bluuebunny/crossref_metadata_2025 huggingface dataset:
The River Street Autism Program
Authors: Dyer Kathleen , Martino Gayle M. , Parvenski Tom
Published: October 2006

An urgent demand from Connecticut parents for behavioral intervention resulted in the development of the River Street Autism Program (RSAP). This research-to-practice program implements intervention service based on empirical research findings conducted with children diagnosed with autism and pervasive developmental disorders. RSAP is provided through a regional service center and provides services for children entering the program at 2 to 5 years old. Because of the diverse nature of the districts served by RSAP, the delivered services varied according to the needs of the districts, available funding, and family preferences. Program evaluation data were therefore examined with regard to outcomes for children who received programs with differing numbers of treatment components. Treatment components that varied across children were treatment intensity, duration, extent of family participation, staff training, and supervision. Outcome data revealed that families reported greater gains in child functioning and quality of life when children received programs with more treatment components.
Imaginative demographics: the emergence of a radio talkback audience in Australia
Authors: Tebbutt John
Published: October 2006

This article provides a genealogy of the radio talkback audience in Australia. It analyses audiences from the perspective of ‘commodity audience production’ which was first introduced by Dallas Smythe. It also draws on work about the role of affect in cultural theory. The primary material it analyses consists of articles and advertisements from the media and advertising industry journal B&T. It uses this material to discuss issues related to affect and advertising, as well as to provide examples of the conversation about a commodity audience between media and advertisers. It also provides a historical overview of the policy formation in relation to talkback audiences in Australia to make the point about the importance of an authoritative voice in talkback formats.
Parental Mattering
Authors: Marshall Sheila K. , Lambert J. David
Published: October 2006

Studies of parental identity tend to focus on historical influences or experiences with the other parent of the child and overlook the influence of children on parents. To investigate children’s influence on parental identity, this study examines individuals’ perceived mattering or significance to their school-aged children. Cross-case qualitative analysis of data from 47 parents ( n = 30 females, 17 males) reveals that mattering emerges from interactions with children and attention from children. Mattering is not viewed by participants as a global and stable trait but is identified as malleable. Parents also view their obligation and fulfillment of the role as an indication of mattering. As such, mattering helps to define the parental role, and enactment of the parental role enables parents to define themselves as significant to others.
Bourdieu, Critic of Foucault
Authors: Callewaert Staf
Published: October 2006

An attempt is made to confront Foucault and Bourdieu. First of all by answering the question: Why did Foucault never discuss Bourdieu, while Bourdieu increasingly discusses Foucault, more and more in the sense of a sharp rejection of some of Foucaults main positions? In a second move, the similarities and differences between their positions in the field and their intellectual life histories are outlined. In a third part, Bourdieu's critique of Foucault is presented extensively, up to some pages of Ein soziologischer Selbstversuch.
Autonomy, Reciprocity and Science in the Thought of Pierre Bourdieu
Authors: Fowler Bridget
Published: October 2006

This article addresses the increasingly widespread view that Bourdieu's sociological analysis is flawed by excessive determinism and thus is anti-rationalist in its socio-political implications. Against this contention, it argues that works such as Distinction should be viewed as critiques of an absolutist universalism rather than of universalism as such. Moreover, Bourdieu's logic of practice, it is claimed, caters not only for a degree of autonomy at the level of the individual, but also identifies two key intellectual fields as pivotal cultural accumulators of autonomous or critical thought: the artistic field and the scientific field. In this context, it is particularly important that one of his very late works, Science of Science and Reflexivity, gives such a vital role to the free `corporation' of scientists as judges of scientific reputations. His concept of artistic autonomy is further explored by illustrations from casestudies in historical sociology, by writers who have been decisively influenced by his sociology of literature. The article ends with an application of his ideas to contemporary newspaper obituaries of cultural producers. This illuminates in particular an underlying issue in his sociology: current dangers to artistic autonomy.
Growth, Stability, and the Urban Portfolio
Authors: Spelman William
Published: October 2006

Local governments provide infrastructure improvements, guarantee loans, and offer tax incentives to lure new businesses and keep old ones. This is usually done with one objective in mind—maximizing economic growth. Application of investment portfolio theory to historic data on metropolitan growth rates suggests that there are clear costs to this strategy in the form of increased volatility in growth rates. In addition, most cities are economically inefficient in the sense that the volatility in growth rates is greater than it would be if their economies were better diversified. The extent of this inefficiency, referred to here as avoidable risk, is an effective performance measure for local economic development activities. Local officials should consider this measure and the objective of diversification when making economic development decisions.
Cash Lotteries as Incentives in Online Panels
Authors: Göritz Anja S.
Published: October 2006

Six incentive experiments were conducted in a nonprofit online panel. In each experiment, the incentive offered for participation was a cash lottery. The control group was not offered any incentive. The cash lottery was offered in two versions: Either the total payout of the lottery was mentioned, or the lottery was split into multiple prizes. Dependent measures included response and retention rates. The results of the six individual experiments were meta-analytically summarized. Cash lotteries relative to no incentives did not reliably increase response or retention; neither did it make a significant difference if one large prize or multiple smaller prizes were raffled.
Victim and Survivor: Narrated Social Identities of Women Who Experienced Rape During the War in Bosnia-Herzegovina
Authors: Skjelsbæk Inger
Published: October 2006

This article presents a narrative analysis of interviews with five women who were victims of war rape during the Bosnian war. By giving a voice to women who have experienced such an ordeal and letting them position their experiences, we gain insight into the diverse impacts that war rapes have on different victims, their families and relationships. The narrative analysis makes it possible to analyze the war-rape experiences as unique and different from other war-trauma experiences, while simultaneously recognizing the totality in which the war rapes occurred.
I. Analytic Third or Law? Reflection vs. Regulation in Psychotherapy Case Notes
Authors: Burman Erica
Published: October 2006

Sally Swartz’s impassioned and poetic rendering of the possibilities of psychotherapy case-note writing as a forum in which to reflect and generate new interpretations on her therapeutic encounters inspired in me a sense of simultaneous exhilaration and envy. Her juxtaposition of Ogden’s (1994) notion of the ‘analytic third’ and other intersubjective psychoanalytic theorists (Stolorow and Atwood, 1992) alongside feminist, postcolonial and dialogical theorists, applying these to her work as a white African woman therapist with black and white clients (men and women), does indeed indicate something of the radical potential of such resources. The extracts from her therapy notes convey something of the struggle to find a way to forge communication across complex and interweaving power relationships that–in a therapy situation, as all others perhaps–are both structural and personal, and shift from moment to moment with particular effects and affects.

As both (group) therapist and academic, I ache to see such work happen here in the postcolonial ‘centre’. For it speaks of real engagement and commitment to use therapy as an arena to explore the impacts and insults of racism, sexism and heterosexism in all their meticulous, gross and microscopic inscriptions on our bodies and minds. I know such work happens here (and I have tried to contribute to some of this–cf. Aitken and Burman, 1999; Gowrisunkur et al., 2002; Walker et al., 2002) – but it is becoming increasingly difficult to write and talk about. In the name of protecting the public and transparency, and in a climate where professions are both required to regulate their own practice and are increasingly subject to state scrutiny, psychotherapists in the UK are being recommended by their training organizations to keep as few notes as possible, and certainly not to own up to writing extensive notes. The legal ambiguities surrounding the notion
Callous-Unemotional Traits in a Community Sample of Adolescents
Authors: Essau Cecilia A. , Sasagawa Satoko , Frick Paul J.
Published: October 2006

This study examined the structure, distribution, and correlates of a new measure of self-reported callous-unemotional (CU) traits in 1,443 adolescents (774 boys, 669 girls) between the ages of 13 to 18 years. The Inventory of Callous-Unemotional Traits was subjected to exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis produced three factors: callousness, uncaring, and unemotional. Fit indexes suggested that the three-factor model, with a single higher-order factor, represented a satisfactory solution for the data. This factor structure fits well for both boys and girls. CU traits correlated significantly with measures of conduct problems and psychosocial impairment. Furthermore, the traits showed predicted associations with sensation seeking and the Big Five personality dimensions, supporting the construct validity of the measure of CU traits.
Using Client Satisfaction to Improve Case Management Services for the Elderly
Authors: Hsieh Chang-ming
Published: October 2006

Although client satisfaction has long been an important form of program evaluation, one of the major limitations regarding client satisfaction studies has been the inability to provide concrete feedback for service providers. This study describes the use of a client-centered approach to developing a client satisfaction measure for a case management setting, Client Satisfaction: Case Management (CSAT-CM). The CSAT-CM overcomes major limitations associated with prior client satisfaction studies and can be used to collect client satisfaction data that will provide concrete feedback for the service providers to improve their case management services. Preliminary results indicate that CSAT-CM has desirable psychometric properties. The proposed practical method of measuring client satisfaction has the potential to be adapted by other types of social service agencies.
Concepts of culture in the sociology of punishment
Authors: Garland David
Published: October 2006

The author analyses the different ways in which the concept of ‘culture’ is currently deployed in the sociology of punishment. Using a distinction first developed by W.H. Sewell Jr, he distinguishes two usages of the concept—culture as an analytical dimension of social relations (‘the cultural’) and culture as a collective entity (‘a culture’). The theoretical issues and problems entailed in these two usages are discussed and several pragmatic solutions proposed. The author argues that analytical accounts of ‘the cultural’ should be regarded as artificial (though necessary) abstractions. Descriptive ethnography, discourse analysis and textual explication ought to be viewed as components of historical or sociological explanation, not as substitutes for explanatory analysis. The author argues for the integration of cultural analysis into the explanatory project of a multi-dimensional sociology of punishment.
Tangled up in blue
Authors: Herbert Steve
Published: October 2006

Police departments struggle to legitimate themselves to the publics they serve. This challenge is fundamentally related to different possible articulations of the relation between society and state. Three key articulations are critical to the relationship between the police and the citizenry, what I term subservience, separation and generativity. I explore each of these, and illustrate their presence in everyday police practice, drawing upon qualitative data gathered during observations of police patrol and police-community forums in Seattle. Because each of these modes of the state-society relation is significant, and because they lie in some tension with one another, the legitimacy of the police promises to be a site of ongoing political contestation.
Capital's brandscapes
Authors: Goldman Robert , Papson Stephen
Published: October 2006

This article explores the contradictory cultural tendencies at play in the political economy of corporate brand values.Corporate brand values often serve mutually contradictory goals of capital accumulation and legitimation.Though competitive branding aims at distinguishing firms from one another, in the overall landscape of branding, the semiotics of branding contributes to tightly condensed, yet overarching, capitalist metanarratives.What additional contradictions evolve out of a branding process that indiscriminately mines culture for the purpose of boosting brand values?
The benefits and challenges of voluntary-academic-sector research partnerships
Authors: Saltus Roiyah
Published: October 2006

The aim of this paper is to offer a critical reflection on some of the benefits and challenges of conducting research that seeks to improve the health of Black and minority ethnic groups, with a specific focus on voluntary-academic-sector research collaboration. A recently completed study, on improving the quality of access to mental health information and care to targeted Black and minority ethnic (BME) groups based in Wales, will be used as a case study. The critical reflection will be framed in the context of the eight categories or dimensions that Meleis (1996) proposed as essential for evaluating methodological rigour in research and scholarship: contextuality, relevance, communication styles, the awareness of identity and power differentials, disclosure, reciprocation, empowerment and time. The paper will conclude by highlighting the usefulness of tools such as the Meleis criteria in both the design and the evaluation of research activity.
From Shadow Citizens to Teflon Stars: Reception of the Transfiguring Effects of New Moving Image Technologies
Authors: Bode Lisa
Published: October 2006

This article examines and compares a couple of moments of fleeting strangeness punctuating the history of the cultural reception of moving image technologies. Maxim Gorky read the early cinematographic image in terms of ‘cursed grey shadows’ (1896), while recent reviewers of Hironobu Sakaguchi’s Final Fantasy: The Spirits Within (2001) have rendered the film’s computer-generated cast as cadavers, dummies, dolls and silicon-skinned mannequins. This article argues that it is not merely the image’s unfamiliar and new aesthetics that evoke the uncanny. Rather the image is received within a cultural framework where its perceived strangeness speaks allegorically of what it means to be ‘human’ at that historical moment.
Assessing the validity of tuberculosis surveillance data in California
Authors: Sprinson Joan E , Lawton Elizabeth S , Porco Travis C , Flood Jennifer M , Westenhouse Janice L
Published: October 2006

Background

The Centers for Disease Control and Prevention (CDC) convened a workgroup to revise the tuberculosis (TB) case report in the United States of America (U.S.). The group proposed substantial revisions. Study objectives were to systematically assess the validity and completeness of reported TB case surveillance data in California and to inform TB case report revision process.

Methods

A sample of 594 cases was retrospectively selected from the cohort of all TB cases reported during 6/1/96-5/31/97 to the State TB Registry. Cases, stratified by treatment outcome, were randomly sampled within each outcome category. Data for 53 variables were abstracted from each case's public health medical record and compared to data recorded on the TB case report. Using the medical record as the "gold standard," estimates were developed for 1) concordance, sensitivity, and positive predictive value of reported data for categorical variables; 2) the absolute mean difference between the two information source for date variables; and 3) the completeness of data on the case report and in medical record.

Results

At least 90% of the values for 35 (79.5%) categorical variables submitted on the TB case report form were identical to values in the medical record. Concordance between data on the case report and medical record was lower for the remaining nine (20.5%) categorical variables: status of abnormal chest x-ray (46.8%); directly observed therapy (48.6%); smear result for tissue or body fluid other than sputum (49.2%); type(s) of tissue or body fluid for smears and cultures other than sputum (76.4% and 73.9% respectively); provider type (73.4%); occupation (84.4%); sputum culture conversion (85.4%); and sputum smear result (89.6%). Case report data were more complete than data in the medical record; 2.9% versus 9.8% of data were missing/unknown, respectively.

Conclusion

For most variables examined on the TB case report, data validity was excellent, indicating a robust surveillance system. However, lower data quality was noted for a small number of variables primarily impacting treatment adherence, including assessment and planning; advocacy; allocation and garnering of resources; and research. The study provides compelling evidence supporting the CDC workgroup's proposed revisions to the TB case report.
The effects of a controlled worksite environmental intervention on determinants of dietary behavior and self-reported fruit, vegetable and fat intake
Authors: Engbers Luuk H , van Poppel Mireille NM , Chin A Paw Marijke , van Mechelen Willem
Published: October 2006

Background

Eating patterns in Western industrialized countries are characterized by a high energy intake and an overconsumption of (saturated) fat, cholesterol, sugar and salt. Many chronic diseases are associated with unhealthy eating patterns. On the other hand, a healthy diet (low saturated fat intake and high fruit and vegetable intake) has been found important in the prevention of health problems, such as cancer and cardio-vascular disease (CVD). The worksite seems an ideal intervention setting to influence dietary behavior. The purpose of this study is to present the effects of a worksite environmental intervention on fruit, vegetable and fat intake and determinants of behavior.

Methods

A controlled trial that included two different governmental companies (n = 515): one intervention and one control company. Outcome measurements (short-fat list and fruit and vegetable questionnaire) took place at baseline and 3 and 12 months after baseline. The relatively modest environmental intervention consisted of product information to facilitate healthier food choices (i.e., the caloric (kcal) value of foods in groups of products was translated into the number of minutes to perform a certain (occupational) activity to burn these calories).

Results

Significant changes in psychosocial determinants of dietary behavior were found; subjects at the intervention worksite perceived more social support from their colleagues in eating less fat. But also counter intuitive effects were found: at 12 months the attitude and self-efficacy towards eating less fat became less positive in the intervention group. No effects were found on self-reported fat, fruit and vegetable intake.

Conclusion

This environmental intervention was modestly effective in changing behavioral determinant towards eating less fat (social support, self-efficacy and attitude), but ineffective in positively changing actual fat, fruit and vegetable intake of office workers.
The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions
Authors: Choi Dongseok , Dickey Jamie , Wessel Kristen , Girard Donald E
Published: October 2006

Background

To assess the impact of work hours' limitations required by the Accreditation Council for Graduate Medical Education (ACGME) on residents' career satisfaction, emotions and attitudes.

Methods

A validated survey instrument was used to assess residents' levels of career satisfaction, emotions and attitudes before and after the ACGME duty hour requirements were implemented. The "pre" implementation survey was distributed in December 2002 and the "post" implementation one in December 2004. Only the latter included work-hour related questions.

Results

The response rates were 56% for the 2002 and 72% for the 2004 surveys respectively. Although career satisfaction remained unchanged, numerous changes occurred in both emotions and attitudes. Compared to those residents who did not violate work-hour requirements, those who did were significantly more negative in attitudes and emotions.

Conclusion

With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them. Graduate medical education leaders must innovate to make the experiences for selected residents improved and still maintain compliance with the work hour requirements.
Phase II Trial of Erlotinib in Gastroesophageal Junction and Gastric Adenocarcinomas: SWOG 0127
Authors: Dragovich Tomislav , McCoy Sheryl , Fenoglio-Preiser Cecilia M. , Wang Jiang , Benedetti Jacqueline K. , Baker Amanda F. , Hackett Christopher B. , Urba Susan G. , Zaner Ken S. , Blanke Charles D. , Abbruzzese James L.
Published: October 2006

Purpose

A phase II trial of the oral epidermal growth factor receptor (EGFR) inhibitor erlotinib in patients with gastroesophageal adenocarcinomas stratified according to primary tumor location into two groups: gastroesophageal junction (GEJ)/cardia and distal gastric adenocarcinomas.

Patients and Methods

Patients with a histologically proven diagnosis of adenocarcinoma of the GEJ or stomach (ST) that was unresectable or metastatic; presence of measurable disease; no prior chemotherapy for advanced or metastatic cancer; Zubrod performance status (PS) of 0 to 1; and adequate renal, hepatic, and hematologic function were treated with erlotinib 150 mg/d orally. Patient characteristics were median age, GEJ—63 years, ST—64 years; sex, GEJ—84% male and 16% female, ST—60 male and 40 female; Zubrod PS, GEJ—25 had a PS of 0 and 18 had a PS 1, ST—13 had a PS of 0 and 12 had a PS of 1.

Results

Percentage of common toxicities were skin rash, 86% and 72%; fatigue, 51% and 44%; and AST/ALT elevation, 28% and 28%, respectively for GEJ and ST. There has been one confirmed complete response, three confirmed partial responses (PRs) and one unconfirmed PR for an overall response probability of 9% confirmed (95% CI, 3% to 22%), all occurring in GEJ stratum. No responses were observed in ST stratum. The median survival was 6.7 months in GEJ and 3.5 months in ST stratum. Neither intratumoral EGFR, transforming growth factor–alpha or phosphorylated Akt kinase expression nor plasma proteomic analyses were predictive of clinical outcome. No somatic mutations of the EGFR exons 18, 19, or 21 were detected and there was no gross amplification of EGFR by fluorescence in situ hybridization.

Conclusion

Erlotinib is active in patients with GEJ adenocarcinomas, but appears inactive in gastric cancers. The molecular correlates examined were not predictive of the patient therapeutic response.
Intravascular Ultrasound for Intracranial Angioplasty and Stent Placement: Technical Case Report
Authors: Christopher Wehman J. , Holmes David R. , Hanel Ricardo A. , Levy Elad I. , Hopkins L. Nelson
Published: October 2006

OBJECTIVE:

Intravascular ultrasound (IVUS) imaging has been used extensively in coronary artery interventions and has provided invaluable information for the understanding and treatment of coronary arterial disease. We present here the first description, to our knowledge, of IVUS-guided intracranial arterial interventions in the clinical setting.

CLINICAL PRESENTATION:

Two patients underwent intracranial angioplasty and stent placement with the assistance of IVUS for the evaluation of their lesions. One patient underwent stenting to treat an occlusive dissection of the left internal carotid artery that occurred during arteriovenous malformation embolization. Another patient underwent angioplasty and stenting for high-grade restenosis of a basilar artery atherosclerotic lesion.

RESULTS:

Both patients underwent successful revascularization procedures. The patient with the dissection had a small intraventricular and parenchymal hemorrhage documented by computed tomography 4 hours after treatment, but did not develop hydrocephalus or further hemorrhage. Both patients did well clinically and had no permanent neurological deficits. IVUS provided important information in terms of lesion evaluation, stent selection, and stent placement in each case.

CONCLUSION:

IVUS of the intracranial circulation may assist the performance of intracranial angioplasty and stenting. It provides useful information that can affect clinical decisions. It may prove to be a valuable tool in clinical use and enhance our understanding of vascular disease of the intracranial circulation, as it has in the coronary circulation.
Microsurgery in the Removal of a Large Cerebral Hydatid Cyst: Technical Case Report
Authors: Balak Naci , C¸avumirza Cengiz , Yıldırım Hu¨meyra , Ozdemir Sec¸il , Kınay Demet
Published: October 2006

OBJECTIVE:

Surgery is presently the mainstay in the treatment of cerebral hydatid cysts, but removal without perforation of the cyst wall is critical. The Dowling-Orlando technique has been the main surgical choice for the intact removal of intracranial hydatid cysts. Dowling described his technique in 1929, well before the introduction of the microscope in neurosurgery. Using the operating microscope has not been reported in the removal of a large hydatid cyst.

CLINICAL PRESENTATION:

The case of a 16-year-old male with a large, right parieto-occipital hydatid cyst is presented.

INTERVENTION:

In this case, surgery was greatly aided by the use of the microscope in the initial stage of the removal of the cyst. Cyst extraction during the delivery process was continued without the aid of the microscope. The cyst was successfully removed intact.

CONCLUSION:

The use of the magnification during the early part of the surgery of a hydatid cyst is extremely helpful because, at a crucial stage of the procedure, it prevents inadvertent damage of the very thin cyst wall and allows development of the critical surgical plane.
Coating the Wall of an Injured Intracranial Carotid Artery During Tumor Removal With N-Butyl-2-Cyanoacrylate: Technical Case Report
Authors: Requejo Flavio , Schumacher Martin , van Velthoven Vera
Published: October 2006

OBJECTIVE:

Carotid artery injury close to the clinoid process is difficult to repair, and is even more so when the vessel is firmly attached to a calcified tumor. We treated a patient with an intraoperative carotid lesion by coating the vessel wall with N-butyl-2-cyanoacrylate (NBCA).

CLINICAL PRESENTATION:

A 7-year-old boy was referred to our clinic with a 3-month history of somnolence, apathy, and headache. Neurological examination revealed bitemporal hemianopsia. The cranial magnetic resonance imaging and computed tomographic scans showed a sellar and suprasellar calcified mass with heterogeneous contrast enhancement, a cyst component in the upper part of the tumor displaced upward and back from the mesen-cephalic and diencephalic structures.

INTERVENTION:

The patient underwent a pterional craniotomy. Using a microsurgical technique, the suprasellar part of the craniopharyngioma was removed. In an attempt to dissect the calcified mass from the carotid artery on the right side, the vessel was unintentionally injured, followed by severe bleeding. Temporary occlusion and suturing of the vessel was impossible because of the overlying hard mass. To avoid a permanent occlusion, we decided to coat the injured artery wall with 100% NBCA. For this, 0.5 ml of NBCA was distributed on the surface of the injured segment and surrounding subarach-noid space by injection through a needle. An excellent hemostasis could be obtained immediately after coating. The patient woke up with no new neurological deficits. A digital cerebral angiogram obtained a few days after the procedure did not show vasospasm, stenosis, or pseudoaneurysm in the supraclinoidal segment of the carotid artery. A magnetic resonance angiogram obtained 3 years later showed a normal shape of the internal carotid artery and a stable residual tumor without inflammatory signs. The child is now attending school and is under hormonal therapy.

CONCLUSION:

For hemostatic purposes, the technique of coating an injured arterial wall with NBCA may be useful in cases in which a microsuture is impossible and a permanent artery occlusion is unwanted because of a risk of an ischemic stroke. It could serve as a transitory measure until a microsurgical bypass or the balloon test occlusion tolerance allow the trapping of the affected artery.
“Target Bypass”: A Method for Preoperative Targeting of A Recipient Artery in Superficial Temporal Artery-to-Middle Cerebral Artery Anastomoses
Authors: Kikuta Ken-ichiro , Takagi Yasushi , Fushimi Yasutaka , Ishizu Kouichi , Okada Tsutomu , Hanakawa Takashi , Miki Yukio , Fukuyama Hidenao , Nozaki Kazuhiko , Hashimoto Nobuo
Published: October 2006

OBJECTIVE:

To introduce a method for preoperative targeting of a proper recipient artery in superficial temporal artery-to-middle cerebral artery anastomosis.

METHODS:

Six operations for superficial temporal artery-to-middle cerebral artery anastomosis in four patients with moyamoya disease or moyamoya-like disease and two operations in two patients with atherosclerotic cerebrovascular occlusive disease accompanied by coronary artery stenosis were performed using our method. Before surgery, a 3-Tesla magnetic resonance imaging study was performed with axial T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient-echo sequences and three-dimensional time-of-flight magnetic resonance angiography. Data on quantitative regional cerebral blood flow were obtained by iodine-123-labeled N-isopropyl-iodoamphetamine single-photon emission computed tomography or positron emission computed tomography. The magnetic resonance angiography and regional cerebral blood flow data sets were registered with the magnetization-prepared rapid acquisition gradient-echo data set by means of the coregistration function of the SPM2 software. We examined the arteries located on or near the cortex where the regional cerebral blood flow had significantly decreased and used the coregistered data set and MRIcro software to select the cortical artery with the largest diameter as the target recipient artery. At the surgery, the data sets were applied to the neuronavigation system and the actual site of the target was confirmed in the operation before scalp incision. The superficial temporal artery was anastomosed with the target through a small craniotomy.

RESULTS:

Successful bypass surgery to the target was confirmed in all cases. @@CONCLUSION:@@ The “target bypass” method might be effective for cases with moya-moya disease or for cases requiring surgery through a small craniotomy.
Stent Placement For Intracranial Cysts By Combined Stereotactic/Endoscopic Surgery
Authors: Berlis Ansgar , Vesper Jan , Ostertag Christoph
Published: October 2006

OBJECTIVE:

The treatment of space-occupying cystic lesions includes percutaneous cyst aspiration, marsupialization, percutaneous ventriculocystotomy, or Rickham catheter implantation. In some patients, the cysts tend to recur and repeated evacuations are necessary. The authors present a new treatment method with internal drainage of cysts into the ventricular system using a balloon-mounted vascular stent.

METHODS:

Six patients with cysts of low-grade gliomas, one with monocystic craniopharyngioma, and one with suprasellar arachnoid cyst were treated between September 2003 and May 2005. All patients were symptomatic after multiple previous treatments. Stent implantations were performed under local anesthesia in adults and under general anesthesia in children. In all patients, the stereotactic frame and computed tomographic and magnetic resonance fusion were used for an optimized approach. The treatment was performed in a compassionate manner and the patients were informed about the off-label use of the device.

RESULTS:

Stent placement was successful in all eight patients without procedure-related complications. Improvement of clinical symptoms was seen in seven out of eight patients. Seven out of eight cysts decreased in size within a follow-up period of up to 23 months (mean, 17 mo; median, 18 mo; range, 6-23 mo). The first patient showed recurrence of the tumor cyst 3 months after initial treatment with a Herkulink stent (5 × 18 mm), followed by retreatment with an Omnilink stent (6 × 28 mm; Guidant Corp., Santa Clara, CA). Stenting was ineffective in one patient. @@CONCLUSION:@@ Treatment of intracranial cystic lesions by internal drainage is possible with the use of stent-assisted ventriculocystostomy.
Complication Avoidance in Peripheral Nerve Surgery: Preoperative Evaluation of Nerve Injuries and Brachial Plexus Exploration—part 1
Authors: Russell Stephen M. , Kline David G.
Published: October 2006

Complication avoidance during peripheral nerve surgery has received little attention in the neurosurgical literature. The goal of our two-part review is to discuss these possible complications, with this initial article highlighting the pitfalls associated with pre- and intraoperative assessment of nerve injuries, as well as the operative nuances used during brachial plexus exploration to minimize complications.
The Management of Vein of Galen Aneurysmal Malformations
Authors: Lasjaunias Pierre L. , Chng Soke M. , Sachet Marina , Alvarez Hortensia , Rodesch Georges , Garcia-Monaco Ricardo
Published: October 2006

OBJECTIVE:

The vein of Galen aneurysmal malformation (VGAM) is a choroidal type of arteriovenous malformation involving the vein of Galen forerunner. This is distinct from an arteriovenous malformation with venous drainage into a dilated, but already formed, vein of Galen. Reports of endovascular treatment of VGAM in the literature approach the disease from a purely technical viewpoint and often fail to provide satisfactory midterm results. To focus the therapeutic challenge to a strictly morphological goal overlooks the fundamental aspects of neonatal and infant anatomy and fluid physiology. During the past 20 years, our approach to VGAM has remained the same. Our experience, based on 317 patients with VGAM who were studied in Hospital Bicêtre between October 1981 and October 2002, allows us to describe the angioarchitecture, natural history, and management of VGAM in neonates, infants, and children.

METHODS:

Of our cohort of 317 patients, 233 patients were treated with endovascular embolization; of these, 216 patients were treated in our hospital. The treatment method of choice was a transfemoral arterial approach to deliver glue at the fistulous zone.

RESULTS:

Of 216 patients, 23 died despite or because of the embolization (10.6%). Twenty out of the 193 (10.4%) surviving patients were severely retarded, 30 (15.6%) were moderately retarded, and 143 (74%) were neurologically normal on follow-up.

CONCLUSION:

Our data demonstrate that most treated children survive and undergo normal neurological development; an understanding of the clinical, anatomical, and pathophysiological features of VGAM has, therefore, reversed the former poor prognosis. Our level of understanding about the lesion allows us to predict most situations and remedy them by applying a strict evaluation protocol and working within an optimal therapeutic window. Patient selection and timing remain the keys in the management of this condition. It is more important to restore normal growth conditions than a normal morphological appearance, with the primary therapeutic objective being normal development in a child without neurological deficit.
Current Status of Manpower Needs for Management of Cerebrovascular Disease
Authors: Zipfel Gregory J. , Derdeyn Colin P. , Dacey Ralph G.
Published: October 2006

THE CEREBROVASCULAR DISCIPLINE has undergone dramatic changes in recent years. The advent, development, and now widespread application of endovascular therapy for various cerebrovascular diseases has been the predominant influence behind many of these changes, but other factors (some scientific, others less so) have also contributed significantly. As our discipline evolves, it is critical to periodically examine how such changes have altered our manner of practice and to determine what impact such changes might have on manpower allocation and training for the future. This article is our attempt at providing such an assessment. First, we will critically review recent trends within the fields of intracranial aneurysms, arteriovenous malformations, carotid atherosclerotic occlusive disease, and ischemic stroke and how these trends have impacted our profession. Thereafter, we will provide a perspective on what the cerebrovascular manpower needs of the future might be and by whom these needs will be met. Finally, we will examine how the new generation of cerebrovascular specialists, including neurosurgeons, neuroradiologists, and some neurologists, will attain their requisite surgical or endovascular training and attempt to determine which careers, pathways, and opportunities will be available to these individuals in the future.
A Novel Technique and New Grading Scale for the Embolization of Cerebral Vascular Malformations
Authors: Amar Arun P. , Teitelbaum George P. , Larsen Donald W.
Published: October 2006

OBJECTIVE:

Effective transarterial embolization of a dural arteriovenous fistula or pial arteriovenous malformation (AVM) requires penetration of a durable occlusive agent into the fistula or AVM nidus. Cyanoacrylate glue often cannot traverse the tortuous vessels that typically supply such malformations, leading to proximal occlusion and recruitment of collateral flow. Other embolic agents, such as polyvinyl alcohol particles, achieve better penetration, but their effects are short lived, often leading to recanalization. The authors sought to overcome these obstacles by developing a technique to enhance glue penetration into the fistula or AVM nidus itself.

METHODS:

After placing a guide catheter in the proximal feeding artery, a microcatheter is advanced coaxially to its limit. As glue is injected through the microcatheter, a column of 5% dextrose in water (D5W) is pushed manually through the guide catheter lumen to propel the glue forward. This technique has been bench tested in a standard flow model of vascular malformations, using a pump capable of delivering various rates of D5W. It has also been validated in treating 17 patients with cerebral dural arteriovenous fistulae or AVMs, with real-time adjustment of D5W flow according to the extent of glue penetration.

RESULTS:

In the bench model, the extent of glue penetration, as graded by a new scale of liquid agent embolization proposed by the authors, correlated directly with the rate of D5W flow (P = 0.5, analysis of variance). In vivo, this technique has enhanced the penetration of glue into the fistula or AVM nidus, resulting in longstanding embolization of these malformations.

CONCLUSION:

Coaxial injection of D5W through the guide catheter can propel cyanoacrylate glue through tortuous feeding arteries and can enhance its penetration into dural fistulae and AVMs, leading to more effective endovascular treatment of these malformations.
Modification of the upwind schemes for the computation of condensing two-phase flows
Authors: Mei Y , Guha A
Published: October 2006

The eigenvalues and eigenvectors of the Jacobian matrix of the homogeneously condensing two-phase flow equations are derived. These are useful for all upwind schemes. Details of the implementation in the Roe scheme are described. Example calculations for condensing wet steam flow are provided, which compare well with the experimental results.
A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers
Authors: Larsen Simon B , Clemensen Jane , Ejskjaer Niels
Published: October 2006

We tested the feasibility of Universal Mobile Telephone System (UMTS) mobile phones for video consultations in the home. Five patients with diabetic foot ulcers were included in the study. Each of them was offered three video consultations instead of visits to the hospital outpatient clinic. The consultations took from 5 to 18 min. In all 15 consultations, the hospital experts were able to assess the ulcer in cooperation with the visiting nurse and to decide on the treatment. However, technical problems sometimes made it difficult for them. Connectivity problems occurred in seven of the 15 consultations. Also, the audio signal was rather unstable at times. In all situations except one, however, the clinicians were able to reach a decision that the expert felt confident about, and after all consultations the atmosphere and participants' attitudes were very positive.
A costing model for videoconferencing in Alberta
Authors: Ohinma Arto , Scott Richard
Published: October 2006

The Alberta Telehealth Network uses a provincial scheduling system, which allows use of the network to be monitored via reporting procedures. We developed a province-wide costing model for videoconferencing in Alberta, including administrative, clinical and educational activities. In 2003, there were 212 different videoconferencing sites. During the year, 5766 videoconferencing sessions were provided and in these sessions the sites were connected to the network a total of 21,596 times. About 27% of the connections were from providing sites and about 73% of the connections were from receiving sites. On average, one site in the telehealth system was connected to another site about 100 times, and the average videoconferencing session included about 3.8 sites, varying from mainly two sites in clinical sessions to 4.2 sites in administrative sessions and 6.1 sites in educational sessions. The total cost of videoconferencing in Alberta for administrative, clinical and educational activities was about CA $5.74 million in 2003. About 52% of the annual cost was for educational sessions, 34% for administrative meetings and 14% for clinical consultations. The average cost of videoconferencing at a single site ranged from $223.48 (for providing clinical consultations) to $278.57 (for receiving educational sessions). The costing model provides information for decision-makers about the cost of videoconferencing activities and can be used in the development of a sustainable telehealth system in Alberta.
Otolaryngologic manifestations of acute leukemia
Authors: Sklansky B. Donald , Jafek Bruce W. , Wiernik Peter H.
Published: October 2006

This report documents the principles of diagnosis and management of acute leukemia from an otolaryngologic standpoint, based on our experience with 273 patients at the Baltimore Cancer Research Center of the National Cancer Institute. Infection, hemorrhage, infiltration and chemo‐therapeutic complications are considered. The need for a high index of suspicion and an aggressive approach to these problems is stressed.
Electronystagmographic findings in motor neuron disease
Authors: Steinmetz Edward F. , Lebo Charles P. , Norris Forbes H.
Published: October 2006

The electronystagmogram (ENG) was abnormal in 94 percent of 88 consecutive patients with motor neuron disease (MND). The most common ENG abnormalities were dysrhythmic caloric responses (64 percent), active random eye movements with eyes closed (25 percent), caloric directional preponderance (24 percent), and caloric vestibular preponderance (20 percent). Torsional preponderance, poor fixation suppression (of induced vestibular nystagmus), spontaneous nystagmus, square waves, tracking and optokinetic abnormalities were also frequent. Most of these ENG findings are considered to be of central nervous system origin. Although these findings are not considered specific for MND, they appear to have clinical significance.
The biomechanics of facial bone fracture.
Authors: Nahum Alan M.
Published: October 2006

Selected facial bone locations were impacted to simulate clinical trauma conditions. Locations selected included the nose, zygoma, mandible, maxilla, and frontal bone. The experiment clearly delineate tolerance bands for the facial bones for both sexes. These data should permit the improved design of injury producing structures.
Bell's palsy and the chorda tympani nerve: A clinical and electron microscopic study
Authors: May Mark , Schlaepfer William W.
Published: October 2006

The chorda tympani nerve plays an important role in the pathogenesis of Bell's palsy. The chorda tympani nerve is altered early in the course of the disease, perhaps before involvement of the facial nerve occurs. This was demonstrated by studying the pathophysiologic alterations of the chorda tympani nerves of 15 patients with Bell's palsy. Fifty‐seven percent of the patients noted taste aberrations two days before the onset of the facial paralysis. In addition, chorda tympani nerve function, tested by electro‐gustometry and by determining submandibular salivary flow, was altered before the response to nerve excitability became reduced; further, the electron micrographic findings in two patients indicated that the involvement of the chorda tympani nerve preceded the time of onset of the facial paralysis.

The study established a relationship between the pathologic involvement of the chorda tympani nerve and the facial nerve. There was a direct relationship between the severity of changes noted microscopically in the chorda tympani nerve specimens and the ultimate recovery of facial motor function.

Examination of the chorda tympani nerve specimens was used to correlate the effectiveness of treatment. The results of steroid therapy and surgical decompression were compared. Steroids had no beneficial effect. Complete return of facial function was associated with surgical management when surgery was performed based on reduced salivary flow to 25 percent of normal and while the response to maximal stimulation was still normal.
Evaluation of tonsils and adenoids in sleep apnea syndrome
Authors: Richardson Mark A. , Seid Allan B. , Cotton Robin T. , Benton Corning , Kramer Milton
Published: October 2006

Peripheral Sleep Apnea syndrome has been associated with enlarged tonsils and adenoids as well as other abnormalities which may cause upper airway obstruction in children. A multidisciplinary approach is used at the Sleep Disorder Center of Cincinnati General Hospital to evaluate the role of tonsils and adenoids in sleep apnea.

Polysomnographic techniques combined with cine sleep studies of the upper airway document the degree, site and type of obstruction. This presentation highlights the entity of obstructive sleep apnea and provides a rational clinical approach in the management of these patients.