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Sutures of the Skull01:22

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The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
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The cranium (skull) is the skeletal structure of the head that supports the face and protects the brain. It is subdivided into the facial bones and the brain case, or cranial vault. The facial bones underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws.
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Lewis Acids and Bases02:33

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In 1923, G. N. Lewis proposed a generalized definition of acid-base behavior in which acids and bases are identified by their ability to accept or to donate a pair of electrons and form a coordinate covalent bond.
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Some compounds produce hydroxide ions when dissolved by chemically reacting with water molecules. In all cases, these compounds react only partially and so are classified as weak bases. These types of compounds are also abundant in nature and important commodities in various technologies. For example, global production of the weak base ammonia is typically well over 100 metric tons annually, being widely used as an agricultural fertilizer, a raw material for chemical synthesis of other...
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One of the common DNA damages is the chemical alteration of single bases by alkylation, oxidation, or deamination. The altered bases cause mispairing and strand breakage during replication. This type of damage causes minimal change to the DNA double helix structure and can be repaired by the base excision repair (BER) pathways. BER corrects damaged DNA sequences by removing the damaged base and restoring the original base sequence using the complementary strand as a template.
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Salts with Acidic Ions
Salts are ionic compounds composed of cations and anions, either of which may be capable of undergoing an acid or base ionization reaction with water. Aqueous salt solutions, therefore, may be acidic, basic, or neutral, depending on the relative acid-base strengths of the salt’s constituent ions. For example, dissolving the ammonium chloride in water results in its dissociation, as described by the equation:
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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Meningiomas: skull base versus non-skull base.

Torstein R Meling1,2, Michele Da Broi3, David Scheie4

  • 1Faculty of Medicine, University of Oslo, N-0027, Oslo, Norway. torsteinrmeling@gmail.com.

Neurosurgical Review
|April 9, 2018
PubMed
Summary

Skull base meningiomas (SBM) present with more neurological deficits and have shorter retreatment-free survival compared to non-skull base meningiomas (NSBM). However, SBMs do not significantly impact overall survival rates.

Keywords:
CraniotomyIntracranial tumorMeningiomaOverall survivalRetreatment-free survival

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Area of Science:

  • Neurosurgery
  • Oncology
  • Neuropathology

Background:

  • Meningiomas are the most common primary intracranial tumors.
  • Skull base meningiomas (SBM) represent a significant subset with unique clinical challenges.
  • Distinguishing SBM from non-skull base meningiomas (NSBM) is crucial for understanding prognosis and treatment.

Purpose of the Study:

  • To delineate the distinct clinical, surgical, and prognostic characteristics of SBM compared to NSBM.
  • To identify differences in presenting symptoms, surgical outcomes, and long-term survival between SBM and NSBM.
  • To provide data that can inform surgical decision-making and patient counseling for meningioma management.

Main Methods:

  • Retrospective analysis of 1148 adult patients operated for intracranial meningiomas between 1990 and 2010.
  • Tumors dichotomized into SBM and NSBM based on Al-Mefty's definition.
  • Comparison of patient demographics, presenting symptoms, extent of resection, histopathological grades, and survival outcomes.

Main Results:

  • SBM (49%) and NSBM (51%) groups were similar in age and follow-up duration.
  • SBMs showed a higher female-to-male ratio (3.2:1 vs 2.2:1) and more frequent neurological deficits (RR 1.4) but fewer seizures (RR 0.4).
  • Gross total resection was less frequent in SBM (62% vs 84%), with higher rates of neurological function worsening (21% vs 12%). SBMs had lower WHO grades II/III risk (4.5% vs 9.5%). Retreatment-free survival was significantly shorter for SBM (p<0.0001), but overall survival was comparable (p=0.14).

Conclusions:

  • Skull base meningiomas exhibit distinct clinical presentations, including a higher incidence of neurological deficits.
  • Despite challenges in achieving gross total resection and higher rates of neurological worsening, SBMs do not adversely affect overall survival compared to NSBM.
  • These findings underscore the importance of tailored surgical approaches and long-term follow-up for SBM patients.