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https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#1
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28079757/pathogenesis-of-abdominal-pain-in-bowel-obstruction-role-of-mechanical-stress-induced-upregulation-of-nerve-growth-factor-in-gut-smooth-muscle-cells
#2
You-Min Lin, Yu Fu, John Winston, Ravi Radhakrishnan, Sushil K Sarna, Li-Yen M Huang, Xuan-Zheng Shi
Abdominal pain is one of the major symptoms in bowel obstruction (BO); its cellular mechanisms remain incompletely understood. We tested the hypothesis that mechanical stress in obstruction upregulates expression of nociception mediator nerve growth factor (NGF) in gut smooth muscle cells (SMC), and NGF sensitizes primary sensory nerve to contribute to pain in BO. Partial colon obstruction was induced with a silicon band implanted in the distal bowel of Sprague-Dawley rats. Colon-projecting sensory neurons in the dorsal root ganglia (DRG, T13 to L2) were identified for patch clamp and gene expression studies...
January 6, 2017: Pain
https://www.readbyqxmd.com/read/28079752/changes-in-dorsal-root-ganglion-gene-expression-in-response-to-spinal-cord-stimulation
#3
Dana M Tilley, David L Cedeño, Courtney A Kelley, Margaret DeMaegd, Ramsin Benyamin, Ricardo Vallejo
BACKGROUND AND OBJECTIVES: Spinal cord stimulation (SCS) has been shown to influence pain-related genes in the spinal cord directly under the stimulating electrodes. There is limited information regarding changes occurring at the dorsal root ganglion (DRG). This study evaluates gene expression in the DRG in response to SCS therapy. METHODS: Rats were randomized into experimental or control groups (n = 6 per group). Experimental animals underwent spared-nerve injury, implantation of lead, and continuous SCS (72 hours)...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079677/cadaveric-testing-of-robot-assisted-access-to-the-internal-auditory-canal-for-vestibular-schwannoma-removal
#4
Neal P Dillon, Ramya Balachandran, Michael A Siebold, Robert J Webster, George B Wanna, Robert F Labadie
HYPOTHESIS: An image-guided robotic system can safely perform the bulk removal of bone during the translabyrinthine approach to vestibular schwannoma (VS). BACKGROUND: The translabyrinthine approach to VS removal involves extensive manual milling in the temporal bone to gain access to the internal auditory canal (IAC) for tumor resection. This bone removal is time consuming and challenging due to the presence of vital anatomy (e.g., facial nerve) embedded within the temporal bone...
January 10, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#5
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28077887/examination-of-the-predictive-power-of-electromyography-and-urodynamic-study-in-patients-with-cauda-equina-syndrome-horse-tail-syndrome
#6
Mohammadreza Shahmohammadi, Reza Jalil Khoshuod, Alireza Zali, Amir Saied Seddeghi, Nima Mohseni Kabir
BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. OBJECTIVE: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28076964/trigeminal-neuralgia-diagnosis-and-treatment
#7
Stine Maarbjerg, Giulia Di Stefano, Lars Bendtsen, Giorgio Cruccu
Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28076019/viral-and-prion-infections-of-the-central-nervous-system-radiologic-pathologic-correlation-from-the-radiologic-pathology-archives
#8
Kelly K Koeller, Robert Y Shih
Viral infections of the central nervous system (CNS) range in clinical severity, with the most severe proving fatal within a matter of days. Some of the more than 100 different viruses known to affect the brain and spinal cord are neurotropic with a predilection for producing CNS infection. The host response to viral infection of the CNS is responsible for the pathophysiology and imaging findings seen in affected patients. Viral CNS infections can take the form of meningitis, encephalitis, encephalomyelitis, or, when involving the spinal cord and nerve roots, encephalomyeloradiculitis...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28074292/reliability-of-the-nociceptive-blink-reflex-evoked-by-electrical-stimulation-of-the-trigeminal-nerve-in-humans
#9
Yuri Martins Costa, Lene Baad-Hansen, Leonardo Rigoldi Bonjardim, Paulo César Rodrigues Conti, Peter Svensson
OBJECTIVE: The nociceptive blink reflex (nBR) can be useful to investigate trigeminal nociceptive function. The aim of this study was to estimate the reliability of the nBR evoked by electrical stimulation of the three branches of the trigeminal nerve under the following conditions: over time (test-retest and intrarater reliability) and by two examiners (interrater reliability). MATERIALS AND METHODS: Twenty-one healthy participants were evaluated in two sessions (24 h apart)...
January 10, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28073391/magnetic-resonance-myelography-in-congenital-absence-of-the-cervical-pedicle
#10
Rami Alhazmi, Jean-Pierre Farmer, Christine Saint-Martin
Absence of the cervical pedicle is a very rare congenital anomaly, easily misrecognized as a unilateral facet dislocation in a setting of acute trauma or a neoplastic process like a nerve sheath tumor. Although correct diagnosis can be achieved on the cervical radiograph and confirmed by the CT, MRI Myelography is clearly of additional value because shows the specific relationship and orientation of the nerve roots. To the best to our knowledge, this is the first description of MR Myelography findings.
January 11, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28073317/activation-of-kcnq-channels-suppresses-spontaneous-activity-in-drg-neurons-and-reduces-chronic-pain-after-spinal-cord-injury
#11
Zizhen Wu, Lin Li, Fuhua Xie, Junhui Du, Yan Zuo, Jeffrey A Frost, Susan M Carlton, Edgar T Walters, Qing Yang
A majority of people who have sustained spinal cord injury (SCI) experience chronic pain after injury, and this pain is highly resistant to available treatments. Contusive SCI in rats at T10 results in hyperexcitability of primary sensory neurons, which contributes to chronic pain. KCNQ channels are widely expressed in nociceptive dorsal root ganglion (DRG) neurons, are important for controlling their excitability, and their activation has proven effective in reducing pain in peripheral nerve injury and inflammation models...
January 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#12
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28070856/mir-29c-prkci-regulates-axonal-growth-of-dorsal-root-ganglia-neurons-under-hyperglycemia
#13
Longfei Jia, Lei Wang, Michael Chopp, Chao Li, Yi Zhang, Alexandra Szalad, Zheng Gang Zhang
Diabetes initially induces distal axonal damage of peripheral nerves, but molecular mechanisms that mediate axonal injury are not fully understood. MircoRNAs (miRNAs) regulate axonal growth. We found that diabetic db/db mice exhibited substantial upregulation of miR-29c in dorsal root ganglia (DRG) neurons, sciatic nerve, and foot pad tissues. Bioinformatic analysis revealed PRKCI, a gene that encodes a member of the protein kinase C (PKC) iota, as a putative target for miR-29c. Western blot analysis showed that diabetic mice exhibited a considerable reduction of PRKCI protein levels in sciatic nerve tissues and DRG neurons...
January 9, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28069923/map7-regulates-axon-collateral-branch-development-in-dorsal-root-ganglia-neurons
#14
Stephen R Tymanskyj, Benjamin Yang, Aditi Falnikar, Angelo C Lepore, Le Ma
: Collateral branches from axons are key components of functional neural circuits that allow neurons to connect with multiple synaptic targets. Like axon growth and guidance, formation of collateral branches depends on the regulation of microtubules, but how such regulation is coordinated to ensure proper circuit development is not known. Based on microarray analysis, we have identified a role for microtubule-associated protein 7 (MAP7) during collateral branch development of dorsal root ganglia (DRG) sensory neurons...
January 9, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28069497/a-modified-collagen-scaffold-facilitates-endogenous-neurogenesis-for-acute-spinal-cord-injury-repair
#15
Caixia Fan, Xing Li, Zhifeng Xiao, Yannan Zhao, Hui Liang, Bin Wang, Sufang Han, Xiaoran Li, Bai Xu, Nuo Wang, Sumei Liu, Weiwei Xue, Jianwu Dai
Due to irreversible neuronal loss and glial scar deposition, spinal cord injury (SCI) ultimately results in permanent neurological dysfunction. Neuronal regeneration of neural stem cells (NSCs) residing in the spinal cord could be an ideal strategy for replenishing the lost neurons and restore function. However, many myelin-associated inhibitors in the SCI microenvironment limit the ability of spinal cord NSCs to regenerate into neurons. Here, a linearly ordered collagen scaffold was used to prevent scar deposition, guide nerve regeneration and carry drugs to neutralize the inhibitory molecules...
January 6, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28064327/application-of-neuroendoscopy-in-the-surgical-treatment-of-complicated-hemifacial-spasm
#16
Ming Zhi, Xiao J Lu, Qing Wang, Bing Li
OBJECTIVE: To explore the value of neuroendoscopy in surgery for primary hemifacial spasm (HFS) in patients with complicated local anatomy. METHODS: Endoscopic-assisted microvascular decompression (MVD) was performed in 42 patients with HFS with complicated local anatomy from Janurary 2008 to Janurary 2012 in our department, in the event of a significant blind spot, endoscopic exploration was performed with multi-angle 360-degree observation, including exploration of the brainstem facial nerve root exit zone (REZ) and exploration of the distal end of the nerve, and the relationships between blood vessels and nerves were carefully determined...
January 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28064059/par1-activation-affects-the-neurotrophic-properties-of-schwann-cells
#17
Elena Pompili, Cinzia Fabrizi, Francesca Somma, Virginia Correani, Bruno Maras, Maria Eugenia Schininà, Viviana Ciraci, Marco Artico, Francesco Fornai, Lorenzo Fumagalli
Protease-activated receptor-1 (PAR1) is the prototypic member of a family of four G-protein-coupled receptors that signal in response to extracellular proteases. In the peripheral nervous system, the expression and/or the role of PARs are still poorly investigated. High PAR1 mRNA expression was found in the rat dorsal root ganglia and the signal intensity of PAR1 mRNA increased in response to sciatic nerve transection. In the sciatic nerve, functional PAR1 receptor was reported at the level of non-compacted Schwann cell myelin microvilli of the nodes of Ranvier...
January 4, 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/28060908/experimental-mouse-model-of-lumbar-ligamentum-flavum-hypertrophy
#18
Takeyuki Saito, Kazuya Yokota, Kazu Kobayakawa, Masamitsu Hara, Kensuke Kubota, Katsumi Harimaya, Kenichi Kawaguchi, Mitsumasa Hayashida, Yoshihiro Matsumoto, Toshio Doi, Keiichiro Shiba, Yasuharu Nakashima, Seiji Okada
Lumbar spinal canal stenosis (LSCS) is one of the most common spinal disorders in elderly people, with the number of LSCS patients increasing due to the aging of the population. The ligamentum flavum (LF) is a spinal ligament located in the interior of the vertebral canal, and hypertrophy of the LF, which causes the direct compression of the nerve roots and/or cauda equine, is a major cause of LSCS. Although there have been previous studies on LF hypertrophy, its pathomechanism remains unclear. The purpose of this study is to establish a relevant mouse model of LF hypertrophy and to examine disease-related factors...
2017: PloS One
https://www.readbyqxmd.com/read/28059947/sensitivity-of-computed-tomography-compared-with-that-of-magnetic-resonance-myelography-in-the-presurgical-diagnosis-of-foraminal-or-extraforaminal-entrapment-at-the-lumbosacral-junction
#19
Sung Ho Lee, Sang-Ho Lee, Soo-Beom Kim, Eun Soo Park, Soo-Nyung Kim, Ki-Hyoung Moon
STUDY DESIGN: This is a retrospective analysis. OBJECTIVE: To investigate and compare the sensitivities of computed tomography (CT) and magnetic resonance myelography (MRM) in the presurgical diagnosis of foraminal or extraforaminal entrapment of the L5 nerve. SUMMARY OF BACKGROUND DATA: CT is more clinically available than MRM. Foraminal or extraforaminal entrapment at the lumbosacral junction may cause L5 radiculopathy but is difficult to diagnose...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28059910/validation-of-mri-and-surgical-decision-making-to-predict-a-complete-resection-in-pelvic-exenteration-for-recurrent-rectal-cancer
#20
Wendy E Brown, Cherry E Koh, Tim Badgery-Parker, Michael J Solomon
BACKGROUND: The main predictor of long-term survival in patients with recurrent rectal cancer is surgical resection with a clear resection margin. MRI plays a role in patient selection and surgical planning. OBJECTIVE: This study aimed to validate MRI in determining pelvic involvement by comparing MRI to histological outcomes, to assess the effect of MRI on surgical planning by comparing MRI findings with the surgical procedure, and to compare MRI anatomical involvement with resection outcome to assess if MRI can predict a clear resection margin...
February 2017: Diseases of the Colon and Rectum
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