bluuebunny/crossref_metadata_2025 huggingface dataset:
Microsurgically produced bifurcation aneurysms in a rabbit model for endovascular coil embolization
Authors: Spetzger Uwe , Reul Jürgen , Weis Joachim , Bertalanffy Helmut , Thron Armin , Gilsbach Joachim M.
Published: June 2009

✓ The authors present a detailed account of the microsurgical production of bifurcation aneurysms in chinchilla rabbits for basic studies of endovascular coil embolization of aneurysms. End-to-side anastomoses of both common carotid arteries (CCAs) were performed, and a venous pouch was fitted into the newly created bifurcation. These experimental aneurysms closely mimic human cerebral aneurysms in size and hemodynamic features. Sixty-three animals underwent operation. Fifteen animals died in the course of the experiment and 15 were excluded because of a CCA occlusion within the carotid bifurcation. Electrical detachable platinum coils, also known as Guglielmi detachable coils (GDCs), and tungsten mechanical detachable coils (MDCs) were used for the endovascular occlusion of 26 bifurcation aneurysms (16 rabbits were treated with GDCs and 10 with MDCs). Initially, complete angiographic obliteration (95%–100% occlusion of the aneurysm) was achieved in nine rabbits and incomplete obliteration (< 95% occlusion) was seen in 17 animals. Final angiography 3 to 6 months later demonstrated complete occlusion in only four and partial occlusion in 22 aneurysms. At present, the histopathological examination of 17 embolized aneurysms has revealed incomplete obliteration of all aneurysms, even in those three cases that were thought to be completely embolized according to angiographic criteria. A general overestimation of the radiological degree of aneurysm obliteration was found.
Rotational obstruction of nondominant vertebral artery and ischemia
Authors: Morimoto Tetsuya , Kaido Takanobu , Uchiyama Yoshitomo , Tokunaga Hidemori , Sakaki Toshisuke , Iwasaki Satoru
Published: June 2009

✓ A 70-year-old man presented with repeated vertebrobasilar insufficiency for 3 years. Four-vessel angiography revealed complete occlusion of the nondominant left vertebral artery on head turning to the right. Three-dimensional computerized tomography angiography demonstrated atlantoaxial joint dislocation when the head was turned to the right, in accordance with simultaneous occlusion of the left vertebral artery caused by stretching of the artery at C1–2. After posterior fixation of C1–2 by a Halifax interlaminar fixation system, the patient had no further episodes. Hemodynamic function associated with nondominant vertebral artery occlusion contributed to the symptoms in this case.
A surgical technique to avoid postoperative enophthalmos in the cranioorbital approach
Authors: Taguchi Yoshio , Tanaka Katsuyuki , Matsuzawa Motoshi , Sekino Hiroaki
Published: June 2009

✓ The authors describe a surgical technique to avoid postoperative enophthalmos when using the cranioorbital approach. To perform osteotomies with a less demanding technique, two separate bone flaps were created: 1) a free frontotemporal bone flap and 2) en bloc removal of the superior and lateral orbital rims. Because the latter bone flap includes both the orbital roof and the posterolateral wall of the orbit with the greater wing of the sphenoid bone, unnecessary bone defects in the lateral orbital wall are avoided. The technique has been performed in seven patients treated for medially located skull base neoplasms or complex anterior circulation aneurysms without postoperative enophthalmos or other cosmetic problems. The authors believe this cranioorbital approach, with its simpler, less invasive surgical technique, offers a definite advantage by avoiding postoperative enophthalmos.
A series of 60 juxtafacet cysts: clinical presentation, the role of spinal instability, and treatment
Authors: Sabo Robert A. , Tracy Patrick T. , Weinger Jesse M.
Published: June 2009

✓ Spinal instability may be a cause of juxtafacet cyst formation and the pain and disability that occur after surgical excision of the cyst. To determine the role of instability, a retrospective review of charts identified 60 facet cysts in 56 patients treated over a 6-year period. Three patients developed an asynchronous cyst at the same level but on the opposite side of the previously resected cyst and one patient had a recurrent cyst in the same location. Forty-one cysts were present in patients with radiculopathy and 16 in patients with neurogenic claudication. Two patients presented with myelopathy and one had cauda equina syndrome. Thirty-six of the 60 cysts were located at L4–5, the most mobile segment. Fifteen patients had spondylolisthesis, of whom two experienced worsening spondylolisthesis postoperatively. Seven patients had scoliosis and 20 had systemic arthritis. Fifty-five cysts were resected via mesial facetectomy. Six of the patients undergoing this procedure had transverse process fusions at initial surgery for preoperative instability. Two others required fusion for postoperative instability and increased spondylolisthesis. Follow-up review was available in 95% of patients with an average duration of 12 months. Forty patients had excellent relief of symptoms, 12 had occasional back pain, and one patient did poorly. Flexion/extension views of the spine are recommended both pre- and postoperatively to identify the need for fusion in patients with juxtafacet cysts.
Microdecompression without fusion for radiculopathy associated with lytic spondylolisthesis
Authors: Weiner Bradley K. , McCulloch John A.
Published: June 2009

✓ Patients with symptomatic L-5 nerve root compression and associated lytic spondylolisthesis are commonly treated by bilateral wide posterior decompression and concomitant fusion, often accompanied by transpedicular instrumentation. More limited surgery aimed solely at the relief of nerve root compression offers the potential for significant relief of radicular pain while avoiding iatrogenic instability, thereby alleviating the need for arthrodesis with its increased surgical morbidity.

Nine patients with unilateral radicular symptoms referable to the L-5 nerve root, minimal back pain, and a lytic pars lesion with mild spondylolisthesis underwent unilateral microdecompression on their symptomatic side without associated fusion. All patients obtained relief of radicular pain at both short- and long-term follow-up examination. One patient demonstrated increased back pain and, accordingly, the procedure is now recommended only for patients with no greater than a 25% spondylolisthesis.

Unilateral microdecompression without stabilization is an effective and safe method for relieving radicular pain in patients with a lytic pars defect, a mild spondylolisthesis, and minimal back pain. This therapeutic option should be considered in select cases as an alternative to bilateral wide decompression with fusion and instrumentation.
Disseminated ependymomas of the central nervous system
Authors: Rezai Ali R. , Woo Henry H. , Lee Mark , Cohen Henry , Zagzag David , Epstein Fred J.
Published: June 2009

✓ Ependymomas are rare central nervous system (CNS) neoplasms that occasionally disseminate along the neuraxis or to extraneural sites. Definitive criteria predictive of dissemination have yet to be determined. One hundred forty patients with CNS ependymoma (88 primary spinal and 52 primary intracranial tumors) were surgically treated by the senior author (F.J.E.) between 1986 and 1994. Sixteen patients (11.4%) demonstrated tumor dissemination. The disseminated group consisted of 11 (12.5%) of 88 primary spinal and five (9.6%) of 52 primary intracranial ependymomas. The authors retrospectively reviewed the patients with CNS ependymoma and have identified several characteristics associated with dissemination from the primary tumor site. The mean time from diagnosis to dissemination was 6.8 years. The patients with disseminated disease were younger (16.8 vs. 28.3 years old, p = 0.02), had fewer gross-total resections (29% vs. 68%, p = 0.015), and had tumors with higher proliferative indices (MIB-1 staining, 13.14% vs. 2.06%, p = 0.02). High-grade tumors had a mean proliferation index of 21%, versus 2.4% and 1.6% for myxopapillary and low-grade tumors, respectively (p = 0.0003). In contrast to previous studies, tumor histology was the most significant variable for time to dissemination as determined by multivariate analysis (p = 0.008). Myxopapillary and high-grade tumors were 3.6 and 5.6 times more likely to have a shorter time to dissemination than low-grade tumors. In addition, dissemination is associated with a worse prognosis. At follow-up review, 31% of patients with disseminated disease had died compared to 7% of patients without dissemination (p = 0.04). It is concluded that younger patients with subtotal resections, myxopapillary or high-grade histology, and tumors with high proliferative indices are at substantial risk for the development of disseminated disease during their clinical course.
Lack of prognostic relevance of alterations in the epidermal growth factor receptor—transforming growth factor-α pathway in human astrocytic gliomas
Authors: Waha Andreas , Baumann Axel , Wolf Helmut K. , Fimmers Rolf , Neumann Jürgen , Kindermann Dietmar , Astrahantseff Kathy , Blümcke Ingmar , von Deimling Andreas , Schlegel Uwe
Published: June 2009

✓ Alterations in the epidermal growth factor receptor (EGFR) and its main ligand, transforming growth factor-α (TGFα), were investigated for a possible prognostic relevance in 125 astrocytic gliomas (44 World Health Organization (WHO) Grade II, 19 WHO Grade III, and 62 WHO Grade IV tumors). The TGFα and EGFR proteins were detected immunohistochemically using monoclonal antibodies. A positive immunoreaction to TGFa was detected in 33 (75%) of 44 WHO Grade II astrocytomas, 18 (95%) of 19 WHO Grade III astrocytoma, and 50 (81%) of 62 WHO Grade IV glioblastomas. No correlation between TGFα immunoreaction and duration of survival could be found. A positive EGFR immunoreaction was detected in seven (16%) of 44 WHO Grade II astrocytomas, five (26%) of 19 WHO Grade III astrocytomas, and 32 (52%) of 62 WHO Grade IV glioblastomas. Of these gliomas, 97 (26 WHO Grade II, 17 WHO Grade III, and 54 WHO Grade IV gliomas) were examined for EGFR gene amplification using a differential polymerase chain reaction assay. Amplification of the EGFR gene was detected in none of the WHO Grade II astrocytomas, one (6%) of 17 WHO Grade III astrocytomas, and 18 (33%) of 54 WHO Grade IV glioblastomas. Twenty-two of the tumors investigated showed a positive EGFR immunoreaction without detectable gene amplification (five WHO Grade II, four WHO Grade III, and 13 WHO Grade IV tumors). Gene amplification was invariably associated with a positive EGFR immunoreaction. For the entire study group, a strong correlation between EGFR alterations (gene amplification and positive immunoreaction) and survival could be found. However, this correlation only reflected the higher percentages of cases with EGFR alterations in malignant gliomas and was not an independent prognostic factor as determined by multifactorial analysis. These data demonstrate that EGFR alterations are frequent events in astrocytic gliomas and are largely restricted to glioblastomas. However, within one tumor grade they do not provide prognostic information.
Treatment of leptomeningeal metastases in a rat model using a recombinant adenovirus containing the HSV-tk gene
Authors: Vincent Arnaud J. P. E. , Esandi Maria del C. , Someren Gerry van , Noteboom Juus L. , Avezaat Cees J. J. , Vecht Charles , Sillevis Smitt Peter A. E. , van Bekkum Dirk W. , Valerio Dinko , Hoogerbrugge Peter M. , Bout Abraham
Published: June 2009

✓ The authors constructed recombinant adenoviral vectors to investigate their potential for gene therapy treatment of leptomeningeal metastases. Several human cell lines that were derived from tumors occurring as leptomeningeal metastases and that were infected in vitro with major late promoter recombinant adenovirus containing the luciferase (luc) gene (IG.Ad.MLP.luc.) showed high levels of expression. When these human tumor cell lines were infected in vitro with recombinant adenovirus harboring the herpes simplex virus—thymidine kinase (HSV-tk) gene (IG.Ad.MLP.TK), they were highly sensitive to the killing effects of ganciclovir (GCV). Transduction efficiency of leptomeningeal tumor cells in vivo was assessed by injecting 9-L rat brain tumor cells into the cerebrospinal fluid of Fischer rats via the cisterna magna. After 3 days, recombinant adenovirus containing the lacZ reporter gene (IG.Ad.MLP.lacZ) was injected via the same route. Six days after tumor cell injection, expression of the reporter gene was observed in tumor cells along the total neural axis. Subsequently, rats with leptomeningeal metastases were treated 3 days after tumor cell injection with HSV-tk. Beginning on the next day, GCV was injected intraperitoneally for 10 days. The rats that developed neurological symptoms were killed immediately. The symptom-free latency of every rat was determined. The rats treated with HSV-tk and subsequent GCV had significantly longer (p < 0.01) symptom-free latency than all control groups. This study demonstrates the feasibility and efficacy of this therapeutic approach in a rat model. Clinically, it should be used in the palliative treatment of patients with leptomeningeal metastases.
Maturation of intracranial immature teratomas
Authors: Shaffrey Mark E. , Lanzino Giuseppe , Lopes M. Beatriz S. , Hessler Richard B. , Kassell Neal F. , Vandenberg Scott R.
Published: June 2009

✓ Immature teratomas arising within the central neuraxis are rare neoplasms. These tumors contain diverse cell lineages that retain an embryonal character and display phenotypic differentiation attributed to the three classic germ layers. The clinical management of these lesions is unclear, due in part to their low incidence and to an incomplete understanding of their natural history. Although the potential for phenotypic differentiation and cellular maturation within immature teratomas arising in the gonads is well documented, this has not been described in the intracranial tumors. In the present report, the authors describe two cases of intracranial immature teratomas, one involving the pineal region and the other involving the left frontotemporal lobes, which underwent cellular differentiation and maturation. At initial resection, the tumors from both cases were composed predominantly of primitive neuroepithelial tissue that was admixed with immature and differentiating mesenchymal and epithelial structures. No foci of germinoma, endodermal sinus, choriocarcinoma, or embryonal carcinoma tissue were present. Subsequent resections in both cases revealed an absence of immature tissue. The tumor in Case 1 contained only differentiated epithelial and mesenchymal tissue with no neuroepithelial component, whereas the tumor in Case 2 demonstrated abundant mature neuronal and glial tissue. These two cases from different intracranial sites suggest that spontaneous maturation may be a significant aspect of the natural history of intracranial immature teratomas.
Isolated extranodal sinus histiocytosis presenting as an intramedullary spinal cord tumor with paraplegia
Authors: Osenbach Richard K.
Published: June 2009

✓ Sinus histiocytosis with massive lymphadenopathy (Rosai—Dorfman disease) is a nonneoplastic lymphoproliferative disorder that usually presents with massive painless cervical lymphadenopathy accompanied by fever and weight loss. Extranodal involvement occurs in over 40% of patients; however, isolated extranodal disease without lymph node involvement is unusual. Extranodal involvement of the nervous system is unusual and isolated central nervous system disease in the absence of nodal disease is distinctly rare. The author describes the case of a 35-year-old man who presented with paraplegia and an enhancing intramedullary lesion on magnetic resonance imaging that was suggestive of a primary spinal cord tumor. The lesion was completely resected and histologically proved to be consistent with an isolated extranodal case of Rosai—Dorfman disease. Although a number of cases of this entity involving the CNS have been published, the author believes this case represents the first report of intramedullary spinal cord involvement as the initial and only sign of disease.
Tethered hindbrain
Authors: Kernan Jennifer C. , Horgan Michael A. , Piatt Joseph H.
Published: June 2009

✓ The authors present the case of an 11-year-old boy with symptomatic tethering of the hindbrain related to a Chiari Type III malformation repaired at birth. Surgical release of the cord resulted in functional improvement.
Cerebellar hemorrhage complicating temporal lobectomy
Authors: Toczek Maria T. , Morrell Martha J. , Silverberg Gerald A. , Lowe Gina M.
Published: June 2009

✓ Four cases of cerebellar hemorrhage complicating temporal lobectomy are presented. A case of postoperative hemorrhage located remote from the operative site as a complication of intracranial surgery is rare, especially when it involves the cerebellum after supratentorial craniotomy. In a review of the literature, the authors identified only 12 such cases, none of which was described in the setting of a temporal lobectomy. The possible etiologies for cerebellar hemorrhage in the four cases presented are examined, including the role of epidural suction drains and the position of the head during surgery. The mechanism of cerebellar hemorrhage in this series of patients is probably multifactorial. Special attention throughout the perioperative course must be given to hemodynamic, anatomical, and physiological factors that together can affect the patient negatively.
History of spinal cord stereotaxy
Authors: Gabriel Eric M. , Nashold Blaine S.
Published: June 2009

✓ Stereotactic and functional neurosurgery has experienced a remarkable degree of development during the last 50 years, from the plaster of Paris frame of Spiegel and Wycis to the technology of frameless stereotaxis. Although predominantly used for intracranial procedures, stereotaxy has its roots in experimental studies of the spinal cord. The field of spinal cord stereotaxy has not received the same amount of attention as supratentorial surgery, but there have been significant contributions to the field that have helped to further our understanding of spinal cord anatomy and physiology. Now that frameless stereotaxis has reached clinical practice, there may be further developments in the field of spinal surgery: this technique may prove useful for spinal fusion operations and, possibly, intramedullary operations as well.
The worth of a neurosurgeon
Authors: Tolchin Sidney
Published: June 2009

✓ The author speaks to the necessity of volunteerism in organized neurosurgery and congratulates some of the individuals who have graciously given of their time and energy. In addition, the author calls on all neurosurgeons to assess their self-worth and to continue to wear the mantles of nurturing and caring while providing the highest quality of medical care, even in the age of increasing encroachment of health management corporations.
Is “unilateral” moyamoya disease different from moyamoya disease?
Authors: Houkin Kiyohiro , Abe Hiroshi , Yoshimoto Tetsuyuki , Takahashi Akihiro
Published: June 2009

✓ Whether a diagnosis of moyamoya disease is justified in patients with typical angiographic evidence of moyamoya disease unilaterally and normal angiographic findings contralaterally remains controversial. In this study the authors analyzed longitudinal angiographic change, familial occurrence, and basic fibroblast growth factor (bFGF) concentration in the cerebrospinal fluid (CSF) of patients with “unilateral” moyamoya disease. Over a 10-year period, 10 cases of unilateral moyamoya disease were followed using conventional angiography or magnetic resonance angiography. Basic FGF in CSF, obtained from the subarachnoid space of the cerebral cortex during revascularization surgery, was measured in five cases. Among the 10 cases of unilateral moyamoya disease, only one pediatric case showed obvious signs of progression to typical bilateral disease. The other nine cases (including six adults and three children) remained stable throughout follow-up radiological examinations (magnetic resonance angiography) with a mean observation period of 3.5 years. There was no familial occurrence in these cases of unilateral moyamoya disease. Levels of bFGF, which are high in typical moyamoya disease, were low in these patients. The progression from unilateral moyamoya disease to the typical bilateral form of the disease appears to be infrequent. The low levels of bFGF in the CSF of these patients and the lack of familial occurrence strongly suggest that most cases of unilateral moyamoya disease, especially those found in adults, are distinct from typical bilateral moyamoya disease.
Ruptured fusiform aneurysm of the superior third of the basilar artery associated with the absence of the midbasilar artery
Authors: Ricolfi Frederic , Decq Philippe , Brugieres Pierre , Blustajn Jerry , Melon Eliane , Gaston Andre
Published: June 2009

✓ A case involving the absence of the midthird portion of the basilar artery (BA) associated with a ruptured fusiform aneurysm of the superior third of the basilar artery discovered after a subarachnoid hemorrhage is reported. Surgical clipping was precluded by the anatomical conditions. The aneurysm was treated by occlusion (surgical clipping and balloon occlusion) of both posterior communicating arteries to decrease the hemodynamic stress on the aneurysm wall. The pericerebellar arterial network was allowed to supply the distal BA and its collateral vessels indirectly. This treatment proved to be efficient; angiography and magnetic resonance imaging demonstrated shrinkage of the aneurysm cavity. The absence of the midthird of the BA is usually associated with a persisting trigeminal artery (nonexistent in this case) or disclosed in cases of acute BA occlusion in dramatic clinical conditions. A similar anatomical feature has been described only once before. There may be a segmental maldevelopment of the longitudinal neural arteries during embryogenesis or a defect in fusion of these paired structures during the development of the BA itself.
Coil placement after clipping: endovascular treatment of incompletely clipped cerebral aneurysms
Authors: Forsting Michael , Albert Friedrich K. , Jansen Olav , Kummer Rüdiger von , Aschoff Alfred , Kunze Stefan , Sartor Klaus
Published: June 2009

✓ In up to 4% of patients whose aneurysms are microsurgically clipped, there is an expected or unexpected aneurysm residuum. The authors describe two patients in whom surgical clipping did not result in complete obliteration of the aneurysm sac and in whom a second operation was not believed to be the solution to the problem. In both patients complete occlusion of the aneurysm residuum was achieved via an endovascular approach. Using the Guglielmi detachable coil system, it was possible to place two platinum coils selectively into the aneurysms. The endovascular approach may be a good treatment option for all patients in whom surgical clipping does not result in complete obliteration of the aneurysm sac and reoperation is contraindicated or unacceptable to the patient.
Electrosurgery
Authors: Malis Leonard I.
Published: June 2009

✓ In this paper the author reviews the development of electrosurgery in neurosurgical procedures. Particular stress is placed on bipolar coagulation and the more recent addition of bipolar cutting. Basic electric principles are discussed as well as the electrophysiological basis of coagulating and cutting currents. Neurosurgical techniques and instrumentation criteria are presented. The material is planned to provide the neurosurgeon with greater understanding of the function of the equipment and, perhaps, to improve usage.
Characteristics and somatotopic organization of kinesthetic cells in the globus pallidus of patients with Parkinson's disease
Authors: Taha Jamal M. , Favre Jacques , Baumann Thomas K. , Burchiel Kim J.
Published: June 2009

✓ Information is limited on the characteristics and topographic localization of pallidal kinesthetic cells in patients with Parkinson's disease. The authors analyzed the data from 298 neurons recorded in 38 patients with Parkinson's disease who underwent pallidotomy via microrecording techniques. Sixty-five neurons (22%) responded to passive movement of contralateral limbs. Of 17 kinesthetic cells that were tested in six patients, seven (41%) responded to ipsilateral limb movement as well. Nineteen cells (6%) fired synchronously with tremor. More kinesthetic cells were activated (63%) than inhibited (28%) by movement of single (68%) rather than multiple (32%) joints, and proximal (75%) rather than distal (25%) joints. The lateral globus pallidus externus (GPe) and medial globus pallidus internus (GPi) pallidal segments contained similar proportions of kinesthetic cells, activated or inhibited cells, arm- or leg-activated cells, and cells responding to single or multiple joints. Significantly more kinesthetic cells that responded to distal joints were recorded in GPi compared to GPe segments (p = 0.01). Arm and leg cells had similar characteristics pertaining to activation versus inhibition and responses to single, multiple, proximal, or distal joint movements. Arm and leg cells were somatotopically organized in GPi. Arm cells were clustered at the rostral and caudal segments of GPi and leg cells were clustered centrally. In GPe, leg cells were clustered at the caudal border. No somatotopic organization was identified for activated or inhibited cells; cells that responded to single, multiple, proximal, or distal joints; tremor-synchronous cells; or cells responding to specific joints within somatotopic arm or leg cells. It is concluded that kinesthetic cells provide a roadmap that localizes limb cells during pallidotomy. More studies are needed to identify the clinical significance of the different characteristics of kinesthetic cells.
Intramedullary spinal cord tumors in children under the age of 3 years
Authors: Constantini Shlomo , Houten John , Miller Douglas C. , Freed Diana , Ozek Memet M. , Rorke Lucy B. , Allen Jeffrey C. , Epstein Fred J.
Published: June 2009

✓ Over a 13-year period extending from 1980 to 1993, 27 children less than 3 years of age underwent operation for removal of an intramedullary spinal cord tumor (IMSCT). The majority (18 of 27) of children had undergone surgery before being referred to New York University (NYU) Medical Center. The most common reasons for radiological investigation were pain (42%), motor regression (36%), gait abnormalities (27%), torticollis (27%), and progressive kyphoscoliosis (24%).

Forty procedures were performed in 27 children. Nine children underwent two operations and two children underwent three procedures. A gross-total resection was achieved in 72% of the procedures. There was no surgical mortality. A comparison of the preoperative and 3-month postoperative functional grades for the first NYU procedure (NYU-1) yielded the following findings: 20 patients' conditions remained the same, five patients improved, and two patients deteriorated. The functional outcomes of a second operation (NYU-2) were similar.

The majority of the children (24 of 27, 89%) had histologically determined low-grade lesions. There were 12 patients with low-grade astrocytomas (Grades I-III), eight with gangliogliomas, two with ganglioglioneurocytomas, one with a glioneurofibroma, and one child with a mixed astro/oligodendroglioma. Two children had anaplastic astrocytomas (Grades II–III) and one child had a glioblastoma multiforme.

In a median follow-up review of 76 months, two patients died and two patients were lost to follow up. The 3- and 5-year progression-free survival (PFS) rates were 81.7% (standard error of the mean (SEM) 0.083) and 76.2% (SEM 0.094), respectively. Eight of 24 patients suffered a recurrence within a mean time of 45.4 ± 28.9 months. All were treated with surgery (NYU-2). Lesions recurred in three of 12 children with low-grade astrocytomas, two of eight children with gangliogliomas, one child with an anaplastic astrocytoma, one child with a ganglioglioneurocytoma, and one child with a glioblastoma multiforme. At follow-up review, most of these children were doing well. Sixteen are in functional Grades I or II and 18 children attend a normal school system.

The authors conclude that surgery for the removal of IMSCTs in children less than 3 years of age can be performed radically and safely. The postoperative functional performance is determined by the degree of the preoperative deficit. It is, therefore, of utmost importance to diagnose and treat these children as early as possible. Spinal cord tumors should be recognized as potentially excisable lesions on their initial presentation and when they recur. The optimum treatment for malignant lesions is still to be determined.
Apoptosis of human glioma cells in vitro and in vivo induced by a neutralizing antibody against human basic fibroblast growth factor
Authors: Murai Nozomu , Ueba Tetsuya , Takahashi Jun A. , Yang Hong-Qiong , Kikuchi Haruhiko , Hiai Hiroshi , Hatanaka Masakazu , Fukumoto Manabu
Published: June 2009

✓ Basic fibroblast growth factor (bFGF) is mitogenic to neuroectoderm- and mesoderm-derived cells and is a potent angiogenic factor. Abundant amounts of this factor and its receptor are detected in human glioma tissues and cells, and bFGF in glioma is thought to be involved in autonomous cell growth as an autocrine growth factor. A neutralizing mouse monoclonal antibody (MAb) against bFGF, 3H3 MAb, has been shown to inhibit bothin vitroandin vivogrowth of human glioma cell lines. This study shows that the human glioma cell lines U-87MG and U-251MG, which express high levels of bFGF and its receptor, can be induced to undergo apoptosis when cultured with 3H3 MAb. It is also demonstrated that 3H3 MAb can cause apoptosis in the same glioma cells that were transplanted into nude mice. Furthermore, enforced overexpression of bcl-2 protein by gene transfection prevented 3H3 MAb-induced apoptosis of glioma cells. It is concluded that induction of apoptosis by the neutralizing antibody is a promising therapeutic strategy for glioma.
Reduction of brain injury using heparin to inhibit leukocyte accumulation in a rat model of transient focal cerebral ischemia. I. Protective mechanism
Authors: Yanaka Kiyoyuki , Spellman Stephen R. , McCarthy James B. , Oegema Theodore R. , Low Walter C. , Camarata Paul J.
Published: June 2009

✓ Heparin has long been established as an anticoagulant. Although heparin has been demonstrated to reduce brain injury after ischemia and reperfusion, its mechanism of action remains unknown. Recent investigations reveal that it can modulate biological processes such as binding to adhesion receptors on endothelial cells and leukocytes. The authors hypothesized that heparin's protective effect is closely related to its antileukocyte adherence property. They evaluated the efficacy of sulfated polysaccharides (unfractionated heparin, low-molecular-weight heparin, heparan sulfate, chondroitin sulfate C, and dextran sulfate) on leukocyte accumulation, infarction size, and neurological outcome after transient focal cerebral ischemia in rats subjected to 1 hour of ischemia and 48 hours of reperfusion. Forty-nine animals were included in the study. The animals receiving unfractionated heparin or dextran sulfate showed a significant reduction in leukocyte accumulation, infarct size, and neurological dysfunction 48 hours after reperfusion (p < 0.05) when compared to untreated animals. The animals receiving unfractionated heparin also showed significantly better results than the animals receiving an equivalent anticoagulant dose of low-molecular-weight heparin. These data indicate that heparin's antileukocyte property plays a more important role than its anticoagulant ability in neuronal protection. The relative potency of the sulfated polysaccharides tested in leukocyte depletion was closely related to their degree of sulfation. Thus, in addition to demonstrating the potential efficacy of heparin as a therapeutic agent for ischemia and reperfusion injury by the prevention of leukocyte accumulation, the results also serve as a basis for studying important cellular and molecular events that contribute to tissue damage.
Secondary amenorrhea due to hydrocephalus treated with endoscopic ventriculocisternostomy
Authors: Lowry David W. , Lowry Donna L. B. , Berga Sarah L. , Adelson P. David , Roberts Michelle M.
Published: June 2009

✓ The authors present a case of secondary amenorrhea in a 32-year-old woman found to have noncommunicating hydrocephalus due to aqueductal stenosis. Although the presentation of hydrocephalus with amenorrhea has been previously reported, this association remains rare. After treatment via endoscopic third ventriculocisternostomy, the patient resumed normal menstruation and all hormonal abnormalities have resolved except hypothyroidism. A review of the literature on the etiology of endocrinological disturbances in patients with hydrocephalus is presented.
Symptoms of pituitary apoplexy rapidly reversed with bromocriptine
Authors: Brisman Michael H. , Katz Gillian , Post Kalmon D.
Published: June 2009

✓ Macroprolactinomas rarely present with apoplexy. The authors describe a patient with a macroprolactinoma who presented with apoplexy and rapid progression of a third nerve palsy. The patient was managed expectantly with bromocriptine, and within 48 hours, the patient's third nerve palsy had completely resolved. The authors suggest that all patients who present with pituitary apoplexy in the presence of a pituitary tumor receive an immediate course of bromocriptine and steroid therapy until the prolactin level can be determined. Emergency surgery is indicated if visual function is abnormal and the tumor is not a prolactinoma.
Primary Langerhans' cell histiocytosis of the central nervous system with fatal outcome
Authors: Vital Anne , Loiseau Hugues , Kantor Guy , Vital Claude , Cohadon François
Published: June 2009

✓ An unusual case of primary parenchymal Langerhans' cell histiocytosis of the central nervous system is reported. The definitive diagnosis was obtained by ultrastructural detection of Birbeck granules and by immunohistochemical evidence of CD1a expression. Despite complete surgical resection, there was an early recurrence with multiple central nervous system metastases leading to a fatal outcome.
Primary intrinsic brainstem oligodendroglioma in an adult
Authors: Alvarez Jaime A. , Cohen Mark L. , Hlavin Mary Louise
Published: June 2009

✓ Primary intrinsic oligodendrogliomas of the brainstem are exceedingly unusual. The authors report the case of an intraaxial brainstem oligodendroglioma in an adult. In an extensive review of oligodendrogliomas, only six (0.4%) of 1593 cases recorded could be identified as intrinsic brainstem tumors. Five of these cases were found in children. This report documents a 25-year-old woman with a pontomedullary oligodendroglioma. An analysis of the world literature on this tumor type finds that posterior fossa oligodendrogliomas present at an earlier age and appear to be more aggressive biologically than their supratentorial counterparts. The overall prognosis for patients harboring an intrinsic brainstem oligodendroglioma remains unclear, with significant variability between patients.
Occipital neuralgia secondary to exuberant callus formation
Authors: Clavel Manuel , Clavel Pablo
Published: June 2009

✓ The authors report the case of a 78-year-old woman suffering from right occipital neuralgia in whom computerized tomography and magnetic resonance images demonstrated an irregular bone mass in the C-2 vertebral body. This “bone tumor” happened to be an exuberant callus formation that arose as a result of a previous axis body fracture. The patient's occipital pain was immediately relieved after she underwent C2–3 root release.
Transillumination in minimally invasive surgery for carpal tunnel release
Authors: Franzini Angelo , Broggi Giovanni , Servello Domenico , Dones Ivano , Pluchino Maria Grazia
Published: June 2009

✓ An alternative technique for performing minimally invasive release of carpal tunnel syndrome is described. The suggested methodology is based on transillumination of the carpal tunnel during surgery. The advantages of the technique are discussed and compared with other available surgical procedures including endoscopy. The authors also describe preliminary operative results in 50 consecutive patients.
Failure Assessment of Layered Composites Subject to Impact Loadings: a Finite Element, Sigma-Point Kalman Filter Approach
Authors: Mariani Stefano
Published: June 2009

We present a coupled finite element, Kalman filter approach to foresee impactinduced delamination of layered composites when mechanical properties are partially unknown. Since direct numerical simulations, which require all the constitutive parameters to be assigned, cannot be run in such cases, an inverse problem is formulated to allow for modeling as well as constitutive uncertainties. Upon space discretization through finite elements and time integration through the explicit ®¡method, the resulting nonlinear stochastic state model, wherein nonlinearities are due to delamination growth, is attacked with sigma-point Kalman filtering. Comparison with experimental data available in the literature and concerning inter-laminar failure of layered composites subject to low-velocity impacts, shows that the proposed procedure leads to: an accurate description of the failure mode; converged estimates of inter-laminar strength and toughness in good agreement with experimental data.
Towards a Better Understanding of Diversity
Authors: Wink Michael
Published: June 2009

When we look at Planet Earth, its material and organisms, a prominent feature is the diversity of these components and the mechanisms underlying their functions. Biodiversity, which includes the diversity of the living organisms, their genes and the biomes, is a fascinating product of millions of years of evolution. Biodiversity is not static but in continuous change. In addition to the intrinsic natural causes, the biodiversity on Earth is increasingly challenged by human interference. Among the critical factors are the destruction of habitats (by agriculture or technical development, especially loss of rain forests and coral reefs), climate change, direct persecution and extermination of species (for traditional pharmaceutical use, game hunting or in fishery), as well as the introduction of invasive species and environmental pollution (some of them apparently influencing our climate) [1]. Global changes (land-use and climate) and human population growth (with a world population of more than 6.7 billion in 2009 and an annual increase of almost 80 million) are ultimately responsible for affecting biodiversity worldwide. The exact impact of human interference on the Earth’s diversity may not be realised until it is too late to save critical species. [...]
Diversity – An International and Interdisciplinary Journal
Authors: Lin Shu-Kun
Published: June 2009

After many years of careful planning, we are pleased to launch Diversity (ISSN 1424-2818), a new international and interdisciplinary Open Access journal. Among diversity topics, biodiversity has always been a key topic. In 1996, when I was establishing Molecular Diversity Preservation International (MDPI), an organization dedicated to the collection and distribution of rare molecular samples, I read several books on biodiversity. To promote the MDPI project, in 1996 the journal Molecules was launched, where authors are encouraged to deposit authentic samples of chemicals reported in the published articles. One of the topics covered by the journal Molecules was molecular diversity, and my own paper on diversity assessment published in volume 1 of Molecules cited some of the biodiversity books I had read [1] and Molecules still has a section called “Molecular Diversity” [2]. Our founding Editor-in-Chief, Prof. Dr. Michael Wink [3], also cites biological diversity as one of his main research interests. [...]
Theoretical Characterization of Three 2,2-Diphenyl-1,3,2-oxazaborolidin-5-ones: Molecules with Fungicide Activities
Authors: Vilchis Martha , Velasco Benjamin , Penieres Guillermo , Cruz Tonatiuh , Miranda René , Nicolás Inés
Published: June 2009

In this study, a theoretical characterization for three 2,2-diphenyl-1,3,2-oxazaborolidin-5-ones was performed using Density Functional Theory. The analyzed molecules have antifungal activity, making them of particular interest.
Biotransformation of Ginsenoside Rf to Rh1 by Recombinant β-Glucosidase
Authors: Ruan Chang-Chun , Zhang Hao , Zhang Lian-Xue , Liu Zhi , Sun Guang-Zhi , Lei Jun , Qin Yu-Xia , Zheng Yi-Nan , Li Xiang , Pan Hong-Yu
Published: June 2009

An Aspergillus niger strain was isolated from the soil around ginseng fruit. In vitro enzyme assays showed that this strain had the ability to transform total ginsenosides (TGS) into several new products. In a further biochemical study, a β-glucosidase gene isolated from this strain, bgl1, was expressed in Saccharomyces cerevisiae. His-tagged BGL1 protein (~170 kD) showed the ability to transform ginsenoside Rf into Rh1.
A High Isolation Series-Shunt RF MEMS Switch
Authors: Yu Yuan-Wei , Zhu Jian , Jia Shi-Xing , Shi Yi
Published: June 2009

This paper presents a wide band compact high isolation microelectromechanical systems (MEMS) switch implemented on a coplanar waveguide (CPW) with three ohmic switch cells, which is based on the series-shunt switch design. The ohmic switch shows a low intrinsic loss of 0.1 dB and an isolation of 24.8 dB at 6 GHz. The measured average pull-in voltage is 28 V and switching time is 47 µs. In order to shorten design period of the high isolation switch, a structure-based small-signal model for the 3-port ohmic MEMS switch is developed and parameters are extracted from the measured results. Then a high isolation switch has been developed where each 3-port ohmic MEMS switch is closely located. The agreement of the measured and modeled radio frequency (RF) performance demonstrates the validity of the electrical equivalent model. Measurements of the series-shunt switch indicate an outstanding isolation of more than 40 dB and a low insertion loss of 0.35 dB from DC to 12 GHz with total chip size of 1 mm × 1.2 mm.
Input and Output Compensation for the Cochlear Traveling Wave Delay in Wide-Band ABR Recordings: Implications for Small Acoustic Tumor Detection
Authors: Don Manuel , Elberling Claus , Maloff Erin
Published: June 2009

Background: The Stacked ABR (auditory brainstem response) attempts at the output of the auditory periphery to compensate for the temporal dispersion of neural activation caused by the cochlear traveling wave in response to click stimulation. Compensation can also be made at the
input by using a chirp stimulus. It has been demonstrated that the Stacked ABR is sensitive to small tumors that are often missed by standard ABR latency measures. Purpose: Because a chirp stimulus requires only a single data acquisition run whereas the Stacked ABR requires six, we
try to evaluate some indirect evidence justifying the use of a chirp for small tumor detection. Research Design: We compared the sensitivity and specificity of different Stacked ABRs formed by aligning the derived-band ABRs according to (1) the individual's peak latencies, (2) the group
mean latencies, and (3) the modeled latencies used to develop a chirp. Results: For tumor detection with a chosen sensitivity of 95%, a relatively high specificity of 85% may be achieved with a chirp. Conclusion: It appears worthwhile to explore the actual use of a chirp because
significantly shorter test and analysis times might be possible.
Effects of Expansion on Consonant Recognition and Consonant Audibility
Authors: Brennan Marc , Souza Pamela
Published: June 2009

Background: Hearing aid expansion is intended to reduce the gain for low-level noise. However, expansion can also degrade low-intensity speech. Although it has been suggested that the poorer performance with expansion is due to reduced audibility, this has not been measured directly.
Furthermore, previous studies used relatively high expansion kneepoints. Purpose: This study compared the effect of a 30 dB SPL and 50 dB SPL expansion kneepoint on consonant audibility and recognition. Research Design: Eight consonant-vowel syllables were presented at 50, 60,
and 71 dB SPL. Recordings near the tympanic membrane were made of each speech token and used to calculate the Aided Audibility Index (AAI). Study Sample: Thirteen subjects with mild to moderate sensorineural hearing loss. Results: Expansion with a high kneepoint resulted in reduced
consonant recognition. The AAI correlated significantly with consonant recognition across all conditions and subjects. Conclusion: If consonant recognition is the priority, audibility calculations could be used to determine an optimal expansion kneepoint for a given individual.
Long-Term Signal-to-Noise Ratio at the Input and Output of Amplitude-Compression Systems
Authors: Naylor Graham , Johannesson René Burmand
Published: June 2009

We present measurements showing that the long-term signal-to-noise ratio (SNR) at the output of an amplification system that includes amplitude compression may be higher or lower than the long-term SNR at the input, dependent on interactions among the actual long-term input SNR, the
modulation characteristics of the signal and noise being mixed, and the amplitude compression characteristics of the system under test.The effects demonstrated with the measurements shown here have implications for choices of test methods when comparing alternative hearing aid systems. The
results of speech-recognition tests intended to compare alternative systems may be misleading or misinterpreted if the above interactions are not considered.
Comparisons of P300s from Standard Oddball and Omitted Paradigms: Implications to Exogenous/Endogenous Contributions
Authors: McCullag Jennifer , Weihing Jeffrey , Musiek Frank
Published: June 2009

Purpose: To compare the amplitude, latency, morphology, and threshold of the auditory P300 using standard oddball and omitted paradigms. Research Design: P300 waveforms were measured from the Cz electrode site. Frequent stimuli for both paradigms were 1000 Hz tone
bursts. Target stimuli for the standard oddball paradigm were 2000 Hz tone bursts and an omitted stimulus, or silent gap, for the omitted paradigm. Study Sample: Fifteen bilaterally normal-hearing young adults. Results: There were significantly lower amplitudes, poorer
morphology, and higher thresholds for the P300 using an omitted paradigm compared to the standard oddball paradigm. Conclusion: These results suggest that the auditory P300 could have a larger exogenous component than traditionally thought.
Temporal Integration of the Contralateral Acoustic Reflex Threshold for a 1000 Hz Tonal Activator and Its Age-Related Changes
Authors: Emmer Michele B. , Silman Shlomo , Silverman Carol A. , Levitt Harry
Published: June 2009

Background: Previous research has noted an age effect on the temporal integration of the acoustic reflex for a noise activator. Purpose: To determine whether the age effect earlier noted for a noise activator will be noted for a tonal activator. Research Design:
Comparison of ARTs of younger and older groups at activating stimulus durations of 12, 25, 50, 100, 200, 300, 500, and 1000 msec. Study Sample: Two groups of adults with normal-hearing sensitivity: one group of 20 young adults (ten males and ten females, ages 18‐29 years, with
a mean age of 24 years) and one group of 20 older adults (ten males and ten females, ages 59‐75 years, with a mean age of 67.5 years). Results: A significant main effect for duration was obtained. That is, as the duration increased, the acoustic reflex threshold for the 1000
Hz tonal activator decreased. The interactions of duration × age group and duration × hearing level were not significant. There was a nonsignificant main effect (p  =  .889) for the between-subjects factor of age. Conclusion: Results contradict the findings for
broadband noise.