bluuebunny/crossref_metadata_2025 huggingface dataset:
A study on the correlation of matrix metalloproteinase MMP1 in COPD and smoking in the North Indian population
Authors: Rohil Vishwajeet , Vijayan V K , Kumar Raj , Joshi Rini , Pavani P , Paul Shweta , Sharma Anju , Rahman Mujeeb Ur
Published: January 2017

Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized by airway obstruction and destruction of lung tissue, the disease for which at present there is no cure, although the treatment can slow worsening. Nearly 90% of COPD is caused by long term cigarette smoking; however, only 25% of chronic tobacco smokers develop COPD, the exact cause of this predisposition of some smokers to acquire COPD is still poorly understood at the molecular level. Lot of studies are available showing the correlation of MMP1 and asthma but not much work has been done on its correlation with COPD especially in North India. The outcome of our study was also expected to discover MMP1 as a new target for treating COPD and its progression in smokers.Aim and Objectives: The association of COPD and smoking with MMP1 gene product and its SNP in the North Indian population was intended to be studied.Material and Methods: The proposed study was a case control study. In this study adults aged 30 years and above fulfilling the inclusion criteria (Please see Annexure I) were considered and a total of 180 subjects were taken after determining the sample size. Pulmonary function test (PFT) was performed by Spirometry. Three main groups each consisting of 60 subjects were formed on the basis of smoking history and Spirometry: Ist group: Smokers without co-morbidity with normal PFT, IInd group: Smokers with Spirometry proved COPD and without any other co-morbidity, IIIrd group: Healthy Non-smoker controls. Quantification of metalloproteinase MMP1 in all the groups were performed in the serum with ELISA kits and Single Nucleotide Polymorphism (SNP 1G-1607 2G, ID rs1799750) studies in the gene encoding MMP1 linked to COPD susceptibility in smokers was performed by DNA Sequencing Analysis. The correlation between the SNPs, gene product, smoking and COPD was studied.    Results: MMP1 concentration was seen increased in serum of COPD and smokers when compared to healthy controls.  And there is high negative correlation between *FEV1/FVC % (post-bronchodilator) and MMP1 in COPD compared to Smokers and Healthy Controls. However, from the results of present analysis, we could show negative correlation between MMP1 and *FEV1/FVC % in all the 3 groups but the correlation proves to be much more negative in Group II i.e. Smokers with COPD. Statistically Significant Positive Correlation of Pack Years with MMP1 conc., and Statistically Significant Negative Correlation between Pack Years and *FEV1/FVC % was seen.Conclusion:In conclusion, our present analyses did show significant association between MMP1 and COPD risk in North Indian population. MMP1 levels of COPD patients were significantly increased in smokers and may contribute to or be a marker of the pathophysiology of COPD. Asian Journal of Medical Sciences Vol.8(1) 2017 5-14
Image-guided stereotactic radiosurgery for treatment of spinal hemangioblastoma
Authors: Pan James , Ho Allen L. , D'Astous Myreille , Sussman Eric S. , Thompson Patricia A. , Tayag Armine T. , Pangilinan Louisa , Soltys Scott G. , Gibbs Iris C. , Chang Steven D.
Published: January 2017

OBJECTIVE

Stereotactic radiosurgery (SRS) has been an attractive treatment option for hemangioblastomas, especially for lesions that are surgically inaccessible and in patients with von Hippel-Lindau (VHL) disease and multiple lesions. Although there has been a multitude of studies examining the utility of SRS in intracranial hemangioblastomas, SRS has only recently been used for spinal hemangioblastomas due to technical limitations. The purpose of this study is to provide a long-term evaluation of the effectiveness of image-guided radiosurgery in halting tumor progression and providing symptomatic relief for spinal hemangioblastomas.

METHODS

Between 2001 and 2011, 46 spinal hemangioblastomas in 28 patients were treated using the CyberKnife image-guided radiosurgery system at the authors' institution. Fourteen of these patients also had VHL disease. The median age at treatment was 43.5 years (range 19–85 years). The mean prescription radiation dose to the tumor periphery was 21.6 Gy (range 15–35 Gy). The median tumor volume was 0.264 cm3 (range 0.025–70.9 cm3). Tumor response was evaluated on serial, contrast-enhanced CT and MR images. Clinical response was evaluated by clinical and imaging evaluation.

RESULTS

The mean follow-up for the cohort was 54.3 months. Radiographic follow-up was available for 19 patients with 34 tumors; 32 (94.1%) tumors were radiographically stable or displayed signs of regression. Actuarial control rates at 1, 3, and 5 years were 96.1%, 92.3%, and 92.3%, respectively. Clinical evaluation on follow-up was available for 13 patients with 16 tumors; 13 (81.2%) tumors in 10 patients had symptomatic improvement. No patient developed any complications related to radiosurgery.

CONCLUSIONS

Image-guided SRS is safe and effective for the primary treatment of spinal hemangioblastomas and is an attractive alternative to resection, especially for those with VHL disease.
Impact of cervicothoracic region stereotactic spine radiosurgery on adjacent organs at risk
Authors: Sharma Mayur , Bennett Elizabeth E. , Rahmathulla Gazanfar , Chao Samuel T. , Koech Hilary K. , Gregory Stephanie N. , Emch Todd , Magnelli Anthony , Meola Antonio , Suh John H. , Angelov Lilyana
Published: January 2017

OBJECTIVE

Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients.

METHODS

Fifty-six consecutive patients (60 procedures) with a cervicothoracic spine tumor involving segments within C5–T1 who were treated using single-fraction SRS between February 2006 and July 2014 were included in the study. Each patient underwent CT simulation and high-definition MRI before treatment. The clinical target volume and OAR were contoured on BrainScan and iPlan software after image fusion. Radiation toxicity was evaluated using the common toxicity criteria for adverse events and correlated to the radiation doses delivered to these regions. The incidence of vertebral body compression fracture (VCF) before and after SRS was evaluated also.

RESULTS

Metastatic lesions constituted the majority (n = 52 [93%]) of tumors treated with SRS. Each patient was treated with a median single prescription dose of 16 Gy to the target. The median percentage of tumor covered by SRS was 93% (maximum target dose 18.21 Gy). The brachial plexus received the highest mean maximum dose of 17 Gy, followed by the esophagus (13.8 Gy) and spinal cord (13 Gy). A total of 14 toxicities were encountered in 56 patients (25%) during the study period. Overall, 14% (n = 8) of the patients had Grade 1 toxicity, 9% (n = 5) had Grade 2 toxicity, 2% (n = 1) had Grade 3 toxicity, and none of the patients had Grade 4 or 5 toxicity. The most common (12%) toxicity was dysphagia/odynophagia, followed by axial spine pain flare or painful radiculopathy (9%). The maximum radiation dose to the brachial plexus showed a trend toward significance (p = 0.066) in patients with worsening post-SRS pain. De novo and progressive VCFs after SRS were noted in 3% (3 of 98) and 4% (4 of 98) of vertebral segments, respectively.

CONCLUSIONS

From the analysis, the current SRS doses used at the Cleveland Clinic seem safe and well tolerated at the cervicothoracic junction. These preliminary data provide tolerance benchmarks for OAR in this region. Because the effect of dose-escalation SRS strategies aimed at improving local tumor control needs to be balanced carefully with associated treatment-related toxicity on adjacent OAR, larger prospective studies using such approaches are needed.
Pathological characteristics of spine metastases treated with high-dose single-fraction stereotactic radiosurgery
Authors: Katsoulakis Evangelia , Laufer Ilya , Bilsky Mark , Agaram Narasimhan P. , Lovelock Michael , Yamada Yoshiya
Published: January 2017

OBJECTIVE

Spine radiosurgery is increasingly being used to treat spinal metastases. As patients are living longer because of the increasing efficacy of systemic agents, appropriate follow-up and posttreatment management for these patients is critical. Tumor progression after spine radiosurgery is rare; however, vertebral compression fractures are recognized as a more common posttreatment effect. The use of radiographic imaging alone posttreatment may makeit difficult to distinguish tumor progression from postradiation changes such as fibrosis. This is the largest series from a prospective database in which the authors examine histopathology of samples obtained from patients who underwent surgical intervention for presumed tumor progression or mechanical pain secondary to compression fracture. The majority of patients had tumor ablation and resulting fibrosis rather than tumor progression. The aim of this study was to evaluate tumor histopathology and characteristics of patients who underwent pathological sampling because of radiographic tumor progression, fibrosis, or collapsed vertebrae after receiving high-dose single-fraction stereotactic radiosurgery.

METHODS

Between January 2005 and January 2014, a total of 582 patients were treated with linear accelerator–based single-fraction (18–24 Gy) stereotactic radiosurgery. The authors retrospectively identified 30 patients (5.1%) who underwent surgical intervention for 32 lesions with vertebral cement augmentation for either mechanical pain or instability secondary to vertebral compression fracture (n = 17) or instrumentation (n = 15) for radiographic tumor progression. Radiation and surgical treatment, histopathology, and long-term outcomes were reviewed. Survival and time to recurrence were calculated using the Kaplan-Meier method.

RESULTS

The mean age at the time of radiosurgery was 59 years (range 36–80 years). The initial pathological diagnoses were obtained for all patients and primarily included radioresistant tumor types, including renal cell carcinoma in 7 (22%), melanoma in 6 (19%), lung carcinoma in 4 (12%), and sarcoma in 3 (9%). The median time to surgical intervention was 24.7 months (range 1.6–50.8 months). The median follow-up and overall survival for all patients were 42.5 months and 41 months (overall survival range 7–86 months), respectively. The majority of assessed lesions showed no evidence of tumor on pathological review (25 of 32, 78%), while a minority of lesions revealed residual tumor (7 of 32, 22%). The median survival for patients after tumor recurrence was 5 months (range 2–70 months).

CONCLUSIONS

High-dose single-fraction radiosurgery is tumor ablative in the majority of instances. In a minority of cases, tumor persists and salvage treatments should be considered.
Image-guided resection of aggressive sacral tumors
Authors: Drazin Doniel , Bhamb Neil , Al-Khouja Lutfi T. , Kappel Ari D. , Kim Terrence T. , Johnson J. Patrick , Brien Earl
Published: January 2017

OBJECTIVE

The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors.

METHODS

The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumors treated between 2009 and 2016. They also reviewed the literature to identify articles related to aggressive sacral tumors, their diagnosis, and their surgical treatment and discuss the results together with their own experience. Information, including background, imaging, treatment, and surgical pearls, is organized by tumor type.

RESULTS

Review of the institutional records identified 6 patients with sacral tumors who underwent surgery between 2009 and 2016. All 6 patients were treated with image-guided surgery using cone-beam CT technology (O-arm). The surgical technique used is described in detail, and 2 illustrative cases are presented. From the literature, the authors compiled information about chordomas, chondrosarcomas, giant cell tumors, and osteosarcomas and organized it by tumor type, providing a detailed discussion of background, imaging, and treatment as well as surgical pearls for each tumor type.

CONCLUSIONS

Aggressive sacral tumors can be an extremely difficult challenge for both the patient and the treating physician. The selected surgical intervention varies depending on the type of tumor, size, and location. Surgery can have profound risks including neural compression, lumbopelvic instability, and suboptimal oncological resection. Focusing on the operative nuances for each type can help prevent many of these complications. Anecdotal evidence is provided that utilization of image-guided surgery to aid in tumor resection at our institution has helped reduce blood loss and the local recurrence rate while preserving function in both malignant and aggressive benign tumors affecting the sacrum.
Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series
Authors: de Ruiter Godard C. W. , Nogarede Claudine O. , Wolfs Jasper F. C. , Arts Mark P.
Published: January 2017

OBJECTIVE

The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL.

METHODS

The authors prospectively followed a cohort of 113 patients with spinal metastases who were referred to their clinic for surgical evaluation between July 2012 and July 2014. Quality of life was assessed using the EQ-5D at intake and at 3, 6, 9, and 12 months after treatment.

RESULTS

Nineteen patients were treated conservatively, 41 underwent decompressive surgery with or without stabilization, 47 underwent a piecemeal corpectomy procedure with stabilization and expandable cage reconstruction, and 6 had a stabilization procedure without decompression. Among all surgical patients, the mean EQ-5D score was significantly increased from 0.44 pretreatment to 0.59 at 3 months after treatment (p < 0.001). Mean EQ-5D scores at 1 year after surgery further increased to 0.84 following decompression with stabilization, 0.74 after corpectomy with stabilization, and 0.94 after stabilization without decompression. Frankel scores also improved after surgery. There were no significant differences in improvements in EQ-5D scores and Frankel grades among the different surgical procedures. In addition, mortality and complication rates were similar.

CONCLUSIONS

Quality of life can improve significantly after various extensive and less extensive surgical procedures in patients with spinal metastases. The relatively invasive corpectomy procedure, as compared with alternative less invasive techniques, does not negatively affect outcome.
Rapid and complete radiological resolution of an intradural cervical cord lung cancer metastasis treated with spinal stereotactic radiosurgery: case report
Authors: Bennett E. Emily , Berriochoa Camille , Habboub Ghaith , Brigeman Scott , Chao Samuel T. , Angelov Lilyana
Published: January 2017

Stereotactic radiosurgery (SRS) has emerged as a treatment option for patients with spinal metastatic disease. Although SRS has been shown to be successful in a multitude of extradural metastatic tumors causing cord compression, very few cases of intradural treatment have been reported. The authors present a rare case of an intradural extramedullary metastatic small cell lung cancer lesion to the cervical spine resulting in cord compression in an area that had also been extensively pretreated with conventional external-beam radiation therapy. The patient underwent successful SRS to this metastatic site, with rapid and complete resolution of his lesion.
Anatomic and functional imaging in the diagnosis of spine metastases and response assessment after spine radiosurgery
Authors: Soliman Moaaz , Taunk Neil K. , Simons Robert E. , Osborne Joseph R. , Kim Michelle M. , Szerlip Nicholas J. , Spratt Daniel E.
Published: January 2017

Spine stereotactic radiosurgery (SSRS) has recently emerged as an increasingly effective treatment for spinal metastases. Studies performed over the past decade have examined the role of imaging in the diagnosis of metastases, as well as treatment response following SSRS. In this paper, the authors describe and review the utility of several imaging modalities in the diagnosis of spinal metastases and monitoring of their response to SSRS. Specifically, we review the role of CT, MRI, and positron emission tomography (PET) in their ability to differentiate between osteoblastic and osteolytic lesions, delineation of initial bony pathology, detection of treatment-related changes in bone density and vertebral compression fracture after SSRS, and tumor response to therapy. Validated consensus guidelines defining the imaging approach to SSRS are needed to standardize the diagnosis and treatment response assessment after SSRS. Future directions of spinal imaging, including advances in targeted tumor-specific molecular imaging markers demonstrate early promise for advancing the role of imaging in SSRS.
Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance
Authors: Monserrate Andrés , Zussman Benjamin , Ozpinar Alp , Niranjan Ajay , Flickinger John C. , Gerszten Peter C.
Published: January 2017

OBJECTIVE

Cone-beam CT (CBCT) image guidance technology has been widely adopted for spine radiosurgery delivery. There is relatively little experience with spine radiosurgery for intradural tumors using CBCT image guidance. This study prospectively evaluated a series of intradural spine tumors treated with radiosurgery. Patient setup accuracy for spine radiosurgery delivery using CBCT image guidance for intradural spine tumors was determined.

METHODS

Eighty-two patients with intradural tumors were treated and prospectively evaluated. The positioning deviations of the spine radiosurgery treatments in patients were recorded. Radiosurgery was delivered using a linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality assurance CBCTs were performed and recorded in 30 patients: before, halfway, and after the radiosurgery treatment. The positioning data and fused images of planning CT and CBCT from the treatments were analyzed to determine intrafraction patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained.

RESULTS

The radiosurgery procedure was successfully completed for all patients. Lesion locations included cervical (22), thoracic (17), lumbar (38), and sacral (5). Tumor histologies included schwannoma (27), neurofibromas (18), meningioma (16), hemangioblastoma (8), and ependymoma (5). The mean prescription dose was 17 Gy (range 12–27 Gy) delivered in 1–3 fractions. At the halfway point of the radiation, the translational variations and standard deviations were 0.4 ± 0.5, 0.5 ± 0.8, and 0.4 ± 0.5 mm in the lateral (x), longitudinal (y), and anteroposterior (z) directions, respectively. Similarly, the variations immediately after treatment were 0.5 ± 0.4, 0.5 ± 0.6, and 0.6 ± 0.5 mm along x, y, and z directions, respectively. The mean rotational angles were 0.3° ± 0.4°, 0.3° ± 0.4°, and 0.3° ± 0.4° along yaw, roll, and pitch, respectively, at the halfway point and 0.5° ± 0.5°, 0.4° ± 0.5°, and 0.2° ± 0.3° immediately after treatment.

CONCLUSIONS

Radiosurgery offers an alternative treatment option for intradural spine tumors in patients who may not be optimal candidates for open surgery. CBCT image guidance for patient setup for spine radiosurgery is accurate and successful in patients with intradural tumors.
CyberKnife stereotactic radiosurgery for the treatment of symptomatic vertebral hemangiomas: a single-institution experience
Authors: Zhang Michael , Chen Yi-Ren , Chang Steven D. , Veeravagu Anand
Published: January 2017

OBJECTIVE

Symptomatic vertebral hemangiomas (SVHs) are a very rare pathology that can present with persistent pain or neurological deficits that warrant surgical intervention. Given the relative rarity and difficulty in assessment, the authors sought to present a dedicated series of SVHs treated using stereotactic radiosurgery (SRS) to provide insight into clinical decision making.

METHODS

A retrospective review of a single institution's experience with hypofractionated radiosurgery for SVH from 2004 to 2011 was conducted to determine the clinical and radiographic outcomes following SRS treatment. The authors report and analyze the treatment course of 5 patients with 7 lesions, 2 of which were treated primarily by SRS.

RESULTS

Of the 5 patients studied, 4 presented with a chief complaint of pain refractory to conservative measures. Three patients reported dysesthesias, and 2 reported upper-extremity weakness. Following radiosurgery, 4 of 5 patients exhibited improvement in their primary symptoms (3 for pain and 1 for weakness), achieving a clinical response after a mean period of 1 year. In 2 cases there was 20%–40% reduction in lesion size in the most responsive dimension as noted on images. All treatments were well tolerated.

CONCLUSIONS

SRS for SVH is a safe and feasible treatment strategy, comparable to prior radiotherapy studies, and in select cases may successfully confer delayed decompressive effects. Additional investigation will determine future patient selection and how conformal SRS treatment can best be administered.
Spinal stereotactic body radiotherapy following intralesional curettage with separation surgery for initial or salvage chordoma treatment
Authors: Lockney Dennis T. , Shub Timothy , Hopkins Benjamin , Lockney Natalie A. , Moussazadeh Nelson , Lis Eric , Yamada Yoshiya , Schmitt Adam M. , Higginson Daniel S. , Laufer Ilya , Bilsky Mark
Published: January 2017

OBJECTIVE

Chordoma is a rare malignant tumor for which en bloc resection with wide margins is advocated as primary treatment. Unfortunately, due to anatomical constraints, en bloc resection to achieve wide or marginal margins is not feasible for many patients as the resulting morbidity would be prohibitive. The objective of this study was to evaluate the efficacy of intralesional curettage and separation surgery followed by spinal stereotactic body radiation therapy (SBRT) in patients with chordomas in the mobile spine.

METHODS

The authors performed a retrospective chart review of all patients with chordoma in the mobile spine treated from 2004 to 2016. Patients were identified from a prospectively collected database. Initially 22 patients were identified with mobile spine chordomas. With inclusion criteria of cytoreductive separation surgery followed closely by SBRT and a minimum of 6 months of follow-up imaging, 12 patients were included. Clinical and pathological characteristics of each patient were collected and data were analyzed. Patients were divided into two cohorts—those undergoing intralesional resection followed by SBRT as initial chordoma treatment at Memorial Sloan Kettering Cancer Center (MSKCC) (Cohort 1) and those undergoing salvage treatment following recurrence (Cohort 2). Treatment toxicities were classified according to the Common Terminology Criteria for Adverse Events version 4.03. Overall survival was analyzed using Kaplan-Meier analysis.

RESULTS

The 12 patients had a median post-SBRT follow-up time of 26 months. Cohort 1 had 5 patients with median post-SBRT follow-up time of 65.9 months and local control rate of 80% at last follow-up. Only one patient had disease progression, at 48.2 months following surgery and SBRT. Cohort 2 had 7 patients who had been treated at other institutions prior to undergoing both surgery and SBRT (salvage therapy) at MSKCC. The local control rate was 57.1% and the median follow-up duration was 10.7 months. One patient required repeat irradiation. Major surgery- and radiation-related complications occurred in 18% and 27% of patients, respectively. Epidural spinal cord compression scores were collected for each patient pre- and postoperatively.

CONCLUSIONS

The combination of surgery and SBRT provides excellent local control following intralesional curettage and separation surgery for chordomas in the mobile spine. Patients who underwent intralesional curettage and spinal SBRT as initial treatment had better disease control than those undergoing salvage therapy. High-dose radiotherapy may offer several biological benefits for tumor control.
Dynamic contrast-enhanced magnetic resonance imaging of osseous spine metastasis before and 1 hour after high-dose image-guided radiation therapy
Authors: Lis Eric , Saha Atin , Peck Kyung K. , Zatcky Joan , Zelefsky Michael J. , Yamada Yoshiya , Holodny Andrei I. , Bilsky Mark H. , Karimi Sasan
Published: January 2017

OBJECTIVE

High-dose image-guided radiation therapy (HD IGRT) has been instrumental in mitigating some limitations of conventional RT. The recent emergence of dynamic contrast-enhanced (DCE) MRI to investigate tumor physiology can be used to verify the response of human tumors to HD IGRT. The purpose of this study was to evaluate the near-immediate effects of HD IGRT on spine metastases through the use of DCE MRI perfusion studies.

METHODS

Six patients with spine metastases from prostate, thyroid, and renal cell carcinoma who underwent HD IGRT were studied using DCE MRI prior to and 1 hour after HD IGRT. The DCE perfusion parameters plasma volume (Vp) and vascular permeability (Ktrans) were measured to assess the near-immediate and long-term tumor response. A Mann-Whitney U-test was performed to compare significant changes (at p ≤ 0.05) in perfusion parameters before and after RT.

RESULTS

The authors observed a precipitous drop in Vp within 1 hour of HD IGRT, with a mean decrease of 65.2%. A significant difference was found between Vp values for before and 1 hour after RT (p ≤ 0.05). No significant change was seen in Vp (p = 0.31) and Ktrans (p = 0.1) from 1 hour after RT to the first follow-up.

CONCLUSIONS

The data suggest that there is an immediate effect of HD IGRT on the vascularity of spine metastases, as demonstrated by a precipitous decrease in Vp. The DCE MRI studies can detect such changes within 1 hour after RT, and findings are concordant with existing animal models.
Two-level cervical arthroplasty using a “no-distraction” technique
Authors: Rajakumar Deshpande , Sharma Ankit , Hari Akshay , Konar Subhas , Krishna Murali
Published: January 2017

Cervical arthroplasty is being recognized as an emerging alternative to anterior cervical fusion with comparable or superior outcomes. The authors describe the surgical nuances of 2-level cervical arthroplasty in a case of 2-level degenerative disease. In this surgical technique, conventional vertebral body distraction has been avoided to prevent facet distraction, which can be a cause of persistent postoperative neck pain. Good motion preservation was observed at the 1-year follow-up examination.

The video can be found here: https://youtu.be/YTpRVRXuZZk.
Resection of uncovertebral joints and posterior longitudinal ligament for cervical disc arthroplasty
Authors: Tu Tsung-Hsi , Chang Chih-Chang , Wu Jau-Ching , Fay Li-Yu , Huang Wen-Cheng , Cheng Henrich
Published: January 2017

The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the physiological range of motion of the indexed joint. Thus, the effect of indirect decompression gained by the insertion of a sufficiently large interbody graft and incorporation into arthrodesis after ACDF cannot be duplicated for CDA. For patients undergoing CDA, during extreme flexion/extension or rotation, the exiting nerve roots might be impinged by inadequately decompressed foraminal osteophytes. Therefore, the authors advocate generous decompression, including resection of the posterior longitudinal ligament (PLL) and bilateral uncovertebral joints (UVJs), even in the asymptomatic side. This video demonstrates full dural expansion and enlarged neuroforamen after removal of the PLL and UVJs. Venous hemorrhage encountered during foraminotomy can always be controlled by cottonoid packing or hemostatic agents. Also, the endplates of the surrounding vertebral bodies were meticulously prepared for parallel insertion of the ProDisc-C Nova (DePuy Synthes Spine) artificial disc. Please note that the ProDisc-C Nova is currently not available on the US market.

The video can be found here: https://youtu.be/XUo34j6WFYs.
Surgical technique for revision surgery of cervical artificial disc replacements
Authors: Onken Julia , Meyer Bernhard , Vajkoczy Peter
Published: January 2017

OBJECTIVE

Cervical artificial disc replacement (C-ADR) is a widely used procedure with low risk at implantation. Few cases have been reported about the surgical techniques of C-ADR revision. The authors describe their surgical experience with the explantation of a Galileo C-ADR.

METHODS

Revision surgery was performed in a 58-year-old patient. Patient positioning and surgical opening techniques were performed as appropriate for anterior cervical decompression.

RESULTS

Revision surgery via the initial anterior approach was successful following an atraumatic removal of the implant. Fusion of the C5–6 segment was performed without complications.

CONCLUSIONS

In general, the authors observed recurrent nerve palsy and malpositioning of the revised implant in C-ADR revision surgery. Problems with implant removal did not occur because the fusion rate was low due to the short time between initial surgery and C-ADR revision surgery.

The video can be found here: https://youtu.be/32CUEDquinc.
Stepwise illustration of teeth-fixation semi-constrained cervical disc arthroplasty
Authors: Chang Chih-Chang , Wu Jau-Ching , Chang Peng-Yuan , Yeh Mei-Yin , Kuo Yi-Hsuan , Fay Li-Yu , Tu Tsung-Hsi , Huang Wen-Cheng , Cheng Henrich
Published: January 2017

There are many kinds of artificial discs available for cervical disc arthroplasty (CDA), with various designs of fixation and articulation mechanisms. Each of these designs has different features and theoretically fits most optimally in selected types of patients. However, there has been insufficient literature to guide individualized selection among these CDA devices. Since CDA aims to restore the joint function rather than arthrodesis, tailor-made size, shape, and mechanical properties should be taken into account for each candidate's target disc. Despite several large-scale prospective randomized control trials that have demonstrated the effectiveness and durability of CDA for up to 8 years, none of them involved more than one kind of artificial disc. In this video the authors present detailed steps and technical aspects of the newly introduced ProDisc-C Vivo (DePuy Synthes Spine), which has the same ball-and-socket design for controlled, predictable motion as the ProDisc-C. The newly derived teeth fixation provides high primary stability and multilevel capability by avoidance of previous keel-related limitations and complications (e.g., split vertebral fracture). Please note that the ProDisc-C Vivo is currently not available on the US market.

The authors present the case of a 53-year-old woman who had symptoms of both radiculopathy and myelopathy caused by a large, calcified disc herniation at C4–5. There was no improvement after 4 months of medical treatment and rehabilitation. A single-level CDA was successfully performed with the ProDisc-C Vivo, and her symptoms were completely ameliorated afterward. The follow-up images demonstrated preservation of motion at the indexed level.

The video can be found here: https://youtu.be/4DSES1xgvQU.
Hybrid cervical disc arthroplasty
Authors: Tu Tsung-Hsi , Wu Jau-Ching , Cheng Henrich , Mummaneni Praveen V.
Published: January 2017

For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level.

The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3–4 and bulging disc at C5–6. After nonoperative treatment failed, she underwent a single-level ACDF at C3–4 and single-level arthroplasty at C5–6, which successfully relieved her symptoms. No intervention was performed at the normal intervening C4–5 segment. By using ACDF combined with arthroplasty, the authors have avoided a 3-level fusion for this patient and maintained the range of motion of 2 disc levels.

The video can be found here: https://youtu.be/OrxcPUBvqLk.
M6-C artificial disc placement
Authors: Coric Domagoj , Parish John , Boltes Margaret O.
Published: January 2017

There has been a steady evolution of cervical total disc replacement (TDR) devices over the last decade resulting in surgical technique that closely mimics anterior cervical discectomy and fusion as well as disc design that emphasizes quality of motion. The M6-C TDR device is a modern-generation artificial disc composed of titanium endplates with tri-keel fixation as well as a polyethylene weave with a polyurethane core. Although not yet approved by the FDA, M6-C has finished a pilot and pivotal US Investigational Device Exemption (IDE) study. The authors present the surgical technique for implantation of a 2-level M6-C cervical TDR device.

The video can be found here: https://youtu.be/rFEAqINLRCo.
Intrahemispheric theta rhythm desynchronization impairs working memory
Authors: Alekseichuk Ivan , Pabel Stefanie Corinna , Antal Andrea , Paulus Walter
Published: January 2017

Background: There is a growing interest in large-scale connectivity as one of the crucial factors in working memory. Correlative evidence has revealed the anatomical and electrophysiological players in the working memory network, but understanding of the effective role of their connectivity remains elusive.

Objective: In this double-blind, placebo-controlled study we aimed to identify the causal role of theta phase connectivity in visual-spatial working memory.

Methods: The frontoparietal network was over- or de-synchronized in the anterior-posterior direction by multi-electrode, 6 Hz transcranial alternating current stimulation (tACS).

Results: A decrease in memory performance and increase in reaction time was caused by frontoparietal intrahemispheric desynchronization. According to the diffusion drift model, this originated in a lower signal-to-noise ratio, known as the drift rate index, in the memory system. The EEG analysis revealed a corresponding decrease in phase connectivity between prefrontal and parietal areas after tACS-driven desynchronization. The over-synchronization did not result in any changes in either the behavioral or electrophysiological levels in healthy participants.

Conclusion: Taken together, we demonstrate the feasibility of manipulating multi-site large-scale networks in humans, and the disruptive effect of frontoparietal desynchronization on theta phase connectivity and visual-spatial working memory.
Leaf micromorphological features of the genus Cordia L. (Boraginaceae) from Egypt
Authors: Amer Wafaa , Hamdy Rim , Mahdy Riham
Published: January 2017

Foliar epidermal characters of nine Cordia L. species found in Egypt are investigated. Glandular trichomes are observed in C. boissieri A. DC. and C. cylindristachya (Ruiz & Pav.) Roem. & Schult., while eglandular trichomes are predominant in all studied species. Different stomatal characters were examined including: shape, size, rims, stomatal level, aperture, cuticular deposition and wax ornamentation. The retrieved results showed a great variation among the studied species. The observed trichomes and stomata were used to construct two different taxonomic keys.Bangladesh J. Plant Taxon. 23(2): 119-131, 2016 (December)
Evaluation of Antibiotic Sensitivity Pattern and Plasmid Isolation of Klebsiella Pneumoniae Isolates from Clinical Specimens in Sylhet City, Bangladesh
Authors: Bhattacharjee P. , Alam M. Z. , Sayem S. M. A.
Published: January 2017

Klebsiella pneumoniae is recognized as an emerging opportunistic bacterial pathogen of clinical relevance for its association with both community acquired and nosocomial infections. Moreover, increased resistance to common antimicrobial agents complicates and limits available therapeutic options. The aim of this study was to investigate an antibiotic sensitivity pattern of K. pneumoniae isolated from clinical samples against commonly used antibiotics and to focus on the associated therapeutic challenges. Presumptive K. pneumoniae isolates were collected from a variety of sources like urine sample, pus, wound swab etc. and further analyzed through standard microbiological methods. Following the identification of 23 bacterium isolates from the collected specimens, an antimicrobial sensitivity test was carried out. The results of this test indicated that the organisms possess diversity of susceptibility profiles towards the drugs tested. A high rate of resistance to the first line antibiotics like Amoxicillin (100%), Vancomycin (90.90%), Erythromycin (83.33%), and Cotrimoxazole (83.33%), designates a critical therapeutic challenge. However, inspite of a moderate sensitivity to the Gentamicin (43.5%), increased number of intermediate sensitivity to the drugs tested clearly point towards the multi-drug resistance of the K. pneumoniae isolates. Plasmid profiling experiment revealed that the size of the isolated plasmids varied in length, ranging from 800-900bp.
Effect of Hydromagnetic Mixed Convection Double Lid-Driven Square Cavity with Inside Elliptic Heated Block
Authors: Munshi M. J. H. , Alim M. A.
Published: January 2017

Mixed convection heat transfer in a two-dimensional the effect of hydromagnetic mixed convection in a double lid driven square cavity with inside elliptic heated block is studied numerically. The left wall of the square cavity and inside the elliptic block was  kept at Th while the right wall  of the square cavity at a cold temperature Tc with Th > Tc. The lid is assumed to be upper wall moving in left to right and lower wall right to left directions respectively. The magnetic field of strength B is applied parallel to x- axis. Result is presented firstly for different Reynolds number (50 ? Re ? 150), Prandtl number Pr= 0.733 and presented for different Grashof number (103 ? Gr ? 106). The numerical results studied the effect of Reynolds number, Grashof number and buoyancy ratio on the local values. It is found that direction of lid and different elliptic heated block are more effective on heat and mass transfer on fluid flow with increasing magnetic field for all studied parameters.
Bayesian Analysis of Warners Randomized Response Technique
Authors: Adepetun A. O. , Adewara A. A.
Published: January 2017

This paper proposed alternative beta estimators of the population proportion of a sensitive attribute when life data were obtained through the administration of survey questionnaires on abortion of some matured women. The results showed that the proposed alternative beta estimators were more efficient in capturing responses from respondents than the simple beta estimator proposed by Winkler and Franklin for relatively small, medium as well as large sample sizes respectively.
Abundance of Shrimp (Penaeus Monodon) Post Larvae (PL) and to Quantify the Damage of Different Aquatic Fauna during Shrimp PL Collection in Mongla Tidal River (Rampal), Bagerhat
Authors: Ferdousy J. , Islam M. S. , Begum N.
Published: January 2017

The study was conducted in Mongla tidal river (Rampal) of Bagerhat district from November 2014 to October 2015 to assess the abundance of black tiger shrimp (Penaeus monodon) post larvae (PL) and to quantify the damage of different aquatic fauna during collection of P. monodon PL. Insignificant variation in water temperature, pH, salinity and hardness were found but salinity and hardness showed great fluctuation during the study period. On average 6.3 million of P. monodon PL were collected annually from the studied area and around 0.16 million man days/year were estimated to be involved in shrimp PL collection activities. It was found that about 412 other shrimp larvae, 391 fin fishes and 1696 other macrozooplankton were killed during the period of collection for only one PL of P. monodon. It was also calculated from the present study that about 29,874 million of other shrimp species, fin fishes and macrozooplankton were destroyed annually by the shrimp seed harvesting process in Mongla river. The study implies that present seed collection practice caused severe damage of other valuable aquatic fauna, which directly affect the biodiversity of tidal waters, natural productivity, improvement of mother stock and environment friendly of coastal and marine water.
Shrimp Post-Larvae Nursing in Earthen Ponds, Bangladesh
Authors: Jannat M. , Ahmed M. K. , Islam M. M. , Kundu G. K. , Kamruzzaman M.
Published: January 2017

In Bangladesh, shrimp post-larvae (PL) are mainly produced in hatcheries. From 2000s shrimp PL are reared in nurseries containing small earthen ponds by relatively poor people for a few days before stocking into the shrimp farms. This study assesses the physical and chemical parameters of five such nurseries at Satkhira district, Bangladesh using scientific instruments and semi-structured questionnaire. The nursing process involved stocking of PL (4151.8 ± 1581.35 PL/m2) in small earthen ponds (<18m2 area/pond) and raring for up to 10 days with feeding. Most of the physico-chemical parameters were within the suitable range recommended for shrimp culture. The survival rate of PL ranged from 80% to 90%. The nursing system was profitable as the average Benefit-Cost Ratio (BCR) was 1.19. The establishment and operation of these nurseries do not require any expensive equipment or complex technology and can be run by less educated and poor people. However, constraints like lack of credit and continuous water supply are hindering the scaling up of these nurseries in size and number. By providing means to overcome the constraints these nurseries can be an excellent income generating source for the poor entrepreneurs as well as contribute in increasing shrimp production in Bangladesh.
Mid Latitude Sporadic E-layer Variability during Ascending Phase of Solar Cycle 24
Authors: Atulkar R. , Khan P. A. , Mansoori A. A. , Purohit P. K.
Published: January 2017

The paper presents a comparative study of the ionospheric sporadic E layer parameters (fbEs, foEs, and hEs) retrieved from ground based ionosonde at mid latitude station Yamagawa, Japan (31.20 N, 130.370 E) during the ascending phase of 24th solar cycle i.e. during January 2012 to December 2014. The comparison between the E-region parameters has been carried out on a diurnal, seasonal, annual and day night basis. The diurnal maxima of foEs, fbEs, and hEs are generally higher during high solar activity. From the present study it is found that the highest values of fbEs are observed during the summer while the lowest values are observed during autumn at mid latitude. Similarly, the highest values of foEs are observed during the summer season while the lowest values are recorded in autumn season. However, the highest values of hEs are recorded during the spring and the lowest values are recorded in autumn. The variability of Es during the day and night time is also studied. The sporadic E can form and disappear in a short time during either the day or night. We have also studied the percentage occurrence of sporadic E. The occurrence of Es changes from year to year.
Effects of Essential Fatty Acids Containing Natural and Commercial Diets on Larvae Rearing of the Green Mud Crab Scylla Paramamosain (Estampador 1949)
Authors: Islam M. L. , Islam M. S. , Yahya K. , Hashim R.
Published: January 2017

Effect of essential fatty acids (EFA) on growth and survival of the green mud crab (Scylla paramamosain) larvae was assessed by feeding with natural to commercial diets. The feeding schemes were: larvae reared with Artemia (T1); larvae initially fed with rotifers (up to Z2) and ended (Z3 to megalopa) with Artemia (T2); and larvae fed with rotifers up to Z2 and ended (Z3 to megalopa) with commercial diet (T3). The commercial diet had significantly (p<0.05) higher levels of docosahexaenoic acid (11.23%), ?n-3s (15.90%) and ?n-6s (4.21%); and lacked in eicosapentaenoic acid (2.25%) than rotifer and Artemia. The earliest commencement of megalopa stage within 15 days with significantly (p<0.05) higher larval stage index (LSI) of 5.90±0.17 was achieved from the feeding scheme of T2 than other two feeding schemes. This feeding scheme deposited 17.32±0.19% eicosapentaenoic acid (EPA) and 3.82±0.11% docosahexaenoic acid (DHA); the ?n-3 to ?n-6 ratio of 0.20 and EPA to DHA ratio of 0.22 in megalopa, that stimulated significantly higher (p<0.05) megalopa survival (20.00±6.96%) indicating the superiority over rest feeding schemes. Meanwhile, some deformities and mortalities in Z5 and megalopa stages suggested further studies for optimization of specific fatty acid requirements for late larval stages (Z5 and megalopa).
Child Weaning Practices among Selected Urban Slums of Dhaka City, Bangladesh
Authors: Afroz H. , Khan M. N. I. , Hasan M. N.
Published: January 2017

When a baby reaches 4-6 months, milk alone is not sufficient to meet the increased nutritional needs of the baby. Weaning is the process by which a baby slowly gets used to eating family or adult foods along with breast milk. The aim of the study was to assess the weaning practices in the selected urban slums of Dhaka city, Bangladesh among male and female children in the age group of 6 months to 1 year by random sampling. It revealed that 54% infants were fed breast milk and 38.5% infants were fed honey as their first food. About 94.5% infants were given breast milk within (1-24) h, 5% within (24-48) h and 0.5% within (48-72) h. As a weaning food majority of the respondents (39%) used khichuri, 24.5% used mashed potato/banana, 19% used powdered rice, 17% used suzi and 0.5% used others. 33% respondents had no knowledge about nutritious food. About 54%, 38.5%, 6.5% and 1.0% mothers fed their baby breast milk, honey, sugar and other food items respectively just after birth. The studied population group is not only poverty stricken, but also has poor knowledge, attitude and practice on health, hygiene, nutrition and nutritious food.