bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of surgical castration of dogs and cats in the United States
Authors: Trevejo Rosalie , Yang Mingyin , Lund Elizabeth M.
Published: April 2011

Objective—To estimate the prevalence of surgical castration among dogs and cats evaluated at private US veterinary hospitals and to determine the influence of sex, age, breed, geographic location, and prepaid wellness plan enrollment on the likelihood of castration.

Design—Retrospective period prevalence study.

Animals—320,172 cats and 1,339,860 dogs examined at 651 hospitals during 2007

Procedures—Univariate and multivariate analyses were used to compare prevalence among subpopulations for each species.

Results—The overall prevalence of castration was 82% in cats and 64% in dogs. Prevalence increased significantly with age in both species. Among cats, males were slightly more likely to be castrated than females (prevalence ratio [PR] = 1.03) and mixed breeds slightly less likely than purebreds (PR = 0.99). Among dogs, males were less likely to be castrated than females (PR = 0.93) and mixed breeds more likely than purebreds (PR = 1.19). Prevalence was lowest in dogs in the Southeastern United States (61%). Dogs and cats on a wellness plan were more likely to be castrated than those not on a plan (PR = 1.33 and 1.18, respectively). Among commonly reported dog breeds, pit bull-type dogs (27%) and Chihuahuas (46%) were least likely to be castrated.

Conclusions and Clinical Relevance—Many young adult (1- to < 4-year-old) dogs (32%) were uncastrated, signaling a need to promote earlier castration. Outreach efforts should be directed toward owners of pets least likely to be castrated, such as male dogs, dogs of specific breeds (ie, pit bull-type and Chihuahua), and dogs in the Southeastern United States. Additional research is needed to evaluate the potential impact of wellness programs on an owner's decision to have his or her pet castrated.
Use of a duodenal serosal patch in the repair of a colon rupture in a female Solomon Island eclectus parrot
Authors: Briscoe Jeleen A. , Bennett R. Avery
Published: April 2011

Case Description—A 444-g (0.98-lb) 4-year-old sexually intact female Solomon Island eclectus parrot (Eclectus roratus solomonensis) was referred and evaluated for a suspected colonic obstruction.

Clinical Findings—The parrot had a 3-day history of not passing feces and lack of appetite following treatment of dystocia that included percutaneous collapse of the egg and manual removal of egg fragments via the cloaca. During this procedure, a tear in the cloacal mucosa developed. The tear was repaired via a midline cloacotomy. Although clinically stable at the time of referral, the parrot became lethargic and bradycardic and had delayed crop emptying.

Treatment and Outcome—A midline celiotomy and cloacotomy were performed to relieve the colonic obstruction, during which the severely distended colon ruptured. The colonic defects were closed in a simple interrupted pattern, and a serosal patch was applied by use of the adjacent duodenum. The bird recovered uneventfully from anesthesia and was passing voluminous feces with mildly increased effort within 1 hour after surgery. At 3 weeks after surgery, the parrot was passing feces with no increase in effort and had a normal appetite.

Clinical Relevance—Application of a duodenal serosal patch for repair of a colon rupture was successful in this parrot. Gastrointestinal obstruction is rare in birds, but should be considered in birds that have regurgitation, decreased fecal production, and gastrointestinal dilation. Because birds lack an omentum, serosal patching with adjacent duodenum should be considered as a viable option in avian surgery.
Infinitives in the 1820 Settler Letters of Denunciation: What can a Contextualised Application of Corpus-Based Results Tell us About the Expression of Persuasion?
Authors: Włodarczyk Matylda
Published: April 2011

Infinitives in the 1820 Settler Letters of Denunciation: What can a Contextualised Application of Corpus-Based Results Tell us About the Expression of Persuasion?

This paper takes issue with Biber's (1988) findings concerning the significance of infinitives for what he calls the "overt expression of persuasion" (Biber 1988: 115). It aims to demonstrate that statistically generated results of research on large electronic corpora of contemporary English may not be verifiable in small, well-contextualised, single-genre collections, such as the one representing 19th century English used in this study. The collection comprises denunciation letters addressed to the colonial authorities (the Colonial Office) by the first British settlers in the Cape Colony (the 1820 Settlers). The letters follow the generic model of petition (Włodarczyk 2010) understood as an official written request. An act of denunciation, as we may assume, contributes to the inherent persuasiveness of petitions by increasing the illocutionary force (in the sense of Searle 1969, 1979) of the letter. Therefore, patterns of distribution of infinitives as markers of persuasion (Biber 1988) are particularly interesting to trace in the 1820 Settler denunciation letters. The paper shows that some of Biber's statements may not be taken as valid generalizations, as the persuasive potential of infinitives may not be corroborated unless each and every token is thoroughly contextualized. Furthermore, an analysis of requests in denunciations conducted within Speech Act Theory (Austin 1962; Searle 1969; Blum-Kulka 1984; Culpeper and Archer 2008) shows that it is first and foremost politeness concerns (cf. Brown and Levinson 1987), not the increased need for persuasiveness, that determine the degree of the illocutionary force of requests.
A Guide to Jane, an Open Source Hierarchical Translation Toolkit
Authors: Stein Daniel , Vilar David , Peitz Stephan , Freitag Markus , Huck Matthias , Ney Hermann
Published: April 2011

A Guide to Jane, an Open Source Hierarchical Translation Toolkit

Jane is RWTH's hierarchical phrase-based translation toolkit. It includes tools for phrase extraction, translation and scaling factor optimization, with efficient and documented programs of which large parts can be parallelized. The decoder features syntactic enhancements, reorderings, triplet models, discriminative word lexica, and support for a variety of language model formats. In this article, we will review the main features of Jane and explain the overall architecture. We will also indicate where and how new models can be included.
Comparative Efficiency Assessment of Primary Care Service Delivery Models Using Data Envelopment Analysis
Authors: Milliken Olga , Devlin Rose Anne , Barham Victoria , Hogg William , Dahrouge Simone , Russell Grant
Published: April 2011

This paper compares the relative productive efficiencies of four models of primary care service delivery using the data envelopment analysis method on 130 primary care practices in Ontario, Canada. A quality-controlled measure of output and two input scenarios are employed: one with full-time-equivalent labour inputs and the other with total expenditures. Regression analysis controls for the mix of patients in the practice population. Overall, we find that community health centres fare the worst when it comes to relative efficiency scores.
Thermodynamic modelling of the Ag–Cu–Ti ternary system
Authors: Dezellus Olivier , Arroyave Raymundo , Fries Suzana G.
Published: April 2011

The Ag–Cu–Ti system is important for brazing applications, particularly for ceramic joining. This system is characterized by numerous intermetallics in the Cu–Ti binary and the existence of a miscibility gap in the liquid phase. For applications, knowledge of the phase equilibria, invariant reactions in the temperature range of interest and thermodynamic activity values (mainly of Ti) are important. Thermodynamic model parameters for all the stable phases in the Ag–Cu, Cu–Ti and Ag–Ti systems, previously obtained using the Calphad method and available in the literature are used. A new thermodynamic description for the ternary interaction parameter of the liquid is obtained from experimental informations. Ti2Cu and Ti2Ag which have the same crystallographic structure were modelled as a single phase. The same was done for TiCu and TiAg. Finally, solid solubility of Ag in the Ti–Cu intermetallics is taken into account. The parameters obtained in this assessment are later used for the calculation of selected sections that can be useful for research and applications in the field of joining with Ti-activated Ag–Cu braze.
Some thermophysical properties of the intermetallic Ti40Al60 alloy in the melting-solidification temperature range
Authors: Plevachuk Yuriy , Sklyarchuk Vasyl , Hermann Regina , Gerbeth Gunter
Published: April 2011

TiAl intermetallic alloys are being developed as potential materials for applications in aerospace and automotive industries, and also for chemical and biomedical applications, because of their excellent chemical and physical properties such as low density, high modulus and corrosion resistance at high temperatures. The thermophysical properties (electrical conductivity, thermoelectric power and thermal conductivity) of the solid and liquid intermetallic alloy Ti40Al60 have been measured during melting and solidification processes in order to supply necessary information for crystal growth and casting processes. Good reproducibility of the results has been obtained.
Three-dimensional braided fabrics-reinforced composites for load-bearing orthopedic applications Part I: mechanical performance
Authors: Gao Chuan , Wan Yizao , Yan Tao , Ren Kaijing , Li Xiaolei , Wang Fan , Luo Honglin , Guo Qing
Published: April 2011

Composite materials are being used in orthopedics and traumatology in light of their reduced weight, radiolucency and their lower stiffness than that of metals. Studies on biostable fibrous composites have recently demonstrated that these materials have a range of properties which make them suitable for orthopedic applications. In this study, three different three-dimensional (3-D) braided composites, carbon fiber- epoxy (C3D/EP), Kevlar fiber-epoxy (K3D/EP) and carbon fiber-poly(methyl methacrylate) (C3D/PMMA), were assessed in terms of mechanical properties and in-vitro durability to evaluate the feasibility of these composites as potential biomaterials. In addition, comparisons with other reported composites in original strength and modulus and in-vitro degradation were also made. Our studies indicate that a material with an appropriate stiffness combined with sufficient flexural and shear strength and high impact strength can be gained by tuning the combination of fiber and matrix, which opens an effective way of replacing conventional metallic devices with fibrous composites.
Phase equilibria in the Sn–Zn–Ni system
Authors: Gandova Vania , Soares Delfim , Lilova Kristina , Tedenac Jean-Claude , Vassilev Gueorgui P.
Published: April 2011

The objective of this study is to elucidate the phase equilibria of the Sn–Zn–Ni system. For this purpose, ternary alloys were synthesized using quartz ampoules and annealing. The samples were characterized using differential scanning calorimetry, X-ray diffraction, optical and scanning electron microscopy and microhardness measurements. The results show relatively significant solubility of tin or zinc (about 10 at.% roughly) in Ni–Zn and Ni–Sn phases, respectively. Moreover, evidence of the presence of two formerly unknown ternary compounds denoted as T1 and T2 was found. The first one has a composition (mole fraction) of about: XSn = 0.38 ± 0.04, XNi = 0.36 ± 0.02, XZn = 0.26 ± 0.03 while the approximate composition of the second is XSn = 0.26 ± 0.03, XNi = 0.55 ± 0.00, XZn = 0.19 ± 0.03. Three unidentified compositions were observed: U1 (XSn = 0.26 ± 0.07, XNi = 0.29 ± 0.03, XZn = 0.45 ± 0.04), U2 (XSn = 0.55 ± 0.01, XNi = 0.21 ± 0.00, XZn = 0.24 ± 0.01), and U3 (XSn = 0.48 ± 0.05, XNi = 0.08 ± 0.00, XZn = 0.44 ± 0.05) but there was still a lack of evidence to categorize any of them as a ternary compound. A tentative isothermal section of the Sn–Zn–Ni phase diagram at 600 °C was constructed.
Experimental investigation and thermodynamic calculation of the Zn–Al–Sb system
Authors: Su Xuping , Zhu Zhongxi , Wu Changjun , Yin Fucheng , Wang Jianhua , Li Zhi
Published: April 2011

The 873 K isothermal section of the Zn–Al–Sb ternary system was experimentally determined using scanning electron microscopy coupled with wave and energy dispersive X-ray spectroscopy. No ternary compound was found in the present study. Based on the experiment results together with available information in the literature, the phase diagram calculation for Zn–Al–Sb was carried out by means of the CALPHAD technique. A consistent set of thermodynamic parameters for each phase was derived. The optimized results and the experimental data are in good agreement.
One-dimensional red photoluminescence of (Y,Gd)BO3 nanofibers doped with Eu3+
Authors: Wei Liu , Ce Wang
Published: April 2011

One-dimensional (Y,Gd)BO3: Eu3+ nanofibers with hexagonal structure have been prepared as potential red phosphors by an electrospinning technique, and characterized with Xray diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy, thermogravimetric analysis, differential thermal analysis and photoluminescence spectra. The effect of annealing temperature on the crystallization and luminescence properties has been studied. The main emission position is centered at 591 nm (5D0–7F1). Photoluminescence spectra indicate that higher temperature would result in improved fluorescence capability.
Arachnoscopy: a special application of spinal intradural endoscopy
Authors: Mauer Uwe Max , Gottschalk Andreas , Kunz Ulrich , Schulz Chris
Published: April 2011

Object

The microsurgical removal of obstructions to CSF flow is the treatment of choice in the surgical management of intradural arachnoid cysts. Cardiac-gated phase-contrast MR imaging is an effective tool for the primary diagnosis and localization of arachnoid cysts. Microsurgery, however, does not lend itself to assessments of further adhesions beyond the borders of the exposed area. The use of a thin endoscope allows surgeons to assess intraoperatively whether the exposure is wide enough.

Methods

Between 2006 and 2010, a single neurosurgeon performed 31 consecutive microsurgical procedures with endoscopic assistance in 28 patients with spinal arachnoid adhesions. A MurphyScope endoscope was used for this purpose. The CSF flow was studied before and after surgery in all patients by using phase-contrast MR imaging in the region of the craniocervical junction, the cervical spine, the thoracic spine, and the lumbar spine.

Results

In all 31 procedures, CSF flow obstructions were detected at the level identified by phase-contrast MR imaging. In 29 procedures, image quality was sufficient for an inspection of the adjacent subarachnoid space. In 6 cases, the surgeon detected further adhesions that obstructed CSF flow in the adjacent subarachnoid space that were not visualized with the microscope. In all cases, these adhesions were identified and removed during microsurgery.

Conclusions

Arachnoscopy is a helpful adjunct to microsurgery and can be performed safely and easily. It allows the surgeon to detect further adhesions in the subarachnoid space that would remain undetected by microscopy alone.
Surgical nuances for removal of retrochiasmatic craniopharyngioma via the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach
Authors: Liu James K. , Christiano Lana D. , Patel Smruti K. , Eloy Jean Anderson
Published: April 2011

Retrochiasmatic craniopharyngiomas are challenging tumors to remove given their deep location and proximity to critical neurovascular structures. Complete surgical removal offers the best chance of cure and prevention of recurrence. The endoscopic endonasal extended transsphenoidal approach offers direct midline access to the retrochiasmatic space through a transplanum transtuberculum corridor. Excellent visualization of the undersurface of the optic chiasm and hypothalamus can be obtained to facilitate bimanual extracapsular dissection to permit complete removal of these formidable tumors. In this report the authors review the endoscopic endonasal extended transsphenoidal approach, with specific emphasis on technical operative nuances in removing retrochiasmatic craniopharyngiomas. An illustrative intraoperative video demonstrating the technique is also presented.
Thoracoscopic discectomy and instrumented fusion using a minimally invasive plate system: surgical technique and early clinical outcome
Authors: Bisson Erica F. , Jost Gregory F. , Apfelbaum Ronald I. , Schmidt Meic H.
Published: April 2011

Object

The use of minimally invasive noninstrumented fusions has increased as thoracoscopic approaches to the spine have evolved. The addition of instrumentation is infrequent, in part because of the lack of a minimally invasive implant system. The authors describe a technique for thoracoscopic plating after discectomy and report early clinical outcomes.

Methods

After a standard endoscopic discectomy and partial corpectomy and before exposure of the ventral thecal sac, the authors implanted a polyaxial screw and clamping element under fluoroscopic guidance. Reconstruction involves placement of autograft in the defect and subsequent placement of the remainder of the screw/plate construct with 2 screws per vertebral level.

Results

Twenty-five patients underwent thoracoscopic and thoracoscopy-assisted discectomies and fusion in which the aforementioned plate system was used. Of 19 patients presenting with pain, 10 had 6-month clinical follow-up with a greater than 50% reduction in visual analog scale score, which continued to improve up to 2 years postoperatively. There were 3 cases of pneumonia, 3 CSF leaks, 1 chyle leak, and 1 death due to a massive pulmonary embolus on the 1st postoperative day.

Conclusions

The authors conclude that thoracoscopic discectomy and plate-instrumented fusion can be achieved with acceptable results and morbidity. Further studies should evaluate the role of instrumented fusions after thoracoscopic discectomy in larger groups of patients and during a longer follow-up period.
Endoscopic endonasal transsphenoidal surgery for functional pituitary adenomas
Authors: Hofstetter Christoph P. , Shin Benjamin J. , Mubita Lynn , Huang Clark , Anand Vijay K. , Boockvar John A. , Schwartz Theodore H.
Published: April 2011

Object

The purpose of this study was to analyze preoperative predictors of endocrinological remission following endonasal endoscopic resection of therapy-resistant prolactin-, growth hormone (GH)–, and adrenocorticotropic hormone (ACTH)–secreting pituitary adenomas and to establish benchmarks for cure by using the most recent consensus criteria.

Methods

The authors reviewed a prospective database of 86 consecutive functional pituitary adenomas that were resected by a purely endoscopic endonasal transsphenoidal technique. Extent of resection was evaluated on postoperative contrast-enhanced MR imaging. Endocrinological remission was defined according to the most recent consensus criteria.

Results

The majority of functional adenomas (62.8%) were classified as macroadenomas (> 1 cm in maximum diameter), and 20.9% of lesions had invaded the cavernous sinus (CS) at the time of surgery. A gross-total resection was achieved in 75.6% of all patients. The rate of endocrinological remission differed between various types of functional adenomas. Cure rates were 92.3% (microadenomas) and 57.1% (macroadenomas) for prolactinomas, 75% (microadenomas) and 40% (macroadenomas) for GH-secreting tumors, and 54.5% (microadenomas) and 71.4% (macroadenomas) for ACTH-secreting tumors. Lower rates of cure occurred in GH-secreting macroadenomas due to a high rate of CS invasion, and in ACTH-secreting adenomas due to a high rate of lesions that were not visible on preoperative MR imaging. Whereas univariate analysis showed that macroadenoma, suprasellar, cavernous extension, or extent of resection correlated with cure, on multivariate analysis, only extent of resection and suprasellar extension predicted cure. One patient developed postoperative meningitis that was complicated by hydrocephalus requiring a ventriculoperitoneal shunt. Two patients developed postoperative panhypopituitarism, and 2 patients suffered from CSF leaks, which were treated with lumbar CSF diversion.

Conclusions

This paper reports benchmarks for endocrinological cure as well as complications in a large series of purely endoscopic pituitary surgeries by using the most recent consensus criteria. The advantages of extended endonasal approaches are most profound in tumors with suprasellar extension and CS invasion.
Complete endoscopic removal of colloid cyst using a nitinol basket retriever
Authors: Schirmer Clemens M. , Heilman Carl B.
Published: April 2011

Neuroendoscopic treatment of colloid cysts is limited by the reach and flexibility of the instruments that can be passed through the working channels of the rigid neuroendoscope. The authors describe a case of a third ventricular colloid cyst where a large solid colloid fragment was recovered using a nitinol stone retrieval basket as a flexible wall-guided atraumatic salvage instrument. A flexible nitinol stone retrieval basket was successfully used through an endoscopic working channel to retrieve a large portion of the colloid cyst from the occipital horn of the lateral ventricle in a 70-year-old man who presented with progressive memory loss, urinary incontinence, and slowness of gait. A flexible nitinol stone retrieval basket can be safely and effectively maneuvered in the ventricular system, using the ventricular wall for deflection, and can be used to retrieve colloid cyst fragments as a salvage technique. Remaining free-floating large colloid cyst fragments in the ventricular system do not necessarily require a second craniotomy or bur hole for access but may be retrieved using a nitinol stone retrieval basket.
Neuroendoscopic biopsy of ventricular tumors: a multicentric experience
Authors: Oppido Piero Andrea , Fiorindi Alessandro , Benvenuti Lucia , Cattani Fabio , Cipri Saverio , Gangemi Michelangelo , Godano Umberto , Longatti Pierluigi , Mascari Carmelo , Morace Enzo , Tosatto Luigino
Published: April 2011

Object

Although neuroendoscopic biopsy is routinely performed, the safety and validity of this procedure has been studied only in small numbers of patients in single-center reports. The Section of Neuroendoscopy of the Italian Neurosurgical Society invited some of its members to review their own experience, gathering a sufficient number of cases for a wide analysis.

Methods

Retrospective data were collected by 7 centers routinely performing neuroendoscopic biopsies over a period of 10 years. Sixty patients with newly diagnosed intraventricular and paraventricular tumors were included. No patient harboring a colloid cyst was included. Data regarding clinical presentation, neuroimaging findings, operative techniques, pathological diagnosis, postoperative complications, and subsequent therapy were analyzed.

Results

In all patients, a neuroendoscopic tumor biopsy was performed. In 38 patients (64%), obstructive hydrocephalus was present. In addition to the tumor biopsy, 32 patients (53%) underwent endoscopic third ventriculostomy (ETV), and 7 (12%) underwent septum pellucidotomy. Only 2 patients required a ventriculoperitoneal shunt shortly after the endoscopy procedure because ETV was not feasible. The major complication due to the endoscopy procedure was ventricular hemorrhage noted on the postoperative images in 8 cases (13%). Only 2 patients were symptomatic and required medical therapy. Infection occurred in only 1 case, and the other complications were all reversible. In no case did clinically significant sequelae affect the patient's outcome. Tumor types ranged across the spectrum and included glioma (low- and high-grade [27%]), pure germinoma (15%), pineal parenchymal tumor (12%), primary neuroectodermal tumor (4%), lymphoma (9%), metastasis (4%), craniopharyngioma (6%), and other tumor types (13%). In 10% of patients, the pathological findings were inconclusive. According to diagnosis, specific therapy was performed in 35% of patients: 17% underwent microsurgical removal, and 18% underwent chemotherapy or radiotherapy.

Conclusions

This is one of the largest series confirming the safety and validity of the neuroendoscopic biopsy procedure. Complications were relatively low (about 13%), and they were all reversible. Neuroendoscopic biopsy provided meaningful pathological data in 90% of patients, making subsequent tumor therapy feasible. Cerebrospinal fluid pathways can be restored by ETV or septum pellucidotomy (65%) to control intracranial hypertension. In light of the results obtained, a neuroendoscopic biopsy should be considered a possible alternative to the stereotactic biopsy in the diagnosis and treatment of ventricular or paraventricular tumors. Furthermore, it could be the only surgical procedure necessary for the treatment of selected tumors.
Cranial vault expansion by distraction osteogenesis
Authors: Winston Ken R. , Ketch Lawrence L. , Dowlati Dylaan
Published: April 2011

Object

The object of this report is to present a conceptual and technical approach for expanding the cranial vault, by distraction osteogenesis, in patients with craniocephalic disproportion secondary to pancraniosynostosis and in patients with complex syndromic craniofaciosynostoses undergoing operations for aesthetic improvement.

Methods

The clinical characteristics, techniques used, outcome and complications for all patients who underwent cranial vault expansions with distraction osteogenesis in Children's Hospital of Denver were reviewed.

Results

Twenty-six cranial vault expansions were done in 24 patients. Nineteen patients presented with intracranial hypertension. Twelve of these had pancraniosynostosis and 8 had a syndromic diagnosis. Large segments of cranial bone were translated in a controlled manner for distances up to 30 mm. All but one of the patients with intracranial hypertension experienced complete resolution.

Conclusions

Cranial vault expansion by distraction osteogenesis has the great advantage, as the name implies, of generating new and vascularized autologous bone of the correct shape and in correct locations. The technique, although not simple and not risk free, is much less technically complicated and places patients at lower risk for the most serious complications than does single-stage vault expansion. Less soft tissue dissection and less devascularization of bone are required and there are no postoperative dead spaces. Distraction osteogenesis facilitates far greater vault expansions than do single-stage procedures and can be accomplished in any desired direction.
Bilateral invasive electroencephalography in patients with tuberous sclerosis complex: a path to surgery?
Authors: Carlson Chad , Teutonico Federica , Elliott Robert E. , Moshel Yaron A. , LaJoie Josiane , Miles Daniel , Devinsky Orrin , Weiner Howard L.
Published: April 2011

Object

Many children with epilepsy and tuberous sclerosis complex (TSC) have multiple tubers on MR imaging and poorly localized/lateralized video electroencephalography (EEG) findings. Given the long-term risks associated with frequent seizures and multiple antiepileptic drugs, along with improved success in identifying focal epileptogenic zones in patients with multifocal lesions, the authors used bilateral intracranial EEG to lateralize the epileptogenic zone in patients with nonlateralizable noninvasive preoperative evaluations.

Methods

A retrospective analysis from January 1, 1998, to June 30, 2008, identified 62 children with TSC who were presented at a surgical conference. Of the 52 patients undergoing diagnostic or therapeutic procedures during the study period, 20 underwent bilateral intracranial EEG. The presurgical testing results, intracranial EEG findings, surgical interventions, and outcomes were reviewed.

Results

Fourteen of 20 patients had intracranial EEG findings consistent with a resectable epileptogenic zone. One patient is awaiting further resection. Five patients had findings consistent with a nonresectable epileptogenic zone, and 1 of these patients underwent a callosotomy. Seven patients had Engel Class I outcomes, 1 was Class II, 3 were Class III, and 3 were Class IV (mean follow-up 25 months).

Conclusions

Bilateral intracranial EEG can identify potential resectable seizure foci in nonlateralizable epilepsy in TSC. Although 6 of 20 patients did not undergo resection (1 patient is pending future resection), significant improvements in seizures (Engel Class I or II) were noted in 8 patients. In the authors' experience, this invasive monitoring provided a safe method for identifying the ictal onset zone.
Osteopetrosis with Chiari I malformation: presentation and surgical management
Authors: Dlouhy Brian J. , Menezes Arnold H.
Published: April 2011

Osteopetrosis is a heterogeneous group of rare, inherited disorders of the skeleton that results in neurological manifestations due to restriction of growth of cranial foramina and calvarial thickening. A 25-year-old woman with a history of autosomal dominant osteopetrosis presented to the authors' institution with headache worsened by exertion and radiating from the occipital region forward with episodes of choking/coughing when eating and a loss of gag reflex on physical examination. On MR imaging, she was found to have severe posterior fossa calvarial thickening resulting in a small posterior fossa and tonsillar ectopia of 9 mm and compression and deformation of the brainstem. She underwent posterior fossa craniectomy, foramen magnum decompression, and partial C-1 laminectomy with external durotomy. The patient did well postoperatively with resolution of symptoms. This case describes a new neurological manifestation of autosomal dominant osteopetrosis. To the authors' knowledge, this report represents the first described case of extreme posterior fossa calvarial thickening from autosomal dominant osteopetrosis with associated Chiari I malformation (CM-I) requiring posterior fossa decompression and extradural decompression. Given previously published MR imaging data that demonstrate the association of osteopetrosis and CM may be more common than in this case alone, the authors discuss the need for further investigation of the incidence of CM-I in patients with autosomal dominant osteopetrosis. Additionally, they review osteopetrosis and other diagnoses of calvarial hyperostosis presenting as CM-I.
Etiology and cranial CT scan profile of nontumoral hydrocephalus in a tertiary black African hospital
Authors: Idowu Olufemi , Olumide Adebayo
Published: April 2011

Object

Hydrocephalus is a common condition in the pediatric population. The cause of hydrocephalus, Evans ratio, ventricular index, and cerebral mantle thickness are some of the factors associated with poor surgical outcome. This study was conducted to evaluate the profile of these factors in the authors' patient population.

Methods

The authors conducted a prospective study from the August 1, 2006, to May 30, 2010. The consecutive patients were all 6 years of age or younger. The demographic information, cause of hydrocephalus, and cranial computerized measurements were taken (including widths of the frontal/occipital horns, third ventricle, and cerebral mantle thickness) and entered into the procedural forms.

Results

One hundred thirty-seven patients presented to the unit over the stipulated period. The male/female ratio was 1.1:1. The median age at presentation was 4 months (mean 7.3 months, range 4 days to 6 years). Myelomeningocele-associated hydrocephalus, aqueductal stenosis, and postmeningitic hydrocephalus accounted for 30.7%, 22.6%, and 17.5%, respectively, of the cases. The mean Evans ratio was 0.56 (range 0.43–0.70), the mean ventricular index was 197.18 (range 135.0–245.3), and the mean cerebral mantle was 10.8 mm (10–14 mm).

Conclusions

This study shows that the congenital form of hydrocephalus is the predominant variety in the authors' population. Myelomeningocele-associated hydrocephalus, aqueductal stenosis, Dandy-Walker malformation, and postmeningitic hydrocephalus are common causes of hydrocephalus.
Vagal nerve stimulator placement for medically refractory seizures in a child treated with phrenic nerve pacing for congenital central hypoventilation syndrome
Authors: Duty Brian D. , Wozniak Susan E. , Selden Nathan R.
Published: April 2011

Congenital central hypoventilation syndrome (CCHS) is a rare, idiopathic disorder characterized by a failure of automatic respiration. Abnormalities such as seizure disorder, failure to thrive, and Hirschsprung disease have been associated with CCHS. In this report, the authors discuss the use of vagal nerve stimulation (VNS) to treat a medically refractory seizure disorder in a child who had previously undergone placement of bilateral phrenic nerve stimulators for treatment of CCHS. Concomitant use of phrenic and vagal nerve stimulators has not previously been reported in the literature. No adverse reactions were noted with both devices working. Diaphragmatic pacing (DP) was clinically unaffected by VNS. The patient experienced a marked reduction in seizure frequency and severity following vagal nerve stimulator placement. Based on this case, the authors conclude that VNS is a potentially safe and efficacious treatment option for seizure disorder associated with CCHS in patients undergoing DP.
Iatrogenic cerebral venous sinus occlusion with flowable topical hemostatic matrix
Authors: Singleton Richard H. , Jankowitz Brian T. , Wecht Daniel A. , Gardner Paul A.
Published: April 2011

Object

The use of commercially available topical hemostatic adjuncts has increased the safety profile of surgery as a whole. Cranial surgery has also benefited from the development of numerous agents designed to permit more rapid achievement of hemostasis. Flowable topical hemostatic agents applied via syringe injection are now commonly employed in many neurosurgical procedures, including cranial surgery. Intravascular use of these strongly thrombogenic agents is contraindicated, but in certain settings, inadvertent intravascular administration can occur, resulting in vascular occlusion, thrombosis, and potential dissemination. To date, there have no reports detailing the presence and incidence of this complication.

Methods

The authors conducted a retrospective review of all cranial surgeries performed at Presbyterian University Hospital by members of the University of Pittsburgh Medical Center's Department of Neurological Surgery between 2007 and 2009. Cases complicated by vascular occlusion due to inadvertent intravascular administration of flowable topical hemostatic matrix (FTHM) were identified and analyzed.

Results

Iatrogenic vascular occlusion induced by FTHM was identified in 5 (0.1%) of 3969 cranial surgery cases. None of these events occurred in 3318 supratentorial cases, whereas 5 cases of cerebral venous sinus occlusion occurred in 651 infratentorial cases (0.8%). The risk of accidental vessel occlusion was significantly associated with infratentorial surgery, and all events occurred in the transverse and/or sigmoid sinus. No episodes of inadvertent vascular occlusion occurred during endoscopic surgery. No cases of arterial occlusion were identified. Of the 5 patients with FTHM-related cerebral venous sinus occlusion, none developed long-term neurological sequelae referable to the event.

Conclusions

Inadvertent intravascular administration of FTHM is a rare complication associated with cranial surgery that occurs most commonly during infratentorial procedures around the transverse and/or sigmoid sinuses. Modifications in the choice of when to use an FTHM and the method of application may help prevent accidental venous sinus administration.
The materials and methods of hand-colouring zoological illustrations
Authors: Jackson Christine E.
Published: April 2011

Thousands of colourists were employed to hand-colour illustrations in zoological books and journals during two centuries. They followed pattern plates that were prints with monochrome outlines coloured by the artist for them to copy. Accounts of the materials that they used, and the methods employed to achieve fine coloured plates closely resembling the original water-colours, have been collected from many documents.
Charles Plumier's “Manicou Caraibarum” (c.1690): a previously unpublished description and drawing of the common opossum,Didelphis marsupialisLinnaeus, 1758
Authors: Pietsch Theodore W.
Published: April 2011

A previously unpublished description and drawing of the common opossum, Didelphis marsupialis Linnaeus, 1758, made by French Minim friar Charles Plumier (1646–1704) during the first (1689–1690) of three voyages of exploration to the West Indies, are presented and compared with earlier depictions, especially that of Georg Marcgrave (1610–1644) in his Historiae rerum naturalium Brasiliae of 1648. Evidence is presented to emphasis the originality and scientific accuracy of Plumier's account.
Early oligochaete science, from Aristotle to Francesco Redi
Authors: Rota Emilia
Published: April 2011

The paper reviews knowledge on earthworms from early classical times to the end of the seventeenth century. The Aristotelian view that these “imperfect” animals developed spontaneously from mud and lacked internal organs except the gut was not challenged until the late Renaissance but, by the end of the 1600s, it was overthrown. Aldrovandi and Mouffet presented field observations of sexual reproduction and specific habitat requirements. Willis demonstrated the complex internal anatomy of an earthworm. Finally Redi, based on numberless dissections, showed the existence of variations on that basic anatomical plan, which anyway remained distinct from that of parasitic worms. Through a series of controlled laboratory tests, Redi also proved that earthworms have a physiology of their own and are most sensible to water loss. In those same years, Swammerdam investigated earthworm cocoons nursing them in his room, and Tyson discovered earthworms’ hermaphroditism. Two significant interpretations of earthworm's locomotion, by Fabrici ab Aquapendente and Borelli, also belong to this period, but were both short-lived in their influence. An awareness of the ecological role of earthworms in pedogenesis and soil fertility did not emerge until the late eighteenth century.
Attitudes of Caregivers to Management of End-Stage Renal Disease in Infants
Authors: Teh Jun Chuan , Frieling Michelle L. , Sienna Julianna L. , Geary Denis F.
Published: April 2011

Objectives

To characterize the attitudes of pediatric nephrologists caring for infants with end-stage renal disease (ESRD) compared with attitudes from a survey published in 1998. Nephrology nurses and social workers were included.

Methods

An e-mail survey was distributed to pediatric nephrology teams in Canada, Germany, Japan, the United Kingdom, and the United States.

Results

Survey responders totaled 270. Renal replacement therapy (RRT) is offered by all nephrologists to some children 1 – 12 months, and by 98% to some less than 1 month of age (93% in 1998). Of responding nephrologists, 30% offer RRT to all children less than 1 month of age (41% in 1998), and 50%, to all children 1 – 12 months. Among respondents, 50% indicated that parents can never refuse RRT for children aged 1 – 12 months, compared with 27% for younger infants. The most influential factor in rejecting RRT for infants was the presence of a co-existing abnormality. Nurses were more likely to believe that parents have the right to refuse RRT for infants.

Conclusions

Attitudes of pediatric nephrologists have changed since 1998. Also, nurses have opinions that are different from those of the nephrologists on some issues, and a consensus should be reached before speaking to families.
Difference in the Expression of Hormone Receptors and Fibrotic Markers in the Human Peritoneum—Implications for Therapeutic Targets to Prevent Encapsulating Peritoneal Sclerosis
Authors: Braun Niko , Fritz Peter , Biegger Dagmar , Kimmel Martin , Reimold Fabian , Ulmer Christoph , Alscher M. Dominik
Published: April 2011

Objective

Encapsulating peritoneal sclerosis (EPS) is a rare but life-threatening complication of peritoneal dialysis (PD). The optimal management of patients with EPS is uncertain. In the present study, we investigated differences in the expression of nuclear receptors [progesterone (PR), androgen (AR), vitamin D (VDR), and glucocorticoid (GCR)] in the human peritoneum. We also investigated estrogen receptor (ER), matrix metalloproteinase 9 (MMP9), and transforming growth factor β1 (TGFβ1) in the context of their potential role in tamoxifen therapy.

Methods

We analyzed clinical and histologic characteristics of 72 peritoneal biopsy specimens (22 from EPS patients, 11 from PD patients, 15 from uremic patients, and 24 from control subjects undergoing hernia repair). For immunophenotyping, we used antibodies against VDR, GCR, ER, PR, AR, MMP9, and TGFβ1.

Results

In human peritoneum, VDR and GCR are highly expressed (98.6% and 87.3% respectively). Except in the case of VDR ( p = 0.0012), we observed no significant difference in receptor expression between the groups. Expression of ER and PR was sparse (11.4% and 31% respectively), with higher expression in women, and AR was absent. Minimal MMP9 expression and moderate TGFβ1 expression were observed in all groups. The differences between the groups were nonsignificant.

Conclusions

Nuclear receptors are present in human peritoneum. Except in the case of VDR, the pattern for any one group is nonspecific. Glucocorticoids, vitamin D, and angiotensin converting-enzyme inhibitors or angiotensin II receptor blockers (via the vitamin D/angiotensin II pathway) might be suitable interventions for preservation of the integrity of the peritoneal membrane. The mechanism of action of tamoxifen is still not elucidated, ER expression in the peritoneum is sparse, and data about the studied pathways (MMP9, TGFβ) are inconsistent.
Antiviral Pharmacodynamics in Hollow Fibre Bioreactors
Authors: McSharry James J , Drusano George L
Published: April 2011

Pharmacodynamic investigation of antiviral compounds studies the relationship between drug exposure and the virological response. These studies are usually performed in animals and, eventually, in humans and are a very expensive proposition. To find a more efficient and less expensive method for determining pharmacodynamics of antiviral and antimicrobial compounds, the hollow fibre infection model (HFIM) system was developed to perform pharmacodynamic studies in vitro. This review covers the authors' studies on the use of in vitro hollow fibre bioreactor technologies for determining the pharmacodynamics of antiviral compounds for viruses grown in cultured cells, including HIV grown in CD4+ lymphoblastoid cells, vaccinia viruses grown in HeLa-S3 cells and influenza viruses grown in Madin–Darby canine kidney cells. Where possible, correlations between the pharmacodynamic index derived from the in vitro HFIM systems and clinical pharmacodynamic studies are made.
Relationship of Focal Erosions, Bone Mineral Density, and Parathyroid Hormone in Rheumatoid Arthritis
Authors: ROSSINI MAURIZIO , BAGNATO GIANFILIPPO , FREDIANI BRUNO , IAGNOCCO ANNAMARIA , LA MONTAGNA GIOVANNI , MINISOLA GIOVANNI , CAMINITI MAURIZIO , VARENNA MASSIMO , ADAMI SILVANO
Published: April 2011

Objective.

To investigate the relationship among focal bone erosions and bone mineral density (BMD), 25(OH) vitamin D (25OHD), and parathyroid hormone (PTH) values in patients with rheumatoid arthritis (RA).

Methods.

The study included 1191 RA patients (1014 women, 177 men, mean age 58.9 ± 11.1 yrs) participating in a multicenter, cross-sectional study.

Results.

Radiographic evidence of typical bony erosions on hands or forefeet was found in 64.1% of patients. In those with bone erosions as compared to those without, mean BMD Z score values were significantly lower at both the spine (−0.74 ± 1.19 vs −0.46 ± 1.31; p = 0.05) and the hip (−0.72 ± 1.07 vs −0.15 ± 1.23; p < 0.001). In the subgroup of patients not taking vitamin D supplements, PTH levels were significantly higher in those with erosive arthritis (25.9 ± 14.0 vs 23.1 ± 11.6 pg/ml; p = 0.01); whereas the 25OHD concentrations were very similar in the 2 groups. The mean differences for BMD and PTH among the erosive and nonerosive RA remained statistically significant when values were simultaneously adjusted for all disease and mineral metabolism factors (i.e., age, sex, menopause, disease duration, Disease Activity Score 28-joint count, Health Assessment Questionnaire, activities of daily living, Steinbrocker functional state, glucocorticoid therapy, body weight, and bisphosphonate treatment).

Conclusion.

Our results suggest that the presence of bone erosions in RA correlates with low BMD levels and high PTH levels, and that these associations are independent of the degree of functional impairment and other common determinants of bone mass and mineral metabolism in adults with RA. These findings suggest that treatments to prevent bone loss or suppress PTH levels might positively affect the progression of bone erosions in RA.
Longterm Therapeutic Response to Milnacipran Treatment for Fibromyalgia. A European 1-Year Extension Study Following a 3-Month Study
Authors: BRANCO JAIME C. , CHERIN PATRICK , MONTAGNE AGNES , BOUROUBI ATHMANE
Published: April 2011

Objective.

This double-blind, 1-year extension study investigated the longterm efficacy and safety of milnacipran 100, 150, and 200 mg/day in the treatment of fibromyalgia (FM) in completers of a 3-month European double-blind lead-in study of milnacipran 200 mg/day versus placebo.

Methods.

A total of 468 patients with FM successfully completing the lead-in study were either blindly maintained on milnacipran 200 mg/day (MLN200:MLN200, n = 198) or (if previously receiving placebo) rerandomized to milnacipran 100 mg/day (PBO:MLN100, n = 91), 150 mg/day (PBO:MLN150, n = 92), or 200 mg/day (PBO:MLN200, n = 87) for an additional 12 months (including a 4-week dose escalation). The main efficacy endpoint was a 2-measure composite responder rate (relative to lead-in study baseline) incorporating the weekly-recall pain score recorded on a visual analog scale and the Patient Global Impression of Change score. A panel of other assessments including the Fibromyalgia Impact Questionnaire explored the multidimensional aspects of FM. Descriptive analyses using the last observation carried forward approach were performed.

Results.

At the 1-year endpoint, the proportion of composite responders (relative to the lead-in study baseline) ranged from 27.5% (PBO:MLN100) to 35.9% (MLN200:MLN200), and had increased from the extension study baseline by 15.2% (PBO:MLN150) to 20.7% (PBO:MLN200 and MLN200:MLN200). At endpoint, an improvement from both baselines was shown in all groups on pain, fatigue, sleep, and quality of life measures. Up to 1 year, all doses of milnacipran were safe and well tolerated. The most common drug-related adverse events were hyperhidrosis and nausea.

Conclusion.

Over 1 year, milnacipran 100, 150, and 200 mg/day exhibited sustained and safe therapeutic effects on predominant symptoms of FM. Registered as trial no.NCT00757731.