Silicon nanowires (SiNWs) offer promising inorganic nanostructures for biomedical application. Here, we report the development of a novel SiNW array designed for isolating primary CD4(+) T lymphocytes from the heterogeneous mixture of cell populations. Our system employed the specific high-affinity binding features of streptavidin (STR)-functionalized SiNW with biotin-labeled CD4(+) T lymphocytes. Fabricated SiNW arrays easily separated the CD4(+) T lymphocytes from the mouse whole splenocytes with over approximately 88% purity and demonstrated tight attachment to CD4(+) T lymphocytes by scanning electron microscopy. Thus, our STR-SiNW arrays provide a potential tool for specific cell separation and further present a possibility to be applied to the other area of biomedical applications.

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Anterior communicating artery aneurysm can cause visual symptoms by compressing the optic nerve or direct rupture to the optic nerve with focal hematoma formation. We emphasize that cerebral vascular study is highly recommended to detect intracranial aneurysm before its rupture in the case of normal CT findings with visual symptoms and frequent headache.

PurposeUpper cervical fractures can heal with conservative treatments such as halo-vest immobilization (HVI) and Minerva jackets without surgery. The most rigid of these, HVI, remains the most frequently used treatment in many centers despite its relatively high frequency of orthosis-related complications. We conducted this study to investigate the clinical outcome, effectiveness, patient satisfaction, and associated complications of HVI.Materials and MethodsFrom April 1997 to December 2008, we treated 23 patients for upper cervical spinal injuries with HVI. For analysis, we divided high cervical fractures into four groups, including C1 fracture, C2 dens fracture, C2 hangman's fracture, and C1-2 associated fracture. We evaluated the clinical outcome, complications, and patient satisfaction through chart reviews and a telephone questionnaire.ResultsThe healing rate for upper cervical fracture using HVI was 60.9%. In most cases, bony healing occurred within 16 weeks. Older patients required longer fusion time. We observed a 39.1% failure rate, and 60.9% of patients experienced complications. The most common complications were frequent pin loosening (34.8%; 8/23) and pin site infection (17.4%; 4/23). The HVI treatment failed in 66.7% of patients with pin site problems. The patient approval rate was 31.6%.ConclusionThe HVI produced frequent complications and low patient satisfaction. Bony fusion succeeded in 60.9% of patients. Pin site complications showed a tendency to influence the outcome of HVI, and would be promptly addressed to prevent treatment failure if they develop. The decision to use HVI requires an explanation to the patient of potential complications and constant vigilance to prevent such complications and unsatisfactory outcomes.

The relationship between the hypoglossal nerve and the carotid bifurcation is quite variable, and this explains the vulnerability of the nerve during carotid endarterectomy. The sternocleidomastoid artery is a good landmark for identifying the hypoglossal nerve. If there is exact anatomical knowledge about the relationship between the sternocleidomastoid artery and the hypoglossal nerve, the incidence of nerve injuries during carotid endarterectomy can be minimized.

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Spontaneous cervical epidural hematoma (SCEDH) is a rare disease, but can cause severe neurologic impairment. We report a case of a 68-year-old female who presented with sudden onset, posterior neck pain, right shoulder pain, and progressive right hemiparesis mimicking stroke with no trauma history. Initial brain CT and diffusion MRI performed to rule out brain lesion did not show any positive findings. Laboratory examination presented only severe thrombocytopenia (45,000/mm3). Subsequent cervical MRI revealed a cervical epidural mass lesion. We confirmed that it was pure hematoma through C5 unilateral total laminectomy and C6 partial hemilaminectomy. She achieved complete neurologic recovery with active rehabilitation. Early surgical decompression for SCEDH with neurologic impairment should be recommended for better outcome.