Clinical and radiographic benefits of skipping C7 instrumentation in posterior cervicothoracic fusion: a retrospective analysis.

Background: C7 instrumentation during posterior cervicothoracic fusion can be challenging because it requires additional work of either placing side connectors to a single rod or placing two rods. Our clinical observations suggested that skipping instrumentation at C7 in a multi-level posterior cervicothoracic fusion will result in minimal intraoperative complications and decreased blood-loss while still maintaining sagittal balance parameters of cervical fusion. The objective of this study is to determine the clinical and radiographic outcomes of skipping C7 instrumentation compared to instrumenting the C7 vertebra in posterior cervicothoracic fusion.

Utility of neuromuscular blockade reversal in the evaluation of acute neurosurgical patients: A retrospective case-series.

Objective: Sugammadex reversal of neuromuscular blocking agents (NMBAs) is usually performed postoperatively. A scarcity of literature exists exploring sugammadex use for timely neurological examination of neurosurgical patients. NMBAs, like rocuronium, are used in the Emergency Department during intubation and their unpredictable duration of action often impedes timely and accurate assessment of patient neurological status.

Unpacking the Role of Extracellular Vesicles in Ischemic and Hemorrhagic Stroke: Pathophysiology and Therapeutic Implications.

Stroke is a leading cause of death and disability worldwide. Inflammation and microvascular dysfunction have been associated with brain injury and long-term disability after both ischemic and hemorrhagic stroke. Recent studies have suggested a potential role of extracellular vesicles (EVs) as a link underlying these pathogenic processes.

Generational Changes in Lumbar Spinal Canal Dimensions: Findings from a Sample U.S. Population.

Objective: Evaluation of lumbar canal dimensions in a Chicago population born in 2 different decades.

Methods: This is a retrospective chart review analyzing computed tomography reconstruction from patients born between 1940 and 1949 (older group) and 1970 and 1979 (younger group). The cross-sectional area (CSA) and anterior-posterior diameter (APD) of the lumbar bony canal was measured at each lumbar level at the level of the pedicle.

Activated Mesenchymal Stem Cells Induce Recovery Following Stroke Via Regulation of Inflammation and Oligodendrogenesis.

Background Brain repair mechanisms fail to promote recovery after stroke, and approaches to induce brain regeneration are scarce. Mesenchymal stem cells (MSC) are thought to be a promising therapeutic option. However, their efficacy is not fully elucidated, and the mechanism underlying their effect is not known.

Safety and Efficacy of Skipping C7 Instrumentation in Posterior Cervicothoracic Fusion.

Objective: To analyze the safety and efficacy of skipping instrumentation at the C7 vertebra during posterior cervicothoracic fusions.

Methods: This is a retrospective chart review of 53 patients who underwent multilevel posterior cervical fusion between 2010 and 2015. Of 53 patients, 7 patients were instrumented at C7, serving as the control group, whereas the remaining 46 patients were not.

Human Hippocampal Neurogenesis Persists in Aged Adults and Alzheimer's Disease Patients.

Whether hippocampal neurogenesis persists throughout life in the human brain is not fully resolved. Here, we demonstrate that hippocampal neurogenesis is persistent through the tenth decade of life and is detectable in patients with mild cognitive impairments and Alzheimer's disease. In a cohort of 18 participants with a mean age of 90.

Cytosolic Phospholipase A Facilitates Oligomeric Amyloid-β Peptide Association with Microglia via Regulation of Membrane-Cytoskeleton Connectivity.

Cytosolic phospholipase A (cPLA) mediates oligomeric amyloid-β peptide (oAβ)-induced oxidative and inflammatory responses in glial cells. Increased activity of cPLA has been implicated in the neuropathology of Alzheimer's disease (AD), suggesting that cPLA regulation of oAβ-induced microglial activation may play a role in the AD pathology. We demonstrate that LPS, IFNγ, and oAβ increased phosphorylated cPLA (p-cPLA) in immortalized mouse microglia (BV2).

Depletion of adult neurogenesis exacerbates cognitive deficits in Alzheimer's disease by compromising hippocampal inhibition.

Background: The molecular mechanism underlying progressive memory loss in Alzheimer's disease is poorly understood. Neurogenesis in the adult hippocampus is a dynamic process that continuously changes the dentate gyrus and is important for hippocampal plasticity, learning and memory. However, whether impairments in neurogenesis affect the hippocampal circuitry in a way that leads to memory deficits characteristic of Alzheimer's disease is unknown.

T-1 pedicle subtraction osteotomy for the treatment of rigid cervical kyphotic deformity: report of 4 cases.

Cervical kyphotic deformity represents a difficult to treat pathology often arising from multiple factors including, but not limited to, traumatic injuries, degenerative changes, and ankylosing spondylitis. Furthermore, treatment of these deformities becomes increasingly difficult with any preexisting instrumentation. Currently, several options exist to treat these severe deformities, with the Smith-Petersen osteotomy and C-7 pedicle subtraction osteotomy being the most frequently used approaches.

Pica in a Child with Anterior Cingulate Gyrus Oligodendroglioma: Case Report.

The anterior cingulate gyrus (ACG) is a continued focus of research as its exact role in brain function and vast connections with other anatomical locations is not fully understood. A review of the literature illustrates the role the ACG likely plays in cognitive and emotional processing, as well as a modulating role in motor function and goal-oriented behaviors. While lesions of the cingulate gyrus are rare, each new case broadens our understanding of its role in cognitive neuroscience and higher order processing.

Corticosteroid Treatment for Metastatic Spinal Cord Compression: A Review.

Study Design: Narrative review.

Objective: Metastatic spinal cord compression (MSCC) is a very frequent complication among cancer patients. Presenting commonly as nocturnal back pain, MSCC typically progresses to lower extremity paresis, loss of ambulatory capabilities, and paraplegia.

Spinal Compression Fracture Management: A Review of Current Treatment Strategies and Possible Future Avenues.

Study Design: Narrative review.

Objective: Despite the numerous treatment options for vertebral compression fractures, a consensus opinion for the management of patients with these factures has not been established. This review is meant to provide an up-to-date overview of the most common treatment strategies for compression fractures and to suggest possible routes for the development of clearer treatment guidelines.

Pilot study of a multidisciplinary gout patient education and monitoring program.

Objective: Gout patient self-management knowledge and adherence to treatment regimens are poor. Our objective was to assess the feasibility and acceptability of a multidisciplinary team-based pilot program for the education and monitoring of gout patients.

Methods: Subjects completed a gout self-management knowledge exam, along with gout flare history and compliance questionnaires, at enrollment and at 6 and 12 months.

Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report.

Nonaccidental head injury, as seen in domestic child abuse cases, is often associated with spinal injury, and spinal subdural hematoma is the most frequent diagnosis. While spinal epidural hematomas are a rare occurrence, the incidence of spontaneous epidural hematomas occurring in nonaccidental head injury patients is even lower. Epidural hematomas often result in acute focal neurological deficits necessitating emergent neurosurgical intervention.

Replacing Windows Reduces Childhood Lead Exposure: Results From a State-Funded Program.

Context: Despite considerable evidence that window replacement reduces childhood lead exposure and improves energy conservation and market value, federal policies in childhood lead poisoning, home improvement, and weatherization programs all tend to discourage it.

Objective And Intervention: To evaluate a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones.

Design And Setting: Pre-/post evaluation in 1 urban and 1 rural jurisdiction.

Intramedullary spinal cord tumors: a review of current and future treatment strategies.

Intramedullary spinal cord tumors have low incidence rates but are associated with difficult treatment options. The majority of patients with these tumors can be initially treated with an attempted resection. Unfortunately, those patients who cannot undergo gross-total resection or have subtotal resection are left with few treatment options, such as radiotherapy and chemotherapy.

Presenilin-1 Dependent Neurogenesis Regulates Hippocampal Learning and Memory.

Presenilin-1 (PS1), the catalytic core of the aspartyl protease γ-secretase, regulates adult neurogenesis. However, it is not clear whether the role of neurogenesis in hippocampal learning and memory is PS1-dependent, or whether PS1 loss of function in adult hippocampal neurogenesis can cause learning and memory deficits. Here we show that downregulation of PS1 in hippocampal neural progenitor cells causes progressive deficits in pattern separation and novelty exploration.

Improvement in venous outflow following superior sagittal sinus decompression after a gunshot wound to the head: case report.

The most commonly described indications for surgical management of closed depressed skull fractures are hematoma evacuation and repair of extensive cosmetic deformity. Venous sinus injury, which occurs in a subset of depressed skull fractures, is not typically listed as an indication for surgical treatment due to the potential for major venous hemorrhage associated with surgery near these structures. However, if patients exhibit signs and symptoms of intracranial hypertension and radiographic findings demonstrate sinus compromise, surgical elevation of the depressed skull fragments is indicated.

Neurogenesis and inflammation after ischemic stroke: what is known and where we go from here.

This review covers the pathogenesis of ischemic stroke and future directions regarding therapeutic options after injury. Ischemic stroke is a devastating disease process affecting millions of people worldwide every year. The mechanisms underlying the pathophysiology of stroke are not fully understood but there is increasing evidence demonstrating the contribution of inflammation to the drastic changes after cerebral ischemia.

Role of argatroban during neurointerventional procedures in patients with heparin induced thrombocytopenia.

Background: Currently, heparin is used routinely for anticoagulation during cerebral angiography and neurointerventional procedures. In patients with heparin sensitivity, however, heparin cannot be used. Therefore, an alternative method of anticoagulation is necessary to prevent clot formation during such procedures.

Composite tissue allotransplantation and dysregulation in tissue repair and regeneration: a role for mesenchymal stem cells.

Vascularized composite tissue allotransplantation is a rapidly evolving area that has brought technological advances to the forefront of plastic surgery, hand surgery, and transplant biology. Composite tissue allografts (CTAs) may have profound functional, esthetic, and psychological benefits, but carry with them the risks of life-long immunosuppression and the inadequate abilities to monitor and prevent rejection. Allografts may suffer from additional insults further weakening their overall benefits.

Role of cranial and spinal virtual and augmented reality simulation using immersive touch modules in neurosurgical training.

Recent studies have shown that mental script-based rehearsal and simulation-based training improve the transfer of surgical skills in various medical disciplines. Despite significant advances in technology and intraoperative techniques over the last several decades, surgical skills training on neurosurgical operations still carries significant risk of serious morbidity or mortality. Potentially avoidable technical errors are well recognized as contributing to poor surgical outcome.

Directed Evolution and Biocatalysis.

This review describes the current state of biocatalysis in the chemical industry. Although we recognize the advantages of chemical approaches, we suggest that the use of biological catalysis is about to expand dramatically because of the recent developments in the artificial evolution of genes that code for enzymes. For the first time it is possible to consider the rapid development of an enzyme that is designed for a specific chemical reaction.