bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis, Surface, Thermodynamic Properties of Some Biodegradable Vanillin‐Modified Polyoxyethylene Surfactants
Authors: Sayed Galal Hosni , Ghuiba Ferial Mohamed , Abdou Mahmoud Ibrahim , Badr Emad Abdel Aatty , Tawfik Salah Mahmoud , Negm Nabel Abdel Moneem
Published: June 2012

Four water‐soluble non‐ionic ethoxylated surfactants based on vanillin were synthesized (VE15, VE20, VE40, and VE60). The chemical structures of these surfactants were confirmed using FT‐IR and 1H‐NMR spectra. The molecular weights of the compounds were determined using viscosity measurements and gel permeation chromatography. Surface tension as a function of the concentration of the surfactant in aqueous solution was measured at 25, 40 and 55 °C. From these measurements, the critical micelle concentration (CMC), effectiveness (πcmc), efficiency (pC20), maximum surface (Γmax) excess and minimum surface area (Amin), were calculated. The surface activity measurements showed their high tendency towards adsorption and micellization and their good surface tension reduction, and low interfacial tension. The emulsion stability measurements showed the applicability of these surfactants as emulsifying agents. The thermodynamic parameters of micellization (ΔGmic, ΔHmic, ΔSmic) and adsorption (ΔGads, ΔGads, ∆Sads) showed their tendency towards adsorption at the interfaces and also micellization in the bulk of their solutions. The biodegradability of the prepared surfactants was tested in river water using die‐away method and showed their readily biodegradation in the open environment.
OF APPLES AND ORANGES (AND HORMONES IN BEEF): SCIENCE AND THE STANDARD OF REVIEW IN WTO DISPUTES UNDER THE SPS AGREEMENT
Authors: Peel Jacqueline
Published: June 2012

The standard of review applied by WTO decision-makers in disputes under the Sanitary and Phytosanitary (SPS) Measures Agreement plays a critical role in determining the scope of SPS risk regulatory authority afforded WTO Members by governing the degree to which such measures must be science-based. The standard of review question in SPS jurisprudence finds resonances in international environmental legal adjudication of highly technical disputes, as well as in comparative law concerning judicial review of science-based risk regulation in the United States and European Union. This article considers recent case law of the WTO Appellate Body inContinued SuspensionandAustralia–Applesand the extent to which these decisions permit a more deferential approach on the part of WTO decision-makers in evaluating the scientific underpinnings of Members' disputed SPS measures. It is argued that the case law has failed to articulate a strong normative rationale for the current interpretation of the standard of review applied in SPS disputes. Drawing on social scientific findings regarding the limitations of science-based risk assessment in diverse risk settings, the article contends that a more coherent and principled approach to application of the standard of review would allow for its adjustment according to the nature of the risk situation under consideration.
THE DURBAN PLATFORM FOR ENHANCED ACTION AND THE FUTURE OF THE CLIMATE REGIME
Authors: Rajamani Lavanya
Published: June 2012

The Durban Climate Conference,1 marked by tension, high drama and sleepless nights, agreed on a set of historic decisions under the climate regime 36 hours after the scheduled end of the conference. The climate regime—comprising the 1992 Framework Convention on Climate Change2 and its 1997 Kyoto Protocol,3 and decisions taken by Parties under these instruments—has been plagued in the last few years, in particular after the debacle at Copenhagen,4 by doubt and uncertainty. Doubt over its ability to meet climate goals, and uncertainty over its future, in particular that of the Kyoto Protocol. At Durban, Parties strengthened the climate regime with decisions to implement the 2010 Cancun Agreements,5 extend the beleaguered Kyoto Protocol, for a second commitment period,6 and launch a new process to negotiate a post-2020 climate regime.7 This new process, christened the Ad-Hoc Working Group on the Durban Platform for Enhanced Action, is intended to craft the agreement that will govern, regulate and incentivize the next generation of climate actions.
The ‘dark’ side of normative argumentation – The case of counterterrorism policy
Authors: HELLER REGINA , KAHL MARTIN , PISOIU DANIELA
Published: June 2012

After 9/11 state actors in different parts of the world and to various degrees decided to give security and counterterrorism measures priority over human rights and fundamental freedoms. In order to legitimize their policy choices, governmental actors used normative argumentation to redefine what is ‘appropriate’ to ensure security. We argue that, in the long run, this may lead to a setback dynamic hollowing out established human and civil rights norms. In this article, we develop a theoretical and analytical framework, oriented along the model of the life cycle of norms, in order to trace ‘bad’ norm dynamics in the field of counterterrorism. We conceptualize the norm erosion process, particularly focusing on arguments such as speech acts put forward by governmental norm challengers and their attempts to create new meaning and understanding. We also draw on convergence theory and argue that when a coalition of norm challengers develops, using the same or similar patterns of arguments, established international normative orders protecting human rights and civil liberties might be weakened over time and a more fundamental process of norm erosion may take place.
Global distributive justice? State boundaries as a normative problem
Authors: FOLLESDAL ANDREAS
Published: June 2012

Should state borders matter for claims of distributive justice? The article explores, only to reject, the best reasons for an ‘Anti-Cosmopolitan’ position which grants some minimum international obligations, including social and economic human rights. At the same time this Anti-Cosmopolitanism rejects distinctlydistributiveprinciples of justice, familiar from discussions of justice among compatriots: There are no further limits on permissible global inequalities. ‘Anti-Cosmopolitans’ do not deny that the tangled web of domestic and international institutions has a massive impact on individuals, their life plans and opportunities, albeit often indirectly and surreptitiously. What they deny is that claims to equality or limits to inequality should apply across state borders. The article explores what it is about states that can justify such a disjunct in the normative claims individuals have against each other. Several arguments about such alleged salient aspects of states and their constitutions are considered, but are found lacking. The main conclusion is to challenge the reasons Anti-Cosmopolitans offer against bringing distributive principles to the ‘Global Basic Structure’.
Diurnal tides from the troposphere to the lower mesosphere as deduced from TIMED/SABER satellite data and six global reanalysis data sets
Authors: Sakazaki T. , Fujiwara M. , Zhang X. , Hagan M. E. , Forbes J. M.
Published: June 2012

We compare and examine diurnal temperature tides including their migrating component (DW1) from the troposphere to the lower mesosphere, using data from Thermosphere‐Ionosphere‐Mesosphere‐Energetics and Dynamics/Sounding of the Atmosphere using Broadband Emission Radiometry (TIMED/SABER) and from six different reanalysis data sets: (1) the Modern Era Retrospective analysis for Research and Applications (MERRA), (2) the European Centre for Medium‐range Weather Forecasts (ECMWF) reanalysis (ERA‐Interim) (3) the National Centers for Environmental Prediction (NCEP) Climate Forecast System Reanalysis (CFSR), (4) the Japanese 25‐year reanalysis by Japanese Meteorological Agency (JMA) and the Central Research Institute of Electric Power Industry (CRIEPI) (JRA25), (5) the NCEP/National Center for Atmospheric Research reanalysis (NCEP1), and (6) the NCEP and Department of Energy (DOE) Atmospheric Model Intercomparison Project (AMIP‐II) reanalysis data (NCEP2). The horizontal and vertical structures of the diurnal tides in SABER and reanalyses reasonably agree, although the amplitudes are up to 30–50% smaller in the reanalyses than in the SABER in the upper stratosphere to lower mesosphere. Of all tidal components, the DW1 is dominant while a clear eastward propagating zonal wave number 3 component (DE3) is observed at midlatitudes of the Southern Hemisphere in winter. Among the six reanalyses, MERRA, ERA‐Interim and CFSR are better at reproducing realistic diurnal tides. It is found that the diurnal tides extracted from SABER data in the winter‐hemisphere stratosphere suffer from sampling issues that are caused by short‐term variations of the background temperature. In addition, the GSWM underestimates the amplitude in the midlatitude upper stratosphere by about 50%.
Insights into the nature of northwest‐to‐southeast aligned ionospheric wavefronts from contemporaneous Very Large Array and ionosonde observations
Authors: Helmboldt J. F.
Published: June 2012

The results of contemporaneous summer nighttime observations of midlatitude medium scale traveling ionospheric disturbances (MSTIDs) with the Very Large Array (VLA) in New Mexico and nearby ionosondes in Texas and Colorado are presented. Using 132, 20‐minute observations, several instances of MSTIDs were detected, all having wavefronts aligned northwest to southeast and mostly propagating toward the southwest, consistent with previous studies of MSTIDs. However, some were also found to move toward the northeast. It was found that both classes of MSTIDs were only found when sporadic‐E (Es) layers of moderate peak density (1.5​ < ​ foEs​ < ​3 MHz) were present. Limited fbEs data from one ionosonde suggests that there was a significant amount of structure within the Es layers during observations when foEs > ​3 MHz that was not present when 1.5​ < foEs < ​3 MHz. No MSTIDs were observed either before midnight or when the F‐region height was increasing at a relatively high rate, even when these Es layers were observed. Combining this result with AE indices which were relatively high at the time (an average of about 300 nT and maximum of nearly 700 nT), it is inferred that both the lack of MSTIDs and the increase in F‐region height are due to substorm‐induced electric fields. The northeastward‐directed MSTIDs were strongest post‐midnight during times when the F‐region was observed to be collapsing relatively quickly. This implies that these two occurrences are related and likely both caused by rare shifts in F‐region neutral wind direction from southwest to northwest.
Quantitative analysis of the influence of dust sea surface forcing on the primary production of the subtropical Atlantic Ocean using a ten‐year time series of satellite observations
Authors: Chami Malik , Mallet Marc , Gentili Bernard
Published: June 2012

Dust aerosols that are not deposited over oceans are able to significantly reduce the solar energy available at the sea surface. Here, the impact of dust aerosols on the photosynthetically available radiation (PAR) at the sea surface and on the associated oceanic primary production (PP) is quantified over the subtropical Atlantic Ocean based on a ten‐year time series of satellite observations. The ten‐year average value of the attenuation of bothPAR and PP due to dust aerosols is high (∼15%). The comparisons with predictions suggested that the decrease of PP might be ∼35% in the case of intense episodic events (i.e., dust aerosols optical depth > 0.6). Therefore, dust aerosol events could significantly alter the organic carbon budget of the underlying oceanic ecosystems. The analysis of the interannual variations of the relative reduction of primary production (ΔPP/PP) due to dust aerosols showed that the evolution of ΔPP/PP does not exhibit any major trend of variation within the entire study area over the decade. However, a significant tendency (0.22% per year) is found near Africa in summer. Thus, dust aerosol events might induce a major decrease of the marine productivity the next centuries. The radiative forcing of dust aerosols on the sea surface needs to be accounted for in coupled atmosphere–ocean models for calculating correctly the primary production. A more extensive analysis of the aerosol radiative budget is also required to better understand the link between the atmospheric and oceanic processes driving the primary production over dust aerosol areas.
Seasonal sea level cycle in the Caribbean Sea
Authors: Torres R. Ricardo , Tsimplis Michael N.
Published: June 2012

The seasonal sea level cycle has been investigated in the Caribbean Sea using altimetry and tide gauge time series from 27 stations and is characterized by large spatial variability. The coastal annual harmonic has amplitudes that range from 2 cm to 9 cm, peaking between August and October and semi‐annual harmonic with maximum amplitude of 6 cm, with most stations peaking in April and October. The coastal seasonal sea level cycle contributes significantly at most areas to sea level variability and can explain the sea level variance up to 78%. The barometric effect on the coastal sea level seasonal cycles is insignificant in the annual component but dominant at 9 stations in the semi‐annual cycle. The seasonal sea level cycle from 18 years of altimetry confirm the results obtained from the tide‐gauges and allow us to identify some dominant sea level forcing parameters in the annual and semi‐annual frequencies such as the Panama‐Colombia gyre driven by the wind stress curl and the Caribbean Low Level Jet modulating the sea level in the northern coast of South America and linked to the local upwelling. The seasonal sea level cycle in the Caribbean Sea is unsteady in time, with large variations in amplitude and phase lag at most of the stations, where the 5‐year amplitude in the coastal annual cycle can change over 6 cm in a 24 year period. The seasonal sea level cycle peaks about October when the probability of coastal impacts increases, especially in the northern coast of South America where the range is larger.
Increase of 20-HETE Synthase after Brain Ischemia in Rats Revealed by PET Study with 11C-Labeled 20-HETE Synthase-Specific Inhibitor
Authors: Kawasaki Toshiyuki , Marumo Toshiyuki , Shirakami Keiko , Mori Tomoko , Doi Hisashi , Suzuki Masaaki , Watanabe Yasuyoshi , Chaki Shigeyuki , Nakazato Atsuro , Ago Yukio , Hashimoto Hitoshi , Matsuda Toshio , Baba Akemichi , Onoe Hirotaka
Published: June 2012

20-Hydroxyeicosatetraenoic acid (20-HETE), an arachidonic acid metabolite known to be produced after cerebral ischemia, has been implicated in ischemic and reperfusion injury by mediating vasoconstriction. To develop a positron emission tomography (PET) probe for 20-HETE synthase imaging, which might be useful for monitoring vasoconstrictive processes in patients with brain ischemia, we synthesized a 11C-labeled specific 20-HETE synthase inhibitor, N′(4-dimethylaminohexyloxy)phenyl imidazole ([11C]TROA). Autoradiographic study showed that [11C]TROA has high-specific binding in the kidney and liver consistent with the previously reported distribution of 20-HETE synthase. Using transient middle cerebral artery occlusion in rats, PET study showed significant increases in the binding of [11C]TROA in the ipsilateral hemisphere of rat brains after 7 and 10 days, which was blocked by co-injection of excess amounts of TROA (10 mg/kg). The increased [11C]TROA binding on the ipsilateral side returned to basal levels within 14 days. In addition, quantitative real-time PCR revealed that increased expression of 20-HETE synthase was only shown on the ipsilateral side on day 7. These results indicate that [11C]TROA might be a useful PET probe for imaging of 20-HETE synthase in patients with cerebral ischemia.
Interaction specificity between the chaperone and proteolytic components of the cyanobacterial Clp protease
Authors: Tryggvesson Anders , Ståhlberg Frida M. , Mogk Axel , Zeth Kornelius , Clarke Adrian K.
Published: June 2012

The Clp protease is conserved among eubacteria and most eukaryotes, and uses ATP to drive protein substrate unfolding and translocation into a chamber of sequestered proteolytic active sites. In plant chloroplasts and cyanobacteria, the essential constitutive Clp protease consists of the Hsp100/ClpC chaperone partnering a proteolytic core of catalytic ClpP and noncatalytic ClpR subunits. In the present study, we have examined putative determinants conferring the highly specific association between ClpC and the ClpP3/R core from the model cyanobacterium Synechococcus elongatus. Two conserved sequences in the N-terminus of ClpR (tyrosine and proline motifs) and one in the N-terminus of ClpP3 (MPIG motif) were identified as being crucial for the ClpC–ClpP3/R association. These N-terminal domains also influence the stability of the ClpP3/R core complex itself. A unique C-terminal sequence was also found in plant and cyanobacterial ClpC orthologues just downstream of the P-loop region previously shown in Escherichia coli to be important for Hsp100 association to ClpP. This R motif in Synechococcus ClpC confers specificity for the ClpP3/R core and prevents association with E. coli ClpP; its removal from ClpC reverses this core specificity.
Transition from Acute to Persistent Low Back Pain: Do Fear-Avoidance Beliefs, Magnification, and Helplessness Cognitions Screen Best at First Medical Consultation or Afterwards at 3-, 6-, or 12-Week Follow-Up?
Authors: Melloh M. , Käser A. , Rolli Salathé C. , Elfering A.
Published: June 2012

Introduction

There is a gap in the knowledge regarding the ideal time point to screen patients at risk of developing persistent LBP. Therefore, our research question was, “what is the best time point to identify patients with acute/subacute LBP at risk of developing persistent LBP at 6 months”? The aim of our study was to identify, in a group of patients presenting to a health practitioner with a new episode of LBP, the key time point at which those at risk of developing persistent LBP can be best detected.

Materials and Methods

Prospective cohort study of patients presenting to a health practitioner with a new episode of acute/subacute LBP. Patients were assessed at baseline and at 3, 6, 12 weeks and 6 months looking at factors of “maladaptive cognition” (fear-avoidance beliefs, magnification, helplessness) as potential predictors. Multivariate logistic regression analysis was performed for all time points.

Results

The best time point to predict the development of persistent LBP at 6 months was the 12-week follow-up (sensitivity 52%; overall predictive value 75%). The odds ratio of predicting persistent LBP was 1.77 for the index “maladaptive cognition” (95% CI, 1.04–3.03). The 6-week follow-up assessment was the next best time point (sensitivity 43%; overall predictive value 73%). The odds of predicting persistent LBP were 1.63 for the index “maladaptive cognition” (95% CI, 1.02–2.62). Even after 3 weeks, maladaptive cognitions were predictive whereas cognitions assessed at first visit to a health practitioner were not.

Conclusion

Our study revealed that maladaptive cognitions at 12 and at 6 weeks are suitable predictors for a transition from acute to persistent LBP in primary care. After 3 weeks, patients were present to a health care practitioner with an episode of acute/subacute, LBP cognitions influence the development of persistent LBP. Consequently, according to our results, patients at risk of developing persistent LBP should not be screened at baseline but rather at a later time point such as the 12- or 6-week follow-up for a better overall predictive value. Furthermore, cognitive behavioral interventions should be considered as early adjuvant LBP treatment in patients at risk of developing persistent LBP. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Total Disk Replacement Compared to Lumbar Fusion: A Randomized Controlled Trial with 5-Year Follow-Up
Authors: Tropp H. T. , Nyqvist C. , Berg S.
Published: June 2012

Introduction

The main objective of this study is long-term evaluation of clinical outcome of total disk replacement (TDR) compared to posterior fusion in surgical treatment at chronic low back pain (CLBP) due to degenerative disk disease.

Materials and Methods

The study is a prospective randomized controlled trial comprising 152 patients; 80 were randomized to TDR and 72 to fusion. Mean age was 40 years (21 to 55) and 59% were women. All patients suffered from CLBP with varying degrees of leg pain and had not responded to a nonsurgical treatment program. Diagnosis was based on clinical examination, radiographs, and MRI. Primary outcome measure was global assessment (GA) of back pain and secondary outcome measures were back and leg pain, Oswestry Disability Index (ODI), EQ5D, and SF-36. All measures were collected from SweSpine, the Swedish national register for spinal surgery, at 1, 2, and 5 years. Follow-up rate at 5 years were 99.3% with no crossover.

Results

Both groups showed clinical improvement at 5-year follow-up. There was no deterioration over time. Regarding GA, 38% (30/80) in the TDR group was totally pain free vs. 15% (11/71) in the fusion group ( p < 0.003). Back pain and improvement of back pain were better in the TDR group (23 ± 29 vs. 31 ± 27, p = 0.008). ODI and improvement in ODI were also better in the TDR group (ODI at 5 years 17 ± 19 vs. 23 + 17, p = 0.016,) (ODI diff 5 years 25 ± 18 vs. 18 ± 19 ( p = 0.019). EQ-5D and VAS leg pain also showed significantly better improvement in the TDR group. Achievement of surgical goal (nonmobile fusions) at 2 years was not related to clinical outcome neither at 2 nor at 5 years. Achievement of surgical goal (mobile disk arthroplasties) at 2 years was related to greater improvement in back pain at 5 years. There was no difference in complications between the two groups. A difference was registered between the two groups in numbers of reoperation. A total of 16% (13/80) in the TDR group had undergone one or more reoperation compared to 31% (22/72) in the fusion group ( p = 0.365).

Conclusion

Global assessment of back differed between the two surgical groups at all follow-up occasions. The difference between groups concerning back pain, pain improvement and ODI had been present at 1 year, disappeared after 2 years but reappeared at the 5-year follow-up. There is no deterioration of results over time. I confirm having declared any potential conflict of interest for all authors listed on this abstract No Disclosure of Interest None declared
Association of Body Mass Index in Early Childhood with Lumbar Disk Degeneration at 21 Years
Authors: Huikari V. , Paananen M. , Takatalo J. , Kaakinen M. , Taimela S. , Niinimäki J. , Blanco Sequeiros R. , Järvelin M. R. , Tervonen O. , Karppinen J.
Published: June 2012

Introduction

There are no studies on association between early childhood body mass index and lumbar disk degeneration (DD) later.

Materials and Methods

The Oulu back study includes children who belong to the Northern Finland Birth Cohort 1986 and have been followed up to 21 years. Data from child health clinic records were used to derive BMI at birth, at adiposity peak (AP), and at adiposity rebound (AR). Lumbar MRI was performed using a 1.5-T scanner at the age of 21. Lumbar intervertebral disks were graded as normal (0), mildly (1), moderately (2), or severely (3) degenerated. The sum score of lumbar DD was categorized as 0, 1 to 2, or at least 3. The associations of BMI at birth, AP, and AR with DD were analyzed using multinomial logistic regression with and without adjustment for relevant confounders. All analyses were stratified by gender.

Results

Of the 520 scanned subjects, 46% had no DD, 38% had sum score of 1 or 2, and 16% had sum score of at least 3. In the univariate models, BMI at birth among females and BMI at AR among males were positively associated with DD sum score of at least 3 (OR 1.3; 95% CI, 1.0–1.7 and OR 1.8; 95% CI, 1.1–2.7, respectively). In adjusted models, the results weakened among females, while among males the associations between BMI at AP and AR with DD sum score of at least 3 strengthened (OR 2.0; 95% CI, 1.1–3.7 and OR 2.2; 95% CI, 1.4–3.7).

Conclusion

High BMI at AP and AR in early childhood increased the likelihood of lumbar DD at the age of 21 among males. This novel finding may help to understand the pathomechanisms of DD. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Association of the Tag SNPs in the Human Skt Gene with Lumbar Disk Herniation
Authors: Kawaguchi Y. , Karasugi T. , Semba K. , Chiba K. , Togawa D. , Karppinen J. , Ikegawa S.
Published: June 2012

Introduction

Lumbar disk herniation (LDH) is a major cause of low back pain and unilateral leg pain. Although the etiology is unknown, it has been suggested that a genetic factor contributes to the development of LDH. Sickle tail (Skt) protein shows specific expression in mice nucleus pulposus (NP) cells. SktGt mice were established through a gene-trap mutagenesis in embryonic stem cells. Skt homozygous mutant mice showed late-onset intervertebral disk abnormalities. The purpose of this study was to evaluate whether the human Skt gene was involved in the etiology of LDH. A case-control association study was performed in Japanese and Finnish populations.

Materials and Methods

On the basis of information in the International HapMap Project database, we selected SNPs with minor allele frequencies of >10%. A total of 68 tag SNPs were selected. We recruited 525 cases and 564 controls for the first screen and 337 cases and 332 controls for the replication study. The diagnosis of LDH required the following: (1) positive MRI findings for LDH; (2) treatment and monitoring for >1 year by orthopedic surgeons; and (3) a history of unilateral leg pain for a period >3 months. The Finnish population consisted of 257 patients and 249 controls.

Results

Three SNPs were significantly associated with LDH. The SNP rs16924573 showed the most significant association with LDH ( p = 0.0015). The association was replicated in a Finnish case-control population ( p = 0.026). The combined p value of the two population by meta-analysis is 0.00040 (OR, 1.34; 95% CI, 1.14–1.58).

Conclusion

Our data indicate that Skt is involved in the etiology of LDH. Skt contains a proline-rich region and a coiled-coil domain. It is possible that impaired Skt may not be capable of forming cytoskeleton complexes or interacting with other proteins. Such malfunctions of Skt could lead to LDH through NP dysfunction. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Karasugi T, Semba K, Hirose Y, et al. Association of the tag SNPs in the human Skt gene (KIAA1217) with lumbar disc herniation. Journal of Bone and Mineral Research. 2009;24:1537–1543
Diffusion Tensor Imaging: New Diagnostic Tool for Degenerated Lumbar Disease
Authors: Oikawa Y. , Eguchi Y. , Ohtori S. , Inoue G. , Ishikawa T. , Miyagi M. , Kamoda H. , Suzuki M. , Sakuma Y. , Kubota G. , Sato H. , Ando H. , Okumura K. , Masuda Y. , Watanabe A. , Takahashi K.
Published: June 2012

Introduction

It is difficult to correctly diagnose lumbar degenerated disease with foraminal stenosis using conventional X-ray imaging, CT, and MRI. This difficulty can sometimes result in failed back syndrome. Diffusion Tensor Imaging (DTI) was reported as a potential tool for the diagnosis for foraminal stenosis. The purpose of this study is to evaluate the efficacy of DTI for diagnosis of degenerated lumbar disease.

Materials and Methods

Total 27 patients (20 men, mean age, 68.5 years) with degenerated lumbar disease who underwent 3.0 T MRI and surgical treatment were included. DTI (tractography), fractional anisotropy (FA), and improvement in Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) pain score were investigated.

Results

The diagnoses by conventional imaging were lumbar spinal stenosis without foraminal stenosis in 11 cases, with foraminal stenosis in 10 cases, lumbar disk herniation in 3 cases, spondylolisthesis in 2 cases, and discogenic low back pain in 1 case. We classified the patients into following four groups by the shape of the tractography; disruption, narrowing, tapering, and no abnormalities. The mean preoperative JOA and VAS score were 14 and 88, and postoperative score were 21 and 12, respectively. The JOA score was improved by 46%. Tractography of the ipsilateral side showed disruption, narrowing, and tapering, and a lower FA compared with the contralateral side. There was no significant correlation between FA and symptoms.

Conclusion

Although there is no significant correlation between DTI and postsurgical symptoms, DTI has the possibility of detecting lesions of nerve damage, and to be a new diagnostic tool for the degenerated lumbar disease. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Is there a Value in Repeated Computer Tomography Testing in Patients with Lumbar Spine Symptoms?
Authors: Schroeder J. E. , Hiller N. , Kaplan L. , Hasharoni A. , Barzilay Y.
Published: June 2012

Introduction

CT scans of the lumbar spine are indicated in the search of neural compressive lesions and in search of a cause for specific low back pain (LBP). They are associated with a high radiation exposure of 700 to 1500 mREMs per exam. The goal of the study was to investigate whether repeat spine CT scans, in patients who are symptomatic 2 years after the initial exam, contribute new clinical data.

Materials and Methods

Repeated CT scans performed for LBP or radiculopathy between 2008 and 2010 were identified in our radiology department. Only patients 60 years of age and below were included. Patients with a history of trauma or surgery between exams were excluded. All scan (original and repeat) were reviewed by a senior musculoskeletal radiologist. Interval changes between scans were rated as: no change, worsening of the pathology, improvement of the pathology, or new pathology.

Results

Total 6000 lumbar spine CT scans were performed between the years 2008 and 2010. Total 550 were repeatedly examined. Total 108 repeated CT scans met the inclusion criteria; 35 scans were ordered to investigate LBP, 46 for radiculopathy and in 27 exams the indication was not stated. The average age of the patients was 48.1 (range: 18 to 60). The average interval between the scans was 24.1 months (SD = 6 months). Spine pathology was identified in 287 levels. In 10 patients, the spine was without any pathology. Total 274 pathologies did not changed (92.3%; p < 0.05), 10 improved, and 10 worsened (disk herniation or spinal stenosis). Three new pathologies were identified (one fracture two disk herniations). In case of worsening, no substantial therapeutic change was required. In patients who were sent for a repeated CT for LBP, only two pathologies changed between exams.

Conclusion

CT scans cause 1% of annual cancer mortality in the USA. The repeated radiation from unnecessary exams accumulates and causes secondary malignant changes. In the time frame of 2 to 3 years, in patients suffering chronic or recurrent LBP or radiculopathy, there is a little added diagnostic value for repeated CT scans. Repeated scan should be considered only in patients with progressive neurologic deficits or signs implying serious underlying conditions. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Aaron Sodickson, Pieter F. Baeyens, Katherine P. Andriole, et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology 2009;251:175–184
Correlation between MMP-3 Activity and Intervertebral Disk Degeneration According to Radiologic Data
Authors: Canbay S. , caglar S. , turhan N. , Arda K.
Published: June 2012

Introduction

During the degeneration process, tissue resorption causes a progressive and important decrease in intervertebral disk height. The main characteristics of disk degeneration are intradiscal clefts and teardrops. It is accepted that matrix-degrading enzymes, such as matrix metalloproteinases (MMPs), play an important role in disk tissue degeneration and destruction.

Materials and Methods

This study involved 42 patients between 26 and 69 years of age who underwent surgery for lumbar disk herniation (46 disk spaces). Tissue sections were used to immunolocalize MMP-3. The number of labeled cells was determined using morphometric analysis. Cell proliferation, cleft and teardrop formation, granular matrix changes, and mucosal degeneration were statistically assessed. Additionally, enzymatic gelatinolytic activity was determined using zymography. MMP-3 levels and histological degeneration scores were compared using the Pfirrmann classification, a radiologic disk degeneration grading system.

Results

The intradiscal expression of MMPs in the nucleus pulposus and annulus fibrosus cells was confirmed using immunohistochemistry, and gelatinolytic enzymatic activity was confirmed with in situ zymography. A significant relationship was determined between disk degeneration, characterized by intradiscal cleft and teardrop formation, and MMP-3 levels. Disk cell proliferation and matrix degeneration (granular changes and mucosal degeneration) were also found to be related to MMP-3 expression. Similarly, a relationship between enzymatic activity and cleft formation was determined.

Conclusion

Our findings support the hypothesis that MMP-3 enzyme levels play an important role in IVD degeneration. This association is supported by the high correlation between cleft and teardrop formation and MMP expression. These findings indicate the important role of MMPs in the loss of normal disk function as a result of IVD degeneration, which causes lumbar pain. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Kanemoto M, Hukuda S, Komiya Y, Katsuura A, Nishioka J. Immunohistochemical study of matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 human intervertebral discs. Spine 1996;21(1):1–8 Kang JD, Stefanovic-Racic M, McIntyre LA, Georgescu HI, Evans CH. Toward a biochemical understanding of human intervertebral disc degeneration and herniation. Contributions of nitric oxide, interleukins, prostaglandin E2, and matrix metalloproteinases. Spine 1997;22(10):1065–073 Crean JK, Roberts S, Jaffray DC, Eisenstein SM, Duance VC. Matrix metalloproteinases in the human intervertebral disc: role in disc degeneration and scoliosis. Spine 1997;22(24):2877–2884
Determinants of Health Care Use for Low Back Pain in Adolescence
Authors: Tiira A. , Paananen M. , Taimela S. , Zitting P. , Järvelin M. R. , Karppinen J.
Published: June 2012

Introduction

Recent studies have indicated that LBP is already common in adolescence, but only a few studies have evaluated the factors that determine LBP-related health care use at this age.

Materials and Methods

The study population included 1987 adolescents aged 18 from the Oulu Back Study (OBS), a subcohort of the 1986 Northern Finland Birth Cohort (NFBC 1986). We used logistic regression to evaluate whether enabling resources need factors; personal health habits or psychological problems are associated with seeking health care for LBP, among adolescents reporting LBP during the last year.

Results

Of the 1987 respondents, 50% of the women and 42% of the men reported having had LBP during the previous year. Of the 921 respondents with LBP, 89 (16%) women and 59 (16%) men had consulted a health care professional. In both the genders, pain intensity was strongly associated with seeking care (VAS 8–10 vs. VAS 0–3; men: OR 16.6, 95% CI, 3.8–72.5, women: OR 18.8 95% CI, 6.3–56.1). In addition, LBP-related daily activity limitations (impairment index 4–6 vs. 0 OR 15.7 95% CI, 1.7–142.5) were associated with care seeking among males. Student status was also associated with care-seeking among males (OR 2.34 95% CI, 1.02–5.36). (Fig. proportion of adolescents seeking medical care for LBP according to pain intensity in VAS.)

Conclusion

Approximately one out of six adolescents with LBP seeks medical care. Intensity of pain and daily activity limitations appear to be the main determinants of seeking care for LBP in adolescence. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Frequency of Antidepressant Medication in Spine Surgery Patients
Authors: Kuittinen P. , Savolainen S. , Nyyssönen T. , Kröger H. , Sipola P. , Airaksinen O. , Leinonen V.
Published: June 2012

Introduction

Previous studies have shown that preoperative depression is associated with poorer outcome of lumbar spinal stenosis. However, much is still not known about the prevalence of antidepressant treatment among spine surgery patients. The purpose of this study was to analyze the prevalence of antidepressant treatment in the different spine surgery groups.

Materials and Methods

We evaluated retrospectively 3145 spine surgery patients treated between the years 2003 and 2007 in Kuopio University Hospital. Patients mean age was 51.7 years, range: 18 to 84 years. Total 56.5% were male. We collected the medication data from the patient records, and compared the prevalence of antidepressant treatment at the time of operation in spine surgery groups.

Results

The prevalence antidepressant treatment was highest in the posterior cervical decompression surgery group (14.3%) followed by LSS (10.1%), anterior cervical decompression (ACD, 9.8%), and lumbar spondylolisthesis (8.5%). The lowest prevalence for antidepressant treatment was in the lumbar disk herniation group (5.6%) and this group differed significantly from other groups (LSS p < 0.001, ACD p = 0.001 and posterior cervical decompression p = 0.004).

Conclusion

Our results indicate that the frequency of antidepressant treatment varies significantly between different spine surgery groups. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
May Extraspinal Lumbar Compression Mimic Lumbar Pain and Sciatica? A Presentation of Unusual Cases
Authors: Velnar T. , Bunc G. , Ravnik J. , Vorsic M.
Published: June 2012

Introduction

Compression of sciatic nerve may often cause symptoms of lumbar radiculopathy. In 90% of patients with sciatica, spinal causes may be found. On the other hand, extraspinal compression of the sciatic nerve is very rare, found only in 10%. Most frequently, the lesion is in the pelvis due to tumors and bony compression. Clinical features are very similar to the usual causes of sciatica. Precise diagnosis is difficult to establish with standard diagnostic procedures due to absence of specific tests. We present cases of extraspinal sciatic nerve compression.

Materials and Methods

At our department, patients with concomitant intra- and extraspinal sciatic nerve compression were treated. All had typical sciatica that was unresponsive to conservative treatment in the beginning, as well as to standard surgical spinal decompression.

Results

Extraspinal origin was found as a cause for the pain: in one case, the tumor in presacral region behind the bladder with destruction of sacrum and compression of sacral plexus; in the second, femoral vein thrombosis, which resulted in massive pulmonary embolism; in the third, abscess of the Douglas pouch, involving the sacral plexus; in the fourth, abscess of psoas muscle and in the fifth, paravertebral muscle abscess.

Conclusion

Clinically, extraspinal compressive pain may hardly be distinguished from intraspinal radicular pain. In contemporary double compressions particularly, the diagnosis is aggravated. The candidates are patients with no improvement after appropriate intraspinal surgery as a result of initial sciatic pain. Early diagnosis of extraspinal compression leads to effective treatment and additional extended diagnostic workup is therefore important. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Kleiner JB, Donaldson WF, Curd JG, et al. Extraspinal causes of lumbosacral radiculopathy. Journal of Bone and Joint Surgery 1991;73:817–821 Paksoy Y, Gormus N. Epidural venous plexus enlargements presenting with radiculopathy and back pain in patients with inferior vena cava obstruction or occlusion. Spine 2004;29:2419–2424 Servant CT. An unusual cause of sciatica: a case report. Spine 1998;23:2134–2136 Doniec J, Gaździk T, Folta K, et al. Extraspinal sciatica. Chir Narzadow Ruchu Ortop Pol 1988; 53(5):359–361 Arct W. Extraspinal symptomatic sciatica. Chir Narzadow Ruchu Ortop Pol 1980;45:71–75
Primary Ewing's Sarcoma of Spine Mimicking Nerve Sheath Tumor
Authors: Aydin E. H. , Özbek Z. , Çiftçi E. , Arslantaş A.
Published: June 2012

Introduction

A 32-year-old man admitted to our clinic after 1 month history of progressively worsening back pain. He had no previous pain or systemic symptoms before this history. Neurological examination revealed paraparesis at lower extremity. Sensibility was decreased below the level Th 12. Bladder dysfunction was admitted. Laboratory assessments including erythrocyte sedimentation rate are normal limits. Magnetic resonance imaging demonstrated an epidural mass at the T5-7. Lesion invading chest and soft tissues. Sagittal projection of T2 MRI image demonstrating tumor 7 × 5 × 4 cm size, displacing the spinal cord to the left side and invasion of mediastinum (Fig. 1). PET CT shows increased activity in T5-6 level. The patient underwent surgery as the first line of management. The tumor was removed mostly by the combined anterior and posterior approach. Anterior reconstruction was carried out using a titanium cage.

Materials and Methods

Histopathological examinations confirmed an Ewing's sarcoma arising from the thoracic epidural space. After 1 week of surgery, the patient was referred to the oncology department. He underwent a combined radiotherapy and chemotherapy protocol.

Results

Occurrence of primary Ewing's sarcoma of the spine has been rarely reported in the literature. It occurs from 12 to 24 years of age and is very rare after 30 years. Local back pain usually is the first and typical complaint occur like a schwannoma. MRI of the thoracal spine revealed lesion at the right neural foramen appearing to originate from the nerve root and invading mediastinum, suspicious for a giant spinal schwannomas.

Conclusion

In ES cases, vertebrae are affected in less than 5%. Unlike schwannomas, the ES prognosis is usually poor. After surgery, radiation therapy, and chemotherapy the mean survival time was 2.9 years. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Comparison between Anterior Lumbar Interbody Fusion and Posterolateral Fusion in a Punctured Disk Model in Rats
Authors: Kamoda H. , Ohtori S. , Inoue G. , Yamauchi K. , Eguchi Y. , Miyagi M. , Ishikawa T. , Suzuki M. , Sakuma Y. , Oikawa Y. , Saino T. , Inage K. , Kubota G. , Orita S. , Takahashi K.
Published: June 2012

Introduction

Conservative treatments are sufficient for patients with discogenic pain; however, fusion surgery is performed to relieve unresolved pain. Of several available fusion techniques, the method remains controversial. This study used pain assessment to compare anterior lumbar interbody fusion (ALIF) versus posterolateral fusion (PLF) in a rat-punctured disk model.

Materials and Methods

Total 80 male Sprague-Dawley rats (200 to 250 g) were divided into four groups, nonpuncture group( n = 20), puncture group( n = 20), puncture + ALIF group( n = 20), and puncture + PLF group( n = 20). The neurotracer fluoro-gold was applied to detect dorsal root ganglion (DRG) neuron disk innervation. After 1 week of the procedure, surgical treatment was performed in ALIF and PLF groups. After 4 and 8 weeks of surgery, bone union was verified using micro CT, pain behavior was analyzed using CatWalk system, and the proportion of calcitonin gene-related peptide (CGRP) (pain neuropeptide)-immunoreactive, FG-labeled DRG neurons were determined.

Results

Bone union was confirmed at 4 and 8 weeks in both fusion groups. In CatWalk analysis, ALIF animals significantly improved over 8 weeks compared to PLF animals ( p < 0.05). CGRP-immunoreactive DRG neurons increased in all puncture groups compared to nonpuncture group ( p < 0.01); however, these decreased in the fusion groups to control levels at 8 weeks, and the significant difference between ALIF and PLF animals was observed only at 2 weeks ( p < 0.05).

Conclusion

After completion of bone union, punctured disk-related pain decreased to control levels in both fusion groups; however, ALIF animals showed faster recovery of pain behavior than PLF animals. These results suggest that both ALIF and PLF are similarly effective for pain originated from degenerated disks, but posterior muscle injury might influence postoperative healing. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Influence of Mechanical Stress on Low Back Pain Related to Osteoporosis: Dynamics of Sensory Nerve Transmission of Pain in the Caudal Vertebrae under Compression using a Rat Model of Osteoporosis
Authors: Suzuki M. , Ohtori S. , Inoue G. , Orita S. , Miyagi M. , Ishikawa T. , Kamoda H. , Arai G. , Sakuma Y. , Oikawa Y. , Takahashi K.
Published: June 2012

Introduction

We have previously reported that inflammatory mediators secreted by osteoclasts increased the expression of calcitonin gene-related peptide (CGRP), a marker of inflammatory pain in dorsal root ganglia (DRG) neurons innervating lumbar vertebrae of osteoporotic rats. We sought to determine whether osteoporotic pain is simply inflammatory pain. We focused on the possibility that pain is exacerbated by mechanical stress on the vertebral body, particularly in elderly people. The purpose of this study was to examine the dynamics of sensory nerve transmission of pain and the effect of mechanical stress on osteoporotic pain using a caudal vertebrae compression model in osteoporotic rats.

Materials and Methods

As an osteoporosis model, we used female rats ovariectomized (OVX) at 5 weeks ( n = 24). Fluoro-Gold (FG) was applied to the periosteal surface of a caudal vertebra to detect DRG neuronal cells innervating the caudal vertebra. After FG-labeling, we divided into two groups: OVX  + CMP group (n = 12) with K-wires inserted above and below a caudal vertebral body compressed using rubber bands and OVX group (n = 12) without compression. After 1, 2, 4, and 8 weeks of FG-labeling, bilateral S1 to S3 DRGs were resected ( n = 3 for each). In FG-labeled neurons, expression of CGRP and activating transcription factor 3 (ATF3), a marker of neuropathic pain, were compared between two groups using immunohistochemistry.

Results

The proportions of FG-labeled CGRP immunoreactive neurons in the OVX  + CMP group were significantly elevated at 4 and 8 weeks compared with the OVX group ( p < 0.05). The proportion of FG-labeled ATF3 immunoreactive neurons significantly increased compared with the FG-positive OVX group at 8 weeks ( p < 0.05).

Conclusion

The rat caudal vertebra compression model with osteoporosis expressed significantly more ATF3 in DRG cells at 8 weeks. This suggests that micronerve injury occurred in sensory neurons innervating caudal vertebra of these osteoporotic rats. Therefore, mechanical stress may possibly exacerbate osteoporotic pain. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared