Spinal Cord Neoplasms: Benign and malignant neoplasms which occur within the substance of the spinal cord (intramedullary neoplasms) or in the space between the dura and spinal cord (intradural extramedullary neoplasms). The majority of intramedullary spinal tumors are primary CNS neoplasms including ASTROCYTOMA; EPENDYMOMA; and LIPOMA. Intramedullary neoplasms are often associated with SYRINGOMYELIA. The most frequent histologic types of intradural-extramedullary tumors are MENINGIOMA and NEUROFIBROMA.Spinal Cord: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).Spinal Cord Diseases: Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord.Spinal Cord Compression: Acute and chronic conditions characterized by external mechanical compression of the SPINAL CORD due to extramedullary neoplasm; EPIDURAL ABSCESS; SPINAL FRACTURES; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence.Spinal Cord Ischemia: Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness.Spinal Nerve Roots: Paired bundles of NERVE FIBERS entering and leaving the SPINAL CORD at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots are efferent, comprising the axons of spinal motor and PREGANGLIONIC AUTONOMIC FIBERS.Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included.Motor Neurons: Neurons which activate MUSCLE CELLS.Spinal Cord Regeneration: Repair of the damaged neuron function after SPINAL CORD INJURY or SPINAL CORD DISEASES.Spinal NeoplasmsSpinal Canal: The cavity within the SPINAL COLUMN through which the SPINAL CORD passes.Cervical Vertebrae: The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Quadriplegia: Severe or complete loss of motor function in all four limbs which may result from BRAIN DISEASES; SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or rarely MUSCULAR DISEASES. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper BRAIN STEM which injures the descending cortico-spinal and cortico-bulbar tracts.Thoracic Vertebrae: A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region.Spinal DiseasesUmbilical Cord: The flexible rope-like structure that connects a developing FETUS to the PLACENTA in mammals. The cord contains blood vessels which carry oxygen and nutrients from the mother to the fetus and waste products away from the fetus.Posterior Horn Cells: Neurons in the SPINAL CORD DORSAL HORN whose cell bodies and processes are confined entirely to the CENTRAL NERVOUS SYSTEM. They receive collateral or direct terminations of dorsal root fibers. They send their axons either directly to ANTERIOR HORN CELLS or to the WHITE MATTER ascending and descending longitudinal fibers.Laminectomy: A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Lumbosacral Region: Region of the back including the LUMBAR VERTEBRAE, SACRUM, and nearby structures.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Nerve Regeneration: Renewal or physiological repair of damaged nerve tissue.Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body.Spinal Stenosis: Narrowing of the spinal canal.Pancreatic Neoplasms: Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).Ganglia, Spinal: Sensory ganglia located on the dorsal spinal roots within the vertebral column. The spinal ganglion cells are pseudounipolar. The single primary branch bifurcates sending a peripheral process to carry sensory information from the periphery and a central branch which relays that information to the spinal cord or brain.Spinal Cord Stimulation: Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms.Spinal Fusion: Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed)Spinal Injuries: Injuries involving the vertebral column.Anterior Horn Cells: MOTOR NEURONS in the anterior (ventral) horn of the SPINAL CORD which project to SKELETAL MUSCLES.Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; AUTOIMMUNE DISEASES; SPINAL CORD; and ischemia (see also SPINAL CORD VASCULAR DISEASES). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Cordotomy: Any operation on the spinal cord. (Stedman, 26th ed)Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents.Paralysis: A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Muscular Atrophy, Spinal: A group of disorders marked by progressive degeneration of motor neurons in the spinal cord resulting in weakness and muscular atrophy, usually without evidence of injury to the corticospinal tracts. Diseases in this category include Werdnig-Hoffmann disease and later onset SPINAL MUSCULAR ATROPHIES OF CHILDHOOD, most of which are hereditary. (Adams et al., Principles of Neurology, 6th ed, p1089)Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the NERVOUS SYSTEM.Neoplasms, Cystic, Mucinous, and Serous: Neoplasms containing cyst-like formations or producing mucin or serum.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Electric Stimulation Therapy: Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the threshold of the skin to pain.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Myelography: X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Electric Stimulation: Use of electric potential or currents to elicit biological responses.Spine: The spinal or vertebral column.Epidural Space: Space between the dura mater and the walls of the vertebral canal.Afferent Pathways: Nerve structures through which impulses are conducted from a peripheral part toward a nerve center.Urinary Bladder, Neurogenic: Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.Hematoma, Epidural, Spinal: A rare epidural hematoma in the spinal epidural space, usually due to a vascular malformation (CENTRAL NERVOUS SYSTEM VASCULAR MALFORMATIONS) or TRAUMA. Spontaneous spinal epidural hematoma is a neurologic emergency due to a rapidly evolving compressive MYELOPATHY.Hindlimb: Either of two extremities of four-footed non-primate land animals. It usually consists of a FEMUR; TIBIA; and FIBULA; tarsals; METATARSALS; and TOES. (From Storer et al., General Zoology, 6th ed, p73)Neurons, Afferent: Neurons which conduct NERVE IMPULSES to the CENTRAL NERVOUS SYSTEM.Nociceptors: Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.Lumbar Vertebrae: VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE.Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.Neoplasms, Multiple Primary: Two or more abnormal growths of tissue occurring simultaneously and presumed to be of separate origin. The neoplasms may be histologically the same or different, and may be found in the same or different sites.Lampreys: Common name for the only family (Petromyzontidae) of eellike fish in the order Petromyzontiformes. They are jawless but have a sucking mouth with horny teeth.Skin Neoplasms: Tumors or cancer of the SKIN.Cats: The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801)Motor Activity: The physical activity of a human or an animal as a behavioral phenomenon.Autonomic Dysreflexia: A syndrome associated with damage to the spinal cord above the mid thoracic level (see SPINAL CORD INJURIES) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include HYPERTENSION; TACHYCARDIA (or reflex bradycardia); FEVER; FLUSHING; and HYPERHIDROSIS. Extreme hypertension may be associated with a STROKE. (From Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; J Spinal Cord Med 1997;20(3):355-60)Interneurons: Most generally any NEURONS which are not motor or sensory. Interneurons may also refer to neurons whose AXONS remain within a particular brain region in contrast to projection neurons, which have axons projecting to other brain regions.Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts.Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Tuberculosis, Spinal: Osteitis or caries of the vertebrae, usually occurring as a complication of tuberculosis of the lungs.Myelin Sheath: The lipid-rich sheath surrounding AXONS in both the CENTRAL NERVOUS SYSTEMS and PERIPHERAL NERVOUS SYSTEM. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (SCHWANN CELLS in the peripheral and OLIGODENDROGLIA in the central nervous system). Deterioration of the sheath in DEMYELINATING DISEASES is a serious clinical problem.Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges.Fetal Blood: Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery.Physical Stimulation: Act of eliciting a response from a person or organism through physical contact.Neuroglia: The non-neuronal cells of the nervous system. They not only provide physical support, but also respond to injury, regulate the ionic and chemical composition of the extracellular milieu, participate in the BLOOD-BRAIN BARRIER and BLOOD-RETINAL BARRIER, form the myelin insulation of nervous pathways, guide neuronal migration during development, and exchange metabolites with neurons. Neuroglia have high-affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitters, but their role in signaling (as in many other functions) is unclear.Contusions: Injuries resulting in hemorrhage, usually manifested in the skin.Evoked Potentials, Somatosensory: The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM.Kidney Neoplasms: Tumors or cancers of the KIDNEY.Brain Stem: The part of the brain that connects the CEREBRAL HEMISPHERES with the SPINAL CORD. It consists of the MESENCEPHALON; PONS; and MEDULLA OBLONGATA.Spinal Curvatures: Deformities of the SPINE characterized by abnormal bending or flexure in the vertebral column. They may be bending forward (KYPHOSIS), backward (LORDOSIS), or sideway (SCOLIOSIS).Oligodendroglia: A class of large neuroglial (macroglial) cells in the central nervous system. Oligodendroglia may be called interfascicular, perivascular, or perineuronal (not the same as SATELLITE CELLS, PERINEURONAL of GANGLIA) according to their location. They form the insulating MYELIN SHEATH of axons in the central nervous system.Spermatic Cord: Either of a pair of tubular structures formed by DUCTUS DEFERENS; ARTERIES; VEINS; LYMPHATIC VESSELS; and nerves. The spermatic cord extends from the deep inguinal ring through the INGUINAL CANAL to the TESTIS in the SCROTUM.Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.Syringomyelia: Longitudinal cavities in the spinal cord, most often in the cervical region, which may extend for multiple spinal levels. The cavities are lined by dense, gliogenous tissue and may be associated with SPINAL CORD NEOPLASMS; spinal cord traumatic injuries; and vascular malformations. Syringomyelia is marked clinically by pain and PARESTHESIA, muscular atrophy of the hands, and analgesia with thermoanesthesia of the hands and arms, but with the tactile sense preserved (sensory dissociation). Lower extremity spasticity and incontinence may also develop. (From Adams et al., Principles of Neurology, 6th ed, p1269)Neoplasms, Second Primary: Abnormal growths of tissue that follow a previous neoplasm but are not metastases of the latter. The second neoplasm may have the same or different histological type and can occur in the same or different organs as the previous neoplasm but in all cases arises from an independent oncogenic event. The development of the second neoplasm may or may not be related to the treatment for the previous neoplasm since genetic risk or predisposing factors may actually be the cause.Muscle Spasticity: A form of muscle hypertonia associated with upper MOTOR NEURON DISEASE. Resistance to passive stretch of a spastic muscle results in minimal initial resistance (a "free interval") followed by an incremental increase in muscle tone. Tone increases in proportion to the velocity of stretch. Spasticity is usually accompanied by HYPERREFLEXIA and variable degrees of MUSCLE WEAKNESS. (From Adams et al., Principles of Neurology, 6th ed, p54)Efferent Pathways: Nerve structures through which impulses are conducted from a nerve center toward a peripheral site. Such impulses are conducted via efferent neurons (NEURONS, EFFERENT), such as MOTOR NEURONS, autonomic neurons, and hypophyseal neurons.Strychnine: An alkaloid found in the seeds of STRYCHNOS NUX-VOMICA. It is a competitive antagonist at glycine receptors and thus a convulsant. It has been used as an analeptic, in the treatment of nonketotic hyperglycinemia and sleep apnea, and as a rat poison.Cauda Equina: The lower part of the SPINAL CORD consisting of the lumbar, sacral, and coccygeal nerve roots.Spinal Muscular Atrophies of Childhood: A group of recessively inherited diseases that feature progressive muscular atrophy and hypotonia. They are classified as type I (Werdnig-Hoffman disease), type II (intermediate form), and type III (Kugelberg-Welander disease). Type I is fatal in infancy, type II has a late infantile onset and is associated with survival into the second or third decade. Type III has its onset in childhood, and is slowly progressive. (J Med Genet 1996 Apr:33(4):281-3)Animals, Newborn: Refers to animals in the period of time just after birth.Decompression, Surgical: A surgical operation for the relief of pressure in a body compartment or on a body part. (From Dorland, 28th ed)Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Glial Fibrillary Acidic Protein: An intermediate filament protein found only in glial cells or cells of glial origin. MW 51,000.Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; MUSCULAR DISEASES; INTRACRANIAL HYPERTENSION; parasagittal brain lesions; and other conditions.Spinal Fractures: Broken bones in the vertebral column.Wheelchairs: Chairs mounted on wheels and designed to be propelled by the occupant.

*  Intramedullary Spinal Cord Tumors

Intramedullary Spinal Cord Tumors Leslie Hutchins, MD Shore Memorial Cancer Conference September 18, 2008 ... Classification of Spinal Cord Lesions * 17. Pediatric Intramedullary Spinal Cord Tumors ,ul,,li,4-6% of Pediatric CNS Neoplasms ... 8. Spinal Cord Cross Section: Fiber Tracts * 9. Spinal Cord Anatomy: Vasculature ,ul,,li,Upper Cervical Spine ,/li,,/ul,,ul,,ul ... 5. Spinal Cord Anatomy ,ul,,li,31 pairs of spinal nerves (Each formed by 2 roots) ,/li,,/ul,,ul,,li,The spinal nerves exit ...

*  Intramedullary schwannoma of the spinal cord. A case report and review of the literature.

Spinal Cord Neoplasms / pathology*, surgery. From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine ...

*  EPB41L3 Gene - GeneCards | E41L3 Protein | E41L3 Antibody

spinal cord ependymoma. *ependymal neoplasm of the spinal cord. meningioma, familial. *meningioma ... Diseases associated with EPB41L3 include Bejel and Spinal Cord Ependymoma. Among its related pathways are Protein-protein ... This gene is overexpressed in Frontal cortex (30.3), Brain (14.6), and Spinal cord (8.3). ... This gene is overexpressed in Brain - Spinal cord (cervical c-1) (x4.4). ...

*  Study of SBRT Efficacy on Intra and Extra -Cranial Tumors or Metastasis in Pediatrics Population (SBRT Pediatrics) - Full Text...

Neoplasms. Neoplasm Metastasis. Spinal Cord Neoplasms. Spinal Neoplasms. Neoplasms, Neuroepithelial. Neuroectodermal Tumors. ... Central Nervous System Neoplasms. Nervous System Neoplasms. Neoplasms by Site. Spinal Cord Diseases. Bone Neoplasms. Spinal ... Neoplasms, Germ Cell and Embryonal. Neoplasms by Histologic Type. Neoplasms, Glandular and Epithelial. Neoplasms, Nerve Tissue ... Spinal metastasis. Pulmonary primary tumor. Spinal primary tumor. Relapsed irradiated tumors. Pediatrics. SBRT. Pulmonary ...
https://clinicaltrials.gov/ct2/show/NCT02013297?term=Brain and Spinal Tumors&rank=9

*  Surgical Spinal Decompression of Metastatic Spinal Cord Compression, Minimal Access Versus Open Surgery

... traditional open surgery spinal surgery in patients with meta ... wish to evaluate the effect of minimal access spinal surgery ... metastatic spinal cord compression. *EQ-5D. *HRQOL. *Neoplasm Metastasis. *Spinal Cord Compression ... Surgical Spinal Decompression of Metastatic Spinal Cord Compression, Minimal Access Versus Open Surgery. A Randomized Clinical ... Surgical Spinal Decompression of Metastatic Spinal Cord Compression, Minimal Access Versus Open Surgery. A Randomized Clinical ...

*  Wesley Hsu, MD, Neurosurgery - Wake Forest Baptist, North Carolina

Spinal Neoplasms; Spinal Cord Neoplasms; Chordoma; Neurosurgical Procedures; Thoracic Vertebrae More » Contact Information. ... Animal model of intramedullary spinal cord glioma using human glioblastoma multiforme neurospheres. Hsu W, Siu I-M, Pradilla G ... Malignant transformation of an intramedullary epidermoid cyst in the thoracic region of the spinal cord: case report. ... Pediatric spinal tumors. Hsu W, Jallo GI. In: Vinken PJ, Bruyn GW, eds. Handbook of clinical neurology. New York: Elsevier;2013 ...

*  https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq

Brain and spinal cord. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: ... Disease progression, subsequent neoplasms, or recurrences. There are no randomized trials to delineate the role of repeat ... High-quality MRI is the diagnostic study of choice in the evaluation of intramedullary and extramedullary spinal cord lesions.[ ... Childhood Brain and Spinal Cord Tumors Treatment Overview (treatment of brain tumors in children). ...

*  Volumetric modulated arc therapy planning for distal oesophageal malignancies.

... spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were ... Esophageal Neoplasms / pathology, radiotherapy*. Heart / radiation effects. Humans. Radiotherapy Dosage. Radiotherapy Planning ... The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy ,20%, was evaluated for ...

*  Case Reports - Reviews sub-cluster 49

AT/RT of the paraspinal region with involvement of the spine and spinal cord is extremely rare, with only few case reports in ... In most cases, the underlying cause of TIO is a small mesenchymal neoplasm that is often difficult to detect, resulting in ... Purely intramedullary spinal cord primitive neuroectodermal tumor: case report and review of ... ... We report a case of a 54-year-old Caucasian woman with an earlier diagnosis of Peutz-Jeghers Syndrome (PJS) and sex cord tumor ...

*  Spinal haemangioblastoma | Radiology Reference Article | Radiopaedia.org

This article specifically relates to spinal hemangioblastomas. For a discussion on intracranial hemangiobl... ... Spinal haemangioblastomas are the third most common intramedullary spinal neoplasm, representing 2-6% of all intramedullary ... neoplasms of the spinal canal (enhancing component) and vascular malformations of the spinal cord (enlarged vessels) ... Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 1, Intramedullary spinal neoplasms. AJR Am ...

*  Brain and Spinal Cord Tumors in Children

Whether your child has just been diagnosed with a brain or spinal cord tumor, is going through treatment, or is trying to stay well after treatment, this detailed guide can help you find the answers you need.

Spinal tumorNeuromere: Neuromeres are morphologically or molecularly defined transient segments of the early developing brain. Rhombomeres are such segments that make up the rhombencephalon or hindbrain.Rehabilitation in spinal cord injury: When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method.Canine degenerative myelopathy: Canine degenerative myelopathy, also known as chronic degenerative radiculomyelopathy, is an incurable, progressive disease of the canine spinal cord that is similar in many ways to amyotrophic lateral sclerosis (ALS). Onset is typically after the age of 7 years and it is seen most frequently in the German shepherd dog, Pembroke Welsh corgi, and boxer dog, though the disorder is strongly associated with a gene mutation in SOD1 that has been found in 43 breeds as of 2008, including the wire fox terrier, Chesapeake Bay retriever, Rhodesian ridgeback, and Cardigan Welsh corgi.List of people with paraplegia: This is a list of people who have or had paraplegia.Sacral anterior root stimulator: An implantable medical device enabling patients with a spinal cord lesion to empty their bladders.Superior cluneal nerves: The superior cluneal nerves innervate the skin of the upper part of the buttocks. They are the terminal ends of lateral rami of the posterior rami of lumbar spinal nerves (L1, 2, 3).Renshaw cell: Renshaw cells are inhibitory interneurons found in the gray matter of the spinal cord, and are associated in two ways with an alpha motor neuron.Cervical fractureSpinal anaesthesia: Spinal anaesthesia (or spinal anesthesia), also called spinal analgesia, spinal block or subarachnoid block (SAB), is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space, generally through a fine needle, usually 9 cm long (3.5 inches).Upper-limb surgery in tetraplegia: Upper-limb surgery in tetraplegia includes a number of surgical interventions that can help improve the quality of life of a patient with tetraplegia.Clay-shoveler fracture: Clay-shoveler's fracture is a stable fracture through the spinous process of a vertebra occurring at any of the lower cervical or upper thoracic vertebrae, classically at C6 or C7. In Australia in the 1930s, men digging deep ditches tossed clay 10 to 15 feet above their heads using long handled shovels.Cervical spine disorder: Cervical Spine Disorders are illnesses that are relatively detrimental to ones physical health. These ailments exist in the cervical spine which is made up of the upper first seven vertebrae, encasing and shielding the Spinal cord.Umbilical cord compressionLaminectomyNeuroregeneration: Neuroregeneration refers to the regrowth or repair of nervous tissues, cells or cell products. Such mechanisms may include generation of new neurons, glia, axons, myelin, or synapses.Axon guidance: Axon guidance (also called axon pathfinding) is a subfield of neural development concerning the process by which neurons send out axons to reach the correct targets. Axons often follow very precise paths in the nervous system, and how they manage to find their way so accurately is being researched.Spinal stenosis: Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit.PancreatoblastomaWalker (BEAM): In BEAM robotics, a walker is a walking machine that has a driven mode of locomotion by intermittent ground-contacting legs. They usually possess 1 to 12 (generally, three or less) motors.Interbody fusion cage: An interbody fusion cage (colloquially known as a "spine cage") is a prosthesis used in spinal fusion procedures to maintain foraminal height and decompression. They are cylindrical or square-shaped devices, and usually threaded.Peripheral nerve injury classification: Classification of peripheral nerve injury assists in prognosis and determination of treatment strategy. Classification of nerve injury was described by Seddon in 1943 and by Sunderland in 1951.Hopkins syndrome: Hopkins syndrome is a neurological disorder. Its cause has not been established, but its association with asthma exacerbations (usually with a respiratory infection as a trigger) has led to suspicion that the initial viral insult that causes the respiratory infection is also implicated in the subsequent paralysis.CordotomyFlaccid paralysisCancer pain: Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response. Most chronic (long-lasting) pain is caused by the illness and most acute (short-term) pain is caused by treatment or diagnostic procedures.Congenital distal spinal muscular atrophy: Congenital distal spinal muscular atrophy (congenital dSMA) is a hereditary genetic condition characterized by muscle wasting (atrophy), particularly of distal muscles in legs and hands, and by early-onset contractures (permanent shortening of a muscle or joint) of the hip, knee, and ankle. Affected individuals often have shorter lower limbs relative to the trunk and upper limbs.Gross pathology: Gross pathology refers to macroscopic manifestations of disease in organs, tissues, and body cavities. The term is commonly used by anatomical pathologists to refer to diagnostically useful findings made during the gross examination portion of surgical specimen processing or an autopsy.HSD2 neurons: HSD2 neurons are a small group of neurons in the brainstem which are uniquely sensitive to the mineralocorticosteroid hormone aldosterone, through expression of HSD11B2. They are located within the caudal medulla oblongata, in the nucleus of the solitary tract (NTS).Cystic, mucinous, and serous neoplasms: Cystic, mucinous, and serous neoplasms is a group of tumors.Opioid-induced hyperalgesia: Opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity, also called paradoxical hyperalgesia is a phenomenon associated with the long term use of opioids such as morphine, hydrocodone, oxycodone, and methadone. Over time, individuals taking opioids can develop an increasing sensitivity to noxious stimuli, even evolving a painful response to previously non-noxious stimuli (allodynia).Sensory stimulation therapy: Sensory stimulation therapy (SST) is an experimental therapy that aims to utilize neural plasticity mechanisms to aid in the recovery of somatosensory function after stroke or cognitive ageing. Stroke and cognitive ageing are well known sources of cognitive loss, the former by neuronal death, the later by weakening of neural connections.Neuropathic painTemporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingHyperintensityCortical stimulation mapping: Cortical stimulation mapping (often shortened to CSM) is a type of electrocorticography that involves a physically invasive procedure and aims to localize the function of specific brain regions through direct electrical stimulation of the cerebral cortex. It remains one of the earliest methods of analyzing the brain and has allowed researchers to study the relationship between cortical structure and systemic function.Epidural space: In the spine, the epidural space (from Ancient Greek ἐπί, "on, upon" + dura mater also known as "epidural cavity", "extradural space" or "peridural space") is an anatomic space that is the outermost part of the spinal canal. It is the space within the canal (formed by the surrounding vertebrae) lying outside the dura mater (which encloses the arachnoid mater, subarachnoid space, the cerebrospinal fluid, and the spinal cord).Upper motor neuron lesion: An upper motor neuron lesion (also known as pyramidal insufficiency) is a lesion of the neural pathway above the anterior horn cell of the spinal cord or motor nuclei of the cranial nerves. This is in contrast to a lower motor neuron lesion, which affects nerve fibers traveling from the anterior horn of the spinal cord or the cranial motor nuclei to the relevant muscle(s).Nociceptor: A nociceptor is a sensory neuron (nerve cell) that responds to potentially damaging stimuli by sending signals to the spinal cord and brain. This process, called nociception, usually causes the perception of pain.Withdrawal reflex: The withdrawal reflex (nociceptive or flexor withdrawal reflex) is a spinal reflex intended to protect the body from damaging stimuli. It is polysynaptic, causing stimulation of sensory, association, and motor neurons.Surfeit of Lampreys: Surfeit of Lampreys is a detective novel by Ngaio Marsh; it is the tenth novel to feature Roderick Alleyn, and was first published in 1941. The plot concerns the murder of a British peer, a theme to which Marsh would return; the novel was published as Death of a Peer in the United States.Cats in the United States: Many different species of mammal can be classified as cats (felids) in the United States. These include domestic cat (both house cats and feral), of the species Felis catus; medium-sized wild cats from the genus Lynx; and big cats from the genera Puma and Panthera.HyperreflexiaParvalbuminAging movement control: Normal aging movement control in humans is about the changes on the muscles, motor neurons, nerves, sensory functions, gait, fatigue, visual and manual responses, in men and women as they get older but who do not have neurological, muscular (atrophy, dystrophy...) or neuromuscular disorder.Pain scale: A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data.Remyelination: Remyelination is the process of propagating oligodendrocyte precursor cells to form oligodendrocytes to create new myelin sheaths on demyelinated axons in the CNS. This is a process naturally regulated in the body and tends to be very efficient in a healthy CNS.Brain healing: Brain healing is the process that occurs after the brain has been damaged. If an individual survives brain damage, the brain has a remarkable ability to adapt.Cerebral contusionKidney tumour: Kidney tumours (or kidney tumors), also known as renal tumours, are tumours, or growths, on or in the kidney. These growths can be benign or malignant (cancerous).Central tegmental tract: The central tegmental tractKamali A, Kramer LA, Butler IJ, Hasan KM. Diffusion tensor tractography of the somatosensory system in the human brainstem: initial findings using high isotropic spatial resolution at 3.Camptocormia: CamptocormiaPampiniform venous plexus: The pampiniform plexus is a network of many small veins found in the human male spermatic cord. It is formed by the union of multiple spermatic veins from the back of the testis and tributaries from the epididymis.Sciatic nerve: The sciatic nerve (; also called ischiadic nerve, ischiatic nerve) is a large nerve in humans and other animals. It begins in the lower back and runs through the buttock and down the lower limb.SyringomyeliaStrychnine poisoningCauda equina: The cauda equina (Latin for "horse's tail") is a bundle of spinal nerves and spinal nerve roots, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord. The cauda equina occupies the lumbar cistern, a subarachnoid space inferior to the conus medullaris.Spinal muscular atrophiesSpinal decompression: Spinal decompression is the relief of pressure on one or many pinched nerves (neural impingement) of the spinal column.Glial fibrillary acidic protein: Glial fibrillary acidic protein (GFAP) is a protein that is encoded by the GFAP gene in humans.Spinal fractureMotorized wheelchair: A motorized wheelchair, powerchair, electric wheelchair or electric-powered wheelchair (EPW) is a wheelchair that is propelled by means of an electric motor rather than manual power. Motorized wheelchairs are useful for those unable to propel a manual wheelchair or who may need to use a wheelchair for distances or over terrain which would be fatiguing in a manual wheelchair.

(1/586) Extraneural metastasizing ependymoma of the spinal cord.

This paper reports a case of the rare entity of an extraneural metastasizing ependymoma of the spinal cord. The tumor which arose in the conus medullaris and in the cauda equina was first diagnosed in 1956 when a thoracolumbar myeloresection was performed. At autopsy, 40 years after the primary diagnosis, a massive local tumor recurrence with extraneural metastases in the lungs, the pleura, the liver, and the thoracal and abdominal lymph nodes were found. Immunohistochemical stains of the extraneural metastases showed a strong cytoplasmatic expression of glial fibrillary acidic protein (GFAP). Neither the primary tumor nor its metastases showed any of the conventional morphological criteria of malignancy. Reviewing the literature we discuss the possible mechanism of extraneural tumor spread and the incidence of metastases with regard to the tumor type.  (+info)

(2/586) Recurrent spinal epidural metastases: a prospective study with a complete follow up.

OBJECTIVES: Prospective studies with a complete follow up in patients with spinal epidural metastases (SEM) are rare, so little is known of the incidence and relevance of recurrent spinal epidural metastases (RSEM). This prospective study was undertaken as a part of a previously started and extended prospective study to determine the occurrence and details of RSEM. METHODS: Patients with SEM of various primary malignancies were followed up until death. The diagnosis was confirmed after neurological examination by imaging studies visualising not only the clinically suspected level, but also as much of the spinal canal as possible. RESULTS: Recurrent spinal epidural metastases (RSEM) occurred in 21 of the 103 patients (20%) after a median interval of 7 months and, after treatment, a second recurrence occurred in 11 patients (11%), a third recurrence in two patients (2%), and a sixth recurrence in one patient (1%). RSEM developed about as often at the initial level (55%) as at a different level (45%), did not occur more often in patients with initially multiple SEM, but, not surprisingly, occurred much more often in patients with longer survival. About one half of the patients surviving 2 years, and nearly all patients surviving 3 years or longer developed RSEM. Ambulatory state could be preserved in most patients, even after their second recurrence. CONCLUSION: RSEM are common and even several episodes of RSEM in the same patient are not rare. Patients with SEM who survive long enough have a high risk of RSEM and prompt treatment of RSEM to maintain the ambulatory state of the patient is valuable.  (+info)

(3/586) Phase I trial of methotrexate-albumin in a weekly intravenous bolus regimen in cancer patients. Phase I Study Group of the Association for Medical Oncology of the German Cancer Society.

Methotrexate-albumin conjugate (MTX-HSA) is a novel human albumin-based prodrug conjugate of methotrexate (MTX). A low MTX loading rate provided optimal tumor targeting and therapeutic efficacy during preclinical testing. The objectives of this first Phase I study of MTX-HSA were to determine dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) in a weekly regimen. Seventeen cancer patients who were no longer amenable to standard treatment were enrolled and were evaluable for DLT. Up to eight injections were performed in weekly intervals. Dose escalation was as follows: 20, 40, 50, and then 60 mg/m2 MTX-HSA (based on the amount of MTX bound to albumin). Additional MTX-HSA courses were feasible in case of tumor response. DLT (mainly stomatitis, Common Toxicity Criteria grade 3) occurred, beginning at the 50 mg/m2 dose level after repeated administrations; in one case, thrombocytopenia was dose-limiting. Two events of DLT occurred at the 60 mg/m2 dose level within the first two administrations. Mild anemia, transaminitis, and one case of skin toxicity were found. No significant leukopenia, nausea, renal toxicity, or other toxicities were observed. MTX-HSA was well tolerated. Drug accumulation occurred on the weekly schedule. The half-life of the drug was estimated to be up to 3 weeks. Tumor responses were seen in three patients: (a) a partial response was seen in one patient with renal cell carcinoma (response duration, 30 months, ongoing); (b) a minor response was seen in one patient with pleural mesothelioma (response duration, 31 months, ongoing); and (c) a minor response was seen in one patient with renal cell carcinoma (response duration, 14 months until progression). Poststudy treatment was administered at 2-4-week intervals. No signs of toxicity or drug accumulation were seen. Altered pharmacological properties of MTX-HSA such as plasma half-life, tumor targeting, or intracellular metabolism might have contributed to these responses. The MTD for weekly administration was 4 x 50 mg/m2 MTX-HSA during short-term treatment. A regimen with MTX-HSA injections of 50 mg/m2 every 2 weeks was recommended for a further clinical Phase I study.  (+info)

(4/586) Diffusion tensor MR imaging and comparative histology of glioma engrafted in the rat spinal cord.

MR imaging using contrast material derived from the diffusion of tissue water was tested for its ability to provide a nondestructive histologic analysis of tumor morphology. An apparent diffusion tensor MR image of a glioma engrafted within a rat spinal cord was generated in which fiber orientation in three dimensions was displayed in color. This imaging method clearly separated tumor from host white and gray matter and corresponded well with conventional histologic microscopy.  (+info)

(5/586) Second lung adenocarcinoma after combination chemotherapy in two patients with primary non-Hodgkin's lymphoma.

We report a rare complication of a secondary malignant solid tumor in two patients with non-Hodgkin's malignant lymphoma who developed lung adenocarcinoma after treatments with combination chemotherapies. The first was a case of primary malignant lymphoma of the cervical spinal cord which had been previously treated with radiation to the spinal lesion and combination chemotherapies and entered complete remission. The patient was further treated for relapse with autologous bone marrow transplantation preconditioned with high-dose chemotherapy. Lung adenocarcinoma developed 5.5 years after the initial diagnosis. The second case of malignant lymphoma of lymph nodes did not respond to conventional combination chemotherapies and did not enter remission. Lung adenocarcinoma developed 1 year after the initial diagnosis. The two patients died of lung carcinoma. The clinical profiles of these cases are presented and the causal relationship of primary malignant neoplasms to the second malignant neoplasms is discussed.  (+info)

(6/586) Molecular genetic analysis of ependymal tumors. NF2 mutations and chromosome 22q loss occur preferentially in intramedullary spinal ependymomas.

Ependymal tumors are heterogeneous with regard to morphology, localization, age at first clinical manifestation, and prognosis. Several molecular alterations have been reported in these tumors, including allelic losses on chromosomes 10, 17, and 22 and mutations in the NF2 gene. However, in contrast to astrocytic gliomas, no consistent molecular alterations have been associated with distinct types of ependymal tumors. To evaluate whether morphological subsets of ependymomas are characterized by specific genetic lesions, we analyzed a series of 62 ependymal tumors, including myxopapillary ependymomas, subependymomas, ependymomas, and anaplastic ependymomas, for allelic losses on chromosome arms 10q and 22q and mutations in the PTEN and NF2 genes. Allelic losses on 10q and 22q were detected in 5 of 56 and 12 of 54 tumors, respectively. Six ependymomas carried somatic NF2 mutations, whereas no mutations were detected in the PTEN gene. All six of the NF2 mutations occurred in ependymomas of WHO grade II and were exclusively observed in tumors with a spinal localization (P = 0.0063). These findings suggest that a considerable fraction of spinal ependymomas are associated with molecular events involving chromosome 22 and that mutations in the NF2 gene may be of primary importance for their genesis. Furthermore, our data suggest that the more favorable clinical course of spinal ependymomas may relate to a distinct pattern of genetic alterations different from that of intracerebral ependymomas.  (+info)

(7/586) Association of lower cranial nerve schwannoma with spinal ependymoma in ? NF2.

A 15 year old male, who had earlier been operated for intraspinal intramedullary ependymoma, subsequently developed a right cerebello pontine (CP) angle mass. A diagnosis of right CP angle ependymoma was considered, in view of established histology of previously operated spinal lesion. Histopathological examination of the well defined extra-axial mass, which was attached with ninth cranial nerve, however revealed a schwannoma. A diagnosis of Neurofibromatosis-2 (NF2) is strongly suspected, because of well established fact, that the spinal ependymomas may have association with lower cranial nerve schwannomas in NF2. Cranial and spinal MRI screening for early diagnosis of associated, asymptomatic lesions, in suspected cases of NF2, particularly in children, is recommended.  (+info)

(8/586) Management of intramedullary spinal cord tumours: review of 68 patients.

68 consecutive patients admitted with intramedullary spinal cord tumours and operated at Vellore during a six year period from January 1990 are discussed. 41 tumours were radically resected, 11 partially excised while 14 had only a biopsy. Radiation therapy was advised post operatively to those patients for whom a partial excision or biopsy was done. There was no postoperative mortality. Two patients developed wound infection and one developed postoperative hydrocephalus. Postoperative clinical assessment between four to eight weeks after surgery showed that 25 out of 68 patients improved, 29 remained unchanged, while 14 had worsening of deficits. Immediate post operative assessment, however, was less encouraging. Evaluation of these patients was done using a functional scoring system and Karnofsky rating. The follow up period ranged from 2 weeks to 64 months after discharge from hospital with a mean of 14.6 months. The indicators of radical excision were good tumour-cord interface, cranially located tumours, presence of syringomyelia and histology of ependymoma. Two patients had recurrence of tumour.  (+info)


  • Pediatric spinal tumors. (wakehealth.edu)
  • Schwannomas, meningiomas, and ependymomas (79% of primary spinal tumors). (cancer.gov)
  • Primary brain tumors rarely spread to other areas of the body, but they can spread to other parts of the brain and to the spinal axis. (cancer.gov)
  • Desmoid tumors (DTs) are neoplasms of fibroblastic origin characterized by lack of a capsule. (biomedsearch.com)
  • Intradural spinal tumors: current classification and MRI features. (radiopaedia.org)
  • Cerebral Vasculitis related to Neoplasms - Diseases of the arteries may rarely complicate the course of systemic tumors. (strokeassociation.org)
  • Pineal region tumors (PRTs) are uncommon, and treatments vary among neoplasm types. (scielo.br)

intramedullary spinal

  • Animal model of intramedullary spinal cord glioma using human glioblastoma multiforme neurospheres. (wakehealth.edu)
  • Spinal haemangioblastomas are the third most common intramedullary spinal neoplasm, representing 2-6% of all intramedullary tumours 1,4,7 . (radiopaedia.org)
  • Clinical presentation is similar to that of other intramedullary spinal tumours , with pain, weakness and sensory changes common. (radiopaedia.org)
  • Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 1, Intramedullary spinal neoplasms. (radiopaedia.org)


  • Purpose To investigate the effect of minimal access spine surgery (MASS) compared with conventional open surgery in the treatment of patients with metastatic spinalcord compression (MSCC). (knowcancer.com)

posterior spinal

  • Desmoid tumor formation following posterior spinal instrumentation placement. (wakehealth.edu)


  • We present two cases of Hereditary Hemmorhagic Telengiectasia (HHT), one pediatric and the other adult, with a view to highlight the myriad cerebral and spinal vascular manifestations of this disease. (biomedsearch.com)


  • High-quality MRI is the diagnostic study of choice in the evaluation of intramedullary and extramedullary spinal cord lesions. (cancer.gov)


  • This article specifically relates to spinal hemangioblastomas. (radiopaedia.org)
  • Rarely, spinal hemangioblastomas may cause subarachnoid haemorrhage or hematomyelia 4 . (radiopaedia.org)


  • Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6-9 months after GKS. (scielo.br)


  • Diseases associated with EPB41L3 include Bejel and Spinal Cord Ependymoma . (genecards.org)


  • Meningitis (serious inflammation of the meninges - the thin, membrane covering the brain and the spinal cord) caused by cancer or lymphoma may affect the small and middle-sized intracranial arteries. (strokeassociation.org)


  • En bloc spondylectomy for primary malignant fibrous histiocytoma of the thoracic spine with aortic involvement: case report. (wakehealth.edu)


  • Malignant transformation of an intramedullary epidermoid cyst in the thoracic region of the spinal cord: case report. (wakehealth.edu)
  • The most common location is the thoracic cord (50%), followed by the cervical cord (40%) 4,7 . (radiopaedia.org)


  • Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). (biomedsearch.com)


  • One-third of patients with haemangioblastomas (not just spinal) have von Hippel-Lindau syndrome 6-7 and typically these patients present earlier with multiple tumours. (radiopaedia.org)


  • MR findings in spinal hemangioblastoma: correlation with symptoms and with angiographic and surgical findings. (radiopaedia.org)


  • Inclusion criteria are patients with spinal metastases at level Th5-L3 who are candidates for surgery. (knowcancer.com)


  • Although they usually appear as discrete nodules, there can be diffuse cord expansion. (radiopaedia.org)