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1.  Cervical spine motion during swallowing 
European Spine Journal  2013;22(11):2558-2563.
There have been several studies regarding the relationship between deglutition and the cervical spine; however, the movement of the cervical spine during deglutition has not been specifically studied. The purpose of the present study was to clarify how the cervical spine moves during normal deglutition.
We conducted videofluorography in 39 healthy individuals (23 men; 16 women; mean age, 34.3 years) with no evidence of cervical spine disease and analyzed images of the oral and pharyngeal phases of swallowing using an image analysis technique. Analyzed sections included the occiput (C0) and the first to seventh cervical vertebrae (C1–C7). The degrees of change in angle and position were quantified in the oral and pharyngeal phases.
In the pharyngeal phase, C1, C2, and C3 were flexed (the angle change in C2 was the most significant with a mean flexion angle of 1.42°), while C5 and C6 were extended (the angle change in C5 was the most significant with a mean extension angle of 0.74°) in reference to the oral phase. Angle changes in C0, C4, and C7 were not statistically significant. C3, C4, C5, and C6 moved posteriorly (the movement in C4 was the most significant, mean = 1.04 mm). C1, C2, and C3 moved superiorly (the movement in C2 was the largest, mean = 0.55 mm), and C5 and C6 moved inferiorly. Movements in C0 and C7 were not statistically significant.
These findings suggest that the cervical spine moves to reduce physiological lordosis during deglutition.
PMCID: PMC3886508  PMID: 23996008
Cervical spine; Deglutition; Swallowing; Dysphagia; Videofluorographic study; Manuscript text
2.  Neuroprotective therapy using granulocyte colony-stimulating factor for acute spinal cord injury: a phase I/IIa clinical trial 
European Spine Journal  2012;21(12):2580-2587.
Granulocyte colony-stimulating factor (G-CSF) is a cytokine that is clinically used to treat neutropenia. G-CSF also has non-hematopoietic functions and could potentially be used to treat neuronal injury. To confirm the safety and feasibility of G-CSF administration for acute spinal cord injury (SCI), we have initiated a phase I/IIa clinical trial of neuroprotective therapy using G-CSF.
The trial included a total of 16 SCI patients within 48 h of onset. In the first step, G-CSF (5 μg/kg/day) was intravenously administered for 5 consecutive days to 5 patients. In the second step, G-CSF (10 μg/kg/day) was similarly administered to 11 patients. We evaluated motor and sensory functions of patients using the American Spinal Cord Injury Association (ASIA) score and ASIA impairment scale (AIS) grade.
In all 16 patients, neurological improvement was obtained after G-CSF administration. AIS grade increased by one step in 9 of 16 patients. A significant increase in ASIA motor scores was detected 1 day after injection (P < 0.01), and both light touch and pin prick scores improved 2 days after injection (P < 0.05) in the 10 μg group. No severe adverse effects were observed after G-CSF injection.
These results indicate that intravenous administration of G-CSF (10 μg/kg/day) for 5 days is essentially safe, and suggest that some neurological recovery may occur in most patients. We suggest that G-CSF administration could be therapeutic for patients with acute SCI.
PMCID: PMC3508205  PMID: 22391867
Spinal cord injury; Neuroprotective therapy; G-CSF; Clinical trial
3.  Motion Induced Artifact Mimicking Cervical Dens Fracture on the CT Scan: A Case Report 
Asian Spine Journal  2012;6(3):216-218.
The diagnostic performance of helical computed tomography (CT) is excellent. However, some artifacts have been reported, such as motion, beam hardening and scatter artifacts. We herein report a case of motion-induced artifact mimicking cervical dens fracture. A 60-year-old man was involved in a motorcycle accident that resulted in cervical spinal cord injury and quadri plegia. Reconstructed CT images of the cervical spine showed a dens fracture. We assessed axial CT in detail, and motion artifact was detected.
PMCID: PMC3429615  PMID: 22977704
Reconstruction; Motion artifact; Mimicking; Cervical fracture
4.  Arterial spin-labeled MRI study of migraine attacks treated with rizatriptan 
The Journal of Headache and Pain  2010;11(3):255-258.
Spin-tag perfusion imaging is an MRI method that quantitatively measures cerebral blood flow. Compared with conventional perfusion techniques, advantages of this arterial spin-labeling (ASL) include repeatability and the avoidance of intravenous contrast administration. In the present study, we performed an analysis of 3T high-field MRI examinations utilizing ASL perfusion during migraine attacks. A 32-year-old male patient was studied in three situations: during migraine attack within 1 h post-onset, 30 min after oral administration of rizatriptan 10 mg, and attack-free period. Normalized ASL images acquired during migraine attack showed significant relative hypoperfusion in the bilateral median thalamic areas including hypothalamus and significant relative hyperperfusion in the frontal cortex compared to images acquired during the migraine-free state. When normalized ASL images acquired 30 min after treatment were compared with those acquired during the attack, relative improvement of perfusion in the bilateral median thalamic areas including hypothalamus was observed. Hypothalamus and its surrounding areas may participate in the pathogenesis in migraine attack.
PMCID: PMC3451919  PMID: 20411294
Arterial spin labeling; MRI; Migraine without aura; Hypothalamus
5.  Translocation of Inhaled Ultrafine Manganese Oxide Particles to the Central Nervous System 
Environmental Health Perspectives  2006;114(8):1172-1178.
Studies in monkeys with intranasally instilled gold ultrafine particles (UFPs; < 100 nm) and in rats with inhaled carbon UFPs suggested that solid UFPs deposited in the nose travel along the olfactory nerve to the olfactory bulb.
To determine if olfactory translocation occurs for other solid metal UFPs and assess potential health effects, we exposed groups of rats to manganese (Mn) oxide UFPs (30 nm; ~ 500 μg/m3) with either both nostrils patent or the right nostril occluded. We analyzed Mn in lung, liver, olfactory bulb, and other brain regions, and we performed gene and protein analyses.
After 12 days of exposure with both nostrils patent, Mn concentrations in the olfactory bulb increased 3.5-fold, whereas lung Mn concentrations doubled; there were also increases in striatum, frontal cortex, and cerebellum. Lung lavage analysis showed no indications of lung inflammation, whereas increases in olfactory bulb tumor necrosis factor-α mRNA (~ 8-fold) and protein (~ 30-fold) were found after 11 days of exposure and, to a lesser degree, in other brain regions with increased Mn levels. Macrophage inflammatory protein-2, glial fibrillary acidic protein, and neuronal cell adhesion molecule mRNA were also increased in olfactory bulb. With the right nostril occluded for a 2-day exposure, Mn accumulated only in the left olfactory bulb. Solubilization of the Mn oxide UFPs was < 1.5% per day.
We conclude that the olfactory neuronal pathway is efficient for translocating inhaled Mn oxide as solid UFPs to the central nervous system and that this can result in inflammatory changes. We suggest that despite differences between human and rodent olfactory systems, this pathway is relevant in humans.
PMCID: PMC1552007  PMID: 16882521
brain; central nervous system; CNS; inhalation; intranasal instillation; manganese; metals; nose; olfactory bulb; respiratory tract

Results 1-5 (5)