Neurosurgery
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The current members of the faculty at the University of Chicago are acutely aware of the great historic tradition they have inherited. Like all academic medical centers, they are challenged by the current socioeconomic climate, but with the vast intellectual resources of the University of Chicago and its secure place in the community, both locally and nationally, we are confident of our ability to make a continuing contribution to the development of neurosurgery.
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The aim of the present study is to monitor the extracellular gamma-aminobutyric acid (GABA) levels in the lumbar dorsal horn of allodynic rats, which respond to spinal cord stimulation (SCS) with a normalization of the tactile withdrawal threshold. In addition, we monitored the GABA levels in nonresponding and sham-stimulated rats. ⋯ Our results indicate that the development of allodynia, a common symptom in neuropathic pain states, may be linked to a decreased spinal release of GABA. We suggest that an SCS-induced release of GABA could be important for the suppression of allodynia observed in rats after SCS. Similar mechanisms could also be involved in the SCS-induced alleviation of pain in patients with peripheral neuropathy.
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This study analyzed selection criteria, clinical outcome, and tumor growth rates in patients with acoustic neuromas in whom the initial management strategy was observation. ⋯ Observation is a reasonable management strategy in carefully selected patients with acoustic neuromas. Diligent follow-up with serial magnetic resonance imaging is recommended, because some tumors will enlarge to the point at which active treatment is required.
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Biography Historical Article
Birthday of peripheral nervous system surgery: the contribution of Gabriele Ferrara (1543-1627).
SURGERY OF THE peripheral nerves has only recently achieved brilliant results thanks to technological advances in the development of neurosurgical instrumentation. In past centuries, few surgeons made relevant contributions to this topic and improvement was slow and difficult. ⋯ He described applying gentle traction on the retracted stumps, suturing using a special needle with an eye, after immersion in a decoction of red wine, rosemary, and roses (alcoholic disinfection?), and, finally, insulating the sutured segment with a mixture of oils. We are celebrating the 400th anniversary of the first edition of his fundamental work (1596-1996), and we truly esteem this surgeon, a pioneer of peripheral nerve surgery wo primarily contributed to its progress.
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Intrinsic brain tumors can arise within regions of the cortex that are essential to language, motor, and somatosensory functions. Although it is commonly thought that such tumors can be safely resected, as long as the resection is limited to grossly abnormal cortex, functional mapping of the cerebral cortex during tumor resection does not support this contention. ⋯ Intrinsic brain tumors grow by infiltration of normal brain. Consequently, brain that appears to be abnormal may remain functional, thus precluding safe tumor resection.