Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Biography Historical Article
Harvey Cushing and some Australian connections: Part 2--post World War 1.
Part 1 of this article (see Vol 17, pp. 168-172) described the early life of Harvey Cushing and his encounters with Australian doctors, mostly in various military hospitals, in France, in World War 1. As none of the doctors he met at that time became neurosurgeons, and hence did not shape their professional development. ⋯ He received the Companion of the Bath from the British Government for his war services and wrote the history of US Base Hospital No. 5, which he directed during the War. Cushing's reputation as a neurosurgeon was now secure and he was ready to play an even greater part as an academic neurosurgeon, teaching students from all parts of the world and continuing his researches into cerebral tumours and the pituitary gland.
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Tadalafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Nitric oxide (NO) functions as a retrograde neurotransmitter in the spinal cord, and postsynaptic structures respond to NO by producing cGMP. The concentrations of cGMP in the spinal cord are controlled by the actions of PDE. ⋯ Tissue MDA levels in the tadalafil and methylprednisolone groups tended to be lower than in the non-treatment group and sham groups (p>0.05). Although there was no difference in neurological outcome scores between the tadalafil, methylprednisolone and non-treatment groups (p>0.05), the animals in the tadalafil and methylprednisolone groups tended to have better scores than the non-treatment group. Thus, tadalafil appears to be beneficial in reducing the effects of injury to the spinal cord by increasing tissue levels of NO and serum activity of SOD.
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We studied 27 patients with cervical ossification of the posterior longitudinal ligament (OPLL) but no clinical symptoms of myelopathy. We investigated the occupation ratio of the spinal canal by OPLL with cervical radiographs, assessed the morphological types of OPLL, and measured the segmental range of motion (ROM) at the level of maximum cord compression on flexion and extension radiographs. Patients were classified as having continuous-type OPLL (17 patients), mixed-type OPLL (seven patients), or segmental-type OPLL (three patients). ⋯ No patient developed myelopathy during the study period. Three patients with massive OPLL did not develop myelopathy and the mobility of their cervical spine was highly restricted, suggesting that dynamic factors such as the segmental ROM preferentially contribute to the development of myelopathy in patients with cervical OPLL. Thus, by controlling the dynamic factors (hypermobility), we might be able to reduce neurological deterioration in patients with cervical OPLL.
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Factors predictive of neurosurgery resident or applicant choice of an academic career compared to private practice are highly desired and difficult to discern. Neither medical school choice, student induction to faculty membership, age nor gender predict academic versus private practice choice among neurosurgery residents. This study was performed to examine the role of pre-residency peer-reviewed publications (PRP) in post-residency career choice. ⋯ Graduates with at least one PRP were 1.34 times more likely to choose an academic career than graduates with no PRP. Therefore, peer-reviewed PRP are strongly associated with resident choice of an academic over private practice neurosurgery career. This information might be useful in predicting the career choices of neurosurgery residents and residency applicants.
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Spontaneous intracranial hypotension (SIH) is a syndrome caused by low cerebrospinal fluid (CSF) pressure due to leakage of CSF. Clinically, orthostatic headache, neck pain, nausea, emesis, interscapular pain, diplopia, dizziness, changes in hearing, visual blurring and radicular upper extremity symptoms are most frequently observed. ⋯ Lumbar puncture identified low CSF pressure and intrathecal gadolinium enhanced MR cisternography showed diffuse CSF leakage in the thoracolumbar region. The patient underwent epidural blood patching, which resulted in complete resolution of postural tremor within 2 months.