Prospective Investigation of Postoperative Complications in Anterior Decompression with Fusion for Severe Cervical Ossification of the Posterior Longitudinal Ligament: A Multi-institutional Study

xlomafota13 shared this article with you from Inoreader Prospective Investigation of Postoperative Complications in Anterior Decompression with Fusion for Severe Cervical Ossification of the Posterior Longitudinal Ligament: A Multi-institutional Study Via leak of cerebrospinal fluid Spine (Phila Pa 1976). 2021 Dec 1;46(23):1621-1629. doi: 10.1097/BRS.0000000000004088. ABSTRACT STUDY DESIGN: A prospective multicenter study. OBJECTIVE: This study aims to investigate the postoperative complications of anterior decompression with fusion (ADF) for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Surgical treatment for cervical OPLL has a high risk of various complications. ADF is reported to be effective for cervical OPLL, especially for massive OPLL. However, few studies have focused on the surgical complications of ADF. METHODS: We prospectively included 102 patients undergoing ADF for severe cervical OPLL with average canal occupying ratio of 49.8%. We evaluated systemic and local complications, neurological complications, and risk factors related to the postoperative complications. RESULTS: Frequently observed complications included g raft/ implant complications (18.6%), neurological complications (11.8%), and cerebrospinal fluid leak (11.8%). Motor palsy involving only the upper extremity was found in nine patients (8.8%), and other motor palsies involving the lower extremities were found in three patients (2.9%). None of the preoperative factors were significantly associated with the occurrence of neurological palsies, whereas the number of operated levels was a significant factor related to the postoperative graft/implant complications (P = 0.003; odds ratio, 2.112). The incidence of graft/implant complications and related reoperation increased as the number of operated levels increased (especially four levels or more). Most motor palsies were observed immediately after surgery. Of the motor palsies in the bilateral upper extremities and palsies involving the lower extremities, 85.7% showed good recovery, whereas only 40% of unilateral upper extremity motor palsies showed good recovery during the follow-up per iod. CONCLUSION: In ADF for cervical OPLL, the number of operated levels was a significant factor related to the postoperative complication. Specifically, the incidence of graft/implant complications and reoperation rate increased in ADF with four or more levels.Level of Evidence: 3. PMID:34747909 | DOI:10.1097/BRS.0000000000004088 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Small Intestinal Submucosal Graft and Autologous Tissue in Prevention of CSF leak after Posterior Fossa Craniotomy

xlomafota13 shared this article with you from Inoreader Comparison of Small Intestinal Submucosal Graft and Autologous Tissue in Prevention of CSF leak after Posterior Fossa Craniotomy Via leak of cerebrospinal fluid J Neurol Surg B Skull Base. 2021 Mar 12;82(6):695-699. doi: 10.1055/s-0040-1713772. eCollection 2021 Dec. ABSTRACT Objective To compare the use of porcine small intestinal submucosal grafts (SISG) and standard autologous material (fascia) in prevention of cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine resection. Setting Set at the tertiary skull base center. Methods This is a retrospective chart review. After Institutional Review Board approval, we performed a retrospective cohort study evaluating CSF leak in patients who underwent resection of lateral skull base defects with multilayered reconstruction using either fascia autograft or porcine SISGs. Demographics were summarized with descriptive statistics. Logistic regression was used to compare autograft and xenograft cohorts in terms of CSF complications. Results Seventy-seven patients underwent lateral skull base resectio n, followed by reconstruction of the posterior cranial fossa. Of these patients, 21 (27.3%) underwent multilayer repair using SISG xenograft. There were no significant differences in leak-associated complications between autograft and xenograft cohorts. Ventriculoperitoneal shunt was necessary in one (1.8%) autograft and one (4.8) xenograft cases ( p = 0.49). Operative repair to revise surgical defect was necessary in three (5.4%) autograft cases and none in xenograft cases. Conclusion The use of SISG as a component of complex skull base reconstruction after translabyrinthine tumor resection may help reduce CSF leak rates and need for further intervention. PMID:34745839 | PMC:PMC8563263 | DOI:10.1055/s-0040-1713772 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MicroRNA-146b-5p/EPHA7 axis regulates cell invasion, metastasis, proliferation, and temozolomide-induced chemoresistance via regulation of IRAK4/TRAF6/NF-κB signaling pathway in aggressive pituitary adenoma

xlomafota13 shared this article with you from Inoreader MicroRNA-146b-5p/EPHA7 axis regulates cell invasion, metastasis, proliferation, and temozolomide-induced chemoresistance via regulation of IRAK4/TRAF6/NF-κB signaling pathway in aggressive pituitary adenoma Via Cellular and Molecular Biology Histol Histopathol. 2021 Nov 4:18391. doi: 10.14670/HH-18-391. Online ahead of print. ABSTRACT BACKGROUND: Aggressive pituitary adenoma (APA) is a huge challenge for neurosurgeons. Temozolomide (TMZ) is conventionally used in chemotherapy against APA, but acquired resistance developed during long-term therapy limits its benefits. MiRNA-146b-5p has been confirmed to inhibit tumor metastasis. This study aimed to explore the underlying biological functions of miRNA-146b-5p in APA. METHODS: Sixty confirmed APA tissues and corresponding adjacent normal tissues were collected. We established a TMZ-resistant cell line (GH3/TMZ) by exposing GH3 cells to gradually increasing doses of TMZ for 5 months. Cell Counting Kit-8 assay, flow cytometric analysis, RNA pull-down assay, 5-ethynyl-20-deoxyuridine assay, dual-luciferase reporter gene assay, wound healing assay, and invasion assay were used to explore the malignant biological characteris tics of cells. Immunohistochemistry (IHC), western blotting analysis, and real-time quantitative PCR (qRT-PCR) were used to analyze the expression level of related proteins and nucleic acids. RESULTS: The expression of miRNA-146b-5p was down-regulated not only in APA tissues but also in PA cell lines compared with the matched adjacent non-tumor tissues or normal human astrocyte (NHA) cells. Low expression of miRNA-146b-5p was notably associated with poorer disease-free survival rate (P=0.032), overall survival rate (P=0.039), larger tumor size (P=0.028), poorer Knosp grade (P=0.020), and poorer Hardy grade (P=0.006) in APA patients. MiRNA-146b-5p negatively regulated cell proliferation, invasion, migration, and induced apoptosis in GH3 cells. Overexpression of miRNA-146b-5p suppressed IRAK4 and TRAF6 protein expression and negatively regulated NF-κB phosphorylation. The restoration of EPHA7 expression in GH3 cells notably reversed the inhibitory effects of miRNA-146b-5p. MiRN A-146b-5p expression was significantly down-regulated and EPHA7 gene expression was significantly up-regulated in GH3/TMZ cells, compared to the parental cell line. Similarly, EPHA7 was up-regulated, while the miRNA-146b-5p level was down-regulated in chemoresistance tissues more than in chemosensitive tissues. The autophagic activity was decreased markedly with increasing miRNA-146b-5p expression, while it was enhanced after Lv-EPHA7 treatment in GH3/TMZ cells. CONCLUSIONS: MiRNA-146b-5p can inhibit EPHA7 expression, suppress the IRAK4/TRAF6/NF-κB signaling pathway, and weaken PA cell invasion, metastasis, proliferation, and TMZ-induced chemoresistance in vitro. PMID:34746996 | DOI:10.14670/HH-18-391 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of systemic application of propolis on tongue damage and oral mucositis in rats exposed to radiation

xlomafota13 shared this article with you from Inoreader The effect of systemic application of propolis on tongue damage and oral mucositis in rats exposed to radiation Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Nov 8. doi: 10.1007/s00405-021-07159-9. Online ahead of print. ABSTRACT PURPOSE: In this experimental study, the effect of dose-dense systemic application of propolis on oral mucosity, histological changes in papilla, and inflammatory and hypoxic markers in rats exposed to radiation was investigated. METHODS: Seven rats were in the control and 30 rats in the experimental group. Three experimental groups were formed. In Group 1 RT (15 Gy) was delivered only to the head and neck region. In Group 2, RT (15 Gy) and systemic administration of 100 mg/kg/ml propolis, in Group 3, RT (15 Gy) and systemic administration of 200 mg/kg/ml propolis were applied. Oral mucositis index (OMI) was scored in control and experimental groups. Proinflammatory markers [interleukin-6 (IL-6), myeloperoxidase (MPO), tumor-necrosis factor-α (TNF-α)] hypoxia markers [glucose transporter-1 (GLUT-1), hypoxia-inducible factor 1 α (HIF-1α)] were studied histomorphologically. RESULTS: The significantly highest OMI score was observed in the G1. OMI score was statistically significantly decreased in experimental groups receiving systemic propolis, especially in G3. Proinflammatory markers increased significantly only in the experimental RT group, G1. Serum levels of MPO and TNF-α significantly decreased in the dose-dense systemic propolis arm. The highest levels of hypoxia markers (HIF-1α and GLUT-1) were detected in the RT group, then in G2, G3, and control groups in order of decreasing frequency. However, the difference between the groups did not reach the level of statistical significance. CONCLUSION: Systemic propolis can be reduced acute mucositis with its anti-inflammatory effect without developing resistance to RT (tumor protection). However, greater number of clinical studies should be designed to arrive at definitive conclusions. PMID:34746967 | DOI:10.1007/s00405-021-07159-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

2D versus 3D Endoscopy: Head-to-Head Comparison in a Simulated Model of Endoscopic Endonasal Dural Suturing

xlomafota13 shared this article with you from Inoreader 2D versus 3D Endoscopy: Head-to-Head Comparison in a Simulated Model of Endoscopic Endonasal Dural Suturing Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1736635 Objective Endonasal dural suturing (EDS) has been reported to decrease the incidence of cerebrospinal fluid fistula. This technique requires handling of single-shaft instrumentation in the narrow endonasal corridor. It has been proposed that three-dimensional (3D) endoscopes were associated with improved depth perception. In this study, we sought to perform a comparison of two-dimensional (2D) versus 3D endoscopy by assessing surgical proficiency in a simulated model of EDS. Materials and Methods Twenty-six participants subdivided into groups based on previous endoscopic experience were asked to pass barbed sutures through preset targets with either 2D (Storz Hopkins II) or 3D (Storz TIPCAM) endoscopes on 3D-printed simulation model. Surgical precision and procedural time were measured. All participants completed a Likert scale questionnaire. Results Novice, intermediate, and expert groups took 11.0, 8.7, and 5.7 minutes with 2D endoscopy and 10.9, 9.0, and 7.6 minutes with 3D endoscopy, respectively. The average deviation for novice, intermediate, and expert groups (mm) was 5.5, 4.4, and 4.3 with 2D and 6.6, 4.6, and 3.0 with 3D, respectively. No significant difference in procedural time or accuracy was found in 2D versus 3D endoscopy. 2D endoscopic visualization was preferred by the majority of expert/intermediate participants, while 3D endoscopic visualization by the novice group. Conclusion In this pilot study, there was no statistical difference in procedural time or accuracy when utilizing 2D versus 3D endoscopes. While it is possible that widespread familiarity with 2D endoscopic equipment has biased this study, preliminary analysis suggests that 3D endoscopy offers no definitive advantage over 2D endoscopy in this simulated model of EDS. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract &nb sp;|  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Management of Rhabdomyosarcoma of the Nasal Cavity and Paranasal Sinuses: Analysis of Operative Indications, Settings, and Outcomes

xlomafota13 shared this article with you from Inoreader Surgical Management of Rhabdomyosarcoma of the Nasal Cavity and Paranasal Sinuses: Analysis of Operative Indications, Settings, and Outcomes Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1736590 Objectives The role of surgery in management of sinonasal rhabdomyosarcoma (SNRMS) has traditionally been limited, owing to anatomic and technological challenges and the established role of systemic therapy. Herein, we report our institutional experience with surgical management of SNRMS, with a particular focus on operative approaches, extent and outcomes. Design This study is a retrospective cohort study. Setting This study was conducted at a single-institution, academic center. Participants Patients of any age with histologically confirmed RMS of the nasal cavity, maxillary, ethmoid, frontal, or sphenoid sinus, nasolacrimal duct, or nasopharynx presenting between 1994 and 2020 were included in this study. Main Outcome Measures Demographics, tumor characteristics, operative settings, complications and recurrence, and survival outcomes were the primary outcomes of this study. Results Our study cohort comprised of 29 patients (mean [range] age: 27.0 [3.1–65.7], n = 12 [41%] female). Tumors of the nasal cavity (n = 10, 35%) and ethmoid sinuses (n = 10, 35%) and those with alveolar histology (n = 21, 72%) predominated. Patients who had surgery as part of their treatment (n = 13, 45%) had improved distant metastasis-free survival (DMFS) overall (hazard ratio [HR]: 0.32, 95% CI: 0.11, 0.98, p = 0.05) as compared with those who did not have surgery. Surgical approaches included open (n = 7), endoscopic (n = 4), and combined (n = 2). Eight of these 13 patients (62%) had an R0 resection. Additionally, surgical salvage of recurrent disease was employed in five patients (17%). Conclusion SNRMS is an aggressive malignancy with a high rate of recurrence and spread requiring a multidisciplinary approach for optimal outcomes. Our data supports an expanding role for surgery for SNRMS given its feasibility, tolerability, and potential to improve outcomes. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Progressive Protrusive Tongue Exercise Does Not Alter Aging Effects in Retrusive Tongue Muscles

xlomafota13 shared this article with you from Inoreader Progressive Protrusive Tongue Exercise Does Not Alter Aging Effects in Retrusive Tongue Muscles Via swallowing exercises Front Physiol. 2021 Oct 21;12:740876. doi: 10.3389/fphys.2021.740876. eCollection 2021. ABSTRACT Purpose: Exercise-based treatment approaches for dysphagia may improve swallow function in part by inducing adaptive changes to muscles involved in swallowing and deglutition. We have previously shown that both aging and progressive resistance tongue exercise, in a rat model, can induce biological changes in the genioglossus (GG); a muscle that elevates and protrudes the tongue. However, the impacts of progressive resistance tongue exercise on the retrusive muscles (styloglossus, SG; hyoglossus, HG) of the tongue are unknown. The purpose of this study was to examine the impact of a progressive resistance tongue exercise regimen on the retrusive tongue musculature in the context of aging. Given that aging alters retrusive tongue muscles to more slowly contracting fiber types, we hypothesized that these biological changes may be mitigated by tongue exercise. Methods: Hyoglossus (HG) and styloglossus (SG) muscles of male Fischer 344/Brown Norway rats were assayed in age groups of young (9 months old, n = 24), middle-aged (24 months old, n = 23), and old (32 months old, n = 26), after receiving an 8-week period of either progressive resistance protrusive tongue exercise, or sham exercise conditions. Following exercise, HG and SG tongue muscle contractile properties were assessed in vivo. HG and SG muscles were then isolated an d assayed to determine myosin heavy chain isoform (MyHC) composition. Results: Both retrusive tongue muscle contractile properties and MyHC profiles of the HG and SG muscles were significantly impacted by age, but were not significantly impacted by tongue exercise. Old rats had significantly longer retrusive tongue contraction times and longer decay times than young rats. Additionally, HG and SG muscles showed significant MyHC profile changes with age, in that old groups had slower MyHC profiles as compared to young groups. However, the exercise condition did not induce significant effects in any of the biological outcome measures. Conclusion: In a rat model of protrusive tongue exercise, aging induced significant changes in retrusive tongue muscles, and these age-induced changes were unaffected by the tongue exercise regimen. Collectively, results are compatible with the interpretation that protrusive tongue exercise does not induce changes to retrusive tongue muscle function. PMID:34744782 | PMC:PMC8567011 | DOI:10.3389/fphys.2021.740876 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A safe area for sternal puncture in children: an MSCT study based on sternal development

xlomafota13 shared this article with you from Inoreader A safe area for sternal puncture in children: an MSCT study based on sternal development Via radiol anat Surg Radiol Anat. 2021 Nov 8. doi: 10.1007/s00276-021-02850-2. Online ahead of print. ABSTRACT PURPOSE: Multislice spiral CT (MSCT) was used to investigate the anatomical characteristics of sternal development, and to provide anatomical basis for sternal puncture in children. METHODS: We retrospectively analyzed the thoracic MSCT data of 600 children who received thoracic MSCT from January to June 2020 with their age ranging from 1 month to 19 years. The distribution o f sternal ossification centers and adjacent tissues and organs was observed. Subcutaneous soft tissue thickness and the distance between the skin and the posterior margin of the sternum were measured in the central areas of sternal manubrium and mesosternum (segments I and II), and the correlation between the two was calculated using linear correlation. RESULTS: A total of 600 patients were enrolled, the mean age was 9.87 years and the standard deviation was 8.28 years. The sternal manubrium and ossification centers at the I and II segments of the mesosternum were visible in all cases (100%). There was no ossification in segment III of the mesosternum in 15 cases (2.5%), including 12 cases (80%) adjacent to the posterior pericardium and 7 cases (46.7%) of lung tissue. There were 274 cases (45.7%) of segment IV without ossification, including 204 cases (74.5%) of adjacent pericardium and 95 cases (32.8%) of lung tissue. The xiphoid process was not ossified in 258 cases (43%), i ncluding 190 cases (73.6%) adjacent to the pericardium and 97 cases (37.6%) adjacent to the lung tissue. Correspondingly, the thickness of subcutaneous soft tissue of the sternal manubrium and the central region of the I and II segments of the mesosternum had a low positive correlation with age (P < 0.001), the distance between the skin and the posterior margin of the sternum showed a moderate positive correlation with age (P < 0.001), and the distance between the skin and the posterior margin of the sternum showed a high positive correlation with the thickness of subcutaneous soft tissue (P < 0.001). CONCLUSIONS: Nonossification of the sternal ossification center usually occurs below segment III of the mesosternum and is usually adjacent to heart and lung tissue. Pediatric sternal puncture should be performed at the sternal manubrium and the mesosternum of segments I and II. However, attention should be paid to the space between multiple ossification centers. The thi ckness of subcutaneous soft tissue is a critical factor that determines the depth of the puncture. PMID:34748048 | DOI:10.1007/s00276-021-02850-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Congenital Hypothyroidism Can Dictate the Mode of Delivery and Intra-Labor Medication Usage

xlomafota13 shared this article with you from Inoreader Congenital Hypothyroidism Can Dictate the Mode of Delivery and Intra-Labor Medication Usage Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of patients with unilateral microtia and aural atresia: recent advances and updates

xlomafota13 shared this article with you from Inoreader Management of patients with unilateral microtia and aural atresia: recent advances and updates Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review The management of patients with unilateral microtia and aural atresia is complex. Recent literature suggests significant strides in hearing habilitation and ear reconstruction. Recent findings Several options of hearing management are available and are associated with improved outcomes. Timelines for hearing habilitation and ear reconstruction vary by institution. We offer our timeline as a reference. Three dimensional (3D) printed models are increasingly used for training and reconstruction. Bioprinting is on the horizon, though safety and effectiveness studies are pending. Lastly, application of qualitative methods has provided a foundation on which to improve communication between physicians and patients and their families. Better understanding of the patient and family experiences will provide opportunities to target interventions to improve care. Summary Current developments include expanding options for hearing management, changing approaches to timing of atresiaplasty, utilization of 3D printed models, and focus on patient and family experience to improve reconstructive outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.