A novel technique to treat acquired Chiari I malformation after supratentorial shunting

PURPOSE: The acquired Chiari I malformation with abnormal cranial vault thickening is a rare late complication of supratentorial shunting. It poses a difficult clinical problem, and there is debate about the optimal surgical strategy. Some authors advocate supratentorial skull enlarging procedures while others prefer a normal Chiari decompression consisting of a suboccipital craniectomy, with or without C1 laminectomy and dural patch grafting. METHODS: We illustrate three cases of symptomatic acquired Chiari I malformation due to inward cranial vault thickening. RESULTS: We describe a new surgical approach that appears to be effective in these patients. This approach includes the standard Chiari decompression combined with posterior fossa augmentation by thinning the occipital planum. CONCLUSION: Internal volume re-expansion of the posterior fossa by thinning the occipital planum appears to be an effective novel surgical strategy in conjunction with the standard surgical therapy of Chiari decompression

Sperm storage and mating in the deep-sea squid Taningia danae Joubin, 1931 (Oegopsida:Octopoteuthidae)

Spermatangium implantation is reported in the large oceanic squid Taningia danae, based on ten mated females from the stomachs of sperm whales. Implanted spermatangia were located in the mantle, head and neck (on both sides) or above the nuchal cartilage, under the neck collar and were often associated with incisions. These cuts ranged from 30 to 65 mm in length and were probably made by males, using the beak or arm hooks. This is the first time wounds facilitating spermatangium storage have been observed in the internal muscle layers (rather than external, as observed in some other species of squid). The implications of these observations for the mating behavior of the rarely encountered squid T. danae are discussed

Themadag: Balans tussen fokkerij en biodiversiteit bij paarden

Aan kondiging van de themadag:"Balans tussen fokkerij en biodiversiteit bij paarden". Tijdens deze themadag worden basisprincipes van fokkerij en van behoud vangenetische diversiteit binnen een ras uitgelegd. Een goed doordacht fokbeleid op rasniveau is nodig om het ras te behouden of te verbeteren. Daarbij moet ook worden gelet op behoud van genetische diversiteit binnen het ras. Een te sterke inteelttoename kan tot serieuze problemen leiden, zoals bepaalde erfelijke gebreken. Een kleine populatie is kwetsbaarder voor inteelt dan een grote populatie. Tevens geeft een sterke selectie op één of enkele kenmerken een groter risico op inteel

Surgical intervention for hydrocephalus in infancy; etiology, age and treatment data in a Dutch cohort

Contains fulltext : 217415.pdf (Publisher’s version ) (Open Access

Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition

The supplementary motor area syndrome is a characteristic neurosurgical syndrome that can occur after unilateral resection of the supplementary motor area. Clinical symptoms may vary from none to a global akinesia, predominantly on the contralateral side, with preserved muscle strength, and mutism. A remarkable feature is that these symptoms completely resolve within weeks to months, leaving only a disturbance in alternating bimanual movements. In this review we give an overview of the old and new insights from the supplementary motor area syndrome and extrapolate these findings to seemingly unrelated diseases and symptoms such as Parkinson’s disease and tics. Furthermore, we integrate findings from lesion, stimulation and functional imaging studies to provide insight in the motor function of the supplementary motor area

The estimated burden of fungal disease in South Africa

Background. With a population of 56.5 million, over 7 million persons living with HIV, one of the world’s highest rates of tuberculosis (TB) and a large proportion of the population living in poverty, South Africa (SA)’s fungal disease burden is probably substantial and broad in scope.Objectives. To estimate the burden of fungal disease in SA.Methods. Using total and at-risk populations and national, regional and occasionally global data, we estimated the incidence and prevalence of the majority of fungal diseases in SA.Results. Estimates for the annual incidence of HIV-related life-threatening fungal disease include cryptococcal meningitis (8 357 cases), Pneumocystis pneumonia (4 452 cases) and endemic mycoses (emergomycosis, histoplasmosis and blastomycosis, with 100, 60 and 10 cases per year, respectively). We estimate 3 885 cases of invasive aspergillosis annually. The annual burden of candidaemia and Candida peritonitis is estimated at 5 421 and 1 901 cases, respectively. The epidemic of pulmonary TB has probably driven up the prevalence of chronic pulmonary aspergillosis to 99 351 (175.8/100 000), perhaps the highest in the world. Fungal asthma probably affects >100 000 adults. Mucosal candidiasis is common, with an annual prevalence estimated at 828 666 and 135 289 oral and oesophageal cases, respectively, complicating HIV infection alone (estimates in other conditions not made), and over a million women are estimated to be affected by recurrent vulvovaginal candidiasis each year. Tinea capitis in children is common and conservatively estimated at >1 000 000 cases. The inoculation mycoses sporotrichosis, chromoblastomycosis and eumycetoma occur occasionally (with 40, 40 and 10 cases estimated, respectively). Overall, we estimate that over 3.2 million South Africans are afflicted by a fungal disease each year (7.1% of the population).Conclusions. Significant numbers of South Africans are estimated to be affected each year by fungal infections, driven primarily by the syndemics of HIV, TB and poverty. These estimates emphasise the need for better epidemiological data, and for improving the diagnosis and management of these diseases

The estimated burden of fungal disease in South Africa

Publication fees were paid via funding from a grant from Fonds.Peer reviewedPublisher PD