Sixth Thoracic Vertebra Research Articles

The QT Variability Index and Cardiac Autonomic Modulation: Perspectives from Apparently Healthy Men with Spinal Cord Injury

Objective: To describe the effect of spinal cord injury (SCI) on the QT variability index (QTVI). Methods: Digital electrocardiograms from 113 age-matched men (40 with tetraplegia, 26 with high paraplegia, 17 low paraplegia and 31 controls) were analyzed. RR interval, heart rate (HR) variability [total power (TP_RR), low frequency (LF_RR) and high frequency (HF_RR)], QT interval duration, Bazett HR-corrected QT (QTc), QT interval variance (QTVN) and QTVI were compared. Results: Significant group main effects were present for RR, QTc, TP_RR and LF_RR, but not QT duration, QTVN or HF_RR. Post hoc comparisons revealed the following: (1) longer RR in controls versus subjects with high paraplegia and low paraplegia, and in subjects with tetraplegia versus high paraplegia and low paraplegia; (2) QTc was longer in subjects with low paraplegia versus controls and shorter in subjects with tetraplegia versus high paraplegia, and (3) TP_RR and LF_RR were different in controls and subjects with high paraplegia compared to those with low paraplegia. QTVI was significantly elevated in all SCI groups compared to controls. Significant negative correlations between QTVI and HF_RR were observed in all SCI groups, and TP_RR and LF_RR in subjects with tetraplegia and high paraplegia only. Age was negatively correlated in controls. Conclusions: QTVI is negatively affected in otherwise healthy SCI men compared to age-matched controls. This observation appears to reflect the attenuation of vagal modulation, sympathetic impairment above the sixth thoracic vertebra and/or a heightened degree of cardiovascular disease risk.

Pathogenesis of Mediastinal Paravertebral Müllerian Cysts of Hattori

Hattori reported isolated posterior mediastinal paravertebral müllerian cysts of undetermined pathogenesis in women. We report a 41-year-old woman with a family history of anencephaly, spina bifida, and scoliosis who presented with increasing left-sided mid-thoracic pain uncontrolled by her usual pain medication for symptomatic moderate rotary scoliosis. A magnetic resonance imaging demonstrated a paravertebral saccular lesion at the level of the sixth thoracic vertebra. The 2.1×1.5×1.3 cm T6 paravertebral cyst was excised through a left thoracotomy. The final microscopic diagnosis and immunohistochemistry revealed endosalpingiosis. On the basis of histology, immunohistochemical staining characteristics, and the presence of estrogen and progesterone receptors, we conclude that our patient with a benign mediastinal paravertebral endosalpingiotic müllerian cyst had a lesion identical to those described by Hattori, Thomas-de-Montpreville and Dulmet, and Businger et al. We explain the pathogenesis and thoracic location of posterior mediastinal endosalpingiotic cysts by Ludwig's theory of pathogenesis for the Mayer-Rokitansky-Küster-Hauser syndrome.

Chronic expanding hematoma after spinal surgery

Background context Chronic expanding hematoma after spinal surgery is extremely rare, with no case previously reported in the literature. Purpose To report a rare case of a chronic expanding hematoma of the spine that occurred 24 years after thoracic laminectomy and spinal cord tumor resection. Study design Case report. Methods A 71-year-old man presented with a spinal mass located approximately at the level of the sixth thoracic vertebral body. The patient had undergone thoracic laminectomy with tumor resection 24 years previously. The mass had appeared 5 years after this and had gradually enlarged over 19 years. Results The tumor was resected en bloc. The lamina and spinous processes had been partially eroded by the tumor at the fifth and sixth thoracic vertebrae, but the dura was intact. Histopathologic examination confirmed the diagnosis of chronic expanding hematoma. The hematoma had not recurred at the 1-year follow-up. Conclusion We report herein an extremely rare case of chronic expanding hematoma after spinal surgery. This entity may be considered a late complication after surgery regardless of the number of years that have passed since the index surgery.

Synchronous osteosarcoma of mandible

Osteosarcoma is the most common primary malignant bone tumor, but only 5% of lesions occur in the jaws. The incidence of synchronous osteosarcomas (1% to 3%) is even less. A combination of synchronous osteosarcoma, with one of the lesions occurring in the jaws, is a very rare combination. A case of synchronous osteosarcoma with involvement of the mandible in a 16-year-old girl is reported. In addition to the mandible, lesions were identified in the left femur, sixth thoracic vertebra, and possibly in the lungs. Imaging and histopathological features are described.

The Impact of Autonomic Dysreflexia on Blood Flow and Skin Response in Individuals with Spinal Cord Injury

Autonomic dysreflexia (AD) is an inappropriate response of the sympathetic nervous system that commonly occurs when individuals with spinal cord injury (SCI), at or above the sixth thoracic (T6) vertebra, are subjected to a noxious stimulus below the level of injury. An AD event can be put into motion by something as simple as an ingrown toenail or a full bladder, with symptoms ranging from headache, high blood pressure, and even stroke. We have characterized the onset of AD and resulting autonomic events in an individual with SCI using a fiberoptic-based probe. Two probes were located above and below the injury level, on the subjects forearm and thigh, respectively, and were connected to a dual channel spectrophotometer. Oxygen saturation was calculated using the reflectance spectra and an algorithm based on melanin and hemoglobin absorption. We noticed that during an AD event the amount of oxygen in the skin below the injury level dropped by as much as 40%, while above the injury level, skin oxygenation remained constant. In addition, we found that the level of skin perspiration below the level of injury increased significantly. We hypothesize that the combination of AD-related ischemia with pressure-related ischemia and increased perspiration places individuals with spinal cord injury level at T6 or above at an elevated risk for developing a pressure sore below the injury site.

Predicting tissue distribution and partitioning in terminal sire sheep using x-ray computed tomography1

The utility of x-ray computed tomography (CT) scanning in predicting carcass tissue distribution and fat partitioning in vivo in terminal sire sheep was examined using data from 160 lambs representing combinations of 3 breeds (Charollais, Suffolk, and Texel), 3 genetic lines, and both sexes. One-fifth of the lambs were slaughtered at each of 14, 18, and 22 wk of age, and the remaining two-fifths at 26 wk of age. The left side of each carcass was dissected into 8 joints with each joint dissected into fat (intermuscular and subcutaneous), lean, and bone. Chemical fat content of the LM was measured. Tissue distribution was described by proportions of total carcass tissue and lean weight contained within the leg, loin, and shoulder regions of the carcass and within the higher-priced joints. Fat partitioning variables included proportion of total carcass fat contained in the subcutaneous depot and intramuscular fat content of the LM. Before slaughter, all lambs were CT scanned at 7 anatomical positions (ischium, midshaft of femur, hip, second and fifth lumbar vertebrae, sixth and eighth thoracic vertebrae). Areas of fat, lean, and bone (mm(2)) and average fat and lean density (Hounsfield units) were measured from each cross-sectional scan. Areas of intermuscular and subcutaneous fat were measured on 2 scans (ischium and eighth thoracic vertebra). Intramuscular fat content was predicted with moderate accuracy (R(2) = 56.6) using information from only 2 CT scans. Four measures of carcass tissue distribution were predicted with moderate to high accuracy: the proportion of total carcass (R(2) = 54.7) and lean (R(2) = 46.2) weight contained in the higher-priced joints and the proportion of total carcass (R(2) = 77.7) and lean (R(2) = 55.0) weight in the leg region. Including BW in the predictions did not improve their accuracy (P > 0.05). Although breed-line-sex combination significantly affected fit of the regression for some tissue distribution variables, the values predicted were changed only trivially. Within terminal sire type animals, using a common set of prediction equations is justified. Tissue distribution and fat partitioning affect eating satisfaction and efficiency of production and processing; therefore, including such carcass quality measures in selection programs is increasingly important, and CT scanning appears to provide opportunities to do so.

High-speed gallop locomotion in the Thoroughbred racehorse. II. The effect of incline on centre of mass movement and mechanical energy fluctuation

During locomotion on an incline, mechanical work is performed to move an animal up the slope and increase the potential energy (PE) of the trunk and hence the centre of mass (CoM). Thus, at a given speed the total net mechanical work increases with the PE of the animal. In this study we investigate the mechanical energy (ME) fluctuations and the mechanical cost of transport (MCT) in six horses galloping up a range of gradients. We captured trunk movement with a six degrees-of-freedom inertial sensor mounted over the dorsal spinous process of the fourth to sixth thoracic vertebrae of the horse. Footfall timings were measured using a previously validated system of limb-mounted accelerometers. Speed was measured using a Global Positioning System (GPS) data logger. A track survey provided detailed incline information for the track. Linear (craniocaudal, mediolateral and dorsoventral) and rotational (roll, pitch and heading) kinematic parameters (displacement, velocity and acceleration) were calculated at speeds ranging from 9.0 to 12.0 m s(-1) during routine training over a range of inclines. Estimates of ME fluctuations and the MCT were made. Results showed the effect of incline on trunk motion during galloping was small. Increases in linear mechanical work and MCT were primarily explained by an increase in the work required to move the animal up the slope (and increase the PE of the CoM). Within the stride the majority of the work was performed during hindlimb stance. Our results have provided new insights into how horses power uphill locomotion.

Single-Lung Ventilation for Right-Sleeve Pneumonectomy With a Modified Nasal RAE Endotracheal Tube

Single-Lung Ventilation for Right-Sleeve Pneumonectomy With a Modified Nasal RAE Endotracheal Tube

Espondilolistese em frango de corte no Brasil

Eight 28-day-old broiler chickens of both sexes were examined. Clinical signs, gross findings, radiological, and histopathological changes were described. Spondylolisthesis was characterized by dorsal displacement of the sixth and seventh thoracic vertebrae, resulting in compression of the spinal cord. The major clinical manifestation was paraplegia. Risk factors such as genetics, nutrition, stress, rate of growth, and age were discussed.

Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography

The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis. Over a 5-year period (2000-2005), 251 consecutive patients with hemoptysis underwent multidetector-row CT angiography of the thorax. From this population, 37 patients were excluded because of a suboptimal CTA examination (n = 19), the presence of extensive mediastinal disease (n = 15) or severe chest deformation (n = 3) precluding any precise analysis of the bronchial arteries at CTA. Our final study group included 214 patients who underwent a thin-collimated CT angiogram (contrast agent: 300 to 350 mg/ml) on a 4- (n = 56), 16- (n = 119) and 64- (n = 39) detector-row scanner. The site of origin and distribution of bronchial arteries were analyzed on transverse CT scans, maximum intensity projections and volume-rendered images. The site of the ostium of a bronchial artery was coded as orthotopic when the artery originated from the descending aorta between the levels of the fifth and sixth thoracic vertebrae; all other bronchial arteries were considered ectopic. From the studied population, 137 (64%) patients had only orthotopic bronchial arteries, whereas 77 patients (36%) had at least one bronchial artery of ectopic origin. A total of 147 ectopic arteries were depicted, originating as common bronchial trunks (n = 23; 19%) or isolated right or left bronchial arteries (n = 101; 81%). The most frequent sites of origin of the 124 ostiums were the concavity of the aortic arch (92/124; 74%), the subclavian artery (13/124; 10.5%) and the descending aorta (10/124; 8.5%). The isolated ectopic bronchial arteries supplied the ipsilateral lung in all but three cases. Bronchial artery embolization was indicated in 26 patients. On the basis of CTA information, (1) bronchial embolization was attempted in 24 patients; it was technically successful in 21 patients (orthotopic BAs: 6 patients; orthotopic and ectopic BAs: 3 patients; ectopic BAs: 12 patients) and failed in 3 patients due to an instable catheterization of the ectopic BAs; the absence of additional bronchial arterial supply and no abnormalities of nonbronchial systemic arteries at CTA avoided additional arteriograms in these 3 patients; (2) owing to the iatrogenic risk of the embolization procedure of ectopic BAs, the surgical ligation of the abnormal vessels was the favored therapeutic option in 2 patients. This study enabled the depiction of ectopic bronchial arteries in 36% of the studied population, important anatomical information prior to therapeutic decision making.

Three-dimensional kinematic analysis of head and limb movements of lame and non-lame colts

AbstractLameness manifests itself during the movement of the animal or at rest, indicating a structural or functional disturbance in one or more limbs. Videographic analyses allow the qualitative and quantitative investigation of the movement, reducing the subjectivity of evaluations. The objective was to record the alterations in the movement of the head and limbs of horses in a lame and non-lame condition. Video cameras (60 Hz) and computational methods were used. Six Purebred Arabian colts were filmed on a treadmill, at walk and at trot, before and after induction of lameness. Lameness was induced in the left forelimb utilizing a transient lameness model. Markers were placed on the zygomatic process of the temporal bone, spiny process of the sixth thoracic and first lumbar vertebrae and on the proximal phalange. Nine strides were analysed. At walk and at trot, the animals demonstrated two vertical head movements per stride, while after induction of lameness only one head movement was observed per stride, where this movement was of greater amplitude. The head was shown to be in a more elevated position when the lame limb made first contact with the treadmill belt, which was not observed in the case of the healthy limbs. Only with trotting did the lame animals manifest a prolonged duration of the stance phase for all limbs. The lame animals had a longer support time, lifted the non-lame limbs and showed a shorter stride. Videographic analyses offered details of the alterations in the movement of horses, which are important in the diagnosis of lameness.

Centre of mass movement and mechanical energy fluctuation during gallop locomotion in the Thoroughbred racehorse

During locomotion cyclical interchange between different forms of mechanical energy enhances economy; however, 100% efficiency cannot be achieved and ultimately some mechanical work must be performed de novo. There is a metabolic cost associated with fluctuations in mechanical energy, even in the most efficient animals. In this study we investigate the exchanges between different forms of mechanical energy involved in high-speed gallop locomotion in Thoroughbred race horses during over-ground locomotion using innovative, mobile data collection techniques. We use hoof-mounted accelerometers to capture foot contact times, a GPS data logger to monitor speed and an inertial sensor mounted over the dorsal spinous processes of the fourth to sixth thoracic vertebrae (the withers) of the horse to capture trunk movement with six degrees of freedom. Trunk movement data were used to estimate the movement of the centre of mass (CoM). Linear (craniocaudal, mediolateral and dorsoventral) and rotational (roll, pitch and heading) kinematic parameters (displacement, velocity and acceleration) were calculated for seven horses at gallop speeds ranging from 7 to 17 m s(-1) during their regular training sessions. These were used to estimate external mechanical energy (potential energy and linear kinetic energy of the CoM) as well as selected components of internal energy (angular kinetic energy). Elastic energy storage in the limbs was estimated from duty factor, sine wave assumptions and published leg stiffness values. External mechanical energy changes were dominated by changes in craniocaudal velocity. Potential energy change, which was in phase with craniocaudal energy during the front limb stances, was small. Elastic energy storage in the limbs was small compared to the overall amplitude of fluctuation of external mechanical energy. Galloping at high speeds does not therefore fit classical spring mass mechanics.

THE CLASSIC: Tuberculosis of the Spine in Children

THE CLASSIC: Tuberculosis of the Spine in Children

A spinal foreign body

2122 www.thelancet.com Vol 366 December 17/24/31, 2005 A 61-year-old man presented with thoracic back pain and cough. Despite receiving a blow to the back in a fight 3 weeks earlier, his general condition at admission was good. He had an axillary temperature of 37·4oC, and when examined closely, we saw a wound of about 2 cm over the dorsal thoracic midline. Standard laboratory test results were normal. Chest radiographs showed a foreign body projecting from the ascending aorta (figure, A). A CT scan showed a knife blade 12 cm long at the sixth thoracic vertebra (figure, B). The blade extended from the subcutaneous adipose tissue to the middle of the spinal canal and the vertebral body adjacent to the aorta. A neurological examination did not show any sensory or motor problems. The blade was removed surgically under general anaesthetic. As a complication of the procedure, the patient became paraplegic. A spinal foreign body

Hypervitaminosis A in the cat: a case report and review of the literature

A case of hypervitaminosis A with secondary entrapment and compression of the left brachial plexus nerve roots is described. A 9-year-old male castrated domestic shorthair, fed a home-made diet based on raw pork liver, was submitted for examination for a left forelimb lameness that evolved to paralysis over a 2-month period. Clinical examination revealed a flaccid paralysis and atrophy of all left forelimb muscles. An ipsilateral Horner's syndrome was also noted. Radiological examination of the cervical and thoracic spine showed massive new bone formation at the ventral aspect of the second cervical to sixth thoracic vertebra. The diagnosis of hypervitaminosis A was made, based on the clinical and radiographic findings, as well as the determination of serum vitamin A concentration, which was 630 microg/dl, three times above the upper normal limit for this species. Despite the unfavourable initial prognosis, the cat progressively regained function of the affected limb approximately 6 months after the diet was changed to a commercial canned food.

A benign leiomyoma causing paraparesis: a case report and histopathogenesis

A benign leiomyoma causing paraparesis: a case report and histopathogenesis

Tuberculosis of the Spine in Children

Tuberculosis of the Spine in Children

Comparison of CO 2 stunning with manual electrical stunning (50 Hz) of pigs on carcass and meat quality

The effects of carbon dioxide stunning on carcass and pork quality attributes were compared with the effects of manual electrical stunning using either head-only or head-to-brisket electrodes. A total of 30 Large White×Landrace boars (homozygous dominant for the halothane gene) were randomly allocated immediately prior to slaughter to one of three stunning treatments: carbon dioxide (90% CO 2), head only (HO; 1.3 A for 4 s at a frequency of 50 Hz) or head to brisket (HBR; 1.3 A for 4 s at a frequency of 50 Hz) electrical stunning. The pH of the M. longissimus thoracis (LT) muscle measured at two sites [between the fifth and sixth thoracic vertebrae (Site 1) and the last thoracic rib (Site 2)] at 40 min post-slaughter was lower ( P<0.001) in HBR stunned pigs compared with both CO 2 and HO stunned pigs. No differences in ultimate pH of the LT at either measurement site were found due to stunning method. However, a faster ( P<0.05) relative rate of pH decline was found in the LT at Site 1 from HBR stunned pigs compared with CO 2 stunned pigs. No difference in the relative rate of muscle pH decline ( P>0.05) between stunning methods was found in the LT muscle at Site 2. Pork from HBR stunned pigs was paler ( P<0.05) and had a higher ( P<0.001) percentage drip loss compared with pork from HO and CO 2 stunned pigs. LT muscles from HBR stunned pigs had lower ( P<0.001) WB shear force values compared with pork from HO stunned pigs (6.57 vs. 8.12 kg, S.E.D. 0.49). Carcass quality was improved by CO 2 stunning, with less ( P<0.05) ecchymosis-affected pork trimmed from shoulder primals compared with electrically stunned pigs. These results indicate that manual electrical stunning of pigs using HO tongs and CO 2 stunning reduced percentage drip loss, reduced muscle lightness and reduced the rate of muscle pH decline compared with pigs manually electrically stunned using HBR tongs.

Multiple myeloma: an odyssey of discovery

Multiple myeloma: an odyssey of discovery

Cryptococcosis of thoracic vertebra simulating tuberculosis: Diagnosis by fine‐needle aspiration biopsy cytology—a case report

A rare case of cryptococcosis of sixth thoracic vertebra (T6) along with pulmonary involvement in an old diabetic patient is presented. The infection resulted in lytic lesion of T6 vertebra and girdle pain. A computerized tomographic (CT) guided fine-needle aspiration biopsy (FNAB) cytology was performed, which showed encapsulated fungal spores of Cryptococcus neoformans with granulomatous reaction, later confirmed by fungal culture. Diagn. Cytopathol. 1999;20:385–386. © 1999 Wiley-Liss, Inc.