Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 7 Articles
Introduction: Representing up to 15% of cervical injuries, odontoid type II\nfractures may cause spinal cord compression through atlanto-axial instability.\nAnterior screw fixation provides direct fracture site stability, high fusion rate\nand most importantly keeping cervical spine move free. We will highlight\nsuccess keys in early experience for better outcome. Methods: We operated\nten cases with traumatic type II odontoid fractures in neurotrauma unit,\nCairo University hospitals from March 2015 till June 2017. Six males and\nfour females were included. Preoperative MRI and dynamic CT were among\nthe assessment criteria. Uni-planner fluoroscopy was used. Results: No\npost-operative deficit appeared. One screw was inserted in all cases. Immediate\nand 6 weeks later CT cervical spine showed stable reduced fracture site.\nConclusions: Anterior odontoid screw fixation done with prior good selection\nof the patient and fracture shape is an effective motion preserving surgical\noption for type II odontoid fractures. Limited resources shouldnâ??t prevent\nstarting experience especially in developing countries, but larger studies are\nneeded....
Introduction: Chiari malformation Type I (CM-I) is typically defined as descent\nof the caudal tip of cerebellar tonsils at least 5 mm below the foramen\nmagnum. The incidence of the malformation is not exactly known. Treatment\nof Chiari I malformation is debatable. Some advocate posterior fossa decompression\n(PFD) with duroplasty and others advocate posterior fossa decompression\nonly without duroplasty. Aim of the Study: To compare the outcomes\nof patients who undergoing PFD with duroplasty and PFD without\nduroplasty, in Chiari I malformation. Patients and Methods: In the period\nbetween â??January 2015-June 2016â?, a prospective study was conducted involving\n20 patients complaining of headache, motor and/or sensory affection\nsecondary to Chiari I malformation. These patients were randomly divided\ninto 2 groups. The first one had PFD with duroplasty and the other will have\nPFD without duroplasty. All patients had chiari one malformation in form of\ntonsillar herniation and cervical or cervico-dorsal syrinx. The average follow-\nup period was 9 months. Results: Over 90% of patients had a good clinical\noutcome, with improvement or resolution of their symptoms at last follow-\nup. There were no major complications. The mean length of hospital stay\nwas 2.0 days. There was no perioperative death or neurological deterioration.\nThe use of duroplasty was significantly associated with presence of complications\nand longer duration of hospital stay. Conclusion: PFD without duroplasty\nin cases of chiari I malformation carries a good results as well as PFD\nwith duroplasty with lower risk of complications....
Intracranial arachnoid cysts (IAC) are benign lesions containing cerebrospinal\nfluid (CSF). Most of them are clinically silent and remain static in size.\nHowever some may present with mild and slow progressive symptoms caused\nby the cyst. The authors present the case of 54-year-old woman who presented\nwith acute symptoms of severe headache, vomiting, and gait disturbance\nof 2 dayâ??s duration. She had no history of head trauma. On admission,\nneurological examination revealed that the patient had a Glasgow Coma Scale\nscore of 15, and a left side hemiplegia. A CT scan revealed a hypodense fluid\ncollection in the right frontoparietal region that mimicked an arachnoid cyst.\nThe symptoms were improved after an emergency marsupialisation via craniotomy....
Background: Spinal schwannomas are common tumors of spinal neoplasm\nand account for about 25% of intradural spinal cord tumors in adults. They\nare generally benign and slow-growing. Advanced in radiologic and surgical\ntechniques have brought about better surgical results. The goal of surgical\ntreatment must be total resection if possible. In this report, the authors\npresent the incidence, clinical presentation, localization, and results of surgically\ntreated spinal schwannomas. The results of a literature review are also\npresented. Methods: Eleven consecutive patients with histologically confirmed\nspinal schwannomas were treated from January 2013 to December\n2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako,\nMali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI\nin 4 patients. All patients were operated on via the posterior approach. All\ncases were surgically excised, and they were confirmed to be schwannomas by\npathologists. The patients were followed for 6 to 38 months (mean 28 months).\nFunctional outcome was assessed using the motor grade and sensory change.\nResults: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females.\nThe mean age was 40.3 years (range 23 - 62 years). The most common symptom\nat the time of diagnosis was radicular pain in 9 (81.8%) patients followed\nby motor weakness in 8 (72.7%) patients. The most frequent site of spinal\nschwannomas was the thoracic region in 5 (45.5%) patients. During surgery,\nGross-total resection was achieved in 8 patients (72.7%) and subtotal removal\nin 3 (27.3%) patients. Histological findings were benign schwannoma in all cases. Postoperative complications developed in two patients, including one\nwith cerebrospinal fluid leakage and other one with wound infection. In the\nshort-term follow-up period, most of the patients (90.9%) appeared to be improved\nin comparison with their preoperative neurological status. There was\nno operative mortality. Conclusion: In this study, the clinical manifestations\nand surgical results of 11 cases of spinal schwannoma have been reviewed.\nEarly diagnosis and appropriate treatment are essential for good outcome....
Background.MiR-29a is known as a repressor of human cancer.However, its relevance in glioma proliferation and invasion remains\nlargely unknown. In this study, we aimed to investigate the function and mechanismofmiR-29a in glioma tumorigenesis. Methods.\nThe expression of miR-29a was determined by using qRT-PCR. CCK-8, wound healing, and transwell invasion assays were carried\nout to analyze the effects of miR-29a in glioblastoma cells. qRT-PCR, luciferase reporter, and western blot experiments were done\nto validate the targeting of TRAF4/Akt pathway by miR-29a. The expression correlation between levels of TRAF4 and miR-29a\nwas analyzed. Regulation of miR-29a expression by enhanced/reduced TRAF4/Akt expression was finally confirmed by qRT-PCR.\nResults. MiR-29a was decreased in the glioma tissues, especially in those at higher grades. Following its mimic transfection, we\nvalidated thatmiR-29a inhibited cell proliferation, migration, and invasion. Consistently, miR-29a inhibition induced the opposite\neffects on cell proliferation, migration, and invasion. We confirmed TRAF4 as a direct target of miR-29a, which might mediate\nthe Akt pathway activation. We showed a significantly negative expression correlation between TRAF4 and miR-29a in normal\nand glioma tissues. Finally we observed an upregulation of miR-29a in TRAF4/Akt activated cells. Conclusion. MiR-29a is critical\ntumor suppressor for glioma tumorigenesis by forming a negative feedback loop of TRAF4/Akt signaling and represents a potent\ntherapeutic candidate for treating gliomas....
Cerebral ischemia-reperfusion (I/R) injury is a major problem worldwide. The Notch signaling pathway plays an important role in\nneural progenitor cell differentiation and in the inflammatory response after central nervous system injury.This study evaluated\nwhether the neuroprotective effect of cerebral ischemic preconditioning (cIPC) is mediated by the preactivation of the Notch\nsignaling pathway. A rat middle cerebral artery occlusion/reperfusion (MCAO/R) model and glucose deprivation/reoxygenation\n(OGD/R) cell model were constructed to detect the neuroprotective effects of cIPC. In in vivo experiments, cIPC reduces the\nneurological functional deficit, cerebral infarction, and cellular apoptosis in the hippocampus induced by middle cerebral artery\nocclusion/reperfusion (MCAO/R), thus indicating that cIPC can improve neurologic function. Moreover, cIPC can reveal the\nexpression peak of Jagged1,Notch1,NICD, andHes1 protein, thereby indicating that cIPCcanpreactivateNotch signaling.However,\ncIPC-induced improvements in neurologic function are compromised by the .. secretase inhibitor N-(N-(3,5-difluorophenacetyl)-\n1-alanyl)-S-phenylglycine t-butyl ester (DAPT). In in vitro experiments, OGD preconditioning (OGDPC) can clearly upregulate\nNotch1 expression in the OGD/R-treated neuron and neural stem cell. Notch1 pre-overexpression can decrease neuron death and\napoptosis under OGD/R treatment. Notch1 pre-overexpression can decrease the percentage of G1 stage cells and increase the\npercentage of S stage cells in OGD/R-treated neural stem cell. Furthermore, Notch1 pre-knockdown has the opposite effect on\ncell survival, apoptosis, and cycle in both OGD/R-treated neuron and neural stemcell. In conclusion, our results demonstrate that\nthe neuroprotective effects of cIPC in a ratMCAO/R model are mediated by the preactivation of the Notch signaling pathway....
Multiple sclerosis (MS) is a chronic inflammatory disorder of central nervous\nsystem (CNS), characterized by the presence of multifocal demyelination\nplaques with characteristic symptoms as fatigue, balance disorder, reduced\nendurance in gait and decrease in quality of life. The study supposed that the\nmotor treatment through dance could represent useful therapeutic option,\ntogether with other treatments already in use such as the pharmacological\nand physiotherapy one. We included 9 person (6 male and 3 female) affected\nby relapsing-remitting multiple sclerosis (RRMS) with an expanded disability\nstatus scale (EDSS) score less than 3, underwent rehabilitation treatment with\nArgentine Tango (Riabilitango method). The study lasted twenty months,\nconsidering a sixty-minute session a week. The aim of the study was to verify\nthe real improvement of quality of life, fatigue, balance disorder and gait endurance\ndue to the dance treatment. We collected outcomes data of Short\nForm 36 (SF-36) in physical function (PF) (45.56 ± 21.42 vs. 69.44 ± 23.64),\nvitality (VT) (45.00 ± 7.90 vs. 67.77 ± 6.18), social function (SF) (54.00 ±\n13.86 vs. 75.11 ± 6.25), general health (GH) (32.22 ± 5.06 vs. 54.11 ± 5.20);\nModified fatigue impact test scales (MFSI) (3.56 ± 3.72 vs. 37.22 ± 3.88); Berg\nbalance scale (BBS-it) (33.89 ± 4.12 vs. 45.11 ± 3.51); Six Minute Walk Test\n(6mWT), in distance (m) (352.89 ± 174.56 vs. 397.22 ± 174.83), oxygen saturation\nin arterial blood (%SpO2) (87.67 ± 3.35 vs. 91.78 ± 5.92) and beast per\nminute (bpm) (82.67 ± 13.08 vs. 72.67 ± 10.52). We found statistically significant\n(p < 0.05) improvements in each evaluation scale. In conclusion, despite\nthe small sample size included, the results confirm that Riabilitango\nsignificantly leads to better functional performances in person affected by\nRRMS with EDSS less then 3, finding benefits in terms of quality of life. Data\nsuggest that integration between dance treatment method and the pharmacological,\ncould represent the useful approach....
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