Neurosurgery Commons^™

Outcomes Of Children With Low-Grade Gliomas In Low- And Middle-Income Countries: A Systematic Review, Richard Ward, Hannah M Jones, Davis Witt, Frederick Boop, Eric Bouffet, Carlos Rodriguez-Galindo, Ibrahim Qaddoumi, Daniel C Moreira

Department of Medical Oncology Faculty Papers

Purpose: Pediatric CNS tumors are increasingly a priority, particularly with the WHO designation of low-grade glioma (LGG) as one of six index childhood cancers. There are currently limited data on outcomes of pediatric patients with LGGs in low- and middle-income countries (LMICs).

Methods: To better understand the outcomes of LGGs in LMICs, this systematic review interrogated nine literature databases.

Results: The search identified 14,977 publications. Sixteen studies from 19 countries met the selection criteria and were included for data abstraction and analysis. Eleven studies (69%) were retrospective reviews from single institutions, and one (6%) captured institutional data prospectively. The studies …

Testing A Behavioral Activation Gaming App For Depression During Pregnancy: Multimethod Pilot Study, Philipp Karschnia, Jacob S Young, Antonio Dono, Levin Häni, Stephanie T Juenger, Tommaso Sciortino, Francesco Bruno, Nico Teske, Ramin A Morshed, Alexander F Haddad, Yalan Zhang, Sophia Stoecklein, Michael A Vogelbaum, Juergen Beck, Nitin Tandon, Shawn Hervey-Jumper, Annette M Molinaro, Roberta Rudà, Lorenzo Bello, Oliver Schnell, Yoshua Esquenazi, Maximilian I Ruge, Stefan J Grau, Martin Van Den Bent, Michael Weller, Mitchel S Berger, Susan M Chang, Joerg-Christian Tonn

Faculty, Staff and Student Publications

In IDH-wildtype glioblastomas which meet the histopathological or molecular diagnosis criteria, it remains unclear whether the presence of TERT promotor mutations provides additional prognostic information. Based on a multicenter cohort of 466 IDH-wildtype glioblastomas (including 396 with and 70 patients without TERT promotor mutations), we found that TERT promotor mutations were neither associated with progression-free survival nor overall survival. This held true in various treatment-based or molecular subgroups. This argues against standardized analysis for TERT promotor mutation status for the purpose of prognostic or therapeutic relevance in newly diagnosed IDH-wildtype glioblastoma that otherwise meets the histopathological and …

The Complex Relationship Between Integrins And Oncolytic Herpes Simplex Virus 1 In High-Grade Glioma Therapeutics, Kimberly Ann Rivera-Caraballo, Mitra Nair, Tae Jin Lee, Balveen Kaur, Ji Young Yoo

Faculty, Staff and Student Publications

High-grade gliomas (HGGs) are lethal central nervous system tumors that spread quickly through the brain, making treatment challenging. Integrins are transmembrane receptors that mediate cell-extracellular matrix (ECM) interactions, cellular adhesion, migration, growth, and survival. Their upregulation and inverse correlation in HGG malignancy make targeting integrins a viable therapeutic option. Integrins also play a role in herpes simplex virus 1 (HSV-1) entry. Oncolytic HSV-1 (oHSV) is the most clinically advanced oncolytic virotherapy, showing a superior safety and efficacy profile over standard cancer treatment of solid cancers, including HGG. With the FDA-approval of oHSV for melanoma and the recent conditional approval of …

Patterns Of Failure After Radiation Therapy In Primary Spinal High-Grade Gliomas: A Single Institutional Analysis, Rituraj Upadhyay, Swapnil Khose, Halyna Pokhylevych, Arnold C Paulino, Mary Frances Mcaleer, Amol Ghia, Jing Li, Debra Nana Yeboa, Monica Loghin, Rebecca Harrison, Barbara O'Brien, Carlos Kamiya-Matsuoka, John De Groot, Vinay K Puduvalli, Claudio Tatsui, Christopher Alvarez-Breckenridge, Sujit Prabhu, Larry Rhines, Wafik Zaky, Frank Lin, Jeffery S Weinberg, Gregory Fuller, David I Sandberg, Jason Michael Johnson, Susan L Mcgovern

Faculty, Staff and Student Publications

Background

Primary spinal high-grade gliomas (S-HGG) are rare aggressive tumors; radiation therapy (RT) often plays a dominant role in management. We conducted a single-institution retrospective review to study the clinicopathological features and management of S-HGGs.

Methods

Patients with biopsy-proven S-HGG who received RT from 2001 to 2020 were analyzed for patient, tumor, and treatment characteristics. Kaplan–Meier estimates were used for survival analyses.

Results

Twenty-nine patients were identified with a median age of 25.9 years (range 1–74 y). Four patients had GTR while 25 underwent subtotal resection or biopsy. All patients were IDH wildtype and MGMT-promoter unmethylated, where available. H3K27M mutation …

Asymmetric Synthesis Of Nortropanes Via Rh-Catalyzed Allylic Arylation, Yan Zhang, F Wieland Goetzke, Kirsten E Christensen, Stephen P Fletcher

Faculty, Staff and Student Publications

Tropane derivatives are extensively used in medicine, but catalytic asymmetric methods for their synthesis are underexplored. Here, we report Rh-catalyzed asymmetric Suzuki–Miyaura-type cross-coupling reactions between a racemic N-Boc-nortropane-derived allylic chloride and (hetero)aryl boronic esters. The reaction proceeds via an unexpected kinetic resolution, and the resolved enantiopure allyl chloride can undergo highly enantiospecific reactions with N-, O-, and S-containing nucleophiles. The method was applied in a highly stereoselective formal synthesis of YZJ-1139(1), a potential insomnia treatment that recently completed Phase II clinical trials. Our report represents an asymmetric catalytic method for the synthesis of YZJ-1139(1) and related compounds.

Pineal Cyst Apoplexy And Memory Loss: A Novel Complication, Areez Shafqat, Hanin Jaber Algethami, Shameel Shafqat, Syed Shafqat Ul Islam

Medical College Documents

An 8-year-old boy presented to our hospital complaining of a bilateral headache associated with episodes of anterograde amnesia. He had a road traffic accident 3 years ago when a computed tomography (CT) scan revealed traumatic brain injury. In addition, a small pineal cyst (PC) was noted with minor intramural calcifications. A follow-up CT a day later demonstrated increased density in the pineal gland of 60 Hounsfield Units, suggestive of apoplectic changes in the PC. However, the patient was lost to follow-up and presented with memory loss a year and a half later, upon which CT and magnetic resonance imaging revealed …

Tale Of Two Cities: Narrative Review Of Oxygen, Sung-Ho Ahn, Angela Burkett, Atzhiry Paz, Jude P Savarraj, Sarah Hinds, Georgene Hergenroeder, Aaron M Gusdon, Xuefeng Ren, Jeong-Ho Hong, Huimahn A Choi

Faculty, Staff and Student Publications

BACKGROUND: Cerebral edema (CE) at admission is a surrogate marker of 'early brain injury' (EBI) after subarachnoid hemorrhage (SAH). Only recently has the focus on the changes in CE after SAH such as delayed resolution or newly developed CE been examined. Among several factors, an early systemic inflammatory response has been shown to be associated with CE. We investigate inflammatory markers in subjects with early CE which does not resolve, i.e., persistent CE after SAH.

METHODS: Computed tomography scans of SAH patients were graded at admission and at 7 days after SAH for CE using the 0-4 'subarachnoid hemorrhage early …

Dual Leucine Zipper Kinase Regulates Dscam Expression Through A Noncanonical Function Of The Cytoplasmic Poly(A)-Binding Protein, Monika Singh, Bing Ye, Jung Hwan Kim

Faculty, Staff and Student Publications

Dual leucine zipper kinase (DLK) plays a pivotal role in the development, degeneration, and regeneration of neurons. DLK can regulate gene expression post-transcriptionally, but the underlying mechanism remains poorly understood. The Drosophila DLK, Wallenda (Wnd), regulates the expression of Down syndrome cell adhesion molecule (Dscam) to control presynaptic arbor growth. This regulation is mediated by the 3′ untranslated region (3′UTR) of Dscam mRNA, which suggests that RNA binding proteins (RBPs) mediate DLK function. We performed a genome-wide cell-based RNAi screen of RBPs and identified the cytoplasmic poly(A)-binding protein, pAbp, as an RBP that mediates Wnd-induced increase in Dscam expression. Genetic …

Event-Related Phase Synchronization Propagates Rapidly Across Human Ventral Visual Cortex, Oscar Woolnough, Kiefer J Forseth, Patrick S Rollo, Zachary J Roccaforte, Nitin Tandon

Faculty, Staff and Student Publications

Visual inputs to early visual cortex integrate with semantic, linguistic and memory inputs in higher visual cortex, in a manner that is rapid and accurate, and enables complex computations such as face recognition and word reading. This implies the existence of fundamental organizational principles that enable such efficiency. To elaborate on this, we performed intracranial recordings in 82 individuals while they performed tasks of varying visual and cognitive complexity. We discovered that visual inputs induce highly organized posterior-to-anterior propagating patterns of phase modulation across the ventral occipitotemporal cortex. At individual electrodes there was a stereotyped temporal pattern of phase progression …

Association Between Vitamin D Supplementation And Cancer Mortality: A Systematic Review And Meta-Analysis, Renjie Zhang, Yu Zhang, Zheran Liu, Yiyan Pei, Ping Xu, Weelic Chong, Yang Hai, Ling He, Yan He, Jiayi Yu, Jingjing Wang, Fang Fang, Xingchen Peng

Department of Medical Oncology Faculty Papers

Background: Vitamin D deficiency is related to increased cancer risk and deaths. However, whether vitamin D supplementation reduces cancer mortality remains unclear, and several randomized controlled trials yield inconsistent results.

Methods: Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception until 28 June 2022, for randomized controlled trials investigating vitamin D supplementation. Pooled relative risks (RRs) and their 95% confidence intervals (CIs) were estimated. Trials with vitamin D supplementation combined with calcium supplementation versus placebo alone and recruiting participants with cancer at baseline were excluded in the present study.

Results: This study included 12 …

Evolution Of The Ao Spine Sacral And Pelvic Classification System: A Systematic Review, Barry Ting Sheen Kweh, Jin W. Tee, F. Cumhur Oner, Klaus J. Schnake, Emiliano N. Vialle, Frank Kanziora, Shanmuganathan Rajasekaran, Marcel Dvorak, Jens R. Chapman, Lorin M. Benneker, Gregory Schroeder, Alexander R. Vaccaro

Rothman Institute Papers

OBJECTIVE: The purpose of this study was to describe the genesis of the AO Spine Sacral and Pelvic Classification System in the context of historical sacral and pelvic grading systems.

METHODS: A systematic search of MEDLINE, EMBASE, Google Scholar, and Cochrane databases was performed consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all existing sacral and pelvic fracture classification systems.

RESULTS: A total of 49 articles were included in this review, comprising 23 pelvic classification systems and 17 sacral grading schemes. The AO Spine Sacral and Pelvic Classification System represents both the evolutionary …

Metastatic Primary Brain Rhabdomyosarcoma In A Pediatric Patient: Illustrative Case, Michel Gustavo Mondragón-Soto, Luis Del Valle, José Alfredo González-Soto, Roberto Alfonso De Leo-Vargas

School of Medicine Faculty Publications

BACKGROUND: Primary intracranial rhabdomyosarcoma is an extraordinarily rare malignant tumor, with even fewer presenting with distant metastasis. To date, only five cases, including the one presented here, have been reported to present metastatic activity. OBSERVATIONS: A 12-year-old boy presented with a few days of headache, nausea, vomiting, but no neurological deficit. Brain computed tomography and magnetic resonance imaging demonstrated hydrocephalus and a cystic lesion with left parieto-occipital extension. After resection, pathology reported primary rhabdomyosarcoma, with positive desmin and myogenin on immunohistochemistry. The patient presented with pulmonary metastasis. The patient had an overall survival of 21 months after diagnosis with optimal …

Magnetically Recoverable Silica-Decorated Ferromagnetic-Nanoceria Nanocatalysts And Their Use With O- And N-Butyloxycarbonylation Reaction Via Solvent-Free Condition, Shripad M Patil, Runjhun Tandon, Nitin Tandon

Faculty, Staff and Student Publications

Silica-decorated ferrite nanoparticles, a new kind, coated with ceric ammonium nitrate (CAN), have been prepared successfully by simple coprecipitation techniques. Powder X-ray diffraction spectroscopy (PXRD), Fourier transform-infrared spectroscopy (FT-IR), field emission-scanning electron microscope (FE-SEM), wavelength-dispersive X-ray spectroscopy (WDX), energy-dispersive spectroscopy (EDS), inductive coupled plasma-optical emission spectroscopy (ICP-OES), and thermogravimetric analysis (TGA) techniques were used to characterize these nanoparticles. The catalysts are further studied for catalytic activity in solvent-free conditions. Importantly, these nanoparticles have been collected from the reaction mixture using an external magnet and recycled up to minimum of 15 cycles with no substantial loss of catalytic characteristics.

Glyoxal Fixation Is Optimal For Immunostaining Of Brain Vessels, Pericytes And Blood-Brain Barrier Proteins, Sithara Thomas, Jayanarayanan Sadanandan, Spiros L Blackburn, Devin W Mcbride, Ari Dienel, Sungha Hong, Hussein A Zeineddine, Peeyush Kumar Thankamani

Faculty, Staff and Student Publications

Brain vascular staining is very important for understanding cerebrovascular pathologies. 4% paraformaldehyde is considered the gold standard fixation technique for immunohistochemistry and it revolutionized the examination of proteins in fixed tissues. However, this fixation technique produces inconsistent immunohistochemical staining results due to antigen masking. Here, we test a new fixation protocol using 3% glyoxal and demonstrate that this method improves the staining of the brain vasculature, pericytes, and tight junction proteins compared to 4% paraformaldehyde. Use of this new fixation technique will provide more detailed information about vascular protein expressions, their distributions, and colocalizations with other proteins at the molecular …

A Spatiotemporal Map Of Reading Aloud, Oscar Woolnough, Cristian Donos, Aidan Curtis, Patrick S Rollo, Zachary J Roccaforte, Stanislas Dehaene, Simon Fischer-Baum, Nitin Tandon

Faculty, Staff and Student Publications

Reading words aloud is a fundamental aspect of literacy. The rapid rate at which multiple distributed neural substrates are engaged in this process can only be probed via techniques with high spatiotemporal resolution. We probed this with direct intracranial recordings covering most of the left hemisphere in 46 humans (26 male, 20 female) as they read aloud regular, exception and pseudo-words. We used this to create a spatiotemporal map of word processing and to derive how broadband γ activity varies with multiple word attributes critical to reading speed: lexicality, word frequency, and orthographic neighborhood. We found that lexicality is encoded …

Primary Middle Meningeal Artery Embolization For A Chronic Subdural Hematoma After Non-Accidental Trauma In A Child: A Case Report, Saisree Ravi, Sohum Desai, Ameer E. Hassan, Wondwossen G. Tekle

School of Medicine Publications

Chronic subdural hematoma in children can be pathognomonic of abusive head trauma. Treatment options for these range from observation to surgical evacuation depending on clinical circumstance and presenting features, which can include mental status changes, headaches, focal neurologic deficits, or asymptomatic presentation. Standalone endovascular treatments represent an area of growing interest in the adult population as an effective treatment modality. However, embolization as a singular treatment approach has not been reported in the pediatric population. We report the first case of stand-alone middle meningeal artery (MMA) embolization of a chronic subdural hematoma as a sequela of abusive head trauma in …

Clinical Trial Innovations In A Post-Covid World, Francisco A. Ponce, Ludy Chen Shih, Michael Staudt

Conference Presentation Abstracts

No abstract provided.

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Lumbar Motion Is Maintained With Paraspinous Tension Band For Degenerative Spondylolisthesis: Results From 24-Month Fda Study, Kee D. Kim, Rick Sasso, Serena Hu, Alan Villavicencio, S Tim Yoon, William Lavelle, Harvinder Sandhu, Hyun Bae, Jeffrey Fischgrund, Mick Perez-Cruet

Conference Presentation Abstracts

Introduction

Durable outcome for degenerative spondylolisthesis (DS) usually requires decompression and fusion. Fusion, however, places greater stress at adjacent levels with increased incidence of adjacent segment disease. A novel interspinous tension band is proposed for segmental stabilization after decompression for DS, as an alternative to fusion. An FDA IDE study (NCT03115983) compares decompression and stabilization with the tension band (treatment group) to decompression and transforaminal interbody instrumented fusion (control group) for symptomatic DS.

Methods

Prospectively enrolled IDE study subjects with 24 months postoperative radiographic follow-up were included in this analysis. X-rays obtained during the follow-up period for both the treatment …

The Impact Of Volume Of Tissue Activation On Cortical-Striatal Networks And Verbal Fluency Declines In Post-Deep Brain Stimulation Parkinson's Disease Patients., Alexander Luke Alley

Electronic Theses and Dissertations

This study investigated the cortical-striatal networks of verbal fluency declines in 6-month, post-operative, deep brain stimulation Parkinson’s Disease patients. Nine Parkinson’s disease participants with implanted STN or GPi DBS systems were recruited for this study. Verbal fluency data was obtained from each patient preoperatively and 6- months post implantation. The stimulation-based volume of tissue activated area (VTA) of each target site (STN or GPi) was analyzed using Lead-DBS and Lead-Group. The white matter tracks intersecting each patient’s VTA, terminating in the pre-SMA, SMA, caudate nucleus, and anterior cingulate were investigated and correlated with verbal fluency declines. We found statistically significant …