Balloon protection of the Labbé vein during transarterial embolization of a dural arterio-venous fistula.

Introduction: Endovascular treatment of type III dural arterio-venous fistulas can be challenging if the fistulous point is close to a functionally important cortical vein.

Methods: A technique is described for temporary balloon protection of the vein of Labbé during transarterial Onyx embolization of a type III dural arterio-venous fistula. One illustrative case is presented.

Proposed Criteria for Appraising Goal Attainment Scales Used as Outcome Measures in Rehabilitation Research.

Goal Attainment Scaling (GAS) is a method for writing personalized evaluation scales to quantify progress toward defined rehabilitation goals. In the published literature, GAS methodology is used with different levels of rigor, ranging from precisely written GAS scales that ensure minimal bias and explicitly describe 5 levels of goal attainment to subjective ratings of goal attainment by adjectives (eg, worse/better than expected), which are transformed into a T score, wrongly giving the reader the impression of a truly standardized, interval scale. A drawback of GAS methodology is that it is highly dependent on the ability of the GAS setting team/person to generate valid, reliable, and meaningful scales; therefore, reliability and validity of GAS scales are idiosyncratic to each study.

House Dust Mite Respiratory Allergy: An Overview of Current Therapeutic Strategies.

Although house dust mite (HDM) allergy is a major cause of respiratory allergic disease, specific diagnosis and effective treatment both present unresolved challenges. Guidelines for the treatment of allergic rhinitis and asthma are well supported in the literature, but specific evidence on the efficacy of pharmacotherapy treatment for known HDM-allergic patients is weaker. The standard diagnostic techniques--skin prick test and specific IgE testing--can be confounded by cross-reactivity.

New practical definitions for the diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay.

Objective: Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is caused by mutations in the SACS gene. SACS encodes sacsin, a protein whose function remains unknown, despite the description of numerous protein domains and the recent focus on its potential role in the regulation of mitochondrial physiology. This study aimed to identify new mutations in a large population of ataxic patients and to functionally analyze their cellular effects in the mitochondrial compartment.

Distal Radius Isoelastic Resurfacing Prosthesis: A Preliminary Report.

Background Here we present a preliminary case series of unicompartmental isoelastic resurfacing prosthesis of the distal radius to treat comminuted articular fractures of osteoporotic elderly patients. Materials and Methods Our study included 12 patients, mean age 76 years, who presented with comminuted osteoporotic distal radius fracture. Because of the severity of injury and poor bone quality; osteosynthesis was not deemed to be a good option.

Mechanical properties of a bioabsorbable nerve guide tube for long nerve defects.

The mechanical properties of nerve guide tubes must be taken into consideration when they are being developed. We previously reported the feasibility of using 50:50 tubes in a canine 40mm peroneal nerve defect model, where 50:50 represents the proportion of poly(L-lactic) acid (PLLA) and polyglycolic acid (PGA). The aim of the current study was to show that 50:50 tubes have suitable mechanical properties for repairing long nerve defects.

Spontaneous thrombosis of a basilar tip aneurysm after ventriculoperitoneal shunting.

We present a case of a large unruptured basilar tip aneurysm with concomitant hydrocephalus. Complete thrombosis of the aneurysm was observed after ventriculoperitoneal shunting. Analyzing preoperative and postoperative MRI and DSA images, we identified reduced intracranial pressure and widening of the aneurysm-artery inclination angle as possible factors influencing spontaneous thrombosis.

Spontaneous thrombosis of a basilar tip aneurysm after ventriculoperitoneal shunting.

We present a case of a large unruptured basilar tip aneurysm with concomitant hydrocephalus. Complete thrombosis of the aneurysm was observed after ventriculoperitoneal shunting. Analyzing preoperative and postoperative MRI and DSA images, we identified reduced intracranial pressure and widening of the aneurysm-artery inclination angle as possible factors influencing spontaneous thrombosis.

Reliability of Endocervical Curettage in the Diagnosis of High-grade Cervical Neoplasia and Cervical Cancer in Selected Patients.

Aim: To analyze the reliability of endocervical curettage (ECC) in the diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, and to identify risk factors associated with diagnostic underestimation.

Materials And Methods: A retrospective study was carried-out involving 445 patients who underwent ECC for: endocervical lesion incompletely visible on colposcopy or inaccessible to biopsy; atypical glandular cells on smear, or discrepancy between colposcopic impression and cytological abnormalities.

Results: Comparison between ECC and final diagnosis showed a perfect match in 362 patients (81.

Enlargement of the flexor pulleys by an omega plasty: A study comparing the release of one or both sides of the A2 and/or A4 pulley.

Purpose: The omega plasty on one side of the A2 and/or A4 pulley improves the gliding of repaired flexor tendons in zone II. The purpose of this study was whether or not the enlargement of the digital channel was better after the release of one or both sides of each pulley.

Methods: In fresh cadavers, the technique was to first disinsert the ulnar attachments of the A2 and A4 pulleys and then the radial insertions.

Plastic and reconstructive robotic microsurgery--a review of current practices.

Introduction: We sought to review the current state of robotics in this specialty.

Methods: A Pubmed and Medline search was performed using key search terms for a comprehensive review of the whole cross-section of plastic and reconstructive practice.

Results: Overall, 28 publications specific to robotic plastic and reconstructive procedures were suitable for appraisal.

Three-dimensional MR imaging of the brachial plexus.

Pathologic conditions of the brachial plexus often result in serious and disabling complications. With the increasing availability and use of new and powerful MRI sequences and coils, understanding and assessment of the complex anatomy and pathology of the brachial plexus have been greatly facilitated. These new technical developments have led to an improved assessment of brachial plexus lesions, thereby improving patient care.

Hyperparathyroidism-related extensor tenosynovitis at the wrist: a general review of the literature.

Extensor tenosynovitis often occurs accompanying with rheumatoid arthritis, gout, trauma, mycobacterium and dialysis-related amyloidosis. However, there is no recognition of extensor tenosynovitis accompanying with hyperparathyroidism. The purpose of this general review was to describe the clinical condition and to report the results of surgical intervention in the extensor tenosynovitis at the wrist related to hyperparathyroidism.

PCSK9, apolipoprotein E and lipoviral particles in chronic hepatitis C genotype 3: evidence for genotype-specific regulation of lipoprotein metabolism.

Background & Aims: Hepatitis C virus (HCV) associates with lipoproteins to form "lipoviral particles" (LVPs) that can facilitate viral entry into hepatocytes. Initial attachment occurs via heparan sulphate proteoglycans and low-density lipoprotein receptor (LDLR); CD81 then mediates a post-attachment event. Proprotein convertase subtilisin kexin type 9 (PCSK9) enhances the degradation of the LDLR and modulates liver CD81 levels.

Spinal cord ischemia: practical imaging tips, pearls, and pitfalls.

Ischemia of the spinal cord is a rare entity with a poor prognosis. Brain ischemia is no longer a diagnostic challenge; on the contrary, ischemia of the spinal cord remains difficult, particularly in children. In this article, we illustrate the principal causes in children and adults, clinical presentation, different techniques for the diagnosis by MR imaging (diffusion, spinal MR angiography, and 1.

Fractures and dislocation of the base of the thumb metacarpal.

Acute traumatic lesions of the base of the first metacarpal are frequent and their consequences can affect the opposition of the thumb. They usually occur after trauma in compression along the axis of the thumb in flexion. Restoring the anatomy and biomechanics of the trapeziometacarpal joint is essential when treating these injuries, hence why surgical treatment is usually indicated.

Robotic phrenic nerve harvest: a feasibility study in a pig model.

The aim of this study was to report on the feasibility of robotic phrenic nerve harvest in a pig model. A surgical robot (Da Vinci S™ system, Intuitive Surgical(®), Sunnyvale, CA) was installed with three ports on the pig's left chest. The phrenic nerve was transected distally where it enters the diaphragm.

Blade-plate fixation for distal femoral fractures: a case-control study.

Background: The blade-plate is the earliest of the contemporary internal fixation devices introduced for distal femoral fractures. The recent development of dedicated, fixation devices has considerably limited its use. The objective of this study was to evaluate outcomes after blade-plate fixation and after fixation using other devices.

The use of navigation forces for assessment of wrist arthroscopy skills level.

Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy.

A comparative study about ionizing radiation emitted during radiological "skyline" view of the wrist in pronation versus supination.

The dorsal tangential view to the distal radius or "skyline," used to control the length of the screws for the ORIF with volar plates, is carried out in supination (fluoroscope vertical) or in pronation (fluoroscope horizontal). The purpose of this study was to compare the dose of ionizing radiation emitted during a "skyline" view in supination versus pronation. A "skyline" was performed on 14 fresh cadaveric wrists.

Placental abruption: risk factors, management and maternal-fetal prognosis. Cohort study over 10 years.

Objective: To describe maternal and fetal risk factors, diagnosis, management and prognosis of placental abruption (PA).

Study Design: A retrospective cohort study between January 2003 and December 2012 within the three maternity units of a French university hospital. We included 55,926 deliveries after 24 weeks' gestation including 247 cases of PA (0.

Robotic microsurgery optimization.

The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition 12×-15× digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity.

Arthroscopic assisted percutaneous screw fixation of Bennett's fracture.

Several techniques are used for fixation of Bennett's fractures. The aim of this study was to assess a technique of arthroscopic-assisted reduction and percutaneous cannulated screw fixation of Bennett's fractures. Seven patients (mean age 29 years) with three fractures Type I and four fractures Type II according to Gedda were operated under arthroscopic lavage, fluoroscopic screw fixation, and arthroscopic control of the joint reduction.

Can ring finger injuries be prevented by pre-weakened rings? Three clinical cases.

Prevention of finger trauma can be directly related to the manufacture of pre-weakened rings. We report on three clinical cases of finger injuries caused by pre-weakened rings. Lesions were less severe than conventional ring finger injuries, such as those caused by iron fences.