bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethylene oxide gas sterilization: a simple technique for storing explanted skull bone
Authors: Jho David H. , Neckrysh Sergey , Hardman Julian , Charbel Fady T. , Amin-Hanjani Sepideh 
Published: January 2008

✓ The authors evaluated the effectiveness of a simple technique using ethylene oxide (EtO) gas sterilization and room temperature storage of autologous bone grafts for reconstructive cranioplasty following decompressive craniectomy. The authors retrospectively analyzed data in 103 consecutive patients who underwent cranioplasty following decompressive craniectomy for any cause at the University of Illinois at Chicago between 1999 and 2005. Patients with a pre-existing intracranial infection prior to craniectomy or lost to follow-up before reconstruction were excluded. Autologous bone grafts were cleansed of soft tissue, hermetically sealed in sterilization pouches for EtO gas sterilization, and stored at room temperature until reconstructive cranioplasty was performed.
Cranioplasties were performed an average of 4 months after decompressive craniectomy, and the follow-up after reconstruction averaged 14 months. Excellent aesthetic and functional results after single-stage reconstruction were achieved in 95 patients (92.2%) as confirmed on computed tomography. An infection of the bone flap occurred in eight patients (7.8%), and the skull defects were eventually reconstructed using polymethylmethacrylate with satisfactory results. The mean preservation interval was 3.8 months in patients with uninfected flaps and 6.4 months in those with infected flaps (p = 0.02). A preservation time beyond 10 months was associated with a significantly increased risk of flap infection postcranioplasty (odds ratio [OR] 10.8, p = 0.02). Additionally, patients who had undergone multiple craniotomies demonstrated a trend toward increased infection rates (OR 3.0, p = 0.13).
Data in this analysis support the effectiveness of this method, which can be performed at any institution that provides EtO gas sterilization services. The findings also suggest that bone flaps preserved beyond 10 months using this technique should be discarded or resterilized prior to reconstruction.
A novel treatment approach to cholesterol granulomas
Authors: Sincoff Eric H. , Liu James K. , Matsen Laura , Dogan Aclan , Kim Ilman , Mcmenomey Sean O. , Delashaw Johnny B. 
Published: January 2008

✓ The authors report a novel technique for the treatment of cholesterol granulomas. An extradural middle fossa approach was used to access the granuloma, with drainage through silastic tubes into the sphenoid sinus via the anteromedial triangle between V1 and V2.
Cholesterol granulomas occur when the normal aeration and drainage of temporal bone air cells is occluded, resulting in vacuum formation and transudation of blood into the air cells. This process results in anaerobic breakdown of the blood with resulting cholesterol crystal formation and an inflammatory reaction. Traditional treatment of this lesion involves extensive drilling of the temporal bone to drain the granuloma cyst and establish a drainage tract into the middle ear. Such drainage procedures can be time consuming and difficult, and potentially involve structural damage to the inner ear and facial nerve. An extradural middle fossa approach provides easy access to the granuloma and anterior petrous bone entry into the granuloma for resection. Granuloma drainage is then achieved using shunt tubing in the sphenoid sinus via a small hole in the anteromedial triangle between V1 and V2.
Five patients with symptomatic cholesterol granuloma were treated without complication using this novel extradural middle fossa approach. One patient required reoperation 1-year postoperatively for cyst regrowth and occlusion of the drainage tube. At the 5-year follow-up examination, no patient reported recurrent symptoms.
Extradural middle fossa craniotomy and silastic tube drainage into the sphenoid sinus is a viable alternative method for treatment of cholesterol granuloma.
Otfrid Foerster, the great neurologist and neurosurgeon from Breslau (Wrocław): his influence on early neurosurgeons and legacy to present-day neurosurgery
Authors: Piotrowska Natalia , Winkler Peter A. 
Published: January 2008

✓ As a result of the turbulences of World War II, Wrocław, Poland (formerly Breslau, Germany) lost its internationally acknowledged position in the field of neurosurgery, which it once had thanks to Otfrid Foerster. This innovative German doctor and scientist made a considerable contribution to the development of neurological and neurosurgical research worldwide. He also made Breslau a renowned center for scientific study, luring researchers from around the world. His achievements influenced many neurosurgeons during his lifetime, above all those from the US and England, including, for example, such well-known men as Fulton, Bucy, Bailey, and Penfield (who worked with Foerster in Breslau for quite a long time). Together Foerster and Penfield searched for the causes of epilepsy and the surgical methods to treat it. For young American neurosurgeons it was a very significant step in their careers to be able to train in Breslau under the guidance of Otfrid Foerster. In 1937 the British Association of Neurological Surgeons visited Breslau and awarded him with the honor of “Member Emeritus,” which could be seen as the culmination of Foerster's career.
In this paper the authors give an overview of Foerster's work and evaluate its significance. They also elucidate the difficult historical background during fascism in Germany using the sources of the Polish National Archives. Dr. Foerster's remaining traces in today's Wrocl/aw are meticulously reported.
Predicting the location of mouth motor cortex in patients with brain tumors by using somatosensory evoked field measurements
Authors: Kirsch Heidi E. , Zhu Zhao , Honma Susanne , Findlay Anne , Berger Mitchel S. , Nagarajan Srikantan S. 
Published: January 2008

Object
Before resective brain surgery, localization of the functional regions is necessary to minimize postoperative deficits. The face area has been relatively difficult to map noninvasively by using functional imaging techniques. Preoperative localization of face somatosensory cortex with magnetoencephalography (MEG) may allow the surgeon to predict the location of mouth motor areas.

Methods
The authors compared the location of face somatosensory cortex obtained with somatosensory evoked fields during preoperative MEG with the mouth motor areas identified during intraoperative electrocortical stimulation (ECS) mapping in 13 patients undergoing resection of brain tumor.

Results
In this group of patients, ECS mouth motor sites were usually anterior and lateral to MEG localizations of lip somatosensory cortex. The consistent quantitative relationship between results of these two mapping procedures allows the practitioner to predict the location of mouth motor cortex based on noninvasive preoperative MEG measurements.

Conclusions
Based on this result, the authors suggest that somatosensory mapping using MEG can be used to guide intraoperative mapping and neurosurgical planning.
Accuracy of diffusion tensor magnetic resonance imaging tractography assessed using intraoperative subcortical stimulation mapping and magnetic source imaging
Authors: Berman Jeffrey I. , Berger Mitchel S. , Chung Sungwon , Nagarajan Srikantan S. , Henry Roland G. 
Published: January 2008

Object
Resecting brain tumors involves the risk of damaging the descending motor pathway. Diffusion tensor (DT)–imaged fiber tracking is a noninvasive magnetic resonance (MR) technique that can delineate the subcortical course of the motor pathway. The goal of this study was to use intraoperative subcortical stimulation mapping of the motor tract and magnetic source imaging to validate the utility of DT-imaged fiber tracking as a tool for presurgical planning.

Methods
Diffusion tensor-imaged fiber tracks of the motor tract were generated preoperatively in nine patients with gliomas. A mask of the resultant fiber tracks was overlaid on high-resolution T1- and T2-weighted anatomical MR images and used for stereotactic surgical navigation. Magnetic source imaging was performed in seven of the patients to identify functional somatosensory cortices. During resection, subcortical stimulation mapping of the motor pathway was performed within the white matter using a bipolar electrode.

Results
A total of 16 subcortical motor stimulations were stereotactically identified in nine patients. The mean distance between the stimulation sites and the DT-imaged fiber tracks was 8.7 ±3.1 mm (±standard deviation). The measured distance between subcortical stimulation sites and DT-imaged fiber tracks combines tracking technique errors and all errors encountered with stereotactic navigation.

Conclusions
Fiber tracks delineated using DT imaging can be used to identify the motor tract in deep white matter and define a safety margin around the tract.
Diffusion tensor imaging analysis of long association bundles in the presence of an arteriovenous malformation
Authors: Bérubé Josée , Mclaughlin Nancy , Bourgouin Pierre , Beaudoin Gilles , Bojanowski Michel W. 
Published: January 2008

Object
Conventional imaging demonstrates intertwined fibers of the cerebral white matter as a homogeneous substrate. Recently, diffusion tensor imaging has allowed 3D reconstruction of these fiber bundles. The goal of this study was to analyze the modifications of the association fibers induced by an arteriovenous malformation (AVM) in the parietotemporooccipital (PTO) associative area and their clinical significance.

Methods
The authors analyzed the long association fibers in seven patients harboring an AVM in or near the PTO region in relation with the fibers' clinical manifestation. The fibers include the arcuate fasciculus (AF), the occipitofrontal fasciculus (OFF), and the inferior longitudinal fasciculus (ILF). These structures were compared with the contra-lateral bundles.

Results
The modification of the tracts could establish a pattern signature depending on the specific location of the vascular malformation. There was a positive correlation between the degree of modifications of OFF and ILF fiber tracts and visual deficits. Alteration of the AF correlated with a speech disorder and the risk of postoperative deficits.

Conclusions
Diffusion tensor imaging enables in vivo dissection of fiber tracts coursing through the PTO area. Depending on the location of the AVMs, long association fibers are variously modified. These findings correlate with clinical manifestations and may predict outcome after surgery.
Use of endovascular coil embolization and surgical clip occlusion for cerebral artery aneurysms
Authors: Cowan John A. , Ziewacz John , Dimick Justin B. , Upchurch Gilbert R. , Thompson B. Gregory 
Published: January 2008

Object
In recent years, endovascular treatment of cerebral artery aneurysms (CAAs) has received greater attention. The authors evaluated patient demographics, endovascular and surgical approaches, and basic outcomes in the treatment of CAAs in a nationally representative administrative database.

Methods
Using the Nationwide Inpatient Sample from 1998 to 2003, diagnosed CAA coded as either an unruptured or ruptured lesion and treated with surgical clip occlusion, wrapping combined with endovascular repair, or endovascular repair alone was included in the present study.

Results
Treatment of CAAs significantly increased for unruptured (from 4036 to 8334 cases, p = 0.002) but not ruptured (from 9330 to 11,269 cases, p = 0.231) lesions. Endovascular treatment of CAAs in particular also increased in patients with unruptured (from 11 to 43%, p <0.001) and ruptured (from 5 to 31%, p <0.001) lesions. In 2003, the mortality rate associated with unruptured CAAs treated using clip occlusion (1.36%) or endovascular repair (1.41%) was similar, whereas rate differences were noted between these treatments for ruptured CAAs (12.7% for clip occlusion compared with 16.6% for endovascular repair; p = 0.05). Endovascular treatment of unruptured CAAs was associated with a shorter length of stay (LOS) and higher rate of discharge to home compared with those for clip occlusion. The LOS was also shorter in patients with endovascularly treated ruptured CAAs. Aneurysm type (odds ratio [OR] 10.1, ruptured lesion), patient age (OR 1.28, each 10 years), comorbid conditions (OR 1.08, each condition), and hospital case volume (OR 0.97, each additional case) were significant predictors of death in the regression model.

Conclusions
Endovascular techniques for the treatment of CAAs are being used increasingly in the US, although the majority of patients with this pathological entity still undergo surgical clip occlusion. In cases of unruptured CAAs, endovascular treatment is associated with a shorter LOS and higher discharge-to-home rate. Aneurysm status, patient age, comorbid conditions, and hospital case volume are significant predictors of death. Finally, demographic differences exist between the populations presenting with unruptured or ruptured CAAs.
Induction of glioma cell migration by vitronectin in human serum and cerebrospinal fluid
Authors: Fukushima Yuji , Tamura Masakazu , Nakagawa Hidemitsu , Itoh Kazuyuki 
Published: January 2008

Object
Malignant gliomas are often highly invasive and can migrate along blood vessels. The purpose of the current study was to identify the substance in human serum and/or cerebrospinal fluid (CSF) that promotes glioma cell migration.

Methods
The authors used a Boyden chamber cell migration assay to study the effect of serum from patients with glioma and healthy volunteers on chemotaxis of A172 human glioma cells. Heat inactivation, trypsinization, and ultra-filtration of serum were used to establish the nature of the active factor. Vitronectin and fibronectin were chosen for further investigations; chemotactic effects were studied in both serum and CSF.

Results
Serum from both patients with glioma and healthy volunteers was found to promote chemotaxis of human glioma cells. This activity was greatly reduced by heat inactivation or trypsinization. Fractionation of the serum by ultrafiltration through membranes with various pore sizes showed that the active molecule was larger than 50 kD. Antibodies against integrin αv or αvβ5 or arginine-glycine-aspartic acid–containing peptides, both of which block the vitronectin–glioma cell interactions, significantly reduced serum-induced cell migration, whereas blocking the interaction of glioma cells with fibronectin had no effect. Furthermore, the ability of serum to promote the migration of A172 or T98G glioma cells was suppressed by immunodepletion of vitronectin and restored by the addition of exogenous vitronectin. The migration of glioma cells induced by CSF collected from the postoperative cavity of a malignant glioma patient was also reduced by blocking the interaction of glioma cells with vitronectin.

Conclusions
These results suggest that vitronectin is one of the major factors in serum- and CSF-induced glioma cell migration.
Wilms tumor 1 expression in malignant gliomas and correlation of +KTS isoforms with p53 status
Authors: Clark Aaron J. , Dos Santos Wagner G. , Mccready Jessica , Chen Mike Y. , Van Meter Timothy E. , Ware Joy L. , Wolber Sharon B. , Fillmore Helen , Broaddus William C. 
Published: January 2008

Object
The WT1 gene is overexpressed in many types of human cancer. It has been demonstrated that Wilms tumor 1 (WT1) promotes tumor cell proliferation and survival in some cell lines by inhibiting p53-mediated apoptosis; however, this relationship has not been investigated in gliomas. The goal in this study was to characterize the expression pattern of WT1 in human gliomas and to determine if a correlation exists between WT1 expression and p53 status.

Methods
The authors screened nine malignant glioma cell lines, 50 glioblastoma multiforme (GBM) samples, and 16 lower-grade glial tumors for WT1 expression.

Results
Five of nine cell lines, 44 of 50 GBM samples, and 13 of 16 lower-grade gliomas expressed WT1 mRNA on reverse transcriptase polymerase chain reaction (PCR) analysis. Expression of WT1 was not detected in normal astrocytes. Two WT1 isoforms, +/+ and −/+, were expressed in the majority of these samples. Real-time PCR analysis of the GBM cell lines revealed that the level of WT1 mRNA ranged from 6.33 to 214.70 ng per ng 18S ribosomal RNA. The authors screened the GBM samples for p53 mutation by using PCR and single-stranded conformational polymorphism analysis, and they demonstrated an association between WT1 expression and p53 status. Tumors that contained wild-type p53 were significantly more likely to express WT1 than tumors that contained mutant p53.

Conclusions
The presence of WT1 in glioma cell lines and the majority of primary tumor samples and its absence in normal astrocytes support the suggestion that WT1 expression is important in glioma biology.
Prediction of oligodendroglial tumor subtype and grade using perfusion weighted magnetic resonance imaging
Authors: Whitmore Robert G. , Krejza Jaroslaw , Kapoor Gurpreet S. , Huse Jason , Woo John H. , Bloom Stephanie , Lopinto Joanna , Wolf Ronald L. , Judy Kevin , Rosenfeld Myrna R. , Biegel Jaclyn A. , Melhem Elias R. , O'rourke Donald M. 
Published: January 2008

Object
Treatment of patients with oligodendrogliomas relies on histopathological grade and characteristic cytogenetic deletions of 1p and 19q, shown to predict radio- and chemosensitivity and prolonged survival. Perfusion weighted magnetic resonance (MR) imaging allows for noninvasive determination of relative tumor blood volume (rTBV) and has been used to predict the grade of astrocytic neoplasms. The aim of this study was to use perfusion weighted MR imaging to predict tumor grade and cytogenetic profile in oligodendroglial neoplasms.

Methods
Thirty patients with oligodendroglial neoplasms who underwent preoperative perfusion MR imaging were retrospectively identified. Tumors were classified by histopathological grade and stratified into two cytogenetic groups: 1p or 1p and 19q loss of heterozygosity (LOH) (Group 1), and 19q LOH only on intact alleles (Group 2). Tumor blood volume was calculated in relation to contralateral white matter. Multivariate logistic regression analysis was used to develop predictive models of cytogenetic profile and tumor grade.

Results
In World Health Organization Grade II neoplasms, the rTBV was significantly greater (p < 0.05) in Group 1 (mean 2.44, range 0.96–3.28; seven patients) compared with Group 2 (mean 1.69, range 1.27–2.08; seven patients). In Grade III neoplasms, the differences between Group 1 (mean 3.38, range 1.59–6.26; four patients) and Group 2 (mean 2.83, range 1.81–3.76; 12 patients) were not significant. The rTBV was significantly greater (p < 0.05) in Grade III neoplasms (mean 2.97, range 1.59–6.26; 16 patients) compared with Grade II neoplasms (mean 2.07, range 0.96–3.28; 14 patients). The models integrating rTBV with cytogenetic profile and grade showed prediction accuracies of 68 and 73%, respectively.

Conclusions
Oligodendroglial classification models derived from advanced imaging will improve the accuracy of tumor grading, provide prognostic information, and have potential to influence treatment decisions.
Conditions of protection by hypothermia and effects on apoptotic pathways in a rat model of permanent middle cerebral artery occlusion
Authors: Zhao Heng , Wang Jade Q. , Shimohata Takayoshi , Sun Guohua , Yenari Midori A. , Sapolsky Robert M. , Steinberg Gary K. 
Published: January 2008

Object
Hypothermia is protective in stroke models, but findings from permanent occlusion models are conflicting. In this article the authors induced focal ischemia in rats by permanent distal middle cerebral artery (MCA) occlusion plus transient occlusion of the common carotid arteries (CCAs). This models a scenario in which the MCA remains occluded but partial reperfusion occurs through collateral vessels. The authors also determined whether hypothermia mediates ischemic damage by blocking apoptotic pathways.

Methods
The left MCA was occluded permanently and the CCAs were reopened after 2 hours, leading to partial reperfusion in rats maintained at 37°C, 33°C (mild hypothermia), or 30°C (moderate hypothermia) for 2 hours during and/or after CCA occlusion (that is, for a total of 2 or 4 hours of hypothermia or normothermia). Infarct size was measured 2 days after the stroke. Immunofluorescence staining and Western blot analysis were used to detect cytochrome c and apoptosis inducing factor (AIF) translocation.

Results
Four hours of prolonged mild hypothermia (33°C) reduced the infarct size 22% in the model of permanent MCA occlusion, whereas 2 hours of such mild hypothermia maintained either during CCA occlusion or after CCA release did not attenuate ischemic damage. However, moderate hypothermia (30°C) during CCA occlusion was significantly more protective than 4 hours of 33°C (46% decrease in infarct size). Four hours of mild or moderate hypothermia reduced cytosolic cytochrome c release and both nuclear and cytosolic AIF translocation in the penumbra 2 days after stroke.

Conclusions
These findings suggest that hypothermic neuroprotection might be achieved by blocking AIF and cytochrome c–mediated apoptosis.
Extranodal NK/T-cell lymphoma presenting as a pituitary mass
Authors: Liu James K. , Sayama Christina , Chin Steven S. , Couldwell William T. 
Published: January 2008

✓ Primary pituitary lymphomas (PPLs) are rare tumors of the central nervous system, and most are of B-cell origin. Extranodal NK/T-cell lymphomas are uncommon neoplasms that are highly aggressive and show a strong association with Epstein–Barr virus. They most commonly affect the nasal cavity and paranasal sinuses; manifestation as a primary pituitary tumor has never been described. The authors report a case of NK/T-cell lymphoma of the pituitary gland and review 17 cases of PPL from the literature.
All patients had been evaluated at presentation for clinical, neuroimaging, and histopathological findings. Patients who had systemic lymphoma with secondary involvement of the pituitary gland were excluded. The mean patient age was 55.5 years (range 26–86 years); the male/female ratio was 13:5. The most common presentation was pituitary insufficiency (72%), followed by headache (56%), diplopia (39%), visual loss (28%), and fever (22%). Thirteen patients (72%) exhibited anterior hypopituitarism and seven (39%) had diabetes insipidus at presentation. Magnetic resonance imaging demonstrated enhancing parasellar masses with diffuse enlargement of the pituitary gland (94%), suprasellar extension (44%), cavernous sinus extension (39%), and stalk thickening (22%). Thirteen patients (72%) had B-cell lymphoma, four (22%) had T-cell lymphoma, and one (6%) had NK/T-cell lymphoma.
Primary pituitary lymphomas are rare entities with a range of clinical presentations and neuroimaging findings that are unique from those of patients who present with pituitary adenomas. The pathological entity of NK/T-cell lymphoma is distinct, and its course is very aggressive with a poor prognosis.