Arildsenstiles6670

RESULTS ARM was positive in 46 patients (93.8%) in group A and 43 patients (87.8%) in group B, ARM + ve LN revealed positive metastasis only in 1 patient (2.3%) in group B. Lymphedema developed in 3 (6.5% patients in group A and 9 patients (20.9%) in group B. Restriction of shoulder movement showed a non-significant difference between the two groups. CONCLUSION Axillary reverse mapping and preservation of arm lymphatics helped to decrease the lymphedema rate without compromising oncological safety in early breast cancer. BACKGROUND Regulations limit residency work hours and operating time, limiting the amount of hands-on surgical training. click here To develop alternative hands-on training, many programs teach surgical skills in laboratories and workshops with the use of simulators. The expense of computer simulators and lack of replication of the manual skills and tactile feedback of surgery limit their usefulness. We have developed 2 replicable simulators constructed from low-cost materials, which allow residents to practice the manual skills required in key portions of minimally invasive lumbar decompression and Chiari decompression surgeries. The objective was to review the efficacy of our lumbar and Chiari decompression simulators in improving resident and medical student surgical skills. METHODS Resident and medical student participants completed one or both simulators 10 times. The lumbar decompression simulations were evaluated by the length of time participants blocked the field of view and by the number of times they lost control of the drill. Chiari decompression simulations were evaluated by the length of time to complete the simulation and by the regularity of their sutures. RESULTS After 10 attempts, participants of the lumbar decompression simulator decreased the amount of time blocking the field of view by 52% and decreased the number of times they lost control of the drill by 69%. Participants of the Chiari decompression simulator decreased their suturing time by 56% and improved the regularity of their sutures. CONCLUSIONS The simple and inexpensive simulators evaluated in this study were shown to improve the speed, quality of work, and comfort level of the participants. BACKGROUND Normal pressure hydrocephalus (NPH) is a syndrome that was characterized several decades ago; however, its optimal diagnosis and management remain unclear. Our objective was to evaluate citation and bibliometric characteristics of the 100 most cited articles about NPH to better understand the state of research efforts in the field and where improvements may arise. METHODS Elsevier's Scopus database was searched for the 100 most cited articles that focused on NPH. Articles were characterized and various bibliometric parameters were compared. Categorical data were analyzed using Pearson χ2, and continuous data were analyzed using either linear regression or a Student t test. RESULTS The 100 most cited articles were published between 1965 and 2014, from 16 unique countries in 38 unique journals. The most common outcome types of these articles were clinical (n = 77). Median number of citations and rate of citations were 114 citations and 5.9 citations/year since publication, respectively, with a significant inverse linear relationship between the 2 parameters (P less then 0.01). The most common year of publication was 2002 (n = 10), and the most common country of origin was the United States (n = 40). Higher citation rates were associated with more recent articles (P less then 0.01) and more authors (P less then 0.01). CONCLUSIONS In the 100 most cited articles about NPH, there has been a distinct shift toward a more globalized effort in recent decades. The lack of more impactful articles in recent decades highlights that particular classic studies still penetrate practice and the possible need to reconsider our contemporary views on NPH to further advance the field. BACKGROUND It is well known that clinical improvements following surgical intervention are variable. While all surgeons strive to maximize reliability and degree of improvement, certain patients will fail to achieve meaningful gains. We aim to analyze patients who failed to reach minimal clinically important difference (MCID) in an effort to improve outcomes for minimally invasive deformity surgery. METHODS Data were collected on a multicenter registry of minimally invasive surgery adult spinal deformity surgeries. Patient inclusion criteria were age ≥18 years, coronal Cobb ≥20 degrees, pelvic incidence-lumbar lordosis ≥10 degrees, or a sagittal vertical axis >5 cm. All patients had minimum 2 years' follow-up (N = 222). MCID was defined as 12.8 or more points of improvement in the Oswestry Disability Index. Up to 2 different etiologies for failure were allowed per patient. RESULTS We identified 78 cases (35%) where the patient failed to achieve MCID at long-term follow-up. A total of 82 identifiable causes were seen in these patients with 14 patients having multiple causes. In 6 patients, the etiology was unclear. The causes were subclassified as neurologic, medical, structural, under treatment, degenerative progression, traumatic, idiopathic, and floor effects. In 71% of cases, an identifiable cause was related to the spine, whereas in 35% the cause was not related to the spine. CONCLUSIONS Definable causes of failed MIS ASD surgery are often identifiable and similar to open surgery. In some cases the cause is treatable and structural. However, it is also common to see failure due to pathologies unrelated to the index surgery. BACKGROUND Although previous studies have reported the expression of JAK1, STAT3, and phosphorylated STAT3 in hypertrophied ligamentum flavum (LF), the role of the Janus kinase-signal transducer and activator of transcription (JAK/STAT) signaling pathway in hypertrophied LF has not been fully elucidated. The aim of this study was to identify the important JAK/STAT gene expression patterns of the 3 main receptors involved in this pathway interferon (IFN)-γ receptor (IFN-γR), IFN-α receptor (IFNAR), and interleukin (IL)-6 receptor (IL-6R). METHODS The human LF specimens were obtained from 28 patients who underwent lumbar spine surgery for either degenerative lumbar canal stenosis (DLCS) (n = 28) or lumbar disc herniation (LDH) (n = 20). In this design, patients with LDH served as the control group. The degree of fibrosis was demonstrated by Masson's trichrome staining. The location and expression profiling of the JAK/STAT pathway were analyzed by quantitative real-time polymerase chain reaction and Western blotting.