(PACE 2009; 32:1123-1129).”
“Biochemical markers of bone turnover have been shown to be useful as inexpensive and noninvasive tools for monitoring skeletal health. The reference range for bone markers in dogs has been set by different age groups. However, other sources of biological variations were not fully investigated in dogs. To explore whether sex influences the interpretation of bone marker data we examined serum bone markers in 33 male JPH203 clinical trial and 25 female dogs. The bone markers selected for this study were: bone alkaline phosphatase (BALP) and osteocalcin

(OC) as indicators of bone formation, and C-terminal telopeptide (CTx) of type I collagen as marker of bone resorption. All concentrations of bone markers were lower, but still within the reference range reported for dogs. We found statistically significant differences of the median OC and CTx serum

concentrations between males and this website females. The results of this study suggest that there are sex differences in biochemical markers of bone turnover in dogs which should be considered in interpretation of bone marker data. (C) 2012 Elsevier Ltd. All rights reserved.”
“Study Design. A clinicopathologic study of synovial cysts in the ligamentum flavum (LF) in patients with spinal stenosis.

Objective. To investigate the pathogenesis of lumbar juxtafacet cysts.

Summary of Background Data. Contradictions in the terminology applied to lumbar juxtafacet cysts arise from the frequent sparsity of synovial lining cells, which has led to synovial cysts often being called “”ganglion cysts”" despite lacking confirmatory pathology.

Methods. Dihydrotestosterone A total of 27 consecutive patients with radiologically confirmed stenosis underwent laminectomy. LF/facet joint (FJ) relationships were retained by en bloc excision of the LF and the medial inferior FJ. Controls were LF/FJ specimens from 47 cadaver lumbar spines.

Results. The 27 patients yielded 51 LF/FJ specimens containing 28 synovial cysts, 12 of which

were unilateral and 8 were bilateral. Fragments of articular cartilage and bone were embedded in the walls of 89% of cysts and in the walls of a bursa-like channel originating from the medial aspect of the FJ capsule and extending into the LF. Communication with the FJ via this channel was observed in 21 (75%) of the 28 synovial cysts. Extending up to 12 mm in length, the channel was present in nearly all control spines at the L4-L5 level but in only about half at the T12-L1 level.

Conclusion. Cysts having an extensive or meagre synovial cell lining are common in the LF of patients with symptomatic lateral or central stenosis. The cysts communicate with the FJ by a bursa-type channel within the LF. Advanced osteoarthritis of the FJ causes the liberation of fragments of cartilage and bone into the synovial fluid of the joint space.

The films were characterized using several techniques, including x-ray diffraction, high-resolution transmission electron VX-809 order microscopy, and magnetic property measurements. Films prepared at lower oxygen pressures were found to be monoclinic, whereas the films prepared at high oxygen pressures were cubic. Both film phases exhibited superparamagnetic-like responses,

with the monoclinic films showing a very high coercive field at low temperatures. Careful microstructural analysis showed no secondary phases or compositional variation that could account for the observed magnetic response. A model, based on the widely accepted bound polaron theory for insulating ferromagnets, is proposed to explain the magnetic behavior of Co doped Sm2O3 films. In this model, exchange mediating defects form magnetically active regions that behave like superparamagnetic clusters; however, unlike in superparamagnetic systems, the size of magnetically active regions is not static but changes find protocol dynamically with temperature. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3610790]“
“No data are available on 2009 H1N1 influenza in human immunodeficiency virus (HIV)-infected children, a highly susceptible and vulnerable population. We report 13 cases of pandemic influenza

among a cohort of HIV-infected pediatric patients. Clinical features of H1N1 influenza were similar to those described in the general population. Most patients received antivirals on an outpatient basis. An uneventful evolution was observed in all patients, only 2 of whom required hospitalization. Influenza had no effect on the evolution of HIV infection.”
“Objective:

Our aim was to evaluate the relationship between bone mineral density (BMD) and fasting serum long-acting natriuretic peptide (LANP) concentration in renal transplant recipients.

Patients and methods: Fasting blood samples were obtained from 65 renal transplant recipients. BMD was measured using dual energy X-ray absorptiometry in lumbar vertebrae (L2-L4). Serum LANP levels were measured using a commercial enzyme immunoassay kit.

Results: Six patients (9.2%) had osteoporosis and 28 patients (43.1%) had osteopenia in renal transplant recipients. Increased serum LANP (p < 0.001) was significantly correlated with low lumbar T-score cut-off points between groups (normal, osteopenia, and osteoporosis) BKM120 in renal transplant recipients. Female patients had lower lumbar BMD than male renal transplant recipients (p = 0.027). Univariate linear regression analysis indicated that lumbar BMD were positively correlated with height (p = 0.038), body weight (p = 0.003), and body mass index (BMI; p = 0.019), whereas negatively correlated with LANP (p = 0.004) among the renal transplant recipients. Multivariate forward stepwise linear regression analysis of the significant variables revealed that body weight (R 2 change = 0.132; p = 0.006) and LANP (R 2 change = 0.093; p = 0.

Maximum wall thickness and luminal area were measured with gadolinium-enhanced magnetic resonance (MR) imaging in both common carotid arteries (CCAs) and in one internal carotid artery (ICA)

2 mm above the flow divider. Complete data were available for 1064 ICAs and 3348 CCAs. The association of maximum wall thickness with lumen area was evaluated with linear regression, and adjustments were made for participant age, sex, race, height, and height squared.

Results: In the ICA, lumen area was relatively constant across patients with a wall thickness of 1.38 mm or less. In patients with a wall thickness of more than 1.38 mm, however, lumen area decreased linearly as wall thickness increased. Wall area represented a median of 61.9% of the area circumscribed by the vessel at a maximum wall thickness of 1.50 mm +/- 0.05 (standard deviation) Entinostat cost and 75.4% at a maximum wall thickness of 4.0 mm +/- 0.10. In the CCA,

lumen area was preserved across wall thicknesses less than 2.06 mm, representing 99% of vessels.

Conclusion: Atherosclerotic thickening in the ICA appears to be accommodated for vessels with a maximum wall thickness of less than 1.5 mm. Beyond this threshold, greater thickness is associated NVP-AUY922 price with a smaller lumen. The CCA appears to accommodate a wall thickness of less than 2.0 mm. These estimates indicate that the carotid arteries are able to compensate for a greater degree of thickening than are the coronary arteries. (C) RSNA, 2010″
“QUESTIONS UNDER STUDY/PRINCIPLES:

Analysis of changes in the behaviour of wearing protective equipment by alpine skiers and snowboarders after injury, performed at a level I trauma centre in Switzerland.

METHODS: We present a study, using a standardised questionnaire, assessing behaviour on ski slopes by adult patients admitted between Oct 2007 and April 2008. Patients were re-interviewed after the 2008/2009 season. McNemar tests were used to analyse selleck compound differences in protective clothing wearing rates between the two seasons. Multiple logistic regression with age, gender and injury severity score (ISS) as predictors, was used to compare findings in those who started wearing protective equipment and those who did not.

RESULTS: A total of 104/132 patients from the 2007/2008 season were questioned about wearing protective equipment in 2008/2009. 20 patients could not be reassessed (7 declined, 13 had abandoned winter sports). A total of 84 patients were reassessed (61 alpine skiers and 23 snowboarders). The median age of participants was 39 years and 70.2% were male. Helmet and back protector wearing rates increased from 40.5% to 78.6% (p <0.001) and from 14.3% to 23.8% (p = 0.021), respectively. Snowboarders more than doubled their helmet wearing rate (39.1% to 82.6%, p = 0.002). Skiers showed a trend towards doubling their back protector wearing rate (6.6% to 14.8%, p = 0.063). Younger skiers started wearing back protectors more often than older skiers.

Also, strain in the substrate and possible textures in the film structure can be excluded as the origin of the magnetic behavior as studied by grazing incidence wide angle x-ray scattering. Thus, probably only the substrate shape in connection with the amorphous or polycrystalline film structure can explain the rotation of the uniaxial magnetic anisotropy. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3576135]“
“The effects of nitrate (NO(3)(-)) on the root system are complex and depend on several factors, such as the concentration available to the plant, endogenous nitrogen status and the sensitivity of the species. Though these effects have been

widely documented on Arabidopsis and cereals, no reports are available in the Capsicum genus. In this paper, we have determined this website the effect of an exogenous in vitro application of this nutrient on root growth in habanero pepper (Capsicum chinense Jacq.). Exposure to NO(3)(-) inhibited primary root growth in both, dose- and time-dependent manners. The highest inhibition was attained with 0.1 mM NO(3)(-)

between the fourth and fifth days of treatment. Inhibition of primary root growth was observed by exposing the root to both homogeneous and heterogeneous conditions of the nutrient; in contrast, ammonium was not able to induce similar changes. NO(3)(-)-induced inhibition of primary root growth was reversed by treating Z-DEVD-FMK inhibitor the roots with IAA or NPA, a polar auxin transport inhibitor. Heterogeneous NO(3)(-) application stimulated the

formation and elongation of lateral roots in the segment where the nutrient was present, and this response was influenced by exogenous phytohormones. These results demonstrate that habanero pepper responds to NO(3)(-) in a similar fashion to other species with certain particular differences. Therefore, studies Mdivi-1 chemical structure in this model could help to elucidate the mechanisms by which roots respond to NO(3)(-) in fluctuating soil environments. (C) 2011 Elsevier Masson SAS. All rights reserved.”
“This open-label, randomized study challenged 4- to 8-year-old children from Spain (N = 1478) with a single dose of hepatitis B vaccine to estimate anamnestic responses. At the time of preimmunization, 15.9% to 51.2% of subjects had antibody values >= 10 mIU/mL. One month postimmunization, 91.6% to 97.3% of subjects had antibody titers >= 10 mIU/mL. There were no serious, vaccine-related, adverse experiences, and no discontinuations as a result of adverse experience.”
“The issue of variable bandgap values for InN films grown on c-sapphire has been addressed in this work. alpha-InN films have been deposited in nitrogen rich condition at different substrate temperatures on bare Al2O3 (0001) by plasma assisted molecular beam epitaxy (PA-MBE). The results of several complementary characterization techniques show that single crystalline wurtzite InN is formed, but their orientation depends on the substrate temperature.

The results indicated that the earliest iron chelation starts in liver in patients receiving deferasirox. Additionally, by the 6th month of deferasirox, the status of cardiac and renal iron in chronically transfused patients with beta-TM were preserved. This may indicate that the serum creatinine increases may not be attributed to iron decompartmantalization from other organs to kidneys.</.”
“Soft drinks have many potential

health problems. The inherent acids and sugars have both acidogenic and cariogenic potential, resulting in dental caries and potential enamel erosion. In this report we present a 25-year-old man complaining with the severe worn-out of the front teeth during the past 3 years. He had a history of drinking cola for more than 7 years and had a poor oral hygiene. Severe decays were present see more Raf inhibitor review in the incisors and the canines, while less severe lesions were noted on the premolars and the molars. The review is to show the relationship between dental erosion and caries and soft drinks. Some efforts have been taken to reduce the harmful effect of soft drinks.”
“A simple profile-fitting method is applied to determine the concentrations of metastable and resonant species in a cold atmospheric pressure argon plasma jet. This method is based on the analysis of the

effect of self-absorption broadening on the profiles of spectral lines emitted from plasma. The Argon lines which correspond to transitions to metastable and resonant lower states were measured with high resolution optical emission spectroscopy. Fitting the measured line contours yields line-integrated densities (N(l) x L) of metastable Ar(1s(5)) and

Ar(1s(3)) of 1.2 x 10(5) m(-2) and 5.0 x 10(14) m(-2), respectively. For resonant species, it is difficult to perform a good density-estimation by fitting measured line contours because of the broad intrinsic resonant line shape and the low resonant densities in the plasma. Top-limits of 4.8 x 10(15) m(-2) and 7.2 x 10(14) m(-2) are estimated for resonant states Ar(1s(2)) and Ar(1s(4)), respectively. By comparing the fittings of metastable and resonant lines, it is found that the applicability of the profile-fitting routine is sensitive to the line-center optical Omipalisib purchase thickness of emission lines (mainly determined by the lower states densities) and the sharpness of intrinsic line profiles of corresponding transitions. (C) 2011 American Institute of Physics. [doi:10.1063/1.3643004]“
“Nanocomposite polymer electrolytes (NCPEs) composed of poly(ethylene oxide), calcium phosphate [Ca3(PO4)2], and lithium perchlorate (LiClO4)/lithium bis(trifluoromethane sulfonyl)imide [LiN(CF3SO2)2 or LiTFSI] in various proportions were prepared by a hot-press method. The membranes were characterized by scanning electron microscopy, differential scanning calorimetry, thermogravimetrydifferential thermal analysis, ionic conductivity testing, and transference number studies.

1502T>G mutation. The mutation is predicted to substitute valine for glycine at a highly conserved amino acid residue 501 (p.Val501Gly). Other healthy family members were either heterozygotes Selleckchem TH-302 or mutation-free. The mutation was not detected in 50 healthy unrelated individuals. In silico analyses using PolyPhen-2 and SIFT predicted that the p.Val501Gly mutation is functionally “”damaging.”" Tertiary modeling showed structural alterations in the active site of the mutant TPO. In conclusion, a novel mutation, p.Val501Gly, in the TPO gene was detected

expanding the mutation spectrum of TPO associated with CH and MNG.”
“Background: It has been estimated that major orthopaedic surgery has the highest risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) when compared with other surgery. Two new orally active anticoagulants have recently become licensed in Ireland for the primary prevention of venous thromboembolism in adult patients undergoing elective total hip replacement (THR) or total knee replacement (TKR). Rivaroxaban (Xarelto (R)) is a direct factor Xa inhibitor and dabigatran etexilate (Pradaxa (R)) is a prodrug of the active compound dabigatran, which

inhibits LBH589 solubility dmso thrombin.

Objective: To evaluate the cost effectiveness of rivaroxaban and dabigatran etexilate compared with enoxaparin sodium for the prophylaxis of venous thromboembolism in patients undergoing elective THR and TKR in the Irish healthcare setting.

Methods: The evaluation was conducted from the Irish health-payer perspective. A static decision-tree model was developed with a 180-day post-surgery time horizon. Separate models for the disease states THR and TKR were run to accommodate the different venous thromboembolism risks associated

with each procedure. Outcome measures were QALYs and life-years XL184 molecular weight gained (LYG). Costs were valued in E, year 2008 values.

One-way sensitivity analysis of all probabilities in the model was performed. A probabilistic sensitivity analysis using second-order Monte Carlo simulation was performed to determine the probability of cost effectiveness at a (sic)45 000 per QALY threshold.

Results: In the THR base-case model, rivaroxaban dominated both dabigatran etexilate and enoxaparin sodium. The incremental cost-effectiveness ratios for dabigatran etexilate relative to enoxaparin were (sic)23 934 per LYG and (sic)17835 per QALY. In the TKR base-case model, rivaroxaban dominated both dabigatran etexilate and enoxaparin sodium. Dabigatran etexilate also dominated enoxaparin sodium.

In the one-way sensitivity analysis, the THR model was robust to all but four probability variations; the TKR model was robust to all variations. At a cost-effectiveness threshold of (sic)45 000 per QALY, the probability that rivaroxaban was the most cost-effective strategy after THR was 39%, followed by dabigatran etexilate at 32% and enoxaparin sodium at 29%.

GmWNK1 expression was detected in the root, specifically in root cells

associated with lateral root formation, and was down-regulated by abscisic acid (ABA), as well as by mannitol, sucrose, polyethylene glycol and NaCl. In vitro and in vivo experiments showed that GmWNK1 interacts with another soybean protein, GmCYP707A1, which is a key ABA 8′-hydroxylase that functions in ABA catabolism. Furthermore, 35S-GmWNK1 transgenic soybean plants had reduced lateral root number and length compared with wild-type, suggesting a role of learn more GmWNK1 in the regulation of root system architecture. We propose that GmWNK1 functions to fine-tune ABA-dependent ABA homeostasis, thereby mediating the regulation of the root system architecture by ABA and osmotic signals.

The study has revealed a new function of a plant WNK1 gene from the important staple crop soybean, and has identified a new component of a regulatory pathway that is involved not only in ABA signaling, but also in the repression of lateral root formation by an ABA-dependent mechanism distinct from known ABA signaling pathways.”
“Asian Americans represent an important cohort at high risk for viral hepatitis. To determine the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection and HBV vaccination in a Vietnamese community, a total of 322 Fosbretabulin solubility dmso Vietnamese subjects from a local doctor’s office and annual Vietnamese Health Fair were included in this study. Demographic and clinical data were collected. 2.2% of the screened cohort tested positive for anti-HCV and 9.3% tested positive for HBsAg. Unlike HBV-positive subjects, HCV-positive subjects had significantly higher liver enzymes (P = 0.0045 and P = 0.0332, respectively). The HBV-positive group was more likely Erastin ic50 to report jaundice (P = 0.0138) and a family history of HBV (P = 0.0115) compared to HBV-negative subjects. Forty-eight patients (15.5%) reported a family history of liver disease (HBV, HCV, HCC, cirrhosis, other). Of

this 48, 68.8% reported no personal history of HBV vaccination and 77.1% reported no family history of vaccination for HBV. Among the 183 subjects without a family history of liver disease, 156 (85.2%) reported no personal history of vaccination and 168 (91.8%) reported no family history of vaccination. HBV vaccination rates in those reporting a family history of liver disease were significantly higher (P = 0.020). There was a high prevalence of HBV infection in this community screening. Nevertheless, the rate for HBV vaccination was low. The low prevalence of abnormal liver enzymes in HBV-positive subjects emphasizes the need for screening to be triggered by risk factors and not by abnormal liver enzymes.”
“Anthrax is rare among humans, few data can be collected from infected individuals and they provide a fragmentary view of the dynamics of infection and human host-pathogen interactions. Therefore, the development of animal models is necessary.

Clinical practice along with further trials will have to prove their value, along with other compounds that are still in their early phase of development.”
“The prevalence of fatty liver is rising not only in adults but also in children and adolescents. The authors describe the ultrastructure of 12 biopsies from 10 males and 2 females aged 7-18 years. All subjects had fatty liver by ultrasonography and were overweight or obese according to BMI classification. They all had elevated aminotransferases and/or lipid/cholesterol levels, ultimately confirmed by biopsy. Steatosis was mild in 2, moderate in 3, and severe in 7 cases. Nonalcoholic steatohepatitis was diagnosed in 7 and nonalcoholic

fatty liver disease in 5 patients. Lipolysosomes, identified in all 17-AAG 12 biopsies, were defined as fat droplets surrounded by a trilaminar membrane and lipofuscin-like deposits within or adjacent to the enveloping membrane. The lysosome marker CD68 revealed lysosomal activity in all lipolysosomes PD0332991 mw identified by electron microscopy. The ultrastructural features, here illustrated in diverse human biopsies, enabled lipolysosome classification in 3 types: monolocular (type I), multilocular (type II), and giant multilocular (type III). Type II, previously described in some conditions with abnormal lipid metabolism, was found in all biopsies, though with variable frequency. Type III was

observed only in severe steatosis and associated with prominent connective tissue and conspicuous lipofuscin deposits. These new findings demonstrate the presence of lipolysosomes

in a variety of fatty livers, in conditions hitherto unknown, in relation to the severity of steatosis, fibrogenic process, autophagy, lipolysis, and lipofuscin formation.”
“OBJECTIVE: To prospectively determine the diagnostic accuracy of massively parallel sequencing to detect whole chromosome fetal aneuploidy from maternal plasma.

METHODS: Blood samples were collected in a prospective, blinded study from 2,882 women undergoing prenatal diagnostic procedures at 60 U.S. sites. An independent biostatistician selected all singleton pregnancies with any abnormal karyotype and a balanced number of randomly selected pregnancies with euploid karyotypes. Chromosome classifications were made for each sample by massively parallel sequencing and compared with fetal karyotype.

RESULTS: Within an analysis cohort of Ipatasertib mw 532 samples, the following were classified correctly: 89 of 89 trisomy 21 cases (sensitivity 100%, 95% [confidence interval] CI 95.9-100), 35 of 36 trisomy 18 cases (sensitivity 97.2%, 95% CI 85.5-99.9), 11 of 14 trisomy 13 cases (sensitivity 78.6%, 95% CI 49.2-99.9), 232 of 233 females (sensitivity 99.6%, 95% CI 97.6 to more than 99.9), 184 of 184 males (sensitivity 100%, 95% CI 98.0-100), and 15 of 16 monosomy X cases (sensitivity 93.8%, 95% CI 69.8-99.8). There were no false-positive results for autosomal aneuploidies (100% specificity, 95% CI more than 98.5 to 100).

A dose of 0.5 mL of triamcinolone acetonide (40 mg/mL) was injected TPCA-1 nmr into the subconjunctival space at the upper margin of the tarsus. If the upper lid retraction had not improved or was still severe 2 weeks after the initial injection, then triamcinolone was injected repeatedly at 2-week intervals. Photographs were taken before the injection and at the follow-up visit,

and lid parameters including marginal reflex distance 1, interpalpebral fissure height, total palpebral fissure area, the upper nasal palpebral fissure area, and the upper temporal palpebral fissure area were measured. Changes in the lid parameters after the injection were evaluated.

The mean number of injections per patient was 2.67, and the mean (SD) follow-up period was 260.97 (91.10) days. All lid parameters improved significantly after the triamcinolone injection (all P’s < 0.05). Nineteen of 22 patients in the congestive phase responded to this website the triamcinolone injection; however, 6 of 8 patients in the fibrotic phase did not respond to the triamcinolone injection. Complications associated with the triamcinolone injection included an increased intraocular pressure (2 patients) and a mild ptosis (1 patient).

The subconjunctival triamcinolone injection

is a simple and effective treatment option for the upper lid retraction associated with thyroid eye disease, and this treatment is more effective for the patients in the congestive phase.”
“Leukemogenesis is a multistep process in which successive transformational events enhance the ability of a clonal population arising from hematopoietic AL3818 concentration progenitor cells to proliferate, differentiate and survive. Clinically and pathologically, leukemia is subdivided into four main categories: chronic

lymphocytic leukemia, chronic myeloid leukemia, acute lymphocytic leukemia and acute myeloid leukemia. Leukemia has been previously considered only as a genetic disease. However, in recent years, significant advances have been made in the elucidation of the leukemogenesis-associated processes. Thus, we have come to understand that epigenetic alterations including DNA methylation, histone modifications and miRNA are involved in the permanent changes of gene expression controlling the leukemia phenotype. In this article, we will focus on the epigenetic defects associated with leukemia and their implications as biomarkers for diagnostic, prognostic and therapeutic applications.”
“Preclinical assessment of drug abuse and dependence has been the subject of several recent regulatory guidelines. Both the European and US authorities recommend a tiered approach and are generally aligned on the methods which should be used. The first tier simply compares the pharmacology of the novel substance to known drugs of abuse. The second tier aims to identify abuse and dependence liability more directly. The most direct approach to assessing reinforcing properties is the i.v. self-administration procedure.

“
“Because the vagus nerve is implicated in control of inflammation, we investigated if brain death (BD) causes impairment of the parasympathetic nervous system, thereby contributing to inflammation. BD was induced in rats. Anaesthetised ventilated rats (NBD) served as control. Heart rate buy ARN-509 variability (HRV) was assessed by ECG. The vagus nerve was electrically stimulated (BD + STIM) during BD. Intestine, kidney, heart and liver were recovered after 6 hours. Affymetrix chip-analysis was performed

on intestinal RNA. Quantitative PCR was performed on all organs. Serum was collected to assess TNF alpha concentrations. Renal transplantations were performed to address the influence of vagus nerve stimulation on graft outcome. HRV was significantly lower in BD animals. Vagus nerve stimulation inhibited the increase in serum TNF alpha concentrations and resulted in down-regulation of a multiplicity of pro-inflammatory genes in intestinal tissue. In renal tissue vagal stimulation significantly decreased the expression of

E-selectin, IL1 beta and ITGA6. Renal function was significantly better in recipients that received a graft from a BD + STIM donor. Our study demonstrates impairment of the parasympathetic nervous system during BD and inhibition of serum TNF alpha through vagal stimulation. selleck kinase inhibitor Vagus nerve stimulation variably affected gene expression in donor organs and improved renal function in recipients.”
“Study Design. Retrospective radiographic study of the technique for C1 lateral mass screw (C1LMS) and C2 pedicle screw (C2PS) fixation.

Objective. To evaluate (1) the accuracy of the C1LMS and C2PS placement; (2) the fusion rate between C1 and C2; (3) the risk for vertebral artery (VA) injury.

Summary of Background Data. C1LMS and C2PS fixation

is widely used when treating atlantoaxial instability. Several authors have reported their experience focusing on the technical outcomes, with selleck many reporting fusion rates near 100%. However, most of them are relatively small series, and many have applied only plain postoperative radiographs instead of computed tomography (CT). Thus, we feel that the accuracy of C1LMS and C2PS placement has not been fully analyzed, as well as the anatomic relationship between the VA and the screws.

Methods. Between December 2000 and September 2008, the fusion status and accuracy of the screws were evaluated on the postoperative reconstructive CT of 319 patients with atlantoaxial instability. Cases with malpositioned screws underwent CT angiography or magnetic resonance angiography after surgery, to evaluate potential VA injury.

Results. C1LMS of 95.5% and C2PS of 92.8% were found to be in a “”good”" position. After 2007, six cases had malpositioned screws, which were all in the “”out”" or “”down”" area of the C2 pedicle. Five cases underwent CT angiography and 1 had magnetic resonance angiography to evaluate potential VA injury. No occlusion, associated aneurysm or fistula of the VA was found.