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Δευτέρα 8 Νοεμβρίου 2021

Anterior cerebral artery trifurcation with infraoptic origin and contralateral A1 segment absence

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Surg Radiol Anat. 2021 Nov 6. doi: 10.1007/s00276-021-02855-x. Online ahead of print.

ABSTRACT

PURPOSE: To describe an uncommon anatomical variant of the anterior cerebral artery and the imaging findings.

METHODS: A 2-month-old infant with known history of atrial and ventricular septal defects was admitted to our institution for evaluation and management of growth failure. Given the clinical presentation and medical history, magnetic resonance imaging (MRI) of the brai n and MR angiography (MRA) were performed to exclude congenital hypopituitarism and any vascular abnormality.

RESULTS: Time of flight MRA revealed trifurcation of the anterior cerebral artery with one of the vessels arising from the ophthalmic segment of the right internal carotid artery; thus, the A1 segment of the left anterior cerebral artery (ACA) was absent, and the right posterior cerebral artery (PCA) had a fetal origin.

CONCLUSION: Anatomical variants of the cerebral circulation are asymptomatic and found incidentally. Knowledge of these variants and careful examination of CT/MRI angiograms are important for diagnosis and treatment planning.

PMID:34741640 | DOI:10.1007/s00276-021-02855-x

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A comparison between abdominal based and inner thigh based free flaps in breast reconstruction: A single surgeon's experience

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J Plast Reconstr Aesthet Surg. 2021 Oct 22:S1748-6815(21)00487-3. doi: 10.1016/j.bjps.2021.09.048. Online ahead of print.

NO ABSTRACT

PMID:34742658 | DOI:10.1016/j.bjps.2021.09.048

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Acute appendicitis secondary to desmoplastic melanoma metastasis in immune-checkpoint inhibitors era

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imageNo abstract available
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Prospective study of clinical characteristics of melanoma patients with retinopathy caused by a high-dose interferon α-2b

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imageRetinopathy is a rare side effect of interferon α-2b treatment. The goal of this study was to prospectively investigate the clinical characteristics of Chinese patients with melanomas who developed retinopathy following high doses of interferon α-2b (HD-IFN) therapy. The study included 56 melanoma stage I–III patients that were treated with HD-IFN. Fourty-three patients developed HD-IFN-induced retinopathies. Forty-three melanoma patients (76%) developed retinopathy after being treated with HD-IFN. Among these patients, 49% had cotton–wool spots, 19% had retinal hemorrhage, and 30% had retinal hemorrhage. The me dian time of occurrence of retinopathy was 4 weeks after treatment, and the median time of duration was 4 weeks. No patient showed other symptoms except one who had blurred vision. A comparison of clinical characteristics (age, gender, primary site, stage, and ulceration) and laboratory examinations (white blood cell and platelet counts, hemoglobin, serum lactate dehydrogenase, alanine transaminase, aspartate aminotransferase, triiodothyronine, thyroxine, thyroid-stimulating hormone, and lipid) between the HD-IFN-induced retinopathy patients and nonretinopathy patients did not show any significant differences (P > 0.05). Although all patients that developed retinopathy had diabetes or hypertension, an equal percentage of patients were without retinopathy had diabetes or hypertension. HD-IFN therapy in patients with melanomas may induce mild retinopathy. Our results; however, do not necessarily suggest to discontinue the HD-IFN treatment because retinopathy is a reversible disorder.
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Diagnostic and prognostic value of Beclin 1 expression in melanoma: a meta-analysis

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imageAutophagy plays a complicated role in the occurrence and development of cancer. Beclin 1 is a significant autophagy-related protein that plays an essential role in tumorigenesis, but its expression is controversial in melanoma. In this meta-analysis, we searched seven studies involving 638 melanoma patients. PubMed, Web of Science, Google Scholar, Elsevier, and Chinese National Knowledge Infrastructure were used for literature retrieval. The I2 index was used to assess heterogeneity. The expression of Beclin 1 in the primary melanoma group was significantly lower than the non-tumor group tissues (P 0.05). Different expres sion intensities of Beclin 1 did not affect the overall survival and disease-free survival of melanoma patients. This study showed a trend of low expression of Beclin 1 in melanoma; patients with low expression of Beclin 1 were prone to the possibility of distant metastasis. The inconsistent profile of Beclin 1 expression in the prognosis of melanoma patients warrants further clinical investigation.
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Novel strategy for applying hierarchical density-based spatial clustering of applications with noise towards spectroscopic analysis and detection of melanocytic lesions

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imageAdvancements in dermoscopy techniques have elucidated identifiable characteristics of melanoma which revolve around the asymmetrical constitution of melanocytic lesions consequent of unfettered proliferative growth as a malignant lesion. This study explores the applications of hierarchical density-based spatial clustering of applications with noise (HDBSCAN) in terms of the direct diagnostic implications of applying agglomerative clustering in the spectroscopic analysis of malignant melanocytic lesions and benign dermatologic spots. 100 images of benign (n = 50) and malignant moles (n = 50) were sampled from the Inter national Skin Imaging Collaboration Archive and processed through two separate Python algorithms. The first of which deconvolutes the three-digit tupled integer identifiers of pixel color in image composition into three separate matrices corresponding to the red, green and blue color channel. Statistical characterization of integer variance was utilized to determine the optimal channel for comparative analysis between malignant and benign image groups. The second applies HDBSCAN to the matrices, identifying agglomerative clustering in the dataset. The results indicate the potential diagnostic applications of HDBSCAN analysis in fast-processing dermoscopy, as optimization of clustering parameters according to a binary search strategy produced an accuracy of 85% in the classification of malignant and benign melanocytic lesions.
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Prospective Investigation of Postoperative Complications in Anterior Decompression with Fusion for Severe Cervical Ossification of the Posterior Longitudinal Ligament: A Multi-institutional Study

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Spine (Phila Pa 1976). 2021 Dec 1;46(23):1621-1629. doi: 10.1097/BRS.0000000000004088.

ABSTRACT

STUDY DESIGN: A prospective multicenter study.

OBJECTIVE: This study aims to investigate the postoperative complications of anterior decompression with fusion (ADF) for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL).

SUMMARY OF BACKGROUND DATA: Surgical treatment for cervical OPLL has a high risk of various complications. ADF is reported to be effective for cervical OPLL, especially for massive OPLL. However, few studies have focused on the surgical complications of ADF.

METHODS: We prospectively included 102 patients undergoing ADF for severe cervical OPLL with average canal occupying ratio of 49.8%. We evaluated systemic and local complications, neurological complications, and risk factors related to the postoperative complications.

RESULTS: Frequently observed complications included g raft/ implant complications (18.6%), neurological complications (11.8%), and cerebrospinal fluid leak (11.8%). Motor palsy involving only the upper extremity was found in nine patients (8.8%), and other motor palsies involving the lower extremities were found in three patients (2.9%). None of the preoperative factors were significantly associated with the occurrence of neurological palsies, whereas the number of operated levels was a significant factor related to the postoperative graft/implant complications (P = 0.003; odds ratio, 2.112). The incidence of graft/implant complications and related reoperation increased as the number of operated levels increased (especially four levels or more). Most motor palsies were observed immediately after surgery. Of the motor palsies in the bilateral upper extremities and palsies involving the lower extremities, 85.7% showed good recovery, whereas only 40% of unilateral upper extremity motor palsies showed good recovery during the follow-up per iod.

CONCLUSION: In ADF for cervical OPLL, the number of operated levels was a significant factor related to the postoperative complication. Specifically, the incidence of graft/implant complications and reoperation rate increased in ADF with four or more levels.Level of Evidence: 3.

PMID:34747909 | DOI:10.1097/BRS.0000000000004088

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The effect of systemic application of propolis on tongue damage and oral mucositis in rats exposed to radiation

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Eur Arch Otorhinolaryngol. 2021 Nov 8. doi: 10.1007/s00405-021-07159-9. Online ahead of print.

ABSTRACT

PURPOSE: In this experimental study, the effect of dose-dense systemic application of propolis on oral mucosity, histological changes in papilla, and inflammatory and hypoxic markers in rats exposed to radiation was investigated.

METHODS: Seven rats were in the control and 30 rats in the experimental group. Three experimental groups were formed. In Group 1 RT (15 Gy) was delivered only to the head and neck region. In Group 2, RT (15 Gy) and systemic administration of 100 mg/kg/ml propolis, in Group 3, RT (15 Gy) and systemic administration of 200 mg/kg/ml propolis were applied. Oral mucositis index (OMI) was scored in control and experimental groups. Proinflammatory markers [interleukin-6 (IL-6), myeloperoxidase (MPO), tumor-necrosis factor-α (TNF-α)] hypoxia markers [glucose transporter-1 (GLUT-1), hypoxia-inducible factor 1 α (HIF-1α)] were studied histomorphologically.

RESULTS: The significantly highest OMI score was observed in the G1. OMI score was statistically significantly decreased in experimental groups receiving systemic propolis, especially in G3. Proinflammatory markers increased significantly only in the experimental RT group, G1. Serum levels of MPO and TNF-α significantly decreased in the dose-dense systemic propolis arm. The highest levels of hypoxia markers (HIF-1α and GLUT-1) were detected in the RT group, then in G2, G3, and control groups in order of decreasing frequency. However, the difference between the groups did not reach the level of statistical significance.

CONCLUSION: Systemic propolis can be reduced acute mucositis with its anti-inflammatory effect without developing resistance to RT (tumor protection). However, greater number of clinical studies should be designed to arrive at definitive conclusions.

PMID:34746967 | DOI:10.1007/s00405-021-07159-9

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Progressive Protrusive Tongue Exercise Does Not Alter Aging Effects in Retrusive Tongue Muscles

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Front Physiol. 2021 Oct 21;12:740876. doi: 10.3389/fphys.2021.740876. eCollection 2021.

ABSTRACT

Purpose: Exercise-based treatment approaches for dysphagia may improve swallow function in part by inducing adaptive changes to muscles involved in swallowing and deglutition. We have previously shown that both aging and progressive resistance tongue exercise, in a rat model, can induce biological changes in the genioglossus (GG); a muscle that elevates and protrudes the tongue. However, the impacts of progressive resistance tongue exercise on the retrusive muscles (styloglossus, SG; hyoglossus, HG) of the tongue are unknown. The purpose of this study was to examine the impact of a progressive resistance tongue exercise regimen on the retrusive tongue musculature in the context of aging. Given that aging alters retrusive tongue muscles to more slowly contracting fiber types, we hypothesized that these biological changes may be mitigated by tongue exercise. Methods: Hyoglossus (HG) and styloglossus (SG) muscles of male Fischer 344/Brown Norway rats were assayed in age groups of young (9 months old, n = 24), middle-aged (24 months old, n = 23), and old (32 months old, n = 26), after receiving an 8-week period of either progressive resistance protrusive tongue exercise, or sham exercise conditions. Following exercise, HG and SG tongue muscle contractile properties were assessed in vivo. HG and SG muscles were then isolated an d assayed to determine myosin heavy chain isoform (MyHC) composition. Results: Both retrusive tongue muscle contractile properties and MyHC profiles of the HG and SG muscles were significantly impacted by age, but were not significantly impacted by tongue exercise. Old rats had significantly longer retrusive tongue contraction times and longer decay times than young rats. Additionally, HG and SG muscles showed significant MyHC profile changes with age, in that old groups had slower MyHC profiles as compared to young groups. However, the exercise condition did not induce significant effects in any of the biological outcome measures. Conclusion: In a rat model of protrusive tongue exercise, aging induced significant changes in retrusive tongue muscles, and these age-induced changes were unaffected by the tongue exercise regimen. Collectively, results are compatible with the interpretation that protrusive tongue exercise does not induce changes to retrusive tongue muscle function.

PMID:34744782 | PMC:PMC8567011 | DOI:10.3389/fphys.2021.740876

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Congenital Hypothyroidism Can Dictate the Mode of Delivery and Intra-Labor Medication Usage

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Thyroid, Ahead of Print.
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