bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative Cross Talk between NFAT1 and Stat5 Signaling in Breast Cancer
Authors: Zheng Jiamao , Fang Feng , Zeng Xianke , Medler Terry R. , Fiorillo Alyson A. , Clevenger Charles V.
Published: September 2011

The molecular mechanisms that modulate the activity of the signal transducers and activators of transcription 5 (Stat5) during the progression of breast cancer remain elusive. Here, we present evidence that the calcineurin/nuclear factor of activated T cells (NFAT) pathway negatively regulates the activation of Stat5, and vice versa in breast cancer. NFAT1 interacts with Stat5 in breast cancer cells, and their physical association is mediated by the DNA binding and transactivation domains of Stat5. Ectopically expressed NFAT1 is capable of inhibiting Stat5-dependent functions, including Stat5 transactivation, Stat5-mediated transcription of the downstream target gene expression, and binding of Stat5a to the Stat5 target promoter. By contrast, overexpression of a selective NFAT inhibitor VIVIT reversed NFAT1-mediated suppression of Stat5-dependent gene expression, whereas silencing of NFAT1 through RNA interference enhanced prolactin-induced, Stat5-mediated gene transcription, and breast cancer cell proliferation. A reciprocal inhibitory effect of Stat5 activity on NFAT1 signaling was also observed, implying these two signaling cascades antagonize each other in breast cancer. Importantly, analysis of a matched breast cancer progression tissue microarray revealed a negative correlation between levels of NFAT1 and Stat5 (pY694) during the progression of breast cancer. Taken together, these studies highlight a novel negative cross talk between the NFAT1- and Stat5-signaling cascades that may affect breast tumor formation, growth, and metastasis.
Coordinating cell behaviour during blood vessel formation
Authors: Geudens Ilse , Gerhardt Holger
Published: September 2011

The correct development of blood vessels is crucial for all aspects of tissue growth and physiology in vertebrates. The formation of an elaborate hierarchically branched network of endothelial tubes, through either angiogenesis or vasculogenesis, relies on a series of coordinated morphogenic events, but how individual endothelial cells adopt specific phenotypes and how they coordinate their behaviour during vascular patterning is unclear. Recent progress in our understanding of blood vessel formation has been driven by advanced imaging techniques and detailed analyses that have used a combination of powerful in vitro, in vivo and in silico model systems. Here, we summarise these models and discuss their advantages and disadvantages. We then review the different stages of blood vessel development, highlighting the cellular mechanisms and molecular players involved at each step and focusing on cell specification and coordination within the network.
Aurora promotes cell division during recovery from TOR-mediated cell cycle arrest by driving spindle pole body recruitment of Polo
Authors: Hálová Lenka , Petersen Janni
Published: September 2011

The coordination of cell division and growth in response to changes in nutrient supply is mediated by TOR signalling. In fission yeast, increased nutrient provision transiently delays mitotic onset without affecting growth. The result is an increase in cell size at division. We find that this block to cell division relies upon TOR and MAPK signalling and that mitotic entry during recovery from this block is regulated by the Aurora kinase Ark1. We show that Ark1 phosphorylation of polo kinase Plo1 within the linker region between the kinase domain and polo boxes drives Plo1 onto the spindle poles where it promotes mitosis. Interestingly, the use of Ark1 to phosphorylate Plo1 and promote mitotic entry is dependent on the environment.
Assessment of bruise age on dark-skinned individuals using tristimulus colorimetry
Authors: Thavarajah D , Vanezis P , Perrett D
Published: September 2011

Introduction

Studies on the ageing of bruises have been reported on Caucasians or individuals of fair ethnicity. This study focuses on bruise changes in dark-skinned individuals using tristimulus colorimetry for forensic analysis in such individuals.

Methods

Eighteen subjects of South Indian or Sri-Lankan ethnicity were recruited. Subjects were bruised using a vacuum pump and then daily colour measurements were taken of the bruise using a tristimulus colorimeter. The L* a* b* readings were recorded of a control area and of the bruise until it disappeared. Two Caucasians were used for comparison.

Results

This study showed that, using colorimetry, bruises on dark-skinned individuals can be measured and analysed even if the bruises are unclear visually. As the bruise is beneath the skin, the colour difference Δ L*, Δ a* and Δ b* were calculated. All values showed a trend, indicating that the L* a* b* measuring technique is a reliable method to analyse bruises on dark-skinned individuals. Comparisons of Asian subjects and Caucasian subjects were performed. The largest difference was seen in the b* value. Statistical analysis showed that Δ L* colour difference was the most consistent (95% CI −4.05 to −2.49) showing a significant difference between days 1–4 and 5–8.

Conclusion

Objective assessment of bruises on dark-skinned individuals using the L* a* b* method of measuring gave reproducible results. Furthermore, the study showed that the yellowing of a bruise cannot be seen or measured with a tristimulus colorimeter on dark-skinned individuals due to the pigmentation of the skin. With further studies and more subjects, the age of bruises could potentially be assessed for use in forensic analysis.
Decreased concentration of adiponectin together with a selective reduction of its high molecular weight oligomers is involved in metabolic complications of myotonic dystrophy type 1
Authors: Daniele Aurora , De Rosa Anna , De Cristofaro Mario , Monaco Maria Ludovica , Masullo Mariorosario , Porcile Carola , Capasso Mario , Tedeschi Gioacchino , Oriani Giovannangelo , Di Costanzo Alfonso
Published: September 2011

Objective

The hormone adiponectin exerts beneficial pleiotropic effects on biological and metabolic processes. Although a well-recognized insulin sensitizer, its characteristic has yet to be clearly defined. Myotonic dystrophy type 1 (DM1) is a rare genetic disorder that features muscle wasting and metabolic comorbidity, and patients have an increased risk of developing type 2 diabetes. We analyzed circulating levels of adiponectin and its oligomers to determine whether their expression correlates with metabolic alterations in DM1 patients.

Design and methods

We measured the anthropometric and biochemical features and three insulin resistance (IR) indices (homeostasis model assessment, quantitative insulin sensitivity check index, and McAuley) of 21 DM1 patients and of 82 age-, sex-, and weight-matched controls. In the blood samples of patients and controls, adiponectin levels were measured by ELISA, and its oligomers were characterized by using western blotting and gel filtration. The adiponectin gene was molecularly analyzed in patients.

Results

DM1 patients had significantly higher body mass index, waist circumference, triglycerides (TGs), glucose, tumor necrosis factor α, and IR; conversely, they had significantly lower concentrations of total serum adiponectin with a selective, pronounced decrease of its high molecular weight (HMW) oligomers. There was a strong negative correlation between adiponectin and TGs in DM1 patients.

Conclusions

Our results endorse the hypothesis that decreased expression of adiponectin together with a selective reduction of its HMW oligomers contributes to the worsening of IR and its metabolic complications in DM1 patients. These findings suggest that adiponectin and HMW oligomers may serve as biomarkers and are promising therapeutic agents for IR and its consequences in DM1.
A motivation for mapping the others’ inner world; Spontaneous mentalization and machiavellianism
Authors: Esperger Zsófia , Bereczkei Tamás
Published: September 2011

Elmeolvasó képességünk, mellyel következtetéseket tehetünk mások mentális állapotára, és ezáltal előre jelezhetjük viselkedésüket, nélkülözhetetlen szerepet tölt be mindennapjaink társas interakcióinak hatékony lebonyolításában. A felnőttkori elmeteória egyéni különbségeinek kutatásában eddig az elmeolvasás mint egyfajta kognitív képesség kapott szinte kizárólagos szerepet. Vizsgálatunkban ezt a felfogást kiegészítve egy motivációs szempontú megközelítésre helyeztük a hangsúlyt, melyet később spontán mentalizációként fogunk részletesen tárgyalni. Ez röviden azt jelenti, hogy társas kapcsolatainkban törekszünk mások gondolatainak és szándékainak a feltérképezésére, és motiváltak vagyunk arra, hogy hipotéziseket alkossunk a másik személy mentális állapotára vonatkozóan. Az elmeteória és machiavellizmus pozitív összefüggésére tett korábbi sikertelen kutatásokra reagálva feltételeztük, hogy nem annyira az elmeolvasás mint képesség, hanem a spontán mentalizáció mint egyfajta késztetés mutat összefüggést a machiavellizmussal. A spontán mentalizáció mérésére egy képi ingeranyagot hoztunk létre, és a kísérleti személyeket arra kértük, hogy írják le benyomásaikat a képen látottakról, majd a válaszokat tartalomelemző módszerrel kódoltuk. A machiavellizmus egyéni különbségeit a Mach-IV teszt segítségével mértük. Eredményeink azt mutatják, hogy lényeges egyéni különbségek találhatók a spontán mentalizáció terén, és ezek a különbségek pozitív korrelációt mutatnak a machiavellizmus pontszámaival. Ezt úgy értelmeztük, hogy aki a többieknél nagyobb késztetést, illetve motivációt mutat arra, hogy belehelyezkedjen mások gondolataiba és feltevéseket hozzon létre a másik elméjére vonatkozóan, az sikeresebb lehet a másik személy félrevezetésében és kihasználásában. A sikeres manipuláció feltétele ugyanis gyakran az, hogy a csaló gondolatban egy lépéssel mindig mások előtt járjon, és törekedjen a másik ember belső világának gyors feltérképezésére. Ez a törekvés (spontán mentalizáció) azonban nem feltétlenül függ össze magával az elmeolvasó képességgel; csak az ezt követő kutatások tisztázhatják, hogy mennyiben tekinthetők különálló mechanizmusoknak, és milyen hatást gyakorolnak egymás kialakulására.
Disparities Between Blacks and Whites in Tobacco and Lung Cancer Treatment
Authors: Park Elyse R. , Japuntich Sandra J. , Traeger Lara , Cannon Sheila , Pajolek Hannah
Published: September 2011

Racial disparities exist in lung cancer incidence, morbidity, and mortality. Smoking is responsible for the majority of lung cancers, and racial disparities also exist in smoking outcomes. Black smokers are less likely than white smokers to engage in evidence-based tobacco treatment, and black smokers are less likely than white smokers to stop smoking. Continued smoking following a lung cancer diagnosis is a potential indicator of poor lung cancer treatment outcomes, yet lung cancer patients who smoke are unlikely to receive evidence-based tobacco treatment. The risks from continued smoking after diagnosis deserve attention as a modifiable factor toward lessening racial disparities in lung cancer outcomes.
Microbial community structure of a slow sand filter schmutzdecke: a phylogenetic snapshot based on rRNA sequence analysis
Authors: Wakelin S. , Page D. , Dillon P. , Pavelic P. , Abell G. C. J. , Gregg A. L. , Brodie E. , DeSantis T. Z. , Goldfarb K. C. , Anderson G.
Published: September 2011

Slow sand filters (SSF) are widely used to treat water for potable use. The process is dependent on the activities of complex microbial communities in the biofilm (schmutzdecke) layer. In this study, we generated a comprehensive view of three-domain microbiological complexity within a model SSF. DNA was analysed using a high-density microarray (PhyloChip) and rRNA library analysis. The Eukaryotic community was dominated by Cercozoa (Ebridd-type protists); these are likely to be involved in predation of other organisms in the schmutzdecke layer, thus proving opportunity for successional development. Ciliate protozoa, green microalgae, stramenopiles, amoeboid protozoa and fungi in the Phylum Ascomycota and the deep-branching Chytridiomycota were also detected. The Archaeal community was dominated by Euryarchaeota, and most were Halobacteriales. These organisms may contribute to filter function through removal of dissolved organic carbon, a primary treatment goal of these filters. Given that the Eukaryotic and Archaeal communities were examined using clone libraries, the expected richness of taxa present is expected to be greater than detected here and dependent on sampling effort (library size). The bacterial community was rich in taxa (21 Phyla) but was not dominated by any phylogenetic group. The successful function of SSF's relies on interactions between taxa (e.g. grazing of Cercozoa protists on bacteria), and removal of dissolved organic matter from the influent. Understanding the taxa and functions in these systems will aid in monitoring and managing SSF for optimal water quality.
Reliability assessment of water distribution systems with statistical entropy and other surrogate measures
Authors: Tanyimboh Tiku T. , Tietavainen Marika T. , Saleh Saleh
Published: September 2011

There is ever increasing commercial and regulatory pressure to minimise the cost of water distribution networks even as the demand for them keeps on growing. But cost minimizing is only one of the demands placed on network design. Satisfactory networks are required to operate above a minimum level even if they experience failure of components. Reliable hydraulic performance can be achieved if sufficient redundancy is built in the network. This has given rise to various water distribution system optimization methods including genetic algorithms and other evolutionary computing methods. Evolutionary computing approaches frequently assess the suitability of enormous numbers of potential solutions for which the calculation of accurate reliability measures could be computationally prohibitive. Therefore, surrogate reliability measures are frequently used to ease the computational burden. The aim of this paper is to assess the correlation of surrogate reliability measures in relation to more accurate measures. The surrogate measures studied are statistical entropy, network resilience, resilience index and modified resilience index. The networks were simulated with the prototype software PRAAWDS that produces more realistic results for pressure-deficient water distribution systems. Statistical entropy outperformed resilience index in this study. The results also demonstrate there is a strong correlation between entropy and failure tolerance.
Adoption of Hazard Adjustments by Large and Small Organizations: Who is Doing the Talking and Who is Doing the Walking?
Authors: Sadiq Abdul‐Akeem
Published: September 2011

Environmental hazards pose a considerable and genuine threat to the survival of organizations. However, organizations can increase their likelihood of survival by adopting various hazard adjustments. Prior studies on hazard adjustments have found a positive relationship between the adoption of hazard adjustments and organization size. However, no study on hazard adjustments has grouped hazard adjustments into active and passive and studied the relationship between active and passive hazard adjustments and organization size. The author investigates whether large organizations adopt more active and passive hazard adjustments than small organizations, using data from a survey of 227 organizations in Memphis, Tennessee. The results show that large organizations adopt more active and passive hazard adjustments than small organizations and both large and small organizations engage in different types of hazard adjustments.
Early Outcomes among Those Initiating Chronic Dialysis in the United States
Authors: Chan Kevin E. , Maddux Frank W. , Tolkoff-Rubin Nina , Karumanchi S. Ananth , Thadhani Ravi , Hakim Raymond M.
Published: September 2011

Background and objectives

Approximately one million Americans initiated chronic dialysis over the past decade; the first-year mortality rate reported by the U.S. Renal Data System was 19.6% in 2007. This estimate has historically excluded the first 90 days of chronic dialysis.

Design, setting, participants, & measurements

To characterize the mortality and hospitalization risks for patients starting chronic renal replacement therapy, we followed all patients initiating dialysis in 1733 facilities throughout the United States (n = 303,289). Mortality and hospitalizations within the first 90 days were compared with outcomes after this period, and the results were analyzed. Standard time-series analyses were used to depict the weekly risk estimates for each outcome.

Results

Between 1997 and 2009, >300,000 patients initiated chronic dialysis and were followed for >35 million dialysis treatments; the highest risk for morbidity and mortality occurred in the first 2 weeks of treatment. The initial 2-week risk of death for a typical dialysis patient was 2.72-fold higher, and the risk of hospitalization was 1.95-fold higher when compared to a patient who survived the first year of chronic dialysis (week 53 after initiation). Similarly, over the first 90 days, the risk of mortality and hospitalization remained elevated. Thereafter, between days 91 and 365, these risks decreased considerably by more than half. Surviving these first weeks of dialysis was most associated with the type of vascular access. Initiating dialysis with a fistula was associated with a decreased early death risk by 61%, whereas peritoneal dialysis decreased the risk by 87%.

Conclusions

The first 2 weeks of chronic dialysis are associated with heightened mortality and hospitalization risks, which remain elevated over the ensuing 90 days.
Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial
Authors: Dunning James R. , Cleland Joshua A. , Waldrop Mark A. , Arnot Cathy , Young Ian , Turner Michael , Sigurdsson Gisli
Published: September 2011

Study Design

Randomized clinical trial.

Objective

To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain.

Background

Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain.

Methods

Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA).

Results

One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively.

Conclusion

The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain.

Level of Evidence

Therapy, level 1b. J Orthop Sports Phys Ther 2012;42(1):5–18, Epub 30 September 2011. doi:10.2519/jospt.2012.3894
Management of incidental durotomy in minimally invasive spine surgery
Authors: Ruban Dmitry , O'Toole John E.
Published: September 2011

Object

Unintended durotomy is one of the most common complications in spine surgery that may lead to serious complications if not recognized or treated properly. There are few reports on the management of durotomies incurred during minimally invasive spine surgery (MISS). The authors describe their experience in a series of consecutive MISS patients with unintended durotomies.

Methods

All patients who underwent MISS by the senior author between August 2006 and February 2011 were retrospectively reviewed, and cases with unintended durotomies were identified. A case-control study was carried out comparing patient demographics and perioperative data between patients with and without durotomy. Surgical technique, including a proposed algorithm for management of durotomies, is described.

Results

Unintended durotomy occurred in 53 (9.4%) of 563 patients. The mean age at surgery was 60.7 years (range 30–85 years). Previous surgery at the same level was performed in 5 patients (9.4%). Two patients underwent posterior cervical surgery, and 51 patients underwent posterior lumbar surgery. Decompression alone was performed in 32 patients (60.4%), and fusion was performed in 21 patients (39.6%). The mean operative time was 105 minutes in the decompression group and 310 minutes in the fusion group (p < 0.001). Estimated blood loss was 60 ml in the decompression group and 381 ml in the fusion group (p < 0.001). The hospital length of stay was 52 hours in the decompression group and 106 hours in the fusion group (p < 0.001). The mean follow-up was 310 days, and there were no cases of cutaneous CSF fistula, pseudomeningocele, or other complications referable to durotomy in either group. Risk factors identified for durotomy included previous operation at the same level (p = 0.019) and operation in the lumbar spine region (p = 0.001).

Conclusions

In the authors' consecutive series of patients undergoing MISS, an unintended durotomy was associated with fewer complications than previously reported for open spinal surgery. The authors propose a simple management algorithm that includes early mobilization and results in excellent clinical outcomes with no incidence of postoperative cutaneous CSF fistula or other complications.
Minimally invasive lateral lumbar interbody fusion and transpsoas approach–related morbidity
Authors: Moller David J. , Slimack Nicholas P. , Acosta Frank L. , Koski Tyler R. , Fessler Richard G. , Liu John C.
Published: September 2011

Object

Recently, the minimally invasive, lateral retroperitoneal, transpsoas approach to the thoracolumbar spinal column has been described by various authors. This is known as the minimally invasive lateral lumbar interbody fusion. The purpose of this study is to elucidate the approach-related morbidity associated with the minimally invasive transpsoas approach to the lumbar spine. To date, there have been only a couple of reports regarding the morbidity of the transpsoas muscle approach.

Methods

A nonrandomized, prospective study utilizing a self-reported patient questionnaire was conducted between January 2006 and June 2008 at Northwestern University. Data were collected in 53 patients with a follow-up period ranging from 6 months to 3.5 years. Only 2 patients were lost to follow-up.

Results

Thirty-six percent (19 of 53) of patients reported subjective hip flexor weakness, 25% (13 of 53) anterior thigh numbness, and 23% (12 of 53) anterior thigh pain. However, 84% of the 19 patients reported complete resolution of their subjective hip flexor weakness by 6 months, and most experienced improved strength by 8 weeks. Of those reporting anterior thigh numbness and pain, 69% and 75% improved to their baseline function by the 6-month follow-up evaluations, respectively. All patients with self-reported subjective hip flexor weakness underwent examinations during subsequent clinic visits after surgery; however, these examinations did not confirm a motor deficit less than Grade 5. Subset analysis showed that the L3–4 and L4–5 levels were most often affected.

Conclusions

The minimally invasive, transpsoas muscle approach to the lumbar spine has a number of advantages. The data show that a percentage of the patients undergoing the transpsoas approach will have temporary sensory and motor symptoms related to this approach. The majority of the symptoms are thought to be related to psoas muscle inflammation and/or stretch injury to the genitofemoral nerve due to the surgical corridor traversed during the operation. No major injuries to the lumbar plexus were encountered. It is important to educate patients prior to surgery of the possibility of these largely transient symptoms.
Complication avoidance and management in anterior lumbar interbody fusion
Authors: Than Khoi D. , Wang Anthony C. , Rahman Shayan U. , Wilson Thomas J. , Valdivia Juan M. , Park Paul , La Marca Frank
Published: September 2011

The goal of this study was to review the literature to compare strategies for avoiding and treating complications from anterior lumbar interbody fusion (ALIF), and thus provide a comprehensive aid for spine surgeons. A thorough review of databases from the US National Library of Medicine and the National Institutes of Health was conducted. The complications of ALIF addressed in this paper include pseudarthrosis and subsidence, vascular injury, retrograde ejaculation, ileus, and lymphocele (chyloretroperitoneum). Strategies identified for improving fusion rates included the use of frozen rather than freeze-dried allograft, cage instrumentation, and bone morphogenetic protein. Lower cage heights appear to reduce the risk of subsidence. The most common vascular injury is venous laceration, which occurs less frequently when using nonthreaded interbody grafts such as iliac crest autograft or femoral ring allograft. Left iliac artery thrombosis is the most common arterial injury, and its occurrence can be minimized by intermittent release of retraction intraoperatively. The risk of retrograde ejaculation is significantly higher with laparoscopic approaches, and thus should be avoided in male patients. Despite precautionary measures, complications from ALIF may occur, but treatment options do exist. Bowel obstruction can be treated conservatively with neostigmine or with decompression. In cases of postoperative lymphocele, resolution can be attained by creating a peritoneal window. By recognizing ways to minimize complications, the spine surgeon can safely use ALIF procedures.
Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions
Authors: Drazin Doniel , Shirzadi Ali , Rosner Jack , Eboli Paula , Safee Michael , Baron Eli M. , Liu John C. , Acosta Frank L.
Published: September 2011

Object

The elderly population (age > 60 years) is the fastest-growing age group in the US. Spinal deformity is a major problem affecting the elderly and, therefore, the demand for surgery for spinal deformity is becoming increasingly prevalent in elderly patients. Much of the literature on surgery for adult deformity focuses on patients who are younger than 60 years, and therefore there is limited information about the complications and outcomes of surgery in the elderly population.

In this study, the authors undertook a review of the literature on spinal deformity surgery in patients older than 60 years. The authors discuss their analysis with a focus on outcomes, complications, discrepancies between individual studies, and strategies for complication avoidance.

Methods

A systematic review of the MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: “adult scoliosis surgery” and “adult spine deformity surgery.” Exclusion criteria included patient age younger than 60 years. Data on major Oswestry Disability Index (ODI) scores, visual analog scale (VAS) scores, patient-reported outcomes, and complications were recorded.

Results

Twenty-two articles were obtained and are included in this review. The mean age was 74.2 years, and the mean follow-up period was 3 years. The mean preoperative ODI was 48.6, and the mean postoperative reduction in ODI was 24.1. The mean preoperative VAS score was 7.7 with a mean postoperative decrease of 5.2. There were 311 reported complications for 815 patients (38%) and 5 deaths for 659 patients (< 1%).

Conclusions

Elderly patient outcomes were inconsistent in the published studies. Overall, most elderly patients obtained favorable outcomes with low operative mortality following surgery for adult spinal deformity.
Complications associated with the treatment for spinal ependymomas
Authors: Nagasawa Daniel T. , Smith Zachary A. , Cremer Nicole , Fong Christina , Lu Daniel C. , Yang Isaac
Published: September 2011

Spinal cord ependymomas are rare neoplasms, comprising approximately 5% of all CNS tumors and 15% of all spinal cord tumors. Although surgery was once reserved for diagnosis alone, the evolution of surgical practices has elevated resection to the treatment of choice for these lesions. While technological advances continue to improve the capacity for gross-total resections and thus decrease the risk of recurrence, ependymoma spinal surgery still contains a variety of potential complications. The presence of neurological deficits and deterioration are not uncommonly associated with spinal cord ependymoma surgery, including sensory loss, dorsal column dysfunction, dysesthetic syndrome, and bowel and bladder dysfunction, particularly in the immediate postoperative period. Surgical treatment may also lead to wound complications and CSF leaks, with increased risk when radiotherapy has been involved. Radiation therapy may also predispose patients to radiation myelopathy and ultimately result in neurological damage. Additionally, resections of spinal ependymomas have been associated with postoperative spinal instability and deformities, particularly in the pediatric population. Despite the advances in microsurgical techniques and intraoperative cord monitoring modalities, there remain a number of serious complications related to the treatment of spinal ependymoma tumors. Identification and acknowledgment of these potential problems may assist in their prevention, early detection, and increased quality of life for patients afflicted with this disease.
Idiopathic intracranial hypertension following spinal deformity surgery in children
Authors: Kunes Justin , Thompson George H. , Manjila Sunil , Poe-Kochert Connie , Cohen Alan R.
Published: September 2011

Idiopathic intracranial hypertension (IIH) after pediatric spinal deformity surgery has not been previously reported. The authors conducted a retrospective analysis of more than 1500 pediatric spinal surgeries performed between 1992 and 2011. From their analysis, they report on 3 adolescent patients who underwent uncomplicated segmental spinal instrumentation for pediatric spinal deformity correction and subsequently developed features of IIH. The common variables in these 3 patients were adolescent age, spinal deformity, being overweight, symptom onset within 2 weeks postoperatively, significant estimated blood loss, and intraoperative use of ε–aminocaproic acid (antifibrinolytic) injection. The authors postulate that the development of IIH could be the result of venous outflow obstruction due to derangement of the epidural venous plexus during surgery. The use of ε–aminocaproic acid could potentially have the risk of causing IIH, probably mediated through hyperfibrinogenemia, although there have not been published cases in the neurosurgical, orthopedic, cardiac, or general surgical literature. Idiopathic intracranial hypertension after spinal deformity correction is a condition that should be recognized by neurosurgeons and orthopedic surgeons, because appropriate intervention with early medical therapy can lead to a satisfactory clinical outcome.
Strategies to avoid wrong-site surgery during spinal procedures
Authors: Hsu Wesley , Kretzer Ryan M. , Dorsi Michael J. , Gokaslan Ziya L.
Published: September 2011

Wrong-site surgery (WSS) is a rare occurrence that can have devastating consequences for patient care. There are several factors inherent to spine surgery that increase the risk of WSS compared with other types of surgery. Not only can a surgeon potentially operate on the wrong side of the spine or the wrong level, but there are unique issues related to spinal localization that can be challenging for even the most experienced clinicians. The following review discusses important issues that can help prevent WSS during spinal procedures.
Prenatal molecular diagnosis of a severe type of L1 syndrome (X-linked hydrocephalus)
Authors: Yamasaki Mami , Nonaka Masahiro , Suzumori Nobuhiro , Nakamura Hiroaki , Fujita Hiroshi , Namba Akira , Kamei Yoshimasa , Yamada Takahiro , Pooh Ritsuko K. , Tanemura Mitsuyo , Sudo Norihito , Nagasaka Masato , Yoshioka Ema , Shofuda Tomoko , Kanemura Yonehiro
Published: September 2011

Object

The aim of this study was to evaluate the feasibility of prenatal L1CAM gene testing for X-linked hydrocephalus (XLH).

Methods

In a nationwide study conducted in Japan between 1999 and 2009, the authors identified 51 different L1CAM gene mutations in 56 families with XLH. Of these 56 families, 9 obligate carriers requested prenatal gene mutation analysis for the fetal L1CAM gene in 14 pregnancies.

Results

In 2004, new clinical guidelines for genetic testing were established by 10 Japanese genetic medicine–related societies. These guidelines stated that the genetic testing of carriers should be done only with their consent and with genetic counseling. Therefore, because females are carriers, since 2004, L1CAM gene analysis has not been performed for female fetuses. The authors report on 7 fetal genetic analyses that were performed at the request of families carrying L1CAM mutations, involving 3 female (prior to 2004) and 4 male fetuses. Of the 7 fetuses, 3 (1 male and 2 female) carried L1CAM mutations. Of these 3, 1 pregnancy (the male fetus) was terminated; in the other cases, the pregnancies continued, and 3 female and 3 male babies without the XLH phenotype were born.

Conclusions

Prenatal L1CAM gene testing combined with genetic counseling was beneficial for families carrying L1CAM mutations.
Father of neurosurgery: Harvey Cushing's early experience with a pediatric brainstem glioma at the Johns Hopkins Hospital
Authors: Dmetrichuk Jennifer M. , Pendleton Courtney , Jallo George I. , Quiñones-Hinojosa Alfredo
Published: September 2011

Object

The early 20th century posed several challenges in the diagnosis and surgical treatment of intracranial tumors. However, this was a time in which more information was becoming more readily available based on pathological examination and surgical case reports. Such early work was crucial in shaping the current understanding of the nervous system and in developing modern treatment strategies. An early historical overview of the diagnosis and surgical interventions in pediatric patients with brainstem gliomas has not been described. Furthermore, Dr. Harvey Cushing's contributions to this field have not been reported.

Methods

Following institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the authors reviewed the Johns Hopkins Hospital surgical files dating from 1896 to 1912.

Results

The authors describe Cushing's early experience with a pediatric brainstem glioma during his time as a young attending physician at the Johns Hopkins Hospital. The case, presented in 1909, described the clinical events in a 15-year-old schoolgirl who presented with signs of a cerebellopontine lesion. A suboccipital exploration was performed by Cushing; his findings and surgical approach are described.

Conclusions

Harvey Cushing's early contributions to the field of pediatric neurosurgery, and to the operative treatment of pediatric brainstem gliomas have remained largely unknown. The case presented here represents the early work of the American “Father of Neurosurgery.”
Outcomes of Gamma Knife surgery for trigeminal neuralgia secondary to vertebrobasilar ectasia
Authors: Park Kyung-Jae , Kondziolka Douglas , Kano Hideyuki , Berkowitz Oren , Ahmed Safee Faraz , Liu Xiaomin , Niranjan Ajay , Flickinger John C. , Lunsford L. Dade
Published: September 2011

Object

Vertebrobasilar ectasia (VBE) is an unusual cause of trigeminal neuralgia (TN). The surgical options for patients with medically refractory pain include percutaneous or microsurgical rhizotomy and microvascular decompression (MVD). All such procedures can be technically challenging. This report evaluates the response to a minimally invasive procedure, Gamma Knife surgery (GKS), in patients with TN associated with severe vascular compression caused by VBE.

Methods

Twenty patients underwent GKS for medically refractory TN associated with VBE. The median patient age was 74 years (range 48–95 years). Prior surgical procedures had failed in 11 patients (55%). In 9 patients (45%), GKS was the first procedure they had undergone. The median target dose for GKS was 80 Gy (range 75–85 Gy). The median follow-up was 29 months (range 8–123 months) after GKS. The treatment outcomes were compared with 80 case-matched controls who underwent GKS for TN not associated with VBE.

Results

Intraoperative MR imaging or CT scanning revealed VBE that deformed the brainstem in 50% of patients. The trigeminal nerve was displaced in cephalad or lateral planes in 60%. In 4 patients (20%), the authors could identify only the distal cisternal component of the trigeminal nerve as it entered into the Meckel cave.

After GKS, 15 patients (75%) achieved initial pain relief that was adequate or better, with or without medication (Barrow Neurological Institute [BNI] pain scale, Grades I–IIIb). The median time until pain relief was 5 weeks (range 1 day–6 months). Twelve patients (60%) with initial pain relief reported recurrent pain between 3 and 43 months after GKS (median 12 months). Pain relief was maintained in 53% at 1 year, 38% at 2 years, and 10% at 5 years. Some degree of facial sensory dysfunction occurred in 10% of patients. Eventually, 14 (70%) of the 20 patients underwent an additional surgical procedure including repeat GKS, percutaneous procedure, or MVD at a median of 14 months (range 5–50 months) after the initial GKS. At the last follow-up, 15 patients (75%) had satisfactory pain control (BNI Grades I–IIIb), but 5 patients (25%) continued to have unsatisfactory pain control (BNI Grade IV or V). Compared with patients without VBE, patients with VBE were much less likely to have initial (p = 0.025) or lasting (p = 0.006) pain relief.

Conclusions

Pain control rates of GKS in patients with TN associated with VBE were inferior to those of patients without VBE. Multimodality surgical or medical management strategies were required in most patients with VBE.
Entropy Generation Analysis of Desalination Technologies
Authors: Mistry Karan H. , McGovern Ronan K. , Thiel Gregory P. , Summers Edward K. , Zubair Syed M. , Lienhard John H.
Published: September 2011

Increasing global demand for fresh water is driving the development and implementation of a wide variety of seawater desalination technologies. Entropy generation analysis, and specifically, Second Law efficiency, is an important tool for illustrating the influence of irreversibilities within a system on the required energy input. When defining Second Law efficiency, the useful exergy output of the system must be properly defined. For desalination systems, this is the minimum least work of separation required to extract a unit of water from a feed stream of a given salinity. In order to evaluate the Second Law efficiency, entropy generation mechanisms present in a wide range of desalination processes are analyzed. In particular, entropy generated in the run down to equilibrium of discharge streams must be considered. Physical models are applied to estimate the magnitude of entropy generation by component and individual processes. These formulations are applied to calculate the total entropy generation in several desalination systems including multiple effect distillation, multistage flash, membrane distillation, mechanical vapor compression, reverse osmosis, and humidification-dehumidification. Within each technology, the relative importance of each source of entropy generation is discussed in order to determine which should be the target of entropy generation minimization. As given here, the correct application of Second Law efficiency shows which systems operate closest to the reversible limit and helps to indicate which systems have the greatest potential for improvement.
Potential Impact of Biotechnology on Adaption of Agriculture to Climate Change: The Case of Drought Tolerant Rice Breeding in Asia
Authors: Pray Carl , Nagarajan Latha , Li Luping , Huang Jikun , Hu Ruifa , Selvaraj K.N. , Napasintuwong Ora , Babu R. Chandra
Published: September 2011

In Asia and Africa the poor tend to live in marginal environments where droughts and floods are frequent. Global warming is expected to increase the frequency of these weather-induced perturbations of crop production. Drought tolerance (DT) has been one of the most difficult traits to improve in genetic crop improvement programs worldwide. Biotechnology provides breeders with a number of new tools that may help to develop more drought tolerant varieties such as marker assisted selection (MAS), molecular breeding (MB), and transgenic plants. This paper assesses some preliminary evidence on the potential impact of biotechnology using data from surveys of the initial DT cultivars developed through one of the main programs in Asia that has been funding DT rice breeding since 1998—The Rockefeller Foundation’s Resilient Crops for Water-Limited Environments program in China, India, and Thailand. Yield increases of DT rice varieties are 5 to 10 percent better than conventional varieties or currently grown commercial varieties than it has been in years. So far we only have experiment station evidence that DT varieties yielded better than conventional or improved varieties during moderate drought years (the one drought year during our study period in South India gave inconclusive results) and in severe drought both the DT and the conventional varieties were either not planted or, if planted, did not yield. We find that the governments could help overcome some of the constraints to the spread of DT cultivars by increasing government funding of DT research programs that take advantage of new biotech techniques and new knowledge from genomics. Secondly, public scientists can make breeding lines with DT traits and molecular markers more easily available to the private seed firms so that they can incorporate DT traits into their commercial hybrids particularly for poor areas. Third, governments can subsidize private sector production of DT seed or provide more government money for state extension services to produce DT varieties.
Efficient and selective chemical transformations under flow conditions: The combination of supported catalysts and supercritical fluids
Authors: Burguete M Isabel , García-Verdugo Eduardo , Luis Santiago V
Published: September 2011

This paper reviews the current trends in the combined use of supported catalytic systems, either on solid supports or in liquid phases and supercritical fluids (scFs), to develop selective and enantioselective chemical transformations under continuous and semi-continuous flow conditions. The results presented have been selected to highlight how the combined use of those two elements can contribute to: (i) Significant improvements in productivity as a result of the enhanced diffusion of substrates and reagents through the interfaces favored by the scF phase; (ii) the long term stability of the catalytic systems, which also contributes to the improvement of the final productivity, as the use of an appropriate immobilization strategy facilitates catalyst isolation and reuse; (iii) the development of highly efficient selective or, when applicable, enantioselective chemical transformations. Although the examples reported in the literature and considered in this review are currently confined to a limited number of fields, a significant development in this area can be envisaged for the near future due to the clear advantages of these systems over the conventional ones.
Unexpectedly high levels of parasitism of wheat stem sawfly larvae in postcutting diapause chambers
Authors: Rand Tatyana A. , Waters Debra K. , Shanower Thomas G.
Published: September 2011

We examined rates of late-season parasitism of larvae of the wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), by native species of Bracon F. (Hymenoptera: Braconidae) over 8 years in Montana and North Dakota, United States of America. We found that rates of parasitism of larvae in diapause chambers reached a maximum of 46%, exceeding the previously reported maximum of 2.5% in 75% of sites and years examined. In contrast to previous work, our results demonstrate that C. cinctus larvae are suitable hosts for braconid parasitoids, even after the formation of diapause chambers, and suggest that parasitism rates may be underestimated if stems are sampled prior to harvest.
Sampling Tribolium confusum and Tribolium castaneum in mill and laboratory settings: differences between strains and species
Authors: Hawkin Karen J. , Stanbridge Dean M. , Fields Paul G.
Published: September 2011

The efficacy of pitfall traps baited with pheromone and cereal oil in capturing Tribolium confusum Jacquelin du Val and T. castaneum (Herbst) (Coleoptera: Tenebrionidae) was low (trap catch) in mill and simulated warehouse settings. In a simulated warehouse experiment, strains of Tribolium Macleay recently taken from mills were caught 24% less often in traps than were laboratory strains, and T. confusum was caught 40% less often than T. castaneum. Both species were found together in all flour samples taken from a Canadian flour mill. A comparison of the species ratio in flour samples with that found in traps revealed that T. confusum was caught less often in traps than was T. castaneum. In flour, T. castaneum burrowed more than did T. confusum, and there were differences in burrowing behaviour between the four T. castaneum strains. Mills infested with T. confusum may have higher levels of infestation than was previously thought, indicating that further research into beetle behaviour in mills is needed.
Hydrocephalus, a Rare Manifestation of Sarcoidosis
Authors: van Rooijen Johan M. , Mijnhout Gerritje S. , Aalders Tom T.A. , de Bondt R.B.J.
Published: September 2011

A 36-week-pregnant woman developed a symptomatic hydrocephalus. Chest imaging showed bihilar lymphadenopathy and histological examination of a mediastinal lymph node revealed non-caseating granulomas. After delivery, her neurologic complaints progressed. Placement of a ventriculoperitoneal drain (VPD) did not reduce the symptoms. However, steroids resulted in rapid disappearance of the hydrocephalus. Hydrocephalus is a very rare manifestation of sarcoidosis. The diagnosis relies on the ability of clinicians to recognize this disorder. This case shows how a difference in opinion of the several specialists involved can lead to a delay in diagnosis and treatment.