Lei Zhao

Background: Periacetabular osteotomy (PAO) is a common procedure for the treatment of symptomatic acetabular dysplasia in adolescent patients. Despite concerns regarding surgical outcomes and complications in patients with hypermobility spectrum disorders (HSD), the outcomes of PAO in such patients are not well documented. Methods: We conducted a retrospective cohort review of patients who underwent PAO for the treatment of symptomatic acetabular dysplasia. Radiographic parameters including the lateral center edge angle of Wiberg (LCEA), medial center edge angle (MCEA), anterior wall index (AWI), posterior wall index (PWI), and Tönnis angle were measured. Patient-reported outcomes (PROs) were also collected. Results: The mean duration of follow-up of non-HSD and HSD patients was 2.86 ± 0.73 years and 3.00 ± 1.11 years, respectively. No significant differences were found in mean age ( P = 0.289), sex, body mass index ( P = 0.125), laterality ( P = 0.192), or the duration of follow-up ( P = 0.636). Postoperatively, LCEA and AWI in patients with HSD were higher than those in non-HSD patients ( P = 0.002, P = 0.007, respectively). No notable differences were observed in Modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool, Hip Dysfunction and Osteoarthritis Outcome Score, or mean changes in PROs between the non-HSD and HSD groups at preoperative, 1-year postoperative, and most recent follow-up timepoints. However, patient-reported satisfaction with surgery in the HSD group (9.39 ± 1.04) was significantly higher than the non-HSD group (8.35 ± 1.95; P = 0.047). Conclusion: Patients with HSD exhibited similar outcomes to patients without HSD after PAO for symptomatic acetabular dysplasia. Postoperative AWI and LCEA were markedly greater in patients with HSD consistent with our technical bias toward increased correction in such hips, suggesting greater anterolateral coverage of the femoral head after PAO may be a promising strategy to achieve improved outcomes in patients with HSD.

Stainless-steel screws are commonly used for fragment fixation during periacetabular osteotomy (PAO) at our institutions. Titanium is reserved for patients with documented nickel allergies. Titanium screws possess a significantly lower Young’s modulus than stainless steel and, therefore, potentially less resistance to physiologic loading. Thus, we hypothesized that the use of titanium screws might be associated with changes in acetabular correction prior to healing. The aim of this study was to compare the maintenance of acetabular correction following PAO using stainless-steel or titanium screws. A documented nickel allergy was confirmed with an allergy specialist. Patients’ age at surgery, gender and BMI were collected. The lateral center–edge angle of Wiberg (LCEA), medial center–edge angle (MCEA), anterior wall index (AWI), posterior wall index (PWI) and Tönnis angle were measured. The delta value for radiographic parameters was calculated as the difference between values immediately post-operation and at 6 months post-operation. Only age at surgery (P < 0.001) and the pre-operative LCEA (P = 0.013) were significantly different between groups ( Tables I and II). The remaining pre- and post-operative radiological measurements were similar ( Table II). Comparison of delta values at 6 months follow-up indicated no significant differences between screw types ( Table III). No patients in the titanium group had a trans-iliac retrograde screw included in their construct (P = 0.003). All patients healed from their osteotomies. The use of titanium screws in patients with an allergy to nickel was not associated with differences in acetabular correction or the rate of osseous union rates despite its lower inherent mechanical properties.

Objectives The current video presents the nuances of the endoscopic endonasal transcavernous transoculomotor triangle approach for the resection of a Knosp 4 pituitary adenoma protruding through the superior wall of left cavernous sinus. Design The video analyzes the clinical presentation, preoperative workup, and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team with bimanual, three- to four-handed endoscopic technique. Participants The patient was a 54-year-old male with a Knosp 4 prolactinoma presented with headaches and blurred vision in both eyes for 3 weeks. He was managed with endoscopic surgery due to his preference of surgery as a rapid primary therapy to relieve mental stress of an invasive brain tumor after awareness of all therapeutic options, including the preoperative medical treatment. Main Outcome Measures The main outcome was measured in the following aspects, including the resection extent, the symptoms improvement, the radiological and endocrinological follow-up results, as well as the postoperative course of complications. Results Nearly gross total resection was achieved with one-stage endoscopic surgery. The patient recovered well with improved headaches. Postop oculomotor deficit was recovered in 2 months. Endocrinological remission was kept for 12 months with one pill of bromocriptine daily. Conclusion The endoscopic endonasal transcavernous transoculomotor triangle approach is an appropriate option for resecting Knosp 4 pituitary tumors with intracranial extension through the roof of cavernous sinus at one stage. The link to the video can be found at https://youtu.be/-YJ2PKP9voY. Received: 17 March 2020 Accepted: 31 August 2022 Article published online: 07 October 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Various extracts of Wikstroemia chamaedaphne were evaluated their acaricidal activities against Tetranychus cinnabarinus (Boisduval) and Tetranychus urticae Koch (Acari: Tetranychidae) in laboratory. According to our study, the Wikstroemia chamaedaphne extracts had significant acaricidal activities against T. cinnabarinus and T. urticae. In this study, the mean LC₅₀ value for T. cinnabarinus and T. urticae were 0.79 mg/mL for methanol extracts of W. chamaedaphne, which were liquid partitioned from the crude methanol extracts using the water bath immersion method. Conventional column chromatography was used to further purify active components from methanol partition extracts. The obtained 7^th chromatographic fraction caused a mortality rate of 94.21 % for T. cinnabarinus, 91.52 % for T. urticae, and the 10^th chromatographic fraction caused a mortality rate of 85.92 % for T. cinnabarinus, 88.21 % for T. urticae.