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Background: Left atrial dissection is a rare and occasionally fatal complication of cardiac surgery and is defined as the creation of a false chamber through a tear in the mitral valve annulus extending into the left atrial wall. Some patients are asymptomatic, while others present with various symptoms, such as chest pain, dyspnea, and even cardiac arrest. Although there is no established management for left atrial dissection, surgery should be considered in patients with hemodynamic disruption.

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Genetic and clinical spectrum of steroid-resistant nephrotic syndrome with nuclear pore gene mutation.

Pediatr Nephrol

January 2025

Department of Nephrology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Center), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.

Background: Steroid-resistant nephrotic syndrome (SRNS) is insensitive to steroid therapy and overwhelmingly progresses to kidney failure (KF), the known pathogenic genes of which include key subunits of the nuclear pore complex (NPC), a less-recognized contributor to glomerular podocyte injury.

Methods: After analyzing their clinical characterizations and obtaining parental consent, whole-exome sequencing (WES) was performed on patients with SRNS. Several nucleoporin (NUP) biallelic pathogenic variants were identified and further analyzed by cDNA-PCR sequencing from white cells of peripheral blood, minigene assay, immunohistochemical (IHC) staining, and electron microscopy (EM) ultrastructure observation of kidney biopsy, as well as multiple in silico prediction tools, including 3D protein modeling.

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Review of Outcomes After Peripheral Nerve Transfers for Motor Nerve Injury in the Upper Extremity.

JBJS Rev

November 2024

Division of Plastic and Reconstructive Surgery, University of Colorado School of Medicine, Anschutz Medical Center, Aurora, Colorado.

Background: Modern nerve-to-nerve transfers are a significant advancement in peripheral nerve surgery. Nerve transfers involve transferring donor nerves or branches to recipient nerves close to the motor end unit, leading to earlier reinnervation and preservation of the musculotendinous units in proximal nerve injuries. After nerve reinnervation, function may be superior to traditional tendon transfer techniques in terms of strength and independent motion.

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Current Concepts of the Management of Painful Traumatic Peripheral Nerve Neuromas.

J Am Acad Orthop Surg

November 2024

From the Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore (Lee), the Department of Orthopedic Surgery (Sammarco), the Department of Neurosurgery (Spinner), Mayo Clinic, Rochester, MN, and the Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (Shin).

Painful neuromas are a complex clinical condition that results in notable disability and functional impairment after injury to a peripheral nerve. When regenerating axons lack a distal target, they form a stump neuroma. Up to 60% of neuromas are painful because of mechanical sensitivity and crosstalk between nerve fibers.

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Objective: Superior vena cava syndrome (SVC) is a debilitating disease, and surgical reconstruction has been described with some of the best results using spiral great saphenous vein (SGSV) grafts. SGSV grafts can be difficult to construct, and a long segment of saphenous vein is needed. Femoral vein has been an excellent conduit for infected aortic and peripheral reconstructions in our hands, and we sought to review outcomes using this conduit for SVC reconstruction.

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