Comparison of Reoperation after Fusion and after Decompression for Degenerative Lumbar Spinal Stenosis: A Single-Center Experience of 987 Cases.

Background And Study Aim:  Reoperation for lumbar spinal stenosis (LSS) is technically challenging. Studies comparing preoperative risk factors and reoperation outcomes between spinal fusion and spinal decompression are limited. Thus this study compared fusion and decompression with respect to reoperation rates, preoperative factors related to re-surgery, and clinical outcomes.

Safety and completeness of using indocyanine green videoangiography combined with digital subtraction angiography for aneurysm surgery in a hybrid operating theater.

This study aimed to evaluate the safety and completeness of using intraoperative indocyanine green videoangiography (ICGV) combined with intraoperative angiography (IOA) for aneurysm clipping in a hybrid operating room (hOR). All patients who underwent microsurgical clipping in the hOR were identified from prospectively maintained neurosurgical databases. Medical charts and operative videos with ICGV and IOA were reviewed to determine the adequacy of clipping, and clinical and angiographic outcomes were retrospectively analyzed.

Endovascular Coiling for a Wide-neck Bifurcated Aneurysm with Anterograde Horizontal Stenting via Microcatheter Looping: A Technical Case Report.

Technical advances with devices such as catheters, balloons, and stents have widened the indications for endovascular coiling for unfavorable aneurysms. The authors report two cases of coil embolization for a wide-neck bifurcated aneurysm with anterograde horizontal stenting via microcatheter looping. Two women, aged 56 and 38 years, respectively, had an undertall- and overwide-neck aneurysm with bifurcated branches at the basilar bifurcation and middle cerebral bifurcation, respectively.

Transcervical access via direct neck exposure for neurointerventional procedures in the hybrid angiosuite.

Purpose: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice.

Methods: From January 2014 to March 2017, this approach was used in 17 of 453 (3.

Magnetic Resonance Imaging Patterns of Post-Operative Spinal Infection: Relationship between the Clinical Onset of Infection and the Infection Site.

Objective: To investigate the magnetic resonance imaging (MRI) findings and the patterns of postoperative spinal infection according to the passage of time.

Methods: Institutional review board approval was obtained, and informed consent was not obtained for the retrospective review of patients' medical records. A total of 43 patients (27 men and 16 women; mean age, 64) diagnosed with postoperative spinal infection were included in this study.

Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review.

Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions.

Surgical Treatment for Falcotentorial Meningiomas.

Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience.

Biomechanical Comparisons of Pull Out Strengths After Pedicle Screw Augmentation with Hydroxyapatite, Calcium Phosphate, or Polymethylmethacrylate in the Cadaveric Spine.

Objective: In vertebrae with low bone mineral densities pull out strength is often poor, thus various substances have been used to fill screw holes before screw placement for corrective spine surgery. We performed biomechanical cadaveric studies to compare nonaugmented pedicle screws versus hydroxyapatite, calcium phosphate, or polymethylmethacrylate augmented pedicle screws for screw tightening torques and pull out strengths in spine procedures requiring bone screw insertion.

Methods: Seven human cadaveric T10-L1 spines with 28 vertebral bodies were examined by x-ray to exclude bony abnormalities.

The use of magnetic resonance imaging in predicting the clinical outcome of spinal arteriovenous fistula.

Purpose: Magnetic resonance imaging (MRI) has been used to screen and follow-up spinal dural arteriovenous fistulae (SDAVF). The purpose of this study was to evaluate the association between MRI findings and neurologic function in SDAVF. This study also investigated clinical features and treatment results of SDAVF.

Cryptococcal brainstem abscess mimicking brain tumors in an immunocompetent patient.

Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare.

Comparative characterization of direct and indirect substrate probes for on-chip transamidating activity assay of transglutaminases.

The development of molecular probes is a prerequisite for activity-based protein profiling. This strategy helps in characterizing the catalytic activity and function of proteins, and how these proteins and protein complexes control biological processes of interest. These probes are composed of a reactive functional group and a reporter tag.

Quantitative kinetics of proteolytic enzymes determined by a surface concentration-based assay using peptide arrays.

Peptide arrays have emerged as a key technology for drug discovery, diagnosis, and cell biology. Despite the promise of these arrays, applications of peptide arrays to quantitative analysis of enzyme kinetics have been limited due to the difficulty in obtaining quantitative information of enzymatic reaction products. In this study, we developed a new approach for the quantitative kinetics analysis of proteases using fluorescence-conjugated peptide arrays, a surface concentration-based assay with solid-phase peptide standards using dry-off measurements, and compared it with an applied concentration-based assay.

Endovascular treatment of iatrogenic intracranial pseudoaneurysm following stent angioplasty.

Intracranial pseudoaneurysm (IPA) is a rare disease entity associated with blunt trauma or penetration injury and less likely surgical or endovascular procedure. Decision of the therapeutic option is difficult and challenging in the treatment of iatrogenic pseudoaneurysm from the middle cerebral artery (MCA) that is necessary to maintain. We report our experience of reconstructive treatment of iatrogenic IPA, which was developed after stenting and balloon angioplasty, in the left MCA with overlapping Enterprise stents.

Characteristics and management of residual or slowly recurred intracranial aneurysms.

Objective: Residual aneurysm from incomplete clipping or slowly recurrent aneurysm is associated with high risk of subarachnoid hemorrhage. We describe complete treatment of the lesions by surgical clipping or endovascular treatment.

Methods: We analyzed 11 patients of residual or recurrent aneurysms who had undergone surgical clipping from 1998 to 2009.

A biomechanical study of the instrumented and adjacent lumbar levels after In-Space interspinous spacer insertion.

Object: Interspinous process implants are becoming more common for the treatment of lumber disc degeneration. The authors undertook this study to evaluate the effect of the In-Space interspinous spacer on the biomechanics of the lumbosacral spine.

Methods: Seven L2-S1 cadaver spines were physiologically loaded in extension, flexion, lateral bending, and axial rotation modes.

Novel small molecule activators of beta-catenin-mediated signaling pathway: structure-activity relationships of indirubins.

Based on the beta-catenin-drived Wnt activator of bromoindirubin-3'-oxime (BIO), indirubin analogs were evaluated for beta-catenin-mediated gene expression. A novel indirubin analog, indirubin-5-nitro-3'-oxime (INO), was considered a potential activator, and structure-activity studies were conducted with indirubins. These data suggest that INO might be a novel Wnt activator and has a potential of signaling regulator in beta-catenin-mediated signaling pathways.

Suppression of inducible nitric oxide synthase by (-)-isoeleutherin from the bulbs of Eleutherine americana through the regulation of NF-kappaB activity.

Eleutherine americana Merr. et Heyne (Iridaceae) has been used as a folk medicine for the treatment of coronary disorders and wound-healing. In our previous phytochemical study, several pyranonaphthoquinoids, including (-)-isoeleutherin, were isolated from the bulbs of E.

Biomechanical evaluation of an interspinous stabilizing device, Locker.

Study Design: A biomechanical study.

Objective: To evaluate the biomechanical properties of a novel dynamic interspinous device named Locke

Summary Of Background Data: There has been no biomechanical study on this device.

Methods: Five human cadaveric lumbar spine specimens (L2-S1) were tested in the following sequence: (1) intact state; (2) after removal of the interspinous ligaments of L3-L4; (3) after application of the Locker at the interspinous space; (4) after destabilization of the L3-L4 motion segments; and (5) after reapplication of the Locker to the destabilized segments.

Valve pressure upgrade may produce progressive deterioration of vision in children with slit ventricle syndrome.

Recently, valve upgrade and/or endoscopic third ventriculostomy, which have the merit of no additional shunting, were introduced for the treatment of slit ventricle syndrome, because lumboperitoneal shunting entails various complications including development of Chiari malformation, shunt malfunction, and infection. However, the safety of valve upgrading is not confirmed, especially in a child with slit ventricle syndrome developed as a result of pseudotumor cerebri. A 5-year-old boy with pseudotumor cerebri presented with headache, intermittent vomiting, and sudden deterioration of visual acuity.

Infantile lumbosacral spinal subdural abscess with sacral dermal sinus tract.

Study Design: Clinical case report of a spinal subdural abscess in an infant presenting with sacral dermal sinus tract (DST).

Objectives: To suggest that sacral DST with caudal direction may require surgical resection as early as possible.

Summary Of Background Data: DST may induce the formation of a spinal abscess.

A large arachnoid cyst of the lateral ventricle extending from the supracerebellar cistern--case report.

Background: The pathogenetic mechanism of intraventricular arachnoid cyst development is still controversial, but is believed to originate from the vascular mesenchyme or as an extension of the arachnoid cyst in the subarachnoid space into the ventricle through the choroidal fissure. We report a case supporting the extension hypothesis and suggest differential points between an intraventricular arachnoid cyst that extended from the supracerebellar space and a lateral ventricular diverticulum that extended into the supracerebellar cistern.

Case Description: A 12-month-old girl presented with macrocephaly and developmental delay.

A case of Sotos syndrome with subduroperitoneal shunt.

The authors present a case of Sotos syndrome with increasing severity of subdural hygroma from the age of 5 months, which was managed with a subduroperitoneal shunt at 10 months of age. The patient had been followed up until 30 months of age with continuing improvement of symptoms. The patient initially presented with dolichocephaly accompanied by macrocrania, early tooth development, repeated pneumonia infections and developmental retardation concerning crawling, sitting, walking and speaking at 5 months of age.

Helmetlike skull deformity with a large arachnoid cyst.

Background: It is not difficult to find localized skull ballooning or macrocrania in patients with intracranial arachnoid cysts. However, there have been no previous reports regarding large localized skull protuberant deformities resembling a war helmet. The authors report with a review of literature a case of an adult with helmetlike skull deformity resulting from a large supratentorial arachnoid cyst.

Successful reduction for a pediatric chronic atlantoaxial rotatory fixation (Grisel syndrome) with long-term halter traction: case report.

Study Design: Clinical case report of atlantoaxial rotatory fixation (AARF) in a girl presenting with torticollis and neck pain.

Objective: To report this rare case that was successfully treated with long-term traction and a brace.

Summary Of Background Data: AARF is a rare kind of subluxation that is a pathologic fixation of the atlas on the axis.