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Relationship between Thoracic Cage and Spine Deformity in Rabbits with Experimental Scoliosis Hemal Mehta, MSc, Brian D. Snyder, MD, PhD Children's Hospital, Boston, MA ; , Edward Sun, MD, Andrew Jackson, PhD a - Synthes Spine, North America PURPOSE: Investigate the relationship between growth of the spine and thorax under conditions that create symmetrical or asymmetrical growth disturbances of the spine or rib cage in a growing rabbit. BACKGROUND: Campbell developed the opening wedge thoracostomy in conjunction with implantation of a Vertical Expandable Prosthetic Titanium Rib VEPTR ; to expand the constricted hemithorax in children with congenital, infantile and neuromuscular scoliosis, acquired or congenital anomalies of the thorax and skeletal dysplasia. Understanding the relationship between growth of the rib cage and growth of the spine will help produce more predictable outcomes relative to the development of the thorax, lung and spine when using the VEPTR device. HYPOTHESIS: Growth of the thoracic spine and growth of the rib cage are directly related - a disturbance of one induces a deformity in the other. METHODS: Symmetric or asymmetric growth disturbances of the spine or rib cage were established in 15 five-week-old rabbits by means of tethering either the transverse processes of T5 - T8 unilaterally 3 ; or bilaterally 3 ; or ribs 5 - 8 unilaterally 3 ; or bilaterally 3 ; . 3 rabbits were controls. Unilateral tethers were on the left. At time points during growth of the rabbits through maturity, structural changes in the spine and rib cage were assessed using serial CT scans of the entire spine and chest wall. Right, left and total lung volumes were calculated by integrating the area of lung tissue imaged on each transaxial CT summed over sequential slices T1 - T13. Measures of spine deformity, rib cage deformity and pulmonary function were related to one another across the experimental groups using ANOVA and Fisher's probable least significant difference. RESULTS: The mean Cobb angle of the resultant thoracic scoliosis was significantly greater for the unilateral RESULT tethered rib group 13 ; compared to: bilateral tethered rib group 4.3, p 0.001 ; , unilateral tethered spine group 4.3, p 0.001 ; , bilateral tethered spine group 1.5, p 0.001 ; and control group 3, p 0.001 ; . The distortion of the thoracic cage measured by the maximal chest rotation angle at the apex of the scoliosis was significantly greater for the unilateral tethered rib group 8.4 ; compared to the control group 3.5, p 0.04 ; and to the bilateral tethered spine group 3.6, p 0.04 ; . There were no significant differences in total lung volume among the experimental groups. However the right: left lung volume ratio was significantly different for the unilateral tethered rib group compared to the control group p 0.02 ; . Normalizing lung volumes by the weight of the animal, the left lung was equivalent to the right lung for the control group whereas the left lung was 62% of the right lung for the unilateral tethered rib group. CONCLUSIONS: A unilateral deformity of the spine or rib cage induces both a scoliosis and thoracic cage deformity with asymmetric lung growth. The deformity induced by unilateral tethered ribs is much greater than the deformity induced by unilateral tethered spine. The rib provides a longer moment arm than the transverse process so that tethered ribs create a larger deforming moment on the spine.
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By Rachel Strohl, Psy.M. On Monday, September 13, 2004, the NJ Obsessive Compulsive Foundation met for their quarterly meeting to hear a lecture by William Hayes, MD, FAACAP. Dr. Hayes is a licensed physician practicing at Alexander Road Associates in Princeton, and presently a NJ Delegate to the American Academy of Child and Adolescent Psychiatry. He spoke about obsessive compulsive disorder OCD ; medication issues and focused on medication for children and adolescents with OCD. Dr. Hayes began by defining the characteristics of an obsessive compulsive diagnosis. The obsessions and compulsions must be recurrent, intrusive, distressing, and interfere with daily functioning, routines, and relationships. Except with children, individuals with OCD view the symptoms as excessive and unreasonable. He explained that 2 3 of preschoolers develop obsessive concerns e.g., sameness, cleanliness ; but there must be distress and interference for the diagnosis. In addition, OCD's onset generally occurs in adolescent or early adulthood with onset earlier for males, and the disorder is chronic with waxing and waning. Next, Dr. Hayes outlined the treatment and research for OCD. An effective and durable psychotherapy for OCD is cognitive-behavioral therapy CBT ; and an effective pharmacology is selective serotonin reuptake inhibitor SSRIs ; medications. The National Institute of Mental Health NIMH ; conducted the Treatment of Adolescent Depression Study TADS ; to investigate the different treatment modalities. Four hundred and thirty-nine adolescents were randomly assigned to different groups. After 12 weeks, results of phase one found that individuals receiving both CBT and Prozac had the best treatment response 71% ; , followed by Prozac alone 60.6% ; , CBT alone 43% ; , and placebo 34.8% ; . Dr. Hayes then reviewed and updated the audience on a current "hot topic" in the field. In June 2003 the Food and Drug Administration FDA ; issued safety warnings concerning the SSRI Paxil and an association with suicidality. Dr. Hayes presented several explanations for this association: some people taking Paxil experience withdrawal symptoms since Paxil leaves the body quicker than other SSRIs after 24 hours ; , as opposed to contributing suicidality to the direct effects of the medication. Also, many people are prescribed Paxil for depression and this factor increases their risk for suicidality. The American College of Neuropsychopharmacology ACNP ; formed a task force and conducted research trials on over 2000 children and adolescents on SSRIs. They concluded SSRIs do not increase suicidal thoughts or behavior in youth. Individuals on SSRIs should be "observed closely for clinical worsening and suicidality" by their physician, especially at the beginning of treatment and times of dosage increase. Dr. Haye's lively and energetic lecture concluded with comments on the following augmenting medications with SSRIs: tricyclics e.g., Anafranil ; and atypical antipsychotics. It is common for those with OCD to augment their SSRI treatment with the atypical antipsychotic Risperdal, but Dr. Hayes recommends considering the medications Geodon and Abilify because of the low risk of weight gain and occurrence of diabetes. Tapes of this informative lecture are available through NJOCF. Please visit the website at : njocf.
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4.3.1. Open field test In most of experiments a wooden, grey painted arena 100 x 100 cm with 40 cm sidewalls was used. On the test day, one hour before the experiment the animals were moved into the testing room. After drug treatment 30 min before test ; the animals were returned to the home cage. For the test, the animal was placed into one of the central squares and observed during for 4 min for 1 ; horizontal number of line crossings on the floor ; and 2 ; vertical activity number of rears ; . On the basis of these criteria 3 ; the sum of exploratory events was calculated. The horizontal activity was counted only if the animal crossed the line with four paws. Vertical activity was counted when the animal removed the forepaws from ground and stretched itself. In the experiments with acute MK-801 a metal quadrate arena 50 x 100 cm with 40 cm sidewalls was used. The surface of the floor was divided into eight squares of equal size.
PRENATE GT PREVACID PREVPAC PRILOSEC primidone probenecid prochlorperazine maleate promethazine hcl promethazine vc promethazine vc w codeine promethazine w codeine promethazine w dm PROMETRIUM propranolol hcl propylthiouracil PROSCAR PROTONIX PROTOPIC PROTROPIN PROVENTIL HFA PROZAC WEEKLY PSORCON E PULMICORT quinidine gluconate QUIXIN QVAR ranitidine hcl REBETOL REBIF RELENZA RELPAX REMERON M tab REQUIP RESCULA RESTASIS RESTORIL RETIN-A RETIN-A MICRO RHINOCORT AQUA RISPERDAL RITALIN LA ROFERON-A RYNATAN SAIZEN salsalate selegiline hcl selenium sulfide SEMPREX-D SEREVENT SEREVENT DISKUS SEROQUEL silver sulfadiazine SINGULAIR SKELAXIN SKELID sod.sulfacetamide sulfur tf SOF-TACT and serzone.
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Osteopontin as a neuroprotective treatment for Parkinson's disease Prof. Peter Jenner, King's College London 222, 500.00 awarded over 36 months Mechanisms leading to dopamine depletion and dopaminergic cell death in a transgenic mouse model Dr Maria-Grazia Spillantini, University of Cambridge 226, 691.00 awarded over 36 months Linking alpha-synuclein over-expression with defects in mitochondrial function Dr Philip Robinson, St James's University Hospital 157, 704.00 awarded over 36 months The role of mitochondrial DNA in the pathogenesis of Parkinson's disease Prof. Patrick Chinnery, The Medical School, Newcastle 181, 207.00 awarded over 36 months, for example, alzheimers and risperdal.
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Lactimabon. Infrequent: hyponatramia, weight ne pisesphotrinase iecrease, tttirs weigh decroasa, diabetes Pare: decreased serum iron, cacheaia, dehydration, hypolealemia, hyperphosphatemia, hypertriglpaeridevrria, hypeeunicamia, UHfl incontinence, hematuna, dysuna. polyun&polydipsma. Infrequent: unnary System Disorders: Frequent. Rare: unrxary retention, cystitis, rn insufficiency. MUSCUIO.k.JSYIWIP Infrequent myalgia. Rare: arthrosis, bursitis, arftsnbs, skeletal pain. Disorders, Female: Frequent: menorrhagia, orgastic dy vagmna. Infrequent. nonpuerperal lactation, amenorrhea, femata breast pain, Ieukorrhea, mastths, dysmevorrhea, female penveal pjn ilteflTaifl5tflJ& btaeding, vaginal hemorrhage. Liver and Billary System Disorders: Infrequent: increased SGOT, increased SGPT. Rare: hepatic failure, cholestatxc hepatitis, ChOteCystrtiS, hOPistOCOlkMT daiTtOgO. Pte1e Ooi * sg and CMabg OWxs: infreaint epstaxm, pupura Rare: hemorrhage, superficial phiabntis, thrombophlebitra, thrombocytopenia, H * sgid Va.t.uIarDias: Rare: bnnitus, hyperacusis, decreased heamnng. Red Blood Cell Disorders: Infrequent: anemia, hypochromic anemia. Rare: normocybc anemea. # t# : erete dysfunrien. Infreopenl: Freopent RplOductIve elaculatmon tailors. WhiCe1aridPaweDiacws: Rare: laUkOC1OSiS hmc, hadenecsittY UC0P Peiger-Huet anomaly Endocrkie Oisors: Rare: gynecomasba, mate breast pain, antaburetic hOfl5OO disOrder. Specth!Senaes: Rare: biter taste. Incidence based on ehCited reports. Adverse events reported since market introdtion which were temporally but not necessanly causally ; related to RISPERDAL# therapy, include the following: anaphylactic reaction, angioedema, apnea, au-rat fibrillation, cerabrovascular disorder, diabetes aggravated, inducting diabetic ketoacidosis, aggravated, obstruction, intestinal jjse pulmonary have been rare reports of sudden death andlor cardioputFSp patients recarvrng RISPERDAL A causalnote that sudden relationship with RDAL f not been established. ft is important to uneapected death may eocur in psychotic patients whether they remain untreated or whether they are treated with other antipsychotic drugs. DRUG ABUSE AND DEPENDENCE Caa: RlSPERDAL ; nspendone ; a cuntroled trot and tamoxifen.
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Probenecid prochlorperazine maleate PROCRIT [inj] [PA] promethazine hcl promethazine vc, w codeine promethazine w codeine promethazine w dm PROMETRIUM propafenone hcl PROPLEX T propoxyphene w apap propranolol hcl propylthiouracil PROTONIX [ST] PULMICORT Q quinaretic quinidine gluconate QVAR R ranitidine hcl REBETRON REBIF [inj] REPRONEX [inj] REQUIP RESTASIS REYATAZ ribasphere ribavirin rifampin RISPERDAL excluding M tabs ; ROFERON-A [inj] ROZEX S SAIZEN [inj] salsalate selegiline hcl selenium sulfide SENSIPAR SEROQUEL silver sulfadiazine SINGULAIR [ST] SKELAXIN * sod.sulfacetamide w sulfur solia SONATA sotalol SPIRIVA spironolactone, w hctz sprintec STALEVO STRATTERA sucralfate SULAR sulfacetamide sodium sulfamethoxazole w trimethoprim sulfasalazine and temazepam.
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JOURNAL: Medical Journal of Australia. 2005 Oct 3; 183 7 ; : 384388. SUMMARY: The use of nonsteroidal anti-inflammatory drugs to treat most muscle, ligament and tendon injuries should be reassessed. They have, at best, a mild effect on relieving symptoms and are potentially deleterious to tissue healing. Soft-tissue injury associated with definite inflammatory conditions such as bursitis or synovitis or involving nerve impingement does warrant short-term treatment with NSAIDs. Paracetamol has similar efficacy to NSAIDs in soft-tissue injury, is cheaper and has a lower side-effect profile. It is the analgesic of choice for most soft-tissue injury. Cyclo-oxygenase-2 inhibitors should not be used to treat soft-tissue injuries unless impingement is a major feature and nonselective NSAIDs are contraindicated e.g., coexisting gastric disorder ; , and the patient is not at cardiovascular risk. Corticosteroid injections for tendon injuries may achieve a mild to moderate reduction in pain for up to six weeks. However, they do not promote tendon healing, so should generally be used only when healing is not a critical goal. Promising new therapeutic treatments for soft-tissue injuries include topical glyceryl trinitrate, aprotinin injections and prolotherapy. The widespread use of non-steroidal anti-inflammatory drugs and corticosteroid injections for treating soft tissue injuries is not always appropriate. AUTHORS: Paoloni JA, Orchard JW.
Publication history issue online: 23 aug 2005 received may 15, 1980 accepted september 20, 1980 home list of issues table of contents article abstract bjog: an international journal of obstetrics and gynaecology volume 88 issue 2 page 146-149, february 1981 to cite this article: b ousfield tutor in obstetrics and gynaecology , k.
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