Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

Alcohol is mainly consumed in social settings, in which people often adapt their drinking behaviour to that of others, also called imitation of drinking. Yet, it remains unclear what drives this drinking in a social setting. In this study, we expected to see stronger brain and behavioural responses to social compared to non‐social alcohol cues, and these responses to be associated with drinking in a social setting. The sample consisted of 153 beer‐drinking males, aged 18–25 years. Brain responses to social alcohol cues were measured during an alcohol cue‐exposure task performed in an fMRI scanner. Behavioural responses to social alcohol cues were measured using a stimulus‐response compatibility task, providing an index of approach bias towards these cues. Drinking in a social setting was measured in a laboratory mimicking a bar environment. Specific brain responses to social alcohol cues were observed in the bilateral superior temporal sulcus and the left inferior parietal lobe. There was no approach bias towards social alcohol cues specifically; however, we did find an approach bias towards alcohol (versus soda) cues in general. Brain responses and approach bias towards social alcohol cues were unrelated and not associated with actual drinking. Thus, we found no support for a relation between drinking in a social setting on the one hand, and brain cue‐reactivity or behavioural approach biases to social alcohol cues on the other hand. This suggests that, in contrast to our hypothesis, drinking in a social setting may not be driven by brain or behavioural responses to social alcohol cues.     

Tailored therapy: Surgical and radiosurgical treatment for two distinct myxopapillary ependymomas in the same patient. A case report

Myxopapillary ependymomas are low grade neoplasms, which originate mostly from the medullary conus, cauda equina and the filum terminale. To date the principal treatment is surgical, total- or subtotal removal (GTR or STR), which can be associated with adjuvant radiotherapy. We report a patient with two tumor locations, one larger tumor at the L3 to S1 level and a smaller S2-S3 localized lesion. The patient was treated successfully with a combined approach of GTR of L3-S1 lesion and radiosurgical treatment of S2-S3 lesion.     

Cauda equina biopsy as a tool in the diagnosis of malignant tumors

The prevalence of malignant lymphoma is increasing. With the advent of novel therapeutic approaches, the distinct pathology of each type of malignant lymphoma is used to tailor its treatment for the most effective outcome. Therefore, analysis of the malignant cell pathophysiology within the cauda equina is important to devising a treatment strategy. In some cases, the tumor only invades the cauda equina. Composed of an uninterrupted bundle of nerve fibers, the cauda equina is more complex than the brain parenchyma; hence, the method for performing a biopsy of the cauda equina is relatively more challenging and requires improvement. The appropriate surgical procedure to confirm the posterior ramus, which consists of sensory roots, is mandatory. In the lumbar region, the denticulate ligaments that distinguish between the motor and sensory nerve roots do not exist. Microsurgical techniques and neurophysiological monitoring can aid with removal of posterior roots and allow for the reliable performance of a cauda equina biopsy. First, we determined where the spinal root pierces the dura mater, and then we performed electromyography. We performed cauda equina biopsy with this method for patients with malignant lymphoma and reviewed the efficacy of this procedure. This strategy prevented postoperative neurological impairments and provided detailed information to ensure optimal adjuvant therapy. Based on advances in personalized therapies for malignant tumors, opportunities for cauda equina biopsy are increasing. Our method using both morphological feature observation and neurophysiological monitoring may contribute to successful biopsy of the cauda equina.     

Hemopatch® with fibrin glue as a dural sealant in cranial and spinal surgery. A technical note with a review of the literature

A major complication in cranial and spinal surgery is the post-operative occurrence of a cerebrospinal fluid (CSF) leak. Here we reported a technical note firstly describing the use of Hemopatch® with fibrin glue as a dural sealant in cranial and spinal neurosurgical procedures. Moreover we carried out a review of the literature. Further to the best of our knowledge this was the first series including patients submitted to different spinal surgeries in whom Hemopatch® was used as dural sealant. We prospectively collected the data of 22 patients. In all procedures, fibrin glue was applied after Hemopatch®. The mean age was 59.68 ± 10.79 years and the mean follow-up (FU) was 3.63 ± 1.46 months, respectively. Overall, Hemopatch® with fibrin glue was used in 8 cranial procedures (36.36%; all were retrosigmoid craniotomies) and 14 spinal procedures (63.64%). 9/14 spinal cases (64.28%) were incidental durotomies during a spinal decompression procedure. No CSF leak, no postoperative infection, no adverse reaction were observed during the FU in all cases. The literature search revealed only two retrospective series, reporting only patients submitted to cranial surgery for a total of 56 patients and a CSF leak occurring in 3 patients (5.35%). In conclusion, we firstly reported the feasibility and the safety of using Hemopatch® with fibrin glue as dural sealant in cranial surgery and different spinal procedures. Further larger comparative studies are needed to confirm our initial encouraging results.     

Five-year survival rates for implants placed using digitally-designed static surgical guides: a systematic review

Digitally-designed static surgical guides provide an acceptable level of accuracy and predictability for the placement of dental implants. However, to our knowledge, few published studies have compared the long-term survival of implants placed in this way with those placed using other methods. A systematic search of electronic databases using a population, intervention, comparison, and outcome (PICO) framework was conducted of Medline and EMBASE, as well as grey literature and hand searches, to obtain all relevant work pertaining to the survival of dental implants placed by guided surgery. The studies were required to have at least 10 patients with a follow up of at least five years. A total of 621 titles were screened. Four studies met the inclusion criteria for quantitative analysis, and they all reported the exclusive use of Nobel Biocare implants and the NobelGuide system (Nobel Biocare Services). Cumulative survival rates ranged from 94.5% to 100% over five years. The survival rates of implants placed using digitally-designed static surgical guides are comparable to the estimated overall survival rate (95.6% over five years), despite the complex nature of the treatments done with guided surgery. Clinicians who do these operations should, however, have the experience and ability to revert to conventional freehand techniques if complications arise.     

内镜辅助经下颌下入路腮腺深叶多形性腺瘤切除术

摘要：目的探讨内镜辅助经下颌下入路切除腮腺深叶多形性腺瘤的可行性及疗效。方法采用内镜辅助经下颌下入路切除腮腺深叶多形性腺瘤7例，其中男2例，女5例，年龄36～65岁，平均年龄47岁。主要症状是吞咽异物感5例，咀嚼不适感2例；主要体征为发现患侧咽侧壁、软腭部膨隆6例，另1例无明显阳性体征。结果本组7例手术均在1.5～2.5 h内顺利完成，肿瘤获得完全切除，切口甲级愈合。且无腮腺区肿胀、声嘶、呛咳、呼吸及吞咽困难、伸舌偏斜发生，其中1例术后2 d出现患侧口角歪斜，约1个月后完全恢复。术后病理均为多形性腺瘤。随访时间6～38个月，平均为20个月。结论内镜辅助经下颌下入路可以完全、彻底切除腮腺深叶多形性腺瘤，既能保留面神经功能，又有助于同时保护颈部重要血管、神经，值得临床推广应用。     

鼻腔鼻窦内翻性乳头状瘤的临床分期及术式选择

鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papilloma,SNIP)是鼻腔最常见的良性肿瘤,三个特征使SNIP与其它鼻腔肿瘤有很大的不同:局部破坏性大,复发率较高,有癌变可能。SNIP分期至关重要,其在SNIP术式选择以及预后评估方面具有公认的价值,但目前还没有普遍接受的分期系统。手术是SNIP首选治疗方式,术式可分为鼻外入路、鼻内镜入路以及联合入路,但是切除SNIP的最佳术式仍然存在争议。本文对SNIP分期系统以及术式管理的最新进展进行综述。