Osteometric Dimensions of the Laminas of the Spine

The present study was undertaken to evaluate the dimensions of the laminas from C2 to L5 by using adult human spine specimens for the objective of providing a set of quantitative data for the laminas from C2 to L5 vertebrae.There exists enormous amount of Anatomic data based on facet and pedicle parameters by different research workers, but it seems that the detailed studies based on measurements of laminar parameters from cervical to lumbar spines are almost nil.Forty spines (920 vertebrae) were considered for the present study. Anatomic evaluation of the laminas'included the laminar height, width, thickness, width angle & slope angle.The greatest laminar height was observed at T11 for males & females ( 22.8 ± 2.1 mm, 23.0 + 1.8mm) respectively. There was a marked change in pattern at L5 where there was a decrease in laminar height from that of preceding lumbar levels.The greatest laminar width was at-L5 for males & females (12.1 ± 2.4mm 11.5 ± 2.1 mm ) respectively. The laminar thickness was maximum at T3 for males and females (5:2 ± 0.7mm & 5.1 ± 0.2mm ) respectively. The maximum width angle was at T9 for males (99.2 ± 9.7mm) & at L4for females (100.6 ± 12.3mm). The-slope angle was maximum at L5 for males and females (113.5 ± 4.8mm & 118.0 ± 1.4mm) respectively.Thus, for the proper, understanding of the weight transmission through the spine and it related hypothesis the Anatomic parameters of the laminas provided by the present study are very important and also they provide an adequate database necessary for the surgical placement of sublaminar instruments in spine related surgeries.     

International validation of the Chinese University Prognostic Index for staging of hepatocellular carcinoma:a joint United Kingdom and Hong Kong study

The outcome of hepatocellular carcinoma （HCC） patients significantly differs between western and eastern population centers. Our group previously developed and validated the Chinese University Prognostic Index （CUPI） for the prognostication of HCC among the Asian HCC patient population. In the current study, we aimed to validate the CUPI using an international cohort of patients with HCC and to compare the CUPI to two widely used staging systems, the Barcelona Clinic Liver Cancer （BCLC） classification and the Cancer of the Liver Italian Program （CLIP）. To accomplish this goal, two cohorts of patients were enrolled in the United Kingdom （UK; n = 567; 2006-2011） and Hong Kong （HK; n = 517; 2007-2012）. The baseline clinical data were recorded. The performances of the CUPI, BCLC, and CLIP were compared in terms of a concordance index （C-index） and were evaluated in subgroups of patients according to treatment intent. The results revealed that the median follow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overall survival of the UK and HK cohorts were 22.9 and 8.6 months, respectively. The CUPI stratified the patients in both cohorts into three risk subgroups corresponding to distinct outcomes. The median overall survival of the CUPI low-, intermediate-, and high-risk subgroups were 3.15, 1.24, and 0.29 years, respectively, in the UK cohort and were 2.07, 0.32, and 0.10 years, respectively, in the HK cohort. For the patients who underwent curative treatment, the prognostic performance did not differ between the three staging systems, and all were suboptimal. For those who underwent palliative treatment, the CUPI displayed the highest C-index, indicating that this staging system was the most informative for both cohorts. In conclusion, the CUPI is applicable to both western and eastern HCC patient populations. The performances of the three staging systems differed according to treatment intent, and the CUPI was demonstrated to be optimal for those     

How common is polycystic ovary syndrome in recurrent miscarriage?

The association between polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM) has been long established, but the relative importance of this condition as a cause of RM is far from clear. Previous studies on the prevalence of PCOS in RM have been hampered by a lack of objective and universally accepted criteria for the diagnosis of PCOS, resulting in considerable controversy. However, the Rotterdam criteria have since been accepted as the gold standard for diagnosis of PCOS, and therefore these criteria have been used to produce a much clearer and more objective assessment of the prevalence of PCOS in RM. Three hundred women with recurrent miscarriage were studied. A diagnosis of PCOS was established via measurement of cycle length and day 21 serum progesterone, determination of the free androgen index and pelvic ultrasonography. All ultrasound reports prior to publication of the Rotterdam criteria were reviewed, ensuring consistency in the diagnosis of a polycystic ovary. Ultrasound scans of 27 patients confirmed polycystic ovaries with a further 10 scans suggestive of polycystic ovaries, but with insufficient information for the Rotterdam criteria to be applied. Hence, 27–37 (9.0–12%) patients presented with ultrasonographic polycystic ovaries. Using the Rotterdam criteria, 25–30 (8.3–10%) patients had PCOS. It is concluded that the prevalence of PCOS in RM is considerably lower than has previously been accepted.     

Treatment of recurrent miscarriage and antiphospholipid syndrome with low-dose enoxaparin and aspirin

The aim of this retrospective, observational study was to determine the impact of low-dose enoxaparin (20 mg) in conjunction with low-dose aspirin on the pregnancy outcome of women with antiphospholipid syndrome and recurrent miscarriage. The study was conducted in a tertiary referral teaching hospital. A total of 35 women with antiphospholipid syndrome were treated with low-dose enoxaparin and aspirin as soon as pregnancy was confirmed. The outcome of pregnancy was analysed. The miscarriage rate was 7/35 (20%) whereas the live birth rate was 28/35 (80%). In conclusion, low-dose (20 mg) enoxaparin in conjunction with low-dose aspirin treatment produced encouraging results. The findings in this study suggest that there is a case for randomized controlled trials to compare low-dose (20 mg) enoxaparin with higher doses.     

Clonal relationship between lymphocytic predominance Hodgkin's disease and concurrent or subsequent large-cell lymphoma of B lineage

The occurrence of a large-cell lymphoma (LCL) concurrent with or subsequent to lymphocytic predominance Hodgkin's disease (LPHD) is well documented. Given the well-characterized B-cell nature of the Reed- Sternberg cell variants in LPHD, there may be a clonal relationship between the LPHD and the associated B-cell LCL. In this study, we adapted a highly sensitive, clonospecific assay to test whether the clone comprising the LCL exists in the corresponding LPHD tumor. Nine cases meeting the histologic criteria of nodular LPHD and B-cell LCL were identified, reviewed, and studied. Initially, clonality of both lesions was assessed using consensus primers to conserved regions in the IgH variable (frame-work III) and joining region genes in a polymerase chain reaction (PCR) assay. The PCR assay detected a clonal B-cell population in five of the LCLs, whereas analysis of eight cases of LPHD did not detect a dominant clone. Clonal products from the LCL were then sequenced, and clonospecific oligonucleotides were designed from the unique nucleotide sequence encoding the complementarity- determining region-III. These were then used as primers and/or probes in sensitive PCR-based assays on the corresponding LPHD tumors. In two cases, the clonospecific assay showed that the LPHD and LCL shared a common clone that was further confirmed by sequence analysis. This finding provides genotypic evidence that, at least in some cases, the LCL represents a clonal progression of LPHD.     

Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound,CT and MR appearance

The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. The previous literature is also reviewed.