scholarly journals Surgical management of aneurysmal bone cysts of the spine

2003 ◽  
Vol 15 (5) ◽  
pp. 1-7 ◽  
Author(s):  
James K. Liu ◽  
Douglas L. Brockmeyer ◽  
Andrew T. Dailey ◽  
Meic H. Schmidt
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Bone Destruction ◽  
Unknown Origin ◽  
Neurological Deficits ◽  
Bone Cysts ◽  
Complete Excision ◽  
Aneurysmal Bone Cysts ◽  
Special Factors

Object Aneurysmal bone cysts of the spine are benign, highly vascular osseous lesions of unknown origin that may present difficult diagnostic and therapeutic challenges. They are expansile lesions containing thin-walled, blood-filled cystic cavities that cause bone destruction and sometimes spinal deformity and neurological compromise. The treatment of aneurysmal bone cysts of the spine remains controversial according to the literature. In this review, the authors discuss the clinical manifestations, pathophysiological features, neuroimaging characteristics, and treatment strategies for these lesions. Methods Treatment options include simple curettage with bone grafting, complete excision, embolization, and radiation therapy. Reconstruction and stabilization of the spine may be warranted if deformity and instability are present. Special factors need to be considered in the management of these lesions. Conclusions Complete excision of aneurysmal bone cysts offers the best chance of cure and spinal decompression if neurological deficits are present.

Using Naïve Bayes Algorithm to Estimate the Response to Drug in Lung Cancer Patients

2019 ◽  
Vol 21 (10) ◽  
pp. 734-748 ◽  
Author(s):  
Baoling Guo ◽  
Qiuxiang Zheng
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Drug Response ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cancer Resistance ◽  
Lung Cancer Patients ◽  
Bayes Algorithm

Aim and Objective: Lung cancer is a highly heterogeneous cancer, due to the significant differences in molecular levels, resulting in different clinical manifestations of lung cancer patients there is a big difference. Including disease characterization, drug response, the risk of recurrence, survival, etc. Method: Clinical patients with lung cancer do not have yet particularly effective treatment options, while patients with lung cancer resistance not only delayed the treatment cycle but also caused strong side effects. Therefore, if we can sum up the abnormalities of functional level from the molecular level, we can scientifically and effectively evaluate the patients' sensitivity to treatment and make the personalized treatment strategies to avoid the side effects caused by over-treatment and improve the prognosis. Result & Conclusion: According to the different sensitivities of lung cancer patients to drug response, this study screened out genes that were significantly associated with drug resistance. The bayes model was used to assess patient resistance.

scholarly journals From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 22 (2) ◽  
pp. 686
Author(s):  
Chao-Yi Wu ◽  
Huang-Yu Yang ◽  
Shue-Fen Luo ◽  
Jenn-Haung Lai
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Bone Destruction ◽  
Response To Therapy ◽  
Current Evidence ◽  
Prognosis Prediction ◽  
Diagnosis And Prognosis ◽  
Systemic Inflammatory Disease ◽  
Citrullinated Protein

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy.

Aneurysmal bone cysts of the spine: treatment options and considerations

2014 ◽  
Vol 120 (1) ◽  
pp. 171-178 ◽  
Author(s):  
Stefano Boriani ◽  
◽  
Sheng-fu L. Lo ◽  
Varun Puvanesarajah ◽  
Charles G. Fisher ◽  
...  
Keyword(s):  
Treatment Options ◽  
Bone Cysts ◽  
Aneurysmal Bone Cysts

scholarly journals Aneurysmal bone cyst in thoracolumbar spine

2020 ◽  
Vol 6 (3) ◽  
pp. 20190133
Author(s):  
Alex Kiu ◽  
Tiffany Fung ◽  
Pranav Chowdhary ◽  
Sungmi Jung ◽  
Tom Powell ◽  
...  
Keyword(s):  
Treatment Options ◽  
Bone Cyst ◽  
Thoracolumbar Spine ◽  
Cord Compression ◽  
Central Canal ◽  
Neurological Deficits ◽  
Primary Bone Tumors ◽  
Canal Stenosis ◽  
Aneurysmal Bone Cysts ◽  
Primary Bone

Aneurysmal bone cysts (ABC) are rare, benign primary bone tumors. Although benign, they can be locally aggressive resulting in erosion of bone and surrounding tissues over time. In later stages, depending on the clinical urgency, immunotherapy or surgical resection remain treatment options. This report illustrates a case of a 32-year-old female who presented with chronic worsening low back pain without neurological deficits. Radiological imaging revealed a large destructive mass arising from the thoracic spine invading into the central canal, causing critical central stenosis and cord compression. Histopathology revealed ABC. This case highlights the importance of including ABCs and other ‘benign’/locally aggressive lesions in the differential of patients with insidious musculoskeletal complaints. This case also demonstrates that one can be neurologically asymptomatic despite having critical central canal stenosis and cord compression if the causative lesion is slow growing. Understanding this allows us to arrange for most appropriate management.

Surgical treatment for primary spinal aneurysmal bone cysts: experience from Children's Hospital Boston

2012 ◽  
Vol 9 (3) ◽  
pp. 305-315 ◽  
Author(s):  
Georgios Zenonos ◽  
Osama Jamil ◽  
Lance S. Governale ◽  
Sarah Jernigan ◽  
Daniel Hedequist ◽  
...  
Keyword(s):  
Spinal Instrumentation ◽  
Neurological Deficits ◽  
Preoperative Embolization ◽  
Bone Cysts ◽  
Children's Hospital ◽  
Initial Intervention ◽  
Children’S Hospital ◽  
Aneurysmal Bone Cysts

Object Spinal aneurysmal bone cysts (ABCs) constitute a rare and clinically challenging disease, primarily affecting the pediatric population. Information regarding the management of spinal ABCs remains sparse. In this study the authors review their experience with spinal ABCs at Children's Hospital Boston. Methods The medical records of all patients treated surgically for primary spinal ABCs between January 1998 and July 2010 were retrospectively reviewed. Results Fourteen cases were identified (6 males and 8 females, ages 5–19 years old). The ABCs were located throughout the spine, with an equal number in the thoracic and lumbar spine, and rarely in the cervical spine. The majority of patients presented with back pain, but neurological deficits and spinal deformity were common. A variety of radiographic techniques were used to establish the diagnosis, including needle biopsy. Preoperative selective arterial embolization was performed in 7 cases (50%), and the majority of cases required spinal instrumentation along with resection. Mean follow-up was 55.9 months (range 15–154 months) after initial intervention. Two ABCs recurred (14%), at 9 months and 8 years after incomplete initial resection, and the patients underwent reoperation. Complete resection was ultimately achieved in all cases. All patients were asymptomatic and neurologically intact at their last follow-up evaluation, and showed no evidence of deformity or recurrence on imaging. Conclusions Computed tomography and MR imaging are adequate for an initial evaluation of spinal ABCs, although solid variants can present a diagnostic challenge. Given the high rates of recurrence with residual disease, complete obliteration of the lesion should be the goal of treatment. Preoperative embolization is often performed, although in the authors' opinion the degree of bleeding tends not to support its routine use. Long-term follow-up is warranted as recurrences can occur years after initial intervention. However, gross-total excision in conjunction with spinal stabilization, as needed, usually provides cure of the ABC and excellent long-term spinal alignment.

scholarly journals Lipoma of the cerebellopontine angle: case reports and literature review

1994 ◽  
Vol 52 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Marcelo P. Ferreira ◽  
Nelson P. Ferreira ◽  
Rene Lenhardt
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Cerebellopontine Angle ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Diagnostic Methods ◽  
Surgical Indications ◽  
Complete Excision

Two patients with cerebellopontine angle (CPA) lipoma were studied. They were submitted to surgical treatment. Available literature was reviewed and 29 cases with same lesion were identified which had been treated by surgery. Clinical manifestations, possibility of diagnostic methods, surgical indications and treatment strategies are discussed. Attention is called to the peculiarities of CPA lipomas and the doubtful vality of attempting complete excision in all cases.

scholarly journals Aneurysmal Bone Cyst of the Skull

1984 ◽  
Vol 11 (4) ◽  
pp. 466-471 ◽  
Author(s):  
N.O. Ameli ◽  
K. Abbassioun ◽  
A. Azod ◽  
H. Saleh
Keyword(s):  
Young Adults ◽  
Aneurysmal Bone Cyst ◽  
Low Dose ◽  
Bone Cyst ◽  
Bone Cysts ◽  
Complete Excision ◽  
Low Dose Radiotherapy ◽  
Aneurysmal Bone Cysts ◽  
Children And Young Adults ◽  
Prompt Diagnosis

ABSTRACTAneurysmal bone cysts rarely affect the skull. Thirty-six cases including four reported in this paper are reviewed. The condition usually affects children and young adults and progresses rapidly. It may result in raised intracranial or intraorbital pressure. Complete excision of the mass is the treatment of choice, but if not feasible curettage followed by low dose radiotherapy is effective. As the prognosis in this condition is good, prompt diagnosis and early treatment are of utmost importance.

scholarly journals Anterior thoracic intradural arachnoid cysts

1999 ◽  
Vol 6 (5) ◽  
pp. E10 ◽  
Author(s):  
Gerardo Caruso ◽  
Antonino Germanò ◽  
Mariella Caffo ◽  
Massimo Belvedere ◽  
Giovanni La Rosa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Treatment Options ◽  
Relevant Literature ◽  
Spastic Paraparesis ◽  
Treatment Strategies ◽  
Arachnoid Cysts ◽  
Complete Excision ◽  
Medline Search ◽  
Excellent Outcome ◽  
Intradural Arachnoid Cysts

Anterior thoracic intradural arachnoid cysts (ATIACs) are a rare cause of spinal cord and nerve root compression, for which different treatment strategies have been proposed. Although ATIAC represents a well-known clinical entity, the choice of surgical method has not been uniform, and no study has been specifically designed to compare the results of the different treatment options adopted. The authors report the case of a 40-year old man with a 1-year history of dorsal pain, weakness in the lower extremities, gait disturbance, and mild sexual and urinary dysfunction. On neurological examination spastic paraparesis, lower-extremity hypertonia, and hypesthesia below T-2 were demonstrated. Magnetic resonance imaging revealed the presence of an ATIAC at the T-2 level. The patient underwent complete microsurgical removal of the cyst. The authors conducted a Medline search of the relevant literature from 1966 to 1998 and also obtained data on other cases in which patients underwent surgical treatment of ATIAC. The literature search yielded five such cases. Treatment strategies were complete excision and fenestration followed by placement of a shunt. In addition, one case was characterized by intraoperative cyst rupture during retraction of the spinal cord. Correct preoperative workup coupled with microneurosurgical technique allow for successful removal of the lesion and excellent outcome. Based on the literature review and the results in our case, the complete excision of ATIAC is associated with an excellent outcome, which is different from results achieved using other surgical strategies.

scholarly journals AB5 Enterotoxin-Mediated Pathogenesis: Perspectives Gleaned from Shiga Toxins

Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 62
Author(s):  
Erika N. Biernbaum ◽  
Indira T. Kudva
Keyword(s):  
Foodborne Pathogens ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Antibiotic Use ◽  
Fluid Replacement ◽  
Shiga Toxins ◽  
Increased Risk ◽  
Uremic Syndrome ◽  
Primary Focus

Foodborne diseases affect an estimated 600 million people worldwide annually, with the majority of these illnesses caused by Norovirus, Vibrio, Listeria, Campylobacter, Salmonella, and Escherichia coli. To elicit infections in humans, bacterial pathogens express a combination of virulence factors and toxins. AB5 toxins are an example of such toxins that can cause various clinical manifestations, including dehydration, diarrhea, kidney damage, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Treatment of most bacterial foodborne illnesses consists of fluid replacement and antibiotics. However, antibiotics are not recommended for infections caused by Shiga toxin-producing E. coli (STEC) because of the increased risk of HUS development, although there are conflicting views and results in this regard. Lack of effective treatment strategies for STEC infections pose a public health threat during outbreaks; therefore, the debate on antibiotic use for STEC infections could be further explored, along with investigations into antibiotic alternatives. The overall goal of this review is to provide a succinct summary on the mechanisms of action and the pathogenesis of AB5 and related toxins, as expressed by bacterial foodborne pathogens, with a primary focus on Shiga toxins (Stx). The role of Stx in human STEC disease, detection methodologies, and available treatment options are also briefly discussed.

scholarly journals Takayasu’s Arteritis: An Uncommon Cause of Renal Artery Stenosis and Therapeutic Considerations

2013 ◽  
Vol 6 (1) ◽  
pp. 14-19
Author(s):  
Mary Virmani1 ◽  
Luis Ortega ◽  
Loay Salman ◽  
Tushar Vachharajani ◽  
Arif Asif ◽  
...  
Keyword(s):  
Takayasu’S Arteritis ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Transluminal Angioplasty ◽  
Cytotoxic Agents ◽  
Takayasu's Arteritis ◽  
Revascularization Procedures ◽  
Therapeutic Considerations

Takayasu’s arteritis is a rare disorder characterized by granulomatous and necro-inflammatory disease of the aorta and its major branches. Its etiology remains unknown. We report a young woman with Takayasu’s arteritis affecting the aortic arch, carotid, mesenteric, celiac and bilateral renal arteries resulting in severe hypertension, unilateral renal atrophy and renal insufficiency. The immunosuppressive therapy did not halt the progression of her vascular disease, which required revascularization procedures on numerous occasions. Here, the clinical manifestations and histopathological features of Takayasu’s arteritis are reviewed. In addition, the available medical treatment options including glucocorticoids, cytotoxic agents and TNF-alpha inhibitors are discussed. Furthermore, current revascularization procedures such as percutaneous transluminal angioplasty and reconstructive vascular surgery in the treatment of occlusive vasculopathy due to Takayasu’s arteritis are discussed. Although the prognosis of this debilitating disease has improved over the past two decades, a better understanding of its etiology and pathogenesis will facilitate the discovery of effective target-specific treatment strategies with a narrow adverse effects profile.

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