bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of dynamic computed tomography angiography in the preoperative evaluation of skull base tumors
Authors: Bi Wenya Linda , Brown Patrick A. , Abolfotoh Mohammad , Al-Mefty Ossama , Mukundan Srinivasan , Dunn Ian F. 
Published: April 2015

OBJECT
The anatomical complexity of skull base tumors mandates detailed preoperative planning for safe resection. In particular, the location of critical vascular and bony structures can influence the surgical approach. Traditional methods, such as MRI, MR angiography and/or venography (MRA/MRV), CT angiography and/or venography (CTA/CTV), and digital subtraction angiography, each have their limitations. One alternative that combines the benefits of both detailed anatomy compatible with intraoperative image guidance and visualization of the vascular flow is the 320–detector row dynamic volume CTA/CTV. The authors investigated this technique’s impact on the surgical approach used in a series of complex intracranial tumors.

METHODS
All patients with complex intracranial tumors who had undergone preoperative dynamic CTA/CTV as well as MRI in the period from July 2010 to June 2012 were retrospectively reviewed. Those in whom only routine CTA/CTV sequences had been obtained were excluded. Clinical records, including imaging studies, operative reports, and hospital course, were reviewed. Ease in detecting specific major arterial and venous tributaries using dynamic CTA/CTV was graded for each case. Furthermore, 2 skull base neurosurgeons projected a desired surgical approach for each tumor based on MRI studies, independent of the CTA/CTV sequences. The projected approach was then compared with the ultimately chosen surgical approach to determine whether preoperative awareness of vasculature patterns altered the actual operative approach.

RESULTS
Sixty-four patients were eligible for analysis. Dynamic CTA/CTV successfully demonstrated circle of Willis arteries, major draining sinuses, and deep internal venous drainage in all cases examined. The superior petrosal sinus, vein of Labbé, tentorial veins, and middle fossa veins were also identified in a majority of cases, which played an important role in preoperative planning. Visualization of critical vascular—especially venous—anatomy influenced the surgical approach in 39% (25 of 64) of the cases.

CONCLUSIONS
Dynamic CTA/CTV has been applied to few neurosurgical disease pathologies to date. This noninvasive technology offers insight into vascular flow patterns as well as 3D anatomical relationships and provides thin-cut sequences for intraoperative navigation. The authors propose dynamic CTA as an addition to the preoperative planning for complex skull base tumors.
Preparedness of neurosurgery graduates for neuroendovascular fellowship: a national survey of fellowship programs
Authors: Chalouhi Nohra , Zanaty Mario , Tjoumakaris Stavropoula , Manasseh Philip , Hasan David , Bulsara Ketan R. , Starke Robert M. , Lawson Kevin , Rosenwasser Robert , Jabbour Pascal 
Published: April 2015

OBJECT
Endovascular interventions have become an essential part of a neurosurgeon’s practice. Whether endovascular procedures have been effectively integrated into residency curricula, however, remains uncertain. The purpose of this study was to assess the preparedness of US neurosurgery graduate trainees for neuroendovascular fellowship.

METHODS
A multidomain, global assessment survey was sent to all directors/faculty of neuroendovascular fellowship programs involved in training of US neurosurgery graduates. Surveyees were asked to assess trainees as they entered fellowship.

RESULTS
The response rate was 78% (25/32). Of respondent program directors, 38% reported that new fellows did not know the history and imaging of the patient and 50% were unable to formulate an appropriate treatment plan. As many as 79% of fellows were unfamiliar with endovascular devices and 75% were unfamiliar with angiographic equipment. Furthermore, 58% of fellows were unable to perform femoral access, 54% were unable to perform femoral closure, 79% were unable to catheterize a major vessel, 86% were unable to perform a 4-vessel angiogram, and 100% were unable to catheterize an aneurysm. Additionally, program directors reported that over 50% of fellows could not recognize neurovascular anatomy and 54% could not recognize/classify vascular abnormalities. There was an overall agreement that fellows demonstrated professionalism and interest in research and had good communication/clinical skills.

CONCLUSIONS
The results of this study suggest potential gaps in the training of neurosurgery residents with regard to endovascular neurosurgery. In an era of minimally invasive therapies, changes in residency curricula may be needed to keep pace with the ever-changing field of neurosurgery.
The predictive value of magnetic resonance imaging in evaluating intracranial arteriovenous malformation obliteration after stereotactic radiosurgery
Authors: Lee Cheng-Chia , Reardon Michael A. , Ball Benjamin Z. , Chen Ching-Jen , Yen Chun-Po , Xu Zhiyuan , Wintermark Max , Sheehan Jason 
Published: April 2015

OBJECT
The current gold standard for diagnosing arteriovenous malformation (AVM) and assessing its obliteration after stereotactic radiosurgery (SRS) is digital subtraction angiography (DSA). Recently, MRI and MR angiography (MRA) have become increasingly popular imaging modalities for the follow-up of patients with an AVM because of their convenient setup and noninvasiveness. In this study, the authors assessed the sensitivity and specificity of MRI/MRA in evaluating AVM nidus obliteration as assessed by DSA.

METHODS
The authors study a consecutive series of 136 patients who underwent SRS between January 2000 and December 2012 and who underwent regular clinical examinations, several MRI studies, and at least 1 post-SRS DSA follow- up evaluation at the University of Virginia. The average follow-up time was 47.3 months (range 10.1–165.2 months). Two blinded observers were enrolled to interpret the results of MRI/MRA compared with those of DSA. The sensitivity, specificity, positive predictive value, and negative predictive value for the obliteration of AVM were reported.

RESULTS
On the basis of DSA, 73 patients (53.7%) achieved final angiographic obliteration in a median of 28.8 months. The sensitivity (the probability of finding obliteration on MRI/MRA among those for whom complete obliteration was shown on DSA) was 84.9% for one observer (Observer 1) and 76.7% for the other (Observer 2). The specificity was 88.9% and 95.2%, respectively. The false-negative interpretations were significantly related to the presence of draining veins, perinidal edema on T2-weighted images, and the interval between the MRI/MRA and DSA studies.

CONCLUSIONS
MRI/MRA predicted AVM obliteration after SRS in most patients and can be used in their follow-up. However, because the specificity of MRI/MRA is not perfect, DSA should still be performed to confirm AVM nidus obliteration after SRS.
Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas
Authors: Gondim Jackson A. , Almeida João Paulo , de Albuquerque Lucas Alverne F. , Gomes Erika , Schops Michele , Mota Jose Italo 
Published: April 2015

OBJECT
With the increase in the average life expectancy, medical care of elderly patients with symptomatic pituitary adenoma (PA) will continue to grow. Little information exists in the literature about the surgical treatment of these patients. The aim of this study was to present the results of a single pituitary center in the surgical treatment of PAs in patients > 70 years of age.

METHODS
In this retrospective study, 55 consecutive elderly patients (age ≥ 70 years) with nonfunctioning PAs underwent endoscopic transsphenoidal surgery at the General Hospital of Fortaleza, Brazil, between May 2000 and December 2012. The clinical and radiological results in this group were compared with 2 groups of younger patients: < 60 years (n = 289) and 60–69 years old (n = 30).

RESULTS
Fifty-five patients ≥ 70 years of age (average age 72.5 years, range 70–84 years) underwent endoscopic surgery for treatment of PAs. The mean follow-up period was 50 months (range 12–144 months). The most common symptoms were visual impairment in 38 (69%) patients, headache in 16 (29%) patients, and complete ophthalmoplegia in 6 (10.9%). Elderly patients presented a higher incidence of ophthalmoplegia (p = 0.032) and a lower frequency of pituitary apoplexy before surgery (p < 0.05). Tumors with cavernous sinus invasion were treated surgically less frequently than in younger patients. Although patients with an American Society of Anesthesiologists score of 3 were more common in the elderly group (p < 0.05), no significant difference regarding surgical time, extent of resection, and hospitalization were observed. Elderly patients presented with more complications than patients < 60 years (32.7% vs 10%, p < 0.05). Complications observed in the elderly group included 5 CSF leaks (9%), 2 permanent diabetes insipidus cases (3.6%), 4 postoperative refractory hypertension cases (7.2%), 1 myocardial ischemia (1.8%), and 1 death (1.8%). Postoperative new anterior pituitary deficit was more common in the younger group (< 60 years old: 17.7%) than in the elderly (≥ 70 years old: 12.7%); however, there was no statistical difference.

CONCLUSIONS
Endoscopic transsphenoidal surgery for elderly patients with PAs may be associated with higher complication rates, especially secondary to early transitory complications, when compared with surgery performed in younger patients. Although the worst preoperative clinical status might be observed in this group, age alone is not associated with a worst final prognosis after endoscopic removal of nonfunctioning PAs.
Unplanned reoperation after lumbopelvic fixation with S-2 alar-iliac screws or iliac bolts
Authors: Mazur Marcus D. , Ravindra Vijay M. , Schmidt Meic H. , Brodke Darrel S. , Lawrence Brandon D. , Riva-Cambrin Jay , Dailey Andrew T. 
Published: April 2015

OBJECT
S-2 alar-iliac (S2AI) screws are an attractive alternative to conventional fixation with iliac bolts because they are lower profile, require less muscle dissection, and have greater pullout strength. Few studies, however, compare outcomes between these techniques.

METHODS
The authors conducted a retrospective cohort study of consecutive adult patients at a single institution from December 2009 to March 2012 who underwent lumbopelvic fixation using S2AI screws or iliac bolts. Medical records were reviewed for patients with clinical failure, defined as an unplanned reoperation because of instrumentation failure and/or wound-related complications. Univariate, multivariate, and survival analyses were used to compare patients who required reoperation with those who did not. Method of pelvic fixation was the main predictor variable of interest, and the authors adjusted for potential confounding risk factors.

RESULTS
Of the 60 patients included, 23 received S2AI screws. Seventeen patients (28%) underwent an osteotomy. The mean follow-up was 22 months. A Kaplan-Meier survival model was used to evaluate the time to reoperation from the initial placement of lumbopelvic instrumentation. The failure-free rate was 96.6% at 6 months, 87.0% at 1 year, and 73.5% at 2 years. Reoperation was more common in patients with iliac bolts than in those with S2AI screws (13 vs 2; p = 0.031). Univariate analysis identified potential risk factors for unplanned reoperation, including use of iliac bolts (p = 0.031), absence of L5–S1 interbody graft (p = 0.048), previous lumbar fusion (p = 0.034), and pathology other than degenerative disease or scoliosis (p = 0.034). After adjusting for other risk factors, multivariate analysis revealed that the use of S2AI screws (OR 8.1 [1.5–73.5]; p = 0.030) was the only independent predictor for preventing unplanned reoperation.

CONCLUSIONS
Both S2AI screws and iliac bolts were effective at improving fusion rates at the lumbosacral junction. The use of S2AI screws, however, was independently associated with fewer unplanned reoperations for wound-related complications and instrumentation failures than the use of iliac bolts.
Syrinx location and size according to etiology: identification of Chiari-associated syrinx
Authors: Strahle Jennifer , Muraszko Karin M. , Garton Hugh J. L. , Smith Brandon W. , Starr Jordan , Kapurch Joseph R. , Maher Cormac O. 
Published: April 2015

OBJECT
Syrinx size and location within the spinal cord may differ based on etiology or associated conditions of the brain and spine. These differences have not been clearly defined.

METHODS
All patients with a syrinx were identified from 14,118 patients undergoing brain or cervical spine imaging at a single institution over an 11-year interval. Syrinx width, length, and location in the spinal cord were recorded. Patients were grouped according to associated brain and spine conditions including Chiari malformation Type I (CM-I), secondary CM (2°CM), Chiari malformation Type 0 (CM-0), tethered cord, other closed dysraphism, and spinal tumors. Syringes not associated with any known brain or spinal cord condition were considered idiopathic. Syrinx characteristics were compared between groups.

RESULTS
A total of 271 patients with a syrinx were identified. The most common associated condition was CM-I (occurring in 117 patients [43.2%]), followed by spinal dysraphism (20 [7.4%]), tumor (15 [5.5%]), and tethered cord (13 [4.8%]). Eighty-three patients (30.6%) did not have any associated condition of the brain or spinal cord and their syringes were considered idiopathic. Syringes in patients with CM-I were wide (7.8 ± 3.9 mm) compared with idiopathic syringes (3.9 ± 1.0, p < 0.0001) and those associated with tethered cord (4.2 ± 0.9, p < 0.01). When considering CM-I–associated and idiopathic syringes, the authors found that CM-I–associated syringes were more likely to have their cranial extent in the cervical spine (88%), compared with idiopathic syringes (43%; p < 0.0001). The combination of syrinx width greater than 5 mm and cranial extent in the cervical spine had 99% specificity (95% CI 0.92–0.99) for CM-I–associated syrinx.

CONCLUSIONS
Syrinx morphology differs according to syrinx etiology. The combination of width greater than 5 mm and cranial extent in the cervical spine is highly specific for CM-I–associated syringes. This may have relevance when determining the clinical significance of syringes in patients with low cerebellar tonsil position.
Encephaloduroarteriosynangiosis and encephalomyoarteriosynangiosis for treatment of moyamoya syndrome in pediatric patients with sickle cell disease
Authors: Griessenauer Christoph J. , Lebensburger Jeffrey D. , Chua Michelle H. , Fisher Winfield S. , Hilliard Lee , Bemrich-Stolz Christina J. , Howard Thomas H. , Johnston James M. 
Published: April 2015

OBJECT
Pediatric patients with sickle cell disease (SCD) and moyamoya syndrome (MMS) are at significant risk for cerebrovascular accidents despite chronic transfusion therapy. Encephaloduroarteriosynangiosis (EDAS) and encephalomyoarteriosynangiosis (EMAS) are additional therapeutic options for these patients. To date, the incidence of complications after and efficacy of EDAS and EMAS in stroke prevention in this population have been described in several institutional case series reports, but no randomized prospective trials have been reported.

METHODS
The authors retrospectively reviewed the cases of all pediatric patients at the University of Alabama at Birmingham with a history of homozygous hemoglobin S (HbS) and sickle cell/β-thalassemia (SB0 thalassemia) and on chronic transfusion therapy, including 14 patients with MMS who underwent EDAS or EMAS.

RESULTS
Sixty-two patients with SCD and on chronic transfusion therapy were identified. After exclusion of patients on chronic transfusion therapy for indications other than stroke prevention, 48 patients (77.4%) remained. Of those patients, 14 (29.1%) underwent EDAS or EMAS. Nine (18.8%) and 25 (52.1%) patients were on chronic transfusion therapy for primary or secondary stroke prevention, respectively, but did not undergo EDAS or EMAS. The 14 patients with SCD and radiological evidence of MMS and on chronic transfusion therapy for primary or secondary stroke prevention underwent 21 EDAS or EMAS procedures for progressive vascular disease (92.9% of patients), stroke (71.4%), and/or seizure (7.1%). The mean (± SD) time from initiation of chronic transfusion therapy to EDAS or EMAS was 76.8 ± 58.8 months. Complications included 1 perioperative stroke, 1 symptomatic subdural hygroma, 1 postoperative seizure, and 1 case of intraoperative cerebral edema that required subsequent cranioplasty. Before EDAS or EMAS, the stroke rate was calculated to be 1 stroke per 7.8 patient-years. One additional stroke occurred during the follow-up period (mean follow-up time 33.7 ± 19.6 months), resulting in a post-EDAS/EMAS stroke rate of 1 stroke per 39.3 patient-years, a 5-fold reduction compared with that in the pre-EDAS/EMAS period. The patients’ mean pre-EDAS/EMAS HbS level of 29.5% ± 6.4% was comparable to the mean post-EDAS/EMAS HbS level of 25.5% ± 6.1% (p = 0.104).

CONCLUSIONS
The results of this retrospective case series in a large cohort of pediatric patients with SCD and MMS suggest that EDAS/EMAS provides a stroke-prevention benefit with an acceptably low morbidity rate. Given the combined experience with EDAS and EMAS for this indication at this and other institutions, a prospective clinical trial to assess their efficacy compared with that of chronic transfusion therapy alone is warranted.
Development and characterization of EST‐SSR markers in Bombax ceiba (Malvaceae)
Authors: Ju Miao‐Miao , Ma Huan‐Cheng , Xin Pei‐Yao , Zhou Zhi‐Li , Tian Bin 
Published: April 2015

Premise of the study:Bombax ceiba (Malvaceae), commonly known as silk cotton tree, is a multipurpose tree species of tropical forests. Novel expressed sequence tag–simple sequence repeat (EST‐SSR) markers were developed and characterized for the species using transcriptome analysis.Methods and Results:A total of 33 new EST‐SSR markers were developed for B. ceiba, of which 13 showed polymorphisms across the 24 individuals from four distant populations tested in the study. The results showed that the number of alleles per polymorphic locus ranged from two to four, and the expected heterozygosity and observed heterozygosity per locus varied from 0.043 to 0.654 and from 0 to 0.609, respectively.Conclusions:These newly developed EST‐SSR markers can be used in phylogeographic and population genetic studies to investigate the origin of B. ceiba populations. Furthermore, these EST‐SSR markers could also greatly promote the development of molecular breeding studies pertaining to silk cotton tree.
Improved Repeatability of Retinal Thickness Measurements Using Line-Scan Ophthalmoscope Image-Based Retinal Tracking
Authors: Hu Jennifer , Gottlieb Cornelia B. , Barajas Daniel J. , Barnett Cullen J. , Schoenholz Tamera , Sadda SriniVas R. 
Published: April 2015

BACKGROUND AND OBJECTIVE:
To assess repeatability and speed of a line-scan ophthalmoscope (LSO) image-based tracking system and compare to the point-scanning approach.

PATIENTS AND METHODS:
Thirty-five eyes with retinal diseases underwent volume scans using two spectral-domain optical coherence tomography (OCT) devices: a line-scan tracking Cirrus HD-OCT (Carl Zeiss Meditec; Dublin, CA) and point-scan tracking Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany). Eyes were also imaged on the Cirrus HD-OCT with tracking disabled.

RESULTS:
Mean difference in central subfield thickness (CST) between consecutive scans was 2.6 µm for the Cirrus without tracking, 1.7 µm with tracking, and 3.6 µm for the Spectralis. The repeatability standard deviation was 3.0 µm for the Cirrus without tracking, 1.5 µm with tracking, and 4.0 µm for the Spectralis. Coefficient of variation for the CST was 1.1% for the Cirrus without tracking, 0.5% with tracking, and 1.4% for the Spectralis. Mean scan acquisition time was 12.3 ± 6.2 seconds for the Spectralis, 7.8 ± 6.7 for the Cirrus with tracking, and 4.3 ± 0.6 for the Cirrus without tracking.

CONCLUSION:
Real-time LSO image-based retinal tracking appears to improve repeatability of OCT retinal thickness measurements.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:310–314.]
Gene Expression Profiling and Regression Rate of Irradiated Uveal Melanomas
Authors: Rao Rajesh C. , Khan Mehnaz , Badiyan Shahed N. , Harbour J. William 
Published: April 2015

BACKGROUND AND OBJECTIVE:
Uveal melanoma is the most common primary intraocular cancer; however, the molecular features that predict response to therapy are poorly understood. Our objective was to determine whether gene expression profiling (GEP) is associated with rate of tumor regression after I-125 plaque brachytherapy for uveal melanoma.

PATIENTS AND METHODS:

Retrospective review of 138 patients with posterior uveal melanoma treated with I-125 plaque brachytherapy in which GEP class and 3-month post-radiation ultrasonographic tumor thickness data were available. Statistical analysis was performed using
t
test and Fisher’s exact test.

RESULTS:

GEP class assignment was class 1 in 83 (60.1%) and class 2 in 55 (39.9%) patients. Mean patient age was 60.9 years for class 1 and 68.1 years for class 2 tumors (
P
= .002). Mean initial tumor diameter was 13.0 mm for class 1 and 14.1 mm for class 2 tumors (
P
= .02). Mean initial tumor thickness was 5.2 mm for class 1 and 6.1 mm for class 2 tumors (
P
= .047). Three months after I-125 plaque radiotherapy, mean reduction in tumor thickness was 26.5% for class 1 and 16.7% for class 2 tumors (
P
= .03).

CONCLUSION:
Class 1 uveal melanoma tumors exhibit more rapid early tumor regression than class 2 tumors after I-125 plaque radiotherapy.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:333–337.]
Invasive Fungal Laryngitis in an Immunocompetent Person
Authors: Khaund Gautam , Agarwal Vivek , Barman Surajit , Baruah Debika 
Published: April 2015

ABSTRACT
Fungal laryngitis is common in immunocompromised patients. But it is rarely seen in a immunocompetent person. Only around 40 cases have been reported in world literature so far. This condition is often confused with premalignant conditions like leukoplakia, dysplasia. Our patient, a 35 years old immunocompetent male, presented with hoarseness, who later on developed stridor and had to be tracheostomized. Laryngoscopy was done under general anesthesia and biopsy taken. Histopathological examination revealed fungal laryngitis (Aspergillus). The patient recovered completely after antifungal treatment.

How to cite this article
Khaund G, Baruah D, Agarwal V, Barman S. Invasive Fungal Laryngitis in an Immunocompetent Person. Int J Phonosurg Laryngol 2014;4(2):73-75.