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https://www.readbyqxmd.com/read/29158992/hrv-derived-data-similarity-and-distribution-index-based-on-ensemble-neural-network-for-measuring-depth-of-anaesthesia
#1
Quan Liu, Li Ma, Ren-Chun Chiu, Shou-Zen Fan, Maysam F Abbod, Jiann-Shing Shieh
Evaluation of depth of anaesthesia (DoA) is critical in clinical surgery. Indices derived from electroencephalogram (EEG) are currently widely used to quantify DoA. However, there are known to be inaccurate under certain conditions; therefore, experienced anaesthesiologists rely on the monitoring of vital signs such as body temperature, pulse rate, respiration rate, and blood pressure to control the procedure. Because of the lack of an ideal approach for quantifying level of consciousness, studies have been conducted to develop improved methods of measuring DoA...
2017: PeerJ
https://www.readbyqxmd.com/read/29152442/combination-intensity-modulated-proton-therapy-and-passive-scatter-boost-for-rapidly-progressing-nasal-cavity-squamous-cell-carcinoma
#2
Sweet Ping Ng, Ethan B Ludmir, Manuel A Oyervides, Richard Y Wu, Steve Frank, G Brandon Gunn
Cancers of the nasal cavity and septum are associated with poor prognosis and are usually treated with surgery followed by post-operative radiotherapy with or without concurrent chemotherapy. Definitive radiotherapy is used in cases where the tumor is unresectable, patient is unfit for surgery, and/or the patient declines surgical intervention. Here, we present a case of a patient, who for non-medical reasons, opted to have non-surgical management of his rapidly progressing nasal cavity tumor. He was successfully treated with concurrent chemoradiotherapy utilizing a combination of intensity modulated proton therapy (IMPT) with passive scatter boost to reduce dose to the adjacent critical neural structures...
September 14, 2017: Curēus
https://www.readbyqxmd.com/read/29152227/promising-neuroprotective-strategies-for-traumatic-spinal-cord-injury-with-a-focus-on-the-differential-effects-among-anatomical-levels-of-injury
#3
REVIEW
Antigona Ulndreaj, Anna Badner, Michael G Fehlings
Traumatic spinal cord injury (SCI) is a devastating condition of motor, sensory, and autonomic dysfunction. The significant cost associated with the management and lifetime care of patients with SCI also presents a major economic burden. For these reasons, there is a need to develop and translate strategies that can improve outcomes following SCI. Given the challenges in achieving regeneration of the injured spinal cord, neuroprotection has been at the forefront of clinical translation. Yet, despite many preclinical advances, there has been limited translation into the clinic apart from methylprednisolone (which remains controversial), hypertensive therapy to maintain spinal cord perfusion, and early decompressive surgery...
2017: F1000Research
https://www.readbyqxmd.com/read/29147635/global-and-targeted-pathway-impact-of-gliomas-on-white-matter-integrity-based-on-lobar-localization
#4
David R Ormond, Shawn D'Souza, John A Thompson
Primary brain tumors comprise 28% of all tumors and 80% of malignant tumors. Pathophysiology of high-grade gliomas includes significant distortion of white matter architecture, necrosis, the breakdown of the blood brain barrier, and increased intracranial pressure. Diffusion tensor imaging (DTI), a diffusion weighted imaging technique, can be used to assess white matter architecture. Use of DTI as a non-invasive pathophysiological tool to analyze glioma impact on white matter microstructure has yet to be fully explored...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29145253/anterior-endoscopically-assisted-bone-grafting-for-iatrogenic-distraction-of-odontoid-fracture-after-percutaneous-anterior-screw-fixation-a-case-report
#5
Ze-Xin Chen, Hui Zhang, Nai-Feng Tian, Xiang-Yang Wang, Yan Lin, Yao-Sen Wu
RATIONALE: The complication of iatrogenic distraction of odontoid fracture after anterior screw fixation has not been reported in the literature. We treated the patient with endoscopically assisted bone grafting with good results. The new technique was not reported in the management of odontoid fracture or nonunion before. PATIENT CONCERNS: A 22-year-old man presented with neck pain after a motorcycle crash. The cervical spine radiograph and computed tomographic scan demonstrated the base of dens displaced 2 mm anteriorly...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145167/contraction-response-to-muscle-percussion-a-reappraisal-of-the-mechanism-of-this-bedside-test
#6
Christoph Czarnetzki, André Truffert, Abdelhafid Mekideche, Antoine Poncet, Christopher Lysakowski, Martin R Tramèr, Michel R Magistris
OBJECTIVE: To study whether the contraction evoked by muscle percussion stems from the excitation of the muscle or of the nerve and to discuss the changes of this response in neuromuscular disorders. METHODS: In 30 neurologically healthy patients undergoing surgery (for ear, nose, or throat problems unrelated to the study) under general anesthesia with propofol and sufentanil we measured with an electrogoniometer the maximal dorsiflexion of the ankle evoked by reflex hammer percussion of the tibialis anterior muscle before and under neuromuscular junction blockade with rocuronium bromide...
October 28, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29142848/injury-of-the-external-branch-of-the-superior-laryngeal-nerve-in-thyroid-surgery
#7
REVIEW
Andre S Potenza, Vergilius J F Araujo Filho, Claudio R Cernea
The external branch of the superior laryngeal nerve (EBSLN) innervates the cricothyroid muscle (CTM) to promote lengthening and thinning of the vocal fold, thus increasing voice pitch. The close relation with the superior thyroid vessels (STV) puts the EBSLN in risk every time the superior pole of the thyroid is dissected. It travels downward to innervate the CTM, lateral to the thyroid cartilage and to the inferior pharyngeal constrictor muscle (IPCM), being eventually covered by this muscle fibers as it approaches its entry point...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142846/opportunities-and-challenges-of-intermittent-and-continuous-intraoperative-neural-monitoring-in-thyroid-surgery
#8
REVIEW
Rick Schneider, Andreas Machens, Gregory W Randolph, Dipti Kamani, Kerstin Lorenz, Henning Dralle
The number of thyroid operations and there radically continues to rise in the western hemisphere, bringing prevention of recurrent laryngeal nerve (RLN) palsy to the fore. Overall, the incidence of RLN palsy is fairly low but continues to prompt litigation for malpractice. In an effort to diminish transient, and more importantly permanent, RLN palsy rates, intraoperative neuromonitoring (IONM) has been advocated as a risk minimization tool. Recent meta-analyses of studies, many of which were limited by poor study design and the sole use of intermittent nerve stimulation, were unable to demonstrate superiority of IONM over mere anatomic RLN dissection...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142834/two-stage-thyroidectomy-in-the-era-of-intraoperative-neuromonitoring
#9
Christos Christoforides, Ioannis Papandrikos, Georgios Polyzois, Nikolaos Roukounakis, Gianlorenzo Dionigi, Kyriakos Vamvakidis
Background: The use of intraoperative neuromonitoring (IONM) provides surgeons with real time information about recurrent laryngeal nerves (RLN) functional integrity. Hence, allowing them to modify the initially scheduled bilateral procedure, to a two-stage thyroidectomy in cases of loss of signal (LOS) on the first side of resection resulting in minimization of bilateral RLN injury. The purpose of our study was to present our results since the implementation of the above mentioned process in both malignant and benign thyroid disease...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29138702/a-case-of-c5-vertebral-chordoma-in-a-73-year-old-patient-with-more-than-8-years-of-follow-up-after-total-piecemeal-spondylectomy
#10
Keigo Tanaka, Harutoshi Sakakima, Kazutoshi Hida, Kanako Hatanaka, Kosei Ijiri
Chordoma arising from the cervical spine is rare and the traditional long-term prognosis is typically poor. Total en bloc spondylectomy with a wide margin is generally accepted to be the most appropriate management for thoracic and lumbar malignant tumors. However, this method is still challenging for the cervical spine because of the proximity of the tumor to the vertebral arteries and neural elements. Here, we report a 73-year-old man with a C5 vertebral chordoma treated with total piecemeal spondylectomy...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29135866/importance-of-perimodiolar-electrode-position-for-psychoacoustic-discrimination-in-cochlear-implantation
#11
Angel Ramos Macias, Maria Teresa Perez Zaballos, Angel Ramos de Miguel, Javier Cervera Paz
HYPOTHESIS: Modiolar proximity of the cochlear implant electrodes and low impedance values have a positive effect on electrical pitch discrimination. BACKGROUND: The proximity of the cochlear electrode to the modiolar wall can determine changes in tissue and fluid environment. With the onset of soft-surgery techniques, the trauma caused during surgery has been reduced, minimizing fibrous growth. METHODS: Computed tomography-scan measurements of electrode-inner wall distance and psychoacoustic electrode discrimination tests were done...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135596/general-anesthetics-to-treat-major-depressive-disorder-clinical-relevance-and-underlying-mechanisms
#12
Laszlo Vutskits
Major depressive disorder is a frequent and devastating psychological condition with tremendous public health impact. The underlying pathophysiological mechanisms involve abnormal neurotransmission and a relatedly impaired synaptic plasticity. Since general anesthetics are potent modulators of neuronal activity and, thereby, can exert long-term context-dependent impact on neural networks, an intriguing hypothesis is that these drugs could enhance impaired neural plasticity associated with certain psychiatric diseases...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29120924/potential-mechanisms-underlying-the-effect-of-bariatric-surgery-on-eating-behaviour
#13
Roxanna Zakeri, Rachel L Batterham
PURPOSE OF REVIEW: Reduced energy intake, resulting from favourable changes in eating behaviour, is the predominant driver of weight loss following bariatric surgery. Here we review the most recent studies examining the impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy, the two most common bariatric procedures, upon eating behaviour and the suggested underlying biological mechanisms. RECENT FINDINGS: Following RYGB or sleeve gastrectomy, most people report subjective changes in appetite, taste and food preference, with decreased high-fat preference most commonly reported...
November 7, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29117061/three-dimensional-analysis-of-the-fundus-of-the-human-internal-acoustic-canal
#14
Nadine Schart-Morén, Sune Larsson, Helge Rask-Andersen, Hao Li
OBJECTIVES: Documentation of the nerve components in the internal acoustic canal is essential before cochlea implantation surgery. Interpretations may be challenged by wide anatomical variations of the VIIIth nerve and their ramifications. Malformations may further defy proper nerve identification. DESIGN: Using microcomputed tomography, we analyzed the fundus bone channels in an archival collection of 113 macerated human temporal bones and 325 plastic inner molds...
November 7, 2017: Ear and Hearing
https://www.readbyqxmd.com/read/29107772/gastric-bypass-surgery-induced-widespread-neural-plasticity-of-the-obese-human-brain
#15
Michael Rullmann, Sven Preusser, Sindy Poppitz, Stefanie Heba, Jana Hoyer, Tatjana Schütz, Arne Dietrich, Karsten Müller, Burkhard Pleger
Bariatric surgery has become the gold standard for the treatment of morbid obesity (body mass index (BMI) ≥ 40 kg/m(2)), but only few studies investigated its plastic influences on the obese brain. In this longitudinal study, we combined structural and functional magnetic resonance brain imaging (MRI) in 27 patients (BMI 47.8 ± 5.5 kg/m(2)) undergoing gastric-bypass surgery and 14 non-obese matched controls (BMI 24.7 ± 3.4 kg/m(2)). Over the first year after surgery, patients presented widespread changes in white matter density (WMD) as well as gray matter density (GMD) in the cerebral cortex of all lobes, subcortical structures, the brainstem as well as the cerebellum, but no changes in white matter water diffusivity throughout the brain...
October 28, 2017: NeuroImage
https://www.readbyqxmd.com/read/29105478/-possible-living-factors-influencing-the-efficacy-of-acupuncture-analgesia-between-chinese-and-western-populations-caffeine
#16
Xiang Cui, Kun Liu, Mu-Jun Zhi, Ting Zhao, Xun He, Hao Liu, Xin-Yan Gao, Bing Zhu
It has been known for thousands of years that acupuncture can relieve pain. However, the efficacy of acupuncture analgesia (AA) now has to be reconsidered due to negative reports from western countries. In the present study, the possible correlation between caffeine and the difference in AA in China and western countries was determined using the following factors:1) caffeine and pain; 2) adenosine, adenosine receptor and caffeine; 3) AA and caffeine. As a non-selective antagonist of the adenosine receptor, caffeine at low doses can be used as an adjuvant analgesic, and can augment antinociception combined with other analgesics...
October 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29104593/optogenetic-inhibition-of-striatal-neuronal-activity-improves-the-survival-of-transplanted-neural-stem-cells-and-neurological-outcomes-after-ischemic-stroke-in-mice
#17
Yifan Lu, Lu Jiang, Wanlu Li, Meijie Qu, Yaying Song, Xiaosong He, Zhijun Zhang, Guo-Yuan Yang, Yongting Wang
Neural stem cell (NSC) transplantation is a promising treatment to improve the recovery after brain ischemia. However, how the survival, proliferation, migration, and differentiation of implanted NSC are influenced by endogenous neuronal activity remains unclear. In this work, we used optogenetic techniques to control the activity of striatal neurons and investigated how their activity affected the survival and migration of transplanted NSCs and overall neurological outcome after ischemic stroke. NSCs cultured from transgenic mice expressing fluorescent protein were transplanted into the peri-infarct region of the striatum after transient middle cerebral artery occlusion (tMCAO) surgery...
2017: Stem Cells International
https://www.readbyqxmd.com/read/29100727/operative-and-therapeutic-advancements-in-breast-cancer-metastases-to-the-brain
#18
REVIEW
Rahul Jandial, Reid Hoshide, J Dawn Waters, George Somlo
Patients with breast cancer are surviving longer as the state of the art for care advances. Because patients are surviving longer with primary breast cancer, the incidence of secondary metastatic disease has risen. Metastatic breast cancer to the brain was once thought to be universally fatal. While it is still quite lethal, its treatment after diagnosis is increasingly safe and effective. Critical progress has been made in understanding the interaction between breast metastases and the neural niche, neuroimaging of functional anatomy, minimally invasive image-guided brain surgery, characterizing subtypes of breast cancer based on molecular and genetic profiles, and individualized pharmaceuticals and immunotherapies...
October 7, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29100648/erythropoietin-s-beta-common-receptor-mediates-neuroprotection-in-spinal-cord-neurons
#19
Lisa S Foley, David A Fullerton, Joshua Mares, Mitchell Sungelo, Michael J Weyant, Joseph C Cleveland, T Brett Reece
BACKGROUND: Paraplegia from spinal cord ischemia-reperfusion (SCIR) remains an elusive and devastating complication of complex aortic operations. Erythropoietin (EPO) attenuates this injury in models of SCIR. Upregulation of the EPO beta common receptor (βcR) is associated with reduced damage in models of neural injury. The purpose of this study was to examine whether EPO-mediated neuroprotection was dependent on βcR expression. We hypothesized that spinal cord neurons subjected to oxygen-glucose deprivation would mimic SCIR injury in aortic surgery and EPO treatment attenuates this injury in a βcR-dependent fashion...
October 31, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100338/patient-derived-dipg-cells-preserve-stem-like-characteristics-and-generate-orthotopic-tumors
#20
Cheng Xu, Xiaoqing Liu, Yibo Geng, Qingran Bai, Changcun Pan, Yu Sun, Xin Chen, Hai Yu, Yuliang Wu, Peng Zhang, Wenhao Wu, Yu Wang, Zhen Wu, Junting Zhang, Zhaohui Wang, Rui Yang, Jenna Lewis, Darell Bigner, Fangping Zhao, Yiping He, Hai Yan, Qin Shen, Liwei Zhang
Diffuse intrinsic pontine glioma (DIPG) is a devastating brain tumor, with a median survival of less than one year. Due to enormous difficulties in the acquisition of DIPG specimens and the sophisticated technique required to perform brainstem orthotopic injection, only a handful of DIPG pre-clinical models are available. In this study, we successfully established eight patient-derived DIPG cell lines, mostly derived from treatment-naïve surgery or biopsy specimens. These patient-derived cell lines can be stably passaged in serum-free neural stem cell media and displayed distinct morphologies, growth rates and chromosome abnormalities...
September 29, 2017: Oncotarget
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