Safety and immunogenicity of VGX-3100 formulations in a healthy young adult population.

HPV remains the most common sexually transmitted disease worldwide, despite improvements in awareness, screening, prophylactic vaccination uptake, and surgical treatment. VGX-3100 is an immunotherapy that uses electroporation to introduce DNA encoding for modified HPV-16 and HPV-18, E6-and E7 proteins into myocytes to stimulate an effector T cell response. We now report immunogenicity and safety of VGX-3100 for a refrigeration-stable formulation, which improves patient-care setting usability.

Exploration of Morbidity in a Serial Study of Long-Term Brain Tumor Survivors: A Focus on Pain.

Purpose: Children surviving brain tumors are frequently identified as having substantially decreased health-related quality of life (HRQL) in cross-sectional studies. This study explored the HRQL of a cohort of such survivors, who were recruited as adolescents and followed for a decade, in order to determine the trajectory of their morbidities.

Method: Children diagnosed between January 1, 1985, and December 31, 1998, more than 2 years from diagnosis (N = 40), were recruited in 2000/2001 (T1) aged 16.

Health-related Quality of Life in Long-term Survivors of Brain Tumors in Childhood and Adolescence: A Serial Study Spanning a Decade.

Survivors of brain tumors in childhood experience adverse sequelae that are greater in prevalence and severity than those encountered by survivors of all other forms of cancer in early life, reflected in a burden of morbidity by instruments measuring health-related quality of life (HRQL). However, there are few studies of the change in HRQL over time in such populations. Patients who were above 5 years of age, at least 2 years from completion of therapy, and able to communicate in English were eligible for study of HRQL by the Health Utilities Index HUI2 and HUI3 at study entry, and again 5 and 10 years later.

A Balanced Protocol for Return to School for Children and Youth Following Concussive Injury.

Background: Few protocols exist for returning children/youth to school after concussion. Childhood concussion can significantly affect school performance, which is vital to social development, academic learning, and preparation for future roles. The goal of this knowledge translation research was to develop evidence based materials to inform physicians about pediatric concussion.

Development of a conservative protocol to return children and youth to activity following concussive injury.

Background: Consensus-based guidelines exist for adult athletes returning to play after concussion, but there are no protocols developed specifically for children. The goal of this knowledge translation research was to develop evidence-based materials to inform physicians about pediatric concussion.

Methods: A pediatric concussion protocol was developed based on the National Institute for Health and Care Excellence procedures.

Bmi1 marks intermediate precursors during differentiation of human brain tumor initiating cells.

The master regulatory gene Bmi1 modulates key stem cell properties in neural precursor cells (NPCs), and has been implicated in brain tumorigenesis. We previously identified a population of CD133+ brain tumor cells possessing stem cell properties, known as brain tumor initiating cells (BTICs). Here, we characterize the expression and role of Bmi1 in primary minimally cultured human glioblastoma (GBM) patient isolates in CD133+ and CD133- sorted populations.

Sonic hedgehog regulates Bmi1 in human medulloblastoma brain tumor-initiating cells.

Bmi1 is a key stem cell regulatory gene implicated in the pathogenesis of many aggressive cancers, including medulloblastoma. Overexpression of Bmi1 promotes cell proliferation and is required for hedgehog (Hh) pathway-driven tumorigenesis. This study aimed to determine if Sonic hedgehog (Shh) modulates the key stem cell regulatory gene Bmi1 in childhood medulloblastoma brain tumor-initiating cells (BTICs).

"My child doesn't have a brain injury, he only has a concussion".

Objective: The term "concussion" is frequently used in clinical records to describe a traumatic head injury; however, there are no standard definitions of this term, particularly in how it is used with children. The goals of this study were to examine the clinical correlates of the concussion diagnosis and to identify the factors that lead to the use of this term in a regional pediatric center.

Methods: Medical data were prospectively collected from 434 children with traumatic brain injury who were admitted to a Canadian children's hospital.

Navigating the gray zone: a guideline for surgical decision making in obstetrical brachial plexus injuries.

Object: In the literature, the best recommendations are imprecise as to the timing and selection of infants with obstetrical brachial plexus injury (OBPI) for surgical intervention. There is a gray zone (GZ) in which the decision as to the benefits and risks of surgery versus no surgery is not clear. The authors propose to describe this category, and they have developed a guideline to assist surgical decision-making within this GZ.

Ventricular catheter tack-down screw.

The frequent need for revision of ventriculoperitoneal shunts particularly in the pediatric population is a well-known complication of the procedure. A not infrequent etiology demanding revision is the dislodgement of the catheter, particularly, in our experience, with posterior fossa shunts. Suturing the shunt to the periosteum is a common practice amongst pediatric neurosurgeons.

Management of traumatic dislocation of the mandibular condyle into the middle cranial fossa.

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of facial trauma that can have neurological and life-threatening implications. This article discusses the anatomic features that predispose patients to this type of injury, as well as the clinical features and mechanism of injury for this rare type of condylar deformity, to help practitioners recognize this easily overlooked injury and avoid disastrous complications. The article summarizes previously published case reports of this rare complication of condylar trauma and presents a case for which initial diagnosis and a management protocol are described.

Fracture of glenoid fossa and traumatic dislocation of mandibular condyle into middle cranial fossa.

Traumatic mandibular condyle dislocations into the middle cranial fossa are rare. Thirty-three cases of middle cranial fossa injuries caused by condylar dislocations have been reported in the literature. A case report of a patient with a traumatic dislocated condyle into the middle cranial fossa, which was treated conservatively, is presented.

Variations on a segmental theme: muscle receptor organs and extensor neuromusculature in the squat lobster Munida quadrispina (Anomura, Galatheidae).

Extensor neuromusculature and the muscle receptor organs (MROs) associated with them have been conserved during the evolution of malacostracan crustaceans, despite species-specific differences between homologous segments in divergent taxa. Investigations of these differences could provide insight into how sensory and neuromuscular elements are modified to accommodate changing behavioural patterns. The most obvious differences between squat lobsters (galatheid anomurans) and macruran decapods, such as crayfish, are the greater dorso-ventral flattening of the galatheid abdomen and its flexed resting posture.

Cloacal exstrophy: prenatal diagnosis before rupture of the cloacal membrane.

Embryologically, cloacal exstrophy is thought to result from persistence and subsequent rupture of the infraumbilical cloacal membrane during the fifth embryonic week. We report a case of cloacal exstrophy in which a prenatal diagnosis was made prior to rupture of the cloacal membrane. A routine ultrasound at 17 weeks' gestation demonstrated monoamniotic twins.

Sex hormone receptors in a congenital meningioma.

The authors report a case of a congenital meningioma in a male infant in whom receptor binding sites for progesterone were significantly elevated.

Occult transorbital intracranial penetrating injuries.

Emergency physicians who are confronted with orbital injuries must recognize that the transorbital route offers little resistance to intracranial penetration. Neither direct inspection of an orbital wound nor plain radiographs are sufficient to evaluate the extent of penetration beyond the orbital confines. A high index of suspicion is critical to the proper assessment and subsequent management of such injuries.

Hypothalamic polar spongioblastoma associated with the diencephalic syndrome. Ultrastructural demonstration of a neuro-endocrine organization.

A tumor was resected from the third ventricle of a four years and eleven month old girl with the diencephalic syndrome. By light microscopy, it was diagnosed as a polar spongioblastoma . Its ultrastructural study was undertaken and the features were found to be distinctive and previously unreported.

Subependymal giant cell tumor of tuberose sclerosis. A light and ultrastructural study.

In a small number of cases of tuberose sclerosis, tumors develop in the cerebral subependymal region. Their exact nature has been the subject of debate. The cytology, histology and electron microscopy of a tumor which developed in a 16 year old male suffering from tuberose sclerosis are presented and the findings are discussed.

A spinal arteriovenous malformation with hereditary cutaneous hemangiomas.

A 16-month-old girl with cutaneomeningospinal angiomatosis became paraplegic because of the intraspinal arteriovenous malformation. Since skin hemangiomas occurred in three successive generations of the girl's family, this may represent the first inherited case of this condition. In children with signs of a spinal space-occupying lesion, the presence of a skin hemangioma, especially if it is in a corresponding dermatome, could be the clue to early diagnosis of a spinal angioma.