Bone Flap Management In Neurosurgery

Bone flap removal procedure is growing in frequency in neurosurgical practice. Decompressive craniotomy has gained more scientifical evidences of its therapeutical value in post-traumatic brain swelling, in cerebrovascular diseases and in brain edema non - responding to clinical treatment after elective surgeries. Bone flap destination after craniotomy has many possible fates. We present a literature review of bone flap management in neurosurgical practice: technical preservation of bone flaps (under the scalp, in the abdominal wall, frozen), when to remove the bone flap and what to do when it is dropped during the craniotomy or is infected.172133137Movassaghi, K., Ver Halen, J., Ganchi, P., Amin-Hanjani, S., Mesa, J., Yaremchuk, M.J., Cranioplasty with subcutaneously preserved autologous bone grafts (2006) Plast Reconstr Surg, 117 (1), pp. 202-206Hauptli, J., Segantini, P., New tissue preservation method for bone flaps following decompressive craniotomy (1980) Helv Chir Acta, 47 (1-2), pp. 121-124Tybor, K., Fortuniak, J., Komunski, P., Papiez, T., Andrzejak, S., Jaskólski, D., Supplementation of cranial defects by an autologous bone flap stored in the abdominal wall (2005) Neurol Neurochir Pol, 39 (3), pp. 220-224Josan, V.A., Sgouros, S., Walsh, A.R., Dover, M.S., Nishikawa, H., Hockley, A.D., Cranioplasty in children (2005) Childs Nerv Syst, 21 (3), pp. 200-204Flannery, T., McConnell, R.S., Cranioplasty: Why throw the bone flap out? (2001) Br J Neurosurg, 15 (6), pp. 518-520Krishnan, P., Bhattacharyya, A.K., Sil, K., De, R., Bone flap preservation after decompressive craniectomy - experience with 55 cases (2006) Neurol India, 54 (3), pp. 291-292Korfali, E., Aksoy, K., Preservation of craniotomy bone flaps under the scalp (1988) Surg Neurol, 30 (4), pp. 269-272Goel, A., Deogaonkar, M., Subgaleal preservation of calvarial flaps (1995) Surg Neurol, 44 (2), pp. 181-182. , Aug;, discussion 182-3Pasaoglu, A., Kurtsoy, A., Koc, R.K., Kontas, O., Akdemir, H., Öktem, I.S., Cranioplasty with bone flaps preserved under the scalp (1996) Neurosurg Rev, 19 (3), pp. 153-156Iwama, T., Yamada, J., Imai, S., Shinoda, J., Funakoshi, T., Sakai, N., The use of frozen autogenous bone flaps in delayed cranioplasty revisited (2003) Neurosurgery, 52 (3), pp. 591-596Winkler, P.A., Stummer, W., Linke, R., Krishnan, K.G., Tatsch, K., The influence of cranioplasty on postural blood flow regulation, cerebrovascular reserve capacity, and cerebral glucose metabolism (2000) Neurosurg Focus, 8 (1), pp. e9Matsuno, A., Tanaka, H., Iwamuro, H., Takanashi, S., Miyawaki, S., Nakashima, M., Analyses of the factors influencing bone graft infection after delayed cranioplasty (2006) Acta Neurochir (Wien), 148 (5), pp. 535-540Yacubian-Fernandes, A., Laronga, P.R., Coelho, R.A., Ducati, L.G., Silva, M.V., Prototyping as an alternative to cranioplasty using methylmethacrylate: Technical, 62 (3 B), pp. 865-868. , note. Arq Neuropsiquiatr 2004;Chiarini, L., Figurelli, S., Pollastri, G., Torcia, E., Ferrari, F., Albanese, M., Cranioplasty using acrylic material: A new technical procedure (2004) J Craniomaxillofac Surg, 32 (1), pp. 5-9Korinek, A.M., Risk factors for neurosurgical site infections after craniotomy: A prospective multicenter study of 2944 patients. The French Study Group of Neurosurgical Infections, the SEHP, and the C-CLIN Paris-Nord. Service Epidemiologie Hygiene et Prevention (1997) Neurosurgery, 41 (5), pp. 1073-1079Bruce, J.N., Bruce, S.S., Preservation of bone flaps in patients with postcraniotomy infections (2003) J Neurosurg, 98 (6), pp. 1203-1207Auguste, K.I., McDermott, M.W., Salvage of infected craniotomy bone flaps with the wash-in, wash-out indwelling antibiotic irrigation system. Technical note and case series of 12 patients (2006) J Neurosurg, 105 (4), pp. 640-644Jankowitz, B.T., Kondziolka, D.S., When the bone flap hits the floor (2006) Neurosurgery, 59 (3), pp. 585-59

The flavonoid agathisflavone modulates the microglial neuroinflammatory response and enhances remyelination

Myelin loss is the hallmark of the demyelinating disease multiple sclerosis (MS) and plays a significant role in multiple neurodegenerative diseases. A common factor in all neuropathologies is the central role of microglia, the intrinsic immune cells of the central nervous system (CNS). Microglia are activated in pathology and can have both pro- and anti-inflammatory functions. Here, we examined the effects of the flavonoid agathisflavone on microglia and remyelination in the cerebellar slice model following lysolecithin induced demyelination. Notably, agathisflavone enhances remyelination and alters microglial activation state, as determined by their morphology and cytokine profile. Furthermore, these effects of agathisflavone on remyelination and microglial activation were inhibited by blockade of estrogen receptor α. Thus, our results identify agathisflavone as a novel compound that may act via ER to regulate microglial activation and enhance remyelination and repair

Study of using marker assisted selection on a beef cattle breeding program by model comparison

[EN] A data set of a commercial Nellore beef cattle selection program was used to compare breeding models that assumed or not markers effects to estimate the breeding values, when a reduced number of animals have phenotypic, genotypic and pedigree information available. This herd complete data set was composed of 83,404 animals measured for weaning weight (WW), post-weaning gain (PWG), scrotal circumference (SC) and muscle score (MS), corresponding to 116,652 animals in the relationship matrix. Single trait analyses were performed by MTDFREML software to estimate fixed and random effects solutions using this complete data. The additive effects estimated were assumed as the reference breeding values for those animals. The individual observed phenotype of each trait was adjusted for fixed and random effects solutions, except for direct additive effects. The adjusted phenotype composed of the additive and residual parts of observed phenotype was used as dependent variable for models' comparison. Among all measured animals of this herd, only 3160 animals were genotyped for 106 SNP markers. Three models were compared in terms of changes on animals' rank, global fit and predictive ability. Model 1 included only polygenic effects, model 2 included only markers effects and model 3 included both polygenic and markers effects. Bayesian inference via Markov chain Monte Carlo methods performed by TM software was used to analyze the data for model comparison. Two different priors were adopted for markers effects in models 2 and 3, the first prior assumed was a uniform distribution (U) and, as a second prior, was assumed that markers effects were distributed as normal (N). Higher rank correlation coefficients were observed for models 3_U and 3_N, indicating a greater similarity of these models animals' rank and the rank based on the reference breeding values. Model 3_N presented a better global fit, as demonstrated by its low DIC. The best models in terms of predictive ability were models 1 and 3_N. Differences due prior assumed to markers effects in models 2 and 3 could be attributed to the better ability of normal prior in handle with collinear effects. The models 2_U and 2_N presented the worst performance, indicating that this small set of markers should not be used to genetically evaluate animals with no data, since its predictive ability is restricted. In conclusion, model 3_N presented a slight superiority when a reduce number of animals have phenotypic, genotypic and pedigree information. It could be attributed to the variation retained by markers and polygenic effects assumed together and the normal prior assumed to markers effects, that deals better with the collinearity between markers. (C) 2012 Elsevier B.V. All rights reserved.We are grateful to the Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), Merialilgenity and Conselho Nacional de apoio a Pesquisa (CNPq) for the financial support, to Agro-Pecuaria CFM for data set and the Institut de Investigacion y Tecnologia Agroalimentarias de Cataluña (IRTA) as the host institution for its full backing while preparing the research and the manuscript.Rezende, F.; Ferraz, J.; Eler, J.; Silva, R.; Mattos, E.; Ibáñez-Escriche, N. (2012). Study of using marker assisted selection on a beef cattle breeding program by model comparison. Livestock Science. 147(1-3):40-48. https://doi.org/10.1016/j.livsci.2012.03.017S40481471-

Inhalation of the prodrug PI3K inhibitor CL27c improves lung function in asthma and fibrosis

PI3K activation plays a central role in the development of pulmonary inflammation and tissue remodeling. PI3K inhibitors may thus offer an improved therapeutic opportunity to treat non-resolving lung inflammation but their action is limited by unwanted on-target systemic toxicity. Here we present CL27c, a prodrug pan-PI3K inhibitor designed for local therapy, and investigate whether inhaled CL27c is effective in asthma and pulmonary fibrosis. Mice inhaling CL27c show reduced insulin-evoked Akt phosphorylation in lungs, but no change in other tissues and no increase in blood glycaemia, in line with a local action. In murine models of acute or glucocorticoid-resistant neutrophilic asthma, inhaled CL27c reduces inflammation and improves lung function. Finally, inhaled CL27c administered in a therapeutic setting protects from bleomycin-induced lung fibrosis, ultimately leading to significantly improved survival. Therefore, local delivery of a pan-PI3K inhibitor prodrug reduces systemic on-target side effects but effectively treats asthma and irreversible pulmonary fibrosis

Sources and rates of potassium for sweet orange production

Fruit yield and quality of citrus trees (Citrus spp.) is markedly affected by potassium (K) fertilization. Potassium chloride is the major source of K, even though other sources are also available for agricultural use when crops are sensitive to chloride or where potential for accumulation of salts in soils exists. Only few studies addressed the effect of K sources on yield and quality of citrus fruits. Therefore, the present study was conducted to evaluate K2SO4 and KCl fertilizer sources at 0, 100, 200, and 300 kg ha-1 per year K2O on fruit yield and quality of 'Pêra' and 'Valencia' sweet orange trees in the field. The experiments were carried out in a 4 × 2 factorial design under randomized complete blocks, with four replicates from 2001 to 2004. Fruit yield increased with increased K fertilization. Nutrient rate for maximum economic yield of 'Pêra' was 200 kg ha-1 of K2O and for 'Valencia', 270 kg ha-1 of K2O. Differences were attributed to higher production and K exportation by fruits of 'Valencia'. Fruit mass also increased with increased K fertilization what decreased total soluble solids in juice, and which correlated with leaf K concentrations for 'Valencia' (r = 0.76; p < 0.05). Leaf Ca, Mg and B concentrations decreased with K rates. Additionally, leaf Cl increased up to 440 mg kg-1 with KCl rates, even though no negative effects occurred either on fruit yield or quality of trees