The foramen magnum is an important landmark of the skull base and is of particular interest for anthropology, anatomy, forensic medicine, and other medical fields. Despite its importance, few osteometric studies of the foramen magnum have been published so far. A total of 110 transverse and 111 sagittal diameters from Central European male and female dry specimens dating from the Pleistocene to modern times were measured, and related to sex, age, stature, ethnicity, and a possible secular trend. Only a moderate positive correlation between the transverse and the sagittal diameter of the foramen magnum was found. Surprisingly, neither sexual dimorphism, individual age-dependency, nor a secular trend was found for either diameter. Furthermore, the relationship between the individual stature and foramen magnum diameters was weak: thus foramen magnum size cannot be used as reliable indicator for stature estimation. Further consideration of possible factors influencing the variability of human foramen magnum size shall be explored in larger and geographically more diverse samples, thus serving forensic, clinical, anatomical, and anthropological interests in this body part. Anat Rec, 292:1713Rec, 292: -1719Rec, 292: , 2009. V V C 2009 Wiley-Liss, Inc.Key words: anthropology; forensic medicine; osteometry; Pleistocene; secular trend; skull baseSpinal osteometry is a versatile and important method in many research fields including anthropology and basic medical sciences (Saillant, 1976;Krag et al., 1988;Schaeffer, 1999;Mitra et al., 2002;Ahern, 2005;Muthukumar et al., 2005). The foramen magnum, as a transition zone between spine and skull, plays an important role as a landmark because of its close relationship to key structures such as the brain and the spinal cord. There is a small heterogeneous group of anthropological and medical papers focusing on the foramen magnum: simple morphometric analysis of foramen magnum dimensions (Sendemir et al., 1994), foramen magnum size as a part of human occipital bone biometry (Olivier, 1975), its size relative to sex (Catalina-Herrera, 1987;Uysal et al., 2005), its relationship to the intra-cranial volume (Acer et al., 2006), its relationship to stature (Röthig, 1971), the use of the foramen magnum as an identification mark for fire victims (Holland, 1989), the inter-and intra-variability of the foramen magnum position in different species (Ahern, 2005), foramen magnum-carotid foramina relationship as a probable species diagnostic mark (Schaeffer, 1999), and the foramen magnum region in relation to surgical approaches (Muthukumar et al., 2005).Despite its anatomical and clinical relevance, there is still a lack of basic osteometric studies. Furthermore, to the best of our knowledge, no study has ever
We introduce a generative probabilistic model for segmentation of brain lesions in multi-dimensional images that generalizes the EM segmenter, a common approach for modelling brain images using Gaussian mixtures and a probabilistic tissue atlas that employs expectation-maximization (EM) to estimate the label map for a new image. Our model augments the probabilistic atlas of the healthy tissues with a latent atlas of the lesion. We derive an estimation algorithm with closed-form EM update equations. The method extracts a latent atlas prior distribution and the lesion posterior distributions jointly from the image data. It delineates lesion areas individually in each channel, allowing for differences in lesion appearance across modalities, an important feature of many brain tumor imaging sequences. We also propose discriminative model extensions to map the output of the generative model to arbitrary labels with semantic and biological meaning, such as “tumor core” or “fluid-filled structure”, but without a one-to-one correspondence to the hypo-or hyper-intense lesion areas identified by the generative model. We test the approach in two image sets: the publicly available BRATS set of glioma patient scans, and multimodal brain images of patients with acute and subacute ischemic stroke. We find the generative model that has been designed for tumor lesions to generalize well to stroke images, and the generative-discriminative model to be one of the top ranking methods in the BRATS evaluation.
Taurolidine, the active agent of Taurolin, is a broad spectrum anti-biotic that has been used for over 15 years for the treatment of severe surgical infections. Recently, taurolidine has been shown to possess anti-neoplastic properties in vitro and in vivo against a variety of cancers including ovarian, colon and prostate. In this study we assessed the cytotoxic activity of taurolidine against human osteosarcoma (OS) cell lines and normal human bone cells. Treatment with taurolidine inhibited the growth of all ten osteosarcoma cell lines tested and taurolidine was equally potent against cell lines with and without distinct genetic defects (i.e. p53, Rb). Moreover, taurolidine-induced growth inhibition was found to be associated with a dose dependent increase in the number of apoptotic cells and apoptosis was shown to be caspase-dependent. Taurolidine treatment was also found to inhibit adhesion of OS cell lines. Compared to OS cell lines, normal bone cells in primary culture were found to be less sensitive to the cytotoxic and anti-adhesive effects of taurolidine. These data indicate that taurolidine possesses potent anti-neoplastic activity against osteosarcoma cell lines and may have potential as a novel OS chemotherapeutic agent.
Objective: To expand upon the limited knowledge of the long-term effects of prolonged-release (PR) fampridine in patients with multiple sclerosis (PwMS) regarding safety, walking improvements, and changes in drug responsiveness. Methods: Fifty-three PwMS who completed the FAMPKIN core study were included in this extension trial. Drug efficacy was assessed in an open-label and randomized doubleblind, placebo-controlled study design with regular baseline assessments over a period of 2 years using the Timed 25-Foot Walk (T25FW), 6-Minute Walk Test (6MWT), and 12-item MS Walking Scale (MSWS-12) as outcome measures. Results: The data showed good tolerability and persisting efficacy of PR fampridine during long-term treatment in PwMS. Significant improvements in walking speed, endurance, and self-perceived ambulatory function were observed during open-label (T25FW: +11.5%; 6MWT: 10.7%; MSWS-12: 6.1 points) and double-blind controlled treatment with PR fampridine (T25FW: +13.1%; 6MWT: 11.9%; MSWS-12: 7.4 points). Several patients showed changes in drug responsiveness over time, resulting in an increased proportion of patients exceeding 10% or 20% improvements in walking measures after long-term treatment. Conclusions: Efficacy and tolerability data confirmed PR fampridine as a valuable long-term treatment for improving ambulatory function in gait-impaired PwMS. Similar results in open-label and double-blind phases reveal that the walking tests used are objective and reliable. The considerable proportion of patients in whom responsiveness to PR fampridine changed over time emphasizes the importance of regular reassessment of drug efficacy in clinical practice to optimize treatment. Such reassessments seem to be particularly important in patients with poor initial drug responses, as this group demonstrated enhanced responsiveness after long-term treatment. Monitoring long-term efficacy of fampridine in gait-impaired patients with multiple sclerosis ABSTRACT Objective: To expand upon the limited knowledge of the long-term effects of prolonged-release
Overweight and obesity are considered a major burden on public health in developed countries. Underlying etiologies are enigmatic and metabolic causes have been suggested to various extents before. We analyze links of major blood parameters to individual body mass in a young male cohort, controlling for socio-cultural factors, in order to explore an underlying metabolic cause of obesity. Anthropometric (height, weight) physiologic (blood pressure) and metabolic data (total cholesterol, alanine transaminase, creatinine, postprandial glucose, blood cell counts, haemoglobin) of Swiss conscripts (N = 46,684; 18 - 20 yrs old; 2005-2007 census) were examined in the context of their socio-cultural groupings (occupation, mother tongue, religion) by ANOVA and stepwise multiple regression analysis. Swiss Armed Forces recruiting is mandatory, thus each year’s group studied reflects more than 80% of a year’s male Swiss citizen birth cohort. Individual body mass index ranged from 19 kg/m<sup>2</sup> (5th percentile) to 29 kg/m<sup>2</sup> (95th percentile) with a median of 22 kg/m<sup>2</sup>. BMI increases significantly, even within its normal range (18.5 - 25 kg/m<sup>2</sup>) with increases in alanine transaminase (r<sup>2</sup> = 0.10), total cholesterol (r<sup>2</sup> = 0.08) and erythrocyte counts (r<sup>2</sup> = 0.02). All other parameters, including socio-cultural categories, explain individually 1% or less of total BMI variation. Glucose values do not correlate with BMI significantly, thus suggesting a specific metabolic co-etiology of individual mass increases. There may occur a biochemical anomaly in liver metabolism that underlies development of the metabolic syndrome later in life. Were it so, pharmacological intervention rather than just diet and exercise regime could be more effective treatment of obesity
The accurate segmentation of lesions in magnetic resonance images of stroke patients is important, for example, for comparing the location of the lesion with functional areas and for determining the optimal strategy for patient treatment. Manual labeling of each lesion turns out to be time-intensive and costly, making an automated method desirable. Standard approaches for brain parcellation make use of spatial atlases that represent prior information about the spatial distribution of different tissue types and of anatomical structures of interest. Different from healthy tissue, however, the spatial distribution of a stroke lesion varies considerably, limiting the use of such brain image segmentation approaches for stroke lesion analysis, and for integrating brain parcellation with stroke lesion segmentation. In this study, we propose to amend the standard atlas-based generative image segmentation model by a spatial atlas of stroke lesion occurrence by making use of information about the vascular territories. As the territories of the major arterial trees often coincide with the location and extensions of large stroke lesions, we use 3D maps of the vascular territories to form patient-specific atlases combined with outlier information from an initial run, following an iterative procedure. We find our approach to perform comparable to (or better than) standard approaches that amend the tissue atlas with a flat lesion prior or that treat lesion as outliers, and to outperform both for large heterogeneous lesions.
Today, lumbar disc disease is a very common disease, which will be often seen in both the family practice as well as in the consultations of orthopedics, neurology, rheumatology or neurosurgery. Furthermore, lumbar disc surgery is one of the most common spinal surgical procedures worldwide. But, for many centuries, physician had no clear understanding of the anatomical condition and the pathomechanism of this disease. Therefore, no rational treatment was available. The Hippocratic physicians knew the signs and symptoms of lumbar disc disease, which they then called "sciatica". But, they subsumed different disorders, like hip diseases under this term. In the mid-18th century, it was the Italian physician Domenico Felice Antonio Cotugno (1736-1822), who first brought clarity in the concept of radicular syndromes; he recognized, that the so-called "sciatica" could be of neurogenic origin. In 1742, a contemporary of Cotugno, the German Josias Weitbrecht (1702-1747) has to be credited for the first precise description of the intervertebral disc. Nearby a hundred years later, the German Hubert von Luschka (1820-1875) described for the first time a herniated disc in a pathologic specimen. With the landmark report of the New England Journal of Medicine in 1934, the two American surgeons, William Jason Mixter (1880-1958) and Joseph Seaton Barr (1901-1963), finally cleared the pathomechanism of lumbar disc disease.
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