Is posttraumatic cerebrospinal fluid fistula a predictor of posttraumatic meningitis? A US Nationwide Inpatient Sample database study.

Object: Various factors have been reported in literature to be associated with the development of posttraumatic meningitis. There is a paucity of data regarding skull fractures and facial fractures leading to CSF leaks and their association with the development of meningitis. The primary objective of this study was to analyze the US Nationwide Inpatient Sample (NIS) database to elucidate the factors associated with the development of posttraumatic meningitis.

Outcome for patients with triple-negative breast cancer is not dependent on race/ethnicity.

Introduction. Triple negative breast cancer (TNBC) is biologically aggressive and is associated with a worse prognosis. To understand the impact of race/ethnicity on outcome for patients with TNBC, confounding factors such as socioeconomic status (SES) need to be controlled.

Should a routine metastatic workup be performed for all patients with pathologic N2/N3 breast cancer?

Background: Node-positive breast cancer patients are at risk for metastatic disease. A routine metastatic workup might or might not be necessary for all patients with N2 or N3 diseases. The National Comprehensive Cancer Network guidelines recommend a metastatic workup for patients with T3N1 disease, yet no definitive recommendations are made for N2/N3 diseases.

Head and spinal cord injury: diagnosis and management.

This article reviews aspects of management of traumatic brain and spinal cord injury. A discussion of management of intracranial pressure after traumatic brain injury is followed by a discourse on cerebrovascular trauma and pediatric injuries. Specific management methods are discussed, including medical and surgical management in intracranial hypertension.

L-DOPA ropes in tRNA(Phe).

L-DOPA is the most commonly prescribed drug for the treatment of Parkinson's disease. Here, Moor et al. (2011) report that phenylalanyl-tRNA synthetase catalyzes the misacylation of tRNA(Phe) by L-DOPA, suggesting that it may contribute to the elevated levels of L-DOPA-containing proteins found in patients treated with this drug.

Chemokine receptor CXCR4 level in primary tumors independently predicts outcome for patients with locally advanced breast cancer.

Background: Chemokine receptor CXCR4 is a marker of metastatic disease. We found initially that CXCR4 level is a predictive marker for patients with locally advanced breast cancer (LABC). We now confirm our initial observations.

Dominant Intermediate Charcot-Marie-Tooth disorder is not due to a catalytic defect in tyrosyl-tRNA synthetase.

Charcot-Marie-Tooth disorder (CMT) is the most common inherited peripheral neuropathy, afflicting 1 in every 2500 Americans. One form of this disease, Dominant Intermediate Charcot-Marie-Tooth disorder type C (DI-CMTC), is due to mutation of the gene encoding the cytoplasmic tyrosyl-tRNA synthetase (TyrRS). Three different TyrRS variants have been found to give rise to DI-CMTC: replacing glycine at position 41 by arginine (G41R), replacing glutamic acid at position 196 by lysine (E196K), and deleting amino acids 153-156 (Δ(153-156)).

Biphasic dopamine regulation in mesoaccumbens pathway in response to non-contingent binge and escalating methamphetamine regimens in the Wistar rat.

Rationale: Methamphetamine (MA) increases extracellular dopamine (DA) and at chronic high doses induces toxicity as indicated by decreased expression of tyrosine hydroxylase (TH) and dopamine transporter (DAT). Notably, rats will self-administer MA in escalating quantities producing such toxicity. However, the impact of MA at sub-toxic doses on DA regulation is not well established.

Imaging NF-κB signaling in mice for screening anticancer drugs.

The activation of NF-κB has been implicated in various forms of cancer. Thereafter, targeting NF-κB has been suggested for cancer therapy. Instant and accurate tools to monitor NF-κB activation are necessary for such drug screening.

A penrose drain to help reflect the resected "specimen side" jejunum beneath the mesenteric vessels during a pancreaticoduodenectomy.

Introduction: Reflecting the resected portion of the proximal jejunum behind the mesenteric vessels during a pancreaticoduodenectomy (Whipple) procedure can be a challenging maneuver.

Methods: We describe a simple technique employing a penrose drain that is sutured to the resected "specimen" portion of the jejunum and then pulling it behind the mesenteric vessels.

Results: Seven patients underwent this procedure over a 2-month period without difficulties.

Trimodal therapy for inflammatory breast cancer: a surgeon's perspective.

Inflammatory breast cancer (IBC) is a rare and most aggressive form of breast cancer. The onset and progression of disease are rapid; diagnosis must be made expediently to initiate treatment quickly. In this review, the clinical presentation, trimodal therapy, surgical principles and a brief summary of the Louisiana State University at Shreveport experience with IBC are presented.

CXCR4 as a predictive marker for locally advanced breast cancer post-neoadjuvant therapy.

Background: CXCR4 is a G-protein coupled receptor that has been linked with metastasis in several cancers, including breast cancer. We recently demonstrated that high CXCR4 levels in primary tumors of patients with breast cancer had a prognostic significance. We hypothesize that patients whose tumors had a low CXCR4 overexpression level following neoadjuvant chemotherapy will have a lower recurrence rate than those whose tumors remained high.

Impact of race and ethnicity on outcomes for estrogen receptor-negative breast cancers: experience of an academic center with a charity hospital.

Background: African American women have a higher breast cancer mortality rate than Caucasian women. Estrogen receptor (ER)-negative tumors, which are more aggressive than ER-positive tumors, occur more frequently in African American women than in Caucasian women and may contribute to apparent disparities in outcomes. However, outcome results need to be controlled for socioeconomic status (SES).

Methods of esophagogastric anastomoses following esophagectomy for cancer: A systematic review.

Anastomotic complications are responsible for significant morbidity and mortality following esophagectomy for cancer. Conflicting reports exist regarding the superiority of hand-sewn versus stapled techniques. This systematic review identified eight randomized clinical trials examining this issue.

Far-lateral approach for lower basilar artery aneurysms.

Objectives: Aneurysms of the lower basilar artery are surgically difficult to expose and clip. Various cranial base approaches, which are associated with significant morbidity, have been used to access this region. We have used the far-lateral approach without occipital condyle drilling for clipping of lower basilar junction aneurysms to assess the exposure for adequate visualization and clipping, and to study the complications and outcome.

Race/Ethnicity has no effect on outcome for breast cancer patients treated at an academic center with a public hospital.

Background: African American women have a higher breast cancer mortality rate than Caucasian women. To understand this difference, socioeconomic status (SES) needs to be controlled, which can be achieved by evaluating outcome within a population that is underinsured or low SES. We elected to examine the effect of race/ethnicity on outcome of patients with operable breast cancer by evaluating outcome in a population with low SES and similar access to care.

Overexpression of CXCR4 in primary tumor of patients with HER-2 negative breast cancer was predictive of a poor disease-free survival: a validation study.

Background: Although HER-2 negative tumors are thought to be less aggressive than their counterpart, there is a subset that behaves poorly. The molecular mechanism to account for this is unknown. The chemokine receptor CXCR4 is often upregulated in a wide array of cancers.

High chemokine receptor CXCR4 level in triple negative breast cancer specimens predicts poor clinical outcome.

Introduction: Basal-like tumors or triple negative breast cancers are those that lack hormone-receptor and HER-2 expressions. They are considered to be aggressive tumors, and molecular mechanism to account for this is poorly understood. CXCR4 is a chemokine receptor that has been linked to breast cancer invasion and metastasis.

Effects of the endothelin-converting enzyme inhibitor SM-19712 in a mouse model of dextran sodium sulfate-induced colitis.

Background: Ingestion by mice of dextran sodium sulfate (DSS) induces colonic vasoconstriction and inflammation, with some of the effects potentially mediated by the vasoconstrictor endothelin-1 (ET-1).

Methods: In this study, mice given 5% 40 kD DSS for 5-6 days had elevated colonic immunostaining for ET-1 and platelet endothelial cell adhesion molecule-1 (PECAM-1). Increased ET-1 can induce microvascular constriction; however, the increase in PECAM-1 is consistent with angiogenesis that could decrease flow resistance.

Global transcriptional profiling reveals Streptococcus agalactiae genes controlled by the MtaR transcription factor.

Background: Streptococcus agalactiae (group B Streptococcus; GBS) is a significant bacterial pathogen of neonates and an emerging pathogen of adults. Though transcriptional regulators are abundantly encoded on the GBS genome, their role in GBS pathogenesis is poorly understood. The mtaR gene encodes a putative LysR-type transcriptional regulator that is critical for the full virulence of GBS.

Ethanol exhibits specificity in its effects on differentiation of hematopoietic progenitors.

Ethanol is a known teratogen but the mechanisms by which this simple compound affects fetal development remain unresolved. The goal of the current study was to determine the mechanism by which ethanol affects lymphoid differentiation using an in vitro model of ethanol exposure. Primitive hematopoietic oligoclonal-neonatal-progenitor cells (ONP), with the phenotype Lin(-)HSA(lo)CD43(lo)Sca-1(-)c-Kit(+) that are present in neonatal but not adult bone marrow were sorted from the bone marrow of 2-week-old C57BL/6J mice and cultured under conditions that favor either B cell or myeloid cell differentiation with or without addition of ethanol.

Cranial vault metastasis of giant cell tumor.

Giant cell tumors are benign bony tumors involving the epiphysis of long bones. Here, we present a case of giant cell tumor involving the parietal bone that had metastasized from the sacrum. A 36-year-old healthy woman presented to neurosurgery clinic in April 2005 reporting a "bump" over the left parietal area that had been increasing in size over the past 6 months.

Expression of the Streptococcus agalactiae virulence-associated protease CspA in a soluble, active form utilizing the Gram-positive host, Lactococcus lactis.

The heterologous expression of streptococcal genes in common Gram-negative hosts may be complicated by low-level expression, toxicity to the host, formation of inclusion bodies, and mislocalization of the encoded proteins. Biochemical study of the Streptococcus agalactiae virulence-associated cell-envelope protease (CEP) CspA, as well as other CEPs, has been limited by the lack of effective expression systems. In this study, we present a simple strategy to express cspA as a catalytically active exoprotein.