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Journal of Biological Regulators and... 2020Low Back Pain (LBP) is the most common spine disease and it is the most common cause of absence from work in developed countries. At lumbar level, the natural history of... (Review)
Review
Low Back Pain (LBP) is the most common spine disease and it is the most common cause of absence from work in developed countries. At lumbar level, the natural history of herniated disc is characterized by a disappearance of clinical symptoms in up to 60% with conservative treatment through simple rest for about 6 weeks and reduction of the disk heniation revealed by CT or MR scans within eight to nine months after the onset of back pain. Surgery is considered the treatment of choice for extruded, migrated and free fragment herniated disk associated to clinical symptomatology of cono-cauda syndrome, progressive foot droop and hyperalgic radiculopathy. patients with a small or contained herniated disk, without any benefit from conservative medical treatment, can be candidates for one of minimally invasive percutaneous techniques, whose outcome, though, depends on the characteristics of hernia itself and on the chosen technique. The aim of this paper is to discuss about O2-O3 treatment for symptomatic not extruded herniated disk at lumbar level, highlighting about indication inclusion exclusion criteria and our results.
Topics: Fluoroscopy; Humans; Intervertebral Disc Displacement; Low Back Pain; Lumbar Vertebrae; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 33176413
DOI: No ID Found -
JMIR Medical Informatics May 2021Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back...
BACKGROUND
Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back pain. Magnetic resonance (MR) imaging is one of the most efficient techniques for detecting lumbar diseases and is widely used for making clinical diagnoses at hospitals. However, there is a lack of efficient tools for effectively interpreting massive amounts of MR images to meet the requirements of many radiologists.
OBJECTIVE
The aim of this study was to present an automatic system for diagnosing disk bulge and herniation that saves time and can effectively and significantly reduce the workload of radiologists.
METHODS
The diagnosis of lumbar vertebral disorders is highly dependent on medical images. Therefore, we chose the two most common diseases-disk bulge and herniation-as research subjects. This study is mainly about identifying the position of IVDs (lumbar vertebra [L] 1 to L2, L2-L3, L3-L4, L4-L5, and L5 to sacral vertebra [S] 1) by analyzing the geometrical relationship between sagittal and axial images and classifying axial lumbar disk MR images via deep convolutional neural networks.
RESULTS
This system involved 4 steps. In the first step, it automatically located vertebral bodies (including the L1, L2, L3, L4, L5, and S1) in sagittal images by using the faster region-based convolutional neural network, and our fourfold cross-validation showed 100% accuracy. In the second step, it spontaneously identified the corresponding disk in each axial lumbar disk MR image with 100% accuracy. In the third step, the accuracy for automatically locating the intervertebral disk region of interest in axial MR images was 100%. In the fourth step, the 3-class classification (normal disk, disk bulge, and disk herniation) accuracies for the L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1 IVDs were 92.7%, 84.4%, 92.1%, 90.4%, and 84.2%, respectively.
CONCLUSIONS
The automatic diagnosis system was successfully built, and it could classify images of normal disks, disk bulge, and disk herniation. This system provided a web-based test for interpreting lumbar disk MR images that could significantly improve diagnostic efficiency and standardized diagnosis reports. This system can also be used to detect other lumbar abnormalities and cervical spondylosis.
PubMed: 34018488
DOI: 10.2196/14755 -
Vestnik Oftalmologii 2022Papilledema (choked disk) is a sign of intracranial hypertension (ICH) - condition that presents danger not only for patient's vision, but also for their life. Despite... (Review)
Review
Papilledema (choked disk) is a sign of intracranial hypertension (ICH) - condition that presents danger not only for patient's vision, but also for their life. Despite the fact that ICH is usually a neurosurgical pathology, sometimes an ophthalmologist is the first doctor such patients visit, most often in a primary healthcare clinic. At the same time, as practice shows, not all ophthalmologists are well aware about in this pathology; difficulties occur in differential diagnosis of papilledema against similar changes of the optic nerve head seen during ophthalmoscopic examination. This article reviews scientific literature on ICH, including benign ICH, diagnosis and differential diagnosis of papilledema. The authors also share their decades-long experience of working in a neurosurgical facility.
Topics: Diagnosis, Differential; Humans; Intracranial Hypertension; Ophthalmoscopy; Optic Disk; Papilledema
PubMed: 36004596
DOI: 10.17116/oftalma202213804187 -
The Journal of Chemical Physics Dec 2022We discuss pressure computations for the hard-disk model performed since 1953 and compare them to the results that we obtain with a powerful event-chain Monte Carlo and...
We discuss pressure computations for the hard-disk model performed since 1953 and compare them to the results that we obtain with a powerful event-chain Monte Carlo and a massively parallel Metropolis algorithm. Like other simple models in the sciences, such as the Drosophila model of biology, the hard-disk model has needed monumental efforts to be understood. In particular, we argue that the difficulty of estimating the pressure has not been fully realized in the decades-long controversy over the hard-disk phase-transition scenario. We present the physics of the hard-disk model, the definition of the pressure and its unbiased estimators, several of which are new. We further treat different sampling algorithms and crucial criteria for bounding mixing times in the absence of analytical predictions. Our definite results for the pressure, for up to one million disks, may serve as benchmarks for future sampling algorithms. A synopsis of hard-disk pressure data as well as different versions of the sampling algorithms and pressure estimators are made available in an open-source repository.
PubMed: 36550024
DOI: 10.1063/5.0126437 -
Frontiers in Medicine 2023Intervertebral disk (IVD) degeneration (IVDD) is a main factor in lower back pain, and immunomodulation plays a vital role in disease progression. The IVD is an immune... (Review)
Review
Intervertebral disk (IVD) degeneration (IVDD) is a main factor in lower back pain, and immunomodulation plays a vital role in disease progression. The IVD is an immune privileged organ, and immunosuppressive molecules in tissues reduce immune cell (mainly monocytes/macrophages and mast cells) infiltration, and these cells can release proinflammatory cytokines and chemokines, disrupting the IVD microenvironment and leading to disease progression. Improving the inflammatory microenvironment in the IVD through immunomodulation during IVDD may be a promising therapeutic strategy. This article reviews the normal physiology of the IVD and its degenerative mechanisms, focusing on IVDD-related immunomodulation, including innate immune responses involving Toll-like receptors, NOD-like receptors and the complement system and adaptive immune responses that regulate cellular and humoral immunity, as well as IVDD-associated immunomodulatory therapies, which mainly include mesenchymal stem cell therapies, small molecule therapies, growth factor therapies, scaffolds, and gene therapy, to provide new strategies for the treatment of IVDD.
PubMed: 38179277
DOI: 10.3389/fmed.2023.1289642 -
Journal of AAPOS : the Official... Oct 2021To report a case series of children with central retinal vein occlusion (CRVO) showing a high prevalence of crowded optic disks with minimal cupping.
PURPOSE
To report a case series of children with central retinal vein occlusion (CRVO) showing a high prevalence of crowded optic disks with minimal cupping.
METHODS
We retrospectively reviewed the medical records of children diagnosed with CRVO from 2008 to 2019 at a single tertiary care pediatric hospital. Clinical records, fundus photographs, and optical coherence tomography (OCT) images were reviewed. Optic disk anatomical parameters of the unaffected fellow eyes, including OCT-measured optic disk area and vertical cup:disk ratio, were collected and analyzed.
RESULTS
Six patients with unilateral CRVO were identified. All patients were female. Age at presentation ranged between 9 and 17 years. Five patients were otherwise healthy, with negative systemic investigations (idiopathic group). The remaining patient had a known systemic risk factor of active Takayasu arteritis. Within the idiopathic group, "disk-at-risk" optic nerve configuration, defined as a cup:disk ratio of 0.2 or smaller, was identified in the fellow eye of all 5 patients. In the unaffected eyes, mean OCT-measured optic disk area was 1.67 ± 0.13 mm and mean cup:disk ratio was 0.19 ± 0.12. The patient with Takayasu arteritis had normal OCT disk area of 2.1 mm and cup:disk ratio of 0.61.
CONCLUSIONS
We observed a high prevalence of anatomical features potentially consistent with a constrictive optic disk configuration in pediatric patients with CRVO.
Topics: Adolescent; Child; Diagnostic Techniques, Ophthalmological; Female; Humans; Optic Disk; Retinal Vein Occlusion; Retrospective Studies; Tomography, Optical Coherence
PubMed: 34562620
DOI: 10.1016/j.jaapos.2021.05.009 -
Micromachines Dec 2023A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN)...
A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN) powder with silica sol film coating (A/S powder) is added to the polishing disk, and a specific solution is used to dissolve the A/S powder during polishing, forming a pore structure on the polishing disk. To realize the self-sharpening process, the dissolution property of the A/S powder is analyzed. The effect of A/S powder content on the friction and wear performance and the polishing performance of 4H-SiC wafers are investigated. Results showed that the friction coefficient of the polishing disk with 9 wt% A/S powder content is the most stable. The surface roughness of 2.25 nm can be achieved, and there is no obvious glazing phenomenon on the polishing disk after polishing. The surface roughness of the 4H-SiC wafer is reduced by 38.8% compared with that of the polishing disk with no A/S powder addition after rough polishing, and the 4H-SiC wafer then obtained a damage-free surface with a less than 0.4 nm after fine polishing by chemical mechanical polishing (CMP).
PubMed: 38258175
DOI: 10.3390/mi15010056 -
Cureus Mar 2022Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance...
Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance secondary to irrational use of antibiotics, nonadherence to infection control practices, and increased use of intravascular devices in healthcare systems. Detection of MRSA is critical in clinical microbiology laboratories as it helps identify MRSA carriers and avoid treatment failure in patients. Hence, this study compared various phenotypic methods with the standard genotyping method to determine a method that permits rapid and accurate detection of MRSA. Materials & Methods () was initially identified based on colony morphology, Gram staining, standard biochemical tests, and antibiotic susceptibility using disk diffusion. MRSA was identified based on the detection of the mecA gene by polymerase chain reaction (PCR) and subsequent gel electrophoresis. Disk diffusion using cefoxitin or oxacillin and mannitol salt agar with 6-µg/ml oxacillin were used for phenotypic detection of MRSA. The D test was used to detect inducible clindamycin resistance in isolates. Results Of the 100 isolates analyzed, 37% were identified as MRSA by PCR and the cefoxitin disk diffusion method; however, only 31% were detected by the oxacillin disk diffusion method and 29% by the mannitol salt agar method. The sensitivity of the cefoxitin disk diffusion test, oxacillin disk diffusion, and mannitol salt agar methods was 86.05%, 83.78%, and 70.73%, respectively. Specificity was 100% for all the three phenotypic methods (p < 0.001). Notably, inducible clindamycin resistance was found in 37.2% of the MRSA isolates, indicating potential challenges in treatment. Conclusion Among the three phenotypic methods tested, the cefoxitin disk diffusion method had 100% sensitivity and specificity, which is similar to that of PCR-based MRSA detection. Hence, the cefoxitin disk diffusion method is recommended for use in clinical laboratories, where molecular methods are not available as it is both cost-effective and easy to perform.
PubMed: 35481290
DOI: 10.7759/cureus.23396 -
The American Journal of Sports Medicine Mar 2022Injuries of the acromioclavicular joint (ACJ) are common shoulder injuries that often lead to pain and dysfunction of the affected shoulder. Regardless of operative or...
BACKGROUND
Injuries of the acromioclavicular joint (ACJ) are common shoulder injuries that often lead to pain and dysfunction of the affected shoulder. Regardless of operative or nonoperative treatment, a relatively large number of patients remain symptomatic and experience pain. However, the specific source of persistent pain in the ACJ remains ambiguous.
PURPOSE
To investigate the presence of sensory nerve fibers or pain-generating neurotransmitters within the intra-articular disk of the ACJ to determine its potential role as an independent pain generator in ACJ disorders.
STUDY DESIGN
Descriptive laboratory study.
METHODS
Twelve paired ACJs from 6 fresh human cadavers (mean age, 56 years; range, 41-82 years) were harvested and freed from surrounding soft tissues, leaving only the ACJ capsule intact. The specimens were placed in 4.5% formaldehyde fixative for a minimum of 48 hours. Coronal plane sections were obtained and demineralized in EDTA for a week, embedded in paraffin for 12 hours, and dehydrated overnight. With a rotation microtome, 2-μm sections were cut and stained with hematoxylin and eosin to investigate tissue architecture and confirm the presence of a fibrocartilaginous intra-articular disk. The sections were immunohistochemically stained with antisera against S100, neuropeptide Y (NPY), and substance P (SP) to detect for neural tissue. Additionally, a nerve fiber count per 10 high-power fields representing an area of 0.2 mm was conducted for S100 stains. All sections were examined for the presence of positive immunoreactivity to S100, NPY, and SP.
RESULTS
The presence of a fibrocartilaginous intra-articular disk could be observed in all 12 examined ACJs. In all specimens, an immunoreactivity to S100, NPY, and SP could be observed within the superior peripheral region of the intra-articular disk. High-power field nerve counts of the S100 stains revealed a mean ± SD of 7.9 ± 2.28 nerves per 10 high-power fields (range, 4-12).
CONCLUSION
The documented immunoreactivity to S100, NPY, and SP indicates the presence of somatic and autonomic nerve fibers within the intra-articular disk of the ACJ.
CLINICAL RELEVANCE
Confirming the presence of nerve fibers within the intra-articular disk of the ACJ suggests that the disk itself could be an independent source of pain after injury and thus a possible explanation for recalcitrant pain after treatment.
Topics: Acromioclavicular Joint; Humans; Joint Capsule; Joint Dislocations; Joints; Middle Aged; Pain
PubMed: 35099332
DOI: 10.1177/03635465211070276 -
Indian Journal of Ophthalmology Mar 2023: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the...
BACKGROUND AND PURPOSE
: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the radial peripapillary capillary (RPC) network in congenital optic disk anomalies with optical coherence tomography-angiography (OCTA) can shed light on its pathogenesis. This video describes the OCTA findings of optic nerve head and RPC network using the angio-disk mode in five cases of congenital cavitary optic disk anomalies.
SYNOPSIS
The video presents characteristic RPC network alterations in two eyes of ODP, one eye of optic disk coloboma, and two eyes of noncontractile MGDA.
HIGHLIGHTS
OCTA in ODP and coloboma shows absence of RPC microvascular network and a region of capillary dropout. This finding is in contrast to MGDA, where the microvascular network is dense. OCTA is an effective imaging modality to study vascular plexus and RPC and their alteration in congenital disk anomalies, which could provide information about the structural differences among them.
VIDEO LINK
https://youtu.be/TyZOzpG4X4U.
Topics: Humans; Optic Disk; Coloboma; Eye Abnormalities
PubMed: 36872758
DOI: 10.4103/IJO.IJO_2743_22