A novel technique for transaxillary resection of fully formed cervical ribs with long-term clinical outcomes.

Objective: Although the supraclavicular approach has been widely adopted for cervical rib resection, a transaxillary approach has been favored by many. We have reviewed more than two decades of experience with decompression of the thoracic outlet to treat thoracic outlet syndrome (TOS) in patients with complete cervical ribs using a novel transaxillary approach.

Methods: A prospectively maintained database of patients undergoing surgery for TOS was searched for patients with complete (class 3 and 4) cervical ribs from 1997 to 2019.

Nationwide comparison of the medical complexity of patients by surgical specialty.

Objective: Intuitively, the chronic disease burden of surgical patients varies considerably by surgical specialty, although sparse evidence in the literature supports this notion. We sought to characterize the medical complexity of surgical patients by surgical specialty and to quantify the association between medical complexity and outcomes.

Methods: The National Inpatient Sample, an all-payer inpatient database representative of 97% of all U.

New predictors of complications in carotid body tumor resection.

Objective: This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury.

Methods: Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected.

Acute Aortic Dissection and Intramural Hematoma: A Systematic Review.

Importance: Acute aortic syndrome (AAS), a potentially fatal pathologic process within the aortic wall, should be suspected in patients presenting with severe thoracic pain and hypertension. AAS, including aortic dissection (approximately 90% of cases) and intramural hematoma, may be complicated by poor perfusion, aneurysm, or uncontrollable pain and hypertension. AAS is uncommon (approximately 3.

Endovascular-first approach is not associated with worse amputation-free survival in appropriately selected patients with critical limb ischemia.

Objective: Endovascular interventions for critical limb ischemia are associated with inferior limb salvage (LS) rates in most randomized trials and large series. This study examined the long-term outcomes of selective use of endovascular-first (endo-first) and open-first strategies in 302 patients from March 2007 to December 2010.

Methods: Endo-first was selected if (1) the patient had short (5-cm to 7-cm occlusions or stenoses in crural vessels); (2) the disease in the superficial femoral artery was limited to TransAtlantic Inter-Society Consensus II A, B, or C; and (3) no impending limb loss.

Immune-mediated loss of transgene expression from virally transduced brain cells is irreversible, mediated by IFNγ, perforin, and TNFα, and due to the elimination of transduced cells.

The adaptive immune response to viral vectors reduces vector-mediated transgene expression from the brain. It is unknown, however, whether this loss is caused by functional downregulation of transgene expression or death of transduced cells. Herein, we demonstrate that during the elimination of transgene expression, the brain becomes infiltrated with CD4(+) and CD8(+) T cells and that these T cells are necessary for transgene elimination.

Development of the Drosophila entero-endocrine lineage and its specification by the Notch signaling pathway.

In this paper we have investigated the developmental-genetic steps that shape the entero-endocrine system of Drosophila melanogaster from the embryo to the adult. The process starts in the endoderm of the early embryo where precursors of endocrine cells and enterocytes of the larval midgut, as well as progenitors of the adult midgut, are specified by a Notch signaling-dependent mechanism. In a second step that occurs during the late larval period, enterocytes and endocrine cells of a transient pupal midgut are selected from within the clusters of adult midgut progenitors.