bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraventricular fat from a ruptured sacral dermoid cyst: clinical, radiographic, and pathological correlation
Authors: Scearce Tim A. , Shaw Cheng-Mei , Bronstein Andrew D. , Swanson Phillip D.
Published: May 2009

✓ The authors report a unique case of a dermoid cyst that ruptured into the lumbosacral subarachnoid space following trauma, resulting in dissemination of cyst contents into the ventricles and cerebrospinal subarachnoid spaces. An intraspinous source should be considered when intraventricular fat is identified without a clear intracranial source.
Compression of the C-2 root by a rare anomalous ectatic vertebral artery
Authors: Sharma Rewati Raman , Parekh Harshad C. , Prabhu Sujit , Gurusinghe Nihal T. , Bertolis George
Published: May 2009

✓ The authors report a symptomatic congenitally anomalous ectatic vertebral artery not passing through the transverse foramen of the atlas (C-1), but instead piercing the dura mater below the posterior arch of the C-1 in the atlantoaxial (C1–2) interlaminar space. This occurrence is exceptionally rare, but in this case it was uniquely associated with occipital neuralgia due to vascular compression of the C-2 root. Microvascular decompression was curative. Neuroradiological and surgical findings are presented and their implications discussed.
The mandibular swing-transcervical approach to the skull base: anatomical study
Authors: Ammirati Mario , Ma Jianya , Cheatham Melvin L. , Mei Zhong Tao , Bloch Joseph , Becker Donald P.
Published: May 2009

✓ This report describes in a stepwise fashion the surgical anatomy of an approach to the midline and lateral compartments of the skull base (clivus, infralabyrinthine/infratemporal regions). The salient features of this procedure are represented by a mandibulotomy and by detachment of the pharynx from the skull base through a combined oral and cervical approach. There is full neurovascular control of the internal carotid artery and lower cranial nerves with the possibility of complete exposure of the intrapetrous and intracavernous segments of the internal carotid artery on the side of the exposure. This approach, which may be regarded as an expansion of the original work of Krespi, should be considered when dealing aggressively with extensive skull-base lesions invading the midline and lateral compartments of the skull base.
Decompressive lumbar laminectomy for spinal stenosis
Authors: Silvers H. Roy , Lewis P. Jeffrey , Asch Harold L.
Published: May 2009

✓ A total of 258 consecutive decompressive lumbar laminectomies performed on 244 individuals presenting with spinal stenosis were analyzed retrospectively. Spinal fusion was avoided in all but two patients. Outcome in terms of pain relief and return to normal activity was evaluated in two stages, one derived from patient charts and having a relatively short-term follow-up time (mean 8.4 months) and a second derived from patient responses to a questionnaire (which also scored for satisfaction with the results of surgery), which had a longer follow-up time (mean 4.7 years). More than 20 clinical and operative parameters were analyzed. Overall, a high degree of success (93% pain relief, 95% return to normal activity) was achieved in the short term, which was supported by the longer-term follow-up data (64% pain relief, 56% activity return, 75% satisfaction). The following factors were not significantly correlated with outcome: patient age; sex; worker's compensation or no-fault insurance status; employed versus not employed; a history of back surgery prior to the laminectomy studied; existence of degenerative spondylolisthesis or scoliosis; complete versus incomplete myelographic block; or the level of the lumbar spine undergoing surgery.

The major conclusions arising from these data are: 1) for all age groups through at least the eighth decade of life, decompressive lumbar laminectomy is a relatively safe operation having a high medium-to-long-term success rate; 2) lumbar instability following laminectomy is rare, even in individuals presenting prior to surgery with degenerative instability conditions; and 3) lumbar fusion in addition to the decompressive laminectomy procedure is rarely required for degenerative spinal stenosis.
Repair of facial nerve after removal of cerebellopontine angle tumors: a comparative study
Authors: King T. T. , Sparrow O. C. , Arias J. M. , O'Connor A. F.
Published: May 2009

✓ The results of repair of 18 facial nerves were examined by means of a modified House-Brackmann grading system. Six were repaired by end-to-end anastomosis and 12 by nerve graft. The reliability of the simplified House-Brackmann grading system was also assessed, using the kappa statistic to analyze the agreement between pairs of observers who examined the function of 40 nerves in 37 patients. Facial nerves studied had been either preserved, repaired or grafted, or divided and treated by faciohypoglossal nerve anastomosis. One nerve was not treated.

The grading system proved to be somewhat unreliable, with complete agreement between observers in only 25% of cases. Facial nerve repair produced a fair return of function in just under two-thirds of the cases. The ability of an examiner ignorant of the patient's history to assess from the end result how the nerve had been managed was also estimated. Observers showed little ability to decide correctly on the previous treatment of the nerve when the patient showed moderate dysfunction postoperatively. The implications of these findings for grading systems and for management of the facial nerve in acoustic nerve tumor surgery are discussed.
Preservation of hearing in surgery for acoustic neuromas
Authors: Glasscock Michael E. , Hays James W. , Minor Lloyd B. , Haynes David S. , Carrasco Vincent N.
Published: May 2009

✓Preservation of hearing was attempted in 161 cases of histologically confirmed acoustic neuroma removed by the senior author between January 1, 1970, and September 30, 1991. There were 136 patients with unilateral tumors: 22 patients had bilateral tumors (neurofibromatosis 2) and underwent a total of 25 procedures. Hearing was initially preserved in 35% of patients with unilateral tumors and in 44% of those with bilateral tumors. Results are reported in terms of pre- and postoperative pure tone average and speech discrimination scores.

Surgical access to the tumor was obtained via middle cranial fossa and suboccipital approaches. The latter has been used more often over the past 5 years because of a lower associated incidence of transient facial paresis. Persistent postoperative headaches have been the most common complication following the suboccipital approach.

The results of preoperative brain-stem auditory evoked response (BAER) studies were useful in predicting the outcome of hearing preservation attempts. Patients with intact BAER waveform morphology and normal or delayed latencies had a higher probability of hearing preservation in comparison to those with abnormal preoperative BAER morphology.
Epileptogenic effect of antibiotic drugs
Authors: Grøndahl Tor Ø. , Langmoen Iver A.
Published: May 2009

✓ The epileptogenicity of antibiotic drugs represents a clinical problem, and it is well known that the use of penicillin and certain other preparations can induce seizures. In the present study, the authors investigated the epileptogenic properties of different concentrations of 12 commonly used antibiotic medications belonging to seven separate groups. The drugs were tested in the hippocampus, which has a low threshold for the development of epileptiform activity. The hippocampal slice technique, using rat tissue, was employed since absence of the blood-brain barrier allows administration of the drugs in known concentrations. The preparation was exposed to antibiotics in known concentrations and the amplitude and number of population spikes were recorded. Penicillin G was used as a reference substance. Cloxacillin (≥ 1 gm/liter), cephalothin (≥ 1 gm/liter), gentamicin (≥ 80 mg/liter), chloramphenicol (≥ 1 gm/liter), ciprofloxacin (≥ 50 mg/liter), erythromycin (≥ 1 gm/liter), and ampicillin (≥ 1 gm/liter) showed moderate to marked epileptogenic effects, whereas cefuroxime, clindamycin, cefotaxime, vancomycin, and tobramycin had no epileptogenic effects.
Near-infrared spectroscopic localization of intracranial hematomas
Authors: Gopinath Shankar P. , Robertson Claudia S. , Grossman Robert G. , Chance Britton
Published: May 2009

✓ Near-infrared spectroscopy (NIRS) of the cerebral hemispheres, applied transcranially through the intact scalp and skull, was evaluated for its ability to detect the presence of an intracranial hematoma in 46 head-injured patients. In 40 patients intracranial hematomas (22 subdural, 10 epidural, eight intracerebral) were identified on computerized tomography (CT); in all 40 cases, NIRS demonstrated greater absorption of light at 760 nm on the side of the hematoma. The mean difference in optical density (OD) between the hemisphere with the hematoma and the normal hemisphere was 0.99 ± 0.30 for epidural hematomas, 0.87 ± 0.31 for subdural hematomas, but only 0.41 ± 0.11 for intracerebral hematomas. In 36 patients, the asymmetry in OD resolved after surgical evacuation of the hematoma or with spontaneous resorption of the hematoma. Four patients who developed postoperative or delayed hematomas exhibited persistence of the asymmetry in OD. Six patients had only diffuse injuries and exhibited only minor differences in OD between the hemispheres, similar to 10 patients in the control group with no head injury. It appears that NIRS is useful in the initial examination of the head-injured patient, as an adjunct to CT, and in following patients postoperatively in the intensive care unit.
Attenuation of potassium cyanide-mediated neuronal cell death by adenosine
Authors: Sturm Christopher D. , Frisella William A. , Yoon Kong-Woo
Published: May 2009

✓ Glutamate has been shown to play an important role in delayed neuronal cell death occurring due to ischemia. Attenuation of synaptically released glutamate can be accomplished by modulators such as adenosine and baclofen. This study focused on the ability of adenosine to attenuate the excitotoxicity secondary to glutamate receptor activationin vitroafter exposure to potassium cyanide (KCN) in hippocampal neuronal cell cultures.

For this study, hippocampal cell cultures were obtained from 1-day-old rats and trypan blue staining was used for assessment of cell viability. It was found that the N-methyl-D-aspartate-specific antagonist MK801 (10µM) attenuated neuronal cell death resulting from exposure to 1 mM KCN for 60 minutes. Adenosine (10 to 1000µM) decreased neuronal cell death secondary to the same concentration of KCN in a dose-dependent manner. This same neuroprotective effect is mimicked by the adenosine A1-specific receptor agonist N6-cyclopentyladenosine (10µM). The A1-specific receptor antagonist 8-cyclopentyl-1,3-dimethylxanthine (10 to 1000 nM) blocked the neuroprotective effect of adenosine in a dose-dependent manner. Therefore, neuronal cell death produced by KCN in the experimental model described was mediated at least in part by glutamate. This neuronal cell death was attenuated by adenosine via the A1-specific mechanism.
Posterior subscapular approach to the brachial plexus
Authors: Dubuisson Annie S. , Kline David G. , Weinshel Steven S.
Published: May 2009

✓ A 15-year operative experience with 105 posterior subscapular approaches to the brachial plexus in 102 patients is presented. The procedure is indicated in carefully selected cases, especially where the proximal portions of lower spinal nerves are involved. Its main advantage is proximal exposure of the plexus spinal nerves, particularly at an intraforaminal level. The indications in this series were thoracic outlet syndrome (TOS) in 51 carefully selected procedures, brachial plexus tumor involving proximal roots in 22 patients, post-irradiation brachial plexopathy in 14 cases, and proximal traumatic brachial plexus palsy in 18 patients. Thoracic outlet syndrome associated with neurological loss, recurrent TOS after a prior operation, or proximal brachial plexus surgical lesions involving the spinal nerve(s), especially at an intraforaminal level, can be approached advantageously by such a posterior subscapular approach. The technique should also be considered when prior operation, trauma, or irradiation to the neck or anterior chest wall make a posterior exploration of the plexus easier than an anterior one. Anterior exposure of the plexus is the preferable approach for the majority of lesions needing an operation, but the posterior subscapular procedure can be useful in well-selected cases.
Magnetic resonance imaging documentation of coexistent traumatic locked facets of the cervical spine and disc herniation
Authors: Doran Stephen E. , Papadopoulos Stephen M. , Ducker Thomas B. , Lillehei Kevin O.
Published: May 2009

✓ The coexistence of traumatic locked facets of the cervical spine and a herniated disc is not well described. The authors present a series of patients with traumatic locked facets who demonstrated a high incidence of associated disc herniation documented on magnetic resonance (MR) imaging. Thirteen patients with either unilateral (four cases) or bilateral (nine cases) locked facets of the cervical spine were analyzed retrospectively. Immediate closed reduction using traction and/or manipulation was attempted in the first nine cases treated and was successful in only three; however, the procedure was abandoned in three cases due to deterioration in the patient's clinical status. In the subsequent four patients, an MR image was obtained prior to attempts at closed reduction. All patients underwent MR imaging of the cervical spine. Of eight consecutive cases treated at the University of Michigan, frank disc herniation with fragmented disc in the canal was found in five while pathological disc bulging was found in the other three. All five cases contributed by other institutions had concurrent disc herniation.

This series illustrates the importance of using MR imaging to document the presence of a herniated disc during the initial evaluation of a patient with traumatic locked facets of the cervical spine and prior to attempted reduction of the locked facets. Experience indicates that closed reduction of facet dislocation associated with disc rupture may result in increased spinal cord compression and neurological deficit. If a herniated disc is discovered. anterior discectomy and fusion would be favored as the initial therapy over attempts at closed reduction or operative posterior reduction.
A clinical study of the relationship of timing to outcome of surgery for ruptured cerebral aneurysms
Authors: Miyaoka Makoto , Sato Kiyoshi , Ishii Shozo
Published: May 2009

✓ Between 1980 and 1987, 1622 patients with angiographically verified ruptured cerebral aneurysms were admitted within 7 days after subarachnoid hemorrhage. A retrospective analysis evaluated both the timing of surgery in operative patients and the status of nonsurgical patients. The patients' clinical grade according to the Hunt and Hess classification was assessed at admission, and a comparative analysis of outcome was carried out for each grade in relation to time of surgery: those operated on from Day 0 to 3 and those undergoing surgery on Day 4 or later.

Among nonsurgical cases, fatal rebleeding occurred in 105 cases and fatal vasospasm in 69 cases. These nonsurgical cases were divided into one of two groups, either an early- or a late-management group, and the outcome of each group was analyzed by clinical grade. The mortality rates in the early-surgery groups were higher than in the late-surgery groups, especially in Grade V, in which the rate was significantly different. However, with the 174 nonsurgical patients included in these management results, marked differences in mortality rates disappeared except in Grade V, which failed to show statistical significance. A higher rate of good recovery among Grade III patients receiving early surgery shifted significantly in the early-management group.

The results suggest that the timing of surgery in clinical Grade I or II patients is not a major factor; however, early surgery appears to be beneficial in Grade III and IV patients. The incidence of rebleeding in the early-and late-management groups was 2.7% and 9.5%, respectively.
A comparison of the protective effect of dexamethasone to other potential prophylactic agents in a neonatal rat model of cerebral hypoxia-ischemia
Authors: Chumas Paul D. , Del Bigio Marc R. , Drake James M. , Tuor Ursula I.
Published: May 2009

✓ It has recently been reported that pretreatment with a single dose of dexamethasone (0.1 mg/kg) 24 hours before hypoxia in 7-day-old rat pups is protective against an hypoxic-ischemic insult (unilateral carotid artery occlusion followed by 3 hours of hypoxia in 8% O2). The authors now examine whether pretreatment 6 hours before insult is equally effective and compare other agents potentially suitable for prophylaxis in neonatal hypoxia-ischemia, including the calcium antagonists flunarizine (30 mg/kg pretreatment), nimodipine (0.5 mg/kg pretreatment), and the 21-aminosteroid U-74389F (10 mg/kg pre- and posttreatment). For each active agent, there was also a vehicle-treated control group.

Comparison of the mean area of ipsilateral infarction on brain coronal sections showed that there was no statistically significant difference between the various control groups (mean area of infarction 66% ± 4%). Pretreatment with dexamethasone 6 hours prior to hypoxia offered complete protection with no infarction. A beneficial effect was seen following pretreatment with flunarizine (mean area of infarction 33.6% ± 7.8%), although this degree of damage was still significantly different from that seen with dexamethasone pretreatment. Pretreatment with nimodipine or U-74389F offered no protection (mean area of infarction 77.5% ± 4% and 59% ± 10%, respectively). Unlike findings in adult animals and clinical studies, the current studies show that dexamethasone may have a role in the treatment of neonatal hypoxia-ischemia and deserves reappraisal.
Traumatic brain injury, hemorrhagic shock, and fluid resuscitation: effects on intracranial pressure and brain compliance
Authors: Hariri Robert J. , Firlick Andrew D. , Shepard Scott R. , Cohen Douglas S. , Barie Philip S. , Emery John M. , Ghajar Jamshid B. G.
Published: May 2009

✓ Intracranial hypertension following traumatic brain injury is associated with considerable morbidity and mortality. Hemorrhagic hypovolemia commonly coexists with head injury in this population of patients. Therapy directed at correcting hypovolemic shock includes vigorous volume expansion with crystalloid solutions. It is hypothesized that, following traumatic brain injury, cerebrovascular dysfunction results in rapid loss of brain compliance, resulting in increased sensitivity to cerebrovascular venous pressure. Increased central venous pressure (CVP) occurring with vigorous crystalloid resuscitation may therefore contribute to the loss of brain compliance and the development of intracranial hypertension.

The authors tested this hypothesis in miniature swine subjected to traumatic brain injury, hemorrhage, and resuscitation. Elevated CVP following resuscitation from hemorrhage to a high CVP significantly worsened intracranial hypertension in animals with concurrent traumatic brain injury, as compared to animals subjected to traumatic brain injury alone (mean ± standard error of the mean: 33.0 ± 2.0 vs. 20.0 ± 2.0 mm Hg, p < 0.05) or to animals subjected to the combination of traumatic brain injury, hemorrhage, and resuscitation to a low CVP (33.0 ± 2.0 vs. 24.0 ± 2.0 mm Hg, p < 0.05). These data support the hypothesis that reduction in brain compliance can occur secondary to elevation of CVP following resuscitation from hemorrhagic shock. This may worsen intracranial hypertension in patients with traumatic brain injury and hemorrhagic shock.
Historical Vignette
Authors: Rish Berkley L.
Published: May 2009

✓ The Vanderbilt University Hospital heritage was influenced by the excellence of the Johns Hopkins era — by Osier, Halsted, Cushing, Brooks, and many others. Upon this strong origin, the neurosurgery department was built by Cobb Pilcher and perpetuated by William F. Meacham.
Experimental chronic compressive cervical myelopathy
Authors: Al-Mefty Ossama , Harkey H. Louis , Marawi Isam , Haines Duane E. , Peeler Dudley F. , Wilner Harvey I. , Smith Robert R. , Holaday Howard R. , Haining Joseph L. , Russell William F. , Harrison Brent , Middleton Troy H.
Published: May 2009

✓ A canine model simulating both cervical spondylosis and its results in delayed progressive myelopathy is presented. This model allowed control of compression, an ongoing assessment of neurological deficits, and evaluation using diagnostic images, frequent electrophysiological tests, local blood flow measurements, and postmortem histological examinations. Subclinical cervical cord compression was achieved in 14 dogs by placing a Teflon washer posteriorly and a Teflon screw anteriorly, producing an average of 29% stenosis of the spinal canal. Four dogs undergoing sham operations were designated as controls. Twelve of the animals undergoing compression developed delayed and progressive clinical signs of myelopathy, with a mean latent period to onset of myelopathy of 7 months.

Spinal cord blood flow studies using the hydrogen clearance method showed a significant transient increase in blood flow immediately after compression and a decrease before sacrifice. Somatosensory evoked potential studies indicated progressive deterioration during the period of compression. Magnetic resonance images revealed intramedullary changes. Histological studies showed abnormalities overwhelmingly within the gray matter, including changes in vascular morphology, loss of large motor neurons, necrosis, and cavitation. Axonal degeneration and obvious demyelination were rarely seen. The most profound morphological changes occurred at the site of greatest compression. It is proposed that a momentary arrest of microcirculation occurs during extension of the neck because of loss of the reserve space in the compromised spinal canal. This microcirculatory disturbance is predominant in the watershed area of the cord and mainly affects the highly vulnerable anterior horn cells, leading to neuronal death, necrosis, and eventual cavitation at the junction of the dorsal and anterior horns. Additional supportive evidence of this hypothesis was derived from the literature.
Cytotoxicity and antitumor effects of growth factor-toxin fusion proteins on human glioblastoma multiforme cells
Authors: Kunwar Sandeep , Pai Lee H. , Pastan Ira
Published: May 2009

✓ The prognosis of glioblastoma multiforme remains poor despite advances in treatment by surgery, irradiation, and chemotherapy. Many malignant gliomas overexpress growth factor receptors. The possibility of targeting these receptors with selective cytotoxic molecules constructed by fusing deoxyribonucleic acid (DNA)-encoding mutant forms of Pseudomonas exotoxin A (PE) with complementary DNA-encoding growth factors was investigated. Several recombinant toxins have been produced, including those in which transforming growth factor (TGF)-α, insulin-like growth factor (IGF)-I and acidic fibroblast growth factor (FGF) were fused to mutant forms of PE lacking the native cell-binding domain. These recombinant proteins are cytotoxic to cells that express specific cell-surface receptors. The cytotoxic activity of TGF-α, IGF-I, and acidic FGF chimeric toxins was tested in vitro against human glioblastoma cell lines. Each recombinant toxin exhibited potent and specific killing of cells. The TGF-α-PE40 construct was cytotoxic to seven of the eight cell lines and was active at concentrations as low as 0.5 ng/ml (1.1 × 10−11 M). The acidic FGF-PE40 toxin was also active on seven of the eight cell lines but was 50-fold less active than the TGF-α-PE40. The IGF-I-PE40 construct was active on only two cell lines. To determine the possible therapeutic effect in animals, TGF-α-PE40 was administered to nude mice bearing subcutaneous human glioblastoma xenografts. The animals were treated for 7 days via a continuous infusion pump placed in the peritoneal cavity. A constant serum level of TGF-α-PE40 was achieved that was nontoxic to the mice yet caused a reduction in tumor volume and retarded growth beyond the treatment period. The overexpression of the epidermal growth factor receptor in glioblastomas multiforme and the potency and specificity of the TGF-α-PE40 construct designed to target this receptor suggests that TGF-α-PE40 has the potential to be an effective antitumor agent for the adjuvant therapy of these carcinomas.
Corpus callosotomy: a quantitative study of the extent of resection, seizure control, and neuropsychological outcome
Authors: Mamelak Adam N. , Barbaro Nicholas M. , Walker John A. , Laxer Kenneth D.
Published: May 2009

✓ Corpus callosotomy is valuable for controlling medically intractable generalized seizures in appropriate patients, but postoperative development of language disorders, neuropsychological impairment, and motor dysfunction have all been noted. The extent of callosum resection has been implicated as a possible determinant of outcome, but this hypothesis has not been formally tested. Analysis of the records of all patients who underwent corpus callosotomy at the University of California, San Francisco, from 1986 to 1991 showed that, of 15 patients who underwent anterior or complete callosotomy, seven were entirely or nearly seizure-free, four had at least a 50% reduction in seizure frequency, and four had no change.

To determine callosal size and extent of callosotomy, preoperative and postoperative magnetic resonance images were measured with computer-based planimetry. Seizure outcome was not significantly associated with preoperative callosal size or extent of callosotomy. Intelligence quotient scores did not change significantly after callosotomy. No severe neuropsychological deficits developed after anterior or complete callosotomy, even in patients with mixed cerebral dominance or bilateral language representation. These results indicate that division of the anterior one-half to two-thirds of the corpus callosum is nearly as effective as more extensive anterior sectioning or complete callosotomy in reducing drop-attack and generalized tonic-clonic seizures in appropriate patients, and that the extent of callosotomy is not an important factor on outcome when at least 50% to 65% of the callosum is divided. Mixed cerebral dominance and other unusual patterns of language and memory organization do not appear to increase the postoperative risk for neuropsychological deficits, regardless of the extent of anterior section.
Documented reversal of global ischemia immediately after removal of an acute subdural hematoma
Authors: Schröder Marc L. , Muizelaar J. Paul , Kuta A. John
Published: May 2009

✓ The authors report two cases of severe head injury with acute subdural hematoma, in which cerebral blood flow (CBF) and cerebral blood volume (CBV) measurements were obtained prior to evacuation of the subdural hematoma and again immediately after removal. The first patient, a 21-year-old man with a motor response localizing to pain, had a global CBF of 18.2 ml/100 gm/min and a decreased global CBV of 3.7 ml/100 gm at 2.3 hours after injury. Immediately after removal of the subdural hematoma (8.1 hours after injury), CBF and CBV measurements revealed increases to 35.5 ml/100 gm/min and 5.8 ml/100 gm, respectively. The second patient, a 49-year-old woman with a normal flexor motor response to pain, had preoperative global values of 15.8 ml/100 gm/min for CBF and 2.0 ml/100 gm for CBV at 3 hours after injury. Postoperatively (9.3 hours after injury), the CBF and CBV values increased to 41.6 ml/100 gm/min and 4.0 ml/100 gm, respectively. The first patient, with only borderline ischemia and removal of the subdural hematoma within 3 hours, made a good recovery, while the second patient, with prolonged lower levels of CBF, remained in a persistent vegetative state. The low values of preoperative CBV argue for compression of the microcirculation as the cause of ischemia.
Wrap-clipping with a Dacron mesh Silastic sheet
Authors: Fujitsu Kazuhiko , Ishiwata Yuusuke , Gondo Gakuji , Fujii Satoshi , Feng Deng Dong
Published: May 2009

✓ A technique combining wrapping and clipping using a Silastic sheet coated with Dacron mesh is described for treatment of fusiform or broad-based cerebral aneurysms. This sheet is easily tailored to wrapping the aneurysm base while avoiding involvement of the cranial nerves or branching vessels. The sheet is semitransparent so that the caliber of the newly constructed parent artery is easily adjusted during wrap-clipping. After the aneurysm and the parent artery have been circumferentially wrapped with the sheet, aneurysm clips are applied on the sheet so that the base of the aneurysm is clipped between the two leaves of the sheet. This wrap-clipping technique avoids the risks involved in extracting the aneurysm from the parent artery. The Dacron mesh coating the outer surface and sufficient clip closing pressure are both helpful in preventing the clip blades from sliding. Similar previously reported techniques are reviewed and discussed in detail.
Louise Eisenhardt, M.D.: First editor of the Journal of Neurosurgery (1944–1965)
Authors: Davey Lycurgus M.
Published: May 2009

✓ This is a literary portrait of Louise Eisenhardt, M.D., associate of Harvey Cushing, scholar, investigator, editor, teacher, and curator of the Brain Tumor Registry at Yale. She was a Charter Member of the Harvey Cushing Society which she served as President, long-term Secretary-Treasurer, and Historian. She achieved many “firsts” for women in medicine. A figure in the Homeric tradition of observing accurately and reporting honestly, Dr. Eisenhardt set high standards for both colleagues and students as well as for aspiring medical authors. She left a tradition worthy of emulation.
Deoxyamphimedine, a Pyridoacridine Alkaloid, Damages DNA via the Production of Reactive Oxygen Species
Authors: Marshall Kathryn  M. , Andjelic Cynthia  D. , Tasdemir Deniz , Concepción Gisela  P. , Ireland Chris  M. , Barrows Louis  R.
Published: May 2009

Marine pyridoacridines are a class of aromatic chemicals that share an 11H-pyrido[4,3,2-mn]acridine skeleton. Pyridoacridine alkaloids display diverse biological activities including cytotoxicity, fungicidal and bactericidal properties, production of reactive oxygen species (ROS) and topoisomerase inhibition. These activities are often dependent on slight modifications to the pyridoacridine skeleton. Here we demonstrate that while structurally similar to neoamphimedine and amphimedine, the biological activity of deoxyamphimedine differs greatly. Deoxyamphimedine damages DNA in vitro independent of topoisomerase enzymes through the generation of reactive oxygen species. Its activity was decreased in low oxygen, with the removal of a reducing agent and in the presence of anti-oxidants. Deoxyamphimedine also showed enhanced toxicity in cells sensitive to single or double strand DNA breaks, consistent with the in vitro activity.
Efficacy of Essential Oils from Edible Plants as Insecticides Against the House Fly, Musca Domestica L.
Authors: Palacios Sara  M. , Bertoni Alberto , Rossi Yanina , Santander Rocío , Urzúa Alejandro
Published: May 2009

The compositions of 12 essential oils (EOs) obtained by hydrodistillation of edible fruits and herbs were analyzed by gas chromatography/mass spectroscopy (GC/MS). The insecticidal activity of each oil against the house fly Musca domestica was evaluated by placing flies in a glass jar with a screw cap that held a piece of EO-treated cotton yarn. The dose necessary to kill 50% of flies (LC50) in 30 min was determined at 26 ± 1°C. Twelve EOs and 17 individual terpenes were assayed against M. domestica, showing LC50 values ranging from 3.9 to 85.2 and from 3.3 to >100 mg/dm3, respectively. EO from Citrus sinensis was the most potent insecticide (LC50 = 3.9 mg/dm3), followed by EOs from C. aurantium (LC50 = 4.8 mg/dm3) and Eucalyptus cinerea (LC50 = 5.5 mg/dm3). According to GC/MS analysis, limonene (92.47%), linalool (1.43%), and b-myrcene (0.88%) were the principal components of C. sinensis EO. Limonene was also the principal constituent (94.07%) of C. aurantium, while 1,8-cineole (56.86%) was the major constituent of E. cinerea EO. 1,8-Cineole was most active against M. domestica (LC50 = 3.3 mg/dm3), while (4R)(+)-limonene, was moderately active (LC50 = 6.2 mg/dm3). Dimethyl 2,2-dichlorovinyl phosphate (DDVP) selected as a positive control, showed an LC50 of 0.5 mg/dm3. EOs from C. sinensis, C. aurantium, and E. cinerea show promise as natural insecticides against houseflies.
Corrections: “Synthesis of Sulfonamides and Evaluation of Their Histone Deacetylase (HDAC) Activity” by Jung et al., Molecules 2007, 12, 1125-1135
Authors: McPhee Derek J.
Published: May 2009

At the request of the authors of this paper [1], we wish to announce the following corrections: [...]
Synthesis of novel photochromic pyrans via palladium-mediated reactions
Authors: Böttcher Christoph , Zeyat Gehad , Ahmed Saleh A , Irran Elisabeth , Cordes Thorben , Elsner Cord , Zinth Wolfgang , Rueck-Braun Karola
Published: May 2009

Photochromic pyrans for applications in material and life sciences were synthesized via palladium-mediated cyanation, carbonylation and Sonogashira cross-coupling starting from bromo-substituted naphthopyran 1 and benzopyrans 2a/b. A novel photoswitchable benzopyran-based ω-amino acid 6 for Fmoc-based solid-phase peptide synthesis is presented. The photochromic behaviour of the 3-cyano-substituted benzopyran 5a was investigated by time-resolved absorption spectroscopy in the picosecond time domain.
Survey of Pharmacist Activities and Attitudes in Diabetes Management
Authors: Simpson Scot H. , Haggarty Susan , Johnson Jeffrey A. , Schindel Theresa J. , Tsuyuki Ross T. , Lewanczuk Richard
Published: May 2009

Background:

With the epidemic of diabetes in our population, pharmacists must become more actively involved in the management of this chronic illness. This study was designed to examine the relationship between diabetes-specific training and pharmacists' activities in and attitudes toward diabetes management.

Methods:

This was a cross-sectional survey of licensed pharmacists in Alberta. Respondents were grouped according to diabetes-specific training: Certified Diabetes Educator, completion of one or more diabetes-specific continuing education courses or no diabetes-specific training. A list of 67 activities related to diabetes management was generated through a review of the literature describing activities related to pharmacist involvement in diabetes management, national guideline recommendations, indicators for best practice and discussions with pharmacists specializing in diabetes management. Survey respondents were asked how frequently they provided each of these activities. Attitudes were measured using the Diabetes Attitude Scale.

Results:

Certified Diabetes Educators reported conducting significantly more activities related to diabetes management, especially in the areas of patient education in self-monitoring of blood glucose, hypoglycemia management, sick-day management, diabetes drug therapy and management of comorbid diseases. Pharmacists who had completed diabetes-specific continuing education courses and pharmacists with no diabetes-specific training reported similar levels of activities. There was a significant and graded relationship between attitudes and diabetes-specific training.

Conclusion:

Pharmacists with more advanced, experiential-based training and national certification consistently reported providing more activities related to diabetes practice and generally held more positive attitudes toward the disease and its management, compared to other pharmacists.
Resource Pharmacist at Kinburn Pharmasave
Authors: Beresford Susan
Published: May 2009

Objective:

To provide and measure the effects of having a resource pharmacist committed to the front store for his or her work shift. Clients could use this service to access individualized, timely, professionally provided information to guide them in their health choices.

Methods:

A resource pharmacist was scheduled to be located in the front of the store for his or her whole shift. An immediate record of interventions was kept in a pocket notebook, with more in-depth recording done later on a standardized form. Clients were greeted by the pharmacist and counted, with a goal of showcasing pharmacists' accessibility. Clients who required counselling were counted separately and categorized. Our highest number day had 82 clients greeted and 32 counselled — a total of 114 clients; our lowest had 15 greeted and 10 counselled — a total of 25 clients. Promotion, signage and mailout were done to increase awareness of the new service. The key message promoted was of the benefits of a one-on-one consult with the resource pharmacist on the client's health concerns and counselling for over-the-counter medication.

Results:

This has proven to be a successful professional service that can be easily implemented into any community pharmacy. Professional satisfaction with the process was high. The dispensing pharmacist could focus on prescriptions, while the resource pharmacist was able to provide a patient-centred and individualized service. The clients had ready access to information that clarified their choices; gave them immediate, individualized health information; and sometimes ended with a referral to other health care providers. An example of some of the health issues addressed were cancer, suicide, depression and various chronic illnesses. The resource pharmacist was able to provide a service that will increase the efficiency of the health care system by empowering clients to take charge of their health and making professionally advised decisions.
OPERATIONAL VARIABLE JOB SCHEDULING WITH ELIGIBILITY CONSTRAINTS: A RANDOMIZED CONSTRAINT‐GRAPH‐BASED APPROACH
Authors: Eliiyi Deniz Türsel , Korkmaz Aslıhan Gizem , Çiçek Abdullah Ercüment
Published: May 2009

In this study, we consider the problem of Operational Variable Job Scheduling, also referred to as parallel machine scheduling with time windows. The problem is a more general version of the Fixed Job Scheduling problem, involving a time window for each job larger than its processing time. The objective is to find the optimal subset of the jobs that can be processed. An interesting application area lies in Optimal Berth Allocation, which involves the assignment of vessels arriving at the port to appropriate berths within their time windows, while maximizing the total profit from the served vessels. Eligibility constraints are also taken into consideration. We develop an integer programming model for the problem. We show that the problem is NP‐hard, and develop a constraint‐graph‐based construction algorithm for generating near‐optimal solutions. We use genetic algorithm and other improvement algorithms to enhance the solution. Computational experimentation reveals that our algorithm generates very high quality solutions in very small computation times.

Santrauka

Nagrinėjama nepastovių darbų planavimo problema, susijusi su mašinų darbo planavimu laiko tarpais. Ši problema yra bendresnė fiksuotų darbų planavimo problemos versija, kai laiko tarpai ilgesni už darbų trukmę. Siekiama rasti optimalų atliekamų darbų poaibį. Geras pavyzdys yra optimali laivų priežiūra prieplaukoje, kai laivai prisišvartuoja laiko tarpais, taip maksimizuodami iš laivų gaunamą pelną. Taip pat įvertinami tinkamumo ribojimai. Problemai spręsti sukurtas sveikųjų skaičių programavimo modelis. Sukurtas apribojimų ir kreivių pavidalo algoritmas, gebantis generuoti apytikslius sprendinius. Jiems patikslinti naudojamas genetinis algoritmas ir kiti korekciniai algoritmai. Kompiuteriniai eksperimentai atskleidė, kad sukurtieji algoritmai generuoja labai tikslius sprendinius per labai trumpą laiko tarpą.
FORMATION OF ECONOMIC BUBBLES: CAUSES AND POSSIBLE PREVENTIONS
Authors: Girdzijauskas Stasys , Štreimikienė Dalia , Čepinskis Jonas , Moskaliova Vera , Jurkonytė Edita , Mackevičius Ramūnas
Published: May 2009

The article deals with economic bubbles and analyses causes, means of prevention and results of economic bubbles. The exact cause of economic bubbles has been analyzed by many economists. The article discusses with different theories explaining the causes of bubbles formation and presents the possibilities to apply Logistic function for prediction of bubbles enabling to take preventive measures against bubbles creation. Some economists think that bubbles are related to inflation and therefore believe that the factors causing inflation could also be the same factors that cause bubbles to occur. Other economists think that there is a basic fundamental value to every asset and the bubbles represent an increase or rise over that fundamental value. There are also chaotic theories regarding the formation of bubbles. These theories argue that bubbles come from certain critical states on the market that originate from the communication of economic players. The aim of the article is to present a new theory explaining formation of economic bubbles based on Logistic growth models encountering the limited (financial, natural, physical, human etc.) capital resources. Santrauka Nagrinėjami ekonominiai burbulai bei supažindinama su jų susidarymo priežastimis, galimais jų prognozavimo metodais ir išvengimo galimybėmis. Juos analizuoja daugelis ekonomistų, tačiau nėra vieningo sutarimo dėl šių burbulų susidarymo priežasčių. Straipsnyje aptariamos įvairios jų susidarymo teorijos. Ekonominiai burbulai susidaro akcijų, nekilnojamojo turto, žaliavų ir kitose rinkose. Straipsnio tikslas – supažindinti su nauja logistinio augimo teorija ir pritaikyti logistinius modelius ekonominių burbulų analizei bei prognozei, todėl straipsnyje tie burbulai analizuojami pritaikant logistinio augimo koncepciją. Siekiama parodyti, kaip jie susidaro išsenkant augimo ištekliams ir priartėjus prie prisotinimo fazės, po kurios prasideda staigus nuosmukis. Taigi remiantis logistinio augimo dėsniais, detaliai išnagrinėtais straipsnyje, galima prognozuoti ekonominių burbulų susidarymą, o kartu ir valdyti šį procesą.
GLOBAL OPTIMIZATION USING THE BRANCH‐AND‐BOUND ALGORITHM WITH A COMBINATION OF LIPSCHITZ BOUNDS OVER SIMPLICES
Authors: Paulavičius Remigijus , Žilinskas Julius
Published: May 2009

Many problems in economy may be formulated as global optimization problems. Most numerically promising methods for solution of multivariate unconstrained Lipschitz optimization problems of dimension greater than 2 use rectangular or simplicial branch‐and‐bound techniques with computationally cheap, but rather crude lower bounds. The proposed branch‐and‐bound algorithm with simplicial partitions for global optimization uses a combination of 2 types of Lipschitz bounds. One is an improved Lipschitz bound with the first norm. The other is a combination of simple bounds with different norms. The efficiency of the proposed global optimization algorithm is evaluated experimentally and compared with the results of other well‐known algorithms. The proposed algorithm often outperforms the comparable branch‐and‐bound algorithms. Santrauka Daug įvairių ekonomikos uždavinių yra formuluojami kaip globaliojo optimizavimo uždaviniai. Didžioji dalis Lipšico globaliojo optimizavimo metodų, tinkamų spręsti didesnės dimensijos, t. y. n > 2, uždavinius, naudoja stačiakampį arba simpleksinį šakų ir rėžių metodus bei paprastesnius rėžius. Šiame darbe pasiūlytas simpleksinis šakų ir rėžių algoritmas, naudojantis dviejų tipų viršutinių rėžių junginį. Pirmasis yra pagerintas rėžis su pirmąja norma, kitas – trijų paprastesnių rėžių su skirtingomis normomis junginys. Gautieji eksperimentiniai pasiūlyto algoritmo rezultatai yra palyginti su kitų gerai žinomų Lipšico optimizavimo algoritmų rezultatais.
CHOOSING THE RISK CURVE TYPE
Authors: Vlasenko Olga , Kozlov Sergey
Published: May 2009

Dialectics of categories of risk and return are becoming increasingly important in business process. The knowledge of risk indices allows to shape the judgement and make a decision. The provided risk‐management method lets to make more reasonable and adequate managing decisions. The paper provides the substantiation of necessity of the enterprise risk level integral estimation. A calculation method for determining the probability curve of enterprise financial losses level has been worked out. Examples of risk curve use are given. Methodology of plotting the curve of possible loss probability or at least determination of regions and indices for acceptable, critical and catastrophic risk is seen as quite an efficient tool of management decision‐making by an organization.

Santrauka

Rizikos ir grąžos kategorijų dialektika tampa vis svarbesnė versle. Informacija apie rizikos rodiklius
leidžia įvertinti ir priimti sprendimą. Siūlomas rizikos valdymo metodas leidžia priimti protingesnius ir tinkamesnius sprendimus. Straipsnyje aprašoma, kaip atlikti įmonės rizikos lygmens integralinį vertinimą. Sukurtas metodas, kuriuo galima nustatyti įmonės finansinių nuostolių lygmens tikimybės kreivę. Pateikti rizikos kreivės naudojimo pavyzdžiai. Metodologija, leidžianti grafiškai pavaizduoti galimų nuostolių tikimybės kreivę ar bent jau nustatyti priimtinos, kritinės ir katastrofiškos rizikos sritis ir rodiklius, yra gana efektyvus įrankis priimant efektyvius sprendimus organizacijoje.
ROBUSTNESS OF THE MULTI‐OBJECTIVE MOORA METHOD WITH A TEST FOR THE FACILITIES SECTOR
Authors: Brauers Willem K. , Zavadskas Edmundas K.
Published: May 2009

The definition of robustness in econometrics, the error term in a linear equation, was not only broadened, but in addition moved to the meaning of common language: from a cardinal to a qualitative one. These interpretations were tested by an application on the Facilities Sector in Lithuania. The application is multi‐objective: like costs, experience and effectiveness at the side of the contractors; quality, duration of the work and cost price at the side of the owners. These objectives having all different units the dimensionless ratios of the MOORA method avoids the difficulties of normalization. In a first part of MOORA these ratios were aggregated and in a second one they were used as distances to a reference point. The results of both parts control each other, a test on robustness. Additionally, MOORA shows a robust domination on all other methods of multi‐objective optimization. For the Facilities Sector in Lithuania, both parts of MOORA resulted in a comparable ranking. In this way a double check was made on the robustness of the results. Santrauka Patikimumo apibrėžimas ekonometrikoje, kaip neteisingas terminas tiesinėje lygtyje, buvo ne tik papildytas, bet ir išreikštas įprasta kalba: nuo kiekybinio prie kokybinio. Šios interpretacijos buvo patikrintos taikant jas Lietuvos paslaugų sektoriuje. Taikymas yra daugiatikslis: iš rangovo pusės kaip išlaidos, patirtis, efektyvumas; kokybė, darbo trukmė, kaina iš užsakovo pusės. Minėtieji tikslai turi skirtingus matavimo vienetus. O jų santykiniai dydžiai neturi mato vienetų, todėl taikant MOORA metodą yra išvengiama sunkumų juos normalizuojant. Pirmoje MOORA metodo taikymo dalyje šie santykiai yra sujungiami, o antroje dalyje ieškoma atstumo iki geriausio sprendinio. Abiejų metodo dalių rezultatai pagrindžia sprendinio teisingumą. Tai rodo aiškų MOORA metodo pranašumą, palyginti su kitais daugiatikslio optimizavimo metodais. Taikant abi MOORA metodo dalis Lietuvos paslaugų sektoriui buvo sudarytas lyginamasis rangavimas, buvo atliktas dvigubas rezultatų patikimumo patikrinimas.