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Alawieh A, Zohdy YM, El Annan R, Assi JH, Dimisko L, Grossberg JA, Cawley CM, Chandler K, Chern JJ, Sawvel MS, Brahma B, Garzon-Muvdi T, Pradilla G, Barrow D, Reisner A, Howard BM. Pediatric infectious aneurysms: individual patient pooled analysis on presentation, management and outcomes. J Neurointerv Surg 2024:jnis-2023-021195. [PMID: 38171606 DOI: 10.1136/jnis-2023-021195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Infectious intracranial aneurysms (IIAs) are a rare sequel of systemic infection and occur most commonly in patients with infective endocarditis (IE). Despite the increasing use of non-invasive screening angiography in patients with IE, the incidence remains low, yielding limited data on the management of IIAs in pediatric populations. We performed a pooled analysis of all published series of pediatric patients with IIAs to study the disease landscape including presentation, management, and outcomes. METHODS Data included in this study were pooled from published literature on IIAs between 1960 and 2023. Abstracts were selected for full review to include only manuscripts reporting at least one case of pediatric IIA (age 0-18 years). RESULTS A total of 145 pediatric patients with 178 IIAs were included. Patients presented with rupture in 68% of cases, of which 36% had intraparenchymal hemorrhage and 39% had subarachnoid hemorrhage. Using multivariate logistic regression, independent predictors of rupture were posterior location (aOR 10, P=0.041) and history of IE (aOR 7.2, P=0.001). Primary medical management was successful in 82% of cases with unruptured aneurysms while, in those with ruptured IIAs, medical management was successful in 26% of cases. The 90-day mortality rate was 28%. Using multivariate logistic regression, ruptured IIAs (aOR 5.4, P<0.01) and failure of medical management (aOR 11.1, P<0.05) were independent predictors of 90-day mortality. CONCLUSION Pediatric IIAs remain a rare complication of systemic or localized CNS infection in the pediatric population. Medical management of unruptured aneurysms is highly successful, while ruptured aneurysms have a remarkably high rate of failure of medical management and should be treated by early surgical or endovascular intervention when feasible.
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Affiliation(s)
- Ali Alawieh
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Youssef M Zohdy
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Rim El Annan
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Jad H Assi
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | | | | | - C Michael Cawley
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Joshua J Chern
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Michael S Sawvel
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Barunashish Brahma
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | | | - Gustavo Pradilla
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Daniel Barrow
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Andrew Reisner
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Brian M Howard
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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Acero MA, Adamson P, Aliaga L, Anfimov N, Antoshkin A, Arrieta-Diaz E, Asquith L, Aurisano A, Back A, Baird M, Balashov N, Baldi P, Bambah BA, Bashar S, Bays K, Bernstein R, Bhatnagar V, Bhattarai D, Bhuyan B, Bian J, Booth AC, Bowles R, Brahma B, Bromberg C, Buchanan N, Butkevich A, Calvez S, Carroll TJ, Catano-Mur E, Childress S, Chatla A, Chirco R, Choudhary BC, Christensen A, Coan TE, Colo M, Cremonesi L, Davies GS, Derwent PF, Ding P, Djurcic Z, Dolce M, Doyle D, Dueñas Tonguino D, Dukes EC, Ehrlich R, Elkins M, Ewart E, Feldman GJ, Filip P, Franc J, Frank MJ, Gallagher HR, Gandrajula R, Gao F, Giri A, Gomes RA, Goodman MC, Grichine V, Groh M, Group R, Guo B, Habig A, Hakl F, Hall A, Hartnell J, Hatcher R, Hausner H, He M, Heller K, Hewes V, Himmel A, Jargowsky B, Jarosz J, Jediny F, Johnson C, Judah M, Kakorin I, Kaplan DM, Kalitkina A, Keloth R, Klimov O, Koerner LW, Kolupaeva L, Kotelnikov S, Kralik R, Kullenberg C, Kubu M, Kumar A, Kuruppu CD, Kus V, Lackey T, Lang K, Lasorak P, Lesmeister J, Lin S, Lister A, Liu J, Lokajicek M, Lopez JMC, Mahji R, Magill S, Manrique Plata M, Mann WA, Manoharan MT, Marshak ML, Martinez-Casales M, Matveev V, Mayes B, Messier MD, Meyer H, Miao T, Mikola V, Miller WH, Mishra S, Mishra SR, Mislivec A, Mohanta R, Moren A, Morozova A, Mu W, Mualem L, Muether M, Mulder K, Naples D, Nath A, Nayak N, Nelleri S, Nelson JK, Nichol R, Niner E, Norman A, Norrick A, Nosek T, Oh H, Olshevskiy A, Olson T, Ott J, Pal A, Paley J, Panda L, Patterson RB, Pawloski G, Petrova O, Petti R, Phan DD, Plunkett RK, Pobedimov A, Porter JCC, Rafique A, Prais LR, Raj V, Rajaoalisoa M, Ramson B, Rebel B, Rojas P, Roy P, Ryabov V, Samoylov O, Sanchez MC, Sánchez Falero S, Shanahan P, Shukla S, Sheshukov A, Singh I, Singh P, Singh V, Smith E, Smolik J, Snopok P, Solomey N, Sousa A, Soustruznik K, Strait M, Suter L, Sutton A, Swain S, Sweeney C, Sztuc A, Talaga RL, Tapia Oregui B, Tas P, Temizel BN, Thakore T, Thayyullathil RB, Thomas J, Tiras E, Tripathi J, Trokan-Tenorio J, Torun Y, Urheim J, Vahle P, Vallari Z, Vasel J, Vrba T, Wallbank M, Warburton TK, Wetstein M, Whittington D, Wickremasinghe DA, Wieber T, Wolcott J, Wu W, Xiao Y, Yaeggy B, Yallappa Dombara A, Yankelevich A, Yonehara K, Yu S, Yu Y, Zadorozhnyy S, Zalesak J, Zhang Y, Zwaska R. Measurement of the ν_{e}-Nucleus Charged-Current Double-Differential Cross Section at ⟨E_{ν}⟩=2.4 GeV Using NOvA. Phys Rev Lett 2023; 130:051802. [PMID: 36800478 DOI: 10.1103/physrevlett.130.051802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 06/18/2023]
Abstract
The inclusive electron neutrino charged-current cross section is measured in the NOvA near detector using 8.02×10^{20} protons-on-target in the NuMI beam. The sample of GeV electron neutrino interactions is the largest analyzed to date and is limited by ≃17% systematic rather than the ≃7.4% statistical uncertainties. The double-differential cross section in final-state electron energy and angle is presented for the first time, together with the single-differential dependence on Q^{2} (squared four-momentum transfer) and energy, in the range 1 GeV≤E_{ν}<6 GeV. Detailed comparisons are made to the predictions of the GENIE, GiBUU, NEUT, and NuWro neutrino event generators. The data do not strongly favor a model over the others consistently across all three cross sections measured, though some models have especially good or poor agreement in the single differential cross section vs Q^{2}.
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Affiliation(s)
- M A Acero
- Universidad del Atlantico, Carrera 30 No. 8-49, Puerto Colombia, Atlantico, Colombia
| | - P Adamson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Aliaga
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - N Anfimov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - A Antoshkin
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - E Arrieta-Diaz
- Universidad del Magdalena, Carrera 32 No 22-08 Santa Marta, Colombia
| | - L Asquith
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - A Aurisano
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - A Back
- Indiana University, Bloomington, Indiana 47405, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - M Baird
- Indiana University, Bloomington, Indiana 47405, USA
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - N Balashov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - P Baldi
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - B A Bambah
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - S Bashar
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - K Bays
- California Institute of Technology, Pasadena, California 91125, USA
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - R Bernstein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Bhatnagar
- Department of Physics, Panjab University, Chandigarh 160 014, India
| | - D Bhattarai
- University of Mississippi, University, Mississippi 38677, USA
| | - B Bhuyan
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - J Bian
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A C Booth
- Particle Physics Research Centre, Department of Physics and Astronomy, Queen Mary University of London, London E1 4NS, United Kingdom
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Bowles
- Indiana University, Bloomington, Indiana 47405, USA
| | - B Brahma
- Department of Physics, IIT Hyderabad, Hyderabad 502 205, India
| | - C Bromberg
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Buchanan
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - A Butkevich
- Institute for Nuclear Research of Russia, Academy of Sciences 7a, 60th October Anniversary prospect, Moscow 117312, Russia
| | - S Calvez
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - T J Carroll
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E Catano-Mur
- Department of Physics, William & Mary, Williamsburg, Virginia 23187, USA
| | - S Childress
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Chatla
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - R Chirco
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - B C Choudhary
- Department of Physics and Astrophysics, University of Delhi, Delhi 110007, India
| | - A Christensen
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - T E Coan
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - M Colo
- Department of Physics, William & Mary, Williamsburg, Virginia 23187, USA
| | - L Cremonesi
- Particle Physics Research Centre, Department of Physics and Astronomy, Queen Mary University of London, London E1 4NS, United Kingdom
| | - G S Davies
- Indiana University, Bloomington, Indiana 47405, USA
- University of Mississippi, University, Mississippi 38677, USA
| | - P F Derwent
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Ding
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Djurcic
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Dolce
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - D Doyle
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - D Dueñas Tonguino
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - E C Dukes
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - R Ehrlich
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Elkins
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - E Ewart
- Indiana University, Bloomington, Indiana 47405, USA
| | - G J Feldman
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - P Filip
- Institute of Physics, The Czech Academy of Sciences, 182 21 Prague, Czech Republic
| | - J Franc
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - M J Frank
- Department of Physics, University of South Alabama, Mobile, Alabama 36688, USA
| | - H R Gallagher
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - R Gandrajula
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - F Gao
- Department of Physics, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Giri
- Department of Physics, IIT Hyderabad, Hyderabad 502 205, India
| | - R A Gomes
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Goiás 74690-900, Brazil
| | - M C Goodman
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Grichine
- Nuclear Physics and Astrophysics Division, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - M Groh
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
- Indiana University, Bloomington, Indiana 47405, USA
| | - R Group
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Guo
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A Habig
- Department of Physics and Astronomy, University of Minnesota Duluth, Duluth, Minnesota 55812, USA
| | - F Hakl
- Institute of Computer Science, The Czech Academy of Sciences, 182 07 Prague, Czech Republic
| | - A Hall
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Hartnell
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Hatcher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H Hausner
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M He
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - K Heller
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Hewes
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - A Himmel
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Jargowsky
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - J Jarosz
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - F Jediny
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - C Johnson
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - M Judah
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
- Department of Physics, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - I Kakorin
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - D M Kaplan
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - A Kalitkina
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - R Keloth
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - O Klimov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - L W Koerner
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - L Kolupaeva
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - S Kotelnikov
- Nuclear Physics and Astrophysics Division, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - R Kralik
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - Ch Kullenberg
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - M Kubu
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - A Kumar
- Department of Physics, Panjab University, Chandigarh 160 014, India
| | - C D Kuruppu
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - V Kus
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - T Lackey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
- Indiana University, Bloomington, Indiana 47405, USA
| | - K Lang
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - P Lasorak
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - J Lesmeister
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - S Lin
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - A Lister
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Liu
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - M Lokajicek
- Institute of Physics, The Czech Academy of Sciences, 182 21 Prague, Czech Republic
| | - J M C Lopez
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - R Mahji
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - S Magill
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | | | - W A Mann
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M T Manoharan
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - M L Marshak
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - M Martinez-Casales
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - V Matveev
- Institute for Nuclear Research of Russia, Academy of Sciences 7a, 60th October Anniversary prospect, Moscow 117312, Russia
| | - B Mayes
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - M D Messier
- Indiana University, Bloomington, Indiana 47405, USA
| | - H Meyer
- Department of Mathematics, Statistics, and Physics, Wichita State University, Wichita, Kansas 67206, USA
| | - T Miao
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Mikola
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - W H Miller
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Mishra
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi 221 005, India
| | - S R Mishra
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A Mislivec
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Mohanta
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - A Moren
- Department of Physics and Astronomy, University of Minnesota Duluth, Duluth, Minnesota 55812, USA
| | - A Morozova
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - W Mu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Mualem
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Muether
- Department of Mathematics, Statistics, and Physics, Wichita State University, Wichita, Kansas 67206, USA
| | - K Mulder
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - D Naples
- Department of Physics, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Nath
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - N Nayak
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - S Nelleri
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - J K Nelson
- Department of Physics, William & Mary, Williamsburg, Virginia 23187, USA
| | - R Nichol
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - E Niner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Norman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Norrick
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Nosek
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - H Oh
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - T Olson
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - J Ott
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - A Pal
- National Institute of Science Education and Research, Khurda 752050, Odisha, India
| | - J Paley
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Panda
- National Institute of Science Education and Research, Khurda 752050, Odisha, India
| | - R B Patterson
- California Institute of Technology, Pasadena, California 91125, USA
| | - G Pawloski
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - O Petrova
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - R Petti
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - D D Phan
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - R K Plunkett
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Pobedimov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - J C C Porter
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - A Rafique
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - L R Prais
- University of Mississippi, University, Mississippi 38677, USA
| | - V Raj
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Rajaoalisoa
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - B Ramson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Rebel
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - P Rojas
- Department of Physics, Colorado State University, Fort Collins, Colorado 80523-1875, USA
| | - P Roy
- Department of Mathematics, Statistics, and Physics, Wichita State University, Wichita, Kansas 67206, USA
| | - V Ryabov
- Nuclear Physics and Astrophysics Division, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - O Samoylov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - M C Sanchez
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - S Sánchez Falero
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - P Shanahan
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Shukla
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi 221 005, India
| | - A Sheshukov
- Joint Institute for Nuclear Research, Dubna, Moscow region 141980, Russia
| | - I Singh
- Department of Physics and Astrophysics, University of Delhi, Delhi 110007, India
| | - P Singh
- Department of Physics and Astrophysics, University of Delhi, Delhi 110007, India
- Particle Physics Research Centre, Department of Physics and Astronomy, Queen Mary University of London, London E1 4NS, United Kingdom
| | - V Singh
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi 221 005, India
| | - E Smith
- Indiana University, Bloomington, Indiana 47405, USA
| | - J Smolik
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - P Snopok
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - N Solomey
- Department of Mathematics, Statistics, and Physics, Wichita State University, Wichita, Kansas 67206, USA
| | - A Sousa
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - K Soustruznik
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - M Strait
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - L Suter
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Sutton
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - S Swain
- National Institute of Science Education and Research, Khurda 752050, Odisha, India
| | - C Sweeney
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - A Sztuc
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - R L Talaga
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B Tapia Oregui
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - P Tas
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - B N Temizel
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - T Thakore
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - R B Thayyullathil
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - J Thomas
- Physics and Astronomy Department, University College London, Gower Street, London WC1E 6BT, United Kingdom
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E Tiras
- Department of Physics, Erciyes University, Kayseri 38030, Turkey
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - J Tripathi
- Department of Physics, Panjab University, Chandigarh 160 014, India
| | - J Trokan-Tenorio
- Department of Physics, William & Mary, Williamsburg, Virginia 23187, USA
| | - Y Torun
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - J Urheim
- Indiana University, Bloomington, Indiana 47405, USA
| | - P Vahle
- Department of Physics, William & Mary, Williamsburg, Virginia 23187, USA
| | - Z Vallari
- California Institute of Technology, Pasadena, California 91125, USA
| | - J Vasel
- Indiana University, Bloomington, Indiana 47405, USA
| | - T Vrba
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - M Wallbank
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - T K Warburton
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - M Wetstein
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - D Whittington
- Indiana University, Bloomington, Indiana 47405, USA
- Department of Physics, Syracuse University, Syracuse New York 13210, USA
| | | | - T Wieber
- School of Physics and Astronomy, University of Minnesota Twin Cities, Minneapolis, Minnesota 55455, USA
| | - J Wolcott
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - W Wu
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - Y Xiao
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - B Yaeggy
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - A Yallappa Dombara
- Department of Physics, Syracuse University, Syracuse New York 13210, USA
| | - A Yankelevich
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - K Yonehara
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Yu
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - Y Yu
- Illinois Institute of Technology, Chicago Illinois 60616, USA
| | - S Zadorozhnyy
- Institute for Nuclear Research of Russia, Academy of Sciences 7a, 60th October Anniversary prospect, Moscow 117312, Russia
| | - J Zalesak
- Institute of Physics, The Czech Academy of Sciences, 182 21 Prague, Czech Republic
| | - Y Zhang
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Zwaska
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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3
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Reisner A, Smith AD, Wrubel DM, Buster BE, Sawvel MS, Blackwell LS, Laxpati NG, Brahma B, Chern JJ. Utility of ventriculogallbladder shunts in complex cases of hydrocephalus related to extreme prematurity. J Neurosurg Pediatr 2021; 27:511-517. [PMID: 33636696 DOI: 10.3171/2020.9.peds20522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/03/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The management of hydrocephalus resulting from intraventricular hemorrhage related to extreme prematurity remains demanding. Given the complexities of controlling hydrocephalus in this population, less commonly used procedures may be required. The authors examined the utility of ventriculogallbladder (VGB) shunts in a series of such children. METHODS The authors retrospectively reviewed the medical records of all children who underwent surgery for hydrocephalus in the period from 2011 through 2019 at Children's Healthcare of Atlanta. Six patients who underwent VGB shunt placement were identified among a larger cohort of 609 patients who had either a new shunt or a newly changed distal terminus site. The authors present an analysis of this series, including a case of laparoscopy-assisted distal VGB shunt revision. RESULTS The mean age at initial shunt placement was 5.1 months (range 3.0-9.4 months), with patients undergoing a mean of 11.8 shunt procedures (range 5-17) prior to the initial VGB shunt placement at a mean age of 5.3 years (range 7.9 months-12.8 years). All 6 patients with VGB shunt placement had hydrocephalus related to extreme prematurity (gestational age < 28 weeks). At the time of VGB shunt placement, all had complex medical and surgical histories, including poor venous access due to congenital or iatrogenic thrombosis or thrombophlebitis and a peritoneum hostile to distal shunt placement related to severe necrotizing enterocolitis. VGB complications included 1 case of shunt infection, identified at postoperative day 6, and 2 cases of distal shunt failure due to retraction of the distal end of the VGB shunt. In all, there were 3 conversions back to ventriculoperitoneal or ventriculoatrial shunts due to the 2 previously mentioned complications, plus 1 patient who outgrew their initial VGB shunt. Three of 6 patients remain with a VGB shunt, including 1 who underwent laparoscopy-assisted distal shunt revision 110.5 months after initial VGB shunt insertion. CONCLUSIONS Placement of VGB shunts should be considered in the armamentarium of procedures that may be used in the particularly difficult cohort of children with hydrocephalus related to extreme prematurity. VGB shunts show utility as both a definitive treatment and as a "bridge" procedure until the patient is larger and comorbid abdominal and/or vascular issues have resolved sufficiently to allow conversion back to ventriculoperitoneal or ventriculoatrial shunts, if needed.
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Affiliation(s)
- Andrew Reisner
- Departments of1Pediatrics.,2Neurosurgery, and.,Departments of4Neurosurgery and
| | - Alexis D Smith
- 3Surgery, Emory University School of Medicine, Atlanta; and.,Departments of4Neurosurgery and
| | | | | | | | | | | | | | - Joshua J Chern
- Departments of1Pediatrics.,2Neurosurgery, and.,Departments of4Neurosurgery and
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4
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Shaw KA, Griffith M, Schmitz ML, Brahma B, Fletcher ND, Murphy JS. Application of a Halo Fixator for the Treatment of Pediatric Spinal Deformity. JBJS Essent Surg Tech 2021; 11:ST-D-20-00005. [PMID: 34123553 DOI: 10.2106/jbjs.st.20.00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In spine surgery, the halo fixator was initially utilized to stabilize cervical fusions in patients with poliomyelitis. More recently, the indications for halo fixation have evolved to include stabilization and definitive treatment for upper cervical spine injuries (Jefferson fractures, atlanto-occipital dissociations, odontoid fractures, etc.), treatment of atlantoaxial rotatory subluxation, stabilization of long cervical fusions, and preoperative traction. In the realm of pediatric spinal deformity, halo fixation has proved to be a valuable resource for severe or neglected spinal deformities. In this video article, we demonstrate the application of a halo fixator in a pediatric patient with severe scoliosis. Description The procedure includes appropriate pin placement in the safe zones of the skull performed under either general anesthesia or local anesthesia. Pins are secured to a halo frame that is sized to be 2 cm larger than the circumference of the skull and are tightened according to age-specific torque guidelines. Alternatives Alternative treatments vary from cervical spine immobilization to definitive surgical treatment in the spine, or even spinal osteotomies, depending on the underlying spinal pathology. Rationale The halo fixator works by limiting motion of the cervical spine in flexion, extension, and axial rotation. The halo is also able to control and correct translational injuries of the cervical spine. In the setting of spinal deformity, the halo fixator can also be utilized to overcome the effects of gravity and lengthen the spine. Expected Outcomes For spinal deformities, the halo fixator can be expected to lengthen the spine and increase deformity flexibility prior to definitive surgical treatment in the spine or growth-friendly spinal instrumentation. Important Tips Correct identification of safe zones for pin placement is vital to correct pin placement.For pediatric patients, it is important to obtain fixation with a minimum of 6 to 8 pins.Pins should be tightened with use of a torque-limiting wrench, up to no more than 1 in/lb (55.9 mm/kg) per year of age, up to a maximum of 8 in/lb (447.9 mm/kg).Applied traction should be a maximum of 50% of the body weight of the patient.Neurovascular examination is vital following application of weight.
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Affiliation(s)
- K Aaron Shaw
- Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
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5
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Rajabto W, Angkasa YK, Harahap AS, Ham MF, Brahma B. Primary breast lymphoma - a case report. Klin Onkol 2021; 34:477-480. [PMID: 34911334 DOI: 10.48095/ccko2021477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Primary breast lymphoma is a rare disease and accounts for 0.4-0.5% of malignant breast neoplasms and 1.7-2.2% of extra-nodal lymphomas, with diffuse large B-cell lymphoma (DLBCL) as the most common histologic subtype. CASE A 47-year-old female with beta thalassemia presented with a lump of the left breast, redness, pain, and swelling of her left breast. Physical examination showed tender, red, swollen left breast. Laboratory findings show mild anemia and normal level of lactate dehydrogenase 329 U/L (normal range: 240-480 U/L). PET scan showed hypermetabolic mass with irregular margins covering the whole left breast quadrants with the size of 11.25 x 5.17cm with left pectoralis major, left parasternal, and left axillary hypermetabolic nodules. Histopathology and immunohistochemistry staining showed a non-germinal center B-cell-like subtype of DLBCL CD20+. We administered the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednison) every 3 weeks for 6 cycles. The response was complete remission. The patient tolerated the chemotherapy well and achieved long term complete remission. CONCLUSION Primary breast lymphoma is a rare disease with the most common subtype is diffuse large B-cell lymphoma. Systemic chemother-apy R-CHOP is the treatment option for primary breast diffuse large B-cell lymphoma.
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6
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Gupta N, Goumnerova LC, Manley P, Chi SN, Neuberg D, Puligandla M, Fangusaro J, Goldman S, Tomita T, Alden T, DiPatri A, Rubin JB, Gauvain K, Limbrick D, Leonard J, Geyer JR, Leary S, Browd S, Wang Z, Sood S, Bendel A, Nagib M, Gardner S, Karajannis MA, Harter D, Ayyanar K, Gump W, Bowers DC, Weprin B, MacDonald TJ, Aguilera D, Brahma B, Robison NJ, Kiehna E, Krieger M, Sandler E, Aldana P, Khatib Z, Ragheb J, Bhatia S, Mueller S, Banerjee A, Bredlau AL, Gururangan S, Fuchs H, Cohen KJ, Jallo G, Dorris K, Handler M, Comito M, Dias M, Nazemi K, Baird L, Murray J, Lindeman N, Hornick JL, Malkin H, Sinai C, Greenspan L, Wright KD, Prados M, Bandopadhayay P, Ligon KL, Kieran MW. Prospective feasibility and safety assessment of surgical biopsy for patients with newly diagnosed diffuse intrinsic pontine glioma. Neuro Oncol 2019; 20:1547-1555. [PMID: 29741745 DOI: 10.1093/neuonc/noy070] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Diagnosis of diffuse intrinsic pontine glioma (DIPG) has relied on imaging studies, since the appearance is pathognomonic, and surgical risk was felt to be high and unlikely to affect therapy. The DIPG Biology and Treatment Study (DIPG-BATS) reported here incorporated a surgical biopsy at presentation and stratified subjects to receive FDA-approved agents chosen on the basis of specific biologic targets. Methods Subjects were eligible for the trial if the clinical features and imaging appearance of a newly diagnosed tumor were consistent with a DIPG. Surgical biopsies were performed after enrollment and prior to definitive treatment. All subjects were treated with conventional external beam radiotherapy with bevacizumab, and then stratified to receive bevacizumab with erlotinib or temozolomide, both agents, or neither agent, based on O6-methylguanine-DNA methyltransferase status and epidermal growth factor receptor expression. Whole-genome sequencing and RNA sequencing were performed but not used for treatment assignment. Results Fifty-three patients were enrolled at 23 institutions, and 50 underwent biopsy. The median age was 6.4 years, with 24 male and 29 female subjects. Surgical biopsies were performed with a specified technique and no deaths were attributed to the procedure. Two subjects experienced grade 3 toxicities during the procedure (apnea, n = 1; hypertension, n = 1). One subject experienced a neurologic deficit (left hemiparesis) that did not fully recover. Of the 50 tumors biopsied, 46 provided sufficient tissue to perform the study assays (92%, two-stage exact binomial 90% CI: 83%-97%). Conclusions Surgical biopsy of DIPGs is technically feasible, associated with acceptable risks, and can provide biologic data that can inform treatment decisions.
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Affiliation(s)
- Nalin Gupta
- UCSF Benioff Children's Hospital & University of California San Francisco, San Francisco, California
| | - Liliana C Goumnerova
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
| | - Peter Manley
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
| | - Susan N Chi
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
| | | | | | - Jason Fangusaro
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University, Chicago, Illinois
| | - Stewart Goldman
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University, Chicago, Illinois
| | - Tadanori Tomita
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University, Chicago, Illinois
| | - Tord Alden
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University, Chicago, Illinois
| | - Arthur DiPatri
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University, Chicago, Illinois
| | - Joshua B Rubin
- Washington University Medical Center & St. Louis Children's Hospital, St. Louis, Missouri
| | - Karen Gauvain
- Washington University Medical Center & St. Louis Children's Hospital, St. Louis, Missouri
| | - David Limbrick
- Washington University Medical Center & St. Louis Children's Hospital, St. Louis, Missouri
| | - Jeffrey Leonard
- Washington University Medical Center & St. Louis Children's Hospital, St. Louis, Missouri
| | - J Russel Geyer
- Seattle Children's Hospital & University of Washington, Seattle, Washington
| | - Sarah Leary
- Seattle Children's Hospital & University of Washington, Seattle, Washington
| | - Samuel Browd
- Seattle Children's Hospital & University of Washington, Seattle, Washington
| | - Zhihong Wang
- Children's Hospital of Michigan & Wayne State University, Detroit, Michigan
| | - Sandeep Sood
- Children's Hospital of Michigan & Wayne State University, Detroit, Michigan
| | - Anne Bendel
- Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Mahmoud Nagib
- Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | - William Gump
- University of Louisville & Norton's Children's Hospital, Louisville, Kentucky
| | - Daniel C Bowers
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bradley Weprin
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Tobey J MacDonald
- Children's Healthcare of Atlanta & Emory University, Atlanta, Georgia
| | - Dolly Aguilera
- Children's Healthcare of Atlanta & Emory University, Atlanta, Georgia
| | | | | | - Erin Kiehna
- Children's Hospital Los Angeles, Los Angeles, California
| | - Mark Krieger
- Children's Hospital Los Angeles, Los Angeles, California
| | - Eric Sandler
- Nemours Children's Clinic, Wolfson's Children's Hospital & University of Florida, Jacksonville, Florida
| | - Philipp Aldana
- Nemours Children's Clinic, Wolfson's Children's Hospital & University of Florida, Jacksonville, Florida
| | - Ziad Khatib
- Nicklaus Children's Hospital, Miami, Florida
| | - John Ragheb
- Nicklaus Children's Hospital, Miami, Florida
| | | | - Sabine Mueller
- UCSF Benioff Children's Hospital & University of California San Francisco, San Francisco, California
| | - Anu Banerjee
- UCSF Benioff Children's Hospital & University of California San Francisco, San Francisco, California
| | - Amy-Lee Bredlau
- Medical University of South Carolina, South Carolina, Charleston, South Carolina
| | - Sri Gururangan
- Preston Robert Tisch Brain Tumor Center & Duke University Medical Center, Durham, North Carolina
| | - Herbert Fuchs
- Preston Robert Tisch Brain Tumor Center & Duke University Medical Center, Durham, North Carolina
| | | | | | - Kathleen Dorris
- Children's Hospital of Colorado & University of Colorado School of Medicine, Denver, Colorado
| | - Michael Handler
- Children's Hospital of Colorado & University of Colorado School of Medicine, Denver, Colorado
| | - Melanie Comito
- Penn State Health Children's Hospital, Hershey, Pennsylvania
| | - Mark Dias
- Penn State Health Children's Hospital, Hershey, Pennsylvania
| | - Kellie Nazemi
- Oregon Health & Science University & Doernbecher Children's Hospital, Portland, Oregon
| | - Lissa Baird
- Oregon Health & Science University & Doernbecher Children's Hospital, Portland, Oregon
| | - Jeff Murray
- Cook Children's Medical Center, Fort Worth, Texas
| | | | | | | | - Claire Sinai
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Karen D Wright
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
| | - Michael Prados
- UCSF Benioff Children's Hospital & University of California San Francisco, San Francisco, California
| | - Pratiti Bandopadhayay
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Broad Institute, Cambridge, Massachusetts
| | - Keith L Ligon
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts
| | - Mark W Kieran
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
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7
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Ahlawat S, Sharma P, Sharma R, Arora R, Verma NK, Brahma B, Mishra P, De S. Evidence of positive selection and concerted evolution in the rapidly evolving PRDM9 zinc finger domain in goats and sheep. Anim Genet 2016; 47:740-751. [PMID: 27621101 DOI: 10.1111/age.12487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 01/20/2023]
Abstract
Meiotic recombination contributes to augmentation of genetic diversity, exclusion of deleterious alleles and proper segregation of chromatids. PRDM9 has been identified as the gene responsible for specifying the location of recombination hotspots during meiosis and is also the only known vertebrate gene associated with reproductive isolation between species. PRDM9 encodes a protein with a highly variable zinc finger (ZF) domain that varies between as well as within species. In the present study, the ZF domain of PRDM9 on chromosome 1 was characterized for the first time in 15 goat breeds and 25 sheep breeds of India. A remarkable variation in the number and sequence of ZF domains was observed. The number of ZF repeats in the ZF array varied from eight to 12 yielding five homozygous and 10 heterozygous genotypes. The number of different ZF domains was 84 and 52 producing 36 and 26 unique alleles in goats and sheep respectively. The posterior mean of dN/dS or omega values were calculated using the codeml tool of pamlx to identify amino acids that are evolving positively in goats and sheep, as positions -1, +3 and +6 in the ZF domain have been reported to experience strong positive selection across different lineages. Our study identified sites -5, -1, +3, +4 and +6 to be experiencing positive selection. Small ruminant zinc fingers were also found to be evolving under concerted evolution. Our results demonstrate the existence of a vast diversity of PRDM9 in goats and sheep, which is in concert with reports in many metazoans.
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Affiliation(s)
- S Ahlawat
- National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India.
| | - P Sharma
- National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India
| | - R Sharma
- National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India
| | - R Arora
- National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India
| | - N K Verma
- National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India
| | - B Brahma
- National Dairy Research Institute, Karnal 132001, Haryana, India
| | - P Mishra
- National Dairy Research Institute, Karnal 132001, Haryana, India
| | - S De
- National Dairy Research Institute, Karnal 132001, Haryana, India
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8
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Chandler WF, Barkan AL, Hollon T, Sakharova A, Sack J, Brahma B, Schteingart DE. Outcome of Transsphenoidal Surgery for Cushing Disease: A Single-Center Experience Over 32 Years. Neurosurgery 2016; 78:216-23. [PMID: 26348007 DOI: 10.1227/neu.0000000000001011] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Transsphenoidal surgery is the standard approach for treating Cushing disease. Evidence is needed to document effectiveness. OBJECTIVE To analyze results of transsphenoidal surgery in 276 consecutive patients, including 19 children. METHODS Medical records were reviewed for patients treated initially with surgery for Cushing disease from 1980 to 2012. Radiographic features, pathology, remissions, recurrences, and complications were recorded. Patients were categorized for statistical analysis based on tumor size (microadenomas, macroadenomas, and negative imaging) and remission type (type 1 = morning cortisol ≤3 μg/dL; type 2 = morning cortisol normal). RESULTS Females comprised 78% of patients and were older than men. Imaging showed 50% microadenomas, 13% macroadenomas, and 37% negative for tumor. Remission rates for microadenomas, macroadenomas, and negative imaging were 89%, 66%, and 71%, respectively. Patients with microadenomas were more likely to have type 1 remission. Pathology showed adrenocorticotropic hormone-secreting adenomas in 82% of microadenomas, in 100% of macroadenomas, and in 43% of negative imaging. The incidence of hyperplasia was 8%. The finding of hyperplasia or no tumor on pathology predicted treatment failure. The recurrence rate was 17%, with an average time to recurrence of 4.0 years. Patients with type 1 remission had a lower rate of recurrence (13% type 1 vs 50% type 2) and a longer time to recurrence. Children had similar imaging findings, remission rates, and pathology. There were no operative deaths. CONCLUSION Transsphenoidal surgery provides a safe and effective treatment for Cushing disease. For both adults and children, the best outcomes occurred in patients with microadenomas and/or those with type 1 remission.
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Affiliation(s)
- William F Chandler
- *Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan; ‡Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan; §Michigan Endocrine Consultants, Berkley, Michigan; ¶Department of Neurosurgery, University of San Diego Health System, San Diego, California; ‖Pediatric Neurosurgery Associates, Children's Healthcare of Atlanta, Atlanta, Georgia
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9
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Ahlawat S, Chopra M, Jaiswal L, Sharma R, Arora R, Brahma B, Lal SV, De S. Exon skipping creates novel splice variants of DMC1 gene in ruminants. Mol Cell Probes 2016; 30:66-73. [PMID: 26945774 DOI: 10.1016/j.mcp.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 03/02/2016] [Accepted: 03/02/2016] [Indexed: 11/26/2022]
Abstract
Disrupted meiotic cDNA1 (DMC1) recombinase plays a pivotal role in homology search and strand exchange reactions during meiotic homologous recombination. In the present study, full length coding sequence of DMC1 gene was sequence characterized for the first time from four ruminant species (cattle, buffalo, sheep and goat) and phylogenetic relationship of ruminant DMC1 with other eukaryotes was analyzed. DMC1 gene encodes a putative protein of 340 amino acids in cattle, sheep and buffalo and 341 amino acids in goat. A high degree of evolutionary conservation at both nucleotide and amino acid level was observed for the four ruminant orthologs. In cattle and sheep, novel alternatively spliced mRNAs with skipping of exons 7 and 8 (Transcript variant 1, TV1) were isolated in addition to the full length (FL) transcript. Novel transcript variants with partial skipping of exon 7 and complete skipping of exon 8 (Transcript variant 2, TV2) were found in sheep and goat. The presence of these variants was validated by amplifying cDNA isolated from testis tissue of ruminants using two oligonucleotides flanking the deleted region. To accurately estimate their relative proportions, real-time PCR was performed using primers specific for each variant. Expression level of DMC1-FL was significantly higher than that of TV1 in cattle and TV2 in goat (P < 0.05). Relative ratio for expression of DMC1-FL: TV1: TV2 in sheep was 6.78: 1.43: 1. In-silico analysis revealed presence of splice variants of DMC1 gene across other mammalian species underpinning the role of alternative splicing in functional innovation.
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Affiliation(s)
- S Ahlawat
- National Bureau of Animal Genetic Resources, Karnal, 132001, India.
| | - M Chopra
- National Dairy Research Institute, Karnal, 132001, India
| | - L Jaiswal
- National Dairy Research Institute, Karnal, 132001, India
| | - R Sharma
- National Bureau of Animal Genetic Resources, Karnal, 132001, India
| | - R Arora
- National Bureau of Animal Genetic Resources, Karnal, 132001, India
| | - B Brahma
- Krishi Vigyan Kendra, Bhaderwah, SKUAST, Jammu, 180016, India
| | - S V Lal
- National Dairy Research Institute, Karnal, 132001, India
| | - S De
- National Dairy Research Institute, Karnal, 132001, India
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10
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Aguilera D, Janss A, Mazewski C, Castellino RC, Schniederjan M, Hayes L, Brahma B, Fogelgren L, MacDonald TJ. Successful Retreatment of a Child with a Refractory Brainstem Ganglioglioma with Vemurafenib. Pediatr Blood Cancer 2016; 63:541-3. [PMID: 26579623 DOI: 10.1002/pbc.25787] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 09/01/2015] [Indexed: 02/05/2023]
Abstract
A child with brainstem ganglioglioma underwent subtotal resection and focal radiation. Magnetic resonance imaging confirmed tumor progression 6 months later. Another partial resection revealed viable BRAF V600E-positive residual tumor. Vemurafenib (660 mg/m(2) /dose) was administered twice daily, resulting in >70% tumor reduction with sustained clinical improvement for 1 year. Vemurafenib was then terminated, but significant tumor progression occurred 3 months later. Vemurafenib was restarted, resulting in partial response. Toxicities included Grade I pruritus and Grade II rash. Vemurafenib was effectively crushed and administered in solution via nasogastric tube. We demonstrate benefit from restarting vemurafenib therapy.
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Affiliation(s)
- Dolly Aguilera
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Anna Janss
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Claire Mazewski
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Robert Craig Castellino
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | | | - Laura Hayes
- Department of Radiology, Children's HealthCare of Atlanta at Scottish Rite, Atlanta, Georgia
| | - Barunashish Brahma
- Department of Neurosurgery, Children's Health Care of Atlanta, Emory University, School of Medicine, Atlanta, Georgia
| | - Lauren Fogelgren
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Tobey J MacDonald
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
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11
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Chern JJ, Sarda S, Howard BM, Jea A, Tubbs RS, Brahma B, Wrubel DM, Reisner A, Boydston W. Utility of surveillance imaging after minor blunt head trauma. J Neurosurg Pediatr 2014; 14:306-10. [PMID: 25014322 DOI: 10.3171/2014.6.peds13682] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Nonoperative blunt head trauma is a common reason for admission in a pediatric hospital. Adverse events, such as growing skull fracture, are rare, and the incidence of such morbidity is not known. As a result, optimal follow-up care is not clear. METHODS Patients admitted after minor blunt head trauma between May 1, 2009, and April 30, 2013, were identified at a single institution. Demographic, socioeconomic, and clinical characteristics were retrieved from administrative and outpatient databases. Clinical events within the 180-day period following discharge were reviewed and analyzed. These events included emergency department (ED) visits, need for surgical procedures, clinic visits, and surveillance imaging utilization. Associations among these clinical events and potential contributing factors were analyzed using appropriate statistical methods. RESULTS There were 937 admissions for minor blunt head trauma in the 4-year period. Patients who required surgical interventions during the index admission were excluded. The average age of the admitted patients was 5.53 years, and the average length of stay was 1.7 days; 15.7% of patients were admitted for concussion symptoms with negative imaging findings, and 26.4% of patients suffered a skull fracture without intracranial injury. Patients presented with subdural, subarachnoid, or intraventricular hemorrhage in 11.6%, 9.19%, and 0.53% of cases, respectively. After discharge, 672 patients returned for at least 1 follow-up clinic visit (71.7%), and surveillance imaging was obtained at the time of the visit in 343 instances. The number of adverse events was small and consisted of 34 ED visits and 3 surgeries. Some of the ED visits could have been prevented with better discharge instructions, but none of the surgery was preventable. Furthermore, the pattern of postinjury surveillance imaging utilization correlated with physician identity but not with injury severity. Because the number of adverse events was small, surveillance imaging could not be shown to positively influence outcomes. CONCLUSIONS Adverse events after nonoperative mild traumatic injury are rare. The routine use of postinjury surveillance imaging remains controversial, but these data suggest that such imaging does not effectively identify those who require operative intervention.
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Affiliation(s)
- Joshua J Chern
- Pediatric Neurosurgery Associates, Children's Healthcare of Atlanta
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Shofty B, Bokstein F, Ram Z, Ben-Sira L, Freedman S, Kesler A, Constantini S, Shofty B, Mauda-Havakuk M, Ben-Bashat D, Dvir R, Pratt LT, Weizman L, Joskowicz L, Tal M, Ravid L, Ben-Sira L, Constantini S, Dodgshun A, Maixner W, Sullivan M, Hansford J, Ma J, Wang B, Toledano H, Muhsinoglu O, Luckman J, Michowiz S, Goldenberg-Cohen N, Schroeder K, Rosenfeld A, Grant G, McLendon R, Cummings T, Becher O, Gururangan S, Aguilera D, Mazewski C, Janss A, Castellino RC, Schniederjan M, Hayes L, Brahma B, MacDonald T, Osugi Y, Kiyotani C, Sakamoto H, Yanagisawa T, Kanno M, Kamimura S, Kosaka Y, Hirado J, Takimoto T, Nakazawa A, Hara J, Hwang E, Mun A, Kilburn L, Chi S, Knipstein J, Oren M, Dvir R, Hardy K, Rood B, Packer R, Kandels D, Schmidt R, Geh M, Breitmoser-Greiner S, Gnekow AK, Bergthold G, Bandopadhayay P, Rich B, Chan J, Santagata S, Hoshida Y, Ramkissoon S, Ramkissoon L, Golub T, Tabak B, Ferrer-Luna R, Weng PY, Stiles C, Grill J, Kieran MW, Ligon KL, Beroukhim R, Fisher MJ, Levin MH, Armstrong GT, Broad JH, Zimmerman R, Bilaniuk LT, Feygin T, Liu GT, Gan HW, Phipps K, Spoudeas HA, Kohorst M, Warad D, Keating G, Childs S, Giannini C, Wetjen N, Rao; AN, Nakamura H, Makino K, Hide T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Rush S, Madden J, Hemenway M, Foreman N, Sie M, den Dunnen WFA, Lourens HJ, Meeuwsen-de Boer TGJ, Scherpen FJG, Kampen KR, Hoving EW, de Bont ESJM, Gnekow AK, Kandels D, Walker DA, Perilongo G, Grill J, Stokland T, Sehested AM, van Schouten AYN, de Paoli A, de Salvo GL, Pache-Leschhorn S, Geh M, Schmidt R, Gnekow AK, Gass D, Rupani K, Tsankova N, Stark E, Anderson R, Feldstein N, Garvin J, Deel M, McLendon R, Becher O, Karajannis M, Wisoff J, Muh C, Schroeder K, Gururangan S, del Bufalo F, Carai A, Macchiaiolo M, Messina R, Cacchione A, Palmiero M, Cambiaso P, Mastronuzzi A, Anderson M, Leary S, Sun Y, Buhrlage S, Pilarz C, Alberta J, Stiles C, Gray N, Mason G, Packer R, Hwang E, Biassoni V, Schiavello E, Bergamaschi L, Chiaravalli S, Spreafico F, Massimino M, Krishnatry R, Kroupnik T, Zhukova N, Mistry M, Zhang C, Bartels U, Huang A, Adamski J, Dirks P, Laperriere N, Silber J, Hawkins C, Bouffet E, Tabori U, Riccardi R, Rizzo D, Chiaretti A, Piccardi M, Dickmann A, Lazzareschi I, Ruggiero A, Guglielmi G, Salerni A, Manni L, Colosimo C, Falsini B, Rosenfeld A, Etzl M, Miller J, Carpenteri D, Kaplan A, Sieow N, Hoe R, Tan AM, Chan MY, Soh SY, Orphanidou-Vlachou E, MacPherson L, English M, Auer D, Jaspan T, Arvanitis T, Grundy R, Peet A, Bandopadhayay P, Bergthold G, Sauer N, Green A, Malkin H, Dabscheck G, Marcus K, Ullrich N, Goumnerova L, Chi S, Beroukhim R, Kieran M, Manley P, Donson A, Kleinschmidt-DeMasters B, Aisner D, Bemis L, Birks D, Mulcahy-Levy J, Smith A, Handler M, Rush S, Foreman N, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, van Eyssen A, Parkes J, Gass D, Dewire M, Chow L, Rose SR, Lawson S, Stevenson C, Jones B, Pai A, Sutton M, Pruitt D, Fouladi M, Hummel T, Cruz O, de Torres C, Sunol M, Morales A, Santiago C, Alamar M, Rebollo M, Mora J, Sauer N, Dodgshun A, Malkin H, Bergthold G, Manley P, Chi S, Ramkissoon S, MacGregor D, Beroukhim R, Kieran M, Sullivan M, Ligon K, Bandopadhayay P, Hansford J, Messina R, De Benedictis A, Carai A, Mastronuzzi A, Rebessi E, Palma P, Procaccini E, Marras CE, Aguilera D, Castellino RC, Janss A, Schniederjan M, McNall R, Kim S, MacDOnald T, Mazewski C, Zhukova N, Pole J, Mistry M, Fried I, Krishnatry R, Stucklin AG, Bartels U, Huang A, Laperriere N, Dirks P, Zelcer S, Sylva M, Johnston D, Scheinemann K, An J, Hawkins C, Nathan P, Greenberg M, Bouffet E, Malkin D, Tabori U, Kiehna E, Da Silva S, Margol A, Robison N, Finlay J, McComb JG, Krieger M, Wong K, Bluml S, Dhall G, Ayyanar K, Moriarty T, Moeller K, Farber D. LOW GRADE GLIOMAS. Neuro Oncol 2014; 16:i60-i70. [PMCID: PMC4046289 DOI: 10.1093/neuonc/nou073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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Classen CF, William D, Linnebacher M, Farhod A, Kedr W, Elsabe B, Fadel S, Van Gool S, De Vleeschouwer S, Koks C, Garg A, Ehrhardt M, Riva M, De Vleeschouwer S, Agostinis P, Graf N, Van Gool S, Yao TW, Yoshida Y, Zhang J, Ozawa T, James D, Nicolaides T, Kebudi R, Cakir FB, Gorgun O, Agaoglu FY, Darendeliler E, Van Gool S, De Vleeschouwer S, Al-Kofide A, Al-Shail E, Khafaga Y, Al-Hindi H, Dababo M, Haq AU, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Vugts D, Hoekstra O, van Dongen G, Kaspers G, Cockle J, Ilett E, Scott K, Bruning-Richardson A, Picton S, Short S, Melcher A, Benesch M, Warmuth-Metz M, von Bueren AO, Hoffmann M, Pietsch T, Kortmann RD, Eyrich M, Graf N, Rutkowski S, Fruhwald MC, Faber J, Kramm C, Porkholm M, Valanne L, Lonnqvist T, Holm S, Lannering B, Riikonen P, Wojcik D, Sehested A, Clausen N, Harila-Saari A, Schomerus E, Thorarinsdottir HK, Lahteenmaki P, Arola M, Thomassen H, Saarinen-Pihkala UM, Kivivuori SM, Buczkowicz P, Hoeman C, Rakopoulos P, Pajovic S, Morrison A, Bouffet E, Bartels U, Becher O, Hawkins C, Gould TWA, Rahman CV, Smith SJ, Barrett DA, Shakesheff KM, Grundy RG, Rahman R, Barua N, Cronin D, Gill S, Lowisl S, Hochart A, Maurage CA, Rocourt N, Vinchon M, Kerdraon O, Escande F, Grill J, Pick VK, Leblond P, Burzynski G, Janicki T, Burzynski S, Marszalek A, Ramani N, Zaky W, Kannan G, Morani A, Sandberg D, Ketonen L, Maher O, Corrales-Medina F, Meador H, Khatua S, Brassesco M, Delsin L, Roberto G, Silva C, Ana L, Rego E, Scrideli C, Umezawa K, Tone L, Kim SJ, Kim CY, Kim IA, Han JH, Choi BS, Ahn HS, Choi HS, Haque F, Rahman R, Layfield R, Grundy R, Gandola L, Pecori E, Biassoni V, Schiavello E, Chiruzzi C, Spreafico F, Modena P, Bach F, Pignoli E, Massimino M, Drogosiewicz M, Dembowska-Baginska B, Jurkiewicz E, Filipek I, Perek-Polnik M, Swieszkowska E, Perek D, Bender S, Jones DT, Warnatz HJ, Hutter B, Zichner T, Gronych J, Korshunov A, Eils R, Korbel JO, Yaspo ML, Lichter P, Pfister SM, Yadavilli S, Becher OJ, Kambhampati M, Packer RJ, Nazarian J, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Vaidya S, Koh DM, Leach MO, Pearson AD, Zacharoulis S, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Schrey D, Barone G, Vaidya S, Koh DM, Pearson AD, Zacharoulis S, Panditharatna E, Stampar M, Siu A, Gordish-Dressman H, Devaney J, Kambhampati M, Hwang EI, Packer RJ, Nazarian J, Chung AH, Mittapalli RK, Elmquist WF, Becher OJ, Castel D, Debily MA, Philippe C, Truffaux N, Taylor K, Calmon R, Boddaert N, Le Dret L, Saulnier P, Lacroix L, Mackay A, Jones C, Puget S, Sainte-Rose C, Blauwblomme T, Varlet P, Grill J, Entz-Werle N, Maugard C, Bougeard G, Nguyen A, Chenard MP, Schneider A, Gaub MP, Tsoli M, Vanniasinghe A, Luk P, Dilda P, Haber M, Hogg P, Ziegler D, Simon S, Tsoli M, Vanniasinghe A, Monje M, Gurova K, Gudkov A, Haber M, Ziegler D, Zapotocky M, Churackova M, Malinova B, Zamecnik J, Kyncl M, Tichy M, Puchmajerova A, Stary J, Sumerauer D, Boult J, Vinci M, Taylor K, Perryman L, Box G, Jury A, Popov S, Ingram W, Monje M, Eccles S, Jones C, Robinson S, Emir S, Demir HA, Bayram C, Cetindag F, Kabacam GB, Fettah A, Boult J, Li J, Vinci M, Jury A, Popov S, Jamin Y, Cummings C, Eccles S, Bamber J, Sinkus R, Jones C, Robinson S, Nandhabalan M, Bjerke L, Vinci M, Burford A, Ingram W, Mackay A, von Bueren A, Baudis M, Clarke P, Collins I, Workman P, Jones C, Taylor K, Mackay A, Vinci M, Popov S, Ingram W, Entz-Werle N, Monje M, Olaciregui N, Mora J, Carcaboso A, Bullock A, Jones C, Vinci M, Mackay A, Burford A, Taylor K, Popov S, Ingram W, Monje M, Alonso M, Olaciregui N, de Torres C, Cruz O, Mora J, Carcaboso A, Jones C, Filipek I, Drogosiewicz M, Perek-Polnik M, Swieszkowska E, Dembowska-Baginska B, Jurkiewicz E, Perek D, Nguyen A, Pencreach E, Mackay A, Moussalieh FM, Guenot D, Namer I, Chenard MP, Jones C, Entz-Werle N, Pollack I, Jakacki R, Butterfield L, Hamilton R, Panigrahy A, Potter D, Connelly A, Dibridge S, Whiteside T, Okada H, Ahsan S, Raabe E, Haffner M, Warren K, Quezado M, Ballester L, Nazarian J, Eberhart C, Rodriguez F, Ramachandran C, Nair S, Quirrin KW, Khatib Z, Escalon E, Melnick S, Classen CF, Hofmann M, Schmid I, Simon T, Maass E, Russo A, Fleischhack G, Becker M, Hauch H, Sander A, Kramm C, Grasso C, Truffaux N, Berlow N, Liu L, Debily MA, Davis L, Huang E, Woo P, Tang Y, Ponnuswami A, Chen S, Huang Y, Hutt-Cabezas M, Warren K, Dret L, Meltzer P, Mao H, Quezado M, van Vuurden D, Abraham J, Fouladi M, Svalina MN, Wang N, Hawkins C, Raabe E, Hulleman E, Li XN, Keller C, Spellman PT, Pal R, Grill J, Monje M, Jansen MHA, Sewing ACP, Lagerweij T, Vuchts DJ, van Vuurden DG, Caretti V, Wesseling P, Kaspers GJL, Hulleman E, Cohen K, Raabe E, Pearl M, Kogiso M, Zhang L, Qi L, Lindsay H, Lin F, Berg S, Li XN, Muscal J, Amayiri N, Tabori U, Campbel B, Bakry D, Aronson M, Durno C, Gallinger S, Malkin D, Qaddumi I, Musharbash A, Swaidan M, Bouffet E, Hawkins C, Al-Hussaini M, Rakopoulos P, Shandilya S, McCully C, Murphy R, Akshintala S, Cole D, Macallister RP, Cruz R, Widemann B, Warren K, Salloum R, Smith A, Glaunert M, Ramkissoon A, Peterson S, Baker S, Chow L, Sandgren J, Pfeifer S, Popova S, Alafuzoff I, de Stahl TD, Pietschmann S, Kerber MJ, Zwiener I, Henke G, Kortmann RD, Muller K, von Bueren A, Sieow NYF, Hoe RHM, Tan AM, Chan MY, Soh SY, Hawkins C, Burrell K, Chornenkyy Y, Remke M, Golbourn B, Buczkowicz P, Barzczyk M, Taylor M, Rutka J, Dirks P, Zadeh G, Agnihotri S, Hashizume R, Ihara Y, Andor N, Chen X, Lerner R, Huang X, Tom M, Solomon D, Mueller S, Petritsch C, Zhang Z, Gupta N, Waldman T, James D, Dujua A, Co J, Hernandez F, Doromal D, Hegde M, Wakefield A, Brawley V, Grada Z, Byrd T, Chow K, Krebs S, Heslop H, Gottschalk S, Yvon E, Ahmed N, Truffaux N, Philippe C, Cornilleau G, Paulsson J, Andreiuolo F, Guerrini-Rousseau L, Puget S, Geoerger B, Vassal G, Ostman A, Grill J, Parsons DW, Lin F, Trevino LR, Gao F, Shen X, Hampton O, Lindsay H, Kosigo M, Qi L, Baxter PA, Su JM, Chintagumpala M, Dauser R, Adesina A, Plon SE, Li XN, Wheeler DA, Lau CC, Pietsch T, Gielen G, Muehlen AZ, Kwiecien R, Wolff J, Kramm C, Lulla RR, Laskowski J, Goldman S, Gopalakrishnan V, Fangusaro J, Mackay A, Taylor K, Vinci M, Jones C, Kieran M, Fontebasso A, Papillon-Cavanagh S, Schwartzentruber J, Nikbakht H, Gerges N, Fiset PO, Bechet D, Faury D, De Jay N, Ramkissoon L, Corcoran A, Jones D, Sturm D, Johann P, Tomita T, Goldman S, Nagib M, Bendel A, Goumnerova L, Bowers DC, Leonard JR, Rubin JB, Alden T, DiPatri A, Browd S, Leary S, Jallo G, Cohen K, Prados MD, Banerjee A, Carret AS, Ellezam B, Crevier L, Klekner A, Bognar L, Hauser P, Garami M, Myseros J, Dong Z, Siegel PM, Gump W, Ayyanar K, Ragheb J, Khatib Z, Krieger M, Kiehna E, Robison N, Harter D, Gardner S, Handler M, Foreman N, Brahma B, MacDonald T, Malkin H, Chi S, Manley P, Bandopadhayay P, Greenspan L, Ligon A, Albrecht S, Pfister SM, Ligon KL, Majewski J, Gupta N, Jabado N, Hoeman C, Cordero F, Halvorson K, Hawkins C, Becher O, Taylor I, Hutt M, Weingart M, Price A, Nazarian J, Eberhart C, Raabe E, Kantar M, Onen S, Kamer S, Turhan T, Kitis O, Ertan Y, Cetingul N, Anacak Y, Akalin T, Ersahin Y, Mason G, Nazarian J, Ho C, Devaney J, Stampar M, Kambhampati M, Crozier F, Vezina G, Packer R, Hwang E, Gilheeney S, Millard N, DeBraganca K, Khakoo Y, Kramer K, Wolden S, Donzelli M, Fischer C, Petriccione M, Dunkel I, Afzal S, Carret AS, Fleming A, Larouche V, Zelcer S, Johnston DL, Kostova M, Mpofu C, Decarie JC, Strother D, Lafay-Cousin L, Eisenstat D, Fryer C, Hukin J, Bartels U, Bouffet E, Hsu M, Lasky J, Moore T, Liau L, Davidson T, Prins R, Fouladi M, Bartels U, Warren K, Hassal T, Baugh J, Kirkendall J, Doughman R, Leach J, Jones B, Miles L, Hawkins C, Bouffet E, Hargrave D, Grill J, Jones C, Jacques T, Savage S, Goldman S, Leary S, Packer R, Saunders D, Wesseling P, Varlet P, van Vuurden D, Wallace R, Flutter B, Morgenestern D, Hargrave D, Blanco E, Howe K, Lowdell M, Samuel E, Michalski A, Anderson J, Arakawa Y, Umeda K, Watanabe KI, Mizowaki T, Hiraoka M, Hiramatsu H, Adachi S, Kunieda T, Takagi Y, Miyamoto S, Venneti S, Santi M, Felicella MM, Sullivan LM, Dolgalev I, Martinez D, Perry A, Lewis PW, Allis DC, Thompson CB, Judkins AR. HIGH GRADE GLIOMAS AND DIPG. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jain A, Betancur M, Patel GD, Valmikinathan CM, Mukhatyar VJ, Vakharia A, Pai SB, Brahma B, MacDonald TJ, Bellamkonda RV. Guiding intracortical brain tumour cells to an extracortical cytotoxic hydrogel using aligned polymeric nanofibres. Nat Mater 2014; 13:308-16. [PMID: 24531400 DOI: 10.1038/nmat3878] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 01/02/2014] [Indexed: 05/19/2023]
Abstract
Glioblastoma multiforme is an aggressive, invasive brain tumour with a poor survival rate. Available treatments are ineffective and some tumours remain inoperable because of their size or location. The tumours are known to invade and migrate along white matter tracts and blood vessels. Here, we exploit this characteristic of glioblastoma multiforme by engineering aligned polycaprolactone (PCL)-based nanofibres for tumour cells to invade and, hence, guide cells away from the primary tumour site to an extracortical location. This extracortial sink is a cyclopamine drug-conjugated, collagen-based hydrogel. When aligned PCL-nanofibre films in a PCL/polyurethane carrier conduit were inserted in the vicinity of an intracortical human U87MG glioblastoma xenograft, a significant number of human glioblastoma cells migrated along the aligned nanofibre films and underwent apoptosis in the extracortical hydrogel. Tumour volume in the brain was significantly lower following insertion of aligned nanofibre implants compared with the application of smooth fibres or no implants.
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Affiliation(s)
- Anjana Jain
- 1] Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA [2]
| | - Martha Betancur
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - Gaurangkumar D Patel
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - Chandra M Valmikinathan
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - Vivek J Mukhatyar
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - Ajit Vakharia
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - S Balakrishna Pai
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
| | - Barunashish Brahma
- Department of Neurosurgery Children's Health Care of Atlanta Georgia 30342 USA
| | - Tobey J MacDonald
- Department of Pediatrics, Aflac Cancer And Blood Disorders Center Emory University School of Medicine Atlanta, Georgia 30322 USA
| | - Ravi V Bellamkonda
- Neurological Biomaterials and Cancer Therapeutics Laboratory, Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology/Emory University School of Medicine, 313 Ferst Drive, Atlanta Georgia 30332 USA
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Wrubel DM, Riemenschneider KJ, Braender C, Miller BA, Hirsh DA, Reisner A, Boydston W, Brahma B, Chern JJ. Return to system within 30 days of pediatric neurosurgery. J Neurosurg Pediatr 2014; 13:216-21. [PMID: 24286158 DOI: 10.3171/2013.10.peds13248] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Quality assessment measures have not been well developed for pediatric neurosurgical patients. This report documents the authors' experience in extracting information from an administrative database to establish the rate of return to system within 30 days of pediatric neurosurgical procedures. METHODS Demographic, socioeconomic, and clinical characteristics were prospectively collected in administrative, business, and operating room databases. The primary end point was an unexpected return to the hospital system within 30 days from the date of a pediatric neurosurgical procedure. Statistical methods were used to identify clinical and demographic factors associated with the primary end point. RESULTS There were 1358 pediatric neurosurgical procedures performed in the Children's Healthcare of Atlanta operating rooms in 2012, with 37.4% of these surgeries being preceded by admissions through the emergency department. Medicare or Medicaid was the payor for 54.9% of surgeries, and 37.6% of surgeries were shunt related. There were 148 unexpected returns to the system within 30 days after surgery, and in 109 of these cases, the patient had a presenting complaint that was attributable to the index surgery (related returns). The most common complaints were headache, nausea, vomiting, or seizure after shunt revision or cranial procedures (n = 62). The next most common reason for re-presentation was for wound concerns (n = 30). Thirty-seven of the 109 related returns resulted in a reoperation. The monthly rate of related returns was 8.1% ± 2.5% over the 12-month study period. When using related returns as the dependent variable, the authors found that patients who underwent a shunt-related surgery were both more likely to unexpectedly return to the system (OR 1.86, p = 0.008) and to require surgery upon readmission (OR 3.28, p = 0.004). Because an extended hospitalization shortened the window of time for readmission after surgery, extended length of stay was protective against return to system within 30 days of surgery. Importantly, if related and unrelated returns were analyzed together as the dependent variable (n = 148), no independent clinical and demographic risk factor could be identified. CONCLUSIONS Quality assessment measures need to be clearly and carefully defined, as the definition itself will impact the analytical results. Clinicians must play a leading role in the development of these measures to ensure their clinical meaningfulness.
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Abstract
OBJECT The authors describe the use of inside-outside occipital screws in 21 children with occipitocervical instability requiring occipitocervical fusion. METHODS The ages of the patients were from 2 to 15 years, and patients presented with a variety of causes of occipitocervical instability, including congenital disorders, posttraumatic instability, idiopathic degeneration, and postoperative instability. Surgeries frequently included foramen magnum decompression, duraplasty, and laminectomy, but all patients required occipitocervical instrumentation and arthrodesis. Postoperative orthosis included the use of either a cervical collar or halo device. In all but one case, patients were followed postoperatively for at least 12 months. RESULTS The mean age of patients was 9.93 years. Inside-outside screws were used in all reported cases. Rib autograft was used in all patients. In addition, demineralized bone matrix was used in 2 cases, and bone morphogenetic protein was used in 2 patients. Two patients required halo placement, and the other 19 were placed in cervical collars. The average time postoperative orthotics were used was 2.82 months. Arthrodesis was determined radiographically and was noted in all patients. No operative complications were noted; however, postoperative complications included 1 wound infection, 2 cases of hardware loosening, and the need for tracheostomy in 2 patients. CONCLUSIONS Inside-outside screws were found to be a useful component of occipitocervical instrumentation in pediatric patients ranging from 2 to 15 years of age. Arthrodesis was demonstrated in all cases.
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Brahma B, Yulian E, Ramli M, Setianingsih I, Gautama W, Brahma P, Sastroasmoro S, Harimurti K. 44. Surgical perspective of T1799a BRAF mutation diagnostic value in papillary thyroid carcinoma. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Shi Z, Esiashvili N, Janss AJ, Mazewski CM, MacDonald TJ, Wrubel DM, Brahma B, Schwaibold FP, Marcus RB, Crocker IR, Shu HKG. Transient enlargement of craniopharyngioma after radiation therapy: pattern of magnetic resonance imaging response following radiation. J Neurooncol 2012; 109:349-55. [PMID: 22692563 DOI: 10.1007/s11060-012-0900-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/07/2012] [Indexed: 11/25/2022]
Abstract
Clinical experience suggests that craniopharyngiomas may temporarily increase in size after radiation therapy (RT). The study goal is to determine the incidence and natural history of this response in a cohort of patients managed at Children's Healthcare of Atlanta (CHOA) or Emory Healthcare (EHC). Between 08/1998 and 06/2009, 41 children and young adults were diagnosed with craniopharyngioma at CHOA and/or EHC. Of these, 21 received external-beam radiation and were included in our analysis. Serial magnetic resonance imaging (MRI) studies were evaluated volumetrically to assess response to RT. Median age at diagnosis was 8.2 years (range 3.2-23.5 years). Median radiation dose was 54.0 Gy using standard fractionation (1.8-2.0 Gy/day). With median follow-up of 41.3 months (range 7.2-121.8 months), actuarial local control and overall survival rates at 5 years were 78.7 % and 100 %, respectively. Of subjects, 52.4 % of subjects (11 of 21) were noted on serial MRI evaluation to have tumor enlargement (mostly cystic component) after radiation before eventual shrinkage without further intervention. For tumors that expanded, the median volume increase was 33.9 % (range 15.6-224.4 %). Median time to maximal tumor/cyst expansion was 1.5 months (range 1.0-5.0 months). Finally, nearly all patients (20 of 21) showed a measurable objective response to therapy by MRI regardless of ultimate disease control. Median time to maximal response post-radiation, as defined by MRI, was 9.5 months (range 3.5-39.9 months). In summary, RT is effective for managing craniopharyngioma. However, despite good ultimate responses, approximately 50 % of the patients show tumor/cyst expansion on MRI over the first few months post-radiation. Caution should be taken not to subject these patients to "salvage surgery" or cyst aspiration during this early time unless there are other overriding surgical indications. Understanding the natural history of this phenomenon could potentially help guide the management of these craniopharyngioma patients.
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Affiliation(s)
- Zheng Shi
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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Roy B, Brahma B, Ghosh S, Pankaj P, Mandal G. Evaluation of Milk Urea Concentration as Useful Indicator for Dairy Herd Management: A Review. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/ajava.2011.1.19] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Direct trauma, compression caused by muscle hypertrophy or other soft tissue changes, or excessive stretching of a peripheral nerve in the upper extremity may lead to uncommon-but potentially serious-complications. Clinicians are seeing more of these injuries as weight training, power lifting, bodybuilding, cross-training, and general physical conditioning with weights become more popular. Symptoms of pain, weakness, paresthesia, or palsy; physical exam findings; electromyography; and nerve conduction studies are used to make the diagnosis. Most conditions respond well to conservative measures, such as rest from the offending exercise and correction of poor technique, but surgery may be required for complete clinical resolution in severe cases.
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Affiliation(s)
- Keith R Lodhia
- Department of Neurosurgery, University of Michigan Health Center, Ann Arbor, MI, 48109-0338, USA.
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Rath TJ, Sundgren PC, Brahma B, Lieberman AP, Chandler WF, Gebarski SS. Massive symptomatic subependymoma of the lateral ventricles: case report and review of the literature. Neuroradiology 2005; 47:183-8. [PMID: 15702322 DOI: 10.1007/s00234-005-1342-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Accepted: 12/14/2004] [Indexed: 10/25/2022]
Abstract
Subependymomas are benign intraventricular tumors with an indolent growth pattern, which are usually asymptomatic, and most commonly occur in the fourth and lateral ventricles. When symptomatic, subependymomas often obstruct critical portions of the cerebrospinal fluid (CSF) pathway, causing hydrocephalus, and range from 3 cm to 5 cm in size. We report a case of an unusually massive subependymoma of the lateral ventricles treated with subtotal resection, ventriculoperitoneal shunt, and post-surgical radiation. The clinical course, radiographic and pathologic characteristics of this massive intraventricular subependymoma are discussed, as well as the differential diagnosis of lateral ventricular masses and a review of the literature concerning subependymomas.
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Affiliation(s)
- T J Rath
- Department of Radiology, University of Michigan Health Systems, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0030, USA
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Abstract
Ascorbate is an essential antioxidant in the CNS, localized predominantly in neuronal cytosol. Slices of mammalian brain rapidly lose ascorbate, however, when incubated in ascorbate-free media; brain slices also take up water and swell. Here we investigated water gain in coronal slices of rat forebrain incubated with and without ascorbate for 1-3 h at 34 degrees C. Slices progressively gained water in ascorbate-free media, with a significant 12% water increase after 3 h at 34 degrees C, compared with the water content of slices after a 1-h recovery period at 24 degrees C, immediately following slice preparation. Inclusion of 400 micro M ascorbate in the medium led to an increase in tissue ascorbate content and prevented water gain at 34 degrees C. By contrast, water gain was not inhibited by isoascorbate or thiourea, which are antioxidants that are not accumulated in brain cells. The oxidant H2O2 enhanced water gain, whereas a cocktail of NMDA and non-NMDA receptor blockers inhibited edema formation to the same extent as ascorbate. These data demonstrate that brain edema, linked to glutamate-receptor activation, can result from intracellular oxidative stress and that this can be prevented by ascorbate.
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Affiliation(s)
- B Brahma
- Department of Physiology, New York University School of Medicine, New York 10016, USA
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Brahma B, Singh M. The man behind the name: Ernest William Hey Groves 1872-1944. NATNEWS 1982; 19:26. [PMID: 7048104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Brahma B, Singh M, James W, Horace C. The man behind the name: Dr. William Worral Mayo - b. 1819, Dr William James 1861-1939, Dr Charles Horace 1865-1939. NATNEWS 1982; 19:11. [PMID: 7040978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Brahma B, Singh M. The man behind the name: Eugene Louis Doyen 1859 - 1916. NATNEWS 1981; 18:14. [PMID: 7035957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Brahma B, Singh M. The man behind the name. James Syme, 1799-1870. NATNEWS 1981; 18:42. [PMID: 7029302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Brahma B, Singh M. What lies behind a name? (Sir Thomas Spencer Wells 1818-1897). NATNEWS 1981; 18:15. [PMID: 7022220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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