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Παρασκευή 1 Φεβρουαρίου 2019
Mammakarzinom: Molekulare Diagnostik und Erkenntnisse zum Lebensstil ,Fortgeschrittenes/metastasiertes Mammakarzinom: Ribociclib jetzt breiter einsetzbar,PD-L1- und PARP-Inhibition - neue Therapieoptionen beim metastasierten triple-negativen Mammakarzinom,Literaturtipp: Neue Aspekte in der Therapie von Schilddrüsenkarzinomen ,Voneinander lernen: Pathologie und Gynäko-Onkologie im Zeitalter der personalisierten Therapie - Anmeldung läuft,Experten diskutieren wichtige Fragestellungen beim Nierenzell- und Blasenkarzinom,Save the Date: 7. Heidelberg Myelom Workshop - Anmeldung läuft,Neuer Wirkstoff bei MDS, schonendere Sequenz bei AML,Mitreden beim „Brennpunkt Onkologie“,Jetzt vormerken: COMBATing Breast Cancer im März in Berlin
Protein engineering comes of age
Journal Name: Biological Chemistry
Issue: Ahead of print
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The conserved theme of ribosome hibernation: from bacteria to chloroplasts of plants
Journal Name: Biological Chemistry
Issue: Ahead of print
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Editorial Board
Publication date: 1 April 2019
Source: Behavioural Brain Research, Volume 361
Author(s):
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Ablation of NMDA receptors in dopamine neurons disrupts attribution of incentive salience to reward-paired stimuli
Publication date: Available online 31 January 2019
Source: Behavioural Brain Research
Author(s): Przemysław Eligiusz Cieślak, Jan Rodriguez Parkitna
Abstract
Midbrain dopamine (DA) neurons play a crucial role in the formation of conditioned associations between environmental cues and appetitive events. Activation of N-methyl-D-aspartate (NMDA) receptors is a key mechanism responsible for the generation of conditioned responses of DA neurons to reward cues. Here, we tested the effects of the cell type-specific inactivation of NMDA receptors in DA neurons in adult mice on stimulus-reward learning. Animals were trained in a Pavlovian learning paradigm in which they had to learn the predictive value of two conditioned stimuli, one of which (CS+) was paired with the delivery of a water reward. Over the course of conditioning, mutant mice learned that the CS + predicted reward availability, and they approached the reward receptacle more frequently during CS + trials than CS- trials. However, conditioned responses to the CS + were weaker in the mutant mice, possibly indicating that they did not attribute incentive salience to the CS + . To further assess whether the attribution of incentive salience was impaired by the mutation, animals were tested in a conditioned reinforcement test. The test revealed that mutant mice made fewer instrumental responses paired with CS + presentation, confirming that the CS + had a weaker incentive value. Taken together, these results indicate that reward prediction learning does occur in the absence of NMDA receptors in DA neurons, but the ability of reward-paired cues to invigorate and reinforce behavior is attenuated.
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DNA methylation of the Tacr2 gene in a CUMS model of depression
Publication date: Available online 31 January 2019
Source: Behavioural Brain Research
Author(s): Dan Xiang, Jiawei Xiao, Linyan Fu, Lihua Yao, Qirong Wan, Ling Xiao, Fan Zhu, Gaohua Wang, Zhongchun Liu
Abstract
Tacr2, the gene encoding the NK2 receptor, belongs to G protein-coupled receptors. Accumulating evidence has indicated that the tachykinin receptors may contribute to the pathophysiology of depression. During the last decade, some studies have shown that Tacr2 activation is involved in the modulation of emotional processes. However, the extent, to which stress impacts Tacr2 expression remains unclear. The molecular mechanisms underlying depression also remain poorly understood. In this study, we subjected adult male Sprague Dawley (SD) rats to chronic unpredictable mild stress (CUMS) to induce a depression-like phenotype. We then measured the body weight and performed the sucrose preference test, forced swimming test (FST) and open field test to detect the effects of stress on anhedonia and activity. Western blotting and real-time PCR were used to study the protein and mRNA expression levels of Tacr2, respectively, in the hypothalamus. To explore DNA methylation of the Tacr2 gene, we used methylated DNA immunoprecipitation sequencing (MeDIP-seq). Additionally, we used the bisulfite sequencing PCR (BSP) to further verify the DNA methylation levels of the Tacr2 receptor gene in rats. We found that the CUMS-sensitive rats exhibited a decrease in body weight and sucrose preference, a decrease in the distance traveled, rearing frequency and velocity in the open field test, and an increase in immobility time in the FST. Compared with the expression in the control rats, Tacr2 protein and mRNA expression in the hypothalamus significantly increased in the CUMS-sensitive rats; however, the DNA methylation levels of the Tacr2 gene were significantly lower than in the control rats. In summary, according to our findings, the stress-induced increase in Tacr2 expression in the hypothalamus correlated with a specific decrease in DNA methylation of the Tacr2 gene. These results may enrich the understanding of the pathological processes of depression and provide insights into therapeutic approaches for its treatment.
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Management of Australia’s Murray–Darling basin deemed ‘negligent’
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Systemic thrombolysis for acute submassive pulmonary embolism after laparoscopic Roux-en-Y bypass: A case report.
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Systemic thrombolysis for acute submassive pulmonary embolism after laparoscopic Roux-en-Y bypass: A case report.
Int J Surg Case Rep. 2019 Jan 19;55:66-68
Authors: Brañes A, Orellana M, Muñoz R
Abstract
INTRODUCTION: Venous thromboembolism (VTE) in bariatric surgery is a low incidence disease; however, it is the first cause of morbimortality in this group of patients.
PRESENTATION OF THE CASE: We present the case of a female patient with morbid obesity who was readmitted due to an acute submassive bilateral pulmonary embolism (PE) nineteen days after a laparoscopic Roux-en-Y gastric bypass (RYGB). After diagnosis, anticoagulation was initiated, and decision to add mechanical and pharmacological thrombolysis was made with the patient been successfully treated, as shown by normalization of pulmonary hypertension.
DISCUSSION: VTE in bariatric surgery is rare but contributes to significant morbidity and mortality in patients undergoing bariatric surgery.
CONCLUSION: It is necessary to have a high index of suspicion to make a timely diagnosis and initiate an early treatment. In selected cases, adding mechanical and pharmacological thrombolysis could increase chance of reverse pulmonary hypertension.
PMID: 30703719 [PubMed - as supplied by publisher]
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A case of aggressive giant dermatofibrosarcoma protuberance occurring in the parotid gland.
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A case of aggressive giant dermatofibrosarcoma protuberance occurring in the parotid gland.
Int J Surg Case Rep. 2019 Jan 22;55:58-61
Authors: Adilbay D, Khozhamkul F, Toiynbekova S, Ahmetov D
Abstract
INTRODUCTION: Dermatofibrosarcoma protuberans (DFSP) is a cutaneous malignancy that arises from the dermis and invades deeper tissue. The cellular origin of DFSP is not clear. Evidence supports the cellular origin being fibroblastic, histiocytic, or neuroectodermal.
PRESENTATION OF CASE: A 38 years old, women presented with slow-growing large right parotid mass. A total parotidectomy performed with auriculectomy and reconstruction using ALT flap. Diagnosis confirmed by pathology and immunohistochemistry. Tumor recurred in 10 months, the second surgery with subsequent chemoradiotherapy performed. Patient initially treated with wide resection, 4 cycles of chemotherapy and postoperative radiotherapy 40 Gy, with the recurrence in 10 months. We performed a second surgery followed by radiotherapy. She is disease-free for more than two years under follow-up.
DISCUSSION: The main treatment of DFSP is surgical resection with wide negative margins or Moh's surgery. Advanced cases treated with addition of radiotherapy or chemoradiotherapy, but with unclear benefits. In our case, huge tumor located in the parotid region recurred after initial surgery and adjuvant treatment.
CONCLUSION: Clinically, DFSP usually manifest as well circumscribed, slow-growing, smooth, and painless masses. In cases with advanced tumor in parotid region, recurrence may occur despite aggressive initial treatment with wide resection and chemoradiotherapy.
PMID: 30703718 [PubMed - as supplied by publisher]
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Factors associated with renal Doppler resistive index in critically ill patients: a prospective cohort study
The renal Doppler resistive index (renal RI) is a noninvasive tool that has been used to assess renal perfusion in the intensive care unit (ICU) setting. However, many parameters have been described as influen...
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Hemoadsorption therapy in the critically ill: solid base but clinical haze
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Photogeneration of hydroxyl radical in Fe(III)-citrate-oxalate system for the degradation of fluconazole: mechanism and products
Abstract
The photochemical role of Fe(III)-citrate complex is significant in natural waters due to its ubiquitous existence and excellent photoreactivity at near neutral pH. Although there are many reports on the photoinduced degradation of pollutants in the Fe(III)-citrate system, the optimum pH for its photoreactivity is yet not clearly understood. Here, for the first time, we demonstrated that the optimum pH was 5.5 for the photoproduction of •OH in the Fe(III)-citrate system via kinetics modeling based on the steady-state approximation. According to the experimental results, the •OH photoproduction increased with increasing pH until 5.5 and then decreased in Fe(III)-citrate solution, which agreed well with the prediction trend of kinetic modeling. The effect of the common ligand oxalate on the photoreactivity of Fe(III)-citrate system was also investigated. The addition of oxalate promoted the photoproduction of •OH in Fe(III)-citrate solutions, and the measured [•OH]ss increased with oxalate concentration under a fixed Fe(III)-to-citrate ratio. Little synergistic effect exists in Fe(III)-citrate-oxalate system at pH 4.0–5.5. In contrast, an appreciable synergistic effect was observed at near neutral pH (6.0–8.0). Higher oxalate-to-citrate ratio facilitated the synergistic effect. Furthermore, antifungal drug fluconazole could be removed efficiently in the Fe(III)-citrate-oxalate system. The photodegradation kinetics also verified the optimum pH of Fe(III)-citrate system and synergistic effect of oxalate. By LC-ESI-MS/MS analyses, the photoproducts of fluconazole in the Fe(III)-citrate-oxalate system were identified and the reaction mechanism involving hydroxylation substitution and subsequent cleavage of heterocyclic amine was proposed. These findings suggest that Fe(III)-citrate exhibits best photoreactivity at pH 5.5, and the coexistence of reactive ligands will enhance its photoreactivity at circumneutral pH, indicating potential application in wastewater treatment via addition of appropriate citrate and co-ligands.
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Fine particulate matter alters the microecology of the murine respiratory tract
Abstract
Fine particulate matter is a global challenge to human health. We investigated the effects and potential mechanisms of fine particulate matter on respiratory tract microecology in a lung injury mouse model. BALB/c mice were randomized into exposed and control groups. We found that the levels of soluble tumor necrosis factor receptor I was increased following the PM2.5 exposure. 16S rRNA sequencing of respiratory tract lavage fluid confirmed that the composition of the respiratory tract microecology was altered by the exposure. Lactobacillus was the most abundant of bacterial species present. Collectively, these results establish a link between exposure to fine particulate matter and alterations to the respiratory tract microecology. Elucidation of the underlying mechanisms may lead to treatment strategies in lung injury.
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The role of the phosphatase and tensin homolog status in predicting pathological complete response to neoadjuvant anti-HER2 therapies in HER2-positive primary breast cancer: A meta-analysis.
The role of the phosphatase and tensin homolog status in predicting pathological complete response to neoadjuvant anti-HER2 therapies in HER2-positive primary breast cancer: A meta-analysis.
Medicine (Baltimore). 2019 Feb;98(5):e14261
Authors: Zhang C, Guo Y, Li J, Tian X, Duan X
Abstract
PURPOSE: The addition of anti-HER2 therapies to neoadjuvant treatment significantly enhances pathological complete response (PCR) rate in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Selecting patients unlikely to benefit from neoadjuvant anti-HER2 therapies is increasingly important. In this study, we proposed to assess the role of the phosphatase and tensin homolog (PTEN) as a biomarker in predicting PCR to neoadjuvant anti-HER2 therapies by conducting meta-analysis.
METHODS: Our team searched Embase, Medline, and the Cochrane Library by the end of September 16, 2018, for trials on patients with HER2-positive breast cancer treated with neoadjuvant anti-HER2 therapies. The associations between PTEN expression and PCR rate were then assessed. Odds ratio (ORs) and hazard ratio (HRs) with 95% confidence intervals (CIs) with 2-sided P values were calculated. The Newcastle-Ottawa scale (NOS) was used to estimate the quality of the involved trials.
RESULTS: A total of 820 patients from 8 trials were included in this meta-analysis. Overall, the PTEN normal tumors was related to a significant increase in PCR rate (OR 0.55; 95% CI = 0.31-0.96; P = .04; I = 54%). In different anti-HER2 agents analysis, the PTEN normal tumors was related to a significant increase in PCR rate in patients treated with trastuzumab alone (OR 0.40; 95% CI = 0.24-0.67; P = .0005; I = 15%). Besides, no significant association between PTEN status and PCR rate was detected in patients treated with lapatinib alone (OR 1.90; 95% CI = 0.78-4.60; P = .16; I = 0%) or trastuzumab plus lapatinib (OR 1.27; 95% CI = 0.27-5.97; P = .76; I = 73%).
CONCLUSION: Based on current evidence, PTEN status could be n suitable biomarker in predicting PCR rate to neoadjuvant anti-HER2 therapies, especially in trastuzumab-treated patients.
PMID: 30702584 [PubMed - in process]
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Involvement of the Dysregulation of miR-23b-3p, miR-195-5p, miR-656-5p, and miR-340-5p in Trastuzumab Resistance of HER2-Positive Breast Cancer Cells and System Biology Approach to Predict Their Targets Involved in Resistance.
Involvement of the Dysregulation of miR-23b-3p, miR-195-5p, miR-656-5p, and miR-340-5p in Trastuzumab Resistance of HER2-Positive Breast Cancer Cells and System Biology Approach to Predict Their Targets Involved in Resistance.
DNA Cell Biol. 2019 Jan 31;:
Authors: Rezaei Z, Sebzari A, Kordi-Tamandani DM, Dastjerdi K
Abstract
Resistance to trastuzumab has become a limiting factor for therapeutic efficacy of human epidermal growth factor 2 (HER2)-positive breast cancer. Different expression levels of miRNAs in cancer cells have been associated with poor prognosis and response to chemotherapy. The aim of this study was to evaluate miRNAs that were thought to be associated with HER2-positive breast cancer chemoresistance. In this study, the relative expression of candidate miRNAs to U6 RNA was evaluated in trastuzumab-resistant and trastuzumab-sensitive cells using relative real-time PCR. Our results demonstrated that miR-23b-3p, miR-195-5p, miR-656-5p, and miR-340-5p were significantly dysregulated. For the first time in this study, these miRNAs were identified to be involved in trastuzumab resistance. TargetScan and miRDB were then used for predicting the potential targets of the candidate miRNAs. Our results also revealed that the predicted potential targets of these miRNAs were strongly associated with drug resistance pathways. As a relative expression of candidate miRNAs was statistically different in trastuzumab-resistant and trastuzumab-sensitive cells, their potential targets were involved in drug resistance pathways. We strongly hypothesized the dysregulation of miRNAs as a possible mechanism of trastuzumab resistance. We also assumed that the strategic manipulation of these regulatory networks might be a possible therapeutic strategy to improve the results of chemotherapy for this resistance. However, more research is needed to evaluate the role of these miRNAs in the acquisition of trastuzumab resistance.
PMID: 30702337 [PubMed - as supplied by publisher]
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Targeting of the HER2/HER3 signaling axis overcomes ligand-mediated resistance to trastuzumab in HER2-positive breast cancer.
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Targeting of the HER2/HER3 signaling axis overcomes ligand-mediated resistance to trastuzumab in HER2-positive breast cancer.
Cancer Med. 2019 Jan 31;:
Authors: Watanabe S, Yonesaka K, Tanizaki J, Nonagase Y, Takegawa N, Haratani K, Kawakami H, Hayashi H, Takeda M, Tsurutani J, Nakagawa K
Abstract
HER2-targeted therapy, especially the anti-HER2 antibody trastuzumab, is standard for HER2-positive breast cancer; however, its efficacy is limited in a subpopulation of patients. HER3 ligand (heregulin)-dependent HER2-HER3 interactions play a critical role in the evasion of apoptosis and are therefore a target for oncotherapy to treat HER2-positive breast cancer. The anti-HER2 antibody pertuzumab and anti-HER3 antibody patritumab both target this heregulin-HER3-HER2 complex in different ways. This study examined the anticancer efficacy of dual HER2 and HER3 blockade in trastuzumab-resistant HER2-positive breast cancer. HER2-positive SKBR3 or BT474 cells overexpressing heregulin (SKBR3-HRG, BT474-HRG) were used to evaluate the efficacy of trastuzumab, pertuzumab, and patritumab in vitro by performing cell viability, immunoblotting, and clonogenic assays. The effects of these agents were then evaluated in vivo using BT474-HRG and an intrinsic heregulin-expressing and HER2-positive JIMT-1 xenograft models. SKBR3-HRG and BT474-HRG cells lost sensitivity to trastuzumab, which was accompanied by Akt activation. Unexpectedly, trastuzumab in combination with pertuzumab or patritumab also showed limited efficacy toward these cells. In contrast, trastuzumab/pertuzumab/patritumab triple treatment demonstrated potent anticancer efficacy, concomitant with strong repression of Akt. Finally, in heregulin-expressing BT474-HRG and JIMT-1 xenograft models, the addition of pertuzumab and patritumab to trastuzumab also enhanced antitumor efficacy leading to tumor regression. The current study found that triple blockade of HER2 and HER3 using trastuzumab, pertuzumab, and patritumab could overcome resistance to trastuzumab therapy in heregulin-expressing and HER2-positive breast cancer, which could be exploited clinically.
PMID: 30701699 [PubMed - as supplied by publisher]
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Association of p53 Overexpression with Hormone Receptor Status and Triple Negative Breast Carcinoma.
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Association of p53 Overexpression with Hormone Receptor Status and Triple Negative Breast Carcinoma.
J Coll Physicians Surg Pak. 2019 Feb;29(2):164-167
Authors: Qamar S, Khokhar MA, Farooq S, Ashraf S, Humayon WA, Rehman A
Abstract
OBJECTIVE: To determine association of p53 overexpression with hormone receptor status in breast carcinoma.
STUDY DESIGN: Descriptive cross-sectional study.
PLACE AND DURATION OF STUDY: Department of Pathology in collaboration with Department of Oncology, King Edward Medical University, Lahore, from January 2017 to January 2018.
METHODOLOGY: All adult female patients coming to Department of Oncology with reports of breast cancer biopsy and receptor status were included. Their age, type of surgery, grade of cancer, stage of cancer, and hormone receptor status were noted from records. P53 immunomarker was applied on tumor containing tissue blocks. Pearson Chi-square test was run for strength of association between the variables using SPSS V. 22.
RESULTS: Mean age of 91 patients at diagnosis was 48 years ±12.49. Fifty-five (60.4%) patients had ER positive tumors, 36 (39.6%) were ER negative, 53 (58.2%) had PR positive status, and 38 (41.8%) were negative. Same number was seen in HER2 neu staining. Out of 91 cases, 31 (34.1%) were p53 positive and 60 (65.9%) were negative. Out of 55 (60.4%) ER positive cases, 11 (12.1%) were positive for p53 and 44 (48.4%) were p53 negative (p<0.001). PR positive cases (53/58.2%) showed p53 positivity in 7 (7.7%) and negativity in 46 (50.5%) cases (p< 0.001). HER2 positive cases were positive for p53 stain in 8 (8.8%) and negative in 45 (49.5%) cases (p<0.001). Fifteen (16.48%) biopsies were negative for all three hormone receptors. P53 was positive in all of these hormone receptor negative tumors (15/15, 100%), although 9 (60%) showed strong positivity and 6 (40%) exhibited weak staining intensity of p53.
CONCLUSION: P53 overexpression is less frequent in hormone receptor positive breast cancers. However, hormone receptor negative (triple negative) tumors overwhelmingly overexpress p53 protein in tumor cells. P53, detected either immunohistochemically or serologically, can serve to predict poor prognosis and survival in breast cancer patients, unless newer anti-p53 treatments are introduced in Pakistan.
PMID: 30700357 [PubMed - in process]
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Pathologic Complete Response in HER2-Positive Breast Cancer Patients Receiving Trastuzumab in Neoadjuvant Setting.
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Pathologic Complete Response in HER2-Positive Breast Cancer Patients Receiving Trastuzumab in Neoadjuvant Setting.
J Coll Physicians Surg Pak. 2019 Feb;29(2):159-163
Authors: Sheikh F, Nazir A, Yasmeen S, Badar F, Ahmad U, Siddiqui N
Abstract
OBJECTIVE: To compare the pathological complete response in human epidermal growth factor receptor type 2 (HER-2) positive breast cancer patients getting neoadjuvant chemotherapy with or without trastuzumab.
STUDY DESIGN: Retrospective randomised double-arm observational study.
PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from 2008 to 2016.
METHODOLOGY: HER2-positive, lymph node positive, breast cancer patients receiving neoadjuvant chemotherapy (NACT) were retrospectively observed. Patients getting neoadjuvant trastuzumab, fulfilling the inclusion criteria were studied. The comparison group included randomly selected equal number of HER2-positive breast cancer patients having similar tumor characteristics, getting NACT only. Pathological complete response (pCR) was defined as no residual invasive or in situ residual tumor in breast tissue, or in the lymph nodes. One hundred and fifty-six patients were studied. Eighty-nine patients with HER2-positive disease received trastuzumab preoperatively. Sixty-four (n=64) patients received the complete standard dose of neoadjuvant trastuzumab along with chemotherapy. Almost equal number of patients (n=67) with HER2- positive disease were selected by random assortment for the reference group who did not receive trastuzumab before surgery.
RESULTS: The pathological complete response of study group was (n=32) 50%, which was 26.1% higher than the reference group (n=16) 23.9%; and this difference was statistically significant with a p-value of 0.002 (<0.05). The overall pCR was 36.6% (n=48).
CONCLUSION: Addition of trastuzumab to neoadjuvant chemotherapy doubled the pCR in HER2-positive breast cancer. Targeted therapy should be offered to all eligible patients with HER2-overexpressing breast cancer.
PMID: 30700356 [PubMed - in process]
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Discovery and characterization of a novel C-terminal peptide carboxyl methyltransferase in a lassomycin-like lasso peptide biosynthetic pathway
Abstract
Lasso peptides belong to a peculiar family of ribosomally synthesized and post-translationally modified peptides (RiPPs)—natural products with an unusual isopeptide-bonded slipknot structure. Except for assembling of this unusual lasso fold, several further post-translational modifications of lasso peptides, including C-terminal methylation, phosphorylation/poly-phosphorylation, citrullination, and acetylation, have been reported recently. However, most of their biosynthetic logic have not been elucidated except the phosphorylated paeninodin lasso peptide. Herein, we identified two novel lassomycin-like lasso peptide biosynthetic pathways and, for the first time, characterized a novel C-terminal peptide carboxyl methyltransferase involved in these pathways. Our investigations revealed that this new family of methyltransferase could specifically methylate the C terminus of precursor peptide substrates, eventually leading to lassomycin-like C-terminal methylated lasso peptides. Our studies offer another rare insight into the extraordinary strategies of chemical diversification adopted by lasso peptide biosynthetic machinery and predicated two valuable sources for methylated lasso peptide discovery.
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Neurenteric cyst of the ventral craniocervical junction: Case report and a literature review.
Neurenteric cyst of the ventral craniocervical junction: Case report and a literature review.
World Neurosurg. 2019 Jan 28;:
Authors: Menéndez RH, D'Osvaldo DH, Vilariño A, Amante MF, Dillon HS
Abstract
BACKGROUND: Neurenteric cysts (NCs) are rare, non-neoplastic lesions arising from a failure of dissolution of the transient neurenteric canal between the foregut and the notochord. They are most frecuently seen in the intradural extramedullary space in the lower cervical and upper thoracic spine. The authors describe a rare case of neurenteric cyst arising from the ventral cervicomedullary junction that was totally resected via a posterior approach.
CASE DESCRIPTION: A 24-year-old woman presented with a four week history of neck pain and progressive left hemiparesis. Admission magnetic resonance imaging (MRI) demonstrated an intradural extramedullary cystic mass lesion ventral to the upper spinal cord from medulla to C2. We performed a posterior approach and the lesion was totally removed. Surgical treatment resulted in resolution of the neurological impairments. The histological results were consistent with neurenteric cyst. Postoperative course was uneventful. At sixth month of follow-up the patient is asymptomatic and MRI shows no residual lesion.
CONCLUSION: Neurenteric cyst is a rare lesion of the craniospinal junction, and should be considered among differential diagnoses. Complete excision is the treatment of choice. In most instances a dorsal surgical approach will be satisfactory.
PMID: 30703605 [PubMed - as supplied by publisher]
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The Reliability of YouTube Videos Describing Stereotactic Radiosurgery: A Call for Action.
The Reliability of YouTube Videos Describing Stereotactic Radiosurgery: A Call for Action.
World Neurosurg. 2019 Jan 28;:
Authors: ReFaey K, Tripathi S, Bohnen AM, Waddle MR, Peterson J, Vazquez-Ramos C, Bondoc CM, Quiñones-Hinojosa A, Trifiletti DM
Abstract
BACKGROUND: Gamma Knife Radiosurgery (GKRS) was introduced in the 1960s and is currently used worldwide. The internet has become a foremost source of information utilized by patients and their families. In this study, we aim to evaluate the accuracy and reliability of the GKRS-related YouTube videos.
METHODS: We searched YouTube and the first three pages sorted according to "Relevance-Based Ranking" were included for analysis. Four independent healthcare workers from different disciplines evaluated the videos using the validated DISCERN tool.
RESULTS: Our search resulted in 65,774 videos and fourteen videos met inclusion criteria. Our study found 50% (7/14) were uploaded by university-affiliated hospitals, 14% of videos scored a 3; the search term "Radiosurgery for intraaxial brain lesions" had the highest percentage of moderate videos (DISCERN = 3) (50%).
CONCLUSION: Patients and caregivers turn to online sources to gather information about the disease. However, the available YouTube published videos were published without proper academic monitoring, as such a free platform, published videos tend to catches a general audience for different purposes which leads to diminishing in the quality control. Academic medical institutions should consider proper monitoring process for videos in order to improve the accuracy of the published information for the patients.
PMID: 30703604 [PubMed - as supplied by publisher]
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Direct Neck Exposure for Rescue Endovascular Mechanical Thrombectomy in a Patient with Acute Common Carotid Occlusion Concurrent with Type A Aortic Dissection.
Direct Neck Exposure for Rescue Endovascular Mechanical Thrombectomy in a Patient with Acute Common Carotid Occlusion Concurrent with Type A Aortic Dissection.
World Neurosurg. 2019 Jan 28;:
Authors: Lin CM, Chang CH, Chen SW, Huang YH, Yi-Chou Wang A, Chen CC
Abstract
BACKGROUND: Mechanical thrombectomy is an effective management for acute large vessel occlusion. However, when difficult anatomy is encountered in which the reperfusion catheter cannot be positioned well, the outcomes can be less than optimal. Herein, we presented a patient with right common carotid artery and internal carotid artery occlusion after repair of an acute type A aortic dissection. Successful mechanical thrombectomy and stenting through direct neck exposure and puncture was performed.
CASE DESCRIPTION: A 45-year-old male had a type A aortic dissection that presented with sudden onset neck pain and cold sweating. Aortic valve resuspension, proximal anastomosis of the ascending aortic graft, partial aortic arch graft replacement, and innominate artery reimplantation was performed. After the aortic surgery, left limb weakness was noted in the intensive care unit. Computed tomography angiography of the brain showed right common carotid artery (CCA) occlusion up to the internal carotid artery (ICA). The right CCA was exposed and directly punctured. A thrombus was successfully removed, and a total of 5 stents were deployed to treat the ICA and CCA dissection. Angiography showed a final TICI 3 result, and the patient had excellent clinically recovery.
CONCLUSIONS: Acute mechanical thrombectomy through open direct neck puncture due to an acute type A aortic dissection and concurrent CCA dissection and occlusion is an effective and optimal method.
PMID: 30703603 [PubMed - as supplied by publisher]
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Giant Thoracic Calcified Disc: Conservative Management with 3-Year Follow-up.
Giant Thoracic Calcified Disc: Conservative Management with 3-Year Follow-up.
World Neurosurg. 2019 Jan 28;:
Authors: Desai B, Kolcun JPG, Shaffrey ME
PMID: 30703602 [PubMed - as supplied by publisher]
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Comparison of Safety and Effect of Endovascular Treatments for Unruptured Intracranial Large or Giant Aneurysms in Internal Carotid Artery.
Comparison of Safety and Effect of Endovascular Treatments for Unruptured Intracranial Large or Giant Aneurysms in Internal Carotid Artery.
World Neurosurg. 2019 Jan 28;:
Authors: Yan P, Zhang Y, Liang F, Ma C, Liang S, Guo F, Jiang C
Abstract
PURPOSE: To analyze and compare the safety and efficacy of different endovascular treatment modalities for unruptured intracranial large or giant aneurysms.
METHODS: We retrospectively reviewed 126 consecutive patients with 128 large (15mm ≤size<25mm) or giant (≥ 25mm) aneurysms which were treated with different endovascular procedures between January 2014 and February 2017 in our center. We then compared clinical and angiographic outcomes, as well as the technical events rate among different treatment modalities.
RESULTS: In this study, complete occlusion at last follow-up was achieved in 65.6%, 90.5% and 72.0% of aneurysms in SAC, PAO and PED group (P=0.119). Both at 6 months (OR=1.81, P=0.396) and last angiographic follow-up (OR=3.64, P=0.123), PAO was not superior to PED regarding complete occlusion rate. Retreatment rate was statistically different among 3 groups (P<0.001) and the rate was highest in the SAC group (21.9%). The rates of hemorrhagic events and ischemic events were not significantly different among 3 groups (P=0.581). However, mass effect exacerbation was more frequently seen in SAC group (24.4% vs 7.7% and 3.3%, P=0.004). Major complication rate was higher in PAO group compared with PED group, however, the difference did not reach statistical difference (19.2% vs 16.4%, OR=1.21, P=0.763). The rate of technical events was statistically different in three groups (p=0.0437) and these problems occurred more often during the employment of PED (18.0%).
CONCLUSION: For large and giant aneurysms located in internal carotid artery, the outcome for endovascular treatment remains poor, even after the introduction of Pipeline embolization device.
PMID: 30703601 [PubMed - as supplied by publisher]
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The Relationship between Apoptosis of Endplate Microvasculature and Degeneration of the Intervertebral Disc.
The Relationship between Apoptosis of Endplate Microvasculature and Degeneration of the Intervertebral Disc.
World Neurosurg. 2019 Jan 28;:
Authors: Xu HM, Hu F, Wang XY, Tong SL
Abstract
OBJECTIVE: To explore the relationship between intervertebral disc degeneration and endplate microvasculature, and determine the role of apoptosis in the pathophysiology underlying endplate microvasculature.
METHODS: Twelve 6-month-old rabbits were randomly divided into Groups A (The Control Group, animals were accepted a sham operation, in which the loading device was implanted but without loading) and B (The Degeneration Group, a calibrated spring within the loading device would immediately create static shear force of 50 N to the disc of L4/5). Paraffin-embedded midsagittal sections of the L4-L5 disc were obtained 4 weeks after surgery in the both groups. Sections were stained with CD31 immunohistochemistry to measure the blood vessel density in the endplate, with CD31 immunofluorescence and the terminal dUTP nick-end labeling (TUNEL) to detect the apoptosis of vascular endothelial cells in the endplate.
RESULTS: After 4 weeks, the microvasculature density was 91 ± 8 vessels/mm2 in Group A, 47 ± 2 vessels/mm2 (P<0.001) in Group B, demonstrating that vessels were reduced in the endplate of intervertebral disc degeneration. The CD31 immunofluorescence and TUNEL showed that the apoptosis of vascular endothelial cells exists in the endplate of intervertebral disc degeneration.
CONCLUSIONS: The results of this study suggest that apoptosis of vascular endothelial cells results in a decrease in the endplate microvasculature density, further affect the pathological process of intervertebral disc degeneration.
PMID: 30703600 [PubMed - as supplied by publisher]
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The Great Auricular Nerve: Anatomical Study with Application to Nerve Grafting Procedures.
The Great Auricular Nerve: Anatomical Study with Application to Nerve Grafting Procedures.
World Neurosurg. 2019 Jan 28;:
Authors: Altafulla J, Iwanaga J, Lachkar S, Prickett J, Dupont G, Yilmaz E, Ishak B, Litvack Z, Tubbs RS
Abstract
INTRODUCTION: When it comes to autogenous nerve grafting, the sural and great auricular nerve are the two nerves predominately used for trigeminal and facial nerve repair. Arising from the second and third cervical ventral rami, the great auricular nerve emerges from the posterior border of the sternocleidomastoid coursing superiorly and anteriorly toward the ear.
MATERIALS AND METHODS: Eleven sides from five Caucasian and 1 Asian cadaveric heads (all fresh-frozen) were used. One male and five females were used with an age at death ranging from 57 to 91 years with a mean of 80.3 years. Measurements were made from the inferior border of the ear to the GAN, the distance from the GAN to EJV, the distance from the inferior border of the mastoid process to the GAN; the proximal, medial and distal diameters of the GAN were also measured as well as the length of the GAN that was obtained from this exposure.
CONCLUSIONS: The great auricular nerve is an excellent option for use in nerve grafting for repair of, for example, facial dysfunction. In this study, we review our measurements, techniques for identification and dissecting techniques for the GAN. The proximity to the operative area and minimal complications associated with GAN grafting might contribute to improved patient satisfaction and better outcomes for regarding functional restoration.
PMID: 30703599 [PubMed - as supplied by publisher]
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Comparison of outcomes between anterior cervical decompression and fusion and posterior laminoplasty in the treatment of four-level cervical spondylotic myelopathy.
Comparison of outcomes between anterior cervical decompression and fusion and posterior laminoplasty in the treatment of four-level cervical spondylotic myelopathy.
World Neurosurg. 2019 Jan 28;:
Authors: Chen Q, Qin M, Chen F, Ni B, Guo Q, Han Z
PMID: 30703598 [PubMed - as supplied by publisher]
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Low TGF-β3 expression predicts tumor malignancy in meningiomas.
Low TGF-β3 expression predicts tumor malignancy in meningiomas.
World Neurosurg. 2019 Jan 28;:
Authors: Ma J, Li D, Chen Y, Zhang Y, Song L, Tian K, Yang Y, Chen L, Weng J, Cao X, Hao S, Wang L, Wu Z, Zhang J
Abstract
OBJECTIVE: To clarify the expression characteristics and prognostic significance of TGF-β3 in cranial meningiomas.
METHODS: We analyzed the expression of TGF-β3 at the mRNA level in 38 frozen meningioma samples. Clinical data collection, follow-up, correlations and survival analyses were performed.
RESULTS: WHO grade I meningiomas showed an average expression level of 2.55, which was higher than that of WHO grade II (average of 1.50 ) and WHO grade III (average of 0.21 ) (Kruskal-Wallis test, P=0.008). For meningiomas with history of surgery, the mean TGF-β3 expression level was 0.71, much lower than that of primary meningiomas with a mean value of 2.55 (Mann-Whitney U-test, P=0.008). According to the Kaplan-Meier analysis and univariate Cox analysis, WHO grade (P=0.001), history of surgery (P<0.001), tumor volume (P=0.045), preoperative KPS (Karnofsky Performance Status, P=0.001), peritumoral brain edema (P=0.039), postoperative radiotherapy (P=0.001), degree of resection (P=0.039) and TGF-β3 expression (P=0.038) were prognostic factors for tumor recurrence. In addition, WHO grade (P<0.001), history of surgery (P<0.001), preoperative KPS (P=0.002), peritumoral brain edema (P=0.006), postoperative radiotherapy (P=0.007), bone invasion (P=0.03) and TGF-β3 expression (P=0.041) were prognostic factors for mortality.
CONCLUSIONS: TGF-β3 expression levels gradually declined with the increase of WHO grade and were lower in recurrent meningiomas than in primary meningiomas. Besides, low TGF-β3 expression was found to predict tumor recurrence and mortality in meningiomas based on univariate analysis.
PMID: 30703597 [PubMed - as supplied by publisher]
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Design and application of an individualized, three-dimensional-printed navigation template for placing cortical bone trajectory screws in the middle-upper thoracic spine: A cadaver research study.
Design and application of an individualized, three-dimensional-printed navigation template for placing cortical bone trajectory screws in the middle-upper thoracic spine: A cadaver research study.
World Neurosurg. 2019 Jan 28;:
Authors: Wang K, Zhang ZJ, Chen JX, Wu AM, Wang XY, Sheng SR
Abstract
OBJECTIVE: To evaluate the safety and accuracy of use of a three-dimensional (3D) printed navigation template in the placement of a cortical bone trajectory (CBT) screw in the middle-upper thoracic spine.
METHODS: Ten human cadavers were included in the study. Sixty CBT screws were placed on one side, using the free-hand technique, and 60 CBT screws were placed on the other side, using the navigation template that was designed and printed on the basis of the data of 10 cadavers. The safety and accuracy of use of the CBT screws were directly evaluated by radiography and computed tomography (CT).
RESULTS: CT revealed that 2 and 3 of 60 screws, placed using the navigation template, were broken in the medial or lateral areas and in the superior or inferior pedicle wall, respectively. Furthermore, 8 screws were broken in the medial or lateral areas and 11 screws were broken in the superior or inferior pedicle wall when the free-hand technique was used. Radiography revealed that 3 screws in zone I, 55 screws in zone II, and 2 screws in zone III were placed using the navigation template. Furthermore, 7 screws in zone I, 45 screws in zone II, and 8 screws in zone III were placed using the free-hand technique.
CONCLUSION: In this cadaver study, insertion of the CBT screws in the middle-upper thoracic spine with the assistance of the navigation template was safe and convenient.
PMID: 30703596 [PubMed - as supplied by publisher]
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Small Cell Lung Carcinoma Metastasis To Atypical Meningioma: The Importance Of Perfusion Mri Graphics In Differential Diagnosis.
Small Cell Lung Carcinoma Metastasis To Atypical Meningioma: The Importance Of Perfusion Mri Graphics In Differential Diagnosis.
World Neurosurg. 2019 Jan 28;:
Authors: Danisman Specialist MÇ, Koplay M, Paksoy Y, Keleşoğlu KS, Karabağlı P, Köktekir E
PMID: 30703595 [PubMed - as supplied by publisher]
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Endoscopic and microscopic segmental decompression via translaminar crossover spinal approach in elderly patients.
Endoscopic and microscopic segmental decompression via translaminar crossover spinal approach in elderly patients.
World Neurosurg. 2019 Jan 28;:
Authors: Rieger B, Sitoci-Ficici KH, Reinshagen C, Brautferger U, Schackert G, Molcanyi M, Pinzer T
Abstract
OBJECTIVE: For an effective minimally invasive lumbar decompression we changed the routine of segmental decompression. With a high-speed drill or an ultrasound knife we create a working channel, starting at the base of the spinous process of the upper vertebra slightly above the disc level, to target and decompress the contralateral recess: the translaminar crossover decompression (TCD). This study aims to evaluate the feasibility and compare outcomes of a navigation-guided endoscopic translaminar crossover approach for segmental decompression (eTCD) in elderly patients with microscopic decompression using the same approach (mTCD).
METHODS: A total of 740 elderly patients were enrolled in a prospective cohort study design. 297 mTCD patients and 253 eTCD patients completed 1-year follow-up visits. In addition to surgical data, numeric rating scales (NRS) for back and leg pain, core outcome measures index (COMI) and Oswestry disability index (ODI) were recorded preoperatively as well as three, six months and one year after surgery. MacNab criteria were supplemented by qualitative assessment of postoperative pain-free walking distance.
RESULTS: Comparison of preoperative and postoperative clinical scores showed significant improvement after TCD in both cohorts (p<0.01): ODI from 50.3% ± 12.6% to 15.5% ± 7.43%; NRS (back) from 6.9 ± 1.9 to 2.5 ± 1.3; NRS (leg) from 8.0 ± 0.85 to 1.6 ± 0.33; COMI (back) from 7.8 ± 2.0 to 2.7 ± 1.5 whereas there were no significant differences in outcome between the cohorts.
CONCLUSIONS: TCD inherently eliminates central stenosis and facilitates the decompression of both recesses via mutual undercutting while preserving facet joint integrity.
PMID: 30703594 [PubMed - as supplied by publisher]
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Single- versus Double-Barrel Superficial Temporal Artery to Middle Cerebral Artery Bypass: A Comparative Analysis.
Single- versus Double-Barrel Superficial Temporal Artery to Middle Cerebral Artery Bypass: A Comparative Analysis.
World Neurosurg. 2019 Jan 28;:
Authors: Burkhardt JK, Winkler EA, Gandhi S, Lawton MT
Abstract
INTRODUCTION: The superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass is the most common bypass for augmenting or restoring cerebral blood flow. While the single barrel (SB) STA-MCA bypass is sufficient in most cases, the double barrel (DB) STA-MCA bypass can supply the demands of different vascular territories or multiple efferent arteries. We present a comparative analysis of SB and DB STA-MCA bypass in a large, consecutive series to examine indications, surgical results, and patient outcomes.
METHODS: A retrospective review of a prospectively maintained database identified all STA-MCA bypasses performed by a single surgeon over 21 years.
RESULTS: In total, 261 patients received 378 STA-MCA bypasses in 351 surgeries. SB STA-MCA bypasses were performed in 234 patients (90%), while DB STA-MCA bypasses were performed in 27 patients (10%). Patients with DB STA-MCA bypasses were more likely to undergo bilateral bypass procedures than those receiving SB STA-MCA bypass (p <0.0001). In patients with bilateral STA-MCA bypasses (n=91, 35%), 69 patients received bilateral SB STA-MCA bypasses (76%), while 22 patients received a DB STA-MCA bypass on one hemisphere (24%). There was no difference in bypass patency or clinical outcome in patients with SB and DB STA-MCA bypasses.
CONCLUSIONS: DB STA-MCA bypasses are reserved for patients requiring revascularization of multiple vascular territories or efferent arteries. DB STA-MCA bypasses have patency rates and patient outcomes comparable to SB STA-MCA, with the advantages of a single incision and reduced operative complexity compared to high-flow bypasses. DB STA-MCA bypass is an important element in the vascular neurosurgeon's bypass armamentarium.
PMID: 30703593 [PubMed - as supplied by publisher]
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A Case of Primary Sellar Paraganglioma: Immunohistochemistry Resource and Review.
A Case of Primary Sellar Paraganglioma: Immunohistochemistry Resource and Review.
World Neurosurg. 2019 Jan 28;:
Authors: Lyne SB, Polster SP, Fidai S, Pytel P, Yamini B
Abstract
BACKGROUND: The differential diagnosis of sellar masses includes adenoma, meningioma, craniopharyngioma, and metastasis. Seldom is primary paraganglioma considered. Here we present a case of this unique pathology, review the relevant literature and compile a compendium of immunohistochemical characteristics for use as a resource.
CASE DESCRIPTION: A 73-year old female presented to the hospital with visual changes in her left hemifield. Non-contrasted head computer tomography (CT) demonstrated a large sellar mass with suprasellar extension and displacement of the optic chiasm (diameter of 3.1 cm). Magnetic resonance imaging was unobtainable due to an incompatible pacemaker. CT characterization was most consistent with a macroadenoma. Given the acute visual decline, surgical decompression via an endonasal transsphenoidal route was completed without complication. Histopathology revealed a diagnosis of paraganglioma. Following resection the patient's visual field deficit improved. CT body imaging was negative for a metastatic origin.
CONCLUSIONS: Paraganglioma is a rare but potential diagnosis when evaluating sellar masses.
PMID: 30703592 [PubMed - as supplied by publisher]
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Examination of plasma cell-free DNA of glioma patients by whole exome sequencing.
Examination of plasma cell-free DNA of glioma patients by whole exome sequencing.
World Neurosurg. 2019 Jan 28;:
Authors: Sun J, Zhou W, Mao K, He Y, Yao J, Tang Z, Song M, Liu Q, Zhu H, Ju S, Shi J, Shi W
Abstract
OBJECTIVES: To analyze the plasma cell-free DNA (cf-DNA) in glioma patients with high throughout sequencing for a novel non-invasive method for the early diagnosis and management of glioma.
METHODS: six patients with glioma were recruited from the Affiliated Hospital of Nantong University from June 2015 to September 2016. Their plasma samples were tested for Cf-DNA by Whole Exon Sequencing (WES) and mutations were analyzed by bioinformatics.
RESULTS: After filtering the raw sequencing data of Cf-DNA, 33,173 mutations were obtained from 12,462 genes, of which 442 genes and 655 mutation sites were identical to that in the Cosmic database. However, when we compared the Cf-DNA data with the glioma mutated loci in the TCGA database, only 4 mutations matched with the glioma sequences in TCGA, and did not correspond to that of the paired-tumor tissues.
CONCLUSIONS: There were some cancer-related somatic mutations in the Cf-DNA of glioma patients, but no identical mutations were found in the paired solid tumors. Therefore, plasma Cf-DNA mutations may not be a suitable marker for the detection of glioma.
PMID: 30703591 [PubMed - as supplied by publisher]
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The Impact of Colloid Cyst Treatment on Neuro-cognition.
The Impact of Colloid Cyst Treatment on Neuro-cognition.
World Neurosurg. 2019 Jan 28;:
Authors: Roth J, Sela G, Andelman F, Nossek E, Elran H, Ram Z
Abstract
BACKGROUND: Colloid cysts (CC) have been associated with neurocognitive function (NCF) decline, both preoperatively and following resection. Factors such as local pressure on the fornix and hydrocephalus are thought to contribute to preoperative NCF decline. Potential cause of post-operative decline is thought to be forniceal injury during surgery. In the current series, we describe NCF outcomes amongst patients with CC, both non-operated and operated.
METHODS: 36 patients (23 operated, 13 non-operated) were included in this retrospective study. All patients underwent at least one NCF evaluation battery. Five of the 13 non-operated cases had follow up tests too. Of the 23 operated, 14 had both pre-and post-operative tests, 8 had early and late postoperative tests.
RESULTS: There was no significant difference in baseline NCF between non-operated and operated cases (as evaluated preoperatively). Non-operated patients had a stable NCF test over time. Patients that were operated showed a significant improvement after surgery in several NCF variables. There was no significant change in NCF between early and late postoperative evaluation. None of the operated patients had a postoperative NCF decline.
CONCLUSIONS: Patients with CC should undergo routine NCF testing with a standardized protocol, whether they are operated or followed. Surgery has a positive impact on NCF; however, it remains to be determined if the improvement is solely secondary to treatment of hydrocephalus, or to a reduction of local pressure on the fornices. It remains to be determined whether the surgical technique - i.e. endoscopic, interhemispheric, or transcortical, has an impact on NCF outcome.
PMID: 30703590 [PubMed - as supplied by publisher]
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Predictors of periprocedural complications and angiographic outcomes of endovascular therapy in large and giant intracranial posterior circulation aneurysms.
Predictors of periprocedural complications and angiographic outcomes of endovascular therapy in large and giant intracranial posterior circulation aneurysms.
World Neurosurg. 2019 Jan 28;:
Authors: Liang F, Zhang Y, Yan P, Ma C, Liang S, Jiang P, Jiang C
Abstract
OBJECTIVE: To explore the predictors of periprocedural complications and angiographic outcomes in large and giant intracranial posterior circulation aneurysms after endovascular treatment.
METHODS: Ninety-nine patients with 103 large (size ≥10 mm, n=94) and giant (size >25 mm, n=9) posterior circulation aneurysms treated with endovascular therapy at a single center were retrospectively analyzed. Treatment procedures included endovascular trapping (n=15), coiling (n=6), stent only (n=10), stent-assisted coiling (n=48), and pipeline embolization device (PED, n=24). The outcome endpoints were the number of periprocedural complications and number of complete occlusions without any complication.
RESULTS: Multivariate analysis revealed that intradural vertebral aneurysms (P=0.041) and aneurysms ≤25 mm (P=0.042) were associated with a low periprocedural complication rate after endovascular therapy. Aneurysms not involving side branches (P=0.024) and intradural vertebral aneurysms (P=0.032) were predictors of complete aneurysm obliteration. There were no statistical differences in aneurysmal complete obliteration (P=0.119) and periprocedural complications (P=0.248) between PED and traditional stent and coiling. Additionally, aneurysms not involving side branches (P=0.030), intradural vertebral artery aneurysms (P=0.003), and aneurysms treated by PED (P=0.020) were more likely to achieve complete occlusion over time.
CONCLUSIONS: Aneurysm location, aneurysm size, and side branch involvement were predictors of periprocedural complications and angiographic outcomes of endovascular therapy in large and giant intracranial posterior circulation aneurysms. PED has no advantages over traditional stent and coiling in aneurysmal occlusion and periprocedural complications. Large case-control and long-term follow-up studies are needed to further explore the predictors of complications and angiographic outcomes and optimal treatment options for these aneurysms.
PMID: 30703589 [PubMed - as supplied by publisher]
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Extent of Depression in Juvenile and Adolescent Idiopathic Scoliosis Patients during Treatment with Braces.
Extent of Depression in Juvenile and Adolescent Idiopathic Scoliosis Patients during Treatment with Braces.
World Neurosurg. 2019 Jan 28;:
Authors: Lin T, Meng Y, Ji Z, Jiang H, Shao W, Gao R, Zhou X
Abstract
PURPOSE: To make a comparison between depression levels of juvenile and adolescent idiopathic scoliosis who underwent bracing and (2) to identify the factors that influenced the extent of depression of the patients.
METHODS: 112 AIS (adolescent idiopathic scoliosis) patients and 96 JIS (juvenile idiopathic scoliosis) patients were included in our study. The demographic characteristics and the SDS, SDQ, and CES-DC scores were used for the evaluation or selection of relative factors of depression in patients (and parents). Cognitive evaluations, based on the WISC-R scale and an independent evaluation that was based on the WeeFIM scale, were conducted.
RESULTS: The mean of the CES-DC index in the AIS group (38.3±3.0) was higher than that of the JIS group (23.8±4.6), and the differences were significant (p<0.05). Finally, the age of the initial bracing, the duration of bracing, parental depression, the Cobb angle at the initial age of bracing, cognitive function, independence, peer problems, prosocial behaviors, emotional symptoms, and total difficulties were significant factors in our regression model for the JIS patients; the AIS patients showed similar results, except for the age of the initial bracing, cognitive function, and independence.
CONCLUSIONS: AIS and JIS patients who underwent bracing showed differences in the extent of depression, and female adolescents were more vulnerable to depressive psychological statuses. Higher levels of cognitive function and independence, as well as an older age of bracing, a longer duration of bracing, a larger Cobb angle, negative attitudes of parents, and undesirable SDQ scores contributed to a higher depression extent.
PMID: 30703588 [PubMed - as supplied by publisher]
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Lipoma with agenesis of the corpus callosum: about 02 cases with literature review.
Lipoma with agenesis of the corpus callosum: about 02 cases with literature review.
World Neurosurg. 2019 Jan 28;:
Authors: Ben Elhend S, Belfquih H, Hammoune N, Athmane E, Mouhsine A
Abstract
Intra-cranial lipomas are extremely rare fat-containing lesion, comprising 0.1 to 0.5 of all primary brain tumours. LoCCs constitute the commonest variety of all intra-cranial lipomas ( 40 to 50 % ) and are associated with varying degrees of dysgenesis of corpus callosum [ 1 ], they generally remain asymptomatic. In this study, we report two cases of pericallosal lipomas admitted with seizures and discuss the clinical and radiological finding in the light of the litterature.
PMID: 30703587 [PubMed - as supplied by publisher]
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The Role of Additional Spine Surgery in the Management of Failed Back Surgery Syndrome, CRPS and Intractable Pain in the setting of Prior or Concurrent Spinal Cord Stimulation: Indications and Outcomes.
The Role of Additional Spine Surgery in the Management of Failed Back Surgery Syndrome, CRPS and Intractable Pain in the setting of Prior or Concurrent Spinal Cord Stimulation: Indications and Outcomes.
World Neurosurg. 2019 Jan 28;:
Authors: Maldonado-Naranjo AL, Golubovsky J, Frizon LA, Hogue O, Lobel DA, Machado AG, Steinmetz MP, Nagel SJ
Abstract
OBJECTIVE: Spinal cord stimulation (SCS) is both relatively safe and reversible. Although SCS is generally regarded as a last resort, some of these patients will have additional spinal surgery after the device is implanted or following its removal. The following is a descriptive study of subsequent spinal surgery following SCS.
MATERIALS AND METHODS: A retrospective review of patients who had percutaneous or paddle SCS leads placed at our institution between 2009 and 2016 was performed. Patients who only underwent trials or who did not undergo spine surgery following SCS implantation were excluded.
RESULTS: We identified 22 patients (5.7%) who underwent spine surgery during the course of SCS treatment, following SCS removal, or both, out of a total 383 patients who had paddle or/and percutaneous SCS. The most common additional spine interventions included 15 (42%) lumbosacral decompression and fusions. Out of 36 surgeries, the most frequent indications for subsequent intervention were stenosis/re-stenosis in 16 patients (73%) and spine deformity in 6 patients (27%). The median EQ-5D index preoperatively was 0.397 versus 0.678 in the postoperative group.
CONCLUSIONS: To our knowledge, this is the first study to describe spine surgery in the setting of SCS. Our results indicate that spine surgery subsequent or concurrent to SCS appears to occur in a minority of patients. Our study suggests a modest improvement in quality of life outcomes. Therefore, clinicians should take into account that patients may need further spine surgery despite the use of SCS, and thus may require re-evaluation by the spine team.
PMID: 30703586 [PubMed - as supplied by publisher]
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Use of antidepressants after colon cancer diagnosis and risk of recurrence.
Use of antidepressants after colon cancer diagnosis and risk of recurrence.
Psychooncology. 2019 Jan 31;:
Authors: Pocobelli G, Yu O, Ziebell RA, Aiello Bowles EJ, Fujii MM, Sterrett AT, Boggs JM, Chen L, Boudreau DM, Ritzwoller DP, Hubbard RA, Chubak J
Abstract
OBJECTIVES: Prior research examining the association between use of antidepressants after colon cancer diagnosis and risk of recurrence is scant. We evaluated this association among colon cancer patients diagnosed at two integrated health care delivery systems in the United States.
METHODS: We conducted a cohort study of stage I-IIIA colon cancer patients diagnosed at ≥18 years of age at Kaiser Permanente Colorado and Kaiser Permanente Washington during 1995-2014. We used pharmacy records to identify dispensings for antidepressants, and tumor registry records and patients' medical charts to identify cancer recurrences. Using Cox proportional hazards models, we estimated the adjusted hazard ratio (HR) of colon cancer recurrence comparing patients who used antidepressants after diagnosis to those who did not. We also evaluated the risk associated with use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) separately.
RESULTS: Among the 1,923 eligible colon cancer patients, 807 (42%) used an antidepressant after diagnosis and 139 had a colon cancer recurrence during an average 5.6 years of follow-up. Use of antidepressants after colon cancer diagnosis was not associated with risk of recurrence (HR: 1.14, 95% confidence interval [CI]: 0.69-1.87). The HR for use of SSRIs was 1.22 (95% CI: 0.64-2.30) and for TCAs it was 1.18 (95% CI: 0.68-2.07).
CONCLUSIONS: Our findings suggest that use of antidepressants after colon cancer diagnosis was common and not associated with risk of recurrence. Future larger studies with greater power to examine risk associated with individual antidepressants would be valuable additions to the evidence base.
PMID: 30703275 [PubMed - as supplied by publisher]
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Evaluating the Impact of Treatment Care Planning on Quality Measures.
Evaluating the Impact of Treatment Care Planning on Quality Measures.
J Oncol Pract. 2019 Jan 31;:JOP1800390
Authors: Rocque GB, Williams CP, Hathaway AR, Halilova KI, Stricker CT, Coombs NC, Dudley WN, Thomas KA, Gaguski M, Crist S, Kozlik MM, Larkin P, Cadden A, Jones MI
Abstract
PURPOSE:: The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients' engagement in their care plan.
METHODS:: A multicenter quality improvement project was conducted to develop a strategy to meet the OCM treatment planning (TP) requirement (Plan), pilot clinician education coupled with use of electronic TP in early-stage breast cancer (Do), evaluate the impact of TP on QOPI measures (Study), and develop recommendations for future implementation (Act).
RESULTS:: Thirty-three clinical providers and 171 women with breast cancer were included. Improved performance on several QOPI measures was observed for the intervention group compared with the historical control group.
CONCLUSION:: Meeting the OCM TP requirement through incorporating a technology solution provided an opportunity for quality improvement and preparation for full-scale TP within the OCM. TP delivery was associated with improved performance on select ASCO QOPI measures, which is likely to correspond with improved performance on quality measures within OCM.
PMID: 30702963 [PubMed - as supplied by publisher]
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Long-term survival of an elderly female with metastatic colon cancer after treated with capecitabine monotherapy: A case report.
Long-term survival of an elderly female with metastatic colon cancer after treated with capecitabine monotherapy: A case report.
Medicine (Baltimore). 2019 Feb;98(5):e14326
Authors: Liu J, Wang Y, Jiang H, Yu X, Xu N
Abstract
RATIONALE: Colorectal cancer (CRC) is one of the most common cancers all over the world, and approximately 70% of the newly diagnosed patients are over 65 years old. Due to the aging of society, there will be more and more elderly patients of CRC in the future. Treatment of CRC in elderly patients is much more challenging thanks to multiple factors including disabling comorbidities as well as declines in organs function, especially in advanced or metastatic settings.
PATIENT CONCERNS: An 82-year-old female without history of disease was admitted to the emergency room because of abdominal pain in December 2009. A computed tomography (CT) scan of the abdomen was performed immediately, which revealed bowel obstruction.
DIAGNOSES: The histopathological examination of the resected specimen confirmed well-to-moderately differentiated colonic adenocarcinoma with a stage of IIIB (T3N1M0) based on the NCCN tumor-node-metastasis (TNM) classification system.
INTERVENTIONS: The patient underwent emergency surgery and rejected adjuvant chemotherapy, but was diagnosed with multiple liver metastases 3 months later. Then she received capecitabine monotherapy as first-line treatment.
OUTCOMES: The efficacy achieved complete response (CR) when 8 cycles were completed and the agent was continued as maintenance treatment until totally 16 cycles were completed. Up to the latest follow-up, the disease remained CR and the progression-free survival (PFS) has achieved approximately 87 months. She is still alive and has good quality of life.
LESSONS: Capecitabine monotherapy may be an effective treatment in advanced or metastatic colorectal cancer (mCRC) for elderly patients.
PMID: 30702615 [PubMed - in process]
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Survival impact of treatment-related time intervals in nasopharyngeal carcinoma in the United States.
Survival impact of treatment-related time intervals in nasopharyngeal carcinoma in the United States.
Laryngoscope. 2019 Jan 31;:
Authors: Tham T, Ahn S, Teckie S, Roche A, Frank D, Kraus D, Costantino P
Abstract
OBJECTIVE: To determine if delayed or prolonged treatment-related time intervals (TRTIs) was associated with survival in patients with nasopharyngeal carcinoma (NPC) undergoing curative-intent concurrent chemoradiation (CCRT). The TRTIs investigated were duration of radiation treatment (RTd), time to radiation start (TTR), and time to chemotherapy start (TTC).
METHODS: Observational cohort study using the National Cancer Database (NCDB). In this observational cohort study, 3,893 eligible patients with NPC were identified from the NCDB. Patients received CCRT of at least 66 grays and radiation treatment time of at least 40 days. Separate univariable Cox regression model was used to analyze overall survival (OS) as a function of TRTIs, as well as for Charlson/Deyo Score, tumor classification, node classification, histological type, ethnicity, age, sex, and facility type. Upon finding significance at P < 0.05, the multivariable Cox regression analysis with backward elimination was performed to yield the final prediction model. Results were considered statistically significant when P < 0.05.
RESULTS: Radiation treatment was significantly associated with OS in the univariable analysis (hazard ratio: 1.006, 95% confidence interval = 1.004-1.008, P < 0.001). However, RTd was not related to OS in the multivariable analysis (P = 0.19). The TTR and TTC variables were not associated with OS in the univariable analysis (P = 0.88 and P = 0.88, respectively).
CONCLUSION: TRTIs were not independently associated with OS in this cohort of NPC patients in the NCDB. Future research into the association of TRTI with other disease outcomes, such as disease-free survival and locoregional control, is needed.
LEVEL OF EVIDENCE: NA. Laryngoscope, 2019.
PMID: 30702156 [PubMed - as supplied by publisher]
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Extended-release naltrexone versus standard oral naltrexone versus placebo for opioid use disorder: the NEAT three-arm RCT.
Extended-release naltrexone versus standard oral naltrexone versus placebo for opioid use disorder: the NEAT three-arm RCT.
Health Technol Assess. 2019 Jan;23(3):1-72
Authors: Strang J, Kelleher M, Mayet S, Day E, Hellier J, Byford S, Murphy C, McLennan B, Shearer J, Ryan E, Marsden J
Abstract
BACKGROUND: People recovering from heroin addiction need better treatments than are currently offered. The chronic relapsing nature of drug dependence means that helping a patient to achieve abstinence is often difficult. Naltrexone blocks the effects of ingested heroin; however, evidence is conflicting regarding the best delivery method.
OBJECTIVES: The primary purpose of the trial was to evaluate the clinical effectiveness and cost-effectiveness of extended-release naltrexone versus standard oral naltrexone versus relapse prevention therapy without medication for opioid use disorder (OUD).
DESIGN: This was a 3-year, definitive, three-centre, three-arm, parallel group, placebo-controlled, double-blind, double-dummy, randomised controlled trial.
SETTING: Two specialist NHS outpatient addiction clinics: one in London and one in Birmingham.
PARTICIPANTS: Planned study sample - 300 adult patients with OUD who had completed detoxification.
INTERVENTIONS: One iGen/Atral-Cipan Extended Release Naltrexone device (iGen/Atral-Cipan, Castanheira do Ribatejo, Portugal) (765 mg naltrexone or placebo) at day 0 of study week 1. Three weekly directly observed active or placebo oral naltrexone tablets (2 × 50 mg, Monday and Wednesday; 3 × 50 mg, Friday) at day 0 of study week 1 (for 4 weeks) and then an 8-week regimen of patient-administered dosing at the same dosing level.
MAIN OUTCOME MEASURE: The primary outcome measure was the proportion of heroin-negative urine drug screen (UDS) results at the end of the 12-week post-randomisation time point.
RESULTS: Six patients were recruited and randomised to receive study interventions. Two patients had no positive UDS samples for heroin during the 12-week treatment period, one patient had only one positive UDS sample and the remaining patients had two, six and eight positive UDS results for heroin. All patients had at least one missed clinic visit (range 1-14).
CONCLUSIONS: Considerable problems were encountered with (1) the stipulated requirement of a validated 'detoxified' status prior to the initiation of the study naltrexone, (2) the requirement for a consent cooling-off period and (3) delays awaiting the surgical implant procedure. Major upheaval to the organisation and delivery of NHS community treatment services across England led to extremely poor levels of actual entry of patients into the trial. Research-vital clinical and procedural requirements were, therefore, more challenging to implement. The potential therapeutic value of the opioid antagonist naltrexone still needs clear investigation, including comparison of the established oral form with the new ultra-long-acting depot implant formulations (for which no licensed products exist in Europe). Despite the small number of study participants, some tentative conclusions can be reached, relevant to potential future work. The blinding of the active/placebo medications appeared to be good. Self-report was not sufficient to detect instances of heroin use. Self-report plus UDS information provided a fuller picture. Instances of lapsed heroin use were not necessarily followed by full relapse, and future work should consider the lapse-relapse relationship. The prison release setting also warrants special consideration. In future, investigators should consider seeking ethics approval for studies in which clinical procedures to accelerate the treatment process are permitted, even if outside orthodox clinical practice, if they address a clinical need at the time of challenge and clinical risk. In addition, it may be appropriate to seek exemption from the ordinary requirement of a cooling-off period after securing consent because it is often essential to initiate treatment promptly.
TRIAL REGISTRATION: Current Controlled Trials ISRCTN95809946.
FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 3. See the NIHR Journals Library website for further project information.
PMID: 30702059 [PubMed - in process]
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Sunitinib in patients with pancreatic neuroendocrine tumors: update of safety data.
Sunitinib in patients with pancreatic neuroendocrine tumors: update of safety data.
Future Oncol. 2019 Jan 31;:
Authors: Valle JW, Borbath I, Rosbrook B, Fernandez K, Raymond E
Abstract
AIM: To describe the long-term safety of sunitinib in patients with progressive, well-differentiated, advanced/metastatic pancreatic neuroendocrine tumors.
PATIENTS & METHODS: Sunitinib- and placebo-treated patients from the Phase III study continued to receive sunitinib (37.5 mg on a continuous daily-dosing regimen) in two open-label extension studies.
RESULTS: Median (range) treatment exposure: 30.2 (0.7-269.4) and 87.1 (3.9-319.4) weeks for medium-term (n = 41) and long-term-treated (n = 61) populations, respectively. All patients experienced ≥1 adverse event (AE); 47 (45.6%) reported serious AEs. Common all-causality AEs: diarrhea (63.1%); neutropenia (43.7%); abdominal pain (40.8%). Fifteen (14.6%) patients discontinued treatment due to treatment-related AEs.
CONCLUSION: The safety of extended sunitinib treatment was consistent with the known safety profile of sunitinib in pancreatic neuroendocrine tumors.
PMID: 30701988 [PubMed - as supplied by publisher]
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First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality: results from SEARCH.
| Related Articles |
First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality: results from SEARCH.
Cancer Causes Control. 2019 Jan 30;:
Authors: Griffin K, Csizmadi I, Howard LE, Pomann GM, Aronson WJ, Kane CJ, Amling CL, Cooperberg MR, Terris MK, Beebe-Dimmer J, Freedland SJ
Abstract
PURPOSE: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP).
METHODS: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT.
RESULTS: During a median (IQR) follow-up of 81 (46-119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40-6.97), PCSM (HR 4.73; 95% CI 1.59-14.0), and ACM (HR 2.16; 95% CI 1.25-3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73-3.42), CRPC (HR 1.33; 95% CI 0.66-2.66), and PCSM (HR 2.44; 95% CI 0.84-7.11) were elevated, but not statistically significant.
CONCLUSIONS: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.
PMID: 30701374 [PubMed - as supplied by publisher]
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Back to the Colorectal Cancer Consensus Molecular Subtype Future.
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Back to the Colorectal Cancer Consensus Molecular Subtype Future.
Curr Gastroenterol Rep. 2019 Jan 30;21(2):5
Authors: Menter DG, Davis JS, Broom BM, Overman MJ, Morris J, Kopetz S
Abstract
PURPOSE OF REVIEW: This review seeks to provide an informed prospective on the advances in molecular profiling and analysis of colorectal cancer (CRC). The goal is to provide a historical context and current summary on how advances in gene and protein sequencing technology along with computer capabilities led to our current bioinformatic advances in the field.
RECENT FINDINGS: An explosion of knowledge has occurred regarding genetic, epigenetic, and biochemical alterations associated with the evolution of colorectal cancer. This has led to the realization that CRC is a heterogeneous disease with molecular alterations often dictating natural history, response to treatment, and outcome. The consensus molecular subtypes (CMS) classification classifies CRC into four molecular subtypes with distinct biological characteristics, which may form the basis for clinical stratification and subtype-based targeted intervention. This review summarizes new developments of a field moving "Back to the Future." CRC molecular subtyping will better identify key subtype specific therapeutic targets and responses to therapy.
PMID: 30701321 [PubMed - in process]
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Mass spectrometry-based absolute quantification of 20S proteasome status for controlled ex-vivo expansion of Human Adipose-derived Mesenchymal Stromal/Stem Cells.
| Related Articles |
Mass spectrometry-based absolute quantification of 20S proteasome status for controlled ex-vivo expansion of Human Adipose-derived Mesenchymal Stromal/Stem Cells.
Mol Cell Proteomics. 2019 Jan 30;:
Authors: Menneteau T, Fabre B, Garrigues L, Stella A, Zivkovic D, Roux-Dalvai F, Mouton-Barbosa E, Beau M, Renoud ML, Amalric F, Sensebe L, Gonzalez-de-Peredo A, Ader I, Burlet-Schiltz O, Bousquet MP
Abstract
The proteasome controls a multitude of cellular processes through protein degradation and has been identified as a therapeutic target in oncology. However, our understanding of its function and the development of specific modulators are hampered by the lack of a straightforward method to determine the overall proteasome status in biological samples. Here, we present a method to determine the absolute quantity and stoichiometry of ubiquitous and tissue-specific human 20S proteasome subtypes based on a robust, absolute SILAC-based multiplexed LC-Selected Reaction Monitoring (SRM) quantitative mass spectrometry assay with high precision, accuracy, and sensitivity. The method was initially optimized and validated by comparison with a reference ELISA assay and by analyzing the dynamics of catalytic subunits in HeLa cells following IFNγ-treatment and in range of human tissues. It was then successfully applied to reveal IFNγ- and O2-dependent variations of proteasome status during primary culture of Adipose-derived-mesenchymal Stromal/Stem Cells (ADSCs). The results show the critical importance of controlling the culture conditions during cell expansion for future therapeutic use in humans. We hypothesize that a shift from the standard proteasome to the immunoproteasome could serve as a predictor of immunosuppressive and differentiation capacities of ADSCs and, consequently, that quality control should include proteasomal quantification in addition to examining other essential cell parameters. The method presented also provides a new powerful tool to conduct more individualized protocols in cancer or inflammatory diseases where selective inhibition of the immunoproteasome has been shown to reduce side effects.
PMID: 30700495 [PubMed - as supplied by publisher]
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