Impact of increasing one-carbon metabolites on traumatic brain injury outcome using pre-clinical models

Traumatic brain injury is a major cause of death and disability worldwide,affecting over 69 million individuals yearly.One-carbon metabolism has been shown to have beneficial effects after brain damage,such as ischemic stroke.However,whether increasing one-carbon metabolite vitamins impacts traumatic brain injury outcomes in patients requires more investigation.The aim of this review is to evaluate how one-carbon metabolites impact outcomes after the onset of traumatic brain injury.PubMed,Web of Science,and Google Scholar databases were searched for studies that examined the impact of B-vitamin supplementation on traumatic brain injury outcomes.The search terms included combinations of the following words:traumatic brain injury,dietary supplementation,one-carbon metabolism,and B-vitamins.The focus of each literature search was basic science data.The year of publication in the literature searches was not limited.Our analysis of the literature has shown that dietary supplementation of B-vitamins has significantly improved the functional and behavioral recove ry of animals with traumatic brain injury compared to controls.Howeve r,this improvement is dosage-dependent and is contingent upon the onset of supplementation and whether there is a sustained or continuous delive ry of vitamin supplementation post-traumatic brain injury.The details of supplementation post-traumatic brain injury need to be further investigated.Overall,we conclude that B-vitamin supplementation improves behavioral outcomes and reduces cognitive impairment post-traumatic brain injury in animal model systems.Further investigation in a clinical setting should be stro ngly considered in co njunction with current medical treatments for traumatic brain injury-affected individuals.

Classical bovine spongiform encephalopathy and chronic wasting disease:two sides of the prion coin

Transmissible spongiform encephalopathies(TSEs)are a group of progressive and ultimately fatal neurologic diseases of man and animals,all resulting from the propagated misfolding of the host's normal cellular prion protein.These diseases can be spontaneous,heritable,anthropogenic/iatrogenic,or in some cases horizontally transmissible,and include such notable TSEs as bovine spongiform encephalopathy(BSE)of cattle and chronic wasting disease(CWD)of cervids.Although they are both unequivocally protein misfolding disorders,they differ markedly in their pathogenesis,transmissibility,and zoonotic potential.While the BSE epidemic has largely abated over the past three decades following global feed bans on ruminant meat and bone meal,CWD,which is readily transmitted through various forms of excreta,has rapidly expanded from its original endemic zone to encompass much of North America,along with recently identified foci in Scandinavia.Most importantly,although the classical form of BSE has proven transmissible to humans consuming contaminated beef or beef products,so far there have been no conclusive reports on the zoonotic transmission of cWD to humans.The underlying basis for these differences-whether host or agent directed-are not well understood,though may be due to inherent differences in the three-dimensional structure of the misfolded BSE or CWD prion proteins or the expression levels and tissue distribution of respective cellular prion proteins.With the uncontrolled geographic spread of CWD,it is imperative that we improve our understanding of the factors governing prion disease pathogenesis,transmission,and zoonotic potential.

Maternal dietary deficiencies in folic acid or choline worsen stroke outcomes in adult male and female mouse offspring

Maternal one-carbon metabolism plays an important role in early life programming.There is a well-established connection between the fetal environment and the health status of the offspring.Howeve r,there is a knowledge gap on how maternal nutrition impacts stro ke outcomes in offspring.The aim of our study was to investigate the role of maternal dietary deficiencies in folic acid or choline on stroke outcomes in 3-month-old offspring.Adult female mice were fed a folic acid-deficient diet,choline-deficient diet,or control diet 4 weeks before pregnancy.They we re continued on diets during pregnancy and la ctation.Male and female offspring were weaned onto a control diet and at 2 months of age were subjected to ischemic stroke within the sensorimotor cortex via photothrombotic damage.Mothers maintained on either a folic acid-deficient diet or choline-deficient diet had reduced levels of S-adenosylm ethionine in the liver and S-adenosylhomocysteine in the plasma.After ischemic stro ke,motor function was impaired in 3-month-old offspring from mothers receiving either a folic acid-deficient diet or choline-deficient diet compared to the animals receiving a control diet.In brain tissue,there was no difference in ischemic damage volume.When protein levels were assessed in ischemic brain tissue,there were lower levels of active caspase-3 and hypoxia-inducible factor 1α in males compared to females and betaine levels were reduced in offspring from the mothers receiving a choline-deficient diet.Our results demonstrate that a deficient maternal diet at critical time points in neurodevelopment results in worse stro ke outcomes.This study emphasizes the importance of maternal diet and the impact it can have on offspring health.

Necrotizing Fasciitis Secondary to Emphysematous Cholecystitis and Cholecystocutaneous Fistula: A Rare Case Report Presentation

Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise with a concomitant infection from gas-forming organisms such as Clostridium species, Klebsiella species, or Escherichia coli. The mortality rate of acute emphysematous cholecystitis is 15% - 20% compared with 1.4% in uncomplicated acute cholecystitis. The subsequent development of a cholecystocutaneous fistula, an abnormal connection between the gallbladder and the skin, is also a rare complication of gallbladder disease. We describe a case of a 77-year-old male who presented with right flank necrotizing fasciitis which developed from a cholecystocutaneous fistula secondary to emphysematous cholecystitis. Once the necrotic tissues were adequately debrided, the large open wound was treated with negative pressure wound therapy with instillation (NPWT-i) utilizing hypochlorous acid (HOCL). The wound was closed with a split-thickness skin graft.

Troubleshooting a Difficult Trans-Tibial/Fibula Amputation: A Case Report

Necrotic feet secondary to vascular compromise in the diabetic patient may require an emergent guillotine amputation. Unrecognized, retained hardware in a distal ankle years after fracture repair may complicate the intraoperative guillotine amputation at the transtibial/fibula level. Troubleshooting such an unexpected surgical problem is not necessarily straightforward depending on the clinical situation. Presented is a case report where a patient with a necrotic burned foot failed to inform the burn team that he had implanted ankle hardware, prior to his surgical intervention. A successful amputation was completed after proceeding down a specific algorithm devised for such a scenario.

青少年及儿童近视进展及其危险因素

近视是全球重要的公共卫生问题。青少年及儿童近视患病率因在全球范围，尤其在亚洲地区，快速增长且影响因素复杂多样而受到广泛关注。尽管目前已有大量关于青少年及儿童近视进展及其危险因素的报道，然而由于人群、近视定义、睫状肌麻痹剂、验光方法等不同导致彼此间难以比较。本文就1990年至今关于青少年（〈18岁）和儿童近视进展及其与年龄、性别、屈光状态、近距工作、户外活动、父母近视或父母生育年龄等危险因素关系的报道进行总结。

一个2N体问题空间中心构型的存在性

研究2 N体问题在单位球上的两层正多边形中心构型的存在性,根据对动力学运动方程的分析,得出否定的结论.本文还讨论了中心构型的数学定义,以及中心构型与梯度流的关系.

N体问题4个中心构型的存在性

对于N体问题,研究了4个中心构型的存在性,根据对动力学运动方程的分析,得出否定的结论.本文还对其中的原因进行了分析.

Role of vitamin B12 deficiency in ischemic stroke risk and outcome

Currently,ischemic stroke is the most prevalent form of stroke compared to hemorrhagic and there is a high incidence in older adults.Nutrition is a modifiable risk factor for stroke.B-vitamins are part of a metabolic network that integrates nutritional signals with biosynthesis,redox homeostasis,and epigenetics.These vitamins play an essential role in the regulation of cell proliferation,stress resistance,and embryo development.A deficiency in vitamin B12 is common in older adults and has been reported to be implicated in ischemic stroke.The aim of this review was to investigate whether vitamin B12 deficiencies impact the risk and outcome of ischemic stroke.Clinical data from our literature review strongly suggest that a deficiency in vitamin B12 is a risk factor for ischemic stroke and possible outcome.Our survey of the literature has identified that there is a gap in the understanding of the mechanisms through which a vitamin B12 deficiency leads to an increased risk of stroke and outcome.A vitamin B12 deficiency can increase homocysteine levels,which are a well-established risk factor for ischemic stroke.Another potential mechanism through which vitamin B12 deficient may impact neurological function and increase risk of stroke,is changes in myelination,however this link requires further investigation.Further studies are required in model systems to understand how a vitamin B12 deficiency changes the brain.

A unified intrinsic functional expansion theory for solitary waves

A new theory is developed here for evaluating solitary waves on water, with results of high accuracy uniformly valid for waves of all heights, from the highest wave with a corner crest of 120 down to very low ones of diminishing height. Solutions are sought for the Euler model by employing a unified expansion of the logarithmic hodograph in terms of a set of intrinsic component functions analytically determined to represent all the intrinsic properties of the wave entity from the wave crest to its outskirts. The unknown coefficients in the expansion are determined by minimization of the mean-square error of the solution, with the minimization optimized so as to take as few terms as needed to attain results as high in accuracy as attainable. In this regard, Stokess formula, F2= tan , relating the wave speed (the Froude number F) and the logarithmic decrement of its wave field in the outskirt, is generalized to establish a new criterion requiring (for minimizing solution error) the functional expansion to contain a finite power series in M terms of Stokess basic term (singular in ), such that 2M is just somewhat beyond unity, i.e. 2M1. This fundamental criterion is fully validated by solutions for waves of various amplitude-to-water depth ratio =a/h, especially about 0.01, at which M=10 by the criterion. In this pursuit, the class of dwarf solitary waves, defined for waves with 0.01, is discovered as a group of problems more challenging than even the highest wave. For the highest wave, a new solution is determined here to give the maximum height hst=0.8331990, and speed Fhst=1.290890, accurate to the last significant figure, which seems to be a new record.

Seeing through the magnetite:Reassessing Eoarchean atmosphere composition from Isua(Greenland) ≥3.7 Ga banded iron formations

Estimates of early atmosphere compositions from metamorphosed banded iron formations(BIFs)including the well-studied ≥3.7 BIFs of the Isua supracrustal belt(Greenland)are dependent on knowledge of primary versus secondary Fe-mineralogical assemblages.Using new observations from locally well preserved domains,we interpret that a previously assumed primary redox indicator mineral,magnetite,is secondary after sedimentary Fe-clays(probably greenalite)±carbonates.Within ~3.7 Ga Isua BIF,pre-tectonic nodules of quartz+Fe-rich amphibole±calcite reside in a finegrained(≤100 μm)quartz+magnetite matrix.We interpret the Isua nodule amphibole as the metamorphosed equivalent of primary Fe-rich clays,armoured from diagenetic oxidative reactions by early silica concretion.Additionally,in another low strain lacunae,~3.76 Ga BIF layering is not solid magnetite but instead fine-grained magnetite+quartz aggregates.These magnetite+quartz aggregates are interpreted as the metamorphosed equivalent of Fe-clay-rich layers that were oxidised during diagenesis,because they were not armoured by early silicification.In almost all Isua BIF exposures,this evidence has been destroyed by strong ductile deformation.The Fe-clays likely formed by abiotic reactions between aqueous Fe^(2+)and silica.These clays along with silica±carbonate were deposited below an oceanic Fe-chemocline as the sedimentary precursors of BIF.Breakdown of the clays on the sea floor may have been by anaerobic oxidation of Fe^(2+),a mechanism compatible with iron isotopic data previously published on these rocks.The new determinations of the primary redoxsensitive Fe-mineralogy of BIF significantly revise estimates of early Earth atmospheric oxygen and CO_2 content,with formation of protolith Fe-rich clays and carbonates compatible with an anoxic Eoarchean atmosphere with much higher CO_2 levels than previously estimated for Isua and in the present-day atmosphere.

Elementary school comprehensive intervention and myopia development:the Wenzhou Epidemiology of Refraction Error Study

AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.

Effects of Religious vs. Conventional Cognitive-Behavioral Therapy on Inflammatory Markers and Stress Hormones in Major Depression and Chronic Medical Illness: A Randomized Clinical Trial

Background: Depressive disorder is often accompanied by physiological changes that may adversely affect the course of medical illness, including an increase in pro-inflammatory cytokines. Methods: We examine the effects of religious cognitive behavioral therapy (RCBT) vs. conventional CBT (CCBT) on pro-/anti-inflammatory indicators and stress hormones in 132 individuals with major depressive disorder (MDD) and chronic medical illness who were recruited into a multi-site randomized clinical trial. Biomarkers (C-reactive protein and pro-inflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6, IL-12-p70), anti-inflammatory cytokines (IL1ra, IL-4, IL-10), and stress hormones (urinary cortisol, epinephrine, norepinephrine) were assessed at baseline, 12 weeks, and 24 weeks. Differential effects of baseline religiosity on treatment response were also examined, along with effects of religiosity on changes in biomarkers over time independent of treatment group. Biomarker levels were log transformed where possible to normalize distributions. Mixed models were used to examine trajectories of change. Results: CRP increased and IL-4, IL-10, and epinephrine decreased over time, mostly in the opposite direction expected (except epinephrine). No significant difference between RCBT and CCBT was found on average trajectory of change in any biomarkers. Religiosity interacted with treatment group in effects on IL-6, such that CCBT was more effective than RCBT in lowering lL-6 in those with low religiosity whereas RCBT appeared to be more effective than CCBT in those with high religiosity. Higher baseline religiosity also tended to predict an increase in pro-inflammatory cytokines INF-γ and IL-12 (p70) and urinary cortisol over time. Conclusions: RCBT and CCBT had similar effects on stress biomarkers. CCBT was more effective in reducing IL-6 levels in those with low religiosity, whereas RCBT tended to be more effective in those with high religiosity. Unexpectedly, higher baseline religiosity was associated with an increase in several stress biomarkers.

偏头痛与月经过多和子宫内膜异位症相关

Objective. -To evaluate the frequency of menorrhagia and endometriosis in female migraineurs compared to age-matched women without headache. Background. -Migraine predominantly affects women of childbearing age and is often associated with the menstrual period, yet there is a paucity of data regarding the relationship of migraine and menstrual disorders. Methods. -Women diagnosed with migraine, using International Headache Society criteria and an age-and sex-matched control group, were administered a semistructured questionnaire regarding migraine and migraine-related disability, menstrual history, other bleeding history, vascular event history, and vascular risk factors. Results. -Fifty female migraineurs between the ages of 22 and 50 years and 52 age-matched women (mean age 37 years) were enrolled in the study. Similar proportions of women in each group reported using hormone contraceptives (30%vs. 33%, P= .77) and hormone replacement therapy (12%vs. 8%, P= .69). The proportions presently menstruating (64 %vs. 80%, P= .20) and status after hysterectomy were similar (24%vs. 14%, P= .84). Menorrhagia (defined as at least three consecutive heavy periods), both current and prior, was more commonly reported in migraineurs (63%vs. 37%, P=.009), with higher likelihood of staining clothes by menses (35%vs. 8%, P= .003), and significant impact of menses on activities of daily living (on a 10-point Likert scale) with work/school participation (P= .02), family activities (P < .0001), sleep (P= .003), life enjoyment (P= .001), mood (P= .02), and overall quality of life (P= .003). Endometriosis, which may be associated with menorrhagia, was also more commonly diagnosed in the migraineurs (30%vs. 4%, P= .001). The migraineurs more frequently described bruising (40%vs. 10%, P < .001) and rectal bleeding (18%vs. 2%, P= .017) but not more serious bleeding problems. Nonsteroidal anti-inflammatory drug (NSAID) use was more frequent in the migraine group (28%vs. 12%, P= .036), and significance for increased menorrhagia, endometriosis, menstrual interference, and bruising was maintained, even when controlling for the use of NSAIDs. With logistic regression, menorrhagia was significantly associated with migraine, adjusted odds ratio (OR) = 2.8 (95%CI 1.2 to 6.5), and with endometriosis, adjusted OR = 10.5 (95%CI 2.2 to 51.4). There were no differences in vascular events and risk factors, except for trends of increased hypertension (25%vs. 10%, P= .05), transient ischemic attack/stroke (10%vs. 2%, P= .08), and Raynaud’s disease (10%vs. 2%, P= .08) in the migraineurs. Conclusion. -Women with migraine have a higher frequency of menorrhagia, endometriosis, and associated psychosocial consequences. These findings suggest that there should be further study of factors influencing endometriosis and menstrual blood flow, such as eicosanoids and platelet function, in migraineurs.

Sanguinarine-Mediated Sensitization of Cervical Cancer SiHa Cells to TRAIL

Introduction: Cervical cancer is primarily caused by the human papilloma virus (HPV), which transforms normal cervical cells into cancerous cells that are highly resistant to radiation and chemotherapy. Induction of apoptosis in transformed cells is a key strategy in successfully treating HPV-induced cervical cancer. TRAIL (tumor necrosis factor related apoptosis-inducing ligand) has been shown to selectively induce apoptosis in cancer cells by binding to death receptors and activating extrinsic pathways for apoptosis. However, certain cervical cancers—such as the cultured cell line SiHa—are remarkably resistant to TRAIL. In this study, SiHa cells were sensitized to TRAIL by using sanguinarine—derived from the plant Sanguinaria Canadensis—which is known to induce oxidative stress and lead to the upregulation of receptors for TRAIL. Methods: Cultured SiHa cells were exposed to sub-lethal doses of sanguinarine in combination with TRAIL. Cell viability changes as well as the production of reactive oxygen species (ROS) were assessed. The induction of apoptosis was investigated by assays for caspase activation. Flow cytometry was performed to analyze expression of death receptors 4/5. Results: Treatment of SiHa cells with a combination of sanguinarine and TRAIL led to a significant reduction in cell viability. Significant increase in ROS was observed and caspase activation assays confirmed the induction of apoptosis. Conclusions: The observed synergistic effect of sanguinarine and TRAIL on SiHa cells is promising for the treatment of cervical, and possibly other, HPV-induced cancers. Oxidative stress caused by sanguinarine seems to play a central role in this synergy. The precise link between reactive oxygen species and the possible upregulation of death receptors needs further investigation. This knowledge will enable us to devise more effective treatments for those who suffer from this devastating disease.

<i>In Vitro</i>Model Systems to Investigate Drug Resistance Mechanisms in Pancreatic Cancer Cells

With a 5-year survival rate of less than 6%, the diagnosis of pancreatic cancer is devastating news for any patient. Gemcitabine, the most commonly used chemotherapy drug, only improves survival by approximately 1.5 months. A major obstacle to the treatment of pancreatic cancer with gemcitabine is the development of drug resistance. To better understand the precise mechanisms by which patient tumor cells gain resistance to gemcitabine, a cell culture model system that more accurately reflects the development of drug resistance in vivo is required. In this study, cultured pancreatic adenocarcinoma BxPC-3 cells were subjected to two different treatment regimens. The first method—termed pulse method—involves periodically treating separate cultures of BxPC-3 cells with constant predetermined doses of gemcitabine. The second treatment regimen—termed incremental method—consists of treating BxPC-3 cells with increasing doses of gemcitabine from 10 to 100 nM. While all treated cells showed enhanced resistance to gemcitabine, low-dose pulse treatments were sufficient to produce highly drug-resistant cells as evidenced by higher IC50 measurements. Pulse treatments also resulted in slower growth rates and increased doubling time of the drug-resistant cells. Morphological changes indicate cellular abnormalities linked to likely epithelial-to-mesenchymal transition and drug resistance. Our preliminary results indicate that the pulse method may better simulate resistance observed in patients undergoing chemotherapy and may serve as a superior model to investigate drug-resistance. This model can also help with identification of appropriate markers that determine the presence of drug-resistant cells and help clinicians adjust treatment strategies to improve outcomes for patients suffering from pancreatic cancer.

Plastic Additives Decrease Agrin-Induced Acetylcholine Receptor Clusters and Myotube Formation in C2C12 Skeletal Muscle Cell Culture

Common additives in plastics such as bisphenol A (BPA) or phthalates like di-(2-ethylhexyl) phthalate (DEHP) are environmental estrogens that have been shown to be endocrine disruptors in some experimental animal models. This project used the C2C12 cell culture model to examine how exposure to BPA or DEHP affects two aspects of skeletal muscle development, the fusion of myoblasts into myotubes and agrin-induced clustering of acetylcholine receptors (AChRs). During myotube formation AChRs cluster spontaneously. Treatment with motor neuron derived agrin increases the frequency of AChR clusters through an agrin signaling pathway that also clusters other postsynaptic components of the neuromuscular synapse. For this project C2C12 cells were exposed to BPA or DEHP while myoblasts fused into myotubes. After exposure to 10 μM BPA or 100 μM DEHP the frequency of agrin-induced AChR clusters decreased. In addition, myotube formation decreased as a higher percentage of nuclei remained in myoblasts. Furthermore, BPA or DEHP reduced the amount of the myogenic regulatory factor myogenin. This suggests that BPA and DEHP decrease AChR clustering by reducing myogenin. Moreover, plastic additives like BPA and DEHP may pose a risk for skeletal muscle development in humans.

Analysis of Volutin Granule Formation in <i>Saccharomyces cerevisiae</i>

The budding yeast Saccharomyces cerevisiae serves as an effective model organism for many cellular pathways including phosphate transport, accumulation, and storage. In S. cerevisiae, phosphate is actively transported across the plasma membrane via several phosphate carriers and is then transported into the acidic vacuole (roughly equivalent to the mammalian lysosome with degradative functions but with additional storage functions, such as calcium) where it is synthesized into volutin, a storage form of polyphosphate, found in many organisms. We have been studying volutin granule formation in wild type cells to determine the physiological requirements for formation and in mutants to determine the pathway by which the volutin biosynthetic proteins are transported to the vacuole. Undertaking an analysis of volutin formation in yeast vacuoles by blocking vacuole function with pharmacological agents, such as ionomycin and CCCP, we see that vacuole pH as well as vacuolar calcium seems critical for volutin formation. Different blocks in vacuolar protein sorting have differential effects on volutin granule accumulation, with volutin granule formation seen in all mutant strains thus far tested, except for vps33, a mutant cell strain lacking all vacuolar structure. Our data are consistent with pleiotrophic effects of vacuolar physiological function blocks leading to a decrease in volutin formation.

Assessing learning potential in people with schizophrenia using the Rey Osterrieth Complex Figure Test

A growing literature indicates that learning potential (LP) measures, which examine performance changes following training on a task, may be important for understanding the role of cognition in functional outcome among people with schizophrenia and other serious mental illnesses. Because much of what is known about LP in this population has been demonstrated using the Wisconsin Card Sorting Test, the present study sought to extend this work by administering the Rey Osterrieth Complex Figure Test (ROCFT) in an LP format. 81 adults with schizophrenia or schizoaffective disorder were tested on the ROCFT using a test-train-test LP protocol. Results indicated significant performance improvements following training on the ROCFT. Further, the LP protocol differentiated subgroups of learners, non-learners, and high scorers, consistent with other LP work. These findings support the feasibility of adapting existing neurocognitive measures to examine learning potential. Further development of the LP literature is needed in order to examine the extent to which LP is test-dependent or is a more generalized construct.

Endocsopic Decompression of Intermetatarsal Nerve (EDIN) for the Treatment of Morton’s Entrapment— Multicenter Retrospective Review

Background: The authors present the results of a four surgeon, multicenter study of endoscopic decompression for the treatment of Civinini-Morton’s entrapment of 193 interspaces. Methods: A retrospective review of 193 interspaces, which were decompressed by four different surgeons. Results: The overall success rate was high, with 92% of patients reporting a good or fair outcome. Higher success rates were reported in the 3rd interspace decompression group (95%) compared to the 2nd interspace decompression group (85%). Complications reported were minimal, with only seven cases requiring a revision with traditional neurectomy. No revisions were required in the 3rd interspace decompression group. Five of the revisions were in the 2nd interspace decompression group, with the remaining two revisions in the combined 2nd/3rd interspace decompression group. Conclusions: Endoscopic decompression for the treatment of Civinnini-Morton’s entrapment is a safe and efficacious method of treatment of this nerve entrapment, with very low complication rates and rapid return to normal activity.