Analysis of apex and transitional vertebra of the spine according to pelvic incidence using orientation and position parameters

Objective: To identify the different apex and transitional vertebra according to the shape of the pelvis of individuals despite their difference in sagittal alignment using our measurement system. Methods: Full spine X-rays using EOS in standard stand-position of 99 volunteers were selected (47 women, 52 men, mean age 31years old). Validated 3D reconstruction technique allowing extraction of spinopelvic parameters, and position and rotation of each vertebra and lumbar discs. Subjects were divided in three groups: low PI (low PI, n=37), moderate PI (mid PI, n=52), high PI (high PI, n=10), with respectively a PI below 45 °, between 45 °-60 ° and above 60 °. Occurrence of specific position and rotation values of apex and transitional vertebra were assessed in each groups. Results: Frequency curves tend to move cranially when the incidence increases except in cervicothoracic where T1 is a constant for all shape of spine with occurrence approaching 90%. Angulation value of relevant vertebra and lumbar lordosis are significantly positively correlated for the whole population. Conclusions: Our study allowed the assessment of the distribution of spine curvatures according to the pelvic incidence. It describes the occurrence of localization of the apex and transitional vertebrae according to pelvic incidence. These results should be taken into account during the analysis of the sagittal balance, especially when planning deformity surgery in adults

Sagittal Balance Using Position and Orientation of Each Vertebra in an Asymptomatic Population

Study design: A monocentric, retrospective radiographic study with 99 asymptomatic volunteers. Objective: We performed the postural analysis commonly scheduled when evaluating sagittal balance in a vertebra-by-vertebra manner by enrolling an asymptomatic population. We measured the position and angulation of each vertebra to reveal those for which the spatial positioning could be relevant during spinal surgeries. Methods: We obtained full-spine EOS X-rays of 99 volunteers in the standard free-standing position. We used a validated three-dimensional (3D) reconstruction technique to extract current spinal parameters and the positions and angulations of all vertebrae and lumbar discs. Particular attention was paid to the positions and angulations of the apical and transitional vertebrae. Results: T1 was the most common transitional cervicothoracic vertebra (in 89.9% of subjects) and was oriented downwards by an average of 22.0° (standard deviation 7.3°, minimum 2.3°, maximum 40.1°). The thoracic apex trio of T5 (22.2%), T6 (28.3%) and T7 (36.4%) were equally found. The transitional thoracolumbar vertebrae were L1 (39.4%) and T12 (33.3%). The lumbar apex was usually the L3L4 disc (36.4%). T1 seemed to be the transitional vertebra (90%) irrespective of the pelvic incidence (PI). For the other relevant vertebrae, the greater the PI, the more cranial the vertebra. Conclusions: We performed a detailed 3D assessment of overall spinal balance using positional and rotational parameters. The positions and orientations of all vertebrae were specified, particularly the apical and transitional vertebrae

Changis-sur-Marne – Le Dessus de la Chaussée, les Pétreaux (secteur 5)

Le cinquième secteur de Changis-sur-Marne, Le Dessus de la Chaussée-les Pétreaux, a fait l’objet d’une évaluation archéologique à la fin du printemps 1997 suivie d’une fouille de trois mois encore en cours à la date où cette notice est écrite.Le décapage intégral des 2,5 ha du site a fait apparaître une occupation plus dense que les précédentes, notamment dans la partie basse du terrain la plus proche de la Marne, où se confirme l’installation successive des habitats ruraux pré et protohisto..

Changis-sur-Marne – Les Pétreaux

La 6e phase de fouille (1998) du site situé dans l’emprise de la Carrière Morillon-Corvol de Changis-sur-Marne (Seine-et-Marne) s’est déroulée sur environ 2,6 ha, et, comme à l’accoutumée, en anticipation des travaux d’extraction de la carrière dont le front de taille se déplace perpendiculairement à la Marne, du nord vers le sud-est (fig. 1). On rappellera que l’occupation humaine de Changis-sur-Marne « les Pétreaux » appartient à la longue durée puisque 15 ha de la nappe alluviale déjà foui..

The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

International audienceBACKGROUND:Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers.METHODS:Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort.RESULTS:For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc = 0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and ≥4 FTPs, respectively, P trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] = 1.69, 95% CI = 1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc = 1.33, 95% CI = 1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc = 0.72, 95% CI = 0.54 to 0.98).CONCLUSIONS:These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers

Identification of a BRCA2-Specific modifier locus at 6p24 related to breast cancer risk

Common genetic variants contribute to the observed variation in breast cancer risk for BRCA2 mutation carriers; those known to date have all been found through population-based genome-wide association studies (GWAS). To comprehensively identify breast cancer risk modifying loci for BRCA2 mutation carriers, we conducted a deep replication of an ongoing GWAS discovery study. Using the ranked P-values of the breast cancer associations with the imputed genotype of 1.4 M SNPs, 19,029 SNPs were selected and designed for inclusion on a custom Illumina array that included a total of 211,155 SNPs as part of a multi-consortial project. DNA samples from 3,881 breast cancer affected and 4,330 unaffected BRCA2 mutation carriers from 47 studies belonging to the Consortium of Investigators of Modifiers of BRCA1/2 were genotyped and available for analysis. We replicated previously reported breast cancer susceptibility alleles in these BRCA2 mutation carriers and for several regions (including FGFR2, MAP3K1, CDKN2A/B, and PTHLH) identified SNPs that have stronger evidence of association than those previously published. We also identified a novel susceptibility allele at 6p24 that was inversely associated with risk in BRCA2 mutation carriers (rs9348512; per allele HR = 0.85, 95% CI 0.80-0.90, P = 3.9×10−8). This SNP was not associated with breast cancer risk either in the general population or in BRCA1 mutation carriers. The locus lies within a region containing TFAP2A, which encodes a transcriptional activation protein that interacts with several tumor suppressor genes. This report identifies the first breast cancer risk locus specific to a BRCA2 mutation background. This comprehensive update of novel and previously reported breast cancer susceptibility loci contributes to the establishment of a panel of SNPs that modify breast cancer risk in BRCA2 mutation carriers. This panel may have clinical utility for women with BRCA2 mutations weighing options for medical prevention of breast cancer