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1.
Soft Robot ; 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38598720

RESUMEN

Insects, bats, and small birds show outstanding flight performance even under complex atmospheric conditions, which is partially due to the ability of these natural fliers to sense and react to disturbances quickly. These biological systems often use large numbers of sensors arrayed across their bodies to detect disturbances, but previous efforts to use large arrays of sensors in engineered fliers have typically resulted in slow responses due to the need to scan and process data from the large number of sensors. To address the challenges of capturing disturbances in a large sensing array with low latency, this work proposes and demonstrates a modular soft sensing system to quickly detect disturbances in small unmanned aerial vehicles. A large array of soft strain sensors with high sensing resolution covers the entire wingspan, providing rich information on wing deformation. Owing to the modular design, decentralized computation enables the sensing system to efficiently manage sensor data, resulting in sufficiently fast sampling to capture wing dynamics while all 32 sensors embedded in the modular soft sensing skin are used. This hardware architecture also results in significantly reduced noise in the sensing system, leading to a high signal-to-noise ratio. These methods can ultimately enable fast and reliable control of both soft and rigid robotic systems using large arrays of soft sensors.

2.
Proc Natl Acad Sci U S A ; 121(14): e2400868121, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38547066

RESUMEN

Partial cystectomy procedures for urinary bladder-related dysfunction involve long recovery periods, during which urodynamic studies (UDS) intermittently assess lower urinary tract function. However, UDS are not patient-friendly, they exhibit user-to-user variability, and they amount to snapshots in time, limiting the ability to collect continuous, longitudinal data. These procedures also pose the risk of catheter-associated urinary tract infections, which can progress to ascending pyelonephritis due to prolonged lower tract manipulation in high-risk patients. Here, we introduce a fully bladder-implantable platform that allows for continuous, real-time measurements of changes in mechanical strain associated with bladder filling and emptying via wireless telemetry, including a wireless bioresorbable strain gauge validated in a benchtop partial cystectomy model. We demonstrate that this system can reproducibly measure real-time changes in a rodent model up to 30 d postimplantation with minimal foreign body response. Studies in a nonhuman primate partial cystectomy model demonstrate concordance of pressure measurements up to 8 wk compared with traditional UDS. These results suggest that our system can be used as a suitable alternative to UDS for long-term postoperative bladder recovery monitoring.


Asunto(s)
Vejiga Urinaria , Infecciones Urinarias , Animales , Humanos , Vejiga Urinaria/cirugía , Urodinámica/fisiología , Prótesis e Implantes , Cistectomía
3.
World Neurosurg ; 181: e294-e302, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37839571

RESUMEN

BACKGROUND: The risk factors for the progression from early minor recanalization to major recanalization are not well established. Herein, we evaluated ruptured intracranial aneurysms (IAs) with minor recanalization within 1 year of coiling and their progression to major recurrence. METHODS: We retrospectively reviewed our database of coiled IAs and searched for ruptured saccular IAs that were successfully embolized without residual sacs. We selected IAs with minor recanalization confirmed on radiological studies within 1 year of coil embolization. All the IA cases had a follow-up period longer than 36 months based on the radiological results. RESULTS: Minor recanalization occurred in 45 IAs within 1 year of coil embolization. Among them, 14 IAs (31.1%) progressed to major recanalization, and 31 remained stable. Progression to major recanalization was detected 12 months after minor recanalization in 2 patients, 24 months in 7 patients, and 36 months in 5 patients. Moreover, the progression to major recanalization occurred more frequently in IAs at the posterior location (P = 0.024, odds ratio 11.20) and IAs with a proportional forced area > 9 mm2 (P = 0.002, odds ratio 17.13), which was a newly proposed variable in the present study. CONCLUSIONS: Our results showed that approximately one third of the ruptured IAs with early minor recanalization after coiling progressed to major recanalization within 3 years. Physicians should focus on the progression of ruptured IAs from minor to major recanalization, especially those with a posterior circulation location and a proportional forced area >9 mm2.


Asunto(s)
Aneurisma Roto , Embolización Terapéutica , Aneurisma Intracraneal , Humanos , Resultado del Tratamiento , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Estudios Retrospectivos , Embolización Terapéutica/métodos , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/terapia , Factores de Riesgo , Angiografía Cerebral
4.
Proc Natl Acad Sci U S A ; 120(37): e2308762120, 2023 09 12.
Artículo en Inglés | MEDLINE | ID: mdl-37669394

RESUMEN

The medial prefrontal cortex (mPFC) and basolateral amygdala (BLA) are involved in the regulation of defensive behavior under threat, but their engagement in flexible behavior shifts remains unclear. Here, we report the oscillatory activities of mPFC-BLA circuit in reaction to a naturalistic threat, created by a predatory robot in mice. Specifically, we found dynamic frequency tuning among two different theta rhythms (~5 or ~10 Hz) was accompanied by agile changes of two different defensive behaviors (freeze-or-flight). By analyzing flight trajectories, we also found that high beta (~30 Hz) is engaged in the top-down process for goal-directed flights and accompanied by a reduction in fast gamma (60 to 120 Hz, peak near 70 Hz). The elevated beta nested the fast gamma activity by its phase more strongly. Our results suggest that the mPFC-BLA circuit has a potential role in oscillatory gear shifting allowing flexible information routing for behavior switches.


Asunto(s)
Amígdala del Cerebelo , Complejo Nuclear Basolateral , Animales , Ratones , Corteza Prefrontal , Citoplasma , Rayos gamma
5.
Medicine (Baltimore) ; 102(30): e34493, 2023 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-37505181

RESUMEN

Because of the risk of intraoperative rupture and technical difficulties, coil embolization of very small aneurysms (VSIAs) with a diameter of ≤3 mm is challenging. Herein, we reviewed our treatment strategies and outcomes in performing coil embolization for VSIAs compared to those for larger sized intracranial aneurysms (IAs) with 4 to 4.5 mm. We retrospectively reviewed the data on ruptured and unruptured VSIAs and larger-sized IAs treated with coiling from January 2012 to June 2021. Saccular IAs treated with coil embolization and followed up for at least 6 months with imaging studies were included in the study. Fifty-eight VSIAs (27 subarachnoid hemorrhages [SAH group] and 31 unruptured hemorrhages [URA group]) were identified. The wide-necked VSIAs were significantly more common in the URA group (90.3% vs 63.0%, P = .013). Procedural complications occurred in 8 cases (13.8%): intra-procedural rupture (n = 3), coil prolapse (n = 3), and thromboembolic events (n = 2). Complications were more frequent in the SAH group (P = .020). SAH was an independent risk factor for procedural complications (odds ratio, 11.293 [95% confidence interval: 1.173-108.684], P = .036), and the outcomes were affected by SAH presentation (P = .007) and poor clinical status of SAH (P = .001). When compared with larger IAs (n = 57), there were no significant differences in treatment outcomes, procedural complications, and clinical outcomes. VSIAs ≤ 3 mm in diameter were successfully treated with coil embolization, with reasonable procedure-related complications and treatment outcomes. The safety and efficacy of coil embolization for VSIAs were comparable to those of 4 to 4.5 mm sized IAs in this single-center cohort.


Asunto(s)
Aneurisma Roto , Embolización Terapéutica , Aneurisma Intracraneal , Hemorragia Subaracnoidea , Humanos , Aneurisma Roto/cirugía , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Aneurisma Intracraneal/cirugía , Estudios Retrospectivos , Stents , Hemorragia Subaracnoidea/etiología , Hemorragia Subaracnoidea/terapia , Resultado del Tratamiento
6.
Exp Ther Med ; 25(5): 207, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37090084

RESUMEN

The Neuroform Atlas® stent is one of the most recently developed stents for coil embolization, with advancements in a lower-profile delivery system, enhanced trackability, smaller cell size, and increased wall conformability. Because of these advantages, the Neuroform Atlas® stent shows high technical success with few procedure-related complications. However, the present study reported a rare complication of a stretched and partially fractured Neuroform Atlas® stent due to unexpected partial withdrawal of microcatheter during deployment for coil embolization of an intracranial aneurysm. The measured length of the stent was ~30 mm, which was greater than the normal length (21 mm). An additional stent was inserted into the distal part of the deployed stent to stabilize the damaged stent and remodel the aneurysm neck. This complication was considered to potentially result from the combination of several factors, including: Curved vessel; open-cell stent; unexpected microcatheter withdrawal during stent deployment; and hooking of the aneurysm selecting microcatheter with stent strut. Understanding the stent design and careful manipulation while avoiding unexpected withdrawal of the microcatheter could prevent this complication.

7.
Exp Neurobiol ; 32(1): 31-41, 2023 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-36919334

RESUMEN

Developing social strategies to share limited resources equally and maximize the long-term benefits of conflict resolution is critical for appropriate social interactions. During social interactions, social decision-making depends not only on the external environment, but also on internal factors, such as hunger, thirst, or fatigue. In particular, hunger, which is related to food as a physical need, plays a dominant role in social decision-making. However, the consequences of food deprivation on social decision-making are not well understood. We have previously shown that mice with rule-observance behavior are capable of resolving conflict during social decision-making by observing a well-established social strategy based on reward zone allocation. Here, we developed a rule-observance behavior paradigm wherein the hunger state is achieved by applying food restrictions on mice prior to social behavior experiments. We found that the hunger state in mice deteriorated the established social strategy by decreasing reaction time, implying an increase in impulsivity. In contrast, the hunger state did not affect reward zone allocation, indicating no effect on spatial memory. This decrease in reaction time led to a significant increase in the percentage of violations during rule observance and a significant decrease in the amount of reward (payoff equity). Our study proposes that the hunger state exerts a detrimental effect on appropriate social decision-making by decreasing reaction time, increasing violation, and decreasing payoff equity in rule-observance behavior.

8.
Proc Natl Acad Sci U S A ; 120(6): e2217828120, 2023 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-36716364

RESUMEN

Thermal sensations contribute to our ability to perceive and explore the physical world. Reproducing these sensations in a spatiotemporally programmable manner through wireless computer control could enhance virtual experiences beyond those supported by video, audio and, increasingly, haptic inputs. Flexible, lightweight and thin devices that deliver patterns of thermal stimulation across large areas of the skin at any location of the body are of great interest in this context. Applications range from those in gaming and remote socioemotional communications, to medical therapies and physical rehabilitation. Here, we present a set of ideas that form the foundations of a skin-integrated technology for power-efficient generation of thermal sensations across the skin, with real-time, closed-loop control. The systems exploit passive cooling mechanisms, actively switchable thermal barrier interfaces, thin resistive heaters and flexible electronics configured in a pixelated layout with wireless interfaces to portable devices, the internet and cloud data infrastructure. Systematic experimental studies and simulation results explore the essential mechanisms and guide the selection of optimized choices in design. Demonstration examples with human subjects feature active thermoregulation, virtual social interactions, and sensory expansion.


Asunto(s)
Piel , Realidad Virtual , Humanos , Electrónica , Sensación Térmica , Comunicación
9.
Neuron ; 111(3): 418-429.e4, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36460007

RESUMEN

Observational fear, a form of emotional contagion, is thought to be a basic form of affective empathy. However, the neural process engaged at the specific moment when socially acquired information provokes an emotional response remains elusive. Here, we show that reciprocal projections between the anterior cingulate cortex (ACC) and basolateral amygdala (BLA) in the right hemisphere are essential for observational fear, and 5-7 Hz neural oscillations were selectively increased in those areas at the onset of observational freezing. A closed-loop disruption demonstrated the causal relationship between 5-7 Hz oscillations in the cingulo-amygdala circuit and observational fear responses. The increase/decrease in theta power induced by optogenetic manipulation of the hippocampal theta rhythm bi-directionally modulated observational fear. Together, these results indicate that hippocampus-dependent 5-7 Hz oscillations in the cingulo-amygdala circuit in the right hemisphere are the essential component of the cognitive process that drives empathic fear, but not freezing, in general.


Asunto(s)
Complejo Nuclear Basolateral , Empatía , Ratones , Animales , Amígdala del Cerebelo/fisiología , Complejo Nuclear Basolateral/fisiología , Giro del Cíngulo/fisiología , Miedo/fisiología
10.
Taehan Yongsang Uihakhoe Chi ; 83(3): 712-718, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-36238517

RESUMEN

Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.

11.
Nat Neurosci ; 25(11): 1405-1406, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36280800
12.
Exp Neurobiol ; 31(2): 116-130, 2022 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-35674000

RESUMEN

Absence seizures are caused by abnormal synchronized oscillations in the thalamocortical (TC) circuit, which result in widespread spike-and-wave discharges (SWDs) on electroencephalography (EEG) as well as impairment of consciousness. Thalamic reticular nucleus (TRN) and TC neurons are known to interact dynamically to generate TC circuitry oscillations during SWDs. Clinical studies have suggested the association of Plcß1 with early-onset epilepsy, including absence seizures. However, the brain regions and circuit mechanisms related to the generation of absence seizures with Plcß1 deficiency are unknown. In this study, we found that loss of Plcß1 in mice caused spontaneous complex-type seizures, including convulsive and absence seizures. Importantly, TRN-specific deletion of Plcß1 led to the development of only spontaneous SWDs, and no other types of seizures were observed. Ex vivo slice patch recording demonstrated that the number of spikes, an intrinsic TRN neuronal property, was significantly reduced in both tonic and burst firing modes in the absence of Plcß1 . We conclude that the loss of Plcß1 in the TRN leads to decreased excitability and impairs normal inhibitory neuronal function, thereby disrupting feedforward inhibition of the TC circuitry, which is sufficient to cause hypersynchrony of the TC system and eventually leads to spontaneous absence seizures. Our study not only provides a novel mechanism for the induction of SWDs in Plcß1 -deficient patients but also offers guidance for the development of diagnostic and therapeutic tools for absence epilepsy.

13.
Genes Brain Behav ; 21(5): e12810, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35451184

RESUMEN

Prior experience of social hierarchy is known to modulate emotional contagion, a basic form of affective empathy. However, it is not known whether this behavioral effect occurs through changes in an individual's traits due to their experience of social hierarchy or specific social interrelationships between the individuals. Groups of four mice with an established in-group hierarchy were used to address this in conjunction with a tube test. The rank-1 and rank-4 mice were designated as the dominant or subordinate groups, respectively. The two individuals in between were designated as the intermediate groups, which were then used as the observers in observational fear learning (OFL) experiments, an assay for emotional contagion. The intermediate observers showed greater OFL responses to the dominant demonstrator than the subordinate demonstrators recruited from the same home-cage. When the demonstrators were strangers from different cages, the intermediate observers did not distinguish between dominant and subordinate, displaying the same level of OFL. In a reverse setting in which the intermediate group was used as the demonstrator, the subordinate observers showed higher OFL responses than the dominant observers, and this occurred only when the demonstrators were cagemates of the observers. Furthermore, the bigger the rank difference between a pair, the higher the OFL level that the observer displayed. Altogether, these results demonstrate that the hierarchical interrelationship established between a given pair of animals is critical for expressing emotional contagion between them rather than any potential changes in intrinsic traits due to the experience of dominant/subordinate hierarchy. PRACTITIONER POINTS: Subordinate observer or dominant demonstrator resulted in higher affective empathic response in familiar pairs but not unfamiliar pairs. The relative social rank of the observer with respect to the demonstrator had a negative linear correlation with the affective empathic response of the observer in familiar pairs but not unfamiliar pairs. The effect of social rank on affective empathy is attributed to the prior social hierarchical interrelationship between them and is not due to intrinsic attributes of an individual based on one's dominance rank.


Asunto(s)
Emociones , Empatía , Animales , Emociones/fisiología , Miedo , Jerarquia Social , Aprendizaje , Ratones
14.
J Neurol Surg A Cent Eur Neurosurg ; 83(3): 217-223, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35170003

RESUMEN

BACKGROUND: The classic surgical position for microvascular decompression (MVD) is lateral decubitus with the head rotated 10 degrees away from the affected side. In this study, we measured the angles of the posterior fossa, specifically focusing on the surgical corridors used in MVD surgery for hemifacial spasm (HFS), to identify the proper surgical position. METHOD: The following parameters were assessed on preoperative magnetic resonance images (MRI): petrous angle (PA), sigmoid angle (SA), sigmoid diameter (SD), and root exit zone-sigmoid sinus edge angle (REZ-SEA). RESULTS: The mean PA was 59.7 ± 5.6 degrees, SA was 16.8 ± 8.6 degrees, SD was 13.4 ± 3.5 mm, and the mean REZ-SEA was 59.6 ± 5.8 degrees. The difference between the maximum SA to avoid cerebellar hemisphere injury and the minimum REZ-SEA required to verify the facial nerve REZ is assumed to be the usable range of angles for the operative microscope; the average midpoint of this range was 38.2 ± 6.4 degrees. CONCLUSION: Turning the patient's head 10 degrees away from the affected side was generally appropriate for performing MVD surgery because it provided a mean microscope angle of 48 degrees. However, some patients had corner values for the sigmoid angle, REZ-SEA, and sigmoid sinus diameter. Rotating a patient's head based on precise calculations from preoperative MRI helps to achieve successful surgery.


Asunto(s)
Espasmo Hemifacial , Cirugía para Descompresión Microvascular , Nervio Facial/diagnóstico por imagen , Nervio Facial/cirugía , Espasmo Hemifacial/diagnóstico por imagen , Espasmo Hemifacial/etiología , Espasmo Hemifacial/cirugía , Humanos , Imagen por Resonancia Magnética/efectos adversos , Cirugía para Descompresión Microvascular/métodos , Resultado del Tratamiento
15.
J Neurol Surg A Cent Eur Neurosurg ; 83(4): 377-382, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33690877

RESUMEN

BACKGROUND: The treatment protocol for hemifacial spasm (HFS) associated with dissecting vertebral artery aneurysm (DVAA) has not been established. CASE DESCRIPTION: A-42-year-old man with left HFS underwent endovascular trapping for a DVAA that was identified on brain imaging. Although the dissecting segment was treated successfully, the HFS persisted for 3 months, and subsequently microvascular decompression (MVD) was needed. The posteroinferior cerebellar artery (PICA) was found to be interposed between the root exit zone of the facial nerve and DVAA during surgery. After pulling out the PICA, the HFS ceased immediately. CONCLUSION: HFS associated with DVAA should be considered carefully before formulating a treatment strategy. Moreover, the cause of pulsatile compression may not be visible on brain imaging, and MVD surgery may be indicated in such cases.


Asunto(s)
Espasmo Hemifacial , Cirugía para Descompresión Microvascular , Disección de la Arteria Vertebral , Nervio Facial/cirugía , Espasmo Hemifacial/diagnóstico por imagen , Espasmo Hemifacial/etiología , Espasmo Hemifacial/cirugía , Humanos , Masculino , Cirugía para Descompresión Microvascular/métodos , Resultado del Tratamiento , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/cirugía , Disección de la Arteria Vertebral/cirugía
16.
Biosens Bioelectron ; 195: 113665, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34610533

RESUMEN

Competition is one of the most fundamental, yet complex, conflicts between social animals, and previous studies have indicated that the medial prefrontal cortex (mPFC) region of a brain is involved in social interactions. However, because we do not have a lightweight, wireless recording system that is free of interference, it is still unclear how the neural activity of the mPFC region is involved in the diverse, interacting behaviors that comprise competition. Herein, we present an interference-free, lightweight, wireless neural probe system that we applied to two mice to measure mPFC neural activities during a food competition test. In the test, we categorized 18 behavioral repertoires expressed by the mice. From the analysis of the neural signals during each repetition of the test, we found that the mPFC neural activity had the most positive correlation with goal-driven competitive behaviors, such as guarding resources and behaviors related to the extortion of resources. Remarkably, we found that the neural activity associated with guarding behavior was higher than that of extorting behavior, and this highlighted the importance of resource-guarding behavior for winning the competition, i.e., 'winning a trophy is hard, but keeping it is harder'. Our approach in which a wireless system is used will enable in-depth studies of the brains of mice in their natural social interactions.


Asunto(s)
Técnicas Biosensibles , Neuronas , Animales , Encéfalo , Ratones , Corteza Prefrontal
18.
Curr Opin Neurobiol ; 68: 181-189, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34091136

RESUMEN

Empathy is an essential function for humans as social animals. Emotional contagion, the basic form of afffective empathy, comprises the cognitive process of perceiving and sharing the affective state of others. The observational fear assay, an animal model of emotional contagion, has enabled researchers to undertake molecular, cellular, and circuit mechanism of this behavior. Such studies have revealed that observational fear is mediated through neural circuits involved in processing the affective dimension of direct pain experiences. A mouse can also respond to milder social stimuli induced by either positive or negative emotional changes in another mouse, which seems not dependent on the affective pain circuits. Further studies should explore how different neural circuits contribute to integrating different dimensions of affective empathy.


Asunto(s)
Empatía , Roedores , Altruismo , Animales , Emociones , Miedo , Ratones , Conducta Social
19.
J Korean Neurosurg Soc ; 64(5): 693-704, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33985322

RESUMEN

OBJECTIVE: Endovascular mechanical thrombectomy (MT) has been regarded as one of the standard treatments for acute ischemic stroke caused by large vessel occlusion. Despite the wide use of stent retrievers for MT, arterial intimal damage caused when deployed stent is pulled has been a certain disadvantage. We hypothesized that statin could protect and stabilize vessel damage after endovascular MT using a stent retriever. In this animal study, we observed the protective effects of the statins towards MT-induced vessel wall injury. METHODS: Twenty-eight carotid arteries of fourteen rabbits were used in the experiments with MT using stent retriever. We divided the rabbits into four groups as follows : group 1, negative control; group 2, positive control; group 3, statin before MT; and group 4, statin after MT. After MT procedures, we harvested the carotid arteries and performed histomorphological and immunohistochemical analyses. RESULTS: In histomorphological analysis with hematoxylin and eosin and Masson's trichrome stain, significant intimal thickening (p<0.05) was observed in the positive control (group 2), compared to in the negative control (group 1). Intimal thickening was improved in the statin-administered groups (groups 3 and 4 vs. group 2, p<0.05). We also observed that statin administration after MT (group 4) resulted in a more effective decrease in intimal thickness than statin administration before MT (group 3) (p<0.05). We performed immunohistochemical analysis with the antibodies for tumor necrosis factor-alpha (TNF-α), cluster of differentiation (CD)11b, and CD163. In contrast to the negative control (group 1), the stained percentage areas of all immunological markers were markedly increased in the positive control (group 2) (p<0.05). Based on statin administration, the percentage area of TNF-α staining was significantly reduced (p<0.05) in group 3, compared to the positive control group (group 2). However, significant differences were not observed for CD11b and CD163 staining. In group 4, no significant differences were observed for TNF-α, CD11b, and CD163 staining (p≥0.05). The differences in the percentage areas of the different markers between the statin-administered groups (groups 3 and 4) were also not revealed. CONCLUSION: We presented that statin administration before and after MT exerted protective effects towards vessel wall injury. The efficacy of statins was greater post-administration than pre-administration. Thus, statin administration in routine prescriptions in the peri-procedural period is strongly advised.

20.
J Korean Neurosurg Soc ; 64(1): 110-119, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33105530

RESUMEN

OBJECTIVE: Preoperative prediction of the arachnoid membrane descent in pituitary surgery is useful for achieving gross total removal and avoiding cerebrospinal fluid leakage resulting from tearing of the arachnoid membrane in the chiasmatic cistern. In this study, we analyzed the patterns of arachnoid membrane descent during or after pituitary tumor surgery and identified the factors related to this descent. METHODS: Analysis was restricted to pituitary macroadenomas not extending into the third ventricle or over the internal carotid artery. To minimize confounding factors, patients who underwent revision surgery, those who had a torn arachnoid during operation or small medial diaphragma sellae (DS) opening, and subtotal resections were excluded. We enrolled 41 consecutive patients in this retrospective analysis. The degree of arachnoid descent was categorized using intraoperative videos. Preoperative magnetic resonance findings, including tumor height, suprasellar extension, and variables including DS area and medial opening size, tumor composition, and displacement of the pituitary stalk and gland were evaluated to determine their correlations with arachnoid membrane descent. RESULTS: Arachnoid membrane descent was significantly correlated with DS area and medial opening size. Based on T2-weighted images (T2WI) magnetic resonance (MR) images, tumor composition was significantly associated with arachnoid membrane descent. Other factors were not significantly correlated with arachnoid membrane descent. CONCLUSION: T2WI of tumor composition and preoperative MR imaging of DS area and medial opening provided valuable information regarding arachnoid membrane descent. These parameters may serve as fundamental measures to facilitate complete resection of pituitary macroadenomas.

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