bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tissue-engineered intervertebral discs: MRI results and histology in the rodent spine
Authors: Grunert Peter , Gebhard Harry H. , Bowles Robby D. , James Andrew R. , Potter Hollis G. , Macielak Michael , Hudson Katherine D. , Alimi Marjan , Ballon Douglas J. , Aronowitz Eric , Tsiouris Apostolos John , Bonassar Lawrence J. , Härtl Roger 
Published: February 2014

Object
Tissue-engineered intervertebral discs (TE-IVDs) represent a new experimental approach for the treatment of degenerative disc disease. Compared with mechanical implants, TE-IVDs may better mimic the properties of native discs. The authors conducted a study to evaluate the outcome of TE-IVDs implanted into the rat-tail spine using radiological parameters and histology.

Methods
Tissue-engineered intervertebral discs consist of a distinct nucleus pulposus (NP) and anulus fibrosus (AF) that are engineered in vitro from sheep IVD chondrocytes. In 10 athymic rats a discectomy in the caudal spine was performed. The discs were replaced with TE-IVDs. Animals were kept alive for 8 months and were killed for histological evaluation. At 1, 5, and 8 months, MR images were obtained; T1-weighted sequences were used for disc height measurements, and T2-weighted sequences were used for morphological analysis. Quantitative T2 relaxation time analysis was used to assess the water content and T1ρ-relaxation time to assess the proteoglycan content of TE-IVDs.

Results
Disc height of the transplanted segments remained constant between 68% and 74% of healthy discs. Examination of TE-IVDs on MR images revealed morphology similar to that of native discs. T2-relaxation time did not differ between implanted and healthy discs, indicating similar water content of the NP tissue. The size of the NP decreased in TE-IVDs. Proteoglycan content in the NP was lower than it was in control discs. Ossification of the implanted segment was not observed. Histological examination revealed an AF consisting of an organized parallel-aligned fiber structure. The NP matrix appeared amorphous and contained cells that resembled chondrocytes.

Conclusions
The TE-IVDs remained viable over 8 months in vivo and maintained a structure similar to that of native discs. Tissue-engineered intervertebral discs should be explored further as an option for the potential treatment of degenerative disc disease.
Surgical outcomes using a medial-to-lateral endonasal endoscopic approach to pituitary adenomas invading the cavernous sinus
Authors: Woodworth Graeme F. , Patel Kunal S. , Shin Benjamin , Burkhardt Jan-Karl , Tsiouris Apostolos John , McCoul Edward D. , Anand Vijay K. , Schwartz Theodore H. 
Published: February 2014

Object
This study details the extent of resection and complications associated with endonasal endoscopic surgery for pituitary tumors invading the cavernous sinus (CS) using a moderately aggressive approach to maximize extent of resection through the medial CS wall while minimizing the risk of cranial neuropathy and blood loss. Tumor in the medial CS was aggressively pursued while tumor in the lateral CS was debulked in preparation for radiosurgery.

Methods
A prospective surgical database of consecutive endonasal pituitary surgeries with verified CS invasion on intraoperative visual inspection was reviewed. The extent of resection as a whole and within the CS was assessed by an independent neuroradiologist using pre- and postoperative Knosp-Steiner (KS) categorization and volumetrics of the respective MR images. The extent of resection and clinical outcomes were compared for medial (KS 1–2) and lateral (KS 3–4) lesions.

Results
Thirty-six consecutive patients with pituitary adenomas involving the CS who had surgery via an endonasal endoscopic approach were identified. The extent of resection was 84.6% for KS 1–2 and 66.6% for KS 3–4 (p = 0.04). The rate of gross-total resection was 53.8% for KS 1–2 and 8.7% for KS 3–4 (p = 0.0006). Six patients (16.7%) had preoperative cranial neuropathies, and all 6 had subjective improvement after surgery. Surgical complications included 2 transient postoperative cranial neuropathies (5.6%), 1 postoperative CSF leak (2.8%), 1 reoperation for mucocele (2.8%), and 1 infection (2.8%).

Conclusions
The endoscopic endonasal “medial-to-lateral” approach permits safe debulking of tumors in the medial and lateral CS. Although rates of gross-total resection are moderate, particularly in the lateral CS, the risk of permanent cranial neuropathy is extremely low and there is a high chance of improvement of preexisting deficits. This approach can also facilitate targeting for postoperative radiosurgery.
Medial acoustic neuromas: clinical and surgical implications
Authors: Dunn Ian F. , Bi Wenya Linda , Erkmen Kadir , Kadri Paulo A. S. , Hasan David , Tang Chi-Tun , Pravdenkova Svetlana , Al-Mefty Ossama 
Published: February 2014

Object
Medial acoustic neuroma is a rare entity that confers a distinct clinical syndrome. It is scarcely discussed in the literature and is associated with adverse features. This study evaluates the clinical and imaging features, pertinent surgical challenges, and treatment outcome in a large series of this variant. The authors postulate that the particular pathological anatomy with its arachnoidal rearrangement has a profound implication on the surgical technique and outcome.

Methods
The authors conducted a retrospective analysis of 52 cases involving 33 women and 19 men who underwent resection of medial acoustic neuromas performed by the senior author (O.A.) over a 20-year period (1993–2013). Clinical, radiological, and operative records were reviewed, with a specific focus on the neurological outcomes and facial nerve function and hearing preservation. Intraoperative findings were analyzed with respect to the effect of arachnoidal arrangement on the surgeon's ability to resect the lesion and the impact on postoperative function.

Results
The average tumor size was 34.5 mm (maximum diameter), with over 90% of tumors being 25 mm or larger and 71% being cystic. Cerebellar, trigeminal nerve, and facial nerve dysfunction were common preoperative findings. Hydrocephalus was present in 11 patients. Distinguishing intraoperative findings included marked tumor adherence to the brainstem and frequent hypervascularity, which prompted intracapsular dissection resulting in enhancement on postoperative MRI in 18 cases, with only 3 demonstrating growth on follow-up. There was no mortality or major postoperative neurological deficit. Cerebrospinal fluid leak was encountered in 7 patients, with 4 requiring surgical repair. Among 45 patients who had intact preoperative facial function, only 1 had permanent facial nerve paralysis on extended follow-up. Of the patients with preoperative Grade I–II facial function, 87% continued to have Grade I–II function on follow-up. Of 10 patients who had Class A hearing preoperatively, 5 continued to have Class A or B hearing after surgery.

Conclusions
Medial acoustic neuromas represent a rare subgroup whose site of origin and growth patterns produce a distinct clinical presentation and present specific operative challenges. They reach giant size and are frequently cystic and hypervascular. Their origin and growth pattern lead to arachnoidal rearrangement with marked adherence against the brainstem, which is critical in the surgical management. Excellent surgical outcome is achievable with a high rate of facial nerve function and attainable hearing preservation. These results suggest that similar or better results may be achieved in less complex tumors.
Smoking and postoperative outcomes in elective cranial surgery
Authors: Alan Nima , Seicean Andreea , Seicean Sinziana , Schiltz Nicholas K. , Neuhauser Duncan , Weil Robert J. 
Published: February 2014

Object
The goal in this study was to assess whether a current or prior history of smoking and the number of smoking pack years affect the risk for adverse outcomes in the 30-day postoperative period in patients who undergo elective cranial surgery.

Methods
Data from the 2006–2011 American College of Surgeons' National Surgical Quality Improvement Project were used in this study. The authors identified 8296 patients who underwent elective cranial surgery, of whom 1718 were current smokers, 854 were prior smokers, and 5724 were never smokers. Using propensity scores and age, the authors matched current and prior smokers to never smokers. Odds ratios for adverse postoperative outcomes were predicted with logistic regression. The relationship between number of pack years and poor outcomes was also examined.

Results
In unadjusted analyses, prior and current smokers did not differ from never smokers for having poor outcomes postoperatively. Similarly, in matched analyses, no association was found between smoking and adverse outcomes. Number of pack years in propensity-matched analyses did not predict worse outcomes in prior or current smokers versus never smokers.

Conclusions
The authors did not find smoking to be associated with 30-day postoperative morbidity or mortality. Although smoking cessation is beneficial for overall health, it may not improve the short-term (≤ 30 days) outcome of elective cranial surgery. Thus postponement of elective cranial cases only for smoking cessation may not be necessary.
Novel embalming solution for neurosurgical simulation in cadavers
Authors: Benet Arnau , Rincon-Torroella Jordina , Lawton Michael T. , González Sánchez J. J. 
Published: February 2014

Object
Surgical simulation using postmortem human heads is one of the most valid strategies for neurosurgical research and training. The authors customized an embalming formula that provides an optimal retraction profile and lifelike physical properties while preventing microorganism growth and brain decay for neurosurgical simulations in cadavers. They studied the properties of the customized formula and compared its use with the standard postmortem processing techniques: cryopreservation and formaldehyde-based embalming.

Methods
Eighteen specimens were prepared for neurosurgical simulation: 6 formaldehyde embalmed, 6 cryopreserved, and 6 custom embalmed. The customized formula is a mixture of ethanol 62.4%, glycerol 17%, phenol 10.2%, formaldehyde 2.3%, and water 8.1%. After a standard pterional craniotomy, retraction profiles and brain stiffness were studied using an intracranial pressure transducer and monitor. Preservation time—that is, time that tissue remained in optimal condition—between specimen groups was also compared through periodical reports during a 48-hour simulation.

Results
The mean (± standard deviation) retraction pressures were highest in the formaldehyde group and lowest in the cryopreserved group. The customized formula provided a mean retraction pressure almost 3 times lower than formaldehyde (36 ± 3 vs 103 ± 14 mm Hg, p < 0.01) and very similar to cryopreservation (24 ± 6 mm Hg, p < 0.01). For research purposes, preservation time in the cryopreserved group was limited to 4 hours and was unlimited for the customized and formaldehyde groups for the duration of the experiment.

Conclusions
The customized embalming solution described herein is optimal for allowing retraction and surgical maneuverability while preventing decay. The authors were able to significantly lower the formaldehyde content as compared with that in standard formulas. The custom embalming solution has the benefits from both cryopreservation (for example, biological brain tissue properties) and formaldehyde embalming (for example, preservation time and microorganism growth prevention) and minimizes their drawbacks, that is, rapid decay in the former and stiffness in the latter. The presented embalming formula provides an important advance for neurosurgical simulations in research and teaching.
Pial synangiosis in patients with moyamoya younger than 2 years of age
Authors: Jackson Eric M. , Lin Ning , Manjila Sunil , Scott R. Michael , Smith Edward R. 
Published: February 2014

Object
Patients with moyamoya who are younger than 2 years of age represent a therapeutic challenge because of their frequent neurological instability and concomitant anesthetic risks. The authors report their experience with pial synangiosis revascularization in this population.

Methods
The authors reviewed the clinical and radiographic records of all patients with moyamoya in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution.

Results
During a 12-year period (1994–2005), 34 procedures (bilateral in 15 patients, unilateral in 4) were performed in 19 patients younger than 2 years (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or transient ischemic attack. The average age of the 19 patients at first surgery was 1.4 years (range 6 months–1.9 years). Unanticipated staged operations occurred in 3 patients, due to persistent electroencephalographic changes during the initial surgery in 2 cases and due to brain swelling during the procedure requiring ventriculostomy in the other. There were 2 perioperative strokes; both patients had postoperative seizures but made clinical recoveries. The average follow-up was 7 years (range 1–14 years). Long term, at follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures performed years later for frontal lobe ischemia (2), late infarction (1), and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre- and postoperative angiography demonstrated progression of disease.

Conclusions
Despite the challenges inherent to this population, the majority of children with moyamoya under the age of 2 years have a good long-term prognosis. The data from this study support the use of pial synangiosis as a safe, effective, and durable method for treatment of moyamoya for most children in this potentially high-risk population.
Cumulative survival analysis of patients with spinal myxopapillary ependymomas in the first 2 decades of life
Authors: Kukreja Sunil , Ambekar Sudheer , Sin Anthony Hunkyun , Nanda Anil 
Published: February 2014

Object
Reports of myxopapillary ependymomas (MPEs) of the spinal cord in pediatric patients are scarce. In the literature, various authors have shared their experiences with small groups of patients, which makes it difficult to create a consensus regarding the treatment approach for spinal MPEs in young patients. The aim of this study was to perform a survival analysis of patients in the first 2 decades of life whose cases were selected from the published studies, and to examine the influence of various factors on outcomes.

Methods
A comprehensive search of studies published in English was performed on PubMed. Patients whose age was ≤ 20 years were included for integrative analysis. Information about age, treatment characteristics, critical events (progression, recurrence, and death), time to critical events, and follow-up duration was recorded. The degree of association of the various factors with the survival outcome was calculated by using Kaplan-Meier estimator and Cox proportional hazard model techniques.

Results
A total of 95 patients were included in the analysis. The overall rate of recurrence (RR) was 34.7% (n = 33), with a median time to recurrence of 36 months (range 2–100 months). Progression-free survival (PFS) and overall survival rates at 5 years were 73.7% and 98.9%, respectively. Addition of radiotherapy (RT) following resection significantly improved PFS (log-rank test, p = 0.008). In patients who underwent subtotal resection (STR), administering RT (STR + RT) improved outcome with the lowest failure rates (10.3%), superior to patients who underwent gross-total resection (GTR) alone (RR 43.1%; log-rank test, p < 0.001). Addition of RT to patients who underwent GTR was not beneficial (log-rank test, p = 0.628). In patients who had disseminated tumor at presentation, adjuvant RT controlled the disease effectively. High-dose RT (≥ 50 Gy) did not change PFS (log-rank test, p = 0.710).

Conclusions
Routine inclusion of RT in the treatment protocol for spinal MPEs in young patients should be considered. Complete resection is always the goal of tumor resection. However, when complete resection does not seem to be possible in complex lesions, RT should be used as an adjunct to avoid aggressive resection and to minimize inadvertent injury to the surrounding neural tissues. High-dose RT (≥ 50 Gy) did not provide additional survival benefits, although this association needs to be evaluated by prospective studies.
A preliminary comparative clinical study of vertebroplasty with multineedle or single-needle interstitial implantation of 125I seeds in the treatment of osteolytic metastatic vertebral tumors
Authors: Li Tao , Li Jianmin , Wang Zhen , Liu Baodong , Han Dunfu , Wang Pengyun 
Published: February 2014

Object
Percutaneous vertebroplasty (PVP) combined with brachytherapy using the interstitial implantation of 125I seeds has previously yielded encouraging clinical results in the treatment of metastatic vertebral tumors. However, the bone cement injection volume is very small due to the osteolytic damage to the metastatic vertebrae, and the ideal spatial distribution of the 125I seeds is difficult to achieve. In the current study, the authors present a clinical method for puncture needle insertion to achieve a greater bone cement injection volume and a more ideal spatial distribution of the 125I seeds.

Methods
Twenty-nine patients with osteolytic metastatic vertebral tumors were divided into 2 groups and were treated with either PVP combined with multineedle interstitial implantation of 125I seeds, or PVP combined with single-needle interstitial implantation of 125I seeds. Clinical efficacy was evaluated according to a visual analog scale (VAS) of pain, the Karnofsky Performance Scale (KPS), and the Response Evaluation Criteria In Solid Tumors (RECIST).

Results
Back pain was significantly alleviated in all patients after surgery. Compared with the preoperative scores, the VAS scores were significantly decreased in both groups at 1 week and 3 months postoperatively (p < 0.05), but there were no significant intergroup differences (p > 0.05). The postoperative quality of life was improved in both groups; the KPS scores increased significantly compared with the preoperative scores (p < 0.05), and the postoperative KPS scores were significantly different between the 2 groups (p < 0.05). No intergroup differences were observed in pain alleviation, but the bone cement injection volume was significantly greater in the multineedle group than in the single-needle group (p < 0.05). The clinical benefit rate and disease control rate at 3 months after the operation were both significantly better for the multineedle group (p < 0.05).

Conclusions
The outcomes of PVP combined with multineedle interstitial implantation of 125I seeds in patients with osteolytic metastatic vertebral tumors appeared to be better than the outcomes of PVP combined with single-needle interstitial implantation of 125I seeds. These better outcomes may be the result of the greater bone cement injection volume and the more ideal spatial distribution of the 125I seeds.
« La grande épinettière » d’Alex Michelet : une lecture postcoloniale
Authors: Lacroix Denis , Rao Sathya 
Published: February 2014

Récit composé par Alex Michelet (1886-1979) à l’aube de sa vie, « La grande épinettière » raconte l’histoire d’une jeune institutrice d’ascendance française, Jeanne, qui se trouve affectée dans un petit village de l’Ouest canadien au tournant des années 1915-1920. En apparence anodin, ce récit inédit est remarquable à plusieurs égards : 1) il propose une description précise de la francophonie albertaine que l’auteur connaît bien pour avoir vécu en Alberta entre 1915-1919; 2) à travers le personnage de Jeanne, ce roman met en scène le conflit identitaire – éminemment actuel – qui tiraille les Français de la deuxième génération vivant dans l’Ouest; 3) à la différence des récits traditionnels de pionniers (Durieux, Giscard, Maturié), qui font état du combat épique contre la nature, « La grande épinettière » se focalise sur l’intériorité des personnages (qui apparaît alors dans toute sa complexité). De fait, c’est toute l’esthétique romanesque qui s’en trouve modifiée et n’a plus grand-chose à voir avec les récits coloniaux de pionniers. L’objet de cet article est d’explorer ces trois axes de lecture tout en réfléchissant en filigrane à la question de l’héritage laissée par la présence française dans l’Ouest canadien en général et en Alberta en particulier.
Les mots patrimoniaux au Manitoba (Canada) entre 1963 et 2006 : déclin des mots religieux, maintien des mots de coutumes
Authors: Rodriguez Liliane 
Published: February 2014

La langue maternelle, vecteur d’identité sans pareil, véhicule le souvenir individuel et collectif, le préserve et le transmet, tout en évoluant pour accueillir dans sa forme (ses accents, ses vocabulaires, sa syntaxe) les nouvelles donnes du temps présent. La langue, dans son ensemble, est au coeur du patrimoine vivant d’une communauté linguistique, mais sa composante lexicale, en particulier, contient des éléments chargés d’histoire et de culture qui, au delà des dénotations et des nuances de sens répertoriées dans les dictionnaires, sont hautement symboliques d’une appartenance. Ces éléments sont d’autant plus symboliques que la communauté à laquelle ils sont liés est minoritaire. Nous présenterons un corpus de ces mots « patrimoniaux ». Ils sont extraits de corpus lexicométriques établis d’après les données de terrain de quatre enquêtes lexicales réalisées au Manitoba entre 1963 et 2006. Nous suivrons l’évolution quantitative et qualitative de ces mots particuliers dans le vocabulaire de jeunes francophones. Qu’ils appartiennent au français transnational ou régional, les exemples choisis sont représentatifs de champs lexicaux de coutumes manitobaines (bâtir, chasser, etc.) et de celui de la religion (prière, catéchèse, crucifix, etc.). Nous montrerons que le vocabulaire de la religion a perdu de sa disponibilité, contrairement à ceux d’autres activités traditionnelles (comme la construction ou la pêche). Nous soulignerons la pertinence patrimoniale de ces mots et nous nous interrogerons sur la signification que le maintien, la hausse ou le déclin de leurs indices de disponibilité peuvent avoir dans une perspective identitaire.
Maillardville (Colombie-Britannique), du village au coeur symbolique d’un (fragile) réseau francophone
Authors: Chignier-Riboulon Franck 
Published: February 2014

Dans les ouvrages de géographie, Maillardville (quartier de Coquitlam) apparaît bien souvent comme l’implantation ultime d’un extrême Ouest canadien. Cette communauté, essentiellement bâtie autour d’une scierie, prend forme, au début du XXe siècle, avec l’arrivée de travailleurs, principalement venus du Québec puis, par la suite, des Prairies. La logique d’urbanisation in situ conforte pendant plusieurs décennies la communauté et sa spécificité. Cependant, la croissance et l’étalement de Vancouver, l’immigration, mais aussi la recherche d’autres emplois et les mariages mixtes ont déstructuré une communauté fragile. En 1979, Paul Villeneuve insiste déjà sur l’importance de l’assimilation. Aujourd’hui, la situation est quelque peu paradoxale puisque les francophones sont minoritaires dans le quartier, qu’ils sont même éclatés entre plusieurs municipalités (où ils sont aussi très minoritaires), et que, par ailleurs, l’école de Maillardville a été délocalisée dans la municipalité voisine; pourtant, « l’esprit de communauté demeure », selon Lionel Daneault, interrogé par Florence Debeugny (2009).