bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave
Authors: Hausfater Pierre , Doumenc Benoît , Chopin Sébastien , Le Manach Yannick , Santin Aline , Dautheville Sandrine , Patzak Anabela , Hericord Philippe , Mégarbane Bruno , Andronikof Marc , Terbaoui Nabila , Riou Bruno 
Published: May 2010

Abstract
Introduction
The prognostic value of cardiac troponin I (cTnI) in patients having a heat-related illness during a heat wave has been poorly documented.

Methods
In a post hoc analysis, we evaluated 514 patients admitted to emergency departments during the August 2003 heat wave in Paris, having a core temperature >38.5°C and who had analysis of cTnI levels. cTnI was considered as normal, moderately elevated (abnormality threshold to 1.5 ng.mL-1), or severely elevated (>1.5 ng.mL-1). Patients were classified according to our previously described risk score (high, intermediate, and low-risk of death).

Results
Mean age was 84 ± 12 years, mean body temperature 40.3 ± 1.2°C. cTnI was moderately elevated in 165 (32%) and severely elevated in 97 (19%) patients. One-year survival was significantly decreased in patients with moderate or severe increase in cTnI (24 and 46% vs 58%, all P < 0.05). Using logistic regression, four independent variables were associated with an elevated cTnI: previous coronary artery disease, Glasgow coma scale <12, serum creatinine >120 μmol.L-1, and heart rate >110 bpm. Using Cox regression, only severely elevated cTnI was an independent prognostic factor (hazard ratio 1.93, 95% confidence interval 1.35 to 2.77) when risk score was taken into account. One-year survival was decreased in patients with elevated cTnI only in high risk patients (17 vs 31%, P = 0.04).

Conclusions
cTnI is frequently elevated in patients with non-exertional heat-related illnesses during a heat wave and is an independent risk factor only in high risk patients where severe increase (>1.5 ng.mL-1) indicates severe myocardial damage.
Methylprednisolone Treatment in Patients with Brain Tumors
Authors: Miller J.D. , Sakalas R. , Ward J.D. , Young H.F. , Adams W.E. , Vries J.K. , Becker D.P. 
Published: May 2010

Abstract
A study was made in 10 patients with brain tumors of the effect of methylprednisolone sodium succinate (Solu-Medrol) on clinical neurological status, intracranial pressure, and periventricular elastance. Significant clinical improvement and reduction in periventricular elastance both occurred within 24 hours of starting treatment, whereas intracranial pressure was not significantly reduced until the 2nd day of therapy.
Lumbar Disc Disease in Children
Authors: Garrido Eddy , Humphreys Robin P. , Hendrick Bruce E. , Hoffman Harold J. 
Published: May 2010

Abstract
The clinical experience with lumbar disc disease in 38 patients at a large children's hospital is reviewed. Thirty children underwent surgical treatment; eight patients were not operated upon. The surgical results were excellent, with 93% of the children cured or markedly improved on follow-up. The main differential aspects of lumbar disc disease between children and adults are emphasized.
Subdural Hygroma of the Spinal Meninges
Authors: Black Peter McL. , Zervas Nicholas T. , Caplan Louis R. , Ramirez Lincoln F. 
Published: May 2010

Abstract
A case of a subdural hygroma or chronic subdural hematoma of the thoracolumbar spinal meninges is described. This became symptomatic 9 years after trauma. Terminological ambiguity is discussed, along with the detailed clinical, radiological, and operative presentations of this rare condition.
Endoscopic Biopsy of Intraventricular Tumors with the Use of a Ventriculofiberscope
Authors: Fukushima Takanori 
Published: May 2010

Abstract
The results of endoscopic biopsy in 21 cases of intraventricular tumor are presented. The details of the equipment are given. Of the 21 tumors biopsied, there were 9 in the lateral ventricle, 2 in the thalamus, 6 in the anterior portion of the 3rd ventricle, and 4 in the pineal region. A correct histological diagnosis was made in 11 cases (52.4%). No serious complications were noted. The value of the procedure is discussed.
Large Decompressive Craniotomy in the Treatment of Acute Subdural Hematoma
Authors: Britt Richard H. , Hamilton Richard D. 
Published: May 2010

Abstract
A series of 42 patients who had large decompressive craniotomies for acute subdural hematoma has been reviewed with regard to long term results. Postoperative mortality (within 30 days of surgery) was 36%. Delayed but related deaths accounted for an additional 19% mortality, for a total mortality of 55%. Fourteen patients (33%) were able to return home, but there was a significant morbidity in terms of intellectual impairment, hemiparesis, and dysphasia. Recommended management includes establishment of an adequate airway, intravenous administration of mannitol, and performance of an emergency computerized tomographic (CT) scan before operation. A large decompressive craniotomy is performed, with removal of the blood clot, establishment of hemostasis, patch-grafting of the dura, and removal of the bone flap to allow the edematous, swollen brain to expand away from the brain stem. The mortality and morbidity will probably always remain high because in the majority of the cases significant structural damage to the cortical and brain stem structures occurs at the time of the injury.
Stereotactic Localization (with Computerized Tomographic Scanning), Biopsy, and Radiofrequency Treatment of Deep Brain Lesions
Authors: Gleason Curtis A. , Wise Burton L. , Feinstein Bertram 
Published: May 2010

Abstract
In eight patients stereotactic biopsy of deep brain lesions was performed. Adequate tissue was obtained, and the information helped considerably in planning further therapy. No significant complications occurred in these patients. In three of the cases, the stereotactic coordinates were determined from the computerized tomographic (CT) scan. In one patient, after biopsy, stereotactic radiofrequency (RF) lesions in the tumor resulted in temporary improvement.
Eight-Year Follow-up of Experimental Carotid-Middle Cerebral and Carotid-Basilar Arterial Bypass Grafts and Anastomoses
Authors: Khodadad G. 
Published: May 2010

Abstract
Fifty-one dogs were operated upon, and various microvascular bypass grafts and anastomoses were completed. Seventeen of these dogs were followed for 5 to 8 years. Of these, three had a carotid-middle cerebral arterial bypass graft, five had a carotid-basilar arterial bypass graft, five had a lingual-basilar anastomosis, and four had a sublingualbasilar anastomosis. Postoperative carotid angiograms showed patent grafts and anastomoses in all of the dogs. Except for slight to moderate enlargement of the donor artery in the lingual and sublingual-basilar anastomoses or minor irregularities in the carotid-middle cerebral and carotid-basilar arterial bypass grafts, no significant changes were noted. In five dogs with lingual-basilar anastomoses in which both internal carotid arteries were ligated, the mean blood flow of the lingual artery was increased to 1.1 to 2.4 times normal. This study shows that, when experimental arterial bypass grafts and anastomoses remain patent for a few weeks after the operation, they stay patent for years, and, depending on the need, the blood flow through the anastomosis may increase.
Trans-sphenoidal Removal of a Rathke's Cleft Cyst
Authors: Martinez Lucas J. , Osterholm Jewell L. , Berry Richard G. , Lee Francis K. , Schatz Norman J. 
Published: May 2010

Abstract
Symptomatic Rathke's cleft cysts are uncommon. We present a case with suprasellar extension manifested by hypopituitarism and visual disturbances. The treatment was trans-sphenoidal evacuation and partial removal of the capsule. We suggest that the trans-sphenoidal approach to these lesions is usually adequate and that radical removal of the capsule is not necessary.
Electrophysiological Assessment of Spinal Circuits in Spasticity by Direct Dorsal Root Stimulation
Authors: Fasano Victor Aldo , Barolat-Romana Giancarlo , Zeme Sergio , Sguazzi Angelo 
Published: May 2010

Abstract
Experimental researchers have shown that, because of normal inhibitory processes, repetitive orthodromic stimulation of the dorsal spinal roots induces a depression of the reflex discharge in the spinal motoneurons that is a function of the stimulation rate. Because a lack of inhibitory processes is considered to be the basic mechanism of spasticity, intraoperative stimulation of dorsal spinal roots from L-1 to S-1 bilaterally was performed in 80 patients affected by cerebral palsy. In these patients spasticity (exaggerated stretch reflexes, marked increase of proprioceptive reflexes, and clonus) was the main symptom. We stimulated the dorsal roots adjacent to the spinal cord and recorded motor responses by electromyogram (EMG) in the corresponding muscle groups. The most important findings were that: (a) variable inhibition (diminished, increased, or normal) was encountered in the spinal circuits of the spastic patient; and (b) the individual roots and rootlets can have different effects upon segmentary output. The absence of normal inhibitory processes was the most common finding; surgical sectioning of the corresponding roots resulted in immediate reduction in muscle tone in the related muscles. Selecting the dorsal roots for section results in a remarkable reduction of negative side effects that may follow total or random rhizotomy (marked hypotonia, ataxia, sensory defects) and of the percentage of late recurrences. This procedure results in additional positive effects at segmentary and suprasegmentary levels. These results confirm the idea that the basic mechanism of spasticity is a central defect in the traffic regulation of peripheral afferents as they are transmitted to the spinal cord. This defect causes segmentary and suprasegmentary adaptive reactions that extend the negative outcome of the local increase of muscle tone.
Alexia without Agraphia in a Musician after Transcallosal Removal of a Left Intraventricular Meningioma
Authors: Levin Harvey S. , Rose James E. 
Published: May 2010

Abstract
After a meningioma situated in the trigone of the left lateral ventricle was excised by the transcallosal approach of Kempe and Blaylock, a right-handed musician with a right hemianopsia developed alexia without agraphia. In contrast to previously reported cases of this syndrome arising from other etiologies, he was unable to read single letters or numbers. Neuropsychological studies at 42 and 126 days after operation also disclosed an inability to associate auditory or tactile stimuli with visually perceived material, whereas speech and verbal comprehension were intact. Although the alexia extended to musical notes, he could interpret other musical symbols (e.g., treble clef). Appreciation of rhythm and expressive musical ability were relatively preserved, although judgment of other musical features (including discrimination of pitch, duration, and loudness) was compromised. The findings suggest that alexia may occur as a consequence of the transcallosal procedure when a right hemianopsia is present. However, other linguistic abilities may be better preserved by the transcallosal approach to the ventricle than by a transcortical operation.
Diencephalic Syndrome and Its Relation to Opticochiasmatic Glioma
Authors: DeSousa Alonso L. , Kalsbeck John E. , Mealey John , Fitzgerald Joseph 
Published: May 2010

Abstract
This report, which includes 12 cases of opticochiasmatic glioma with diencephalic syndrome, is a 22-year review of such cases at Indiana University Medical Center. These patients were initially seen because of their failure to thrive, and all were without significant subcutaneous fat. All had pneumoencephalography or ventriculography that showed a suprasellar mass displacing the anterior 3rd ventricle. Surgical confirmation of the diagnosis was obtained in every case. Ten patients underwent radiotherapy with subsequent reversal of the diencephalic syndrome.
Peripheral Nerve Injection Injury
Authors: Gentili Fred , Hudson Alan , Kline David G. , Hunter Dan 
Published: May 2010

Abstract
In an attempt to answer questions regarding nerve injection injuries, we injected 11 agents in current use and commonly administered by intramuscular injection into the sciatic nerves of adult Wistar rats. Equal volumes of normal saline were used as control. We harvested the sciatic nerves at various times after injection and examined them by both light and electron microscopy. We performed myelinated nerve fiber counts and constructed histograms. Any impairment of motor function was also noted. We gave injections to 79 animals a total of 158 times; 116 injections were directly into the nerve fascicle (intrafascicular) and 42 were into the epineural tissue (extrafascicular). The results revealed considerable variation in the degree of nerve fiber injury according to the agent injected. Minimal damage resulted from the injection of irondextran. meperidine, and cephalothin, and maximal nerve injury followed the injection of penicillin, diazepam, and chlorpromazine. The site of injection was crucial. Intrafascicular injection was invariably associated with severe nerve injury, but, with few exceptions, extrafascicular injection resulted in minimal damage. The quantity of drug injected was also important in determining the degree of injury. Large, heavily myelinated fibers were more susceptible to injection injury than smaller, thinly myelinated nerve fibers. The effect of the injected drug seemed to be related to injury of the nerve fiber unit—both the axon and the Schwann cell with its myelin sheath. Regeneration in damaged nerves was a constant finding; even the most severely injured nerves, with total axonal degeneration, underwent subsequent regeneration.
Osteochondroma of the Cervical Spine
Authors: MacGee Edwin E. 
Published: May 2010

Abstract
A 16-year-old girl presented with the sudden onset of transient quadriplegia that occurred while she was swimming. Roentgenograms showed abnormal intraspinal calcification. A computerized tomographic scan was virtually diagnostic of a solitary osteochondroma arising from the posterior arch of the atlas. Surgical excision was curative.
Intraoperative Monitoring of Facial Muscle Evoked Responses Obtained by Intracranial Stimulation of the Facial Nerve
Authors: Delgado Tomas E. , Buchheit William A. , Rosenholtz Henry R. , Chrissian Shavarash 
Published: May 2010

abstract
Total microsurgical removal of 14 acoustic neuromas greater than 2 cm in diameter was performed through a unilateral suboccipital approach. Precise quantitative intracranial stimulation of the 7th nerve and recording of the evoked responses of the facial muscles were used to improve the identification and facilitate the dissection of the facial nerve. Preoperative evaluations, techniques, and results are discussed.
Neurofibromatosis and Optic Glioma
Authors: Stern Jack , DiGiacinto George V. , Housepian Edgar M. 
Published: May 2010

abstract
Although an association between optic glioma and neurofibromatosis is well recognized, there has been no previous analysis of cases relating the locus of tumor to the presence or absence of von Recklinghausen's disease. This paper presents the results of such an analysis as well as a description of the comparative histology of optic gliomas in patients with and without neurofibromatosis. We conclude that optic gliomas in patients with neurofibromatosis present preferentially as multicentric lesions or as lesions affecting the optic nerve alone without invasion of the chiasm, that these tumors frequently differ morphologically, and that patients with neurofibromatosis and optic glioma may have a clinical course different from that of patients with optic glioma unassociated with neurofibromatosis. Previously published reports are reviewed in light of these observations.
Visual Evoked Potentials
Authors: Sklar Frederick H. , Ehle Albert L. , Clark Kemp W. 
Published: May 2010

abstract
Visual evoked potentials (VEPs) to repetitive flash stimuli were abnormal in 10 patients with documented hydrocephalus. Abnormalities included latency delays, fatigability, and asymmetries. Both latency and wave form disturbances improved in the postshunt period. Clinical progression of the hydrocephalus occurred in several patients, and this correlated well with worsening of the VEPs. We suggest that this noninvasive technique may be valuable in following patients with cerebrospinal fluid shunts, patients with presumed “arrested” hydrocephalus, and patients who are being weaned from their shunts.
Radionuclide Cerebral Angiography and the Timing of Aneurysm Surgery
Authors: Kelly P.J. , Gorten R.J. , Rose J.E. , Grossman R.G. , Eisenberg H.M. 
Published: May 2010

Abstract
Forty-five patients with subarachnoid hemorrhage due to verified intracranial aneurysms were studied prospectively to determine whether delaying operations in those patients with abnormal cerebral perfusion, assessed by radionuclide dynamic scanning, would lower case management mortality. Twenty-nine patients had intracranial operations when their radionuclide dynamic scans demonstrated normal perfusion. The one death in this group occurred in a patient who suffered a massive hemorrhage during operation as the bone flap was elevated. There were no instances of delayed spasm after operation. Of the 16 remaining patients who were treated without operation, 5 died. Only 1 of these deaths resulted from recurrent hemorrhage. This patient had normal cerebral perfusion but was not operated upon because of severe associated medical problems. Cerebral infarction occurred in 10 of the 16 unoperated patients, all of whom had persistently decreased cerebral perfusion. Four of these patients died of their infarctions or related causes. Although a trend related vessel caliber as seen on arteriograms and perfusion delay seen on dynamic scanning, individual exceptions were numerous. This study shows that radionuclide scanning, a safe procedure, is useful for identifying two types of patients: those with normal perfusion prone to rebleeding in whom an early operation is safe and those in whom perfusion is decreased. The latter group is prone to cerebral infarction, but rebleeding from the aneurysm is unlikely. Operation should be delayed in these patients until cerebral perfusion returns to normal or for several weeks if cerebral perfusion remains diminished.
Surgical Treatment of Basilar Aneurysms
Authors: Wright Donald C. , Wilson Charles B. 
Published: May 2010

Abstract
The surgical therapy and results in 17 cases of basilar aneurysm are reported, extending a series of 15 reported previously. Three surgical approaches were used: subtemporal, pterional, and suboccipital. The subtemporal route was satisfactory for most lesions, although the pterional approach has advantages for upper basilar aneurysms projecting either more than I cm above the dorsum sellae or directly anteriorly. A low lateral-suboccipital approach is described and recommended for aneurysms of the proximal basilar trunk and vertebrobasilar junction. The recent literature regarding surgical results, classification, pathogenesis, and technical developments for management of these lesions is reviewed. Most of the morbidity resulting from surgery in the midbrain and pontine region is due to direct or indirect injury to perforating vessels. Superiorly directed bifurcation aneurysms carry the highest risk because of their association with perforating vessels. General precepts regarding size, location, patient condition, and timing of operation with respect to aneurysms of the anterior circulation hold true for aneurysms of the posterior circulation.
Extrusion of Peritoneal Catheter through Abdominal Incision
Authors: DeSousa Alonso L. , Worth Robert M. 
Published: May 2010

Abstract
A rare complication of a ventriculoperitoneal shunt is reported. The peritoneal catheter extruded through the well-healed abdominal incision. This is the first report of such an occurrence in an adult patient.
Artificial Vision for the Blind by Electrical Stimulation of the Visual Cortex
Authors: Dobelle William H. , Dobelle William H. , Quest Donald O. , Antunes Joao L. , Roberts Theodore S. , Girvin John P. 
Published: May 2010

Abstract
Artificial vision for the blind may be feasible by interfacing a television camera with electronics stimulating the visual cortex. The status of a major collaborative effort involving the College of Physicians and Surgeons of Columbia University, the University of Utah, and the University of Western Ontario is reviewed. Results have been very encouraging, although much work remains to be done.
Spinal Cord Injury in the Monkey
Authors: Black Perry , Shepard Richard H. , Markowitz Ronald S. 
Published: May 2010

Abstract
We have investigated the effectiveness of surface cord cooling in reducing spinal cord temperature with respect to the rate of cooling and the temperature gradient within the spinal cord parenchyma. Another question of some practical importance if spinal cooling is to be used clinically is that of the temperature within the spinal cord as a function of the dura being intact or open. In five monkeys, a laminectomy was carried out at T-10 and an impact injury of 350 g-cm force was applied to the spinal cord with the dura intact. Hypothermic perfusion with Elliott's B solution (artificial cerebrospinal fluid) was started, and we measured temperatures in the spinal cord with a thermistor probe mounted on a stereotactic drive. A series of measurements were made with the dura intact and the measurements were then repeated with the dura open. For comparison, we also recorded temperatures in one animal that had not been cord-injured. The rate of cord cooling was rapid during the first 3 minutes of hypothermic perfusion, after which there was a slight further reduction in cord temperature; a low level plateau of 6.7° C was reached within 21 minutes after the start of cooling. The temperature gradient at varying depths of the spinal cord was approximately 6° C (3.8° C at the posterior surface to 10.1° C in the deepest portion of the spinal cord), representing a temperature gradient of 1.3° C/mm of cord tissue. Transmission of the cooling effect from perfusate to the spinal cord was not appreciably affected by the dura being intact or open.
Trigeminal Neuralgia and Multiple Sclerosis
Authors: Lazar Martin L. , Kirkpatrick Joel B. 
Published: May 2010

Abstract
Trigeminal neuralgia is unique to humans. The most common cause seems to be an injury to the myelin of the trigeminal nerve root entry zone as it extends for several millimeters lateral to the pons. Jannetta has developed an elegant retromastoid microsurgical approach to this region. He has identified a compression-distortion phenomenon of this nerve root entry zone, usually from an anomalous position of the superior cerebellar artery. Trigeminal neuralgia can also occur in association with multiple sclerosis, when the plaque lies in this same location. The historical evidence for this explanation is reinforced by the electron microscopic demonstration of the plaque in this region in a patient with multiple sclerosis who was suffering from tic douloureux.
Hypoglycorrhachia after Subarachnoid Hemorrhage
Authors: Vincent Frederick M. 
Published: May 2010

Abstract
The cerebrospinal fluid (CSF) of 33 patients with a nontraumatic subarachnoid hemorrhage was analyzed to determine whether hypoglycorrhachia occurred frequently after a subarachnoid hemorrhage. Twenty-three patients (70%) developed an abnormally low CSF glucose concentration or a lowered CSF-blood glucose ratio after their hemorrhage. Thus, hypoglycorrhachia seems to be a common spinal fluid finding after subarachnoid hemorrhage.