World Neurosurg
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Gross total resection (GTR) is not always possible in acromegalic patients, especially in patients with invasive growth hormone-secreting adenomas. We analyzed the biochemical remission outcome in relation to extent of tumor resection and effectiveness of medical treatment in cases of remnant tumor. ⋯ The more aggressive surgical resection is, the greater the chance of attaining final biochemical remission, whether or not GTR is achieved. Medical therapy effectiveness is enhanced in cases with STR. Invasive growth hormone-secreting macroadenomas that are not surgically amenable to total resection are best managed with a combination of safe STR and medical treatment.
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Sevoflurane (Sev) is a rapidly acting, potent inhalation anesthetic with rapid uptake and elimination. But many studies have shown that Sev could result in cognition dysfunction in adolescent or aging patients. Now, therapeutic targeting with IL-17A antibody has shown a promising effect on Sev-induced cognition impairment. In the study we report that P300 inhibition could act as an alternative approach to decrease IL-17A activity. ⋯ These data show that P300 will potentially be a new drug target for the therapy of cognition impairment caused by Sev.
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Retrotransverse foramen (RTF) and retrotransverse groove (RTG) are anatomic variations of the atlas (C1) vertebrae. RTF contains an anastomotic vein connecting atlanto-occipital and atlanto-axodian venous sinuses. The purpose of this study was to analyze the arterial vascular structures running though the RTF and RTG. ⋯ The RTF or RTG of C1 was a common anatomical variant. No arterial vascular structure runs though the RTF or RTG. The presence of C1 RTF and RTG variants had no effect on the V3 segmental course of the vertebral artery. Preoperative understanding of these variations using 3D CTA are helpful for the safe execution of the upper cervical posterior approach surgeries.