Vital Structures Research Articles

A Unique Case of Primary Subfrontal Lobe Meningioma with Intraorbital Extension

Introduction: Meningiomas, tumors originating from the meninges covering the brain, are typically considered benign. They primarily develop from arachnoid cap cells within the meninges and can manifest as primary orbital meningiomas (affecting structures like the optic nerve sheath) or secondary orbital meningiomas that extend from intracranial origins, such as the sphenoid wing and rarely from frontal lobe as in our case. Case Presentation: This report documents a very rare case where a meningioma emerged in the subfrontal lobe of the brain and subsequently spread to the orbit. The presence of such malignant variants in the orbit poses unique diagnostic challenges due to their potential to compress critical adjacent brain structures. Impact on Orbital Structures: The extension of these tumors into the orbit can have significant consequences, affecting structures like the cavernous sinus, superior orbital fissure, intraorbital contents, and the optic nerve. This further complicates their surgical management, given their proximity to essential neurological systems. Conclusion: This case study underscores the atypical growth pattern of malignant meningioma and highlights the complexities associated with identifying and treating meningioma with orbital extensions. The propensity of these tumors to impact vital brain structures necessitates a comprehensive approach to their diagnosis and management.

Optical Fiber-Based Needle Shape Sensing in Real Tissue: Single Core vs. Multicore Approaches.

Flexible needle insertion procedures are common in minimally-invasive surgeries for diagnosing and treating prostate cancer. Bevel-tip needles provide physicians the capability to steer the needle during long insertions to avoid vital anatomical structures in the patient and reduce post-operative patient discomfort. To provide needle placement feedback to the physician, sensors are embedded into needles for determining the real-time 3D shape of the needle during operation without needing to visualize the needle intra-operatively. Through expansive research in fiber optics, a plethora of bio-compatible, MRI-compatible, optical shape-sensors have been developed to provide real-time shape feedback, such as single-core and multicore fiber Bragg gratings. In this paper, we directly compare single-core fiber-based and multicore fiber-based needle shape-sensing through similarly constructed, four-active area sensorized bevel-tip needles inserted into phantom and ex-vivo tissue on the same experimental platform. In this work, we found that for shape-sensing in phantom tissue, the two needles performed identically with a p-value of 0.164 > 0.05, but in ex-vivo real tissue, the single-core fiber sensorized needle significantly outperformed the multicore fiber configuration with a p-value of 0.0005 < 0.05. This paper also presents the experimental platform and method for directly comparing these optical shape sensors for the needle shape-sensing task, as well as provides direction, insight and required considerations for future work in constructively optimizing sensorized needles.

Utilizing the photodynamic properties of curcumin to disrupt biofilms in Cutibacterium acnes: A promising approach for treating acne

BackgroundThe treatment of acne vulgaris is often challenging due to the antibiotic resistance frequently observed in Cutibacterium acnes (C.acnes), a prevalent bacterium linked to this condition. ObjectiveThe objective of this research was to examine the impact of curcumin photodynamic therapy (PDT) on the survival of C.acnes and activity of biofilms produced by this microorganism. MethodsFollowing the Clinical and Laboratory Standards Institute (CLSI) guidelines, we assessed the drug sensitivity of 25 clinical C.acnes strains to five antibiotics (erythromycin, clindamycin, tetracycline, doxycycline, minocycline) and curcumin by implementing the broth microdilution technique. In addition, we established C.acnes biofilms in a laboratory setting and subjected them to curcumin-PDT(curcumin combined with blue light of 180 J/cm2). Afterwards, we evaluated their viability using the XTT assay and observed them using confocal laser scanning microscopy. ResultsThe result revealed varying resistance rates among the tested antibiotics and curcumin, with erythromycin, clindamycin, tetracycline, doxycycline, minocycline, and curcumin exhibiting resistance rates of 72 %, 44 %, 36 %, 28 %, 0 %, and 100 %, respectively. In the curcumin-PDT inhibition tests against four representative antibiotic-resistant strains, it was found that the survival rate of all strains of planktonic C. acnes was reduced, and the higher the concentration of curcumin, the lower the survival rate. Furthermore, in the biofilm inhibition tests, the vitality and three-dimensional structure of the biofilms were disrupted, and the inhibitory effect became more significant with higher concentrations of curcumin. ConclusionThe results emphasize the possibility of using curcumin PDT as an alternative approach for the treatment of C.acnes, especially in instances of antibiotic-resistant variations and infections related to biofilms.

The Mandibular Canal: A Study to Determine If Cortical Bone Exists as a Protective Roof for the Inferior Alveolar Nerve.

Placement of dental implants has many inherent risks, of which all clinicians must be aware. One of the most important concepts in dental implantology is avoidance of the vital structures present in the human jaws, which can have both immediate as well as long-standing implications. The inferior alveolar nerve (IAN) is one of these vital structures located in the posterior body of the mandible. Invasion of this sensory nerve with a dental implant can result in transient or permanent paresthesia, anesthesia, or dysesthesia. Radiographic imaging is done routinely order to assess the bone volume prior to implant surgery and plan for a safety zone above the IAN. The IAN is contained within the mandibular canal, and this structure is usually visualized during cone-beam computerized tomography (CBCT) scans. The mandibular canal, as it is viewed on CBCT, appears to have a cortical layer of bone protecting the IAN, and clinicians often discuss a bony layer of protection that can be felt by the clinician during osteotomy preparation. The purpose of this research project was to ascertain whether the mandibular canal has continuous or partial remnants of cortical bone lining the roof of the canal or whether the IAN simply travels through spongy, cancellous bone with no cortical bony protection.

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Dual plating of comminuted distal femoral fractures allows for early patient mobilization. An additional helically shaped medial plate avoids the medial vital structures of the thigh. The aim of this study is to investigate the biomechanical competence of an augmented lateral locking compression plate distal femur (LCP-DF) using an additional straight versus a helically shaped medial LCP of the same length. Ten pairs of human cadaveric femora were instrumented with a lateral anatomical 15-hole LCP-DF. Following, they were pairwise instrumented with either an additional medial straight 14-hole LCP (group 1) or a 90°-helical shape LCP (group 2). All specimens were biomechanically tested under quasi-static and progressively increasing combined cyclic axial and torsional loading until failure. Initial interfragmentary axial displacement and flexion under static compression were significantly smaller in group 1 (0.11 ± 0.12 mm and 0.21 ± 0.10°) versus group 2 (0.31 ± 0.14 mm and 0.68 ± 0.16°), p ≤ 0.007. Initial varus deformation under static compression remained not significantly different between group 1 (0.57 ± 0.23°) and group 2 (0.75 ± 0.34°), p = 0.085. Flexion movements during dynamic loading were significantly bigger in group 2 (2.51 ± 0.54°) versus group 1 (1.63 ± 1.28°), p = 0.015; however, no significant differences were observed in terms of varus, internal rotation, and axial and shear displacements between the groups, p ≥ 0.204. Cycles to failure and load at failure were higher in group 2 (25,172 ± 6376 and 3017 ± 638 N) compared to group 1 (22,277 ± 4576 and 2728 ± 458 N) with no significant differences between them, p = 0.195. From a biomechanical perspective, helical double plating may be considered a useful alternative to straight double plating, demonstrating ameliorated damping capacities during flexion deformation and safer application as the medial neurovascular structures of the thigh are avoided.

Laparoscopic Colorectal Surgery with Anatomical Recognition with Artificial Intelligence Assistance for Nerves and Dissection Layers

BackgroundIn digestive tract surgery, dissection of an avascular space consisting of loose connective tissue (LCT) appearing by countertraction improves oncological outcomes and reduces complications.1–3 Kumazu et al.4 described a deep learning approach that automatically segments LCT to help surgeons.4 During left colorectal surgery, lumbar splanchnic, hypogastric, and pelvic visceral nerve injuries cause sexual dysfunction and/or urinary issues.5 As nerve preservation is critical for functional preservation, the AI model Kumazu reported is named Eureka (Anaut Inc., Tokyo, Japan) and was developed to separate nerves automatically. The educative efficacy of intraoperative nerve visualization has been described.6 Artificial intelligence (AI) assisted navigation is expected to aid in the anatomical recognition of nerves and the safe dissection layers surrounding nerves in the future.MethodsWe used Eureka as an educational tool for surgeons’ training during laparoscopic colorectal surgery. The laparoscopic system used was Olympus VISERA ELITE3 (Tokyo, Japan).ResultsTotal mesorectal excision (TME) was safely performed with nerve preservation. No postoperative complications occurred. Automatic segmentation and highlighting of LCT in the dissected layers, lumbar splanchnic, hypogastric, and pelvic visceral nerves (S3, S4), were performed in real time.ConclusionsIn colorectal cancer surgery, the nerves are vital anatomical structures serving as landmarks for dissection. Lumbar splanchnic, hypogastric, and pelvic visceral nerve injuries (S3, S4) cause sexual dysfunction or urinary disorders.5 Nerve preservation is important for functional preservation. AI-assisted navigation methods are noninvasive, user-friendly, and expected to improve in accuracy in the future. They have the potential to develop nerve-guided TME.

CT-Guided Trans-osseous Biopsy: Experience in 24 Patients.

The objective of this study is to assess the effectiveness of computed tomography-guided trans-osseous biopsies in deep-seated lesions and report encountered complications. A retrospective cohort study was performed which included twenty-four patients with pathologic medical history and lesions non-accessible by common approaches. Exclusion criteria include patients who could be biopsied without trans-osseous access, as for example procedures aided with hydro- or pneumo-dissection. The population studied included 13 females (54.2%) and the overall average age was 64.5 (IIQ 43-69). The procedures were carried out through the following bones: sternum (n = 6), vertebral (n = 5), iliac (n = 5), scapula (n = 3), rib (n = 2), sacral (n = 2), and pubis (n = 1). The efficiency for these procedures was 87.5%, while 8.33% of them were non-diagnostic and 4.17% were inconclusive due to vital risk during the procedure. Computed tomography-guided trans-osseous biopsy resulted in a safe and effective technique for those lesions blocked by vital structures or apparently directly inaccessible.

The occurrence of ultralow friction even superlubricity for graphene oxide/hydrogenated diamond-like carbon composites in multi-environments

The establishment of ultralow friction and superlubricity can significantly decrease the dissipation of energy and failure of parts in moving mechanical systems. Hydrogenated diamond-like carbon (H-DLC) film can realize the frictionless state at engineering scale by the stress-induced graphitization that leads to the formation of the vital superlubricious structures: graphene-like carbon and onion-like carbon during the sliding process. Herein, we designed some composites by combination H-DLC film and graphene oxide (GO) nanosheets to provide the “pre-graphitized” sliding interface for decreasing the friction. Frictional behaviors of these composites in different atmospheres and the as-formed structures of sliding interfaces were investigated comprehensively in this work. It was demonstrated that the existence of GO on H-DLC film could significantly decrease the friction and even establish the near friction-vanishing state. The structural investigations showed that the existence of GO on H-DLC film could work as a “pre-graphitization” process, hinder the structural evolution of H-DLC film from amorphous to sp2-rich ones and endow the composite with ultralow friction even superlubricious performance. The investigation would provide some helpful advices for H-DLC film to establish ultralow even superlow friction from inert atmospheres to humid air at engineering scale by depositing GO flakes on the surface of H-DLC film.

Advances in Virtual Cutting Guide and Stereotactic Navigation for Complex Tumor Resections of the Sacrum and Pelvis: Case Series with Short-Term Follow-Up.

Primary malignancies of the sacrum and pelvis are aggressive in nature, and achieving negative margins is essential for preventing recurrence and improving survival after en bloc resections. However, these are particularly challenging interventions due to the complex anatomy and proximity to vital structures. Using virtual cutting guides to perform navigated osteotomies may be a reliable method for safely obtaining negative margins in complex tumor resections of the sacrum and pelvis. This study details the technique and presents short-term outcomes. Patients who underwent an en bloc tumor resection of the sacrum and/or pelvis using virtual cutting guides with a minimum follow-up of two years were retrospectively analyzed and included in this study. Preoperative computer-assisted design (CAD) was used to design osteotomies in each case. Segmentation, delineating the tumor from normal tissue, was performed by the senior author using preoperative CT scans and MRI. Working with a team of biomedical engineers, virtual surgical planning was performed to create osteotomy lines on the preoperative CT and overlaid onto the intraoperative CT. The pre-planned osteotomy lines were visualized as "virtual cutting guides" providing real-time stereotactic navigation. A precision ultrasound-powered cutting tool was then integrated into the navigation system and used to perform the osteotomies in each case. Six patients (mean age 52.2 ± 17.7 years, 2 males, 4 females) were included in this study. Negative margins were achieved in all patients with no intraoperative complications. Mean follow-up was 38.0 ± 6.5 months (range, 24.8-42.2). Mean operative time was 1229 min (range, 522-2063). Mean length of stay (LOS) was 18.7 ± 14.5 days. There were no cases of 30-day readmissions, 30-day reoperations, or 2-year mortality. One patient was complicated by flap necrosis, which was successfully treated with irrigation and debridement and primary closure. One patient had local tumor recurrence at final follow-up and two patients are currently undergoing treatment for metastatic disease. Using virtual cutting guides to perform navigated osteotomies is a safe technique that can facilitate complex tumor resections of the sacrum and pelvis.

Is antero-lateral complex of knee joint of critical importance in restoring rotational instability in patients with anterior cruciate ligament tear?

Antero-lateral ligament complex (ALC) is a vital structure for maintaining rotational stability of the knee. Evaluation of ALC radiologically (MRI) is still unpopular in setting of anterior cruciate ligament injury. A dire necessity exists for the orthopedic surgeons in outdoor patient department settings to rule out involvement of ALC. So, that it can be addressed during operating for Anterior Cruciate Ligament injury. The authors have formulated an algorithm on a personal level and have implemented this screening program and initiated screening of young to middle aged patients reporting with rotational knee instability for ALC involvement before recommending final operative plan. This screening program which uses specifically devised physical tests have significantly reduced the number of underdiagnosed Antero Lateral Ligament tear.

Cryosurgery for Basal Cell Skin Cancer of the Head: 15 Years of Experience.

The clinical relevance of head and neck (H&N) tumors is related to the potential disfiguration of anatomical structures (by the tumor or surgical intervention), defining patients' individual features and emotional expression, loss or restraint of vital structures functions, and untoward socio-economic sequelae. This study is aimed to improve clinical outcomes of cryosurgery in patients with H&N basal cell skin cancer by refining the indications for cryosurgical treatment. In this study, cryosurgery was used in 234 patients with different stages of cutaneous basal cell carcinoma (BCC) of the head, including 101 patients with T1 tumors, 86-with T2, 5-T3, and 42 patients with tumors relapsing after failure of preceding various treatment modalities. Post-cryosurgery recurrence rate in patients with stage I BCC was 2.7%, with stage II tumors-5.6% and 34.9%-in patients with recurred tumors. Re-recurrence after cryoablation of recurrent tumors correlated with the tumor baseline size. The best aesthetic and long-term clinical results were documented in patients with lesions <1 cm in size with clear boundaries. Thus, cryosurgery is the method of choice for the majority of stage I basal cell carcinomas of the head. For patients with advanced and recurrent skin cancer, cryosurgery is relevant in rare cases selected according to refined indications.

Revitalization Approaches to Maximize Heritage Urban DNA Characteristics in Declined Cities: Foah City as a Case Study

Revitalization is an important process in action area planning, especially in the heritage sites located within urban area contexts. Varied techniques and tools of revitalization are applied at various spatial levels, some are suitable for the urban scope, and others suit the architectural building scope. Urban DNA is a term used academically to reflect social, economic, and urban characteristics but has a different interpretation that depends on the spatial scale and context. In action areas, urban DNA refers to the essential visual, social, economic, and physical characteristics that preserve the vital structure of an urban area. Heritage areas are vital in a city structure, in the journey of maximizing the urban DNA chrematistics of heritage sites, sometimes the urban DNA is lost in the process. This paper identifies and encapsulates the importance of Urban DNA in heritage site considerations in the revitalization process within heritage urban context to maximize the socio-economic and visual impacts, especially in declined cities such as Foah City the case study in the Nile Delta region in Egypt. The results pinpoint the most effective urban DNA structure for the declined Foah Heritage Center, despite the city's importance as a ranked third of heritage cities in the country.

SURG-30. CLINICAL CONSIDERATIONS, APPROACH SELECTION, AND OUTCOMES ASSOCIATED WITH TREATMENT STRATEGIES FOR FALCOTENTORIAL MENINGIOMAS: SYSTEMATIC REVIEW AND META-ANALYSIS OF THE CURRENT EVIDENCE

Abstract INTRODUCTION Meningiomas at the falcotentorial (FT) junction are rare, as they account for only 0.3%-1.1% of all intracranial meningiomas. Clinical management of FT meningiomas can be challenging. METHODS The authors queried three databases per PRISMA guidelines to identify all studies reporting indications for surgical resection of FT meningioma. RESULTS Thirty studies reporting 224 FT patients met pre-specified inclusion criteria. Patients diagnosed with FT meningioma demonstrated a predilection for headache on initial examination (p = 0.030).Headache was the mostly commonly reported symptom, present more often than visual disturbance (RR 2.28 [1.59, 3.26], I2=0%, P &amp;lt; 0.00001), ataxia or imbalance (RR 0.21 [0.08, 0.35], I2= 0%, P = 0.002), and cognitive disturbance (RR 0.34 [0.20, 0.47], I2 = 12%, P &amp;lt; 0.00001). An overwhelming majority of lesions (n = 97, 80.2%) were benign, WHO Grade I. The primary arterial feeders supplying the FT lesions were reported in 13 studies; most commonly, these arterial feeders included the distal branches of the ICA (n = 29), ECA (n = 25), and vertebrobasilar vasculature (n = 35). Visual deficits (n = 32, 14.3%) were the most common postoperative complication.Bassiouni classification of the tumors was reported in 10 studies, with 27 (31.8%) classified as type I, 16 (18.8%) as type II, 37 (43.5%) as type III, and five (5.9%) as type IV FT meningiomas.Simpson Grade I resection (n = 76, 43.7%) was achieved in slightly less than half of cases. Cases involving multi-stage resections appeared to confer greater risk (RR 1.42 [0.72, 2.80], I2=0%, P = 0.31) for STR (failure to achieve GTR or Simpson Grade I resection). CONCLUSION The primary objective when treating FT meningiomas is to achieve gross total resection (GTR) or Simpson Grade 1 resection. Grade 2 resection is also regarded as a good outcome for these lesions. This goal should be pursued while minimizing cerebellar retraction and protecting vital vascular structures, such as the Galenic venous system.

Study of the Effect Age and Gender of the Bone Height on the Position of the Inferior Dental Canal Using Cone Beam Computed Tomography

Inferior alveolar canal considered as one from the most important vital structures exist in the mandible and any injury to the (IAC) during the surgical procedures should be avoided, knowing the exact position of the (IAC) can help in avoiding the injury of the (IAC). The sample was consist of 100 patients divided into 2 main groups 1st group consist of 50 males (25 males dentulous, 25 males edentulous), and the 2nd group consisted of 50 females (25 females before menopause &amp; 25 females after menopause). Two measurements were taken the 1st from the crest of alveolar ridge to the superior rim of the (IDC), and the 2nd from the inferior rim of (IDC) to the lower border of the mandible in both right and left sides of the mandible. Results: the stastical analysis of the distance from the crest of alveolar ridge to the superior rim of the (IDC) for both males &amp; females groups showed that there were highly significant difference between male (edentulous versus dentulous) the mean values less in edentulous groups ,and female ( before menopause versus after menopause) the mean values are greater in the ( before menopause ) groups, the stastical analysis of the distance from the inferior rim of (IDC) to the lower border of the mandible showed that the mean values in case of dentulous in males groups was less in edentulous group than dentulous group (right side) with non-significant difference while in the measurement of left side the mean value was higher in the edentulous group with non-significant difference and in females groups the mean values were greater in( before menopause) groups. Conclusion : it can be concluded that the position of the inferior dental canal heavy influenced by the due to the dental status ,due to the teeth loss , age and hormonal changes affect the bone height which is also affected by gender. the vertical distance from the crest of the alveolar ridge to superior rim of (IAC)., the vertical distance from the crest of the alveolar ridge to superior rim of (IAC) , and the distance from lower rim of (IAC) to the lower border of the mandible would be smaller due to the effect of bone height.

The construction of gamer identity in narratives about video game playing and formal education learning experiences

This study investigates how video game play influences gamers’ formal education through perceptions of their ‘gamer’ and ‘learner’ identities. Based on identity foundation in symbolic interactionism, we take gamer and learner identities as meaning structures with both dynamic and stable dimensions. The basis of this gamer identity perspective is identity has a crucial role in investigating learning. Applying a life history approach, we interviewed 10 participants in one-to-one interviews, with three interviews for each participant. Applying the narrative portrait, we analysed participant data. We found that gamer identity construction from video game playing, as a vital meaning structure, has four main aspects, namely in-game identification, social community expansion, restorative effect and meaning recognition, providing gamers with expansive ways to build learner and personal identity as that can benefit their formal education.

Endovascular embolization for basal ganglia and thalamic arteriovenous malformations.

Basal ganglia and thalamic arteriovenous malformations (AVMs) represent a special subset of malformations. Due to the involvement of vital brain structures and the specifically fine and delicate angioarchitecture of these lesions, it presents unique therapeutic challenges and technical difficulties that require thorough treatment planning, individualized treatment strategies, and advanced techniques for good clinical outcome. In this study, we presented a series of ruptured basal ganglia and thalamic AVMs embolized via a transarterial, transvenous or combined approach. Herein, we summarized our treatment experience and clinical outcomes to further evaluate the effectiveness and safety of endovascular embolization for these AVMs as well as the indications, therapy strategies, and techniques of embolization procedures. Twelve patients with basal ganglia and thalamus AVMs were included in the study. Their average age was 23.83 ± 16.51 years (range, 4-57 years) with a female predominance of 67% at presentation. The AVMs were located in the thalamus in 3 (25%) patients, in the basal ganglia in 3 (25%) patients, and in both sites of the brain in 6 (50%) patients. There were 5 AVMs located on the left side and 7 on the right. The mean nidus diameter was 3.32 ± 1.43 cm (range 1.3-6.1 cm). According to the Spetzler-Martin grading classification, 4 (33.3%) brain AVMs were Grade III, 7 (58.3%) were Grade IV, and 1 (8.3%) was Grade V. All of them presented with bleeding at admission: four of these patients presented with an intracerebral hemorrhage (ICH), 8 ICH in combination with intraventricular hemorrhage (IVH), and no patient with subarachnoid hemorrhage (SAH). Among these patients treated with endovascular embolization, 7 patients were treated by the transarterial approach, 4 patients transvenous approach, and 1 patient underwent the combined approach. A single embolization procedure was performed in 6 patients (50%) and the other 6 cases (50%) were treated in a staged manner with up to three procedures. Procedure-related complications occurred only in two patient (16.7%). Complete AVM obliteration was obtained in 7 patients (58.3%), and partial obliteration was in 4 patients (33.3%). Overall, good or excellent outcomes were obtained in 7 patients (58.3%), and poor functional outcome was observed in 5 patients (41.7%) at the last follow-up. All survived patients achieved anatomic stabilization and there was no postoperative bleeding or recurrence in the follow-up. The management of the basal ganglia and thalamic AVMs is a great challenge, which needs multimodal individualized treatment to improve the chances of radiographic cure and good outcomes. Endovascular therapy is safe and effective in the treatment of cerebral AVMs particularly for deep-seated AVMs such as the basal ganglia and thalamus. Our results demonstrate a high rate of anatomic obliteration with an acceptable rate of complications in the endovascular treatment of these vasculopathies via a transarterial approach or a transvenous approach.

The Poetry of the Tanatic Imaginary

The article studies the artistic representations of death in several poetic texts signed by Emilian Galaicu-Păun, Nicolae Popa, Dumitru Crudu, Leo Bordeianu, Irina Nechit, Marcela Benea, Alexandru Vakulovski. The tanatic imaginary is produced in a multitude of projections depending on the position of man towards the religious vision, through the prism of which death is only a release of the (immortal) soul from the body, from the matter that degrades and transforms into other vital structures, and with the profane perception, which defines the phenomenon as a complete end of the organism’s life cycle. The author especially researches the system of tanatic images formed through the artistic reconceptualization of the ideational relationship death-creation, intensively explored in contemporary Bessarabian poetry.

Laparoscopic Photoacoustic Imaging System Based on Side-Illumination Diffusing Fibers.

To develop a flexible miniaturized photoacoustic (PA) imaging probe for detecting anatomical structures during laparoscopic surgery. The proposed probe aimed to facilitate intraoperative detection of blood vessels and nerve bundles embedded in tissue not directly visible to the operating physician to preserve these delicate and vital structures. We modified a commercially available ultrasound laparoscopic probe by incorporating custom-fabricated side-illumination diffusing fibers that illuminate the probe's field of view. The probe geometry, including the position and orientation of the fibers and the emission angle, was determined using computational models of light propagation in the simulation and subsequently validated through experimental studies. In wire phantom studies within an optical scattering medium, the probe achieved an imaging resolution of 0.43 ±0.09 mm and a signal-to-noise ratio of 31.2±1.84 dB. We also conducted an ex vivo study using a rat model, demonstrating the successful detection of blood vessels and nerves. Our results indicate the viability of a side-illumination diffusing fiber PA imaging system for guidance during laparoscopic surgery. The potential clinical translation of this technology could enhance the preservation of critical vascular structures and nerves, thereby minimizing post-operative complications.

Effect of the Bacteriocin Subtylosin P19 on &lt;i&gt;Bacillus Anthracis&lt;/i&gt; Spores

Abstract—This is the first report on electron microscopic investigation of the effect of bacteriocin on Bacillus anthracis dormant spores. The new bacteriocin, subtilosin P19, isolated from a natural Bacillus subtilis strain, effectively killed dormant B. anthracis spores at concentrations of 0.5‒35 µg/mL after 60-min exposure. Our data, combined with analysis of the known mechanisms of the action of bacteriocins, suggest that the mechanism of spore inactivation was apparently based on multiple disruptions of the integrity of the inner and outer membranes surrounding the cortex of the resting spore. It is also likely that the molecular configuration of subtilisin P19 allows it to penetrate through the outer integuments and to damage the vital membrane structures of the anthrax spores. Subtilosin P19 can serve as a promising basis for new antimicrobial preparations of natural origin.

Quantitative Anatomical Comparison of Surgical Approaches to Meckel's Cave.

Meckel's cave is a challenging surgical target due to its deep location and proximity to vital neurovascular structures. Surgeons have developed various microsurgical transcranial approaches (MTAs) to access it, but there is no consensus on the best method. Newer endoscopic approaches have also emerged. This study seeks to quantitatively compare these surgical approaches to Meckel's cave, offering insights into surgical volumes and exposure areas. Fifteen surgical approaches were performed bilaterally in six specimens, including the pterional approach (PTA), fronto-temporal-orbito-zygomatic approach (FTOZA), subtemporal approach (STA), Kawase approach (KWA), retrosigmoid approach (RSA), retrosigmoid approach with suprameatal extension (RSAS), endoscopic endonasal transpterygoid approach (EETPA), inferolateral transorbital approach (ILTEA) and superior eyelid approach (SEYA). All the MTAs were performed both with 10 mm and 15 mm of brain retraction, to consider different percentages of surface exposure. A dedicated navigation system was used to quantify the surgical working volumes and exposure of different areas of Meckel's cave (ApproachViewer, part of GTx-Eyes II, University Health Network, Toronto, Canada). Microsurgical transcranial approaches were quantified with two different degrees of brain retraction (10 mm and 15 mm). Statistical analysis was performed using a mixed linear model with bootstrap resampling. The RSAS with 15 mm of retraction offered the maximum exposure of the trigeminal stem (TS). If compared to the KWA, the RSA exposed more of the TS (69% vs. 46%; p = 0.01). The EETPA and ILTEA exposed the Gasserian ganglion (GG) mainly in the anteromedial portion, but with a significant 20% gain in exposure provided by the EETPA compared to ILTEA (42% vs. 22%; p = 0.06). The STA with 15 mm of retraction offered the maximum exposure of the GG, with a significant gain in exposure compared to the STA with 10 mm of retraction (50% vs. 35%; p = 0.03). The medial part of the three trigeminal branches was mainly exposed by the EETPA, particularly for the ophthalmic (66%) and maxillary (83%) nerves. The EETPA offered the maximum exposure of the medial part of the mandibular nerve, with a significant gain in exposure compared to the ILTEA (42% vs. 11%; p = 0.01) and the SEY (42% vs. 2%; p = 0.01). The FTOZA offered the maximum exposure of the lateral part of the ophthalmic nerve, with a significant gain of 67% (p = 0.03) and 48% (p = 0.04) in exposure compared to the PTA and STA, respectively. The STA with 15 mm of retraction offered the maximum exposure of the lateral part of the maxillary nerve, with a significant gain in exposure compared to the STA with 10 mm of retraction (58% vs. 45%; p = 0.04). The STA with 15 mm of retraction provided a significant exposure gain of 23% for the lateral part of the mandibular nerve compared to FTOZA with 15 mm of retraction (p = 0.03). The endoscopic approaches, through the endonasal and transorbital routes, can provide adequate exposure of Meckel's cave, especially for its more medial portions, bypassing the impediment of major neurovascular structures and significant brain retraction. As far as the most lateral portion of Meckel's cave, MTA approaches still seem to be the gold standard in obtaining optimal exposure and adequate surgical volumes.