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T C Ryken

Publications and source records attributed to T C Ryken.

51 records · Page 3Linked to original sources
PubMed1995

Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws.

The bone mineral density (BMD) of 99 cadaveric cervical vertebral bodies (C3-7) was determined using dual x-ray absorptiometry. The vertebral bodies were randomly assigned to receive either a unicortical (51 bodies) or bicortical (48 bodies) Caspar cervical plating screw. The initial insertion torque was measured using a digital electronic torque wrench, and the force required to withdraw the screw from the vertebral body was determined. The mean BMD for the total group of 99 was 0.787 +/- 0.154 g/cm2, the mean insertion torque was 0.367 +/- 0.243 newton-meters, and the mean pullout force was 210.4 +/- 158.1 newtons. A significant correlation was noted between BMD and torque (p < 0.0001, r = 0.42), BMD and pullout force (p < 0.0001, r = 0.54), and torque and pullout force (p < 0.0001, r = 0.88). Although the BMD of the unicortical and biocortical groups was equivalent (p = 0.92), the insertion torque and pullout force differed significantly (p = 0.02 and p = 0.008, respectively) for the unicortical and bicortical groups. A holding index for each screw and insertion technique was defined as the product of the BMD and insertion torque. The calculated holding index and resultant pullout force were significantly correlated for both techniques of screw insertion (r = 0.92), and a significant difference in holding index was observed with unicortical versus bicortical screw placement (p = 0.04). The determination of BMD and measurement of insertion torque to create a unique holding index provides an assessment of bone-screw interaction and holding strength of the screw, both of which impact on the resultant stability of cervical instrumentation. As the number of cervical plating systems increases, the determination of a holding index for various screws and insertion techniques may assist in the comparison of cervical instrumentation.

Absorptiometry, Photon↗
PubMed1994

Interstitial brachytherapy versus cytoreductive surgery in recurrent malignant glioma.

In selected patients with recurrent malignant glioma, interstitial brachytherapy has been advocated as an effective method for tumor control and prolonged survival. We are presenting our results with brachytherapy in patients with recurrent glioma, and comparing this technique with cytoreductive surgery. Twenty patients (9 male, 11 female) underwent stereotactic 125I implantation for recurrent malignant glioma (9 grade III, 11 grade IV). The average age was 43 years and the average Karnofsky score was 76. All patients had received radiation therapy following their initial surgical procedure and 17 received chemotherapy. The median interval from initial procedure to implantation was 70.5 weeks. The median survival following implantation was 24 weeks and total median survival for the group was 94.5 weeks. This group was compared to a contemporary series of 22 patients (16 male, 6 female) who underwent cytoreductive surgery for malignant glioma (10 grade III, 12 grade IV). The average age was 44 years and the average Karnofsky score was 76. All patients received radiation therapy following their initial procedure and 20 patients also received chemotherapy. The median interval from initial procedure to second procedure was 35.5 weeks, and from the second procedure to death was 28 weeks. The median survival for the group was 63.5 weeks. The interval from the first procedure to the second procedure was statistically significant comparing the implant group (median 70.5 weeks) versus the cytoreductive surgery group (median 35.5 weeks; p = 0.04). No significant difference could be demonstrated between the interval from second procedure to death in the implant group (median 24 weeks) versus cytoreductive surgery group (median 28 weeks; p = 0.45).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Familial occurrence of subependymoma. Report of two cases.

Subependymomas are unusual tumors believed to arise from the bipotential subependymal cell. Previous reports of familial occurrence of subependymoma have involved monozygous twins and siblings. The authors describe the first reported occurrence of fourth ventricular subependymoma in a father and son, suggesting the possibility of direct inheritance.

Adult↗
PubMed1994

Cervicomedullary compression in achondroplasia.

Six patients with achondroplasia and symptoms suggestive of cervicomedullary junction compression are reviewed; these included three females and three males, with an average age of 8 years (range 7 months to 30 years). The mean duration of symptoms prior to intervention was 1.9 years. Symptoms included occipitocervical pain, ataxia, incontinence, apnea, and respiratory arrest. Radiological investigations consisted of plain films with flexion and extension views, pluridirectional tomography, thin-section computerized tomography, and magnetic resonance imaging. Typical findings included marked foramen magnum stenosis, ventrolateral cervicomedullary junction compression secondary to central and paramesial basilar invagination, and dorsal cervicomedullary junction compression secondary to ligamentous hypertrophy and invagination of the posterior atlantal arch. All patients underwent posterior fossa decompression and atlantal laminectomy. Surgery consistently revealed marked dorsal and paramesial overgrowth of the rim of the rim of the foramen magnum, with thickening and invagination of the atlantal posterior arch and a dense fibrotic epidural band resulting in dorsal cervicomedullary compression. Intraoperative ultrasonography was used to determine the extent of decompression required. Three patients required duraplasty. Three patients had concurrent hydrocephalus, two of whom had undergone ventriculoperitoneal shunting prior to surgical decompression of the posterior fossa. One patient developed a pseudomeningocele postoperatively, requiring serial lumbar punctures before it resolved. No patient developed craniovertebral instability following decompression. Improvement or resolution of symptoms was noted in all patients, with an average follow-up period of 4.8 years. Thus, cervicomedullary compression in patients with achondroplasia can be successfully treated with dorsal decompression of the craniovertebral junction. Dense epidural fibrotic bands are frequently noted in these cases and must be aggressively released to ensure satisfactory decompression.

Achondroplasia↗
PubMed1992

Infratentorial stereotactic biopsy. A review of 11 cases.

A review of the stereotactic cases performed at the University of Iowa between February, 1985, and December, 1990, yielded 12 infratentorial stereotactic biopsies in 11 patients. A definitive diagnosis was obtained in 9 of 11 patients. One patient required a second biopsy to obtain a diagnosis and 1 yielded cystic fluid only. The pathological diagnosis obtained included 4 high-grade gliomas, 2 undifferentiated adenocarcinomas, 2 low-grade astrocytomas, 1 malignant ependymoma, 1 pontine hematoma and 1 cyst. None of the patients experienced increased neurological deficit following biopsy and there was no mortality. One patient developed postoperative meningitis. We conclude that stereotactic biopsy of infratentorial lesions can be performed safely with a high probability of obtaining a diagnosis. Adequate tissue diagnosis is necessary to direct further therapy.

Adult↗
PubMed1992

Craniovertebral abnormalities in Down's syndrome.

The ligamentous laxity associated with atlantoaxial subluxation has been assumed as a normal occurrence in 15-20% of Down's syndrome patients. The occipitoatlantoaxial instability that accompanies this entity has been poorly recognized. The medical records and radiographic findings of 18 symptomatic patients with Down's syndrome and cervicomedullary compromise were reviewed (1979-1991). All patients were evaluated prospectively under protocol for abnormalities of the cranial vertebral junction. There were 11 males and 7 females (age 3-42). 'Fixed' atlantoaxial luxation was seen in 8 (5 developed precipitous onset of cervical medullary compression). Occipitoatlantoaxial instability was present in 9 and associated rotary luxation in 9. The average predental space was 8 mm in the neutral position in 18 individuals. Two adolescents had previously undergone atlantoaxial dorsal fusion with subsequent progressive basilar invagination due to unrecognized occipitoatlantal instability. An os odontoideum was seen in 3 patients. Irreducible invagination in 2 was treated with anterior decompression followed by dorsal occipital cervical fixation. The occipital cervical fixation was utilized in 10 individuals. Atlantoaxial dorsal fusion was made in 7 and 2 patients with acute rotary luxation of C1 and C2 were treated with immobilization. Halo immobilization in two individuals following a dorsal occipital cervical fixation produced an anterior fusion at the cranial vertebral complex indicating active vertebral ligamentous pathology. The review focuses on increased incidence of occiput cervical instability in the spectrum of craniovertebral junction abnormalities associated with Down's syndrome. A large percentage has an odontoid ossicle probably as a result of repeated minor trauma. The results of surgical stabilization have been shown to be excellent.

Adolescent↗
PubMed1992

Interaction of acidic fibroblast growth factor and transforming growth factor-beta in normal and transformed glia in vitro.

The mitogenic and morphological effects of acidic fibroblast growth factor (aFGF) and transforming growth factor-beta (TGF-beta) were assessed on cultured fetal rat astrocytes and C6 rat glioma cells in the presence and absence of serum. Astrocytes incubated with aFGF exhibited an increase in mitotic activity and characteristic morphological changes involving extensive process formation and rounding of cell bodies. Astrocytes incubated with TGF-beta underwent a slight decrease in mitotic activity and remained morphologically unchanged. Cells exposed to a combination of aFGF and TGF-beta demonstrated an attenuation of both the mitogenic and morphological changes observed in the presence of aFGF alone. The C6 glioma cells cultured in the presence of aFGF underwent a characteristic morphological change from a rounded piling cell mass to a more spindle-shaped bipolar cell layer, accompanied by an increase in mitotic activity. In contrast to the astrocyte cultures, increased growth and similar morphological effects were produced by TGF-beta. The combination of aFGF and TGF-beta did not result in attenuation of the mitogenic and morphological changes (as seen in astrocytic cells). These results suggest that, in normal fetal rat astrocytes, TGF-beta is capable of attenuating the mitogenic and morphological changes induced by aFGF in vitro. In the transformed C6 glioma cell line, aFGF and TGF-beta elicit similar mitogenic and morphological changes, without evidence of an antagonistic interaction as seen in normal astrocytes.

Animals↗
PubMed1990

Bilateral testicular torsion in a pre-term neonate.

Bilateral testicular torsion in the neonate, although uncommon, is being reported with increasing frequency. Most previously reported cases have been full term, average to above average weight infants born with nonviable testes. We report a case of bilateral neonatal testicular torsion in a 32-week newborn in whom testicular viability may have been preserved by pre-term birth.

Humans↗
PubMed1988

Endogenous immunoreactive glia maturation factor-like molecule in cultured rat Schwann cells.

Using the monoclonal antibody G2-09 raised against bovine glia maturation factor (GMF), we demonstrated that cultured rat Schwann cells and Schwannoma cells, but not their conditioned media, possessed endogenous GMF-like immunoreactivity. The presence of immunoreactive GMF correlated well with GMF bioactivity. The GMF-like factor in Schwann cells was characterized by immunodotting, immunofluorescence, immunoadsorption and immunoblotting. Immunofluorescence confirmed the intracellular location of GMF. Immunoadsorption completely eliminated the GMF-like bioactivity from the cell extracts. Immunoblotting identified a protein band with a molecular weight of 14,000. Thus, the evidence strongly supports the argument that the GMF-like factor in rat Schwann cells is identical with GMF from the bovine brain. The GMF-like molecule in Schwannoma cells showed properties similar to those in Schwann cells, but for unknown reasons was not detectable by immunofluorescence. The presence of GMF in cultured rat Schwann cells suggests that the factor may play a role in the peripheral nervous system.

Antibodies, Monoclonal↗
PubMed1987

Endogenous immunoreactive glia maturation factor-like molecule in astrocytes and glioma cells.

Using the monoclonal antibody G2-09 raised against bovine glia maturation factor (GMF), we conducted a survey of GMF-like immunoreactivity in various cell types. Of all the normal and neoplastic cells tested, only extracts from astroblasts, gliomas, Schwann cells and schwannomas, but not their conditioned media, possessed endogenous GMF-like immunoreactivity. The presence of immunoreactive GMF correlated well with GMF bioactivity. Using the same monoclonal antibody, the GMF-like factor in astroblasts and C6 glioma cells was characterized by immunofluorescence, immunoadsorption and immunoblotting. Immunofluorescence confirmed the intracellular location of GMF. Immunoadsorption completely eliminated the GMF-like bioactivity from the cell extracts. Immunoblotting identified a protein band having a mol. wt. of 14,000 Da. Thus, the evidence strongly supports the argument that the GMF-like factor in astroblasts and C6 cells is identical with GMF from the bovine brain. In order to explain the fact that astroblasts and C6 cells are both the source and targets of GMF, we propose the hypothesis that GMF functions as an injury signal, being released from the injured glia and serving as a stimulant for gliosis in the neighboring intact glia.

Animals↗
PubMed1987

Induction of cytoskeletal alterations in C6 glioma by glia maturation factor.

C6 rat glioma cells respond to glia maturation factor (GMF) with characteristic morphological alterations. Observed under phase-contrast microscopy, the cells changed from a rounded morphology in random formation to a spindle-shaped appearance in parallel arrays. Observed under scanning electron microscopy, GMF led to a decrease in the number of microvilli and cell surface knobs. Transmission electron microscopy demonstrated the appearance of numerous microtubules aligned with the long axis of the cells after GMF stimulation. The change in cell shape and histotypic pattern was inhibited by vinblastin, further implicating the involvement of microtubules. Immunofluorescence using anti-alpha-tubulin revealed a well-defined cytoskeletal system in GMF-stimulated cells but not in the control cells. Finally, an increase in tubulin was confirmed with enzyme-linked immunosorbent assay (ELISA) on extracts from these cultures. The findings indicate that morphological alterations induced by GMF are associated with changes in the quantity and arrangement of microtubules.

Animals↗
PubMed1986

Suppression of glioma growth in vitro and in vivo by glia maturation factor.

Glia maturation factor (GMF), a 14,000 Mr acidic protein of the brain, is capable of promoting differentiation of cultured astroblasts. In this study we report the effect of GMF on two glioma cell lines: the C6 line, of rodent origin, and the HG-1 line, of human origin. When tested in culture, GMF promotes the initial growth of the two cell lines when the cells are sparse but limits proliferation by restoring contact inhibition when the cells are confluent. Cell cycle analysis confirms the arrest of the cells at the G0/G1 phase when the tumor cells are contact inhibited by GMF. When C6 cells are inoculated into the athymic (nude) mice at a s.c. site, a single solid tumor grows out with a 100% take. Intraperitoneal injection of GMF leads to the slowing down of tumor growth. That the in vivo effect of GMF is not due to cytotoxicity is evidenced by the lack of necrosis and by the appearance of more mature astrocytic cells in the tumors. The results lend support to the concept of GMF as a cellular regulator and suggest the therapeutic potential of GMF for brain tumors.

Animals↗
PubMedDate not supplied

Cervicomedullary compression by separate atlantal lateral mass.

Compression of the cervicomedullary junction can result from a variety of congenital craniovertebral anomalies. We report an unusual case of cervicomedullary compression by a free lateral atlantal mass associated with contralateral occipito-atlantal fusion.

Brain↗