bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of Economic Analyses Studying Rituximab in R-CHOP Therapy in Patients with Non-Hodgkin Lymphoma
Authors: Yoder Jenna L. , Kamal Khalid M. 
Published: September 2009

Objectives:
To explore the use of pharmacoeconomic principles through examination of economic evaluations pertaining to the combination of the monoclonal antibody rituximab with conventional CHOP (cyclophosphamide/doxorubicin/ vincristine/ prednisone) or CHOP-like chemotherapy regimens in patients with non-Hodgkin lymphoma.

Methods:
A literature search was conducted using Evidence-Based Medical Reviews (EBMR), International Pharmaceutical Abstracts (IPA), and Medline databases to identify all economic studies relating to rituximab in combination with CHOP or CHOP-like regimens. The systematic evaluation also utilized the Quality of Health Economic Studies instrument to assess the quality of each study that was included in the final review.

Results:
Initially, eight studies were retrieved which included the use of rituximab in non-Hodgkin lymphoma treatment. Of these, four studies were excluded as rituximab was used as a stand-alone treatment option. The remaining four studies involved conventional CHOP therapy versus the combination with rituximab (R-CHOP) in patients with non-Hodgkin lymphoma. One study employed a cost-effectiveness analysis while the remaining three studies used a cost-utility analysis
and reported the outcomes in terms of quality-adjusted life years (QALYs).

Conclusions:
The cost-effectiveness evaluation illustrated the dominance of R-CHOP over CHOP-alone in terms of both lower costs and increased life years gained. The cost-utility of R-CHOP in terms of costs/QALYs were below the accepted threshold of 50,000 in international monetary units. Through examination of evaluation principles employed, it is found that valid results are highly dependent on the input data, assumptions, and sensitivity analyses. Clinical decisionmakers
must take into account specific inclusions of costs relevant to their own practice setting.
Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study
Authors: Ruetten Sebastian , Komp Martin , Merk Harry , Godolias Georgios 
Published: September 2009

Object
Extensive decompression with laminectomy where appropriate is often still described as the method of choice in surgery for lateral recess stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. Transforaminal and interlaminar access provide 2 full-endoscopic (FE) techniques for lumbar spine surgery. The goal of this prospective randomized controlled study was to compare the surgical results for the FE technique via the interlaminar approach with those of the conventional microsurgical technique in patients with degenerative lateral recess stenosis.

Methods
A total of 161 patients with FE or microsurgical decompression underwent follow-up for 2 years. In addition to general and specific parameters, the following measuring instruments were used: visual analog scale, German version of the North American Spine Society instrument, and the Oswestry low-back pain disability questionnaire.

Results
The results show that 74.5% of patients reported no longer having leg pain, and 20.5% had only occasional pain. The clinical results were the same in both groups. The rate of complications and revisions was significantly reduced in the FE group. The FE techniques brought advantages in the following areas: operation, complications, traumatization, and rehabilitation.

Conclusions
The clinical results of the FE interlaminar technique are equal to those of the microsurgical technique. At the same time, there are advantages in the operation technique, such as reduced traumatization. The FE interlaminar spinal decompression procedure is a sufficient and safe supplement and alternative to microsurgical procedures.
Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients
Authors: Chibbaro Salvatore , Mirone Giuseppe , Makiese Orphée , George Bernard 
Published: September 2009

Object
The multilevel oblique corpectomy (MOC) allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not require vertebral stabilization or fusion. In the present study, the authors' goal was to demonstrate the long-term efficacy and safety of MOC in the treatment of selected cases of spondylotic myelopathy.

Methods
The authors conducted a prospective study in a series of 268 patients who underwent MOC for cervical spondylotic myelopathy over a 14-year period. Preoperative and postoperative neurological functioning were evaluated with the modified Japanese Orthopaedic Association scale. Spinal stability was assessed in all patients on serial plain and dynamic cervical radiographs at the last follow-up. The degree of canal expansion after MOC was also measured using the spinal canal/vertebral body ratio, and directly by measuring the diameter of osseous canal on pre- and postoperative CT scans and high-resolution MR images.

Results
At a mean follow-up of 96 months, clinical improvement was recorded in 86.6% of patients with a global recovery rate of 87.6%, clinical stability in 8%, and worsening in 5%. Long-term spinal stability was demonstrated in 98% of patients.

Conclusions
Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability.
Trajectory analysis and pullout strength of self-centering lumbar pedicle screws
Authors: Crawford Neil R. , Yüksel K. Zafer , Doğan Şeref , Villasana-Ramos Octavio , Soto-Barraza Julio C. , Baek Seungwon , Porter Randall W. , Marciano Frederick F. , Theodore Nicholas 
Published: September 2009

Object
An experiment was performed to study the limits of the ability of screws designed to center themselves in the pedicle during insertion, and to study whether straight-ahead versus inward screw insertion trajectories differ in their resistance to pullout.

Methods
Forty-nine human cadaveric lumbar vertebrae were studied. Pedicle screws were inserted in trajectories starting 0°, 10°, 20°, or 30° from the optimal trajectory, either medially or laterally misdirected. The surgeon then inserted the screw with forward thrust but without resisting the screw's tendency to reorient its own trajectory during insertion. On the opposite pedicle, a control screw was inserted with the more standard inward-angled anatomical trajectory and insertion point. Cortical wall violation during insertion was recorded. Screws were then pulled out at a constant displacement rate while ultimate strength was recorded.

Results
Lateral misdirection as small as 10° was likely to lead to cortical wall violation (3 of 7 violations). Conversely, medial misdirection usually resulted in safe screw insertion (1 of 21 violations for 10°, 20°, or 30° medial misdirection). The resistance to pullout of screws inserted in a straight-ahead trajectory did not differ significantly from that of screws inserted along an inward trajectory (p = 0.68).

Conclusions
Self-tapping, self-drilling pedicle screws can redirect themselves to a much greater extent during medial than during lateral misdirection. The cortical wall is more likely to be violated laterally than medially. The strength of straight-ahead and inward trajectories was equivalent.
Variety of spinal vascular pathology seen in adult Cobb syndrome
Authors: Johnson Walter D. , Petrie Michelle M. 
Published: September 2009

Cobb syndrome is a rare clinical entity that includes the combination of a vascular skin nevus and an angioma in the spinal canal present at identical dermatomal level(s) (cutaneomeningospinal angiomatosis). To date, 38 cases have been reported, only 18 of which are in adults (> 18 years of age). The majority of these cases have been described in the era predating current neuroimaging techniques, and most authors have assumed that each case involves similar vascular pathology. This report highlights 2 patients presenting with similar thoracic cutaneous vascular nevi yet with markedly differing spinal vascular pathology.
A 29-year-old man presented with cutaneous hemangioma and a progressive paraparesis and paresthesia of the lower extremities. A 20 × 20–cm port-wine stain over his right upper midback (T6–10) correlated precisely with MR imaging that demonstrated an enhancing epidural mass between T-6 and T-10 causing compression of the cord and cord edema. A 34-year-old man also presented with progressive myelopathy and a 15 × 20–cm port-wine stain within the same dermatomal region as a Type III spinal arteriovenous malformation.
Workup for each patient included pre- and postoperative contrast-enhanced MR imaging with vascular sequencing and spinal angiography. The first patient was treated with bilateral laminectomy at the T6–10 levels, with significant postoperative improvement in motor strength. The second patient underwent coil embolization of an intranidal aneurysm, with follow-up embolization 8 years later.
Cobb syndrome is an unusual entity in the adult population and should be considered when there is a constellation of cutaneous manifestation and underlying neurological deficit. The vascular skin nevus associated with Cobb syndrome is accompanied by a wide variety of vascular pathologies.
Spinal glomus-type arteriovenous malformations: microsurgical treatment in 20 cases
Authors: Boström Azize , Krings Timo , Hans Franz J. , Schramm Johannes , Thron Armin K. , Gilsbach Joachim M. 
Published: September 2009

Object
Glomus-type spinal arteriovenous malformations (AVMs) are rare. In the literature only small series and anecdotal reports can be found, and there are no prospective series elucidating the natural course or the superiority of 1 treatment regimen over another (such as surgery versus embolization versus conservative treatment). Microsurgical treatment of spinal AVMs often seems difficult because many lesions are not anatomically suitable for primary microsurgical occlusion and are therefore treated with first-line neuroradiological interventions or not at all.

Methods
Between 1989 and 2005, 20 patients with glomus-type AVMs underwent microsurgical treatment at 2 major neurosurgical centers in Germany. The history of symptoms in these patients ranged from 2 days to 11 years. Four patients presented with subarachnoid hemorrhage, 2 with intramedullary hematoma, 4 with paresthesia or pain, and 10 with clinical signs of myelopathy. Seven patients underwent partial embolization prior to microsurgery. The authors only operated on AVMs accessible from a dorsal or dorsolateral approach. Neurological status was assessed with the McCormick classification scheme. Follow-up data were obtained from outpatient records. Three patients were interviewed over the telephone and 4 patients were not available for follow-up evaluation.

Results
Surgery was performed via a laminectomy in 14 and hemilaminectomy in 6 patients. The microsurgical technique used consisted of retrograde dissection of the AVM from the venous side in most cases. Four (20%) of 20 patients showed worsening of neurological symptoms to a worse McCormick grade, probably caused by suspected venous stasis directly after surgery, however only 1 patient (5%) suffered permanent deterioration after surgery. In 14 patients postoperative angiography proved complete occlusion in 11 patients, including the presence of a remnant requiring a second operation with complete occlusion thereafter in 1 patient. In 3 patients occlusion was incomplete: a small residual AVM remained in 1 patient, and a discrete feeding vessel without a vein was evident in 2 patients.

Conclusions
Spinal cord AVMs are rare. If embolization is not possible, surgery may be indicated in selected cases. Spinal AVMs behave differently after incomplete occlusion either surgically or with embolization. A postoperative reduction in symptoms is frequent despite the presence of small remnants, and the risk of neurological deficits seems relatively low even in residual AVMs. Therefore, treatment need not necessarily aim at complete occlusion if that would be associated with an unacceptably high risk of neurological deficits.
Immunogenicity of bone morphogenetic proteins
Authors: Hwang Chang Ju , Vaccaro Alexander R. , Lawrence James P. , Hong Joseph , Schellekens Huub , Alaoui-Ismaili Moulay Hicham , Falb Dean 
Published: September 2009

Object
The object of this paper is to review the immunogenicity of bone morphogenetic proteins (BMPs) and to compare the results of the immunogenicity characterization and clinical consequences between recombinant human (rh)BMP-2 and recombinant human osteogenic protein-1 (rhOP-1/BMP-7).

Methods
The immunogenicity of therapeutic proteins and its clinical effects were reviewed. The characteristics of BMPs were also described in terms of immunogenicity. The methods and results of antibody detection in various clinical trials of rhBMP-2 and rhOP-1 were compared, including the most recent studies using a systematic characterization strategy with both a binding assay and bioassay.

Results
Similar to all recombinant human proteins, rhBMPs induce immune responses in a select subgroup of patients. Adverse effects from this response in these patients, however, have not been reported with antibody formation to either rhBMP-2 or rhOP-1. Overall, the incidence of antibody formation was slightly higher in rhOP-1 trials than in rhBMP-2 trials.

Conclusions
Although they occur in a subgroup of patients, the immune responses against rhBMPs have no correlation with any clinical outcome or safety parameter. Clinicians, however, must be aware of the potential complications caused by the immunogenicity of BMPs until more studies clearly elucidate their safety.
Clinical study of reconstructed bladder innervation below the level of spinal cord injury to produce urination by Achilles tendon–to-bladder reflex contractions
Authors: Lin Haodong , Hou Chunlin , Zhen Xianyou , Xu Zhen 
Published: September 2009

Object
Neurogenic bladder dysfunction following spinal cord injury (SCI) is a major medical and social problem for which there is no ideal treatment strategy. In the present study, the authors analyze the effectiveness of neurogenic bladder reinnervation in patients with SCIs by using Achilles tendon reflexes below the paraplegic level.

Methods
Spinal root anastomoses were performed in 12 paraplegic patients with hyperreflexic neurogenic bladder and detrusor external sphincter dyssynergia (DESD) caused by complete suprasacral SCI, in an attempt to reinnervate the bladder. The surgery anastomosed the unilateral proximal end of the S-1 ventral root and the distal end of the S-2 and/or S-3 ventral roots to build the Achilles tendon–to-bladder reflex, while the S-1 dorsal root was kept intact as the trigger for micturition after axonal regeneration. All patients underwent urodynamic evaluation before surgery and at follow-up.

Results
The mean follow-up duration was 3 years. Of the 12 patients, 9 (75%) regained satisfactory bladder control within 6 to 12 months after ventral root microanastomosis. In these 9 patients, urodynamic studies revealed a change from detrusor hyperreflexia with DESD and high detrusor pressure to almost normal storage and synergic voiding without DESD. The average bladder capacity increased from 258 ± 33 ml to 350 ± 49 ml, residual urine decreased from 214 ± 36 ml to 45 ± 11 ml, and urinary infections were not observed. Patients with impaired renal function experienced a full recovery. Three patients failed to show any improvement after the operation.

Conclusions
These results suggest the effectiveness of bladder innervation below the level of SCI to produce urination by Achilles tendon–to-bladder reflex contractions, and might therefore provide a new clinical approach to reconstructing spasmodic bladder urination function.
Unilateral C-1 lateral mass sagittal split fracture: an unstable Jefferson fracture variant
Authors: Bransford Richard , Falicov Alexis , Nguyen Quynh , Chapman Jens 
Published: September 2009

Object
The object of this study was to describe an unusual fracture subtype within C-1 injuries with a propensity to result in late deformity and pain. Most patients with C-1 injuries are nonsurgically treated using external immobilization unless there is an injury of the transverse atlantal ligament. The authors describe an unusual variant involving a unilateral sagittal split with a high tendency to late deformity and pain. They also review the literature and treatment of C-1 fractures.

Methods
A retrospective review of 12,671 CT scans from a Level I trauma center over a 6-year period yielded 54 patients with C-1 fractures. Among these patients, 6 had an unusual unilateral lateral mass sagittal split, which resulted in a late cock-robin deformity in all survivors and thus a surgical deformity correction with occipital-cervical instrumented fusions. Patient charts and radiographs were reviewed, this fracture subtype is described, and its treatment discussed.

Results
Radiographic studies in 6 patients with C-1 fractures demonstrated a unilateral sagittal split of the lateral mass but an intact transverse atlantal ligament. In the 3 surviving patients, a late cock-robin deformity, significant loss of neck rotation, and severe neck pain developed. Vertebral artery occlusion, as revealed on CT angiography, occurred in 1 patient. All patients were placed in traction and underwent successful occipital-cervical fusion and deformity correction. At the final follow-up, all patients had satisfactory pain relief and improved head alignment.

Conclusions
Patients with a unilateral sagittal split of the C-1 lateral mass have unstable injuries and must be carefully monitored, with a low threshold for surgical reconstruction or prolonged traction. Patients with late deformity can be successfully treated with occipital-cervical instrumented fusions.
Surgical results of intramedullary spinal cord tumor with spinal cord monitoring to guide extent of resection
Authors: Matsuyama Yukihiro , Sakai Yoshihito , Katayama Yoshito , Imagama Shiro , Ito Zenya , Wakao Norimitsu , Sato Koji , Kamiya Mitsuhiro , Yukawa Yasutsugu , Kanemura Tokumi , Yanase Makoto , Ishiguro Naoki 
Published: September 2009

Object
The authors investigated the outcome of intramedullary spinal cord tumor surgery, focusing on the effect of preoperative neurological status on postoperative mobility and the extent of tumor excision guided by intraoperative spinal cord monitoring prospectively.

Methods
Intramedullary spinal cord tumor surgery was performed in 131 patients between 1997 and 2007. The authors compared the pre- and postoperative neurological status and examined the type of surgery in 106 of these patients. A modified McCormick Scale (Grades I–V) was used to assess ambulatory ability (I = normal ambulation; II = mild motor sensory deficit, independent without external aid; III = independent with external aid; IV = care required; and V = wheelchair required). The type of surgery was classified into 4 levels: total resection, subtotal resection, partial resection, and biopsy.

Results
The 106 patients consisted of 47 females and 59 males, whose average age was 42.5 years (range 6–75 years). The mean follow-up period was 7.3 years (range 2.5 months–21 years). The tumor types included astrocytoma (12 cases), ependymoma (46 cases), hemangioblastoma (16 cases), cavernous hemangioma (17 cases), and others (15 cases overall: gangliocytoma, 1; germ cell tumor, 1; lymphoma, 3; neurinoma, 1; meningioma, 1; oligodendroglioma, 1; sarcoidosis, 2; glioma, 1; and unknown, 4). Initial total excision, subtotal resection, partial resection, biopsy, and duraplasty were performed in 59, 12, 22, 12, and 1 patients, respectively. According to the preoperative McCormick Scale, ambulatory status was classified as Grades I, II, III, IV, and V in 41(38%), 30 (28%), 14 (13%), 19 (19%), and 2 (2%) patients, respectively. Thirty-three (31%) of 106 patients suffered postoperative neurological deterioration. The number of patients who did not lose ambulatory ability or who achieved an ambulatory status of Grade I or II postoperatively was 33 (80%), 21 (70%), 10 (71%), 8 (42%), and 1 (50%) in patients with preoperative Grades I, II, III, IV, and V, respectively. Total excision was performed in 31 (79%) of 39 patients with preoperative Grade I, 12 (40%) of 30 patients with Grade II, 7 (50%) of 14 patients with Grade III, and 9 of 21 patients (38%) with Grade IV or V, indicating that the rate of total excision was significantly higher in patients with Grade I status.

Conclusions
The postoperative ambulatory ability was excellent in patients with a good preoperative neurological status. Total excision in patients with Grade I or II ambulation was associated with a good prognosis for postoperative mobility. However, the rate of postoperative deterioration was 31.5%, which is relatively high, and patients should be fully informed of this concern prior to intramedullary spinal cord tumor surgery.
Choosing between A+N compounds and lexicalized A+N phrases: The position of French in comparison to Germanic languages
Authors: Van Goethem Kristel 
Published: September 2009

It has been demonstrated in the literature on Germanic languages that lexicalized A+N phrases may have the same naming function as A+N compounds ( Jackendoff 1997 , 2002 ; Booij 2002 ; Hüning 2004 , forthcoming a ; Schlücker 2008 ). However, these languages may show particular preferences for either the former or the latter naming strategy, even when both strategies are available. In German A+N compounding is, comparatively speaking, very productive, whereas it is said to be no longer productive in English, which generally uses A+N phrases for the same function (e.g. Festplatte – hard disk). Dutch seems to take an intermediary position: here, both word formation processes are productive; but compared to German, Dutch shows a stronger preference for lexicalized A+N phrases (cf. De Caluwe 1990 ; Booij 2002 ; Hüning forthcoming a ).The central aim of this paper is to situate French on this lexicon-grammar continuum. This, however, requires first of all the formulation of a univocal definition of compounding, since the notion generally receives a less restrictive interpretation in Romance languages than it does in Germanic languages. It will be shown that French has a strong preference for lexicalized A+N phrases: even when both German and Dutch use A+N compounds, French – like English – generally still opts for the syntactic naming strategy (e.g. Schnellzug – sneltrein – fast train – train rapide).
Discovery: Discovery Motions
Authors: Wheate Rhonda M. 
Published: September 2009

AbstractDiscovery motions are a means of compelling disclosure in adversarial law systems. This article sets out the general principles of discovery motions in the United Kingdom, both in criminal and civil law contexts. The effect of European developments including theEuropean Convention on Human Rightsand decisions of the European Court of Human Rights, on legislation and common law in the United Kingdom, is also discussed. The highly regulated discovery motion process in the United States is described elsewhere (see FSA014 and FSA015).