Tracking Lumbar Vertebrae in Digital Videofluoroscopic Video Automatically

Low back pain becomes one of the significant problem in the industrialized world. Efficient and effective spinal motion analysis is required to understand low back pain and to aid the diagnosis. Videofluoroscopy provides a cost effective way for such analysis. However, common approaches are tedious and time consuming due to the low quality of the images. Physicians have to extract the vertebrae manually in most cases and thus continuous motion analysis is hardly achieved. In this paper, we propose a system which can perform automatic vertebrae segmentation and tracking. Operators need to define exact location of landmarks in the first frame only. The proposed system will continuously learn the texture pattern along the edge and the dynamics of the vertebrae in the remaining frames. The system can estimate the location of the vertebrae based on the learnt texture and dynamics throughout the sequence. Experimental results show that the proposed system can segment vertebrae from videofluoroscopic images automatically and accurately. © Springer-Verlag 2004.postprintThe International Workshop on Medical Imaging and Augmented Reality (MIAR 2004), Beijing, China, 19-20 August 2004. In Lecture Notes in Computer Science, 2004, v. 3150, p. 154-16

A correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis

BACKGROUND: It has been proposed that in-brace correction is the best guideline for prediction of the results of brace treatment for patients with Adolescent Idiopathic Scoliosis (AIS). However, bracing may be a stressful experience for patients and bracing non-compliance could be psychologically related. The purpose of this study was to assess the correlation between brace compliance, in-brace correction and QoL of patients with AIS. METHODS: Fifty-five patients with a diagnosis of AIS were recruited. All were female and aged 10 years or above when a brace was prescribed, none had undergone prior treatment, and all had a Risser sign of 0–2 and a Cobb angle of 25-40°. The patients were examined in three consecutive visits with 4 to 6 months between each visit. The Chinese translated Trunk Appearance Perception Scale (TAPS), the Chinese translated Brace Questionnaires (BrQ) and the Chinese translated SRS-22 Questionnaires were used in the study. The in-brace Cobb angle, vertebral rotation and trunk listing were also measured. Patients’ compliance, in-brace correction and patients’ QoL were assessed. To identify the relationship among these three areas, logistic regression model and generalized linear model were used. RESULT: For the compliance measure, a significant difference (p = 0.008) was detected on TAPS mean score difference between Visit 1 and Visit 2 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). In addition, a significant difference (p = 0.000) was detected on BrQ mean score difference between Visit 2 and Visit 3 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). For the orthosis effectiveness measure, no significant difference was detected between the three groups of bracing hours (0–8 hours, 9–16 hours, 17–23 hours) on in-brace correction (below 40% and 40% or above). For the QoL measure, no significant difference was detected between the two different in-brace correction groups (below 40% and 40% or above) on QoL as reflected by the TAPS, BrQ and SRS-22r mean scores. CONCLUSION: The results showed a positive relationship between patients’ brace wear compliance and patients’ QoL. Poor compliance would cause a lower QoL

iCartiGD: the Integrated Cartilage Gene Database

BACKGROUND: Diseases of cartilage, such as arthritis and degenerative disc disease, affect the majority of the general population, particularly with ageing. Discovery and understanding of the genes and pathways involved in cartilage biology will greatly assist research on the development, degeneration and disorders of cartilage. DESCRIPTION: We have established the Integrated Cartilage Gene Database (iCartiGD) of genes that are known, based on results from high throughput experiments, to be expressed in cartilage. Information about these genes is extracted automatically from public databases and presented as a single page report via a web-browser. A variety of flexible search options are provided and the chromosomal distribution of cartilage associated genes can be presented. CONCLUSION: iCartiGD provides a comprehensive source of information on genes known to be expressed in cartilage. It will remain current due to its automatic update capability and provide researchers with an easily accessible resource for studies involving cartilage. Genetic studies of the development and disorders of cartilage will benefit from this database

Association between promoter -1607 polymorphism of MMP1 and Lumbar Disc Disease in Southern Chinese

<p>Abstract</p> <p>Background</p> <p>Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix of the intervertebral disc. A SNP for guanine insertion/deletion (G/D), the -1607 promoter polymorphism, of the <it>MMP1 </it>gene was found significantly affecting promoter activity and corresponding transcription level. Hence it is a good candidate for genetic studies in DDD.</p> <p>Methods</p> <p>Southern Chinese volunteers between 18 and 55 years were recruited from the population. DDD in the lumbar spine was defined by MRI using Schneiderman's classification. Genomic DNA was isolated from the leukocytes and genotyping was performed using the Sequenom^®platform. Association and Hardy-Weinberg equilibrium checking were assessed by Chi-square test and Mann-Whitney U test.</p> <p>Results</p> <p>Our results showed substantial evidence of association between -1607 promoter polymorphism of <it>MMP1 </it>and DDD in the Southern Chinese subjects. D allelic was significantly associated with DDD (p value = 0.027, odds ratio = 1.41 with 95% CI = 1.04–1.90) while Genotypic association on the presence of D allele was also significantly associated with DDD (p value = 0.046, odds ratio = 1.50 with 95% CI = 1.01–2.24). Further age stratification showed significant genotypic as well as allelic association in the group of over 40 years (genotypic: p value = 0.035, odds ratio = 1.617 with 95% CI = 1.033–2.529; allelic: p value = 0.033, odds ratio = 1.445 with 95% CI = 1.029–2.029). Disc bulge, annular tears and the Schmorl's nodes were not associated with the D allele.</p> <p>Conclusion</p> <p>We demonstrated that individuals with the presence of D allele for the -1607 promoter polymorphism of <it>MMP1 </it>are about 1.5 times more susceptible to develop DDD when compared with those having G allele only. Further association was identified in individuals over 40 years of age. Disc bulge, annular tear as well as Schmorl's nodes were not associated with this polymorphism.</p

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Treatment of stiff thoracic scoliosis by thoracoscopic anterior release combined with posterior instrumentation and fusion

Abstract Background Thoracoscopic anterior release has been shown that it can effectively improve spinal flexibility in animal and human cadaveric studies, and has been advocated for use in patients with scoliosis. This prospective case series aims to investigate the improvement of the spinal flexibility and the effectiveness in deformity correction by anterior thoracoscopic release and posterior spinal fusion. Methods Eleven patients with stiff idiopathic thoracic scoliosis underwent anterior thoracoscopic release followed by posterior instrumentation. The average number of discs excised was five. Spinal flexibility was assessed by the fulcrum bending technique. Cobb angle before and after the anterior release was compared. Results The patients were followed for an average of 5.6 years (range 2.2 to 8.1 years). Fulcrum bending flexibility was increased from 39% before the thoracoscopic anterior spinal release to 54% after the release. The average Cobb angle before anterior release was 74° on the standing radiograph and 45° with the fulcrum-bending radiograph. This reduced to 34° on the fulcrum-bending radiograph after the release, and highly corresponded to the 31° measured at the post-operative standing radiograph. Conclusion It was demonstrated in patients with stiff idiopathic thoracic scoliosis that thoracoscopic anterior spinal release can effectively improve the spinal flexibility and increase the correction of the spinal deformity.</p

ALFF values of healthy subjects and CSM patients (mean ± SEM).

<p>ALFF values of healthy subjects and CSM patients (mean ± SEM).</p

ALFF comparison between healthy subjects and CSM patients.

<p>In the whole cervical cord (CC) and each segment from C2 to C6, amplitude of low frequency fluctuation (ALFF) had the trend of healthy subjects < CSM patients. From two sample t-test results, all of the differences were significant (a). After separating CSM patients into mild (JOA≥13, 8 patients, age = 49±11 years, age ranged from 26 to 67 years) and severe (JOA<13, 10 patients, age = 67±7 years, age ranged from 59 to 83 years) groups, Anterior-Posterior Compression Ratio (APCR) of each patients in mild and severe groups was compared. The difference of APCR between mild and severe CSM patients was not significant (b). ALFF had the trend of mild CSM patients < severe CSM patients. From two sample t-test results, all of the differences were significant (c) (*: P<0.05, significant, ns: P>0.05, not significant).</p