bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Motor Thalamus in Neurosurgery
Authors: Hamani Clement , Dostrovsky Jonathan O. , Lozano Andres M. 
Published: December 2005

Abstract
THE MOTOR THALAMUS is an important target for the treatment of tremor. It receives afferents from the cerebellum, globus pallidus internus, and substantia nigra and projects mainly to the motor cortex, premotor cortex, and supplementary motor area. Various nomenclatures have been proposed to subdivide the motor thalamus, none of which are universally accepted. Both thalamic lesions and high-frequency stimulation ameliorate tremor in diverse pathological conditions. Modern neurophysiological techniques have allowed the recording of the activity of thalamic neurons in patients with different clinical conditions. This has provided a better understanding of the functions of the motor thalamus in humans. The aim of the present article is to briefly review the major anatomic and physiological aspects of the motor thalamus as well as the electrophysiological findings described in humans undergoing surgical procedures.
Expression of Integrins in Cerebral Arteriovenous and Cavernous Malformations
Authors: Seker Aşkın , Yildirim Özlem , Kurtkaya Özlem , Sav Aydin , Günel Murat , Pamir M Necmettin , Kılıç Türker 
Published: December 2005

AbstractOBJECTIVE:To assess and compare levels and patterns of expression for integrins αvβ1, αvβ3, and αvβ5 in arteriovenous malformations (AVMs) and cavernous malformations (CCMs) of the brain.MATERIALS AND METHODS:Specimens from 10 AVM and 10 CCM lesions were selected from 112 patients with AVMs and 97 patients with CCMs who were treated microsurgically in the Department of Neurosurgery, Marmara University, Istanbul, Turkey. Sections were immunohistochemically stained with antibodies for integrins αvβ1, αvβ3, and αvβ5. Separate histological layers of the vascular wall were evaluated, and levels of expression were graded using a four-tier system.RESULTS:Integrin αvβ1 was more strongly expressed in AVMs than in CCMs. This difference was most pronounced in the endothelium and subendothelium/media. Integrin αvβ3 was more strongly expressed in CCM endothelium than in AVM endothelium (average grades, 0.9 and 0.4, respectively). All 10 of the CCM lesions expressed integrin αvβ5 in the endothelium, whereas only five of the AVMs showed minimal expression of this molecule in the endothelium.CONCLUSION:Current scientific understanding of the roles integrins play in angiogenesis is far from complete. The levels and patterns of expression for these molecules in the histological layers of the vascular walls of AVMs and CCMs provide some clues about the complex biological activities of integrins in these lesions. If one accepts the premise that immunohistochemistry has its inherent methodological problems, integrins αvβ1, αvβ3, and αvβ5 are expressed in AVMs and CCMs in different ways that may be linked to stages of angiogenic maturation. Integrin αvβ1 is expressed more strongly in endothelium and subendothelium/media of AVMs than in the corresponding layers of CCMs. Integrins αvβ3 and αvβ5 are expressed more strongly in CCM endothelium than in AVM endothelium. In addition, integrin αvβ5 staining was stronger in CCM subendothelium than AVM subendothelium/media.
Traumatic Leptomeningeal Cyst in a 24-Year-Old Man: Case Report
Authors: Houra Karlo , Beros Vili , Sajko Tomislav , Cupic Hrvoje 
Published: December 2005

Abstract

OBJECTIVE AND IMPORTANCE:
Traumatic leptomeningeal cysts represent a rare complication of a childhood cranial fracture, and occur in only 0.05 to 0.6% of all cranial fractures. In adults, clinical manifestations of a childhood trauma are very rare and usually appear in the form of nontender, nonpulsatile, subcutaneous mass, accompanied by a progressive neurological deficit and seizures, as shown in our case.

CLINICAL PRESENTATION:
We present the case of a 24-year-old man with seizures caused by a traumatic leptomeningeal cyst resulting from the head injury he suffered at the age of 9 months.

INTERVENTION:
Right-sided craniotomy was performed with consequent microsurgical removal of the leptomeningeal cyst. The dura was reconstructed in a watertight manner and a cranioplasty was performed with Palacos (Howmedica International, Limerick, Ireland).

CONCLUSION:
It is important to consider traumatic leptomeningeal cysts when treating adult patients with erosive bone lesions who have a history of head trauma.
Resolution of Hemifacial Spasm after Surgical Obliteration of a Tentorial Arteriovenous Fistula: Case Report
Authors: Deshmukh Vivek R. , Maughan Peter H. , Spetzler Robert F. 
Published: December 2005

Abstract

OBJECTIVE AND IMPORTANCE:
We describe a patient with a tentorial dural arteriovenous fistula who presented with ipsilateral hemifacial spasm.

CLINICAL PRESENTATION:
A 50-year-old man sought treatment for left facial twitching that worsened over 6 months. Magnetic resonance imaging and catheter angiography demonstrated a left tentorial dural arteriovenous fistula.

INTERVENTION:
The patient underwent a retrosigmoid craniotomy and ligation of the draining vein at the site of the fistula. Intraoperative angiography showed complete obliteration of the fistula. The patient's hemifacial spasm improved significantly after the fistula was obliterated.

CONCLUSION:
Posterior fossa arteriovenous fistulas can present with a hemifacial spasm related to compression of the facial nerve by arterialized leptomeningeal veins. Microsurgical obliteration of the fistula can resolve the related symptoms.
Unrecognized Intracerebral Glass Particle Mimicking Cavernoma: Case Report
Authors: Inci Servet , Karakoc Ebru , Saygi Serap , Ozgen Tuncalp 
Published: December 2005

Abstract

OBJECTIVE AND IMPORTANCE:
Although the presence of a foreign body in the cranium after a head injury is a well-known entity, cases of retained intracranial foreign bodies causing a delayed onset of neurological symptoms are rare. To our knowledge, an unrecognized intracerebral glass particle mimicking a cavernoma has not been previously reported in the literature.

CLINICAL PRESENTATION:
We report a unique case regarding an intracranial foreign body. A 39-year-old patient presented with new-onset epilepsy. The patient had no history of trauma. According to the magnetic resonance imaging findings and the patient's clinical course, the responsible lesion was considered to be a temporal cavernoma.

INTERVENTION:
During the operation, surprisingly, a glass particle was found within the temporal lobe. The glass had penetrated the cranium during a minor head injury and had remained undetected for 33 years. The patient was seizure-free without medication during 3 years of follow-up.

CONCLUSION:
Intracranial small foreign bodies can be difficult to diagnose, especially in patients with no history or a vague history of head trauma. Patients with long-standing retained foreign bodies may remain clinically well until complications arise. Intracranial foreign bodies may mimic other pathologies clinically and radiologically.
Repeat Endovascular Treatment in Post-Embolization Recurrent Intracranial Aneurysms
Authors: Kang Hyun-Seung , Han Moon Hee , Kwon Bae Ju , Kwon O-Ki , Kim Sung Hyun 
Published: December 2005

Abstract

OBJECTIVE:
The purpose of this study was to describe clinical situations requiring repeat embolization in patients previously treated by endovascular coil embolization for intracranial aneurysms, and to report on our experiences of repeat embolization (RE).

METHODS:
A total of 466 patients harboring 522 intracranial aneurysms were treated by endovascular coil embolization at our institution during the period between December 1992 and August 2004. We studied 32 patients who underwent repeat coil embolization (RE) owing to recanalization or aneurysm recurrence. Radiological and clinical data were reviewed to determine the reasons, results, and technical problems of RE.

RESULTS:
Thirty-nine sessions of RE were performed in 32 patients; four patients underwent RE twice and another patient three times. The major reason for RE was asymptomatic aneurysmal recanalization owing to coil compaction and/or loosening. The time interval between RE and the previous embolization was 12 months or less in 27 sessions. Complete or near complete occlusion of the aneurysm was achieved in all cases without procedure-related morbidity or mortality. Radiolucent gaps between the coil masses were observed in 17 cases.

CONCLUSION:
RE is a safe and effective treatment option in cases of recanalized or recurrent aneurysms. Close follow-up evaluation is essential in patients with intracranial aneurysms after coil embolization.
Durability of Aneurysm Embolization with Matrix Detachable Coils
Authors: Fiorella David , Albuquerque Felipe C. , McDougall Cameron G. 
Published: December 2005

Abstract

OBJECTIVE:
Matrix detachable coils (MDC; Boston Scientific/Target, Fremont, CA) are platinum coils coated with a bioabsorbable polymeric material (polyglycolic-polylactic acid). In animal models, the introduction of polyglycolic-polylactic acid-coated coils into experimental aneurysms resulted in a cellular reaction which promoted stable intra-aneurysmal scar tissue formation. The current study was undertaken to assess the durability of aneurysm occlusion after embolization with MDC.

METHODS:
All patients undergoing embolization were prospectively enrolled in an endovascular database at our institution. All coils used for embolization were recorded in the operative notes for the procedure. Only aneurysms embolized with 50% or greater length of MDC were included. All patients with Neuroform stents (Boston Scientific/Target, Fremont, CA) were excluded from the study. Patients were followed with conventional angiography and magnetic resonance angiography.

RESULTS:
During a 20-month period, 131 aneurysms were embolized with MDC. Follow up data (average, 6.9 mo; range, 1.5–22 mo) were available for 82 aneurysms (61 with conventional angiography, 21 with magnetic resonance angiography only). Of the aneurysm patients with follow-up available, 65 had small aneurysms with small necks, three were small aneurysms with wide necks, 12 were large aneurysms, and two were giant aneurysms. Overall, there were 30 (36.6%) recanalizations, 19 (23.1%) of which required retreatment. In two additional patients, retreatment was either recommended (n = 1) or attempted unsuccessfully (n = 1). Fifty–two aneurysms were unchanged or demonstrated progressive thrombosis (63.4%). The recanalization rate for small aneurysms with small necks was 26.1% (17 out of 65) with a 13.8% retreatment rate (9/65). The recanalization rate for large aneurysms was 75% (9 out of 12) with seven requiring retreatment.

CONCLUSION:
In the absence of Neuroform stent support, aneurysms embolized with the MDC system demonstrated a significant rate of recanalization. Many of the recanalizations were of sufficient size to warrant retreatment. The rates of recanalization observed in the present series were comparable to, or worse than, those reported for bare platinum coils.
Virological, serological and epidemiological study of 255 consecutive cases of genital herpes in a sexually transmitted disease clinic of Paris (France): a prospective study
Authors: Janier M , Scieux C , Méouchi R , Tournoux C , Porcher R , Maillard A , Fouéré S , Taquin Y , Lassau F , Morel P 
Published: December 2005

Some studies (mostly retrospective) have pointed to an increasing frequency (up to 60%) of herpes simplex virus type 1 (HSV-1) in genital herpes (GH), but they were biased towards severe or atypical cases. We wished to evaluate the frequency of HSV-1 in patients attending our clinic for both first and recurrent episodes of GH. All patients (men and women) with genital lesions compatible with GH were included in a prospective study between May 1999 and April 2002. For all patients a standardized questionnaire, clinical examination, MRC5 culture (Dade Behring), polymerase chain reaction (PCR)-herpes consensus (Argène Biosoft) in case of negative culture and type-specific herpes serology HSV-1 and HSV-2 (Elisa Eurobio) were obtained. Predictive factors associated with HSV-1 and HSV-2 GH were studied by uni- and multivariable analyses. In all, 255 patients had a positive culture ( n = 216) or PCR ( n = 39). A total of 248 patients had typable herpes (148 men and 100 women). Median age was 33 (27–43); 20% had anal herpes; 48% had clinically recurrent lesions; 21% were HIV +; 20% of men were homosexual; 77% practised oral sex. In all, 36 were HSV-1 (14.5%): more in women, 25/100 (25%), than in men, 11/148 (7.5%) (odds ratio [OR]: 4 [1.8–9.1], P = 0.008). HSV-1 accounted for 23% of cases of first clinical episodes (women: 31.5%;men: 14.7%) ( P = 0.02) and 6% of clinically recurrent episodes (women: 15%;men: 1.2%) (OR: 3.8 [1.6–9.1], P = 0.0033). Serological study was done in 239: primary infection was disclosed in 33 (HSV-1: 61%), HSV-2 non-primary first episode in 22 and recurrence in 184 (HSV-1: 8%). In all, 37% of recurrent episodes presented as a first clinical episode. HSV-1 was linked in men with homosexuality ( P<0.01) and anilingus ( P<0.01), in women with younger age ( P<0.01), more sexual intercourses ( P<0.0001) and more oral sex ( P<0.001). Although HSV-1 is frequent in first clinical (23%) and primary (61%) episodes of GH, recurrent GH remains mostly due to HSV-2 (94%).
Decrease of human immunodeficiency virus prevalence in antenatal clinics in Abidjan, Côte d'Ivoire, 1995–2002
Authors: Msellati Philippe , Sakarovitch Charlotte , Bequet Laurence , Atta Hubert , Alioum Ahmadou , Viho Ida , Timothée Ouassa , Leroy Valeriane , Welffens-Ekra Christiane , Dabis François ,   ANRS Ditrame (049) and Ditrame Plus (1201) Studies Groups
Published: December 2005

Antenatal HIV seroprevalence surveys are important tools to understand the extent of the HIV epidemic in Africa. The main objective is to describe HIV prevalence trends from 1995–2002 in pregnant women consulting antenatal clinics in Abidjan, Côte d'Ivoire. We proposed HIV test to pregnant women consulting antenatal clinics in Abidjan from 1995–2002 in a programme of prevention of mother-to-child transmission of HIV. Yearly prevalence was estimated. Overall, 36,442 women were tested. Prevalence decreased from 14–15% in 1995–96 to 11% in 2002. The prevalence among 18–22-year-old women dropped from 15% in 1995 to 8% in 2002, while for older women it increased slightly, or remained stable from 1995–1999 and decreased thereafter. HIV prevalence among women consulting antenatal clinics has been decreasing overall. This is the first such report among pregnant women in Abidjan, probably the result of different phenomena: ageing of the epidemic and behaviour changes (disease awareness and prevention campaigns).
Genital infection in male partners of women with chlamydial infection
Authors: Manavi K , McMillan A , Young H 
Published: December 2005

The aim of the present study was to examine the prevalence of infection among male contacts of women with endocervical chlamydiae. The study population consisted of men who attended the Department of Genitourinary Medicine at Edinburgh Royal Infirmary as named contacts of women with endocervical chlamydiae. The diagnosis of Chlamydia trachomatis was based on a polymerase chain reaction. Of 632 male contacts of 404 infected women, 155 (24%) attended the clinic, and 147 had satisfactory tests for chlamydiae; 64 (44%) men had chlamydial infection. A greater proportion of symptomatic men (14/22) were infected compared with asymptomatic men (50/125) ( P<0.02). Symptomatic men attended the department earlier (median 0.0 days) than asymptomatic male contacts (median 11 days) ( P<0.05). A greater proportion of male contacts of women with one partner (105/254) attended the clinic than those of women with two or more partners (42/112). Better counselling policies for chlamydial infection are needed to ensure improved rate of diagnosis and treatment of male contacts.
Neonatal screening of glucose-6-phosphate dehydrogenase deficiency in Yanbu, Saudi Arabia
Authors: Muzaffer Mohammed Ahmed 
Published: December 2005

Objective: To determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the population tested, and to evaluate the prevalence of neonatal jaundice in newborns with G6PD deficiency. Methods: Cord blood of all babies born between October 1996 and October 1998 at the Royal Commission Medical Center in Yanbu, Saudi Arabia, was screened for G6PD deficiency by fluorescent spot test. The results of screening of cord blood samples were reported to the physician in charge, and also placed on the files of the babies and their mothers. These babies were observed for 72 h and discharged if no jaundice developed. Results: During this two-year period, 2505 neonatal cord blood samples from 1278 boys and 1227 girls were screened for G6PD. There were 50 positive results for G6PD deficiency (39 boys and 11 girls), and the prevalence was estimated to be around 2%. The sex-specific prevalence for boys was 3.05%, and for girls 0.9%. Male to female ratio was 3:1. Neonatal jaundice developed in six (12%) babies, five male and one female. All were treated with phototherapy and discharged within one week of birth. Conclusion: The prevalence of G6PD is relatively high in Yanbu. Routine neonatal screening in areas with a high prevalence of G6PD in Saudi Arabia is justifiable.
Screening for congenital hypothyroidism: the value of retesting after four weeks in neonates with low and very low birth weight
Authors: Tylek-Lemańska Dorota , Kumorowicz-Kopiec Małgorzata , Starzyk Jerzy 
Published: December 2005

Objectives: Thyroid-stimulating hormone (TSH), normally a reliable screening test for congenital hypothyroidism (CH), may fail to detect cases among infants who have low and very low birth weight. The purpose of this study was to identify neonates with false-negative screening results. Setting: A province in Poland in which 3854 neonates had body weight ≤2500 g, between 1999 and 2001. Methods: TSH levels in blood on filter paper were measured in all neonates between the third and sixth days after birth, but were repeated in low and very low birth weight infants after four weeks of age. Results: The repeat test showed TSH levels ≥ 10 mIU/L in 19 of the 3854 low birth weight neonates. The final diagnosis in these neonates was permanent CH in two, transient CH in five, possible compensated CH in six and transient high TSH in six. Of the 19, 16 (84%) required iodine and/or thyroxine replacement therapy. Conclusions: In neonates with low and very low birth weight, normal TSH levels measured between the third and sixth day of life do not exclude thyroid dysfunction, but a repeat TSH measurement after the fourth week of life identifies the false-negative results. In our data, the prevalence of primary and secondary hypothyroidism (both permanent and transient) was about 0.5%.
Improving uptake of cervical cancer screening in women with prolonged history of non-attendance for screening: a randomized trial of enhanced invitation methods
Authors: Stein K , Lewendon G , Jenkins R , Davis C 
Published: December 2005

Objective: To compare the effectiveness and cost-effectiveness of three methods of inviting women with a long history of non-attendance to undergo cervical screening. Methods: Randomized controlled trial and cost-effectiveness analysis. In all, 1140 women were identified from routine NHS screening records as having no smear for at least 15 years and randomly allocated to receive a telephone call from a nurse, a letter from a well-known celebrity (Claire Rayner) or letter from the local NHS Cervical Screening Commissioner. Uptake of screening was measured using routine data and attributed to interventions if occurring within three months. Uptake was compared with a control group. Costs of carrying out the interventions were noted from the perspective of the NHS and cost-effectiveness, as cost per additional attender, calculated. Results: Uptake following all interventions was low: telephone call (1.4, 95% confidence interval [CI] 0.38–3.6%); celebrity letter (1.8, 95% CI 0.57–4.0%); commissioner letter (4.6, 95% CI 2.5–7.7%); control group (1.8, 95% CI 0.57–4.0%). There were no significant differences between groups. Telephone intervention was not possible in a quarter of women whose numbers were unlisted. Telephone intervention was the most expensive and least effective of the interventions. The commissioner letter yielded an additional attender within three months at an incremental cost of £23.21 compared with taking no action. Conclusions: Neither a telephone call from a nurse nor a letter from a celebrity to encourage attendance for cervical screening were effective or cost-effective in women with a prolonged history of non-participation in the screening programme. A letter from the local cervical screening programme commissioner resulted in a small, non-significant increase in uptake. The low cost and ease of implementation of this intervention supports further research into its use in routine practice.
A study of Pap test history and histologically determined cervical cancer in NSW women, 1997–2003
Authors: Morrell Stephen , Taylor Richard , Wain Gerard 
Published: December 2005

Objectives: To determine the risk of a histological diagnosis of cervical cancer following a given Pap test result and for a given history of Pap test results in a screened population across the full spectrum of possible cytological results. Methods: All the Pap screening results held on the New South Wales Pap Test Register for 1997–2003 (five million tests for 1.87 million women) were analysed using Cox proportional hazards regression to estimate the odds of having a histologically determined cervical cancer for a given Pap test result and test result history. The hazard ratios of having cervical cancer in relation to Pap test result histories were estimated: (i) in regard only to the last Pap test result adjusting for age, frequency of Pap testing and proportion of high grade (≥cervical intraepithelial neoplasia 2 [CIN2]) abnormalities found in a woman's total recorded test result history; and (ii) with regard to the last Pap test result against the highest grade of cytological abnormality found prior to the last Pap test result. The hazard ratios are for a cancer diagnosis occurring before the next Pap test and were adjusted for age, quintile of socioeconomic status of residence, frequency of past Pap testing and proportion of high-grade abnormalities detected in each woman's prior Pap test history. The adjusted hazard ratios were then applied to the tabulated proportions of referent women with negative cytology in each broad age group, and for all women, to estimate the ′1 in n′ odds of being diagnosed histologically with cervical cancer for a given last Pap test result, and by a given last Pap test result for various prior Pap test result histories. Results: After adjusting for age, socioeconomic status, frequency of previous Pap testing and proportion of past high-grade screen-detected abnormalities, the adjusted hazard ratio of having a subsequent cervical cancer diagnosis for women with a negative Pap test result was 1 in 5546, compared with 1 in 833 for a low-grade epithelial abnormality (atypia, CIN1), 1 in 56 for a high-grade epithelial abnormality and 1 in seven for a cytological prediction of cervical cancer. These odds estimates were significantly modified by age and by the highest Pap test result prior to the most recent Pap test result: the higher the age and, less consistently, the higher the previous highest Pap test result for a given last Pap test result, the shorter the odds of having a subsequent histological diagnosis of cervical cancer. Conclusions: The results presented here will enable clinicians to inform their patients of their chances of being diagnosed with cervical cancer for a given Pap test result, and for some combinations of the last Pap test result and highest recorded prior Pap test result.