bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic orthotic cranioplasty: treatment of the older infant.
Authors: Littlefield Timothy R. , Pomatto Jeanne K. , Kelly Kevin M. 
Published: January 2008

The Dynamic Orthotic Cranioplasty Band is a cranial orthotic device used to treat deformational plagiocephaly in infants. The device works by applying a mild holding pressure to the most anterior and posterior prominences, where growth is not desired, while encouraging growth in adjacent flattened regions. Although this technique has been successfully used to treat infants as young as 3 months of age, it is often assumed that decreasing cranial growth and increasing cranial rigidity prohibit treatment in infants older than 1 year of age.
The authors' experience with older infants suggests the contrary. Through a series of case reports, they present evidence that this treatment remains viable during the 2nd year of life and that improvement has been observed in infants in whom treatment has been initiated as late as 18 months. These examples certainly suggest that additional prospective studies are warranted.
Thoracoscopic surgery: historical perspectives
Authors: Das Kaushik , Rothberg Martin 
Published: January 2008

Recent technical advances have revolutionized the fields of surgical endoscopy, laparoscopy, thoracoscopy, and microsurgical spinal endoscopy. The authors discuss the rich history and recent evolution of these techniques.
Thoracoscopy had been widely used for the treatment of pleural conditions associated with tuberculosis. It was largely abandoned in the 1950s when effective antituberculosis medications were introduced. In the 1980s the development of video-assisted endoscopic procedures in the fields of general surgery, orthopedics, and otolaryngology provided new impetus to revive thoracoscopy. As a result of these advances thoracoscopy replaced open thoracotomy in many cardiothoracic procedures.
These improvements led to the application of these techniques to treat disorders of the spine. By the mid-1990s microsurgical endoscopy was being used effectively to treat thoracic disc disease, perform anterior surgical release procedures for scoliosis, resect tumors, and even to conduct complex spinal fusions and reconstructions. As technology continues to improve, there is no doubt that thoracoscopic surgery will find a permanent place in the armamentarium of techniques used to treat pathological entities of the spine.
Transpedicular approach for thoracic disc herniations
Authors: Bilsky Mark H. 
Published: January 2008

Object
Patients with symptomatic herniated thoracic discs may require operation for intractable radiculopathy or functionally disabling myelopathy. In the past, laminectomy was the procedure of choice for the treatment of thoracic herniations, but it was found that the approach was associated with an unacceptably high rate of neurological morbidity. Several strategies have been developed to excise the disc without manipulating the spinal cord. The focus of this paper is the transpedicular approach.

Methods
The author retrospectively reviewed the cases of 20 consecutive patients presenting with herniated thoracic discs in whom surgery was performed via a transpedicular approach. Fourteen patients presented with acute myelopathy and six with radiculopathy. Of those with myelopathy six of six regained ambulation and six of seven regained normal bladder function. No patient with myelopathy experienced neurological worsening. In four patients presenting with radiculopathy postoperative pain resolved, and in two it remained unchanged. Three minor complications (15%) occurred. No patient suffered postoperative spinal instability–related pain or delayed kyphosis.

Conclusions
As experience accumulates in the use of multiple approaches for the treatment of thoracic disc herniations, the role of each is becoming more clearly defined. The transpedicular approach is most applicable to lateral or centrolateral calcified or soft discs. The more anterior (transthoracic or thoracoscopic) and lateral (costotransversectomy or lateral extracavitary) approaches may be more useful for excision of central calcified discs.
Endoscopic transpedicular thoracic discectomy
Authors: Jho Hae-Dong 
Published: January 2008

Object
To reduce the invasiveness and risk of thoracic disc surgery, a transpedicular endoscopic approach has been created. The surgical technique and outcome of endoscopic transpedicular thoracic discectomy are reported.

Methods
The surgical technique of posterior transpedicular thoracic discectomy was modified to endoscopic transpedicular surgery. A 1.5-cm trocar was placed in the interlaminar space via a 2-cm transverse paramedian skin incision. At the ventral aspect of the spinal cord discectomy was performed under direct visualization by using a 70°-lens endoscope. This surgical technique was used in 25 patients. Twelve patients were men and 13 were women, aged 29 to 70 years (median 46 years). Myelopathy, with or without radiculopathy was present in 13 patients, radiculopathy in 10, and segmental pain in two. The follow-up periods ranged from 4 to 60 months (median 27 months).
In 12 of the 13 patients with myelopathy excellent improvement was shown postoperatively; the remaining patient suffered recurrence of symptoms after a motor vehicle accident three months postoperatively. In nine of the 10 patients with radiculopathy, pain was resolved completely. In one patient with right-sided hypochondral pain and two patients with segmental pain, relief was not achieved despite excellent results of discectomy demonstrated on postoperative magnetic resonance imaging. The average length of hospital stay was one night.

Conclusions
Endoscopic transpedicular thoracic discectomy was found to be a minimally invasive and effective surgical treatment.
Bedside microdialysis for early detection of cerebral hypoxia in traumatic brain injury
Authors: Sarrafzadeh Asita S. , Sakowitz Oliver W. , Callsen Tim A. , Lanksch Wolfgang R. , Unterberg Andreas W. 
Published: January 2008

Object
The authors evaluated the use of bedside cerebral online microdialysis for the detection of impending and present cerebral hypoxia in patients who had sustained traumatic brain injury.

Methods
Thirty-five severely head injured patients (with Glasgow Coma Scale scores ≤ 8) were studied. Patients underwent continuous brain tissue PO2 (PtiO2) monitoring. The PtiO2 catheter was placed into the unaffected frontal white matter within 32.2 hours postinjury (range 7–48 hours). The microdialysis catheter was placed close to the PtiO2 probe via a 2- or 3-way skull screw that was connected to a pump and perfused with Ringer's solution at 0.3 μl/minute. The microdialysis samples were collected hourly and analyzed at the bedside for glucose, lactate, lactate–pyruvate 5-minute ratio, and glutamate. Data were analyzed for identification of episodes of impending (PtiO2 10–15 mm, Hg > 5-minute duration) and present cerebral hypoxia (PtiO2 10 mm, Hg, > 5-minute duration). In 62% of the patients hypoxic episodes occurred and were most frequently associated with hyperventilation (p < 0.001). During impending hypox-ia, extracellular glutamate concentrations were increased (p = 0.006) whereas energy metabolites remained stable. During cerebral hypoxia, the extracellular glutamate (p < 0.001) and lactate (p = 0.001) concentrations were significantly higher than during normal oxygenation, whereas the lactate–pyruvate ratio was only slightly increased (p = 0.088, not significant).

Conclusions
The authors conclude that a PtiO2 below 10 mm Hg is critical to induce metabolic changes seen during hypoxia/ischemia. Early markers of cerebral hypoxia are increased levels of glutamate and lactate. Regional hypoxia is not always associated with anaerobic cerebral metabolism. In the future, this technology of bedside monitoring may allow optimization of the treatment of severely head injured patients.
Comparative analysis of paracrine immunotherapy in experimental brain tumors
Authors: Lesniak Maciej S. , Sampath Prakash , DiMeco Francesco , Viglione Michael P. , Tyler Betty M. , Pardoll Drew M. , Brem Henry 
Published: January 2008

Object
Local delivery of cytokines has been shown to have a potent antitumor activity against a wide range of malignant brain tumors. In this study, the authors examined the efficacy of treating central nervous system (CNS) tumors by transfecting poorly immunogenic B16/F10 melanoma cells with interleukin (IL)-2, IL-4, or granulocyte-macrophage–colony stimulating factor (GM-CSF) gene, and using these cells to deliver the cytokine locally at the site of the CNS tumor. The object was to determine which cytokine would possess the greatest antitumor activity and to further elucidate its mechanism of action.

Methods
The transfected B16/F10 cells were irradiated to prevent replication and injected intracranially into C57BL/6 mice (10 mice per group) along with nonirradiated, nontransfected B16/F10 (wild-type) melanoma cells. Sixty percent of mice treated with IL-2 (p < 0.001 compared with control) and 10% treated with IL-4 (median survival = 31 days, p < 0.001 compared with control) were long term survivors (> 120 days). The median survival for animals treated with GM-CSF was 22 days with no long term survivors (p = 0.01 compared with control). Control animals that received only wild-type cells had a median survival of 18 days (range 15–20 days). Histopathological examination of brains from animals killed at different times showed minimal infiltration of tumor cells in the IL-2 group, moderate infiltration of tumor cells in the IL-4 group, and gross tumor invasion and tissue necrosis in the GM-CSF group. Animals treated with IL-2 showed a strong CD8 T cell–mediated response, whereas IL-4 evoked a prominent eosinophilic infiltrate in the area of the tumor.

Conclusions
High levels of locally expressed IL-2 rather than IL-4 or GM-CSF stimulate a strong immunological cytotoxic antitumor response that leads to significant prolongation of survival in mice challenged with B16/F10 intracranial melanoma tumor cells. Consequently, IL-2 may be a superior candidate for use in paracrine immunotherapy.
In vitro efficacy of recombinant diphtheria toxin–murine interleukin-4 immunoconjugate on mouse glioblastoma and neuroblastoma cell lines and the additive effect of radiation
Authors: Kim Ki-Uk , Vallera Daniel A. , Ni Hsaio-Tzu , Cho Kwan H. , Low Walter C. , Hall Walter A. 
Published: January 2008

Object
The prognosis for patients with primary malignant brain tumors is poor despite aggressive treatment, and tumor recurrence is common regardless of the chosen therapy. Although multimodal treatment does not provide a cure, it is necessary to determine which treatment modalities have the greatest cytotoxic effect and can potentially prolong survival. Immunotoxin therapy is a novel approach for the treatment of tumors, and it has been successfully used in the central nervous system. Because the interleukin (IL)–4 receptor is commonly expressed on brain tumor cells, the purpose of this study was to evaluate the cytotoxic effect of using a modified diphtheria toxin–murine IL-4 (DT390-mIL4) immunoconjugate for the treatment of murine brain tumor cell lines and to determine whether the addition of radiation therapy could potentiate the effect of this agent.

Methods
Spontaneous murine glioblastoma (SMA-560) and two neuroblastoma (Neuro-2a and NB41A3) cell lines were treated using DT390-mIL4 at different concentrations, and the anti–mouse IL-4 monoclonal antibody (11B11) was used for blocking its cytotoxicity. Other SMA-560 and Neuro-2a cell lines were treated using 500 cGy of radiation 3 hours before DT390-mIL4 treatment. Cytotoxity was evaluated using a trypan blue viability assay.
The immunoconjugate exhibited a dose-dependent cytotoxic effect with 50% inhibitory concentration values of 0.56 × 10−9 M in SMA-560, 1.28 × 10−9 M in Neuro-2a, and 0.95 × 10−10 M in NB41A3 cell lines. The cytotoxicity of DT390-mIL4 was specifically blocked by an excess of 11B11. Cytotoxicity was additive when the DT390-mIL4 at 10−9 M immunoconjugate administration was followed by radiation therapy.

Conclusions
These results indicate that the IL-4 receptor can be a target for diphtheria toxin fusion proteins and that radiation can potentiate the effects of DT390-mIL4. The development of multimodal approaches to treat malignant brain tumors with agents that have different mechanisms of action may be beneficial.
Induction of a therapeutic antitumor immunological response by intratumoral injection of genetically engineered Semliki Forest virus to produce interleukin-12
Authors: Yamanaka Ryuya , Zullo Susan A. , Tanaka Ryuichi , Ramsey Jay , Blaese Michael , Xanthopoulos Kleanthis G. 
Published: January 2008

Object
The authors investigated immunogene therapy for malignant glioma to determine whether its therapeutic efficacy could be improved.

Methods
Four groups of 203-glioma–bearing mice were treated with injections of phosphate-buffered saline, Semliki Forest virus (SFV)–LacZ, retrovirus vector DFG–interleukin (IL)–12, and SFV-IL12, respectively.
The results indicated that therapeutic immunization with SFV-IL12 prolonged the survival of mice with established tumors. Semliki Forest virus induces apoptotic death to glioma cells, which facilitates the uptake of apoptotic cells by dendritic cells, providing a potential mechanism for enhanced immunogenicity.

Conclusions
Immunogene therapy with IL-12 via SFV may be an excellent candidate for the development of new cancer vaccines.
Cardiorespiratory fitness and the progression of carotid atherosclerosis in middle-aged men. Ann Intern Med 134:12–20, 2001
Authors: Couldwell William T. 
Published: January 2008

Background
Good cardiorespiratory fitness has been associated with reduced risk for clinical events of atherosclerotic vascular diseases, but whether it is related to slower progression of early atherosclerosis is unclear. Objective: To study the association between cardiorespiratory fitness and the progression of early carotid atherosclerosis. Design: 4-year follow-up study. Setting: Eastern Finland. Participants: Population-based sample of 854 men 42 to 60 years of age. Measurements: Maximal oxygen uptake (VO2max [L/kg per minute]) was measured directly by using respiratory gas exchange in a cycle ergometer exercise test. Carotid atherosclerosis was assessed by using B-mode ultrasonography. Results: After adjustments for age, technical covariates, and cigarette smoking, VO2max had strong, inverse, and graded associations with 4-year increases i maximal intima-media thickness (IMT) (standard regression coefficient β = 0.120; P = 0.002); plaque height (β = 0.140; P < 0.001), surface roughness, and mean IMT (β = 0.080; P = 0.035). These associations weakened but remained statistically significant after additional adjustment for systole blood pressure, serum levels of apolipoprotein B, diabetes, and plasma fibrinogen levels. The increases in maximal IMT, surface roughness, and mean 26.1 mL/kg per IMT (23%, 32% and 100%, respectively) were larger among men in the lowest quartile of VO2max (< minute) than among those in the highest quartile (> 36.2 ML/kg per minute). Conclusions: Good cardiorespiratory fitness is associated with slower progression of early atherosclerosis in middle-aged men. These findings are important because they emphasize that middle-aged men can be evaluated for cardiorespiratory fitness to estimate their future risk for atherosclerotic vascular disease. Additional research is warranted to investigate a possible causal relationship between cardiorespiratory fitness and atherosclerosis.
Chordomas of the skull base: follow-up review and prognostic factors
Authors: Colli Benedicto O. , Al-Mefty Ossama 
Published: January 2008

Object
Chordomas are rare tumors that arise from the remnants of the notochord. Because of their deep location, local infiltrative nature, and involvement of surrounding bone, treatment of chordoma is a challenge. The authors analyze the data and prognostic factors obtained during the follow-up period (range 1–150 months, median 38 months) in 53 patients with craniocervical junction chordoma and 10 patients with chondrosarcoma.

Methods
Several surgical approaches were used, and some tumor excisions required staged procedures. Survival was calculated according the Kaplan–Meier method. Statistical analysis was performed using the Fisher exact and Kruskal–Wallis tests. Radical/subtotal resection was achieved in 77.8% of the patients. The mortality rate during the follow-up period was 14.3%. In patients harboring chondrosarcoma better 5-year recurrence-free survival (RFS) rates were demonstrated than in those with chordoma (100% and 50.7%, respectively). Histological patterns (typical or chondroid chordoma) and patient age at onset of symptoms had no effect on the RFS rates. Radical/subtotal resections were associated with better RFS rates than partial resection. Adjuvant proton-beam radiotherapy was shown to increase the RFS rates compared with conventional radiotherapy (90.9% and 19.4%, respectively at 4 years posttreatment). Karyotypically abnormal tumors were associated with worst RFS rates as compared with karyotypically normal lesions (44.5% and 90.3%, respectively at 3 years). Cases of cranial nerve palsy, followed by CSF leakages were the most frequent postoperative complication. Permanent postoperative neurological deficit was observed in 28.6% of the patients.

Conclusions
A better prognosis was observed in patients with chondrosarcoma compared with those harboring chordoma. Histological pattern and the patient's age at symptom onset were not factors that influenced prognosis in cases of chordoma. Extensive resection and possibly adjuvant proton-beam radiotherapy provided better prognosis for these patients.
Identification of isochromosome 1q as a recurring chromosome aberration in skull base chordomas: a new marker for aggressive tumors?
Authors: Sawyer Jeffrey R. , Husain Muhammad , Al-Mefty Ossama 
Published: January 2008

Object
The authors conducted a study of 22 skull base chordomas.

Methods
A series of 22 skull base chordomas was analyzed with G banding. Subsequently, metaphase cells obtained from three tumors were reexamined using multicolor spectral karyotyping. Clonal chromosome aberrations were identified in 11 cases, all of which were recurrent tumors. Three tumors showed a remarkable similarity in cytogenetic features, and these features appear to characterize a recurring combination of nonrandom chromosome aberrations, including isochromosome 1q, gain of chromosome 7, and monosomy for chromosomes 3, 4, 10,13, and 18. Isochromosome 1q was identified as the sole recurring structural chromosome rearrangement in these tumors. The pattern of chromosome loss reported in the progression of lumbosacral chordoma also appears to be true of skull base chordomas with the additional findings of isochromosome 1q, gain of chromosome 7, and loss of chromosome 18.

Conclusions
Skull base chordomas characterized by isochromosome 1q and monosomy 13 provide support for the concept of the loss of putative tumor suppressor loci on 1p and 13q and aggressive tumor behavior.
Anterior cervical interbody fusion with hydroxyapatite graft and plate system
Authors: Bruneau Michael , Nisolle Jean-Francois , Gilliard Claude , Gustin Thierry 
Published: January 2008

Object
In cases of spondylosis or spine trauma, cervical interbody grafts are sometimes required after anterior discectomy. To avoid morbidity related to the harvesting of iliac crest bone, numerous materials have been developed such as allografts, methylmethacrylate, biocompatible osteoconductive polymer, and coralline grafts or cages. Some of these materials, however, are inefficient for fusion or are associated with specific complications. Conversely, hydroxyapatite (HA) grafts have numerous advantages. For example, their mechanical properties provide adequate load resistance and their porosity allows infiltration by newly formed bone, leading to complete fusion. The authors studied the results of using HA grafts combined with plating in patients who underwent anterior cervical discectomy.

Methods
Fifty-four patients underwent 68 cervical interbody fusion procedures in which an HA graft and plating were used. Indications for surgery were radiculopathy (caused by soft-disc herniation or spondylosis) in 46 cases, spondylotic myelopathy in two cases, and spinal trauma in six cases. Postoperatively the patients were followed for a mean of 24.6 months. Patients underwent radiography to evaluate fusion, intervertebral disc height, and the degree of lordosis.
Clinically, excellent or good results (based on the Odon classification) were demonstrated in 91% of patients who presented with radiculopathy. Complete interbody fusion was achieved in 99% of all cases. Preoperative kyphotic deformities were corrected in all cases after surgery. Intervertebral disc height was maintained throughout follow up. Surgery-related morbidity was low; only one patient suffered from a permanent dysphagia. Graft deterioration was observed in 13 cases and two graft fractures occurred but without adversely affecting fusion. There were no cases of graft extrusion.

Conclusions
Hydroxyapatite grafts are very efficient in achieving cervical fusion, maintaining intervertebral disc height, and restoring lordosis. When combined with the placement of a cervical plate, immediate stability is achieved and graft displacement is prevented.
Transcortical surgery for lateral ventricular tumors
Authors: Ellenbogen Richard G. 
Published: January 2008

Object
Tumors of the lateral ventricle can be removed via two major approaches: the transcallosal or the transcortical route. The purpose of this study is to discuss the techniques and outcomes in transcortical surgery of tumors located in the lateral ventricle.

Methods
An experience with 29 consecutive lateral ventricular tumors resected via the transcortical route, over a 5-year period, is presented. The risks, complications, and outcomes of this surgical series, as well as those reported in the literature, are discussed. Surgical approaches to all five regions of the lateral ventricle are described. Neuropsychological, functional, and neurological outcomes are evaluated.

Conclusions
The transcortical technique makes it possible to resect lesions in each of the five regions of the lateral ventricle. It provides superior microsurgical working space and flexibility for maneuvering within the lateral ventricle. The key to a successful transcortical approach is an understanding of the functional anatomy of eloquent cortex to be broached, the location of the lesion, and its vascular supply. A clear understanding of the advantages and limitations of the transcortical approach makes performing this procedure for resection of large lesions in the ventricle both safe and effective. The majority of the patients in this series (86%) had a good outcome, returning to baseline functional status and suffering minimal morbidity. In the microsurgical era, transcortical surgery–related postoperative morbidity and outcome are dependent more on tumor histological type and site of origin than on approach.