bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic variation in founder populations of the Mediterranean gecko, Hemidactylus turcicus, across the southern United States
Authors: DeVries Ashleigh , Budge Deborah , Schwaner Terry , Schwaner Delilah
Published: May 2010

Populations initially founded by a small number of individuals risk chance increases in some genetic variants and experience periods during which only a few individuals survive to continue the existence of the population. Colonization of new locations by individuals from these founder populations is expected to result in further reduction of variation in founding populations. Tissue samples from the Mediterranean gecko, Hemidactylus turcicus, were subjected to allozyme electrophoresis to measure gene frequencies at two polymorphic loci for populations initially introduced to port cities along the Gulf Coast, and which are now distributed across the southern United States. We observed levels of polymorphism and heterozygosity that were markedly reduced in populations more distant from coastal localities, consistent with a hypothesis of founder effect.
Capture-mark-recapture analysis reveals survival correlates in Salamandrina perspicillata (Savi, 1821)
Authors: Antonelli Damiano , Angelini Claudio , Utzeri Carlo
Published: May 2010

We carried out a mark-recapture survival analysis of female Salamandrina perspicillata in two central Italian populations. Overall survival was similar in both populations (about 85-90% per year) and the estimated lifespan was about twelve years. We detected transients in one population, possibly related to the high density of females in this site. The breeding probability of females was independent from that of the preceding year.
Low mitochondrial divergence of rediscovered southern relict populations of Rana temporaria parvipalmata in Spain
Authors: Ludewig Ann-Kathrin , Vences Miguel , Hauswaldt Susanne , Ferreiro Ricardo , Galán Pedro , Kmiec Jacek , Cabana Martiño
Published: May 2010

We determined DNA sequences of the mitochondrial cytochrome b gene for 44 specimens of the common frog, Rana temporaria parvipalmata, from 14 localities in Galicia, northwestern Spain. We found a low differentiation among all studied individuals, with a maximum of four mutational steps between haplotypes, including those from the southernmost isolated populations on the Manzaneda-Queixa and Trevinca-Segundeira massifs which thus probably originated by a rather recent colonization and likely maintained intermittent gene flow to more northern populations during climatically colder, glacial periods with a higher habitat connectivity.
Can social support in the guise of an oral health education intervention promote mother–infant bonding in Chinese immigrant mothers and their infants?
Authors: Yuan Si-Yang , Freeman Ruth
Published: May 2010

Objective: To examine if social support in the guise of a culturally sensitive, community-based oral health intervention could promote mother–infant bonding in socially-isolated immigrant mothers.

Design: A quasi-experimental design.

Participants: A convenience sample of 36 Chinese immigrant mothers with 8-week-old infants was divided into intervention and control groups.

Intervention: The ChIME (Chinese Immigrant Mothers oral health Education) programme, a culturally-sensitive oral health education intervention included social support elements. Intervention mothers had five home-visits augmented by telephone calls and open access to the first author (SY). All mothers completed the Postpartum Bonding Questionnaire (PBQ) at baseline, when the infant was aged six months and 12 months. The PBQ screened for impaired mother–infant bonding.

Results: At baseline, the Chinese mothers had significantly greater mean scores for bonding disorder; rejection and pathological anger and for incipient abuse compared with normative values but equivalent mean scores when compared with normative values for depressed mothers. At 12-month follow-up the intervention compared with control group mothers had significantly greater decreases in mean scores for bonding disorder, rejection and pathological anger and infant-centred anxiety.

Conclusion: Social support provided within the guise of a culturally-sensitive oral health education programme assisted socially-isolated immigrant mothers to improve the quality of their relationship with their infants.
Not loving thy neighbour as thyself: Trade, democracy and military expenditure explanations underlying India—Pakistan rivalry
Authors: Mansoob Murshed Syed , Mamoon Dawood
Published: May 2010

This article analyses whether greater international trade, democracy and reduced military spending lower hostility between India and Pakistan. Conflict between the two nations can be best understood in a multivariate framework where variables such as economic performance, multilateral trade with the rest of the world, bilateral trade, military expenditure, democracy scores and population are simultaneously taken into account. The empirical investigation is based on time series econometrics from 1950— 2005, allowing causality to be examined. The results suggest that reduced bilateral trade, greater military expenditure, less development expenditure, lower levels of democracy, lower growth rates and less general trade openness are all conflict enhancing, albeit with lags in some cases. Moreover, there is reverse causality between bilateral trade, militarization and conflict; low levels of bilateral trade and high militarization are conflict enhancing, but conflict also reduces bilateral trade and raises militarization. Economic growth is conflict mitigating, but the reverse is not true. Globalization, or greater openness to trade with the rest of the world, is the most significant driver of a liberal peace, corroborating a modified form of the capitalist peace, rather than a common democratic political orientation suggested by the pure form of the Kantian liberal peace.
Effects of Staple Strength and Raw Wool Blend Make-Up on Processing and Properties from Top to Fabric
Authors: Prins Martin W. , Pierlot Anthony P.
Published: May 2010

The impact of staple strength on later stage processing of fine fleece wools (19 µm) and the blending with pieces is investigated. The staple strength findings complement those of previous researchers who used wools of different fibre diameters or from single flocks. The results reported here show that, as previously, the direct effect of staple strength is limited to the production of tops, where staple strength influences fibre length in the top and the generation of combing waste. Blending fleece wool and pieces was shown to increase combing noil and reduce fibre length in the top. The topmaking results conducted at CSIRO suggest that there may be an economic advantage in incorporating lower staple strength, and hence cheaper wools, in an all-fleeces consignment while still being able to meet the technical requirements for yarn and fabric production. Although statistically significant, the small tenacity and elongation differences for 1/64 Nm yarns produced from the high and low staple strength test batches appear to have had no significant impact on the fabric tensile properties. There were no inter-batch yarn evenness and fault level differences recorded, with top dyeing having a much greater influence on yarn quality than any differences associated with staple strength.

Blending fleeces and pieces in a 60/40 ratio had a greater impact on processing from raw wool to fabric than the effect of staple strength over the range investigated. In comparison to an all-fleeces batch it would appear the economics of processing a fleeces-and-pieces batch may not be attractive, as the blend composition had an adverse effect on yarn fault levels, tenacity and elongation, which in turn may adversely affect weaving performance. However, the effect on fabric properties appears to be minor.
Subjective and Objective Pilling Evaluations of Textile Fabrics: A Comparison
Authors: Mendes António de Oliveira , Torrão Fiadeiro Paulo , Lopes Miguel Rui Alberto
Published: May 2010

This paper addresses a comparison between three different approaches used to evaluate a set of different textile fabric samples in terms of pilling formation. Originally, the set was subjectively evaluated by a panel of experts, being that, our reference evaluation. Then, the same set of fabrics was analysed by a dual-scanning optical system which has been implemented by our team to reconstruct 3D images of the topography of the fabrics. With the obtained range data, an objective evaluation of the pilling formation was carried out based on the total pilling volume and the results showed to be in agreement with the original subjective evaluation. In this paper, our purpose is to establish a correspondence model in order to automatically attribute the equivalent pilling grade. Furthermore, the same set of fabrics was then subjectively reevaluated by different observers for comparison with the reference evaluation, and the results obtained by the correspondence model.
A Multi-component Fiber-reinforced PHEMA-based Hydrogel/HAPEXTM Device for Customized Intervertebral Disc Prosthesis
Authors: Gloria Antonio , De Santis Roberto , Ambrosio Luigi , Causa Filippo , Tanner K. Elizabeth
Published: May 2010

Spinal disease due to intervertebral disc degeneration represents a serious medical problem which affects many people worldwide.

Disc arthroplasty may be considered the future ‘‘gold standard’’ of back pain treatment, even if problems related to available disc prostheses are considered. Hence, the aim of the present study was to improve the artificial disc technology by proposing the engineering of a pilot-scale device production process for a total multi-component intervertebral disc prosthesis. The device is made up of a poly(2-hydroxyethyl methacrylate)/poly(methyl methacrylate) (PHEMA/PMMA) (80/20 w/w) semi-interpenetrating polymer network (s-IPN) composite hydrogel reinforced with poly(ethylene terephthalate) (PET) fibers as annulus/nucleus substitute, and two hydroxyapatite-reinforced polyethylene composite (HAPEX TM) endplates in order to anchor the multi-component device to the vertebral bodies. Static and dynamic—mechanical characterization show appropriate mechanical behavior. An example of engineering of a suitable pilot-scale device production process is also proposed in order to manufacture custom made implants.
Stressors Over the Life Course and Neuroendocrine System Dysregulation in Costa Rica
Authors: Gersten Omer , Dow William H. , Rosero-Bixby Luis
Published: May 2010

Objectives: A key aspect of the increasingly popular allostatic load (AL) framework is that stressors experienced over the entire life course result in physiological dysregulation. Although core to AL theory, this idea has been little tested, and where it has been tested, the results have been mixed. Method: The study analyzes the Costa Rican Study on Longevity and Healthy Aging (CRELES), a new, cross-sectional, and nationally representative survey of older Costa Rican men and women (aged between 60 and 109 years). The survey period is between 2004 and 2006, and the survey has a sample size of 2,827 individuals. This article focuses on the relationship between a variety of stressors experienced over the life course and cortisol, dehydroepiandrosterone sulfate (DHEAS), epinephrine, and norepinephrine analyzed separately and in an index. Results: There are some links between certain stressors and worse cortisol levels, but overall, almost all of the stressors examined are not associated with riskier neuroendocrine biomarker profiles. Discussion: More work is needed, in order to establish the connection between stressors experienced over the life course and resting levels of the neuroendocrine markers.
Guided Wave Beamsteering using MFC Phased Arrays for Structural Health Monitoring: Analysis and Experiment
Authors: Kim Daewon , Philen Michael
Published: May 2010

Phased array beamsteering is an effective tool for damage detection and assessment method in a guided wave structural health monitoring system. Monolithic piezoceramic (PZT) actuators have been widely utilized for beamsteering by assuming omnidirectional point sources for each actuator. However, this assumption can lead to erroneous results for a phased array of actuators with anisotropic actuation, such as macro-fiber composites (MFC). The MFC actuators are investigated in this research for beamsteering considering the main lobe width, main lobe magnitude, and side lobe levels and compared to equivalently sized PZT actuators. Analytical models of the MFC and PZT actuators attached to an isotropic plate structure are presented and the genetic algorithm is used to determine the optimal timing sequences of the phased array elements for beamforming enhancement. The analysis results show that the MFC phased arrays have reduced the main lobe width and side lobe levels compared to the PZT phased arrays for a range of beamsteering angles. The area ratios of the MFC arrays are also found to be greater than the PZT arrays for these beamsteering angles. Experiments using the PZT and MFC phased arrays on an aluminum plate are performed and compared to the analysis results. The experiment results agree with the analysis results and demonstrate improved beamsteering of the MFC phased arrays for specific applications.
Establishing a Clinical Research Council in Home Health and Hospice
Authors: Freysteinson Wyona M. , Allbritton Belinda , Arnold Diana W. , Hernandez Renee R. , Moore Terri , Smith Teresa
Published: May 2010

This project focused on the development of a clinical research council in a home health and hospice organization. Strengths of establishing a council included enhanced use of evidence-based practice, an increase in cross-discipline collaboration, and recruitment and retention. Council members evaluated their learning needs to establish a research education program. An organizational evaluation reviewed library and institutional review board access, system research departments, internal policies, electronic database, and clinical tools. Planning for sustainability included developing an organizing framework, creating community collaborations, and establishing a research pathway.
Perceptions of Health and Attractiveness
Authors: Yanover Tovah , Thompson J. Kevin
Published: May 2010

Three hundred and thirty-three participants rated the health and attractiveness of schematic figures varying in muscularity, adiposity, gender, and race. In general, overweight and underweight figures were rated as less healthy and attractive. However, overweight figures with high levels of muscularity were rated more highly on these dimensions than figures with less muscularity. Females assigned higher attractiveness ratings than males; African Americans provided higher ratings than Caucasians and Hispanics for female figures and lower ratings than Caucasian and Hispanic raters for male figures. Theoretical explanations and applied implications are offered.
Tryptophan/kynurenine metabolism in human leukocytes is independent of superoxide and is fully maintained in chronic granulomatous disease
Authors: De Ravin Suk See , Zarember Kol A. , Long-Priel Debra , Chan King C. , Fox Stephen D. , Gallin John I. , Kuhns Douglas B. , Malech Harry L.
Published: May 2010

In chronic granulomatous disease (CGD), defective phagocytic nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity causes reduced superoxide anion (O2·̄) radical production leading to frequent infections as well as granulomas and impaired wound healing indicative of excessive inflammation. Based on recent mouse studies, the lack of O2·̄-dependent interferon γ (IFNγ)–induced synthesis of kynurenine (kyn), an anti-inflammatory tryptophan metabolite produced by indolamine 2,3 deoxygenase (IDO), was proposed as a cause of hyperinflammation in CGD and this pathway has been considered for clinical intervention. Here, we show that IFNγ induces normal levels of kynurenine in cultures of O2·̄-deficient monocytes, dendritic cells, and polymorphonuclear leukocytes from gp91PHOX- or p47PHOX-deficient human CGD donors. Kynurenine accumulation was dose- and time-dependent as was that of a downstream metabolite, anthranilic acid. Furthermore, urinary and serum levels of kynurenine and a variety of other tryptophan metabolites were elevated rather than suppressed in CGD donors. Although we did not specifically evaluate kyn metabolism in local tissue or inflamed sites in humans, our data demonstrates that O2·̄ anion is dispensable for the rate-limiting step in tryptophan degradation, and CGD patients do not appear to have either hematopoietic cell or systemic deficits in the production of the anti-inflammatory kynurenine molecule.
Fractures of the Second Cervical Vertebra
Authors: Salmon James H.
Published: May 2010

Fractures of the 2nd cervical vertebra are frequently undetected on initial evaluation. Tomography may be necessary to delineate the fracture. This is a report of 20 patients treated by internal fixation using interlaminar wiring. There was no operative mortality. Follow-up studies, an average of 25 months after operation, demonstrated satisfactory results and no evidence of delayed neurological deficit.
Self-contained Tubular Drill Guard for Anterior Cervical Fusion
Authors: Solomon Alexandre , Herz David A.
Published: May 2010

A self-contained tubular drill guard was adapted for use in performing anterior cervical discectomies and interbody fusions. The use of this instrument climinates steps. provides absolute safety against drilling too deeply, allows for adjustment in individual cases, provides for easy inspection of the trephine hole, permits electing the cephalocaudal angle of the drill, and gives a measurement of the ultimate depth of the trephine hole. In 171 consecutive operations only one neurological complication occurred, and total morbidity related to cervical surgery was 6% (7% morbidity was associated with surgery at the donor site). The data suggest that the technical modification herein advocated reduces the surgical complication rate.
Combined Cranio-orbital Surgery for Extensive Malignant Neoplasms of the Orbit
Authors: Sypert George W. , Habal Mutaz B.
Published: May 2010

Extensive, invasive neoplasms of the cranio-orbital region are generally considered to be inoperable and are treated with local radiation therapy and occasionally with chemotherapy. Upon local recurrence of these neoplasms, further treatment efforts are usually deemed futile. Over the past 4 years, 10 patients with extensive neoplasms of the cranioorbital region that were previously thought to be inoperable were referred to us for further evaluation. Five of these patients had failed an intensive course of radiation therapy. Radical regional cranio-orbital resection was performed. The resection included the skin, globe, sphenoid wings, and orbitofrontal bone. The maxillary sinus and nasal septum were left exposed. The exposed dura mater and the frontal and temporal bones were resurfaced with split-thickness skin grafts. All patients in this series have survived free of local disease to date. Combined cranio-orbital resection offers both palliation and a possible cure for patients with extensive, invasive neoplasms of the cranio-orbital region. Reconstructive surgery can be performed using full-thickness flaps after 2 years of observation for local recurrence.
Os Odontoideum in Children
Authors: Dyck Peter
Published: May 2010

The os odontoideum is a congenital anomaly of the 2nd cervical vertebra. It is an ossicle that is separated from the body of the axis by a variable transverse gap. This weakens atlantoaxial stability. When ligamentous support also fails, subluxation ensues. Compressive myelopathy and vertebral artery obliteration may occur. Eight cases, all in children, were studied prospectively. The neurological manifestations and surgical indications and treatment are discussed.
Chronic Intracerebral Hematoma
Authors: Yashon David , Kosnik Edward J.
Published: May 2010

Twelve patients with chronic intracerebral hematoma are reported. This condition may be unrecognized as possibly being benefited by relatively simple diagnostic and therapeutic measures. The neurological symptoms and signs may be acute but may also be intermittent and progressive. The etiology is usually systemic hypertension, but trauma, coagulopathics, and obscure etiologies have been implicated. After diagnosis by computerized tomographic scan and/or arteriography, aspiration of the liquid hematoma usually results in improvement. It is hypothesized that recovery is hastened by removal of the hematoma. Often complete recovery ensues, but mild to severe neurological signs may persist depending on the initial damage.
Evaluation and Surgical Treatment of Congenital Craniofacial Deformities
Authors: Maniscalco Jack E. , Habal Mutaz B.
Published: May 2010

The field of craniofacial surgery has rapidly developed over the last decade in the United States and abroad. Congenital malformations heretofore considered hopeless are now being corrected by a team of specialists working together in the cranial-facial junction. The evaluation of patients for craniofacial surgery must include consideration of associated neurological impairment, and in certain syndromes the incidence of brain malformation and mental retardation are extremely high. The method of evaluation and the various surgical techniques are presented. Mortality rates from this surgery have ranged from 0 to 5%, according to the severity of the deformities.
Regional Cortical Blood Flow at Craniotomy
Authors: Carter Philip L. , White William L. , Atkinson James R.
Published: May 2010

Regional cortical blood flow was monitored at craniotomy in 32 patients with a thermal diffusion flow probe in an attempt to assess the effects of surgical conditions on flow. Changes in flow due to vascular manipulation, retraction, hypotension, and hyperventilation were readily apparent. Eleven patients with supratentorial tumors had intermittent measurements of cerebral blood flow; the expected differences in blood flow with halothane anesthesia and hyperventilation were observed. Fourteen patients with aneurysms were monitored continuously and demonstrated a reduction in flow during hypotension; in two of these cases, the reduction was to disastrously low levels. Flow reduction occurred secondary to branch occlusion by the aneurysm clip in a patient with three middle cerebral artery aneurysms and was corrected by changing the clip position. Direct measurement of regional flow may be of value in estimating the safety of temporary clips and the degree of hypotension that can be tolerated.
Mechanism and Localization of Speech in the Parietotemporal Cortex
Authors: Van Buren J. M. , Fedio P. , Frederick G. Canal
Published: May 2010

Cortical stimulation of the supramarginal and angular gyri elicited dysphasia. Delays in verbal response, misnaming, and difficulties in speech production were also elicited from this region. In two patients speech arrest occurred when stimulation was extended into the occipital cortex and the cortex medial to the supramarginal gyrus, respectively. In a left-handed patient, with speech representation presumed to be in the right hemisphere, neither stimulation nor ablation of the angular gyrus resulted in dysphasia. After anterior temporal resections two patients exhibited dysphasia in association with cortical edema. In one of these an additional resection in the inferior temporo-occipital region produced a marked but transient dyslexia. Observations of the disintegration of speech function during stimulation suggest that such stimulation interferes with a search mechanism by which the nonverbal concept of a visual stimulus is linked to a specific word in memory that is then withdrawn for use. A review of autopsy specimens demonstrates how close the cortex bearing indispensable speech representation lies to the occipital pole and the parietal midline. Because the gyral pattern is obscured by the meninges and is subject to anomalies, elective resection in these areas should be preceded by cortical stimulation and functional mapping.
Diaphragm Pacing in Central von Recklinghausen's Disease
Authors: Richardson Robert R. , Johnson Norris , Cerullo Leonard J.
Published: May 2010

A patient with central von Recklinghausen's disease with multiple lower cranial nerve tumors developed nocturnal central hypoventilation that was successfully treated with diaphragm pacing. An unusual postimplant complication requiring an increased amplitude of stimulation occurred and was later found to be due to a neurofibroma that had partially displaced the electrode cuff off the phrenic nerve.
Value of Computed Tomography in the Diagnosis and Management of Subarachnoid Hemorrhage
Authors: Modesti Luciano M. , Binet Eugene F.
Published: May 2010

The diagnostic value of computed tomography is analyzed in 31 patients with documented spontaneous subarachnoid hemorrhage. In 50% of all cases, the computed tomogram confirmed the presence of subarachnoid hemorrhage. This figure rose to 68% for cooperative patients examined within 24 hours of their ictus. With enhanced tomography the responsible aneurysm was identified in 30% of the cases. The distribution of the subarachnoid hemorrhage correctly predicted the location of the aneurysm in an additional 35%. Intracerebral or intraventricular hemorrhages were present in 35%. They occurred most frequently within the first 24 hours, were most commonly associated with ruptured anterior communicating aneurysms, and carried a poor prognosis. Cerebral infarction was demonstrated in five patients. Ventricular dilatation was present in 11 (63%) of the 19 patients who were examined during the first 24 hours after the hemorrhage. Seven patients showed progressive hydrocephalus on serial scanning. Shunting before aneurysm surgery was required in four cases. Computed tomography is the procedure of choice for the detection of intracerebral and intraventricular hemorrhage and cerebral infarction: it is superior to angiography in this respect. Computed tomography is also helpful in detecting the presence of subarachnoid hemorrhage and determining ventricular size. Frequently the offending aneurysm can be identified or its location can be accurately predicted, allowing more effective management. We recommend that a computerized tomographic scan be performed (preferably within 24 hours of the ictus) on all patients suspected of having had a subarachnoid hemorrhage. The studies should be done before and after enhancement with a contrast medium.
Servo-controlled Lumbar Infusions
Authors: Sklar Frederick H. , Beyer Chester W. , Ramanathan Murugappan , Elashvili Ilya , Cooper Paul R. , Clark Kemp W.
Published: May 2010

The variable rate lumbar subarachnoid infusion technique allows rapid quantitative study of the cerebrospinal fluid (CSF) compartment. Numerous pressure plateaus are studied in a brief time period with a servo-controlled system. The test determines the difference between rates of CSF absorption and formation as a function of pressure. On-line computer data analysis increases experimental efficiency to guarantee statistical significance. Animal and patient data are presented in the report.
Cytotoxic Edema Produced by 6-Aminonicotinamide and Its Response to Therapy
Authors: James Hector E. , Bruce Derek A. , Welsh Frank
Published: May 2010

Cytotoxic brain edema was produced in rabbits with intraperitoneal administration of a metabolic inhibitor, 6-aminonicotinamide. Paraplegia, diminished feeding, globally diminished muscle tone, and poor coordination were evident 48 hours after the initial administration of the drug and the electroencephalogram (EEG) was characterized by pronounced slowing and diminished voltage. Cisternal monitoring of intracranial pressure (at a pACO2 of 38 to 42 torr) revealed that it was significantly higher than in controls (p < 0.001). Measurements of phosphocreatine, lactate, and NADH did not differ from control values, but total nicotinamide adenine dinucleotide (NAD+/NADH) showed a significant decrease in the experimental group (p < 0.001). Water content of the gray matter was significantly higher in the experimental group when compared to that in controls (p < 0.001). Mannitol and furosemide produced a significant reduction in intracranial pressure (ICP) (p < 0.001) and lowered the water content of the gray matter (p < 0.001). Both agents improved the slow wave form of the EEG 20 minutes after their administration intravenously in 50% of the animals. Dexamethasone (1 mg/kg) was administered with 6-aminonicotinamide 2 days before the experimental day. In 50% of this group, the behavior and EEG were similar to those of normal rabbits, and on the experimental day ICP was slightly lower than that in untreated animals (p < 0.01). The decrease in water content of the gray matter in the steroid group was significantly less than that produced by mannitol and furosemide.
Saccular Aneurysm Associated with Absence of the Left Cervical Carotid Arteries
Authors: Waga Shiro , Okada Masahiko , Kojima Tadashi
Published: May 2010

The authors report successful surgical treatment of a patient with an anterior communicating artery aneurysm associated with absence of all of the left cervical carotid arteries. A review of the previous reports of 15 cases of intracranial aneurysm in association with absence of the internal carotid artery emphasizes the rarity of this lesion. Aneurysms with such an association have a distinct distribution different from that observed in the usual population. The data suggest that intracranial aneurysm develops more frequently in the absence of the internal carotid artery as a result of altered hemodynamics.
Cystic Lesions Associated with Intracranial Meningiomas
Authors: Rengachary Setti , Batnitzky Solomon , Kepes John J. , Morantz Robert A. , O'Boynick Paul , Watanabe Itaru
Published: May 2010

Three unusual cases of large, peritumoral cystic lesions associated with intracranial meningiomas are reported. In each case, the cyst caused difficulty in the interpretation of the computed tomogram when the latter was considered as a diagnostic test by itself, but the composite information obtained from the clinical history, cerebral angiography, and a radionuclide brain scan led to the correct preoperative diagnosis. The cyst was extrinsic to the tumor and contained xanthochromic fluid with a high protein content. The cyst wall consisted of brain parenchyma that showed glial cell proliferation (confirmed by the presence of glial fibrillary acidic protein by immunoperoxidase staining).
Diagnostic Brain Biopsy
Authors: Kaufman Howard H. , Catalano Louis W.
Published: May 2010

A consecutive series of 50 diagnostic cerebral biopsies carried out over a 12-year period (1960 to 1972) at The Neurological Institute of New York is reported. The goal of the biopsy was to acquire a definitive diagnosis to aid the patient, counsel the family, and advance scientific knowledge. General indications for biopsy were either chronic bilateral cerebral findings associated with progressive dementia or profound retardation or acute unilateral cerebral findings, usually associated with signs of meningoencephalitis. Four patients were not suitable for analysis, leaving 46 patients to be surveyed. Diagnostic neuropathological features were judged to be present in 17 specimens (37%). Abnormal but not diagnostic pathological changes were found in 22 specimens (48%). Thus, 39 specimens (85%) displayed some abnormality. No apparent neuropathological changes were present in 7 specimens (15%). These findings correspond favorably with the results of others and suggest that a certain “irreducible minimum” of normal biopsies occurs with the techniques utilized. Fourteen (30%) of the patients were known to be alive at the conclusion of the study. Twenty-two patients (48%) had died, but necropsy findings were available for only 10 of these. Except in 2 cases in which biopsies had been normal, no discrepancy was noted between the basic neuropathological changes found at necropsy and those of the biopsy specimen. One death could be directly attributed to the procedure, and total morbidity and mortality was approximately 13%. The authors recommend that any biopsy program should be organized at an institutional level to take into account the patient's special illness and the capabilities of that institution. In addition, suitable material must be forwarded to appropriate experts who have the knowledge and facility to make full use of biopsy material.
Microsurgical Lumbar Discectomy
Authors: Wilson Donald H. , Kenning James
Published: May 2010

The application of microsurgical technique to lumbar discectomy may be of dual value: minimal disruption of the integrity of normal anatomy and meticulous hemostasis may help to speed the process of convalescence, and the retention of epidural fat around the nerve root may help to prevent adhesions, a common cause of the late, “failed disc” syndrome. The authors report their experience with 83 consecutive microdiscectomies for lumbar disc protrusions. The results must be considered as tentative because the follow-up period has been short and the authors found it difficult to quantify the quality of health during the convalescent phase, although this seemed to be excellent. Their short term results are similar to those of the larger series reported by Williams, whose experience with microsurgical lumbar discectomies began 6 years ago. No other series have been reported. The authors describe their technique and compare it to that of Williams.
Successful Management of Bilateral Carotid-Cavernous Fistulae with a Trans-sphenoidal Approach
Authors: Laws Edward R. , Onofrio Burton M. , Pearson Bruce W. , McDonald Thomas J. , Dirrenberger Richard A.
Published: May 2010

A patient with traumatic bilateral carotid-cavernous fistulae was successfully treated by an entirely extracranial approach. The larger fistula on the left was exposed via a transethmoidal, trans-sphenoidal route and was directly opened and packed while the cavernous carotid artery was stented open by an intraluminal balloon catheter. The balloon catheter provided temporary hemostasis and was removed after the fistula had been packed. The left carotid artery remained patent, and the smaller fistula on the right was subsequently obliterated by a balloon catheter. The fistulae have remained cured, and the left internal carotid artery supplies the cerebral circulation.
Cyanoacrylate Occlusion of Carotid-Cavernous Fistula with Preservation of Carotid Artery Flow
Authors: Kerber Charles W. , Bank William O. , Cromwell Laurence D.
Published: May 2010

We report a new treatment for carotid-cavernous fistula. Using a flow-guided, balloon-tipped microcatheter, we catheterize the fistula itself, verify balloon entry into the fistula with fluoroscopy and x-ray films, and then infuse the tissue adhesive isobutyl-2-cyanoacrylate with careful fluoroscopic control. Three patients have had their fistulas occluded, with preservation of flow through the internal carotid artery. This balloon microcatheter allows the radiologist to perform a reversible test occlusion. All three patients had neurological changes during or after the procedure, and in one we inadvertently occluded several distal middle cerebral artery branches without permanent neurological deficit. No patient became blind or developed 3rd, 4th, or 6th nerve palsy from the treatment. This technique seems to have promise as another method for the obliteration of carotid-cavernous fistula.
Spinal Subdural Cyst Associated with a Meningioma
Authors: Morley Thomas P.
Published: May 2010

An extensive spinal subdural cyst was unexpectedly encountered during an operation for the removal of a thoracic spinal meningioma. The gross and microscopic appearances of the cyst are described. It coexisted with a meningioma, but no definite conclusion can be drawn regarding the etiology of this cyst.
Primary Intraosseous Meningioma Presenting as a Solitary Osteolytic Skull Lesion
Authors: Pearl Gary S. , Takei Yoshio , Parent Andrew D. , Boehm Walter M.
Published: May 2010

Meningiomas that are either intraosseous in origin or osteolytic are rare. Intraosseous meningiomas are generally osteoblastic. Our case is the second reported case of a primary intraosseous meningioma presenting as an osteolytic skull lesion.
Enhancement of Experimental Cerebral Edema after Decompressive Craniectomy
Authors: Cooper Paul R. , Hagler Herbert , Clark Kemp W. , Barnett Peggy
Published: May 2010

Decompressive craniectomy has been advocated as a treatment for the cerebral edema associated with massive head injury. Although craniectomy has been successful in lowering intracranial pressure after head injury, a comparison of computerized tomographic scans of comparable patients with traumatic brain edema treated by medical means or decompressive craniectomy showed that bony decompression resulted in apparent exacerbation of edema. To investigate the possibility of enhancement of brain edema by craniectomy, we produced standardized cold lesions in the brains of 10 dogs. Five animals served as controls. In the other 5 animals we performed large decompressive craniectomies after lesioning. Physiological parameters were comparable in both groups. The dogs were killed 8 hours after lesioning. After fixation, their brains were cut into 1-mm-thick slices. We used an image analysis facility built around a PDP 11/05 computer to measure the volume of edema as outlined by Evans blue staining. The mean volume of the brain edema in the control animals was 0.27 ± 0.19 ml. Mean edema volume was over 7 times greater in craniectomized animals (1.96 ± 1.89 ml). This difference is statistically significant (p < 0.05). The driving force for the formation of edema fluid is the difference between intravascular and interstitial pressure. Decompression of the brain by bone removal probably results in a reduction of interstitial fluid pressure and edema enhancement. The clinical literature contains no evidence that craniectomy decreases the morbidity or mortality of human head injury. In view of our experimental findings, this is not surprising. Indeed, pathological evidence indicates that severe edema (such as that accentuated by craniectomy) may produce permanent changes in the neuropil.
Recurrent Intracerebral Blastomycotic Granuloma
Authors: Morgan David , Young Ronald F. , Chow Anthony W. , Mehringer Mark C. , Itabashi Hideo
Published: May 2010

We present a patient with a recurrent intracerebral blastomycotic granuloma. The computerized tomographic scan appearance of this lesion is illustrated. Of the 81 reported cases of intracranial blastomycosis, only 35 have represented solid intracerebral lesions; the other patients have had spinal lesions or meningitis. This patient represents the first reported recurrence of an intracerebral blastomycotic granuloma. The treatment utilized, surgical resection combined with intravenous and intraventricular amphotericin B, represents a unique approach to this problem. The diagnosis and currently advocated treatment of intracranial blastomycosis is reviewed, particularly in regard to the potential for recurrence of blastomycosis.
Candida albicans Mycotic Aneurysm Associated with Systemic Lupus Erythematosus
Authors: Goldman John A. , Fleischer Alan S. , Leifer William , Parent Andrew , Schwarzman Stephen W. , Raggio John
Published: May 2010

A 16-year-old girl with systemic lupus erythematosus and diabetes mellitus who was receiving prednisone, azathioprine, and insulin developed headaches, fever, irritability, and seizures. Studies revealed a large proximal basilar artery aneurysm with subarachnoid hemorrhage. Despite intubation and a ventriculopleural shunt, she became decerebrate and died. Postmortem studies revealed that this patient had an intracranial mycotic aneurysm due to Candida albicans.
Xanthogranulomas of the Third Ventricle
Authors: Rush Jeffery L. , Kusske John A. , Porter Robert W. , Pribram Henry W.
Published: May 2010

Two patients with xanthogranuloma of the 3rd ventricle are described. In each instance the tumor obstructed the interventricular foramina and caused dilatation of the lateral ventricles and signs of increased intracranial pressure; computerized tomography demonstrated the dense, nonenhancing lesion in the anterior 3rd ventricle. The pathogenesis of these rare tumors is discussed. These cases affirm the need to consider xanthogranuloma in the differential diagnosis of anterior 3rd ventricle tumors in adults.
Cranioplasty
Authors: Rish Berkley L. , Dillon J. Daniel , Meirowsky Arnold M. , Caveness William F. , Mohr Jay P. , Kistler J. Philip , Weiss George H.
Published: May 2010

abstract

A total of 491 cranioplasties performed in a population of 1030 cases of penetrating head injury are reviewed. The morbidity rate was 5.5%, and the mortality rate was 0.2%. The clinical criteria of improving cosmetic defects and restoring craniocerebral protection are established, based on the location and size of the skull defect. Cranioplasty after penetrating head injury should be deferred for a minimum of 1 year to control morbidity. Complications of the original injury and surgical debridement increase the morbidity rate of cranioplasty. Post-traumatic epilepsy is not related to skull defects per se; neither is it affected by cranioplasty. Acrylic is an acceptable cranioplasty material if there is strict adherence to good surgical technique.
Hydatid Cyst of the Skull
Authors: Gökalp Hamit Z. , Kanpolat Yücel , Gökben Bekir
Published: May 2010

abstract

A rare case of hydatid cyst of the skull is presented. The presenting symptom was an acute increase of the intracranial pressure. The patient was operated upon under emergency conditions with the diagnosis of a cystic lesion of the brain. After a brief review of the literature, the symptomatology of the disease is discussed. It is emphasized that radiological studies, especially plain x-ray films of the skull, are most important in diagnosing the disease.
Distal Anterior Cerebral Artery Aneurysm
Authors: Becker Dennis H. , Newton Thomas H.
Published: May 2010

abstract

The incidence of aneurysms of the distal anterior cerebral artery (DACA) has been reported at 2 to 4%. In this paper we report a series of 12 patients with DACA aneurysms diagnosed at various hospitals in the San Francisco area during the past 10 years. The clinical presentation, surgical approach, and anatomical location are reviewed. Comparisons are made between traumatic, mycotic, and berry DACA aneurysms.
Autonomic Hyper-reflexia Modulated by Percutaneous Epidural Neurostimulation
Authors: Richardson Robert R. , Cerullo Leonard J. , Meyer Paul R.
Published: May 2010

abstract

Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.
Needle Biopsy of Intracranial Lesions Guided by Computerized Tomography
Authors: Hahn Joseph F. , Levy Walter J. , Weinstein Meredith J.
Published: May 2010

abstract

Biopsies can be performed directly with computerized tomography (CT) head scanners with some difficulty. The small scanning orifice does not allow enough room for needle placement; therefore, biopsy is difficult. In contrast, the scanning orifice of the CT body scanner is large enough to permit biopsies without hindrance. Over 300 CT-guided abdominal biopsy procedures have been performed at the Cleveland Clinic Foundation. We are reporting the technique and the results of 14 CT-guided brain biopsies. There were no complications in the series and an accurate diagnosis was made for 13 of the 14 patients.
Extracranial-Intracranial Arterial Bypass in the Treatment of Aneurysms of the Carotid and Middle Cerebral Arteries
Authors: Hopkins Leo Nelson , Grand Walter
Published: May 2010

abstract

Eleven patients with lesions of the internal carotid and middle cerebral arteries that could not be treated by direct approach are presented. Major vessel occlusion was chosen as definitive therapy. Prophylactic extracranial-intracranial bypass was employed in an attempt to reduce the incidence of ischemic complications. Emphasis is placed on complications, from which several important lessons were learned. Our best results occurred in patients with carotid artery lesions treated with bypass and immediate internal carotid ligation. We believe this to be an effective and safe mode of therapy in cases in which direct approach is not feasible. The low risk and high potential benefit of prophylactic bypass justifies its use before major vessel occlusion in selected cases.
Traumatic Lesions of the Corpus Callosum
Authors: Komatsu Shinro , Sato Tomohiko , Kagawa Shigeki , Mori Teruaki , Namiki Tsuneo
Published: May 2010

abstract

We investigated the mechanism of damage to the corpus callosum in a study of 46 brains obtained at the autopsies of patients with head injuries. After correlating the gross findings with the site of impact on the head, we think that such lesions in the corpus callosum are caused by stretching of callosal fibers and/or shearing forces in cases in which lateral movement or twisting of the brain occurs. This mechanism of the dynamic development of callosal injuries is also supported by the retraction bulb formation of axons found histologically in the corpus callosum.
Symptomatic Cyst of the Choroid Plexus of the Lateral Ventricle
Authors: Giorgi C.
Published: May 2010

abstract

A case of symptomatic cyst of the choroid plexus of a lateral ventricle in a child is reported. The characteristics of the case are compared with those of the other three cases in the literature.
Blunt Trauma to the High Cervical Carotid Artery
Authors: Batzdorf Ulrich , Bentson John R. , Machleder Herbert I.
Published: May 2010

Closed injuries to the neck, occasionally associated with mandibular fractures, can result in trauma to the internal carotid artery at the high cervical level opposite the uppermost cervical vertebrae. Such arterial injuries range from spasm to intimal tear with thrombus formation, medial tear, and aneurysm formation. These types of lesions may overlap. Ten patients are presented, five with traumatic carotid occlusions and five with traumatic aneurysms. The clinical diagnosis of traumatic cervical carotid occlusion may be difficult because of the absence of physical trauma to the neck. The diagnosis of aneurysm poses fewer problems. Oculopneumoplethysmography, computerized tomographic head scanning, and carotid arteriography with cross compression are the most useful diagnostic techniques. Thrombectomy should be carried out early, particularly in the presence of fluctuating neurological signs. Aneurysms that cannot be approached directly may necessitate carotid ligation.
Ommaya Reservoir Placement
Authors: Leavens Milam E. , Aldama-Luebert Alfonso , Aldama-Luebert Alfonso
Published: May 2010

The technique of Ommaya reservoir placement in the frontal region is described.