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Enrichment of segmental duplications in regions of breaks of synteny between the human and mouse genomes suggest their involvement in evolutionary rearrangements.

The sequence of the mouse genome allows one to compare the conservation of synteny between the human and mouse genome and exploration of regions that might have been involved in major rearrangements during the evolution of these two species (evolutionary genome rearrangements). Recent segmental duplications (or duplicons) are paralogous DNA sequences with high sequence identity that account for about 3.5-5% of the human genome and have emerged during the past approximately 35 million years of evolution. These regions are susceptible to illegitimate recombination leading to rearrangements that result in genomic disorders or genomic mutations. A catalogue of several hundred segmental duplications potentially leading to genomic rearrangements has been reported. The authors and others have observed that some chromosome regions involved in genomic disorders are shuffled in orientation and order in the mouse genome and that regions flanked by segmental duplications are often polymorphic. We have compared the human and mouse genome sequences and demonstrate here that recent segmental duplications correlate with breaks of synteny between these two species. We also observed that nine primary regions involved in human genomic disorders show changes in the order or the orientation of mouse/human synteny segments, were often flanked by segmental duplications in the human sequence. We found that 53% of all evolutionary rearrangement breakpoints associate with segmental duplications, as compared with 18% expected in a random location of breaks along the chromosome (P<0.0001). Our data suggest that segmental duplications have participated in the recent evolution of the human genome, as driving forces for evolutionary rearrangements, chromosome structure polymorphisms and genomic disorders.

Animals↗

Exercise testing for assessment of the significance of ST segment depression observed during episodes of paroxysmal supraventricular tachycardia.

Sixteen patients who had manifested ST segment depression during episodes of paroxysmal supraventricular tachycardia (PSVT) were studied with exercise testing in order to detect coronary artery disease and myocardial ischaemia. No ST segment depression was observed during exercise testing in 15 out of the 16 patients tested. Paroxysms of supraventricular tachycardia associated with ST segment depression occurred during exercise testing in three cases. The ST segment depression was immediately apparent, remained constant throughout the supraventricular tachycardia and was almost instantly abolished following conversion to sinus rhythm. Patients with heart rates greater than 250 beats min-1 during PSVT had marked ST segment depression associated with the tachycardia. These results suggest that coronary artery disease and myocardial ischaemia are not involved in the genesis of ST segment depression during PSVT. Tachycardia per se may be the cause of ST segment depression by altering the slope of phase 2 of the ventricular action potential. Retrograde atrial activation may also induce ST segment shifts in some of the cases.

Adolescent↗

Predicting cardiac mortality after uncomplicated myocardial infarction by exercise radionuclide ventriculography and exercise-induced ST segment elevation.

In 183 consecutive patients with recent, uncomplicated myocardial infarction, the following variables were associated with 4-year cardiac death: haemodynamic decompensation with exercise (P = 0.01), left ventricular ejection fraction at rest (P = 0.004) and at peak exercise (P = 0.003), persistent ST segment elevation at rest in the area of infarction = (P = 0.004), exercise-induced ST segment elevation (P = 0.02), and late aneurysmal evolution (P = 0.01). Exercise left ventricular ejection fraction was the sole variable selected by Cox regression analysis as an independent predictor of cardiac death. In 40 patients with ST segment elevation at rest, left ventricular ejection fraction was 42 +/- 17% at rest and 40 +/- 18% at peak exercise, versus 52 +/- 12% and 52 +/- 14% in the remaining patients (both P less than 0.01). Among these 40, 16 (all with anterior infarction) also had exercise-induced ST segment elevation; their ejection fraction was 32 +/- 13% at rest, 30 +/- 13% during exercise, versus 53 +/- 15% and 53 +/- 15% in 129 patients with no ST segment elevation either at rest, or during exercise (both P less than 0.01). The 4-year risk of death was 20% in the former 40 patients, 36% in the latter 16, while in the complete absence of ST segment elevation, such risk was 3%. All 14 patients with ST segment elevation only during exercise were alive after 4 years: their left ventricular ejection fraction was 47 +/- 12% at rest, 45 +/- 13% with exercise. ST segment elevation was associated with late aneurysmal evolution but not with exercise-induced ischaemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Dyspnea↗

Segmental bioelectrical impedance analysis improves the prediction for extracellular water volume changes during abdominal surgery.

OBJECTIVE: To determine whether the segmental multifrequency bioelectrical impedance analysis may improve the prediction for intraoperative changes in extracellular water volume (deltaECW) compared with whole body multifrequency bioelectrical impedance analysis in abdominal surgical patients. DESIGN: Prospective, consecutive sample. SETTING: Surgical operative patients in a university-affiliated city hospital. PATIENTS: Thirty patients who underwent elective gastrointestinal surgery. INTERVENTIONS: Multifrequency bioelectrical impedance analysis was conducted preoperatively (before the induction of anesthesia) and postoperatively (after recovery from anesthesia). Resistance values fitted at zero frequency (R0) in the whole body and in each body segment (arm, trunk, and leg) were determined by performing nonlinear curve-fitting and subsequent extrapolation. DeltaECW values were estimated from the whole body resistance between wrist and ankle using two different prediction formulas. In segmental multifrequency bioelectrical impedance analysis, however, ECW was obtained as the sum of each body segment (arms, trunk, and legs) using the equation newly derived from the cell suspension theory. DeltaECW estimated from both measurements were compared with net fluid balances during surgery. MEASUREMENTS AND MAIN RESULTS: R0 in whole body and all body segments significantly decreased after surgery (p < .0001). The most striking decrease in post/preoperative ratios was found in the R0 in the trunk. The post/preoperative ratio of the R0 value in the trunk was significantly lower than the post/preoperative ratio of the R0 value in the leg (p = .0007). DeltaECW from segmental multifrequency bioelectrical impedance analysis was similar to net fluid balance (r2 = .80, bias = -0.03 L), whereas whole body multifrequency bioelectrical impedance analysis resulted in considerable underestimations of deltaECW (r2 = .50, .51, bias = 0.95, 0.53 L). CONCLUSIONS: The difference in the prediction of deltaECW between whole body and segmental multifrequency bioelectrical impedance analysis may be explained by the significant decrease in the resistance of the trunk, which contributed only minimally to the whole body resistance. Segmental multifrequency bioelectrical impedance analysis provides a better approach to predict ECW changes in critically ill patients with nonuniform fluid distribution.

Abdomen↗

Evaluation of K-space segmented cine sequences for fast functional cardiac imaging.

RATIONALE AND OBJECTIVES: In functional cardiac magnetic resonance imaging, reduction of measuring time is very important for many patients who are not able to rest motionless for long-lasting examinations. In this study, the image quality of sequences with k-space segmented data recording was compared with conventional gradient-echo sequences for cine imaging with flow compensation in applications on patients with normal and reduced ejection fractions. METHODS: Thirty-one subjects (4 volunteers and 27 patients with cardiac diseases) were examined using different techniques for cine imaging of the left and right ventricles. The ejection fraction in the patients was calculated based on images of a conventional two-dimensional gradient-echo technique using a biplane ellipsoid model. The results from k-space segmented methods (3 to 9 Fourier lines per cardiac cycle for each phase image) were compared with the conventional images of the same short-axis view separately for groups of subjects with normal and reduced ejection fraction. The contrast between blood and myocardium at several sites of the heart and the homogeneity of the blood signal in the ventricle were evaluated for several phases of the heart cycle. RESULTS: The segmentation in the acquisition of raw data allows reduction of measuring time to approximately 20% to 40% of the time required for conventional sequences in cine imaging of the heart. In patients with normal or only slightly reduced heart function (ejection fraction > or = 60%) the image quality of k-space segmented sequences was not significantly different from the conventionally recorded images. In contrast, patients with markedly lowered ejection fraction (< 60%) showed degraded results of the k-space segmented sequences compared with the conventional sequence (P < 0.001). The anterolateral border and the right ventricle especially were not sufficiently delineated by the k-space segmented sequences in these patients. CONCLUSION: The k-space segmentation for the reduction of examination time is suitable for measuring heart volumes and functional parameters of patients expected to have a nearly normal ejection fraction, whereas for patients with markedly reduced cardiac function further technical improvements of segmented techniques are necessary.

Adult↗

Automated segmentation and visualization of the pulmonary vascular tree in spiral CT angiography: an anatomy-oriented approach based on three-dimensional image analysis.

A new method for automated segmentation of the pulmonary vascular tree in spiral CT angiography was developed based on 3D image analysis techniques and anatomic knowledge. For efficient and effective segmentation, an anatomy-oriented approach was introduced, in which several anatomic structures are segmented sequentially and the properties of each segmented structure are used for the next step of segmentation and for validation of intermediate results. By use of clinical data of 12 patients, parameters for segmentation were analyzed and optimized. The effectiveness of the segmentation method was evaluated through the visual assessment by comparison between images of the segmentation results by volume rendering and images of maximum intensity projection of the original volume data.

Angiography↗

Correlations between ST-segment depressions in patients with arterial hypertension and changes in arterial blood pressure and the heart rate.

In 10 treated hypertensives without coronary heart disease we carried out 24-h monitoring of the ST-segment and blood pressure. Twenty-four periods with ST-segment depressions of greater than 0.1 mV were recorded in nine of 10 patients. In nine of 24 periods with ST-segment depressions blood pressure was elevated. The heart rate was increased in 20 of 24 ST-segment depressions. During nine periods with ST-segment depressions angina pectoris was reported, and 27 anginal attacks without ST-segment depressions were observed. These results indicate that only 38% of ST-segment depressions in hypertensive heart disease are paralleled by increases in blood pressure, but 83% are paralleled by increases in the heart rate (P less than 0.001), which shows a better correlation with ST-segment depressions than blood pressure.

Angina Pectoris↗

Isolated, perfused rabbit ear artery: a model for studying segmental vasoconstriction and dilatation.

Severe increases in blood pressure (BP) are associated with a segmental pattern of constriction and dilatation in small arteries and arterioles, but the pathogenesis is poorly understood. We showed that the isolated, perfused rabbit ear artery typically develops segmental constriction and dilatation when intraluminal pressure is > 160-180 mm Hg during field stimulation of perivascular nerves (> 6 Hz) or extra- or intraluminal infusions of norepinephrine (NE > 10(-7) M) or phenylephrine (PE) (> 5 x 10(-7) M). Light, transmission, and scanning electron microscopy showed that the dilated vessel segments initially show endothelial injury with no smooth muscle lesions. After repeated or prolonged exposure to high intraluminal pressure, dilated segments manifest extensive and severe endothelial and smooth muscle damage. Dilated regions also became abnormally permeable to tracer particles (ferritin). Constricted segments did not show evidence of endothelial or smooth muscle injury or hyperpermeability. These changes, i.e., segmental vasoconstriction/dilatation, hyperpermeability, and vessel wall damage localized to dilated segments, are comparable to those that occur in small arteries and arterioles during severe hypertension. We discuss the potential usefulness of the isolated ear artery as a model for studying the pathogenesis and morphology of segmental vasoconstriction/dilatation.

Animals↗

The vascularized pig fibula bone flap model: effects of multiple segmental osteotomies on growth and viability.

Previous work by this laboratory introduced the pig fibula bone flap as a model for the study of the pathophysiology of vascularized bone flaps. Anatomic and hemodynamic studies demonstrated a significant (p < 0.05) decrease in vascular perfusion after a series of segmental osteotomies and rigid fixation (lag screws and miniplates) in the distal end of the flap, suggesting that blood flow to the distal osteotomized segment of the flap may be impaired. Killing the animals after blood flow studies precluded assessment of the effect of these hemodynamic changes on bone healing. Therefore, the aim of this study was to assess the pig fibula bone flap model with respect to viability, healing, and subsequent growth after multiple segmental osteotomies and rigid fixation to contribute to the understanding of vascularized bone flap pathophysiology. Yorkshire pigs (20 to 25 kg) were used for all experiments. Eight pigs underwent unilateral elevation of a vascularized fibula bone flap, which was osteotomized into three segments and orthotopically rigidly fixed using a 2.4-mm mandibular reconstruction plate. The left fibula remained as the control. Fluorochrome labels were injected to assess bone viability and turnover, and both fibulae were assessed for growth radiologically. The fibulae were harvested 21 days postoperatively (when the animals were killed), and bone healing was assessed histologically and clinically. There were no significant differences in preoperative and postoperative lengths of the osteotomized fibulae compared with the controls, suggesting that there was no impairment of growth potential after multiple segmental osteotomies and rigid fixation. Significant (p < 0.05) bony hypertrophy of the osteotomized fibulae was noted when compared with controls. Mobility was observed in 3 of the 32 osteotomies (9 percent), occurring across one proximal and two distal osteotomies in association with failure of fixation. However, histologic and fluorochrome assessment confirmed the viability of all bone segments, as supported by the presence of tetracycline given 2 days postoperatively. The pig fibula bone flap model is well tolerated by the pig. Multiple segmental osteotomies and rigid fixation, previously associated with a significant decrease in blood flow in the distal segment, did not impair either growth potential, viability, or healing ability. It is suggested that the pig fibula is a suitable model for the study of bone flap pathophysiology.

Animals↗

The vascularized pig fibula bone flap model: effect of segmental osteotomies and internal fixation on blood flow.

The free fibular flap is the flap of choice for reconstruction of complex mandibular defects, although two or more osteotomies may be required to recreate the normal mandibular contour. The effect of these surgical manipulations on the fibula has not been adequately investigated. This study was designed to study the effect of multiple segmental osteotomies and internal fixation techniques on blood flow in the vascularized pig fibula bone flap model. The hindlimbs of 15 Yorkshire pigs were randomized into 1 of 5 groups (n = 6 fibulae per group) consisting of: (1) a nonoperated, in situ fibula; (2) an elevated fibula flap; (3) an elevated fibula flap with two segmental osteotomies; (4) an elevated fibula with two segmental closing osteotomies rigidly fixed with 2-mm miniplates; (5) an elevated fibula with two segmental closing osteotomies rigidly fixed with 2-mm lag screws. Total and gradient blood flow was measured in the bone and soft-tissue components of these flaps using the 15-microm radioactive microsphere technique. The creation of two segmental osteotomies in the vascularized pig fibula bone flap model resulted in a significant decrease (p<0.05) in the gradient blood flow in the segment of bone distal to the second osteotomy. Application of miniplates or lag screws across closing osteotomies resulted in a significant decrease (p<0.05) in total and gradient blood flow to the bone component of the fibulae, as compared with the elevated and osteotomized fibulae groups. An increase in blood flow suggesting a hyperemic response was noted in the bone and soft tissue in the elevated and osteotomized flap groups as compared with the in situ, nonoperated controls. This study established the validity of the pig fibula as a suitable model for investigating the pathophysiology of blood flow changes in the face of standard surgical maneuvers necessary for the restoration of mandibular form and function. The results demonstrated that the creation of multiple segmental osteotomies and the application of internal fixation significantly decreases (p<0.05) blood flow to the distal portion of the flap. The effects of segmental osteotomies and internal fixation on healing and growth of the pig fibula bone flap model are investigated in a separate study.

Animals↗

A biomechanical analysis of short segment spinal fixation using a three-dimensional geometric and mechanical model.

Vertebral stabilization using spinal fixation devices is a widely used technique. A three-dimensional geometric and mechanical finite element model has been used as a simulation tool for the evaluation of the mechanical behavior of spinal devices. The geometry of lumbar vertebrae was parameterized, which allows the construction of the geometric model for a given lumbar segment from the digitization of two roentgenographs. This procedure was used to construct a finite element model for a three-vertebra segment with simulation of fractures in the middle vertebra, and with simulation of a restoration using an osteosynthesis device, implemented in a frame fashion with four screws and two rods linked by two transverse rods, and/or an anterior bone graft. Compression force and torsion moment were considered, and different cases were investigated, by varying the severity of the fracture, the geometric characteristics of the device, and the mechanical characteristics of the material joining the two intact vertebral bodies. Results were analyzed considering the mobility of the vertebral segment, which indicates the ability of the restoration system to stabilize the vertebral segment, and considering the forces and moments distribution in the device, which gives information on part of the forces that pass through the device in each situation. Results show that maximum values of forces and moments in the device are more important in compression than in torsion. Adding an anterior bone graft has an effect mainly for compression, whereas in torsion its effect is negligible. For a rigid fixation device, no significant difference was found between different fracture models, indicating that the posterior arch does not play an important role for an instrumented segment. For compression, a rigid posterior wall, or the presence of a bone graft, reduces greatly the mobility of the instrumented segment. For torsion, suppressing the two transverse rods in the device greatly increases the mobility of the instrumented segment. Using a finite element model of a lumbar vertebral segment appears to be an interesting tool to analyze the behavior of an instrumented spine and to compare between different stabilization systems.

Biomechanical Phenomena↗

Effects of short anterior lumbar interbody fusion on biomechanics of neighboring unfused segments.

STUDY DESIGN: Segmental mobility and intradiscal pressure were measured and the data compared in six cadaveric lumbar spine specimens before and after in vitro simulated single level L4-5 and double level L4-5-S1 anterior interbody fusions. OBJECTIVE: The experimental objective was to study the biomechanical effects of single level L4-5 and double level L4-5-S1 anterior interbody fusions on the neighboring unfused segments. SUMMARY OF BACKGROUND DATA: The relationship between the local rigidity created by fusion mass and accelerated degeneration reported at the neighboring unfused intervertebral discs is not clear. METHODS: Six cadaveric lumbar spine specimens were biomechanically tested in flexion and extension. Segmental mobility and intradiscal pressure of the specimens were measured before and after in vitro simulation of single level L4-5 and double level L4-5-S1 anterior interbody fusions. RESULTS: The mobility of the motion segments immediately above and below an L4-5 fusion was increased in flexion. When the L5-S1 segment was also fused, the loss of segmental motion in both flexion and extension at the L4-5 and L5-S1 were compensated for by increased motion in all levels above the fusion. In both flexion and extension, the intradiscal pressures of all unfused intervertebral discs were increased after a single level L4-5 fusion and this increase was even more marked after a double level L4-5-S1 fusion. CONCLUSIONS: There is no evidence that the neighboring unfused segments are loaded beyond their physiological limits due to the fusion. However, the neighboring unfused segments have to work more frequently toward the extremes of their functional ranges of motion after fusion and these effects will be more marked after a double level L4-5-S1 fusion.

Aged↗

Measurement of cadaver lumbar spine motion segment stiffness.

STUDY DESIGN: Prospective. OBJECTIVES: To measure lumbar spine motion segment stiffness and relate it to the degree of disc degeneration. SUMMARY OF BACKGROUND DATA: The association between the instability of the lumbar spine motion segment and disc degeneration remains unclear. The traditional method for determining motion segment instability at the time of decompressive surgery is a manual test performed by the surgeon. To quantify instability of the lumbar spine, a vertebrae distractor was developed in the authors' laboratory to measure motion segment stiffness by applying a defined load at a constant rate. METHODS: Lumbar stiffness was measured by subjecting cadaver lumbar spine motion segments to a constant rate flexion-traction load and recording the magnitude of the resistance to distraction versus the range of motion. Disc degeneration was measured by pressure-volume discography and by grading of disc morphology. RESULTS: Motion segment stiffness decreased with the initial stages of disc degeneration and then increased with severe disc degeneration. This measure of motion segment stiffness correlated well with a manual stiffness measure. CONCLUSIONS: The observed results follow an accepted hypothesis of motion segment instability associated with disc degeneration.

Adult↗

Risk factors for adjacent segment degeneration after PLIF.

STUDY DESIGN: A retrospective study of 87 patients who underwent posterior lumbar interbody fusion (PLIF) at L4-L5 for L4 degenerative spondylolisthesis. OBJECTIVE: To clarify: 1) the correlation between radiologic degeneration of cranial adjacent segment and clinical results, 2) risk factors for radiologic degeneration of cranial adjacent segment, and 3) preoperative radiologic features of patients who underwent additional surgery with cranial adjacent segment degeneration. SUMMARY OF BACKGROUND DATA: Whereas PLIF with pedicle screw fixation has shown satisfactory clinical results, a solid fusion has been reported to accelerate a degenerative change at unfused adjacent levels, especially in the cranial level. Although several authors have reported the adjacent segment degeneration after PLIF, there are no previous reports of risk factors for adjacent segment degeneration after PLIF. MATERIALS AND METHODS: Eighty-seven patients who underwent PLIF for L4 degenerative spondylolisthesis and could be followed for at least 2 years were included in this study. We measured lumbar lordosis, scoliosis, laminar inclination angle at L3, facet sagittalization at L3-L4, facet tropism at L3-L4, preexisting disc degeneration at L3-L4, and lordosis at the fused segment. Progression of L3-L4 segment degeneration was defined as a condition in which disc narrowing, posterior opening, and progress of slippage in comparison with preoperative dynamic lateral radiographs. Patients were divided into three groups according to postoperative progression of L3-L4 degeneration: Group 1 with neither progression of L3-L4 degeneration nor neurologic deterioration, Group 2 with progression of L3-L4 degeneration but no neurologic deterioration, and Group 3 with an additional surgery required for neurologic deterioration. Correlation between clinical results and radiologic progression of L3-L4 degeneration, and risk factors for progression of radiologic degeneration were investigated. Further, preoperative radiologic features of Group 3 were studied to detect risk factors for clinical deterioration. RESULTS: There were 58 (67%) patients classified into Group 1, 25 (29%) patients into Group 2, and 4 (4%) patients into Group 3. There was no significant difference in average age in each group. No obvious difference was observed in recovery rate between Groups 1 and 2. Laminar inclination angle and facet tropism in Group 3 were more significant than those in Groups 1 and 2. Further, apparent lamina inclination and facet tropism coexisted in Group 3. There were no obvious differences in other factors between each group. CONCLUSION: 1) There was no correlation between radiologic degeneration of cranial adjacent segment and clinical results. 2) Risk factors for postoperative radiologic degeneration could not be detected in terms of each preoperative radiologic factor. 3) Coexistence of horizontalization of the lamina at L3 and facet tropism at L3-L4 may be one of the risk factors for neurologic deterioration resulting from accelerated L3-L4 degenerative change after L4-L5 PLIF.

Adult↗

Torso flexion loads and the fatigue failure of human lumbosacral motion segments.

STUDY DESIGN: Spine loads associated with lifting a 9-kg weight were estimated at three torso flexion angles (0 degrees, 22.5 degrees, and 45 degrees), and lumbosacral motion segments were cyclically loaded using these loads until failure or to a maximum of 10,020 cycles. OBJECTIVES: To simulate the postures and loads experienced by the lumbar spine during repetitive lifting of moderate weights in different torso flexion postures, and to analyze the fatigue failure response of lumbosacral motion segments. SUMMARY OF BACKGROUND DATA: Previous fatigue failure studies of lumbar motion segments have not reproduced the combination of spinal postures, loads, and load rates anticipated in different torso flexion postures during lifting tasks characteristic of those in occupational settings. METHODS: Twelve fresh human lumbosacral spines were dissected into three motion segments each (L1-L2, L3-L4, and L5-S1). Motion segments within each spine were randomly assigned to a simulated torso flexion angle (0 degrees, 22.5 degrees, or 45 degrees) using a partially balanced incomplete block experimental design. Spinal load and load rate were determined for each torso flexion angle using previously collected data from an EMG-assisted biomechanical model. Motion segments were creep loaded for 15 minutes, then cyclically loaded at 0.33 Hz. Fatigue life was taken as the number of cycles to failure (10 mm displacement after creep loading). Specimens were inspected to determine failure mechanisms. RESULTS: The degree of torso flexion had a dramatic impact on cycles to failure. Motion segments experiencing the 0 degrees torso flexion condition averaged 8,253 cycles to failure (+/-2,895), while the 22.5 degrees torso flexion angle averaged 3,257 (+/-4,443) cycles to failure, and motion segments at the 45 degrees torso flexion angle lasted only 263 cycles (+/-646), on average. The difference was significant at P < 0.0001, and torso flexion accounted for 50% of the total variance in cycles to failure. CONCLUSIONS: Fatigue failure of spinal tissues can occur rapidly when the torso is fully flexed during occupational lifting tasks; however, many thousands of cycles can be tolerated in a neutral posture. Future lifting recommendations should be sensitive to rapid development of fatigue failure in torso flexion.

Aged↗

Open-door laminoplasty for cervical myelopathy resulting from adjacent-segment disease in patients with previous anterior cervical decompression and fusion.

STUDY DESIGN: This is a retrospective study of patients with cervical myelopathy resulting from adjacent-segment disease who were treated by open-door expansive laminoplasty. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of laminoplasty for cervical myelopathy resulting from adjacent-segment disease. SUMMARY OF BACKGROUND DATA: Adjacent-segment disease is one of the problems associated with anterior cervical decompression and fusion. However, the optimal surgical management strategy is still controversial. METHODS: Thirty-one patients who underwent open-door expansive laminoplasty for cervical myelopathy resulting from adjacent-segment disease and age- and sex-matched 31 patients with myelopathy who underwent laminoplasty as the initial surgery were enrolled in the study. The pre- and postoperative Japanese Orthopedic Association scores (JOA scores) and the recovery rate were compared between the two groups. RESULTS: The average JOA scores in the patients with adjacent-segment disease and the controls were 9.2 +/- 2.6 and 9.4 +/- 2.3 before the expansive laminoplasty and 11.9 +/- 2.8 and 13.3 +/- 1.7 at the follow-up examination, respectively; the average recovery rates in the two groups were 37.1 +/- 22.4% and 50.0 +/- 21.3%, respectively (P = 0.04). The mean number of segments covered by the high-intensity lesions on the T2-weighted magnetic resonance images was 1.87 and 0.9, respectively (P = 0.001). CONCLUSIONS: Moderate neurologic recovery was obtained after open-door laminoplasty in patients with cervical myelopathy resulting from adjacent-segment disc disease, although the results were not as satisfactory as those in the control group. This may be attributed to the irreversible damage of the spinal cord caused by persistent compression at the adjacent segments.

Adult↗

Evidence for sequence heterogeneity among the double-stranded RNA segments of Penicillium chrysogenum mycovirus.

We have examined the dsRNA segments of the multipartite virus from Penicillium chrysogenum (ATCC 9480). A fourth RNA segment has been detected recently and, in the present work, we separated the four RNA segments and looked for possible homologies among them by thermal denaturation and electron microscopical heteroduplex studies. Differences were found between the differential melting profiles of the separated RNA segments, and no extensive regions of homology were detected among the various RNA segments by heteroduplex analyses. The results suggest that each RNA segment contains unique sequences. A comparison of the lengths of the RNA segments determined by electron microscopy with those determined by gel electrophoresis suggests that one of the segments has a distinct tertiary structure.

Electrophoresis, Agar Gel↗

Characterization of Chelonus inanitus polydnavirus segments: sequences and analysis, excision site and demonstration of clustering.

Polydnaviruses (genera Ichnovirus and Bracovirus) have a segmented genome of circular double-stranded DNA molecules, replicate in the ovary of parasitic wasps and are essential for successful parasitism of the host. Here we show the first detailed analysis of various segments of a bracovirus, the Chelonus inanitus virus (CiV). Four segments were sequenced and two of them, CiV12 and CiV14, were found to be closely related while CiV14.5 and CiV16.8 were unrelated. CiV12, CiV14.5 and CiV16.8 are unique while CiV14 occurs also nested in another larger segment. All four segments are predicted to contain genes and predictions could be substantiated in most cases. Comparison with databases revealed no significant similarities at either the nucleotide or amino acid level. Inverted repeats with identities between 77% and 92% and lengths between 26 bp and 100 bp were found on all segments outside of predicted genes. Hybridization experiments indicate that CiV12 and CiV14 are both flanked by other virus segments, suggesting that proviral CiV segments are clustered in the genome of the wasp. The integration/excision site of CiV14 was analysed and compared to that of CiV12. On both termini of proviral CiV12 and CiV14 as well as in the excised circular molecule and the rejoined DNA a very similar repeat of 14 bp was found. A model to illustrate where the terminal repeats might recombine to yield the circular molecule is presented. Excision of CiV12 and CiV14 is restricted to the female and sets in at a very specific time-point in pupal-adult development.

Animals↗