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Normal pressure hydrocephalus treatment: is it time to rethink? 正压性脑积水治疗:是时候重新思考了吗?
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-11-19 DOI: 10.23736/S0390-5616.24.06361-6
Loay Shoubash
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引用次数: 0
Comparison of intra-operative skull fixation techniques on cervical sagittal parameters. 术中颅骨固定技术对颈椎矢状面参数的影响比较。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-11-19 DOI: 10.23736/S0390-5616.24.06255-6
Connor C Jacob, Ryan G Eaton, Andrew J Grossbach, Asad Akhter, Nathaniel Toop, Joshua Wang, Joravar Dhaliwal, Stephanus V Viljoen

Background: There is limited literature concerning the use of bi-vector traction to a Mayfield following posterior cervical fusion with respect to cervical alignment parameters. The objective of this study was to determine how variability of intra-operative fixation methods for posterior cervical fusion affects post-operative cervical sagittal alignment parameters.

Methods: After institutional review board (IRB) approval, retrospective chart review of a total of 54 patients who underwent posterior cervical fusion from July 2017 to December 2019 was conducted. The patients were divided into two cohorts based on their intra-operative positioning, those who were affixed to a three-point fixation system, and those who were placed in bi-vector traction. Pre- and post-operative cervical alignment parameters were measured.

Results: There was no difference in post-operative sagittal parameters between the two groups. Each group showed a statistically significant difference in T1-slope when comparing pre- and post-operative measurements.

Conclusions: In our study we did not find that any of our techniques including bi-vector traction, static Mayfield positioning, or dynamic Mayfield positioning were very effective in adding lordosis during posterior cervical fusion surgeries. Interestingly, we also found a statistically significant increase in T1 slope and resulting trend towards increased cervical SVA.

背景:关于颈椎后路融合术后对 Mayfield 使用双矢量牵引对颈椎对位参数的影响,相关文献十分有限。本研究旨在确定颈椎后路融合术术中固定方法的变化如何影响术后颈椎矢状位对齐参数:经机构审查委员会(IRB)批准后,对2017年7月至2019年12月期间接受颈椎后路融合术的共54名患者进行了回顾性病历审查。根据术中定位将患者分为两组,分别是三点固定系统固定患者和双矢量牵引患者。对术前和术后的颈椎排列参数进行了测量:结果:两组患者术后矢状面参数无差异。结果:两组患者术后矢状面参数无差异,术前和术后测量的T1-斜度差异有统计学意义:在我们的研究中,我们没有发现任何一种技术,包括双矢量牵引、静态梅菲尔德定位或动态梅菲尔德定位,在颈椎后路融合手术中对增加前凸非常有效。有趣的是,我们还发现 T1 斜度在统计学上有显著增加,从而导致颈椎 SVA 有增加的趋势。
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引用次数: 0
Roxadustat protects oxidative stress and tissue injury in the brain induced by ischemic stroke via the HIF-1α/NRF2 axis. 罗沙司他通过HIF-1α/NRF2轴保护缺血性中风引起的脑氧化应激和组织损伤。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-28 DOI: 10.23736/S0390-5616.24.06329-X
Keping Jiao, Huiqin Zhang, Bin Li, Yanyan Wang, Jian Liu
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引用次数: 0
Follow-up neuroimaging after non-perimesencephalic, angiogram-negative subarachnoid hemorrhage. 非脑周血管造影阴性蛛网膜下腔出血后的后续神经影像学检查。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-01-31 DOI: 10.23736/S0390-5616.22.05686-7
Jean-Philippe Dufour, Menno R Germans, Emanuela Keller, Zsolt Kulcsàr, Luca Regli, Giuseppe Esposito

Background: In approximately 15% of spontaneous subarachnoid hemorrhage (SAH) patients, no bleeding source is found in the initial imaging. These patients can be categorized as either perimesencephalic (PM-SAH) or non-perimesencephalic (NP-SAH) subarachnoid hemorrhage patients. Follow-up imaging is routinely performed after NP-SAH to detect treatable etiologies; however, the optimal follow-up imaging protocol remains unclear. This study examines the optimal time interval to re-imaging and the performance of magnetic resonance imaging and angiography (MRI/A) in this setting.

Methods: In this retrospective study, the records of NP-SAH patients treated at the University Hospital of Zurich (Switzerland) from 2005 to 2018 were analyzed. Clinical and radiological data were collected. Re-imaging data was grouped according to imaging modality and divided into three time-categories after bleeding: short-term (<2 weeks), medium-term (2-8 weeks) and long-term (>8 weeks) re-imaging.

Results: Eighty-one NP-SAH patients were included. In 8 patients an aneurysm was diagnosed during re-imaging via digital subtraction angiography (9.9% diagnostic yield). Five aneurysms were detected at short-term in 81 patients (6.2% short-term yield) and three at medium-term re-imaging in 27 patients (11.1% medium-term yield). No aneurysms were found after 8 weeks in 56 patients. Five of these 8 patients also received MRI/A re-imaging, which was able to show the aneurysm in all 5 cases.

Conclusions: Our study emphasizes the importance of re-imaging in NP-SAH patients, which should be done both at short-term and at medium-term follow-up after the hemorrhage. Long-term re-imaging after 8 weeks might not be of diagnostic benefit. MRI/A might be considered as a possible noninvasive re-imaging modality in this setting.

背景:大约 15%的自发性蛛网膜下腔出血(SAH)患者在最初的造影检查中没有发现出血源。这些患者可分为脑膜周围性(PM-SAH)或非脑膜周围性(NP-SAH)蛛网膜下腔出血患者。NP-SAH 后常规进行随访成像以检测可治疗的病因,但最佳随访成像方案仍不明确。本研究探讨了在这种情况下再次成像的最佳时间间隔以及磁共振成像和血管造影(MRI/A)的性能:在这项回顾性研究中,分析了 2005 年至 2018 年在苏黎世大学医院(瑞士)接受治疗的 NP-SAH 患者的病历。收集了临床和放射学数据。根据成像方式对再成像数据进行分组,并将出血后再成像分为三个时间类别:短期(8 周)再成像:结果:共纳入81例NP-SAH患者。结果:共纳入 81 例 NP-SAH 患者,其中 8 例患者在再次成像时通过数字减影血管造影术诊断出动脉瘤(诊断率为 9.9%)。81 名患者在短期检查中发现了 5 个动脉瘤(短期诊断率为 6.2%),27 名患者在中期再造影检查中发现了 3 个动脉瘤(中期诊断率为 11.1%)。56 名患者在 8 周后未发现动脉瘤。在这8名患者中,有5名患者还接受了核磁共振/A再成像检查,5例患者均显示出动脉瘤:我们的研究强调了对 NP-SAH 患者进行再次成像的重要性,在出血后的短期和中期随访中都应进行再次成像。8 周后的长期再成像可能对诊断无益。在这种情况下,MRI/A 可被视为一种可能的无创再成像方式。
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引用次数: 0
Predictive value of neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio in severe traumatic brain injury: a retrospective cohort. 中性粒细胞与淋巴细胞比率和中性粒细胞与单核细胞比率在严重脑外伤中的预测价值:回顾性队列。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-03-08 DOI: 10.23736/S0390-5616.23.05877-0
Luiz F Matias, Murilo D Pimentel, Mateus F Medeiros, Franciani R Rocha, Marcelo V Gambetta, Samantha C Lopes

Background: The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), the neutrophil-monocyte ratio (NMR) and the systemic immune inflammation index (SII) are associated with clinical outcomes in oncological diseases, cardiovascular diseases, infectious / inflammatory diseases, endocrinological, pulmonary and brain injuries. Here, we investigate its association with hospital mortality in patients with severe traumatic brain injury.

Methods: We retrospectively reviewed clinical data from patients with severe traumatic brain injury (sTBI) who were treated in our department between January 2015 and December 2020. NLR, PLR, NMR, LMR and SII data were collected between admission and day 3, as well as other indicators related. The relationship between hematological ratios and in-hospital mortality were analyzed.

Results: A total of 96 patients were included in study, hospital mortality was 40.6% (N.=39). The levels of NLR on admission (D0), NLR day 1 (D1), NLR day 2 (D2), NLR day 3 (D3), NMR day 1 (D1) and NMR day (2) remained significantly higher in patients with death intra-hospital (P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 and P=0.001, respectively). Multivariate logistic analysis showed that higher NLR values at admission and day 2 NMR were associated with in-hospital mortality (OR=1.120, P=0.037; and OR=1.307, P=0.004, respectively). Analysis of the recipient operating characteristic (ROC) curve showed that the NLR on admission had a sensitivity of 59.0% and a specificity of 66.7% (area under the curve 0.630, P=0.031, Youden's Index 0.26) and the NMR of day 2 had a sensitivity of 67.7% and a specificity of 70.4% (area under the curve 0.719, P=0.001, Youden's index 0.38) to predict mortality intra-hospital based on the best threshold.

Conclusions: Our analysis indicates that higher NLR levels on admission and day 2 NMR are independent predictors of in-hospital mortality in patients with sTBI.

背景:中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、淋巴细胞-单核细胞比值(LMR)、中性粒细胞-单核细胞比值(NMR)和全身免疫炎症指数(SII)与肿瘤疾病、心血管疾病、感染性/炎症性疾病、内分泌疾病、肺部疾病和脑损伤的临床结果相关。在此,我们研究了其与严重脑外伤患者住院死亡率的关系:我们回顾性分析了 2015 年 1 月至 2020 年 12 月期间在我科接受治疗的严重创伤性脑损伤(sTBI)患者的临床数据。收集了入院至第 3 天的 NLR、PLR、NMR、LMR 和 SII 数据以及其他相关指标。分析了血液学比率与院内死亡率之间的关系:研究共纳入96名患者,住院死亡率为40.6%(N=39)。入院时(D0)、NLR 第 1 天(D1)、NLR 第 2 天(D2)、NLR 第 3 天(D3)、NMR 第 1 天(D1)和 NMR 第 2 天(D2)的水平在院内死亡患者中仍显著较高(分别为 P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 和 P=0.001)。多变量逻辑分析显示,入院时较高的NLR值和第2天的NMR值与院内死亡率相关(OR=1.120,P=0.037;OR=1.307,P=0.004)。受试者操作特征曲线(ROC)分析显示,根据最佳阈值,入院时的NLR预测院内死亡率的灵敏度为59.0%,特异度为66.7%(曲线下面积为0.630,P=0.031,Youden指数为0.26),第2天的NMR预测院内死亡率的灵敏度为67.7%,特异度为70.4%(曲线下面积为0.719,P=0.001,Youden指数为0.38):我们的分析表明,入院时较高的 NLR 水平和第 2 天的 NMR 是 sTBI 患者院内死亡率的独立预测因素。
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引用次数: 0
Association of baseline frailty and age with postoperative outcomes in metastatic brain tumor patients. 转移性脑肿瘤患者的基线虚弱程度和年龄与术后效果的关系。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-11-07 DOI: 10.23736/S0390-5616.22.05865-9
Christine J Colasacco, Joanna Abouezzi, Sophia Arbuiso, Derek B Asserson, Syed F Kazim, Kyril L Cole, Alis J Dicpinigaitis, Jose Dominguez, Rohini G McKEE, Meic H Schmidt, William T Couldwell, Christian A Bowers

Background: The impact of baseline frailty status versus that of chronological age on surgical outcomes of metastatic brain tumor patients remains largely unknown. The present study aimed to evaluate this relationship for preoperative risk stratification using a large national database.

Methods: The National Surgical Quality Improvement Program database was queried to extract data of metastatic brain tumor patients who underwent surgery between 2015 and 2019 (N.=5943). Univariate and multivariate analyses were performed to assess the effect of age and modified Frailty Index-5 on mortality, major complications, unplanned readmission and reoperation, extended length of stay (eLOS), and non-home discharge.

Results: Both univariate and multivariate analyses demonstrated that frailty status was significantly predictive of 30-day mortality, major complications, eLOS, and non-home discharge. Although increasing age was also a significant predictor of eLOS and discharge to non-home destination, effect sizes were smaller compared with frailty.

Conclusions: The present study, based on analysis of data from a large national registry, shows that frailty, when compared with age, is a superior predictor of postoperative outcomes in metastatic brain tumor patients. A future prospective study, namely a randomized controlled trial, would be beneficial in helping to corroborate the findings of this retrospective study.

背景:基线虚弱状态与实际年龄对转移性脑肿瘤患者手术结果的影响在很大程度上仍是未知数。本研究旨在利用大型国家数据库评估这种关系,以便进行术前风险分层:查询国家外科质量改进计划数据库,提取2015年至2019年期间接受手术的转移性脑肿瘤患者数据(n=5943)。研究人员进行了单变量和多变量分析,以评估年龄和改良虚弱指数-5(mFI-5)对死亡率、主要并发症、非计划再入院和再手术、延长住院时间(eLOS)和非居家出院的影响:单变量和多变量分析表明,虚弱状态对 30 天死亡率、主要并发症、eLOS 和非居家出院有显著的预测作用。虽然年龄的增加也是预测 eLOS 和非居家出院的一个重要因素,但与虚弱状态相比,其效应大小较小:本研究基于一项大型全国性登记数据的分析,结果表明,与年龄相比,体弱是预测转移性脑肿瘤患者术后结果的更优指标。未来的前瞻性研究,即随机对照试验,将有助于证实这项回顾性研究的结果。
{"title":"Association of baseline frailty and age with postoperative outcomes in metastatic brain tumor patients.","authors":"Christine J Colasacco, Joanna Abouezzi, Sophia Arbuiso, Derek B Asserson, Syed F Kazim, Kyril L Cole, Alis J Dicpinigaitis, Jose Dominguez, Rohini G McKEE, Meic H Schmidt, William T Couldwell, Christian A Bowers","doi":"10.23736/S0390-5616.22.05865-9","DOIUrl":"10.23736/S0390-5616.22.05865-9","url":null,"abstract":"<p><strong>Background: </strong>The impact of baseline frailty status versus that of chronological age on surgical outcomes of metastatic brain tumor patients remains largely unknown. The present study aimed to evaluate this relationship for preoperative risk stratification using a large national database.</p><p><strong>Methods: </strong>The National Surgical Quality Improvement Program database was queried to extract data of metastatic brain tumor patients who underwent surgery between 2015 and 2019 (N.=5943). Univariate and multivariate analyses were performed to assess the effect of age and modified Frailty Index-5 on mortality, major complications, unplanned readmission and reoperation, extended length of stay (eLOS), and non-home discharge.</p><p><strong>Results: </strong>Both univariate and multivariate analyses demonstrated that frailty status was significantly predictive of 30-day mortality, major complications, eLOS, and non-home discharge. Although increasing age was also a significant predictor of eLOS and discharge to non-home destination, effect sizes were smaller compared with frailty.</p><p><strong>Conclusions: </strong>The present study, based on analysis of data from a large national registry, shows that frailty, when compared with age, is a superior predictor of postoperative outcomes in metastatic brain tumor patients. A future prospective study, namely a randomized controlled trial, would be beneficial in helping to corroborate the findings of this retrospective study.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"526-532"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10444368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tuberculum sellae meningiomas: surgical outcomes in 65 patients, review of the literature and proposal for an anatomical and radiological classification. 蝶鞍管脑膜瘤:65 例患者的手术结果、文献综述以及解剖学和放射学分类建议。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-06-12 DOI: 10.23736/S0390-5616.23.06061-7
Giulio Maira, Biagia LA Pira, Alessandra Serraino, Maria P Tropeano, Delia Cannizzaro

Tuberculum sellae meningiomas (TSM) are challenging tumors due to their proximity to vital neurovascular structures. We propose a new classification system based on anatomical and radiological parameters. All patients treated for TSM, between January 2003 and December 2016, have been retrospectively reviewed. A systematic research was performed in PubMed database to review all studies comparing the performance of transcranial (TCA) and transphenoidal (ETSA) approaches. Overall, 65 patients were included in the surgical series. Gross total removal (GTR) was achieved in 55 patients (85%) and near total resection in 10 (15%). 54 patients (83%) showed a stability or an improvement of visual functions and 11 (17%) worsened. Postoperative complications were observed in seven patients (11%): CSF leak in one patient (1.5%); diabetes insipidus in two (3%); hypopituitarism in two (3%) third cranial nerve paresis and subdural empyema in one (1.5%). For the literature review, data about 10,833 patients (TCA N.=9159; ETSA N.=1674) were recorded; GTR was achieved in 84.1% (range 68-92%) of TCA and in 79.1% (range 60-92%) of ETSA; visual improvement (VI) occurred in 59.3% of TCA (range 25-84%) and in 79.3% of ETSA (range 46-100%); visual deterioration (VD) was registered in 12.7% of TCA (0-24%) and in 4.1% of ETSA (range 0-17%); a CSF-leak was observed in 3.8% of TCA (range 0-8%) while in ETSA in 18.6% of patients (range 0-62%); vascular injuries was reported in 4% (range 0-15%) of TCA and in 1.5% (range 0-5%) of ETSA. In conclusion, TSMs represent a unique category of midline tumors. The proposed classification system provides an intuitive and reproducible method in the choice of the most suitable approach.

椎管内脑膜瘤(TSM)是一种具有挑战性的肿瘤,因为它靠近重要的神经血管结构。我们提出了一种基于解剖学和放射学参数的新分类系统。我们对2003年1月至2016年12月间所有接受TSM治疗的患者进行了回顾性研究。我们在 PubMed 数据库中进行了系统性研究,回顾了所有比较经颅(TCA)和经蝶窦(ETSA)方法性能的研究。共有 65 例患者被纳入手术系列。55例患者(85%)实现了完全切除(GTR),10例患者(15%)接近完全切除。54名患者(83%)的视功能稳定或有所改善,11名患者(17%)的视功能恶化。7名患者(11%)出现术后并发症:一名患者(1.5%)出现脑脊液漏;两名患者(3%)出现尿崩症;两名患者(3%)出现垂体功能减退;一名患者(1.5%)出现第三颅神经麻痹和硬膜下水肿。84.1% 的 TCA(范围 68-92%)和 79.1%的 ETSA(范围 60-92%)实现了 GTR;59.3% 的 TCA(范围 25-84%)和 79.3%的 ETSA(范围 25-84%)实现了视力改善(VI)。视力改善(VI)发生在 59.3% 的 TCA 患者中(范围为 25-84%)和 79.3% 的 ETSA 患者中(范围为 46-100%);视力恶化(VD)发生在 12.7% 的 TCA 患者中(范围为 0-24%)和 4.1% 的 ETSA 患者中(范围为 0-17%);3.8% 的 TCA 患者(范围为 0-8%)和 18.6% 的 ETSA 患者(范围为 0-62%)观察到脑脊液渗漏;4% 的 TCA 患者(范围为 0-15%)和 1.5% 的 ETSA 患者(范围为 0-5%)报告有血管损伤。总之,TSM 代表了中线肿瘤的一个独特类别。建议的分类系统为选择最合适的方法提供了直观且可重复的方法。
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引用次数: 0
VEGF gene polymorphisms in Iranian patients with intracranial glioblastoma. 伊朗颅内胶质母细胞瘤患者的 VEGF 基因多态性。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-01-18 DOI: 10.23736/S0390-5616.22.05832-5
Sara Hanaei, Hanieh Mojtahedi, Mohamad Namvar, Arad Iranmehr, Reyhaneh Safaei, Azadehsadat Razavi, Marzie Esmaeili, Maryam Sadr, Arezou Rezaei, Maryam Edalatfar, Hamidreza Khayat Kashani, Mohsen Sadeghi-Naini, Farzaneh Darbeheshti, Jaber Gharehdaghi, Mehdi Forouzesh, Abdolali Ebrahimi, Nima Rezaei

Background: Glioblastoma is one of the most common malignant brain tumors in adults with poor prognosis. Neovascularization is one of the characteristics of these tumors, which is associated with overexpression of vascular endothelial growth factor (VEGF). Accordingly, single nucleotide polymorphisms of this gene could play an important role in structural and functional alterations leading to overexpression of this gene in GBM.

Methods: A total number of 49 patients with GBM and 50 healthy controls were included in the current study. The Genomic DNA was extracted from brain tumor/tissue samples, and after purification assessment, the alleles, and genotypes of rs3025039 and rs2010963 polymorphisms of the VEGF gene were investigated using T-ARMS-PCR.

Results: The "T" allele of rs3025039 was 2.79 times more frequent in GBM patients compared to controls (P=0.01). Moreover, the "CT" genotype was 2.83 times more common among patients (P=0.015), while the "CC" was more frequent in controls (P=0.009). The mean overall survival was significantly different between three genotypes of rs3025039, with the longest survival time in "CT" genotype (15.10±5.21, P=0.041). Besides, rs2010963, was significantly associated with GBM occurrence, with the "G" allele being 1.96 times more frequent in patients (P=0.01), as well as the "GG" genotype, which was 7.87 times more common in patients (P<0.001).

Conclusions: Polymorphisms of VEGF could potentially play a role in pathogenesis of GBM, as the allele and genotype distributions of rs3025039 and rs2010963 SNPs were significantly associated with GBM occurrence.

背景:胶质母细胞瘤是成人中最常见的恶性脑肿瘤之一,预后较差。血管新生是这些肿瘤的特征之一,这与血管内皮生长因子(VEGF)的过度表达有关。因此,该基因的单核苷酸多态性可能在导致 GBM 中该基因过度表达的结构和功能改变中发挥重要作用:本研究共纳入 49 名 GBM 患者和 50 名健康对照者。从脑肿瘤/组织样本中提取基因组 DNA,经纯化评估后,使用 T-ARMS-PCR 检测 VEGF 基因 rs3025039 和 rs2010963 多态性的等位基因和基因型:结果:rs3025039的 "T "等位基因在GBM患者中的频率是对照组的2.79倍(P=0.01)。此外,"CT "基因型在患者中的发生率为 2.83 倍(P=0.015),而 "CC "基因型在对照组中的发生率更高(P=0.009)。rs3025039的三种基因型的平均总生存期有明显差异,其中 "CT "基因型的生存期最长(15.10±5.21,P=0.041)。此外,rs2010963 与 GBM 的发生显著相关,"G "等位基因在患者中的发生率为 1.96 倍(P=0.01),而 "GG "基因型在患者中的发生率为 7.87 倍(PConclusions:由于rs3025039和rs2010963 SNP的等位基因和基因型分布与GBM的发生显著相关,VEGF的多态性可能在GBM的发病机制中起潜在作用。
{"title":"VEGF gene polymorphisms in Iranian patients with intracranial glioblastoma.","authors":"Sara Hanaei, Hanieh Mojtahedi, Mohamad Namvar, Arad Iranmehr, Reyhaneh Safaei, Azadehsadat Razavi, Marzie Esmaeili, Maryam Sadr, Arezou Rezaei, Maryam Edalatfar, Hamidreza Khayat Kashani, Mohsen Sadeghi-Naini, Farzaneh Darbeheshti, Jaber Gharehdaghi, Mehdi Forouzesh, Abdolali Ebrahimi, Nima Rezaei","doi":"10.23736/S0390-5616.22.05832-5","DOIUrl":"10.23736/S0390-5616.22.05832-5","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma is one of the most common malignant brain tumors in adults with poor prognosis. Neovascularization is one of the characteristics of these tumors, which is associated with overexpression of vascular endothelial growth factor (VEGF). Accordingly, single nucleotide polymorphisms of this gene could play an important role in structural and functional alterations leading to overexpression of this gene in GBM.</p><p><strong>Methods: </strong>A total number of 49 patients with GBM and 50 healthy controls were included in the current study. The Genomic DNA was extracted from brain tumor/tissue samples, and after purification assessment, the alleles, and genotypes of rs3025039 and rs2010963 polymorphisms of the VEGF gene were investigated using T-ARMS-PCR.</p><p><strong>Results: </strong>The \"T\" allele of rs3025039 was 2.79 times more frequent in GBM patients compared to controls (P=0.01). Moreover, the \"CT\" genotype was 2.83 times more common among patients (P=0.015), while the \"CC\" was more frequent in controls (P=0.009). The mean overall survival was significantly different between three genotypes of rs3025039, with the longest survival time in \"CT\" genotype (15.10±5.21, P=0.041). Besides, rs2010963, was significantly associated with GBM occurrence, with the \"G\" allele being 1.96 times more frequent in patients (P=0.01), as well as the \"GG\" genotype, which was 7.87 times more common in patients (P<0.001).</p><p><strong>Conclusions: </strong>Polymorphisms of VEGF could potentially play a role in pathogenesis of GBM, as the allele and genotype distributions of rs3025039 and rs2010963 SNPs were significantly associated with GBM occurrence.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"583-589"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10541870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of MRgFUS in the treatment of neuropsychiatric disorders: a state of the art. MRgFUS 在治疗神经精神疾病中的作用:最新进展。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-05 DOI: 10.23736/S0390-5616.24.06306-9
Benedetta M Campisi, Roberta Costanzo, Manfredi Noto, Giuseppe P Cipollina, Silvia Marino, Giuseppe DI Lorenzo, Lapo Bonosi, Lara Brunasso, Domenico G Iacopino, Rosario Maugeri

Introduction: Magnetic resonance-guided focused ultrasound (MRgFUS) is a contemporary non-invasive ablative procedure that utilizes high- or low-intensity ultrasound, guided and monitored by magnetic resonance imaging (MRI). While MRgFUS has been established as an effective treatment for conditions like essential tremor and tremor-dominant Parkinson's disease, it has recently emerged as a safe and promising ablative minimally invasive procedure for the management of treatment-resistant psychiatric disorders. Indeed, despite the availability of various pharmacological and behavioral therapies, a subset of psychiatric patients remains refractory to conventional treatments.

Evidence acquisition: To assess the feasibility and safety of MRgFUS in psychiatric disorders, a comprehensive literature search in PubMed and Scopus databases was conducted, resulting in the inclusion of five relevant articles in this review.

Evidence synthesis: While data on this innovative procedure are still limited, MRgFUS demonstrates potential as a safer and less invasive surgical technique for treating these disorders.

Conclusions: Continued research efforts and data validation are imperative to establish MRgFUS as an additional, minimally invasive procedure for treatment-resistant psychiatric patients in the near future.

导言:磁共振引导下聚焦超声(MRgFUS)是一种现代无创消融术,它利用高强度或低强度超声,在磁共振成像(MRI)的引导和监控下进行。磁共振聚焦超声已被确定为治疗本质性震颤和以震颤为主的帕金森病等疾病的有效方法,最近它又成为治疗耐药性精神疾病的一种安全、有前景的微创消融术。事实上,尽管有各种药物和行为疗法,但仍有一部分精神病患者对传统疗法难治:为了评估 MRgFUS 治疗精神疾病的可行性和安全性,我们在 PubMed 和 Scopus 数据库中进行了全面的文献检索,最终将五篇相关文章纳入本综述:虽然有关这种创新手术的数据仍然有限,但 MRgFUS 显示出作为一种更安全、创伤更小的手术技术治疗这些疾病的潜力:要在不久的将来将 MRgFUS 确立为治疗耐药精神病患者的另一种微创手术,继续开展研究工作和数据验证势在必行。
{"title":"The role of MRgFUS in the treatment of neuropsychiatric disorders: a state of the art.","authors":"Benedetta M Campisi, Roberta Costanzo, Manfredi Noto, Giuseppe P Cipollina, Silvia Marino, Giuseppe DI Lorenzo, Lapo Bonosi, Lara Brunasso, Domenico G Iacopino, Rosario Maugeri","doi":"10.23736/S0390-5616.24.06306-9","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06306-9","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance-guided focused ultrasound (MRgFUS) is a contemporary non-invasive ablative procedure that utilizes high- or low-intensity ultrasound, guided and monitored by magnetic resonance imaging (MRI). While MRgFUS has been established as an effective treatment for conditions like essential tremor and tremor-dominant Parkinson's disease, it has recently emerged as a safe and promising ablative minimally invasive procedure for the management of treatment-resistant psychiatric disorders. Indeed, despite the availability of various pharmacological and behavioral therapies, a subset of psychiatric patients remains refractory to conventional treatments.</p><p><strong>Evidence acquisition: </strong>To assess the feasibility and safety of MRgFUS in psychiatric disorders, a comprehensive literature search in PubMed and Scopus databases was conducted, resulting in the inclusion of five relevant articles in this review.</p><p><strong>Evidence synthesis: </strong>While data on this innovative procedure are still limited, MRgFUS demonstrates potential as a safer and less invasive surgical technique for treating these disorders.</p><p><strong>Conclusions: </strong>Continued research efforts and data validation are imperative to establish MRgFUS as an additional, minimally invasive procedure for treatment-resistant psychiatric patients in the near future.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reliability of facet fluid on preoperative MRI for prediction of segmental instability after decompression surgery for degenerative lumbar spinal stenosis. 术前核磁共振成像上的切面液预测退行性腰椎管狭窄症减压手术后节段不稳定性的可靠性。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-01 Epub Date: 2022-04-05 DOI: 10.23736/S0390-5616.22.05654-5
Seung-Chan Yoo, Chung-Kee Chough

Background: The purpose of this study is to determine whether preoperative facet fluid on MRI can help predict segmental instability (SI) after decompression surgery.

Methods: We analyzed 34 patients (14 men and 20 women, a total of 37 segments) who underwent decompression for degenerative lumbar spinal stenosis from June 2011 to August 2019 at a single institution. Mean age at the time of operation was 67.8. Postoperative assessment was performed uniformly 12 months (11~15 months) after the surgery. Preoperative facet fluid on MRI, pre- and postoperative slip percentage, and segmental motion on lumbar lateral neutral and flexion-extension (LFE) radiographic images were measured. Visual Analog Scale (VAS) and necessities of interventional procedure or medication was also assessed for clinical outcomes.

Results: No significant association was found between preoperative facet fluid indices and pre- or postoperative slip percentage (P=0.134) and segmental motion (P=0.936). There were no significant association also between facet fluid indices and VAS of back or leg (P=0.997 and P=0.437 respectively).

Conclusions: Preoperative facet fluid is not a predictive index of postoperative segmental instability or clinical outcome. Without segmental instability on LFE radiographic images, the presence of facet fluid in MRI is not an absolute indication for fusion.

背景:本研究旨在确定核磁共振成像上的术前面液是否有助于预测减压手术后的节段不稳定性(SI):本研究旨在确定核磁共振成像上的术前面液是否有助于预测减压手术后的节段不稳定性(SI):我们分析了 2011 年 6 月至 2019 年 8 月在一家医疗机构接受减压手术治疗退行性腰椎管狭窄症的 34 名患者(14 名男性,20 名女性,共 37 节段)。手术时的平均年龄为 67.8 岁。术后评估统一在术后12个月(11~15个月)进行。测量核磁共振成像上术前的切面液、术前和术后的滑脱百分比以及腰椎侧中立位和屈伸(LFE)位影像上的节段运动。此外,还对视觉模拟量表(VAS)和介入手术或药物治疗的必要性进行了临床结果评估:结果:术前切面液指数与术前或术后滑脱百分比(P=0.134)和节段运动(P=0.936)之间无明显关联。面液指数与背部或腿部 VAS 之间也无明显关联(分别为 P=0.997 和 P=0.437):结论:术前关节面液体不是术后节段不稳定性或临床结果的预测指标。结论:术前切面积液并不是术后节段不稳定性或临床预后的预测指标。在LFE放射影像上没有节段不稳定性的情况下,核磁共振成像中出现切面积液并不是融合的绝对指征。
{"title":"Reliability of facet fluid on preoperative MRI for prediction of segmental instability after decompression surgery for degenerative lumbar spinal stenosis.","authors":"Seung-Chan Yoo, Chung-Kee Chough","doi":"10.23736/S0390-5616.22.05654-5","DOIUrl":"10.23736/S0390-5616.22.05654-5","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to determine whether preoperative facet fluid on MRI can help predict segmental instability (SI) after decompression surgery.</p><p><strong>Methods: </strong>We analyzed 34 patients (14 men and 20 women, a total of 37 segments) who underwent decompression for degenerative lumbar spinal stenosis from June 2011 to August 2019 at a single institution. Mean age at the time of operation was 67.8. Postoperative assessment was performed uniformly 12 months (11~15 months) after the surgery. Preoperative facet fluid on MRI, pre- and postoperative slip percentage, and segmental motion on lumbar lateral neutral and flexion-extension (LFE) radiographic images were measured. Visual Analog Scale (VAS) and necessities of interventional procedure or medication was also assessed for clinical outcomes.</p><p><strong>Results: </strong>No significant association was found between preoperative facet fluid indices and pre- or postoperative slip percentage (P=0.134) and segmental motion (P=0.936). There were no significant association also between facet fluid indices and VAS of back or leg (P=0.997 and P=0.437 respectively).</p><p><strong>Conclusions: </strong>Preoperative facet fluid is not a predictive index of postoperative segmental instability or clinical outcome. Without segmental instability on LFE radiographic images, the presence of facet fluid in MRI is not an absolute indication for fusion.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"453-458"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of neurosurgical sciences
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