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James T. Rutka

the text in the Methods and Introduction sections in the following articles are very similar to those found in the article cited above: Pan HC, Yang DY, Ho SP, Sheu ML, Chen CJ, Hwang SM, Chang MH, Cheng FC: Escalated regeneration in sciatic nerve crush injury by the combined therapy of human amniotic fluid mesenchymal stem cells and fermented soybean extracts, Natto. J Biomed Sci 16: 75, 2009 Cheng FC, Tai MH, Sheu ML, Chen CJ, Yang DY, Su HL, Ho SP, Lai SZ, Pan HC: Enhancement of regeneration with glia cell line-derived neurotrophic factor

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James T. Rutka

pathophysiology and emerging therapies: promise on the horizon Rowland, James W.; Hawryluk, Gregory W. J.; Kwon, Brian; Fehlings, Michael G. 2008 182 20.2 Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases Gooch, M. Reid; Gin, Greg E.; Kenning, Tyler J.; German, John W. 2009 113 14.12 Protection and repair of the injured spinal cord: a review of completed, ongoing, and planned clinical trials for acute spinal cord injury: a review Hawryluk, Gregory W. J.; Rowland, James; Kwon, Brian K.; Fehlings, Michael G. 2008

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Discovering neurosurgery: new frontiers

The 2011 AANS Presidential Address

James T. Rutka

, juvenile diabetes was a death sentence. Survival was measured in months not years. Based on his conviction that a cure for diabetes would be found within soluble extracts of the endocrine pancreas, Banting, along with Charles Best, performed experiments that led to the purification of insulin and its successful use in the first human clinical trials. 13 The third patient in the world to receive insulin therapy was Elizabeth Hughes, the daughter of famed U.S. presidential candidate and Secretary of State, Charles Evans Hughes. In 1923 Elizabeth Hughes came to Toronto to

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James T. Rutka

cavernous malformations Demonstration of the dynamic nature of cavernous malformations  Brem, Tamargo, Olivi, et al. Biodegradable polymers for controlled delivery of chemotherapy with and without radiation therapy Description of the use of controlled-release polymers impregnated w/ BCNU for brain tumors  Oldfield, Muraszko, Shawker Pathophysiology of syringomyelia associated with Yaşargil/Chiari I malformation of the cerebellar tonsils Determination of the critical pressure gradient across the foramen magnum leading to syringomyelia We have done much these past 5 years

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Merdas Al-Otibi and James T. Rutka

/hypothalamic tumors. Intraorbital tumors are relatively rare and cause progressive proptosis of the globe, strabismus, optic nerve papilledema, and atrophy ( Fig. 2 ). Occlusion of the central retinal artery may occur, resulting in unilateral or bilateral blindness. Good long-term results can be achieved with total excision of the intraorbital part of the optic nerve in progressive cases, even if the margin of the proximal cut end is not tumor free. Radiation therapy and chemotherapy are typically not used for intraorbital tumors. F ig . 2. A: Axial MR image with contrast

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Corey Raffel and James T. Rutka

delivered. The case presented in this paper seems to meet these criteria because the PNET arose in the field of irradiation delivered to treat the initial craniopharyngioma, the PNET presented 8 years after radiotherapy, the patient was not known to have any of the syndromes associated with the development of PNETs, and the 2 tumors were distinctly different. Although other reports of radiation-induced PNETs exist and are referenced in this paper, the current case is of interest because the patient was treated with radiation therapy without adjuvant chemotherapy, a common

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Scellig S. D. Stone and James T. Rutka

E pilepsy claims 4–10 individuals per 1000 population-translating to roughly 40 million people worldwide-and affects 50–100 new cases per 100,000 persons each year. 17 , 83 , 104 In addition to the enormous social impact and increased mortality associated with this condition, the annual economic burden to Europe approached 16 billion Euro in 2004 alone. 19 , 75 Antiepileptic drug therapy, the mainstay of epilepsy treatment, successfully leads to long-term remission in ~ 70% of patients. 43 In the remaining ~ 30%, pharmacotherapy is intolerable

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Alexandra D. Beier and James T. Rutka

from 74% to 85%. 2 , 24 Preoperative Planning In order for a patient to be a candidate for surgery, his or her seizures have to be proven intractable. Although the definition of intractability varies in the literature, it typically involves failure of 3 first-line antiepileptic medications. Other variables that can predict intractability are: early age at seizure onset, remote symptomatic etiology, infantile spasms, status epilepticus, poor response to short-term antiepileptic therapy, and failure of initial antiepileptic drug trial. 23 Hemispherectomy should

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Eve C. Tsai, Stephen Santoreneos and James T. Rutka

Although many treatment strategies for skull base tumors in adults have been reported, relatively little has been reported regarding such therapies in the pediatric population. Skull base tumors in children present a therapeutic challenge because of their unique pathological composition, the constraints of the maturing skull and brain, and the small size of the patients. In this review, the authors examine the pediatric skull base lesions that occur in the anterior, middle, and posterior cranial base, focusing on unique pediatric tumors such as encepahalocele, fibrous dysplasia, esthesioneuroblastoma, craniopharyngioma, juvenile nasopharyngeal angiofibroma, cholesteatoma, chordoma, chondrosarcoma, and Ewing sarcoma. They review management strategies that include radio- and chemotherapy, as well as surgical approaches with emphasis on the modifications and complications associated with the procedures as they apply in children. Evidence for the advantages and limitations of radiotherapy, chemotherapy, and surgery as it pertains to the pediatric population will be examined. With a working knowledge of skull base anatomy and special considerations of the developing craniofacial skeleton, neurosurgeons can treat skull base lesions in children with acceptable morbidity and mortality rates. Outcomes in this population may be better than those in adults, in part because of the benign histopathology that frequently affects the pediatric skull base, as well as the plasticity of the maturing nervous system.

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James T. Rutka

There is perhaps no other primary brain tumor that evokes more passion, emotion, and, as a result, controversy than does the craniopharyngioma. From the outset, it should be acknowledged that there are proponents who have traditionally advocated aggressive radical resection of craniopharyngiomas as the best form of treatment, and there are others who strongly believe that craniopharyngiomas cannot be totally excised with acceptable morbidity; thus, a cautious neurosurgical approach should be taken and complemented by radiation therapy or cyst sclerotherapy. In