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Meniere's disease (MD) is a disorder of the inner ear characterized by chronic episodes of vertigo, tinnitus, increased aural pressure, and sensorineural hearing loss. Causes of MD are unknown, but endolymphatic hydrops is a hallmark. In addition, 5%-15% of MD cases have been identified as familial. Whole-genome sequencing studies of individuals with familial MD identified DTNA and FAM136A as candidate genes for autosomal dominant inheritance of MD. Although the exact roles of these genes in MD are unknown, FAM136A encodes a mitochondrial protein, and DTNA encodes a cytoskeletal protein involved in synapse formation and maintenance, important for maintaining the blood-brain barrier. It is also associated with a particular aquaporin. We tested vestibular and auditory function in dtna and fam136a knockout (KO) mice, using RotaRod and startle reflex-based clicker tests, respectively. Three-factor analysis of variance (ANOVA) results indicated that sex, age, and genotype were significantly correlated with reduced mean latencies to fall ("latencies") for male dtna KO mice, while only age was a significant factor for fam136a KO mice. Fam136a KO mice lost their hearing months before WTs (9-11 months vs. 15-20 months). In male dtna KO mice, divergence in mean latencies compared with other genotypes was first evident at 4 months of age, with older males having an even greater decrease. Our results indicate that fam136a gene mutations generate hearing problems, while dtna gene mutations produce balance deficits. Both mouse models should help to elucidate hearing loss and balance-related symptoms associated with MD.
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Perda Auditiva Neurossensorial , Doença de Meniere , Vestíbulo do Labirinto , Animais , Camundongos , Masculino , Doença de Meniere/genética , Doença de Meniere/complicações , Doença de Meniere/diagnóstico , Reflexo de Sobressalto , MutaçãoRESUMO
STUDY DESIGN: Retrospective case series. OBJECTIVE: Posterior surgery for thoracic disc herniation was associated with increased morbidity and mortality and new minimally invasive approaches have been recommended for soft disc herniation but not for calcified central disc. The objective of this study is to describe a posterolateral microscopic transpedicular approach for central thoracic disc herniation. METHODS: This is a single center retrospective review of all the cases of giant thoracic calcified disc herniation as defined by Hott et al. Presence of myelopathy, percentage of canal compromise, T2 hypersignal, ASIA score, and ambulatory status were recorded. This posterolateral technique using a tubular retractor was thoroughly described. RESULTS: Eight patients were operated upon with a mean follow-up of 16 months. Mean canal compromise was 61%. Mean operative time was 228 minutes and mean operative bleeding was 250 mL. There were no cases of dural tear or neurologic degradation. CONCLUSION: This is the first report of posterior minimally invasive transpedicular approach for giant calcified disc herniation. There were neither cases of neurological deterioration nor increased rate of dural tears. This technique is thus safe and could be recommended for treatment of this rare disease.
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Cavernous angiomas are congenital vascular malformations that affect the central nervous system. Reports implicated radiation therapy as a triggering factor for the formation of cavernomas but not in relation with head and neck radiation therapy. Radiation-induced cavernomas (RIC) should be considered in the differential diagnosis of focal neurological symptoms in any patient who has received previous cranial-spinal or head and neck radiotherapy.
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Despite extensive research efforts focusing on tackling membrane biofouling, one of the biggest problems associated with membrane technology, there has been little headway in this area. This study presents novel polyethersulfone (PES) membranes synthesized via a phase inversion method at incremental loadings of functionalized oxidized multiwalled carbon nanotubes (OMWCNT) along with 1 wt. % arabic gum (AG). The synthesized OMWCNT were examined using scanning electron microscopy and transmission electron microscopy for morphological changes compared to the commercially obtained carbon nanotubes. Additionally energy-dispersive X-ray spectroscopy was carried out on the raw and OMWCNT materials, indicating an almost 2-fold increase in oxygen content in the latter sample. The cast PES/OMWCNT membranes were extensively characterized, and underwent a series of performance testing using bovine serum albumin solution for fouling tests and model Gram-positive (Bacillus subtilis) and Gram-negative (Escherichia coli) bacterial species for anti-biofouling experiments. Results indicated that the composite PES membranes, which incorporated the OMWCNT and AG, possessed significantly stronger hydrophilicity and negative surface charge as evidenced by water contact angle and zeta potential data, respectively, when compared to plain PES membranes. Furthermore atomic force microscopy analysis showed that the PES/OMWCNT membranes exhibited significantly lower surface roughness values. Together, these membrane surface features were held responsible for the anti-adhesive nature of the hybrid membranes seen during biofouling tests. Importantly, the prepared membranes were able to inhibit bacterial colonization upon incubation with both Gram-positive and Gram-negative bacterial suspensions. The PES/OMWCNT membranes also presented more resilient normalized flux values when compared to neat PES and commercial membrane samples during filtration of both bacterial suspensions and real treated sewage effluents. Taken together, the results of this study allude to OMWCNT and AG as promising additives, for incorporation into polymeric membranes to enhance biofouling resistance.
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Polysulfone (PS) membranes blended with different loadings of arabic gum (AG) were synthesized using phase inversion method and the antibacterial properties of the synthesized membranes were tested using a number Gram-negative (Escherichia coli, Klebsiella pneumonia and Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus) bacterial species. It was shown that AG addition to the dope polymer solutions essentially changed porous structure, hydrophilicity and zeta potential of the cast PS/AG membranes. These changes were due to the amphiphilic properties of AG macromolecules that contained negatively charged hydrophilic residues. A pronounced decrease in bacterial attachment was seen in the field emission scanning electron microscopy (FESEM) images for PS/AG membrane samples compared to both commercial (Microdyn-Nadir) and bare PS (without AG) membranes. AG loading dependent trend was observed where the prevention of bacterial colonization on the membrane surface was strongest at the highest (7 wt. %) AG loading in the casting solution. Possible mechanisms for the prevention of bacterial colonization were discussed. Significantly, the inhibition of bacterial attachment and growth on PS/AG membranes was observed for both Gram-positive and Gram-negative bacterial models, rendering these novel membranes with strong biofouling resistance attractive for water treatment applications.
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BACKGROUND: Abdominoplasty is increasingly performed after weight loss surgery. However, performing a laparoscopic sleeve gastrectomy (LSG) after abdominoplasty poses technical challenges. OBJECTIVE: The present study aimed to compare operative events and postoperative outcomes between LSG patients with and without a history of prior abdominoplasty. SETTING: University hospital, Qatar. METHODS: A case-control study was conducted on 2 groups of patients with (n = 33) and without (n = 69) prior abdominoplasty who underwent LSG. Patient demographics, baseline characteristics, as well as operative and postoperative events were compared between the 2 groups. RESULTS: A total of 102 patients with an average age of 39.6±7.7 years and body mass index (BMI) of 42.8±5.9 kg/m2 were included. There were no significant differences between the 2 groups in terms of demographic characteristics, preoperative BMI, and co-morbidities. The number of ports required was significantly higher in the LSG patients with a history of prior abdominoplasty than in the nonabdominoplasty patients. The operation time was also significantly longer in the abdominoplasty patients than in the nonabdominoplasty patients (90.3±36.7 minutes versus 57.1±17.7 minutes; P<.0001). However, no significant differences were observed in terms of postoperative complications, length of hospital stay, and weight loss results. CONCLUSION: LSG after abdominoplasty is associated with longer operative times and the need for additional port placement to overcome the decreased working space. However, operative strategies should be considered to overcome the technical challenges during LSG in patients who underwent a prior abdominoplasty.
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Abdominoplastia , Gastrectomia/métodos , Laparoscopia/métodos , Adolescente , Adulto , Idoso , Cirurgia Bariátrica/instrumentação , Cirurgia Bariátrica/métodos , Estudos de Casos e Controles , Feminino , Gastrectomia/instrumentação , Humanos , Laparoscopia/instrumentação , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Cirurgia de Second-Look , Instrumentos Cirúrgicos/estatística & dados numéricos , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (SAH) is a devastating event with a high rate of morbidity and mortality. With the improvement of diagnostic modalities and the adoption of different screening strategies, more aneurysms are being diagnosed prior to rupture. Based on large multi-center trials, size has become the most important determinant of treatment decisions. Unfortunately, these studies did not take into account the regional and racial variations, challenging the generalizability of their results. MATERIAL AND METHODS: We conducted a retrospective analysis on a series of 192 patients harboring 213 aneurysms. RESULTS: The critical finding in our study is that the majority of patients presenting with SAH due to ruptured aneurysms are <10 mm in size. CONCLUSION: Decision to treatment of a given unruptured intracranial aneurysm should be individually assessed and not taken from general international literature as this may mistakenly apply factors from one population to another.