bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orthogonal Interlocking Tandem Clipping Technique for the Reconstruction of Complex Middle Cerebral Artery Aneurysms
Authors: Clatterbuck Richard E. , Galler Robert M. , Tamargo Rafael J. , Chalif David J. 
Published: October 2006

Abstract

OBJECTIVE:
Complex aneurysms arising at the middle cerebral artery (MCA) bifurcation frequently present a microsurgical challenge to effectively obliterate while maintaining patency of the distal MCA branches. These aneurysms are often multilobed, with their long axis aligned with the long axis of the M1 trunk, placing the dome of the aneurysm in the surgeons' line of sight, preventing an unobstructed view of the entire bifurcation and proximal M1 segment. MCA aneurysms often have a broad neck, splaying the bifurcation. An orthogonal interlocking tandem clipping technique, maximizing the use of fenestrated aneurysm clips, is presented as a means to completely obliterate the aneurysm and simultaneously “reconstruct” the MCA bifurcation. CLINICAL PRESENTATIONS AND INTERVENTION: Fifteen complex MCA aneurysms were treated using an interlocking tandem clipping technique. In its simplest application, the blades of the initial aneurysm clip are incorporated into the fenestration of the second clip. Obliteration of the residual aneurysm is achieved with the blades of the second, fenestrated clip.

RESULTS:
Satisfactory aneurysm obliteration and reconstruction of the MCA bifurcation was achieved in all cases using this technique, with excellent neurological outcomes.

CONCLUSION:
Morphologically complex multilobed MCA aneurysms can be effectively clipped with “reconstruction” of the normal vascular anatomy using a tandem interlocking clipping technique. A fenestrated clip is used to incorporate the blades of the initial clip, while obliterating the remainder of the aneurysm.
Endoscope-Assisted Microvascular Decompression for Trigeminal Neuralgia:Technical Case Report
Authors: Teo Charles , Nakaji Peter , Mobbs Ralph J. 
Published: October 2006

Abstract

OBJECTIVE:
Microvascular decompression may fail to relieve trigeminal neuralgia because a compressing vessel at the root entry zone may be overlooked during surgery. Alternatively, effective decompression may not always be achieved with the visualization provided by the microscope alone. We theorized that the addition of an endoscope would improve the efficacy of microvascular decompression.

METHODS:
We retrospectively reviewed microvascular decompression of the trigeminal nerve in 114 patients. Before closure, the endoscope was used to inspect the root entry zone. When visualization with the microscope was poor, the endoscope was used to identify an aberrant vessel and to perform or improve the subsequent decompression.

RESULTS:
Of 114 patients who underwent microvascular decompression, 113 successfully underwent endoscopy. In 38 patients (33%), endoscopy revealed arteries that were poorly seen (25%) or not seen at all (8%) with the microscope. At a mean follow-up period of 29 months, the pain was completely relieved in 112 patients (99.1%), all of whom were off medication. Complications included trigeminal dyses-thesias in nine patients and a wound infection, partial hearing loss, and complete hearing loss in one patient each. The overall complication rate was 9%.

CONCLUSION:
Endoscopy is a simple and safe adjunct to microscopic exploration of the trigeminal nerve. The markedly improved visualization increases the likelihood of identifying the offending vessel and consequently of achieving satisfactory decompression of the nerve. Thus far, the success rate has been high, and the complication profile is comparable to that of other large series.
Endoscopic Fenestration of A Symptomatic Cavum Septum Pellucidum:Technical Case Report
Authors: Weyerbrock Astrid , Mainprize Todd , Rutka James T. 
Published: October 2006

Abstract

OBJECTIVE:
Cysts of the septum pellucidum (CSPs) may become symptomatic because of obstruction of cerebrospinal fluid flow, resulting in increased intracranial pressure and hydrocephalus requiring surgical intervention. Endoscopic fenestration may be the most effective and least invasive technique to treat this pathological condition. CLINICAL PRESENTATION: An 11-year-old boy sought treatment for frequent episodes of severe headache. On examination, he had papilledema. There was evidence on magnetic resonance imaging scans of a space-occupying CSP with obstructive hydrocephalus.

INTERVENTION:
The endoscopic technique of fenestration of both lateral walls of an enlarged CSP via a left frontal approach under ultrasound guidance using a rigid endoscope was successful. After surgery, the patient became asymptomatic, his papilledema resolved, and magnetic resonance imaging scans demonstrated collapse of the walls of the CSP toward the midline.

CONCLUSION:
Neuroendoscopic fenestration should be strongly considered as the treatment of choice for symptomatic CSPs. This procedure alone can lead to complete resolution of clinical symptoms and hydrocephalus, can reduce the size of the CSP, and can obviate the need for an implantable cerebrospinal fluid shunt.
Endovascular Management of Intracranial Aneurysms: Current Experience and Future Advances
Authors: Koebbe Christopher J. , Veznedaroglu Erol , Jabbour Pascal , Rosenwasser Robert H. 
Published: October 2006

Abstract

OBJECTIVE:
The past 15 years have seen a revolution in the treatment of intracranial aneurysms. Endovascular technology has evolved rapidly since the Food and Drug Administration approval of Guglielmi detachable coils in 1995, which now allows successful treatment of most aneurysms. The authors provide a review of their 11-year experience at Jefferson Hospital for Neuroscience with endovascular embolization of intracranial aneurysms and discuss clinical trial outcomes and future directions of this treatment method.

METHODS:
The authors reviewed the clinical and angiographic outcomes for 1307 patients undergoing endovascular treatment of intracranial aneurysms. Their analysis focuses on posterior circulation and middle cerebral artery aneurysms, as well as cases of stent-assisted coil embolization. They review their procedural protocol and patient selection criteria for endovascular management.

RESULTS:
Several large clinical trials have demonstrated the safety and efficacy of endovascular treatment of intracranial aneurysms. The International Subarachnoid Aneurysm Trial provides Level I evidence demonstrating a significant reduction in disability or death with endovascular treatment compared with surgical clipping. The most common procedural complications include intraprocedural rupture and thromboembolic events; avoidance strategies are also discussed. Vasospasm after subarachnoid hemorrhage causes neurological morbidity and mortality and can be successfully managed by early recognition and interventional treatment with angioplasty, pharmacologic agents, or both.

CONCLUSION:
Long-term studies evaluating experience with aneurysm coil embolization during the past decade indicate that this is a safe and durable treatment method. The introduction of stent-assist techniques has improved the management of wide-neck aneurysms. Future technology developments will likely improve the durability of endovascular treatment further by delivering bioactive agents that promote aneurysm thrombosis beyond the coil mass alone. It is clear that endovascular therapy of both ruptured and unruptured aneurysms is becoming a mainstay of practice in this patient population. Although not replacing open surgery, the continued improvements have allowed aneurysms that previously were amenable only to open clip ligation to be treated safely with durable long-term outcomes.
Penetrating neck wounds: Selective exploration.
Authors: May Mark , Chadaratana Phadung , West Joseph W. , Ogura Joseph H. 
Published: October 2006

AbstractThis study of 223 patients with penetrating neck wounds justifies individualizing surgical treatment. Twenty‐four percent was selected for neck surgery. In spite of selective rather than mandatory neck exploration, the mortality rate related to the neck wound in this series was three percent. This compared favorably with the experience of others employing mandatory exploration. There were no deaths in our series attributable to selective observation.
Otologic history, audiometry and tympanometry as a case finding procedure for school screening
Authors: Beery Quinter C. , Bluestone Charles D. , Cantekin Erdem I. 
Published: October 2006

AbstractAn algorithm for identification of hearing loss and middle ear effusion based on otologic history, audiometry and tympanometry was designed and tested on 771 first grade school children. Each ear was profiled as being normal, at risk, at high risk, or in need of otologic referral based on test‐retest screening. In addition, each child was categorized on the basis of the worse ear. Results showed 57 percent of the children as being normal; otologic referral was indicated in 14 percent. The remaining children (29 percent) were at risk or at high risk. The combination of medical history, audiometry and tympanometry constitutes an excellent case finding procedure for screening the otologic status of young school children. Through the utilization of specific criteria, optimal referrals can be made, thereby providing better health care.
Primary monomorphic adenoma of the middle ear
Authors: Hagan Warren E. , Leonard George L. , Ichinose Herbert , Cox Robert H. 
Published: October 2006

AbstractThe benign, monomorphic adenoma, derived from the respiratory epithelium of the middle ear, is a well circumscribed, greyish, avascular tumor. Its histology — documented by light and electron micrographs contained in this report — supports a distinct entity and pathogenesis apart from the malignant adenocarcinoma. Utilizing two case reports, this compendium emphasizes the clinical presentations, as well as radiographic and audiometrical characteristics, of the tumor. The first case represents the typical tumor with conductive hearing loss. The second case is the first reported facial paralysis associated with hemorrhagic infarction of an adenoma which was reversible by surgical resection of the tumor. Based on the histology and four year postoperative follow‐up, the authors conclude the adenoma may be effectively managed by surgical resection.
Significance of tomography in meniere's disease: Periaqueductal pneumatization
Authors: Hall Stephen F. , O'Connor A. Fitzgerald , Thakkar C. H. , Wylie I. G. , Morrison A. W. 
Published: October 2006

AbstractThe revival of endolymphatic sac surgery has led to many investigations in Meniere's disease, including lateral tomography of the periaqueductal pneumatization. We radiologically assessed a series of Meniere's patients and a control group, and found hypocellularity to be more common in Meniere's disease as the literature has stated. However, we found this finding bilaterally in patients with unilateral disease. Our assessment of this information in regard to the etiology and treatment of Meniere's disease is presented.
Ventilation tube surgery and middle ear irrigation
Authors: Balkany Thomas J. , Kaufman Arenberg I. , Steenerson Ronald Leif 
Published: October 2006

AbstractTympanostomy and insertion of ventilation tubes has become one of the most commonly performed operations in the United States. Most authors reporting complications of this procedure describe a postoperative rate of otorrhea in the range of 10%–20% with some reports much higher. This rate of presumed suppuration would generally be considered high by surgeons operating in other areas of the body.It is a commonly accepted surgical practice to follow incision and drainage of a relatively closed space effusion with irrigation of that space. This is true in the surgery for the paranasal sinuses, deep space infections of the neck, joint spaces, and abscesses in general. However, this practice is not routinely performed when incising and draining the middle ear.We have completed a prospective controlled double blind study on post‐tympanostomy tube otorrhea utilizing irrigation of the middle ear. In 220 consecutive cases, the use of middle ear irrigation reduced postoperative infections in the first 6 months from 16% to 4%. Irrigation was also found to be useful in removing very thick effusions from the middle ear by displacement, including those effusions localized in the hypo or epitympanum which were not initially identified at the time of incision and suction. A soft plastic, angled irrigation catheter with radial ports was developed for this purpose.
Complications following reconstruction with the pectoralis major myocutaneous flap: The effect of prior radiation therapy
Authors: Keidan Richard D. , Kusiak Joseph F. 
Published: October 2006

AbstractOver the past 5 years, 40 patients with head and neck cancer underwent pectoralis major myocutaneous flap (PMMF) reconstruction following radical ablative surgery. Twenty‐three patients received prior radiation therapy (55 to 70.2 Gy), while 17 patients had no radiation preoperatively. Thirty‐five percent of the irradiated patients had flap‐related complications, compared to 47% of the nonirradiated patients (P = .52, not statistically significant [NSS]). There were no reoperations and no operative deaths in either group. There was 1 fistula in each group, both of which closed with conservative management. The PMMF for head and neck reconstruction is well tolerated following radiation therapy and has shown comparable morbidity in patients who have not undergone prior radiation.
The role of early tracheotomy in the management of the neurosurgical patient
Authors: Boyd Susan Webb , Benzel Edward C. 
Published: October 2006

AbstractNeurosurgical patients often require prolonged laryngeal intubation. The literature regarding the management of these patients is controversial, with some series reporting increased benefits of early tracheotomy and others reporting similar benefits of prolonged transtracheal intubation. One hundred sixteen consecutive neurosurgical patients who had tracheotomies performed during a 5‐year period are presented in order to clarify some of the factors involved with these issues.The complications that occurred in this series were less frequent than those reported in most of the published series. Of the 116 patients, 7 had posttracheotomy complications. These complications included stomal infections (4 patients), hemorrhage (1 patient), subglottic granulation tissue (1 patient), and tracheitis (1 patient). All complications were easily treated and caused no significant long‐term morbidity. Furthermore, pulmonary care was universally facilitated by the placement of a tracheotomy.The performance of an early postinjury tracheotomy may prevent the known complications of prolonged endotracheal intubation while providing effective ventilation and pulmonary toilet through safe and comfortable access to the airway. Early postinjury tracheotomy is not associated with a high incidence of significant complications in the neurosurgical patient population.
Electrical promontory stimulation in patients with intact cochlear nerve and anacusis following acoustic neuroma surgery
Authors: Cueva Roberto A. , Thedinger Britt A. , Harris Jeffrey P. , Glasscock Michael E. 
Published: October 2006

AbstractAnacusis following hearing preservation surgery for acoustic neuroma removal in which the cochlear nerve was preserved has been explained on the basis of neural or vascular compromise. In the absence of pathologic evidence for either theory, a physiologic model was chosen. Electrical promontory stimulation with monitoring of subjective and electrically evoked auditory brainstem responses was undertaken. A positive response to stimulation suggests a vascular impairment of the cochlea sparing the cochlear nerve and spiral ganglion. The absence of response suggests loss of neural integrity at the level of the spiral ganglion or cochlear nerve. Six patients who suffered anacusis following hearing preservation surgery for acoustic neuroma were studied. Data regarding electrical promontory stimulation, auditory brainstem responses, and implications of the possible role of cochlear implantation are discussed.
The role of guaifenesin in the treatment of sinonasal disease in patients infected with the human immunodeficiency virus (HIV)
Authors: Wawrose Stephen F. , Tami Thomas A. , Amoils C. Phillip 
Published: October 2006

AbstractInflammatory sinonasal disease is a common problem in patients infected with the human immunodeficiency virus (HIV). Although some patients present with acute or chronic sinusitis, many describe persistent nasal congestion and thick, tenacious postnasal drainage, even in the absence of infection. The efficacy of guaifenesin as a mucolytic is poorly documented and support for its use in this setting is primarily anecdotal. This double‐blind, placebo‐controlled study assessed changes in nasal symptoms among 23 HIV‐infected patients receiving either 3 weeks of guaifenesin (2400 mg daily) or placebo. The guaifenesin group reported less nasal congestion and thinner postnasal drainage compared to the placebo group and these differences were statistically significant (P <.05). Guaifenesin appears to be effective in managing HIV‐infected patients with symptomatic rhinosinusitis and may be a useful adjunct for treating acute and chronic sinusitis in this population.
Antimicrobial susceptibility patterns of respiratory tract pathogens from sheep and goats
Authors: Berge Anna Catharina B. , Sischo William M. , Craigmill Arthur L. 
Published: October 2006

Abstract
Objective—To determine the antimicrobial susceptibility of common respiratory tract pathogens from sheep and goats.
Design—Cross-sectional study.
Sample Population—41 respiratory tract isolates from sheep and 36 isolates from goats.
Procedures—Disk diffusion assay was used to determine antimicrobial susceptibility of isolates to amoxicillin-clavulanic acid, ceftiofur, ciprofloxacin, florfenicol, and tetracycline. Minimum inhibitory concentrations of florfenicol for these isolates were determined by use of the microbroth dilution technique.
Results—The most common isolates were Pasteurella multocida (n = 28) and Mannheimia haemolytica (39). All isolates were susceptible to amoxicillin-clavulanic acid, ceftiofur, ciprofloxacin, and florfenicol. Five percent (4/77) of isolates were resistant to tetracycline.
Conclusions and Clinical Relevance—Susceptibility of respiratory tract pathogens isolated from sheep and goats to commonly used antimicrobial drugs in this study was high. Treatment of these species for bacterial respiratory tract disease is likely not complicated by antimicrobial resistance.
Smart blending technology enabled by chaotic advection
Authors: Zumbrunnen D. A. , Subrahmanian R. , Kulshreshtha B. , Mahesha C. 
Published: October 2006

AbstractPolymer blending has been typically regarded as a mixing process rather than a structuring process so polymer blends and composites are not necessarily optimized with regard to structure, properties, and composition. In this article, a new smart blending technology is described whereby melt components and solid additives are more controllably organized into micrometer‐scale and sub‐micrometer‐scale shapes and arrangements to improve properties or impart functionality to extruded plastics. Chaotic advection is an enabling recent subfield of fluid mechanics for smart blending. It provides a method to controllably stretch and fold melt domains and evolve a multilayered structure leading to derivative morphologies, or indirectly manipulate solid additives. Recent advances in fluid mechanics have thereby been implemented to reconsider how blending is done. A variety of structured plastic materials are producible with a single smart blending device with no device alterations. Several examples and their improved physical properties are shown or discussed. © 2006 Wiley Periodicals, Inc. Adv Polym Techn 25:152–169, 2006; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20073
Role of drug efflux carriers in the healthy and diseased brain
Authors: Hermann Dirk M. , Kilic Ertugrul , Spudich Annett , Krämer Stefanie D. , Wunderli‐Allenspach Heidi , Bassetti Claudio L. 
Published: October 2006

AbstractThe blood–brain barrier is a natural diffusion barrier, which expresses active carriers extruding drugs on their way to the brain back into the blood against concentration gradients. Whereas these so‐called adenosine triphosphate–binding cassette (ABC) transporters prevent the brain entry of toxic compounds under physiological conditions, they complicate pharmacotherapies in neurological disease. Recent observations in animal models of ischemic stroke, drug‐resistant epilepsy, and brain cancer showed that the prototype of ABC transporters, ABCB1, is upregulated on brain injury, deactivation of this carrier considerably enhancing the accumulation of neuroprotective, antiepileptic, and chemotherapeutic compounds. These studies provide the proof of concept that the efficacy of brain‐targeting drugs may significantly be improved when drug efflux is blocked. Under clinical conditions, efforts currently are made to enhance drug accumulation by selecting new compounds that do not bind to efflux carriers or deactivating ABC transporters by targeted downregulation or pharmacological inhibition. We predict that strategies aiming at circumventing drug efflux may greatly facilitate progress in neurological therapies. Ann Neurol 2006
Boran‐Addukte des Narkotins und Hydrastins und ihrer Reduktionsprodukte
Authors: Prior Silvia , Wiegrebe Wolfgang 
Published: October 2006

Abstractα‐Narkotin (3), β‐Hydrastin (6) und ihre Reduktionsprodukte binden Boran koordinativ am Stickstoff. — Aus α‐Narkotindiol (8) entsteht mit K‐tert. butylat/Benzophenon nicht α‐Anhydronarkotindiol7), sondern eine Quettamin‐ähnliche Verbindung 9 ohne Racemisierung am Benzyl‐C.
Synthesis of 6‐Substituted 2‐Phenyl‐3‐(5‐substituted mercapto‐1,3,4,thiadiazol‐2‐yl)quinazolin‐4‐(3H)‐ones as Antitubercular Agents
Authors: Kumar Piyush , Dhawan Keshav N. , Vrat Satya , Bhargava Krishna P. , Kishore Kesari 
Published: October 2006

Abstract2‐Amino‐5‐mercapto‐1,3,4‐thiadiazole was condensed with various 6‐substituted 2‐phenylbenzoxazin‐4 (3H)‐ones to yield the compounds 1. When these compounds were subjected to mercaptoetherification the title compounds 2–4 were obtained. They were screened for their antitubercular activity against Mycobacterium smegmatis and Mycobacterium tuberculosis H37 Rv in vitro. Structure‐activity relationships were established.
Synthese von Leukotrien E3
Authors: Spur Bernd , Falsone Gioacchino , Crea Attilio , Peters Wilfried , König Wolfgang 
Published: October 2006

AbstractDie Synthese von Leukotrien E3 (5b) sowie von Leukotrien C3 (6b) und Leukotrien D3 (7b) aus Leukotrien A3 (3) wird beschrieben.
Photo‐Akustische Spektroskopie in der Pharmazie
Authors: Stahl Egon , Breuer Hans Dieter 
Published: October 2006

AbstractZur farblichen Bewertung von Drogenpulvern und Carotinoiden werden Remissionsspektren mit photo‐akustischen Spektren (PAS) verglichen. Mit einem Eigenbaugerät werden Messungen im Bereich zwischen 350 und 750 nm bei einer Chopperfrequenz von 415 Hz durchgeführt. Wie die abgebildeten Spektren zeigen, ist die PAS der Remissionsspektroskopie deutlich überlegen.
Zum Schmelzverhalten hydratisierter tensidhaltiger Suppositoriengrundlagen
Authors: Fischer Wilfried , Knie Ulrich 
Published: October 2006

AbstractIn Mischungen von Witepsol® W 35WZ der Firma Dynamit Nobel, Witten.
mit Tween® 60WZ der Firma Atlas Chemie, Essen.
treten nach Zusatz geringer Wassermengen flüssig‐kristalline Phasen auf, deren Schmelzpunkt bei 46° liegt. Diese Mesophasen verleihen den Suppositorienmassen unerwünschte Eigenschaften wie erhöhte Viskosität bei Körpertemperatur, Solubilisierung von Arzneistoffen und können unter Umständen die Resorption von Arzneistoffen behindern. Nicht hydroxylhaltiges Hartfett (Witepsol® H 35) zeigt dieses Verhalten nicht. Aus diesem Unterschied wird auf eine aktive Beteiligung der hydroxylhaltigen Hartfettmasse an der vermutlich lamellaren Struktur der Mesophasen geschlossen.