bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial dural arteriovenous fistulae: angiographic predictors of intracranial hemorrhage and clinical outcome in nonsurgical patients
Authors: Brown Robert D. , Wiebers David O. , Nichols Douglas A. 
Published: May 2009

✓ This long-term follow-up study of 54 patients clarifies the angiographic predictors of intracranial hemorrhage (ICH) and clinical outcome in individuals with unoperated intracranial dural arteriovenous fistulae (AVF's). All of these patients were examined at the Mayo Clinic between 1976 and 1989, and all available cerebral arteriograms were reviewed by a neuroradiologist. Follow-up information was obtained for 52 patients (96%) until death or treatment intervention, or for at least 1 year after diagnosis, with a mean follow-up period of 6.6 years.
Throughout this 6.6-year follow-up period, ICH related to dural AVF occurred in five of the 52 patients, for a crude risk of hemorrhage of 1.6% per year. The risk of hemorrhage at the time of mean follow-up examination was 1.8% per year. Angiographic examination revealed several characteristics that were considered potential predictors of ICH during the follow-up period. Lesions of the petrosal sinus and straight sinus had a higher propensity to bleed, although the small numbers in the series precluded a definite conclusion. A person suffering from a dural AVF with a venous varix on a draining vein had an increased risk of hemorrhage, whereas no hemorrhage was seen in the 20 patients without a varix (p < 0.05). Lesions draining into leptomeningeal veins had an increased occurrence of hemorrhage, although this increased risk was not statistically significant. Patients' initial symptoms were compared to those at follow-up evaluation. Pulsatile tinnitus improved in more than half of the 52 patients, and resolved in 75% of those showing some improvement. Individuals without a sinus or venous outflow occlusion at initial cerebral angiography were more likely to improve or remain stable (89%), whereas patients with an occlusion showed infrequent improvement (11%; p < 0.05).
Cerebral damage caused by interrupted, repeated arterial occlusion versus uninterrupted occlusion in a focal ischemic model
Authors: Steinberg Gary K. , Panahian Nariman , Sun Go-Hua , Maier Carolina M. , Kunis David 
Published: May 2009

✓ Temporary intracranial arterial occlusion is often utilized during the surgical treatment of intracranial aneurysms. Although numerous experimental studies have suggested that repetitive, brief periods of global ischemia cause more severe cerebral injury than a similar single period of global ischemia, this issue has not been extensively studied in relation to focal ischemia. It remains controversial whether it is safer to use brief periods of interrupted, temporary occlusion separated by reperfusion periods, or a more prolonged, single temporary occlusion. This question is addressed in studies on a rabbit model of transient, focal cerebral ischemia.
Sixteen anesthetized rabbits underwent transorbital occlusion of the left internal carotid, middle cerebral, and anterior cerebral arteries, with one of two paradigms: uninterrupted occlusion (1 hour of temporary occlusion followed by 5 hours of reperfusion in eight rabbits), or interrupted occlusion (three separate 20-minute periods of occlusion, with 10 minutes of reperfusion between occlusions, followed by 4 hours, 40 minutes of reperfusion in eight rabbits). Histopathological evaluation for ischemic neuronal damage and magnetic resonance imaging studies for ischemic edema were conducted 6 hours after the initial arterial occlusion.
The animals in the interrupted, repeated occlusion group showed a 59% decrease in the area of cortical ischemic neuronal damage (mean ± standard error of the mean 10.0% ± 1.7%) compared with the uninterrupted occlusion group (24.4% ± 5%, p = 0.016). There was no difference between the groups in the extent of striatal ischemic damage or area of ischemic edema. These results suggest that interrupted, repeated focal ischemia causes less cortical ischemic injury than uninterrupted transient ischemia of a similar total duration. Although caution should be exercised in extrapolating from these results to the clinical situation, they may have important implications for temporary arterial occlusion during intracranial surgery.
Precocious puberty in a girl with an hCG-secreting suprasellar immature teratoma
Authors: Kitanaka Chifumi , Matsutani Masao , Sora Shigeo , Kitanaka Sachiko , Tanae Ayako , Hibi Itsuro 
Published: May 2009

✓ Although precocious puberty is common in boys with human chorionic gonadotropin (hCG)-secreting brain tumors, it is extremely rare in girls. The authors describe a 6-year-old girl with an hCG-secreting suprasellar immature teratoma who presented with diabetes insipidus, increased intracranial pressure, and precocious puberty. On admission, breast budding was observed. The serum hCG level was 1230 mIU/ml. Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) remained below detectable levels, even after gonadotropin-releasing hormone stimulation. Serum estrogen and androgen were moderately elevated. After chemotherapy, breast budding disappeared with normalization of serum hCG.
It has been believed that hCG does not produce precocious puberty in girls in the absence of FSH, and this has been used as an explanation for the rarity of precocious puberty in girls with hCG-secreting brain tumors. However, it has also been reported that hCG has not only LH activity but also intrinsic, although weak, FSH-like activity. In the present case, this FSH-like activity was considered to have played a role in the development of precocious puberty. It is speculated that a very high level of serum hCG can produce precocious puberty in girls. The rarity of intracranial germ-cell tumors with a high potential of hCG secretion may be one of the reasons why hCG-induced precocious puberty is uncommon in girls.
Outcome after laminectomy for lumbar spinal stenosis
Authors: Tuite Gerald F. , Doran Stephen E. , Stern Joseph D. , McGillicuddy John E. , Papadopoulos Stephen M. , Lundquist Craig A. , Oyedijo Dotun I. , Grube Susan V. , Gilmer Holly S. , Schork M. Anthony , Swanson Steven E. , Hoff Julian T. 
Published: May 2009

✓ The pre- and postoperative lumbar spine radiographs of 119 patients who underwent decompressive lumbar laminectomy were studied to evaluate radiographic changes and to correlate them with clinical outcome. An accurate and reproducible method was used for measuring pre- and postoperative radiographs that were separated by an average interval of 4.6 years. Levels of the spine that underwent laminectomy showed greater change in spondylolisthesis, disc space angle, and disc space height than unoperated levels. Outcome correlated with radiographic changes at operated and unoperated levels.This study demonstrates that radiographic changes are greater at operated than at unoperated levels and that some postoperative symptoms do correlate with these changes. Lumbar fusion should be considered in some patients who undergo decompressive laminectomy. The efficacy of and unequivocal indications for lumbar fusion can only be determined from randomized, prospective, controlled trials, however, and these studies have not yet been undertaken.
Update on the Cloward procedure: new instruments
Authors: Otero Vich José M. 
Published: May 2009

✓ A series of 283 patients who suffered from cervical spondylosis, herniated disc, or traumatic pathology of the cervical spine were operated on using an anterior approach. Intersomatic arthrodesis was performed in 350 cases; in every case, a threaded bone graft was screwed into the intervertebral orifice using the technique described by the author. Fusion was achieved within 6 months in 93% of cases with 92 autologous grafts and in 81% of cases with 258 heterologous grafts.
In addition to the use of threaded intervertebral holes and threaded bone grafts, the Cloward technique was modified by the introduction of a set of new instruments, which largely replaced the ones previously in use. These included a low-speed motor with different drills and trephines, a trephine guide retractor, and an intersomatic retractor.
Quantitative imaging of estrogen and progesterone receptors, estrogen-regulated protein, and growth fraction: immunocytochemical assays in 52 meningiomas
Authors: Bouillot Pablo , Pellissier Jean-François , Devictor Benedicte , Graziani Noel , Bianco Nicole , Grisoli F. , Figarella-Branger Dominique 
Published: May 2009

✓ Quantitative imaging of estrogen receptors (ER's), progesterone receptors (PR's), estrogen-regulated protein (pS2), and growth fraction (Ki67) immunocytochemical assays were performed in 52 meningiomas. The results were correlated with clinical (age, sex, hormonal status, and tumor volume and location) and morphological (histological types and grades) data.
The authors observed a lack of ER's in all meningiomas but the presence of PR's in 53% of these meningiomas. The immunoreactivity was restricted to tumor cell nuclei. The PR immunocytochemical assay was correlated with tumor location, histological type, histological grade, and pS2 immunocytochemical assay, but not with Ki67 immunocytochemical assay; high PR content was observed in cisternae, transitional, meningothelial, and low-grade meningiomas. Only 11 meningiomas showed more than 1% Ki67 immunoreactive nuclei. These meningiomas were usually located in the convexity and were of high histological grade. Estrogen-regulated protein immunoreactivity was observed in 34 meningiomas but the number of immunoreactive nuclei was low. The pS2 immunocytochemical assay was not related to clinicopathological features but was preferentially observed in PR-negative meningiomas.
The results of this study are compared with those previously reported, and the function and regulation of PR's in meningiomas is discussed. The results indicate that 1) regulation of PR's and pS2 proteins in meningiomas differs from regulation in estrogen-dependent tissues such as breast or endometrium; 2) interruption of hormonal therapy in women presenting with a meningioma is not absolutely necessary; 3) meningiomas have different biological properties according to their clinicopathological features; and 4) future studies of hormonal clinical trials should be performed on well-defined meningioma subgroups.
Progressive perturbations in cerebral energy metabolism after experimental whole-brain radiation in the therapeutic range
Authors: D'Avella Domenico , Cicciarello Rocco , Gagliardi Maria E. , Albiero Francesca , Mesiti Mario , Russi Elvio , D'Aquino Antonio , Tomasello Francesco 
Published: May 2009

✓ Basic mechanisms underlying the tolerance and reaction of the central nervous system to ionizing radiation have not been fully elucidated in the literature. The authors employed the [14C]-2-deoxy-D-glucose autoradiography method to investigate the effect of whole-brain x-irradiation on local cerebral glucose utilization in the rat brain. The animals were exposed to conventional fractionation (200 ± 4 cGy/day, 5 days/week for a total dose of 4000 cGy), and the effects of this regimen were assessed at 2 weeks and 3 months postirradiation. In rats evaluated 2 weeks after treatment, statistically significant decreases in cerebral metabolic activity were found in 13 of the 27 regions studied, compared to control animals. In rats studied 3 months after treatment, additional metabolic suppression and statistically significant decreases in cerebral metabolic activity were found in 11 of the 27 regions, compared to rats studied 2 weeks after treatment. A weighted-average rate for the brain as a whole was approximately 15% and approximately 25% below that of control animals 2 weeks and 3 months after exposure, respectively.
Although the difference in species is significant enough so that direct extrapolation to humans may not be appropriate, the data reported here may have potential clinical implications for the evaluation of the risk-benefit ratio for radiotherapy. This model can be used reproducibly for further investigations, including evaluation of therapies that may reduce irradiation-induced brain injury.
Cerebral circulation and oxygen metabolism in childhood moyamoya disease: a perioperative positron emission tomography study
Authors: Ikezaki Kiyonobu , Matsushima Toshio , Kuwabara Yasuo , Suzuki Satoshi O. , Nomura Tomojiro , Fukui Masashi 
Published: May 2009

✓ Thirteen children with moyamoya disease who had no apparent cerebral infarction or hemorrhage were examined pre- and postoperatively by means of positron emission tomography (PET) to investigate the underlying cerebral circulation and metabolism and the effect of bypass surgery. The preoperative regional cerebral blood flow (rCBF) and mean transit time were significantly decreased and increased, respectively, in the cerebral cortex of these patients compared to control values. The regional cerebral blood volume (rCBV) and the regional oxygen extraction fraction (rOEF) had significantly increased to compensate for the reduced rCBF and perfusion pressure and also to maintain the regional cerebral metabolic rate of oxygen (rCMRO2). In the basal ganglia, rCBV elevation was more prominent than that in the cerebral cortex, although changes in rCBF, rOEF, and rCMRO2 were relatively minor.
Postoperative improvements were observed predominantly near the cortex where bypass surgery had been performed and in the basal ganglia. Direct and combined indirect bypass procedures improved cerebral circulation more effectively than single indirect bypass surgery. Although the angiographic findings were not always compatible with the clinical results, the postoperative improvements on PET scans correlated with the disappearance of transient ischemic attacks. In addition to the clinical courses and angiographic findings, PET analysis was indispensable in evaluating the cerebral circulation and metabolism in childhood moyamoya disease.
Reversal of hemiparkinsonian syndrome in nonhuman primates by amnion implantation into caudate nucleus
Authors: Bankiewicz Krzysztof S. , Palmatier Meg , Plunkett Robert J. , Cummins Alex , Oldfield Edward H. 
Published: May 2009

✓ Although recent animal and human experiments suggest that tissue implantation can ameliorate parkinsonism, there is controversy about what mechanism underlies recovery. Secretion of dopamine from the graft seems unlikely to be the sole restorative factor. Regenerative sprouting by the host brain may also underlie behavioral recovery. Fetal amnion and term amnion, which were shown to produce and secrete a factor that supports the outgrowth of neurite processes in vitro, were implanted in hemiparkinsonian monkeys. Fetal amnion implants induced sprouting of dopaminergic fibers from the host brain and behavioral improvement, despite failure of the grafts to survive. Animals implanted with term amnion also had some sprouted dopaminergic fibers and behavioral improvement, but these were limited and were similar to the recovery, in prior experiments using the same primate model of parkinsonism, of animals that received surgical cavitation only.
Recovery after central nervous system grafting with fetal amnion, a fetal accessory tissue, does not require secretion of a deficient neurotransmitter(s) from the graft and occurs despite the failure of graft survival. Recovery after cerebral implantation of fetal tissues appears to depend more on the regenerative and recuperative processes of the host brain than on graft replacement of deficient neurotransmitters or development of functional synaptic connections between the graft and the host brain.
Effect of hypoglycemia on postischemic cortical blood flow, hypercapnic reactivity, and interstitial adenosine concentration
Authors: Kim Young-Baeg , Gidday Jeffrey M. , Gonzales Ernesto R. , Shah Aarti R. , Park T. S. 
Published: May 2009

✓ Hypoglycemia increases the vulnerability of the perinatal brain to asphyxia, but it is not known if hypoglycemia-induced changes in cerebral hemodynamics and vascular reactivity underlie this vulnerability. This study tested the hypothesis that hypoglycemia exacerbates postischemic hypoperfusion, and impairs postischemic CO2reactivity. The authors also examined the hypothesis that postischemic hypoperfusion is associated with a reduction in the interstitial concentration of the vasodilator metabolite adenosine. Global cerebral ischemia of 10 minutes duration was induced in newborn pigs anesthetized with isoflurane by occlusion of subclavian and brachiocephalic arteries; cortical cerebral blood flow (CBF) and interstitial adenosine concentration were evaluated simultaneously using the combined hydrogen clearance/microdialysis technique. Hypoglycemia (blood glucose < 25 mg/dl) was induced by regular insulin (25 IU/kg) administered intravenously 2 hours prior to induction of ischemia. In the eight normoglycemic animals, baseline CBF was 38 ± 4 ml/min/100 gm and baseline adenosine concentration was 1.2 ± 0.1 µM; in the eight hypoglycemic animals, these values were 39% (p < 0.05) and 62% (p < 0.05) greater, respectively, under baseline conditions. At 1 hour of postischemic reperfusion in normoglycemic animals, CBF was reduced 39% relative to the preischemic baseline (p < 0.01), concomitant with a 27% reduction (p < 0.05) in adenosine concentration, suggesting that this lowered concentration may underlie delayed hypoperfusion.These postischemic reductions in CBF and interstitial adenosine concentration were significantly greater in hypoglycemic animals, with CBF and adenosine concentration reduced 70% (p < 0.001) and 71% (p < 0.01), respectively, relative to baseline. In nine animals preischemic reactivity to hypercapnia was unaffected by hypoglycemia. Postischemic hypercapnic reactivity was retained in the eight normoglycemic animals, but was attenuated 73% (p < 0.05) in hypoglycemic animals. Thus, in the newborn pig, hypoglycemia exacerbates postischemic cortical hypoperfusion and impairs postischemic cerebrovascular reactivity to hypercapnia.
Hemoglobin augmentation of interleukin-1β-induced production of nitric oxide in smooth-muscle cells
Authors: Suzuki Satoshi , Takenaka Katsunobu , Kassell Neal F. , Lee Kevin S. 
Published: May 2009

✓ The roles of hemoglobin (Hb) in the pathogenesis of cerebral vasospasm remain a matter of discussion. Hemoglobin is known to be released from extravasated red blood cells in a variety of pathological conditions, including subarachnoid hemorrhage. These conditions are often accompanied by infiltration of inflammatory cells and an associated release of multiple cytokines. Certain of these cytokines, including interleukin-1β (IL-1β), are capable of increasing nitric oxide (NO) production via the inducible form of nitric oxide synthase (NOS), and excessive NO production under these conditions may contribute to cellular dysfunction. This study further examines these questions by investigating the effects of Hb on the induction of NOS by IL-1β.The effects of Hb on IL-1β-induced NO production were examined in cultured smooth-muscle cells of rat aorta (RA-SMC's). Production of NO was estimated from the accumulation of nitrite, an oxidative product of NO, in the culture medium. The synthesis of NO was induced by IL-1β in a concentration-dependent manner. This activation of NO production was inhibited by: 1) a general inhibitor of NOS (Nω-nitro-L-arginine); 2) a protein synthesis inhibitor (cycloheximide); and 3) two selective inhibitors of the inducible form of NOS (hydrocortisone and aminoguanidine). These results suggest that IL-1β promotes the expression of the inducible form of NOS in RA-SMC's. The effects of Hb on NO production were tested by adding purified human Hb to the culture medium of the cells in both the presence and absence of IL-1β. Nitrite accumulation was slightly but significantly increased by Hb in the absence of IL-1β. In contrast, Hb markedly augmented nitrite accumulation induced by IL-1β. This augmentation persisted even after the removal of Hb from the culture medium. The number of cells was not affected by Hb or IL-1β.The findings demonstrate that Hb can modify cytokine-induced production of NO in RA-SMC's by increasing the inducible form of NOS. These observations suggest that Hb can also modify the action of inflammatory cells by facilitating NO production in target cells.
Characterization of local hyperfibrinolysis in chronic subdural hematomas by SDS-PAGE and immunoblot
Authors: Nomura Sadahiro , Kashiwagi Shiro , Fujisawa Hirosuke , Ito Haruhide , Nakamura Kazuyuki 
Published: May 2009

✓ Fibrinogen, fibrin monomer, and D dimer were analyzed in 41 cases of chronic subdural hematoma (SDH) to characterize local rebleeding, coagulation, and fibrinolysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. Chronic SDH's were divided into five groups according to their appearance on computerized tomography: high-density, isodensity, low-density, mixed-density, and layering types. The concentration of fibrinogen, which indicates rebleeding, was higher in the mixed-density (15.7 ± 3.4 mg/dl (mean ± standard error of the mean)) and layering (15.7 ± 2.6 mg/dl) types of hematoma, and lower in the low-density hematomas (1.4 ± 0.6 mg/dl) compared with the isodense hematomas (6.9 ± 1.1 mg/dl). Fibrin monomer, which indicates coagulative activity, had a distribution similar to that of fibrinogen: 87 ± 22, 18 ± 8, 175 ± 40, and 177 ± 23 µg/ml in isodense, low and mixed-density, and layering types of hematomas, respectively. The D dimer, which indicates fibrinolytic activity, was higher in the layering hematoma type (2032 ± 384 µg/ml), and lower in low-density hematomas (301 ± 164 µg/ml) compared to isodense (1310 ± 256 µg/ml) and mixed-density (1039 ± 207 µg/ml) types of hematomas.
These observations suggest the following characterization of each type of chronic SDH. The layering type is active, with a high tendency to rebleed and for hyperfibrinolytic activity. The mixed-density type has a high tendency to rebleed with lower hyperfibrinolytic activity than the layering type. The low-density hematoma is stable with a low tendency to rebleed and to fibrinolytic activity.
Macroscopic and microscopic study of the mandibular salivary gland of Black Bengal goats
Authors: Rauf SMA , Islam MR , Anam MK 
Published: May 2009

The gross anatomy and microscopic structures of the mandibular salivary gland of 15 Black Bengal goats of either sex and different ages were carried out during the period from January 1999 to December 2000. The mandibular salivary gland was irregularly triangular in shape and was situated ventral and caudal part of the angle of the mandible and partly covered by the ventral part of the parotid gland. The gland was cream colored in fresh condition and the lobules were coarser and less compact in texture. The Â Â mandibular duct left the gland near the middle of the cranio-dorsal border and opened into the caruncula sublingualis with the sublingual duct in common. The average length of the duct was 11 cm. The branches of external carotid, lingual and occipital arteries supplied the mandibular salivary gland. The mandibular gland was drained by the lingofacial and lingiual veins and occasionally by the laryngeal vein. It was mixed tubulo-alveolar gland and consisted to numerous lobes and lobules; supported by connective tissue capsule. The mixed alveoli were more than the isolated serous and mucous alveoli.Key words: Mandibular salivary gland; macroscopic, microscopic; Black Bengal goatsdoi: 10.3329/bjvm.v2i2.2556Bangl. J. Vet. Med. (2004). 2 (2): 137-142