Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174: 01/06/19

Κυριακή 6 Ιανουαρίου 2019

Convergence in CO 2 emissions, carbon footprint and ecological footprint: evidence from OECD countries

Abstract

The aim of this paper is to augment the existing literature on convergence of CO₂ emissions, by adding carbon footprint per capita and ecological footprint per capita to the convergence debate. We use the residual augmented least squares regression to examine the stochastic convergence of the environmental indices in 27 OECD countries. Furthermore, in contrast to the previous studies which mainly used the conventional beta-convergence approach to examine conditional convergence, we use a beta-convergence method that is capable of identifying the actual number of countries that contribute to conditional convergence. The sigma-convergence of the environmental indices is also examined. The results suggest that conditional convergence exists in 12 countries for CO₂ emissions per capita, 15 countries for carbon footprint per capita and also 13 countries for ecological footprint per capita. There is evidence for sigma-convergence for all the three indicators. The policy implications of the results are discussed in the body of the paper.

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One-step synthesis of versatile magnetic nanoparticles for efficiently removing emulsified oil droplets and cationic and anionic heavy metal ions from the aqueous environment

Abstract

Versatile polyethyleneimine (PEI)-coated Fe₃O₄ magnetic nanoparticles (MNPs) have been synthesized by a one-step solvothermal method. The morphologies, structures, and properties of MNPs prepared for different reaction times have been characterized through various techniques. The synthesized MNPs were then used to separate emulsified oil and cationic and anionic heavy metal ions from the aqueous environment; moreover, the effects of the temperature, pH, and ionic strength of aqueous media, the solvothermal reaction time, and the number of reuse cycles on the removal efficiency have been investigated in detail. The results showed that pseudo-second-order kinetics and the Langmuir isotherm well described the adsorption processes of Cu(II) and Cr(VI). The Langmuir model yielded maximum adsorption capacities of 66.6 mg g⁻¹ for Cu(II) and 54.5 mg g⁻¹ for Cr(VI) at pH 5.0 and 25 °C. The synthetic MNPs could also efficiently separate diesel oil or olive oil droplets stabilized by sodium dodecyl sulfate from aqueous media. Moreover, these MNPs could be recycled five times without showing significant loss in separation efficiency. Notably, the synthesized PEI-coated MNPs could simultaneously separate emulsified oil and cationic and anionic heavy metal ions from multicomponent wastewater. Such versatile PEI-coated MNPs displayed good affinity towards emulsified oil and cationic and anionic heavy metal ions, showing great potential for practical applications in the treatment of complicated industrial wastewater matrices.

Graphical abstract

Simultaneous separation of emulsified oil and cationic and anionic heavy metal ions from aqueous media by using polyethyleneimine-coated Fe₃O₄ magnetic nanoparticles.

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Comparison of two devices to simulate vision with intraocular lenses

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Correction to: Effluent composition prediction of a two-stage anaerobic digestion process: machine learning and stoichiometry techniques

The original publication of this paper contains a mistake. Unfortunately, an author was inadvertently missed out, Constanza Arriagada had participated in the operation of the anaerobic digesters cited in the work and now as a PhD student, she is involved in the production of other publication

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Correction to: Migration and transformation of different phosphorus forms in rainfall runoff in bioretention system

The corresponding Author of this paper transferred to another institution. The correct affiliation is shown in this paper.

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Non-additive responses of soil C and N to rice straw and hairy vetch ( Vicia villosa Roth L. ) mixtures in a paddy soil

Abstract

Aims

We studied the effects of mixing rice straw and hairy vetch plant residues in a subtropical paddy soil, on subsequent carbon (C) and nitrogen (N) dynamics.

Methods

Using a theoretical framework, we designed two groups of experiments (involving equal amounts of residual C or N addition, referred to as either C or N treatments). Each experiment included mixed residues of rice straw and hairy vetch at different mixing ratios. Soils together with residues were incubated at 25 °C under waterlogged conditions for 100 days. Greenhouse gas (GHG) emissions and soil C and N fractions were measured continuously.

Results

Both C and N treatments affected soil C and N dynamics, and these dynamics were quantitatively dependent on residue C/N ratios. The effect of residue mixtures on C and N dynamics could not be predicted from single residues, since there were non-additive effects of residue mixtures. Synergistic effects were generally more frequent than antagonistic effects. Residue mixtures tended to enhance CO₂ and CH₄ emissions in both C and N treatments but decreased N₂O emissions in the N treatment. In the N treatment, dissolved organic C (DOC), dissolved organic N (DON), and microbial biomass C (MBC) concentrations increased. DOC and DON concentrations decreased in the C treatment. Residue mixtures enhanced the global warming potentials (GWP) of greenhouse gases (GHG) emitted from soil by non-additive synergistic effects. The C/N ratio of residue mixtures affected the non-additive responses of soil C and N dynamics, for example mixtures with a C/N ratio of 25 had higher CO₂ emissions and DOC concentrations than those with a C/N ratio of 35 as a consequence of non-additive effects, however, CH₄ emissions and MBC concentrations were higher in mixtures with a C/N ratio of 35 than in mixtures with a C/N ration of 25.

Conclusions

These results indicated that non-additive effects can impact soil C and N dynamics and that residue C/N ratios play an important role in influencing non-additive effects. Applying a single residue to paddy soils may be better than residue mixtures from a GWP mitigation perspective.

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Effects of nitrogen-phosphorus imbalance on plant biomass production: a global perspective

Abstract

Background and aims

Unparalleled inputs of anthropogenic nitrogen (N) and phosphorus (P) cause a strong N-P imbalance in terrestrial ecosystems. However, the effects of N-P imbalance on plant biomass production remains unclear.

Methods

Given that tissue N:P ratio may serve as an indicator of plant N or P limitations, we compiled a dataset reporting aboveground biomass (AGB) and tissue N:P ratio simultaneously from worldwide N addition experiments and explored the relationship between the responses of AGB and tissue N:P ratio to N enrichment.

Results

The N-induced changes in AGB exhibited an asymptotic relationship (i.e., Michaelis-Menten function) with changes in tissue N:P ratio, indicating a progressive P limitation with increasing N. Our results further revealed that plant N and P status was related to the changes in soil inorganic N and P concentrations. Soil N increased while soil P remained unchanged with increasing N rate, thus resulting in an unbalanced soil N and P as N continues to increase.

Conclusions

This study is the first to report the influences of human-induced N-P imbalance on plant biomass production at the global scale. The biomass-N:P ratio relationship needs to be considered for reliable predictions of the future global carbon dynamics under global change.

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Trichoderma affects the physiochemical characteristics and bacterial community composition of saline–alkaline maize rhizosphere soils in the cold-region of Heilongjiang Province

Abstract

Aims

Heilongjiang Province in China experiences extremely cold weather, and its soil is saline–alkaline. Salinity and alkalinity severely restrain the growth of maize. Although Trichoderma treatment has been extensively evaluated as a promising strategy to improve soil quality, its impact on the bacterial community and physiochemical properties of this soil type is unclear.

Methods

In the current study, different amounts of Trichoderma were used in field experiments in the Heilongjiang Province for two consecutive years. High-throughput sequencing was used to analyse the impact of Trichoderma on bacterial diversity in maize rhizosphere soils. Changes in root growth, crop yield, and soil physicochemical properties were also monitored.

Results

Treatment with Trichoderma increased the overall abundance of bacteria in soil and affected the bacterial community structure in the rhizosphere soil. It also significantly increased the relative abundance of beneficial bacterial genera, including Nitrospira and Sphingomonas. Bacteria from the genus Stenotrophomonas were identified exclusively in Trichoderma treatment groups. Pearson's correlation analysis revealed that changes in soil bacterial community composition were closely related to soil characteristics such as the pH, organic matter, and total nitrogen, and were highly correlated with Trichoderma treatment. Trichoderma treatment increased crop yield by 4.87–12.41%.

Conclusions

These findings suggest that Trichoderma treatment remarkably improves enzyme activity and nutrient content in soil; optimizes the microecological environment of the rhizosphere soil of maize; alleviates bacterial community degeneration in saline–alkaline soil from cold-region; and promotes the growth of maize plants, ultimately increasing crop yield.

Graphical abstract

Relationships among bacterial diversity composition and soil and plant properties in the rhizosphere soil under Trichoderma treatments.

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Biodentine TM versus formocresol pulpotomy technique in primary molars: a 12–month randomized controlled clinical trial

Abstract

Background

The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of Biodentine^TM pulpotomies versus formocresol pulpotomies in children vital primary molars.

Methods

A randomized, split–mouth study design was used with a sample of 37 healthy children aged 4– to 8–year–old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the Biodentine^TM pulpotomy group or the formocresol pulpotomy group. Children were followed–up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05.

Results

At 12 months, the clinical success rates of both Biodentine^TM and formocresol groups were 100%, while the radiographic success rates for Biodentine^TM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12–month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the Biodentine^TM and formocresol groups, respectively.

Conclusions

Both Biodentine^TM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference.

Trial registration

Registered on NCT03779698. Date of Registration: 18 December 2018.

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Mechanisms into the removal and translocation of cadmium by Oudemansiella radicata in soil

Abstract

This study investigated the removal and translocation mechanism of cadmium (Cd) by Oudemansiella radicata (O. radicata) in mushroom-soil rhizosphere and the fruiting body of mushroom. For this, the biomass, physiochemical parameters, and Cd distribution of O. radicata were examined in the soil spiked with 0, 10, 20, and 30 mg kg⁻¹ Cd. The soil microecology and the Cd fractionation in the soil rhizosphere were also measured. Results showed that, O. radicata possesses high capability to tolerate Cd, although its surface phenotypic structure was influenced by high concentrations of Cd. The observed concentrations of Cd in O. radicata were in the following order: root (the part of stipe in soil) > pileus > stipe. The presence of Cd led to an increase in the production of antioxidant enzymes and glutathione (GSH). These results suggested that antioxidant enzymes and GSH assisted detoxification and accumulation of Cd within the mushroom. Meanwhile, in the soil rhizosphere, the concentrations of oxalic, citric, and malic acids were enhanced with the treatment of Cd, indicating that the production of these acids was closely related to the presence of Cd in soils. Additionally, the proportion of acid-soluble Cd was increased and the soil microecology (microbial counts, urease, and acid phosphatase activities) also enhanced with the inoculation of O. radicata. Overall, this study demonstrated that O. radicata is a promising candidate for the remediation of Cd-contaminated soil.

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Author Index for Volume 71

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Substance Index for Volume 71

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Author Index for Volume 71

Author Index for Volume 71

Author Index for Volume 71, Published online: 07 January 2019; doi:10.1038/s41429-018-0116-1

Author Index for Volume 71

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Substance Index for Volume 71

Substance Index for Volume 71

Substance Index for Volume 71, Published online: 07 January 2019; doi:10.1038/s41429-018-0119-y

Substance Index for Volume 71

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Tremorgenic and neurotoxic paspaline-derived indole-diterpenes: biosynthetic diversity, threats and applications

Abstract

Indole-diterpenes (IDTs) such as the aflatrems, janthitrems, lolitrems, paspalitrems, penitrems, shearinines, sulpinines, and terpendoles are biogenetically related but structurally varied tremorgenic and neurotoxic mycotoxins produced by fungi. All these metabolites derive from the biosynthetic intermediate paspaline, a frequently occurring IDT on its own right. In this comprehensive review, we highlight the similarities and differences of the IDT biosynthetic pathways that lead to the generation of the main paspaline-derived IDT subgroups. We survey the taxonomic distribution and the regulation of IDT production in various fungi and compare the organization of the known IDT biosynthetic gene clusters. A detailed assessment of the highly diverse biological activities of these mycotoxins leads us to emphasize the significant losses that paspaline-derived IDTs cause in agriculture, and compels us to warn about the various hazards they represent towards human and livestock health. Conversely, we also describe the potential utility of these versatile molecules as lead compounds for pharmaceutical drug discovery, and examine the prospects for their industrial scale manufacture in genetically manipulated IDT producers or domesticated host microorganisms in synthetic biological production systems.

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Health-related quality of life in patients treated with eslicarbazepine acetate monotherapy: Pooled analysis from two registered clinical trials.

Health-related quality of life in patients treated with eslicarbazepine acetate monotherapy: Pooled analysis from two registered clinical trials.

Epilepsy Behav. 2019 Jan 02;92:31-35

Authors: Cramer JA, Rajagopalan K, Anastassopoulos KP, Blum D, Covance

Abstract
PURPOSE: While antiepileptic drug (AED) treatment effectiveness is traditionally assessed based on seizure frequency reduction (SFR), the overall value of AEDs in managing epilepsy and associated sequelae may be best assessed by how patients feel and function in terms of overall health-related quality of life (HRQoL). We conducted a pooled analysis of the Quality of Life in Epilepsy-31 (QOLIE-31) questionnaire from two phase 3 trials to explore the effect of response to conversion to eslicarbazepine acetate (ESL) monotherapy on HRQoL.
METHODS: Data were pooled from two multicenter, randomized, double-blind, historical control phase 3 trials examining conversion to ESL monotherapy in adults with inadequately controlled partial-onset seizures (POS). The relationship between HRQoL and ESL treatment response was examined through the analysis of week 18 QOLIE-31 scores between patients who met the SFR ≥50% threshold (responders) and patients with SFR <50% (nonresponders). The analysis was conducted in the efficacy population (intent-to-treat (ITT) patients who entered the AED taper/conversion period) and completer population (efficacy patients who completed the ESL monotherapy period) and was repeated using an SFR ≥75% threshold.
RESULTS: In the efficacy population, week 18 QOLIE-31 total score least squares mean (LSM) was significantly higher for responders with ≥50% SFR (LSM difference: 3.0; 95% confidence interval (CI): 0.2-5.8; p = 0.037) and with ≥75% SFR (LSM difference: 7.0; 95% CI: 3.6-10.3; p < 0.001) than nonresponders. In the completer population, overall quality of life (QoL) (LSM difference: 5.1; 95% CI: 1.5-8.6; p = 0.006) and social functioning (LSM difference: 5.4; 95% CI: 0.1-10.7; p = 0.046) were significantly higher for responders with ≥50% SFR than nonresponders, and all domain LSMs were higher for responders with ≥75% SFR (all p < 0.05) than nonresponders.
CONCLUSIONS: This analysis of data from the phase 3 trials demonstrated significantly higher HRQoL among ESL responders with SFR of ≥75% and also at the lower SFR threshold of ≥50% compared with nonresponders.

PMID: 30611005 [PubMed - as supplied by publisher]

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Nose-to-brain delivery of lipid-based nanosystems for epileptic seizures and anxiety crisis.

Nose-to-brain delivery of lipid-based nanosystems for epileptic seizures and anxiety crisis.

J Control Release. 2019 Jan 02;:

Authors: Costa C, Moreira JN, Amaral MH, Sousa Lobo JM, Silva AC

Abstract
Epileptic seizures and anxiety crisis are severe conditions that require fast and effective treatment, targeting the brain. Current emergency antiepiletics and anxiolytics have limited brain bioavailability, following oral, intravenous or rectal administration. This relates with the limited extent at which these drugs bypass the blood brain barrier (BBB). Thereby, the development of strategies that significantly improve the brain bioavailability of these drugs, along with a simple and safe administration by patients, attenuating and/or preventing epileptic seizures or anxiety crisis, are still a major need. In this respect, the nasal/intranasal route has been suggested as a promising strategy for drug targeting to the brain, thus avoiding the BBB. Besides, the use of lipid-based nanosystems, such as solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC), liposomes, nanoemulsions and microemulsions, have been demonstrating high efficiency for nose-to-brain transport. This review highlights the potential of using lipid-based nanosystems in the management of epilepsy and anxiety, by means of the nasal/intranasal route. So far, the reported studies have shown promising results, being required more in vivo experiments to further advance for clinical trials. Furthermore, toxicological concerns related to the need of evaluate the impairment on the mucociliary clearance mechanism have been pointed.

PMID: 30610952 [PubMed - as supplied by publisher]

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Could propranolol be beneficial in adult cerebral cavernous malformations?

Could propranolol be beneficial in adult cerebral cavernous malformations?

Neurosurg Rev. 2019 Jan 04;:

Authors: Apra C, Dumot C, Bourdillon P, Pelissou-Guyotat I

Abstract
Surgery is the only therapeutic option for cerebral cavernous malformations (CCM) and is proposed, whenever possible, after haemorrhagic events, neurological symptoms, or epilepsy, radiosurgery being a controversial alternative in some cases. However, there is no treatment for non-accessible lesions, such as brainstem CCM, multiple CCM, or those located in functional areas. Propranolol, a non-selective beta-blocker used as first-line treatment for infantile haemangiomas, has proved spectacularly effective in a few cases of adult patients with CCM. We herein review the histological, in vitro data and clinical findings that support the idea of propranolol as a potential treatment for CCM. Since one retrospective study has not been conclusive, we support the idea that prospective trials are necessary.

PMID: 30610500 [PubMed - as supplied by publisher]

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Adherence with psychotherapy and treatment outcomes with psychogenic nonepileptic seizures.

Adherence with psychotherapy and treatment outcomes with psychogenic nonepileptic seizures.

Neurology. 2019 Jan 04;:

Authors: Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G

Abstract
OBJECTIVE: We conducted a prospective cohort study of patients with psychogenic nonepileptic seizures (PNES) to examine the association between adherence with psychotherapy and outcomes, including significant (≥50%) reduction in PNES frequency, PNES freedom, improvement in quality of life, and reduction in emergency department (ED) utilization.
METHODS: A total of 105 participants were referred to receive psychotherapy either at Brigham and Women's Hospital or with a local therapist. We called participants at 12-24 months follow-up and obtained detailed follow-up data from 93 participants (89%). Participants were considered adherent with psychotherapy if they attended at least 8 sessions within a 16-week period starting at the time of referral.
RESULTS: Adherence with psychotherapy was associated with reduction in seizure frequency (84% in adherent group vs 61% in nonadherent, p = 0.021), improvement in quality of life (p = 0.044), and reduction in ED utilization (p = 0.040), with medium effect sizes; there was no difference in PNES freedom. The association between adherence and ≥50% reduction in PNES frequency persisted when controlling for potential confounders in a multivariate model. Psychotherapy nonadherence was associated with baseline characteristics of self-identified minority status (odds ratio 7.47, p = 0.019) and history of childhood abuse (odds ratio 3.30, p = 0.023).
CONCLUSIONS: Our study is limited in that it cannot establish a causal relationship between adherence with psychotherapy and outcomes, and the results may not generalize beyond the single quaternary care center study site. Among participants with documented PNES, adherence with psychotherapy was associated with reduction in PNES frequency, improvement in quality of life, and decrease in ED visits.

PMID: 30610097 [PubMed - as supplied by publisher]

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Epilepsy in Children: From Diagnosis to Treatment with Focus on Emergency.

Epilepsy in Children: From Diagnosis to Treatment with Focus on Emergency.

J Clin Med. 2019 Jan 02;8(1):

Authors: Minardi C, Minacapelli R, Valastro P, Vasile F, Pitino S, Pavone P, Astuto M, Murabito P

Abstract
Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive, or synchronous neuronal activity in the brain characterized by abrupt and involuntary skeletal muscle activity. An early diagnosis, treatment, and specific medical support must be performed to prevent Status Epilepticus (SE). Seizure onset, especially in the child population, is related to specific risk factors like positive family history, fever, infections, neurological comorbidity, premature birth, mother's alcohol abuse, and smoking in pregnancy. Early death risk in children without neurological comorbidity is similar to the general population. Diagnosis is generally based on the identification of continuous or recurrent seizures but Electroencephalogram (EEG) evaluation could be useful if SE condition is suspected. The main goal of therapy is to counteract the pathological mechanism which occurs in SE before neural cells are irreversibly damaged. According to the latest International Guidelines and Recommendations of seizure related diseases, a schematic and multi-stage pharmacological and diagnostic approach is proposed especially in the management of SE and its related causes in children. First measures should focus on early and appropriate drugs administration at adequate dosage, airway management, monitoring vital signs, Pediatric Intensive Care Unit (PICU) admission, and management of parent anxiety.

PMID: 30609770 [PubMed]

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Uptake and distribution of fluopyram and tebuconazole residues in tomato and bell pepper plant tissues

Abstract

The present study describes the uptake and distribution of fungicides, fluopyram, and tebuconazole in tomato and bell pepper plant tissues from the soil drench application of their combination product fluopyram17.7% + tebuconazole 17.7%. For extraction and cleanup of fluopyram, its metabolite fluopyram benzamide, and tebuconazole samples, the QuEChERS method was used in conjunction with LC-MS/MS. The limit of detection (LOD) and limit of quantification (LOQ) of the method determined were 1.5 μg kg⁻¹ and 0.005 mg kg⁻¹, respectively, and recoveries of all analytes from sample matrices remained within the acceptable range of 70–120%. Rapid uptake of the fungicides by tomato and bell pepper plants was observed from the first day onwards. In the tomato plant, the major part of the fungicides accumulated in the roots, whereas in bell pepper plant, it accumulated both in the roots and in the leaves. Accumulation of fluopyram and tebuconazole residues was lowest in tomato and bell pepper fruits which were much below their respective maximum residue limits (MRLs). The highest residue concentration of fluopyram and tebuconazole in tomato fruits was 0.060 and 0.009 mg kg⁻¹; the corresponding values in bell pepper fruits were 0.080 and 0.013 mg kg⁻¹. In field soil, fluopyram residues were 3.18–3.570 mg kg⁻¹ initially which dissipated at the half-life of 36 days. Tebuconazole concentration was 1.57–1.892 mg kg⁻¹ initially, and it dissipated at the half-life of 44.5–49.5 days. The major metabolite of fluopyram, fluopyram benzamide, was detected in plant tissues as well as in soil, and remained within 12% of the parent compound. The results of the study indicated that fluopyram and tebuconazole are less likely of entry into food chain through intake of tomato and bell pepper fruits if these crops are grown on soil contaminated with these fungicides.

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Assessment of Pb and Cd contaminations in the urban waterway sediments of the Nen River (Qiqihar section), Northeastern China, and transfer along the food chain

Abstract

The increasing anthropogenic inputs of Pb and Cd into China's Nen River (Qiqihar section) owing to rapid urbanization in the past 50 years may pose ecological risks to the river's aquatic system. To confirm this hypothesis, we determined the Pb and Cd concentrations in the sediments of the Nen River flowing across Qiqihar City by comparing the control group (samplings in the Nen River branch bypassing the city) and bioaccumulation along the food chain. We found significantly higher Pb concentrations in the sediments than in the control group (39.21 mg kg⁻¹ dry weight [dw] vs. 22.44 mg kg⁻¹ dw; p < 0.05). However, the difference between the Cd contents of the two groups was nonsignificant (0.33 mg kg⁻¹ dw vs. 0.30 mg kg⁻¹ dw) (p = 0.07). Accumulated Pb and Cd in the sediments pose a medium risk to the system of Nen River according to the result of risk assessment code analysis. The increased Pb and Cd levels along the food chain had adverse health effects in the species at the top level of the food chain. For example, the feathers of Corvus frugilegus and Sterna hirundo contained 0.28–2.25 mg kg⁻¹ dw of Cd. These values are considered potentially toxic to common avian species. The bone Pb level of C. frugilegus ranged from 4.82 to 7.41 mg kg⁻¹ dw within the increasing Pb range (2–15 mg kg⁻¹ dw) of common water birds. The inputs of Pb and Cd into the local environment should be reduced for the preservation of aquatic system health.

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Characteristics of pipe corrosion scales in untreated water distribution system and effect on water quality in Peshawar, Pakistan

Abstract

This study investigated the characteristics of iron corrosion scales in pipes at tube well, overhead tank, and consumers' end in older untreated water distribution system in Peshawar city, Pakistan. Effect of water quality conditions on corrosion scales and that of scales on drinking water quality in such systems was also assessed by undertaking a comparison with new piped distribution systems. The scales were analyzed for chemical composition and morphology using X-ray diffraction (XRD), inductively coupled plasma (ICP), and a scanning electron microscope (SEM), while water quality was examined for physicochemical and biological characteristics. The main crystalline phases of corrosion scales were goethite, magnetite, siderite, and quartz. From tube well to consumers' end, goethite increased from 36 up to 48%, quartz declined from 22 to 15%, while magnetite fluctuated and siderite disappeared. Elemental composition of scales showed the deposition of Zn, Al, Mn, Cr, Pb, Cu, As, and Cd with Zn (13.9 g/kg) and Al (3.6 g/kg) in highest proportion. The SEM analysis illustrated the presence of microbial communities indicating the formation of biofilms in the corrosion scales. The significant difference (P < 0.05) in levels of dissolved oxygen (DO), Cl⁻, SiO₄⁴⁻, electrical conductivity (EC), SO₄²⁻, NO₃⁻, alkalinity, hardness, and trace metals between old (DS-O) and new piped systems indicated their role in corrosion scale formation/destabilization and the effect of scale dissolution on water quality. In DS-O, EC, Cu, and Mn were significantly higher (P < 0.05), whereas turbidity, EC, DO, and SiO₄⁴⁻ significantly increased from source to consumers' end implying a higher dissolution of scales and lowered corrosion rates in DS-O to utilize SiO₄⁴⁻ and DO for iron oxidation.

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Biodegradation of malachite green by an endophytic bacterium Klebsiella aerogenes S27 involving a novel oxidoreductase

Abstract

Endophytic microorganisms can metabolize organic contaminants and assist in plant growth, thus facilitating the phytoremediation of polluted environments. An endophytic bacterium capable of decoloring malachite green (MG) was isolated from the leaves of the wetland plant Suaeda salsa and was identified as Klebsiella aerogenes S27. Complete decolorization of MG (100 mg/l) was achieved in 8 h at 30 °C and pH 7.0. Ultraviolet-visible spectroscopy and Fourier-transform infrared spectroscopy analyses indicated the degradation of MG by the isolate. The enzymic assays of the strain showed the triphenylmethane reductase (TMR) activity. A gene encoding putative TMR-like protein (named as KaTMR) was cloned and heterologously expressed in Escherichia coli. KaTMR showed only 42.6–43.3% identities in amino acids compared with well-studied TMRs, and it phylogenetically formed a new branch in the family of TMRs. The degraded metabolites by recombinant KaTMR were detected by liquid chromatography-mass spectrometry, showing differences from the products of reported TMRs. The biotransformation pathway of MG was proposed. Phytotoxicity studies revealed the less-toxic nature of the degraded metabolites compared to the dye. This study presented the first report of an endophyte on the degradation and detoxification of triphenylmethane dye via a novel oxidoreductase, thus facilitating the study of the plant-endophyte symbiosis in the bioremediation processes.

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Optimization of the Gal4/UAS transgenic tools in zebrafish

Abstract

The Gal4/UAS system provides a powerful tool to analyze the function of genes. The system has been employed extensively in zebrafish; however, cytotoxicity of Gal4 and methylation of UAS can hinder future applications of Gal4/UAS in zebrafish. In this study, we provide quantitative data on the cytotoxicity of Gal4-FF and KalTA4 in zebrafish embryos. A better balance between induction efficiency and toxicity was shown when the injection dosage was 20 pg for Gal4-FF and 30 pg for KalTA4. We tested the DNA methylation of UAS in different copies (3×, 5×, 7×, 9×, 11×, and 14×), and the results showed, for the first time, that the degree of UAS methylation increases with the increase in the copy number of UAS. We detected insertions of the Tol2-mediated transgene in the Gal4 line and found as many as three sites of insertion, on average; only about 20% of individuals contained single-site insertion in F1 generation. We suggested that the screening of Gal4 lines with single-site insertion is essential when Tol2-mediated Gal4 transgenic lines are created. Moreover, we designed a novel 5 × non-repetitive UAS (5 × nrUAS) to reduce the appeal of multicopy UAS as a target for methylation. Excitingly, the 5 × nrUAS is less prone to methylation compared to 5 × UAS. We hope the results will facilitate the future application of the Gal4/UAS system in zebrafish research.

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Cerebral hyperperfusion syndrome after a burr hole drainage surgery for chronic subdural hematoma.

Cerebral hyperperfusion syndrome after a burr hole drainage surgery for chronic subdural hematoma.

World Neurosurg. 2019 Jan 02;:

Authors: Omura T, Fukushima Y, Yoshikawa G, Matsuhashi A, Sato D, Endo T, Sato K, Inoue M, Saito A, Tsutsumi K

Abstract
BACKGROUND: Although chronic subdural hematoma (CSDH) has a good prognosis after classical minimally invasive drainage surgery, severe complications still occur at a substantial rate. In particular, cerebral hyperperfusion syndrome (CHS), which is a common severe complication after carotid endarterectomy or carotid artery stenting for cervical carotid artery stenosis, is rare after drainage surgery for a CSDH.
CASE DESCRIPTION: We describe the case of an 82-year-old woman who presented with ipsilesional symptoms including contralateral hemiparesis and dysarthria, progressively worsening consciousness, and status epilepticus after a burr hole drainage surgery for CSDH. Magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) imaging showed diffuse subcortical low intensity in the ipsilesional hemisphere almost simultaneously with the appearance of the symptoms. Arterial spin labeling (ASL) MR perfusion imaging showed the abnormal increase of cerebral blood flow in the hemisphere. Continuous propofol administration and blood pressure management improved the symptoms.
CONCLUSIONS: CHS can cause severe postoperative complications after drainage surgery for CSDH. Subcortical low-intensity FLAIR imaging is a useful investigation for early detection of CHS in CSDH, and ASL imaging is an effective minimally invasive modality for confirming the diagnosis.

PMID: 30610989 [PubMed - as supplied by publisher]

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Rare hereditary Klippel-Feil syndrome and Arnold-chiani Malformation caused by cervical spondylotic myelopathy.

Rare hereditary Klippel-Feil syndrome and Arnold-chiani Malformation caused by cervical spondylotic myelopathy.

World Neurosurg. 2019 Jan 02;:

Authors: Xinyu G, Na Z, Dingjun H

Abstract
We report a rare case of familial genetic disorder Klippel-Feil syndrome and Arnold-chiani Malformation caused by cervical spondylotic myelopathy. Complete reconstruction of stability and spinal cord decompression were achieved by anterior cervical discectomy, fusion and internal fixation. Although the disease of inheritance characteristics were still researched, it is necessary to operation when it presents abnormal neurological symptoms , and the effect of surgical is worthy to be affirmed.

PMID: 30610988 [PubMed - as supplied by publisher]

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Back pain and outcomes of pregnancy after instrumented spinal fusion for adolescent idiopathic scoliosis.

Back pain and outcomes of pregnancy after instrumented spinal fusion for adolescent idiopathic scoliosis.

World Neurosurg. 2019 Jan 02;:

Authors: Grabala P, Helenius I, Buchowski JM, Larson AN, Shah SA

Abstract
PURPOSE: We hypothesized that women undergoing scoliosis surgery who became pregnant would go to full-term, have uncomplicated pregnancies, and similar patient-reported outcome measures than non-pregnant patients and healthy controls.
METHODS: 205 females with AIS undergoing scoliosis surgery during 1998-2015 at several institutions in one country and 173 healthy women, without AIS, parous and nulliparous selected at random.
RESULTS: 108 women with AIS and no pregnancy (SNP), 97 with AIS and pregnancy (SP), 91 healthy controls and no pregnancy (HNP), and 82 healthy controls with pregnancy (HP) were reviewed. Mean follow-up was 5.0 years in the SNP, 6.0 years in the SP, 5.0 years in the HNP, and 5.0 years in the HP. The average time from surgery to childbirth was 5 years. Back pain (BP) during pregnancy was observed in 48% of the SP and 34% of the HP. BP after childbirth was present in 43% of the SP and 42% of the HP. Patients fused to L3 or L4 experienced more frequent low BP during pregnancy (40%) than those fused above L3, p<0.05). Cesarean section (CS) was performed for 64% and 33% in SP and HP, (p<0.05). As the lowest instrumented vertebra moved caudal to L4, the frequency of CS increased (p<0.05, R=0.8). The majority of CS in the SP were performed in patients fused to L4 (55%) vs. patients fused above and to L3 (45%), (p<0.05). The most common analgesia for CS was spinal (75% and 86% in SP and HP). Patients fused to L4 required general anesthesia significantly more often (7%) vs. those fused above L4 (4%, p<0.05). The health-related quality of life after spinal fusion showed general satisfaction and were similar for SNP and SP (mean 3.84 and 3.91, respectively). No sexual dysfunction was reported.
CONCLUSIONS: Women with a history of spinal fusion for AIS fused to L3 or L4 reported a higher incidence of low BP, and CS are more frequently required. This risk increased to 55% when spinal fusion to L4 was performed. The quality of life and sexual function were at same level in women after scoliosis surgery than in healthy controls.

PMID: 30610987 [PubMed - as supplied by publisher]

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Prognostic Value of Neutrophil-to-Lymphocyte Ratio in predicting the 6-Month Outcome of Traumatic Brain Injury Patients: A Retrospective Study.

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in predicting the 6-Month Outcome of Traumatic Brain Injury Patients: A Retrospective Study.

World Neurosurg. 2019 Jan 02;:

Authors: Zhao JL, Du ZY, Yuan Q, Yu J, Sun YR, Wu X, Li ZQ, Wu XH, Hu J

Abstract
BACKGROUND: Peripheral white blood cells (WBC) are regularly analyzed upon admission for traumatic brain injury (TBI) patients. The prognostic value of Neutrophil-to-Lymphocyte Ratio (NLR) in predicting the 6-month outcome of TBI patients is unclear.
METHODS: We designed a single-center retrospective cohort study. Patients admitted to Fudan University Huashan Hospital within 6 hours after TBI were identified between Dec.2004 and Dec.2017. The primary outcome was 6-month GOS score. Independent predictors of 6-month outcome were assessed using uni- and multivariate analyses. Three models based on admission characteristics were built to evaluate the prognostic value of NLR to the outcome of TBI patients. The discriminative ability of predictive models was evaluated by the area under the curve (AUC).
RESULTS: A total of 1291 TBI patients were included. Multivariate analysis showed age, GCS scores at admission, SDH, IPH tSAH, NLR (p<0.001) and coagulopathy (p=0.028) were independent predictors of the 6-month outcome. The model combining NLR and standard variables (AUC=0.936; 95% CI, 0.923-0.949) was more favorable in predicting the 6-month outcome of TBI patients than the model without NLR (AUC=0.901; 95% CI, 0.883-0.919) and the model based only on NLR (AUC=0.827; 95% CI, 0.802-0.852).
CONCLUSIONS: NLR is an independent prognostic factor of the 6-month outcome in TBI patients. A high NLR in TBI patients is associated with poor outcome. The prognostic value of NLR to the 6-month outcome of TBI patients is favorable.

PMID: 30610986 [PubMed - as supplied by publisher]

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Intractable Rathke's cleft cyst hidden behind co-existing giant pituitary adenoma - Case report.

Intractable Rathke's cleft cyst hidden behind co-existing giant pituitary adenoma - Case report.

World Neurosurg. 2019 Jan 02;:

Authors: Nishimura F, Park YS, Motoyama Y, Nakagawa I, Yamada S, Tamura K, Matsuda R, Takeshima Y, Takamura Y, Nakase H

Abstract
BACKGROUND: Although pituitary adenoma (PA) and Rathke's cleft cyst (RCC) share a common embryological origin, concurrent appearances have rarely been reported. We present a case of intractable RCC hidden behind a co-existing giant PA.
CASE DESCRIPTION: A 39-year-old female visited an ophthalmologist with visual disturbance. Brain MRI findings showed a giant mass in the intra- and supra-sellar portion, with a cystic portion contained in the posterior part. Endoscopic endonasal surgery was performed to remove the tumor and histopathology findings revealed a non-functioning pituitary adenoma. Furthermore, another brain MRI procedure showed the appearance of a residual cyst. A second endonasal endoscopic surgery was performed to decompress the growing cyst for the optic chiasma, with cyst drainage and irrigation performed, and portions of the cyst walls obtained. The histopathological diagnosis was RCC with inflammation. Over the course of 1 year, 3 separate recurrences of the growing cyst were noted, with cyst drainage and irrigation performed each time. Finally, ethanol cauterization was used, which stopped the symptomatic RCC recurrence. Eight years after the final procedure, there was no cyst recurrence, and the patient showed a good condition with improved visual acuity and normal pituitary function.
CONCLUSIONS: The presence of a non-enhanced cyst with a PA shown by MRI suggests the possibility of coexisting RCC and PA.

PMID: 30610983 [PubMed - as supplied by publisher]

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Early Post-Operative Morbidity after Chronic Subdural Haematoma: Predictive Utility of POSSUM, ACS-NSQIP and ASA in a Prospective Cohort.

Early Post-Operative Morbidity after Chronic Subdural Haematoma: Predictive Utility of POSSUM, ACS-NSQIP and ASA in a Prospective Cohort.

World Neurosurg. 2019 Jan 02;:

Authors: Thomas PA, Mitchell PS, Marshman LA

Abstract
BACKGROUND: Although generally 'benign', long-term survival (LTS) after chronic subdural haematoma (CSDH) is poor in a significant sub-group. Such dichotomy has been compared to fractured-neck-of-femur. However, whilst early post-operative mortality (POMT) is well recorded with CSDH and similar to fractured neck-of-femur (4-8%), scant accurate data exists regarding early post-operative morbidity (POMB). POMB which prolongs length-of-stay (LOS) after major non-neurosurgery is associated with decreased LTS. One recent CSDH study suggested a POMB 'standard' of 10%: i.e. notably less than with fractured-neck-of-femur (45%).
METHODS: POMB was recorded in a novel prospective single-centre cohort after CSDH. The Physiological-and-Operative-Severity-Score-(POSSUM), American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program-(ACS-NSQIP)-score and ASA were assessed as tools for potentially predicting POMB. Receiver-operator -curves-(ROC) were calculated.
RESULTS: POMT was n=3/114 (3%). N=71 POMB events occurred in n=54/114 (47%), with n=27/54 (50%) Clavien-Dindo≥2 severity. Most POMB was 'neurological' (n=47/71, 66%). Age (P=0.01), GCS (P=0.001), Markwalder grade (MG) (P=0.01), hypertension (P=0.047) and/or ≥1 pre-existent co-morbidity (P=0.041) were predictive. LOS (P=0.01) and discharge-mRS (P<0.001) were significantly associated. Predicted and observed POMB with POSSUM were significantly disparate (χ2=15.23, P=0.001): POSSUM area-under-ROC (AUROC:0.611) was also 'non-discriminatory'. ACS-NSQIP (χ2=18.51, P<0.001;AUROC=0.629) and ASA (P=0.25) were also non-predictive.
CONCLUSIONS: POMB was frequently disabling, mostly 'neurological', and as frequent and diverse as with fractured-neck-of-femur. POMB was significantly correlated with LOS and discharge-mRS. Surprisingly, POSSUM, ACS-NSQIP and ASA were not predictive, and would not aid consent. Simple parameters (age, GCS, MG, hypertension and/or ≥1 other co-morbidity) were instead predictive. Longitudinal-follow-up will determine whether POMB affects LTS. CSDH, like fractured-neck-of-femur, is distinct.

PMID: 30610985 [PubMed - as supplied by publisher]

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Spontaneous resorption of Herniated Lumbar Disc "observational retrospective study in 9 patients".

Spontaneous resorption of Herniated Lumbar Disc "observational retrospective study in 9 patients".

World Neurosurg. 2019 Jan 02;:

Authors: El-Kholy AR, Farid AM, Shamhoot IA

Abstract
BACKGROUND: Spontaneous resorption of herniated lumbar disc was explained in the literature by different mechanisms and multiple predictive factors for resorption were reported in numerous studies.
PURPOSE: Evaluation of the phenomena of spontaneous resorption of herniated lumbar disc without surgery (mechanisms, predictive factors, expected time for resorption and proper time for conservative treatment).
STUDY DESIGN: A retrospective clinical case series.
PATIENTS AND METHODS: This study included 9 patients with herniated lumbar disc in the initial MRI. The mean age was 39±6.3 years and male to female ratio was 2:1. All patients presented by pack pain and sciatica without any motor deficit. All patients refused surgical intervention, therefore, they were treated conservatively. Patients were followed up clinically and radiologically (MRI) in the outpatient clinic in regular visits (for 18 months).
RESULTS: Spontaneous resorption of herniated disc was found in all patients in a mean time of 8.7±3.2 months. All patients recovered clinically in a mean time of 5.7±1.6 weeks by conservative treatment. Large and/or sequestrated disc were associated with rapid resorption. Early recovered patients showed early spontaneous resorption of the disc.
CONCLUSION: Spontaneous resorption of herniated lumbar disc can occur by different mechanisms (retraction, dehydration and inflammatory mediated mechanism). Large and/or sequestrated disc are essential predictive factors for rapid spontaneous resorption. Furthermore, early clinical recovery is usually associated with quick resorption of the herniated disc.

PMID: 30610984 [PubMed - as supplied by publisher]

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The Role and Real Impact of an Iterative Surgical Approach for the Management of Recurrent High Grade Glioma: an Observational Analytic Cohort study.

The Role and Real Impact of an Iterative Surgical Approach for the Management of Recurrent High Grade Glioma: an Observational Analytic Cohort study.

World Neurosurg. 2019 Jan 02;:

Authors: Salvati M, Pesce A, Palmieri M, Brunetto F, Santoro A, Frati A

Abstract
BACKGROUND: The benefits of multiple interventions on recurrences of High Grade Gliomas are renowned, the real impact of re-operation on survival parameters appears to be not overall assessed yet. The aim of this study is to show that proposing re-operation to selected patients is safe and feasible.
MATERIALS AND METHODS: 78 patients affected by High Grade Gliomas have been operated between 2004 and 2014. All patient respected the following inclusion criteria: ASA score=1-3, KPS>60 and re-intervention after at least 4 months after the first surgical procedure. The following parameters have been evaluated: Overall Survival after diagnosis and after re-intervention, Progression Free Survival after re-intervention, number of surgical procedures, Overall Survival in patients operated on more than 2 times. The results have been compared to 78 cases of High Grade Gliomas treated with adjuvant chemotherapeutic protocols.
RESULTS: Overall survival at 1 year resulted of 100%, at 2 years we registered 39.4% in case of Glioblastoma and 58.3% for Anaplastyc Astrocitoma. Progression free survival after 6 months resulted of 53.03% in case of Glioblastoma and 75.0% for Anaplastic Astrocytoma. 55 patients have been re-operated on, 15 underwent a third intervention and 8 received four surgical procedure. Major complications were registered in only 2 cases. The statistical analysis ruled out significant differences between in terms of complication and worsening of the neurological status.
CONCLUSIONS: The data show excellent outcomes in terms of survival and clinical conditions after multiple surgical procedures. Therefore, re-intervention appears to be a feasible and safe solution in selected patients.

PMID: 30610982 [PubMed - as supplied by publisher]

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Prediction of Recurrence in Parasagittal and Parafalcine Meningiomas: Added Values of Diffusion-Weighted MR Imaging.

Prediction of Recurrence in Parasagittal and Parafalcine Meningiomas: Added Values of Diffusion-Weighted MR Imaging.

World Neurosurg. 2019 Jan 02;:

Authors: Ko CC, Chen TY, Lim SW, Kuo YT, Wu TC, Chen JH

PMID: 30610981 [PubMed - as supplied by publisher]

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Pipeline Embolization of Vertebrobasilar Aneurysms - a Multicenter Case Series.

Pipeline Embolization of Vertebrobasilar Aneurysms - a Multicenter Case Series.

World Neurosurg. 2019 Jan 02;:

Authors: Wallace AN, Madaelil TP, Kamran M, Miller TR, Delgado Almandoz JE, Grossberg JA, Kansagra AP, Gandhi D, Kayan Y, Cawley CM, Moran CJ, Jindal G, CreveCoeur T, Howard BM, Cross DT, Kole MJ, Roy AK, Dion JE, Osbun JW

Abstract
BACKGROUND: and purpose: The Pipeline Embolization Device (PED) is being increasingly utilized for treatment of posterior circulation aneurysms. The purpose of this study was to examine the clinical and angiographic outcomes of patients with vertebrobasilar aneurysms treated with the PED.
METHODS: Retrospective review of vertebrobasilar aneurysms treated with the PED at four high-volume neurovascular centers was performed. Patient, aneurysm, and procedural data were collected, including perioperative and delayed complications. Aneurysm occlusion on follow-up imaging was defined as complete (Raymond 1), near-complete (Raymond 2), or incomplete (Raymond 3).
RESULTS: The cohort included 35 patients with 37 vertebrobasilar aneurysms who underwent 36 treatments. The patients were 31% (11/35) men, mean age 54.1 years (range, 32-75 years). Eight patients (23%) were treated urgently for ruptured aneurysms (n=6), brainstem perforator stroke (n=1), or post-traumatic pseudoaneurysm (n=1). Aneurysms arose from the vertebral (59%, 22/37) or basilar artery (41%, 15/37). There were 19 saccular aneurysms (51%, 19/37), mean size 7.7 mm (range, 1.7-38.0 mm); 17 fusiform aneurysms (46%, 17/37), mean size of 11.0 mm (range, 4.3-34 mm); and one 2.9-mm blister aneurysm. The overall procedural complication rate was 14% (5/36), including three neurologically-symptomatic complications. At mean follow up of 14 months (range, 3-59 months), 71% (24/34) of aneurysms were completely occluded and 85% (29/34) were completely or near-completely occluded.
CONCLUSION: Pipeline embolization of vertebrobasilar aneurysms is associated with acceptable occlusion and complication rates.

PMID: 30610980 [PubMed - as supplied by publisher]

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Effect of vertebroplasty at the upper instrumented vertebra (UIV) and UIV +1 for prevention of proximal junctional failure in adult spinal deformity surgery: A comparative matched cohort study.

Effect of vertebroplasty at the upper instrumented vertebra (UIV) and UIV +1 for prevention of proximal junctional failure in adult spinal deformity surgery: A comparative matched cohort study.

World Neurosurg. 2019 Jan 02;:

Authors: Han S, Hyun SJ, Kim KJ, Jahng TA, Jeon SI, Wui SH, Lee JY, Lee S, Rhim SC, Chung S, Jang J, Lee BH

Abstract
BACKGROUND: This study aimed to compare radiographic outcomes of adult spinal deformity (ASD) surgery with or without two-level prophylactic vertebroplasty (PVP) at the uppermost instrumented vertebra (UIV) and the vertebra one level proximal to the UIV (UIV+1).
METHODS: This retrospective 1:2 matched-cohort comparative study enrolled two groups of patients undergoing ASD surgery, including 28 patients with PVP (PVP group) and 56 patients without PVP (non-PVP group), in three institutes between 2012 and 2015. The primary outcome measure was the incidence of proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and proximal junctional fracture (PJFX). The secondary outcome measure were radiologic outcomes between PVP segments and non-PVP segments.
RESULTS: Between the PVP group and non-PVP group, no significant differences were found in the incidence of PJK (13[46.4%] vs 26[46.4%], P=1.000), PJF (11[39.3%] vs 18[32.1%], P=0.516), and PJFX (11[39.3%] vs 18[32.1%], P=0.516). The numbers of the PJFX segments were 16 and 33 in PVP segments and non-PVP segments, respectively. Until revision surgery or final follow-up, the PJFX had progressed in 24 (82.7%) non-PVP segments, but not in PVP segments. The PJFX progression in all PVP segments stopped right near the PVP mass at the final follow-up. Reoperation due to PJFX was performed in one (3.6%) and eight (14.3%) patients in PVP and non-PVP groups, respectively.
CONCLUSIONS: PVP at UIV and UIV+1 cannot prevent PJK, PJF and PJFX; however, it plays a positive role by delaying their progression. Furthermore, PVP tend to lower the reoperation rate after PJFX in ASD surgery.

PMID: 30610979 [PubMed - as supplied by publisher]

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Outcome of Transforminal Lumbar Thorough Debridement, Decompression and Spondylodesis (TLTDDS) technique in Treatment of 25 patients with Pyogenic Spondylodiscitis.

Outcome of Transforminal Lumbar Thorough Debridement, Decompression and Spondylodesis (TLTDDS) technique in Treatment of 25 patients with Pyogenic Spondylodiscitis.

World Neurosurg. 2019 Jan 02;:

Authors: Omran K, Ibrahim AH

Abstract
BACKGROUND: Lumbar Pyogenic Spondylodiscitis (LPS) is still a tangled problem in its management especially after increasing rates of its incidence in cases underwent different spinal procedures and in patients with chronic medical disease. One stage posterior direct Transroforminal Lumbar Thorough Debridement of septic lesion, Decompression and Spondylodesis (TLTDDS) are the main goals in treatment of complicated LPS without additional morbidity of anterior surgery.
PURPOSE: Retrospective assessment of the clinical, laboratory, functional and radiological outcomes in 25 patients with LPS underwent TLTDDS procedure.
PATIENTS AND METHODS: Twenty nine patients with complicated LPS were treated surgically by TLTDDS surgery from January 2014 to August 2017. Complete records of 25 patients were available for evaluation. All patients were examined clinically back or leg pain using Visual Analog Scale (VAS) and neurological assessment by American Spine Injury Association (ASIA). Perioperative outcome and complications were documented. All patients were serially followed up between 12 and 32 months as regard pain (VAS), functional status by Kirkaldy Willis Criteria (KWC) and Oswestry Disability Index (ODI); laboratory and radiological outcomes (angle of segmental kyphosis, Lumbar Lordosis (LL) correction and fusion criteria).
RESULTS: Definitive solid bony fusion was seen between 6 and 14 months except 3 cases showed probable fusion. There was significant improvement in VAS, ASIA, laboratory investigations and ODI. One patient (5%) had transient neurological deficit, which resolved completely within 2 months.
CONCLUSIONS: TLTDDS surgery is an effective procedure in treatment of symptomatic LPS and allows abscess evacuation with adequate neural decompression, segmental kyphosis correction and functional improvement.

PMID: 30610978 [PubMed - as supplied by publisher]

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Clinical features and prognosis of primary intraventricular hemorrhage in the elderly: a single center experience.

Clinical features and prognosis of primary intraventricular hemorrhage in the elderly: a single center experience.

World Neurosurg. 2019 Jan 02;:

Authors: Guo R, Chen R, Yu Z, Tian R, Ren Y, You C, Ma L

Abstract
OBJECTIVE: Primary intraventricular hemorrhage (PIVH) is rare in the aging population and remains a challenge for cerebrovascular surgeons. In the present study, the authors reviewed the patient characteristics, angiographic results, as well as treatments, and determined clinical outcomes in 34 patients over 60 years of age who were treated at West China Hospital between 2010 and 2014.
METHODS: The medical records of elderly patients was queried. The parameters regarding patient demographics, presenting symptoms, treatment modalities, angiographic results, and clinical outcomes were assessed and analyzed.
RESULTS: There were 19 male (55.9%) and 15 female (44.1%) patients, with an average age (± SD) of 67.9 ± 7.7 years in our study. The most common symptoms on presentation were headache (50.0%), followed by disturbance of consciousness (26.5%). Only 5 patients (14.3%) were diagnosed with underlying cerebrovascular etiologies, including Moyamoya disease (5.9%), arteriovenous malformations (2.9%), and aneurysms (5.9%). Idiopathic PIVH was diagnosed in 29 patients (85.7%). Thirteen patients (38.2%) underwent surgical intervention, while 21 patients (61.8%) received conservative treatment. Twelve patients (35.3%) had an unfavorable outcome at discharge and unfavorable was observed in 14 patients (41.2%) at the 3-month follow up. Patients with higher Graeb score might be associated with an unfavorable outcome both in short-time and long-time follow-up.
CONCLUSIONS: Most PIVH patients were diagnosed with idiopathic PIVH in the elderly. Surgical treatment of aging patients should be optimized to improve clinical outcomes. The admission Graeb score were considered to be the independent prognostic factors for both short-term and long-time outcome.

PMID: 30610977 [PubMed - as supplied by publisher]

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Endoscopic endonasal surgery for craniopharyngiomas: a series of 60 patients.

Endoscopic endonasal surgery for craniopharyngiomas: a series of 60 patients.

World Neurosurg. 2019 Jan 02;:

Authors: Mou J, Wang X, Huo G, Ruan L, Jin K, Tan S, Wang F, Hua H, Yang G

Abstract
OBJECTIVE: To report our experience of the management of 60 craniopharyngioma patients with endoscopic endonasal surgery (EES) and evaluate the feasibility and safety of EES for craniopharyngiomas.
METHOD: The clinical data of 60 craniopharyngioma patients who underwent EES between November 2014 and December 2017 were analysed retrospectively. All patients had vascularized nasoseptal flaps, and the most recent 4 patients had "in situ bone flaps" for better skull base reconstruction. Visual improvements, tumour resection extents, recurrence rates, endocrine functional changes and surgical complications were evaluated.
RESULTS: The resection rates were as follows: gross-total,68.3% (41 patients); near-total (>95% of tumour removed),15% (9 patients); subtotal (≥80% of tumour removed),10% (6 patients), and partial (PR<80% of tumour removed)6.7% (4 patients). Fifty-two patients presented with visual impairment; of these, 46 (88.5%) improved or returned to normal after surgery. Regarding the 32 patients with hypopituitarism before surgery, pituitary function was unchanged in 15 (46.8%), improved or normalized in 4 (12.5%) and deteriorated in 13 (40.6%). Eleven patients (18.3%) suffered from diabetes insipidus before treatment, and 27 more patients had this condition after surgery. Twenty-two patients had hyposmia postoperatively, and 17 patients experienced significant weight gain. Four patients had recent memory loss, and two of them had a temporary recent mental disorder. Three (5%) patients had CSF leakage after surgery. Three patients (5%) contracted meningitis and were cured with antibiotic treatment. One patient showed recurrence by MRI re-examination, at the mean follow-up time of 22 months (range, 8-45 months; SD, 11 months).

PMID: 30610976 [PubMed - as supplied by publisher]

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Cerebral Venous Thrombosis with Tumor-like Features: A Case Report and Review of the Literature.

Cerebral Venous Thrombosis with Tumor-like Features: A Case Report and Review of the Literature.

World Neurosurg. 2019 Jan 02;:

Authors: Xu T, Liang R

Abstract
BACKGROUND: Cerebral venous thrombosis (CVT), a rare cerebrovascular condition, is induced by blocked cerebral venous reflux, often presenting non-specific symptoms. Magnetic resonance imaging (MRI) of the brain may improve the often elusive diagnosis of CVT. However, the sensitivity, specificity and full spectrum of such MRI findings are poorly understood.
CASE DESCRIPTION: We report the case of a 53-year-old male patient with CVT. The patient complained of a severe headache in addition to an enhanced lesion on contrasted T1-weighted MR images, which was originally considered an angiogenic tumor. However, surgery and pathology confirmed the case to be CVT. Following surgery and administration of an anticoagulation agent, the patient's symptoms alleviated, and cranial MRI and CT 1 month after surgery showed no abnormalities.
CONCLUSIONS: We conclude that such cases may occur where CVT appears tumor-like on MRI, including mass effect and abnormal contrast enhancement. Therefore, for young and middle-aged adults with episodic and progressive headaches presenting such MRI findings, the possibility of CVT should always be considered. MRI combined with magnetic resonance venography should be used as the preferred strategy for early diagnosis of CVT.

PMID: 30610975 [PubMed - as supplied by publisher]

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Decompressive cranioplasty (osteoplastic hinged craniectomy): A novel technique for increased intracranial pressure, initial experience and outcome.

Decompressive cranioplasty (osteoplastic hinged craniectomy): A novel technique for increased intracranial pressure, initial experience and outcome.

World Neurosurg. 2019 Jan 02;:

Authors: Hsu YC, Po-Hao Huang A, Xiao FR, Kuo LT, Tsai JC, Lai DM

Abstract
BACKGROUND: We redesign the decompressive craniectomy and cranioplasty procedures in the hope to decrease the inherent risk of complications. This novel technique called decompressive cranioplasty may not only decrease the complication rate but also improve the cosmetic result, obviate the need for artificial skull implant and may even increase the decompressive volume compared to traditional craniectomy.
METHODS: In decompressive cranioplasty, the Agnes FAST craniotomy was adopted without cutting the temporalis muscle from the underlying bone flap. After opening the dura with or without removal of intracranial hematomas, duraplasty will be performed with an intracranial pressure monitor inserted. Four miniplates were bended into Z shape and the vascularized bone flap is elevated (about 1.2-1.5cm above the outer cortex of the skull) and fixed with the miniplates. Subsequent cranioplasty can be done mini-incision on the miniplate sites and reshaping the miniplate to align the outer cortex of the bone flap.
RESULTS: We have successfully performed decompressive cranioplasty on three emergent cases - two traumatic subdural hematomas and one malignant middle cerebral artery infarction. The post-operative brain computed tomography revealed adequate decompression in all cases. Cosmetic outcome was excellent and there was no temporal hallowing. Mastication function were also not affected. At 6 months follow-up there is no bone flap shrinkage and no hydrocephalus.
CONCLUSIONS: Decompressive cranioplasty is a safety and effective method in the management of patients with brain edema and intracranial hypertension. It is simple to perform and may reduce the morbidity associated with traditional decompressive craniectomy and subsequent cranioplasty.

PMID: 30610974 [PubMed - as supplied by publisher]

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Supraorbital Occipital Circumferential Stimulation (SOCS) for the Treatment of Refractory Chronic Primary Headache: A Case Series.

Supraorbital Occipital Circumferential Stimulation (SOCS) for the Treatment of Refractory Chronic Primary Headache: A Case Series.

World Neurosurg. 2019 Jan 02;:

Authors: Jiang JF, Diaz AN, Campbell M, Boulis NM, Keifer OP

Abstract
BACKGROUND: Patients with refractory chronic primary headache disorders have extremely debilitating symptoms, severe comorbidities (e.g. anxiety, depression), and a significant reduction in quality of life. The headaches are extremely difficult to treat, as they are often refractory to pharmacologic and procedural interventions. Neuromodulation with stimulation of the occipital and supraorbital nerves has been proposed as a viable treatment for these refractory headaches.
OBJECTIVE: We retrospectively review the long-term (33.5 ± 20 months) results of supraorbital occipital nerve circumferential stimulation (SOCS) in patients with chronic primary headache disorders.
METHODS: A retrospective review of 25 patients that were evaluated for SOCS for chronic primary headache disorders from 2010 to 2017 at a single institution with a single neurosurgeon.
RESULTS: Of these 25 patients, 14 saw benefit to their trial stage of stimulation and underwent full implantation. A total 3 patients were excluded from further analysis due to having <2 months of follow-up or discordant data. Of the 11 patients analyzed, there was an overall response rate (>=50% pain reduction) of 82%. The average preoperative 10-point pain score dropped from 7.1 ±1.6 to a postoperative score of 3.3 ±2.1. However, there was a high rate of complications including infection, erosion, and loss of effect.
CONCLUSION: The results (82% response) suggest that SOCS may be an effective treatment and should be studied more extensively. Occipital nerve stimulation alone has shown 40-50% response rate in published studies. However, the relatively high complication rate highlights an obstacle for the approach for the treatment of refractory headache disorders and room for device optimization.

PMID: 30610973 [PubMed - as supplied by publisher]

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Microscopic Keyhole Technique for Surgical Removal of Thoracic Spinal Meningiomas.

Microscopic Keyhole Technique for Surgical Removal of Thoracic Spinal Meningiomas.

World Neurosurg. 2019 Jan 02;:

Authors: Xu J, Yu BF, Liu CH, Zheng W, Xiao YH, Lin Y

Abstract
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of microscopic minimally invasive keyhole technique for surgical resection of thoracic spinal meningiomas.
METHODS: Seventeen consecutive patients with thoracic spinal meningiomas were included in the series from May 2015 to August 2017. All patients were treated using a microscopic keyhole technique through a tubular retractor system. The demographic data, perioperative variables were recorded. At last follow-up, clinical outcome was assessed using the visual analog scale (VAS) for pain and the American Spinal Injury Association (ASIA) scale for motor/sensory outcome.
RESULTS: All of them underwent microscopic keyhole surgery and complete resection was achieved. Mean operative time was 153.2 min (range115-300 min). Mean blood loss during surgery was 110.3mL (range 50-175mL). No infection or aggravation of spinal cord injury occurred after operation, except for two patients who had postoperative cerebrospinal fluid leakage that recovered after conservative treatment. The mean duration of hospital stay was 6.8days(range5-10 days). At the last follow-up, all patients had a reduced level of pain as suggested by an average VAS score that improved from 7.6 to 0.2. The ASIA grade improved or remained normal in all patients except one. No evidence of tumor recurrence or secondary spinal deformity was observed in any patients during the postoperative follow-up period, and spinal stabilities were found to be satisfactory.
CONCLUSIONS: Based on our results, the microscopic minimally invasive keyhole technique can be used safely and effectively for resection of thoracic spinal meningiomas.

PMID: 30610972 [PubMed - as supplied by publisher]

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Composition and settling properties of suspended particulate matter in estuaries of the Chesapeake Bay and Baltic Sea regions

Abstract

Purpose

Our goal was to understand how differences in source material (allochthonous vs. autochthonous) and phytoplankton communities (diatoms vs. cyanobacteria) influence composition and settling properties of suspended particulate matter.

Materials and methods

We characterized the composition and settling properties of suspended particulate matter in two systems—one which has a high hydrologic loading factor (watershed to surface area ratio), and a diatom-dominated phytoplankton community (James River Estuary, USA), and a second, where hydrologic inputs are proportionally smaller, and the summer phytoplankton community is dominated by cyanobacteria (Curonian Lagoon, Lithuania).

Results and discussion

In the James, we found that TSS concentrations were positively related to discharge, whereas POC concentrations were negatively correlated with discharge and positively correlated with Chl-a. We infer that suspended particulate matter in this system was largely derived from allochthonous inputs, but that the organic matter fraction was derived from autochthonous production. In the Curonian Lagoon, TSS concentrations were correlated with Chl-a, but not discharge, indicating that suspended particulate matter was largely of autochthonous origin. In the James, the proportion of settleable materials was greater during high TSS concentrations, indicating that high discharge events delivered heavier particulates. In the Curonian Lagoon, we observed a seasonal decline in settling rates associated with the shift from mixed (diatoms and chlorophytes) to cyanobacteria-dominated phytoplankton, which we attribute to the presence of positively buoyant cyanobacteria.

Conclusions

We found that a comparative approach yielded useful insights regarding sources, composition, and settling properties of suspended particulate matter in two estuaries that differ in hydrologic loading and phytoplankton community composition. Our findings suggest that the presence of positively buoyant cyanobacteria favors export losses of particulate C, N, and P to marine waters over retention through sedimentation in transitional zones.

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Redox characterization of humins in sediments from the Yangtze Estuary to the East China Sea and their effects on microbial redox reactions

Abstract

Purpose

Humins, as solid-phase redox mediators, are important for enhancing anaerobic biotransformation processes. Although humins are broadly distributed in estuarine and marine sediments, to date, their electron transfer capacity (ETC) from marine sediments has been poorly characterized. This study determined the potential of humins as redox mediators for microbial redox metabolic reactions in sediments along a transect from the Yangtze Estuary to the adjacent East China Sea and analyzed their electron-mediating characteristics.

Materials and methods

Comparative analyses of humins in sediments along this transect were conducted to investigate their ETC as redox mediators for microbial redox metabolic reactions, namely dissimilatory iron reduction (DIR) and dissimilatory nitrate reduction to ammonium (DNRA), using Shewanella oneidensis MR-1. Elemental composition, electrochemical, and Fourier transform infrared analyses were performed to better understand the functional redox groups in humins.

Results and discussion

All the humins functioned as solid-phase redox mediators and enhanced DIR and DNRA by Shewanella oneidensis, although with varying efficacy. The humins extracted from sampling site P1 (P1-HM), located close to the Yangtze Estuary, most effectively enhanced iron and nitrate reduction without nitrite accumulation. Electrochemical analysis confirmed the highest redox activity and ETC in P1-HM and a weakening trend of ETC with increasing distance from the estuary. Fourier transform infrared analysis suggested that quinone moieties might serve as key redox functional groups in humins.

Conclusions

Considering their high yield and ETC, P1-HM could be important redox mediators that influence microbial redox metabolic reactions in sedimentary ecosystems of the Yangtze Estuary. Thus, this study provides insights into the distribution of humins, their ECT, and their potential role as redox mediators for microbial redox reactions, which could improve understanding of elemental biogeochemical cycling processes involving microorganisms in the Yangtze Estuary and East China Sea sedimentary ecosystems and provide important reference information for researches on other estuary areas.

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'Nasal flossing': A case report of nasopharyngeal stenosis due to severe erosive lichen planus and a novel therapeutic intervention.

'Nasal flossing': A case report of nasopharyngeal stenosis due to severe erosive lichen planus and a novel therapeutic intervention.

Int J Surg Case Rep. 2018 Nov 13;54:99-102

Authors: Henry A, Biddlestone J, McCaul J

Abstract
INTRODUCTION: We describe a case of severe erosive oral lichen planus that led to nasopharyngeal stenosis. This is a rare clinical presentation that was ultimately, successfully treated by surgery combined with post-operative 'nasal flossing': a novel therapeutic intervention.
PRESENTATION OF CASE: A 76-year-old male suffering from a rare case of severe oral lichen planus that was resistant to conservative measures is described. Initial surgery was complicated by recurrence of nasopharyngeal stenosis. Definitive surgery required revision of nasopharyngeal stenosis release combined with a course of post- operative 'nasal flossing'. The technique for 'nasal flossing' is described and demonstrated in photographs. The patient remained asymptomatic at 3 years using this combined approach, with restoration of olfaction, taste perception and voice quality, significantly enhancing quality of life.
DISCUSSION: Erosive oral lichen planus is a rare but important presentation in oral medicine. We found 'nasal flossing' to be a successful treatment to maintain nasopharyngeal patency following surgical repair of this uncommon condition. We are not aware that this combined approach has previously been described in the published literature.
CONCLUSIONS: Severe erosive oral lichen planus can lead to nasopharyngeal stenosis. Nasopharyngeal stenosis in these patients may be refractive to conventional surgical approaches. 'Nasal flossing' is demonstrated to be both practical and acceptable as a surgical adjunct in these difficult to treat cases of recurrent nasopharyngeal stenosis. This report has relevance for all those practicing oral and maxillofacial surgery, ear nose and throat surgery and oral medicine.

PMID: 30611058 [PubMed - as supplied by publisher]

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Genome-Wide Analysis of Head and Neck Squamous Cell Carcinomas Reveals HPV, TP53, Smoking and Alcohol-Related Allele-Based Acquired Uniparental Disomy Genomic Alterations

Publication date: February 2019

Source: Neoplasia, Volume 21, Issue 2

Author(s): Musaffe Tuna, Christopher I. Amos, Gordon B. Mills

Abstract

Smoking and alcohol intake are major risk factors in head and neck squamous cell carcinomas (HNSCCs). Although the link between TP53 mutation and smoking has been well established, very little is known about the link between acquired uniparental disomy (aUPD) and smoking and/or alcohol consumption or other clinical characteristics. We used TCGA genomic data to investigate whether smoking, alcohol intake, clinical and demographic variables, HPV status and TP53 mutation are associated with aUPD at specific chromosomal regions. In multivariate analysis, we found association between aUPD regions and risk factors and clinical variables of disease. aUPD regions on chromosome 4q, 5q, 9p, 9q, 13q, 17p and CDKN2A occurred significantly more often in patients with TP53-mutated HNSCC than in those with wild-type HNSCC, while aUPD regions on chromosome 9p and at CDKN2A were significantly more frequent in females than in males. Besides, aUPD occurred more frequent in HPV-positive than in HPV-negative samples with all HNSCC and larynx cancers on chromosome 9q 15q and 17p. Moreover, aUPD on CDKN2A region occurred more often in alcohol drinkers than nondrinkers in patients with all HNSCC and oral cavity cancers, while aUPD region on chromosome 5q occurred less in alcohol drinkers than nondrinkers in patients with all HNSCC and oral cavity cancers. Similarly, aUPD region on chromosome 5q occurred less in smokers than nonsmokers in patients with all HNSCC and oral cavity cancers. In conclusion, aUPD regions are not random, and certain regions are associated with risk factors for disease, and with TP53 mutation status.

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Robotic Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis with Trial Sequential Analysis.

Robotic Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis with Trial Sequential Analysis.

World J Surg. 2019 Jan 04;:

Authors: Ng KT, Tsia AKV, Chong VYL

Abstract
BACKGROUND: Minimally invasive surgery has been considered as an alternative to open surgery by surgeons for colorectal cancer. However, the efficacy and safety profiles of robotic and conventional laparoscopic surgery for colorectal cancer remain unclear in the literature. The primary aim of this review was to determine whether robotic-assisted laparoscopic surgery (RAS) has better clinical outcomes for colorectal cancer patients than conventional laparoscopic surgery (CLS).
METHODS: All randomized clinical trials (RCTs) and observational studies were systematically searched in the databases of CENTRAL, EMBASE and PubMed from their inception until January 2018. Case reports, case series and non-systematic reviews were excluded.
RESULTS: Seventy-three studies (6 RCTs and 67 observational studies) were eligible (n = 169,236) for inclusion in the data synthesis. In comparison with the CLS arm, RAS cohort was associated with a significant reduction in the incidence of conversion to open surgery (ρ < 0.001, I2 = 65%; REM: OR 0.40; 95% CI 0.30,0.53), all-cause mortality (ρ < 0.001, I2 = 7%; FEM: OR 0.48; 95% CI 0.36,0.64) and wound infection (ρ < 0.001, I2 = 0%; FEM: OR 1.24; 95% CI 1.11,1.39). Patients who received RAS had a significantly shorter duration of hospitalization (ρ < 0.001, I2 = 94%; REM: MD - 0.77; 95% CI 1.12, - 0.41; day), time to oral diet (ρ < 0.001, I2 = 60%; REM: MD - 0.43; 95% CI - 0.64, - 0.21; day) and lesser intraoperative blood loss (ρ = 0.01, I2 = 88%; REM: MD - 18.05; 95% CI - 32.24, - 3.85; ml). However, RAS cohort was noted to require a significant longer duration of operative time (ρ < 0.001, I2 = 93%; REM: MD 38.19; 95% CI 28.78,47.60; min).
CONCLUSIONS: This meta-analysis suggests that RAS provides better clinical outcomes for colorectal cancer patients as compared to the CLS at the expense of longer duration of operative time. However, the inconclusive trial sequential analysis and an overall low level of evidence in this review warrant future adequately powered RCTs to draw firm conclusion.

PMID: 30610272 [PubMed - as supplied by publisher]

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Racial and Socioeconomic Disparities in the Surgical Management and Outcomes of Patients with Colorectal Carcinoma.

Racial and Socioeconomic Disparities in the Surgical Management and Outcomes of Patients with Colorectal Carcinoma.

World J Surg. 2019 Jan 04;:

Authors: Cairns AL, Schlottmann F, Strassle PD, Di Corpo M, Patti MG

Abstract
INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer mortality in the USA. We aimed to determine racial and socioeconomic disparities in the surgical management and outcomes of patients with CRC in a contemporary, national cohort.
METHODS: We performed a retrospective analysis of the National Inpatient Sample for the period 2009-2015. Adult patients diagnosed with CRC and who underwent colorectal resection were included. Multivariable linear and logistic regressions were used to assess the effect of race, insurance type, and household income on patient outcomes.
RESULTS: A total of 100,515 patients were included: 72,552 (72%) had elective admissions and 27,963 (28%) underwent laparoscopic surgery. Patients with private insurance and higher household income were consistently more likely to have laparoscopic procedures, compared to other insurance types and income levels, p < 0.0001. Black patients, compared to white patients, were more likely to have postoperative complications (OR 1.23, 95% CI, 1.17, 1.29). Patients with Medicare and Medicaid, compared to private insurance, were also more likely to have postoperative complications (OR 1.30, 95% CI, 1.24, 1.37 and OR 1.40, 95% CI, 1.31, 1.50). Patients in low-household-income areas had higher rates of any complication (OR 1.11, 95% CI 1.06, 1.16).
CONCLUSIONS: The use of laparoscopic surgery in patients with CRC is strongly influenced by insurance type and household income, with Medicare, Medicaid and low-income patients being less likely to undergo laparoscopic surgery. In addition, black patients, patients with public insurance, and patients with low household income have significant worse surgical outcomes.

PMID: 30610271 [PubMed - as supplied by publisher]

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Global Disparities in Breast Cancer Genetics Testing, Counselling and Management.

Global Disparities in Breast Cancer Genetics Testing, Counselling and Management.

World J Surg. 2019 Jan 04;:

Authors: Yip CH, Evans DG, Agarwal G, Buccimazza I, Kwong A, Morant R, Prakash I, Song CY, Taib NA, Tausch C, Ung O, Meterissian S

Abstract
Hereditary breast cancers, mainly due to BRCA1 and BRCA2 mutations, account for only 5-10% of this disease. The threshold for genetic testing is a 10% likelihood of detecting a mutation, as determined by validated models such as BOADICEA and Manchester Scoring System. A 90-95% reduction in breast cancer risk can be achieved with bilateral risk-reducing mastectomy in unaffected BRCA mutation carriers. In patients with BRCA-associated breast cancer, there is a 40% risk of contralateral breast cancer and hence risk-reducing contralateral mastectomy is recommended, which can be performed simultaneously with surgery for unilateral breast cancer. Other options for risk management include surveillance by mammogram and breast magnetic resonance imaging, and chemoprevention with hormonal agents. With the advent of next-generation sequencing and development of multigene panel testing, the cost and time taken for genetic testing have reduced, making it possible for treatment-focused genetic testing. There are also drugs such as the PARP inhibitors that specifically target the BRCA mutation. Risk management multidisciplinary clinics are designed to quantify risk, and offer advice on preventative strategies. However, such services are only possible in high-income settings. In low-resource settings, the prohibitive cost of testing and the lack of genetic counsellors are major barriers to setting up a breast cancer genetics service. Family history is often not well documented because of the stigma associated with cancer. Breast cancer genetics services remain an unmet need in low- and middle-income countries, where the priority is to optimise access to quality treatment.

PMID: 30610270 [PubMed - as supplied by publisher]

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Trends in the Nature and Management of Serious Abdominal Trauma.

Trends in the Nature and Management of Serious Abdominal Trauma.

World J Surg. 2019 Jan 04;:

Authors: Ferrah N, Cameron P, Gabbe B, Fitzgerald M, Martin K, Beck B

Abstract
BACKGROUND: There have been recommendations for increased non-operative management (NOM) of abdominal trauma in adults. To assess the impact of this trend and changes in the epidemiology of trauma, we examined the management of serious abdominal injuries and mortality, in Victorian major trauma patients 16 years or older, between 2007 and 2016.
METHODS: Using data from the population-based Victorian Trauma Registry, characteristics of patients who underwent laparotomy, embolisation, laparotomy and embolisation, or NOM, were compared with the Chi-square test. Poisson regression was used to determine whether the incidence of serious abdominal injury changed over time. Temporal trends in the management of abdominal injury and in-hospital mortality were analysed using, respectively, the Chi-square test for trend, and multivariable logistic regression.
RESULTS: Of 2385 patients with serious abdominal injuries, 69% (n = 1649) had an intervention; predominantly a laparotomy (n = 1166). The proportion undergoing laparotomy decreased from 60% in 2007 to 44% in 2016 (p < 0.001), whilst embolisation increased from 6 to 20% (p < 0.001). Population-adjusted incidence of abdominal injury increased 1.6% per year (IRR 1.016, 95% CI 1.002-1.031; p < 0.024), predominantly in people aged 65 years and over (4.6% per year). Adjusted odds of in-hospital mortality declined 6.0% per year (adjusted odds ratio 0.94; 95% CI 0.89, 1.00; p = 0.04).
CONCLUSIONS: Whilst the incidence of major abdominal trauma increased during the study period, there was a reduction in the proportion of patients managed with laparotomy and reduction in the adjusted odds of in-hospital mortality. Older patients, for whom management is influenced by the complex interplay of frailty and co-morbidities, had lower laparotomy rates.

PMID: 30610269 [PubMed - as supplied by publisher]

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Porto-Rex Shunt for Left Portal Vein Reconstruction During Right Extended Hepatectomy for Advanced Extrahepatic Biliary Cancer.

Porto-Rex Shunt for Left Portal Vein Reconstruction During Right Extended Hepatectomy for Advanced Extrahepatic Biliary Cancer.

World J Surg. 2019 Jan 04;:

Authors: Lahat E, Jaber A, Salloum C, Lim C, Golan G, Ben-Ari Z, Gutman M, Azoulay D

Abstract
Resection offers the only chance of long-term survival or cure for perihilar cancer, provided R0 resection is achieved with margin-negative status of the remnant liver, bile duct, proximal hepatic artery, and portal vein. End-to-end anastomosis of the portal trunk to the left portal branch is the conventional portal reconstruction in cases of right extended hepatectomy requiring resection of the portal vein bifurcation. This mandatory reconstruction may be challenging due to (1) vessel incongruence, (2) fragility of the left portal branch wall, and more importantly, and (3) the divergent orientation of the two vessels exposing to vascular twisting/kinking. We report here the first two cases of porto-Rex shunt, between the portal vein trunk and the left portal vein in the umbilical fissure during right extended hepatectomy for advanced extrahepatic biliary cancer: one following failed conventional portal reconstruction and one to achieve macroscopically complete resection.

PMID: 30610268 [PubMed - as supplied by publisher]

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Brazilein induces apoptosis and G1/G0 phase cell cycle arrest by up-regulation of miR-133a in human vestibular schwannoma cells.

Brazilein induces apoptosis and G1/G0 phase cell cycle arrest by up-regulation of miR-133a in human vestibular schwannoma cells.

Exp Mol Pathol. 2019 Jan 02;:

Authors: Mou Z, Wang Y, Li Y

Abstract
BACKGROUND: Acoustic neuroma is a benign and usually slow growing tumor. Brazilein is a natural compound extracted from hematoxylin. However, there has been no study of the mechanism of brazilein in acoustic neuroma cells. Thus, we aimed to investigate the effects and mechanism of brazilein on human VS cells in this study.
METHODS: The vestibular schwannoma (VS) cells were collected from patient tissues and used in this study. Different concentrations of brazilein (0, 10, 20 and 30 μM) were used to treat VS cells. The expression of miR-133a was altered by transfection with miR-133a inhibitor. Further, cell viability, apoptosis, cell cycle, the mRNA and phosphorylation levels of cell cycle, apoptosis-related proteins and main factors in MAPK and JNK pathways were detected using CCK-8 assay, flow cytometry analysis, qRT-PCR and western blot analysis, respectively.
RESULTS: The results showed that brazilein decreased cell viability, increased apoptosis and induced G1/G0 cell cycle arrest in VS Cells. Further, miR-133a expression was up-regulated in the brazilein-treated cells. Brazilein promoted apoptosis and induced G1/G0 cell cycle arrest via up-regulation of miR-133a. In addition, brazilein inhibited the activations of MAPK and JNK pathways by up-regulating miR-133a expression.
CONCLUSION: In conclusion, our study demonstrated that brazilein could induce apoptosis and G1/G0 phase cell cycle arrest, and deactivate MAPK and JNK signaling pathways via up-regulation of miR-133a in human VS cells. These results provide theoretical evidence for the clinical application of brazilein and a new strategy for the treatment of acoustic neuroma.

PMID: 30610843 [PubMed - as supplied by publisher]

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Cycloartenol exerts anti-proliferative effects on Glioma U87 cells via induction of cell cycle arrest and p38 MAPK-mediated apoptosis.

Cycloartenol exerts anti-proliferative effects on Glioma U87 cells via induction of cell cycle arrest and p38 MAPK-mediated apoptosis.

J BUON. 2018 Nov-Dec;23(6):1840-1845

Authors: Niu H, Li X, Yang A, Jin Z, Wang X, Wang Q, Yu C, Wei Z, Dou C

Abstract
PURPOSE: Gliomas are destructive malignancies affecting mainly the central nervous system. Gliomas constitute around 50% of all the central nervous system tumors. The purpose of this study was to examine the anticancer activity of cycloartenol against the glioma U87 cells and to investigate the underlying mechanisms.
METHODS: MTT and colony formation assay were used to determine the proliferation rate. Acridine orange/ethidium bromide (AO/EB) and annexin V/propidium iodide (PI) were used to determine apoptosis and cell cycle analysis was carried out by western blotting. Cell migration was checked by cell migration assay and immunoblotting was used for checking protein expressions.
RESULTS: The results revealed that cycloartenol inhibited the proliferation and the colony formation potential of the glioma U87 cells in a concentration-dependent manner. The antiproliferative effects were found to be due to induction of Sub-G1 cell cycle arrest and triggering of apoptosis. These effects were found to be dose-dependent. Cycloartenol also caused significant alteration in the expression of Bax and Bcl-2. Furthermore, cycloartenol inhibited the migration of glioma cells and suppressed the phosphorylation of the p38 MAP kinase.
CONCLUSION: These findings indicate that cycloartenol may prove beneficial in the treatment of glioma and warrants further investigation.

PMID: 30610811 [PubMed - in process]

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Inhibition of human cervical cancer cell growth by Salviolone is mediated via autophagy induction, cell migration and cell invasion suppression, G2/M cell cycle arrest and downregulation of Nf-kB/m-TOR/PI3K/AKT pathway.

Inhibition of human cervical cancer cell growth by Salviolone is mediated via autophagy induction, cell migration and cell invasion suppression, G2/M cell cycle arrest and downregulation of Nf-kB/m-TOR/PI3K/AKT pathway.

J BUON. 2018 Nov-Dec;23(6):1739-1744

Authors: Zhang Y, Li G, Ji C

Abstract
PURPOSE: Cervical cancer is one of the prevalently diagnosed cancers in women worldwide. In this study the antiproliferative and anticancer effects of Salviolone were evaluated against HeLa cervical cancer cell line along with determining the anticancer mode of action.
METHODS: MTT assay was employed to examine the proliferation rate of HeLa cells. Transmission electron microscopy (TEM) was used for the detection of the autophagic cell death. The cell invasion and migration were investigated by transwell assay and the expression of the proteins was estimated by western blotting.
RESULTS: The results revealed that Salviolone exerts anticancer effects on the HeLa cells with an IC50 of 20 µM. The effect of Salviolone on the viability of normal FR-2 cells was very low. TEM analysis showed that Salviolone triggers autophagic cell death in HeLa cells. Salviolone could also cause arrest of the HeLa cervical cancer cells in the G2/M phase of the cell cycle and suppress their ability to migrate and invade. Western blotting analysis revealed that Salviolone could inhibit the of Nf-kB/m-TOR/PI3K/AKT signalling pathway in HeLa cells.
CONCLUSION: Taken all together, it is concluded that Salviolone could prove to be an important lead molecule for the treatment of cervical cancer.

PMID: 30610802 [PubMed - in process]

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Antiproliferative and cytotoxic action of N-(p-coumaroyl) serotonin in lung cancer cells.

Antiproliferative and cytotoxic action of N-(p-coumaroyl) serotonin in lung cancer cells.

J BUON. 2018 Nov-Dec;23(6):1693-1698

Authors: Mitsis M, Markopoulos G, Alexiou GA, Vartholomatos E, Lazari D, Hodaj E, Nastos D, Lianos G, Zagorianakou P, Galani V, Kyritsis AP

Abstract
PURPOSE: Lung cancer is among the leading causes of cancer-related cases and cancer-associated deaths. Tumor cells frequently acquire chemoresistance and, due to that, new therapies are always needed in the fight against cancer. Pharmaceutical plants continue to offer novel compounds as anticancer therapies.
METHODS: We studied the action of N-p-coumaroyl-serotonin (CS), a natural compound from Centaurea seed and safflower on a lung adenocarcinoma cell line. Cytotoxic or antiproliferative effect was studied using the MTT assay. Cell cycle, caspase-8 activation, mitochondrial membrane potential (MMP) and expression of CD15/CD56/CD24/CD44/CD58/CD71 were studied by flow cytometry.
RESULTS: CS exterted antiproliferative and cytotoxic activity, independent of mitochondrial membrane disruption. This compound caused S phase arrest and a decrease in the expression of CD24/CD44/CD58/CD71.
CONCLUSION: This is the first report on the in vitro action of CS against lung cancer, necessitating further studies towards its use as a potential anticancer agent.

PMID: 30610796 [PubMed - in process]

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Induction of apoptosis by in vitro and in vivo plant extracts derived from Menyanthes trifoliata L. in human cancer cells.

Induction of apoptosis by in vitro and in vivo plant extracts derived from Menyanthes trifoliata L. in human cancer cells.

Cytotechnology. 2019 Jan 04;:

Authors: Kowalczyk T, Sitarek P, Skała E, Toma M, Wielanek M, Pytel D, Wieczfińska J, Szemraj J, Śliwiński T

Abstract
Menyanthes trifoliata L. has been used in traditional medicine for centuries. It exists in Asia, Europe, North America and in Morocco and is exploited as a remedy for anemia and lack of appetite. This plant shows many pharmacological properties, but its most interesting one is its anti-cancer potential. The present study examines the induction of apoptosis in grade IV glioma cells after treatment with the extracts from aerial part and root of M. trifoliata plants derived from in vitro (MtAPV and MtRV, respectively) and from soil (MtAPS and MtRS, respectively) and presents the first comparison of the biological effects of four different extracts of M. trifoliata against glioblastoma cells. The root extracts of M. trifoliata plants were found to exhibit cytotoxic effects against grade IV glioma cells, but not normal human astrocytes. HPLC analysis demonstrated the presence of various polyphenolic compounds, including sinapinic acid, ferulic acid, syringic acid and vanilic acid. Higher amount of pentacyclic triterpene (betulinic acid) was also found in MtRV extract. The growth inhibition of human grade IV glioma cells mediated by MtRV extract appears to be associated with apoptosis and G2/M phase cell cycle arrest, and altered expression of the pro- and anti-apoptotic genes (Bax, Bcl-2, Cas-3 and TP53) and proteins (Bax, Bcl-2, Cas-3 and p53), as well as decreased mitochondrial membrane potential. Our results indicate that M. trifoliata gives promising results as an anti-cancer agent for human glioblastoma cell lines. However, further research is necessary in view of its therapeutic use.

PMID: 30610508 [PubMed - as supplied by publisher]

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Κυριακή 6 Ιανουαρίου 2019

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