Journal of neurosurgery
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Journal of neurosurgery · Dec 2002
Clinical TrialEndovascular reconstruction of intracranial arteries by stent placement and combined techniques.
The authors investigated the feasibility, safety, and short-term outcome of stent treatment for intracranial aneurysms, stenoses, and dissections. ⋯ These findings indicate that stent treatment is feasible and seems to be an effective modality for arterial reconstruction. This versatile tool allows the treatment of a wide variety of challenging intracranial lesions.
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Journal of neurosurgery · Dec 2002
Vision of the future: initial experience with intraoperative real-time high-resolution dynamic infrared imaging. Technical note.
High-resolution dynamic infrared (DIR) imaging provides intraoperative real-time physiological, anatomical, and pathological information; however, DIR imaging has rarely been used in neurosurgical patients. The authors report on their initial experience with intraoperative DIR imaging in 30 such patients. A novel, long-wave (8-10 microm), narrow-band, focal-plane-array infrared photodetector was incorporated into a camera system with a temperature resolution of 0.006 degrees C, providing 65,000 pixels/frame at a data acquisition rate of 200 frames/second. ⋯ Dynamic infrared imaging may prove to be a powerful adjunctive intraoperative diagnostic tool in the neurosurgical imaging armamentarium. Real-time assessment of cerebral vessel patency and cerebral perfusion are the most direct applications of this technology. Uses of this imaging modality in the localization of epileptic foci, identification of functional cortex during awake craniotomy, and determination of tumor border and intraoperative brain shift are avenues of inquiry that require further investigation.
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Journal of neurosurgery · Dec 2002
Plasma endothelin and big endothelin concentrations and serum endothelin-converting enzyme activity following aneurysmal subarachnoid hemorrhage.
Pathogenesis of delayed ischemia after aneurysmal subarachnoid hemorrhage (SAH) seems to be complex. An important mediator of chronic vasospasm may be endothelin (ET)-1 with its powerful and long-lasting vasoconstricting activity. In this prospective study the author investigated the correlations between serial plasma concentrations of ET-1 and big ET-1 as well as the ET-1/big ET-1 molar concentration ratio and serum endothelin-converting enzyme (ECE)-1 activity, and ischemic complications after SAH. ⋯ The plasma ET-1 concentration correlates with delayed cerebral ischemia after SAH, suggesting that an increased ET conversion rate in the endothelium predicts ischemic symptoms. Increased serum ECE-1 activity during the 2nd week may reflect the severity of endothelial injury to cerebral arteries.
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Journal of neurosurgery · Dec 2002
New laboratory model for neurosurgical training that simulates live surgery.
Laboratory training models are essential for developing and refining surgical skills, especially for microsurgery. The closer to live surgery the model is, the greater the benefit. In this paper the authors introduce a cadaver model with unique characteristics: dynamic filling of the cerebral vasculature with colored liquid and clear fluid filling of the arachnoid cisterns. This model is distinctive and has great practical value for training in a wide range of surgical procedures. ⋯ This model mimics the normal human anatomy and dynamic vascular filling found in real surgery and presents it from the training perspective, allowing a wide range of skill development and repeated practice. It provides an alternative model to laboratory animals. It is inexpensive and readily available, and has great value for the acquisition and refinement of surgical skills that are not only specific to neurosurgery, but are applicable to other surgical disciplines.
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Journal of neurosurgery · Dec 2002
Analysis of loss of chromosome 10q, DMBT1 homozygous deletions, and PTEN mutations in oligodendrogliomas.
Chromosomal deletions of 10q and candidate genes such as PTEN and DMBT1 have been thoroughly investigated in glioblastomas but few data specifically address oligodendrogliomas. ⋯ Frequent inactivation of DMBT1 contrasting with rare mutations of PTEN may indicate that DMBT1 is preferentially involved in oligodendrogliomas. Nevertheless, the absence of a correlation with survival makes the role of DMBT1 in tumorigenesis still questionable and warrants further investigation.