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Availability of emergency contraception at rural and urban pharmacies in Pennsylvania. | compared with urban counties (p=.01). Pharmacies that did not stock EC most frequently cited lack of perceived need as the reason (61%).Emergency contraception availability in pharmacies is uniformly low in this region of Pennsylvania; creating a significant access barrier. Although there were no significant differences in EC availability between rural and urban pharmacies; additional barriers in rural settings could impede timely access to EC for rural women. | 16531172 | [
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Performance of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | This multisite; randomized; crossover trial comparing the performance of the Reality female condom (FC1) with a new synthetic latex prototype (FC2) was conducted in Durban; South Africa.In total; 276 women were enrolled and 201 women completed the study. Altogether; 1910 FC1 condoms and 1;881 FC2 condoms were used.Total breakage was 0.73% in FC1 and 0.85% in FC2 (95% confidence interval; -0.64 to 0.87). The number of clinical breakages (those that could result in a pregnancy or sexually transmitted infectio | 16531173 | [
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Performance of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | n) was similar for each condom type (FC1; n=9; FC2; n=8). Incorrect penetration (penis between condom and vaginal wall) was 1.26% and 0.64% for FC1 and FC2; respectively. Outer ring displacements (outer ring pushed into the vagina partially or fully) were comparable for both condoms (FC1; 3.14%; FC2; 2.98%). Slippage (condom came out of the vagina) was rare and reported in 0.37% or less of devices used. Total clinical failure was 5.24% in FC1 and 4.3% in FC2.The FC1 and FC2 performed comparably within this | 16531173 | [
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Performance of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | trial. | 16531173 | [
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Short-term acceptability of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | This multisite; randomized; crossover trial comparing the acceptability of the Reality(R) female condom (FC1); with a new synthetic latex prototype (FC2) of similar design and appearance to FC1; was conducted in Durban; South Africa.In total; 276 women were enrolled and 1910 FC1 condoms and 1881 FC2 condoms were used by 218 and 216 women; respectively.Overall experience of use was reported as good for over half the participants with both condom types (FC1=50.9%; FC2=55.1%). Similar acceptability issues were | 16531174 | [
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Short-term acceptability of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | reported in like proportions for FC1 and FC2; with features such as the lubricant (FC1=36.7%; FC2=37.0%) and the material (FC1=36.2%; FC2=29.2%) most commonly viewed positively for both condom types. Negative aspects commonly reported for both female condoms were the lubricant (FC1=30.3%; FC2=31.5%) and the appearance (FC1=29.8%; FC2=34.0%). Preference for FC1 was 29.5% and was slightly higher for FC2 (36.6%). Some women felt that there was no real difference between the two devices (33.8%).The acceptabili | 16531174 | [
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Short-term acceptability of the Reality polyurethane female condom and a synthetic latex prototype: a randomized crossover trial among South African women. | ty of FC1 and FC2 was comparable; and women who find FC1 acceptable to use should also find FC2 acceptable. | 16531174 | [
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Consistency between most important reasons for using contraception and current method used: the influence of health care providers. | To identify factors related to consistency between women's "most important" reason for using contraception and their current contraceptive method.A sample of 433 women completed a written questionnaire on demographics; contraceptive use history and the "most important" reason for using contraception. Women were grouped by whether their current contraceptive method "agreed" or "disagreed" with their "most important" reason for contracepting. Multivariable regression was used to identify factors associated wi | 16531175 | [
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Consistency between most important reasons for using contraception and current method used: the influence of health care providers. | th consistency between stated "most important" reason and current method used ("agreed").Current contraceptive method was inconsistent with the "most important" reason for using a method in 25% of women. Demographic characteristics and knowledge of contraceptive effectiveness did not differ between the "agreed" and "disagreed" groups. Women using a method consistent with their reason were more likely to have discussed contraception with a health care provider (RR=1.59; 95% CI 1.13-2.25) even after adjusting | 16531175 | [
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Consistency between most important reasons for using contraception and current method used: the influence of health care providers. | for source of contraceptive method or source of contraceptive information (RR=1.57; 95% CI 1.10-2.23).Contact with a health care provider was the only factor associated with consistency between birth control method and reasons for initiating contraception. This association appears to be independent of knowledge about contraceptive effectiveness. | 16531175 | [
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Barriers to obtaining a desired postpartum tubal sterilization. | To determine why women do not undergo postpartum sterilization despite expressing desire during antepartum care.In a retrospective chart review; we identified all women between March 2002 and November 2003 who requested postpartum sterilization during antepartum care but did not undergo the procedure. We report the reasons why sterilizations were not performed.We reviewed 6;589 prenatal care and delivery records identifying 324 women meeting inclusion criteria. One hundred and four women changed their mind. | 16531176 | [
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Barriers to obtaining a desired postpartum tubal sterilization. | Of women still desiring sterilization at discharge; the most common reasons for not undergoing the procedure were lack of valid Medicaid sterilization consent forms [n=121; 37.3%; 95% confidence interval (CI) 32.0-42.6%]; a medical condition precluding the procedure (n=47; 14.5%; 95% CI 10.7-18.3%); lack of availability of an operating room (n=2; 6.5%; 95% CI 3.8-9.2%).We found that the Medicaid consent process; medical conditions and insufficient operating room space prevented women from having the desire | 16531176 | [
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Abortion education in nurse practitioner, physician assistant and certified nurse-midwifery programs: a national survey. | This study was undertaken to examine the inclusion and extent of abortion education in accredited nurse practitioner (NP); physician assistant (PA) and certified nurse-midwifery (CNM) programs in the United States.In January 2000; a confidential survey requesting information about the curricular inclusion of eight reproductive health topics was mailed to program directors at all 486 accredited NP; PA and CNM programs in the United States.Two hundred two surveys were returned; with a response rate of 42%. Ov | 16531177 | [
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Abortion education in nurse practitioner, physician assistant and certified nurse-midwifery programs: a national survey. | erall; 53% of programs reported didactic instruction on surgical abortion; manual vacuum aspiration or medication abortion and 21% reported including at least one of these three procedures in their routine clinical curriculum.Abortion education is deficient in NP; PA and CNM programs in the United States. As integral components of women's health care; abortion; pregnancy options counseling and family planning merit incorporation into routine didactic and clinical education. | 16531177 | [
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Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy. | The objective of this retrospective; descriptive study is to assess the adequacy and safety of buccal misoprostol with and without laminaria for cervical preparation prior to second-trimester abortion.We analyzed Planned Parenthood Federation of America data from 2;218 elective dilation and evacuation (D&E) procedures conducted on women at 12 to 23 6/7 weeks of gestation from April 2002 to March 2003. Each woman received 400; 600 or 800 microg of buccal misoprostol with or without laminaria for preprocedura | 16531179 | [
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Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy. | l cervical preparation.Of the patients; 62% received 400 mug; 32% received 600 microg and 6% received 800 microg of buccal misoprostol; 42.8% had laminaria inserted for phased cervical preparation. The adequacy of cervical dilation was 88.7%. The D&E procedure was completed during a single surgical procedure for 99.8%. The overall adverse event rate was 19.39 per 1;000 women; with a rate of 4.51 per 1;000 women for serious adverse events.This descriptive study suggests that use of buccal misoprostol with or | 16531179 | [
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Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy. | without laminaria is effective and safe. If buccal misoprostol eliminates or reduces the need for phased; multiday laminaria 1-3 days prior to the surgical procedure; then its use may offer service advantages such as reduced number of clinic visits and fewer pelvic examinations per woman. | 16531179 | [
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Bleeding after medication-induced termination of pregnancy with two dosing schedules of mifepristone and misoprostol. | This study examines bleeding pattern following medication-induced termination of pregnancy; comparing two different dosing schedules of mifepristone and misoprostol.Diary information was analyzed from a randomized; multicenter trial in which women used vaginal misoprostol 800 mug either 6-8 or 24 h following 200 mg of oral mifepristone.One thousand eighty women with pregnancies up to 63 days' gestation were recruited for the study; 540 were randomized to the 6- to 8-h dosing schedule; and 540 were randomize | 16531178 | [
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Bleeding after medication-induced termination of pregnancy with two dosing schedules of mifepristone and misoprostol. | d to the 24-h dosing schedule. Subjects recorded daily bleeding in a diary over 5 weeks.Total duration of bleeding ranged from 1 to 54 days; with a median of 7 days. Duration of spotting ranged from 1 to 80 days; with a median of 5 and 6 days (NS) in each of the two groups. Neither duration of bleeding nor duration of spotting were related to interval between mifepristone and misoprostol. Bleeding and spotting durations were not correlated with maternal age or smoking. Increased gestational age was correlat | 16531178 | [
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Bleeding after medication-induced termination of pregnancy with two dosing schedules of mifepristone and misoprostol. | ed with longer bleeding and spotting times. Nulliparity was associated with longer bleeding time.Varying the interval between mifepristone and misoprostol in medication abortion does not affect duration or quantity of bleeding. | 16531178 | [
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Atypical presentation of serious pelvic inflammatory disease following mifepristone-induced medical abortion. | Mifepristone-induced abortion is increasingly common. Recent alerts have highlighted the occurrence of infrequent but serious complications. We report a case of serious bacterial infection after medical termination that occurred in the absence of the usual signs of infection. | 16531180 | [
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Principles and practice of evidence-based orthopaedics. Editorial comment. | nan | 16531182 | [
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Sonographic recognition of three cases of septate uteri diminishes failures of quinacrine sterilization. | Using sonography; the bicornate and septate uterus as causes of failure of quinacrine sterilization (QS) are explored. Whether QS can be effectively performed on women with a bicornate or septate uterus is a question answered by a presentation of three such cases.Three cases presented were part of a prospective nonrandomized study of QS in 205 women requesting sterilization at the Family Planning Clinic; School of Medicine of the Federal University of Minas Gerais; Belo Horizonte; Brazil. Sonography was per | 16531181 | [
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Sonographic recognition of three cases of septate uteri diminishes failures of quinacrine sterilization. | formed on all patients before; during and after QS. Quinacrine was packaged as seven pellets in a modified Copper-T IUD inserter (Sipharm; Sisseln; Switzerland). Each woman received the first transcervical insertion of 252 mg of quinacrine during the follicular phase of the menstrual cycle; usually immediately after menses. One month later; a second insertion was similarly performed. Patients were advised to use an alternate method of birth control for 12 weeks to allow time for scarring of the oviducts. A | 16531181 | [
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Sonographic recognition of three cases of septate uteri diminishes failures of quinacrine sterilization. | blood pregnancy test was done before the QS procedure.The diagnosis of a septate or bicornuate uterus was made by sonography in three of the 205 patients in the study. It was obvious that quinacrine had to be inserted into the two horns of such an anomalous uterus if the dissolved drug was to enter both fallopian tubes. Quinacrine dissolved into "lakes of quinacrine;" and sonographically could be seen at the top of the uterine fundus. For this clinical trial of 205 patients; there were 546 woman-years of fo | 16531181 | [
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Sonographic recognition of three cases of septate uteri diminishes failures of quinacrine sterilization. | llow-up; and the Pearl index was 0.73 per 100 woman-years (95% confidence limits: 0.02; 1.4).The bicornate or septate uterus can be a cause of failure of QS if undetected. Advantages of sonography prior to; during and after QS are apparent in the three patients with septate uteri. Sonography is advantageous when performing QS by demonstrating an anomaly of the uterus; which required separate insertions of quinacrine into each horn of a septate uterus and helping to direct quinacrine into each horn of these | 16531181 | [
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Sonographic recognition of three cases of septate uteri diminishes failures of quinacrine sterilization. | anomalous uteri. | 16531181 | [
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Principles of teaching evidence-based medicine. | Teaching EBM is to impart the process of asking the question; acquiring and appraising the literature and applying it to the care of the patient; while weighing the risks; benefits and considering patient values. Teaching this process and its necessary content requires as with everything else; dedication; knowledge and practice. The best way to teach both patient care and EBM is by example. | 16531183 | [
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Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. | The use of NSAID medications is a well-established effective therapy for both acute and chronic nonspecific neck and back pain. Extreme complications; including gastric ulcers; bleeding; myocardial infarction; and even deaths; are associated with their use. An alternative treatment with fewer side effects that also reduces the inflammatory response and thereby reduces pain is believed to be omega-3 EFAs found in fish oil. We report our experience in a neurosurgical practice using fish oil supplements for pa | 16531187 | [
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Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. | in relief.From March to June 2004; 250 patients who had been seen by a neurosurgeon and were found to have nonsurgical neck or back pain were asked to take a total of 1200 mg per day of omega-3 EFAs (eicosapentaenoic acid and decosahexaenoic acid) found in fish oil supplements. A questionnaire was sent approximately 1 month after starting the supplement.Of the 250 patients; 125 returned the questionnaire at an average of 75 days on fish oil. Seventy-eight percent were taking 1200 mg and 22% were taking 2400 | 16531187 | [
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Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. | mg of EFAs. Fifty-nine percent discontinued to take their prescription NSAID medications for pain. Sixty percent stated that their overall pain was improved; and 60% stated that their joint pain had improved. Eighty percent stated they were satisfied with their improvement; and 88% stated they would continue to take the fish oil. There were no significant side effects reported.Our results mirror other controlled studies that compared ibuprofen and omega-3 EFAs demonstrating equivalent effect in reducing ar | 16531187 | [
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Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. | thritic pain. omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain in this selective group. | 16531187 | [
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Endonasal transsphenoidal surgery: the patient's perspective-survey results from 259 patients. | Patient impressions remain an important yet often overlooked aspect of surgical success. Herein we present postoperative questionnaire results in patients after a standard direct endonasal approach; an extended suprasellar endonasal approach; and a reoperative transsphenoidal surgery for tumor removal with the operating microscope.From July 1998 through April 2005; of 452 patients undergoing endonasal surgery; 346 were sent questionnaires; and of these; 259 (75%) completed them. Nasal packing was placed for | 16531188 | [
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Endonasal transsphenoidal surgery: the patient's perspective-survey results from 259 patients. | 24 hours in the first 95 patients but not in the last 357.Overall; 73% of patients reported a better experience than expected and 8% worse than expected. A worse than expected overall experience was noted in 15% of patients with nasal packing compared with 5% of patients without packing (P = .001). Of patients with preoperative headache; 49% resolved; 34% somewhat resolved; and 5% worsened. The frequency of rhinological complaints declined from 2 weeks to 3 months postsurgery (P < .001); by 3 months or mor | 16531188 | [
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Endonasal transsphenoidal surgery: the patient's perspective-survey results from 259 patients. | e postsurgery; 67% to 87% of patients had no rhinological complaints and 1% to 2% had severe complaints. Of 30 patients with prior sublabial surgery; the endonasal procedure afforded easier recovery (87%); less pain (80%); better nasal airflow (79%); and a shorter hospital stay (median 3 vs 5 days) (P < .001). Of 28 patients with complications; the severity of rhinological complaints was similar to those without complications except this subgroup reported greater loss of sense of smell 3 months after surger | 16531188 | [
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Endonasal transsphenoidal surgery: the patient's perspective-survey results from 259 patients. | y (P < .001).Rhinological recovery is typically rapid and relatively complete after direct endonasal transsphenoidal surgery using both standard and extended suprasellar approaches. Compared with the sublabial route; the endonasal approach is associated with less pain; better nasal airflow; and a shorter hospital stay. | 16531188 | [
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Gamma knife radiosurgery for intracranial mature teratoma--long-term results and review of literature. | The purpose of this report is to present long-term outcomes of gamma knife radiosurgery for intracranial mature teratoma after debulking surgery.Three patients with intracranial mature teratoma had initial target volumes of 5.4; 18.7; and 5.1 cm(3); respectively; and were treated by gamma knife radiosurgery between 1993 and 2004. Marginal doses of 17; 12.5; and 13.5 Gy; respectively; were delivered to the tumors at isodose levels of 50%; 50%; and 62%; respectively. The first patient received radiosurgery af | 16531191 | [
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Gamma knife radiosurgery for intracranial mature teratoma--long-term results and review of literature. | ter surgical removal and conventional radiotherapy. The second patient received similar management; including surgery and radiotherapy; with tumor recurrence. Two additional operations and subsequent radiosurgery were performed on this patient. Based on the favorable results of the first 2 patients; we performed radiosurgery instead of conventional radiotherapy after subtotal surgical removal in the last patient. By reviewing literatures concerning the therapeutic modalities and the long-term results of our | 16531191 | [
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Gamma knife radiosurgery for intracranial mature teratoma--long-term results and review of literature. | 3 patients; we discuss the role of radiosurgery in treating intracranial mature teratoma.A follow-up period of 121; 89; and 31 months; respectively; demonstrated tumor volume reduction rates of 70%; 89%; and 48%; respectively. No evidence of further tumor progression and no radiosurgery-related complication or morbidity was noted. The school performances of the affected children are all above average.Gamma knife radiosurgery provides a safe and effective alternative as the adjuvant treatment of intracrania | 16531191 | [
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Gamma knife radiosurgery for intracranial mature teratoma--long-term results and review of literature. | l mature teratoma after surgical debulking. Previous conventional radiotherapy does not alter final tumor control. Radiosurgery should be considered when residual tumor growth continues with no related symptoms or evaluations of tumor markers during follow-up. | 16531191 | [
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The key to improving prognosis for aneurysmal subarachnoid hemorrhage remains in the pre-hospitalization period. | Despite advances in neurosurgical management; aneurismal subarachnoid hemorrhage (aSAH) still has high mortality and morbidity. This study aimed to clarify how delaying hospital admission after aSAH contributes to worse prognosis even today and to find the possibility for an improvement of its prognosis by early admission.Four hundred twenty-one consecutive patients are the basis for this study. Cause of delay was classified into 5 categories: patient delay (PD); doctor delay (DD); transportation delay (TD) | 16531194 | [
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The key to improving prognosis for aneurysmal subarachnoid hemorrhage remains in the pre-hospitalization period. | ; no delay (ND) (within 2 hours of onset); and others. Condition of each patient was assessed at time of onset and admission using H&K. The relationships between cause of delay and worsening of Hunt and Kosnik grading (H&K) were examined.The median delay time was 1.7 days. Only 41% of patients visited our institution without delay. Admission delay; especially PD and DD; exhibited a significant correlation to worsening of H&K. In addition to nondirect admission; misdiagnosis or delayed diagnosis contributed | 16531194 | [
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The key to improving prognosis for aneurysmal subarachnoid hemorrhage remains in the pre-hospitalization period. | significantly to worsening of H&K. Incidence of DD has declined in recent years; whereas that of PD has increased. Consequently; no change in total number of delays was found.There remains much room for an improvement of prognosis for aSAH by early admission. We need to fully realize this reality and to directly face this problem. | 16531194 | [
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The use of abciximab in the treatment of acute cerebral thromboembolic events during neuroendovascular procedures. | Recently; a great interest has emerged regarding the use of abciximab for treatment of stroke. Thromboembolic events that occur during neuroendovascular procedures represent a unique subset of stroke patients because definitive angiographic diagnosis and treatment can be performed immediately. The existing literature on this situation suggests excellent results; however; most publications are case reports; and the largest series is 13 cases. We report our experience using abciximab in the treatment of acute | 16531192 | [
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The use of abciximab in the treatment of acute cerebral thromboembolic events during neuroendovascular procedures. | thromboembolic events that occur during neuroendovascular procedures.We reviewed the last 1373 consecutive patients who underwent neuroendovascular procedures at the University of Florida from our prospectively maintained clinical database. Of these patients; 29 (2.11%) endovascular cases were complicated by acute cerebral thromboembolic events that were treated with abciximab. Abciximab was administered in less than 1 hour after the onset of the occlusion in every patient. The Thrombolysis In Myocardial I | 16531192 | [
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The use of abciximab in the treatment of acute cerebral thromboembolic events during neuroendovascular procedures. | nfarction (TIMI) scale was used to measure immediate angiographic outcome; and the Modified Rankin Scale (MRS) was used to measure clinical outcome at the time of follow-up. Independent outcome was defined as an MRS of 3 or less at follow-up.Angiographic improvement in the TIMI grade was achieved in 29 (81%) of 36 arteries. Three intracerebral hemorrhages occurred with abciximab when administered with concurrent mechanical clot disruption; in two of these hemorrhages; recombinant tissue plasminogen activato | 16531192 | [
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The use of abciximab in the treatment of acute cerebral thromboembolic events during neuroendovascular procedures. | r (r-tPA) was also administered. The mean follow-up time for the living cohort was 7.54 months. Twenty-four (83%) patients were independent at follow-up; 3 (10%) were dependent at follow-up; and 2 (7%) died.Abciximab appears to be safe and effective in the treatment of acute cerebral thromboembolic complications during neuroendovascular procedures. | 16531192 | [
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Trigonal cavernous angiomas: report of three cases and review of literature. | Intraventricular cavernous angiomas are very rare. Only few cases of trigonal angiomas have been reported.We report three cases of trigonal cavernous angiomas who presented with raised intracranial pressure or seizures and who underwent total excision with a good recovery. We also review the literature and discuss surgical approaches.On magnetic resonance imaging; intraventricular cavernous angiomas lack the hemosiderin ring characteristically seen around parenchymal cavernous angiomas. This explains why tr | 16531197 | [
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Trigonal cavernous angiomas: report of three cases and review of literature. | igonal cavernous angiomas can mimic malignant neoplasm on imaging; and they should be considered in the differential diagnosis of intraventricular masses. Total excision should be the goal of surgery. | 16531197 | [
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Leptomeningeal carcinomatosis in a patient with metastatic prostate cancer: case report and literature review. | Leptomeningeal metastasis is discovered at autopsy in approximately 5% of patients with systemic cancer. Until recently with the introduction of magnetic resonance imaging (MRI); premorbid diagnosis was extremely difficult. In particular; initial spinal fluid cytology is diagnostic in less than 50% of autopsy-verified patients; although repeated spinal fluid examinations may increase the yield significantly. Leptomeningeal metastasis in metastatic prostate cancer has been reported in only 14 patients previo | 16531199 | [
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Leptomeningeal carcinomatosis in a patient with metastatic prostate cancer: case report and literature review. | usly.We recently studied such a patient and were able to establish a correct diagnosis based solely on the MRI and the presence of an elevated cerebrospinal fluid (CSF) prostate-specific antigen (PSA). Only 3 previous patients with leptomeningeal prostate metastasis have undergone CSF PSA evaluations.We believe that; in such patients; the combination of MRI and CSF studies can overcome the lack of sensitivity of CSF cytology. | 16531199 | [
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Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases. | To define the etiologic; clinical; histological; and surgical features of lumbar hemorrhagic synovial cysts (LHSCs). Three personal cases are reported together with a review of the pertinent literature.We identified 3 cases of LHSC treated in our departments and 20 cases culled from the literature.A total of 23 cases of LHSC were selected. All the patients underwent surgical treatment because of untreatable radicular pain and/or neurological deficits. The amount of bleeding; either massive or minor but repe | 16531204 | [
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Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases. | ated; influenced the timing of surgery. In our cases; the histological examinations showed an inflammatory reaction within the cyst and the consequent formation of neoangiogenic vessels.Hemorrhagic synovial cyst of the spine is rare and its most common localization is lumbar. Bleeding within the cyst leads to an increase of its volume; accompanied by neurological deficits and/or painful symptoms that are violent and generally intractable. In this event; surgical excision is the treatment of choice and; in s | 16531204 | [
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Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases. | ome cases; emergency surgery is necessary. Hemorrhages are probably caused by the rupture of fragile neoangiogenic vessels. | 16531204 | [
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Spinal compression due to ossified yellow ligament: a short series of 5 patients and literature review. | Ossification of ligamentum flavum in the thoracic region causing compressive myelopathy among middle-aged patients is a poorly described entity.Five patients of Indian origin with OYL are described. Their clinical presentations; surgical options; and long-term outcome are presented. Radiologic and clinical follow-up of one of the patient is described over a span of 10 years.Decompressive laminectomy and excision of the OYL is the commonly performed surgical procedure. A rapid neurologic improvement follows | 16531201 | [
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Spinal compression due to ossified yellow ligament: a short series of 5 patients and literature review. | decompression. The persistent spasticity in certain patients is attributed to irreversible changes within the cord. The disease is thought to be progressive in nature. The prolonged follow-up of these patients suggests that the long-term prognosis is poor. Selective racial involvement and variable clinical presentations; with treatment options; are discussed. | 16531201 | [
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Usefulness of transcervical approach for surgical treatment of hypoglossal schwannoma with paraspinal extension: case report. | Usefulness of transcervical approach to hypoglossal schwannoma with paraspinal extension is described herein.A 54-year-old woman presented with gradually worsening left hypoglossal nerve palsy. The findings were of a tumor lying in the left hypoglossal canal and paraspinal region and were consistent with hypoglossal schwannoma. Subtotal intracapsular removal of the tumor was performed via transcervical approach. The symptoms improved; and no additional symptoms were noted.The transcervical approach and intr | 16531208 | [
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Usefulness of transcervical approach for surgical treatment of hypoglossal schwannoma with paraspinal extension: case report. | acapsular removal of the tumor under electrophysiological monitoring provided for successful minimally invasive surgery in this case of hypoglossal schwannoma. | 16531208 | [
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Uncommon presentation of pediatric ruptured intracranial aneurysm after radiotherapy for retinoblastoma. Case report. | Radiation-induced intracranial aneurysms are a rare entity with high mortality. Their pathogenesis is still in debate. Their unique anatomy and behavior should be considered when deciding the proper management. A background of radiation; uncommon anatomic aspects; age of presentation; and location guide us to suspect a radiation-induced etiology. We report the case of a pediatric patient with a ruptured intracranial aneurysm; who previously received radiation therapy to the orbits. We aim to contribute to t | 16531206 | [
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Uncommon presentation of pediatric ruptured intracranial aneurysm after radiotherapy for retinoblastoma. Case report. | he literature of this uncommon condition and stress the importance of its prompt diagnosis and treatment.A 12-year-old boy; who received radiation therapy for recurrent bilateral retinoblastomas at age 4 months; suddenly developed severe headache associated with nausea and vomiting. A computed tomography scan revealed subarachnoid hemorrhage. A 4-vessel cerebral angiogram revealed a 2-mm aneurysm in the right A1 segment. The aneurysm was clipped successfully with excellent outcome. After 3 years of follow-u | 16531206 | [
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Uncommon presentation of pediatric ruptured intracranial aneurysm after radiotherapy for retinoblastoma. Case report. | p; the patient remains neurologically intact and asymptomatic. A new computed tomography angiogram revealed no new aneurysms.Vascular abnormalities develop after radiation injury to the brain. Aneurysm formation after radiation therapy has been previously reported; probably secondary to endothelial injury. In this case; early presentation; unusual anatomy; location; and small size at rupture; in contrast with saccular aneurysms; suggest a radiation-induced etiology. | 16531206 | [
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An unusual case of tumor-to-cavernoma metastasis. A case report and literature review. | Metastases of systemic neoplasia to preexisting intracranial mass lesions are uncommon phenomena. Tumor-to-intracranial cavernoma metastases are even more unusual and rarely reported. We describe here a case of melanoma to intracranial cavernoma metastasis.A 39-year-old woman presented after an episode of generalized tonic-clonic seizure on a background of infrequent epilepsy. She was found to have a left parieto-occipital hemorrhagic lesion on imaging studies. The lesion was surgically removed and histopat | 16531212 | [
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An unusual case of tumor-to-cavernoma metastasis. A case report and literature review. | hology showed a metastatic melanoma within a cavernoma.This case report represents the third recorded case of tumor-to-intracranial cavernoma metastasis and the first melanoma to intracranial cavernoma metastasis. An extensive literature review of tumor-to-intracranial tumor metastases was conducted and disclosed an increase in reporting of the uncommon phenomenon of metastasis into preexisting intracranial lesions. It should therefore be considered as a differential diagnosis in patients with history of sy | 16531212 | [
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An unusual case of tumor-to-cavernoma metastasis. A case report and literature review. | stemic cancer who present with progression of preexistent intracranial lesions. | 16531212 | [
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Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks. | Cerebrospinal fluid (CSF) leak is a complication of spinal surgery. Intraoperative or postoperative identification of a CSF leak often results in wound healing complications; lumbar drain placement; and/or reoperation. These complications usually extend a patient's hospital stay; can be painful; and have their own associated risks. The authors describe a technique that may improve on traditional interventions by managing postoperative CSF leaks after lumbar instrumentation without an additional procedure or | 16531215 | [
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Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks. | extended hospitalization.A retrospective review of lumbar instrumentation cases performed by 5 attending surgeons from the Division of Neurosurgery; University of California at San Diego; was performed. In all; 184 charts were reviewed; spanning a 3-year period. There were 16 cases in which a dural tear and repair were carried out and subsequently treated with subfascial Jackson-Pratt (JP) drainage. Of those 16 cases; 8 patients were managed with prolonged JP drainage using the intraoperatively placed subf | 16531215 | [
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Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks. | ascial drain. Patients were discharged home on oral antibiotics according to the customary criteria with the JP drain in place and were instructed regarding proper drain maintenance. Jackson-Pratt drains were removed in clinic in a delayed fashion; approximately 10 to 17 days postoperatively. Patients were subsequently reevaluated at regular intervals for any persistent CSF leak.In the 8 cases reviewed; all patients were discharged in a time frame comparable to that of patients undergoing similar instrument | 16531215 | [
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Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks. | ation in which no CSF leak was identified; or in whom a CSF leak was identified and repaired intraoperatively. No patients suffered complications arising from prolonged drain presence. No patients suffered from persistent CSF leak after drains were removed.Our study suggests that routine intraoperative subfascial JP drain placement aids in the early diagnosis of postoperative lumbar CSF leak. Primary closure of dural tear remains the standard of care. Furthermore; in select cases; prolonged JP drainage in t | 16531215 | [
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Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks. | he setting of postoperative CSF leak may be a useful technique for the treatment of these leaks. | 16531215 | [
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Malpractice issues in neurological surgery. | Malpractice litigation continues to be a serious problem in neurosurgery despite many suggestions to contain liability; including proposed federal legislation.A current study of 275 malpractice claims has been compared with a prior study of 300 cases of liability and potential liability reported in 1985. Twenty years later; the results are surprisingly similar. Spinal surgery continues to dominate neurosurgical malpractice claims with 42% of the total; most from lumbar spine operations. As in the previous s | 16531218 | [
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Malpractice issues in neurological surgery. | tudy; trauma and intracranial surgery account for the next largest groups. Of particular significance in terms of improved diagnostic methodology were spinal operations at the wrong level as well as failure to diagnose sentinel bleeds; aneurysms; arteriovenous malformation; and other cerebral lesions.Although many cases believed defensible were settled often because of significant neurological deficit; a number were dropped or dismissed after review; reports; or depositions; and defense verdicts were achiev | 16531218 | [
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Malpractice issues in neurological surgery. | ed in a similar number that went to trial.Most plaintiff claims that had merit were settled. Although hope continues for tort reform; uniform capitation of noneconomic awards; and contingency fees; it should be noted that 119 claims; more than 40%; were considered either not defensible by defendants or had merit for the plaintiff. | 16531218 | [
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Re: Cerebellar mutism in adults after posterior fossa surgery: a report of 2 cases (Sherman JH et al. Surg Neurol 2005;63:476-9). | nan | 16531220 | [
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Simulation of diffusion time of small molecules in protein crystals. | A simple model for evaluation of diffusion times of small molecule into protein crystals has been developed; which takes into account the physical and chemical properties both of protein crystal and the diffusing molecules. The model also includes consideration of binding and the binding affinity of a ligand to the protein. The model has been validated by simulation of experimental set-ups of several examples found in the literature. These experiments cover a wide range of situations: from small to relative | 16531224 | [
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Simulation of diffusion time of small molecules in protein crystals. | ly large diffusing molecules; crystals having low; medium; or high protein density; and different size. The reproduced experiments include ligand exchange in protein crystals by soaking techniques. Despite the simplifying assumptions of the model; theoretical and experimental data are in agreement with available data; with experimental diffusion times ranging from a few seconds to several hours. The method has been used successfully for planning intermediate cryotrapping experiments in maltodextrin phosphor | 16531224 | [
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] |
Structural model of the mAb 806-EGFR complex using computational docking followed by computational and experimental mutagenesis. | In this work; we combined computational protein-protein docking with computational and experimental mutagenesis to predict the structure of the complex formed by monoclonal antibody 806 (mAb 806) and the epidermal growth factor receptor (EGFR). We docked mAb 806; an antitumor antibody; to its epitope of EGFR residues 287-302. Potential mAb 806-EGFR orientations were generated; and computational mutagenesis was used to filter them according to their agreement with experimental mutagenesis data. Further compu | 16531225 | [
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] |
Structural model of the mAb 806-EGFR complex using computational docking followed by computational and experimental mutagenesis. | tational mutagenesis suggested additional mutations; which were tested to arrive at a final structure that was most consistent with experimental mutagenesis data. We propose that this is the EGFR-mAb 806 structure; in which mAb 806 binds to an untethered form of the receptor; consistent with published experimental results. The steric hindrance created by the antibody near the EGFR dimer interface interferes with receptor dimerization; and we postulate this as the structural origin for the antitumor effect o | 16531225 | [
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Structural model of the mAb 806-EGFR complex using computational docking followed by computational and experimental mutagenesis. | f mAb 806. | 16531225 | [
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Conformational diversity in the TPR domain-mediated interaction of protein phosphatase 5 with Hsp90. | Protein phosphatase 5 (Ppp5) is one of several proteins that bind to the Hsp90 chaperone via a tetratricopeptide repeat (TPR) domain. We report the solution structure of a complex of the TPR domain of Ppp5 with the C-terminal pentapeptide of Hsp90. This structure has the "two-carboxylate clamp" mechanism of peptide binding first seen in the Hop-TPR domain complexes with Hsp90 and Hsp70 peptides. However; NMR data reveal that the Ppp5 clamp is highly dynamic; and that there are multiple modes of peptide bind | 16531226 | [
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Conformational diversity in the TPR domain-mediated interaction of protein phosphatase 5 with Hsp90. | ing and mobility throughout the complex. Although this interaction is of very high affinity; relatively few persistent contacts are found between the peptide and the Ppp5-TPR domain; thus explaining its promiscuity in binding both Hsp70 and Hsp90 in vivo. We consider the possible implications of this dynamic structure for the mechanism of relief of autoinhibition in Ppp5 and for the mechanisms of TPR-mediated recognition of Hsp90 by other proteins. | 16531226 | [
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] |
Structure of a transient intermediate for GTP hydrolysis by ras. | The flexibility of the conserved 57DTAGQ61 motif is essential for Ras proper cycling in response to growth factors. Here; we increase the flexibility of the 57DTAGQ61 motif by mutating Gln61 to Gly. The crystal structure of the RasQ61G mutant reveals a new conformation of switch 2 that bears remarkable structural homology to an intermediate for GTP hydrolysis revealed by targeted molecular dynamics simulations. The mutation increased retention of GTP and inhibited Ras binding to the catalytic site; but not | 16531227 | [
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] |
Structure of a transient intermediate for GTP hydrolysis by ras. | to the distal site of Sos. Most importantly; the thermodynamics of RafRBD binding to Ras are altered even though the structure of switch 1 is not affected by the mutation. Our results suggest that interplay and transmission of structural information between the switch regions are important factors for Ras function. They propose that initiation of GTP hydrolysis sets off the separation of the Ras/effector complex even before the GDP conformation is reached. | 16531227 | [
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Molecular dynamics simulations of the complete satellite tobacco mosaic virus. | This work presents an all-atom molecular dynamics simulation of a complete virus; the satellite tobacco mosaic virus. Simulations with up to 1 million atoms for over 50 ns demonstrate the stability of the entire virion and of the RNA core alone; while the capsid without RNA exhibits a pronounced instability. Physical properties of the simulated virus particle including electrostatic potential; radial distribution of viral components; and patterns of correlated motion are analyzed; and the implications for t | 16531228 | [
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Molecular dynamics simulations of the complete satellite tobacco mosaic virus. | he assembly and infection mechanism of the virus are discussed. | 16531228 | [
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Crystal structure of the boronic acid-based proteasome inhibitor bortezomib in complex with the yeast 20S proteasome. | The dipeptide boronic acid bortezomib; also termed VELCADE; is a proteasome inhibitor now in use for the treatment of multiple myeloma; and its use for the treatment of other malignancies is being explored. We determined the crystal structure of the yeast 20S proteasome in complex with bortezomib to establish the specificity and binding mode of bortezomib to the proteasome's different catalytically active sites. This structure should enable the rational design of new boronic acid derivatives with improved a | 16531229 | [
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Solution structure of the SWIRM domain of human histone demethylase LSD1. | SWIRM is an evolutionarily conserved domain involved in several chromatin-modifying complexes. Recently; the LSD1 protein; which bears a SWIRM domain; was found to be a demethylase for Lys4-methylated histone H3. Here; we report a solution structure of the SWIRM domain of human LSD1. It forms a compact fold composed of 6 alpha helices; in which a 20 amino acid long helix (alpha4) is surrounded by 5 other short helices. The SWIRM domain structure could be divided into the N-terminal part (alpha1-alpha3) and | 16531230 | [
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Solution structure of the SWIRM domain of human histone demethylase LSD1. | the C-terminal part (alpha4-alpha6); which are connected to each other by a salt bridge. While the N-terminal part forms a SWIRM-specific structure; the C-terminal part adopts a helix-turn-helix (HTH)-related fold. We discuss a model in which the SWIRM domain acts as an anchor site for a histone tail. | 16531230 | [
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The structural basis of actin interaction with multiple WH2/beta-thymosin motif-containing proteins. | Participation of actin in cellular processes relies on the dynamics of filament assembly. Filament elongation is fed by monomeric actin in complex with either profilin or a Wiscott-Aldrich syndrome protein (WASP) homology domain 2 (WH2)/beta-thymosin (betaT) domain. WH2/betaT motif repetition (typified by ciboulot) or combination with nonrelated domains (as found in N-WASP) results in proteins that yield their actin to filament elongation. Here; we report the crystal structures of actin bound hybrid protein | 16531231 | [
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The structural basis of actin interaction with multiple WH2/beta-thymosin motif-containing proteins. | s; constructed between gelsolin and WH2/betaT domains from ciboulot or N-WASP. We observe the C-terminal half of ciboulot domain 2 bound to actin. In solution; we show that cibolout domains 2 and 3 bind to both G- and F-actin; and that whole ciboulot forms a complex with two actin monomers. In contrast; the analogous portion of N-WASP WH2 domain 2 is detached from actin; indicating that the C-terminal halves of the betaT and WH2 motifs are not functionally analogous. | 16531231 | [
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Structure and dimerization of the kinase domain from yeast Snf1, a member of the Snf1/AMPK protein family. | The Snf1/AMPK kinases are intracellular energy sensors; and the AMPK pathway has been implicated in a variety of metabolic human disorders. Here we report the crystal structure of the kinase domain from yeast Snf1; revealing a bilobe kinase fold with greatest homology to cyclin-dependant kinase-2. Unexpectedly; the crystal structure also reveals a novel homodimer that we show also forms in solution; as demonstrated by equilibrium sedimentation; and in yeast cells; as shown by coimmunoprecipitation of differ | 16531232 | [
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Structure and dimerization of the kinase domain from yeast Snf1, a member of the Snf1/AMPK protein family. | entially tagged intact Snf1. A mapping of sequence conservation suggests that dimer formation is a conserved feature of the Snf1/AMPK kinases. The conformation of the conserved alphaC helix; and the burial of the activation segment and substrate binding site within the dimer; suggests that it represents an inactive form of the kinase. Taken together; these studies suggest another layer of kinase regulation within the Snf1/AMPK family; and an avenue for development of AMPK-specific activating compounds. | 16531232 | [
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