Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 31 Δεκεμβρίου 2017

Combining advantages of homogeneous organocatalysis and heterogeneous catalysis with thermosensitive single-chain nanoparticles in a representative tetrahydropyranilation of alcohols

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Misha Rumyantsev, Sergey Rumyantsev
A significant scientific problem solved in this work is the development of effective polymer catalysts that allow carrying out organic reactions under homogeneous conditions with high rates and to remove catalyst from the system as a heterophase without the use of special treatment, thus combining the advantages of both homogeneous and heterogeneous catalysis. Kinetic experiments show high catalytic activity of the synthesized catalyst in homogeneous regime even at low dosage of the catalyst. Thus, it was demonstrated that tetrahydropyranilation of methanol was completed in nearly quantitative yield of the corresponding ether in 80 min at 60 °C with a dosage of the polymeric catalyst as low as 0.2 mol%. On the other hand anomalous decrease in the values of the effective rate constant was observed when the reaction was run at temperatures below the phase transition temperature. Kinetic data were used along with thermodynamic calculations to discuss the effect of the synthesized polymeric catalyst on the stabilization of the transition state. The high activity of the catalyst is complemented by its high sedimentation ability; thus, it usually takes a few minutes for the polymer to precipitate from the alcohol solution when cooled below the phase-transition temperature after the completion of the reaction. It was also revealed via dynamic light scattering that catalytic polymers adopt a thermodynamically stable conformation of the single-chain nanoparticles with average hydrodynamic radius in the range 2–2.5 nm.

Graphical abstract

image


http://ift.tt/2CqbcRK

Selective synthesis of highly soluble cyclic olefin copolymers with pendant vinyl groups using 1,5-hexadiene as a comonomer

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Ryo Tanaka, Akane Sasaki, Takuma Takenaka, Yuushou Nakayama, Takeshi Shiono
Copolymerization of norbornene (NB) and 1,5-hexadiene (HD) was performed using a fluorenylamido-ligated titanium catalyst which conducts copolymerization of NB and 1-alkene. The obtained copolymers possessed pendant vinyl groups, of which content was varied from 0 to 9.4% by the initial feed ratio of the monomers. The copolymers were soluble in various solvents even at high conversion (>85%), showing that the crosslinking of pendant vinyl groups was negligible. The glass transition temperature of the copolymer was changed from 79 °C to over 300 °C, depending on the comonomer composition. Post-functionalization of the pendant vinyl groups with 3,3,4,4,5,5,6,6,6-nonafluoro-1-hexene via ruthenium-catalyzed metathesis reaction was also performed and fluoroalkyl-functionalized cyclic olefin copolymer was successfully obtained. The fluorinated copolymer film showed higher contact angle than the unfunctionalized copolymer.

Graphical abstract

image


http://ift.tt/2CpEMH1

Effects of pH on the photophysics of conjugated polyelectrolyte complexes

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Pamela Schleissner, Alexander L. Ayzner
We have previously reported the formation of complexes between oppositely charged, conjugated polyelectrolytes (CPECs), resulting in electronic energy transfer between the donor and acceptor components. The ionic self-assembly process that forms CPECs is heavily influenced by environmental circumstances including solvent composition, temperature, and pH. In this article, we report the effect of polyelectrolyte chain protonation on complex formation and resulting energy transfer. The particular polyelectrolytes used in this study were a pH inactive energy donor and an acceptor polymer with protonatable sidechains. We find that over a large range of acidic pH, the optical properties do not change appreciably up to precipitation (pH 3). Surprisingly in the basic regime where the acceptor polymer is fully deprotonated, complex formation is hindered. However, at pH 11, which corresponds to an excess ion concentration of 0.001 M, the photophysical properties of the complex begin to once again resemble that of the neutral or acidic environments. Our results show that the CPEC displays impressive stability over a relatively broad range of proton concentrations, which may have implications for the construction of supramolecular light-harvesting assemblies.

Graphical abstract

image


http://ift.tt/2Ctk60M

Morphometric study of the posterior longitudinal ligament at the lumbar spine.

Related Articles

Morphometric study of the posterior longitudinal ligament at the lumbar spine.

Surg Radiol Anat. 2017 Dec 29;:

Authors: Salaud C, Ploteau S, Hamel O, Armstrong O, Hamel A

Abstract
PURPOSE: There are only two descriptions of posterior longitudinal ligament (PLL) at the lumbar spine level but its morphologic characteristics are different to cervical and thoracic levels.
METHOD: Spine explantation (from Th12 to L5) followed by resection of the neural arch and the dural sheath in 13 fresh cadavers was performed. The PLL was isolated from other epidural structures and its width was measured and compared to the vertebral body width at each vertebral levels. It was conducted at a microanatomic study concerning the PLL and the posterior outer annulus fibrosus.
RESULTS: The PLL width was reduced craniocaudaly significantly, becoming thin from L4. The average width of PLL was 7.8 mm at L1 and 1.9 mm at L5. The width decreased gradually from L1 to L5 or abruptly from L4. The ratio of PLL width compared to the vertebral body width was 21% at L1 and 3% at L5. Microanatomic study confirmed that the PLL is less thick at its annulus fibrosus adhesion at L4-L5 and L5-S1. The relationship between the PLL and other epidural structures are discussed.
CONCLUSIONS: The presence and function of the ilio-lumbar ligaments and the articular process orientation of L5-S1 may be explanations for PLL width decrease at L4-L5 and L5-S1. Furthermore, this aspect may be considered as one factor contributing to the occurrence of disc herniations at these levels, which levels are more frequently involved in this pathology.

PMID: 29288395 [PubMed - as supplied by publisher]



http://ift.tt/2q5bQPN

"Int J Pediatr Otorhinolaryngol"[jour]; +46 new citations

46 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Int J Pediatr Otorhinolaryngol"[jour]

These pubmed results were generated on 2017/12/31

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.



http://ift.tt/2lrC1eF

Near infrared hyperspectral dataset of healthy and infected apple tree leaves images for the early detection of apple scab disease

S23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Maroua Nouri, Nathalie Gorretta, Pierre Vaysse, Michel Giraud, Christian Germain, Barna Keresztes, Jean-Michel Roger
This dataset presents two series of hyperspectral images of healthy and infected apple tree leaves acquired daily, from two days after inoculation until an advanced stage of infection (11 days after inoculation). The hyperspectral images were calibrated by reflection correction and registered to match the geometry of one reference image. On the last experiment day, scab positions are provided.



http://ift.tt/2CrQyRa

Fibroblast and keratinocyte gene expression following exposure to extracts of neem plant (Azadirachta indica)

S23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Takao Someya, Katsura Sano, Kotaro Hara, Yoshimasa Sagane, Toshihiro Watanabe, R.G.S. Wijesekara
This data article provides gene expression profiles, determined by using real-time PCR, of fibroblasts and keratinocytes treated with 0.01% and 0.001% extracts of neem plant (Azadirachta indica), local name "Kohomba" in Sri Lanka, harvested in Sri Lanka. For fibroblasts, the dataset includes expression profiles for genes encoding hyaluronan synthase 1 (HAS1), hyaluronan synthase 2 (HAS2), hyaluronidase-1 (HYAL1), hyaluronidase-2 (HYAL2), versican, aggrecan, CD44, collagen, type I, alpha 1 (COL1A1), collagen, type III, alpha 1 (COL3A1), collagen, type VII, alpha 1 (COL7A1), matrix metalloproteinase 1 (MMP1), acid ceramidase, basic fibroblast growth factor (bFGF), fibroblast growth factor-7 (FGF7), vascular endothelial growth factor (VEGF), interleukin-1 alpha (IL-1α), cyclooxygenase-2 (cox2), transforming growth factor beta (TGF-β), and aquaporin 3 (AQP3). For keratinocytes, the expression profiles are for genes encoding HAS1, HAS2, HYAL1, HYAL2, versican, CD44, IL-1α, cox2, TGF-β, AQP3, Laminin5, collagen, type XVII, alpha 1 (COL17A1), integrin alpha-6 (ITGA6), ceramide synthase 3 (CERS3), elongation of very long chain fatty acids protein 1 (ELOVL1), elongation of very long chain fatty acids protein 4 (ELOVL4), filaggrin (FLG), transglutaminase 1 (TGM1), and keratin 1 (KRT1). The expression profiles are provided as bar graphs.



http://ift.tt/2BZVTMm

Data on a single oral dose of camu camu (Myrciaria dubia) pericarp extract on flow-mediated vasodilation and blood pressure in young adult humans

S23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Tadayoshi Miyashita, Ryosuke Koizumi, Takao Myoda, Yoshimasa Sagane, Koichi Niwa, Toshihiro Watanabe, Kazuhiro Minami
This data article describes the flow-mediated vasodilation (FMD) responses, represented by changes in arterial diameter, and blood pressure changes in young adults after a single oral dose of camu camu (Myrciaria dubia) pericarp extract or placebo (cross-over design). Ten healthy men and 10 healthy women participated in this study. Ultrasonic diagnostic equipment was used to monitor arterial diameter changes, indicative of FMD, for 110s after the administration of the camu camu extract or placebo. In addition, the systolic and diastolic blood pressure values were recorded.



http://ift.tt/2CqydEf

Data on a delivery of biomolecules into Nicothiana benthamiana leaves using different nanoparticles

S23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Antonida V. Makhotenko, Ekaterina A. Snigir, Natalia O. Kalinina, Valentin V. Makarov, Michael E. Taliansky
Nanoparticles (NPs) have a number of unique properties associated with their ultrasmall size and exhibit many advantages compared with existing plant biotechnology platforms for delivery of proteins, RNA and DNA of various sizes into the plant cells (Arruda et al., 2015; Silva et al., 2010; Martin-Ortigosa et al., 2014; Mitter et al., 2017) [1–4]. The data presented in this article demonstrate a delivery of biomolecules into Nicotiana benthamiana plant leaves using various types of NPs including gold, iron oxide and chitosan NPs and methods of biolistic bombardment and infiltration. The data demonstrate physical characteristics of NPs coated with fluorescently labeled protein and small RNA (size and zeta-potential) and visualization of nanocomplexes delivery into cells of N. benthamiana leaves by fluorescence microscopy.



http://ift.tt/2C0bcEC

Neurodegenerative processes in temporal lobe epilepsy with hippocampal sclerosis: Clinical, pathological and neuroimaging evidence.

Related Articles

Neurodegenerative processes in temporal lobe epilepsy with hippocampal sclerosis: Clinical, pathological and neuroimaging evidence.

Neuropathol Appl Neurobiol. 2017 Dec 30;:

Authors: Tai XY, Bernhardt B, Thom M, Thompson P, Baxendale S, Koepp M, Bernasconi N

Abstract
Cognitive decline is increasingly described as a co-morbidity of temporal lobe epilepsy (TLE). Mechanisms underlying cognitive impairment are not fully understood despite examining clinical factors, such as seizure frequency, and cellular mechanisms of excitotoxicity. We review the neuropsychometry evidence for progressive cognitive decline and examine the pathology and neuroimaging evidence supporting a neurodegenerative process in hippocampal sclerosis (HS)-related TLE. Accelerated cognitive decline is described in groups of adult HS-related TLE patients. Large childhood studies show early onset of seizures result in poor development of verbal memory and a hindrance in achieving cognitive potential. We discuss HS classification according to different patterns of neuronal loss and correlation to post-temporal lobectomy cognitive outcomes in refractory TLE patients. Factors such as lateralization of HS pathology, neuronal density and sub-type have correlated to cognitive outcomes with varying significance between different studies. Furthermore, alterations in neuronal maturity, regenerative capacity and aberrant connectivity appear to affect cognitive performance post-operatively suggesting a complex multifactorial process. More recent studies have identified tau pathology being present in HS-related TLE and correlated to post-operative cognitive decline in some patients. A traumatic head injury-related or novel tauopathy has been hypothesised as an underlying process. We discuss the value of prospective and cross-sectional imaging in assessing cognition and review volumetric magnetic resonance studies with progressive ipsilateral hippocampal atrophy identified to correlate with seizure frequency. Finally, we consider the use of positron emission tomography biomarkers, such as tau tracers, and connectivity studies that may examine in vivo pathways and further explore cognitive decline in TLE. This article is protected by copyright. All rights reserved.

PMID: 29288503 [PubMed - as supplied by publisher]



http://ift.tt/2luoSRg

Risk Factors for Mortality and Morbidity in Elderly Patients Presenting with Digestive Surgical Emergencies.

Related Articles

Risk Factors for Mortality and Morbidity in Elderly Patients Presenting with Digestive Surgical Emergencies.

World J Surg. 2017 Dec 30;:

Authors: Hentati H, Salloum C, Caillet P, Lahat E, Disabato M, Levesque E, Compagnon P, Lim C, Azoulay D

Abstract
BACKGROUND: Emergency digestive surgery is being increasingly performed in elderly patients. The aim of the present study was to identify the predictors of mortality and morbidity following emergency digestive surgery in patients aged 80 years and older.
METHODS: A single-center retrospective review was performed of consecutive patients aged ≥65 years operated for a digestive surgical emergency between January 2011 and December 2013. Two groups were compared: group A (aged 65-79 years) and group B (aged ≥80 years).
RESULTS: The study population included 185 patients: 76 patients in group A and 109 in group B. The mean age was 79.9 years (65-104 years). The overall 90-day mortality rate was 23.2 and 31.9% at 1 year, which was similar between groups. The overall morbidity was 28.6%. No differences were noted between the two groups in overall, minor (Dindo I-II) or major (Dindo III-IV) morbidity rates. Multivariate analysis identified pulmonary disease (odds ratio, OR = 6.43, p = 0.02), bowel ischemia (OR = 11.41, p = 0.01), postoperative ICU stay (OR = 7.37, p < 0.0001) and the occurrence of postoperative complications (OR = 2.66, p = 0.03) as predictors of 90-day mortality. Predictors of in-hospital morbidity were preoperative hemoglobin <12 g/dL (OR = 2.49, p = 0.02) and postoperative intensive care unit (ICU) stay (OR = 6.69, p < 0.0001). An age ≥80 year was not associated with mortality or morbidity in this study.
CONCLUSIONS: The decision to perform abdominal surgery in the emergency setting should be based on physiological status, which accounts for a patient's comorbidities and health status, rather than on chronological age per se.

PMID: 29288316 [PubMed - as supplied by publisher]



http://ift.tt/2lwuZVn

Characteristics, Stratification and Time to Death in a Population-Based Cohort of Patients with Ruptured Abdominal Aortic Aneurysms Not Undergoing Surgery.

Related Articles

Characteristics, Stratification and Time to Death in a Population-Based Cohort of Patients with Ruptured Abdominal Aortic Aneurysms Not Undergoing Surgery.

World J Surg. 2017 Dec 30;:

Authors: Vetrhus M, Reite A, Vennesland JB, Søreide K

Abstract
BACKGROUND: The available literature on ruptured abdominal aortic aneurysms (rAAA) centers on survival after operation and commonly, reasons why some patients do not undergo surgery are not addressed. The aim of the present study is to examine, in a population-based cohort, the characteristics, stratification and time to death of patients admitted to hospital, but not undergoing operation for rAAA.
METHODS: A retrospective, single-center study. All patients admitted to Stavanger University Hospital from the primary catchment area with rAAA on admission or in-hospital from 2000 to 2014 were included.
RESULTS: Altogether 214 patients with rAAA were identified; 57 (27%) patients did not undergo surgery. The proportion of women was significantly higher (37 vs. 14%; p < .001) in patients not having surgery. The reasons for not undergoing operation were patient 'not fit for surgery' (30%), 'dying or agonal' at time of diagnosis (26%), 'did not want operation' (21%) and 'diagnosed at autopsy' (23%). Of the non-operated patients, 45 had rAAA on arrival to hospital, 12 had in-hospital rupture and 21 patients had previously been diagnosed with an abdominal aortic aneurysm. Non-operative treatment was uniformly fatal. The 45 patients with rAAA on arrival were scored using four scoring systems, the predicted mortality varied widely, and the median time from admission to death was 7.4 h (range 0-1337).
CONCLUSION: In about half of patients, a decision not to operate was made by the consultant vascular surgeon or the patient. In the subgroup of patients not diagnosed until autopsy or having an in-hospital rupture, an earlier diagnosis might have altered the outcome.

PMID: 29288315 [PubMed - as supplied by publisher]



http://ift.tt/2lvVUk9

Pancreaticobiliary Maljunctions in European Patients with Bile Duct Cysts.

Related Articles

Pancreaticobiliary Maljunctions in European Patients with Bile Duct Cysts.

World J Surg. 2017 Dec 30;:

Authors: Khan TT, Ahmad N

PMID: 29288314 [PubMed - as supplied by publisher]



http://ift.tt/2lvez0j

Parastomal Hernia Repair with a 3D Funnel Intraperitoneal Mesh Device and Same-Sided Stoma Relocation: Results of 56 Cases.

Related Articles

Parastomal Hernia Repair with a 3D Funnel Intraperitoneal Mesh Device and Same-Sided Stoma Relocation: Results of 56 Cases.

World J Surg. 2017 Dec 30;:

Authors: Li J, Zhang W

PMID: 29288313 [PubMed - as supplied by publisher]



http://ift.tt/2lr2SYq

Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and Costs-Time for Centralization?

Related Articles

Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and Costs-Time for Centralization?

World J Surg. 2017 Dec 30;:

Authors: Schlottmann F, Strassle PD, Patti MG

Abstract
BACKGROUND: Few studies have analyzed the relationship between surgical volume and outcomes after antireflux procedures. The aim of this study was to determine the effect of surgical volume on postoperative results and costs for patients undergoing surgery for gastroesophageal reflux disease.
METHODS: We analyzed the National Inpatient Sample (period 2000-2013). Adult patients (≥18 years old) with gastroesophageal reflux disease who underwent fundoplication were included. Hospital surgical volume was determined using the 30th and 60th percentile cut points using weighted discharges and categorized as low (<10 operations/year), intermediate (10-25 operations/year), or high (>25 operations/year). We performed multivariable logistic regression models to assess the effect of surgical volume on patient outcomes.
RESULTS: The studied cohort comprised 75,544 patients who had antireflux surgery. When operations performed at low-volume hospitals, postoperative bleeding, cardiac failure, renal failure, respiratory failure, and inpatient mortality were more common. In intermediate-volume hospitals, patients were more likely to have postoperative infection, esophageal perforation, bleeding, cardiac failure, renal failure, and respiratory failure. The length of hospital stay was longer at low- and intermediate-volume hospitals (1.08 and 0.55 days longer, respectively). There was an increase in charges of 5120 dollars per patient at low-volume centers, and 4010 dollars per patient at intermediate-volume centers.
CONCLUSIONS: When antireflux surgery is performed at high-volume hospitals, morbidity is lower, length of hospital stay is shorter, and costs for the healthcare system are decreased.

PMID: 29288311 [PubMed - as supplied by publisher]



http://ift.tt/2lrp3O9

The Effect of Intraoperative Nefopam Administration on Acute Postoperative Pain and Chronic Discomfort After Robotic or Endoscopic Assisted Thyroidectomy: A Randomized Clinical Trial.

Related Articles

The Effect of Intraoperative Nefopam Administration on Acute Postoperative Pain and Chronic Discomfort After Robotic or Endoscopic Assisted Thyroidectomy: A Randomized Clinical Trial.

World J Surg. 2017 Dec 29;:

Authors: Kim BG, Moon JY, Choi JY, Park IS, Oh AY, Jeon YT, Hwang JW, Ryu JH

Abstract
BACKGROUND: Acute postoperative pain and chronic discomfort are reported after robotic or endoscopic thyroidectomy. The purpose of this prospective, randomized, and double-blinded clinical trial was to investigate whether intraoperative infusion of nefopam decreases acute postoperative pain and chronic discomfort following either a robotic or endoscopic thyroidectomy via the bilateral axillo-breast approach (BABA).
METHODS: Patients were randomized into two groups: The control group (n = 29) or the nefopam group (n = 29). Patients in each group were infused with the same volume of saline or nefopam (0.2 mg/kg bolus, 120 μg/kg/h continuous infusion) during surgery. Acute postoperative pain, the need for rescue analgesics, and other postoperative adverse effects were assessed at 1, 6, 24, and 48 h postoperatively. Chronic pain and discomfort was recorded at 3 months after surgery.
RESULTS: Patients in the nefopam group reported lower pain scores in the neck, as well as the axilla and anterior chest areas at 1, 6, 24, and 48 h postoperatively, when compared with the control group (P < 0.05 at each time points). Rescue analgesics were required less in the nefopam group than in the control group (1.4 [1] vs. 2.3 [1.5]; P = 0.001). The degree of chronic pain and discomfort were relatively lower in the nefopam group (P < 0.05).
CONCLUSION: We report that intravenous nefopam infusion during surgery decreased acute postoperative pain and the need for rescue analgesics, as well as chronic discomfort, following BABA robotic or endoscopic thyroidectomy without adverse events.

PMID: 29288309 [PubMed - as supplied by publisher]



http://ift.tt/2lsgZMQ

Comments on 'Sentinel Lymph Node Mapping with Isosulfan Blue or Indocyanine Green in Colon Cancer Shows Comparable Results and Identifies Patients with Decreased Survival: A Prospective Single-Center Trial'.

Related Articles

Comments on 'Sentinel Lymph Node Mapping with Isosulfan Blue or Indocyanine Green in Colon Cancer Shows Comparable Results and Identifies Patients with Decreased Survival: A Prospective Single-Center Trial'.

World J Surg. 2017 Dec 29;:

Authors: Liberale G

PMID: 29288308 [PubMed - as supplied by publisher]



http://ift.tt/2lsubSe

The Value of the C-Reactive Protein-to-Albumin Ratio is Useful for Predicting Survival of Patients with Child-Pugh Class A Undergoing Liver Resection for Hepatocellular Carcinoma.

Related Articles

The Value of the C-Reactive Protein-to-Albumin Ratio is Useful for Predicting Survival of Patients with Child-Pugh Class A Undergoing Liver Resection for Hepatocellular Carcinoma.

World J Surg. 2017 Dec 29;:

Authors: Shimizu T, Ishizuka M, Suzuki T, Tanaka G, Shiraki T, Sakuraoka Y, Matsumoto T, Kato M, Aoki T, Kubota K

Abstract
BACKGROUND: Although a recent study has shown that the C-reactive protein-to-albumin ratio (CAR) can predict the survival in patients with hepatocellular carcinoma (HCC), it is unclear whether CAR can predict the survival after surgery.
OBJECTIVE: To investigate the utility of CAR for prediction of postoperative survival among HCC patients with Child-Pugh class A.
METHODS: We retrospectively reviewed 239 patients with Child-Pugh class A who were newly diagnosed with HCC and received initial liver resection. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS), and their cutoff values were identified using receiver operating characteristic curve analyses. The cutoff value of CAR was 0.028. Kaplan-Meier analysis and the log-rank test were used for the comparison of OS and disease-free survival (DFS) between two CAR groups (>0.028/≤0.028).
RESULTS: Multivariate analysis using 16 clinical characteristics selected by univariate analyses revealed that CAR (>0.028/≤0.028) (HR, 3.211; 95% CI 1.065-9.680; P = 0.038) was significantly associated with OS, as well as anatomical resection (presence/absence) (HR, 0.275; 95% CI 0.119-0.635; P = 0.275). A significant difference in OS and DFS was observed between patients with low CAR (≤0.028) and patients with high CAR (>0.028).
CONCLUSIONS: CAR is a useful predictor of postoperative survival among HCC patients with Child-Pugh class A.

PMID: 29288307 [PubMed - as supplied by publisher]



http://ift.tt/2ls3WLt

Risk Factors for Incisional Hernia in Children.

Related Articles

Risk Factors for Incisional Hernia in Children.

World J Surg. 2017 Dec 29;:

Authors: Tanaka K, Misawa T, Ashizuka S, Yoshizawa J, Akiba T, Ohki T

Abstract
BACKGROUND: Incisional hernia (IH) is a major complication of abdominal surgery. Although previous studies reported that the incidence of IH after abdominal surgery in adults was 5-50% and that various independent risk factors were involved, IH in children is still not well known. The objective of our study was to investigate the incidence and risk factors for IH in children.
METHODS: We retrospectively reviewed all children who underwent abdominal surgery at the Jikei University Hospitals (Jikei University Hospital, Kashiwa Hospital, Katsushika Medical Center and Daisan Hospital) between January 2001 and December 2016. Abdominal surgery in children was defined as open laparotomy and laparoscopic abdominal surgery in patients ≤ 15 years old. Conventional open repair for inguinal hernias, umbilical hernia repair, congenital abdominal defect repair and orchiopexy were excluded.
RESULTS: Overall, 2049 children were performed abdominal surgery. Among them, 14 children (10 males and 4 females) developed IH, and the incidence of IH was 0.68% (14/2049). There is no significant difference between laparotomy and laparoscopic surgery. The statistically significant variables and identified risk factors were operation in neonates, laparoscopic fundoplication and open supraumbilical pyloromyotomy. In all patients who had IH repair, there was no recurrence during the follow-up period 50.4 months (range 1 months-10 years) except two recurrence cases.
CONCLUSION: The incidence of IH in children is significantly lower than that in adults, and the above three risk factors were revealed. Before abdominal surgery, we recommend that pediatric surgeons should mention the risk of developing IH when the patient has the above risk factors.

PMID: 29288306 [PubMed - as supplied by publisher]



http://ift.tt/2lr4sJO

Label-free optical imaging technologies for rapid translation and use during intraoperative surgical and tumor margin assessment.

Related Articles

Label-free optical imaging technologies for rapid translation and use during intraoperative surgical and tumor margin assessment.

J Biomed Opt. 2017 Dec;23(2):1-10

Authors: Boppart SA, Brown JQ, Farah CS, Kho E, Marcu L, Saunders CM, Sterenborg HJCM

Abstract
The biannual International Conference on Biophotonics was recently held on April 30 to May 1, 2017, in Fremantle, Western Australia. This continuing conference series brought together key opinion leaders in biophotonics to present their latest results and, importantly, to participate in discussions on the future of the field and what opportunities exist when we collectively work together for using biophotonics for biological discovery and medical applications. One session in this conference, entitled "Tumor Margin Identification: Critiquing Technologies," challenged invited speakers and attendees to review and critique representative label-free optical imaging technologies and their application for intraoperative assessment and guidance in surgical oncology. We are pleased to share a summary in this outlook paper, with the intent to motivate more research inquiry and investigations, to challenge these and other optical imaging modalities to evaluate and improve performance, to spur translation and adoption, and ultimately, to improve the care and outcomes of patients.

PMID: 29288572 [PubMed - in process]



http://ift.tt/2Cm6V1U

Tumor-Associated Macrophages and the Tumor Immune Microenvironment of Primary and Recurrent Epithelial Ovarian Cancer (EOC).

Related Articles

Tumor-Associated Macrophages and the Tumor Immune Microenvironment of Primary and Recurrent Epithelial Ovarian Cancer (EOC).

Hum Pathol. 2017 Dec 26;:

Authors: Ojalvo LS, Thompson ED, Wang TL, Meeker AK, Shih IM, Fader AN, Cimino-Mathews AM, Emens LA

Abstract
Tumor infiltrating lymphocytes (TILs) are associated with better prognosis in newly diagnosed epithelial ovarian cancer (EOC), but clinical trials of immunotherapies in patients with heavily-treated disease reveal limited activity. Understanding the tumor microenvironment (TME) of primary and recurrent EOC should guide future trials. Here, we evaluated the TME of paired primary and recurrent tumors (n=17), and non-paired primary (n=20) and recurrent (n=15) tumors, for CD8+ T cells, FOXP3+ regulatory T cells (Tregs), CD68+ tumor-associated macrophages (TAMs), programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1). CD8+ T cells were similar in primary and recurrent tumors, but Tregs were higher in recurrent tumors (p=0.0210). Higher TAM density (≥5%) associated with higher Tregs (p=0.001) and CD8+ T cells (p<0.001) in recurrent tumors, but only with higher Tregs in primary tumors (p=0.02). TAM-dense recurrent tumors expressed PD-L1 on tumor and immune cells, whereas TAM-dense primary tumors expressed PD-L1 predominantly on immune cells. In survival analyses, higher Tregs in primary tumors correlated with decreased time to first recurrence (17.0 vs 28.5 months, p=0.022). Conversely, higher Tregs in recurrent tumors correlated with longer overall survival (OS) from recurrence (median not met vs 20.0 months, p=0.022). TAM density did not affect patient survival. However, patients with increased TAMs at recurrence (n=5) had longer OS from recurrence compared to patients without increased TAMs (n=12) (56.0 vs 20.0 months); with the small sample size, this did not reach statistical significance (p=0.074). Further characterization of the evolution of the TME is warranted.

PMID: 29288043 [PubMed - as supplied by publisher]



http://ift.tt/2CpEyQo

The Patient Perspective on Radiogenomics Testing for Breast Radiation Toxicity.

Related Articles

The Patient Perspective on Radiogenomics Testing for Breast Radiation Toxicity.

Clin Oncol (R Coll Radiol). 2017 Dec 26;:

Authors: Rattay T, Symonds RP, Shokuhi S, Talbot CJ, Schnur JB

Abstract
AIMS: In the field of radiogenomics, several potential predictive genetic markers have been identified that are associated with individual susceptibility to radiation toxicity. Predictive models of radiation toxicity incorporating radiogenomics and other biomarkers are being developed as part of the ongoing multicentre REQUITE trial. The purpose of this study was to explore patient attitudes towards future predictive radiogenomics testing for breast radiation toxicity.
PATIENTS AND METHODS: Twenty-one semi-structured interviews were conducted with breast cancer patients taking part in the REQUITE study at one centre. We used inductive thematic analysis to generate common themes.
RESULTS: We identified three emerging themes describing attitudes and feelings towards a predictive radiogenomics test for breast radiation toxicity: theme 1 - willingness to undergo a test (subthemes - information, trusted expert); theme 2 - implications of a test (subthemes - preparation and planning, anxiety without recourse); theme 3 - impact on treatment decision-making (subthemes - prioritising cancer cure, preserving breast integrity, patient preferences).
CONCLUSIONS: Results from the present study indicate that patients support and have confidence in the validity of a radiogenomics test for breast radiation toxicity, but they would prefer the result be provided to healthcare professionals. Except in cases of significant chronic symptoms and pain or significant end-organ damage, participants in this study rarely felt that advance knowledge of their personal risk of breast radiation toxicity would influence their treatment decision-making. These findings provide a number of insights that will allow us to anticipate how patients are likely to engage with predictive radiogenomics testing in the future.

PMID: 29287972 [PubMed - as supplied by publisher]



http://ift.tt/2lwlpSc

Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer.

Related Articles

Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer.

J Minim Invasive Gynecol. 2017 Dec 26;:

Authors: Yim GW, Eoh KJ, Chung YS, Kim SW, Kim S, Nam EJ, Lee JY, Kim YT

Abstract
STUDY OBJECTIVE: To investigate and compare surgical outcomes of 3 versus 4 robotic arm approach for robotic surgery in patients with cervical cancer.
DESIGN: Retrospective analysis of prospectively-collected data (Canadian Task Force II-2).
SETTING: Academic tertiary hospital PATIENTS: A total of 142 patients with stage 1A1-IIB cervical carcinoma that underwent robotic surgery were included for analysis. The subjects were divided according to the surgical approach (number of robotic arms) and the two groups were compared in terms of intraoperative data and postoperative outcomes.
INTERVENTIONS: Robotic radical hysterectomy (RRH) with lymphadenectomy using 3 robotic arms (n = 101) versus 4 robotic arms (n = 41).
MAIN OUTCOME MEASURES: Perioperative surgical outcomes RESULTS: Three-arm robotic approach consisted of a camera arm, 2 robotic arms, and 1 conventional assistant port. An additional robotic arm was placed on the right side of the patient's abdomen for the 4-arm robotic approach. Mean age, body mass index, cell type, FIGO (International Federation of Gynecology and Obstetrics) stage, and type of surgery were not significantly different between the two cohorts. Three-arm approach showed favorable outcomes over 4-arm approach in terms of postoperative pain at 6 and 24 hours (3.8 ± 1.8 vs 4.5 ± 1.7 and 2.8 ± 1.7 vs 3.4 ± 1.6, respectively, p = .033 and .049) and postoperative hemoglobin difference (1.8 ± 0.9 vs 2.6 ± 1.3 and 1.9 ± 1.1 vs 2.4 ± 0.9 on day 1 and 3, respectively, p = .002 and .004). The median length of postoperative hospital stay, total operative time, docking time, lymph node yield, intraoperative and postoperative complication rates were comparable between the two cohorts.
CONCLUSIONS: Surgical outcomes and complications rates of RRH for cervical cancer using the 4-arm approach were comparable to that of the 3-arm approach with decreased early postoperative pain in the 3-arm group. Cost-benefit analysis as well as the impact on surgical training is needed in the future.

PMID: 29287717 [PubMed - as supplied by publisher]



http://ift.tt/2lwfkp3

Drug-associated hyperpigmentation of the oral mucosa: report of four cases.

Related Articles

Drug-associated hyperpigmentation of the oral mucosa: report of four cases.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov 03;:

Authors: Tosios KI, Kalogirou EM, Sklavounou A

Abstract
OBJECTIVE: The aim of this study was to describe 4 patients with oral mucosa hyperpigmentation associated with 4 drug classes and to review the relevant literature.
STUDY DESIGN: Two patients under imatinib and hydroxychloroquine treatment exhibited diffuse palatal hyperpigmentation and 2 patients treated with minocycline and golimumab showed multifocal pigmented macules. In all cases, biopsy was performed.
RESULTS: Microscopically, in all cases, there was no increase in the number of melanocytes in the epithelium, and pigment granules were present in the lamina propria. The pigment granules in minocycline- and golimumab-associated hyperpigmentation were seen in the superficial lamina propria and reacted for silver but not iron, whereas in imatinib- and hydroxychloroquine-associated hyperpigmentation, pigment granules were found in the reticular lamina propria and reacted for both silver and iron. A review of the literature found 38 cases of hyperpigmentation of the oral mucosa attributed to minocycline, 23 to imatinib, 1 to hydroxychloroquine without microscopic documentation, and none to golimumab.
CONCLUSIONS: The temporal relationship between pigmentation and onset of drug effect, resolution following drug withdrawal, and exclusion of other causes support the diagnosis of drug-induced hyperpigmentation. Microscopic examination may be contributory to diagnosis, as there are differences among drugs with regard to the distribution of pigment granules and the histochemical reactions of the drugs.

PMID: 29287748 [PubMed - as supplied by publisher]



http://ift.tt/2DE99Xt

Quality of life in differentiated thyroid cancer.

Related Articles

Quality of life in differentiated thyroid cancer.

Int J Surg. 2017 Dec 26;:

Authors: McIntyre C, Jacques T, Palazzo F, Farnell K, Tolley N

Abstract
BACKGROUND: The incidence of thyroid cancer has increased significantly over the last ten years and conversely the mortality has decreased. With 85% of patients with thyroid cancer surviving for ten years or longer it is increasingly important to study the quality of life in these patients and identify which aspects of the patients' health and wellbeing could be improved.
METHODS: During the first UK patient-doctor thyroid cancer forum, patient attendees filled in an anonymized questionnaire. Patients with a diagnosis of differentiated thyroid cancer were studied, and patients less than 6 months from diagnosis were excluded. The questionnaire included demographic data, the EQ-5D-3L validated tool, information on post-operative outcomes; scar satisfaction, use of calcium supplements >6months post-operatively, vocal cord palsy, anti-depressant use and psychological counselling.
RESULTS: 82 completed questionnaires were used for the study. The median age at diagnosis was 42 years (range 13-72), and there was a female:male ratio of 6:1. EQ-5D utility health scores: The mean weighted health outcome of the average population in the UK is 0.86 (SD 0.23). Our group had a significantly lower quality of life compared to the average UK population, with a mean weighted health outcome of 0.776 (SD 0.26, p value < .0004).
CONCLUSION: This study assesses quality of life in a group of self-selected patients who attended the patient-doctor thyroid cancer forum and, although accepting there is a sampling bias, the conference provided an opportunity to assess the quality of life of patients with differentiated thyroid cancer. The study has found that the average quality of life in this group of patients is lower than that of the UK population, and lower than that of patients with breast, colorectal and prostate cancer. A large number of these patients suffer with fatigue, and depression requiring anti-depressants and/or counselling.

PMID: 29288117 [PubMed - as supplied by publisher]



http://ift.tt/2EliPXH

Open peroral endoscopic myotomy for achalasia with failed Heller myotomy.

Related Articles

Open peroral endoscopic myotomy for achalasia with failed Heller myotomy.

Dig Endosc. 2017 Dec 29;:

Authors: Liu W, Wu CC, Hu B

Abstract
In May 2017, a 55-year-old man was referred to our endoscopy center because of dysphagia and chest pain. The patient with a history of failed Heller myotomy was diagnosed as a recurrence of achalasia (type II) with an Eckardt score of 13. Selective myotomy was achieved by peroral endoscopic myotomy without a submucosal tunnel for this case. We describe this technique as open peroral endoscopic myotomy(O-POEM) (Fig 1, 2). This article is protected by copyright. All rights reserved.

PMID: 29288508 [PubMed - as supplied by publisher]



http://ift.tt/2CsHFof

Molecular imaging of tumor photoimmunotherapy: Evidence of photosensitized tumor necrosis and hemodynamic changes

Publication date: 20 February 2018
Source:Free Radical Biology and Medicine, Volume 116
Author(s): Shun Kishimoto, Nobu Oshima, Kazutoshi Yamamoto, Jeeva Munasinghe, Jan Henrik Ardenkjaer-Larsen, James B. Mitchell, Peter L. Choyke, Murali C. Krishna
Near-infrared photoimmunotherapy (NIR PIT) employs the photoabsorbing dye IR700 conjugated to antibodies specific for cell surface epidermal growth factor receptor (EGFR). NIR PIT has shown highly selective cytotoxicity in vitro and in vivo. Cell necrosis is thought to be the main mode of cytotoxicity based mainly on in vitro studies. To better understand the acute effects of NIR PIT, molecular imaging studies were performed to assess its cellular and vascular effects.In addition to in vitro studies for cytotoxicity of NIR PIT, the in vivo tumoricidal effects and hemodynamic changes induced by NIR PIT were evaluated by 13C MRI using hyperpolarized [1,4-13C2] fumarate, R2* mapping from T2*-weighted MRI, and photoacoustic imaging. In vitro studies confirmed that NIR PIT resulted in rapid cell death via membrane damage, with evidence for rapid cell expansion followed by membrane rupture. Following NIR PIT, metabolic MRI using hyperpolarized fumarate showed the production of malate in EGFR-expressing A431 tumor xenografts, providing direct evidence for photosensitized tumor necrosis induced by NIR PIT. R2* mapping studies showed temporal changes in oxygenation, with an accompanying increase of deoxyhemoglobin at the start of light exposure followed by a sustained decrease after cessation of light exposure. This result suggests a rapid decrease of blood flow in EGFR-expressing A431 tumor xenografts, which is supported by the results of the photoacoustic imaging experiments. Our findings suggest NIR PIT mediates necrosis and hemodynamic changes in tumors by photosensitized oxidation pathways and that these imaging modalities, once translated, may be useful in monitoring clinical treatment response.

Graphical abstract

image


http://ift.tt/2ElLGv4

[Neurocognition: Impact of radiotherapy].

Related Articles

[Neurocognition: Impact of radiotherapy].

Bull Cancer. 2017 Dec 26;:

Authors: Delphine A

Abstract
The cognitive evaluation is essential to arrest the impact of brain tumours on brain functions. Radiation therapy on the brain has side effects, which can impact on the cognitive functioning. The cognitive disorders constitute a predictive factor of the quality of life of the patients impacting on their autonomy, as well as on their social and professional life. This problem thus takes a more and more important place in the reflection on the cancer care. A better detection of these cognitive disorders requires a better cognitive evaluation from the diagnosis. What would allow the implementation of preventive actions upstream. This prospect of improvement of the coverage of the cognitive consequences of the irradiation should allow a better social reinstatement after the treatment, as well as a facilitation for the preservation of autonomy and functional independence. However, a complete cognitive evaluation is expensive in time and asks for a qualified personnel, which often slows down the exploration and the follow-up of the disorders.

PMID: 29287892 [PubMed - as supplied by publisher]



http://ift.tt/2zU3EkO

Adaptation and validation of Mandarin Chinese version of the pediatric Voice Handicap Index (pVHI).

Related Articles

Adaptation and validation of Mandarin Chinese version of the pediatric Voice Handicap Index (pVHI).

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:19-24

Authors: Lu D, Huang M, Li Z, Yiu EM, Cheng IK, Yang H, Ma EP

Abstract
OBJECTIVE: The aim of this study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Mandarin Chinese.
 METHODS: A cross-sectional study was performed from May 2016 to April 2017. A total of 367 parents participated in this study, and 338 parents completed the translated questionnaire without missing data, including 213 parents of children with voice disorders (patients group), and 125 parents of children without voice disorders (control group). The internal consistency, test-retest reliability, contents validity, construct validity, clinical validity, and cutoff point were calculated.
RESULTS: The most common voice disorder in the patients group was vocal fold nodules (77.9%), followed by chronic laryngitis (18.8%), and vocal fold polyps (3.3%). The prevalence for voice disorders was higher in boys (67.1%) than girls (32.9%). The most common vocal misuse and abuse habit was shouting loudly (n = 186, 87.3%), followed by speaking for a long time (n = 158, 74.2%), and crying loudly (n = 99, 46.5%). The internal consistency for the Mandarin Chinese version of pVHI was excellent in patients group (Cronbach α = 0.95). The inter-class correlation coefficient indicated strong test-retest reliability (ICC = 0.99). The principal-component analysis demonstrated three-factor eigenvalues greater than 1, and the cumulative proportion was 66.23%. The mean total scores and mean subscales scores were significantly higher in the patients group than the control group (p < 0.05). The physical domain had the highest mean score among the three subscales (functional, physical and emotional) in the patients group. The optimal cutoff point of the Mandarin Chinese version of pVHI was 9.5 points with a sensitivity of 80.3% and a specificity of 84.8%.
CONCLUSION: The Mandarin Chinese version of pVHI was a reliable and valid tool to assess the parents' perception about their children's voice disorders. It is recommended that it can be used as a screening tool for discriminating between children with and without dysphonia.

PMID: 29287865 [PubMed - in process]



http://ift.tt/2q5bmJd

Autoimmune arthritis in Ménière's disease: A systematic review of the literature.

Related Articles

Autoimmune arthritis in Ménière's disease: A systematic review of the literature.

Semin Arthritis Rheum. 2017 Nov 29;:

Authors: Caulley L, Quimby A, Karsh J, Ahrari A, Tse D, Kontorinis G

Abstract
INTRODUCTION: Successful management of patients with Ménière's disease (MD) involves understanding the pathophysiology of the disease and its comorbidities. The role of autoimmune diseases (AD) in MD remains unclear. The aim of this study was to further investigate the association between MD and AD. Specific goals were to characterize the prevalence, distribution, clinical and laboratory findings, and outcomes of autoimmune arthritis (AA) in MD.
EVIDENCE REVIEW: This systematic review was conducted according to PRISMA guidelines. Articles were identified through searches of MEDLINE, and EMBASE, as well as manual reviews of references, from 1947 to May 2017. We performed a systematic review of randomized-controlled trials (RCTs) and non-RCTs of cases of AA in MD. Due to the heterogeneity of the study methods and measures, a meta-analysis was not possible and a qualitative synthesis of the literature results was performed. The study protocol was registered with PROSPERO database (Trial Registration: CRD42017070516).
FINDINGS: A total of 237 abstracts were identified and screened by two independent reviewers. Based on inclusion and exclusion criteria, nine studies were selected and subjected to a quality assessment. This quality control measure yielded eight studies for analysis in the systematic review. The prevalence of AA was higher in MD (1.0-10.0%) as compared to the general population (0-1.1%), and noted to be higher in patients with familial MD as compared to sporadic MD (16.9% vs 4.5%, p = 0.002). There was no evidence to suggest a difference in immunologic profiles or selected treatment regimens. The most commonly reported AA in patients with MD was rheumatoid arthritis with a mean point prevalence of 4.3%. Many studies did not standardize their diagnostic criteria and did not measure clinically meaningful outcomes.
CONCLUSIONS: There is a low level of evidence because of the lack of RCTs and original prospective studies. However, in this systematic review, we have identified the latest point prevalence data on AA in MD, indicating AA to be more prevalent within the MD population. RCTs treating MD as a local AD will enhance our understanding of the disease, and potentially change the way we manage MD.

PMID: 29287768 [PubMed - as supplied by publisher]



http://ift.tt/2lrqDPP

Endoscopic transorbital route to the petrous apex: a feasibility anatomic study.

Related Articles

Endoscopic transorbital route to the petrous apex: a feasibility anatomic study.

Acta Neurochir (Wien). 2017 Dec 29;:

Authors: Di Somma A, Andaluz N, Cavallo LM, Topczewski TE, Frio F, Gerardi RM, Pineda J, Solari D, Enseñat J, Prats-Galino A, Cappabianca P

Abstract
BACKGROUND: While the subtemporal approach represents the surgical module milestone designed to reach the petrous apex, a novel ventral route, which is the superior eyelid endoscopic transorbital approach, has been proposed to access the skull base. Accordingly, we aimed to evaluate the feasibility of this route to the petrous apex, providing a qualitative and quantitative analysis of this relatively novel pathway.
METHODS: Five human cadaveric heads were dissected at the Laboratory of Surgical NeuroAnatomy of the University of Barcelona. After proper dissection planning, anterior petrosectomy via the endoscopic transorbital route was performed. Specific quantitative analysis, as well as dedicated three-dimensional reconstruction, was done.
RESULTS: Using the endoscopic transorbital approach, it was possible to reach the petrous apex with an average volume bone removal of 1.33 ± 0.21 cm3. Three main intradural spaces were exposed: cerebellopontine angle, middle tentorial incisura, and ventral brainstem. The first one was bounded by the origin of the trigeminal nerve medially and the facial and vestibulocochlear nerves laterally, the second extended from the origin of the oculomotor nerve to the entrance of the trochlear nerve into the tentorium free edge while the ventral brainstem area was hardly accessible through the straight, ventral endoscopic transorbital trajectory.
CONCLUSION: This is the first qualitative and quantitative anatomic study concerning details of the lateral aspect of the incisura and ventrolateral posterior fossa reached via the transorbital window. This manuscript is intended as a feasibility anatomic study, and further clinical contributions are mandatory to confirm the effectiveness of this approach, defining its possible role in the neurosurgical armamentarium.

PMID: 29288394 [PubMed - as supplied by publisher]



http://ift.tt/2q6Fhkx

Marinobufagin, a molecule from poisonous frogs, causes biochemical, morphological and cell cycle changes in human neoplasms and vegetal cells.

Related Articles

Marinobufagin, a molecule from poisonous frogs, causes biochemical, morphological and cell cycle changes in human neoplasms and vegetal cells.

Toxicol Lett. 2017 Dec 26;:

Authors: Pinheiro Ferreira PM, da Conceição Machado K, de Sousa LQ, Barbosa Lima DJ, Soares BM, Cavalcanti BC, Anna Maranhão SS, da Costa de Noronha J, de Jesus Rodrigues D, Gadelha Militão GC, Chaves MH, Vieira-Júnior GM, Pessoa C, de Moraes MO, de Castro E Sousa JM, de Carvalho Melo-Cavalcante AA

Abstract
Skin toad secretion present physiologically active molecules to protect them against microorganisms, predators and infections. This work detailed the antiproliferative action of marinobufagin on tumor and normal lines, investigate its mechanism on HL-60 leukemia cells and its toxic effects on Allium cepa meristematic cells. Initially, cytotoxic action was assessed by colorimetric assays. Next, HL-60 cells were analyzed by morphological and flow cytometry techniques and growing A. cepa roots were examined after 72 h exposure. Marinobufagin presented high antiproliferative action against all human tumor lines [IC50 values ranging from 0.15 (leukemia) to 7.35 (larynx) μM] and it failed against human erythrocytes and murine lines. Human normal peripheral blood mononuclear cells (PBMC) were up to 72.5-fold less sensitive [IC50: 10.88 μM] to marinobufagin than HL-60 line, but DNA strand breaks were no detected. Leukemia treaded cells exhibited cell viability reduction, DNA fragmentation, phosphatidylserine externalization, binucleation, nuclear condensation and cytoplasmic vacuoles. Marinobufagin also reduced the growth of A. cepa roots (EC50: 7.5 μM) and mitotic index, caused cell cycle arrest and chromosomal alterations (micronuclei, delays and C-metaphases) in meristematic cells. So, to find out partially targeted natural molecules on human leukemia cells, like marinobufagin, is an amazing and stimulating way to continue the battle against cancer.

PMID: 29287997 [PubMed - as supplied by publisher]



http://ift.tt/2EnTs7Q

Recurrent laryngeal nerve reinnervation for management of aspiration in a subset of children.

Related Articles

Recurrent laryngeal nerve reinnervation for management of aspiration in a subset of children.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:104-107

Authors: Zur KB, Carroll LM

Abstract
Pediatric aspiration is a multifactorial process that is often complex to manage. Recurrent laryngeal nerve (RLN) injury can cause glottic insufficiency and aspiration. We describe three cases of unilateral vocal fold paralysis resulting in aspiration and the successful use of the RLN reinnervation for its treatment. The theory for utilizing the reinnervation procedure is that when glottic closure improves and a less breathy vocalization occurs, then the larynx is better equipped to protect the lower airway and avoid aspiration. Our cases demonstrate stronger voice and improved swallow function, with normalization of modified barium swallow evaluation, at approximately 6-months post reinnervation.

PMID: 29287848 [PubMed - in process]



http://ift.tt/2q2MphA

Distribution of nerve fibers during the development of palatine glands in rats.

Related Articles

Distribution of nerve fibers during the development of palatine glands in rats.

Acta Histochem. 2017 Dec 26;:

Authors: Hakami Z

Abstract
BACKGROUND: Salivary gland maturation and function are modulated by the nervous system. Nevertheless, little is known about salivary gland innervation during development, particularly minor salivary glands. This study investigated the development of the innervation of the palatine glands of rat.
MATERIALS AND METHODS: Frozen sections of rat palatine glands at different stages were immunohistochemically labeled for detection of the general nerve markers protein gene product 9.5 (PGP 9.5) and growth associated protein 43 (GAP-43), and the autonomic nerve markers calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY).
RESULTS: PGP 9.5 and GAP-43-immunoreactive fibers (IRF) were present in the mesenchyme and in association with developing acini, ducts and blood vessels. GAP-43-IRF were more abundant and diffuse than PGP 9.5-IRF at early stages, but showed similar distribution with growth, ramifying out from thick bundles in connective tissues until encircling the secretory units observed around postnatal day 21 (PN21). CGRP-IRF were detected in the mesenchyme at embryonic day 20 (E20) and PN0. CGRP-IRF became numerous around PN7 and PN10. They then decreased to the adult level at PN21, mainly located around ducts and infrequently blood vessels. NPY-IRF were sparsely detected in the mesenchyme at E20, then detected in close proximity to acini in addition to blood vessels at PN3. NPY-IRF increased till reaching the adult stage, and were mainly associated with blood vessels and around mucous cells and some serous demilunes.
CONCLUSION: The findings indicated a developmental modification of the sensory and autonomic innervation which may play a role in the functional maturation of the palatine salivary glands.

PMID: 29287611 [PubMed - as supplied by publisher]



http://ift.tt/2EmoJIk

Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014-2016.

Related Articles

Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014-2016.

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Dec 26;:

Authors: Londero A, Bonfils P, Lefaucheur JP

Abstract
Subjective tinnitus is a symptom in many ENT pathologies, for which there is no curative treatment. It may be poorly tolerated by some patients, who develop attention or sleep disorder or even major anxiety and depression, severely impairing quality of life. Pathophysiological models of the genesis and maintenance of tinnitus symptomatology highlight maladaptive cerebral plasticity induced by peripheral hearing loss. Although not fully elucidated, these changes in neuronal activity are the target of various attempts at neuromodulation, particularly using repetitive transcranial magnetic stimulation (rTMS), which has been the focus of various clinical studies and meta-analyses. A recent consensus statement (Lefaucheur, 2014) reported level-C evidence (possible efficacy) for rTMS using low frequency (1Hz) tonic stimulation targeting the left cerebral cortex. However, many questions remain concerning the use of this technique in everyday practice. The present article reports a recent literature review using the search-terms "tinnitus" and "rTMS" in the PubMed and Cochrane databases for April 2014 to December 2016.

PMID: 29287622 [PubMed - as supplied by publisher]



http://ift.tt/2ltQaqW

Variability in Surgical Treatment of Spondylolisthesis among Spine Surgeons.

Variability in Surgical Treatment of Spondylolisthesis among Spine Surgeons.

World Neurosurg. 2017 Dec 27;:

Authors: Lubelski D, Alentado V, Williams S, O'Rourke C, Obuchowski N, Wang JC, Steinmetz M, Melillo A, Benzel E, Modic M, Quencer R, Mroz T

Abstract
BACKGROUND: There are a multitude of treatments for low grade lumbar spondylolisthesis. There are no clear guidelines for the optimal approach.
OBJECTIVE: To identify the surgical treatment patterns for spondylolisthesis, among United States spine surgeons METHODS: 445 US spine surgeons completed a survey of clinical/radiographic case scenarios on patients with lumbar spondylolisthesis with neurogenic claudication with (S+BP) or without (S-BP) associated mechanical back pain. Treatment options included decompression, laminectomy with posterolateral fusion, posterior lumbar interbody fusion, or none of the above. The primary outcome measure was the probability of two randomly chosen surgeons disagreeing on the treatment method.
RESULTS: There was 64% disagreement (36% agreement) among surgeons for treatment of spondylolisthesis with mechanical back pain (S+BP) and 71% disagreement (29% agreement) for spondylolisthesis without mechanical back pain (S-BP). For S+BP, disagreement was 52% for those practicing 5-10 years versus 70% among those practicing >20 years. Orthopedic surgeons had greater disagreement compared to neurosurgeons (76% vs 56%) for S+BP. Greater clinical equipoise was seen for S-BP compared to S+BP regardless of surgeon characteristics. For spondylolisthesis without mechanical back pain, neurosurgeons were significantly more likely to select decompression-only as compared to orthopedic surgeons who more commonly fused.
CONCLUSIONS: Clinical equipoise exists for the treatment of spondylolisthesis. Differences are greater when the patient presents without associated back pain. Surgeon case volume, practice duration, and specialty training influence operative decisions for a given pathology. Recognizing this practice variation will hopefully lead to better evidence and practice guidelines for the optimal and most cost effective treatment paradigms.

PMID: 29288862 [PubMed - as supplied by publisher]



http://ift.tt/2CwBoI3

Resolution of tachyarrhythmia following posterior fossa decompression surgery for chiari malformation type I: A case report.

Resolution of tachyarrhythmia following posterior fossa decompression surgery for chiari malformation type I: A case report.

World Neurosurg. 2017 Dec 27;:

Authors: Elia C, Brazdzionis J, Tashjian V

Abstract
INTRODUCTION: Chiari malformation type I (CM) commonly present with symptoms such as tussive headaches, paresthesias and in severe cases, corticobulbar dysfunction.3 However, patients may present with atypical symptoms lending to the complexity in this patient population. We present a case of a CM patient presenting with atypical cardiac symptoms and arrhythmias, all of which resolved after surgical decompression.
CASE DESCRIPTION: A 31-year-old female presented with atypical chest pain, palpitations, tachycardia, headaches, and dizziness for 2 years. Multiple anti-arrhythmics and ultimately cardiac ablation procedure proved to be ineffective. MRI revealed CM and patient ultimately underwent surgical decompression with subsequent resolution of her symptoms.
CONCLUSION: The surgical management of CM patients presenting with atypical symptoms can be challenging and often times leading to delay in intervention. To our knowledge this is the only reported case of a patient presenting with tachyarrhythmia and atypical chest pain with resolution after chiari decompression. We believe the dramatic improvement documented in the present case should serve to advance chiari decompression in CM patients presenting with refractory tachyarrhythmia in whom no other discernable cause has been elucidated. Further studies are needed to better correlate the findings and to hopefully establish a criteria for patients that will likely benefit from surgical decompression.

PMID: 29288861 [PubMed - as supplied by publisher]



http://ift.tt/2DBpLyI

Association between IDH1/2 mutation and preoperative seizures in patients with low-grade versus high-grade glioma: a systematic review and meta-analysis.

Association between IDH1/2 mutation and preoperative seizures in patients with low-grade versus high-grade glioma: a systematic review and meta-analysis.

World Neurosurg. 2017 Dec 27;:

Authors: Phan K, Ng W, Lu VM, McDonald KL, Fairhall J, Reddy R, Wilson P

Abstract
BACKGROUND: Seizures are a common presentation of brain tumors particularly in gliomas. Higher incidences of seizure have been reported in low-grade glioma and tumors located within the temporal and insular area. The association between IDH1/2 mutations with preoperative seizures in glioma and the magnitude of this association in low versus high-grade gliomas remains unclear. To clarify this relationship, a systematic review and meta-analysis was performed.
METHOD: Following the PRISMA guidelines and systematic review recommendations, electronic searches were performed on varies journal database and included literature up to May 2017. Data were extracted and pooled via meta-analysis.
RESULTS: 8 studies including 782 IDH1/2 mutation patients were compared with 803 IDH1/2 wild-type patients before surgery. There was a significant difference between seizure incidence in the IDH1 mutation group (61.6%) compared to the IDH1 wild-type group (32.1%) (OR 2.76; 95% CI 1.26-6.02; I2=73%, p = 0.01). Similar findings were observed during the analysis of IDH1/2 mutation (OR 2.74; 95% CI 1.74-4.33; I2=58%, p < 0.0001). The difference remained in both the IDH1 mutation group and the IDH1/2 mutation group within grade II gliomas but not in grade III and IV gliomas. Grade II glioma patients also showed a higher rate of IDH1/2 mutations and seizure compared to grade III or IV patients.
CONCLUSION: This study demonstrated a significant association between the presence of IDH1/2 mutation with the incidence of preoperative seizures. This association is only significant in patients with low-grade glioma (grade II) but not with higher grade (grade III and grade IV gliomas).

PMID: 29288860 [PubMed - as supplied by publisher]



http://ift.tt/2CufrcQ

In Reply to the Letter to the Editor Regarding "WHO grade II meningiomas: the Role of Adjuvant/Salvage Gamma Knife Surgery After Initial Surgery and Prognostic Factor Assessment".

In Reply to the Letter to the Editor Regarding "WHO grade II meningiomas: the Role of Adjuvant/Salvage Gamma Knife Surgery After Initial Surgery and Prognostic Factor Assessment".

World Neurosurg. 2017 Dec 27;:

Authors: Liu X, Shan B, Wang M, Xu J

PMID: 29288859 [PubMed - as supplied by publisher]



http://ift.tt/2DBpEDi

Risk factors associated with meningitis after neurosurgery operation: a retrospective cohort study in a Chinese hospital.

Risk factors associated with meningitis after neurosurgery operation: a retrospective cohort study in a Chinese hospital.

World Neurosurg. 2017 Dec 27;:

Authors: Chen S, Cui A, Yu K, Huang C, Zhu M, Chen M

Abstract
OBJECTIVE: Meningitis is a serious complication occurring after neurosurgical operations, which can result in severe morbidity and high mortality. This retrospective cohort study aimed to determine the risk factors of postoperative meningitis in a large clinical center of Neurosurgery in China.
METHODS: Patients who underwent neurosurgeries between January 2014 and December 2015 were selected and 1016 cases were included the final analysis. On the basis of propensity scores, 84 post-operative meningitis patients were successfully matched to the 84 patients without post-operative meningitis.
RESULTS: After propensity score matching, age, hospitalization duration, intraoperative use of corticoids, intraoperative use of antibiotics, external ventricular drainage, lumbar drainage, enteral nutrition, surgery duration, major craniotomy and transsphenoidal surgery were associated with post-operative meningitis. Also, we further confirmed preoperative use of corticoids, intraoperative use of corticoids, intraoperative use of antibiotics, external ventricular drainage, lumbar drainage, and major craniotomy were independent predictors of postoperative meningitis in propensity score-matched cohort. Then prediction model including these 6 independent predictors above was established. Finally, ROC curve and discriminant analysis validated this model has strong predictive power to evaluate post-operative meningitis.
CONCLUSION: The prediction model built in our study can be an excellent tool to predict meningitis after neurosurgical procedures.

PMID: 29288858 [PubMed - as supplied by publisher]



http://ift.tt/2CvT8mI

Differentiating Optic Meningioma from Cavernous Hemangioma Using Multiparametric MRI.

Differentiating Optic Meningioma from Cavernous Hemangioma Using Multiparametric MRI.

World Neurosurg. 2017 Dec 27;:

Authors: Lecler A, Savignac A

PMID: 29288857 [PubMed - as supplied by publisher]



http://ift.tt/2DBpyLW

Risk Factors and Management of Dural Defects in Anterior Surgery for Cervical Ossification of the Posterior Longitudinal Ligament.

Risk Factors and Management of Dural Defects in Anterior Surgery for Cervical Ossification of the Posterior Longitudinal Ligament.

World Neurosurg. 2017 Dec 27;:

Authors: Du YQ, Duan WR, Chen Z, Wu H, Jian FZ

Abstract
OBJECTIVE: To investigate risk factors and outcomes and to develop a cogent perioperative management algorithm for dural defects (DDs) in anterior surgery for cervical ossification of the posterior longitudinal ligament (OPLL).
METHODS: Ninety OPLL patients underwent anterior cervical decompression between January 2014 and December 2016 were reviewed. DDs occurred in 12 patients. Demographic, clinical and radiological data; intra- and postoperative management; and complications were analyzed. Risk factors for DDs were assessed using multivariate analysis. A treatment algorithm was identified based on these findings and our experience.
RESULTS: The prevalence of DDs is 13.3% (12/90). Univariate and multivariate analyses showed that the ratio of OPLL base to spinal canal (OR 1.09, P=0.012), kyphotic cervical alignment with thick OPLL masses (OR 9.44, P=0.026), and lateral, curved and irregular OPLL masses (OR 8.28, P=0.037) could be risk factors for DDs. DDs were repaired intraoperatively using onlay grafts, and lumbar drains were placed in all DD patients. The treatment was successful in all DD patients, and outcome measures did not differ between the DD and no DD groups. No patient developed complications associated with DDs and CSF leaks at the final follow-up.
CONCLUSIONS: Patients with broad-based OPLL, kyphotic cervical alignment with thick OPLL masses, and lateral, curved and irregular OPLL masses are associated with higher risks of DDs in anterior surgery for OPLL. Intraoperative primary repair using onlay grafts combined with early lumbar drains are simple, safe and effective strategies for DDs. The long-term sequelae of DDs are optimistic if they are managed adequately.

PMID: 29288856 [PubMed - as supplied by publisher]



http://ift.tt/2CwBkrN

Biomechanical Analysis of Porous Additive Manufactured Cages for Lateral Lumbar Interbody Fusion: a Finite Element Analysis.

Biomechanical Analysis of Porous Additive Manufactured Cages for Lateral Lumbar Interbody Fusion: a Finite Element Analysis.

World Neurosurg. 2017 Dec 27;:

Authors: Zhang Z, Li H, Fogel GR, Liao Z, Li Y, Liu W

Abstract
BACKGROUND: A porous additive manufactured (AM) cage may provide stability similar to that of traditional solid cages, and may be beneficial to bone ingrowth. The biomechanical influence of various porous cages on stability, subsidence, stresses in cage, and facet contact force has not been fully described. The purpose of this study was to verify biomechanical effects of porous AM cages.
METHODS: The surgical FE models with various cages were constructed. The partially porous titanium (PPT) cages and fully porous titanium (FPT) cages were applied. The mechanical parameters of porous materials were obtained by mechanical test. Then the porous AM cages were compared to solid titanium (TI) cage and solid PEEK cage. The four motion modes were simulated. Range of motion (ROM), cage stress, endplate stress, and facet joint force (FJF) were compared.
RESULTS: For all the surgical models, ROM decreased by more than 90%. Compared with TI and PPT cages, PEEK and FPT cages substantially reduced the maximum stresses in cage and endplate in all motion modes. Compared with PEEK cages, the stresses in cage and endplate for FPT cages decreased, whereas the ROM increased. Compared among FPT cages, the stresses in cage and endplate decreased with increasing porosity, whereas ROM increased with increasing porosity. After interbody fusion, FJF was substantially reduced in all motion modes except for flexion.
CONCLUSIONS: Fully porous cages may offer an alternative to solid PEEK cages in lateral lumbar interbody fusion. However, it may be prudent to further increase the porosity of cage.

PMID: 29288855 [PubMed - as supplied by publisher]



http://ift.tt/2DE1oRl

Lesional Temporal Lobe Epilepsy: Beware the Deceitful "Panic Attack".

Lesional Temporal Lobe Epilepsy: Beware the Deceitful "Panic Attack".

World Neurosurg. 2017 Dec 27;:

Authors: Kulason KO, Schneider JR, Rahme R, Pramanik B, Chong D, Boockvar JA

Abstract
BACKGROUND: Ganglioglioma is a rare, benign, intraaxial glioneuronal tumor, but a relatively common cause of pharmacoresistant temporal lobe epilepsy (TLE). Given its often nonspecific neuropsychiatric manifestations and frequently negative electroencephalographic workup, TLE can be easily misdiagnosed as a psychiatric disorder, particularly panic attacks.
CASE DESCRIPTION: We present a case of a 17-year old boy who was found to have lesional TLE secondary to a left temporal ganglioglioma, 5 years after having been misdiagnosed with panic disorder and undergone ineffective and unnecessary psychotherapy. He was successfully cured by surgery. Although a few similar cases of TLE masquerading as a panic disorder have been previously reported in the literature, this is the youngest and only pediatric patient described to date.
CONCLUSION: This report underscores the challenges in making an accurate clinical diagnosis of TLE and the importance of timely brain imaging whenever an atypical or medically refractory panic disorder is encountered.

PMID: 29288854 [PubMed - as supplied by publisher]



http://ift.tt/2CtY4bS

Evaluation of Patient Perspectives Toward Awake, Frame-Based Deep-Brain Stimulation Surgery.

Evaluation of Patient Perspectives Toward Awake, Frame-Based Deep-Brain Stimulation Surgery.

World Neurosurg. 2017 Dec 27;:

Authors: Ben-Haim S, Falowski S

Abstract
BACKGROUND: Deep brain stimulation (DBS) is an effective therapeutic modality, however only a percentage of eligible patients undergo the procedure.
OBJECTIVES: To study patients perspectives towards Deep-Brain Stimulation (DBS) surgery.
METHODS: A survey was sent to 95 consecutive adult patients who underwent DBS surgery for Parkinson's disease, essential tremor, or dystonia with a 73% response rate(69 patients). Post-hoc analyses were performed evaluating factors that led to favorable outcomes. The average time between surgical procedure to survey completion was 16 months.
RESULTS: Awake-surgery, use of a rigid head-frame, and having hair clipped were seldom reported as major deterrents to surgery. Patients retrospectively report an average comfort level of 8.3±1.8 during surgery. The average comfort level with head-frame placement was reported as 5.2±3.15, and those patients reporting discomfort with the frame nonetheless reported overall comfort with the procedure (8.7±1.8). An analysis of satisfaction revealed that 90% of patients would recommend the procedure to a family member or friend, and that 78 % of patients would undergo the procedure again. A post-hoc analysis of patients that were not satisfied with the procedure revealed that this subset reported significantly less overall comfort (6.9+/-1.7, p=0.0003), and were less likely to report that the goals and expectations of surgery were clearly discussed prior to surgery (p=0.0004) CONCLUSIONS: Frame placement, awake surgery, and head shaving did not appear to play a significant role in most patients' decision-making process to undergo DBS, as analyzed in this retrospective cohort. The majority of patients are satisfied with the procedure and report being comfortable. Managing goals and expectations pre-operatively plays a significant role in ultimate overall satisfaction.

PMID: 29288853 [PubMed - as supplied by publisher]



http://ift.tt/2CnoLkP

An infratentorial pure pleomorphic xanthoastrocytoma arising from middle cerebellar peduncle: a rare location of an uncommon tumor.

An infratentorial pure pleomorphic xanthoastrocytoma arising from middle cerebellar peduncle: a rare location of an uncommon tumor.

World Neurosurg. 2017 Dec 27;:

Authors: Gupta S, Mehrotra A, Pal L, Bhiashora KS, Jaiswal AK, Kumar R

Abstract
Pleomorphic xanthoastrocytomas (PXA) are rare tumors of glial origin comprising <1% of all astrocytic tumors of brain. These are rare in the infratentorial compartment and have not known to arise from middle cerebellar peduncle till date. The authors here discuss a case of a 16 year boy who presented in an altered sensorium and features of raised intracranial pressure and was found to have a 4 x 4 x 3 cms mass arising from the middle cerebellar peduncle. The authors also discuss the histopathological features of these tumors suggesting their resemblance to other mal-developmental tumors, the rarity of pure WHO grade II PXA in infratentorial compartment, as well as the appropriate management.

PMID: 29288852 [PubMed - as supplied by publisher]



http://ift.tt/2DE1dWb

Flat posterior cranial fossa affects outcomes of microvascular decompression for trigeminal neuralgia.

Flat posterior cranial fossa affects outcomes of microvascular decompression for trigeminal neuralgia.

World Neurosurg. 2017 Dec 27;:

Authors: Fukuoka T, Nishimura Y, Hara M, Nomura K, Ryu H, Yoshikawa S, Wakabayashi T

Abstract
OBJECTIVE: The aim of this study was to investigate prognostic factors for microvascular decompression (MVD) in patients with primary trigeminal neuralgia (TN), with a particular focus on the morphology of the posterior cranial fossa (PCF).
METHODS: The present study investigated 126 surgically treated primary TN patients with more than 1-year follow-up who underwent high-resolution magnetic resonance imaging between April 2003 and September 2015. We retrospectively reviewed clinical information and operative findings. Outcomes of MVD were also evaluated and patients were classified into "success" and "failure" groups. Furthermore, length, width, and height of the PCF were measured by approximation to an ellipsoid with reference to the anterior commissure-posterior commissure line. These values were compared between groups.
RESULTS: Atypical type-2 TN (P<0.001) and weak neurovascular compression (NVC) (P<0.001) correlated significantly with poor outcomes of MVD for primary TN. In terms of PCF morphology, the failure group showed a flatter PCF than the success group, while sex, age, affected side, topography of facial pain, interval between onset and surgery, responsible vessel, location of compression along the nerve, and site of compression around the circumference of the nerve root did not significantly affect outcomes of MVD for primary TN.
CONCLUSIONS: The present study identified type-2 TN, weak NVC, and flatness of the PCF as predictors of poor prognosis after MVD for primary TN.

PMID: 29288851 [PubMed - as supplied by publisher]



http://ift.tt/2CtOsOu

Angiographic "blush" after stereotactic radiosurgery ablation of a residual arteriovenous malformation in a pediatric patient: case report and review of the literature.

Angiographic "blush" after stereotactic radiosurgery ablation of a residual arteriovenous malformation in a pediatric patient: case report and review of the literature.

World Neurosurg. 2017 Dec 27;:

Authors: Szujewski CC, Heiferman DM, Rosenbaum MD, Reynolds MR, Anderson DE, Serrone JC

PMID: 29288850 [PubMed - as supplied by publisher]



http://ift.tt/2DE7Do2

Intractable Hiccups After Coil Embolization of Partially Thrombosed Posterior Inferior Cerebellar Artery Aneurysm.

Intractable Hiccups After Coil Embolization of Partially Thrombosed Posterior Inferior Cerebellar Artery Aneurysm.

World Neurosurg. 2017 Dec 27;:

Authors: Hashiguchi M, Fujita A, Ikeda M, Morikawa M, Kohmura E

PMID: 29288849 [PubMed - as supplied by publisher]



http://ift.tt/2CuBGiz

Repeated short-term recurrence of a chronic subdural hematoma associated with metastasis to hematoma capsule originating from extracranial malignant tumor.

Repeated short-term recurrence of a chronic subdural hematoma associated with metastasis to hematoma capsule originating from extracranial malignant tumor.

World Neurosurg. 2017 Dec 27;:

Authors: Ikeda H, Nakajima N, Terashima T, Kawabata Y, Miyake H, Miyamoto S

Abstract
BACKGROUND: The recurrence rate of chronic subdural hematoma (CSDH) after trepanation is relatively high, and involves various factors. We encountered an extremely rare case in which metastasis of an extracranial malignant tumor to the hematoma capsule was thought to be causing short-term repeated recurrences of CSDH.
CASE DESCRIPTION: The patient was a 74-year-old man who had undergone burr-hole evacuation of left CSDH 7 months earlier and had been receiving chemotherapy for stage IV gastric cancer for the preceding 6 months. He presented with symptoms of right hemiparesis and was diagnosed with left CSDH. Burr-hole evacuation was performed twice, but the hematoma enlarged again both times within a short period. A third burr-hole evacuation was performed after middle meningeal artery embolization, but the hematoma again enlarged shortly thereafter. Hematoma enlargement was finally suppressed by extracting the hematoma capsule under craniotomy. In histopathological examinations, hematoxylin and eosin staining showed poorly differentiated adenocarcinoma primarily along the luminal side of the hematoma capsule, and immunohistochemical staining showed results identical to findings from the existing gastric cancer. Pathological results confirmed metastasis of the gastric cancer to the hematoma capsule, and this was considered to be the cause of short-term repeated recurrence of CSDH.
CONCLUSIONS: To the best of our knowledge, this is the first report of metastasis to a hematoma capsule originating from an extracranial malignant tumor. The clinical course in the present case suggests metastasis of extracranial malignant tumor to the CSDH capsule as an extremely rare cause of recurrence.

PMID: 29288848 [PubMed - as supplied by publisher]



http://ift.tt/2DEc2XY

Decision making for the surgical treatment of vertebral metastases among patients with short predicted survival.

Decision making for the surgical treatment of vertebral metastases among patients with short predicted survival.

World Neurosurg. 2017 Dec 27;:

Authors: Bouras T, Zairi F, Arikat A, Vieillard MH, Allaoui M, Assaker R

Abstract
BACKGROUND: A wide spectrum of treatment choices is proposed for poor-prognosis patients with vertebral metastases. The continuous increase of this population and the propagation of less invasive techniques necessitate further study concerning which patients could benefit from palliative surgery.
METHODS: All patients with a Tokuhashi score ≤ 8 undergone palliative surgical treatment for vertebral metastasis within four years were retrospectively reviewed. Demographics, clinical parameters, and data concerning the disease and the operation were recorded. Patients were assessed on discharge and at two months concerning eventual benefit from surgery, based on pain measurements, motor function (Frankel grade), spinal stability assessment and complications. Statistical analysis was performed to detect possible inter-relations.
RESULTS: Eighty-eight patients were reviewed. Average age was 56.5 years. The mean Tokuhashi score was 5.9 with a mean Karnofsky score of 56.4. Thirty-six patients were immediately improved, 12 were lost on follow-up and 42 were found to have benefitted from surgery two months later. High Karnofsky score, radicular pain, morphine use, absence of complications and immediate improvement predicted benefit from surgery.
CONCLUSIONS: Decision making for a patient with poor prognosis concerning eventual surgery for a vertebral metastasis should be based mainly on the patient's clinical presentation and the primary cancer site is of less importance.

PMID: 29288847 [PubMed - as supplied by publisher]



http://ift.tt/2CuLSb3

Symptomatic brainstem cavernoma of elderly patients: timing and strategy of surgical treatment: Two case reports and review of the literature.

Symptomatic brainstem cavernoma of elderly patients: timing and strategy of surgical treatment: Two case reports and review of the literature.

World Neurosurg. 2017 Dec 27;:

Authors: Negoto T, Terachi S, Baba Y, Yamashita S, Kuramoto T, Morioka M

Abstract
BACKGROUND: Brainstem cavernoma (BSC) is rare and difficult to treat. The treatment strategy for symptomatic lesions in elderly patients remains unclear. This review discusses the optimal treatment strategy and considers the effective surgical strategy in elderly patients.
CASE DESCRIPTION: The clinical data of eight elderly patients (>70 years) with symptomatic BSC drawn from the literature and two of our own cases have been summarized in this review. The mean age of the patients was 73.3±3.13 years and the most common location was the pons. Multiple rebleeding before surgery was seen in at least four cases and clinical presentation and surgical approach varied depending on the location. Surgical removal was performed in nine cases and one case was treated with radiosurgery. The mean duration of clinical follow up was 26.1±18.2 months. Neurological improvement was found in five cases and postoperative decline in one of the surgery cases.
CONCLUSIONS: Radical resection of the cavernoma with severe symptoms might be recommended even in elderly patients, especially in those with multiple rebleeding events. From the viewpoint of surgery, we consider the subacute phase as the optimal time to remove the cavernoma in elderly hemorrhagic patients. However, multiple rebleeding events might exacerbate the neurological deficit. Therefore, the subacute phase from the first or second rebleeding might be the best timing for the surgical resection. At surgical intervention, preservation of the surrounding brain should be prioritized over complete removal of the cavernoma and hematoma.

PMID: 29288846 [PubMed - as supplied by publisher]



http://ift.tt/2DBplIE

Surgical revascularization for the treatment of complex anterior cerebral artery aneurysms: Experience and illustrative review.

Surgical revascularization for the treatment of complex anterior cerebral artery aneurysms: Experience and illustrative review.

World Neurosurg. 2017 Dec 27;:

Authors: Lee SH, Jung Y, Ryu JW, Choi SK, Kwun BD

Abstract
BACKGROUND: A variety of methods for tackling complex anterior cerebral artery (ACA) aneurysms are available; however, there is substantial variation among methods because of various aneurysm locations, the relationship of the aneurysm to arterial branches, aneurysm size and other morphological characteristics, and/or the diameters of the parent or branching arteries.
METHODS: We review complex ACA aneurysm cases based on both our own experience as well as the available literature. Each unique case is analyzed in terms of the characteristics of the aneurysm, along with an analysis and classification of the revascularization method used. Computer tablet-drawn illustrations of every unique technique are provided for easy comprehension and application in various possible situations.
RESULTS: Over the prior six years, we have treated a total of five cases of complex ACA aneurysms (one precommunicating, one communicating, one postcommunicating, and two precallosal-supracallosal segment) with revascularization. Side-to-side anastomosis was performed between A3-A3 in three cases, between A4-A4 in another case, and between the ipsilateral callosomarginal artery-pericallosal in the remaining case. Final modified Rankin scale was 0 in four of the five cases, and three in one case. Six treatment strategies were used for the precommunicating case, eight for the communicating case, seven for the postcommunicating case, and nine for the two precallosal-supracallosal segment aneurysms.
CONCLUSION: Treatment of complex ACA aneurysms should be tailored according to the location and nature of the aneurysm, as well as collateral circulation. Viable and feasible treatment strategies must be established by the neurovascular surgeon.

PMID: 29288845 [PubMed - as supplied by publisher]



http://ift.tt/2Ct173Z

Primary Extradural Melanoma Arising in Cervical Spinal Nerve Root.

Primary Extradural Melanoma Arising in Cervical Spinal Nerve Root.

World Neurosurg. 2017 Dec 27;:

Authors: Zou C, Cheng W, Zhu C, Guo Q, Wu A

Abstract
BACKGROUND: Primary cervical melanoma is rare; this is especially true of extradural melanoma arising in the nerve root. Characterizing these cases can provide a basis for improved melanoma management.
CASE DESCRIPTION: A 42-year-old female patient with numbness and pain in the right shoulder and arm persisting for 5 years was admitted. Preoperative magnetic resonance imaging revealed an epidural ladle-shaped mass shape beyond the C7-T1 intervertebral foramen that resembleda nerve sheath tumor. Histopathologic analysis following complete resection confirmed the lesion as malignant melanoma. Radiotherapy and temozolomide and cisplatin chemotherapy were administered in an accompanying hospital with regular follow-ups atour institution. After 2 months of postoperative adjuvant therapy, hepatic metastatic lesions developed. The chemotherapy regimen was changed to carboplatin, nab-paclitaxel, and recombinant human endostatin injections for a 6-month period. A follow-up 8months after chemotherapy (16 months post-surgery) indicated a good prognosis.
CONCLUSIONS: In the past 10 years only one case of primary extradural spinal melanoma incervical intervertebral foramen has been described, with no reported cases of hepatic metastasis. As radiographic results are not unequivocal, a diagnosis of spinal melanoma must be based on post-operative histological confirmation. However, to date there is no standard post-operative adjuvant therapy for these patients. The chemotherapy regimen described in this report has broader implications for melanoma treatment.

PMID: 29288844 [PubMed - as supplied by publisher]



http://ift.tt/2ElkTip

[Monitoring of hypertension in patients orally treated by angiogenesis inhibitor in daily practice].

Related Articles

[Monitoring of hypertension in patients orally treated by angiogenesis inhibitor in daily practice].

Nephrol Ther. 2017 Dec 26;:

Authors: Belaid L, Bayat-Makoei S, Laguerre B, Vigneau C

Abstract
OBJECTIVE: The aim of this study is to measure the monitoring and the incidence of renovascular effects of angiogenesis inhibitors in real population.
METHOD: Are included in this descriptive, monocentric, practical study, patients of 18 years old and more, orally treated by angiogenesis inhibitors and monitored in consultation by clinician nurses. The main interest variable is the incidence of hypertension at three months of treatment.
RESULTS: From January, 2011 to July, 2014, 324 patients have been included, whose 53% are men. Mean age is 62±13 years old. Antecedents are: 37% of hypertension, 17% of chronic renal insufficiency, 21% of nephrectomy, 13% of diabetes. Most frequent cancers are kidney (31%), liver (23%) and breast (16%). Most used molecules are: sorafenib (30%), sunitinib (23%) and everolimus (16%). Blood pressure has been measured at the beginning of the treatment in 157 patients (48%). Among them, during the first three months of treatment, 55 (35%) present hypertension according to the oncological definition and 59 (38%) according to the classical definition; 30 patients (19%) are considered as hypertensive according to only one of the two definitions. In multivariable analysis, variables significantly associated with hypertension are: age (OR=1.04; 95% CI 1.02-1.08; P<0.01) and antecedent of nephrectomy (OR=4.29; 95%CI 1.86-9.92; P<0.01).
CONCLUSION: In this cohort, only 48% of the patients had blood pressure determination before treatment. Hypertension under angiogenesis inhibitors is probably underestimated. Age and antecedent of nephrectomy seem to be correlated with the occurrence of hypertension.

PMID: 29287894 [PubMed - as supplied by publisher]



http://ift.tt/2CuANGL

Salivary gland epithelial neoplasms in pediatric population: a single-institute experience with a focus on the histologic spectrum and clinical outcome.

Salivary gland epithelial neoplasms in pediatric population: a single-institute experience with a focus on the histologic spectrum and clinical outcome.

Hum Pathol. 2017 Dec 27;:

Authors: Andreasen S, Stevens E, Bjørndal K, Homøe P

PMID: 29288694 [PubMed - as supplied by publisher]



http://ift.tt/2EiTNZj

What Factors Necessitate Removal of Retained Ballistic Fragments in the Head and Neck?

What Factors Necessitate Removal of Retained Ballistic Fragments in the Head and Neck?

J Oral Maxillofac Surg. 2017 Dec 05;:

Authors: Vorrasi J, Calvi R, Lv M, Hammond R

Abstract
PURPOSE: The purpose of this study was to estimate the frequency of retained ballistic fragment (RBF) removal and to identify factors associated with an increased risk for RBF removal. To date, there are no studies focused on identifying factors associated with removal of RBFs localized to the maxillofacial region.
MATERIALS AND METHODS: Using a retrospective cohort study design, the authors enrolled a sample composed of patients with RBFs localized to the maxillofacial region. The predictor variables included bullet size, location, involvement of bone, involvement of sinus, antibiotics, multiple antibiotics, and multiple locations. The primary outcome variable was RBF retrieval. The secondary outcome variables were timing of operative retrieval, fragment site infection, and migration of RBF. Appropriate uni- and bivariate statistics were computed and logistic regression modeling was used.
RESULTS: The sample was composed of 20 patients (mean age, 30 yr; 80% male) and 55% (11 patients) required or desired object removal overall. The number of projectiles ranged from 1 to 19 (total, 48) in the 20 patients. The logistic model identified larger size, final location of bone, final location of soft tissue, and final location of sinus as having a higher probability of removal that was statistically significant (P < .05); however, size was the only variable with a substantial odds ratio (OR; 1.96; P < .05). There was no evidence of migration and a low rate (2.3%) of infection was noted at subsequent follow-up radiography and clinical examination.
CONCLUSION: Size was the only statistically significant predictor variable with a substantial OR (1.96; 95% confidence interval, 1.31-3.40; P < .05). There was a low risk of infection even when considering oral pharyngeal contamination and low risk of migration. Further studies could focus on prudent antibiotic use and larger patient populations.

PMID: 29288648 [PubMed - as supplied by publisher]



http://ift.tt/2EplfEH

Assessing the Different Oncologic Disease Distribution and Postoperative Complications of Octogenarian and Nonagenarian Head and Neck Oncology Patients.

Assessing the Different Oncologic Disease Distribution and Postoperative Complications of Octogenarian and Nonagenarian Head and Neck Oncology Patients.

J Oral Maxillofac Surg. 2017 Dec 07;:

Authors: Sagiv D, Nadel S, Talmi YP, Yahalom R, Wolf M, Alon EE

Abstract
PURPOSE: The admission rate of patients aged 80 years or older (oldest-old) with head and neck (HN) oncologic disease is on the rise. Our goal was to study the demographic characteristics, reasons for admission, types of surgical procedures, and postoperative complications of the oldest-old patients with HN malignancy.
MATERIALS AND METHODS: We conducted a retrospective cohort study including all inpatients aged 80 years or older who were admitted to the department of otolaryngology-head and neck surgery or department of oral and maxillofacial surgery because of HN oncologic disease between 2009 and 2013. The control group was composed of a matched number of randomly selected patients aged 60 to 79 years. We compared the demographic characteristics, diagnoses, comorbidities, surgical interventions, and postoperative complications of the 2 age groups to characterize the oldest-old patients' admissions and determine whether age alone increases the risk of postoperative complications.
RESULTS: The study included 109 oldest-old patients (median age, 83 years) and 107 patients in the control group (median age, 68 years). Although the oldest-old patients had significantly more underlying diseases (4.41 vs 2.86) and drugs prescribed (4.76 vs 3.21), similar rates of postoperative complications occurred in both groups. An important finding was that ischemic heart disease and chronic lung disease were the only significant risk factors for postoperative complications among the oldest-old patients (odds ratio on multivariate analysis of 5.5 and 4.5, respectively).
CONCLUSIONS: Although comorbidities and prescribed drugs are more prevalent in the oldest-old patients, the rate of postoperative complications did not differ between the age groups, suggesting that age alone should not be a factor in the surgical treatment of HN malignancies.

PMID: 29288647 [PubMed - as supplied by publisher]



http://ift.tt/2pZLNt8

Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid.

Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid.

J Ultrasound Med. 2017 Dec 30;:

Authors: Frank SJ, Koenigsberg T, Gutman D, Koenigsberg M

Abstract
Ultrasonography (US) of the neck is an accepted, useful imaging modality for many applications beyond its usefulness in thyroid disease. Two-dimensional US has been effectively used for evaluation of many types of neck conditions, and now, 3-dimensional US can be added to the imaging armamentaria. Three-dimensional US is useful in the evaluation of cervical lymph nodes, recurrent/residual thyroid neoplasia, parathyroid glands, parotid and submandibular glands, as well as thyroglossal duct cysts and other assorted palpable and visible abnormalities because of its unique capabilities, including multiplanar reconstruction, accessibility of the coronal view, volume calculation, and regularly spaced incremental slice evaluation.

PMID: 29288583 [PubMed - as supplied by publisher]



http://ift.tt/2En1EVG

Αρχειοθήκη ιστολογίου