World Neurosurg
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After a 4-year planning period, a joint Ethiopian/Norwegian training program in neurosurgery was started in June 2006. The collaborating partners were Addis Ababa University; Department of Surgery, Tikur Anbessa Specialized Hospital; University of Bergen; Haukeland University Hospital; and Myungsung Christian Medical Center, a Korean missionary hospital in Addis Ababa, Ethiopia. ⋯ This article gives an account of the strategies underlying the program planning, the history of the program, and on the experience gained by it. Finally, ethical problems and challenges encountered in the program are discussed.
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To conduct a comparative analysis of 2 groups of patients with skull base chordomas extending onto the craniovertebral junction, who underwent surgical treatment using extracranial approaches with and without craniocervical fusion. ⋯ Use of the proposed surgical technique in clinical practice may help increase the radicality of tumor excisions, decrease the number of postoperative complications, accelerate the rehabilitation process, and increase the quality of life in patients with skull base tumors extending to the craniovertebral junction.
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Cranial defects following anterior cranial base surgery have been frequently reconstructed using the pericranial flap. ⋯ Because pericranium thickness in the frontal areas is reported to be thinner than in other areas, a beginning neurosurgeon may have difficulty harvesting an anteriorly based flap of sufficient size. The technique presented here can help increase awareness of the subgaleal layer, facilitate the dissection process, and reduce additional tissue injury resulting from electrocautery manipulation.
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To evaluate the histopathologic effects of smoking before, during, and after pregnancy on the intervertebral disk structure of newborns in an experimental rat model. ⋯ Results of this study imply that maternal smoking before and during pregnancy and in the lactation period may have deleterious effects on the intervertebral disk of the newborn. The duration of smoking and fertility period can influence the type and severity of these effects.
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In patients with progressive low-grade glioma (LGG), the presence of new magnetic resonance imaging (MRI) enhancement is commonly used as an indicator of malignant degeneration, but its accuracy in this setting is uncertain. ⋯ In patients with progressive LGG, new MRI enhancement and pathologic grade were discordant in greater than 20% of cases. Pathologic confirmation of grade should therefore be attempted, when safe, to dictate management. Beyond functioning as a surrogate for pathologic grade, new MRI enhancement may predict for worse outcomes, a concept that merits prospective investigation.