المؤلفون: Habeeb, Tamer A. A. M., Araujo-Castro, Marta, Chiaretti, Massimo, Podda, Mauro, Aiolfi, Alberto, Kryvoruchko, Igor A., Manangi, Mallikarjuna N., Shelat, Vishal, Kalmoush, Abd-Elfattah, Labib, Mohamed Fathy, Elshafey, Mohammed Hassan, Ibrahim, Sameh Mohamed Mahmoud, Abo Alsaad, Mohamed Ibrahim, Elbelkasi, Hamdi, Mansour, Mohamed Ibrahim, Elshahidy, Tamer Mohamed, Heggy, Ibrahim A., Elsayed, Rasha S., Fiad, Alaa A., Yehia, Ahmed M., Yassin, Mahmoud Abdou, Elballat, Mahmoud R., Hebeishy, Mohamed H., AboZeid, Ahmed Khaled, Saleh, Mohamed Adel Ahmed, Hamed, Abd Elwahab M., Abdelghani, Amr A., Mousa, Bassam

المصدر: Surgical Endoscopy; 20240101, Issue: Preprints p1-12, 12p

مستخلص: Background: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA). Methods: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023. Patients were divided into LRA (N= 122) and LLA (N= 149) groups. Univariate and multivariate logistic regression analyses were used to predict intraoperative HDI. In multivariate analysis for the prediction of HDI, right-sided PHEO, PHEO size, preoperative comorbidities, and preoperative systolic blood pressure were included. Results: Intraoperative HDI was significantly higher in the LRA group than in the LLA (27% vs. 9.4%, p< 0.001). In the multivariate regression analysis, right-sided tumours showed a higher risk of intraoperative HDI (odds ratio [OR] 5.625, 95% confidence interval [CI], 1.147–27.577, p= 0.033). The tumor size (OR 11.019, 95% CI 3.996–30.38, p< 0.001), presence of preoperative comorbidities [diabetes mellitus, hypertension, and coronary heart disease] (OR 7.918, 95% CI 1.323–47.412, p= 0.023), and preoperative systolic blood pressure (OR 1.265, 95% CI 1.07–1.495, p= 0.006) were associated with a higher risk of HDI in both LRA and LLA, with no superiority of one side over the other. Conclusion: LRA was associated with a significantly higher intraoperative HDI than LLA. Right-sided PHEO was a risk factor for intraoperative HDI.

المؤلفون: Labib, Mohamed, Görtz, Jonas, Brüsseler, Christian, Kallscheuer, Nicolai, Gätgens, Jochem, Jupke, Andreas, Marienhagen, Jan, Noack, Stephan

المصدر: doi:10.1101/2021.02.12.430943

جغرافية الموضوع: DE

الوصف: 3,4-Dihydroxybenzoate (protocatechuate, PCA) is a phenolic compound naturally found in edible vegetables and medicinal herbs. PCA is of interest in the chemical industry as a building block for novel polymers and has wide potential for pharmaceutical applications due to its antioxidant, anti-inflammatory, and antiviral properties. In the present study, we designed and constructed a novel Corynebacterium glutamicum strain to enable the efficient utilization of d -xylose for microbial production of PCA. The engineered strain showed a maximum PCA titer of 62.1 ± 12.1 mM (9.6 ± 1.9 g L −1 ) from d -xylose as the primary carbon and energy source. The corresponding yield was , which corresponds to 38 % of the maximum theoretical yield and is 14-fold higher compared to the parental producer strain on d -glucose. By establishing a one-pot bioreactor cultivation process followed by subsequent process optimization, the same maximum titer and a total amount of 16.5 ± 1.1 g was reached. Downstream processing of PCA from this fermentation broth was realized via electrochemically induced crystallization by taking advantage of the pH-dependent properties of PCA. Since PCA turned out to be electrochemically unstable in combination with several anode materials, a threechamber electrolysis setup was established to crystallize PCA and to avoid direct anode contact. This resulted in a maximum final purity of 95.4 %. In summary, the established PCA production process represents a highly sustainable approach, which will serve as a blueprint for the bio-based production of other hydroxybenzoic acids from alternative sugar feedstocks.

العلاقة: info:eu-repo/semantics/altIdentifier/hdl/2128/28599; https://juser.fz-juelich.de/record/894762Test; https://juser.fz-juelich.de/search?p=id:%22FZJ-2021-03376%22Test

الإتاحة: https://doi.org/10.1101/2021.02.12.430943Test
https://juser.fz-juelich.de/record/894762Test
https://juser.fz-juelich.de/search?p=id:%22FZJ-2021-03376%22Test

المؤلفون: Albalkhi, Ibrahem, Shafqat, Areez, Bin-Alamer, Othman, Mallela, Arka N., Kuminkoski, Chloe, Labib, Mohamed A., Lang, Michael J., Lawton, Michael T., Morcos, Jacques J., Couldwell, William T., Abou-Al-Shaar, Hussam

المصدر: Neurosurgical Review; 9/20/2023, p1-11, 11p

مصطلحات موضوعية: BRAIN stem, FUNCTIONAL status, MICROSURGERY, HUMAN abnormalities, CRANIAL nerves, ANGIOMAS, MESENCEPHALON, PROGRESSIVE supranuclear palsy

مستخلص: Brainstem cavernous malformations (CMs) encompass up to 20% of all intracranial CMs and are considered more aggressive than cerebral CMs because of their high annual bleeding rates. Microsurgical resection remains the primary treatment modality for CMs, but long-term functional outcomes and complications are heterogenous in the literature. The authors performed a systematic review on brainstem CMs in 4 databases: PubMed, EMBASE, Cochrane library, and Google Scholar. We included studies that reported on the long-term functional outcomes and complications of brainstem CMs microsurgical resection. A meta-analysis was performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search yielded 4781 results, of which 19 studies met our inclusion criteria. Microsurgery was performed on 940 patients (mean age 35 years, 46.9% females). Most of the brainstem CMs were located in the pons (n = 475). The pooled proportions of improved, stable, and worsened functional outcomes after microsurgical resection of brainstem CMs were 56.7% (95% CI 48.4–64.6), 28.6% (95% CI 22.4–35.7), and 12.6% (95% CI 9.6–16.2), respectively. CMs located in the medulla were significantly (p = 0.003) associated with a higher proportion of improved outcome compared with those in the pons and midbrain. Complete resection was achieved in 93.3% (95% CI 89.8–95.7). The immediate postoperative complication rate was 37.2% (95% CI 29.3–45.9), with new-onset cranial nerve deficit being the most common complication. The permanent morbidity rate was 17.3% (95% CI 10.5–27.1), with a low mortality rate of 1% from the compiled study population during a mean follow-up of 58 months. Our analysis indicates that microsurgical resection of brainstem CMs can result in favorable long-term functional outcomes with transient complications in the majority of patients. Complete microsurgical resection of the CM is associated with a lower incidence of CM hemorrhage and the morbidity related to it. [ABSTRACT FROM AUTHOR]

: Copyright of Neurosurgical Review is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Houlihan, Lena Mary, Loymak, Thanapong, Abramov, Irakliy, Labib, Mohamed A., O'Sullivan, Michael G. J., Lawton, Michael T., Preul, Mark C.

المساهمون: Dr. Mark Preul and from the Barrow Neurological Foundation

المصدر: Journal of Neurological Surgery Part B: Skull Base ; ISSN 2193-6331 2193-634X

الوصف: Objectives Transorbital neuroendoscopic surgery (TONES) has ignited interest in the transorbital access corridor, increasing its use for single and multi-portal skull base interventions. However, the crowding of a small corridor and two-dimensional viewing restrict this access portal. Design Cadaveric qualitative study to assess the feasibility of transorbital microsurgery (TMS). Setting Anatomical dissection steps and instrumentation were recorded for homogeneous methodology. Participants Six cadaveric specimens were systematically dissected using TMS to the anterior cranial fossa and paramedian structures. Main Outcome Measures Anatomical parameters of the TMS craniectomy were established, and the visible and accessible neuroanatomy was highlighted. Results A superior lid crease incision achieved essential orbital rim exposure and preseptal dissection. The orbital roof craniectomy is defined by three boundaries: (1) frontozygomatic suture to the frontosphenoid suture, (2) frontal sinus and cribriform plate, and (3) frontal sinus and orbital rim. The mean (standard deviation) craniectomy was 440 mm2 (78 mm2). Exposing the ipsilateral optic nerve and internal carotid artery obviated the need for frontal lobe retraction to identify the A1–M1 bifurcation as well as near-complete visualization of the M1 artery. Conclusion TMS is a feasible corridor for intracranial access. Mobilization of orbital contents is imperative for maximal intracranial access and protection of the globe. TMS enables access to the frontal lobe base, ipsilateral optic nerve, and most of the ipsilateral anterior circulation. This cosmetically satisfactory approach causes minimal destruction of the anterior skull base with satisfactory exposure of the anterior cranial fossa floor without sinus invasion.

الإتاحة: https://doi.org/10.1055/s-0043-1772202Test

المؤلفون: Rahmani, Redi, Abramov, Irakliy, Srinivasan, Visish M., Labib, Mohamed A., Houlihan, Lena Mary, Catapano, Joshua S., Quinn, Peter Q., Lawton, Michael T., Preul, Mark C.

المصدر: Journal of Neurological Surgery Part B: Skull Base ; volume 85, issue 01, page 095-105 ; ISSN 2193-6331 2193-634X

الوصف: Objective To describe the anatomy related to a novel approach to the petroclival region through the mandibular fossa for the treatment of petroclival and anterior pontine lesions. Design Five dry skulls were examined for surgical approach. Three adult cadaveric heads underwent bilateral dissection. One cadaveric head was evaluated with computed tomography after dissection. Setting This study was performed in an academic medical center. Participants Neurosurgical anatomy researchers performed this study using dry skulls and cadaveric heads. Main Outcome Measurements This was a proof-of-concept anatomical study. Results The mandibular fossa approach uses a vertical preauricular incision above the facial nerve branches. Removal of the temporomandibular joint exposes the mandibular fossa. The anterior boundary is the mandibular nerve at the foramen ovale, and the posterior boundary is the jugular foramen. The chorda tympani, eustachian tube, and tensor tympani muscle are sectioned. The carotid artery is transposed out of the petrous canal, and a petrosectomy is performed from Meckel's cave to the foramen magnum and anterior occipital condyle. Dural opening exposes the anterior pons, vertebrobasilar junction, bilateral vertebral arteries, and the ipsilateral anterior and posterior inferior cerebellar arteries. At completion, the temporomandibular joint is reconstructed with a prosthetic joint utilizing a second incision along the mandible. Conclusions The mandibular fossa approach is a new trajectory to the petroclival region and the anterior pons. It combines the more anterior angle of endoscopic approaches along with the enhanced control of open approaches. Further study is necessary before this approach is used clinically.

الإتاحة: https://doi.org/10.1055/s-0042-1759873Test

المؤلفون: Essibayi, Muhammed Amir, Ibrahim Abdallah, Omar, Mortezaei, Ali, Zaidi, Saif Eddine, Vaishnav, Dhrumil, Cherian, Jacob, Parikh, Gunjan, Altschul, David, Labib, Mohamed

المصدر: Journal of Intensive Care Medicine ; ISSN 0885-0666 1525-1489

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الوصف: Intraventricular hemorrhage (IVH) is a clinical challenge observed among 40–45% of intracerebral hemorrhage (ICH) cases. IVH can be classified according to the source of the hemorrhage into primary and secondary IVH. Primary intraventricular hemorrhage (PIVH), unlike secondary IVH, involves only the ventricles with no hemorrhagic parenchymal source. Several risk factors of PIVH were reported which include hypertension, smoking, age, and excessive alcohol consumption. IVH is associated with high mortality and morbidity and several prognostic factors were identified such as IVH volume, number of ventricles with blood, involvement of fourth ventricle, baseline Glasgow Coma Scale score, and hydrocephalus. Prompt management of patients with IVH is required to stabilize the clinical status of patients upon admission. Nevertheless, further advanced management is crucial to reduce the morbidity and mortality associated with intraventricular bleeding. Recent treatments showed promising outcomes in the management of IVH patients such as intraventricular anti-inflammatory drugs, lumbar drainage, and endoscopic evacuation of IVH, however, their safety and efficacy are still in question. This literature review presents the epidemiology, physiopathology, risk factors, and outcomes of IVH in adults with an emphasis on recent treatment options.

الإتاحة: https://doi.org/10.1177/08850666231204582Test

المؤلفون: Caffes, Nicholas, Kim, Kevin T., Nagm, Alhusain, Wang, Tina I., Cherian, Jacob, Gandhi, Dheeraj, Labib, Mohamed

المصدر: Operative Neurosurgery ; volume 26, issue 5, page 608-609 ; ISSN 2332-4252 2332-4260

الإتاحة: https://doi.org/10.1227/ons.0000000000001028Test

المؤلفون: Srinivasan, Visish M., Scherschinski, Lea, Rhodenhiser, Emmajane, Karahalios, Katherine, Garcia, Joseph, Catapano, Joshua, Labib, Mohamed, Graffeo, Christopher Salvatore, Spetzler, Robert F., Lawton, Michael T.

المصدر: Neurosurgery ; volume 69, issue Supplement_1, page 85-85 ; ISSN 0148-396X 1524-4040

الوصف: INTRODUCTION: Intramedullary spinal arteriovenous malformations (SpiAVM) are complex lesions. Due to their rarity, reports of their management and outcomes are limited. METHODS: Our neurovascular database was reviewed SpiAVMs between January 1986 and December 2021. Demographic, clinical, radiographic, and outcome data were obtained. Eccentric SpiAVMs were defined as those with a significant portion presenting through the pia mater into the subarachnoid space, with large vessels coursing outside the parenchyma. Concentric SpiAVMs were defined as those embedded within the spinal cord parenchyma, not presenting to pia mater, and well circumscribed. RESULTS: Fifty-nine patients (mean [SD] age, 34 [15] years; female sex, 34) were identified. Patients exhibited myelopathy (88%), including pain (51%), paresis (88%), sensory deficits (46%), and bowel and bladder dysfunction (46%). Twenty-seven patients (46%) presented with hemorrhage. Forty-nine percent of lesions were located in the cervical spine and 51% in the thoracic spine. Thirty-five lesions (59%) were previously embolized. Twenty-eight patients (51%) were classified as eccentric and 27 (49%) as concentric SpiAVMs. Postoperative outcomes were similar with no significant differences (improved, 8/18 [44%] vs. 9/17 [53%]; unchanged, 8/18 [44%] vs. 7/17 [41%]; worse, 2/18 [11%] vs. 1/17 [6%]). Retreatment rates were not significantly different between both subtypes (eccentric, 9/28 [32%]; concentric, 6/27 [22%]). Eccentric and concentric SpiAVMs were associated with similar rates of complete resection (eccentric, 14/26 [54%], concentric, 18/26 [69%]). Of 55 classifiable lesions, 4 (7%) were determined to have a mixed phenotype, harboring characteristics of eccentric and concentric SpiAVMs. CONCLUSIONS: Intramedullary AVMs may cause significant symptoms. The eccentric and concentric subtypes have different angioarchitecture and outcomes. While complete resection is usually the preferred surgical objective, eccentric SpiAVMs are amenable to the pial resection that may ...

الإتاحة: https://doi.org/10.1227/neu.0000000000002375_429Test

المؤلفون: Caffes, Nicholas, Kim, Kevin T., Wang, Ting I., Chryssikos, Timothy, Labib, Mohamed

المصدر: Operative Neurosurgery ; volume 25, issue 4, page e231-e231 ; ISSN 2332-4252 2332-4260

الإتاحة: https://doi.org/10.1227/ons.0000000000000805Test

المؤلفون: Labib, Mohamed E, Hassanein, Olfat E, Moussa, Makeen, Yassen, Asmaa, Schwendicke, Falk

مصطلحات موضوعية: Original research

الوصف: Objectives To compare the success, survival and costs of selective versus stepwise carious tissue removal (SE/SW) in permanent teeth with deep (>2/3 dentine depth) carious lesions. Design Randomised controlled, unicentre, clustered two-arm superiority trial. Setting Outpatient clinic of a private university in Cairo, Egypt. Participants One hundred and fifteen participants (n=132 teeth), aged 18–47 years, from Cairo, Egypt, were enrolled. Premolars/molars with occlusal/occlusal-proximal deep lesions (radiographically >2/3 dentine), sensible pulps, without spontaneous pain, were included. Interventions Peripheral carious tissue removal to hard dentine was performed. Pulpo-proximally, soft dentine was left. A glass ionomer (GI) restoration was placed. After 3–4 months, teeth were randomly allocated to SE (n=66), with reduction of the GI into a base and no further tissue removal, followed by a composite resin restoration, or SW (n=66), with full removal of the GI, additional excavation until firm dentine pulpo-proximally, followed by a GI-based composite restoration. Mean follow-up was 1 year. Primary and secondary outcome measures Primary outcome was success (absence of endodontic/restorative complications). Secondary outcomes were tooth survival and initial and total treatment costs. Results Zero/five pulp exposures occurred during SE/SW, and seven/five SE/SW teeth required endodontic therapy. Success after 12 months was 89.4% for SE and 84.9% for SW. The estimated mean time free of complications was 23 and 18 months for SE and SW, respectively, without significant differences between SE and SW (p>0.05/Cox). Initial treatment costs were significantly higher for SW (mean (SD): 507.5 (123.4) Egyptian pounds (EGP)) than SE (mean (SD): 456.6 (98.3) EGP), while total costs showed no significant difference (p>0.05). Conclusion Within the limitations of this interim analysis, and considering the depth of these lesions (>2/3 dentine), SE and SW showed similar risk of failure and overall costs after 1 year. ...

وصف الملف: text/html

العلاقة: http://bmjopen.bmj.com/cgi/content/short/9/9/e030957Test; http://dx.doi.org/10.1136/bmjopen-2019-030957Test

الإتاحة: https://doi.org/10.1136/bmjopen-2019-030957Test
http://bmjopen.bmj.com/cgi/content/short/9/9/e030957Test