bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrathecal endoscopy to enhance the diagnosis of tethered cord syndrome
Authors: Woods Kamal R. M. , Colohan Austin R. T. , Yamada Shokei , Yamada Shoko M. , Won Daniel J.
Published: October 2010

Object

Tethered cord syndrome (TCS) is being diagnosed in an increasing number of adults and late teens. Before referral to neurosurgeons, however, the majority of patients in this group suffers back and leg pain for a long period without a definitive diagnosis. The diagnostic difficulty derives from 2 factors: the signs and symptoms are subtle and easily overlooked, and the combination of an elongated cord and a thickened filum is lacking in 65% of patients. When a patient presents with signs and symptoms typical for TCS but demonstrates no elongated cord or thickened filum on MR imaging, one must search for a more reliable finding to establish a diagnosis of TCS. Based on the authors' earlier surgical experiences, posterior displacement of the terminal filum is consistently found at surgery in all patients with TCS. In previous publications they interpreted this finding as the lower cord and filum traveling along the concave side of the lumbosacral spinal canal to minimize cord tension. In the present prospective study, the authors attempt to confirm posterior displacement of the filum terminale by using intrathecal endoscopy prior to wide exposure of the spinal cord and filum. Further, the stretch test was applied to the terminal filum to evaluate its elasticity.

Methods

Sixty-eight patients with signs and symptoms as well as MR imaging studies indicative of TCS underwent endoscopic examination of the filum and cauda equina. After lumbar or sacral laminectomy, a flexible endoscope was inserted through a small dural and arachnoid incision into the subarachnoid space. The filum and cauda equina fibers were identified. Once the dura mater and arachnoid were opened widely, a stretch test was done to confirm filum inelasticity. In 3 patients, percutaneous endoscopy was also performed before open surgery to determine its applicability as compared with the open method.

Results

On inserting the endoscope into the intrathecal space, the filum was immediately identified medioposterior to the cauda equina fibers in all 68 patients. The stretch test revealed a lack of filum elasticity in all patients. Preoperative percutaneous endoscopy was equally effective in identifying the position of the filum.

Conclusions

Currently, endoscopic identification of the posteriorly displaced filum, which was confirmed at open surgery, is the essential diagnostic study for TCS or the tethered spinal cord. Furthermore, the stretch test of the filum proves its inelasticity, and filum sectioning leads to ascension and relaxation of the caudal spinal cord. These results can be linked to the impaired oxidative metabolism of the lumbosacral cord under excessive tension and to the metabolic and neurological improvements seen after filum sectioning.
The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury
Authors: Kaner Tuncay , Karadag Tolga , Cirak Bayram , Erken Haydar Ali , Karabulut Aysun , Kiroglu Yilmaz , Akkaya Semih , Acar Feridun , Coskun Erdal , Genc Osman , Colakoglu Nagihan
Published: October 2010

Object

Even though there have been many efforts to recover neuronal dysfunction following spinal cord injuries, there are limitations to the treatment of these injuries. The purpose of this laboratory investigation was to determine the clinical and neurophysiological effects of human umbilical cord blood (HUCB) transplantation in a rat hemisection model of spinal cord injury.

Methods

In this study, experimental hemisection of the thoracic spinal cord was performed in rats. The rats were divided into 4 groups (6 rats in each group). One group of rats (Group 1) underwent thoracic laminectomy only. Rats in Group 2 underwent laminectomy and right hemisection of the thoracic spinal cord. Rats in Group 3 underwent right hemisection and implantation of freshly obtained HUCB on Day 0 postinjury. Rats in Group 4 underwent hemisection and implantation of freshly obtained HUCB on Day 4 postinjury. Clinical evaluations of rat motor function included the following: neurological examination, Rotarod performance, and inclined plane tests. Rats also underwent reflex evaluation.

Results

The neurological examinations revealed that the frequency of plegic rats was 70.8% at the beginning of the study across all 4 groups; this value decreased to 20.8% by the end of the study. The percentage of rats with a normal examination increased from 25% to 50%. The results of Rotarod performance and 8-week inclined plane performance tests showed statistical significance (p < 0.05) in an overall group comparison across all time points. At the end of the 8 weeks, a statistically significant difference was found in the inclined plane test results between rats in Groups 1 and 2. There were no statistically significant differences between Groups 1, 3, and 4 (p < 0.05). When the reflex responses of the hemisectioned sides were compared, statistically significant differences were detected between groups (p < 0.05). All groups were significantly different with regard to the right-side reflex response score (p < 0.05). Spinal cord preparations of rats in all groups were examined for histopathological changes.

Conclusions

Human umbilical cord blood is stem cell rich and easily available, and it carries less risk of inducing a graft-versus-host reaction in the recipient. Human umbilical cord blood serum is also noted to contain stem cell–promoting factors, which is why cell isolation was not used in this study. Freshly obtained cord blood was also used because storage of cord blood has been reported to have some negative effects on stem cells. Transplantation of freshly obtained HUCB into the hemisectioned spinal cord experimental model demonstrated clinical and neurophysiological improvement.
Paraspinal-approach transforaminal lumbar interbody fusion for the treatment of lumbar foraminal stenosis
Authors: Fujibayashi Shunsuke , Neo Masashi , Takemoto Mitsuru , Ota Masato , Nakamura Takashi
Published: October 2010

Object

Foraminal stenosis is a common cause of lumbar radicular symptoms. Recognition of the dynamic pathology, as well as the static anatomical changes, is important to achieving successful surgical outcomes. Excessive facet and anulus removal leads to subsequent disc space narrowing and/or segmental instability, which can cause poor results after decompressive surgery. The objective of this study was to evaluate the efficacy of the paraspinalapproach transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar foraminal stenosis.

Methods

Twenty levels of lumbar foraminal stenosis in 16 patients were treated using an instrumented paraspinal-approach TLIF. There were 12 single-level and 4 two-level cases. Pathologies included foraminal stenosis at 13 levels and lateral disc herniation with disc space narrowing at 7.

Results

In all patients, preoperative radicular symptoms and mechanical low-back pain were resolved immediately after the operation and leg weakness improved gradually. The recovery rate using the Japanese Orthopaedic Association score was 89.1%. Bony union was achieved within 6 months after the operation in all cases. Postoperative MR imaging showed minimal changes in the paraspinal muscles in the single-level cases.

Conclusions

The paraspinal-approach TLIF is a minimally invasive, safe, and secure procedure for treating lumbar foraminal lesions. Direct visualization and decompression for the foraminal lesion, distraction of the collapsed disc space, and stabilization of the unstable segments can be achieved simultaneously through the paraspinal approach, which produces successful clinical and radiological results.
Normal anatomical variations of the V3 segment of the vertebral artery: surgical implications
Authors: Ulm Arthur J. , Quiroga Monica , Russo Antonino , Russo Vittorio M. , Graziano Francesca , Velasquez Angel , Albanese Erminia
Published: October 2010

Object

The authors undertook this cadaveric and angiographic study to examine the microsurgical anatomy of the V3segment of the vertebral artery (VA) and its relationship to osseous landmarks. A detailed knowledge of these variations is important when performing common neurosurgical procedures such as the suboccipital craniotomy and the far-lateral approach and when placing atlantoaxial instrumentation.

Methods

A total of 30 adult cadaveric specimens (59 sides) were studied using magnification × 3 to × 40 after perfusion of the arteries and veins with colored silicone. Seventy-three vertebral angiograms were also analyzed. The morphological detail of the V3segment was described and measured in both the cadavers and angiograms. Transarticular screws were placed into 2 cadavers and the relationship of the trajectory to the V3segment was analyzed.

Results

The authors identified 4 sites along the V3segment that are anatomically the most likely to be injured during surgical approaches to the craniovertebral junction. In 35% of the cadaveric specimens the vertical portion of V3formed a posteriorly oriented loop that could be injured during surgical exposures of the dorsal surface of C-2. The mean distance from the midline to the most posteromedial edge of the loop was 25.6 ± 3.5 mm (range 20–35 mm) on the left side and 30.4 ± 3.8 mm (range 23–36 mm) on the right side. On lateral angiograms, this loop projected posteriorly, with a mean distance of 9.8 ± 3.5 mm (range 0–15.7 mm) on the right side and 11.7 ± 1.2 mm (range 10–13.6 mm) on the left side. The horizontal segment of V3can be injured when exposing the lower lateral occipital bone and when the C-1 arch is exposed. The mean distance from the inferior border of the occipital bone to the superior surface of the horizontal segment of V3was 6 ± 2.8 mm on the right side and 5.6 ± 2.3 mm on the left. In 12% of cases the authors found no space between the horizontal portion of V3and the occipital bone. The medial edge of the horizontal segment of V3was located 23 ± 5.5 mm (range 10–30 mm) from the midline on the right side and 24 ± 5.7 mm (range 15–32 mm) on the left side. The transition between the V2–V3segments after exiting the C-2 vertebral foramen is the most likely site of injury when placing C1–2 transarticular screws or C-2 pars screws.

Conclusions

The normal variation of the V3segment of the VA has been described with quantitative measurements. An awareness of the anatomical variations and the relationships to the surrounding bony anatomy will aid in reducing VA injury during suboccipital approaches, exposure of the dorsal surfaces of C-1 and C-2, and when placing atlantoaxial spinal instrumentation.
Total subaxial reconstruction
Authors: Traynelis Vincent C.
Published: October 2010

Object

Certain cervical spinal conditions require decompression and reconstruction of the entire subaxial cervical spine. There are limited data concerning the clinical details and outcomes of patients treated in this manner. The object of this study was to describe the specific technique employed to perform a total subaxial reconstruction and review the postoperative outcomes following surgery.

Methods

The author performed a review of data prospectively collected in 27 consecutive patients undergoing complete anterior decompression and reconstruction of the anterior cervical spine and followed by posterior instrumented arthrodesis with or without decompression.

Results

There were 16 men and 11 women whose mean age was 59 years (range 35–86 years). The minimum follow-up was 12 months and the mean follow-up period for all patients was 26 months. One patient underwent C2–7 surgery, and in all others the procedure crossed the cervicothoracic junction.

Following surgery patients remained intubated for an average of 3.3 days (range 1–22 days). The mean hospital length of stay was 11 days (range 3–45 days). One patient died 6 weeks following an uneventful surgery. Pneumonia developed in 5 patients, 1 patient experienced a minor pulmonary embolism, and 2 patients had posterior wound infections. No patient was neurologically worse following surgery. A single patient presented with a C-8 radiculopathy 6 weeks after surgery. At final follow-up no patient complained of dysphagia when specifically questioned about this potential problem. In all patients solid fusions developed at each treated levels. Preoperatively the mean sagittal Cobb angle was 15.4° (kyphosis) and the postoperative mean angle was −10.9° (lordosis) representing a total average correction of over 25° (p < 0.0001). The mean preoperative Neck Disability Index was 27.6; this score decreased to 15.5 (p = 0.0008) postoperatively. The mean pre- and postoperative visual analog scale neck pain scores were 6.0 and 2.1, respectively (p = 0.0004), and mean visual analog scale arm pain scores decreased by 3.7 following surgery (p = 0.001). Based on Odom criteria, the author found that 8 patients had an excellent outcome and 14 patients a good outcome. There were 4 patients in whom the outcome was judged to be fair and the single death was recorded as a poor outcome. The mean preoperative Nurick score was 2.68. Postoperatively the group improved to an average score of 1.5; the difference between the 2 was statistically significant (p = 0.002).

Conclusions

Segmental anterior decompression and reconstruction of the entire subaxial cervical spine, combined with an instrumented posterolateral fusion, can be performed with acceptable morbidity and is of significant benefit in selected patients.
Craniometric changes in patients with acromegaly from a surgical perspective
Authors: Ebner Florian H. , Kürschner Verena , Dietz Klaus , Bültmann Eva , Nägele Thomas , Honegger Juergen
Published: October 2010

Object

The objective of this study was to evaluate and analyze morphometric and volumetric changes of the skull due to acromegaly in areas relevant for neurosurgical practice, focusing on the surgical implications.

Methods

On preoperatively acquired CT scans, cephalometric and volumetric measurements were performed on 45 patients with acromegaly (Group A) and 45 control patients (Group B). The authors determined thickness of the cranial vault, inner and outer diameters of the skull, and the diameter of sphenoidal and maxillary sinus, as well as frontal and maxillary sinus volumetry. The morphometric and volumetric CT data of the patients with acromegaly were compared with the data of a control group and correlated with clinical parameters.

Results

Cranial vault thickness differed significantly (p < 0.0001) between the 2 groups. A correlation of the vault thickness with preoperative human growth hormone, insulin-like growth factor–I levels, and duration of clinical history in acromegaly could not be established. The outer anterior-posterior skull diameter of Group A (18.47 ± 0.94 cm) differed significantly (p = 0.0146) from Group B (17.98 ± 0.93 cm) and correlated significantly with preoperative human growth hormone (r = 0.3277; p = 0.0299) and insulin-like growth factor-–I serum levels (r = 0.3756; p = 0.0120). Measurements of the anterior-posterior diameter of the sphenoidal sinus differed significantly (p = 0.0074) between patients with acromegaly and controls. Volumetric analysis of the frontal sinus resulted in a statistically significant difference (p = 0.0382) between patients with acromegaly (14.89 ± 10.85 cm3) and controls (10.06 ± 6.93 cm3).

Conclusions

Significant craniometric changes and volumetric remodelling of the paranasal sinus occur in acromegaly. The bone alterations are of surgical importance for using the transsphenoidal approach. Detailed preoperative diagnostic examination and planning as well as selection of appropriate instruments are mandatory for safe and successful pituitary adenoma removal in patients with acromegaly.
Pharmacological management of acromegaly: a current perspective
Authors: Manjila Sunil , Wu Osmond C. , Khan Fahd R. , Khan Mehreen M. , Arafah Baha M. , _ _ , Selman Warren R.
Published: October 2010

Acromegaly is a chronic disorder of enhanced growth hormone (GH) secretion and elevated insulin-like growth factor–I (IGF-I) levels, the most frequent cause of which is a pituitary adenoma. Persistently elevated GH and IGF-I levels lead to substantial morbidity and mortality. Treatment goals include complete removal of the tumor causing the disease, symptomatic relief, reduction of multisystem complications, and control of local mass effect. While transsphenoidal tumor resection is considered first-line treatment of patients in whom a surgical cure can be expected, pharmacological therapy is playing an increased role in the armamentarium against acromegaly in patients unsuitable for or refusing surgery, after failure of surgical treatment (inadequate resection, cavernous sinus invasion, or transcapsular intraarachnoid invasion), or in select cases as primary treatment. Three broad drug classes are available for the treatment of acromegaly: somatostatin analogs, dopamine agonists, and GH receptor antagonists.

Somatostatin analogs are considered as the first-line pharmacological treatment of acromegaly, although efficacy varies among the different formulations. Octreotide long-acting release (LAR) appears to be more efficacious than lanreotide sustained release (SR). Lanreotide Autogel (ATG) has been shown to result in similar biological control as octreotide LAR, and there may be a benefit in switching from one to the other in some cases of treatment failure. The novel multireceptor somatostatin analog pasireotide, currently in Phase II clinical trials, also shows promise in the treatment of acromegaly. Dopamine agonists have been the earliest and most widely used agents in the treatment of acromegaly but have been found to be less effective than somatostatin analogs. In this class of drugs, cabergoline has shown greater efficacy and tolerability than bromocriptine. Dopamine agonists have the advantage of oral administration, resulting in increased use in select patient groups. Selective GH receptor antagonists, such as pegvisomant, act by blocking the effects of GH, resulting in decreased IGF-I production despite persistent elevation of GH serum levels. Thus far, tumor growth has not been a concern during pegvisomant therapy. However, combination treatment with somatostatin analogs may counteract these effects. The authors discuss the latest guidelines for biochemical cure and highlight the efficacy of combination therapy. In addition, the effects of pharmacological presurgical treatment on surgical outcome are explored.
Growth hormone-secreting adenomas: pathology and cell biology
Authors: Lopes M. Beatriz S.
Published: October 2010

The majority of patients with acromegaly harbor a functioning growth hormone (GH) pituitary adenoma. Growth hormone–secreting adenomas correspond to about 20% of all pituitary adenomas. From the histopathological point of view, a variety of adenomas may present with clinical signs and symptoms of GH hypersecretion including pure GH cell adenomas (densely and sparsely granulated GH adenomas), mixed GH and prolactin cell adenomas, and monomorphous adenomas with primitive cells able to secrete GH and prolactin including the acidophilic stem cell adenoma and the mammosomatotroph cell adenoma. In this article, the author reviews the main pathological features of the GH-secreting adenomas and some of the molecular genetics mechanisms involved in their pathogenesis.
Magnetic resonance imaging versus ultrasonography for the in utero evaluation of central nervous system anomalies
Authors: Peruzzi Pierpaolo , Corbitt Rebecca J. , Raffel Corey
Published: October 2010

Object

The use of fetal MR imaging for the in utero evaluation of pathological conditions of the CNS is widely accepted as an adjunct to fetal ultrasonography studies. Magnetic resonance imaging is thought to characterize CNS anomalies better, and to provide a more exact diagnosis and accurate prognosis. The purpose of this study was to determine the role of and indications for fetal MR imaging in evaluating fetuses with different CNS abnormalities that were seen initially on prenatal sonograms.

Methods

Over a 3-year period, fetuses with prior sonographic evidence of CNS abnormalities who consequently received prenatal MR imaging at Columbus Nationwide Children's Hospital within 2 weeks of the fetal ultrasonography study were included in this study. For each patient, radiological reports from both studies were reviewed, analyzed, and compared with the findings at postnatal imaging or physical examination. Results of the 2 modalities were then compared in terms of diagnostic accuracy.

Results

Twenty-six fetuses were included in this study on the basis of an in utero sonogram showing a CNS anomaly. Their gestational age ranged from 17 to 35 weeks, with a mean of 25 weeks at the time of fetal ultrasonography. Hydrocephalus was identified in 16 fetuses, 6 had evidence of a spinal dysraphic defect, 2 had holoprosencephaly, 1 had an encephalocele, and 1 had multiple body abnormalities requiring detailed CNS evaluation. Twenty-five of the fetuses were correctly evaluated as having abnormal CNS findings on both fetal ultrasonography and fetal MR imaging. Fetal ultrasonography provided a correct prenatal diagnosis in 20 cases, whereas fetal MR imaging was correct in 22 cases. There were 9 cumulative false-positive results for fetal ultrasonography and 7 for fetal MR imaging, whereas for false-negative results there were a total of 34 and 19, respectively.

Conclusions

Fetal MR imaging is more sensitive in detecting fetal CNS abnormalities, but its ability to provide a correct prenatal diagnosis is only marginally superior to fetal ultrasonography. Moreover, fetal MR imaging is not exempt from misdiagnosis, and still shows a significantly high rate of false-negative results. Particularly for spinal dysraphic defects, fetal MR imaging does not seem to add important diagnostic or prognostic details when compared with fetal ultrasonography.
Small ventricular access prior to rigid neuroendoscopy
Authors: Naftel Robert P. , Tubbs R. Shane , Reed Gavin T. , Wellons John C.
Published: October 2010

The authors describe a new technique that may be used in conjunction with neuronavigation or freehand techniques for obtaining small ventricular access. Using this modification, the introducer sheath and trocar can be guided down a ventriculostomy tract with endoscopic visual control. With increasing focus on endoscopic therapies in patients without hydrocephalus, this adjunct, based on the authors' experience, may provide an additional technique for safely treating patients.
Correlation of thin fibrous cap possessing adipophilin-positive macrophages and intraplaque hemorrhage with high clinical risk for carotid endarterectomy
Authors: Hao Hiroyuki , Iihara Koji , Ishibashi-Ueda Hatsue , Saito Fumio , Hirota Seiichi
Published: October 2010

Object

Preoperative clinical risk classification of carotid artery (CA) stenosis anticipates the outcome of CA intervention. A higher incidence of neurological morbidity was noted after CA stenting (CAS) in patients with medical risks than in those without risks. However, little is known about the correlation between clinical risks and plaque composition. The purpose of this study was to characterize the CA plaque histology in 3 groups of patients who were classified based on clinical risks for carotid endarterectomy (CEA). Furthermore, the authors examined whether the plaque with high embolic potential after CA intervention, particularly CAS, could be predicted based on clinical risks for CEA.

Methods

Patients were divided into 4 groups, according to the CEA risk classification system, and 3 groups with more than 10 cases were enrolled in this study as follows: absence of all angiographic, medical, and neurological risks (Grade I, 27 cases); presence of medical risk, but no neurological risk (Grade III, 31 cases); and presence of neurological risk (Grade IV, 17 cases). Histopathological characteristics of CA plaques, including fibrous cap thickness, plaque disruption, thrombus formation, intraplaque hemorrhage (IPH), and adipophilin expression were examined without information regarding clinical status.

Results

Plaques in patients in Grades III and IV demonstrated a thin fibrous cap and enhanced IPH, compared with those in Grade I. Plaques in patients in Grade IV showed more adipophilin-expressing macrophages in the fibrous cap than in those of the other groups.

Conclusions

Plaques in Grades III and IV patients were characterized by thin fibrous cap atheroma with IPH. Adipophilin-positive macrophage infiltration in the fibrous cap might be correlated with instability in neurological status. The plaque morphology in patients with medical and neurological risks needs to be examined carefully with the aid of imaging modalities. In plaques demonstrating a thin fibrous cap and IPH, the CAS procedure should be avoided and CEA should be performed instead.
Anatomical triangles defining surgical routes to posterior inferior cerebellar artery aneurysms
Authors: Rodríguez-Hernández Ana , Lawton Michael T.
Published: October 2010

Object

Surgical routes to posterior inferior cerebellar artery (PICA) aneurysms are opened between the vagus (cranial nerve [CN] X), accessory (CN XI), and hypoglossal (CN XII) nerves for safe clipping, but these routes have not been systematically defined. The authors describe 3 anatomical triangles and their relationships with PICA aneurysms, routes for surgical clipping, outcomes, and angiographically demonstrated anatomy.

Methods

The vagoaccesory triangle is defined by CN X superiorly, CN XI laterally, and the medulla medially. It is divided by CN XII into the suprahypoglossal triangle (above CN XII) and the infrahypoglossal triangle (below CN XII). From a consecutive surgical series of 71 PICA aneurysms in 70 patients, 51 aneurysms were analyzed using intraoperative photographs.

Results

Forty-three PICA aneurysms were located inside the vagoaccessory triangle and 8 were outside. Of the aneurysms inside the vagoaccessory triangle, 22 (51%) were exposed through the suprahypoglossal triangle and 19 (44%) through the infrahypoglossal triangle; 2 were between triangles. The lesions were evenly distributed between the anterior medullary (16 aneurysms), lateral medullary (19 aneurysms), and tonsillomedullary zones (16 aneurysms). Neurological and CN morbidity linked to aneurysms in the suprahypoglossal triangle was similar to that associated with aneurysms in the infrahypoglossal triangle, but no morbidity was associated with PICA aneurysms outside the vagoaccessory triangle. A distal PICA origin on angiography localized the aneurysm to the suprahypoglossal triangle in 71% of patients, and distal PICA aneurysms were localized to the infrahypoglossal triangle or outside the vagoaccessory triangle in 78% of patients.

Conclusions

The anatomical triangles and zones clarify the borders of operative corridors to PICA aneurysms and define the depth of dissection through the CNs. Deep dissection to aneurysms in the anterior medullary zone traverses CNs X, XI, and XII, whereas shallow dissection to aneurysms in the lateral medullary zone traverses CNs X and XI. Posterior inferior cerebellar artery aneurysms outside the vagoaccessory triangle are frequently distal and superficial to the lower CNs, and associated surgical morbidity is minimal. Angiography may preoperatively localize a PICA aneurysm's triangular anatomy based on the distal PICA origin or distal aneurysm location.
Metachronous multifocal desmoid-type fibromatoses along the neuraxis with adenomatous polyposis syndrome
Authors: Carlos Chung K. H. , Charlton Amanda , Arbuckle Susan , Chaseling Raymond , Owler Brian K.
Published: October 2010

Desmoid-type fibromatosis, aggressive fibromatosis, or desmoid tumor is an uncommon benign but locally aggressive fibroblastic lesion. Although intraabdominal desmoid-type fibromatoses are well described in association with adenomatous polyposis syndrome, their occurrence along the neuraxis is extremely rare. The authors report the case of a 14-year-old boy with metachronous intracranial and spinal desmoid-type fibromatoses with preceding medulloblastoma. He was ultimately diagnosed with adenomatous polyposis syndrome. This is the first reported case of spinal desmoid-type fibromatosis in association with adenomatous polyposis syndrome. The identification of an underlying genetic instability allows for screening to detect lesions and institute measures to avoid preventable mortality from nonneurological tumors.
Classification of Legal Families Today. Is it time for a memorial hymn ?
Authors: Husa Jaakko
Published: October 2010

Classifying and grouping legal systems is said to be an elemental part of macrocomparative law. The author asks if it still is feasible to continue this macro-project or has it come time to play a memorial hymn now? Traditional comparative law has constructed manifold groupings and classifications, but according to the author the pieces of the puzzle have largely remained the same. However, the new strands of comparative law are saying that attempts to draw a map of the world’s legal systems are non-neutral biased projects because all classifications, categories, taxonomies and groupings are fundamentally flawed. The controversy between the tradition and critical or post-modern comparative law seems to end up in a state of epistemic confusion. What should be done in order to overcome the present deadlock of this debate? Two novel sketches for classification of the legal systems are presented and critically analysed in the article. According to the author both of these are a clear indication of some inborn epistemic difficulties that macro-comparative law a priori seems to contain. The article looks critically into these drafts, and re-positions the focus to the more general issue of classifying legal systems into larger groups. One of the main findings is the foundation of the current epistemic problems. The author points at the importance of Max Weber’s methodological influence to the project of comparative law which seems to produce basically the same kind of categorical classifications over and over again even when the scholars themselves are explicitly trying to avoid these problems. Basically, the article presents an argument according to which the very basic epistemic limitation of macro-comparative law is the categorical tradition that excludes truly novel ideas and empirical finesse. The main contemporary challenge of comparative law is to develop a common perspective through which the empirical reality of legal systems would be adequately reflected in the global map of macro-comparative law. In order to do this comparative lawyers must, however, methodologically incorporate the insights and findings of other disciplines studying law. This is inevitable if the vast complexity of law in the 21st century is going to be the empirical base of the classifications and groupings of macro-comparative law.
Entre la reconnaissance et la protection : la situation de l’embryon et du foetus au Canada et au Québec
Authors: Langevin Louise
Published: October 2010

Le gouvernement fédéral canadien a déposé au printemps 2002 un autre projet de loi concernant les techniques de procréation assistée et la recherche connexe. Dans ce contexte, il est utile de faire le point, de façon critique, sur le statut juridique du foetus au Québec et au Canada en droit fédéral et provincial. La première partie du texte aborde le statut juridique du foetus au Québec et au Canada dans le contexte de l’avortement, dans d’autres situations concernant le droit criminel, en cas d’intervention médicale sur le foetus ou sur la femme enceinte, et lors du recours juridique de l’enfant pour le préjudice subi pendant sa vie intra-utérine. La Cour suprême du Canada a progressivement reconnu le droit à l’autonomie reproductive de la femme et l’absence de personnalité juridique du foetus. Dans la seconde partie, l’auteure traite de la protection de l’embryon ex utero et du contrôle juridique de la procréation assistée et de la recherche génétique. Sont analysées les mesures de protection de l’embryon ex utero présentement disponibles en vertu des principes de common law et de droit civil québécois, de certaines lois fédérales et provinciales, de codes de conduite adoptés par des organismes subventionnaires, ainsi que les mesures de protection qui seront offertes par le nouveau projet de loi, s’il est adopté. Une courte critique du projet de loi est proposée.
Quelques développements récents dans le droit du statut personnel en Égypte
Authors: Bernard-Maugiron Nathalie
Published: October 2010

Taking as a starting point a Law of 2000 unifying and re-organizing the rules of procedure in the field of personal status, this article introduces the main developments that took place in Egyptian family law during the last few years. Through the study of provisions of this law dealing more particularly with the dissolution of the marriage, the payment of alimonies and improvement of judicial procedure, the evolution of Egyptian family law all over the XXth century is also sketched. The methods to which the legislator resorted to reform this branch of law while remaining within the framework of the Islamic shari ´ a will also be presented, as well as the way the constitutional judge has validated these reforms.
Y a-t-il un droit à la représentation syndicale en Grande-Bretagne ?
Authors: Palli Barbara
Published: October 2010

The aim of this paper is to show that the European Court of Human Rights (ECrHR) decisions may exercise a particular influence on the promotion of Human Rights of workers within the British legal order. In that perspective, I will first study the Wilson and Palmer cases in their British context so as to grasp their resulting from a hostile environment towards trade unionism and collective bargaining. The ECrHR decision which came about on 2nd July 2002, corroborates the State’s obligation to guarantee trade union representation rights and, to prohibit discriminatory action on this ground. I will then see how this decision, so much awaited by trade union circles, served as a starting point for the setting up of a parliament bill which is intended to ensure conformity of British law to the ECrHR decision. This bill was submitted to the House of Commons on 2ndDecember 2003 and proposes, on the one hand, the introduction of trade union representation rights on an individual basis and, on the other, a ban on incentives to quit union representation. Finally, though I recognise the value of this first step I propose to conclude this article on some critical appraisal of the proposed bill with regard to the spirit of the ECrHR decision.
L’effacement des dettes permet-il un nouveau départ ? Comparaison franco-américaine
Authors: Schiller Sophie
Published: October 2010

Il existe quatre procédures françaises d’effacement des dettes. Trois sont ouvertes à des débiteurs particuliers: la faillite civile d’application limitée au territoire d’Alsace Moselle, la procédure d’effacement partiel des dettes susceptible d’être recommandée par une commission de surendettement et la procédure de rétablissement personnel créée par la loi du 1er août 2003. Une quatrième procédure est applicable dans l’hypothèse où le débiteur est une entreprise ayant fait l’objet d’une liquidation clôturée pour insuffisance d’actif. Ces procédures ont pour points communs de n’être accordées que lorsque la situation du débiteur est totalement désespérée, c’est-à-dire trop tard, et de faire l’objet d’une vaste publicité. Leurs bénéficiaires sont donc exsangues et marqués au fer rouge de la défaillance. Dans ces conditions ils ne pourront que fort rarement prendre un nouveau départ. Les États Unis sont le pays de la seconde chance et les débiteurs en difficulté ont de réelles possibilités de rebondir. L’étude du droit américain permet de découvrir les raisons de ce succès. Il existe deux principales différences avec les règles françaises. D’une part, le régime américain permet un traitement précoce des difficultés et il favorise le débiteur exerçant encore une activité économique. D’autre part, le droit américain encourage le traitement conventionnel des difficultés économiques. Les procédures sont ainsi mieux acceptées, plus rapides, moins onéreuses et donc globalement plus efficaces. Ses créanciers acceptant précocement et généreusement d’effacer des dettes, un débiteur en difficulté bénéficiera d’une réelle possibilité de nouveau départ.
Libres propos sur l’efficacité des systèmes de droit civil
Authors: Mallet-Bricout Blandine
Published: October 2010

Le Bicentenaire du Code civil français offre l’occasion à l’ensemble de la communauté des juristes de réfléchir, plus largement, sur l’avenir des systèmes de droit civil. Les débats sur la mondialisation du droit se multiplient, la concurrence de la

common law s’avère forte au sein même des pays traditionnellement rattachés aux systèmes de droit civil: certains s’en inquiètent, d’autres s’y résolvent... Dans ce contexte, peut-être faudrait-il davantage promouvoir l’efficacité des systèmes de droit romano-germanique, en s’interrogeant sur la notion même d’efficacité, qui ne se confond pas forcément avec une analyse économique du droit, et en défendant le pluralisme des systèmes juridiques, gage de modernité: la concurrence des droits permet l’émulation juridique et n’empêche pas une convergence raisonnée ou spontanée des droits, dans certains domaines spécifiques. A cet égard, l’influence des systèmes de droit civil passe aussi certainement par la construction d’instruments juridiques internationaux, dans le respect des diverses traditions juridiques. Les systèmes de droit civil, en particulier le droit français, sont performants; leurs qualités intrinsèques, leur rayonnement toujours actuel et leur souci renouvelé de suivre les évolutions -notamment technologiques -les plus récentes, en sont la preuve. Loin d’être moribonds, c’est d’un soutien positif dont ils ont besoin.
Fine Mapping of the SCN Resistance Locus rhg1‐b from PI 88788
Authors: Kim Myungsik , Hyten David L. , Bent Andrew F. , Diers Brian W.
Published: October 2010

Soybean cyst nematode (SCN) (Heterodera glycines Ichinohe) is the most economically damaging soybean [Glycine max (L.) Merr.] pest in the USA and genetic resistance is a key component for its control. Although SCN resistance is quantitative, the rhg1 locus on chromosome 18 (formerly known as Linkage Group G) confers a high level of resistance. The objective of this study was to fine‐map the rhg1‐b allele that is derived from plant introduction (PI) 88788. F2 and F3 plants and F3:4 lines from crosses between SCN resistant and susceptible genotypes were tested with genetic markers to identify recombination events close to rhg1‐b. Lines developed from these recombinant plants were then tested for resistance to the SCN isolate PA3, which originally had an HG type 0 phenotype, and with genetic markers. Analysis of lines carrying key recombination events positioned rhg1‐b between the simple sequence repeat (SSR) markers BARCSOYSSR_18_0090 and BARCSOYSSR_18_0094. This places rhg1‐b to a 67‐kb region of the ‘Williams 82’ genome sequence. The receptor‐like kinase gene that has been previously identified as a candidate for the ‘Peking’‐derived SCN resistant rhg1 gene is adjacent to, but outside of, the rhg1‐b interval defined in the present study.
Investigation of the Transcriptome of Prairie Cord Grass, a New Cellulosic Biomass Crop
Authors: Gedye Kristene , Gonzalez‐Hernandez Jose , Ban Yuguang , Ge Xijin , Thimmapuram Jyothi , Sun Fengjie , Wright Chris , Ali Shahjahan , Boe Arvid , Owens Vance
Published: October 2010

Prairie cordgrass (Spartina pectinata Bosc ex Link) is being developed as a cellulosic biomass crop. Development of this species will require numerous steps, including breeding, agronomy, and characterization of the species genome. The research in this paper describes the first investigation of the transcriptome of prairie cordgrass via Next Generation Sequencing Technology, 454 GS FLX. A total of 556,198 expressed sequence tags (ESTs) were produced from four prairie cordgrass tissues: roots, rhizomes, immature inflorescence, and hooks. These ESTs were assembled into 26,302 contigs and 71,103 singletons. From these data were identified, EST–SSR (simple sequence repeat) regions and cell wall biosynthetic pathway genes suitable for the development of molecular markers which can aid the breeding process of prairie cordgrass by means of marker assisted selection.
Roost Selection by Male Indiana Myotis Following Forest Fires in Central Appalachian Hardwoods Forests
Authors: Johnson Joshua B. , Ford W. Mark , Rodrigue Jane L. , Edwards John W. , Johnson Catherine M.
Published: October 2010

Despite the potential for prescribed fire and natural wildfire to increase snag abundance in hardwood forests, few studies have investigated effects of fire on bat roosting habitat, particularly that of the endangered Indiana myotis Myotis sodalis. From 2001 to 2009, we examined roost selection of Indiana myotis in burned and unburned forests in Tucker County, West Virginia. We radiotracked 15 male Indiana myotis to 50 roost trees; 16 in burned stands and 34 in unburned stands. Indiana myotis roosted in stands that had initially been burned 1–3 y prior to our observations. In burned stands, Indiana myotis roosted exclusively in fire-killed maples (Acer spp.). In unburned stands, they roosted in live trees, predominately hickories (Carya spp.), oaks (Quercus spp.), and maples. Roost trees in burned stands were surrounded by less basal area and by trees in advanced stages of decay, creating larger canopy gaps than at random trees in burned stands or actual roost trees located in unburned stands. Compared to random trees in unburned stands, roost trees in unburned stands were less decayed, had higher percent bark coverage, and were surrounded by less basal area, also resulting in larger canopy gaps. Roost-switching frequency and distances moved by Indiana myotis among roost trees were similar between burned and unburned stands. Our research indicates that use of fire for forest management purposes, at minimum provoked no response from Indiana myotis in terms of roost tree selection, and may create additional roost resources, depending on spatial context.
Skilled Cardiac Monitoring at the Bedside: An Algorithm for Success
Authors: Evenson Laura , Farnsworth Monica
Published: October 2010

The ECG lead monitoring algorithm was developed to provide a tool to assist bedside nurses in monitoring ST segments and dysrhythmias.
Basic Interpretation of Metabolic Acidosis
Authors: Jones Melissa Beaudet
Published: October 2010

What are the basic concepts of acid-base balance, the 2 types of metabolic acidosis, and the common causes of each type of metabolic acidosis?
Holistic redemptive pastoral ministry in the fragmented transit hall of existence
Authors: Meylahn Johann-Albrecht
Published: October 2010

The grand narratives have all but gone – what is left are numerous narratives, each addressing a certain aspect of our lives; there is a different narrative for our professional lives, another for our family lives, for our social lives and yet another for our spiritual lives. We find ourselves in this ‘transit hall’, forever changing flights or trains, depending on which narrative sphere we are entering or leaving. In each narrative we take on a different character, defined and shaped by the specificities of that narrative. Thus, ‘transition’ in the sense of change can no longer be understood as only linear, but as constant and multidimensional. With the use of Lacan’s discourse theory, this fragmented existence will be unpacked and a redemptive alternative sought.This paper is an attempt to address this multi-narrative existence without imposing yet another grand narrative. Thus it focuses on offering a narrative space that is, (1) holistic, in the sense that it addresses all the different narratives, (2) pastoral, in that it addresses the person and (3) redemptive, in that it offers something new, meaningful and hopeful. Such a narrative space moves the church from its ‘ghetto mindset’, where traditions and values are maintained, to being fully open and vulnerable to the present reality, whilst yearning for the Messianic to reveal an alternative future.
Römisch-katholische Kirche und mediale Kommunikation
Authors: Kraleva Valia
Published: October 2010

Since the world today is so significantly shaped by media technologies, it has become crucial for organizations, institutions and political parties to embrace this phenomenon in order for them to be able to communicate their message and programmes effectively. If they fail to do so, they in effect fail to exist in the public consciousness. Mass media hugely influence how culture is created: intelligence, artistic talent and technological innovation become visible through the media. The Roman Catholic Church, the world’s largest religious organization has, for the longest time, on the one hand denied the influence of the media, while on the other hand calling it ‘the work of evil’. When the Church eventually came to acknowledge the media as a powerful force, it proceeded to use this power as a mouthpiece for its authorities. The Catholic Church is still not wholly at ease with the media. The question is whether the Catholic Church has sufficiently familiarized itself with how the media function, in order to utilise the media to communicate the Church’s message to a large public audience. Against the background of ecclesial documents this article investigates the attitude of the Catholic Church towards the media as it has developed over the past 50 years.
Nonlinear stability analysis of a two-dimensional diffusive free boundary problem
Authors: Webster Micah , Guidotti Patrick
Published: October 2010

We explore global existence and stability of planar solutions to a multi-dimensional Case II polymer diffusion model which takes the form of a one-phase free boundary problem with phase onset. Due to a particular boundary condition, convergence cannot be expected on the whole domain. A boundary integral formulation derived in [13] is shown to remain valid in the present context and allows us to circumvent this difficulty by restricting the analysis to the free boundary. The integral operators arising in the boundary integral formulation are analyzed by methods of pseudodifferential calculus. This is possible as explicit symbols are available for the relevant kernels. Spectral analysis of the linearization can then be combined with a known principle of linearized stability [12] to obtain local exponential stability of planar solutions with respect to two-dimensional perturbations.
Cellular Absorption of Herbicides
Authors: Sterling Tracy M. , Namuth‐Covert Deana
Published: October 2010

Herbicides are effective because they each target a specific metabolic pathway in plants. In order for a herbicide to kill a plant, it must first be absorbed by the plant's leaves or roots. Once the herbicide is absorbed, it will enter a cell which possesses the metabolic pathway the herbicide was designed to target. This lesson follows the fate of the herbicide after it has entered the plant via leaf or root tissue, and explains the factors controlling transport of a herbicide into plant cells. This lesson describes (1) the barriers to herbicide entry, such as the plant cell membrane, (2) the role that the herbicide's chemical properties have on the rate of cellular absorption, and (3) experimental approaches to understanding herbicide absorption at the cellular level.