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Crutu A, Hanna A. [The role of surveillance bronchoscopy after lung transplantation]. Rev Mal Respir 2024; 41:59-68. [PMID: 37827927 DOI: 10.1016/j.rmr.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/23/2023] [Indexed: 10/14/2023]
Abstract
The role of surveillance bronchoscopy after lung transplantation. Lung transplantation is currently accepted as a potential treatment for end-stage respiratory diseases. That said, airway complications and the onset of chronic lung allograft dysfunction remain major causes of morbidity and mortality subsequent to lung transplantation and a significant obstacle to long-term survival. In this article, we discuss the advantages and limitations of bronchial endoscopy in post-lung transplant monitoring.
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Affiliation(s)
- A Crutu
- Service de chirurgie thoracique et transplantation cardio-pulmonaire, hôpital Marie-Lannelongue, Le Plessis-Robinson, France.
| | - A Hanna
- Service de chirurgie thoracique et transplantation cardio-pulmonaire, hôpital Marie-Lannelongue, Le Plessis-Robinson, France
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2
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Sribhasyam V, Maddikunta S, Hanna B, Hanna A. Accessory head of flexor carpi radialis and abnormal course of the median nerve in the forearm. Surg Neurol Int 2023; 14:411. [PMID: 38213422 PMCID: PMC10783689 DOI: 10.25259/sni_822_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 01/13/2024] Open
Abstract
Background The median nerve anatomy and its clinical presentation are crucial for surgeons to consider avoiding iatrogenic injury and performing effective surgical interventions. Case Description An atypical presentation of median nerve anatomy proximal to the carpal tunnel was found during cadaveric dissection. The median nerve was located deep to a uniquely double-headed flexor carpi radialis and curved medially around the tendons of the forearm to enter the carpal tunnel superficially. Conclusion The atypical presentation of median nerve anatomy can assist surgeons in adverse event reduction during surgeries such as carpal tunnel and pronator teres syndrome releases.
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Affiliation(s)
- Vaishnavi Sribhasyam
- College of Letters and Science, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Shilpa Maddikunta
- College of Letters and Science, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Barbara Hanna
- M.D. Program, Mayo Clinic Alix School of Medicine, Rochester, Minnesota, United States
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin, Madison, Wisconsin, United States
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3
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Bello JSR, Moscote-Salazar LR, Florez-Perdomo WA, Lugo CMR, Hanna A. YouTube and pudendal neuralgia: Is it a good source of information for patients? Clin Neurol Neurosurg 2023; 233:107965. [PMID: 37738937 DOI: 10.1016/j.clineuro.2023.107965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study aims to identify the shortcomings and quality content of YouTube videos and its effectiveness as a source of patient information on pudendal neuralgia treatment. METHODS A search was conducted on YouTube using the words "pudendal neuralgia physical therapy," "medications for pudendal neuralgia," "pudendal nerve block," "pudendal neuralgia surgery," and "alternative treatments for pudendal neuralgia." The results were analyzed based on the source, general descriptive statistics, the intended audience, and five content areas. The DISCERN scoring system was used to evaluate the quality of videos. RESULTS After the search, 73 videos met the inclusion criteria for further analysis. The majority of these videos (61.64%) were intended to target the general population, whereas a smaller percentage were identified as professional (41.10%) or targeted for physicians (35.62%). From the videos included, 10 (13.70%) described treatment options in a balanced and evidence-based manner. The higher DISCERN score positively correlated with the presence of this last content criterion. With a total DISCERN mean score of 35.42, a significant proportion of the videos (41.10%) were rated very poor. The remaining videos were classified as poor (23.29%), fair (19.18%), good (8.22%), and excellent (8.22%). CONCLUSION The quality of the information included in YouTube videos regarding pudendal neuralgia treatment was considered generally poor. Healthcare providers must recognize the potential influence of this platform on patients' understanding of pudendal neuralgia treatment. There is a need for additional research and randomized studies regarding YouTube content about this condition.
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Affiliation(s)
| | | | | | - Claudia Marcela Restrepo Lugo
- Department of Research Colombian Clinical Research Group in Neurocritical Care, Bogotá, Colombia; Department of Neurosurgery, Hospital Federico Lleras Acosta, Ibague, Colombia
| | - Amgad Hanna
- Department of Biomedical Engineering and Neurological Surgery, University of Wisconsin, Madison, WI, USA
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4
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Munier J, Shen S, Rahal D, Hanna A, Marty V, O'Neill P, Fanselow M, Spigelman I. Chronic intermittent ethanol exposure disrupts stress-related tripartite communication to impact affect-related behavioral selection in male rats. Neurobiol Stress 2023; 24:100539. [PMID: 37131490 PMCID: PMC10149313 DOI: 10.1016/j.ynstr.2023.100539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/04/2023] Open
Abstract
Alcohol use disorder (AUD) is characterized by loss of intake control, increased anxiety, and susceptibility to relapse inducing stressors. Both astrocytes and neurons contribute to behavioral and hormonal consequences of chronic intermittent ethanol (CIE) exposure in animal models. Details on how CIE disrupts hypothalamic neuro-glial communication, which mediates stress responses are lacking. We conducted a behavioral battery (grooming, open field, reactivity to a single, uncued foot-shock, intermittent-access two-bottle choice ethanol drinking) followed by Ca2+ imaging in ex-vivo slices of paraventricular nucleus of the hypothalamus (PVN) from male rats exposed to CIE vapor or air-exposed controls. Ca2+ signals were evaluated in response to norepinephrine (NE) with or without selective α-adrenergic receptor (αAR) or GluN2B-containing N-methyl-D-aspartate receptor (NMDAR) antagonists, followed by dexamethasone (DEX) to mock a pharmacological stress response. Expectedly, CIE rats had altered anxiety-like, rearing, grooming, and drinking behaviors. Importantly, NE-mediated reductions in Ca2+ event frequency were blunted in both CIE neurons and astrocytes. Administration of the selective α1AR antagonist, prazosin, reversed this CIE-induced dysfunction in both cell types. Additionally, the pharmacological stress protocol reversed the altered basal Ca2+ signaling profile of CIE astrocytes. Signaling changes in astrocytes in response to NE were correlated with anxiety-like behaviors, such as the grooming:rearing ratio, suggesting tripartite synaptic function plays a role in switching between exploratory and stress-coping behavior. These data show how CIE exposure causes persistent changes to PVN neuro-glial function and provides the groundwork for how these physiological changes manifest in behavioral selection.
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Affiliation(s)
- J.J. Munier
- Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, United States
- Corresponding author.
| | - S. Shen
- Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, United States
| | - D. Rahal
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, United States
| | - A. Hanna
- Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, United States
| | - V.N. Marty
- Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, United States
| | - P.R. O'Neill
- Hatos Center for Neuropharmacology, Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, UCLA, United States
| | - M.S. Fanselow
- Department of Psychology, College of Life Sciences, Department of Psychiatry & Biobehavioral Science, David Geffen School of Medicine, UCLA, United States
| | - I. Spigelman
- Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, United States
- Corresponding author. Laboratory of Neuropharmacology, Section of Biosystems & Function, School of Dentistry, UCLA, 10833 Le Conte Avenue, 63-078 CHS, Los Angeles, CA, 90095-1668, United States.
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Khalil AS, Hellenbrand D, Reichl K, Umhoefer J, Filipp M, Choe J, Hanna A, Murphy WL. A Localized Materials-Based Strategy to Non-Virally Deliver Chondroitinase ABC mRNA Improves Hindlimb Function in a Rat Spinal Cord Injury Model. Adv Healthc Mater 2022; 11:e2200206. [PMID: 35882512 PMCID: PMC10031873 DOI: 10.1002/adhm.202200206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/14/2022] [Indexed: 01/27/2023]
Abstract
Spinal cord injury often results in devastating consequences for those afflicted, with very few therapeutic options. A central element of spinal cord injuries is astrogliosis, which forms a glial scar that inhibits neuronal regeneration post-injury. Chondroitinase ABC (ChABC) is an enzyme capable of degrading chondroitin sulfate proteoglycan (CSPG), the predominant extracellular matrix component of the glial scar. However, poor protein stability remains a challenge in its therapeutic use. Messenger RNA (mRNA) delivery is an emerging gene therapy technology for in vivo production of difficult-to-produce therapeutic proteins. Here, mineral-coated microparticles as an efficient, non-viral mRNA delivery vehicles to produce exogenous ChABC in situ within a spinal cord lesion are used. ChABC production reduces the deposition of CSPGs in an in vitro model of astrogliosis, and direct injection of these microparticles within a glial scar forces local overexpression of ChABC and improves recovery of motor function seven weeks post-injury.
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Affiliation(s)
- Andrew S. Khalil
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53705
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI 53705
| | - Daniel Hellenbrand
- Department of Neurosurgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705
| | - Kaitlyn Reichl
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53705
| | - Jennifer Umhoefer
- Department of Biology, University of Wisconsin-Madison, Madison, WI 53705
| | - Mallory Filipp
- Department of Neurosurgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705
| | - Joshua Choe
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53705
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI 53705
- Medical Scientist Training Program, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705
| | - William L. Murphy
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53705
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI 53705
- Department of Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI 53705
- Forward BIO Institute, University of Wisconsin-Madison, Madison, WI 53705
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Taher AW, Page PS, Greeneway GP, Ammanuel S, Bunch KM, Meisner L, Hanna A, Josiah D. Spinal fractures in the setting of diffuse idiopathic skeletal hyperostosis conservatively treated via orthosis: illustrative cases. Journal of Neurosurgery: Case Lessons 2022; 3:CASE21689. [PMID: 36303482 PMCID: PMC9379645 DOI: 10.3171/case21689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fractures in patients with diffuse idiopathic skeletal hyperostosis (DISH) are considered highly unstable injuries with high risk for neurological injury. Surgical intervention is the standard of care for these patients to avoid secondary spinal cord injuries. Despite this, certain cases may necessitate a nonoperative approach. Herein within, the authors describe three cases of cervical, thoracic, and lumbar fractures in the setting of DISH that were successfully treated via orthosis. OBSERVATIONS The authors present three cases of fractures in patients with DISH. A 74-year-old female diagnosed with an acute fracture of a flowing anterior osteophyte at C6–C7 treated with a cervical orthosis. A 78-year-old male with an anterior fracture of the ankylosed T7–T8 vertebrae managed with a Jewett hyperextension brace. Finally, a 57-year-old male with an L1–L2 disc space fracture treated with a thoraco-lumbo-sacral orthosis. All patients recovered successfully. LESSONS In certain cases, conservative treatment may be more appropriate for fractures in the setting of DISH as an alternative to the surgical standard of care. Most fractures in the setting of DISH are unstable, therefore it is necessary to manage these patients on a case-by-case basis.
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Affiliation(s)
- Ayman W. Taher
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; and
| | - Paul S. Page
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Garret P. Greeneway
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Simon Ammanuel
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Katherine M. Bunch
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Lars Meisner
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Amgad Hanna
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Darnell Josiah
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
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Elmaraghi S, Burkett D, Meisner L, Gander B, Hanna A. Radial Nerve Branch to Anterior Interosseous Nerve Transfer to Restore Finger Pinch: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2022; 22:e276. [DOI: 10.1227/ons.0000000000000170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
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8
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Thimjon C, Olewnik Ł, Iwanaga J, Loukas M, Dumont AS, Hanna A, Tubbs RS. C6 and not C5 nerve fibers more commonly contribute most to deltoid muscle innervation: anatomical study with application to better diagnosing cervical nerve injuries. Neurosurg Rev 2022; 45:2401-2406. [PMID: 35246783 DOI: 10.1007/s10143-022-01761-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/06/2022] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
Most anatomical textbooks list both the C5 and C6 spinal nerves as contributing to the deltoid muscle's innervation via the axillary nerve. To our knowledge, no previous study has detailed the exact spinal nerve components of the axillary nerve terminating in the deltoid via cadaveric dissection. Twenty formalin-fixed cadavers (40 sides) underwent dissection of the brachial plexus. The fascicles making up the axillary nerve branch that specifically terminated in the deltoid muscle were traced proximally. The axillary nerve branch to the deltoid muscle was most commonly (70%) made up of three spinal nerve segments and less commonly (30%) by two spinal nerve segments. For all axillary nerve branches to the deltoid muscle, C4 spinal nerves contributed 0-5%, C5 spinal nerves contributed 1-80%, C6 spinal nerve contributed 15-99%, C7 spinal nerves contributed 0-30%, and C8 and T1 spinal nerves were not found to contribute any fibers to any deltoid muscle branches. The nerve to the deltoid muscle was contributed to equally by C5 and C6 nerve fibers on 10% of sides. On 16% of sides, C5 contributed the most nerve fibers to this muscle. On 35% of sides, C6 contributed the majority fibers found in the axillary nerve branches to the deltoid. Based on our anatomical study, C6 is more often than not the main level of innervation. C5 was never the sole component of the axillary nerve branches to the deltoid muscle. Such anatomical data will now need to be reconciled with clinical studies.
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Affiliation(s)
- Connor Thimjon
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Łódź, Łódź, Poland
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA. .,Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Amgad Hanna
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.,Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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9
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Dauriat G, Pradere P, Feuillet S, Crutu A, Florea V, Hanna A, Le Pavec J, Mercier O, Fadel E. Réponse vaccinale contre la Covid en transplantation pulmonaire. Revue des Maladies Respiratoires Actualités 2022. [PMCID: PMC8709669 DOI: 10.1016/j.rmra.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction La vaccination contre la Covid a été recommandée chez les patients transplantés d’organes solides en début d’année 2021, selon un schéma comprenant 3 doses chez les patients n’ayant pas présenté d’infection par la Covid 19 et selon un schéma comprenant 2 injections chez les patients ayant été infectés par la Covid. Méthodes Nous avons étudié la réponse vaccinale après un schéma complet dans une cohorte de patients transplantés pulmonaires et cardiopulmonaires à l’hôpital Marie Lannelongue. Selon les recommandations de l’OMS, l’absence de réponse vaccinale est définie par une sérologie dont le taux est < 30 BAU/ml. Le taux d’Anticorps considéré comme protecteur est un taux > 260 BAU/ml. Les patients dont le taux est compris entre 30 et 260 BAU/ml sont considérés comme faiblement répondeurs. La sérologie a été effectuée entre 1 et 3 mois après la dernière injection. Résultats Dans notre cohorte comprenant 373 patients, une sérologie Covid a pu être obtenue chez 75% des patients. Une absence complète de séroconversion a été constatée chez 75% des patients. Une séroconversion avec un taux d’anticorps considéré comme protecteur n’a été obtenu que chez 14% des patients, dont la moitié a présenté une infection par la Covid. Par ailleurs, 11% des patients ont été faiblement répondeurs. Conclusion Notre étude mono-centrique suggère une très faible réponse vaccinale chez les patients transplantés pulmonaires et cardiopulmonaires, suggérant la réalisation d’une 4e dose chez les patients partiellement répondeurs et/ou un traitement par anticorps monoclonaux spécifiques chez les patients non répondeurs.
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10
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Daniels SP, Ross AB, Sneag DB, Gardon SN, Li G, Hanna A, Tuite MJ. Intravenous contrast does not improve detection of nerve lesions or active muscle denervation changes in MR neurography of the common peroneal nerve. Skeletal Radiol 2021; 50:2483-2494. [PMID: 34021773 DOI: 10.1007/s00256-021-03812-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the effect of intravenous (IV) contrast on sensitivity, specificity, and accuracy of magnetic resonance (MR) neurography of the knee with attention to the common peroneal nerve (CPN) in identifying nerve lesions and active muscle denervation changes. MATERIALS AND METHODS A retrospective search for contrast-enhanced MR neurography cases evaluating the CPN at the knee was performed. Patients with electrodiagnostic testing (EDX) within 3 months of imaging were included and those with relevant prior surgery were excluded. Two radiologists independently reviewed non-contrast sequences and then 4 weeks later evaluated non-contrast and contrast sequences. McNemar's tests were performed to detect a difference between non-contrast only and combined non-contrast and contrast sequences in identifying nerve lesions and active muscle denervation changes using EDX as the reference standard. RESULTS Forty-four exams in 42 patients (2 bilateral) were included. Twenty-eight cases had common peroneal neuropathy and 29, 21, and 9 cases had active denervation changes in the anterior, lateral, and posterior compartment/proximal muscles respectively on EDX. Sensitivity, specificity, and accuracy of non-contrast versus combined non-contrast and contrast sequences for common peroneal neuropathy were 50.0%, 56.2%, and 52.3% versus 50.0%, 56.2%, and 52.3% for reader 1 and 57.1%, 50.0%, and 54.5% versus 64.3%, 56.2%, and 61.4% for reader 2. Sensitivity, specificity, and accuracy of non-contrast and combined non-contrast and contrast sequences in identifying active denervation changes for anterior, lateral, and posterior compartment muscles were not significantly different. McNemar's tests were all negative. CONCLUSION IV contrast does not improve the ability of MR neurography to detect CPN lesions or active muscle denervation changes.
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Affiliation(s)
- Steven P Daniels
- Department of Radiology, NYU Langone Health, 660 First Avenue, New York, NY, 10016, USA.
| | - Andrew B Ross
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Darryl B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th St., New York, NY, 10021, USA
| | - Stephanie N Gardon
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Geng Li
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Michael J Tuite
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
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Danlos FX, Goubet AG, Aglave M, Alfaro A, Job B, Francillette M, Hanna A, Pradere P, Dolidon S, Lecluse Y, Droin N, Deloger M, Besse B, Robert C, Michot JM, Soria JC, Barlesi F, Zitvogel L, Marabelle A, Le Pavec J. 1773P Anti-PD1-induced acute interstitial pneumonitis is characterized by alveolar infiltration of PD-1+CD38+TIGIT+ cytotoxic effector CD8+ T cells and CD206+ inflammatory macrophages. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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12
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Page PS, Parmar V, Momin E, Burkett DJ, Greeneway GP, Hanna A, Resnick DK. Classification and Reliability of Lumbar Facet Cysts Grading Scales. World Neurosurg 2021; 155:e391-e394. [PMID: 34425294 DOI: 10.1016/j.wneu.2021.08.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The presence of symptomatic lumbar facet cysts has been associated with segmental instability. Given this association, decompression versus decompression with fusion is a frequently debated topic. Multiple grading scales have been devised to identify patients at high risk for development of cyst recurrence; however, there exists no external evaluation of these scales. METHODS A retrospective review of 54 patients undergoing initial treatment for lumbar synovial cysts at a single institution over the past 12 years was conducted. Surgical treatment consisted of decompression with cystectomy without fusion. Patients were assessed and classified according to the NeuroSpine Surgery Research Group (NSURG) and Rosenstock Classification systems. Five neurosurgeons reviewed the preoperative magnetic resonance images, and results were classified. Interrater reliability was assessed using both Gwet's AC1 coefficient and Krippendorff's alpha. A 1-way analysis of variance was used to evaluate predictive ability of both classification systems. RESULTS In total, of the 54 patients who underwent decompression, 7 had cyst recurrence. Overall cyst recurrence was most common in NSURG grade 2 cysts (3/12, 25%) followed by grade 1 cysts (4/27, 14.8%). Of the NSURG grade 3 and 4 patients, none had cyst recurrence. In the Rosenstock grades the most common recurrence was in grade 3 cysts (1/4, 25%) followed by grade 1 cysts (5/26, 19.2%). Interrater reliability demonstrated good reproducibility on Gwet's AC1 and Krippendorff's alpha on both grading scales. Neither score was predictive of cyst recurrence (P > 0.05). CONCLUSIONS The Rosenstock and NeuroSpine scores demonstrate good overall interrater reliability but are inconsistent in their ability to predict recurrence of lumbar facet cysts.
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Affiliation(s)
- Paul S Page
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Vikas Parmar
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Eric Momin
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Daniel J Burkett
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Garret P Greeneway
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Amgad Hanna
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA
| | - Daniel K Resnick
- University of Wisconsin Hospitals and Clinics, Department of Neurosurgery, Madison, Wisconsin, USA.
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13
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Page PS, Paige S, Hanna A. Vascular entrapment neuropathy of the tibial nerve within the gastrocnemius muscle. Surg Neurol Int 2021; 12:224. [PMID: 34221555 PMCID: PMC8247925 DOI: 10.25259/sni_75_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Vascular compression is an extremely rare cause of mononeuropathy and compression of selective tibial nerve branches is an additionally a rare finding and makes diagnosis difficult. Case Description: Here within, we describe the case of a 41-year-old male who presented with isolated mononeuropathy of the medial gastrocnemius (MG) branch of the tibial nerve presented as persistent fasciculations and atrophy. After electromyography and clinical evaluation, surgical exploration was recommended. A vascular bundle was found to be compressing the MG branch of the tibial nerve and thus was ligated to decompress the nerve. Postoperatively, all fasciculations improved and muscle atrophied improved. Conclusion: Vascular compression resulting in mononeuropathy of the peripheral nerves is a rare clinical entity. Clinicians should include these etiologies on their differential when considering surgical exploration of mononeuropathies.
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Affiliation(s)
- Paul Samuel Page
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States
| | - Stewart Paige
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States
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Hanna A. Letter: Fascicular Topography of the Suprascapular Nerve in the C5 Root and Upper Trunk of the Brachial Plexus: A Microanatomic Study From a Nerve Surgeon's Perspective. Neurosurgery 2021; 89:E88. [PMID: 33989422 DOI: 10.1093/neuros/nyab132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amgad Hanna
- Department of Neurosurgery University of Wisconsin School of Medicine and Public Health Madison, Wisconsin, USA
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Daniels SP, Xu HS, Hanna A, Greenberg JA, Lee KS. Ultrasound-guided microwave ablation in the treatment of inguinal neuralgia. Skeletal Radiol 2021; 50:475-483. [PMID: 33000286 DOI: 10.1007/s00256-020-03618-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 02/02/2023]
Abstract
Chronic groin pain can be due to a variety of causes and is the most common complication of inguinal hernia repair surgery. The etiology of pain after inguinal hernia repair surgery is often multifactorial though injury to or scarring around the nerves in the operative region, namely the ilioinguinal nerve, genital branch of the genitofemoral nerve, and the iliohypogastric nerve, is thought to be a key factor in causing chronic post-operative hernia pain or inguinal neuralgia. Inguinal neuralgia is difficult to treat and requires a multidisciplinary approach. Radiologists play a key role in the management of these patients by providing accurate image-guided injections to alleviate patient symptoms and identify the pain generator. Recently, ultrasound-guided microwave ablation has emerged as a safe technique, capable of providing durable pain relief in the majority of patients with this difficult to treat condition. The objectives of this paper are to review the complex nerve anatomy of the groin, discuss diagnostic ultrasound-guided nerve injection and patient selection for nerve ablation, and illustrate the microwave ablation technique used at our institution.
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Affiliation(s)
- Steven P Daniels
- Department of Radiology, NYU Langone Heath, 660 First Avenue, New York, NY, 10016, USA.
| | - Helen S Xu
- Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY, 10065, USA
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Jacob A Greenberg
- Department of General Surgery, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Kenneth S Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
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Arden J, Quinn T, Wilson T, Hanna A, Baschnagel A, Wilson G. CD44 Expression Is Correlated With MTOR Expression And p16 Status In Head And Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Imam Z, Odish F, Gill I, O'Connor D, Armstrong J, Vanood A, Ibironke O, Hanna A, Ranski A, Halalau A. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States. J Intern Med 2020; 288:469-476. [PMID: 32498135 PMCID: PMC7300881 DOI: 10.1111/joim.13119] [Citation(s) in RCA: 218] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Higher comorbidity and older age have been reported as correlates of poor outcomes in COVID-19 patients worldwide; however, US data are scarce. We evaluated mortality predictors of COVID-19 in a large cohort of hospitalized patients in the United States. DESIGN Retrospective, multicenter cohort of inpatients diagnosed with COVID-19 by RT-PCR from 1 March to 17 April 2020 was performed, and outcome data evaluated from 1 March to 17 April 2020. Measures included demographics, comorbidities, clinical presentation, laboratory values and imaging on admission. Primary outcome was mortality. Secondary outcomes included length of stay, time to death and development of acute kidney injury in the first 48-h. RESULTS The 1305 patients were hospitalized during the evaluation period. Mean age was 61.0 ± 16.3, 53.8% were male and 66.1% African American. Mean BMI was 33.2 ± 8.8 kg m-2 . Median Charlson Comorbidity Index (CCI) was 2 (1-4), and 72.6% of patients had at least one comorbidity, with hypertension (56.2%) and diabetes mellitus (30.1%) being the most prevalent. ACE-I/ARB use and NSAIDs use were widely prevalent (43.3% and 35.7%, respectively). Mortality occurred in 200 (15.3%) of patients with median time of 10 (6-14) days. Age > 60 (aOR: 1.93, 95% CI: 1.26-2.94) and CCI > 3 (aOR: 2.71, 95% CI: 1.85-3.97) were independently associated with mortality by multivariate analyses. NSAIDs and ACE-I/ARB use had no significant effects on renal failure in the first 48 h. CONCLUSION Advanced age and an increasing number of comorbidities are independent predictors of in-hospital mortality for COVID-19 patients. NSAIDs and ACE-I/ARB use prior to admission is not associated with renal failure or increased mortality.
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Affiliation(s)
- Z Imam
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - F Odish
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - I Gill
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - D O'Connor
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - J Armstrong
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - A Vanood
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - O Ibironke
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - A Hanna
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Internal Medicine Residents, Beaumont Hospital, Royal Oak, MI, USA
| | - A Ranski
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - A Halalau
- From the, Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA.,Oakland University William Beaumont School of Medicine, Rochester, MI, USA.,Department of Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
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Hanna A. Letter to the Editor. Meralgia paresthetica: what to do? J Neurosurg 2020; 132:2020-2021. [DOI: 10.3171/2019.10.jns192708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Schmidt BT, Hanna A. Deadly Proliferation and Transformation of Pilocytic Astrocytoma in Pregnancy. World Neurosurg 2020; 133:99-103. [DOI: 10.1016/j.wneu.2019.09.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
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Arden J, Quinn T, Wilson T, Hanna A, Baker K, Baschnagel A, Wilson G. Automated Assessment of Biomarker Expression in Head and Neck Squamous Cell Carcinoma (HNSCC) Patients Shows Association between High CD44, c-MET, EGFR, and GLUT1 Expression with Decreased Disease-Free Survival and Overall Survival. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hanna A. Classification of the variations of the palmar recurrent branch of the median nerve with special emphasis on angulation. J Neurosurg 2019; 133:1-8. [PMID: 31277070 DOI: 10.3171/2019.4.jns19516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 04/18/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Iatrogenic nerve injuries are devastating to both the patient and the surgeon. This study focuses on the anatomical relationship of the palmar recurrent branch with the parent median nerve in an attempt to identify higher risk types. METHODS The palmar recurrent branch was dissected in 75 embalmed cadavers. The median nerve was divided into 4 sections from lateral to medial, defined as zones 1-4. The angle to the axial plane of the median nerve was also measured and classified as 0°, 45°, 60°, and 90°. RESULTS Accessory recurrent branches were found in 36.2% of cases. The recurrent branch originated from zone 1 in 32.42%, zone 2 in 61.54%, zone 3 in 6.04%, and zone 4 in 0%. These are respectively classified as types I, II, III, and IV. The motor branch made an angle with the median nerve of 0° in 17% of cases, 45° in 37.4%, 60° in 26.4%, and 90° in 19.2%. These are respectively classified as types A, B, C, and D. CONCLUSIONS Close attention should be paid to the potential anatomical variabilities when performing nerve surgeries. For the palmar recurrent branch, the more medial the origin and the greater the angle it makes with the median nerve, the more dangerous it is. This classification is helpful in unifying the language and comparing results.
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Abstract
Nerve stimulation is a reversible technique that is used successfully for the treatment of traumatic neuropathic pain, complex regional pain syndrome, and craniofacial neuropathic pain. Nerve field stimulation targets painful regions rather than a single nerve and has expanded indications, including axial low back pain. Appropriate patient education and motivation are crucial prior to surgery. Ongoing research is necessary to provide high-level evidence for the use of nerve stimulation. Most electrodes are primarily designed for spinal cord stimulation, hence the need to develop nerve electrodes dedicated for nerve stimulation.
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Affiliation(s)
- Mark Corriveau
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Wendell Lake
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA.
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Bordes S, Jenkins S, McBain L, Hanna A, Loukas M, Tubbs RS. The clinical anatomy of crucifixion. Clin Anat 2019; 33:12-21. [PMID: 30989719 DOI: 10.1002/ca.23386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/15/2019] [Indexed: 11/10/2022]
Abstract
Crucifixion was a widely used form of execution for capital crimes in antiquity. Civilizations and empires perfected the technique, leading to centuries of discussions, controversies, and questions, many of which concerned the death of Jesus Christ. To this day, much remains to be discovered in both religious and scientific realms. However, the aim of this study is to discuss such facts as are known from the medical perspectives of clinical anatomists. Nails/spikes were driven through the hands/wrists and feet of five adult cadavers, and the cadavers were then dissected to observe the anatomical structures that had been injured or placed at risk for injury. While many historical and archeological facts remain to be discovered, we hope that this cadaveric study will enhance our modern understanding of ancient practices from a medical and anatomical perspective. Clin. Anat. 32:12-21, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Stephen Bordes
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Skyler Jenkins
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Lexian McBain
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin, Madison, Wisconsin
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
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Rosario J, Lebowitz D, Leon L, Hanna A, Fusco N, Dub L, Ganti L. 311 Addressing the Overuse of Neuro-Imaging for Patients With a Primary Headache and a Normal Neurologic Examination. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Affiliation(s)
- Amgad Hanna
- Department of NeurosurgeryUniversity of WisconsinMadison Wisconsin
| | - Barbara Hanna
- Edgewood High School of Sacred HeartMadison Wisconsin
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Abstract
OBJECTIVEMeralgia paresthetica causes pain, burning, and loss of sensation in the anterolateral thigh. Surgical treatment traditionally involves neurolysis or neurectomy of the lateral femoral cutaneous nerve (LFCN). After studying and publishing data on the anatomical feasibility of LFCN transposition, the author presents here the first case series of patients who underwent LFCN transposition.METHODSNineteen patients with meralgia paresthetica were treated in the Department of Neurological Surgery at University of Wisconsin between 2011 and 2016; 4 patients underwent simple decompression, 5 deep decompression, and 10 medial transposition. Data were collected prospectively and analyzed retrospectively. No randomization was performed. The groups were compared in terms of pain scores (based on a numeric rating scale) and reoperation rates.RESULTSThe numeric rating scale scores dropped significantly in the deep-decompression (p = 0.148) and transposition (p < 0.0001) groups at both the 3- and 12-month follow-up. The reoperation rates were significantly lower in the deep-decompression and transposition groups (p = 0.0454) than in the medial transposition group.CONCLUSIONSBoth deep decompression and transposition of the LFCN provide better results than simple decompression. Medial transposition confers the advantage of mobilizing the nerve away from the anterior superior iliac spine, giving it a straighter and more relaxed course in a softer muscle bed.
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Hanna A, Bodden LO, Siebiger GRL. Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases. J Brachial Plex Peripher Nerve Inj 2018; 13:e1-e3. [PMID: 29497457 PMCID: PMC5829993 DOI: 10.1055/s-0037-1607977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 09/01/2017] [Indexed: 11/04/2022] Open
Abstract
Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus.
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Affiliation(s)
- Amgad Hanna
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, United States
| | - Larry O'Neil Bodden
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, United States
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Haldeman C, Hanna A. Neurofibroma of the peroneal nerve. Neurosurg Focus 2018; 44:V2. [PMID: 29291298 DOI: 10.3171/2018.1.focusvid.17546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Neurofibromas are benign tumors composed of different cell types from the peripheral nervous system. Neurofibromas infiltrate between nerve fascicles and do not have a discrete capsule. On MRI, they are T1 hypointense or isointense, T2 hyperintense, often with a "target sign," and contrast enhancing. The video shows gross-total resection of a peroneal nerve neurofibroma presenting as a painful mass in the popliteal fossa. Incisions across a skin crease can be either oblique or zigzag, but never perpendicular to it. It is also key to expose normal nerve proximal and distal to the tumor. The patient had a good functional outcome. The video can be found here: https://youtu.be/G74Zoa1Y2JM .
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Rosich K, Hanna BF, Ibrahim RK, Hellenbrand DJ, Hanna A. The Effects of Glial Cell Line-Derived Neurotrophic Factor after Spinal Cord Injury. J Neurotrauma 2017; 34:3311-3325. [DOI: 10.1089/neu.2017.5175] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Konstantin Rosich
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Bishoy F. Hanna
- Department of Neurological Surgery, Ross University School of Medicine, Dominica, West Indies
| | - Rami K. Ibrahim
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Daniel J. Hellenbrand
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
| | - Amgad Hanna
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
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Hanna A. Letter: Preoperative Ultrasound-Guided Wire Localization of the Lateral Femoral Cutaneous Nerve. Oper Neurosurg (Hagerstown) 2017; 13:E13. [PMID: 28521352 DOI: 10.1093/ons/opx049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
OBJECTIVE
Meralgia paresthetica causes dysesthesias and burning in the anterolateral thigh. Surgical treatment includes nerve transection or decompression. Finding the nerve in surgery is very challenging. The author conducted a cadaveric study to better understand the variations in the anatomy of the lateral femoral cutaneous nerve (LFCN).
METHODS
Twenty embalmed cadavers were used for this study. The author studied the LFCN's relationship to different fascial planes, and the distance from the anterior superior iliac spine (ASIS).
RESULTS
A complete fascial canal was found to surround the nerve completely in all specimens. The canal starts at the inguinal ligament proximally and follows the nerve beyond its terminal branches. The nerve could be anywhere from 6.5 cm medial to the ASIS to 6 cm lateral to the ASIS. In the latter case, the nerve may lodge in a groove in the iliac crest. Other anatomical variations found were the LFCN arising from the femoral nerve, and a duplicated nerve. A thick nerve was found in 1 case in which it was riding over the ASIS.
CONCLUSIONS
The variability in the course of the LFCN can create difficulty in surgical exposure. The newly defined LFCN canal renders exposure even more challenging. This calls for high-resolution pre- or intraoperative imaging for better localization of the nerve.
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Vuksan V, Jenkins AL, Brissette C, Choleva L, Jovanovski E, Gibbs AL, Bazinet RP, Au-Yeung F, Zurbau A, Ho HVT, Duvnjak L, Sievenpiper JL, Josse RG, Hanna A. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: A double-blind randomized controlled trial. Nutr Metab Cardiovasc Dis 2017; 27:138-146. [PMID: 28089080 DOI: 10.1016/j.numecd.2016.11.124] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/25/2016] [Accepted: 11/29/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIM Preliminary findings indicate that consumption of Salba-chia (Salvia hispanica L.), an ancient seed, improves management of type 2 diabetes and suppresses appetite. The aim of this study was to assesse the effect of Salba-chia on body weight, visceral obesity and obesity-related risk factors in overweight and obese adults with type 2 diabetes. METHODS A double-blind, randomized, controlled trial with two parallel groups involved 77 overweight or obese patients with type 2 diabetes (HbA1c: 6.5-8.0%; BMI: 25-40 kg/m2). Both groups followed a 6-month calorie-restricted diet; one group received 30 g/1000 kcal/day of Salba-chia, the other 36 g/1000 kcal/day of an oat bran-based control. Primary endpoint was change in body weight over 6-months. Secondary endpoints included changes in waist circumference, body composition, glycemic control, C-reactive protein, and obesity-related satiety hormones. RESULTS At 6-months, participants on Salba-chia had lost more weight than those on control (1.9 ± 0.5 kg and 0.3 ± 0.4 kg, respectively; P = 0.020), accompanied by a greater reduction in waist circumference (3.5 ± 0.7 cm and 1.1 ± 0.7 cm, respectively; P = 0.027). C-reactive protein was reduced by 1.1 ± 0.5 mg/L (39 ± 17%) on Salba-chia, compared to 0.2 ± 0.4 mg/L (7 ± 20%) on control (P = 0.045). Plasma adiponectin on the test intervention increased by 6.5 ± 0.7%, with no change observed on control (P = 0.022). CONCLUSIONS The results of this study, support the beneficial role of Salba-chia seeds in promoting weight loss and improvements of obesity related risk factors, while maintaining good glycemic control. Supplementation of Salba-chia may be a useful dietary addition to conventional therapy in the management of obesity in diabetes. REGISTRATION: clinicaltrials.gov identifier: NCT01403571.
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Affiliation(s)
- V Vuksan
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, ON, Canada.
| | - A L Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - C Brissette
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - L Choleva
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - E Jovanovski
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A L Gibbs
- Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - R P Bazinet
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - F Au-Yeung
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A Zurbau
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - H V T Ho
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - L Duvnjak
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - J L Sievenpiper
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, ON, Canada
| | - R G Josse
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, ON, Canada
| | - A Hanna
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, ON, Canada
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Hellenbrand DJ, Kaeppler KE, Ehlers ME, Thompson CD, Zurko JC, Buchholz MM, Springer AR, Thompson DL, Ibrahim RK, Hanna A. Immunohistochemical assessment of rat nerve isografts and immunosuppressed allografts. Neurol Res 2016; 38:1094-1101. [PMID: 27809726 DOI: 10.1080/01616412.2016.1248626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Autologous peripheral nerve grafts are commonly used clinically as a treatment for peripheral nerve injuries. However, in research using an autologous graft is not always feasible due to loss of function, which in many cases is assessed to determine the efficacy of the peripheral nerve graft. In addition, using allografts for research require the use of an immunosuppressant, which creates unwanted side effects and another variable within the experiment that can affect regeneration. The objective of this study was to analyze graft rejection in peripheral nerve grafts and the effects of cyclosporine A (CSA) on axonal regeneration. METHODS Peripheral nerve grafts in inbred Lewis rats were compared with Sprague-Dawley (SD) rats to assess graft rejection, CSA side effects, immune responses, and regenerative capability. Macrophages and CD8+ cells were labeled to determine graft rejection, and neurofilaments were labeled to determine axonal regeneration. RESULTS SD rats without CSA had significantly more macrophages and CD8+ cells compared to Lewis autografts, Lewis isografts, and SD allografts treated with CSA. Lewis autografts, Lewis isografts, and SD autografts had significantly more regenerated axons than SD rat allografts. Moreover, allografts in immunosuppressed SD rats had significantly less axons than Lewis rat autograft and isografts. DISCUSSION Autografts have long been the gold standard for treating major nerve injuries and these data suggest that even though CSA is effective at reducing graft rejection, axon regeneration is still superior in autografts versus immunosuppressed allografts.
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Affiliation(s)
- Daniel J Hellenbrand
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Katie E Kaeppler
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Mark E Ehlers
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Colton D Thompson
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Joanna C Zurko
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Morgan M Buchholz
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Alexandra R Springer
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Daniel L Thompson
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Rami K Ibrahim
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
| | - Amgad Hanna
- a Department of Neurological Surgery , University of Wisconsin , Madison , WI , USA
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Krueger S, Kane J, Dabjan M, Hanna A, Wilson G, Guerrero T, Marples B. Characterizing Pulmonary Damage After Thoracic Irradiation Using Magnetic Resonance Imaging, Positron Emission Tomography, and Computed Tomography. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
| | - Amgad Hanna
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
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Hanna A. The SPA arrangement of the branches of the upper trunk of the brachial plexus: a correction of a longstanding misconception and a new diagram of the brachial plexus. J Neurosurg 2016; 125:350-4. [DOI: 10.3171/2015.5.jns15367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Brachial plexus (BP) diagrams in most textbooks and papers represent the branches and divisions of the upper trunk (UT) in the following sequence from cranial to caudal: suprascapular nerve, anterior division, and then posterior division. This concept contradicts what is seen in the operating room and is noticed by most peripheral nerve surgeons. This cadaveric study was conducted to look specifically at the exact pattern of branching of the upper trunk of the BP.
METHODS
Ten cadavers (20 BPs) were dissected. Both supra- and infraclavicular exposures were performed. The clavicle was retracted or resected to identify the divisions of the BP. A posterior approach was used in 2 cases.
RESULTS
In all dissections the origin of the posterior division was in a more cranial and dorsal plane in relation to the anterior division. In most dissections the supra scapular nerve branched off distally from the UT, giving it the appearance of a trifurcation, taking off just cranial and dorsal to the posterior division. The branching pattern of the UT consistently had the following sequential arrangement from cranial and posterior to caudal and anterior: suprascapular nerve (S), posterior division (P), and anterior division (A), hence the acronym SPA.
CONCLUSIONS
Supraclavicular exposure of the BP exposes only the trunks and divisions. Recognizing the “SPA” arrangement of the branches helps in identifying the correct targets for neurotization, especially given that these 3 branches are the most common targets for BP repair. Understanding the anatomy means better surgical planning and better patient outcomes.
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Grayev A, Reeder S, Hanna A. Use of chemical shift encoded magnetic resonance imaging (CSE-MRI) for high resolution fat-suppressed imaging of the brachial and lumbosacral plexuses. Eur J Radiol 2016; 85:1199-207. [PMID: 27161071 DOI: 10.1016/j.ejrad.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/05/2016] [Accepted: 04/08/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE In the era of increasingly complex surgical techniques for peripheral nerve repair, there is a need for high spatial resolution imaging of the neural plexuses in the body. We describe our experience with chemical shift encoded MRI and its implications for patient management. MATERIALS AND METHODS IDEAL water-fat separation is a chemical shift based method of homogeneously suppressing signal from fat, while maintaining adequate signal. This technique was used in clinical practice and the patient images reviewed. RESULTS IDEAL water-fat separation was shown to improve visualization of the brachial and lumbosacral plexuses with good fat suppression and high signal to noise ratio. CONCLUSION IDEAL water - fat separation is an excellent technique to use in the imaging of the brachial and lumbosacral plexuses as it balances the need for homogeneous fat suppression with maintenance of excellent signal to noise ratio.
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Affiliation(s)
- Allison Grayev
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA.
| | - Scott Reeder
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA; Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, 600Highland Avenue, Madison, WI, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600Highland Avenue, Madison, WI, USA; Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA
| | - Amgad Hanna
- Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA
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Kane J, Krueger S, Hanna A, Raffel T, Wilson G, Madlambayan G, Marples B. OC-0048: Tumor microenvironment response and bone marrow cell migration after pulsed radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hanna A, Thompson DL, Hellenbrand DJ, Lee JS, Madura CJ, Wesley MG, Dillon NJ, Sharma T, Enright CJ, Murphy WL. Sustained release of neurotrophin-3 via calcium phosphate-coated sutures promotes axonal regeneration after spinal cord injury. J Neurosci Res 2016; 94:645-52. [DOI: 10.1002/jnr.23730] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 02/17/2016] [Accepted: 02/17/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Amgad Hanna
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - Daniel L. Thompson
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
- Department of Biomedical Engineering; University of Wisconsin; Madison Wisconsin
| | - Daniel J. Hellenbrand
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
- Department of Biomedical Engineering; University of Wisconsin; Madison Wisconsin
| | - Jae-Sung Lee
- Department of Biomedical Engineering; University of Wisconsin; Madison Wisconsin
- Department of Orthopedics and Rehabilitation; University of Wisconsin; Madison Wisconsin
| | - Casey J. Madura
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - Meredith G. Wesley
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - Natalie J. Dillon
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - Tapan Sharma
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - Connor J. Enright
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin
| | - William L. Murphy
- Department of Biomedical Engineering; University of Wisconsin; Madison Wisconsin
- Department of Orthopedics and Rehabilitation; University of Wisconsin; Madison Wisconsin
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Johnson M, Baschnagel A, Stone B, Thibodeau B, Galoforo S, Grills I, Hanna A, Wilson G. Novel Target Identification in Pancreatic Adenocarcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Hyder J, Bentzen S, Hanna A, Choi E, Boggs H, Kwok Y, Feigenberg S, Regine W, Woodworth G, Barnholtz-Sloan J, Weltman E, Sperduto P, Mehta M. Prognostic Models for Patients With Brain Metastases Treated With Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Boggs DH, Tarabolous C, Morris CG, Hanna A, Burrows W, Horiba N, Suntharalingam M. Analysis of pathological complete response rates with paclitaxel-based regimens in trimodality therapy for esophageal cancer. Dis Esophagus 2015; 28:619-25. [PMID: 24863682 DOI: 10.1111/dote.12243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The study aimed to examine whether omission of 5-fluorouracil (5-FU)-containing chemotherapy alters pathological complete response rates in patients receiving trimodality therapy for locally advanced esophageal cancer. A total of 159 patients were identified. One hundred twenty-nine patients received platinum/5-FU concurrently with radiotherapy, and 30 received taxane/platinum-containing chemoradiotherapy prior to esophagectomy. Patients were staged using the 2002 American Joint Committee on Cancer staging system. Patients were matched between chemotherapeutic groups, with no significant demographic or clinical differences other than T stage (14% T2 in the 5-FU group; no T2 in the platinum/taxane group) and radiotherapy technique (8.5% received intensity-modulated radiotherapy in the 5-FU group; 60% in the platinum/taxane group). Pathological complete response rates for 5-FU and platinum/taxane-based groups were not significantly different (45% and 30%, respectively; P = 0.1548). Five-year overall survival and progression-free survival were not statistically different between the two groups. Significant predictors of pathological complete response included N stage (56% N0 and 33% N1; P = 0.0083), histology (37% adenocarcinoma and 59% squamous cell; P = 0.0123), tumor location (39% distal and 59% proximal/mid; P = 0.048), gastroesophageal junction involvement (33% involved and 55% uninvolved; P = 0.005), and radiotherapy end-to-surgery interval (50% < 55 days and 34% ≥ 55 days; P = 0.04). Grades 3-4 hematological toxicity was higher in the 5-FU group (36%) than in the paclitaxel-containing therapy group (17%; P = 0.0484). Use of paclitaxel-containing chemoradiotherapy did not result in inferior pathological complete response, overall survival, or progression-free survival rates, and resulted in less hematological toxicity than 5-FU treatment.
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Affiliation(s)
- D H Boggs
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD, USA
| | - C Tarabolous
- Department of Medical Oncology, University of Maryland Medical Center, Baltimore, MD, USA
| | - C G Morris
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - A Hanna
- University of Maryland Medical School, Baltimore, MD, USA
| | - W Burrows
- Department of Thoracic Surgery, University of Maryland Medical Center, Baltimore, MD, USA
| | - N Horiba
- Department of Medical Oncology, University of Maryland Medical Center, Baltimore, MD, USA
| | - M Suntharalingam
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
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Hill AA, Dewé T, Kosmider R, Von Dobschuetz S, Munoz O, Hanna A, Fusaro A, De Nardi M, Howard W, Stevens K, Kelly L, Havelaar A, Stärk K. Modelling the species jump: towards assessing the risk of human infection from novel avian influenzas. R Soc Open Sci 2015; 2:150173. [PMID: 26473042 PMCID: PMC4593676 DOI: 10.1098/rsos.150173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/12/2015] [Indexed: 05/06/2023]
Abstract
The scientific understanding of the driving factors behind zoonotic and pandemic influenzas is hampered by complex interactions between viruses, animal hosts and humans. This complexity makes identifying influenza viruses of high zoonotic or pandemic risk, before they emerge from animal populations, extremely difficult and uncertain. As a first step towards assessing zoonotic risk of influenza, we demonstrate a risk assessment framework to assess the relative likelihood of influenza A viruses, circulating in animal populations, making the species jump into humans. The intention is that such a risk assessment framework could assist decision-makers to compare multiple influenza viruses for zoonotic potential and hence to develop appropriate strain-specific control measures. It also provides a first step towards showing proof of principle for an eventual pandemic risk model. We show that the spatial and temporal epidemiology is as important in assessing the risk of an influenza A species jump as understanding the innate molecular capability of the virus. We also demonstrate data deficiencies that need to be addressed in order to consistently combine both epidemiological and molecular virology data into a risk assessment framework.
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Affiliation(s)
- A. A. Hill
- Royal Veterinary College, London, UK
- Animal and Plant Health Agency, New Haw, Surrey, UK
- Author for correspondence: A. A. Hill e-mail:
| | - T. Dewé
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - R. Kosmider
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - S. Von Dobschuetz
- Royal Veterinary College, London, UK
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - O. Munoz
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - A. Hanna
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - A. Fusaro
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - M. De Nardi
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - W. Howard
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | | | - L. Kelly
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | | | - K. Stärk
- Royal Veterinary College, London, UK
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Hanna A, Birla R, Iosif C, Boeriu M, Tomsa R, Puscasu A, Constantinoiu S. Evaluation of Neoadjuvant Radiochemotherapy Response (RCT) in Squamous Esophageal Cancer (ESC) and Implications in Therapeutic Conduct. Chirurgia (Bucur) 2015; 110:214-23. [PMID: 26158730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 10/28/2022]
Abstract
The multidisciplinary approach in ESC emerged as a result of efforts to maximize the treatment outcome of this disease.Surgical approach as the only therapeutic option is not always followed by a good distance survival. A concomitant neoadjuvant radiochemotherapy in ESC may result in a favourable outcome for responding patients, reducing the size of the tumor and the degree of lymph node damage increasing resectability and the R0 resection rate, improving prognosis. For non-responding patients or if the disease continues to progress under RCT therapy, the surgical time is delayed, adverse effects of radiochemotherapy are added and postoperative morbidity and mortality are increased. The imaging methods for the assessment of response have only limited value and metabolic response; only FDG-PET manages to come close to pathological response. Determining the response degree is very important for the establishment of the surgical conduct: planned or necessity surgery, or non-surgical palliative therapy.
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Choi E, Diamond A, Hanna A, Boggs H, Feigenberg S, Kwok Y, Simard J, Barnholtz-Sloan J, Mehta M. Application of a Survival-Predicting Nomogram Based Primarily on Whole-Brain Radiation Therapy–Treated Patients With Brain Metastases Yields Significant Underestimates for Radiosurgery-Treated Patients. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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46
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Boggs H, Hanna A, Horiba N, Burrows W, Suntharalingam M. Primary Gross Tumor Volume Is an Important Prognostic Factor in Locally Advanced Esophageal Cancer Patients Treated With Trimodality Therapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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47
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Hanna A, Boggs D, Kwok Y, Eisenberg H, Simard M, Woodworth G, Regine W, Mehta M. Factors Predicting for Increase in Peritumoral Edema Following Radiosurgery of Brain Metastases. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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48
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Baschnagel A, Williams L, Hanna A, Chen P, Krauss D, Pruetz B, Akervall J, Wilson G. c-Met Expression Is a Marker of Poor Prognosis in Patients With Locally Advanced Head-and-Neck Squamous Cell Carcinoma Treated With Chemoradiation. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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49
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Hellenbrand DJ, Kaeppler KE, Hwang E, Ehlers ME, Toigo RD, Giesler JD, Vassar-Olsen ER, Hanna A. Basic techniques for long distance axon tracing in the spinal cord. Microsc Res Tech 2013; 76:1240-9. [DOI: 10.1002/jemt.22291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 08/22/2013] [Accepted: 08/27/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Daniel J. Hellenbrand
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
- Department of Biomedical Engineering; University of Wisconsin; Madison Wisconsin 53706
| | - Katie E. Kaeppler
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Euhaa Hwang
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Mark E. Ehlers
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Ross D. Toigo
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Joseph D. Giesler
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Erika R. Vassar-Olsen
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
| | - Amgad Hanna
- Department of Neurological Surgery; University of Wisconsin; Madison Wisconsin 53792
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Thompson CD, Zurko JC, Hanna BF, Hellenbrand DJ, Hanna A. The therapeutic role of interleukin-10 after spinal cord injury. J Neurotrauma 2013; 30:1311-24. [PMID: 23731227 DOI: 10.1089/neu.2012.2651] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Spinal cord injury (SCI) is a devastating condition affecting 270,000 people in the United States. A potential treatment for decreasing the secondary inflammation, excitotoxic damage, and neuronal apoptosis associated with SCI, is the anti-inflammatory cytokine interleukin-10. The best characterized effects of IL-10 are anti-inflammatory-it downregulates pro-inflammatory species interleukin-1β (IL-1β), interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor-α, interferon-γ, matrix metalloproteinase-9, nitric oxide synthase, myeloperoxidase, and reactive oxygen species. Pro-apoptotic factors cytochrome c, caspase 3, and Bax are downregulated by IL-10, whereas anti-apoptotic factors B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X, B-cell lymphoma-extra large (Bcl-xl) are upregulated by IL-10. IL-10 also provides trophic support to neurons through the IL-10 receptor. Increased tissue sparing, functional recovery, and neuroprotection are seen with an immediate post-SCI systemic administration of IL-10. Treatment of SCI with IL-10 has been used successfully in combination with Schwann cell and olfactory glial cell grafts, as well as methylprednisolone. Minocycline, tetramethylpyrazine, and hyperbaric oxygen treatment all increase IL-10 levels in a SCI models and result in increased tissue sparing and functional recovery. A chronic systemic administration of IL-10 does not appear to be beneficial to SCI recovery and causes increased susceptibility to septicemia, pneumonia, and peripheral neuropathy. However, a localized upregulation of IL-10 has been shown to be beneficial and can be achieved by herpes simplex virus gene therapy, injection of poliovirus replicons, or surgical placement of a slow-release compound. IL-10 shows promise as a treatment for SCI, although research on local IL-10 delivery timeline and dosage needs to be expanded.
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Affiliation(s)
- Colton D Thompson
- Department of Neurological Surgery, University of Wisconsin , Madison, Wisconsin, USA
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