Which factors prognosticate rotational instability following lumbar laminectomy?

Purpose: Reduced strength and stiffness of lumbar spinal motion segments following laminectomy may lead to instability. Factors that predict shear biomechanical properties of the lumbar spine were previously published. The purpose of the present study was to predict spinal torsion biomechanical properties with and without laminectomy from a total of 21 imaging parameters. Method: Radiographs and MRI of ten human cadaveric lumbar spines (mean age 75.5, range 59-88 years) were obtained to quantify geometry and degeneration of the motion segments. Additionally, dual X-ray absorptiometry (DXA) scans were performed to measure bone mineral content and density. Facet-sparing lumbar laminectomy was performed either on L2 or L4. Spinal motion segments were dissected (L2-L3 and L4-L5) and tested in torsion, under 1,600 N axial compression. Torsion moment to failure (TMF), early torsion stiffness (ETS, at 20-40 % TMF) and late torsion stiffness (LTS, at 60-80 % TMF) were determined and bivariate correlations with all parameters were established. For dichotomized parameters, independent-sample t tests were used. Results: Univariate analyses showed that a range of geometric characteristics and disc and bone quality parameters were associated with torsion biomechanical properties of lumbar segments. Multivariate models showed that ETS, LTS and TMF could be predicted for segments without laminectomy (

THE INITIATION OF BINOCULAR RIVALRY

Binocular rivalry refers to the perceptual alternation that occurs while viewing incompatible images, in which one monocular image is dominant and the other is suppressed. Rivalry has been closely studied but the neural site at which it is initiated is still controversial. The central claim of this thesis is that primary visual cortex is responsible for its initiation. This claim is supported by evidence from four experimental studies. The first study (described in Chapter 4) introduces the methodology for measuring visual sensitivity during dominance and suppression and compares several methods to see which yields the greatest difference between these two sensitivities. Suppression depth was measured by comparing the discrimination thresholds to a brief test stimulus delivered during dominance and suppression phases. The deepest suppression was achieved after a learning period, with the test stimulus presented for 100 ms and with post-test masking. The second study (Chapter 5) compares two hypotheses for the mechanism of binocular rivalry. Under eye suppression, visibility decreases when the tested eye is being suppressed, regardless of the test stimulus’s features. Feature suppression, however, predicts that reduction of visibility is caused by suppression of a stimulus feature, no matter which eye is suppressed. Eye suppression claims that monocular channels in the visual system alternate between dominance and suppression, while Feature suppression assumes that the features of stimuli inhibit each other perceptually in the high-level cortex. The experiment used a test stimulus similar in features to one, but not the other, rivalry-inducing stimulus. Test sensitivity was found to be lowered when the test stimulus was presented to the eye whose rivalry-inducing stimulus was suppressed. Sensitivity was not lowered when the test stimulus was presented to the other eye, even when the test shared features with the suppressed stimulus. The conclusion is that feature suppression is weak or does not exist without eye suppression, and that rivalry therefore originates in the primary visual cortex. If binocular rivalry is initiated in the primary visual cortex, stimuli producing no coherent activity in that area should produce no rivalry. In the third study (Chapter 6) this idea was tested with rotating arrays of short-lifetime dots. The dots with the shortest lifetime produced an image with no rotation signal, and an infinite lifetime produced rigid rotation. Subjects could discriminate the rotation direction with high accuracy at all but the shortest lifetime. When the two eyes were presented with opposite directions of rotation, there was binocular rivalry only at the longest lifetimes. Stimuli with short lifetimes produce a coherent motion signal, since their direction can be discriminated, but do not produce rivalry. A simple interpretation of this observation is that binocular rivalry is initiated at a level in the visual hierarchy below that which supports the motion signal. The model supported by the results of previous chapters requires that binocular rivalry suppression be small in the primary visual cortex, and builds up as signals progress along the visual pathway. This model predicts that for judgements dependent on activity in high visual cortex: 1. Binocular rivalry suppression should be deep; 2. Responses should be contrast invariant. The fourth and last study (chapter 7) confirmed these predictions by measuring suppression depth in two ways. First, two similar forms were briefly presented to one eye: the difference in shapes required for their discrimination was substantially greater during suppression than during dominance. Second, the two forms were made sufficiently different in shape to allow easy discrimination at high contrast, and the contrast of these forms was lowered to find the discrimination threshold. The results in the second experiment showed that contrast sensitivity did not differ between the suppression and dominance states. This invariance in contrast sensitivity is interpreted in terms of steep contrast-response functions in cortex beyond the primary visual area. The work in this thesis supports the idea that binocular rivalry is a process distributed along the visual pathway. More importantly, the results provide several lines of evidence that binocular rivalry is initiated in primary visual cortex

A cost effeciency approach to universal access for public transport for disabled people

Purpose To determine the intervendor variability of Agatston scoring determined with state-of-the-art computed tomographic (CT) systems from the four major vendors in an ex vivo setup and to simulate the subsequent effects on cardiovascular risk reclassification in a large population-based cohort. Materials and Methods Research ethics board approval was not necessary because cadaveric hearts from individuals who donated their bodies to science were used. Agatston scores obtained with CT scanners from four different vendors were compared. Fifteen ex vivo human hearts were placed in a phantom resembling an average human adult. Hearts were scanned at equal radiation dose settings for the systems of all four vendors. Agatston scores were quantified semiautomatically with software used clinically. The ex vivo Agatston scores were used to simulate the effects of different CT scanners on reclassification of 432 individuals aged 55 years or older from a population-based study who were at intermediate cardiovascular risk based on Framingham risk scores. The Friedman test was used to evaluate overall differences, and post hoc analyses were performed by using the Wilcoxon signed-rank test with Bonferroni correction. Results Agatston scores differed substantially when CT scanners from different vendors were used, with median Agatston scores ranging from 332 (interquartile range, 114-1135) to 469 (interquartile range, 183-1381; P < .05). Simulation showed that these differences resulted in a change in cardiovascular risk classification in 0.5\%-6.5\% of individuals at intermediate risk when a CT scanner from a different vendor was used. Conclusion Among individuals at intermediate cardiovascular risk, state-of the-art CT scanners made by different vendors produced substantially different Agatston scores, which can result in reclassification of patients to the high- or low-risk categories in up to 6.5\% of cases. © RSNA, 2014

Zinc sulphate-induced anosmia decreases the nerve fibre density in the anterior cerebral artery of the rat.

Contains fulltext : 186971.pdf (publisher's version ) (Closed access)Detailed quantitative studies have demonstrated a topographical heterogeneity of nerve fibre densities in the cerebral arteries at the base of the brain as well as local changes in ageing and Alzheimer's patients. In this study, we test the hypothesis that local patterns of innervation are influenced by changes in flow fluctuations. This was investigated by inducing chronic anosmia and monitoring the nerve fibre density in the basal cerebral arteries in the adult rat. The olfactory epithelium was examined after staining with hematoxylin and eosin and showed a marked reduction of thickness in the anosmic group compared to the control group. The olfactory bulb was histochemically stained for succinate dehydrogenase (SDH) activity and showed a reduced staining in the anosmic group compared to the controls. Whole mount preparations of the basal cerebral arteries were immunostained for the general neural marker protein gene product (PGP) 9.5. The nerve fibre densities of the vessel walls were quantified by image analysis and expressed as area percentage and intercept density. This analysis showed a significant reduction in area percentage for the first part of the anterior cerebral artery, as well as for the second part of the anterior cerebral artery, and a significant reduction in intercept density for the second part of the anterior cerebral artery in the anosmic group. We conclude that peripherally induced anosmia decreases nerve fibre density in the anterior cerebral artery that may be due to a decreased metabolic activity in the rhinencephalon and, as a consequence, a reduction of flow fluctuations in the blood vessels supplying this area occurs

Computed Tomography Radiation Dose Reduction: Effect of Different Iterative Reconstruction Algorithms on Image Quality

We evaluated the effects of hybrid and model-based iterative reconstruction (IR) algorithms from different vendors at multiple radiation dose levels on image quality of chest phantom scans.A chest phantom was scanned on state-of-the-art computed tomography scanners from 4 vendors at 4 dose levels (4.1 mGy, 3.0 mGy, 1.9 mGy, and 0.8 mGy). All data were reconstructed with filtered back projection (FBP) and reduced-dose data also with IR (iDose4, Adaptive Iterative Dose Reduction 3D, Adaptive Statistical Iterative Reconstruction, Sinogram-Affirmed Iterative Reconstruction, prototype Iterative Model Reconstruction, and Veo). Computed tomography numbers and noise were measured in the spine and lungs. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated and differences were analyzed with the Friedman test.For all vendors, radiation dose reduction with FBP resulted in significantly increased noise levels (≤148\%) as well as decreased SNR (≤57\%) and CNR (≤58\%) (P < 0.001). Conversely, IR resulted in decreased noise levels (≤48\%) as well as increased SNR (≤94\%) and CNR (≤94\%). The SNRs and CNRs of the model-based algorithms at 80\% reduced dose were similar to reference-dose FBP.Hybrid IR algorithms have the potential to reduce radiation dose with 27\% to 54\% and model-based IR algorithms with up to 80\%