bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcomes for low-grade intracranial ganglioglioma: 30-year experience from the Mayo Clinic
Authors: Compton Julia J. , Issa Laack Nadia N. , Eckel Laurence J. , Schomas David A. , Giannini Caterina , Meyer Fredric B. 
Published: September 2012

Object
Gangliogliomas comprise less than 1% of all brain tumors and occur most often in children. Therefore, there are a limited number of patients and data involving the use or role of adjuvant therapy after subtotal resections (STRs) of gangliogliomas. The objective of this study was to examine and review the Mayo Clinic experience of 88 patients with gangliogliomas, their follow-up, risk of recurrence, and the role of radiation therapy after STR or only biopsy.

Methods
Eighty-eight patients with gangliogliomas diagnosed between 1970 and 2007 were reviewed. Data on clinical outcomes and therapy received were analyzed. The Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival.

Results
The median age at diagnosis was 19 years. The median potential follow-up as of June 2008 was 142 months (range 9–416 months). Fifteen-year overall survival was 94%, median PFS was 5.6 years, with a 10-year PFS rate of 37%. Progression-free survival was dramatically affected by extent of initial resection (p < 0.0001).

Conclusions
This single-institution retrospective series of patients with gangliogliomas is unique given its large cohort size with a long follow-up duration, and confirms the excellent long-term survival rate in this group. The study also shows the importance of resection extent on likelihood of recurrence. Patients with gangliogliomas who undergo STR or biopsy alone have poor PFS. Radiation therapy may delay time to progression in patients with unresectable disease.
Differences in simple morphological variables in ruptured and unruptured middle cerebral artery aneurysms
Authors: Lin Ning , Ho Allen , Gross Bradley A. , Pieper Steven , Frerichs Kai U. , Day Arthur L. , Du Rose 
Published: September 2012

Object
Management of unruptured intracranial aneurysms remains controversial in neurosurgery. The contribution of morphological parameters has not been included in the treatment paradigm in a systematic manner or for any particular aneurysm location. The authors present a large sample of middle cerebral artery (MCA) aneurysms that were assessed using morphological variables to determine the parameters associated with aneurysm rupture.

Methods
Preoperative CT angiography (CTA) studies were evaluated using Slicer software to generate 3D models of the aneurysms and their surrounding vascular architecture. Morphological parameters examined in each model included 5 variables already defined in the literature (aneurysm size, aspect ratio, aneurysm angle, vessel angle, and size ratio) and 3 novel variables (flow angle, distance to the genu, and parent-daughter angle). Univariate and multivariate statistical analyses were performed to determine statistical significance.

Results
Between 2005 and 2008, 132 MCA aneurysms were treated at a single institution, and CTA studies of 79 aneurysms (40 ruptured and 39 unruptured) were analyzed. Fifty-three aneurysms were excluded because of reoperation (4), associated AVM (2), or lack of preoperative CTA studies (47). Ruptured aneurysms were associated with larger size, greater aspect ratio, larger aneurysm and flow angles, and smaller parent-daughter angle. Multivariate logistic regression revealed that aspect ratio, flow angle, and parent-daughter angle were the strongest factors associated with ruptured aneurysms.

Conclusions
Aspect ratio, flow angle, and parent-daughter angle are more strongly associated with ruptured MCA aneurysms than size. The association of parameters independent of aneurysm morphology with ruptured aneurysms suggests that these parameters may be associated with an increased risk of aneurysm rupture. These factors are readily applied in clinical practice and should be considered in addition to aneurysm size when assessing the risk of aneurysm rupture specific to the MCA location.
Diaphragmatic height index: new diagnostic test for phrenic nerve dysfunction
Authors: Pornrattanamaneewong Chaturong , Limthongthang Roongsak , Vathana Torpon , Kaewpornsawan Kamolporn , Songcharoen Panupan , Wongtrakul Saichol 
Published: September 2012

Object
The diaphragmatic height index (DHI) was developed to measure the difference in diaphragm levels. The purpose of this study was to set definite DHI values and test the accuracy of these values for use as a new diagnostic test for phrenic nerve dysfunction.

Methods
All data for this study were obtained from medical charts and retrospectively reviewed.

Results
One hundred sixty-five patients with brachial plexus injury who had undergone nerve transfers between 2005 and 2008 were divided into Groups A and B. Group A consisted of 40 patients (mean age 28.0 years) who had sustained concomitant injury of the brachial plexus and phrenic nerves. Patients in Group A1 had right phrenic nerve injury and those in Group A2 had left phrenic nerve injury. Intraoperative direct electrical stimulation of the phrenic nerve was considered the gold standard in assessing nerve function in all patients with brachial plexus injury. Group B consisted of 125 patients (mean age 28.7 years) with brachial plexus injury and normal phrenic nerve function. Group C, the control group, consisted of 80 patients with nonbrachial plexus injury (mean age 34.0 years) who had undergone other kinds of orthopedic operations between April and June 2009.
Standard posteroanterior chest radiographs were blindly interpreted using the Siriraj inhouse picture archiving and communication system in all 245 patients in the study. First, a reference line (R line) was drawn along the inferior endplate of T-10. Then, 2 lines (lines A and B) were drawn through the highest point of each diaphragm and parallel to the R line. The difference between these 2 lines divided by the height of T-10 was defined as the DHI. The cutoff points of the DHI for diagnosing right and left phrenic nerve dysfunction were analyzed with a receiver operating characteristic curve. The accuracy of these DHI values was then evaluated. The DHI in Group C was 0.64 ± 0.44, slightly higher than the DHI in Group B, with no significant difference. Diaphragmatic height indexes in Groups A1 and A2 were 2.0 ± 0.99 and −1.04 ± 0.83, respectively, which were significantly different from those in Groups B and C (p < 0.05). The cutoff point of the DHI for diagnosing right phrenic nerve dysfunction was > 1.1, and that for left phrenic nerve dysfunction was < 0.2. The sensitivity and specificity of right and left DHI values were 90.5% and 86.3%, and 94.7 and 88.3%, respectively.

Conclusions
Data in this study show that diaphragm paralysis can be simply and reliably predicted by the DHI. Diaphragmatic height index values > 1.1 and < 0.2 are proposed as the new diagnostic test for right and left phrenic nerve dysfunction with a high degree of accuracy. This index is applicable in diagnosing phrenic nerve dysfunction that occurs concomitantly with brachial plexus injury or from other etiologies.
Short circuit in deep brain stimulation
Authors: Samura Kazuhiro , Miyagi Yasushi , Okamoto Tsuyoshi , Hayami Takehito , Kishimoto Junji , Katano Mitsuo , Kamikaseda Kazufumi 
Published: September 2012

Object
The authors undertook this study to investigate the incidence, cause, and clinical influence of short circuits in patients treated with deep brain stimulation (DBS).

Methods
After the incidental identification of a short circuit during routine follow-up, the authors initiated a policy at their institution of routinely evaluating both therapeutic impedance and system impendence at every outpatient DBS follow-up visit, irrespective of the presence of symptoms suggesting possible system malfunction. This study represents a report of their findings after 1 year of this policy.

Results
Implanted DBS leads exhibiting short circuits were identified in 7 patients (8.9% of the patients seen for outpatient follow-up examinations during the 12-month study period). The mean duration from DBS lead implantation to the discovery of the short circuit was 64.7 months. The symptoms revealing short circuits included the wearing off of therapeutic effect, apraxia of eyelid opening, or dysarthria in 6 patients with Parkinson disease (PD), and dystonia deterioration in 1 patient with generalized dystonia. All DBS leads with short circuits had been anchored to the cranium using titanium miniplates. Altering electrode settings resulted in clinical improvement in the 2 PD cases in which patients had specific symptoms of short circuits (2.5%) but not in the other 4 cases. The patient with dystonia underwent repositioning and replacement of a lead because the previous lead was located too anteriorly, but did not experience symptom improvement.

Conclusions
In contrast to the sudden loss of clinical efficacy of DBS caused by an open circuit, short circuits may arise due to a gradual decrease in impedance, causing the insidious development of neurological symptoms via limited or extended potential fields as well as shortened battery longevity. The incidence of short circuits in DBS may be higher than previously thought, especially in cases in which DBS leads are anchored with miniplates. The circuit impedance of DBS should be routinely checked, even after a long history of DBS therapy, especially in cases of miniplate anchoring.
Reliability of postoperative photographs in assessment of facial nerve function after vestibular schwannoma resection
Authors: Gordon Amber S. , Westrick Ashly C. , Falola Michael I. , Shannon Chevis N. , Walters Beverly C. , Fisher Winfield S. 
Published: September 2012

Object
This study was undertaken to assess the reliability of observations of postoperative photographs in assigning House-Brackmann scores as outcome measures for patients following resection of vestibular schwannomas.

Methods
Forty pictures of differing facial expressions typically elicited from patients for assigning House-Brackmann scores were individually evaluated by neurosurgery residents and faculty members at the University of Alabama at Birmingham; a score was assigned to each picture by the individual raters. The interrater reliability was measured using the Spearman correlation coefficient, Kendall coefficient of concordance, and kappa statistic; internal consistency was calculated using the Cronbach alpha reliability estimate.

Results
The Spearman correlation coefficients showed strong positive association among raters, with a range of values of 0.66 to 0.90. Internal consistency measured by the Cronbach alpha coefficient was excellent (α = 0.97). The Kendall coefficient of concordance for the ordinal grades suggested a substantial degree of agreement among the raters (w = 0.76, p < 0.001).

Conclusions
Static postoperative photographs are a reliable outcome measure for determining facial nerve function after vestibular schwannoma resection and may serve as a surrogate for the dynamic patient interview.
Influence of the combination of patient age and deep venous drainage on brain arteriovenous malformation recurrence after surgery
Authors: Morgan Michael Kerin , Patel Nirav J. , Simons Mary , Ritson Elizabeth Anne , Heller Gillian Z. 
Published: September 2012

Object
Case reports suggest that young age is a critical factor in determining recurrence of brain arteriovenous malformations (AVMs) after surgery. However, other factors that may contribute to the increased risk of recurrence have not been considered. In this study, the authors' goal was to ascertain the risk and risk factors of recurrence after resection of AVMs of the brain.

Methods
A consecutive case series (prospectively collected data) of 600 cases of resection of brain AVMs was retrospectively analyzed. Radiological evidence of recurrence or nonrecurrence, as well as clinical evidence of recurrence, could be established in 427 of these cases that underwent follow-up for more than 350 days after initial surgery. These cases were analyzed using Kaplan-Meier curves and Cox regression with respect to age and the presence of deep venous drainage.

Results
Nine recurrent AVMs were found in 8 patients. By analysis of the Kaplan-Meier curves, the 10-year recurrence rate was 14% for those with deep venous drainage, compared with 4% for those without deep venous drainage. Stratifying by age, in the 0- to 20-year age group, the 10-year recurrence rates were 63% and 13% for those with and without deep venous drainage, respectively. In the 20- to 39-year age group, the rates were 5% and 0% respectively, and in the 40-year and older age group they were 0% and 3%, respectively. The hazard ratio for deep venous drainage, adjusted for age, was 5.97 (95% CI 1.20–29.69, p = 0.029).

Conclusions
The risk of recurrence after AVM resection is significant for young patients with deep venous drainage.
Feasibility of repeat surgery for pediatric brain tumors: an objective assessment of perioperative outcomes
Authors: Moiyadi Aliasgar V. , Shetty Prakash 
Published: September 2012

Object
Repeat surgery for pediatric brain tumors is gaining acceptance, with extent of resection an important predictor of outcome. However, repeat surgeries may be associated with increased morbidity. Few studies in the literature provide such outcomes objectively. The authors report on their experience with repeat surgery at a tertiary care neurooncology referral center in India.

Methods
A prospectively maintained database documented epidemiological, clinical, radiological, operative, and perioperative events. The authors analyzed 117 children (younger than 18 years of age) who had undergone various resective surgeries for brain tumors over a period of 5 years. Assessed end points included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality.

Results
The majority of children (48%) were between 3 and 10 years of age. Elevated intracranial pressure (70% of patients) and neurological deficits (60% of patients) were the commonest presenting symptoms. A significant proportion of patients (35%) had a poor Karnofsky Performance Scale score (≤ 70). Supratentorial procedures were performed in 58% of the patients. Most patients (72%) had large (> 4 cm) tumors. Fifty-eight patients (50%) had received prior treatment, surgery in 55. Neurological morbidity (worsening), regional complications, and systemic complications occurred in 27%, 32%, and 25% of patients overall, respectively. Overall morbidity was 44.4% (26.5% major), and perioperative mortality was 7.7%. Neurological worsening occurred more frequently in patients undergoing a first surgery (p = 0.038), whereas wound-related complications were more common in those undergoing reoperations (p = 0.00).

Conclusions
Pediatric patients had larger tumors and were more likely to present with a poor performance status, often after prior treatment, than their adult counterparts. Wound-related complications were higher in the previously treated subgroup; however, neurological complications were fewer, probably because of a favorable selection of patients. Despite the unavailability of advanced intraoperative aids, acceptable levels of overall morbidity and mortality could be achieved in repeat surgeries for pediatric brain tumors.
Creating a Void or Sublimation in Lacan
Authors: Saint-Cyr Viviana M. 
Published: September 2012

Nous étudions la théorie lacanienne de la sublimation dont la formule principale est celle du séminaire sur l’éthique de la psychanalyse : la sublimation « élève un objet à la dignité de la Chose ». Nous nous efforçons de démontrer la logique de cette définition, qui va de l’objet imaginaire désiré au vide de l’Autre entouré, et approfondissons les paradoxes qu’elle implique en ce qu’elle a affaire au rapport des trois registres de la réalité humaine : Symbolique, Imaginaire, Réel. Ce parcours nous permet de tirer l’enseignement de l’architecture, art paradigmatique de la sublimation pour autant qu’elle est créatrice de vide. Comme la sublimation, l’art de bâtir parvient à nous mettre en rapport avec notre propre vide en tant que sujets du désir. L’une et l’autre organisent le vide tout en créant un vide. Ainsi, elles pallient à l’horreur du vide réel de la Chose sans pour autant refermer la possibilité de s’en rapprocher.
Hug-Hellmuth ou les impasses d'une conception objectivante de l'infantile
Authors: Lenormand Marie 
Published: September 2012

Hermine von Hug-Hellmuth fut, avant Melanie Klein et Anna Freud, la première psychanalyste d’enfants. Pourtant, ses œuvres théoriques et cliniques au service d’une orthodoxie freudienne demeurent en général tout aussi peu connues que son existence tragique et exceptionnelle. S’inscrivant dans un questionnement épistémologique, cet article ne cherche pas situer les énoncés théoriques de cette théoricienne dans l’histoire des idées psychanalytiques, mais s’interroge sur les effets du « rapport à l’inconscient » de cette dernière – tel qu’il est repérable dans ses écrits – sur sa conception et sa pratique de la cure de l’enfant. L’auteur soutient l’hypothèse que, chez Hug-Hellmuth, la conception de l’infantile témoigne d’un malentendu métapsychologique et éthique fondamental qui eut des conséquences tragiques sur sa pratique, sa théorie ainsi que sur son existence. Au-delà ou plutôt via l’étude du cas singulier de pionnière de l’analyse de l’enfant, il s’agira donc de repérer, de manière actuelle, comment la position subjective d’un auteur se révèle décisive quant à la théorie et la pratique clinique mises en œuvre.
Masse et impuissance
Authors: Neau Françoise 
Published: September 2012

L’auteur propose une lecture du roman de J. M. Coetzee, Disgrâce (1999). Ce roman actualise, avec la force analysante de l’œuvre littéraire, le questionnement freudien de Psychologie des masses et analyse du moi (1921). Si « la non-liberté de l’individu est le principal phénomène de la psychologie des masses », comment, jusqu’où et avec quel coût psychique dans une Afrique du Sud post-apartheid qui institutionnalise la vérité et la réconciliation, l’individu peut-il dans la fiction, et selon son genre, sa race, sa génération, être rejeté ou absorbé par la nouvelle « âme de masse » ? Quel travail de désillusion et de renoncement David, le personnage principal, et sa fille, Lucy, devront-ils effectuer, chacun à leur manière, pour « s’élever jusqu’à une parcelle d’autonomie et d’originalité » ? (Freud, 1921).
The Mass and Powerlessness
Authors: Neau Françoise 
Published: September 2012

L’auteur propose une lecture du roman de J. M. Coetzee, Disgrâce (1999). Ce roman actualise, avec la force analysante de l’œuvre littéraire, le questionnement freudien de Psychologie des masses et analyse du moi (1921). Si « la non-liberté de l’individu est le principal phénomène de la psychologie des masses », comment, jusqu’où et avec quel coût psychique dans une Afrique du Sud post-apartheid qui institutionnalise la vérité et la réconciliation, l’individu peut-il dans la fiction, et selon son genre, sa race, sa génération, être rejeté ou absorbé par la nouvelle « âme de masse » ? Quel travail de désillusion et de renoncement David, le personnage principal, et sa fille, Lucy, devront-ils effectuer, chacun à leur manière, pour « s’élever jusqu’à une parcelle d’autonomie et d’originalité » ? (Freud, 1921).
A2B Adenosine Receptor Expression by Myeloid Cells Is Proinflammatory in Murine Allergic-Airway Inflammation
Authors: Belikoff Bryan G. , Vaickus Louis J. , Sitkovsky Michail , Remick Daniel G. 
Published: September 2012

Abstract
Asthma is a chronic condition with high morbidity and healthcare costs, and cockroach allergens are an established cause of urban pediatric asthma. A better understanding of cell types involved in promoting lung inflammation could provide new targets for the treatment of chronic pulmonary disease. Because of its role in regulating myeloid cell-dependent inflammatory processes, we examined A2B R expression by myeloid cells in a cockroach allergen model of murine asthma-like pulmonary inflammation. Both systemic and myeloid tissue-specific A2B R deletion significantly decreased pulmonary inflammatory cell recruitment, airway mucin production, and proinflammatory cytokine secretion after final allergen challenge in sensitized mice. A2B R deficiency resulted in a dramatic reduction on Th2-type airways responses with decreased pulmonary eosinophilia without augmenting neutrophilia, and decreased lung IL-4, IL-5, and IL-13 production. Chemokine analysis demonstrated that eotaxin 1 and 2 secretion in response to repeated allergen challenge is myeloid cell A2B R dependent. In contrast, there were no differences in the levels of the CXC chemokines keratinocyte-derived chemokine and MIP-2 in the myeloid cell A2B R-deficient mice, strengthening A2B R involvement in the development of Th2-type airways inflammation. Proinflammatory TNF-α, IFN-γ, and IL-17 secretion were also reduced in systemic and myeloid tissue-specific A2B R deletion mouse lines. Our results demonstrate Th2-type predominance for A2B R expression by myeloid cells as a mechanism of development of asthma-like pulmonary inflammation.
Diversity of Antigen-Specific Responses Induced In Vivo with CTLA-4 Blockade in Prostate Cancer Patients
Authors: Kwek Serena S. , Dao Vinh , Roy Ritu , Hou Yafei , Alajajian David , Simko Jeffrey P. , Small Eric J. , Fong Lawrence 
Published: September 2012

Abstract
CTLA-4 is a surface receptor on activated T cells that delivers an inhibitory signal, serving as an immune checkpoint. Treatment with anti–CTLA-4 Abs can induce clinical responses to different malignancies, but the nature of the induced Ag-specific recognition is largely unknown. Using microarrays spotted with &gt;8000 human proteins, we assessed the diversity of Ab responses modulated by treatment with CTLA-4 blockade and GM-CSF. We find that advanced prostate cancer patients who clinically respond to treatment also develop enhanced Ab responses to a higher number of Ags than nonresponders. These induced Ab responses targeted Ags to which preexisting Abs are more likely to be present in the clinical responders compared with nonresponders. The majority of Ab responses are patient-specific, but immune responses against Ags shared among clinical responders are also detected. One of these shared Ags is PAK6, which is expressed in prostate cancer and to which CD4+ T cell responses were also induced. Moreover, immunization with PAK6 can be both immunogenic and protective in mouse tumor models. These results demonstrate that immune checkpoint blockade modulates Ag-specific responses to both individualized and shared Ags, some of which can mediate anti-tumor responses.