bluuebunny/crossref_metadata_2025 huggingface dataset:
Geothermal subsidence study at Wairakei–Tauhara, New Zealand
Authors: Bromley Chris , Brockbank Kerin , Glynn-Morris Trystan , Rosenberg Michael , Pender Michael , O'Sullivan Michael , Currie Steve
Published: April 2013

Geothermal, as a source of renewable energy (power and heating), has the potential to meet 3–5% of global demand by 2050. For some high-temperature reservoirs, a technical challenge that may constrain deployment is ground subsidence caused by reservoir pressure decline. At the Wairakei–Tauhara geothermal system in New Zealand, an integrated geotechnical-geoscientific investigation of the causes of local subsidence anomalies (up to 15 m, accumulated over 50 years) has successfully identified and modelled the factors, mechanisms and processes involved. Zones of hydrothermally altered porous sediments and clays, at up to 400 m depth, display inelastic deformation behaviour, yielding to a highly compressible state once subjected to a fluid pressure decline. Monitoring shows that pressure dissipates slowly through these low-permeability capping formations. Adaptive management involves continued monitoring of subsidence rates, and sampling, analysis and predictive modelling where necessary. Simulation modelling indicates that long-term mitigation can be achieved by sustaining pressures through targeted shallow injection.
Plant Available Phosphorus Analysis for Recently Acidified Soils of the Columbia Basin Washington State
Authors: Bair Kyle E. , Davenport Joan R.
Published: April 2013

Soil acidification in the Columbia Basin (CB) of Washington State, brings into question the validity of the sodium bicarbonate (NaHCO3) extractable phosphorus (Olsen P, OP) method for making fertilizer recommendations. The objectives of this research are to (i) identify the soil test method (OP, Bray P, BP1; Mehlich‐III, M3P; Morgan, MMP; and plant root simulator, PRS probes [Western Ag Innovations, Saskatoon, SK]) that correlates best with plant available P at pH < 7.0 in CB soils and (ii) evaluate relationships between OP and biomass production, plant tissue P and plant P uptake in acidified CB soils.
A Simple Tool for the Inverse Estimation of Soil Gas Diffusion Coefficients
Authors: Schwen Andreas , Böttcher Jürgen
Published: April 2013

For the calculation of gas fluxes through soils, the soil gas diffusion coefficient Ds needs to be known. Ds can be derived from diffusion chamber experiments or from field experiments measuring diffusive gas fluxes across larger spatial scales. Within these methods, the gas concentration depletion or enrichment in an accumulation chamber is used to derive Ds based on Fick's law. However, since this approach does not account for retardation of soluble gases in the soil water phase, the applicability is restricted to rather inert gases. The method also does not account for convective fluxes due to sampling. To overcome these limitations and to enable the applicability of an earlier presented two‐side in situ method, Ds needs to be estimated inversely from the transient diffusion experiments. In this paper, a convenient computer tool is presented that allows the estimation of Ds from diffusion chamber experiments and two in situ methods.
Vascular and Renal Hemodynamic Changes after Renal Denervation
Authors: Ott Christian , Janka Rolf , Schmid Axel , Titze Stephanie , Ditting Tilmann , Sobotka Paul A. , Veelken Roland , Uder Michael , Schmieder Roland E.
Published: April 2013

Background and objectives

Renal denervation (RDN) has been shown to be effective in reducing BP in treatment-resistant hypertension. Measurement of the renal and sympathetic activity revealed a decrease in sympathetic drive to the kidney and small resistance vessels after RDN. However, the consequences on renal perfusion and renal vascular resistance (RVR), as well as central hemodynamics, are unknown.

Design, setting, participants, & measurements

Nineteen patients with treatment-resistant hypertension (office BP≥140/90 mmHg, despite at least three antihypertensive drugs [including a diuretic], and diagnosis confirmed by 24-hour ambulatory BP monitoring) underwent RDN between January and October 2011. Renal perfusion and RVR were noninvasively assessed by magnetic resonance imaging with arterial spin labeling, and renal function was assessed by estimating GFR before (day −1), after (day +1), and again after 3 months of RDN. Central hemodynamics was assessed using pulse wave analysis at day −1 and after 6 months of RDN.

Results

Peripheral office BP (systolic, 158±26 versus 142±23 mmHg, P=0.002; diastolic, 83±13 versus 76±9 mmHg, P=0.02) and mean systolic 24-hour ambulatory BP (159±17 versus 152±17 mmHg, P=0.02) were significantly reduced 6 months after RDN. Renal perfusion was not statistically different between day −1 and day +1 (256.8 [interquartile range (IQR), 241–278] versus 263.4 [IQR, 252–277] ml/min per 100 g; P=0.17) as well as after 3 months (256.8 [IQR, 241–278] versus 261.2 [IQR, 240–285] ml/min per 100 g; P=0.27) after RDN. RVR dropped (432.1 [IQR, 359–525] versus 390.6 [IQR, 338–461] AU; P=0.02), whereas renal function was not statistically different at any time point. Central systolic BP (145±31 versus 131±28 mmHg; P=0.009), diastolic BP (85±18 versus 80±14 mmHg; P=0.03), and central pulse pressure (61±18 versus 52±18 mmHg; P=0.02) were significantly reduced 6 months after RDN. Central augmentation index (24±8 versus 20±8%; P=0.02) was decreased 6 months after RDN.

Conclusion

The data indicate that RDN significantly reduced peripheral and central BP. Despite reduced systemic BP, renal perfusion and function did not change after RDN.
Future of Medicare Immunosuppressive Drug Coverage for Kidney Transplant Recipients in the United States
Authors: Tanriover Bekir , Stone Patricia W. , Mohan Sumit , Cohen David J. , Gaston Robert S.
Published: April 2013

Kidney transplantation is the preferred treatment for patients with ESRD. It improves the quality of life in recipients, increases patient survival, and is also substantially less costly than maintenance dialysis. Long-term transplant success requires immunosuppressant drug therapy for the life of the allograft. Under current law, Medicare coverage for most recipients (except for those recipients over 65 years of age or with nonkidney-related disabilities) lasts only 3 years, leaving many recipients unable to afford these medications. Lack of drug therapy often leads to allograft rejection, resulting in premature graft failure, return to dialysis, or death. This article reviews the current policy for Medicare immunosuppressive drug coverage and analyzes the potential impact of pending legislative proposals H.R. 2969 and S. 1454 and the Patient Protection and Affordable Care Act.
Baptist Hospital and the State of North Carolina: Alleged Malfeasance and Whistleblowing Aftermath
Authors: Taylor Eileen Z. , Guthrie Cynthia P.
Published: April 2013

Do you know what choices you would make if faced with an ethical dilemma? This fact-based case includes situations and issues that a real citizen considered when faced with the knowledge that his employer may have been overbilling the state of North Carolina for health care. Professionals, especially those in accounting and finance positions, are likely to face serious dilemmas in the course of their careers. These situations may require them to choose between honoring a confidentiality clause in an employment contract and acting according to ethical and professional values. This case provides facts gathered from an actual case in which an individual faced this particular challenge. By working through the case, students should develop an appreciation of the pressures and personal ethical challenges they are likely to face in the workplace. By engaging in discussion and role-play, students will be more likely to recognize these issues when they occur, and will have already developed critical thinking skills to help them develop a plan of action.
Potential of Protein Phosphatase Inhibitor 1 As Biomarker of Pancreatic β-Cell Injury In Vitro and In Vivo
Authors: Jiang Lei , Brackeva Benedicte , Ling Zhidong , Kramer Gertjan , Aerts Johannes M. , Schuit Frans , Keymeulen Bart , Pipeleers Daniel , Gorus Frans , Martens Geert A.
Published: April 2013

There is a need for plasma-based tests that can directly measure the extent of β-cell injury in vivo in patients receiving islet grafts and in animal models. In this study, we propose protein phosphatase 1, regulatory (inhibitor) subunit 1A (PPP1R1A) as a novel biomarker for acute β-cell destruction. Liquid chromatography–tandem mass spectrometry proteome analysis of fluorescence-activated cell sorter–purified β-cells, tissue-comparative Western blotting, and immunohistochemistry indicated relatively high molar abundance and selectivity of PPP1R1A in β-cells. PPP1R1A was discharged into the extracellular space of chemically injured rat and human islets in vitro, proportionate to the extent of β-cell death. Streptozotocin injection in rats led to a progressive PPP1R1A depletion from the cytoplasm of disintegrating β-cells and a marked surge in plasma levels detectable by an affinity-capture method. A similar massive PPP1R1A discharge in blood was also detected in three patients immediately after intraportal islet transplantation. Our findings provide first proof-of-principle for PPP1R1A as real-time biomarker of β-cell destruction in animal models and patients and warrant development of more sensitive methods for its further validation in clinical trials.
FAT/CD36: A Major Regulator of Neuronal Fatty Acid Sensing and Energy Homeostasis in Rats and Mice
Authors: Le Foll Christelle , Dunn-Meynell Ambrose , Musatov Serguei , Magnan Christophe , Levin Barry E.
Published: April 2013

Hypothalamic “metabolic-sensing” neurons sense glucose and fatty acids (FAs) and play an integral role in the regulation of glucose, energy homeostasis, and the development of obesity and diabetes. Using pharmacologic agents, we previously found that ∼50% of these neurons responded to oleic acid (OA) by using the FA translocator/receptor FAT/CD36 (CD36). For further elucidation of the role of CD36 in neuronal FA sensing, ventromedial hypothalamus (VMH) CD36 was depleted using adeno-associated viral (AAV) vector expressing CD36 short hairpin RNA (shRNA) in rats. Whereas their neuronal glucosensing was unaffected by CD36 depletion, the percent of neurons that responded to OA was decreased specifically in glucosensing neurons. A similar effect was seen in total-body CD36-knockout mice. Next, weanling rats were injected in the VMH with CD36 AAV shRNA. Despite significant VMH CD36 depletion, there was no effect on food intake, body weight gain, or total carcass adiposity on chow or 45% fat diets. However, VMH CD36–depleted rats did have increased plasma leptin and subcutaneous fat deposition and markedly abnormal glucose tolerance. These results demonstrate that CD36 is a critical factor in both VMH neuronal FA sensing and the regulation of energy and glucose homeostasis.
Adrenal apoplexy caused by fulminant sepsis in 20-year-old healthy male?: case report
Authors: Stojanović Ivan , Stojanović Jovan , Zdravković Miodrag , Antović Aleksandra , Milić Miroslav , Todorović Stevan
Published: April 2013

Introduction. Bilateral massive adrenal hemorrhage (BMAH) is a rare catastrophic condition that manifests with acute adrenal insufficiency. Death can occur within a few hours or after many days. BMAH in association with fulminant septicemia and sepsis occurring in children and young adults is also known as the Waterhouse-Friderichsen syndrome. Fulminant sepsis associated with purpura is lethal in 40–70% of patients. Case report. The abrupt onset of fever with sore throat occurred in a 20-year old man. Next day in the early morning, he complained of severe symptoms: generalized weakness, shortness of breath and myalgia. Few hours later petechial rash occur. Within 30 hours from first symptoms he died in hospital. On autopsy, there were macroscopic bilateral areas of adrenal hemorrhage. Autopsy also revealed hemorrhage in almost all organs and tissues. Microbiological blood culture and toxicological finding was negative. Discussion. In our case, very high levels of procalcitonin and D-dimer, with all other clinically and autopsy findings, was directing medical examiners that a main cause of death was fulminant bacterial sepsis. Blood culture did not reveal any bacteria, so the cause of BMAH stays uncovered. The bacteria that most often cause fulminant sepsis connected with BMAH and death within 12–24 hours from first symptoms is N. meningitidis. It is very likely that N. meningitidis caused BMAH in our case, but it will stay in domain of speculation.
The effects of a 6-OHDA induced lesion in murine nuccleus accumbens on memory and oxidative stress status
Authors: Lefter Radu , Ciobica Alin , Hritcu Lucian , Stoica Bogdan , Cojocaru Dumitru , Olteanu Zenovia
Published: April 2013

Nucleus accumbens (NAcc) are a collection of neurons that form the main part of the ventral striatum, which is a significant dopaminergic structure. Also, NAcc is thought to play an important role in reward, pleasure, laughter, addiction, aggression, fear, and the placebo effect. In the present work we were interested in studying the effects of a 6-OHDA induced lesion in the nucleus accumbens (NAcc), which is known as an important dopaminergic structure, on a specific behavioral task that involves both short term and long term spatial memory (the radial-8-arm-maze task), as well as on the oxidative stress markers (two antioxidant enzymes: superoxide dismutase-SOD and glutathione peroxidase-GPX and a lipid peroxidation marker: malondialdehyde-MDA, as well as the total antioxidant status-TAS) from the temporal lobe, which is considered to be the most vulnerable cortical area to oxygen levels fluctuations and hypoxia. Our results showed some significant effects of this lesion on the reference memory errors and time necessary to finish the test in the radial-8-arm-maze task. Additionally, increased oxidative stress status was demonstrated in the temporal lobe of the lesioned rats, as demonstrated by the high levels of lipid peroxidation and decreased total antioxidant status. Moreover, significant correlations are reported here between the behavioral parameters which we studied in the radial-8-arm-maze task and the aforementioned oxidative stress markers.
Infective endocarditis due to a rare pathogen, Streptococcus constellatus, in a patient with gingivitis: A case report and review of the literature
Authors: Yoshino Yusuke , Kimura Yoshitaka , Sakai Takashi , Kanzaki Takeyuki , Seo Kazunori , Koga Ichiro , Kitazawa Takatoshi , Ota Yasuo
Published: April 2013

A 78-year-old Japanese man with a 5-day history of fever (∼38°C) and decreased appetite was admitted to our hospital. Transesophageal echocardiography revealed aortic valve vegetation. Streptococcus constellatus was detected from a blood culture. An antibiotic sensitive to this strain was administered for 6 weeks, and the patient has been well for 6 months without any sign of relapse. A review of all documented cases of infective endocarditis due to S. constellatus revealed nonspecific initial symptoms, especially coughing, and complications of abscess formation and septic embolisation. Clinicians should carefully consider the choice of antibiotic agents in the treatment of infective endocarditis due to S. constellatus, because penicillin-resistant strains have been documented in some cases.
Italian Version of the Physical Therapy Patient Satisfaction Questionnaire: Cross-Cultural Adaptation and Psychometric Properties
Authors: Vanti Carla , Monticone Marco , Ceron Daniele , Bonetti Francesca , Piccarreta Raffaella , Guccione Andrew A. , Pillastrini Paolo
Published: April 2013

Background

Patient satisfaction is an important measure for evaluating interventions in health care. No patient satisfaction questionnaire for physical therapy treatment has been validated to date for use in an Italian outpatient population.

Objective

The aim of this study was to translate, culturally adapt, and validate the Italian version of the Physical Therapy Patient Satisfaction Questionnaire (PTPSQ-I).

Design

A measurement study was conducted.

Methods

The PTPSQ-I was developed through forward-backward translation, final review, and pre-final version. An acceptability analysis was first conducted. Reliability was measured by internal consistency (Cronbach α), and a factor analysis was applied to investigate the internal structure. Divergent validity was measured by comparing the PTPSQ-I with a visual analog scale (VAS) and with a 5-point Likert-type scale evaluating the global perceived effect (GPE) for the physical therapy treatment.

Results

The process for developing the PTPSQ-I required 3 months using data on 315 outpatients. Based on our initial analyses, 5 items were deleted from the PTPSQ-I, which was renamed the PTPSQ-I(15). The PTPSQ-I(15) showed high internal consistency (α=.905). Divergent validity was moderate for the GPE (r=.33) but not significant for the VAS (r=−.07). A factor analysis revealed evidence for a 2-factor structure related to perceived “Overall Experience” and “Professional Impression” that explained 62% of the total variance. A third factor, “Efficiency and Convenience,” brought explained total variance to near 70%.

Limitations

It may be necessary to add items to the PTPSQ-I(15) to assess other dimensions not currently represented by these 15 items.

Conclusion

The PTPSQ-I(15) showed good psychometric properties, and its use can be recommended with Italian-speaking outpatient populations.
Effect of Therapeutic Exercise on Pain and Disability in the Management of Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis of Randomized Trials
Authors: Bertozzi Lucia , Gardenghi Ivan , Turoni Francesca , Villafañe Jorge Hugo , Capra Francesco , Guccione Andrew A. , Pillastrini Paolo
Published: April 2013

Background

Given the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition.

Purpose

The purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding.

Data Sources

Data were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked.

Study Selection

All published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP.

Data Extraction

Two reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model.

Data Synthesis

Seven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=−0.53, 95% confidence interval [CI]=−0.86 to −0.20, and g=−0.45, 95% CI=−0.82 to −0.07, respectively) and medium but not significant short-term and intermediate-term effects on disability (g=−0.39, 95% CI=−0.86 to 0.07, and g=−0.46, 95% CI=−1.00 to −0.08, respectively).

Limitations

Only one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention.

Conclusions

Consistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.
Relationship between degree of focal kyphosis correction and neurological outcomes for patients undergoing cervical deformity correction surgery
Authors: Grosso Matthew J. , Hwang Roy , Mroz Thomas , Benzel Edward , Steinmetz Michael P.
Published: April 2013

Object

Reversal of the normal cervical spine curvature, as seen in cervical kyphosis, can lead to mechanical pain, neurological dysfunction, and functional disabilities. Surgical intervention is warranted in patients with sufficiently symptomatic deformities in an attempt to correct the deformed cervical spine. In theory, improved outcomes should accompany a greater degree of correction toward lordosis, although there are few data available to test this relationship. The purpose of this study is to determine if the degree of deformity correction correlates with improvement in neurological symptoms following surgery for cervical kyphotic deformity.

Methods

A retrospective review of 36 patients with myelopathic symptoms who underwent cervical deformity correction surgery between 2001 and 2009 was performed. Preoperative and postoperative radiographic findings related to the degree of kyphosis were collected and compared with functional outcome measures. The minimum follow-up time was 2 years.

Results

A significant relationship was observed between a greater degree of focal kyphosis correction and improved neurological outcomes according to the modified Japanese Orthopaedic Association (mJOA) score (r = −0.46, p = 0.032). For patients with severe neurological symptoms (mJOA score < 12) a trend toward improved outcomes with greater global kyphosis correction was observed (r = −0.56, p = 0.057). Patients with an mJOA score less than 16 who attained lordosis postoperatively had a significantly greater improvement in total mJOA score than patients who maintained a kyphotic position (achieved lordosis: 2.7 ± 2.0 vs maintained kyphosis: 1.1 ± 2.1, p = 0.044).

Conclusions

The authors' results suggest that the degree of correction of focal kyphosis deformity correlates with improved neurological outcomes. The authors also saw a positive relationship between attainment of global lordosis and improved mJOA scores. With consideration for the risks involved in correction surgery, this information can be used to help guide surgical strategy decision making.
Safety of spinal decompression using an ultrasonic bone curette compared with a high-speed drill: outcomes in 337 patients
Authors: Bydon Mohamad , Xu Risheng , Papademetriou Kyriakos , Sciubba Daniel M. , Wolinsky Jean-Paul , Witham Timothy F. , Gokaslan Ziya L. , Jallo George , Bydon Ali
Published: April 2013

Object

Unintended durotomies are a common complication of spine surgery and are often correlated with increased postoperative morbidity. Recently, ultrasonic bone curettes have been introduced in spine surgery as a possible alternative to the conventional high-speed drill, offering the potential for greater bone-cutting precision and less damage to surrounding soft tissues. To date, however, few studies have investigated the safety and efficacy of the ultrasonic bone curette in reducing the rates of incidental durotomy compared with the high-speed drill.

Methods

The authors retrospectively reviewed the records of 337 consecutive patients who underwent posterior cervical or thoracic decompression at a single institution between January 2009 and September 2011. Preoperative pathologies, the location and extent of spinal decompression, and the use of an ultrasonic bone curette versus the high-speed drill were noted. The rates of incidental durotomy, as well as hospital length of stay (LOS) and perioperative outcomes, were compared between patients who were treated using the ultrasonic bone curette and those treated using a high-speed drill.

Results

Among 88 patients who were treated using an ultrasonic bone curette and 249 who were treated using a high-speed drill, 5 (5.7%) and 9 (3.6%) patients had an unintentional durotomy, respectively. This finding was not statistically significant (p = 0.40). No patients in either cohort experienced statistically higher rates of perioperative complications, although patients treated using an ultrasonic bone curette tended to have a longer hospital LOS. This difference may be attributed to the fact that this series contained a statistically higher number of metastatic tumor cases (p < 0.0001) in the ultrasonic bone curette cohort, likely increasing the LOS for that patient population. In 13 patients, the dural defect was repaired intraoperatively. No patients who experienced an incidental durotomy had new-onset or permanent neurological deficits postoperatively.

Conclusions

The safety and efficacy of ultrasonic bone curettes in spine surgery has not been well established. This study shows that the ultrasonic bone curette has a similar safety profile compared with the high-speed drill, although both are capable of causing iatrogenic dural tears during spine surgery.
Moyamoya disease with mesial temporal sclerosis
Authors: Lohani Subash , Madsen Joseph R. , Bergin Ann M. , Smith Edward R.
Published: April 2013

The combination of moyamoya syndrome and symptomatic mesial temporal sclerosis (MTS) has not previously been reported. The authors present the case of a 5-year-old boy with symptomatic MTS who developed progressive moyamoya syndrome. This combination of progressive moyamoya and a structural seizure focus presented a unique clinical problem, with the natural history of MTS predicting a high likelihood of needing resection in the future, which could be challenging following any type of moyamoya-related revascularization surgery. In anticipation of this problem, the patient underwent resection of the right inferior and mesial temporal lobe followed by right pial synangiosis as a 1-day combined operation. Postoperatively he recovered well without any neurological deficits and had an uneventful hospital stay. This case of moyamoya is unique in its association with MTS, and for the simultaneous operations for pial synangiosis and temporal lobectomy, highlighting the importance of surgical planning in patients with dual pathological processes.
Long-term clinical results of microsurgical transdural discectomy with laminoplasty: follow-up results over 10 years
Authors: Tanaka Nobuhiro , Fujimoto Yoshinori , Sumida Tadayoshi , Manabe Hideki , Nakanishi Kazuyoshi , Fujiwara Yasushi , Kamei Naosuke , Nakamae Toshio , Izumi Bunichiro , Ochi Mitsuo
Published: April 2013

Object

In this retrospective analysis the authors describe the long-term clinical results of microsurgical transdural discectomy with laminoplasty (MTDL) in patients with cervical disc herniation (CDH).

Methods

Thirty patients (21 males, 9 females; mean age at surgery 55 years) with CDH had surgical treatments consisting of MTDL between 1990 and 1998. All patients demonstrated signs or symptoms of cervical myelopathy and/or radiculomyelopathy. Clinical outcomes were evaluated by the Japanese Orthopaedic Association (JOA) scoring system and by recovery rate (RR). The degenerative grades of the intervertebral discs were also evaluated based on preoperative, postoperative, and final follow-up MR images. The average follow-up period was 14.1 years (range 10–22 years).

Results

Twenty (67%) of the 30 patients completed the follow-up in this study. The preoperative JOA scores in these patients averaged 11.8, and the postoperative scores at the final follow-up averaged 15.5 (average RR 69.6%). None of these patients required reoperation after MTDL. Although disc degeneration progressed during the follow-up period, there were no cases of clinical deterioration, recurrence of disc herniation, or postoperative kyphotic deformity.

Conclusions

Sufficient clinical results were obtained after the MTDL for a long-term follow-up period exceeding 10 years. The MTDL may be an option for an alternative procedure if the patients are correctly selected and the procedure is safely performed.
Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture
Authors: Gu Yutong , Zhang Feng , Jiang Xiaoxing , Jia Lianshun , McGuire Robert
Published: April 2013

Object

The purpose of this study was to evaluate the feasibility and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty (PVP) for treating acute thoracolumbar osteoporotic vertebral compression fracture (VCF) and preventing secondary VCF after PVP.

Methods

Twenty patients with a mean age of 73.6 years (range 65–85 years) who sustained fresh thoracic or lumbar osteoporotic VCFs without neurological deficits underwent minimally invasive pedicle screw fixation combined with PVP. Visual analog scale pain scores were recorded, and the Cobb angles and the central and anterior vertebral body (VB) heights were measured on the lateral radiographs before surgery and immediately, 1 month, 2 months, 3 months, 6 months, 1 year, and 2 years after surgery.

Results

The patients were followed up for an average of 26 months (range 24–30 months) after sugery. The visual analog scale score was found to be significantly decreased; from 7.3 ± 1.3 before surgery to 1.2 ± 0.7 immediately after surgery and to 0.7 ± 0.7 (p < 0.001) at the end of follow-up. The Cobb angle was 17.0° ± 4.3° before surgery and 6.4° ± 3.6° immediately after surgery. The central VB height that was 44.5% ± 7.6% before surgery increased to 74.6% ± 6.4% of the estimated intact central height immediately after surgery (p < 0.001). The anterior VB height increased from 50.7% ± 7.4% before surgery to 82.5% ± 6.7% of the estimated intact anterior height immediately after surgery (p < 0.001). There were no significant changes in the results obtained over the follow-up time period. There was no occurrence of new fracture in surgically treated or adjacent vertebrae in these patients.

Conclusions

Minimally invasive pedicle screw fixation combined with PVP is a good choice for the treatment of acute thoracolumbar osteoporotic VCF and can prevent the occurrence of new VCFs after PVP.
Die Verbreitung und Entwicklung der Grünerlenbestände in der Ostschweiz
Authors: Huber Barbara , Frehner Monika
Published: April 2013

Expansion and development of Green Alder stands in eastern Switzerland

In many subalpine regions of Switzerland, the Green Alder (Alnus viridis) is expanding as summer pastures are abandoned. The Federal Office for the Environment has set up a research project to improve the understanding of the characteristics of Green Alder and the consequences of its expansion. This project is based on a literature search, interviews with experts and GIS-based analysis of the past and present occurrence of Green Alder in three areas of eastern Switzerland. The results show that Green Alder is present at all exposures in the research areas. It is not lime-intolerant, but is less present on well drained basic subsoils. It is much more widespread than hitherto believed. In the canton of Glarus as well as in the Surselva, the area of Green Alder stands has doubled in the past 75 years. Only a few have developed to high forest stands. Therefore Green Alder stands should be considered, at least in their optimum oceanic sites, as permanent association, and not pioneer forests. In many places a broad belt of Green Alder has developed at the upper treeline, which is preventing the establishment of other species (e.g. Spruce) which might be possible because of climate change. Without intervention, the Green Alder stands will in all likelihood continue to expand over the coming decades. The areas affected by this expansion should be identified as of now, and a decision taken as to whether or not to tolerate this expansion. It is important that planning measures (agriculture, forestry, regional development) be taken early enough.
Making a Right Tit of Myself: Subverting the Trajectory of Mastectomy: Soma, Psyche, Techné
Authors: O'Neill Fiona K.
Published: April 2013

In the UK, when one is suspected of having breast cancer there is usually a rapid transition from being diagnosed, to being told you require treatment, to this being effected. Hence, there is a sense of an abrupt transition from ‘normal’ embodiment through somatechnic engagement; from normality, to failure and otherness. The return journey to ‘embodied normality’, if indeed there can be one, is the focus of this paper; specifically the durée and trajectory of such normalisation. I offer a personal narrative from encountering these ‘normalising interventions’, supported by the narratives of other ‘breast cancer survivors’. Indeed, I havechosento become acquainted with my altered/novel embodiment, rather than the symmetrisation of prosthetication, to ‘wear my scars’,and thus subvert the trajectory of mastectomy. I broach and brook various encounters with failure by having, being and doing a body otherwise; exploring, mastering and re-capacitating my embodiment, finding the virtuosity of failure and subversion. To challenge the durée of ‘normalisation’ I have engaged in somatic movement practices which allow actual capacities of embodiment to be realised; thorough kinaesthetic praxis and expression. This paper asks is it soma, psyche or techné that has failed me, or have I failed them? What mimetic chimera ‘should’ I become? What choices do we have in the face of failure? What subversions can be allowed? How subtle must one be? What referent shall I choose? What might one assimilate? Will mimesis get me in the end? What capacities can one find? How shall I belong? Where / wear is my fidelity? The hope here is to address the intra-personal phenomenological character and the inter-corporeal socio-ethico-political aspects that this body of failure engenders, as one amongst many.
Violating Failures: Rosa Luxemburg's Spartacus Manifesto and Dada Berlin Anti-manifestation
Authors: Katsouraki Eve
Published: April 2013

Some of the greatest Marxist historical accounts of revolutionary events are the accounts of great failures. One needs only mention the German Peasants' War, the Jacobins in the French Revolution, the Paris Commune, the October Revolution, the Chinese Cultural Revolution while numerous others lurk behind many of the battles of the proletariat throughout the twentieth century. In the most radical political engagement, such as the Cultural Revolution for Badiou, or the Nazi Revolution for Heidegger, failure also signals the end of the traditional mode of political engagement as such. But what is failure precisely? And what our confrontation with such failures really means for revolutionary politics and anarchist artistic movements of the early twentieth century such as Dada Berlin? The aim of this articleis thus toexamine failure's capacity to act as a mode of (political) resistance firmly rooted in revolutionary politics and radical anarchist cultural projects. As I argue, failure's radical properties are found in acts of ‘determinate negation'which exhibit a profound anti-conformist ideology that aims to shatter conventional standards of hegemonic value and seek to reshape and loosen the boundaries that determine lived experience in a socio-political and artistic level. To follow through this hypothesis, I explore the embodied activity of the ‘agonal’ embedded in the manifesto in relation to the failed revolution of SpartacusUprise in Berlin of 1919 and the aesthetic attitude of ‘anti-manifestation'exhibited by the deeply politicised, andintimately aliened to the Spartacus agitational project, cultural movement of Dada Berlin. In this context, failure, I argue, is appropriated into a function of doing of the ‘negative’ –anegative poiesis, whose violent tension,already embedded in the performativity of the genre of the manifesto that seeks to subject to the real the foundational force of a future to come,marks artistic praxis onto the political moment with such a creative vigour as if in violently seeking the arrival of the new world and its making.And by looking at Badiou's theories on the four modes of subjectivities, Zizek's reflections on the formation of Badiou's Event, in relation of Heidegger's ontological violence found in the essencing ability of language and of Luxemburg's political philosophy, failure reveals a truly ‘miraculous’ proposition that is other than acceptance of defeat but the call for fidelity, ‘the work of love,’ which resides at the heart of every such violating failure.
Embodying Failure: Music Performance, Risk and Authenticity
Authors: Newland Imogene
Published: April 2013

Certain trends in the recital of Western art music composition and performance have embraced indeterminacy through an emerging sonic aesthetic that seeks to redefine the notion of failure. From Charles Ives' adoption of bi-tonality in the early twentieth century to the ‘glitch’ movement in contemporary computer music, this article traces ways in which musicians have sought to embrace the risk for failure in performance with special attention to virtuosic instrumental music ( Cascone 2006 ; Rodgers 2003 ; Godlovitch 1998 ; Rosen 2002 ). Drawing upon the author's recent interdisciplinary practice-led research ‘Woman=Music=Desire’ (2010) and adopting a choreographic approach to the re-appropriation of musical gesture, the author explores how the risk for failure contributes to live musical experience. This discussion is then extended to the process of corporeal acquisition necessary in rehearsing and performing a piece of music which, the author suggests, results in a degree of gestural self-simulation. In this way, the performer's personal authenticity is discussed as a potential locus of failure in which the physical manifestation of emotional expression helps to determine empathetic identification between performer, spectator and instrument ( Kivy 1995 ). Drawing upon Steven Baker's notion of ‘botched taxidermy’ (2000), the author suggests that this empathetic identification creates a space in which the potential risk for failure might be considered intrinsic to conceptions of corporeality in music performance. In this way, live musical experience is posited a site of risk in which the performer, as a desiring subject, emerges as the embodiment of failure. A short excerpt of the case study ‘Woman=Music=Desire’ may be viewed at: http://www.imogene-newland.co.uk/perf_women_md.php
Human Adult Periodontal Ligament-Derived Cells Integrate and Differentiate after Implantation into the Adult Mammalian Brain
Authors: Bueno Carlos , Ramirez Carmina , Rodríguez-Lozano Francisco J. , Tabarés-Seisdedos Rafael , Rodenas Mónica , Moraleda Jose M. , Jones Jonathan R. , Martinez Salvador
Published: April 2013

Previous studies suggest that neural crest (NC)-derived stem cells may reside in NC derivatives including the human periodontal ligament (hPDL). The isolation and manipulation of autologous NC-derived cells could be an accessible source of adult neural stem cells for their use in cell replacement and gene transfer to the diseased central nervous system. In this study, we examined the expression of NC markers and neural differentiation potential of hPDL-derived cells both in vitro and in vivo. In vitro we found that hPDL-derived cells expressed stem cell markers (Oct3/4, Nestin, Sox2, and Musashi-1) and a subset of NC cell markers (Slug, p75NTR, Twist, and Sox9). hPDL-derived cells differentiated into neural-like cells based on cellular morphology and neural marker expression (TUJ1, MAP2, MAP1b, GAD65/67, GABA, NeuN, ChAT, GAT1, synaptophysin, GFAP, NG2, and O4). In vivo, hPDL-derived cells survive, migrate, and give rise to DCX+, NF-M+, GABA+, GFAP+, and NG2+ cells after grafting the adult mouse brain. Some of the grafted hPDL-derived cells were located in stem cell niches such as the ventricular epithelium and the subventricular zone of the anterolateral ventricle wall as well as in the subgranular zone of the hippocampal dentate gyrus. Thus, the hPDL contains stem cells that originate from the NC and can differentiate into neural cells. The engraftment and differentiation properties of hPDL-derived cells in the adult brain indicate that they are a potential stem cell source to be used in neuroregenerative and/or neurotrophic medicine.
Therapeutic Potential of Human Induced Pluripotent Stem Cells in Experimental Stroke
Authors: Chang Da-Jeong , Lee Nayeon , Park In-Hyun , Choi Chunggab , Jeon Iksoo , Kwon Jihye , Oh Seung-Hun , Shin Dong Ah , Do Jeong Tae , Lee Dong Ryul , Lee Hyunseung , Hong Kwan Soo , Daley George Q. , Song Jihwan , Moon Hyeyoung
Published: April 2013

Ischemic stroke mainly caused by middle cerebral artery occlusion (MCAo) is a major type of stroke, but there are currently very limited therapeutic options for its cure. Neural stem cells (NSCs) or neural precursor cells (NPCs) derived from various sources are known to survive and improve neurological functions when they are engrafted in animal models of stroke. Induced pluripotent stem cells (iPSCs) generated from somatic cells of patients are novel cells that promise the autologous cell therapy for stroke. In this study, we successfully differentiated iPSCs derived from human fibroblasts into NPCs and found their robust therapeutic potential in a rodent MCAo stroke model. We observed the significant graft-induced behavioral recovery, as well as extensive neural tissue formation. Animal MRI results indicated that the majority of contralaterally transplanted iPSC-derived NPCs migrated to the peri-infarct area, showing a pathotropism critical for tissue recovery. The transplanted animals exhibited the significant reduction of stroke-induced inflammatory response, gliosis and apoptosis, and the contribution to the endogenous neurogenesis. Our results demonstrate that iPSC-derived NPCs are effective cells for the treatment of stroke.
Enhanced Oxygen Supply Improves Islet Viability in a New Bioartificial Pancreas
Authors: Barkai Uriel , Weir Gordon C. , Colton Clark K. , Ludwig Barbara , Bornstein Stefan R. , Brendel Mathias D. , Neufeld Tova , Bremer Chezi , Leon Assaf , Evron Yoav , Yavriyants Karina , Azarov Dimitri , Zimermann Baruch , Maimon Shiri , Shabtay Noa , Balyura Maria , Rozenshtein Tania , Vardi Pnina , Bloch Konstantin , De Vos Paul , Rotem Avi
Published: April 2013

The current epidemic of diabetes with its overwhelming burden on our healthcare system requires better therapeutic strategies. Here we present a promising novel approach for a curative strategy that may be accessible for all insulin-dependent diabetes patients. We designed a subcutaneous implantable bioartificial pancreas (BAP)—the “β-Air”—that is able to overcome critical challenges in current clinical islet transplantation protocols: adequate oxygen supply to the graft and protection of donor islets against the host immune system. The system consists of islets of Langerhans immobilized in an alginate hydrogel, a gas chamber, a gas permeable membrane, an external membrane, and a mechanical support. The minimally invasive implantable device, refueled with oxygen via subdermally implanted access ports, completely normalized diabetic indicators of glycemic control (blood glucose intravenous glucose tolerance test and HbA1c) in streptozotocin-induced diabetic rats for periods up to 6 months. The functionality of the device was dependent on oxygen supply to the device as the grafts failed when oxygen supply was ceased. In addition, we showed that the device is immunoprotective as it allowed for survival of not only isografts but also of allografts. Histological examination of the explanted devices demonstrated morphologically and functionally intact islets; the surrounding tissue was without signs of inflammation and showed visual evidence of vasculature at the site of implantation. Further increase in islets loading density will justify the translation of the system to clinical trials, opening up the potential for a novel approach in diabetes therapy.
Human Multipotent Adult Progenitor Cells Are Nonimmunogenic and Exert Potent Immunomodulatory Effects on Alloreactive T-Cell Responses
Authors: Jacobs Sandra A. , Pinxteren Jef , Roobrouck Valerie D. , Luyckx Ariane , Van't Hof Wouter , Deans Robert , Verfaillie Catherine M. , Waer Mark , Billiau An D. , Van Gool Stefaan W.
Published: April 2013

Multipotent adult progenitor cells (MAPCs) are bone marrow-derived nonhematopoietic stem cells with a broad differentiation potential and extensive expansion capacity. A comparative study between human mesenchymal stem cells (hMSCs) and human MAPCs (hMAPCs) has shown that hMAPCs have clearly distinct phenotypical and functional characteristics from hMSCs. In particular, hMAPCs express lower levels of MHC class I than hMSCs and cannot only differentiate into typical mesenchymal cell types but can also differentiate in vitro and in vivo into functional endothelial cells. The use of hMSCs as cellular immunomodulatory stem cell products gained much interest since their immunomodulatory capacities in vitro became evident over the last decade. Currently, the clinical grade stem cell product of hMAPCs is already used in clinical trials to prevent graft-versus-host disease (GVHD), as well as for the treatment of acute myocardial infarct, ischemic stroke, and Crohn's disease. Therefore, we studied the immune phenotype, immunogenicity, and immunosuppressive effect of hMAPCs in vitro. We demonstrated that hMAPCs are nonimmunogenic for T-cell proliferation and cytokine production. In addition, hMAPCs exert strong immunosuppressive effects on T-cell alloreactivity and on T-cell proliferation induced by mitogens and recall antigens. This immunomodulatory effect was not MHC restricted, which makes off-the-shelf use promising. The immunosuppressive effect of hMAPCs is partially mediated via soluble factors and dependent on indoleamine 2,3-dioxygenase (IDO) activity. At last, we isolated hMAPCs, the clinical grade stem cell product of hMAPCs, named MultiStem, and hMSCs from one single donor and observed that both the immunogenicity and the immunosuppressive capacities of all three stem cell products are comparable in vitro. In conclusion, hMAPCs have potent immunomodulatory properties in vitro and can serve as a valuable cell source for the clinical use of immunomodulatory cellular stem cell product.
Therapeutic Superiority for Cartilage Repair by CD271-Positive Marrow Stromal Cell Transplantation
Authors: Mifune Yutaka , Matsumoto Tomoyuki , Murasawa Satoshi , Kawamoto Atsuhiko , Kuroda Ryosuke , Shoji Taro , Kuroda Tomoya , Fukui Tomoaki , Kawakami Yohei , Kurosaka Masahiro , Asahara Takayuki
Published: April 2013

Recent reports indicated that human isolated CD271+ bone marrow mesenchymal stromal cells (BM-MSCs) have a greater expansion and potential for multipotent differentiation including chondrogenesis than classical plastic adherent (PA) BM-MSCs in vitro. Therefore, we set up a hypothesis that CD271+ MSCs may have a greater chondrogenic potential than PA-MSCs in vitro and in vivo. We investigated the superiority of CD271+ MSCs on chondrogenesis using in vitro expansion and pellet culture system and in vivo rat model of cartilage defect when compared to PA-MSCs. In the in vitro study, CD271+ MSCs showed higher expansion potential and produced larger pellets with higher expressions of chondrogenic genes when compared to the control groups. During the culture, CD271 expression decreased, which resulted in decreased chondrogenesis. In the in vivo study, immunohistochemical staining demonstrated differentiated human chondrocytes identified as double-stained cells with human-specific collagen type 2 and human leukocyte antigen-ABC in CD271+ and PA groups. The number of double-stained cells was significantly higher in the CD271+ group than PA group. Real-time RT-PCR analysis of tissue RNA isolated from the chondral defect site for human-specific chondrogenic markers demonstrated a significantly higher expression in CD271+ group than PA group. Macroscopic examination of chondral defect sites at week 8 revealed glossy white and well-integrated repaired tissues in the CD271+ and PA groups, but not in the PBS group. The average histological score in the CD271+ group was significantly greater than in the other groups. Apoptosis analysis at the cell transplanted site with TUNEL staining showed that the CD271+ group had significantly fewer apoptotic chondrocytes compared with the PA group. These results indicate that CD271+ MSCs have a greater chondrogenic potential than PA-MSCs in both in vitro and in vivo conditions.