Multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients

Journal ArticleObject. Previous reports suggest that adjustable valves may improve the survival of cerebrospinal fluid shunts or relieve shunt-related symptoms. To evaluate these claims, the authors conducted a prospective multicenter cohort study of children who underwent placement of Strata valves. Methods. Patients undergoing initial shunt placement (Group 1) or shunt revision (Group 2) were treated using Strata valve shunt systems. Valves were adjustable to five performance level settings by using an externally applied magnet. The performance levels were checked using an externally applied hand tool and radiography. Patients were followed for 1 year or until they underwent shunt revision surgery. Between March 2000 and February 2002, 315 patients were enrolled in the study. In Group 1 (201 patients) the common causes of hydrocephalus were myelomeningocele (16%), aqueductal stenosis (14%), and hemorrhage (14%). The overall 1-year shunt survival was 67%. Causes of shunt failure were obstruction (17%), overdrainage (1.5%), loculated ventricles (2%), and infection (10.6%). Patients in Group 2 (114 patients) were older and the causes of hydrocephalus were similar. Among patients in Group 2 the 1-year shunt survival was 71%. There were 256 valve adjustments. Symptoms completely resolved (26%) or improved (37%) after 63% of adjustments. When symptoms improved or resolved, they did so within 24 hours in 89% of adjustments. Hand-tool and radiographic readings of valve settings were the same in 234 (98%) of 238 assessments. Conclusions. The 1-year shunt survival for the Strata valve shunt system when used in initial shunt insertion procedures or shunt revisions was similar to those demonstrated for other valves. Symptom relief or improvement following adjustment was observed in 63% of patients. Hand-tool assessment of performance level settings reliably predicted radiographic assessments

Juvenile pilocytic astrocytoma of the brainstem in children

Journal ArticleObject. In reports involving the operative treatment of brainstem tumors, multiple histological types are often grouped together. To determine prognosis after resection, histology-specific data may be helpful. Methods. Twenty-eight patients with juvenile pilocytic astrocytoma (JPA) of the brainstem (six in the midbrain, four in the pons, and 18 in the medulla) were identified from the medical records. Initial treatment was resection in 25 and biopsy sampling in three. Postoperative imaging revealed gross-total resection (GTR) or resection with linear enhancement (RLE) in 12 of 25 patients and solid residual tumor in the other 13. In 10 of the 13 patients harboring solid residual tumor, observation was undertaken; the residual lesion disappeared in one, was stable in four, and progressed in five. Of the 12 patients with complete excision or RLE only, seven underwent no further treatment, with tumor progression occurring in one. All patients were alive at last follow-up examination (range 0.3-20.4 years, mean 6 years). New neurological deficits commonly appeared immediately after resection but often resolved. In six of the 28 patients, the new postoperative deficit was still present at last follow-up visit. The 5- and 10-year progression-free survival was 74 and 62%, respectively, after GTR or RLE and 19 and 19%, respectively, when solid residual tumor was present. Conclusions. Long-term survival after resection of JPAs of the brainstem has been observed and appears to be related to the extent of initial excision

Recommended Practice for Pressure Measurements and Calculation of Effective Pumping Speeds During Electric Propulsion Testing

The electric propulsion community has been implored to establish and implement a set of universally applicable test standards during the research, development, and qualification of electric propulsion systems. Variability between facility-to-facility and more importantly ground-to-flight performance can result in large margins in application or aversion to mission infusion. Performance measurements and life testing under appropriate conditions can be costly and lengthy. Measurement practices must be consistent, accurate, and repeatable. Additionally, the measurements must be universally transportable across facilities throughout the development, qualification, spacecraft integration, and on-orbit performance. A recommended practice for making pressure measurements, pressure diagnostics, and calculating effective pumping speeds with justification is presented

Skin-Friction Measurements in Incompressible Flow

Experiments have been conducted to measure the local surface-shear stress and the average skin-friction coefficient in Incompressible flow for a turbulent boundary layer on a smooth flat plate having zero pressure gradient. Data were obtained for a range of Reynolds numbers from 1 million to 45 million. The local surface-shear stress was measured by a floating-element skin-friction balance and also by a calibrated total head tube located on the surface of the test wall. The average skin-friction coefficient was obtained from boundary-layer velocity profiles

Ordering our world: the quest for traces of temporal organization in autobiographical memory

An experiment examined the idea, derived from the Self Memory System model (Conway & Pleydell-Pearce, 2000), that autobiographical events are sometimes tagged in memory with labels reflecting the life era in which an event occurred. The presence of such labels should affect the ease of judgments of the order in which life events occurred. Accordingly, 39 participants judged the order of two autobiographical events. Latency data consistently showed that between-era judgments were faster than within-era judgments, when the eras were defined in terms of either: (a) college versus high school, (b) academic quarter within year, or (c) academic year within school. The accuracy data similarly supported the presence of a between-era judgment effect for the college versus high school dichotomy

Exploring the Chemical Composition and Double Horizontal Branch of the Bulge Globular Cluster NGC 6569

Photometric and spectroscopic analyses have shown that the Galactic bulge cluster Terzan 5 hosts several populations with different metallicities and ages that manifest as a double red horizontal branch (HB). A recent investigation of the massive bulge cluster NGC 6569 revealed a similar, though less extended, HB luminosity split, but little is known about the cluster's detailed chemical composition. Therefore, we have used high-resolution spectra from the Magellan-M2FS and VLT-FLAMES spectrographs to investigate the chemical compositions and radial velocity distributions of red giant branch and HB stars in NGC 6569. We found the cluster to have a mean heliocentric radial velocity of -48.8 km/s (sigma = 5.3 km/s; 148 stars) and a mean [Fe/H] =-0.87 dex (19 stars), but the cluster's 0.05 dex [Fe/H] dispersion precludes a significant metallicity spread. NGC 6569 exhibits light- and heavy-element distributions that are common among old bulge/inner Galaxy globular clusters, including clear (anti)correlations between [O/Fe], [Na/Fe], and [Al/Fe]. The light-element data suggest that NGC 6569 may be composed of at least two distinct populations, and the cluster's low mean [La/Eu] = -0.11 dex indicates significant pollution with r-process material. We confirm that both HBs contain cluster members, but metallicity and light-element variations are largely ruled out as sources for the luminosity difference. However, He mass fraction differences as small as delta Y ~ 0.02 cannot be ruled out and may be sufficient to reproduce the double HB.Comment: 72 pages, 14 figures, 8 tables; published in The Astronomical Journal; electronic versions of all tables are available in the published versio