World Neurosurg
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Myths are the keystone of mythology. They are interpretations of events that have been told as stories and legends for thousands of years, inherited from generation to generation, and have reached the present day. Although most myths are considered figments of the imagination or fictitious legends, all of them contain references to facts from the time they occurred. ⋯ Through the use of symbols, mythology has attempted to explain several subjects, such as human nature, disease, birth, and death. In this respect, mythology and medicine dance arm in arm, and this dance has been going on for centuries. As a result, mythology has manifested itself in many fields within medicine, either anatomically or by giving names to various diseases.
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Convection-enhanced delivery (CED) is a promising new method of local drug delivery therapy for a diverse type of antitumor agents. CED offers significant advantages over systemic chemotherapy by bypassing the blood-brain barrier and obtaining adequate drug concentration with limited systemic toxicity. Actually, there is no effective treatment of malignant gliomas (MGs); survival rates remain poor despite decades of clinical trials. ⋯ On the basis of the preclinical and clinical studies, we demonstrated that CED could produce effective drug delivery to large brain and tumor areas. However, clinical studies to date have not found any substantial improvement in overall survival in the treatment of MG. This overview presents up-to-date clinical results in the treatment of MG by the application of CED.
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Case Reports Clinical Trial
Soft membrane sheath for endoscopic surgery of intracerebral hematomas.
Although the functional efficacy of surgical evacuation of an intracerebral hematoma (ICH) remains controversial, it has a valuable role for managing ICHs. Endoscopic surgery is increasingly used to evacuate ICHs; however, the narrow rigid sheath may be limiting. We report the usefulness of a soft plastic membrane sheath for endoscopic evacuation of ICHs. ⋯ This flat membrane sheath is disposable and easy to prepare, which could overcome the limitation of the instruments to allow for efficient evacuation of an ICH using the same microsurgical techniques.
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A retrospective study was conducted to clarify the predictors of the operation results for ossification of the posterior longitudinal ligament (OPLL) patients with acute spinal cord injury (SCI). Detailed analyses of surgical outcomes of OPLL patients with SCI have been rare because most surveys have aimed to investigate OPLL or SCI, but not both. ⋯ HIZ on magnetic resonance imaging was significantly related to the surgical outcomes, which should be highlighted in the preoperative communication with patients. Patients with lower Nirick grade and segmental OPLL would show better symptom before the operation. In addition, SCI caused by slipping or falling showed better symptoms before the operation. Patients with segmental OPLL should show better resolution of symptoms after the operation.
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Comparative Study
Superior efficacy of gross total resection in anaplastic astrocytoma patients relative to glioblastoma patients.
Because of their relative rarity, anaplastic astrocytomas (AAs) often are grouped with glioblastomas in clinical treatment paradigms. There are reasons, however, to expect that the therapeutic response of AAs may differ from those of glioblastoma. Here, we examined the clinical benefit of gross total resection (GTR) in AA relative to glioblastoma patients. ⋯ The Surveillance, Epidemiology and End Results data suggest that survival benefit associated with GTR was greater for patients with AA relative to glioblastoma patients, particularly for patients < age 50.