Innate immune responses recognizing pathogen associated molecular patterns (PAMPs) play a crucial role in adaptive immunity. Toll-like receptors (TLRs) and C-type lectin receptors (CLRs) contribute to antigen capture, uptake, presentation and activation of immune responses.
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In this contribution, metal-free reversible addition–fragmentation chain transfer (RAFT) polymerization of N-3,4-dihydroxybenzenethyl methacrylamide (DMA) and 2-(methacrylamido) glucopyranose (MAG) under sunlight irradiation using 2-cyanoprop-2-yl-α-dithionaphthalate (CPDN) as iniferter agent, can be employed to fabricate the multivalent glycopolymer containing bioresponsive sugar group and multifunctional catechol functionalities. The polymerization behavior is investigated and it presents controlled features. Moreover, bioinspired dopamine chemistry can be successfully utilized to form in situ glycopolymer-coated gold nanoparticles (AuNPs) without the need of additional reducing reagent, design “pathogen-mimetic” glycoadjuvant recognized by both CLRs and TLRs. The synthetic glycoadjuvant is found to enhance the adjuvant activity as “infected signals” in vitro. Ca' Foscari University of Venice. Cagliari State University. Free University of Bolzano.
Politecnico di Bari. Scuola Superiore Sant'Anna. University of Bologna.
University of Camerino. University of Genoa. University of Messina. University of Naples Federico II. University of Padova. University of Palermo. University of Parma.
University of Pavia. University of Perugia. University of Pisa.
University of Roma TRE. University of Rome Tor Vergata. University of Siena. University of Verona.
. Attenello, Frank J; Lee, Brian; Yu, Cheng; Liu, Charles Y; Apuzzo, Michael L J 2014-01-01 A central concept of scientific advancement in the medical and surgical fields is the incorporation of successful emerging ideas and technologies throughout the scope of human endeavors. The field of automation and robotics is a pivotal representation of this concept. Arising in the mythology of Homer, the concept of automation and robotics grew exponentially over the millennia to provide the substrate for a paradigm shift in the current and future practice of neurosurgery.
We trace the growth of this field from the seminal concepts of Homer and Aristotle to early incorporation into neurosurgical practice. Resulting changes provide drastic and welcome advances in areas of visualization, haptics, acoustics, dexterity, tremor reduction, motion scaling, and surgical precision. Published by Elsevier Inc. Ono, Hajime; Takasuna, Hiroshi; Tanaka, Yuichiro 2016-01-01 Allergic reactions to the metal head-pins of a head fixation holder are rare. A 45-year-old woman was referred to our hospital for the treatment of unruptured cerebral aneurysms.
She underwent successful surgical treatment using four head-pins of the Sugita frame. At her first outpatient visit 3 weeks after discharge, redness, sores, and focal hair loss were noted at all four areas where the pinning had been performed. The pin fixation was considered to be responsible for the alopecia because the condition of the scalp lesions was even in all four parts. Six months later, the scalp regained hair. The head-pins were made of stainless steel, containing iron, nickel, chromium, and other components. A previous history of contact dermatitis to metal jewellery was later proven. The history of metal allergy should have been carefully elicited because head fixation with head-pins is essential for neurosurgical procedures.
Chidambaram, Swathi; Vasudevan, Madabushi Chakravarthy; Nair, Mani Nathan; Joyce, Cara; Germanwala, Anand V 2018-02-01 Postoperative central nervous system infections (PCNSIs) are serious complications following neurosurgical intervention. We previously investigated the incidence and causative pathogens of PCNSIs at a resource-limited, neurosurgical center in south Asia. This follow-up study was conducted to analyze differences in PCNSIs at the same institution following only one apparent change: the operating room air filtration system.
This was a retrospective study of all neurosurgical cases performed between December 1, 2013, and March 31, 2016 at our center. Providers, patient demographic data, case types, perioperative care, rate of PCNSI, and rates of other complications were reviewed. These results were then compared with the findings of our previous study of neurosurgical cases between June 1, 2012, and June 30, 2013. All 623 neurosurgical operative cases over the study period were reviewed. Four patients (0.6%) had a PCNSI, and no patients had a positive cerebrospinal fluid (CSF) culture. In the previous study, among 363 cases, 71 patients (19.6%) had a PCNSI and 7 (1.9%) had a positive CSF culture (all Gram-negative organisms). The differences in both parameters are statistically significant (P Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure.
Fabelo, Himar; Ortega, Samuel; Kabwama, Silvester; Callico, Gustavo M.; Bulters, Diederik; Szolna, Adam; Pineiro, Juan F.; Sarmiento, Roberto 2016-05-01 Hyperspectral images allow obtaining large amounts of information about the surface of the scene that is captured by the sensor. Using this information and a set of complex classification algorithms is possible to determine which material or substance is located in each pixel. The HELICoiD (HypErspectraL Imaging Cancer Detection) project is a European FET project that has the goal to develop a demonstrator capable to discriminate, with high precision, between normal and tumour tissues, operating in real-time, during neurosurgical operations. This demonstrator could help the neurosurgeons in the process of brain tumour resection, avoiding the excessive extraction of normal tissue and unintentionally leaving small remnants of tumour. Such precise delimitation of the tumour boundaries will improve the results of the surgery.
The HELICoiD demonstrator is composed of two hyperspectral cameras obtained from Headwall. The first one in the spectral range from 400 to 1000 nm (visible and near infrared) and the second one in the spectral range from 900 to 1700 nm (near infrared).
The demonstrator also includes an illumination system that covers the spectral range from 400 nm to 2200 nm. A data processing unit is in charge of managing all the parts of the demonstrator, and a high performance platform aims to accelerate the hyperspectral image classification process. Each one of these elements is installed in a customized structure specially designed for surgical environments.
Preliminary results of the classification algorithms offer high accuracy (over 95%) in the discrimination between normal and tumour tissues. Tocco, Nikki; Brunsvold, Melissa; Kabbani, Loay; Lin, Jules; Stansfield, Brent; Mueller, Dean; Minter, Rebecca M 2013-08-01 An operative anatomy course was developed within the construct of a surgical internship preparatory curriculum. This course provided fourth-year medical students matching into a surgical residency the opportunity to perform intern-level procedures on cadavers under the guidance of surgical faculty members. Senior medical students performed intern-level procedures on cadavers with the assistance of faculty surgeons. Students' confidence, anxiety, and procedural knowledge were evaluated both preoperatively and postoperatively. Preoperative and postoperative data were compared both collectively and based on individual procedures.
Student confidence and procedural knowledge significantly increased and anxiety significantly decreased when preoperative and postoperative data were compared (P 50 hours per week (OR: 2.13; 95% CI, 1.25-3.61; p = 0.005). This working time.
Stratton-Powell, Ashley A; Anderson, Ian A; Timothy, Jake; Kapur, Nikil; Culmer, Peter 2015-07-01 Neurosurgical patties are textile pads used during most neurosurgical operations to protect tissues, manage the fluid environment, control hemostasis, and aid tissue manipulation. Recent research has suggested that, contrary to their aim, patties adhere to brain tissue and cause damage during removal. This study aimed to characterize and quantify the degree of and consequences resulting from adhesion between neurosurgical patties and brain tissue.
Using a customized peel apparatus, the authors performed 90° peel tests on 5 patty products: Policot, Telfa, Americot, Delicot, and Ray-Cot (n = 247) from American Surgical Company. They tested 4 conditions: wet patty on glass (control), wet patty on wet brain peeled at 5 mm/sec (wet), dry patty on wet brain peeled at 5 mm/sec (dry), and wet patty on wet brain peeled at 20 mm/sec (speed). The interaction between patty and tissue was analyzed using peel-force traces and pre-peel histological analysis. Adhesion strength differed between patty products (p. 2011-04-01. 21 Food and Drugs 8 2011-04-01 false Neurosurgical chair. 882.4125 Section 882.4125 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4125 Neurosurgical chair.
2011-04-01. 21 Food and Drugs 8 2011-04-01 false Neurosurgical paddie. 882.4700 Section 882.4700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4700 Neurosurgical paddie. Bowman, Robin M.; McLone, David G.
2010-01-01 The neurosurgical goal when treating children with spina bifida (predominantly myelomeningocele) is to maintain stable neurological functioning throughout the patient's life time. Unfortunately, few long-term outcome studies are available to help direct the neurosurgical care of a child born with myelomeningocele and often treatment relies more. Ban, Vin Shen; Botros, James A; Madden, Christopher J; Batjer, H Hunt 2016-09-01 Athletic neurosurgical emergencies are injuries that can lead to mortality or significant morbidity and require immediate recognition and treatment. This review article discusses the epidemiology of sports-related traumatic brain injury (TBI) with an attempt to quantify the incidence of neurosurgical emergencies in sports.
Emergencies such as intracranial hemorrhage, second impact syndrome, vascular injuries, and seizures are discussed. The incidence of sports-related TBI presenting to level I or II trauma centers in the USA is about 10 in 100,000 population per year.
About 14% of the adult sports-related TBIs and 13% of the pediatric sports-related TBIs were moderate or severe in nature. Patients presenting with headache and neck pain should prompt further investigation for cervical spine and vascular injuries. CT angiography is becoming the modality of choice to screen for blunt cerebrovascular injuries. The treatment of these injuries remains controversial. High-quality evidence in sports-related TBI is lacking.
Further research is required to help guide management of this increasingly prevalent condition. The role of prevention and education should also not be underestimated. Goo, Hyun Woo 2018-02-01 Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT. To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016.
We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography. The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P. Zhu, Hongwei; Liu, Xiyao; Wang, Zhanxiang 2017-09-01 Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors.
Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection. Results A total of 33 patients (40 cases) experienced postoperative infection representing 3.19% of the study population. Twenty cases were incision infections (1.94%), and 20 were cranial/spinal infections (1.94%) including 15 intracranial infections and 5 intraspinal infections.
The 2.4-fold greater incidence of postoperative infection in 2008 to 2010 was compared with that in 2011 to 2014 with perioperative antibiotic prophylaxis ( p 4 hours, and cerebrospinal fluid (CSF) leak (13 infections in 158 patients; p. Kuo, Benjamin J; Vissoci, Joao Ricardo N; Egger, Joseph R; Smith, Emily R; Grant, Gerald A; Haglund, Michael M; Rice, Henry E 2017-03-01 OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives.
The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform. METHODS Data on 9996 pediatric neurosurgical patients were acquired from the 2012-2014 NSQIP-Peds participant user file.
Neurosurgical cases were analyzed by the NSQIP-Peds targeted procedure categories, including craniotomy/craniectomy, defect repair, laminectomy, shunts, and implants. The primary outcome measure was 30-day mortality, with secondary outcomes including individual AEs, composite morbidity (all AEs excluding mortality and unplanned reoperation), surgical-site infection, and unplanned reoperation. Univariate analysis was performed between individual AEs and patient characteristics using Fischer's exact test. Associations between individual AEs and continuous variables (duration from admission to operation, work relative value unit, and operation time) were examined using the Student t-test. Patient characteristics and continuous variables associated with any AE by univariate analysis were used to develop category-specific multivariable models through backward stepwise logistic regression. RESULTS The authors analyzed 3383 craniotomy/craniectomy, 242 defect repair, 1811 laminectomy, and 4560 shunt and implant cases and found a composite overall morbidity of 30.2%, 38.8%, 10.2%, and 10.7%, respectively. Unplanned reoperation rates were highest for defect repair (29.8%).
The mortality rate ranged from 0.1% to 1.2%. Preoperative ventilator dependence was a significant predictor of any AE for all procedure groups, whereas.
Mooney, James F; Glazier, Stephen S; Barfield, William R 2012-11-01 The management of pediatric patients with complex spinal deformity often requires both an orthopedic and a neurosurgical intervention. The reasons for multiple subspecialty involvement include, but are not limited to, the presence of a tethered cord requiring release or a syrinx requiring decompression. It has been common practice to perform these procedures in a staged manner, although there is little evidence in the literature to support separate interventions. We reviewed a series of consecutive patients who underwent spinal deformity correction and a neurosurgical intervention concurrently in an attempt to assess the safety, efficacy, and possible complications associated with such an approach. Eleven patients were reviewed who underwent concurrent orthopedic and neurosurgical procedures. Data were collected for patient demographics, preoperative diagnosis, procedures performed, intraoperative and perioperative complications, as well as any unexpected return to the operating room for any reason.
Operative notes and anesthesia records were reviewed to determine estimated blood loss, surgical time, and the use of intraoperative neurological monitoring. Patient diagnoses included myelodysplasia (N=6), congenital scoliosis and/or kyphosis (N=4), and scoliosis associated with Noonan syndrome (N=1). Age at the time of surgery averaged 9 years 2 months (range=14 months to 17 years 2 months). Estimated blood loss averaged 605 ml (range=50-3000 ml). The operative time averaged 313 min (range=157-477 min). There were no intraoperative complications, including incidental dural tears or deterioration in preoperative neurological status.
One patient developed a sore associated with postoperative cast immobilization that led to a deep wound infection. It appears that concurrent orthopedic and neurosurgical procedures in pediatric patients with significant spinal deformities can be performed safely and with minimal intraoperative and postoperative complications when utilizing. Bergman, William C; Schulz, Raymond A; Davis, Deanna S 2.