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Direct Anterior Approach

Burcin Yavuz, Uday B Kompella
Although the eye is an accessible organ for direct drug application, ocular drug delivery remains a major challenge due to multiple barriers within the eye. Key barriers include static barriers imposed by the cornea, conjunctiva, and retinal pigment epithelium and dynamic barriers including tear turnover and blood and lymphatic clearance mechanisms. Systemic administration by oral and parenteral routes is limited by static blood-tissue barriers that include epithelial and endothelial layers, in addition to rapid vascular clearance mechanisms...
October 26, 2016: Handbook of Experimental Pharmacology
Thabo Lapp, Antonia Hildebrand, Daniel Böhringer, Paola Kammrath Betancor, Günther Schlunck, Thomas Reinhard
PURPOSE: To evaluate the feasibility of anterior segment spectral domain optic coherence tomography (ASOCT) as rejection readout in a keratoplasty mouse model and to compare ASOCT against the current standard (i.e., a clinical score system). Furthermore, to compare both approaches with respect to intra- and inter-individual observer variability and to calculate a critical point that distinguishes between rejection and non-rejection in ASOCT analysis. METHODS: Allogeneic penetrating keratoplasties (PKs) were performed using C3H/He donor mice and BALB/c recipient mice; syngeneic transplantations served as controls using BALB/c donors and recipients...
2016: Molecular Vision
Y Ozaki, Y Homma, K Sano, T Baba, H Ochi, A Desroches, M Matsumoto, T Yuasa, K Kaneko
INTRODUCTION: Lateral femoral cutaneous nerve (LFCN) injury is a risk specific to the direct anterior approach (DAA) for total hip arthroplasty (THA). However, prevention strategies have not been established. This study aimed to identify the predisposing factors determining LFCN injury during THA via a DAA. HYPOTHESIS: Patients with LFCN injury after THA via DAA would demonstrate predisposing factors. MATERIAL AND METHODS: LFCN injury was identified using a patient questionnaire...
October 21, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ayse Sakalli Kani, Ann K Shinn, Kathryn E Lewandowski, Dost Öngür
OBJECTIVES: A variety of treatment options exist for schizophrenia, but the effects of these treatments on brain function are not clearly understood. To facilitate the development of more effective treatment strategies, it is important to identify how brain function in schizophrenia patients is affected by the diverse therapeutic approaches that are currently available. The aim of the present article is to systematically review the evidence for functional brain changes associated with different treatment modalities for schizophrenia...
October 19, 2016: Journal of Psychiatric Research
E Mazerand, N Karmani, L Le Fournier, L Laccourreye, H-D Fournier
INTRODUCTION: The image-guided transoral approach (IGTOA) provides a safe exposure to skull base midline lesions and the ventral aspect of the craniovertebral junction (CVJ). The IGTOA has several advantages: the head being placed in the extended position, it decreases the brainstem angulation during surgery; the approach being done through the avascular median pharyngeal raphe, not only lowers the bleeding risk but also provides a direct access to the bony pathology and granulation tissue accessible only via the ventral route...
October 19, 2016: Neuro-Chirurgie
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
Masateru Nagae, Yasuo Mikami, Kentaro Mizuno, Tomohisa Harada, Takumi Ikeda, Hitoshi Tonomura, Ryota Takatori, Hiroyoshi Fujiwara, Toshikazu Kubo
INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained...
October 2016: Medicine (Baltimore)
Rei Ogawa, Shimpei Ono, Satoshi Akaishi, Teruyuki Dohi, Takeshi Iimura, Junichi Nakao
: It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy. METHODS: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified...
September 2016: Plastic and Reconstructive Surgery. Global Open
Deepak N Bhatia
Distal biceps tendon (DBT) ruptures are infrequent injuries that result in pain, weakness, and cosmetic deformity. Severe retraction of the ruptured DBT can occur at the time of injury, or in chronic neglected ruptures, and surgical exposure is performed using a single incision or a 2-incision technique. The technique presented here describes an endoscopic approach using 3 portals that provide access to the retracted DBT, biceps sheath, and radial tuberosity. Preoperative sonographic localization of the retracted DBT and neurovascular structures is used to guide portal placement...
October 12, 2016: Journal of Hand Surgery
Chad D Watts, Matthew T Houdek, Cody C Wyles, Rafael J Sierra, Robert T Trousdale, Michael J Taunton
We conducted a study to compare 90-day outcomes of patients who underwent simultaneous bilateral total hip arthroplasties (THAs) through the direct anterior (DA) approach (n = 19 patients) or the posterior approach (n = 21) over a 2-year period (2012-2014). Compared with patients in the posterior group, patients in the DA group had longer operative times (153 vs 106 min; P < .001) and longer anesthesia times (257 vs 221 min; P = .007) but were more likely to be discharged home (100.0% vs 71.4%; P = .02)...
September 2016: American Journal of Orthopedics
Nozomu Tanabe, Takahiro Tomita, Shoichi Nagai, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda
The authors report a rare case of an intracranial dermoid cyst found in Meckel's cave. A 63-year-old woman developed left oculomotor nerve palsy and was referred to their hospital. Magnetic resonance imaging revealed a cystic lesion in the left Meckel's cave and prepontine cistern, but her symptoms gradually improved during conservative observation. However, three years later she complained of left facial pain in the territory of the second branch of the trigeminal nerve. The left oculomotor nerve palsy exacerbated again...
October 2016: No Shinkei Geka. Neurological Surgery
Carlo Serra, Uğur Türe, Niklaus Krayenbühl, Gülgün Şengül, Dianne C H Yaşargil, M Gazi Yaşargil
OBJECT: To describe the topographic anatomy of the surgically accessible surfaces of the human thalamus as a guide to surgical exploration of this sensitive area. METHODS: Using the operating microscope, we applied the fiber microdissection technique to study 10 brain specimens. Step by step dissections in superior-inferior, medial-lateral and posterior-anterior directions were conducted in order to expose the surfaces and nuclei of the thalamus and to investigate the relevant anatomic relationships and visible connections...
October 7, 2016: World Neurosurgery
Catarina C Lins, Diego T Prado, Andrei F Joaquim
Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD), but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view...
September 2016: Arquivos de Neuro-psiquiatria
Antonia F Chen, Chi-Lung Chen, Sara Low, Wei-Ming Lin, Karthikeyan Chinnakkannu, Fabio R Orozco, Alvin C Ong, Zachary D Post
BACKGROUND: Surgical approach is known as a risk factor that influences cup malposition while performing total hip arthroplasty (THA). However, no study has been conducted comparing cup positioning between the supine direct anterior (DA) and supine direct lateral (DL) THA approaches. QUESTIONS/PURPOSES: (1) Is there a difference in acetabular cup positioning between supine DA and supine DL THA approaches? (2) Are there differences in complications based on acetabular cup positioning between the two approaches? METHODS: From 2012 to 2014, 186 patients who underwent primary THAs using DA approach were matched with 186 patients using DL approach by body mass index, age, and gender...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Julie Hamaide, Geert De Groof, Gwendolyn Van Steenkiste, Ben Jeurissen, Johan Van Audekerke, Maarten Naeyaert, Lisbeth Van Ruijssevelt, Charlotte Cornil, Jan Sijbers, Marleen Verhoye, Annemie Van der Linden
Zebra finches are an excellent model to study the process of vocal learning, a complex socially-learned tool of communication that forms the basis of spoken human language. So far, structural investigation of the zebra finch brain has been performed ex vivo using invasive methods such as histology. These methods are highly specific, however, they strongly interfere with performing whole-brain analyses and exclude longitudinal studies aimed at establishing causal correlations between neuroplastic events and specific behavioral performances...
September 30, 2016: NeuroImage
Evangelia G Chrysikou, Claire Gorey, Robin L Aupperle
Approach-avoidance conflict refers to situations associated with both rewarding and threatening outcomes. The approach-avoidance conflict (AAC) task was developed to measure approach-avoidance conflict decision-making. Approach behavior during this task has been linked to self-reported anxiety sensitivity and has elicited anterior cingulate, insula, caudate, and right dorsolateral prefrontal cortex (dlPFC) activity, with right lateral PFC tracking the extent of approach behavior. Guided by these results, we used excitatory transcranial direct current stimulation (tDCS) to demonstrate the causal involvement of right dlPFC in approach-avoidance conflict decision-making...
October 1, 2016: Social Cognitive and Affective Neuroscience
Xiujuan Zhang, Ying Chen, Ying Ye, Jianfeng Wang, Hong Wang, Guohong Yuan, Zhe Lin, Yihui Wu, Yan Zhang, Xinhua Lin
Wnt signaling plays essential roles in both embryonic pattern formation and postembryonic tissue homoestasis. High levels of Wnt activity repress foregut identity and facilitate hindgut fate through forming a gradient of Wnt signaling activity along the anterior-posterior axis. Here, we examined the mechanisms of Wnt signaling in hindgut development by differentiating human embryonic stem cells (hESCs) into the hindgut progenitors. We observed severe morphological changes when Wnt signaling was blocked by using Wnt antagonist Dkk1...
September 29, 2016: Cellular Signalling
Tze E Cheng, Jason A Wallis, Nicholas F Taylor, Chris T Holden, Paul Marks, Catherine L Smith, Michael S Armstrong, Parminder J Singh
BACKGROUND: We report a prospective randomized study comparing early clinical results between the direct anterior approach (DAA) and posterior approach (PA) in primary hip arthroplasty. METHODS: Surgeries were performed by 2 senior hip arthroplasty surgeons. Seventy-two patients with complete data were assessed preoperatively 2, 6, and 12 weeks postoperatively. The primary outcomes were the Western Ontario McMasters Arthritis Index and Oxford Hip Scores. Secondary outcome measures included the EuroQoL, 10-meter walk test, and clinical and radiographic parameters...
August 31, 2016: Journal of Arthroplasty
Z L Luo, M Chen, X F Shang, F Hu, Z Ni, P Cheng, X F Ji, K R Wu, X Q Zhang
Objective: To compare the clinical efficacy of the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in the lateral decubitus position. Methods: From July to December, 2014, 104 patients randomly divided into two equal groups of the DAA group and the PLA group underwent unilateral primary THA procedures.All procedures were performed by the same surgeon in the Department of Orthopaedics, the Affiliated Anhui Provincial Hospital of Anhui Medical University.General data, perioperative index, postoperative function and radiological evaluation were recorded and statistically analyzed...
September 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Giulia Fontana, Marco Riboldi, Chiara Gianoli, Cezarina I Chirvase, Gaetano Villa, Chiara Paganelli, Paul E Summers, Barbara Tagaste, Andrea Pella, Piero Fossati, Mario Ciocca, Guido Baroni, Francesca Valvo, Roberto Orecchia
Particle therapy (PT) has shown positive therapeutic results in local control of locally advanced pancreatic lesions. PT effectiveness is highly influenced by target localization accuracy both in space, since the pancreas is located in proximity to radiosensitive vital organs, and in time as it is subject to substantial breathing-related motion. The purpose of this preliminary study was to quantify pancreas range of motion under typical PT treatment conditions. Three common immobilization devices (vacuum cushion, thermoplastic mask, and compressor belt) were evaluated on five male patients in prone and supine positions...
2016: Journal of Applied Clinical Medical Physics
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