ABSTRACT
Major advances have been made over the past few decades in identifying and managing disorders of consciousness (DOC) in patients with acquired brain injury (ABI), bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration. Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools, sophisticated neuroimaging, and electrophysiological techniques, a considerably higher diagnostic accuracy rate of DOC may now be reached. During the treatment of patients with DOC, a variety of intervention methods are available, including amantadine and transcranial direct current stimulation, which have both provided class II evidence, zolpidem, which is also of high quality, and non-invasive stimulation, which appears to be more encouraging than pharmacological therapy. However, heterogeneity is profoundly ingrained in study designs, and only rare schemes have been recommended by authoritative institutions. There is still a lack of an effective clinical protocol for managing patients with DOC following ABI. To advance future clinical studies on DOC, we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of DOC. We propose a preliminary clinical decision protocol, which could serve as an ideal reference tool for many medical institutions.
Subject(s)
Humans , Transcranial Direct Current Stimulation/methods , Consciousness Disorders/etiology , Brain Injuries/complications , Consciousness , NeuroimagingABSTRACT
Correction for the Results section of the Abstract is needed. There was a mistake in the numerical values of Results section of the Abstract.
ABSTRACT
Objective @#To explore the therapeutic efficacy of chairside CEREC all-ceramic restorations in children with first permanent molars with severe defects and to summarize the clinical methods and procedures.@*Methods@# Forty teeth of 7-15 years old thirty-four children with first permanent molars with severe defects were selected. After careful tooth preparation, a total of 40 all-ceramic restorations (8 inlays, 32 onlays) were designed and manufactured using the CEREC 3D system, and all prostheses were bonded with composite resin cement. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was assessed. The clinical efficacy was analyzed using modified USPHS criteria at 12 months and 24 months. Evaluations included secondary caries, marginal adaptation, surface texture, color matching, fracture, anatomical form, adjacency relationship and gingival health.@*Results @# For the 40 all-ceramic restorations of the first permanent molars, after 24 months, 100% of the teeth were grade A for secondary caries, surface texture and fracture of the prosthesis, and 85% of the teeth were up to grade A for the other indexes at 12 and 24 months. There were no significant differences (P > 0.05) between 12 months and 24 months. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was greater than 94%. @*Conclusion @#Application of the CEREC 3D system had a clear curative effect and resulted in high satisfaction in the repair of permanent molars with severe defects in children.
ABSTRACT
<p><b>OBJECTIVE</b>To gain a better understanding of gene expression changes in the brain following microwave exposure in mice. This study hopes to reveal mechanisms contributing to microwave-induced learning and memory dysfunction.</p><p><b>METHODS</b>Mice were exposed to whole body 2100 MHz microwaves with specific absorption rates (SARs) of 0.45 W/kg, 1.8 W/kg, and 3.6 W/kg for 1 hour daily for 8 weeks. Differentially expressing genes in the brains were screened using high-density oligonucleotide arrays, with genes showing more significant differences further confirmed by RT-PCR.</p><p><b>RESULTS</b>The gene chip results demonstrated that 41 genes (0.45 W/kg group), 29 genes (1.8 W/kg group), and 219 genes (3.6 W/kg group) were differentially expressed. GO analysis revealed that these differentially expressed genes were primarily involved in metabolic processes, cellular metabolic processes, regulation of biological processes, macromolecular metabolic processes, biosynthetic processes, cellular protein metabolic processes, transport, developmental processes, cellular component organization, etc. KEGG pathway analysis showed that these genes are mainly involved in pathways related to ribosome, Alzheimer's disease, Parkinson's disease, long-term potentiation, Huntington's disease, and Neurotrophin signaling. Construction of a protein interaction network identified several important regulatory genes including synbindin (sbdn), Crystallin (CryaB), PPP1CA, Ywhaq, Psap, Psmb1, Pcbp2, etc., which play important roles in the processes of learning and memorye.</p><p><b>CONCLUSION</b>Long-term, low-level microwave exposure may inhibit learning and memory by affecting protein and energy metabolic processes and signaling pathways relating to neurological functions or diseases.</p>
Subject(s)
Animals , Mice , Computational Biology , Gene Expression , Radiation Effects , Learning , Memory , Microwaves , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
STUDY DESIGN: Retrospective, case control evaluation of 86 patients who underwent microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of lumbar disc herniation (LDH). PURPOSE: To evaluate the safety and the outcomes of MED and PTED for the treatment of LDH. OVERVIEW OF LITERATURE: MED and PTED are minimally invasive surgical techniques for lower back pain. Studies to date have shown that MED and PTED are safe and effective treatment modalities for LDH. METHODS: A retrospective study was performed in patients with LDH treated with MED (n=50) and transforaminal endoscopic discectomy (PTED; n=36) in our hospital. All patients were followed-up with self-evaluation questionnaires, Oswestry disability index (ODI), medical outcomes study 36-item short form health survey and MacNab criteria. All the patients in both groups were followed up to 12 months after the operation. RESULTS: ODI questionnaire responses were not statistically different between the MED and PTED groups (53.00 vs. 48.72) before treatment. Average scores and minimal disability after 5 days to 12 months of follow-up were 4.96 in the MED group and 3.61 in the PTED group. According to MacNab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. CONCLUSIONS: There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed.
Subject(s)
Humans , Case-Control Studies , Diagnostic Self Evaluation , Diskectomy , Follow-Up Studies , Health Surveys , Intervertebral Disc Degeneration , Low Back Pain , Retrospective Studies , Minimally Invasive Surgical ProceduresABSTRACT
Bioactivity of Indonesian mahogany, Toona sureni (Blume) (Meliaceae), against the red flour beetle, Tribolium castaneum (Coleoptera, Tenebrionidae). The insecticidal activity of Toona sureni (Blume) Merr. was evaluated considering repellency, mortality and progeny production of F1 adults of Tribolium castaneum (Herbst, 1797) (Coleoptera, Tenebrionidae). Dried extract of seeds of T. sureni was dissolved in acetone to prepare solution of various concentrations (0.5, 1.0, 2.5 and 5.0%). To test for repellency, the insects were exposed to treated filter paper. Mortality of larvae, pupae and adults was evaluated by the treatment of spraying the insects with different concentrations of T. sureni extract. Residual effect of the extract was also evaluated considering the production of progeny of F1 adults. The highest repellency (93.30%) of T. castaneum occurred at the highest concentration (5.0% suspension of T. sureni); while the lowest (0.0%) repellency occurred at 0.5% suspension after 1 day of treatment. The highest mortality against adults (86.71%), larvae (88.32%) and pupae (85%) occurred at 5% suspension at 8 days after application. There was a negative correlation between the concentrations of T. sureni and the production of F1 adult's progeny of T. castaneum. The highest number of progeny (147) of T. castaneum occurred in the control at 7 days after treatment; and the lowest number of progeny (43) occurred at 5.0% concentration in 1 day after treatment. The results show that T. sureni is toxic to T. castaneum and has the potential to control all stages of this insect in stored wheat.
Bioatividade do mogno da Indonésia, Toona sureni (Blume) (Meliaceae), contra o besouro-das-farinhas, Tribolium castaneum (Coleoptera, Tenebrionidae). A atividade inseticida de Toona sureni (Blume) Merr. foi avaliada considerando repelência, mortalidade e a produção de progênie de adultos F1 de Tribolium castaneum (Herbst, 1797) (Coleoptera, Tenebrionidae). Extrato seco de sementes de T. sureni foi dissolvido em acetona, para preparar soluções de várias concentrações (0,5; 1,0; 2,5 e 5,0%). Para testar a repelência, os insetos foram expostos a papel de filtro tratado. A mortalidade de larvas, pupas e adultos foi avaliada pulverizando os insetos com diferentes concentrações do extrato de T. sureni. O efeito residual do extrato também foi avaliado pela produção de progênie dos adultos F1. A maior repelência (93,30%) de T. castaneum ocorreu na maior concentração (5,0% suspensão de T. sureni); enquanto que a mais baixa repelência (0%) ocorreu na suspensão de 0,5% em um dia após o tratamento. A mortalidade mais elevada de adultos (86,71%), larvas (88,32%) e de pupas (85%) ocorreu com a suspensão a 5%, aos oito dias após a aplicação. Houve uma correlação negativa entre a concentração das suspensões de T. sureni e a produção de progênie de T. castaneum. O maior número de progênie (147) foi produzido na testemunha aos sete dias após o tratamento; enquanto o menor número de progênie (43) foi na suspensão de 5,0% no primeiro dia após o tratamento. Os resultados demostram que T. sureni é tóxico para T. castaneum e tem potencial para ser usado no controle de todos os estágios deste inseto em trigo armazenado.
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<p><b>OBJECTIVES</b>To analyze the risk factors of skin necrosis around incision after total knee arthroplasty, and explore measures for prevention and treatment.</p><p><b>METHODS</b>From January 2003 to November 2005, skin necrosis around incision occurred to 15 out of the 382 cases (494 knees) treated by total knee arthroplasty. The data of the 15 cases were analyzed. Preoperative hospital for special surgery knee score (HSS) was 60 points on average.</p><p><b>RESULTS</b>All wound were healed after debridement. However, the recover time was over 3 weeks longer than the healing time by first intention. Extensor weakness with anterior knee pain appeared among 9 patients, and 6 months later, the symptoms improved obviously. At two years follow-up, the average range of motion was 92 degrees, and the average HSS improved to 86. There were no secondary infection and deformity in the group.</p><p><b>CONCLUSIONS</b>It is the key to prevent skin necrosis around incision during total knee arthroplasty that surgeons must accurately grasp technique of minimally invasive surgery for total knee arthroplasty. To acquire satisfactory outcome, it is imperative to perform debridement as soon as possible while the skin necrosis happens. At the same time, it is important to persist in doing adequate functional exercises throughout the period of treatment.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Follow-Up Studies , Necrosis , General Surgery , Postoperative Complications , General Surgery , Retrospective Studies , Risk Factors , Surgical Flaps , PathologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical results and improve perioperative management in patients with hemophilic arthropathy.</p><p><b>METHODS</b>From May 2002 to March 2007, 20 patients with hemophilic arthropathy were admitted. Fourteen patients (20 knees) were performed total knee arthroplasty, and 6 patients (8 hips) were performed total hip arthroplasty, while 2 patients were performed ankle arthrodesis. The average preoperative HSS score, hip Harris score and ankle AOFAS score were 83, 89 and 78 points respectively.</p><p><b>RESULTS</b>All patients had been followed up, and the mean time was 27.3 months. The average postoperative knee HSS score increased to 83 points, and hip Harris score increased to 89 points, while the AOFAS score increased to 78 points. Delayed bleeding and deep venous thrombosis and late infection with loose prosthesis occurred in one case respectively.</p><p><b>CONCLUSIONS</b>Arthroplasty and arthrodesis are promising for severe hemophilic arthropathy to obtain pain relief and functional improvement Correct perioperative management is the key to successful treatment in hemophilic arthropathy.</p>
Subject(s)
Adolescent , Adult , Humans , Male , Middle Aged , Arthritis , General Surgery , Arthrodesis , Arthroplasty, Replacement , Blood Coagulation Factors , Therapeutic Uses , Follow-Up Studies , Hemophilia A , Hemophilia B , Perioperative Care , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To compare the effect of posterior correction and fusion between segmental pedicle screw instrumentation with hybrid constructs in adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>Study the clinical data of 40 AIS patients retrospectively. They were underwent posterior fusion and be distributed into two group, group A was hybrid instrumentation (20 cases) and group B was pedicle screw instrumentation (20 cases). Compared therapy effect, operative time, intraoperative blood loss.</p><p><b>RESULTS</b>The average major curve correction was 82.4% in the screw group and 71.8% in the hybrid group (P = 0.004). After one to three years follow-up, major curve correction was 77.0% and 62.5% respectively (P = 0.001). Average apical vertebral derotation showed 63% correction in the screw group and 32% in the hybrid group (P = 0.001). There was no statistical significance between two group in thoracic sagittal correction, the lowest instrumented vertebra below the lower end vertebra, trunk shift, operative time, and average estimated blood loss. There were no neurologic complications related to hybrid or pedicle screw instrumentation.</p><p><b>CONCLUSION</b>Pedicle screw instrumentation was significantly better than hybrid constructs.</p>