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Cureus Nov 2021Craniotomy, cranioplasty, and craniofacial procedures may involve reoperation for additional treatment of the primary pathological condition or treatment of...
Craniotomy, cranioplasty, and craniofacial procedures may involve reoperation for additional treatment of the primary pathological condition or treatment of complications, requiring removal of previously placed hardware. During removal of the titanium hardware, there is a risk of losing, dropping, or misplacing the titanium screws because of their small size. There are also instances of difficulty disengaging the screw from the screwdriver. We describe the use of a plastic specimen cup in retrieving titanium screws after detaching them from the screwdriver by screwing the screw into the cup, thus rapidly and safely securing and storing screws for collection/discarding or possible reuse. When the empty screwdriver is used to retrieve and unscrew the titanium screw from the cranial flap or the skull bone, a plastic specimen cup should be placed adjacent to the site of screw removal. Once the screw is removed, while it is still fastened to the screwdriver, it is immediately re-screwed and secured onto the base of the plastic specimen cup, which is then placed into a second plastic specimen cup. This method prevents misplacement or dropping of the screw that may otherwise occur when manipulating the screw on or off the screwdriver and avoids perforating the surgeon's glove during handling. We describe the adjunctive use of a plastic specimen cup when removing cranial screws and hardware to rapidly and safely detach the screw and prevent the misplacement, dropping, or loss of screws intraoperatively that results in additional operative time and personnel assistance.
PubMed: 34976503
DOI: 10.7759/cureus.19891 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To compare the outcomes of primary uncomplicated rhegmatogenous retinal detachment (RRD) repair using pars plana vitrectomy (PPV), scleral buckling (SB), or combined...
PURPOSE
To compare the outcomes of primary uncomplicated rhegmatogenous retinal detachment (RRD) repair using pars plana vitrectomy (PPV), scleral buckling (SB), or combined scleral buckling with vitrectomy (SB/PPV).
PATIENTS AND METHODS
Single-institution, retrospective, observational study of 179 patients with primary RRD managed at a large academic hospital system. We excluded patients with less than 6 months of follow-up, previous vitrectomy or buckle, giant retinal tears, aphakia, recurrent forms of RRD, or extensive proliferative vitreoretinopathy (Grade C or worse) documented on exam or requiring membrane peel. Outcome measures included primary anatomical success at 6 months, functional success defined as BCVA ≥ 20/200, and best corrected visual acuity (BCVA) using logMAR scoring. Subgroup analysis was performed in the following patient groups: phakic, pseudophakic, inferior detachments, and prior pneumatic retinopexy.
RESULTS
Primary anatomical success was achieved in 145 of 179 eyes (81.0%), with SB/PPV showing a significantly greater success rate (p = 0.046) when compared to SB and PPV. Functional success was achieved in 137 of the 145 anatomically successful eyes (94.5%), with values ranging between 92% and 97% amongst the interventions (p = 0.552). No difference was found in final BCVA (p = 0.367). Patients with inferior detachment had an odds ratio of 2.15 for primary anatomic failure. Prior pneumatic retinopexy did not significantly affect any of the primary outcomes.
CONCLUSION
SB/PPV yielded a significantly better primary anatomical success rate when compared to SB and PPV. Functional success and final BCVA was similar amongst the interventions. Inferior detachments were associated with worse primary anatomic outcomes. Prior pneumatic retinopexy did not significantly affect surgical outcomes.
PubMed: 36960322
DOI: 10.2147/OPTH.S405913 -
The Journal of Biological Chemistry May 2018Nontransformed cells that become detached from the extracellular matrix (ECM) undergo dysregulation of redox homeostasis and cell death. In contrast, cancer cells often... (Review)
Review
Nontransformed cells that become detached from the extracellular matrix (ECM) undergo dysregulation of redox homeostasis and cell death. In contrast, cancer cells often acquire the ability to mitigate programmed cell death pathways and recalibrate the redox balance to survive after ECM detachment, facilitating metastatic dissemination. Accordingly, recent studies of the mechanisms by which cancer cells overcome ECM detachment-induced metabolic alterations have focused on mechanisms in redox homeostasis. The insights into these mechanisms may inform the development of therapeutics that manipulate redox homeostasis to eliminate ECM-detached cancer cells. Here, we review how ECM-detached cancer cells balance redox metabolism for survival.
Topics: Animals; Autophagy; Cell Survival; Extracellular Matrix; Humans; Neoplasms; Oxidation-Reduction; Reactive Oxygen Species; Signal Transduction
PubMed: 29339552
DOI: 10.1074/jbc.TM117.000260 -
Indian Journal of Ophthalmology Nov 2020In the present study, we describe a step-by-step technique for cortex aspiration during cataract surgery- POPS (positioning, occlusion, posterior displacement, and...
In the present study, we describe a step-by-step technique for cortex aspiration during cataract surgery- POPS (positioning, occlusion, posterior displacement, and swiping). Firstly, the aspiration probe is positioned under the bulk of cortical fibers beyond the capsulorhexis margin. Subsequently, the aspiration port is occluded with minimal vacuum, and the occluded port is displaced posteriorly to detach the cortical fibers off the anterior capsule. Now, tangential, arc-like swiping movements are performed while gradually increasing vacuum at the same time. The fibers are brought to the center and finally aspirated. This allows complete removal of the equatorial fibers and lens epithelial cells (LEC) with the least stress to the capsulozonular complex. Unlike the conventional technique, which involves the radial pull of cortical fibers, in this technique, there is swiping and posterior displacement of the cortical fibers before pulling towards the center and aspirating. We believe this technique will ensure safer, more effective cortical and LEC removal, reducing zonular stress.
Topics: Capsulorhexis; Cataract; Cataract Extraction; Epithelial Cells; Humans; Lens, Crystalline; Vacuum
PubMed: 33120645
DOI: 10.4103/ijo.IJO_2384_19 -
Journal of Nephrology Dec 2022Detachment of podocytes represents a turning point in the development of glomerular sclerosis and consequently, of CKD progression. Furthermore, detachment may...
BACKGROUND
Detachment of podocytes represents a turning point in the development of glomerular sclerosis and consequently, of CKD progression. Furthermore, detachment may differentiate minimal change disease (MCD) cases-which have only podocyte effacement-from early focal segmental glomerulosclerosis (FSGS) in which effacement and detachment are observed by electron microscopy. Noteworthy, it is not uncommon for early FSGS to present with clinical presentation and light microscopy (LM) pictures identical to MCD. In our routine practice, we often find cells that lie freely in Bowman's space by LM. In this study, we try to determine whether these cells are detached podocytes that are worth reporting or just an artifact that can be ignored.
METHODS
To the best of our knowledge, no study has discussed the accuracy of LM in detecting detached podocytes by the routinely used stains. We retrospectively selected 118 cases that were diagnosed as MCD by LM, and searched for detached cells in Bowman's space in their archived, routinely stained LM slides. After that, we tried to find any correlation between the clinical course, detached cells in LM picture and the EM reports.
RESULTS
LM can significantly detect detached podocytes with a positive predictive value of 93%, specificity of 85%, and sensitivity of 46%. Significant correlations were found between detached cells and degree of proteinuria and late steroid resistance.
CONCLUSION
Detecting detached podocytes by LM is a specific finding that must be reported whenever detected, as it predicts response to steroids and may be able to differentiate MCD from early FSGS by identifying patients who could have podocytopenia.
Topics: Humans; Glomerulosclerosis, Focal Segmental; Nephrosis, Lipoid; Podocytes; Retrospective Studies; Microscopy, Electron
PubMed: 36350562
DOI: 10.1007/s40620-022-01456-0 -
Micromachines Feb 2023To expand the applications of the electroencephalogram (EEG), long-term measurement, a short installation time, and little stress on the participants are needed. In this...
To expand the applications of the electroencephalogram (EEG), long-term measurement, a short installation time, and little stress on the participants are needed. In this study, we designed, fabricated, and evaluated an EEG headset with three candle-like microneedle electrodes (CMEs). The user is able to detach and reattach the electrodes, enabling long-term measurement with little stress. The design of the CMEs was experimentally determined by considering the skin-to-electrode impedance and user comfort. An EEG was successfully measured from areas with a high hair density without any preparation. The installation time was shorter than 60 s and the electrodes could be detached and reattached. The headset was designed such that the discomfort caused by its ear pads was higher than that caused by the electrodes. In 1 h experiments, the participants did not feel pain and the detachment of the CMEs was found to improve the comfort level of the participants in most cases. A successful demonstration of the long-term measurement of EEGs while watching a whole movie verified that the developed EEG headset with CMEs is applicable for EEG measurement in a variety of applications.
PubMed: 36838100
DOI: 10.3390/mi14020400 -
Journal of Clinical Medicine May 2022We examined the vessel density (VD) of the deep capillary plexus (DCP) and choriocapillaris plexus (CCP) by optical coherence tomography (OCT) angiography in eyes with...
We examined the vessel density (VD) of the deep capillary plexus (DCP) and choriocapillaris plexus (CCP) by optical coherence tomography (OCT) angiography in eyes with rhegmatogenous retinal detachment, which had similar amounts of detached and nondetached areas in the macula region, and then determined the morphology by OCT until 6 months after surgery. A total of 13 eyes of 13 patients whose average age was 55.8 ± 12.3 years and were successfully treated were enrolled in this study. Throughout the postoperative period, the VD of the DCP in the detached area decreased significantly compared to that in the nondetached area. Conversely, there was no significant difference in the VD of the CCP between the detached and the nondetached areas. The ratio of VD of both the DCP and CCP in the detached area to the in the nondetached area did not show significant changes during the follow-up period of 6 months. The ratio of VD of the DCP in the detached area to that in the nondetached area correlated significantly with the ratio of the external limiting membrane−ellipsoid zone (r = 0.57, p < 0.001) and ellipsoid zone−retinal pigment epithelium (r = 0.39, p < 0.001) thickness in the detached area to that in the nondetached area. A well-preserved DCP blood flow could result in the restoration of the outer retina.
PubMed: 35629003
DOI: 10.3390/jcm11102881 -
Frontiers in Oncology 2022The onset and progression of cancer are strongly associated with the dissipation of adhesion forces between cancer cells, thus facilitating their incessant attachment...
The onset and progression of cancer are strongly associated with the dissipation of adhesion forces between cancer cells, thus facilitating their incessant attachment and detachment from the extracellular matrix (ECM) to move toward metastasis. During this process, cancer cells undergo mechanical stresses and respond to these stresses with membrane deformation while inducing protrusions to invade the surrounding tissues. Cellular response to mechanical forces is inherently related to the reorganization of the cytoskeleton, the dissipation of cell-cell junctions, and the adhesion to the surrounding ECM. Moreover, the role of focal adhesion proteins, and particularly the role of vinculin in cell attachment and detachment during migration, is critical, indicating the tight cell-ECM junctions, which favor or inhibit the metastatic cascade. The biomechanical analysis of these sequences of events may elucidate the tumor progression and the potential of cancer cells for migration and metastasis. In this work, we focused on the evaluation of the spreading rate and the estimation of the adhesion strength between breast cancer cells and ECM prior to and post-treatment with anti-tumor agents. Specifically, different tamoxifen concentrations were used for ER breast cancer cells, while even concentrations of trastuzumab and pertuzumab were used for HER2 cells. Analysis of cell stiffness indicated an increased elastic Young's modulus post-treatment in both MCF-7 and SKBR-3 cells. The results showed that the post-treatment spreading rate was significantly decreased in both types of breast cancer, suggesting a lower metastatic potential. Additionally, treated cells required greater adhesion forces to detach from the ECM, thus preventing detachment events of cancer cells from the ECM, and therefore, the probability of cell motility, migration, and metastasis was confined. Furthermore, post-detachment and post-treatment vinculin levels were increased, indicating tighter cell-ECM junctions, hence limiting the probability of cell detachment and, therefore, cell motility and migration.
PubMed: 36052248
DOI: 10.3389/fonc.2022.811508 -
Journal of Neuroendovascular Therapy 2022Owing to the limited time since the introduction of the PulseRider (PR), inconsequential or rare complications that clinicians should be aware of remain unreported yet....
OBJECTIVE
Owing to the limited time since the introduction of the PulseRider (PR), inconsequential or rare complications that clinicians should be aware of remain unreported yet. Here, we report a rare complication of incomplete detachment.
CASE PRESENTATION
A 50-year-old male underwent PR-assisted coil embolization for a basilar tip aneurysm. Coiling was completed, and the detachment procedure was performed using a detachment machine; the success signal was observed. The delivery microcatheter was subsequently advanced back up to the proximal markers, and no reapproximation of the proximal markers, which indicates successful detachment, was observed. However, only one of the proximal markers returned to the microcatheter, and incomplete detachment of only one leg was detected. Ultimately, electrical detachment was not possible, and physical separation by tension was achieved.
CONCLUSION
Our case report presents a rare case of a detachment problem in the PR. The PR could not be detached, although the signal revealed successful detachment. Therefore, careful withdrawal of the delivery wire by checking not only the proximal markers but also the behavior of the entire PR and coil complex is important.
PubMed: 37502632
DOI: 10.5797/jnet.cr.2021-0095 -
Ophthalmology and Therapy Dec 2020Retinal pigment epithelial detachment is defined as a separation of the retinal pigment epithelium from the inner collagenous layer of Bruch's membrane. It is a common... (Review)
Review
Retinal pigment epithelial detachment is defined as a separation of the retinal pigment epithelium from the inner collagenous layer of Bruch's membrane. It is a common manifestation in both dry and wet types of age-related macular degeneration. This review aims to provide a comprehensive guide to the pathophysiology, clinical and imaging characteristics, natural course and treatment of the various types of pigment epithelial detachments in order to assist in diagnosis and management of this important feature of age-related macular degeneration.
PubMed: 32809132
DOI: 10.1007/s40123-020-00291-5