bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Electrophysiological Monitoring of Oculomotor Nuclei and Their Intramedullary Tracts during Midbrain Tumor Surgery
Authors: Sekiya Tetsuji , Hatayama Toru , Shimamura Norihito , Suzuki Shigeharu 
Published: September 2004

Abstract

OBJECTIVE
During surgery for intrinsic midbrain lesions, we intraoperatively recorded evoked compound muscle action potentials (ECMAPs) from the extraocular muscles and evaluated how this type of intraoperative electrophysiological monitoring could minimize postoperative oculomotor nerve palsy (ptosis and/or diplopia).

METHODS
The ECMAPs were recorded through a spring electrode applied to the extraocular muscle (Method 1, seven cases) or a needle electrode inserted into the superior intraorbital space (Method 2, five cases). The surgeon repeated electrical stimulations whenever tissue of unknown origin was encountered intraoperatively, and this information was used to safely guide surgical resection of the tumors.

RESULTS
Using these monitoring techniques, the response-free areas were resected and the areas from which ECMAP responses were recorded were avoided. For all 12 patients, ECMAPs were successfully recorded from the extraocular muscles. Ten patients did not exhibit any postoperative deterioration of oculomotor nerve function. Two patients exhibited deterioration of oculomotor nerve function immediately after surgery, which resolved within 1 month. Equally robust ECMAPs could be recorded with Method 2, compared with Method 1.

CONCLUSION
Intraoperative ECMAP recordings from the extraocular muscles precisely indicated the locations of the oculomotor nuclei and/or intramedullary oculomotor tracts. Although Method 2 is a more indirect method for recording ECMAPs than is Method 1, Method 2 was equally useful in recording ECMAPs, which seemed to be the summed potentials from the superior rectus muscle and the levator palpebrae superioris muscle. These monitoring techniques are valuable in guiding surgeons to avoid causing inadvertent harm to the oculomotor nuclei and tracts during midbrain surgery, particularly when the neuroanatomic features are distorted by the presence of tumor.
Imaging the Trigeminal Nerve and Pons before and after Surgical Intervention for Trigeminal Neuralgia
Authors: Jawahar Ajay , Kondziolka Douglas , Kanal Emanuel , Bissonette David J. , Lunsford L. Dade 
Published: September 2004

Abstract

OBJECTIVE
To study the various imaging changes occurring in the trigeminal nerve and brainstem in patients before or after trigeminal neuralgia surgery.

METHODS
During a 7-year period, 275 patients with trigeminal neuralgia underwent high-resolution, contrast-enhanced magnetic resonance imaging (MRI) of the pons during gamma knife radiosurgery. Ninety-seven patients had no previous surgical intervention for trigeminal neuralgia, and 178 patients had undergone one or more previous procedures. Two independent observers, one of whom was blinded to patients' clinical details, reviewed MRI scans retrospectively. The analysis of the independent observers was then correlated with all previous therapeutic interventions.

RESULTS
One hundred one MRI scans demonstrated no radiological changes related to trigeminal neuralgia, and 174 MRI scans exhibited some radiological abnormality. The average axial plane diameter of the nerve for all patients was 4 mm (range, 2–6 mm). In the group that had not undergone previous surgery, 65 patients (67%) exhibited vascular compression. In the 88 patients who had undergone previous microvascular decompression, 21 (24%) had evidence of a pontine infarction. Twenty-six patients experienced facial sensory loss, 22 (88%) of whom had undergone previous surgery with evidence of a pontine infarction (n = 11) or perineural scarring (n = 6).

CONCLUSION
The majority of patients who had undergone previous trigeminal neuralgia surgery demonstrated readily identifiable abnormalities of the trigeminal nerve or brainstem. The frequency of such changes correlated with the type and number of procedures. Evidence of vascular compression was detected in the majority of patients. Most patients with postoperative facial sensory loss demonstrate changes in the nerve or pons on MR images.
Surgical Experience with Frontolateral Keyhole Craniotomy through a Superciliary Skin Incision
Authors: Czirják Sándor , Szeifert György T. 
Published: September 2004

Abstract

OBJECTIVE
The purpose of this study was to evaluate the results of 173 frontolateral keyhole minicraniotomies performed on 155 patients with aneurysms of the anterior or posterior cerebral circulation and for supratentorial tumors.

METHODS
The frontolateral keyhole craniotomy is a modification of the generally used pterional approach. Of the 155 patients studied, 102 harbored saccular arterial aneurysms in the vessels of the anterior or posterior cerebral circulation, and 53 had various tumors in the frontal base, suprasellar, or parasellar region. The operations were carried out through an approximately 2.5- × 3-cm frontolateral miniaturized craniotomy after a skin incision just above the eyebrow.

RESULTS
Despite the small size of the craniotomy, the exploration allows enough room for intracranial manipulation with maximal protection of the brain and other intracranial structures. The presented series of patients did not have any craniotomy-related complications.

CONCLUSION
In our experience, the frontolateral keyhole craniotomy, together with the advent of the modern neuroanesthesia, cerebrospinal fluid drainage, and microsurgical techniques, is a safe approach for an experienced neurosurgeon to use in the treatment of supratentorial aneurysms or tumors of the anterior fossa and sellar regions.
Tonicity of Resuscitative Fluids Influences Outcome after Spinal Cord Injury
Authors: Sumas MariaElaina , Legos Jeffrey J. , Nathan David , Lamperti Albert A. , Tuma Ronald F. , Young William F. 
Published: September 2004

Abstract

OBJECTIVE
This investigation was designed to test the hypothesis that the tonicity of resuscitative fluids administered after spinal cord injury influences the magnitude of secondary injury and, therefore, outcome.

METHODS
Rat spinal cords were compressed with 50 g of weight for 5 minutes to produce injury. After spinal cord injury, the animals were randomized into three experimental groups. Group 1 (n = 10) received no fluid resuscitation after spinal cord injury. Group 2 (n = 6) received 5 ml/kg of intravenously administered Ringer's lactate 1 minute after the removal of compression. Group 3 (n = 7) was treated with 5 ml/kg of intravenously administered 7.5% hypertonic saline 1 minute after the removal of compression. Neurological outcome was assessed daily for 10 days using the Basso, Beattie, and Bresnahan locomotor rating scale. Histological evaluations of the spinal cord were obtained on Day 10.

RESULTS
The average number of recovery days before the rats were able to spontaneously void their bladders was significantly less (P &lt; 0.05) in the hypertonic saline-treated group. Spontaneous hindlimb movement also occurred sooner in the hypertonic saline-treated animals. The average neurological score was significantly higher (P &lt; 0.05) in the hypertonic saline-treated group during each of the 10 days of recovery. Histological evaluation supported the finding of attenuation of injury in the hypertonic saline-treated animals.

CONCLUSION
The results of this investigation with a chronic model of spinal cord injury support the contention that hypertonic saline treatment may provide protection to the spinal cord after mechanical injury.
Anti‐inflammatory properties of desloratadine
Authors: Agrawal D. K. 
Published: September 2004

SummaryBackground
Allergic rhinitis (AR) is associated with robust infiltration of immune cells and mediators that may contribute to clinical manifestations of the disease.Objective
To review the complex immune effector mechanisms involved in the allergic response and discuss their effects on the pathophysiological and clinical manifestations of AR. Desloratadine, a novel antihistamine, was used as a probe with the goal of attaining a better understanding of the inflammatory processes underlying the allergic response.Methods
Data were obtained from abstracts and peer‐reviewed journals. The pathophysiology of the allergic response has been extensively studied. This paper presents only data from studies that used desloratadine at physiologically relevant concentrations.Results
Key mediators involved in the allergic response and in pathophysiological and clinical manifestations of the immune response were reviewed. Desloratadine was used as a probe to further elucidate the mechanisms involved during an allergic response.Conclusions
Some have proposed a link between the pathophysiology of AR and the clinical manifestation of symptoms. Desloratadine, a new‐generation antihistamine, has demonstrated anti‐inflammatory effects in vitro; indeed, desloratadine is capable of intervening at various points in the immune cascade. Although in vitro results do not necessarily correlate with clinical efficacy, the anti‐inflammatory properties of desloratadine may contribute to its efficacy in patients with AR, allergy‐induced asthma, and other related allergic conditions. Antihistamines that modulate in the immune system at various stages may optimize treatment of allergic disease.
Altered β2‐adrenergic regulation of T cell activity after allergen challenge in asthma
Authors: Heijink I. H. , Van Den Berge M. , Vellenga E. , De Monchy J. G. R. , Postma D. S. , Kauffman H. F. 
Published: September 2004

SummaryBackground
Airway inflammation in asthma is orchestrated by recruitment of T helper (Th)2 lymphocytes to the lung and subsequent production of Th2‐like cytokines upon allergen challenge.Objective
To examine whether allergen‐induced dysfunction of the β2‐adrenergic receptor (β2‐AR) contributes to the enhanced T(h2) cell activity in asthma.Methods
β2‐adrenergic regulation of cytokine mRNA expression was studied in α‐CD3/α‐CD28‐activated peripheral blood lymphocytes from seven asthma patients before and 6 h after allergen challenge, in conjunction with the effects of β2‐agonist fenoterol on T cell chemotaxis and signalling pathways.Results
A complete loss of β2‐AR control over expression of the Th2 cytokines IL‐4, IL‐5 and IL‐13, but not of the Th1 cytokine IFN‐γ, was observed after allergen challenge. Furthermore, we found impaired β2‐AR regulation of T cell migration as well as signal transduction pathways, i.e. the phosphorylation of cyclic adenosine monophosphate‐responsive element binding protein and the inhibition of the mitogen‐activated protein kinase pathway. The loss of β2‐AR control was associated with increased β‐adrenergic receptor kinase expression, which might be involved in β2‐AR desensitization. In addition, we demonstrate for the first time that T cells exposed to the chemokine thymus and activation‐regulated chemokine show hyporesponsiveness to fenoterol.Conclusion
Our results suggest that allergen‐induced loss of β2‐AR control, possibly mediated by chemokine release, plays an important role in enhanced Th2‐like activity in asthma.
Increase of CC chemokine receptor 4‐positive cells in the peripheral CD4+ cells in dogs with atopic dermatitis or experimentally sensitized to Japanese cedar pollen
Authors: Maeda S. , Ohmori K. , Yasuda N. , Kurata K. , Sakaguchi M. , Masuda K. , Ohno K. , Tsujimoto H. 
Published: September 2004

SummaryBackground
Since dogs frequently develop allergic diseases, similar to those in humans, dogs represent a possible animal model for allergy in humans. In human atopic dermatitis (AD), CC chemokine receptor 4 (CCR4) has been shown to play an important role in the development of allergic inflammation of AD; however, the association between allergic reaction and CCR4 is not well understood in dogs.Objective
To examine CCR4 expression in peripheral blood CD4+ cells in dogs that had AD and were experimentally sensitized with Japanese cedar pollen.Materials and methods
Peripheral blood mononuclear cells (PBMCs) were isolated from 17 dogs with AD. The proportion of CCR4+ cells in peripheral blood CD4+ cells (CCR4/CD4) was evaluated by flow cytometry and compared with that in 10 healthy dogs. Similarly, in dogs that were experimentally sensitized to Japanese cedar pollen antigen, the proportion of CCR4/CD4 was examined pre‐ and post‐sensitization.Results
The proportion of CCR4/CD4 in dogs with AD was 40.3±3.3%, which was significantly higher than that in normal dogs (23.6±4.3%) (P<0.01). In the experimentally sensitized dogs, the proportion of CCR4/CD4 was 25.4±2.6% at pre‐sensitization and it was significantly increased (29.8±2.9%) at post‐sensitization (P<0.01).Conclusion
The proportion of CCR4+ cells in peripheral blood CD4+ cells was measured in dogs with allergic conditions. The present findings indicate that CCR4+ cells may be involved in the pathogenesis of allergy in dogs as in humans.
Nerve growth factor‐induced substance P in capsaicin‐insensitive vagal neurons innervating the lower mouse airway
Authors: Dinh Q. T. , Groneberg D. A. , Peiser C. , Springer J. , Joachim R. A. , Arck P. C. , Klapp B. F. , Fischer A. 
Published: September 2004

SummaryBackground
Nerve growth factor (NGF) is elevated in allergic diseases such as bronchial asthma and can lead to an induction of substance P (SP) and related neuropeptides in guinea‐pigs large‐diameter, neurofilament‐positive airway neurons.Objective
In the present study, the effect of NGF on tyrosine kinase receptor trkA and the capsaicin receptor TRPV1 expression in airway‐specific vagal sensory neurons located in the jugular–nodose ganglia complex (JNC) of mice was investigated.Methods
Using retrograde neuronal tracing in combination with double‐labelling immunohistochemistry, SP, trkA‐ and TRPV1‐receptor expression was examined in airway‐specific sensory neurons of BALB/c mice before and after NGF treatment.Results
NGF injected into the lower airway was able to induce SP (13.0±2.03% vs. 5.9±0.33%) and trkA expression (78±2.66% vs. 60±2.11%) in larger diameter (>25 μm), capsaicin‐insensitive and trkA‐positive vagal sensory neurons that were retrograde‐labelled with Fast Blue dye from the main stem bronchi.Conclusion
Based on the extent of SP and trkA co‐expression in airway‐specific neurons by NGF treatment, the present study suggests that, following a peripheral activation of trkA receptor on SP afferent by NGF which is elevated in allergic inflammation, there may be trkA‐mediated SP induction to mediate neurogenic airway inflammation.
Medullary thyroid carcinoma
Authors: Leboulleux Sophie , Baudin Eric , Travagli Jean‐Paul , Schlumberger Martin 
Published: September 2004

SummaryMedullary thyroid carcinoma (MTC) arises from parafollicular or C cells that produce calcitonin (CT), and accounts for 5–10% of all thyroid cancers. MTC is hereditary in about 25% of cases. The discovery of a MTC in a patient has several implications: disease extent should be evaluated, phaeochromocytoma and hyperparathyroidism should be screened for and whether the MTC is sporadic or hereditary should be determined by a direct analysis of the RET proto‐oncogene. In this review, pathological characteristics, tumour markers and genetic abnormalities in MTC are discussed. The diagnostic and therapeutic modalities applied to patients with clinical MTC and those identified with preclinical disease through familial screening are also described. Progresses concerning genetics, initial treatment, follow‐up, screening and treatment of pheochromocytoma have permitted an improvement in the long‐term outcome. However, there is no effective treatment for distant metastases, and new therapeutic modalities are urgently needed.
The relation of insulin, leptin and IGF‐1 to birthweight in offspring of women with type 1 diabetes
Authors: Lindsay R. S. , Hamilton B. A. , Calder A. A. , Johnstone F. D. , Walker J. D. 
Published: September 2004

Summaryobjective  Maternal diabetes is associated with excess foetal growth. We have assessed the influence of maternal diabetes on hormones associated with foetal growth and the relationship of these hormones to birthweight.design  Case–control study.patients  Singleton offspring of mothers with type 1 diabetes (ODM, n = 140) and control mothers (Control, n = 49).measurements  Birthweight, cord blood insulin, proinsulin, 32–33 split proinsulin, leptin, IGF‐1, IGFBP‐3, cortisol.results  Maternal diabetes was associated with higher birthweight (ODM 3·80 ± 0·69 kg; Control; 3·56 ± 0·52 kg, P = 0·02) and marked increases in insulin (median [interquartile range]: ODM 110 [60–217] pmol/l; Control 22 [15–37] pmol/l; P < 0·0001) and leptin (ODM 32 [15–60] ng/ml; Control 9 [4–17] ng/ml; P < 0·0001) but no absolute difference in IGF‐1 (ODM 7·9 [6·2–9·8] nmol/l, Control 7·5 [6·2–9·8] nmol/l, P = 0·24) or its principle binding protein IGFBP‐3 (ODM 1·63 ± 0·38 µg/ml, Control 1·63 ± 0·28 µg/ml; P = 0·12). Individually, insulin, insulin propeptides, leptin, IGF‐1 and IGFBP‐3 were significantly (P < 0·05) correlated with birthweight (in ODM and Control). IGF‐1 and leptin were positively related to birthweight independently of each other and insulin in both ODM and Control. By contrast, insulin showed independent relationships to birthweight in ODM (P < 0·0001) but not in Control (P = 0·4).conclusions  Maternal diabetes is associated with marked elevation of insulin and leptin in cord blood of their offspring. Hormonal correlates of birthweight differ between ODM and Control with an independent relationship of insulin to birthweight observed only in ODM.
Variation in identifying neonatal percutaneous central venous line position
Authors: Odd DE , Battin MR , Kuschel CA 
Published: September 2004

Objective:  The study objective was to obtain data on interpretation, including intra and interobserver variation and action taken for a given line tip location, for a series of radiographs demonstrating neonatal long lines.Methods:  Nineteen radiographs taken to identify line tip position were digitized and published on an internet site. One film was included twice in order to assess intraobserver variation giving a total of 20 images. Fourteen used radio‐opaque contrast and five no contrast. Australian and New Zealand Neonatal Network members and National Women's Hospital NICU staff were invited to participate in the study. For each radiograph, participants were asked to identify if long line tip could be identified, the likely anatomical position and desired action. Interobserver agreement was assessed by the maximum proportion of agreement per radiograph and by the number of different options selected. Intraobserver agreement was assessed by comparing the two reports from the duplicate radiograph.Results:  Twenty‐seven responses were received. Overall, 50% of the reports stated that the long line tips could be identified. The most commonly reported position was in the right atrium (31%) and most commonly reported action was to pull the line back (53%). The median agreement of whether the line was seen was 68%, agreement on position 62% and agreement on action 86%. On analysis of intraobserver variability, from the identical radiographs, 27% of respondents differed on whether the line tip could be visualized.Conclusion:  Interobserver and intraobserver reliability was poor when using radiographs to assess long line tips. The major determinant of line repositioning was the perceived location.
Clinical significance of isolated paraventricular cysts on cranial ultrasonography
Authors: Wong F , Fraser S , Kelly E , Acton C 
Published: September 2004

Objectives:  Isolated paraventricular cysts detected on routine cranial ultrasonography in premature and full term neonates are often incidental findings. The aetiology and clinical significance of these lesions is uncertain. A case control study was designed to attempt to clarify the clinical significance of isolated paraventricular cysts in terms of growth and neurodevelopment.Methods:  Ten infants with isolated paraventricular cysts on neonatal cranial ultrasonography were identified. These were matched with 10 control infants for sex, gestational age and birthweight. All infants were assessed at a corrected age of 18−31 months for growth and neurodevelopment. Two index infants and their controls were excluded from analysis of psychometric data as the neurodevelopmental assessment tools used were different.Results:  There was no statistically significant difference between the index and control groups in terms of growth, motor and psychometric assessment at follow up.Conclusions:  The study suggests that isolated paraventricular cysts detected on routine cranial ultrasonography have no prognostic significance. However the study involved a small sample size with limited power of study (power = 0.3). A larger prospective cohort study would help to clarify the clinical significance of this condition.
Trial of nurse‐run asthma clinics based in general practice versus usual medical care
Authors: PILOTTO Louis S. , SMITH Brian J. , HEARD Adrian R. , McELROY Heather J. , WEEKLEY Josephine , BENNETT Paul 
Published: September 2004

Objective:  The aim of this study was to assess the ability of nurse‐run asthma clinics based in general practice compared with usual medical care to produce at least a moderate improvement in the quality of life of adults with asthma.Methodology:  A randomized controlled trial involving 80 asthma clinic and 90 usual medical care asthma participants, aged 18 years and older was conducted in 11 general practices in Adelaide. The main outcome measure was the St George's respiratory questionnaire (SGRQ), from which quality‐of‐life scores were used to assess therapeutic benefit. Lung function measurements and health services utilization data were also collected.Results:  One hundred and fifty‐three participants (90%) were reviewed at follow up after 6–9 months. There was little difference between groups in baseline measures or for the 6‐month follow‐up  outcomes,  including  the  mean  difference  in  total  SGRQ  scores  (−0.5,  95%  confidence  interval  (CI) −4.0, 2.9) and the mean difference in percentage predicted FEV1 (2.3%, 95% CI −0.7, 5.3 pre‐bronchodilator; 0.4%, 95% CI −5.1, 5.9 post‐bronchodilator). Trends in health services utilization were noted.Conclusions:  Nurse‐run asthma clinics based in general practice and usual medical care were similar in their effects on quality of life and lung function in adults. These findings cannot be generalized to hospital outpatients and other clinics that manage more severe asthmatic patients.