Neurosurgery
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Direct cellular reprogramming has emerged as an innovative alternative to generating neurons in the brain after injury. We were among the first to recently demonstrate in vivo reprogramming of nonneuronal cells into neurons in the brain of rodents following stroke. Human clinical trails will require an adeno-associated virus (AAV) with a greater safety profile. ⋯ We have demonstrated for the first time the capacity to generate reactive astrocyte cultures in vitro from adult canine neocortex after stroke. Using this culture model we have found that AAV8 has the highest transduction efficiency.
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Our goal was to identify and compare the normal occipital-condyle-C1 interval (CCI) in healthy adults with the CCI in adults with atlanto-occipital dislocation (AOD) and establish a highly sensitive and specific cutoff value to diagnose AOD radiographically. ⋯ The revised CCI (1.5 mm) and condylar sum (3.0 mm) cutoff values have the highest sensitivity and specificity for the diagnosis of AOD in the adult population.
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To examine the microsurgical anatomy of the nucleus accumbens and related structures using fiber dissection technique. ⋯ The nucleus accumbens and its related cortical and subcortical gray matter and fiber pathways play a major role in the etiopathogenesis of psychiatric disorders. Therefore, a better understanding of the neuroanatomical features of the nucleus accumbens and its related structures will enable more accurate surgical treatment of neuropsychiatric disorders.
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Microglia, the resident immune cells of the central nervous system, play a critical role in health and disease. Following injury, microglia upregulate inducible nitric oxide synthase (iNOS), and can exert neurotoxic effects by releasing large quantities of nitric oxide (NO). Expression of iNOS, and many other proinflammatory genes, is regulated in part by Ca influx and Ca-dependent transcription factors. The expression of the nonselective cation channel Sur1-Trpm4 may be 1 molecular mechanism by which microglia dynamically modulate Ca influx. We hypothesized that microglial Sur1-Trpm4 plays a role in microglial-mediated neuroinflammation by regulating the calcium-sensitive induction of iNOS. ⋯ Our results strongly support our hypothesis that Sur1-Trpm4 regulates the calcium-sensitive induction of iNOS by controlling NFAT activity. These observations have impactful therapeutic implications. Inhibition of Sur1-Trpm4 using the well-tolerated sulfonylurea glibenclamide (a.k.a. glyburide) may be a promising approach to limit the deleterious effects of microglial-mediated neuroinflammation.
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The spine surgeon often encounters patients with a foot drop. It is the task of spine physicians to be able to determine the etiology and responsible pathological process based upon history, physical examination, electrophysiological testing, and radiographic studies. A detailed knowledge of the musculoskeletal anatomy of the lower extremity and of the peripheral nervous system is beneficial to interpret the aforementioned findings in order to arrive at an accurate diagnosis. Specifically, the spine surgeon needs to be able to identify whether a "foot drop" is the result of a central, radicular, or neuropathic etiology. Peroneal neuropathy must be differentiated from L5 radiculopathy, because the treatment strategies for each of the pathologies differ. ⋯ There may be a lack of knowledge among spine surgeons of the lumbosacral plexus and lower extremity anatomy. Medical education dedicated to the musculoskeletal system and neuroanatomy may be necessary so that gaps in knowledge may be minimized.