Abstract:
OBJECTIVE:Convection-enhanced delivery (CED) and osmotic pump delivery both have been promoted as promising techniques to deliver drugs to pediatric diffuse intrinsic pontine gliomas (DIPGs). Correspondingly, the aim of this study was to understand how infusate molecular weight (MW), duration of delivery, and mechanism of delivery (CED or osmotic pump) affect volume of distribution (Vd) in the brainstem, to better inform drug selection and delivery in future DIPG investigations. METHODS:A series of in vivo experiments were conducted using rat models. CED and osmotic pump delivery systems were surgically implanted in the brainstem, and different MW fluorescent dextran beads were infused either once (acute) or daily for 5 days (chronic) in a volume infused (Vi). Brainstems were harvested after the last infusion, and Vd was quantified using serial sectioning and fluorescence imaging. RESULTS:Fluorescence imaging showed infusate uptake within the brainstem for both systems without complication. A significant inverse relationship was observed between infusate MW and Vd in all settings, which was distinctly exponential in nature in the setting of acute delivery across the 570-Da to 150-kDa range. Chronic duration and CED technique resulted in significantly greater Vd compared to acute duration or osmotic pump delivery, respectively. When accounting for Vi, acute infusion yielded significantly greater Vd/Vi than chronic infusion. The distribution in CED versus osmotic pump delivery was significantly affected by infusate MW at higher weights. CONCLUSIONS:Here the authors demonstrate that infusate MW, duration of infusion, and infusion mechanism all impact the Vd of an infused agent and should be considered when selecting drugs and infusion parameters for novel investigations to treat DIPGs.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Rechberger JS,Power EA,Lu VM,Zhang L,Sarkaria JN,Daniels DJdoi
10.3171/2019.10.FOCUS19703subject
Has Abstractpub_date
2020-01-01 00:00:00pages
E2issue
1issn
1092-0684pii
2019.10.FOCUS19703journal_volume
48pub_type
杂志文章abstract:OBJECT:Convection-enhanced delivery (CED) is an increasingly used novel local/regional delivery method targeted directly to tissue. It relies on a continuous pressure gradient for distribution of therapeutic agents into the interstitial space, with administration of the infusate over a few days. Cintredekin besudotox (...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-04-15 00:00:00
abstract::The benefits of anterior interbody arthrodesis in deformity surgery are well known and include load sharing and increased fusion rates. A minimally invasive lateral transpsoas approach to the anterior lumbar spine is a promising alternative to traditional interbody techniques for the treatment of adult degenerative sc...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.V2.FOCUS13198
更新日期:2013-07-01 00:00:00
abstract:OBJECT:The percentage of patients responding to conservative treatment for cervical radiculopathy secondary to nerve root compression is not well quantified. To clarify this question, the authors retrospectively reviewed the records obtained over a 4-year period in patients with cervical radiculopathy to determine thei...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.2.4
更新日期:2002-02-15 00:00:00
abstract::OBJECTIVE The objective of this study was to identify clinically relevant predictors of progression-free survival and functional outcomes in patients who underwent surgery for intramedullary spinal cord tumors (ISCTs). METHODS An institutional spinal tumor registry and billing records were reviewed to identify adult p...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.5.FOCUS16147
更新日期:2016-08-01 00:00:00
abstract:OBJECT:The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. METHODS:A retrospective chart review was conducted for patients with tumors of the facial nerve t...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.1.FOCUS12380
更新日期:2013-03-01 00:00:00
abstract:OBJECT:Although a rarely reported occurrence, late failure of endoscopic third ventriculostomy (ETV) may occur in children as a result of a variety of factors. Delay in recognition of symptoms can lead to harmful deterioration in the patient's condition. The authors undertook this study to assess the capacity of cine p...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.1.FOCUS10303
更新日期:2011-04-01 00:00:00
abstract::The development of less invasive methods to evacuate intracerebral hematomas (ICHs) has improved outcome in patients with traumatic brain injury. Eighteen patients with ICHs underwent surgery via one of two methods: stereotactic endoscopic removal (SER) or stereotactic catheter drainage (SCD). The outcome results were...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.4.2
更新日期:1996-10-15 00:00:00
abstract::Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rar...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.3.FOCUS1528
更新日期:2015-06-01 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldie...
journal_title:Neurosurgical focus
pub_type: 历史文章
doi:10.3171/2010.3.FOCUSMar2010Intro
更新日期:2010-05-01 00:00:00
abstract:OBJECT:The management of pediatric intraventricular tumors is highly dependent on identification of the tumor type. Choroid plexus papillomas, a common intraventricular tumor in children, can be difficult to distinguish radiographically from choroid plexus carcinomas and other common pediatric central nervous system (C...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-06-15 00:00:00
abstract::Brain-machine interface (BMI) is the latest solution to a lack of control for paralyzed or prosthetic limbs. In this paper the authors focus on the design of anatomical robotic hands that use BMI as a critical intervention in restorative neurosurgery and they justify the requirement for lower-level neuromusculoskeleta...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.5.4
更新日期:2006-05-15 00:00:00
abstract::OBJECT Cushing's disease (CD) is a potentially lethal neuroendocrinopathy that often requires specialized multidisciplinary treatment to achieve optimized outcomes. The authors analyzed data pertaining to patient, hospital, and admission characteristics as they relate to outcomes following transsphenoidal surgery (TSS...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.11.FOCUS14694
更新日期:2015-02-01 00:00:00
abstract::In addition to standard management for the treatment of the acute phase of spinal cord injury (SCI), implementation of novel neuroprotective interventions offers the potential for significant reductions in morbidity and long-term health costs. A better understanding of the systemic changes after SCI could provide insi...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.12.FOCUS18206
更新日期:2019-03-01 00:00:00
abstract::The Pipeline embolization device (PED) has become a very important tool in the treatment of nonruptured cerebral aneurysms. However, a patient's difficult anatomy or vascular stenosis may affect the device delivery. The purpose of this article was to describe an alternate technique for PED deployment when ipsilateral ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.2.FOCUS16485
更新日期:2017-06-01 00:00:00
abstract:OBJECT:The middle third of the clivus and the region around the petrous internal carotid artery (ICA) is a difficult area of the skull base in terms of access. This is a deep area rich with critical neurovascular structures, which is often host to typical skull base diseases. Expanded endoscopic endonasal approaches of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-07-15 00:00:00
abstract::Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to var...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
abstract::Vein of Galen malformations are rare congenital intracranial vascular malformations. Based on reports in the literature, spontaneous thrombosis or regression of these lesions is rare. Patients have variable outcomes from an asymptomatic course to death. The reasons behind spontaneous thrombosis are not entirely unders...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09162
更新日期:2009-11-01 00:00:00
abstract::Intraoperative optical imaging (IOI) is a marker-free, contactless, and noninvasive imaging technique that is able to visualize metabolic changes of the brain surface following neuronal activation. Although it has been used in the past mainly for the identification of functional brain areas under general anesthesia, t...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.11.FOCUS19759
更新日期:2020-02-01 00:00:00
abstract::The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the ph...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.1.FocusVid.16380
更新日期:2017-01-01 00:00:00
abstract:OBJECT:Ossification of the posterior longitudinal ligament (OPLL) is a disorder afflicting as many as 2% of East Asians. However, reports of OPLL in non-Asians have been sporadic in the medical literature. This study describes clinical and radiographic findings with OPLL in non-Asians at a tertiary care center treating...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.12.FOCUS10277
更新日期:2011-03-01 00:00:00
abstract::Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options acc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.9.FOCUS11222
更新日期:2011-12-01 00:00:00
abstract:OBJECT:The DIAM is a polyester-encased silicone interspinous dynamic stabilization device that can unload the anterior column and reestablish the functional integrity of the posterior column. METHODS:The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was perform...
journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/foc.2007.22.1.6
更新日期:2007-01-15 00:00:00
abstract:OBJECT:In this report the authors review the role of bioinformatics in the design of a research project in which the molecular genetics of malignant glioma were studied. A project to characterize Pokemon expression in malignant glioma was developed, refined, and implemented using bioinformatics methods. METHODS:Using ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2005.19.4.9
更新日期:2005-10-15 00:00:00
abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-09-15 00:00:00
abstract:OBJECT:Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09148
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Tractography is a useful technique that is standardly applied to visualize subcortical pathways. However, brain shift hampers tractography use during the course of surgery. While intraoperative MRI (ioMRI) has been shown to be beneficial for use in oncology, intraoperative tractography can rarely be performed...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.10.FOCUS20774
更新日期:2021-01-01 00:00:00
abstract:Objective:The aim of this study was to investigate the diagnostic potential of the inflammatory markers interleukin-6 (IL-6), total leukocyte count (TLC), and protein in the CSF and IL-6, C-reactive protein, and white blood cell count in the serum for the early diagnosis of ventriculitis in patients with traumatic brai...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.8.FOCUS19407
更新日期:2019-11-01 00:00:00
abstract::Frontal sinus fractures are heterogeneous, and management of these fractures is often modified based on injury pattern and institutional experience. The optimal initial treatment of frontal sinus fractures is controversial. Treatment strategies are aimed at correcting cosmetic deformity, as well as at preventing delay...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.3.focus1266
更新日期:2012-06-01 00:00:00
abstract::OBJECT Although the length of hospital stay is often used as a measure of quality of care, data evaluating the predictors of extended hospital stay after craniotomy for tumor are limited. The goals of this study were to use multivariate regression to examine which preoperative characteristics and postoperative complic...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15386
更新日期:2015-12-01 00:00:00