bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment for posterior fossa dissemination of primary supratentorial glioma
Authors: Smith Justin S. , Parney Ian F. , Lamborn Kathleen R. , McDermott Michael W. , Sneed Penny K. , Chang Susan M. 
Published: January 2008

Object
This study was designed to assess the presentation, management, and outcome of cases involving patients who had a supratentorial glioma that subsequently progressed in the posterior fossa (PF).

Methods
The authors performed a retrospective chart review of adult patients treated between 1997 and 2005 for supratentorial gliomas that progressed in the PF. The 29 patients with PF progression in this study were relatively young (median age of 34 years at original presentation). Twenty of these patients presented with symptoms. The symptoms were typically nonspecific to this population, at times leading to delays in diagnosis. Overall, these symptoms resolved in eight patients (40%) and progressed or remained unchanged in 12 (60%). Patients treated with more than 5000 cGy of radiation administered to the PF were more likely to have symptom resolution than those who received any other form of treatment, including reduced doses of radiation (p = 0.004). The patients treated with higher doses also survived significantly longer after PF progression (univariate analysis, p = 0.01, and after adjusting for tumor grade, p = 0.04).

Conclusions
Patients with PF progression of supratentorial infiltrative gliomas may benefit from treatment, and the authors recommend more than 5000 cGy of radiation to the PF if prior radiotherapy ports and doses allow.
Increase in glutamate as a sensitive indicator of extracellular matrix integrity in peritumoral edema: a 3.0-tesla proton magnetic resonance spectroscopy study
Authors: Kimura Teruo , Ohkubo Masaki , Igarashi Hironaka , Kwee Ingrid L. , Nakada Tsutomu 
Published: January 2008

Object
The authors of previous studies based on diffusion tensor imaging have indicated that there are two types of peritumoral edema—namely, edema with preserved structural integrity of the glial matrix and edema with compromised glial matrix. The authors of this study hypothesized that functionality of the glutamate (Glu)–glutamine shuttle, a vital neuron–glia interaction, may be differentially affected by peritumoral edema. They tested this hypothesis using proton magnetic resonance (MR) spectroscopy on a 3.0-tesla system that is capable of quantifying Glu without need of editing.

Methods
Twenty-three patients, each with a single brain tumor mass and peritumoral edema (nine high-grade gliomas, eight metastatic brain tumors, and six meningiomas), and nine healthy individuals participated in this study. Single-voxel proton MR imaging targeting the region of peritumoral edema was performed using a 3.0-tesla system.
Glutamate levels in the peritumoral edema of nonglial tumors was significantly elevated (p < 0.01) compared with edema associated with glial tumors or normal white matter. The finding confirmed that peritumoral edema in nonglial tumors is distinct from that of glial tumors, as previously indicated in diffusion tensor imaging studies. The authors hypothesized that the former condition represents a compensatory increase in activities of the Glu–glutamine shuttle brought about by simple expansion of the extracellular space due to edema.

Conclusions
The assessment of Glu concentrations in peritumoral edema using 3.0-tesla proton MR spectroscopy may be developed into an objective index of the structural integrity of the glial matrix.
Correlation of magnetic resonance spectroscopic and growth characteristics within Grades II and III gliomas
Authors: McKnight Tracy R. , Lamborn Kathleen R. , Love Tonya D. , Berger Mitchel S. , Chang Susan , Dillon William P. , Bollen Andrew , Nelson Sarah J. 
Published: January 2008

Object
The accurate diagnosis of World Health Organization Grades II and III gliomas is crucial for the effective treatment of patients with such lesions. Increased cell density and mitotic activity are histological features that distinguish Grade III from Grade II gliomas. Because increased cellular proliferation and density both contribute to the in vivo magnetic resonance (MR) spectroscopic peak corresponding to choline-containing compounds (Cho), the authors hypothesized that multivoxel MR spectroscopy might help identify the tumor regions with the most aggressive growth characteristics, which would be optimal locations for biopsy. They investigated the ability to use one or more MR spectroscopic parameters to predict the MIB-1 cell proliferation index (PI), the terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick-end labeling cell death index (DI), the cell density, and the ratio of proliferation to cell death (PI/DI) within different regions of the same tumor.

Methods
Patients with presumed Grades II or III glioma underwent 3D MR spectroscopic imaging prior to surgery, and two or three regions within the tumor were targeted for biopsy retrieval based on their spectroscopic features. Biopsy specimens were extracted from the tumor during image-guided resection, and the PI, DI, and cell density were assessed in the specimens using immunohistochemical methods.

Conclusions
The authors found that the relative levels of Cho and N-acetylaspartate (NAA) correlated with the cell density, PI, and PI/DI ratio within different regions of the same tumor and that the association held for the subpopulation of nonenhancing tumors. The association was stronger in tumors with large ranges of Cho/NAA values, irrespective of the presence of contrast enhancement. The findings demonstrate the validity of using MR spectroscopy to identify regions of aggressive growth in presumed Grade II or III gliomas that would be suitable targets for retrieving diagnostic biopsy specimens.
Pressure-dependent effect of shock waves on rat brain: induction of neuronal apoptosis mediated by a caspase-dependent pathway
Authors: Kato Kaoruko , Fujimura Miki , Nakagawa Atsuhiro , Saito Atsushi , Ohki Tomohiro , Takayama Kazuyoshi , Tominaga Teiji 
Published: January 2008

Object
Shock waves have been experimentally applied to various neurosurgical treatments including fragmentation of cerebral emboli, perforation of cyst walls or tissue, and delivery of drugs into cells. Nevertheless, the application of shock waves to clinical neurosurgery remains challenging because the threshold for shock wave–induced brain injury has not been determined. The authors investigated the pressure-dependent effect of shock waves on histological changes of rat brain, focusing especially on apoptosis.

Methods
Adult male rats were exposed to a single shot of shock waves (produced by silver azide explosion) at over-pressures of 1 or 10 MPa after craniotomy. Histological changes were evaluated sequentially by H & E staining and terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick-end labeling (TUNEL). The expression of active caspase-3 and the effect of the nonselective caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD-FMK) were examined to evaluate the contribution of a caspase-dependent pathway to shock wave–induced brain injury.
High-overpressure (> 10 MPa) shock wave exposure resulted in contusional hemorrhage associated with a significant increase in TUNEL-positive neurons exhibiting chromatin condensation, nuclear segmentation, and apoptotic bodies. The maximum increase was seen at 24 hours after shock wave application. Low-overpressure (1 MPa) shock wave exposure resulted in spindle-shaped changes in neurons and elongation of nuclei without marked neuronal injury. The administration of Z-VAD-FMK significantly reduced the number of TUNEL-positive cells observed 24 hours after high-overpressure shock wave exposure (p < 0.01). A significant increase in the cytosolic expression of active caspase-3 was evident 24 hours after high-overpressure shock wave application; this increase was prevented by Z-VAD-FMK administration. Double immunofluorescence staining showed that TUNEL-positive cells were exclusively neurons.

Conclusions
The threshold for shock wave–induced brain injury is speculated to be under 1 MPa, a level that is lower than the threshold for other organs. High-overpressure shock wave exposure results in brain injury, including neuronal apoptosis mediated by a caspase-dependent pathway. This is the first report in which the pressure-dependent effect of shock wave on the histological characteristics of brain tissue is demonstrated.
The nerve to the mylohyoid as a donor for facial nerve reanimation procedures: a cadaveric feasibility study
Authors: Tubbs R. Shane , Loukas Marios , Shoja Mohammadali M. , Acakpo-Satchivi Leslie , Wellons John C. , Blount Jeffrey P. , Oakes W. Jerry 
Published: January 2008

Object
Facial nerve injury with resultant facial muscle paralysis is disfiguring and disabling. Reanimation of the facial nerve has been performed using different regional nerves. The nerve to the mylohyoid has not been previously explored as a donor nerve for facial nerve reanimation procedures.

Methods
Five fresh adult human cadavers (10 sides) were dissected to identify an additional nerve donor candidate for facial nerve neurotization. Using a curvilinear cervicofacial skin incision, the nerve to the mylohyoid and facial nerve were identified. The nerve to the mylohyoid was transected at its point of entrance into the anterior belly of the digastric muscle. Measurements were made of the length and diameter of the nerve to the mylohyoid, and this nerve was repositioned superiorly to the various temporofacial and cervicofacial parts of the extracranial branches of the facial nerve.
All specimens had a nerve to the mylohyoid. The mean length of this nerve available inferior to the mandible was 5.5 cm and the mean diameter was 1 mm. In all specimens, the nerve to the mylohyoid reached the facial nerve stem and the temporofacial and cervicofacial trunks without tension. No gross evidence of injury to surrounding neurovascular structures was identified.

Conclusions
To the authors' knowledge, the use of the nerve to the mylohyoid for facial nerve reanimation has not been explored previously. Based on the results of this cadaveric study, the use of the nerve to the mylohyoid may be considered for facial nerve reanimation procedures.
Inhibition of Src tyrosine kinase and effect on outcomes in a new in vivo model of surgically induced brain injury
Authors: Jadhav Vikram , Matchett Gerald , Hsu Frank P. K. , Zhang John H. 
Published: January 2008

Object
Brain tissue at the periphery of a neurosurgical resection site is vulnerable to injury by a variety of mechanisms including direct trauma, edema, hemorrhage, retractor stretch, and electrocautery. The goal in the present study was to develop an in vivo model of surgically induced brain injury and to test an Src tyrosine kinase inhibitor for neuro-protective properties in this model.

Methods
The authors developed a new surgically induced brain injury model in rats. This model involves resection of part of the frontal lobe. Sprague–Dawley male rats weighing between 300 and 350 g were divided randomly into four groups: Group 1, surgical injury with vehicle treatment; Group 2, surgical injury after treatment with PP1 (an Src tyrosine kinase inhibitor with known neuroprotective properties); Group 3, sham surgery; and Group 4, control. Postoperative assessment included blood–brain barrier (BBB) permeability studies, and histological, immunohistochemical, and Western blot analyses. The authors found that surgical injury caused localized edema and disruption of the BBB compared with findings in the sham surgery group. Treatment with PP1 was associated with decreased edema, decreased breakdown of the BBB, decreased expression of both vascular endothelial growth factor and phosphorylated extracellular signal–regulated kinase 1 and 2, and preservation of ZO-1 expression.

Conclusions
In this study the authors describe a simple and reproducible in vivo animal model of surgically induced brain injury. Pretreatment with PP1 results in improved outcomes in this model, which suggests a possible role for Src tyrosine kinase inhibitors as preoperative therapy for planned neurosurgical procedures.
A new method for superselective middle cerebral artery infusion in the rat
Authors: Woitzik Johannes , Schilling Lothar 
Published: January 2008

Object
Selective intraarterial drug delivery is used to achieve enhanced local uptake with reduced systemic side effects. In the present paper the authors describe and characterize a new microcatheter-based model of superselective perfusion of the middle cerebral artery (MCA) in rats combined with blockade of blood flow through the MCA.

Methods
Selectivity of administration was shown by infusion of Evans blue which diffusely stained the MCA territory, indicating an increased permeability of the blood–brain barrier during the blockade of blood flow to the MCA. Perfusion of autologous blood through the microcatheter resulted in a flow rate–related increase in the cerebral blood flow measured by laser Doppler flowmetry. Similarly, infusion of an artificial O2 carrier, Oxycyte, was accompanied by an increase in tissue oxygenation as measured using a Licox sensor. Blockade of blood flow to the MCA with the new microcatheter for an extended period of time resulted in the development of ischemia, which was comparable to that induced by intravascular occlusion using a silicone-coated thread. In a 24-hour MCA occlusion model, selective administration of a low dose of MK-801 (0.3 mg/kg body weight) resulted in a significantly smaller infarct volume than systemic application (339 ± 53 mm3 compared with 508 ± 26 mm3, p < 0.001).

Conclusions
This new model of superselective MCA infusion is a valuable tool for investigating the effect of selective delivery and enhanced drug uptake into cerebral ischemic tissue. Without constant blockade of blood flow through the MCA it may also be useful for enhanced drug uptake, gene transfer, or application of stem cells in other neuro-pathological conditions.
Microsurgical anatomy of the mesencephalic veins
Authors: Ardeshiri Ardavan , Ardeshiri Ardeshir , Linn Jennifer , Tonn Jörg-Christian , Winkler Peter A. 
Published: January 2008

Object
The mesencephalic veins drain crucial brainstem areas. Due to the narrowness of the tentorial notch, these veins can become obstructed as a result of herniation or surgery, leading to hemorrhage and severe consequences for the patient. There is little in the literature about the mesencephalic veins. The aim of this study was to perform an exact analysis of their microanatomy.

Methods
Fifty-two cadaveric hemispheres were examined under an operating microscope, and measurements were made with a digital caliper. The authors focused on the basal vein (BV), pontomesencephalic vein (PMV), peduncular vein (PV), lateral mesencephalic vein (LMV), and other smaller veins.
The PMV was identified in 84.6% of specimens (mean diameter 0.54 mm); the PV, in 86.5% (mean diameter 0.86 mm); and the LMV, in 100% (mean diameter 1.07 mm). Four types of LMV were identified on the basis of the vein's course. Other smaller veins were also differentiated according to whether they drained mainly the cerebral peduncle, the lemniscal trigone, or the tectum. These veins and their junctions with other veins were depicted.

Conclusions
A thorough understanding of the microanatomy of the mesencephalic veins is crucial in brainstem surgery in order to avoid brain damage due to venous infarction and subsequent edema. Because knowledge of the course, variations, and outflow system of these veins could improve surgical outcome, they warrant special attention during surgery.
Stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery origin and treatment with the stent-in-stent technique
Authors: Kim Seong-Rim , Baik Min-Woo , Yoo Seung-Hoon , Park Ik-Seong , Kim Sang-Don , Kim Moon-Chan 
Published: January 2008

✓ The authors report two cases of stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery (VA) origin, and describe management of restenosis with the stent-in-stent technique. Two women, one 62 and the other 67 years of age, underwent stent placement in the VA origin to treat symptomatic and angiographically significant stenosis in this vessel. Sirolimus-eluting coronary stents (Cypher) were used in both cases. Four months after placement of the devices, the symptoms recurred. Follow-up angiography performed 5 months after insertion of the devices revealed a transverse stent fracture with separation of the fragments and severe in-stent restenosis in both cases. The restenoses were treated with reinsertion of coronary stents (Cypher and Jostent FlexMaster) by using the stent-in-stent technique. After stent reinsertion, the patients exhibited relief of symptoms.
This paper is the first report of fracture in a drug-eluting stent and restenosis after stent placement in the VA origin. Restenosis caused by such a fracture can be managed successfully by performing the stent-in-stent maneuver. The physical properties of metallic devices, stent strut geometry, and anatomical peculiarities of the subclavian artery may be associated with stent fractures. Earlier follow-up angiography studies (within 6 months) are warranted.
Identification of venous variants in the pineal region with 3D preoperative computed tomography and magnetic resonance imaging navigation
Authors: Giordano Mario , Wrede Karsten H. , Stieglitz Lennart H. , Samii Madjid , Lüdemann Wolf O. 
Published: January 2008

Object
The purpose of this study was to determine the ability of software-assisted 3D reconstruction performed using a neuronavigation system to delineate the anatomy and variation patterns of the pineal region venous complex, and then to compare these data with previous anatomical findings.

Methods
The authors retrospectively reviewed the neuroimages obtained in 100 patients with intracranial lesions (50 computed tomography [CT] scans obtained with contrast agents and 50 magnetic resonance [MR] images obtained with gadolinium) by using a neuronavigation workstation for 3D reconstruction. Particular attention was given to the internal cerebral vein, basal vein (BV), and the vein of Galen. The various connection patterns between the major vessels were classified and statistically analyzed.

Conclusions
The venous system of the pineal region shows a wide range of sex-related variations. In the female patient the absence of a BV (Type 0) is significantly more frequent than in the male. In this study the authors illustrate the ability to depict the venous drainage patterns in the pineal region for all cases studied by using 3D neuronavigation software without the need for additional examinations. This simple tool provides important information for surgical planning and may be of significant help intraoperatively.
When “Abegg” is read and (“A, B, E, G, G”) is not: a cortical stimulation study of musical score reading
Authors: Roux Franck-Emmanuel , Lubrano Vincent , Lotterie Jean-Albert , Giussani Carlo , Pierroux Clémence , Démonet Jean-François 
Published: January 2008

Object
To spare the cortical areas involved both in musical score reading and in language, the authors used a score reading task during direct cortical stimulation mapping in musicians undergoing operations for brain lesions. The organization of the cortical areas involved in language and score reading, respectively, was analyzed in relation with these surgical data.

Methods
Seven patients with brain lesions were tested using three language tasks and a score-reading task. Preoperatively, none of them had exhibited significant language or musical ability deficits, and all had a special interest in music. All were involved in professional or amateur musical activities.
Interference in score reading was found in small cortical areas, mainly in the dominant parietal lobe and sometimes in the frontal gyri. During direct stimulation, interference was either language-specific (15 sites), common to language and score-reading tasks (18 sites), or specific to the score-reading task (four sites). Different patterns of score-reading interferences (score-reading arrest, semantic paraphasia) were observed, probably corresponding to different stages of score reading. Postoperatively, some patients showed transitory score-reading difficulties related to the surgical procedure.

Conclusions
The cortical areas involved in score reading can occasionally be distinct from other language areas. This could explain differential word- and score-reading impairments sometimes observed in musicians with brain lesions. Brain mapping for neurosurgical procedures in musicians should ideally be performed using a score-reading task in addition to standard language tasks, especially for mapping in the dominant parietal lobe.
Range of motion change after cervical arthroplasty with ProDisc-C and Prestige artificial discs compared with anterior cervical discectomy and fusion
Authors: Chang Ung-Kyu , Kim Daniel H. , Lee Max C. , Willenberg Rafer , Kim Se-Hoon , Lim Jesse 
Published: January 2008

Object
Range of motion (ROM) changes were evaluated at the surgically treated and adjacent segments in cadaveric specimens treated with two different cervical artificial discs compared with those measured in intact spine and fusion models.

Methods
Eighteen cadaveric human cervical spines were tested in the intact state for the different modes of motion (extension, flexion, lateral bending, and axial rotation) up to 2 Nm. Three groups of specimens (fitted with either the ProDisc-C or Prestige II cervical artificial disc or submitted to anterior cervical discectomy and fusion [ACDF]) were tested after implantation at C6–7 level. The ROM values were measured at treated and adjacent segments, and these values were then compared with those measured in the intact spine.

Results
At the surgically treated segment, the ROM increased after arthroplasty compared with the intact spine in extension (54% in the ProDisc-C group, 47% in the Prestige group) and in flexion (27% in the ProDisc-C group, 10% in the Prestige group). In bending and rotation, the postarthroplasty ROMs were greater than those of the intact spine (10% in the ProDisc-C group and 55% in the Prestige group in bending, 17% in the ProDisc-C group and 50% in the Prestige group in rotation). At the adjacent levels the ROMs decreased in all specimens treated with either artificial disc in all modes of motion (< 10%) except for extension at the inferior the level (29% decrease for ProDisc-C implant, 12% decrease for Prestige disc). The ROM for all motion modes in the ACDF-treated spine decreased at the treated level (range 18–44%) but increased at the adjacent levels (range 3–20%).

Conclusions
Both ProDisc-C and Prestige artificial discs were associated with increased ROM at the surgically treated segment compared with the intact spine with or without significance for all modes of testing. In addition, adjacent-level ROM decreased in all modes of motion except extension in specimens fitted with both artificial discs.