bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advances to Bayesian network inference for generating causal networks from observational biological data
Authors: Yu Jing , Smith V. Anne , Wang Paul P. , Hartemink Alexander J. , Jarvis Erich D. 
Published: July 2004

Abstract
Motivation: Network inference algorithms are powerful computational tools for identifying putative causal interactions among variables from observational data. Bayesian network inference algorithms hold particular promise in that they can capture linear, non-linear, combinatorial, stochastic and other types of relationships among variables across multiple levels of biological organization. However, challenges remain when applying these algorithms to limited quantities of experimental data collected from biological systems. Here, we use a simulation approach to make advances in our dynamic Bayesian network (DBN) inference algorithm, especially in the context of limited quantities of biological data.
Results: We test a range of scoring metrics and search heuristics to find an effective algorithm configuration for evaluating our methodological advances. We also identify sampling intervals and levels of data discretization that allow the best recovery of the simulated networks. We develop a novel influence score for DBNs that attempts to estimate both the sign (activation or repression) and relative magnitude of interactions among variables. When faced with limited quantities of observational data, combining our influence score with moderate data interpolation reduces a significant portion of false positive interactions in the recovered networks. Together, our advances allow DBN inference algorithms to be more effective in recovering biological networks from experimentally collected data.
Availability: Source code and simulated data are available upon request.
Supplementary information: http://www.jarvislab.net/Bioinformatics/BNAdvances/
Choroid Plexus Tumors in Children: Significance of Stromal Invasion
Authors: Levy Michael L. , Goldfarb Amy , Hyder Douglas J. , Gonzales-Gomez Ignacio , Nelson Marvin , Gilles Floyd H. , McComb J. Gordon 
Published: July 2004

AbstractOBJECTIVEA group of choroid plexus tumors fit the cellular criteria for choroid plexus papilloma (CPP) except for invasion into the adjacent parenchyma, with associated loss of the normal villus architecture at the site of invasion. These tumors retain a benign cellular appearance. In the existing literature, it is unclear whether these tumors are classified as choroid plexus carcinomas or as CPPs. In our experience, although evidence of invasion is present, these tumors tend to exhibit benign behavior. We suggest that stromal invasion of this type remains consistent with a benign clinical course, although surgical results may demonstrate higher morbidity rates, given the invasive nature of the tumors. The failure to classify these tumors as CPPs may explain some of the variability in outcomes reported for various studies.METHODSTo study this question, clinical and histological data for children diagnosed with CPPs (either with or without stromal invasion) between 1985 and 1995 were examined. Only cases with pre- and postoperative magnetic resonance imaging data were included in the series.RESULTSA total of 12 patients with CPPs were identified, with 4 tumors being notable for stromal invasion. After gross total tumor removal, none of the eight children with CPPs received adjuvant therapy at our institution; all are alive without evidence of tumor recurrence after surgical excision (mean, 108 mo). Of the four patients with stromal invasion, three underwent gross total resection. The one patient who underwent subtotal resection received chemotherapy at another facility. All four of these patients are alive, after a mean of 100 months of follow-up monitoring.CONCLUSIONIt is recommended that CPPs with a benign cellular appearance but with evidence of local parenchymal invasion and loss of the normal villus architecture at the site of invasion be classified as CPPs. Patients with these tumors respond to surgical therapy alone, without the need for adjuvant treatment.
Prodromal Signs and Clinical Factors Influencing Outcome in Patients with Intraventricular Rupture of Purulent Brain Abscess
Authors: Takeshita Mikihiko , Kawamata Takakazu , Izawa Masahiro , Hori Tomokatsu 
Published: July 2004

Abstract

OBJECTIVE
To elucidate prodromal signs and clinical factors influencing the prognosis in patients with intraventricular rupture of brain abscess (IVROBA) to prevent and manage this catastrophic condition.

METHODS
In this study, 33 consecutive patients with IVROBA diagnosed by computed tomography (CT) were treated. Basic and therapeutic parameters were evaluated as independent predictive factors of a poor prognosis by using univariate analysis. The factors were statistically analyzed based on the interval between initial symptoms and IVROBA.

RESULTS
Patients with a good outcome were younger (&lt;21 yr old) (P &lt; 0.003) and had fewer complications after IVROBA (P &lt; 0.03). For the most part, these patients had undergone aspiration for brain abscess with ventricular drainage combined with the immediate administration of appropriate intravenous and intrathecal antibiotics (P &lt; 0.02). In just a short time, abscesses located in the parieto-occipital region ruptured into the ventricle (P &lt; 0.004), and those with nonsterile cultures (P &lt; 0.01) developed into IVROBA. Just before IVROBA, patients had severe headaches, signs of meningeal irritation, and a rapidly deteriorating clinical condition within 10 days after the signs of meningeal irritation developed. A CT scan obtained before IVROBA ascertained localized enhancement of the ventricular wall adjacent to the abscess.

CONCLUSION
Our findings suggest that signs of meningeal irritation and localized enhancement of the ventricular wall adjacent to the abscess, as observed on CT scans, preceded IVROBA. To decrease the mortality rate associated with purulent brain abscesses, signs forewarning of IVROBA should be recognized, and aggressive management of IVROBA should be initiated. Aggressive CT-guided aspiration of deep-seated abscesses, particularly in the parieto-occipital region, at the time forewarning signs of IVROBA are observed lead to the prevention of IVROBA and an improvement in outcome.
Utility of Three-dimensional Computed Tomographic Angiography for Assessment of Relationships between the Vertebrobasilar System and the Cranial Base
Authors: Villavicencio Alan T. , Gray Linda , Leveque Jean-Christophe , Fukushima Takanori , Kureshi Sohaib , Friedman Allan H. 
Published: July 2004

Abstract

OBJECTIVE
The optimal surgical exposure for basilar tip aneurysms is dictated by the relationship of the basilar bifurcation to the cranial base. This study was designed to evaluate three-dimensional computed tomographic angiography as a means of obtaining detailed anatomic information on the basilar artery and the surrounding cranial base in individual patients before surgery.

METHODS
We studied 30 patients using three-dimensional computed tomographic angiographic reconstructions from 1-mm computed tomographic slices. Detailed anatomic measurements were performed to define the relationship between the basilar artery and the cranial base. Particular attention was paid to the height of the dorsum sellae and its relationship to the basilar bifurcation.

RESULTS
The heights of the basilar apex and the vertebrobasilar junction, relative to the cranial base, were extremely variable. Considerable asymmetries in the heights of the left and right posterior clinoid processes were identified; in one case, this difference was more than 1 cm (mean difference in height, 0.9 mm; range, 0–10.3 mm). The heights of the posterior clinoid processes above the sellar floor ranged from 5.8 to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of the pterional/orbitozygomatic, middle fossa/anterior petrosal, and presigmoid retrolabyrinthine approaches to an individual basilar bifurcation. We also estimated the amount of bone removal required and determined the operative distances via those approaches.

CONCLUSION
Three-dimensional computed tomographic angiography is a useful tool for assessing critical anatomic relationships and represents an adjunct to conventional angiography in the planning of individualized, precisely tailored, cranial base approaches to the vertebrobasilar system.
Anterior Lumbar Microdiscectomy and Interbody Fusion for the Treatment of Recurrent Disc Herniation
Authors: Giancarlo Vishteh A. , Dickman Curtis A. 
Published: July 2004

Abstract

OBJECTIVE
To demonstrate the feasibility of anterior lumbar microdiscectomy in patients with recurrent, sequestered lumbar disc herniations.

METHODS
Between 1997 and 1999, six patients underwent a muscle-sparing “minilaparotomy” approach and subsequent microscopic anterior lumbar microdiscectomy and fragmentectomy for recurrent lumbar disc extrusions at L5–S1 (n = 4) or L4–L5 (n = 2). A contralateral distraction plug permitted ipsilateral discectomy under microscopic magnification. Effective resection of the extruded disc fragments was accomplished by opening the posterior longitudinal ligament. Interbody fusion was performed by placing cylindrical threaded titanium cages (n = 4) or threaded allograft bone dowels (n = 2).

RESULTS
There were no complications, and blood loss was minimal. Follow-up magnetic resonance imaging revealed complete resection of all herniated disc material. Plain x-rays revealed excellent interbody cage position. Radicular pain and neurological deficits resolved in all six patients (mean follow-up, 14 mo).

CONCLUSION
Anterior lumbar microdiscectomy with interbody fusion provides a viable alternative for the treatment of recurrent lumbar disc herniations. Recurrent herniated disc fragments can be removed completely under direct microscopic visualization, and interbody fusion can be performed in the same setting.
Malignant Giant-cell Tumor of the Parietal Bone: Case Report and Review of the Literature
Authors: Leonard Jeffrey , Gökden Murat , Kyriakos Michael , Derdeyn Colin P. , Rich Keith M. 
Published: July 2004

AbstractOBJECTIVE AND IMPORTANCEGiant-cell tumors (GCTs) are primary bone tumors that involve long bones in 75 to 90% of patients. They seldom develop in the cranium and are very rare in patients older than 60 years of age. A GCT rarely occurs with Paget's disease; when it does, however, it is most commonly associated with the polyostotic form and tends to involve the craniofacial bones. Pagetic GCTs are less aggressive than GCTs that are not associated with Paget's disease.CLINICAL PRESENTATIONWe report the case of an 81-year-old woman with a painless left parietal mass and asymptomatic monostotic parietal Paget's disease.INTERVENTIONSurgical resection was performed, and histological examination of the lesion demonstrated Paget's disease with a malignant GCT. An incidental, low-grade, small-cell lymphocytic lymphoma also was noted. The patient experienced local recurrence of the malignant GCT and eventually died after developing pulmonary metastases of the malignant GCT.CONCLUSIONThis case is the first reported example of a patient with a malignant GCT of the cranium associated with monostotic Paget's disease. It provides evidence that not all pagetic GCTs in the cranium are benign, as has been reported.
Stereotactic Radiosurgery for Recurrent Central Neurocytoma: Case Report
Authors: Pollock Bruce E. , Stafford Scott L. 
Published: July 2004

Abstract

OBJECTIVE AND IMPORTANCE
Neurocytomas are typically benign tumors that have high local control rates after gross total resection. Nevertheless, tumor recurrence is possible, and some patients have aggressive tumors.

CLINICAL PRESENTATION
A 26-year-old woman had a recurrent, asymptomatic neurocytoma 3 years after gross total resection.

INTERVENTION
The patient underwent stereotactic radiosurgery for the tumor recurrence. Thirty-four months later, the patient remained neurologically intact, and the tumor had decreased significantly in size.

CONCLUSION
Radiosurgery may be a viable treatment option for patients with recurrent neurocytomas or for patients whose tumor resections were subtotal.
Preservation of Large Bridging Veins of the Cranial Base: Technical Note
Authors: Kyoshima Kazuhiko , Oikawa Susumu , Kobayashi Shigeaki 
Published: July 2004

Abstract

OBJECTIVE
Sacrifice of a bridging vein in the cranial base occasionally may cause significant postoperative morbidity. We report a simple method for preserving large bridging veins of the cranial base by reflecting the dura when a subtemporal or transsylvian approach is used.

METHODS
In the subtemporal approach, when a larger bridging vein enters the dura attached to the bone of the temporal base before it empties into the dural sinus, the dura is dissected widely from the bone and is cut vertically toward the medial side of the temporal base in front of the entrance of the vein into the dura. The dura, which includes part of the entrance and interdural course of the vein, is reflected and retracted over the brain. In the transsylvian approach, when the bridging segment of the superficial sylvian vein becomes taut because of retraction of the temporal lobe, the dura is incised along the sphenoid ridge and is dissected and freed from the sphenoid bone.

RESULTS AND CONCLUSION
This dura-reflecting technique facilitates brain retraction without exerting tension on the bridging vein of the cranial base and is expected to help avoid injury to bridging veins during neurosurgical procedures.
Treating Complex Nervous System Vascular Disorders through a “Needle Stick”: Origins, Evolution, and Future of Neuroendovascular Therapy
Authors: Hopkins L. Nelson , Lanzino Giuseppe , Guterman Lee R. 
Published: July 2004

AbstractIN THE PAST few decades, dramatic improvements have occurred in the field of neuroendovascular surgery. Endovascular therapy today is a well-established treatment modality for a variety of cerebrovascular and nonvascular central nervous system diseases. The foundation of this spectacular evolution was laid by the efforts of pioneering visionaries who often worked alone and under difficult, almost impossible, conditions. Ongoing device development and refinement have revolutionized the field at a dizzying, exhilarating pace. With a better understanding of the molecular basis of diseases and further advancements in gene therapy, neuroendovascular techniques have an enormous potential for application to the entire spectrum of central nervous system diseases as a minimally invasive vehicle for the delivery of biological factors.
Is the Aspect Ratio a Reliable Index for Predicting the Rupture of a Saccular Aneurysm?
Authors: Ujiie Hiroshi , Tamano Yoshinori , Sasaki Kuri , Hori Tomokatsu 
Published: July 2004

Abstract

OBJECTIVE
The present retrospective study was undertaken to prove the reliability of the aspect ratio (aneurysm depth to aneurysm neck width) for predicting an aneurysmal rupture. The aspect ratio is considered a better geometric index than aneurysm size for determining the intra-aneurysmal blood flow.

METHODS
We measured the aspect ratios and the sizes of aneurysms, as determined by examining angiographic films magnified 1.4×, in 129 patients with ruptured aneurysms and in 72 patients with 78 unruptured aneurysms. After categorizing the aneurysms into four groups on the basis of their locations (aneurysms of the anterior communicating artery, middle cerebral artery, internal carotid artery-posterior communicating artery [ICA-PComA], and other aneurysms), a statistical analysis of ruptured and unruptured aneurysms was performed.

RESULTS
The mean aneurysm size was found to be statistically significant in the aneurysms at the ICA-PComA and in locations excluding the anterior communicating artery, the middle cerebral artery, and the ICA-PComA. However, the mean aspect ratio was statistically significant at all four locations. In patients with ruptured aneurysms, no ruptured aneurysms with an aspect ratio of less than 1.0 were found. The distribution of the ruptured group versus the unruptured group with an aspect ratio of less than 1.6 at each location was 13 versus 79%, respectively, at the anterior communicating artery, 11 versus 58% at the middle cerebral artery, 11% versus 85% at the ICA-PComA, and 7 versus 81% at other locations.

CONCLUSION
The aspect ratio between ruptured aneurysms and unruptured aneurysms was found to be statistically significant, and almost 80% of the ruptured aneurysms showed an aspect ratio of more than 1.6, whereas almost 90% of the unruptured aneurysms showed an aspect ratio of less than 1.6. This study therefore suggests that the aspect ratio may be useful in predicting imminent aneurysmal ruptures.
Spontaneous Resolution of Chiari I Malformation and Syringomyelia: Case Report and Review of the Literature
Authors: Klekamp Jörg , Iaconetta Giorgio , Samii Madjid 
Published: July 2004

Abstract

OBJECTIVE AND IMPORTANCE
Indications for surgery and the surgical technique of foramen magnum decompression for patients with Chiari I malformation and syringomyelia are controversial issues. This case report supports the view that observation may be adequate for patients without progressive symptoms or with mild clinical symptoms.

CLINICAL PRESENTATION
A 37-year-old woman presented with a 3-month history of burning dysesthesias and hypesthesia in her right arm. A neurological examination revealed hypesthesia in the right trigeminal distribution. A magnetic resonance imaging scan revealed a Chiari I malformation with syringomyelia between C2 and T2. No hydrocephalus was observed.

CLINICAL COURSE
Because the patient's symptoms regressed spontaneously, surgery was not performed. Thirty-two months after her initial examination, the patient was asymptomatic. A second magnetic resonance imaging scan was obtained, which demonstrated complete spontaneous resolution of the Chiari I malformation and syringomyelia.

CONCLUSION
We attribute the regression of the patient's symptoms to spontaneous recanalization of cerebrospinal fluid pathways at the foramen magnum, which most likely was due to rupture of the arachnoid membranes that had obstructed cerebrospinal fluid flow.
A Posterior Tibial Nerve Neurilemoma Unrecognized for 10 Years: Case Report
Authors: Ghaly Ramsis F. 
Published: July 2004

Abstract

OBJECTIVE AND IMPORTANCE
Neoplasms of peripheral nerves can be obscured, especially during the early phase. The author reports a patient with a posterior tibial nerve neurilemoma (schwannoma). For a decade, the tumor was misdiagnosed as nonspecific S1 radiculopathy and psychogenic chronic pain syndrome. The patient's presentation and initial management are unique.

CLINICAL PRESENTATION
A 40-year-old woman reported severe left foot and calf pain, numbness, and weakness. The symptoms were evident during three pregnancies, and they gradually progressed. The neuropathic pain was protracted, despite implantation of a dorsal column stimulator and administration of a wide variety of medications and therapies. The symptoms were unresponsive to both inpatient and outpatient treatments, which resulted in a misdiagnosis of psychogenic pain for more than a decade. Diagnostic scans obtained by computed tomography, ultrasonography, and nuclear scintigraphy confirmed a popliteal fossa mass.

INTERVENTION
A high, large posterior tibial nerve neurilemoma was found intraoperatively, positioned just below the sciatic nerve bifurcation with extensive degenerative features and hemorrhages. Surgical resection provided immediate recovery.

CONCLUSION
Peripheral nerve tumors are rarely acknowledged clinical entities. Chronic unexplained foot and calf pain and a positive Tinel's sign should raise suspicion of posterior tibial nerve neurilemoma. Even in patients who have had such tumors for a decade, surgical resection remains the treatment of choice.
Cord Compression Secondary to Cervical Disc Herniation Associated with Calcification of the Ligamentum Flavum: Case Report
Authors: Ugarriza L. Fernando , Cabezudo José M. , Porras Luis F. , Rodríguez-Sánchez José A. 
Published: July 2004

Abstract

OBJECTIVE AND IMPORTANCE
Calcification of the ligamentum flavum is a rare disease that occurs almost exclusively in elderly Japanese people. We report the case of a young Caucasian woman who presented with a C5–C6 disc herniation associated with a cervical calcified ligamentum flavum.

CLINICAL PRESENTATION
The patient presented with a cord compression syndrome of 76 hours' evolution. At exploration, a Brown-Séquard syndrome at the C6 level was found. Magnetic resonance imaging and computed tomography led to a correct diagnosis and planning for decompression.

INTERVENTION
We operated on the patient through a combined anterior and posterior approach. After the patient underwent anterior discectomy with intersomatic arthrodesis, we performed posterior decompression. During the operation, we observed that the dura mater could not be separated from the ligamentum, so an en bloc excision of both structures was performed. Microscopic examination indicated that the excised ligamentum had calcification, and total integration of the dura mater into the structure of the ligamentum was demonstrated. To our knowledge, this circumstance has never been described before. A posterior C3–C7 arthrodesis was performed to prevent postoperative kyphosis. Recovery was successful, with total recovery from neurological deficits 4 months later.

CONCLUSION
Calcification of the ligamentum flavum is a progressive disease that starts early in life and becomes symptomatic later in life when spinal stenosis occurs. Magnetic resonance imaging and computed tomography provide adequate diagnosis and allow proper surgical planning for decompression. The presence of hyperintense areas within the spinal cord parenchyma, in the absence of a traumatic antecedent, does not preclude a complete recovery.
Intrasellar Rhabdomyosarcoma: Case Report
Authors: Arita Kazunori , Sugiyama Kazuhiko , Tominaga Atushi , Yamasaki Fumiyuki 
Published: July 2004

Abstract

OBJECTIVE AND IMPORTANCE
There has been only one reported case of an intrasellar rhabdomyosarcoma, the origin of which was in the paranasal sinus. The authors encountered a patient with an intrasellar rhabdomyosarcoma with no evidence of tumor at any additional sites.

CLINICAL PRESENTATION
A 28-year-old otherwise healthy man complaining of headache exhibited left abducent nerve palsy and left visual disturbance. The patient was diagnosed as having a sellar tumor invading the left cavernous sinus.

INTERVENTION
Near total removal of the tumor was achieved via a transsphenoidal approach. Histologically, the tumor was composed of small, round-to-elongated undifferentiated cells and large spindle cells with myoblastic features. Immunohistochemically, tumor cells were positive for antibodies against desmin, myoglobin, and α-smooth muscle actin. The tumor was identified as an embryonal rhabdomyosarcoma on the basis of the above pathological findings. Systemic investigation, including the nasal and paranasal regions, failed to detect any additional tumors. Postoperative local radiation therapy and chemotherapy with the use of ifosfamide, etoposide, and vincristine brought about complete initial remission.

CONCLUSION
Rhabdomyosarcoma should be considered in the differential diagnosis of a primary intrasellar neoplasm.