bluuebunny/crossref_metadata_2025 huggingface dataset:
Myoclonic jerks secondary to piperacillin and nafcillin
Authors: Meyer Michael A.
Published: November 2014

A 66-year-old male receiving intravenous piperacillin and nafcillin for a post-surgical wound infection developed intermittent myoclonic jerks of all four extremities that disappeared after discontinuation of these two medications. In addition there was a mild yet definite intermittent encephalopathic effect; head computed tomography examination as negative and there was no prior history for seizure or myoclonus. These two beta lactam ring antibiotics are structurally similar to penicillin, which is well known to induce not only myoclonus but also seizure activity by reducing the gamma-aminobutyric acid (GABA) induced inhibitory currents by inducing an open chloride channel block of the GABA type A receptors within the brain. Clinicians need to be fully aware of the potential epileptogenic effects of piperacillin, nafcillin, and related antibiotics.
Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients
Authors: Marrone Luiz Carlos Porcello , Gadonski Giovani , Diogo Luciano Passamani , Brunelli João Pedro Farina , Martins William Alves , Laguna Gabriela De Oliveira , Bahlis Laura Fuchs , Hoefel-Filho João Rubião , Da Costa Bartira Ercilia Pinheiro , Poli-de-Figueiredo Carlos Eduardo , Marrone Antônio Carlos Huf , Da Costa Jaderson Costa
Published: November 2014

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiologic entity not yet understood, that presents with transient neurologic symptoms and particular radiological findings. Few papers show the differences between pregnant and non-pregnant patients. We review the cases of 38 women diagnosed with PRES, in order to find significant differences between pregnant (18) and non-pregnant (20) patients. We found differences among the age of patients (25.83 years old in pregnant and 29.31 years old in non pregnant; P=0.001); in the mean of highest systolic blood pressure, that was higher in non-pregnant group (185:162 mmHg; P=0.121); and in creatinine levels that was higher in non-pregnant group (3.47:1.04 mg/dL; P=0.001). To our knowledge, just a few papers analyzed whether PRES syndrome presented in the same way in pregnant and non-pregnant patients. The differences and the possible pathophisiology of this syndrome still remain enigmatic.
Oromandibular dystonia in Yemeni patients with khat chewing: a response to botulinum toxin treatment
Authors: Shehata Hatem S. , El-Tamawy Mohamed S. , Mohieldin Nevin , Edrees Mohammed , Bohlega Saeed
Published: November 2014

Khat-(Catha edulis) related oromandibular dystonia is a difficult-to-treat subset of movement disorders that involve masticatory muscles with diverse and incapacitating manifestations. The aim of this study was to evaluate the efficacy of Botulinum toxin-type A therapy in khat chewer Yemeni patients with oromandibular dystonia. This prospective study included 18 khat-chewers Yemeni patients with refractory oromandibular dystonia, who were subjected to Botulinum toxin-A injection and followed up for 3 months thereafter. Primary efficacy outcome was the global impression scale, and secondary outcome measure was the Unified Dystonia Rating Scale. Patients showed improvement of both efficacy measures, maximum satisfactory responses were detected at the forth week after injection. No major adverse events were detected. Botulinum toxin-A is considered an effective and safe treatment option for refractory oromandibular dystonia in khat-chewers.
Highly expressed genes within hippocampal sector CA1: implications for the physiology of memory
Authors: Meyer Michael A.
Published: November 2014

As the CA1 sector has been implicated to play a key role in memory formation, a dedicated search for highly expressed genes within this region was made from an on-line atlas of gene expression within the mouse brain (GENSAT). From a data base of 1013 genes, 16 were identified that had selective localization of gene expression within the CA1 region, and included Angpt2, ARHGEF6, CCK, Cntnap1, DRD3, EMP1, Epha2, Itm2b, Lrrtm2, Mdk, PNMT, Ppm1e, Ppp2r2d, RASGRP1, Slitrk5, and Sstr4. Of the 16 identified, the most selective and intense localization for both adult and post-natal day 7 was noted for ARHGEF6, which is known to be linked to non-syndromic mental retardation, and has also been localized to dendritic spines. Further research on the role played by ARHGEF6 in memory formation is strongly advocated.
Proteomic Analysis of the Pulvinus, a Heliotropic Tissue, in Glycine max
Authors: Lee Hakme , Garrett Wesley , Sullivan Joseph , Forseth Irwin , Natarajan Savithiry S.
Published: November 2014

Certain plant species respond to light, dark, and other environmental factors by leaf movement. Leguminous plants both track and avoid the sun through turgor changes of the pulvinus tissue at the base of leaves. Mechanisms leading to pulvinar turgor flux, particularly knowledge of the proteins involved, are not well-known. In this study we used two-dimensional gel electrophoresis and liquid chromatography-tandom mass spectrometry to separate and identify the proteins located in the soybean pulvinus. A total of 183 spots were separated and 195 proteins from 165 spots were identified and functionally analyzed using single enrichment analysis for gene ontology terms. The most significant terms were related to proton transport. Comparison with guard cell proteomes revealed similar significant processes but a greater number of pulvinus proteins are required for comparable analysis. To our knowledge, this is a novel report on the analysis of proteins found in soybean pulvinus. These findings provide a better understanding of the proteins required for turgor change in the pulvinus.
A New Start
Authors: Sofo Adriano
Published: November 2014

Dear editors, scientists and readers [...]
Carbon Dioxide Enrichment Restrains the Impact of Drought on Three Maize Hybrids Differing in Water Stress Tolerance in Water Stressed Environments
Authors: Yang Jinyoung , Sicher Richard , Kim Moon , Reddy Vangimalla
Published: November 2014

Three maize genotypes were grown in controlled environment chambers with ambient (38 Pa) or elevated (70 Pa) carbon dioxide and water stress treatments were initiated 17 days after sowing. Shoot dry weight of the drought tolerant hybrid in both CO2 treatments was 44 to 73% less than that of the intermediate and sensitive hybrids when seedlings were well watered. Decreased shoot and root dry weights of the tolerant maize hybrid due to drought were about one-half that of the other two hybrids. Genotypic differences were observed in decreases of soil water content, leaf water potential, net photosynthesis and stomatal conductance in response to drought. Eleven of 19 amino acids measured in this study increased, methionine was unchanged and alanine and aspartate decreased in response to drought in the ambient CO2 treatment. Increased amino acid levels under elevated CO2 were observed at the end of the experiment. Significant genotypic differences were detected for amino acid responses to drought. Effects of drought on all three genotypes were mitigated by CO2 enrichment. Decreased shoot growth likely improved the stress tolerance of a highly drought resistant maize hybrid by reducing moisture loss, improving soil moisture content and increasing leaf water potential.
Precursory seismicity pattern before strong earthquakes in Greece
Authors: Baskoutas Ioannis , Papadopoulos George Anatoli
Published: November 2014

The temporal variation of seismicity, based on the retrospective analyses of three seismic parameters i.e., number of earthquakes, bvalue and energy released, have shown significant changes. Their remarkable relation with strong earthquakes occurrence was formulated as a qualitative character precursory seismicity pattern, which were interpreted in terms of a strong earthquakes occurrence preparation phases. The main characteristic of this pattern is that permits the identification of two period of low and high probability for an earthquake occurrence, suggesting its utility in the current seismic hazard assessment, by the continuous monitoring of the temporal variation of the seismic parameters in a given area. This paper investigates the qualitative and quantitative characteristics of the proposed precursory seismicity pattern, before al strong earthquakes occurrence in Greece the time period 2000-2008.
Robotic-Assisted Surgery Approach in a Biliary Rhabdomyosarcoma Misdiagnosed as Choledochal Cyst
Authors: Nakib Ghassan , Calcaterra Valeria , Goruppi Ilaria , Romano Piero , Raffaele Alessandro , Schleef Jurgen , Pelizzo Gloria
Published: November 2014

Rhabdomyosarcoma is a soft tissue malignant tumor affecting 1% of children from 0 to 14 years. Preoperative imaging may not always be diagnostic for hepatobiliary rhabdomyosarcoma and differential diagnosis with choledochal cyst (CC) could be difficult. We report a case of 2-years-old girl with a strange CC pattern of presentation. A grapelike lesion involving the choledochal and biliary ducts was easily and completely resected by robotic assisted surgery. Since no previous reports were available about oncologic safety of robotic approach, the porto-enterostomy was performed in open surgery. On histologic examination, the specimen revealed a botryoidembryonal rhabdomyosarcoma affecting both the common bile duct and the common hepatic duct. One year postoperatively the child is safe of tumor relapse. Robotic approach seems to be safe and advantageous to obtain a radical excision of the tumor at the porta hepatis, even in case of misdiagnosed malignant lesion mimicking a CC.
Vena Cava ınvasion by Adrenal Leiomyosarcoma
Authors: Öztürk Hakan
Published: November 2014

Primary adrenal mesenchymal tumors are extremely rare. These tumors are hard to diagnose, and similar to certain adrenal tumors, as they do not produce hormones, and they can only manifest themselves when the tumor reaches an advanced size. These tumors are generally detected incidentally. This study reports a rare case of primary leiomyosarcoma of the right adrenal gland with vena cava invasion, in a 70-year-old woman who presented with right flank pain. Computerized tomography showed an adrenal mass with a diameter of 78 mm, which exerted pressure on the vena cava inferior. The invasive part was excised by using adrenalectomy and cavatomy. Tumor invasion was determined on the wall of the vena cava. Histopathological examination on 10× magnification showed 8-10 mitotic events. Immunohistochemical staining showed that the cells were SMA (+), desmin (+), cytokeratin (-), and Bcl-2 (-). The Ki67 proliferation index was 70%. Widespread metastasis developed six months after the adrenalectomy.
The End-of-Life Experience of Patients with Rare Cancers and their Caregivers
Authors: Loggers Elizabeth Trice , Prigerson Holly G.
Published: November 2014

Little is known about the end-of-life (EOL) experience of patients with rare cancers (PRC) or their caregivers. From September 2002 to August 2008, 618 stage IV cancer patients [195 PRC and 423 patients with common cancers (PCC)] and their caregivers participated in an interview-based cohort study. Patients were interviewed about EOL preferences, planning, medical care, and followed until death. Interviews with caregivers at baseline assessed caregiver mental and physical health; and postmortem, assessed EOL patient care. PRC were four times more likely than PCC to be receiving both radiation and chemotherapy at study entry (10.3% vs 3.3%, respectively, adjusted odds ratio 4.31, P=0.003). PRC's caregivers were more likely to report declining health (22.1% vs 15.7%, P=0.05) and marginally more likely to report using mental health services to cope than PCC's caregivers. PRC were as likely to acknowledge their illness was terminal, have EOL discussions, and participate in advance care planning as PCC. Future research should investigate terminal care for PRC and how providing care affects caregivers’ physical and mental health.
Squamoid Cystosis of Pancreatic Ducts: A Variant of a Newly-Described Cystic Lesion, with Evidence for an Obstructive Etiology
Authors: Foo Wai Chin , Wang Huamin , Prieto Victor G. , Fleming Jason B. , Abraham Susan C.
Published: November 2014

We describe a 40-year-old man who was found to have a cystic mass in the pancreatic tail during workup for weight loss and abdominal discomfort. Although computed tomography scan showed a single cyst associated with dilatation of the main pancreatic duct, gross and histologic examination of the distal pancreatectomy specimen actually revealed a central cyst that was surrounded by multiple smaller cystic spaces. This distinctive appearance was formed from extensive cystic dilatation and squamous metaplasia of the native pancreatic duct system. Further, a traumatic neuroma was discovered near the junction between normal and abnormal parenchyma. We believe that this case represents a variant of the newly-described squamoid cyst of pancreatic ducts which we term squamoid cystosis of pancreatic ducts. The presence of chronic pancreatitis and a traumatic neuroma supports the hypothesis that squamoid cysts are non-neoplastic lesions arising from prior duct obstruction.
Connection between Cell Phone use, p53 Gene Expression in Different Zones of Glioblastoma Multiforme and Survival Prognoses
Authors: Akhavan-Sigari Reza , Baf Morteza Mazloum Farsi , Ariabod Vahid , Rohde Veit , Rahighi Saeed
Published: November 2014

The aim of this paper is to investigate p53 gene expression in the central and peripheral zones of glioblastoma multiforme using a real-time reverse transcription polymerase chain reaction (RT-PCR) technique in patients who use cell phones ≥3 hours a day and determine its relationship to clinicopathological findings and overall survival. Sixty-three patients (38 males and 25 females), diagnosed with glioblastoma multiforme (GBM), underwent tumor resection between 2008 and 2011. Patient ages ranged from 25 to 88 years, with a mean age of 55. The levels of expression of p53 in the central and peripheral zone of the GBM were quantified by RT-PCR. Data on p53 gene expression from the central and peripheral zone, the related malignancy and the clinicopatholagical findings (age, gender, tumor location and size), as well as overall survival, were analyzed. Forty-one out of 63 patients (65%) with the highest level of cell phone use (≥3 hours/day) had higher mutant type p53 expression in the peripheral zone of the glioblastoma; the difference was statistically significant (P=0.034). Results from the present study on the use of mobile phones for ≥3 hours a day show a consistent pattern of increased risk for the mutant type of p53 gene expression in the peripheral zone of the glioblastoma, and that this increase was significantly correlated with shorter overall survival time. The risk was not higher for ipsilateral exposure. We found that the mutant type of p53 gene expression in the peripheral zone of the glioblastoma was increased in 65% of patients using cell phones ≥3 hours a day.
A Case of Cystic Schwannoma in the Neck Masquerading as Branchial Cleft Cyst
Authors: Bohara Sangita , Dey Biswajit , Agarwal Swapnil , Gupta Richa , Khurana Nita , Gulati Achal
Published: November 2014

One-third of schwannomas occur in head and neck region, mostly in the parapharyngeal region. Cystic change is seen in only 4% of schwannomas. The diagnosis of such tumors remains a challenge due to the rarity of these lesions and limited utility of fine needle aspiration cytology. When cystic, branchial cleft cyst is an important differential diagnosis more so due to radiological resemblance. We present a case of 42-year-old male with left sided neck mass masquerading as branchial cleft cyst clinically and radiologically. Multiple sections examined from the cystic areas of the mass revealed lymphoid aggregates beneath the cyst wall in addition to the schwannomatous areas.
Schwannoma of the Cervical Esophagus
Authors: Ferrante Marc , Khan Arfa , Fan Cathy , Jelloul Fatima Zahra
Published: November 2014

Esophageal schwannoma is a rare tumor first described in 1967 by Chaterlin and Fissore. These tumors are most commonly found incidentally or from diagnostic work up of dysphagia or dyspnea. This entity cannot be diagnosed on clinical or radiographic basis alone. Histology demonstrates palisading spindle cells, few if any mitotic figures, and a peripheral cuff of lymphoid cells. Immunohistochemically, tumor cells stain positive for S100, a characteristic marker of Schwann cells. Once diagnosed, surgical enucleation is the typical treatment method employed.
Tumor Lysis Syndrome in Solid Tumors: An up to Date Review of the Literature
Authors: Mirrakhimov Aibek E. , Ali Alaa M. , Khan Maliha , Barbaryan Aram
Published: November 2014

Tumor lysis syndrome (TLS) is a potentially deadly complication of tumors or their treatment. This syndrome consists of a constellation of laboratory findings such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, known as laboratory TLS. When clinical complications such as seizures, acute renal failure, and cardiac dysrhythmias occur in patients with laboratory TLS, the syndrome is called clinical TLS. TLS is especially common in patients with hematological malignancies with rapid cellular turnover rates such as acute lymphocytic leukemia and Burkitt lymphoma, but is very rare in patients with solid tumors. Nevertheless, there are multiple reports in the literature on the occurrence of TLS in patients with solid tumors. In this review article, we summarize the current data on the occurrence of TLS in patients with solid tumors. We propose an algorithm of risk stratification and prevention of TLS in patients with solid cancers.
Rare Primary Central Nervous System Tumors
Authors: Kubicky Charlotte Dai , Sahgal Arjun , Chang Eric L. , Lo Simon S.
Published: November 2014

There are close to 70,000 new cases of primary central nervous system tumors diagnosed annually in the United States. Meningiomas, gliomas, nerve sheath tumors and pituitary tumors account for 85% of them. There is abundant literature on these commonly occurring tumors but data from the literature on infrequently encountered tumors such as atypical teratoid/rhabdoid tumor, choroid plexus carcinoma, ganglioglioma, hemangiopericytoma, and pleomorphic xanthoastrocytoma are limited. This review provides an overview of the clinicopathologic and therapeutic aspects of these rare primary central nervous system tumors.
Immature Uterine Teratoma Associated with Uterine Inversion
Authors: Souza Karla Teixeira , Negrão Marcelo Vailati , da Silva Rocha Lucila Soares , Di Favero Giovanni , da Costa Samantha Cabral Severino , Diz Maria Del Pilar Estevez
Published: November 2014

Teratomas are the most commonly diagnosed germ cell tumors and occur primarily in testes and ovaries. Platinum-based therapy followed by surgical resection of the residual lesion is generally the recommended treatment. In contrast, immature uterine teratomas are rare, with few cases reported in the literature. Moreover, there is no standard treatment for these tumors. Non-puerperal uterine inversion is also rare in women younger than 45 years of age, and neoplastic lesions are responsible for this condition. Here, we report a case of an immature uterine teratoma associated with uterine inversion. The patient underwent surgery followed by adjuvant chemotherapy and continues to be monitored.
Outbreak prevalence of Newcastle disease in Erbil and surrounding areas (Iraq)
Authors: Babaca Zahir Abdullateef J.
Published: November 2014

The researcher has selected 17 farms in and around Erbil City (Iraq) with a history of Newcastle Disease (ND) outbreaks for the investigation during late spring, summer and winter of 2008, a time of the year when the outbreaks in Erbil start to occur. The strain of birds (all vaccinated with Lasota strain) including age, clinical diagnostic lesions, flock strength and mortality rate, were recorded. The study found that fowls with ages of (1-8 weeks) were susceptible to ND and that the mortality rate was (8.1%) in chicks broilers.
Experimental caprine coccidiosis: the pattern of changes in antioxidant micronutrients and vitamins
Authors: Rakhshandehroo Ehsan , Razavi Seyed Mostafa , Nazifi Saeed
Published: November 2014

This study aimed at investigating the status of non-enzymatic antioxidant agents during experimental caprine coccidiosis. A total of 20 newborn kids were selected and allocated into 2 (diseased and healthy) groups. Ten of the kids were infected with sporulated oocysts of the most pathogenic species of Eimeria and ten served as controls. Blood samples were taken at 0 (before inoculation), 3, 7, 14, 21, 28 and 35 days post infection (dpi) and the concentrations of antioxidant trace elements, antioxidant vitamins and ceruloplasmin were measured. Our data showed remarkable reductions in serum concentrations of some antioxidant trace elements (zinc, manganese and selenium) and vitamins (vitamin C) in the diseased kids, however, significant increases were observed in the serum level of ceruloplasmin in infected animals. These alterations became more prominent at 14 to 21 dpi. These observations suggest that Eimeria parasites can significantly interfere with the levels of some antioxidant trace elements and vitamins during caprine coccidiosis. These changes indicate the overproduction of oxidative radicals during the pathogenesis of Eimeria species that may account for extensive oxidative damage in infected animals.
Boosting Newcastle disease vaccination efficacy under field conditions by aromatic plant essential oil extracts
Authors: Khalifeh Mohammad S. , Abu-Basha Ehab A.
Published: November 2014

This study was performed to evaluate the effects of commercially available aromatic plant essential oil extracts (MixOilTM) on the protection outcome achieved after a Newcastle disease (ND) vaccination. Antibody production, after a MixOil treatment administered along with a vaccination program applying a live attenuated Newcastle disease virus (NDV) vaccine, was assessed under field conditions. The antibody response was evaluated via a Hemagglutination Inhibition test and an Enzyme-Linked Immunosorbent Assay. Later, the experimental groups were challenged with two velogenic NDV strains: Herts 33 and a local virulent NDV strain. A MixOil treatment effect with a higher dose was also examined. It was observed that ND antibody titers were enhanced when the birds were placed on a MixOil immune system-boosting program during vaccination. The mortality rate decreased by at least 50% after regular MixOil immune boosting; it also decreased following larger treatment doses. Clearly, promoting a strong bird immune system through herbal supplementation would naturally be expected to create a successful vaccination outcome and healthy flocks of birds. In addition, the results suggest that, by applying a higher dose of MixOil, the treatment can exceed its immune-stimulator benefits; it resulted in controlling the mortality outcome from the experimental ND infection.
Missionale kerkwees en die elektroniese sosiale media
Authors: Lazenby Martin J. , Niemandt Cornelius J.P.
Published: November 2014

Die geweldige toename in die benutting van die sosiale media as interaktiewe kommunikasiemiddel wêreldwyd, bied aan die Christelike kerk groot missionale geleenthede, maar stel ook groot uitdagings en eise. Hierdie geleentheid moet benut word om missionaal ’n verskil ten gunste van God se koninkryk te maak. Die inhoud en die kommunikasiestyl kom onder die vergrootglas. Hierdie artikel poog om ’n paar bybels-etiese beginsels aan te dui wat as basis vir die missionale styl van kommunikasie moet dien. As uitgangspunt word die Bybel as die Woord van God gebruik. Daar word geredeneer dat die moreel-etiese beginsels wat in die Bybel aan die gelowige voorgeskryf word, van die grootste belang is om gestalte te gee aan die koninkryk van God in hierdie wêreld wanneer via die sosiale media op horisontale vlak met mense gekommunikeer word. Dit gaan dus vir die gelowige nooit net om humanistiese, sosiale kommunikasie nie, maar altyd dat die beeld van God in hierdie wêreld geëer en sy koninkryk daardeur uitgebou word. Vir die Christen-gelowige gaan dit nooit om die mens nie, maar altyd om God se eer en die manifestasie van sy koninkryk.Being a missional church and the social media. The tremendous increase in using the social media as interactive communication medium worldwide creates the opportunity for the Christian church to make a missional difference in favour of God’s kingdom on earth. It also brings great challenges with it. This means that the way communication via the mass social media is done, becomes of the utmost importance. The content as well as the manner in which the communication is conducted must be considered. This article aims at providing certain basic biblical-ethical principles for communicating in the mass social media that will serve the missional calling of the church. The point of departure is the Word of God. The basic focus of the argument is that the moral-ethical principles given to the believer in the Bible are of the utmost importance to give practical form to the kingdom of God on earth by means of horisontal communication via the social media. For the Christian believer the focus never falls on humanistic social communication as such, but always to glorify the image of God and thereby expand God’s kingdom in this world.
An examination of the factors fueling migration amongst Community Service practitioners
Authors: Reardon Candice , George Gavin
Published: November 2014

Background: Research is needed in order to understand the potential influence of the Bilateral Agreement between South Africa and the United Kingdom (UK), as well as other more recent international and local policies restricting movement of South African health workers abroad; and to determine what effect they have on the migration intentions and plans of health professionals in South Africa.Aim: The aims were to (1) explore the migration intentions and the factors that influence these intentions amongst Community Service (CS) nurses and doctors; (2) explore their views and opinions about the Bilateral Agreement between the UK and South Africa (SA) and other UK policies around the recruitment and employment of foreign health professionals; and (3) understand the impact of these policies on the migration plans of these CS doctors and nurses.Method: Qualitative focus groups and interviews were conducted with 23 CS doctors and nurses. To supplement this, 6 interviews were conducted with nurses and a doctor who had worked in the UK.Results: A higher disposition toward moving abroad was apparent amongst those who had experienced a challenging and frustrating CS year. Poor working conditions, including long work hours, high patient loads and inadequate resources and equipment, as well as low salaries and the perceived ambivalence of the government to the complaints of health practitioners, were influencing decisions to migrate abroad.Conclusion: The findings suggest that government efforts to better manage, recognise and respect the work and contribution of health professionals to the country would go a long way toward retaining health professionals.
Dorsally exophytic glioblastoma arising from the medulla oblongata in an adult presenting as 4th ventricular mass
Authors: Das Kuntal , Bettaswamy Guru , Mehrotra Anant , Jaiswal Sushila , Jaiswal Awadhesh , Behari Sanjay
Published: November 2014

Brainstem gliomas are relatively rare in adults (<2% of all gliomas). Exophytic gliomas are focal brainstem lesions, which project into the 4th ventricle or cerebellopontine angles. These exophytic lesions are usually of low-grade histology (pilocytic astrocytoma or ganglioglioma) and have a relatively better outcome compared with brainstem gliomas as a whole. Glioblastoma is the commonest primary glial cell neoplasm and mostly occurs in the supratentorial compartment. It is rather uncommon in the brainstem and seldom has been described as having an exophytic growth pattern. Here we describe an exophytic brainstem glioblastoma arising from the medulla oblongata in a 55-year-old lady who presented with a 4th ventricular mass, and present a brief review of the literature. Till now, six cases of glioblastoma arising from the medulla oblongata have been reported. So, ours is the seventh such report. To the best of our knowledge, it also happens to be the sixth reported case of dorsally exophytic brainstem glioblastoma till date.
Challenges in a case of ophthalmic artery aneurysm associated with abnormal internal carotid arteries
Authors: Dinca Eduard , Brehar Felix , Giovani Andrei , Ciurea Alexandru
Published: November 2014

Ophthalmic artery aneurysms account for 5% of all cerebral aneurysms and are an important cause of morbidity and mortality related to subarachnoid hemorrhage. The diagnosis is often made only when the aneurysm is large enough to become symptomatic. They remain technically challenging for both neurosurgeon and interventional radiologist. We present the case of a 62-year-old woman admitted for transient loss of consciousness, followed by generalized tonic-clonic seizures. Computed tomography (CT) showed a subarachnoid hemorrhage (SAH), clinically graded as Hunt and Hess III. Magnetic resonance imaging (angioMR) and the four-vessel digital subtraction angiography (DSA) identified a ruptured, 8 mm left ophthalmic artery aneurysm. Embolization was the first therapeutic choice. Nevertheless, the attempt had to be aborted due to a combination of a hypoplastic right internal carotid artery (ICA) and an irregular atheromatous plaque on the left ICA, rendering the procedure unduly hazardous. Therefore, microsurgical clipping of the aneurysm became the procedure of choice. Postoperatively, the patient was in good condition, with no visual and neurological deficits. At 6 months follow up, she was assigned maximum scores of 5 and 8 on the Glasgow Outcome Scale (GOS) and Extended GOS (GOS-E), respectively. Aneurysm rupture represents a neurosurgical emergency and an early intervention (less than 48 h) is recommended to maximize the chances of deficit-free survival. The peculiarities of this case consisted in the combination between the size and the location of the aneurysm, abrupt presentation, and the impossibility of embolization due to bilateral ICA abnormalities, congenital (hypoplastic right ICA) and acquired (extensively atherosclerotic left ICA).
Pleomorphic xanthoastrocytoma with anaplastic features: A rare case report and review of literature with reference to current management
Authors: Patibandla M , Nayak Madhukar , Purohit A , Thotakura Amit , Uppin Megha , Challa Sundaram
Published: November 2014

Pleomorphic xanthoastrocytoma (PXA) is an uncommon tumor constitutes less than 1% of all astrocytic glial neoplasms was first reported in 1979.PXA commonly occurs in young patients and manifests itself first as seizures followed by focal neurological deficits. The role of radiotherapy or chemotherapy has not yet been established because of the relative infrequency of this disease. PXA is classified as grade II tumor in the WHO classification of tumors of the CNS. In literature 9 to 20 % PXA may undergo malignant change at recurrence or may display at the time of initial presentation. Malignant transformation is mainly associated with high mitotic activity and necrosis. The criteria for PXA with anaplastic features was five or more mitotic activity per 10 high power fields, necrosis, microvascular proliferation, marked cellular anaplasia, and high Ki-67 labeling indices. PXA with anaplastic features management is highly controversial as very sparse literature is available.We are reporting a case of PXA with anaplastic features with atypical radiology and tried to review the up to date literature regarding this rare tumor.
Postoperative hematoma involving brainstem, peduncles, cerebellum, deep subcortical white matter, cerebral hemispheres following chronic subdural hematoma evacuation
Authors: Patibandla Mohana , Thotakura Amit , Shukla Dinesh , Purohit Anirudh , Addagada Gokul , Nukavarapu Manisha
Published: November 2014

Among the intracranial hematomas, chronic subdural hematomas (CSDH) are the most benign with a mortality rate of 0.5-4.0%. The elderly and alcoholics are commonly affected by CSDH. Even though high percentage of CSDH patients improves after the evacuation, there are some unexpected potential complications altering the postoperative course with neurological deterioration. Poor outcome in postoperative period is due to complications like failure of brain to re-expand, recurrence of hematoma and tension pneumocephalus. We present a case report with multiple intraparenchymal hemorrhages in various locations like brainstem, cerebral and cerebellar peduncles, right cerebellar hemisphere, right thalamus, right capsulo-ganglionic region, right corona radiata and cerebral hemispheres after CSDH evacuation. Awareness of this potential problem and the immediate use of imaging if the patient does not awake from anesthesia or if he develops new onset focal neurological deficits, are the most important concerns to the early diagnosis of this rare complication.
Medullomyoblastoma: A rare case in an unusual location in an atypical age group
Authors: Bansal Sumit , Borkar Sachin , Suri Ashish , Sharma Mehar , Mahapatra Ashok
Published: November 2014

Medullomyoblastoma is a variant of medulloblastoma with an aggressive course. It is typically seen in children less than 10 years of age and usually arises from the cerebellar vermis. Authors report an unusual case of medullomyoblastoma arising from the right middle cerebellar peduncle in an adult patient and pertinent literature is reviewed regarding this uncommon entity.
Interhemispheric transcallosal transforaminal approach and its variants to colloid cyst of third ventricle: Technical issues based on a single institutional experience of 297 cases
Authors: Nair Suresh , Gopalakrishnan C , Menon Girish , Easwer H , Abraham Mathew
Published: November 2014

Context: Colloid cysts are benign intracranial lesions that usually involve the anterior third ventricle with varying appearance on imaging studies. The number of articles debating the origin of this tumor is surpassed by papers proposing the best modality available for its treatment
Aim: The purpose of this study is to analyze the clinical presentation and surgical outcome of colloid cysts surgically managed over a period of thirty-two years and evaluate the technical issues based on our experience.
Study Design: This is a retrospective case series study. Materials and Methods: This is a retrospective case series study on 297 consecutive patients with colloid cysts who were operated. The case records of all the patients were evaluated to record the clinical symptoms and signs, imaging findings, surgical procedure, complications and follow-up data. Results: There were 178 (60%) males and 119 (40%) females, their age ranging from 9 to 66 years with a mean age of 28 years. The mean duration of symptoms was 1.8 months. Raised intracranial pressure headache was the most common initial presenting symptom followed by visual blurring, memory disturbance and drop attacks with gait unsteadiness. The tumor was an incidental imaging finding in five patients (2%). While an interhemispheric transcallosal approach was used in 275 (92.6%) patients, it was trans-cortical in 22 (7.4%). Twenty-two patients required emergency surgery in view of worsening sensorium. Postoperative complications included memory impairment, limb weakness and seizures. Despite documented complete excision of the tumor in 6 cases, 8 patients had recurrence of tumor during follow-up. Conclusion: Colloid cysts are potential life threatening but benign lesions that can be removed safely with low morbidity and mortality through the interhemispheric transcallosal approach and its variants. The possibility for recurrence warrants, close imaging follow-up after surgery. It is essential for neurosurgeons to be familiar with the different transcallosal approaches to reach the third ventricle especially for a posteriorly situated cyst and a narrow foramen of Munro.
Distal posterior cerebral artery revascularization for a fusiform PCA aneurysm: A lesson learned
Authors: Britz Gavin , Zomorodi Ali , Powers Ciaran
Published: November 2014

The need for revascularization with proximal posterior cerebral artery occlusion in the treatment of giant and fusiform aneurysms is unclear. While early series demonstrated only about a 10% chance of infarction following posterior cerebral artery occlusion, recently several authors have advocated a bypass prior to parent vessel sacrifice in all cases. We present the case of an adult man with a fusiform aneurysm of the right posterior cerebral artery at the P2-P3 junction. He clinically failed a balloon test occlusion preoperatively and therefore underwent an occipital artery to distal posterior cerebral artery bypass with subsequent endovascular occlusion of the parent vessel and aneurysm. Despite the fact that the immediate and 6 month follow up cerebral angiography confirmed a patent bypass, the patient still developed a posterior cerebral artery territory stroke. We believe this case demonstrates that successful distal revascularization in the setting of proximal posterior cerebral artery occlusion does not guarantee against cerebral ischemia and infarction even in those patients that fail a test occlusion.
Lethal penetrating stab injury to the vertebral artery: A case report with review of literature
Authors: Sarkari Avijit , Singh Pankaj , Mahapatra Ashok
Published: November 2014

The vertebral arteries are rarely injured in penetrating neck trauma due to their deep location in the foramen transversarium. These injuries in isolation are not associated with neurological deficits or ischemic changes on radiology as the collaterals are usually sufficient. We report a case of fatal unilateral vertebral artery stab injury leading to bilateral cerebellar and brainstem infarction. The carotid Doppler ruled out the presence of any carotid artery injury. Life-threatening injuries are possible in the presence of hypoplastic contralateral vertebral artery or inadequate flow from the anterior circulation not making up for the deficit. This emphasizes that thorough evaluation and timely management of suspected injuries to even a single vertebral artery should be undertaken.
Alveolar soft part sarcoma with brain metastases
Authors: Perumall Vinodh , Harun Rahmat , Sellamuthu Pulivendhan , Shah Mohd
Published: November 2014

Metastatic tumors are the most common mass lesions in the brain. This case reports a rare form of sarcoma with metastasis to the brain. The appropriate management of a patient with metastatic alveolar soft part sarcoma to the brain is discussed. Author describes a 32-year-old gentleman diagnosed with primary tumor at gluteus and distant metastases at lower lobe of right lung and the brain. Histopathology proves diagnosis as alveolar soft part sarcoma. Craniotomy with excision of brain lesion was done. Repeated magnetic resonance imaging of the brain after 2 months showed rapidly growing new lesions. The next step of management was made by the oncology team as recurrence rate was high and due to multi-systemic involvement. Patient was planned for palliative chemotherapy and to be reassessed later. This case report discusses the appropriate approach to any form of brain metastases and the role of early follow-up especially after surgery for better outcome and choice of post operative management such as radiotherapy or chemotherapy or both for malignant tumors. Based on this report, it was concluded that every brain tumor patient should be frequently monitored even in the outpatient setting as most of them are metastatic and rapidly spreading. The patient should be considered for radiotherapy or chemotherapy or both after surgery if the histopathology result is suggestive of malignancy.
Clival defect causing primary spontaneous rhinorrhea
Authors: Tandon Vivek , Garg Kanwaljeet , Suri Ashish , Garg Ajay
Published: November 2014

Primary cerebrospinal fluid (CSF) rhinorrhea due to a defect in clivus is an extremely rare entity, till date only four such cases are reported in the world literature. We present a case of 55-year-old female who presented with primary spontaneous CSF rhinorrhea, for which endonasal surgery was performed about 9 years back. Patient developed recurrent CSF leak with a history of meningitis. Repeat imaging showed clival defect causing CSF leak. Transsphenoidal repair was performed under neuronavigation. In this paper, we discuss the possible mechanism of fistula formation and literature is reviewed.
The C*–algebras of Compact Transformation Groups
Authors: Archbold Robert J. , an Huef Astrid
Published: November 2014

We investigate the representation theory of the crossed–product C*–algebra associated with a compact group G acting on a locally compact space X when the stability subgroups vary discontinuously. Our main result applies when G has a principal stability subgroup or X is locally of finite G–orbit type. Then the upper multiplicity of the representation of the crossed product induced from an irreducible representation V of a stability subgroup is obtained by restricting V to a certain closed subgroup of the stability subgroup and taking the maximum of the multiplicities of the irreducible summands occurring in the restriction of V. As a corollary we obtain that when the trivial subgroup is a principal stability subgroup; the crossed product is a Fell algebra if and only if every stability subgroup is abelian. A second corollary is that the C*–algebra of the motion group ℝn ⋊ SO(n) is a Fell algebra. This uses the classical branching theorem for the special orthogonal group SO(n) with respect to SO(n − 1). Since proper transformation groups are locally induced from the actions of compact groups, we describe how some of our results can be extended to transformation groups that are locally proper.
Continuous and discontinuous variation in ecosystem carbon stocks with elevation across a treeline ecotone
Authors: Speed J. D. M. , Martinsen V. , Hester A. J. , Holand Ø. , Mulder J. , Mysterud A. , Austrheim G.
Published: November 2014

Abstract. Treelines differentiate vastly contrasting ecosystems: open tundra from closed forest. Treeline advance has implications for the climate system due to the impact of the transition from tundra to forest ecosystem on carbon (C) storage and albedo. Treeline advance has been seen to increase above-ground C stocks as low vegetation is replaced with trees, but decrease organic soil C stocks as old carbon is decomposed. However, studies comparing across the treeline typically do not account for elevational variation within the ecotone. Here we sample ecosystem C stocks along an elevational gradient (970 to 1300 m), incorporating a large-scale and long-term livestock grazing experiment, in the Southern Norwegian mountains. We investigate whether there are continuous or discontinuous changes in C storage across the treeline ecotone, and whether these are modulated by grazing. We find that vegetation C stock decreases with elevation, with a clear breakpoint between the forest line and treeline above which the vegetation C stock is constant. In contrast, C stocks in organic surface horizons of the soil increase linearly with elevation within the study's elevational range, whereas C stocks in mineral soil horizons are unrelated to elevation. Total ecosystem C stocks also showed a discontinuous elevational pattern, increasing with elevation above the treeline (8 g m−2 m−1 increase in elevation), but decreasing with elevation below the forest line (−15 g m−2 m−1 increase in elevation), such that ecosystem C storage reaches a minimum between the forest line and treeline. We did not find any effect of short-term (12 years) grazing on the elevational patterns. Our findings demonstrate that patterns of C storage across the treeline are complex, and should be taken account of when estimating ecosystem C storage with shifting treelines.
Sampling frequency trade-offs in the assessment of mean transit times of tropical montane catchment waters under semi-steady-state conditions
Authors: Timbe E. , Windhorst D. , Celleri R. , Timbe L. , Crespo P. , Frede H.-G. , Feyen J. , Breuer L.
Published: November 2014

Abstract. Stream and soil waters were collected on a weekly basis in a tropical montane cloud forest catchment for two years and analyzed for stable water isotopes in order to infer transit time distribution functions and to define the mean transit times. Depending on the water type (stream or soil water), lumped distribution functions such as Exponential-Piston flow, Linear-Piston flow and Gamma models using temporal isotopic variations of precipitation event samples as input, were fitted. Samples were aggregated to daily, weekly, biweekly, monthly and bimonthly time scales in order to check the sensitivity of temporal sampling on model predictions. The study reveals that the effect of decreasing sampling frequency depends on the water type. For soil waters with transit times in the order of weeks to months, there was a clear trend of over prediction. In contrast, the trend of prediction for stream waters, with a dampened isotopic signal and mean transit times in the order of 2 to 4 years, was less clear and depending on the type of model used. The trade-off to coarse data resolutions could potentially lead to misleading conclusions on how water actually moves through the catchment, while at the same time predictions can reach better fitting efficiencies, lesser uncertainties, errors and biases. For both water types an optimal sampling frequency seems to be one or at most two weeks. The results of our analyses provide information for the planning (in particular in terms of cost-benefit and time requirements) of future fieldwork in similar Andean or other catchments.
Vehicle Detection and Classification from High Resolution Satellite Images
Authors: Abraham L. , Sasikumar M.
Published: November 2014

Abstract. In the past decades satellite imagery has been used successfully for weather forecasting, geographical and geological applications. Low resolution satellite images are sufficient for these sorts of applications. But the technological developments in the field of satellite imaging provide high resolution sensors which expands its field of application. Thus the High Resolution Satellite Imagery (HRSI) proved to be a suitable alternative to aerial photogrammetric data to provide a new data source for object detection. Since the traffic rates in developing countries are enormously increasing, vehicle detection from satellite data will be a better choice for automating such systems. In this work, a novel technique for vehicle detection from the images obtained from high resolution sensors is proposed. Though we are using high resolution images, vehicles are seen only as tiny spots, difficult to distinguish from the background. But we are able to obtain a detection rate not less than 0.9. Thereafter we classify the detected vehicles into cars and trucks and find the count of them.
Indoor Ultra-Wide Band Network Adjustment using Maximum Likelihood Estimation
Authors: Koppanyi Z. , Toth C. K.
Published: November 2014

Abstract. This study is the part of our ongoing research on using ultra-wide band (UWB) technology for navigation at the Ohio State University. Our tests have indicated that the UWB two-way time-of-flight ranges under indoor circumstances follow a Gaussian mixture distribution that may be caused by the incompleteness of the functional model. In this case, to adjust the UWB network from the observed ranges, the maximum likelihood estimation (MLE) may provide a better solution for the node coordinates than the widely-used least squares approach. The prerequisite of the maximum likelihood method is to know the probability density functions. The 30 Hz sampling rate of the UWB sensors enables to estimate these functions between each node from the samples in static positioning mode. In order to prove the MLE hypothesis, an UWB network has been established in a multi-path density environment for test data acquisition. The least squares and maximum likelihood coordinate solutions are determined and compared, and the results indicate that better accuracy can be achieved with maximum likelihood estimation.