Abdilundsgaard5496

Results in cases after multilevel stabilizations were slightly worse, but still very significant in most parameters. Only one patient with the most severe morphological and clinical findings did not benefit from surgery. CONCLUSION In 10 out of 11 patients, the lower back pain and quality of life improved significantly after lumbar fusion performed in levels diagnosed by PET or SPECT/CT. These methods certainly have their place in the evaluation of CBP, especially in the case of unclear findings or multiple degenerative changes.INTRODUCTION Instrumentation of the lateral mass of atlas via posterior arch attachment (PALMS) is a method that, unlike the traditional direct screw insertion into the lateral mass, prevents damage to the periarticular venous plexus and C2 nerve root. The method itself may be, however, limited by the anatomical situation. The small cranio-caudal pedicle dimension may lead to vertebral artery damage. The aim of this study was to use morphometric examination of CT findings from the healthy population to evaluate theoretical feasibility of this technique in a randomly selected population sample. METHODS Morphometric measurements determining dimensions of C1 pedicle at the site of expected screw insertion were performed on reformatted parasagittal CT scans of 42 healthy probands. Using the software of the Jivex browser, we measured the minimum height of posterior arch insertion under the vertebral artery groove and evaluated the possibility of introducing 3.5 mm and 4 mm screws. RESULTS The mean minimum height of the critical segment was calculated as 4.29 mm (left insertion 4.28 mm, right insertion 4.31 mm, range 3.02-5.62 mm). Despite the highest size in a female and the lowest in a male, the male population showed larger bone stock (mean of 4.71 mm left connection 4.70 mm, right connection 4.71 mm) than the female one (mean of 4.29 mm left 4.28 mm, right 4.31 mm). Overall, we found 59.5% insertions higher than 4 mm and 86.9% arch connections bigger than 3.5 mm. CONCLUSION The anatomical situation allows inserting at least a 3.5mm diameter screw in a vast majority of cases. The posterior arch attachment point thus seems to be a suitable anatomical target for instrumentation of C1 lateral mass. Nevertheless, individual presurgical planning and intraoperative spinal navigation should be implemented, as well.INTRODUCTION Purpose of the study is to evaluate a possible influence of subdural drainage duration and burr hole quantity on a relapse of a unilateral chronic subdural haematoma (CHSH). METHODS Sixty - five patients who underwent evacuation of unilateral CHSH via 1 or 2 burr holes and subdural drainage during a period from January 2014 to December 2018 were retrospectively analyzed. Duration of the subdural drainage and the number of burr holes used were assessed in relation to an incidence of CHSH recurrence. According to the subdural drainage duration, we divided the patient cohort into two subgroups with the subdural drainage duration of 1-3 days and 4-5 days. We also evaluated a possible influence of the subdural drainage duration on risk of postoperative infection. RESULTS An overall incidence of CHSH recurrence was 18.5%. In 45 patients treated by means of a single burr hole the haematoma recurrence was observed in 10 patients (22.2%), in 22 patients with two burr holes recurrence occurred in 2 of them (9.1%). The difference was however, not statistically significant (p=0.3214). We did not observe any significant influence of age, gender and subdural drainage duration on the incidence of CHSH recurrence. The duration of subdural drainage had not significant impact on postoperative infection rate (p=0.0950). CONCLUSION The number of burr holes used does not affect the rate of unilateral CHSH recurrence. Similarly the duration of subdural drainage affects neither the unilateral CHSH recurrence rate nor the incidence of postoperative infection.INTRODUCTION Atlanto-occipital dissociation (AOD) is a rare and unstable injury of the craniocervical junction, associated with very high morbidity and mortality. The most common cause of this injury is high energy trauma with hyperextension of the cranium, such as car accidents. Due to specific anatomical predispositions, children and young adults are the frequently affected populations. Improving pre-hospital and early emergency care has resulted in a higher sensitivity of AOD diagnosis. METHODS A retrospective analysis of all patients with cervical spine trauma, treated at the Masaryk Hospital Trauma Center between 2008 and 2018, identified 7 patients with AOD. The cohort consisted of 5 males and 2 females, with a mean age of 19,6 years and with the age range 9 to 35 years. All cases occurred as a result of a car accident. RESULTS All patients in the cohort had findings of a highly unstable C0-C1 injury on their CT scans on admission. Four patients died early, while undergoing CPR in the emergency department. Two patients were in severe neurological states, with lesions of the upper cervical spinal cord and medulla oblongata on MRI. These patients were treated with external halo fixation and died within 3 days of the trauma. Only one patient with a new progressive neurological deficit was successfully treated using acute occipitocervical stabilization and fusion. CONCLUSION The increasing incidence of AOD requires an early diagnosis, which minimizes the risk of successive clinical deterioration. The diagnostic method of choice is the C1-condyle interval (CCI) CT assessment along with cervical spine MRI. Standard treatment of stable patients with unstable AOD injuries consists in posterior occipitocervical stabilization and fusion of C0-C2.The main goal of this comprehensive paper is to clarify the way of thoracolumbar spine The main goal of this summary paper is to describe the way of thoracolumbar spine injury classification development and to provide a detailed description of two of the most commonly used classifications - the Thoracolumbar Injury Classification and Severity Scale (TLICS) and the AOSpine Classification for Traumatic Fracture of the Thoracolumbar Spine, including their comparison and clarification of the merits introduced by the second one. The paper also formulates a recommendation of a simple algorithm enabling even less experienced clinicians to distinguish between an injury indicated for conservative treatment and one that requires surgery.Through the decades of its use in the management of neurosurgical emergencies decompressive craniectomy has found its place as a life-saving procedure capable of a radical reduction of the intracranial pressure. Clinical results and rate of survival after decompressive craniectomy vary according to the primary diagnosis, and they have been a subject of multicentric randomized trials. However,  considerable attention also needs to be kept on complications associated with the craniectomy. They are based not only on the procedures invasivity but also on the pathophysiological changes associated with a conversion of the closed intracranial space to an open one. The complications may further disturb the postoperative care and convalescence in the surviving patients, and therefore in the salvageable patients the indication of decompressive craniectomy should be based on information about the expected outcome and complications rate, at the same moment prevention, early recognition and adequate therapy of the complications should be emphasized. This work describes the most common complications occurring in patients after decompressive craniectomy, their pathophysiological principles and means of treatment and prevention.A single nickel atom embedded in graphene is one of the most representative single-atom catalysts, and it has a high activity and selectivity for electrochemical CO2 reduction (CO2R) to CO. However, the catalytic origin, especially the coordination structure of Ni, remains highly puzzling, as previous density functional theory (DFT) calculations showed that all the possible structures should be inactive and/or nonselective. Here, using ab initio molecular dynamics (AIMD) and a "slow-growth" sampling approach to evaluate the reaction kinetic barriers, we show that the charge capacity (of the site) and hydrogen bonding (with the intermediates), which were neglected/oversimplified in previous DFT calculations, play crucial roles, and including their effects can resolve the catalytic origin. Particularly, a high charge capacity allows the catalytic site to carry more charges than required for the electrochemical step, lowering the electrochemical barrier, and hydrogen bonding promotes the reaction that produces polar intermediates by stabilizing the intermediates and facilitating the H transfer from water, explaining the high selectivity for CO2R over the hydrogen evolution reaction. Consequently, we find that a hybrid coordination environment (with one nitrogen and three carbon atoms) for the Ni-atom is most active and selective for CO2R. Our work not only explains a long-standing puzzle for an important catalyst but also highlights the crucial roles of charge capacity and hydrogen bonding, which can help elucidate the mechanisms of other heterogeneous electrocatalysts in aqueous solution and enable more effective catalyst design.Novel per- and polyfluoroalkyl substances (PFASs) have become a key issue in global environmental studies. Although several novel PFASs have been discovered in atmospheric particulate matter through nontarget analysis, information on the environmental occurrence of novel PFASs in atmospheric gaseous phases and conventional sampling techniques is somewhat deficient. Therefore, this Article describes a new type of air sampler, the cryogenic air sampler (CAS), which was used to collect all atmospheric components simultaneously. Nontarget analysis then was performed through PFASs homologue analysis. A total of 117 PFAS homologues (38 classes) were discovered, 48 of which (13 classes) were identified with confidence Level 4 or above. Eleven chlorinated perfluoropolyether alcohols (3 classes) and four chlorinated perfluoropolyether carboxylic acids (2 classes) have been reported for the first time in this Article. This Article is also the first report of 12 hydrosubstituted perfluoroalkyl carboxylates (H-PFCAs) in the atmosphere. H-PFCAs and chlorinated perfluoropolyether carboxylic acids were mainly distributed in the particular phase. These results are evidence that novel chlorinated polyether PFASs should be the focus of future study.Since coffee is a significant contributor to the consumption of acrylamide, its reduction is required. Acrylamide is produced during the roasting of coffee beans, but the roasting process is an essential step in determining the taste of coffee. Acrylamide content in coffee has been suggested to decrease by reacting with proteins and/or other substances during storage, but details are unknown. Investigation of acrylamide adducts may contribute to a strategy for acrylamide reduction in coffee. In this study, a stable isotope labeling technique, combined with high-resolution mass spectrometry, allows the identification of acrylamide adducts (3-hydroxypyridine-acrylamide and pyridine-acrylamide) in canned milk coffee. Other acrylamide adducts derived from milk coffee proteins, Lys-acrylic acid and CysSO2-acrylic acid, were identified. During a 4-month storage period, the formation of these four adducts was found to reduce the total content of acrylamide by 75.3% in canned milk coffee. Therefore, endogenous proteins can be used in acrylamide reduction.