Remodeling of Metastatic Vasculature Reduces Lung Colonization and Sensitizes Overt Metastases to Immunotherapy.

Due to limited current therapies, metastases are the primary cause of mortality in cancer patients. Here, we employ a fusion compound of the cytokine LIGHT and a vascular targeting peptide (LIGHT-VTP) that homes to angiogenic blood vessels in primary tumors. We show in primary mouse lung cancer that normalization of tumor vasculature by LIGHT-VTP prevents cancer cell intravasation.

Classification of foot drop gait characteristic due to lumbar radiculopathy using machine learning algorithms.

Background: Recently, the study of walking gait has received significant attention due to the importance of identifying disorders relating to gait patterns. Characterisation and classification of different common gait disorders such as foot drop in an effective and accurate manner can lead to improved diagnosis, prognosis assessment, and treatment. However, currently visual inspection is the main clinical method to evaluate gait disorders, which is reliant on the subjectivity of the observer, leading to inaccuracies.

Validation of foot pitch angle estimation using inertial measurement unit against marker-based optical 3D motion capture system.

Gait analysis is relevant to a broad range of clinical applications in areas of orthopedics, neurosurgery, rehabilitation and the sports medicine. There are various methods available for capturing and analyzing the gait cycle. Most of gait analysis methods are computationally expensive and difficult to implement outside the laboratory environment.

The application of inertial measurements unit for the clinical evaluation and assessment of gait events.

Foot drop is one of the common gait abnormalities which are difficult to detect, diagnose and evaluate. While various gait monitoring systems are available, many are computationally expensive and difficult to implement outside laboratory environments. This study introduces an in-house designed system based on inertial measurement units to capture the gait symptoms, specifically in the case of foot drop symptoms.

Clinical, radiological, and microbiological profile of patients with autogenous cranioplasty infections.

Objective: Bone flap infections after autogenous cranioplasty can present a diagnostic and management challenge. Little is known about the clinical, radiological, and microbiological profile of these patients.

Methods: Patients who developed bone flap infective complications requiring explantation after autogenous cranioplasties between 1999 and 2009 were identified.

Microbial contamination assessment of cryostored autogenous cranial bone flaps: should bone biopsies or swabs be performed?

Background: Autogenous cranioplasty infection requiring bone flap removal is under-recognised as a major complication causing significant morbidity. Microbial contamination of stored bone flaps may be a significant contributing factor. Current infection control practices and storage procedures vary.

Autogenous skull flaps stored frozen for more than 6 months: do they remain viable?

Autogenous cranioplasties with cryopreserved skull flaps are associated with disproportionately high infection and bone resorption rates. Bone flap non-viability may be a contributing factor. Viable osteoblasts have been cultured recently from cryopreserved long bones.

Bone flap storage following craniectomy: a survey of practices in major Australian neurosurgical centres.

Introduction: The resurgence of decompressive craniectomy surgeries for management of intracranial hypertension has led to a parallel increase in cranioplasty procedures for subsequent reconstruction of the resultant extensive skull defects. Most commonly, cranioplasties are performed using the patients' own cryopreserved skull flaps. Currently, there are no standardized guidelines for freeze-storage of bone flaps either nationally or internationally.

A rare anatomical variation of the C7 pedicle and intraspinal course of the C7 nerve root.

We report a 58 year old man who presented with severe C7 radiculopathy which failed to respond to conservative measures. Subsequent CT and MR imaging of his cervical spine demonstrated C6/7 foraminal stenosis as well as unusual low take-off of the C7 nerve root in relation to a congenital low-set C7 pedicle, findings which were subsequently confirmed intra-operatively. The relevance of the bony and neural anatomy is described and its implications for surgical management are discussed.

Clinical accuracy of cervicothoracic pedicle screw placement: a comparison of the "open" lamino-foraminotomy and computer-assisted techniques.

Objective: Posterior transpedicular fixation at the cervicothoracic junction (CTJ) is increasing in popularity. However, the clinical accuracy of pedicle screw placement at the CTJ has not been specifically assessed.

Methods: Between January 2000 and July 2004, 60 consecutive patients underwent a variety of posterior spinal procedures necessitating pedicle screw placement at C7, T1, and T2.

Multimodality intraoperative neurophysiologic monitoring findings during surgery for adult tethered cord syndrome: analysis of a series of 44 patients with long-term follow-up.

Study Design: Prospective analysis of a consecutive series in which multimodality intraoperative neurophysiologic monitoring was used as an adjunct to microneurosurgery for adult tethered cord syndrome. The results of multimodality intraoperative neurophysiologic monitoring were compared with the "gold standard" (neurologic outcomes).

Objective: To assess the sensitivity, specificity, and positive and negative predictive values of multimodality intraoperative neurophysiologic monitoring in surgery for adult tethered cord syndrome.

Surgical management of tethered cord syndrome in adults: indications, techniques, and long-term outcomes in 60 patients.

Object: The adult presentation of tethered cord syndrome (TCS) is well recognized but continues to pose significant diagnostic and management challenges. The authors performed a retrospective study of clinical outcomes after neurosurgical intervention in 60 adults with TCS.

Methods: All patients who underwent detethering surgery for caudal cord tethering at Toronto Western Hospital between August 1993 and 2004 were identified.

Multi-modality neurophysiological monitoring during surgery for adult tethered cord syndrome.

During complex microneurosurgery performed in patients with tethered cord syndrome, the conus medullaris and the roots that innervate the lower limbs, bladder and bowel are potentially exposed to damage. The aim of multimodality intraoperative monitoring (IOM) is to reduce the risk of inadvertent injury of neural tissue. We simultaneously record tibial nerve somatosensory evoked potentials (SSEPs) from the scalp and free run electromyography (EMG) of limb muscles supplied by L2 to S2 roots, anal and urethral sphincters.

Image-guided transsacral approach to presacral lesions of nerve root origin: technical note.

Objective And Importance: The utility of image guidance in fashioning a posterior transsacral operative corridor for approaching small presacral neural lesions has not previously been reported.

Clinical Presentation: A 61-year-old woman presented with unilateral sciatica and worsening leg weakness. Subsequent investigations disclosed a well-defined, 1.

Spinal cord ganglioglioma presenting as acute paraparesis.

A 17-year-old male presented with acute onset paraparesis in the lower limbs. Urinary retention was present and the patient required catheterisation. Clinical examination confirmed severe bilateral lower limb weakness and a sensory level at T8.

Origin of macrophages in a kaolin-induced model of rat syringomyelia: a study using radiation bone marrow chimeras.

Study Design: Animal experimental study.

Objective: To study the origin of macrophages in a rat model of syringomyelia.

Summary Of Background Data: Syringomyelia is a clinically important condition in which a cystic cavity forms within the spinal cord.

Suprapineal recess: an alternate site for third ventriculostomy? Case report.

This 30-year-old woman presented with clinical symptoms and signs of intracranial hypertension and Parinaud syndrome secondary to ventriculoperitoneal shunt dysfunction. Magnetic resonance (MR) imaging revealed gross triventricular hydrocephalus with a large suprapineal recess due to aqueductal stenosis. Using an endoscopic approach, a ventriculostomy was performed within the floor of the dilated suprapineal recess.

Prolonged and severe dysphagia following anterior cervical surgery.

While mild swallowing difficulties are commonly reported transiently following anterior cervical surgery, marked dysphagia is unusual. The authors report a patient who experienced severe and prolonged dysphagia following elective cervical corpectomies with iliac grafting and anterior plate fusion for multilevel cervical canal stenosis. The literature is reviewed and discussed.

'Ecstasy'-induced subarachnoid haemorrhage: an under-reported neurological complication?

In the face of escalating recreational use of 'Ecstasy' (3,4-methylenedioxymethamphetamine, MDMA), physicians need to be aware of its possible adverse effects. We report two young patients who suffered subarachnoid haemorrhage following ingestion of 'Ecstasy' tablets. Angiographic studies demonstrated features consistent with vasculitis in both cases.

Functioning paraganglioma of the thoracic spine: case report.

Objective And Importance: Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma.

Ventriculoperitoneal shunt failure as a secondary complication of ovarian hyperstimulation syndrome. Case report.

The authors report on a patient who presented with shunt failure due to ovarian hyperstimulation syndrome (OHSS) following in vitro fertilization treatment. Shunt dysfunction was attributed to intraabdominal hypertension as a consequence of ascites. At surgery, the shunt was found to be patent.

Surgical treatment of nocardial brain abscesses.

Objective: Nocardial brain abscesses are associated with significant morbidity and mortality rates. The optimal management remains unclear. We reviewed the surgical outcomes of patients treated with a relatively uniform policy at a single institution.

Low-pressure hydrocephalic state complicating hemispherectomy: a case report.

Unlabelled: Low-pressure hydrocephalic state (LPHS) has only recently been described as a distinct clinical entity occurring in patients with bioatrophic lesions of the brain. We report a patient in whom this syndrome developed after subtotal hemispherectomy for intractable epilepsy.

Methods: A 30-year-old man developed cerebrospinal fluid (CSF) rhinorrhea after subtotal hemispherectomy.