The blood-brain barrier (BBB) is formed by the brain capillary endothelium and excludes from the brain ∼100% of large-molecule neurotherapeutics and more than 98% of all small-molecule drugs. Despite the importance of the BBB to the neurotherapeutics mission, the BBB receives insufficient attention in either academic neuroscience or industry programs. The combination of so little effort in developing solutions to the BBB problem, and the minimal BBB transport of the majority of all potential CNS drugs, leads predictably to the present situation in neurotherapeutics, which is that there are few effective treatments for the majority of CNS disorders. This situation can be reversed by an accelerated effort to develop a knowledge base in the fundamental transport properties of the BBB, and the molecular and cellular biology of the brain capillary endothelium. This provides the platform for CNS drug delivery programs, which should be developed in parallel with traditional CNS drug discovery efforts in the molecular neurosciences.

https://link.springer.com/content/pdf/10.1602%2Fneurorx.2.1.3.pdf

The Blood-Brain Barrier: Bottleneck in Brain Drug Development

In an electrosurgical generator for generating radio frequency power, the generator includes a radio frequency output stage having two or more output connections, and a power supply coupled to the output stage for supplying power to the output stage. A controller is operable to cause the generator to supply a blended output signal alternating constantly between a first output signal across the output connections in which the radio frequency output voltage developed across the output connections is limited to at least a first predetermined threshold value for cutting or vaporisation of tissue, and a second output signal across the output connections in which the radio frequency output voltage developed across the output connections is limited to a second threshold value for coagulation. There is also provided adjustment means, operable by a user of the electrosurgical generator, for changing between various preset settings for the blended signal, the preset settings each having a predetermined duty cycle of the blended signal that is limited to the first threshold value for cutting or vaporisation, and a predetermined duty cycle of the blended signal that is limited to the second threshold value for coagulation.

Electrosurgical generator and system

von Hippel-Lindau disease

PATIENTS AND METHODS Patients Baseline assessments Morphological features of the PCF Volume of the PCF Pedigree development and assessment of familial aggregation Statistical analyses

http://chiariconnectioninternational.com/docs/ChiariI_Malformation_Redefined_Dr_Milhorat.pdf

Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients.

Surgical site infection: Incidence and impact on hospital utilization and treatment costs

Intramedullary spinal cord tumors.

The sagittal diameter of the bony cervical spinal canal and its significance in cervical spondylosis.

In this paper the author reviews the development of electrosurgery in neurosurgical procedures. Particular stress is placed on bipolar coagulation and the more recent addition of bipolar cutting. Basic electric principles are discussed as well as the electrophysiological basis of coagulating and cutting currents. Neurosurgical techniques and instrumentation criteria are presented. The material is planned to provide the neurosurgeon with greater understanding of the function of the equipment and, perhaps, to improve usage.

Electrosurgery. Technical note.

The risk of neurological deterioration after removal of cerebrospinal fluid below the level of a complete spinal subarachnoid block is generally accepted. The actual incidence of deterioration after lumbar puncture in the presence of a complete block remains unknown. The present retrospective case analysis includes a review of 100 patients found to have complete block on myelography: 50 cases with a lumbar puncture and 50 cases with a C1-2 puncture. Each group consisted of a similar age range, neurological status prior to myelography, level of block, and nature of disease. Seven patients (14%) had significant neurological deterioration after lumbar puncture, while no deterioration was seen after a C1-2 puncture. A summary of those cases in which deterioration followed lumbar puncture is presented and the possible pathophysiology is discussed. From this analysis, the estimated risk of downward spinal coning after lumbar puncture below a complete spinal subarachnoid block caused by a mass lesion is at least 14%.

Leonard I. Malis

Papers

Intramedullary spinal cord tumors.

The sagittal diameter of the bony cervical spinal canal and its significance in cervical spondylosis.

Electrosurgery. Technical note.

Neurological deterioration after lumbar puncture below complete spinal subarachnoid block

Action potentials in "motor" cortex evoked by peripheral nerve stimulation