A prospective assessment of SRS-24 scores after endoscopic anterior instrumentation for scoliosis

Study Design. Prospective clinical case series. Objective. To evaluate the clinical outcome of anterior endoscopic instrumention for scoliosis using the SRS-24 questionnaire and to examine how these scores change over a 2-year follow-up period. Summary of Background Data. Anterior endoscopic instrumentation correction has several advantages compared with open procedures. However, the clinical results of this technique using a validated outcome measure have rarely been reported in the literature. Methods. A total of 83 consecutive patients underwent endoscopic anterior instrumentation performed at a single unit. Patients completed the SRS-24 questionnaire before surgery and at 3, 6, 12, and 24 months after surgery. The SRS-24 scores were compared between each of the follow-up intervals. Results. The pain, general self-image, and function from back condition domains improved after surgery (P < 0.05). Activity level significantly improved between 3 and 6 months, and both function domains improved between 6 and 12 months (P < 0.05). None of the domains increased significantly after 1 year. Conclusions. Endoscopic anterior instrumentation for scoliosis significantly improved pain, self-image, and function. The greatest improvement in function occurred between 6 and 12 months after surgery. The SRS-24 scores at 1 year from surgery may provide a good indicator of patient outcome in the long-term.

Retinoic acid disrupts anterior ectodermal and endodermal development in ascidian larvae and postlarvae

In vertebrates, excess all-trans retinoic acid (RA) applied during axis formation leads to the apparent truncation of anterior structures. In this study we sought to determine the type of defects caused by ectopic RA on the development of the ascidian Herdmania curvata. We demonstrate that H. curvata embryos cultured in the presence of RA develop into larvae whose trunks are shortened and superficially resemble those of early metamorphosing postlarvae. Despite RA-treated larvae lacking papillar structures they respond normally to natural cues that induce metamorphosis, indicating that chemosensory functionality previously mapped to the most anterior region of normal larvae is unaffected by RA. Excess RA applied during postlarval development leads to a graded loss of the juvenile pharynx, apparently by respecifying anterior endoderm to a more posterior fate. This structure is considered homologous to the gill slits of amphioxus. which are also lost upon RA treatment. This suggests that RA may have had a role in the development of the pharynx of the ancestral chordate and that this function has been maintained in ascidians and cephalochordates and lost in vertebrates.

Quantum error correction for continuously detected errors

We show that quantum feedback control can be used as a quantum-error-correction process for errors induced by a weak continuous measurement. In particular, when the error model is restricted to one, perfectly measured, error channel per physical qubit, quantum feedback can act to perfectly protect a stabilizer codespace. Using the stabilizer formalism we derive an explicit scheme, involving feedback and an additional constant Hamiltonian, to protect an (n-1)-qubit logical state encoded in n physical qubits. This works for both Poisson (jump) and white-noise (diffusion) measurement processes. Universal quantum computation is also possible in this scheme. As an example, we show that detected-spontaneous emission error correction with a driving Hamiltonian can greatly reduce the amount of redundancy required to protect a state from that which has been previously postulated [e.g., Alber , Phys. Rev. Lett. 86, 4402 (2001)].

Bayesian analysis of the error correction model

This paper presents a method for estimating the posterior probability density of the cointegrating rank of a multivariate error correction model. A second contribution is the careful elicitation of the prior for the cointegrating vectors derived from a prior on the cointegrating space. This prior obtains naturally from treating the cointegrating space as the parameter of interest in inference and overcomes problems previously encountered in Bayesian cointegration analysis. Using this new prior and Laplace approximation, an estimator for the posterior probability of the rank is given. The approach performs well compared with information criteria in Monte Carlo experiments. (C) 2003 Elsevier B.V. All rights reserved.

Two-dimensional approximation for tidal dynamics in coastal aquifers: Capillarity correction

Most previous investigations on tide-induced watertable fluctuations in coastal aquifers have been based on one-dimensional models that describe the processes in the cross-shore direction alone, assuming negligible along-shore variability. A recent study proposed a two-dimensional approximation for tide-induced watertable fluctuations that took into account coastline variations. Here, we further develop this approximation in two ways, by extending the approximation to second order and by taking into account capillary effects. Our results demonstrate that both effects can markedly influence watertable fluctuations. In particular, with the first-order approximation, the local damping rate of the tidal signal could be subject to sizable errors.

The design of planar gradient coils. Part I: A winding path correction method

In this work a new approach for designing planar gradient coils is outlined for the use in an existing MRI apparatus. A technique that allows for gradient field corrections inside the diameter-sensitive volume is deliberated. These corrections are brought about by making changes to the wire paths that constitute the coil windings, and hence, is called the path correction method. The existing well-known target held method is used to gauge the performance of a typical gradient coil. The gradient coil design methodology is demonstrated for planar openable gradient coils that can be inserted into an existing MRI apparatus. The path corrected gradient coil is compared to the coil obtained using the target field method. It is shown that using a wire path correction with optimized variables, winding patterns that can deliver high magnetic gradient field strengths and large imaging regions can be obtained.

Effect of hypothalamo-pituitary disconnection on the development of anterior pituitary cells in late gestation ovine fetuses

The specific role of the hypothalamus in regulating the developmental profile of anterior pituitary (AP) cells remains largely unknown. The present study evaluated hypothalamic contributions to AP cell development, utilizing the technique of hypothalamo-pituitary disconnection (HPD). HPD of fetal sheep or sham surgery was performed at 110 days gestation (d) (n=6 each group; term ~ 147d). Fetuses were removed and pituitaries collected at 110d (no surgery; n=6) or 141d (sham and HPD groups). The impact of HPD on AP cell development was assessed by single-labeled immunofluorescence for five hormones to identify proportions of AP cells expressing each hormone. HPD was associated with a 70% increase (P

Induction of metamorphosis with potassium ions requires development of competence and an anterior signalling centre in the ascidian Herdmania momus

Increased Kt concentration in seawater induces metamorphosis in the ascidian Herdmania momus. Larvae cultivated at 24 degrees C exhibit highest rates of metamorphosis when treated with 40 mM KCl-elevated seawater at 21 degrees C. At 24 degrees C, H. momus larvae develop competence to respond to KCl-seawater and initiate metamorphosis approximately 3 h after hatching. Larval trunks and tails separated from the anterior papillae region, but maintained in a common tunic at a distance of greater than 60 mu m, do not undergo metamorphosis when treated with KCl-seawater; normal muscle degradation does not occur in separated tails while ampullae develop from papillae-containing anterior fragments. Normal programmed degradation of myofibrils occurs when posterior fragments are fused to papillae-containing anterior fragments. These data indicate that H. momus settlement and metamorphosis only occurs when larvae have attained competence, and suggest that an anterior signalling centre is stimulated to release a factor that induces metamorphosis.

A comparison of anterior adhesive areas and secretions in Troglocephalus rhinobatidis and Neoheterocotyle rhinobatidis (Monogenea : Monocotylidae) from the gills of the shovelnose ray, Rhinobatos typus (Rhinobatidae)

This study continues the collection of data on the anterior adhesive areas and secretions of monopisthocotylean monogenean (flatworm) parasites and begins an investigation of their phylogenetic usefulness. Here, two species of parasitic worms from an elasmobranch, Troglocephalus rhinobatidis (Monocotylidae: Dasybatotreminae) and Neoheterocotyle rhinobatidis (Monocotylidae: Heterocotylinae), are compared and contrasted. It has been suggested in recent literature that these two taxa are more closely related than is currently recognised. Our data support this view. Both species have multiple apertures on the ventral anterior margin through which adhesive is secreted. Two types of secretion exit from multiple adjacent duct endings terminating in each aperture: rod-shaped (S1) and spherical-shaped (S2) bodies. S1 bodies of both species show nano-banding of similar size and are membrane bound. Ultrastructure of the glands, ducts, duct endings and secreted adhesive is similar for both species, but aperture shape differs. Away from the adhesive areas, tegumental inclusions are found to differ between the two species and another, apparently non-adhesive, secretion is found in N. rhinobatidis.

Irritative symptoms after colposuspension: Are they due to distortion or overelevation of the anterior vaginal wall and trigone?

Symptoms of bladder irritability are common after incontinence surgery but their cause is unknown. This study tests the hypothesis that irritative symptoms after colposuspension are due to distortion of the trigone. As part of longitudinal follow-up studies, 175 women were examined 6 months to 12 years after either an open or a laparoscopic Burch colposuspension. The main outcome measures were symptoms of bladder irritability (frequency, nocturia and urge incontinence) and ultrasound findings (bladder neck position at rest and on Valsalva, the presence of a colposuspension ridge, ridge depth and ridge distance, and trigonal angle). Two positive associations between ultrasound parameters and symptoms of bladder irritability were observed: urge incontinence was more likely in the presence of bladder neck funneling, and women with nocturia had a higher trigonal angle. Increased distortion of the trigone was associated with a reduced incidence of urge incontinence in the subgroup of patients after laparoscopic colposuspension. The data presented in this study do not support the hypothesis that symptoms of bladder irritability are due to trigonal distortion or overelevation.

Is the irritable bladder associated with anterior compartment relaxation? A critical look at the 'integral theory of pelvic floor dysfunction'

The 'integral theory of pelvic floor dysfunction', first proposed by Petros and Ulmsten in 1990, claims that anterior vaginal wall relaxation is associated with symptoms of urgency, frequency, nocturia and urge incontinence. A retrospective study was designed to test this hypothesis. Imaging data and urodynamic reports from 272 women suffering from symptoms of lower urinary tract dysfunction were evaluated. Opening of the retrovesical angle, bladder neck descent, urethral rotation and descent of a cystocele during Valsalva were used to quantify anterior vaginal wall laxity None of the tested parameters were associated with symptoms and signs of detrusor overactivity. On the contrary, patients with higher grades of urethral and bladder descent were less likely to suffer from nocturia and urge incontinence and were less likely to leave sensory urgency and detrusor instability diagnosed on urodynamic testing. The findings of this study therefore do not support this hypothesis of the 'integral theory'.

Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis

This study assessed the quadriceps and hamstring strength before and 6 months after anterior cruciate ligament (ACL) reconstructive surgery using the hamstrings and related the findings to functional performance. Six months after surgery is a critical time for assessment as this is when players are returning to sport. Maximum isokinetic strength of 31 patients with complete unilateral ACL ruptures was measured at speeds of 60 degrees and 120 degrees per second. Functional assessment included the single hop, the triple hop, the shuttle run, side-step and carioca tests. All patients underwent a controlled quadriceps emphasized home-based physiotherapy program both before and after surgery. Results show that before surgery there was a 7.3% quadriceps strength deficit at 60 degrees per second compared to the uninjured leg but no hamstring strength deficit. After surgery there was a statistically significant but relatively small loss of muscle strength. The quadriceps strength deficit had increased to 12% and there was a 10% hamstring deficit. Post-operatively there was an 11% and 6.3% improvement in the hop tests, a 9% (P < 0.01) improvement in the shuttle run, a 15% (P < 0.001) improvement in the side step and a 24% (P < 0.001) improvement in the carioca tests (P < 0.001) despite the loss of muscle strength. (C) 2001 Elsevier Science B.V. All rights reserved.