Reflections on the Ecolab and the Zone of Proximal Development

Luckin, R; Du Boulay, B; (2016) Reflections on the Ecolab and the Zone of Proximal Development. International Journal of Artificial Intelligence in Education , 26 (1) pp. 416-430. 10.1007/s40593-015-0072-x .

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Design and synthesis of self-assembling systems with multiple hydrogen bonding interactions.

Lafitte, V.G.H.; (2005) Design and synthesis of self-assembling systems with multiple hydrogen bonding interactions. Doctoral thesis, University of London. Green open access

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Effects of neutrophin-3 (NT-3) administration on gene expression and dorsal root ganglion neuron loss and repair following axotomy in adult rats.

Kuo, L-T.; (2005) Effects of neutrophin-3 (NT-3) administration on gene expression and dorsal root ganglion neuron loss and repair following axotomy in adult rats. Doctoral thesis, University of London. Green open access

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Similarities and differences among eosinophilic esophagitis, proton-pump inhibitor-responsive esophageal eosinophilia, and reflux esophagitis: comparisons of clinical, endoscopic, and histopathological findings in Japanese patients.

Similarities and differences among eosinophilic esophagitis, proton-pump inhibitor-responsive esophageal eosinophilia, and reflux esophagitis: comparisons of clinical, endoscopic, and histopathological findings in Japanese patients.

J Gastroenterol. 2016 Apr 23;

Authors: Jiao D, Ishimura N, Maruyama R, Ishikawa N, Nagase M, Oshima N, Aimi M, Okimoto E, Mikami H, Izumi D, Okada M, Ishihara S, Kinoshita Y

Abstract
BACKGROUND: Esophageal eosinophilia is classified as either eosinophilic esophagitis (EoE) or proton-pump inhibitor-responsive esophageal eosinophilia (PPI-REE), depending on the response to PPI treatment. The aim of this study was to compare the clinical, endoscopic, and histopathological findings of EoE and PPI-REE in Japanese patients. In addition, the characteristics of these cases were compared with those of reflux esophagitis (RE) cases.
METHODS: Eleven patients diagnosed with EoE, 16 with PPI-REE, and 39 with RE, who were all consecutively examined from 2005 to 2015 at Shimane University Hospital, were enrolled. Clinical, endoscopic, and histopathological esophageal findings in these groups were retrospectively examined and compared.
RESULTS: The differences in the clinical characteristics of EoE and PPI-REE were not remarkable, though patients with EoE and PPI-REE were younger, presented a higher prevalence of allergic comorbidities, and complained of symptoms of dysphagia more frequently than those with RE. The only noteworthy differences between EoE and PPI-REE were more frequent reports of asthma (36.4 vs. 2.6 %) and food allergy (27.3 vs. 0 %) by patients with EoE (P < 0.05, P < 0.05, respectively). Endoscopic findings in patients with EoE and PPI-REE were similar, with the presence of esophageal erosions in a small percentage of PPI-REE cases being the only difference. There were no histopathological differences between EoE and PPI-REE.
CONCLUSIONS: Comparisons of clinical, endoscopic, and histopathological findings between EoE and PPI-REE showed that these two types have similar characteristics, though EoE patients showed a higher atopic background. Predicting PPI responsiveness in cases with esophageal eosinophilia is difficult and requires further investigation.

PMID: 27108416 [PubMed - as supplied by publisher]

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Early reintervention after anterior cervical spine surgery: Epidemiology and risk factors: A case-control study.

Early reintervention after anterior cervical spine surgery: Epidemiology and risk factors: A case-control study.

Orthop Traumatol Surg Res. 2016 Apr 20;

Authors: Boudissa M, Lebecque J, Boissière L, Gille O, Pointillart V, Obeid I, Vital JM

Abstract
INTRODUCTION: Anterior cervical spine surgery is a frequent and effective procedure; complications are rare, but potentially fatal. The objective of the present study was to assess epidemiology and risk factors for early reintervention in anterior cervical spine surgery.
METHODS: A retrospective case-control study recruited 2319 patients operated on in our department, with 7 years' follow-up. Incidence and prevalence of causes of early reintervention were analyzed. Each case was matched to 2 controls from the same source population. Risk factors were identified and odds ratios (OR) were calculated.
RESULTS: Thirteen patients (0.6%: 3 female, 10 male; mean age, 59±12 years) underwent surgical reintervention within 72hours. Causes comprised: retropharyngeal hematoma (0.2%), epidural hematoma (0.3%) and dural breach (0.04%). As risk factor for early reintervention, only ASA score≥3 proved significant (OR: 5.5; 95% confidence interval: 1.1-29.85). As risk factor for epidural hematoma, only smoking proved significant (OR: 14.67; 95% confidence interval: 1.16-185.29). No risk factors emerged for onset of retropharyngeal hematoma.
CONCLUSION: ASA score≥3 and smoking entail risk of epidural hematoma and early reintervention. Postoperative pain, neurologic deficit, dysphagia, dysphonia, dyspnea and agitation suggest onset of complications, requiring necessary measures to be taken. Implementation of drainage fails to prevent such complications.

PMID: 27108258 [PubMed - as supplied by publisher]

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A clinically unsuspected nasopharyngeal sarcoidosis.

A clinically unsuspected nasopharyngeal sarcoidosis.

Kulak Burun Bogaz Ihtis Derg. 2016 May-Jun;26(3):169-71

Authors: Tuğrul S, Göktaş SS, Özücer B, Sönmez FC, Özturan O

Abstract
Sarcoidosis is a multi-system disease which rarely involves the upper respiratory tract, leading to hoarseness, dysphagia, laryngeal paralysis, and upper airway obstruction. The Waldeyer's ring involvement in sarcoidosis is also very rare. In this article, we report a 32-year-old male case in whom a nasopharyngeal mass was detected based on the Waldeyer's ring involvement due to sarcoidosis.

PMID: 27107604 [PubMed - as supplied by publisher]

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Iron-naphthalenedicarboxylic acid gels and their highly efficient arsenic (V) removal

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01621A, Communication

Jianfei Sui, Lihuan Wang, Wenrong Zhao, Jingcheng Hao
Metal-organic gels (MOGs) of three-dimensional (3D) networks comprising nanosheets with ~30 nm in thickness and square-micrometer in size were easily produced via coordination interactions of iron (Fe3+) and 1,4-naphthalenedicarboxylic acid...
The content of this RSS Feed (c) The Royal Society of Chemistry

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IJMS, Vol. 17, Pages 619: Glycated Albumin versus Glycated Hemoglobin as a Glycemic Indicator in Diabetic Patients on Peritoneal Dialysis

Compared with glycated hemoglobin (HbA1c), glycated albumin (GA) is superior in estimating glycemic control in diabetic patients on hemodialysis (HD). However, the better index for assessment of glycemic control in diabetic patients on peritoneal dialysis (PD) and the impact of protein loss on GA are unknown. Twenty diabetic patients on HD were matched by age, sex, and baseline postprandial plasma glucose (PG) levels to 20 PD patients. PG, HbA1c, GA, and serum albumin levels were measured for six months. Protein loss in PD patients was estimated by measuring the protein concentration in the peritoneal dialysate and by 24 h urine collection. Although PG and HbA1c did not differ significantly between the groups, the PD group had significantly lower GA (17.8% versus 20.8%, p < 0.001) and GA/HbA1c ratio (2.95% versus 3.45%, p < 0.0001) than the HD group. Although the PG level correlated significantly with the GA levels in both groups, it was not correlated with the HbA1c levels in both groups. HbA1c level was negatively associated with erythropoiesis-stimulating agent (ESA) dose in both groups, whereas GA was not significantly associated with serum albumin, hemoglobin concentration, ESA dose, and protein loss. Multiple regression analysis identified GA as the only independent factor associated with PG in PD patients. Our results suggested that GA was not significantly associated with protein loss, hemoglobin, serum albumin, and ESA dose. Although GA might underestimate glycemic status, it provided a significantly better measure for estimating glycemic control than HbA1c, even in PD patients.

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IJMS, Vol. 17, Pages 617: New Is Old, and Old Is New: Recent Advances in Antibiotic-Based, Antibiotic-Free and Ethnomedical Treatments against Methicillin-Resistant Staphylococcus aureus Wound Infections

Staphylococcus aureus is the most common pathogen of wound infections. Thus far, methicillin-resistant S. aureus (MRSA) has become the major causative agent in wound infections, especially for nosocomial infections. MRSA infections are seldom eradicated by routine antimicrobial therapies. More concerning, some strains have become resistant to the newest antibiotics of last resort. Furthermore, horizontal transfer of a polymyxin resistance gene, mcr-1, has been identified in Enterobacteriaceae, by which resistance to the last group of antibiotics will likely spread rapidly. The worst-case scenario, "a return to the pre-antibiotic era", is likely in sight. A perpetual goal for antibiotic research is the discovery of an antibiotic that lacks resistance potential, such as the recent discovery of teixobactin. However, when considering the issue from an ecological and evolutionary standpoint, it is evident that it is insufficient to solve the antibiotic dilemma through the use of antibiotics themselves. In this review, we summarized recent advances in antibiotic-based, antibiotic-free and ethnomedical treatments against MRSA wound infections to identify new clues to solve the antibiotic dilemma. One potential solution is to use ethnomedical drugs topically. Some ethnomedical drugs have been demonstrated to be effective antimicrobials against MRSA. A decline in antibiotic resistance can therefore be expected, as has been demonstrated when antibiotic-free treatments were used to limit the use of antibiotics. It is also anticipated that these drugs will have low resistance potential, although there is only minimal evidence to support this claim to date. More clinical trials and animal tests should be conducted on this topic.

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IJMS, Vol. 17, Pages 615: TNFSF15 Inhibits Blood Retinal Barrier Breakdown Induced by Diabetes

Tumor necrosis factor superfamily 15 (TNFSF15) is an endogenous neovascularization inhibitor and an important negative regulator of vascular homeostasis. This study aimed to explore the potential role of TNFSF15 in diabetic retinopathy. Vitreous TNFSF15 and VEGF levels in proliferative diabetic retinopathy (PDR) patients were detected by ELISA. Retinal expression of TNFSF15 and the content of tight junction proteins (TJPs) in rats were detected by immunohistochemistry and Western blot, respectively. The blood retinal barrier (BRB) permeability was evaluated using Evans Blue (EB) dye. The TNFSF15/VEGF ratio was decreased in the vitreous fluid of patients with PDR relative to the controls, even though the expression levels of TNFSF15 were higher. TNFSF15 was dramatically decreased one month later after diabetes induction (p < 0.001), and then increased three months later and thereafter. TNFSF15 treatment significantly protected the BRB in the diabetic animals. Diabetes decreased TJPs levels in the retina, and these changes were inhibited by TNFSF15 treatment. Moreover, TNFSF15 decreased activation of VEGF both in mRNA and protein levels caused by diabetes. These results indicate that TNFSF15 is an important inhibitor in the progression of DR and suggest that the regulation of TNFSF15 shows promise for the development of diabetic retinopathy treatment strategies.

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Management of Complications arising from the Treatment of Small Renal Masses.

Management of Complications arising from the Treatment of Small Renal Masses.

Int J Surg. 2016 Apr 20;

Authors: Caputo PA, Kaouk J

Abstract
This article offers a review of the complications, and management of such complications, associated with different modalities used for the treatment of the small renal mass.

PMID: 27107664 [PubMed - as supplied by publisher]

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Meta-analysis of hand-sewn versus mechanical gastrojejunal anastomosis during laparoscopic Roux-en-Y gastric bypass for morbid obesity.

Meta-analysis of hand-sewn versus mechanical gastrojejunal anastomosis during laparoscopic Roux-en-Y gastric bypass for morbid obesity.

Int J Surg. 2016 Apr 20;

Authors: Jiang HP, Lin LL, Jiang X, Qiao HQ

Abstract
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most performed bariatric procedures in treating morbid obesity. There is no consensus on which technique used for gastrojejunal anastomosis is optimal. The meta-analysis aimed to solve the issue by comparing hand-sewn with mechanical gastrojejunostomy during LRYGB for morbid obesity.
METHODS: PubMed, Embase, Cochrane Library, Scopus, Google Scholar and Research Gate were searched (from inception to April 2016). Primary outcome was operation time. Secondary outcomes were postoperative complications (anastomotic leak, stricture, bleeding, marginal ulcer and wound infection), percent excess weight loss during one-year follow-up, reoperation, and postoperative hospital stay. Odds ratios (OR) were calculated for dichotomous outcomes and mean differences (MD) for continuous outcomes.
RESULTS: Twelve trials were included comprising 13626 patients (3309 hand-sewn vs. 6791 circular vs. 3526 linear). There was no difference in operation time when hand-sewn anastomosis was compared with mechanical gastrojejunostomy (MD, - 6.00; 95% confidence interval (CI), -34.85 - 22.85; P = 0.68), circular stapled anastomosis (MD, -5.24; 95% CI, -32.71 - 22.24; P = 0.71) or linear stapled anastomosis (MD, - 3.75; 95% CI, -64.81 - 57.31; P = 0.90). Hand-sewn anastomosis had significantly lower incidence rate of postoperative bleeding (OR, 0.48; 95% CI, 0.31 - 0.74; P = 0.001) and wound infection (OR, 0.19; 95% CI, 0.08 - 0.45; P = 0.0002) than circular stapled anastomosis; there were no significant differences in the other secondary outcome. And there were no significant differences in all the comparable outcomes between hand-sewn anastomosis and linear stapled anastomosis.
CONCLUSIONS: This meta-analysis revealed no significant differences between mechanical and hand-sewn anastomosis except for greater incidence rates of postoperative bleeding and wound infection with the use of circular staplers. Besides, more trials with adequate power are required and a cost analysis also worth trying.

PMID: 27107663 [PubMed - as supplied by publisher]

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Damage Control Resuscitation.

Damage Control Resuscitation.

Int J Surg. 2016 Apr 20;

Authors: Briggs A, Askari R

Abstract
None Required as this is a concise Review.

PMID: 27107662 [PubMed - as supplied by publisher]

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Risk factors for cage retropulsion after lumbar interbody fusion surgery: Series of cases and literature review.

Risk factors for cage retropulsion after lumbar interbody fusion surgery: Series of cases and literature review.

Int J Surg. 2016 Apr 20;

Authors: Pan FM, Wang SJ, Yong ZY, Liu XM, Huang YF, Wu DS

Abstract
OBJECTIVE: To identify the risk factors for cage retropulsion after lumbar interbody fusion surgery.
METHODS: 667 patients underwent lumbar interbody fusion surgery between November 2011 to December 2014 were retrospectively reviewed by the medical recording system in our institute. 8 patients experiencing cage retropulsion were included and 2 underwent the initial surgery in other hospitals. The clinical outcomes were evaluated by visual analogue scores (VAS) and Oswestry Disability Index (ODI). Plain radiographs and three-dimensional computed tomography scans were used to analyze the incidence of cage retropulsion. Data were analyzed by SPSS 19.0.
RESULTS: The incidence of cage retropulsion was 0.90%(6 out of 665) in our institution. There were 6 male and 2 female with an average age of 45.63±15.48(range,21 - 60). The average follow-up time was 23.88±12.69 months(range,6-43 months) and average retropulsion onset time was 2.75 months(range,1-6 months). 6 patients experienced cage retropulsion at L5/S1 and 2 at L4/5. 6 used bullet-shaped cages and two had kidney-shaped cages. Average bed rest time after the initial surgery was 5.75±1.67 days. 6 patients had neurological deficits and underwent revision surgery. Average operation time and blood loss for revision surgery were much higher than those of the initial surgery (P<0.05). All the patients got a good result in VAS and ODI both from initial surgery and revision surgery (P<0.05).
CONCLUSIONS: There were multiple risk factors for cage retropulsion after lumbar interbody fusion surgery, including patient factors, radiological characteristics, surgical techniques and postoperative reasons. In case of retropulsion, revision surgery was essential for the patients who presented neurological deficits and conservative treatment was recommended for asymptomatic patients.

PMID: 27107661 [PubMed - as supplied by publisher]

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Transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: a systematic review and meta-analysis.

Transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: a systematic review and meta-analysis.

Int J Surg. 2016 Apr 20;

Authors: Xia L, Zhang X, Wang X, Xu T, Qin L, Zhang X, Zhong S, Shen Z

Abstract
PURPOSE: To compare the perioperative outcomes of the transperitoneal (TP) and retroperitoneal (RP) approaches in robot-assisted partial nephrectomy (RAPN).
METHODS: A literature search of MEDLINE, EMBASE, SCOPUS and the Cochrane Library was performed to identify relevant studies up to March 2016. All studies with enough data comparing TP-RAPN with RP-RAPN were included. Outcomes of interest were complication, conversion, operative time (OT), warm ischemia time (WIT), estimated blood loss (EBL), and positive surgical margin (PSM). Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model. Publication bias was assessed by funnel plots.
RESULTS: Four studies with the total number of 449 patients assessing TP-RAPN (n=229) versus RP-RAPN (n=220) were included. There was no significant difference between the two groups in any of demographic variables. There were also no significant differences between TP-RAPN and RP-RAPN groups regarding tumor size, tumor laterality, R.E.N.A.L. nephrometry score, and tumor pathology. There was marginally significant difference between the two groups regarding OT (p=0.05, WMD: 28.03; 95% CI, 0.41 to 55.65). No significant differences were found regarding complication, conversion, WIT, EBL, and PSM. No obvious publication bias was observed.
CONCLUSIONS: The present meta-analysis suggests that RP-RAPN appears to be equally safe and efficacious in terms of complication, conversion, WIT, EBL and PSM compared with TP-RAPN. In addition, RP-RAPN has marginally significant advantage of shorter OT. Randomized controlled trials and high-quality observational cohort studies with large sample size and long-term follow-up are needed to update our findings.

PMID: 27107660 [PubMed - as supplied by publisher]

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Chemoradiation for organ preservation in the treatment of muscle-invasive bladder cancer.

Chemoradiation for organ preservation in the treatment of muscle-invasive bladder cancer.

Urol Oncol. 2016 Apr 20;

Authors: McHaffie DR, Kruser TJ, Gaston K, Mahoney J, Graham D, Haake M

Abstract
INTRODUCTION: Standard therapy for muscle invasive bladder cancer includes neoadjuvant chemotherapy followed by radical cystectomy with urinary diversion. Three decades of interest in primary radiation and chemotherapy for bladder preservation have yielded mature that deserve closer examination.
METHODS: We reviewed the literature with an emphasis on outcomes from major clinical trials and prospective studies, while highlighting important aspects of effective treatment delivery and unanswered questions surrounding this approach.
RESULTS: There are no randomized trials comparing radical cystectomy to primary chemotherapy and radiation for bladder preservation, and future phase III comparisons are unlikely to be planned. Mature results from single institution protocols and phase II cooperative group trials demonstrate favorable disease-specific survival and bladder preservation rates. Here we review the results of relevant clinical trials, including cancer-related and patient functional outcomes. We outline multi-modal treatment specifics with respect to radiation delivery, incorporation of transurethral resection and chemotherapy selection, and future directions for optimizing results of non-operative strategies.
CONCLUSIONS: Combination chemotherapy and radiation can be used as an alternative to conserve the native bladder in appropriately selected patients, mirroring successful non-operative treatment paradigms used for organ-preservation for other cancer sites.

PMID: 27108225 [PubMed - as supplied by publisher]

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Onco-cardiology: Present and future.

Onco-cardiology: Present and future.

Int J Cardiol. 2016 Apr 13;215:38-40

Authors: Sueta D, Hokimoto S

Abstract
"Onco-cardiology" is a term that indicates cardiotoxicity during treatment of malignant diseases. Many studies have demonstrated that chemotherapy agents induce cardiotoxicity in certain ratios. In clinical settings, active malignant diseases or a history thereof are often encountered in patients with cardiovascular disease (CVD); it is not uncommon for a patient to struggle with a prior treatment. We have previously demonstrated a close association between malignant diseases and coronary calcifications in coronary artery disease. The concurrence of arteriosclerotic diseases, including CVD, with malignant diseases should be carefully considered in clinical settings, particularly with regard to scheduled surgical procedures. Moreover, it is essential that all medical professionals associated with cancer care understand these associations. Our advocacy will provide new insight into onco-cardiology.

PMID: 27107544 [PubMed - as supplied by publisher]

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Correlative Light-Electron Microscopy Shows RGD-Targeted ZnO Nanoparticles Dissolve in the Intracellular Environment of Triple Negative Breast Cancer Cells and Cause Apoptosis with Intratumor Heterogeneity

ZnO nanoparticles (NPs) are reported to show a high degree of cancer cell selectivity with potential use in cancer imaging and therapy. Questions remain about the mode by which the ZnO NPs cause cell death, whether they exert an intra- or extracellular effect, and the resistance among different cancer cell types to ZnO NP exposure. The present study quantifies the variability between the cellular toxicity, dynamics of cellular uptake, and dissolution of bare and RGD (Arg-Gly-Asp)-targeted ZnO NPs by MDA-MB-231 cells. Compared to bare ZnO NPs, RGD-targeting of the ZnO NPs to integrin αvβ3 receptors expressed on MDA-MB-231 cells appears to increase the toxicity of the ZnO NPs to breast cancer cells at lower doses. Confocal microscopy of live MDA-MB-231 cells confirms uptake of both classes of ZnO NPs with a commensurate rise in intracellular Zn²⁺ concentration prior to cell death. The response of the cells within the population to intracellular Zn²⁺ is highly heterogeneous. In addition, the results emphasize the utility of dynamic and quantitative imaging in understanding cell uptake and processing of targeted therapeutic ZnO NPs at the cellular level by heterogeneous cancer cell populations, which can be crucial for the development of optimized treatment strategies.

A fluorescently labeled RGD-targeted ZnO nanoparticle (ZnO-GFP-HCV-RGD NP) is developed for targeted delivery of ZnO to integrin αvβ3 receptors expressed on triple negative breast cancer cells (TNBCs). Correlative light-electron microscopy shows ZnO-GFP-HCV-RGD NPs dissolve in the intracellular environment of TNBCs and cause apoptosis with intratumor heterogeneity. More importantly, these NPs provide a possible strategy for targeted breast cancer therapy.

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Development and Characterization of Organic Electronic Scaffolds for Bone Tissue Engineering

Bones have been shown to exhibit piezoelectric properties, generating electrical potential upon mechanical deformation and responding to electrical stimulation with the generation of mechanical stress. Thus, the effects of electrical stimulation on bone tissue engineering have been extensively studied. However, in bone regeneration applications, only few studies have focused on the use of electroactive 3D biodegradable scaffolds at the interphase with stem cells. Here a method is described to combine the bone regeneration capabilities of 3D-printed macroporous medical grade polycaprolactone (PCL) scaffolds with the electrical and electrochemical capabilities of the conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT). PCL scaffolds have been highly effective in vivo as bone regeneration grafts, and PEDOT is a leading material in the field of organic bioelectronics, due to its stability, conformability, and biocompatibility. A protocol is reported for scaffolds functionalization with PEDOT, using vapor-phase polymerization, resulting in a conformal conducting layer. Scaffolds' porosity and mechanical stability, important for in vivo bone regeneration applications, are retained. Human fetal mesenchymal stem cells proliferation is assessed on the functionalized scaffolds, showing the cytocompatibility of the polymeric coating. Altogether, these results show the feasibility of the proposed approach to obtain electroactive scaffolds for electrical stimulation of stem cells for regenerative medicine.

PEDOT-coated 3D macroporous scaffolds are developed as active substrates for mesenchymal stem cell culture. The conducting polymer PEDOT:tosylate is deposited on medical-grade polycaprolactone scaffolds via vapor phase polymerization. This results in a continuous conformal layer, and electrically and electrochemically active scaffolds. The mechanical strength of the functionalized scaffolds can be preserved, and they are shown to promote stem cell proliferation.

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Erratum to: Significance of endothelial progenitor cells (EPC) for tumorigenesis of head and neck squamous cell carcinoma (HNSCC): possible marker of tumor progression and neovascularization?

Erratum to: Significance of endothelial progenitor cells (EPC) for tumorigenesis of head and neck squamous cell carcinoma (HNSCC): possible marker of tumor progression and neovascularization?

Clin Oral Investig. 2016 Apr 23;

Authors: Ziebart T, Blatt S, Günther C, Voelxen N, Pabst A, Sagheb K, Kühl S, Lambrecht T

PMID: 27108343 [PubMed - as supplied by publisher]

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Direct perturbation of neural integrator by bilateral galvanic vestibular stimulation.

Direct perturbation of neural integrator by bilateral galvanic vestibular stimulation.

Med Biol Eng Comput. 2016 Apr 23;

Authors: Hong K, Shim HM, Goh M, Jang SY, Lee S, Kim KS

Abstract
Caloric vestibular stimulation (CVS) and galvanic vestibular stimulation (GVS) act primarily on the peripheral vestibular system. Although the electrical current applied during GVS is thought to flow through peripheral vestibular organs, some current may spread into areas within the central nervous system, particularly when the bilateral galvanic vestibular stimulation (bGVS) method is used. According to Alexander's law, the magnitude of nystagmus increases with eccentric gaze movement, due to the function of the neural integrator (NI); thus, if the information for vestibular stimulation corresponds to Alexander's law, the peripheral vestibular organ is stimulated. Therefore, it would appear that if CVS results comply with Alexander's law, and bGVS results do not, the sites stimulated by bGVS are not perfectly located in the peripheral vestibular area. In our experiments on normal human subjects, the magnitude of nystagmus under CVS increased with rising gaze eccentricity in the direction that the magnitude of the nystagmus increases, and this change was found to follow Alexander's law. However, in the case of nystagmus under bGVS, results did not follow Alexander's law. In addition, study of the influences of bGVS at different current intensities on nystagmus magnitude showed that bGVS at 5 mA distorted nystagmus magnitude more than at 3 mA, which suggests bGVS acts not only on the peripheral vestibular nerves, but also on some areas of the central nervous system, particularly the NI. According to our experiments, bGVS directly affects neural integrator function.

PMID: 27108289 [PubMed - as supplied by publisher]

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Integrin αvβ3 Expression in Tongue Squamous Carcinoma Cells Cal27 Confers Anticancer Drug Resistance Through Loss of pSrc(Y418).

Integrin αvβ3 Expression in Tongue Squamous Carcinoma Cells Cal27 Confers Anticancer Drug Resistance Through Loss of pSrc(Y418).

Biochim Biophys Acta. 2016 Apr 20;

Authors: Stojanović N, Brozovic A, Majhen D, Bosnar MH, Fritz G, Osmak M, Ambriović-Ristov A

Abstract
Integrins play key roles in the regulation of tumor cell adhesion, migration, invasion and sensitivity to anticancer drugs. In the present study we investigate the mechanism of resistance of tongue squamous carcinoma cells Cal27 with de novo integrin αvβ3 expression to anticancer drugs. Cal27-derived cell clones, obtained by transfection of plasmid containing integrin subunit β3 cDNA, as compared to control cells demonstrate: expression of integrin αvβ3; increased expression of integrin αvβ5; increased adhesion to fibronectin and vitronectin; resistance to cisplatin, mitomycin C, doxorubicin and 5-fluorouracil; increased migration and invasion, increased amount of integrin-linked kinase (ILK) and decreased amounts of non-receptor tyrosine kinase (Src) and pSrc(Y418). Knockdown of ILK and integrin β5 in cells expressing integrin αvβ3 ruled out their involvement in drug resistance. Opposite, Src knockdown in Cal27 cells which led to a reduction in pSrc(Y418), as well as treatment with the pSrc(Y418) inhibitors dasatinib and PP2, conferred resistance to all four anticancer drugs, indicating that the loss of pSrc(Y418) is responsible for the observed effect. We identified differential integrin signaling between Cal27 and integrin αvβ3-expressing cells. In Cal27 cells integrin αv heterodimers signal through pSrc(Y418) while this is not the case in integrin αvβ3-expressing cells. Finally, we show that dasatinib counteracts the effect of cisplatin in two additional head and neck squamous cell carcinoma (HNSCC) cell lines Cal33 and Detroit562. Our results suggest that pSrc(Y418) inhibitors, potential drugs for cancer therapy, may reduce therapeutic efficacy if combined with chemotherapeutics, and might not be recommended for HNSCC treatment.

PMID: 27108184 [PubMed - as supplied by publisher]

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International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations.

International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations.

Int J Pediatr Otorhinolaryngol. 2016 Apr 7;

Authors: Carter J, Rahbar R, Brigger M, Chan K, Cheng A, Daniel SJ, De Alarcon A, Garabedian N, Hart C, Hartnick C, Jacobs I, Liming B, Nicollas R, Pransky S, Richter G, Russell J, Rutter MJ, Schilder A, Smith RJ, Strychowsky J, Ward R, Watters K, Wyatt M, Zalzal G, Zur K, Thompson D

Abstract
OBJECTIVE: To provide recommendations for the comprehensive management of young infants who present with signs or symptoms concerning for laryngomalacia.
METHODS: Expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG).
RESULTS: Consensus recommendations include initial care and triage recommendations for health care providers who commonly evaluate young infants with noisy breathing. The consensus statement also provides comprehensive care recommendations for otolaryngologists who manage young infants with laryngomalacia including: evaluation and treatment considerations for commonly debated issues in laryngomalacia, initial work-up of infants presenting with inspiratory stridor, treatment recommendations based on disease severity, management of the infant with feeding difficulties, post-surgical treatment management recommendations, and suggestions for acid suppression therapy.
CONCLUSION: Laryngomalacia care consensus recommendations are aimed at improving patient-centered care in infants with laryngomalacia.

PMID: 27107728 [PubMed - as supplied by publisher]

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[Acantholytic squamous cell carcinoma of larynx as an uncommon variant of squamous cell carcinoma].

[Acantholytic squamous cell carcinoma of larynx as an uncommon variant of squamous cell carcinoma].

Kulak Burun Bogaz Ihtis Derg. 2016 May-Jun;26(3):176-80

Authors: Tiken EE, Çolpan Öksüz D, Batur Ş, Uzel EK, Öz B, Öz F, Uzel Ö, Turkan S

Abstract
Acantholytic squamous cell carcinoma is an uncommon variant of squamous cell carcinoma. Acantholytic squamous cell carcinoma occurs in the sun-exposed areas of the skin and lip. It is rarely observed in the respiratory and digestive tract and may present more aggressively. The incidence of distant metastases of squamous cell head and neck cancers is low and the lungs are the most common metastatic sites. Metastasis to the soft tissue, skin, and adrenal glands from the laryngeal region is very uncommon. In this article, we report a 58-year-old female case who underwent postoperative radiation therapy with the diagnosis of acantholytic squamous cell carcinoma of the larynx and developed metastasis to the soft tissue and adrenal gland at the early period.

PMID: 27107606 [PubMed - as supplied by publisher]

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Pectoralis major myofascial interposition flap prevents postoperative pharyngocutaneous fistula in salvage total laryngectomy.

Pectoralis major myofascial interposition flap prevents postoperative pharyngocutaneous fistula in salvage total laryngectomy.

Eur Arch Otorhinolaryngol. 2016 Apr 23;

Authors: Anschütz L, Nisa L, Elicin O, Bojaxhiu B, Caversaccio M, Giger R

Abstract
Pharyngocutaneous fistula (PCF) is the most cumbersome complication after salvage total laryngectomy (STL) in patients who have been previously irradiated for laryngeal or hypopharyngeal cancer. To assess the fistula rate, risk factors and effects of primary closure with and without pectoralis major myofascial interposition flap (PMMIF) on fistula formation, we conducted a retrospective review. We identified 48 patients from 2004 to 2013 who underwent STL after failure of primary curative (chemo)radiotherapy in laryngeal or hypopharyngeal cancer. Details of risk factors for PCF formation, other postoperative complications and general outcome data were analyzed. Ten (20.8 %) out of 48 patients underwent STL with PMMIF closure. Patient and tumor features were not different between the groups with or without PMMIF closure. PCF rates were 0 and 42.1 % in patients with and without PMMIF, respectively (p = 0.002). Other operative complications were similar. We identified prior neck irradiation to be a risk factor for fistula formation (p = 0.04). Patients without PCF had a statistically significant reduction of average hospital stay (20 vs. 56 days; p = 0.001). Analysis of fistula management revealed 50 % of PCF to be closed secondarily by a pectoralis major myocutaneous flap. Over one-third of fistulae persisted despite attempted surgical closure in some cases. PMMIF is useful to prevent PCF in STL following (chemo)radiotherapy. Neck irradiation during primary treatment is a risk factor for PCF formation.

PMID: 27107580 [PubMed - as supplied by publisher]

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Mandibular melanotic neuroectodermal tumor of infancy: a role for neoadjuvant chemotherapy.

Mandibular melanotic neuroectodermal tumor of infancy: a role for neoadjuvant chemotherapy.

Eur Arch Otorhinolaryngol. 2016 Apr 23;

Authors: Maroun C, Khalifeh I, Alam E, Akl PA, Saab R, Moukarbel RV

Abstract
Melanotic Neuroectodermal Tumor of Infancy (MNTI) is a rare, locally aggressive neoplasm with a predilection for the head and neck area, most commonly occurring in the maxilla. The vast majority of treatment modalities for all cases of MNTI to date have involved surgical intervention only, with just 9.6 % involving some sort of chemotherapy, radiotherapy, or a combination of the prior mentioned modalities. There is very limited information available regarding the use of neoadjuvant chemotherapy, due to its rare nature. In this report, a 4 month old girl presented to our clinic with a chief complaint of a large oral mass of about 2.5 months in duration. Intraoral examination showed an oral mass arising from the lingual aspect of inferior alveolar ridge with extensive mandibular invasion. The patient received three cycles of vincristine, Adriamycin, and cyclophosphamide as neodajuvant therapy. Upon completion, the tumor had decreased significantly in size. The patient was then scheduled for surgery and underwent surgical resection of the tumor. We were able to obtain adequate shrinkage of the tumor to allow better resectability, easier surgical access and a more minimally invasive approach with no lip split and a smaller neck incision. In conclusion, we have reported an extremely rare case of MNTI of the mandible that was successfully treated with neoadjuvant chemotherapy and surgical resection. This approach was advantageous to minimize the chance of recurrence and improve resectability in particularly large tumors, while maximizing functional outcomes and minimizing deformity.

PMID: 27107579 [PubMed - as supplied by publisher]

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Deboronative cyanation of potassium alkyltrifluoroborates via photoredox catalysis

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01530A, Communication

Jian-Jun Dai, Wen-Man Zhang, Yong-Jin Su, Yu-Yang Sun, Jun Xu, Yi-Si Feng, Hua-Jian Xu
A photoredox catalytic method was developed for the direct cyanation of alkyltrifluoroborates. This reaction provides a new and useful transformation of the easily available alkyltrifluoroborates. The photocatalytic reaction can tolerate...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Chemotherapy for intracranial ependymoma in adults.

Chemotherapy for intracranial ependymoma in adults.

BMC Cancer. 2016;16(1):287

Authors: Gramatzki D, Roth P, Felsberg J, Hofer S, Rushing EJ, Hentschel B, Westphal M, Krex D, Simon M, Schnell O, Wick W, Reifenberger G, Weller M

Abstract
BACKGROUND: Ependymal tumors in adults are rare, accounting for less than 4 % of primary tumors of the central nervous system in this age group. The low prevalence of intracranial ependymoma in adults limits the ability to perform clinical trials. Therefore, treatment decisions are based on small, mostly retrospective studies and the role of chemotherapy has remained unclear.
METHODS: We performed a retrospective study on 17 adult patients diagnosed with intracranial World Health Organisation grade II or III ependymoma, who were treated with chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by applying Macdonald criteria. Progression-free (PFS) and overall survival (OS) were calculated from start of chemotherapy, using the Kaplan-Meier method.
RESULTS: Eleven patients had supratentorial and 6 infratentorial tumors. Ten patients were treated with temozolomide (TMZ), 3 with procarbazine/lomustine/vincristine (PCV), 3 with platinum-based chemotherapy and 1 patient received epirubicin/ifosfamide. Response rates were as follows: TMZ 8/10 stable disease; PCV 3/3 stable disease; platinum-based chemotherapy 1/3 partial response; epirubicin/ifosfamide 1/1 complete response. PFS rates at 6, 12 and 24 months were 52.9, 35.3 and 23.5 %. OS rates at 6, 12 and 24 months were 82.4, 82.4 and 70.1 %. There was no indication for a favourable prognostic role of O (6) -methylguanyl-DNA-methyltransferase (MGMT) promoter methylation which was detected in 3/12 investigated tumors.
CONCLUSIONS: Survival outcomes in response to chemotherapy in adult intracranial ependymoma patients vary substantially, but individual patients may respond to any kind of chemotherapy. There were too few patients to compare survival data between chemotherapeutic subgroups.

PMID: 27108407 [PubMed - as supplied by publisher]

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Epistemology applied to conclusions of expert reports.

Epistemology applied to conclusions of expert reports.

Forensic Sci Int. 2016 Apr 11;264:122-131

Authors: Lucena-Molina JJ

Abstract
It is believed that to build a robust reasoning logic to make probabilistic inferences in forensic science from a merely mathematical or logistical viewpoint is not enough. Mathematical logic is the positive science of reasoning and as for that it is only interested in the positive calculus of its validity, regardless any prior ontological assumption. But without a determined ontology and epistemology which imply to define the concepts that they will use, it seems difficult that the proposed scientifically correct mathematical solution be successful as a European standard for making conclusions in forensic reports because it has to be based on judicial language. Forensic experts and Courts are not interested in the development of a positive science but in a practical science: in clarifying whether certain known facts are related to a possible crime. Therefore, not only the coherence of the demonstrative logic reasoning used (logic of propositions) is important, but also the precision of the concepts used by language and consistency among them in reasoning (logic of concepts). There is a linguistic level essential for a successful communication between the forensic practitioner and the Court which is mainly related, in our opinion, to semantics and figures of speech. The first one is involved because words used in forensic conclusions often have different meanings - it is said that they are polysemic - and the second one because there is often metonymy as well. Besides, semantic differences among languages regarding words with the same etymological root add another difficulty for a better mutual understanding. The two main European judicial systems inherit a wide and deep culture related to evidence in criminal proceedings and each of them has coined their own terminology but there are other two more abstract levels such as logical and epistemological, where we can find solid arguments by which terms used at legal level on conclusions of forensic reports could be accurate and consistent for all users of an intended EU guideline. An effort has been made to elucidate the following terms: truth, certainty, uncertainty, opinion, conjecture, probability, evidence, belief, credibility, determinism, indeterminacy, cause, principle, condition, and occasion.

PMID: 27108354 [PubMed - as supplied by publisher]

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Evaluation of radiocesium concentrations in new leaves of wild plants two years after the Fukushima Dai-ichi Nuclear Power Plant accident

Publication date: August 2016
Source:Journal of Environmental Radioactivity, Volume 160
Author(s): Yuki Sugiura, Michihiro Shibata, Yoshimune Ogata, Hajime Ozawa, Tsutomu Kanasashi, Chisato Takenaka
Radiocesium (¹³⁷Cs) transfer to plants immediately after the Fukushima Dai-ichi Nuclear Power Plant accident was investigated by collecting newly emerged leaf and soil samples between May 2011 and November 2012 from 20 sites in the Fukushima prefecture. Radiocesium concentrations in leaf and soil samples were measured to calculate concentration ratios (CR). Woody plants exhibited high CR values because ¹³⁷Cs deposited on stems and/or leaves were transferred to newly emerging tissues. The CR values in 2012 declined as compared to that in 2011. Exchangeable ¹³⁷Cs rates in soil (extraction rate) samples were measured at five sites. These rates decreased at four sites in 2012 and depended on environmental conditions and soil type. Both CR values and extraction rates decreased in 2012. However, CR values reflected the changes in extraction rates and characteristics of each species. Amaranthaceae, Chenopodiaceae, and Polygonaceae, which had been identified as Cs accumulators, presented no clear ¹³⁷Cs accumulation ability. In 2012, the perennial plant Houttuynia cordata and deciduous trees Chengiopanax sciadophylloides and Acer crataegifolium displayed high CR values, indicating that these species are ¹³⁷Cs accumulators and may be considered as potential species for phytoremediation.



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Determination of 226Ra in produced water by liquid scintillation counting

Publication date: August 2016
Source:Journal of Environmental Radioactivity, Volume 160
Author(s): José Marcus Godoy, Lucas M. Vianna, Maria Luiza D.P. Godoy, Ana Cristina Almeida
It is proposed a method for the determination of ²²⁶Ra in offshore platform liquid effluent samples (produced water). The method is based on a two-phase liquid scintillation counting system and allows for the direct and simple determination of ²²⁶Ra content. Samples with high barium content may also have high ²²⁶Ra concentration. Therefore, the sample volume is based on the barium concentration and ranges from 10 mL to 100 mL. Our new method was tested using multiple real samples and was compared with the BaSO4 precipitation method. The results based on the LSC were 30% higher than the precipitation method, which is attributed to the self-absorption of alpha particles in the BaSO4 precipitate. The determination of both ²²⁶Ra and ²²⁸Ra in the liquid effluent of offshore oil platforms is mandatory in Brazil. Thus, a second method of accurately assessing ²²⁸Ra content remains necessary.

Graphical abstract

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3D printing in Neurosurgery Imagination is more important than knowledge (Albert Einstein).

3D printing in Neurosurgery Imagination is more important than knowledge (Albert Einstein).

World Neurosurg. 2016 Apr 20;

Authors: Tomasello F, Conti A, La Torre D

PMID: 27108033 [PubMed - as supplied by publisher]

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Natural history of asymptomatic moderate carotid artery stenosis in the era of medical therapy.

Natural history of asymptomatic moderate carotid artery stenosis in the era of medical therapy.

World Neurosurg. 2016 Apr 20;

Authors: Park YJ, Kim DI, Kim GM, Kim DK, Kim YW

Abstract
OBJECTIVE: to determine the incidence and risk factors of carotid stenosis progression in patients with asymptomatic moderate carotid artery stenosis (CAS).
METHODS: Patients with asymptomatic moderate CAS in duplex ultrasound (DUS) were identified from 2003 to 2008, and only those with more than one DUS were included during a 5-year follow-up after index DUS. Study end-points were carotid stenosis progression to severe stenosis ≥70%, development of ipsilateral neurologic symptoms (INS), and death.
RESULTS: One hundred twenty-nine carotid arteries in 124 patients were included in the study. Carotid stenosis progression occurred in 41 (31.8%) arteries, and 4 (3.2%) patients developed INS during a mean follow-up of 49 months (range, 2-128 months). The 5-year freedom from carotid stenosis progression and development of INS were 63.5% ± 5.3% and 98.1% ± 1.4%, respectively, with no difference from those of statin. There was no significant predictor of carotid stenosis progression, and it was not significantly associated with development of INS. The 5-year actuarial patient survival and symptom-free survival were 95.3% ± 2.7 and 93.4% ± 3.0%, respectively, with no difference from those of statin. The only independent predictor of death and INS/death was a remote history of INS (HR 18.166, P = 0.021, HR 4.840, P = 0.046).
CONCLUSIONS: The incidence of carotid stenosis progression in asymptomatic moderate CAS was high even in popular use of aspirin and statin. Although development of INS was not associated with carotid stenosis progression, it was a risk factor of long-term morbidity and survival.

PMID: 27108032 [PubMed - as supplied by publisher]

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Paradoxical brain herniation after decompressive craniectomy provoked by drainage of subdural hygroma: case report.

Paradoxical brain herniation after decompressive craniectomy provoked by drainage of subdural hygroma: case report.

World Neurosurg. 2016 Apr 20;

Authors: Nasi D, Dobran M, Iacoangeli M, Di Somma L, Gladi M, Scerrati M

Abstract
BACKGROUND: Paradoxical brain herniation (PBH) is a rare and potentially life-threatening complication of decompressive craniectomy (DC) and results from the combined effects of brain gravity, atmospheric pressure and intracranial hypotension causing herniation in the direction opposite to the site of the DC with subsequent brainstem compression. To date, the cases of PBH reported in literature are spontaneous or provoked by a lumbar puncture (LP), a CSF shunt or ventriculostomy.
CASE DESCRIPTION: We present an uncommon case of PBH provoked by percutaneous drainage of a huge subdural hygroma (SH) ipsilateral to the decompressive craniectomy causing mass effect and neurological deterioration. After percutaneous evacuation of SH, the patient became unresponsive with dilated and fixed left pupil. A brain CT scan showed marked midline shift in the direction opposite to the craniectomy site with subfalcine herniation and effacement of the peripontine cisterns. Paradoxical brain herniation (PBH) was diagnosed. Conservative treatment failed and the patient required an emergency cranioplasty for reverse PBH.
CONCLUSIONS: The present case highlights the possibility that all forms of CSF depletion, including percutaneous drainage of subdural CSF collection and not only CSF shunting and/or lumbar puncture, can be dangerous for patients with large craniotomies and can result in PBH. Moreover, an emergency cranioplasty could represent a safe and effective procedure in patient not responding to conservative treatment.

PMID: 27108031 [PubMed - as supplied by publisher]

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CyberKnife Stereotactic Radiosurgery for Atypical and Malignant Meningiomas.

CyberKnife Stereotactic Radiosurgery for Atypical and Malignant Meningiomas.

World Neurosurg. 2016 Apr 20;

Authors: Zhang M, Ho AL, D'Astous M, Pendharkar AV, Choi CY, Thompson PA, Tayag AT, Soltys SG, Gibbs IC, Chang SD

Abstract
OBJECTIVE: Recurrent WHO Grade II and III meningiomas have traditionally been treated by surgery alone, but early literature suggests that adjuvant stereotactic radiosurgery (SRS) may greatly improve outcomes. The authors sought to present the long-term tumor control and safety of a hypofractionated SRS regimen.
METHODS: We reviewed the prospectively collected information of 44 WHO Grade II and 9 WHO Grade III meningiomas treated by CyberKnife for adjuvant or salvage therapy. Patient demographics, treatment parameters, local control, regional control, locoregional control, overall survival, radiation history, and complications were documented.
RESULTS: For WHO Grade II patients, recurrence occurred in 41%, with local, regional, and locoregional failure at 60 months recorded as 49%, 58% and 36%, respectively. For WHO Grade III patients, recurrence occurred in 66%, with local, regional, and locoregional failure at 12 months recorded as 57%, 100%, and 43%. The 60-month locoregional control rates for radiation naïve and experienced patients were 48% and 0% (p = 0.14), respectively. Overall, 7 of 44 Grade II patients and 8 of 9 Grade III patients had died at last follow-up. The 60-month and 12-month overall survival rates for Grade II and III meningioma were 87% and 50%, respectively. Serious complications occurred in 7.5% of patients.
CONCLUSIONS: SRS for adjuvant and salvage treatment of WHO Grade II meningioma by a hypofractionated plan is a viable treatment strategy with acceptable long-term tumor control, overall survival, and complication rates. Future work should contribute additional study toward the radiation naïve and the local management of malignant meningioma.

PMID: 27108030 [PubMed - as supplied by publisher]

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Endoscopic Endonasal Surgery for Purely Intra-Third Ventricle Craniopharyngioma.

Endoscopic Endonasal Surgery for Purely Intra-Third Ventricle Craniopharyngioma.

World Neurosurg. 2016 Apr 20;

Authors: Nishioka H, Fukuhara N, Yamaguchi-Okada M, Yamada S

Abstract
BACKGROUND: Extended endoscopic transsphenoidal surgery (EETS) is a safe and effective treatment for many suprasellar craniopharyngiomas, including those with third-ventricle involvement. Craniopharyngioma entirely within the third ventricle (purely intraventricular type), however, is generally regarded unsuitable for treatment with EETS.
CASE DESCRIPTION: Three patients underwent total removal of a purely intraventricular craniopharyngioma with inferior extension via EETS by direct incision of the bulging, stretched ventricular floor and fine dissection from the ventricular wall. In two patients with an anteriorly displaced chiasm, the space between the chiasm and pituitary stalk created a wide corridor to the ventricle, whereas in the third case, in which the infrachiasmal space was somewhat narrowed, partial sacrifice of the pituitary gland was necessary to obtain sufficient space. Despite preservation of the stalk in two patients, hypoptuitarism and diabetes insipidus developed after surgery. There was no other complication including obesity.
CONCLUSIONS: Selected patients with purely intraventricular craniopharyngioma can be effectively and safely treated with EETS. Those with inferior extension in the interpeduncular fossa and anterior displacement of the chiasm may be suitable candidates.

PMID: 27108029 [PubMed - as supplied by publisher]

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Second Impact Syndrome in sport Life.

Second Impact Syndrome in sport Life.

World Neurosurg. 2016 Apr 20;

Authors: Quintana LM

PMID: 27108028 [PubMed - as supplied by publisher]

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Coma and stroke following surgical treatment of unruptured intracranial aneurysm: an ACS-NSQIP study.

Coma and stroke following surgical treatment of unruptured intracranial aneurysm: an ACS-NSQIP study.

World Neurosurg. 2016 Apr 20;

Authors: McCutcheon BA, Kerezoudis P, Porter AL, Rinaldo L, Murphy M, Maloney P, Shepherd D, Hirshman BR, Carter BS, Lanzino G, Bydon M, Meyer F

PMID: 27108027 [PubMed - as supplied by publisher]

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Size and Location of Ruptured Intracranial Aneurysms: A 5 Year Clinical Survey.

Size and Location of Ruptured Intracranial Aneurysms: A 5 Year Clinical Survey.

World Neurosurg. 2016 Apr 20;

Authors: Froelich JJ, Neilson S, Peters-Wilke J, Dubey A, Thani N, Erasmus A, Carr MW, Hunn AW

Abstract
BACKGROUND: Prospective international cohort trials have suggested that incidental cerebral aneurysms with diameters less than 10 mm are unlikely to rupture. Consequently small ruptured cerebral aneurysms should rarely be seen in clinical practice. To verify this theory, dimensions and locations of ruptured cerebral aneurysms were analyzed across the state of Tasmania, Australia.
METHODS: We retrospectively reviewed medical records and diagnostic tests of all patients admitted with ruptured cerebral aneurysms over a 5 year interval. Aneurysm location, maximum size, dome to neck ratio, volume and presence of daughter sacs were determined by preoperative digital subtraction angiography or computed tomography angiography.
RESULTS: 131 ruptured cerebral aneurysms were encountered and treated by microsurgical clipping (n=59) or endovascular techniques (n=72). The mean maximum aneurysm diameter was 6.4 ± 3.7 mm, DNR 2 ± 0.8, aneurysm volume 156 ± 372 mm(3) and daughter sacs were present in 70 aneurysms (53.4 percent). The anterior communicating artery was the most common location (37.4 percent). Cumulative maximum diameters of ruptured aneurysms were ≤ 5 mm in 49 percent, ≤ 7 mm in 73 percent, and ≤ 10 mm in 90 percent.
CONCLUSIONS: Despite findings from prospective international cohort trials, small ruptured intracranial aneurysms are common in clinical practice. In consequence, it seems important to identify those patients with small but vulnerable unruptured aneurysms before conservative management is considered.

PMID: 27108026 [PubMed - as supplied by publisher]

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Effective Steroid Treatment in Traumatic Cervical Spinal Epidural Hematoma Presenting with Delayed Tetraparesis: two cases report and literature review.

Effective Steroid Treatment in Traumatic Cervical Spinal Epidural Hematoma Presenting with Delayed Tetraparesis: two cases report and literature review.

World Neurosurg. 2016 Apr 20;

Authors: Lin TC, Liu ZH, Bowes AL, Lee ST, Tu PH

Abstract
BACKGROUND: Traumatic spinal epidural hematoma (TSEH) is a rare neurosurgical condition that according to conventional treatment requires prompt surgical decompression. However, recent reports suggest that conservative management within the acute phase post-trauma can also lead to similar long-term functional outcomes without the need for immediate neurosurgical intervention.
CASE DESCRIPTION: In the present paper, we describe 2 cases of TSEH located in the ventral upper cervical spine, which presented with delayed neurological deficits. In both cases, conservative management with steroid treatment was initiated prior to neurosurgical decompression, resulting in improved neurological outcomes.
CONCLUSION: Urgent surgical decompression may not be necessary acutely in TSEH if patients respond well to conservative therapy. Though there is currently no consensus for the initial management strategies, steroid treatment could individually tailored and applied according to the clinical condition and evolving symptoms.

PMID: 27108025 [PubMed - as supplied by publisher]

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Morphological Analysis of Occipital Sinuses for Occipital Screw Fixation using Digital Subtraction Angiography.

Morphological Analysis of Occipital Sinuses for Occipital Screw Fixation using Digital Subtraction Angiography.

World Neurosurg. 2016 Apr 20;

Authors: Lee DH, Hong JT, Sung JH, Jain A, Huh J, Kim SU, Kim JY, Kwon JY, Cho CB, Kim IS, Lee SW

PMID: 27108024 [PubMed - as supplied by publisher]

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Atlantoaxial synovial cyst: Case report and literature review.

Atlantoaxial synovial cyst: Case report and literature review.

World Neurosurg. 2016 Apr 20;

Authors: Theodotou CB, Urakov TM, Vanni S

PMID: 27108023 [PubMed - as supplied by publisher]

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A modified microsurgical endoscopic assisted transpedicular corpectomy of the thoracic spine based on virtual 3D planning, technical note.

A modified microsurgical endoscopic assisted transpedicular corpectomy of the thoracic spine based on virtual 3D planning, technical note.

World Neurosurg. 2016 Apr 20;

Authors: Archavlis E, Schwandt E, Kosterhon M, Gutenberg A, Ulrich P, Nimer A, Giese A, Kantelhardt SR

Abstract
BACKGROUND: The main difficulties of transpedicular corpectomies is lack of space for vertebral body replacement in the neighborhood of critical structures, the necessity for sacrifice of nerve roots in the thoracic spine and the extent of hemorrhage due to venous epidural bleeding.
OBJECTIVE: We present a modified technique of transpedicular corpectomy by using an endoscopic assisted microsurgical technique performed through a single posterior approach. A 3D preoperative reconstruction could be helpful in preoperative planning for this complex anatomical region.
METHODS: Surface and volume 3D reconstruction were performed by Amira or the Dextroscope. The clinical experience of this study includes 7 cases, two with an unstable burst fracture and five with metastatic destructive vertebral body disease, all with significant retropulsion and obstruction of the spinal canal. We performed a comparison with a conventional cohort of transpedicular thoracic corpectomies.
RESULTS: Qualitative parameters of the 3D virtual reality planning included degree of bone removal, distance from critical structures such as myelon and implant diameter. Parameters were met in each case, with demonstration of optimal positioning of the implant without neurologic complications. In all cases, the endoscope was a significant help in identifying the origins of active bleeding, residual tumor, extent of bone removal, facilitating cage insertion in a minimally invasive way and helping to avoid root sacrifice on both sides.
CONCLUSION: Microsurgical endoscopic assisted transpedicular corpectomy may prove valuable in enhancing the safety of corpectomy in destructive vertebral body disease. The 3D virtual anatomical model greatly facilitated the preoperative planning.

PMID: 27108022 [PubMed - as supplied by publisher]

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Fourth stable radical species in X-irradiated solid-state sucrose

High-energy radiation produces radicals in crystalline sucrose. As such, sucrose is considered as a relevant model system for studying radiation damage to the sugar units of DNA. Many of these radicals are stable, detectable at room temperature with electron paramagnetic resonance (EPR) and their concentration is proportional to the absorbed dose in a considerable range. This makes sucrose also an interesting system for dosimetry. Dose assessment protocols rely on measurements of the total intensity of the EPR powder spectrum, so it is likely that they could be further improved if the composite nature of the spectrum was understood completely. Recently, it was shown that the three known stable radicals can only account for the central part of the spectrum and that features in the wings remain unidentified. In this work, we show, based on the analysis of the powder EPR patterns recorded at three microwave frequencies, that the contribution of one more species is sufficient to explain the entire spectrum. The determination of the spin Hamiltonian parameters is corroborated by a Q-band (34 GHz) single crystal electron-nuclear double resonance (ENDOR) analysis. The chemical structure of the fourth species is explored by analysis of the determined g and four 1H hyperfine (HF) tensors, and verified using density functional theory (DFT) calculations. The ENDOR spectrum of the largest HF interaction of the fourth species was exploited to isolate the radical's absorption-like EPR spectrum from a multicomponent powder pattern.

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Continuum tensor network field states, path integral representations and spatial symmetries

A natural way to generalize tensor network variational classes to quantum field systems is via a continuous tensor contraction. This approach is first illustrated for the class of quantum field states known as continuous matrix-product states (cMPS). As a simple example of the path-integral representation we show that the state of a dynamically evolving quantum field admits a natural representation as a cMPS. A completeness argument is also provided that shows that all states in Fock space admit a cMPS representation when the number of variational parameters tends to infinity. Beyond this, we obtain a well-behaved field limit of projected entangled-pair states (PEPS) in two dimensions that provide an abstract class of quantum field states with natural symmetries. We demonstrate how symmetries of the physical field state are encoded within the dynamics of an auxiliary field system of one dimension less. In particular, the imposition of Euclidean symmetries on the physical system requires that the auxiliary system involved in the class' definition must be Lorentz-invariant. The physical field states automatically inherit entropy area laws from the PEPS class, and are fully described by the dissipative dynamics of a lower dimensional virtual field system. Our results lie at the intersection many-body physics, quantum field theory and quantum information theory, and facilitate future exchanges of ideas and insights between these disciplines.

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Compactifications of conformal gravity

We study conformal theories of gravity, i.e. those whose action is invariant under the local transformation g(mu nu) -> omega(2)(x) g(mu nu). As is well known, in order to obtain Einstein gravity in 4D it is necessary to introduce a scalar compensator with a VEV that spontaneously breaks the conformal invariance and generates the Planck mass. We show that the compactification of extra dimensions in a higher dimensional conformal theory of gravity also yields Einstein gravity in lower dimensions, without the need to introduce the scalar compensator. It is the field associated with the size of the extra dimensions ( the radion) that takes the role of the scalar compensator in 4D. The radion has in this case no physical excitations since they are gauged away in the Einstein frame for the metric. In these models the stabilization of the size of the extra dimensions is therefore automatic.

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Import of polypeptides into chloroplasts

The majority of the protein components of chloroplasts are synthesized outside the organelle and are subsequently imported. These imported polypeptides are produced as precursors containing an amino-terminal extension. Recent experiments have demonstrated that foreign polypeptides can be imported into chloroplasts when fused to these amino-terminal extensions. This ability provides exciting opportunities for improvement of economically important plants through genetic manipulation.

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A novel ex vivo training model for peroral endoscopic myotomy (POEM) using hydrogel.

A novel ex vivo training model for peroral endoscopic myotomy (POEM) using hydrogel.

Dig Endosc. 2016 Apr 24;

Authors: Sato H, Mizuno KI, Terai S

PMID: 27108058 [PubMed - as supplied by publisher]

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The short-term effects of aflibercept on the size of choroidal neovascularization lesion in treatment-resistant neovascular age-related macular degeneration as determined by spectral-domain optical coherence tomography

Background and Objectives

To evaluate the changes in the size of choroidal neovascularization (CNV) lesion using spectral domain-optical coherence tomography (SD-OCT) in patients with treatment-resistant neovascular age-related macular degeneration (AMD) who were switched from ranibizumab to aflibercept.

Materials and Methods

In this prospective case-series, 33 eyes of 30 patients with treatment-resistant neovascular AMD were included. Treatment-resistant neovascular AMD was defined as choriodal neovascularization secondary to AMD determined by subretinal fluid and/or intraretinal fluid/cysts after more than 6 months of monthly ranibizumab therapy. Enrolled eyes were received intravitreal aflibercept injections at weeks 0, 4, and 8. Maximum area of CNV lesion in the cross-sectional area in the B-scan was measured using Heidelberg Eye Explorer software. The same cross-sectional sections containing maximum area of CNV lesion were used during the follow-up. CNV subtypes were determined based on fluorescein angiography images prior to ranibizumab therapy. Main outcome measures were changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), and area of CNV lesion.

Results

There were five classic (15%), seven minimally classic (21%), and 21 occult subtypes of CNV (64%). Four weeks after the third injection, BCVA improvement and reduction of the retinal thickness in nine standard ETDRS subfields were significant (both P < 0.001). Regarding and regardless of CNV subtypes, mean area of CNV lesion decreased significantly at final visit. Overall, a dry macula was achieved in 21 eyes (64%) and 12 eyes (36%) showed decreased or unchanged edema.

Conclusions

Switching to aflibercept seems to result in reduction of CNV lesion area in short-term follow-up of patients with treatment-resistant neovascular AMD. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc.

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Increased incidence of bladder cancer, lymphoid leukaemia, and myeloma in a cohort of Queensland melanoma families.

Increased incidence of bladder cancer, lymphoid leukaemia, and myeloma in a cohort of Queensland melanoma families.

Fam Cancer. 2016 Apr 23;

Authors: Read J, Symmons J, Palmer JM, Montgomery GW, Martin NG, Hayward NK

Abstract
Familial cancer risk has been proposed as a shared feature of many cancers, and overall susceptibility is influenced by combinations of low to moderate risk polymorphisms, rare high penetrance germline mutations, and modulation of risk by environmental and genetic factors. Clustering of melanoma occurs in approximately 10 % of families, and an over-representation of additional cancers has been noticed in some 'melanoma' families. The degree to which other cancers aggregate in families affected by melanoma has not been well defined. Therefore, this study aimed to assess the risk of cancers other than melanoma in a cohort of 178 'intermediate risk' melanoma families, not selected for specific genetic mutations. Families designated as 'intermediate risk' had two first degree relatives (FDRs) affected by melanoma when ascertained between 1982 and 1990, and were followed up over a 33 year period to assess new occurrences of cancer. We included 414 melanoma cases and 529 FDRs, comprising 25,264 person years of observation. Standardised incidence ratios and their 95 % confidence intervals were calculated for all invasive cancers, comparing observed to expected cases of cancer based on age and sex specific incidence rates for the Queensland population. Statistically significant increases were found for bladder cancer in females (observed, 7; expected, 1.99; SIR, 3.52; 95 % CI 1.41-7.25), lymphoid leukaemia in females (observed, 6; expected, 1.75; SIR, 3.43; 95 % CI 1.26-7.46), and myeloma in female melanoma cases (observed, 4; expected, 0.82; SIR, 4.89; 95 % CI 1.33-12.52). Over-representation of bladder cancer, lymphoid leukaemia, and myeloma in females of the cohort may suggest sex-dependent co-modifiers, and it is possible that specific combinations of polymorphisms predispose to certain cancer types.

PMID: 27108303 [PubMed - as supplied by publisher]

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