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The Kobe Journal of Medical Sciences Jun 2024Olfactory neuroblastoma (ONB) is an uncommon malignant tumor and is usually treated by a multidisciplinary approach includes surgery, radiotherapy, and chemotherapy. A...
Olfactory neuroblastoma (ONB) is an uncommon malignant tumor and is usually treated by a multidisciplinary approach includes surgery, radiotherapy, and chemotherapy. A 62 years-old male had a tumor in the nasal cavity and diagnosed as ONB with Kadish A stage. Anterior skull base surgery was performed as radical treatment. Since the surgical margin was negative, no postoperative radiotherapy was administered. 14 years after the surgery, bilateral otitis media with effusion (OME) was occurred, we found the recurrence tumor at bilateral retropharyngeal lymph node (RPLN) which surrounded the internal carotid arteries. Since these were unresectable, we planned chemoradiotherapy which was 70Gy of intensity modulated radiotherapy combined with two courses of carboplatin and etoposide. The tumor volume was reduced and bilateral OME were improved. He has been alive for 3 years after salvage treatment. Although ONB has a relatively good prognosis, it is known to often cause cervical lymph node metastasis. Grades III and IV of Hyams classification are considered high risk. This case, initial tumor was limited in the nasal cavity and its clinical classification was early stage, but Hyams classification was grade III. In reference to this case, considering that RPLN metastasis are difficult to radically resect at the salvage surgery, including this area in postoperative radiotherapy was considered an option.
Topics: Humans; Male; Esthesioneuroblastoma, Olfactory; Middle Aged; Lymphatic Metastasis; Nose Neoplasms; Nasal Cavity; Skull Base; Neoplasm Recurrence, Local; Chemoradiotherapy
PubMed: 38936878
DOI: 10.24546/0100489917 -
PLoS Genetics Jun 2024Sperm heads contain not only the nucleus but also the acrosome which is a distinctive cap-like structure located anterior to the nucleus and is derived from the Golgi...
Sperm heads contain not only the nucleus but also the acrosome which is a distinctive cap-like structure located anterior to the nucleus and is derived from the Golgi apparatus. The Golgi Associated RAB2 Interactors (GARINs; also known as FAM71) protein family shows predominant expression in the testis and all possess a RAB2-binding domain which confers binding affinity to RAB2, a small GTPase that is responsible for membrane transport and vesicle trafficking. Our previous study showed that GARIN1A and GARIN1B are important for acrosome biogenesis and that GARIN1B is indispensable for male fertility in mice. Here, we generated KO mice of other Garins, namely Garin2, Garin3, Garin4, Garin5a, and Garin5b (Garin2-5b). Using computer-assisted morphological analysis, we found that the loss of each Garin2-5b resulted in aberrant sperm head morphogenesis. While the fertilities of Garin2-/- and Garin4-/- males are normal, Garin5a-/- and Garin5b-/- males are subfertile, and Garin3-/- males are infertile. Further analysis revealed that Garin3-/- males exhibited abnormal acrosomal morphology, but not as severely as Garin1b-/- males; instead, the amounts of membrane proteins, particularly ADAM family proteins, decreased in Garin3 KO spermatozoa. Moreover, only Garin4 KO mice exhibit vacuoles in the sperm head. These results indicate that GARINs assure correct head morphogenesis and some members of the GARIN family function distinctively in male fertility.
PubMed: 38935810
DOI: 10.1371/journal.pgen.1011337 -
PloS One 2024To evaluate structural alterations and healing responses in the trabecular meshwork region with optical coherence tomography (AS-OCT) following after gonioscopy assisted...
PURPOSE
To evaluate structural alterations and healing responses in the trabecular meshwork region with optical coherence tomography (AS-OCT) following after gonioscopy assisted transluminal trabeculotomy (GATT) and microincisional trabeculectomy (MIT).
METHODS
73 eyes of 67 patients (M:F = 45:22) with ≥6 months of follow-up after MIT (n = 41) or GATT (n = 32) with or without combined cataract surgery were included for this prospective study. The angle as seen on AS-OCT at 1, 3, 6 months after surgery were evaluated for structural alterations like peripheral anterior synechiae (PAS), hyphema, and hyperreflective scarring responses. The scarring was graded according to the linear extent measured from the centre of the trabecular meshwork (TM) gutter to the sclera/cornea as mild (<250μ), moderate (250-500μ), and severe(˃500μ), while the pattern of scarring was graded as open saucer/gutter, closed gutter, and trench pattern. The association of the need for medication or surgical outcome and clinical variables and AS-OCT parameters including the pattern and severity of scarring were analysed using multivariate regression.
RESULTS
All eyes achieved significant reduction of IOP and number of medications with a final IOP of 15±3.2mm Hg at a mean follow-up of 8±32. months. While mild scarring was seen more common in MIT, severe scarring was seen in >65% of GATT eyes compared to 31% of MIT eye, p<0.001. An open saucer was equally seen in MIT and GATT while the trench pattern was more commonly seen in GATT eyes (>50%). Severe scarring in a trench pattern seemed to predict the need for medications for IOP control, though they independently did not seem to influence the final IOP or surgical outcome.
CONCLUSION
A severe form of scarring in a trench pattern on AS-OCT predicted the need for glaucoma medications after MIGS surgery. Regular monitoring of the scarring responses by AS-OCT and clinical examination are necessary to identify those at need for medications after MIGS.
Topics: Humans; Male; Tomography, Optical Coherence; Female; Aged; Trabeculectomy; Middle Aged; Glaucoma; Prospective Studies; Trabecular Meshwork; Wound Healing; Intraocular Pressure; Gonioscopy; Treatment Outcome
PubMed: 38935644
DOI: 10.1371/journal.pone.0305740 -
PloS One 2024Although sloped surfaces are common in daily living, most studies of body balance are carried out on flat surfaces, and few data are available for sloping angles below...
INTRODUCTION
Although sloped surfaces are common in daily living, most studies of body balance are carried out on flat surfaces, and few data are available for sloping angles below 14°.
OBJECTIVES
The purpose of this study was to explore the effect of forward and backward sloping surfaces at 7° and 15° on postural equilibrium and the activity of flexor/extensor ankle muscles.
METHODS
Fifteen healthy subjects (8 males and 7 females) (27.67 ± 3.9 years) underwent a posturographic examination associated with a surface electromyogram (EMG) of tibialis anterior (TA), soleus (Sol) and gastrocnemius medialis (GasM) under five conditions of support inclination: 0° (H0), backward inclination at 7° and 15° (DF7 and DF15), forward inclination at 7° and 15° (PF7 and PF15).
RESULTS
Results showed that the center of pressure (CP) was shifted according to the surface slope, with a forward move in PF7 (p <0.001) and PF15 (p <0.001) and a backward move in DF7 (p <0.01) and in DF15 (p <0.001). The mean displacement of the CP along the anterior-posterior axis (Xm) was increased in DF15 (p <0.01) relative to the H0 condition but reduced in PF7 (p <0.01). The normalized EMG revealed higher values when the muscles were in a shortened position (PF7 for Sol, p <0.05; PF15 for GasM, p <0.01; DF15 for TA, p<0.01) and lower values of GasM and Sol when lengthened (DF15, p <0.05).
CONCLUSION
Our findings indicate that standing on a backward sloped surface impairs body balance, while low-angle forward sloped surfaces might improve postural stability. Muscular activity variations of the ankle flexors/extensors, which are stretched or shortened, also seem to be related to the length-tension relationship of skeletal muscles.
Topics: Humans; Male; Female; Adult; Muscle, Skeletal; Postural Balance; Electromyography; Ankle; Young Adult; Ankle Joint
PubMed: 38935639
DOI: 10.1371/journal.pone.0305840 -
Journal of the American Heart... Jun 2024Anterior-posterior electrode placement is preferred in electrical cardioversion of atrial fibrillation. However, the optimal anterior-posterior electrode position in...
BACKGROUND
Anterior-posterior electrode placement is preferred in electrical cardioversion of atrial fibrillation. However, the optimal anterior-posterior electrode position in relation to the heart is not studied.
METHODS AND RESULTS
We performed a prospective observational study on patients presenting for cardioversion of atrial fibrillation. Electrodes were placed in the anterior-posterior position and shock was delivered in a step-up approach (100 J→200 J→360 J). Fluoroscopic images were obtained, and distances were measured from points A, midanterior electrode; and B, midposterior electrode, to midpoint of the cardiac silhouette. Patients requiring one 100 J shock for cardioversion success (group I) were compared with those requiring >1 shock/100 J (group II). Logistic regression was used to determine the impact of electrode distance on low energy (100 J) cardioversion success. Computed tomography scans from this cohort were analyzed for anatomic landmark correlation to the cardiac silhouette. Of the 87 patients included, 54 (62%) comprised group I and 33 (38%) group II. Group I had significantly lower distances from the mid-cardiac silhouette to points A (5.0±2.4 versus 7.4±3.3 cm; <0.001) and B (7.3±3.0 versus 10.0±3.8 cm; =0.002) compared with group II. On multivariate analysis, higher distances from the mid-cardiac silhouette to point A (odds ratio, 1.33 [95% CI, 1.07-1.70]; =0.01) and B (odds rsatio, 1.24 [95% CI, 1.05-1.50]; =0.01) were independent predictors of low energy (100 J) cardioversion failure. Based on review of computed tomography scans, we suggest that the xiphoid process may be an easy landmark to guide proximity to the myocardium.
CONCLUSIONS
In anterior-posterior electrode placement, closer proximity to the cardiac silhouette predicts successful 100 J cardioversion irrespective of clinical factors.
PubMed: 38934869
DOI: 10.1161/JAHA.123.034817 -
Journal of the American Heart... Jun 2024Outcomes from cardiopulmonary resuscitation (CPR) following sudden cardiac arrest are suboptimal. Postresuscitation targeted temperature management has been shown to...
BACKGROUND
Outcomes from cardiopulmonary resuscitation (CPR) following sudden cardiac arrest are suboptimal. Postresuscitation targeted temperature management has been shown to have benefit in subjects with sudden cardiac arrest due to ventricular fibrillation, but there are few data for outcomes from sudden cardiac arrest due to pulseless electrical activity. In addition, intra-CPR cooling is more effective than postresuscitation cooling. Physical cooling is associated with increased protein kinase B activity. Therefore, our group developed a novel peptide, TAT-PHLPP9c, which regulates protein kinase B. We hypothesized that when given during CPR, TAT-PHLPP9c would improve survival and neurologic outcomes following pulseless electrical activity arrest.
METHODS AND RESULTS
In 24 female pigs, pulseless electrical activity was induced by inflating balloon catheters in the right coronary and left anterior descending arteries for ≈7 minutes. Advanced life support was initiated. In 12 control animals, epinephrine was given after 1 and 3 minutes. In 12 peptide-treated animals, 7.5 mg/kg TAT-PHLPP9c was also administered at 1 and 3 minutes of CPR. The balloons were removed after 2 minutes of support. Animals were recovered and neurologically scored 24 hours after return of spontaneous circulation. Return of spontaneous circulation was more common in the peptide group, but this difference was not significant (8/12 control versus 12/12 peptide; =0.093), while fully intact neurologic survival was significantly more common in the peptide group (0/12 control versus 11/12 peptide; <0.00001). TAT-PHLPP9c significantly increased myocardial nicotinamide adenine dinucleotide levels.
CONCLUSIONS
TAT-PHLPP9c resulted in improved survival with full neurologic function after sudden cardiac arrest in a swine model of pulseless electrical activity, and the peptide shows potential as an intra-CPR pharmacologic agent.
PubMed: 38934857
DOI: 10.1161/JAHA.123.033371 -
Indian Journal of Dental Research :... Jan 2024Rehabilitation of partially edentulous arches with a cast partial denture is a commonly opted treatment modality where fixed prosthesis is not indicated. However, due to...
Rehabilitation of partially edentulous arches with a cast partial denture is a commonly opted treatment modality where fixed prosthesis is not indicated. However, due to the aesthetic compromise of the various metal components when placed in the esthetic zone, different modifications have been considered for its fabrication. This case report describes a novel way of restoring partially edentulous arches with increased masticatory efficiency and good emergence profile without compromising the patient's esthetic desires. The report describes an aesthetic alternative using thermoplastic denture base clasp like extension for anterior abutment teeth while restoring the missing teeth with a cast partial denture.
Topics: Humans; Dental Abutments; Denture Design; Denture Bases; Jaw, Edentulous, Partially; Esthetics, Dental; Dental Clasps; Female; Male
PubMed: 38934758
DOI: 10.4103/ijdr.ijdr_97_23 -
Journal of Surgical Case Reports Jun 2024Chest wall sarcomas are reported to be infrequent among thoracic tumors. The spindle cell subtype makes up a small percentage of this group. These tumors can be...
Chest wall sarcomas are reported to be infrequent among thoracic tumors. The spindle cell subtype makes up a small percentage of this group. These tumors can be asymptomatic or cause symptoms of chest pain and shortness of breath due to the mass effect, which can lead to a delay in diagnosis. A 10-year-old female with a persistent cough, shortness of breath on exertion, and left-sided chest pain presented to the ED. Imaging indicated a chest wall mass filling the left hemithorax with a rightward mediastinal shift. During surgical resection, two tumors were removed, with resection of parts of the latissimus dorsi and serratus anterior. A diagnosis of MGA:NUTM1 spindle cell sarcoma was made pathologically. The patient was successfully treated with surgery and adjuvant chemoradiotherapy. We hope to add to our academic knowledge by presenting the presentation and treatment of SCS in a pediatric patient.
PubMed: 38933828
DOI: 10.1093/jscr/rjae431 -
Frontiers in Veterinary Science 2024A spayed, 8-year-old female Poodle, weighing 5.7 kg, was presented with the chief complaint of vision impairment. Vision assessment, including pupillary light...
Case report: Unilateral papilledema in a dog with a large suprasellar mass and suspected intracranial hypertension: insights from funduscopy, optical coherence tomography, and magnetic resonance imaging.
A spayed, 8-year-old female Poodle, weighing 5.7 kg, was presented with the chief complaint of vision impairment. Vision assessment, including pupillary light reflexes, menace response, dazzle reflex, and maze navigation in photopic and scotopic circumstances, revealed a negative response in both eyes except for positive direct pupillary light reflex in the right eye and positive consensual pupillary light reflex from the right eye to the left eye. Systemic evaluation, including neurologic status, blood profile, and thoracic radiographs, did not reveal any abnormalities. Complete ophthalmic examinations, ocular ultrasonography, and electroretinography did not identify a cause of blindness. Upon funduscopy, the left eye exhibited an increased optic disk diameter, blurred optic disk borders, and loss of the physiologic pit, as well as an increase in vascular tortuosity. In the right eye, there were multifocal depigmented areas in the non-tapetal fundus and several pigmented spots surrounded by a region of dull tapetal reflection in the tapetal fundus. The optical coherence tomography revealed severe anterior deformation of the optic nerve head and Bruch's membrane in the peripapillary region of the left eye. Magnetic resonance imaging revealed an irregular, broad-based suprasellar mass, with features suggestive of intracranial hypertension, including dorsal displacement of third ventricles, a rightward shift of the falx cerebri, -tentorial herniation, perilesional edema, flattening/protrusion of the posterior sclera, and lager optic nerve sheath diameter in left side than right side. This is the first comprehensive report that describes unilateral papilledema in a dog with a brain tumor, using advanced ophthalmic and neuro-imaging modalities.
PubMed: 38933701
DOI: 10.3389/fvets.2024.1372802 -
Frontiers in Bioengineering and... 2024Achieving an adequate level of detail is a crucial part of any modeling process. Thus, oversimplification of complex systems can lead to overestimation,...
Achieving an adequate level of detail is a crucial part of any modeling process. Thus, oversimplification of complex systems can lead to overestimation, underestimation, and general bias of effects, while elaborate models run the risk of losing validity due to the uncontrolled interaction of multiple influencing factors and error propagation. We used a validated pipeline for the automated generation of multi-body models of the trunk to create 279 models based on CT data from 93 patients to investigate how different degrees of individualization affect the observed effects of different morphological characteristics on lumbar loads. Specifically, individual parameters related to spinal morphology (thoracic kyphosis (TK), lumbar lordosis (LL), and torso height (TH)), as well as torso weight (TW) and distribution, were fully or partly considered in the respective models according to their degree of individualization, and the effect strengths of these parameters on spinal loading were compared between semi- and highly individualized models. T-distributed stochastic neighbor embedding (T-SNE) analysis was performed for overarching pattern recognition and multiple regression analyses to evaluate changes in occurring effects and significance. We were able to identify significant effects ( < 0.05) of various morphological parameters on lumbar loads in models with different degrees of individualization. Torso weight and lumbar lordosis showed the strongest effects on compression ( ≈ 0.9) and anterior-posterior shear forces ( ≈ 0.7), respectively. We could further show that the effect strength of individual parameters tended to decrease if more individual characteristics were included in the models. The induced variability due to model individualization could only partly be explained by simple morphological parameters. Our study shows that model simplification can lead to an emphasis on individual effects, which needs to be critically assessed with regard to complexity. At the same time, we demonstrated that individualized models representing a population-based cohort are still able to identify relevant influences on spinal loading while considering a variety of influencing factors and their interactions.
PubMed: 38933541
DOI: 10.3389/fbioe.2024.1363081