Repeated, intense, cutaneous stimulation results in the gradual development of inhibition of spinal interneurones. This change in neuronal activity could not be demonstrated in rats whose spinal cords had been transected, and was considered to be the consequence of supraspinal mechanisms. . Experiments sere carried out to determine which areas of the brain were involved. Unitary recordings from neurones situated in nucleus reticularis pontis-caudalis, nucleus reticularis giganto-cellularis, nucleus reticularis parvocellularis and nucleus medulla oblongata pars ventralis demonstrated a progressively increasing excitatory response to repeated intense cutaneous stimulation. These areas were shown to have direct projections to the spinal cord, by retrograde transport of horseradish peroxidase. Cells in nucleus reticularis gigantocellularis, which demonstrated a progressively increasing excitatory response, could also be antidromically activated from the spinal cord. Repeated stimulation of some of these areas produced a progressive inhibition of spinal interneurones which was similar to that resulting from cutaneous stimulation. It would appear that nucleus reticularis gigantocellularis and nucleus reticularis pontis-caudalis are involved in the development of a progressive inhibition of spinal interneurones. A similar role for other reticular and raphe nuclei can not be excluded on the basis of evidence presently available. / Medicine, Faculty of / Cellular and Physiological Sciences, Department of / Graduate

This work presents an alternative approach to the production of cellulose-based biomaterials. Instead of extracting, processing and regenerating plant and or bacteria-derived cellulose into a biomaterial, my work established a decellularization protocol to remove cellular plant content from plant tissue resulting in a scaffold composed of cellulose with the evolved architecture of the plant cell wall. Tracheophyte plants, including clubmosses, horsetails, and ferns, gymnosperms and angiosperms, have evolved distinct vascular structures that support the transport of water and nutrients in xylem and phloem that form the vascular bundles (VBs)1. This thesis took it’s inspiration from the dense, linearly arranged, parallel microchannels which include (VBs) in the stalks of Asparagus officinalis possess an architecture with striking similarities to biomaterial scaffolds intended to repair damaged tissue. My work demonstrated that the plant cell wall contains many of the ideal characteristics of a medical biomaterial. The scaffold is biocompatible with mammalian cells and maintains high viability even with cell densities comparable to commercially available scaffolds. The cellulose scaffold could be biochemically functionalized or cross-linked to control the scaffolds' surface biochemistry and mechanical properties. My in vivo model demonstrated that the lignocellulose scaffold did not elicit a foreign body response. The scaffold was permissive to host cell invasion, including active host fibroblast, leading to the deposition of host collagen extracellular matrix. Importantly, active blood vessels formed within the scaffold to support the population of host cells. The scaffold retained much of its original shape and provided an inert, pro-vascular long-term environment for host cells to invade. Taken together, this led to the hypothesis that the innate plant cell wall architecture could restore the function of injured tissue, specifically that the vascular bundles could be used to promote axonal regeneration in spinal cord injuries. Rats with complete spinal cord transection were implanted with cellulose scaffolds with vascular bundles. Animals that received plant-derived scaffolds demonstrated a significant improvement in motor function. This thesis defines a novel and parallel route for exploiting naturally occurring plant microarchitectures of the underlying crystalline cellulose scaffold.

Purpose. As motor vehicle accidents and violence cause the majority of spinal cord injuries (SCI) sustained in the USA and people with SCI will likely struggle with emotional issues related to the offender, the purpose of this exploratory study was to examine potential salutary effects of forgiveness among people with SCI incurred traumatically. Specifically, we hypothesized that forgiveness would have positive associations with health-related outcomes. Method. A community-based sample of 140 adults (19-82 years of age) with SCI completed a self-report survey regarding dispositional forgiveness of self and others, health behavior, health status, and life satisfaction. Hierarchical multiple regression analyses were employed to examine the relationships in question. Results. After controlling for demographic variables, forgiveness of self was significantly associated with health behavior and life satisfaction (uniquely accounting for 7% and 13% of the variance, respectively) and forgiveness of others was significantly associated with health status (uniquely accounting for 9% of the variance). Conclusion.Results suggest that forgiveness may play a role in the health and life satisfaction of people with traumatic SCI, with the benefit depending on the type of forgiveness offered.

Bakgrund: Trauma förekommer över hela världen och olyckor står för den främsta dödsorsaken hos personer under 45 år, både internationellt och nationellt. Trauma är en av de vanligaste orsakerna till akuta skador i halskotpelaren och halsryggmärgen. Varje år drabbas cirka 4000 patienter i Sverige av frakturer i hals, bröst och ländrygg. För patienten kan spinal skada beskrivas som det mest livsomvälvande ögonblicket i patientens liv. Ambulanssjuksköterskans förmåga att omhänderta patienten gällande spinal rörelsebegränsning (SRB) har betydelse för vården av den drabbade patienten. Syfte: Syftet var att beskriva ambulanssjuksköterskans upplevelse av omhändertagandet vid misstänkt traumatisk spinal skada.  Metod: En kvalitativ metod med deskriptiv design och induktiv ansats har använts. Tretton semistrukturerade intervjuer gjordes. Manifest innehållsanalys inspirerad av Graneheim och Lundman (2004) utfördes. Resultat: Två kategorier framkom ur analysen: yrkesrollen och bemötande. Yrkesrollen innebar att ambulanssjuksköterskornas upplevelse var att det fanns teoretisk kunskap kring SRB. Däremot upplevdes vissa situationer oklara där beslut om SRB skulle tas. Ambulanssjuksköterskorna upplevde då en viss osäkerhet och tog det säkra före det osäkra. Ambulanssjuksköterskan upplevde ett stort ansvar samt att fokus för omhändertagandet var den fysiska skadan. I bemötandet upplevde ambulanssjuksköterskorna betydelsen av att vara och att inge lugn. Information och kommunikation upplevdes vara viktig i omhändertagandet med patienten vid misstänkt spinala skada. Teamet kring ambulanssjuksköterskan, både kollegan i samma ambulans och andra aktörer samt patienten själv upplevdes som viktigt. Slutsats: Ambulanssjuksköterskorna upplevde osäkerhet i omhändertagandet av patienter med misstänkt traumatisk spinal skada. Av studiens resultat behövs mer träning och övning i klinisk verksamhet. / Background: Trauma occurs all over the world and accidents are the leading cause of death in people under the age of 45, both internationally and nationally. Trauma is one of the most common causes of acute injuries to the cervical spine. Every year, about 4,000 patients in Sweden suffer fractures in the neck, chest and lumbar spine. For the patient, spinal injury can be described as the most life-changing moment in the patient's life. The ambulance nurse's ability to care for the patient regarding spinal movement restriction is crucial for the care of the affected patient.  Aim: The purpose was to describe the ambulance nurse's experience of care in case of suspected traumatic spinal injury. Method: A qualitative method with descriptive design and inductive approach has been used. Thirteen semi-structured interviews were conducted. Manifest content analysis inspired by Graneheim and Lundman (2004) was performed. Result: Two categories emerged: the professional role and approach. The professional role was described as the ambulance nurses' experience that there is a theoretical knowledge about spinal immobilization. However, some situations were perceived as unclear where decisions about the spinal immobilization should be taken and the situation made the ambulance nurses feel uncertain about a decision. The ambulance nurse felt a huge responsibility where focus was the physical injury. In the approach with the patient the ambulance nurses emphasized the importance of being calm. Information and communication were perceived as important in the care of the patient in case of suspected traumatic spinal injury. The team around the ambulance nurse, both the colleague in the same ambulance and other actors as well as the patient, were perceived as important. Conclusion: Ambulance nurses’ experienced uncertainty in the care of patients with suspected traumatic spinal injuries. As a results of the study, more training and practice is needed.

Introduction: Implicit within spinal manipulative therapy is the assumption that treatment loads are effectively transcribed to actuate consistent mechanisms for expected clinical results. There is conflicting evidence between the mechanistic understandings and the physiologic responses from experimental evidence. Greater clarity on how loads are transferred through tissues to the target sites would be useful in enhancing utilization and efficacy of spinal manipulative procedures. Purpose: Directly monitor displacement of tissue in strata at sequential depths between the load application site and target articulation in the thoracic spine. Tissue displacement served as a surrogate for evidence of load transmission. Methods: Ultrasound elastography techniques monitored displacement in sequential strata while electromyographic signals, force, kinematic motions were monitored synchronously. Volunteers were placed prone on a treatment table, while a typical spinal manipulative pre-load maneuver was applied in the thoracic spine. Results: When applying a therapeutic load to the skin the results demonstrate with increasing depth of tissue there is a sequentially decreasing rank order in the mean cumulative displacement with each layer being significantly greater than the deeper adjacent layer. Superficial loose connective tissue layer (0.34 mm ± 0.15) vs. intermediate muscle layer (0.28 mm ± 0.11), p=0.004. Intermediate muscle layer (0.28 mm ± 0.11) vs. deep muscle layer (0.16 mm ± 0.6), p<0.0001. Filtered myoelectric signals were linearly correlated with tissue strata cumulative displacements, but the relationship was not strong (-0.23 < r < 0.46). Conversely, Pearson correlation analysis revealed strong and relatively stable correlations (0.74 < r < 0.90) for the association between displacement at the load application site and tissue layers. Conclusion: The sequential tissue motion demonstrates that some degree of load transfer through layers occurs. Both direct and indirect stimulation of tissues across both depth and breadth is feasible, to an extent consistent with the stimulation of mechanoreceptors. / Thesis / Master of Science (MSc)

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Current scoliosis corrective surgeries may include the use of multiple instrumentation devices including screws, wires, nuts, and rods. The instrumentation in most cases is implemented in its native form. However, the instrumentation rods must be contoured to a desired shape prior to fixation to the spine. The contouring of the instrumentation rod is currently performed manually and may require significant time for completion. This results in an increase of operation time and reduced accuracy of the instrumentation rod. The feasibility of automating the contouring process was studied to determine if the time required to contour a rod could be reduced and if the accuracy of the rod could be improved. This study built upon a previous effort to construct a prototype that would automate the manufacture of spinal instrumentation rods. The Spinal Instrumentation Bending Prototype (SIBP) focused on ease of use, time of manufacture, and accuracy. In order to complete the manufacturing process, the current SIBP uses a set of three dimensional control points that represent the desired contour of the rod. These control points are translated into manufacturing inputs that control the SIBP. The control application for the SIBP contains local and global feedback routines that correct for any manufacturing errors. A comparative study was made between the SIBP and an experienced orthopedic surgeon to determine the level of bending accuracy improvement. / Master of Science

by Wai-Ying Li. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves 87-94). / ABSTRACT --- p.i / CONTENTS --- p.iii / Chapter CHAPTER I. --- INTRODUCTION / Chapter A. --- Plasticity of central nervous system --- p.1 / Chapter B. --- The response of spinal cord after injury --- p.2 / Chapter C. --- Sprouting in the corticospinal tracts --- p.3 / Chapter D. --- Influential factors of sprouting in CNS --- p.5 / Chapter E. --- The objective of the present study --- p.6 / Chapter CHAPTER II. --- THE NORMAL RAT CORTICOSPINAL TRACTS --- p.9 / Chapter CHAPTER III. --- MATERIALS AND METHODS / Chapter A. --- The experimental model --- p.15 / Chapter B. --- Retrograde fluorescing tracer study to confirm sprouting --- p.16 / Chapter C. --- Protagol silver study to detect axonal sprouting --- p.19 / Chapter D. --- Chromatolysis study to prove the sprouting --- p.22 / Chapter E. --- Degenerating silver study to detect where sprouting might have come from --- p.25 / Chapter F. --- Cytochrome oxidase study to evaluate the cytochemical change of the motor neurons after hemisection --- p.28 / Chapter G. --- Labelled uptake studies to assay the biochemical changes after hemisection --- p.31 / Chapter H. --- The Raman spectroscopy study to detect proteins change after hemisection --- p.33 / Chapter I. --- Study on preferential growth sprouts into spinal cord or peripheral nerve --- p.35 / Chapter J. --- Study on target specificity of sprouting fibers --- p.37 / Chapter K. --- Study on the behavior of the hemisected rats --- p.39 / Chapter CHAPTER IV. --- RESULTS / Chapter A. --- Examination of the sprouting / Chapter 1. --- Results of the retrograde fluorescent tracer study --- p.50 / Chapter 2. --- Result of protagol silver study --- p.51 / Chapter 3. --- Result of chromatolysis study --- p.52 / Chapter 4. --- Result of degenerating silver study --- p.52 / Chapter B. --- Estimation of biochemical changes / Chapter 1. --- Result of cytochemical changes --- p.53 / Chapter 2. --- Result of labelled uptake study --- p.54 / Chapter 3. --- Result of Ramam spectroscopy study --- p.54 / Chapter C. --- Result on preferential growth of sprouts into the spinal cord or peripheral nerve --- p.55 / Chapter D. --- Result of target specificity study --- p.55 / Chapter E. --- Changes in the walking ability --- p.56 / Chapter CHAPTER V. --- Conclusion and discussion / Chapter A. --- Evaluation of the sprouting --- p.77 / Chapter B. --- Estimation on the source of sprouting --- p.79 / Chapter C. --- Evaluation of promoting effect of peripheral nerve --- p.79 / Chapter D. --- Evaluation of target specificity of sprouting --- p.80 / Chapter E. --- Analysis of functional activity of sprouting --- p.80 / Chapter F. --- Factors influencing sprouting --- p.81 / REFERENCES --- p.87 / ACKNOWLEDGEMENT --- p.95

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.