bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Soluble CD163 and Interleukin-6 Levels in Women with Ovarian Endometriomas
Authors: Jee Byung Chul , Suh Chang Suk , Kim Seok Hyun , Moon Shin Yong
Published: February 2008

Background: CD163 is a hemoglobin scavenger receptor exclusively expressed in the monocyte-macrophage system and its soluble form (sCD163) has not yet been studied as a serum marker in women with endometriosis. The purpose of this study was to evaluate whether serum levels of sCD163 and interleukin-6 (IL-6) could be possible markers for ovarian endometriomas discriminating adnexal benign cystic tumors. Methods: The concentrations of sCD163 and IL-6 were determined using commercial ELISA kits in frozen sera collected from 95 women prior to surgery for adnexal benign cystic tumors: 44 with ovarian endometriomas, 24 with mature cystic teratomas, 10 with mucinous cystadenomas, 8 with serous cystadenomas and 9 with parovarian cysts. Serum levels of CA-125 were also recorded preoperatively. The volume of cysts was evaluated in women with ovarian endometriomas. Results: The serum levels of sCD163 and IL-6 were not significantly different among the women with various adnexal benign cystic tumors. In patients with endometriomas (n = 44), the levels were similar to those with nonendometriotic benign cystic tumors (n = 51): 3,431.7 ± 343.9 vs. 3,231.0 ± 391.7 ng/ml for sCD163 and 5.3 ± 0.9 vs. 12.9 ± 4.0 pg/ml for IL-6 (mean ± SEM). No correlation was noted between serum levels of two markers with volume of endometriomas. Conclusion: Our findings suggest that serum levels of sCD163 as well as IL-6 are not useful markers for ovarian endometriomas.
A Novel Real-Time Multiplex Reverse Transcriptase-Polymerase Chain Reaction for the Detection of HIV-1 RNA by Using Dual-Specific Armored RNA as Internal Control
Authors: Huang Jie , Yang Chang-Mei , Wang Lu-Nan , Meng Shuang , Deng Wei , Li Jin-Ming
Published: February 2008

Objective: Transmission of HIV-1 and diagnosis of infection in hospitals and public health settings remains a worldwide concern. HIV-1 detection is sometimes not possible using current commercial assays, probably due to mismatches between the selected primers and probes. Methods: By screening primers and probes, we developed a dual-specificity probe real-time reverse transcriptase-polymerase chain reaction (DSPrtRT-PCR) assay using dual-specific armored RNA as the internal control. The specificity and sensitivity were compared between the monospecificity probe real-time and DSPrtRT-PCR techniques. Results: The sensitivity of DSPrtRT-PCR improved significantly, with no effect on its specificity. The detection limit was 173 IU/ml. All the HIV-1 group M and group O could be detected. In clinical assays, 1,000 copies/ml of armored RNA was required as internal control. When applied to negative samples, 100% specificity was achieved. Among 60 samples from the tested patients, DSPrtRT-PCR demonstrated high sensitivity, accurately detecting 50 positives and 10 negatives that were confirmed by the COBAS AmpliScreen assay. Conclusion: DSPrtRT-PCR is a more efficient and effective viral assay with high sensitivity and specificity as compared to monospecificity probe PCR. It can be widely applied in blood donor screening and qualitative individual detection of HIV-1 RNA.
Connexin 40 Promoter-Based Enrichment of Embryonic Stem Cell-Derived Cardiovascular Progenitor Cells
Authors: David R. , Theiss H. , Franz W.-M.
Published: February 2008

Background: Pluripotent embryonic stem (ES) cells that can differentiate into functional cardiomyocytes as well as vascular cells in cell culture may open the door to cardiovascular cell transplantation. However, the percentage of ES cells in embryoid bodies (EBs) which spontaneously undergo cardiovascular differentiation is low (<10%), making strategies for their specific labeling and purification indispensable. Methods: The human connexin 40 (Cx40) promoter was isolated and cloned in the vector pEGFP. The specificity of the construct was initially assessed in Xenopus embryos injected with Cx40-EGFP plasmid DNA. Stable Cx40-EGFP ES cell clones were differentiated and fluorescent cells were enriched manually as well as via fluorescence-activated cell sorting. Characterization of these cells was performed with respect to spontaneous beating as well as via RT-PCRs and immunofluorescent stainings. Results: Cx40-EGFP reporter plasmid injection led to EGFP fluorescence specifically in the abdominal aorta of frog tadpoles. After crude manual enrichment of highly Cx40-EGFP-positive EBs, the appearance of cardiac and vascular structures was increased approximately 3-fold. Immunofluorescent stainings showed EGFP expression exclusively in vascular-like structures simultaneously expressing von Willebrand factor and in formerly beating areas expressing α-actinin. Cx40-EGFP-expressing EBs revealed significantly higher numbers of beating cardiomyocytes and vascular-like structures. Semiquantitative RT-PCRs confirmed an enhanced cardiovascular differentiation as shown for the cardiac markers Nkx2.5 and MLC2v, as well as the endothelial marker vascular endothelial cadherin. Conclusions: Our work shows the feasibility of specific labeling and purification of cardiovascular progenitor cells from differentiating EBs based on the Cx40 promoter. We provide proof of principle that the deleted CD4 (ΔCD4) surface marker-based method for magnetic cell sorting developed by our group will be ideally suitable for transference to this promoter.
Association of Suboptimal Prescribing and Change in Lower Extremity Physical Function over Time
Authors: Pugh Mary Jo V. , Palmer Raymond F. , Parchman Michael L. , Mortensen Eric , Markides Kyriakos , Espino David V.
Published: February 2008

Background: Previous studies have found inconsistent links between suboptimal prescribing and negative patient outcomes. While suboptimal prescribing consists of multiple components, e.g. drugs to avoid in the elderly (DAE), potential drug interactions (PDI) and polypharmacy, most research has focused on the impact of drugs to avoid. This study explores the relationship between suboptimal prescribing, comorbid disease, and change in lower extremity functional limitation (LEFL). Methods: This prospective cohort study used data from the Hispanic Established Population for the Epidemiologic Study of the Elderly. Baseline data collection occurred between 1993 and 1994 with three additional waves of data collected approximately every 2 years. Based on the disablement process model, the dependent variable was change in LEFL over the 7-year study period. Independent variables included suboptimal prescribing: DAE, PDI and polypharmacy. Measures of pathology included comorbid diseases (stroke, cancer, hypertension, cardiovascular disease, arthritis, and diabetes). Age, gender, education, smoking, cognitive status, depression, body mass index, marital status, and self-reported health were controlled in analyses. Results: Diabetes, stroke, and arthritis were associated with a decline in LEFL. Polypharmacy mediated the relationship between diabetes and LEFL, and polypharmacy was also significantly associated with decrements in LEFL. Conclusion: The effect of suboptimal prescribing on change in LEFL was limited to both direct and mediational effects of polypharmacy. Additional research exploring the association between suboptimal prescribing and a variety of quality measures using a diverse set of outcomes would improve our understanding of the impact of suboptimal prescribing more broadly defined.
Freeze-Fracture Study of Human Brain Tumors
Authors: Tani Eiichi , Higashi Noboru
Published: February 2008

This freeze-fracture study was performed in 3 astrocytomas, 6 glioblastomas, 2 ependymomas, 3 medulloblastomas, 1 cerebellar sarcoma, 3 germinomas, and 1 medulloepithelioma. The number of nuclear pores/µm2 nuclear membrane was not correlated with biological malignancy. Fracture faces A and B were discernible in nuclear, Golgi and rough endoplasmic reticulum (ER), mitochondrial surface, and plasma membranes. Fenestrae were evident in Golgi and ER membranes. The transitional zone of cristae from the inner surface membrane appeared as a circular hole and broken-off neck on faces A and B of the inner surface membrane, respectively. The decrease in number of membrane particles in the plasma membrane seemed to correlate with the frequency of metastases, and, in addition, the membrane particles appeared to cluster in glioblastoma, medulloblastoma, and medulloepithelioma. The gap junctions were abundant in astrocytomas, moderate in number in ependymomas and germinomas, and rare in glioblastomas, cerebellar sarcoma, and medulloepithelioma. Tight junctions were often found in germinomas and medulloepithelioma, and rarely in ependymomas.
Diagnosis and Surgical Treatment of Choroid Plexus Papillomas
Authors: Raimondi Anthony J. , Gutierrez Francisco A.
Published: February 2008

This is a report of 22 cases of papillomas of the choroid plexus diagnosed and managed personally by the author. The angiographic diagnosis and extension of choroid plexus papillomas are described, as is the surgical technique for removing these tumors from the lateral, third, and fourth ventricles. Specific attention is given to using the angiogram as the study of choice upon which surgical technique is planned. The diagnosis of choroid plexus papilloma of the lateral ventricle is made by observing the presence of a hypertrophied anterior choroidal artery, a ‘double tumor’ sign with one tumor at the trigone and the other within the temporal or frontal horn, tumor stain at the trigone, and asymmetrical hydrocephalus, generally, with a shift away from the side of the larger ventricle. Posterior fossa papillomas cause symmetrical hydrocephalus and generally have tumor stain located within the mid-line, with the major feeding coming from either the superior cerebellar or the posteroinferior cerebellar arteries. Surgical removal of the tumor should entail an ‘en bloc’ resection following occlusion of the feeding and draining vessels. The tumor should be removed directly when it is in the lateral ventricle and following ventriculocerebral spinal fluid shunting when it is in the posterior fossa.
The So-Called Dandy-Walker Syndrome: Analysis of 12 Operated Cases
Authors: Udvarhelyi George B. , Epstein Melvin H.
Published: February 2008

Twelve patients between the years of 1964 and 1971 underwent surgical treatment for the so-called Dandy-Walker syndrome at the Johns Hopkins Hospital. Five patients belonged to an early group (1–8 weeks); four patients to an intermediary group (3–20 months); and a late group consisted of three patients (3 years, 14 years and 34 years). The value of the various diagnostic studies is discussed on the basis of an analysis of the plain skull X-rays, cerebral angiograms, and combined air studies. The importance of a careful delineation of the underlying pathological condition is stressed to enable the surgeon to choose the appropriate technique. The diagnostic studies confirmed the diagnosis of a true Dandy-Walker syndrome in six of the twelve cases. The remaining six proved to have either an independent posterior fossa cyst with communication of the subarachnoid space and occasionally with the ventricles; or an isolated posterior fossa cyst with no communication but with impingement on the aqueduct and on the midline structures. In six patients, a primary simple shunt procedure was performed which had to be followed by a posterior fossa craniectomy in one and by a double-shunt (ventricle and posterior fossa cyst) in another. Four patients underwent a posterior fossa craniectomy; as the primary and only procedure (2), craniectomy followed by a ventriculoperitoneal shunt (1), or an unsuccessful shunt followed by craniectomy (1). In two patients, a so-called ‘double shunt’ was performed as a second operation, draining simultaneously the right lateral ventricle and the posterior fossa cyst. There was no death in this series. Three children had evidence of infected shunts; they responded to adequate therapy. Four had excellent results, with normal neurological examination and normal development. Four had good results, performing in school (working) was markedly improved; two had fair results with residual neurological deficit and some mental retardation. Two patients had to be considered as poor results. Both of them, however, have shown evidence of concomitant severe congenital abnormalities of the cerebellum on the diagnostic studies. The follow-up period ranged from 1½ to 7½ years.
Correction of Ocular Hypertelorism
Authors: Epstein Fred , Ransohoff Joseph , Wood-Smith Donald , Converse John M.
Published: February 2008

36 patients with congenital hypertelorism, eight with Crouzon’s disease, and three with a posttraumatic deformity, were operated with Tessier’s technique with some modifications, i.e. the dura is not separated from the cribriform plate avoiding olfactory damage. The entire procedure for hypertelorism could be carried out in less than 5 h but correction of Crouzon’s disease required 6–8 h, and longer in older patients. There was only one intraoperative anesthesic death in a 3-year-old child. One cardiac arrest recovered. Nine staphylococcus infections were superficial and readily treated. There was postoperative cerebral edema in one case and convulsions following surgery in another. Anticonvulsants and steroids were subsequently routinely employed. There were no SF fistulas. Excellent cosmetic results are due primarily to the skill of the plastic surgeons.
An Analysis of External Ventricular Drainage as a Treatment for Infected Shunts
Authors: Mori Koreaki , Raimondi Anthony J.
Published: February 2008

An analysis of EVD as a treatment for infected shunts is reported. The study consists of 6 patients with ventriculo-jugular shunts and 17 patients with ventriculo-peritoneal shunts. When infection of the shunting system is suspected on a clinical basis, the shunt should be removed immediately. EVD is adequate to control intraventricular pressure. After the infection clears, reimplantation of shunt should be considered.
Acute Subdural Hematoma in Infancy and Childhood
Authors: Gutierrez Francisco A. , Raimondi Anthony J.
Published: February 2008

27 cases of acute posttraumatic subdural hematomas diagnosed and treated by the authors from 1968 to 1972 are presented. Five were newborns, 18 were infants, and three were toddlers. The youngest patient was 38 h and the oldest 5 years old. The most common age was between 1 and 3 months. Falls were the most frequent cause of injury, parental or familial abuse was next. A correlative analysis of the different clinical pictures in each of these age groups is made. We stressed that the presence of hemorrhages in the fundi, and convulsions, in the infant who has suffered a head injury, are indications for contrast studies. A critical analysis of subdural taps, as a method of diagnosis and treatment, is made: we seriously doubt that subdural taps are of any real value in the clinical management of a child with acute head injury. Comparative analysis of the surgical treatment and results is made. Twelve patients were treated with repeated subdural taps, 15 with craniotomy. Of the former group, 41.6% developed a chronic subdural whereas only 13% of the latter group developed this complication. Five out of the 27 patients died. Comparative psychological evaluation of these two groups, surgical and nonsurgical, is presented. In the surgical group 72.7% had an IQ over 80 and in the nonsurgical group only 25 % had an IQ over 80. A correlative analysis of the clinical picture, method of diagnosis, surgical result, and psychological tests are analyzed.
Technique of Fontanelle and Persutural Ventriculoscopy and Endoscopic Ventricular Surgery in Infants
Authors: Griffith H.B.
Published: February 2008

The author describes a new type of neurosurgical operating telescope which makes possible the foundation of endoneurosurgery. Illumination through a fibre-optic bundle and image transmission through a series of coated air lenses in glass are based on Hopkins optical systems. The telescope is 2.6 mm in external diameter. The operating sheath introduced around the telescope by means of split obturators which dilate the telescope track, enlarges the external diameter of the instrument to 4.5 mm. Up to four special instruments (electrode, aspirating cannula, accessory light, perfusing cannula, scissors) or a grasping forceps can be introduced through the instrument sheath. The instrument can be introduced, using a sharp trocar, through the fontanelle or lambdoid suture in infants and through a burr hole in children. It has been used for third ventriculoscopy and choroid plexus coagulation. The latter has been carried out successfully through the anterior fontanelle and the lambdoid suture, bilaterally in 2–4 stages. Complications – one meningitis – have been the exception.
Measurement of Respiration in Arnold-Chiari Malformation
Authors: Krieger Abbott J.
Published: February 2008

Respiratory distress occurs in infants with myelomeningocele and Arnold-Chiari malformation. It is difficult to measure it because of the small volume exchanged and the lack of cooperation of infants. Existing equipment had to be modified to do so by decreasing the dead space and reducing the bulkiness of the sensing device. In infants with tracheostomies, a continuous flow of gas was applied to reduce the dead space. In infants without tracheostomies, a continuous flow of gas was applied, but the mask was too bulky to seal around the baby’s face. A nose-piece pneumotachograph was developed to alleviate the problem. Respiration was measured in 15 patients with myelomeningocele and hydrocephalus from 1 day to 5 months of age. After gas was administered, they breathed 38.5 times a minute with a tidal volume of 6.25 ml/kg, producing a minute ventilation of 0.254 l/min/kg. After administration of 5% CO2–95% O2, respiratory frequency rose to 47 breaths a minute, with a tidal volume of 8.8 ml/kg, producing a minute ventilation of 0.410 l/min/kg, comparable to that of normal infants.
Computerised Axial Tomography. Particular Applications and Advantages in Paediatric Neurosurgery
Authors: Till Kenneth
Published: February 2008

The first year’s experience of computerised axial tomography (the EMI scanner) in a department of neurosurgery is described, and those features of particular importance in the younger age group are emphasised.
Cephalocranial Disproportion
Authors: Hoffman Harold J. , Tucker William S.
Published: February 2008

Eight children with hydrocephalus showed signs of posterior fossa tonsillar impaction despite arrest of the hydrocephalus and patency of their CSF shunts. Contrast studies performed because of their clinical deterioration demonstrated cerebellar tonsillar herniation, and at posterior fossa decompression, this was confirmed in all cases. Improvement followed decompression. The pathogenesis of a state of cephalocranial disproportion following successful treatment of hydrocephalus resulting in symptomatic tonsillar herniation, is discussed.
Subacute Radiation Myelopathy in a 12-Year-Old Boy
Authors: Ballweg Gail P. , Donnenfeld Hyman , Chusid Joseph G.
Published: February 2008

Rapid onset over several days of a complete transverse myelopathy occurred 3½ months after completion of mediastinal radiation for Hodgkin’s disease in a 12-year-old boy. Postmortem examination revealed low cervical and high thoracic radiation myelopathy. The name ‘subacute radiation myelopathy’ is proposed for this type of rapidly developing myelopathy.
X-Linked Hydrocephalus, with Aqueductal Stenosis, Mental Retardation, and Adduction-Flexion Deformity of the Thumbs
Authors: Faivre J. , Lemarec B. , Bretagne J. , Pecker J.
Published: February 2008

A new family is reported of a Bickers-Adams-Edwards syndrome. This family has been studied up to three generations. Two female carriers are known. Among the six male children who are affected, four are severely mentally retarded, have spasticity of the legs, and survived with a mild macrocephaly, and two show a more severe and rapid progression of head enlargement. A partial aqueductal stenosis, with remarkable ventricular dilatation, has been demonstrated by pneumoencephalography in three boys. A deformity of the thumbs links these six children together. One of them has been treated by a ventriculoperitoneal shunt, when 18 months old, without any improvement in the neurological condition. The mental deficiency is much more severe than could be expected from the degree of hydrocephalus, at least as estimated clinically by the macrocephaly. Hydrocephalus is precocious, and the ventricular dilatation very advanced when seen by PEG studies. Recognition of the female carriers is not possible.
Pediatric Pneumoencephalography with Nitrous Oxide
Authors: Kerber Charles , Cromwell Laurence D.
Published: February 2008

The recent advances in neurodiagnostic procedures have changed pneumoencephalography. Now we must find the smallest lesions and demonstrate accurately their relationships to the ventricular system cisterns and surrounding structures. Complex blurring motion tomography gives this detail, but the pediatric patients are difficult to examine and immobilization during the long exposure needed for tomography frequently compromises the airway. Hypoventilation from sedation and from the radiographic positioning may lead to increased intracranial pressure. By performing pediatric pneumoencephalography under general anesthesia, with nitrous oxide as both an anesthetic agent and as the contrast material, we are able to control patient motion, preserve the child’s airway, and prevent hypoventilation, The nitrous oxide, rapidly diffusible, is a good contrast agent, as large volumes can be used and the gas leaves the ventricular system quickly after the discontinuation of the anesthetic. This rapid reabsorption and elimination of the subarachnoid gas may decrease pneumoencephalographic morbidity.
Experimental Congenital Hydrocephalus
Authors: Adeloye Adelola , Warkany Josef
Published: February 2008

A review was made of experimental methods available to produce congenital hydrocephalus by teratogenic methods. Radiation, infections, trypan blue, hypervitaminosis A, salicylates and nutritional deficiencies were considered. In the course of prenatal zinc deficiency experiments, congenital hydrocephalus was frequently encountered and histologic sections were made of many representative specimens. Details of the findings are described, among them various types of aqueduct stenosis or obliteration. Although these anomalies suggest that occlusion of the aqueduct is the cause of the enlargement of the ventricular system it was noted that there was also ventricular dilatation caudal to the stenotic point of the aqueduct. Hydrocephalus without aqueductal stenosis has also been observed in experimental animals. It seems possible that some cases of congenital hydrocephalus attributed to aqueductal stenosis are examples of hydrocephalus with secondary block of the aqueduct.
Preoperative Radiotherapy in the Management of Posterior Fossa Choroid Plexus Papillomas
Authors: Carrea Raúl , Polak Moises
Published: February 2008

Although primary radical removal is the procedure of choice in the treatment of choroid plexus papillomas, the age of the child, the size and/or location of the tumor and an above average surgical risk can make advisable the use of a first stage shunt operation, with section of the tentorium if there are signs of upwards tentorial herniation. The present two observations clearly demonstrate that radiotherapy shrinks the vascular stroma of these tumors, thus reducing its size and vascularity making possible the postponement of radical surgery and greatly simplifying the final radical removal of the lesion. Preoperative radiotherapy as well as shunt operations and tentorial section can be considered as first stage procedures for the surgical management of choroid plexus neoplasms in certain cases.
Hypothalamic Symptomatology and its Relationship to Diencephalic Tumor in Childhood
Authors: Connors Matthew H. , Sheikholislam Bagher M.
Published: February 2008

Autonomic dysfunction in a child may present confusing clinical phenolmena which mimic other diseases. Various clinical manifestations were seen during the 6-year course of a child with an astrocytoma of the hypothalamus. These ranged from the initial features of the diencephalic syndrome of infancy to autonomic seizures with striking paroxysms of hypertension, tachycardia, and sweating. Disturbances in hormonal regulation and gastrointestinal abnormalities were possibly related to the autonomic disturbance. The mechanisms for these findings were poorly understood. We conclude that a diencephalic lesion should be suspected in any child exhibiting such findings.
Ganglioneuroblastoma Presenting as Myasthenia gravis
Authors: Hassan Mahmoud Mohamed
Published: February 2008

Neuroblastoma is one of the most common malignant neoplasms in infants and children under 5 years of age. The commonest manifestations are abdominal masses or metastases. The case reported showed unusual manifestations as the presenting features simulated myasthenia gravis in all aspects. He was a child, aged 3 years, who was admitted because of generalized weakness, inability to open his eyes and lethargy. Radiography showed an oval opacity at the right upper zone of the chest. A thorocotomy was performed and a tumour was removed from the posterior mediastinum. Histopathology confirmed diagnosis of ganglioneuroblastoma. There is only one similar report in the medical literature.
Natural History of Postparoxysmal Hemiparesis in Childhood
Authors: Lesný I. , Roštoková R. , Kaprasová A.
Published: February 2008

In a period of 4 years, 43 children with postparoxysmal hemiparesis (PH) were observed. Two of them had tumors, five Sturge-Weber’s disease, and 36 were ‘primary’. The natural history of these is as follows: PH appears more frequently in children than in adults, girls more frequently suffer from PH than boys. The seizure which precedes the PH is most frequently unilaterally clonic with loss of consciousness. PH lasts mostly between 1 h and 2 weeks and recedes slowly, the type is mostly of the deficitary or pseudoflaccid, and rarely spastic. EEG changes are, in the majority, focal. Most children with PH have got a positive case history of a prenatal, perinatal or postnatal disorder. It seems therefore that PH appears in children with an already disturbed brain structure. The type of hemiparesis points to a pure lesion of the corticospinal tract, which matures slowly and relatively late.
Sphenoethmoidal Encephalocele
Authors: Modesti L.M. , Glasauer F.E. , Terplan K.L.
Published: February 2008

A rare case of sphenoethmoidal encephalocele with detailed pathological studies is reported. Only a few cases have been documented and were reviewed. The etiology and embryology of the congenital malformation remains speculative with an agreement on their development at an early embryonic stage. The mass presenting in the nasopharyngeal cavity remains often undetected unless causing respiratory embarrassment and is frequently misdiagnosed. Thorough radiological investigations detect the bone defect and outline the extent of the herniated mass and associated cerebral abnormalities. Small lesions have been successfully repaired. Larger ones prove less amenable to surgery and carry a high mortality.
Intracranial Ependymomas in Children
Authors: Coulon Richard A. , Till Kenneth
Published: February 2008

43 cases of intracranial ependymomas in children 0–13 years of age have been reviewed with attention given to various clinical aspects, including location, age, duration of history, signs and symptoms, and plain skull film abnormalities. 39 of the patients were treated by intracranial surgical procedures and 30 of these also had radiation therapy. Three patients had needle biopsy only and one died without treatment. The survival rate was below that anticipated and in part felt to be related to the frequent occurrence of malignant tumors in this series.
Instrumentation of the Spine for Fracture Dislocations in Children
Authors: Benner Benjamin , Moiel Richard , Dickson Jesse , Harrington Paul
Published: February 2008

13 children, ages 11–16 years, sustained severe compression fractures or fracture dislocations of the thoracolumbar spine. All cases were treated with Harrington instrumentation with fusion and six also had decompressive laminectomy. All injuries had significant instability and neurologic deficits (nine complete). Follow-up of 2–10 years is provided for analysis of maintenance of reduction and neurologic improvement. This technique appears to offer stability, reduction of orthopedic defects, and assumption of a more aggresive rehabilitation program without introducing significant operative morbidity or neurologic deficit.
Hypothalamic Tumors in Children
Authors: Menezes Arnold H. , Bell William E. , Perret George E.
Published: February 2008

17 intrinsic hypothalamic tumors in infancy and childhood occurring between 1963 and 1973 were analyzed in detail because of the consistent mode of approach to diagnosis, therapy and follow-up care. Careful examination of the symptom-time sequence and location provided anatomical-clinical correlations and was even suggestive of the probable histologic type of lesion present. The postoperative and long-term management problems have led to significant conclusions. The best results were obtained with those patients who underwent craniotomy and biopsy, followed by irradiation therapy.
Ependymomas of Childhood
Authors: Liu Mei , McLone David G. , Clark Sandra
Published: February 2008

Electron-microscopic study of various histological types of ependymoma has shown three basic types of cells. One type of cells has features typical of normal ependymal cells, the second type consists of cells resembling normal or reactive astrocytes, and the third type of cells is undifferentiated. The three types of cells are present in various proportions in every tumor. Generally speaking, the astrocyte-like cells are more frequently encountered than the ependymol cells. The undifferentiated cells are seen, in small numbers, in all forms of ependymoma but they are the dominant cell type in the ependymoblastomas.
Craniolacunia in Newborn with Myelomeningocele
Authors: Tajima Masataka , Yamada Hiroshi , Kageyama Naoki
Published: February 2008

Plain skull films were taken within 7 days of birth in 34 newborn with myelomeningocele. There appears to be a correlation between hydrocephalus or Arnold-Chiari malformation and the severity of craniolacunia. Craniolacunia was observed in 28 cases (82%). The incidence of craniolacunia in myelomeningocele in this series is higher than in previous reports. One of the reasons is that plain skull films of newborn with myelomeningocele are usually not taken early at birth. We would like to emphasize that plain skull films be taken early at birth in newborn with myelomeningocele and that the presence of craniolacunia be considered as being associated with hydrocephalus and the Arnold-Chiari malformation.
Congenital Meningioma
Authors: Bueno J. Gómez , Esteban H. Márquez , López C. Botana , Puentes M.L. Fernandez
Published: February 2008

The clinical, operative and autopsy findings associated with a huge meningioma in an 8-month-old boy are described. Especially noteworthy are the patient’s age, the size of the tumour and the poorness of neurological symptoms.
Congenital Brain Defect Masked by Subdural Fluid Collection
Authors: Osaka Kunihiko , Shirataki Kunio , Matsumoto Satoshi , Yokoyama Sumiyoshi , Ogino Hitoshi
Published: February 2008

Two rare cases of subdural fluid collection are reported. In these cases, the subdural space was in direct communication with the lateral ventricle through the congenital brain defects. The subdural fluid was formed by the cerebrospinal fluid which passed from the lateral ventricle through the brain defects. The difficulty to diagnose these cases from the usual subdural hygroma is emphasized.
Complications of Ventriculo-Peritoneal Shunting and a Critical Comparison of the Three-Piece and One-Piece Systems
Authors: Raimondi Anthony J. , Robinson J. Sam , Kuwamura Keiichi
Published: February 2008

This is a report of our experience with ventriculo-peritoneal shunting, the treatment of congenital and secondary hydrocephalus. It includes a detailed listing of all complications and an analysis of the number of complications per patient and per procedure in patients in whom either a three-piece or a one-piece shunt system had been inserted. A total of 161 patients were in the one-piece series and 196 patients in the three-piece series, with the follow-up being a minimum of 6 months. There were 598 procedures in 196 patients in the three-piece series and 302 procedures in 161 patients in the one-piece series, so that the average number of operations per child in the three-piece series was 3.1 and only 1.9 in the one-piece series. There were 106 instances of ventriculitis in the three-piece series and only 22 in the one-piece series, and 47 non-ventriculitis related complications in the three-piece series, but only 17 in the one-piece series. Data are presented descriptively with listing of specific complications and as computer analysis statistical printouts for categories (disconnections, infections, obstructions) comparing the three-piece and one-piece systems.
The Recreational Drug Ecstasy Disrupts the Hypothalamic-Pituitary-Gonadal Reproductive Axis in Adult Male Rats
Authors: Dickerson Sarah M. , Walker Deena M. , Reveron Maria E. , Duvauchelle Christine L. , Gore Andrea C.
Published: February 2008

Reproductive function involves an interaction of three regulatory levels: hypothalamus, pituitary, and gonad. The primary drive upon this system comes from hypothalamic gonadotropin-releasing hormone (GnRH) neurosecretory cells, which receive afferent inputs from other neurotransmitter systems in the central nervous system to result in the proper coordination of reproduction and the environment. Here, we hypothesized that the recreational drug (±)-3,4-methylenedioxymethamphetamine (MDMA; ‘ecstasy’), which acts through several of the neurotransmitter systems that affect GnRH neurons, suppresses the hypothalamic-pituitary-gonadal reproductive axis of male rats. Adult male Sprague-Dawley rats self-administered saline or MDMA either once (acute) or for 20 days (chronic) and were euthanized 7 days following the last administration. We quantified hypothalamic GnRH mRNA, serum luteinizing hormone concentrations, and serum testosterone levels as indices of hypothalamic, pituitary, and gonadal functions, respectively. The results indicate that the hypothalamic and gonadal levels of the hypothalamic-pituitary-gonadal axis are significantly altered by MDMA, with GnRH mRNA and serum testosterone levels suppressed in rats administered MDMA compared to saline. Furthermore, our finding that hypothalamic GnRH mRNA levels are suppressed in the context of low testosterone concentrations suggests that the central GnRH neurosecretory system may be a primary target of inhibitory regulation by MDMA usage.
Adiponectin Protects Against Angiotensin II–Induced Cardiac Fibrosis Through Activation of PPAR-α
Authors: Fujita Koichi , Maeda Norikazu , Sonoda Mina , Ohashi Koji , Hibuse Toshiyuki , Nishizawa Hitoshi , Nishida Makoto , Hiuge Aki , Kurata Akifumi , Kihara Shinji , Shimomura Iichiro , Funahashi Tohru
Published: February 2008

Objectives—

Adiponectin is recognized as an antidiabetic, antiatherosclerotic, and anti-inflammatory protein derived from adipocytes. However, the role of adiponectin in cardiac fibrosis remains uncertain. We herein explore the effects of adiponectin on cardiac fibrosis induced by angiotensin II (Ang II).

Methods and Results—

Wild-type (WT), adiponectin knockout (Adipo-KO), and PPAR-α knockout (PPAR-α-KO) mice were infused with Ang II at 1.2 mg/kg/d. Severe cardiac fibrosis and left ventricular dysfunction were observed in Ang II–infused Adipo-KO mice compared to WT mice. Adenovirus-mediated adiponectin treatment improved the above phenotypes and the dysregulation of reactive oxygen species (ROS)-related mRNAs in Adipo-KO mice, whereas such amelioration was not observed in PPAR-α-KO mice despite adiponectin accumulation in heart tissue. In cultured cardiac fibroblasts, adiponectin improved the reduction of AMP-activated protein kinase (AMPK) activity and elevation of extracellular signal–regulated kinase 1/2 (ERK1/2) activity induced by Ang II. Adiponectin significantly enhanced PPAR-α activity, whereas the adiponectin-dependent PPAR-α activation was diminished by Compound C, an inhibitor of AMPK.

Conclusion—

The present study suggests that adiponectin protects against Ang II–induced cardiac fibrosis possibly through AMPK-dependent PPAR-α activation.
Associations of Dyslipidemias From Childhood to Adulthood With Carotid Intima-Media Thickness, Elasticity, and Brachial Flow-Mediated Dilatation in Adulthood
Authors: Juonala Markus , Viikari Jorma S.A. , Rönnemaa Tapani , Marniemi Jukka , Jula Antti , Loo Britt-Marie , Raitakari Olli T.
Published: February 2008

Background—

Dyslipidemias are the major cause for atherosclerosis. They may act synergistically with nonlipid risk factors to increase atherogenesis. In the present study, we examined the effects of dyslipidemias from childhood to adulthood and their interaction with nonlipid risk factors on markers of subclinical atherosclerosis.

Methods and Results—

Study subjects were participants of the longitudinal Cardiovascular Risk in Young Finns Study started in 1980 (n=2265, age 3 to 18 years). To phenotype type IIa, IIb, and IV dyslipidemias and hypoHDL-cholesterolemia, we calculated age and sex-specific
z
scores for lipid values for each subject in 1980, 1983, 1986, and 2001. Subjects with mean
z
score over 90th percentile for LDL-cholesterol or triglycerides were considered having type IIa or IV dyslipidemia. Subjects with mean
z
score over 90th percentile for LDL-cholesterol and triglycerides had type IIb dyslipidemia, and those with mean
z
score below 10th percentile for HDL-cholesterol had hypoHDL-cholesterolemia. Compared to controls, subjects with type IIb dyslipidemia had increased carotid IMT (
P
<0.01). This difference remained significant when adjusted with other risk factors (
P
<0.05). Carotid IMT also increased significantly more with increasing number of nonlipid risk factors (
P
<0.001) or presence of the metabolic syndrome (
P
<0.05) in subjects with type IIb than in controls. Subjects with type IIb or type IV dyslipidemia had decreased carotid elasticity (
P
<0.05), but these differences became nonsignificant (
P
>0.3) when adjusted with blood pressure.

Conclusions—

Our findings suggest that type IIb dyslipidemia has deleterious effects on vasculature already since childhood. Subjects with type IIb dyslipidemia are more vulnerable to the effects of cardiovascular risk factors and metabolic syndrome.
Bone Morphogenetic Protein-9 Is a Circulating Vascular Quiescence Factor
Authors: David Laurent , Mallet Christine , Keramidas Michelle , Lamandé Noël , Gasc Jean-Marie , Dupuis-Girod Sophie , Plauchu Henri , Feige Jean-Jacques , Bailly Sabine
Published: February 2008

Angiogenesis is a complex process, requiring a finely tuned balance between numerous stimulatory and inhibitory signals. ALK1 (activin receptor like-kinase 1) is an endothelial-specific type 1 receptor of the transforming growth factor-β receptor family. Heterozygotes with mutations in the ALK1 gene develop hereditary hemorrhagic telangiectasia type 2 (HHT2). Recently, we reported that bone morphogenetic protein (BMP)9 and BMP10 are specific ligands for ALK1 that potently inhibit microvascular endothelial cell migration and growth. These data lead us to suggest that these factors may play a role in the control of vascular quiescence. To test this hypothesis, we checked their presence in human serum. We found that human serum induced Smad1/5 phosphorylation. To identify the active factor, we tested neutralizing antibodies against BMP members and found that only the anti-BMP9 inhibited serum-induced Smad1/5 phosphorylation. The concentration of circulating BMP9 was found to vary between 2 and 12 ng/mL in sera and plasma from healthy humans, a value well above its EC
50
(50 pg/mL). These data indicated that BMP9 is circulating at a biologically active concentration. We then tested the effects of BMP9 in 2 in vivo angiogenic assays. We found that BMP9 strongly inhibited sprouting angiogenesis in the mouse sponge angiogenesis assay and that BMP9 could inhibit blood circulation in the chicken chorioallantoic membrane assay. Taken together, our results demonstrate that BMP9, circulating under a biologically active form, is a potent antiangiogenic factor that is likely to play a physiological role in the control of adult blood vessel quiescence.
Endothelial Arginase II
Authors: Ryoo Sungwoo , Gupta Gaurav , Benjo Alexandre , Lim Hyun Kyo , Camara Andre , Sikka Gautam , Lim Hyun Kyung , Sohi Jayson , Santhanam Lakshmi , Soucy Kevin , Tuday Eric , Baraban Ezra , Ilies Monica , Gerstenblith Gary , Nyhan Daniel , Shoukas Artin , Christianson David W. , Alp Nicholas J. , Champion Hunter C. , Huso David , Berkowitz Dan E.
Published: February 2008

Oxidized low-density lipoproteins increase arginase activity and reciprocally decrease endothelial NO in human aortic endothelial cells. Here, we demonstrate that vascular endothelial arginase activity is increased in atherogenic-prone apolipoprotein E–null (ApoE
−/−
) and wild-type mice fed a high cholesterol diet. In ApoE
−/−
mice, selective arginase II inhibition or deletion of the arginase II gene (Arg II
−/−
mice) prevents high-cholesterol diet–dependent decreases in vascular NO production, decreases endothelial reactive oxygen species production, restores endothelial function, and prevents oxidized low-density lipoprotein–dependent increases in vascular stiffness. Furthermore, arginase inhibition significantly decreases plaque burden. These data indicate that arginase II plays a critical role in the pathophysiology of cholesterol-mediated endothelial dysfunction and represents a novel target for therapy in atherosclerosis.
Computer Three-Dimensional Reconstruction of the Atrioventricular Node
Authors: Li Jue , Greener Ian D. , Inada Shin , Nikolski Vladimir P. , Yamamoto Mitsuru , Hancox Jules C. , Zhang Henggui , Billeter Rudi , Efimov Igor R. , Dobrzynski Halina , Boyett Mark R.
Published: February 2008

Because of its complexity, the atrioventricular node (AVN), remains 1 of the least understood regions of the heart. The aim of the study was to construct a detailed anatomic model of the AVN and relate it to AVN function. The electric activity of a rabbit AVN preparation was imaged using voltage-dependent dye. The preparation was then fixed and sectioned. Sixty-five sections at 60- to 340-μm intervals were stained for histology and immunolabeled for neurofilament (marker of nodal tissue) and connexin43 (gap junction protein). This revealed multiple structures within and around the AVN, including transitional tissue, inferior nodal extension, penetrating bundle, His bundle, atrial and ventricular muscle, central fibrous body, tendon of Todaro, and valves. A 3D anatomically detailed mathematical model (≈13 million element array) of the AVN and surrounding atrium and ventricle, incorporating all cell types, was constructed. Comparison of the model with electric activity recorded in experiments suggests that the inferior nodal extension forms the slow pathway, whereas the transitional tissue forms the fast pathway into the AVN. In addition, it suggests the pacemaker activity of the atrioventricular junction originates in the inferior nodal extension. Computer simulation of the propagation of the action potential through the anatomic model shows how, because of the complex structure of the AVN, reentry (slow–fast and fast–slow) can occur. In summary, a mathematical model of the anatomy of the AVN has been generated that allows AVN conduction to be explored.
Genomewide Linkage in a Large Dutch Family With Intracranial Aneurysms
Authors: Ruigrok Ynte M. , Wijmenga Cisca , Rinkel Gabriel J.E. , Slot Ruben van’t , Baas Frank , Wolfs Marcel , Westerveld Andries , Roos Yvo B.W.E.M.
Published: February 2008

Background and Purpose—

Approximately 2% of the general population harbor intracranial aneurysms. The prognosis after rupture of an intracranial aneurysm is poor; 50% of the patients die as a result of the rupture. Familial occurrence of intracranial aneurysms suggests there are genetic factors involved in the development of such aneurysms.

Methods—

A large, consanguineous pedigree with 7 of 20 siblings affected by intracranial aneurysms was compiled and a genomewide linkage analysis on this family was performed using Illumina’s single nucleotide polymorphism-based linkage panel IV, which includes 5861 single nucleotide polymorphisms. A nonparametric linkage affecteds-only approach with GENEHUNTER was used.

Results—

Two loci with suggestive linkage (nonparametric linkage=3.18) on chromosome regions 1p36 and Xp22 were identified. Additional microsatellite markers were genotyped in the 2 candidate loci and showed suggestive linkage to the locus on chromosome 1 with a nonparametric linkage of 3.18 at 1p36.11-p36.13 and significant linkage to the locus on chromosome X with a nonparametric linkage of 4.54 at Xp22.2-p22.32.

Conclusions—

The 2 potential loci for intracranial aneurysms, which we identified in this large Dutch family, overlap with loci that have already been identified in previous linkage studies from different populations. Identification of genes from these loci will be important for a better understanding of the disease pathogenesis.
Mechanical Thromboembolectomy for Acute Ischemic Stroke
Authors: Brekenfeld Caspar , Schroth Gerhard , El-Koussy Marwan , Nedeltchev Krassen , Reinert Michael , Slotboom Johannes , Gralla Jan
Published: February 2008

Background and Purpose—

The purpose of the study was to compare efficacy and potential complications of 2 commercially available devices for mechanical thromboembolectomy.

Methods—

Devices were tested in an established animal model allowing the use of routine angiography catheters and thrombectomy devices. Radio-opaque thrombi were used for visualization of thrombus–device interaction during angiography. The Merci Retrieval System and the Catch Thromboembolectomy System were assessed each in 10 vessel occlusions. For every occluded vessel up to 5 retrieval attempts were performed.

Results—

Sufficient recanalization was achieved with the Merci Retriever in 90% of occlusions, and with the Catch device recanalization was achieved in 70% of occlusions. Recanalization at the first attempt occurred significantly more often with the Merci Retriever compared to the Catch device (OR, 21; 95% CI, 1.78–248.11). Consequently, significantly more attempts (
P
=0.02) had to be performed with the Catch device; therefore, time to recanalization was longer. Thrombus fragmentations during retrieval were caused more often by the Catch device compared to the Merci Retriever (OR, 15.6; 95% CI, 1.73–140.84), resulting in a higher distal embolization rate. During retrieval both devices lost thrombotic material at the tip of the guide catheter, which was then aspirated in most cases.

Conclusions—

Both distal devices are effective for thromboembolectomy. To avoid loss of thrombotic material and distal embolization, the use of large luminal balloon guide catheters and aspiration during retrieval seems to be mandatory. The design of the Merci Retriever appears to be more efficient during thrombus mobilization and retrieval with less fragmentation compared to the Catch Thromboembolectomy System.