bluuebunny/crossref_metadata_2025_split huggingface dataset:
CNTF receptor subunit α as a marker for glioma tumor-initiating cells and tumor grade
Authors: Lu Jie , Ksendzovsky Alexander , Yang Chunzhang , Mehta Gautam U. , Yong Raymund L. , Weil Robert J. , Park Deric M. , Mushlin Harry M. , Fang Xueping , Balgley Brian M. , Lee Dae-Hee , Lee Cheng S. , Lonser Russell R. , Zhuang Zhengping 
Published: October 2012

Object
Tumor-initiating cells are uniquely resilient to current treatment modalities and play an important role in tumor resistance and recurrence. The lack of specific tumor-initiating cell markers to identify and target these cells presents a major obstacle to effective directed therapy.

Methods
To identify tumor-initiating cell markers in primary brain tumors, the authors compared the proteomes of glioma tumor-initiating cells to their differentiated progeny using a novel, nongel/shotgun-based, multidimensional liquid-chromatography protein separation technique. An in vivo xenograft model was used to demonstrate the tumorigenic and stem cell properties of these cells. Western blot and immunofluorescence analyses were used to confirm findings of upregulated ciliary neurotrophic factor receptor subunit–α (CNTFRα) in undifferentiated tumor-initiating cells and gliomas of increasing tumor grade. Sequencing of the CNTFRα coding regions was performed for mutation analysis. Finally, antibody-dependent cell-mediated cytotoxicity was used to establish the role of CNTFRα as a potential immunotherapeutic target.

Results
Ciliary neurotrophic factor receptor subunit–α expression was increased in tumor-initiating cells and was decreased in the cells' differentiated progeny, and expression levels increased with glioma grade. Mutations of CNTFRα are not common in gliomas. Functional studies using CNTF treatment in glioma tumor-initiating cells showed induction of differentiation through the CNTFRα pathway. Treatment with anti-CNTFRα antibody resulted in increased antibody-dependent cell-mediated cytotoxicity in CNTFRα expressing DAOY cells but not in cell lines that lack CNTFRα.

Conclusions
These data indicate that CNTFRα plays a role in the formation or maintenance of tumor-initiating cells in gliomas, is a marker that correlates with histological grade, may underlie treatment resistance in some cases, and is a potential therapeutic target.
Impaired pulsation absorber mechanism in idiopathic normal pressure hydrocephalus
Authors: Park Eun-Hyoung , Eide Per Kristian , Zurakowski David , Madsen Joseph R. 
Published: October 2012

Object
The pathophysiology of normal pressure hydrocephalus (NPH), and the related problem of patient selection for treatment of this condition, have been of great interest since the description of this seemingly paradoxical condition nearly 50 years ago. Recently, Eide has reported that measurements of the amplitude of the intracranial pressure (ICP) can both positively and negatively predict response to CSF shunting. Specifically, the fraction of time spent in a “high amplitude” (> 4 mm Hg) state predicted response to shunting, which may represent a marker for hydrocephalic pathophysiology. Increased ICP amplitude might suggest decreased brain compliance, meaning a static measure of a pressure-volume ratio. Recent studies of canine data have shown that the brain compliance can be described as a frequency-dependent function. The normal canine brain seems to show enhanced ability to absorb the pulsations around the heart rate, quantified as a cardiac pulsation absorbance (CPA), with properties like a notch filter in engineering. This frequency dependence of the function is diminished with development of hydrocephalus in dogs. In this pilot study, the authors sought to determine whether frequency dependence could be observed in humans, and whether the frequency dependence would be any different in epochs with high ICP amplitude compared with epochs of low ICP amplitude.

Methods
Systems analysis was applied to arterial blood pressure (ABP) and ICP waveforms recorded from 10 patients undergoing evaluations of idiopathic NPH to calculate a time-varying transfer function that reveals frequency dependence and CPA, the measure of frequency-dependent compliance previously used in animal experiments. The ICP amplitude was also calculated in the same samples, so that epochs with high (> 4 mm Hg) versus low (≤ 4 mm Hg) amplitude could be compared in CPA and transfer functions.

Results
Transfer function analysis for the more “normal” epochs with low amplitude exhibits a dip or notch in the physiological frequency range of the heart rate, confirming in humans the pulsation absorber phenomenon previously observed in canine studies. Under high amplitude, however, the dip in the transfer function is absent. An inverse relationship between CPA index and ICP amplitude is evident and statistically significant. Thus, elevated ICP amplitude indicates decreased performance of the human pulsation absorber.

Conclusions
The results suggest that the human intracranial system shows frequency dependence as seen in animal experiments. There is an inverse relationship between CPA index and ICP amplitude, indicating that higher amplitudes may occur with a reduced performance of the pulsation absorber. Our findings show that frequency dependence can be observed in humans and imply that reduced frequency-dependent compliance may be responsible for elevated ICP amplitude observed in patients who respond to CSF shunting.
Validation of the superior interhemispheric approach for tuberculum sellae meningioma
Authors: Curey Sophie , Derrey Stéphane , Hannequin Pierre , Hannequin Didier , Fréger Pierre , Muraine Marc , Castel Hélène , Proust François 
Published: October 2012

Object
The objective of this study was to evaluate the ophthalmological outcome, nonvisual morbidity, and surgical complications after tuberculum sellae meningioma (TSM) removal using a superior interhemispheric approach.

Methods
In the last decade, 20 consecutive patients with TSM underwent operations using the superior interhemispheric approach. Visual acuity, visual field, and ocular fundus examination were assessed both preoperatively and 6-months postoperatively. Nonvisual morbidity was determined at an early postoperative period and at 6 months based on assessment of the Karnofsky Performance Scale score, leakage of CSF, endocrinological status, and olfactory function, which was assessed using a visual analog scale (VAS). The potential brain injury related to the approach was assessed by MRI at 6 months. Magnetic resonance imaging was then performed yearly to detect a recurrence. The mean follow up was 56.3 ± 34 months.

Results
The primary presenting symptom for diagnosis of TSM in 20 patients (female:male ratio of 6.6:1, mean age 59.1 ± 11.1 years) was visual disturbance in 12 patients (60%), headache in 4 (20%), cognitive alteration in 1 (5%), epilepsy in 2 (10%), and accidental in 1 (5%). In a total of 40 eyes, 17 eyes in 11 patients presented with preoperative deterioration of visual acuity. Postoperatively, the visual acuity improved in 13 eyes in 8 patients (72.8%), remained unchanged in 3 eyes in 2 patients (18.2%) and deteriorated in 1 patient (9%). The nonvisual morbidity included olfactory deterioration in 7 patients (35%), and panhypopituitarism in 1 patient (5%). No patients experienced a CSF leak. The impact of olfactory deterioration on the quality of life, as estimated by a VAS score (range 0–10), was a mean of 5.7 ± 2.2 (95% CI 4.1–7.3). On the follow-up MRI, no additional lesions or recurrences were observed on the medial aspect of the frontal lobe along the surgical corridor.

Conclusions
The superior interhemispheric approach appears to be effective in resolving the problem of visual deterioration due to a TSM, without inducing surgical injury on the brain surface along the surgical corridor. Olfactory deterioration remained the challenging predominant nonvisual morbidity using this approach.
A randomized controlled study comparing omeprazole and cimetidine for the prophylaxis of stress-related upper gastrointestinal bleeding in patients with intracerebral hemorrhage
Authors: Liu Bo-lin , Li Bing , Zhang Xiang , Fei Zhou , Hu Shi-jie , Lin Wei , Gao Da-kuan , Zhang Li 
Published: October 2012

Object
Patients with intracerebral hemorrhage (ICH) are at high risk for severe stress-related upper gastrointestinal (UGI) bleeding, which is predictive of higher mortality. The aim of this study was to evaluate the effectiveness of omeprazole and cimetidine compared with a placebo in the prevention and management of stress-related UGI bleeding in patients with ICH.

Methods
In a single-center, randomized, placebo-controlled study, 184 surgically treated patients with CT-proven ICH within 72 hours of ictus and negative results for gastric occult blood testing were included. Of these patients, 165 who were qualified upon further evaluation were randomized into 3 groups: 58 patients received 40 mg intravenous omeprazole every 12 hours, 54 patients received 300 mg intravenous cimetidine every 6 hours, and 53 patients received a placebo. Patients whose gastric occult blood tests were positive at admission (n = 70) and during/after the prophylaxis procedure (n = 48) were treated with high-dose omeprazole at 80 mg bolus plus 8 mg/hr infusion for 3 days, followed by 40 mg intravenous omeprazole every 12 hours for 7 days.

Results
Of the 165 assessable patients, stress-related UGI bleeding occurred in 9 (15.5%) in the omeprazole group compared with 15 patients (27.8%) in the cimetidine group and 24 patients (45.3%) in the placebo group (p = 0.003). The occurrence of UGI bleeding was significantly related to death (p = 0.022). Nosocomial pneumonia occurred in 14 patients (24.1%) receiving omeprazole, 12 (22.2%) receiving cimetidine, and 8 (15.1%) receiving placebo (p > 0.05). In patients with UGI bleeding in which high-dose omeprazole was initiated, UGI bleeding arrested within the first 3 days in 103 patients (87.3%).

Conclusions
Omeprazole significantly reduced the morbidity of stress-related UGI bleeding in patients with ICH due to its effective prophylactic effect without increasing the risk of nosocomial pneumonia, but it did not reduce the 1-month mortality or ICU stay. Further evaluation of high-dose omeprazole as the drug of choice for patients presenting with UGI bleeding is warranted. Clinical trial registration no.: ChiCTR-TRC-12001871, registered at the Chinese clinical trial registry (http://www.chictr.org/en/proj/show.aspx?proj=2384).
Symptomatic patients with intraluminal carotid artery thrombus: outcome with a strategy of initial anticoagulation
Authors: Vellimana Ananth K. , Kadkhodayan Yasha , Rich Keith M. , Cross DeWitte T. , Moran Christopher J. , Zazulia Allyson R. , Lee Jin-Moo , Chicoine Michael R. , Dacey Ralph G. , Derdeyn Colin P. , Zipfel Gregory J. 
Published: October 2012

Object
The aim of this study was to define the optimal treatment for patients with symptomatic intraluminal carotid artery thrombus (ICAT).

Methods
The authors performed a retrospective chart review of patients who had presented with symptomatic ICAT at their institution between 2001 and 2011.

Results
Twenty-four patients (16 males and 8 females) with ICAT presented with ischemic stroke (18 patients) or transient ischemic attack ([TIA], 6 patients). All were initially treated using anticoagulation with or without antiplatelet drugs. Eight of these patients had no or only mild carotid artery stenosis on initial angiography and were treated with medical management alone. The remaining 16 patients had moderate or severe carotid stenosis on initial angiography; of these, 10 underwent delayed revascularization (8 patients, carotid endarterectomy [CEA]; 2 patients, angioplasty and stenting), 2 refused revascularization, and 4 were treated with medical therapy alone. One patient had multiple TIAs despite medical therapy and eventually underwent CEA; the remaining 23 patients had no TIAs after treatment. No patient suffered ischemic or hemorrhagic stroke while on anticoagulation therapy, either during the perioperative period or in the long-term follow-up; 1 patient died of an unrelated condition. The mean follow-up was 16.4 months.

Conclusions
Results of this study suggest that initial anticoagulation for symptomatic ICAT leads to a low rate of recurrent ischemic events and that carotid revascularization, if indicated, can be safely performed in a delayed manner.
Comparison of pulsed versus continuous convective flow for central nervous system tissue perfusion
Authors: Nduom Edjah K. , Walbridge Stuart , Lonser Russell R. 
Published: October 2012

Object
Although pulsatile and continuous infusion paradigms have been described for convective delivery of drugs, the effectiveness and properties of each flow paradigm are unknown. To determine the effectiveness and properties of pulsatile and continuous convective infusion paradigms, the authors compared these convective flow methods in the gray and white matter of primates.

Methods
Six primates (Macaca mulatta) underwent convective infusion of Gd-DPTA (5 mM) into the cerebral gray matter (thalamus) or white matter (frontal lobe) using pulsed (intermittent pulses of 15 μl/min) or continuous (1 μl/min) convective flow. Results were assessed by clinical MRI and histological analyses.

Results
Distribution of Gd-DTPA infusate in gray and white matter by pulsed and continuous flow was clearly identified using MRI, which revealed that both convective flow methods demonstrated an increase in the volume of distribution (Vd) with increasing volume of infusion (Vi) in the surrounding gray and white matter. Although the mean (± SD) gray matter Vd:Vi ratio for the pulsed infusions (4.2 ± 0.5) was significantly lower than the mean Vd:Vi ratio for continuous infusions (5.4 ± 0.5; a 22% difference [p = 0.0006]), the difference between pulsed (3.8 ± 0.4) and continuous (4.3 ± 1.2) infusions in white matter was not significantly different (p = 0.3). Pulsed infusions were associated with more leakback (12.3% ± 6.4% of Vi) than continuous infusions (3.9% ± 7.8%), although this difference was not significant (p = 0.2). All animals tolerated the infusions and there was no histological evidence of tissue injury at the infusion sites.

Conclusions
Although pulsed and continuous infusion flow paradigms can be safely and effectively used for convective delivery into both gray and white matter, continuous infusion is associated with a higher Vd:Vi ratio than pulsatile infusion in gray matter. High rates of infusion (15 μl/min) can be used to deliver infusate without any significant leakback and without any clinical or histological evidence of injury.
Pegylated interferon-α-2b for children with recurrent craniopharyngioma
Authors: Yeung Jacky T. , Pollack Ian F. , Panigrahy Ashok , Jakacki Regina I. 
Published: October 2012

Object
Previous studies of systemic and intralesional administration of nonpegylated interferon have shown efficacy against craniopharyngioma. Pegylaion of interferon-α-2b (PI) prolongs the half-life, allowing sustained exposure of the drug over time, and enhances efficacy. The authors report the results of the use of PI in 5 children with recurrent craniopharyngiomas.

Methods
Five children, ranging in age from 9 to 15 years, with recurrent craniopharyngiomas were treated for up to 2 years with subcutaneous injections of PI at a dose of 1–3 μg/kg/week. Tumor response was assessed using MRI.

Results
All patients had stable disease or better in response to PI. One patient experienced a recurrence after gross-total resection (GTR). She initially showed an increase in the predominantly cystic tumor after 3 months of treatment, followed by a complete response. She required no further intervention and remains without evidence of disease 10 years after starting treatment. Another patient experienced recurrence 3.3 years after subtotal resection (STR) and radiation therapy. He had complete disappearance of the predominantly cystic component after 4 months of treatment, and a small residual calcified mass remains 5 years later. The third patient experienced recurrence after 3 GTRs. He had a complete response after 7 months of treatment and remains without evidence of disease 19 months after starting treatment. The fourth patient experienced recurrence after 2 STRs. He had a 30% decrease in tumor size after 4 months of treatment, which was maintained for 12 months at which point the cyst began to increase in size. The final patient experienced recurrence after GTR and has stable disease 6 months after starting treatment with PI.

Conclusions
The use of PI in children with recurrent craniopharyngiomas can result in significant and durable responses and potentially delay or avoid the need for radiation therapy.
Transition Within a Graduate Nurse Residency Program
Authors: Varner Kendra D. , Leeds Ruth A. 
Published: October 2012

How to Obtain Contact Hours by Reading This IssueInstructions: 2.3contact hours will be awarded for this activity. A contact hour is 60 minutes of instruction. This is a Learner-paced Program. Vindico Medical Education does not require submission of the quiz answers. A contact hour certificate will be awarded 4–6 weeks following receipt of your completed Registration Form, including the Evaluation portion. To obtain contact hours:1.Read the article, “Transition Within a Graduate Nurse Residency Program,” on pages 491–499, carefully noting the tables and other illustrative materials that are provided to enhance your knowledge and understanding of the content.2.Read each question and record your answers. After completing all questions, compare your answers to those provided within this issue.3.Type or print your full name and address and your Social Security number in the spaces provided on the Registration Form. Indicate the total time spent on the activity (reading article and completing quiz). Forms and quizzes cannot be processed if this section is incomplete. All participants are required by the accreditation agency to attest to the time spent completing the activity.4.Forward the completed Registration Form with your check or money order for $20 made payable toJCEN-CNE. Payment must be in U.S. dollars drawn on a U.S. bank. This activity is valid from November 1, 2012 to October 31, 2014.Vindico Medical Education, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.This activity is co-provided by Vindico Medical Education and TheJournal ofContinuingEducation inNursing.Objectives:After studying the article, “Transition Within a Graduate Nurse Residency Program,” in this issue, the participant will:1.Explain how nursing role transition theory was incorporated into the nurse residency program (NRP) design.2.Discuss elements essential for a positive transition to practice experience within an NRP.3.Describe positive outcomes associated with a successful NRP.4.Discuss challenges associated with NRP evaluation.Author Disclosure StatementThe authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.Commercial Support StatementAll author(s) and planners have agreed that this activity will be free of bias.There is no commercial company support for this activity. There is no noncommercial support for this activity.As evidence of the effectiveness of these programs grows, nurse leaders feel the pressure to establish high-quality, yet cost-effective graduate nurse transition programs. In 2009, the authors developed an innovative program by incorporating transition theory, research results, stakeholder involvement, and the recommendations of the National Council of State Boards of Nursing. The graduate nurse residency program yielded positive outcomes, including stakeholder satisfaction and high retention rates.
Surgical Outcomes Following Repair of Traumatic Retinal Detachments in Cognitively Impaired Adolescents With Self-Injurious Behavior
Authors: Sisk Robert A. , Motley W. Walker , Yang Michael B. , West Constance E. 
Published: October 2012

Purpose:
To assess anatomic outcomes following repair of traumatic retinal detachment (RD) among a cohort of cognitively impaired adolescents with self-injurious behaviors.

Methods:
Main outcome measures in this retrospective, consecutive, interventional case series were retinal attachment and postoperative complications.

Results:
Complete retinal reattachment was initially achieved in all 9 eyes of 9 patients. Six (67%) eyes had chronic RD at initial presentation, and 7 (78%) patients had limited vision from inoperable RD in the fellow eye. Proliferative vitreoretinopathy led to recurrent RD in 4 (44%) eyes at a mean of 2.7 months. Final total or partial retinal attachment was achieved in 6 (67%) and 3 (33%) eyes, respectively, with a mean of 1.7 procedures over a mean follow-up of 22.4 months. Silicone oil emulsification led to progressive glaucoma in 4 (50%) of 8 eyes in which it was used, requiring silicone oil exchange (2 eyes) or removal (2 eyes). Recurrent RD developed in both eyes from which silicone oil was removed despite prior retinal anatomic stability for more than 6 months.

Conclusion:
Cognitively impaired adolescents with self-injurious behaviors typically presented with severe visual impairment from chronic traumatic RD in one or both eyes. Despite initial anatomic success, formation of proliferative vitreoretinopathy and further ocular trauma from continued self-injurious behaviors led to a high rate of recurrent RD. Long-term silicone oil tamponade may prevent recurrent RD in this challenging scenario but is associated with vision loss from progressive glaucoma and corneal decompensation.
Corneal Higher Order Aberrations After LASIK for High Myopia With a Fast Repetition Rate Excimer Laser, Optimized Ablation Profile, and Femtosecond Laser–assisted Flap
Authors: Vega-Estrada Alfredo , Alió Jorge L. , Mosquera Samuel Arba , Moreno Luis J. 
Published: October 2012

PURPOSE:
To evaluate corneal higher order aberrations (HOAs) after LASIK for the correction of high myopia using a new generation of excimer laser (500-Hz repetition rate) and optimized ablation profiles.

METHODS:
Retrospective consecutive study including 29 eyes from 17 patients (age range: 24 to 61 years) with high levels of myopia (spherical equivalent refraction ⩾8.50 diopters). All cases underwent LASIK using the sixth-generation Amaris (SCHWIND eye-tech-solutions) excimer laser and flap creation with the IntraLase (Abbott Medical Optics) femtosecond laser. Postoperative changes in corneal HOAs and corneal asphericity were analyzed during 6-month follow-up.

RESULTS:

Significant improvement in uncorrected distance visual acuity and spherical equivalent was observed (
P
<.01). Corrected distance visual acuity did not change after surgery (
P
=.37). Significant increases in corneal root-mean-square (RMS) HOA, RMS spherical aberration (SA), and RMS coma were observed 6 months after surgery (
P
<.01). Corneal asphericity for the 4.5-mm (Q45) and 8-mm (Q8) corneal diameter also increased significantly during the postoperative period (
P
<.01). Significant correlations were found between postoperative RMS HOA and RMS SA and RMS coma (r
2
=0.375,
P
=0.000 and r
2
=0.596,
P
=.000, respectively). Linear regression analysis showed a significant relationship between postoperative Q45 and preoperative pachymetry and treatment optical zone (R
2
=0.24,
P
<.05). A correlation was also found between postoperative Q8 and preoperative sphere and treatment ablation zone (R
2
=0.459,
P
<.006).

CONCLUSIONS:

A significant induction of corneal HOAs still exists with the latest generation S
chwind
excimer laser. Linear regression analysis will help predict postoperative asphericity obtained when using LASIK for the correction of high myopia.