Anatomical relationships of the anterior blood vessels to the lower lumbar intervertebral discs: analysis based on magnetic resonance imaging of patients in the prone position.

BACKGROUND: Intra-abdominal vascular injuries are rare during posterior lumbar spinal surgery, but they can result in major morbidity or mortality when they do occur. We are aware of no prior studies that have used prone patient positioning during magnetic resonance imaging for the purpose of characterizing the retroperitoneal iliac vasculature with respect to the intervertebral disc. The purpose of this study was to define the vascular anatomy adjacent to the lower lumbar spine with use of supine and prone magnetic resonance imaging. METHODS: A prospective observational study included thirty patients without spinal abnormality who underwent supine and prone magnetic resonance imaging without abdominal compression. The spinal levels of the aortic bifurcation and confluence of the common iliac veins were identified. The proximity of the anterior iliac vessels to the anterior and posterior aspects of the anulus fibrosus in sagittal and coronal planes was measured by two observers, and interobserver reliability was calculated. RESULTS: The aortic bifurcation and confluence of the common iliac veins were most commonly at the level of the L4 vertebral body and migrated cranially with prone positioning. The common iliac vessels were closer to the anterior aspect of the intervertebral disc and to the midline at L4-L5 as compared with L5-S1, consistent with the bifurcation at the L4 vertebral body. Prone positioning resulted in greater distances between the disc and iliac vessels at L4-L5 and L5-S1 by an average of 3 mm. The position of the anterior aspect of the anulus with respect to each iliac vessel demonstrated substantial variation between subjects. The intraclass correlation coefficient for measurement of vessel position exceeded 0.9, demonstrating excellent interobserver reliability. CONCLUSIONS: This study confirmed the L4 level of the aortic bifurcation and iliac vein coalescence but also demonstrated substantial mobility of the great vessels with positioning. Supine magnetic resonance imaging will underestimate the proximity of the vessels to the intervertebral disc. Large interindividual variation in the location of vasculature was noted, emphasizing the importance of careful study of the location of the retroperitoneal vessels on a case-by-case basis. CLINICAL RELEVANCE: Anatomic relationships between vessels and intervertebral discs on supine magnetic resonance imaging may differ from relationships during surgery with the patient in a prone position

Treatment with a corticotrophin releasing factor 2 receptor agonist modulates skeletal muscle mass and force production in aged and chronically ill animals

<p>Abstract</p> <p>Background</p> <p>Muscle weakness is associated with a variety of chronic disorders such as emphysema (EMP) and congestive heart failure (CHF) as well as aging. Therapies to treat muscle weakness associated with chronic disease or aging are lacking. Corticotrophin releasing factor 2 receptor (CRF2R) agonists have been shown to maintain skeletal muscle mass and force production in a variety of acute conditions that lead to skeletal muscle wasting.</p> <p>Hypothesis</p> <p>We hypothesize that treating animals with a CRF2R agonist will maintain skeletal muscle mass and force production in animals with chronic disease and in aged animals.</p> <p>Methods</p> <p>We utilized animal models of aging, CHF and EMP to evaluate the potential of CRF2R agonist treatment to maintain skeletal muscle mass and force production in aged animals and animals with CHF and EMP.</p> <p>Results</p> <p>In aged rats, we demonstrate that treatment with a CRF2R agonist for up to 3 months results in greater extensor digitorum longus (EDL) force production, EDL mass, soleus mass and soleus force production compared to age matched untreated animals. In the hamster EMP model, we demonstrate that treatment with a CRF2R agonist for up to 5 months results in greater EDL force production in EMP hamsters when compared to vehicle treated EMP hamsters and greater EDL mass and force in normal hamsters when compared to vehicle treated normal hamsters. In the rat CHF model, we demonstrate that treatment with a CRF2R agonist for up to 3 months results in greater EDL and soleus muscle mass and force production in CHF rats and normal rats when compared to the corresponding vehicle treated animals.</p> <p>Conclusions</p> <p>These data demonstrate that the underlying physiological conditions associated with chronic diseases such as CHF and emphysema in addition to aging do not reduce the potential of CRF2R agonists to maintain skeletal muscle mass and force production.</p

Synthesis and electrical property study of La3Ni2MO9 (M=Nb and TA)

© 2015 Elsevier B.V. All rights reserved.Synthesis of La3Ni2NbO9 and La3Ni2TaO9 double perovskite materials was successfully carried out. Both isostructural niobates and tantalates exhibited a monoclinic structure. Sample preparation via solid state reaction yielded a single phase of La3Ni2NbO9, while samples with impurities were obtained when using the sol-gel process. Nb and Ta substitution in La3Ni2MO9 had effects on the sintering behavior. The electrical conductivity of La3Ni2NbO9 was found to significantly increase with increasing temperature, but the electrical conductivity of La3Ni2TaO9 decreased with temperature when the temperature was lower than 300°C then slightly increased again at higher temperature

Effect of Sr substituted La2-xSrxNiO4+δ (x = 0, 0.2, 0.4, 0.6, and 0.8) on oxygen stoichiometry and oxygen transport properties

© The Royal Society of Chemistry 2015.Stoichiometry and oxygen diffusion properties of La2-xSrxNiO4±δ with x = 0.2, 0.4, 0.6, and 0.8 prepared via a sol-gel method were investigated in this study. Iodometric titration and thermogravimetric analysis were used to determine the oxygen non-stoichiometry. Over the entire compositional range, the samples exhibit oxygen hyperstoichiometry with the minimum value δ = 0.14 at x = 0.4. Mixed effects of reduction of oxygen excess and increasing valence of Ni were found to serve as charge compensation mechanisms; the former dominated at a low level of substitution, x < 0.4, while the latter dominated at higher levels of Sr (0.4 < x < 0.8). The highest oxygen diffusion coefficient was found for the minimum amount of Sr substitution, x = 0.2, continuously decreasing with x until x = 0.6. An unusual increase in D∗ was observed when the Sr content increased up to x = 0.8