Current and Future Perspectives in Craniosynostosis.

Craniosynostosis has a varied clinical spectrum, ranging from isolated single suture involvement to multi-sutural fusions. Greater understanding of the pathogenesis of craniosynostosis has led to the development of practical treatment protocols. Three stages of growth have determined the approach to managing craniosynostosis : the early period, up to 12 months; the intermediate period, from 1 to 10 years; and the late period, beginning at 10 years.

Foraminoplastic Superior Vertebral Notch Approach with Reamers in Percutaneous Endoscopic Lumbar Discectomy : Technical Note and Clinical Outcome in Limited Indications of Percutaneous Endoscopic Lumbar Discectomy.

To describe the details of the foraminoplastic superior vertebral notch approach (FSVNA) with reamers in percutaneous endoscopic lumbar discectomy (PELD) and to demonstrate the clinical outcomes in limited indications of PELD. Retrospective data were collected from 64 patients who underwent PELD with FSVNA from August 2012 to April 2014. Inclusion criteria were high grade migrated disc, high canal compromised disc, and disc protrusion combined with foraminal stenosis.

Radicular compression by intraspinal epidural gas bubble occurred in distant two levels after lumbar microdiscectomy.

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure.

Surgical management and outcome of tethered cord syndrome in school-aged children, adolescents, and young adults.

Objective: The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS.

Methods: All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007.

Surgical decompression of supratentorial arachnoid cysts in pediatric patients younger than one year.

Background: There has been much debate about the optimal surgical management of arachnoid cysts in infants younger than 1 year of age. The authors present the clinical and neuroimaging findings in pediatric patients with supratentorial arachnoid cysts treated by surgical decompression.

Methods: A retrospective chart review was conducted to identify all pediatric patients who had been diagnosed with arachnoid cysts since 2003.

Simple excision and periosteal reattachment for the treatment of calcified cephalhematoma. Technical note.

Until now, calcified cephalhematoma has been treated by excision of the lesion and the use of an onlay autograft. The authors report their use of a less complicated alternative, simple excision and periosteal reattachment, in a 3-month-old male infant. They excised the calcified cap of cephalhematoma and reattached the periosteum to the exposed bone surface instead of using an onlay autograft technique.

Temozolomide chemotherapy in patients with recurrent malignant gliomas.

Numerous studies have demonstrated the clinical activity of temozolomide, a second-generation alkylating agent, against malignant brain tumors, however, its activity has not been reported in an Asian population. This study analyzed the efficacy and toxicity of temozolomide in 25 adult patients with recurrent or progressive malignant gliomas after surgery and standard radiation therapy with or without chemotherapy, enrolled in our institution since July 2000. Sixteen patients had glioblastoma multiforme (GBM), six with anaplastic astrocytoma, and three with anaplastic oligodendroglioma.

Anatomy of neurovascular structures around the carpal tunnel during dynamic wrist motion for endoscopic carpal tunnel release.

Objective: The purpose of this study is to investigate the anatomic relationship between neurovascular structures and the transverse carpal ligament (TCL) so as to avoid complications during an endoscopic carpal tunnel release procedure.

Methods: Fresh cadaver hands from seven men and 12 women (age range, 48-74 yr) were used. The neurovascular structures just over and under the TCL were meticulously dissected under loupe magnification.

Cytotoxicity of rat marrow stromal cells against malignant glioma cells.

Objects: Marrow stromal cells (MSCs) have been shown to have the capacity of orthodox and unorthodox plasticity. In this study, the authors tried to access in vitro cytotoxicity of MSCs from rat and also to differentiate MSCs into immune effector cell.

Methods: Rat MSCs (rMSCs) were isolated by standard methodology and were activated by interleukin-2 (IL-2), interleukin-15 (IL-15), granulocyte macrophage colony stimulating factor, and combinations, which were effector cells.

Merlin, a tumor suppressor, interacts with transactivation-responsive RNA-binding protein and inhibits its oncogenic activity.

The neurofibromatosis type 2 gene-encoded protein, merlin, is related to the ERM (ezrin, radixin, and moesin) family of membrane-cytoskeleton-associated proteins. Recent studies suggest that the loss of neurofibromatosis type 2 function contributes to tumor development and metastasis. Although the cellular functions of merlin as a tumor suppressor are relatively well characterized, the cellular mechanism whereby merlin controls cell proliferation from membrane locations is still poorly understood.

Lymphokine activated killer cells from umbilical cord blood show higher antitumor effect against anaplastic astrocytoma cell line (U87) and medulloblastoma cell line (TE671) than lymphokine activated killer cells from peripheral blood.

Objects: The aims of this study were to assess the cytotoxic capability of lymphokine-activated killer (LAK) cells from umbilical cord blood (UCB), to compare them with those of peripheral blood (PB)-derived cells against anaplastic astrocytoma cell line (U87) and medulloblastoma cell line (TE671), and to identify which mechanism and genes were involved in cytotoxicity.

Methods: The effector cells were generated by interleukin-2 from UCB and PB. The antitumor property of effector cells against the target cells (U87, TE671) were estimated using a visual survival cell assay.

Intraspinal extradural teratoma mimicking neural sheath tumor in infant.

Introduction: An intraspinal teratoma that is located entirely extradurally is unusual both in children and in adults.

Case History: The authors present a case of an 8-month-old male infant with an extradurally arising intraspinal mature teratoma located from T-2 to T-4, who had suffered from progressive paraparesis (grade 1). The patient did not have any stigmata or anomalies suggesting spinal dysraphism.

Merlin suppresses the SRE-dependent transcription by inhibiting the activation of Ras-ERK pathway.

The neurofibromatosis type 2 (NF2) gene encodes an intracellular membrane-associated protein called merlin or schwannomin, which is known to be a tumor suppressor. Numerous studies have suggested that merlin is involved in the regulation of cell growth and proliferation. Previously, merlin/schwannomin was reported to block Ras-induced cell proliferation and anchorage-independent cell growth.

Motor cortex stimulation in a patient with intractable complex regional pain syndrome type II with hemibody involvement. Case report.

The authors describe the effectiveness of motor cortex stimulation (MCS) in a patient with complex regional pain syndrome (CRPS) Type II, formerly known as causalgia, with hemibody allodynia. During MCS, a subjective sensation of warm paresthesia developed in the painful hand and forearm and spread toward the trunk. Pain and allodynia in the areas associated with this sensation were alleviated significantly.

Role of surgery for maintaining urological function and prevention of retethering in the treatment of lipomeningomyelocele: experience recorded in 75 lipomeningomyelocele patients.

Object: The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients.

Methods And Results: Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three types: type I, type II, and type III.

Takayasu's arteritis presented with subarachnoid hemorrhage: report of two cases.

Takayasu's arteritis is a chronic inflammatory disease that produces a narrowing of the aorta and its major branches. Fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. The authors report two young women patients who presented with subarachnoid hemorrhage (SAH) and occlusive cerebrovasular disease associated with Takayasu's arteritis.

Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures.

Object: The use of polymethylmethacrylate (PMMA) cement by percutaneous injection in cases requiring vertebroplasty provides pain relief in the treatment of osteoporotic vertebral compression fractures. A retrospective study was performed to assess what caused PMMA cement to leak into the epidural space and to determine if this leakage caused any changes in its therapeutic benefits.

Methods: Polymethylmethacrylate was injected into 347 vertebral compression fractures in 159 patients.