A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond

xlomafota13 shared this article with you from Inoreader A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jun 20. doi: 10.1007/s00405-021-06935-x. Online ahead of print. ABSTRACT BACKGROUND: Extended endoscopic endonasal operations of the sinuses and the frontal skull base require a bimanual action of the surgeon in many cases. Thus, typically an assistant guides the endoscope and centers the field of view. In this study, we investigate in which cases an endoscope holding arm can be used alternatively. MATERIALS AND METHODS: The electromagnetic system ENDOFIXexo was used in different surgical interventions of the paranasal sinuses and beyond questioning ergonomics and geometrical limitations. The realized degrees of freedom were documented, and a topography of possible applications compiled. RESULTS: The presented system is limited by the anatomy of the anterior ethmoid and dynamic working conditions in the sagittal direction. Especially in extended interventions in the posterior ethmoid, in whic h parts of the nasal septum have been resected and a static position of the endoscope is desired the surgeon can greatly benefit from the robotic arm. Moreover, through the high flexibility of the endoscopic arm surgeries of the pharynx and larynx were performed, questioning the current gold standard of microscope-assisted surgical procedures. CONCLUSION: Under the impression of an urging staff shortage and due to its unlimited patience, the ENDOFIXexo arm seems promising. Taking into account the complex anatomy and the limited access, we especially see a favorable field of application in the surgery of the pituitary gland and skull base tumors. PMID:34148145 | DOI:10.1007/s00405-021-06935-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case report of cerebrospinal fluid leak secondary to inner ear malformation

xlomafota13 shared this article with you from Inoreader A case report of cerebrospinal fluid leak secondary to inner ear malformation Via leak of cerebrospinal fluid Radiol Case Rep. 2021 Jun 7;16(8):1931-1933. doi: 10.1016/j.radcr.2021.04.072. eCollection 2021 Aug. ABSTRACT Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea. Temporal bone computed tomography should be performed in children with hearing impairments. We describe a case of congenital inner ear anomaly in a 12-month-old girl who presented with intermittent rhinorrhea after birth and detected hearing problems when she was 6 months. After diagnosis, the CSF leak was surgically repaired without complications. PMID:34149977 | PMC:PMC8193066 | DOI:10.1016/j.radcr.2021.04.072 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adductor magnus muscle transfer to restore knee extension: Anatomical studies and clinical applications

xlomafota13 shared this article with you from Inoreader Adductor magnus muscle transfer to restore knee extension: Anatomical studies and clinical applications Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 8:S1748-6815(21)00152-2. doi: 10.1016/j.bjps.2021.03.063. Online ahead of print. ABSTRACT BACKGROUND: Loss of knee extension causes significant impairment. Though nerve-based reconstruction is preferable in cases of femoral nerve palsy or injury, these surgeries are not always appropriate if the pathology involves the quadriceps muscles or presentation too late for muscle reinnervation. Muscle transfers are another option that has been underutilized in the lower extremity. We describe the successful restoration of knee extension by adductor magnus muscle transfer without functional donor morbidity, along with anatomical considerations. METHODS: Ten fresh frozen cadaveric lower limbs were dissected at the groin and thigh. In addition, three patients presented with femoral nerve palsy for which nerve-based reconstruction was not appropriate because of late presentation. In these patients, add uctor magnus muscle transfers were performed, along with sartorius, gracilis, and tensor fasciae latae transfers if available and healthy. RESULTS: In cadavers, the pedicle for the adductor magnus is at the level of the gracilis and adequate for muscle transfer, with sufficient weavable tendon length. The only major structure at risk is the femoral neurovascular bundle, which is in a reliable anatomic position. Two patients recovered 4/5 active knee extension and ambulation without assistive devices. A third required reoperation for a loosened tendon weave, after which the noted improved stability and strength with ambulation but did not regain strong active knee extension and continued to require a cane. CONCLUSIONS: We present a novel reconstructive approach for loss of quadriceps function in patients, which yields good clinical outcomes, with anatomic and technical details to demonstrate the utility of this technique. Ongoing evaluation of optimal technique and rehabi litation to maximize functional outcomes is still needed. PMID:34148834 | DOI:10.1016/j.bjps.2021.03.063 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resident experiences with virtual education during the COVID-19 crisis

xlomafota13 shared this article with you from Inoreader Resident experiences with virtual education during the COVID-19 crisis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 8:S1748-6815(21)00286-2. doi: 10.1016/j.bjps.2021.05.037. Online ahead of print. ABSTRACT BACKGROUND: Residency education has adapted to current social distancing recommendations by relying heavily on videoconferences. There is concern however, that this new paradigm may lead to over-saturation or burnout. METHODS: A 12-question survey investigating resident experiences with educational videoconferences was distributed to University of Washington plastic surgery residents. A modified Maslach Burnout Inventory was used to assess resident burnout from virtual conferences. Conference attendance and reasons for missing conferences were compared using paired two-tailed t-tests. RESULTS: A total of 24 residents were given the survey with 100% response rate. There was a significant decrease in the total number of weekly attended videoconferences (p<0.01) and in the number of attended educ ational videoconferences (p<0.01) over time. Reasons for absences included clinical duties (92% of respondents) followed by symptoms of burnout, including forgetfulness (67%) and feeling fatigued by videoconferencing lectures (54%), and to a lesser extent the belief that the lecture was not educational (25%). 79% of residents reported at least occasionally feeling emotionally drained from videoconferencing and 88% reported at least occasionally feeling burned out due to the number of videoconferencing activities. Despite declining attendance and burnout, 96% believe that videoconferences should continue after the end of quarantine but in a limited quantity. CONCLUSION: Videoconferences have become a valued means of resident education. The data suggests however that attendance has waned, largely due to what can be perceived as burnout. Residents remain interested in continuing educational videoconferences, although prioritizing quality over quantity will remain essential to prevent emotional fatigue and burnout. PMID:34148839 | DOI:10.1016/j.bjps.2021.05.037 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Running a safe and effective Cleft Network Service in response to the COVID-19 pandemic

xlomafota13 shared this article with you from Inoreader Running a safe and effective Cleft Network Service in response to the COVID-19 pandemic Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00287-4. doi: 10.1016/j.bjps.2021.05.035. Online ahead of print. ABSTRACT Maintaining an excellent level of service in a network Cleft Lip and Palate service in the UK has been an added challenge for both clinicians and patients throughout the COVID-19 pandemic. We describe the changes to our service, and report a high level of patient satisfaction with the changes. Some of the enforced changes may last beyond the duration of this pandemic. PMID:34148832 | DOI:10.1016/j.bjps.2021.05.035 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Whole-body diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient values as prognostic factors in multiple myeloma

xlomafota13 shared this article with you from Inoreader Whole-body diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient values as prognostic factors in multiple myeloma Via Experimental and therapeutic medicine Exp Ther Med. 2021 Aug;22(2):827. doi: 10.3892/etm.2021.10259. Epub 2021 Jun 3. ABSTRACT Multiple myeloma (MM) is a neoplasm of the B lymphocytes characterized by the uncontrolled proliferation of a plasmocyte clone. Magnetic resonance imaging (MRI) remains the most sensitive and specific imaging method for the detection of bone marrow infiltration, before macroscopic bone changes are visible, with evidence that the detection rate and overall performance of MRI could be enhanced by applying diffusion-weighted imaging (DWI). The aim of our research was to evaluate whether measuring apparent diffusion coefficient (ADC) values in newly diagnosed patients with MM could be a prognostic factor for the course of the disease and to ascertain whether there is any correlation with other prognostic factors in MM. A retrospective study was performed on a group of 32 patients with newly diagnosed MM that underwent at least two whole-body (WB)-MRIs; one before and one after induction therapy. Patients with advanced stage of disease showed an increased ADC value: Stage 2 vs. stage 1 (1.162 vs. 0.289, P=0.033), respectively, stage 3 vs. stage 1 (0.867 vs. 0.289, P=0.041). In addition, ADC values were inversely correlated with survival time: r=-0.641, P<0.001. According to the multivariate linear regression model, we observed that for every point of ADC value (before treatment) the survival was decreased/reduced by 14.5 months. Moreover, bortezomib therapy predicted an increase in the survival length/duration by 7.9 months. Our regression equation proved to be a good fit for the model, explaining 57.8% of survival duration (adjusted R2=0.578). In conclusion, the negative prognostic factors associated with WB-MRI are represented by high ADC values before treatment (for every point of ADC the survival was decreased by 14.5 months) and focal/diffuse marrow involvement. PMID:34149873 | PMC:PMC8200804 | DOI:10.3892/etm.2021.10259 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Celecoxib ameliorates diabetic neuropathy by decreasing apoptosis and oxidative stress in dorsal root ganglion neurons via the miR-155/COX-2 axis

xlomafota13 shared this article with you from Inoreader Celecoxib ameliorates diabetic neuropathy by decreasing apoptosis and oxidative stress in dorsal root ganglion neurons via the miR-155/COX-2 axis Via Experimental and therapeutic medicine Exp Ther Med. 2021 Aug;22(2):825. doi: 10.3892/etm.2021.10257. Epub 2021 Jun 2. ABSTRACT Celecoxib (CXB) is the only clinical cyclooxygenase-2 (COX-2) inhibitor. Oral administration of CXB in experimental diabetic mice effectively relieved the symptoms of diabetic neuropathy (DN); however, the molecular mechanism remains unclear. The present study aimed to investigate the potential molecular mechanisms of CXB in the treatment of DN. An in vitro cellular model of DN was produced by stimulating dorsal root ganglion (DRG) neurons with high glucose. Cell viability and apoptosis were assessed by Cell Counting Kit-8 assays and flow cytometry, respectively. Reactive oxygen species (ROS) kits, ELISA kits and western blotting were used to determine oxidative cellular damage. The expression level of microRNA (miR)-155 was analyzed by reverse transcription-quantitative PCR. The starBase database and dual-luciferase assays were performed to predict and determine the interaction between miR-155 and COX-2. Protein expression of neurotrophic factors, oxidative stress-related proteins and COX-2 were analyzed by western blotting. Incubation with high glucose led to a decrease in DRG neuron cell viability, facilitated apoptosis, downregulated NGF and BDNF expression, increased ROS and MDA generation and decreased SOD activity. Treatment with CXB significantly protected DRG neurons against high glucose-evoked damage. CXB promoted the expression of miR-155 and COX-2 was revealed to be a direct target of miR-155. Inhibition of COX-2 enhanced the protective effect of CXB on DRG neurons and that treatment with an miR-155 inhibitor partially rescued this effect. The present study demonstrated the involvement of the miR-155/COX-2 axis in the protective effect of CXB against high glucose-induced DN. PMID:34149871 | PMC:PMC8200812 | DOI:10.3892/etm.2021.10257 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

miR-125b-5p inhibits cell proliferation by targeting ASCT2 and regulating the PI3K/AKT/mTOR pathway in an LPS-induced intestinal mucosa cell injury model

xlomafota13 shared this article with you from Inoreader miR-125b-5p inhibits cell proliferation by targeting ASCT2 and regulating the PI3K/AKT/mTOR pathway in an LPS-induced intestinal mucosa cell injury model Via Experimental and therapeutic medicine Exp Ther Med. 2021 Aug;22(2):838. doi: 10.3892/etm.2021.10270. Epub 2021 Jun 6. ABSTRACT Intestinal barrier injury is an important cause of death in patients with acquired immune deficiency syndrome (AIDS). Therefore, it is of great significance to identify a therapeutic target for intestinal barrier injury to delay the progression of AIDS. microRNA (miRNA/miR)-125b-5p has an extensive role in cancer and controlling intestinal epithelial barrier function, but its role in human immunodeficiency virus-related intestinal mucosal damage remains unknown. The present study was designed to explore the effects of miR-125b-5p on lipopolysaccharide (LPS)-induced intestinal mucosal injury and the underlying mechanism. The expression of miR-125b-5p and ASCT2 mRNA was detected in colon biopsy samples of 10 patients with AIDS and 10 control healthy subjects. Human intestinal embryonic mucosa cells (CCC-HIE-2) were used to establish an LPS-induced in testinal mucosa cell injury model in vitro. Cell proliferation and apoptosis were determined by MTT assays and flow cytometry, respectively. miR-125b-5p levels and ASCT2 mRNA and protein expression levels in the LPS-induced intestinal mucosa cell injury model were detected by reverse transcription-quantitative PCR (RT-qPCR) and western blotting. The interaction between miR-125b-5p and ASCT2 was analyzed using a dual luciferase reporter assay. The results demonstrated that miR-125b-5p levels were increased and ASCT2 mRNA expression levels were decreased in colon samples from patients with AIDS and in LPS-induced intestinal mucosa cells. In the LPS-induced intestinal mucosa cell injury model, transfection with miR-125b-5p mimic inhibited cell proliferation and promoted cell apoptosis, while transfection with a miR-125b-5p inhibitor increased cell proliferation and attenuated cell apoptosis. Furthermore, miR-125b-5p mimic transfection resulted in a decrease of ASCT2 mRNA and pro tein expression, whereas the inhibitor increased ASCT2 mRNA and protein expression. Dual luciferase reporter assays suggested that ASCT2 was a direct target of miR-125b-5p, and its restoration weakened the effect of miR-125b-5p on LPS-induced intestinal mucosa cell injury. Transfection with the miR-125b-5p mimic also exhibited a suppressive effect on the PI3K/AKT/mTOR pathway in the LPS-induced intestinal mucosal cell injury model. Overall, the present study indicated that miR-125b-5p accelerated LPS-induced intestinal mucosa cell injury by targeting ASCT2 and upregulating the PI3K/AKT/mTOR pathway. The current findings may provide novel targets for the treatment of intestinal barrier injury in patients with AIDS. PMID:34149884 | PMC:PMC8210225 | DOI:10.3892/etm.2021.10270 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

STK10 knockout inhibits cell migration and promotes cell proliferation via modulating the activity of ERM and p38 MAPK in prostate cancer cells

xlomafota13 shared this article with you from Inoreader STK10 knockout inhibits cell migration and promotes cell proliferation via modulating the activity of ERM and p38 MAPK in prostate cancer cells Via Experimental and therapeutic medicine Exp Ther Med. 2021 Aug;22(2):851. doi: 10.3892/etm.2021.10283. Epub 2021 Jun 8. ABSTRACT Prostate cancer (PCa) is one of the most common types of cancer and is a serious threat to men's health due to the high rate of incidence and metastasis. However, the exact underlying pathology of this malignant disease has yet to be fully elucidated. The ezrin-radixin-moesin (ERM) family of proteins are associated with the development and metastasis of various types of cancer. Serine threonine kinase 10 (STK10) is an ERM kinase that is involved in the activation of ERM proteins and serves essential roles in the aggregation and adhesion of lymphocytes. To evaluate the functional roles of STK10 in the pathogenesis of PCa, a STK10-knockout (KO) DU145 PCa cell line was generated using the CRISPR-Cas9 gene editing system, and the effects of STK10 deletion on tumor biological behaviors were further analyzed. The present data suggested that STK10 KO promoted PCa cell proliferation by inhibiting p38 MAPK activation and suppressed migration primarily via the inhibition of p38 MAPK signaling and ERM protein activation. To the best of our knowledge, this is the first study to provide evidence that STK10 plays important roles in the proliferation and migration of PCa cells, which will be useful for further investigation into the pathogenesis of this disease. PMID:34149897 | PMC:PMC8210223 | DOI:10.3892/etm.2021.10283 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changes in bone density, intraosseous pressure of distal femoral articular cartilage and subchondral bone after proximal femoral medullary cavity cement filling in rabbits

xlomafota13 shared this article with you from Inoreader Changes in bone density, intraosseous pressure of distal femoral articular cartilage and subchondral bone after proximal femoral medullary cavity cement filling in rabbits Via Experimental and therapeutic medicine Exp Ther Med. 2021 Aug;22(2):839. doi: 10.3892/etm.2021.10271. Epub 2021 Jun 6. ABSTRACT Bone cement is widely used, particularly in hip replacements, but the potential clinical complications of its use have been largely unrecognized. The purpose of the present study was to investigate the effects of bone cement in the proximal femoral medullary cavity (PFMC) on bone mineral density (BMD), intraosseous pressure (IOP), articular cartilage and subchondral bone in the distal femurs of rabbits. A total of 32 New Zealand white rabbits were randomly numbered and the left hind limb of the odd-numbered rabbits and the right hind limb of the even numbered rabbits were selected as the experimental side. For each rabbit, the non-experimental hind limb was labeled as the control side by the principal investigator. An intramedullary injection of polymethyl methacrylate was made into the experimental hindlimb of each rabbit and the PFMC filled with bone cement. BMD and IOP of the distal femur of the bilateral hindlimb were measured at 4 and 16 weeks after surgery, and histological and ultra-fine structural features were examined by light and transmission electron microscopy, respectively. At week 4 after the operation, IOP in the experimental limb was significantly higher and BMD lower compared with the control limb. At the 16th week after operation, the IOP in the experimental limb was lower than at the 4th week after operation, but still higher compared with controls, and the BMD was significantly higher than the controls. In the controls, IOP and BMD was not significantly different between the 4th and 16th week after operation. Compared with controls, the cartilage in the experimental group was thinner, the chondrocytes partially necrotic and the trabecular structure of the subchondral bone broken. Analysis of ultra-fine structural features in the experimental group showed chondrocytes with necrotic cytoplasm and pyknotic n uclei relative to controls. The results indicated that blockage of the PFMC with bone cement resulted in an increase in the IOP in the distal femur, a change in BMD and damage to the subchondral bone and articular cartilage. PMID:34149885 | PMC:PMC8210259 | DOI:10.3892/etm.2021.10271 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.