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Article ; Online: A prospective study of shared decision-making in brain tumor surgery.

Leu, Severina / Cahill, Julian / Grundy, Paul L

2022 Volume 165, Issue 1, Page(s) 15–25

Abstract: Purpose: Shared decision-making (SDM) is a key tenet of personalized care and is becoming an essential component of informed consent in an increasing number of countries. The aim of this study is to analyze patient and healthcare staff satisfaction with ...

Abstract	Purpose: Shared decision-making (SDM) is a key tenet of personalized care and is becoming an essential component of informed consent in an increasing number of countries. The aim of this study is to analyze patient and healthcare staff satisfaction with the SDM process before and after SDM was officially introduced as the standard of care. Decision grids are important tools in the SDM process, and we developed them for three different types of intracranial tumors. Methods: This prospective study was conducted in a high-volume neuro-oncological center on all consecutive eligible patients undergoing consideration of treatment for intracranial glioma and metastases. Twenty-two patients participated before and 74 after the introduction of SDM. Six and 5 staff members respectively participated in the analysis before and after team training and the introduction of SDM. The main outcome was patient and healthcare staff satisfaction with the SDM process. Results: Patients reported high satisfaction with the SDM process before (mean CollaboRATE score 26 of 27 points) and after (mean CollaboRATE score 26.3 of 27 points, p = 0.23) the introduction of SDM. Interestingly, staff attitude toward SDM improved significantly from 61.68 before to 90.95% after the introduction of SDM (p-value < 0.001). Decision grids that were developed for three different types of intracranial tumors are presented. Conclusions: Team training in SDM and the introduction of techniques into daily practice can increase staff satisfaction with the SDM process. High levels of patient satisfaction were observed before, with a non-significant increase after the introduction of SDM. Decision grids are an important tool to facilitate the conveyance and understanding of complex information and to achieve SDM in daily clinical practice.
MeSH term(s)	Humans ; Prospective Studies ; Patient Participation ; Attitude of Health Personnel ; Patient Satisfaction ; Decision Making
Language	English
Publishing date	2022-12-28
Publishing country	Austria
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-022-05451-z
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Article ; Online: Speech bubble: dysphasia secondary to spontaneous intraparenchymal pneumocephalus.

Mitra, Rathijit / Kumaria, Ashwin / Harrisson, Stuart / Cahill, Julian

British journal of neurosurgery

2019 Volume 34, Issue 6, Page(s) 619–620

Abstract: Spontaneous pneumocephalus is exceptionally rare, with few published cases in the literature. We describe a patient presenting with dysphasia, right facial weakness, headache and confusion who was subsequently found to have pneumocephalus due to an ... ...

Abstract	Spontaneous pneumocephalus is exceptionally rare, with few published cases in the literature. We describe a patient presenting with dysphasia, right facial weakness, headache and confusion who was subsequently found to have pneumocephalus due to an encephalocoele herniating into a tegmen tympani defect.
MeSH term(s)	Aphasia/etiology ; Encephalocele ; Headache ; Humans ; Pneumocephalus/complications ; Pneumocephalus/diagnostic imaging ; Speech
Language	English
Publishing date	2019-08-13
Publishing country	England
Document type	Journal Article
ZDB-ID	639029-8
ISSN	1360-046X ; 0268-8697
ISSN (online)	1360-046X
ISSN	0268-8697
DOI	10.1080/02688697.2019.1643008
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Article ; Online: Rapid, Untargeted Chemical Profiling of Single Cells in Their Native Environment.

Cahill, John F / Riba, Julian / Kertesz, Vilmos

Analytical chemistry

2019 Volume 91, Issue 9, Page(s) 6118–6126

Abstract: We report a method that enables untargeted, high throughput, and quantitative mass spectrometric analysis of single cells from cell suspension without needing additional sample preparation procedures (e.g., molecular tagging) through the combination of ... ...

Abstract	We report a method that enables untargeted, high throughput, and quantitative mass spectrometric analysis of single cells from cell suspension without needing additional sample preparation procedures (e.g., molecular tagging) through the combination of single-cell printer technology and liquid vortex capture-mass spectrometry (SCP-LVC-MS). The operating principle behind the SCP-LVC-MS technology is single cell isolation via small droplet piezoelectric ejection followed by capture of the droplet into an LVC-MS sampling probe. Once exposed to an appropriate solvent, the cell is lysed, extracted, and analyzed by MS. The SCP-LVC-MS approach was validated by measuring the lipid composition of microalgae, Chlamydomonas reinhardtii (ChRe) and Euglena gracilis (EuGr), and HeLa cells in their native growth media. Numerous diacylglyceryltrimethylhomo-Ser (DGTS), phosphatidylcholine (PC), monogalactosyldiacylglycerol (MGDG), and digalactosyldiacylglycerol (DGDG) lipids were observed in single cells. Continuous solvent flow ensures that cells are analyzed rapidly, and no signal carryover between cells is observed. ChRe and EuGr microalgae mixed together in the same solution were differentiated cell-by-cell in real-time based on differences between levels of diacylglyceryltrimethylhomo-Ser (DGTS) and phosphatidylcholine (PC) lipids measured in each cell. Several DGTS lipids present in ChRe were quantified with single-cell resolution by normalizing to a DGTS(32:0) internal standard added to the LVC probe solvent during analysis. Quantitative peak areas were validated by comparing to bulk lipid extracts. Lastly, peak area distributions comprised of hundreds of cells were compared for ChRe after 5 days of nitrogen-limited and normal growth conditions, which show clear differences and the ability to resolve cellular population differences with single-cell resolution.
MeSH term(s)	Chlamydomonas reinhardtii/chemistry ; Chlamydomonas reinhardtii/cytology ; Chlamydomonas reinhardtii/growth & development ; Euglena gracilis/chemistry ; Euglena gracilis/cytology ; Euglena gracilis/growth & development ; HeLa Cells ; Humans ; Laser Capture Microdissection ; Lipids/analysis ; Mass Spectrometry ; Particle Size ; Single-Cell Analysis ; Surface Properties
Chemical Substances	Lipids
Language	English
Publishing date	2019-04-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1508-8
ISSN	1520-6882 ; 0003-2700
ISSN (online)	1520-6882
ISSN	0003-2700
DOI	10.1021/acs.analchem.9b00680
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Article: Rapid, Untargeted Chemical Profiling of Single Cells in Their Native Environment

Cahill, John F / Kertesz, Vilmos / Riba, Julian

Analytical chemistry. 2019 Apr. 08, v. 91, no. 9

2019

Abstract	We report a method that enables untargeted, high throughput, and quantitative mass spectrometric analysis of single cells from cell suspension without needing additional sample preparation procedures (e.g., molecular tagging) through the combination of single-cell printer technology and liquid vortex capture–mass spectrometry (SCP-LVC-MS). The operating principle behind the SCP-LVC-MS technology is single cell isolation via small droplet piezoelectric ejection followed by capture of the droplet into an LVC-MS sampling probe. Once exposed to an appropriate solvent, the cell is lysed, extracted, and analyzed by MS. The SCP-LVC-MS approach was validated by measuring the lipid composition of microalgae, Chlamydomonas reinhardtii (ChRe) and Euglena gracilis (EuGr), and HeLa cells in their native growth media. Numerous diacylglyceryltrimethylhomo-Ser (DGTS), phosphatidylcholine (PC), monogalactosyldiacylglycerol (MGDG), and digalactosyldiacylglycerol (DGDG) lipids were observed in single cells. Continuous solvent flow ensures that cells are analyzed rapidly, and no signal carryover between cells is observed. ChRe and EuGr microalgae mixed together in the same solution were differentiated cell-by-cell in real-time based on differences between levels of diacylglyceryltrimethylhomo-Ser (DGTS) and phosphatidylcholine (PC) lipids measured in each cell. Several DGTS lipids present in ChRe were quantified with single-cell resolution by normalizing to a DGTS(32:0) internal standard added to the LVC probe solvent during analysis. Quantitative peak areas were validated by comparing to bulk lipid extracts. Lastly, peak area distributions comprised of hundreds of cells were compared for ChRe after 5 days of nitrogen-limited and normal growth conditions, which show clear differences and the ability to resolve cellular population differences with single-cell resolution.
Keywords	Chlamydomonas reinhardtii ; culture media ; droplets ; Euglena gracilis ; human cell lines ; lipid composition ; liquids ; mass spectrometry ; microalgae ; phosphatidylcholines ; printers ; solvents
Language	English
Dates of publication	2019-0408
Size	p. 6118-6126.
Publishing place	American Chemical Society
Document type	Article
ZDB-ID	1508-8
ISSN	1520-6882 ; 0003-2700
ISSN (online)	1520-6882
ISSN	0003-2700
DOI	10.1021/acs.analchem.9b00680
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Article ; Online: Gamma Knife Stereotactic Radiosurgery for the treatment of chordomas and chondrosarcomas.

Cahill, Julian / Ibrahim, Ramez / Mezey, Geza / Yianni, John / Bhattacharyya, Debapriya / Walton, Lee / Grainger, Alison / Radatz, Matthias W R

Acta neurochirurgica

2021 Volume 163, Issue 4, Page(s) 1003–1011

Abstract: Introduction: Primary chordomas and chondrosarcomas of the skull base are difficult tumours to treat successfully. Despite advances in surgical techniques, a gross total resection is often impossible to achieve. In addition, some patients may be deemed ... ...

Abstract	Introduction: Primary chordomas and chondrosarcomas of the skull base are difficult tumours to treat successfully. Despite advances in surgical techniques, a gross total resection is often impossible to achieve. In addition, some patients may be deemed unsuitable or not wish to undergo extensive surgery for these conditions. This study examines the role of Gamma Knife Stereotactic Radiosurgery (GKRS) in the treatment of these difficult cases. Methods: All patients harbouring either a chordoma or chondrosarcoma treated at the National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, UK, between 1985 and 2018, were reviewed with regard to their clinical presentations, pre- and post-treatment imaging, GKRS prescriptions and outcomes. Results: In total, 24 patients with a mean tumour volume of 13 cm Conclusions: GKRS offers a comparable option to proton beam therapy for the treatment of these tumours. Early intervention for tumour volumes of less than 7 cm
MeSH term(s)	Adult ; Aged ; Chondrosarcoma/pathology ; Chondrosarcoma/radiotherapy ; Chordoma/pathology ; Chordoma/radiotherapy ; Female ; Humans ; Male ; Middle Aged ; Radiosurgery/methods ; Skull Base Neoplasms/pathology ; Skull Base Neoplasms/radiotherapy ; Survival Rate ; Tumor Burden
Language	English
Publishing date	2021-02-19
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-021-04768-5
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Article ; Online: A Retrospective Analysis of the Role of Single-Session Gamma Knife Stereotactic Radiosurgery in Sporadic Vestibular Schwannomas with Tumor Volumes Greater Than 10 cm3: Is It Worth Stretching the Boundaries?

Mezey, Geza / Cahill, Julian / Rowe, Jeremy G / Yianni, John / Bhattacharyya, Debapriya / Walton, Lee / Rodgers, Joanne / Radatz, Matthias W R

Stereotactic and functional neurosurgery

2020 Volume 98, Issue 2, Page(s) 85–94

Abstract: Objective: To evaluate the role of single-session Gamma Knife stereotactic radiosurgery (GK-SRS) in the treatment of vestibular schwannomas (VSs) with volumes of greater 10 cm3.: Methods: A retrospective analysis was performed of 103 patients treated ...

Abstract	Objective: To evaluate the role of single-session Gamma Knife stereotactic radiosurgery (GK-SRS) in the treatment of vestibular schwannomas (VSs) with volumes of greater 10 cm3. Methods: A retrospective analysis was performed of 103 patients treated with single-session GK-SRS between 1993 and 2011 with a mean follow-up of 6.2 years ± 4.4 SD. Treatment, clinical and outcome details were recorded and assessed. Results: Eighty-one (78.6%) patients achieved radiological control with slow progression in a further 5 (4.9%) patients, who did not require further treatment. Linear measurements did not correlate well with volume, which can predict outcome following treatment more precisely. 2.9% of patients developed a new facial paresis, 5.8% trigeminal numbness and 2.9% facial pain. In all, 26 (25.2%) patients who were tested preserved some level of hearing following treatment. Conclusions: The overall radiological control rate in this study was 78.6%, while tumor volumes less than 20 cm3 can be safely treated with single-stage GK-SRS with an expected control rate of 83.2% without unacceptable morbidity rates. GK-SRS can be utilized as a first-line treatment option in patients with large-volume VSs especially in whom surgery is unattractive.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic/diagnostic imaging ; Neuroma, Acoustic/surgery ; Radiosurgery/methods ; Retrospective Studies ; Treatment Outcome ; Tumor Burden/physiology ; Young Adult
Language	English
Publishing date	2020-03-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	645069-6
ISSN	1423-0372 ; 1011-6125
ISSN (online)	1423-0372
ISSN	1011-6125
DOI	10.1159/000504857
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Article ; Online: Subarachnoid hemorrhage: is it time for a new direction?

Cahill, Julian / Zhang, John H

Stroke

2008 Volume 40, Issue 3 Suppl, Page(s) S86–7

Abstract: Background and purpose: Despite recent advances in the treatment of patients after subarachnoid hemorrhage, morbidity and mortality rates have failed to improve significantly. Although this was often blamed on vasospasm, is it time to consider ... ...

Abstract	Background and purpose: Despite recent advances in the treatment of patients after subarachnoid hemorrhage, morbidity and mortality rates have failed to improve significantly. Although this was often blamed on vasospasm, is it time to consider alternative etiologies? Summary of Review- Early brain injury (EBI) is a recently described term that describes the immediate injury to the brain after subarachnoid hemorrhage. A number of pathways have been recognized as having a role in the etiology of EBI. This review provides a brief synopsis of EBI and its implications for the future. Conclusions: EBI may be responsible for the detrimental effects seen in patients after subarachnoid hemorrhage. Additional studies are needed to determine the pathophysiology of EBI and to explore potential therapeutic options.
MeSH term(s)	Apoptosis ; Blood-Brain Barrier/physiopathology ; Brain Injuries/pathology ; Brain Injuries/physiopathology ; Humans ; Subarachnoid Hemorrhage/physiopathology ; Vasospasm, Intracranial/physiopathology
Language	English
Publishing date	2008-12-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.108.533315
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Article ; Online: Paediatric lumbar disc herniation in the very young: a case-based update.

Cahill, Julian / Frost, Geoffrey / Solanki, Guirish A

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2011 Volume 27, Issue 5, Page(s) 687–691

Abstract: Background: A lumbar disc prolapse is commonly seen in the adult population and as a result, the signs and symptoms are well recognised and easily treated. A disc prolapse, in the adolescent and particularly the paediatric age group, is very rare indeed. ...

Abstract	Background: A lumbar disc prolapse is commonly seen in the adult population and as a result, the signs and symptoms are well recognised and easily treated. A disc prolapse, in the adolescent and particularly the paediatric age group, is very rare indeed. The signs and symptoms are atypical in this age group, and there is often difficulty in recognising the pathology. This can lead to delays in the diagnosis and treatment of a very painful condition. Discussion: Lumbar disc herniation in very young children can be hard to diagnose. There is limited information currently available in the literature on the topic of lumbar disc herniation in very young children. Overall, the surgical option in these children appears to have a favourable outcome. Illustrative case: This case highlights an 18-month-old child who was not able to walk, following a fall. The child had a normal neurological examination and normal bladder and bowel function. A magnetic resonance imaging (MRI) scan of her lumbar sacral spine indicated a large right paracentral L4/5 disc prolapse indenting the right anterolateral margin of the thecal sac and abutting the right L5 nerve root. She subsequently underwent a laminoplasty and excision of a sub-ligamentous L4/5 disc prolapse under an operating microscope. Conclusions: This case report highlights the problems in diagnosing an acute lumbar disc prolapse in an 18-month-old child and reviews the current literature dealing with an acute disc prolapse in very young children.
MeSH term(s)	Accidental Falls ; Decompression, Surgical ; Female ; Humans ; Infant ; Intervertebral Disc Displacement/diagnosis ; Intervertebral Disc Displacement/surgery ; Lumbosacral Region
Language	English
Publishing date	2011-01-18
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-010-1369-6
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Article: Early brain injury following aneurysmal subarachnoid hemorrhage: emphasis on cellular apoptosis.

Yuksel, Simge / Tosun, Yusuf Berk / Cahill, Julian / Solaroglu, Ihsan

Turkish neurosurgery

2012 Volume 22, Issue 5, Page(s) 529–533

Abstract: Subarachnoid hemorrhage (SAH) due to intracranial aneurysm rupture is a complex clinical disease with high mortality and morbidity. Recent studies suggest that early brain injury (EBI) rather than vasospasm might be responsible for morbidity ... ...

Abstract	Subarachnoid hemorrhage (SAH) due to intracranial aneurysm rupture is a complex clinical disease with high mortality and morbidity. Recent studies suggest that early brain injury (EBI) rather than vasospasm might be responsible for morbidity and mortality within 24-72 hours after SAH. The rise in intracranial pressure following SAH causes a significant drop in cerebral perfusion pressure that leads to global cerebral ischemia and initiates the acute injury cascade. Various molecular mechanisms have been shown to involve in the pathophysiology of EBI including cellular apoptosis. In this review, we summarize apoptotic molecular mechanisms involved in the etiology of EBI and its potential as a target for future therapeutic intervention.
MeSH term(s)	Apoptosis/physiology ; Brain Injuries/etiology ; Brain Injuries/pathology ; Brain Ischemia/etiology ; Humans ; Nervous System Diseases/etiology ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/pathology ; Subarachnoid Hemorrhage/physiopathology ; Tumor Suppressor Protein p53/genetics ; Tumor Suppressor Protein p53/physiology
Chemical Substances	Tumor Suppressor Protein p53
Language	English
Publishing date	2012
Publishing country	Turkey
Document type	Journal Article ; Review
ZDB-ID	1203779-5
ISSN	1019-5149
ISSN	1019-5149
DOI	10.5137/1019-5149.JTN.5731-12.1
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Article ; Online: Infected intracranial meningiomas.

Lo, William B / Cahill, Julian / Carey, Martyn / Mehta, Hiten / Shad, Amjad

World neurosurgery

2014 Volume 81, Issue 3-4, Page(s) 651.e9–13

Abstract: Objective: Infection associated with an intracranial meningioma is an extremely rare condition. Only six cases have been described in the literature. Because of its dual pathologies, initial radiologic diagnosis can be difficult. We present the first ... ...

Abstract	Objective: Infection associated with an intracranial meningioma is an extremely rare condition. Only six cases have been described in the literature. Because of its dual pathologies, initial radiologic diagnosis can be difficult. We present the first reported case of multiple infected intracranial meningiomas and correlate the radiologic and histologic findings. Methods: A 70-year-old woman presented with sepsis and a left hemiparesis following ureteroscopy and lithotripsy. A large right parietal lesion and a smaller left frontal lesion were diagnosed on magnetic resonance imaging. Diffusion-weighted imaging and an apparent diffusion coefficient map demonstrated features of cerebral metastases. Results: A 2-stage excision confirmed atypical meningiomas containing an intratumoral abscess secondary to Escherichia coli. The patient made a full neurologic recovery. Despite the additional techniques, the radiologic diagnosis was initially challenging because of the dual pathologies. Nonetheless, the radiologic appearance was consistent with the complex histologic findings. Conclusions: In the appropriate clinical context, diffusion-weighted imaging and apparent diffusion coefficient map aid the diagnosis of infected intracranial meningiomas.
MeSH term(s)	Aged ; Diffusion Magnetic Resonance Imaging ; Escherichia coli Infections/pathology ; Escherichia coli Infections/surgery ; Female ; Humans ; Meningeal Neoplasms/microbiology ; Meningeal Neoplasms/pathology ; Meningeal Neoplasms/surgery ; Meningioma/microbiology ; Meningioma/pathology ; Meningioma/surgery ; Neurosurgical Procedures ; Reoperation
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2013.07.081
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