bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study of microscope-integrated intraoperative fluorescein videoangiography during arteriovenous malformation surgery: preliminary results
Authors: Lane Brandon C. , Cohen-Gadol Aaron A. 
Published: February 2014

Object
The authors report on the use of a recently developed microscope-integrated fluorescent module using low-dose intravenous fluorescein for videoangiography during arteriovenous malformation (AVM) surgery.

Methods
The authors analyzed the application of a low-dose intraoperative fluorescein in 4 consecutive patients undergoing AVM surgery. The ability to distinguish the associated vessels of the AVM from normal vessels and to assess the degree of AVM obliteration based on videoangiography of venous drainage was specifically analyzed.

Results
All 4 patients underwent fluorescein angiography without complication. In each case, videoangiography confirmed recognition of feeding arteries and draining veins through the operating oculars under the fluorescent mode. In one case involving a large frontal AVM, videoangiography demonstrated mainly cortical veins on the surface of the AVM and alerted the senior author to first tackle the feeding arteries in the interhemispheric space. While evaluating the flow within the different draining veins after most of the AVM was disconnected, videoangiography also prioritized the order for disconnection of large draining veins to allow mobilization the AVM and exposure of the remaining deep arterial feeders. In the other 3 cases, videoangiography allowed easy recognition of the angioarchitecture of the AVMs, estimated its cortical boundaries, and most importantly, assessed the flow within the draining veins before their disconnection.

Conclusions
The authors found fluorescein videoangiography to be a useful adjunct in resection of AVMs. This technology offers the unique ability to visualize fluorescent vessels and nonfluorescent tissues in near-natural colors simultaneously and permits microsurgical manipulation of relevant structures under the fluorescent mode. Largerscale studies are needed to establish its efficacy and wider applicability.
Is fluorescein-guided technique able to help in resection of high-grade gliomas?
Authors: Acerbi Francesco , Broggi Morgan , Eoli Marica , Anghileri Elena , Cavallo Claudio , Boffano Carlo , Cordella Roberto , Cuppini Lucia , Pollo Bianca , Schiariti Marco , Visintini Sergio , Orsi Chiara , La Corte Emanuele , Broggi Giovanni , Ferroli Paolo 
Published: February 2014

Object
Fluorescein, a dye that is widely used as a fluorescent tracer, accumulates in cerebral areas where the blood-brain barrier is damaged. This quality makes it an ideal dye for the intraoperative visualization of high-grade gliomas (HGGs). The authors report their experience with a new fluorescein-guided technique for the resection of HGGs using a dedicated filter on the surgical microscope.

Methods
The authors initiated a prospective Phase II trial (FLUOGLIO) in September 2011 with the objective of evaluating the safety of fluorescein-guided surgery for HGGs and obtaining preliminary evidence regarding its efficacy for this purpose. To be eligible for participation in the study, a patient had to have suspected HGG amenable to complete resection of the contrast-enhancing area. The present report is based on the analysis of the short- and long-term results in 20 consecutive patients with HGGs (age range 45–74 years), enrolled in the study since September 2011.
In all cases fluorescein (5–10 mg/kg) was injected intravenously after intubation. Tumor resection was performed with microsurgical technique and fluorescence visualization by means of BLUE 400 or YELLOW 560 filters on a Pentero microscope.

Results
The median preoperative tumor volume was 30.3 cm3 (range 2.4–87.8 cm3). There were no adverse reactions related to fluorescein administration. Complete removal of contrast-enhanced tumor was achieved in 80% of the patients. The median duration of follow-up was 10 months. The 6-months progression-free survival rate was 71.4% and the median survival was 11 months.

Conclusions
Analysis of these 20 cases suggested that fluorescein-guided technique with a dedicated filter on the surgical microscope is safe and allows a high rate of complete resection of contrast-enhanced tumor as determined on early postoperative MRI. Clinical trial registration no.: 2011-002527-18 (EudraCT).
Near-infrared imaging of brain tumors using the Tumor Paint BLZ-100 to achieve near-complete resection of brain tumors
Authors: Butte Pramod V. , Mamelak Adam , Parrish-Novak Julia , Drazin Doniel , Shweikeh Faris , Gangalum Pallavi R. , Chesnokova Alexandra , Ljubimova Julia Y. , Black Keith 
Published: February 2014

Object
The intraoperative clear delineation between brain tumor and normal tissue in real time is required to ensure near-complete resection without damaging the nearby eloquent brain. Tumor Paint BLZ-100, a tumor ligand chlorotoxin (CTX) conjugated to indocyanine green (ICG), has shown potential to be a targeted contrast agent. There are many infrared imaging systems in use, but they are not optimized to the low concentration and amount of ICG. The authors present a novel proof-of-concept near-infrared (NIR) imaging system using a standard charge-coupled device (CCD) camera for visualizing low levels of ICG attached to the tumors. This system is small, inexpensive, and sensitive. The imaging system uses a narrow-band laser at 785 nm and a notch filter in front of the sensor at the band. The camera is a 2-CCD camera, which uses identical CCDs for both visible and NIR light.

Methods
The NIR system is tested with serial dilution of BLZ-100 from 1 μM to 50 pM in 5% Intralipid solution while the excitation energy is varied from 5 to 40 mW/cm2. The analog gain of the CCD was changed from 0, 6, and 12 dB to determine the signal-to-noise ratio. In addition to the Intralipid solution, BLZ-100 was injected 48 hours before euthanizing the mice that were implanted with the human glioma cell line. The brain was removed and imaged using the NIR imaging system.

Results
The authors' results show that the NIR imaging system using a standard CCD is able to visualize the ICG down to 50 nM of concentration with a high signal-to-noise ratio. The preliminary experiment on human glioma implanted in mouse brains demonstrated that BLZ-100 has a high affinity for glioma compared with normal brain tissue. Additionally, the results show that NIR excitation is able to penetrate deeply and has a potential to visualize metastatic lesions that are separate from the main tumor.

Conclusions
The authors have seen that BLZ-100 has a very high affinity toward human gliomas. They also describe a small, cost-effective, and sensitive NIR system for visualizing brain tumors tagged using BLZ-100. The authors hope that the use of BLZ-100 along with NIR imaging will be useful to delineate the brain tumors in real time and assist surgeons in near-complete tumor removal to increase survival and reduce neurological deficits.
Application of indocyanine green video angiography in parasagittal meningioma surgery
Authors: Della Puppa Alessandro , Rustemi Oriela , Gioffrè Giorgio , Rolma Giuseppe , Grandis Marzia , Munari Marina , Scienza Renato 
Published: February 2014

Object
There are no doubts about the role that indocyanine green video angiography (ICGVA) can play in current vascular neurosurgery. Conversely, in brain tumor surgery, and particularly in meningioma surgery, this role is still unclear. Vein management is pivotal for approaching parasagittal meningiomas, because venous preservation is strictly connected to both extent of resection and clinical outcome. The authors present the technical traits and the postoperative outcome of the application of ICGVA in patients undergoing parasagittal meningioma surgery.

Methods
The authors retrospectively collected demographic, radiological, intraoperative, and follow-up data in 43 patients with parasagittal meningiomas who underwent surgery with the assistance of ICGVA at Padua Neurosurgical Department between October 2010 and July 2013. Intraoperative ICGVA findings at different stages (before dural opening, after dural opening, during resection, after resection) were reviewed. Additional data on functional monitoring, temporary venous clipping, and flow measurements were also recorded. The overall postoperative outcome was evaluated by assessing both the extent of resection and the clinical outcome data.

Results
The ICGVA studies were performed 125 times in 43 patients, providing helpful data for vein management and tumor resection in all stages of surgery. In 16% of meningiomas completely occluding the superior sagittal sinus, the ICGVA data differed from radiological findings and changed the surgical approach. In 20% of cases the intraoperative ICGVA findings directly guided the surgical strategy: venous sacrifice was necessary in 7 cases, without postoperative consequences; temporary clipping with neurophysiological monitoring proved to be predictive of safe venous sacrifice. In 7% of cases the ICGVA data needed to be supplemented with flow measurements. Simpson Grade I–II and Grade III resections were achieved in 86% and 14% of cases, respectively, with a 4.6% rate of overall morbidity.

Conclusions
This study shows that ICGVA can assist the different stages of parasagittal meningiomas surgery, guiding the vein management and tumor resection strategies with a favorable final clinical outcome. However, in the authors' experience the use of other complementary tools was mandatory in selected cases to preserve functional areas. Further studies are needed to confirm that the application of ICGVA in parasagittal meningioma surgery may improve the morbidity rate, as reported in this study.
Use of fluorescence to guide resection or biopsy of primary brain tumors and brain metastases
Authors: Marbacher Serge , Klinger Elisabeth , Schwyzer Lucia , Fischer Ingeborg , Nevzati Edin , Diepers Michael , Roelcke Ulrich , Fathi Ali-Reza , Coluccia Daniel , Fandino Javier 
Published: February 2014

Object
The accurate discrimination between tumor and normal tissue is crucial for determining how much to resect and therefore for the clinical outcome of patients with brain tumors. In recent years, guidance with 5-aminolevulinic acid (5-ALA)–induced intraoperative fluorescence has proven to be a useful surgical adjunct for gross-total resection of high-grade gliomas. The clinical utility of 5-ALA in resection of brain tumors other than glioblastomas has not yet been established. The authors assessed the frequency of positive 5-ALA fluorescence in a cohort of patients with primary brain tumors and metastases.

Methods
The authors conducted a single-center retrospective analysis of 531 patients with intracranial tumors treated by 5-ALA–guided resection or biopsy. They analyzed patient characteristics, preoperative and postoperative liver function test results, intraoperative tumor fluorescence, and histological data. They also screened discharge summaries for clinical adverse effects resulting from the administration of 5-ALA. Intraoperative qualitative 5-ALA fluorescence (none, mild, moderate, and strong) was documented by the surgeon and dichotomized into negative and positive fluorescence.

Results
A total of 458 cases qualified for final analysis. The highest percentage of 5-ALA–positive fluorescence in open resection was found in glioblastomas (96%, n = 99/103). Among other tumors, 5-ALA–positive fluorescence was detected in 88% (n = 21/32) of anaplastic gliomas (WHO Grade III), 40% (n = 8/19) of low-grade gliomas (WHO Grade II), no (n = 0/3) WHO Grade I gliomas, and 77% (n = 85/110) of meningiomas. Among metastases, the highest percentage of 5-ALA–positive fluorescence was detected in adenocarcinomas (48%, n = 13/27). Low rates or absence of positive fluorescence was found among pituitary adenomas (8%, n = 1/12) and schwannomas (0%, n = 0/7). Biopsies of high-grade primary brain tumors showed positive rates of fluorescence similar to those recorded for open resection. No clinical adverse effects associated with use of 5-ALA were observed. Only 1 patient had clinically silent transient elevation of liver enzymes.

Conclusions
Study findings suggest that the administration of 5-ALA as a surgical adjunct for resection and biopsy of primary brain tumors and brain metastases is safe. In light of the high rate of positive fluorescence in high-grade gliomas other than glioblastomas, meningiomas, and a variety of metastatic cancers, 5-ALA seems to be a promising tool for enhancing intraoperative identification of neoplastic tissue and optimizing the extent of resection.
Analysis of 5-aminolevulinic acid–induced fluorescence in 55 different spinal tumors
Authors: Millesi Matthias , Kiesel Barbara , Woehrer Adelheid , Hainfellner Johannes A. , Novak Klaus , Martínez-Moreno Mauricio , Wolfsberger Stefan , Knosp Engelbert , Widhalm Georg 
Published: February 2014

Object
Subtotal resection (STR) of spinal tumors can result in tumor recurrence. Currently, no clinically reliable marker is available for intraoperative visualization of spinal tumor tissue. Protoporphyrin IX (PpIX) fluorescence induced by 5-aminolevulinic acid (5-ALA) is capable of visualizing malignant gliomas. Fluorescence-guided resections of malignant cerebral gliomas using 5-ALA have resulted in an increased rate of complete tumor removal. Recently, the application of 5-ALA has also been described in the first cases of spinal tumors. Therefore, the aim of this observational study was to systematically investigate 5-ALA–induced fluorescence characteristics in different spinal tumor entities.

Methods
Three hours before the induction of anesthesia, 5-ALA was administered to patients with different intra- and extradural spinal tumors. In all patients a neurosurgical resection or biopsy of the spinal tumor was performed under conventional white-light microscopy. During each surgery, the presence of PpIX fluorescence was additionally assessed using a modified neurosurgical microscope. At the end of an assumed gross-total resection (GTR) under white-light microscopy, a final inspection of the surgical cavity of fluorescing intramedullary tumors was performed to look for any remaining fluorescing foci. Histopathological tumor diagnosis was established according to the current WHO classification.

Results
Fifty-two patients with 55 spinal tumors were included in this study. Resection was performed in 50 of 55 cases, whereas 5 of 55 cases underwent biopsy. Gross-total resection was achieved in 37 cases, STR in 5, and partial resection in 8 cases. Protoporphyrin IX fluorescence was visible in 30 (55%) of 55 cases, but not in 25 (45%) of 55 cases. Positive PpIX fluorescence was mainly detected in ependymomas (12 of 12), meningiomas (12 of 12), hemangiopericytomas (3 of 3), and in drop metastases of primary CNS tumors (2 of 2). In contrast, none of the neurinomas (8 of 8), carcinoma metastases (5 of 5), and primary spinal gliomas (3 of 3; 1 pilocytic astrocytoma, 1 WHO Grade II astrocytoma, 1 WHO Grade III anaplastic oligoastrocytoma) revealed PpIX fluorescence. It is notable that residual fluorescing tumor foci were detected and subsequently resected in 4 of 8 intramedullary ependymomas despite assumed GTR under white-light microscopy.

Conclusions
In this study, 5-ALA–PpIX fluorescence was observed in spinal tumors, especially ependymomas, meningiomas, hemangiopericytomas, and drop metastases of primary CNS tumors. In cases of intramedullary tumors, 5-ALA–induced PpIX fluorescence is a useful tool for the detection of potential residual tumor foci.
In vivo visualization of GL261-luc2 mouse glioma cells by use of Alexa Fluor–labeled TRP-2 antibodies
Authors: Fenton Kathryn E. , Martirosyan Nikolay L. , Abdelwahab Mohammed G. , Coons Stephen W. , Preul Mark C. , Scheck Adrienne C. 
Published: February 2014

Object
For patients with glioblastoma multiforme, median survival time is approximately 14 months. Longer progression-free and overall survival times correlate with gross-total resection of tumor. The ability to identify tumor cells intraoperatively could result in an increased percentage of tumor resected and thus increased patient survival times. Available labeling methods rely on metabolic activity of tumor cells; thus, they are more robust in high-grade tumors, and their utility in low-grade tumors and metastatic tumors is not clear. The authors demonstrate intraoperative identification of tumor cells by using labeled tumor-specific antibodies.

Methods
GL261 mouse glioma cells exhibit high expression of a membrane-bound protein called second tyrosinase-related protein (TRP-2). The authors used these cells to establish an intracranial, immunocompetent model of malignant glioma. Antibodies to TRP-2 were labeled by using Alexa Fluor 488 fluorescent dye and injected into the tail vein of albino C57BL/6 mice. After 24 hours, a craniotomy was performed and the tissue was examined in vivo by using an Optiscan 5.1 handheld portable confocal fiber-optic microscope. Tissue was examined ex vivo by using a Pascal 5 scanning confocal microscope.

Results
Labeled tumor cells were visible in vivo and ex vivo under the respective microscopes.

Conclusions
Fluorescently labeled tumor-specific antibodies are capable of binding and identifying tumor cells in vivo, accurately and specifically. The development of labeled markers for the identification of brain tumors will facilitate the use of intraoperative fluorescence microscopy as a tool for increasing the extent of resection of a broad variety of intracranial tumors.
National Trends in Pediatric Systemic Lupus Erythematosus Hospitalization in the United States: 2000–2009
Authors: Knight Andrea M. , Weiss Pamela F. , Morales Knashawn H. , Keren Ron 
Published: February 2014

Objective.In the setting of recent healthcare advances and emphasis on reduced spending, we aimed to characterize US trends in inpatient healthcare use and mortality for pediatric systemic lupus erythematosus (SLE).Methods.We performed a retrospective, serial, cross-sectional analysis of the national Kids’ Inpatient Database (for 2000, 2003, 2006, and 2009). We identified patients with SLE aged 2 to 21 years using an International Classification of Diseases, 9th revision (ICD-9) code of 710.0 listed as a discharge diagnosis. Using sampling weights, we estimated trends in hospitalization, inpatient mortality, procedure rates, and length of stay (LOS). We analyzed patient and hospital-specific risk factors for mortality and LOS, and compared those outcomes to those without SLE.Results.We identified 26,903 estimated pediatric SLE hospitalizations. The hospitalization rate of 8.6 (95% CI 7.6–9.6) per 100,000 population and mean LOS of 5.9 days (95% CI 5.6–6.2) were stable over time. We found a significant downward trend in mortality, decreasing from 1% to 0.6% (p = 0.04), which paralleled a less pronounced trend for those without SLE. The rate of dialysis, blood transfusions, and vascular catheterization procedures increased. Patients with SLE nephritis and non-white race were at risk for increased healthcare use and death.Conclusion.Pediatric SLE hospitalization rate and LOS remained stable, but inpatient mortality decreased as the rate of common therapeutic procedures increased. More research is needed to understand the drivers of these relationships.
Des inégalités scolaires, des moyens de les mesurer et d'en étudier les processus de production
Authors: Rochex Jean-Yves 
Published: February 2014

L’article présente des éléments de bilan, non seulement sur ce que l’on sait des inégalités scolaires et de leurs évolutions depuis les travaux fondateurs de la sociologie de l’éducation dans les années 1960-70, mais aussi des outils de mesure et des cadres de pensée avec lesquels on s’efforce, depuis lors, de les appréhender et de mieux en comprendre les dimensions et les processus de production. Il examine les données concernant les inégalités d’accès aux différents niveaux de formation ou de diplôme, mais aussi d’acquisition de savoirs et de compétences, à l’échelle nationale ou internationale. S’intéressant aux inégalités scolaires entre élèves appartenant aux différentes classes sociales, mais aussi aux inégalités sexuées, aux inégalités territoriales et aux « effets de contexte », il s’efforce de donner à voir les évolutions, les paradoxes et les contradictions au travers desquels se re-produisent et se renouvèlent les processus sociaux et scolaires de production des inégalités face au savoir et à la formation.
Les inégalités sociales en France. Entretiens
Authors: Maurin Louis , Dubet François , Mucchielli Laurent , Bruno Pierre 
Published: February 2014

Les trois entretiens, recueillis et mis en forme par Pierre Bruno, montrent que la question des inégalités est complexe et conflictuelle. Complexe car elle ne peut être réduite à la seule question des revenus : il ne faut pas sousestimer la diversité des fondements des inégalités (éducation, accès au soin, logement...), ni celle des populations qui en sont victimes (femmes, jeunes, ouvriers...). Conflictuelle car sa représentation reste sous-tendue par des visions différentes de la justice sociale, parfois concurrentielles voire antagonistes, qui peuvent privilégier pour certaines la réduction des écarts entre les positions sociales ou pour d’autres la lutte contre les discriminations et le traitement inéquitable des minorités. Les auteurs suggèrent de garder un regard critique par rapport aux manières successivement dominantes de penser les inégalités – tout particulièrement face aux lectures « culturelles » ou « ethniques » des tensions sociales.
Littératie, forme et inégalités scolaires : le cas de la « scolarisation » de l'école maternelle
Authors: Joigneaux Christophe 
Published: February 2014

Pourquoi la « scolarisation » récente de l’école maternelle ne permet-elle pas de réduire, autant qu’escompté, les inégalités de prédispositions à réussir scolairement ? Pour répondre à cette question, l’étude cherche à comprendre comment les évolutions pédagogiques, que cette institution a connues durant les trente dernières années, ont conduit à valoriser des pratiques langagières de plus en plus décontextualisées, ainsi que des usages de l’écrit exploitant davantage le pouvoir que peut avoir la permanence de ce dernier de communication à distance et d’autorégulation cognitive. In fine , à travers le cas (de moins en moins) particulier de l’école maternelle, nous montrons comment les derniers états de la forme et de la littératie scolaires se conjuguent pour reproduire les inégalités face et à l’école.
Les inégalités dans l'enseignement supérieur
Authors: Aschieri Gérard 
Published: February 2014

Si le développement de l’accès aux études supérieures est venu atténuer les très fortes inégalités sociales qui existaient autrefois, ces inégalités persistent dans l’accès aux formations, et se sont même accentuées de façon insidieuse. Les raisons sont nombreuses : dégradation de la situation matérielle des étudiants, dualité du système français d’enseignement supérieur, poids de la scolarité antérieure qui détermine l’orientation des jeunes mais aussi leur réussite... L’auteur analyse les défis majeurs de notre enseignement supérieur qui sont d’assurer la réussite non seulement des étudiants issus des formations et des catégories sociales qui l’alimentent traditionnellement, mais aussi d’un public nouveau qui va, sans doute, proportionnellement croitre.
Les inégalités scolaires aux sources de la réflexion didactique.
Authors: Bishop Marie-France 
Published: February 2014

L’étude étudie le rôle que joue la prise en compte de l’échec scolaire et des inégalités sociales dans l’émergence de la didactique du français. Une première partie s’attache à retracer les différentes étapes de la rénovation du français et à restituer les travaux des différentes commissions. Puis, l’analyse des contenus travaillés par les équipes de recherche de l’INRP, à partir de 1970, permet de comprendre les liens qui existent entre l’analyse des productions d’élèves et le souci d’enseigner une langue d’usage, et non plus une langue littéraire. La didactique du français s’attachant à réduire les inégalités linguistiques et sociales se constitue