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At least 289 records · Page 16Linked to original sources
PubMed1976

Pathology of the cervical spine in rheumatoid arthritis: a controlled study of 44 spines.

Cervical spines (with occiputs) of 44 patients with rheumatoid arthritis (RA) were compared with 44 control spines from patients without RA, matched for sex and age. There were six severe and seven slight atlanto-axial dislocations (both horizontal and vertical, two of which had been treated surgically) in the RA group and none in the control group. Ankylosis, synchondrosis, syndesmosis, bone erosions, and redness of synovial tissue in the atlanto-axial, atlanto-occipital and cervical intervertebral joints were more frequent in the RA group than in the control spines. The lesions permitting the best discrimination between the RA and control groups were used to calculate an overall score for the whole cervical spine. Sixteen of the 44 RA patients scored higher than the highest control value; only nine scored lower than the median control score. A higher score than the average value found for the RA spines was obtained by the male patients, the patients with seropositivity or subcutaneous nodules, the patients treated with corticosteroids, the patients who died in the Department of Rheumatology, and those whose death was related to the RA itself or to the treatment given.

Adult↗
PubMed1994

Volume and glucose concentration of rat amniotic fluid: effects on embryo nutrition and axis rotation.

In order to pursue our previous studies of the changes in neural tube microvilli produced by glucose, we developed a micro method of measuring glucose concentration in the very small volumes of amniotic fluid during neurulation. The volume of amniotic fluid was found to increase nearly 10-fold during major neurulation (day 10 to day 11 in the rat). This increase in volume and our repeated observations that physical removal of the restraining amnion initiates embryonic rotation leads us to propose that the growth of the amniotic cavity is essential for conversion from the ventral- to dorsi-flexion of the embryonic axis. Amniotic fluid volume continues to increase until day 18 but dropped by day 20. A method for glucose determination was developed using the color reaction on glucose oxidase indicator paper. The intensity of the color was analyzed with a color scanner. Amniotic glucose was 27.1 +/- 1.6 mg/dl on day 10 and continued in this range with some fluctuation until day 20 when it decreased. We isolated days 10, 11, and 16 embryonic sites from their decidua and incubated them at 0 degrees C and 38 degrees C while measuring glucose concentration. The glucose concentration did not show significant decrease at 0 degrees C on day 10 or 11 or on day 16 at 38 degrees C. At 38 degrees C the day 10 embryo amniotic fluid glucose disappeared after 22 minutes and the day 11 amniotic fluid glucose was gone in 34 minutes. These depletion times were statistically different. The magnitude of glucose depletion on day 10 was shown by calculation to be approximately 323 mumoles/gm protein per hour which is a substantial portion of the glucose utilized by the embryo as determined in previous experiments (731 mumoles/gm protein per hour). This model may serve as a way to study glucose utilization by embryos after their exposure to various teratogens.

Amniotic Fluid↗
PubMed2002

Cell lineage, axis formation, and the origin of germ layers in the amphipod crustacean Orchestia cavimana.

Embryos of the amphipod crustacean Orchestia cavimana are examined during cleavage, gastrulation, and segmentation by using in vivo labelling. Single blastomeres of the 8- and 16-cell stages were labelled with DiI to trace cell lineages. Early cleavage follows a distinct pattern and the a/p and d/v body axes are already determined at the 4- and 8-cell stages, respectively. In these stages, the germinal rudiment and the naupliar mesoderm can be traced back to a single blastomere each. In addition, the ectoderm and the postnaupliar mesoderm are separated into right and left components. At the16-cell stage, naupliar ectoderm is divided from the postnaupliar ectoderm, and extraembryonic lineages are separated from postnaupliar mesoderm and endoderm. From our investigation, it is evident that the cleavage pattern and cell lineage of Orchestia cavimana are not of the spiral type. Furthermore, the results of the labelling show many differences to cleavage patterns and cell lineages in other crustaceans, in particular, other Malacostraca. The cleavage and cell lineage patterns of the amphipod Orchestia are certainly derived within Malacostraca, whose ancestral cleavage mode was most likely of the superficial type. On the other hand, Orchestia exhibits a stereotyped cell division pattern during formation and differentiation of the germ band that is typical for malacostracans. Hence, a derived (apomorphic) early cleavage pattern is the ontogenetic basis for an evolutionarily older cell division pattern of advanced developmental stages. O. cavimana offers the possibility to trace the lineages and the fates of cells from early developmental stages up to the formation of segmental structures, including neurogenesis at a level of resolution that is not matched by any other arthropod system.

Animals↗
PubMed1988

Posterior acrylic surgical fixation of odontoid fractures.

Fourteen cases of odontoid fractures had, as primary treatment, a posterior surgical fixation (C1 + C2 + C3 and occiput in some cases) by means of acrylate and stainless steel wires, without waiting for the unpredictable final results of external systems of stabilization. The youngest patient was 20 years old, the oldest 84 years old. No immediate or late neurological complications occurred (follow-up: one year to ten years). All the patients were mobilized early without external fixation. Union of the dens took place in eleven cases, and good stabilization in the remainder. Thirteen patients recovered, one improved. Posterior acrylic fixation is the treatment of choice in cases of odontoid fracture, particularly in elderly patients in whom a solid union rarely is obtained.

Acrylates↗
PubMed1988

Realignment and surgical fixation of atlanto-axial and subaxial dislocations in rheumatoid arthritis (RA) patients.

One hundred consecutive patients with atlanto-axial dislocation(s) were subjected to posterior occipito-cervical fusion and followed up to 16 1/2 years postoperatively (mean: 4 1/2 years). The mean age at surgery was 60.3 years. At the time of follow-up, 45 patients had died, mostly due to cardiopulmonary disease. Out of the 100 patients, 67% showed a major improvement and in an additional 14% there was a slight or moderate improvement. Some patients with a stable fusion later developed subaxial dislocation(s) necessitating an anterior fusion which in patients with RA is difficult due to poor bone quality. MRI revealed pannus formation around the odontoid peg in many patients, in several to such a degree that cord compression was evident. Following the posterior fixation, the pannus disappeared or was reduced which may at least partly explain the generally favourable operative outcome following the fixation procedure. Early occipito-cervical fusion appears to prevent further vertical dislocation or upwards migration of the odontoid which is a more severe condition, and does not appear to result in increased incidence of subsequent subaxial dislocation(s). Such luxation(s) pose a technically difficult problem since the quality of the patients' own bone usually does not permit a common anterior fusion procedure with autologous graft. In such cases with cord compression, acrylic cement may be used to obtain a normalized realignment.

Adult↗
PubMed1991

The normal posterior atlantoaxial relationship.

The relationship of the posterior aspects of the atlas and the axis were studied in 100 normal adult volunteers. The ratio of the height of the atlantal spinolaminar line to the atlantoaxial interspinous distance was found to be remarkably constant and was less than 2.0 in all men and women. This ratio should prove helpful in detecting hyperflexion injuries isolated to the atlantoaxial level.

Adult↗
PubMed1984

[Hangman's fracture in ventrally flexed traction].

Hangman's fracture in ventrally flexed traction between 10(6) and 75 degrees is analyzed on the basis of 220 fracture trials on plaster of real bone preparations of the atlas and axis of two adults. Hangman's fractures, which are usually regarded as a form of injury from dorsal flexion, occurred in 25% of the fracture trials under this kind of strain. Frequency depended on flexion angle, as well as on inclination of the dens axis. Thus Hangman's fractures occurred, as a whole, more frequently in the kyphotic dens type than in the lordotic type and were found as a rule at 75 degrees flexion. Furthermore, the investigations showed that pedicles can by no means be regarded as the sole predilection site for fracture. A detailed description is provided on why the Hangman's fracture type, due to ventrally flexed traction, can be included in the group of bone injuries arising from flexion, with tensile stress of the dorsal parts of the dens and the corpus axis, on the one hand, and the upper side of the axis arch on the other. Hence, the injury picture ranges from the dorsal arch fracture to the horizontal rupture through the superior articular facies and the corpus axis, as documented by substantial evidence.

Adult↗
PubMed1982

[Severe trauma of neck and skull base ].

The concept of internal decapitation comprises lesions within the skull base, upper spinal column with partial or complete destruction of the cervical part of the medulla. By means of casualties due to internal decapitation we demonstrate that, besides the known causes, a rotational damage at the juncture of the upper spinal column to the skull base as well as fractures by axial stretching may cause such traumas. A decrease of such accident's consequences is hardly possible because of the amount of energy involved causing the damage. Due to a steady increase of traffic, particularly by motor-bicycle, we shall have to cope with more cases of this kind of damage.

Accidents, Traffic↗
PubMed1981

Osteoarthritis of the alanto-axial joint.

Thirty-one patients suffering from osteoarthritis of the atlanto-axial joint are described, suggesting that this disease is not particularly uncommon. The most characteristic radiological signs are narrowing of the joint space from loss of articular cartilage, marginal cortical thickening and osteophyte formation. Histological examination in the cadaver has shown thinning and fibrillation of articular cartilage and intra-cartilaginous ossification. The radiological appearances of the atlanto-axial joint are classified in three types, lateral atlanto-axial, atlanto-odontoid and mixed. Peak age distribution occurs between 50 and 69 years of age. Patients complain of occipital pain, a stiff shoulder and paraesthesia of the fingers. Treatment was conservative in all cases except one, a 63-year-old woman with severe occipital pain. A transoral atlanto-axial fusion was performed in this case with marked improvement. The transoral approach allows fixation and curettage of the degenerative lesions.

Adult↗
PubMed1981

Pathologic fracture of odontoid process secondary to amyloid deposition.

Immunocyte dyscrasias have increasingly been reported in patients with gammopathy-associated systemic amyloidosis. In "primary" amyloidosis, deposits occur in heart, smooth and skeletal muscle, bones and joints, skin, lungs and peripheral nerves. The formation of amyloid fibrils appears related to the lambda light chains in these monoclonal gammopathies. A 72-year-old white man is reported who developed massive deposits of amyloid in joints and bones, as well as other tissues. Twenty percent of his bone marrow population was comprised of plasma cells in various maturational stages, without forming solitary masses diagnostic of myeloma. Lambda light chains were the sole contributors to a selective increase in IgD, with a concomitant reduction of IgA, IgG, and IgM. The patient sustained a pathologic fracture through a deposit of amyloid in the odontoid. While he suffered severe posterior nuchal and occipital pain, no clinical features of compression myelopathy were evident. Postmortem examination revealed a minor degree of posterior column degeneration and an axonal reaction of anterior horn cells of the C-1 spinal cord segment. This case represents the second to be reported with amyloidosis of the vertebral column, pathologic fracture, and a spinal cord lesion.

Aged↗
PubMed1977

Computer tomography for lesions of the craniovertebral region.

The images obtained by computed tomography constitute a new and interesting approach to lesions of the craniovertebral region. The criteria of basilar invagination must be systematically checked in routine examination. The main interest of CT scanning is the simultaneous view of the bony structures as well as the central nervous system in a completely innocuous way.

Axis, Cervical Vertebra↗