World Neurosurg
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The Council of State Neurosurgical Societies surveyed neurosurgeons applying for oral board certification in 2008 to assess their preparedness to practice. This survey was repeated in 2013 for a subsequent group of board applicants to evaluate the quality of neurosurgery training and identify opportunities for improvement. ⋯ The 2013 survey suggests that candidates for board certification in neurosurgery perceive themselves to be adequately prepared to independently perform nearly all neurosurgical procedures. However, additional work is required to optimize neurosurgery training in endovascular procedures and the socioeconomic aspects of neurosurgery practice.
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Effects of the tight junction protein CLDN6 on cell migration and invasion in high-grade meningioma.
Meningioma is a common tumor of the central nervous system, and malignant meningioma is highly aggressive and frequently recurs after surgical resection. Claudin 6 (CLDN6) is involved in cell proliferation, migration, and invasion and plays a role in maintaining tight junctions between cells and obstructing the movement of cells to neighboring tissues. ⋯ CLDN6 might play an important role in meningioma migration and invasion and, thus, might serve as a novel diagnostic and/or prognostic biomarker and as a potential therapeutic target.
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The penetrating end plate screw (PES) technique improved the fixation strength of the pedicle screw by penetrating the end plate in posterior fusion. The "double" PES, which is a trajectory that penetrates both the upper end plate of the corresponding vertebra and the lower end plate of the upper adjacent vertebral body, provides a stronger tricortical fixation but requires a stricter trajectory. The purpose of this study was to measure the cephalad angles from T7-L5 that would allow a safe trajectory for "double" PES. ⋯ It is important to measure the optimal cephalad angle by preoperative computed tomography imaging according to the vertebral level. In L4 and L5, "double" PES should be avoided because it is often unsafe.
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Hypertrophy of the ligamentum flavum (LF) contributes to the development of spinal stenosis. Smad proteins can mediate the fibrogenesis activity through the transforming growth factor β1 (TGF-β1) pathway, but which Smad protein plays a more important role in the hypertrophy process of LF is unclear. ⋯ Our findings suggest that Smad2 plays a potential role in the pathologic development of hypertrophy of LF. We also found that Smad2 knockdown by Smad-siRNA can influence the TGF-β1 signaling pathway through decreasing expression of TGF-β1, tumor necrosis factor α, and nuclear factor κb.
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We performed a retrospective cohort study to investigate the prevalence of and risk factors for asymptomatic spondylotic cervical spinal stenosis (ASCSS) in the setting of lumbar spinal stenosis (LSS). ⋯ Our findings suggest that an LLA >35.85° and a DCSA <84.50 mm2 are risk factors for the development of ASCSS. For LSS patients with an enlarged LLA and reduced DSCA, a whole spinal magnetic resonance imaging examination should be performed.