In conclusion, hyperthermia depresses cell viability and induces

In conclusion, hyperthermia depresses cell viability and induces bovine mammary cell apoptosis and necrosis through the mitochondrial-triggered cell death pathway. (c) 2007 Elsevier Ltd. All rights reserved.”
“OBJECTIVE: Several studies have shown that human gliomas contain a small population of cells with stem cell-like features. It has been proposed that these “”cancer stem cells”" may be uniquely responsible for glioma formation and recurrence. However, human gliomas also contain an abundance of cells that closely resemble more differentiated glial progenitors. Animal model studies have shown that these cells also possess the capacity

to form malignant gliomas.

METHODS: To investigate the contributions of stem-like and PF-4708671 order progenitor-like cells in human gliomas, we used flow cytometry to characterize the expression see more of a cancer stem cell marker (CD133) and a glial progenitor marker (A2B5) in 25 tumors. We found that human gliomas consistently express A2B5 in a large percentage of cells (61.7 +/- 3.8%, standard error of the mean). In contrast, CD133 expression was less abundant and less consistent (14.8 +/- 3.6%,

standard error of the mean), with several glioblastomas containing very few or no detectable CD133(+) cells. When present, the CD133(+) population was almost entirely contained within the A2B5(+) population. Thus, most gliomas could be divided into three distinct populations on the basis of these markers (A2B5(+)CD133(+), A2B5(+)CD133(-), and A2B5(-)CD133(-)). To test the tumorigenic potential of

these populations, we separated cells from six tumors by fluorescence-activated cell sorting and reinjected them into nude rats.

RESULTS: We found that the capacity for these different populations to form tumors varied depending on the human tumor specimen from which they were isolated. Of the six human gliomas tested, four contained A2B5(+)/CD133(-) cells that formed tumors when transplanted into nude rats, three contained A2B5(+)/CD133(+) cells that formed tumors, and only one glioma contained A2B5(-)/CD133(-) cells with the capacity to form tumors.

CONCLUSION: Together, these results demonstrate that human gliomas contain multiple populations of cells with the capacity Ulixertinib clinical trial to form tumors and specifically identify a population of tumorigenic A2B5(+) cells that are phenotypically distinct from CD133(+) cells.”
“1. We investigated whether heat tolerance has a crucial impact on the altitudinal distribution of a high-altitude lizard, Takydromus hsuehshanensis (> 1800m altitude).

2. We measured and compared its heat tolerance with that of another two lowland species. Heat tolerance measurement included critical thermal maximum (CTMax) and survival rates under three fluctuating daily temperature treatments over a 3-month period.

We assessed the responsiveness of each outcome measure by calcula

We assessed the responsiveness of each outcome measure by calculating a standardized response mean and performing

receiver operator characteristics curve analysis.

Results: Incontinence Severity Index, Pelvic Floor Distress Inventory-Short Form 20, Urinary Distress Inventory-Short EPZ-6438 research buy Form, Pelvic Floor Impact Questionnaire-Short Form 7 and Urinary Impact Questionnaire-Short Form 7 showed excellent responsiveness (standardized response mean >= 1.0). Using receiver operator characteristics curve data the bladder diary had the greatest ability to discriminate patients who did vs did not improve (area under the curve 0.97). Incontinence Severity Index, Pelvic Floor Distress Inventory-Short Form 20 and Urinary Distress Inventory-Short Form also showed strong responsiveness according to these data (area under the curve greater than 0.7).

Conclusions: In this study of women undergoing mid urethral sling surgery for stress urinary incontinence

the greatest responsiveness was noted on Incontinence Severity Index, Pelvic Floor Distress Inventory-Short Form 20, Urinary Distress Inventory-Short Form and bladder diary. Thus, they may be preferable as primary outcome measures in trials selleck products of stress urinary incontinence treatment.”
“BACKGROUND: In spinal cord stimulation for the management of chronic, intractable pain, a satisfactory analgesic effect can be obtained only when the stimulation-induced paresthesias cover all painful body areas completely or partially.

OBJECTIVE: To investigate the effect of stimulus pulse width (PW) and contact configuration (CC) on the area of paresthesia (PA), perception threshold (V-PT), discomfort threshold (V-DT), and usage range (UR) in spinal cord stimulation.

METHODS: Chronic pain patients were tested during a follow-up visit. They were stimulated monopolarly and with the CC giving each patient the best analgesia. V-PT, V-DT, and UR were determined for PWs of 90, 210, and 450 microseconds. The paresthesia contours at V-DT were drawn on

a body map and digitized; PA was calculated; and its anatomic composition was GDC-0449 concentration described. The effects of PW and CC on PA, V-PT, V-DT, and UR were tested statistically.

RESULTS: Twenty-four of 31 tests with low thoracic stimulation and 8 of 9 tests with cervical stimulation gave a significant extension of PA at increasing PW. In 14 of 18 tests (low thoracic), a caudal extension was obtained (primarily in L5-S2). In cervical stimulation the extension was predominantly caudal as well. In contrast to V-PT and V-DT, UR is not significantly different when stimulating with any CC.

CONCLUSION: PA extends caudally with increasing PW. The mechanism includes that the larger and smaller dorsal column fibers have a different mediolateral distribution and that smaller dorsal column fibers have a smaller UR and can be activated only when PW is sufficiently large. A similar effect of CC on PA is unlikely as long as electrodes with a large intercontact distance are applied.

Methods: HIV-positive and HIV-negative

members of 197 ser

Methods: HIV-positive and HIV-negative

members of 197 serodiscordant couples (159 male/female, 38 male/male) were assessed using instruments measuring depressive symptoms, sexual risk, and couple satisfaction. Results: HIV-positive partners with higher depression scores were less likely to be part of couples reporting unprotected sex, and HIV-positive partners’ higher depression scores were associated with less CA3 clinical trial unprotected intradyadic sex acts. This decrease in intradyadic sexual risk behavior was partially explained by a decrease in any sexual behavior within the couple. On the other hand, HIV-positive subjects with moderate or higher depression were more likely to have outside partners. Adding the partner satisfaction measure to the models was able to account for the relationship between the HIV-positive subjects’ depression scores and outside partners, but not for that between higher depression score and reduced intradyadic sexual risk. Conclusions: HIV-positive individuals with more depressive symptoms may be less likely

to engage in high-risk sexual behavior with their partners than those with less depressive symptoms, but more likely to have sexual partners outside the relationship. These findings suggest that the relationship between depressive symptoms and sexual risk behavior in this population may be mixed and complex, and suggest that clinicians should assess sexual risk behavior across the range of depression symptom severity.”
“Foxp3(+)CD4(+) T cells represent a population of naturally arising suppressor T cells that are crucial for the control of autoimmune GW786034 purchase responses. The suppressive activity of this

T cell subset relies on multiple mechanisms that include secretion of anti-inflammatory factors such as TGF-beta or IL-10. Novel studies now establish that, through the generation of the immunosuppressive factor adenosine, the ectoenzymes CD39 and CD73 are important contributors to the regulatory activity of Foxp3(+)CD4(+) T cells.”
“Within the developing mammalian cortex, neural progenitors first generate deep-layer neurons and subsequently more superficial-layer neurons, in an inside-out manner. Oxalosuccinic acid It has been reported recently that mouse embryonic stem cells (mESCs) can, to some extent, recapitulate cortical development in vitro, with the sequential appearance of neurogenesis markers resembling that in the developing cortex. However, mESCs can only recapitulate early corticogenesis; superficial-layer neurons, which are normally produced in later developmental periods in vivo, are under-represented. This failure of mESCs to reproduce later corticogenesis in vitro implies the existence of crucial factor(s) that are absent or uninduced in existing culture systems. Here we show that mESCs can give rise to superficial-layer neurons efficiently when treated with valproic acid (VPA), a histone deacetylase inhibitor.

“We studied error monitoring in a human patient with uniqu

“We studied error monitoring in a human patient with unique implantation of depth electrodes in both the left dorsal cingulate gyrus and medial temporal lobe prior to surgery. The patient performed a speeded go/nogo task and made a substantial number of commission errors (false alarms). As predicted, intracranial Local Field Potentials (iLFPs) in dorsal anterior cingulate indexed the detection of errors, showing an early differential activity around motor execution for false alarms, relative to correct responses (either hits or correct inhibitions). More surprisingly, we found

that the left amygdala also participated to error Smad inhibitor monitoring (although no emotional stimuli were used), but with a very different neurophysiological profile as compared with the dorsal cingulate cortex. Amygdala iLFPs showed a precise and reproducible temporal unfolding, characterized by an early monophasic response for correct hits around motor execution, which was delayed by similar to 300 ms for errors (even though actual RTs were

almost identical in these two conditions). Moreover, time-frequency analyses demonstrated a reliable and transient coupling in the theta band around motor execution between these two distant regions. Additional fMRI investigation in the same patient confirmed a differential involvement of the dorsal cingulate cortex vs. amygdala in error monitoring during this go/nogo task. Finally, these intracranial results for the left amygdala were replicated in a second patient with intracranial electrodes in the right amygdala. Altogether, these results suggest that the amygdala may register the motivational significance of motor learn more actions on a trial-by-trial basis, while the dorsal anterior cingulate cortex may provide

signals concerning failures of cognitive control and behavioral adjustment. More generally, these data shed new light on neural mechanisms underlying self-monitoring by showing that even “”simple”" motor actions recruit not DNA Damage inhibitor only executive cognitive processes (in dorsal cingulate) but also affective processes (in amygdala). (C) 2009 Elsevier Ltd. All rights reserved.”
“Objectives: Notwithstanding preoperative staging, a number of procedures still end in an exploratory thoracotomy as a result of unexpected findings. The aim of this work is to evaluate the validity of routine videothoracoscopy, performed as the first step of every planned resection for non-small cell lung cancer, to assess tumor resectability and feasibility of the resection through thoracoscopy.

Methods and Results: From November 1991 to December 2007, in our department, 1306 patients with non small cell lung cancer, judged operable at conventional staging, underwent videothoracoscopy before the operation. Thoracoscopy revealed inoperability in 58 (4.4%) patients, mostly owing to pleural dissemination (2.5%) or mediastinal infiltration (1.7%). In the remaining 1248 (95.6%), thoracoscopy did not reveal inoperability. Of these, 449 (34.

In addition to this commonly targeted domain, some paramyxovirus

In addition to this commonly targeted domain, some paramyxovirus V proteins target additional regions of mda-5. In contrast, V proteins cannot bind to RIG-I and consequently have no effect on the ability of RIG-I to bind dsRNA or to form oligomers.”
“The rostral ventrolateral medulla (RVLM) is critically important in the generation of sympathetic activity. The purpose of this study was to investigate whether discharges of RVLM neurons contribute to low-frequency (LF) sympathetic rhythms. Blood pressure (BP), renal sympathetic nerve activity (SNA), and

neuronal activity in the RVLM were simultaneously recorded in seven anesthetized, paralyzed, and artificially ventilated rats. Fifty-one RVLM neurons were recorded and classified into three differential functional groups according to their activities related PF-573228 manufacturer to baroreceptor input. Those in the category

of spike firing inhibited by a BP increase (BP(I)) and which excited sympathetic discharges was the most abundant (24%). Coherence analysis was used to examine the relationship of the firing frequency of RVLM neurons with the LF (0.2-0.8 Hz) rhythm of SNA. Forty-one percent of RVLM neurons showed a significant correlation to LF rhythms, and BP(I) neurons with sympathoexcitatory R788 price properties were the major contributors. In another 4 baroreceptor-denervated rats, 36 RVLM neurons were recorded. In these rats, RVLM neuronal activities no longer changed with BP fluctuations. Nevertheless, more than 40% of RVLM neurons were sympathoexcitatory, and 36% of RVLM neurons were still correlated with the LF SNA rhythm. Our results suggest that there are RVLM neurons involved in generating the LF rhythm in SNA and that the baroreflex can induce the participation of more neurons in LF rhythm generation. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“Murine gammaherpesvirus 68 (MHV68) establishes a lifelong infection in mice and is used as a model pathogen to study the role of viral and host factors in chronic infection. The maintenance of chronic MHV68 infection, at least in some latency reservoirs, appears to be dependent

on the capacity of the virus to reactivate from latency in vivo. However, the signals that lead to MHV68 reactivation in vivo are not well selleck compound characterized. Toll-like receptors (TLRs), by recognizing the specific patterns of microbial components, play an essential role in the activation of innate immunity. In the present study, we investigated the capacity of TLR ligands to induce MHV68 reactivation, both in vitro and in vivo. The stimulation of latently infected B cell lines with ligands for TLRs 3, 4, 5, and 9 enhanced MHV68 reactivation; the ex vivo stimulation of latently infected primary splenocytes, recovered from infected mice, with poly(I:C), lipopolysaccharide, flagellin, or CpG DNA led to early B-cell activation, B-cell proliferation, and a significant increase in the frequency of latently infected cells reactivating the virus.

Furthermore, parallel changes in the kinetics of the synaptic eve

Furthermore, parallel changes in the kinetics of the synaptic events and the distribution of spines indicated a more prominent functional contribution of synaptic inputs from across the dendritic tree. The shift in spine distribution across the dendritic tree was further confirmed with the examination of Golgi-stained tissue. This abnormal physiological drive of BA neurons after repeated stress may contribute to heightened

affective responses after chronic MX69 stress. A reduction in the impact of excitatory drive in the BA may therefore be a potential treatment for the harmful effects of chronic stress in psychiatric disorders.”
“The range of cognitive and psychotomimetic effects produced by antagonists of the N-methyl-D-aspartate (NMDA) receptor has lead to widespread usage of these molecules as pharmacological models of cognitive impairment for drug discovery. Historically, NMDA

receptor antagonists have been used interchangeably on the assumption that they produce analogous effects.

To profile a subset of these antagonists across a novel within-subject cognitive battery in the rat.

Na < ve male Lister Hooded rats were subjected to a series of tests in which they were required to learn a simple visuo-auditory conditional discrimination. They then underwent testing in a delayed discrimination test followed by rule reversal and rule extinction tests.

All NMDA receptor antagonists tested impaired acquisition performance and, with the exception of ketamine and the GluN2A preferring antagonist, NVP-AAM077, impaired ISRIB molecular weight consolidation of extinction. GluN2B antagonism produced a singular profile with potentially enhanced delayed discrimination performance and reduced hit rates

in the reversal phase. Only PCP (phencyclidine) and ketamine disrupted performance in the delay phase but did so in a delay-independent manner. MK-801, PCP and memantine all increased the hit rate in the reversal phase; whilst only MK-801 and PCP impaired extinction per se.

NMDA receptor-dependent mechanisms are requisite in the acquisition of a simple conditional discrimination and consolidation of extinction. Their role in working memory and reversal tasks appear to be less critical and potentially specific to the paradigm and NMDA receptor antagonist used. It is clearly misleading to generalise across NMDA antagonists with respect to their preclinical cognitive profile.”
“Purpose: Historically the placement of testicular prosthesis during orchiectomy for torsion is delayed despite reports of safe prosthesis placement during mastectomy and orchiectomy for cancer as well as the removal of infected penile prostheses. We describe our experience with intravaginal testicular prosthesis at orchiectomy in adolescents with torsion.

Materials and Methods: Consecutive pubertal patients undergoing exploration for torsion from 2010 to 2011 were offered orchiectomy with staged prosthesis or combined orchiectomy and prosthesis exchange for nonsalvageable testis.

77, 1 21-2 58, p=0 003; and violent

77, 1.21-2.58, p=0.003; and violent CH5183284 off ending in 122 [5.1%] of 2582 men with exposure to five to 16 traumatic events, 1.65, 1.12-2.40, p=0.01; test for trend, p=0.032). Violent off ending was strongly associated with post-deployment alcohol misuse (violent off ending in 120 [9.0%] of 1363 men with alcohol misuse vs 155 [2.3%] of 6768 with no alcohol misuse; 2.16, 1.62-2.90; p<0.0001), post-traumatic stress

disorder (violent off ending in 25 [8.6%] of 344 men with post-traumatic stress disorder vs 221 [3.0%] of 7256 with no symptoms of post-traumatic stress disorder; 2.20, 1.36-3.55; p=0.001), and high levels of self-reported aggressive behaviour (violent off ending in 56 [6.7%] of 856 men with an aggression score of six to 16 vs 22 [1.2%] of 1685 with an aggression score of zero; 2.47, 1.37-4.46; p=0.003). Of the post-traumatic stress disorder symptoms, the hyperarousal cluster was most strongly associated with violent off ending (2.01, 1.50-2.70; p<0.0001).

Interpretation Alcohol misuse and aggressive behaviour might be appropriate targets for interventions, but any action must be evidence based. Post-traumatic stress disorder, though less prevalent, is also a risk factor for violence, especially hyperarousal symptoms, so if diagnosed it should

be appropriately treated and associated risk monitored.”
“Background Clinical remission and low disease activity are essential treatment targets in patients with rheumatoid arthritis. Although moderately active rheumatoid arthritis is common, treatment effects in moderate disease have not been well studied. Additionally, optimum use of biologics needs further investigation, including Poziotinib ic50 the use of induction, maintenance, and withdrawal treatment strategies. The aim of the PRESERVE trial was to assess whether low disease activity would be sustained with reduced doses or withdrawal of etanercept in patients with moderately active disease.

Methods In a randomised controlled trial, patients aged between 18 and 70 years with moderately active rheumatoid arthritis (disease activity score in 28 joints [DAS28] >3.2 and <= 5.1) despite treatment with

methotrexate were enrolled at 80 centres in Europe, Latin America, Asia, and Australia between March 6, 2008, and Sept 9, 2009. To be eligible, patients had to have been receiving 15-25 mg of methotrexate every week for at least 8 weeks. In an open-label period of 36 weeks, all patients were given 50 mg etanercept plus methotrexate every week. To be eligible for a subsequent double-blind period of 52 weeks, participants had to have achieved sustained low disease activity. These patients were randomly assigned (1: 1: 1) by an interactive voice-response system to one of three treatment groups: 50 mg etanercept plus methotrexate, 25 mg etanercept plus methotrexate, or placebo plus methotrexate. Patients were stratified in blocks of three by DAS28 response (low disease activity or remission) at week 36.

However, no significant correlation was found in group ORG Using

However, no significant correlation was found in group ORG. Using power spectrum analysis (FFT), we identified 3 frequency components of postural sway: group A (0.02-0.21 Hz), group B (0.22-2.01 Hz), and group C (2.01-10 Hz). Statistical significance of the data was examined by ANOVA. Group C reflected somatosensory inputs, and group A reflected vestibular inputs. The power of group C decreased in the high anxiety group, whereas the power of group A increased in the AZD2014 research buy high anxiety group. These phenomena disappeared in the eyes-closed condition. Our study shows that the effect of visual

input on vestibular and somatosensory input is affected by anxiety. In conclusion, our results indicate that anxiety affects the postural perturbation in the antero-posterior axis and that anxiety possibly affects the interactions of visual inputs with vestibular and somatosensory inputs in the maintenance of postural balance in patients complaining of dizziness. (C) 2010 Elsevier Ireland

Ltd. All rights reserved.”
“Objective: This study investigated short-term and long-term outcomes in patients with abdominal aortic infection (mycotic aneurysm, prosthetic graft infection, aortoenteric fistula) managed by total excision of the aneurysm or the infected vascular graft and in situ aortic reconstruction with a cryopreserved arterial homograft (CAH).

Methods: From January 2000 to December 2008, 110 consecutive patients underwent CAH implantation for treatment of vascular infections. In 57 (52%); in situ revascularization BI-D1870 of the abdominal aorta with Y-prosthesis constructed from CAHs was performed. Early outcome included 30-day

mortality and the levels of Rigosertib mouse daily blood markers (leucocytes, C-reactive protein, and platelets) during the postsurgical 10-day period. We reported long-term survival and freedom from reoperation rates, including all indications for reoperation.

Results: Indications for operation were infected vascular graft in 31 patients (55%), aortodigestive fistulae in 11 (19%), nonruptured mycotic aneurysms in 4 (7%), and ruptured mycotic aneurysms of abdominal aorta in 11 (19%). In 39 of 57 patients (68%), the intraoperative specimens were positive for at least one microorganism, and Staphylococcus aurcus was present in 14 (25%). In 32 patients (82%) with intraoperative specimens positive for microorganisms, there was no evidence of the intraoperatively detected microorganisms in the postoperative specimens (wound, blood culture, and drainage fluid). The peak value of leucocytes (13.7 +/- 4.4 x 10(3)/L) and C-reactive protein (200 +/- 75 mg/L) occurred on postoperative day 3. Platelets reached the lowest value on postoperative day 2 (178 +/- 67 x 10(9)/L). Median peak body temperature was 37.7 degrees +/- 0.6 degrees C. Thirty-day mortality was 9% (5 of 57 patients).

The lunar soil simulant JSC-1 has been developed by NASA from vol

The lunar soil simulant JSC-1 has been developed by NASA from volcanic ash found in Arizona to facilitate testing of toxicity and system requirements for lunar exploration. A concentration-response study of JSC-1 was undertaken on the murine macrophage cell line RAW 264.7. Results demonstrated concentrations of 50-2000 g/ml JSC-1 induced enhanced expression of inducible nitric oxide synthase (iNOS). Data suggest that extraterrestrial regolith has the potential to induce

an inflammatory response, and that selleck products future development of anti-inflammatory mitigative strategies may be necessary to counteract lunar dust-associated cellular toxicity.”
“OBJECTIVE: This study examined the usefulness of a surgical approach (retrosigmoid suprafloccular transhorizontal fissure approach) for resection of brainstem cavernous malformations (CMs).

METHODS: An anatomic study concerning the retrosigmoid suprafloccular transhorizontal fissure approach was performed with 3 cadaveric heads. Clinical course was retrospectively reviewed for 10 patients who underwent microsurgical

resection of brainstem CMs with this approach. Medical, surgical, and neuroimaging records of these patients were CB-839 in vitro evaluated.

RESULTS: In the anatomic study, after standard suboccipital retrosigmoid craniotomy, the horizontal fissure on the petrosal surface MTMR9 of the cerebellum was dissected between the superior semilunar lobule and flocculus. With this approach, the root entry zone of the trigeminal nerve and the middle cerebellar peduncle could be exposed by superior retraction of the superior semilunar lobule. The lateral surface of the pons was then easily visible around

the root entry zone. When this approach was used for 10 brainstem CMs, complete resection was achieved in 9 patients (90%). No mortality was encountered in this study. New neurological deficits occurred in the early postoperative period for 4 patients but were transient in 3 patients. Neurological status at final follow-up was improved in 4 patients (40%), unchanged in 5 patients (50%), and worse in 1 patient (10%) compared with preoperative conditions.

CONCLUSION: The retrosigmoid suprafloccular transhorizontal fissure approach is useful for the resection of lateral pontine CMs.”
“Lead (Pb) poisoning is preventable but continues to be a public health problem in several countries. Measuring Pb in the surface dental enamel (SDE) using microbiopsies is a rapid, safe, and painless procedure. There are different protocols to perform these microbiopsies, but the reliability of dental enamel lead levels (DELL) determination is dependent upon biopsy depth (BD). It is established that DELL decrease from the outermost superficial layer to the inner layer of dental enamel.

25 mm; the smallest diameter was identified at L2 and had a mean

25 mm; the smallest diameter was identified at L2 and had a mean diameter of 2.05 mm. The largest spinal artery diameter was at L3 (mean, 0.56 mm) and the smallest at L1 (mean, 0.42 mm). The largest anastomotic artery diameter was at L4 (mean, 0.42 mm) and the smallest at L1 (mean, 0.32 mm). For the right and left sides, the mean greatest distance between the origin of the lumbar artery and the tendinous arch was at L4 (mean, 40.9 and 31.8 mm, respectively)

and the least at L1 (mean, 31.8 and 22.5 mm, respectively). The mean of the greatest distance between the anastomotic branch and the base of the transverse process NCT-501 of the lumbar vertebrae was at L4 (mean, 4.41 and 4.35 mm, respectively) and the smallest at L1 (mean, 4.04 and 4.08 mm, respectively).

CONCLUSION: These anatomic findings of the lumbar segmental arteries would be useful for emphasizing their surgical importance.”
“APOBEC proteins have evolved as innate defenses against retroviral infections. Human immunodeficiency virus (HIV) encodes the Vif protein to evade human APOBEC3G; however, mouse retroviruses do not encode a Vif homologue, and it has not been understood how they evade mouse APOBEC3. We report here a murine leukemia virus (MuLV) that utilizes its glycosylated Gag protein (gGag)

to evade APOBEC3. gGag is critical for infection of in vitro cell lines in the presence of APOBEC3. Furthermore, a gGag-deficient virus restricted for replication in wild-type mice replicates efficiently in APOBEC3 knockout mice, implying a novel role of gGag in circumventing the action DNA Damage inhibitor of APOBEC3 in vivo.”
“BACKGROUND: Intramedullary spinal ependymomas are rare tumors.

OBJECTIVE: To provide a large retrospective review in the modern neuroimaging era from a tertiary center where aggressive surgical resection is favored.

METHODS: Charts of intramedullary spinal ependymomas treated between 1983 and 2006 were reviewed.

RESULTS: Sixty-seven cases were reviewed. The mean age was 45.6 years (range, 11-78 years) with a male-to-female ratio of 2:1. The most common location was the cervical spine, followed by the thoracic and lumbar spine. The average duration of symptoms was 33 months, with the most

common symptom being pain and/or dysesthesias, followed by weakness, numbness, and urinary or sexual symptoms. Gross total resection was achieved in 55 patients and a subtotal resection was performed in 12 patients; 9 patients were treated with adjuvant radiation therapy. Mean follow-up was 32 months. The mean McCormick neurological grade at last follow-up was 2.0. The preoperative outcome correlated significantly with postoperative outcome (P < .001). A significant number of patients who initially worsened improved at their 3-month follow-up examination. Outcomes were significantly worse in patients undergoing subtotal resection with or without radiation therapy (P < .05). There were 3 recurrences. The overall complication rate was 34%.