Minimally Invasive Resection of Brain Metastases.

Background: Minimally invasive resection of brain metastases aims to maximize resection while minimizing brain trauma.

Methods: Patients with 1 or more metastases that underwent resection following neuro-oncology multidisciplinary meeting discussion from September 2014 to October 2018, with pre- and postoperative magnetic resonance imaging, were included. All patients including posterior fossa metastases or multiple metastases were positioned supine.

Intracranial desmoplastic small round cell tumor presenting as a suprasellar mass.

Desmoplastic small round cell tumors (DSRCTs) are rare, aggressive neoplasms that typically arise from abdominal and pelvic peritoneum in young adults. Other primary sites are uncommon, and an intracranial origin is exceptionally rare. Here the authors report the first case of a DSRCT presenting as a primary suprasellar tumor causing panhypopituitarism and severe bitemporal hemianopia in a young man.

Treatment by specialist surgical neurooncologists improves survival times for patients with malignant glioma.

Object: Surgeries for CNS tumors are frequently performed by general neurosurgeons and by those who specialize in surgical neurooncology. Subspecialization in neurosurgical practice has become common and may improve patient morbidity and mortality rates. However, the potential benefits for patients of having their surgeries performed by surgical neurooncologists remain unclear.

On-call neurosurgery: can this continue as a free service?

Since 2005, Acute National Health Service (NHS) Trusts have been funded using a system called Payment by Results. This provides a national or regionally set tariff per patient treated, according to a health resource group code. Health resource group codes vary according to diagnosis or procedures carried out and patient co-morbidities.

Trigeminal neuralgia as initial symptom of paramedian tentorial meningioma.

Posterior cranial fossa tumours, not involving the cerebellopontine angle cistern, are a rare cause of trigeminal neuralgia (TN). We describe a patient with a large paramedian tentorial meningioma associated with acquired Chiari malformation who presented with TN. Trigeminal pain resolved after gross total tumour resection and postoperative magnetic resonance images disclosed a minimal residual tumour in the torcular region as well as ascent of cerebellar tonsils.

An internal amplification control system based on primer-dimer formation for PCR product detection by DNA hybridization.

The detection of PCR products by DNA hybridization techniques can suffer from inhibition of the amplification process by sample matrix components. We have designed a simple internal control system for PCR based on the incorporation of a primer pair with complementary 3' ends, resulting in the generation of a unique "primer-dimer" detectable by hybridization with a specific capture probe immobilized on polyester cloth as part of an array of amplicon-specific probes. The inclusion of this primer pair did not adversely affect the amplification and subsequent detection of target gene sequences by hybridization with immobilized probes in either single gene amplification or multiplex PCR systems.

Microplate fluorescence assay for the quantification of double stranded DNA using SYBR Green I dye.

A high-throughput, 96-well microplate fluorescence assay (MFA) was developed for DNA quantification using the double-stranded DNA-binding dye SYBR Green I. Samples mixed with SYBR Green I in the wells of a microtiter plate produced fluorescence in proportion with DNA concentration which was measured using a fluorescence plate reader. The performance characteristics of the assay were compared with spectrophotometric quantification based on ultraviolet absorption and the Hoefer DyNA Quant assay utilizing the fluorescent dye, Hoechst 33258.

Detection of Escherichia coli O157 in foods by a novel polymyxin-based enzyme-linked immunosorbent assay.

An enzyme-linked immunosorbent assay (ELISA) system was developed using polymyxin immobilized in the wells of a microtiter plate as a high-affinity adsorbent for Escherichia coli O157 lipopolysaccharide (LPS) antigens. Extracts from cell suspensions were reacted with polymyxin-coated microwells followed by immunoenzymatic detection of captured LPS antigens using a commercially available anti-E. coli O157 antibody-peroxidase conjugate and a 3,3',5,5'-tetramethylbenzidine substrate.

Comparison of fluorogenic and chromogenic assay systems in the detection of Escherichia coli O157 by a novel polymyxin-based ELISA.

Aims: Different indicator enzymes and fluorogenic or chromogenic substrates were compared as detector systems in a novel polymyxin-based enzyme-linked immunosorbent assay (ELISA) for Escherichia coli O157 lipopolysaccharide (LPS) antigens.

Methods And Results: An ELISA system was developed using polymyxin immobilized in the wells of a microtitre plate as a high-affinity adsorbent for E. coli O157 LPS antigens, which were immunoenzymatically detected using anti-E.

Zig-zag bicoronal scalp incision for cranio-facial cases in paediatric neurosurgery.

Technique: We present the use of a zig-zag bicoronal scalp incision for cranial-facial cases in paediatric neurosurgery.

Conclusion: The authors believe that this technique leads to improved cosmesis, especially when the hair is wet.

Generic waiting lists for routine spinal surgery.

National Health Service Hospitals are under pressure to reduce waiting lists within the constraints of a limited infrastructure. We implemented two systems to reduce waiting times for elective non-complex spinal surgery. The first of these was the introduction of managed generic waiting lists for both initial outpatient appointments and subsequent surgery.

Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia.

Cerebral aspergillosis carries a high mortality in immunocompromised patients. However, favorable outcome can be achieved by the prolonged use of antifungal agents and the maintenance of adequate drug levels. The authors report a 2-year-old girl who developed an aspergillus brain abscess during treatment for acute lymphoblastic leukemia.

Fibromuscular hyperplasia of the internal carotid artery. A further cause of the 'moyamoya' collateral circulation.

Fibromuscular hyperplasia is a rare cause of internal carotid artery occlusion. We present a case where long stenoses of both internal carotid arteries were associated with terminal carotid occlusions and a ruptured basilar aneurysm.

Prevention of bone loss by hormone replacement therapy is probably not due to stimulation of calcitonin secretion.

Weekly fasting serum calcitonin levels and biochemical indices of bone metabolism were measured in 13 postmenopausal women being given hormone replacement therapy over a period of 8 weeks. All of the biochemical indices except urinary hydroxyproline creatinine ratios fell significantly, indicating that the treatments were effective in reducing bone turnover. Calcitonin levels fell significantly and, within the individual, levels were positively correlated with adjusted calcium levels.

Systems analysis of cerebrovascular pressure transmission: an observational study in head-injured patients.

In an observational study in head-injured patients, cerebrovascular pressure transmission was investigated using a systems analysis approach whereby the blood pressure (BP) waveform was used as a measure of an input stimulus to the cerebrovascular bed (CVB) and the intracranial pressure (ICP) waveform as the response to that stimulus. The transfer function is a measure of how much pressure is transmitted through the CVB at a given frequency and is calculated using Fourier analysis of the pressure waveforms. The transfer function allows quantification of the pressure transmission performance of the CVB, thus providing a basis for comparison between normal and abnormal function.

Aqueduct stenosis--presentation and prognosis.

In the 14-year period from 1974-1987 during which CT scanning was available in Edinburgh, 36 patients with benign, non-tumour related aqueduct stenosis were identified from a group of 342 patients with hydrocephalus. In terms of age at presentation, the patients separate into two groups, 9 cases diagnosed during the first year of life and 27 patients aged from 7 to 72 years. The presentation in the early cases was fairly acute, the diagnosis was secure and the operative treatment by ventricular peritoneal shunt was relatively free of complications.

Extradural haematoma in infants.

The clinical and operative findings of 40 infants treated for Extradural Haematomas (EDH) between 1960 and 1988 are presented. This series represents 19% of the total number of children with EDH during this period. Twenty-five (63%) were male, fifteen (37%) female.

Role of a separate subcutaneous cerebro-spinal fluid reservoir in the management of hydrocephalus.

A retrospective survey has been carried out on 56 children with shunted hydrocephalus either with a primary idiopathic cause or as a result of a low spina bifida complex. In all 56 children, a separate reservoir has been inserted at some stage in the management of their hydrocephalus. There was no mortality.

Effect of subdermal oestrogen and oestrogen/testosterone implants on calcium and phosphorus homeostasis after oophorectomy.

Various biochemical aspects of calcium metabolism were studied serially in 32 post-menopausal patients treated with subdermal implants of oestrogen, either alone or in combination with testosterone. Significant reductions in serum calcium, serum phosphate, the renal phosphate threshold (TmPO4) and the urinary calcium/creatinine ratio were observed for periods of up to 6 mth in both treatment groups as compared with baseline. The findings suggest that oestrogen replacement therapy by subdermal implant is effective in reversing the characteristic alterations in calcium metabolism which occur in the post-menopausal patient.

Effect on lipoproteins of Trisequens, a combined hormone preparation.

Lipoprotein concentrations were measured in 31 post-menopausal women during 1 yr of treatment with Trisequens, a natural oestrogen-progestogen preparation. Serum triglyceride, high density lipoprotein and very low density lipoprotein cholesterol concentrations did not change significantly, but low density lipoprotein cholesterol concentrations fell over the first 6 mth. After 1 yr none of the lipoprotein fractions differed significantly in concentration from pre-treatment levels.

Calcitonin and postmenopausal osteoporosis.

Fasting serum calcitonin levels were measured in 54 postmenopausal women who had for 10 years been taking part in a double blind trial to assess the effect of the synthetic oestrogen, mestranol, on postmenopausal bone loss. There were no differences in calcitonin levels between mestranol treated and placebo groups. Fifteen of the women were challenged with a calcium infusion to measure the secretory reserve of calcitonin.