bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity Mapping of the Human Foot: Thresholds at 30 Skin Locations
Authors: Hennig Ewald Max , Sterzing Thorsten 
Published: October 2009

Background: Mechanoreceptors in the skin provide sensory input for the central nervous system about foot placement and loading. This information is used by the brain to actively control or regain balance and is important to establish memory traces for subsequent movement. A sensitivity map of the human foot could help to understand the mechanisms of the foot as a sensory organ for movement adjustment and balance control. Materials and Methods: Touch and vibration perception threshold values from 30 plantar and dorsal foot locations were determined in more than 40 women and men between 20 and 35 years. Semmes Weinstein monofilaments and a vibrotactile neurothesiometer were used for skin sensitivity threshold detection. Results: Large sensitivity differences were present between the 30 different foot sites. Gender effects were not present for touch but women had better sensitivities for vibration ( p < 0.01), especially on the dorsal aspect of the foot. Age, in our cohort of 20- to 35-year-olds, did not have an influence on vibration or touch sensitivity. The heel had the highest detection thresholds for touch but was very sensitive for vibration stimuli. Compared to the dorsum, the plantar foot was substantially more sensitive, especially for vibration detection. Conclusion: The results suggest that primarily the fast adapting plantar mechanoreceptors are important in assisting balance control during human locomotion. Clinical Relevance: The sensitivity map of the foot will help in understanding the function of the foot as a sensory organ and could be useful in creating footwear for better balance control and for the design of comfortable shoes.
Quantitative Analysis of Bacteria in Forefoot Surgery: A Comparison of Skin Preparation Techniques
Authors: Cheng Kenneth , Robertson Hannah , St. Mart Jean Pierre , Leanord Alistair , McLeod Ian 
Published: October 2009

Background: Currently a lack of consensus exists on the optimum solution and preparation methods needed to decrease bacteria present during forefoot surgery. We therefore compared the effect of povidine-iodine and chlorhexidine gluconate on lowering bacterial load and to study any additional benefits gained by pre-treatment with the use of a bristled brush. Materials and Methods: Fifty consecutive patients undergoing forefoot surgery were recruited into the study and randomized to receive one of two surgical skin preparations (Povidine-iodine 1% with isopropyl alcohol 23% or Chlorhexidine gluconate 0.5% with isopropyl alcohol 70%). In addition to the skin preparation of the foot with the randomized solution, the subjects other foot was also scrubbed with a sterile surgical bristled brush for three minutes and then painted with the same solution. Swabs were taken from three sites and analyzed via qualitative and quantitative analysis before and after prepping. Results: All four preparation methods significantly decreased ( p < 0.001), in all three sites, the number of colony forming units. Using two-way analysis of variance, no significant interaction was observed between preparation method and number of colony-forming units, suggesting that no difference in bacterial inhibition between preparation methods. Conclusion: We suggest that either povidone - iodine with no more that 23% isopropyl alcohol or chlorhexidine gluconate with 70% isopropyl alcohol be used for surgical preparation in forefoot surgery. No additional benefit in reduction in bacterial load was gained by scrubbing the foot with bristles prior to painting.
The motor-evoked potential threshold evaluated by tractography and electrical stimulation
Authors: Kamada Kyousuke , Todo Tomoki , Ota Takahiro , Ino Kenji , Masutani Yoshitaka , Aoki Shigeki , Takeuchi Fumiya , Kawai Kensuke , Saito Nobuhito 
Published: October 2009

Object
To validate the corticospinal tract (CST) illustrated by diffusion tensor imaging, the authors used tractography-integrated neuronavigation and direct fiber stimulation with monopolar electric currents.

Methods
Forty patients with brain lesions adjacent to the CST were studied. During the operation, the motor responses (motor evoked potential [MEP]) elicited at the hand by the cortical stimulation to the hand motor area were continuously monitored, maintaining the consistent stimulus intensity (mean 15.1 ± 2.21 mA). During lesion resection, direct fiber stimulation was applied to elicit MEP (referred to as fiber MEP) to identify the CST functionally. The threshold intensity for the fiber MEP was determined by searching for the best stimulus point and changing the stimulus intensity. The minimum distance between the resection border and illustrated CST was measured on postoperative isotropic images.

Results
Direct fiber stimulation demonstrated that tractography accurately reflected anatomical CST functioning. There were strong correlations between stimulus intensity for the fiber MEP and the distance between the CST and the stimulus points. The results indicate that the minimum stimulus intensity of 20, 15, 10, and 5 mA had stimulus points ~ 16, 13.2, 9.6, and 4.8 mm from the CST, respectively. The convergent calculation formulated 1.8 mA as the electrical threshold of the CST for the fiber MEP, which was much smaller than that of the hand motor area.

Conclusions
The investigators found that diffusion tensor imaging–based tractography is a reliable way to map the white matter connections in the entire brain in clinical and basic neuroscience applications. By combining these techniques, investigating the cortical-subcortical connections in the human CNS could contribute to elucidating the neural networks of the human brain and shed light on higher brain functions.
Resolution of hydrocephalus-associated sensorineural hearing loss after insertion of ventriculoperitoneal shunt
Authors: Sammons Vanessa J. , Jacobson Erica , Lawson John 
Published: October 2009

The authors present a pediatric patient with severe hearing loss due to communicating hydrocephalus. This is the first clearly documented case of de novo sensorineural deafness caused by hydrocephalus, with subsequent improvement in hearing after shunt insertion.
The patient initially presented with otitis media and was found to have hearing loss. After reporting ongoing headaches, he received a diagnosis of communicating hydrocephalus, which was treated with the insertion of a ventriculoperitoneal shunt. Formal hearing tests showed dramatic improvement postsurgery; his hearing was normal at 2 months. At 3 years postsurgery the patient's hearing remains within normal limits.
Hearing loss is a rare complication of hydrocephalus. Based on this case, the authors suggest that the diagnosis of hydrocephalus be considered as a cause of unexplained hearing loss, and conversely, that patients with hydrocephalus might benefit from hearing assessment.
Efficacy of antibiotic-impregnated shunt catheters in reducing shunt infection: data from the United Kingdom Shunt Registry
Authors: Richards Hugh K. , Seeley Helen M. , Pickard John D. 
Published: October 2009

Object
In recent years CSF shunt catheters impregnated with rifampicin and clindamycin have been introduced to the United Kingdom (UK) market. These catheters have been shown to be effective in vitro against cultures of Staphylococcus epidermidis. The authors used data collected by the UK Shunt Registry to assess the efficacy of antibiotic-impregnated catheters (AICs) against shunt infection by using a matched-pair study design.

Methods
The UK Shunt Registry contains data on nearly 33,000 CSF shunt-related procedures. The authors identified 1139 procedures in which impregnated catheters had been used, and accurate information was known about diagnosis, number of revisions, sex, and age in these cases. The database was ordered chronologically and searched forward and backward for cases with these same characteristics but involving conventional catheters. Matches were found for 994 procedures.

Results
Among the 994 procedures in which AICs had been used, 30 shunts were subsequently revised because of shunt infection. Among the 994 controls, 47 were subsequently revised for infection (p = 0.048, chi-square test).

Conclusions
The UK Shunt Registry does not collect data on causative organisms, and the surgeon is relied on entirely for the diagnosis of infection. However, with the large number of matched pairs evaluated, the authors attempted to reduce bias to a minimum. Their data suggest that AICs have the potential to significantly reduce shunt infections.
Modified orbitozygomatic craniotomy for craniopharyngioma resection in children
Authors: Golshani Kiarash J. , Lalwani Kirk , Delashaw Johnny B. , Selden Nathan R. 
Published: October 2009

Object
In this study, the authors evaluated the efficacy and safety of modified orbitozygomatic craniotomy for resection of craniopharyngioma in children.

Methods
A prospective, institutional review board–approved database was retrospectively reviewed for pediatric patients undergoing craniopharyngioma resection performed by a single surgeon.

Results
Ten patients underwent craniopharyngioma resection surgery between July 2000 and January 2006 (4 girls and 6 boys, ages 1.5–17 years). Nine patients presented to the authors' institution, and 1 patient was referred after surgery and radiation therapy were administered elsewhere. Nine patients presented with visual field deficits (2 with unilateral or bilateral light perception only) and 5 with endocrine dysfunction. Eight patients had large tumors that significantly displaced the optic chiasm and hypothalamus. All patients underwent a modified frontotemporal orbitozygomatic osteotomy in a single piece. The lamina terminalis was opened in 4 patients with third ventricular extension. One patient required a staged transsphenoidal operation to remove residual tumor in the sella turcica, and 1 patient underwent a contralateral subtemporal approach to resect a daughter lesion in the prepontine cistern. Complete radiographic resection was achieved in all patients. Follow-up averaged 55 months (range 12–95 months). Vision was improved in 8 patients and remained stable in 2. All patients had postoperative endocrine dysfunction. One patient experienced transient cranial nerve IV palsy and 1 suffered a small caudate stroke 5 months after surgery without sequelae. Two patients experienced polyphagia and weight gain without other symptoms of hypothalamic dysfunction. There were no other new neurological deficits.

Conclusions
Modified orbitozygomatic craniotomy provides excellent exposure of the suprasellar region with minimal brain retraction, allowing complete resection of craniopharyngiomas with good visual and neurological results.
Hemispherotomy: efficacy and analysis of seizure recurrence
Authors: Limbrick David D. , Narayan Prithvi , Powers Alexander K. , Ojemann Jeffrey G. , Park Tae Sung , Bertrand Mary , Smyth Matthew D. 
Published: October 2009

Object
Hemispherotomy generally is performed in hemiparetic patients with severe, intractable epilepsy arising from one cerebral hemisphere. In this study, the authors evaluate the efficacy of hemispherotomy and present an analysis of the factors influencing seizure recurrence following the operation.

Methods
The authors performed a retrospective review of 49 patients (ages 0.2–20.5 years) who underwent functional hemispherotomy at their institution. The first 14 cases were traditional functional hemispherotomies, and included temporal lobectomy, while the latter 35 were performed using a modified periinsular technique that the authors adopted in 2003.

Results
Thirty-eight of the 49 patients (77.6%) were seizure free at the termination of the study (mean follow-up 28.6 months). Of the 11 patients who were not seizure free, all had significant improvement in seizure frequency, with 6 patients (12.2%) achieving Engel Class II outcome and 5 patients (10.2%) achieving Engel Class III. There were no cases of Engel Class IV outcome. The effect of hemispherotomy was durable over time with no significant change in Engel class over the postoperative follow-up period. There was no statistical difference in outcome between surgery types. Analysis of factors contributing to seizure recurrence after hemispherotomy revealed no statistically significant predictors of treatment failure, although bilateral electrographic abnormalities on the preoperative electroencephalogram demonstrated a trend toward a worse outcome.

Conclusions
In the present study, hemispherotomy resulted in freedom from seizures in nearly 78% of patients; worthwhile improvement was demonstrated in all patients. The seizure reduction observed after hemispherotomy was durable over time, with only rare late failure. Bilateral electrographic abnormalities may be predictive of posthemispherotomy recurrent seizures.
Pus and free bone flaps
Authors: Widdel Lars , Winston Ken R. 
Published: October 2009

Object
The goal of this investigation is to describe the results of a vigorous attempt to preserve contaminated free bone flaps and avoid the problems associated with the traditional and common practice of discarding the flap, administering a course of antibiotics, and after several months, performing a cranioplasty.

Methods
Patients with clearly contaminated, free cranial bone flaps, including so-called high risk cases, were treated by meticulous debridement of the surgical bed, scrubbing, soaking, and then replacing the bone flap in its normal position, and administering a course of intravenous antibiotics.

Results
Fourteen patients with contaminated avascular cranial bone flaps were treated using this technique. All bone flaps were able to be preserved.

Conclusions
Patients with bacteriologically contaminated, free bone flaps can be treated successfully without discarding the flaps. Success is dependent upon aggressive surgical debridement and persistence.
Impact of anesthesia on transcranial electric motor evoked potential monitoring during spine surgery: a review of the literature
Authors: Wang Anthony C. , Than Khoi D. , Etame Arnold B. , La Marca Frank , Park Paul 
Published: October 2009

Object
Transcranial motor evoked potential (TcMEP) monitoring is frequently used in complex spinal surgeries to prevent neurological injury. Anesthesia, however, can significantly affect the reliability of TcMEP monitoring. Understanding the impact of various anesthetic agents on neurophysiological monitoring is therefore essential.

Methods
A literature search of the National Library of Medicine database was conducted to identify articles pertaining to anesthesia and TcMEP monitoring during spine surgery. Twenty studies were selected and reviewed.

Results
Inhalational anesthetics and neuromuscular blockade have been shown to limit the ability of TcMEP monitoring to detect significant changes. Hypothermia can also negatively affect monitoring. Opioids, however, have little influence on TcMEPs. Total intravenous anesthesia regimens can minimize the need for inhalational anesthetics.

Conclusions
In general, selecting the appropriate anesthetic regimen with maintenance of a stable concentration of inhalational or intravenous anesthetics optimizes TcMEP monitoring.
Intraoperative neurophysiological monitoring during spine surgery: a review
Authors: Gonzalez Andres A. , Jeyanandarajan Dhiraj , Hansen Chris , Zada Gabriel , Hsieh Patrick C. 
Published: October 2009

Spinal surgery involves a wide spectrum of procedures during which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk for injury. Neuromonitoring provides an opportunity to assess the functional integrity of susceptible neural elements during surgery.
The methodology of obtaining and interpreting data from various neuromonitoring modalities—such as somatosensory evoked potentials, motor evoked potentials, spontaneous electromyography, and triggered electromyography—is reviewed in this report. Also discussed are the major benefits and limitations of each modality, as well as the strength of each alone and in combination with other modalities, with regard to its sensitivity, specificity, and overall value as a diagnostic tool. Finally, key clinical recommendations for the interpretation and step-wise decision-making process for intervention are discussed.
Multimodality neuromonitoring relies on the strengths of different types of neurophysiological modalities to maximize the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Thorough knowledge of the benefits and limitations of each modality helps in optimizing the diagnostic value of intraoperative monitoring during spinal procedures. As many spinal surgeries continue to evolve along a pathway of minimal invasiveness, it is quite likely that the value of neuromonitoring will only continue to become more prominent.
Eosinophils Oxidize Damage-Associated Molecular Pattern Molecules Derived from Stressed Cells
Authors: Lotfi Ramin , Herzog Gloria Isabelle , DeMarco Richard Anthony , Beer-Stolz Donna , Lee James Joseph , Rubartelli Anna , Schrezenmeier Hubert , Lotze Michael Thomas 
Published: October 2009

Abstract
Eosinophils (Eos) are found at increased numbers within necrotic areas of tumors. We show that necrotic material from cell lysates containing damage-associated molecular pattern molecules induce eosinophil degranulation (release of major basic protein and eosinophil peroxidase) and enhance their oxidative burst while the stimulatory capacity of cell lysates is significantly diminished following oxidation. High mobility group box 1 (HMGB1), a prototypic damage-associated molecular pattern molecule, released following necrosis but not apoptosis, induced a similar effect on Eos. Additionally, we demonstrate that HMGB1 enhances eosinophil survival and acts as a chemoattractant. Consistently, we show that Eos express an HMGB1 receptor, the receptor for advanced glycation end product, and that anti-receptor for advanced glycation end product could diminish the HMGB1-mediated effects. Of all tested biologic activities, Eos respond most sensitively to the presence of necrotic material including HMGB1 with generation of peroxide. We postulate that Eos “sense” necrotic cell death, migrating to and responding to areas of tissue injury/necrosis. Oxidation of cell lysates reduces their biologic activity when compared with native lysates. We postulate that eosinophil-associated modulation of immunity within tumor and other damaged tissues may be primarily by promoting oxidative degradation of necrotic material. Novel therapeutic strategies may be considered by advancing oxidative denaturation of released necrotic material using Eos or other aerobic strategies.
Costimulatory Pathways in Multiple Sclerosis: Distinctive Expression of PD-1 and PD-L1 in Patients with Different Patterns of Disease
Authors: Trabattoni Daria , Saresella Marina , Pacei Michela , Marventano Ivana , Mendozzi Laura , Rovaris Marco , Caputo Domenico , Borelli Manuela , Clerici Mario 
Published: October 2009

Abstract
T lymphocytes costimulatory molecules, including CD80, CD86, CD28, CTLA4, PD-1, PD-L1, and B7-H3, are associated with the preferential production of pro- or anti-inflammatory cytokines. We analyzed the expression of these molecules and myelin basic protein (MBP)-specific IL-10 and IFN-γ production in patients with multiple sclerosis (MS) with relapsing-remitting acute (AMS, n = 40) or stable (SMS, n = 38). Twenty-two patients successfully undergoing therapy with glatimer acetate (n = 12) or IFNβ (n = 10) were also analyzed. MBP-specific and PD-1-expressing T lymphocytes, PD-L1-expressing CD19+ cells, and PD-L1+/IL-10+/CD14+ and CD19+ cells were significantly augmented in SMS patients. Additionally, MBP-specific and annexin V-expressing CD4+ and CD8+ (apoptotic) T lymphocytes were augmented and pAkt-positive (proliferating) cells were decreased in SMS compared with AMS patients. PD-1 ligation resulted in the increase of pAkt+ lymphocytes in AMS patients alone. B7-H3 expression and IFN-γ production were comparable in all individuals but the PD-L1+/IL-10+ over B7-H3+/IFN-γ+ ratio was significantly lower in AMS compared with SMS patients. Finally, PD-L1 expression on immune cells was reduced in treated patients, suggesting that therapy-induced disease remission is not associated with the modulation of the expression of this molecule. The PD-1/PD-L1 pathway plays an important role in modulating immune functions in MS patients; monitoring and targeting these proteins could offer diagnostic and therapeutic advantages.
Recent Developments in the Application of Phosphorescent Iridium(III) Complex Systems
Authors: Ulbricht Christoph , Beyer Beatrice , Friebe Christian , Winter Andreas , Schubert Ulrich S. 
Published: October 2009

AbstractThe recent developments in using iridium(III) complexes as phosphorescent emitters in electroluminescent devices, such as (white) organic light‐emitting diodes and light‐emitting electrochemical cells, are discussed. Additionally, applications in the emerging fields of molecular sensors, biolabeling, and photocatalysis are briefly evaluated. The basic strategies towards charged and non‐charged iridium(III) complexes are summarized, and a wide range of assemblies is discussed. Small‐molecule‐ and polymer‐based materials are under intense investigation as emissive systems in electroluminescent devices, and special emphasis is placed on the latter with respect to synthesis, characterization, electro‐optical properties, processing technologies, and performance.
A bi‐criterion optimization approach for the design and planning of hydrogen supply chains for vehicle use
Authors: Guillén‐Gosálbez Gonzalo , Mele Fernando D. , Grossmann Ignacio E. 
Published: September 2009

AbstractIn this article, we address the design of hydrogen supply chains for vehicle use with economic and environmental concerns. Given a set of available technologies to produce, store, and deliver hydrogen, the problem consists of determining the optimal design of the production‐distribution network capable of satisfying a predefined hydrogen demand. The design task is formulated as a bi‐criterion mixed‐integer linear programming (MILP) problem, which simultaneously accounts for the minimization of cost and environmental impact. The environmental impact is measured through the contribution to climate change made by the hydrogen network operation. The emissions considered in the analysis are those associated with the entire life cycle of the process, and are quantified according to the principles of Life Cycle Assessment (LCA). To expedite the search of the Pareto solutions of the problem, we introduce a bi‐level algorithm that exploits its specific structure. A case study that addresses the optimal design of the hydrogen infrastructure needed to fulfill the expected hydrogen demand in Great Britain is introduced to illustrate the capabilities of the proposed approach. © 2009 American Institute of Chemical Engineers AIChE J, 2010