Case Report:Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele in a child

Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia.Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord.A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1.The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved.Arachnoid cyst was confirmed by histological examination.The patient recovered well postoperatively.This is the second report of such a case in the world according to the available literature.The take-home message for our case is that the surgical approach should be individualized,depending on the size and location.     

Unilateral hemilaminectomy for patients with intradural extramedullary tumors

A modified hemilaminectomy was introduced in an attempt to explore the operative techniques and the values of the limited approach to spinal cord tumors. Forty-five consecutive patients with intradural extramedullary lesions, who underwent modified hemilaminectomy, were studied retrospectively. The intraspinal tumors were removed via the limited bone window with a 3.3-cm mean length (range: 2.0–6.5 cm) and a 1.2-cm mean width (range: 0.6–1.5 cm), in which the inner parts of the medial and lateral laminae were mostly undercut for wider view. Spinal lesions were cervical in 21 cases, thoracic in 12 cases, lumbar in 10 cases, and multiple in 2 cases. Forty-three cases were completely excised via hemilaminectomy alone. Two subjects with dumbbell neurinoma underwent two-stage tumor removal via anterolateral cervical approach following hemilaminectomy. With respect to neurological status, the percentage of good Frankel scale (D+E grade) was markedly improved from 22.2% on admission to 93.3% at follow-up. At the median 26-month follow-up evaluation by magnetic resonance imaging (MRI), none of the subjects showed spinal deformity or instability. By preserving musculoligamentous attachments and posterior bony elements as much as possible, the modified approach is minimally invasive and may be routinely used to remove intradural and extramedullary tumors, especially in patients with meningiomas and neurinomas.     

Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury

Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Spragne-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day l, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.     

Ciliated hepatic foregut cyst: report of first case in China and review of literature

Objective: To report the first case of ciliated hepatic foregut cyst in China, and review of literature to introduce the characteristics of this disease for doctors to recognize this disease. Method: Report the clinical procedure of diagnosis and treatment for the first case of ciliated hepatic foregut cyst in China, and to review the embryologic genesis, incidence, clinical manifestation, radiologic features and therapeutic principle of this disease. Results: We performed the resection for ciliated hepatic foregut cyst under laparoscopy; the patient recovered well after the procedure. Conclusion: Ciliated hepatic foregut cyst is quite rare clinically, belongs to non-parasitic, solitary and unilocular cystic lesion, is always less than 4 cm in diameter, mostly seen in the left lobe, and has the tendency of malignant change. It should be removed as soon as diagnosed.     

Ciliated hepatic foregut cyst: report of first case in China and review of literature

INTRODUCTIONCysticlesionofliverisgenerallydividedintoparasiticandnon-parasiticones.Ciliatedhepaticforegutcyst(CHFC)isnon-parasitic,andfirstusedbyWheelerandEdomondson(1984)todescribethehepaticcysticlesionarisingfromtheembryologicforegut.Ciliatedforegutcystmostlyoccursinthetracheobronchialtreeandesophagus,andisrarelyfoundintheliver.Accordingtotheforeignlitera-ture,therewere72casesreported,noneinChina.Recentlyweperformedalaparoscopichepatectomyforamassintheleftlobe.Thepostoperativepatho-l…     

Tornwaldt囊肿的低场MRI与临床分析

目的：探讨Tornwaldt囊肿的低场MRI表现特征与临床特点。方法：回顾性分析5840例颅脑低场MRI资料,重点分析Tornwaldt囊肿MRI表现特点、出现率、临床表现。结果：5840例中发现108例Tornwaldt囊肿,出现率为1.85%。病变位于鼻咽后壁正中粘膜下,均呈圆形或椭圆形,直径或长径：2mm～23mm,平均9mm。病灶呈T1W低T2WI高信号（类似脑脊液信号）75例,呈T1WI及T2WI高信号33例。82例无明显相关症状,26例有咽部和（或）颈前不适症状。结论：Tornwaldt具有特征性的发病部位及MRI信号特点。     

Mauthner细胞实验中几种典型波形与记录电极位置的关系

硬骨鱼类Mauthner(M)细胞作为一种优秀的实验模型,长期以来被用于中枢神经系统的研究。在实验中需要刺激鲫鱼脊髓,逆向激活M细胞轴突,用玻璃微电极记录其细胞内、外的电变化。为了鉴别电反应是否来自M细胞,该实验室结合多年实验经验总结了不同细胞的电反应特征,以正确判断记录电极在实验动物体内所处的位置。     

单通道神经信号再生集成电路

将利用分立器件设计的4通道神经信号再生电子系统成功地应用于大鼠和家兔的活体动物实验,再生了它们的神经信号．采用相同的原理,用CSMC0．6μm CMOS工艺设计实现了单通道神经信号再生集成电路．电路由增益可调的神经信号探测电路、缓冲器和神经功能电激励电路构成．电路采用±2．5V双电源电压供电．芯片尺寸为1．42mm×1．34mm．在片测试电路的静态功耗小于10mW,输出电阻为118mΩ,3dB带宽大于30kHz,增益在50～90dB可调．电路芯片与卡肤电极、针状双体电极一起,用于大鼠的神经信号再生的活体动物实验,成功地再生了大鼠的坐骨神经和脊髓神经信号．     

AS伴严重后凸畸形患者手术体位的护理

为了探讨强直性脊柱炎后凸畸形手术体位护理经验,分析21例脊柱后凸畸形术中护理,并总结特点。护理结果表明手术体位摆放达到医生满意,21例患者均未发生压疮及再次出现脊柱应力性骨折和脊髓损伤加重等并发症。认为手术体位合理摆放是防止并发症发生,是手术成功的重要环节。     

多通道神经信号激励模块的研制及其动物实验

为了研究植入式神经功能再生微电子系统,设计了功能激励神经信号产生模块.首先用分立器件设计并实现了体外应用的单通道功能激励神经信号产生模块,并将该模块成功应用于激励老鼠和兔子的坐骨神经和脊椎神经的神经功能再生微电子系统的动物试验.在此基础上,设计了用于12个电极点的卡肤电极或者10个电极点的剑状电极四通道神经信号激励模块.用5只老鼠和2只兔子进行了3次坐骨神经和脊髓神经束活体动物试验.试验中,功能激励神经信号产生模块再生了大鼠体内的自发神经信号和模拟的神经信号,模块所产生的信号使大鼠和兔子的腿部、尾巴甚至脚趾产生了相应的动作,验证了神经功能再生微电子系统的可行性.     

The Use of Coffee Spoons in the Assessment of Teaching

This article reports on In‐Service Education and Training (INSET) workshops offered in Limpopo and Mpumalanga Provinces in the field of environmental education. The purpose of these workshops is to assist practising teachers to enhance their teaching skills, to infuse environmental education in their teaching and to participate in solving environmental problems in their communities. Aspects of the workshops were assessed using a questionnaire which was completed by teachers on conclusion of the workshops. These data are provided as well as recommendations provided by the attendees. Although this is a case study report where findings are usually not perceived to be generalisable, it is believed that the participants' perceptions of and recommendations for improving INSET opportunities could substantially inform similar INSET initiatives.     

Exploring effectiveness in brain removal techniques: A comparison of approaches

Brain dissection is typically an important part of teaching neuroscience in health professional programs. This results in the need to effectively remove brains, which is often performed in a gross anatomy laboratory in the same curriculum. The aim of this study was to determine the most effective method of brain removal based on the time required for removal, difficulty of removal, and preservation of key brain structures for educational purposes. Six different dissectors performed each of the three calvaria removal approaches and three different spinal cord transection methods rating them for difficulty and tracking the time required. The combination of calvaria and brainstem approaches and the order of completion was randomized to control for fatigue and previous individual experience. After all brains were removed, each was evaluated by neuroscience faculty for utility in education contexts. The study found little difference between the individual approaches for both calvaria removal and spinal cord transection in regards to quality of outcome. The use of a circumferential cut only proved to be the most time-effective method for calvaria removal while a posterior cut between C1 and C2 was the most time-effective and least difficult method for brainstem release. There was no one technique that proved to be most beneficial across all three measures. However, different approaches resulted in a different combination of benefits across the time, difficulty, and outcome ratings that should be considered in light of the individual needs of any program or researcher.     

Umbilical cord blood: information for childbirth educators

Umbilical cord blood was once thought of as a waste product. Now, years after the first successful umbilical cord blood transplant, more families seek information about whether or not to save their newborn's cord blood. Childbirth educators may be one of the main sources that an expectant family depends on to gain more knowledge about cord blood banking in order to make an informed decision. Preserving umbilical cord blood in public banks is advisable for any family; however, it is recommended that expectant families only consider private cord blood banking when they have a relative with a known disorder that is treatable by stem cell transplants. The childbirth educator is encouraged to be well versed on the topic of cord blood banking, so that as questions from class participants arise, the topic can be explored and addressed appropriately.     

Technology to Advance Research in Kinesiology: The Case for Light,Sound, and Radiofrequencies

Technology has strongly impacted research in kinesiology. Recent technological advances have greatly enhanced our ability to noninvasively quantify activity-related changes in skeletal muscles and peripheral arteries. In people with spinal cord injuries, we can track changes in muscle size, composition, and the presence of injury. We can also measure changes in artery size, health, and the ability to deliver oxygen. However, large investments in time are needed to both obtain these measurements and to be able to interpret them. The monetary costs of advancing technology are rising as well, serving as a major limitation to the promise of technology in kinesiology.     

Development of the Stretch Reflex in the Newborn: Reciprocal Excitation and Reflex Irradiation

The stretch reflex is a spinal cord pathway between a muscle's stretch receptors and its own motor units. This reflex is thought to play an important role in normal motor function, because it is unique as a monosynaptic pathway, and because its hyperactivity is a hallmark of many motor disorders. We previously reported a difference in the stretch reflexes in healthy newborn infants and nonambulatory individuals with cerebral palsy (CP): these reflexes are characterized by responses from the stretched muscle and from the reciprocal or antagonist muscle. We proposed the existence of a functional spinal cord pathway that connects both agonist and antagonist muscles at a single joint. We hypothesized that this "reciprocal excitation" is a functional pathway of all newborn infants, which during the normal course of development of motor skills in infants is eliminated. If the CNS is damaged at birth, as in CP, the pathway of reciprocal excitation endures and is reinforced. In the current study of newborns, we recorded stretch reflex responses from all major muscle groups of the lower limb. This "irradiation of reflexes" is a normal phenomenon of the newborn CNS. This pathway becomes suppressed during normal maturation and control of coordinated limb movements.     

The Human Nervous System: A Framework for Teaching and the Teaching Brain

The teaching brain is a new concept that mirrors the complex, dynamic, and context‐dependent nature of the learning brain. In this article, I use the structure of the human nervous system and its sensing, processing, and responding components as a framework for a re‐conceptualized teaching system. This teaching system is capable of responses on an instinctual level (e.g., spinal cord teaching) as well as higher order student‐centered teaching and even more complex teaching brain teaching. At the most complex level the teacher and student engage in a synchronistic teaching flow that achieves the optimal teaching and learning experience.     

Exploring Facilitators to Participation for Wheelchair Users at a South African University

ABSTRACT

The focus of research to date has been on barriers rather than facilitating factors to participation for wheelchair users at higher education institutions (HEIs). This article reports on a single case study that explored the facilitating factors which contributed to a young male student with a spinal cord injury’s participation at a South African university. Semi-structured interviews were conducted with the student and two peers whom he identified as key informants. The interviews focused on exploring his lived experience to identify factors which the participants perceived as facilitators to participation at university. The four most prominent facilitating factors that emerged during the data analysis were his drive, attitude, disposition and relationships. As the young man fully engaged in a variety of occupations at university, his sense of independence and self-worth were enhanced, which in turn led to him having a meaningful and productive university life, being able to manage any of the barriers he encountered on campus.     

Spousal adaptation to disability: Ramifications and implications for counseling

The authors review the reactive patterns of adjustment by the families of the severely disabled as proposed by Bray (1977, 1978). The model is critiqued in light of evidence gained from a phenomenological study of 10 women married to spinal cord injured males. Implications and ramifications for the field of counseling are noted.     

Dose-response study of spinal hyperbaric ropivacaine for cesarean section

Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.     

Technical Education,the Performance of South Wales Industrialists and the Haldane Commission

The article begins with a brief introduction to the development of Welsh society and industry between 1870 and 1914. This is followed by a review of Welsh education, especially technical education, in that period, highlighting its backwardness and the factors accounting for that backwardness. The report of the Haldane Commission is then examined against a background of a brief statement of the ‘revisionist’ case. Against the British Retardation theory, the performance of south Wales' industrialists is assessed. This reveals that in contradiction to the ‘revisionist’ view that British industrialists did as well as could have been expected, such was not the case in south Wales.