scholarly journals Neural plasticity following surgical correction of strabismus in monkeys

2018 ◽  
Author(s):  
Mythri Pullela ◽  
Mehmet N. Ağaoğlu ◽  
Anand C. Joshi ◽  
Sevda Ağaoğlu ◽  
David K. Coats ◽  
...  
Keyword(s):  
Neural Plasticity ◽  
Strabismus Surgery ◽  
Muscle Adaptation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Monkey Model ◽  
Divergent Strabismus ◽  
Peripheral Muscle ◽  
Before And After ◽  
Correction Surgery

AbstractThe preferred treatment for correcting strabismus in humans involves the surgical manipulation of extraocular muscles (EOM). Although widely practiced, this treatment has varying levels of success and permanence, possibly due to adaptive responses within the brain or at the muscle. We investigated neural plasticity following strabismus surgery by recording responses from cells in the oculomotor and abducens nuclei before and after two monkeys with exotropia (divergent strabismus) underwent a strabismus correction surgery that involved weakening of the lateral rectus (LR) and strengthening of the medial rectus (MR) muscle of one eye. Eye movement and neuronal data were collected for a period of 6-10 months after surgery during a monocular viewing smooth-pursuit task. These data were fit with a first-order equation and resulting coefficients were used to estimate the population neuronal drive (ND) to each EOM of the viewing and deviated eyes. Surgery resulted in an ~70% reduction in strabismus angle in both animals that reverted towards pre-surgical misalignment by about 6 months after treatment. In the first month after surgery, the ND to the treated MR reduced in one animal and ND to the LR increased in the other animal, both indicating active neural plasticity that reduced the effectiveness of the treatment. Although these neuronal drive changes resolved by 6 months, we also found evidence for an inappropriate peripheral muscle adaptation that limited the effectiveness of surgery over the long term. Outcome of strabismus correction surgery could be improved by identifying ways to enhance ‘positive’ adaptation and limit ‘negative’ adaptation.Significance statementThis is the first study of its kind to longitudinally follow behavioral and neural responses before and after a typical strabismus correction surgery in a monkey model for strabismus. We show the nature of muscle and neuronal plasticity that follows strabismus correction surgery.

Cervicogenic dizziness – musculoskeletal findings before and after treatment and long-term outcome

2007 ◽  
Vol 29 (15) ◽  
pp. 1193-1205 ◽  
Author(s):  
Eva-Maj Malmström ◽  
Mikael Karlberg ◽  
Agneta Melander ◽  
Måns Magnusson ◽  
Ulrich Moritz
Keyword(s):  
Term Outcome ◽  
Long Term Outcome ◽  
Before And After ◽  
Cervicogenic Dizziness

RENAL FUNCTION IN HYPERPARATHYROIDISM

1970 ◽  
Vol 63 (1) ◽  
pp. 161-174 ◽  
Author(s):  
Lave Ohlsson
Keyword(s):  
Renal Function ◽  
Kidney Stones ◽  
Inulin Clearance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Studies ◽  
Before And After ◽  
Spontaneous Disappearance ◽  
Pah Clearance

ABSTRACT Clearances of inulin and para-aminohippurate (PAH) were studied before as well as three to nine years (average 5½) after surgery in 35 cases of primary hyperparathyroidism. The preoperative inulin clearance ranged from 18 to 105 (average 67) and the PAH clearance from 61 to 666 (349) ml/min/1.73 m2 BSA. In the follow-up studies clearances of inulin and PAH were, on the whole, well maintained both in subjects with normal as well as in cases showing depressed clearance values before surgery. In fact, a slight but statistically significant increase of inulin clearance was demonstrated in the material as a whole, whereas no significant change occurred in PAH clearance. The renal concentrating capacity was estimated before and after operation in 22 of the patients. An increase was almost regularly observed postoperatively but the concentrating capacity remained subnormal in almost half of the subjects studied. The changes in the concentrating capacity and clearances of inulin and PAH did not always run parallel. The renal clearance of phosphate was studied simultaneously with inulin and PAH clearances. Phosphate clearance decreased after surgery concomitantly with an elevation of serum phosphorus. However, restoration to the normal was not always obtained. Arterial hypertension was present in 40 per cent of the patients before and/or after surgery. Only grade I-II eye ground changes were found. Blood pressure was easily controlled by hypotensive drugs. A spontaneous disappearance or a decrease in the number of kidney stones was demonstrated radiologically at the follow-up studies in almost half of the patients. In only two subjects were additional kidney stones found. It is concluded that, following surgical treatment of hyperparathyroidism, the long-term outcome regarding renal function may be more favourable than has hitherto been thought.

Microsurgical Management of Midbrain Cavernous Malformations: Predictors of Outcome and Lesion Classification in 72 Patients

2019 ◽  
Vol 17 (6) ◽  
pp. 562-572 ◽  
Author(s):  
Yoshihito Tsuji ◽  
Souvik Kar ◽  
Helmut Bertalanffy
Keyword(s):  
Clinical Results ◽  
Surgical Approaches ◽  
Time Interval ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Before And After ◽  
Oculomotor Disturbances ◽  
Eye Movement Disorders

Abstract BACKGROUND Due to the complex segmental organization of the brainstem, it is preferable to study midbrain cavernous malformations (MCMs) separately from pontine and medullary lesions. OBJECTIVE To evaluate clinical results after microsurgical removal of MCMs, assess predictors for outcome and introduce a topographical classification of MCMs. METHODS A retrospective study was conducted on consecutive patients who underwent MCM resection. Clinical parameters before and after surgery, morphological CM features, surgical approaches and outcomes were analyzed. MCMs were classified according to their exact location within the midbrain and their axial and sagittal extension. RESULTS The authors reviewed 72 patients (35 male). Lesions varied in size between 4 and 55 mm. The vast majority of patients benefited from surgery. The mean modified Rankin Scale (mRS) decreased significantly from 1.6 at admission to 1.3 at discharge and to 0.7 at follow-up (6-247 mo postoperatively). Five patients (6.9%) suffered from delayed hypertrophic olivary degeneration as visualized on magnetic resonance imaging. One male suffered from early postoperative re-bleeding that required surgical hematoma evacuation. There were no severe long tract impairment or other disabling complications, no delayed re-bleedings, and no surgical mortality. CONCLUSION We present a new topographic classification of MCMs that may be useful for predicting the occurrence of postoperative eye movement disorders. Other predictors of persistent oculomotor disturbances are time interval between onset of symptoms and surgery, and patient's age over 40 yr. Early surgery is recommendable in patients with oculomotor disturbances. MCM size over 18 mm, patient age over 40 yr, and poor mRS at admission are important predictors for the long-term outcome.

Altered serum levels of thyroxine, triiodothyronines and diiodothyronines in endogenous depression

1981 ◽  
Vol 96 (2) ◽  
pp. 199-207 ◽  
Author(s):  
C. Kirkegaard ◽  
J. Faber
Keyword(s):  
Similar Pattern ◽  
Serum Levels ◽  
Endogenous Depression ◽  
Serum Concentrations ◽  
Electroconvulsive Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Before And After ◽  
Altered Serum

Abstract. Serum levels of thyroxine (T4), 3,3',5-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), 3,5-diiodothyronine (3,5-T2), 3,3'-diiodothyronine (3,3'-T2) and 3',5'-diiodothyronine (3',5'-T2) were studied in 80 patients with endogenous depression before and after electroconvulsive treatment (ECT). Compared to the values found after recovery, the patients when depressed had significant increased serum levels of T4, rT3, 3,3'-T2 and 3',5'-T2. Serum concentrations of T3 and 3,5-T2 were not significantly altered. Similarly the free T4 index (FT4I) was increased, while the free T3 index (FT3I) was unaffected. Previous studies have shown a reduced TSH response to TRH in patients with endogenous depression and that the long-term outcome after ECT is strongly related to changes in the TSH response. However, patients with increased TSH response to TRH (n = 23) had a pattern of serum iodothyronine concentrations similar to those (n = 57) with an unchanged TSH response. A similar pattern was also found in 7 patients with non-endogenous psychosis, in whom the TSH response to TRH was unchanged after recovery. It is concluded that the alterations of the TSH response to TRH found in endogenous depression cannot be explained by changes of FT4I or FT3I.

Does a fabella-tibial suture alter the outcome for dogs with cranial cruciate ligament insufficiency undergoing arthrotomy and caudal pole medial meniscectomy?

2009 ◽  
Vol 22 (04) ◽  
pp. 283-288 ◽  
Author(s):  
E.J. Comerford ◽  
M.R. Owen ◽  
M.S. Tivers
Keyword(s):  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Control Group ◽  
Term Outcome ◽  
Cranial Cruciate Ligament ◽  
Long Term Outcome ◽  
Stifle Joint ◽  
Medial Meniscectomy ◽  
Before And After ◽  
Clinical Records

Summary Objectives: The objective of this study was to evaluate the effects of fabella-tibial suture (FTS) on long-term outcome in dogs with cranial cruciate ligament (CCL) insufficiency and concurrent medial meniscal tear (MMT) that were managed by an open, caudal pole medial meniscectomy (CPMM). Methods: A retrospective review was performed of the clinical records of dogs treated for CCL insufficiency with concurrent MMT by open CPMM, with or without the non-random addition of a nylon FTS according to surgeon preference, during the period of 2001 to 2004. The Bristol Osteoarthritis in Dogs questionnaire was modified for owner assessment of outcome using a visual analogue scale based on several criteria: level of activity, disability, severity of lameness and frequency of lameness before and after surgery. Results: Completed questionnaires from 31 dog owners were received. A FTS was used after CPMM in 22 dogs (FTS group), but in nine dogs (control group) only a CPMM was performed. The median time to follow up was longer in the FTS group (25 months) than the control group (16 months) (P=0.03). There were not any significant differences between the two groups before and after surgery for the following: disability, activity, frequency of lameness, severity of lameness, ability to climb stairs and ability to sit down. Clinical Significance: The placement of a FTS following stifle joint arthrotomy and CPMM in dogs with CCL deficiency and concurrent MMT may not be a significant factor affecting the ultimate surgical outcome, although our study is limited by the non-randomised study design.

Malignancies before and after Heart Transplantation - A Single-Centre Long-Term Outcome Study

2021 ◽  
Vol 40 (4) ◽  
pp. S242-S243
Author(s):  
C.F. Stenman ◽  
A. Wallinder ◽  
E. Holmberg ◽  
K. Karason ◽  
J. Magnusson ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Outcome Study ◽  
Single Centre ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Before And After

scholarly journals Balloon-mounted stenting for ICAS in a multicenter registry study in China: a comparison with the WEAVE/WOVEN trial

2020 ◽  
pp. neurintsurg-2020-016658
Author(s):  
Kaijiang Kang ◽  
Yong Zhang ◽  
Jie Shuai ◽  
Changchun Jiang ◽  
Qiyi Zhu ◽  
...  
Keyword(s):  
Registry Study ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Arterial Access ◽  
Stent Restenosis ◽  
Atherosclerotic Stenosis ◽  
Before And After ◽  
Intracranial Artery Stenosis ◽  
Multicenter Registry

BackgroundThe outcome of deploying balloon-mounted stents for symptomatic intracranial atherosclerotic stenosis (ICAS) has not been fully investigated. In this study we evaluate the safety and long-term outcome of using balloon-mounted stents to treat symptomatic ICAS in comparison with the WEAVE/WOVEN study.MethodsIn a multicenter registry study of stenting for symptomatic intracranial artery stenosis in China, 159 patients treated with an intracranial balloon-mounted stent approved by the China Food and Drug Administration were evaluated. The morphological features of the lesions were categorized by Mori classification. The endpoints, including periprocedural and long-term clinical and radiological outcomes, were the same as those in the WEAVE/WOVEN study.ResultsIn the present study the mean percent stenosis before and after stenting was 84.0% and 6.1%, respectively. The proportions of Mori A, Mori B, and Mori C lesions were 33.3%, 52.2%, and 14.5%, respectively. The 72-hour rates of stroke and mortality after the procedure were 0%. The 1-year rates of any stroke, ischemic stroke, hemorrhagic stroke, and death were 6.3% (10/159), 5.7% (9/159), 0.6% (1/159), and 0.6% (1/159), respectively. The 1-year rate of in-stent restenosis (ISR) was 23.4% (15/64). The rate of ISR in Mori C lesions (53.8%, 7/13) was significantly higher than that in Mori A (15.8%, 3/19) or Mori B lesions (15.6%, 5/32) (p=0.024).ConclusionsThe short-term and long-term outcomes of using a balloon-mounted stent for symptomatic ICAS with focal and non-angular lesions (Mori A and B type) and smooth arterial access were comparable to the results of the WEAVE/WOVEN trial.

scholarly journals Spinal Hemangioblastomas: Analysis of Surgical Outcome and Prognostic Factors

2021 ◽  
Author(s):  
Alberto Feletti ◽  
Alessandro Boaro ◽  
Davide Giampiccolo ◽  
Giorgio Casoli ◽  
Fabio Moscolo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neurological Outcome ◽  
Statistical Significance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Neurological Condition ◽  
Before And After ◽  
Vhl Disease ◽  
The Impact

Abstract Background. The prognostic factors for surgically removed spinal hemangioblastomas, the impact of VHL disease on outcome, and the role of intraoperative neuromonitoring are still not completely clear. The aim of this study was to review our experience with spinal hemangioblastomas in order to assess potential predictors of neurological outcome after surgery.Methods. All cases of spinal hemangioblastomas removed at two Italian academic institutions from 1985 to 2020 were reviewed. Data about clinical presentation and symptoms duration, diagnosis of VHL, surgical approach, use of IONM, duration of hospital stay, follow up, McCormick grade before and after surgery were extracted.Results. Sixty-one patients (31 F, 30 M) underwent 69 surgeries to remove 74 spinal hemangioblastomas (37 cervical, 32 thoracic, 5 lumbar). Improvement was found in 32.3% of cases, neurological condition remained stable in 51.6% of cases, and deteriorated in 16.1% of patients.A worsening trend in VHL patients and an improvement trend in non-VHL patients were detected, despite the lack of statistical significance. Laminotomy and use of IONM were found to be associated with better outcome, although no association was found between surgery without IOM and worse outcome.Conclusion. In most cases, patients affected by spinal hemangioblastomas can expect a good long-term outcome. In our experience, laminotomy seems to be associated with better outcome compared to laminectomy. While its absence is not associated with worse outcome, IONM seems to be associated with a better neurological outcome. Our study suggests that the more impaired the preoperative neurological condition, the worse the outcome.

scholarly journals Intracranial Stenting for Severe Symptomatic Stenosis: Self-Expandable versus Balloon-Expandable Stents

2013 ◽  
Vol 19 (3) ◽  
pp. 276-282 ◽  
Author(s):  
Soonchan Park ◽  
Jae-Hyuk Kim ◽  
Jae Kyun Kwak ◽  
Hye Jin Baek ◽  
Bo Hyun Kim ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Medical Treatment ◽  
Group Analysis ◽  
Reperfusion Therapy ◽  
Time Frame ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intracranial Stenting ◽  
Before And After ◽  
The Difference

Intracranial atherosclerosis against optimal medical treatment requires reperfusion therapy to improve the clinical outcome. We compared outcomes between self-expandable stent (SES) and/ or balloon-expandable stent (BES) and present the potential advantages of using each stent. During the same time frame before and after Wingspan introduction to our institute, 115 consecutive patients underwent intracranial stenting for symptomatic severe intracranial stenosis against optimal medical treatment using BES alone (n = 71) vs. BES or SES (n = 44). We analyzed 15 factors including outcome related to an adverse event (AE), modified Rankin Scale (mRS) and restenosis at six months and retrospectively compared the potential advantages of using each stent. BES or SES groups had a significantly lower AE rate (2.3%) than the BES only group (14%) (P = 0.049) revealing mRS of ≤ 2 in all patients at six months compared to 93% of the patients in the BES group. Analysis of BES or SES subgroups revealed that BES was associated with less residual stenosis after stenting than SES (18 vs. 32%; P < 0.001). Both SES and BES can improve the clinical outcome of intracranial stenting especially with a selective choice of SES or BES. Further study is needed to analyse the difference in long-term outcome and the restenosis rate between SES and BES.

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