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Jonathan D Breshears, Derek G Southwell, Edward F Chang
BACKGROUND: Intraoperative stimulation of the posterior inferior frontal lobe (IFL) induces speech arrest, which is often interpreted as demonstration of essential language function. However, prior reports have described "negative motor areas" in the IFL, sites where stimulation halts ongoing limb motor activity. OBJECTIVE: To investigate the spatial and functional relationship between IFL speech arrest areas and negative motor areas (NMAs). METHODS: In this retrospective cohort study, intraoperative stimulation mapping was performed to localize speech and motor function, as well as arrest of hand movement, hand posture, and guitar playing in a set of patients undergoing awake craniotomy for dominant hemisphere pathologies...
December 12, 2018: Neurosurgery
Gavin W Britz, Virendra R Desai
No abstract text is available yet for this article.
December 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Mehmet Volkan Harput, Ayda Parnian Fard, Ugur Türe
Intramedullary tumors of the spinal cord are rare and account for 2% to 8.5% of all central nervous system tumors. In adults, ependymomas are the most common intramedullary tumors. The primary choice of treatment should be radical surgical removal, as this is curative for most tumors. Adequate tumor exposure is crucial and mostly achieved through standard laminectomy followed by midline myelotomy. However, extensive removal of posterior spinal elements may lead to worsening kyphotic deformities. After obtaining patient consent, this 3-dimensional video publication was prepared to present microneurosurgical removal of a C3-C6 cervical intramedullary tumor using right-sided hemilaminoplasty...
December 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Guangxian Yang, Xicheng Deng, Yifeng Yang, Ni Yin, Jinhua Wang, Pingbo Liu
OBJECTIVES: The aim of this study is to describe an effective surgical strategy for the treatment of children with pectus excavatum (PE) and concurrent congenital heart defect (CHD). METHODS: We retrospectively reviewed the medical records of all children (n = 16) who underwent simultaneous repair of PE with concurrent CHD at the Hunan Children's Hospital from July 2007 to December 2017. Among them, 7 patients had a simple atrial septal defect (ASD); 4 patients had a simple ventricular septal defect (VSD); 3 patients had both VSD and ASD; 1 patient had VSD, ASD and patent ductus arteriosus; and 1 patient had VSD complicated by pulmonary hypertension...
December 11, 2018: Interactive Cardiovascular and Thoracic Surgery
Richard Heyes, Courtney M Tomblinson, David G Lott
Post-transplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression. It can present throughout the head and neck, and tonsillar involvement is not limited to children. We report the case of a 67-year-old woman who developed odynophagia associated with putrid halitosis 4 months after she had undergone renal transplantation. Direct visualization of the oropharynx revealed multiple sites of severe ulceration and erythema, with erosion of both the anterior and posterior right tonsillar pillars and a necrotic ulceration fistulating deeply...
December 2018: Ear, Nose, & Throat Journal
Charles C Yu, Omar Kadri, Allen Kadado, Morenikeji Buraimoh, Jacob Pawloski, Stephen Bartol, Gregory Graziano
STUDY DESIGN: A prospective randomized trial of patients enrolled at a university affiliated tertiary medical center between February and December 2017. OBJECTIVE: To compare perioperative blood loss in patients undergoing elective posterior thoracolumbar fusion who were treated with IV versus PO TXA. SUMMARY OF BACKGROUND DATA: The use of antifibrinolytic agents such as tranexamic acid (TXA) to decrease operative blood loss and allogenic blood transfusions is well documented in the literature...
December 11, 2018: Spine
Jeungchan Lee, Ishtiaq Mawla, Jieun Kim, Marco L Loggia, Ana Ortiz, Changjin Jung, Suk-Tak Chan, Jessica Gerber, Vincent J Schmithorst, Robert R Edwards, Ajay D Wasan, Chantal Berna, Jian Kong, Ted J Kaptchuk, Randy L Gollub, Bruce R Rosen, Vitaly Napadow
Although self-report pain ratings are the gold standard in clinical pain assessment, they are inherently subjective in nature and significantly influenced by multidimensional contextual variables. Although objective biomarkers for pain could substantially aid pain diagnosis and development of novel therapies, reliable markers for clinical pain have been elusive. In this study, individualized physical maneuvers were used to exacerbate clinical pain in patients with chronic low back pain (N = 53), thereby experimentally producing lower and higher pain states...
October 17, 2018: Pain
Shohei Tsujino, Megumi Tsujino, Akihito Tsujino
CASE: A 19-year-old college baseball outfielder presented with a 3-month history of right shoulder pain. Radiographs, computed tomography, and magnetic resonance imaging showed a large osteochondral defect at the posterosuperior aspect of the glenoid. Arthroscopic evaluation identified an unstable fragment that was partially attached. Fixation of the osteochondral fragment was achieved with autogenous osteochondral plugs through a posterior arthrotomy. At 8 months after surgery, the patient was able to return to his former competitive level of performance...
December 12, 2018: JBJS Case Connector
Mitsuharu Nagao, Chihiro Masaki, Mihoko Nakao, Yoshinori Ito, Shintaro Tsuka, Taro Mukaibo, Yusuke Kondo, Ryuji Hosokawa
To perform safe implant treatment, the anatomical structure and bone quality at implant placement sites are evaluated based on a patient's CT data, but there is no definite method to determine placement sites and the appropriate number of implants. The objective of this study was to investigate the influence of the number and arrangement of implants on the stress distribution in 3-unit posterior fixed partial dentures for the posterior mandible by mechanical analysis using the finite element method. Three-dimensional finite element analysis models were constructed from the CT data of a patient with missing mandibular teeth (Nos...
December 12, 2018: Journal of Oral Implantology
Youjun Wu, Bingjie Han, Timothy J Gauvin, Jarrett Smith, Abhyudai Singh, Erik E Griffin
During the asymmetric division of the C. elegans zygote, germ (P) granules are disassembled in the anterior cytoplasm and stabilized/assembled in the posterior cytoplasm, leading to their inheritance by the germline daughter cell. P granule segregation depends on MEG-3 and MEG-4, which are enriched in P granules and in the posterior cytoplasm surrounding P granules. Here, we use single molecule imaging and tracking to characterize the reaction/diffusion mechanisms that underpin MEG-3::Halo segregation. We find that the anteriorly-enriched RNA-binding proteins MEX-5 and MEX-6 suppress the retention of MEG-3 in the anterior cytoplasm, leading to MEG-3 enrichment in the posterior...
December 12, 2018: Molecular Biology of the Cell
Viraj Vasavada, Samaresh Srivastava, Shail A Vasavada, Aditya Sudhalkar, Abhay R Vasavada, Vaishali A Vasavada
PURPOSE: To evaluate the outcomes of a new posterior chamber phakic intraocular lens (IPCL; Care Group, Baroda, India) to correct myopia. METHODS: This prospective, observational case series included 30 eyes undergoing implantation of the IPCL for high myopia (> -8.00 diopters [D]). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, vault, endothelial cell loss, and adverse events were evaluated 3 years after implantation of the IPCL for high myopia...
December 1, 2018: Journal of Refractive Surgery
Daniele de P Faria, Fabio L Duran, Paula Squarzoni, Artur M Coutinho, Alexandre T Garcez, Pedro P Santos, Sonia M Brucki, Maira O de Oliveira, Eduardo S Trés, Orestes V Forlenza, Ricardo Nitrini, Carlos A Buchpiguel, Geraldo Busatto Filho
OBJECTIVE: To compare results of positron emission tomography (PET) with carbon-11-labeled Pittsburgh compound B (11C-PIB) obtained with cerebellar or global brain uptake for voxel intensity normalization, describe the cortical sites with highest tracer uptake in subjects with mild Alzheimer's disease (AD), and explore possible group differences in 11C-PIB binding to white matter. METHODS: 11C-PIB PET scans were acquired from subjects with AD (n=17) and healthy elderly controls (n=19)...
December 6, 2018: Revista Brasileira de Psiquiatria
Leah H Rubin, Siyi Li, Li Yao, Sarah K Keedy, James L Reilly, Scot K Hill, Jeffrey R Bishop, C Sue Carter, Hossein Pournajafi-Nazarloo, Lauren L Drogos, Elliot Gershon, Godfrey D Pearlson, Carol A Tamminga, Brett A Clementz, Matcheri S Keshavan, Su Lui, John A Sweeney
BACKGROUND: Oxytocin (OT) and arginine vasopressin (AVP) exert sexually dimorphic effects on cognition and emotion processing. Abnormalities in these hormones are observed in schizophrenia and may contribute to multiple established sex differences associated with the disorder. Here we examined sex-dependent hormone associations with resting brain activity and their clinical associations in schizophrenia patients. METHODS: OT and AVP serum concentrations were assayed in 35 individuals with schizophrenia (23 men) and 60 controls (24 men) from the Chicago BSNIP study site...
December 2018: Schizophrenia Research
J A Wegdam, J M M Thoolen, S W Nienhuijs, N de Bouvy, T S de Vries Reilingh
BACKGROUND: Transversus abdominis release (TAR), as a type of posterior component separation, is a new myofascial release technique in complex ventral hernia repair. TAR preserves rectus muscle innervation, creates an immense retromuscular plane and allows bilaminar ingrowth of the mesh. The place of the TAR within the range of established anterior component separation techniques (CST) is unclear. Aim of this systematic literature review is to estimate the position of the TAR in the scope of ventral hernia repair techniques...
December 11, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Antonio Mazzotti, Fabrizio Perna, Davide Golinelli, Irene Quattrini, Susanna Stea, Barbara Bordini, Cesare Faldini
PURPOSE: The aim of this study was to assess whether preoperative valgus or varus deformity affected survivorship after total knee arthroplasty (TKA) and to quantify the risk factors for implant failure in a registry-based population. METHODS: The Emilia-Romagna Registry of Prosthetic Orthopedic Implants was examined regarding TKAs performed on patients with a preoperative diagnosis of valgus or varus deformity. Demographics, implant characteristic and survivorships were investigated and compared...
December 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Lei Shi, Kai Shen, Rui Deng, Zheng-Jian Yan, Kai-Lu Liang, Liang Chen, Zhen-Yong Ke, Zhong-Liang Deng
PURPOSE: To investigate the anatomical and biomechanical feasibility of the unilateral C1 double screw [pedicle screw (PS) + lateral mass screw (LMS)] and ipsilateral C2 PS combined with contralateral C2 laminar screw (LS)-rod fixation for atlantoaxial instability by comparison with traditional posterior fixation methods. METHODS: Fifteen sets of complete dry bony specimens of atlas were used for morphometric analysis. The working length, width and thickness of the C1 PSs and LMSs were manually measured...
December 11, 2018: European Spine Journal
Andrew S Maertens, Murphy P Martin, Chase S Dean, David Rojas, Joshua A Parry, Michael Maher, Cyril P Mauffrey
PURPOSE: To determine the most common injury patterns, root cause, and the frequency with which unrecognized contralateral posterior ring injury occurs in patients presenting with surgically treated pelvic fractures. METHODS: The medical records of 73 patients presenting to our level I trauma center (52 male and 21 female patients; mean age 41.8 years; range 18-89 years) with surgically treated pelvic ring fractures between January 1, 2016 and January 1, 2018 were reviewed...
December 11, 2018: International Orthopaedics
Shearwood McClelland, Paul H Cooper, Anupama K Acheson, Jeremy N Ciporen, Jerry J Jaboin, Timur Mitin
Introduction: Stereotactic body radiotherapy (SBRT) of the spine has become an increasingly utilized modality in the United States, most commonly for metastatic disease (McClelland et al., 2017). Spinal SBRT in patients with spinal instrumentation has been sparsely examined. We report a patient who developed myelitis following spinal SBRT to a region with existing hardware. Methods: A 55-year-old woman with Stage IV breast cancer developed a T4 vertebral body metastasis and underwent tumor debulking with posteriorly instrumented T3-T5 fusion...
2018: Journal of Radiosurgery and SBRT
Seza Tetikkurt, Faruk Taş, Funda Emre, Şule Özsoy, Zeki Tolga Bilece
A 53-year-old man was admitted for tooth mobility. A mass was identified at the tooth base by CT. Histopathology of the excisional biopsy revealed a moderately differentiated squamous cell carcinoma. Many intact neutrophils were observed within the malignant cell cytoplasm. The patient underwent partial maxillectomy and bilateral neck dissection. Significant neutrophilic emperipolesis was detected in the resected material. Four tumor recurrences developed in the head and neck region during follow-up. Surgery and chemoradiotherapy was performed...
2018: Case Reports in Oncological Medicine
Vincent M Borderie, Sara Touhami, Cristina Georgeon, Otman Sandali
Objective: Big bubble (BB)-deep anterior lamellar keratoplasty (DALK) has become the reference transplantation technique for corneal stromal disorders. Type 1 BB is the desired aspect but it is not constant. We aimed to determine the predictive factors of type 1 BB success. Methods: Observational cohort study including 77 consecutive eyes of 77 patients undergoing DALK by one surgeon at a single reference center without any selection. Clinical and spectral domain optical coherence tomography data were collected pre- and postoperatively...
2018: Journal of Ophthalmology
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