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Bad Facts
Published in R. Annie Gough, Injury Illustrated, 2020
Cruising through the night, Mickey hit another truck head-on. Ryanne smashed into the dash and continued to fly through the windshield into a dark, dry, grassy field. Unconscious at the scene, she was placed on a backboard with a visible open ankle fracture and a laceration on her thigh. Assessed urgently and passed through radiology, Ryanne was rushed into surgery. The doctors hoped to save her spinal cord from a serious compression fracture between T10 and T11. The surgeons successfully stabilized her spinal column, but could not save her spinal cord from paralysis. Additional fixation hardware was placed in her ankle, at the tibia, and fibula. Her jaw was wired shut. Mandible and skull base fractures were watched closely for associated intracranial pressure and bleeding. The young, pretty, and now paraplegic Ryanne was eventually discharged from the hospital into a rehabilitation facility.
Thoracolumbar spine injury
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Monica S. Tandon, Priyanka Khurana
The T–L junction (T11–L2) marks an abrupt transition between the long, rigid, kyphotic thoracic spine and the shorter, more dynamic, lordotic lumbar spine. Most of the bending and axial loads of the spine are concentrated at the T–L junction, hence, this biomechanically vulnerable zone is one of the most common sites for spine fractures. The T–L junction also represents the termination of the SC as conus medullaris (T11–L2/L3 in adults) and a further continuation of the lumbosacral roots as “cauda equina” through the sacral canal.
Complications related to neurogenic bladder dysfunction II: Vesicoureteral reflux and renal insufficiency
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Claire C. Yang, Brandon M. Haynes
Although signs of renal insufficiency may not be apparent on physical examination, providers should observe for evidence of volume overload and measure blood pressure. In addition, the findings of flank pain and costovertebral angle tenderness may indicate renal stones or pyelonephritis. In patients with SCI and others who are insensate at the T11–T12 spinal levels (levels at which renal innervation originates), these symptoms and examination findings might not be reported by the patient.
ADAM12 abrogation alters immune cell infiltration and improves response to checkpoint blockade therapy in the T11 murine model of triple-negative breast cancer
Published in OncoImmunology, 2023
Guanpeng Wang, Yeni Romero, Indhujah Thevarajan, Anna Zolkiewska
ADAM metalloproteases are the family of cell surface proteolytic enzymes expressed in cancer cells and/or in other cells in the TME.25–28 Since ADAMs have the capability to release or post-translationally modify various chemokines and cytokines,29–32 they are well positioned to modulate anti-tumor immune responses. Yet, the role of ADAMs in the recruitment, expansion, or activation of intratumoral immune cells in solid tumors, including TNBC, and in the modulation of ICB responses is poorly understood. In this study, we investigate the role of ADAM12, a prominent member of the ADAM family,33,34 in suppressing anti-tumor immunity and inhibiting ICB responses in the T11 mouse transplantation model of claudin-low breast cancer. T11 is a mouse cell line derived from a Tp53-/- mammary tumor syngeneic transplant.35,36 T11 cells have a mesenchymal appearance. When orthotopically injected into BALB/c mice, T11 cells form triple negative breast tumors with claudin-low features37 which are resistant to ICB treatment.18,19,38
Ultrasound-guided axial facet joint interventions for chronic spinal pain: A narrative review
Published in Canadian Journal of Pain, 2023
Michael J. Wong, Manikandan Rajarathinam
Facet joint sensory innervation is provided by the medial branches, which are terminal divisions of each nerve root’s dorsal ramus (Figure 2).33–36 In general, each facet joint receives dual innervation, from the same level and also the level above (e.g., the C3–C4 facet joint is innervated by the C3 and C4 medial branches, and the L2–L3 facet joint is innervated by the L1 and L2 medial branches); therefore, both contributing medial branches must be targeted to block sensation for a given facet joint. The localization of the medial branches varies depending on the region of the spine.29,37,38 Most cervical medial branches are found on the lateral waist of their respective vertebrae’s articular pillars. However, the superficial medial branch of C3 (third occipital nerve; TON) crosses the lateral surface of the C2–C3 joint, which it innervates, and the C7 medial branch is found at the junction of the C7 superior articular process and transverse process. Medial branches arising from T1 to T4 and T9 to T10 cross the superolateral margins of the transverse process below and then continue inferomedially. From T5 to T8, the medial branches are suspended just superior to the transverse process, in the intertransverse space. The T11 and T12 medial branches follow a course similar to that of the lumbar medial branches, which reliably pass over the junction of the transverse process and superior articular process of the level below. The L5–S1 facet joint is unique in that its innervation is thought to arise from the L5 dorsal ramus itself, rather than a discrete medial branch.29
Predicting the effective compressive modulus of human cancellous bone using the convolutional neural network method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Yongtao Lu, Zhuoyue Yang, Hanxing Zhu, Chengwei Wu
In the present study, the bone samples from elderly females were used. Because the microarchitecture of these bone samples can be hardly characterized in the regular clinical CT images, the high-resolution CT images (HR-pQCT) were used instead of the clinical CT images in the present study. The detailed procedure for acquiring the HR-pQCT images of the vertebral specimens was described in the previous studies (Lu et al. 2014; 2015). Briefly, thirty-five cadavers were harvested from the female patients with a mean age of 81.3 ± 7.2 year-old (range: 65-to 90-year-old). The spinal segments of T11/T12/L1 were dissected and the specimens were scanned in the frozen state using the HR-pQCT scanner (XtremeCT, Scanco Medical AG, Bruettisellen, Switzerland) operated at 59.4 kV, 900 µAs with an image voxel size of 82.0 × 82.0 × 82.0 µm3. An image sample of the T11/T12/L1 is shown in Figure 1. In the present study, only the cancellous fraction was used for the demonstration. Therefore, the volumes of interest covering only the cancellous bone were cropped out from the images of the spinal segments (Figure 1).