Prospective Randomized Controlled Trial Comparing Anesthetic Management With Remimazolam Besylate and Flumazenil Versus Propofol During Awake Craniotomy Following an Asleep-awake-asleep Method.

BACKGROUND: Awake craniotomy is performed to resect brain tumors in eloquent brain areas to maximize tumor reduction and minimize neurological damage. Evidence suggests that intraoperative anesthetic management of awake craniotomy with remimazolam is safe. We compared the time to arousal and efficacy of anesthetic management with remimazolam and propofol during awake craniotomy. METHODS: In a single-institution randomized, prospective study, patients who underwent elective awake craniotomy were randomized to receive remimazolam and reversal with flumazenil (group R) or propofol (group P). The primary end point was time to awaken. Secondary end points were time to loss of consciousness during induction of anesthesia, the frequency of intraoperative complications (pain, hypertension, seizures, nausea, vomiting, and delayed arousal), and postoperative nausea and vomiting. Intraoperative task performance was assessed using a numerical rating scale (NRS) score. RESULTS: Fifty-eight patients were recruited, of which 52 (26 in each group) were available for the efficacy analysis. Patients in group R had faster mean (±SD) arousal times than those in the P group (890.8±239.8 vs. 1075.4±317.5 s; P=0.013)and higher and more reliable intraoperative task performance (NRS score 8.81±1.50 vs. 7.69±2.36; P=0.043). There were no significant intraoperative complications. CONCLUSIONS: Compared with propofol, remimazolam was associated with more rapid loss of consciousness and, after administration of flumazenil, with faster arousal times and improved intraoperative task performance.

FAM98A is localized to stress granules and associates with multiple stress granule-localized proteins.

Stress granules are evolutionally conserved ribonucleoprotein structures that are formed in response to various stress stimuli. Recent studies have demonstrated that proteins with low complexity (LC) regions play a critical role for the formation of stress granules. In this study, we report that FAM98A, whose biological functions are unknown, is a novel component of stress granules. FAM98A is localized to stress granules, but not to P-bodies, after various stress stimuli. Analysis with deletion mutants revealed that C-terminal region that contains LC region was essential for FAM98A accumulation to stress granules. Depletion of FAM98A using two different siRNAs decreased the number of stress granules formed per cell. Finally, we show that FAM98A associates with stress granule-localized proteins, such as DDX1, ATXN2, ATXN2L, and NUFIP2. Our results show a partial role of FAM98A for the organization of stress granules.

Three-dimensional analysis system for orthognathic surgery patients with jaw deformities.

INTRODUCTION: Traditionally, lateral and frontal cephalograms are used with facial photographs to evaluate a patient's maxillofacial skeletal and facial soft-tissue morphology. However, the enlargement and distortion of 2-dimensional radiography made it difficult to accurately conceptualize the patient's anatomy. The purpose of this article was to introduce a new method for comparing 3-dimensional (3D) standard values of the maxillofacial skeletal and facial soft-tissue morphology before and after orthognathic surgery. METHODS: Normative 3D standard values of the maxillofacial skeletal and facial soft-tissue morphology were calculated from normal women. The pre- and postoperative morphology of one woman who underwent orthognathic surgery was compared with the normative data. RESULTS: This 3D analysis has clinical value to evaluate patients before and after surgical treatment. CONCLUSIONS: This quantitative assessment of 3D maxillofacial morphology can evaluate the area and degree of displacement and rotation of the facial skeleton and facial soft tissues. This method is sufficiently useful for routine clinical applications.