It is often difficult to find an adenoma in patients with Cushing's disease (CD) whose preoperative magnetic resonance imaging (MRI) normal. Better localizing modalities are needed.The aim of this study was determine the accuracy inferior petrosal sinus sampling (IPSS) predicting lateralization.We conducted a prospective observational at tertiary care clinical research center.A total 501 consecutive (363 female) confirmed ACTH adenomas and IPSS were included.We measured predict intrasellar...

Factors influencing the outcome of surgical treatment pediatric Cushing's disease (CD) have not been fully established. The aim this study was to examine features surgery for CD. In prospective observational study, clinical, imaging, endocrinological, and operative outcomes were analyzed in consecutive patients treated at National Institutes Health (NIH) from 1982 through 2010. conducted a tertiary referral center. Two hundred CD (106 females, 94 males) included. Mean age symptom development...

Vestibular schwannoma surgery has evolved as new therapeutic options have emerged, patients' expectations risen, and the psychological effect of facial nerve paralysis been studied. For large vestibular schwannomas for which extirpation is primary therapy, goals remain complete tumor resection maintenance normal neurological function. Improved microsurgical techniques intraoperative monitoring decreased complication rate increased likelihood to near-normal postoperative Nevertheless,...

Dural invasion by adrenocorticotropic hormone (ACTH)-secreting adenomas is a significant risk factor for incomplete resection and recurrence in Cushing disease (CD). Since ACTH-producing are often the smallest of various types pituitary tumors at time resection, examining their provides best opportunity to identify precise sites early dural adenomas. To characterize incidence anatomical distribution ACTH-secreting adenomas, authors prospectively systematically analyzed features patients with...

Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome of these tumors, authors analyzed long-term results who underwent resection brainstem hemangioblastomas. Methods Consecutive VHL disease a follow-up 12 months or more were included this study. Serial functional assessments, radiographic examinations,...

The history of psychosurgery is described and analyzed. This historical perspective largely begins with analysis the work Egas Moniz in development leukotomy, follows rise fall its popularity 1900s. reemergence psychosurgical procedures new therapeutic technologies such as vagus nerve stimulation deep brain are discussed. In addition, an introduction to field neuroethics provided, given importance any discussion about surgical therapy for psychiatric patients.

The authors present the case of a 3-month-old boy with third ventricular tumor consistent choroid plexus papilloma. This child presented macrocephaly, irritability, inability to roll over, and vomiting. He was found have an enlarged head circumference, full tense fontanel, splayed sutures, forced downward gaze. Imaging revealed severe ventriculomegaly brightly enhancing lesion Treatment planning included placement ventriculoperitoneal shunt treat hydrocephalus allow grow prior resection. Due...

While autologous bone grafts remain the gold standard for spinal fusion procedures, harvesting is associated with significant complications, including donor site infection, hematomas, increased operative time, and prolonged pain. Cellular allograft (CBA) presents an alternative to harvesting, a favorable efficacy safety profile. The current study further investigates CBA as adjunct lumbar procedures.A prospective, multicenter, open-label clinical was conducted in subjects undergoing...

The object of this study was to demonstrate that a posterior-only approach for craniocervical junction pathology is feasible with intraoperative reduction. authors reviewed 3 cases instability. All patients had instability according radiological imaging and various methods measurement, results outside the normal range. Posterior instrumentation aided reduction techniques while maintaining structural integrity desired fusion construct. No anterior necessary in any patients. Neurological...

A new version of the single-reference-extended kinetic method is presented in which direct entropy correction incorporated. Results calibration experiments with monodentate base pyridine and bidentate ethylenediamine are for provides proton affinities excellent agreement published values reasonable predictions protonation entropies. The then used to determine affinity non-protein amino acid beta-oxalylaminoalanine (BOAA). PA BOAA found be 933.1 +/- 7.8 kJ/mol a prediction -39 J mol(-1) K(-1)...

Mounting evidence demonstrates a promising safety and efficacy profile for spinal fusion procedures using cellular bone allograft (CBA). However, limited data exists on outcomes stratified by surgical approach. The current study investigates the effectiveness of CBA in lumbar approach (ie, anterior, lateral, posterior approaches).

The energetics of cis−trans proline isomerization in small peptide models have been investigated using the hybrid density functional theory method B3LYP with a 6-31+G* basis set. molecules studied are for phospho-Ser/Thr-Pro substrate Pin-1, peptidyl-prolyl isomerase (PPIase) involved cell division. Pin-1 requires phosphorylation Ser or Thr residue adjacent to Pro and catalyzes about amide bond. dihedral angle that would correspond reaction coordinate ω bond was several models. Relaxed...

Pleomorphic xanthoastrocytomas are glial-based tumors that arise most frequently in young patients and usually follow a more benign indolent clinical course than their other tumor counterparts. These present with seizures, only 3 previous case reports exist of hemorrhagic as the presentation. The authors first life-threatening intracerebral hemorrhage from pleomorphic xanthoastrocytoma child.

Object No extant literature documents the analysis of patient perceptions hearing as a corollary to objective audiometric measures in patients with vestibular schwannoma (VS), or acoustic neuroma. Therefore, using data and function outlined on questionnaire, authors evaluated who underwent VS resection. Methods This investigation involved retrospective review 176 had undergone resections which preservation was goal. Both pre- postoperative audiometry, expressed speech discrimination score...

Accurately localizing a spine level in the thoracic is often not easily achieved with existing imaging modalities available operating room. The coordination of preoperative pathology intraoperative even more difficult patients challenging anatomy. Using standard percutaneous techniques, authors placed radiopaque embolization coil into pedicle interest under biplanar fluoroscopy 1 patient. Thoracic MRI along scout was then performed to confirm marker placement relation actual prior surgical...

Lumbar spinal fusion surgeries are increasing steadily due to an aging and ever-growing population. Patients undergoing lumbar surgery may present with risk factors that contribute complications, pseudarthrosis, prolonged pain, reduced quality of life. Pulsed electromagnetic field (PEMF) stimulation represents adjunct noninvasive treatment intervention has been shown improve successful patient outcomes following surgery.A prospective, multicenter study investigated PEMF as therapy procedures...

Autologous bone grafts are the gold standard for spinal fusion; however, harvesting autologous can result in donor site infection, hematomas, increased operative time, and prolonged pain. Cellular allografts (CBAs) a viable alternative that avoids need may increase fusion success alone or when used as an adjunct material. The present study examined efficacy safety of CBA graft material to lumbar arthrodesis.A prospective, single-arm, multicenter clinical trial (NCT02969616) was conducted...