Disc Arthroplasty Essay Example for Free

Disc Arthroplasty Essay Degenerative disc disease have been a problem for many people as this disease brings about low back pain that seems to paralyze the working force,   the middle adulthood population (Smeltzer, 2004). Not only does it bring impaired quality of life to those who suffer from it, but Arvind Kulkarni adds large health care expenses to the list of problems brought about by this disease as seen in his article entitled Prosthetic Lumbar disc replacement for degenerative disc disease. Spinal fusion, which is the medical management for degenerative disc disease, has been criticized by several doctors in the practice due to its untoward effects in the patient’s overall recovery and lifetime improvement. Specialist in the field, Christoph Siepe, identified these unpleasant effects as accelerated adjacent system degeneration, pseudarthrosis, spinal canal stenosis, and donor site morbidity. Adjacent segment degeneration, as mentioned by Peter Ullrich in his article entitled Fusion versus Artificial Disc Arthroplasty for Lumbar Degenerative Disc Disease, stated that this is the major complication of spinal fusion and the reason why most surgeons want this procedure replaced. Adjacent segment degeneration or ASD happens when mechanical stress is transferred to the adjacent segment, also mentioned by Peter Ullrich. But research showed that this procedure can be modified to show more positive results. An anterior lumbar interbody fusion showed a low occurrence of revision surgery needed, which meant low frequency of adjacent segment degeneration, all pointed out in Mr. Ullrich’s paper.   However, to achieve this outcome, Mr. Ullrich declared that there should be an improvement in patient selection and in the procedure. The patients should be those patients having degenerative disc disease in their 5th lumbar to 1st sacral segment, because there is minimal motion at this level. By doing so, he states that fusing these segments do not change the patient’s mobility as much.   But not all are satisfied of this result. Doctors and specialists are continuously making efforts to totally changing the primary medical management for degenerative disc diseases. Studies have been conducted, and several replacement procedures were approved by the FDA. Peter Ullrich stated in his paper that the total disk replacement procedure was approved for medical use by the FDA in the year 2004 using the Charite artificial disc but for only one level of the spinal vertebrae, being the L4 – L5 or the L5 – S1. This is not the first time that a total or partial disc replacement was done. The history of this procedure was mentioned in an article in a website by Spine-Health that disc nucleus replacement was done first in 1955 by David Cleveland by injecting methyl-acrylic. Ever since then, there have two other FDA approved products aside from the Charite, the website Spine-Health states that the Prodisc was approved on August 2006 and the Kineflex lumbar on June 2005.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A total disc replacement is being described by Jose Reyna in his article, Advances in Artificial Disc Technology, as being composed of two pieces of plates made of metal that has teeth to be able to attach itself to the end plates of the vertebral bones above and below it. This means that the particular intervertebral disc that is causing pain has to be removed and replaced by an artificial disc. Several artificial discs have been developed by various manufacturers in the country and they only differ in design and composition. The Charite, as mentioned earlier, is made up of a unique sliding core with two metal alloy end plates. The Prodisc being based on spherical articulations is made up of cobalt chromium molybdenum alloy as stated in the website Spine-Health. Inventors Qi-Bin Bao and Paul Higham developed a hydrogel prosthetic nucleus made up of PVA powder and a solvent mixed together, as seen on the article, Hydrogel intervertebral disc nucleus with diminished lateral bulging. The total disc replacement procedure has its advantages and disadvantages. Even after some models being approved by the FDA, it is still being assessed thoroughly by specialists in the field. Charles Rosen and Douglas Kiester report poor results and complications in the total disc replacement procedure. As it was mentioned in their study, this procedure causes fractures, severe pain, dislocations, extrusion of the implant, facet joint degeneration, and unexplained radiculopathy. They attribute these substandard results to the fact that the center of rotation of segmented motion is erroneous. Jose Reyna Jr. also mentions several disadvantages of the procedure in his study, stating that the anterior approach to the surgery can cause injury to the aorta and the common iliac vessels, can cause retrograde ejaculation in men by injuring the superior hypogastric plexus, hemorrhage can result from the retroperitoneal approach, and infection can occur. However, he also stated some advantages, as this procedure is said to maintain range of motion in majority of the patients as a long-term outcome. There are still a lot of studies to be conducted, and patients to be experimented on. A three year study conducted by Christoph Siepe et al., entitled Clinical Results of Total Lumbar Disc Replacement With ProDisc II: Three-Year Results for Different Indications, intended to assess total disc replacement outcome in patients who actually underwent the operation. Their results showed that not all degenerative disc diseases can be treated with this medical management. The best outcome was seen in patients exhibiting degenerative disc disease condition plus soft disc herniation or nucleus pulposus prolapse. Outcome was measured against the patient’s improvement from their preoperative levels. There were inferior results from the patients who had bisegmental damages, and a higher complication rate. Also it was mentioned that the younger patients, more specifically those aged below forty exhibited better outcome than those older than forty. Technology like this is still being developed, studied and modified as we speak. What is important is that there are people out there who care and who try to make a difference, whether it is by inventing, criticizing or being the experimental person wherein these new devices will be made a reality. References Charles Rosen, Douglas Kiester, Thay Q. Lee: The Potential Biomechanical Etiology for Lumbar Disc Replacement Failures: Review of 24 Patients and the Rationale for Revision . The Internet Journal of Minimally Invasive Spinal Technology. 2007. Volume 1 Number 2. Medscape. (2002). Advance in Artificial Disc Technology. Retrieved January 22, 2008 from http://www.medscape.com/viewarticle/445057 Medscape. (2002). Clinical Results of Total Lumbar Disc Replacement With ProDisc II: Three-Year Results for Different Indications. Retrieved January 22, 2008 from http://www.medscape.com/viewarticle/542479 Neurology India. (2005). Prosthetic Lumbar disc replacement for degenerative disc disease. Retrieved January 22, 2008 from http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2005;volume=53;issue=4;spage=499;epage=505;aulast=Kulkarni Neurospine. (no indicated year). Fusion versus Artificial Disc Arthroplasty for Lumbar Degenerative Disc Disease. Retrieved January 22, 2008 from http://www.neurospinewi.com/newsletters/fusionvsartificial.html Patent Storm. (1996). Hydrogel intervertebral disc nucleus with diminished lateral bulging. Retrieved January 22, 2008 from http://www.patentstorm.us/patents/5534028-fulltext.html Smeltzer, S. and Bare, B. (2004). Medical-Surgical Nursing. Philadelphia: Lippincott Williams Wilkins. Spine-Health. (1997-2007). Lumbar artificial disc surgery for chronic back pain. Retrieved January 22, 2008 from http://www.spine-health.com/research/discupdate/artificial/artificial01.html

Frankensteins character :: Essays Papers

Frankensteins character In Mary Shelley’s Frankenstein, Victor Frankenstein caused many complications that could have been easily prevented. These problems were the result of his secrecy regarding his creation. The result was the deaths of many loved ones. Victor brought this upon himself because of his character flaws. His goal was not to destroy human life, but to put his knowledge to use in eliminating death. â€Å"I had worked hard for nearly two years, for the sole purpose of infusing life into an inanimate body. For this I had deprived myself of rest and health. I had desired it with an ardour that far exceeded moderation...†. The purpose of his experiment was to eliminate death. His reason for doing this was the mounting sentiment from his mother’s death. One of Victor’s flaws was that he couldn’t accept something that wasn’t perfect. Because the physical appearance of the creature scared him, he rejected it. Before giving the creation a chance, Victor decided that it wasn’t normal. Victor can be held responsible not only for creating the monster, but for all of the results of the monster’s actions. If Victor had communicated his problem with the people he needed to tell, the tragedies that occurred my not have happened. Unfortunately he never told his family of the creature and a few weeks later he received a letter informing him that his brother William had been murdered. When Victor arrived home, he saw his creation in the woods and was confident that the monster was the cause of the murder. The only person suspect was a girl named Justine, whom had lived in the Frankenstein house for a long while. Because of Victor’s timid nature in relation to the creature, Justine was executed for William’s death. Victor’s main problem with telling his loved ones about the creature was that the story was so unbelievable that he thought he would be considered crazy. He was a coward and didn’t take responsibility for his actions, and because of that, all of his loved ones were casualties. Victor played the tragic role of God by altering human life and transforming it. His role as the creator makes him consider himself not only a God-like figure, but a mother-figure. He feels responsible for the creature’s actions as well he should. Frankensteins character :: Essays Papers Frankensteins character In Mary Shelley’s Frankenstein, Victor Frankenstein caused many complications that could have been easily prevented. These problems were the result of his secrecy regarding his creation. The result was the deaths of many loved ones. Victor brought this upon himself because of his character flaws. His goal was not to destroy human life, but to put his knowledge to use in eliminating death. â€Å"I had worked hard for nearly two years, for the sole purpose of infusing life into an inanimate body. For this I had deprived myself of rest and health. I had desired it with an ardour that far exceeded moderation...†. The purpose of his experiment was to eliminate death. His reason for doing this was the mounting sentiment from his mother’s death. One of Victor’s flaws was that he couldn’t accept something that wasn’t perfect. Because the physical appearance of the creature scared him, he rejected it. Before giving the creation a chance, Victor decided that it wasn’t normal. Victor can be held responsible not only for creating the monster, but for all of the results of the monster’s actions. If Victor had communicated his problem with the people he needed to tell, the tragedies that occurred my not have happened. Unfortunately he never told his family of the creature and a few weeks later he received a letter informing him that his brother William had been murdered. When Victor arrived home, he saw his creation in the woods and was confident that the monster was the cause of the murder. The only person suspect was a girl named Justine, whom had lived in the Frankenstein house for a long while. Because of Victor’s timid nature in relation to the creature, Justine was executed for William’s death. Victor’s main problem with telling his loved ones about the creature was that the story was so unbelievable that he thought he would be considered crazy. He was a coward and didn’t take responsibility for his actions, and because of that, all of his loved ones were casualties. Victor played the tragic role of God by altering human life and transforming it. His role as the creator makes him consider himself not only a God-like figure, but a mother-figure. He feels responsible for the creature’s actions as well he should.

Mad Blood Stirring: Vendetta in Renaissance Italy Essay

Written by Edward Muir, this powerful microhistory analyses the events during 1511 in the town of Friuli, Italy at the time of the carnival. Muir’s thesis for his book, Mad Blood Stirring comes together in separate parts throughout his introduction. Firstly, Muir attempts to establish the importance of the Venetian rule over the province and people of Friuli and its capital city, Udine. Due to its geographical location, this part of Italy was essential to the country to protect due to risk of invasion and trading posts. Muir emphasises Friuli’s larger place in the politics of Italy, as well as an important part of the European principalities developed in the early modern period. The population of Friuli faced many obstacles in their daily life, such as the Venetian wartime taxation, oppression from local lords, the strain of a mixed group of people, as well as a broad financial decline. During this time Friuli became the birthplace of the type of feud known as the vendetta, which involved a blood feud between families or factions. Particularly in Friuli politics were divided between the two major family factions of the Savorgnan family and the Della Torre family. With all these different factors contributing to the wide scale outbreak of violence, Muir takes them all into consideration while conducting a systematic analysis of the social structure, economy, institutional and political history, and particularly the riot at the carnival of 1511. Overall, Muir sets out to answer the question of why the carnival was so explosive and what caused its events to be so cruel and revolting. Muir’s microhistory looks at many broad themes in its mission to examine the role of vendetta and factions in Italian and family politics, contributing to peasant revolt, the nature of the culture of population within the state and the incidents at the Carnival. To begin, Muir offers an anaylsis of the change in aristocratic behaviour from widespread uncontrolled violence to controlled duels subjecting only the two participants in harm. Next Muir attempts to explain the new workings in which Venice ruled its subject provinces such as Friuli. Also contributing to the peasants distress was the Italian wars involving imperial forces threatening to invade Friuli. Muir finally forms an understanding of the peasants revolts who wished to destroy the records of their debt and gain control over their own local affairs. By using historical methods such as narrative, social history and even anthropology in attempts to gain a â€Å"keener sense of how vendetta operated in Renaissance Italy, how factions dominated political life and how contemporaries understood their own violence† (p.12) Because of the important role vendettas have during the Renaissance in both city and family politics they appeared to be the most logical solution to failed political institutions. Muir uncovers underlying connections between the theme of the carnival, vendetta rituals and hunting traditions. Muir states the idea that the carnival massacre was the defining moment where the people of Friuli moved from the mentality of vendetta towards that of funnelled expression of anger in the form of duels. The wide range of sources used by Muir dates back to the Iliad and references feuds in the nineteenth and twentieth century, however he is always able to connect them to his Friuli situation. An important factor in analyzing Mad Blood Stirring is how the observers and participants retold their story in both written and oral history. By using a wide range of sources which mention the type of life the peasants and aristocrats were living, Muir is able to paint a colourful picture of the type of poverty and hard times many were experiencing. In Muir’s analysis of the Friulian social and political structures and their indifferences while in vendetta is based largely on the most recently available Italian historians as well as some primary sources. Through the use of his sources he is able to show that the Savorgnan taking on the duty of protecting the peasant population in Udine and attempting to build the relationship with Venice instead of diminishing it like their enemies. Although the author tries notably to give as much evidence as possible to bring forward connections regarding the carnival and the larger concept of the massacre, Muir fails to bring forward an example of who normally organizes carnivals and what carnivals are generally like in Udine. In order to consciously recognize this carnival as one that went horribly wrong, an comparison between two would make a far better justification as to why this carnival was so notable. In another example of Muir failing to fully justify his thesis, he states the carnival was one of the main instigators of the massacre in 1511, however his evidence to support this claim is very thin and questionable. Although Muir is excellent in his collection of sources, when it comes to simplifications he sometimes uses to broad of a source. This leaves Muir’s claim that the pattern of killing evolved out of the carnival itself appearing not completely proven. Like almost every piece of historical work, Muir’s book has room for debate, questions and more answers.

If it means that the schoolrooms will be more orderly and...

If it means that the schoolrooms will be more orderly and more disciplined, and that our young people will learn to evaluate themselves by what they are on the inside instead of what theyre wearing on the outside, then our public schools should be able to require their students to wear uniforms. Former President Clinton said this in a speech in in March of 1996. There is an immense controversy about whether a school uniform will help or hinder a student. After much deliberation and inquiry, public schools should be allowed to enforce their students to wear uniforms. The largest part of the debate is whether or not the uniform hinders a students personal expression.. Along with giving kids the chance to learn different ways to express†¦show more content†¦A uniform saves parents from having to keep buying their kid the latest trend and name brand clothing. Buying five different uniform styles is a lot cheaper than having to buy 30-40 different clothing styles and colors. Most uniforms can be easily altered or added to for the changing of the seasons, which saves time and money from not having to shop the seasons. Along with easy purchase, uniforms also help cut down bullying. Implementing uniforms gives kids a better sense of school pride, in which they care more about the school and each other. For example when Long Beach introduced uniforms in 1995 they received data that showed the in school fights decreased by 38%, suspension rates dropped by 90% and furthermore the overall crime rates dropped by 91%. School uniforms would work in the same way an athletic team uniform would; it would give them a sense of pride and belonging. Like athletic teams, when a team member or student would wear their jersey, or in this case uniform, they would cloak themselves in their school color they would feel obligated to make sure they represent the best for their school to show that they care and they are going to prove how exceptional their school is. A uniform can improve the overall school and also move beyond the school halls and out to the community. Most bullies make fun of a kid by how he or she lo oks, so by schools implementing uniforms they â€Å"level the playing fields†Show MoreRelatedSchool Uniforms Should Not Be Banned1440 Words   |  6 Pagescrimes even with uniforms (Wilkins, 1999, Pg. 20). With the uniforms, the gang members would not be able to recognize each other for six hours, but it won’t do anything about the gang violence in a wide sense (Wilkins, 1999, Pg. 20). There will be even more bullying due to the children getting used to less diversity (Wilkins, 1999, Pg. 21). Not only will the violence go down with school uniforms, but the student’s attendance will go up as well. Long Beach district had a record of ninety five percentRead MoreThe Effects Of Social Media On Education1657 Words   |  7 PagesOur educational system has changed quite drastically. It is no longer just a place where one goes to learn Arithmetic, English, and Penmanship. It has evolved into something much more complex than that. The challenges our Educators are experiencing today are far more different than the ones they faced ten years ago. Technology has introduced some valuable tools that has vastly improved the way school administrators and parents are educating their children, but this type of advancement came with someRead MoreSchool Uniforms And Public Schools1547 Words   |  7 Pagesâ€Å"If it means that the schoolrooms will be more orderly, more disciplined,† President Clinton said, â€Å"and that our young people will learn to evaluate themselves by what they are on the inside instead of what they’re wearing on the outside, then our public schools should be able to require their students to wear school uniforms.† President Clinton is referring to the outfits or sets of standardized clothes that are worn primarily for an educational institution, usually in primary and secondary schools