bluuebunny/crossref_metadata_2025 huggingface dataset:
Rutting Resistance of Asphalt Concrete Mixtures that Contain Recycled Asphalt Pavement
Authors: Apeagyei Alex K. , Diefenderfer Brian K. , Diefenderfer Stacey D.
Published: November 2011

This study evaluated the rutting resistance of plant-produced asphalt concrete (AC) mixtures in the laboratory. Nineteen plant-produced AC mixtures were used; these mixtures contained reclaimed asphalt pavement (RAP) amounts that ranged from 0% to 25%. Tests on the mixtures included the dynamic modulus (|E*|) test at multiple temperatures and the flow number (FN) test at 54°C to characterize stiffness and rutting resistance, respectively. Mixtures that contained no RAP showed |E*| values comparable to those that contained 25% RAP in most cases. For most of the 19 mixtures tested, mixtures with lower FNs either contained no RAP, contained 25% RAP, or had PG 64-22 as the design binder grade. Mixtures that contained moderate amounts of RAP (10% and 15%), regardless of design binder grade, had higher FNs than mixtures with either high or low RAP amounts. Statistical analysis showed that the RAP amount was the most significant factor to affect rutting resistance in the mixtures studied. A linear inverse relationship between RAP and FN appeared to describe the data well. As the RAP amount increased, a downward trend occurred in both effective binder content (Pbe) and rutting parameter (G*/sin δ). The effect of RAP on FN was unexpected, because it showed the rutting resistance to decrease with increased RAP. Possible reasons might have been the use of softer asphalt binder in mixtures with higher RAP and the observed decrease in both Pbe and G*/sin δ with increased RAP amounts. More rutting-related mechanistic studies are needed of AC mixtures that contain RAP.
Fatigue Evaluation of Warm-Mix Asphalt Mixtures
Authors: Haggag Mohamed Monir , Mogawer Walaa S. , Bonaquist Ramon
Published: November 2011

Warm-mix asphalt (WMA) is the generic term used to refer to a group of technologies that are used to produce asphalt pavement mixtures at temperatures lower than those of traditional hot-mix asphalt (HMA). One of the potential benefits of WMA is that it provides better fatigue cracking characteristics than does HMA. The lower temperatures should reduce the aging of asphalt binders that occur during production. The reduced aging of asphalt binders should lead to improved fatigue characteristics of asphalt mixtures. The research reported here addressed two main objectives. The first was to study the impacts of three WMA technologies on the fatigue cracking resistance of HMA by using one asphalt binder and two aggregate sources. The fatigue characteristics were measured by using a uniaxial, cyclic, direct tension compression test. The second objective was to analyze the data produced by the test by using the simplified viscoelastic continuum damage approach proposed in the NCHRP 9–43 Phase I report. Three WMA technologies were used: Advera, Evotherm 3G, and Sasobit. All mixtures were produced by using a PG 64-22 virgin binder. Data showed no significant difference between HMA mixtures and WMA mixtures for each mix except for the Advera.
Effect of Mineral Filler Characteristics on Asphalt Mastic and Mixture Rutting Potential
Authors: Wang Hao , Al-Qadi Imad L. , Faheem Ahmed F. , Bahia Hussain U. , Yang Shih-Hsien , Reinke Gerald H.
Published: November 2011

This study, part of the NCHRP 9–45 Project, analyzed the effect of mineral filler properties on asphalt mastic and the rutting potential of asphaltic mixture. The mineral filler properties were characterized by four tests: Rigden voids (RV), fineness modulus (FM), calcium oxide (CaO) content, and methylene blue value. The rheological properties of asphalt binder and mastic were characterized with the use of apparent viscosity and multiple stress creep recovery tests. Dynamic modulus and flow number tests were conducted to examine the asphaltic mixture rutting potential. The tested mixtures included several variables: four asphalt binder types, including virgin and polymer modified; two aggregate gradations; and a selected group of fillers. The study concluded that asphalt mastic performance was significantly affected by the fractional voids in the filler and possibly by the CaO content and FM. This effect, however, depended on binder type. On the one hand, the styrene–butadiene–styrene modified binder showed the strongest effect as a result of the mineral filler inclusion when tested as mastic. On the other hand, RV and CaO content showed relatively greater correlation with the mixture rutting potential, as compared with other filler properties. Addition of RV improved the prediction models for dynamic modulus and flow number. The effect of RV on the mixture rutting potential was more pronounced for the coarse mixture than for the fine mixture.
Low-Temperature Fracture Characteristics of Selected Warm-Mix Asphalt Concretes
Authors: Yoo Min-Yong , Jeong Seung-Ho , Park Ji-Yong , Kim Nam-Ho , Kim Kwang-Woo
Published: November 2011

Warm-mix asphalt (WMA) technology is developed by lowering the binder melting point, which may cause WMA to be weak against rutting at high service temperatures. Much research has been done on the high-temperature characteristics of WMA mixtures, but the low-temperature fracture behavior that leads to cracking has not been well evaluated. Because WMA is produced at lower temperatures with a lower aggregate heating, the behavior at the interface where the binder is coating aggregate is in question at low temperatures. In this study, 13-mm, dense-grade WMA mixtures were produced by using WMA binders. Beam specimens were prepared for fracture toughness (KIC) evaluation at −20°C by a three-point bending test. The results and analyses revealed that the KIC values of WMA mixtures at −20°C were similar to or better than those of HMA mixtures, even though they were produced at temperatures 30°C or 40°C lower than HMA mixtures.
Estimating the Effect of Recycled Asphalt Pavements and Asphalt Shingles on Fresh Binder, Low-Temperature Properties without Extraction and Recovery
Authors: Swiertz Daniel , Mahmoud Enad , Bahia Hussain U.
Published: November 2011

The use of recycled asphalt pavements (RAP) and recycled asphalt shingles (RAS) as components of new asphalt mixes is expected to reduce construction costs, protect the environment, and conserve dwindling natural resources. However, the use of high percentages of RAP and RAS requires mix adjustments to accommodate the stiffer binder, which in turn requires quantification of the effect of the RAP and RAS binder on the fresh binder used in the mixture. Current methods for such estimates are performed on the basis of either chemical extraction and recovery of the binder or backcalculation from gyratory compacted samples. The former is not desirable because of the unknown effects of the chemical solvents on the binder, and the latter requires extensive laboratory work and resources. This paper modifies the analysis procedure for estimating the low-temperature properties of RAP binder by means of testing mortars and binders in the recently developed bending beam rheometer. The modified testing procedure was verified by testing artificial RAP materials, and found capable of estimating low-temperature grade of aged binder within 1°C of the known grade. Furthermore, the application of the procedure to RAS allowed for the introduction of the basis for the development of RAP and RAS blending charts to estimate the final grade of blended binder in mixtures. The feasibility of extending the procedure to study the effect of RAP and RAS on binder fracture properties is also presented in this paper.
Full-Scale Structural Evaluation of Fatigue Characteristics in High Reclaimed Asphalt Pavement and Warm-Mix Asphalt
Authors: Timm David H. , Willis J. Richard , Kvasnak Andrea
Published: November 2011

Warm-mix asphalt (WMA) and the inclusion of higher percentages of reclaimed asphalt pavement (RAP) are two strategies for developing environmentally friendly pavement structures that can also reduce pavement cost. Although demonstration projects have evaluated the constructability and short-term performance of these technologies in the field, questions remain about the structural characterization and longer-term field performance. As part of the 2009 National Center for Asphalt Technology test track, four sections were constructed; they included both WMA and high-RAP contents (50% RAP). A control section did not include either technology. Every section featured embedded instrumentation that facilitated strain versus temperature characterization under truck loading. Statistical comparisons of measured strain response were conducted at three reference temperatures. At the lowest temperature (50°F), the measured strain in the control section was not statistically different from the strains of the experimental sections. At the intermediate temperature (68°F), strains in the RAP with WMA section were statistically lower than the control, but the other sections were not distinguished from the control. At the highest temperature (110°F), the strain in the control section was statistically higher than all other sections. The WMA sections were next highest, and the RAP sections were the lowest. The base mixtures of each section underwent beam fatigue testing from which fatigue transfer functions were developed. Strains entered into their section-specific transfer functions showed that the RAP–WMA section would perform the best. Continued testing and monitoring of the sections are necessary to validate this finding.
Novel Moisture-Conditioning Method for Adhesive Failure of Hot- and Warm-Mix Asphalt Binders
Authors: Wasiuddin Nazimuddin M. , Saltibus Nibert E. , Mohammad Louay N.
Published: November 2011

A novel moisture-conditioning procedure consists mainly of heating an asphalt-coated substrate at 64°C inside an oven in a submerged condition. The proposed conditioning procedure can produce purely adhesive failure in most cases. On the basis of the adhesive failure achieved, a new mechanism on moisture damage has been proposed: under a submerged condition at pavement service temperatures, water develops randomly distributed, micro- and macroscale, cylindrical holes within a reasonable time period that penetrate up to the asphalt–substrate interface. Water then starts to replace the asphalt film from the substrate surface, and adhesive failure, or stripping, is observed. The first process is the dewetting of asphalt film from substrate, and the second process is the spread of moisture on substrate. With this moisture-conditioning procedure, it was observed that original PG 64-22, with 1% LOF 6500 and with 1% LOF 6500, plus Sasobit, exhibited adhesive failure, whereas PG 64-22 plus Sasobit produced a mixed mode of failure. For PG 76-22M, only original samples (without additives) exhibited adhesive failure. The adhesive strengths of the moisture-conditioned samples were determined by a modified pull-off test with the use of a pneumatic adhesion tensile testing instrument. In this study, the free energy of adhesion and cohesion was also determined with the surface free energy (SFE) method. The results of the two methods did not necessarily correlate well, except that both methods (pull-off and SFE) indicated that the combination of 2% Sasobit and 1% LOF 6500 increased the moisture susceptibility.
Low-grade gliomas in adults
Authors: Sanai Nader , Chang Susan , Berger Mitchel S.
Published: November 2011

In recent years, advances in the understanding of low-grade glioma (LGG) biology have driven new paradigms in molecular markers, diagnostic imaging, operative techniques and technologies, and adjuvant therapies. Taken together, these developments are collectively pushing the envelope toward improved quality of life and survival. In this article, the authors evaluate the recent literature to synthesize a comprehensive review of LGGs in the modern neurosurgical era.
Traumatic brain injury in pediatric patients: evidence for the effectiveness of decompressive surgery
Authors: Appelboom Geoffrey , Zoller Stephen D. , Piazza Matthew A. , Szpalski Caroline , Bruce Samuel S. , McDowell Michael M. , Vaughan Kerry A. , Zacharia Brad E. , Hickman Zachary , D'Ambrosio Anthony , Feldstein Neil A. , Anderson Richard C. E.
Published: November 2011

Traumatic brain injury (TBI) is the current leading cause of death in children over 1 year of age. Adequate management and care of pediatric patients is critical to ensure the best functional outcome in this population. In their controversial trial, Cooper et al. concluded that decompressive craniectomy following TBI did not improve clinical outcome of the analyzed adult population. While the study did not target pediatric populations, the results do raise important and timely clinical questions regarding the effectiveness of decompressive surgery in pediatric patients. There is still a paucity of evidence regarding the effectiveness of this therapy in a pediatric population, and there is an especially noticeable knowledge gap surrounding age-stratified interventions in pediatric trauma. The purposes of this review are to first explore the anatomical variations between pediatric and adult populations in the setting of TBI. Second, the authors assess how these differences between adult and pediatric populations could translate into differences in the impact of decompressive surgery following TBI.
Effective surgical treatment of cerebral cavernous malformations: a multicenter study of 79 pediatric patients
Authors: Hugelshofer Michael , Acciarri Nicola , Sure Ulrich , Georgiadis Dimitrios , Baumgartner Ralf W. , Bertalanffy Helmut , Siegel Adrian M.
Published: November 2011

Object

Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%–20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms.

Methods

The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures.

Results

Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found.

Conclusions

Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.
Treatment practices for Chiari malformation Type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons
Authors: Rocque Brandon G. , George Timothy M. , Kestle John , Iskandar Bermans J.
Published: November 2011

Object

The purpose of this study was to report the results of a survey of the American Society of Pediatric Neurosurgeons (ASPN) on treatment of Chiari malformation Type I (CM-I) with syringomyelia.

Methods

A questionnaire was circulated during the 2006 meeting of the ASPN, in which surgeons were surveyed on their management of patients with CM-I and syringomyelia. The survey consisted of questions about 4 clinical scenarios, common causes of surgical failures, and complications.

Results

There were 72 respondents, representing more than 90% of attendees at the 2006 ASPN meeting and approximately half of the society's members. The majority of respondents (85%) reported that they perform posterior fossa decompression as first-line treatment for CM-I with syringomyelia. Seven percent perform bony decompression alone, 36% open the dura, and 27% shrink the tonsils. Very few respondents indicated that they offer syrinx drainage as first-line therapy (< 3%). Although all respondents reported that they treat symptomatic CM-I/syringomyelia patients surgically, 15% of respondents indicated that they do not operate on asymptomatic patients. Finally, respondents stated that their most common complications are pseudomeningocele and chemical meningitis.

Conclusions

This survey, given to a representative group of experienced North American pediatric neurosurgeons, confirms that posterior fossa decompression is still the preferred treatment modality in children with CM-I and syringomyelia, regardless of symptoms. Although most surgeons open the dura, preferred techniques for decompression vary. In contrast to the results of past surveys, conservative follow-up is now only used by a minority of respondents and only in the asymptomatic patient, and primary syrinx drainage seems to have lost popularity. A multicenter trial of surgical outcomes has been designed based on the information from this survey.
Spontaneous intracranial hemorrhage and multiple intracranial aneurysms in a patient with Roberts/SC phocomelia syndrome
Authors: Wang Anthony C. , Gemmete Joseph J. , Keegan Catherine E. , Witt Cordelie E. , Muraszko Karin M. , Than Khoi D. , Maher Cormac O.
Published: November 2011

Roberts/SC phocomelia syndrome (RBS) is a rare but distinct genetic disorder with an autosomal recessive inheritance pattern. It has been associated with microcephaly, craniofacial malformation, cavernous hemangioma, encephalocele, and hydrocephalus. There are no previously reported cases of RBS with intracranial aneurysms. The authors report on a patient with a history of RBS who presented with a spontaneous posterior fossa hemorrhage. Multiple small intracranial aneurysms were noted on a preoperative CT angiogram. The patient underwent emergency craniotomy for evacuation of the hemorrhage. A postoperative angiogram confirmed the presence of multiple, distal small intracranial aneurysms.
Freehand placement of depth electrodes using electromagnetic frameless stereotactic guidance
Authors: Wray Carter D. , Kraemer Diana L. , Yang Tong , Poliachik Sandra L. , Ko Andrew L. , Poliakov Andrew , Hebb Adam O. , Novotny Edward J. , Ojemann Jeffrey G.
Published: November 2011

The presurgical evaluation of patients with epilepsy often requires an intracranial study in which both subdural grid electrodes and depth electrodes are needed. Performing a craniotomy for grid placement with a stereotactic frame in place can be problematic, especially in young children, leading some surgeons to consider frameless stereotaxy for such surgery. The authors report on the use of a system that uses electromagnetic impulses to track the tip of the depth electrode. Ten pediatric patients with medically refractory focal lobar epilepsy required placement of both subdural grid and intraparenchymal depth electrodes to map seizure onset. Presurgical frameless stereotaxic targeting was performed using a commercially available electromagnetic image-guided system. Freehand depth electrode placement was then performed with intraoperative guidance using an electromagnetic system that provided imaging of the tip of the electrode, something that has not been possible using visually or sonically based systems. Accuracy of placement of depth electrodes within the deep structures of interest was confirmed postoperatively using CT and CT/MR imaging fusion. Depth electrodes were appropriately placed in all patients. Electromagnetic-tracking–based stereotactic targeting improves the accuracy of freehand placement of depth electrodes in patients with medically refractory epilepsy. The ability to track the electrode tip, rather than the electrode tail, is a major feature that enhances accuracy. Additional advantages of electromagnetic frameless guidance are discussed.
Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance–guided laser-induced thermal therapy
Authors: Jethwa Pinakin R. , Lee Jason H. , Assina Rachid , Keller Irwin A. , Danish Shabbar F.
Published: November 2011

Supratentorial primitive neuroectodermal tumors (PNETs) are rare tumors that carry a poorer prognosis than those arising from the infratentorial compartment (such as medulloblastoma). The overall prognosis for these patients depends on several factors including the extent of resection, age at diagnosis, CSF dissemination, and site in the supratentorial space. The authors present the first case of a patient with a newly diagnosed supratentorial PNET in which cytoreduction was achieved with MR-guided laser-induced thermal therapy. A 10-year-old girl presented with left-sided facial weakness and a large right thalamic mass extending into the right midbrain. The diagnosis of supratentorial PNET was made after stereotactic biopsy. Therapeutic options for this lesion were limited because of the risks of postoperative neurological deficits with resection. The patient underwent MR-guided laser-induced thermal ablation of her tumor. Under real-time MR thermometry, thermal energy was delivered to the tumor at a core temperature of 90°C for a total of 960 seconds. The patient underwent follow-up MR imaging at regular intervals to evaluate the tumor response to the thermal ablation procedure. Initial postoperative scans showed an increase in the size of the lesion as well as the amount of the associated edema. Both the size of the lesion and the edema stabilized by 1 week and then decreased below preablation levels at the 3-month postsurgical follow-up. There was a slight increase in the size of the lesion and associated edema at the 6-month follow-up scan, presumably due to concomitant radiation she received as part of her postoperative care. The patient tolerated the procedure well and has had resolution of her symptoms since surgery. Further study is needed to assess the role of laser-induced thermal therapy for the treatment of intracranial tumors. As such, it is a promising tool in the neurosurgical armamentarium. Postoperative imaging has shown no evidence of definitive recurrence at the 6-month follow-up period, but longer-term follow-up is required to assess for late recurrence.
Left thorascopic sympathectomy for refractory long QT syndrome in children
Authors: Hwang Steven W. , Thomas Jonathan G. , Whitehead William E. , Curry Daniel J. , Dauser Robert C. , Kim Eugene S. , Luerssen Thomas G. , Jea Andrew
Published: November 2011

Congenital long QT syndrome (LQTS) is a rare genetic ion transmembrane disorder that has been associated with multiple various genetic mutations including life-threatening cardiac arrhythmias and sudden death. Left thorascopic sympathectomy is an effective treatment for patients who are refractory to medical therapy or who need frequent epicardial internal cardiodefibrillator intervention. Although there is substantial literature about this therapy in adults, few reports detail the outcomes in children who undergo left thorascopic sympathectomies to treat LQTS.

The authors report the successful use of a left thoracic sympathectomy for the treatment of an 11-year-old girl who had persistently symptomatic LQTS, even after implantation of an automatic cardioverter-defibrillator. The patient remained clinically stable without arrhythmias through 6 months' of follow-up.

The authors also reviewed the relevant literature and found that it suggests that 77% of patients will have immediate resolution of their symptoms/arrhythmias after the procedure. When the outcome definition was broadened to include patients who had only 1 or 2 cardiac episodes in the follow-up period, 88% of cases were considered successful. The results of this case study and literature review suggest that left thorascopic sympathectomy is a safe and effective approach for treating pediatric patients with LQTS.
Variation in the BRCA2 gene in a child with medulloblastoma and a family history of breast cancer
Authors: Bayrakli Fatih , Akgun Bekir , Soylemez Burcak , Kaplan Metin , Gurelik Mustafa
Published: November 2011

The fact that BRCA genes operate as tumor suppressors is evident from the genetics of the different human disorders caused by inherited mutations. Germline mutations affecting 1 allele of either BRCA1 or BRCA2 confer susceptibility to different types of cancers such as breast cancer and medulloblastoma. A family with a history of cancer was identified in Eastern Turkey in which one of the family members (a 13-year-old boy) had medulloblastoma. Venous blood was collected from available family members. The BRCA1 and BRCA2 genes were sequenced in the patient with medulloblastoma and the healthy father. An Asn372His homozygous variation was noted in the BRCA2 gene in the patient with medulloblastoma whereas the variation was heterozygous in the healthy father. A biallelic homozygous variation was demonstrated in the BRCA2 gene, which is important in medulloblastoma suppression, and may have caused medulloblastoma formation in the 13-year-old boy. Further investigations in large human populations with medulloblastoma are necessary for further delineation of BRCA gene malfunctions and their relationship to medulloblastoma formation, and to clarify the therapeutic implications of these malfunctions.
Lateral posterior fossa encephalocele with associated migrational disorder of the cerebellum in an infant
Authors: Hamilton Kimberly M. , Wiens Andrea L. , Fulkerson Daniel H.
Published: November 2011

Encephaloceles are acquired or congenital defects in which intracranial contents protrude through a defect in the calvaria. The embryogenesis of these lesions is incompletely understood. The vast majority of lesions occur at or near the anatomical midline. The authors present an extremely rare case of a laterally oriented, pathologically proven encephalocele associated with a posterior fossa cyst and cerebellar migrational defect in an infant. The authors review past and current theories of encephalocele formation as it relates to this case.
Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome
Authors: Durnford Andrew J. , Kirkham Fenella J. , Mathad Nijaguna , Sparrow Owen C. E.
Published: November 2011

Object

The goal of this study was to externally validate the proposed Endoscopic Third Ventriculostomy Success Score (ETVSS), which predicts successful treatment for hydrocephalus on the basis of a child's individual characteristics.

Methods

The authors retrospectively identified 181 cases of consecutive endoscopic third ventriculostomy (ETV) performed in children at a single neurosurgery center in the United Kingdom. They compared actual success at both 6 and 36 months, with mean predicted probabilities for low, moderate, and high chance of success strata based on the ETVSS. Long-term success was calculated using Kaplan-Meier methods and comparisons were made by means of unpaired t-tests.

Results

Overall, 166 primary ETVs were performed; ETV success was 72.9% at 6 and 64.5% at 36 months. At long-term follow-up, the mean predicted probability of success was significantly higher in those with a successful ETV (99 patients) than in those with a failed ETV (67 patients) (p = 0.001). The ETVSS accurately predicted outcome at 36 months; the low, medium, and high chance of success strata had mean predicted probabilities of success of 82%, 63%, and 36%, and actual success of 76%, 66%, and 42%, respectively. The overall complication rate was 6%.

Conclusions

The ETVSS closely predicted the overall long-term success rates in high-, moderate-, and low-risk groups. The results of this study suggest that the ETVSS will aid clinical decision making in predicting outcome of ETV.
Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes
Authors: Drazin Doniel , Shirzadi Ali , Jeswani Sunil , Ching Harry , Rosner Jack , Rasouli Alexandre , Kim Terrence , Pashman Robert , Johnson J. Patrick
Published: November 2011

Object

Athletes present with back pain as a common symptom. Various sports involve repetitive hyperextension of the spine along with axial loading and appear to predispose athletes to the spinal pathology spondylolysis. Many athletes with acute back pain require nonsurgical treatment methods; however, persistent recurrent back pain may indicate degenerative disc disease or spondylolysis. Young athletes have a greater incidence of spondylolysis. Surgical solutions are many, and yet there are relatively few data in the literature on both the techniques and outcomes of spondylolytic repair in athletes. In this study, the authors undertook a review of the surgical techniques and outcomes in the treatment of symptomatic spondylolysis in athletes.

Methods

A systematic review of the MEDLINE and PubMed databases was performed using the following key words to identify articles published between 1950 and 2011: “spondylolysis,” “pars fracture,” “repair,” “athlete,” and/or “sport.” Papers on both athletes and nonathletes were included in the review. Articles were read for data on methodology (retrospective vs prospective), type of treatment, number of patients, mean patient age, and mean follow-up.

Results

Eighteen articles were included in the review. Eighty-four athletes and 279 nonathletes with a mean age of 20 and 21 years, respectively, composed the population under review. Most of the fractures occurred at L-5 in both patient groups, specifically 96% and 92%, respectively. The average follow-up period was 26 months for athletes and 86 months for nonathletes. According to the modified Henderson criteria, 84% (71 of 84) of the athletes returned to their sports activities. The time intervals until their return ranged from 5 to 12 months.

Conclusions

For a young athlete with a symptomatic pars defect, any of the described techniques of repair would probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively.
Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics
Authors: Hanak Brian W. , Zada Gabriel , Nayar Vikram V. , Thiex Ruth , Du Rose , Day Arthur L. , Laws Edward R.
Published: November 2011

Object

Intrasellar aneurysms are rare lesions that often mimic pituitary tumors, potentially resulting in catastrophic outcomes if they are not appropriately recognized. The authors aimed to characterize the clinical and anatomical details of this poorly defined entity in the modern era of neuroimaging and open/endovascular neurosurgery.

Methods

A PubMed literature review was conducted to identify all studies reporting noniatrogenic aneurysms with intrasellar extension, as confirmed by CT or MR imaging and angiography. Clinical, anatomical, and treatment characteristics were analyzed.

Results

Thirty-one studies reporting 40 cases of intrasellar aneurysms were identified. Six patients (15%) presented with aneurysmal rupture. Patients with unruptured aneurysms presented with the following signs and symptoms: headache (61%), visual field cuts/decreased visual acuity (61%), endocrinopathy (57%), symptomatic hyponatremia (21%), and cranial nerve paresis (other than optic nerve) (18%). The most common endocrine abnormalities were hyperprolactinemia and hypogonadism. Eight aneurysms (20%) were diagnosed in conjunction with a pituitary adenoma. Aneurysms could be categorized into 2 primary anatomical groups as follows: 1) cavernous/clinoid segment internal carotid artery (ICA) (infradiaphragmatic) aneurysms with medial extension into the sella; and 2) suprasellar (supradiaphragmatic) aneurysms originating from the ophthalmic segment of the ICA or from the anterior communicating artery, with inferomedial extension into the sella. The mean diameters of infradiaphragmatic and supradiaphragmatic aneurysms were 14.5 and 21.8 mm, respectively. Infradiaphragmatic aneurysms were much more likely to present with endocrinopathy, whereas supradiaphragmatic ones presented more commonly with visual disturbances. Aneurysms with infradiaphragmatic growth were generally treated using either endovascular techniques or surgical trapping and bypass, while supradiaphragmatic aneurysms were more often treated by surgical clipping.

Conclusions

Aneurysms with intrasellar extension typically present due to mass effect on surrounding structures, and they can be classified as infradiaphragmatic cavernous or clinoid segment ICA aneurysms, or supradiaphragmatic ophthalmic ICA or anterior communicating artery aneurysms. Varying approaches exist for treating these complex aneurysms, and intervention strategies depend substantially on the anatomical subtype.
Cost per quality-adjusted life year gained of laminectomy and extension of instrumented fusion for adjacent-segment disease: defining the value of surgical intervention
Authors: Adogwa Owoicho , Parker Scott L. , Shau David N. , Mendenhall Stephen K. , Devin Clinton J. , Cheng Joseph S. , McGirt Matthew J.
Published: November 2011

Object

Over the past decade, there has been a dramatic increase in the number of spinal fusions performed in the US and a corresponding increase in the incidence of adjacent-segment disease (ASD). Surgical management of symptomatic ASD consists of decompression of neural elements and extension of fusion. It has been shown to have favorable long-term outcomes, but the cost-effectiveness remains unclear. In this study, the authors set out to assess the cost-effectiveness of revision surgery in the treatment of ASD over a 2-year period.

Methods

Fifty patients undergoing neural decompression and extension of fusion construct for ASD-associated back and leg pain were included in the study. Two-year total back-related medical resource utilization, missed work, and health state values (quality-adjusted life years [QALYs], calculated from the EQ-5D with US valuation) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost), and patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Mean total 2-year cost per QALY gained after revision surgery was assessed.

Results

The mean (± SD) interval between prior fusion and revision surgery for ASD was 3.07 ± 2.02 years. A mean cumulative 2-year gain of 0.76 QALYs was observed after revision surgery. The mean total 2-year cost of extension of fusion constructs was $47,846 ± $32,712 (surgery cost: $24,063 ± $300; outpatient resource utilization cost: $4175 ± $3368; indirect cost: $19,607 ± $32,187). Revision decompression and extension of fusion was associated with a mean 2-year cost per QALY gained of $62,955.

Conclusions

In the authors' practice, revision decompression and extension of fusion provided a significant gain in health state utility for patients with symptomatic ASD, with a 2-year cost per QALY gained of $62,995. When indicated, revision surgery for ASD is a valuable treatment option for patients experiencing back and leg pain secondary to ASD. The findings provide a value measure of surgery that can be compared with future cost-per-QALY-gained studies of medical management or alternative surgical approaches.
Hand surgery - let it flourish and develop in Bangladesh
Authors: Hasan Shamim
Published: November 2011

DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8793BDJPS 2010; 1(2): 1-2
Vaginal Reconstruction with Pudendal Thigh Flap- an early experience in Shaheed Sohrawardi Medical College Hospital
Authors: Kalam MA , Rahman SA
Published: November 2011

The surgical management of the absence of the vagina is a complex problem and constitutes a significant technical  challenge. The aim is to create a neovagina that is satisfactory both functionally and aestheticaly using a technique that is simple, reliable, and applicable to most patients. Earlier techniques used were skin grafts, or local skin  flaps with various degrees of success. Tissue expanders and vascularized flaps like gracilis myocutaneous flaps  were used for more extensive reconstruction. In 1989 Wee and Joseph introduced a new technique using bilateral  pudendal thigh flaps based on post labial artery; a branch of perineal artery, which itself is the continuation of  the internal pudendal artery. A 16 year old girl with congenital vaginal stenosis in whom previous two attempts of  vaginal recanalization have failed, a neovagina was created using the bilateral pudendal thigh flaps, the lining of the cavity was made by the fasciocutaneous flap with the blood supply from the posterior labial artery, a branch of perineal artery. There was no per-operative or post operative complications. Follow-up shows no significant  contractions, the reconstructed vagina is expansible and post operative stenting or dilatation was not required.  There is good sensation in the wall of the constructed vagina because sensory nerves run through the flaps. Key words: Vaginal stenosis; Neo-vagina; Pudendal Thigh Flaps. DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8798 BDJPS 2010; 1(2): 3-9
Breast Implant Surgery in Bangladesh: An Experience of 126 cases
Authors: Siddiky SA , Quader F , Rahman MH
Published: November 2011

Augmentation mammoplasty is one of the common plastic surgical operations in the western countries. The procedure  has received particular attention among patients with hypo-plastic breasts. The first silicone breast implant was  performed in 1963 by Cronin and Gerow, and at present more than 250,000 breast implants are done every year in the USA alone. Due to skepticism and ignorance this surgery took a very long time to become popular in Bangladesh. We started breast implant surgery in Bangladesh in September 2001. Since then it gradually became popular and is now a rather common procedure in our centre. In spite of our conservative culture and religious taboos, women in  Bangladesh are no longer lagging behind in deriving the benefit of this wonderful procedure.  The study was done at a private hospital from September 2001 to September 2008. A total of 126 cases were done, 125 being females and 1 male. Complications were minimal and the overall results very encouraging. The result of  the present work evidenced that silicone breast implants can boost confidence by alleviating depression in women  of different age groups with hypoplastic breasts. Research studies have further revealed that silicone implant does not impair lactation. Key words: Silicone implant; augmentation mammoplasty DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8799 BDJPS 2010; 1(2): 10-13
Microtia reconstruction: our experiences of first 10 cases in Bangladesh
Authors: Khondoker MS , Awwal R , Sarker MM , Khundkar SH
Published: November 2011

Varying degrees of congenital ear deformity (microtia) occurs 1 in about 8000 to 10,000 live births. One of the greatest challenges in plastic surgery is total auricular reconstruction as it demands precise technique as well as artistic creativity. In Bangladesh, recent advancement in the technique of carving and sculpting rib cartilage  and better training for achieving finer anatomic details has given a break through in the surgical management of  deformed ear. Between January 2009 and January 2010, total ear reconstruction was done with a two-stage method using  autogenous costal cartilage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka. In the first stage, lobule rotation, fabrication of the cartilage framework and its implantation were performed. In  the second stage, elevation of the auricle and formation of the tragus were done. A total of 10 cases with microtia comprising different age group have been operated. All of them underwent stage I operation; among them 8 patients went through stage II procedure while the other 2 are waiting for the same. Results: 10 patients, ranging in age between 8 and 25 years, were operated on using autogenous costal cartilage between 2009 and 2010. Six patients were males and four were females. Unilateral microtia was present in all of these patients (7 right, 3 left). Eight cases were with Grade III microtia; the remaining 2 cases presented with Grade II microtia. The follow-up period was one month to one year. Seven among 8 cases presented acceptable ear contour after second stage ear reconstruction. The cranioauricular angle of the reconstructed ears was also similar to that of the opposite ears. Unfavourable result was deformation of the constructed helix which occurred in one case. Though it is impossible to reconstruct an ear that appears exactly as the opposite one, the new ears which were  made were of correct size and in normal position with impressive finer three dimensional details that achieved patients satisfaction as well as surgeons professional gratification.Key words: Microtia; Two stage auricular reconstruction; Autologous costochondral cartilageBDJPS 2010; 1(2): 14-19
Management of post CABG sternal oesteomyelitis
Authors: Deb AK , Akand MU , Islam MA
Published: November 2011

Two cases of post CABG sternal wound with sternal osteomyelitis were managed in plastic surgery unit from year 2007-2008. One of them was male and other was female. Both were diabetic. The male one had multiple sinus tracts with discharge and the female one had well granulated wound with discharge. Both the cases were managed by adequate debridement of the wound with removal of some loose sternal wire and placement of a cutaneous flap over the wound. In both cases, the flaps survived well, infection was completely resolved. The scar over the chest wall was cosmetically acceptable. DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8804 BDJPS 2010; 1(2): 38-41
Society News v1i2
Authors: Editors The
Published: November 2011

DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8805 BDJPS 2010; 1(2): 45-46
COMPARATIVE EFFICACY OF STEVIA LEAF (STEVIA REBAUDIANA BERTON), METHI SEEDS (TRIGONELLA FOENUM-GRAECUM) AND GLIMEPIRIDE IN STREPTPZOTOCIN INDUCED DIABETEIC RATS
Authors: Mostofa M , Rafiq Kazi , Nishiyama Akira , Barman BC , Sherajee Shamshad J
Published: November 2011

Medicinal plants are becoming very popular for the treatment of different diseases all over the world. The present study was conducted during January 2009 to June 2009 and investigated the effects of Stevia (Stevia rebaudiana Bertoni) leaves, methi (Trigonella foenum-graecum) seeds in terms of their hypoglycemic activity compared to Glimepiride (Amaryl®, Aventies Pharmaceuticals). Diabetes was induced experimentally in the rats with Streptozotocin (STZ; 55 mg/kg, i.p.). Stevia, methi, combination of stevia-methi extracts and Amaryl® tablet were orally administered daily at the rate of 100mg/kg, 500mg/kg, 500mg/kg and 800μg/kg respectively after 15 days of STZ injection for a period of 60 days. Changes in the blood glucose levels and body weights were measured and the results were compared statistically. The combined stevia-methi extract showed potent hypoglycemic effect than stevia and methi alone. STZ-induced body weight loss was improved in all groups except stevia treatment group. DOI = 10.3329/bjvm.v8i1.8351 Bangl. J. Vet. Med. (2010). 8(1): 57-61
Effects of frequent oil treatment on the performance of native growing rams under intensive management system
Authors: Sultana N , Hossain SMJ , Hassan MR
Published: November 2011

The effects of oral administration of seven mL soybeen oil/kg live weight (LW) on the performance and carcass characteristics of native ram. In a 162 days feeding trial, 18 growing native rams (9.4 ± 1.2 kg BW and 176 ± 5.6 d of age) were randomly allocated to three treatments (T0, control, T1, monthly infusion of oil and T2, fortnightly oil infusion group) with six replicates in each. All animals were fed roughage (Ad lib urea molasses straw, UMS) and concentrate (1.5% of body weight). After feeding and digestion trial, five animals in each group were slaughtered for carcass characteristics. During the trial, growth rate was significantly (P<0.05) influenced by the treatments (T0, T1 and T2 were 69.5, 83.8 and 69.8 g/d). On average, T1 group showed 20.7% higher growth over the control and T1. The protozoa populations were reduced by 74% and 84% in T1 and T2 than that of control group. Consequently, the ammonia concentration in the rumen fluid of T1 group was significantly (P<0.05) lower (177 mg/L) than that of T2 (208.0 mg/L) and control (245.0 mg/L) group, respectively. Consequently, Feed conversion ratio (FCR) was better (8.0) belonged to T1 than that of control (8.6) and T2 (9.3). Interestingly, fat deposition was inclined significantly (P<0.05) in T2 group than that of T1 and control, which is unacceptable to the customers. Meanwhile, fortnightly oil treatment (T2) is not recommended, but further study is required with different intervals. DOI: http://dx.doi.org/10.3329/bvet.v28i1.8810   Bangl. vet. 2011. Vol. 28, No. 1, 19-30
Conducting correlation seminars in basic sciences at KIST Medical College, Nepal
Authors: Shankar P. Ravi
Published: November 2011

KIST Medical College is a new medical school in Lalitpur, Nepal. In Nepal, six basic science subjects are taught together in an integrated organ system-based manner with early clinical exposure and community medicine. Correlation seminars are conducted at the end of covering each organ system. The topics are decided by the core academic group (consisting of members from each basic science department, the Department of Community Medicine, the academic director, and the clinical and program coordinators) considering the public health importance of the condition and its ability to include learning objectives from a maximum number of subjects. The learning objectives are decided by individual departments and finalized after the meeting of the core group. There are two student coordinators for each seminar and an evaluation group evaluates each seminar and presenter. Correlation seminars help students revise the organ system covered and understand its clinical importance, promote teamwork and organization, and supports active learning. Correlation seminars should be considered as a learning modality by other medical schools.
Cromwell's Edinburgh Press and the Development of Print Culture in Scotland
Authors: Spurlock R. Scott
Published: November 2011

Alasdair Mann, the noted scholar of book culture in early modern Scotland, has suggested that a significant change had occurred in Scotland's relationship with the printed word by the late seventeenth century. This study sets out to explain how the interregnum served as a ‘watershed’ during which a consumer demand was created for popular print and how this in turn necessitated a significant increase in the production and distribution of printed material. Beginning with the sale of the press and patent of Evan Tyler to the London Stationers’ Company in 1647, the article charts the key factors that transformed Scotland's printing industry from the production of official declarations and works for foreign markets to the production of polemical texts for a Scottish audience. These developments also witnessed publication of the first serial news journal and the growth of a competitive market for up-to-date printed news. More than just an anomaly that flourished during a decade of occupation, these fundamental changes altered Scotland by introducing the large-scale consumption of chapbooks and printed ephemera, thereby initiating the nation's enduring print culture.