bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical Meningitis after Cerebral Aneurysm Treatment Using Two Second-generation Aneurysm Coils: Report of Two Cases
Authors: Meyers Philip M. , Lavine Sean D. , Fitzsimmons Brian-Fred , Commichau Chris , Parra Augusto , Mayer Stephan A. , Solomon Robert A. , Connolly E Sander 
Published: October 2004

Abstract

OBJECTIVE AND IMPORTANCE:
In the quest for effective and durable endovascular aneurysm treatment, second-generation aneurysm coils endeavor to increase the biological healing response to the implanted material. We report two cases of large cerebral aneurysms treated concurrently with both available second-generation aneurysm coils and the subsequent development of symptomatic nonbacterial meningitis.

CLINICAL PRESENTATION:
Two previously healthy patients underwent endovascular treatment for large (≥2 cm) cerebral aneurysms. Both aneurysms were treated using multiple Hydrogel coils (MicroVention, Inc., Aliso Viejo, CA) and Matrix coils (Boston Scientific/Target, Fremont, CA). Careful aseptic technique was observed throughout each procedure, and prophylactic intravenous antibiotics were administered during the perioperative period to both patients. Treatment proceeded uneventfully in both cases with excellent aneurysm occlusion and no immediate postoperative neurological deficits.

INTERVENTION:
In both cases, the patients were discharged from hospital but quickly were readmitted with stigmata of meningitis. Imaging demonstrated durable occlusion of the aneurysms in both patients and also abnormalities indicative of perianeurysmal and diffuse intracranial inflammatory response. Complete septic workup failed to identify an organism in either patient. Both patients responded to treatment with corticosteroid medication used to modulate the inflammatory response induced by the coil implants.

CONCLUSION:
Second-generation aneurysm coils were developed to promote more durable occlusion of cerebral aneurysms by promoting more complete volumetric aneurysm occlusion or by eliciting a more prolific inflammatory response. The concurrent use of Hydrogel and Matrix coil systems in large aneurysms may cause an exuberant inflammatory response with both local and systemic manifestations. Although vigilant evaluation and treatment for presumptive bacterial meningitis is required in all such cases, patients respond to immunomodulatory therapy with corticosteroids. More information to understand better the interaction of Hydrogel and Matrix coils is needed.
Routine Cerebral Angiography after Surgery for Saccular Aneurysms: Is It Worth It?
Authors: Kivisaari Riku P. , Porras Matti , Öhman Juha , Siironen Jari , Ishii Keisuke , Hernesniemi Juha 
Published: October 2004

Abstract

OBJECTIVE:
The objective of this study was to determine whether an angiographically proven rate of saccular intracranial aneurysm occlusion after surgical clipping suggests that postoperative angiography should continue to be used routinely or should be supplanted by intraoperative angiography. These data also should establish a basis for comparing surgery with new endovascular methods of treatment.

METHODS:
During a 3.5-year period, a consecutive series of 622 patients (955 aneurysms, 808 of which were surgically clipped) who underwent postoperative angiography were studied retrospectively. This series comprised 493 ruptured and 315 unruptured aneurysms.

RESULTS:
Complete aneurysm closure was achieved in 88% of aneurysms, a neck remnant was discovered in 9%, and a fundus remnant was revealed in 3%. Of 493 ruptured aneurysms, 86% were completely occluded. Of 315 unruptured aneurysms, 91% were completely occluded. The results for clipping of complex aneurysms, i.e., posterior circulation or large to giant aneurysms, were significantly inferior to those for small and anterior circulation aneurysms. In one-third of the large and giant aneurysms, a part of the base was left intentionally because of calcifications or strong wall or to prevent occlusion of any branches. In the series, a significant 5% complication rate of major vessel occlusion was detected.

CONCLUSION:
Our retrospective analysis revealed that ruptured, posterior circulation, and large/giant aneurysms are more prone to incomplete clipping. Therefore, these aneurysms require postoperative if not intraoperative evaluation with angiography. Many clippings of anterior circulation aneurysms experience unexpected failures, which suggests that intraoperative angiography could be beneficial. This series, which has no selection bias, can be used as a basis to compare the results of other series reporting surgical or endovascular treatment.
Vagus Nerve Stimulation Therapy after Failed Cranial Surgery for Intractable Epilepsy: Results from the Vagus Nerve Stimulation Therapy Patient Outcome Registry
Authors: Amar Arun Paul , Apuzzo Michael L.J. , Liu Charles Y. 
Published: October 2004

Abstract

OBJECTIVE:
To determine the effectiveness of vagus nerve stimulation (VNS) therapy among patients with persistent or recurrent seizures after lobar resection, callosotomy, and other cranial operations for intractable epilepsy.

METHODS:
Data were obtained from the VNS therapy patient outcome registry, which was established after United States Food and Drug Administration approval of the VNS device in 1997 as a means of capturing open-label clinical data outside of protocol. The integrity of the systems for collecting and processing registry data was authenticated by an independent auditing agency. The effect of potential selection bias, however, remains uncertain.

RESULTS:
Two nonconsecutive cohorts were compared: patients tracked in the registry who had previously undergone cranial surgery for epilepsy (CS group, n = 921) and those who had not (non-CS group, n = 3822). For the CS group, the median reduction in seizure frequency was 42.5% after 3 months of VNS therapy, 42.9% at 6 months, 45.7% at 12 months, 52.0% at 18 months, and 50.5% at 24 months. For the non-CS group, analogous rates were 47.0%, 52.9%, 60.0%, 62.7%, and 66.7%, respectively. In the CS group, seizures were reduced by at least 50% in 55.1% of patients, at least 75% in 31.4% of patients, at least 90% in 17.3% of patients, and 100% in 5.1% of patients after 24 months of VNS therapy. Response rates were more pronounced in the non-CS group: at least 50% in 62.2% of patients, at least 75% in 43.7% of patients, at least 90% in 26.8% of patients, and 100% in 8.3% of patients. Patients in both groups experienced marked improvements in quality of life parameters.

CONCLUSION:
The effectiveness of VNS is maintained during prolonged stimulation, and overall seizure control continues to improve with time. Patients in whom prior cranial surgery had failed did not respond as favorably as all other patients receiving VNS therapy. Nonetheless, many of the former group improved substantially. Thus, on the basis of these open-label data, VNS therapy represents a potentially palliative treatment option for patients with refractory seizures after failed cranial surgery.
Anteroinferior Cerebellar Artery Aneurysms: Surgical Approaches and Outcomes—A Review of 34 Cases
Authors: Gonzalez L Fernando , Alexander Michael J. , McDougall Cameron G. , Spetzler Robert F. 
Published: October 2004

Abstract

OBJECTIVE:
Anteroinferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment requires expertise in vascular, endovascular, and cranial base surgery. This article presents the largest series treated at one center.

METHODS:
We retrospectively analyzed presenting symptoms, aneurysm characteristics, surgical approaches, postoperative outcomes, and the application of endovascular techniques.

RESULTS:
We found 32 patients with 34 AICA aneurysms (11 men and 21 women; age range, 6–77 yr; mean age, 51 yr). Twenty-one aneurysms had ruptured; 13 were unruptured. Seven of the unruptured aneurysms presented with brainstem compression, and six were found incidentally. Surgical approaches included the retrosigmoid, far-lateral transcochlear, translabyrinthine, and orbitozygomatic. Eighteen patients (56%) had neurological complications. Thirty aneurysms were at proximal locations, and four were distal. Intraoperative hypothermic cardiac arrest was used to clip eight giant aneurysms. Follow-up was available in 56% of the patients for a mean of 41 months. The mean Glasgow Outcome Scale scores at discharge were not significantly different from the patients' status at their initial assessment.

CONCLUSION:
We recommend the standard retrosigmoid approach for treating small to medium aneurysms involving the lower two-thirds of the clivus or distal AICA aneurysms. Cranial base approaches are recommended for large or giant aneurysms or for those proximal to the emergence of the AICA from the basilar trunk. Hypothermic cardiac arrest facilitates dissection of giant aneurysms. Endovascular treatment is a useful adjunct for treating residual aneurysms but did not provide definitive treatment in any of our patients.
Traumatic Venous Varix Causing Sciatic Neuropathy: Case Report
Authors: Maniker Allen H. , Thurmond James , Padberg Frank T. , Blacksin Marcia , Vingan Roy 
Published: October 2004

Abstract

OBJECTIVE AND IMPORTANCE:
Sciatic neuropathy rarely presents in nonpenetrating trauma because of protection of the nerve by the pelvis, the gluteal muscles, and the tissues in the posterior thigh. We present the case of a patient who fell and subsequently developed a traumatic venous varix of the inferior gluteal vein that caused compression sciatic neuropathy.

CLINICAL PRESENTATION:
Seven days after a fall onto her right buttock, the patient developed a painful burning paresthesia in her leg and numbness on the dorsum of her foot. Numerous studies ruled out lumbar spine pathological abnormalities as the cause of the pain. Conventional magnetic resonance imaging revealed a lesion adjacent to the sciatic nerve. Gradient echo and two-dimensional time-of-flight magnetic resonance imaging sequences confirmed this to be a vascular lesion originating from the inferior gluteal vein and compressing the sciatic nerve.

INTERVENTION:
Operative resection obliterated the venous varix, thereby relieving the patient's pain and neurological deficit.

CONCLUSION:
No case of a traumatic venous varix of the inferior gluteal vein compressing the sciatic nerve has been reported to date. Surgical resection was successful in obliterating the lesion and relieving the symptoms.
Laboratory Assessment of Oxygenation in Methemoglobinemia
Authors: Haymond Shannon , Cariappa Rohit , Eby Charles S , Scott Mitchell G 
Published: October 2004

AbstractBackground: This case conference reviews laboratory methods for assessing oxygenation status: arterial blood gases, pulse oximetry, and CO-oximetry. Caveats of these measurements are discussed in the context of two methemoglobinemia cases.Cases: Case 1 is a woman who presented with increased shortness of breath, productive cough, chest pain, nausea, fever, and cyanosis. CO-oximetry indicated a carboxyhemoglobin (COHb) fraction of 24.9%. She was unresponsive to O2 therapy, and no source of carbon monoxide could be noted. Case 2 is a man who presented with syncope, chest tightness, and signs of cyanosis. His arterial blood was dark brown, and CO-oximetry showed a methemoglobin (MetHb) fraction of 23%.Issues: Oxygen saturation (So2) can be measured by three approaches that are often used interchangeably, although the measured systems are quite different. Pulse oximetry is a noninvasive, spectrophotometric method to determine arterial oxygen saturation (SaO2). CO-oximetry is a more complex and reliable method that measures the concentration of hemoglobin derivatives in the blood from which various quantities such as hemoglobin derivative fractions, total hemoglobin, and saturation are calculated. Blood gas instruments calculate the estimated O2 saturation from empirical equations using pH and Po2 values. In most patients, the results from these methods will be virtually identical, but in cases of increased dyshemoglobin fractions, including methemoglobinemia, it is crucial that the distinctions and limitations of these methods be understood.Conclusions: So2 calculated from pH and Po2 should be interpreted with caution as the algorithms used assume normal O2 affinity, normal 2,3-diphosphoglycerate concentrations, and no dyshemoglobins or hemoglobinopathies. CO-oximeter reports should include the dyshemoglobin fractions in addition to the oxyhemoglobin fraction. In cases of increased MetHb fraction, pulse oximeter values trend toward 85%, underestimating the actual oxygen saturation. Hemoglobin M variants may yield normal MetHb and increased COHb or sulfhemoglobin fractions measured by CO-oximetry.
Latex Immunoturbidimetric Assay for Soluble Fibrin Complex
Authors: Hamano Akiei , Umeda Mamoru , Ueno Yukiko , Tanaka Seiji , Mimuro Jun , Sakata Yoichi 
Published: October 2004

Abstract
Background: Soluble fibrin complex (SFC), composed of fibrin monomer and fibrinogen derivatives, is known to exist in the circulating blood in patients with thrombosis. Its detection and quantification are useful for obtaining information about the condition and degree of intravascular coagulation in early-stage thrombosis, but there is no rapid method to measure SFC in plasma for clinical use.
Methods: We obtained a monoclonal antibody that specifically reacts with SFC, with desAA-fibrin as the immunogen, and developed a rapid and sensitive latex immunoturbidimetric assay (LIA) using latex-immobilized anti-SFC monoclonal antibody. The assay system was based on the increase in turbidity induced by the reaction of the latex-immobilized anti-SFC monoclonal antibody with SFC in plasma, and the assay procedure was fully automated on a Hitachi 911 analyzer.
Results: The method had an analytical range of 3–300 mg/L. Intra- and interassay precision studies indicated that this system provided reproducible data (CVs &lt;3.0% and &lt;2.0%, respectively). The assay detection limit was &lt;0.5 mg/L. There was no interference from bilirubin (up to 440 mg/L), hemoglobin (up to 9.6 g/L), Intralipid (up to 10%), D-dimer (up to 200 mg/L), and rheumatoid factor (up to 470 000 IU/L). SFC concentrations in plasma from patients with thrombotic diseases [mean (SD), 48.9 (57.6) mg/L; n = 160) were significantly higher than those in plasma from healthy individuals [1.8 (2.1) mg/L; P &lt;0.001; n = 304].
Conclusion: In terms of linearity, precision, and sensitivity, the LIA, performed on a Hitachi 911 automated analyzer, may be useful for measurement of SFC in plasma.
Evidence That the Amino-Terminal Composition of Non-(1–84) Parathyroid Hormone Fragments Starts before Position 19
Authors: D’Amour Pierre , Brossard Jean-Hugues , Räkel Agnès , Rousseau Louise , Albert Caroline , Cantor Tom 
Published: October 2004

AbstractBackground: Non-(1–84) parathyroid hormone (PTH) fragments are large C-terminal fragments of PTH with a partially preserved N-terminal structure. They differ from other C-terminal PTH fragments, which do not have an N-terminal structure and do not react in intact PTH assays. We aimed to identify the minimal N-terminal structure common to all non-(1–84) PTH fragments.Methods: Sera obtained from six healthy individuals and six patients with primary hyperparathyroidism, and six serum pools from dialysis patients with different PTH concentrations were fractionated by HPLC and analyzed by four different PTH assays. Each assay was characterized by saturation analysis of its detection antibody and capacity to react with different PTH fragments. Human PTH(1–84) [hPTH(1–84)] calibrators were normalized to an in-house hPTH(1–84) calibrator.Results: The cyclase-activating PTH (CA-PTH) assay had an early (1, 2,) epitope and reacted only with hPTH(1–84). The other assays had epitopes in region (13–34). Total and intact PTH assays had epitopes proximal to position 18 and reacted equally well with hPTH(1–84) and hPTH(7–84), and the Elecsys PTH assay had an epitope distal to position 19, being saturable by hPTH(18–48) and also reacting with [Tyr34]hPTH(19–84). The HPLC profiles obtained with these assays showed that non-(1–84) PTH fragments did not react in the CA-PTH assay, as expected. The amount of non-(1–84) PTH detected by the other three assays was similar when the assay results were normalized to a common calibrator.Conclusions: The results suggest that the amount of non-(1–84) PTH detected by epitopes proximal or distal to position 19 of the PTH structure is identical, indicating a common minimum structure starting before position 19. This in turn points to a probable high-affinity interaction with the C-PTH receptor, as observed previously with [Tyr34]hPTH(19–84) in various cell lines and in mouse osteocytes with PTH/PTHrP type I receptor ablation.
Ein Hindernisvermeidungssystem für ein Autonomes Unterwasserfahrzeug (An Obstacle Avoidance System for an Autonomous Underwater Vehicle)
Authors: Eichhorn Mike 
Published: October 2004

Abstract
In diesem Artikel wird ein System zum Ausweichen von Hindernissen für das autonome Unterwasserfahrzeug DeepC vorgestellt. Bei Auswahl und Entwicklung der eingesetzten Strategien wurden die besonderen Anforderungen in der Unterwasserwelt und die im Fahrzeug zur Verfügung stehende Rechenleistung und Sensorik sowie dessen Manövrierfähigkeit berücksichtigt. Anforderungen in der Unterwasserwelt sind die Einbeziehung der Strömungsinformation, die Berücksichtigung von bewegten Objekten, ein Ausweichen im 3-D Raum sowie ein begrenzter Auffassbereich durch das Sonar.
Charakterisierung von OLED-Schichten mittels Spektral-Ellipsometrie (Characterization of OLED Layers by Spectroscopic Ellipsometry)
Authors: Hartmann Elmar 
Published: October 2004

Abstract
Das optische Absorptionsverhalten organischer Schichten, die für organische Leuchtdioden (OLEDs) verwendet werden, bestimmt entscheidend die Leuchteffizienz des fertigen Bauelements. Gleichzeitig soll die Dicke von Einzelschichten oder von ganzen Schichtsystemen kontrolliert werden können. Die spektroskopische Ellipsometrie ist ein zerstörungsfreies und berührungsloses Verfahren, mit dem sich simultan strukturelle und optische Materialeigenschaften routinemäßig erfassen lassen.
Entwicklung eines Fokussensors und Integration in die Nanopositionier- und Nanomessmaschine (Development of a Focus Sensor and its Integration into the Nanopositioning and Nanomeasuring Machine)
Authors: Mastylo Rostyslav , Manske Eberhard , Jäger Gerd 
Published: October 2004

Abstract
Ein Fokussensor auf der Basis einer Hologramm-Laser-Unit wurde entwickelt und in einer Nanopositionier- und Nanomessmaschine als Nullindikator erfolgreich getestet. Die Messungen wurden im dynamischen Modus mit permanenter Differenzbildung zwischen dem Ausgangssignal des Fokussensors und dem Längenwert des Z-Interferometers der Nanopositionier- und Nanomessmaschine durchgeführt. Die Messergebnisse und Messmöglichkeiten sind dargestellt.
Schaumcharakterisierung mit optischen Messtechniken und PC-gestützter Bildverarbeitung (Foam Characterization by Optical Measuring Techniques and Computer-Aided Image Processing)
Authors: Haß Ernst-Christoph , Ottensmeyer Ralph , Wittstock Arne 
Published: October 2004

Abstract
In diesem Beitrag wird ein optisches Mess- und Aufnahmeverfahren mit anschließender automatischer Bildverarbeitung am PC zur Charakterisierung stabiler und zerfallender Schäume beschrieben, die Aussagen über deren Morphologie, Poren- bzw. Blasengrößenverteilung, Zerfallsprozess, Alterungseigenschaften usw. zulässt. Hierzu wird eine Messanordnung verwendet, die aus einer hoch auflösenden monochromen CCD-Kamera mit einem telezentrischen Objektiv, einer koaxialen, diffusen Beleuchtung mit optionaler Blitzlichtsteuerung und einer schnellen Framegrabber-Karte besteht. Die Bilder werden automatisch am PC mit einer speziell von uns entwickelten Software hinsichtlich folgender Charakteristika ausgewertet: (a) fraktale Dimensionen von Schäumen, die deren Körnigkeit und somit ihre Morphologie kennzeichnen, (b) Flüssigkeitsanteil beim Zerfallsprozess instabiler Schäume durch Auswertung zeitlich aufeinander folgender Schaumbilder und (c) Änderung der Blasengrößenverteilungen bei Alterung des Schaums.
Evaluation of Oral and Nasal Odor in Patients with and without Cleft Lip and Palate: Preliminary Report
Authors: Monteiro-Amado Flávio , Chinellato Luiz Eduardo Montenegro , Tárzia Olinda , de Rezende Maria Lúcia Rubo 
Published: October 2004

Objective To evaluate oral and nasal halitosis parameters in patients with and without clefts. Design Randomized and prospective study. Patients with and without clefts were evaluated as to oral and nasal halitosis. Setting University of São Paulo, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil. Patients Twelve patients with clefts and 12 without clefts were evaluated, and no exclusion criteria were followed. Interventions Nasal and oral halitosis were measured with the use of a portable sulfide monitor during a single visit. Results One hundred percent of the patients with clefts had altered values for volatile sulfur compounds. Only 33.3% of the patients without clefts had at least one strong value for nasal halimeter measurements, and 58.3% of these patients showed alteration in the nasal values. Statistical evaluation, made using the Mann-Whitney U test, classifying the nasal halimeter values as normal, weak, and strong, showing a statistical significant group difference (p = .003). There was no significant difference in the oral halimeter values between the two groups. Conclusions Patients with cleft lip and palate had a tendency to present higher values for the nasal halimeter measurements, when compared with patients without clefts.
The Prevalence of Caries in Children with a Cleft Lip and/or Palate in Southern Vietnam
Authors: Besseling Sjobbe , Dubois Leander 
Published: October 2004

Objective The aim of this study was to investigate the prevalence of caries in South Vietnamese children with a known oral cleft. Setting The children were screened at local dental hospitals in five different cities in southern Vietnam. Participants One hundred fifty-four children aged 4 to 6, 11 to 13, and 14 to 16 years old with a cleft lip, cleft palate, or both were included in the study. Outcome Measurements For every age group, clefts were divided in four types. The dmft/DMFT was specified according to criteria of the World Health Organization (1997). Results The mean number of teeth affected by caries was 9.95 for 4- to 6-year-old children, 2.97 for 11- to 13-year-old children, and 4.93 for 14- to 16-year-old children, respectively. Four- to 6-year-old children with a unilateral or bilateral cleft lip and palate had significantly more caries and a higher dmft (decayed, missing, and filled teeth index) than children of the same age with only a cleft lip or a cleft lip and alveolus. Conclusions Vietnamese children with an oral cleft have high numbers of teeth affected by dental caries, and special attention will be necessary for their oral health.