Temperature affects the firing pattern and electrical activity of neurons in animals, eliciting diverse responses depending on neuronal cell type. However, the mechanisms underlying such diverse responses are not well understood. In the present study, we performed in vitro recording of abdominal ganglia cells of Aplysia juliana , and analyzed their burst firing patterns. We identified atypical bursting patterns dependent on temperature that were totally different from classical bursting patterns observed in R15 neurons of A. juliana . We classified these abnormal bursting patterns into type 1 and type 2; type 1 abnormal single bursts are composed of two kinds of spikes with a long interspike interval (ISI) followed by short ISI regular firing, while type 2 abnormal single bursts are composed of complex multiplets. To investigate the mechanism underlying the temperature dependence of abnormal bursting, we employed simulations using a modified Plant model and determined that the temperature dependence of type 2 abnormal bursting is related to temperaturedependent scaling factors and activation or inactivation of potassium or sodium channels.

Temperature affects the firing pattern and electrical activity of neurons in animals, eliciting diverse responses depending on neuronal cell type. However, the mechanisms underlying such diverse responses are not well understood. In the present study, we performed in vitro recording of abdominal ganglia cells of Aplysia juliana , and analyzed their burst firing patterns. We identified atypical bursting patterns dependent on temperature that were totally different from classical bursting patterns observed in R15 neurons of A. juliana . We classified these abnormal bursting patterns into type 1 and type 2; type 1 abnormal single bursts are composed of two kinds of spikes with a long interspike interval (ISI) followed by short ISI regular firing, while type 2 abnormal single bursts are composed of complex multiplets. To investigate the mechanism underlying the temperature dependence of abnormal bursting, we employed simulations using a modified Plant model and determined that the temperature dependence of type 2 abnormal bursting is related to temperaturedependent scaling factors and activation or inactivation of potassium or sodium channels.

Objective: Tracheostomy is a necessary procedure for patients admitted to the neurosurgery intensive care unit (ICU) with severe brain injury, because mechanical ventilation must be maintained for a long time following neurologic failure. The purpose of this study was to compare conventional surgical tracheostomy (CST) and percutaneous dilatational tracheostomy (PDT) performed at the bedside in critically ill neurosurgery patients requiring tracheostomy to determine which procedure has comparative advantages. Methods: This retprospective study was conducted between January 2019 and December 2020. PDT was performed on 52 patients and CST was performed on 44 patients. The baseline characteristics, procedural characteristics, and clinical outcomes were recorded. Results: The mean operative time in the CST group was 25.5±6.5 minutes and that in the PDT group was 15.1±2.5 minutes; the difference was statistically significant (p<0.01). Four patients in the CST group and none in the PDT group experienced bleeding requiring transfusion. However, there was no significant difference in total ICU mortality or length of hospital stay. There were no statistical differences in the individual complication categories between the 2 study groups. Conclusion There were fewer procedure-induced complications among patients receiving PDT than among those receiving CST. In addition, the treatment time for PDT was shorter than that for CST treatment.

Lateral spinal artery (LSA) aneurysms are extremely rare lesions that can rupture and cause subarachnoid hemorrhage (SAH) even though the spinal arteries communicate directly with the subarachnoid space. To date, six cases of LSA aneurysms have been reported in the literature. Herein, three such cases are reported. All patients presented to the emergency department with headaches. The patients in the first two cases were confirmed to have SAH and LSA aneurysms on a brain computed tomography (CT) angiography performed at the hospital. Two patients had prior instances of cerebral infarction and coronary disease, respectively, and were undergoing antiplatelet therapy. The antiplatelet medication was stopped for 2 weeks and 1 week, respectively, while conservative care was provided. Subsequently, a suboccipital craniectomy was performed, followed by aneurysm clipping. Following the surgery, both patients were discharged without any significant neurological deficits. Regarding the third patient, no aneurysm was found on brain CT angiography, and cerebral angiography was performed during the patient’s hospital stay. She was hospitalized, where she received medication and conservative care, and was discharged with an improvement in bleeding without neurological symptoms. Subsequently, a LSA aneurysm was identified on a brain CT angiography performed at an outpatient clinic; however, the patient was transferred because she wanted to be treated at another hospital. LSA aneurysms are difficult to visualize using CT angiography; therefore, careful angiographic studies are required. Surgical clipping is the treatment of choice if the aneurysm is inaccessible by the endovascular treatment.

Persistent primitive trigeminal artery (PPTA) is the most common carotid-basilar anastomosis; on the other hand, persistent primitive otic artery (PPOA) is extremely rare. PPTA is often misdiagnosed as PPOA on cerebral angiography. We present a case of PPTA that mimicked PPOA on cerebral angiography. We further describe the utility of brain computed tomography angiography for differential diagnosis of PPTA from PPOA, together with a review of previous literature.
Angiography ; Arteries* ; Brain ; Central Nervous System Vascular Malformations ; Cerebral Angiography* ; Diagnosis, Differential ; Hand

Background: This study aims to investigate the frequency of distal femoral and popliteal arterial calcification and to evaluate the intraoperative and postoperative effects of arterial calcification in patients undergoing total knee arthroplasty using a tourniquet. Methods: The records of 5,438 patients who had undergone primary total knee arthroplasty between January 2003 and January 2017 were retrospectively reviewed. We examined the preoperative radiographs of the knee from all patients for calcifications of the femoral and popliteal arteries. Vascular calcification was identified on preoperative radiographs in 223 cases. Intraoperative and postoperative complications were investigated among these patients. Postoperative complications were analyzed from the time of surgery to the last follow-up (minimum 1-year follow-up). Results: Vascular calcification of the arteries around the knee was found in 223 cases (4.1%). The mean patient age was 70.6 years in the non-calcification group and 73.8 years in the calcification group (p > 0.05). The calcification group was classified into medial, intimal, or mixed subgroups according to the morphology of calcification on preoperative radiographs. The medial type included 46 cases (20.6%); intimal type, 161 cases (72.2%); and mixed type, 16 cases (2.7%). There was no statistically significant difference in demographic and surgical data among the three groups. There were intraoperative complications in two cases in the medial type group, both of which involved tourniquet failure. There was also a postoperative complication in one case in the medial type group, which involved wound dehiscence at 2 weeks postoperatively. No other postoperative complications were identified during 1-year follow-up. Conclusions Despite the presence of calcifications in the arteries around the knee, total knee arthroplasty (using a tourniquet) can be performed without serious complications.

Idiopathic portal hypertension (IPH) is a rare disorder which is clinically characterized by portal hypertension, splenomegaly, hypersplenism and the absence of liver cirrhosis. Patients with IPH have massive splenomegaly leading to increased portal venous flow and subsequent portal hypertension. In selected IPH patients with splenomegaly and hypersplenism, splenectomy can be regarded as an effective treatment protocol for decreasing portal hypertension. We report a case of a 44-year-old woman who was diagnosed with IPH accompanied by splenomegaly and hypersplenism. She underwent laparoscopic splenectomy and clinical symptoms and hypersplenism resolved. Our study shows that laparoscopic splenectomy can be considered as a procedure for treating patients with splenomegaly and hypersplenism due to IPH.
Adult ; Clinical Protocols ; Female ; Humans ; Hypersplenism* ; Hypertension, Portal* ; Liver Cirrhosis ; Splenectomy* ; Splenomegaly*

OBJECTIVE: The objective of this study was to determine the efficiency and safety of Y configuration stent-assisted coiling with double-closed stents for wide-necked intracranial aneurysms located at arterial bifurcations thorough analysis of a multicenter case series. MATERIALS AND METHODS: A retrospective chart review was done on 10 patients who underwent endovascular treatment of wide-necked intracranial aneurysms with Y-configuration stent-assisted coil embolization in three centers from August 2011 to March 2014. The degree of aneurysmal occlusion was assessed using the Raymond scale. Clinical outcomes were assessed before operation, at discharge, and at the last follow-up visit using the Glasgow outcome scale. RESULTS: The 10 patients included 6 females and 4 males with a mean age of 58.6 years. Indications for treatment included 6 unruptured intracranial aneurysms and 4 ruptured intracranial aneurysms. Five aneurysms were located at the basilar artery bifurcation, four aneurysms were located in an anterior communicating artery, and one aneurysm was in the pericallosal artery. The mean size of the 10 aneurysms was 9.7 mm. All aneurysms had a dome-to-neck ratio of < 1.5 (mean, 0.89). Immediate complications included one thromboembolic event out of the 10 cases. Immediate posttreatment angiograms showed complete occlusion in 1 aneurysm and residual necks in 9 aneurysms. Follow-up results showed 8 complete occlusions and 2 residual necks. No delayed complications were observed during the follow-up period (mean: 20 months). CONCLUSION: Y configuration using double-closed cell stents is feasible and safe in selected patients. This method is an acceptable option for managing complex wide-necked bifurcations.
Aneurysm* ; Arteries ; Basilar Artery ; Embolization, Therapeutic* ; Female ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm ; Male ; Methods ; Neck ; Retrospective Studies ; Stents

Transplantation studies about the clinical differences according to the type of donors are mostly conducted in western countries with rare reports from Asians. The aims of this study were to evaluate the clinical impacts of the type of donor, and the predictors of 1-year mortality in patients who underwent liver transplantation (LT). This study was performed for liver transplant recipients between May 2010 and December 2014 at the Pusan National University Yangsan Hospital. A total of 185 recipients who underwent LT were analyzed. Of the 185 recipients, 109 (58.9%) belonged to the living donor liver transplantation (LDLT) group. The median age was 52.4 years. LDLT recipients had lower model for end-stage liver disease (MELD) score compared with better liver function than deceased donor liver transplantation (DDLT) recipients (mean ± standard deviation [SD], 12.5 ± 8.3 vs. 24.9 ± 11.7, respectively; P < 0.001), and had more advanced hepatocellular carcinoma (HCC) (62.4% vs. 21.1%, respectively; P = 0.001). In complications and clinical outcomes, LDLT recipients showed shorter stay in intensive care unit (ICU) (mean ± SD, 10.8 ± 8.8 vs. 23.0 ± 13.8 days, respectively, P < 0.001), ventilator care days, and post-operative admission days, and lower 1-year mortality (11% vs. 27.6%, respectively, P = 0.004). Bleeding and infectious complications were less in LDLT recipients. Recipients with DDLT (P = 0.004) showed higher mortality in univariate analysis, and multi-logistic regression analysis found higher MELD score and higher pre-operative serum brain natriuretic peptide (BNP) were associated with 1-year mortality. This study may guide improved management before and after LT from donor selection to post-operation follow up.
Asian Continental Ancestry Group ; Busan ; Carcinoma, Hepatocellular ; Donor Selection ; Follow-Up Studies ; Gyeongsangnam-do ; Hemorrhage ; Humans ; Intensive Care Units ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Mortality* ; Natriuretic Peptide, Brain ; Tissue Donors* ; Transplant Recipients ; Ventilators, Mechanical

Traumatic neuroma (TN), also known as amputation neuroma, is a reactive hyperplasia of nerve fibers and connective tissue arising from Schwann cells after trauma or surgery. TN of the bile duct is usually asymptomatic, but rarely can lead to right upper quadrant pain, biliary obstruction, and acute cholangitis. It is very difficult to discriminate TN from malignancy before surgery, although doing so could avoid an unnecessary radical resection of the lesion. In the course of surgery, TN can be caused by unintentional injury of a nerve fiber near the common bile duct (CBD) and heat damage to an artery, complete ligation of an artery, and excessive manipulation of the CBD. Therefore, to prevent TN after cholecystectomy, surgery should be performed carefully with appropriate consideration of anatomic variations, and a cystic duct should not be resected too close to the CBD. The possibility of TN should be considered if a patient who has undergone CBD resection with hepaticojejunostomy or cholecystectomy long ago experiences symptoms of jaundice, cholangitis, or obliteration of the CBD. In this report, we present a case of TN mimicking cholangiocarcinoma that emerged from a cystic duct stump after cholecystectomy.