ATR-FTIR spectroscopy coupled with chemometric analysis discriminates normal, borderline and malignant ovarian tissue: classifying subtypes of human cancer

Analyst, 2016, 141,585-594
DOI: 10.1039/C5AN00939A, Paper

Open Access

  This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.

Georgios Theophilou, Kassio M. G. Lima, Pierre L. Martin-Hirsch, Helen F. Stringfellow, Francis L. Martin
Spectrochemical discrimination of ovarian cancer.
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Microfluidics for research and applications in oncology

Analyst, 2016, 141,504-524
DOI: 10.1039/C5AN00382B, Critical Review

Parthiv Kant Chaudhuri, Majid Ebrahimi Warkiani, Tengyang Jing, Kenry, Chwee Teck Lim
Cancer is currently one of the top non-communicable human diseases, and continual research and developmental efforts, particularly in microfluidics technology, are being made to better understand and manage this disease.
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Acute Pyelonephritis: RadioPath Correlation

We are starting a new series for Radio-pathological correlation Dr Sumer Sethi (Radiologist) and Dr Sanjeev Chitragar (Pathologist). Here is presenting the first of the series.

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Retrocerebellar arachnoid cyst resulting in syringomyelia in a patient without tonsillar herniation: successful surgical treatment with reconstruction of CSF flow in the foramen magnum region

Abstract

A retrocerebellar arachnoid cyst causing syringomyelia is extremely rare without tonsillar herniation. The authors present a 44-year-old woman with symptoms of foramen magnum compression and syringomyelia. Magnetic resonance imaging demonstrated a large retrocerebellar arachnoid cyst with a large cervicothoracic syrinx but no signs of tonsillar herniation or hydrocephalus. The patient underwent a foramen magnum decompression with C1 laminectomy, microsurgical fenestration of the cyst, and duraplasty. After successful reconstruction of CSF flow, the patient experienced a relief of symptoms and a significant reduction of the syrinx. The intraoperative findings support the theory of a piston mechanism in the development of syringomyelia. Additional arachnoidal adhesions may also obstruct the CSF flow around the craniocervical junction. We recommend the surgical treatment should consist of an adequate decompression of the foramen magnum, wide microsurgical arachnoidal debridement, and duraplasty with autologous grafts sutured in a watertight way.

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A systematic review of the use of expandable cages in the cervical spine

Abstract

Expandable vertebral body replacement cages (VBRs) have been widely used for reconstruction of the thoracolumbar spine following corpectomy. However, their use in the cervical spine is less common, and currently, no expandable cages on the market are cleared or approved by the US Food and Drug Administration for use in the cervical spine. The objective of this study was to perform a systematic review on the use of expandable cages in the treatment of cervical spine pathology with a focus on fusion rates, deformity correction, complications, and indications. A comprehensive Medline search was performed, and 24 applicable articles were identified and included in this review. The advantages of expandable cages include greater ease of implantation with less risk of damage to the end plate, less intraoperative manipulation of the device, and potentially greater control over lordosis. They may be particularly advantageous in cases with poor bone quality, such as patients with osteoporosis or metastatic tumors that have been radiated. However, there is a potential risk of overdistraction, which is increased in the cervical spine, their minimum height limits their use in cases with collapsed vertebra, and the amount of hardware in the expansion mechanism may limit the surface area available for fusion. The use of expandable VBRs are a valuable tool in the armamentarium for reconstruction of the anterior column of the cervical spine with an acceptable safety profile. Although expandable cervical cages are clearly beneficial in certain clinical situations, widespread use following all corpectomies is not justified due to their significantly greater cost compared to structural bone grafts or non-expandable VBRs, which can be utilized to achieve similar clinical outcomes.

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Microsurgery and endovascular treatment of posterior inferior cerebellar artery aneurysms

Abstract

Aneurysms located on the posterior inferior cerebellar artery are rare, and treatment guidelines for them have not yet been established. In this paper, we present the results of a retrospective study which analyzes the management and treatment of 15 patients with posterior inferior cerebellar artery aneurysms from 2004 to 2013. The aneurysms were ruptured and presented with a subarachnoid hemorrhage. Of the 15 aneurysms, ten were of saccular, three fusiform, and two were dissecting. Computed tomography angiography or digital subtraction angiography revealed other aneurysms or intracerebral artery hypoplasia in seven patients. Either surgical or endovascular treatment was performed depending on the localization and morphology of the aneurysm. Six aneurysms were coiled, and surgery was performed in nine cases. Of the nine surgically treated patients, six (75 %) had good outcomes. Of the six patients treated using endovascular procedures, three patients (50 %) recovered. Patient outcomes were classified using the Hunt&Hess scale. Patients with Hunt&Hess 1–3 recovered without a neurological deficit. On the other hand, patients with Hunt&Hess 4–5 had a risk of up to 93 % of death or a poor outcome. In two cases of endovascular and in two cases before any therapy, aneurysmal rebleeding occurred and resulted in deterioration of clinical state of the patient and a poor prognosis with high risk of death. This study shows the necessity of acute treatment of posterior inferior cerebellar artery aneurysm, of thorough diagnostic, and of interdisciplinary cooperation.

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Surgery on motor area metastasis

Abstract

The role of surgery on central area metastasis remains unclear, and outcome data are still controversial. The aim of our study is to analyze the predictive value of clinical and surgical data on motor and functional outcome of patients, taking into account new emerging data on boundary irregularity of brain metastasis. We retrospectively analyzed 47 consecutive patients who underwent surgery assisted by neurophysiologic monitoring for a solitary metastasis in central area between 2010 and 2013. Inclusion criteria were as follows: good functional status (Karnofsky Performance Status (KPS) ≥70), controlled systemic disease, and absence of extra-cranial dissemination. At 1-month follow up, motor and functional outcomes were compared with preoperative clinical status, response to corticosteroids, extent of tumor resection, boundary irregularity, and size of tumor. Gross total resection was achieved in 93.6 % of cases. In preoperative symptomatic patients, motor outcome (according to Medical Research Council grading scale) improved in 55.5 % and worsened in 16.7 %, while functional outcome (according to KPS score) improved in 50 % and worsened in 14.2 % of cases. No worsening occurred in preoperative asymptomatic patients. Motor outcome resulted to be not correlated with preoperative deficits, tumor volume, or preoperative response to corticosteroid treatment. Remarkably, motor outcome and extent of surgical resection appeared strongly correlated with tumor boundary irregularity (p < 0.05). Surgery with neurophysiologic monitoring on motor area metastasis can improve functional and motor condition in selected patients. Tumor volume does not represent a limit in surgery. The high correlation between clinical outcome, resection rate, and tumor boundary irregularity strengthens a new belief on the infiltrative growing pattern of brain metastasis. Motor function was evaluated according to Medical Research Council grading scale (Ott et al. 2014) while functional status was assessed according to KPS score.

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