Notes

Farnesylthiosalicylic acid-derivatized PEI-based nanocomplex pertaining to enhanced tumour vaccine.
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A scientific publication is a mirror that defines the image of a researcher in his academic and professional world. Neurosurgery and Journal of Neurosurgery (JNS) are the 2 most reputed journals in the neurosurgical community.

We evaluated all the original articles published in these 2 journals in the last issue of the year/December (2000-2019). We excluded all review articles and determined number of authors, institutions, and highest educational degrees. Individual abstracts were evaluated for the nature of the study, population, and citations with individual and comparative statistical analyses.

A total of 682 original articles were analyzed. Neurosurgery had an increase in the number of authors (8.0 ± 4.11 compared with 5.65 ± 1.99), an increase in title word count (15.14 ± 5.05 from 13.2 ± 4.46), and an increase in basic science research (0.9% to 11.6%). Retrospective studies increased in JNS (35.8% to 46.8%), with fewer studies on animals (18.4% to 8.1%). An increase in number of authors from 6.1 and thus better impact. Limited by the sample size, only a weak correlation was found with increased title count and retrospective studies with citations, although their increase is an indicator of future trends. Both journals have shown a steady increase in their impact and quality of publications. To the best of our knowledge, our study is the first to examine the correlation of various factors and citations in neurosurgery in the post-2000 era.We present a case of a 28-year-old woman with a history of severe headaches and pituitary insufficiency. She was found to have a large, enhancing, sellar mass consistent with a pituitary adenoma. The patient's surgical care was delayed due to the coronavirus disease 2019 (COVID-19) pandemic, and follow-up imaging revealed spontaneous involution of the sellar mass. Spontaneous involution of pituitary masses has been described but not often encountered in clinical practice. This case highlights that follow-up imaging is necessary when scheduling elective surgeries during the COVID-19 pandemic.An adult with Sprengel deformity and Klippel-Feil syndrome associated with an omovertebral bone has rarely been reported in literature. JR-AB2-011 mouse The omovertebral bone is an abnormal cartilaginous connection between the scapula and the cervical spine. Limited cases have previously been reported in the literature describing surgical intervention when neurologic deficits such as cervical myelopathy or radiculopathy are present. In the present case, an omovertebral bone extended into the cervical lamina resulting in cervical myeloradiculopathy requiring resection of the bony anomaly and cervicothoracic fusion. The omovertebral bone as an etiology for radiculopathy or myelopathy is rarely seen in an adult population, and surgical decompression and fusion should be considered with this constellation of anomalies.
Diagnosis of spontaneous intracranial hypotension (SIH) may be delayed due to nonspecific symptoms and variable imaging findings. Cases of hyperostosis in children who are overshunted, a process that may be physiologically analogous to adults with SIH, have been reported by others and observed in our practice. The purpose of this retrospective study was to assess the frequency and pattern of calvarial hyperostosis in patients with SIH.

We retrospectively reviewed computed tomography and magnetic resonance imaging examinations from consecutive patients who underwent myelography for the evaluation of SIH to assess for the presence of generalized calvarial thickening or development of a secondary layer of bone. Patients with typical benign hyperostosis frontalis were excluded. Patient demographics and clinical factors were evaluated for association with hyperostosis.

Among 285 patients with SIH, 40 (14.0%) demonstrated diffuse calvarial hyperostosis on imaging. Most of these patients (32/40; 80.0%) demonstrated a distinct circumferentially layered appearance to the skull, whereas 8 of 40 (20.0%) had generalized calvarial thickening without layering.

Diffuse calvarial hyperostosis, particularly the concentrically layered form that we term "layer cake skull," is a relatively common imaging feature in patients with SIH. In the appropriate clinical context, this finding will allow the possibility of SIH to be raised based on computed tomography imaging, which is otherwise of limited utility in the initial diagnosis of this condition.
Diffuse calvarial hyperostosis, particularly the concentrically layered form that we term "layer cake skull," is a relatively common imaging feature in patients with SIH. In the appropriate clinical context, this finding will allow the possibility of SIH to be raised based on computed tomography imaging, which is otherwise of limited utility in the initial diagnosis of this condition.
Craniovertebral junction (CVJ) hydatid disease, although rare, forms an important differential diagnosis of CVJ bony pathologies, especially in endemic areas due to the sheer volume of cases presented there. The authors report a rare case of CVJ hydatid disease mimicking a bony expansile tumor on imaging.

A 21-year-old woman presented with a left-sided neck tilt and pain for 3 months, intermittent low-grade fever, and features of high cervical myelopathy (Nurick grade II). Magnetic resonance imaging and computed tomography imaging showed a solid enhancing mass with numerous small cystic areas with bony erosion of the basiocciput, C1 and C2 vertebrae, suggestive of an expansile bony lesion (osteoblastoma/giant cell tumor/aneurysmal bone cyst). She underwent a posterior approach for decompression and spinal fixation, and multiple clear grape-like cysts were encountered that were confirmed to be hydatid cysts on histopathology. All visible cysts were excised and instrumented fusion of the CVJ performed. Albet removal of cysts have a significant effect on reducing the recurrence rate and improving the outcome.A 79-year-old man with coronary artery disease and tremor-predominant Parkinson's disease underwent a gross total resection of a high-grade glioma and exhibited what appeared to be polymorphic ventricular tachycardia lasting 15-20 seconds on postoperative day 1. Further evaluation revealed that the patient did not have ventricular tachycardia, and that his abnormal telemetry signals were instead an artifact of his Parkinson's tremor. This case underscores the importance of considering tremor artifact when evaluating abnormal telemetry and electrocardiogram signals in patients with tremor, and highlights some features that can distinguish tremor artifact from a true arrhythmia.
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