Inside Front and Back Covers: Poetry

“Writing Class” and “Elegy

Functional Regeneration of Supraspinal Connections in a Patient With Transected Spinal Cord Following Transplantation of Bulbar Olfactory Ensheathing Cells With Peripheral Nerve Bridging

Treatment of patients sustaining a complete spinal cord injury remains an unsolved clinical problem because of the lack of spontaneous regeneration of injured central axons. A 38-year-old man sustained traumatic transection of the thoracic spinal cord at upper vertebral level Th9. At 21 months after injury, the patient presented symptoms of a clinically complete spinal cord injury (American Spinal Injury Association class A-ASIA A). One of the patient's olfactory bulbs was removed and used to derive a culture containing olfactory ensheathing cells and olfactory nerve fibroblasts. Following resection of the glial scar, the cultured cells were transplanted into the spinal cord stumps above and below the injury and the 8-mm gap bridged by four strips of autologous sural nerve. The patient underwent an intense pre- and postoperative neurorehabilitation program. No adverse effects were seen at 19 months postoperatively, and unexpectedly, the removal of the olfactory bulb did not lead to persistent unilateral anosmia. The patient improved from ASIA A to ASIA C. There was improved trunk stability, partial recovery of the voluntary movements of the lower extremities, and an increase of the muscle mass in the left thigh, as well as partial recovery of superficial and deep sensation. There was also some indication of improved visceral sensation and improved vascular autoregulation in the left lower limb. The pattern of recovery suggests functional regeneration of both efferent and afferent long-distance fibers. Imaging confirmed that the grafts had bridged the left side of the spinal cord, where the majority of the nerve grafts were implanted, and neurophysiological examinations confirmed the restitution of the integrity of the corticospinal tracts and the voluntary character of recorded muscle contractions. To our knowledge, this is the first clinical indication of the beneficial effects of transplanted autologous bulbar cells

Poetry Review: A Wound on Stone

Review of poet Faye George\u27s A Wound on Stone

Addendum to Final Plan

p. 3

E-Government und New Public Management

Die vorliegende Arbeit beschäftigt sich mit den theoretischen und praktischen Aspekten des Verwaltungshandelns am beginnenden 21. Jh. im Spannungsverhältnis zwischen E-Government und New Public Management (NPM). Im öffentlichen Sektor soll nämlich der verstärkte Einsatz neuer Informations- und Kommunikationstechnologien (IKT) die treibende Kraft für Veränderungsprozesse werden; diese sollen das neue Verhältnis sowohl nach innen (z.B. zwischen den einzelnen Verwaltungseinheiten) als auch nach außen neu definieren. E-Government wird dabei als Werkzeug beschrieben, mit dem ein „besseres“ Regieren im Sinne einer "besseren" Verwaltung (OECD) erreicht werden soll. Eine Konsequenz der feststellbaren Neuinterpretation des öffentlichen Sektors im Sinne betriebswirtschaftlicher Reformstrategien ("Managerialismus") ist die "Gegenreform" des New Public Management (NPM) und sein Anspruch auf Umgestaltung der öffentlichen Verwaltung mittels Privatisierung, Deregulierung, Segmentierung und Auslagerung des Verwaltungshandelns. Eines der Instrumente des NPM ist der verstärkte Einsatz neuer Informations- und Kommunikationstechnologien; dieser steht im Spannungsfeld zwischen beabsichtigter Beschleunigung, Vereinfachung, Ersparnis, etc. im Verwaltungshandeln und bürokratisch organisierter Verwaltung. In den Anfängen des Technikeinsatzes in der öffentlichen Verwaltung dominierte die Binnenperspektive: Man setzte auf Vereinfachung von routinemäßig auftretenden Tätigkeiten; die Ambivalenz des (scheinbar) paradigmatischen Perspektivenwechsels bedeutet, daß sich die öffentliche Verwaltung durch den Einsatz webbasierter IuK-Technologien zwar nach außen zu "öffnen", beginnt, andererseits festigt aber die Informatisierung die bürokratischen Elemente innerhalb der staatlichen Verwaltung. Somit wirkt die Technologie herrschaftsstabilisierend – bzw. erweiternd. Darüber hinaus wurde der traditionelle weberianische Staat mit seiner traditionellen Bürokratie durch die "Ökonomisierungs"-basierte Performance-Bewegung beeinflußt und ist in ein neo-weberianisches System übergegangen (Bouckaert).The present work deals with the theoretical and practical aspects of public administration acting at the beginning of the 21st Century in the tension between E-Government and New Public Management (NPM). The increased use of new information and communication technologies (ICTs) in the public sector should be the driving force for change processes, which will redefine the new relationship - internally (eg between the various administrative units) and externally. E-Government is described as a tool with which a "better" governance in the sense of a "better" administration (OECD) should be achieved. One consequence of the ascertainable reinterpretation of the public sector in terms of business reform strategies ( "managerialism") is the "counter-reform" of the New Public Management (NPM) and its claim to transform public administration through privatization, deregulation, segmentation and removal of administrative action. One of the instruments of NPM is the increased use of new ICTs; this is the tension between the intention to accelerate, simplify, save, etc. in the governance and organized bureaucratic administration. In the early days of the use of technology inside public administration domestic perspective was dominated: Simplification of mostly routinely occurring activities; the ambivalence of the (seemingly) paradigmatic change means that the public administration "opens" to the outside through the use of web-based ICTs, but on the other hand the informatisation firms the bureaucratic elements within the state administration. Thus, the technology helps to stabilize or even enlarge the ruling conditions. Over an above that, the traditional weberian state with its traditional bureaucracy is influenced through the "economization"-based performance-movement and turned into a neo-weberian system (Bouckaert)

Oponiak zatoki strzałkowej górnej z towarzyszącymi obustronnymi przewlekłymi krwiakami podtwardówkowymi – opis przypadku i studium patofizjologiczne

Bilateral chronic subdural haemorrhage accompanying meningioma is a very rare clinical condition. We present a case of a 69-year-old female patient with large meningioma completely obliterating the posterior third part of the superior sagittal sinus with accompanying bilateral chronic subdural haematomas. Three anatomical zones of venous collateral circulation were revealed by the preoperative digital subtraction angiography. The tumour and haematomas were removed completely with no major complications. The most likely pathomechanism of the development of bilateral chronic subdural haematomas was venous hypertension caused by an occlusion of major cerebral venous trunks. As a result of a minor thrombotic incident or insignificant head injury, the distended veins of collateral circulation that were volumetrically burdened could have been damaged. Patients with large tumours occluding the superior sagittal sinus, who did not qualify for or refused surgery, should be carefully monitored clinically and neuroradiologically because of possibly increased risk of an intracranial haemorrhage.Przewlekłe krwawienie podtwardówkowe towarzyszące oponiakowi wewnątrzczaszkowemu jest stwierdzane niezwykle rzadko. W pracy zaprezentowano przypadek 69-letniej pacjentki, bez istotnej przeszłości chorobowej, u której stwierdzono olbrzymi oponiak sklepistości czaszki całkowicie zarastający światło tylnej jednej trzeciej zatoki strzałkowej górnej współistniejący z obustronnymi mnogimi przewlekłymi krwiakami podtwardówkowymi. Przedoperacyjna cyfrowa angiografia subtrakcyjna wykazała obecność trzech stref krążenia obocznego kompensującego niedrożność zatoki strzałkowej górnej. Guz oraz przewlekłe krwiaki podtwardówkowe usunięto doszczętnie, przebieg pooperacyjny był pomyślny. Jedną z opisywanych przyczyn powstawania przewlekłych krwiaków podtwardówkowych w przypadkach powolnego zamknięcia dużych żył mózgowych jest pękanie przeciążonych objętościowo naczyń krążenia obocznego. Opisywany przypadek to prawdopodobnie pierwszy dobrze udokumentowany przykład potwierdzający słuszność tej tezy. Pacjenci z guzami zamykającymi światło zatoki strzałkowej górnej, którzy nie są poddawani leczeniu operacyjnemu, powinni być monitorowani klinicznie i radiologicznie ze względu na zwiększone ryzyko krwawienia wewnątrzczaszkowego

Three-dimensional Collagen Scaffolds in Cultures of Olfactory Ensheathing Cells Used for Severed Spinal Cord Regeneration

BACKGROUND/AIM: The regeneration of a completely damaged spinal cord is still a challenge in modern medicine. A promising treatment method is autologous transplantation of olfactory ensheathing cells (OECs). This study aimed primarily to test methods of culturing OECs with the use of materials and reagents that are certified for pharmaceutical use in the production of an advanced cell therapy product intended for humans. MATERIALS AND METHODS: The culture of OECs was performed using various modifications of the surface of the culture vessels (with fibronectin and poly-D-lysine). The number of cells was assessed after immunofluorescence staining using anti-fibronectin and anti-p75 NGF receptor antibodies. The study compared, in terms of surgical manipulations, scaffolds with OECs prepared based on 3 types of collagen: Acid Solubilized Telo Collagen and Pepsin Solubilized Atelocollagen, and the popular Corning collagen. RESULTS: We have shown that when suspending OECs in collagen gel, it is much better to use acid-solubilized collagen (ASC) than pepsin-solubilized collagen (PSC) because the 3D collagen scaffold from ASC provides much easier handling of the product during a surgical procedure. We also found that the OEC cultures should be grown on the surface modified with fibronectin. Furthermore, we have also shown that the optimal concentration of fetal bovine serum (FBS) for culturing these cells should be around 10%. CONCLUSION: The culture of OECs based on reagents intended for human use can be successfully carried out, obtaining sufficient OECs content in the heterogeneous cell culture to produce a functional advanced therapy medicinal product