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PURPOSE A retrospective multi-center comparative study to evaluate whether pregnancy leads to the loss of deformity correction (LOC) in female patients surgically treated for idiopathic scoliosis. METHODS One hundred twenty-eight female patients underwent segmental spinal instrumentation and fusion for AIS between 1999 and 2014 were reviewed. Of them 62 became pregnant (surgery-pregnancy group SPG) while 66 did not (surgery-non-pregnancy group SNP). Radiographic parameters were analyzed before surgery, after surgery, before pregnancy, and up to 1 year after delivery, and at final follow-up (FFU). Health-related quality of life was analyzed using the Scoliosis Research Society outcome questionnaire (SRS-22r). RESULTS The mean age at the time of surgery was 16 years in both groups. The mean (SD) preoperative major curves were 65° (12°) vs. 67° (11°), 18° (9°) vs. 17° (9°) immediately after surgery, and 20° (8°) vs. 20° (8°) at the FFU in the SPG and SNP groups respectively (p>0.10 for all comparisons). The mean loss of correction was 3.5° (3°) in the SPG and 4.5 (3) for SNP groups, respectively (p=0.379). The mean (SD) preoperative thoracic kyphosis (T5-T12) was 26.5° (11.9) for SPG and 24.7° (14.5) for SNP, after surgery 19.2° (9.5) for SPG, 18.8 (8.9) for SNP and at the FFU, respectively, 20.3° (9) for SPG and 21.3° (8.5) for SNP. CONCLUSION Women who have undergone pedicle screw instrumentation and fusion have had one or more pregnancies do not have curve progression or deterioration in the longer-term outcomes as compared to patients who have not become pregnant. OBJECTIVE Characterization of factors that attract and concern medical students about a career in neurosurgery have never been clearly delineated in a large nationwide cohort of medical students intending to pursue a career in neurosurgery. The objective of this study is to characterize the factors that influence medical student interest in neurosurgery and assess the impact of a formal neurosurgery training course on participants' perceptions of a career in neurosurgery. METHODS Prior to the Medical Student Neurosurgery Training Camp for sub-internship preparation, registered students were surveyed about their interest level in neurosurgery, factors that attracted or concerned them about a career in neurosurgery, attendance at a national neurosurgery conference or course, formal clinical neurosurgery exposure in medical school, and whether they have a resident or attending mentor in neurosurgery. At the end of the course, all participants were re-surveyed. A p-value 95% completed both pre- and post-course su providing transparency and positively influencing factors that attract and concern students about a career in neurosurgery. Characterization of medical student perceptions of neurosurgery from a large, nationwide cohort of students pursuing sub-internship provides novel data and may help identify factors protecting against burnout later in life. Fluorescence-guided resection of brain tumors using 5-aminolevulinic acid (5-ALA) has been established for high-grade gliomas. Recently, its application for the resection of low grade tumors and benign lesions including meningioma has been suggested in the literature.1 Achieving a Simpson grade I resection in meningioma surgery is associated with a lower rate of recurrence.2,3 While meningiomas are mostly benign and well circumscribed lesions, they can be locally aggressive, invading brain parenchyma and other critical structures. In these cases, 5-ALA guided resection may help maximize the extent of tumor resection and limit disruption of normal structures. In this video, we present three cases demonstrating the use of 5-ALA-induced fluorescence to alleviate three specific challenges in meningioma resection first, to aid visualization with a minimally invasive approach; second, to distinguish recurrent tumor from scar tissue from prior treatments; third, to ensure that no viable tumor cells remain on the surface of a critical artery. The first patient is a 60-year-old female who was found to have an incidental left sphenoid wing meningioma on MRI; we elected for an extended lateral orbital (XLO) craniotomy through a transpalpebral approach. The second patient is a 72-year-old male with recurrent left occipital parietal meningioma who underwent a parietal craniotomy. The third case was a 62-year-old female with a foramen magnum meningioma encircling the left vertebral artery. selleckchem These cases demonstrate the utility of 5-ALA in a variety of challenges associated with resection of meningiomas. The zinc-metalloprotease pseudolysin (PLN) secreted from bacteria degrades extracellular proteins to produce bacterial nutrition. Since PLN has a Zn ion at the inhibitor-binding site, the interactions between Zn and PLN residues as well as inhibitor can be significantly changed depending on the protonation states of PLN residues at the inhibitor-binding site. To determine stable protonation states of these residues, we here considered different protonation states for Glu and His residues located around Zn and investigated the electronic states of the PLN + inhibitor complex, using ab initio molecular simulations. The protonation state of His223 was found to significantly affect the specific interactions between PLN and the inhibitor. OBJECTIVES Dengue caused by infection with the dengue virus (DENV) is endemic in the tropical and subtropical regions of the world and of greatest public health concern. With more large outbreaks in rural areas, the purpose of this study was to develop a point-of-care test using recombinase aided amplification and lateral flow dipsticks for detecting DENV rapidly in low-resource settings. METHODS The primers for recombinase aided amplification (RAA) assay were designed based on 3' UTR of DENV genome and screened. The RAA temperature, time and the concentration of primers were then optimized, as well as the lateral-flow dipstick assay (LFD) time. Finally, the diagnostic performance of the RT-RAA-LFD assay was evaluated using blood samples of 247 patients clinically suspected to be infected with DENV. RESULTS The RAA primer pair F1/R2 was the optimal combination for detecting DENV. The RT-RAA was performed in an incubator block at 37℃ for 20 min, and the amplicons were visible in the flow dipsticks with naked eyes within 3 min.
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