bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiogenic shock in myocardial infarction-results of in-hospital follow-up
Authors: Kawecki Damian , Morawiec Beata , Rybczyk Renata , Trzepaczyńska Zofia , Przywara-Chowaniec Brygida , Wojciechowska Celina , Fudal Marcin , Wilczewski Przemysław , Jacheć Wojciech , Nowalany-Kozielska Ewa
Published: December 2010

The purpose of this study was to present the outcomes of treatment of cardiogenic shock (CS) complicating acute myocardial infarction (AMI) among patients hospitalized from 1999 through 2006. The study enrolled 1003 patients. Group 1 comprised 87 patients presenting with AMI complicated with CS, whereas Group 2 comprised 916 patients presenting with AMI without CS symptoms. Determination of invasive treatment was according to standard guidelines. The endpoint comprised death, stroke, and reocclusion/reinfarction. Follow-up was confined to the intra-hospital period. CS was observed more frequently in cases of ST-elevation MI (STEMI) and right ventricular MI. The transportation and door-to-needle time were shorter in Group 1. CS patients were characterized by a more severe coronary artery disease, higher maximal creatinine kinase levels, lower global ejection fractions, and increased incidence of atrioventricular conduction disorders. The efficacy of percutaneous coronary intervention (PCI) was 82.26% in Group 1 and 95.03% in Group 2. Death occurred in 33.3% of CS patients and in 3.6% of AMI patients (p<0.0001). Our study proved that in a short-term follow-up, PCI is a procedure of high efficacy in CS patients. The short-term follow-up precluded a conclusion of statistically significant benefits from the shortening of the transportation and door-to-needle time.
Evaluation of CO2 Emissions from Energy Sources in Latvia
Authors: Blumberga D. , Veidenbergs I. , Gusca J. , Rosa M.
Published: January 2011

Evaluation of CO2Emissions from Energy Sources in Latvia

The authors propose an empirical model for evaluation of the CO2emissions released from the energy generation sources as a function of the fuel types, energy efficiency of the technologies used, and the emission factors of the fuels. In the research, multifactor linear and nonlinear regression equations are employed. The developed model has been proved with the data of the energy generation sources taking part in the Latvian Emission Trading Scheme.
Ciliates on the Macrophytes in Industrially Heated Lakes (Kujawy Lakeland, Poland)
Authors: Babko R. , Fyda J. , Kuzmina T. , Hutorowicz A.
Published: December 2010

Ciliates on the Macrophytes in Industrially Heated Lakes (Kujawy Lakeland, Poland)

The ciliate assemblage on the macrophytes was examined in 2005 during the vegetation period in the Konińskie Lakes which are heating by post-cooling waters from thermal electric plants. As a result of changed temperature regimen the alien thermophilic macrophyteVallisneria spiralisis becoming increasingly common in the littoral zone. A total of 150 ciliate taxa belonging to 27 orders were found. Greater ciliate species diversity was found on architecturally complex, submerged forms such asCeratophyllum demersumandMyriophyllum spicatum. By contrast the ciliate compositions on emergent macrophytes with simple architecture in their submerged parts, such asTypha, Sparganium, orAcorus, were less species rich. Despite the simple architecture ofVallisnerialeaves, the ciliate diversity on them was high. The results show that replacement of native macrophytes by the alien formV. spiralisin heated lakes did not impoverish the ciliate diversity.
Hymenolepidoid Cestodes (Cyclophyllidae, Hymenolepidoidae) of Pratincole (Glareola Pratincola) from the South of Ukraine
Authors: Kornyushin V. , Greben O.
Published: December 2010

Hymenolepidoid Cestodes (Cyclophyllidae, Hymenolepidoidae) of Pratincole (Glareola Pratincola) from the South of Ukraine

Four hymenolepidoid cestode speciesGlareolepis porale(Meggitt, 1927) Spassky, 1967;Wardium(s. l.)tauricumKornyushin et Greben, sp. n.;Wardium(s. l.) sp. n.; andEchinocotyloides longirostris(Rudolphi, 1819) Kornyushin, 1983 from pratincole from the Southern Ukraine are discribed. The morphology ofG. poraleis described in details. An interesting new observation is that testes are lacking in female proglottides ofG. porale; the structures described in literature as testes in hermaphroditic proglottides are, in fact, ovarian lobes. The new cestode speciesWardium(s. l.)tauricumsp. n. is described. It is characterised by aploparaksoid hooks, 13-15 μm long, and conical armed cirrus, 20-22 μm long. Another cestode species,Wardium(s. l.) sp., is identified to the generic level only. It differs from all the species of the genus in the size and armament of the cirrus; however, no scolex was present in the material studied.
Helminths of the Marbled Goby (Pomatoschistus Marmoratus) a Mediterranean Immigrant in the Black Sea Fauna
Authors: Kvach Yu.
Published: December 2010

Helminths of the Marbled Goby (Pomatoschistus Marmoratus) a Mediterranean Immigrant in the Black Sea Fauna

The marbled goby,Pomatoschistus marmoratus(Risso, 1810), the Mediterranean immigrant in the Black Sea fauna, was examined for the metazoan parasites. In total, 12 parasite species were found to occurre. The component community consists of 7 trematode species, two nematodes, two acanthocephalans, and one cestode species. Two parasite species (Aphalloides coelomicolaandDichelyne minutus) were represented by both adults and larvae, four parasite species were presented by adults (Asymphylodora pontica, Paratimonia gobii, Acanthocephaloides propinquus, andTelosentis exiguus), and six species were presented by larvae (Bothriocephalus gregarius, Cryptocotyle concavum, C. lingua, Pygidiopsis genata, Timoniella imbutiforme, andContracaecum microcephalum).T. imbutiformehas the great tendency to join the infracommunity. The core of parasite fauna of the marbled goby consists of two specialists,A. coelomicolaandP. gobii, which immigrated to the Black Sea together with their hosts. The co-immigration is a result of co-evolution of the parasites' and host's life cycles.
First Record of Mites of the Family Stigmaeidae (Acari, Raphignathoidea) from Rovno Amber with Description of a New Species of the Genus Mediolata
Authors: Kuznetsov N. , Khaustov A. , Perkovsky E.
Published: December 2010

First Record of Mites of the Family Stigmaeidae (Acari, Raphignathoidea) from Rovno Amber with Description of a New Species of the Genus Mediolata

A new species, Mediolata eocenica Kuznetsov, Khaustov et Perkovsky, sp. n., is described from the Late Eocene Rovno amber. It is the first fossil record of Stigmaeidae.
Cross-border Cultural Tourism in Europe: Drivers for Cross-border Travels for the Performing Arts
Authors: Tajtáková Mária , Kopaničová Janka , Francová Zuzana
Published: December 2010

Cross-border Cultural Tourism in Europe: Drivers for Cross-border Travels for the Performing Arts

The aim of this paper is to examine the drivers for cross-border tourist exchanges between the two closest capitals in Europe - Bratislava (Slovakia) and Vienna (Austria). We focus on the field of cultural tourism in view of the cross-border visits to two major performing arts institutions - the Slovak National Theatre in Bratislava and the Staatsoper in Vienna. The basic question raised by the study is: What makes tourists travel for the performing arts? The paper presents partial results of a bigger research analyzing intercultural differences in perception of cultural products among different audiences.
Poisson Downward Continuation Solution by the Jacobi Method
Authors: Kingdon R. , Vaníček P.
Published: January 2011

Poisson Downward Continuation Solution by the Jacobi Method

Downward continuation is a continuing problem in geodesy and geophysics. Inversion of the discrete form of the Poisson integration process provides a numerical solution to the problem, but because the B matrix that defines the discrete Poisson integration is not always well conditioned the solution may be noisy in situations where the discretization step is small and in areas containing large heights. We provide two remedies, both in the context of the Jacobi iterative solution to the Poisson downward continuation problem. First, we suggest testing according to the upward continued result from each solution, rather then testing between successive solutions on the geoid, so that choice of a tolerance for the convergence of the iterative method is more meaningful and intuitive. Second, we show how a tolerance that reflects the conditioning of the B matrix can regularize the solution, and suggest an approximate way of choosing such a tolerance. Using these methods, we are able to calculate a solution that appears regular in an area of Papua New Guinea having heights over 3200 m, over a grid with 1 arc-minute spacing, based on a very poorly conditioned B matrix.
Ecological English Language Learning Among Ethnic Minority Youth
Authors: Borrero Noah E. , Yeh Christine J.
Published: December 2010

To empirically investigate language learning in relational and cultural settings, the authors developed and administered the Ecological Language Learning and Academic Success scale to an ethnically diverse sample of 269 urban high school students who speak a language other than English at home. Exploratory factor analysis revealed a four-factor structure (Educational Learning, Friend-Based Learning, Family-Based Learning, and Community-Based Learning) with strong reliability estimates. To explore the interrelationships across the various ecological settings, the authors then conducted multidimensional scaling to create a visual representation of the distances between scale items in three-dimensional space. Their findings reveal a disconnect among the various settings. The authors discuss these findings in the context of maximizing bilingual students’ cultural assets by bridging the social communities in which they learn English and achieve academically.
Adapting to the System or the Student? Exploring Teacher Adaptations to Disadvantaged Students in an English and a Belgian Secondary School
Authors: Stevens Peter A. J. , Van Houtte Mieke
Published: December 2010

This article builds on research on teacher adaptations to students by exploring how Belgian and English national contexts influence teachers’ definitions of educational success, their explanations of educational failure, and their allocation of scarce educational resources to disadvantaged students. Ethnographic data from one Flemish (Belgian) and one English secondary multicultural school suggest that teachers in both schools adapt their expectations to students in line with the perceived ability and interests of students. However, differences between England and Flanders in how students and schools are evaluated can help to explain differences between Flemish and English teachers’ allocation of scarce educational resources and responsibility for educational success. The conclusions discuss the implications of these findings for social policy and further research.
Introducing the Nepal Journal of Epidemiology: A Pioneer in its Domain
Authors: Sathian Brijesh
Published: December 2010

The Nepal Journal of Epidemiology is the first journal of its kind in Nepal.  Our main objective in pioneering this journal is to attempt to provide a common platform for all researchers, particularly those doing epidemiological studies on prevailing public health problems in the community.DOI: 10.3126/nje.v1i1.4099Nepal Journal of Epidemiology 2010;1 (1):1-3
Relevance of Sample Size Determination in Medical Research
Authors: Sathian Brijesh , Sreedharan Jayadevan , Baboo Suresh N , Sharan Krishna , Abhilash E S , Rajesh E
Published: December 2010

Sample size determination is one of the central tenets of medical research. If the sample size is inadequate, then the study will fail to detect a real difference between the effects of two clinical approaches. On the contrary, if the sample size is larger than what is needed, the study will become cumbersome and ethically prohibitive. Apart from this, the study will become expensive, time consuming and will have no added advantages. A study which needs a large sample size to prove any significant difference in two treatments must ensure the appropriate sample size. It is better to terminate such a study when the required sample size cannot be attained so that the funds and manpower can be conserved. When dealing with multiple sub-groups in a population the sample size should be increased the adequate level for each sub-group.  To ensure the reliability of final comparison of the result, the significant level and power must be fixed before the sample size determination. Sample size determination is very important and always a difficult process to handle. It requires the collaboration of a specialist who has good scientific knowledge in the art and practice of medical statistics. A few suggestions are made in this paper regarding the methods to determine an optimum sample size in descriptive and analytical studies.Key Words: Sample size; Power analysis; Medical researchDOI: 10.3126/nje.v1i1.4100Nepal Journal of Epidemiology 2010;1 (1):4-10
Diabetes mellitus as a Potential Risk Factor for Renal Disease among Nepalese: A Hospital Based Case Control Study
Authors: Mittal Ankush , Sathian Brijesh , Kumar Arun , Chandrasekharan Nishida , Sunka Aditya
Published: December 2010

BackgroundDiabetes mellitus is a well recognized public health concern and projections of its future effect are alarming.  It is one of the leading causes of end stage renal disease in both developed and emerging nations. The objective of the present study was to assess the progressive deterioration of renal function in Diabetes mellitus among Nepalese.Materials and Methods  It was a hospital based case control study carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between 1st January 2010 and 31st August 2010. The variables collected were age, gender, random blood glucose, serum urea and creatinine levels of the patients. ResultsOut of 440 patients, there was a slight predominance of males (54.1%) as compared to females (45.8%). Patients in between 41-100 years were 2.8 times more at risk of developing kidney disease as compared to age group (0-40 years)(Odds Ratio=2.8, p=0.0001). Diabetic patients were twice at risk of developing kidney disease than non diabetics (Odds Ratio=1.97, p=0.001). There was a significant increase in mean values of serum creatinine (CI 4.3 to 4.8) and urea (CI 118.55 to 153.50) in kidney disease patients with Diabetes mellitus. In non diabetic kidney disease patients, mean values of serum creatinine (CI 3.29 to 3.70) and urea (CI 98.88 to 116.92) were also moderately raised as compared to controls.ConclusionDiabetic renal lesions are not only preventable but also reversible. In summary, glycemic control significantly influences the rate of progression from microalbuminuria to proteinuria and from overt nephropathy to end stage renal disease. The best modality of treatment includes strict control over blood glucose levels and its evaluation at frequent intervals.Key Words: Diabetic Mellitus; Kidney Disease; Case Control Study; NepalDOI: 10.3126/nje.v1i1.4108Nepal Journal of Epidemiology 2010;1 (1):22-25
Epidemiologic Analysis of Gastric Carcinoma in the Western Region of Nepal
Authors: Ghosh Arnab , Sathian Brijesh , Ghartimagar Dilasma , Narasimhan Raghavan , Talwar Om Prakash
Published: December 2010

BackgroundGastric cancer is among the most common malignancies in Asia, comprising 74% of all global cases. Identifying the environmental risk factors may possibly shed more light on effective treatment and the prevention of this disease. The aim of our study is to document  different histologic types of gastric cancer as per age, sex and ethnic groups in the patients in Nepal, to know the frequency of different gross and microscopic subtypes (according to Lauren's classification) of tumor and to find out the association of H. pylori and other major risk factors with gastric cancer.Materials and Methods  The present study is a hospital based retrospective study done in the Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal, from Jan 1999 to July 2010. All the endoscopic biopsies and gastrectomy specimens from patients with diagnosed gastric carcinoma were reviewed and the clinical and other data were analyzed.ResultsIn this study period, a total of 1223 cases related to stomach were received in Department of Pathology. Considering the inclusion and exclusion criteria, a total of 397 cases - 315 cases of endoscopic biopsy and 82 cases of gastrectomy - were included in the study. In our study, the most affected age group and caste were 61-70 years ( 47.36%, CI 42.44% to 52.27%) and Gurungs (32%, CI 27.16% to 36.32%). The commonest gross and microscopic types were Borrmann's type IV (40%, CI 29.63% to 50.86%) and intestinal type (53%, CI 47.99% to 57.81%). Gastric antrum was the most affected site (70%, CI 65.26% to 74.29%). Among the cases with H pylori, antrum (62.5% CI 45.73% to 79.27%) was found to be the commonest site. Among all cases in Gurung, Chhetri and Brahmin communities, we retrieved data regarding risk factors in 93, 65 and 50 cases respectively. Significant relationship was found between the three risk factors studied and the ethnic groups. Smoked meat and alcohol were found to be associated with gastric carcinoma more in Gurungs and Chhetris than in Brahmins (p= 0.0001). On the contrary, cases among Brahmins are found to more associated with smoking than Gurungs and Chhetris (p= 0.0001).ConclusionGastric carcinoma is a common malignancy in this part of world. The most high risk group includes elderly males with history of alcoholism and smoked meat consumption in Gurung community and with history of smoking from Brahmin family. We advise that regular endoscopic surveillance should be done at least in high risk group for the early detection of cancer.Key Words: Gastric Carcinoma; Ethnicity; Risk Factors; Epidemiology; Helicobacter pylori; NepalDOI: 10.3126/nje.v1i1.4109Nepal Journal of Epidemiology 2010;1 (1):27-32
The Significance of Transaminases and Deritis Ratio for Predicting Alcoholic Liver Disease: A Hospital Based Comparative Study in Western Nepal
Authors: Mittal Ankush , Sathian Brijesh , Kumar Arun , Chandrasekharan Nishida , Yadav Shambhu Kumar
Published: December 2010

BackgroundIn Nepal, alcoholic liver disease (ALD) is a major public health problem. In testing for biochemical abnormalities in ALD, Deritis ratio (AST/ALT) is more sensitive than other conventional parameters, at any stage of the disease. The aim of our study was to assess closely the significance of transaminases and deritis ratio and their predictive implications among the patients of alcoholic liver disease in Pokhara valley.Materials and Methods  It was a hospital based retrospective study carried out from the data maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January 2009 and 31st July 2010. The variables collected were age, gender, total protein, albumin, AST, ALT and AST/ALT ratio. Descriptive statistics and testing of hypothesis were used for the analysis. Data was analyzed using EPI INFO and SPSS 16 software.ResultsOf the four hundred forty-five patients, there was a slight preponderance of males (55.5%) towards ALD as compared to females (44.5%), projecting the percentage of ALD to around 28.8. Males were 2.3 times more at risk of developing alcoholic liver disease than females (Odds Ratio=2.3, p=0.0001). Patients over 40 years of age had 3.2 times greater propensity of developing alcoholic liver disease (Odds Ratio=3.2, p=0.0001). In ALD patients, mean value of AST (131.5 ± SD94.46 IU/L) was markedly increased in comparison to ALT (85.12 ± SD58.24 IU/L) leading to significantly higher AST/ALT ratio (1.59 ± SD0.58). In cases, mean value of Deritis ratio was 1.59 with  CI (1.49, 1.69) which was significantly increased as compared to the ratio in controls which was 1.04 with CI (1.02, 1.06) (p=0.001). 96.9% of patients with alcoholic liver disease had an AST:ALT ratio of >1.0 with CI (93.9%,99.9%). The mean value of each variable in cases was significantly elevated as compared to controls (p=0.001).ConclusionEthanol consumption leads to a spectrum of liver diseases, the importance of which is magnified by its widespread use. Laboratory tests play an important role in this endeavor. Equally important is the fact that once complications of alcoholism are identified, it is imperative to be able to accurately determine their magnitude. Therefore, the estimation of deritis ratio is useful for the rational understanding of the extent of damage in alcoholic liver disease.Key Words: Transaminase; Deritis ratio; Alcohol Liver Disease; NepalDOI: 10.3126/nje.v1i1.4110Nepal Journal of Epidemiology 2010;1 (1): 33-37
Statistical Modelling Technique in Forecasting of Palliative Oncotherapy Load in Hospitals
Authors: Sathian Brijesh , Sreedharan Jayadevan , Sharan Krishna , Baboo Suresh N , Chawla Rachit , Chandrasekharan Nishida , Rajesh E , Shah Ravi Kumar , Baniya Ramkaji , Dixit Shyam B
Published: December 2010

BackgroundAn increase in cancer incidence in developing countries is expected due to the possible decline of mortality from infectious diseases, improved healthcare, population growth and increasing life expectancy. It can therefore be anticipated that the number of cancer patients requiring palliative treatment will also rise in Nepal, creating a discrepancy between the requirement and delivery of health care.  Estimation of trends is very essential for the planning of future requirements in any such programme.Method  This retrospective study analysed the records from the Radiotherapy Department at Manipal Teaching Hospital, Pokhara, Nepal to calculate the number of cancer patients who received palliative treatment with radiotherapy between September 2000 and December 2008. Descriptive statistics was used for the analysis and subsequently, statistical modelling techniques were applied for forecasting of future trends.ResultsOf 1001 cancer cases, 363 patients received radiotherapy with palliative intent during the study period. Excluding the constant term from the equation, the Logarithmic model was the best fitted, with R2 = 0.727, p = 0.002 for the forecasting of cancer patients receiving palliative treatment. Using this model, the number of cancer cases receiving palliative radiotherapy at the hospital in the year 2015 was estimated to be 68. Thus, the number of patients requiring radiotherapy with palliative intent shows a pattern of increasing trend over the coming years.ConclusionThe data analysed in the present study indicates an increasing future trend of patients requiring palliative therapy at the centre. In the future, a discrepancy may arise between the requirement and capacity of care available to these patients. Government and healthcare agencies of Nepal must ready themselves to promote better strategies for adequate provision to the cancer patients receiving palliative treatment in the coming years.Key WordsStatistical Modelling; Palliative Oncotherapy; ForecastingDOI: 10.3126/nje.v1i1.4111Nepal Journal of Epidemiology 2010;1 (1):38-43
Primitive neuroectodermal tumors of the spine: a comprehensive review with illustrative clinical cases
Authors: Ellis Jason A. , Rothrock Robert J. , Moise Gaetan , McCormick Paul C. , Tanji Kurenai , Canoll Peter , Kaiser Michael G. , McCormick Paul C.
Published: December 2010

Primary spinal primitive neuroectodermal tumors (PNETs) are uncommon malignancies that are increasingly reported in the literature. Spinal PNETs, like their cranial counterparts, are aggressive tumors and patients with these tumors typically have short survival times despite maximal surgery, chemotherapy, and radiation. Because no standard management guidelines exist for treating these tumors, a multitude of therapeutic strategies have been employed with varying success. In this study the authors perform a comprehensive review of the literature on primary spinal PNETs and provide 2 new cases that highlight the salient features of their clinical management.
Scoliosis and Chiari malformation Type I in children
Authors: Krieger Mark D. , Falkinstein Yuri , Bowen Ira E. , Tolo Vernon T. , McComb J. Gordon
Published: December 2010

Object

The identification of Chiari malformations Type I (CM-Is) has increased in recent years, commonly during MR imaging for evaluation of a possible cause of scoliosis. The treatment of this abnormality remains controversial, and the expected success of treatment is unclear. The goal of the present study is to evaluate the effects of a craniotomy for CM-I decompression on scoliosis in children and adolescents.

Methods

The authors conducted a 10-year retrospective review of pediatric patients who were found to have a CM-I during evaluation for scoliosis. Seventy-nine patients were identified, ranging in age from 6 months to 18 years (median 12 years). There were 42 girls (54%) and 37 boys (46%). All were noted on MR imaging to have hydrosyringomyelia of the spinal cord. Forty-nine patients had curvatures less than 20° prior to treatment. The other 30 patients had curves ranging from 25° to 80° and underwent orthopedic follow-up and treatment. None of these patients were referred for specific neurological complaints, but 12 (16%) had neurological signs on physical examination. All were treated with a craniocervical decompression in a standard fashion. Follow-up ranged from 6 to 93 months with a median of 35 months. Magnetic resonance images obtained at 6 months postoperatively and serial standing anteroposterior spine radiographs were used to evaluate outcomes.

Results

On the MR images obtained 6 months postoperatively, 70 patients (89%) had a significant reduction in the syrinx with an associated ascent of the cerebellar tonsils. Persistent large syringes were treated with reoperation in 6 patients, and shunts were inserted for hydrocephalus in 2 patients. None of the 49 patients with curves less than 20° had progression of their curvature postoperatively. Of the 30 patients with curves greater than 25°, 9 had no change in the scoliosis or had a reduction in curve magnitude after Chiari decompression. This group required no further therapy and was effectively treated by Chiari decompression alone. Twenty-one patients required further scoliosis treatment after Chiari decompression; 12 required orthotic treatment, 11 received spinal instrumentation and fusion surgery, and 2 received orthoses followed by fusion and instrumentation. The severity of the curvature beyond 20° did not predict the need for spinal surgery.

Conclusions

This large series reports on the efficacy of treatment for scoliosis associated with a CM-I and syrinx in children. A CM-I decompression alone was adequate treatment for mild scoliosis of less than 20°. Patients with scoliosis greater than 20° required bracing and/or spinal fusion surgery 70% of the time in addition to the CM-I decompression.
Surgical treatment and perioperative management of moyamoya disease associated with glycogen storage disease Type 1a
Authors: Egashira Yusuke , Takahashi Jun C. , Ohnishi Hiroyuki , Kawasaki Yukako , Higashigawa Masamune , Iihara Koji , Miyamoto Susumu
Published: December 2010

The authors report a case of concurrent moyamoya disease and glycogen storage disease Type 1a that was successfully managed with bypass surgery. This 7-year-old Japanese girl, diagnosed with glycogen storage disease Type 1a at the age of 2 years, presented with repeated transient ischemic attacks. Cerebral angiography revealed severe stenosis at the terminal portions of the bilateral internal carotid arteries, with typical moyamoya vessels. The patient underwent superficial temporal artery–middle cerebral artery anastomosis and encephalomyosynangiosis bilaterally, in 2 staged procedures at an interval of 4 months. Despite perioperative administration of glucose, hypoglycemia and metabolic acidosis occurred after both surgeries. The symptoms were milder after the second surgery, in which an increased dose of glucose was used. The patient tolerated the perioperative conditions well under intensified medical treatment, and no further ischemic symptoms occurred.
Morbidity and mortality associated with spinal surgery in children: a review of the Scoliosis Research Society morbidity and mortality database
Authors: Fu Kai-Ming G. , Smith Justin S. , Polly David W. , Ames Christopher P. , Berven Sigurd H. , Perra Joseph H. , Glassman Steven D. , McCarthy Richard E. , Knapp D. Raymond , Shaffrey Christopher I. , _ _
Published: December 2010

Object

Currently, few studies regarding morbidity and mortality associated with operative treatment of spinal disorders in children are available to guide the surgeon. This study provides more detailed morbidity and mortality data with an analysis of 23,918 pediatric cases reported in the multicenter, multisurgeon Scoliosis Research Society morbidity and mortality database.

Methods

The Scoliosis Research Society morbidity and mortality database was queried for the years from 2004 to 2007. The inclusion criterion was age 18 years or younger. Cases were categorized by operation type and diagnosis. Details on the surgical approach, use of neurophysiological monitoring, and type of instrumentation were recorded. Major perioperative complications and deaths were evaluated. Statistical analysis was performed with chi-square testing, with a p value < 0.05 considered significant.

Results

A total of 23,918 patients were included. The mean age was 13 ± 3.6 years (± SD). Spinal pathology included the following: scoliosis (in 19,642 patients), kyphosis (in 1455), spondylolisthesis (in 748), trauma (in 478), and other (in 1595 patients). The overall complication rate was 8.5%. Major complications included wound infections (2.7%), new neurological deficits (1.4%), implant-related complications (1.6%), and hematomas (0.4%). The most common medical complications were respiratory related (0.9%). Morbidity rates differed based on pathology, with patients undergoing treatment for kyphosis and spondylolisthesis having higher overall rates of morbidity (14.7% and 9.6%, respectively). Patients undergoing revision procedures (2034) or corrective osteotomies (2787) were more likely to suffer a complication or new neurological deficit. The majority of these deficits improved at least partially. Thirty-one deaths were reported for an overall rate of 1.3 per 1000. Respiratory complications were the most common cause of mortality (13 cases). Twenty-six of the deaths occurred in children undergoing scoliosis correction.

Conclusions

Spinal surgery in children is associated with a range of complications depending on the type of operation. Mortality rates for all indications and operations were low. Patients undergoing more aggressive corrective procedures for deformity are more likely to suffer complications and new neurological deficits.
Small-ventricle neuroendoscopy for pediatric brain tumor management
Authors: Naftel Robert P. , Shannon Chevis N. , Reed Gavin T. , Martin Richard , Blount Jeffrey P. , Tubbs R. Shane , Wellons John C.
Published: December 2010

Object

The use of intraventricular endoscopy to achieve diagnosis or to resect accessible intraventricular or paraventricular tumors has been described in the literature in both adults and children. Traditionally, these techniques have not been used in patients with small ventricles due to the perceived risk of greater morbidity. The authors review their experience with the effectiveness and safety of endoscopic brain tumor management in children with small ventricles.

Methods

Between July 2002 and December 2009, 24 children with endoscopically managed brain tumors were identified. Radiological images were reviewed by a radiologist blinded to study goals and clinical setting. Patients were categorized into small-ventricle and ventriculomegaly groups based on frontal and occipital horn ratio. Surgical success was defined a priori and analyzed between groups. Trends were identified in selected subgroups, including complications related to pathological diagnosis and surgeon experience.

Results

Six children had small ventricles and 18 had ventriculomegaly. The ability to accomplish surgical goals was statistically equivalent in children with small ventricles and those with ventriculomegaly (83% vs 89%, respectively, p = 1.00). There were no complications in the small-ventricle cohort, but in the ventriculomegaly cohort there were 2 cases of postoperative hemorrhages and 1 case of infection. All hemorrhagic complications occurred in patients with high-grade tumor histopathological type and were early in the surgeon's endoscopic career.

Conclusions

Based on our experience, endoscopy should not be withheld in children with intraventricular tumors and small ventricles. Complications appear to be more dependent on tumor histopathological type and surgeon experience than ventricular size.
Harvey Cushing and early spinal dysraphism repair at Johns Hopkins Hospital
Authors: Pendleton Courtney , Ahn Edward S. , Jallo George I. , Quiñones-Hinojosa Alfredo
Published: December 2010

As neurological surgery began developing into a surgical subspecialty in the US at the turn of the 20th century, with Harvey Cushing at the forefront, the operative treatment of spinal dysraphism was refined with attempts to minimize complications. Following institutional approval, and through the courtesy of the Alan Mason Chesney Archives, the authors reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912. Patients presenting with spinal dysraphism who underwent surgical intervention by Dr. Harvey Cushing were selected for further analysis. Ten patients presented for surgical intervention for spinal dysraphism, and 7 of these had concurrent hydrocephalus. The mean age of these patients was 5.8 months (range 1–14 months). The mean length of stay was 20.4 days. There were 6 inpatient deaths. At the time of last follow-up, 2 patients were well, 1 patient remained unimproved, and 1 patient (for whom no discharge outcome was available) had died. The cases described in detail offer insight into the breadth of Cushing's practice and the varied approaches he employed. The use of Faradic stimulation to assess nerve root function, the use of complex multilayered closures, and the creation of operative tables for combined treatment of hydrocephalus and spinal dysraphism illustrate Cushing's contributions to developing the field of pediatric neurosurgery.
The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts
Authors: Maher Cormac O. , Goumnerova Liliana
Published: December 2010

Object

The aim of this study was to report the long-term outcomes of patients receiving endoscopic ventriculocystocisternostomy (VCC) for suprasellar arachnoid cysts (SACs), and to analyze all published reports on outcomes of ventriculocystostomy (VC) versus VCC to compare the effectiveness of the 2 techniques.

Methods

Eleven consecutive patients with previously untreated SACs were surgically treated using endoscopic VCC. Another 2 patients were treated with VCC following ventriculoperitoneal shunt placement. Clinical imaging data were recorded. An analysis was performed of all published patient outcomes following endoscopic VC or VCC for an SAC.

Results

Developmental delay and progressive macrocephaly were the most common preoperative symptoms. At a mean clinical follow-up interval of 63 months, 10 of 11 patients undergoing primary VCC did not require reoperation. An analysis of the literature suggests that VCC may be more effective than VC. Of the 44 reported patients that underwent VC as a first treatment, 7 (16%) required reoperation, and 7 (8%) of 86 patients who underwent VCC as a first treatment required reoperation. When VC or VCC was performed following a prior surgical procedure, 4 of 11 patients undergoing VC had a treatment failure requiring reoperation. In contrast, only 2 of the 17 reported cases of VCC following a prior procedure required further treatment. The difference in reoperation rates following either primary or secondary VC was significantly higher than following primary or secondary VCC (p = 0.04).

Conclusions

The authors conclude that VCC is an effective and durable treatment for symptomatic SACs in most cases.
Idiopathic syrinx in the pediatric population: a combined center experience
Authors: Magge Suresh N. , Smyth Matthew D. , Governale Lance S. , Goumnerova Liliana , Madsen Joseph , Munro Becca , Nalbach Stephen V. , Proctor Mark R. , Scott R. Michael , Smith Edward R.
Published: December 2010

Object

Discovery of a syrinx in a child, without a readily identifiable proximate cause such as a Chiari malformation, tumor, or site of tethering, is often a cause of concern for families and a source of consternation for clinicians. There is a paucity of data describing the natural history of an idiopathic syrinx in the pediatric population. The authors present the combined data of 2 major pediatric neurosurgical centers to describe their experience with this condition.

Methods

Data were collected at Children's Hospital Boston and St. Louis Children's Hospital according to institutional review board–approved protocols and captured visits over a 2.5-year interval (October 2006–March 2009), with records reviewed if the patient had a preexisting diagnosis of syrinx. Patients were identified by ICD-9 codes derived from departmental databases. All pediatric patients (age < 19 years) in whom idiopathic syrinx had been diagnosed, as defined by MR imaging findings (dilated central canal in the spinal cord of ≥ 1 mm in axial dimension and extending over at least 2 vertebral levels), were included.

Results

Forty-eight patients met the criteria for idiopathic syrinx during this period, and in 32 of them detailed follow-up imaging was available. Discovery of a syrinx was incidental in 6 patients, whereas the others were referred for imaging because of the presence of pain, neurological symptoms, scoliosis, or skin markings. The average age at the first MR imaging session was 9.7 years, with a mean syrinx size of 4 mm (range 1.2–9.4 mm). The majority (52%) of patients had a thoracic syrinx, with the average lesion spanning 7.1 vertebral levels. The average follow-up was 23.8 months (range 2–64 months), and subgroups of patients with < 3 years and ≥ 3 years of follow-up were independently reviewed. Overall, symptoms improved in 34% and worsened in 9%; 57% of the patients remained asymptomatic or stable. Radiographically (in the subgroup of 32 patients with detailed follow-up imaging), syrinx size decreased in 25% of patients, increased in 12.5%, and remained unchanged in 62.5%, with no apparent correlation between change in syrinx size and clinical symptoms.

Conclusions

Clinically, children with an idiopathic syrinx remained asymptomatic, stable, or improved in 91% of cases. The majority of syringes (87.5%) remained stable or shrank over time, with no apparent correlation between changes in size and changes in symptoms. Although longer follow-up is needed, these data suggest that the natural history of an idiopathic syrinx in children is benign, and that repeated imaging may not be necessary.
Primitive neuroectodermal tumor after radiation therapy for craniopharyngioma
Authors: Chan Michael , Herrera Sebastian R. , Neckrysh Sergey , Wallace Adam , Valyi-Nagy Tibor , Charbel Fady T.
Published: December 2010

The authors report a case of primitive neuroectodermal tumor induced by radiation therapy of craniopharyngioma. This African-American male patient originally presented with craniopharyngioma, for which he underwent resection and whole-brain radiation therapy. Eight years later, at the age of 20 years, he returned with a left facial droop and left hemiparesis. A right basal ganglia mass was identified and resected. Histopathological examination identified the lesion as primitive neuroectodermal tumor.

Although radiation therapy has shown to be beneficial in decreasing the recurrence rate in subtotally resected craniopharyngioma, the risks of radiation treatment should be clearly communicated to the patients, their families, and neurosurgeons before starting such treatment. This report expands the spectrum of reported radiation-induced neoplasms in the CNS.
Association of bacteria with hydrocephalus in Ugandan infants
Authors: Li Lingling , Padhi Abinash , Ranjeva Sylvia L. , Donaldson Sarah C. , Warf Benjamin C. , Mugamba John , Johnson Derek , Opio Zephania , Jayarao Bhushan , Kapur Vivek , Poss Mary , Schiff Steven J.
Published: December 2010

Object

Infantile hydrocephalus in East Africa is predominantly postinfectious. The microbial origins remain elusive, since most patients present with postinfectious hydrocephalus after antecedent neonatal sepsis (NS) has resolved.

Methods

To characterize this syndrome in Ugandan infants, the authors used polymerase chain reaction targeting bacterial 16S ribosomal DNA from CSF to determine if bacterial residua from recent infections were detectable. Bacteria were identified based on the relationship of genetic sequences obtained with reference bacteria in public databases. The authors evaluated samples from patients presenting during dry and rainy seasons and performed environmental sampling in the villages of patients.

Results

Bacterial DNA was recovered from 94% of patients. Gram-negative bacteria in the phylum Proteobacteria were the most commonly detected. Within this phylum, Gammaproteobacteria dominated in patients presenting after infections during the rainy season, and Betaproteobacteria was most common following infections during the dry season. Acinetobacter species were identified in the majority of patients admitted after rainy season infection.

Conclusions

Postinfectious hydrocephalus in Ugandan infants appears associated with predominantly enteric gram-negative bacteria. These findings highlight the need for linking these cases with antecedent NS to develop more effective treatment and prevention strategies.
Encephalocele in Uganda: ethnic distinctions in lesion location, endoscopic management of hydrocephalus, and survival in 110 consecutive children
Authors: Warf Benjamin C. , Stagno Vita , Mugamba John
Published: December 2010

Object

This study characterizes the first clinical series of encephalocele (EC) from East or Central Africa, and is the largest reported from the African continent. The authors explored survival, the efficacy of primary endoscopic management of associated hydrocephalus, and ethnic differences in EC location.

Methods

One hundred ten consecutive children presented to CURE Children's Hospital of Uganda for treatment of EC over a 9-year period. Clinical data, including patient demographic information, birth date, lesion type (sincipital, parietal, or occipital), operative data, and subsequent course had been entered prospectively into a clinical database. Home visits to update the status of those lost to follow-up were done when possible. With appropriate institutional approvals, the database was reviewed for this retrospective study. Two-tailed probability values calculated using the Fisher exact test were used to assess the significance of differences among groups, with p < 0.05 being considered significant. The Kaplan-Meier method was used for analysis of survival and treatment success probabilities.

Results

There were 53 (48%) occipital, 33 (30%) sincipital, and 24 (22%) parietal lesions. Occipital lesions were significantly more common among children of Bantu origin (p = 0.02). Nilotes demonstrated a roughly equal distribution among sincipital, parietal, and occipital locations. The female/male ratio was 1.2, with no difference between EC types (range 1.0–1.4, p = 0.6–0.8). Of 110 patients, 108 (98%) underwent surgical repair at a median age of 1 month (mean 15.7 months), whereas 2 had treatment for hydrocephalus only. Wound revision was required in 13% of cases. Surgery-related mortality was 3%. One-year and 5-year survival rates were 87% (95% CI 0.79–0.93) and 61% (95% CI 0.51–0.70), respectively. Hydrocephalus required treatment in 32%, and was equally common among the 3 EC types. Thirteen patients were treated with combined endoscopic third ventriculostomy/choroid plexus cauterization (ETV/CPC) and 2 with ETV alone, whereas 18 patients received primary shunt placement. Predicted treatment success at 1 year was 79% for ETV or ETV/CPC (95% CI 0.50–0.94) and 47% for shunt placement (95% CI 0.24–0.71).

Conclusions

Analysis of this first EC series from this region suggests that sincipital lesions are 3 times more common in East than in West Africa. Occipital lesions predominate in patients of Bantu origin, but not among those of Nilotic descent. Hydrocephalus incidence was equally common among different EC types, and endoscopic treatment was more successful (79%) than shunting (47%) at 1 year. The 5-year mortality rate was similar to that for infants with myelomeningocele in Uganda, and more than twice that for their unaffected peers.
Offshore Antarctic Peninsula Gas Hydrate Reservoir Characterization by Geophysical Data Analysis
Authors: Loreto Maria Filomena , Tinivella Umberta , Accaino Flavio , Giustiniani Michela
Published: December 2010

A gas hydrate reservoir, identified by the presence of the bottom simulating reflector, is located offshore of the Antarctic Peninsula. The analysis of geophysical dataset acquired during three geophysical cruises allowed us to characterize this reservoir. 2D velocity fields were obtained by using the output of the pre-stack depth migration iteratively. Gas hydrate amount was estimated by seismic velocity, using the modified Biot-Geerstma-Smit theory. The total volume of gas hydrate estimated, in an area of about 600 km2, is in a range of 16 × 109–20 × 109 m3. Assuming that 1 m3 of gas hydrate corresponds to 140 m3 of free gas in standard conditions, the reservoir could contain a total volume that ranges from 1.68 to 2.8 × 1012 m3 of free gas. The interpretation of the pre-stack depth migrated sections and the high resolution morpho-bathymetry image allowed us to define a structural model of the area. Two main fault systems, characterized by left transtensive and compressive movement, are recognized, which interact with a minor transtensive fault system. The regional geothermal gradient (about 37.5 °C/km), increasing close to a mud volcano likely due to fluid-upwelling, was estimated through the depth of the bottom simulating reflector by seismic data.
Four Polygamous Families with Congenital Birth Defects from Fallujah, Iraq
Authors: Alaani Samira , Savabieasfahani Mozhgan , Tafash Mohammad , Manduca Paola
Published: December 2010

Since 2003, congenital malformations have increased to account for 15% of all births in Fallujah, Iraq. Congenital heart defects have the highest incidence, followed by neural tube defects. Similar birth defects were reported in other populations exposed to war contaminants. While the causes of increased prevalence of birth defects are under investigation, we opted to release this communication to contribute to exploration of these issues. By using a questionnaire, containing residential history and activities that may have led to exposure to war contaminants, retrospective reproductive history of four polygamous Fallujah families were documented. Our findings point to sporadic, untargeted events, with different phenotypes in each family and increased recurrence. The prevalence of familial birth defects after 2003 highlights the relevance of epigenetic mechanisms and offers insights to focus research, with the aim of reducing further damage to people’s health.
Iwanaga, H. Development of Highly Soluble Anthraquinone Dichroic Dyes and Their Application to Three-Layer Guest-Host Liquid Crystal Displays. Materials 2009, 2, 1636-1661
Authors: Iwanaga Hiroki
Published: December 2010

I found some mistakes on Table 2 (page 1643) in my published paper in Materials [1]. A correct table is provided here. [...]