Traumatic Brain Injury (TBI) is one of the most common causes of neurological damage in young populations. It has been previously suggested that one of the mechanisms that underlie brain injury is Axonal Outgrowth Inhibition (AOI) that is caused by altered composition of the gangliosides on the axon surface. In the present study, we have found a significant reduction of GM1 ganglioside levels in the cortex in a closed head traumatic brain injury model of a mouse, induced by a weight drop device. In addition, axonal regeneration in the brains of the injured mice was affected as seen by the expression of the axonal marker pNF-H and the growth cones (visualized by F-actin and β-III-tubulin). NeuN immunostaining revealed mTBI-induced damage to neuronal survival. Finally, as expected, spatial and visual memories (measured by the Y-maze and the Novel Object Recognition tests, respectively) were also damaged 7 and 30 days post injury. A single low dose of GM1 shortly after the injury (2 mg/kg; IP) prevented all of the deficits mentioned above. These results reveal additional insights into the neuroprotective characteristics of GM1 in prevention of biochemical, cellular and cognitive changes caused by trauma, and may suggest a potential intervention for mTBI.

Over the past four decades, advancements in adjuvant treatments of bone sarcomas have catalyzed development of novel surgical technologies that continue to improve limb salvage surgeries. To date, these technologies have made limb salvage surgery the mainstay of treatment, while limb amputations became negligible. These advancements include pre-and intra-operative imaging technologies enabling accurate 3D-preoperative planning, and intraoperative patient-specific instruments allowing accurate execution of surgical plans. The introduction of customized 3D-printed porous titanium implants gave surgeons more freedom to retain surrounding healthy tissue and optimize reconstruction fit, thereby improving quality of life and reducing comorbidities post-operatively. Creating these custom implants has brought forth novel processes, materials and technologies and given rise to a new era in orthopedic oncology.

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Autologous breast reconstruction is a standard procedure performed during mastectomy for the treatment of breast cancer. [1][2][3][4][5][6] The transverse rectus abdominis muscle (TRAM) and the deep inferior epigastric perforator (DIEP) are the most common flaps used, both of which are harvested from the lower abdomen. 4,7,8 To ensure flap viability, high-resolution imaging and meticulous surgical planning are required. The procedure itself can still involve complications, including venous congestion, fat necrosis in 1.28%-2.93% of cases, and even total flap loss in 1.16%-3.61% of all patients whether performed unilaterally or bilaterally, according to Serletti et al. 9 Virtual reality (VR) has recently emerged as a comprehensive tool for stereoscopic three-dimensional (3D) imaging since it provides an interactive, realistic, and intuitive understanding of anatomical and pathological Breast Original articleIntroduction: This study was designed to compare VR stereoscopical three-dimensional (3D) imaging with two-dimensional computed tomography angiography (CTA) images for evaluating the abdominal vascular anatomy before autologous breast reconstruction. Methods: This prospective case series feasibility study was conducted in two tertiary medical centers. Participants were women slated to undergo free transverse rectus abdominis muscle, unilateral or bilateral deep inferior epigastric perforator flap immediate breast reconstruction. Based on a routine CTA, a 3D VR model was generated. Before each procedure, the surgeons examined the CTA and then the VR model. Any new information provided by the VR imaging was submitted to a radiologist for confirmation before surgery. Following each procedure, the surgeons completed a questionnaire comparing the two methods. Results: Thirty women between 34 and 68 years of age were included in the study; except for one, all breast reconstructions were successful. The surgeons ranked VR higher than CTA in terms of better anatomical understanding and operative anatomical findings. In 72.4% of cases, VR models were rated having maximum similarity to reality, with no significant difference between the type of perforator anatomical course or complexity. In more than 70% of the cases, VR was considered to have contributed to determining the surgical approach. In four cases, VR imaging modified the surgical strategy, without any complications. Conclusions: VR imaging was well-accepted by the surgeons who commented on its importance and ease compared with the standard CTA presentation. Further studies are needed to determine whether VR should become an integral part of preoperative deep inferior epigastric perforator surgery planning.

Objective: The purpose of this study was to examine the feasibility of using augmented reality during lead placement for sacral nerve stimulation (SNS). Methods: The study was a prospective case series performed in a single tertiary center. Patients with fecal incontinence or urinary retention eligible for SNS according to the American society of colon and rectal surgeon's guidelines were included. Each patient underwent a computerized tomography scan of the sacrum and pelvic floor before surgery; and a segmentation of the sacral bone, the skin, and three fiducial markers on the lower back was produced. Surgical planning included the design of an ideal virtual transmission tract leading to the S3 foramen using the most suitable location and needle trajectory for introducing the lead. During the surgical intervention, a needle was inserted into the S3 foramen using the aligned tract as visualized using the Microsoft HoloLens first generation head mounted unit. Results: Overall, 11 patients were included. Mean operative time was 43.8 minutes (range 25-81 minutes). All patients reported a significant reduction from the preoperative level of the mean postoperative Cleveland Clinic Incontinence Score (CCIS) assessed 2 weeks after the temporary SNS implant (CCIS preoperative 13.3, postoperative 8.5; CI -7.35 to -2.25; P < 0.01). The surgeons reported the imaging useful, allowing accurate and easier approach. Conclusions: Intraoperative augmented reality imaging for needle application during SNS appears to be feasible, practical, and may be useful in additional procedures.