bluuebunny/crossref_metadata_2025 huggingface dataset:
Multisegmental Cervical Spondylosis: Treatment by Spondylectomy, Microsurgical Decompression, and Osteosynthesis
Authors: Seifert Volker , Stolke Dietmar
Published: April 2011

Vertebral body replacement after spondylectomy, combined with microsurgical decompression and anterior plating, was performed in 22 patients as an aggressive therapeutic approach to multisegmental cervical spondylosis. The patients were 13 men and 9 women, ranging in age from 32 to 74 years. In 19 patients, the typical signs of cervical myelopathy were present. In three patients, pain was the major symptom, accompanied by moderate spastic paresis and hyperreflexia. Apart from cervical myelography and computed tomographic scanning, which was performed in 10 patients, magnetic resonance imaging was the radiological procedure of choice in 12 patients. During spondylectomy, one vertebra was removed in 14 patients, two vertebrae in seven patients, and three vertebrae in one patient. The time of postoperative follow-up ranged from 8 to 46 months, with an average interval of 21 months. In all 22 patients, satisfactory bony fusion was achieved as demonstrated by radiological control examinations. Seventeen patients (77%) were symptom free or had only minor residual symptoms. Three (14%) patients had intermittent nuchal or cervicobrachial pain, which responded well to analgesic medication or the application of a soft collar. Two (9%) patients still had myelopathic but not incapacitating symptoms. Of 15 patients who were employed before surgery, 13 returned to a full-time job. The only severe complication of surgery was a prevertebral abscess that healed without sequelae. It is concluded that aggressive surgical therapy of multisegmental cervical spondylosis by a combination of vertebrectomy, decompression (using the surgical microscope), bone grafting, and osteosynthesis is a straightforward and promising procedure for the treatment of this debilitating disease.
Trigeminal Cisternal Injection of Glycerol for Treatment of Chronic Intractable Cluster Headaches
Authors: Hassenbusch Samuel J. , Kunkel Robert S. , Kosmorsky Gregory S. , Covington Edward C. , Pillay Prem K.
Published: April 2011

Medical treatment of chronic cluster headaches (cluster headaches that occur frequently without remission) can be very difficult. In many patients, the pain remains severe despite all medication trials. For these patients, previous reports recommend radiofrequency trigeminal rhizotomy, which risks corneal anesthesia and subsequent corneal decompensation. As a safer, yet effective, treatment, retro-Gasserian injections of glycerol were given to eight patients having intractable chronic cluster headaches. Needle penetration into the trigeminal cistern, glycerol amount (0.55 ml), and length of patient elevation after the procedure (80-90 degrees upright for 10 h) were modified for maximal exposure of the V 1 division. Three patients required one additional injection, and one patient required two additional injections. Verbal pain scales (means ± 1 standard error of the mean) were: 9.1 ± 0.30 (preoperative), 2.6 ± 1.10(1 mo postoperative), and 2.1 ± 0.64 (1 yr postoperative). Daily headache frequency decreased from 6.0 ± 2.0 (preoperative) to 0.2 ± 0.09 (i.e., one headache every 5 days) (1 yr postoperative). Three of the eight patients had no headaches after 1 year. There were no instances of corneal or facial anesthesia. One year postoperatively, five patients required no medication, and three remained on low doses of medication for headache treatment. In contrast to previous limited reports of glycerol injections for cluster headaches, results with these patients having chronic cluster headaches support the use of glycerol injections as a viable treatment alternative, with significant pain relief and corneal safety.
Imprints, Smears, and Frozen Sections of Brain Tumors
Authors: Reyes Marc G. , Homsi Fayez M. , McDonald Larry W. , Glick Roberta P.
Published: April 2011

In this study, we compared the suitability and accuracy of imprints, smears, and frozen sections of suspected brain and spinal cord tumors of 150 patients. Eighty-six percent of the imprints, 91% of the smears, and 99% of the frozen sections were suitable for interpretation. Among the suitable preparations, 82% of the imprints, 92% of the smears, and 99% of the frozen sections agreed with our diagnosis on paraffin sections. Although frozen sections were clearly more accurate than imprints and smears, the latter two provided diagnoses in patients with acquired immunodeficiency syndrome where frozen sections were not done to avoid contaminating our cryostat and in a patient with an epidermoid cyst of the middle fossa that could not be adequately frozen sectioned. Our study shows that imprints and smears complement frozen sections in the intraoperative diagnosis of tumors of the central nervous system.
Sudden Appearance of a Mycotic Aneurysm of the Intracavernous Carotid Artery after Symptoms Resembling Cluster Headache: Case Report
Authors: Todo Tomoki , Inoya Hiroshi
Published: April 2011

Acute cavernous sinus syndrome developed in a 44-year-old man after he had experienced symptoms resembling cluster headache for 3 weeks. The cause was determined to be the sudden appearance of a large saccular aneurysm of the intracavernous portion of the left carotid artery secondary to an acute inflammation of the left cavernous sinus. The absence of this aneurysm before the onset of the ophthalmoplegia was confirmed by a computed tomographic scan and angiogram performed only 1 week earlier. The patient was treated with antibiotics in combination with a short regimen of steroids, which resulted in a slowly developing thrombosis of the aneurysm, although the cavernous sinus syndrome remained. This case suggests several important aspects regarding the pathogenesis of mycotic intracavernous carotid aneurysms, the mechanism of an acute manifestation of the cavernous sinus syndrome by an intracavernous carotid aneurysm, and the relation of the intracavernous portion of the carotid artery to cluster headache. (Neurosurgery 29:594-599, 1991)
Neonatal Cavernous Hemangioma of the Dura Mater: Case Report
Authors: Saldana Cristobal J. , Zimman Horacio , Alonso Pedro , Mata Pedro R.
Published: April 2011

A case of dural cavernous hemangioma, diagnosed prenatally as an intracranial mass by ultrasonography and surgically treated after elective delivery, is presented. The clinical and pathological features of this unusual type of congenital vascular malformation are reported, and the relevant literature is reviewed.
Inflammatory Lesion Mimicking a Metastatic Ependymoma
Authors: Friedman Henry S. , Tuori Susan L. , Tuori Susan L. , Hatten Paul H. , Hockenberger Beverly , Vandersteenhoven Jacob J. , Oakes Jerry W.
Published: April 2011

A 2.5-year-old child who had undergone nearly total resection of an infratentorial ependymoma demonstrated a new enhancing lesion on the undersurface of the right cerebellar hemisphere 7 weeks after the initiation of adjuvant chemotherapy. The residual primary tumor demonstrated continued regression during chemotherapy, and magnetic resonance imaging of the spine and cytopathological examination of the cerebrospinal fluid showed no evidence for other sites of metastatic tumor. Because of the unusual anatomic and temporal characteristics of this lesion and despite radiographic criteria highly suspicious for a metastatic lesion, a biopsy was performed, revealing histological evidence of an inflammatory process.
A Survey of 65 Tumors within the Spinal Cord: Surgical Results and the Importance of Preoperative Magnetic Resonance Imaging
Authors: Brotchi Jacques , Dewitte Olivier , Balériaux Danielle , Vandesteene Arlette , Raftopoulos Christian , Flament-Durand Jacqueline , Noterman Jacques
Published: April 2011

Between January 1984 and December 1990. 65 intramedullary spinal cord tumors were diagnosed and operated on. In this series, all patients underwent magnetic resonance imaging investigations and were operated on with the Cavitron ultrasonic surgical aspirator whenever necessary. Major surgical difficulties have been found in patients previously treated by radiotherapy with or without biopsy. We found magnetic resonance imaging to be a highly sensitive imaging procedure and the method of choice for visualizing tumors within the spinal cord. Nevertheless, accurate diagnosis may only be suggested by magnetic resonance imaging, rather than made definitively. Surgery is necessary in every case in order to obtain a definite diagnosis. Radical surgery can be performed when a plane exists between the tumor and the normal spinal cord: biopsy or debulking with the Cavitron ultrasonic surgical aspirator should be performed when the tumor is infiltrative. We have performed 33 so-called total resections, 22 partial resections, and 10 biopsies, among which 5 were performed on lipomas. Surgical results were assessed at 3 months after surgery, showing 35 improvements (53%), 24 stabilizations (37%), and 6 deteriorations (10%).
Incidence and Neurodevelopmental Outcome of Periventricular Hemorrhage and Hydrocephalus in a Regional Population of Very Low Birth Weight Infants
Authors: Hanigan William C. , Morgan Andrew M. , Anderson Robert J. , Bradle Patricia , Cohen Howard S. , Cusack Thomas J. , Thomas-McCauley Tina , Miller Tim C.
Published: April 2011

During the years 1984 to 1987, 459 very low birth weight (VLBW) infants were admitted to a state-designated Level III Neonatal Intensive Care Unit. Cerebral sonography performed in a standardized sequence and graded with the Papile scale diagnosed 97 (21.1%) children with periventricular hemorrhage (PVH). The incidence of PVH declined from a peak of 26.6% in 1985 to 16.4% in 1987, associated with an increase in the incidence of inborn admissions (including maternal transport) from 62.0% in 1984 to 80.4% in 1987. During initial hospitalization, the occurrence of both low-grade (Grades I and II) and high-grade PVH was associated with a significantly higher incidence of perinatal risk factors compared with a concurrent population of VLBW infants without PVH. Developmental follow-up was achieved in 93.3% of VLBW infants without PVH and 95.7% of VLBW infants with PVH who survived their initial hospitalization. The incidence of abnormal outcome ranged from 7 of 37 infants with Grade I PVH to 7 of 8 VLBW infants with Grade IV PVH. Only 1 of 16 VLBW infants with high-grade PVH demonstrated normal motor and cognitive development. Active hydro-cephalus developed in 12 infants; 11 sustained a high-grade PVH. Appropriate treatment of intracranial hypertension did not modify the neurodevelopmental outcome. In conclusion, this regional population of VLBW infants demonstrated a decline in the incidence of PVH during the years 1984 to 1987 associated with an increase in the incidence of inborn admissions. The risk of abnormal neurodevelopmental outcome was elevated for all grades of PVH. A 12.0% incidence of hydrocephalus was associated with high-grade PVH, and appropriate treatment did not alter the poor prognosis.
Infants with Medulloblastoma: A Single Institution Review of Survival
Authors: Geyer Russell , Levy Margaret , Berger Mitchel S. , Milstein Jerrold , Griffin Brian , Bleyer Archie W.
Published: April 2011

Although the prognoses of children with medulloblastoma have improved dramatically over the last several decades, the reported survival for very young children with this tumor remains poor. We undertook a retrospective review of patients less than 36 months of age at the time of the diagnosis of a medulloblastoma who were treated at our institution during a 36-year period. Of 28 such patients. 10 patients are presently surviving without disease at a median of 150 months from diagnosis. The presence of a metastatic tumor at the time of diagnosis was identified as a significant indicator of a poor prognosis, and all completely staged patients without metastasis are surviving without a recurrence of disease. This report suggests that the survival of very young children with a medulloblastoma may not be as poor as has been previously reported, particularly if a disseminated tumor is not present at the time of diagnosis.
Deep Hypothermic Circulatory Arrest for the Management of Complex Anterior and Posterior Circulation Aneurysms
Authors: Solomon Robert A. , Smith Craig R. , Raps Eric C. , Young William L. , Stone Gilbert J. , Fink Matthew E.
Published: April 2011

Giant aneurysm surgery continues to be a technically difficult task with high operative morbidity. Recent advances in cardiac surgery have fueled interest in the technique of deep hypothermic circulatory arrest for the treatment of giant and complex intracranial aneurysms. Fourteen patients with giant intracranial aneurysms operated on with the technique of deep hypothermic circulatory arrest are presented. All 14 aneurysms were successfully treated. There were 2 intraoperative strokes: 1 resulted in severe disability and 1 resulted in mild disability. No significant neurological complications were related to the technique of cardiopulmonary bypass with deep hypothermic circulatory arrest. This initial experience indicates that patients with giant and complex intracranial aneurysms might benefit from a surgical approach that included the use of deep hypothermic circulatory arrest.
Electroencephalographic Activity and Serum and Cerebrospinal Fluid Pentobarbital Levels in Determining the Therapeutic End Point during Barbiturate Coma
Authors: Winer Joel W. , Rosenwasser Robert H. , Rosenwasser Robert H.
Published: April 2011

Controversy exists regarding the optimal means for monitoring the patient receiving pentobarbital therapy during medical coma. Serum pentobarbital levels have been used traditionally to gauge cerebral penetration and efficacy of the drug. These peripheral levels have been assumed to reflect pentobarbital concentrations in the cerebrospinal fluid (CSF) and, therefore, the physiological effect on the central nervous system. To determine the relative accuracy of serum versus CSF pento-barbital levels, continuous electroencephalographic (EEG) monitoring in 10 consecutive patients was studied prospectively. Each patient received pentobarbital therapy for cerebral protection in the face of a traumatic injury. Simultaneous serum and CSF pentobarbital levels were obtained 1) before and after the initial barbiturate bolus, 2) every 12 hours during constant infusion therapy, and 3) before and after subsequent boluses necessary because of elevated intracranial pressure (ICP) (ICP > 15 mm Hg) or loss of burst suppression by continuous EEG monitoring (defined as greater than five bursts per minute). ICP and relevant clinical events were recorded hourly. Serum and CSF levels ranged from 33 to 74 mg/L and 4 to 54 mg/L, respectively. There was poor correlation between serum and CSF pentobarbital levels at any given time, although patients remained in burst suppression 73% of the time during their therapy. The EEG monitoring not only provided dynamic physiological monitoring, but it also permitted the lowest pentobarbital dose to maintain burst suppression for a specific patient's metabolism, reducing the likelihood of toxicity. In conclusion, CSF pentobarbital levels are of no greater accuracy than serum pentobarbital levels in predicting physiological effect. Constant EEG monitoring remains the best modality by showing the presence of burst suppression moment-to-moment and thus establishing the minimal necessary dose.
De Novo Development of an Aneurysm: Case Report
Authors: Koeleveld Robin F. , Heilman Carl B. , Klucznik Richard P. , Shucart William A.
Published: April 2011

A case of the de novo formation of an aneurysm in a young woman is presented. At age 13 years, she had a spontaneous subarachnoid hemorrhage. Cerebral angiography showed an aneurysm of the bifurcation of the left internal carotid artery and a small aneurysm of the left anterior choroidal artery. At surgery, the aneurysm of the internal carotid artery was clipped, and the aneurysm of the left anterior choroidal artery was wrapped with muslin. Thirteen years later, the patient had another subarachnoid hemorrhage. Cerebral arteriography showed four aneurysms that had developed at previously angiographically normal sites. This case suggests that young patients with aneurysms might benefit from follow-up angiography in search of late aneurysm formation.
Silastic Duraplasty in Pediatric Patients
Authors: Boop Frederick A. , Chadduck William M.
Published: April 2011

The role of adhesions in the retethering of the neural elements after surgical treatment of spinal dysraphism has produced refinements in the technique of the closure of the neural tube. Silastic. because of its relative inert property. has been used for duraplasty. but a few reports of late complications of hemorrhage or fibrotic capsule formation have caused concern over its use. We report 33 patients with the following diagnoses-eight spinal lipomyelomeningoceles. three myelomeningoceles. six symptomatic Chiari II malformations, seven tethered cords, six spinal cord tumors, two diastematomyelia. and one cerebellar astrocytoma-in whom Silastic dural grafts were used to prevent the adherence of neural structures to the overlying tissues. Our surgical technique is presented here. The patients have been observed for up to 6 years. Only one became infected, was treated with antibiotics without graft removal, and has remained without sequelae for over 3 years. One had an incidental pseudomeningocele that was noted on follow-up magnetic resonance imaging scan that was not clinically apparent. There have been no hemorrhages. leakage of cerebrospinal fluid. nor other complications from using nonreinforced Silastic sheeting. In one patient. Dacron-reinforced Silastic was used and. upon reexploration. a marked fibroblastic response was noted. A review of the literature suggests that fibrotic complications are related to this Dacron-reinforced Silastic. The hemorrhagic complications that were reported occurred in instances where Silastic grafts were large and no technical modifications were made preventively. We conclude that the use of nonreinforced Silastic dural grafts, with appropriate technical modifications in surgical technique, is safe and may prevent retethering of neural tissues in a variety of neurosurgical lesions.
Anatomy of the Sympathetic Pathways in the Carotid Canal
Authors: v. Overbeeke Jacobus J. , Dujovny Manuel , Dragovic Lubisja , Ausman James I.
Published: April 2011

The sympathetic fibers in the carotid canal were studied in 30 unfixed specimens from human cadavers. Thirty petrous internal carotid arteries were injected with red silicone rubber, and the course of the sympathetic fibers was examined after removal of the inferior and superior wall of the carotid canal. The internal carotid artery was removed completely, leaving the sympathetic fibers intact as much as possible. Instead of a plexus-like configuration of the sympathetic fibers around the petrous carotid artery in all specimens, an anterosuperior group and a posteroinferior group of sympathetic fibers were found together, and both closed on the inferior-anterior side of the terminal portion of the horizontal part of the carotid canal. Seventy-three percent of the anterosuperior group of sympathetic fibers consisted of one large bundle, and 27% consisted of two smaller bundles. The majority of the posteroinferior group of sympathetic fibers consisted only of one bundle (93%). In 60% of the specimens, the majority of sympathetic fibers in the carotid canal were found in the anterosuperior group, 20% were found in the posteroinferior group, and in 20%, there was an equal distribution. The formation of the petrous bone and the related structures of the skull base play an important role in the configuration of these groups of sympathetic fibers. This study shows that, in cases of operative intervention in the carotid canal, the anterosuperior group of sympathetic fibers may be encountered. Damage to this bundle may result in sympathicoparesis, as it often contains the most sympathetic fibers. This group of sympathetic fibers can be easily separated from the internal carotid artery. Furthermore, it is shown that lesions that may damage the anterior part of the carotid canal near its entrance into the cavernous sinus may cause permanent sympathetic disturbances.
The Acoustic Detection of Intracranial Aneurysms: A Clinical Study
Authors: van Bruggen Ariane C. , Mooij Jan J. A. , Journée Henricus L.
Published: April 2011

A new recording method for the acoustical detection of intracranial aneurysms is presented. A study examining the capability of the method to discriminate between patients with an aneurysm and control patients by a simple, objective parameter is reported. Sound signals were recorded over the eyes, and a real-time spectral analysis was performed on these signals. For this study, recordings performed on 26 patients with an aneurysm were compared with recordings on 26 age-and sex-matched control patients without intracerebral abnormalities. As a result of measures taken to reduce artifacts and to improve the signal-to-noise ratio, the measuremmnts were performed reliably, with little inconvenience for the patients; all measurements could be used for analysis. The power spectra measured in the control patients showed a typical, smoothly descending pattern; those measured in the aneurysm patients clearly differed from this pattern, showing peaks of varying width, height, and dominant frequency. For the objective judgment of the power spectra, the power median is introduced. The sensitivity and specificity of this parameter were determined. Possible methods to improve the results will be discussed.
Case reports
Authors: Harris Cheryl P. , Dias Mark S. , Brockmeyer Douglas L. , Townsend Jeannette J. , Willis Brian K. , Apfelbaum Ronald I.
Published: April 2011

Neurenteric cysts are endothelium-lined structures most commonly encountered in the lower cervical or upper thoracic spinal cord. The occurrence of neurenteric cysts within the cranial vault is unusual. We present three patients with neurenteric cysts located within the posterior fossa: one near the jugular foramen deforming the 4th ventricle, a second in the cerebellopontine angle, and a third in the prepontine cistern. Several different theories have been advanced to explain the embryogenesis of neurenteric cysts. We review these theories and conclude that cranial neurenteric cysts may arise from a disturbance of early gastrulation, shortly after the onset of primitive streak regression.
Cystic Falcine Chondroma: Case Report and Review of the Literature
Authors: Hadadian Karim , Abtahii Hossein , Asil Zahra T. , Rakhshan Mohammad , Vessal Parvin
Published: April 2011

A rare case of falcine chondroma in a 25-year-old woman with an 8-year history of headache and a recent generalized seizure is presented. Microscopic examination of the resected tumor revealed that it was a falcine chondroma with chondrocytes and central cystic degeneration.
Classification of Spinal Cord Arteriovenous Shunts: Proposal for a Reappraisal—The Bicêtre Experience with 155 Consecutive Patients Treated between 1981 and 1999
Authors: Rodesch Georges , Hurth Michel , Alvarez Hortensia , Tadié Marc , Lasjaunias Pierre
Published: April 2011

OBJECTIVE

Spinal cord arteriovenous shunts (SCAVSs) are currently classified according to their morphological features. Certain shunts cannot be fully integrated into the predetermined categories that are usually described, however. Can these classifications be reevaluated on the basis of recent anatomic, biological, and genetic advances?

METHODS

We reviewed the clinical and radiological files for 155 SCAVSs that were treated at Hôpital Bicêtre between 1981 and 1999. The lesions were examined with respect to their number (single or multiple), their primary architectural type (nidus or fistula), and their possible links with associated metameric lesions.

RESULTS

All SCAVSs were either arteriovenous malformations or fistulae, with the latter being either micro- or macrofistulae. All SCAVSs corresponded to three categories, i.e., genetic hereditary lesions (macrofistulae and hereditary hemorrhagic telangiectasia), genetic nonhereditary lesions (all of which were multiple lesions with metameric or myelomeric associations), and single lesions (which could represent incomplete presentations of one of the previous groups). Of the SCAVSs in our series, 81% were single lesions and 19% were multiple; among these, 59% were true intradural shunts with metameric features. Ten cases of Cobb syndrome, three cases of Klippel-Trenaunay syndrome, and two cases of Parkes-Weber syndrome, all with associated cord lesions, were observed. Nineteen percent of SCAVSs were fistulae; 23% of those were macrofistulae, of which 83% were related to Rendu-Osler-Weber disease.

CONCLUSION

It seems legitimate to propose a categorization that takes into consideration a primary malformation (nidus or fistula) that evolves with time and in which angioarchitectural changes occur. Recognition of the factors originally responsible for the shunt (e.g., genetic hereditary or genetic nonhereditary) allows a different classification of SCAVSs.
Endoscopic Third Ventriculostomy for Treatment of Noncommunicating Syringomyelia Associated with a Chiari I Malformation and Hydrocephalus: Case Report and Pathophysiological Considerations
Authors: Métellus Philippe , Dufour Henry , Levrier Olivier , Grisoli François
Published: April 2011

OBJECTIVE AND IMPORTANCE

A Chiari I malformation associated with syringomyelia and hydrocephalus is a rare condition. We report the successful use of endoscopic third ventriculostomy for the treatment of this pathological entity. The successful use of this technique in such a case has not been previously described, and the results allow us to speculate on the pathophysiological mechanism involved.

CLINICAL PRESENTATION

A 34-year-old woman presented with headaches, a motor deficit of the right upper limb, and gait dyspraxia. Magnetic resonance imaging scans demonstrated dilation of all ventricles, compression of the retrocerebellar cerebrospinal fluid space, downward displacement of the tonsils, and syringomyelia. Syringomyelia involved the cervicodorsal cord below C3, with a syrinx-free segment between C1 and C3 and no enlargement of the rostral part of the central canal.

INTERVENTION

Endoscopic third ventriculostomy resulted in prompt improvement of the clinical symptoms. Postoperative magnetic resonance imaging scans demonstrated shrinkage of the syrinx and return of the cerebellar tonsils to their physiological positions.

CONCLUSION

This experience demonstrates that endoscopic third ventriculostomy, which is a simple, safe technique, may be the treatment of choice for associated Chiari I malformations, hydrocephalus, and syringomyelia (even the noncommunicating type).
Yeast Zinc Cluster Proteins Dal81 and Uga3 Cooperate by Targeting Common Coactivators for Transcriptional Activation of Γ-Aminobutyrate Responsive Genes
Authors: Sylvain Marc-André , Liang Xiao Bei , Hellauer Karen , Turcotte Bernard
Published: April 2011

In Saccharomyces cerevisiae, optimal utilization of various compounds as a nitrogen source is mediated by a complex transcriptional network. The zinc cluster protein Dal81 is a general activator of nitrogen metabolic genes, including those for Γ-aminobutyrate (GABA). In contrast, Uga3 (another zinc cluster protein) is an activator restricted to the control of genes involved in utilization of GABA. Uga3 binds to DNA elements found in the promoters of target genes and increases their expression in the presence of GABA. Dal81 appears to act as a coactivator since the DNA-binding activity of this factor is dispensable but its mode of action is not known. In this study, we have mapped a regulatory, as well as an activating, region for Uga3. A LexA–Uga3 chimeric protein activates a lexA reporter in a GABA- and Dal81-dependent manner. Activation by Uga3 requires the SAGA complex as well as Gal11, a component of mediator. ChIP analysis revealed that Uga3 is weakly bound to target promoters. The presence of GABA enhances binding of Uga3 and allows recruitment of Dal81 and Gal11 to target genes. Recruitment of Gal11 is prevented in the absence of Dal81. Importantly, Dal81 by itself is a potent activator when tethered to DNA and its activity depends on SAGA and Gal11 but not Uga3. Overexpression of Uga3 bypasses the requirement for Dal81 but not for SAGA or Gal11. Thus, under artificial conditions, both Dal81 and Uga3 can activate transcription independently of each other. However, under physiological conditions, both factors cooperate by targeting common coactivators.
The Drosophila Gene Disruption Project: Progress Using Transposons With Distinctive Site Specificities
Authors: Bellen Hugo J , Levis Robert W , He Yuchun , Carlson Joseph W , Evans-Holm Martha , Bae Eunkyung , Kim Jaeseob , Metaxakis Athanasios , Savakis Charalambos , Schulze Karen L , Hoskins Roger A , Spradling Allan C
Published: April 2011

The Drosophila Gene Disruption Project (GDP) has created a public collection of mutant strains containing single transposon insertions associated with different genes. These strains often disrupt gene function directly, allow production of new alleles, and have many other applications for analyzing gene function. Here we describe the addition of ∼7600 new strains, which were selected from >140,000 additional P or piggyBac element integrations and 12,500 newly generated insertions of the Minos transposon. These additions nearly double the size of the collection and increase the number of tagged genes to at least 9440, approximately two-thirds of all annotated protein-coding genes. We also compare the site specificity of the three major transposons used in the project. All three elements insert only rarely within many Polycomb-regulated regions, a property that may contribute to the origin of “transposon-free regions” (TFRs) in metazoan genomes. Within other genomic regions, Minos transposes essentially at random, whereas P or piggyBac elements display distinctive hotspots and coldspots. P elements, as previously shown, have a strong preference for promoters. In contrast, piggyBac site selectivity suggests that it has evolved to reduce deleterious and increase adaptive changes in host gene expression. The propensity of Minos to integrate broadly makes possible a hybrid finishing strategy for the project that will bring >95% of Drosophila genes under experimental control within their native genomic contexts.
A Key Temporal Delay in the Circadian Cycle ofDrosophilaIs Mediated by a Nuclear Localization Signal in the Timeless Protein
Authors: Saez Lino , Derasmo Mary , Meyer Pablo , Stieglitz J , Young Michael W
Published: April 2011

Regulated nuclear entry of the Period (PER) and Timeless (TIM) proteins, two components of the Drosophila circadian clock, is essential for the generation and maintenance of circadian behavior. PER and TIM shift from the cytoplasm to the nucleus daily, and the length of time that PER and TIM reside in the cytoplasm is an important determinant of the period length of the circadian rhythm. Here we identify a TIM nuclear localization signal (NLS) that is required for appropriately timed nuclear accumulation of both TIM and PER. Transgenic flies with a mutated TIM NLS produced circadian rhythms with a period of ∼30 hr. In pacemaker cells of the brain, PER and TIM proteins rise to abnormally high levels in the cytoplasm of timΔNLS mutants, but show substantially reduced nuclear accumulation. In cultured S2 cells, the mutant TIMΔNLS protein significantly delays nuclear accumulation of both TIM and wild-type PER proteins. These studies confirm that TIM is required for the nuclear localization of PER and point to a key role for the TIM NLS in the regulated nuclear accumulation of both proteins.
A Balance Between Euchromatic (JIL-1) and Heterochromatic [SU(VAR)2-5 and SU(VAR)3-9] Factors Regulates Position-Effect Variegation inDrosophila
Authors: Wang Chao , Girton Jack , Johansen Jørgen , Johansen Kristen M
Published: April 2011

In this study, we show that the haplo-enhancer effect of JIL-1 has the ability to counterbalance the haplo-suppressor effect of both Su(var)3-9 and Su(var)2-5 on position-effect variegation, providing evidence that a finely tuned balance between the levels of JIL-1 and the major heterochromatin components contributes to the regulation of gene expression.
Lack of Interleukin-1 Receptor I (IL-1RI) Protects Mice From High-Fat Diet–Induced Adipose Tissue Inflammation Coincident With Improved Glucose Homeostasis
Authors: McGillicuddy Fiona C. , Harford Karen A. , Reynolds Clare M. , Oliver Elizabeth , Claessens Mandy , Mills Kingston H.G. , Roche Helen M.
Published: April 2011

OBJECTIVE

High-fat diet (HFD)-induced adipose tissue inflammation is a critical feature of diet-induced insulin resistance (IR); however, the contribution of interleukin-1 receptor I (IL-1RI)-mediated signals to this phenotype has not been defined. We hypothesized that lack of IL-1RI may ameliorate HFD-induced IR by attenuating adipose tissue inflammation.

RESEARCH DESIGN AND METHODS

Glucose homeostasis was monitored in chow- and HFD-fed wild-type (WT) and IL-1RI−/− mice by glucose tolerance and insulin tolerance tests. Macrophage recruitment and cytokine signature of adipose tissue macrophages was evaluated. Insulin sensitivity and cytokine secretion from adipose explants was quantified. Cytokine secretion and adipocyte insulin sensitivity was measured in cocultures of WT or IL-1RI−/− macrophages with 3T3L1 adipocytes. Synergistic effects of IL-1β with tumor necrosis factor (TNF)-α on inflammation was monitored in WT and IL-1RI−/− bone-marrow macrophages and adipose explants.

RESULTS

Lean and obese IL-1RI−/− animals exhibited enhanced glucose homeostasis by glucose tolerance test and insulin tolerance test. M1/M2 macrophage number in adipose tissue was comparable between genotypes; however, TNF-α and IL-6 secretion was lower from IL-1RI−/− adipose tissue macrophages. IL-1RI−/− adipose exhibited enhanced insulin sensitivity, elevated pAKT, lower cytokine secretion, and attenuated induction of phosphorylated signal transducer and activator of transcription 3 and suppressor of cytokine signaling molecule 3 after HFD. Coculture of WT, but not IL-1RI−/− macrophages, with 3T3L1 adipocytes enhanced IL-6 and TNF-α secretion, reduced adiponectin secretion, and impaired adipocyte insulin sensitivity. TNF-α and IL-1β potently synergized to enhance inflammation in WT macrophages and adipose, an effect lost in the absence of IL-1RI.

CONCLUSIONS

Lack of IL-1RI protects against HFD-induced IR coincident with reduced local adipose tissue inflammation, despite equivalent immune cell recruitment.
Insulin Restores Gestational Diabetes Mellitus–Reduced Adenosine Transport Involving Differential Expression of Insulin Receptor Isoforms in Human Umbilical Vein Endothelium
Authors: Westermeier Francisco , Salomón Carlos , González Marcelo , Puebla Carlos , Guzmán-Gutiérrez Enrique , Cifuentes Fredi , Leiva Andrea , Casanello Paola , Sobrevia Luis
Published: April 2011

OBJECTIVE

To determine whether insulin reverses gestational diabetes mellitus (GDM)–reduced expression and activity of human equilibrative nucleoside transporters 1 (hENT1) in human umbilical vein endothelium cells (HUVECs).

RESEARCH DESIGN AND METHODS

Primary cultured HUVECs from full-term normal (n = 44) and diet-treated GDM (n = 44) pregnancies were used. Insulin effect was assayed on hENT1 expression (protein, mRNA, SLC29A1 promoter activity) and activity (initial rates of adenosine transport) as well as endothelial nitric oxide (NO) synthase activity (serine1177 phosphorylation, l-citrulline formation). Adenosine concentration in culture medium and umbilical vein blood (high-performance liquid chromatography) as well as insulin receptor A and B expression (quantitative PCR) were determined. Reactivity of umbilical vein rings to adenosine and insulin was assayed by wire myography. Experiments were in the absence or presence of l-NG-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) or ZM-241385 (an A2A-adenosine receptor antagonist).

RESULTS

Umbilical vein blood adenosine concentration was higher, and the adenosine- and insulin-induced NO/endothelium-dependent umbilical vein relaxation was lower in GDM. Cells from GDM exhibited increased insulin receptor A isoform expression in addition to the reported NO–dependent inhibition of hENT1-adenosine transport and SLC29A1 reporter repression, and increased extracellular concentration of adenosine and NO synthase activity. Insulin reversed all these parameters to values in normal pregnancies, an effect blocked by ZM-241385 and l-NAME.

CONCLUSIONS

GDM and normal pregnancy HUVEC phenotypes are differentially responsive to insulin, a phenomenon where insulin acts as protecting factor for endothelial dysfunction characteristic of this syndrome. Abnormal adenosine plasma levels, and potentially A2A-adenosine receptors and insulin receptor A, will play crucial roles in this phenomenon in GDM.
Impact of Intranasal Insulin on Insulin Antibody Affinity and Isotypes in Young Children With HLA-Conferred Susceptibility to Type 1 Diabetes
Authors: Ryhänen Samppa J. , Härkönen Taina , Siljander Heli , Näntö-Salonen Kirsti , Simell Tuula , Hyöty Heikki , Ilonen Jorma , Veijola Riitta , Simell Olli , Knip Mikael
Published: April 2011

OBJECTIVE

Despite promising results from studies on mouse models, intranasal insulin failed to prevent or delay the development of type 1 diabetes in autoantibody-positive children with HLA-conferred disease susceptibility. To analyze whether the insulin dose was inadequate to elicit an immunomodulatory response, we compared the changes observed in insulin antibody (IA) affinity and isotypes after treatment with nasal insulin or placebo.

RESEARCH DESIGN AND METHODS

Ninety-five children (47 in the placebo group and 48 in the insulin group of the total of 224 children randomized for the trial) with HLA-conferred susceptibility to type 1 diabetes derived from the intervention arm of the Finnish Type 1 Diabetes Prediction and Prevention study were included in these analyses. Blood samples drawn before or at the beginning of the treatment and after treatment for 3 and 6 months were analyzed for IA affinity and isotype-specific IAs (IgG1–4, IgA, IgM, and IgE).

RESULTS

IgG3- and IgA-IA levels (P = 0.031 and 0.015, respectively) and the number of IgG3-IA–positive subjects (P = 0.022) were significantly higher at 6 months after the initiation of the treatment in the insulin group. No significant differences were observed between the two groups in IA affinity or other IA isotypes.

CONCLUSIONS

The insulin dose administered induced a modest change in the IA isotype profile. The lack of impact of nasal insulin on IA affinity implies that the immune response of study subjects was already mature at the beginning of the intervention.
Utility of Hemoglobin A1c for Diagnosing Prediabetes and Diabetes in Obese Children and Adolescents
Authors: Nowicka Paulina , Santoro Nicola , Liu Haibei , Lartaud Derek , Shaw Melissa M. , Goldberg Rachel , Guandalini Cindy , Savoye Mary , Rose Paulina , Caprio Sonia
Published: April 2011

OBJECTIVE

Hemoglobin A1c (A1C) has emerged as a recommended diagnostic tool for identifying diabetes and subjects at risk for the disease. This recommendation is based on data in adults showing the relationship between A1C with future development of diabetes and microvascular complications. However, studies in the pediatric population are lacking.

RESEARCH DESIGN AND METHODS

We studied a multiethnic cohort of 1,156 obese children and adolescents without a diagnosis of diabetes (male, 40%/female, 60%). All subjects underwent an oral glucose tolerance test (OGTT) and A1C measurement. These tests were repeated after a follow-up time of ∼2 years in 218 subjects.

RESULTS

At baseline, subjects were stratified according to A1C categories: 77% with normal glucose tolerance (A1C <5.7%), 21% at risk for diabetes (A1C 5.7–6.4%), and 1% with diabetes (A1C >6.5%). In the at risk for diabetes category, 47% were classified with prediabetes or diabetes, and in the diabetes category, 62% were classified with type 2 diabetes by the OGTT. The area under the curve receiver operating characteristic for A1C was 0.81 (95% CI 0.70–0.92). The threshold for identifying type 2 diabetes was 5.8%, with 78% specificity and 68% sensitivity. In the subgroup with repeated measures, a multivariate analysis showed that the strongest predictors of 2-h glucose at follow-up were baseline A1C and 2-h glucose, independently of age, ethnicity, sex, fasting glucose, and follow-up time.

CONCLUSIONS

The American Diabetes Association suggested that an A1C of 6.5% underestimates the prevalence of prediabetes and diabetes in obese children and adolescents. Given the low sensitivity and specificity, the use of A1C by itself represents a poor diagnostic tool for prediabetes and type 2 diabetes in obese children and adolescents.
One-Hour Postload Plasma Glucose Levels and Left Ventricular Mass in Hypertensive Patients
Authors: Sciacqua Angela , Miceli Sofia , Carullo Giuseppe , Greco Laura , Succurro Elena , Arturi Franco , Sesti Giorgio , Perticone Francesco
Published: April 2011

OBJECTIVE

Left ventricular hypertrophy (LVH), an independent risk factor for cardiovascular (CV) morbidity and mortality, recognizes a multifactorial pathogenesis. A plasma glucose value ≥155 mg/dL for the 1-h postload plasma glucose during an oral glucose tolerance test (OGTT) identifies subjects with normal glucose tolerance (NGT) at high risk for type 2 diabetes. We addressed the question if glucose tolerance status, particularly 1-h postload plasma glucose levels, affects left ventricular mass (LVM) and cardiac geometry in essential hypertension.

RESEARCH DESIGN AND METHODS

We enrolled 767 never-treated hypertensive subjects, 393 women and 374 men (mean age 49.6 ± 8.5 years). All patients underwent an OGTT for the evaluation of glucose tolerance and standard echocardiography. LVM was calculated using the Devereux formula and normalized by body surface area (LVM index [LVMI]). Insulin sensitivity was assessed by the Matsuda index. Among all participants, 514 had NGT, 168 had impaired glucose tolerance (IGT), and 85 had type 2 diabetes. According to the 1-h postload plasma glucose cutoff point of 155 mg/dL, we divided normotolerant subjects into two groups: NGT <155 mg/dL (n = 356) and NGT ≥155 mg/dL (n = 158).

RESULTS

Subjects in the NGT ≥155 mg/dL group had worse insulin sensitivity than subjects in the NGT <155 mg/dL group (Matsuda index 63.9 vs. 88.8; P < 0.0001). Men with NGT ≥155 mg/dL had a higher LVMI than men with NGT <155 mg/dL (126.6 vs. 114.3 g/m2; P = 0.002) and a different LVH prevalence (41.1 vs. 25.8%; P < 0.0001). At multiple regression analysis, 1-h glucose resulted in the major determinant of LVMI in normotolerant, IGT, and diabetic groups.

CONCLUSIONS

These data show that NGT ≥155 mg/dL subjects, compared with NGT <155 mg/dL subjects, have a higher LVMI and a greater prevalence of LVH similar to that of IGT and diabetic patients.
La médiation de rue comme régulation des désordres urbains
Authors: Marlière Éric , Fontaine Séverine
Published: April 2011

Résumé Les ruptures entre les jeunes dits « des cités » et les élus locaux se sont opérées progressivement depuis les années 1980. Elles se sont accentuées brutalement avec les émeutes de novembre 2005, comme le montrent les récentes échauffourées entre jeunes et police dans les cités populaires urbaines. Quelle que soit la culture politique de la commune, les élus locaux ont de plus en plus de mal à conserver de la crédibilité à l’égard d’une frange croissante de la jeunesse des quartiers populaires, celle qui se situe en marge. C’est le cas d’une municipalité « gauche » de la banlieue de Paris étudiée entre 2007 et 2008 qui voit une augmentation graduelle des tensions entre jeunes et institutions. Cette situation que l’on pourrait qualifier d’« explosive » amène les édiles municipaux à concevoir (avant les émeutes de 2005) un dispositif de médiation de rue composé d’adultes originaires des cités HLM qui composent la ville.
L'articulation des temps sociaux comme enjeu central chez les professionnels du social
Authors: Laloy David
Published: April 2011

Résumé Dans cet article, l’auteur démontre en quoi l’articulation des temps sociaux est un enjeu central chez les assistants sociaux et souligne le rôle de l’organisation dans cette activité banale de l’existence qui semble a priori relever de décisions individuelles. En partant d’une comparaison de cadres organisationnels contrastés du point de vue de leur degré de formalisation, l’article met en lumière leur influence sur la façon dont le travailleur inscrit son rôle professionnel dans l’espace et dans le temps et dont il l’articule avec ses engagements hors travail. De cette manière, il montre que les assistants sociaux ne sont pas dans des conditions identiques d’articulation pratique de leurs temporalités. Dans un deuxième temps, l’auteur interroge la dimension subjective de cette articulation et illustre l’importance de son harmonisation pour ces professionnels qui sont confrontés à des nœuds de tension mentale inhérents à la nature de leur travail et qui peuvent potentiellement perturber leur disponibilité dans des activités hors travail.
Dispositif d'insertion par le maraîchage biologique. Épreuve d'une nouvelle gouvernementalité
Authors: Muramatsu Kenjiro
Published: April 2011

Résumé Le travail d’insertion socio-professionnelle montre un mode d’exercice caractéristique de la gouvernementalité néolibérale et contemporaine. Le cas d’un dispositif d’insertion par le maraîchage biologique en Belgique, étudié dans ce texte, vise par sa forme une « production du corps régulateur » combinant concrètement les enjeux de régulation de l’économie et de contrôle de l’individu. Ainsi, loin d’être un simple effet illusoire d’une idéologie, son lieu d’opération constitue un lieu central de légitimation de l’action du « social » inscrit dans une politique de l’État social actif. Suite à une mise en évidence d’éléments de cadrage discursif et normatif de l’action, nous examinerons des effets de ce cadrage à partir de la forme d’engagement des opérateurs dans leur espace d’activités concret. Le régime d’action compassionnel de ces travailleurs, combiné à celui civique, se trouve au cœur de l’épreuve politique et pratique de cette nouvelle gouvernementalité.
3.3 AERIAL RELEASE SYSTEM FOR TRICHOGRAMMA MINUTUM RILEY IN PLANTATION FORESTS
Authors: Hope C.A. , Nicholson S.A. , Churcher J.J.
Published: April 2011

An aerial dispersal system was developed for inundative release of insect eggs, Anagasta kuehniella (Zeller) and Sitotroga cerealella (Olivier), parasitized by Trichogramma minutum Riley. The equipment was used successfully in field tests over a 4-year period (1982–1985) in a coniferous plantation forest near Hearst, Ont. The release equipment consisted of simple electrical components, mechanical components from a small grain planter, and a centrifugal slinger used for aerial seeding of jack pine. The equipment was mounted on a Bell® 47 helicopter, flown at about 25 m above the ground. A swath width of 15 m was attained using this system. Application rates ranged from 12.3 to 263.0 g ♀ ♀ parasitoids per hectare (0.6–25 × 106 ♀ ♀ parasitoids per hectare) during the 4 years of tests.