Stokes Vendelbo (drillsuede16)

Although bisphenol A (BPA) has been associated with impaired spermatogenesis, the mechanisms remain unclear. Tight junction occludin plays important roles in spermatogenesis. The objective of the present study was to explore the effects of BPA exposure in adolescent mice. Male mice were orally treated with low-dose (0.05 mg/kg/d), middle-dose (5.0 mg/kg/d), or high-dose (50 mg/kg/d) BPA in corn oil from postnatal day (PND) 35 to 65. Animals were killed on PND 65 and PND 125. On PND 65, the sperm count, sperm motility, and the expression of occludin showed a dose-related decline. On PND 125, the sperm count, sperm motility, and the expression of occludin were in recovery. However, there remained significant decreases in these parameters in the 50 mg/kg/d group on PND 125 compared with the control. The dose-related effects on the measured parameters and occludin expression suggest an early suppressive or damaging effect on the blood-testis barrier followed by recovery after dosing ceased. Scriptaid At a BPA dose of 50 mg/kg/d, recovery did not occur, suggesting that higher doses of BPA may cause irreversible damage to reproduction in male mice.Background Advances in modern spinal fusion techniques have allowed for less peri-operative morbidity and more rapid recovery from surgery. The addition of endoscopy to minimally invasive surgery (MIS) fusion techniques represents the latest progression of efforts to minimize the impact of surgical intervention. Technique MIS transforaminal lumbar interbody fusion (TLIF) is performed endoscopically through a sub-centimeter working portal. Patients undergo light conscious sedation and remain awake to facilitate feedback with the surgeon and enhance post-operative recovery. Results Previously reported results of the first 100 cases performed by the senior author at a single institution are summarized. This cohort has been characterized by brief post-operative length of stay, low complication profile, and marked improvement in patient-reported outcomes scores, with no cases of pseudarthrosis at 1-year follow up. Conclusions The latest technical considerations and adaptations of a novel technique for endoscopic MIS spinal fusion without general anesthesia are described. A refined surgical technique and anesthetic protocol are presented in detail with recommendations for the successful implementation and performance of the procedure.Background Pseudarthrosis after lumbar fusion can generate pain and disability and often requires revision. However, results of revision procedures have historically been relatively poor. Questions/purpose The aim of this review was to examine the current evidence related to the management of lumbar pseudarthrosis, with a focus on revision after failure of posterolateral fusion or lumbar interbody fusion. Methods A review of orthopedic spine literature published before March 2019 was conducted using PubMed and Google Scholar. Studies addressing revision after failed posterolateral fusions and after failed interbody fusion were selected. We also present a case of successful revision after failed transforaminal lumbar interbody fusion (TLIF). Results The review revealed that persistent pseudarthrosis after revision posterolateral fusion occurs at rates of 35 to 51%. No significant difference has been demonstrated in rates of successful fusion after anterior lumbar interbody fusion (ALIF) and ALIF with revision posterolateral fusion for pseudarthroses after failed TLIF procedures (81% versus 88%), although ALIF alone may be appealing because it avoids further disruption of the posterior musculature. No significant differences have been observed in quality-of-life scores among patients undergoing revision after posterolateral fusion, TLIF, ALIF, or ALIF with posterior fusion. Failed TLIF cages may be extracted and replaced through an anterior or lateral approach. If the geometry of the failed cage permits insertion of a second cage, a contralateral approach may be u