Is Surgical Drain Useful for Lumbar Disc Surgery?

OBJECTIVE: Surgical drains are commonly used after the spine surgeries for minimizing hematoma formation, which can delay wound healing and may become a source of fibrosis, infection, and pain. The drain, however, may provide a direct route for infection if it is contaminated. Our objective was to survey the relationship between surgical drains and infection. METHODS: The 70 patients who had undergone single-level lumbar discectomy from April 2011 to March 2012 were retrospectively analyzed. Each patient's medical chart and magnetic resonance image were thoroughly reviewed after all the patients had been divided into the drainage and the nondrainage groups. The amounts and durations of the surgical drains in the drainage group were analyzed. Additionally, the levels of C-reactive protein, rates of infection, scores of preoperative and postoperative visual analog scale (VAS), and lengths of hospital stay after operation were compared between the 2 groups. RESULTS: In this study, 70 patients were retrospectively analyzed; out of which, 42 and 28 patients were included in the drainage and the nondrainage groups, respectively. Two of the postoperative infection cases in the nondrainage group required to undergo repeated operations. The frequency of the postoperative infection cases was higher in the nondrainage group than in the drainage group; however, there was no significant statistical difference between the 2 groups (p=0.157). CONCLUSION: Surgical drains did not elevate postoperative infection. Furthermore, drain tip cultures allowed us to detect postoperative infection at an early stage, and it led to faster initiation of antibiotics treatment.

An Electroplating-Free and Minimal Noise Polyimide Microelectrode for Recording Auditory Evoked Potentials From the Epicranius.

In this paper, we introduce an electrode for measuring auditory evoked potentials by employing the advantages of polyimide (PI), which is a well-known substrate material for producing flexible electrodes using MEMS technology. The PI multimicroelectrode array has four fingers that include 16 electrodes in order to achieve sufficient adhesion to the curved surface of the animal skull. For high-quality signal acquisition, we optimized the device to decrease crosstalk and improve contact impedance by adding ground channels and fabricating a raised electrode structure. In addition, implantation of the device was facilitated by the addition of an alignment site to ensure optimal positioning and enable signal measurement from the specific part of the cerebral cortex in charge of auditory sensing. After the implantation of the PI electrode on the skull surface, electrical signals were measured following stimulation at different stimulus frequencies (5 or 10 kHz). Unlike other techniques, administration of this PI electrode is less invasive, reducing patient recovery time dramatically in comparison with other electrocorticographic operations. Furthermore, as the exterior of the brain would not be exposed at any point, the chance of infection is minimized.

Solitary metastasis of gastric carcinoma to the cerebellopontine angle.

Internal auditory canal (IAC) and cerebellopontine metastases are very rare lesions and their diagnosis is very difficult due to their similarity to vestibular schwannoma in clinical characteristics and radiologic findings. Our case is peculiar and differs from previously reported cases of malignant metastasis to the IAC in two aspects: 1) solitary IAC metastasis occurred without distant metastasis and 2) symptoms due to IAC metastasis preceded outbreak of primary lesion symptoms or diagnosis of primary lesion. In our literature search, no correlating cases have been reported. In this peculiar case, rapid progression of otologic symptoms, short duration of onset from hearing impairment to facial palsy, and laterally eccentric contrast enhancement in gadolinium-enhanced T1-weighted magnetic resonance imaging may have been clues for metastatic lesion.

The role of peroxiredoxin III in the ototoxic drug-induced mitochondrial apoptosis of cochlear hair cells.

CONCLUSION: Peroxiredoxin (Prx) III plays a protective role in cisplatin- and gentamicin-induced apoptosis via a mitochondria-dependent pathway in cochlear hair cells. OBJECTIVES: The aim of the present study was to investigate the effects of the depletion of endogenous Prx III on oxidative damage to mitochondrial components and on apoptotic events with the use of RNA interference. MATERIALS AND METHOD: . Depletion of Prx III was done by RNA interference in cochlear hair cells (UB/OC-1), and cells were exposed to ototoxic drugs (cisplatin or gentamicin). We then compared the apoptotic signaling between Prx III-depleted and control cells. RESULTS: The depletion of Prx III resulted in increased intracellular ROS levels accompanied by enhanced apoptosis by ototoxic drugs. The Prx III-depleted cells showed mitochondrial membrane potential collapse, cytochrome c release, and caspase activation.

Expression of beta-defensins in human middle ear cholesteatoma.

OBJECTIVE: To establish the eventual presence of human beta-defensins (hBD) in middle ea r cholesteatoma and paired retroauricular skin samples obtained during surgical treatment. MATERIAL AND METHODS: hBD were detected using immunohistochemical techniques and reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: It is hypothesized that hBD-1 and -2 are upregulated in cholesteatoma in comparison with retroauricular skin. The immunohistochemical study demonstrated stronger hBD-2-positive staining in middle ear cholesteatoma in comparison with retroauricular skin. No significant differences in hBD-1 expression were detected between cholesteatoma and skin samples. RT-PCR established elevated expression of hBD-2 mRNA in middle ear cholesteatomas. HBD-1 mRNA was constitutively expressed in cholesteatoma and retroauricular skin specimens. CONCLUSION: These preliminary experimental results lead us to believe that hBD may play an important role in the chronic inflammatory state of middle ear cholesteatoma.