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Full-Text Articles in Medicine and Health Sciences

Virtual Surgical Planning In Subscapular System Free Flap Reconstruction Of Midface Defects., Brian P. Swendseid, Dylan F. Roden, Swar Vimawala, Tony Richa, Larissa Sweeny, Richard A. Goldman, Adam Luginbuhl, Ryan N. Heffelfinger, Shachika Khanna, Joseph Curry Dec 2019

Virtual Surgical Planning In Subscapular System Free Flap Reconstruction Of Midface Defects., Brian P. Swendseid, Dylan F. Roden, Swar Vimawala, Tony Richa, Larissa Sweeny, Richard A. Goldman, Adam Luginbuhl, Ryan N. Heffelfinger, Shachika Khanna, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Reconstruction of the midface has many inherent challenges, including orbital support, skull base reconstruction, optimizing midface projection, separation of the nasal cavity and dental rehabilitation. Subscapular system free flaps (SF) have sufficient bone stock to support complex reconstruction and the option of separate soft tissue components. This study analyzes the effect of virtual surgical planning (VSP) in SF for midface on subsite reconstruction, bone segment contact and anatomic position.

MATERIALS AND METHODS: Retrospective cohort of patients with midface defects that underwent SF reconstruction at a single tertiary care institution.

RESULTS: Nine cases with VSP were compared to fourteen cases …


Feasibility Of Diffusion And Probabilistic White Matter Analysis In Patients Implanted With A Deep Brain Stimulator., J. Muller, M. Alizadeh, L. Li, S. Thalheimer, C. Matias, M. Tantawi, J. Miao, M. D. Silverman, V. Zhang, G. Yun, V. Romo, F. B. Mohamed, C. Wu Dec 2019

Feasibility Of Diffusion And Probabilistic White Matter Analysis In Patients Implanted With A Deep Brain Stimulator., J. Muller, M. Alizadeh, L. Li, S. Thalheimer, C. Matias, M. Tantawi, J. Miao, M. D. Silverman, V. Zhang, G. Yun, V. Romo, F. B. Mohamed, C. Wu

Department of Neurosurgery Faculty Papers

Deep brain stimulation (DBS) for Parkinson's disease (PD) is an established advanced therapy that produces therapeutic effects through high frequency stimulation. Although this therapeutic option leads to improved clinical outcomes, the mechanisms of the underlying efficacy of this treatment are not well understood. Therefore, investigation of DBS and its postoperative effects on brain architecture is of great interest. Diffusion weighted imaging (DWI) is an advanced imaging technique, which has the ability to estimate the structure of white matter fibers; however, clinical application of DWI after DBS implantation is challenging due to the strong susceptibility artifacts caused by implanted devices. This …


Optimizing Cancer Cure Dialog: An Analysis Of Pancreatic Cancer Patients' Views Regarding Survival And Cure., Avinoam Nevler, Scott W. Keith, Harish Lavu, Theresa P. Yeo, Shawnna Cannaday, Charles J. Yeo, Jordan M. Winter Dec 2019

Optimizing Cancer Cure Dialog: An Analysis Of Pancreatic Cancer Patients' Views Regarding Survival And Cure., Avinoam Nevler, Scott W. Keith, Harish Lavu, Theresa P. Yeo, Shawnna Cannaday, Charles J. Yeo, Jordan M. Winter

Department of Surgery Faculty Papers

BACKGROUND: Pancreatic ductal adenocarcinoma (PDA) is a highly lethal cancer. Clinicians commonly refer to surgical therapy as resection with curative intent. However, PDA cure rates after resection remain unknown and the definition of cure remains vague. We investigated how patients (the majority undergoing resection), family members, and clinicians understand the concept of cure, to better inform discussions with patients regarding PDA prognosis.

METHODS: In a prospective survey, cohorts were asked to indicate the best definition of cure from three choices: 5-year survival endpoint (typically used in the literature), a biological endpoint without biochemical or radiographic signs of disease (similar to …


Fracture Repair Requires Trka Signaling By Skeletal Sensory Nerves., Zhu Li, Carolyn A Meyers, Leslie Chang, Seungyong Lee, Zhi Li, Ryan Tomlinson, Ahmet Hoke, Thomas L Clemens, Aaron W James Dec 2019

Fracture Repair Requires Trka Signaling By Skeletal Sensory Nerves., Zhu Li, Carolyn A Meyers, Leslie Chang, Seungyong Lee, Zhi Li, Ryan Tomlinson, Ahmet Hoke, Thomas L Clemens, Aaron W James

Department of Orthopaedic Surgery Faculty Papers

Bone is richly innervated by nerve growth factor-responsive (NGF-responsive) tropomyosin receptor kinase A-expressing (TrKa-expressing) sensory nerve fibers, which are required for osteochondral progenitor expansion during mammalian skeletal development. Aside from pain sensation, little is known regarding the role of sensory innervation in bone repair. Here, we characterized the reinnervation of tissue following experimental ulnar stress fracture and assessed the impact of loss of TrkA signaling in this process. Sequential histological data obtained in reporter mice subjected to fracture demonstrated a marked upregulation of NGF expression in periosteal stromal progenitors and fracture-associated macrophages. Sprouting and arborization of CGRP+TrkA+ sensory nerve fibers …


Brief History Of Spinal Neurosurgical Societies In The United States: Part 1., Sasha Vaziri, Daniel K. Resnick, Christopher P. Ames, James S. Harrop, Christopher I. Shaffrey, Kern Singh, Justin S. Smith, Daniel J. Hoh Dec 2019

Brief History Of Spinal Neurosurgical Societies In The United States: Part 1., Sasha Vaziri, Daniel K. Resnick, Christopher P. Ames, James S. Harrop, Christopher I. Shaffrey, Kern Singh, Justin S. Smith, Daniel J. Hoh

Department of Neurosurgery Faculty Papers

No abstract provided.


Progression-Free But No Overall Survival Benefit For Adult Patients With Bevacizumab Therapy For The Treatment Of Newly Diagnosed Glioblastoma: A Systematic Review And Meta-Analysis., Nagham Kaka, Karim Hafazalla, Haider Samawi, Andrew Simpkin, James Perry, Arjun Sahgal, Sunit Das Nov 2019

Progression-Free But No Overall Survival Benefit For Adult Patients With Bevacizumab Therapy For The Treatment Of Newly Diagnosed Glioblastoma: A Systematic Review And Meta-Analysis., Nagham Kaka, Karim Hafazalla, Haider Samawi, Andrew Simpkin, James Perry, Arjun Sahgal, Sunit Das

Department of Neurosurgery Faculty Papers

Glioblastoma (GBM) is the most common high-grade primary brain tumor in adults. Standard multi-modality treatment of glioblastoma with surgery, temozolomide chemotherapy, and radiation results in transient tumor control but inevitably gives way to disease progression. The need for additional therapeutic avenues for patients with GBM led to interest in anti-angiogenic therapies, and in particular, bevacizumab. We sought to determine the efficacy of bevacizumab as a treatment for newly diagnosed GBM. We conducted a literature search using the PubMed database and Google Scholar to identify randomized controlled trials (RCTs) since 2014 investigating the safety and efficacy of bevacizumab in the treatment …


Pediatric Moyamoya Presenting As A Subarachnoid Hemorrhage From A Ruptured Anterior Cerebral Artery Aneurysm., Mohammad Hassan A. Noureldine, Ibrahim Saikali, Anis Nassif, Rita Chahinian, Ahmad Sweid, Raghid Kikano, Michel Mawad Nov 2019

Pediatric Moyamoya Presenting As A Subarachnoid Hemorrhage From A Ruptured Anterior Cerebral Artery Aneurysm., Mohammad Hassan A. Noureldine, Ibrahim Saikali, Anis Nassif, Rita Chahinian, Ahmad Sweid, Raghid Kikano, Michel Mawad

Department of Neurosurgery Faculty Papers

BACKGROUND: The incidence of Moyamoya disease (MMD)-associated intracranial aneurysms ranges from 3% to 14% in adult patients, whereas this complication has rarely been reported in children.

CASE DESCRIPTION: We herein report the first case, to our knowledge, of an extremely rare subarachnoid hemorrhage presentation of a child with a ruptured anterior cerebral artery dissecting aneurysm secondary to a newly discovered, unilateral Moyamoya-like pathology.

CONCLUSIONS: MMD-associated aneurysms are extremely rare in children, and hemorrhage may be the initial presentation of the disease. Prompt intervention is essential to exclude the ruptured aneurysm that is at risk of rebleeding because of persistent hemodynamic …


False In Name Only-Gastroduodenal Artery Pseudoaneurysm In A Recurrently Bleeding Patient: Case Report And Literature Review., M. Binetti, A. Lauro, R. Golfieri, S Vaccari, V D'Andrea, I. R. Marino, M. Cervellera, M. Renzulli, V. Tonini Nov 2019

False In Name Only-Gastroduodenal Artery Pseudoaneurysm In A Recurrently Bleeding Patient: Case Report And Literature Review., M. Binetti, A. Lauro, R. Golfieri, S Vaccari, V D'Andrea, I. R. Marino, M. Cervellera, M. Renzulli, V. Tonini

Department of Surgery Faculty Papers

INTRODUCTION: Although the diagnosis of visceral pseudoaneurysm is unusual, it requires emergent attention due to the risk of rupture. We describe a 70-year old man with a gastroduodenal artery (GDA) pseudoaneurysm manifest as recurrent hæmorrhage.

AREAS COVERED: We highlight the possible ætiologies, clinical presentations, diagnostic tools and treatment options for this condition. In this instance, the patient was successfully treated by selective angio-embolization.

EXPERT COMMENTARY: A visceral pseudoaneurysm should be considered in patients with abdominal pain and GI hæmorrhage. At present, angio-embolization is first-line therapy.


Nucleus Pulposus Primary Cilia Alter Their Length In Response To Changes In Extracellular Osmolarity But Do Not Control Tonebp-Mediated Osmoregulation., Hyowon Choi, Vedavathi Madhu, Irving M. Shapiro, Makarand V. Risbud Oct 2019

Nucleus Pulposus Primary Cilia Alter Their Length In Response To Changes In Extracellular Osmolarity But Do Not Control Tonebp-Mediated Osmoregulation., Hyowon Choi, Vedavathi Madhu, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

The nucleus pulposus (NP) cells adapt to their physiologically hyperosmotic microenvironment through Tonicity-responsive enhancer binding protein (TonEBP/nuclear factor of activated T-cell5 [NFAT5])-mediated osmoregulation. Primary cilia in different organs serve diverse roles including osmosensing, but its contribution to NP cell osmoadaptive response is unknown. A high percentage of cultured primary NP cells possessed primary cilia that changed length in response to osmotic stimuli. Stable silencing of Intraflagellar Transport 88 (Ift88) or Kinesin Family Member 3 A (Kif3a) to inhibit the formation of primary cilia did not affect hyperosmotic upregulation of TonEBP. While ShKif3a blocked hyperosmotic increase of TonEBP-Transactivation Domain (TAD) activity, …


The Utility Of Impedance Cardiography In Hemodynamic Monitoring Of Patients With Sepsis, James Butz, Yizhi Shan, Andres Samayoa, Orlando C. Kirton, Thai Vu Oct 2019

The Utility Of Impedance Cardiography In Hemodynamic Monitoring Of Patients With Sepsis, James Butz, Yizhi Shan, Andres Samayoa, Orlando C. Kirton, Thai Vu

Abington Jefferson Health Papers

BACKGROUND: Commonly used biochemical indicators and hemodynamic and physiologic parameters of sepsis vary with regard to their sensitivity and specificity to the diagnosis. The aim of this preliminary study was to evaluate non-invasive impedance cardiography as a monitoring tool of the hemodynamic status of patients with sepsis throughout their initial volume resuscitation to explore the possibility of identifying additional measurements to be used in the future treatment of sepsis.

METHODS: Nine patients who presented to the emergency room and received a surgical consultation during a 3-month period in 2016, meeting the clinical criteria of sepsis defined by systemic inflammatory response …


Recovery Priorities In Degenerative Cervical Myelopathy: A Cross-Sectional Survey Of An International, Online Community Of Patients., Benjamin Davies, Oliver Mowforth, Iwan Sadler, Bizhan Aarabi, Brian Kwon, Shekar Kurpad, James S Harrop, Jefferson R Wilson, Robert Grossman, Michael G Fehlings, Mark Kotter Oct 2019

Recovery Priorities In Degenerative Cervical Myelopathy: A Cross-Sectional Survey Of An International, Online Community Of Patients., Benjamin Davies, Oliver Mowforth, Iwan Sadler, Bizhan Aarabi, Brian Kwon, Shekar Kurpad, James S Harrop, Jefferson R Wilson, Robert Grossman, Michael G Fehlings, Mark Kotter

Department of Neurosurgery Faculty Papers

OBJECTIVES: To establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM).

DESIGN: A cross-sectional, observational study.

SETTING: Patients from across the world with a diagnosis of DCM accessed the survey over an 18-month period on Myelopathy.org, an international myelopathy charity.

PARTICIPANTS: 481 individuals suffering from DCM completed the online survey fully.

MAIN OUTCOME MEASURES: Functional recovery domains were established through qualitative interviews and a consensus process. Individuals were asked about their disease characteristics, including limb pain (Visual Analogue Scale) and functional disability (patient-derived version of the modified Japanese Orthopaedic Association score). Individuals ranked recovery domains (arm and …


Ethical Standards For Cardiothoracic Surgeons' Participation In Social Media., Thomas K. Varghese, John W. Entwistle, John E. Mayer, Susan D. Moffatt-Bruce, Robert M. Sade Oct 2019

Ethical Standards For Cardiothoracic Surgeons' Participation In Social Media., Thomas K. Varghese, John W. Entwistle, John E. Mayer, Susan D. Moffatt-Bruce, Robert M. Sade

Department of Surgery Faculty Papers

No abstract provided.


Endovascular Management And The Risk Of Late Failure In The Treatment Of Ureteroarterial Fistulas, George Titomihelakis, Anthony Feghali, Tuong Nguyen, Dawn Salvatore, Paul Dimuzio, Babak Abai Sep 2019

Endovascular Management And The Risk Of Late Failure In The Treatment Of Ureteroarterial Fistulas, George Titomihelakis, Anthony Feghali, Tuong Nguyen, Dawn Salvatore, Paul Dimuzio, Babak Abai

Department of Medicine Faculty Papers

Ureteroarterial fistula (UAF) is a rare and life-threatening source of hematuria. A high index of suspicion is warranted for early diagnosis and timely intervention. Because of high perioperative risk and comorbidities in UAF patients, the endovascular approach has become preferred for repair. Infection can complicate this mode of therapy, and treatment with antibiotics is important. Herein we present five cases of secondary UAFs treated with stent graft alone or stent graft and embolization.


Perioperative Use Of Renin-Angiotensin System Inhibitors And Outcomes In Patients Undergoing Cardiac Surgery., Qian Ding, Zugui Zhang, Hong Liu, Huang Nie, Mark Berguson, Jordan E. Goldhammer, Nilas Young, Douglas Boyd, Rohinton Morris, Jianzhong Sun Sep 2019

Perioperative Use Of Renin-Angiotensin System Inhibitors And Outcomes In Patients Undergoing Cardiac Surgery., Qian Ding, Zugui Zhang, Hong Liu, Huang Nie, Mark Berguson, Jordan E. Goldhammer, Nilas Young, Douglas Boyd, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Faculty Papers

It remains disputable about perioperative use of renin-angiotensin system inhibitors (RASi) and their outcome effects. This multicenter retrospective cohort study examines association between use of perioperative RASi and outcomes in patients undergoing coronary artery bypass graft and/or valve surgery. After the exclusion, the patients are divided into 2 groups with or without preoperative RASi (PreRASi, n = 8581), or 2 groups with or without postoperative RASi (PostRASi, n = 8130). With using of propensity scores matching to reduce treatment selection bias, the study shows that PreRASi is associated with a significant reduction in postoperative 30-day mortality compared with without one …


Irisin Functions To Inhibit Malignant Growth Of Human Pancreatic Cancer Cells Via Downregulation Of The Pi3k/Akt Signaling Pathway., Deguo Zhang, Ping Zhang, Luan Li, Nan Tang, Fei Huang, Xianguo Kong, Xueying Tan, Guangjun Shi Sep 2019

Irisin Functions To Inhibit Malignant Growth Of Human Pancreatic Cancer Cells Via Downregulation Of The Pi3k/Akt Signaling Pathway., Deguo Zhang, Ping Zhang, Luan Li, Nan Tang, Fei Huang, Xianguo Kong, Xueying Tan, Guangjun Shi

Department of Medicine Faculty Papers

Introduction: Irisin is a newly identified cytokine that has gained increasing attention because of its potential therapeutic applications in metabolic diseases and human cancers. Recently, accumulating evidence indicates that irisin plays an important role in the development and metastasis of various tumors. The aim of this study was to evaluate the effects and underlying mechanisms of irisin on malignant growth of pancreatic cancer cells.

Materials and methods: The anti-proliferative effect of irisin was examined using the CCK-8 assay. Irisin-induced apoptosis was determined by the annexin V-FITC/PI staining assay. The effects of irisin on cell migration and invasion were assessed using …


Surgical Stress And Cancer Progression: The Twisted Tango., Zhiwei Chen, Peidong Zhang, Ya Xu, Jiahui Yan, Zixuan Liu, Wayne Bond Lau, Bonnie Lau, Ying Li, Xia Zhao, Yuquan Wei, Shengtao Zhou Sep 2019

Surgical Stress And Cancer Progression: The Twisted Tango., Zhiwei Chen, Peidong Zhang, Ya Xu, Jiahui Yan, Zixuan Liu, Wayne Bond Lau, Bonnie Lau, Ying Li, Xia Zhao, Yuquan Wei, Shengtao Zhou

Department of Emergency Medicine Faculty Papers

Surgical resection is an important avenue for cancer treatment, which, in most cases, can effectively alleviate the patient symptoms. However, accumulating evidence has documented that surgical resection potentially enhances metastatic seeding of tumor cells. In this review, we revisit the literature on surgical stress, and outline the mechanisms by which surgical stress, including ischemia/reperfusion injury, activation of sympathetic nervous system, inflammation, systemically hypercoagulable state, immune suppression and effects of anesthetic agents, promotes tumor metastasis. We also propose preventive strategies or resolution of tumor metastasis caused by surgical stress.


Meta-Analysis A Myriad Of Data - Is It Helpful?, James Harrop Sep 2019

Meta-Analysis A Myriad Of Data - Is It Helpful?, James Harrop

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.


Outcomes Of Bilateral Shoulder Arthroplasties: A Comparison Of Bilateral Total Shoulder Arthroplasties And Bilateral Reverse Shoulder Arthroplasties., Ryan Matthew Cox, Tyler James Brolin, Eric Michael Padegimas, Mark D. Lazarus, Charles Lonnie Getz, Matthew Lee Ramsey, Gerald Ross Williams, Joseph Albert Abboud Sep 2019

Outcomes Of Bilateral Shoulder Arthroplasties: A Comparison Of Bilateral Total Shoulder Arthroplasties And Bilateral Reverse Shoulder Arthroplasties., Ryan Matthew Cox, Tyler James Brolin, Eric Michael Padegimas, Mark D. Lazarus, Charles Lonnie Getz, Matthew Lee Ramsey, Gerald Ross Williams, Joseph Albert Abboud

Rothman Institute Faculty Papers

Background: The purpose of this study was to compare outcomes of patients who underwent bilateral total shoulder arthroplasties (TSAs) for osteoarthritis (OA) versus bilateral reverse shoulder arthroplasties (RSAs) for cuff tear arthropathy (CTA).

Methods: Inclusion criteria were patients who underwent bilateral TSAs for OA or bilateral RSAs for CTA with at least 2 years of follow-up. Twenty-six TSA patients (52 shoulders) were matched 2 to 1 with 13 RSA patients (26 shoulders) by sex, age at first surgery, and time between surgeries. Outcomes measured were shoulder range of motion (ROM), complications, and patient-reported scores.

Results: Preoperatively, TSA patients had significantly …


Optimal Timing And Route Of Nutritional Support After Esophagectomy: A Review Of The Literature., Richard Zheng, Courtney L. Devin, Michael J. Pucci, Adam C. Berger, Ernest L. Rosato, Francesco Palazzo Aug 2019

Optimal Timing And Route Of Nutritional Support After Esophagectomy: A Review Of The Literature., Richard Zheng, Courtney L. Devin, Michael J. Pucci, Adam C. Berger, Ernest L. Rosato, Francesco Palazzo

Department of Surgery Faculty Papers

Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy. Variation in practices during the perioperative period exists including the type of nutrition started, the delivery route, and its timing. Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery, which can affect their ability to regain or maintain weight. Methods of feeding after an esophagectomy include total parenteral nutrition, nasoduodenal/nasojejunal tube feeding, jejunostomy tube feeding, and oral feeding. Recent evidence suggests that early oral feeding is associated with shorter LOS, faster return of …


Commentary: The History Of Neurosurgery At Albany Medical College And Albany Medical Center Hospital, Albany, New York., Pouya Entezami, Michael R. Gooch, Adedamola Adepoju, Julie Pilitsis, Tyler J. Kenning, Alan Boulos, David L. Semenoff Jul 2019

Commentary: The History Of Neurosurgery At Albany Medical College And Albany Medical Center Hospital, Albany, New York., Pouya Entezami, Michael R. Gooch, Adedamola Adepoju, Julie Pilitsis, Tyler J. Kenning, Alan Boulos, David L. Semenoff

Department of Neurosurgery Faculty Papers

The origins of the Department of Neurosurgery at Albany Medical College closely parallel the development of early America and the establishment of modern health care.The tales of Washington Irving, the works of the Hudson River School of painters, and summers in the Catskill Mountains or Adirondacks are the stories that color the history of Upstate New York (Figure1). As a social, industrial, and political hub of the American colonies, New England’s need for centers providing structured medicine led to the creation of Albany Medical College in1839, one of the earliest such institutions in the young nation.1 Rapid progress in nearly …


The Impact Of Cholesterol Deposits On The Fibrillar Architecture Of The Achilles Tendon In A Rabbit Model Of Hypercholesterolemia., Andrzej Steplewski, Jolanta Fertala, Ryan Tomlinson, Kevth'er Hoxha, Lin Han, Ocean Thakar, Jason Klein, Joseph A. Abboud, Andrzej Fertala Jun 2019

The Impact Of Cholesterol Deposits On The Fibrillar Architecture Of The Achilles Tendon In A Rabbit Model Of Hypercholesterolemia., Andrzej Steplewski, Jolanta Fertala, Ryan Tomlinson, Kevth'er Hoxha, Lin Han, Ocean Thakar, Jason Klein, Joseph A. Abboud, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Increased tendon pain and tendon damage is a significant complication related to hyperlipidemia. Unlike the well-established pathogenesis associated with increased serum concentrations of total cholesterol, triglycerides, and low-density lipoprotein in atherosclerotic cardiovascular disease, the role of hyperlipidemia in promoting tendon damage remains controversial and requires mechanistic clarity.

METHODS: In this study, we analyzed the consequences of hypercholesterolemia on the integrity of the collagen-based architecture of the Achilles tendon. The Achilles tendons from rabbits fed with normal-cholesterol (nCH) and high-cholesterol (hCH) diets were analyzed. We studied the morphology of tendons, distribution of lipids within their collagen-rich milieu, the relative amounts …


Comparison Of Surgical Outcomes Of The Posterior And Combined Approaches For Repair Of Cervical Fractures In Ankylosing Spondylitis., Panya Luksanapruksa, Paul William Millhouse, Victor Carlson, Thanase Ariyawatkul, Joshua Heller, Christopher K. Kepler Jun 2019

Comparison Of Surgical Outcomes Of The Posterior And Combined Approaches For Repair Of Cervical Fractures In Ankylosing Spondylitis., Panya Luksanapruksa, Paul William Millhouse, Victor Carlson, Thanase Ariyawatkul, Joshua Heller, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C).

OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results.

METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were …


Automated Fiber Tract Reconstruction For Surgery Planning: Extensive Validation In Language-Related White Matter Tracts., Matteo Mancini, Sjoerd B. Vos, Vejay N. Vakharia, Aidan G. O'Keeffe, Karin Trimmel, Frederik Barkhof, Christian Dorfer, Salil Soman, Gavin P. Winston, Chengyuan Wu, John S. Duncan, Rachel Sparks, Sebastien Ourselin May 2019

Automated Fiber Tract Reconstruction For Surgery Planning: Extensive Validation In Language-Related White Matter Tracts., Matteo Mancini, Sjoerd B. Vos, Vejay N. Vakharia, Aidan G. O'Keeffe, Karin Trimmel, Frederik Barkhof, Christian Dorfer, Salil Soman, Gavin P. Winston, Chengyuan Wu, John S. Duncan, Rachel Sparks, Sebastien Ourselin

Department of Neurosurgery Faculty Papers

Diffusion MRI and tractography hold great potential for surgery planning, especially to preserve eloquent white matter during resections. However, fiber tract reconstruction requires an expert with detailed understanding of neuroanatomy. Several automated approaches have been proposed, using different strategies to reconstruct the white matter tracts in a supervised fashion. However, validation is often limited to comparison with manual delineation by overlap-based measures, which is limited in characterizing morphological and topological differences. In this work, we set up a fully automated pipeline based on anatomical criteria that does not require manual intervention, taking advantage of atlas-based criteria and advanced acquisition protocols …


Cervical Posterior Longitudinal Ligament Ossification : Microscopy-Assisted Anterior Corpectomy And Fusion., Wanyi Wang, Tao Ding, James Harrop, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Yuntao Xue, Miao Lu, Chao Wu May 2019

Cervical Posterior Longitudinal Ligament Ossification : Microscopy-Assisted Anterior Corpectomy And Fusion., Wanyi Wang, Tao Ding, James Harrop, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Yuntao Xue, Miao Lu, Chao Wu

Department of Neurosurgery Faculty Papers

OBJECTIVE: To explore the clinical efficacy and safety of microscopy-assisted anterior corpectomy and fusion for cervical ossification of the posterior longitudinal ligament (OPLL).

METHODS: A retrospective review of 32 cervical OPLL patients who underwent microscopy-assisted anterior corpectomy and fusion from June 2012 to March 2017 was carried out. Patients were evaluated with outcome metrics: Japanese Orthopaedic Association (JOA) scores (17 points method), visual analog scale (VAS), and radiographic parameters of the lordotic angle. The complications during treatment and follow-up were recorded.

RESULTS: This study included 32 patients (15 males and 17 females) with a mean age of 58.3 ± 2.9 …


Management Of Acute Traumatic Central Cord Syndrome: A Narrative Review, Srikanth N. Divi, Gregory D. Schroeder, John J. Mangan, Madeline Tadley, Wyatt L. Ramey, Jetan H. Badhiwala, Michael G. Fehlings, F. Cumhur Oner, Frank Kandziora, Lorin M. Benneker, Emiliano N. Vialle, Shanmuganathan Rajasekaran, Jens R. Chapman, Alexander R. Vaccaro May 2019

Management Of Acute Traumatic Central Cord Syndrome: A Narrative Review, Srikanth N. Divi, Gregory D. Schroeder, John J. Mangan, Madeline Tadley, Wyatt L. Ramey, Jetan H. Badhiwala, Michael G. Fehlings, F. Cumhur Oner, Frank Kandziora, Lorin M. Benneker, Emiliano N. Vialle, Shanmuganathan Rajasekaran, Jens R. Chapman, Alexander R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

Study Design: Narrative review.Objectives:To provide an updated overview of the management of acute traumatic central cord syndrome (ATCCS).

Methods: A comprehensive narrative review of the literature was done to identify evidence-based treatment strategies forpatients diagnosed with ATCCS.

Results: ATCCS is the most commonly encountered subtype of incomplete spinal cord injury and is characterized by worsesensory and motor function in the upper extremities compared with the lower extremities. It is most commonly seen in thesetting of trauma such as motor vehicles or falls in elderly patients. The operative management of this injury has been historicallyvariable as it can be seen in …


Guidance Of Sentinel Lymph Node Biopsy Decisions In Patients With T1-T2 Melanoma Using Gene Expression Profiling., John T. Vetto, Eddy C. Hsueh, Brian R. Gastman, Larry D. Dillon, Federico A. Monzon, Robert W. Cook, Jennifer Keller, Xin Huang, Andrew Fleming, Preston Hewgley, Pedram Gerami, Sancy Leachman, Jeffrey D. Wayne, Adam C. Berger, Martin D. Fleming Apr 2019

Guidance Of Sentinel Lymph Node Biopsy Decisions In Patients With T1-T2 Melanoma Using Gene Expression Profiling., John T. Vetto, Eddy C. Hsueh, Brian R. Gastman, Larry D. Dillon, Federico A. Monzon, Robert W. Cook, Jennifer Keller, Xin Huang, Andrew Fleming, Preston Hewgley, Pedram Gerami, Sancy Leachman, Jeffrey D. Wayne, Adam C. Berger, Martin D. Fleming

Department of Surgery Faculty Papers

AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?

PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.

RESULTS: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.

CONCLUSION: The 31-gene expression profile test identifies patients …


Nelfe-Dependent Myc Signature Identifies A Unique Cancer Subtype In Hepatocellular Carcinoma., Hien Dang, Yotsawat Pomyen, Sean P. Martin, Dana A. Dominguez, Sun Young Yim, Ju-Seog Lee, Anuradha Budhu, Ashesh P. Shah, Adam S. Bodzin, Xin Wei Wang Mar 2019

Nelfe-Dependent Myc Signature Identifies A Unique Cancer Subtype In Hepatocellular Carcinoma., Hien Dang, Yotsawat Pomyen, Sean P. Martin, Dana A. Dominguez, Sun Young Yim, Ju-Seog Lee, Anuradha Budhu, Ashesh P. Shah, Adam S. Bodzin, Xin Wei Wang

Department of Surgery Faculty Papers

The MYC oncogene is dysregulated in approximately 30% of liver cancer. In an effort to exploit MYC as a therapeutic target, including in hepatocellular carcinoma (HCC), strategies have been developed on the basis of MYC amplification or gene translocation. Due to the failure of these strategies to provide accurate diagnostics and prognostic value, we have developed a Negative Elongation Factor E (NELFE)-Dependent MYC Target (NDMT) gene signature. This signature, which consists of genes regulated by MYC and NELFE, an RNA binding protein that enhances MYC-induced hepatocarcinogenesis, is predictive of NELFE/MYC-driven tumors that would otherwise not be identified by gene amplification …


A Novel Handheld Robotic-Assisted System For Unicompartmental Knee Arthroplasty: Surgical Technique And Early Survivorship., Andrew K. Battenberg, Nathan A. Netravali, Jess H. Lonner Feb 2019

A Novel Handheld Robotic-Assisted System For Unicompartmental Knee Arthroplasty: Surgical Technique And Early Survivorship., Andrew K. Battenberg, Nathan A. Netravali, Jess H. Lonner

Department of Orthopaedic Surgery Faculty Papers

Technology, including robotics, has been developed for use in unicompartmental knee arthroplasty (UKA) to improve accuracy and precision of bone preparation, implant positioning, and soft tissue balance. The NAVIO™ System (Smith and Nephew, Pittsburgh, PA, United States) is a handheld robotic system that assists surgeons in planning implant positioning based on an individual patient's anatomy and then preparing the bone surface to accurately achieve the plan. The surgical technique is presented herein. In addition, initial results are presented for 128 patients (mean age 64.7 years; 57.8% male) undergoing UKA with NAVIO. After a mean of follow-up period of 2.3 years, …


An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd Feb 2019

An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd

Phase 1

Introduction: The utilization of ultrasound-guided peripheral nerve blocks in orthopedic surgery has increased in popularity as the anesthesia of choice for the management of perioperative pain. Peripheral nerve blockade has been shown to increase overall surgical efficiency, improve patient satisfaction, reduce postoperative narcotic use, and decrease the duration of facility admissions, while increasing overall cost-effectiveness. To date, scant literature exists regarding the safety and efficacy of ultrasound-guided supraclavicular blocks used in common hand surgery procedures, and the rate of neurologic and vascular complications remains unknown.

Objective: The purpose of this study was to examine the effectiveness and complication rate of …


Stage Of Disease And Likelihood Of Surgical Intervention In Colon Cancer Patients: An Exploratory Analysis Of The Seer Database, R. Denneny, D. Delgado, V. Nguyen, J. Subramoney, B. George, E. Mitchell, Md Feb 2019

Stage Of Disease And Likelihood Of Surgical Intervention In Colon Cancer Patients: An Exploratory Analysis Of The Seer Database, R. Denneny, D. Delgado, V. Nguyen, J. Subramoney, B. George, E. Mitchell, Md

Phase 1

Introduction/Objectives: Colorectal cancer (CRC) remains as the third-leading cause of cancer-related deaths amongst both men and women in the United States. However, the mortality rate from CRC continues to drop, which has been attributed to increased surgical polyp removal. This study explored the association between disease stage and the likelihood of surgical intervention as primary treatment for the disease.

Methods: Retrospective cohort study analysis using de-identified patient data from the NCI’s Surveillance, Epidemiology, and End Results (SEER) database from 1998-2015. Inclusion criteria included patients with colon cancer, over 18 years of age, with known disease in either the proximal or …