bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion-tensor imaging—guided tracking of fibers of the pyramidal tract combined with intraoperative cortical stimulation mapping in patients with gliomas
Authors: Berman Jeffrey I. , Berger Mitchel S. , Mukherjee Pratik , Henry Roland G. 
Published: May 2009

Object. The goal of this study was to use diffusion-tensor (DT) magnetic resonance (MR) imaging to track fibers combined with cortical stimulation mapping to delineate descending motor pathways. Subcortical localization of motor pathways in relation to a glioma may provide critical information to guide tumor resection and prevent surgical morbidity.
Methods. Eleven adult patients harboring gliomas underwent MR imaging 1 day prior to image-guided intraoperative cortical motor mapping and tumor resection. Screens depicting 27 cortical motor sites on a surgical navigation system were saved to launch DT imaging of fiber tracks of descending motor pathways. The position and organization of motor tracts were visualized by fiber tracking. Tracks from 16 motor stimulation sites followed descending pathways from the precentral gyrus, through the corona radiata and internal capsule, and into the cerebral peduncle. These tracks were also observed on DT images to diverge along crossing white matter bundles (four patients) and to terminate or deviate in regions of peritumoral vasogenic edema (five patients).
Conclusions. The use of precise intraoperative cortical mapping information and DT images of fiber tracks can reveal the course of motor pathways beneath the cortex. The subcortical fiber tracks generated are consistent with the known anatomical course and somatotopic organization of the motor tract in relation to its cortical origins. Tracking fibers by using DT imaging in combination with functional localization has the potential to reduce surgical morbidity by revealing subcortical connections of the functional cortex.
Capillary hemangioma of the central nervous system
Authors: Abe Masamitsu , Tabuchi Kazuo , Tanaka Shin , Hodozuka Akira , Kunishio Katsuzo , Kubo Naohiko , Nishimura Yukimasa 
Published: May 2009

Object. Capillary hemangiomas are benign tumors or tumorlike lesions that originate from blood vessels and have rarely been reported to develop in the brain or spinal cord. The authors summarize the clinical and histological features of capillary hemangiomas of the central nervous system (CNS).
Methods. The clinical features, imaging characteristics, and outcomes in 10 patients with CNS capillary hemangiomas were reviewed. Histological studies included immunostaining with CD31, α-smooth muscle actin, vascular endothelial growth factor, and Ki-67 antigen. Three patients with lesions in the brain presented with symptoms of increased intracranial pressure or seizures. Seven patients with lesions in the spinal cord presented with progressive sensorimotor disturbances of the lower limbs. Computerized tomography and magnetic resonance imaging demonstrated well-defined, enhancing lesions associated with marked perifocal edema. Angiography demonstrated hypervascular lesions, which have not recurred after resection. In two cases, multiple satellite lesions resolved after the systemic administration of steroid drugs or interferon-α. Histologically, all lesions were consistent with findings of capillary hemangioma of the skin or soft tissues. The CNS lesions differed significantly from other vascular neoplasms, such as hemangioendotheliomas, hemangiopericytomas, and hemangioblastomas.
Conclusions. Capillary hemangiomas of the CNS are benign lesions that can be surgically removed and cured without adjuvant therapy.
Prospective risk of hemorrhage in patients with vertebrobasilar nonsaccular intracranial aneurysm
Authors: Flemming Kelly D. , Wiebers David O. , Brown Robert D. , Link Michael J. , Nakatomi Hirofumi , Huston John , McClelland Robyn , Christianson Teresa J. H. 
Published: May 2009

Object. Nonsaccular intracranial aneurysms (NIAs) are characterized by dilation, elongation, and tortuosity of intracranial arteries. Dilemmas in management exist due to the limited regarding the natural history of this disease entity. The objective of this study was to determine the prospective risk of subarachnoid hemorrhage (SAH) in patients with vertebrobasilar NIAs.
Methods. All patients with vertebrobasilar fusiform or dolichoectatic aneurysms that had been radiographically demonstrated between 1989 and 2001 were identified. These patients' medical records were retrospectively reviewed. A prospective follow-up survey was sent and death certificates were requested. Based on results of neuroimaging studies, the maximal diameter of the involved artery, presence of SAH, and measurements of arterial tortuosity were recorded. Nonsaccular intracranial aneurysms were classified according to their radiographic appearance: fusiform, dolichoectatic, and transitional. Dissecting aneurysms were excluded. The aneurysm rupture rate was calculated based on person-years of follow up. Predictive factors for rupture were evaluated using univariate analysis (p < 0.05). One hundred fifty-nine patients, 74% of whom were men, were identified. The mean age at diagnosis was 64 years (range 20–87 years). Five patients (3%) initially presented with hemorrhage; four of these patients died during follow up. The mean duration of follow up was 4.4 years (692 person-years). Nine patients (6%) experienced hemorrhage after presentation; six hemorrhages were definitely related to the NIA. The prospective annual rupture rate was 0.9% (six patients/692 person-years) overall and 2.3% in those with transitional or fusiform aneurysm subtypes. Evidence of aneurysm enlargement or transitional type of NIA was a significant predictor of lesion rupture. Six patients died within 1 week of experiencing lesion rupture.
Conclusions. Risk of hemorrhage in patients harboring vertebrobasilar NIAs is more common in those with evidence of aneurysm enlargement or a transitional type of aneurysm and carries a significant risk of death.
Prevention of vasospasm by anti-CD11/CD18 monoclonal antibody therapy following subarachnoid hemorrhage in rabbits
Authors: Pradilla Gustavo , Wang Paul P. , Legnani Federico G. , Ogata Lynn , Dietsch Gregory N. , Tamargo Rafael J. 
Published: May 2009

Object.Adhesion of leukocytes and their migration into the periadventitial space may be critical in the pathophysiology of vasospasm following subarachnoid hemorrhage (SAH). The cell adhesion molecules involved in this process are lymphocyte function—associated antigen—1 (CD11a/CD18) and macrophage antigen—1 (CD11b/CD18), which are present on neutrophils/macrophages, and intercellular adhesion molecule—1 (CD54), which is present in endothelial cells. A humanized monoclonal antibody (mAb), Hu23F2G, targets CD11/CD18 and prevents leukocyte adhesion to endothelial cells. In this study, systemic administration of Hu23F2G prevented vasospasm in the rabbit model of SAH.Methods.Twenty-six New Zealand White rabbits were injected with autologous blood into the cisterna magna to induce SAH, after which they were randomized to receive injections of either Hu23F2G (10 animals) or a placebo at 30 minutes and 24 and 48 hours after SAH (six animals). Control animals underwent sham operations (four animals) or SAH alone (six animals). The animals were killed 72 hours after SAH, their bodies perfused and fixed, and their basilar arteries processed for morphometric analysis. Peripheral white blood cells (WBCs) were counted at 72 hours. The percentages of lumen patency were compared using the Student t-test. The presence of neutrophils and macrophages was confirmed by immunohistochemical analysis in which a rat anti—rabbit anti-CD18 mAb and cresyl violet were used.Treatment with Hu23F2G resulted in the significant prevention of vasospasm. Animals treated with Hu23F2G had 90 ± 7% lumen patency compared with 65 ± 7% in the placebo group (p = 0.025). The percentage of lumen patency in the SAH-only group was 59 ± 10%. The mean WBC count was 16,300 ± 2710/µl in the treatment group, compared with 7000 ± 386/µl in the control group (p = 0.02). Administration of Hu23F2G produced increased numbers of WBCs in 70% of the animals treated.Conclusions.This study supports the concept that leukocyte—endothelial cell interactions play an important role in the pathophysiology of chronic vasospasm after SAH. Systemic therapy with an anti-CD11/CD18 mAb prevents vasospasm after SAH by inhibiting adhesion of neutrophils and macrophages and their migration into the periadventitial space.
Bifurcation geometry and the presence of cerebral artery aneurysms
Authors: Ingebrigtsen Tor , Morgan Michael K. , Faulder Ken , Ingebrigtsen Linda , Sparr Trygve , Schirmer Henrik 
Published: May 2009

Object. The angles of arterial bifurcations are governed by principles of work minimization (optimality principle). This determines the relationship between the angle of a bifurcation and the radii of the vessels. Nevertheless, the model is predicated on an absence of significant communication between these branches. The circle of Willis changes this relationship because the vessels proximal to the ring of vessels have additional factors that determine work minimization compared with more distal branches. This must have an impact on understanding of the relationship between shear stress and aneurysm formation. The authors hypothesized that normal bifurcations of cerebral arteries beyond the circle of Willis would follow optimality principles of minimum work and that the presence of aneurysms would be associated with deviations from optimum bifurcation geometry. Nevertheless, the vessels participating in (or immediately proximal to) the circle of Willis may not follow the geometric model as it is generally applied and this must also be investigated.
Methods. One hundred seven bifurcations of the middle cerebral artery (MCA), distal internal carotid artery (ICA), and basilar artery (BA) were studied in 55 patients. The authors analyzed three-dimensional reconstructions of digital subtraction angiography images with respect to vessel radii and bifurcation angles. The junction exponent (that is, a calculated measure of the division of flow at the bifurcation) and the difference between the predicted optimal and observed branch angles were used as measures of deviation from the geometry thought best to minimize work.
The mean junction exponent for MCA bifurcations was 2.9 ± 1.2 (mean ± standard deviation [SD]), which is close to the theoretical optimum of 3, but it was significantly smaller (p < 0.001; 1.7 ± 0.8, mean ± SD) for distal ICA bifurcations. In a multilevel multivariate logistic regression analysis, only the observed branch angles were significant independent predictors for the presence of an aneurysm. The odds ratio (OR) (95% confidence interval) for the presence of an aneurysm was 3.46 (1.02–11.74) between the lowest and highest tertile of the observed angle between the parent vessel and the largest branch. The corresponding OR for the smallest branch was 48.06 (9.7–238.2).
Conclusions. The bifurcation beyond the circle of Willis (that is, the MCA) closely approximated optimality principles, whereas the bifurcations within the circle of Willis (that is, the distal ICA and BA) did not. This indicates that the confluence of hemodynamic forces plays an important role in the distribution of work at bifurcations within the circle of Willis. In addition, the observed branch angles were predictors for the presence of aneurysms.
Enhancement of C2-ceramide antitumor activity by small interfering RNA on X chromosome—linked inhibitor of apoptosis protein in resistant human glioma cells
Authors: Hatano Manabu , Mizuno Masaaki , Yoshida Jun 
Published: May 2009

Object. Many human glioma cells are resistant to ceramide. In this study the authors investigated the mechanisms of that resistance and considered ways to overcome it.
Methods. The authors first administered C2-ceramide (N-acetylsphingosine) to human glioma cells from rare cell lines susceptible to C2-ceramide (SKMG1 and U87MG) and other cell lines resistant to it (U251SP, T98G, SKAO2, and U251MG). Following this, the authors analyzed the statuses of transduction signals such as cell viability, morphological changes, caspases, mitochondrial membrane potential, apoptosis-inducing factor, oligonucleosomal DNA fragmentation, and the inhibitor of apoptosis protein (IAP) family.
Conclusions. Ceramide resistance was found to arise from the inhibition of caspase-7 induced by IAPs, especially X chromosome—linked IAP (XIAP). Small interfering RNA (siRNA) on XIAP quenched that resistance in ceramide-resistant human glioma cells (U251SP, T98G, SKAO2, U251MG), indicating that a siRNA for XIAP may be a useful tool for overcoming the resistance to ceramide in human glioma cells.
Effects of aminoguanidine and l-arginine methyl ester resuscitation following induction of fluid percussion injury and severe controlled hemorrhagic shock in the rat brain
Authors: Atan Md Shirhan , Moochhala Shabbir M. , Ng Kian Chye , Low Kerwin , Teo Ai Ling , Lu Jia 
Published: May 2009

Object.In this study the authors compared the effects of both a selective inducible nitric oxide synthase (iNOS) inhibitor and a nonselective inhibitor on posttraumatic recovery and neuron survival by using a combined model of lateral fluid percussion injury (FPI) and hemorrhagic shock (HS).Methods.Male Sprague—Dawley rats weighing 300 to 350 g underwent FPI to the brain (3.5 atm) and hemorrhage to a mean arterial blood pressure (MABP) of 40 mm Hg for 1 hour. Rats were then resuscitated during 1 hour with bolus infusions of aminoguanidine (AG) or nitro-l-arginine methyl ester (l-NAME). Neuronal apoptosis was determined by performing Nissl staining and in situ terminal deoxynucleotidyl transferase—mediated deoxyuridine triphosphate nick-end labeling technique. Rats infused with AG showed a significant increase in mean survival time and cerebral tissue perfusion, although the MABP and nitrate/nitrite levels did not significantly change compared with those inl-NAME—treated rats even though both animal groups had been subjected to combined FPI and HS, FPI alone, or HS alone. Furthermore, infusion of AG also significantly decreased the number of apoptotic neurons when compared with the number in rats treated withl-NAME.Conclusions.The authors asserted that treatment with AG, which causes the inhibition of iNOS, might contribute to improved physiological parameters and neuronal cell survival following FPI and HS.
Pulsed holmium:yttrium-aluminum-garnet laser—induced liquid jet as a novel dissection device in neuroendoscopic surgery
Authors: Nakagawa Atsuhiro , Hirano Takayuki , Jokura Hidefumi , Uenohara Hiroshi , Ohki Tomohiro , Hashimoto Tokitada , Menezes Viren , Sato Yasuhiko , Kusaka Yasuko , Ohyama Hideki , Saito Tsutomu , Takayama Kazuyoshi , Shirane Reizo , Tominaga Teiji 
Published: May 2009

Object.A pressure-driven continuous jet of water has been reported to be a feasible tool for neuroendoscopic dissection owing to its superiority at selective tissue dissection in the absence of thermal effects. With respect to a safe, accurate dissection, however, continuous water flow may not be suitable for intraventricular use. The authors performed experiments aimed at solving problems associated with continuous flow by using a pulsed holmium:yttrium-aluminum-garnet (Ho:YAG) laser-induced liquid jet (LILJ). They present this candidate neuroendoscopic LILJ dissection system, having examined its mechanical characteristics and evaluated its controllability both in a tissue phantom and in a rabbit cadaveric ventricle wall.Methods.The LILJ generator was incorporated into the tip of a No. 4 French catheter so that the LILJ could be delivered via a neuroendoscope. Briefly, the LILJ was generated by irradiating an internally supplied column of physiological saline with a pulsed Ho:YAG laser (pulse duration time 350 µsec; laser energy 250–700 mJ/pulse) within a No. 4 French catheter (internal diameter 1 mm) and ejecting it from a metal nozzle (internal diameter 100 µm). The Ho:YAG laser energy pulses were conveyed by an optical fiber (core diameter 400 µm) at 3 Hz, whereas physiological saline (4°C) was supplied at a rate of 40 ml/hour. The mechanical characteristics of the pulsed LILJ were investigated using high-speed photography and pressure measurements; thermal effects and controllability were analyzed using an artificial tissue model (10% gelatin of 1 mm thickness). Finally, the ventricle wall of a rabbit cadaver was dissected using the LILJ.Jet pressure increased in accordance with laser energy from 0.1 to 2 bar; this translated into a penetration depth of 0.08 to 0.9 mm per shot in the ventricle wall of the rabbit cadaver. The gelatin phantom could be cut into the desired shape without significant thermal effects and in the intended manner, with a good surgical view.Conclusions.The present results show that the pulsed LILJ has the potential to become a safe and reliable dissecting method for endoscopic procedures.
Deep brain stimulation for dystonia confirming a somatotopic organization in the globus pallidus internus
Authors: Vayssiere Nathalie , van der Gaag Niels , Cif Laura , Hemm Simone , Verdier Regis , Frerebeau Philippe , Coubes Philippe 
Published: May 2009

Object. In patients with dystonia, symptoms vary greatly in their extent and severity. The efficacy of pallidal stimulation is now established, but an interindividual variability in the responses to this treatment exists. A retrospective analysis of postoperative magnetic resonance (MR) images demonstrated millimetric variations in the positions of electrode contacts inside the posterolateroventral portion of the globus pallidus internus (GPi). It therefore seemed very likely that there is a somatotopic organization within the GPi. The goal of this study was to examine the positions of specific electrode contacts according to patients' clinical evolution, so that a somatotopic organization within the GPi could be defined.
Methods. This study included 19 patients (17 of whom were right handed) with generalized dystonia who were treated by bilateral stimulation of the GPi. Patients were examined pre- and postoperatively by using the Burke-Fahn-Marsden Dystonia Rating Scale. Dividing the patient's body into three parts—cervicoaxial area, superior limb, and inferior limb—we determined the following: 1) where the dystonic symptoms started; 2) where symptoms predominated at the time of surgery; and 3) where the highest postoperative improvement was observed.
Variations in clinical response were correlated to the positions of the electrode contacts. All activated electrode contacts were in the posterolateroventral portion of the GPi (Laitinen target). A correlation between the contact location measured longitudinally and the part of the body in which the highest improvement was observed (three different areas; p = 0.004) showed that a location more anterior for the inferior limb and one more posterior for the superior limb were delineated for the right side, but not for the left side.
Conclusions. Inside the posterolateroventral subvolume of the GPi on the right side, three statistically different locations of electrode contacts were determined to be primary deep brain stimulation treatment sites for particular body parts in cases of dystonia.
Influence of apoptosis on neurological outcome following traumatic cerebral contusion
Authors: Nathoo Narendra , Narotam Pradeep K. , Agrawal Devendra K. , Connolly Catherine A. , van Dellen James R. , Barnett Gene H. , Chetty Runjan 
Published: May 2009

Object. Apoptosis has increasingly been implicated in the pathobiology of traumatic brain injury (TBI). The present study was undertaken to confirm the presence of apoptosis in the periischemic zone (PIZ) of traumatic cerebral contusions and to determine the role of apoptosis, if any, in neurological outcome.
Methods. Brain tissue harvested at Wentworth Hospital from the PIZ in 29 patients with traumatic supratentorial contusions was compared with brain tissue resected in patients with epilepsy. Immunohistochemical analyses were performed on the tissues to see if they contained the apoptosis-related proteins p53, bcl-2, bax, and caspase-3. The findings were then correlated to demographic, clinical, surgical, neuroimaging, and outcome data.
In the PIZ significant increases of bax (18-fold; p < 0.005) and caspase-3 (20-fold; p < 0.005) were recorded, whereas bcl-2 was upregulated in only 14 patients (48.3%; 2.9-fold increase) compared with control tissue. Patients in the bcl-2—positive group exhibited improved outcomes at the 18-month follow-up examination despite an older mean age and lower mean admission Glasgow Coma Scale score (p < 0.03). Caspase-3 immunostaining was increased in those patients who died (Glasgow Outcome Scale [GOS] Score 1, 12 patients) when compared with those who experienced a good outcome (GOS Score 4 or 5, 17 patients) (p < 0.005). Regression analysis identified bcl-2—negative status (p < 0.04, odds ratio [OR] 5.5; 95% confidence interval [CI] 1.1–28.4) and caspase-3—positive status (p < 0.01, OR 1.4, 95% CI 1.1—1.8) as independent predictors of poor outcome. No immunostaining for p53 was recorded in the TBI specimens.
Conclusions. The present findings confirm apoptosis in the PIZ of traumatic cerebral contusions and indicate that this form of cell death can influence neurological outcome following a TBI.
Localization of hand sensory function to the pli de passage moyen of Broca
Authors: Boling Warren W. , Olivier André 
Published: May 2009

Object. The goal of this study was to identify a reliable landmark for hand sensory function in the central area.
Methods. Hand sensory activation on positron emission tomography (PET) scans was analyzed in 27 patients. Each PET study was coregistered with the patient's magnetic resonance image and analyzed in two-dimensional and three-dimensional cortical surface reconstructions to define anatomicofunctional relationships.
Conclusions. The substratum of hand sensory function is a prominent fold of cortex elevating the floor of the central sulcus and connecting the pre- and postcentral gyri. Broca named this cortical fold the pli de passage moyen, and hand motor function has been localized to the precentral component of this structure. In this study the authors demonstrate that hand sensory function is highly correlated with the postcentral component of the pli de passage moyen, and that this structure is a reliable cortical landmark for identifying the aforementioned function.