bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abdominal Cerebrospinal Fluid Pseudocyst: A Complication of Ventriculoperitoneal Shunt in Children
Authors: Roitberg Ben Zion , Tomita Tadanori , McLone David G. 
Published: April 2003

The present paper is a retrospective analysis of 27 consecutive patients, treated for abdominal cerebrospinal fluid (CSF) pseudocyst at the Children’s Memorial Hospital in the years 1991–1996. This series is compared to the previous experience from our institution. Treatment consisted of the removal of the ventriculoperitoneal (VP) shunt and placement of an external ventricular drain. Antibiotics were administered intravenously for 10 days. The cysts were aspirated intraoperatively in 9 patients and postoperatively with ultrasound guidance in 3 patients, while they resolved spontaneously in 15 others. In 21 of 27 cases (78%), the shunt could be reinserted into the abdomen in a new location. Four patients had a ventriculopleural shunt, and in 2 patients, a ventriculoatrial shunt was inserted. Forty-four percent of the patients had a positive culture on presentation. The positive culture rate was 77% for those 4 years old and younger and only 28% for those aged 5 and above (p = 0.03). We conclude that abdominal CSF pseudocysts are resolved by externalizing the shunt. A VP shunt can be safely reinserted in the majority of the patients. Infection, while an important factor, is not likely to account for all cases of pseudocyst.
Combined Posterior and Posterolateral One-Stage Removal of a Giant Cervical Dumbbell Schwannoma
Authors: Oruçkaptan H. Hakan , Gürçay Özdemir 
Published: April 2003

<i>Objective:</i> Huge dumbbell schwannomas in the cervical region are not a rare clinical entity in neurosurgical practice. Despite the benign nature, the adhesions between tumor capsule and spinal cord, vertebral artery, cervical plexus, and carotid sheath can complicate surgery, leading to a fatal outcome. We performed one-stage combined surgery through the posterior midline and an unusual posterolateral cervical route in the same position and describe its advantages. <i>Method:</i> We removed the intraspinal component totally through a posterior midline approach and freed spinal cord and vertebral artery. After removal of the posterolateral extraspinal component using the same incision, a posterolateral cervical approach along the posterior margin of sternocleidomastoid muscle was performed, and the anterolateral extraspinal tumor was excised totally through the dissection plane between anterior and middle scalene muscles. <i>Results and Conclusions:</i> The operative time was less than 3 h, and the patient was discharged on the 3rd postoperative day without any neurological sequel. The combination of posterior midline and posterolateral approach in large dumbbell schwannomas is easier to perform and a more safe technique than the combination with anterolateral accesses in the cervical region and also less invasive than the transuncodiscal technique in selected cases. This approach reduces the risk of neurovascular injury, since it does not require retraction and repositioning of the patient and, therefore, facilitates total excision and reduces the operative time.
Tumor Volume and Growth Kinetics in Hypothalamic-Chiasmatic Pediatric Low Grade Gliomas
Authors: Lazareff Jorge A. , Suwinski Rafal , De Rosa Roberto , Olmstead Charles E. 
Published: April 2003

Pediatric low grade gliomas evidence a tendency towards quiescent growth, thus complicating the clinical management of nonresected tumors whose clinical behavior may be difficult to predict. We decided to explore the hypothesis of possible correlation in pediatric low grade glioma between tumor volume and growth rate. We identified 6 children with hypothalamic chiasmatic lesions. Five of these patients were treated only with biopsy and 1 with repeated partial tumor resection. All of 6 patients had 10–15 sequential brain MRI over a time span of 3–8 years. Tumor volume was determined using Sigma Scan Image<sup>®</sup> software. The results were analyzed utilizing two equations for modeling tumor growth: exponential and Gompertz. In 4 patients whose tumor volume was approximately 80–100 cm<sup>3</sup> at the time of diagnosis, slow spontaneous partial regression was observed. In the other patients deceleratory or exponential tumor growth was volume-dependent. Our results suggest that growth of pediatric low grade glioma decelerates as tumor becomes large and that the Gompertz model for tumor growth is useful for understanding the growth kinetics of pediatric low grade glioma.
Experiences with Cranial Neuronavigation in Pediatric Neurosurgery
Authors: Wagner W. , Gaab M.R. , Schroeder H.W.S. , Sehl U. , Tschiltschke W. 
Published: April 2003

Frameless, infrared-based neuronavigation (Surgical Microscope Navigator<sup>®</sup> and Surgical Tool Navigator<sup>®</sup>) was applied to intracranial neurosurgery in 22 children and infants (age range 7 months to 16 years). Predominant diagnoses were tumor and hydrocephalus (including multiloculated forms); the surgical procedures were open microneurosurgery in 10 cases and neuroendoscopy in 12 patients. There were no principal technical problems even in very young infants. Surgical and clinical results were satisfying in all cases. Neuronavigation proved to be particularly helpful in targeting deep-seated processes and in guiding neuroendoscopy in cases of multiloculated hydrocephalus or small ventricles.
Virtual Endoscopy for Planning Endoscopic Third Ventriculostomy Procedures
Authors: Burtscher J. , Dessl A. , Bale R. , Eisner W. , Auer A. , Twerdy K. , Felber S. 
Published: April 2003

Virtual endoscopy was used to plan 10 endoscopic third ventriculostomy procedures in 9 patients suffering from occlusive hydrocephalus due to idiopathic aqueductal stenosis and tumors. The patients were 4 children (4–14 years, mean age: 9 years) and 5 adults (21–38 years, mean age: 29 years). The aim of the study was to preoperatively evaluate the individual intraventricular and vascular endoscopic anatomy at the floor of the third ventricle based on virtual endoscopic images. The virtual views were correlated with the real endoscopic images, intraoperatively obtained by a standard ventriculoscope (Wolf, Knittlingen, Germany) during endoscopic third ventriculostomy procedures. Contrast-medium-enhanced MR images (3D-MPRAGE; Siemens, Germany) were semiautomatically segmented with a surface-rendering technique (‘Navigator’ software; General Electric Medical, Buc, France) to produce the virtual endoluminal views. The virtual endoscopic images were comparable with the real intraoperative endoscopic view in 8 of 9 patients. Virtual endoscopy can display the position of the basilar artery, the posterior cerebral arteries and the posterior communicating arteries in their relationship to the mammillary bodies and the clivus. Preoperative virtual endoscopy planning can intraoperatively assist the neurosurgeon to find a safe location for third ventriculostomy.
Influence of Asthma in Pregnancy on Labor and the Newborn
Authors: Minerbi-Codish Iris , Fraser Drora , Avnun Lone , Glezerman Marek , Heimer Dov 
Published: April 2003

Asthma in pregnancy has been associated with maternal and fetal morbidity and mortality. This study examines the relations of asthma in pregnancy, its severity and its treatment to the labor process, maternal and fetal parameters. Hundred and one consecutive asthmatic women, who gave birth to single babies between November 1993 and November 1994 at the Soroka Medical Center were studied. A group of 77 nonasthmatic women, matched for age and ethnic origin, who gave birth to single babies during the same period served as controls. A larger percentage of asthmatic women suffered from respiratory and urinary tract infections than in the control group (p < 0.001). Severe asthma was associated with a higher rate of infections than milder asthma (p = 0.01). The incidence of smoking was higher among asthmatic women than among controls (p = 0.037). No association was found between socioeconomic status and smoking or infections. No association was found between maternal asthma or maternal use of corticosteroids and the following: maternal hypertension, maternal diabetes, low birth weight (<2,500 g), preterm delivery (<37 weeks), adequacy of weight to gestational age and Apgar scores. Three infants with congenital heart defects were born to asthmatic mothers. When the presentation of the fetus was not cephalic, all the asthmatic women were delivered by cesarean section, versus only 60% in the control group (p = 0.08). Labor was induced with oxytocin more often in the asthma group than in the control group (p = 0.07). We conclude that the labor and neonatal outcome in pregnant asthmatic women treated medically is good, even when asthma is severe and when the patient is treated with corticosteroids. There is, however, a relation between asthma in pregnancy, especially if severe, and predisposition to infections.
A New Beclomethasone Dipropionate Multidose Powder Inhaler in the Treatment of Bronchial Asthma
Authors: Nieminen M.M. , Vidgren P. , Kokkarinen J. , Laasonen K. , Liippo K. , Lindqvist A. , Paananen M. , Poukkula A. , Ruotsalainen E.-M. , Salomaa E.-R. , Sovijärvi A. , Söderblom T. , Silvasti M. , Vidgren M. , Laitinen L.A. 
Published: April 2003

The clinical efficacy, tolerability and acceptability of a new multidose powder inhaler (MDPI) containing beclomethasone dipropionate (BDP) were compared with those of a BDP aerosol administered with a large volume spacer (MDI-spacer) among adult asthmatics currently receiving from 500 to 1,000 µg/day of an inhaled corticosteroid. During the study, the dosage of BDP from both devices was 400 µg twice daily. Ninety-one patients were randomized to the MDPI group and 42 to the MDI-spacer group. The trial was performed as an open, randomized, parallel group multicenter study. The duration of the treatment period was 12 weeks, and the study was preceded by a 2-week run-in period. During the run-in period, the mean morning peak expiratory flow (PEF) was 487 and 466 1/min in the MDPI and MDI-spacer groups, respectively. After the 12-week treatment, the morning PEF was 491 l/min in the MDPI group and 463 l/min in the MDI-spacer group. The evening values were 500 and 479 l/min during the run-in period and 496 and 476 l/min after the 12-week treatment, respectively. Asthma symptom scores and the use of rescue medication were low in both groups, indicating good efficacy of the preparations tested. The median dose of histamine required to decrease forced expiratory volume in 1 s by 15% increased during the study from 800 to 1,098 µg in the MDPI group and from 795 to 960 µg in the MDI-spacer group. The most frequent adverse events in both groups were hoarseness and sore throat. There were no statistically significant differences between the treatment groups in serum cortisol values or in the number of patients with thrush. Seventy-two percent of the patients regarded the MDPI easier to use while 95% considered it more portable. Over 80% of the patients felt that the MDPI was also easier to clean and as easy or easier to learn to use than the MDI-spacer. To conclude, the novel powder inhaler is well tolerated and at least equally effective as the conventional MDI-spacer combination in the treatment of asthma with BDP. However, in everyday use, patients clearly favored the powder inhaler.
Dirithromycin Concentrations in Bronchial Mucosa and Secretions
Authors: Leroyer Christophe , Muller-Serieys Claudette , Quiot Jean-Jacques , Benhamou Daniel , Clavier Jean , Bergogne-Bérézin Emilie 
Published: April 2003

Since a high tissue penetration of dirithromycin (D) has been assessed in early studies, the aims of this study were to determine D concentrations in bronchial mucosa and secretions in patients suffering from an acute exacerbation of chronic bronchitis (AECB), to compare intra-individual bronchial mucosa and secretion concentrations and to relate bronchial concentrations of D and clinical efficacy. The main inclusion criteria were comprised of (1) AECB, defined by the presence of an increase in dyspnea, sputum production and change in sputum purulence, and (2) clinical indication of fiberoptic bronchoscopy allowing performance of bronchial biopsies. All patients were treated with a 500-mg once-daily D dose for 5 days. Patients were randomly divided into three groups, according to sampling times (24, 48 and 72 h after the last dose). Tissue concentration analyses were performed by one blinded microbiologist (microbiological agar diffusion assay). The results showed: (1) 37 out of the 46 patients (80.4%) had a favorable response to treatment at the time of fiberoptic bronchoscopy (14 cured, 23 improved); (2) bronchial mucosa concentrations were high in all groups, and (3) mean values at 24, 48 and 72 h after the last dose were respectively 6.51 ± 1.44, 6.61 ± 2.7, 5.67 ± 1.02 mg·kg<sup>–1</sup>; no statistical difference was observed between the groups. In bronchial secretions collected simultaneously, concentrations were lower, i.e. 1.26 ± 0.3, 0.61 ± 0.12, 0.84 ± 0.12. Significant associations were observed between bronchial mucosa and secretion concentrations (r = 0.71, p = 0.0001), and between clinical response and bronchial concentrations (p = 0.03, Kruskall-Wallis test). In conclusion, these results may confirm the clinical significance of tissue concentrations measured in bronchial tissues of patients with AECB.
Effects of Air Pollution and Weather Conditions on Asthma Exacerbation
Authors: de Diego Damiá A. , León Fabregas M. , Perpiñá Tordera M. , CompteTorrero L. 
Published: April 2003

<i>Background:</i> Meteorological conditions and a high concentration of air pollutants have been associated with increased respiratory morbidity. However, few studies have examined the association between asthma exacerbation and air pollution. <i>Objectives:</i> In the present study, the possible relationship of the concentration of black smoke and SO<sub>2</sub> in the air, the local weather conditions and emergency room visits for asthma is investigated. <i>Methods:</i> The weekly total of emergency room admissions for asthmatic adults during a 1-year period was recorded together with daily metereological conditions (average temperature, humidity, rainfall, wind speed and barometric pressure) and average weekly levels of daily pollutant concentrations (black smoke and SO<sub>2</sub>). The relationship was assessed by stepwise regression linear models and analysis of variance. The analysis took into account season and metereological variables. <i>Results:</i> Both air pollutants correlated significantly with emergency room admissions for asthma (SO<sub>2</sub> [r = 0.32], black smoke [r = 0.35]); however, multiple regression analysis showed that black smoke was the only significant predictor of weekly visits. There were approximately 3.5 admissions a week per SD of change (34.6 µg·m<sup>–3</sup>). There were no significant correlations between weekly emergency room visits and the weather variables. Analysis of the data stratified by season and weather conditions demonstrated that the association of black smoke with asthma exacerbation was more pronounced in autumn (r = 0.67) or when temperatures were higher than average. <i>Conclusion:</i> In our city, a high concentration of certain air pollutants is indeed associated with an increase in the number of hospital emergency room admissions for asthma.
Effect of Endothelin-1 on the Serotonin-Induced Contraction of Smooth Muscle in the Guinea Pig Trachea
Authors: Yoshida Makoto , Aizawa Hisamichi , Hara Nobuyuki 
Published: April 2003

<i>Background:</i> Endothelin (ET), a potent constrictor of smooth muscle including that of the airways, may contribute to the development of airway hyperresponsiveness. <i>Objective:</i> To investigate the role of ET-1 on the airway smooth muscle, we examined the effects of ET-1 on the serotonin-induced contraction of guinea pig tracheal smooth muscle. <i>Methods:</i> The changes in isometric tension evoked by serotonin were measured before and after the application of a subthreshold dose (a dose which did not induce smooth muscle contraction by itself) of ET-1. <i>Results:</i> Serotonin caused smooth muscle contraction in a dose-dependent manner. The subthreshold doses of ET-1 (1 pM) and sarafotoxin 6c (1 pM), a selective ET<sub>B</sub> receptor agonist, were found to potentiate significantly the contraction induced by serotonin. A potentiating effect of ET-1 was not altered by indomethacin or calphostin C, a protein kinase C inhibitor. <i>Conclusion:</i> These results suggest that a subthreshold concentration of ET-1 can potentiate serotonin-induced contraction of smooth muscle through the activation of ET<sub>B</sub> receptor, while in contrast cyclooxygenase and protein kinase C were found not to be involved in this mechanism.
Decrease in Lung Volume Depends on End-Expiratory Pressure in a Rabbit Model of Airway Lavage
Authors: Krause Martin F. , Hoehn Thomas 
Published: April 2003

<i>Background:</i> In the past, the rabbit model of repeated airway lavage has been extensively used to induce a decrease in lung volume accompanied by impairment in lung mechanics and gas exchange. <i>Objectives:</i> The rationale of our study was to investigate the influence of different end-expiratory pressure (EEP) levels (0.4–4.2 cm H<sub>2</sub>O) on changes in functional residual capacity (FRC) and the efficacy of lavages administered. <i>Methods:</i> Forty-five rabbits were subjected to 2–8 lavages with 20 ml/kg warm normal saline until arterial/alveolar oxygen tension (a/A ratio) had decreased to ≤0.12. <i>Results:</i> FRC and dynamic compliance of the respiratory system (C<sub>rs</sub>) decreased significantly (both p < 0.001; from 19.1 ± 4.2 to 10.5 ± 5.6 ml/kg and from 1.17 ± 0.27 to 0.47 ± 0.10 ml/cm H<sub>2</sub>O, respectively, means ± SD). The decrease in FRC was significantly influenced by EEP (–28.6 ± 15.8% at EEP = 1 cm H<sub>2</sub>O vs. –58.7 ± 12.9% at EEP = 3 cm H<sub>2</sub>O, p < 0.0001). There was a significant correlation between the number of lavages and EEP (p < 0.01), indicating that successive lavages at higher EEP became ineffective in lowering FRC compared to those at lower EEP. <i>Conclusions:</i> We conclude that the EEP levels used in this model are of critical importance for the prediction of a decrease in lung volume (FRC) and the efficacy of lavages.
Microelectrode Recordings Define the Ventral Posteromedial Pallidotomy Target
Authors: Lozano Andres M. , Hutchison William D. , Tasker Ronald R. , Lang Anthony E. , Junn Fred , Dostrovsky Jonathan O. 
Published: April 2003

The benefits of stereotactic ventral posteromedial pallidotomy in the treatment of Parkinson’s disease have been recently rediscovered. Optimal lesion location and lesion volume, however, have yet to be determined. Micro-electrode recording and microstimulation are carried out to determine an appropriate site for the placement of electrocoagulation lesions in the medial pallidum. The cellular activity of the globus pallidus is examined for characteristic firing patterns, mean firing rates, movement-evoked activity, and presence of tremor cells, laminae, and border zones. Microstimulation allows the identification of the adjacent optic tract by reports of visual sensation and of the internal capsule by sensorimotor responses. Lesions are centred at sites in the internal segment of the globus pallidus at least 3 mm from these structures, to avoid injury to them during pallidotomy.
Cytokeratin 8/18 Levels in Patients with Prostate Cancer and Benign Prostatic Hyperplasia
Authors: Wolff J.M. , Borchers H. , Brehmer Jr. B. , Brauers A. , Jakse G. 
Published: April 2003

<b>Objectives:</b> Recently, tissue polypeptide-specific antigen (TPS), a cytokeratin 18 marker, was described to be discriminative between cancer of the prostate (CaP) and benign prostatic hyperplasia (BPH). Cyfra 8/18, a marker which recognizes both cytokeratin 8 and 18 fragments, is discussed to improve sensitivity and specificity of TPS. We investigated whether Cyfra 8/18 serum concentration discriminates between patients with clinically localized CaP and BPH. <b>Methods:</b> Serum Cyfra 8/18 levels were determined in patients with untreated CaP before radical prostatectomy (pT1-3pNoMo; n = 11) and with histologically confirmed BPH (n = 22). Cyfra 8/18 concentration was correlated to the prostate-specific antigen (PSA) concentration. <b>Results:</b> Median Cyfra 8/18 level was 0.64 ng/ml in CaP patients and 0.57 ng/ml in BPH patients. This difference is statistically not significant (p = 0.91). Furthermore, no correlation to PSA levels could be established (CaP: r = 0.036; BPH: r = 0.09). <b>Conclusion:</b> In contrast to a recent report we found the Cyfra 8/18 serum concentration to be a nondiscriminative parameter between CaP and BPH.
The Long-Term Outcome of Cystinuria in Japan
Authors: Akakura Koichiro , Egoshi Kenichi , Ueda Takeshi , Nozumi Kuniyoshi , Kotake Tadashi , Masai Motoyuki , Ito Haruo 
Published: April 2003

Recurrence of growth of urinary stone is frequently observed during the clinical course of cystinuria patients. The aim of the present study is to examine the long-term outcome of cystinuria in Japan and clarify the effects of medical treatment on urinary stone. Thirty-one patients with cystinuria who had been followed up longer than 6 months were included. The follow-up period was 6–264 months with a mean of 89.5 months. Stone event was defined as appearance of new stone or radiological evidence of stone growth. All patients were managed with forced hydration and urine alkalization. Twenty-eight patients were treated with administration of thiol such as <i>D</i>-penicillamine or α-mercaptopropionylglycine. Stone events per year ranged from 0 to 1.09 with a median of 0.09. Stone events per patient-year was 0.19 for all patients. The average urinary cystine concentration during treatment in the favorable outcome group (stone events per year < 0.3) was lower that that in the unfavorable outcome group (stone events per year ≥0.3); 221.2 ± 75.2 vs. 303.3 ± 93.5 mg/l, although the difference was not statistically significant. Prognosis of urinary stone in Japanese patients with cystinuria was relatively good with large variation. The medical treatment to reduce urinary cystine concentration would be useful for the management of cystinuria.
Evaluation of the Effects of Desmopressin in Acute Ureteral Obstruction
Authors: Moro U. , De Stefani S. , Crisci A. , De Antoni P. , Scott C.A. , Selli C. 
Published: April 2003

<i>Objective:</i> To evaluate the effects of desmopressin on pressure values inside the pelvis and ureter of the rat following acute obstruction. <i>Materials and Methods:</i> By means of a microsurgical technique, 24 male Wistar rats were submitted to ureteral obstruction; pressure inside the ureter was recorded using a cannula and a micrometric glass column. In the treatment group (14 animals) 6 <i>m</i>g/kg of desmopressin were administered 30 min before the beginning of the experiment. <i>Results:</i> Rats pretreated with desmopressin showed a statistically significant reduction in mean intraureteral pressure following acute obstruction (p = 0.05). <i>Conclusions:</i> In Wistar rats desmopressin demonstrated a powerful antidiuretic effect, reducing the intraureteral pressure. The experimental model is useful for a better understanding of physiopathology of renal colic and acute obstruction.