Diagnosis of BK Viral Nephropathy in the Renal Allograft Biopsy: Role of Fluorescence in Situ Hybridization

Early recognition of BK viral nephropathy is essential for successful management. Our aim in this study was to evaluate a novel fluorescence in situ hybridization (FISH) assay for detection of BK virus in renal transplant biopsies in the context of standard detection methods. Renal allograft biopsies (n = 108) were analyzed via H&E, immunohistochemistry (IHC) for simian virus 40, and FISH for BK virus. BK virus was detected in 16 (14.8%) cases by H&E, 13 (12%) cases by IHC, 18 (16.6%) cases by FISH, and 19 (17.6%) cases by real-time PCR; 24 of 108 showed a discrepancy in ≥1 testing modalities. Comparison of H&E, IHC, and FISH showed no statistical difference in detection of BK virus. However, performing comparisons between the different tissue-based assays in the context of plasma or urine real-time PCR results showed significant improvement in detection of BK by FISH over H&E (P = 0.02) but not IHC (P = 0.07). This novel FISH-based approach for BK virus identification in renal allograft biopsy tissue mirrored real-time PCR results and showed superior performance to detection of inclusions by H&E. Therefore, use of FISH for BK virus detection in the setting of renal allograft biopsy is a useful and sensitive detection method and could be adopted in any laboratory that currently performs FISH analysis.     

Non-pharmacological experimental treatments for spinal cord injury: a review

Introduction

Spinal cord injury is a complex result of primary mechanical damage and the secondary vascular compromise and inflammatory reactions. Depending on timing, different treatment modalities may have various effects.

Conclusions

We review the latest advances in terms of non-pharmacological experimental treatments.     

Sir Charles Bell (1774–1842) and his contributions to early neurosurgery

The renowned surgeon, neuroanatomist, and artist Sir Charles Bell not only impacted the lives of his peers through his creative endeavors and passion for art, but also sparked noteworthy breakthroughs in the field of neuroscience. His empathetic nature and zest for life enabled him to develop an early proclivity for patient care. As a result of his innovative findings regarding sensory and motor nerves and the anatomical makeup of the brain, he accepted some of the most prestigious awards and received an honorable reputation in society. Bell is recognized for his diligence, perseverance, and his remarkable contributions to surgery. The present review will explore his contributions to the discipline now known as neurosurgery.     

The history of the surgical repair of spina bifida

INTRODUCTION: The history of surgical spina bifida repair has seen many successes and failures. Many early surgeons attempted treatment of open spina bifida defects before a clear understanding of the disease process or pathology had been discovered. CONCLUSIONS: The attempts, while often fruitless, served to better our understanding of the disease and represent stepping-stones to the treatment we successfully use today. The present paper reviews the history of the surgical treatment of myelomeningoceles.     

The proatlas: a comprehensive review with clinical implications

Background  

The proatlas is derived from the fourth occipital sclerotome in human embryos. It usually fuses with the three upper occipital sclerotomes to form the occipital bone. However, this does not always occur. Manifestations of a partial proatlas structure may persist due to failure of fusion.     

Hieronymus Brunschwig (c. 1450–1513): his life and contributions to surgery

Introduction  

The objective of this paper to offer an overview of the life and contributions of Hieronymus Brunschwig (also known as Jerome of Brunswick), a German surgeon of the fifteenth century, whose works have provided insight into the practice of surgery during his lifetime.     

Infantile haemangiomas: a challenge in paediatric dermatology

Infantile haemangiomas, common benign vascular tumours of childhood, are characterized by rapid growth during the first year of life and a slow regression that is usually completed at 7–10 years of age. These tumours are composed of endothelial cells with high mitotic rates and stromal components such as fibroblasts, mast cells and pericytes. Haemangiomas become a challenge when they are part of a syndrome, are located in certain areas of the body or when complications develop. The above‐mentioned factors also influence the treatment modality used. However, although there remain many uncertainties regarding management, the β‐adrenergic receptor blocker propranolol is a promising new candidate for first‐line systemic therapy. It produces such a dramatic and rapid response that the appearance of an infantile haemangioma should impart expeditious consideration of the risks and benefits of its use.     

Surgical landmarks for the proximal portion of the axillary nerve.

OBJECT: The proximal segment of the axillary nerve (ANp) is often difficult to identify without extensive dissection deep into the axilla. The present study was performed to find reliable surgical landmarks for this nerve. METHODS: Thirty dissections of human cadavers were performed to determine the relationships between the ANp and specific anatomical structures. The authors found that the ANp is consistently located within an anatomical triangle constructed by lines passing between the coracobrachialis and pectoralis minor muscles and the axillary artery. In addition, the ANp was routinely found 4 cm distal to the coracoid process of the scapula. CONCLUSIONS: These findings should assist the surgeon in locating the ANp during brachial plexus reconstruction.