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1.
Acta Biomater ; 2024 Jul 09.
Article in English | MEDLINE | ID: mdl-38992411

ABSTRACT

Collagen-based hydrogels are commonly used in mechanobiology to mimic the extracellular matrix. A quantitative analysis of the influence of collagen concentration and properties on the structure and mechanics of the hydrogels is essential for tailored design adjustments for specific in vitro conditions. We combined focused ion beam scanning electron microscopy and rheology to provide a detailed quantitative atlas of the mechanical and nanoscale three-dimensional structural alterations that occur when manipulating different hydrogel's physicochemistry. Moreover, we study the effects of such alterations on the phenotype of breast cancer cells and their mechanical interactions with the extracellular matrix. Regardless of the microenvironment's pore size, porosity or mechanical properties, cancer cells are able to reach a stable mesenchymal-like morphology. Additionally, employing 3D traction force microscopy, a positive correlation between cellular tractions and ECM mechanics is observed up to a critical threshold, beyond which tractions plateau. This suggests that cancer cells in a stable mesenchymal state calibrate their mechanical interactions with the ECM to keep their migration and invasiveness capacities unaltered. STATEMENT OF SIGNIFICANCE: The paper presents a thorough study on the mechanical microenvironment in breast cancer cells during their interaction with collagen based hydrogels of different compositions. The hydrogels' microstructure were obtained using state-of-the-art 3D microscopy, namely focused ion beam-scanning electron microscope (FIB-SEM). FIB-SEM was originally applied in this work to reconstruct complex fibered collagen microstructures within the nanometer range, to obtain key microarchitectural parameters. The mechanical microenvironment of cells was recovered using Traction Force Microscopy (TFM). The obtained results suggest that cells calibrate tractions such that they depend on mechanical, microstructural and physicochemical characteristics of the hydrogels, hence revealing a steric hindrance. We hypothesize that cancer cells studied in this paper tune their mechanical state to keep their migration and invasiveness capacities unaltered.

2.
N Engl J Med ; 390(23): 2156-2164, 2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38899694

ABSTRACT

BACKGROUND: Variants in APOE and PSEN1 (encoding apolipoprotein E and presenilin 1, respectively) alter the risk of Alzheimer's disease. We previously reported a delay of cognitive impairment in a person with autosomal dominant Alzheimer's disease caused by the PSEN1 E280A variant who also had two copies of the apolipoprotein E3 Christchurch variant (APOE3 Ch). Heterozygosity for the APOE3 Ch variant may influence the age at which the onset of cognitive impairment occurs. We assessed this hypothesis in a population in which the PSEN1 E280A variant is prevalent. METHODS: We analyzed data from 27 participants with one copy of the APOE3 Ch variant among 1077 carriers of the PSEN1 E280A variant in a kindred from Antioquia, Colombia, to estimate the age at the onset of cognitive impairment and dementia in this group as compared with persons without the APOE3 Ch variant. Two participants underwent brain imaging, and autopsy was performed in four participants. RESULTS: Among carriers of PSEN1 E280A who were heterozygous for the APOE3 Ch variant, the median age at the onset of cognitive impairment was 52 years (95% confidence interval [CI], 51 to 58), in contrast to a matched group of PSEN1 E280A carriers without the APOE3 Ch variant, among whom the median age at the onset was 47 years (95% CI, 47 to 49). In two participants with the APOE3 Ch and PSEN1 E280A variants who underwent brain imaging, 18F-fluorodeoxyglucose positron-emission tomographic (PET) imaging showed relatively preserved metabolic activity in areas typically involved in Alzheimer's disease. In one of these participants, who underwent 18F-flortaucipir PET imaging, tau findings were limited as compared with persons with PSEN1 E280A in whom cognitive impairment occurred at the typical age in this kindred. Four studies of autopsy material obtained from persons with the APOE3 Ch and PSEN1 E280A variants showed fewer vascular amyloid pathologic features than were seen in material obtained from persons who had the PSEN1 E280A variant but not the APOE3 Ch variant. CONCLUSIONS: Clinical data supported a delayed onset of cognitive impairment in persons who were heterozygous for the APOE3 Ch variant in a kindred with a high prevalence of autosomal dominant Alzheimer's disease. (Funded by Good Ventures and others.).


Subject(s)
Age of Onset , Alzheimer Disease , Apolipoprotein E3 , Heterozygote , Presenilin-1 , Humans , Alzheimer Disease/genetics , Presenilin-1/genetics , Female , Male , Middle Aged , Apolipoprotein E3/genetics , Positron-Emission Tomography , Aged , Brain/pathology , Brain/diagnostic imaging , Adult , Genes, Dominant , Colombia
3.
PLoS One ; 18(12): e0296510, 2023.
Article in English | MEDLINE | ID: mdl-38157369

ABSTRACT

INTRODUCTION: Tissue engineering has emerged as an innovative approach to treat critical-size bone defects using biocompatible scaffolds, thus avoiding complex distraction surgeries or limited stock grafts. Continuous regeneration monitoring is essential in critical-size cases due to the frequent appearance of non-unions. This work evaluates the potential clinical use of gait analysis for the mechanical assessment of a tissue engineering regeneration as an alternative to the traditional and hardly conclusive manual or radiological follow-up. MATERIALS AND METHODS: The 15-mm metatarsal fragment of eight female merino sheep was surgically replaced by a bioceramic scaffold stabilized with an external fixator. Gait tests were performed weekly by making the sheep walk on an instrumented gangway. The evolution of different kinematic and dynamic parameters was analyzed for all the animal's limbs, as well as asymmetries between limbs. Finally, potential correlation in the recovery of the gait parameters was evaluated through the linear regression models. RESULTS: After surgery, the operated limb has an altered way of carrying body weight while walking. Its loading capacity was significantly reduced as the stance phases were shorter and less impulsive. The non-operated limbs compensated for this mobility deficit. All parameters were normalizing during the consolidation phase while the bone callus was simultaneously mineralizing. The results also showed high levels of asymmetry between the operated limb and its contralateral, which exceeded 150% when analyzing the impulse after surgery. Gait recovery significantly correlated between symmetrical limbs. CONCLUSIONS: Gait analysis was presented as an effective, low-cost tool capable of mechanically predicting the regeneration of critical-size defects treated by tissue engineering, as comparing regeneration processes or novel scaffolds. Despite the progressive normalization as the callus mineralized, the bearing capacity reduction and the asymmetry of the operated limb were more significant than in other orthopedic alternatives.


Subject(s)
Bone Regeneration , Tissue Engineering , Female , Sheep , Animals , Gait , Bony Callus , Walking , Tissue Scaffolds
4.
Paleobiology ; 49(3): 377-393, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37809321

ABSTRACT

Over the last 50 years, access to new data and analytical tools has expanded the study of analytical paleobiology, contributing to innovative analyses of biodiversity dynamics over Earth's history. Despite-or even spurred by-this growing availability of resources, analytical paleobiology faces deep-rooted obstacles that stem from the need for more equitable access to data and best practices to guide analyses of the fossil record. Recent progress has been accelerated by a collective push toward more collaborative, interdisciplinary, and open science, especially by early-career researchers. Here, we survey four challenges facing analytical paleobiology from an early-career perspective: (1) accounting for biases when interpreting the fossil record; (2) integrating fossil and modern biodiversity data; (3) building data science skills; and (4) increasing data accessibility and equity. We discuss recent efforts to address each challenge, highlight persisting barriers, and identify tools that have advanced analytical work. Given the inherent linkages between these challenges, we encourage discourse across disciplines to find common solutions. We also affirm the need for systemic changes that reevaluate how we conduct and share paleobiological research.

5.
Tissue Eng Regen Med ; 20(6): 893-904, 2023 10.
Article in English | MEDLINE | ID: mdl-37606809

ABSTRACT

BACKGROUND: 3D-printed bioceramic scaffolds have gained popularity due to their controlled microarchitecture and their proven biocompatibility. However, their high brittleness makes their surgical implementation complex for weight-bearing bone treatments. Thus, they would require difficult-to-instrument rigid internal fixations that limit a rigorous evaluation of the regeneration progress through the analysis of mechanic-structural parameters. METHODS: We investigated the compatibility of flexible fixations with fragile ceramic implants, and if mechanical monitoring techniques are applicable to bone tissue engineering applications. Tissue engineering experiments were performed on 8 ovine metatarsi. A 15 mm bone segment was directly replaced with a hydroxyapatite scaffold and stabilized by an instrumented Ilizarov-type external fixator. Several in vivo monitoring techniques were employed to assess the mechanical and structural progress of the tissue. RESULTS: The applied surgical protocol succeeded in combining external fixators and subject-specific bioceramic scaffolds without causing fatal fractures of the implant due to stress concentrator. The bearing capacity of the treated limb was initially altered, quantifying a 28-56% reduction of the ground reaction force, which gradually normalized during the consolidation phase. A faster recovery was reported in the bearing capacity, stiffening and bone mineral density of the callus. It acquired a predominant mechanical role over the fixator in the distribution of internal forces after one post-surgical month. CONCLUSION: The bioceramic scaffold significantly accelerated in vivo the bone formation compared to other traditional alternatives in the literature (e.g., distraction osteogenesis). In addition, the implemented assessment techniques allowed an accurate quantitative evaluation of the bone regeneration through mechanical and imaging parameters.


Subject(s)
Tissue Engineering , Tissue Scaffolds , Sheep , Animals , Tissue Scaffolds/chemistry , Tissue Engineering/methods , Bone Regeneration , Bone and Bones , Printing, Three-Dimensional
6.
Brain Pathol ; 33(2): e13119, 2023 03.
Article in English | MEDLINE | ID: mdl-36130084

ABSTRACT

In response to brain insults, astrocytes become reactive, promoting protection and tissue repair. However, astroglial reactivity is typical of brain pathologies, including Alzheimer's disease (AD). Considering the heterogeneity of the reactive response, the role of astrocytes in the course of different forms of AD has been underestimated. Colombia has the largest human group known to have familial AD (FAD). This group carries the autosomal dominant and fully penetrant mutation E280A in PSEN1, which causes early-onset AD. Recently, our group identified an E280A carrier who did not develop FAD. The individual was homozygous for the Christchurch mutation R136S in APOE3 (APOEch). Remarkably, APOE is the main genetic risk factor for developing sporadic AD (SAD) and most of cerebral ApoE is produced by astroglia. Here, we characterized astrocyte properties related to reactivity, glutamate homeostasis, and structural integrity of the gliovascular unit (GVU), as factors that could underlie the pathogenesis or protection of AD. Specifically, through histological and 3D microscopy analyses of postmortem samples, we briefly describe the histopathology and cytoarchitecture of the frontal cortex of SAD, FAD, and APOEch, and demonstrate that, while astrodegeneration and vascular deterioration are prominent in SAD, FAD is characterized by hyperreactive-like glia, and APOEch displays the mildest astrocytic and vascular alterations despite having the highest burden of Aß. Notably, astroglial, gliovascular, and vascular disturbances, as well as brain cell death, correlate with the specific astrocytic phenotypes identified in each condition. This study provides new insights into the potential relevance of the gliovasculature in the development and protection of AD. To our knowledge, this is the first study assessing the components of the GVU in human samples of SAD, FAD, and APOEch.


Subject(s)
Alzheimer Disease , Humans , Alzheimer Disease/pathology , Apolipoprotein E3/genetics , Apolipoprotein E3/metabolism , Homozygote , Mutation , Brain/pathology , Amyloid beta-Peptides/metabolism
7.
Ann Biomed Eng ; 50(12): 1798-1809, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35732853

ABSTRACT

Collagen is a ubiquitous protein present in regenerating bone tissues that experiences multiple biological phenomena during distraction osteogenesis until the deposition of phosphate crystals. This work combines fluorescence techniques and mathematical modeling to shed light on the mechano-structural processes behind the maturation and accommodation-to-mineralization of the callus tissue. Ovine metatarsal bone calluses were analyzed through confocal images at different stages of the early distraction osteogenesis process, quantifying the fiber orientation distribution and mean intensity as fiber density measure. Likewise, a mathematical model based on the experimental data was defined to micromechanically characterize the apparent stiffening of the tissue within the distracted callus. A reorganization of the fibers around the distraction axis and increased fiber density were found as the bone fragments were gradually separated. Given the degree of significance between the mathematical model and previous in vivo data, reorganization, densification, and bundle maturation phenomena seem to explain the apparent mechanical maturation observed in the tissue theoretically.


Subject(s)
Osteogenesis, Distraction , Osteogenesis , Sheep , Animals , Bony Callus/diagnostic imaging , Osteogenesis, Distraction/methods , Diagnostic Imaging , Models, Theoretical , Bone Regeneration
8.
J Evol Biol ; 35(5): 669-679, 2022 05.
Article in English | MEDLINE | ID: mdl-35290678

ABSTRACT

Variational properties hold a fundamental role in shaping biological evolution, exerting control over the magnitude and direction of evolutionary change elicited by microevolutionary processes that sort variation, such as selection or drift. We studied the genus Tyrannus as a model for examining the conditions and drivers that facilitate the repeated evolution of exaggerated, secondary sexual traits in the face of significant functional limitations. In particular, we explore the role of allometry, sexual selection and their interaction, on the diversification of tail morphology in the genus, assessing whether and how they promoted or constrained phenotypic evolution. Non-deep-forked species tend to show reduced sexual dimorphism and moderate allometric variation in tail shape. The exaggerated and functionally constrained long feathers of deep-forked species, T. savana and T. forficatus, which show both marked sexual dimorphism and allometric tail shape variation, independently diverged from the rest of the genus following the same direction of main interspecific variation accrued during the evolution of non-deep-forked species. Moreover, the latter direction is also aligned with axes summarising sexual dimorphism and allometric variation on deep-forked species, a feature lacking in the rest of the species. Thus, exaggerated tail morphologies are interpreted as the result of amplified divergence through reorientation and co-option of allometric variation by sexual selection, repeatedly driving morphology along a historically favoured direction of cladogenetic evolution.


Subject(s)
Sex Characteristics , Sexual Selection , Animals , Biological Evolution , Feathers/anatomy & histology , Head/anatomy & histology
9.
J Mech Behav Biomed Mater ; 121: 104613, 2021 09.
Article in English | MEDLINE | ID: mdl-34126507

ABSTRACT

Tissue engineering has recently gained popularity as an alternative to autografts to stimulate bone tissue regeneration through structures called scaffolds. Most of the in vivo experiments on long-bony defects use internally-stabilized generic scaffolds. Despite the wide variety of computational methods, a standardized protocol is required to optimize ceramic scaffolds for load-bearing bony defects stabilized with flexible fixations. An optimization problem was defined for applications to sheep metatarsus defects. It covers biological parameters (porosity, pore size, and the specific surface area) and mechanical constraints based on in vivo and in vitro results reported in the literature. The optimized parameters (59.30% of porosity, 5768.91 m-1 of specific surface area, and 360.80 µm of pore size) and the compressive strength of the selected structure were validated in vitro by means of tomographic images and compression tests of six 3D-printed samples. Divergences between the design and measured values of the optimized parameters, mainly due to manufacturing defects, are consistent with the previous studies. Using the mixed experimental-mathematical scaffold-design procedure described, they could be implanted in vivo with instrumented external fixators, therefore facilitating biomechanical monitoring of the regeneration process.


Subject(s)
Printing, Three-Dimensional , Tissue Scaffolds , Animals , Bone Regeneration , Ceramics , Humans , Porosity , Sheep , Tissue Engineering , Weight-Bearing
10.
Ann Biomed Eng ; 49(4): 1209-1221, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33111968

ABSTRACT

Bone lengthening and bone transport are regeneration processes that commonly rely on distraction osteogenesis, a widely accepted surgical procedure to deal with numerous bony pathologies. Despite the extensive study in the literature of the influence of biomechanical factors, a lack of knowledge about their mechanobiological differences prevents a clinical particularization. Bone lengthening treatments were performed on sheep metatarsus by reproducing the surgical and biomechanical protocol of previous bone transport experiments. Several in vivo monitoring techniques were employed to build an exhaustive comparison: gait analysis, radiographic and CT assessment, force measures through the fixation, or mechanical characterization of the new tissue. A significant initial loss of the bearing capacity, quantified by the ground reaction forces and the limb contact time with the ground, is suffered by the bone lengthening specimens. The potential effects of this anomaly on the musculoskeletal force distribution and the evolution of the bone callus elastic modulus over time are also analyzed. Imaging techniques also seem to reveal lower bone volume in the bone lengthening callus than in the bone transport one, but an equivalent mineralization rate. The simultaneous quantification of biological and mechanical parameters provides valuable information for the daily clinical routine and numerical tools development.


Subject(s)
Bone Regeneration/physiology , Bony Callus/physiology , Gait/physiology , Metatarsal Bones/physiology , Osteogenesis, Distraction , Animals , Biomechanical Phenomena , Bony Callus/diagnostic imaging , Bony Callus/surgery , Elastic Modulus , Female , Metatarsal Bones/diagnostic imaging , Metatarsal Bones/surgery , Sheep , Tomography, X-Ray Computed
11.
Ann Biomed Eng ; 49(2): 642-652, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32808118

ABSTRACT

Bone lengthening is a bone regeneration technique with multiple clinical applications. One of the most common complications of this treatment is the lack of adaptation of the surrounding soft tissue to their extension. A better understanding of the mechanobiology of the tissues involved in distraction osteogenesis would allow better control of the clinical cases. Bone lengthening treatments were performed in vivo in the metatarsus of Merino sheep, measuring the distraction forces by means of an instrumented fixator. The tissue relaxation after distraction was analyzed in this study. A viscoelastic model was also applied to distraction data to assess the mechanical behavior of the tissues during the distraction phase. Tissue relaxation is similar to other bone regeneration processes which do not imply surrounding soft tissue extension, e.g. bone transport. The effects of this tissue on distraction forces are limited to the first minutes of distraction and elongations above 4% of the original length with the protocol applied. Moreover, the surrounding soft tissue initially loses some of its viscoelasticity and subsequently suffers strain hardening from day 5 of distraction until the end of the distraction phase, day 15. Finally, anatomical changes were also evidenced in the elongated limb of our specimens.


Subject(s)
Bone Regeneration/physiology , Metatarsal Bones/physiology , Animals , Biomechanical Phenomena , Female , Models, Biological , Osteogenesis, Distraction , Sheep
12.
Sensors (Basel) ; 20(16)2020 Aug 15.
Article in English | MEDLINE | ID: mdl-32824259

ABSTRACT

For the monitoring of bone regeneration processes, the instrumentation of the fixation is an increasingly common technique to indirectly measure the evolution of bone formation instead of ex vivo measurements or traditional in vivo techniques, such as X-ray or visual review. A versatile instrumented external fixator capable of adapting to multiple bone regeneration processes was designed, as well as a wireless acquisition system for the data collection. The design and implementation of the overall architecture of such a system is described in this work, including the hardware, firmware, and mechanical components. The measurements are conditioned and subsequently sent to a PC via wireless communication to be in vivo displayed and analyzed using a developed real-time monitoring application. Moreover, a model for the in vivo estimation of the bone callus stiffness from collected data was defined. This model was validated in vitro using elastic springs, reporting promising results with respect to previous equipment, with average errors and uncertainties below 6.7% and 14.04%. The devices were also validated in vivo performing a bone lengthening treatment on a sheep metatarsus. The resulting system allowed the in vivo mechanical characterization of the bone callus during experimentation, providing a low-cost, simple, and highly reliable solution.


Subject(s)
Bony Callus , Metatarsal Bones , Monitoring, Physiologic , Animals , Bone Regeneration , External Fixators , Radiography , Sheep
13.
Insect Sci ; 25(6): 1108-1118, 2018 Dec.
Article in English | MEDLINE | ID: mdl-28544122

ABSTRACT

Drosophila buzzatii and D. koepferae are sibling cactophilic species. The former breeds primarily on prickly pears (genus Opuntia) whereas the latter breeds on columnar cacti of the genera Cereus and Trichocereus, although with certain degree of niche overlapping. We examined the interspecific differences in diurnal temporal patterns of adult emergence from puparia and evaluated whether this behavior is affected by rearing in the different cactus hosts available in nature. We detected important host-dependent genetic variation for this trait differentially affecting the emergence schedule of these species. Diurnal pattern of emergence time was directly correlated with developmental time and negatively correlated with adult wing size, suggesting that early emergences are at least indirectly correlated with increased fitness. We discussed our results in terms of their putative effects on fitness and the genetic-metabolic pathways that would be presumably affected by host's nutritional-chemical differences.


Subject(s)
Drosophila/growth & development , Drosophila/genetics , Opuntia , Pupa/growth & development , Animals , Drosophila/anatomy & histology , Female , Genetic Variation , Genotype , Host Specificity , Male , Wings, Animal/anatomy & histology
14.
Radiat Oncol ; 12(1): 63, 2017 Mar 31.
Article in English | MEDLINE | ID: mdl-28359341

ABSTRACT

BACKGROUND: Motion monitoring is essential when treating non-static tumours with pencil beam scanned protons. 4D medical imaging typically relies on the detected body surface displacement, considered as a surrogate of the patient's anatomical changes, a concept similarly applied by most motion mitigation techniques. In this study, we investigate benefits and pitfalls of optical and electromagnetic tracking, key technologies for non-invasive surface motion monitoring, in the specific environment of image-guided, gantry-based proton therapy. METHODS: Polaris SPECTRA optical tracking system and the Aurora V3 electromagnetic tracking system from Northern Digital Inc. (NDI, Waterloo, CA) have been compared both technically, by measuring tracking errors and system latencies under laboratory conditions, and clinically, by assessing their practicalities and sensitivities when used with imaging devices and PBS treatment gantries. Additionally, we investigated the impact of using different surrogate signals, from different systems, on the reconstructed 4D CT images. RESULTS: Even though in controlled laboratory conditions both technologies allow for the localization of static fiducials with sub-millimetre jitter and low latency (31.6 ± 1 msec worst case), significant dynamic and environmental distortions limit the potential of the electromagnetic approach in a clinical setting. The measurement error in case of close proximity to a CT scanner is up to 10.5 mm and precludes its use for the monitoring of respiratory motion during 4DCT acquisitions. Similarly, the motion of the treatment gantry distorts up to 22 mm the tracking result. CONCLUSIONS: Despite the line of sight requirement, the optical solution offers the best potential, being the most robust against environmental factors and providing the highest spatial accuracy. The significant difference in the temporal location of the reconstructed phase points is used to speculate on the need to apply the same monitoring system for imaging and treatment to ensure the consistency of detected phases.


Subject(s)
Artifacts , Image Processing, Computer-Assisted/methods , Proton Therapy/methods , Radiotherapy, Image-Guided/methods , Electromagnetic Phenomena , Four-Dimensional Computed Tomography/methods , Humans , Motion , Movement , Phantoms, Imaging , Respiration
15.
Mol Ecol ; 25(18): 4534-50, 2016 09.
Article in English | MEDLINE | ID: mdl-27483442

ABSTRACT

High-throughput transcriptome studies are breaking new ground to investigate the responses that organisms deploy in alternative environments. Nevertheless, much remains to be understood about the genetic basis of host plant adaptation. Here, we investigate genome-wide expression in the fly Drosophila buzzatii raised in different conditions. This species uses decaying tissues of cactus of the genus Opuntia as primary rearing substrate and secondarily, the necrotic tissues of the columnar cactus Trichocereus terscheckii. The latter constitutes a harmful host, rich in mescaline and other related phenylethylamine alkaloids. We assessed the transcriptomic responses of larvae reared in Opuntia sulphurea and T. terscheckii, with and without the addition of alkaloids extracted from the latter. Whole-genome expression profiles were massively modulated by the rearing environment, mainly by the presence of T. terscheckii alkaloids. Differentially expressed genes were mainly related to detoxification, oxidation-reduction and stress response; however, we also found genes involved in development and neurobiological processes. In conclusion, our study contributes new data onto the role of transcriptional plasticity in response to alternative rearing environments.


Subject(s)
Alkaloids/chemistry , Cactaceae/chemistry , Drosophila/genetics , Transcriptome , Adaptation, Physiological , Animals , Argentina , Desert Climate , Larva/genetics
16.
J Neurol Surg A Cent Eur Neurosurg ; 74(3): 146-51, 2013 May.
Article in English | MEDLINE | ID: mdl-23315669

ABSTRACT

BACKGROUND: There is no satisfactory medical treatment for hydrocephalus and most often surgical treatment is necessary, including shunting or endoscopic third ventriculostomy (ETV), both with their well-known advantages and drawbacks. The objective of this study is to describe a contemporary series of anterior ventriculocisternostomy. PATIENTS: Twenty-two patients with hydrocephalus treated at two institutions between 2005 and 2009 were presented. The authors employed a technique called anterior ventriculocisternostomy to treat selected cases. This technique includes supraciliary incision, small craniotomy, and fenestration of the lamina terminalis and Liliquist membrane. Hydrocephalus was secondary to hemorrhage from arteriovenous malformation (3 cases), spontaneous subarachnoid hemorrhage (2 cases), posterior fossa tumors (4 cases), head injury (1 case), basilar aneurysm (1 case), and posterior fossa hemorrhage (1 case). Eight patients had a normal-pressure hydrocephalus syndrome and one patient a slit ventricle syndrome. Aqueduct obstruction was noticed in one patient. Patients were followed up for 20.2 months (range: 10 to 46 months). RESULTS: No hemorrhagic complications or parenchymal injury were observed. One cerebrospinal fluid leakage occurred. No infection, mortality, and neurological morbidity were reported. Improvements were noticed in 18 cases. Eighty-two percent of the patients remained independent of shunt. CONCLUSION: Anterior ventriculocisternostomy integrates old views of open ventriculocisternostomy with contemporary concepts of minimally invasive neurosurgery. It provides the most straightforward anatomical and physiological alternative to treat many types of hydrocephalus with no significant morbidity. Compared with conventional procedures, it has several advantages. This procedure is an important option to manage hydrocephalus and constitutes a safe, effective, and relatively inexpensive alternative to ETV and shunts.


Subject(s)
Hydrocephalus/surgery , Minimally Invasive Surgical Procedures/methods , Ventriculostomy/methods , Adolescent , Adult , Aged , Aged, 80 and over , Cerebrospinal Fluid Leak , Cerebrospinal Fluid Rhinorrhea/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Intracranial Hemorrhages/epidemiology , Male , Middle Aged , Prospective Studies , Retrospective Studies , Treatment Outcome , Young Adult
17.
León; s.n; 17 feb. 2000. 43 p. tab.
Thesis in Spanish | LILACS | ID: lil-279313

ABSTRACT

Los datos del presente trabajo revelaron en el grupo de 50 hipertensos una edad promedio de 59+-9.3 años con una edad minima de 47 años y una edad máxima de 96 años. En el grupo control 50 la edad promedio fue de 54.5+- 7.1 años, con una edad mínima de 45 años y una edad máxima de 80 años. Al hacer las categorías de los grupos etáreos según la edad en el grupo de hipertenso se encontró un predominio en el grupo de de 45-55 años y en el grupo de 66 años con un 42 porciento 21 casos. En cambio en el grupo control, predominó el grupo entre 45-55 años con 32 casos 64 porciento. En relación al sexo se encontró una distribución similar tanto en el grupo de casos como grupo control. La procedencia en los casos fue también similar tanto para el área urbana como para la rural, no así en el grupo control donde predominó el área urbana con 37 casos para un 74 porciento. En relación a los valores promedios de colesterol, triaciglicéridos y creatinina fue muy similar tanto para el grupo de hipertensos como apra el grupo control, la diferencia de los valores en ambos grupos no fue estadísticamente significativa (p<0.05). La diferencia encontrada entre la presión arterial sistólica y diastólica 155.3 y 82.7 mm Hg, respectivamente en el grupo de hipertensos comparada con lo valores encontrados en el grupo control 124.6 y 71.7 mm Hg, respectivamente, fue estadísticamente singnificativa (p<0.05). Las causas de hospitalización en el grupo de hipertenso fue el accidente cerebro vascular con 8, 16 porciento casos, seguido de la alteración de la conciencia, la enfermedad pulmonar obstructiva crónica, neumonía con 5, 10 porciento casos cada una. La crisis hipertensiva propiamente dicha sólo se observaron en 3, 8 porciento pacientes. La ocupación de la población que padecen de hipertensión predominó los desempleados con 46 porciento en los casos y 36 porciento en los controles, el grupo de hipertenso los comerciantes 7, 14 porciento seguido de los agricultores y conductores fueron los que siguieron a los desempleados con 5, 10 porciento respectivamente. En relación aa los factores de riesgo relacionados con la hipertensión arterial encontrados en el estudio se ve un predomino de colesterol alto,sedentarismo, obesidad, sexo masculino, edad mayor de 56 años y procedencia urbana en el grupo de hipertensos comparados en con el grupo control


Subject(s)
Diabetes Mellitus , Hypertension/classification , Hypertension/complications , Hyperlipidemias , Hypertension, Renal , Hypertension, Renovascular , Blood Pressure/physiology , Risk Factors
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