bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results after Surgical and Endovascular Treatment of Paraclinoid Aneurysms by a Combined Neurovascular Team
Authors: Hoh Brian L. , Carter Bob S. , Budzik Ronald F. , Putman Christopher M. , Ogilvy Christopher S. 
Published: September 2004

Abstract

OBJECTIVE
Advances in surgical and endovascular techniques have improved treatment for paraclinoid aneurysms. A combined surgical and endovascular team can formulate individualized treatment strategies for patients with paraclinoid aneurysms. Patients who are considered to be at high surgical risk can be treated endovascularly to minimize morbidity. We reviewed the clinical and radiographic outcomes of 238 paraclinoid aneurysms treated by our combined surgical and endovascular unit.

METHODS
From 1991 to 1999, the neurovascular team treated 238 paraclinoid aneurysms in 216 patients at the Massachusetts General Hospital. The modality of treatment for each aneurysm was chosen based on anatomic and clinical risk factors, with endovascular treatment offered to patients considered to have higher surgical risks. One hundred eighty aneurysms were treated by direct surgery, 57 were treated by endovascular occlusion, and one was treated by surgical extracranial-intracranial bypass and endovascular internal carotid artery balloon occlusion. Locations were transitional, 12 (5%); carotid cave, 11 (5%); ophthalmic, 131 (55%); posterior carotid wall, 38 (16%); and superior hypophyseal 46 (19%). Lesions contained completely within the cavernous sinus were excluded from this analysis.

RESULTS
Using the Glasgow Outcome Scale (GOS), overall clinical outcomes were excellent or good (GOS 5 or 4), 86%; fair (GOS 3), 7%; poor (GOS 2), 4%; and death (GOS 1), 3%. Among the surgically treated patients, 90% experienced excellent or good outcomes (GOS 5 or 4), 6% had fair outcomes (GOS 3), 2% had poor outcomes (GOS 2), and 3% died (GOS 1). Among the endovascularly treated patients, 74% had excellent or good outcomes (GOS 5 or 4), 12% had fair outcomes (GOS 3), 10% had poor outcomes (GOS 2), and 4% died (GOS 1). The overall major and minor complication rate from surgery was 29%, with a 6% surgery-related permanent morbidity rate and a mortality rate of 0%. The overall major and minor complication rate from endovascular treatment was 21%, with a 3% endovascular-related permanent morbidity rate and a 2% mortality rate. Visual outcomes for patients who presented with visual symptoms were as follows: improved, 69%; no change, 25%; worsened, 6%; and new visual deficits, 3%. In general, angiographic efficacy was lower in the endovascular treatment group.

CONCLUSION
A combined team approach of direct surgery and endovascular coiling can lead to good outcomes in the treatment for paraclinoid aneurysms, including high-risk lesions that might not have been treated in previous surgical series.
Management and Outcomes in a Low-volume Cerebral Aneurysm Practice
Authors: Naso William B. , Rhea Andrew H. , Poole Allen 
Published: September 2004

Abstract

OBJECTIVE
To review management strategies, outcomes, and complications in cerebral aneurysm surgery in a low-volume aneurysm practice.

METHODS
Seventy-nine craniotomies to treat aneurysms were performed between June 1996 and November 1999. Patient management strategy is outlined, complications are assessed, and outcomes are described.

RESULTS
Twenty-six patients underwent surgery to treat unruptured aneurysms. Forty-two patients presented with Hunt and Hess Grade 1 to 3 subarachnoid hemorrhage. Eleven patients presented with Grade 4 or 5 subarachnoid hemorrhage. Twenty-four patients (92.3%) with unruptured aneurysms experienced favorable outcomes. Of the patients with unruptured anterior circulation aneurysms, 96% achieved favorable recoveries. Thirty-eight patients (90.5%) with Grade 1 to 3 subarachnoid hemorrhage experienced favorable outcomes; four of these patients were moderately disabled. Among patients with Grade 1 to 3 subarachnoid hemorrhage, the mortality rate was 7.1%. Of patients with Grade 4 or 5 subarachnoid hemorrhage, five (45.5%) experienced favorable outcomes, but four of these patients were moderately disabled; two patients (18.2%) were severely disabled, and four patients (36.4%) died.

CONCLUSION
Acceptable clinical outcomes can be achieved in lower-volume aneurysm practices. A multidisciplinary subspecialty approach with aggressive perioperative care, especially in the prevention and treatment of cerebral vasospasm, is important in obtaining these results. Close interaction with medical consultants and other subspecialists is necessary.
Transcallosal Resection of Hypothalamic Hamartomas, with Control of Seizures, in Children with Gelastic Epilepsy
Authors: Rosenfeld Jeffrey V. , Harvey A. Simon , Wrennall Jacquie , Zacharin Margaret , Berkovic Samuel F. 
Published: September 2004

Abstract

OBJECTIVE
Hypothalamic hamartomas (HHs) are associated with precocious puberty and gelastic epilepsy; the seizures are often refractory to antiepileptic medications and associated with delayed development and disturbed behavior. The current opinion is that surgery to treat intrahypothalamic lesions is formidable and that complete excision is not technically achievable. We report our experience with a transcallosal approach to the resection of HHs.

METHODS
Five children (age, 4–13 yr) with intractable epilepsy and HHs underwent preoperative clinical, electroencephalographic, and imaging evaluations. Two patients experienced only gelastic seizures, and three patients experienced mixed seizure disorders with drop attacks; all experienced multiple daily seizures. Patients were evaluated with respect to seizures, cognition, behavior, and endocrine status 9 to 37 months (mean, 24 mo) after surgery. The HHs were approached via a transcallosal-interforniceal route to the third ventricle and were resected using a microsurgical technique and frameless stereotaxy.

RESULTS
Complete or nearly complete (&gt;95%) excision of the HHs was achieved for all patients, with no adverse neurological, psychological, or visual sequelae. Two patients experienced mild transient diabetes insipidus after surgery. Two patients developed appetite stimulation, but no other significant endocrinological sequelae were observed. Three patients are seizure-free and two patients have experienced only occasional, brief, mild gelastic seizures after surgery, all with reduced antiepileptic medications. On the basis of parental reports and our own subjective observations, the children also exhibited marked improvements in behavior, school performance, and quality of life.

CONCLUSION
Complete or nearly complete resection of HHs can be safely achieved via a transcallosal approach, with the possibility of seizure freedom and neurobehavioral improvements.
Recurrent Germinoma in the Optic Nerve: Report of Two Cases
Authors: Nakajima Takeshi , Kumabe Toshihiro , Jokura Hidefumi , Yoshimoto Takashi 
Published: September 2004

Abstract

OBJECTIVE AND IMPORTANCE
Intracranial germinomas often disseminate via the ventricular and subarachnoid pathways, but seeding to the perioptic arachnoid space is extremely unusual. We report two cases of recurrent germinoma seeding in the optic nerve.

CLINICAL PRESENTATION
Two men with pure germinoma were initially treated with three cycles of a three-drug regimen of bleomycin, etoposide, and cisplatin, and a complete response was achieved. Patient 1 experienced ventricle wall dissemination 10 months after undergoing the initial treatment and was successfully treated with three cycles of carboplatin and etoposide and then by 24-Gy whole-ventricle radiation. Twelve months later, he complained of progressive visual acuity loss, and magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves. Patient 2 also experienced ventricle wall dissemination 3 months after undergoing the initial chemotherapy, but he exhibited a complete response after undergoing 24-Gy whole-ventricle radiation. Two years later, he complained of progressive visual acuity loss. Magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves and cerebellar hemispheres.

INTERVENTION
None of the locations of recurrence were included in the irradiation field, whereas there was no recurrence within the radiation field. Complete responses were obtained with three cycles of a three-drug regimen of ifosfamide, cisplatin, and etoposide and then by 24-Gy whole-brain radiation that included the bilateral optic nerves. The visual acuity of each patient improved slightly.

CONCLUSION
Delayed seeding in the optic nerve may result from germinoma cells that remain dormant, so they cannot be destroyed by chemotherapy regimens alone.
Chiari Type I Malformation Presenting as Glossopharyngeal Neuralgia: Case Report
Authors: Kanpolat Yucel , Unlu Agahan , Savas Ali , Tan Funda 
Published: September 2004

Abstract

OBJECTIVE AND IMPORTANCE
Chiari Type I malformation is an important pathological state in which the brainstem is compressed by the cerebellar tonsil. We present a case of glossopharyngeal neuralgia caused by Chiari Type I malformation.

CLINICAL PRESENTATION
A 50-year-old male patient was admitted with glossopharyngeal neuralgia. Magnetic resonance imaging studies revealed caudal displacement of the left cerebellar tonsil.

INTERVENTION
Small occipital craniectomy and C1 laminectomy were performed. The left cerebellar tonsil was resected.

CONCLUSION
This glossopharyngeal neuralgia was caused by compression of the lower cranial nerves and brainstem by the displaced left cerebellar tonsil. Decompression and pain relief were obtained with resection of the cerebellar tonsil. The patient was pain-free 30 weeks after the operation.
Inflammation, Immunity and Vaccines for Helicobacter pylori
Authors: Del Giudice Giuseppe , Michetti Pierre 
Published: September 2004

ABSTRACT Helicobacter pylori causes chronic gastritis in the human stomach, yet only a minority of infected individuals develop peptic ulcer disease, atrophic gastritis, or gastric malignancies. The severity, progression, and consequences of H. pylori infection have been shown to depend on the host genetic background, and in particular on gene polymorphisms affecting the host immune response. Numerous studies published last year brought new information on the mechanisms by which the host genetic make‐up modifies the inflammatory and immune responses to H. pylori and the induction of tissue damage secondary to the infection. Novel insights on the regulatory role of H. pylori on the adaptive T‐cell response and on its consequences for the persistence of the infection and for the development of vaccines are discussed.
Pathogenesis of Helicobacter pylori Infection
Authors: Hofman Paul , Waidner Barbara , Hofman Véronique , Bereswill Stefan , Brest Patrick , Kist Manfred 
Published: September 2004

ABSTRACTResearch in the last year has provided new insights into the function of the the cag‐associated type IV secretion system and the vacuolating toxin VacA. A quite new aspect was disclosed by the finding that Helicobacter pylori in Mongolian gerbils colonizes a very distinct topology in the gastric mucous layer, obviously providing optimal conditions for long‐term survival. Further research activities focused on H. pylori ammonia and metal metabolism as well as on bacterial stress defence mechanisms. Differential expression of approximately 7% of the bacterial genome was found at low pH suggesting that H. pylori has evolved a multitude of acid‐adaptive mechanisms. VacA was shown to interrupt phagosome maturation in macrophage cell lines as well as to modulate and interfere with T lymphocyte immunological functions. Gastric mucosa as well as the H. pylori‐infected epithelial cell line AGS strongly express IL‐8 receptor A and B, which might contribute to the augmentation of the inflammatory response. Accumulating evidence implicates genetic variation in the inflammatory response to H. pylori in the etiology of the increased risk of gastric cancer after H. pylori infection. The chronic imbalance between apoptosis and cell proliferation is the first step of gastric carcinogenesis. In this regard, it was demonstrated that coexpression of two H. pylori proteins, CagA and HspB, in AGS cells, caused an increase in E2F transcription factor, cyclin D3, and phosphorylated retinoblastoma protein.Taken together, we now have a better understanding of the role of different virulence factors of H. pylori. There is still a lot to be learned, but the promising discoveries summarized here, demonstrate that the investigation of the bacterial survival strategies will give novel insights into pathogenesis and disease development.
Helicobacter pylori and Extragastric Diseases – Other Helicobacters
Authors: Gasbarrini Antonio , Carloni Emilia , Gasbarrini Giovanni , Chisholm Stephanie A. 
Published: September 2004

ABSTRACTReports on Helicobacter pylori and extragastric diseases have almost doubled this year compared with last year, bearing witness to the persistent scientific interest in this branch of Helicobacter‐related pathology. Data belong increasingly to the area of vascular medicine, as well as hematology, dermatology, pediatrics and other fields. Unfortunately, these studies show overall controversial results, due to the impact of several confounding factors, and to the difficulty of recruiting homogeneous patient populations. Furthermore, many studies continue to be conducted on Helicobacter species other than H. pylori, focusing on animal models of gastroenterological illnesses which may retain strong similarities with human diseases. In this paper, taxonomy, detection and characterisation of Helicobacter spp. will be reviewed, together with the most important data issued this year on other Helicobacters and animal models.
Therapy of Helicobacter pylori
Authors: McLoughlin Ramona , Racz Istvan , Buckley Martin , O'Connor Humphrey J. , O'Morain Colm 
Published: September 2004

ABSTRACTThis represents an overview of the main data published over the last year on the therapy of Helicobacter pylori. The problem of increasing failure of H. pylori eradication has been the main focus, with increasing resistance and poor patient compliance being the main culprits. Simple regimens are necessary to improve patient compliance. New antibiotics and novel agents are appraised with mixed results.
Diagnosis of Helicobacter pylori Infection
Authors: Makristathis Athanasios , Hirschl Alexander M. , Lehours Philippe , Mégraud Francis 
Published: September 2004

ABSTRACTWhile there are some attempts to improve culture of Helicobacter pylori, molecular methods have been the main focus of this interest. Their main application concerns the development of rapid tests also allowing the determination of bacterial resistance, i.e. real‐time polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH), or to genotype the strains. Attempts to improve, simplify or explain the discrepancies of urea breath test results have been made and new generation of stool antigen test with monoclonal antibodies either using the standard ELISA format or rapid immunoenzymatic detection have confirmed their value. With regard to serology, studies have mainly focused on the distinction of infections with more pathogenic strains and the ability to diagnose atrophic gastritis with the Gastropanel.
In vitro allergenicity of peanut after hydrolysis in the presence of polysaccharides
Authors: Mouécoucou J. , Frémont S. , Sanchez C. , Villaume C. , Méjean L. 
Published: September 2004

SummaryBackground
Peanut is a major allergenic product. Manufacturing processes used in food industries to improve the physicochemical properties of food‐based peanut (stabilization, texturization), could cause a modification of the digestibility of peanut proteins and, consequently, their allergenicity.Objective
This study aimed at examining the influence of polysaccharides, i.e., gum arabic, low methylated pectin (LMP) and xylan, on the in vitro hydrolysis of peanut protein isolate (PPI) and the in vitro allergenicity of the digestion products.Methods
PPI was hydrolysed during a two‐step in vitro hydrolysis by pepsin, followed by a trypsin/chymotrypsin (T/C) mixture performed in dialysis bags with molecular weight cut‐offs (MWCO) of 1000 or 8000 Da. SDS‐PAGE electrophoresis and immunoblotting were assessed on the peptic and T/C digestion products in (retentates) and out of the dialysis bags (dialysates).Results
Hydrolysis by all of the digestive enzymes showed retention of some proteins in the dialysis bags in the presence of gum arabic and xylan. The retentates were recognized by IgG and IgE, particularly peptides <20 kDa. The IgE binding with peptides of retentate containing xylan from the dialysis bag with an MWCO of 1000 Da was reduced. The immunoreactivity of hydrolysis products in dialysates was considerably reduced by polysaccharides, regardless of the dialysis bag.Conclusion
Reduction of PPI hydrolysis was probably due to non‐specific interactions between polysaccharides and peptides. In retentates, IgE‐binding epitopes were reduced by digestion and the presence of xylan. In dialysates, they were reduced by all of the polysaccharides. This work highlights the possibility of modulating this food allergy through optimized formulation.
CD28 and secretory immunoglobulin A‐dependent activation of eosinophils: inhibition of mediator release by the anti‐allergic drug, suplatast tosilate
Authors: Woerly G. , Decot V. , Loiseau S. , Loyens M. , Chihara J. , Ono N. , Capron M. 
Published: September 2004

SummaryBackground
Eosinophils are major effector cells in allergic diseases. After their recruitment to sites of inflammation, they contribute to the pathophysiology of the disease by releasing granule proteins and cytokines. Suplatast tosilate (IPD‐1151T), a new anti‐allergic agent, has shown beneficial effect in the treatment of asthma, associated with reduced bronchoalveolar lavage eosinophil infiltration and eosinophilic cationic protein (ECP) release in serum and sputum.Objective
We investigated whether suplatast tosilate could exert direct effects on human eosinophil activation.Methods
Eosinophils from hypereosinophilic patients or normal donors were purified by Percoll gradient and the magnetic cell separation system. Chemotaxis was studied using the Boyden chamber technique using three chemoattractants, formyl‐methionine‐leucine‐phenylalanine (fMLP), IL‐5 and eotaxin. Oxidative metabolism was determined by a luminol‐dependent chemiluminescence assay after activation with eotaxin or secretory IgA (sIgA). The release of ECP and eosinophil derived neurotoxin (EDN) was measured by radioimmunoassay and cytokine production was determined by ELISA following activation with sIgA or anti‐CD28.Results
The chemotactic response to fMLP, IL‐5 and eotaxin was significantly inhibited by IPD‐1151T. Suplatast tosilate was partially inhibiting the release of reactive oxygen species (ROS) induced by eotaxin and sIgA. Activation by sIgA and CD28 ligation resulted in the release of ECP and EDN, which was inhibited by IPD‐1151T. Upon activation by anti‐CD28, only IL‐13 production was inhibited by IPD‐1151T, whereas release of IL‐2 and IFN‐γ was not affected. IL‐10 release induced by sIgA was also inhibited by IPD‐1151T. Additionally, the pro‐inflammatory cytokine IL‐6, which was secreted following anti‐CD28 and sIgA stimulation, was strongly inhibited by IPD‐1151T.Conclusion
Through inhibition of chemotaxis, IPD‐1151T might limit the number of eosinophils at the inflammation site. Furthermore, it could reduce the pathological potential of eosinophils by inhibiting the release of ROS and cationic proteins, main inflammatory mediators produced by eosinophils. Moreover, the inhibition of immunoregulatory cytokines released by eosinophils could locally modify the immune response.
Interleukin‐1β attenuates endothelin B receptor‐mediated airway contractions in a murine in vitro model of asthma: roles of endothelin converting enzyme and mitogen‐activated protein kinase pathways
Authors: Zhang Y. , Adner M. , Cardell L.‐O. 
Published: September 2004

SummaryBackground
Asthma is a chronic airway disease, known to involve several inflammatory mediators. Little is known about how these mediators interact in order to produce or attenuate even basic features of the disease, like airway hyper‐reactivity and remodelling. Endothelin‐1 (ET‐1) and IL‐1β are two mediators suggested to play important roles in the induction of airway inflammation.Objective
To investigate the interactions between ET‐1 and IL‐1β, using a novel in vitro model of asthma, focusing on airway smooth muscle contractility.Methods
Isolated murine tracheal segments were cultured from 1 to 8 days in the absence and presence of IL‐1β. The subsequent contractile responses to sarafotoxin 6c (S6c) (selective agonist for ETB receptor) and sarafotoxin 6b (S6b) (ETA and ETB receptor agonist) were recorded by a myographs system. In all experiments, ETB receptors were desensitized before the contractile response to S6b was recorded. Thus, the response to S6b is only mediated by ETA receptors in the present study. The mRNA expressions for ET‐1 and endothelin (ET) receptors were quantified by real‐time PCR.Results
Organ culture in the presence of IL‐1β attenuated the maximal contraction induced by S6c, but not S6b. This reduction was concentration‐dependent and was significant after 2, 4 and 8 days of culture. To investigate the mechanisms behind this, inhibitors for endothelin converting enzyme (ECE) phosphoramidon, c‐JUN N‐terminal kinase (JNK) SP600125, extracellular‐signal‐regulated kinase 1/2(ERK 1/2) PD98059 and p38 pathway SB203580 were used. Individually, SP600125 and PD98059, but not SB203580, could partly reverse the reduction induced by IL‐1β. An additional effect was obtained when SP600125 and PD98059 were combined. The mRNA expressions for ET‐1 and ETB receptor were up‐ and down‐regulated, respectively, by IL‐1β.Conclusion
Presence of IL‐1β in the airways attenuate the contractile response mediated via ETB receptors, an effect dependent on ECE, JNK and ERK 1/2 pathways.
Effect of montelukast compared with inhaled fluticasone on airway inflammation
Authors: Overbeek S. E. , O'Sullivan S. , Leman K. , Mulder P. G. H. , Hoogsteden H. C. , Prins J.‐B. 
Published: September 2004

SummaryBackground
Inhaled corticosteroids are currently regarded as the gold standard in anti‐inflammatory therapy, however, leukotriene receptor antagonists have been ascribed anti‐inflammatory properties.Objective
We directly compared the anti‐inflammatory effects of inhaled fluticasone propionate (FP, 100 μg Diskus, twice daily) and oral montelukast (MON 10 mg, nocte) in bronchial biopsies of patients with asthma in a double‐blind, double‐dummy, parallel‐group design.Methods
Bronchial biopsies, serum and urine samples were collected from 36 atopic asthmatics before and after 8 weeks of treatment. Activated T cells (CD25+), eosinophils (MBP+) and mast cells (tryptase+) were analysed by immunohistochemistry. Serum eosinophil cationic protein (ECP) and IL‐5 were analysed by radio and enzyme immunoassay (EIA), respectively. Urinary 9α‐11β‐PGF2 and leukotriene E4 (LTE4) were measured by EIA.Results
A comparison of changes from baseline [FP/MON ratio (95% confidence interval)] of activated T cells was not different when subjects were treated with FP compared to treatment with MON [1.00 (0.18–4.86); P=0.924]. Following treatment, mast cells in the FP group were significantly lower than in the group treated with MON [0.39 (0.16–0.97); P=0.041]. There was no difference in the number of eosinophils in the lamina propria following either treatment [0.54 (0.05–2.57); P=0.263]. However, treatment with FP resulted in a significantly greater decrease in serum ECP, compared to treatment with MON [0.37 (0.25–0.71); P=0.002].Conclusions
FP appears to be superior to MON as an anti‐inflammatory therapy in mild asthmatics.