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2. A - 26 AMPAR as a Sports Concussion Biomarker and Its Relationship to Neurocognitive Functioning in Collegiate Athletes

Author

Miskovsky S, Bailey C, Selman W, Tangen C, Gunstad J, Soden D, Dambinova S, Izykenova G, Maroon J, and Briskin S

Subjects
Oncology, Neurocognitive testing, medicine.medical_specialty, biology, Athletes, business.industry, General Medicine, Serum specimen, biology.organism_classification, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Neuropsychology and Physiological Psychology, Internal medicine, Concussion, medicine, Biomarker (medicine), business, Neurocognitive
Abstract

Objective This prospective controlled observational cohort pilot study investigated a potential blood-based biomarker [α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)] and relationship to neurocognitive testing in collegiate athletes. Methods A multisport sample of 60 collegiate athletes (53% female; 44 contact, 16 non-contact controls) completed ImPACT testing and provided blood samples at a pre-season baseline and within 4 weeks post-season. Plasma and serum samples were processed for AMPAR peptides and antibodies. Twelve athletes did not complete all procedures and were excluded from the final analysis (final n = 48; 36 contact; 12 controls). Results Contact athletes demonstrated greater increases in serum AMPAR antibodies compared to controls (t(46) = 3.24;p Conclusions Serum AMPAR antibody levels significantly increased in the contact group and were correlated with reaction time on contact athlete neurocognitive testing at post-season only, with contact athletes showing both slower reaction time and increased levels of AMPAR antibodies compared to controls. No findings were identified in plasma AMPAR peptides, possibly related to sample processing which could not be done immediately in this pilot study. Future research and replication is needed; however, AMPAR may represent a blood-based concussion biomarker, with potential for clinical utility in athletes.

Published
2021
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5. Unusual Case of Jejunal Duplication in A64-Year-Old Female

Author

Antoine Geagea, Maroon J. Tohmeh, Fadi Haddad, and Antoine Kachi

Subjects
Abdominal pain, Gastrointestinal tract, medicine.medical_specialty, Unusual case, business.industry, Ileum, General Medicine, Middle Aged, medicine.disease, Asymptomatic, Abdominal Pain, Surgery, Jejunum, medicine.anatomical_structure, Gene duplication, Humans, Medicine, Female, Cyst, Blood supply, medicine.symptom, Tomography, X-Ray Computed, business
Abstract

Gastrointestinal duplications are rare congenital malformations, which may occur anywhere in the gastrointestinal tract, more commonly in the ileum. Most cases appear during the first two years of life. Usually they are located at the paramesenteric side of the bowel and they share with the latter the same blood supply. Vague abdominal pain and distention are common presentations of duplications in adults, although many of them remain asymptomatic. We report a rare case of a jejunal duplication cyst in an elderly female patient, with atypical anatomic features.

Published
2016
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13. A New Solution for Life Without Blood

Author

Taylor, M. J., primary, Bailes, J. E., additional, Elrifai, A. M., additional, Shih, S.-R., additional, Teeple, E., additional, Leavitt, M. L., additional, Baust, J. G., additional, and Maroon, J. C., additional

Published
1995
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18. A Randomized, Controlled Trial of Methylprednisolone or Naloxone in the Treatment of Acute Spinal-Cord Injury

Author

BRACKEN, M. B., primary, SHEPARD, M. J., additional, COLLINS, W. F., additional, HOLFORD, T. R., additional, YOUNG, W., additional, BASKIN, D. S., additional, EISENBERG, H. M., additional, FLAMM, E., additional, LEOSUMMERS, L., additional, MAROON, J., additional, MARSHALL, L. F., additional, PEROT, P. L., additional, PIEPMEIER, J., additional, SONNTAG, V. K. H., additional, WAGNER, F. C., additional, WILBERGER, J. E., additional, and WINN, H. R., additional

Published
1991
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20. Automated percutaneous discectomy

Author

Onik, G, primary, Mooney, V, additional, Maroon, J C, additional, Wiltse, L, additional, Helms, C, additional, Schweigel, J, additional, Watkins, R, additional, Kahanovitz, N, additional, Day, A, additional, and Morris, J, additional

Published
1990
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25. The learning curve for acoustic tumor surgery.

Author

Buchman, Craig A., Chen, Douglas A., Flannagan, Patrick, Wilberger, Jack E., Maroon, Joseph C., Buchman, C A, Chen, D A, Flannagan, P, Wilberger, J E, and Maroon, J C

Abstract

Although operative experience is considered to be critically important in the surgical management of acoustic tumors, little objective evidence substantiates this claim. The present study was undertaken to determine whether a learning curve exists for acoustic tumor surgery. The first 96 acoustic tumor patients managed surgically by a new neurotologic team were retrospectively reviewed. A significant improvement (P<.0003; F=6.32) in the ability to achieve good (grade II or better) postoperative facial nerve function was identified. Improving trends for complete resection rate and hearing preservation were documented, and the incidence of cerebrospinal fluid (CSF) leaks declined; however, statistical significance was not achieved. For postoperative facial nerve function, approximately 60 cases were necessary before the new team achieved results similar to those of highly experienced surgeons. The frequencies of complete resection, CSF leaks, hearing preservation, stroke, and mortality were comparable to those of experienced neurotologic teams. The findings of this study may have implications for both patient care and physician training. [ABSTRACT FROM AUTHOR]

Published
1996
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27. Intraosseous meningioma.

Author

Daffner, R. H., Yakulis, Robert, Maroon, Joseph C., Yakulis, R, and Maroon, J C

Abstract

A 71-year-old woman with a long history of slowly progressive proptosis was found to have an intraosseous meningioma of the right sphenoid bone. Radiologically, the lesion resembled fibrous dysplasia. The key to the diagnosis is irregularity of the inner table of the skull. The histologic appearance is characteristic. Intraosseous meningioma is one part of the spectrum of diseases known as primary extraneuraxial meningioma. In this paper we discuss the theories of cellular origin as well as the radiologic differential diagnosis. [ABSTRACT FROM AUTHOR]

Published
1998
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28. Chymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients.

Author

Maroon, J C, Holst, R A, and Osgood, C P

Subjects
PROTEOLYTIC enzymes, ANAPHYLAXIS, CHYMOPAPAIN, CLINICAL trials, COMPARATIVE studies, INTERVERTEBRAL disk displacement, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research, THERAPEUTICS
Abstract

The results of chemonucleolysis in 48 patients with lumbar disc disease revealed marked improvement in 58%, slight improvement in 23%, and no improvement in 19%. Serious anaphylactic reactions occurred in two patients. These results and those of other neurosurgical and orthopaedic studies are summarized and compared with the 70% improvement rate obtained with a placebo in a recent double blind controlled cooperative study. Only those few investigators participating in the double blind study are now permitted to use intradiscal chymopapain. It is concluded that the ultimate place of chemonucleolysis, if any, in the treatment of ruptured lumbar discs remains to be determined. [ABSTRACT FROM AUTHOR]

Published
1976

31. Complete Blood Substitution During Profound Hypothermic Cardiac Arrest in Dogs

Author

Leavitt, M. L., Bailes, J. E., Shih, T. S., Elrifai, A. M., Teeple, E., Ciongoli, K., Devenyi, C., Bazmi, B., and Maroon, J. C.

Abstract

This study compared the effects of 3 hours of cardiac arrest performed at 2 different levels of profound hypothermia in totally exsanguinated, blood substituted dogs. Dogs (N=10) were anesthetized and esophageal temperature was lowered to 24° at which time exsanguination began. Once exsanguination was complete and the heart had arrested, continuous whole body perfusion of an oxygenated blood substitute solution was performed for 3 hours. Core temperature during this period remained below 10°C and reached nadirs of 1.3°C in Group I (N=5) versus 7.3°C in Group II (N=5). Once the dog was allowed to rewarm to 10°C replacement of the perfusate with blood was begun. All dogs survived the procedure but 2 dogs from each group died by 4 days following the experiment. The remaining 6 dogs were observed for between 10 and 85 days. The group perfused with blood substitute at the warmer nadir had a faster recovery of motor behavior and showed smaller changes from normal in several biochemical and hematological parameters. These findings indicate that profound hypothermia and total blood substitution can be successfully achieved at either temperature nadir, but the warmer level appears to be associated with a faster recovery.

Published
1992
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32. Comparison of the Effects of Total Blood Substitution During Two Different Levels of Hypothermic Cardiac Arrest

Author

Leavitt, M. L., Bailes, J. E., Elrifai, A. M., Teeple, E., Shih, T. S., Ciongoli, K., Devenyi, C., Bazmi, B., and Maroon, J. C.

Abstract

The effect of total blood replacement with a solution containing neitherhemoglogin nor fluorocarbon was studied under two different levels of hypothermia. Ten dogs were anesthetized and esophageal temperature lowered to about 24° at which time exsanguination began. Upon cardiac arrest and the completion of exsanguination, continuous whole body closed chest extracorporeal circulation of an oxygenated blood substitute was begun. Hematocrit was 1% while core temperature remained < 10°C for 3 hours of perfusion during which nadirs of 1.3°C (Group I, N=5) and 7.3°C (Group II, N=5) were achieved. Replacement of the perfusate with whole blood began once the dog was rewarmed to approximately 10°C. All dogs survived the procedure. Two dogs from each group died by the fourth post-operative day but the others survived long term. Group II showed a faster return to normal based on motor behavioral, biochemical and hematological changes. Thus the combination of profound hypothermia and complete blood substitution with a solution lacking any special oxygen carrying molecule, can be tolerated for 3 hours using both levels of hypothermia, however, the warmer one appears to be associated with faster recovery.

Published
1992
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36. Magnetic resonance imaging and intraoperative neurosonography in syringomyelia.

Author

Wilberger, J E, Maroon, J C, Prostko, E R, Baghai, P, Beckman, I, and Deeb, Z

Abstract

Treatment of syringomyelia remains a difficult and controversial problem. However, the recent advent of magnetic resonance imaging (MRI) and intraoperative ultrasound allows a more precise approach to the diagnosis and management of this disorder. Experience with 27 cases of syringomyelia has shown that MRI is superior to all other forms of diagnostic imaging for the exact anatomical delineation of syrinxes and other spinal cavities. One-third of the syrinxes demonstrated by MRI were either not adequately visualized or missed by myelography and/or computed tomographic scanning. Intraoperative ultrasound has been used to allow more precise operative approaches to the syrinx as well as to guide the exact placement of shunt tubes into syrinx cavities. A method has also been developed to allow intraoperative ultrasound of the spinal cord with patients in the sitting position.

Published
1987
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