MRI影像测量腰椎黄韧带厚度与退变性椎间盘的关系

背景：腰椎间盘退变和黄韧带增厚都被认为是与老化的变化相关。然而,却很少见用MRI评价黄韧带肥厚自然病程的报道。 目的：用MRI评价黄韧带厚度与年龄、椎间隙水平及椎间盘退行性变的关系。 方法：MRI测量178例患有腰腿痛的患者的L2/3、L3/4、L4/5、L5S1水平712条黄韧带的厚度。并检验黄韧带厚度与年龄和椎间隙水平及椎间盘退行性变的关系。 结果与结论：黄韧带的厚度随着年龄的增加而增加。然而,L4/5、L5S1水平黄韧带厚度的增加要比L2/3、L3/4水平明显。在L4/5水平,在20~29岁年龄段的患者黄韧带厚度已超过3 mm。所有的患者如果L2/3水平黄韧带肥厚(> 3.0 mm),那么其余个水平的黄韧带均肥厚。在老年患者中,黄韧带的厚度和椎间盘的退行性变没有相关性。提示在20~29年龄段的患者黄韧带已经开始变厚,而黄韧带的增厚不是随着椎间盘的退变屈曲凸入椎管内的。L2/3水平黄韧带的厚度可以作为一个多水平腰椎管狭窄的指示剂。     

Analysis of dural sac thickness in the human cervical spine

The thickness of the dura mater in the human cervical spine can vary between individuals and by vertebral level; these differences can result in various clinical outcomes. The purpose was to measure and analyze cervical dura mater thickness. Microscopic measurements were made of tissue from human cadavers. The subjects were nine human cadavers with no previous history of spinal deformity or surgery. Fourteen segments of both anterior and posterior dura mater from the C1 to C7 cervical vertebrae were obtained. Dura mater thickness was measured using an infrared laser-based confocal microscope. Statistical analyses were performed to examine the relationships of cervical dura mater thickness with vertebral level, age, and sex. The overall average cervical dura mater thickness was 379.3 × 10^?3 mm. Statistically significant differences in thickness were found between the anterior and posterior segments (P < 0.0001). Moreover, the thickness at each vertebral level was significantly different from the thicknesses at the other levels (P < 0.05). The posterior dura mater thickness was highest at C1 and lowest at C5/6. Posterior dura mater thickness was significantly different at the axial, sub-axial, and lower cervical levels, whereas anterior dura mater thickness was relatively constant among levels. A significant correlation was found between thickness and age (P < 0.05); however, the average dura mater thickness was not significantly different between males and females. This study shows anatomical differences in cervical dura mater thickness with respect to vertebral level and age. These results provide anatomical information that will inform basic research and clinical approaches.     

Microanatomy of Human Left Ventricular Coronary Veins

We describe analyses of the microanatomy of major left ventricular veins, including their relationship to the myocardium. Immediately following fixation of six fresh human hearts, anterior interventricular veins (AIV), left marginal veins (LMV), posterior veins of the left ventricle (PVLV), and posterior interventricular veins (PIV) were sectioned in ～5 mm intervals perpendicular to the veins' length from base to apex. Slides were prepared, digitized, and analyzed; measurements were made of each vein's wall thickness, circumference, distance between vein wall and myocardium, and distance between vein wall and closest artery. For analyses, based on the length of each vein, slides were grouped into three regions: basal (top third), mid (middle third), and apical (bottom third). Vein wall thicknesses and circumferences were significantly smaller (P < 0.05) in apical than basal regions in all veins. Vein wall thicknesses were significantly larger in the AIV and PIV than in the LMV and PVLV (P < 0.05). The AIV was significantly farther away (1.81–2.99 mm) from the myocardium than the other three veins (P < 0.05). Left ventricular venous microanatomy was quantified and analyzed. Variation in venous microanatomy, including distance between vein walls and excitable myocardium, could impact therapies involving the coronary venous system. Anat Rec, 2009. © 2008 Wiley‐Liss, Inc.     

Pathological significance of epidermal growth factor receptor expression and amplification in human gliomas

Zhao L‐l, Xu K‐l, Wang S‐w, Hu B‐l & Chen L‐r
(2012) Histopathology  61, 726–736 Pathological significance of epidermal growth factor receptor expression and amplification in human gliomas Aims: To investigate epidermal growth factor receptor (EGFR) expression and amplification in gliomas and to assess their association with survival. Methods and results: Immunohistochemistry and fluorescence in‐situ hybridization were performed to analyse EGFR status in 158 cases of primary glioma. Kaplan–Meier survival and Cox regression analyses were performed to analyse the prognosis of patients. Overexpression of EGFR and expression of EGFR variant III (EGFRvIII) were found in 102 cases (64.6%) and 47 cases (29.7%), respectively. Overexpression of EGFR was significantly correlated with World Health Organization (WHO) grade and Karnofsky performance score (KPS) (both P < 0.05). Expression of EGFRvIII was significantly correlated with WHO grade, gender, age, and KPS (all P < 0.05). EGFR amplification was found in 46 cases (29.1%), and was significantly correlated with WHO grade, age, KPS and EGFR overexpression (all P < 0.05). Cox multifactor analysis showed that EGFR amplification was an independent unfavourable prognostic factor for human gliomas at all ages, and EGFRvIII was an independent prognostic factor in patients older than 60 years. Conclusions: EGFR amplification and EGFRvIII expression were associated with an unfavourable prognosis for patients of all ages, and for those older than 60 years, respectively. The differing significance of EGFR status in young and old glioma patients and its impact on prognosis needs further study.     

山梨醇增加糖尿病患者腰椎管狭窄症炎性反应因子的表达

目的探讨糖尿病腰椎管狭窄患者黄韧带增生肥厚的发生机制。方法 24例糖尿病和20例非糖尿病的腰椎管狭窄患者列为研究对象,观测黄韧带标本结构,D-Sorbitol/Xylitol试剂盒检测山梨醇水平。体外实验中使用小鼠成纤维细胞(NIH3T3)细胞系,用Western blot及q PCR分别检测高糖培养条件及醛糖还原酶抑制剂(ARI):依帕司他(EP)作用对细胞炎性反应因子及TGF-β表达水平的影响。结果糖尿病组较非糖尿病组的山梨醇水平更高、黄韧带平均厚度更大、标本弹力纤维降解、胶原纤维增生更为显著、免疫组化CD68阳性染色率更高(P0.01);体外实验中,NIH3T3细胞系在高糖培养与正常糖浓度培养相比山梨醇、促炎性细胞因子和TGF-β表达水平更高,而山梨醇、促炎性细胞因子和TGF-β增高的表达水平可被醛糖还原酶抑制剂所抑制并且呈剂量依赖(P0.05)。结论糖尿病腰椎管狭窄患者黄韧带中山梨醇水平显著增高,进而促进炎性反应因子及纤维化相关因子TGF-β表达增加,使得黄韧带炎性增生。     

Internal rib structure can be predicted using mathematical models: An anatomic study comparing the chest to a shell dome with application to understanding fractures

The human rib cage resembles a masonry dome in shape. Masonry domes have a particular construction that mimics stress distribution. Rib cortical thickness and bone density were analyzed to determine whether the morphology of the rib cage is sufficiently similar to a shell dome for internal rib structure to be predicted mathematically. A finite element analysis (FEA) simulation was used to measure stresses on the internal and external surfaces of a chest‐shaped dome. Inner and outer rib cortical thickness and bone density were measured in the mid‐axillary lines of seven cadaveric rib cages using computerized tomography scanning. Paired t tests and Pearson correlation were used to relate cortical thickness and bone density to stress. FEA modeling showed that the stress was 82% higher on the internal than the external surface, with a gradual decrease in internal and external wall stresses from the base to the apex. The inner cortex was more radio‐dense, P < 0.001, and thicker, P < 0.001, than the outer cortex. Inner cortical thickness was related to internal stress, r = 0.94, P < 0.001, inner cortical bone density to internal stress, r = 0.87, P = 0.003, and outer cortical thickness to external stress, r = 0.65, P = 0.035. Mathematical models were developed relating internal and external cortical thicknesses and bone densities to rib level. The internal anatomical features of ribs, including the inner and outer cortical thicknesses and bone densities, are similar to the stress distribution in dome‐shaped structures modeled using FEA computer simulations of a thick‐walled dome pressure vessel. Fixation of rib fractures should include the stronger internal cortex. Clin. Anat. 28:1008–1016, 2015. © 2015 Wiley Periodicals, Inc.     

5-羟色胺与电解质在支气管哮喘豚鼠气道重塑中的作用

目的： 探讨5-羟色胺和电解质在支气管哮喘豚鼠气道重塑中的作用。 方法： 70只雄性豚鼠随机分为正常对照组、哮喘模型组、哮喘模型延续组、5-羟色胺组、5-羟色胺拮抗剂组、高镁组和低镁组。用卵清蛋白（OVA）复制支气管哮喘气道重塑模型。观察指标：血清5-羟色胺浓度，血清钠、钾、氯、钙、镁、磷离子浓度以及气道壁各层厚度。 结果： ①哮喘模型组血清5-羟色胺浓度与气道壁各层厚度明显大于正常对照组（P＜0.05，P＜0.01）；血清镁离子浓度低于正常对照组（P＜0.05）。②哮喘模型延续组血清5-羟色胺浓度与气道壁各层厚度明显大于哮喘模型组（P＜0.05，P＜0.01）。③5-羟色胺组豚鼠气道壁各层厚度大于哮喘模型延续组（P＜0.05）。④5-羟色胺拮抗剂组豚鼠气道壁各层厚度小于哮喘模型延续组 （P＜0.05）。⑤高镁组豚鼠气道壁各层厚度小于哮喘模型延续组（P＜0.05）。⑥低镁组小气道平滑肌厚度大于哮喘模型延续组（P＜0.05）。⑦随气道重塑加重或减轻，血清钙离子浓度升高或下降；血清磷离子浓度下降或升高。⑧在哮喘气道重塑中，各组血清钾、钠、氯离子浓度变化无显著差异。⑨在哮喘气道重塑中，血清5-羟色胺浓度与血清钙离子浓度呈正相关（r=0.348, P＜0.05）。 结论： ①5-羟色胺在哮喘豚鼠气道重塑中起介导作用。②镁离子在哮喘豚鼠气道重塑中可能起调节作用。③血清钙离子浓度升高与血清磷离子浓度降低在哮喘豚鼠气道重塑中可能起促进作用。④血清钠、钾、氯离子在哮喘豚鼠气道重塑中可能不起作用。⑤在哮喘豚鼠气道重塑中，血清5-羟色胺浓度与血清钙离子浓度呈正相关。     

Body mass index in young children and allergic disease: gender differences in a longitudinal study

Background The increase in allergic diseases has occurred in parallel with the obesity epidemic, suggesting a possible association. Objective We investigated the relationship of body mass index (BMI) up to age 8 years with allergic disease within a birth cohort. Methods Children were followed from birth and were reviewed at age 3, 5 and 8 years (n=731; male 406). Parents completed questionnaires; children were weighed, measured, skin prick tested and examined. Results Increasing BMI at 3, 5 and 8 years increased the risk of current wheezing at the corresponding age (odds ratio [95% confidence interval] per standardized deviation score: age 3, 1.26 [1.04–1.53], P=0.02; age 5, 1.33 [1.06–1.67], P=0.02; age 8, 1.27 [1.0–1.62], P=0.05). The effect of BMI on wheeze at age 8 years differed between boys and girls, with a significant positive association in girls, but not in boys (P=0.04 for interaction). The effect of BMI at earlier ages on current or subsequent wheezing did not differ significantly between genders. Increasing BMI significantly increased the risk of physician‐diagnosed eczema at age 5 (1.23 [1.04–1.47], P=0.02) and 8 (1.23 [1.03–1.45], P=0.02), with a significant interaction between gender and BMI at age 5 (P=0.04). There was no association between BMI and sensitization. Being overweight at age 3 years was significantly associated with late‐onset wheeze (3.83 [1.51–9.75], P=0.005), persistent wheeze (4.15 [2.07–8.32], P<0.001) and persistent eczema (1.79 [1.03–3.13], P=0.04) in both boys and girls. Conclusions Being overweight is associated with an increased risk of allergic disease in childhood. However, the strength of the association varies with the gender, age and atopic phenotype. Cite this as: C. S. Murray, D. Canoy, I. Buchan, A. Woodcock, A. Simpson and A. Custovic, Clinical & Experimental Allergy, 2011 (41) 78–85.     

Experimental Spinal Stenosis in Cats: New Insight in Mechanisms of Hydrocephalus Development

In our new experimental model of cervical stenosis without inflammation we have tested hypothesis that cranio‐spinal communication impairment could lead to hydrocephalus development. Spinal and cranial cerebrospinal fluid (CSF) space separation was obtained with positioning of plastic semiring in epidural space at C2 level in cats. Brain ventricles planimetry, and CSF pressure recording in lateral ventricle (LV) and lumbar subarachnoid space (LSS) were performed in acute and subchronic experiments. In all experiments opening CSF pressures were normal. However, in acute experiments, an infusion of artificial CSF into the LV led to increase of CSF pressure and significant gradient pressure development between LV and LSS due to limited pressure transmission. After 3 or 6 weeks spinal cord atrophy was observed at the site of cervical stenosis, and pressure transmission from LV to LSS was improved as a consequence of spinal tissue atrophy. Planimetry of both the coronal brain slices and the ventricles’ surface showed that control ventricular surface was 0.6 ± 0.1% (n = 5), and 1.6 ± 0.2% (n = 4) in animals with subchronic cervical stenosis (P < 0.002). These results support the mentioned hypothesis claiming that CSF volume cranio‐spinal displacement impairment could start pathophysiological processes leading to development of hydrocephalus.     

Proposal for novel histological findings of colorectal liver metastases with preoperative chemotherapy

This study aimed to clarify the histological characteristics related to preoperative chemotherapy for colorectal liver metastases (CRLM). Sixty‐three patients with CRLM were divided into two groups: CRLM with chemotherapy (41 cases, group A) and CRLM without chemotherapy (22 cases; surgical treatment alone, group S) to identify the histological differences associated with chemotherapy. In addition, we investigated the effects of combination chemotherapy on the histology of metastatic lesions. Infarct‐like necrosis (ILN), three‐zonal changes, and cholesterol clefts were more frequent in group A than in group S (P < 0.05). ILN and three‐zonal changes were more common in the 5‐FU with leucovorin and oxaliplatin (FOLFOX), or 5‐FU with leucovorin and irinotecan (FOLFIRI) with or without additional bevacizumab groups than in group S (P < 0.05). Cholesterol clefts in the FOLFOX or FOLFIRI with bevacizumab group and foamy macrophages in the FOLFOX or FOLFIRI group were more common than in group S (P < 0.05). Cases with more than three of the four histological findings—i.e. ILN, three‐zonal changes, cholesterol clefts, and foamy macrophages—were more frequent in the FOLFOX or FOLFIRI with or without additional bevacizumab groups than in group S (P < 0.05). We showed histological findings for every representative chemotherapy regimen for CRLM to clarify the effects of preoperative chemotherapy.     

Distribution of subcutaneous fat and muscle thicknesses in young and middle-aged women

Thicknesses of subcutaneous fat tissue at 13 sites (triceps, biceps, forearm, subscapular, abdomen, suprailiac, axilla, chest, quadriceps, suprapatellar, hamstrings, posterior calf, medial calf), and muscle tissue at nine sites (triceps, biceps, forearm, subscapular, abdomen, quadriceps, suprapatellar, hamstrings, posterior calf) were determined by using the B-mode ultrasound technique. Subjects were 36 young (18–29 years) and 44 middle-aged women (45–64 years). Body density averaged 1.047 ± 0.007 g · ml⁻¹ (SD) for the young, and 1.022 ± 0.005 g · ml⁻¹ for the middle-aged women. The middle-aged women showed significantly thicker subcutaneous fat than the young at all sites, and the relative differences between the two groups were larger on the trunk and adjacent sites. Muscle thicknesses on the trunk and quadriceps were significantly higher in the young women than in the middle-aged, but values for the upper extremities and calf were not significant between the two groups. The sum of subcutaneous fat thicknesses at 13 sites was significantly correlated with fat mass relative to the second power of stature (FM · St⁻²) in both groups, r = 0.766 (P < 0.05) for the young and r = 0.803 (P < 0.05) for the middle aged women. For subcutaneous fat thickness per unit FM · St⁻², the young women showed significantly higher values than the middle-aged on both the upper and lower extremities. The sum of muscle thicknesses at nine sites was significantly correlated with fat-free mass per unit stature² (FFM · St⁻²) in both groups, r = 0.764 (P < 0.05) for the young and r = 0.636 (P < 0.05) for the middle-aged. The relative values of muscle thicknesses to FFM · St⁻² were significantly lower on the abdomen and quadriceps in the middle-aged women than in the young. Thus compared with the young, the middle-aged women have thicker subcutaneous fat thicknesses along the whole body and thinner muscle thicknesses on the trunk and quadriceps regions. Moreover, it appears that in middle-aged women, the relative distribution of subcutaneous fat and muscle thicknesses to FM and FFM, respectively, show disproportionately higher fat stores internally than subcutaneously, and more rapid atrophy of muscle tissues at the anterior sites of the trunk and thigh than at other body sites. Am. J. Hum. Biol. 9:247–255, 1997. © 1997 Wiley-Liss, Inc.     

Spinal cord termination in adult Africans: Relationship with intercristal line and the transumbilical plane

The level of cord termination and level of vertebral intersection of intercristal line and transumbilical plane (TUP), frequently used landmarks, show ethnic variation. The relationship of the spinal cord termination to these lines is vital in spinal surgery and anesthesia, but data on these parameters are scarce in the African population. The purpose of this work is to determine the level of cord termination and establish its relationship with intercristal line and TUP. One hundred and twelve specimens obtained from the department of Human Anatomy at the University of Nairobi were used in this study. The conus medullaris was exposed by laminectomy and its vertebral level together with those of intercristal line and TUP recorded. The distance of conus medullaris from intercristal plane was measured in millimeters. Data obtained were coded and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 16.0 Chicago, Illinois, 2002. Student's t‐test was used in the statistical assessment of gender differences. A P value of less than 0.05 was considered significant. The median level of termination of the cord was the upper third of L2, 51.9% of cases terminating below this. There was no statistically significant gender difference in the level of termination of the cord. The intercristal plane passed through L4/L5 disc (70.9%) and below (29.1%). The TUP corresponded with intercristal line in 78.2% of subjects. The mean distance of the spinal cord termination from intercristal line was 99 ± 24 mm. The spinal cord terminates at or below the upper third of L2. Care should be exercised during lumbar punctures and spinal epidural anesthesia among Africans. Intecristal line and TUP are safe landmarks to use in location of conus medullaris. Clin. Anat. 23:563–565, 2010. © 2010 Wiley‐Liss, Inc.     

经皮大通道内镜下与Wilste入路经椎间孔腰椎椎间融合术治疗退变性腰椎椎管狭窄症的疗效比较

目的 比较经皮大通道脊柱内镜下腰椎椎间融合术（percutaneous coaxial large-channel endoscopic lumbar interbodyfusion,PE-LIF）与Wilste入路经椎间孔腰椎椎间融合术（Wiltse-approachtransforaminallumbar interbody fusion, MIS-TLIF）治疗退变性腰椎椎管狭窄症的临床疗效。方法 回顾性分析2021年1月至2021年12月因退变性腰椎椎管狭窄症于成都中医药大学附属医院行腰椎减压融合术的65例患者的临床资料,据手术方式分为PE-LIF组（24例）和MIS-TLIF组（41例）。比较两组患者的手术时间、术中出血量、术后引流量、术后住院天数及并发症情况。比较两组患者术前、术后1 d、术后3 d全血C反应蛋白（CRP）及术前、术后1 d、术后7 d血清磷酸肌酸激酶（CK）含量评估椎旁肌肉损伤情况。比较两组患者术前,术后3 d、1个月、3个月、12个月的腰腿痛视觉模拟评分（visual analogue scale, VAS）,以及术前,术后3个月、12个月的Oswest...     

Descriptive study of the differences in the level of the conus medullaris in four different age groups

In performing neuraxial procedures, knowledge of the location of the conus medullaris in patients of all ages is important. The aim of this study was to determine the location of conus medullaris in a sample of newborn/infant cadavers and sagittal MRIs of children, adolescents, and young adults. The subjects of both the samples were subdivided into four developmental stages. No statistical difference was seen between the three older age groups (P > 0.05). A significant difference was evident when the newborn/infant stage was compared with the other, older stages (P < 0.001 for all comparisons). In the newborn/infant group the spinal cord terminated most frequently at the level of L2/L3 (16%). In the childhood stage, the spinal cord terminated at the levels of T12/L1 and the lower third of L1 (21%). In the adolescent population, it was most often found at the level of the middle third of L1 and L1/L2 (19%). Finally, in the young adult group, the spinal cord terminated at the level of L1/L2 (25%). This study confirmed the different level of spinal cord termination between newborns/infants less than one‐year‐old and subjects older than one year. In this sample the conus medullaris was not found caudal to the L3 vertebral body, which is more cranial than the prescribed level of needle insertion recommended for lumbar neuraxial procedures. It is recommended that the exact level of spinal cord termination should be determined prior to attempting lumbar neuraxial procedures in newborns or infants. Clin. Anat. 28:638–644, 2015. © 2015 Wiley Periodicals, Inc.     

Effect of altered occlusal function on transseptal ligament and new bone thicknesses in the periodontium of the rat

Alteration of tooth function is assumed to change stress/strain on the adjacent alveolar bone and its mucoperiosteum, producing changes in morphology similar to those described for other load-bearing bones. The present study suggested that crestal alveolar bone and its mucoperiosteum respond differently to stress/strain than load-bearing bones in other locations, possibly due to differences in the mechanism of bone loading by muscles and teeth. Occlusal hypofunction was initiated by extraction of agonist teeth; the contralateral teeth were placed in hyperfunction by the surgery. Untreated animals were also studied. ³H-proline was injected, animals were killed 1–5 weeks later, and the thicknesses of new bone and transseptal ligament were measured. After 5 weeks of altered function, total thickness (new bone + transseptal ligament) was similar in untreated and in hypofunctional and hyperfunctional situations; however, a new ratio between transseptal ligament and new bone thicknesses was established. Occlusal force was negatively correlated with new bone and positively correlated with transseptal ligament thickness; both thicknesses were statistically correlated in each functional situation (P<0.001). Hyperfunction resulted in increased transseptal ligament thickness, but decreased new bone thickness as compared to untreated controls (P<0.001). In contrast, hypofunction resulted in an increased new bone thickness, but a decreased transseptal ligament thickness (P<0.001). Tissue responses assure appropriate support for the teeth in each functional situation.     

单侧双通道内镜下椎板开窗减压术在腰椎管狭窄症中的应用

目的 探讨单侧双通道内镜下椎板开窗减压术在腰椎管狭窄症中的应用。方法 回顾性分析2019年11月至2021年11月石河子市人民医院收治的39例保守治疗无效单侧下肢症状的腰椎管狭窄症患者的资料。其中,男19例,女20例;年龄55 ～ 80岁,平均60.5岁;病程4 ～ 25周,平均12.5周。病变节段L_3-4 5例,L_4-5 30例,L₅-S₁ 4例。记录手术时间、术中出血量、手术切口长度及并发症发生情况。采用疼痛视觉模拟评分法（VAS）和改良的Oswestry功能障碍指数（ODI）比较术前、术后1 d及术后1个月、3个月、1年和末次随访的结果评估手术疗效。末次随访时按MacNab标准评估治疗有效率。结果 所有患者均顺利完成手术,并均获得随访,随访时间为12 ～ 23个月,平均（16.2±3.2）个月。患者的手术时间为（61.55±5.36） min、术中出血量为（50.20±7.53） mL、手术切口长度为（14.26±2.66） cm。术后各时间点腰腿疼痛VAS评分及ODI较术前均明显下降,差异有统计学意义（P＜0.05）;术后各时间点间比较,差异无统计学意义（P＞0.05）。术后有1例出现下肢麻木,感觉过敏;有2例患者硬膜囊撕裂;无感染发生。结论 在腰椎管狭窄症中应用UBE行镜下椎板开窗减压术是安全、有效的,为腰椎管狭窄症的微创治疗提供了选择。     

Clinical relevance of conus medullaris and dural sac termination level with special reference to sacral hiatus apex: anatomical and MRI radiologic study

The aim of this study was to determine the vertebral level and variations in the position of the termination of both conus medullaris (CMT) and dural sac (DST) with special reference to the apex of the sacral hiatus (SHA) using magnetic resonance (MR) images and human cadavers. Different measurements were made on 200 MR sagittal T1- and T2-weighted lumbosacral images and 60 formalin-fixed adult human cadavers. The linear distances between the CMT, DST and SHA, the anteroposterior diameter at SHA, delete length and thickness of the sacrococcygeal membrane were also measured. These measurements were correlated with age and sex. In the MRI study, the mean vertebral level of CMT and its highest incidence were seen at the lower third of L1 (L1L) in male patients and at the L1-2 disc in female patients; that of DST was observed at the upper third of S2 (S2U) in male patients and the middle third of S2 (S2M) in female patients and the mean vertebral level of the SHA was noted at the middle third of S4 (S4M) in both males and females with no significant age or sex differences (P < 0.05). In the cadaveric specimens, the mean vertebral levels of CMT, DST and SHA were seen at L1L, S2M and S4U, respectively in both male and female specimens, with no sex difference. Also in the MRI study, all linear distances in the male patients were significantly different (P < 0.05) from those in female patients with exception of the thickness of SCM and the AP diameter at SHA. Accurate knowledge of these levels and the distances in-between are important for safe and successful spinal and caudal anaesthesia.     

Women are more susceptible than men to oxidative stress and chromosome damage caused by polycyclic aromatic hydrocarbons exposure

Exposure to environmental polycyclic aromatic hydrocarbons (PAHs) has been associated with increased risk of cancer, but evidence for gender differences in this association is limited. The aim of this study was to examine the gender differences in PAHs caused early genotoxic effects such as oxidative stress and chromosome damage, which are potential carcinogenic etiology of PAHs. A total of 478 nonsmoking workers (272 men and 206 women) from a coke oven plant were recruited. We determined 16 environmental PAHs in their workplaces, and measured concentrations of 12 urinary PAH metabolites (OH‐PAHs), plasma benzo[a]pyrene‐r‐7,t‐8,t‐9,c‐10‐tetrahydotetrol‐albumin (BPDE‐Alb) adducts, urinary 8‐hydroxydeoxyguanosine (8‐OHdG) and 8‐iso‐prostaglandin‐F2α (8‐iso‐PGF2α), and micronucleus frequencies in lymphocytes in all subjects. It showed that, women working at the office, adjacent to the coke oven, and on the bottom or side of the coke oven displayed significantly higher levels of urinary 8‐OHdG and 8‐iso‐PGF2α, and lymphocytic micronucleus frequencies compared with men working at above areas, respectively (all P < 0.05). These gender differences remain significant after adjusted for potential confounders and urinary ΣOH‐PAHs or plasma BPDE‐Alb adducts. A significant interaction existed between gender and BPDE‐Alb adducts on increasing micronucleus frequencies (P_interaction < 0.001). We further stratified all workers by the tertiles of urinary ΣOH‐PAHs or plasma BPDE‐Alb adducts, and the above gender differences were more evident in the median‐ and high‐exposure groups (all P < 0.05). In conclusion, women were more susceptible than men to oxidative stress and chromosome damage induced by PAHs, which may add potential evidence underlying gender differences in PAH exposure‐related lung cacinogenesis. Environ. Mol. Mutagen. 55:472–481, 2014. © 2014 Wiley Periodicals, Inc.     

Alterations in the expression and activity of creatine kinase-M and mitochondrial creatine kinase subunits in skeletal muscle following prolonged intense exercise in rats

Creatine kinase (CK) isoenzymes are important structural and energy metabolism components in skeletal muscle. In this study, CK isoenzyme alterations were examined in male rats, with an 8% body mass weight attached to their tail. The rats were either forced to swim for 5 h (5S, n = 51), or were pre-trained for 8 days and then forced to swim for 5 h (T5S, n = 48). Rats were sacrificed either immediately (0 h PS), 3 h (3 h PS), or 48 h post-swimming (48 h PS). Serum CK was increased significantly (P < 0.01) 6.2- and 2.0-fold at 0 h PS following the 5S and T5S protocols, respectively. However, training (T5S protocol) significantly (P < 0.01) decreased CK release. Soleus and white gastrocnemius (WG) CK activity was significantly decreased following the 5S protocol (P < 0.05), but not following the T5S protocol. The CK-M activity of the soleus muscle was significantly (P < 0.05) decreased at 0 h PS following both the 5S and T5S protocols, and returned to control values at 3 h PS. The CK-M activity of the WG was significantly (P < 0.05) decreased at 0 h PS following the 5S protocol. Sarcomeric mitochondrial CK (sCK-Mit) was decreased significantly (P < 0.01) at 0 h PS (20%), 3 h PS (14%), 24 h PS (22%), and 48 h PS (15%) following the 5S protocol. However, sCK-Mit was decreased significantly (P < 0.01) only at 0 h PS (7%) following the T5S. The results of this study demonstrate that prolonged intense exercise causes a loss of skeletal muscle CK-M and sCK-Mit activity and that training prior to the prolonged intense exercise attenuates the exercise-induced CK-M and sCK-Mit loss in both red and white skeletal muscles. Accepted: 18 July 1999     

Cross‐sectional area of lumbar spinal muscles and vertebral endplates: a secondary analysis of 91 computed tomography images of children aged 2–20

Spinal muscle cross‐sectional area has been highly associated with spinal pathology. Despite the medium‐high prevalence of spinal pathology in children, there is very limited knowledge regarding muscle size and growth pattern in individuals younger than 20 years of age. The aim of this study is to analyze the change in size and symmetry of spinal muscles (erector spinae, multifidus, psoas and quadratus lumborum) in children 2–20 years of age. We studied reformatted images from 91 abdominal computed tomographic scans of children aged 2–20 years, from an existing imaging dataset. The cross‐sectional area of the muscles was bilaterally measured parallel to the upper endplate of the lumbar vertebrae L3–L5 and at true horizontal for S1. The cross‐sectional area of the upper vertebral endplate was measured at spinal levels L3–L5. Results were analyzed according to six groups based on children's age: 2–4 years (group 1), 5–7 years (group 2), 8–10 years (group 3), 11–13 years (group 4), 14–16 years (group 5) and 17–20 years (group 6). Vertebral endplate and spinal muscles cross‐sectional area increased with age. Two patterns were observed: Endplate, psoas and quadratus lumborum increased up to our 6th oldest age group (17–20), and multifidus and erector spinae reached their largest size in the 5th age group (14–16). The epaxial muscles (erector spinae and multifidus) reached their maximal cross‐sectional area before skeletal maturity (18–21 years of age). The hypaxial muscles (psoas and quadratus lumborum) continued to increase in size at least until spinal maturity. Contributing factors for the differences in developmental pattern between the epaxial and hypaxial muscles might include functional, embryological and innervation factors. In conclusion, this research is the first to describe the cross‐sectional area of spinal muscles in children. Future longitudinal studies are needed for further understanding of muscle development during childhood and adolescence. Level of evidence: level 2b, Retrospective cohort study.