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Author: search.filters.author.Tubbs, RS

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    Wound or disintegration complex: a theory of wound hybrids
    (2008) Zadeh Farahani, RM; Tubbs, RS; Shoja, MM
    [No abstract available]
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    What did Avicenna (Ibn Sina, 980-1037 A.D.) look like?
    (2013) Erolin, C; Shoja, MM; Loukas, M; Shokouhi, G; Rashidi, MR; Khalili, M; Tubbs, RS
    We present a reconstruction of Avicenna's face from the only photograph of his skull available today. The photograph is more than 50 years old, and was obtained during the exhumation of Avicenna's tomb in Hamadan for relocation. The reconstruction procedure was performed by the Centre for Anatomy and Human Identification at the University of Dundee, UK. This is probably the first scholarly attempt to reconstruct Avicenna's face. Historians and clinicians who are interested in the history of medicine may find the current craniofacial analysis of Avicenna and the final output interesting and worth recording. The life, achievements and contributions of Avicenna to medical sciences and the influence of his "Canon" on Renaissance medicine are discussed. © 2012 Elsevier Ireland Ltd.
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    Use of the scapular spine in lumbar fusion procedures: Cadaveric feasibility study: Laboratory investigation
    (2007) Tubbs, RS; Wartmann, CT; Louis Jr; RG; Shoja, MM; Cormier, J; Loukas, M
    Object. Graft sources for lumbar fusion include synthetic materials, donor grafts, and autologous bone such as the iliac crest. Considering the data indicating that autologous bone grafts generate the best results for fusion, the next logical step is to seek alternative donor sites in an attempt to reduce the complications associated with these procedures. To the authors' knowledge, autologous scapula has not been explored as a potential source for posterior lumbar fusion graft material. Therefore, the following study was performed to verify the utility of this bone in these procedures. Methods. Six adult cadavers (mean age 71 years), four formalin-fixed and two fresh specimens, were used in this study. With the cadaver in the prone position, an incision was made over the spine of the scapula. Soft tissues were stripped from the middle of this region of the scapula, and bone segments were removed with a bone saw and used for a posterior lumbar fusion procedure. Results. A mean length of 11.5 cm was measured for the spine of the scapula and the mean thicknesses of this bone at its medial part, segment just medial to the spinoglenoid notch, and acromion were 1 cm, 2.2 cm, and 2.5 cm, respectively. No obvious injury to surrounding vessels or nerves was found using this procedure, and adequate fusion was achieved with it. Conclusions. Following clinical testing, such a bone substitute as autologous scapular spine might be a reasonable alternative to iliac crest grafts for use in posterior lumbar fusion procedures.
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    The velum interpositum revisited and redefined
    (2008) Tubbs, RS; Louis Jr; RG; Wartmann, CT; Loukas, M; Shoja, MM; Apaydin, N; Oakes, WJ
    Introduction: Descriptions of the velum interpositum (VI) are typically brief and lacking detail in most neuroanatomical and neurosurgical texts. As this structure may be involved clinically or encountered surgically, the present study seemed warranted. Materials and Methods: Twenty-adult (10 male and 10 female) formalin fixed and fresh cadaveric brains underwent a detailed dissection of the VI via an interhemispheric transcollosal approach. Observations were made of the attachment sites and continuation of the VI. Measurements were made of its length and width at its anterior, midportion, and posterior parts. Results: The VI extended laterally over the thalami tobecome continuous with the choroid plexus of the lateral ventricles. At a point along the thalami where the choroid plexus was found, the VI became "tacked" down and thus continuous with the choroid plexus subependymally. No specimen exhibited a separate choroid plexus of the third ventricle. In each, the choroid plexus of the lateral and third ventricles were the same tissue layer, all arising from the VI. This structure was adherent to but not fused to the deep surface of the fornix. The VI was also not fused to the pineal gland or habenula commissure but simply covered these structures. This membrane was confluent with the pia/arachnoid over the cerebellum and from the inferior surface of the parietal/occipital lobes and extended laterally into the choroid fissure. Conclusions: To our knowledge, the extent of the VI as described herein has not been reported earlier. The supratentorial choroid plexus is simply a vascular extension of the VI. There is no separate choroid plexus of the third ventricle as often described. Clear planes exist between the VI and surrounding structures such as the pineal gland. Such data may be useful to neurosurgeons who operate in this region and to clinicians who interpret imaging in the area of the VI. © Springer-Verlag 2007.
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    The split flexor digitorum superficialis
    (2008) Shoja, MM; Tubbs, RS; Loukas, M; Shokouhi, G
    Variations of the muscles of the anterior forearm are common. We report the cadaveric findings of an unusual variant of flexor digitorum superficialis (FDS). The deep part of the FDS was found to be split and showed two distinct fusiform muscle bellies. The medial belly originated from the common flexor tendon from the medial condyle of the humerus and continued as a thin tendon at the middle of the forearm to insert onto the fifth digit. The lateral belly blended proximally with the deep surface of the superficial portion of the FDS and ended in a relatively thicker tendon, which was inserted onto the second digit. The median nerve passed between the medial and lateral bellies of the deep part of the FDS. To our knowledge, this is only the second report of a split FDS in the extant literature. A review of neuromuscular variations of the anterior forearm is presented.
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    The Roman Empire legacy of Galen (129–200 AD)
    (2014) Shoja, MM; Tubbs, RS; Ghabili, K; Griessenauer, CJ; Balch, MW; Cuceu, M
    Introduction Galen of Pergamum was the physician of Roman Emperors and contributed to our early understanding of medicine and anatomy. Herein, we present a short biography of Galen and review his multiple contributions to medicine and anatomy. Conclusions Although it has been almost 2,000 years since Galen walked the streets of the Roman Empire, his legacy continues via multiple eponyms that bare his name.
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    The role of UV irradiation in the progression of diabetic retinopathy
    (2013) Avdian, L; Harris, A; Tubbs, RS; Loukas, M; Shokouhi, G; Ghabili, K; Agutter, PS; Siesky, BA; Shoshani, Y; Shoja, MM
    Diabetic retinopathy is a major cause of blindness. Underlying pathogenicmechanisms that have been suggested include the non-enzymatic glycosylation pathwayand production of advanced glycation end-products (AGEs), retinal neurodegeneration and inflammation, and enhanced reactive oxygen species (ROS) generation. Here, theauthors discuss how the UV component of solar radiation may potentially enhance theprogression of diabetic retinopathy. The mechanisms we suggest are: (1) In hightemperatureenvironments with intense solar radiation, the amount of UV reaching theretina is sufficient to increase de novo ROS generation. (2) Under UV-A irradiation,AGEs generate ROS. (3) Enhanced oxidative stress promotes generation of AGEs. (4)UV-B may enhance intraocular inflammation (production of endothelin and IL-6)in DR patients, and this in turn may accelerate AGE generation. (5) UV-B and ROSindependently up-regulate VEGF expression, inducing fibrovascular proliferation andinflammation. (6) ROS induce apoptosis of the retinal neurons and pericytes. (7)Oxidation of the glycated proteins and lipids produces potentially toxic substanceswithin the retina. Thus, UV irradiation could enhance the progression of diabeticretinopathy, so strategies to limit UV exposure such as wearing protective sunglasses orusing photochromic lenses that could attenuate this progression will become increasinglyimportant as humans are exposed to greater levels of solar radiation. © 2013 Nova Science Publishers, Inc. All rights reserved.
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    The role of myoendothelial gap junctions in the formation of arterial aneurysms: The hypothesis of "connexin 43:40 stoichiometry"
    (2007) Shoja, MM; Tubbs, RS; Ansarin, K
    Heterocellular myoendothelial gap junctions (MEGJs) are essential in coordinating and regulating vasomotion. Little is known about their potential role in disease states. We discuss how alteration in the Cx 43:40 expression ratio at the level of MEGJs may begin a chain of reactions in the arterial wall resulting in an aneurysm formation. In this model, we assumed that aneurysm is a chronic arterial disease associated with medial degeneration and intimal hyperplasia. It also was assumed that MEGJs are composed of Cx43 and Cx40 in different stoichiometry and that the characteristic of a given junction is in the favor of its most abundantly expressed constituent. The hypothesis of Cx 43:40 stoichiometry indicates that impaired MEGJs may play a role in the pathogenesis of arterial aneurysms. Cx43 upregulation and Cx40 downregulation (increased Cx 43:40 stoichiometry) may induce a cascade of inflammatory, electrical, metabolic and proliferative derangements in the arterial wall, which finally lead to the matrix degradation, intimal hyperplasia, endothelial-medial dissociation and loss of endothelium-dependent hyperpolarizing currents, irregular vasomotion, impaired growth factor activation, and arterial sympathetic deprivation. The final consequence of these alterations is aneurysm formation. © 2007.
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    The role of endothelial nitric oxide synthase -786 T/C polymorphism in cardiac instability following aneurysmal subarachnoid hemorrhage
    (2017) Hendrix, P; Foreman, PM; Harrigan, MR; Fisher, WS; Vyas, NA; Lipsky, RH; Lin, M; Walters, BC; Tubbs, RS; Shoja, MM; Pittet, J-F; Mathru, M; Griessenauer, CJ
    INTRODUCTION: Cardiac abnormalities are observed frequently after aneurysmal subarachnoid hemorrhage (aSAH). A subset of aSAH patients develops neurogenic cardiomyopathy, likely induced by catecholamine excess. Genetic polymorphisms of the endothelial nitric oxide synthase (eNOS) gene have been linked to decreased nitric oxide (NO) levels, coronary artery spasm, and myocardial infarction. The role of the eNOS single nucleotide polymorphism (SNP) -786 T/C in cardiac instability following aSAH has not been previously investigated. METHODS: From 2012 to 2015, aSAH patients were prospectively enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study at two academic institutions. Blood samples were used to assess the eNOS SNP -786 T/C rs2070744 through 5'exonuclease (Taqman) genotyping assays. Associations between this polymorphism and cardiac instability following aSAH were analyzed. RESULTS: Multivariable analysis demonstrated a dominant effect of the C allele of eNOS SNP -786 T/C on cardiac instability in patients with aSAH. A lower Glasgow Coma Scale score and a history of ischemic vascular disease were also associated with cardiac instability. Furthermore, cardiac instability independently predicted poor functional outcome upon discharge from the hospital. CONCLUSIONS: The C allele of the eNOS SNP -786 T/C was independently associated with an increased risk for cardiac instability following aSAH. Cardiac instability itself was a risk factor for an unfavorable functional outcome upon discharge from the hospital.