bluuebunny/crossref_metadata_2025 huggingface dataset:
The succession of cutaneous melanophore populations in Taricha torosa
Authors: McCurdy H. M.
Published: April 2011

The normal developmental sequence of the dermal and epidermal melanophores in the California newt, Taricha torosa, with the first documentation of melanoblasts after hatching, is presented. It is shown that the first larval melanophore population of the dorsal integument is confined to the dermis, and that a chronologically separate second melanophore population is confined to the epidermis. This second population of melanophores begins to appear late in larval development and eventually provides the dorsal brown pigmentation of the adult.
A photographic analysis of the air breathing behavior of the catfish, Plecostomus punctatus
Authors: Gradwell Norman
Published: April 2011

In well-aerated aquaria, Plecostomus appears to rely on gill irrigation alone. If aeration is stopped, these fishes complement gill irrigation with regular air breaths at the water surface. At 22C the inhaled air is retained in the well-vascularized stomach of adults, usually for 7 to 12 min. The expulsion of gas through the opercular and oral apertures occurs while the fish is submerged. Both opercular cavities have a membranous lining which is interrupted only at the gill clefts and opercular outlet. The behavior of the fishes varies cyclically with gastroventilation. They also make four basic types of excursion to and from the water surface.
Composition of adipose tissue triglycerides of the elk (Cervus canadensis), caribou (Rangifer tarandus groenlandicus), moose (Alces alces), and white-tailed deer (Odocoileus virginianus)
Authors: Garton G. A. , Duncan W. R. H. , McEwan Ε. Η.
Published: April 2011

Triglycerides were extracted from perinephric and subcutaneous adipose tissue of one male and one female elk, caribou, moose, and white-tailed deer. The fatty acid composition of each triglyceride sample was determined.
The life cycles of Bunodera sacculata and B. luciopercae (Trematoda: Allocreadiidae) in Algonquin Park, Ontario
Authors: Cannon L. R. G.
Published: April 2011

Miracidia of Bunodera sacculata and Bunodera luciopercae develop into sporocysts in the gills of Pisidium variabile, where rediae are first produced after 60 to 70 days at 20C. Each redia has a well-developed pharynx, but neither gut nor lateral processes. Mature rediae, each with a birth pore and a degenerate pharynx, occur near the clam's gonad and contain ophthalmoxiphidiocercariae with a flame cell formula 2[(3+3+3) + (3+3+3)]. Cercarial stylets of B. sacculata and B. luciopercae are 15 and 18 long respectively. Only cercariae of B. sacculata have cystogenous glands. Infective metacercariae of B. sacculata develop in Daphnia similis and Moina affinis within 6 days and have well-developed reproductive structures unlike those of B. luciopercae, which develop within 12 days in Hyalella azteca and Crangonyx gracilis. Juvenile B. sacculata retain dark granules in the excretory bladder until they mature, which is within 3 weeks in the intestine of Perca flavescens. B. luciopercae juveniles, which expel the contents of the excretory bladder when they excyst, mature slowly, gradually moving from the gall bladder, where they first establish, to the intestine, where the first eggs are produced after 5 or 6 months. In B. sacculata spermatogenesis is abortive and reproduction parthenogenetic.
Overwintering ecology of the aquatic fauna associated with the pitcher plant Sarracenia purpurea L.
Authors: Paterson C. G.
Published: April 2011

Larvae of Metriocnemus knabi (Chironomidae) and Wyeomyia smithii (Culicidae) are frozen into their habitat for about 4 months in the winter. Under these conditions the overwintering mortality is estimated to be less than 5%.
Predicted female bias in sex ratios of hatchling loggerhead sea turtles from a Florida nesting beach
Authors: Hanson JoAnne , Wibbels Thane , Martin R Erik
Published: April 2011

Incubation temperatures in loggerhead sea turtle (Caretta caretta) nests were examined as a method for predicting hatchling sex ratios. Incubation temperatures were recorded in 40 nests that were laid on Hutchinson Island, Florida. Small temperature data loggers were placed directly in nests (in the center of the egg mass) and were programmed to record temperature every 1.2 h for the entire incubation period. Nests laid during the early, middle, and late portions of the peak nesting period (June and July) were examined. The nests were equally distributed on an untreated beach and a beach that had been artificially supplemented with sand to compensate for erosion. Three nests received multiple data loggers to assess temperature variation within the nest. The average daily temperatures within these nests varied from a maximum of 2.1°C at the top of the egg chamber to a minimum of 0.4°C at the bottom. During the thermosensitive period, temperatures in the center of the egg mass were significantly higher than those at the top and bottom of the egg chamber (average difference was 0.4 and 0.9°C, respectively). Incubation temperatures within all 40 nests were relatively high, suggesting an overall sex ratio that is highly female biased. Using nest temperature during the thermosensitive period as a predictor, the hatchlings from 37 of the 40 nests were predicted to be 100% female (i.e., 92.5% of the nests). The other three nests had been laid adjacent to or in contact with the vegetation bordering the beach and were shaded by the vegetation during the afternoon. Two of these nests were predicted to produce female-biased sex ratios and one was predicted to produce a sex ratio of nearly 1:1. For beaches examined, the sex ratios were highly female-biased; however, nest temperatures on the beach supplemented with sand were significantly higher than those on the untreated beach. The highly biased sex ratio predicted for Hutchinson Island is similar to that estimated for another C. caretta nesting beach located at Cape Canaveral, Florida. These data collectively suggest that C. caretta nesting along the Atlantic coast of Florida consistently produce hatchlings whose sex ratios are distinctly female-biased.
Development and application of a spatially explicit moose population model
Authors: McKenney Daniel W , Rempel Robert S , Venier Lisa A , Wang Yonghe , Bisset Alan R
Published: April 2011

We developed spatially explicit models of moose (Alces alces) population density for the province of Ontario using the geostatistical technique kriging. The models were based on moose surveys divided into four time periods from 1975 to 1995. Density change was calculated for the 1975-1979, 1980-1984, 1985-1989, and 1990-1995 time periods to visualize regional trends in population change. Between 1975 and 1995, moose density increased in the northwest and southeast parts of the province and decreased in some northern pockets. A marked increase in density occurred in the late 1980s, when both the selective moose harvest system and moose habitat guidelines were introduced in Ontario. Although a general increase in survey effort occurred in about 1986, no effect of survey effort was detected on moose population change between the first and last time periods (P = 0.215). To evaluate the possible effect of reducing number of survey plots on density estimates, we recreated density maps by using 25, 50, and 75% of the original data and compared the full-data maps with the reduced-data maps. The regression slopes and r2 for reduced-data versus full-data maps approached 1.0 as sample rate increased from 25 to 75% (B = 0.88, 0.86, and 0.96; r2 = 0.82, 0.88, and 0.95). A kappa analysis also suggests an acceptable performance of the 75% data map (kappa = 0.716).
Phylogenetic placement of Ectemnia, an autapomorphic black fly (Diptera: Simuliidae), using behavioural characters
Authors: Stuart A E , Hunter F F
Published: April 2011

The black fly genus Ectemnia Enderlein possesses a number of autapomorphic (unique derived structural) features in the larval and adult stages that have made resolution of its phylogenetic relationship within the Simuliidae difficult to establish. We studied cocoon-spinning behaviour in Ectemnia invenusta and discovered synapotypies (shared derived behavioural characters) with other black fly taxa. A behavioural phylogenetic analysis performed on representatives of six black fly genera produced a single most parsimonious tree that places Ectemnia as the sister group of a Simulium + Eusimulium clade.
Role of social and endocrine factors in alloparental behavior of prairie voles (Microtus ochrogaster)
Authors: Roberts R Lucille , Miller Amanda K , Taymans Susan E , Carter C Sue
Published: April 2011

Young, sexually naive prairie voles (Microtus ochrogaster), 21-60 days of age, of both sexes readily exhibit alloparental behavior toward pups without apparent hormonal or experiential priming. The goal of the present study was to quantify the incidence of spontaneously evoked alloparental behavior in young prairie voles and determine prior pup experience (i), gender-related (ii) and age-related (iii) characteristics, and hormonal (iv) and housing (v) conditions associated with alloparental behavior. Overall, 70% of all prairie voles between 21 and 60 days of age exhibited alloparental behavior regardless of hormonal condition or postweaning housing condition (single versus sib-group housing). Experience with pups prior to weaning was associated with a greater percentage of prairie voles exhibiting alloparental responding in comparison with prairie voles that had never been exposed to pups. Male prairie voles were more likely to be alloparental than were females, although most females (64%) exhibited alloparental behavior. Differences in qualitative variables associated with alloparental responsiveness were present between prairie voles <40 days of age and those >=40 days of age, although both age groups responded parentally in equal numbers. This study suggests that although a short period of prior experience may promote the expression of alloparental behavior in young prairie voles, alloparental behavior occurs in most animals in all groups examined. Hormonal, sex-related or age-related changes that might be associated with development, reproductive suppression, or social stress are not related to the differential expression of alloparental behavior.
Ethmoid Adenocarcinoma—From Craniofacial to Endoscopic Resections
Authors: Nicolai Piero , Villaret Andrea Bolzoni , Bottazzoli Marco , Rossi Emanuela , Valsecchi Maria Grazia
Published: April 2011

Objectives

To identify factors that influence hospitalization time, complications, and prognosis of patients with ethmoid adenocarcinoma treated with different surgical techniques.

Design

Single‐institution retrospective review.

Setting

Academic tertiary care center.

Patients

Sixty‐seven patients with ethmoid adenocarcinoma treated from January 1985 to August 2009 were retrospectively evaluated. Surgical treatment included endoscopic resection (n = 12), endoscopic resection with transnasal craniectomy (n = 17), cranioendoscopic resection (n = 9), external approaches limited to the ethmoid (n = 11), and craniofacial resection (n = 18).

Main Outcome Measures

A Cox model was adopted to relate time to death to previous treatment, pT category, grade, and surgical technique. The impact of the same variables on hospitalization time and risk of complications was assessed by linear regression and logistic regression, respectively.

Results

The risk of complications increased for pT4a‐b lesions (P =. 02) and craniofacial resection (P =. 01). Hospitalization time increased by 6.3 days for cranioendoscopic resection (P =. 03) and by 11.7 days for craniofacial resection (P <. 001). Three‐ and 5‐year overall survivals were 68.0% (standard error = 5.8%) and 48.4% (standard error = 6.9%). Three‐year survival was 76.62% and 51.81% for previously untreated and treated patients, respectively, and it was 92.98% and 33.33% in patients treated with endoscopic techniques and craniofacial resection, respectively. Multivariate analysis showed that previous treatment (hazard ratio of death = 3.9, P =. 01) and craniofacial resection (HR = 5.16, P =. 05) were mainly associated with survival.

Conclusions

Endoscopic techniques, in properly selected patients, were associated with a favorable oncologic outcome and a statistically significant reduction in both complication rate and hospitalization time. This study supports the role of endoscopic techniques in surgical treatment of ethmoid adenocarcinoma.
Histopathological Characteristics of Sulcus Vocalis
Authors: Sunter Ahmet Volkan , Yigit Ozgur , Huq Gulben Erdem , Alkan Zeynep , Kocak Ismail , Buyuk Yalcın
Published: April 2011

Objective

To describe the frequency of sulcus vocalis in a population and to establish its histopathological properties.

Study Design

A cadaver study.

Setting

Istanbul Training and Research Hospital and Ministry of Justice National Forensic Institute.

Subjects and Methods

One hundred (21 women, 79 men) fresh cadaver larynges were examined. Two hundred vocal folds were coronally sectioned and examined by light microscopy. Sulcus types, depths, degree of fibrosis in Reinke space, basement membrane thickness, and perisulcus degeneration were determined.

Results

Sulcus vocalis was found in 39 of 100 cases (39%), with a male preponderance of 41.8% compared with women at 28.6%. Twenty‐one (54%) cases had unilateral and 18 (46%) cases had bilateral sulcus. Among 200 vocal folds, 57 had sulcus (28%). A total of 21 sulcus cases were type 1 (37%), 18 were type 2 (31.5%), and the remaining 18 cases were type 3 (31.5%). Of the 39 (30.7%) sulcus cases, 12 were confirmed by histopathological examination, although they looked morphologically normal following macroscopic evaluation. Vocal ligament involvement was found in 14 cases with type 2 (78%) and in 15 cases with type 3 sulcus (83%).

Conclusion

Sulcus vocalis is a common pathology in the population and can be observed at all ages. The accuracy of diagnosis seems to depend on the measurement of the sulcus depth and the histological characteristics. For this reason, tools and strategies should be established in living subjects for effective management of this challenging disorder.
Genetic predictors for stroke in children with sickle cell anemia
Authors: Flanagan Jonathan M. , Frohlich Denise M. , Howard Thad A. , Schultz William H. , Driscoll Catherine , Nagasubramanian Ramamoorthy , Mortier Nicole A. , Kimble Amy C. , Aygun Banu , Adams Robert J. , Helms Ronald W. , Ware Russell E.
Published: April 2011

Stroke is a devastating complication of sickle cell anemia (SCA), affecting 5% to 10% of patients before adulthood. Several candidate genetic polymorphisms have been proposed to affect stroke risk, but few have been validated, mainly because previous studies were hampered by relatively small sample sizes and the absence of additional patient cohorts for validation testing. To verify the accuracy of proposed genetic modifiers influencing stroke risk in SCA, we performed genotyping for 38 published single nucleotide polymorphisms (SNPs), as well as α-thalassemia, G6PD A− variant deficiency, and β-globin haplotype in 2 cohorts of children with well-defined stroke phenotypes (130 stroke, 103 nonstroke). Five polymorphisms had significant influence (P < .05): SNPs in the ANXA2, TGFBR3, and TEK genes were associated with increased stroke risk, whereas α-thalassemia and a SNP in the ADCY9 gene were linked with decreased stroke risk. Further investigation at these genetic regions may help define mutations that confer stroke risk or protection in children with SCA.
MiRPara: a SVM-based software tool for prediction of most probable microRNA coding regions in genome scale sequences
Authors: Wu Yonggan , Wei Bo , Liu Haizhou , Li Tianxian , Rayner Simon
Published: April 2011

Background

MicroRNAs are a family of ~22 nt small RNAs that can regulate gene expression at the post-transcriptional level. Identification of these molecules and their targets can aid understanding of regulatory processes. Recently, HTS has become a common identification method but there are two major limitations associated with the technique. Firstly, the method has low efficiency, with typically less than 1 in 10,000 sequences representing miRNA reads and secondly the method preferentially targets highly expressed miRNAs. If sequences are available, computational methods can provide a screening step to investigate the value of an HTS study and aid interpretation of results. However, current methods can only predict miRNAs for short fragments and have usually been trained against small datasets which don't always reflect the diversity of these molecules.

Results

We have developed a software tool, miRPara, that predicts most probable mature miRNA coding regions from genome scale sequences in a species specific manner. We classified sequences from miRBase into animal, plant and overall categories and used a support vector machine to train three models based on an initial set of 77 parameters related to the physical properties of the pre-miRNA and its miRNAs. By applying parameter filtering we found a subset of ~25 parameters produced higher prediction ability compared to the full set. Our software achieves an accuracy of up to 80% against experimentally verified mature miRNAs, making it one of the most accurate methods available.

Conclusions

miRPara is an effective tool for locating miRNAs coding regions in genome sequences and can be used as a screening step prior to HTS experiments. It is available at http://www.whiov.ac.cn/bioinformatics/mirpara
Open and hidden agendas of "asymptomatic" patients who request check-up exams
Authors: Hunziker Sabina , Schläpfer Martin , Langewitz Wolf , Kaufmann Gilbert , Nüesch Reto , Battegay Edouard , Zimmerli Lukas U
Published: April 2011

Background

Current guidelines for a check-up recommend routine screening not triggered by specific symptoms for some known risk factors and diseases in the general population. Patients' perceptions and expectations regarding a check-up exam may differ from these principles. However, quantitative and qualitative data about the discrepancy between patient- and provider expectations for this type of clinic consultation is lacking.

Methods

For a year, we prospectively enrolled 66 patients who explicitly requested a "check-up" at our medical outpatient division. All patients actively denied upon prompting having any symptoms or specific health concerns at the time they made their appointment. All consultations were videotaped and analysed for information about spontaneously mentioned symptoms and reasons for the clinic consultation ("open agendas") and for cues to hidden patient agendas using the Roter interaction analysis system (RIAS).

Results

All patients initially declared to be asymptomatic but this was ultimately the case in only 7 out of 66 patients. The remaining 59 patients spontaneously mentioned a mean of 4.2 ± 3.3 symptoms during their first consultation. In 23 patients a total of 31 hidden agendas were revealed. The primary categories for hidden agendas were health concerns, psychosocial concerns and the patient's concept of disease.

Conclusions

The majority of patients requesting a general check-up tend to be motivated by specific symptoms and health concerns and are not "asymptomatic" patients who primarily come for preventive issues. Furthermore, physicians must be alert for possible hidden agendas, as one in three patients have one or more hidden reasons for requesting a check-up.
Analysis of frailty and survival from late middle age in the Beijing Longitudinal Study of Aging
Authors: Shi Jing , Song Xiaowei , Yu Pulin , Tang Zhe , Mitnitski Arnold , Fang Xianghua , Rockwood Kenneth
Published: April 2011

Background

Frailty in individuals can be operationalized as the accumulation of health deficits, for which several trends have been observed in Western countries. Less is known about deficit accumulation in China, the country with the world's largest number of older adults.

Methods

This study analyzed data from the Beijing Longitudinal Study of Aging, to evaluate the relationship between age and deficit accumulation in men and women and to evaluate the impact of frailty on mortality. Community dwelling people aged 55+ years at baseline (n = 3275) were followed every two to three years between 1992 and 2000, during which time 36% died. A Frailty Index was constructed using 35 deficits, drawn from a range of health problems, including symptoms, disabilities, disease, and psychological difficulties.

Results

Most deficits increased the eight-year risk of death and were more lethal in men than in women, although women had a higher mean level of frailty (Frailty Index = 0.11 ± 0.10 for men, 0.14 ± 0.12 for women). The Frailty Index increased exponentially with age, with a similar rate in men and women (0.038 vs. 0.039; r > 0.949, P < 0.01). A dose-response relationship was observed as frailty increased.

Conclusions

A Frailty Index employed in a Chinese sample, showed properties comparable with Western data, but deficit accumulation appeared to be more lethal than in the West.
Income level and regional policies, underlying factors associated with unwarranted variations in conservative breast cancer surgery in Spain
Authors: Ridao-López Manuel , García-Armesto Sandra , Abadía-Taira Begoña , Peiró-Moreno Salvador , Bernal-Delgado Enrique
Published: April 2011

Background

Geographical variations in medical practice are expected to be small when the evidence about the effectiveness and safety of a particular technology is abundant. This would be the case of the prescription of conservative surgery in breast cancer patients. In these cases, when variation is larger than expected by need, socioeconomic factors have been argued as an explanation. Objectives: Using an ecologic design, our study aims at describing the variability in the use of surgical conservative versus non-conservative treatment. Additionally, it seeks to establish whether the socioeconomic status of the healthcare area influences the use of one or the other technique.

Methods

81,868 mastectomies performed between 2002 and 2006 in 180 healthcare areas were studied. Standardized utilization rates of breast cancer conservative (CS) and non-conservative (NCS) procedures were estimated as well as the variation among areas, using small area statistics. Concentration curves and dominance tests were estimated to determine the impact of income and instruction levels in the healthcare area on surgery rates. Multilevel analyses were performed to determine the influence of regional policies.

Results

Variation in the use of CS was massive (4-fold factor between the highest and the lowest rate) and larger than in the case of NCS (2-fold), whichever the age group. Healthcare areas with higher economic and instruction levels showed highest rates of CS, regardless of the age group, while areas with lower economic and educational levels yielded higher rates of NCS interventions. Living in a particular Autonomous Community (AC), explained a substantial part of the CS residual variance (up to a 60.5% in women 50 to 70).

Conclusion

The place where a woman lives -income level and regional policies- explain the unexpectedly high variation found in utilization rates of conservative breast cancer surgery.
Activation of NAG-1 via JNK signaling revealed an isochaihulactone-triggered cell death in human LNCaP prostate cancer cells
Authors: Chiu Sheng-Chun , Wang Mei-Jen , Yang Hsueh-Hui , Chen Shee-Ping , Huang Sung-Ying , Chen Yi-Lin , Lin Shinn-Zong , Harn Horng-Jyh , Pang Cheng-Yoong
Published: April 2011

Background

We explored the mechanisms of cell death induced by isochaihulactone treatment in LNCaP cells.

Methods

LNCaP cells were treated with isochaihulactone and growth inhibition was assessed. Cell cycle profiles after isochaihulactone treatment were determined by flow cytometry. Expression levels of cell cycle regulatory proteins, caspase 9, caspase 3, and PARP were determined after isochaihulactone treatment. Signaling pathway was verified by inhibitors pre-treatment. Expression levels of early growth response gene 1 (EGR-1) and nonsteroidal anti-inflammatory drug-activated gene 1 (NAG-1) were determined to investigate their role in LNCaP cell death. NAG-1 expression was knocked down by si-NAG-1 siRNA transfection. Rate of cell death and proliferation were obtained by MTT assay.

Results

Isochaihulactone caused cell cycle arrest at G2/M phase in LNCaP cells, which was correlated with an increase of p53 and p21 levels and downregulation of the checkpoint proteins cdc25c, cyclin B1, and cdc2. Bcl-2 phosphorylation and caspase activation were also observed. Isochaihulactone induced phosphorylation of c-Jun-N-terminal kinase (JNK), and JNK inhibitor partially reduced isochaihulactone-induced cell death. Isochaihulactone also induced the expressions of EGR-1 and NAG-1. Expression of NAG-1 was reduced by JNK inhibitor, and knocking down of NAG-1 inhibited isochaihulactone-induced cell death.

Conclusions

Isochaihulactone apparently induces G2/M cell cycle arrest via downregulation of cyclin B1 and cdc2, and induces cellular death by upregulation of NAG-1 via JNK activation in LNCaP cells.
Antitumour effects of single or combined monoclonal antibodies directed against membrane antigens expressed by human B cells leukaemia
Authors: Loisel Séverine , André Pierre-Alain , Golay Josee , Buchegger Franz , Kadouche Jean , Cérutti Martine , Bologna Luca , Kosinski Marek , Viertl David , Delaloye Angelika Bischof , Berthou Christian , Mach Jean-Pierre , Boumsell Laurence
Published: April 2011

Background

The increasing availability of different monoclonal antibodies (mAbs) opens the way to more specific biologic therapy of cancer patients. However, despite the significant success of therapy in breast and ovarian carcinomas with anti-HER2 mAbs as well as in non-Hodkin B cell lymphomas with anti-CD20 mAbs, certain B cell malignancies such as B chronic lymphocytic leukaemia (B-CLL) respond poorly to anti-CD20 mAb, due to the low surface expression of this molecule. Thus, new mAbs adapted to each types of tumour will help to develop personalised mAb treatment. To this aim, we analyse the biological and therapeutic properties of three mAbs directed against the CD5, CD71 or HLA-DR molecules highly expressed on B-CLL cells.

Results

The three mAbs, after purification and radiolabelling demonstrated high and specific binding capacity to various human leukaemia target cells. Furtherin vitroanalysis showed that mAb anti-CD5 induced neither growth inhibition nor apoptosis, mAb anti-CD71 induced proliferation inhibition with no early sign of cell death and mAb anti-HLA-DR induced specific cell aggregation, but without evidence of apoptosis. All three mAbs induced various degrees of ADCC by NK cells, as well as phagocytosis by macrophages. Only the anti-HLA-DR mAb induced complement mediated lysis. Coincubation of different pairs of mAbs did not significantly modify the in vitro results. In contrast with these discrete and heterogeneousin vitroeffects,in vivothe three mAbs demonstrated marked anti-tumour efficacy and prolongation of mice survival in two models of SCID mice, grafted either intraperitoneally or intravenously with the CD5 transfected JOK1-5.3 cells. This cell line was derived from a human hairy cell leukaemia, a type of malignancy known to have very similar biological properties as the B-CLL, whose cells constitutively express CD5. Interestingly, the combined injection of anti-CD5 with anti-HLA-DR or with anti-CD71 led to longer mouse survival, as compared to single mAb injection, up to complete inhibition of tumour growth in 100% mice treated with both anti-HLA-DR and anti-CD5.

Conclusions

Altogether these data suggest that the combined use of two mAbs, such as anti-HLA-DR and anti-CD5, may significantly enhance their therapeutic potential.
Giant Pediatric Aneurysm Treated with Ligation of the Middle Cerebral Artery with the Drake Tourniquet and Extracranial-Intracranial Bypass
Authors: Lansen Thomas A. , Kasoff Samuel S. , Arguelles Joseph H.
Published: April 2011

Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9-year-old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery-middle cerebral artery anastomosis without excision of the lesion.
Treatment of Acute Traumatic Internal Carotid Artery Occlusion with Extracranial-to-Intracranial Arterial Bypass: Case Report
Authors: Andrews Brian T.
Published: April 2011

Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35-year-old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high-flow extracranial-intracranial arterial bypass graft led to rapid recovery of hemispheric function. High-flow extracranial-intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery.
Intramedullary Cavernous Angioma with Trigeminal Neuralgia: A Case Report and Review of the Literature
Authors: Saito Nobuhito , Yamakawa Kenta , Sasaki Tomio , Saito Isamu , Takakura Kintomo
Published: April 2011

A case of intramedullary cavernous angioma of the upper cervical spinal cord, initially associated with trigeminal neuralgia, is reported. Magnetic resonance imaging precisely depicted the entire extent of the lesion. The angioma was totally removed and the operation was successful in relieving the patient of neuralgia. The previously reported 23 cases of intramedullary cavernous angiomas are reviewed, and the clinical symptoms, diagnosis, and treatment of this rare condition are discussed.
Benign Osteoblastoma of the Parietal Bone: Case Report
Authors: Martin-Ferrer Secundino
Published: April 2011

A case of benign osteoblastoma of the parietal bone is presented. Attention is drawn first to the rarity of this tumor and second to the fact that the radiological and histopathological features of the tumor reported here lead us to suspect the presence of regressive features in its evolution.
Intracranial and Spinal Meningiomas in Patients with Breast Carcinoma: Case Reports
Authors: Knuckey Neville W. , Stoll Julius , Epstein Mel H.
Published: April 2011

Breast carcinoma has a high predisposition to metastasize to the brain parenchyma or spinal epidural space with development of progressive neurological symptoms and signs and frequently death of the patient. We report 8 patients with known breast cancer who developed neurological symptoms attributable to an intracranial meningioma and 1 patient who developed spinal cord dysfunction resulting from a thoracic meningioma. The removal of the meningiomas resulted in return of normal neurological function in all patients. At follow-up, all our patients are alive without evidence of meningioma or breast carcinoma recurrence, except 1 patient who died of a metastatic malignant melanoma. This clinical association requires repeated emphasis because of the potential benefit in management of patients with suspected metastatic disease. We have reviewed and summarized the reported literature and added our 8 cases. The mean age of presentation with a meningioma was 62 years and that for breast carcinoma was 59 years. The mean duration for the presentation before the second tumor was 6 years. Breast carcinoma was diagnosed first in 85% of cases. The clinical symptoms of the meningiomas were focal neurological signs in 50% of the patients, raised intracranial pressure in 40%, and a seizure in 10%
Aspergillus Disc Space Infection: Case Report and Review of the Literature
Authors: Morgenlander Joel C. , Rossitch Eugene , Rawlings Charles E.
Published: April 2011

Aspergillus disc space infection is an unusual complication of the immunocompromised state. Magnetic resonance imaging may aid the clinician in arriving at a prompt diagnosis of discitis in affected patients. We report a case of systemically acquired Aspergillus discitis at multiple levels diagnosed by plain x-ray films, bone scan, magnetic resonance imaging, and biopsy. We review the literature on this subject and suggest that aggressive diagnosis with early biopsy, treatment with systemic antifungal agents, and surgical debridement of the infected disc space yield the best outcome for these patients.
Spinal Meningiomas: Review of 174 Operated Cases
Authors: Solero Carlo L. , Fornari Maurizio , Giombini Sergio , Lasio Giovanni , Oliveri Giuseppe , Cimino Carlo , Pluchino Franco
Published: April 2011

The long-term results obtained in a series of 174 patients operated on for spinal meningiomas are critically analyzed. This series was similar to those of other authors with regard to age, sex, location of the tumors, and clinical presentation. Before surgery, about 70% of the patients were included in Groups I and II (mild neurological impairment), and about 30% of the patients were classified in Groups III and IV (significant to severe neurological impairment, up to paraplegia). Complete tumor removal was achieved in 96.5% of the patients, and surgical mortality was about 1%. Microsurgical technique, which was adopted in the last 29 cases, proved to be very effective in reducing undue damage to the spinal cord and in minimizing the postoperative neurological deficits. Of the 174 patients who underwent surgery, 156 underwent late follow-up study for an average of 15 years (2 patients died in the immediate postoperative period, and 16 patients were lost to follow-up). Twenty-nine patients died of causes unrelated to the spinal meningioma; of the remaining 126 patients, 92% were categorized in Groups I and II, and only 8% in Groups III and IV. The rate of recurrence was 6% (9 patients) among the 150 patients who had complete tumor removal, and the rate of regrowth was 17% (1 patient with anaplastic meningioma) among the 6 patients treated by subtotal removal. The early diagnosis of the disease and the use of microsurgical technique appeared as the most relevant factors for further improvement of the surgical results.
Using a National Health Care Data Base To Determine Surgical Complications in Community Hospitals: Lumbar Discectomy as an Example
Authors: Ramirez Lincoln F. , Thisted Ronald
Published: April 2011

To determine the incidence of acute complications of an operation in a large cross-section of U.S. community hospitals, we developed a method that combines the screening of discharge abstracts with the sampling of medical records. Our target patients were those who underwent discectomy for routine lumbar discogenic radiculopathy. We assembled 39,389 discharge abstracts of patients who underwent lumbar discectomy in the U.S. in 1980. This population contained some nontarget patients with a) errors in principal diagnosis or procedure, b) operations exceeding two levels, c) fusion, d) previous laminectomy, or e) problems of the lumbar spine in excess of routine disc disease. Screening of discharge abstracts allowed us to exclude some of these patients. Those remaining were then divided by the reported hospitalization into three groups: 1) death, 2) nonfatal complication, and 3) normal hospitalization. A sample of patients from each group was selected for detailed study, and questionnaires were mailed to hospital medical records departments to confirm the hospitalization and to obtain other medical information unavailable in the abstract. With this information, we 1) removed the remaining nontarget patients a through e above); 2) categorized reported complications as erroneous, preexistent, trivial or major; 3) calculated the incidence of major complications; and 4) assessed the reliability of the discharge abstract data. Principal diagnosis and procedure were reliably coded in 96.5% of abstracts. No deaths were reported in error and none were excluded in error. Among patients who had complications, 4% of the abstracts incorrectly indicated complications, and 11% omitted one complication while correctly reporting others. Among the abstracts reporting a normal hospitalization, 0.7% omitted a complication. The abstract data had a 62% sensitivity and a 99% specificity for complications. Based on a final clean population of 28,395 patients, the incidence of death (per 10,000) was 5.9, and that of serious complication was 157.
Cerebellar Astrocytomas in Elderly Patients with Very Long Preoperative Histories: Report of Three Cases
Authors: Kepes John J. , Whittaker Keith C. , Watson Kenneth , Morantz Robert A. , Millett Ruth , Clough Charles A. , Oxley Dwight K.
Published: April 2011

Three patients, ages 69, 67, and 74 years, respectively, underwent surgical removal of cystic cerebellar astrocytomas. All three had past histories pointing to the existence of a cerebellar lesion for many decades prior to surgery: Patient 1 had had nystagmus on lateral gaze on the side of the tumor since early childhood; Patient 2 had had sensorineural hearing loss on the side of her neoplasm for 38 years preceding the operation; and Patient 3 was diagnosed as having a brain tumor 51 years before the operation. (He has been blind because of pressure hydrocephalus for half a century, but otherwise managed to live a productive farming and family life until he sustained a head injury in a car accident, which forced him to undergo removal of his cerebellar tumor.) The neoplasms in all three instances were found by histological examination to be low-grade astrocytomas. These cases indicate that low-grade cerebellar astrocytomas, which are well known for their characteristically long postoperative courses, may at times manifest a slow growth potential with an exceptionally long preoperative course.
Myeloradiculopathy Secondary to Pseudogout in the Cervical Ligamentum Flavum: Case Report
Authors: Gomez Heldo , Chou Samuel M.
Published: April 2011

A case of cervical myeloradiculopathy secondary to deposits of calcium pyrophosphate dihydrate (Ca2P2O7 2H2O) (CPPD) crystals in the degenerating ligamentum flavum, with marked granulomatous inflammation, is presented. This uncommon clinical presentation of pseudogout (CPPD deposition disease) was confirmed after surgical removal of a compressive cervical ligamentum flavum. The diagnosis of CPPD crystal deposition was determined by polarized light microscopy and energy-dispersive x-ray microanalysis in frozen sections of the biopsy specimen. A review of seven previously reported cases along with the present case failed to reveal trauma as a causative factor.
Mechanical Aspiration of Hematomas in an in Vitro Model
Authors: Kaufman Howard H. , Herschberger Joyce E. , Maroon Joseph C. , Wilberger Jack E. , Onik Gary M.
Published: April 2011

A modified Nucleotome (Surgical Dynamics, San Leandro, California) was used to aspirate blood clot in an in vitro model of intracerebral hematoma. This machine was successful in removing the clot at a reasonably rapid rate. It aspirates normal rat brain far more slowly. It therefore shows promise for being effective and safe in removing intracerebral hematomas in humans.
Titanium Mesh and Acrylic Cranioplasty
Authors: Malis Leonard I.
Published: April 2011

Since June 1985 100 cranioplasties have been carried out using titanium mesh and acrylic. There have been no complications and no infections. Titanium mesh is virtually radiolucent. Titanium is nonmagnetic and is the most biocompatible metal known.
Titanium Wire Internal Fixation for Stabilization of Injury of the Cervical Spine: Clinical Results and Postoperative Magnetic Resonance Imaging of the Spinal Cord
Authors: Geisler Fred H. , Sutton Leslie N. , Mirvis Stuart E. , Zrebeet Hafez , Joslyn John N.
Published: April 2011

Nine patients with dislocation of the cervical spinal with posterior ligamentous damage were treated with posterior internal fixation using a twisted pair of 22-gauge titanium wires and iliac crest bone fusion. Fixation using the titanium wire was compared with fixation using stainless steel wire for differences in surgical insertion, long term stability of bony fusion, and postoperative magnetic resonance imaging (MRI) artifacts near the implanted wire. MRI of the cervical spine is valuable for diagnosing the acute and chronic consequences of traumatic cervical spinal injury by providing anatomic evaluation of both the spinal cord and the supporting bony/ligamentous structures in the neck. Because MRI is an accurate and sensitive noninvasive test, it is especially useful for the long-term serial assessment of the region near the cervical dislocation site to detect the sequelae of spinal cord injury, including syrinx, arachnoid cyst, cord tethering, and persistent mechanical impingement on the spinal cord or spinal roots. Previous attempts at our institution to obtain useful MRI scans of the cervical region adjacent to stainless steel wires after posterior wire fixation have failed due to marked imaging artifacts arising from the ferromagnetic properties of these wires. Our substitution of biocompatible titanium wire (Titanium 6 A1-4V ELI alloy, Specialty Steel and Forge, Leonia, New Jersey) for stainless steel wire produced identical immediate stabilization and ultimate bony fusion of the fracture and yielded minimal MRI artifacts overlying the immediately adjacent spinal cord and neural canal; however, the installation was technically more difficult, because of the titanium wire's greater stiffness. We believe that the implantation of a permancent fixation device in these patients should be made of an MRI-compatible material, such as titanium wire, to allow serial imaging with MRI in their lifelong medical care.
Stereotactic Craniotomy: Methods and Results Using the Brown-Roberts-Wells Stereotactic Frame
Authors: Moore Matthew R. , Black Peter McL. , Ellenbogen Richard , Gall Clifford M. , Eldredge Elizabeth
Published: April 2011

Combining the power of stereotactic precision with open craniotomy in a stereotactic craniotomy technique decreases surgical time, morbidity, and postoperative hospitalization. Indications for its use are deep intrinsic masses 3.5 cm or less in diameter; small, superficial lesions otherwise difficult to localize; and lesions associated with motor, visual, or speech areas. Using the standard Brown-Roberts-Wells system allows a) precisely planned cortical entries, b) gross total lesion excisions under direct vision, c) use of probe-guided resection margins, d) small craniotomies through linear incisions, and e) use of local anesthetic alone for resections. The method and results of this universally available and relatively inexpensive technique are discussed in reference to 20 patients.
Laser-Assisted Reconstruction of the Oculomotor Nerve: Experimental Study on the Feasibility of Cranial Nerve Repair
Authors: Seifert Volker , Stolke Dietmar
Published: April 2011

In this experimental study the feasibility of microsurgical laser-assisted repair of the oculomotor nerve in the cat was investigated. The 3rd cranial nerve was explored after a temporobasal craniectomy from its exit at the brain stem to its entrance into the cavernous sinus and transected. The cut nerve ends were loosely reapproximated and welded together with a CO2milliwatt laser using a power setting of 80 to 90 mW and a spot size of 150 M. Regeneration of the oculomotor nerve within an observation period of 12 months as assessed by weekly examination of the pupil diameter was excellent in 4 animals and satisfactory in 2. In the two control groups consisting of 6 animals in which the nerve reconstruction had been performed with fibrin glue or by simple nerve reapproximation minimal nerve regeneration could be observed only in one animal. The histomorphological examinations revealed good regeneration across the laser anastomosis including new formation of a perineural sheath without any significant scarring effect or constriction at the anastomotic site. It is concluded that the CO2milliwatt laser might be a useful tool for the microsurgical repair of cranial nerves and should possibly be incorporated into the neurosurgical armamentarium of reconstructive cranial nerve surgery.
Microvascular End-to-Side Arterial Anastomosis Using the Nd: YAG Laser
Authors: Shapiro Scott , Sartorius Carl , Sanders Steven , Clark Steve
Published: April 2011

End-to-side, laser-assisted vascular anastomosis (LAVA) using a Nd:YAG laser was successfully performed on rat carotid arteries. A midline neck incision allowed isolation and approximation of both carotid arteries in an end-to-side fashion using four 10-0 nylon stay sutures. The laser parameters used for vessel fusion were 0.3-second 5-W pulses at a spot size of 600 Mm. Anastomoses were analyzed at various time intervals from 1 day to 6 months by angiogram and histological examination. The anastomotic patency was 86%. Aneurysm formation occurred in 23%. Histological examination revealed an acute/subacute transmural injury both at the anastomotic site and several hundred microns away, with delayed re-endothelialization and some attempt at muscular and elastic regeneration. Histological assessment of the aneurysms demonstrated a total loss of the internal elastic lamina and muscularis. A brief discussion comparing Nd:YAG LAVA to other LAVA techniques follows.
Brain Metastasis from Nonseminomatous Germ Cell Tumors of the Testis: Case Report and Review of the Role of Surgery
Authors: Jelsma Richard K. , Carroll Michael
Published: April 2011

The prognosis for patients with nonseminomatous germ cell tumor of the testis is good, even when extensive metastatic disease is present, because this tumor is very sensitive to chemotherapy with cisplatin, vinblastine, and bleomycin (PVB). If a metastasis occurs in the brain, however, the prognosis is poor because the blood-brain barrier limits the entrance of these drugs into the brain and creates a sanctuary for tumor. The current treatment for a brain metastasis is either standard PVB chemotherapy plus whole brain radiation therapy or a rigorous chemotheraputic regimen that penetrates the blood-brain barrier better than PVB. Surgery is seldom used for brain metastasis, largely because of the poor results with surgical debulking in noncentral nervous system disease. This is the report of a patient with disseminated nonseminomatous germ cell tumor and multiple large brain metastases, who was treated with surgery, PVB, and whole brain radiation therapy and cured. Evidence is presented to support a role for surgical debulking in patients with large brain metastasis.
Causes of Morbidity and Mortality from Surgery of Aneurysms of the Distal Basilar Artery
Authors: Batjer Hunt H. , Samson Duke S.
Published: April 2011

Despite modern neurosurgical technology and neuroanesthetic care, treatment of aneurysms of the distal basilar artery remains fraught with complications. Between 1982 and 1988, 126 patients with aneurysms of the distal basilar artery who had been treated by 2 surgeons were retrospectively analyzed to determine the causes of morbidity and mortality from this disease and its treatment. Ten patients (8%) died, and 14 patients (11%) suffered permanent neurological disability after treatment. The causes of failed management could be grouped into the following categories: 1) direct effects of hemorrhage; 2) errors in surgical timing; 3) conceptual errors; 4) technical errors; 5) morbidity from delayed cerebral ischemia; and 6) complications of hypertensive/hypervolemic therapy for symptomatic vasospasm; a small group of patients who died despite having received what we consider excellent management were grouped under a seventh category, “bad luck.” Frequently, patients who did poorly suffered from multiple complications, each of which contributed to their overall morbidity. It is our hope that increased awareness of these potential pitfalls and the further evolution of intravascular technique in selected cases will, in time, improve the outlook for patients suffering from these dangerous lesions.