevis is sensitive to the degree of damage in the cervical spinal cord. Hand dysfunction is a characteristic of CSM regardless of the cervical level affected by the condition. The motor fibers innervating the intrinsic muscles of the hand in the long tract of the cervical spinal cord are more sensitive than other motor fibers. For this reason, we consider that myelopathy hand is a characteristic impairment of CSM. Transcranial magnetic stimulation of the hand motor cortex is useful for the evaluation of cervical myelopathy. PMID:25473737

  20. Scapular winging as a symptom of cervical flexion myelopathy.

    PubMed

    Yaguchi, Hiroaki; Takahashi, Ikuko; Tashiro, Jun; Tsuji, Sachiko; Yabe, Ichiro; Sasaki, Hidenao

    2007-01-01

    A 23-year-old man complained of weakness of the right arm that he first noted six years prior to his visit. Neurological examination revealed atrophy and weakness of the triceps and serratus anterior muscle on the right side, which resulted in scapular winging on that side. MRI with neck flexion revealed compression of the cervical cord enabling a diagnosis of flexion myelopathy. Proximal muscle weakness and atrophy in flexion myelopathies including Hirayama disease are extremely rare. Here, we report a case of unilateral, proximal upper limb atrophy with scapular winging, attributed to middle cervical flexion myelopathy.

  1. Acute compressive myelopathy due to vertebral haemangioma.

    PubMed

    Macki, Mohamed; Bydon, Mohamad; Kaloostian, Paul; Bydon, Ali

    2014-04-28

    A 47-year-old woman with a history of anaemia presented to the emergency room with an acute onset of leg weakness. Physical examination of the bilateral lower extremities was significant for 0/5 muscle strength in all muscle groups with decreased pinprick and temperature sensation. A sensory level at the umbilicus was appreciated. Fine touch and proprioception were preserved. Bowel and bladder function were intact. CT revealed several thoracic, vertebral haemangiomatas. An MRI was suggestive of an epidural clot at the T8-T10-weighted posterior epidural space. At the level of the lesion, the cerebrospinal fluid space was completely effaced, and the flattened spinal cord exhibited signs of oedema and compressive myelopathy. The patient immediately underwent surgical decompression of the spinal cord. An epidural clot and vessel conglomeration were identified. A postoperative spinal angiogram confirmed the diagnosis of vertebral haemangioma. At 1-month follow-up, the patient regained strength and sensation.

  2. Ayurvedic management in cervical spondylotic myelopathy.

    PubMed

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    The age related spondylotic changes may result in direct compressive and ischemic dysfunction of the spinal cord known as cervical spondylotic myelopathy (CSM). Symptoms often develop insidiously and are characterized by neck stiffness, unilateral or bilateral deep aching neck, arm and shoulder pain, and possibly stiffness or clumsiness while walking. The management available in current mainstream medicine is not satisfactory. Various Ayurvedic treatments have been in use for these manifestations. We present a case of CSM, which was treated with a combination of Panchakarma procedures and Ayurvedic oral drugs. The patient was considered suffering from Greevastambha (neck stiffness) and was treated with Shalishastika pinda svedana (sudation with medicated cooked bolus of rice) for one month and Mustadi yapana basti (enema with medicated milk) for 16 days along with oral Ayurvedic drugs such as Brihatavata chintamani rasa 50 mg, Ekangaveer ras-250 mg, Ardhangavatari rasa-125 mg Amrita satva (dry extract of Tinospora cordifolia Willd)-500 mg, Muktasukti pisti-500 mg, Ashwagandha churna (powder of Withania somnifera Dunal)-500 mg Dashmool kvatha ghana (solid extract of Dashmool kvatha)-500 mg, Trayodashanga guggulu-575 mg, twice a day with honey and Eranda paka-10 g twice a day with milk. Patient's condition which was assessed for symptoms of CSM and Chile's modified Japanese Orthopaedic Association (mJOA) score for cervical spondylotic myelopathy showed substantial improvement. This study shows that the cases of CSM may be successfully managed with Ayurvedic treatment.

  3. Myelopathy following intrathecal chemotherapy in adults: a single institution experience.

    PubMed

    Cachia, David; Kamiya-Matsuoka, Carlos; Pinnix, Chelsea C; Chi, Linda; Kantarjian, Hagop M; Cortes, Jorge E; Daver, Naval; Woodman, Karin

    2015-04-01

    Methotrexate and cytarabine arabinoside are frequently administered intrathecally in the prophylaxis and treatment of patients with hematological malignancies. Myelopathy as a complication of intrathecal (IT) chemotherapy is rare in adults, with most of the cases described in the literature occurring in the pediatric population. Between January 2010 and March 2014, 587 newly diagnosed B cell acute lymphoblastic leukemia and 24 chronic myeloid leukemia lymphoid blast phase patients were seen at The University of Texas MD Anderson Cancer Center. This case series discusses seven adult cases deemed to have IT chemotherapy-induced myelopathy between 2010 and 2014 at MD Anderson Cancer Center. Five out of the seven patients had T2 abnormalities involving the dorsal columns of the spinal cord. An elevated myelin basic protein level was noted in the two patients in whom it was checked. The wide range of dosage and timing with respect to IT chemotherapy administration suggests an idiosyncratic reaction or individual threshold to the development of myelopathy. By describing the largest case series of myelopathy in adults, we aim to raise awareness about this rare albeit devastating complication. Based on the seven cases described we would recommend-MRI of the spine with T2-weighted imaging in the sagittal and axial planes in leukemia patients with unexplained myelopathy and consideration to delay IT chemotherapy until after an extensive work-up to rule out CNS leukemia. Though more data are needed on the use of folate metabolites, preliminary results have shown some promise in the treatment of methotrexate-induced myelopathy and may be a potential consideration for future patients suspected to have chemotherapy induced myelopathy.

  4. [Acute non-traumatic myelopathy in children and adolescents].

    PubMed

    Arroyo, Hugo A

    2013-09-06

    The term 'acute myelopathies'--referred to a spinal cord dysfunction--represent a heterogeneous group of disorders with distinct etiologies, clinical and radiologic features, and prognoses. The objective of this review is to discuss the non-traumatic acute myelopathies. Acute myelopathy can be due to several causes as infective agents or inflammatory processes, such as in acute myelitis, compressive lesions, vascular lesions, etc. The clinical presentation is often dramatic with tetraparesis or paraparesis, sensory disturbances and bladder and/or bowel dysfunction. History and physical examination are used to localize the lesion to the root or specific level of the cord, which can guide imaging. Different syndromes are recognized: complete transverse lesion, central grey matter syndrome, anterior horn syndrome, anterior spinal artery syndrome, etc). The first priority is to rule out a compressive lesion. If a myelopathy is suspected, a gadolinium-enhanced MRI of the spinal cord should be obtained as soon as possible. If there is no structural lesion such as epidural blood or a spinal mass, then the presence or absence of spinal cord inflammation should be documented with a lumbar puncture. The absence of pleocytosis would lead to consideration of non inflammatory causes of myelopathy such as arteriovenous malformations, fibrocartilaginous embolism, or possibly early inflammatory myelopathy. In the presence of an inflammatory process (defined by gadolinium enhancement, cerebrospinal fluid pleocytosis, or elevated cerebrospinal fluid immunoglobulin index), one should determine whether there is an inflammatory or an infectious cause. Different virus, bacterias, parasites and fungi have to be considered as autoimmune and inflammatory diseases that involve the central nervous system.

  5. Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

    PubMed

    Wenger, Markus; Markwalder, Thomas-Marc

    2016-04-01

    This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed.

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

    PubMed

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

    2014-01-01

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

  7. Cervical Spondylotic Myelopathy: What the Neurologist Should Know

    PubMed Central

    de Oliveira Vilaça, Celmir; Orsini, Marco; Leite, Marco A. Araujo; de Freitas, Marcos R.G.; Davidovich, Eduardo; Fiorelli, Rossano; Fiorelli, Stenio; Fiorelli, Camila; Oliveira, Acary Bulle; Pessoa, Bruno Lima

    2016-01-01

    Cervical spondylotic myelopathy is a well-known cause of disability among older people. A significant amount of these patients is asymptomatic. Once the symptoms start, the worsening may follow a progressive manner. We should suspect of spondylotic myelopathy in any individual over 55 years presenting progressive changes in gait or losing fine motor control of the upper limbs. Despite its frequent prevalence, this condition is still neglected and many times confused with other supratentorial lesions regarding diagnostic. Here we address some of most important aspects of this disease, calling attention to pathophysiology, the natural history, presentation, differential diagnosis, clinical assessment, and treatment. PMID:27994827

  8. Treatment of Portosystemic Shunt Myelopathy with a Stent Graft Deployed through a Transjugular Intrahepatic Route

    SciTech Connect

    Jain, Deepak Arora, Ankur; Deka, Pranjal; Mukund, Amar Bhatnagar, Shorav; Jindal, Deepti Kumar, Niteen Pamecha, Viniyendra

    2013-08-01

    A case of surgically created splenorenal shunt complicated with shunt myelopathy was successfully managed by placement of a stent graft within the splenic vein to close the portosystemic shunt and alleviate myelopathy. To our knowledge, this is the first report of a case of shunt myelopathy in a patient with noncirrhotic portal fibrosis without cirrhosis treated by a novel technique wherein a transjugular intrahepatic route was adopted to deploy the stent graft.

  9. Arachnoiditis Ossificans - A Rare Cause of Progressive Myelopathy.

    PubMed

    Steel, Christopher J; Abrames, Erik L; O'Brien, William T

    2015-01-01

    Arachnoiditis ossificans is a rare cause of chronic, progressive myelopathy. In contrast to the more common benign causes of meningeal calcification, arachnoiditis ossificans results in replacement of portions of the spinal arachnoid by bone as an end-stage complication of adhesive arachnoiditis. It is usually the sequela of prior trauma or interventional procedures. Prognosis and treatment options depend upon the location and degree of spinal stenosis with thoracic involvement being more common and more severe than lumbar spine involvement. The imaging findings on magnetic resonance imaging may be confusing; however, the findings of intraspinal ossification on computed tomography are characteristics and diagnostic. We present a classic case of arachnoiditis ossificans in an elderly man who presented with progressive myelopathy and a recent fall, along with a review of the literature. The imaging in this case not only identified the characteristic findings of arachnoiditis ossificans but also identified secondary findings of the underlying causative etiology.

  10. Arachnoiditis Ossificans – A Rare Cause of Progressive Myelopathy

    PubMed Central

    Steel, Christopher J; Abrames, Erik L; O’Brien, William T

    2015-01-01

    Arachnoiditis ossificans is a rare cause of chronic, progressive myelopathy. In contrast to the more common benign causes of meningeal calcification, arachnoiditis ossificans results in replacement of portions of the spinal arachnoid by bone as an end-stage complication of adhesive arachnoiditis. It is usually the sequela of prior trauma or interventional procedures. Prognosis and treatment options depend upon the location and degree of spinal stenosis with thoracic involvement being more common and more severe than lumbar spine involvement. The imaging findings on magnetic resonance imaging may be confusing; however, the findings of intraspinal ossification on computed tomography are characteristics and diagnostic. We present a classic case of arachnoiditis ossificans in an elderly man who presented with progressive myelopathy and a recent fall, along with a review of the literature. The imaging in this case not only identified the characteristic findings of arachnoiditis ossificans but also identified secondary findings of the underlying causative etiology. PMID:26401174

  11. HTLV-1-associated myelopathy in a solid organ transplant recipient.

    PubMed

    Montesdeoca Andrade, Maria Jose; Correa Diaz, Edgar Patricio; Buestán, Maria Eugenia

    2016-06-06

    Human T-cell lymphotropic virus type-1 (HTLV-1) is endemic in Japan, the Caribbean and in South American countries such as Ecuador. This virus is the cause of HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), a myelopathy characterised by chronic progressive paraparesis, spasticity and urinary symptoms. We report the case of a 40-year-old man who received a kidney transplant from a living donor and developed HAM/TSP, 24 months after transplant. The diagnosis was confirmed by detection of HTLV-1 in blood and cerebrospinal fluid by the ELISA and Western Blot tests. For myelopathy, the patient was treated with pulse methylprednisolone, but had poor response to treatment. We recommend that all patients receiving transplants and their donors who come from endemic countries be given a mandatory screening for HTLV-1 through an ELISA test, in an effort to inform candidates for renal transplantation of the potential risk of infection and the development of this disease.

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

    PubMed

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

    1991-07-01

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

  13. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation

    PubMed Central

    Kim, Jin Bum; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-01-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic deformity of upper cervical spine, which has been usually indicative to craniocervical fixation. One patient was referred due to quadriparesis detected after surgery for aortic arch aneurysmal dilatation. The other patient was referred to us due to paraparesis and radiating pain in all extremities developed during gynecological examinations. Decompressive C1 laminectomy was done for one patient and additional suboccipital craniectomy for the other. No craniocervical fixation was done because there was no spinal instability. Motor power improved immediately after the operation in both patients. Motor functions and spinal stability were well preserved in both patients for 2 years. In KFS patients with myelopathy at the C1 level without C1-2 instability, a favorable outcome could be achieved by a simple decompression without spinal fixation. PMID:26512291

  14. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation.

    PubMed

    Kim, Jin Bum; Park, Seung Won; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-09-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic deformity of upper cervical spine, which has been usually indicative to craniocervical fixation. One patient was referred due to quadriparesis detected after surgery for aortic arch aneurysmal dilatation. The other patient was referred to us due to paraparesis and radiating pain in all extremities developed during gynecological examinations. Decompressive C1 laminectomy was done for one patient and additional suboccipital craniectomy for the other. No craniocervical fixation was done because there was no spinal instability. Motor power improved immediately after the operation in both patients. Motor functions and spinal stability were well preserved in both patients for 2 years. In KFS patients with myelopathy at the C1 level without C1-2 instability, a favorable outcome could be achieved by a simple decompression without spinal fixation.

  15. Current techniques in the management of cervical myelopathy and radiculopathy.

    PubMed

    Gerard, Carter S; O'Toole, John E

    2014-04-01

    Posterior decompressive procedures are a fundamental component of the surgical treatment of symptomatic cervical degenerative disease. Posterior approaches have the appeal of avoiding complications associated with anterior approaches such as esophageal injury, recurrent laryngeal nerve paralysis, dysphagia, and adjacent-level disease after fusion. Although open procedures are effective, the extensive subperiosteal stripping of the paraspinal musculature leads to increased blood loss, longer hospital stays, and more postoperative pain, and potentially contributes to instability. Minimally invasive access has been developed to limit approach-related morbidity. This article reviews current techniques in minimally invasive surgical management of cervical myelopathy and radiculopathy.

  16. Acute Tetraplegia after Posterior Cervical Laminectomy for Chronic Myelopathy.

    PubMed

    Iorio, Justin A; Jakoi, Andre M; Wetzel, Franklin T

    2015-11-01

    Spinal cord injury (SCI) during revision surgery for persistent multilevel cervical myelopathy (MCM) after an initial anterior procedure is rare. However, the pathophysiology of MCM, even prior to surgery, is a risk-factor for neurological deterioration due to the development of a "sick cord", which reflects pathological changes in the spinal cord that lower the threshold for injury. We report a case of persistent MCM despite a three-level ACDF and corpectomy who developed an incomplete C6 tetraplegia during revision cervical laminectomy and posterior instrumentation. Intraoperative neuromonitoring signal-changes occurred in the absence of mechanical trauma. Postoperative MRI of the cervical spine demonstrated increased T2 hyperintensity and cord expansion at C3 and C4 compared to the pre-laminectomy MRI. The patient has not made improvements in her neurological status at 13 months postoperatively. The pathophysiology of MCM is discussed in addition to perioperative imaging, neuromonitoring, and use of steroids.

  17. Cervical spondylotic myelopathy: Part II: clinical and imaging considerations *

    PubMed Central

    Burns, SH; O’Connor, SM; Mior, SA

    1991-01-01

    In this, the second of a two part series, we continue to review the recent literature pertaining to cervical spondylotic myelopathy (CSM). Caused by the compromise of the spinal canal resulting from the superimposition of spondylotic changes upon a congenitally narrowed canal, CSM has a predictable radiographic and clinical presentation. The clinical presentation frequently includes both upper and lower motor neuron signs and symptoms. Careful analysis of the plain film images usually reveals a spinal canal measuring 12 mm or less. Additional imaging modalities confirm the diagnosis. This paper presents the clinical and imaging characteristics underlying CSM and stresses the importance of including CSM in the differential diagnosis of patients complaining of neck and leg dysfunctions. ImagesFigure 1Figure 2Figure 3Figure 4

  18. 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.

  19. [Myelopathies in impairment of extravertebral venous blood circulation].

    PubMed

    Tsuladze, I I; Dreval', O N; Kornienko, V N

    2009-01-01

    Development of myelopathies of venous genesis is based on venous hypertension inside vertebral canal which was initially described by J. Aboulker. According to anatomical and functional features of epidural venous system, two factors contribute in development of venous congestion: decreased outflow and increased inflow. Clinical manifestation is presented by spastic movement disorders. Morphological study performed in 18 cadavers allowed to discover so called 'narrow areas' which cause impaired circulation through large feeders of caval veins, which can be discovered by selective phlebography. Main phlebographic features include stenosis, compression, atresia, thrombosis and retrograde flow towards epidural venous plexus. We examined 58 patients with spastic para- and tetraparesis of unknown nature. Phlebographic signs of venous dyscirculation were revealed in 34 cases. 28 surgical operations were performed: 24 on feeders of vena cava superior and 4 on feeders of vena cava inferior. In 18 cases we obtained satisfactory results. This investigation should be continued.

  20. Cervical spondylotic myelopathy: Part I: anatomical and pathomechanical considerations *

    PubMed Central

    Burns, SH; Mior, SA; O’Connor, SM

    1991-01-01

    This two part series reviews the recent literature concerning the etiology and clinical presentation of cervical spondylotic myelopathy (CSM). CSM is the most common neurological spinal cord disorder after middle age. It is caused by the compromise of the cervical spinal cord from narrowing of the spinal canal. In Part I, a review of the anatomy and the pathomechanics of the cervical spine pertinent to CSM is discussed. Emphasis is placed upon the intricate relationship between the osseous, neurological and vascular structures. The consequences of degenerative changes upon this relationship is evidenced by the resulting neurovascular compression. In turn, compression may lead to spinal cord ischemia with characteristic clinical results. ImagesFigure 3Figure 5

  1. Anterior decompression and fusion versus posterior laminoplasty for multilevel cervical compressive myelopathy.

    PubMed

    Liu, Xuzhou; Wang, Hehui; Zhou, Zhilai; Jin, Anmin

    2014-02-01

    The optimal surgical strategy for anterior or posterior approaches remains controversial for multilevel cervical compressive myelopathy caused by multisegment cervical spondylotic myelopathy (MCSM) or ossification of the posterior longitudinal ligament (OPLL). A systematic review and meta-analysis was conducted evaluating the clinical results of anterior decompression and fusion (ADF) compared with posterior laminoplasty for patients with multilevel cervical compressive myelopathy. PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials and nonrandomized cohort studies conducted from 1990 to May 2013 comparing ADF with posterior laminoplasty for the treatment of multilevel cervical compressive myelopathy due to MCSM or OPLL. The following outcome measures were extracted: Japanese Orthopedic Association (JOA) score, recovery rate, complication rate, reoperation rate, blood loss, and operative time. Subgroup analysis was conducted according to the mean number of surgical segments. Eleven studies were included in the review, all of which were prospective or retrospective cohort studies with relatively low quality indicated by GRADE Working Group assessment. A definitive conclusion could not be reached regarding which surgical approach is more effective for the treatment of multilevel cervical compressive myelopathy. Although ADF was associated with better postoperative neural function than posterior laminoplasty in the treatment of multilevel cervical compressive myelopathy due to MCSM or OPLL, there was no apparent difference in the neural function recovery rate between the 2 approaches. Higher rates of surgery-related complication and reoperation should be taken into consideration when ADF is used for patients with multilevel cervical compressive myelopathy. The surgical trauma associated with corpectomy was significantly higher than that associated with posterior laminoplasty.

  2. Flexion myelopathy of the thoracic spine. Case report.

    PubMed

    Fujibayashi, Shunsuke; Neo, Masashi; Nakamura, Takashi

    2007-01-01

    The authors report a rare case of surgically treated symptomatic thoracic kyphosis caused by dynamic compression in an elderly man. Myelopathy due to thoracic kyphosis has been reported in patients with congenital kyphosis, Scheuermann dorsal kyphosis, and Cushing disease, but to the authors' knowledge this is the first report of dynamic kyphosis in an elderly person. This otherwise healthy 84-year-old man presented with a 2-year history of progressive difficulty in walking and bilateral leg dysesthesia. Despite several cervical and lumbar surgeries, his symptoms gradually worsened. A radiological examination revealed severe thoracic kyphosis, with a lateral Cobb angle of 59 degrees from T-2 to T-12. On a dynamic computed tomography (CT) myelogram, severe thoracic spinal cord draping and stretching on flexion was demonstrated. On extension, however, imaging studies failed to show draping or stretching. Posterior corrective fusion was performed with instrumentation from T-2 to T-9. Postoperative CT myelography demonstrated no significant spinal cord compression with restoration of the cerebrospinal fluid space anterior to the spinal cord, and the successful correction of the kyphosis to 44 degrees. The patient's neurological sequelae gradually resolved throughout 6 months of follow up.

  3. Canine degenerative myelopathy: a model of human amyotrophic lateral sclerosis.

    PubMed

    Nardone, Raffaele; Höller, Yvonne; Taylor, Alexandra C; Lochner, Piergiorgio; Tezzon, Frediano; Golaszewski, Stefan; Brigo, Francesco; Trinka, Eugen

    2016-02-01

    Canine degenerative myelopathy (CDM) represents a unique naturally occurring animal model for human amyotrophic lateral sclerosis (ALS) because of similar clinical signs, neuropathologic findings, and involvement of the superoxide dismutase 1 (SOD1) mutation. A definitive diagnosis can only be made postmortem through microscopic detection of axonal degeneration, demyelination and astroglial proliferation, which is more severe in the dorsal columns of the thoracic spinal cord and in the dorsal portion of the lateral funiculus. Interestingly, the muscle acetylcholine receptor complexes are intact in CDM prior to functional impairment, thus suggesting that muscle atrophy in CDM does not result from physical denervation. Moreover, since sensory involvement seems to play an important role in CDM progression, a more careful investigation of the sensory pathology in ALS is also warranted. The importance of SOD1 expression remains unclear, while oxidative stress and denatured ubiquinated proteins appear to play a crucial role in the pathogenesis of CDM. In this updated narrative review we performed a systematic search of the published studies on CDM that may shed light on the pathophysiological mechanisms of human ALS. A better understanding of the factors that determine the disease progression in CDM may be beneficial for the development of effective treatments for ALS.

  4. Myelopathy in adult aortic coarctation: Causes and caveats of an atypical presentation

    PubMed Central

    Mourya, Chandan; Verma, Ashish; Bansal, Anand; Shukla, Ram C; Srivastava, Arvind

    2016-01-01

    A 57-year-old female presenting with acute-onset paraplegia was referred for magnetic resonance imaging (MRI) of cervico-dorsal spine. On MRI, multiple tortuous dilated vessels were noted in the epidural space with long segment cord compression and imaging features of compressive myelopathy. Associated small acute cervico-dorsal epidural hematoma was also noted in the same region. Computed tomography (CT) angiography was performed subsequently which revealed post-ductal coarctation of aorta with multiple arterial collaterals in the chest wall and spinal canal. An extensive review of English language literature pertaining to the clinical presentations of adult aortic coarctation revealed only few reports of acute compressive myelopathy due to spinal epidural collateral vessels. Further, presentation at such a late age has not been reported before. In the present case, apart from a hypertrophied anterior spinal artery and perispinal collaterals, an anterior epidural hematoma was an additional important factor in the causation of myelopathy. PMID:28104936

  5. Compression Myelopathy due to Proliferative Changes around C2 Pars Defects without Instability

    PubMed Central

    Kimura, Tetsuya; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Sairyo, Koichi

    2016-01-01

    We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare. PMID:27340539

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

    PubMed

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

    2007-09-01

    Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients' quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screening test for somatization, HADS, MMPI-2 scale 1 (Hypochondriasis), and self reported severity of symptoms 1 year after treatment. There was no significant difference in initial clinical presentation or demographic characteristics between the patients treated by surgical decompression and those treated by non-surgical means. There was a striking and statistically significant improvement in all symptoms attributed to the fibromyalgia syndrome in the surgical patients but not in the non-surgical patients at 1 year following the treatment of cervical myelopathy (P myelopathy due to spinal cord or caudal brainstem compression in patients carrying the diagnosis of fibromyalgia can result in a significant improvement in a wide array of symptoms usually attributed to fibromyalgia with attendant measurable improvements in the quality of life. We recommend detailed neurological and neuroradiological evaluation of

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-09-01

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

  9. Metrizamide CT myelography in cervical myelopathy and radiculopathy: correlation with conventional myelography and surgical findings

    SciTech Connect

    Badami, J.P.; Norman, D.; Barbaro, N.M.; Cann, C.E.; Weinstein, P.R.; Sobel, D.F.

    1985-04-01

    Conventional myelography, metrizamide computed tomographic (CT) myelography, and surgical findings were correlated in 30 patients with cervical radiculopathy and/or myelopathy. In 60% of patients, metrizamide CT myelography provided significant additional information including better characterization of the abnormality, lateralization if the conventional myelogram was indeterminate, more definitive demonstration of cord atrophy, foraminal narrowing not appreciated on myelography, and demonstration of abnormalities distal to a myelographic block. In no case was a myelographic abnormality not detected on metrizamide CT meyelography. In patients with cervical myelopathy, a cross-sectional diameter of the cord equaling less than 50% of the subarachnoid space is predictive of poor patient response to surgical intervention.

  10. Cortical reorganization in patients with cervical spondylotic myelopathy

    PubMed Central

    Holly, Langston T.; Dong, Yun; Albistegui-DuBois, Richard; Marehbian, Jonathan; Dobkin, Bruce

    2014-01-01

    Object Recent investigations have demonstrated that the cerebral cortex can reorganize as a result of spinal cord injury and may play a role in preserving neurological function. Reorganization of cortical representational maps in patients with cervical spondylotic myelopathy (CSM) has not been previously described. The authors sought to determine the feasibility of using functional magnetic resonance (fMR) imaging in patients with CSM to investigate changes in the cortical representation of the wrist and ankle before and after surgical intervention. Methods Four patients with clinical and imaging evidence of CSM were prospectively enrolled in this study. The patients underwent preoperative neurological examination, functional assessment, cervical imaging, and brain fMR imaging. The fMR imaging activation task undertaken was either wrist extension or ankle dorsiflexion, depending on whether the patient's primary impairment was hand dysfunction or gait difficulty. The cohort then underwent further evaluations at 6 weeks and 3 and 6 months postoperatively. In addition, five healthy volunteers underwent fMR imaging at two different time points and served as controls. In the healthy volunteers fMR imaging demonstrated areas of focal cortical activation limited to the contralateral primary motor area for the assigned motor tasks; the activation patterns were stable throughout repeated imaging. In comparison, in patients with CSM fMR imaging demonstrated expansion of the cortical representation of the affected extremity. Surgical decompression resulted in improvements in neurological function and reorganization of the representational map. Conclusions The findings of this preliminary study demonstrate the potential of fMR imaging to assess changes in cortical representation before and after surgical intervention in patients with CSM. A future study involving a larger cohort of patients as well as the stratification of patients with CSM, based on the aforementioned factors

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

    SciTech Connect

    Modi, Manish; Bapuraj, J. Rajiv; Lal, Anupam; Prabhakar, S.; Khandelwal, N.

    2010-12-15

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

  12. Cardiovascular risk profile in patients with myelopathy associated with HTLV-1.

    PubMed

    Prado, Fabio Luís Silva do; Oliveira, Renata Prado de Fuccio; Ladeia, Ana Marice Teixeira

    2017-03-07

    HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis) is a slowly progressive disease, characterized by a chronic spastic paraparesis. It is not known if the disease carries an independent risk for cardiovascular disease. The objective of this study was to evaluate the cardiovascular risk profile related to HAM/TSP and compare it with the general population.

  13. Cervical disc arthroplasty for the treatment of spondylotic myelopathy and radiculopathy.

    PubMed

    Khong, Peter; Bogduk, Nikolai; Ghahreman, Ali; Davies, Mark

    2013-10-01

    The concept of cervical disc arthroplasty (CDA) for the anterior treatment of cervical pathology has existed for approximately half a decade. In this time, multiple devices have been developed for this purpose, with the ultimate aim to provide an alternative to fusion. Fifty-five patients with cervical spondylotic radiculopathy and myelopathy underwent CDA over a 5 year period. Data was collected on 46 patients, which included Visual Analogue Scale scores for neck pain and arm pain, Neck Disability Index scores, Short Form-36 v2 (SF-36) and Nurick grades for myelopathy patients. Preoperative data and data obtained at the latest clinical follow-up (median 48 months, range, 10-76 months) were analysed to assess the intermediate term efficacy of the procedure. In patients with radiculopathy, arm pain improved by 88% (p<0.001). In those presenting with myelopathy, the Nurick grades improved from a median of 1 to 0 (p<0.001). In both groups of patients, improvements in pain and neurologic deficit were accompanied by significant improvements in multiple domains of the SF-36. Using a composite system which considered neck pain, arm pain, function and myelopathy, we arrived at an overall success rate of 73%. We concluded that CDA is an effective intervention for improving neurologic deficit, arm pain and local neck symptoms that translated into improvements in physical and social functioning in the intermediate term.

  14. Gait analysis of spastic walking in patients with cervical compressive myelopathy.

    PubMed

    Maezawa, Y; Uchida, K; Baba, H

    2001-01-01

    To assess neurological status and to evaluate the effect of surgical decompression in patients with cervical myelopathy, we performed computerized gait analysis in 24 patients with cervical compressive myelopathy who showed spastic walking. Gait analysis was repeated during neurological follow-up that averaged 32.4 months. The gait pattern in patients with severe myelopathy was characterized by hyperextension of the knee in the stance phase without plantar flexion of the ankle in the swing phase, significantly reduced walking speed and step length, prolonged stance phase duration and decreased single-stance phase duration, and increased step width. The angle of flexion of the knee joint in the stance phase was significantly correlated with the Japanese Orthopaedic Association (JOA) score. Postoperative neurological improvement was associated with increased walking speed and decreased extension angle of the knee joint (single-stance phase and swing phase). Postoperatively, 12 patients had normalized extension of the knee in stance phase and their walking speed, cadence, stance phase duration, and single-stance phase duration, as well as step length and width, showed nonsignificant differences from these parameters in healthy controls. Our results show that kinesiological gait analysis is clinically useful for the functional assessment of the severity of spastic walking in cervical myelopathy.

  15. Severity score system for progressive myelopathy: development and validation of a new clinical scale

    PubMed Central

    Castilhos, R.M.; Blank, D.; Netto, C.B.O.; Souza, C.F.M.; Fernandes, L.N.T.; Schwartz, I.V.D.; Giugliani, R.; Jardim, L.B.

    2012-01-01

    Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), was constructed covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter-and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = −0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = −0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies. PMID:22570090

  16. Compression Angle of Ossification of the Posterior Longitudinal Ligament and Its Clinical Significance in Cervical Myelopathy

    PubMed Central

    Lee, Nam; Yoon, Do Heum; Kim, Keung Nyun; Shin, Hyun Chul; Shin, Dong Ah

    2016-01-01

    Objectives The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. Methods Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group. All subjects underwent preoperative plain cervical roentgenogram, computed tomography (CT), and MR imaging (MRI). Radiological parameters (C2–7 sagittal vertical axis, SVA; C2–7 Cobb angle; C2–7 range of motion, ROM; OPLL occupying ratio; and compression angle) were compared. Compression angle of OPLL was defined as the angle between the cranial and caudal surfaces of OPLL at the maximum level of cord compression Results The occupying ratio of the spinal canal, C2–7 Cobb angle, C2–7 SVA, types of OPLL, and C2–7 ROM of the cervical spine were not statistically different between the two groups. However, the OPLL compression angle was significantly greater (p=0.003) in the severe myelopathy group than in the mild myelopathy group and was inversely correlated with JOA score (r=-0.533, p<0.01). Furthermore, multivariate regression analysis demonstrated that the compression angle (B=-0.069, p<0.001) was significantly associated with JOA scores (R=0.647, p<0.005). Conclusion Higher compression angles of OPLL have deleterious effects on the spinal cord and decrease preoperative JOA scores. PMID:27651865

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

    PubMed Central

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

    2007-01-01

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

  18. 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

  19. Radiation

    NASA Video Gallery

    Outside the protective cocoon of Earth's atmosphere, the universe is full of harmful radiation. Astronauts who live and work in space are exposed not only to ultraviolet rays but also to space radi...

  20. The spinal cord in rheumatoid arthritis with clinical myelopathy: a computed myelographic study.

    PubMed Central

    Stevens, J M; Kendall, B E; Crockard, H A

    1986-01-01

    Thirty one patients with suspected myelopathy due to rheumatoid arthritis were examined by plain radiography and 27 had computed myelography. Clinical features and radiological findings were compared. Deformity of the spinal cord could occur in the absence of combined anterior and posterior compression and correlated closely with clinical features only when considered in combination with skeletal and adjacent soft tissue abnormalities. The best surgical results were achieved by transoral odontoidectomy. Images PMID:3950633

  1. Laminoplasty with lateral mass screw fixation for cervical spondylotic myelopathy in patients with athetoid cerebral palsy

    PubMed Central

    Zhou, Hua; Liu, Zhong-jun; Wang, Shao-bo; Pan, Sheng-fa; Yan, Ming; Zhang, Feng-shan; Sun, Yu

    2016-01-01

    Abstract Although several studies report various treatment solutions for cervical spondylotic myelopathy in patients with athetoid cerebral palsy, long-term follow-up studies are very rare. None of the reported treatment solutions represent a gold standard for this disease owing to the small number of cases and lack of long-term follow-up. This study aimed to evaluate the outcomes of laminoplasty with lateral mass screw fixation to treat cervical spondylotic myelopathy in patients with athetoid cerebral palsy from a single center. This retrospective study included 15 patients (9 male patients and 6 female patients) with athetoid cerebral palsy who underwent laminoplasty with lateral mass screw fixation for cervical spondylotic myelopathy at our hospital between March 2006 and June 2010. Demographic variables, radiographic parameters, and pre- and postoperative clinical outcomes determined by the modified Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were assessed. The mean follow-up time was 80.5 months. Developmental cervical spinal canal stenosis (P = 0.02) and cervical lordosis (P = 0.04) were significantly correlated with lower preoperative modified JOA scores. The mean modified JOA scores increased from 7.97 preoperatively to 12.1 postoperatively (P < 0.01). The mean VAS score decreased from 5.30 to 3.13 (P < 0.01), and the mean NDI score decreased from 31.73 to 19.93 (P < 0.01). There was a significant negative correlation between developmental cervical spinal canal stenosis and recovery rate of the modified JOA score (P = 0.01). Developmental cervical spinal canal stenosis is significantly related to neurological function in patients with athetoid cerebral palsy. Laminoplasty with lateral mass screw fixation is an effective treatment for cervical spondylotic myelopathy in patients with athetoid cerebral palsy and developmental cervical spinal canal stenosis. PMID:27684879

  2. Spinal Cord Kinking in Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

    PubMed Central

    Wang, Ting; Pan, Min; Yin, Chu-Qiang; Zheng, Xiu-Jun; Cong, Ya-Nan; Wang, De-Chun; Li, Shu-Zhong

    2015-01-01

    Background: Ossification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy. This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF. Methods: The data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively. The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI). The clinical presentation and radiological characteristics in patients with SK were analyzed. Posterior en bloc laminectomy with OLF was performed, and the surgical results were evaluated. Results: SK was found in seven patients (7.4%) based on preoperative MRI. The patients included one male and six females with an average age of 55.6 years (range, 48–64 years). Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis. In all cases, the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF. The degree of SK varied from mild to severe. The tip of the CM was located between the upper third of T11 to the lower third of L1, above the lower edge of L1. With an average follow-up of 30.4 months, the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t = 12.05; P < 0.0001) with an improvement rate of 63.1 ± 12.3%. Conclusions: SK is a rare radiological phenomenon. It is typically located at the thoracolumbar junction, where the CM is compressed by the OLF. Our findings indicate that these patients may benefit from a posterior decompressive procedure. PMID:26415796

  3. Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

    PubMed Central

    Ito, Shuhei; Hosogane, Naobumi; Nagoshi, Narihito; Yagi, Mitsuru; Iwanami, Akio; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken

    2017-01-01

    Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH. PMID:28133558

  4. Successful treatment of cervical myelopathy with minimal morbidity by circumferential decompression and fusion

    PubMed Central

    Sanchez-Mejia, Rene O.; Ben-Haim, Sharona; Ames, Christopher P.

    2007-01-01

    Circumferential cervical decompression and fusion (CCDF) is an important technique for treating patients with severe cervical myelopathy. While circumferential cervical decompression and fusion may provide improved spinal cord decompression and stability compared to unilateral techniques, it is commonly associated with increased morbidity and mortality. We performed a retrospective analysis of patients undergoing CCDF at the University of California, San Francisco (UCSF) between January 2003 and December 2004. We identified 53 patients and reviewed their medical records to determine the effectiveness of CCDF for improving myelopathy, pain, and neurological function. Degree of fusion, functional anatomic alignment, and stability were also assessed. Operative morbidity and mortality were measured. The most common causes of cervical myelopathy, instability, or deformity were degenerative disease (57%) and traumatic injury (34%). Approximately one-fifth of patients had a prior fusion performed elsewhere and presented with fusion failure or adjacent-level degeneration. Postoperatively, all patients had stable (22.6%) or improved (77.4%) Nurick grades. The average preoperative and postoperative Nurick grades were 2.1 ± 1.9 and 0.4 ± 0.9, respectively. Pain improved in 85% of patients. All patients had radiographic evidence of fusion at last follow-up. The most common complication was transient dysphagia. Our average clinical follow-up was 27.5 ± 9.5 months. We present an extensive series of patients and demonstrate that cervical myelopathy can successfully be treated with CCDF with minimal operative morbidity. CCDF may provide more extensive decompression of the spinal cord and may be more structurally stable. Concerns regarding operation-associated morbidity should not strongly influence whether CCDF is performed. PMID:17216528

  5. HTLV-1-associated infective dermatitis and probable HTLV-1- associated myelopathy in an adolescent female*

    PubMed Central

    Steglich, Raquel Bisacotti; Tonoli, Renata Elise; Souza, Paulo Ricardo Martins; Pinto, Giselle Martins; Riesgo, Rudimar dos Santos

    2015-01-01

    Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (ID) is a chronic, severe and recurrent eczema occurring during childhood in patients vertically infected with HTLV-1. HTLV-1-associated myelopathy/tropical spastic paraparesia (HAM/ TSP) is slow and progressive. We report the case of an adolescent female from a non-endemic area for HTLV-1 who presents ID and, most likely, associated HAM/TSP. PMID:26312674

  6. A simple performance test for quantifying the severity of cervical myelopathy.

    PubMed

    Hosono, N; Sakaura, H; Mukai, Y; Kaito, T; Makino, T; Yoshikawa, H

    2008-09-01

    We evaluated 30 patients with cervical myelopathy before and after decompressive surgery and compared them with 42 healthy controls. All were asked to grip and release their fingers as rapidly as possible for 15 seconds. Films recorded with a digital camera were divided into three files of five seconds each. Three doctors independently counted the number of grip and release cycles in a blinded manner (N1 represents the number of cycles for the first five-second segment, N2 for the second and N3 for the third). N1 [corrected] N2 and N3 of the pre-operative group were significantly fewer than those of the control group, and the post-operative [corrected] group's results were significantly fewer [corrected] than those of the pre-operative group. In the control group, the numbers decreased significantly with each succeeding five-second interval (fatigue phenomenon). In the pre-operative myelopathy group there was no significant difference between N1 and N2 (freezing phenomenon). The 15-second test is shown to be reliable in the quantitative evaluation of cervical myelopathy. Although it requires a camera and animation files, it can detect small changes in neurological status because of its precise and objective nature.

  7. Postural hypotension and abnormalities of salt and water metabolism in myelopathy patients.

    PubMed

    Frisbie, J H; Steele, D J

    1997-05-01

    To describe the clinical manifestations of postural hypotension (PH) in myelopathy patients a standardized interview and chart review were carried out. Of 232 myelopathy patients with more than 2 years of paralysis seen during a 2 year period, 30 had been treated for PH. All PH patients were paralysed at levels higher than thoracic 7. The highest risk patients were tetraplegic, motor complete, 24 of 73 (33%). The common symptoms of PH were those of reduced consciousness (100%), strength (75%), vision (56%) and breath (53%). Precipitating factors were hot weather (77%) bowel care (33%) and meals (30%). Symptoms worsened with the duration of paralysis in 12 patients. Chronic hyponatremia was found in 54% of the PH patients and 16% of those without, P < 0.001. Of five PH-hyponatremic patients with urine sodium and osmolality determinations, five continued to retain water (> 150 mOsm/kg) while four failed to conserve salt (> 19 mmol Na/L). PH is common among myelopathy patients with higher levels of paralysis, symptoms are variable, and abnormal salt and water metabolism often coexist.

  8. Surfer’s myelopathy: a rare presentation in a non-surfing setting and review of the literature

    PubMed Central

    Phan, Kevin; Hariswamy, Soumya; Rao, Prashanth J.

    2016-01-01

    Background Surfers myelopathy can be a rapidly devastating disease and little is known surrounding the pathophysiology of the condition. Although the classical pattern of illness has been well reported, it has never been observed in a non-surfing setting. Methods A 51-year-old demolition worker presented with acute non-traumatic myelopathy. Clinical examination revealed sensory loss to the level of L2. T2-MRI and MRI-DWI revealed a hyperintense signal suggestive of an ischaemic event. A diagnosis of surfer’s myelopathy was made and he was commenced on steroid therapy. Results Following steroid therapy and fluid management the patient was discharged after 6 days with minor anaethesia but significant overall neurological improvement. Conclusions Diagnosis of SM requires a thorough history, clinical examination and imaging (MRI, MRI-DWI). The patient should be admitted early and investigated. The use of rehabilitation services may be useful if available. PMID:27757436

  9. Cervical spondylotic radiculo-myelopathy in patients with athetoid-dystonic cerebral palsy: clinical evaluation and surgical treatment.

    PubMed Central

    Hirose, G; Kadoya, S

    1984-01-01

    The acute onset of symptoms of severe cervical radiculo-myelopathy in four patients with athetoid-dystonic cerebral palsy is reported. Neurological and radiological examination showed that the spondylotic changes of the cervical spine were responsible for new neurological deficits leading to the patients being bedridden. Dystonic-athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result in early degenerative changes of the vertebrae which may enhance the radiculo-myelopathy. The four patients were treated with an anterior discectomy with interbody fusion. They were bedridden pre-operatively but all have since been able to walk with or without a cane. It is concluded that early anterior decompression with interbody fusion is a treatment of choice for cervical spondylotic radiculo-myelopathy in association with athetoid cerebral palsy. Images PMID:6470718

  10. Serious myelopathy due to magnetic resonance imaging-occult arteriovenous fistula: Case report of petrous ridge dural arteriovenous fistula

    PubMed Central

    Kim, Hyun Jeong

    2015-01-01

    Background and purpose We present a case of magnetic resonance imaging (MRI)-occult intracranial dural arteriovenous fistula (DAVF) with serious cervical myelopathy and review the pathophysiological background. Summary of case A 61-year-old man had suffered from progressive neurological deterioration. He had demonstrated swollen spinal cord with diffuse enhancement and no dilated vascularity on MRI. Finally, digital subtraction angiography revealed DAVF at the petrous ridge and it was successfully treated by embolization. Conclusion A slow flow DAVF is not readily recognizable on MRI. Whenever a patient presents with unexplainable progressive myelopathy, a possibility of vascular origin has to be considered. PMID:26116647

  11. [The "pseudo-polyneuropathy" type sensory disturbances in cervical spondylotic myelopathy].

    PubMed

    Yoshiyama, Y; Tokumaru, Y; Hattori, T; Hirayama, K

    1995-02-01

    We reported the pseudo-polyneuropathy type sensory disturbances in cervical spondylotic myelopathy. We defined this clinical type by objective superficial sensory deficits of all four distal limbs, and excluded the patients having only subjective sensory disturbances. Ten out of 61 patients with cervical spondylotic myelopathy had sensory disturbances of this type. Two patients noticed difference of the subjective sensations of the upper and lower limbs. Eight patients developed sensory symptoms initially in the upper limbs. Pin-prick sensation was diminished in the upper limbs more predominantly than in the lower limbs. Vibration sense was affected in the lower limbs predominantly. Motor functions were mildly impaired, and muscle stretch reflex of triceps brachii was preserved in all ten patients. Distribution of sensory disturbances of four patients changed in their course. Nerve conduction studies and F-wave latencies were normal. Electromyography showed mild chronic denervation of the C5-C7 innervated muscles. Somatosensory evoked potentials after median or ulnar nerve stimulation showed delayed latencies or attenuated waveforms of N13 as well as P14 peaks. Spinal cord was compressed mainly at C4/5 and C5/6 intervertebral level, shown by myelography, CT-myelography or magnetic resonance imagings. We conclude that the pseudo-polyneuropathy type sensory disturbance of cervical spondylotic myelopathy indicates the lesion at mid-to-low cervical vertebral level. The anatomical substrates for this type of sensory impairment could be caused by combination of the dorsal horn/anterior comissure lesions for the upper limbs, and the anterolateral funiculi lesions for the lower limbs.

  12. [Transverse myelopathy in an adult with acute lymphoblastic leukemia: case report].

    PubMed

    Brito, J C; da Nóbrega, P V; Guedes Filho, G E; Santos, F J; Souto, M G

    2001-06-01

    We report a case of transverse myelopathy in a 31 year old white man with acute lymphoblastic leukemia, subtype L3 (ALL-L3). This is a severe form of leukemia that affects children more often than adults. Less than 1% of leukemic patients develop neurologic complication in the spinal cord. The symptomatology in the present case started with back pain, flaccid paraplegia, and loss of sensibility and vegetative functions below the lesion. The etiologic diagnostic was obtained through peripheral blood study, bone marrow cytology, cerebrospinal fluid analysis and magnetic resonance image of the dorsal cord. The antileukemic treatment with specific drugs had no influence on the fatal outcome of the disease.

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

    PubMed

    Kovanda, Timothy J; Horn, Eric M

    2014-09-01

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

  14. Delayed myelopathy secondary to stab wound with a retained blade tip within the laminae: case report

    PubMed Central

    Wang, Hui; Ma, Lei; Ding, Wen-Yuan

    2015-01-01

    Delayed neurologic deficit after a stab wound with a retained foreign body near the spinal canal is unusual, adequate radiological examination is fundamental in detecting retained foreign bodies, especially the CT scan, surgical extraction of the foreign body is the primary task and the surgical outcome is satisfactory. Here, we report a rare case of delayed myelopathy caused by spinal stenosis secondary to broken blade tip within thoracic laminae in an old man, who was injured in a knife attack 39 years ago. The incidence, clinical presentation, diagnosis and prognosis are discussed. PMID:26629221

  15. Neuroimmunological aspects of human T cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Saito, Mineki

    2014-04-01

    Human T cell leukemia virus type 1 (HTLV-1) is a human retrovirus etiologically associated with adult T cell leukemia/lymphoma and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Only approximately 0.25-4 % of infected individuals develop HAM/TSP; the majority of infected individuals remain lifelong asymptomatic carriers. Recent data suggest that immunological aspects of host-virus interactions might play an important role in the development and pathogenesis of HAM/TSP. This review outlines and discusses the current understanding, ongoing developments, and future perspectives of HAM/TSP research.

  16. Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy

    PubMed Central

    Buell, Kevin G.; Puri, Aiysha; Demontis, Maria Antonietta; Short, Charlotte L.; Adonis, Adine; Haddow, Jana; Martin, Fabiola; Dhasmana, Divya

    2016-01-01

    HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia. PMID:27077747

  17. Cervical Spondylotic Myelopathy presenting as mechanical neck pain: a case report.

    PubMed

    Smith, Benjamin E; Diver, Claire J; Taylor, Alan J

    2014-08-01

    Cervical Spondylotic Myelopathy (CSM) is the most common type of myelopathy in adults over 55 years of age. In the early stages symptoms may include local neck pain and stiffness that might mimic the presentation of non-specific mechanical neck pain (NSMNP). The patient was a 79 year old male, who complained of eight weeks of neck pain. He had been referred for physiotherapy by his family physician with a diagnosis of NSMNP. Initial presentation was consistent with the referral, but further assessment by the physiotherapist revealed findings suggestive of CSM. He was referred for an urgent cervical MRI scan, which revealed myelomalacic changes at C3/4 due to spondylotic changes. The patient was unsuitable for manual therapy intervention and was referred to a spinal orthopaedic surgeon who performed a posterior decompression and stabilisation at C3-C5, 2 months after the initial presentation. This case report highlights the importance of considering CSM in adults over 55 years of age presenting with NSMNP, particularly as the prevalence of both increases with age. It demonstrates the need for health professionals to carry out detailed examination where CSM may be a potential differential diagnosis. Outcomes are less favourable for patients over the age of 70, therefore an urgent surgical opinion was required for this patient. Deterioration of symptoms whilst he awaited surgery demonstrates how missed diagnosis may lead to possible long term spinal cord damage, with potential medico-legal concerns for the therapist.

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

    PubMed Central

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

    2015-01-01

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

  19. Cervical myelopathy caused by dropped head syndrome. Case report and review of the literature.

    PubMed

    Nakanishi, Kinya; Taneda, Mamoru; Sumii, Toshihisa; Yabuuchi, Tomonari; Iwakura, Norihiro

    2007-02-01

    The authors present a rare case of cervical myelopathy caused by dropped head syndrome. This 68-year-old woman presented with her head hanging forward. After 1 month, she was admitted to the medical service because of head drop progression. Examination of biopsy specimens from her cervical paraspinal muscles showed nonspecific myopathic features without inflammation, and isolated neck extensor myopathy was diagnosed. The patient's condition did not respond to the administration of corticosteroids. During follow up as an outpatient, the patient's head drop continued to gradually progress. At 1 year after onset, she developed bilateral weakness of the upper and lower extremities, clumsiness of the hands, and gait disturbance. A radiograph of the cervical spine obtained in a standing position showed a pronounced kyphotic deformity and instability at the level of C4-5. Magnetic resonance imaging demonstrated spinal cord compression at C-3 and C-4. The patient underwent a C3-4 laminectomy and occipitocervicothoracic fixation. Gait and hand coordination gradually improved, and she was able to walk with no support 1 month postoperatively. Surgical fixation was beneficial in this patient with dropped head syndrome, myelopathy, and cervical instability.

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

    PubMed

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

    2013-09-01

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

  1. Tentorial dural arteriovenous fistula presenting as myelopathy: Case series and review of literature

    PubMed Central

    Gross, Robert; Ali, Rushna; Kole, Max; Dorbeistein, Curtis; Jayaraman, Mahesh V; Khan, Muhib

    2014-01-01

    Dural arteriovenous fistula (DAVF) is a rare type of cerebral arteriovenous malformation. Common presenting symptoms are related to hemorrhage. However, rarely these patients may present with myelopathy. We present two cases of DAVF presenting as rapidly progressive myelopathy. Two treatment options are available: microsurgical interruption of the fistula and endovascular embolization. These treatment options of DAVFs have improved significantly in the last decade. The optimal treatment of DAVFs remains controversial, and there is an ongoing debate as to whether primary endovascular or primary microsurgical treatment is the optimal management for these lesions. However, despite treatment a high percentage of patients are still left with severe disability. The potential for functional ambulation in patients with DAVF is related to the time of intervention. This emphasizes the important of early diagnosis and early intervention in DAVF. The eventual outcome may depend on several factors, such as the duration of symptoms, the degree of disability before treatment, and the success of the initial procedure to close the fistula. The usage of magnetic resonance imaging and selective angiography has significantly improved the ability to characterize DAVFs, however, these lesions remain inefficiently diagnosed. If intervention is delayed even prolonged time in rehabilitation does not change the grave prognosis. This review outlines the presentation, classication and management of DAVF as well as discussing patient outcomes. PMID:25516869

  2. Intrinsic Functional Plasticity of the Sensory-Motor Network in Patients with Cervical Spondylotic Myelopathy

    PubMed Central

    Zhou, F. Q.; Tan, Y. M.; Wu, L.; Zhuang, Y.; He, L. C.; Gong, H. H.

    2015-01-01

    Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); however, the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown. In this study, functional connectivity strength (FCS), a data-driven degree centrality method based on a theoretical approach, was applied for the first time to investigate changes in the sensory-motor network (SMN) at the voxel level. Comparatively, CSM not only showed significantly decreased FCS in the operculum-integrated regions, which exhibited reduced resting-state functional connectivity (rsFC) around the Rolandic sulcus, but it also showed increased FCS in the premotor, primary somatosensory, and parietal-integrated areas, which primarily showed an enhanced rsFC pattern. Correlation analysis showed that altered FCS (in the left premotor-ventral/precentral-operculum, right operculum-parietale 4, and right S1) was associated with worsening Japanese Orthopaedic Association scores and that the rsFC pattern was influenced by cervical cord micro-structural damage at the C2 level. Together, these findings suggest that during myelopathy, the intrinsic functional plasticity of the SMN responds to the insufficient sensory and motor experience in CSM patients. This knowledge may improve our understanding of the comprehensive functional defects found in CSM patients and may inspire the development of new therapeutic strategies in the future. PMID:25897648

  3. The reporting of study and population characteristics in degenerative cervical myelopathy: A systematic review

    PubMed Central

    McHugh, M.; Elgheriani, A.; Kolias, Angelos G.; Tetreault, Lindsay; Hutchinson, Peter J. A.; Fehlings, Michael G.; Kotter, Mark R. N.

    2017-01-01

    Object Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent condition. Variable reporting in interventional trials of study design and sample characteristics limits the interpretation of pooled outcomes. This is pertinent in DCM where baseline characteristics are known to influence outcome. The present study aims to assess the reporting of the study design and baseline characteristics in DCM as the premise for the development of a standardised reporting set. Methods A systematic review of MEDLINE and EMBASE databases, registered with PROSPERO (CRD42015025497) was conducted in accordance with PRISMA guidelines. Full text articles in English, with >50 patients (prospective) or >200 patients (retrospective), reporting outcomes of DCM were deemed to be eligible. Results A total of 108 studies involving 23,876 patients, conducted world-wide, were identified. 33 (31%) specified a clear primary objective. Study populations often included radiculopathy (51, 47%) but excluded patients who had undergone previous surgery (42, 39%). Diagnositic criteria for myelopathy were often uncertain; MRI assessment was specified in only 67 (62%) of studies. Patient comorbidities were referenced by 37 (34%) studies. Symptom duration was reported by 46 (43%) studies. Multivariate analysis was used to control for baseline characteristics in 33 (31%) of studies. Conclusions The reporting of study design and sample characteristics is variable. The development of a consensus minimum dataset for (CODE-DCM) will facilitate future research synthesis in the future. PMID:28249017

  4. Cervical spondylotic myelopathy: a review of surgical indications and decision making.

    PubMed Central

    Law, M. D.; Bernhardt, M.; White, A. A.

    1993-01-01

    Cervical spondylotic myelopathy (CSM) is frequently underdiagnosed and undertreated. The key to the initial diagnosis is a careful neurologic examination. The physical findings may be subtle, thus a high index of suspicion is helpful. Poor prognostic indicators and, therefore, absolute indications for surgery are: 1. Progression of signs and symptoms. 2. Presence of myelopathy for six months or longer. 3. Compression ratio approaching 0.4 or transverse area of the spinal cord of 40 square millimeters or less. Improvement is unusual with nonoperative treatment and almost all patients progressively worsen. Surgical intervention is the most predictable way to prevent neurologic deterioration. The recommended decompression is anterior when there is anterior compression at one or two levels and no significant developmental narrowing of the canal. For compression at more than two levels, developmental narrowing of the canal, posterior compression, and ossification of the posterior longitudinal ligament, we recommend posterior decompression. In order for posterior decompression to be effective there must be lordosis of the cervical spine. If kyphosis is present, anterior decompression is needed. Kyphosis associated with a developmentally narrow canal or posterior compression may require combined anterior and posterior approaches. Fusion is required for instability. Images Figure 1 PMID:8209553

  5. Clinico-Radiological Correlation in a Cohort of Cervical Myelopathy Patients

    PubMed Central

    Kalpana, R.Y.

    2015-01-01

    Objective: Though both clinical evaluation and MRI are complimentary in detection and precise localization of the level of lesion in patients with cervical myelopathy, there is paucity of data comparing segment specific clinical features with the MRI abnormalities in cervical myelopathy. Materials and Methods: Thirty one patients with cervical myelopathy and abnormal MRI of the cervical spine (signal changes in the cord) admitted to the neurology and neurosurgery wards during the study period were included in the study. The patients were prospectively evaluated by a detailed neurological examination. Clinically, the site of lesion was determined by highest of the pyramidal, sensory or segmental features of involvement. The MRI lesions were categorized based on the vertebral level at which the abnormalities were seen. The patients were divided into three groups according to the site of lesion on MRI: (1) cervico-medullary (foramen magnum to C1) lesions (2) upper cervical (C2-C4) lesions and (3) lower cervical (C5-T1) lesions. Comparisons of clinical symptoms, signs and level of lesion with MRI abnormalities were done and the level of significance was set at p < 0.05. Results: Clinical evaluation showed limb weakness in all, sensory loss in 90%, sphincter disturbances in 67.7%, scissoring gait in 32.2%, diaphragmatic weakness in 12.9% of patients. Based on clinical examination the site of lesion was cervico-medullary in 9, upper cervical region in 4 and lower cervical region of involvement in five patients. The maximal antero-posterior extent of the lesion and neurological deficits were concordant (p-0.05). As compared to pyramidal signs or sensory abnormalities, segmental features – segmental sensory loss, weakness, wasting or ‘reflex’ loss – were most concordant with the MRI level of lesion (p - 0.03). Among ‘motor’, ‘sensory’ and ‘reflex’ levels, the ‘reflex (DTR)’ levels were most concordant with the MRI level of lesion (p – 0

  6. [Long-term results of surgery for cervical spondylotic myelopathy using open-door laminoplasty].

    PubMed

    Ryba, L; Chaloupka, R; Repko, M; Cienciala, J

    2015-01-01

    PURPOSE OF THE STUDY Cervical spondylotic myelopathy (CSM) is a serious disease which, in its advanced form, can markedly disable the patient. The aim of the present work was a prospective evaluation of a group of CSM patients treated by open-door laminoplasty. MATERIAL AND METHODS We evaluated 89 patients (59 men and 30 women; average age, 62 years; range, 39 to 81 years) who underwent surgery in the years 2001 to 2011. The average follow-up was 76 months. The patients were examined neurologically, radiologically, by magnetic resonance imaging (MRI) or CT. All of them had quadruparetic disability and showed signs of myelopathy on MRI examination. We used a modified Hirabayashi technique of open-door laminoplasty. We evaluated the surgery time, intra-operative blood loss, neurological deficit on the modified Japanese Orthopaedic Society (mJOA) scale, intra- and postoperative complications, neck pain (NP) and extremity pain (EP) on the visual analogue scale (VAS) and a radiographic sagittal profile change after laminoplasty. RESULTS The average operative time was 117 minutes and the average intra-operative blood loss was 330 ml. The average mJOA score of 12.7 before surgery improved to 14.4. Two patients (2.25 %) showed persisting deterioration of neurological symptoms, conditions of six patients (6.75 %) were assessed as stable and the remaining 81 patients (91 %) showed varying degrees of both subjective and objective amelioration/improvement. Infection was recorded as the most frequent complication (7.8 %). C5 paresis reported in the literature did not occur in our group. One patient (1.1 %) had a moderate epidural haemorrhage. The pre-operative VAS NP score of 5.4 improved to 3.2 and the VAS EP score of 7.7 improved to 4.4. The average value for the radiographic sagittal profile changed from -18.2 pre-operatively to -16.5 post-operatively. CONCLUSIONS Laminoplasty remains the basic surgical option for CSM treatment, particularly in progressive cases of the

  7. Hybrid Decompression and Fixation Technique for the Treatment of Multisegmental Cervical Spondylotic Myelopathy

    PubMed Central

    Araos-Silva, Walter; Reyes-Sánchez, Alejandro; Rosales-Olivarez, Luis Miguel; Alpizar-Aguirre, Armando; Melendez, Francisco Lopez

    2016-01-01

    Background Cervical spondilotic myelopathy (CSM) is defined as the compromise of the spinal cord due to degenerative changes of the cervical spine. It is the most common cause of spinal cord dysfunction in patients over 55 years. An early surgical management it is paramount to achieve better neurological outcome. There is still controversy regarding the appropriate surgical treatment for multisegmental CSM involving three or more levels. The hybrid decompression and fixation technique combines one or two level corpectomy and a single level discectomy in order to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy Methods A prospective case-control study was made between 2011 and 2013. A total of 15 patients with diagnosis of CSM received surgical treatment with an anterior hybrid decompression and fixation technique procedure. Inclusion criteria were myelopathy confirmed by radiographic studies, magnetic resonance image (MRI) and electromyography. Results During the 2010-2013 period 15 patients were managed by hybrid decompression and fixation technique. Average age 64.8 years SD9.4. The follow up period was 29.6 SD ± 9.8 months. The JOA score improved significantly to 13.8 +/- 1.9 points at follow-up (paired t test, P = 0.001), Nurick Scale preoperative was 3.3 and improved to 2.4 mean, was significantly (Wilcoxon signed rank test p=0.006) The mean C2-C7 lordosis angle was 10.8° +/- 8.9 before surgery, and 14.3° +/- 8.8 at follow-up, there was no significant loss of lordosis angle between the preoperative and follow-up measurements (Wilcoxon signed rank test, P =0.149); At follow-up, graft non fusion was seen in 1 patient (7%, k=1); Conclusions In this small number, single surgeon, prospective series the use of a single level corpectomy and an adjacent discectomy was shown to provide similar outcomes and complication rates as alternative surgical techniques. The authors thus consider this a viable surgical alternative with

  8. Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques.

    PubMed

    Wang, Mao-Qiang; Liu, Feng-Yong; Duan, Feng

    2012-12-21

    We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms.

  9. Solitary spinal epidural cavernous haemangiomas as a rare cause of myelopathy.

    PubMed

    Meng, Ying; Shamji, Mohammed F

    2015-09-25

    Cavernous haemangiomas rarely occur in the spinal epidural space. We report the case of a 27-year-old man who presented with myelopathy secondary to spinal cord compression from a purely epidural lesion. The imaging characteristics of cavernous haemangiomas are unique, reflecting a highly vascular lesion. Key differentiating features from intracranial or intramedullary lesions include the lack of a surrounding hemosiderin ring and popcorn appearance. An urgent referral to a neurosurgeon is recommended given the possibility of acute neurological deterioration from intralesional haemorrhage, and good recovery from early surgical resection. Preoperative planning with thorough patient counselling and availability of matched blood is important, and an en bloc resection approach should be taken to minimise blood loss. In this case, the patient experienced complete recovery after surgical resection. No recurrence after complete resection has been reported in the literature. This suggests a good long-term outcome for the patient and that no early adjuvant therapy is necessary.

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

    PubMed

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

    2006-10-21

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

  11. Omovertebral bone associated with Sprengel deformity and Klippel-Feil syndrome leading to cervical myelopathy.

    PubMed

    Füllbier, Lars; Tanner, Philipp; Henkes, Hans; Hopf, Nikolai J

    2010-08-01

    The unusual association of an omovertebral bone with Sprengel deformity and Klippel-Feil syndrome is a complex bone anomaly of unknown incidence and etiology. However, several cases of this rare disease pattern have been reported in the literature. In this paper, the authors present the case of a 34-year-old woman with a 5-month history of progressive gait ataxia and intermittent urinary incontinence, which was found to be caused by aberrant bone growth into the spinal canal from an omovertebral bone that extended from the left scapula pressing into the C-6 vertebral arch and subsequently causing cervical myelopathy. The patient underwent isolated resection of the omovertebral bone and decompression of the spinal canal, and her functional and neurological outcome was favorable.

  12. Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

    PubMed

    Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

    2009-03-01

    Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

  13. Brain necrosis after fractionated radiation therapy: Is the halftime for repair longer than we thought?

    SciTech Connect

    Bender, Edward T.

    2012-11-15

    Purpose: To derive a radiobiological model that enables the estimation of brain necrosis and spinal cord myelopathy rates for a variety of fractionation schemes, and to compare repair effects between brain and spinal cord. Methods: Sigmoidal dose response relationships for brain radiation necrosis and spinal cord myelopathy are derived from clinical data using nonlinear regression. Three different repair models are considered and the repair halftimes are included as regression parameters. Results: For radiation necrosis, a repair halftime of 38.1 (range 6.9-76) h is found with monoexponential repair, while for spinal cord myelopathy, a repair halftime of 4.1 (range 0-8) h is found. The best-fit alpha beta ratio is 0.96 (range 0.24-1.73)Conclusions: A radiobiological model that includes repair corrections can describe the clinical data for a variety of fraction sizes, fractionation schedules, and total doses. Modeling suggests a relatively long repair halftime for brain necrosis. This study suggests that the repair halftime for late radiation effects in the brain may be longer than is currently thought. If confirmed in future studies, this may lead to a re-evaluation of radiation fractionation schedules for some CNS diseases, particularly for those diseases where fractionated stereotactic radiation therapy is used.

  14. Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

    PubMed Central

    Park, Jong-Hwa; Lee, Ho-Jin; Shin, Byung-Kon

    2016-01-01

    Background Laminoplasty is a surgical procedure frequently performed for cervical myelopathy. We investigated correlations between changes in the anteroposterior diameter (APD) of the spinal canal, spinal canal area (SCA), and laminar angle (LA) and clinical outcomes of laminoplasty. Methods Of the 204 cervical myelopathy patients who underwent laminoplasty from July 2010 to May 2015, 49 patients who were evaluated with pre- and postoperative computed tomography of the cervical vertebrae were included. The average age of the patients was 60.4 years (range, 31 to 82 years), and the average duration of follow-up was 31.6 months (range, 9 to 68 months). Changes in the APD and SCA were measured at the middle of the vertebral body. Changes in LA were measured where both pedicles were clearly visible. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) score and visual analog scale score for pain preoperatively (1 day before surgery) and postoperatively (last outpatient visit) and examining postoperative complications. Results The APD showed an average of 54.7% increase from 11.5 to 17.8 mm. The SCA showed an average of 57.7% increase from 225.9 to 356.3 mm2. The LA increased from 34.2° preoperatively to 71.9° postoperatively. The JOA score increased from an average of 9.1 preoperatively to 13.4 postoperatively. Three patients were found to have hinge fractures during surgery. Postoperative complications, including two cases of C5 palsy, were recorded. The correlation coefficient between the LA change and JOA score improvement was −0.449 (p < 0.05). Patients with a < 33° (25%) increase in the LA showed the most significant clinical improvement. Conclusions Patients with a < 33° (25%) change in the LA after laminoplasty with a titanium miniplate showed the most significant clinical improvement. Thus, LA changes can be useful in predicting the clinical outcome of laminoplasty. PMID:27904722

  15. Clinical Presentation of Cervical Myelopathy at C1–2 Level

    PubMed Central

    Takebayashi, Tsuneo; Terashima, Yoshinori; Tsuda, Hajime; Yoshimoto, Mitsunori; Yamashita, Toshihiko

    2016-01-01

    Study Design Single-center retrospective study. Purpose To clarify the clinical features of cervical myelopathy at the C1–2 level. Overview of Literature Methods for distinguishing the affected level based on myelomere symptoms or dysfunction of the conducting pathway were established. However, no symptoms have been identified as being specific to the C1–2 level segment. Methods We evaluated 24 patients with cervical myelopathy due to spinal cord compression at the C1–2 level. Preoperative neurological assessment were investigated and compared with the rate and site of compression of the spinal cord using computed tomography-myelography. Results Impaired temperature and pain sensation were confirmed in 18 of the 24 patients with that localized to the upper arms (n=3), forearm (n=9), both (n=2), and whole body (n=4). Muscle weakness was observed in 18 patients, muscle weakness extended from the biceps brachii to the abductor digiti minimi in 10 patients, and in the whole body in 8 patients. Deep tendon reflexes were normal in 10 patients, whereas hyperactive deep tendon reflexes were noted in 14 patients. The rate of spinal cord compression was significantly higher in patients with perceptual dysfunction and muscle weakness compared with those with no dysfunction. However, no significant difference in the rate and site of compression was identified in those with dysfunction. Conclusions Perceptual dysfunction and muscle weakness localized to the upper limbs was observed in 58% and 42% of patients, respectively. Neurological abnormalities, such as perceptual dysfunction and muscle weakness, were visualized in patients with marked compression. PMID:27559458

  16. Cervical myelopathy caused by atlas osteochondroma and pseudoarthrosis between the osteochondroma and lamina of the axis: case report.

    PubMed

    Miyakoshi, Naohisa; Hongo, Michio; Kasukawa, Yuji; Shimada, Yoichi

    2010-01-01

    A 58-year-old man presented with a 6-month history of progressive cervical myelopathy. Magnetic resonance imaging and computed tomography of the cervical spine revealed a bone tumor arising from the posterior arch of the atlas and osteophytes at a pseudoarthrosis between the tumor and the lamina of the axis, resulting in marked spinal cord compression. The patient's symptoms resolved after en bloc resection of the tumor and removal of the osteophytes. The histological diagnosis was osteochondroma. The primary cause of myelopathy in the present case was osteochondroma arising from the posterior arch of the atlas, but the osteophyte formations appearing at the pseudoarthrosis between the atlas osteochondroma and the lamina of the axis might also have contributed to the symptoms, which appeared when the patient was in his late 50s.

  17. INTERFERON BETA-1A TREATMENT IN HTLV-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: A CASE REPORT

    PubMed Central

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

    2014-01-01

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

  18. Synovial chondromatosis of the lumbar spine with compressive myelopathy: a case report with review of the literature.

    PubMed

    Abdelwahab, Ibrahim Fikry; Contractor, Daniel; Bianchi, Stefano; Hermann, George; Hoch, Benjamin

    2008-09-01

    Synovial chondromatosis has been rarely reported to occur in the spine with only one case found in the lumbar spine. We describe another case of synovial chondromatosis in the lumbar spine in a 41-year-old man who presented with compressive myelopathy. The tumor was located in the left ventrolateral corner of the epidural space just below the L(4)-L(5) intervertebral space. Besides being extremely rare, our case was unusual in that the juxtaposed facet joint was radiologically normal.

  19. Comparative Sensitivity of Intraoperative Motor Evoked Potential Monitoring in Predicting Postoperative Neurologic Deficits: Nondegenerative versus Degenerative Myelopathy

    PubMed Central

    Clark, Aaron J.; Safaee, Michael; Chou, Dean; Weinstein, Philip R.; Molinaro, Annette M.; Clark, John P.; Mummaneni, Praveen V.

    2015-01-01

    Study Design  Retrospective review. Objective  Intraoperative motor evoked potential (MEP) monitoring in spine surgery may assist surgeons in taking corrective measures to prevent neurologic deficits. The efficacy of monitoring MEPs intraoperatively in patients with myelopathy from nondegenerative causes has not been quantified. We compared the sensitivity and specificity of intraoperative MEP monitoring in patients with myelopathy caused by nondegenerative processes to patients with degenerative cervicothoracic spondylotic myelopathy (CSM). Methods  We retrospectively reviewed our myelopathy surgical cases during a 1-year period to identify patients with degenerative CSM and CSM of nondegenerative causes and collected data on intraoperative MEP changes and postoperative new deficits. Categorical variables were analyzed by Fisher exact test. Receiver operator curves assessed intraoperative MEP monitoring performance in the two groups. Results  In all, 144 patients were identified: 102 had degenerative CSM and 42 had CSM of nondegenerative causes (24 extra-axial tumors, 12 infectious processes, 5 traumatic fractures, and 1 rheumatoid arthritis). For degenerative CSM, there were 11 intraoperative MEP alerts and 7 new deficits (p < 0.001). The corresponding sensitivity was 71% and the specificity was 94%. In the nondegenerative group, there were 11 intraoperative MEP alerts and 3 deficits, which was not significant (p > 0.99). The sensitivity (33%) and specificity (74%) were lower. Among patients with degenerative CSM, the model performed well for predicting postoperative deficits (area under the curve [AUC] 0.826), which appeared better than the nondegenerative group, although it did not reach statistical significance (AUC 0.538, p = 0.16). Conclusions  Based on this large retrospective analysis, intraoperative MEP monitoring in surgery for nondegenerative CSM cases appears to be less sensitive to cord injury and less predictive of postoperative

  20. Cervical flexion myelopathy in a patient showing apparent long tract signs: a severe form of Hirayama disease.

    PubMed

    Sakai, Kenji; Ono, Kenjiro; Okamoto, Yoshiyuki; Murakami, Hideki; Yamada, Masahito

    2011-05-01

    We describe an 18-year-old male with cervical flexion myelopathy with Hirayama disease-like features who showed apparent long tract signs. He first experienced insidious-onset hand muscle weakness and atrophy at the age of 15. Subsequently, he developed sensory disturbance in his lower limb. Neurological examination revealed atrophy and weakness in the right hand and forearm, pyramidal signs in the right lower extremity, and disturbance of superficial sensation in the lower left half of the body. Cervical magnetic resonance images and computed tomographic myelography revealed anterior displacement with compression of the cervical cord in flexion that was more apparent in the right side. The right side of the cervical cord showed severe atrophy. The mechanisms of myelopathy in our patient appeared to be same as that of "tight dural canal in flexion," which has been reported to be the mechanism of juvenile muscular atrophy of the unilateral upper extremity (Hirayama disease). Patients with Hirayama disease generally show minimal sensory signs and no pyramidal signs. An autopsy case of Hirayama disease revealed confined necrosis of the cervical anterior horn without obvious changes in the white matter. Our patient's disease progression suggests that cervical flexion myelopathy patients with severe cervical cord compression in flexion may develop extensive cervical cord injury beyond the anterior horn.

  1. Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature.

    PubMed

    Rahimizadeh, Abolfazl; Soufiani, Housain F; Rahimizadeh, Saghayegh

    2016-01-01

    The dropped head syndrome (DHS) is a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder. Isolated cases are owed to the late onset of noninflammatory myopathy designated as INEM, where persistent chin to chest deformity may gradually cause or aggravate preexisting degenerative changes of the cervical spine and ultimately result in myelopathy. In review of the literature, we could find only 5 cases, with no unique guidelines to address the management of these two concomitant pathologies. Herein, a 69-year-old man who had developed cervical myelopathy 2 years after being affected by isolated dropped head syndrome is presented. Chin to chest deformity and cervical myelopathy were managed through three-level anterior cervical discectomy and fusion (ACDF) combined with decompressive cervical laminectomy and stabilization with C2 to C7 pedicle screw-rod construct. At 4-month follow-up, despite recovery in patient's neurological status, flexion deformity reappeared with recurrence of dropped head due to C7 pedicle screws pull-out. However, this was successfully managed with extension of the construct to the upper thoracic levels.

  2. Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature

    PubMed Central

    Soufiani, Housain F.; Rahimizadeh, Saghayegh

    2016-01-01

    The dropped head syndrome (DHS) is a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder. Isolated cases are owed to the late onset of noninflammatory myopathy designated as INEM, where persistent chin to chest deformity may gradually cause or aggravate preexisting degenerative changes of the cervical spine and ultimately result in myelopathy. In review of the literature, we could find only 5 cases, with no unique guidelines to address the management of these two concomitant pathologies. Herein, a 69-year-old man who had developed cervical myelopathy 2 years after being affected by isolated dropped head syndrome is presented. Chin to chest deformity and cervical myelopathy were managed through three-level anterior cervical discectomy and fusion (ACDF) combined with decompressive cervical laminectomy and stabilization with C2 to C7 pedicle screw-rod construct. At 4-month follow-up, despite recovery in patient's neurological status, flexion deformity reappeared with recurrence of dropped head due to C7 pedicle screws pull-out. However, this was successfully managed with extension of the construct to the upper thoracic levels. PMID:27034870

  3. Median Nerve Somatosensory Evoked Potential in HTLV-I Associated Myelopathy

    PubMed Central

    Boostani, Reza; Poorzahed, Ali; Ahmadi, Zahra; Mellat, Ali

    2016-01-01

    Introduction HTLV-I Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) is a progressive Myelopathy that mainly involves the corticospinal tract. Despite pronounced involvement of the lower limbs, patients also have abnormalities in their upper limbs. So, we studied somatosensory-evoked potentials (SSEPs) of the median nerve in HAM/TSP patients to determine the extent of the involvement of the pathway of the central nervous system, especially the cervical spinal cord. Methods In this cross sectional study, 48 patients with HAM/TSP who were referred to Qaem Hospital in Mashhad from October 2010 to October 2011 were evaluated for various indices, including SSEPs of the median nerve for N9, N11, N13, and N20 waveforms and also N11–13 and N13–20 Inter Peak Latency (IPL), severity of disease (based on Osama criteria), disease duration (less or more than 2 years), age, and gender. SPSS software was used for data analysis. The t-test was used for quantitative data, and the chi-squared test was used for the qualitative variables. Results Thirty-four patients (70.2%) were females. The mean age was 45.6 ± 14.2 years. About SSEPs indices of the median nerve, N9 and N11 were normal in all patients, but N13 (50%), N20 (16.7%), IPL11–13 (58.3%), and IPL13–20 (22.9%) were abnormal. No significant relationships were found between age, gender, disease duration, and SSEPs indices (p > 0.05), but IPL11–13 and IPL13–20 had significant relationships with disease disability (p = 0.017 and p = 0.01, respectively). Conclusion Despite the lack of obvious complaints of upper limbs, SSEPs indices of the median nerve from the cervical spinal cord to the cortex were abnormal, which indicated extension of the lesion from the thoracic spinal cord up to the cervical spinal cord and thalamocortical pathways. Also, abnormalities in the cervical spinal cord had a direct correlation with the severity of disability in patients with HAM/TSP. PMID:27382445

  4. The Radiation Dose-Response of the Human Spinal Cord

    SciTech Connect

    Schultheiss, Timothy E.

    2008-08-01

    Purpose: To characterize the radiation dose-response of the human spinal cord. Methods and Materials: Because no single institution has sufficient data to establish a dose-response function for the human spinal cord, published reports were combined. Requisite data were dose and fractionation, number of patients at risk, number of myelopathy cases, and survival experience of the population. Eight data points for cervical myelopathy were obtained from five reports. Using maximum likelihood estimation correcting for the survival experience of the population, estimates were obtained for the median tolerance dose, slope parameter, and {alpha}/{beta} ratio in a logistic dose-response function. An adequate fit to thoracic data was not possible. Hyperbaric oxygen treatments involving the cervical cord were also analyzed. Results: The estimate of the median tolerance dose (cervical cord) was 69.4 Gy (95% confidence interval, 66.4-72.6). The {alpha}/{beta} = 0.87 Gy. At 45 Gy, the (extrapolated) probability of myelopathy is 0.03%; and at 50 Gy, 0.2%. The dose for a 5% myelopathy rate is 59.3 Gy. Graphical analysis indicates that the sensitivity of the thoracic cord is less than that of the cervical cord. There appears to be a sensitizing effect from hyperbaric oxygen treatment. Conclusions: The estimate of {alpha}/{beta} is smaller than usually quoted, but values this small were found in some studies. Using {alpha}/{beta} = 0.87 Gy, one would expect a considerable advantage by decreasing the dose/fraction to less than 2 Gy. These results were obtained from only single fractions/day and should not be applied uncritically to hyperfractionation.

  5. State of the Art in Degenerative Cervical Myelopathy: An Update on Current Clinical Evidence.

    PubMed

    Wilson, Jefferson R; Tetreault, Lindsay A; Kim, Jun; Shamji, Mohammed F; Harrop, James S; Mroz, Thomas; Cho, Samuel; Fehlings, Michael G

    2017-03-01

    Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction that confronts clinicians on a daily basis. Research performed over the past few decades has provided improved insight into the diagnosis, evaluation, and treatment of this disorder. We aim to provide clinicians with an update regarding the state of the art in DCM, focusing on more recent research pertaining to pathophysiology, natural history, treatment, consideration of the minimally symptomatic patient, surgical outcome prediction, and outcome measurement. Current concepts of pathophysiology focus on the combination of static and dynamic elements leading to breakdown of the blood-spinal cord barrier at the site of compression resulting in local inflammation, cellular dysfunction, and apoptosis. With respect to treatment, although there is a dearth of high-quality studies comparing surgical to nonoperative treatment, several large prospective studies have recently associated surgical management with clinically and statistically significant improvement in functional, disability, and quality of life outcome at long-term follow-up. When selecting the specific surgical intervention for a patient with DCM, anterior (discectomy, corpectomy, hybrid discectomy/corpectomy), posterior (laminectomy and fusion, laminoplasty), and combined approaches may be considered as options depending on the specifics of the patient in question; evidence supporting each of these approaches is reviewed in detail. Recently developed clinical prediction models allow for accurate forecasting of postoperative outcomes, permitting enhanced communication and management of patient expectations in the preoperative setting. Finally, an overview of outcome measures recommended for use in the assessment of DCM patients is provided.

  6. [Central nervous system leukemia mimicking rapidly progressive HTLV-1 associated myelopathy].

    PubMed

    Haruki, Hiroyo; Tanaka, Shinichiro; Koga, Michiaki; Kawai, Motoharu; Negoro, Kiyoshi; Kanda, Takashi

    2009-03-01

    A 79-year-old woman was suffered from rapidly progressive paresthesia of lower limbs and gait disturbance. After one month, she showed flaccid paraplegia and hyperreflexia in the lower limbs with positive Babinski signs. Anti-HTLV-1 antibody titer was elevated in the serum, but negative in the cerebrospinal fluid (CSF). CSF examination showed mild pleocytosis, elevated protein, and normal glucose content. Adult T cell lymphoma (ATL)-like cells were seen in the CSF. MRI showed no abnormal intensity in the spinal cord and brain. Two months later, she showed rapid worsening of the paraplegia and she became unable to stand. A tentative diagnosis of rapidly progressive HTLV-1 associated myelopathy (HAM) was given, but intravenous methylprednisolone was ineffective. Six months later, she developed pneumonia, and abundant ATL cells were seen in the peripheral blood, suggesting a diagnosis of ATL. Direct infiltration of ATL cells to central nervous system was therefore suggested to have caused neurological abnormalities in this case. One may consider central nervous system leukemia when rapidly progressive HAM-like symptoms and signs are recognized, especially without positive anti-HTLV-1 antibody in the CSF.

  7. Cervical myelopathy caused by invagination of anomalous lamina of the axis.

    PubMed

    Sakaura, Hironobu; Yasui, Yukihiko; Miwa, Toshitada; Yamashita, Tomoya; Ohzono, Kenji; Ohwada, Tetsuo

    2013-12-01

    The authors report a case of cervical myelopathy caused by invagination of the bilaterally separated lamina of the axis. They also present a literature review. The patient was a previously healthy 68-year-old man with a 1-year history of slowly progressive gait disturbance, right-hand clumsiness, and right dominant sensory disturbance in his trunk and extremities. Both MRI and CT showed that the spinal cord was markedly compressed at the C2-3 level, on the right side, by a deeply invaginated anomalous lamina of the axis. A bilaterally separated lamina was also visible. The patient underwent removal of the anomalous invaginated fragment of the separated lamina and the spinous process of the axis. One year after surgery, his myelopathic symptoms had almost completely resolved. Here, the authors present the case of a patient with an extremely rare anomaly of the lamina of the axis. The underlying pathogenesis of this anomaly could be the failure of the 2 chondrification centers on either side to fuse into a single ossification center. Surgical removal of the anomalous invaginated lamina produced a satisfactory outcome.

  8. Clinical, imaging, and pathologic characteristics of Gurltia paralysans myelopathy in domestic cats from Chile.

    PubMed

    Mieres, Marcelo; Gómez, Marcelo A; Lillo, Carla; Rojas, Marcela A; Moroni, Manuel; Muñoz, Pamela; Acosta-Jamett, Gerardo; Wiegand, Ricardo

    2013-01-01

    Gurltia paralysans is a rare metastrongylid nematode of domestic cats that is found mainly in the veins of the spinal cord subarachnoid space and parenchyma. Endemic regions for G. paralysans mainly include Chile and Argentina. The ante mortem diagnosis of gurltiosis is difficult and based primarily on neurological signs, epidemiological factors, and the exclusion of other causes of feline myelopathies. The purpose of this retrospective case series was to describe clinical, imaging, and pathologic characteristics in nine domestic cats naturally infected with G. paralysans. Imaging tests included radiography, myelography, computed tomographic myelography (myelo-CT), and magnetic resonance imaging (MRI). Neurological signs included paraparesis, paraplegia, pelvic limb ataxia and proprioceptive deficits, pelvic limb tremors, lumbosacral hyperesthesia, and tail trembling or atony. Complete blood count findings included a decrease in the mean corpuscular hemoglobin concentration value in eight cats. Eosinophilia in peripheral blood was observed in three cats, and thrombocytopenia was observed in three cats. Cerebrospinal fluid analysis revealed mononuclear pleocytosis in five cases. Myelo-CT showed diffuse enlargement of the spinal cord at the midthoracic, lumbar, and sacral regions in all cats. Magnetic resonance image findings in the thoracic and lumbar region demonstrated multiple small nodular areas of T2 hyperintensity in the periphery of the spinal cord parenchyma. Localized intraparenchymal areas of increased T2 intensity were also observed in the thoracolumbar spinal cord and lumbosacral conus medullaris. In conclusion, G. paralysans should be considered as a differential diagnosis for domestic cats in endemic regions that have this combination of clinical and imaging characteristics.

  9. Variants within the SP110 nuclear body protein modify risk of canine degenerative myelopathy

    PubMed Central

    Ivansson, Emma L.; Kozyrev, Sergey V.; Murén, Eva; Körberg, Izabella Baranowska; Swofford, Ross; Koltookian, Michele; Tonomura, Noriko; Zeng, Rong; Kolicheski, Ana L.; Hansen, Liz; Katz, Martin L.; Johnson, Gayle C.; Johnson, Gary S.; Coates, Joan R.; Lindblad-Toh, Kerstin

    2016-01-01

    Canine degenerative myelopathy (DM) is a naturally occurring neurodegenerative disease with similarities to some forms of amyotrophic lateral sclerosis (ALS). Most dogs that develop DM are homozygous for a common superoxide dismutase 1 gene (SOD1) mutation. However, not all dogs homozygous for this mutation develop disease. We performed a genome-wide association analysis in the Pembroke Welsh Corgi (PWC) breed comparing DM-affected and -unaffected dogs homozygous for the SOD1 mutation. The analysis revealed a modifier locus on canine chromosome 25. A haplotype within the SP110 nuclear body protein (SP110) was present in 40% of affected compared with 4% of unaffected dogs (P = 1.5 × 10−5), and was associated with increased probability of developing DM (P = 4.8 × 10−6) and earlier onset of disease (P = 1.7 × 10−5). SP110 is a nuclear body protein involved in the regulation of gene transcription. Our findings suggest that variations in SP110-mediated gene transcription may underlie, at least in part, the variability in risk for developing DM among PWCs that are homozygous for the disease-related SOD1 mutation. Further studies are warranted to clarify the effect of this modifier across dog breeds. PMID:27185954

  10. A 66-Year-Old Woman with a Progressive, Longitudinally Extensive, Tract Specific, Myelopathy

    PubMed Central

    Schwetye, Katherine E.; Perrin, Richard; Schmidt, Robert E.

    2016-01-01

    A 66-year-old woman presented with progressive lancinating pain and sensory deficits attributable to a myelopathy of unclear etiology. Spinal cord magnetic resonance imaging showed a longitudinally extensive T2-hyperintense lesion of the dorsal columns. Comprehensive serum, urine, and cerebrospinal fluid analyses failed to identify an etiology. Empiric intravenous methylprednisolone and intravenous immunoglobulin were of no benefit and serial screens for an occult malignancy were negative. She developed dysesthesias and allodynia affecting her entire body and lost the use of her arms and legs due to severe sensory ataxia that was steadily progressive from onset. She opted against additional aggressive medical management of her condition and passed away on hospice eleven months after symptom onset. Autopsy revealed findings most consistent with polyphasic spinal cord ischemia affecting the dorsal and lateral white matter tracts and, to a lesser extent, adjacent gray matter. The underlying etiology for the progressive vasculopathy remains unknown. Spinal cord ischemia affecting the posterior spinal cord is rare and to our knowledge this case represents the only instance of a progressive spinal cord tractopathy attributable to chronic spinal cord ischemia. PMID:27990305

  11. Etanercept-Induced Myelopathy in a Pediatric Case of Blau Syndrome

    PubMed Central

    Caracseghi, Fabiola; Izquierdo-Blasco, Jaume; Sanchez-Montanez, Angel; Melendo-Perez, Susana; Roig-Quilis, Manuel; Modesto, Consuelo

    2011-01-01

    Blau syndrome is a rare autoinflammatory disorder within the group of pediatric granulomatous diseases. Mutations in nucleotide-binding oligomerization domain 2 (NOD2/CARD15) are responsible for this condition, which has an autosomal dominant pattern of inheritance and variable expressivity. The clinical picture includes arthritis, uveitis, skin rash, and granulomatous inflammation. Central nervous system involvement is seldom reported, although some isolated cases of seizures, neurosensorial hearing loss, and transient cranial nerve palsy have been described. Treatment consists of nonsteroidal anti-inflammatory drugs, corticosteroids, and immunosuppressive agents, among which anti-tumor-necrosis-factor-alpha (TNF-α) biologic agents, such as etanercept, play an important role. Among the major adverse effects of TNF-α inhibitors, demyelinating disease, multiple sclerosis, and acute transverse myelitis have been reported in adults. We describe a case of pediatric Blau syndrome affected by etanercept-induced myelopathy, manifesting as a clinical syndrome of transverse myelitis. The patient experienced rapid recovery after etanercept was discontinued. To our knowledge, this is the first such case reported in the literature and, possibly, the one with the latest onset, following 8 years of treatment. We discuss the etiopathogenic mechanisms of this reaction and possible explanations for the imaging findings. PMID:22937436

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

    PubMed Central

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

    2015-01-01

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

  13. Characterization of Intercostal Muscle Pathology in Canine Degenerative Myelopathy: A Disease Model for Amyotrophic Lateral Sclerosis

    PubMed Central

    Morgan, Brandie R.; Coates, Joan R.; Johnson, Gayle C.; Bujnak, Alyssa C.; Katz, Martin L.

    2014-01-01

    Dogs homozygous for missense mutations in the SOD1 gene develop a late-onset neuromuscular disorder called degenerative myelopathy (DM) that has many similarities to amyotrophic lateral sclerosis (ALS). Both disorders are characterized by widespread progressive declines in motor functions accompanied by atrophic changes in the descending spinal cord tracts , and some forms of ALS are also associated with SOD1 mutations. In end-stage ALS, death usually occurs as a result of respiratory failure due to severe functional impairment of respiratory muscles. The mechanisms that lead to this loss of function are not known. Dogs with DM are euthanized at all stages of disease progression providing an opportunity to characterize the onset and progression of any pathological changes in the respiratory muscles that may precede respiratory failure. To characterize such potential disease-related pathology we evaluated intercostal muscles from Boxer and Pembroke Welsh Corgi dogs that were euthanized at various stages of DM disease progression. DM was found to result in intercostal muscle atrophy, fibrosis, increased variability in muscle fiber size and shape, and an alteration in muscle fiber type composition. This pathology was not accompanied by retraction of the motor neuron terminals from the muscle acetylcholine receptor complexes, suggesting that the muscle atrophy did not result from physical denervation. These findings provide a better understanding of the mechanisms that likely lead to respiratory failure in at least some forms of ALS and will be useful in the development and evaluation of potential therapeutic interventions using the DM model. PMID:24043596

  14. Proximal and proximo-distal bimelic amyotrophy: Evidence of cervical flexion induced myelopathy.

    PubMed

    Preethish-Kumar, Veeramani; Polavarapu, Kiran; Singh, Ravinder Jeet; Vengalil, Seena; Prasad, Chandrajit; Verma, Abha; Nalini, Atchayaram

    This report aims at describing two new clinical phenotypes associated with classical features of cervical flexion induced myelopathy (CFIM). The description is of a prospective case series of six young males presenting with progressive bilateral proximal/proximo-distal amyotrophy of upper limbs and demonstrating the typical MRI characteristics of Hirayama disease. All underwent detailed clinical, electrophysiologcal and imaging studies. The affected muscles were shoulder girdles and arms in proximal form (n = 2) and the entire upper limbs in proximo-distal form (n = 4). The mean age at onset was 21.0 ± 3.3 years, duration of illness was 6.7 ± 3.4 years, period of progression was 39.0 ± 27.3 months followed by a stable phase of 45.0 ± 50.0 months. All had severe wasting and weakness of affected muscles leading to significant disability. Nerve conduction studies revealed grossly reduced compound muscle action potential amplitudes with neurogenic pattern on electromyography of affected muscles. On MRI all revealed evidence of cervical cord atrophy with signal changes, dural detachment and extensive posterior epidural enhancement (variably from C1 to T2 level). Altered cervical curvature was prominent. In conclusion, hitherto unreported, we describe two additional clinical phenotypes (proximal and proximo-distal forms) of Hirayama disease demonstrating the cardinal imaging features of CFIM.

  15. Clinical predictors of surgical outcome in cervical spondylotic myelopathy: an analysis of 248 patients.

    PubMed

    Pumberger, M; Froemel, D; Aichmair, A; Hughes, A P; Sama, A A; Cammisa, F P; Girardi, F P

    2013-07-01

    The purpose of this study was to investigate the clinical predictors of surgical outcome in patients with cervical spondylotic myelopathy (CSM). We reviewed a consecutive series of 248 patients (71 women and 177 men) with CSM who had undergone surgery at our institution between January 2000 and October 2010. Their mean age was 59.0 years (16 to 86). Medical records, office notes, and operative reports were reviewed for data collection. Special attention was focused on pre-operative duration and severity as well as post-operative persistence of myelopathic symptoms. Disease severity was graded according to the Nurick classification. Our multivariate logistic regression model indicated that Nurick grade 2 CSM patients have the highest chance of complete symptom resolution (p < 0.001) and improvement to normal gait (p = 0.004) following surgery. Patients who did not improve after surgery had longer duration of myelopathic symptoms than those who did improve post-operatively (17.85 months (1 to 101) vs 11.21 months (1 to 69); p = 0.002). More advanced Nurick grades were not associated with a longer duration of symptoms (p = 0.906). Our data suggest that patients with Nurick grade 2 CSM are most likely to improve from surgery. The duration of myelopathic symptoms does not have an association with disease severity but is an independent prognostic indicator of surgical outcome.

  16. Comparison of Two Reconstructive Techniques in the Surgical Management of Four-Level Cervical Spondylotic Myelopathy

    PubMed Central

    Li, FengNing; Li, ZhongHai; Huang, Xuan; Chen, Zhi; Zhang, Fan; Shen, HongXing; Kang, YiFan; Zhang, YinQuan; Cai, Bin; Hou, TieSheng

    2015-01-01

    To compare the clinical efficacy and radiological outcome of treating 4-level cervical spondylotic myelopathy (CSM) with either anterior cervical discectomy and fusion (ACDF) or “skip” corpectomy and fusion, 48 patients with 4-level CSM who had undergone ACDF or SCF at our hospital were analyzed retrospectively between January 2008 and June 2011. Twenty-seven patients received ACDF (Group A) and 21 patients received SCF. Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and Cobb's angles of the fused segments and C2-7 segments were compared in the two groups. The minimum patient follow-up was 2 years. No significant differences between the groups were found in demographic and baseline disease characteristics, duration of surgery, or follow-up time. Our study demonstrates that there was no significant difference in the clinical efficacy of ACDF and SCF, but ACDF involves less intraoperative blood loss, better cervical spine alignment, and fewer postoperative complications than SCF. PMID:25692140

  17. A Brazilian Portuguese cross-cultural adaptation of the modified JOA scale for myelopathy

    PubMed Central

    Pratali, Raphael R.; Smith, Justin S.; Motta, Rodrigo L.N.; Martins, Samuel M.; Motta, Marcel M.; Rocha, Ricardo D.; Herrero, Carlos Fernando P.S.

    2017-01-01

    OBJECTIVES: To develop a version of the modified Japanese Orthopaedic Association (mJOA) scale that had been translated into Portuguese and cross-culturally adapted for the Brazilian population. METHODS: The well-established process of forward-backward translation was employed along with cross-cultural adaptation. RESULTS: Three bilingual translators (English and native Portuguese) performed the forward translation of the mJOA scale from English to Portuguese based on iterative discussions used to reach a consensus translation. The translated version of the mJOA scale was then back-translated into English by a native English-speaking translator unaware of the concepts involved with the mJOA scale. The original mJOA scale and the back-translated version were compared by a native North American neurosurgeon, and as they were considered equivalent, the final version of the mJOA scale that had been translated into Portuguese and cross-culturally adapted was defined. CONCLUSION: To facilitate global and cross-cultural comparisons of the severity of cervical myelopathy, this study presents a version of the mJOA scale that was translated into Portuguese and cross-culturally adapted for the Brazilian population. PMID:28273233

  18. 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

  19. Symptomatic lumbar disc protrusion causing progressive myelopathy in a low-lying cord.

    PubMed

    Srinivas, Shreya; Shetty, Rohit; Collins, Iona

    2012-06-01

    Low-lying cord is an uncommon entity, and cord compression due lumbar disc disease is rarely encountered. We discuss our experience with a case of lumbar cord compression secondary to a large disc protrusion, which caused myelopathy in a low-lying/tethered cord. A 77-year-old woman with known spina bifida occulta presented with 6-week history of severe low back pain and progressive paraparesis. Magnetic resonance imaging showed a low-lying tethered cord and a large disc prolapse at L2/3 causing cord compression with associated syringomyelia. Medical comorbidities precluded her from anterior decompression, and therefore a posterior decompression was performed. She recovered full motor power in her lower limbs and could eventually walk unaided. She had a deep wound infection, which was successfully treated with debridement, negative pressure therapy (vacuum-assisted closure pump), and antibiotics. Six months after surgery, her Oswestry Disability Index improved from 55% preoperatively to 20%. Posterior spinal cord decompression for this condition has been successful in our case, and we believe that the lumbar lordosis may have helped indirectly decompress the spinal cord by posterior decompression alone.

  20. Cervical Spondylotic Myelopathy due to the Ochronotic Arthropathy of the Cervical Spine

    PubMed Central

    Li, Nan; Yuan, Qiang; He, Da

    2016-01-01

    Ochronosis is a musculoskeletal manifestation of alkaptonuria, a rare hereditary metabolic disorder occurs due to the absence of homogentisic acid oxidase and leading to various systemic abnormalities related to deposition of homogentisic acid pigmentation (ochronotic pigmentation). The present case reports the clinical features, radiographic findings, treatments and results of a cervical spondylotic myelopathy woman patient due to the ochronotic arthropathy of the cervical spine. The patient aged 62 years was presented with gait disturbance and hand clumsiness. Physical examination, X-rays, computed tomography and lab results of the urine sample confirmed the presence of ochronosis with the involvement of the cervical spine. The patient underwent a modified cervical laminoplasty due to multi-segment spinal cord compression. The postoperative follow-up showed a good functional outcome with patient satisfaction. The present study concludes the conditions and important diagnostic and surgical aspects of a patient. It is necessary to identify the condition clinically and if cord compression is observed, appropriate surgical interventions needs to be instituted. PMID:26885289

  1. Characterization of intercostal muscle pathology in canine degenerative myelopathy: a disease model for amyotrophic lateral sclerosis.

    PubMed

    Morgan, Brandie R; Coates, Joan R; Johnson, Gayle C; Bujnak, Alyssa C; Katz, Martin L

    2013-12-01

    Dogs homozygous for missense mutations in the SOD1 gene develop a late-onset neuromuscular disorder called degenerative myelopathy (DM) that has many similarities to amyotrophic lateral sclerosis (ALS). Both disorders are characterized by widespread progressive declines in motor functions, accompanied by atrophic changes in the descending spinal cord tracts. Some forms of ALS are also associated with SOD1 mutations. In end-stage ALS, death usually occurs as a result of respiratory failure from severe functional impairment of respiratory muscles. The mechanisms that lead to this loss of function are not known. Dogs with DM are euthanized at all stages of disease progression, providing an opportunity to characterize the onset and progression of any pathological changes in the respiratory muscles that may precede respiratory failure. To characterize such potential disease-related pathology, we evaluated intercostal muscles from Boxer and Pembroke Welsh Corgi dogs that were euthanized at various stages of DM disease progression. DM was found to result in intercostal muscle atrophy, fibrosis, increased variability in muscle fiber size and shape, and alteration in muscle fiber type composition. This pathology was not accompanied by retraction of the motor neuron terminals from the muscle acetylcholine receptor complexes, suggesting that the muscle atrophy did not result from physical denervation. These findings provide a better understanding of the mechanisms that likely lead to respiratory failure in at least some forms of ALS and will be useful in the development and evaluation of potential therapeutic interventions using the DM model.

  2. Feline ischaemic myelopathy with a predilection for the cranial cervical spinal cord in older cats.

    PubMed

    Simpson, Katherine M; De Risio, Luisa; Theobald, Anita; Garosi, Laurent; Lowrie, Mark

    2014-12-01

    All previous studies on feline ischaemic myelopathy (IM) have reported an acute onset of a single event with no recurrence of clinical signs. This study aimed to evaluate clinical and long-term follow-up data in cats presumptively diagnosed with cervical IM in the territory of the ventral spinal artery (VSA). Eight cats (four females and four males) were included with a mean age of 14 years and 2 months. Neurological status at the time of presentation ranged from ambulatory tetraparesis to tetraplegia with nociception present. Six cats had marked cervical ventroflexion. All eight cats were diagnosed with one or more concurrent medical conditions, including chronic kidney disease (n = 2), hypertrophic cardiomyopathy (n = 2) and hypertension (n = 6). Median time to ambulation was 5.7 days (range 2-14 days). Long-term follow-up ranged from 7 months to 3 years and 3 months (median 1 year and 2 months). Five cats had no reported recurrence of clinical signs and 3/8 had a chronic relapsing disease course. One cat had an acute recurrence of clinical signs 4 months after the first event and was euthanased. Two cats had acute onsets of suspected intracranial infarctions, one of which had further suspected intracranial infarcts every 3 months and was euthanased after one of these. This study highlights the importance of performing ancillary diagnostic tests in older cats presenting with IM, particularly when VSA embolisation is suspected.

  3. Prognostic Value of Preoperative Coping Strategies for Pain in Patients with Residual Neuropathic Pain after Laminoplasty for Compressive Cervical Myelopathy

    PubMed Central

    2015-01-01

    Study Design Single-center retrospective cohort study. Purpose To clarify the prognostic value of preoperative coping strategies for pain due to compressive cervical myelopathy. Overview of Literature Preoperative physical function, imaging and electrophysiological findings are known predictors of surgical outcomes. However, coping strategies for pain have not been considered. Methods Postoperative questionnaires, concerning health-related quality of life (HRQOL) and daily living activities, were sent to 78 patients with compressive cervical myelopathy who had suffered from neuropathic pain before laminoplasty, and been preoperatively assessed with respect to their physical and mental status and coping strategies for pain. Hierarchical multiple regression analysis was performed to clarify the extent to which the patient's preoperative coping strategies could explain the variance in postoperative HRQOL and activity levels. Results Forty-two patients with residual neuropathic pain after laminoplasty were analyzed by questionnaires (28 men, 14 women; mean age, 62.7±10.2 years; symptom duration, 48.0±66.0 months). The valid response rate was 53.8%. Hierarchical multiple regression analysis showed that preoperative coping strategies, which involved coping self-statements, diverting attention, and catastrophizing, were independently associated with postoperative HRQOL and activity level, and could explain 7% to 11% of their variance. Combinations of the coping strategies for pain and upper/lower motor functions could explain 26% to 36% of the variance in postoperative HRQOL and activity level. Conclusions Preoperative coping strategies for pain are good predictors of postoperative HRQOL and activities of daily living in patients with postoperative residual neuropathic pain due to compressive cervical myelopathy. PMID:26435783

  4. One stage laminoplasty and posterior herniotomy for the treatment of myelopathy caused by cervical stenosis with cervical disc herniation

    PubMed Central

    Yue, Bin; Chen, Bohua; Ma, Xue-Xiao; Xi, Yong-Ming; Xiang, Hong-Fei; Hu, You-Gu; Zhang, Guoqing

    2015-01-01

    The aim of the study was to introduce a method of one stage laminoplasty and posterior herniotomy for myelopathy caused by cervical stenosis with cervical disc herniation and to evaluate the clinical efficacy of this surgery. From 1999 to 2008, 18 patients with myelopathy caused by cervical stenosis with cervical disc herniation who underwent this procedure were included. The average age was 63 years (range 48-74 years), and the average follow-up period was 46 months (range 3-108 months). Neurologic status was evaluated using the JOA scoring system. Neurological symptoms improvement was seen in all patients after surgery. The average JOA score was 14.22±1.86 by final follow-up, which was higher than preoperative values (P<0.01), and the average improvement in neurological function was 76.63%. Neurologic examination showed that excellent results had been obtained by 10 patients, good results by 8 patients, with no fair or poor results. 2 patients developed cerebrospinal fluid leakage after surgery and recovered during the follow-up period. One patient with cervical disc herniation developed postoperative C5 palsy on the axle side on the third day after surgery. She completely recovered by 1 month after surgery. No other patients experienced postoperative neurologic complications. Complete anterior and posterior decompression of the spinal cord was achieved after surgery. We concluded that one stage laminoplasty and posterior herniotomy is an effective, reliable, and safe procedure for the treatment of myelopathy caused by cervical stenosis with cervical disc herniation. PMID:26309625

  5. Dermatological findings of human T lymphotropic virus type 1 (HTLV-I)-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Lenzi, Maria E R; Cuzzi-Maya, Tullia; Oliveira, André L A; Andrada-Serpa, Maria J; Araújo, Abelardo Q-C

    2003-02-15

    Dermatological findings for patients with human T lymphotropic virus type 1(HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) were investigated and were compared with dermatological findings for a control group. Only xerosis, cutaneous candidiasis, and palmar erythema were significantly associated with HAM/TSP. Histopathological patterns of cutaneous lymphoma were seen in 25% of 32 patients who underwent biopsy, and, thus, the cutaneous alterations in HAM/TSP can be classified into nonspecific lesions, infectious lesions, immune-inflammatory-mediated lesions, and premalignant or malignant lesions.

  6. Subacute post-traumatic ascending myelopathy (SPAM): two cases of SPAM following surgical treatment of thoracolumbar fractures.

    PubMed

    Farooque, Kamran; Kandwal, Pankaj; Gupta, Ankit

    2014-01-01

    To report two cases of traumatic paraplegia who developed Sub-acute Post-Traumatic Ascending Myelopathy (SPAM) following surgical decompression.We hereby report two cases (both 35yr old male) with traumatic paraplegia that developed ascending weakness at 3rd and 5th Post-Op day respectively following surgical decompression. Both the patients experienced remarkable improvement in Neurology after treatment with steroids. The authors conclude by emphasizing on minimum cord handling during surgical decompression of the spinal cord to avoid this potentially life threatening complication.

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

    PubMed

    Adeleye, A Olufemi; Akinyemi, R Olusola

    2010-09-01

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

  8. Tropical spastic paraparesis and HTLV-1 associated myelopathy: clinical, epidemiological, virological and therapeutic aspects.

    PubMed

    Gessain, A; Mahieux, R

    2012-03-01

    In 1980, Human T cell leukemia/lymphoma virus type 1 (HTLV-1) was the first oncogenic human retrovirus to be discovered. HTLV-1 belongs to the Retroviridae family, the Orthoretrovirinae subfamily and to the deltaretrovirus genus. HTLV-1 preferentially infects CD4(+) lymphoid cells in vivo. Three molecules have been identified for binding and/or entry of HTLV-1: heparan sulfate proteoglycans, neuropilin-1, and glucose transporter 1. An efficient transfer of the virus from an infected cell to a target cell can occur through the formation of a viral synapse and/or by virofilm structure. As for all retroviruses, HTLV-1 genome possesses three major ORFs (gag, pol and env) encoding the structural and enzymatic proteins. HTLV-1 encodes also some regulatory and auxillary proteins including the tax protein with transforming activities and the HBZ protein which plays a role in the proliferation and maintenance of the leukemic cells. HTLV-1 is present throughout the world with clusters of high endemicity including mainly Southern Japan, the Caribbean region, areas in South America and in intertropical Africa. The worldwide HTLV-1 infected population is estimated to be around 10-20 million. HTLV-1 has three modes of transmission: (1): mother to child, mainly linked to prolonged breast-feeding; (2): sexual, mainly occurring from male to female and (3): contaminated blood products. HTLV-1 possesses a remarkable genetic stability. HTLV-1 is the etiological agent of mainly two severe diseases: a malignant T CD4(+) cell lymphoproliferation, of very poor prognosis, named Adult T cell Leukemia/Lymphoma (ATLL), and a chronic neuro-myelopathy named Tropical spastic paraparesis/HTLV-1 Associated Myelopathy (TSP/HAM). The lifetime risk among HTLV-1 carriers is estimated to be around 0.25 to 3%. TSP/HAM mainly occurs in adults, with a mean age at onset of 40-50 years and it is more common in women than in men. Blood transfusion is a major risk factor for TSP/HAM development. Clinically

  9. Prevalence of complications after surgery in treatment for cervical compressive myelopathy

    PubMed Central

    Wang, Tao; Tian, Xiao-Ming; Liu, Si-Kai; Wang, Hui; Zhang, Ying-Ze; Ding, Wen-Yuan

    2017-01-01

    Abstract Purpose: We aim to perform a meta-analysis on prevalence of all kinds of operation-related complications following surgery treating cervical compressive myelopathy (CCM) and to provide reference for surgeons making surgical plan. Methods: An extensive search of literature was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on incidence of operation-related complications from January 2007 to November 2016. Data was calculated and data analysis was conducted with STATA 12.0 and Revman 5.3. Results: A total of 107 studies included 1705 of 8612 patients (20.1%, 95% CI 17.3%–22.8%) on overall complications. The incidence of C5 plasy, cerebrospinal fluid (CSF), infection, axial pain, dysphagia, hoarseness, fusion failure, graft subsidence, graft dislodgment, and epidural hematoma is 5.3% (95% CI 4.3%–6.2%), 1.9% (95% CI 1.3%–2.4%), 2.8% (95% CI 1.7%–4.0%), 15.6% (95% CI 11.7%–19.5%), 16.8% (95% CI 13.6%–19.9%), 4.0% (95% CI 2.3%–5.7%), 2.6% (95% CI 0.2%–4.9%), 3.7% (95% CI 2.0%–5.5%), 3.4% (95% CI 2.0%–4.8%), 1.1% (95% CI 0.7%–1.5%), respectively. Patients with ossification of posterior longitudinal ligament (OPLL) (6.3%) had a higher prevalence of C5 plasy than those with cervical spondylotic myelopathy (CSM) (4.1%), and a similar trend in CSF (12.2% vs 0.9%). Individuals after laminectomy and fusion (LF) had highest rate of C5 plasy (15.2%), while those who underwent anterior cervical discectomy and fusion (ACDF) had the lowest prevalence (2.0%). Compared with patients after other surgical options, individuals after anterior cervical corpectomy and fusion (ACCF) have the highest rate of CSF (4.2%), infection (14.2%), and epidural hematoma (3.1%). Patients after ACDF (4.8%) had a higher prevalence of hoarseness than those with ACCF (3.0%), and a similar trend for dysphagia between anterior corpectomy combined with discectomy (ACCDF) and ACCF (16.8% vs 9.9%). Conclusions: Based on our meta

  10. Effectiveness of the Laminoplasty in the Elderly Patients with Cervical Spondylotic Myelopathy

    PubMed Central

    Son, Doo Kyung; Song, Geun Sung; Lee, Sang Weon

    2014-01-01

    Objective The purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients. Methods A retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation. Results Mean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same. Conclusion We conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group. PMID:25110481

  11. Age-Related Surgical Outcomes of Laminoplasty for Cervical Spondylotic Myelopathy

    PubMed Central

    Maeno, Takafumi; Okuda, Shinya; Yamashita, Tomoya; Matsumoto, Tomiya; Yamasaki, Ryoji; Oda, Takenori; Iwasaki, Motoki

    2014-01-01

    Study Design Retrospective clinical study. Objective To investigate the age-related surgical outcomes of laminoplasty. Methods One hundred patients who underwent an en bloc laminoplasty for cervical spondylotic myelopathy from 2004 to 2008 and were followed for at least 1 year were included in this study. The clinical outcomes were assessed with the Japanese Orthopaedic Association (JOA) score. Acquired points (postoperative JOA score minus preoperative JOA score) were also calculated. To investigate the age-related effect for laminoplasty, two analyses were conducted: (1) the correlation between age and clinical outcome; and (2) the clinical outcomes by decade. Patients were divided into four groups according to their age at the time of operation as follows: group 50s, 50 to 59 years old; group 60s, 60 to 69 years; group 70s, 70 to 79 years; and group 80s, 80 to 89 years. The pre- and postoperative JOA scores, acquired points, preoperative comorbidities, and postoperative complications were then compared among the groups. Results Significant correlations were detected between age and JOA scores at the preoperative (p = 0.03), postoperative maximum (p < 0.0001), and final assessments (p < 0.0001). An age-related decline of JOA scores was observed over all periods. The analysis by decades showed the same results. On the other hand, the significant differences were not found for acquired points over all periods by either method. The preoperative comorbidities of hypertension and diabetes mellitus increased with age. Delirium was more common postoperatively in elderly patients. Conclusions Although an age-related decline of JOA scores was found over all periods, there were no severe sequelae and no differences in the acquired points that were age-related. PMID:25844284

  12. Voxel-based analysis of grey and white matter degeneration in cervical spondylotic myelopathy

    PubMed Central

    Grabher, Patrick; Mohammadi, Siawoosh; Trachsler, Aaron; Friedl, Susanne; David, Gergely; Sutter, Reto; Weiskopf, Nikolaus; Thompson, Alan J.; Curt, Armin; Freund, Patrick

    2016-01-01

    In this prospective study, we made an unbiased voxel-based analysis to investigate above-stenosis spinal degeneration and its relation to impairment in patients with cervical spondylotic myelopathy (CSM). Twenty patients and 18 controls were assessed with high-resolution MRI protocols above the level of stenosis. Cross-sectional areas of grey matter (GM), white matter (WM), and posterior columns (PC) were measured to determine atrophy. Diffusion indices assessed tract-specific integrity of PC and lateral corticospinal tracts (CST). Regression analysis was used to reveal relationships between MRI measures and clinical impairment. Patients showed mainly sensory impairment. Atrophy was prominent within the cervical WM (13.9%, p = 0.004), GM (7.2%, p = 0.043), and PC (16.1%, p = 0.005). Fractional anisotropy (FA) was reduced in the PC (−11.98%, p = 0.006) and lateral CST (−12.96%, p = 0.014). In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC. Light-touch score was associated with atrophy (R2 = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020). This study demonstrates voxel-based degeneration far above the stenosis at a level not directly affected by the compression and provides unbiased readouts of tract-specific changes that relate to impairment. PMID:27095134

  13. Our technique of midsagittal splitting laminoplasty for compressive cervical myelopathy and its short-term results

    PubMed Central

    Srivastava, Niraj Kumar; Singh, Sunita; Chauhan, Shishu Pal Singh; Gopal, Nitya Nand

    2016-01-01

    Objective: The aim of this study was to discuss the technique of midsagittal splitting laminoplasty and to compare its short-term follow-up results with laminectomy in cases of compressive cervical spinal cord myelopathy. Materials and Methods: Exclusion criteria were as follows: Intramedullary compressive lesions, kyphotic cervical spine, previous spinal surgeries, and defective anterior vertebral column. Twenty patients (10 each of laminoplasty and laminectomy groups) were prospectively studied from 2005 to 2008. After clinico-radiological assessment, laminoplasty or laminectomy was performed in patients aged <50 years and >50 years, respectively. The laminoplasty was performed by splitting the excised lamina in midline up to the tip of spinous process. Follow-up was done by neurosurgical cervical spine scoring, Nurick's grading, and the final outcome was determined by Odom's criteria. Results: The mean operative time and blood loss in laminoplasty and laminectomy was 100 ± 0.87 (range 90-140 min), 80 ± 0.67 (range 75-100 min) P = 0.04; and 65 ± 0.07 (range 60-90 ml) and 68 ± 0.61 (range 65-80 ml) P = 0.09, respectively. There were no intraoperative accidents, and no postoperative neurological deterioration/recurrence of symptoms. One patient who underwent laminectomy alone developed progressive kyphosis of the spine, whereas one having rheumatoid arthritis and long symptom duration didn’t improve. 85% (17/20 patients) had sustained excellent to fair outcome (improvement by at least one Nurick's grade). Conclusions: The technique used by us was simple, effective, and inexpensive. There was no minimal postoperative morbidity, although long-term results are awaited. PMID:27366246

  14. Long Term Results of Anterior Corpectomy and Fusion for Cervical Spondylotic Myelopathy

    PubMed Central

    Chen, Huajiang; Liu, Yang; Liang, Lei; Yuan, Wen

    2012-01-01

    Background Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD). Methods This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA) scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. Findings Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA) and the sagittal alignment of the whole cervical spine (SACS) increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8±1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ≤9 were important predictors of the fair recovery rate (≤50%). Repeated surgery due to ASD was performed in 7 (4.8%) cases. Conclusions ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory. PMID:22514669

  15. Does Segmental Kyphosis Affect Surgical Outcome after a Posterior Decompressive Laminectomy in Multisegmental Cervical Spondylotic Myelopathy?

    PubMed Central

    Rustagi, Tarush; Prasad, Gautam; Deore, Tushar; Bhojraj, Shekhar Y.

    2017-01-01

    Study Design Retrospective analysis. Purpose To compare results of laminectomy in multisegmental compressive cervical myelopathy (CSM) with lordosis versus segmental kyphosis. Overview of Literature Laminectomy is an established procedure for decompression in CSM with cervical lordosis. However in patients with segmental kyphosis, it is associated with risk of progression of kyphosis and poor outcome. Whether this loss of sagittal alignment affects functional outcome is not clear. Methods We retrospectively reviewed 68 patients who underwent laminectomy for CSM from 1998 to 2009. As per preoperative magnetic resonance images, 36 patients had preoperative lordosis (Group 1) and 32 had segmental kyphosis (Group 2). We studied age at the time of surgery, duration of preoperative symptoms, recovery rate, magnitude of postoperative backward shifting of spinal cord and loss of sagittal alignment. Results Mean follow up was 5.05 years (range, 2–13 years) and mean age at the time of surgery 61.88 years. Group 1 had 20 men and 16 women and Group 2 had 19 men and 13 women. Mean recovery rate in Group 1 was 60.32%, in Group 2 was 63.7% without any statistical difference (p-value 0.21, one tailed analysis of variance). Two patients of Group 1 had loss of cervical lordosis by five degrees. In Group 2 seven patients had progression of segmental kyphosis by 5–10 degrees and two patients by more than 10 degrees. Mean cord shift was more in Group 1 (mean, 2.41 mm) as compared to Group 2 (mean, –1.97 mm) but it had no correlation to recovery rate. Patients with younger age (mean, 57 years) and less duration of preoperative symptoms (mean, 4.86 years) had better recovery rate (75%). Conclusions Clinical outcome in CSM is not related to preoperative cervical spine alignment. Thus, lordosis is not mandatory for planning laminectomy in CSM. Good outcome is expected in younger patients operated earliest after onset of symptoms. PMID:28243365

  16. Preservation of C7 spinous process does not influence the long-term outcome after laminoplasty for cervical spondylotic myelopathy.

    PubMed

    Higashino, K; Katoh, S; Sairyo, K; Sakai, T; Kosaka, H; Yasui, N

    2006-10-01

    Axial pain is one of the major complications after laminoplasty, and preservation of C7 spinous process during the procedure can reduce the axial pain. However, it has not been elucidated whether laminoplasty preserving the C7 spinous process can maintain neurological improvement for a long time. The purpose of our retrospective study was to investigate the long-term neurological outcome after open-door laminoplasty preserving the C7 spinous process for cervical spondylotic myelopathy (CSM). Clinical and radiological outcomes were analysed in 42 patients who underwent open-door laminoplasty preserving C7 spinous process and followed up for more than 5 years. Neurological function was evaluated by means of the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy. Axial pain was assessed using a visual analog scale (VAS) at the last examination. Alignment and motion of the cervical spine were measured from radiographs, and magnetic resonance imaging (MRI) was used to evaluate postoperative compression at C7. The mean JOA score was 9.4 before surgery and 12.0 at the latest follow-up. The mean VAS score in 26 patients score was 9.7/100. No compression of the spinal cord was observed in any MRI at the latest follow-up. Preservation of the C7 spinous process does not influence the long-term outcome of CSM after laminoplasty. Although we did not have a comparative group, the procedure described here should be considered as the solution.

  17. Clinical Case Report of Expansive Laminoplasty for Cervical Myelopathy Due to Both Disc Herniation and Developmental Cervical Spinal Canal Stenosis in Older Adolescents

    PubMed Central

    Zhou, Hua; Sun, Yu; Zhang, Fengshan; Dang, Gengting; Liu, Zhongjun

    2016-01-01

    Abstract Reports on adolescent patients with cervical myelopathy who underwent anterior cervical discectomy and fusion are scarce. However, to our knowledge, no cases of expansive laminoplasty for cervical myelopathy associated with progressive neurological deficit after a series of conservative treatment, caused by both disc herniation and developmental cervical spinal canal stenosis, have been reported. From January 2006 to July 2012, we retrospectively studied 3 patients in late adolescence presenting with cervical myelopathy who underwent expansive unilateral open-door laminoplasty at our hospital. The outcomes after the surgery were evaluated according to the Japanese Orthopedic Association scores. Symptoms presented by these patients were due to both disc herniation and developmental cervical spinal canal stenosis. No major complications occurred after the surgical procedures. The median follow-up time was 66 months (range 36–112 months). The Japanese Orthopedic Association scores after surgery showed a significant increase. Long-term outcomes after surgery were satisfactory according to the evaluation criteria for the Japanese Orthopedic Association scores. However, the ranges of motion of the cervical spine decreased, especially the ranges of motion on flexion after surgery showed a significant decrease. Expansive laminoplasty is helpful for older adolescent patients with cervical myelopathy due to both disc herniation and developmental cervical spinal canal stenosis, presenting with progressive neurological deficit after long conservative treatment. PMID:26937923

  18. Nerve root distribution of deltoid and biceps brachii muscle in cervical spondylotic myelopathy: a potential risk factor for postoperative shoulder muscle weakness after posterior decompression.

    PubMed

    Yonemura, Hiroshi; Kaneko, Kazuo; Taguchi, Toshihiko; Fujimoto, Hideaki; Toyoda, Kouichiro; Kawai, Shinya

    2004-01-01

    To investigate the nerve root distribution of deltoid and biceps brachii muscle, compound muscle action potentials (CMAPs) were recorded intraoperatively following nerve root stimulation in cervical spondylotic myelopathy. A total of 19 upper limbs in 12 patients aged 55-72 years (mean, 65.5 years) with cervical spondylotic myelopathy were examined. CMAPs were recorded from deltoid and biceps brachii muscle following C5 and C6 root stimulation. Although both C5 and C6 roots were innervated for deltoid and biceps brachii muscle in all subjects, the amplitude ratio of CMAPs (C5/C6) differed individually depending on the symptomatic intervertebral levels of the spinal cord. The C5 root predominantly innervated both deltoid and biceps brachii in patients with symptomatic cord lesions at the C4-C5 intervertebral level compared to patients with symptomatic cord lesions at the C5-C6 intervertebral level. Although no patients sustained postoperative radiculopathy in our study, severe weakness and unfavorable recovery are expected when the C5 root in patients with C4-C5 myelopathy is damaged. From the electrophysiological aspect, C4-C5 cord lesions are likely to be a potential risk factor for postoperative shoulder muscle weakness in patients with compressive cervical myelopathy.

  19. Surgical outcomes of elderly patients with cervical spondylotic myelopathy: a meta-analysis of studies reporting on 2868 patients.

    PubMed

    Madhavan, Karthik; Chieng, Lee Onn; Foong, Hanyao; Wang, Michael Y

    2016-06-01

    OBJECTIVE Cervical spondylotic myelopathy usually presents in the 5th decade of life or later but can also present earlier in patients with congenital spinal stenosis. As life expectancy continues to increase in the United States, the preconceived reluctance toward operating on the elderly population based on older publications must be rethought. It is a known fact that outcomes in the elderly cannot be as robust as those in the younger population. There are no publications with detailed meta-analyses to determine an acceptable level of outcome in this population. In this review, the authors compare elderly patients older than 75 years to a nonelderly population, and they discuss some of the relevant strategies to minimize complications. METHODS In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors performed a PubMed database search to identify English-language literature published between 1995 and 2015. Combinations of the following phrases that describe the age group ("elderly," "non-elderly," "old," "age") and the disease of interest as well as management ("surgical outcome," "surgery," "cervical spondylotic myelopathy," "cervical degenerative myelopathy") were constructed when searching for relevant articles. Two reviewers independently assessed the outcomes, and any disagreement was discussed with the first author until it was resolved. A random-effects model was applied to assess pooled data due to high heterogeneity between studies. The mean difference (MD) and odds ratio were calculated for continuous and dichromatic parameters, respectively. RESULTS Eighteen studies comprising elderly (n = 1169) and nonelderly (n = 1699) patients who received surgical treatment for cervical spondylotic myelopathy were included in this meta-analysis. Of these studies, 5 were prospective and 13 were retrospective. Intraoperatively, both groups required a similar amount of operation time (p = 0.35). The elderly

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

    PubMed

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

    2014-08-01

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

  1. Remote motor system metabolic profile and surgery outcome in cervical spondylotic myelopathy.

    PubMed

    Craciunas, Sorin C; Gorgan, Mircea R; Ianosi, Bogdan; Lee, Phil; Burris, Joseph; Cirstea, Carmen M

    2017-03-17

    OBJECTIVE In patients with cervical spondylotic myelopathy (CSM), the motor system may undergo progressive functional/structural changes rostral to the lesion, and these changes may be associated with clinical disability. The extent to which these changes have a prognostic value in the clinical recovery after surgical treatment is not yet known. In this study, magnetic resonance spectroscopy (MRS) was used to test 2 primary hypotheses. 1) Based on evidence of corticospinal and spinocerebellar, rubro-, or reticulospinal tract degeneration/dysfunction during chronic spinal cord compression, the authors hypothesized that the metabolic profile of the primary motor cortices (M1s) and cerebellum, respectively, would be altered in patients with CSM, and these alterations would be associated with the extent of the neurological disabilities. 2) Considering that damage and/or plasticity in the remote motor system may contribute to clinical recovery, they hypothesized that M1 and cerebellar metabolic profiles would predict, at least in part, surgical outcome. METHODS The metabolic profile, consisting of N-acetylaspartate (NAA; marker of neuronal integrity), myoinositol (glial marker), choline (cell membrane synthesis and turnover), and glutamate-glutamine (glutamatergic system), of the M1 hand/arm territory in each hemisphere and the cerebellum vermis was investigated prior to surgery in 21 patients exhibiting weakness of the upper extremities and/or gait abnormalities. Age- and sex-matched controls (n = 16) were also evaluated to estimate the pre-CSM metabolic profile of these areas. Correlation and regression analyses were performed between preoperative metabolite levels and clinical status 6 months after surgery. RESULTS Relative to controls, patients exhibited significantly higher levels of choline but no difference in the levels of other metabolites across M1s. Cerebellar metabolite levels were indistinguishable from control levels. Certain metabolites-myo-inositol and

  2. Comparison of the Japanese Orthopaedic Association Score and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire Scores: Time-Dependent Changes in Patients with Cervical Spondylotic Myelopathy and Posterior Longitudinal Ligament

    PubMed Central

    Iwasaki, Motoki; Sakaura, Hironobu; Fujimori, Takahito; Nagamoto, Yukitaka; Yoshikawa, Hideki

    2015-01-01

    Study Design Prospective cohort study. Purpose To identify differences in time-dependent perioperative changes between the Japanese Orthopaedic Association (JOA) score and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) score in patients with cervical spondylotic myelopathy (CSM) and posterior longitudinal ligament (OPLL) who underwent cervical laminoplasty. Overview of Literature The JOA score does not take into consideration patient satisfaction or quality of life. Accordingly, the JOACMEQ was designed in 2007 as a patient-centered assessment tool. Methods We studied 21 patients who underwent cervical laminoplasty. We objectively evaluated the time-dependent changes in JOACMEQ scores and JOA scores for all patients before surgery and at 2 weeks, 3 months, 6 months, and 1 year after surgery. Results The average total JOA score and the recovery rate improved significantly after surgery in both groups, with a slightly better recovery rate in the OPLL group. Cervical spine function improved significantly in the CSM group but not in the OPLL group. Upper- and lower-extremity functions were more stable in the CSM group than in the OPLL group. The effectiveness rate of the JOACMEQ for measuring quality of life was quite low in both groups. In both groups, the Spearman contingency coefficients were dispersed widely except for upper- and lower-extremity function. Conclusions Scores for upper- and lower-extremity function on the JOACMEQ correlated well with JOA scores. Because the JOACMEQ can also assess cervical spine function and quality of life, factors that cannot be assessed by the JOA score alone, the JOACMEQ is a more comprehensive evaluation tool. PMID:25705334

  3. Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality.

    PubMed

    Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi

    2014-01-01

    Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with welldemarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides.

  4. Night blindness due to vitamin A deficiency associated with copper deficiency myelopathy secondary to bowel bypass surgery.

    PubMed

    AlHassany, Ali Abdul Jabbar

    2014-04-29

    We present an interesting case of combined vitamin A and copper deficiency after a history of gastric bypass surgery where symptoms improved after parenteral copper and vitamin A treatment. Gastric bypass surgery as a cause of fat soluble vitamin deficiency is generally under-reported. Copper deficiency has been reported after gastric bypass surgery. Vitamin A deficiency after gastric bypass surgery has also been reported in the literature, but the reported cases again fall below the actual figures. B12 and folate deficiencies can produce a type of myelopathy similar to that produced by copper deficiency, and differentiation on the basis of laboratory tests, neurophysiology and improvement of symptoms after replacement therapy might be the hallmark of diagnosis. Combinations of vitamin deficiencies were previously reported, but no cases of combined vitamin A and copper deficiency could be found in the literature.

  5. 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

  6. A role for motor and somatosensory evoked potentials during anterior cervical discectomy and fusion for patients without myelopathy: Analysis of 57 consecutive cases

    PubMed Central

    Xu, Risheng; Ritzl, Eva K.; Sait, Mohammed; Sciubba, Daniel M.; Wolinsky, Jean-Paul; Witham, Timothy F.; Gokaslan, Ziya L.; Bydon, Ali

    2011-01-01

    Background: Although the usage of combined motor and sensory intraoperative monitoring has been shown to improve the surgical outcome of patients with cervical myelopathy, the role of transcranial electric motor evoked potentials (tceMEP) used in conjunction with somatosensory evoked potentials (SSEP) in patients presenting with radiculopathy but without myelopathy has been less clear. Methods: We retrospectively reviewed all patients (n = 57) with radiculopathy but without myelopathy, undergoing anterior cervical decompression and fusion at a single institution over the past 3 years, who had intraoperative monitoring with both tceMEPs and SSEPs. Results: Fifty-seven (100%) patients presented with radiculopathy, 53 (93.0%) with mechanical neck pain, 35 (61.4%) with motor dysfunction, and 29 (50.9%) with sensory deficits. Intraoperatively, 3 (5.3%) patients experienced decreases in SSEP signal amplitudes and 4 (6.9%) had tceMEP signal changes. There were three instances where a change in neuromonitoring signal required intraoperative alteration of the surgical procedure: these were deemed clinically significant events/true positives. SSEP monitoring showed two false positives and two false negatives, whereas tceMEP monitoring only had one false positive and no false negatives. Thus, tceMEP monitoring exhibited higher sensitivity (33.3% vs. 100%), specificity (95.6% vs. 98.1%), positive predictive value (33.3% vs. 75.0%), negative predictive value (97.7% vs. 100%), and efficiency (91.7% vs. 98.2%) compared to SSEP monitoring alone. Conclusions: Here, we present a retrospective series of 57 patients where tceMEP/SSEP monitoring likely prevented irreversible neurologic damage. Though further prospective studies are needed, there may be a role for combined tceMEP/SSEP monitoring for patients undergoing anterior cervical decompression without myelopathy. PMID:22059128

  7. Congestive myelopathy (Foix-Alajouanine Syndrome) due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature.

    PubMed

    Krishnan, Prasad; Banerjee, Tapas Kumar; Saha, Manash

    2013-07-01

    Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients' symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

  8. Venous Congestive Myelopathy due to Chronic Inferior Vena Cava Thrombosis Treated with Endovascular Stenting: Case Report and Review of the Literature

    PubMed Central

    Carvalho, Diego Z.; Hughes, Joshua D.; Liebo, Greta B.; Bendel, Emily C.; Bjarnason, Haraldur; Klaas, James P.

    2015-01-01

    Objective Impaired inferior vena cava (IVC) outflow can lead to collateralization of blood to the valveless epidural venous plexus, causing epidural venous engorgement and venous congestion. Herein we describe a case of chronic IVC thrombosis presenting as venous congestive myelopathy treated with angioplasty and endovascular stenting. The pathophysiological mechanisms of cord injury are hypothesized, and IVC stenting application is evaluated. Methods Case report and review of the literature. Results IVC outflow obstruction has only rarely been associated with neurologic dysfunction, with reports of lumbosacral nerve root compression in the cases of IVC agenesis, compression, or occlusion. Although endovascular angioplasty with stenting is emerging as a leading treatment option for chronic IVC thrombosis, its use to treat neurologic complications is limited to one case report for intractable sciatica. Our case is the first description of IVC thrombosis presenting with venous congestive myelopathy, and treated successfully with IVC stenting. Conclusion Venous congestive myelopathy should be seen as a broader clinical condition, including not only typical dural arteriovenous fistulas, but also disorders of venous outflow. Therefore, identifying a rare, but potentially treatable, etiology is important to avoid permanent neurologic deficits. IVC stenting is proposed as a novel and effective treatment approach. PMID:25825633

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

    PubMed Central

    Joachim, George C.

    2014-01-01

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

  10. Incidence and Risk Factors for Late Neurologic Deterioration after C3–C6 Laminoplasty for Cervical Spondylotic Myelopathy

    PubMed Central

    Sakaura, Hironobu; Miwa, Toshitada; Kuroda, Yusuke; Ohwada, Tetsuo

    2015-01-01

    Study Design Retrospective study. Objective We previously reported that the long-term neurologic outcomes of C3–C6 laminoplasty for cervical spondylotic myelopathy (CSM) are satisfactory, with reduced frequencies of postoperative axial neck pain and kyphotic deformity. However, only 20 patients were included, which is a limitation in that study. The present study investigated the incidence of late neurologic deterioration (LND) of myelopathic symptoms after C3–C6 laminoplasty for CSM and attempted to identify significant risk factors for LND in a larger patient population. Methods Subjects comprised 137 consecutive patients with CSM who underwent C3–C6 laminoplasty (bilateral open-door laminoplasty, n = 85; unilateral open-door laminoplasty, n = 52) and were followed for >24 months (mean follow-up, 70 months; range, 25 to 124 months). The patients' medical records were examined for evidence of LND due to cervical myelopathy. The age at time of surgery, sex, surgical procedures, anteroposterior spinal canal diameter at the C7 level, type of C6 spinous process, pre- and postoperative C2–C7 angle, C3–C6 range of motion (ROM), and disk height at the C6–C7 level were analyzed to identify risk factors for LND. Results Three patients (2.2%) developed LND of myelopathic symptoms due to caudal segment pathology adjacent to the C3–C6 laminoplasty (LND group). In these three patients, mean Japanese Orthopaedic Association (JOA) score improved from 10.2 before surgery to 12.2 at the time of maximum recovery, and declined to 9.7 just before additional surgery. On the other hand, in 134 patients without LND (non-LND group), the mean JOA score significantly improved from 10.2 before surgery to 13.4 at the time of maximum recovery and was maintained by the final follow-up (13.2). Compared with the non-LND group, the LND group showed significantly smaller anteroposterior spinal canal diameter at C7, more restricted postoperative C3–C6 ROM, and

  11. Signal intensity ratio on magnetic resonance imaging as a prognostic factor in patients with cervical compressive myelopathy

    PubMed Central

    Kim, Tae Hyun; Ha, Yoon; Shin, Jun Jae; Cho, Yong Eun; Lee, Ji Hae; Cho, Woo Ho

    2016-01-01

    Abstract Patients with intramedullary signal intensity (SI) changes have a poor prognosis after surgical decompression in cervical compressive myelopathy (CCM); however, some patients show no clear relationship between the SI and postsurgical prognosis. This discrepancy may be because no comprehensive and proper quantitative evaluation exists to assess SI on magnetic resonance imaging (MRI). The purpose of this study was prospectively to evaluate the correlation between the clinical features, neurological outcome of patients with CCM, and the quantitative assessment of SI changes preoperatively and postoperatively, and the correlation with SI severity. A total of 112 patients with CCM at 1 or 2 levels underwent anterior cervical discectomy and fusion. We quantitatively analyzed MR signal changes on T1-weighted MR images (T1WI), gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) contrast-enhanced T1WI, and T2-weighted MR images (T2WI) using the signal intensity ratio (SIR). We evaluated the correlations between various variables and neurological outcome using the Japanese Orthopedic Association (JOA) scale, and the severity of SI change by grade (i.e., grade 0 [“none”], grade 1 [“light”], and grade 2 [“bright on T2WI”]). Significant differences between the 3 grades existed in symptom duration, preoperative JOA score, SIR on T2WI, and JOA recovery ratio. The JOA recovery ratio was negatively correlated with symptom duration and the SIR on T2WI, and positively correlated with the preoperative JOA score and cord compression ratio, but not with the SIR on T1WI and contrast-enhanced T1WI. On the postoperative 12-month follow-up MRI, the JOA recovery ratio and SIR on T2WI of the SI reversal patients were better than those of the nonreversal patients. On multiple regression analysis, the SIR on T2WI was the main significant prognostic factor of surgical outcome. The grading system on T2WI provided reliable predictive information for neurological outcome

  12. Predominant expression of Fas ligand mRNA in CD8+ T lymphocytes in patients with HTLV-1 associated myelopathy.

    PubMed

    Kawahigashi, N; Furukawa, Y; Saito, M; Usuku, K; Osame, M

    1998-10-01

    To determine if Fas ligand (FasL) mediated apoptosis is involved in the pathogenesis of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we examined the expression of FasL mRNA in fresh uncultured peripheral blood mononuclear cells (PBMC) from 17 Japanese patients with HAM/TSP, four adult T-cell leukemia/lymphoma (ATL) patients, three asymptomatic HTLV-1 carriers and three normal individuals. Using competitive PCR with primers specific for FasL mRNA, we demonstrated that nine of 17 HAM/TSP and one of four ATL patients expressed significant levels of FasL mRNA, whereas asymptomatic carriers, normal controls and both HTLV-1 infected and uninfected T-cell lines did not. Cell separation analysis following PCR revealed that FasL mRNA was expressed in CD8 + T lymphocytes. FasL mRNA was preferentially expressed in patients with increased proviral load and longer duration of clinical illness. These results suggest that FasL mediated mechanisms contribute to the pathogenesis of HAM/TSP.

  13. Increased levels of soluble Fas ligand in CSF of rapidly progressive HTLV-1-associated myelopathy/tropical spastic paraparesis patients.

    PubMed

    Saito, M; Nakamura, N; Nagai, M; Shirakawa, K; Sato, H; Kawahigashi, N; Furukawa, Y; Usuku, K; Nakagawa, M; Izumo, S; Osame, M

    1999-08-03

    The interaction of Fas ligand (FasL) with Fas-bearing cells induces apoptosis and contributes to the negative regulation of peripheral T-cell responses. Membrane-bound FasL is cleaved by a matrix metalloproteinase-like enzyme and converted to a soluble form (sFasL). Recent studies suggest that such sFasL can cause systemic tissue damage. Here we report that serum and CSF levels of soluble FasL (sFasL) are markedly higher in three active phase patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). All of these patients showed higher sFasL levels in CSF than in serum. Although the HTLV-1 proviral load of patients showed no correlation with serum or with CSF sFasL, CSF sFasL levels of 14 HAM/TSP patients correlated with the anti-HTLV-1 antibody titer and neopterin concentration in CSF. These results indicate that sFasL mediated mechanisms may contribute to the inflammatory process and subsequent spinal tissue damage seen in HAM/TSP patients.

  14. The Practical Application of Clinical Prediction Rules: A Commentary Using Case Examples in Surgical Patients with Degenerative Cervical Myelopathy

    PubMed Central

    Tetreault, Lindsay; Le, David; Côté, Pierre; Fehlings, Michael

    2015-01-01

    Study Design Commentary. Objective This commentary aims to discuss the practical applications of a clinical prediction rule (CPR) developed to predict functional status in patients undergoing surgery for the treatment of degenerative cervical myelopathy. Methods Clinical cases from the AOSpine CSM-North America study were used to illustrate the application of a prediction rule in a surgical setting and to highlight how this CPR can be used to ultimately enhance patient care. Results A CPR combines signs and symptoms, patient characteristics, and other predictive factors to estimate disease probability, treatment prognosis, or risk of complications. These tools can influence allocation of health care resources, inform clinical decision making, and guide the design of future research studies. In a surgical setting, CPRs can be used to (1) manage patients' expectations of outcome and, in turn, improve overall satisfaction; (2) facilitate shared decision making between patient and physician; (3) identify strategies to optimize surgical results; and (4) reduce heterogeneity of care and align surgeons' perceptions of outcome with objective evidence. Conclusions Valid and clinically-relevant CPRs have tremendous value in a surgical setting. PMID:26682095

  15. On the etiology of tropical spastic paraparesis and human T-cell lymphotropic virus-I-associated myelopathy.

    PubMed

    Zaninovic, V

    1999-01-01

    The purpose of this review is to present some concepts on the etiology of tropical spastic paraparesis or human T-cell lymphotropic virus-I (HTLV-I)-associated myelopathy (TSP/HAM). The large number of syndromes that have been associated with HTLV-I (60 to date), the existence of TSP/HAM cases associated with other retroviruses (human immunodeficiency virus-2 [HIV-2], HTLV-II), the existence of many TSPs without HTLV-I, and the evidence of clear epidemiologic contradictions in TSP/HAM indicate that the etiopathogenesis of TSP/HAM is not yet clear. Tropical spastic paraparesis/HAM affects patients of all human ethnic groups, but usually in well localized and relatively isolated geographic regions where HTLV-I has been endemic for a long time. Environmental factors and geographic locations appear to be critical factors. Because the neuropathology of TSP/HAM suggests a toxometabolic, rather than a viral cause, it is proposed that an intoxication similar to neurolathyrism could account for some of TSP/HAM cases, mainly in tropical and subtropical countries. If this were the case, HTLV-I could be a cofactor or act as a bystander. it is possible that co-infection with another agent is necessary to produce TSP/HAM and most of the syndromes associated with HTLV-I.

  16. 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.

  17. Clinical Pathophysiology of Human T-Lymphotropic Virus-Type 1-Associated Myelopathy/Tropical Spastic Paraparesis

    PubMed Central

    Yamano, Yoshihisa; Sato, Tomoo

    2012-01-01

    Human T-lymphotropic virus type 1 (HTLV-1), a human retrovirus, is the causative agent of a progressive neurological disease termed HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP is a chronic inflammatory disease of the central nervous system and is characterized by unremitting myelopathic symptoms such as spastic paraparesis, lower limb sensory disturbance, and bladder/bowel dysfunction. Approximately 0.25–3.8% of HTLV-1-infected individuals develop HAM/TSP, which is more common in women than in men. Since the discovery of HAM/TSP, significant advances have been made with respect to elucidating the virological, molecular, and immunopathological mechanisms underlying this disease. These findings suggest that spinal cord invasion by HTLV-1-infected T cells triggers a strong virus-specific immune response and increases proinflammatory cytokine and chemokine production, leading to chronic lymphocytic inflammation and tissue damage in spinal cord lesions. However, little progress has been made in the development of an optimal treatment for HAM/TSP, more specifically in the identification of biomarkers for predicting disease progression and of molecular targets for novel therapeutic strategies targeting the underlying pathological mechanisms. This review summarizes current clinical and pathophysiological knowledge on HAM/TSP and discusses future focus areas for research on this disease. PMID:23162542

  18. Neuropathology of HTLV-1-associated myelopathy (HAM/TSP): The 50th Anniversary of Japanese Society of Neuropathology.

    PubMed

    Izumo, Shuji

    2010-10-01

    A series of our neuropathological studies was reviewed in order to clarify pathogenesis of human T lymphotropic virus type 1(HTLV-1)-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). The essential histopathologic finding was chronic inflammation in which inflammatory infiltrates of mononuclear cells and degeneration of myelin and axons were noted in the entire spinal cord. Immunohistochemical analysis demonstrated T-cell dominance, and the numbers of CD4+ cells and CD8+ cells were equally present in patients with shorter clinical courses. Apoptosis of helper/inducer T-cells were observed in these active inflammatory lesions. Horizontal distribution of inflammatory lesions was symmetric at all spinal levels and was accentuated at sites with slow blood flow in the middle to lower thoracic levels. HTLV-1 proviral DNA amounts were well correlated with the numbers of infiltrated CD4+ cells. In situ PCR of HTLV-1 proviral DNA and in situ hybridization of HTLV-1 Tax gene demonstrated the presence of HTLV-1-infected cells exclusively in the mononuclear infiltrates of perivascular areas. From these findings, it is suggested that T-cell mediated chronic inflammatory processes targeting the HTLV-1 infected T-cells is the primary pathogenic mechanism of HAM/TSP. Anatomically determined hemodynamic conditions may contribute to the localization of infected T-cells and the formation of main lesions in the middle to lower thoracic spinal cord.

  19. Human T-lymphotropic virus type I-associated myelopathy and tax gene expression in CD4+ T lymphocytes.

    PubMed

    Moritoyo, T; Reinhart, T A; Moritoyo, H; Sato, E; Izumo, S; Osame, M; Haase, A T

    1996-07-01

    Infection by human T-lymphotropic virus type I (HTLV-I) is associated with adult T-cell leukemia and a slowly progressive disease of the central nervous system (CNS), HTLV-I-associated myelopathy/tropical spastic paraparesis, characterized pathologically by inflammation and white matter degeneration in the spinal cord. One of the explanations for the tissue destruction is that HTLV-I infects cells in the CNS, or HTLV-I-infected CD4+ T lymphocytes enter the CNS, and this drives local expansion of virus-specific CD8+ cytotoxic T lymphocytes, which along with cytokines cause the pathological changes. Because both in the circulation and in the cerebrospinal fluid, CD8+ cytotoxic T lymphocytes are primarily reactive to the product of the HTLV-I tax gene, we sought evidence of expression of this gene within cells in the inflammatory lesions. After using double-label in situ hybridization techniques, we now report definitive localization of HTLV-I tax gene expression in CD4+ T lymphocytes in areas of inflammation and white matter destruction. These findings lend support to a hypothetical scheme of neuropathogenesis in which HTLV-I tax gene expression provokes and sustains an immunopathological process that progressively destroys myelin and axons in the spinal cord.

  20. Anterior Cervical Corpectomy with free vascularized fibular graft versus multilevel discectomy and grafting for Cervical Spondylotic Myelopathy

    PubMed Central

    Addosooki, Ahmad I; El-deen, Mohamed Alam

    2015-01-01

    Purpose A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic myelopathy(CSM). Methods A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic Association (JOA) score, perioperative parameters including operation time and hospital stay, radiological parameters including fusion rate and cervical lordosis, and complications were compared. Results Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in both groups. Conclusion Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative times. PMID:26767152

  1. Psychiatric comorbidities in a young man with subacute myelopathy induced by abusive nitrous oxide consumption: a case report

    PubMed Central

    Mancke, Falk; Kaklauskaitė, Gintarė; Kollmer, Jennifer; Weiler, Markus

    2016-01-01

    Nitrous oxide (N2O), a long-standing anesthetic, is known for its recreational use, and its consumption is on the rise. Several case studies have reported neurological and psychiatric complications of N2O use. To date, however, there has not been a study using standardized diagnostic procedures to assess psychiatric comorbidities in a patient consuming N2O. Here, we report about a 35-year-old male with magnetic resonance imaging confirmed subacute myelopathy induced by N2O consumption, who suffered from comorbid cannabinoid and nicotine dependence as well as abuse of amphetamines, cocaine, lysergic acid diethylamide, and ketamine. Additionally, there was evidence of a preceding transient psychotic and depressive episode induced by synthetic cannabinoid abuse. In summary, this case raises awareness of an important mechanism of neural toxicity, with which physicians working in the field of substance-related disorders should be familiar. In fact, excluding N2O toxicity in patients with recognized substance-related disorders and new neurological deficits is compulsory, as untreated for months the damage to the nervous system is at risk of becoming irreversible. PMID:27729826

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

    PubMed Central

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

    2015-01-01

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

  3. Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality

    PubMed Central

    Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi

    2014-01-01

    Summary Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with well-demarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides. PMID:25014051

  4. Comparative study of CSF neurofilaments in HTLV-1-associated myelopathy/tropical spastic paraparesis and other neurological disorders.

    PubMed

    Alberti, Carolina; Gonzalez, Juan; Maldonado, Horacio; Medina, Fernando; Barriga, Andrés; García, Lorena; Kettlun, Ana; Collados, Lucía; Puente, Javier; Cartier, Luis; Valenzuela, Maria

    2009-08-01

    HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive CNS disease leading to corticospinal tract degeneration. Various degenerative diseases have increased neurofilament subunit concentration in cerebrospinal fluid (CSF), frequently showing hyperphosphorylation in neurofilaments. The aim of this study was to determine if there were elevated concentrations of neurofilament light subunit (NFL) and phosphorylated forms of neurofilament heavy subunit (PNFH) in HAM/TSP CSF. NF concentrations were compared with those of controls and patients with neurodegenerative diseases associated with other retroviruses (HIV-associated dementia, HAD) and a form of prion disease (familiar Creutzfeldt-Jakob, FCJD). Western blotting of CSF with antibodies against NFL showed two immunoreactive bands of 66 and 59 kDa, the latter probably corresponding to a partially degraded NFL form. The concentration of the 59-kDa form was not different in HAM/TSP compared with controls, but it was significantly increased in HAD and FCJD groups. ELISA assay for PNFH did not show differences among HAM/TSP, HAD, and control groups, while PNFH concentration was significantly elevated in FCJD. Our results show that CSF NFL and PNFH are not molecular markers of axonal damage for HAM/TSP probably due to the slow progression of this disease. NFL phosphorylation studies required previous immunoprecipitation from CSF for mass spectrometric analysis. This preliminary analysis indicated phosphorylation at S472 and at some other residues.

  5. Outcomes following Laminoplasty or Laminectomy and Fusion in Patients with Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Systematic Review

    PubMed Central

    Singhatanadgige, Weerasak; Limthongkul, Worawat; Valone, Frank; Yingsakmongkol, Wicharn; Riew, K. Daniel

    2016-01-01

    Study Design Systematic review. Objective To compare laminoplasty versus laminectomy and fusion in patients with cervical myelopathy caused by OPLL. Methods A systematic review was conducted using PubMed/Medline, Cochrane database, and Google scholar of articles. Only comparative studies in humans were included. Studies involving cervical trauma/fracture, infection, and tumor were excluded. Results Of 157 citations initially analyzed, 4 studies ultimately met our inclusion criteria: one class of evidence (CoE) II prospective cohort study and three CoE III retrospective cohort studies. The prospective cohort study found no significant difference between laminoplasty and laminectomy and fusion in the recovery rate from myelopathy. One CoE III retrospective cohort study reported a significantly higher recovery rate following laminoplasty. Another CoE III retrospective cohort study reported a significantly higher recovery rate in the laminectomy and fusion group. One CoE II prospective cohort study and one CoE III retrospective cohort study found no significant difference in pain improvement between patients treated with laminoplasty versus patients treated with laminectomy and fusion. All four studies reported a higher incidence of C5 palsy following laminectomy and fusion than laminoplasty. One CoE II prospective cohort and one CoE III retrospective cohort reported that there was no significant difference in axial neck pain between the two procedures. One CoE III retrospective cohort study suggested that there was no significant difference between groups in OPLL progression. Conclusion Data from four comparative studies was not sufficient to support the superiority of laminoplasty or laminectomy and fusion in treating cervical myelopathy caused by OPLL. PMID:27781191

  6. Outcomes following Laminoplasty or Laminectomy and Fusion in Patients with Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Systematic Review.

    PubMed

    Singhatanadgige, Weerasak; Limthongkul, Worawat; Valone, Frank; Yingsakmongkol, Wicharn; Riew, K Daniel

    2016-11-01

    Study Design Systematic review. Objective To compare laminoplasty versus laminectomy and fusion in patients with cervical myelopathy caused by OPLL. Methods A systematic review was conducted using PubMed/Medline, Cochrane database, and Google scholar of articles. Only comparative studies in humans were included. Studies involving cervical trauma/fracture, infection, and tumor were excluded. Results Of 157 citations initially analyzed, 4 studies ultimately met our inclusion criteria: one class of evidence (CoE) II prospective cohort study and three CoE III retrospective cohort studies. The prospective cohort study found no significant difference between laminoplasty and laminectomy and fusion in the recovery rate from myelopathy. One CoE III retrospective cohort study reported a significantly higher recovery rate following laminoplasty. Another CoE III retrospective cohort study reported a significantly higher recovery rate in the laminectomy and fusion group. One CoE II prospective cohort study and one CoE III retrospective cohort study found no significant difference in pain improvement between patients treated with laminoplasty versus patients treated with laminectomy and fusion. All four studies reported a higher incidence of C5 palsy following laminectomy and fusion than laminoplasty. One CoE II prospective cohort and one CoE III retrospective cohort reported that there was no significant difference in axial neck pain between the two procedures. One CoE III retrospective cohort study suggested that there was no significant difference between groups in OPLL progression. Conclusion Data from four comparative studies was not sufficient to support the superiority of laminoplasty or laminectomy and fusion in treating cervical myelopathy caused by OPLL.

  7. Characteristics of spondylotic myelopathy on 3D driven-equilibrium fast spin echo and 2D fast spin echo magnetic resonance imaging: a retrospective cross-sectional study.

    PubMed

    Abdulhadi, Mike A; Perno, Joseph R; Melhem, Elias R; Nucifora, Paolo G P

    2014-01-01

    In patients with spinal stenosis, magnetic resonance imaging of the cervical spine can be improved by using 3D driven-equilibrium fast spin echo sequences to provide a high-resolution assessment of osseous and ligamentous structures. However, it is not yet clear whether 3D driven-equilibrium fast spin echo sequences adequately evaluate the spinal cord itself. As a result, they are generally supplemented by additional 2D fast spin echo sequences, adding time to the examination and potential discomfort to the patient. Here we investigate the hypothesis that in patients with spinal stenosis and spondylotic myelopathy, 3D driven-equilibrium fast spin echo sequences can characterize cord lesions equally well as 2D fast spin echo sequences. We performed a retrospective analysis of 30 adult patients with spondylotic myelopathy who had been examined with both 3D driven-equilibrium fast spin echo sequences and 2D fast spin echo sequences at the same scanning session. The two sequences were inspected separately for each patient, and visible cord lesions were manually traced. We found no significant differences between 3D driven-equilibrium fast spin echo and 2D fast spin echo sequences in the mean number, mean area, or mean transverse dimensions of spondylotic cord lesions. Nevertheless, the mean contrast-to-noise ratio of cord lesions was decreased on 3D driven-equilibrium fast spin echo sequences compared to 2D fast spin echo sequences. These findings suggest that 3D driven-equilibrium fast spin echo sequences do not need supplemental 2D fast spin echo sequences for the diagnosis of spondylotic myelopathy, but they may be less well suited for quantitative signal measurements in the spinal cord.

  8. Clinical reversible myelopathy in T-cell lymphoblastic lymphoma treated with nelarabine and radiotherapy: report of a case and review of literature of an increasing complication.

    PubMed

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

    2015-01-01

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

  9. Infective dermatitis has similar immunological features to human T lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Nascimento, M C F; Primo, J; Bittencourt, A; Siqueira, I; de Fátima Oliveira, M; Meyer, R; Schriefer, A; Santos, S B; Carvalho, E M

    2009-06-01

    Human T lymphotropic virus-type 1 (HTLV-1) is the causal agent of the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), adult T cell leukaemia/lymphoma and infective dermatitis associated with HTLV-1 (IDH). Over-production of proinflammatory cytokines and an increase in HTLV-1 proviral load are features of HAM/TSP, but the immunological basis of IDH has not been established. In addition to severe cutaneous manifestations, the importance of IDH relies on the observation that up to 30% of children with IDH develop HAM/TSP in childhood and adolescence. In this study we determined the immune response in patients with IDH measuring interleukin (IL)-4, IL-5, IL-10, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha levels as well as the HTLV-1 proviral load. Additionally, regulatory cytokines and anti-cytokines were added to cultures to evaluate the ability of these molecules to down-modulate TNF-alpha and IFN-gamma synthesis. HTLV-1 carriers and patients with HAM/TSP served as controls. TNF-alpha and IFN-gamma levels were higher in IDH than in HTLV-1 carriers. There was no difference in IFN-gamma and TNF-alpha concentrations in IDH and HAM/TSP patients. There was a tendency for higher IL-4 mRNA expression and immunoglobulin E (IgE) levels in IDH than in HTLV-1 carriers, but the difference did not reach statistical significance. The HTLV-1 proviral load was significantly higher in IDH patients than in HTLV-1 carriers. IDH is characterized by an exaggerated Th1 immune response and high HTLV-1 proviral load. The similarities between the immunological response in patients with IDH and HAM/TSP and the high proviral load observed in IDH provide support that IDH is a risk factor for development of HAM/TSP.

  10. Lipoprotein(a)-hyperlipoproteinemia as cause of chronic spinal cord ischemia resulting in progressive myelopathy - successful treatment with lipoprotein apheresis.

    PubMed

    Heigl, Franz; Hettich, Reinhard; Mauch, Erich; Klingel, Reinhard; Fassbender, Cordula

    2017-03-01

    High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD. Spastic tetraplegia and dependency on wheel chair and nursing care represented the nadir of neurological deficits. All conventional risk factors including LDL-cholesterol had already been treated and after exclusion of other causes, genetically determined Lp(a)-HLP was considered as the major underlying etiologic factor of ischemic vascular disease in this patient including spinal cord ischemia with vascular myelopathy. Treatment with an intensive regimen of chronic LA over 4.5 years now was successful to stabilize PAOD and CAD and led to very impressive neurologic and overall physical rehabilitation and improvement of quality of life.Measurement of Lp(a) concentration must be recommended to assess individual cardiovascular risk. Extracorporeal clearance of Lp(a) by LA should be considered as treatment option for select patients with progressive Lp(a)-associated ischemic syndromes.

  11. Multivariate analysis of factors associated with kyphotic deformity after laminoplasty in cervical spondylotic myelopathy patients without preoperative kyphotic alignment

    PubMed Central

    Cao, JunMing; Zhang, JingTao; Yang, DaLong; Yang, Liu; Shen, Yong

    2017-01-01

    The risk factors of post-laminoplasty kyphosis in patients with cervical spondylotic myelopathy (CSM) without preoperative kyphotic alignment are not well known. This study aimed to compare clinical and radiological data between patients with or without post-laminoplasty kyphosis and to investigate the factors associated with post-laminoplasty kyphosis in CSM patients without preoperative kyphotic alignment. Patients (n = 194) who received unilateral expansive open-door cervical laminoplasty with miniplate fixation and completed a 1-year follow-up were enrolled. Patients were grouped according to whether they suffered from postoperative kyphosis (P) or not (NP). Postoperative kyphosis was observed in 21 (10.8%) patients. The recovery rates of the Japanese Orthopaedic Association scores at the 1-year follow-up in the P group were inferior to those in the NP group (31.9% vs. 65.2%, P < 0.001). Logistic regression with post-laminoplasty kyphosis as the dependent variable showed independent risks associated with an increased C2–7 sagittal vertical axis (SVA, odds ratio [OR] = 1.085, 95% confidence interval [CI] = 1.025–1.203, P = 0.015), destroyed facet joints (OR = 1.132, 95% CI = 1.068–1.208, P < 0.001), and cephalad vertebral level undergoing laminoplasty (CVLL, OR = 2.860, 95% CI = 1.164–6.847, P = 0.021). These findings suggest that CVLL, C2–7 SVA, and destroyed facet joints are associated with kyphosis after laminoplasty in CSM patients without preoperative kyphotic alignment. PMID:28240309

  12. Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study

    PubMed Central

    Ding, Huairong; Xue, Yuan; Tang, Yanming; He, Dong; Li, Zhiyang; Zhao, Ying; Zong, Yaqi; Wang, Yi; Wang, Pei

    2014-01-01

    Objective To report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM) associated with hypertrophic ligamentum flavum (HLF). Background Laminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum. Methods This study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA) score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale. Results No hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3±15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05). Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit. Conclusion Hybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients with HLF. PMID:24740151

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

    PubMed Central

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

    2014-01-01

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

  14. Use of multivariate linear regression and support vector regression to predict functional outcome after surgery for cervical spondylotic myelopathy

    PubMed Central

    Hoffman, Haydn; Lee, Sunghoon Ivan; Garst, Jordan H.; Lu, Derek S.; Li, Charles H.; Nagasawa, Daniel T.; Ghalehsari, Nima; Jahanforouz, Nima; Razaghy, Mehrdad; Espinal, Marie; Ghavamrezaii, Amir; Paak, Brian H.; Wu, Irene; Sarrafzadeh, Majid; Lu, Daniel C.

    2016-01-01

    This study introduces the use of multivariate linear regression (MLR) and support vector regression (SVR) models to predict postoperative outcomes in a cohort of patients who underwent surgery for cervical spondylotic myelopathy (CSM). Currently, predicting outcomes after surgery for CSM remains a challenge. We recruited patients who had a diagnosis of CSM and required decompressive surgery with or without fusion. Fine motor function was tested preoperatively and postoperatively with a handgrip-based tracking device that has been previously validated, yielding mean absolute accuracy (MAA) results for two tracking tasks (sinusoidal and step). All patients completed Oswestry disability index (ODI) and modified Japanese Orthopaedic Association questionnaires preoperatively and postoperatively. Preoperative data was utilized in MLR and SVR models to predict postoperative ODI. Predictions were compared to the actual ODI scores with the coefficient of determination (R2) and mean absolute difference (MAD). From this, 20 patients met the inclusion criteria and completed follow-up at least 3 months after surgery. With the MLR model, a combination of the preoperative ODI score, preoperative MAA (step function), and symptom duration yielded the best prediction of postoperative ODI (R2 = 0.452; MAD = 0.0887; p = 1.17 × 10−3). With the SVR model, a combination of preoperative ODI score, preoperative MAA (sinusoidal function), and symptom duration yielded the best prediction of postoperative ODI (R2 = 0.932; MAD = 0.0283; p = 5.73 × 10−12). The SVR model was more accurate than the MLR model. The SVR can be used preoperatively in risk/benefit analysis and the decision to operate. PMID:26115898

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

    PubMed

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

    2015-06-01

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

  16. Common γ-chain blocking peptide reduces in vitro immune activation markers in HTLV-1-associated myelopathy/tropical spastic paraparesis.

    PubMed

    Massoud, Raya; Enose-Akahata, Yoshimi; Tagaya, Yutaka; Azimi, Nazli; Basheer, Asjad; Jacobson, Steven

    2015-09-01

    Human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive inflammatory myelopathy occurring in a subset of HTLV-1-infected individuals. Despite advances in understanding its immunopathogenesis, an effective treatment remains to be found. IL-2 and IL-15, members of the gamma chain (γc) family of cytokines, are prominently deregulated in HAM/TSP and underlie many of the characteristic immune abnormalities, such as spontaneous lymphocyte proliferation (SP), increased STAT5 phosphorylation in the lymphocytes, and increased frequency and cytotoxicity of virus-specific cytotoxic CD8(+) T lymphocytes (CTLs). In this study, we describe a novel immunomodulatory strategy consisting of selective blockade of certain γc family cytokines, including IL-2 and IL-15, with a γc antagonistic peptide. In vitro, a PEGylated form of the peptide, named BNZ132-1-40, reduced multiple immune activation markers such as SP, STAT5 phosphorylation, spontaneous degranulation of CD8(+) T cells, and the frequency of transactivator protein (Tax)-specific CD8(+) CTLs, thought to be major players in the immunopathogenesis of the disease. This strategy is thus a promising therapeutic approach to HAM/TSP with the potential of being more effective than single monoclonal antibodies targeting either IL-2 or IL-15 receptors and safer than inhibitors of downstream signaling molecules such as JAK1 inhibitors. Finally, selective cytokine blockade with antagonistic peptides might be applicable to multiple other conditions in which cytokines are pathogenic.

  17. Performance of IgG and IgG1 anti-HTLV-1 reactivity by an indirect immunofluorescence flow cytometric assay for the identification of persons infected with HTLV-1, asymptomatic carriers and patients with myelopathy.

    PubMed

    Coelho-dos-Reis, Jordana Grazziela Alves; Martins-Filho, Olindo Assis; de Brito-Melo, Gustavo Eustáquio Alvim; Gallego, Sandra; Carneiro-Proietti, Anna Bárbara; Souza, Jaqueline Gontijo; Barbosa-Stancioli, Edel Figueiredo

    2009-09-01

    In this study, the performance of IgG and IgG1 anti-HTLV-1 reactivity obtained by a flow cytometric assay was evaluated to verify its applicability for the diagnosis of persons infected with HTLV-1, including asymptomatic carriers and patients with myelopathy. The ability to identify patients with myelopathy among persons infected with HTLV-1 was also examined. Western blot assays were performed to assess the reactivity profiles of sera from asymptomatic carriers and patients with myelopathy against viral proteins. The data showed that IgG1 detected by flow cytometric assay is effective for the diagnosis of persons infected with HTLV-1 with 97% sensitivity and 100% specificity. IgG and IgG1 exhibited high performance in distinguishing patients with myelopathy from asymptomatic carriers. Using serum dilutions and cut-off points established previously a second HTLV-1 carrier group was tested using flow cytometric assay to detect IgG and IgG1. The data demonstrated sensitivity of 93% and 98%, respectively, confirming the high reactivity of persons infected with HTLV-1 detected by this method. Western blot assays confirmed the high specificity of MT-2 cells as a reliable source of viral antigen since only sera from persons infected with HTLV-1 recognised MT-2 proteins. Furthermore, a high reactivity to Gag and Env proteins was observed, especially among patients with myelopathy. These data suggest that flow cytometric detection of IgG1 is a valuable, non-conventional serological method to diagnose HTLV-1 infection and for research purposes.

  18. Measuring Surgical Outcomes in Cervical Spondylotic Myelopathy Patients Undergoing Anterior Cervical Discectomy and Fusion: Assessment of Minimum Clinically Important Difference

    PubMed Central

    Auffinger, Brenda M.; Lall, Rishi R.; Dahdaleh, Nader S.; Wong, Albert P.; Lam, Sandi K.; Koski, Tyler; Fessler, Richard G.; Smith, Zachary A.

    2013-01-01

    Object The concept of minimum clinically important difference (MCID) has been used to measure the threshold by which the effect of a specific treatment can be considered clinically meaningful. MCID has previously been studied in surgical patients, however few studies have assessed its role in spinal surgery. The goal of this study was to assess the role of MCID in patients undergoing anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). Methods Data was collected on 30 patients who underwent ACDF for CSM between 2007 and 2012. Preoperative and 1-year postoperative Neck Disability Index (NDI), Visual-Analog Scale (VAS), and Short Form-36 (SF-36) Physical (PCS) and Mental (MCS) Component Summary PRO scores were collected. Five distribution- and anchor-based approaches were used to calculate MCID threshold values average change, change difference, receiver operating characteristic curve (ROC), minimum detectable change (MDC) and standard error of measurement (SEM). The Health Transition Item of the SF-36 (HTI) was used as an external anchor. Results Patients had a significant improvement in all mean physical PRO scores postoperatively (p<0.01) NDI (29.24 to 14.82), VAS (5.06 to 1.72), and PCS (36.98 to 44.22). The five MCID approaches yielded a range of values for each PRO: 2.00–8.78 for PCS, 2.06–5.73 for MCS, 4.83–13.39 for NDI, and 0.36–3.11 for VAS. PCS was the most representative PRO measure, presenting the greatest area under the ROC curve (0.94). MDC values were not affected by the choice of anchor and their threshold of improvement was statistically greater than the chance of error from unimproved patients. Conclusion SF-36 PCS was the most representative PRO measure. MDC appears to be the most appropriate MCID method. When MDC was applied together with HTI anchor, the MCID thresholds were: 13.39 for NDI, 3.11 for VAS, 5.56 for PCS and 5.73 for MCS. PMID:23826290

  19. Different Approaches for Treating Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 153 Cases from a Single Spinal Center

    PubMed Central

    Li, Xiumao; Jiang, Liang; Liu, Zhongjun; Liu, Xiaoguang; Zhang, Hua; Zhou, Hua; Wei, Feng; Yu, Miao; Wu, Fengliang

    2015-01-01

    Objective The optimal surgical treatment for multilevel cervical spondylotic myelopathy (MCSM) remains controversial. This study compared the outcomes of three surgical approaches for MSCM treatment, focusing on the efficacy and safety of a combined approach. Methods This retrospective study included 153 consecutive MCSM patients (100 men, 53 women; mean age ± standard deviation, 55.7 ± 9.4 years) undergoing operations involving ≥3 intervertebral segments. The patients were divided into three groups according to surgical approach: anterior (n = 19), posterior (n = 76), and combined (n = 58). We assessed demographic variables, perioperative parameters, and clinical outcomes ≥12 months after surgery (20.5 ± 7.6 months), including Japanese Orthopaedic Association (JOA) score, improvement, recovery rate, and complications. Results The anterior group had the most favorable preoperative conditions, including the highest preoperative JOA score (12.95 ± 1.86, p = 0.046). In contrast, the combined group had the highest occupancy ratio (48.0% ± 11.6%, p = 0.002). All groups showed significant neurological improvement at final follow-ups, with JOA recovery rates of 59.7%, 54.6%, and 68.9% in the anterior, posterior, and combined groups, respectively (p = 0.163). After multivariable adjustments, the groups did not have significantly different clinical outcomes (postoperative JOA score, p = 0.424; improvement, p = 0.424; recovery rate, p = 0.080). Further, subgroup analyses of patients with occupancy ratios ≥50% showed similar functional outcomes following the posterior and combined approaches. Overall complication rates did not differ significantly among the three approaches (p = 0.600). Occupancy ratios did not have a significant negative influence on postoperative recovery following the posterior approach. Conclusions If applied appropriately, all three approaches are effective for treating MCSM. All three approaches had equivalent neurological outcomes, even in

  20. Radiation dosimetry.

    PubMed Central

    Cameron, J

    1991-01-01

    This article summarizes the basic facts about the measurement of ionizing radiation, usually referred to as radiation dosimetry. The article defines the common radiation quantities and units; gives typical levels of natural radiation and medical exposures; and describes the most important biological effects of radiation and the methods used to measure radiation. Finally, a proposal is made for a new radiation risk unit to make radiation risks more understandable to nonspecialists. PMID:2040250

  1. Failure to detect genomic material of HTLV-I or HTLV-II in mononuclear cells of Italian patients with multiple sclerosis and chronic progressive myelopathy.

    PubMed

    Merelli, E; Sola, P; Marasca, R; Salati, R; Torelli, G

    1993-01-01

    To contribute to the undecided question if a retrovirus of the human T-cell lymphotropic virus (HTLV) family may be involved in the development of multiple sclerosis (MS), we investigated by the polymerase chain reaction (PCR) the presence of HTLV-I and HTLV-II sequences in the peripheral blood mononuclear cell DNAs from 30 patients affected by MS and 15 by chronic progressive myelopathy. Moreover a control group of 14 blood donors was examined. All these patients were devoid of anti-HTLV-I antibody in the serum and cerebrospinal fluid at ELISA. For the PCR, primers and probes specific for the tax region common to HTLV-I and HTLV-II, for the pol region of HTLV-I, and for the pol region of HTLV-II were used. In spite of the high sensitivity of the technique used, the three groups of subjects were negative for HTLV-I and HTLV-II genomic sequences.

  2. Prevalence of Klippel-Feil Syndrome in a Surgical Series of Patients with Cervical Spondylotic Myelopathy: Analysis of the Prospective, Multicenter AOSpine North America Study

    PubMed Central

    Nouri, Aria; Tetreault, Lindsay; Zamorano, Juan J.; Mohanty, Chandan B.; Fehlings, Michael G.

    2015-01-01

    Study Design Prospective study. Objective To evaluate the prevalence of Klippel-Feil syndrome (KFS) in a prospective data set of patients undergoing surgical treatment for cervical spondylotic myelopathy (CSM) and to evaluate if magnetic resonance imaging (MRI) features in patients with KFS are more pronounced than those of non-KFS patients with CSM. Methods A retrospective analysis of baseline MRI data from the AOSpine prospective and multicenter CSM-North American study was conducted. All the patients presented with at least one clinical sign of myelopathy and underwent decompression surgery. The MRIs and radiographs were reviewed by three investigators. The clinical and imaging findings were compared with patients without KFS but with CSM. Results Imaging analysis discovered 5 of 131 patients with CSM (∼3.82%) had single-level congenital fusion of the cervical spine. The site of fusion differed for all the patients. One patient underwent posterior surgery and four patients received anterior surgery. Postoperative follow-up was available for four of the five patients with KFS and indicated stable or improved functional status. All five patients demonstrated pathologic changes of adjacent segments and hyperintensity signal changes in the spinal cord on T2-weighted MRI. Multiple MRI features, most notably maximum canal compromise (p = 0.05) and T2 signal hyperintensity area (p = 0.05), were worse in patients with CSM and KFS. Conclusions The high prevalence of KFS in our surgical series of patients with CSM may serve as an indication that these patients are prone to increased biomechanical use of segments adjacent to fused vertebra. This supposition is supported by a tendency of patients with KFS to present with more extensive MRI evidence of degeneration than non-KFS patients with CSM. PMID:26225278

  3. A patient with progressive myelopathy and antibodies to human T-cell leukemia virus type I and human immunodeficiency virus type 1 in serum and cerebrospinal fluid.

    PubMed

    Aboulafia, D M; Saxton, E H; Koga, H; Diagne, A; Rosenblatt, J D

    1990-04-01

    A 52-year-old human immunodeficiency virus type 1-seropositive bisexual black man was evaluated at UCLA because of the recent onset of progressive lower-extremity weakness. Initial neurologic examination showed that the patient's distal weakness was greater than his proximal weakness, with bilateral foot drop and electrophysiologic evidence of denervation in the distal lower extremities. Magnetic resonance imaging of the brain and spinal cord disclosed no abnormalities. Subsequent neurologic evaluation 8 months later showed a myelopathy, with progression of lower-extremity weakness, spasticity, and flexor spasms, and urinary incontinence, as well as the peripheral neuropathy noted previously. A second magnetic resonance imaging scan of the brain showed patchy foci of increased signal intensity in white matter and cortex, with mild generalized cerebral and cerebellar atrophy and no lesions in the spinal cord. Specimens of the patient's serum and cerebrospinal fluid contained antibodies to human immunodeficiency virus type 1. Additionally, specimens of his serum and cerebrospinal fluid were tested for antibody to human T-cell leukemia virus type I by Western blotting and radioimmunoprecipitation, and found to be positive for human T-cell leukemia virus type I gag, env, and tax antibodies. The primary cause of severe myelopathy in this patient may be infection with human T-cell leukemia virus type I rather than with human immunodeficiency virus type 1. Treatment with prednisolone resulted in improvement of the lower-extremity weakness, reduction in flexor spasms, and slower but significant improvement in urinary symptoms. Patients who are infected with human immunodeficiency virus type 1 and have unusual motor findings should be tested for concomitant human T-cell leukemia virus type I infection.

  4. Prevalence of Klippel-Feil Syndrome in a Surgical Series of Patients with Cervical Spondylotic Myelopathy: Analysis of the Prospective, Multicenter AOSpine North America Study.

    PubMed

    Nouri, Aria; Tetreault, Lindsay; Zamorano, Juan J; Mohanty, Chandan B; Fehlings, Michael G

    2015-08-01

    Study Design Prospective study. Objective To evaluate the prevalence of Klippel-Feil syndrome (KFS) in a prospective data set of patients undergoing surgical treatment for cervical spondylotic myelopathy (CSM) and to evaluate if magnetic resonance imaging (MRI) features in patients with KFS are more pronounced than those of non-KFS patients with CSM. Methods A retrospective analysis of baseline MRI data from the AOSpine prospective and multicenter CSM-North American study was conducted. All the patients presented with at least one clinical sign of myelopathy and underwent decompression surgery. The MRIs and radiographs were reviewed by three investigators. The clinical and imaging findings were compared with patients without KFS but with CSM. Results Imaging analysis discovered 5 of 131 patients with CSM (∼3.82%) had single-level congenital fusion of the cervical spine. The site of fusion differed for all the patients. One patient underwent posterior surgery and four patients received anterior surgery. Postoperative follow-up was available for four of the five patients with KFS and indicated stable or improved functional status. All five patients demonstrated pathologic changes of adjacent segments and hyperintensity signal changes in the spinal cord on T2-weighted MRI. Multiple MRI features, most notably maximum canal compromise (p = 0.05) and T2 signal hyperintensity area (p = 0.05), were worse in patients with CSM and KFS. Conclusions The high prevalence of KFS in our surgical series of patients with CSM may serve as an indication that these patients are prone to increased biomechanical use of segments adjacent to fused vertebra. This supposition is supported by a tendency of patients with KFS to present with more extensive MRI evidence of degeneration than non-KFS patients with CSM.

  5. Efficacy of intravenous dexmedetomidine on patient's satisfaction, comfort and sedation during awake fibre-optic intubation in patients with cervical spondylotic myelopathy posted for elective cervical fixation

    PubMed Central

    Niyogi, Saikat; Basak, Samir; Acharjee, Amita; Chakraborty, Indrani

    2017-01-01

    Background and Aims: Various anaesthetic drugs, in addition to airway block, are used for producing favourable intubation conditions during awake fibre-optic intubation (AFOI), but most of them cause respiratory depression and hypoxaemia. The aim of this study was to evaluate the efficacy of intravenous (IV) dexmedetomidine (DEX) on sedation, patient comfort and cardiovascular responses during AFOI in patients with cervical spondylotic myelopathy (CSM). Methods: This randomised, placebo-controlled, double-blinded, prospective study was conducted on 56 adult patients with cervical spondylotic myelopathy (CSM) undergoing elective cervical fixation, who were randomly allocated into two groups - Group D and Group C. Group D patients received DEX infusion at a rate of 1 μg/kg for the first 10 min followed by 0.5 μg/kg/h and Group C received 0.9% normal saline infusion in the same manner. Airway blocks with lignocaine were given to all patients before undergoing AFOI. Patient's alertness, sedation and cardiorespiratory changes during the procedure were assessed by the Observer Assessment Awareness and Sedation (OAA/S) scale. On the 1st post-operative day, patient's' comfort during AFOI was assessed by visual analogue scale (VAS). Results: Patients of Group D had an acceptable level of sedation (OAA/S score: 20 to 17 with greater comfort and satisfaction (VAS: 40–60), compared to control group (VAS: 50–90, P < 0.001.). Moreover, haemodynamic parameters were less significantly altered in the DEX group during AFOI. Conclusions: IV DEX infusion during AFOI improves patient's tolerances with an acceptable level of sedation without significant haemodynamic instability and respiratory depression. PMID:28250482

  6. Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

    PubMed Central

    Dokai, Toshiyuki; Hashiguchi, Hirokazu; Ishii, Hiroyuki; Kameyama, Yasuhiro; Katae, Yuji; Morio, Yasuo; Morishita, Tsugutake; Murata, Masaaki; Nanjo, Yoshiro; Takahashi, Toshiaki; Tanida, Atsushi; Tanishima, Shinji; Yamane, Koji; Teshima, Ryota

    2011-01-01

    With the aging of the population in developed countries, spine surgeons have recently been more likely to encounter elderly patients in need of treatment. This study investigated whether decompression surgery for cervical spondylotic myelopathy (CSM) in elderly patients aged 80 years or older would likely be a reasonable treatment. We retrospectively reviewed 605 consecutive patients with cervical myelopathy who underwent decompression surgery between 2004 and 2008. Patients with other conditions that could affect functional status or compression factors other than spondylosis were excluded from this study. Of the remaining 189 patients, 161 with CSM whose condition could be evaluated 6 months after surgery were analyzed. The patients were divided into two age groups: 80 years or older (Group A, 37 patients) and younger than 80 years of age (Group B, 124 patients). We evaluated the differences in symptom duration, clinical data, involved levels, surgical outcome, comorbidities, and postoperative complications between the two groups. The symptom duration was significantly shorter in Group A. The average JOA scores preoperatively and 6 months postoperatively were significantly lower in Group A; however, there was no significant difference in the recovery ratio. There were no significant differences in the percentages of patients with comorbidities or those with postoperative complications. Elderly patients aged 80 years or older regained approximately 40% of their function postoperatively, and the incidence of postoperative complication was similar to that in younger patients. Since this age group shows a rapid deterioration after onset, prompt decompression surgery is required. PMID:21197553

  7. The incidence and risk factors of postoperative neurological deterioration after posterior decompression with or without instrumented fusion for thoracic myelopathy

    PubMed Central

    Wang, Hui; Ma, Lei; Xue, Rui; Yang, Dalong; Wang, Tao; Wang, Yanhong; Yang, Sidong; Ding, Wenyuan

    2016-01-01

    Abstract The aim of this study was to explore the incidence and risk factors of postoperative neurological deterioration after posterior decompression with or without instrumented fusion for thoracic myelopathy, and hope to provide references in decision-making and surgical planning for both spinal surgeon and thoracic stenosis patients. By retrieving the medical records from January 2001 to November 2015, 168 patients were retrospectively reviewed. According to the occurrence of postoperative neurological deterioration, patients were divided into 2 groups: neurological deterioration (ND) group and non-ND group. To investigate risk values for the occurrence of ND, 3 categorized factors were analyzed statistically: patient characteristics—preoperative data of age, sex, body mass index, bone mineral density, the duration of disease (from first symptoms to operation), the preoperative neurological function (Frankel grade), and diagnosis; surgical variables—surgery time, the amount of bleeding, mean arterial pressure, intervertebral fusion or not, and instrumentation or not; radiographic parameters—the spinal canal occupancy ratio, location of the lesion, thoracic kyphosis, and kyphosis correction. Postoperative neurological deterioration was developed in 23 of 168 patients (13.7%), and were enrolled as ND group. There was no statistically significant difference between the 2 groups in age at operation, sex composition, body mass index, and bone mineral density. The preoperative diagnosis presented significant difference between the 2 groups, because ossification of posterior longitudinal ligament combined with ossification of the ligamentum flavum was more common in ND group, whereas ossification of the ligamentum flavum alone was more common in non-ND group. There was no difference between the 2 groups in mean surgery time, the incidence of intraoperative direct trauma, and the number of patients that received instrumentation. The mean bleeding was much more in

  8. Cervical Spondylotic Myelopathy (CSM)

    MedlinePlus

    ... Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food ... Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and ...

  9. Radiation Therapy

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Radiation Therapy KidsHealth > For Teens > Radiation Therapy A A ... how to cope with side effects. What Is Radiation Therapy? Cancer is a disease that causes cells ...

  10. Radiation Protection

    MedlinePlus

    Jump to main content US EPA United States Environmental Protection Agency Search Search Radiation Protection Share Facebook Twitter Google+ Pinterest Contact Us Radiation Protection Document Library View ...

  11. Atmospheric radiation

    SciTech Connect

    Harshvardhan, M.R. )

    1991-01-01

    Studies of atmospheric radiative processes are summarized for the period 1987-1990. Topics discussed include radiation modeling; clouds and radiation; radiative effects in dynamics and climate; radiation budget and aerosol effects; and gaseous absorption, particulate scattering and surface reflection. It is concluded that the key developments of the period are a defining of the radiative forcing to the climate system by trace gases and clouds, the recognition that cloud microphysics and morphology need to be incorporated not only into radiation models but also climate models, and the isolation of a few important unsolved theoretical problems in atmospheric radiation.

  12. Direct analysis of viral-specific CD8+ T cells with soluble HLA-A2/Tax11-19 tetramer complexes in patients with human T cell lymphotropic virus-associated myelopathy.

    PubMed

    Bieganowska, K; Höllsberg, P; Buckle, G J; Lim, D G; Greten, T F; Schneck, J; Altman, J D; Jacobson, S; Ledis, S L; Hanchard, B; Chin, J; Morgan, O; Roth, P A; Hafler, D A

    1999-02-01

    Human T cell lymphotropic virus-I (HTLV-I)-associated myelopathy is a slowly progressive neurologic disease characterized by inflammatory infiltrates in the central nervous system accompanied by clonal expansion of HTLV-I-reactive CD8+ T-cells. In patients carrying the HLA-A2 allele, the immune response is primarily directed to the Tax11-19 peptide. The frequency, activation state, and TCR usage of HLA-A2/Tax11-19 binding T cells in patients with HTLV-I-associated myelopathy was determined using MHC class I tetramers loaded with the Tax11-19 peptide. Circulating Tax11-19-reactive T cells were found at very high frequencies, approaching 1:10 circulating CD8+ T cells. T cells binding HLA-A2/Tax11-19 consisted of heterogeneous populations expressing different chemokine receptors and the IL-2R beta-chain but not the IL-2R alpha-chain. Additionally, Tax11-19-reactive CD8+ T cells used one predominant TCR Vbeta-chain for the recognition of the HLA-A2/Tax11-19 complex. These data provide direct evidence for high frequencies of circulating Tax11-19-reactive CD8+ T cells in patients with HTLV-I-associated myelopathy.

  13. Pelvic radiation - discharge

    MedlinePlus

    Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - ...

  14. Space Radiation

    NASA Technical Reports Server (NTRS)

    Wu, Honglu

    2006-01-01

    Astronauts receive the highest occupational radiation exposure. Effective protections are needed to ensure the safety of astronauts on long duration space missions. Increased cancer morbidity or mortality risk in astronauts may be caused by occupational radiation exposure. Acute and late radiation damage to the central nervous system (CNS) may lead to changes in motor function and behavior, or neurological disorders. Radiation exposure may result in degenerative tissue diseases (non-cancer or non-CNS) such as cardiac, circulatory, or digestive diseases, as well as cataracts. Acute radiation syndromes may occur due to occupational radiation exposure.

  15. Two Cases of Human T-Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis Caused by Living-Donor Renal Transplantation.

    PubMed

    Tajima, Yasutaka; Matsumura, Mariko; Yaguchi, Hiroaki; Mito, Yasunori

    2016-01-01

    In rare instances, recipients of organ transplants from human T-lymphotropic virus type I- (HTLV-I-) positive donors reportedly developed neurologic symptoms due to HTLV-I-associated myelopathy (HAM). We present herein two cases of HAM associated with renal transplantation from HTLV-I seropositive living-donors. The first patient was a 42-year-old woman with chronic renal failure for twelve years and seronegative for HTLV-I. She underwent renal transplantation with her HTLV-I seropositive mother as the donor, and she developed HAM three years after the transplantation. The second patient was a 65-year-old man who had been suffering from diabetic nephropathy. He was seronegative for HTLV-I and underwent renal transplantation one year previously, with his HTLV-I seropositive wife as the donor. He developed HAM eight months after renal transplantation. Both cases showed neurological improvements after the immunomodulating therapies. We tried to shed some light on the understanding of immunological mechanisms of transplantation-associated HAM, focusing on therapeutic strategies based on the immunopathogenesis of the condition.

  16. HLA DRB1*DQB1* haplotype in HTLV-I-associated familial infective dermatitis may predict development of HTLV-I-associated myelopathy/tropical spastic paraparesis

    SciTech Connect

    LaGrenade, L.; Miller, W.; Pate, E.; Rodgers-Johnson, P.

    1996-01-02

    A possible causal association between infective dermatitis and HTLV-I infection was reported in 1990 and confirmed in 1992. We now report familial infective dermatitis (ID) occurring in a 26-year-old mother and her 9-year-old son. The mother was first diagnosed with ID in 1969 at the age of 2 years in Dermatology Unit at the University Hospital of the West Indies (U.H.W.I.) in Jamacia. The elder of her 2 sons was diagnosed with ID at the age of 3 years, also at U.H.W.I. Both mother and son are HTLV-I-seropositive. A second, younger son, currently age 2 years, is also HTLV-I-seropositive, but without clinical evidence of ID. Major histocompatibility complex (MHC), class II, human leucocyte antigen (HLA) genotyping documented a shared class II haplotype, DRB1*DQB1* (1101-0301), in the mother and her 2 sons. This same haplotype has been described among Japanese patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and has been associated with a possible pathologically heightened immune response to HTLV-I infection. The presence of this haplotype in these familial ID cases with clinical signs of HAM/TSP may have contributed to their risk for development of HAM/TSP. The unaffected, HTLV-I-seropositive, younger son requires close clinical follow-up. 20 refs., 1 fig., 1 tab.

  17. Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy.

    PubMed

    Zhang, Jian; Wang, Huili; Liu, Haiying; Wang, Guangshun

    2016-01-01

    To draw attention to a rare neurological deterioration after spinal cord injury (SCI) and to discuss evidence supporting an increase in cerebrospinal fluid pressure (CSFP), we present an extremely rare case of subacute post-traumatic ascending myelopathy (SPAM) in which the patient sustained a T12 fracture initially resulting in paraplegia and after undergoing posterior fixation and anterior decompression. The patient was a 32-year-old healthy man who sustained a T12 burst fracture with complete paraplegia after a fall injury. The patient underwent a posterior reduction and short-segment fixation 8 h after the injury and an anterior thoracoscopic-assisted decompression on post-traumatic day 8. On post-traumatic day 21, he had a progressive neurological deterioration with dyspnoea and decreased muscle strength of both upper extremities that could not be relieved by conservative intervention. After undergoing a cervical posterior laminectomy and durotomy, the patient exhibited the clinical manifestation of brain herniation. There was no recovery of autonomous respiration, and the patient entered a coma. The patient died on post-traumatic day 25 because of cardiac and respiratory arrest. SPAM is a rare, potentially fatal neurological deterioration after SCI; however, a prompt diagnosis can be made by magnetic resonance imaging. Our observations suggest that an increase in CSFP may be the main cause of SPAM. The paraplegic level should be recorded daily so that neurological deterioration can be recognised as soon as possible.

  18. Two Cases of Human T-Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis Caused by Living-Donor Renal Transplantation

    PubMed Central

    Matsumura, Mariko; Yaguchi, Hiroaki; Mito, Yasunori

    2016-01-01

    In rare instances, recipients of organ transplants from human T-lymphotropic virus type I- (HTLV-I-) positive donors reportedly developed neurologic symptoms due to HTLV-I-associated myelopathy (HAM). We present herein two cases of HAM associated with renal transplantation from HTLV-I seropositive living-donors. The first patient was a 42-year-old woman with chronic renal failure for twelve years and seronegative for HTLV-I. She underwent renal transplantation with her HTLV-I seropositive mother as the donor, and she developed HAM three years after the transplantation. The second patient was a 65-year-old man who had been suffering from diabetic nephropathy. He was seronegative for HTLV-I and underwent renal transplantation one year previously, with his HTLV-I seropositive wife as the donor. He developed HAM eight months after renal transplantation. Both cases showed neurological improvements after the immunomodulating therapies. We tried to shed some light on the understanding of immunological mechanisms of transplantation-associated HAM, focusing on therapeutic strategies based on the immunopathogenesis of the condition. PMID:27777805

  19. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    NASA Astrophysics Data System (ADS)

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-05-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study.

  20. Accumulation of human T lymphotropic virus (HTLV)-I-specific T cell clones in HTLV-I-associated myelopathy/tropical spastic paraparesis patients.

    PubMed

    Höger, T A; Jacobson, S; Kawanishi, T; Kato, T; Nishioka, K; Yamamoto, K

    1997-08-15

    Human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraperesis (HAM/TSP) is a slowly progressive neurologic disorder following infection with HTLV-I. It is characterized by spasticity and hyper-reflexia of the lower extremities, urinary bladder disturbance, lower extremity muscle weakness, and sensory disturbances. HTLV-I, as an inducer of a strong humoral and cytotoxic response, is a well-known pathogenic factor for the progression of HAM/TSP. Peptides derived from proviral tax and env genes provide epitopes recognized by T cells. We herein report an accumulation of distinct clonotypes of alpha/beta TCR+ peripheral blood T lymphocytes from HAM/TSP patients in comparison with that observed in both asymptomatic carriers and healthy controls, using the reverse-transcriptase PCR/single-strand conformation polymorphism method. We also found that some of the accumulated T cell clones in the peripheral blood and cerebrospinal fluid are HTLV-I Tax(11-19) peptide specific. Such clones were found to expand strongly after being cultured with an HTLV-I Tax(11-19) peptide. Moreover, the cultured samples exhibited a strong MHC class I-restricted cytotoxic activity against HTLV-I Tax(11-19) peptide-expressing targets, and therefore most likely also include the disease-associated T cell clones observed in the patients. This is the first report of a direct assessment of Ag-specific T cell responses in fresh PBL and cerebrospinal fluid.

  1. Defective human T-cell lymphotropic virus type I (HTLV-I) provirus in seronegative tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM) patients.

    PubMed

    Ramirez, E; Fernandez, J; Cartier, L; Villota, C; Rios, M

    2003-02-01

    Infection with human T-cell lymphotropic virus type I (HTLV-I) have been associated with the development of the tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). We studied the presence of HTLV-I provirus in peripheral blood mononuclear cells (PBMC) from 72 Chilean patients with progressive spastic paraparesis by polymerase chain reaction: 32 seropositive and 40 seronegative cases. We amplified different genomic regions of HTLV-I using primers of 5' ltr, tax, env/tax, pX, pol and env genes. These genes were detected from all seropositive patients. The seronegative patients were negative with 5' ltr, pol, env, and pX primers. However, amplified product of tax and env/tax genes was detected from 16 and four seronegative patients, respectively. Three of them were positive with both genetic regions. The results of this study show that the complete HTLV-I provirus is found in 100% of seropositive cases. In seronegative cases, clinically very similar of seropositive cases, was found only tax gene in 42.5% (17/40) of patients. These results suggest the presence of a defective HTLV-I provirus in some seronegative patients with progressive spastic paraparesis, and suggest a pathogenic role of this truncate provirus for a group of TSP/HAM.

  2. High production of RANTES and MIP-1alpha in the tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM).

    PubMed

    Montanheiro, Patricia; Vergara, Maria Paulina Posada; Smid, Jerusa; da Silva Duarte, Alberto José; de Oliveira, Augusto César Penalva; Casseb, Jorge

    2007-08-01

    Human T cell lymphotropic virus type 1 (HTLV-1) infection is associated with progressive neurological disorders and tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). The pathogenesis of TSP/HAM is considered as immune mediated, involving cytotoxic T cell (CTL) responses to a number of viral proteins and notably the regulation protein Tax. T CD8+ cells produce beta-chemokines, which are important in the anti-viral response. In the present study, we have analyzed the CC chemokines (RANTES, MIP-1beta and MIP-1alpha) production in retrovirus-infected subjects. A total of 191 subjects were studied: 52 healthy controls, 72 asymptomatic HTLV-1-infected carriers and 67 TSP/HAM patients. Peripheral blood mononuclear cells were maintained in the presence or absence of PHA, and supernatant fluids were assayed using EIA. MIP-1beta concentration was not significantly different across groups, but RANTES and MIP-1alpha concentrations showed significant differences when the three groups were compared. In TSP/HAM patients, the increase in the production of chemokines may lead to a recruitment of pro-inflammatory factors, contributing to the membrane's myelin damage.

  3. Characterization of Thoracic Motor and Sensory Neurons and Spinal Nerve Roots in Canine Degenerative Myelopathy, a Potential Disease Model of Amyotrophic Lateral Sclerosis

    PubMed Central

    Morgan, Brandie R.; Coates, Joan R.; Johnson, Gayle C.; Shelton, G. Diane; Katz, Martin L.

    2014-01-01

    Canine Degenerative Myelopathy (DM) is a progressive adult-onset multisystem degenerative disease with many features in common with amyotrophic lateral sclerosis (ALS). As with some forms of ALS, DM is associated with mutations in superoxide dismutase 1 (SOD1). Clinical signs include general proprioceptive ataxia and spastic upper motor neuron paresis in pelvic limbs, which progress to flaccid tetraplegia and dysphagia. The purpose of this study was to characterize DM as a potential disease model for ALS. We previously reported that intercostal muscle atrophy develops in dogs with advanced stage DM. To determine if other components of the thoracic motor unit (MU) also demonstrated morphological changes consistent with dysfunction, histopathologic and morphometric analyses were conducted on thoracic spinal motor neurons (MN) and dorsal root ganglia (DRG), and in motor and sensory nerve root axons from DM-affected Boxers and Pembroke Welsh Corgis (PWCs). No alterations in MNs, or motor root axons were observed in either breed. However, advanced stage PWCs exhibited significant losses of sensory root axons, and numerous DRG sensory neurons displayed evidence of degeneration. These results indicate that intercostal muscle atrophy in DM is not preceded by physical loss of the motor neurons innervating these muscles, or of their axons. Axonal loss in thoracic sensory roots and sensory nerve death suggest sensory involvement may play an important role in DM disease progression. Further analysis of the mechanisms responsible for these morphological findings would aid in the development of therapeutic intervention for DM and some forms of ALS. PMID:24375814

  4. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    PubMed Central

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-01-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study. PMID:27225189

  5. Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of multilevel cervical spondylotic myelopathy: systematic review and a meta-analysis

    PubMed Central

    Wen, Zhi-qiang; Du, Jing-yu; Ling, Zhi-heng; Xu, Hai-dong; Lin, Xiang-jin

    2015-01-01

    Background To date, the decision to treat multilevel cervical spondylotic myelopathy (CSM) with anterior cervical discectomy and fusion (ACDF) or anterior cervical corpectomy and fusion (ACCF) remains controversial. Therefore, we conducted a meta-analysis to quantitatively determine the efficacy of ACDF and ACCF in the treatment of multilevel CSM. Methods We searched several databases for related research articles published in English or Chinese. We extracted and assessed the data independently. We determined the pooled data, data heterogeneity, and overall effect, respectively. Results We identified 15 eligible studies with 1,368 patients. We found that blood loss and numbers of complications during surgery in ACDF were significantly less that in ACCF; however, other clinical outcomes, such as operation time, bone fusion failure, post Japanese Orthopedic Association scores, recovery rates, and visual analog scale scores between ACDF and ACCF with multilevel CSM were not significantly different. Conclusion Our results strongly suggest that surgical treatments of multilevel CSM are similar in terms of most clinical outcomes using ACDF or ACCF. PMID:25673996

  6. Physalin F, a seco-steroid from Physalis angulata L., has immunosuppressive activity in peripheral blood mononuclear cells from patients with HTLV1-associated myelopathy.

    PubMed

    Pinto, Lorena A; Meira, Cássio S; Villarreal, Cristiane F; Vannier-Santos, Marcos A; de Souza, Claudia V C; Ribeiro, Ivone M; Tomassini, Therezinha C B; Galvão-Castro, Bernardo; Soares, Milena B P; Grassi, Maria F R

    2016-04-01

    Human T-lymphotropic virus type 1 (HTLV-1) induces a strong activation of the immune system, especially in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Physalin F is a secosteroid with potent anti-inflammatory and immunomodulatory activities. The present study aimed to investigate the effects of physalin F on peripheral blood mononuclear cells (PBMC) of HAM/TSP subjects. A concentration-dependent inhibition of spontaneous proliferation of PBMC from HAM/TSP subjects was observed in the presence of physalin F, as evaluated by (3)H-thymidine uptake. The IC50 for physalin F was 0.97 ± 0.11 μM. Flow cytometry analysis using Cytometric Bead Array (CBA) showed that physalin F (10 μM) significantly reduced the levels of IL-2, IL-6, IL-10, TNF-α and IFN-γ, but not IL-17A, in supernatants of PBMC cultures. Next, apoptosis induction was addressed by using flow cytometry to evaluate annexin V expression. Treatment with physalin F (10 μM) increased the apoptotic population of PBMC in HAM/TSP subjects. Transmission electron microscopy analysis of PBMC showed that physalin F induced ultrastructural changes, such as pyknotic nuclei, damaged mitochondria, enhanced autophagic vacuole formation, and the presence of myelin-like figures. In conclusion, physalin F induces apoptosis of PBMC, decreasing the spontaneous proliferation and cytokine production caused by HTLV-1 infection.

  7. Characterization of thoracic motor and sensory neurons and spinal nerve roots in canine degenerative myelopathy, a potential disease model of amyotrophic lateral sclerosis.

    PubMed

    Morgan, Brandie R; Coates, Joan R; Johnson, Gayle C; Shelton, G Diane; Katz, Martin L

    2014-04-01

    Canine degenerative myelopathy (DM) is a progressive, adult-onset, multisystem degenerative disease with many features in common with amyotrophic lateral sclerosis (ALS). As with some forms of ALS, DM is associated with mutations in superoxide dismutase 1 (SOD1). Clinical signs include general proprioceptive ataxia and spastic upper motor neuron paresis in pelvic limbs, which progress to flaccid tetraplegia and dysphagia. The purpose of this study was to characterize DM as a potential disease model for ALS. We previously reported that intercostal muscle atrophy develops in dogs with advanced-stage DM. To determine whether other components of the thoracic motor unit (MU) also demonstrated morphological changes consistent with dysfunction, histopathologic and morphometric analyses were conducted on thoracic spinal motor neurons (MNs) and dorsal root ganglia (DRG) and in motor and sensory nerve root axons from DM-affected boxers and Pembroke Welsh corgis (PWCs). No alterations in MNs or motor root axons were observed in either breed. However, advanced-stage PWCs exhibited significant losses of sensory root axons, and numerous DRG sensory neurons displayed evidence of degeneration. These results indicate that intercostal muscle atrophy in DM is not preceded by physical loss of the motor neurons innervating these muscles, nor of their axons. Axonal loss in thoracic sensory roots and sensory neuron death suggest that sensory involvement may play an important role in DM disease progression. Further analysis of the mechanisms responsible for these morphological findings would aid in the development of therapeutic intervention for DM and some forms of ALS.

  8. Modulation of rodent spinal cord radiation tolerance by administration of platelet-derived growth factor

    SciTech Connect

    Andratschke, Nicolaus H.; Nieder, Carsten M.D. . E-mail: cnied@hotmail.com; Price, Roger E.; Rivera, Belinda; Tucker, Susan L.; Ang, K.

    2004-11-15

    Purpose: To examine the role of platelet-derived growth factor (PDGF) for ameliorating radiation myelopathy of the cervical spinal cord in a rodent model. Methods and materials: After developing the technique for cannulation of the basal cistern, initial animal experiments were conducted to test the feasibility of intrathecal continuous infusion of PDGF in a model of cervical spinal cord irradiation in adult Fisher F-344 rats and to determine the most effective dose level of PDGF. Subsequently, the dose-modification factor was determined in a larger group of rats. Irradiation was given in 2 fractions (16 Gy followed by 14-24 Gy) and animals were examined for the development of paresis. Results: The initial dose-finding experiment revealed significant differences in the incidence of radiation myelopathy (100% in saline-treated control rats, 25% with the most effective dose of PDGF, up to 100% with less effective doses). The most effective dose of PDGF was 0.014 {mu}g per day. Subsequent experiments revealed a median effective dose (ED{sub 50}) of 35.6 Gy (95% confidence interval, 34.7-36.5 Gy) for animals receiving this dose of PDGF in contrast to 33.8 Gy (33.4-34.3 Gy) for the control group (p = 0.003). The dose-modification factor obtained with this dose of PDGF was 1.05. Conclusions: Intrathecal administration of PDGF concomitant to irradiation of the cervical spinal cord in rats was feasible. Treatment with PDGF significantly increased the tolerance of the spinal cord. The PDGF experiments should be viewed as a proof of principle that brief therapeutic intervention in the earliest phase of damage induction can reduce late effects in the spinal cord. They form the basis for further studies of growth factor administration in this particular model.

  9. Radiation Proctopathy

    PubMed Central

    Grodsky, Marc B.; Sidani, Shafik M.

    2015-01-01

    Radiation therapy is a widely utilized treatment modality for pelvic malignancies, including prostate cancer, rectal cancer, and cervical cancer. Given its fixed position in the pelvis, the rectum is at a high risk for injury secondary to ionizing radiation. Despite advances made in radiation science, up to 75% of the patients will suffer from acute radiation proctitis and up to 20% may experience chronic symptoms. Symptoms can be variable and include diarrhea, bleeding, incontinence, and fistulization. A multitude of treatment options exist. This article summarizes the latest knowledge relating to radiation proctopathy focusing on the vast array of treatment options. PMID:26034407

  10. Surgical results and complications of anterior decompression and fusion as a revision surgery after initial posterior surgery for cervical myelopathy due to ossification of the posterior longitudinal ligament.

    PubMed

    Odate, Seiichi; Shikata, Jitsuhiko; Soeda, Tsunemitsu; Yamamura, Satoru; Kawaguchi, Shinji

    2017-04-01

    main complication was an intraoperative CSF leak in 8 patients (42%). Neurological function worsened in 5 patients (26%). The deterioration was due to spinal cord herniation through a defective dura mater in 1 patient, unidentified in 1 patient, and C-5 palsy that gradually recovered in 3 patients. Reintubation, delirium, and hoarseness were observed in 1 patient each (5%). No patient required reoperation for reconstruction failure, and all patients eventually had a solid bony fusion. CONCLUSIONS ACDF as revision surgery after initial posterior surgery for cervical myelopathy due to OPLL is associated with a high incidence of intraoperative CSF leakage and an extremely low improvement rate. The authors think that while the use of revision ACDF must be limited, it is indispensable in special cases, such as progressing myelopathy following posterior surgery due to a very large beak-type OPLL that exceeds the K-line. Postoperative OPLL progression and/or kyphotic changes can possibly cause later neurological deterioration. Fusion should be recommended at the initial surgery for many cases of cervical OPLL to prevent such a challenging revision surgery.

  11. Up-regulation of CB2 receptors in reactive astrocytes in canine degenerative myelopathy, a disease model of amyotrophic lateral sclerosis.

    PubMed

    Fernández-Trapero, María; Espejo-Porras, Francisco; Rodríguez-Cueto, Carmen; Coates, Joan R; Pérez-Díaz, Carmen; de Lago, Eva; Fernández-Ruiz, Javier

    2017-01-09

    Targeting the CB2 receptor afforded neuroprotection in SOD1(G93A) mutant mice, a model of amyotrophic lateral sclerosis (ALS). The neuroprotective effects of CB2 receptors were facilitated by their up-regulation in the spinal cord in SOD1(G93A) mutant mice. Herein, we have investigated whether a similar CB2 receptor up-regulation, as well as parallel changes in other endocannabinoid elements, are evident in the spinal cord of dogs with degenerative myelopathy (DM), caused from mutations in the superoxide dismutase 1 gene (SOD1). We used well-characterized post-mortem spinal cords from unaffected and DM-affected dogs. Tissues were used first to confirm the loss of motor neurons using Nissl staining, which was accompanied by glial reactivity (elevated GFAP and Iba-1 immunoreactivity). Next, we investigated possible differences in the expression of endocannabinoid genes measured by qPCR between DM-affected and control dogs. We found no changes in the CB1 receptor (also found with CB1 receptor immunostaining) as well as in NAPE-PLD, DAGL, FAAH and MAGL enzymes. In contrast, CB2 receptor levels were significantly elevated in DM-affected dogs determined by qPCR and Western-blotting, results reconfirmed in the grey matter using CB2 receptor immunostaining. Using double-labelling immunofluorescence, CB2 receptor immunolabelling co-localized with GFAP but not Iba-1, indicating up-regulation of CB2 receptors on astrocytes in DM-affected dogs. In summary, our results demonstrated a marked up-regulation of CB2 receptors occurring in the spinal cord in canine DM, which was concentrated in activated astrocytes. Such receptors may be used as a potential target to enhance the neuroprotective effects exerted by these glial cells.

  12. HLA-G 3'-untranslated region polymorphisms are associated with HTLV-1 infection, proviral load and HTLV-associated myelopathy/tropical spastic paraparesis development.

    PubMed

    Cilião Alves, Daiani Cristina; Haddad, Rodrigo; Rocha-Júnior, Maurício Cristiano; de Deus Wagatsuma, Virgínia Mara; Martelli-Palomino, Gustavo; Marques, Adriana Aparecida; Takayanagui, Osvaldo Massaiti; Covas, Dimas Tadeu; Kashima, Simone; Donadi, Eduardo Antônio

    2016-10-01

    Most human T-lymphotropic virus type 1 (HTLV-1)-infected patients remain asymptomatic throughout life. The factors associated with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) development have not been fully elucidated; immunological and genetic factors may be involved. The association of 14 bp INS/DEL HLA-G polymorphism with HTLV-1 infection susceptibility has been reported previously. Here, other polymorphic sites at the HLA-G 3'-UTR (14-bp D/I, +3003C/T, +3010C/G, +3027A/C, +3035C/T, +3142C/G, +3187A/G and +3196C/G) were evaluated in 37 HTLV-1-infected individuals exhibiting HAM/TSP, 45 HTLV-1 asymptomatic carriers (HAC) and 153 uninfected individuals, followed up at University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil. It was observed that: (i) 14bpDI genotype is a risk factor for HTLV-1 infection, while the 14bpDD and +3142CC genotypes were associated with protection against infection; (ii) the +3142C allele and the +3003CT and +3142CC genotypes were associated with susceptibility, while 14bpII and +3003TT genotypes were associated with protection against HAM/TSP development; and (iii) the 14bpII, +3010CC, +3142GG and +3187AA genotypes were associated with lower HTLV-1 proviral load compared to respective counterpart genotypes. Findings that HLA-G has a well-recognized immunomodulatory role and that the genetic variability at HLA-G 3'-UTR may post-transcriptionally modify HLA-G production indicate a differential genetic susceptibility to: (i) the development of HTLV-1 infection, (ii) the magnitude of HTLV-1 proviral load and (iii) HAM/TSP development.

  13. Modulatory effects of curcumin on apoptosis and cytotoxicity-related molecules in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients.

    PubMed

    Mohammadi, Asadollah; Fazeli, Bahare; Taheri, Marzieh; Sahebkar, Amirhossein; Poursina, Zohreh; Vakili, Vida; Yazdi, Shadi Zamanian; Keramati, Zahra; Boostani, Reza; Hampson, Ian; Rafatpanah, Houshang

    2017-01-01

    Apoptosis is a universal cellular defense mechanism against viral infection. Curcumin, an anti-inflammatory phytochemical, induces apoptosis through mitochondrial and receptor-mediated pathways, as well as activation of caspase cascades. Here, we investigated the impact of supplementation with curcumin on the expression of a panel of apoptosis- and cytotoxicity-related genes in patients suffering from HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP), a progressive demyelinating neuroinflammatory disease caused by HTLV-1 infection. Twenty-one HAM/TSP patients enrolled in this study. Curcumin nanomicelles (80mg/day, orally) were administered once a day for 12 weeks. The mRNA levels of total Fas (tFas), membrane-bound Fas (mFas), Fas-Ligand (FasL), TNF-related apoptosis-inducing ligand (TRAIL), perforin, granzyme A, granzyme B and granulysin were analyzed before and after treatment in peripheral blood lymphocytes. Protein levels of Fas, FasL, TRAIL and granulysin were also measured in serum using ELISA. Curcumin supplementation inhibited FasL mRNA production and up-regulated the expression of pro-apoptotic molecules granzyme A (at the mRNA level) and granulysin (at the protein level), suggesting degranulation of granulysin-bearing cells following curcumin supplementation. Conversely, Curcumin did not affect Fas, TRAIL, perforin, granzyme B at the mRNA level, and anti-apoptotic molecules sFas, sFasL and sTRAIL at the protein level. The present results suggest that curcumin supplementation increases cytotoxicity-related molecules granzyme A and granulysin in patients with HAM/TSP.

  14. A Review of Fibrocartilaginous Embolic Myelopathy and Different Types of Peracute Non-Compressive Intervertebral Disk Extrusions in Dogs and Cats

    PubMed Central

    De Risio, Luisa

    2015-01-01

    This review discusses terminology, pathological, clinical, and magnetic resonance imaging (MRI) findings, treatment, outcome, and prognostic factors of fibrocartilaginous embolic myelopathy (FCEM), acute non-compressive nucleus pulposus extrusion (ANNPE), and intradural/intramedullary intervertebral disk extrusion (IIVDE). FCEM, ANNPE, and IIVDE have a similar clinical presentation characterized by peracute onset of neurological dysfunction that is generally non-progressive after the initial 24–48 h. Differentiating between these conditions can be challenging, however, certain clinical and imaging findings can help. FCEM can occur in both adult and immature animals, whereas ANNPE or IIVDE have been reported only in animals older than 1 year. In dogs, ANNPE and IIVDE most commonly occur in the intervertebral disk spaces between T12 and L2, whereas FCEM has not such site predilection. In cats, FCEM occurs more frequently in the cervical spinal cord than in other locations. Data on cats with ANNPE and IIVDE are limited. Optimal MRI definition and experience in neuroimaging can help identify the findings that allow differentiation between FCEM, ANNPE, and IIVDE. In animals with ANNPE and IIVDE, the affected intervertebral disk space is often narrowed and the focal area of intramedullary hyperintensity on T2-weighted images is located above the affected intervertebral disk space. In dogs with ANNPE signal changes associated with the extruded nucleus pulposus and epidural fat disruption can be identified in the epidural space dorsal to the affected intervertebral disk. Identification of a linear tract (predominantly hyperintense on T2-weighted images, iso to hypointense on T1-weighted images and hypointense on T2*-weighted gradient recall echo images) extending from the intervertebral disk into the spinal cord parenchyma is highly suggestive of IIVDE. Treatment of FCEM and ANNPE is conservative. Dogs reported with IIVDE have been managed either conservatively or

  15. Texture-based characterization of pre- and post-operative T2-weighted magnetic resonance signals of the cervical spinal cord in cervical spondylotic myelopathy

    NASA Astrophysics Data System (ADS)

    Boniatis, Ioannis; Klironomos, George; Gatzounis, George; Panayiotakis, George

    2009-10-01

    The utility of texture analysis regarding the provision of quantitative prognostic factors, potentially valuable to the prediction of the post-operative outcome of cervical spondylotic myelopathy (CSM) patients, is investigated. The clinical sample of the study comprised six subjects, who had undergone surgical therapeutic intervention for CSM. Following a specific imaging protocol, a pair of MR images of the cervical spine, corresponding to pre- and post-operative MR scans, was obtained for each of the patients. Accordingly, 12 sagittal T2-weighted magnetic resonance (MR) images were studied. Employing custom developed software, a Region Of Interest (ROI) within the spinal cord, corresponding to the region of the high-intensity CSM MR signal, was segmented on each image, according to the region growing method. Utilizing custom developed algorithms, the following sets of textural features were generated from the segmented ROIs: (i) gradient features, (ii) mean values of features from co-occurrence matrices (co-occurrence features) and (iii) range values of co-occurrence features. Utilizing each one of these sets of features, as well as the least-squares minimum distance and the quadratic classification algorithms, pattern recognition classification schemes were implemented for the discrimination between pre-operative and post-operative MR signals. Statistical analysis revealed the existence of statistically significant differences (p < 0.05) between textural features generated from pre-operative and post-operative high-intensity MR signals. The classification accuracies accomplished ranged from 75% to 100%. Textural features, descriptive of relevant properties of the high-intensity MR signal in CSM, may be considered as quantitative information of potential value for the prediction of the post-operative outcome of CSM patients.

  16. Cytoplasmic Localization of HTLV-1 HBZ Protein: A Biomarker of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP)

    PubMed Central

    Baratella, Marco; Forlani, Greta; Raval, Goutham U.; Tedeschi, Alessandra; Gout, Olivier; Gessain, Antoine; Accolla, Roberto S.

    2017-01-01

    HTLV-1 is the causative agent of a severe form of adult T cell leukemia/Lymphoma (ATL), and of a chronic progressive neuromyelopathy designated HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Two important HTLV-1-encoded proteins, Tax-1 and HBZ, play crucial roles in the generation and maintenance of the oncogenic process. Less information is instead available on the molecular and cellular mechanisms leading to HAM/TSP. More importantly, no single specific biomarker has been described that unambiguously define the status of HAM/TSP. Here we report for the first time the finding that HBZ, described until now as an exclusive nuclear protein both in chronically infected and in ATL cells, is instead exclusively localized in the cytoplasm of peripheral blood mononuclear cells (PBMC) from patients suffering of HAM/TSP. Interestingly, at the single cell level, HBZ and Tax-1 proteins are never found co-expressed in the same cell, suggesting the existence of mechanisms of expression uncoupling of these two important HTLV-1 viral products in HAM/TSP patients. Cells expressing cytoplasmic HBZ were almost exclusively found in the CD4+ T cell compartment that was not, at least in a representative HAM/TSP patient, expressing the CD25 marker. Less than 1 percent CD8+ T cells were fond positive for HBZ, while B cells and NK cells were found negative for HBZ in HAM/TSP patients. Our results identify the cytoplasmic localization of HBZ in HAM/TSP patient as a possible biomarker of this rather neglected tropical disease, and raise important hypotheses on the role of HBZ in the pathogenesis of the neuromyelopathy associated to HTLV-1 infection. PMID:28095504

  17. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

    PubMed Central

    Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-01-01

    Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P < 0.05), without statistically relevant differences between the 2 groups. The OSA and FSU angle increased significantly in both groups (P <0.05). Compared with Zero-P group, ROMs at the index levels were well maintained in the Discover group (P < 0.05). However, there were no statistical differences in the ROMs of adjacent levels between the 2 groups (P > 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the

  18. Cytoplasmic Localization of HTLV-1 HBZ Protein: A Biomarker of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP).

    PubMed

    Baratella, Marco; Forlani, Greta; Raval, Goutham U; Tedeschi, Alessandra; Gout, Olivier; Gessain, Antoine; Tosi, Giovanna; Accolla, Roberto S

    2017-01-01

    HTLV-1 is the causative agent of a severe form of adult T cell leukemia/Lymphoma (ATL), and of a chronic progressive neuromyelopathy designated HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Two important HTLV-1-encoded proteins, Tax-1 and HBZ, play crucial roles in the generation and maintenance of the oncogenic process. Less information is instead available on the molecular and cellular mechanisms leading to HAM/TSP. More importantly, no single specific biomarker has been described that unambiguously define the status of HAM/TSP. Here we report for the first time the finding that HBZ, described until now as an exclusive nuclear protein both in chronically infected and in ATL cells, is instead exclusively localized in the cytoplasm of peripheral blood mononuclear cells (PBMC) from patients suffering of HAM/TSP. Interestingly, at the single cell level, HBZ and Tax-1 proteins are never found co-expressed in the same cell, suggesting the existence of mechanisms of expression uncoupling of these two important HTLV-1 viral products in HAM/TSP patients. Cells expressing cytoplasmic HBZ were almost exclusively found in the CD4+ T cell compartment that was not, at least in a representative HAM/TSP patient, expressing the CD25 marker. Less than 1 percent CD8+ T cells were fond positive for HBZ, while B cells and NK cells were found negative for HBZ in HAM/TSP patients. Our results identify the cytoplasmic localization of HBZ in HAM/TSP patient as a possible biomarker of this rather neglected tropical disease, and raise important hypotheses on the role of HBZ in the pathogenesis of the neuromyelopathy associated to HTLV-1 infection.

  19. A Review of Fibrocartilaginous Embolic Myelopathy and Different Types of Peracute Non-Compressive Intervertebral Disk Extrusions in Dogs and Cats.

    PubMed

    De Risio, Luisa

    2015-01-01

    This review discusses terminology, pathological, clinical, and magnetic resonance imaging (MRI) findings, treatment, outcome, and prognostic factors of fibrocartilaginous embolic myelopathy (FCEM), acute non-compressive nucleus pulposus extrusion (ANNPE), and intradural/intramedullary intervertebral disk extrusion (IIVDE). FCEM, ANNPE, and IIVDE have a similar clinical presentation characterized by peracute onset of neurological dysfunction that is generally non-progressive after the initial 24-48 h. Differentiating between these conditions can be challenging, however, certain clinical and imaging findings can help. FCEM can occur in both adult and immature animals, whereas ANNPE or IIVDE have been reported only in animals older than 1 year. In dogs, ANNPE and IIVDE most commonly occur in the intervertebral disk spaces between T12 and L2, whereas FCEM has not such site predilection. In cats, FCEM occurs more frequently in the cervical spinal cord than in other locations. Data on cats with ANNPE and IIVDE are limited. Optimal MRI definition and experience in neuroimaging can help identify the findings that allow differentiation between FCEM, ANNPE, and IIVDE. In animals with ANNPE and IIVDE, the affected intervertebral disk space is often narrowed and the focal area of intramedullary hyperintensity on T2-weighted images is located above the affected intervertebral disk space. In dogs with ANNPE signal changes associated with the extruded nucleus pulposus and epidural fat disruption can be identified in the epidural space dorsal to the affected intervertebral disk. Identification of a linear tract (predominantly hyperintense on T2-weighted images, iso to hypointense on T1-weighted images and hypointense on T2*-weighted gradient recall echo images) extending from the intervertebral disk into the spinal cord parenchyma is highly suggestive of IIVDE. Treatment of FCEM and ANNPE is conservative. Dogs reported with IIVDE have been managed either conservatively or

  20. Effects of robot-driven gait orthosis treadmill training on the autonomic response in rehabilitation-responsive stroke and cervical spondylotic myelopathy patients.

    PubMed

    Magagnin, Valentina; Bo, Ivano; Turiel, Maurizio; Fornari, Maurizio; Caiani, Enrico G; Porta, Alberto

    2010-06-01

    Body weight supported treadmill training (BWSTT) assisted with a robotic-driven gait orthosis is utilized in rehabilitation of individuals with lost motor skills. A typical rehabilitation session included: sitting, standing, suspension, robotic-assisted walking at 1.5 and 2.5km/h, respectively with 50% body weight support and recovery. While the effects of robotic-assisted BWSTT on motor performances were deeply studied, the influences on the cardiovascular control are still unknown. The aim of the study was to evaluate in stroke (ST) and cervical spondylotic myelopathy (CSM) patients: (1) the autonomic response during a traditional robotic-assisted BWSTT session of motor rehabilitation; (2) the effects of 30 daily sessions of BWSTT on cardiovascular regulation. The autonomic response was assessed through symbolic analysis of short-term heart rate variability in 11 pathologic subjects (5 ST and 6 CSM patients) whose motor skills were improved as a result of the rehabilitation therapy. Results showed variable individual responses to the rehabilitation session in ST patients at the beginning of the therapy. At the end of the rehabilitation process, the responses of ST patients were less variable and more similar to those previously observed in healthy subjects. CSM patients exhibited an exaggerated vagal response to the fastest walking phase during the first rehabilitative session. This abnormal response was limited after the last rehabilitative session. We conclude that robotic-assisted BWSTT is helpful in restoring cardiovascular control in rehabilitation-responsive ST patients and limiting vagal responses in rehabilitation-responsive CSM patients.

  1. The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy

    PubMed Central

    2016-01-01

    Objective Degenerative diseases of the spine, such as cervical spondylotic myelopathy (CSM), are increasing among the old age population, and surgical treatment of CSM is becoming more and more common. The aim of this study was to investigate how functional recovery can be influenced by anterior compression of the spinal cord (ACS) after laminoplasty for treatment of patients with CSM. Methods We retrospectively analyzed 32 patients admitted to Ewha Womans Mok-Dong Hospital with CSM who underwent open-door laminoplasty from January 2012 to December 2014. We divided patients into 2 groups according to whether ACS was or not preoperatively. Each group was analyzed clinical and radiological parameters which were Japanese Orthopedic Association (JOA) scores and its recovery rate, sagittal alignment and range of motion (ROM). Results The mean duration of symptom was 11.2 months (range, 6-22 months). A significant difference in recovery rate of the total JOA score was shown between the 2 groups, especially upper extremity motor function. No difference in preoperative JOA score between the 2 groups, but recovery rate of each group was 20.05%±18.1%, 32.21%±25.4%, statistically significant (p<0.005). Upper motor and sensory function was not significantly different in the 2 groups. Preoperative, postoperative and preservation of ROM was 44.3°±10.1°, 41.8°±15.7°, 87.9%±35.4% each at ACS (-) group. A significant difference in postoperative ROM was identified between ACS (-) and ACS (+) group. Postoperative anterior compression of the spinal cord was recognized 14 cases which were classified from its causes. Conclusion Cervical ROM decreased significantly after laminoplasty, but 85.3% of the preoperative ROM was preserved. The postoperative reduction of ROM in group with anterior compression of spinal cord was identified. PMID:28127374

  2. Development and characterization of a novel rat model of cervical spondylotic myelopathy: the impact of chronic cord compression on clinical, neuroanatomical, and neurophysiological outcomes.

    PubMed

    Lee, JangBo; Satkunendrarajah, Kajana; Fehlings, Michael G

    2012-03-20

    Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord impairment worldwide and is a risk factor for traumatic central cord syndrome. Despite advances in surgery, there are no effective neuroprotective treatments for CSM, which reflects a limited understanding of its pathophysiology. In order to develop therapeutic strategies, we have developed a novel rat model of chronic progressive cervical spinal cord compression that mimics CSM. A titanium-screw-based chronic compression device (CCD) was designed to achieve progressive cord compression at the C6 level. The CCD was fixed to the C2 and T2 spinous processes and a threaded screw was turned to induce compression. Sprague-Dawley rats (n=75) were divided into three groups: (1) sham (no compression, n=6), (2) mild compression (1.4 mm stenosis, n=27), and (3) severe compression (2.6 mm stenosis, n=42). Compression was evaluated using micro-computed tomography (micro-CT). The area of spared white matter, extent of cord flattening ratio, and loss of neurons were assessed. Functional deficits were characterized using sensory-evoked potential (SEP) recordings, and with neurobehavioral tests: the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale, inclined plane, paw grip strength, and assessment of mechanical and thermal allodynia. Micro-CT confirmed progressive canal stenosis. The loss of intact white matter and cord flattening were significantly greater in rats with severe cord compression, and the number of neurons was reduced at the epicenter of cord compression. With chronic cord compression there was a significant decline in locomotor function, forelimb function, trunk stability/coordination, an increase in mechanical allodynia, and impaired axonal conduction. The CCD model results in chronic and precise cervical cord compression. The compression is associated with mechanical allodynia and measurable neurobehavioral, neurophysiological, and neuropathological deficits. We anticipate

  3. Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon.

    PubMed

    Takatani, Massanobu; Crispim, Myuki Esashika; Fraiji, Nelson; Stefani, Mariane Martins Araujo; Kiesslich, Dagmar

    2017-04-03

    Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame's motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.

  4. Ultrastructural pathology of a Chilean case of tropical spastic paraparesis/human T-cell lymphotropic type I-associated myelopathy (TSP/HAM).

    PubMed

    Liberski, P P; Buczyński, J; Yanagihara, R; Mora, C; Gibbs, C J; Gajdusek, C; Cartier, L; Verdugo, A; Araya, F; Castillo, L

    1999-01-01

    Human T-cell lymphotropic virus type I (HTLV-I), is the cause of endemic tropical spastic paraparesis (TSP) or HTLV-I-associated myelopathy (HAM). Because TSP/HAM is not a fatal disease, the neuropathology of this disease, albeit relatively well understood, is based on the examination of just a few incidental cases. Previously, we demonstrated peculiar lamellated structures, called "multilamellar bodies" (MLB). In this report, we present the ultrastructural neuropathology of a TSP/HAM case from Chile, with further detailed descriptions of MLB. It is tempting to suggest that MLB may represent specific ultrastructural markers of TSP/HAM. The pathology of the anterior and posterior horns was similar and was comprised of axonal degeneration, accompanied by extensive astrocytic gliosis. Lymphocytic infiltration, particularly observed as "cuffs" around blood vessels, was scattered among other cellular elements. Ultrastructurally, myelin sheaths were relatively well preserved, and some demyelinated but not remyelinated fibers were observed. Moreover, axons with abnormal accumulations of neurofilaments, suggestive of axonal degeneration, were detected. Several axons contained Hirano bodies. In many samples, glial processes replaced most of the remaining neuropil. In a few specimens of the anterior and posterior horns of the spinal cord, MLB were observed. These structures consisted of stacks of 30 to 40 electron-dense lamellae, which were interrupted by narrow electron-lucent spaces. All of the lamellae were immersed within an amorphous substance of intermediate density. Neurons of the dorsal root ganglia were basically normal except for increased lipofuscin accumulation. As in the spinal cord, myelinated axons were well preserved, but a few were demyelinated and surrounded by concentric arrays of Schwann cell membranes. Also, axons of the dorsal roots accumulated increased number of neurofilaments. Mast cells and Schwann cells were increased in number, the latter

  5. Radiator technology

    NASA Technical Reports Server (NTRS)

    Juhasz, Albert J.

    1993-01-01

    Radiator technology is discussed in the context of the Civilian Space Technology Initiative's (CSTI's) high capacity power-thermal management project. The CSTI project is a subset of a project to develop a piloted Mars nuclear electric propulsion (NEP) vehicle. The following topics are presented in vugraph form: advanced radiator concepts; heat pipe codes and testing; composite materials; radiator design and integration; and surface morphology.

  6. Hawking radiation

    NASA Astrophysics Data System (ADS)

    Parentani, Renaud; Spindel, Philippe

    2011-12-01

    Hawking radiation is the thermal radiation predicted to be spontaneously emitted by black holes. It arises from the steady conversion of quantum vacuum fluctuations into pairs of particles, one of which escaping at infinity while the other is trapped inside the black hole horizon. It is named after the physicist Stephen Hawking who derived its existence in 1974. This radiation reduces the mass of black holes and is therefore also known as black hole evaporation.

  7. Radiation Therapy

    MedlinePlus

    ... can watch you during the procedure. As you go through radiation treatment, you may feel like you're all ... treatment. Avoid exposing the treated area to the sun during the weeks you're getting radiation therapy. And when the treatment's over, wear sunscreen ...

  8. Understanding Radiation.

    ERIC Educational Resources Information Center

    Department of Energy, Washington, DC. Nuclear Energy Office.

    Radiation is a natural energy force that has been a part of the environment since the Earth was formed. It takes various forms, none of which can be smelled, tasted, seen, heard, or felt. Nevertheless, scientists know what it is, where it comes from, how to measure and detect it, and how it affects people. Cosmic radiation from outer space and…

  9. Radiation Therapy

    MedlinePlus

    ... Tumors In Children Pediatric Brain Tumor Diagnosis Family Impact Late Effects After Treatment Returning to School Pediatric ... Una publicación de ABTA en español. Radiation Imaging Technology Information on Radiation and Imaging Technology Home Donor and ...

  10. Radiation Therapy

    MedlinePlus

    ... them from spreading. About half of all cancer patients receive it. The radiation may be external, from special machines, or internal, from radioactive substances that a doctor places inside your body. The type of radiation therapy you receive depends on many factors, including The ...

  11. Radiation Exposure

    MedlinePlus

    ... particles. It occurs naturally in sunlight. Man-made radiation is used in X-rays, nuclear weapons, nuclear power plants and cancer treatment. If you are exposed to small amounts of radiation over a long time, it raises your risk ...

  12. Radiation Dose-Volume Effects in the Spinal Cord

    SciTech Connect

    Kirkpatrick, John P.; Kogel, Albert J. van der; Schultheiss, Timothy E.

    2010-03-01

    Dose-volume data for myelopathy in humans treated with radiotherapy (RT) to the spine is reviewed, along with pertinent preclinical data. Using conventional fractionation of 1.8-2 Gy/fraction to the full-thickness cord, the estimated risk of myelopathy is <1% and <10% at 54 Gy and 61 Gy, respectively, with a calculated strong dependence on dose/fraction (alpha/beta = 0.87 Gy.) Reirradiation data in animals and humans suggest partial repair of RT-induced subclinical damage becoming evident about 6 months post-RT and increasing over the next 2 years. Reports of myelopathy from stereotactic radiosurgery to spinal lesions appear rare (<1%) when the maximum spinal cord dose is limited to the equivalent of 13 Gy in a single fraction or 20 Gy in three fractions. However, long-term data are insufficient to calculate a dose-volume relationship for myelopathy when the partial cord is treated with a hypofractionated regimen.

  13. Radiation detector

    DOEpatents

    Fultz, B.T.

    1980-12-05

    Apparatus is provided for detecting radiation such as gamma rays and x-rays generated in backscatter Moessbauer effect spectroscopy and x-ray spectrometry, which has a large window for detecting radiation emanating over a wide solid angle from a specimen and which generates substantially the same output pulse height for monoenergetic radiation that passes through any portion of the detection chamber. The apparatus includes a substantially toroidal chamber with conductive walls forming a cathode, and a wire anode extending in a circle within the chamber with the anode lying closer to the inner side of the toroid which has the least diameter than to the outer side. The placement of the anode produces an electric field, in a region close to the anode, which has substantially the same gradient in all directions extending radially from the anode, so that the number of avalanche electrons generated by ionizing radiation is independent of the path of the radiation through the chamber.

  14. Radiation detector

    DOEpatents

    Fultz, Brent T.

    1983-01-01

    Apparatus is provided for detecting radiation such as gamma rays and X-rays generated in backscatter Mossbauer effect spectroscopy and X-ray spectrometry, which has a large "window" for detecting radiation emanating over a wide solid angle from a specimen and which generates substantially the same output pulse height for monoenergetic radiation that passes through any portion of the detection chamber. The apparatus includes a substantially toroidal chamber with conductive walls forming a cathode, and a wire anode extending in a circle within the chamber with the anode lying closer to the inner side of the toroid which has the least diameter than to the outer side. The placement of the anode produces an electric field, in a region close to the anode, which has substantially the same gradient in all directions extending radially from the anode, so that the number of avalanche electrons generated by ionizing radiation is independent of the path of the radiation through the chamber.

  15. Radiation retinopathy.

    PubMed Central

    Zamber, R W; Kinyoun, J L

    1992-01-01

    Radiation therapy is effective against many cancerous and noncancerous disease processes. As with other therapeutics, side effects must be anticipated, recognized, and managed appropriately. Radiation retinopathy is a vision-threatening complication of ocular, orbital, periorbital, facial, nasopharyngeal, and cranial irradiation. Factors that appear important in the pathogenesis of radiation retinopathy include total radiation dosage, fraction size, concomitant chemotherapy, and preexisting vascular disorders. Clinical manifestations of the disorder include macular edema and nonproliferative and proliferative retinopathy, similar to changes seen in diabetic retinopathy. Argon laser photocoagulation has proved efficacious for managing macular edema and fibrovascular proliferation in some of these patients. Ongoing basic laboratory and clinical research efforts have led to a better understanding of the pathogenesis, natural history, and treatment response of radiation retinopathy. The ultimate goal of this knowledge is to improve the prevention, recognition, and management of this vision-threatening complication. Images PMID:1441494

  16. Diffuse radiation

    NASA Technical Reports Server (NTRS)

    1981-01-01

    A diffuse celestial radiation which is isotropic at least on a course scale were measured from the soft X-ray region to about 150 MeV, at which energy the intensity falls below that of the galactic emission for most galactic latitudes. The spectral shape, the intensity, and the established degree of isotropy of this diffuse radiation already place severe constraints on the possible explanations for this radiation. Among the extragalactic theories, the more promising explanations of the isotropic diffuse emission appear to be radiation from exceptional galaxies from matter antimatter annihilation at the boundaries of superclusters of galaxies of matter and antimatter in baryon symmetric big bang models. Other possible sources for extragalactic diffuse gamma radiation are discussed and include normal galaxies, clusters of galaxies, primordial cosmic rays interacting with intergalactic matter, primordial black holes, and cosmic ray leakage from galaxies.

  17. [Radiation carcinogenesis].

    PubMed

    Hosoi, Yoshio

    2013-11-01

    Misrepair of DNA damage induced by ionizing radiation is a potential cause of carcinogenesis following exposure to radiation. Radiation exposure increases the incidence of the same types of mutations that occur spontaneously in a given population. A high incidence of DNA double-strand breaks is characteristic of damage by ionizing radiation compared with those induced by other environmental mutagens. In China, residents living in areas with high level background radiation(6mSv/y) had a significantly higher frequency of dicentric and ring chromosomes compared to that for the residents living in the control areas(2mSv/y). Radiation-associated increases in risk were seen for most sites. Gender-averaged excess absolute risk rates estimated at age 70, after exposure at age 30, differ in the sites, and the risks of gastric cancer, breast cancer, colon cancer, and lung cancer were highly increased, in that order. Latent periods for the development of leukemia and thyroid cancer after radiation exposure at ages younger than 18 were shorter compared to those for other solid cancers.

  18. Radiation dosimeter

    DOEpatents

    Fox, R.J.

    1981-09-01

    A radiation detector readout circuit is provided which produces a radiation dose-rate readout from a detector even through the detector output may be highly energy dependent. A linear charge amplifier including an output charge pump circuit amplifies the charge signal pulses from the detector and pumps the charge into a charge storage capacitor. The discharge rate of the capacitor through a resistor is controlled to provide a time-dependent voltage which when integrated provides an output proportional to the dose-rate of radiation detected by the detector. This output may be converted to digital form for readout on a digital display.

  19. Radiation dosimeter

    DOEpatents

    Fox, Richard J.

    1983-01-01

    A radiation detector readout circuit is provided which produces a radiation dose-rate readout from a detector even though the detector output may be highly energy dependent. A linear charge amplifier including an output charge pump circuit amplifies the charge signal pulses from the detector and pumps the charge into a charge storage capacitor. The discharge rate of the capacitor through a resistor is controlled to provide a time-dependent voltage which when integrated provides an output proportional to the dose-rate of radiation detected by the detector. This output may be converted to digital form for readout on a digital display.

  20. Radiation Hydrodynamics

    SciTech Connect

    Castor, J I

    2003-10-16

    The discipline of radiation hydrodynamics is the branch of hydrodynamics in which the moving fluid absorbs and emits electromagnetic radiation, and in so doing modifies its dynamical behavior. That is, the net gain or loss of energy by parcels of the fluid material through absorption or emission of radiation are sufficient to change the pressure of the material, and therefore change its motion; alternatively, the net momentum exchange between radiation and matter may alter the motion of the matter directly. Ignoring the radiation contributions to energy and momentum will give a wrong prediction of the hydrodynamic motion when the correct description is radiation hydrodynamics. Of course, there are circumstances when a large quantity of radiation is present, yet can be ignored without causing the model to be in error. This happens when radiation from an exterior source streams through the problem, but the latter is so transparent that the energy and momentum coupling is negligible. Everything we say about radiation hydrodynamics applies equally well to neutrinos and photons (apart from the Einstein relations, specific to bosons), but in almost every area of astrophysics neutrino hydrodynamics is ignored, simply because the systems are exceedingly transparent to neutrinos, even though the energy flux in neutrinos may be substantial. Another place where we can do ''radiation hydrodynamics'' without using any sophisticated theory is deep within stars or other bodies, where the material is so opaque to the radiation that the mean free path of photons is entirely negligible compared with the size of the system, the distance over which any fluid quantity varies, and so on. In this case we can suppose that the radiation is in equilibrium with the matter locally, and its energy, pressure and momentum can be lumped in with those of the rest of the fluid. That is, it is no more necessary to distinguish photons from atoms, nuclei and electrons, than it is to distinguish

  1. Radiation therapy

    MedlinePlus

    ... Intensity-modulated radiotherapy (IMRT) Image-guided radiotherapy (IGRT) Proton therapy is another kind of radiation used to ... than using x-rays to destroy cancer cells, proton therapy uses a beam of special particles called ...

  2. RADIATION DETECTOR

    DOEpatents

    Wilson, H.N.; Glass, F.M.

    1960-05-10

    A radiation detector of the type is described wherein a condenser is directly connected to the electrodes for the purpose of performing the dual function of a guard ring and to provide capacitance coupling for resetting the detector system.

  3. Radiation Basics

    MedlinePlus

    ... of the heaviest radioactive elements, such as uranium , radium and polonium. Even though alpha particles are very ... is roughly the activity of one gram of Radium-226. Curies are not used to measure radiation ...

  4. Role of IL-21 in HTLV-1 infections with emphasis on HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP).

    PubMed

    Rajaei, Taraneh; Farajifard, Hamid; Rafatpanah, Houshang; Bustani, Reza; Valizadeh, Narges; Rajaei, Bahareh; Rezaee, Seyed Abdolrahim

    2017-04-04

    Interleukin-21 (IL-21) enhances the survival and cytotoxic properties of cytotoxic T cells (CTLs) and exhibits essential roles in controlling chronic viral infections. HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive inflammatory disease of the nervous system. The main determinant of disease progression is efficiency of the CTL response to Human T lymphotropic virus types I (HTLV-1). In this study, the expression of host IL-21 and HTLV-I Tax and proviral load (PVL) was evaluated to understand the role and mechanism of IL-21 in HTLV-1 infections and the subsequent development of HAM/TSP. A cross-sectional study was carried out on 20 HAM/TSP patients, 20 asymptomatic HTLV-1 carriers (ACs) and 20 healthy controls (HCs) to evaluate the expression of IL-21 and Tax and PVL in non-activated and phorbol myristate acetate (PMA)-ionomycin-activated peripheral blood mononuclear cells (PBMCs). The mean mRNA expression of IL-21 in the non-activated and activated PBMCs was higher (by 5-13 times) in the HAM/TSP patients than in ACs and HCs (p < 0.05); however, there was no significant difference between ACs and HCs. In contrast to the IL-21 mRNA expression, the serum level of the IL-21 protein was significantly lower in the HAM/TSP patients than in ACs and HCs (p < 0.05). Furthermore, higher expression of Tax and PVL was observed in the HAM/TSP subjects than ACs (p < 0.05). In addition, Tax gene expression was positively correlated with PVL (R = 0.595, p = 0.000) and IL-21 gene expression (R = 0.395, p = 0.021) in the HTLV-1-infected subjects. In conclusion, the increase in IL-21 mRNA expression may reflect the attempt of infected T cells to induce an appropriate antiviral response, and the decrease in IL-21 protein expression may reflect the inhibition of IL-21 mRNA translation by viral factors in favour of virus evasion and dissemination.

  5. Assessing Walking Ability in People with HTLV-1-Associated Myelopathy Using the 10 Meter Timed Walk and the 6 Minute Walk Test

    PubMed Central

    Adonis, Adine; Taylor, Graham P.

    2016-01-01

    Background Five to ten million persons, are infected by HTLV-1 of which 3% will develop HTLV-1-associated myelopathy (HAM) a chronic, disabling inflammation of the spinal cord. Walking, a fundamental, complex, multi-functional task is demanding of multiple body systems. Restricted walking ability compromises activity and participation levels in people with HAM (pwHAM). Therapy aims to improve mobility but validated measures are required to assess change. Study Design Prospective observational study. Objectives To explore walking capacity in pwHAM, walking endurance using the 6 minute walk (6MW), and gait speed, using the timed 10m walk (10mTW). Setting Out-patient setting in an inner London Teaching hospital. Methods Prospective documentation of 10mTW and 6MW distance; walking aid usage and pain scores measured twice, a median of 18 months apart. Results Data analysis was completed for twenty-six pwHAM, (8♂; 18♀; median age: 57.8 years; median disease duration: 8 years). Median time at baseline to: complete 10m was 17.5 seconds, versus 21.4 seconds at follow up; 23% completed the 6MW compared to 42% at follow up and a median distance of 55m was covered compared to 71m at follow up. Using the 10mTW velocity to predict the 6MW distance, overestimated the distance walked in 6 minutes (p<0.01). Functional decline over time was captured using the functional ambulation categories. Conclusions The 10mTW velocity underestimated the degree of disability. Gait speed usefully predicts functional domains, shows direction of functional change and comparison with published healthy age matched controls show that these patients have significantly slower gait speeds. The measured differences over 18 months were sufficient to reliably detect change and therefore these assessments can be useful to detect improvement or deterioration within broader disability grades. Walking capacity in pwHAM should be measured using the 10mTW for gait speed and the 6MW for endurance. PMID

  6. A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy.

    PubMed

    Abbas, Syed F; Spurgas, Morgan P; Szewczyk, Benjamin S; Yim, Benjamin; Ata, Ashar; German, John W

    2016-06-01

    OBJECTIVE Minimally invasive posterior cervical decompression (miPCD) has been described in several case series with promising preliminary results. The object of the current study was to compare the clinical outcomes between patients undergoing miPCD with anterior cervical discectomy and instrumented fusion (ACDFi). METHODS A retrospective study of 74 patients undergoing surgery (45 using miPCD and 29 using ACDFi) for myelopathy was performed. Outcomes were categorized into short-term, intermediate, and long-term follow-up, corresponding to averages of 1.7, 7.7, and 30.9 months, respectively. Mean scores for the Neck Disability Index (NDI), neck visual analog scale (VAS) score, SF-12 Physical Component Summary (PCS), and SF-12 Mental Component Summary (MCS) were compared for each follow-up period. The percentage of patients meeting substantial clinical benefit (SCB) was also compared for each outcome measure. RESULTS Baseline patient characteristics were well-matched, with the exception that patients undergoing miPCD were older (mean age 57.6 ± 10.0 years [miPCD] vs 51.1 ± 9.2 years [ACDFi]; p = 0.006) and underwent surgery at more levels (mean 2.8 ± 0.9 levels [miPCD] vs 1.5 ± 0.7 levels [ACDFi]; p < 0.0001) while the ACDFi patients reported higher preoperative neck VAS scores (mean 3.8 ± 3.0 [miPCD] vs 5.4 ± 2.6 [ACDFi]; p = 0.047). The mean PCS, NDI, neck VAS, and MCS scores were not significantly different with the exception of the MCS score at the short-term follow-up period (mean 46.8 ± 10.6 [miPCD] vs 41.3 ± 10.7 [ACDFi]; p = 0.033). The percentage of patients reporting SCB based on thresholds derived for PCS, NDI, neck VAS, and MCS scores were not significantly different, with the exception of the PCS score at the intermediate follow-up period (52% [miPCD] vs 80% [ACDFi]; p = 0.011). CONCLUSIONS The current report suggests that the optimal surgical strategy in patients requiring dorsal surgery may be enhanced by the adoption of a minimally invasive

  7. Long-term outcomes and prognostic analysis of modified open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy

    PubMed Central

    Su, Nan; Fei, Qi; Wang, Bingqiang; Li, Dong; Li, Jinjun; Meng, Hai; Yang, Yong; Guo, Ai

    2016-01-01

    Objectives The purpose of the present study was to explore and analyze the long-term outcomes and factors that affect the prognosis of expansive open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy (CSM). Methods We retrospectively reviewed 49 patients with multilevel CSM who had undergone expansive open-door laminoplasty with lateral mass screws fixation and fusion in our hospital between February 2008 and February 2012. The average follow-up period was 4.6 years. The clinical data of patients, including age, sex, operation records, pre- and postoperation Japanese Orthopedic Association (JOA) scores, cervical spine canal stenosis, and cervical curvature, were collected. Increased signal intensity (ISI) on T2-weighted magnetic resonance imaging and ossification of the posterior longitudinal ligament were also observed. Paired t-test was used to analyze the treatment effectiveness and recovery of neuronal function. The prognostic factors were analyzed with multivariable linear regression model. Results Forty-nine patients with CSM with a mean age of 59.44 years were enrolled in this study. The average of preoperative JOA score was 9.14±2.25, and postoperative JOA score was 15.31±1.73. There was significant difference between the pre- and postoperative JOA scores. The clinical improvement rate was 80.27%. On follow-up, five patients had complaints of neck and shoulder pain, but no evidence of C5 nerve palsy was found. Developmental cervical spine canal stenosis was present in all patients before surgery. Before surgery, ISI was observed in eight patients, while ossification of the posterior longitudinal ligament was found in 12 patients. The average of preoperative cervical curvature was 21.27°±8.37° and postoperative cervical curvature was 20.09°±1.29°, and there was no significant difference between the pre- and postoperative cervical curvatures. Multivariable linear regression analysis results showed that

  8. Radiation Transport

    SciTech Connect

    Urbatsch, Todd James

    2015-06-15

    We present an overview of radiation transport, covering terminology, blackbody raditation, opacities, Boltzmann transport theory, approximations to the transport equation. Next we introduce several transport methods. We present a section on Caseology, observing transport boundary layers. We briefly broach topics of software development, including verification and validation, and we close with a section on high energy-density experiments that highlight and support radiation transport.

  9. Radiation enteritis.

    PubMed

    Harb, Ali H; Abou Fadel, Carla; Sharara, Ala I

    2014-01-01

    Radiation enteritis continues to be a major health concern in recipients of radiation therapy. The incidence of radiation enteritis is expected to continue to rise during the coming years paralleling the unprecedented use of radiotherapy in pelvic cancers. Radiation enteritis can present as either an acute or chronic syndrome. The acute form presents within hours to days of radiation exposure and typically resolves within few weeks. The chronic form may present as early as 2 months or as long as 30 years after exposure. Risk factors can be divided into patient and treatment-related factors. Chronic radiation enteritis is characterized by progressive obliterative endarteritis with exaggerated submucosal fibrosis and can manifest by stricturing, formation of fistulae, local abscesses, perforation, and bleeding. In the right clinical context, diagnosis can be confirmed by cross-sectional imaging, flexible or video capsule endoscopy. Present treatment strategies are directed primarily towards symptom relief and management of emerging complications. Recently, however, there has been a shift towards rational drug design based on improved understanding of the molecular basis of disease in an effort to limit the fibrotic process and prevent organ damage.

  10. Synchrotron radiation with radiation reaction

    NASA Astrophysics Data System (ADS)

    Nelson, Robert W.; Wasserman, Ira

    1991-04-01

    A rigorous discussion is presented of the classical motion of a relativistic electron in a magnetic field and the resulting electromagnetic radiation when radiation reaction is important. In particular, for an electron injected with initial energy gamma(0), a systematic perturbative solution to the Lorentz-Dirac equation of motion is developed for field strengths satisfying gamma(0) B much less than 6 x 10 to the 15th G. A particularly accurate solution to the electron orbital motion in this regime is found and it is demonstrated how lowest-order corrections can be calculated. It is shown that the total energy-loss rate corresponds to what would be found using the exact Larmor power formula without including radiation reaction. Provided that the particle energy and field strength satisfy the same contraint, it is explicitly demonstrated that the intuitive prescription for calculating the time-integrated radiation spectrum described above is correct.

  11. Brain radiation - discharge

    MedlinePlus

    Radiation - brain - discharge; Cancer-brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  12. Radiation effects.

    PubMed

    Preston, R J

    2012-01-01

    International Commission on Radiological Protection (ICRP) Committee 1 (C1) considers the risk of induction of cancer and heritable disease; the underlying mechanisms of radiation action; and the risks, severity, and mechanisms of induction of tissue reactions (formerly 'deterministic effects'). C1 relies upon the interpretation of current knowledge of radio-epidemiological studies; current information on the underlying mechanisms of diseases and radiation-induced disease; and current radiobiological studies at the whole animal, tissue, cell, and molecular levels. This overview will describe the activities of C1 in the context of the 2007 Recommendations of ICRP. In particular, the conclusions from the most recent C1 Task Group deliberations on radon and lung cancer, and tissue reactions will be discussed. Other activities are described in summary fashion to illustrate those areas that C1 judge to be likely to influence the development of the risk estimates and nominal risk coefficients used for radiation protection purposes.

  13. Radiation receiver

    DOEpatents

    Hunt, A.J.

    1983-09-13

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles. 5 figs.

  14. Radiation receiver

    DOEpatents

    Hunt, Arlon J.

    1983-01-01

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles.

  15. RADIATION SOURCES

    DOEpatents

    Brucer, M.H.

    1958-04-15

    A novel long-lived source of gamma radiation especially suitable for calibration purposes is described. The source of gamma radiation is denoted mock iodine131, which comprises a naixture of barium-133 and cesium-137. The barium and cesium are present in a barium-cesium ratio of approximately 5.7/1 to 14/1, uniformly dispersed in an ion exchange resin and a filter surrounding the resin comprised of a material of atomic number below approximately 51, and substantially 0.7 to 0.9 millimeter thick.

  16. Radiation dermatitis

    SciTech Connect

    Shack, R.B.; Lynch, J.B.

    1987-04-01

    Even in this era of modern radiotherapy, injuries associated with the medical and industrial use of radiation devices will continue to pose a difficult problem for the reconstructive surgeon. It must be borne in mind that the single most serious hazard to surgery in irradiated tissue is the lodgement of bacteria in tissue rendered avascular by the radiation and the secondary necrosis from the infection itself. The basic principles of wound management must be augmented by thorough knowledge of the use of well-vascularized muscle and musculocutaneous flap to provide adequate, blood-rich, soft-tissue coverage.

  17. Clinical and epidemiological aspects of HTLV-II infection in São Paulo, Brazil: presence of tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile diagnosis in HIV-1-co-infected subjects.

    PubMed

    Posada-Vergara, Maria Paulina; Montanheiro, Patrícia; Fukumori, Ligia M I; Bonasser, Francisco; Duarte, Alberto José da Silva; Penalva de Oliveira, Augusto Cesar; Casseb, Jorge

    2006-01-01

    In this study, the epidemiological and clinical features observed in solely HTLV-II-infected individuals were compared to those in patients co-infected with HIV-1. A total of 380 subjects attended at the HTLV Out-Patient Clinic in the Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, Brazil, were evaluated every 3-6 months for the last seven years by infectious disease specialists and neurologists. Using a testing algorithm that employs the enzyme immuno assay, Western Blot and polymerase chain reaction, it was found that 201 (53%) were HTLV-I positive and 50 (13%) were infected with HTLV-II. Thirty-seven (74%) of the HTLV-II reactors were co-infected with HIV-1. Of the 13 (26%) solely HTLV-II-infected subjects, urinary tract infection was diagnosed in three (23%), one case of skin vasculitis (8%) and two cases of lumbar pain and erectile dysfunction (15%), but none myelopathy case was observed. Among 37 co-infected with HIV-1, four cases (10%) presented with tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile. Two patients showed paraparesis as the initial symptom, two cases first presented with vesical and erectile disturbances, peripheral neuropathies were observed in other five patients (13%), and seven (19%) patients showed some neurological signal or symptoms, most of them with lumbar pain (five cases). The results obtained suggest that neurological manifestations may be more frequent in HTLV-II/HIV-1-infected subjects than those infected with HTLV-II only.

  18. Radiation Emergencies

    MedlinePlus

    ... If the exposure is large enough, it can cause premature aging or even death. Although there are no guarantees of safety during a radiation emergency, you can take actions to protect yourself. You should have a disaster plan. Being prepared can help reduce fear, anxiety ...

  19. Ionizing radiation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This chapter gives a comprehensive review on ionizing irradiation of fresh fruits and vegetables. Topics include principles of ionizing radiation, its effects on pathogenic and spoilage microorganisms, shelf-life, sensory quality, nutritional and phytochemical composition, as well as physiologic and...

  20. Radiation Models

    ERIC Educational Resources Information Center

    James, W. G. G.

    1970-01-01

    Discusses the historical development of both the wave and the corpuscular photon model of light. Suggests that students should be informed that the two models are complementary and that each model successfully describes a wide range of radiation phenomena. Cites 19 references which might be of interest to physics teachers and students. (LC)

  1. Radiation accidents

    SciTech Connect

    Saenger, E.L.

    1986-09-01

    It is essential that emergency physicians understand ways to manage patients contaminated by radioactive materials and/or exposed to external radiation sources. Contamination accidents require careful surveys to identify the metabolic pathway of the radionuclides to guide prognosis and treatment. The level of treatment required will depend on careful surveys and meticulous decontamination. There is no specific therapy for the acute radiation syndrome. Prophylactic antibodies are desirable. For severely exposed patients treatment is similar to the supportive care given to patients undergoing organ transplantation. For high-dose extremity injury, no methods have been developed to reverse the fibrosing endarteritis that eventually leads to tissue death so frequently found with this type of injury. Although the Three Mile Island episode of March 1979 created tremendous public concern, there were no radiation injuries. The contamination outside the reactor building and the release of radioiodine were negligible. The accidental fuel element meltdown at Chernobyl, USSR, resulted in many cases of acute radiation syndrome. More than 100,000 people were exposed to high levels of radioactive fallout. The general principles outlined here are applicable to accidents of that degree of severity.

  2. Radiation Insulation

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Radiation insulation technology from Apollo and subsequent spacecraft was used to develop superinsulators, used by makers of cold weather apparel, to make parkas, jackets, boots and outdoor gear such as sleeping bags. The radiant barrier technology offers warmth retention at minimal weight and bulk.

  3. Radiation Therapy: Professions in Radiation Therapy

    MedlinePlus

    ... and typically one to two years of clinical physics training. They are certified by the American Board of Radiology or the American Board of Medical Physics . Radiation Therapist Radiation therapists work with radiation oncologists. ...

  4. 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 ...

  5. 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

  6. Risk Factors: Radiation

    Cancer.gov

    Radiation of certain wavelengths, called ionizing radiation, has enough energy to damage DNA and cause cancer. Ionizing radiation includes radon, x-rays, gamma rays, and other forms of high-energy radiation.

  7. Radiation Engineering for Designers

    NASA Technical Reports Server (NTRS)

    Pellish, Jonathan A.

    2015-01-01

    This tutorial provides an overview of the natural space radiation environment, an introduction to radiation effect types, an overview of EEE parts selection, scrubbing, and radiation mitigation, and an introduction to radiation testing.

  8. Shortwave Radiation

    NASA Technical Reports Server (NTRS)

    Klassen, Steve; Bugbee, Bruce

    2005-01-01

    Accurate shortwave radiation data is critical to evapotranspiration (ET) models used for developing irrigation schedules to optimize crop production while saving water, minimizing fertilizer, herbicide, and pesticide applications, reducing soil erosion, and protecting surface and ground water quality. Low cost silicon cell pyranometers have proven to be sufficiently accurate and robust for widespread use in agricultural applications under unobstructed daylight conditions. More expensive thermopile pyranometers are required for use as calibration standards and measurements under light with unique spectral properties (electric lights, under vegetation, in greenhouses and growth chambers). Routine cleaning, leveling, and annual calibration checks will help to ensure the integrity of long-term data.

  9. Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results.

    PubMed

    Miscusi, Massimo; Polli, Filippo Maria; Forcato, Stefano; Ricciardi, Luca; Frati, Alessandro; Cimatti, Marco; De Martino, Luca; Ramieri, Alessandro; Raco, Antonino

    2015-05-01

    OBJECT Spinal metastasis is common in patients with cancer. About 70% of symptomatic lesions are found in the thoracic region of the spine, and cord compression presents as the initial symptom in 5%-10% of patients. Minimally invasive spine surgery (MISS) has recently been advocated as a useful approach for spinal metastases, with the aim of decreasing the morbidity associated with more traditional open spine surgery; furthermore, the recovery time is reduced after MISS, such that postoperative chemotherapy and radiotherapy can begin sooner. METHODS Two series of oncological patients, who presented with acute myelopathy due to vertebral thoracic metastases, were compared in this study. Patients with complete paraplegia for more than 24 hours and with a modified Bauer score greater than 2 were excluded from the study. The first group (n = 23) comprised patients who were prospectively enrolled from May 2010 to September 2013, and who were treated with minimally invasive laminotomy/laminectomy and percutaneous stabilization. The second group (n = 19) comprised patients from whom data were retrospectively collected before May 2010, and who had been treated with laminectomy and stabilization with traditional open surgery. Patient groups were similar regarding general characteristics and neurological impairment. Results were analyzed in terms of neurological recovery (American Spinal Injury Association grade), complications, pain relief (visual analog scale), and quality of life (European Organisation for Research and Treatment of Cancer [EORTC] QLQ-C30 and EORTC QLQ-BM22 scales) at the 30-day follow-up. Operation time, postoperative duration of bed rest, duration of hospitalization, intraoperative blood loss, and the need and length of postoperative opioid administration were also evaluated. RESULTS There were no significant differences between the 2 groups in terms of neurological recovery and complications. Nevertheless, the MISS group showed a clear and significant

  10. RADIATION DOSIMETER

    DOEpatents

    Balkwell, W.R. Jr.; Adams, G.D. Jr.

    1960-05-10

    An improvement was made in the determination of amounts of ionizing radiation, particularly low-energy beta particles of less than 1000 rad total dose by means of fluid-phase dosimeter employing a stabilized-- sensitized ferrous-ferric colorimetric system in a sulphuric acid medium. The improvement in the dosimeter consists of adding to the ferrous-ferric system in concentrations of 10/sub -2/ to 10/sup -4/M an organic compound having one or more carboxylic or equivalent groups, such compounds being capable of chelating or complexing the iron ions in the solution. Suitable sensitizing and stabilizing agents are benzoic, phthalic, salicylic, malonic, lactic, maleic, oxalic, citric, succinic, phenolic tartaric, acetic, and adipic acid, as well as other compounds which are added to the solution alone or in certain combinations. As in conventional fluid-phase dosimeters, the absorbed dosage is correlated with a corresponding change in optical density at particular wavelengths of the solution.

  11. Radiation dosimeters

    DOEpatents

    Hoelsher, James W.; Hegland, Joel E.; Braunlich, Peter F.; Tetzlaff, Wolfgang

    1992-01-01

    Radiation dosimeters and dosimeter badges. The dosimeter badges include first and second parts which are connected to join using a securement to produce a sealed area in which at least one dosimeter is held and protected. The badge parts are separated to expose the dosimeters to a stimulating laser beam used to read dose exposure information therefrom. The badge is constructed to allow automated disassembly and reassembly in a uniquely fitting relationship. An electronic memory is included to provide calibration and identification information used during reading of the dosimeter. Dosimeter mounts which reduce thermal heating requirements are shown. Dosimeter constructions and production methods using thin substrates and phosphor binder-layers applied thereto are also taught.

  12. Radiation Insulation

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The Apollo and subsequent spacecraft have had highly effective radiation barriers; made of aluminized polymer film, they bar or let in heat to maintain consistent temperatures inside. Tech 2000, formerly Quantum International Corporation used the NASA technology in its insulating materials, Super "Q" Radiant Barrier, for home, industry and mobile applications. The insulation combines industrial aluminum foil overlaid around a core of another material, usually propylene or mylar. The outer layer reflects up to 97 percent of heat; the central layer creates a thermal break in the structure and thus allows low radiant energy emission. The Quantum Cool Wall, used in cars and trucks, takes up little space while providing superior insulation, thus reducing spoilage and costs. The panels can also dampen sound and engine, exhaust and solar heat.

  13. RADIATION COUNTER

    DOEpatents

    Goldsworthy, W.W.

    1958-02-01

    This patent relates to a radiation counter, and more particularly, to a scintillation counter having high uniform sensitivity over a wide area and capable of measuring alpha, beta, and gamma contamination over wide energy ranges, for use in quickly checking the contami-nation of personnel. Several photomultiplier tubes are disposed in parallel relationship with a light tight housing behind a wall of scintillation material. Mounted within the housing with the photomultipliers are circuit means for producing an audible sound for each pulse detected, and a range selector developing a voltage proportional to the repetition rate of the detected pulses and automatically altering its time constant when the voltage reaches a predetermined value, so that manual range adjustment of associated metering means is not required.

  14. Radiative opacities

    NASA Astrophysics Data System (ADS)

    Seaton, M. J.

    1993-01-01

    An overview of opacity calculations performed during the past decade is presented. Attention is given to envelopes and interiors, equations of state, atomic data, line profiles, and mesh points. Results for a Cepheid model are presented. The solar radiative interior, solar abundances, hydrogen and helium, and contributions from the different elements are discussed. Work over the past decade has led to major revisions in envelope opacities, by factors as large as 3 or 4. There are also some revisions in results for deeper layers, which are important but not so pronounced. A comparison of the work of two opacity research groups, OPAL from the Lawrence Livermore National Laboratory and the international OP project, is given.

  15. Adaptors for radiation detectors

    DOEpatents

    Livesay, Ronald Jason

    2015-07-28

    Described herein are adaptors and other devices for radiation detectors that can be used to make accurate spectral measurements of both small and large bulk sources of radioactivity, such as building structures, soils, vessels, large equipment, and liquid bodies. Some exemplary devices comprise an adaptor for a radiation detector, wherein the adaptor can be configured to collimate radiation passing through the adapter from an external radiation source to the radiation detector and the adaptor can be configured to enclose a radiation source within the adapter to allow the radiation detector to measure radiation emitted from the enclosed radiation source.

  16. Adaptors for radiation detectors

    DOEpatents

    Livesay, Ronald Jason

    2014-04-22

    Described herein are adaptors and other devices for radiation detectors that can be used to make accurate spectral measurements of both small and large bulk sources of radioactivity, such as building structures, soils, vessels, large equipment, and liquid bodies. Some exemplary devices comprise an adaptor for a radiation detector, wherein the adaptor can be configured to collimate radiation passing through the adapter from an external radiation source to the radiation detector and the adaptor can be configured to enclose a radiation source within the adapter to allow the radiation detector to measure radiation emitted from the enclosed radiation source.

  17. Breast radiation - discharge

    MedlinePlus

    Radiation - breast - discharge ... away around 4 to 6 weeks after the radiation treatment is over. You may notice changes in ... breast looks or feels (if you are getting radiation after a lumpectomy). These changes include: Soreness or ...

  18. Radiation Therapy for Cancer

    Cancer.gov

    Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Learn about the types of radiation, why side effects happen, which ones you might have, and more.

  19. Foam radiators for transition radiation detectors

    NASA Astrophysics Data System (ADS)

    Chernyatin, V.; Dolgoshein, B.; Gavrilenko, I.; Potekhin, M.; Romaniouk, A.; Sosnovtsev, V.

    1993-02-01

    A wide variety of foam radiators, potentially useful in the design of a transition radiation detector, the possible particle identification tool in collider experiments, have been tested in the beam. Various characteristics of these radiators are compared, and the conclusion is reached that certain brands of polyethylene foam are best suited for use in the detector. Comparison is made with a "traditional" radiator, which is a periodic structure of plastic foils.

  20. Degenerative myelopathy in the Collie breed: a retrospective immunohistochemical analysis of superoxide dismutase 1 in an affected Rough Collie, and a molecular epidemiological survey of the SOD1: c.118G>A mutation in Japan

    PubMed Central

    KOHYAMA, Moeko; KITAGAWA, Masato; KAMISHINA, Hiroaki; KOBATAKE, Yui; YABUKI, Akira; SAWA, Mariko; KAKITA, Shusaku; YAMATO, Osamu

    2016-01-01

    Canine degenerative myelopathy (DM) is an adult-onset, progressive neurodegenerative disease that occurs in multiple dog breeds. A DM-associated mutation of the canine superoxide dismutase 1 (SOD1) gene, designated as c.118G>A (p.E40K), has been implicated as one of pathogenetic determinants of the disease in many breeds, but it remains to be determined whether the c.118G>A mutation is responsible for development or progression of DM in Collies. Previously, a Rough Collie was diagnosed clinically and histopathologically as having DM in Japan, suggesting the possibility that the Collie breed may be predisposed to DM due to the high frequency of c.118G>A in Japan. In this study, accumulation and aggregate formation of SOD1 protein were retrospectively demonstrated in the spinal cord of the DM-affected dog by immunohistochemical analysis. Furthermore, a molecular epidemiological survey revealed a high carrier rate (27.6%) and mutant allele frequency (0.138) of c.118G>A in a population of Collies in Japan, suggesting that the Collie breed may be predisposed to DM associated with c.118G>A, and the prevention of DM in Collies in Japan should be addressed through epidemiological and genetic testing strategies. PMID:27941298

  1. Human T-lymphotropic virus 1 (HTLV-1)-associated lichenoid dermatitis induced by CD8+ T cells in HTLV-1 carrier, HTLV-1-associated myelopathy/tropical spastic paraparesis and adult T-cell leukemia/lymphoma.

    PubMed

    Tokura, Yoshiki; Ito, Taisuke; Kawakami, Chika; Sugita, Kazunari; Kasuya, Akira; Tatsuno, Kazuki; Sawada, Yu; Nakamura, Motonobu; Shimauchi, Takatoshi

    2015-10-01

    Human T-lymphotropic virus type 1 (HTLV-1) induces adult T-cell leukemia/lymphoma (ATLL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and carrier. ATLL is a mature CD4+ CD25+ CCR4+ T-cell neoplasm, and approximately half of patients have direct skin involvement manifesting patch, plaque, tumor, multiple papules, erythroderma and purpura. However, there exist secondary eruptions without tumor cell infiltration in patients with ATLL or HAM/TSP and carriers of HTLV-1. To clarify the presence of reactive skin eruptions in HTLV-1-infected individuals, we reviewed our patients with HTLV-1-associated diseases. In 2002-2012, we saw 50 ATLL or HAM/TSP patients and HTLV-1 carriers presenting with skin lesions. We retrospectively selected cases that histologically showed lichenoid tissue reactions with predominant infiltration of CD8+ T cells, but not CD4+ tumor cells. The cases included erythroderma (HTLV-1 carrier), lichen planus (HTLV-1 carrier), alopecia areata (HAM/TSP), chronic actinic dermatitis (HTLV-1 carrier to acute ATLL conversion) and discoid lupus erythematosus (smoldering ATLL). They were graft-versus-host disease-like, major secondary lesions and seen in HTLV-1 carriers and patients with HAM/TSP and smoldering ATLL. We coin the term HTLV-1-associated lichenoid dermatitis (HALD) to encompass the conditions. HALD may occur in association with the elevated immunity toward HTLV-1-infected CD4+ T cells, thus sharing the pathogenetic role of cytotoxic T cells with HAM/TSP.

  2. Solar radiation resource assessment

    SciTech Connect

    Not Available

    1990-11-01

    The bulletin discusses the following: introduction; Why is solar radiation resource assessment important Understanding the basics; the solar radiation resource assessment project; and future activities.

  3. Stereotactic Body Radiotherapy Is Effective Salvage Therapy for Patients With Prior Radiation of Spinal Metastases

    SciTech Connect

    Sahgal, Arjun Ames, Christopher; Chou, Dean; Ma Lijun; Huang, Kim; Xu Wei; Chin, Cynthia; Weinberg, Vivan; Chuang, Cynthia; Weinstein, Phillip; Larson, David A.

    2009-07-01

    Purpose: To provide actuarial outcomes and dosimetric data for spinal/paraspinal metastases, with and without prior radiation, treated with stereotactic body radiotherapy (SBRT). Methods and Materials: A total of 39 consecutive patients (60 metastases) were treated with SBRT between April 2003 and August 2006 and retrospectively reviewed. In all, 23 of 60 tumors had no previous radiation (unirradiated) and 37/60 tumors had previous irradiation (reirradiated). Of 37 reirradiated tumors, 31 were treated for 'salvage' given image-based tumor progression. Local failure was defined as progression by imaging and/or clinically. Results: At last follow-up, 19 patients were deceased. Median patient survival time measured was 21 months (95% CI = 8-27 months), and the 2-year survival probability was 45%. The median total dose prescribed was 24 Gy in three fractions prescribed to the 67% and 60% isodose for the unirradiated and reirradiated cohorts, respectively. The median tumor follow-up for the unirradiated and reirradiated group was 9 months (range, 1-26) and 7 months (range, 1-48) respectively. Eight of 60 tumors have progressed, and the 1- and 2-year progression-free probability (PFP) was 85% and 69%, respectively. For the salvage group the 1 year PFP was 96%. There was no significant difference in overall survival or PFP between the salvage reirradiated vs. all other tumors treated (p = 0.08 and p = 0.31, respectively). In six of eight failures the minimum distance from the tumor to the thecal sac was {<=}1 mm. Of 60 tumors treated, 39 have {>=}6 months follow-up and no radiation-induced myelopathy or radiculopathy has occurred. Conclusion: Spine SBRT has shown preliminary efficacy and safety in patients with image-based progression of previously irradiated metastases.

  4. Radiation and People

    ERIC Educational Resources Information Center

    Freilich, Florence G.

    1970-01-01

    Describes the development of radiation as a tool of medicine. Includes topics on history of radiation, electromagnetic spectrum, X-ray tubes, high energy machines, radioactive sources, artificial radioactivity, radioactive scanning, units, present radiation background, and effect of radiation on living tissue. (DS)

  5. Radiation transport calculations for cosmic radiation.

    PubMed

    Endo, A; Sato, T

    2012-01-01

    The radiation environment inside and near spacecraft consists of various components of primary radiation in space and secondary radiation produced by the interaction of the primary radiation with the walls and equipment of the spacecraft. Radiation fields inside astronauts are different from those outside them, because of the body's self-shielding as well as the nuclear fragmentation reactions occurring in the human body. Several computer codes have been developed to simulate the physical processes of the coupled transport of protons, high-charge and high-energy nuclei, and the secondary radiation produced in atomic and nuclear collision processes in matter. These computer codes have been used in various space radiation protection applications: shielding design for spacecraft and planetary habitats, simulation of instrument and detector responses, analysis of absorbed doses and quality factors in organs and tissues, and study of biological effects. This paper focuses on the methods and computer codes used for radiation transport calculations on cosmic radiation, and their application to the analysis of radiation fields inside spacecraft, evaluation of organ doses in the human body, and calculation of dose conversion coefficients using the reference phantoms defined in ICRP Publication 110.

  6. Wireless radiation sensor

    DOEpatents

    Lamberti, Vincent E.; Howell, Jr, Layton N.; Mee, David K.; Kress, Reid L.

    2016-08-09

    Disclosed is a sensor for detecting radiation. The sensor includes a ferromagnetic metal and a radiation sensitive material coupled to the ferromagnetic metal. The radiation sensitive material is operable to change a tensile stress of the ferromagnetic metal upon exposure to radiation. The radiation is detected based on changes in the magnetic switching characteristics of the ferromagnetic metal caused by the changes in the tensile stress.

  7. Transgenerational Radiation Epigenetics

    DTIC Science & Technology

    2014-11-01

    human carcinogen to which the military has increased risk of exposure. Radiation causes DNA damage and is a potent mutagen. Radiation also has...Introduction Ionizing radiation is a human carcinogen to which the military has increased risk of exposure (Mettler, 1996). Radiation causes DNA damage...and is a potent mutagen. The dominant paradigm holds that the carcinogenic effects of radiation are due to direct mutagenesis of cancer genes such

  8. Radiation protection guidelines for radiation emergencies

    SciTech Connect

    Lessard, E.T.; Meinhold, C.B.

    1986-01-01

    The system of dose limitation and present guidance for emergency workers and guidance for intervention on behalf of the public are discussed. There are three elements for the system of dose limitation: justification, optimization and dose limits. The first element is basically a political process in this country. Justification is based on a risk-benefit analysis, and justification of the use of radioactive materials or radiation is generally not within the authority of radiation protection managers. Radiation protection managers typically assess detriments or harm caused by radiation exposure and have very little expertise in assessing the benefits of a particular practice involving nuclear material.

  9. Levels of serum chemokines discriminate clinical myelopathy associated with human T lymphotropic virus type 1 (HTLV-1)/tropical spastic paraparesis (HAM/TSP) disease from HTLV-1 carrier state.

    PubMed

    Guerreiro, J B; Santos, S B; Morgan, D J; Porto, A F; Muniz, A L; Ho, J L; Teixeira, A L; Teixeira, M M; Carvalho, E M

    2006-08-01

    Approximately 5% of people infected with human T lymphotropic virus type 1 (HTLV-1) develop clinical myelopathy or tropical spastic paraparesis (HAM/TSP) that is associated with high-levels of Th1 cytokines, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha. Chemokines are known to induce cytokine secretion and direct the trafficking of immune cells to sites of disease. The present study measured serum chemokines correlated with autonomously released IFN-gamma in cell cultures. HTLV-1 infection was defined by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot. Subjects included HTLV-1 carriers (n = 56), patients with HAM/TSP (n = 31) and healthy HTLV-1 seronegative volunteer controls (n = 20). Serum chemokines and IFN-gamma autonomously released by mononuclear cells in culture were quantified by ELISA. Compared to HTLV-1 carriers, serum chemokines in HAM/TSP patients showed significantly increased levels of CXCL9 and CXCL10, significantly diminished levels of CCL2 and similar amounts of CCL11 and CCL24. In contrast, CCL11 and CCL24 were significantly lower in serum of HAM/TSP patients than either control. IFN-gamma was positively correlated with CXCL9 and CXCL10 when HAM/TSP and HTLV-1 carriers were used as a combined group. However, despite a large proportion of HTLV-1 carriers having high IFN-gamma levels, these chemokines were not increased in carriers. This study showed that high levels of CXCL9 and CXCL10 in the systemic circulation and low serum CCL2 levels are features of HAM/TSP. HTLV-1 infection and Tax and/or additional viral encoded factor-mediated pathological processes triggering T cell activation with autogenous IFN-gamma release are probably involved in regulating chemokine release.

  10. Tax posttranslational modifications and interaction with calreticulin in MT-2 cells and human peripheral blood mononuclear cells of human T cell lymphotropic virus type-I-associated myelopathy/tropical spastic paraparesis patients.

    PubMed

    Medina, Fernando; Quintremil, Sebastian; Alberti, Carolina; Barriga, Andres; Cartier, Luis; Puente, Javier; Ramírez, Eugenio; Ferreira, Arturo; Tanaka, Yuetsu; Valenzuela, Maria Antonieta

    2014-04-01

    The human retrovirus human T cell lymphotropic virus type-I (HTLV-1) is the etiologic agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Axonal degeneration in HAM/TSP patients occurs without neuron infection, with the secreted viral Tax protein proposed to be involved. We previously found that Tax secreted into the culture medium of MT-2 cells (HTLV-1-infected cell line) produced neurite retraction in neuroblastoma cells differentiated to neuronal type. To assess the relevance of Tax posttranslational modifications on this effect, we addressed the question of whether Tax secreted by MT-2 cells and peripheral blood mononuclear cells (PBMCs) of HTLV-1-infected subjects is modified. The interaction of Tax with calreticulin (CRT) that modulates intracellular Tax localization and secretion has been described. We studied Tax localization and modifications in MT-2 cells and its interaction with CRT. Intracellular Tax in MT-2 cells was assessed by flow cytometry, corresponding mainly to a 71-kDa protein followed by western blot. This protein reported as a chimera with gp21 viral protein-confirmed by mass spectrometry-showed no ubiquitination or SUMOylation. The Tax-CRT interaction was determined by confocal microscopy and coimmunoprecipitation. Extracellular Tax from HAM/TSP PBMCs is ubiquitinated according to western blot, and its interaction with CRT was shown by coimmunoprecipitation. A positive correlation between Tax and CRT secretion was observed in HAM/TSP PBMCs and asymptomatic carriers. For both proteins inhibitors and activators of secretion showed secretion through the endoplasmic reticulum-Golgi complex. Tax, present in PBMC culture medium, produced neurite retraction in differentiated neuroblastoma cells. These results suggest that Tax, whether ubiquitinated or not, is active for neurite retraction.

  11. Tax secretion from peripheral blood mononuclear cells and Tax detection in plasma of patients with human T-lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis and asymptomatic carriers.

    PubMed

    Medina, Fernando; Quintremil, Sebastián; Alberti, Carolina; Godoy, Fabián; Pando, María E; Bustamante, Andrés; Barriga, Andrés; Cartier, Luis; Puente, Javier; Tanaka, Yuetsu; Valenzuela, María A; Ramírez, Eugenio

    2016-03-01

    Human T-lymphotropic virus-type 1 (HTLV-1) is the etiologic agent of the neurologic disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Tax viral protein plays a critical role in viral pathogenesis. Previous studies suggested that extracellular Tax might involve cytokine-like extracellular effects. We evaluated Tax secretion in 18 h-ex vivo peripheral blood mononuclear cells (PBMCs) cultures from 15 HAM/TSP patients and 15 asymptomatic carriers. Futhermore, Tax plasma level was evaluated from other 12 HAM/TSP patients and 10 asymptomatic carriers. Proviral load and mRNA encoding Tax were quantified by PCR and real-time RT-PCR, respectively. Intracellular Tax in CD4(+)CD25(+) cells occurred in 100% and 86.7% of HAM/TSP patients and asymptomatic carriers, respectively. Percentage of CD4(+)CD25(+) Tax+, proviral load and mRNA encoding Tax were significantly higher in HAM/TSP patients. Western blot analyses showed higher secretion levels of ubiquitinated Tax in HAM/TSP patients than in asymptomatic carriers. In HTLV-1-infected subjects, Western blot of plasma Tax showed higher levels in HAM/TSP patients than in asymptomatic carriers, whereas no Tax was found in non-infected subjects. Immunoprecipitated plasma Tax resolved on SDS-PAGE gave two major bands of 57 and 48 kDa allowing identification of Tax and Ubiquitin peptides by mass spectrometry. Relative percentage of either CD4(+)CD25(+) Tax+ cells, or Tax protein released from PBMCs, or plasma Tax, correlates neither with tax mRNA nor with proviral load. This fact could be explained by a complex regulation of Tax expression. Tax secreted from PBMCs or present in plasma could potentially become a biomarker to distinguish between HAM/TSP patients and asymptomatic carriers.

  12. Tax Posttranslational Modifications and Interaction with Calreticulin in MT-2 Cells and Human Peripheral Blood Mononuclear Cells of Human T Cell Lymphotropic Virus Type-I-Associated Myelopathy/Tropical Spastic Paraparesis Patients

    PubMed Central

    Medina, Fernando; Quintremil, Sebastian; Alberti, Carolina; Barriga, Andres; Cartier, Luis; Puente, Javier; Ramírez, Eugenio; Ferreira, Arturo; Tanaka, Yuetsu

    2014-01-01

    Abstract The human retrovirus human T cell lymphotropic virus type-I (HTLV-1) is the etiologic agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Axonal degeneration in HAM/TSP patients occurs without neuron infection, with the secreted viral Tax protein proposed to be involved. We previously found that Tax secreted into the culture medium of MT-2 cells (HTLV-1-infected cell line) produced neurite retraction in neuroblastoma cells differentiated to neuronal type. To assess the relevance of Tax posttranslational modifications on this effect, we addressed the question of whether Tax secreted by MT-2 cells and peripheral blood mononuclear cells (PBMCs) of HTLV-1-infected subjects is modified. The interaction of Tax with calreticulin (CRT) that modulates intracellular Tax localization and secretion has been described. We studied Tax localization and modifications in MT-2 cells and its interaction with CRT. Intracellular Tax in MT-2 cells was assessed by flow cytometry, corresponding mainly to a 71-kDa protein followed by western blot. This protein reported as a chimera with gp21 viral protein—confirmed by mass spectrometry—showed no ubiquitination or SUMOylation. The Tax–CRT interaction was determined by confocal microscopy and coimmunoprecipitation. Extracellular Tax from HAM/TSP PBMCs is ubiquitinated according to western blot, and its interaction with CRT was shown by coimmunoprecipitation. A positive correlation between Tax and CRT secretion was observed in HAM/TSP PBMCs and asymptomatic carriers. For both proteins inhibitors and activators of secretion showed secretion through the endoplasmic reticulum–Golgi complex. Tax, present in PBMC culture medium, produced neurite retraction in differentiated neuroblastoma cells. These results suggest that Tax, whether ubiquitinated or not, is active for neurite retraction. PMID:24321043

  13. [Comparison of the outcomes between anterior cervical discectomy and fusion versus posterior laminectomy and fusion for the treatment of multi-level cervical spondylotic myelopathy combined with cervical kyphosis].

    PubMed

    Shen, Q F; Xu, T T; Xia, Y P

    2016-12-20

    Objective: To compare the outcomes between anterior cervical discectomy and fusion (ACDF) and posterior laminectomy and fusion(LF) for multilevel cervical spondylotic myelopathy combined with cervical kyphosis. Methods: From January 2010 to June 2014, 54 patients with cervical spondylotic myelopathy combined with cervical kyphosis underwent surgical treatment.Among them, 29 patients were underwent ACDF, and 25 patients were underwent LF in Department of spine surgery, Tianjin Union Medical Centre. The operation time, intraoperative blood loss, fusion segments, Japanese Orthopaedic Association (JOA)score, Neck Disability Index (NDI), Visual Analog Scale (VAS), change of cervical curvature, range of motion(ROM)and complications were recorded and compared between the two groups. Results: Mean operative time was (162.7±21.3)min in the anterior approach group versus (176.3±29.8)min in the posterior group(P>0.05). Mean intraoperative blood loss was (135.6±27.8)ml in the anterior approach group and (255.2±32.3)ml in the posterior approach group(P<0.05). Mean fusion levels are (4.1±0.3)in the anterior approach group and (5.3±0.5) in the posterior approach group(P<0.05). The mean preoperative JOA score were(8.3±2.7)in the anterior approach group and( 8.9±2.1) in the posterior approach group (P>0.05). Mean postoperative JOA score were(13.6±2.5) in the anterior approach group and (14.0±1.7)in the posterior approach group at final follow-up(P>0.05). Mean improvement rate was (55.7%±16.3%)in the anterior approach group and (58.3%±15.7%) in the posterior approach group (P>0.05). Mean preoperative NDI score were(33.8±11.0)in the anterior approach group and (34.4±8.7)in the posterior approach group (P>0.05). Mean postoperative NDI score were (16.9±7.5) in the anterior approach group and (15.5±8.1) in the posterior approach group at final follow-up (P>0.05). Mean VAS score were (2.9±1.5) in the anterior approach group and (2.5±1.0) in the posterior approach group

  14. Plutonium radiation surrogate

    DOEpatents

    Frank, Michael I.

    2010-02-02

    A self-contained source of gamma-ray and neutron radiation suitable for use as a radiation surrogate for weapons-grade plutonium is described. The source generates a radiation spectrum similar to that of weapons-grade plutonium at 5% energy resolution between 59 and 2614 keV, but contains no special nuclear material and emits little .alpha.-particle radiation. The weapons-grade plutonium radiation surrogate also emits neutrons having fluxes commensurate with the gamma-radiation intensities employed.

  15. Introduction to radiation transport

    SciTech Connect

    Olson, G.L.

    1998-12-31

    This lecture will present time-dependent radiation transport where the radiation is coupled to a static medium, i.e., the material is not in motion. In reality, radiation exerts a pressure on the materials it propagates through and will accelerate the material in the direction of the radiation flow. This fully coupled problem with radiation transport and materials in motion is referred to as radiation-hydrodynamics (or in a shorthand notation: rad-hydro) and is beyond the scope of this lecture.

  16. Amelioration of radiation nephropathy in rats by postirradiation treatment with dexamethasone and/or captopril

    SciTech Connect

    Geraci, J.P.; Sun, M.C.; Mariano, M.S.

    1995-07-01

    Dexamethasone (DEX) and captopril are effective drugs in the treatment of radiation nephropathy in experimental animals. The aim of the present study was to determine the relative effectiveness of the two drugs and to see if their combination is more effective than either drug alone. For this purpose both kidneys of 143 rats were exposed surgically and irradiated with 13-20 Gy {gamma} rays. The surrounding tissues, with the exception of a segment of lumbar cord, were shielded. Each group had free access to acidified drinking water containing either DEX (94 {mu}g/l), captopril (500 mg/l), DEX (94{mu}g/l) + captopril (500 mg/l) or drug-free water. Dexamethasone treatment was stopped after 90 days, but animals continued to receive captopril until death. At approximately monthly intervals the animals were weighed and renal function (PUN, hematocrit, {sup 51}Cr-EDTA retention) was measured. A side effect of treatment with DEX and DEX + captopril was a reduced increase in body weight. Paralysis of the hind limbs developed in nine animals that received captopril and/or DEX treatment. The classical histological lesions associated with radiation myelopathy were not evident in these paretic rats. It is therefore suggested that paralysis may be attributed in part to drug-induced neurotoxicity in animals with impaired renal clearance. Macroscopically and histologically, nearly all the animals that survived more than 400 days had evidence of renal tumor development. dexamethasone and/or captopril appear to selectively ameliorate glomerular compared to tubular damage, based on histological findings. All three experimental treatments delayed but did not stop the progression of lethal renal injury as measured by kidney function tests and survival time. Median survival times for nontreated and captopril-DEX- and DEX + captopril-treated animals exposed to 14.5 to 19.0 Gy kidney irradiation were 175,242,261 and 395 days, respectively. 33 refs., 8 figs., 4 tabs.

  17. Radiation protection at synchrotron radiation facilities.

    PubMed

    Liu, J C; Vylet, V

    2001-01-01

    A synchrotron radiation (SR) facility typically consists of an injector, a storage ring, and SR beamlines. The latter two features are unique to SR facilities, when compared to other types of accelerator facilities. The SR facilities have the characteristics of low injection beam power, but high stored beam power. The storage ring is generally above ground with people occupying the experimental floor around a normally thin concrete ring wall. This paper addresses the radiation issues, in particular the shielding design, associated with the storage ring and SR beamlines. Normal and abnormal beam losses for injection and stored beams, as well as typical storage ring operation, are described. Ring shielding design for photons and neutrons from beam losses in the ring is discussed. Radiation safety issues and shielding design for SR beamlines, considering gas bremsstrahlung and synchrotron radiation, are reviewed. Radiation source terms and the methodologies for shielding calculations are presented.

  18. ERLN Radiation Focus Area

    EPA Pesticide Factsheets

    As part of the Environmental Response Laboratory Network, the National Air and Radiation Environmental Laboratory (NAREL) here provides your laboratory with access to radiation-specific laboratory guidance documents and training courses.

  19. What Is Radiation Shielding?

    NASA Video Gallery

    Kerry Lee, NASA Orion radiation system manager, explains how radiation shielding is used to block harmful particles coming into the spacecraft without producing secondary particles that can cause e...

  20. Radiation Oncology Treatment Team

    MedlinePlus

    ... patients to be advocates. View more information Treatment Team Quick Links Meet the Treatment Team Radiation Oncologist ... as medical oncologists and surgeons to maximize radiation’s effectiveness. Radiation oncologists are the only physicians with the ...

  1. Cell Radiation Experiment System

    NASA Technical Reports Server (NTRS)

    Morrison, Dennis R.

    2010-01-01

    The cell radiation experiment system (CRES) is a perfused-cell culture apparatus, within which cells from humans or other animals can (1) be maintained in homeostasis while (2) being exposed to ionizing radiation during controlled intervals and (3) being monitored to determine the effects of radiation and the repair of radiation damage. The CRES can be used, for example, to determine effects of drug, radiation, and combined drug and radiation treatments on both normal and tumor cells. The CRES can also be used to analyze the effects of radiosensitive or radioprotectant drugs on cells subjected to radiation. The knowledge gained by use of the CRES is expected to contribute to the development of better cancer treatments and of better protection for astronauts, medical-equipment operators, and nuclear-power-plant workers, and others exposed frequently to ionizing radiation.

  2. Space Radiation Program Element

    NASA Technical Reports Server (NTRS)

    Krenek, Sam

    2008-01-01

    This poster presentation shows the various elements of the Space Radiation Program. It reviews the program requirements: develop and validate standards, quantify space radiation human health risks, mitigate risks through countermeasures and technologies, and treat and monitor unmitigated risks.

  3. Radiation Protection Handbook

    NASA Technical Reports Server (NTRS)

    1972-01-01

    A handbook which sets forth the Kennedy Space Center radiation protection policy is presented. The book also covers administrative direction and guidance on organizational and procedural requirements of the program. Only ionizing radiation is covered.

  4. Radiation Protection in Canada

    PubMed Central

    Williams, N.

    1965-01-01

    The main emphasis of a provincial radiation protection program is on ionizing radiation produced by machines, although assistance is given to the Federal Radiation Protection Division in its program relating to radioactive substances. The basis for the Saskatchewan program of radiation protection is the Radiological Health Act 1961. An important provision of the Act is annual registration of radiation equipment. The design of the registration form encourages a “do-it-yourself” radiation and electrical safety inspection. Installations are inspected every two years by a radiation health officer. Two hundred and twenty-one deficiencies were found during inspection of 224 items of radiation equipment, the commonest being failure to use personal film badges. Insufficient filtration of the beam, inadequate limitation of the beam, and unnecessary exposure of operators were other common faults. Physicians have a responsibility to weigh the potential advantages against the hazards when requesting radiographic or fluoroscopic procedures. PMID:14282164

  5. Radiation from hard objects

    SciTech Connect

    Canavan, G.H.

    1997-02-01

    The inference of the diameter of hard objects is insensitive to radiation efficiency. Deductions of radiation efficiency from observations are very sensitive - possibly overly so. Inferences of the initial velocity and trajectory vary similarly, and hence are comparably sensitive.

  6. Prostate Cancer (Radiation Therapy)

    MedlinePlus

    ... to three years. If I choose surgery, will radiation treatment still be required? If your surgery is ... option with your physician team. If I choose radiation therapy, will surgical treatment still be an option? ...

  7. Radiation effects in space

    SciTech Connect

    Fry, R.J.M.

    1986-01-01

    The paper discusses the radiation environment in space that astronauts are likely to be exposed to. Emphasis is on proton and HZE particle effects. Recommendations for radiation protection guidelines are presented. (ACR)

  8. Fluorescent radiation converter

    NASA Technical Reports Server (NTRS)

    Viehmann, W. (Inventor)

    1981-01-01

    A fluorescence radiation converter is described which includes a substantially undoped optically transparent substrate and a waveshifter coating deposited on at least one portion of the substrate for absorption of radiation and conversion of fluorescent radiation. The coating is formed to substantially 1000 g/liter of a solvent, 70 to 200 g/liter of an organic polymer, and 0.2 to 25 g/liter of at least one organic fluorescent dye. The incoming incident radiation impinges on the coating. Radiation is absorbed by the fluorescent dye and is re-emitted as a longer wavelength radiation. Radiation is trapped within the substrate and is totally internally reflected by the boundary surface. Emitted radiation leaves the substrate ends to be detected.

  9. Hybrid radiator cooling system

    SciTech Connect

    France, David M.; Smith, David S.; Yu, Wenhua; Routbort, Jules L.

    2016-03-15

    A method and hybrid radiator-cooling apparatus for implementing enhanced radiator-cooling are provided. The hybrid radiator-cooling apparatus includes an air-side finned surface for air cooling; an elongated vertically extending surface extending outwardly from the air-side finned surface on a downstream air-side of the hybrid radiator; and a water supply for selectively providing evaporative cooling with water flow by gravity on the elongated vertically extending surface.

  10. External radiation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  11. (Mis)Understanding Radiation

    SciTech Connect

    Schreiber, Stephen Bruce

    2016-02-10

    This set of slides discusses radiation and fears concerning it at a non-technical level. Included are some misconceptions and practical consequences resulting from these. The concept of radiation hormesis is explained. The author concludes that a number of significant societal benefits are being foregone because of overly cautious concerns about low-level radiation.

  12. Spacecraft radiator systems

    NASA Technical Reports Server (NTRS)

    Anderson, Grant A. (Inventor)

    2012-01-01

    A spacecraft radiator system designed to provide structural support to the spacecraft. Structural support is provided by the geometric "crescent" form of the panels of the spacecraft radiator. This integration of radiator and structural support provides spacecraft with a semi-monocoque design.

  13. Radiation port dermatophytosis

    SciTech Connect

    Rosen, T.; Dupuy, J.; Maor, M.; Altman, A.

    1988-12-01

    We report two cases in which dermatophytic infection developed almost entirely within a radiation field mimicking an acute radiation effect. Radiotherapists and dermatologists should be aware of this possibility and be able to differentiate it from radiation dermatitis. Topical antifungal agents are the recommended treatment after diagnosis is established.

  14. Ionizing Radiation: The issue of radiation quality

    NASA Astrophysics Data System (ADS)

    Prise, Kevin; Schettino, Giuseppe

    Types of Ionising radiations are differentiated from each other by fundamental characteristics of their energy deposition patterns when they interact with biological materials. At the level of the DNA these non-random patterns drive differences in the yields and distributions of DNA damage patterns and specifically the production of clustered damage or complex lesions. The complex radiation fields found in space bring significant challenges for developing a mechanistic understanding of radiation effects from the perspective of radiation quality as these consist of a diverse range of particle and energy types unique to the space environment. Linear energy transfer, energy deposited per unit track length in units of keV per micron, has long been used as a comparator for different types of radiation but has limitations in that it is an average value. Difference in primary core ionizations relative to secondary delta ray ranges vary significantly with particle mass and energy leading to complex interrelationships with damage production at the cellular level. At the cellular level a greater mechanistic understanding is necessary, linking energy deposition patterns to DNA damage patterns and cellular response, to build appropriate biophysical models that are predictive for different radiation qualities and mixed field exposures. Defined studies using monoenergetic beams delivered under controlled conditions are building quantitative data sets of both initial and long term changes in cells as a basis for a great mechanistic understanding of radiation quality effects of relevance to not only space exposures but clinical application of ion-beams.

  15. Radiation Therapy: Additional Treatment Options

    MedlinePlus

    ... Upper GI What is Radiation Therapy? Find a Radiation Oncologist Last Name: Facility: City: State: Zip Code: ... infections. This is refered to as immunotherapy . Intraoperative Radiation Therapy Radiation therapy given during surgery is called ...

  16. RADIATION WAVE DETECTOR

    DOEpatents

    Wouters, L.F.

    1958-10-28

    The detection of the shape and amplitude of a radiation wave is discussed, particularly an apparatus for automatically indicating at spaced lntervals of time the radiation intensity at a flxed point as a measure of a radiation wave passing the point. The apparatus utilizes a number of photomultiplier tubes surrounding a scintillation type detector, For obtainlng time spaced signals proportional to radiation at predetermined intervals the photolnultiplier tubes are actuated ln sequence following detector incidence of a predetermined radiation level by electronic means. The time spaced signals so produced are then separately amplified and relayed to recording means.

  17. Radiation detection system

    DOEpatents

    Nelson, Melvin A.; Davies, Terence J.; Morton, III, John R.

    1976-01-01

    A radiation detection system which utilizes the generation of Cerenkov light in and the transmission of that light longitudinally through fiber optic wave guides in order to transmit intelligence relating to the radiation to a remote location. The wave guides are aligned with respect to charged particle radiation so that the Cerenkov light, which is generated at an angle to the radiation, is accepted by the fiber for transmission therethrough. The Cerenkov radiation is detected, recorded, and analyzed at the other end of the fiber.

  18. Solar cell radiation handbook

    NASA Technical Reports Server (NTRS)

    Carter, J. R., Jr.; Tada, H. Y.

    1973-01-01

    A method is presented for predicting the degradation of a solar array in a space radiation environment. Solar cell technology which emphasizes the cell parameters that degrade in a radiation environment, is discussed along with the experimental techniques used in the evaluation of radiation effects. Other topics discussed include: theoretical aspects of radiation damage, methods for developing relative damage coefficients, nature of the space radiation environment, method of calculating equivalent fluence from electron and proton energy spectrums and relative damage coefficients, and comparison of flight data with estimated degradation.

  19. PERSONAL RADIATION MONITOR

    DOEpatents

    Dilworth, R.H.; Borkowski, C.J.

    1961-12-26

    A transistorized, fountain pen type radiation monitor to be worn on the person is described. Radiation produces both light flashes in a small bulb and an audible warning tone, the frequency of both the tone and light flashes being proportional to radiation intensity. The device is powered by a battery and a blocking oscillator step-up power supply The oscillator frequency- is regulated to be proportional to the radiation intensity, to provide adequate power in high radiation fields, yet minimize battery drain at low operating intensities. (AEC)

  20. Radiation protection in space

    SciTech Connect

    Blakely, E.A.; Fry, R.J.M.

    1995-02-01

    The challenge for planning radiation protection in space is to estimate the risk of events of low probability after low levels of irradiation. This work has revealed many gaps in the present state of knowledge that require further study. Despite investigations of several irradiated populations, the atomic-bomb survivors remain the primary basis for estimating the risk of ionizing radiation. Compared to previous estimates, two new independent evaluations of available information indicate a significantly greater risk of stochastic effects of radiation (cancer and genetic effects) by about a factor of three for radiation workers. This paper presents a brief historical perspective of the international effort to assure radiation protection in space.

  1. Solar radiation measurement project

    NASA Technical Reports Server (NTRS)

    Ioup, J. W.

    1981-01-01

    The Xavier solar radiation measurement project and station are described. Measurements of the total solar radiation on a horizontal surface from an Eppley pyranometer were collected into computer data files. Total radiation in watt hours was converted from ten minute intervals to hourly intervals. Graphs of this total radiation data are included. A computer program in Fortran was written to calculate the total extraterrestrial radiation on a horizontal surface for each day of the month. Educational and social benefits of the project are cited.

  2. Radiation-induced gliomas

    PubMed Central

    Prasad, Gautam; Haas-Kogan, Daphne A.

    2013-01-01

    Radiation-induced gliomas represent a relatively rare but well-characterized entity in the neuro-oncologic literature. Extensive retrospective cohort data in pediatric populations after therapeutic intracranial radiation show a clearly increased risk in glioma incidence that is both patient age- and radiation dose/volume-dependent. Data in adults are more limited but show heightened risk in certain groups exposed to radiation. In both populations, there is no evidence linking increased risk associated with routine exposure to diagnostic radiation. At the molecular level, recent studies have found distinct genetic differences between radiation-induced gliomas and their spontaneously-occurring counterparts. Clinically, there is understandable reluctance on the part of clinicians to re-treat patients due to concern for cumulative neurotoxicity. However, available data suggest that aggressive intervention can lead to improved outcomes in patients with radiation-induced gliomas. PMID:19831840

  3. Americans' Average Radiation Exposure

    SciTech Connect

    NA

    2000-08-11

    We live with radiation every day. We receive radiation exposures from cosmic rays, from outer space, from radon gas, and from other naturally radioactive elements in the earth. This is called natural background radiation. It includes the radiation we get from plants, animals, and from our own bodies. We also are exposed to man-made sources of radiation, including medical and dental treatments, television sets and emission from coal-fired power plants. Generally, radiation exposures from man-made sources are only a fraction of those received from natural sources. One exception is high exposures used by doctors to treat cancer patients. Each year in the United States, the average dose to people from natural and man-made radiation sources is about 360 millirem. A millirem is an extremely tiny amount of energy absorbed by tissues in the body.

  4. RF radiation from lightning

    NASA Technical Reports Server (NTRS)

    Levine, D. M.

    1978-01-01

    Radiation from lightning in the RF band from 3-300 MHz were monitored. Radiation in this frequency range is of interest as a potential vehicle for monitoring severe storms and for studying the lightning itself. Simultaneous measurements were made of RF radiation and fast and slow field changes. Continuous analogue recordings with a system having 300 kHz of bandwidth were made together with digital records of selected events (principally return strokes) at greater temporal resolution. The data reveal patterns in the RF radiation for the entire flash which are characteristic of flash type and independent of the frequency of observation. Individual events within the flash also have characteristic RF patterns. Strong radiation occurs during the first return strokes, but delayed about 20 micron sec with respect to the begining of the return stroke; whereas, RF radiation from subsequent return strokes tends to be associated with cloud processes preceding the flash with comparatively little radiation occurring during the return stroke itself.

  5. Radiation curing of epoxies

    NASA Astrophysics Data System (ADS)

    Dickson, Lawrence W.; Singh, Ajit

    The literature on radiation polymerization of epoxy compounds has been reviewed to assess the potential use of radiation for curing these industrially important monomers. Chemical curing of epoxies may proceed by either cationic or anionic mechanisms depending on the nature of the curing agent, but most epoxies polymerize by cationic mechanisms under the influence of high-energy radiation. Radiation-induced cationic polymerization of epoxy compounds is inhibited by trace quantities of water because of proton transfer from the chain-propagating epoxy cation to water. Several different methods with potential for obtaining high molecular weight polymers by curing epoxies with high-energy radiation have been studied. Polymeric products with epoxy-like properties have been produced by radiation curing of epoxy oligomers with terminal acrylate groups and mixtures of epoxies with vinyl monomers. Both of these types of resin have good potential for industrial-scale curing by radiation treatment.

  6. COHERENCE PROPERTIES OF ELECTROMAGNETIC RADIATION,

    DTIC Science & Technology

    ELECTROMAGNETIC RADIATION , COHERENT SCATTERING), (*COHERENT SCATTERING, ELECTROMAGNETIC RADIATION ), LIGHT, INTERFERENCE, INTENSITY, STATISTICAL FUNCTIONS, QUANTUM THEORY, BOSONS, INTERFEROMETERS, CHINA

  7. Radiation Therapy: Professions in Radiation Therapy

    MedlinePlus

    ... the equipment works properly. They also take precise measurements of radiation beam characteristics and do other safety ... accredited facilities database . This website does not provide cost information. The costs for specific medical imaging tests, ...

  8. Acute radiation syndrome and chronic radiation syndrome.

    PubMed

    Grammaticos, Philip; Giannoula, Evanthia; Fountos, George P

    2013-01-01

    Acute radiation syndrome (ARS) or sickness or poisoning or toxicity is induced after a whole body exposure of men to high doses of radiation between 1-12Gy. First symptoms are from the gastrointestinal system, which together with bone marrow are the most sensitive parts of our body. Chronic radiation syndrome (CRS) may be induced by smaller than 1Gy radiation doses or after a mild form of ARS. Prophylaxis and treatment suggestions are described. In cases of ARS, a large part of the exposed population after proper medical care may survive, while without medical care this part of the population will be lost. Prophylaxis may also save another part of the population.

  9. The Radiation Transport Conundrum in Radiation Hydrodynamics

    SciTech Connect

    Castor, J I

    2005-03-18

    The summary of this paper is: (1) The conundrum in the title is whether to treat radiation in the lab frame or the comoving frame in a radiation-hydrodynamic problem; (2) Several of the difficulties are associated with combining a somewhat relativistic treatment of radiation with a non-relativistic treatment of hydrodynamics; (3) The principal problem is a tradeoff between easily obtaining the correct diffusion limit and describing free-streaming radiation with the correct wave speed; (4) The computational problems of the comoving-frame formulation in more than one dimension, and the difficulty of obtaining both exact conservation and full u/c accuracy argue against this method; (5) As the interest in multi-D increases, as well as the power of computers, the lab-frame method is becoming more attractive; and (6) The Monte Carlo method combines the advantages of both lab-frame and comoving-frame approaches, its only disadvantage being cost.

  10. High-power radiating plasma

    NASA Technical Reports Server (NTRS)

    Rozanov, V. B.; Rukhadze, A. A.

    1984-01-01

    The physical principles underlying the use of radiating plasmas for the optical pumping of lasers are described. Particular consideration is given to the properties of radiating plasmas; radiation selectivity; the dynamics, equilibrium, and stability of radiating plasmas; the radiative Reynolds number; and experimental results on radiating discharges.

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

    PubMed Central

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

    2014-01-01

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

  12. Thermal radiation measuring arrangement

    SciTech Connect

    Berman, H.L.; Sprout, J.C.

    1983-02-08

    In a thermal radiation measuring arrangement, a thermal radiation detector is located at the focal point of a collecting mirror, upon which incident thermal radiation from a surface, such as a building wall, is directed. The thermal radiation detector may be, for example, a thermopile, and provides an output signal having a magnitude proportional to the amount of thermal radiation which it receives. The temperature detection means detects the temperature of the thermal radiation detector and, for example, may detect the cold junction of the thermopile. In a first operating condition, a signal summing means receives the output signal from the thermal radiation detector and the temperature detection means and provides a third output signal proportional to the sum of these first and second output signals. In a second operating condition, a signal biasing means is connected into the signal summing means. The signal biasing means provides a signal to the signal summing means to cause the third output signal to become zero when radiation is received from a reference surface. When the arrangement is in the second operating condition and directed to receive thermal radiation from a second surface different from the reference surface, the signal biasing means maintains the same level of bias to the signal summing means as it did when detecting the radiation from the reference surface.

  13. Complications of radiation therapy

    SciTech Connect

    Dalinka, M.K.; Mazzeo, V.P. Jr.

    1985-01-01

    The skeletal effects of radiation are dependent upon many variables, but the pathologic features are consistent. Radiation may cause immediate or delayed cell death, cellular injury with recovery, arrest of cellular division, or abnormal repair with neoplasia. Radiation necrosis and radiation-induced neoplasm still occur despite the use of supervoltage therapy. Complications of radiotherapy are well known and have led to more judicious use of this therapeutic modality. With few exceptions, benign bone tumors are no longer treated with irradiation. Radiation necrosis may be difficult to differentiate from sarcoma arising in irradiated bone. They both occur within the field of irradiation. Radiation necrosis often has a long latent period which is, of course, the rule in radiation-induced neoplasia. A soft tissue mass favors the diagnosis of neoplasia, while its absence suggests radiation necrosis. Lack of pain favors necrosis. Calcification may occur in radiation necrosis and does not indicate neoplasia. A lack of progression on serial roentgenograms also favors radiation necrosis. 76 references.

  14. Radiation physics, biophysics, and radiation biology

    SciTech Connect

    Hall, E.J.; Zaider, M.

    1993-05-01

    Research at the Center for Radiological Research is a multidisciplenary blend of physics, chemistry and biology aimed at understanding the mechanisms involved in the health problems resulting from human exposure to ionizing radiations. The focus is increased on biochemistry and the application of the techniques of molecular biology to the problems of radiation biology. Research highlights of the program from the past year are described. A mathematical model describing the production of single-strand and double-strand breaks in DNA as a function radiation quality has been completed. For the first time Monte Carlo techniques have been used to obtain directly the spatial distribution of DNA moieties altered by radiation. This information was obtained by including the transport codes a realistic description of the electronic structure of DNA. We have investigated structure activity relationships for the potential oncogenicity of a new generation of bioreductive drugs that function as hypoxic cytotoxins. Experimental and theoretical investigation of the inverse dose rate effect, whereby medium LET radiations actually produce an c effect when the dose is protracted, is now at a point where the basic mechanisms are reasonably understood and the complex interplay between dose, dose rate and radiation quality which is necessary for the effect to be present can now be predicted at least in vitro. In terms of early radiobiological damage, a quantitative link has been established between basic energy deposition and locally multiply damaged sites, the radiochemical precursor of DNA double strand breaks; specifically, the spatial and energy deposition requirements necessary to form LMDs have been evaluated. For the first time, a mechanically understood biological fingerprint'' of high-LET radiation has been established. Specifically measurement of the ratio of inter-to intra-chromosomal aberrations produces a unique signature from alpha-particles or neutrons.

  15. Radiation exposure and pregnancy.

    PubMed

    Labant, Amy; Silva, Christina

    2014-01-01

    Radiological exposure from nuclear power reactor accidents, transportation of nuclear waste accidents, industrial accidents, or terrorist activity may be a remote possibility, but it could happen. Nurses must be prepared to evaluate and treat pregnant women and infants who have been exposed to radiation, and to have an understanding of the health consequences of a nuclear or radiological incident. Pregnant women and infants are a special group of patients who need consideration when exposed to radiation. Initial care requires thorough assessment and decisions regarding immediate care needs. Ongoing care is based on type and extent of radiation exposure. With accurate, comprehensive information and education, nurses will be better prepared to help mitigate the effects of radiation exposure to pregnant women and infants following a radiological incident. Information about radiation, health effects of prenatal radiation exposure, assessment, patient care, and treatment of pregnant women and infants are presented.

  16. RADIATION WAVE DETECTION

    DOEpatents

    Wouters, L.F.

    1960-08-30

    Radiation waves can be detected by simultaneously measuring radiation- wave intensities at a plurality of space-distributed points and producing therefrom a plot of the wave intensity as a function of time. To this end. a detector system is provided which includes a plurality of nuclear radiation intensity detectors spaced at equal radial increments of distance from a source of nuclear radiation. Means are provided to simultaneously sensitize the detectors at the instant a wave of radiation traverses their positions. the detectors producing electrical pulses indicative of wave intensity. The system further includes means for delaying the pulses from the detectors by amounts proportional to the distance of the detectors from the source to provide an indication of radiation-wave intensity as a function of time.

  17. Earth Radiation Measurement Science

    NASA Technical Reports Server (NTRS)

    Smith, G. Louis

    2000-01-01

    This document is the final report for NASA Grant NAG1-1959, 'Earth Radiation Measurement Science'. The purpose of this grant was to perform research in this area for the needs of the Clouds and Earth Radiant Energy System (CERES) project and for the Earth Radiation Budget Experiment (ERBE), which are bing conducted by the Radiation and Aerosols Branch of the Atmospheric Sciences Division of Langley Research Center. Earth Radiation Measurement Science investigates the processes by which measurements are converted into data products. Under this grant, research was to be conducted for five tasks: (1) Point Response Function Measurements; (2) Temporal Sampling of Outgoing Longwave Radiation; (3) Spatial Averaging of Radiation Budget Data; (4) CERES Data Validation and Applications; and (5) ScaRaB Data Validation and Application.

  18. Radiation | Smokefree.gov

    Cancer.gov

    About half of all cancer patients get radiation therapy. This treatment can damage healthy cells, which can cause uncomfortable side effects. Use this action deck to get information on common symptoms that affect people going through radiation and learn how to manage them. The side effects of radiation may depend on the part of your body being treated. If you don’t see the symptom cards that describe what you are going through, try building your own deck.

  19. Prostaglandins and Radiation Enteritis

    DTIC Science & Technology

    1987-12-30

    acid deficient diet did provide significant survival advantage following abdominal radiation. Abdominal radiation did not result in outpouring of fluid...mortality for rats given quinacrine .......... 31 19 PGE excretion for fatty acid deficient rats .......... 35 20 Leukocyte counts for fatty acid ...deficient rats ..... 35 21 Mucosa height for fatty acid deficient rats .......... 36 22 Leukocyte counts for rats prior to radiation ......... 37 23 Mean

  20. RHOBOT: Radiation hardened robotics

    SciTech Connect

    Bennett, P.C.; Posey, L.D.

    1997-10-01

    A survey of robotic applications in radioactive environments has been conducted, and analysis of robotic system components and their response to the varying types and strengths of radiation has been completed. Two specific robotic systems for accident recovery and nuclear fuel movement have been analyzed in detail for radiation hardness. Finally, a general design approach for radiation-hardened robotics systems has been developed and is presented. This report completes this project which was funded under the Laboratory Directed Research and Development program.

  1. Aerosol, radiation, and climate

    NASA Technical Reports Server (NTRS)

    Pollack, J. B.

    1983-01-01

    Airborne, spaceborne, and ground-based measurements are used to study the radiative and climatic effects of aerosols. The data, which are modelled with a hierarchy of radiation and climate models, and their implications are summarized. Consideration is given to volcanic aerosols, polar stratospheric clouds, and the Arctic haze. It is shown that several types of aerosols (volcanic particles and the Arctic haze) cause significant alterations to the radiation budget of the regions where they are located.

  2. Radiation Countermeasures Symposium: Introduction

    DTIC Science & Technology

    2011-06-15

    SH-containing molecules) protected animals from acute radiation syndrome (ARS). Free radical scavengers • 1950s-1980s: US Army (WRAIR) advanced...applications for G-CSF (Neupogen®) in case of radiation incident • Neupogen® in Strategic National Stockpile UNI FORM ED SERVIC ESUNIV ERSI T Y of theHealth...success for any radiation countermeasure under Animal Rule: long-term survival? (Need to cure hematopoietic syndrome when assessing GI

  3. Intracranial interstitial radiation

    SciTech Connect

    Willis, D.; Rittenmeyer, H.; Hitchon, P.

    1986-06-01

    Primary malignant brain tumors are fatal, with 90% of patients having these tumors dying within two years following diagnosis. Cranial interstitial radiation therapy, a technique under investigation to control these tumors, involves implantation of radioactive iodine 125 seeds into the tumor bed by stereotaxic technique. The interstitial radiation technique, monitoring of radiation, and nursing care of patients are discussed. Case histories are presented, along with discussion of results attained using this therapy, and its future.

  4. Radiation budget study

    NASA Astrophysics Data System (ADS)

    Hartmann, D. L.

    Scientific applications of satellite measurements of the radiative flux density at the top of the atmosphere are discussed in a general review and illustrated with diagrams, maps, and graphs. Topics examined include model development and verification, empirical studies of the global radiation budget, regional energy budgeting, interannual-variability studies, and seasonal and nonseasonal variations in ocean-land radiation budgets. The need for long-term homogeneous series of observations with good spatial and temporal resolution is stressed.

  5. Electromagnetic Radiation Analysis

    DTIC Science & Technology

    1978-04-10

    A methodology is given for determining whether electromagnetic radiation of sufficient strength to cause performance degradation to the test item...exists at the test item location. The results of an electromagnetic radiation effects test are used to identify the radio frequencies and electromagnetic ... radiation levels to which the test item is susceptible. Further, using a test bed, comparisons are made with the representative signal levels to

  6. Radiation coloration resistant glass

    DOEpatents

    Tomozawa, M.; Watson, E.B.; Acocella, J.

    1986-11-04

    A radiation coloration resistant glass is disclosed which is used in a radiation environment sufficient to cause coloration in most forms of glass. The coloration resistant glass includes higher proportions by weight of water and has been found to be extremely resistant to color change when exposed to such radiation levels. The coloration resistant glass is free of cerium oxide and has more than about 0.5% by weight water content. Even when exposed to gamma radiation of more than 10[sup 7] rad, the coloration resistant glass does not lose transparency. 3 figs.

  7. Radiation coloration resistant glass

    DOEpatents

    Tomozawa, Minoru; Watson, E. Bruce; Acocella, John

    1986-01-01

    A radiation coloration resistant glass is disclosed which is used in a radiation environment sufficient to cause coloration in most forms of glass. The coloration resistant glass includes higher proportions by weight of water and has been found to be extremely resistant to color change when exposed to such radiation levels. The coloration resistant glass is free of cerium oxide and has more than about 0.5% by weight water content. Even when exposed to gamma radiation of more than 10.sup.7 rad, the coloration resistant glass does not lose transparency.

  8. [Thyroid and radiation].

    PubMed

    Yamashita, S; Namba, H; Nagataki, S

    1993-11-20

    The topic "Thyroid and Radiation" is both an old and a new area to be solved by human beings. The thyroid is an organ that is usually susceptible to exposure to ionizing radiation, both by virtue of its ability to concentrate radioiodine (internal radiation) and by routine medical examination: Chest X-ray, Dental X-ray, X-irradiation of cervical lymphnodes etc. (external radiation). Iodine-131 is widely used for the therapy of Graves' disease and thyroid cancers, of which the disadvantage is radiation-induced hypothyroidism but not complications of thyroid tumor. The thyroid gland is comparatively radioresistant, however, the data obtained from Hiroshima, Nagasaki and Marshall islands indicates a high incidence of external radiation-induced thyroid tumors as well as hypothyroidism. The different biological effects of internal and external radiation remains to be further clarified. Interestingly, recent reports demonstrate the increased number of thyroid cancer in children around Chernobyl in Belarus. In this review, we would like to introduce the effect of radiation on the thyroid gland at the molecular, cellular and tissue levels. Furthermore the clinical usefulness of iodine-131, including the safety-control for radiation exposure will be discussed.

  9. Rotating bubble membrane radiator

    DOEpatents

    Webb, Brent J.; Coomes, Edmund P.

    1988-12-06

    A heat radiator useful for expelling waste heat from a power generating system aboard a space vehicle is disclosed. Liquid to be cooled is passed to the interior of a rotating bubble membrane radiator, where it is sprayed into the interior of the bubble. Liquid impacting upon the interior surface of the bubble is cooled and the heat radiated from the outer surface of the membrane. Cooled liquid is collected by the action of centrifical force about the equator of the rotating membrane and returned to the power system. Details regarding a complete space power system employing the radiator are given.

  10. Flexible radiator system

    NASA Technical Reports Server (NTRS)

    Oren, J. A.

    1982-01-01

    The soft tube radiator subsystem is described including applicable system requirements, the design and limitations of the subsystem components, and the panel manufacturing method. The soft tube radiator subsystem is applicable to payloads requiring 1 to 12 kW of heat rejection for orbital lifetimes per mission of 30 days or less. The flexible radiator stowage volume required is about 60% and the system weight is about 40% of an equivalent heat rejection rigid panel. The cost should also be considerably less. The flexible radiator is particularly suited to shuttle orbiter sortie payloads and also whose mission lengths do not exceed the 30 day design life.

  11. Potential theory of radiation

    NASA Technical Reports Server (NTRS)

    Chiu, Huei-Huang

    1989-01-01

    A theoretical method is being developed by which the structure of a radiation field can be predicted by a radiation potential theory, similar to a classical potential theory. The introduction of a scalar potential is justified on the grounds that the spectral intensity vector is irrotational. The vector is also solenoidal in the limits of a radiation field in complete radiative equilibrium or in a vacuum. This method provides an exact, elliptic type equation that will upgrade the accuracy and the efficiency of the current CFD programs required for the prediction of radiation and flow fields. A number of interesting results emerge from the present study. First, a steady state radiation field exhibits an optically modulated inverse square law distribution character. Secondly, the unsteady radiation field is structured with two conjugate scalar potentials. Each is governed by a Klein-Gordon equation with a frictional force and a restoring force. This steady potential field structure and the propagation of radiation potentials are consistent with the well known results of classical electromagnetic theory. The extension of the radiation potential theory for spray combustion and hypersonic flow is also recommended.

  12. Charms of radiation research.

    SciTech Connect

    Inokuti, M.; Physics

    2005-01-01

    Most of my professional efforts over nearly five decades have been devoted to radiation research, that is, studies of the physical, chemical, and biological actions of high-energy radiation on matter. (By the term 'high-energy radiation' I mean here x rays, .GAMMA. rays, neutrons, and charged particles of high enough energies to produce ionization in matter. I exclude visible light, infrared waves, microwaves, and sound waves.) Charms of radiation research lie in its interdisciplinary character; although my training was in basic physics, the scope of my interest has gradually increased to cover many other areas, to my deep satisfaction. High-energy radiation is an important component of the universe, and of our environment. It often provides an effective avenue for characterizing matter and understanding its behavior. Near Earth's surface this radiation is normally present in exceptionally low quantity, and yet it plays a significant role in some atmospheric phenomena such as auroras, and also in the evolution of life. The recent advent of various devices for producing high-energy radiation has opened up the possibility of many applications, including medical and industrial uses. I have worked on some aspects of those uses. At every opportunity to address a broad audience I try to convey a sense of intellectual fun, together with some of the elements of the basic science involved. A goal of radiation education might be to make the word 'radiation' as common and familiar as words such as 'fire' and 'electricity' through increased usage.

  13. Radiation physics, biophysics, and radiation biology

    SciTech Connect

    Hall, E.J.

    1992-05-01

    The following research programs from the Center for Radiological Research of Columbia University are described: Design and development of a new wall-less ultra miniature proportional counter for nanodosimetry; some recent measurements of ionization distributions for heavy ions at nanometer site sizes with a wall-less proportional counter; a calculation of exciton energies in periodic systems with helical symmetry: application to a hydrogen fluoride chain; electron energy-loss function in polynucleotide and the question of plasmon excitation; a non-parametric, microdosimetric-based approach to the evaluation of the biological effects of low doses of ionizing radiation; high-LET radiation risk assessment at medium doses; high-LET radiobiological effects: increased lesion severity or increased lesion proximity; photoneutrons generated by high energy medical linacs; the biological effectiveness of neutrons; implications for radiation protection; molecular characterization of oncogenes induced by neutrons; and the inverse dose-rate effect for oncogenic transformation by charged particles is LET dependent.

  14. Radiation Therapy (For Parents)

    MedlinePlus

    ... alike, but remember that many kids treated with radiation therapy go on to live healthy, full lives. Don't hesitate to discuss your questions and concerns with the doctor. The more you know about how radiation therapy will affect and help your child, the ...

  15. Electromagnetic radiation detector

    DOEpatents

    Benson, Jay L.; Hansen, Gordon J.

    1976-01-01

    An electromagnetic radiation detector including a collimating window, a cathode member having a photoelectric emissive material surface angularly disposed to said window whereby radiation is impinged thereon at acute angles, an anode, separated from the cathode member by an evacuated space, for collecting photoelectrons emitted from the emissive cathode surface, and a negatively biased, high transmissive grid disposed between the cathode member and anode.

  16. Radiation in the universe

    NASA Technical Reports Server (NTRS)

    Stuhlinger, Ernst; Truemper, Joachim; Weisskopf, Martin

    1992-01-01

    When Wilhelm Conrad Roentgen discovered radiation one hundred years ago, it seemed that what was discovered was one of the rarest and most volatile members of the family of the basic modules of our natural world. Today cosmologists report that a substantial part of the universe's radiation energy consists of X-rays, which travel through cosmic space with the speed of light.

  17. Radiation effects in space

    SciTech Connect

    Fry, R.J.M.

    1987-07-01

    As more people spend more time in space, and the return to the moon and exploratory missions are considered, the risks require continuing examination. The effects of microgravity and radiation are two potential risks in space. These risks increase with increasing mission duration. This document considers the risk of radiation effects in space workers and explorers. 17 refs., 1 fig., 4 tabs.

  18. Treatment of Radiation Injury

    PubMed Central

    Akita, Sadanori

    2014-01-01

    Significance: Radiation exposure as a result of radiation treatment, accident, or terrorism may cause serious problems such as deficiency due to necrosis or loss of function, fibrosis, or intractable ulcers in the tissues and organs. When the skin, bone, oral mucous membrane, guts, or salivary glands are damaged by ionizing radiation, the management and treatment are very lengthy and difficult. Critical Issues: In severe and irreversible injuries, surgery remains the mainstay of treatment. Several surgical procedures, such as debridement, skin grafting, and local and free-vascularized flaps, are widely used. Recent Advances: In specific cases of major morbidity or in high-risk patients, a newly developed therapy using a patient's own stem cells is safe and effective. Adipose tissue, normally a rich source of mesenchymal stem cells, which are similar to those from the bone marrow, can be harvested, since the procedure is easy, and abundant tissue can be obtained with minimal invasiveness. Future Directions: Based on the molecular basis of radiation injuries, several prospective treatments are under development. Single-nucleotide polymorphisms focus on an individual's sensitivity to radiation in radiogenomics, and the pathology of radiation fibrosis or the effect of radiation on wound healing is being studied and will lead to new insight into the treatment of radiation injuries. Protectors and mitigators are being actively investigated in terms of the timing of administration or dose. PMID:24761339

  19. On Blackbody Radiation.

    ERIC Educational Resources Information Center

    Jain, Pushpendra K.

    1991-01-01

    The interrelationship between the various forms of the Planck radiation equation is discussed. A differential equation that gives intensity or energy density of radiation per unit wavelength or per unit frequency is emphasized. The Stefan-Boltzmann Law and the change in the glow of a hot body with temperature are also discussed. (KR)

  20. Radiation belts of jupiter.

    PubMed

    Stansberry, K G; White, R S

    1973-12-07

    Predictions of Jupiter's electron and proton radiation belts are based mainly on decimeter observations of 1966 and 1968. Extensive calculations modeling radial diffusion of particles inward from the solar wind and electron synchrotron radiation are used to relate the predictions and observations.

  1. Ultraviolet radiation changes

    NASA Technical Reports Server (NTRS)

    Mckenzie, Richard L.; Frederick, John E.; Ilyas, Mohammad; Filyushkin, V.; Wahner, Andreas; Stamnes, K.; Muthusubramanian, P.; Blumthaler, M.; Roy, Colin E.; Madronich, Sasha

    1991-01-01

    A major consequence of ozone depletion is an increase in solar ultraviolet (UV) radiation received at the Earth's surface. This chapter discusses advances that were made since the previous assessment (World Meteorological Organization (WMO)) to our understanding of UV radiation. The impacts of these changes in UV on the biosphere are not included, because they are discussed in the effects assessment.

  2. Radiation treatment of pharmaceuticals

    NASA Astrophysics Data System (ADS)

    Dám, A. M.; Gazsó, L. G.; Kaewpila, S.; Maschek, I.

    1996-03-01

    Product specific doses were calculated for pharmaceuticals to be radiation treated. Radio-pasteurization dose were determined for some heat sensitive pharmaceutical basic materials (pancreaton, neopancreatin, neopancreatin USP, duodenum extract). Using the new recommendation (ISO standards, Method 1) dose calculations were performed and radiation sterilization doses were determined for aprotinine and heparine Na.

  3. Radiation-induced disease.

    PubMed

    Bobrow, M

    1993-01-01

    The term radiation covers a wide spectrum of forms of energy, most of which have at one stage or another been suspected of causing human ill health. In general, study of the effects of radiation on health involves a mix of scientific disciplines, from population epidemiology to physics, which are seldom if ever found in a single scientist. As a result, interdisciplinary communication is of the utmost importance, and is a potent source of misunderstanding and misinformation. The forms of radiation which have been most specifically associated with health effects include ionizing and ultraviolet radiation. Claimed effects of electromagnetic and microwave radiation (excluding thermal effects) are too indefinite for detailed consideration. Ionizing radiation is a well-documented mutagen, which clearly causes cancers in humans, and human exposure has been increased by atomic weapons testing and medical and industrial uses of radioactivity. There is also a growing awareness of the possible role of some types of natural radiation, such as radon, in causing disease. Ultraviolet radiation is also associated with cancers, and is suspected of involvement in the increasing incidence of skin cancers in European populations. Factors thought to underlie recent changes in exposure to these mutagens are discussed.

  4. Instrument for assaying radiation

    DOEpatents

    Coleman, Jody Rustyn; Farfan, Eduardo B.

    2016-03-22

    An instrument for assaying radiation includes a flat panel detector having a first side opposed to a second side. A collimated aperture covers at least a portion of the first side of the flat panel detector. At least one of a display screen or a radiation shield may cover at least a portion of the second side of the flat panel detector.

  5. Transgenerational Radiation Epigenetics

    DTIC Science & Technology

    2011-09-01

    AD_________________ Award Number: W81XWH-10-1-0711 TITLE: Transgenerational Radiation Epigenetics ...5a. CONTRACT NUMBER Transgenerational Radiation Epigenetics 5b. GRANT NUMBER W81XWH-10-1-0711 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...weeks for preliminary epigenetic screening. Others were used as breeders for transgenerational studies and still others have been left to take when they

  6. Radiation detection system

    DOEpatents

    Franks, Larry A.; Lutz, Stephen S.; Lyons, Peter B.

    1981-01-01

    A radiation detection system including a radiation-to-light converter and fiber optic wave guides to transmit the light to a remote location for processing. The system utilizes fluors particularly developed for use with optical fibers emitting at wavelengths greater than about 500 nm and having decay times less than about 10 ns.

  7. Microcircuit radiation effects databank

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Radiation test data submitted by many testers is collated to serve as a reference for engineers who are concerned with and have some knowledge of the effects of the natural radiation environment on microcircuits. Total dose damage information and single event upset cross sections, i.e., the probability of a soft error (bit flip) or of a hard error (latchup) are presented.

  8. Synchrotron Radiation II.

    ERIC Educational Resources Information Center

    MOSAIC, 1978

    1978-01-01

    Synchrotron radiation is a unique form of radiation that spans the electro-magnetic spectrum from X-rays through the ultraviolet and visible into the infrared. Tunable monochromators enable scientists to select a narrow band of wavelengths at any point in the spectrum. (Author/BB)

  9. Radiation: Doses, Effects, Risks.

    ERIC Educational Resources Information Center

    Lean, Geoffrey, Ed.

    Few scientific issues arouse as much public controversy as the effects of radiation. This booklet is an attempt to summarize what is known about radiation and provide a basis for further discussion and debate. The first four chapters of the booklet are based on the most recent reports to the United Nations' General Assembly by the United Nations…

  10. Radiation-resistant microorganism

    DOEpatents

    Fliermans, Carl B.

    2010-06-15

    An isolated and purified bacterium is provided which was isolated from a high-level radioactive waste site of mixed waste. The isolate has the ability to degrade a wide variety of organic contaminants while demonstrating high tolerance to ionizing radiation. The organism is uniquely suited to bioremediation of a variety or organic contaminants while in the presence of ionizing radiation.

  11. Radiation-resistant microorganism

    DOEpatents

    Fliermans, Carl B.

    2007-01-09

    An isolated and purified bacterium is provided which was isolated from a high-level radioactive waste site of mixed waste. The isolate has the ability to degrade a wide variety of organic contaminants while demonstrating high tolerance to ionizing radiation. The organism is uniquely suited to bioremediation of a variety or organic contaminants while in the presence of ionizing radiation.

  12. Global radiation oncology waybill

    PubMed Central

    Muñoz-Garzón, Victor; Rovirosa, Ángeles; Ramos, Alfredo

    2013-01-01

    Background/aim Radiation oncology covers many different fields of knowledge and skills. Indeed, this medical specialty links physics, biology, research, and formation as well as surgical and clinical procedures and even rehabilitation and aesthetics. The current socio-economic situation and professional competences affect the development and future or this specialty. The aim of this article was to analyze and highlight the underlying pillars and foundations of radiation oncology, indicating the steps implicated in the future developments or competences of each. Methods This study has collected data from the literature and includes highlights from discussions carried out during the XVII Congress of the Spanish Society of Radiation Oncology (SEOR) held in Vigo in June, 2013. Most of the aspects and domains of radiation oncology were analyzed, achieving recommendations for the many skills and knowledge related to physics, biology, research, and formation as well as surgical and clinical procedures and even supportive care and management. Results Considering the data from the literature and the discussions of the XVII SEOR Meeting, the “waybill” for the forthcoming years has been described in this article including all the aspects related to the needs of radiation oncology. Conclusions Professional competences affect the development and future of this specialty. All the types of radio-modulation are competences of radiation oncologists. On the other hand, the pillars of Radiation Oncology are based on experience and research in every area of Radiation Oncology. PMID:24416572

  13. Radiative Flux Analysis

    DOE Data Explorer

    Long, Chuck [NOAA

    2008-05-14

    The Radiative Flux Analysis is a technique for using surface broadband radiation measurements for detecting periods of clear (i.e. cloudless) skies, and using the detected clear-sky data to fit functions which are then used to produce continuous clear-sky estimates. The clear-sky estimates and measurements are then used in various ways to infer cloud macrophysical properties.

  14. RADIATION BIOLOGY: CONCEPTS FOR RADIATION PROTECTION

    EPA Science Inventory

    ABSTRACT

    The opportunity to write a historical review of the field of radiation biology allows for the viewing of the development and maturity of a field of study, thereby being able to provide the appropriate context for the earlier years of research and its findings. The...

  15. Nuclear radiation actuated valve

    DOEpatents

    Christiansen, David W.; Schively, Dixon P.

    1985-01-01

    A nuclear radiation actuated valve for a nuclear reactor. The valve has a valve first part (such as a valve rod with piston) and a valve second part (such as a valve tube surrounding the valve rod, with the valve tube having side slots surrounding the piston). Both valve parts have known nuclear radiation swelling characteristics. The valve's first part is positioned to receive nuclear radiation from the nuclear reactor's fuel region. The valve's second part is positioned so that its nuclear radiation induced swelling is different from that of the valve's first part. The valve's second part also is positioned so that the valve's first and second parts create a valve orifice which changes in size due to the different nuclear radiation caused swelling of the valve's first part compared to the valve's second part. The valve may be used in a nuclear reactor's core coolant system.

  16. Underwater radiation detector

    DOEpatents

    Kruse, Lyle W.; McKnight, Richard P.

    1986-01-01

    A detector apparatus for differentiating between gamma and neutron radiation is provided. The detector includes a pair of differentially shielded Geiger-Mueller tubes. The first tube is wrapped in silver foil and the second tube is wrapped in lead foil. Both the silver and lead foils allow the passage of gamma rays at a constant rate in a gamma ray only field. When neutrons are present, however, the silver activates and emits beta radiation that is also detected by the silver wrapped Geiger-Mueller tube while the radiation detected by the lead wrapped Geiger-Mueller tube remains constant. The amount of radiation impinging on the separate Geiger-Mueller tubes is then correlated in order to distinguish between the neutron and gamma radiations.

  17. Fundamentals of Radiation Dosimetry

    SciTech Connect

    Bos, Adrie J. J.

    2011-05-05

    The basic concepts of radiation dosimetry are reviewed on basis of ICRU reports and text books. The radiation field is described with, among others, the particle fluence. Cross sections for indirectly ionizing radiation are defined and indicated is how they are related to the mass energy transfer and mass energy absorption coefficients. Definitions of total and restricted mass stopping powers of directly ionizing radiation are given. The dosimetric quantities, kerma, absorbed dose and exposure together with the relations between them are discussed in depth. Finally it is indicated how the absorbed dose can be measured with a calorimeter by measuring the temperature increase and with an ionisation chamber measuring the charge produced by the ionizing radiation and making use of the Bragg-Gray relation.

  18. Fundamentals of Radiation Dosimetry

    NASA Astrophysics Data System (ADS)

    Bos, Adrie J. J.

    2011-05-01

    The basic concepts of radiation dosimetry are reviewed on basis of ICRU reports and text books. The radiation field is described with, among others, the particle fluence. Cross sections for indirectly ionizing radiation are defined and indicated is how they are related to the mass energy transfer and mass energy absorption coefficients. Definitions of total and restricted mass stopping powers of directly ionizing radiation are given. The dosimetric quantities, kerma, absorbed dose and exposure together with the relations between them are discussed in depth. Finally it is indicated how the absorbed dose can be measured with a calorimeter by measuring the temperature increase and with an ionisation chamber measuring the charge produced by the ionizing radiation and making use of the Bragg-Gray relation.

  19. Radiation and health*

    PubMed Central

    Lindell, B.

    1987-01-01

    Radiation has been a source of fascination and concern ever since Wilhelm Konrad Röntgen discovered X-rays on 8 November 1895. Over the years, health workers as well as the public have been concerned about medical uses of X-rays, the presence of radon in buildings, radioactive waste from nuclear power stations, fallout from nuclear test explosions, radioactive consumer products, microwave ovens, and many other sources of radiation. Most recently, the tragic accident at the Chernobyl nuclear power station in the USSR, and the subsequent contamination over most of Europe, has again wakened interest and concern and also reminded us about a number of misconceptions about radiation. This article describes the essentials about radiation (especially ionizing radiation) and its health effects. PMID:3496982

  20. Chitosan and radiation chemistry

    NASA Astrophysics Data System (ADS)

    Chmielewski, Andrzej G.

    2010-03-01

    Chitosan as a raw material with special properties has drawn attention of scientists working in the field of radiation processing and natural polymer products development, and also of specialists working in the field of radiation protection and oncologists. Especially the applications concern reduced molecular weight chitosan which still retain its chemical structure; such form of the compound is fostering biological, physical and chemical reactivity of the product. Chitosan degrades into fragments under γ-ray or electron beam irradiation. Antibacterial properties of the product are applied in manufacturing hydrogel for wound dressing and additional healing properties can be achieved by incorporating in the hydrogel matrix chitosan bonded silver clusters. Another possible application of chitosan is in reducing radiation damage to the radiation workers or radiation cured patients. In the case of radioisotopes oral or respiratory chitosan-based materials can be applied as chelators. Applications of chitosan in oncology are also reported.

  1. [Remote radiation planning support system].

    PubMed

    Atsumi, Kazushige; Nakamura, Katsumasa; Yoshidome, Satoshi; Shioyama, Yoshiyuki; Sasaki, Tomonari; Ohga, Saiji; Yoshitake, Tadamasa; Shinoto, Makoto; Asai, Kaori; Sakamoto, Katsumi; Hirakawa, Masakazu; Honda, Hiroshi

    2012-08-01

    We constructed a remote radiation planning support system between Kyushu University Hospital (KUH) in Fukuoka and Kyushu University Beppu Hospital (KBH) in Oita. Between two institutions, radiology information system for radiotherapy division (RT-RIS) and radiation planning system (RTPS) were connected by virtual private network (VPN). This system enables the radiation oncologists at KUH to perform radiotherapy planning for the patients at KBH. The detail of the remote radiation planning support system in our institutions is as follows: The radiation oncologist at KBH performs radiotherapy planning and the data of the patients are sent anonymously to the radiation oncologists at KUH. The radiation oncologists at KUH receive the patient's data, access to RTPS at KBH, verify or change the radiation planning at KBH: Radiation therapy is performed at KBH according to the confirmed plan by the radiation oncologists at KUH. Our remote radiation planning system is useful for providing radiation therapy with safety and accuracy.

  2. Modifying Radiation Damage

    PubMed Central

    Kim, Kwanghee; McBride, William H.

    2011-01-01

    Radiation leaves a fairly characteristic footprint in biological materials, but this is rapidly all but obliterated by the canonical biological responses to the radiation damage. The innate immune recognition systems that sense “danger” through direct radiation damage and through associated collateral damage set in motion a chain of events that, in a tissue compromised by radiation, often unwittingly result in oscillating waves of molecular and cellular responses as tissues attempt to heal. Understanding “nature’s whispers” that inform on these processes will lead to novel forms of intervention targeted more precisely towards modifying them in an appropriate and timely fashion so as to improve the healing process and prevent or mitigate the development of acute and late effects of normal tissue radiation damage, whether it be accidental, as a result of a terrorist incident, or of therapeutic treatment of cancer. Here we attempt to discuss some of the non-free radical scavenging mechanisms that modify radiation responses and comment on where we see them within a conceptual framework of an evolving radiation-induced lesion. PMID:20583981

  3. Microenvironment and Radiation Therapy

    PubMed Central

    Yoshimura, Michio; Itasaka, Satoshi; Harada, Hiroshi; Hiraoka, Masahiro

    2013-01-01

    Dependency on tumor oxygenation is one of the major features of radiation therapy and this has led many radiation biologists and oncologists to focus on tumor hypoxia. The first approach to overcome tumor hypoxia was to improve tumor oxygenation by increasing oxygen delivery and a subsequent approach was the use of radiosensitizers in combination with radiation therapy. Clinical use of some of these approaches was promising, but they are not widely used due to several limitations. Hypoxia-inducible factor 1 (HIF-1) is a transcription factor that is activated by hypoxia and induces the expression of various genes related to the adaptation of cellular metabolism to hypoxia, invasion and metastasis of cancer cells and angiogenesis, and so forth. HIF-1 is a potent target to enhance the therapeutic effects of radiation therapy. Another approach is antiangiogenic therapy. The combination with radiation therapy is promising, but several factors including surrogate markers, timing and duration, and so forth have to be optimized before introducing it into clinics. In this review, we examined how the tumor microenvironment influences the effects of radiation and how we can enhance the antitumor effects of radiation therapy by modifying the tumor microenvironment. PMID:23509762

  4. Beneficial uses of radiation

    SciTech Connect

    Fox, M.R.

    1991-10-01

    An overall decline in technical literacy within the American public has come at a time when technological advances are accelerating in the United States and around the world. This had led to a large communication gulf between the general public and the technologists. Nowhere is this more evident then with the topic of radiation. Regrettably, too few people know about sources of radiation, the pervasiveness, amounts, and variabilities, and do not have a true understanding of the environment in which we live. Nor do many people know that radiation has been used in beneficial ways for decades around the world. While the general public does not know of the scientific applications to which radiation has been deployed, it nevertheless had benefited tremendously from these efforts. Thanks to the well know properties of radiation, scientific ingenuity has found many uses of radiation in chemical and agricultural research, biomedical research, in the diagnoses and treatment of hundreds of types of diseases, in industrial applications, food irradiation, and many others. This paper provides a sample of the types of uses to which radiation has been used to help advance the betterment of humankind.

  5. Biological Effects of Ionizing Radiation

    DOE R&D Accomplishments Database

    Ingram, M.; Mason, W. B.; Whipple, G. H.; Howland, J. W.

    1952-04-07

    This report presents a review of present knowledge and concepts of the biological effects of ionizing radiations. Among the topics discussed are the physical and chemical effects of ionizing radiation on biological systems, morphological and physiological changes observed in biological systems subjected to ionizing radiations, physiological changes in the intact animal, latent changes following exposure of biological systems to ionizing radiations, factors influencing the biological response to ionizing radiation, relative effects of various ionizing radiations, and biological dosimetry.

  6. Stimulated coherent transition radiation

    SciTech Connect

    Hung-chi Lihn

    1996-03-01

    Coherent radiation emitted from a relativistic electron bunch consists of wavelengths longer than or comparable to the bunch length. The intensity of this radiation out-numbers that of its incoherent counterpart, which extends to wavelengths shorter than the bunch length, by a factor equal to the number of electrons in the bunch. In typical accelerators, this factor is about 8 to 11 orders of magnitude. The spectrum of the coherent radiation is determined by the Fourier transform of the electron bunch distribution and, therefore, contains information of the bunch distribution. Coherent transition radiation emitted from subpicosecond electron bunches at the Stanford SUNSHINE facility is observed in the far-infrared regime through a room-temperature pyroelectric bolometer and characterized through the electron bunch-length study. To measure the bunch length, a new frequency-resolved subpicosecond bunch-length measuring system is developed. This system uses a far-infrared Michelson interferometer to measure the spectrum of coherent transition radiation through optical autocorrelation with resolution far better than existing time-resolved methods. Hence, the radiation spectrum and the bunch length are deduced from the autocorrelation measurement. To study the stimulation of coherent transition radiation, a special cavity named BRAICER is invented. Far-infrared light pulses of coherent transition radiation emitted from electron bunches are delayed and circulated in the cavity to coincide with subsequent incoming electron bunches. This coincidence of light pulses with electron bunches enables the light to do work on electrons, and thus stimulates more radiated energy. The possibilities of extending the bunch-length measuring system to measure the three-dimensional bunch distribution and making the BRAICER cavity a broadband, high-intensity, coherent, far-infrared light source are also discussed.

  7. Liquid sheet radiator

    NASA Technical Reports Server (NTRS)

    Chubb, Donald L.; White, K. Alan, III

    1987-01-01

    A new external flow radiator concept, the liquid sheet radiator (LSR), is introduced. The LSR sheet flow is described and an expression for the length/width (l/w), ratio is presented. A linear dependence of l/w on velocity is predicted that agrees with experimental results. Specific power for the LSR is calculated and is found to be nearly the same as the specific power of a liquid droplet radiator, (LDR). Several sheet thicknesses and widths were experimentally investigated. In no case was the flow found to be unstable.

  8. Ethics and radiation protection.

    PubMed

    Hansson, Sven Ove

    2007-06-01

    Some of the major problems in radiation protection are closely connected to issues that have a long, independent tradition in moral philosophy. This contribution focuses on two of these issues. One is the relationship between the protection of individuals and optimisation on the collective level, and the other is the relative valuation of future versus immediate damage. Some of the intellectual tools that have been developed by philosophers can be useful in radiation protection. On the other hand, philosophers have much to learn from radiation protectors, not least when it comes to finding pragmatic solutions to problems that may be intractable in principle.

  9. Human radiation tolerance

    NASA Technical Reports Server (NTRS)

    Lushbaugh, C. C.

    1974-01-01

    The acute radiation syndrome in man is clinically bounded by death at high dose levels and by the prodromal syndrome of untoward physiological effects at minimal levels of clinically effective exposure. As in lower animals, man experiences principally three acute modes of death from radiation exposure (Bond et al., 1965). These are known collectively as the lethal radiation syndromes: central nervous system death, gastrointestinal death, and hematopoietic death. The effect of multiple exposure on lethality, the effect of multiple exposure on hematopoietic recovery, and quantitative aspects of cell and tissue repair are discussed.

  10. Radiation Safety System

    SciTech Connect

    Vylet, Vaclav; Liu, James C.; Walker, Lawrence S.; /Los Alamos

    2012-04-04

    The goal of this work is to provide an overview of a Radiation safety system (RSS) designed for protection from prompt radiation hazard at accelerator facilities. RSS design parameters, functional requirements and constraints are derived from hazard analysis and risk assessment undertaken in the design phase of the facility. The two main subsystems of a RSS are access control system (ACS) and radiation control system (RCS). In this text, a common approach to risk assessment, typical components of ACS and RCS, desirable features and general design principles applied to RSS are described.

  11. Radiative forcing of climate

    NASA Technical Reports Server (NTRS)

    Ramanswamy, V.; Shine, Keith; Leovy, Conway; Wang, Wei-Chyung; Rodhe, Henning; Wuebbles, Donald J.; Ding, M.; Lelieveld, Joseph; Edmonds, Jae A.; Mccormick, M. Patrick

    1991-01-01

    An update of the scientific discussions presented in Chapter 2 of the Intergovernmental Panel on Climate Change (IPCC) report is presented. The update discusses the atmospheric radiative and chemical species of significance for climate change. There are two major objectives of the present update. The first is an extension of the discussion on the Global Warming Potentials (GWP's), including a reevaluation in view of the updates in the lifetimes of the radiatively active species. The second important objective is to underscore major developments in the radiative forcing of climate due to the observed stratospheric ozone losses occurring between 1979 and 1990.

  12. Microcircuit radiation effects databank

    NASA Technical Reports Server (NTRS)

    1983-01-01

    This databank is the collation of radiation test data submitted by many testers and serves as a reference for engineers who are concerned with and have some knowledge of the effects of the natural radiation environment on microcircuits. It contains radiation sensitivity results from ground tests and is divided into two sections. Section A lists total dose damage information, and section B lists single event upset cross sections, I.E., the probability of a soft error (bit flip) or of a hard error (latchup).

  13. Radiation therapy in horses.

    PubMed

    Fidel, Janean L

    2010-04-01

    Although the diagnosis of cancer is relatively uncommon in horses, tumors do occur in this species. Surgery, radiation, and chemotherapy are traditional cancer treatments in all species. In equine patients, surgery has often been the only treatment offered; however, not all tumors can be controlled with surgery alone. In small animal oncology, newer and better therapies are in demand and available. Radiation therapy is often used to control or palliate tumors locally, especially to satisfy clients who demand sophisticated treatments. The large size of equine patients can make radiation therapy difficult, but it is a valuable tool for treating cancer and should not be overlooked when treating horses.

  14. Fast multilevel radiative transfer

    NASA Astrophysics Data System (ADS)

    Paletou, Frédéric; Léger, Ludovick

    2007-01-01

    The vast majority of recent advances in the field of numerical radiative transfer relies on approximate operator methods better known in astrophysics as Accelerated Lambda-Iteration (ALI). A superior class of iterative schemes, in term of rates of convergence, such as Gauss-Seidel and Successive Overrelaxation methods were therefore quite naturally introduced in the field of radiative transfer by Trujillo Bueno & Fabiani Bendicho (1995); it was thoroughly described for the non-LTE two-level atom case. We describe hereafter in details how such methods can be generalized when dealing with non-LTE unpolarised radiation transfer with multilevel atomic models, in monodimensional geometry.

  15. Composition for radiation shielding

    DOEpatents

    Kronberg, James W.

    1994-01-01

    A composition for use as a radiation shield. The shield has a depleted urum core for absorbing gamma rays and a bismuth coating for preventing chemical corrosion and absorbing gamma rays. Alternatively, a sheet of gadolinium may be positioned between the uranium core and the bismuth coating for absorbing neutrons. The composition is preferably in the form of a container for storing materials that emit radiation such as gamma rays and neutrons. The container is preferably formed by casting bismuth around a pre-formed uranium container having a gadolinium sheeting, and allowing the bismuth to cool. The resulting container is a structurally sound, corrosion-resistant, radiation-absorbing container.

  16. Miniaturized radiation chirper

    DOEpatents

    Umbarger, C. John; Wolf, Michael A.

    1980-01-01

    The disclosure relates to a miniaturized radiation chirper for use with a small battery supplying on the order of 5 volts. A poor quality CdTe crystal which is not necessarily suitable for high resolution gamma ray spectroscopy is incorporated with appropriate electronics so that the chirper emits an audible noise at a rate that is proportional to radiation exposure level. The chirper is intended to serve as a personnel radiation warning device that utilizes new and novel electronics with a novel detector, a CdTe crystal. The resultant device is much smaller and has much longer battery life than existing chirpers.

  17. Radiation physics, biophysics, and radiation biology

    NASA Astrophysics Data System (ADS)

    Hall, E. J.; Zaider, M.

    1990-05-01

    This annual report contains a summary of our current research. Some highlights include: experimental microdosimetry, track structure, extension of the Dual Radiation Action model to be time dependent, experiments showing that the reverse dose-rate effect for onogenic transformation, first rated for neutrons, has also been observed for charged particles of intermediate LET, an analysis of low dose-rate, research in hyperthermia, studies in molecular cloning, low dose rate studies, experimental studies on high LET, and molecular studies on DNA.

  18. Lecture on Thermal Radiation

    NASA Technical Reports Server (NTRS)

    Dennis, Brian R.

    2006-01-01

    This lecture will cover solar thermal radiation, particularly as it relates to the high energy solar processes that are the subject of this summer school. After a general review of thermal radiation from the Sun and a discussion of basic definitions, the various emission and absorption mechanisms will be described including black-body emission, bremsstrahlung, free-bound, and atomic line emissions of all kinds. The bulk of the time will be spent discussing the observational characteristics of thermal flare plasma and what can be learned about the flare energy release process from observations of the thermal radiation at all wavelengths. Information that has been learned about the morphology, temperature distribution, and composition of the flare plasma will be presented. The energetics of the thermal flare plasma will be discussed in relation to the nonthermal energy of the particles accelerated during the flare. This includes the total energy, the radiated and conductive cooling processes, and the total irradiated energy.

  19. Ionizing radiation detector

    DOEpatents

    Thacker, Louis H.

    1990-01-01

    An ionizing radiation detector is provided which is based on the principle of analog electronic integration of radiation sensor currents in the sub-pico to nano ampere range between fixed voltage switching thresholds with automatic voltage reversal each time the appropriate threshold is reached. The thresholds are provided by a first NAND gate Schmitt trigger which is coupled with a second NAND gate Schmitt trigger operating in an alternate switching state from the first gate to turn either a visible or audible indicating device on and off in response to the gate switching rate which is indicative of the level of radiation being sensed. The detector can be configured as a small, personal radiation dosimeter which is simple to operate and responsive over a dynamic range of at least 0.01 to 1000 R/hr.

  20. Radiation Therapy for Cancer

    MedlinePlus

    ... being studied as potential radioprotectors. The use of carbon ion beams in radiation therapy is being investigated ... time, the use of these beams remains experimental. Carbon ion beams are available at only a few ...

  1. Amorphous silicon radiation detectors

    DOEpatents

    Street, Robert A.; Perez-Mendez, Victor; Kaplan, Selig N.

    1992-01-01

    Hydrogenated amorphous silicon radiation detector devices having enhanced signal are disclosed. Specifically provided are transversely oriented electrode layers and layered detector configurations of amorphous silicon, the structure of which allow high electric fields upon application of a bias thereby beneficially resulting in a reduction in noise from contact injection and an increase in signal including avalanche multiplication and gain of the signal produced by incoming high energy radiation. These enhanced radiation sensitive devices can be used as measuring and detection means for visible light, low energy photons and high energy ionizing particles such as electrons, x-rays, alpha particles, beta particles and gamma radiation. Particular utility of the device is disclosed for precision powder crystallography and biological identification.

  2. Blackbody Radiation Tables

    DTIC Science & Technology

    at the indicated wavelength and temperature, Planck’s equation . This equation represents the monochromatic radiant intensity at a particular wavelength from a perfect radiator maintained at the indicated temperature.

  3. Radiation Exposure and Pregnancy

    MedlinePlus

    ... Gynecol 200(1):4-24; 2009. International Atomic Energy Agency. Pregnancy and radiation protection in diagnostic radiology, radiotherapy and nuclear medicine. 2010. Available at: http: / / rpop. iaea. org/ ...

  4. The Space Radiation Environment

    NASA Technical Reports Server (NTRS)

    Bourdarie, Sebastien; Xapsos, Michael A.

    2008-01-01

    The effects of the space radiation environment on spacecraft systems and instruments are significant design considerations for space missions. Astronaut exposure is a serious concern for manned missions. In order to meet these challenges and have reliable, cost-effective designs, the radiation environment must be understood and accurately modeled. The nature of the environment varies greatly between low earth orbits, higher earth orbits and interplanetary space. There are both short-term and long-term variations with the phase of the solar cycle. In this paper we concentrate mainly on charged particle radiations. Descriptions of the radiation belts and particles of solar and cosmic origin are reviewed. An overview of the traditional models is presented accompanied by their application areas and limitations. This is followed by discussion of some recent model developments.

  5. Radiation-Induced Bioradicals

    NASA Astrophysics Data System (ADS)

    Lahorte, Philippe; Mondelaers, Wim

    This chapter represents the second part of a review in which the production and application of radiation-induced radicals in biological matter are discussed. In part one the general aspects of the four stages (physical, physicochemical, chemical and biological) of interaction of radiation with matter in general and biological matter in particular, were discussed. Here an overview is presented of modem technologies and theoretical methods available for studying these radiation effects. The relevance is highlighted of electron paramagnetic resonance spectroscopy and quantum chemical calculations with respect to obtaining structural information on bioradicals, and a survey is given of the research studies in this field. We also discuss some basic aspects of modem accelerator technologies which can be used for creating radicals and we conclude with an overview of applications of radiation processing in biology and related fields such as biomedical and environmental engineering, food technology, medicine and pharmacy.

  6. Amorphous silicon radiation detectors

    DOEpatents

    Street, R.A.; Perez-Mendez, V.; Kaplan, S.N.

    1992-11-17

    Hydrogenated amorphous silicon radiation detector devices having enhanced signal are disclosed. Specifically provided are transversely oriented electrode layers and layered detector configurations of amorphous silicon, the structure of which allow high electric fields upon application of a bias thereby beneficially resulting in a reduction in noise from contact injection and an increase in signal including avalanche multiplication and gain of the signal produced by incoming high energy radiation. These enhanced radiation sensitive devices can be used as measuring and detection means for visible light, low energy photons and high energy ionizing particles such as electrons, x-rays, alpha particles, beta particles and gamma radiation. Particular utility of the device is disclosed for precision powder crystallography and biological identification. 13 figs.

  7. Volcanic Aerosol Radiative Properties

    NASA Technical Reports Server (NTRS)

    Lacis, Andrew

    2015-01-01

    Large sporadic volcanic eruptions inject large amounts of sulfur bearing gases into the stratosphere which then get photochemically converted to sulfuric acid aerosol droplets that exert a radiative cooling effect on the global climate system lasting for several years.

  8. Space radiation studies

    NASA Technical Reports Server (NTRS)

    Gregory, J. C.

    1986-01-01

    Instrument design and data analysis expertise was provided in support of several space radiation monitoring programs. The Verification of Flight Instrumentation (VFI) program at NASA included both the Active Radiation Detector (ARD) and the Nuclear Radiation Monitor (NRM). Design, partial fabrication, calibration and partial data analysis capability to the ARD program was provided, as well as detector head design and fabrication, software development and partial data analysis capability to the NRM program. The ARD flew on Spacelab-1 in 1983, performed flawlessly and was returned to MSFC after flight with unchanged calibration factors. The NRM, flown on Spacelab-2 in 1985, also performed without fault, not only recording the ambient gamma ray background on the Spacelab, but also recording radiation events of astrophysical significance.

  9. Nanotechnology in radiation oncology.

    PubMed

    Wang, Andrew Z; Tepper, Joel E

    2014-09-10

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology.

  10. Radiation Therapy (For Parents)

    MedlinePlus

    ... temporary, it can be permanent. Sore Mouth and Tooth Decay The tissues of the mouth may be sore ... and there may be an increased risk of tooth decay if a child received radiation therapy to the ...

  11. Portal radiation monitor

    DOEpatents

    Kruse, L.W.

    1982-03-23

    A portal radiation monitor combines .1% FAR with high sensitivity to special nuclear material. The monitor utilizes pulse shape discrimination, dynamic compression of the photomultiplier output and scintillators sized to maintain efficiency over the entire portal area.

  12. Portal radiation monitor

    DOEpatents

    Kruse, Lyle W.

    1985-01-01

    A portal radiation monitor combines 0.1% FAR with high sensitivity to special nuclear material. The monitor utilizes pulse shape discrimination, dynamic compression of the photomultiplier output and scintillators sized to maintain efficiency over the entire portal area.

  13. Tin Can Radiation Detector.

    ERIC Educational Resources Information Center

    Crull, John L.

    1986-01-01

    Provides instructions for making tin can radiation detectors from empty aluminum cans, aluminum foil, clear plastic, copper wire, silica gel, and fine, unwaxed dental floss put together with tape or glue. Also provides suggestions for activities using the detectors. (JN)

  14. GEWEX Radiative Flux Assessment

    Atmospheric Science Data Center

    2016-05-20

    ... climate components (atmosphere, ocean, land, cryosphere, biosphere). The GEWEX Radiative Flux Assessment (RFA) project will provide a ... Spatial Coverage: (-20.45, -2.43)(-62.87, -47.90) Full Product Page ...

  15. Nanotechnology in Radiation Oncology

    PubMed Central

    Wang, Andrew Z.; Tepper, Joel E.

    2014-01-01

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology. PMID:25113769

  16. Radiation and Society

    ERIC Educational Resources Information Center

    Shaw, Edward I.

    1974-01-01

    Presents a discussion of the risks, to society, from radiation-associated technologies and urges that science teachers help the public understand the decision-making process relative to nuclear power as well as the problems and alternatives. (PEB)

  17. Radiation detection system

    DOEpatents

    Whited, R.C.

    A system for obtaining improved resolution in relatively thick semiconductor radiation detectors, such as HgI/sub 2/, which exhibit significant hole trapping. Two amplifiers are used: the first measures the charge collected and the second the contribution of the electrons to the charge collected. The outputs of the two amplifiers are utilized to unfold the total charge generated within the detector in response to a radiation event.

  18. Radiative transfer dynamo effect

    NASA Astrophysics Data System (ADS)

    Munirov, Vadim R.; Fisch, Nathaniel J.

    2017-01-01

    Magnetic fields in rotating and radiating astrophysical plasma can be produced due to a radiative interaction between plasma layers moving relative to each other. The efficiency of current drive, and with it the associated dynamo effect, is considered in a number of limits. It is shown here, however, that predictions for these generated magnetic fields can be significantly higher when kinetic effects, previously neglected, are taken into account.

  19. Auditing radiation sterilization facilities

    NASA Astrophysics Data System (ADS)

    Beck, Jeffrey A.

    The diversity of radiation sterilization systems available today places renewed emphasis on the need for thorough Quality Assurance audits of these facilities. Evaluating compliance with Good Manufacturing Practices is an obvious requirement, but an effective audit must also evaluate installation and performance qualification programs (validation_, and process control and monitoring procedures in detail. The present paper describes general standards that radiation sterilization operations should meet in each of these key areas, and provides basic guidance for conducting QA audits of these facilities.

  20. Radiative transfer dynamo effect

    DOE PAGES

    Munirov, Vadim R.; Fisch, Nathaniel J.

    2017-01-17

    Here, magnetic fields in rotating and radiating astrophysical plasma can be produced due to a radiative interaction between plasma layers moving relative to each other. The efficiency of current drive, and with it the associated dynamo effect, is considered in a number of limits. It is shown here, however, that predictions for these generated magnetic fields can be significantly higher when kinetic effects, previously neglected, are taken into account.

  1. Myelopathy with syringomyelia following thoracic epidural anaesthesia.

    PubMed

    Aldrete, J A; Ferrari, H

    2004-02-01

    Under general anaesthesia and muscle relaxation, a thoracic epidural catheter was inserted at the T8-T9 level in a 7-year-old boy scheduled to have a Nissen fundoplication to provide postoperative analgesia. After 4 ml of lignocaine 1.5% was injected through the catheter, hypotension resulted. Fifty-five minutes later 5 ml of bupivacaine 0.25% produced the same effect. In the recovery room a similar injection resulted in lower blood pressure and temporary apnoea. Sensory and motor deficits were noted the next day and four days later magnetic resonance imaging demonstrated spinal cord syringomyelia extending from T5 to T10. Four years later, dysaesthesia from T6 to T10 weakness of the left lower extremity and bladder and bowel dysfunction persist. The risks of inserting thoracic epidural catheters in patients under general anaesthesia and muscle relaxation are discussed, emphasising the possibility of spinal cord injury with disastrous consequences.

  2. Method of enhancing radiation response of radiation detection materials

    DOEpatents

    Miller, Steven D.

    1997-01-01

    The present invention is a method of increasing radiation response of a radiation detection material for a given radiation signal by first pressurizing the radiation detection material. Pressurization may be accomplished by any means including mechanical and/or hydraulic. In this application, the term "pressure" includes fluid pressure and/or mechanical stress.

  3. Packet personal radiation monitor

    DOEpatents

    Phelps, James E.

    1989-01-01

    A personal radiation monitor of the chirper type is provided for detecting ionizing radiation. A battery powered high voltage power supply is used to generate and apply a high voltage bias to a G-M tube radiation sensor. The high voltage is monitored by a low-loss sensing network which generates a feedback signal to control the high voltage power supply such that the high voltage bias is recharged to +500 VDC when the current pulses of the sensor, generated by the detection of ionizing radiation events, discharges the high voltage bias to +450 VDC. During the high voltage recharge period an audio transducer is activated to produce an audible "chirp". The rate of the "chirps" is controlled by the rate at which the high voltage bias is recharged, which is proportional to the radiation field intensity to which the sensor is exposed. The chirp rate sensitivity is set to be approximately 1.5 (chirps/min/MR/hr.). The G-M tube sensor is used in a current sensing mode so that the device does not paralyze in a high radiation field.

  4. Radiator Design and Installation

    NASA Technical Reports Server (NTRS)

    Brevoort, M.J.; Leifer, M.

    1939-01-01

    The fundamental principles of fluid flow, pressure losses, and heat transfer have been presented and analyzed for the case of a smooth tube with fully developed turbulent flow. These equations apply to tubes with large length-diameter ratios where the f1ow is at a high Reynolds Number. The error introduced by using these equations increases as the magnitude of the tube length and the air-flow Reynolds Number approaches the values encountered in modern radiator designs. Accordingly, heat-transfer tests on radiator sections were made and the results are presented in nondimensional form to facilitate their use and for comparison with other heat-transfer data. In addition, pressure losses were measured along smooth tubes of circular, square, and rectangular cross section and the results were also correlated and are presented in nondimensional form. The problem of a radiator design for a particular installation is solved, the experimental heat-transfer and pressure-loss data being used, on a basis of power chargeable to the radiator for form drag, for propelling the weight, and for forcing the air through the radiator. The case of an installation within a wing or an engine nacelle is considered. An illustration of radiator design is carried through for an arbitrary set of conditions. Sufficient detail is given to enable the reader to reproduce the analysis for any given case.

  5. Antarctic radiation exposure doubles

    NASA Astrophysics Data System (ADS)

    Blue, Charles

    New data reveal that the Antarctic Peninsula received twice its normal maximum dose of hazardous solar ultraviolet radiation in December 1990. The prolonged persistence of the ozone hole over Antarctica caused an increased exposure of radiation, according to a paper published in the October issue of Geophysical Research Letters.John Frederick and Amy D. Alberts of the University of Chicago calculated the amount of ultraviolet solar spectral radiation from data collected at Palmer Station, Antarctica. During the spring of 1990 the largest observed values for ultraviolet radiation were approximately double the values expected, based on previous years. “The measurements from Palmer Station are consistent with similar data from McMurdo Sound, where a factor of three [ultraviolet radiation] enhancement was recorded, according to work by Knut Stamnes and colleagues at the University of Alaska,” Frederick said. “The radiation levels observed over Palmer Station in December 1990 may be the largest experienced in this region of the world since the development of the Earth's ozone layer,” he added.

  6. Fabric space radiators

    SciTech Connect

    Antoniak, Z.I.; Krotiuk, W.J.; Webb, B.J.; Prater, J.T.; Bates, J.M.

    1988-01-01

    Future Air Force space missions will require thermal radiators that both survive in the hostile space environment and stow away for minimal bulk during launch. Advances in all aspects of radiator design, construction, and analysis will be necessary to enable such future missions. Currently, the best means for obtaining high strength along with flexibility is through structures known as fabrics. The development of new materials and bonding techniques has extended the application range of fabrics into areas traditionally dominated by monolithic and/or metallic structures. Given that even current spacecraft heat rejection considerations tend to dominate spacecraft design and mass, the larger and more complex designs of the future face daunting challenges in thermal control. Ceramic fabrics bonded to ultra-thin metal liners (foils) have the potential of achieving radiator performance levels heretofore unattainable, and of readily matching the advances made in other branches of spacecraft design. The research effort documented here indicates that both pumped loops and heat pipes constructed in ceramic fabrics stand to benefit in multiple ways. Flexibility and low mass are the main advantages exhibited by fabric radiators over conventional metal ones. We feel that fabric radiators have intrinsic merits not possessed by any other radiator design and need to be researched further. 26 refs., 16 figs., 17 tabs.

  7. Electrostatic space radiation shielding

    NASA Astrophysics Data System (ADS)

    Tripathi, Ram K.; Wilson, John W.; Youngquist, Robert C.

    2008-09-01

    For the success of NASA’s new vision for space exploration to Moon, Mars and beyond, exposures from the hazards of severe space radiation in deep space long duration missions is ‘a must solve’ problem. The payload penalty demands a very stringent requirement on the design of the spacecrafts for human deep space missions. The exploration beyond low Earth orbit (LEO) to enable routine access of space will require protection from the hazards of the accumulated exposures of space radiation, Galactic Cosmic Rays (GCR) and Solar Particle Events (SPE), and minimizing the production of secondary radiation is a great advantage. There is a need to look to new horizons for newer technologies. The present investigation revisits electrostatic active radiation shielding and explores the feasibility of using the electrostatic shielding in concert with the state-of-the-art materials shielding and protection technologies. The full space radiation environment has been used, for the first time, to explore the feasibility of electrostatic shielding. The goal is to repel enough positive charge ions so that they miss the spacecraft without attracting thermal electrons. Conclusions are drawn for the future directions of space radiation protection.

  8. Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles.

    PubMed

    Dörr, Harald; Meineke, Viktor

    2011-11-25

    Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the absorbed radiation dose and its distribution. Multi-organ-involvement and multi-organ-failure need be taken into account. The most vulnerable organ system to radiation exposure is the hematopoietic system. In addition to hematopoietic syndrome, radiation induced damage to the skin plays an important role in diagnostics and the treatment of radiation accident victims. The most important therapeutic principles with special reference to hematopoietic syndrome and cutaneous radiation syndrome are reviewed.

  9. Radiation analysis devices, radiation analysis methods, and articles of manufacture

    DOEpatents

    Roybal, Lyle Gene

    2010-06-08

    Radiation analysis devices include circuitry configured to determine respective radiation count data for a plurality of sections of an area of interest and combine the radiation count data of individual of sections to determine whether a selected radioactive material is present in the area of interest. An amount of the radiation count data for an individual section is insufficient to determine whether the selected radioactive material is present in the individual section. An article of manufacture includes media comprising programming configured to cause processing circuitry to perform processing comprising determining one or more correction factors based on a calibration of a radiation analysis device, measuring radiation received by the radiation analysis device using the one or more correction factors, and presenting information relating to an amount of radiation measured by the radiation analysis device having one of a plurality of specified radiation energy levels of a range of interest.

  10. Gravitational radiation resistance, radiation damping and field fluctuations

    NASA Astrophysics Data System (ADS)

    Schaefer, G.

    1981-03-01

    Application is made of two different generalized fluctuation-dissipation theorems and their derivations to the calculation of the gravitational quadrupole radiation resistance using the radiation-reaction force given by Misner, Thorne and Wheeler and the usual tidal force on one hand and the tidal force and the free gravitational radiation field on the other hand. The quantum-mechanical version (including thermal generalizations) of the well known classical quadrupole radiation damping formula is obtained as a function of the radiation resistance.

  11. Radiation nephritis causing nephrotic syndrome

    SciTech Connect

    Jennette, J.C.; Ordonez, N.G.

    1983-12-01

    Clinical symptoms of acute radiation nephritis with nephrotic syndrome developed in a fifty-six-year-old woman after abdominal radiation therapy for an astrocytoma of the spinal cord. The diagnosis of radiation nephritis was confirmed by renal biopsy. To our knowledge, this is the first documented case of radiation nephritis associated with nephrotic syndrome.

  12. Interaction of Radiation with Matter

    SciTech Connect

    Rickards, J.

    2010-09-10

    A flash introductory course in the interaction of ionizing radiation with matter is presented for students starting out in nuclear physics, medical applications of radiation, materials modification, radiation damage, detectors, materials analysis, radiation protection, and other applications. Emphasis is on defining basic concepts and on a simple visualization of ideas for practical applications, rather than on completeness or rigor.

  13. Radiation Sensitization in Cancer Therapy.

    ERIC Educational Resources Information Center

    Greenstock, Clive L.

    1981-01-01

    Discusses various aspects of radiation damage to biological material, including free radical mechanisms, radiation sensitization and protection, tumor hypoxia, mechanism of hypoxic cell radiosensitization, redox model for radiation modification, sensitizer probes of cellular radiation targets, pulse radiolysis studies of free radical kinetics,…

  14. Ionizing radiation bioeffects and risks

    SciTech Connect

    1992-12-31

    Radiation protection requires an understanding of the prompt and long-term biological effects of radiation and numerical estimates of radiation risks. This chapter presents the characteristics of the ``acute radiation syndrome`` which can occur if an individual is exposed to high doses of radiation, and the effects of high levels of radiation on the skin. It also describes the long term bioeffects of low levels of low LET radiation on individuals and the whole population. These risks are quantified and are put in perspective by comparison to other societal hazards.

  15. Radiation health research, 1986 - 1990

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A collection of 225 abstracts of radiation research sponsored by NASA during the period 1986 through 1990 is reported. Each abstract was categorized within one of four discipline areas: physics, biology, risk assessment, and microgravity. Topic areas within each discipline were assigned as follows: Physics - atomic physics, nuclear science, space radiation, radiation transport and shielding, and instrumentation; Biology - molecular biology, cellular radiation biology, tissue, organs and organisms, radioprotectants, and plants; Risk assessment - radiation health and epidemiology, space flight radiation health physics, inter- and intraspecies extrapolation, and radiation limits and standards; and Microgravity. When applicable subareas were assigned for selected topic areas. Keywords and author indices are provided.

  16. Radiation in Particle Simulations

    SciTech Connect

    More, R; Graziani, F; Glosli, J; Surh, M

    2010-11-19

    Hot dense radiative (HDR) plasmas common to Inertial Confinement Fusion (ICF) and stellar interiors have high temperature (a few hundred eV to tens of keV), high density (tens to hundreds of g/cc) and high pressure (hundreds of megabars to thousands of gigabars). Typically, such plasmas undergo collisional, radiative, atomic and possibly thermonuclear processes. In order to describe HDR plasmas, computational physicists in ICF and astrophysics use atomic-scale microphysical models implemented in various simulation codes. Experimental validation of the models used to describe HDR plasmas are difficult to perform. Direct Numerical Simulation (DNS) of the many-body interactions of plasmas is a promising approach to model validation but, previous work either relies on the collisionless approximation or ignores radiation. We present four methods that attempt a new numerical simulation technique to address a currently unsolved problem: the extension of molecular dynamics to collisional plasmas including emission and absorption of radiation. The first method applies the Lienard-Weichert solution of Maxwell's equations for a classical particle whose motion is assumed to be known. The second method expands the electromagnetic field in normal modes (planewaves in a box with periodic boundary-conditions) and solves the equation for wave amplitudes coupled to the particle motion. The third method is a hybrid molecular dynamics/Monte Carlo (MD/MC) method which calculates radiation emitted or absorbed by electron-ion pairs during close collisions. The fourth method is a generalization of the third method to include small clusters of particles emitting radiation during close encounters: one electron simultaneously hitting two ions, two electrons simultaneously hitting one ion, etc. This approach is inspired by the virial expansion method of equilibrium statistical mechanics. Using a combination of these methods we believe it is possible to do atomic-scale particle simulations of

  17. Bile Duct (Cholangiocarcinoma) Cancer: Radiation Therapy

    MedlinePlus

    ... Situation Bile Duct Cancer Treating Bile Duct Cancer Radiation Therapy for Bile Duct Cancer Radiation therapy uses ... of radiation for bile duct cancer. External beam radiation therapy (EBRT) This type of radiation therapy uses ...

  18. Radiation delivery system and method

    DOEpatents

    Sorensen, Scott A.; Robison, Thomas W.; Taylor, Craig M. V.

    2002-01-01

    A radiation delivery system and method are described. The system includes a treatment configuration such as a stent, balloon catheter, wire, ribbon, or the like, a portion of which is covered with a gold layer. Chemisorbed to the gold layer is a radiation-emitting self-assembled monolayer or a radiation-emitting polymer. The radiation delivery system is compatible with medical catheter-based technologies to provide a therapeutic dose of radiation to a lesion following an angioplasty procedure.

  19. Status of LDEF radiation modeling

    NASA Technical Reports Server (NTRS)

    Watts, John W.; Armstrong, T. W.; Colborn, B. L.

    1995-01-01

    The current status of model prediction and comparison with LDEF radiation dosimetry measurements is summarized with emphasis on major results obtained in evaluating the uncertainties of present radiation environment model. The consistency of results and conclusions obtained from model comparison with different sets of LDEF radiation data (dose, activation, fluence, LET spectra) is discussed. Examples where LDEF radiation data and modeling results can be utilized to provide improved radiation assessments for planned LEO missions (e.g., Space Station) are given.

  20. AREA RADIATION MONITOR

    DOEpatents

    Manning, F.W.; Groothuis, S.E.; Lykins, J.H.; Papke, D.M.

    1962-06-12

    S>An improved area radiation dose monitor is designed which is adapted to compensate continuously for background radiation below a threshold dose rate and to give warning when the dose integral of the dose rate of an above-threshold radiation excursion exceeds a selected value. This is accomplished by providing means for continuously charging an ionization chamber. The chamber provides a first current proportional to the incident radiation dose rate. Means are provided for generating a second current including means for nulling out the first current with the second current at all values of the first current corresponding to dose rates below a selected threshold dose rate value. The second current has a maximum value corresponding to that of the first current at the threshold dose rate. The excess of the first current over the second current, which occurs above the threshold, is integrated and an alarm is given at a selected integrated value of the excess corresponding to a selected radiation dose. (AEC)

  1. Packet personal radiation monitor

    DOEpatents

    Phelps, J.E.

    1988-03-31

    A personal radiation monitor of the chirper type is provided for detecting ionizing radiation. A battery powered high voltage power supply is used to generate and apply a high voltage bias to a G-M tube radiation sensor. The high voltage is monitored by a low-loss sensing network which generates a feedback signal to control the high voltage power supply such that the high voltage bias is recharged to +500 VDC when the current pulses of the sensor, generated by the detection of ionizing radiatonevents, discharges the high voltage bias to +450 VDC. During the high voltage recharge period an audio transducer is activated to produce an audible ''chirp''. The rate of the ''chirps'' is controlled by the rate at which the high voltage bias is recharged, which is proportional to the radiation field intensity to which the sensor is exposed. The chirp rate sensitivity is set to be approximately 1.5 (chirps/min/MR/hr.). The G-M tube sensor is used in a current sensing mode so that the device does not paralyze in a high radiation field. 2 figs.

  2. Remote radiation dosimetry

    DOEpatents

    Braunlich, Peter F.; Tetzlaff, Wolfgang; Hegland, Joel E.; Jones, Scott C.

    1991-01-01

    Disclosed are methods and apparatus for remotely measuring radiation levels. Such are particularly useful for measuring relatively high levels or dosages of radiation being administered in radiation therapy. They are also useful for more general radiation level measurements where remote sensing from the remaining portions of the apparatus is desirable. The apparatus uses a beam generator, such as a laser beam, to provide a stimulating beam. The stimulating beam is preferably of wavelengths shorter than 6 microns, or more advantageously less than 2 microns. The stimulating beam is used to stimulate a remote luminescent sensor mounted in a probe which emits stored luminescent energy resulting from exposure of the sensor to ionizing radiation. The stimulating beam is communicated to the remote luminescent sensor via transmissive fiber which also preferably serves to return the emission from the luminescent sensor. The stimulating beam is advantageously split by a beam splitter to create a detector beam which is measured for power during a reading period during which the luminescent phosphor is read. The detected power is preferably used to control the beam generator to thus produce desired beam power during the reading period. The luminescent emission from the remote sensor is communicated to a suitable emission detector, preferably after filtering or other selective treatment to better isolate the luminescent emission.

  3. Remote radiation dosimetry

    DOEpatents

    Braunlich, P.F.; Tetzlaff, W.; Hegland, J.E.; Jones, S.C.

    1991-03-12

    Disclosed are methods and apparatus for remotely measuring radiation levels. Such are particularly useful for measuring relatively high levels or dosages of radiation being administered in radiation therapy. They are also useful for more general radiation level measurements where remote sensing from the remaining portions of the apparatus is desirable. The apparatus uses a beam generator, such as a laser beam, to provide a stimulating beam. The stimulating beam is preferably of wavelengths shorter than 6 microns, or more advantageously less than 2 microns. The stimulating beam is used to stimulate a remote luminescent sensor mounted in a probe which emits stored luminescent energy resulting from exposure of the sensor to ionizing radiation. The stimulating beam is communicated to the remote luminescent sensor via a transmissive fiber which also preferably serves to return the emission from the luminescent sensor. The stimulating beam is advantageously split by a beam splitter to create a detector beam which is measured for power during a reading period during which the luminescent phosphor is read. The detected power is preferably used to control the beam generator to thus produce desired beam power during the reading period. The luminescent emission from the remote sensor is communicated to a suitable emission detector, preferably after filtering or other selective treatment to better isolate the luminescent emission. 8 figures.

  4. Lunar radiator shade

    NASA Technical Reports Server (NTRS)

    Ewert, Michael K. (Inventor)

    1992-01-01

    An apparatus for rejecting waste heat from a system located on or near the lunar equator is presented. The system utilizes a reflective catenary shaped trough deployed about a vertical radiator to shade the radiator from heat emitted by the hot lunar surface. The catenary shaped trough is constructed from a film material and is aligned relative to the sun so that incoming solar energy is focused to a line just above the vertical radiator and can thereby isolate the radiator from the effects of direct sunlight. The film is in a collapsed position between side by side support rods, all of which are in a transport case. To deploy the film and support rods, a set of parallel tracks running perpendicular to length of the support rods are extended out from the transport case. After the support tracks are deployed, the support rods are positioned equidistant from each other along the length of the support tracks so that the flexible film shade between adjacent support rods is unfolded and hangs in a catenary shaped trough. A heat radiator is supported between each pair of support rods above each hanging reflective trough.

  5. Ionizing radiation and life.

    PubMed

    Dartnell, Lewis R

    2011-01-01

    Ionizing radiation is a ubiquitous feature of the Cosmos, from exogenous cosmic rays (CR) to the intrinsic mineral radioactivity of a habitable world, and its influences on the emergence and persistence of life are wide-ranging and profound. Much attention has already been focused on the deleterious effects of ionizing radiation on organisms and the complex molecules of life, but ionizing radiation also performs many crucial functions in the generation of habitable planetary environments and the origins of life. This review surveys the role of CR and mineral radioactivity in star formation, generation of biogenic elements, and the synthesis of organic molecules and driving of prebiotic chemistry. Another major theme is the multiple layers of shielding of planetary surfaces from the flux of cosmic radiation and the various effects on a biosphere of violent but rare astrophysical events such as supernovae and gamma-ray bursts. The influences of CR can also be duplicitous, such as limiting the survival of surface life on Mars while potentially supporting a subsurface biosphere in the ocean of Europa. This review highlights the common thread that ionizing radiation forms between the disparate component disciplines of astrobiology.

  6. Radiative Forcing by Contrails

    NASA Technical Reports Server (NTRS)

    Meerkoetter, R.; Schumann, U.; Doelling, D. R.; Nakajima, T.; Tsushima, Y.

    1999-01-01

    A parametric study of the instantaneous radiative impact of contrails is presented using three different radiative transfer models for a series of model atmospheres and cloud parameters. Contrails are treated as geometrically and optically thin plane parallel homogeneous cirrus layers in a static atmospheres The ice water content is varied as a function of ambient temperature. The model atmospheres include tropical, mid-latitude, and subarctic summer and winter atmospheres Optically thin contrails cause a positive net forcing at top of the atmosphere. At the surface the radiative forcing is negative during daytime. The forcing increases with the optical depth and the amount of contrail cover. At the top of the atmosphere a mean contrail cover of 0.1% with average optical depth of 0.2 to 0.5 causes about 0.01 to 0.03 W/m(exp 2)a daily mean instantaneous radiative forcing. Contrails cool the surface during the day and heat the surface during the night, and hence reduce the daily temperature amplitude The net effect depends strongly on the daily variation of contrail cloud cover. The indirect radiative forcing due to particle changes in natural cirrus clouds may be of the same magnitude as the direct one due to additional cover.

  7. Reducing Radiation Damage

    SciTech Connect

    Blankenbecler, Richard

    2006-06-05

    This talk describes the use of a modified treatment sequence, i.e., radiation dose, geometry, dwell time, etc., to mitigate some of the deleterious effects of cancer radiotherapy by utilizing natural cell repair processes. If bad side effects can be reduced, a more aggressive therapy can be put into place. Cells contain many mechanisms that repair damage of various types. If the damage can not be repaired, cells will undergo apoptosis (cell death). Data will be reviewed that support the fact that a small dose of radiation will activate damage repair genes within a cell. Once the mechanisms are fully active, they will efficiently repair the severe damage from a much larger radiation dose. The data ranges from experiments on specific cell cultures using microarray (gene chip) techniques to experiments on complete organisms. The suggested effect and treatment is consistent with the assumption that all radiation is harmful, no matter how small the dose. Nevertheless, the harm can be reduced. These mechanisms need to be further studied and characterized. In particular, their time dependence needs to be understood before the proposed treatment can be optimized. Under certain situations it is also possible that the deleterious effects of chemotherapy can be mitigated and the damage to radiation workers can be reduced.

  8. Radiation from Relativistic Jets

    NASA Technical Reports Server (NTRS)

    Nishikawa, K.-I.; Mizuno, Y.; Hardee, P.; Sol, H.; Medvedev, M.; Zhang, B.; Nordlund, A.; Frederiksen, J. T.; Fishman, G. J.; Preece, R.

    2008-01-01

    Nonthermal radiation observed from astrophysical systems containing relativistic jets and shocks, e.g., gamma-ray bursts (GRBs), active galactic nuclei (AGNs), and Galactic microquasar systems usually have power-law emission spectra. Recent PIC simulations of relativistic electron-ion (electron-positron) jets injected into a stationary medium show that particle acceleration occurs within the downstream jet. In the presence of relativistic jets, instabilities such as the Buneman instability, other two-streaming instability, and the Weibel (filamentation) instability create collisionless shocks, which are responsible for particle (electron, positron, and ion) acceleration. The simulation results show that the Weibel instability is responsible for generating and amplifying highly nonuniform, small-scale magnetic fields. These magnetic fields contribute to the electron's transverse deflection behind the jet head. The 'jitter' radiation from deflected electrons in small-scale magnetic fields has different properties than synchrotron radiation which is calculated in a uniform magnetic field. This jitter radiation, a case of diffusive synchrotron radiation, may be important to understand the complex time evolution and/or spectral structure in gamma-ray bursts, relativistic jets, and supernova remnants.

  9. Radiation techniques for acromegaly

    PubMed Central

    2011-01-01

    Radiotherapy (RT) remains an effective treatment in patients with acromegaly refractory to medical and/or surgical interventions, with durable tumor control and biochemical remission; however, there are still concerns about delayed biochemical effect and potential late toxicity of radiation treatment, especially high rates of hypopituitarism. Stereotactic radiotherapy has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. Radiation can be delivered in a single fraction by stereotactic radiosurgery (SRS) or as fractionated stereotactic radiotherapy (FSRT) in which smaller doses are delivered over 5-6 weeks in 25-30 treatments. A review of the recent literature suggests that pituitary irradiation is an effective treatment for acromegaly. Stereotactic techniques for GH-secreting pituitary tumors are discussed with the aim to define the efficacy and potential adverse effects of each of these techniques. PMID:22136376

  10. Solar cell radiation handbook

    NASA Technical Reports Server (NTRS)

    Tada, H. Y.; Carter, J. R., Jr.; Anspaugh, B. E.; Downing, R. G.

    1982-01-01

    The handbook to predict the degradation of solar cell electrical performance in any given space radiation environment is presented. Solar cell theory, cell manufacturing and how they are modeled mathematically are described. The interaction of energetic charged particles radiation with solar cells is discussed and the concept of 1 MeV equivalent electron fluence is introduced. The space radiation environment is described and methods of calculating equivalent fluences for the space environment are developed. A computer program was written to perform the equivalent fluence calculations and a FORTRAN listing of the program is included. Data detailing the degradation of solar cell electrical parameters as a function of 1 MeV electron fluence are presented.

  11. [Acute radiation injury].

    PubMed

    Saito, Tsutomu

    2012-03-01

    Cell death due to DNA damage by ionizing radiation causes acute radiation injury of tissues and organs. Frequency and severity of the injuries increase according to dose increase, when the dose becomes more than threshold dose. The threshold dose of acute human radiation death is 1 Gy and LD50 of human is 4 Gy. Human dies due to the cerebrovascular syndrome, the gastrointestinal syndrome or the hematopoetic syndrome, when he received more than 20 Gy, 10-20 Gy or 3-8 Gy to his total body, respectively. Any tissue or organ, including embryo and fetus, does not show the acute injury, when it received less than 100 mSv. Acute injuries are usually reversible, and late injuries are sometimes irreversible.

  12. Jupiter's radiation belts.

    NASA Technical Reports Server (NTRS)

    Brice, N.; Mcdonough, T. R.

    1973-01-01

    A model for the production and loss of energetic electrons in Jupiter's radiation belt is presented. It is postulated that the electrons originate in the solar wind and are diffused in toward the planet by perturbations which violate the particles' third adiabatic invariant. At large distances, magnetic perturbations, electric fields associated with magnetospheric convection, or interchange instabilities driven by thermal plasma gradients may drive the diffusion. Inside about 10 Jupiter radii, the diffusion is probably driven by electric fields associated with the upper atmosphere dynamo which is driven by neutral winds in the ionosphere. The diurnal component of the dynamo wind fields produces a dawn-dusk asymmetry in the decimetric radiation from the electrons in the belts, and the lack of obvious measured asymmetries in the decimetric radiation measurements provides estimates of upper limits for these Jovian ionospheric neutral winds.

  13. Radiation exposure during ureteroscopy

    SciTech Connect

    Bagley, D.H.; Cubler-Goodman, A. )

    1990-12-01

    Use of fluoroscopy during ureteroscopy increases the risk of radiation exposure to the urologist and patient. Radiation entrance dosages were measured at skin level in 37 patients, and at the neck, trunk and finger of the urologist, and neck and trunk of the circulating nurse. Radiation exposure time was measured in 79 patients, and was related to the purpose of the procedure and the type of ureteroscope used, whether rigid or flexible. Exposure could be minimized by decreasing the fluoroscopy time. A portable C-arm fluoroscopy unit with electronic imaging and last image hold mode should be used to minimize exposure time. Lead aprons and thyroid shields should be used by the urologist and other personnel in the endoscopy room.

  14. Composition for radiation shielding

    DOEpatents

    Kronberg, J.W.

    1994-08-02

    A composition for use as a radiation shield is disclosed. The shield has a depleted uranium core for absorbing gamma rays and a bismuth coating for preventing chemical corrosion and absorbing gamma rays. Alternatively, a sheet of gadolinium may be positioned between the uranium core and the bismuth coating for absorbing neutrons. The composition is preferably in the form of a container for storing materials that emit radiation such as gamma rays and neutrons. The container is preferably formed by casting bismuth around a pre-formed uranium container having a gadolinium sheeting, and allowing the bismuth to cool. The resulting container is a structurally sound, corrosion-resistant, radiation-absorbing container. 2 figs.

  15. Audible radiation monitor

    DOEpatents

    Odell, Daniel M. C.

    1993-01-01

    A method and apparatus for monitoring ionizing radiation comprising radiation detectors in electrical connection with an isotopic analyzer and a device for producing chords to which each isotope is mapped so that the device produces a unique chord for each isotope. Preferably the chords are pleasing to the ear, except for chords representing unexpected isotopes, and are louder or softer depending on the level of radioactivity produced by each isotope, and musical instrument voices may be simulated in producing the chords as an aid to distinguishing similar-sounding chords. Because of the representation by chords, information regarding the level and composition of the radiation in an area can be conveyed to workers in that area more effectively and yet without distracting them.

  16. Radiation Protection in Canada

    PubMed Central

    Duggan, H. E.

    1964-01-01

    Factors that may reduce the dose of radiation, from diagnostic and therapeutic x-ray procedures, to the patient and to the occupational and non-occupational worker are outlined. Suitable basic radiation measuring apparatus is described. It is recommended that, in diagnostic radiography, relatively high kilovoltage, proper cones, collimation and adequate filtration be used. Some specific recommendations are made concerning fluoroscopic, photoroentgen and portable x-ray examinations. Film monitoring of personnel is advisable. Examples are given of protective devices to lessen the dosage to the occupational worker. It is the responsibility of the radiologist or physician in charge to ensure that the x-ray equipment is safe to operate and the radiation dose to the patient is kept to a minimum. The roentgen output for all radiographic examinations should be known by the responsible user. ImagesFig. 2Fig. 3Fig. 4Fig. 5 PMID:14199820

  17. String radiative backreaction

    SciTech Connect

    Battye, R.A.; Shellard, E.P. |

    1995-12-01

    We discuss radiative backreaction for global strings described by the Kalb-Ramond action with an analogous derivation to that for the point electron in classical electrodynamics. We show how local corrections to the equations of motion allow one to separate the self-field of the string from that of the radiation field. Modifications to this {open_quote}{open_quote}local backreaction approximation{close_quote}{close_quote} circumvent the runaway solutions, allowing these corrections to be used to evolve string trajectories numerically. Comparisons are made with analytic and numerical radiation calculations from previous work and the merits and limitations of this approach are discussed. {copyright} {ital 1995 The American Physical Society.}

  18. Radiation Protection in Canada

    PubMed Central

    Brown, John R.; Jarvis, Anita A.

    1964-01-01

    A recent survey was carried out with respect to radiobiological and radiological health projects in Canada. Letters of inquiry, followed by two questionnaires, were sent out to every institution where radiation research was likely to have been undertaken. Approximately 75% of those contacted replied. Of the total of 200 studies, 84% were classified as biological and medical studies, the remaining 16% as environmental radiation studies. Responses to the inquiry stressed the inadequacy of the present governmental budget for radiation research, the need for higher salaries for research workers, and the necessity of a more intensive teaching program for technicians and professional personnel. The granting of longer-term grants, rather than annually renewable grants, is urged. PMID:14226104

  19. Radiation Induced Oral Mucositis

    PubMed Central

    PS, Satheesh Kumar; Balan, Anita; Sankar, Arun; Bose, Tinky

    2009-01-01

    Patients receiving radiotherapy or chemotherapy will receive some degree of oral mucositis The incidence of oral mucositis was especially high in patients: (i) With primary tumors in the oral cavity, oropharynx, or nasopharynx; (ii) who also received concomitant chemotherapy; (iii) who received a total dose over 5,000 cGy; and (iv) who were treated with altered fractionation radiation schedules. Radiation-induced oral mucositis affects the quality of life of the patients and the family concerned. The present day management of oral mucositis is mostly palliative and or supportive care. The newer guidelines are suggesting Palifermin, which is the first active mucositis drug as well as Amifostine, for radiation protection and cryotherapy. The current management should focus more on palliative measures, such as pain management, nutritional support, and maintenance, of good oral hygiene PMID:20668585

  20. Aerothermodynamic radiation studies

    NASA Technical Reports Server (NTRS)

    Donohue, K.; Reinecke, W. G.; Rossi, D.; Marinelli, W. J.; Krech, R. H.; Caledonia, G. E.

    1991-01-01

    We have built and made operational a 6 in. electric arc driven shock tube which alloys us to study the non-equilibrium radiation and kinetics of low pressure (0.1 to 1 torr) gases processed by 6 to 12 km/s shock waves. The diagnostic system allows simultaneous monitoring of shock radiation temporal histories by a bank of up to six radiometers, and spectral histories with two optical multi-channel analyzers. A data set of eight shots was assembled, comprising shocks in N2 and air at pressures between 0.1 and 1 torr and velocities of 6 to 12 km/s. Spectrally resolved data was taken in both the non-equilibrium and equilibrium shock regions on all shots. The present data appear to be the first spectrally resolved shock radiation measurements in N2 performed at 12 km/s. The data base was partially analyzed with salient features identified.

  1. Audible radiation monitor

    SciTech Connect

    Odell, D.M.C.

    1992-12-31

    This invention consists of a method and apparatus for monitoring ionizing radiation comprising radiation detectors in electrical connection with an isotopic analyzer and a device for producing chords to which each isotope is mapped so that the device produces a unique chord for each isotope. Preferably the chords are pleasing to the ear, except for chords representing unexpected isotopes, and are louder or softer depending on the level of radioactivity produced by each isotope, and musical instrument voices may be simulated in producing the chords as an aid to distinguishing similar-sounding chords. Because of the representation by chords, information regarding the level and composition of the radiation in an area can be conveyed to workers in that area more effectively and yet without distracting them.

  2. Pediatric radiation oncology

    SciTech Connect

    Halperin, E.C.; Kun, L.E.; Constine, L.S.; Tarbell, N.J.

    1989-01-01

    This text covers all aspects of radiation therapy for treatment of pediatric cancer. The book describes the proper use of irradiation in each of the malignancies of childhood, including tumors that are rarely encountered in adult practice. These include acute leukemia; supratentorial brain tumors; tumors of the posterior fossa of the brain and spinal canal; retinoblastoma and optic nerve glioma; neuroblastoma; Hodgkin's disease; malignant lymphoma; Ewing's sarcoma; osteosarcoma; rhabdomyosarcoma; Desmoid tumor; Wilms' tumor; liver and biliary tumors; germ cell and stromal cell tumors of the gonads; endocrine, aerodigestive tract, and breast tumors; Langerhans' cell histiocytosis; and skin cancer and hemangiomas. For each type of malignancy, the authors describe the epidemiology, common presenting signs and symptoms, staging, and proper diagnostic workup. Particular attention is given to the indications for radiation therapy and the planning of a course of radiotherapy, including the optimal radiation dose, field size, and technique.

  3. Semiconductor radiation detector

    DOEpatents

    Bell, Zane W.; Burger, Arnold

    2010-03-30

    A semiconductor detector for ionizing electromagnetic radiation, neutrons, and energetic charged particles. The detecting element is comprised of a compound having the composition I-III-VI.sub.2 or II-IV-V.sub.2 where the "I" component is from column 1A or 1B of the periodic table, the "II" component is from column 2B, the "III" component is from column 3A, the "IV" component is from column 4A, the "V" component is from column 5A, and the "VI" component is from column 6A. The detecting element detects ionizing radiation by generating a signal proportional to the energy deposited in the element, and detects neutrons by virtue of the ionizing radiation emitted by one or more of the constituent materials subsequent to capture. The detector may contain more than one neutron-sensitive component.

  4. Radiation rate meter development

    SciTech Connect

    Thacker, L.H.

    1989-01-01

    We are still in a very preliminary stage of examining the potentials of a new series of instruments which may be inexpensive and versatile enough to complement, or conceivably even replace, electroscope dosimeters in Civil Defense and other situations requiring radiation monitoring by the general public. These instruments were developed to provide a qualitative signal so simple to interpret that anyone can tell immediately whether they are in a dangerous radiation field, and whether they are moving into a hotter area or a cooler area. A second goal in the development has been to produce the simplest possible device at minimum cost, without compromise in effectiveness. In the simplest implementation the device is essentially a very inexpensive version of the much older Personal Radiation Monitor (PRM).

  5. Small Active Radiation Monitor

    NASA Technical Reports Server (NTRS)

    Badhwar, Gautam D.

    2004-01-01

    A device, named small active radiation monitor, allows on-orbit evaluations during periods of increased radiation, after extravehicular activities, or at predesignated times for crews on such long-duration space missions as on the International Space Station. It also permits direct evaluation of biological doses, a task now performed using a combination of measurements and potentially inaccurate simulations. Indeed the new monitor can measure a full array of radiation levels, from soft x-rays to hard galactic cosmic-ray particles. With refinement, it will benefit commercial (nuclear power-plant workers, airline pilots, medical technicians, physicians/dentists, and others) and military personnel as well as the astronauts for whom thermoluminescent dosimeters are inadequate. Civilian and military personnel have long since graduated from film badges to thermoluminescent dosimeters. Once used, most dosimeters must be returned to a central facility for processing, a step that can take days or even weeks. While this suffices for radiation workers for whom exposure levels are typically very low and of brief duration, it does not work for astronauts. Even in emergencies and using express mail, the results can often be delayed by as much as 24 hours. Electronic dosimeters, which are the size of electronic oral thermometers, and tattlers, small electronic dosimeters that sound an alarm when the dose/dose rate exceeds preset values, are also used but suffer disadvantages similar to those of thermoluminescent dosimeters. None of these devices fully answers the need of rapid monitoring during the space missions. Instead, radiation is monitored by passive detectors, which are read out after the missions. Unfortunately, these detectors measure only the absorbed dose and not the biologically relevant dose equivalent. The new monitor provides a real-time readout, a time history of radiation exposures (both absorbed dose and biologically relevant dose equivalent), and a count of the

  6. Radiation in Particle Simulations

    SciTech Connect

    More, R M; Graziani, F R; Glosli, J; Surh, M

    2009-06-15

    Hot dense radiative (HDR) plasmas common to Inertial Confinement Fusion (ICF) and stellar interiors have high temperature (a few hundred eV to tens of keV), high density (tens to hundreds of g/cc) and high pressure (hundreds of Megabars to thousands of Gigabars). Typically, such plasmas undergo collisional, radiative, atomic and possibly thermonuclear processes. In order to describe HDR plasmas, computational physicists in ICF and astrophysics use atomic-scale microphysical models implemented in various simulation codes. Experimental validation of the models used to describe HDR plasmas are difficult to perform. Direct Numerical Simulation (DNS) of the many-body interactions of plasmas is a promising approach to model validation but, previous work either relies on the collisionless approximation or ignores radiation. We present four methods that attempt a new numerical simulation technique to address a currently unsolved problem: the extension of molecular dynamics to collisional plasmas including emission and absorption of radiation. The first method applies the Lienard-Weichert solution of Maxwell's equations for a classical particle whose motion is assumed to be known (section 3). The second method expands the electromagnetic field in normal modes (plane-waves in a box with periodic boundary-conditions) and solves the equation for wave amplitudes coupled to the particle motion (section 4). The third method is a hybrid MD/MC (molecular dynamics/Monte Carlo) method which calculates radiation emitted or absorbed by electron-ion pairs during close collisions (section 5). The fourth method is a generalization of the third method to include small clusters of particles emitting radiation during close encounters: one electron simultaneously hitting two ions, two electrons simultaneously hitting one ion, etc.(section 6). This approach is inspired by the Virial expansion method of equilibrium statistical mechanics.

  7. Radiation Hazard Detector

    NASA Technical Reports Server (NTRS)

    1978-01-01

    NASA technology has made commercially available a new, inexpensive, conveniently-carried device for protection, of people exposed to potentially dangerous levels of microwave radiation. Microwaves are radio emissions of extremely high frequency. They can be hazardous but the degree of hazard is not yet well understood. Generally, it is believed that low intensity radiation of short duration is not harmful but that exposure to high levels can induce deep internal burns, affecting the circulatory and nervous systems, and particularly the eyes. The Department of Labor's Occupational Safety and Health Administration (OSHA) has established an allowable safe threshold of exposure. However, people working near high intensity sources of microwave energy-for example, radar antennas and television transmitters-may be unknowingly exposed to radiation levels beyond the safe limit. This poses not only a personal safety problem but also a problem for employers in terms of productivity loss, workman's compensation claims and possible liability litigation. Earlier-developed monitoring devices which warn personnel of dangerous radiation levels have their shortcomings. They can be cumbersome and awkward to use while working. They also require continual visual monitoring to determine if a person is in a dangerous area of radiation, and they are relatively expensive, another deterrent to their widespread adoption. In response to the need for a cheaper and more effective warning system, Jet Propulsion Laboratory developed, under NASA auspices, a new, battery-powered Microwave Radiation Hazard Detector. To bring the product to the commercial market, California Institute Research Foundation, the patent holder, granted an exclusive license to Cicoil Corporation, Chatsworth, California, an electronic components manufacturer.

  8. Saturn Radiation (SATRAD) Model

    NASA Technical Reports Server (NTRS)

    Garrett, H. B.; Ratliff, J. M.; Evans, R. W.

    2005-01-01

    The Saturnian radiation belts have not received as much attention as the Jovian radiation belts because they are not nearly as intense-the famous Saturnian particle rings tend to deplete the belts near where their peak would occur. As a result, there has not been a systematic development of engineering models of the Saturnian radiation environment for mission design. A primary exception is that of Divine (1990). That study used published data from several charged particle experiments aboard the Pioneer 1 1, Voyager 1, and Voyager 2 spacecraft during their flybys at Saturn to generate numerical models for the electron and proton radiation belts between 2.3 and 13 Saturn radii. The Divine Saturn radiation model described the electron distributions at energies between 0.04 and 10 MeV and the proton distributions at energies between 0.14 and 80 MeV. The model was intended to predict particle intensity, flux, and fluence for the Cassini orbiter. Divine carried out hand calculations using the model but never formally developed a computer program that could be used for general mission analyses. This report seeks to fill that void by formally developing a FORTRAN version of the model that can be used as a computer design tool for missions to Saturn that require estimates of the radiation environment around the planet. The results of that effort and the program listings are presented here along with comparisons with the original estimates carried out by Divine. In addition, Pioneer and Voyager data were scanned in from the original references and compared with the FORTRAN model s predictions. The results were statistically analyzed in a manner consistent with Divine s approach to provide estimates of the ability of the model to reproduce the original data. Results of a formal review of the model by a panel of experts are also presented. Their recommendations for further tests, analyses, and extensions to the model are discussed.

  9. Radar frequency radiation

    NASA Astrophysics Data System (ADS)

    Malowicki, E.

    1981-11-01

    A method is presented for the determination of radar frequency radiation power densities that the PAVE PAWS radar system could produce in its air and ground environment. The effort was prompted by the concern of the people in the vicinity of OTIS AFB MA and BEALE AFB CA about the possible radar frequency radiation hazard of the PAVE PAWS radar. The method is based on the following main assumptions that: (a) the total field can be computed as the vector summation of the individual fields due to each antenna element; (b) the individual field can be calculated using distances for which the field point is in the far field of the antenna element. An RFR computer program was coded for the RADC HE 6180 digital computer and exercised to calculate the radiation levels in the air and ground space for the present baseline and the possible Six DB and 10 DB growth systems of the PAVE PAWS radar system at OTIS AFB MA. The average radiation levels due to the surveillance fence were computed for three regions: in the air space in front of the radar, at the radar hazard fence at OTIS AFB MA and at representative ground points in the OTIS AFB vicinity. It was concluded that the radar frequency radiation of PAVE PAWS does not present a hazard to personnel provided there is no entry to the air hazard zone or to the area within the hazard fence. The method developed offers a cost effective way to determine radiation levels from a phased array radar especially in the near field and transition regions.

  10. Thermal radiative properties: Coatings.

    NASA Technical Reports Server (NTRS)

    Touloukian, Y. S.; Dewitt, D. P.; Hernicz, R. S.

    1972-01-01

    This volume consists, for the most part, of a presentation of numerical data compiled over the years in a most comprehensive manner on coatings for all applications, in particular, thermal control. After a moderately detailed discussion of the theoretical nature of the thermal radiative properties of coatings, together with an overview of predictive procedures and recognized experimental techniques, extensive numerical data on the thermal radiative properties of pigmented, contact, and conversion coatings are presented. These data cover metallic and nonmetallic pigmented coatings, enamels, metallic and nonmetallic contact coatings, antireflection coatings, resin coatings, metallic black coatings, and anodized and oxidized conversion coatings.

  11. Solar cell radiation handbook

    NASA Technical Reports Server (NTRS)

    Tada, H. Y.; Carter, J. R., Jr.

    1977-01-01

    Solar cell theory cells are manufactured, and how they are modeled mathematically is reviewed. The interaction of energetic charged particle radiation with solar cells is discussed in detail and the concept of 1 MeV equivalent electron fluence is introduced. The space radiation environment is described and methods of calculating equivalent fluences for the space environment are developed. A computer program was written to perform the equivalent fluence calculations and a FORTRAN listing of the program is included. Finally, an extensive body of data detailing the degradation of solar cell electrical parameters as a function of 1 MeV electron fluence is presented.

  12. LDEF Satellite Radiation Analyses

    NASA Technical Reports Server (NTRS)

    Armstrong, T. W.; Colborn, B. L.

    1996-01-01

    Model calculations and analyses have been carried out to compare with several sets of data (dose, induced radioactivity in various experiment samples and spacecraft components, fission foil measurements, and LET spectra) from passive radiation dosimetry on the Long Duration Exposure Facility (LDEF) satellite, which was recovered after almost six years in space. The calculations and data comparisons are used to estimate the accuracy of current models and methods for predicting the ionizing radiation environment in low earth orbit. The emphasis is on checking the accuracy of trapped proton flux and anisotropy models.

  13. Radiation ageing of polymers

    NASA Astrophysics Data System (ADS)

    Bartoníček, B.; Hnát, V.; Plaček, V.

    1999-01-01

    Radiation effects on polymers in the presence of air are characterized by dose rate effects and at enhanced temperature by synergistic effects of temperature and radiation. For a reliable simulation of long-term ageing of polymers, conditions for the homogeneous radiooxidation have to be reached. The dose rate values, at which the homogeneous oxidation of irradiated EPR/EVA plates of various thicknesses occurs throughout the sample interior, have been determined. The methodology for the lifetime assessment of cable polymeric materials on the base of the oxidation induction time determination is described.

  14. Radiative decays at LHCb

    NASA Astrophysics Data System (ADS)

    Giubega, L. E.

    2016-12-01

    Precise measurements on rare radiative B decays are performed with the LHCb experiment at LHC. The LHCb results regarding the ratio of branching fractions for two radiative decays, B 0 → K *0 γ and B s → ϕ γ, the direct CP asymmetry in B 0 → K *0 γ decay channel and the observation of the photon polarization in the B ± → K ±π∓π± γ decay, are included. The first two measurements were performed in 1 fb-1 of pp collisions data and the third one in 3 fb-1 of data, respectively.

  15. Radiation Detectors and Art

    NASA Astrophysics Data System (ADS)

    Denker, Andrea

    The use of radiation detectors in the analysis of art objects represents a very special application in a true interdisciplinary field. Radiation detectors employed in this field detect, e.g., x-rays, γ-rays, β particles, and protons. Analyzed materials range from stones, metals, over porcelain to paintings. The available nondestructive and noninvasive analytical methods cover a broad range of techniques. Hence, for the sake of brevity, this chapter will concentrate on few techniques: Proton Induced X-ray Emission (PIXE) and Proton Induced γ-ray Emission (PIGE).

  16. Radiation monitor for liquids

    DOEpatents

    Koster, James E.; Bolton, Richard D.

    1999-01-01

    A radiation monitor for use with liquids that utilizes air ions created by alpha radiation emitted by the liquids as its detectable element. A signal plane, held at an electrical potential with respect to ground, collects these air ions. A guard plane or guard rings is used to limit leakage currents. In one embodiment, the monitor is used for monitoring liquids retained in a tank. Other embodiments monitor liquids flowing through a tank, and bodies of liquids, such as ponds, lakes, rivers and oceans.

  17. Radiation monitor for liquids

    DOEpatents

    Koster, J.E.; Bolton, R.D.

    1999-03-02

    A radiation monitor for use with liquids that utilizes air ions created by alpha radiation emitted by the liquids as its detectable element. A signal plane, held at an electrical potential with respect to ground, collects these air ions. A guard plane or guard rings is used to limit leakage currents. In one embodiment, the monitor is used for monitoring liquids retained in a tank. Other embodiments monitor liquids flowing through a tank, and bodies of liquids, such as ponds, lakes, rivers and oceans. 4 figs.

  18. Radiative plateau inflation

    NASA Astrophysics Data System (ADS)

    Ballesteros, Guillermo; Tamarit, Carlos

    2016-02-01

    We describe how monomial chaotic inflation becomes compatible with the latest CMB data thanks to radiative corrections producing a plateau. The interactions of the inflaton with other fields, required for reheating, can flatten the potential and moderate the production of primordial gravitational waves, keeping these below the current upper bound. We show that the appearance of a plateau requires that the inflaton couples to fermions and to another scalar or a gauge group. We give concrete examples of minimal particle physics models leading to plateaus for quadratic and quartic chaotic inflation. We also provide a three-parameter model-independent description of radiatively corrected inflation that is amenable to CMB analyses.

  19. Wireless passive radiation sensor

    DOEpatents

    Pfeifer, Kent B; Rumpf, Arthur N; Yelton, William G; Limmer, Steven J

    2013-12-03

    A novel measurement technique is employed using surface acoustic wave (SAW) devices, passive RF, and radiation-sensitive films to provide a wireless passive radiation sensor that requires no batteries, outside wiring, or regular maintenance. The sensor is small (<1 cm.sup.2), physically robust, and will operate unattended for decades. In addition, the sensor can be insensitive to measurement position and read distance due to a novel self-referencing technique eliminating the need to measure absolute responses that are dependent on RF transmitter location and power.

  20. Radiation Monitoring Equipment Dosimeter Experiment

    NASA Technical Reports Server (NTRS)

    Hardy, Kenneth A.; Golightly, Michael J.; Quam, William

    1992-01-01

    Spacecraft crews risk exposure to relatively high levels of ionizing radiation. This radiation may come from charged particles trapped in the Earth's magnetic fields, charged particles released by solar flare activity, galactic cosmic radiation, energetic photons and neutrons generated by interaction of these primary radiations with spacecraft and crew, and man-made sources (e.g., nuclear power generators). As missions are directed to higher radiation level orbits, viz., higher altitudes and inclinations, longer durations, and increased flight frequency, radiation exposure could well become a major factor for crew stay time and career lengths. To more accurately define the radiological exposure and risk to the crew, real-time radiation monitoring instrumentation, which is capable of identifying and measuring the various radiation components, must be flown. This presentation describes a radiation dosimeter instrument which was successfully flown on the Space Shuttle, the RME-3.

  1. Space Radiation and the Brain

    NASA Astrophysics Data System (ADS)

    Hampson, R. E.

    Solar and cosmic radiation pose a number of physiological challenges to human spaceflight outside the protective region of Earth's magnetosphere. Aside from well-described effects of radiation on the blood-forming tissues of the hematopoietic system, there is increasing evidence of direct effects of radiation on the brain as evidenced by studies showing longitudinal decline in memory and cognitive function following radiation specifically directed at brain tissue. These indications strengthen the need to more fully research effects of radiation - particular those components associated with solar wind and galactic cosmic radiation - on the nervous system of mammals from rodents to humans.

  2. Radiation Safety in Pediatric Orthopaedics.

    PubMed

    Caird, Michelle S

    2015-01-01

    Patients, surgeons, and staff are exposed to ionizing radiation in pediatric orthopaedic surgery from diagnostic studies and imaging associated with procedures. Estimating radiation dose to pediatric patients is based on complex algorithms and dose to surgeons and staff is based on dosimeter monitoring. Surgeons can decrease radiation exposure to patients with careful and thoughtful ordering of diagnostic studies and by minimizing exposure intraoperatively. Surgeon and staff radiation exposure can be minimized with educational programs, proper shielding and positioning intraoperatively, and prudent use of intraoperative imaging. Overall, better awareness among pediatric orthopaedic surgeons of our role in radiation exposure can lead to improvements in radiation safety.

  3. Paradoxes of Thermal Radiation

    ERIC Educational Resources Information Center

    Besson, U.

    2009-01-01

    This paper presents an analysis of the thermal behaviour of objects exposed to a solar-type flux of thermal radiation. It aims to clarify certain apparent inconsistencies between theory and observation, and to give a detailed exposition of some critical points that physics textbooks usually treat in an insufficient or incorrect way. In particular,…

  4. Radiative accidental matter

    NASA Astrophysics Data System (ADS)

    Sierra, D. Aristizabal; Simoes, C.; Wegman, D.

    2016-07-01

    Accidental matter models are scenarios where the beyond-the-standard model physics preserves all the standard model accidental and approximate symmetries up to a cutoff scale related with lepton number violation. We study such scenarios assuming that the new physics plays an active role in neutrino mass generation, and show that this unavoidably leads to radiatively induced neutrino masses. We systematically classify all possible models and determine their viability by studying electroweak precision data, big bang nucleosynthesis and electroweak perturbativity, finding that the latter places the most stringent constraints on the mass spectra. These results allow the identification of minimal radiative accidental matter models for which perturbativity is lost at high scales. We calculate radiative charged-lepton flavor violating processes in these setups, and show that μ → eγ has a rate well within MEG sensitivity provided the lepton-number violating scale is at or below 5×105 GeV, a value (naturally) assured by the radiative suppression mechanism. Sizeable τ → μγ branching fractions within SuperKEKB sensitivity are possible for lower lepton-number breaking scales. We thus point out that these scenarios can be tested not only in direct searches but also in lepton flavor-violating experiments.

  5. Radiation detector spectrum simulator

    DOEpatents

    Wolf, M.A.; Crowell, J.M.

    1985-04-09

    A small battery operated nuclear spectrum simulator having a noise source generates pulses with a Gaussian distribution of amplitudes. A switched dc bias circuit cooperating therewith to generate several nominal amplitudes of such pulses and a spectral distribution of pulses that closely simulates the spectrum produced by a radiation source such as Americium 241.

  6. Radiation detector spectrum simulator

    DOEpatents

    Wolf, Michael A.; Crowell, John M.

    1987-01-01

    A small battery operated nuclear spectrum simulator having a noise source nerates pulses with a Gaussian distribution of amplitudes. A switched dc bias circuit cooperating therewith generates several nominal amplitudes of such pulses and a spectral distribution of pulses that closely simulates the spectrum produced by a radiation source such as Americium 241.

  7. Surface Radiation Budget

    NASA Technical Reports Server (NTRS)

    Stackhouse, Paul W. (Principal Investigator)

    The Surface Radiation Budget (SRB) data sets contain global 3-hourly, daily and monthly averages of surface longwave and shortwave radiative properties, cloud amount, and meteorological properties computed using models. The main input data for these models include cloud information, top-of-atmosphere radiances and profiles of atmospheric water vapor and temperature. Some of the input data include Earth Radiation Budget Energy (ERBE) top-of-atmosphere clear-sky albedo and International Satellite Cloud Climatology Project (ISCCP) radiances and cloud amount. SRB parameters derived for the renewable energy community are also available from the Surface meteorology and Solar Energy (SSE) data set. Other SRB data are available from Clouds and the Earth's Radiant Energy System (CERES) and Multi-angle Imaging SpectroRadiometer (MISR). [Mission Objectives] The objective of the SRB Project is to produce and archive a global data set of shortwave (SW) and longwave (LW) surface and top of the atmosphere parameters. The data generated in the SRB project may be used in conjunction with other data sets to facilitate the development of renewable energy resources and increase understanding of radiative properties within the meteorological community. [Temporal_Coverage: Start_Date=1983-07-01; Stop_Date=2005-06-30] [Spatial_Coverage: Southernmost_Latitude=-90; Northernmost_Latitude=90; Westernmost_Longitude=-180; Easternmost_Longitude=180].

  8. Radiation belts of jupiter.

    PubMed

    Fillius, R W; McIlwain, C E

    1974-01-25

    Pioneer 10 counted relativistic electrons throughout the magnetosphere of Jupiter, with the greatest fluxes being inside 20 Jupiter radii. The peak flux of electrons with energy greater than 50 million electron volts was 1.3 x 10(7) per square centimeter per second at the innermost penetration of the radiation belts.

  9. An Inexpensive Radiation Counter.

    ERIC Educational Resources Information Center

    Holton, Brian; Balla, Zsolt

    1985-01-01

    Describes a radiation counter comparable to commercial units which costs less than $100. It consists of six sections: Geiger-Mueller tube and holder; high voltage supply; low voltage supply; pulse shaping circuit; "start/stop counts" gating circuit; and counter/display. List of materials needed and schematic diagrams are included. (JN)

  10. Continuum radiation at Uranus

    SciTech Connect

    Kurth, W.S.; Gurnett, D.A. ); Desch, M.D. )

    1990-02-01

    Uranus has proven to be a radio source of remarkable complexity with as many as six distinctly different types of emission. One Uranian radio emission which has thus far escaped attention is an analog of continuum radiation at Earth, Jupiter, and Saturn. The emission is found to be propagating in the ordinary mode in the range of one to a few kHz on the inbound leg of the Voyager 2 encounter, shortly after the magnetopause crossing. The continuum radiation spectrum at Uranus also includes bands with frequencies as high as 12 kHz or greater on both the inbound and outbound legs. The Uranian continuum radiation is notably weak, making it more like that detected at Saturn than the extremely intense Jovian continuum radiation. The Uranian emission shows some evidence for narrow-band components lying in the same frequency regime as the continuum, completing the analogy with the other planets, which also show narrow-band components superimposed on the continuum spectrum. The authors argue that the low intensity of the Uranian continuum is most likely related to the lack of a density cavity within the Uranian magnetosphere that is deep relative to the solar wind plasma density.

  11. Thermostatic Radiator Valve Evaluation

    SciTech Connect

    Dentz, Jordan; Ansanelli, Eric

    2015-01-01

    A large stock of multifamily buildings in the Northeast and Midwest are heated by steam distribution systems. Losses from these systems are typically high and a significant number of apartments are overheated much of the time. Thermostatically controlled radiator valves (TRVs) are one potential strategy to combat this problem, but have not been widely accepted by the residential retrofit market.

  12. Radiation Hardening of Computers

    NASA Technical Reports Server (NTRS)

    Nichols, D. K.; Smith, L. S.; Zoutendyk, J. A.; Giddings, A. E.; Hewlett, F. W.; Treece, R. K.

    1986-01-01

    Single-event upsets reduced by use of oversize transistors. Computers made less susceptible to ionizing radiation by replacing bipolar integrated circuits with properly designed, complementary metaloxide-semiconductor (CMOS) circuits. CMOS circuit chips made highly resistant to single-event upset (SEU), especially when certain feedback resistors are incorporated. Redesigned chips also consume less power than original chips.

  13. Modeling Radiation Fog

    NASA Astrophysics Data System (ADS)

    K R, Sreenivas; Mohammad, Rafiuddin

    2016-11-01

    Predicting the fog-onset, its growth and dissipation helps in managing airports and other modes of transport. After sunset, occurrence of fog requires moist air, low wind and clear-sky conditions. Under these circumstances radiative heat transfer plays a vital role in the NBL. Locally, initiation of fog happens when the air temperature falls below the dew-point. Thus, to predict the onset of fog at a given location, one has to compute evolution of vertical temperature profile. Earlier,our group has shown that the presence of aerosols and vertical variation in their number density determines the radiative-cooling and hence development of vertical temperature profile. Aerosols, through radiation in the window-band, provides an efficient path for air layers to lose heat to the cold, upper atmosphere. This process creates cooler air layer between warmer ground and upper air layers and resulting temperature profile facilitate the initiation of fog. Our results clearly indicates that accounting for the presence of aerosols and their radiative-transfer is important in modeling micro-meteorological process of fog formation and its evolution. DST, Govt. INDIA.

  14. Ionizing radiation from tobacco

    SciTech Connect

    Westin, J.B.

    1987-04-24

    Accidents at nuclear power facilities seem inevitably to bring in their wake a great deal of concern on the part of both the lay and medical communities. Relatively little attention, however, is given to what may be the largest single worldwide source of effectively carcinogenic ionizing radiation: tobacco. The risk of cancer deaths from the Chernobyl disaster are tobacco smoke is discussed.

  15. Radiation injury of bone

    SciTech Connect

    Shimanovskaya, K.; Shiman, A.D.

    1983-01-01

    This monograph is devoted to the characteristics of radiation injuries arising in hitherto unaffected parts of the skeleton during the treatment of neoplasms by radiotherapy. These changes frequently accompany the beneficial effects of radiotherapy, and can easily be misunderstood in the absence of any clear idea of their character. An understanding of the mechanism and conditions of appearance of radiation injuries of the skeleton and a knowledge of their clinical and radiological features are essential for physicians and surgeons caring for patients who have been treated by using radiotherapy and for experimental scientists whose work involves such methods. The effect of irradiation is determined by the topographical relations within the irradiated object, the character of distribution of the dose, and the size of the dose. The radiation injuries of the skeleton described in the book were observed during the treatment of carcinoma of the breast, lung, esophagus, and uterus, of malignant tumors in the mouth, certain pituitary tumors, and hemangiomas of the skin in children, by means of ionizing radiation obtained from various sources. A few observations relate to patients treated for certain other diseases. The text is illustrated by roentgenograms on the basis of which the diagnoses were made and the course of the lesion was subsequently confirmed, and also by operative and histological specimens. The book also contains many schemes drawn from roentgenograms.

  16. Psoriasis and ultraviolet radiation

    SciTech Connect

    Farber, E.M.; Nall, L. )

    1993-09-01

    Prevention and detection screening programs as a public health service in curtailing the ever-increasing incidence of all forms of skin cancer are reviewed. The effect of solar and artificial ultraviolet radiation on the general population and persons with psoriasis is examined. 54 refs.

  17. Manifolds and Radiation Protection

    NASA Astrophysics Data System (ADS)

    Rossitto, Franco; Petrov, Vladislav M.; Ongaro, Filippo

    During the past 40 years humans have travelled beyond Earth's atmosphere, orbiting the planets for extended periods of time and landing on the Moon. Humans have survived this overwhelming challenge but to assure future exploration of space further expertise in the long term survival in space must be obtained. The International Space Station (ISS) provides this opportunity and allows space scientist to fine-tune their knowledge and prepare for even bolder human space missions. In this work we focus on the aspect of radiation, perhaps the most complex one from a physical and physiological perspective. Travel beyond the Earth's atmosphere and especially to Moon and Mars requires a precise consideration of the radiation environment as radiation exposure could be a show-stopper. At the moment scientists have not yet developed complete and reliable systems for radiation protection. Most likely an adequate level of protection will be reached through an integrated countermeasure system which could include: shields, monitoring of the environment, drugs to protect from damage, etc.

  18. Photovoltaic radiation detector element

    DOEpatents

    Agouridis, Dimitrios C.

    1983-01-01

    A radiation detector element is formed of a body of semiconductor material, a coating on the body which forms a photovoltaic junction therewith, and a current collector consisting of narrow metallic strips, the aforesaid coating having an opening therein the edge of which closely approaches but is spaced from the current collector strips.

  19. Optical electromagnetic radiation detector

    NASA Astrophysics Data System (ADS)

    Miceli, W. J.; Ludman, J. E.

    1985-08-01

    An optical electromagnetic radiation detector is invented having a probe for receiving nearby electromagnetic radiation. The probe includes a loop antenna connected to a pair of transparent electrodes deposited on the end surfaces of an electro-optic Fabry-Perot interferometer. When the loop antenna picks up the presence of electromagnetic radiation, a voltage will be developed across the crystal of the electro-optic Fabry-Perot interferometer thereby changing the optical length of the interferometer. A beam of light from a remote location is transmitted through an optical fiber onto the Fabry-Perot interferometer. The change in optical length of the Fabry-Perot interferometer alters the intensity of the beam of light as its is reflected from the Fabry-Perot interferometer back through the optical fiber to the remote location. A beamsplitter directs this reflected beam of light onto an intensity detector in order to provide an output indicative of the variations in intensity. The variations in intensity are directly related to the strength of the electromagnetic radiation received by the loop antenna.

  20. VDT Emissions Radiate Debate.

    ERIC Educational Resources Information Center

    Morgan, Bill

    1990-01-01

    Discusses the possible health effects of electromagnetic fields of radiation that are emitted from video display terminals (VDTs). Responses from vendors in the computer industry are related, steps to reduce possible risks are suggested, and additional sources of information on VDTs are listed. (LRW)