bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibodies (anti-CCP) in Patients with Rheumatoid Arthritis
Authors: Damjanovska Ljubinka , Atanasovska Violeta , Gruev Todor 
Published: December 2007

The Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibodies (anti-CCP) in Patients with Rheumatoid ArthritisA cross-sectional study was carried out to analyze the prevalence of anti-CCP antibodies and IgM RF in the sera of 160 randomly selected patients from the Rheumatology Department: 60 with RA, 50 with other rheumatic diseases (non-RA), 50 healthy controls (HC). The mean age of the group was 50.06+/-11.9 years. There were 141 females (88.1%) and 19 males (11.9%). RA patients fulfilled the revised ACR criteria. The mean duration of the disease was 82.4 months. Anti-CCP ELISA kit and IgM RF Latex test were used. The mean anti-CCP values were as follows: RA 60.4+/-57.6, non-RA 2.1+/-3.6, HC 1.3 +/-0.4 U/mL. Respectively, the mean values of IgM RF were: RA 515.8+/-525, non-RA 102+/-294, HC 15+/-57.5. Forty out of 60 (66.6%) RA patients were anti-CCP positive. Forty one out of 60 (68.3%) RA patients were positive for IgM RF. As expected, anti-CCP showed comparable sensitivity (66.8% vs. 68.3%) and higher specificity (98% vs. 87%) than IgM RF, at optimal cut-off values. The presence of either anti-CCP or IgM RF increased the testing sensitivity for the diagnosis of RA to 76.6%. AUC was greater for anti-CCP than for IgM RF (0.92 vs. 0.82).
Aminoglycosides and Kidney Function
Authors: Stanić Momčilo , Mitić Radoslav , Jakovljević Milan 
Published: December 2007

Aminoglycosides and Kidney FunctionThe aminoglycosides are bactericide antibiotics with predominant effecting on the Gramm-negative bacteries, then staphylococci and mycobacteria with a small therapeutic range and with expressive ototoxic, nephrotoxic and with rare neurotoxic side effects. In this work the value of creatinine are investigated in serum of patients who are hospitalized in Internal department of the Health Center in Kosovska Mitrovica, before, in the course of and after therapy with the aminoglycosides antibiotics were given in different doses. The creatinine was determined by kinetic method (Jaffe). The significant increasing of creatinine values in serum was recorded with the groups of patients who have got gentamicine 2x120 mg i.m., gentamicine 2x120 mg in combination with furosemide, the gentamicine 2x120 mg with the patients with diabetes mellitus, gentamicine 2x120 mg in the course of 14 days until with the groups who have been getting gentamicine 1x120 mg, gentamicine 2x80 mg and amikacine 2x500 mg were not recorded the significant increased values of creatinine. The determination of creatinine for the sake of the following degree damage of kidney function in the course therapy of the aminoglycosides was very important.
The Proposal for Solution of Interference Problems Caused By Drugs
Authors: Jovanović Slobodan , Birinji Klara 
Published: December 2007

The Proposal for Solution of Interference Problems Caused By DrugsFor long years the laboratories have the problem of endogenous and axogenous interferences. Drugs are responsable for more than 90% of exogenous interference. The aim of the investigation was to find a rather simple and economic way in solution of every day existing problem in clinical biochemistry. Using the appropriate literature the possible existing of interference is determined. Such approach could be interesting for many of laboratories in every day practice.
Gamma Knife surgery and trigeminal schwannoma: is it possible to preserve cranial nerve function?
Authors: Phi Ji Hoon , Paek Sun Ha , Chung Hyun-Tai , Jeong Sang Soon , Park Chul-Kee , Jung Hee-Won , Kim Dong Gyu 
Published: December 2007

Object
The current study was undertaken to evaluate the tumor control rate and functional outcome after Gamma Knife surgery (GKS) in patients with a trigeminal schwannoma. The conditions associated with the development of cranial neuropathies after radiosurgery were scrutinized.

Methods
The authors reviewed the clinical records and radiological data in 22 consecutive patients who received GKS for a trigeminal schwannoma. The median tumor volume was 4.1 ml (0.2–12.0 ml), and the mean tumor margin dose was 13.3 ± 1.3 Gy at an isodose line of 49.9 ± 0.6% (mean ± standard deviation). The median clinical follow-up period was 46 months (range 24–89 months), and the median length of imaging follow-up was 37 months (range 24–79 months).

Results
Tumor growth control was achieved in 21 (95%) of the 22 patients. Facial pain responded best to radio-surgery, with two thirds of patients showing improvement. However, only one third of patients with facial hypesthesia improved. Six patients (27%) experienced new or worsening cranial neuropathies after GKS. Ten patients (46%) showed tumor expansion after radiosurgery, and nine of these also showed central enhancement loss. Loss of central enhancement, tumor expansion, and a tumor in a cavernous sinus were found to be significantly related to the emergence of cranial neuropathies.

Conclusions
The use of GKS to treat trigeminal schwannoma resulted in a high rate of tumor control and functional improvement. Cranial neuropathies are bothersome complications of radiosurgery, and tumor expansion in a cavernous sinus after radiosurgery appears to be the proximate cause of the complication. Loss of central enhancement could be used as a warning sign of cranial neuropathies, and for this vigilant patient monitoring is required.
Is repeated radiosurgery an alternative to staged radiosurgery for very large brain arteriovenous malformations?
Authors: Karlsson Bengt , Jokura Hidefumi , Yamamoto Masaaki , Söderman Michael , Lax Ingmar 
Published: December 2007

Object
The results of a novel radiosurgical approach to treat large arteriovenous malformations (AVMs) with repeated radiosurgery are presented and discussed.

Methods
The outcome was studied following repeated Gamma Knife surgery (GKS) for large AVMs, defined as a nidus volume of 9 ml or more. The philosophy was to treat the whole AVM with a low dose of radiation (≥ 10 Gy), and to repeat the treatment if the AVM shrank but was not obliterated. The study included 133 patients with AVMs treated at one of three different institutions. Clinical information was available for all patients, and complete radiological follow-up was available in 89 patients after the first treatment, and in 19 after the second treatment.

Results
The estimated obliteration rate following repeated GKS was 62%. Four patients (3%) developed neurological deficits caused by the radiation, whereas five others (4%) developed cystic changes. The annual incidence of hemorrhage was high (7%), of which 35% occurred within the 1st year after the first treatment.

Conclusions
Repeated radiosurgery seems to be a viable option for some AVMs considered to be too large for conventional radiosurgical treatment. The incidence of posttreatment hemorrhages seems to be a larger clinical problem than radiation-induced complications.
Long-term outcomes of Gamma Knife surgery for cavernous sinus meningioma
Authors: Hasegawa Toshinori , Kida Yoshihisa , Yoshimoto Masayuki , Koike Joji , Iizuka Hiroshi , Ishii Dai 
Published: December 2007

Object
The aim of this study was to evaluate long-term outcomes, including tumor control and neurological function, in patients with cavernous sinus meningiomas treated using Gamma Knife surgery (GKS).

Methods
One hundred fifteen patients with cavernous sinus meningiomas, excluding atypical or malignant meningiomas, were treated with GKS between 1991 and 2003. Forty-nine patients (43%) underwent GKS as the initial treatment. The mean tumor volume was 14 cm3, and the mean maximum and margin doses applied to the tumor were 27 and 13 Gy, respectively. The median follow-up period was 62 months. During the follow-up, 111 patients were able to be evaluated with neuroimaging.

Results
The actuarial 5- and 10-year progression-free survival rates were 87 and 73%, respectively. Similarly, the actuarial 5- and 10-year focal tumor control rates were 94 and 92%, respectively. Regarding functional outcomes, 43 patients (46%) experienced some degree of improvement, 40 (43%) remained stable, and 11 (12%) had worse preexisting or newly developed symptoms. Patients who underwent GKS as the initial treatment experienced significant improvement of their symptoms (p = 0.006).

Conclusions
Gamma Knife surgery is a safe and effective treatment over the long term in selected patients with cavernous sinus meningiomas. Tumor progression is more likely to occur from the lesion margin outside the treatment volume. In small to medium-sized tumors, GKS is an excellent alternative to resection, preserving good neurological function. For relatively large-sized tumors, low-dose radiosurgery (≤ 12 Gy) is acceptable for the prevention of tumor progression.
Surgical repair of ulnar nerve lesions caused by gunshot and shrapnel: results in 407 lesions
Authors: Secer Halil Ibrahim , Daneyemez Mehmet , Gonul Engin , Izci Yusuf 
Published: December 2007

Object
Ulnar nerve lesions caused by gunshot wounds have rarely been reported in the current literature. The authors describe the outcome after surgical repair of such injuries, and the factors influencing the results of treatment.

Methods
This retrospective study includes 455 patients with 462 ulnar nerve injuries caused by gunshot wounds who were treated at Gulhane Military Medical Academy over a 40-year period. A total of 407 ulnar lesions were surgically repaired at that institution between 1966 and 2005; 237 patients were injured by shrapnel and 218 patients by gunshot. The authors evaluated the motor, sensory, and electrophysiological recovery in these patients, as well as the patients' judgment of the outcome. The authors also tested the effect of repair level, nerve graft length, time to operation, repair technique used, and the presence of coexisting damages in the nerve repair region. The final outcome in these patients was defined as poor, fair, or good on the basis of the British Medical Research Council scores.

Results
A good outcome was noted in 15.06% of patients who underwent high-level repair, 29.60% of patients who underwent intermediate-level repair, and 49.68% of patients after low-level repair. On average, patients with successful outcomes had a significantly shorter time to operation than those with unsuccessful outcomes. The critical period for surgery was within 6 months of injury. Although the optimal graft length was found to be 5 cm, this finding was not statistically significant.

Conclusions
The reported outcome of repairs to ulnar nerves damaged by gunshot has varied in the literature, but there is a consensus that the duration of the interval to surgery, the repair level, and the graft length used influence the outcome of surgical repair for ulnar nerve lesions.
The Hakim programmable valve: reasons for reprogramming failures
Authors: Mauer Uwe Max , Schuler Jens , Kunz Ulrich 
Published: December 2007

Object
In patients with hydrocephalus, the pressure settings of a Medos Hakim programmable valve may require adjustments even months after implantation. In some cases, however, adjustment proves to be impossible. The object of this study was to illuminate the reasons for reprogramming failures.

Methods
Data pertaining to the authors' experience with programmable valves at their clinic were obtained through retrospective review of patient records from 1992 to 1998 and prospectively collected from 1998 to 2006. Between 1992 and 2006, 585 Medos Hakim programmable valves were implanted at the authors' center, and reprogramming failure was observed in 12 of these 585 cases. The authors investigated and recorded the reasons for reprogramming failure. In cases in which the valves had to be explanted, the valves were returned to the manufacturer for further investigation and the results were recorded.

Results
In three of the 12 cases of reprogramming failure, the pressure settings could eventually be adjusted by placing the transmitter upside down against the flow direction. In the remaining nine cases, the valve had to be removed, yielding a rate of valve explantation of approximately 1.5% in this series. In two of these nine cases, the valve was found to be rotated longitudinally along its axis. In two cases the ratchet wheel had become loose and in one the radiopaque marker had become dislodged from the baseplate. Extensive deposits were identified macroscopically and microscopically within four explanted valves.

Conclusions
The reasons for failed reprogramming of Codman Medos Hakim valves as described in this article have not been mentioned in the literature so far. Failure of adjusting the pressure setting is a very rare event in a Medos Hakim programmable valve. The programming and adjustment mechanism appears to be very reliable. Valve replacement was required due to failed reprogramming in only a few cases.
Prognostic factors for outcome after transsphenoidal hypophysectomy in dogs with pituitary-dependent hyperadrenocorticism
Authors: Hanson Jeanette M. , Teske Erik , Voorhout George , Galac Sara , Kooistra Hans S. , Meij Björn P. 
Published: December 2007

Object
The aim of this study was to determine prognostic factors for outcome after transsphenoidal hypophysectomy in dogs with pituitary-dependent hyperadrenocorticism (PDH).

Methods
One veterinary neurosurgeon performed transsphenoidal hypophysectomies in 181 dogs with PDH over a 12-year period. Survival analysis was performed with the Kaplan–Meier method. Prognostic factors were analyzed with the univariate Cox proportional hazard analysis followed by stepwise multivariate analysis. The log-rank test was used to assess disease-free fractions in three groups categorized according to early postoperative urinary corticoid/creatinine (C/C) ratios.

Results
Multivariate analysis revealed that old age, large pituitary size, and high preoperative concentrations of plasma adrenocorticotropic hormone were associated with an increased risk of PDH-related death. In addition, large pituitary size, thick sphenoid bone, high C/C ratio, and high concentration of plasma α-melanocyte–stimulating hormone (α-MSH) before surgery were associated with an increased risk of disease recurrence in the dogs that went into remission after hypophysectomy. Disease-free fractions were significantly higher in dogs with postoperative urinary C/C ratios in the lower normal range (< 5 × 10−6) than in dogs with postoperative C/C ratios in the upper normal range (5–10 × 10−6).

Conclusions
The results of this study indicate that pituitary size, sphenoid bone thickness, plasma α-MSH concentration, and preoperative level of urinary cortisol excretion are predictors of long-term remission after transsphenoidal hypophysectomy for PDH in dogs. Urinary C/C ratios measured 6 to 10 weeks after surgery can be used as a guide for predicting the risk of tumor recurrence.
Access to cerebrospinal fluid absorption sites by infusion into vascular channels of the skull diploë
Authors: Johnston Kelly D. , Walji Anil H. , Fox Richard J. , Pugh Jeffrey A. , Aronyk Keith E. 
Published: December 2007

Object
The purpose of this human cadaver study was to determine whether or not an intraosseous skull infusion would access the superior sagittal sinus (SSS) via intradural venous channels. The diploic space of the skull bone contains a sinusoidal vascular network that communicates with the underlying dura mater. Diploic veins in the parasagittal area connect with endothelium-lined intradural channels in the subjacent dura and ultimately with the dural venous sinuses. A significant proportion of cerebrospinal fluid (CSF) absorption is thought to occur via arachnoid granulations in the region of the SSS and especially along the parasagittal dura where arachnoid granulations are surrounded by intradural venous channels (lateral lacunae). The CSF is likely to be conducted from the subarachnoid space into the venous system via the fine intradural channels making up the lateral lacunae.

Methods
Infusion of vinyl acetate casting material into the diploic space of the human cadaveric skull resulted in complete filling of the lateral lacunae and SSS. Corrosion casting techniques and examination under magnification were used to characterize the anatomical connections between diploic spaces and dural venous sinuses.

Results
Corrosion casting, performed on five formalin-fixed cadavers, clearly showed the anatomical connections between the diploic infusion site and the venous sinuses in the underlying parasagittal dura where some of the CSF is thought to be absorbed.

Conclusions
The diploic vascular channels of the human skull may represent an indirect pathway into the dural venous sinuses. Intraosseous skull infusion may represent another possible strategy for diversion of CSF into the vascular system in the treatment of hydrocephalus.
Loss of visual evoked potential following temporary occlusion of the superior hypophyseal artery during aneurysm clip placement surgery
Authors: Goto Tetsuya , Tanaka Yuichiro , Kodama Kunihiko , Kusano Yoshikazu , Sakai Keiichi , Hongo Kazuhiro 
Published: December 2007

✓The authors report a case in which a 62-year-old woman with a history of subarachnoid hemorrhage due to a ruptured aneurysm was found to have a de novo paraclinoid aneurysm in the right internal carotid artery during a routine medical examination. Surgical clip placement was performed via a contralateral pterional approach under visual evoked potential (VEP) monitoring. The superior hypophyseal artery (SHA) was found to originate from the aneurysm body. The artery was temporarily occluded prior to application of the clip to the aneurysm neck. The VEP signal was lost 3 minutes after the SHA was occluded, and the potentials gradually recovered 10 minutes after the artery was released. The disappearance of VEP signal was reproducible with SHA occlusion. The clip was applied to the aneurysm body to preserve the origin of the SHA. The patient did not have any deterioration of vision after surgery.
Intraoperative VEP monitoring can be used to help determine whether the SHA can be sacrificed safely.
Management of bone-invasive, hyperostotic sphenoid wing meningiomas
Authors: Bikmaz Kerem , Mrak Robert , Al-Mefty Ossama 
Published: December 2007

Object
The hyperostosis frequently associated with sphenoid wing meningiomas is actual invasion of bone by the tumor. The intracranial portion of the tumor is usually thin with en plaque spread, and the tumor tends to invade the orbit through the superior orbital fissure.

Methods
The authors reviewed the records of 67 patients with sphenoid wing meningiomas who underwent surgery at the University of Arkansas for Medical Sciences between 1994 and 2004. In all 67 cases, the surgery was performed by the senior author. Seventeen of the patients had the distinguishing characteristics of hyperostotic sphenoid wing meningiomas—extensive bone invasion, en plaque dural involvement, and a minimal intracranial mass with minimal orbital involvement. In all patients, hyperostosis was determined on the basis of preoperative neuroimaging. Histopathological evaluation of bone specimens was performed in 14 cases. Estrogen and progesterone receptor expression and Ki 67 labeling were evaluated in all specimens. Chromosome analysis was performed in all tumors resected since 2001 (seven cases). Particular attention was paid to removing all involved bone and dura mater.

Results
Total removal was achieved in 14 cases (82.3%), with only one recurrence (7.1%) over a mean follow-up period of 36 months (range 5–72 months). Radical resection was followed by cranioorbital reconstruction to prevent enophthalmos and to obtain good cosmetic results. No deaths or serious complications occurred in association with surgery. Proptosis was corrected in all cases and visual acuity improved in seven (70%) of 10 cases. Revision of the orbital reconstruction was required because of postoperative enophthalmos (two cases) or restricted postoperative ocular movement (one case).

Conclusions
Sphenoid wing meningiomas frequently invade bone, although such invasion does not represent malignancy. These lesions are generally histologically benign. Total removal with a prospect for cure and visual preservation should be the goal of treatment. This requires extensive drilling of the invaded bone and extensive excision of the involved dura. When the optic canal is involved, it should be decompressed. Extensive bone resection should be followed by cranioorbital reconstruction for good cosmesis and to prevent enophthalmos.
Association of an endogenous inhibitor of nitric oxide synthase with cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage
Authors: Jung Carla S. , Oldfield Edward H. , Harvey-White Judith , Espey Michael G. , Zimmermann Michael , Seifert Volker , Pluta Ryszard M. 
Published: December 2007

Object
Delayed cerebral vasospasm after subarachnoid hemorrhage (SAH) may be evoked by the decreased availability of nitric oxide (NO). Increased cerebrospinal fluid (CSF) levels of asymmetric dimethyl-l-arginine (ADMA), an endogenous inhibitor of NO synthase (NOS), have been associated with the course and degree of cerebral vasospasm in a primate model of SAH. In this study, the authors sought to determine if similar changes in CSF ADMA levels are observed in patients with SAH, and whether these changes are associated with NO and NOS metabolite levels in the CSF and the presence of cerebral vasospasm.

Methods
Asymmetric dimethyl-l-arginine, l-arginine, l-citrulline, and nitrite levels were measured in CSF and serum samples collected during the 21-day period after a single aneurysmal SAH in 18 consecutive patients. Samples were also obtained in a control group consisting of seven patients with Chiari malformation Type I and five patients with spontaneous intracerebral hemorrhage without SAH. Vasospasm, defined as a greater than 11% reduction in the anterior circulation vessel diameter ratio compared with the ratio calculated from the initial arteriogram, was assessed on cerebral arteriography performed around Day 7.

Results
In 13 patients with SAH, arteriographic cerebral vasospasm developed. Cerebrospinal fluid ADMA levels in patients with SAH were higher than in those in the control group (p < 0.001). The CSF ADMA level remained unchanged in the five patients with SAH without vasospasm, but was significantly increased in patients with vasospasm after Day 3 (6.2 ± 1.7 μM) peaking during Days 7 through 9 (13.3 ± 6.7 μM; p < 0.001) and then gradually decreasing between Days 12 and 21 (8.8 ± 3.2 μM; p < 0.05). Nitrite levels in the CSF were lower in patients with vasospasm compared to patients without vasospasm (p < 0.03). Cerebrospinal fluid ADMA levels positively correlated with the degree of vasospasm (correlation coefficient [CC] = 0.88, p = 0.0001; 95% confidence interval [CI] 0.74–0.95) and negatively correlated with CSF nitrite levels (CC = −0.55; p = 0.017; 95% CI −0.81 to −0.12).

Conclusions
These results support the hypothesis that ADMA is involved in the progression of cerebral vasospasm. Asymmetric dimethyl-l-arginine and its metabolizing enzymes may be a future target for treatment of cerebral vasospasm after SAH.