A novel HPLC method for the measurement of thiobarbituric acid reactive substances (TBARS). A comparison with a commercially available kit.

Objectives: Malondialdehyde (MDA) as a part of thiobarbituric acid reacting substances (TBARS) is frequently used as an indicator of lipid peroxidation. Most methods for the measurement of TBARS require long derivatization time and addition of antioxidants in the samples. Furthermore, comparison of these methods with commercially available HPLC kits is lacking.

Responding to change: the challenge of the 1990s.

In 1995, neurosurgery in the United States is facing challenges and threats never before imagined. In its attempts to respond as a relatively small specialty, the neurosurgical community can no longer afford to remain a house divided. Neurosurgical unit has now become a critical matter.

Spinal tuberculosis: a diagnostic and management challenge.

The authors reviewed 29 cases of spinal tuberculosis treated from 1973 to 1993 with an average follow-up time of 7.4 years. Clinical findings included back pain, paraparesis, kyphosis, fever, sensory disturbance, and bowel and bladder dysfunction.

Pleomorphic xanthoastrocytoma--report of four cases, with MRI scan appearances and literature review.

Pleomorphic xanthoastrocytoma (PXA) is a rare glial tumour typically occurring in young patients in the first three decades, having a superficial cortical location and with a relatively good prognosis for long-term survival. Four cases are reviewed. The magnetic resonance imaging (MRI) appearances, which in PXA have been reported only once before, are described in three cases.

Targeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques.

With computed tomography (CT) and magnetic resonance imaging stereotactic systems, biopsies of intracranial lesions can be made with safety and ease. Before the development of this technique, neurosurgeons often performed freehand brain biopsies under CT guidance. While stereotactic biopsy is the procedure of choice for small, deep lesions, few studies have compared the morbidity, mortality, and efficacy in obtaining a diagnosis associated with these two techniques for superficial lesions.

Continual intracavitary administration of amphotericin B as an adjunct in the treatment of aspergillus brain abscess: case report and review of the literature.

Aspergillus brain abscess is often a fatal disease, regardless of the mode of therapy. Most often seen in the compromised host, it is notoriously refractory to systemic antifungal agents and intrathecal antimycotics. Even with radical surgical debridement, only 13 patients, including the present case, have survived longer than 3 months after being treated for aspergillus brain abscess or granuloma.

Microsurgical management of craniopharyngiomas.

A retrospective analysis of 34 patients who underwent microsurgical therapy for craniopharyngioma from 1975 to 1989, a period when CT imaging was routinely used, is presented. Mean follow-up was 6.4 years with no patients lost to follow-up.

Diastematomyelia of the cervical spinal cord with tethering in an adult.

A case of cervical diastematomyelia associated with spinal cord tethering in an adult is presented. The differences between cervicodorsal and lumbar region spinal dysraphic states are emphasized with a review of the embryological factors involved. Possible causes and subsequent treatment are outlined.

Experience in the management of odontoid process injuries: an analysis of 128 cases.

The authors present a retrospective analysis of 128 cases of odontoid process injury treated at the University of Minnesota and affiliated hospitals between the years 1967 and 1983. Of these 128 cases, 110 were acute fractures, while 18 patients suffered from old, unstable odontoid injuries. Motor vehicle accident was the leading cause of injury, and the largest group of patients was in their second decade.

Pituitary adenomas in patients under 20 years old. A clinicopathological study of 12 cases.

The clinical manifestations, pathological features and follow-up data on 12 cases of pituitary adenoma in patient less than 20 years old were evaluated. This group represented 8.5% of our 142 cases of pituitary adenoma from all age groups during the period of study.

Use of the dexamethasone-adrenocorticotropin test to assess the requirement for continued glucocorticoid replacement therapy after pituitary surgery.

We assessed the need for continued glucocorticoid replacement therapy in postsurgical pituitary tumor patients using a dexamethasone-ACTH test. The patients received 1 mg dexamethasone, orally, at 2300 h and 250 micrograms synthetic ACTH (Cosyntropin), iv, at 0800 h the next morning. The mean +/- SD integrated cortisol response for a 2-h period of the 31 pituitary tumor patients [1264 +/- 924 micrograms X min/dl (34.

Extreme lateral disc herniation: diagnosis by computed tomographic scanning.

Extreme lateral disc herniation with compression of the nerve root as it exits through the foramen has been a recognized entity for a number of years. Until recently, this diagnosis was made infrequently except at the time of operation. Reported here are 12 cases of root compression from disc herniation at the level of the pedicle or farther laterally in the foramen (extreme lateral disc herniation).

Pyridine nucleotide synthesis in normal and neoplastic human pituitary cells in culture.

14C-Nicotinic acid (NA) incorporation into nicotinamide adenine dinucleotide (NAD) was studied in cultures from 7 normal human pituitaries and 13 chromophobe adenomas. 14C-NA (7.2 microM) was incubated with both normal and tumor cell cultures for periods up to 48 hours.

Aspergillus infections of the lumbar disc spaces. Report of three cases.

Three cases of lumbar vertebral interspace infection due to the Aspergillus fungus are presented. Two patients responded to vigorous surgical therapy in combination with prolonged administration of antifungal agents. The third patient died of complications related to the antibiotic therapy.

Thoracolumbar injuries.

Thoracolumbar injuries represent an unique neurologic injury. In light of the potential for recovery in the roots of the cauda equina, an aggressive plan of management should be undertaken, to absolutely ensure an adequate decompression of the spinal canal and neural elements, but in addition to accomplish a simultaneous bony reduction and fusion of the injury site. Traditional laminectomy alone has minimal benefit in most of these cases, since compression is usually anterior and decompression is best achieved through a posterolateral or anterior transthoracic approach.

Acromegaly: reassessment of the long-term therapeutic effectiveness of transsphenoidal pituitary surgery.

Of 11 patients with active acromegaly treated with transsphenoidal selective pituitary adenomectomy, four failed to show evidence of clinical improvement. An additional four patients showed clinical and biochemical improvement after the surgical procedure but, with more prolonged follow-up, showed a recurrence of acromegaly. Only three patients had prolonged clinical and biochemical evidence of improvement; they had glucose suppressed growth hormone concentrations of 1.

Neurofibromatosis with congenital glaucoma and buphthalmos in a newborn.

A newborn infant with unilateral eyelid swelling, proptosis, and glaucoma is described. The diagnosis of congenital neurofibromatosis was made on the basis of a positive family history and by inspection of the patient. It is suggested that this clinical problem is more common at birth than generally recognized.

Prolactin suppression of leukocyte chemotaxis in vitro.

Leukocyte chemotaxis in vitro was studied for cells from patients with pituitary adenomas. Leukocytes obtained preoperatively from two of three patients with elevated serum prolactin levels demonstrated chemotaxic alterations described in other malignant disease. Statistically significant suppression of chemotaxis occurred in the leukocytes of four of 12 specimens from normal donors at concentrations of 1000 ng/ml, and in four of eight specimens at 2000 ng/ml of prolactin in preincubation media.

Transnasal excision of a neurohypophyseal tumor.

Neurohypophyseal tumors are rare. A case of a glioma of the neurohypophysis is presented. The tumor closely resembled pituicytomas or infundibulomas.