bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of anterior temporal lobectomy that spares the amygdala in patients with complex partial seizures
Authors: Goldring Sidney , Edwards Isaac , Harding Gary W. , Bernardo Kerry L.
Published: May 2009

✓ In December, 1980, the authors modified their anterior temporal lobectomies to exclude the amygdala from resection, a decision influenced by the dearth of pathology in the amygdala compared to the hippocampus. Furthermore, it had never been demonstrated that a good result was contingent upon including the amygdala per se in the lobectomy. Fifty-five (79%) of 70 patients in whom the amygdala was not resected were benefited by surgery. This result is similar to that achieved in series of anterior temporal lobectomies that include the amygdala in the resection. The results take on a special significance when considered together with those of amygdala-hippocampectomy which has been effective for controlling complex partial seizures of temporal mesiobasal origin (the region of the hippocampus, parahippocampal gyrus, and amygdala). A survey of the combined results strongly suggests that the anterior hippocampus and/or associated entorhinal cortex may be all that need be removed to control complex partial seizures caused by a temporal mesiobasal focus.
Seizure outcome following standard temporal lobectomy: correlation with hippocampal neuron loss and extrahippocampal pathology
Authors: Nakasato Nobukazu , Lévesque Michel F. , Babb Thomas L.
Published: May 2009

✓ The authors reviewed 149 patients who underwent standard anterior temporal lobectomies for intractable complex partial epilepsy with a mean follow-up period of 5 years. Quantitative analyses of hippocampal neuron loss showed that all patients had some cell loss compared to control hippocampi obtained at autopsy. The average hippocampal cell loss was categorized as severe (> 30% of autopsy control levels) or mild. Analysis of hippocampal and extrahippocampal pathologies showed that in 109 cases (73%, the hippocampal lesion group) hippocampal cell loss was mild in 17 cases (16%) and severe in 92 cases (84%); in the remaining 40 cases (27%, the extrahippocampal structural lesion group) hippocampal cell loss was mild in 24 cases (60%) and severe in 16 (40%).

The first index of surgical outcome was worthwhile seizure reduction, which occurred in 94 cases (86%) with mild or severe hippocampal lesions and in 33 cases (82%) with extrahippocampal pathology. In the hippocampal lesion group, worthwhile seizure reduction occurred in 90% of cases with severe and in only 65% of cases with mild hippocampal cell loss (p = 0.015). In the extrahippocampal pathology group, worthwhile seizure was not statistically different, whether hippocampal cell loss was severe (94% of cases) or mild (75% of cases). The second index of surgical outcome was the occurrence of residual seizures in the patients with worthwhile seizure reduction, which would indicate remaining epileptogenic tissue. In the hippocampal lesion group, the incidence of residual seizures was not statistically different whether hippocampal cell loss was severe (24% of cases) or mild (45% of cases). However, in the extrahippocampal pathology group, residual seizures occurred in 53% of cases with severe cell loss (dual pathology) but in only 11% of cases with mild cell loss (p = 0.025).

Worthwhile seizure reduction can be predicted by the presence of either severe hippocampal cell loss or an extrahippocampal structural lesion. However, residual seizures more frequently follow in cases with a combination of both (extrahippocampal pathology associated with severe hippocampal cell loss, or dual pathology), suggesting that epileptogenic tissue more likely extends outside the boundaries of a standard temporal lobectomy.
Aneurysm recurrence following endovascular balloon occlusion
Authors: Heilman Carl B. , Kwan Eddie S. K. , Wu Julian K.
Published: May 2009

✓ Endovascular balloon occlusion is an alternative treatment for surgically unclippable cerebral aneurysms. The results of aneurysm occlusion with either a silicone or a latex balloon in a common carotid artery bifurcation aneurysm model are compared to determine which type of balloon was least likely to result in aneurysm recurrence. Five rabbits each underwent endovascular balloon occlusion with either a silicone or a latex balloon, with seven rabbits serving as controls. At 3 months postocclusion, nine of the 10 balloon-treated aneurysms had recurred. The recurrent aneurysm tended to be larger in animals treated with silicone than with latex balloons. A dense fibrotic response was present around the collar of the latex balloons, but no significant fibrotic response was found in the silicone balloon group. This study suggests that with currently available balloons, the initial complete angiographic obliteration of an aneurysm following balloon occlusion should not be interpreted as a cure and that periodic follow-up angiography should be performed.
Diffuse leptomeningeal involvement by a ganglioglioma in a child
Authors: Wacker Margaret R. , Cogen Philip H. , Etzell Joan E. , Daneshvar Laleh , Davis Richard L. , Prados Michael D.
Published: May 2009

✓ Gangliogliomas are tumors composed of neuronal and glial elements that typically grow slowly by expansion only. This report describes a 20-month-old girl with a ganglioglioma that extensively involved the subarachnoid space; microscopic foci of tumor were found in the brain and spinal cord. Despite chemotherapy and radiation therapy, the child died 5 months after diagnosis. Molecular genetic analysis showed loss of chromosome 17p DNA sequences in the tumor tissue.
Ruptured dermoid tumor of the cavernous sinus associated with the syndrome of fat embolism
Authors: DeMonte Franco , Al-Mefty Ossama
Published: May 2009

✓ The syndrome of fat embolism is a well-known clinicopathological entity that may appear 2 to 4 days after skeletal trauma; nontraumatic causes have been recognized, however. This report details the fat embolism syndrome occurring in a patient after surgery within the cavernous sinus to remove a dermoid tumor.
Barnes Hospital and the Washington University Medical Center
Authors: Schwartz Henry G.
Published: May 2009

✓ The author documents the development of the Medical School at Washington University since 1891, when the St. Louis Medical College was first included as part of the University. In 1909, Robert Brookings, President of the Corporation of Washington University, acquired a large endowment and moved the clinical and hospital facilities to a new location, enabled by the estate of Robert Barnes. Harvey Cushing was offered the chair of surgery but eventually decided in favor of Harvard University in 1910. Dr. Ernest Sachs was recruited to Washington University by Dr. Fred Murphy, and in 1919 became the first ever Professor of Neurological Surgery. The history of neurosurgery and those who served it at the Washington University Medical Center and Barnes Hospital is recounted.
Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve
Authors: Nagaseki Yoshishige , Horikoshi Tohru , Omata Tomohiro , Ueno Takehiko , Uchida Mikito , Nukui Hideaki , Tsuji Reizoh , Sasaki Hideo
Published: May 2009

✓ An oblique sagittal magnetic resonance (MR) imaging method was developed to provide better visualization of vascular compression of nerves. The MR images of 12 patients with trigeminal neuralgia and 24 with hemifacial spasm were analyzed. The oblique sagittal views were obtained along the nerve identified by the axial view at an angle of 105° between the line along the dorsal brain stem and the line along the margin of the pontomedullary junction (in patients with hemifacial spasm) or by the midsagittal view through the midpons (in patients with trigeminal neuralgia). The T1- and T2-weighted, proton-density, and/or gradientecho MR images were evaluated to optimize imaging conditions. The oblique sagittal gradient-echo MR image most clearly visualized vascular compression of the nerves as high-intensity lines in six patients with trigeminal neuralgia, which was confirmed intraoperatively in four. Fifteen (75%) of 20 oblique sagittal gradient-echo MR images demonstrated vascular compression of the facial nerves in patients with hemifacial spasm; 12 of these were confirmed intraoperatively. The control study used 15 oblique sagittal gradient-echo MR images of nonaffected contralateral and normal sites. Four false-positive findings were found. Oblique sagittal gradient-echo MR images are a useful planning aid, allowing differential diagnosis prior to microvascular decompression in trigeminal neuralgia and hemifacial spasm.
Neuropeptide Y in the primate model of subarachnoid hemorrhage
Authors: Pluta Ryszard M. , Deka-Starosta Anna , Zauner Alois , Morgan Jay K. , Muraszko Karin M. , Oldfield Edward H.
Published: May 2009

✓ The cause of cerebral vasospasm after subarachnoid hemorrhage (SAH) remains unknown. Recently, an association between the potent vasoconstricting peptide, neuropeptide Y, and delayed cerebral vasospasm after SAH has been postulated. This was based on the findings of increased neuropeptide Y levels in the cerebrospinal fluid (CSF) and plasma after SAH in animals and humans. For this study, the primate model of SAH was used to assess the possible role of neuropeptide Y in delayed vasospasm after SAH. Fifteen cynomolgus monkeys underwent placement of a clot of either whole blood or red blood cells in the subarachnoid space around the middle cerebral artery (MCA). Sequential arteriography for assessment of MCA diameter and sampling of blood and CSF for neuropeptide Y were performed: before SAH (Day 0); 7 days after SAH, when signs of delayed cerebral vasospasm peak in this model and in humans; 12 days after SAH; and 28 days after SAH.

Subarachnoid hemorrhage did not evoke changes in CSF or plasma levels of neuropeptide Y. Nine monkeys had arteriographic evidence of vasospasm on Day 7, but no change in neuropeptide Y levels occurred in plasma or CSF. In addition, neuropeptide Y levels did not change, even after resolution of vasospasm on Day 12 or Day 28. Neuropeptide Y levels were substantially higher in CSF than in arterial plasma (p < 0.003 at each interval). No correlation was found between neuropeptide Y levels in CSF and in plasma. These results do not confirm a relationship between neuropeptide Y levels in the CSF or peripheral plasma and delayed cerebral vasospasm in SAH.
Insulin and insulin-like growth factors in central nervous system tumors
Authors: Glick Roberta P. , Unterman Terry G. , Van der Woude Mary , Zollner Blaydes Lisa
Published: May 2009

✓ The authors have previously reported the presence of insulin-like growth factor (IGF) receptors in central nervous system (CNS) tumors and the production of IGF's and their binding proteins by CNS tumors in situ. This study was designed to investigate whether CNS tumor cells are capable of autocrine secretion of IGF-I and IGF-II in vitro. Production of IGF's was studied by specific radioimmunoassay of tumor-cell-conditioned serum-free media from 34 CNS tumors: 12 gliomas, 12 meningiomas, and 10 miscellaneous tumors. Normal human serum and cerebrospinal fluid served as controls. Insulin-like growth factor I was detected in five of 12 meningiomas but in none of the gliomas studied. In contrast, IGF-II was detected in four of 12 gliomas and in six of 11 meningiomas studied. Four miscellaneous tumors produced IGF-I and/or IGF-II.

These results suggest that CNS tumors differentially produce IGF-I and IGF-II in vitro. Preferential production of IGF's may be an important marker of the tumor-cell differentiation or malignancy and may be useful as a clinical diagnostic tool. These results add further support to the concept that IGF's may play a role in the regulation of the behavior of CNS tumors.
Sinus pericranii: radiological and etiopathological considerations
Authors: Bollar Alicia , Allut Alfredo G. , Prieto Angel , Gelabert Miguel , Becerra Eugenio
Published: May 2009

✓ Sinus pericranii is a rare vascular anomaly involving an abnormal communication between the extracranial and intracranial circulations. A case of frontal sinus pericranii is presented which appeared to be a posttraumatic sinus because it developed 2 years after a cranial injury. However, the presence of vascular endothelium in the pathological examination and its association with a vascular anomaly (persistent trigeminal artery) suggested a congenital origin. The lesion, pericranial blood sinuses, and bone were totally removed. The computerized tomography, angiography, and magnetic resonance imaging findings are presented. The literature is reviewed and the pathogenesis of sinus pericranii is discussed.
Interhemispheric approach with callosal resection for distal anterior cerebral artery aneurysms
Authors: Traynelis Vincent C. , Dunker Ralph O.
Published: May 2009

✓ Distal anterior cerebral artery aneurysms are commonly found near the genu of the corpus callosum. While these aneurysms may be surgically obliterated through a variety of approaches, exposure via the interhemispheric fissure is used by many surgeons. Early identification of the afferent artery may be difficult with this approach, however, particularly if the aneurysm lies just beneath the genu of the corpus callosum. The authors have modified the interhemispheric approach to distal anterior cerebral artery aneurysms by electively exposing the feeding artery through a small anterior callosotomy. While this maneuver is not necessary for all distal anterior cerebral artery aneurysms, it can greatly enhance exposure in the region just below the genu of the corpus callosum. Experience with this technique in five patients is reported. In all cases, the limited anterior callosotomy enhanced surgical exposure. No morbidity could be attributed to the callosotomy in any patient. It is concluded that, when the interhemispheric approach is used, anterior callosotomy improves exposure of the region just below the genu of the corpus callosum and may be a useful maneuver when treating distal anterior cerebral artery aneurysms.
The benign course of cavernous carotid artery aneurysms
Authors: Kupersmith Mark J. , Hurst Robert , Berenstein Alejandro , Choi In Sup , Jafar Jafar , Ransohoff Joseph
Published: May 2009

✓ Recently, the benign nature of aneurysms of the cavernous carotid artery has been questioned. In a review of cases evaluated from 1980 to 1990 with this developmental aneurysm, the authors found 70 patients with 79 cavernous carotid artery aneurysms. As expected, the great majority (59 patients) had ophthalmoplegia as the initial problem. Retro-orbital pain (three cases) and a carotid-cavernous fistula (five cases) were infrequently the sole manifestation. Mirror-image asymptomatic aneurysms were found in nine patients and asymptomatic cavernous aneurysms were found in three additional patients. Thirty-four patients not surgically treated were followed for a mean of 2.8 years, and 36 surgical patients were followed for a mean of 4.1 years prior to treatment. Of the 79 aneurysms, one (1.3%) ruptured into the subarachnoid space during this period. Other than optic neuropathy or cranial neuropathy, no patient had a permanent neurological deficit; the 12 asymptomatic aneurysms remained asymptomatic. It is concluded that an aneurysm of the cavernous carotid artery is rarely associated with life-threatening complications, and treatment should be considered principally for patients with intolerable pain or problems related to vision.
Pediatric spinal injury: review of 174 hospital admissions
Authors: Hamilton Mark G. , Mylks S. Terence
Published: May 2009

✓ Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury, Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical and biomechanical features, distinguishes the young patient with an immature spine from older adolescents with a more mature, adult-like spine. The younger patients, while less likely to have spinal injury, had a higher incidence of neurological injury, in addition to a higher frequency of both spinal cord injury without radiological abnormality and upper cervical cord injury. In addition, younger patients with spinal cord injury and no radiological abnormality were more likely to have complete or severe cord injury. Prognosis was determined by the severity of spinal cord injury. Patients with complete cord injuries showed little improvement, while patients with incomplete injuries generally fared much better, with 74% showing significant improvement and 59% experiencing a complete recovery of neurological functions. There were six deaths, but none was attributed solely to spinal injury. The authors conclude that outcome is quite good after pediatric spinal cord injury that does not produce a physiologically complete cord deficit.
Hypoglossal-facial nerve anastomosis for facial nerve palsy following surgery for cerebellopontine angle tumors
Authors: Pitty Luis F. , Tator Charles H.
Published: May 2009

✓ Hypoglossal-facial nerve anastomosis is one of the procedures frequently performed to restore function after facial palsy secondary to surgery for removal of cerebellopontine angle tumors. The published results of hypoglossal-facial nerve anastomosis have been variable, and there are still questions about the indications, timing, and surgical techniques for this procedure. The goals of the present retrospective analysis of 22 cases of hypoglossal-facial nerve anastomosis were to assess the extent of the functional recovery and to analyze the factors affecting this recovery.

The 22 cases of complete facial palsy were gleaned from a series of 245 cases of cerebellopontine angle tumors treated surgically by one of the authors. Twenty patients had an acoustic neuroma (average size 3.5 cm), one patient had a petrous meningioma, and one patient had a facial neuroma. The average age of the patients was 47.3 years (range 19 to 69 years). The average interval from tumor surgery to hypoglossal-facial nerve anastomosis was 6.4 months (range 12 days to 17 months), and the average follow-up period after the procedure was 65 months.

The results were graded as good, fair, poor, or failure according to a new method of classifying facial nerve function after hypoglossal-facial nerve anastomosis. The results were good in 14 cases (63.6%), fair in three (13.6%), and poor in four (18.2%); one (4.5%) was a failure. Good and fair results occurred with higher frequency in younger patients who were operated on within shorter intervals, although these relationships were not statistically significant. There were no surgical complications. Good or fair results were achieved in 17 (77.3%) of the 22 cases, and thus hypoglossal-facial nerve anastomosis is considered an effective procedure for most patients with facial palsy after surgery for cerebellopontine angle tumors.
99mTc-hexamethylpropyleneamine oxime leukocyte scintigraphy and C-reactive protein levels in the differential diagnosis of brain abscesses
Authors: Grimstad Ivar Amund , Hirschberg Henry , Rootwelt Kjell
Published: May 2009

✓ The demonstration and accurate localization of intracerebral mass lesions are commonly performed with computerized tomography (CT), which often cannot determine the nature of the lesion. As an aid in the differential diagnosis between brain abscess and neoplasm, the authors have evaluated both 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) leukocyte scintigraphy and the serum C-reactive protein level. Of 23 patients with intracranial mass lesions, 22 individuals showed ring-like contrast enhancement on CT scans; the one exception was a patient treated for a meningioma who had a negative CT scan despite clinical suspicion of intra- or extracranial abscess. The final diagnosis was invariably established by microscopic examination of tissue specimens. In 10 patients the final diagnosis was brain abscess; the other 13 patients harbored a brain neoplasm (glioma in nine, astrocytoma in one, and metastasis in three). The 99mTc-HMPAO leukocyte scintigraphy detected all cases of abscess. There were no false-positive results. An elevated C-reactive protein level (> 13 mg/liter) was found in all but one patient with abscess and in three patients with neoplasm; two of these three patients had dental root infections which could account for the elevation of C-reactive protein.

It is concluded that 99mTc-HMPAO leukocyte scintigraphy should be performed when there is a possibility that a brain abscess may exist. Any steroid treatment should be discontinued for 48 hours prior to leukocyte scintigraphy. Also, C-reactive protein determination should be performed and is useful even when steroids are given.
Is vasospasm related to proliferative arteriopathy?
Authors: Pluta Ryszard M. , Zauner Alois , Morgan Jay K. , Muraszko Karin M. , Oldfield Edward H.
Published: May 2009

✓ Although proliferative arteriopathy has been postulated to play a role in the etiology of vasospasm after subarachnoid hemorrhage (SAH), histological and morphological studies examining cerebral vasospasm have produced conflicting results. To help settle this controversy, the authors used an in vivo label of cell division, bromodeoxycytidine, to assess cell proliferation in a primate model of SAH.

Fifteen cynomolgus monkeys received a clot of either whole blood (11 animals) or red blood cells (four animals) placed around the right middle cerebral artery (MCA). On the day of surgery continuous intravenous infusion of bromodeoxycytidine was begun and continued until the animal was sacrificed immediately after arteriography on Day 7, 12, or 27 following surgery. Sections from the right and left MCA's were stained with a monoclonal antibody against bromodeoxcytidine, and labeled cells were counted.

Arteriographic evidence of vasospasm occurred in nine monkeys on Day 7. On Day 12 and Day 27 no monkeys had persistent vasospasm. Placement of subarachnoid clot around the right MCA increased proliferative activity across all layers of the arterial wall. Most of the labeled cells were in the adventitia and the endothelium. Although there were more dividing cells in all layers of the right MCA than the left MCA (p < 0.01), the number of stained cells per section was limited (range 0.1 to 21.2, mean 8) and the occurrence of vasospasm was not associated with the number of dividing cells in the right MCA on Day 7, 12, 27, or for all days combined (p > 0.6).

Cerebral vasospasm after SAH was not associated with the extent of proliferation of cells in the vessel wall, nor could the intensity of the limited proliferative changes have been responsible for narrowing of the vessel diameter.
Expression of cell adhesion molecule E-cadherin in human arachnoid villi
Authors: Yamashima Tetsumori , Tohma Yasuo , Yamashita Junkoh
Published: May 2009

✓ Calcium-dependent epithelial cell adhesion molecules designated as E-cadherin (also known as uvomorulin or L-CAM) were identified in human arachnoid villi by immunoblotting and immunocytochemical analyses using a monoclonal antibody HECD-1 raised against human mammary carcinoma MCF-7 cells. Immunoblot analysis showed that HECD-1 recognizes E-cadherin with a molecular weight of 124 kD. In all arachnoid cells of an arachnoid villus, E-cadherin was detected by immunolight microscopy within the cytoplasm rather than the cellular boundaries as seen in the control group. Furthermore, the extent of expression by immunolight microscopy varied from portion to portion. The expression was usually weak in the syncytial cluster which was ultrastructurally composed of tightly juxtaposed cells characterized by few extracellular cisterns and numerous cell junctions, while it was intense in the reticular cluster and the surface layer which were ultrastructurally characterized by abundant extracellular cisterns and smaller numbers of cell junctions. The cells of the reticular cluster and the surface layer contained more free ribosomes than those of the syncytial cluster. Immunoelectron microscopy showed that E-cadherin was localized not only to the opposing plasma membranes and the cytoplasm around the free ribosomes or the rough endoplasmic reticulum but also to the extracellular cisterns. As the expression of E-cadherin was closely related to the arachnoid cells adjacent to the cerebrospinal fluid pathway, it is suggested that, instead of the cell junctions, E-cadherin may play an important role in the flexible adhesion of arachnoid cells even in the presence of the cerebrospinal fluid.
Antitumor activity against established intracerebral gliomas exhibited by cytotoxic T lymphocytes, but not by lymphokine-activated killer cells
Authors: Holladay Frank P. , Heitz Teresa , Wood Gary W.
Published: May 2009

✓ Specific immune responses against malignant brain tumors have been difficult to demonstrate. Moreover, immunotherapy has met with little success, despite using lymphocytes with high levels of cytotoxicity against brain tumor cells. Lymphokine-activated killer (LAK) cells that nonspecifically kill brain tumor cells are produced by stimulating resting precursors with high concentrations of interleukin-2 (IL-2). Cytotoxic T lymphocytes that specifically kill brain tumor cells are produced by stimulating antigen receptor-positive immune-cell precursors with tumor cells. In an attempt to gain insight into immune cell function against brain tumors, the present study compared thein vitroandin vivoactivities of LAK cells and cytotoxic T lymphocytes produced against RT2, a fast-growing rat glioma cell line. Lymphokine-activated killer cells were produced by stimulating normal rat spleen cells with 1000 units of IL-2, and RT2-specifie cytotoxic T lymphocytes were produced by priming themin vivowith RT2 andCorynebacterium parvumand restimulating primed spleen cells with RT2in vitro. Lymphokine-activated killer cells were highly cytotoxic for a panel of syngeneic and allogeneic brain tumor and non-brain tumor target cells, including RT2, as measured in a 4-hour51Cr release assay. Cytotoxic T lymphocytes were highly cytotoxic only for syngeneic brain tumor target cells. Lymphokine-activated killer cells and cytotoxic T lymphocytes were tested forin vivoantitumor activity against intracerebral RT2 by intravenous adoptive transfer of activated lymphocytes. Untreated rats died in approximately 2 weeks. Lymphokine-activated killer cells plus IL-2 failed to affect survival when treatment was initiated as early as 1 day following tumor inoculation. Cytotoxic T lymphocytes and IL-2 administered as late as Day 5 rejected progressing intracerebral tumor. Thus, although both cytotoxic T lymphocytes and LAK cells exhibited high levels ofin vitrokilling of glioma cells, only cytotoxic T lymphocytes rejected progressing intracerebral tumors.
Inhibition of delayed arterial narrowing by the iron-chelating agent deferoxamine
Authors: Harada Tsutomu , Mayberg Marc R.
Published: May 2009

✓ The potential role of iron in cerebral vasospasm was examined in the rat femoral artery model by the perivascular application of deferoxamine, a ferric ion chelator and antioxidant. In 25 rats, platelet-rich plasma or fresh autologous whole blood containing deferoxamine at concentrations of 1, 5, 10, or 15 mg/ml was applied to the adventitial surface of the femoral artery in a Silastic cuff to insure chronic exposure to the vessel wall. At 7 days, contralateral femoral arteries exposed to whole blood showed a 70% reduction in luminal cross-sectional area and morphological changes associated with vasospasm. Application of platelet-rich plasma or whole blood containing deferoxamine at 25 mg/ml produced no significant arterial narrowing or structural changes; significant intermediate reductions in arterial narrowing were observed at deferoxamine concentrations of 5 and 10 mg/ml. Presaturation deferoxamine (10 mg/ml) with excess ferric ion prior to application eliminated the protective effect. In addition, deferoxamine chelated the ferric ion released from incubated whole blood in vitro over 7 days in a dose-dependent manner consistent with its protective effect in vivo. Ferric ion may influence the development of chronic arterial narrowing after subarachnoid hemorrhage by a variety of mechanisms.
Leptomeningeal dissemination of cerebellar pilocytic astrocytoma
Authors: Mishima Kazuhiko , Nakamura Masanao , Nakamura Hirohiko , Nakamura Osamu , Funata Nobuaki , Shitara Nobuyuki
Published: May 2009

✓ A case of surgically treated pilocytic astrocytoma in the cerebellar vermis is reported in a patient who subsequently demonstrated multiple subarachnoid nodular masses in the cerebrum and spinal cord 6 years after the initial surgery. The nodular tumors did not indicate a growth tendency on computerized tomography or magnetic resonance imaging over a 2-year observation period. The histology of the nodular masses in the cerebrum and spinal cord was similar to that of the original tumor. The bromodeoxyuridine labeling index indicated low proliferative activity (0.5%). The peculiar pattern of dissemination of the pilocytic astrocytoma is described.
Childhood odontoid fractures evaluated with computerized tomography
Authors: Vining David J. , Benzel Edward C. , Orrison William
Published: May 2009

✓ A case is presented that illustrates the use of computerized tomography for the evaluation of an odontoid fracture in a child. Such a “fracture” may actually represent a “synchondrotic slip” of the odontoid and C-2 vertebral body between the neural arches of C-2. Treatment should almost always be conservative. Complete healing of the injury is expected.
Intracranial arterial aneurysm due to birth trauma
Authors: Piatt Joseph H. , Clunie David A.
Published: May 2009

✓ The authors present what is believed to be the first description of an intracranial arterial aneurysm attributable to birth trauma. A male neonate, the product of a precipitious, instrumented, footling breech delivery, exhibited seizures at the age of 18 hours. A computerized tomography scan of the head showed hemorrhage along the tentorium with a globular component at the incisura. Transfontanel Doppler ultrasound examination detected pulsatile arterial flow within the globular mass. Cerebral angiography demonstrated a 1.5-cm saccular aneurysm arising from a small distal branch of the superior cerebellar artery. The pathogenesis of aneurysms in children is obscure and controversial. Birth trauma may be responsible for some pediatric aneurysms that are currently classified as idiopathic or congenital, particularly aneurysms in the region of the tentorial incisura.
Botulinum toxin enhancement of postoperative immobilization in patients with cervical dystonia
Authors: Traynelis Vincent C. , Ryken Timothy , Rodnitzky Robert L. , Menezes Arnold H.
Published: May 2009

✓ Postoperative immobilization in patients with cervical dystonia requiring fusion presents a unique management problem. Two patients with severe degenerative cervical spine disease secondary to chronic repetitive motion are reported. Both required a surgical fusion and postoperative immobilization. Botulinum toxin was injected intramuscularly to assist in immobilization. The technique used is described.
Transpedicular screw-rod fixation of the lumbar spine: operative technique and outcome in 104 cases
Authors: Dickman Curtis A. , Fessler Richard G. , MacMillan Michael , Haid Regis W.
Published: May 2009

✓ A total of 104 patients underwent transpedicular spinal instrumentation using the Cotrel-Dubousset (71 cases) or the Texas Scottish Rite Hospital (33) screw-rod system. Surgery was performed for lumbar vertebral column instability secondary to fractures (28 cases), spondylolisthesis (29), tumors (four), vertebral osteomyelitis (two), or postoperative causes (41). Pseudoarthrodesis due to failure of a prior fusion was present in 37 cases.

The 55 men and 49 women (mean age 47 years, range 18 to 87 years) all presented with severe back pain. Signs or symptoms of neural compression were noted in 96 patients. Surgery consisted of neural decompression, internal fixation, and autogenous iliac bone grafting. Spondylolistheses were fusedin situ, without reduction; otherwise, major spinal deformities were corrected. A total of 516 pedicle screws were placed. The mean extent of fusion was 2.7 motion segments (range one to six motion segments).

A 96% fusion rate was obtained with a mean follow-up period of 20 months. There were no operative deaths. Major complications included one spinal epidural hematoma, three isolated nerve root deficits (two transient, one permanent), and three wound infections (two deep, one superficial). Instrument failure eventually developed in 18 patients; nine were asymptomatic with a solid fusion and did not require further treatment and the other nine were symptomatic or had a pseudoarthrosis and required operative revision.

Pedicle screw-rod fixation offers biomechanical advantages compared to other forms of internal fixation for the lumbar spine. It enables short-segment fixation with preservation of lumbar lordosis and adjacent normal motion segments. This technique provides a highly successful method to obtain arthrodesis, even with prior pseudoarthrosis.
Unruptured aneurysms and postoperative volume expansion
Authors: Swift Dale M. , Solomon Robert A.
Published: May 2009

✓ After a ruptured aneurysm has been clipped in patients with multiple aneurysms, the question often arises whether to use volume expansion and/or hypertensive treatment to prevent delayed cerebral ischemia (vasospasm). There is understandable concern regarding the possible rupture of unprotected aneurysms under additional hemodynamic stress. In a series of 199 patients with aneurysmal subarachnoid hemorrhage who underwent early surgery, 31 were left with one or more unprotected aneurysms postoperatively. All patients were treated with prophylactic volume expansion based on a previously reported protocol. Mean central venous pressure during treatment was 10.3 cm H2O and mean arterial blood pressure 141/76 mm Hg; volume expansion was continued for 7 to 10 days. Eight patients developed symptoms of delayed cerebral ischemia and required additional volume expansion and induced hypertension. After institution of hypertension, four of these patients experienced a reversal of their symptoms, while four others developed cerebral infarcts. One patient died from massive cerebral infarction following vasospasm refractory to all measures. No patient suffered rupture of an unprotected aneurysm during hypervolemic treatment. It is concluded that the benefit of prophylactic hypervolemic hypertension in postoperative aneurysm patients warrants its use even in patients with unprotected aneurysms.
Effects of intermittent reperfusion during temporal focal ischemia
Authors: Goldman Marc S. , Anderson Robert E. , Meyer Fredric B.
Published: May 2009

✓ There is controversy regarding the role of intermittent reperfusion employed as a cerebroprotective measure when temporary arterial occlusion is necessary during repair of difficult aneurysms. The intraluminal suture middle cerebral artery (MCA) occlusion technique was used in 23 Wistar rats under barbiturate anesthesia to induce 60, 90, or 120 minutes of uninterrupted MCA occlusion. The total infarcted areas obtained were compared to those occurring in 27 animals subjected to identical cumulative ischemic periods but with 5 minutes of reperfusion after every 10-minute ischemic period. The mean total infarcted areas in the groups with 60-minute (1.8 ± 0.89 sq mm), 90-minute (1.08 ± 1.02 sq mm), and 120-minute (8.72 ± 5.89 sq mm) intermittent reperfusion were significantly smaller than those occurring in the 60-minute (12.02 ± 3.10 sq mm), 90-minute (11.54 ± 2.68 sq mm), or 120-minute (30.43 ± 6.51 sq mm) control groups, respectively (p < 0.05). Furthermore, there was no difference in the occurrence of blood-brain barrier breakdown, intraparenchymal hemorrhage, hemispheric edema, or seizures between control and intermittent reperfusion groups. The results support the hypothesis that intermittent reperfusion is beneficial if vessel occlusion is required during aneurysm repair.
Regional metabolism in experimental brain tumors in cats: relationship with acid/base, water, and electrolyte homeostasis
Authors: Okada Yoshikazu , Kloiber Otmar , Hossmann Konstantin A.
Published: May 2009

✓ Experimental brain tumors were produced in cats by xenotransplantation of the rat glioma clone F98 into the white matter of the left hemisphere. One to 4 weeks after implantation, local adenosine triphosphate (ATP), glucose, lactate, and tissue pH were measured via imaging techniques in cryostat sections passing through the center of the tumor and correlated with changes in water and electrolyte content. The tumors exhibited a heterogeneous metabolic pattern, with a tendency for ATP to decrease and lactate to increase during tumor development. Tissue pH was above 7.5 in tumors with high ATP content but it sharply declined at low ATP levels. In peritumoral edema, ATP also decreased and lactate increased but, in contrast to tumor tissue, pH became more alkaline. Metabolic changes were associated with edema formation, as evidenced by the rise in water and sodium content. There was a distinct difference between tumor tissue and peritumoral edema: in tumor tissue, pH declined with increasing water content, whereas in peritumoral edema it increased.

These observations are interpreted as follows: 1) in tumor tissue, “lactacidosis” and ATP depletion are attributed to disturbances in blood flow, resulting in metabolic failure and the intracellular “cytotoxic” accumulation of water; 2) in peritumoral edema, “lactalkalosis” is the result of an efflux of (alkaline) lactate salts from the tumor into the expanded extracellular compartment, and the decrease in ATP is the volumetric effect of extracellular “vasogenic” edema fluid and not the result of cellular energy failure. These findings are of importance for the interpretation of volume-selective magnetic resonance spectroscopy and may contribute to the establishment of spectroscopic criteria for the evaluation of therapeutical interventions.
Angioplasty for basilar artery atherosclerosis
Authors: Ahuja Arvind , Guterman Lee R. , Hopkins Leo N.
Published: May 2009

✓ A case is presented of severe atherosclerosis of the basilar artery, successfully treated with percutaneous transluminal balloon angioplasty. Crescendo daily transient ischemic attacks consisted of alternating hemiplegia and were refractory to medical management, including anticoagulation therapy. The clinical course, endovascular treatment, and results are described. Prior published experiences with this condition are reviewed.
Bilateral morning glory syndrome associated with sphenoid encephalocele
Authors: Itakura Toru , Miyamoto Kazuki , Uematsu Yuji , Hayashi Seiji , Komai Norihiko
Published: May 2009

✓ Morning glory syndrome is a congenital anomaly of the optic disc in which the disc is enlarged and excavated, with white glial tissue in the center. A case is presented of morning glory syndrome associated with sphenoid encephalocele, median cleft lip, and agenesis of the corpus callosum. A 22-day-old boy was referred to the Wakayama Medical College Hospital for management of dyspnea due to a soft-tissue mass in the oral cavity. Magnetic resonance imaging revealed a mass extending through a bone defect in the sphenoid region and into the oral cavity. Surgical repair was attempted through a bifrontal craniotomy. A bone defect was identified in the sphenoid plate, through which the arachnoid membrane was connected to the oral cavity. Both optic nerves were elongated and adhered to the encephalocele. The wall of the meningocele was compressed digitally through the oral cavity and sutured to the dura mater of the bone defect. The operative findings suggest that a basal encephalocele protruding from a bone defect in the sphenoid plate may disturb the normal development of the optic nerve.
Transaqueductal migration of a neurocysticercus cyst
Authors: Kramer Jonathan , Carrazana Enrique J. , Cosgrove G. Rees , Kleefield Jonathan , Edelman Robert R.
Published: May 2009

✓ The clearly documented transaqueductal migration of a solitary intraventricular neurocysticercus cyst is described. The cyst was fortuitously demonstrated on magnetic resonance imaging during migration through the aqueduct. The radiological appearance and clinical significance of this condition are discussed.
Effect of chronic smoking on lipid peroxidation and antioxidant status in gastric carcinoma patients
Authors: Pasupathi Palanisamy , Chinnaswamy Palanisamy , Saravanan Ganesan , Senthil Kumar Utharasamy
Published: May 2009

The effect of chronic cigarette smoking on lipid peroxidation and antioxidant status in 100 newly diagnosed patients with gastric cancer was studied. Equal number of age- and sex-matched healthy control subjects was taken as control. The level of plasma and erythrocyte thiobarbituric acid reactive substances (TBARS) was markedly increased in both the gastric cancer patients when compared to control subjects. The activities of enzymatic and non-enzymatic antioxidants were significantly decreased in both (smokers and non-smokers) gastric cancer groups when compared to control subjects. Comparatively, the increased TBARS level and decreased antioxidants level was observed in smokers than non-smoking gastric cancer patients. The present study highlights the occurrence of lipid peroxidation and possible breakdown of antioxidant status in cigarette smoking, which may subsequently increase the possibility of initiation and progression of gastric cancer. Keywords: Antioxidant; Gastric carcinoma; Lipid peroxidation; SmokingOnline: 20 May 2009DOI: 10.3329/bmrcb.v35i1.2132Bangladesh Med Res Counc Bull 2009; 35: 1-6
Management of vaginal agenesis by modified McIndoe operation and mould made of sponge and condom
Authors: Khanam Nurun Nahar , Akhter Sayebe , Rahman Nusrat , Runa Jakia Sultana
Published: May 2009

Keywords: Agenesis; Condom; McIndoe operation; Sponge; VaginaOnline:Â 22 May 2009DOI: 10.3329/bmrcb.v35i1.2318Bangladesh Med Res Counc Bull 2009; 35: 27-28
Prevalence of hepatitis C virus infection in rural adult population of Bangladesh
Authors: Safiullah A.B.M. , Bhuiyan Md. Muzibur Rahman , Miah M.A. Rahim , Raihan A.S.M.A.
Published: May 2009

Keywords: Bangladesh; Hepatitis C; Prevalence; Viral infectionOnline:Â 22 May 2009DOI: 10.3329/bmrcb.v35i1.2319Bangladesh Med Res Counc Bull 2009; 35: 30-32
Analysis of Airborne Betula Pollen in Finland; a 31-Year Perspective
Authors: Yli-Panula Eija , Fekedulegn Desta Bey , Green Brett James , Ranta Hanna
Published: May 2009

In this 31-year retrospective study, we examined the influence of meteorology on airborne Betula spp. (birch) pollen concentrations in Turku, Finland. The seasonal incidence of airborne birch pollen in Turku occurred over a brief period each year during spring (April 30 – May 31). Mean peak concentrations were restricted to May (May 5 to 13). Statistically significant increases in the annual accumulated birch pollen sum and daily maximum values were observed over the study period. Birch pollen counts collected in April were retrospectively shown to increase over the duration of the study. Increases in April temperature values were also significantly associated with the earlier onset of the birch pollen season. Furthermore, the number of days where daily birch pollen concentrations exceeded 10 and 1,000 grains/m3 also increased throughout the study period. These data demonstrate that increases in temperature, especially during months preceding the onset of the birch pollen season, favor preseason phenological development and pollen dispersal. Birch pollen derived from other geographical locations may also contribute to the aerospora of Turku, Finland. To date, the public health burden associated with personal exposure to elevated birch pollen loads remains unclear and is the focus of future epidemiological research.
Voltage-Dependent Anion Channel 2 of Arabidopsis thaliana (AtVDAC2) Is Involved in ABA-Mediated Early Seedling Development
Authors: Yan Jinping , He Han , Tong Shibo , Zhang Wanrong , Wang Jianmei , Li Xufeng , Yang Yi
Published: May 2009

The voltage-dependent anion channel (VDAC) is the major transport protein in the outer membrane of mitochondria and plays crucial roles in energy metabolism, apoptosis, and metabolites transport. In plants, the expression of VDACs can be affected by different stresses, including drought, salinity and pathogen defense. In this study, we investigated the expression pattern of AtVDAC2 in A. thaliana and found ABA suppressed the accumulation of AtVDAC2 transcripts. Further, phenotype analysis of this VDAC deregulated-expression transgenic Arabidopsis plants indicated that AtVDAC2 anti-sense line showed an ABA-insensitivity phenotype during the early seedling development under ABA treatment. The results suggested that AtVDAC2 might be involved in ABA signaling in A. thaliana.
Applications and Degradation of Proteins Used as Tissue Engineering Materials
Authors: Wang Hua-Jie , Di Ling , Ren Qiu-Shi , Wang Jin-Ye
Published: May 2009

This article provides an up-to-date review on the applications of natural polymers, i.e., proteins, as materials for tissue engineering. Proteins are one of the important candidates for tissue engineering materials based on their superior biocompatibility, biodegradation, bioresorbability, and so on. However, their inferior mechanical properties limit their broad application. Currently-available proteins for application in tissue engineering or drug delivery systems, such as fibrin, collagen, zein, silk fibroin, keratin, casein and albumin, and the biodegradation of tissue-engineered substitutes based on proteins are presented. Techniques of scaffold fabrication are also mentioned. Problems and future possibilities for development of protein-based tissue-engineered substitutes are also introduced in this review.
Nanomaterials - Acetylcholinesterase Enzyme Matrices for Organophosphorus Pesticides Electrochemical Sensors: A Review
Authors: Periasamy Arun Prakash , Umasankar Yogeswaran , Chen Shen-Ming
Published: May 2009

Acetylcholinesterase (AChE) is an important cholinesterase enzyme present in the synaptic clefts of living organisms. It maintains the levels of the neurotransmitter acetylcholine by catalyzing the hydrolysis reaction of acetylcholine to thiocholine. This catalytic activity of AChE is drastically inhibited by trace amounts of organophosphorus (OP) pesticides present in the environment. As a result, effective monitoring of OP pesticides in the environment is very desirable and has been done successfully in recent years with the use of nanomaterial-based AChE sensors. In such sensors, the enzyme AChE has been immobilized onto nanomaterials like multiwalled carbon nanotubes, gold nanoparticles, zirconia nanoparticles, cadmium sulphide nano particles or quantum dots. These nanomaterial matrices promote significant enhancements of OP pesticide determinations, with the thiocholine oxidation occurring at much lower oxidation potentials. Moreover, nanomaterial-based AChE sensors with rapid response, increased operational and long storage stability are extremely well suited for OP pesticide determination over a wide concentration range. In this review, the unique advantages of using nanomaterials as AChE immobilization matrices are discussed. Further, detection limits, sensitivities and correlation coefficients obtained using various electroanalytical techniques have also been compared with chromatographic techniques.
Exosomes in Tumour Immunity
Authors: Clayton A. , Mason M. D.
Published: May 2009

Exosomes are nanometre-size vesicles manufactured within late multi-vesicular endosomes and actively secreted into the extracellular environment [...]