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At least 541 records · Page 30Linked to original sources
PubMed2004

[Calcium pyrophosphate dihydrate deposition disease in the transverse ligament of the atlas].

Calcium pyrophosphate dihydrate (CPPD) deposits, answerable for chondrocalcinosis, are frequently observed in elderly people. Involvement of the spine is not rare. We present the case of a woman hospitalised for an acute arthritis of the right knee related to CPPD crystal deposition disease who suffered from acute neck pain. The computerised tomography showed calcified deposits in the transverse ligament of the atlas highly suggestive of CPPD deposits. This localisation seems to be very common for CPPD deposits. These CPPD crystal deposits may induce pseudo-meningitic attacks or chronic mechanical neck pain. CPPD crystal deposits in the upper cervical spine should be diagnosed when the disease is quiet, in order to avoid unnecessary investigations and therapies when an acute cervical flare occurs.

Aged↗
PubMed2001

Cardiovascular critical event pathways for the progression of heart failure; a report from the ATLAS study.

AIMS: To determine the sequence of critical cardiovascular events in the progression of heart failure, and whether aetiology or high-dose vs low-dose lisinopril affected these pathways. METHODS AND RESULTS: This was a post-hoc investigation of the ATLAS database, which comprised 3164 patients with chronic heart failure, randomized to low- (2.5-5.0 mg. day(-1)) or high-dose (32.5-35.0 mg. day(-1)) lisinopril, followed up for a median of 46 months. Two-thirds (64.3%) of patients had heart failure attributed to ischaemic heart disease. During the study, most patients (61.1%) had at least one cardiovascular hospitalization and 42.5% of all patients died: most deaths (88.2%) were cardiovascular. Nearly half (49.7%) of the cardiovascular deaths were considered sudden and 45.2% of cardiovascular deaths occurred as the first cardiovascular event. A third (30.2%) of deaths resulted from heart failure and were generally preceded by hospitalization, either for heart failure (85.5%), myocardial ischaemic events (21.7%) or arrhythmias (18.0%). Compared with low-dose, high-dose lisinopril was associated with a lower risk of death or hospitalization for any reason (P=0.002) and death or hospitalization with worsening heart failure (P<0.001). High-dose lisinopril delayed the time to all-cause mortality and hospitalization for chronic heart failure by 7.1 months. CONCLUSIONS: Vascular and arrhythmic events may not only be important precipitants of sudden death, but were also seen to contribute to the progression of heart failure. A reduction in vascular events, as well as benefits on ventricular remodelling, could account for the decrease in death or hospitalization with high-dose lisinopril.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2002

Chiropractic care of a patient with temporomandibular disorder and atlas subluxation.

OBJECTIVE: To describe the chiropractic care of a patient with cervical subluxation and complaints associated with temporomandibular disorder. CLINICAL FEATURES: A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which had been treated with prescription antibiotics. Her complaints were attributed to a diagnosis of temporomandibular joint syndrome and had been treated unsuccessfully by a medical doctor and dentist. INTERVENTION AND OUTCOME: High-velocity, low-amplitude adjustments (ie, Gonstead technique) were applied to findings of atlas subluxation. The patient's symptoms improved and eventually resolved after 9 visits. CONCLUSION: The chiropractic care of a patient with temporomandibular disorder, headaches, and subluxation is described. Clinical issues relevant to the care of patients with this disorder are also discussed.

Adult↗
PubMed2006

A case of osteochondroma of the atlas causing obstructive sleep apnea syndrome.

Most osteochondromas affect the long bones, but rarely originate in the spine. We report an extremely rare case of osteochondroma of the atlas causing obstructive sleep apnea syndrome (OSAS) in a 61-year-old female. The osteochondroma was removed completely using a transoral approach, and the symptoms of OSAS disappeared. A review of the literature regarding osteochondroma confirms the rarity of this lesion and the use of a transoral approach is discussed.

Body Mass Index↗
PubMed1990

Tc-99m HMPAO brain perfusion tomography atlas using a high resolution SPECT system.

Excellent SPECT images of brain perfusion with Tc-99m HMPAO were obtained by the use of a three-head rotating gamma camera SPECT system with high resolution (FWHM 7mm) in a normal volunteer. These images should be clinically effective for evaluating various neurologic disorders. Transverse, coronal, and sagittal sectional HMPAO-SPECT images are correlated with corresponding brain MRI images of the same normal volunteer in this atlas.

Adult↗
PubMed1990

Dynamic computerized tomography of the occiput-atlas-axis complex in trauma patients with odontoid lateral mass asymmetry.

Over a 23-month period, 25 patients aged 11 to 74 years presented to our Level I trauma center with odontoid lateral mass asymmetry of 2 to 5 mm on properly centered AP open-mouth X-rays: 32% of patients were asymptomatic, 68% had cervical pain, and 32% had limited range of motion. Patients with cervical spine fractures or dislocations and those with fixed deformity were excluded. The clinical significance of asymmetry was determined utilizing dynamic axial CT scanning of the occiput (C0), atlas (C1) and axis (C2) with the head neutral and with 15 degrees to 30 degrees active rotation. Nineteen patients demonstrated greater than 5 degrees of relative motion of C1 on C2 bilaterally. Three patients had less than 5 degrees of relative motion bilaterally and three patients had less than 5 degrees relative motion with left rotation only. No patient had formal treatment and all had nearly normal cervical range of motion on clinical examination at the time of hospital discharge. The finding of an asymmetric odontoid-lateral mass interspace on properly centered open-mouth AP X-rays in the presence of otherwise normal cervical spine X-rays, in conscious patients without fixed deformity, appears to be incidental and requires no further evaluation or treatment.

Adolescent↗
PubMedDate not supplied

Tuberculosis of the arch of the atlas. Case report.

This rare case of tuberculosis of the arch of atlas illustrates the potential difficulties in making a clinical diagnosis of tuberculosis of the upper cervical spine. Plain roentgenograms may not demonstrate an early lesion of the neural arch, and CT is a valuable adjunct. The use of a halo vest proved a successful alternative to operation in conferring stability to the spine during healing.

Adult↗
PubMed1988

Fractures of the atlas: classification, treatment and morbidity.

Fractures of the atlas vertebra are generally considered to be innocuous injuries. A review of 35 patients with C1 fractures treated in the Acute Spinal Cord Injury Unit of Shaughnessy Hospital indicated that long-term morbidity is not as low as was previously thought. Thirteen of 23 patients (56%) followed up a minimum of 1 year post-trauma had significant symptoms of scalp dysesthesia, neck pain, and/or neck stiffness. A classification is presented, and the results of treatment modalities used are reviewed. Based on the findings, the simplest orthosis consistent with appropriate treatment of any of the often associated other spine fractures is recommended. Surgery is reserved for late instability or pain.

Cervical Atlas↗
PubMed1991

Experimental study of atlas injuries. I. Biomechanical analysis of their mechanisms and fracture patterns.

Understanding injury mechanisms is important for the prevention, diagnosis, and treatment of spinal injuries. Using 10 fresh cadaveric human spine specimens of occiput to C3, clinically similar injuries of the atlas (C1) were produced with high-speed (4.4 m/sec) axial compression. The traumatic event was biomechanically monitored. The resulting injuries were studied with radiography, computed tomography, and a multidirectional instability test. The average compressive failure force was 3,050 N for specimens impacted in neutral posture (n = 437) and 2,100 N for those in extended posture (n = 282). Corresponding values for the impulse were 34.9 Nsec (n = 8.3) and 17.6 Nsec (n = 1.8). Average instability for both groups, as measured by the neutral zone and range of motion, increased by 90% and 44%, respectively, in flexion-extension and 20% in lateral bending, but not in axial rotation. These findings confirm the clinical observations.

Biomechanical Phenomena↗
PubMed1992

Multidirectional instabilities of experimental burst fractures of the atlas.

For the purpose of understanding the acute instability of a burst (Jefferson) fracture of the atlas, the authors produced the fractures experimentally and measured multidirectional flexibilities in seven cadaveric C0-C3 specimens. The flexibilities were measured by the authors' standardized method: they applied six types of physiologically pure moments (up to 1.5 Nm) and recorded the ensuing C0-C2 motions by stereophotogrammetry. The flexibility tests were performed before and after the production of the fracture. The greatest increase in flexibility due to the injury was in flexion-extension (+22.0 degrees, 41.7%). In lateral bending, the increase was 7.7 degrees, or 23.9%. The flexibility was mostly maintained in axial rotation (+4.8 degrees, 5.4%). The increase in motion was due to an increase in neutral zone in flexion-extension, and an increase in the elastic zone in lateral bending. These flexibility results of experimentally produced fractures reflect quite well the acute instabilities seen clinically.

Cervical Atlas↗
PubMed1998

Treatment of stable burst fracture of the atlas (Jefferson fracture) with rigid cervical collar.

STUDY DESIGN: A retrospective review of a clinical series. OBJECTIVE: To evaluate the use of a rigid cervical collar alone as the treatment for stable Jefferson fracture, and to devise an algorithm for treatment of Jefferson fracture with or without an associated cervical injury. SUMMARY OF BACKGROUND DATA: The traditional treatment for Jefferson fracture, if there is no indication for surgery, is immobilization by halo vest. Because halo vest placement is associated with intracranial infection and a significant degree of patient discomfort, slightly less rigid forms of external immobilization may be useful for the treatment of stable Jefferson fractures. No standard protocol calling for the use of one form of stabilization device has been reported. MATERIALS: The medical records and radiographs of 16 consecutive patients with Jefferson fracture during a 2-year period were reviewed. Each patient underwent a complete cervical radiograph series and a computed tomographic scan. The mean C1 lateral mass displacement was 1.8 mm. Cervical spine radiographs, including lateral flexion-extension views were obtained 10 to 12 weeks after injury before the removal of an external immobilization device. RESULTS: Of these 16 patients, 1 sustained a complete injury, and 7 sustained an incomplete injury. Eight patients were neurologically intact. Twelve patients sustained a stable Jefferson fracture and were treated with a rigid cervical collar (Miami-J collar [Jerome Medical, Moorestown, NJ]) alone from 10 to 12 weeks. The patient sustaining the complete neurologic injury died of multisystem trauma. All 15 live patients showed no instability on their follow-up plain radiographs before the removal of an external stabilization device. Six patients underwent further plain radiographs approximately 1 year after the fracture and similarly demonstrated no instability. CONCLUSIONS: Isolated stable burst fracture of the atlas can be treated effectively with a rigid cervical collar alone for 10 to 12 weeks with good neurologic recovery and segmental stability. Unstable Jefferson fractures with concurrent unstable fracture of other cervical vertebrae, especially C2, requires surgical stabilization.

Adolescent↗
PubMed1999

Atlas-axis facet asymmetry. Implications in manual palpation.

STUDY DESIGN: A basic study of six human cervical spines, documenting displacement with applied forces mimicking palpation. OBJECTIVES: To assess the issues of motion palpation of joint restrictions and the inferred link to disease. SUMMARY OF BACKGROUND DATA: Although several investigators have suggested that the issue of asymmetry and normal-abnormal function should be assessed, data are unavailable. METHODS: Atlas-axis specimens were harvested from six cadavers, cleaned of ligamentous and muscle tissue, and potted and secured with dental plaster. Forces (5-25 N) were applied along the mediolateral axis, and the corresponding displacement along three orthogonal axes were documented with infrared diodes and the Optotrak camera system (Northern Digital, Waterloo, Ontario, Canada). Specimen geometry and asymmetry were documented with plain radiographic film and a gimbal apparatus. RESULTS: Each of the six specimens displayed different behavior and differing degrees of asymmetry (e.g., facet inclination 17-35 degrees) so that each was analyzed as a case study. Asymmetrical and discontinuous force-displacement correlations were linked to anatomic asymmetry that appeared to be of natural occurrence. CONCLUSIONS: Asymmetrical joint geometry is common and causes asymmetrical joint dynamics. Thus, a clinician attempting to palpate vertebral motion would be misled by assuming that perceived restricted joint motion universally represented a finding potentially amenable to manipulation. For spine palpation to be a valid indicator for manipulation, the clinician applying it must first be able to differentiate between asymmetrical motion caused by vertebral fixation and that caused by asymmetrical joint anatomy.

Aged↗
PubMed2003

Posterior arch defects of the atlas: significance in trauma and literature review.

Neck pain and stiffness after trauma can be caused by congenital defects in the posterior arch of the atlas. A case is described followed by a description of the pathology, classification, diagnosis and treatment of such defects. The importance of differentiating such defects from fractures in an acute trauma situation is discussed.

Adult↗
PubMedDate not supplied

Combined occipitoatlantoaxial hypermobility with anterior and posterior arch defects of the atlas in Pierre-Robin syndrome.

Combined occipitoatlantoaxial instability of the cervical spine occurred in a 8-year-3-month old boy with Pierre-Robin syndrome. He also had failure of ossification of both the anterior and posterior arches of the atlas. An in situ fusion from the occiput to C2 restored cervical spine stability. This case is discussed in relation to other hypermobility and instability syndromes of the cervical spine.

Atlanto-Axial Joint↗
PubMed2004

Unsupervised learning of an atlas from unlabeled point-sets.

One of the key challenges in deformable shape modeling is the problem of estimating a meaningful average or mean shape from a set of unlabeled shapes. We present a new joint clustering and matching algorithm that is capable of computing such a mean shape from multiple shape samples which are represented by unlabeled point-sets. An iterative bootstrap process is used wherein multiple shape sample point-sets are nonrigidly deformed to the emerging mean shape, with subsequent estimation of the mean shape based on these nonrigid alignments. The process is entirely symmetric with no bias toward any of the original shape sample point-sets. We believe that this method can be especially useful for creating atlases of various shapes present in medical images. We have applied the method to create mean shapes from nine hand-segmented 2D corpus callosum data sets and 10 hippocampal 3D point-sets.

Algorithms↗
PubMed1978

Some specific anatomical features of the atlas and axis: dens, epitransverse process and articular facets.

Metrical and morphological findings, based on 107 human vertebral columns, related to the variations of the dens are given, and differences in the depth of the superior articular facets of the atlas and specific pertinent details related to the os odontoideum and epitransverse process are also provided and their possible clinical relevance indicated. Findings reveal considerable variation in the height of the dens (11 to 18 mm), but remarkably little in its anteroposterior and transverse diameters at the root. The use of the term "hypoplasia" with reference to the dens is discussed, and a need for more rigid criterian in the use of this term stressed. It is also suggested that there may be sufficient radiological evidence in a lateral radiography to lead one to suspect the presence of an os odontoideum or a separate dens caused by trauma in the distant past.

Adult↗
PubMed2026

Spatially resolved single-cell atlas reveals the macroevolutionary trajectory of animal hearts.

Animal hearts display diverse anatomical structures during adaptive evolution. Here, we present a multiomics atlas of adult hearts from 27 species across chordates, arthropods, and mollusks. Joint analysis indicates that Bilateria hearts share a core gene repertoire, taking a stepwise "add-on" approach as a universal evolutionary strategy. The "proto-heart" is populated by key cell types, including cardiomyocytes, fibroblasts, endothelial cells, and neural cells, which maintained core signatures while evolving with shifts in living environments and corresponding adaptations in the cardiovascular system. Additionally, we reveal an evolutionarily conserved cardiomyocyte state dynamic potentially linked to cardiac development and stress responses. Finally, we identify a common molecular program underpinning chamber evolution from a ventricular foundation. This work establishes a resource for understanding the intrinsic mechanisms of heart evolution.

Animals↗