The radiologic anatomy of the lumbar and lumbosacral pedicles.

Study Design: An anatomic and radiologic study of lumbar and lumbosacral pedicle anatomy.

Objectives: To define the radiologic anatomy of the lumbar and first sacral pedicle in the coaxial projection.

Summary Of Background Data: Fluoroscopic assistance for pedicle screw placement requires radiologic landmarks.

Effect of loading rate and hydration on the mechanical properties of the disc.

Study Design: The mechanical response of bovine intervertebral discs to axial compression at different loading rates and hydration levels was quantified.

Objectives: To quantify the effects of hydration and loading rate on the mechanical response of the intervertebral disc to compressive axial load.

Summary Of Background Data: The disc is known to be viscoelastic, but there are few experimental data showing the effect of loading rate and hydration on its response to compression.

ACC and back injuries: the relevance of pre-existing asymptomatic conditions.

The purpose of the ARCI (1992) and AI (198) Acts is to cover those who suffered from personal injury by accident. This purpose should not be distorted. This review does not aim to suggest that cover be extended to victims of disease.

Unusual cluster of mild invasive serogroup C meningococcal infection in a university college.

The objective of this study was to describe the epidemiology and public health response to an apparent cluster of Neisseria meningitidis serogroup C infection in university students in a residential college. A conventional epidemiological approach was taken, supported by routine and novel diagnostic techniques. Over the two days of 21-22 August 1997, three cases of suspected meningococcal infection were notified from a residential college complex at a university campus in the Sydney metropolitan area.

A phase I/II study of carboplatin combined with hyperfractionated radiotherapy for brainstem gliomas.

Background: Brainstem gliomas often respond to radiotherapy but long term disease control is exceptional. The concomitant administration of a chemotherapy agent with radiosensitizing properties such as carboplatin may increase the efficacy of radiotherapy.

Methods: A dose escalation schedule of carboplatin was devised to determine the maximum tolerated dose (MTD) of intravenous carboplatin when given on a twice-weekly schedule during a course of hyperfractionated, involved field radiotherapy (100 centigrays [cGy] twice daily to 7200 cGy).

Pedicle screw placement at the sacrum: anatomical characterization and limitations at S1.

Anatomical and biomechanical data have suggested that pedicle screw fixation at the sacrum is optimum in the anteromedial direction into the S1 vertebral body, yet the possibility of posterior iliac crest interference with this screw pathway has been considered but not defined. This study aimed to determine if the anteromedial direction of screw placement into the vertebral body is possible in all cases at S1 and to assess the limiting effect of the posterior iliac crest. Computed tomography scans of the upper sacrum at the S1 pedicle parallel to the sacral endplate were examined in 100 patients.

Assessment of tissue oxygenation.

A continuous supply of oxygen to all tissues is necessary for the efficient production of ATP, and this supply is considered sufficient when aerobic metabolism is maintained. Nonhealing wounds, necrotizing infections, radiation-induced necrosis, crush injury, decompression illness, and CO poisoning all exhibit impaired tissue oxygenation. The need for efficacy of HBO therapy in such conditions is in part determined by the prevailing state of tissue oxygen supply and demand.

Induction of an acetaminophen-sensitive cyclooxygenase with reduced sensitivity to nonsteroid antiinflammatory drugs.

The transformed monocyte/macrophage cell line J774.2 undergoes apoptosis when treated for 48 h with competitive inhibitors of cyclooxygenase (COX) isoenzymes 1 and 2. Many of these nonsteroid antiinflammatory drugs (NSAIDs), but in particular diclofenac, induce during this time period a COX activity that coincides with a robust induction of COX-2 protein.

Determining the sagittal dimensions of the canal of the cervical spine. The reliability of ratios of anatomical measurements.

The ratio of the sagittal diameter of the cervical canal to the corresponding diameter of the vertebral body has been described as a reliable means for assessing stenosis of the canal and detecting those at risk of cervical neuropraxia. The use of ratio techniques has the advantage of avoiding variation in magnification when direct measurements are made from plain radiographs. We examined the reliability of this method using plain lateral radiographs of unknown magnification and CT scans.

Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study.

Background: The prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. Although there have been several studies examining this question, the results are conflicting, with previous estimates ranging from 20% to 83%. There have been only 2 studies examining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.

Isolation of Aeromonas salmonicida in association with purple-pigmented bacteria in sediment from a Scottish loch.

Aeromonas salmonicida was recovered in close association with an unidentified purple-pigmented organism, which was isolated from sediment in a Scottish loch during November (1997) and February (1998). However, there has not been any evidence of A. salmonicida infections, specifically furunculosis, associated with the fish in this loch.

Cytomegalovirus and human herpesvirus 6 both cause viral disease after renal transplantation.

Background: Systemic viral disease after renal transplantation, especially after treatment with OKT3 or antithymocyte globulin, has usually been attributed to cytomegalovirus (CMV) infection. Identification of human herpesvirus 6 (HHV6) has raised the possibility that infection or reactivation of this virus may also occur in the same setting.

Methods: We thus examined the incidence of CMV and HHV6 infection in a prospective blinded consecutive series of 30 renal and renal/pancreas transplant patients, 22 of whom received OKT3, antithymocyte globulin, or both.

Supporting parents during and after a pregnancy subsequent to a perinatal loss.

The experience of perinatal loss can be devastating for couples who want children. The decision and desire to attempt another pregnancy may be too much for parents to bear, yet the majority of women who experience perinatal loss do become pregnant again soon after the loss. A pregnancy after a perinatal loss can be mentally, emotionally, and physically taxing.

Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?

Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard postoperative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local, with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed or outside the tumor bed, but still within the PF.

Measles immunity and immunization status in under-5-year-old children in New South Wales: a population-based study.

Objective: To estimate the proportion of 1-4-year-old New South Wales children immune to measles and compare the documented immunization history with serologically defined immune status.

Design: Population based seroprevalence survey piggybacked onto the National Survey of Lead in Children. Immune status was determined by two different enzyme immunoassays on plasma samples from subjects.

Posterior surgical treatment for the rheumatoid cervical spine.

Twenty-six patients with rheumatoid disease affecting the cervical spine underwent surgical treatment for neck pain, neurological deficit, or both. Atlantoaxial subluxation (n=13), subaxial subluxation (n=7) and vertical migration of the odontoid (n=6) were treated. Arthrodesis with autologous bone was augmented with wire, Ransford loop, Hartshill rectangle or Magerl technique.

Is there an association between water baths during labor and the development of chorioamnionitis or endometritis?

Objective: Our purpose was to determine whether water baths during labor are associated with the development of chorioamnionitis or endometritis.

Study Design: One hundred ten cases of chorioamnionitis or endometritis and 97 controls were identified among singleton term gestations from the University of California at San Francisco perinatal database. Medical record review and patient interviews provided information on membrane rupture, history of bathing during labor, and relaxation and pain relief perceived by patients who experienced water bathing during labor.

Pediatric brain tumors.

Brain tumors are the most common solid neoplasms in childhood. This article reviews the current classification, clinical presentations, diagnostic procedures, and principles of treatment of pediatric brain tumors. The specific presentation, treatment, and prognosis of the most common, individual types of pediatric brain tumors are discussed.

Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the Children's Cancer Group.

Object: Ependymomas in children continue to generate controversy regarding their histological diagnosis and grading. optimal management, and possible prognostic factors. To increase our knowledge of these tumors the authors addressed these issues in a cohort of children with prospectively staged ependymomas treated with radiotherapy and chemotherapy.

Oral effects of smokeless tobacco use by professional baseball players.

This is a review of studies conducted from 1988-90 on the oral consequences of snuff and chewing tobacco use among professional baseball players. About half of the players studied were smokeless tobacco (ST) users, the majority of whom used snuff. Compared with non-users, players who used ST showed a significantly higher prevalence of leukoplakia, which was related to placement of the ST quid, and the frequency, amount, duration, and type of ST used.

Reliability of axial landmarks for pedicle screw placement in the lower lumbar spine.

Study Design: Measurements were made on transverse-plan, computed tomography scans from three different patient groups.

Objective: To describe the correlation between two previously described pedicle screw entry points to the pedicle axis and the predicted frequency of pedicle breakthrough from the use of a 6.5-mm screw placed parallel to the pedicle axis.

Flow cytometric DNA analysis of pediatric intracranial ependymomas.

Objective: To examine the clinicopathologic features and perform flow cytometric DNA analysis of pediatric intracranial ependymomas to determine whether any of these parameters were predictors of clinical outcome.

Methods: Flow cytometric DNA analysis was performed on 17 paraffin-embedded tumors from patients aged 7 months to 16 years.

Results: Seven cases were aneuploid, while the remaining 10 were diploid.

Chest wall motion in preterm infants using respiratory inductive plethysmography.

Preterm infant tidal breathing may be different from that of healthy full-term infants because of various features of the premature thorax. The purpose of this project was to describe chest wall motion in the preterm infant (gestational age <37 weeks) and compare it with chest wall motion data in a group of healthy, full-term infants. We wanted to use an objective bedside method for assessment with minimal disruption to the infant.