World Neurosurg
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Several factors associated with interrupted and continuous suturing techniques affect the quality of bypass anastomosis. It is difficult to determine the impact of these factors during surgery. The primary objective of this study was to evaluate factors with the potential to influence the quality of bypass anastomosis using either interrupted or continuous suturing. A secondary objective was to evaluate the usefulness of a practical scale when comparing interrupted and continuous suturing techniques to improve bypass anastomosis. ⋯ There were advantages and disadvantages to both suturing techniques. The scale was a practical way to measure and improve performance.
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The surgical repair of a cerebral aneurysm does not always lead to complete occlusion. A standardized repeatable method of reporting results of surgical clipping is desirable. Our purpose was to systematically review methods of classifying aneurysm remnants, provide a new scale with precise definitions of categories, and perform an agreement study to assess the variability in adjudicating remnants after aneurysm clipping. ⋯ Various classification schemes to evaluate angiographic results after surgical clipping exist in the literature, but they lack standardization. Adjudication using fewer, better defined categories may yield more reliable agreement.
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Case Reports
Intraoperative ultrasound guided posterior cervical laminectomy for degenerative cervical myelopathy.
We present our experience with routine intraoperative ultrasound (IOUS)-guided posterior cervical laminectomy (PCL) in patients with degenerative cervical myelopathy (DCM), describe the technique used, and describe relevant IOUS findings that may impact the surgical procedure. ⋯ IOUS is a poorly described yet easy-to-use and very effective tool for guidance and confirmation of adequate posterior decompression of the cervical spinal cord and nerve roots during PCL. Routinely using IOUS-guided decompression for PCL in patients with myelopathy will help avoid residual compression of neural elements and might be beneficial for functional outcome.
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MicroRNAs (miRNAs) are a class of small noncoding RNAs that play important roles in tumor development and progression. miR-20a acts as an oncogene in many cancers; however, the underlying role of miR-20a in human glioma remains unknown. ⋯ Collectively, these results suggest a critical role for miR-20a in glioma cell apoptosis, proliferation, and invasion via the direct targeting of CELF2 and indicate its potential application in cancer therapy.
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Currently, radiologic predictors for the resectability of cervical dumbbell schwannomas remain unknown. To identify radiologic predictors for resectability, we retrospectively reviewed data from 72 patients. ⋯ The resectability of cervical dumbbell schwannomas may be predicted by MRI features, including tumor size, tumor level, and degree of VA involvement.