bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally invasive implantation of the peritoneal catheter in ventriculoperitoneal shunt placement for hydrocephalus: analysis of data in 151 consecutive adult patients
Authors: Bani Alan , Telker Dieter , Hassler Werner , Grundlach Matthias 
Published: January 2008

Object
The authors report on their experience with laparoscopy-guided implantation of a peritoneal catheter in ventriculoperitoneal shunt placement procedures in adults.

Methods
In performing the conventional method of shunt placement in 2001, 8% of the cases resulted in malposition and dislocation of the distal catheter; therefore, the authors together with personnel from the Department of General Surgery decided to utilize an interdisciplinary approach involving laparoscopy-guided implantation of the catheter. Between October 2001 and January 2005, 202 ventriculoperitoneal shunt placement procedures were conducted in adult patients for hydrocephalus of various origins.
In 152 patients, laparoscopy-guided implantation of the distal catheter was performed. In all except one of these patients, implantation was successful. Laparoscopy and the cranial part of the surgery were performed simultaneously. There was an 8% rate of malposition of the distal catheter in the nonlaparoscopy group. In contrast, there was no dislocation or malposition of the distal catheter in the laparoscopy group. Two cases (1.3%) of shunt infection occurred in the laparoscopy group.

Conclusions
Laparoscopic implantation of a distal catheter is a simple, minimally invasive, and easy procedure to perform and allows exact localization of the peritoneal catheter and confirmation of its patency.
Long-term electrical stimulation–induced inhibition of partial epilepsy
Authors: Elisevich Kost , Jenrow Ken , Schuh Lori , Smith Brien 
Published: January 2008

✓The aim of this study was to determine the effects of long-term continuous cerebrocortical electrical stimulation in the treatment of partial epilepsy. The authors review the case of a 44-year-old man with medically intractable postencephalitic localization-related epilepsy with ictal onset in the primary motor cortex. For 5 years he was treated using patterned subthreshold electrical stimulation of the ictal site. This therapy has successfully eliminated the jacksonian march of cortical excitability and secondary generalization and reduced seizure frequency and intensity with an immediate postictal return of motor function. Over time, the seizure frequency subsided by more than 90%, with the patient showing no adverse features resulting from focal stimulation.
The results in this case support the hypothesis that effective and safe long-term modulation of focal epilepsy is possible with focal cerebrocortical electrical stimulation.
Midterm outcomes of paclitaxel-eluting stents for the treatment of intracranial posterior circulation stenoses
Authors: Steinfort Brendan , Ng Perry P. , Faulder Kenneth , Harrington Timothy , Grinnell Verity , Sorby William , Morgan Michael K. 
Published: January 2008

Object
Symptomatic intracranial vertebral and basilar artery atherosclerotic stenoses carry a high risk of stroke and permanent disability if refractory to maximal medical therapy. The authors conducted a study to determine the technical feasibility and midterm clinical and angiographic outcomes in patients in whom paclitaxel-eluting stents were placed for the treatment of symptomatic intracranial posterior circulation stenoses.

Methods
A retrospective review of medical records and imaging studies was performed for 13 consecutive patients in whom paclitaxel-coated stents were used to treat symptomatic posterior circulation intracranial stenoses between 2002 and 2005. Clinical follow-up data were supplemented by telephone interviews.
The technical success rate for stent placement was 100%. One patient (8%) suffered a periprocedural stroke. Twelve patients (92%) underwent clinical follow up for a minimum of 3 months postsurgery, and 11 (92%) of these patients remained asymptomatic after a mean period of 10.9 months. Nine patients (69%) underwent catheter angiographic follow up, and no patient had significant in-stent recurrence of stenosis after a mean period of 5.4 months.

Conclusions
Treatment of intracranial posterior circulation stenoses with drug-eluting stents is technically feasible, and the rate of clinically significant periprocedural complications is low. Rates of stenosis recurrence are reduced compared with those of bare-metal stents in the midterm. Midterm clinical outcome is excellent; no symptom recurrence was observed in this patient cohort.
A prospective single-center analysis of the safety and efficacy of the HydroCoil embolization system for the treatment of intracranial aneurysms
Authors: Deshaies Eric M. , Adamo Matthew A. , Boulos Alan S. 
Published: January 2008

Object
The HydroCoil embolization system is a helical platinum coil coated with a polymeric hydrogel that expands when it contacts aqueous solutions to increase filling volumes, improve mesh stability, and possibly elicit a healing response within the aneurysm. In this paper, the authors report the 1-year recurrence and complication rates of 67 aneurysms embolized with the HydroCoil system.

Methods
Sixty-four consecutive patients (67 total aneurysms) with small (≤ 7 mm), large (8–15 mm), very large (16–24 mm), and giant (≥ 25 mm) aneurysms in the anterior and posterior intracranial circulations were treated with HydroCoils between March 2003 and September 2004. All aneurysms were embolized by the senior author (A.S.B) with HydroCoils alone or in combination with bare platinum coils, until either there was no further angiographic contrast filling of the aneurysm or the microcatheter was pushed out of the dome by the coil mass. Balloon assistance was used in three cases and combined Neuroform stent–coil embolization in eight other cases. To evaluate the safety and 1-year efficacy of the HydroCoil system, periprocedural complications were recorded, and angiographic recurrences were categorized using the Raymond–Roy Occlusion Classification (RROC) system.
The 1-year aneurysm recurrence rate independent of size was 15% in patients treated with HydroCoils. Seventy percent of the patients had stable occlusions. The recurrence rate for small aneurysms was 3.7%, and the combined recurrence rate for small and large aneurysms was 6%. Fifteen percent of the aneurysms initially categorized as RROC Type 2 or 3 with stasis of contrast material at the time of initial embolization improved in RROC type, allowing the authors to develop the aneurysm embolization grade to predict recurrence. The neurological complication rate was 14.9%, of which 4.5% represented permanent neurological deficits.

Conclusions
The HydroCoil embolization system is safe and provides excellent 1-year occlusion of small and large aneurysms with initial RROC Type 1, as well as those with RROC Types 2 and 3 with stasis of contrast material at the time of embolization. Very large and giant aneurysms were not as successfully occluded with this system. Treatment of large and giant internal carotid artery aneurysms was more likely to result in cranial nerve palsies and postembolization headaches than treatment in other locations. The aneurysm embolization grade the authors developed using the results of this study accurately predicted 1-year recurrence rates based on the immediate postembolization angiographic characteristics of the treated aneurysm.
Predictors of hematoma enlargement in patients with intracerebral hemorrhage treated with rapid administration of antifibrinolytic agents and strict blood pressure control
Authors: Sorimachi Takatoshi , Fujii Yukihiko , Morita Kenichi , Tanaka Ryuichi 
Published: January 2008

Object
Hematoma enlargement is a major cause of poor outcome in patients with intracerebral hemorrhage (ICH). A combination of rapid administration of antifibrinolytics and strict blood pressure (BP) control for prevention of hematoma enlargement has been recently reported. The authors examined the incidence and predictors of hematoma enlargement in patients with ICH who were treated with this therapy.

Methods
Rapid administration of antifibrinolytic agents consisted of intravenous administration of 2 g tranexamic acid over 10 minutes. Systolic BP was strictly maintained below 150 mm Hg using intravenous nicardipine. Immediately after diagnosis of ICH on computed tomography (CT), 188 patients who were admitted within 24 hours of symptom onset were treated with a combination of rapid administration of antifibrinolytic agents and BP control. Hematoma enlargement was determined on the basis of a second CT scan performed the day after admission. Several factors, including those that have been reported to affect hematoma enlargement, were compared between patients with and without hematoma enlargement.
Hematoma enlargement (≥ 20% volume increase) was observed in eight (4.3%) of 188 patients. Previous use of antiplatelet agents was significantly more frequent in patients with hematoma enlargement (p < 0.05). No significant between-group difference was found for any other factors.

Conclusions
Previous use of antiplatelet agents was a predictor of hematoma enlargement in patients with ICH treated with rapid administration of antifibrinolytic agents and BP control.
Neuronal expression of Fas-associated death domain protein and caspase-8 in the perinidal parenchyma of cerebral arteriovenous malformations
Authors: Takagi Yasushi , Kikuta Ken-Ichiro , Nozaki Kazuhiko , Fujimoto Motoaki , Hayashi Junya , Hashimoto Nobuo 
Published: January 2008

Object
The expression and localization of phosphorylated Fas-associated death domain protein (pFADD) and cleaved caspase-8 was examined in human cerebral arteriovenous malformations (AVMs). The authors focused on the perinidal parenchyma to clarify the effect of AVMs on perinidal brain tissue.

Methods
Seventeen cerebral AVMs were analyzed using immunohistochemical methods. Specimens were removed from patients during surgical procedures. The characteristics of the areas that stained positively for pFADD or cleaved caspase-8 were also assessed using an image analysis system. Eleven (65%) of the 17 lesions demonstrated anti-pFADD immunoreactivity and 12 (71%) showed anti–cleaved caspase-8 immunoreactivity. The immunoreactive cells in the perinidal parenchyma demonstrated obvious neuronal morphological characteristics.
The characteristics of pFADD-positive and cleaved caspase-8–positive areas were assessed using the image analysis system. The mean distance from the nidus adjacent to either area was not affected by preoperative hemorrhage. The neuronal densities of pFADD-positive and cleaved caspase-8–positive areas were analyzed using the same system. The density of the control area (samples that were pFADD-negative and cleaved caspase-8 negative) was significantly higher when compared with that of pFADD-positive and cleaved caspase-8–positive areas (p < 0.05). The expressions of cleaved caspase-9, cleaved poly(adenosine diphosphate–ribose) polymerase, and apoptotic cells were analyzed using the terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick-end labeling method.

Conclusions
Neuronal areas that stained positively for pFADD and cleaved caspase-8 existed around the nidus of AVMs. In these areas, the neuronal density was lower than that in the other parenchyma around the AVM. Neuronal loss around the nidus may be the origin of brain dysfunction around AVMs.
Evaluation of extracranial–intracranial bypass using quantitative magnetic resonance angiography
Authors: Amin-Hanjani Sepideh , Shin John H. , Zhao Meide , Du Xinjian , Charbel Fady T. 
Published: January 2008

Object
To date, angiography has been the primary modality for assessing graft patency following extracranial–intracranial bypass. The utility of a noninvasive and quantitative method of assessing bypass function postoperatively was evaluated using quantitative magnetic resonance (MR) angiography.

Methods
One hundred one cases of bypass surgery performed over a 5.5-year period at a single institution were reviewed. In 62 cases, both angiographic and quantitative MR angiographic data were available. Intraoperative flow measurements were available in 13 cases in which quantitative MR angiography was performed during the early postoperative period (within 48 hours after surgery).
There was excellent correlation between quantitative MR angiographic flow and angiographic findings over the mean 10 months of imaging follow up. Occluded bypasses were consistently absent on quantitative MR angiograms (four cases). The flow rates were significantly lower in those bypasses that became stenotic or reduced in diameter as demonstrated by follow-up angiography (nine cases) than in those bypasses that remained fully patent (mean ± standard error of the mean, 37 ± 13 ml/minute compared with 105 ± 7 ml/minute, p = 0.001). Flows were appreciably lower in poorly functioning bypasses for both vein and in situ arterial grafts. All angiographically poor bypasses (nine cases) were identifiable by absolute flows of less than 20 ml/minute or a reduction in flow greater than 30% within 3 months. Good correlation was seen between intraoperative flow measurements and early postoperative quantitative MR angiographic flow measurements (13 cases, Pearson correlation coefficient = 0.70, p = 0.02).

Conclusions
Bypass grafts can be assessed in a noninvasive fashion by using quantitative MR angiography. This imaging modality provides not only information regarding patency as shown by conventional angiography, but also a quantitative assessment of bypass function. In this study, a low or rapidly decreasing flow was indicative of a shrunken or stenotic graft. Quantitative MR angiography may provide an alternative to standard angiography for serial follow up of bypass grafts.
Inhibition of angiogenesis induced by cerebral arteriovenous malformations using Gamma Knife irradiation
Authors: Kiliç Kaya , Konya Deniz , Kurtkaya Özlem , Sav Aydin , Pamir M. Necmettin , Kiliç Türker 
Published: January 2008

Object
The authors studied the effect of Gamma Knife irradiation on angiogenesis induced by cerebral arteriovenous malformation (AVM) tissues implanted in the corneas of rats.

Methods
Ten AVM specimens obtained from tissue resections performed at Marmara University between 1998 and 2004 were used. A uniform amount of tissue was implanted into the micropocket between the two epithelial layers of the cornea. Gamma Knife irradiation was applied with dose prescriptions of 15 or 30 Gy to one cornea at 100% iso-dose. Dosing was adjusted so that the implanted cornea of one eye received 1.5 Gy when 15 Gy was applied to the other cornea. Similarly, one cornea received 3 Gy when 30 Gy was applied to the other cornea. Angiogenic activity was graded daily by biomicroscopic observations. Forty-eight other rats were used for microvessel counting and vascularendothelial growth factor (VEGF) staining portions of the experiment. Micropieces of the specimens were again used for corneal implantation. Rats from each group were killed on Days 5, 10, 15, and 20, and four corneas from each group were examined.
Gamma Knife irradiation dose dependently decreased AVM-induced neovascularization in the rat cornea as determined by biomicroscopic grading of angiogenesis, microvessel count, and VEGF expression.

Conclusions
The results suggest that Gamma Knife irradiation inhibits angiogenesis induced by AVM tissue in the cornea angiogenesis model. The data are not directly related to understanding how Gamma Knife irradiation occludes existing AVM vasculature, but to understanding why properly treated AVMs do not recur and do not show neovascularization after Gamma Knife irradiation.
Unilateral deep brain stimulation of the subthalamic nucleus for Parkinson disease
Authors: Slowinski Jerzy L. , Putzke John D. , Uitti Ryan J. , Lucas John A. , Turk Margaret F. , Kall Bruce A. , Wharen Robert E. 
Published: January 2008

Object
The object of this study was to assess the results of unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for management of advanced Parkinson disease (PD).

Methods
A clinical series of 24 patients (mean age 71 years, range 56–80 years) with medically intractable PD, who were undergoing unilateral magnetic resonance imaging–targeted, electrophysiologically guided STN DBS, completed a battery of qualitative and quantitative outcome measures preoperatively (baseline) and postoperatively, using a modified Core Assessment Program for Intracerebral Transplantations protocol.
The mean follow-up period was 9 months. Statistically significant improvement was observed in the Unified Parkinson's Disease Rating Scale (UPDRS) Part II score (18%), the total UPDRS PART III score (31%), the contralateral UPDRS Part III score (63%), and scores for axial motor features (19%), contralateral tremor (88%), rigidity (60%), bradykinesia (54%), and dyskinesia (69%), as well as the Parkinson's Disease Quality of Life questionnaire score (15%) in the on-stimulation state compared with baseline. Ipsilateral symptoms improved by approximately 15% or less. Performance on the Purdue pegboard test improved in the contralateral hand in the on-stimulation state compared with the off-stimulation state (38%, p < 0.05). The daily levodopa-equivalent dose was reduced by 21% (p = 0.018). Neuropsychological tests revealed an improvement in mental flexibility and a trend toward reduced letter fluency. There were no permanent surgical complications. Of the 16 participants with symmetrical disease, five required implantation of the DBS unit on the second side.

Conclusions
Unilateral STN DBS is an effective and safe treatment for selected patients with advanced PD. Unilateral STN DBS provides improvement of contralateral motor symptoms of PD as well as quality of life, reduces requirements for medication, and possibly enhances mental flexibility. This method of surgical treatment may be associated with a reduced risk and may provide an alternative to bilateral STN DBS for PD, especially in older patients or patients with asymmetry of parkinsonism.
Orthotopic transplantation of v-src–expressing glioma cell lines into immunocompetent mice: establishment of a new transplantable in vivo model for malignant glioma
Authors: Smilowitz Henry M. , Weissenberger Jakob , Weis Joachim , Brown Judith D. , O'Neill Rachel J. , Laissue Jean A. 
Published: January 2008

Object
The aim of this study was to develop and characterize a new orthotopic, syngeneic, transplantable mouse brain tumor model by using the cell lines Tu-9648 and Tu-2449, which were previously isolated from tumors that arose spontaneously in glial fibrillary acidic protein (GFAP)-v-src transgenic mice.

Methods
Striatal implantation of a 1-μl suspension of 5000 to 10,000 cells from either clone into syngeneic B6C3F1 mice resulted in tumors that were histologically identified as malignant gliomas. Prior subcutaneous inoculations with irradiated autologous cells inhibited the otherwise robust development of a microscopically infiltrating malignant glioma. Untreated mice with implanted tumor cells were killed 12 days later, when the resultant gliomas were several millimeters in diameter. Immunohistochemically, the gliomas displayed both the astroglial marker GFAP and the oncogenic form of signal transducer and activator of transcription–3 (Stat3). This form is called tyrosine-705 phosphorylated Stat3, and is found in many malignant entities, including human gliomas. Phosphorylated Stat3 was particularly prominent, not only in the nucleus but also in the plasma membrane of peripherally infiltrating glioma cells, reflecting persistent overactivation of the Janus kinase/Stat3 signal transduction pathway. The Tu-2449 cells exhibited three non-random structural chromosomal aberrations, including a deletion of the long arm of chromosome 2 and an apparently balanced translocation between chromosomes 1 and 3. The GFAP-v-src transgene was mapped to the pericentromeric region of chromosome 18.

Conclusions
The high rate of engraftment, the similarity to the high-grade malignant glioma of origin, and the rapid, locally invasive growth of these tumors should make this murine model useful in testing novel therapies for human malignant gliomas.
Nonconvulsive status epilepticus in patients suffering spontaneous subarachnoid hemorrhage
Authors: Little Andrew S. , Kerrigan John F. , McDougall Cameron G. , Zabramski Joseph M. , Albuquerque Felipe C. , Nakaji Peter , Spetzler Robert F. 
Published: January 2008

Object
Nonconvulsive status epilepticus (NCSE) is an underrecognized and poorly understood complication of aneurysmal subarachnoid hemorrhage (SAH). The authors evaluated the risk factors, electroencephalographic (EEG) characteristics, hospital course, and clinical outcomes associated with NCSE in a population with SAH treated at a single institution.

Methods
The hospitalization and outcome data were reviewed in 11 patients who had received a diagnosis of NCSE and SAH. The study included individuals from a cohort of 389 consecutive patients with SAH who were treated between March 2003 and June 2005, and who were analyzed retrospectively. The patients' medical history, neurological grade, events of hospitalization, EEG morphological patterns, and disposition were analyzed.
Advanced age, female sex, need for ventriculostomy, poor neurological grade (Hunt and Hess Grade III, IV, or V), thick cisternal blood clots, and structural lesions (intracerebral hemorrhage and stroke) were common in the population with NCSE. Patients with normal results on angiograms, good neurological grade (Hunt and Hess Grade I or II), and minimal SAH (Fisher Grade 1 or 2) were at lower risk. The most common ictal patterns were intermittent, and consisted of generalized periodic epileptiform discharges. Medical complications were also frequent, and the outcome of these patients was poor despite aggressive treatment regimens.

Conclusions
Nonconvulsive status epilepticus is a devastating complication of SAH with a high rate of associated morbidity. Based on these findings it appears that the patients at highest risk for NCSE can be identified, and this should provide a basis for further studies designed to determine the clinical significance of various EEG patterns and to develop preventative strategies.