Novel cases of amyotrophic lateral sclerosis after treatment of cerebral arteriovenous malformationss.

Previous case studies reported nine patients with cerebral arteriovenous malformations (AVM) who developed amyotrophic lateral sclerosis (ALS) after AVM embolisation. Here, we describe three novel cases of ALS which developed 13-34 years after treatment, including embolisation, of cerebral AVM. This study provides further arguments supporting the thesis that embolisation of cerebral AVM might influence the risk of later ALS development.

Trabectedin as a chemotherapy option for patients with BRCA deficiency.

Trabectedin is a marine-derived product that was originally isolated from the Caribbean sea squirt Ecteinascidia turbinata and the first anticancer marine drug to be approved by the European Union. It is currently used as a single agent for the treatment of patients with soft tissue sarcoma after failure of anthracyclines and ifosfamide, or for those patients who are unsuited to receive these agents, and in patients with relapsed, platinum-sensitive ovarian cancer in combination with pegylated liposomal doxorubicin. Trabectedin has a unique multi-faceted mechanism of action that involves transcription regulation and DNA repair systems, including transcription-coupled nucleotide excision repair and homologous recombination repair (HRR) as the main hallmarks of its antiproliferative activity.

Health-related quality of life in women with recurrent ovarian cancer receiving paclitaxel plus trebananib or placebo (TRINOVA-1).

Background: To evaluate the influence of treatment on health-related quality of life (HRQoL) in 919 women with recurrent ovarian cancer enrolled in the TRINOVA-1 study, a randomized, placebo-controlled phase III study that demonstrated that trebananib 15 mg/kg QW plus weekly paclitaxel significantly improved progression-free survival (PFS) compared with placebo plus weekly paclitaxel (7.2 versus 5.4 months; hazard ratio, 0.

Improving Perfusion Measurement in DSC-MR Imaging with Multiecho Information for Arterial Input Function Determination.

Background And Purpose: Clinical measurements of cerebral perfusion have been increasingly performed with multiecho dynamic susceptibility contrast-MR imaging techniques due to their ability to remove confounding T1 effects of contrast agent extravasation from perfusion quantification. However, to this point, the extra information provided by multiecho techniques has not been used to improve the process of estimating the arterial input function, which is critical to accurate perfusion quantification. The purpose of this study is to investigate methods by which multiecho DSC-MRI data can be used to automatically avoid voxels whose signal decreases to the level of noise when calculating the arterial input function.

Arizona Alzheimer's Registry: Strategy and Outcomes of a Statewide Research Recruitment Registry.

Background: The Arizona Alzheimer's Consortium (AAC) created the Arizona Alzheimer's Registry, a screening and referral process for people interested in participating in Alzheimer's disease related research. The goals of the Registry were to increase awareness of Alzheimer's disease research and accelerate enrollment into AAC research studies.

Methods: Participation was by open invitation to adults 18 and older.

Green Leaf Volatile Emissions during High Temperature and Drought Stress in a Central Amazon Rainforest.

Prolonged drought stress combined with high leaf temperatures can induce programmed leaf senescence involving lipid peroxidation, and the loss of net carbon assimilation during early stages of tree mortality. Periodic droughts are known to induce widespread tree mortality in the Amazon rainforest, but little is known about the role of lipid peroxidation during drought-induced leaf senescence. In this study, we present observations of green leaf volatile (GLV) emissions during membrane peroxidation processes associated with the combined effects of high leaf temperatures and drought-induced leaf senescence from individual detached leaves and a rainforest ecosystem in the central Amazon.

Vertebral artery transposition for revascularization of the posterior circulation: a critical assessment of temporary and permanent complications and outcomes.

Object: Despite advances in medical management and endovascular therapies, including the introduction of statins, antiplatelet agents, and drug-eluting stents, some patients experience medically refractory vertebrobasilar insufficiency and may benefit from robust surgical revascularization. The aim of this study was to evaluate such patients after surgical revascularization, emphasizing long-term outcomes and rates of complications.

Methods: The authors retrospectively identified 22 patients (5 women and 17 men) whose mean age was 69.

Revascularization and pediatric aneurysm surgery.

Object: Aneurysms are relatively rare in the pediatric population and tend to include a greater proportion of large and giant lesions. A subset of these large and giant aneurysms are not amenable to direct surgical clipping and require complex treatment strategies and revascularization techniques. There are limited data available on the management of these lesions in the pediatric population.

Association between an Alzheimer's Disease-Related Index and APOE ε4 Gene Dose.

Background: We introduced a hypometabolic convergence index (HCI) to characterize in a single measurement the extent to which a person's fluorodeoxyglucose positron emission tomogram (FDG PET) corresponds to that in Alzheimer's disease (AD). Apolipoprotein E ε4 (APOE ε4) gene dose is associated with three levels of risk for late-onset AD. We explored the association between gene dose and HCI in cognitively normal ε4 homozygotes, heterozygotes, and non-carriers.

Hardware preservation after sternal wound infection in a lung transplant recipient.

Sternal wound infections can result in significant morbidity and mortality. Managing these complications is particularly challenging when infected hardware is involved. Traditional thinking mandates removal of infected hardware, yet this hardware is often essential to chest wall stability in the early postoperative period.

Thyroid stimulating hormone and cognition during severe, transient hypothyroidism.

Objective: The purpose of our pilot study was to explore the relationship between serum thyroid stimulating hormone (TSH) levels during overt hypothyroidism (OH) and hypothyroid-related neuropsychological symptoms. We hypothesized that TSH level may reflect the degree of 'brain hypothyroidism' such that an inverse correlation may exist between serum TSH and cognitive function in patients experiencing overt hypothyroidism (OH), and sought to explore this hypothesis.

Methods: Eleven thyroidectomized patients underwent neuropsychological and thyroid function testing while overtly hypothyroid, and again following thyroid hormone replacement.

Technetium-99m ethyl cysteinate dimer (ECD) cerebral accumulation and symptom and sign severity during hypothyroidism.

Objective: The purpose of this study was to correlate hypothyroid-related symptomatology with regional cerebral blood flow (rCBF) during hypothyroidism.

Materials And Methods: Nine thyroidectomized patients underwent neuropsychological testing and single photon emission computed tomography (SPECT) of their brains with technetium-99m (Tc-99m) ethyl cysteinate dimer (ECD), a lipophilic cerebral blood flow radiotracer, while hypothyroid, and again following thyroid hormone replacement. Neuropsychological test scores and TSH levels while hypothyroid were correlated with rCBF in hypothyroid-affected areas of the brain.

Modified superior repair for supracardiac total anomalous pulmonary venous connection in the adult.

Repair of total anomalous pulmonary venous connection has been well described and is associated with good long-term outcomes for neonates and infants. Although rare, some patients initially present at adolescence or during adulthood and repair is complicated by compensatory changes related to chronic volume overload. Transection of the superior vena cava facilitates both exposure of the venous confluence and repair in these patients.

Reciprocal regulation between natural killer cells and autoreactive T cells.

The initiation and the progression of autoimmune diseases stem from complex interactions that involve cells of both the innate and the adaptive immune system. As we discuss here, natural killer (NK) cells, which are components of the innate immune system, can inhibit or promote the activation of autoreactive T cells during the initiation of autoimmunity. After they have been activated, autoreactive T cells contribute to the homeostatic contraction of NK-cell populations.

Endolymphatic sac tumor: unique features of two cases and review of the literature.

Endolymphatic sac tumors (EST) are rare intracranial tumors originating from the pars rugosa of the endolymphatic sac. Although typically described as histologically nonaggressive lesions, nevertheless they are termed adenocarcinomas and often become locally invasive. We report two patients with histologically proven EST with unique clinical features: the first pediatric case of an EST in an 11-year-old patient whose complaints started at the age of seven; and, a second patient, a 43-year-old man, the first report of metastatic EST which appeared in a remote location from the original site of surgery.

"...those left behind." Biology and oncology of invasive glioma cells.

Although significant technical advances in surgical and radiation treatment for brain tumors have emerged in recent years, their impact on clinical outcome for patients has been disappointing. A fundamental source of the management challenge presented by glioma patients is the insidious propensity of the malignant cells to invade into adjacent normal brain. Invasive tumor cells escape surgical removal and geographically dodge lethal radiation exposure.

Allogeneic astrocytoma in immune competent dogs.

We have induced in canines long-term immune tolerance to an allogeneic cell line derived from a spontaneous canine astrocytoma. Allogeneic astrocytoma cells were implanted endoscopically into the subcutaneous space of fetal dogs before the onset of immune competency (< 40th gestational day). At adulthood, dogs rendered tolerant successfully serve as recipients of intracranial transplants of their growing allogeneic, subcutaneous tumor.

Migration arrest in glioma cells is dependent on the alphav integrin subunit.

Local invasion is a hallmark of gliomas. Infiltrating tumor cells establish sites of persistent and recurrent lesions that ultimately prove fatal. Determinants of glioma cell migration include integrins and their ligands within the matrix.

Menotropins alone are superior to a clomiphene citrate and menotropin combination for superovulation induction among clomiphene citrate failures.

Objective: To examine the difference in efficacy between two protocols of superovulation induction with IUI among infertile couples.

Design: A prospective randomized trial.

Setting: Normal human volunteers in an infertility clinic.

The role of extracellular matrix in human astrocytoma migration and proliferation studied in a microliter scale assay.

Ligands in the extracellular matrix (ECM) are known to mediate migration of normal as well as tumor cells via adhesion molecules such as the integrin receptor family. We develop a microliter scale (15-20 microliters total volume) monolayer migration assay to investigate the ability of astrocytoma cells to disperse on surfaces coated with purified human ECM protein ligands. In this system the rate of radial migration of the cell population was constant over time.

Catheter ablation of the slow AV nodal pathway in AV nodal re-entry tachycardia.

AV node re-entry tachycardia has been managed with medical therapy to suppress AV node conduction. Radiofrequency ablation of the slow AV nodal pathway can eliminate recurrent spontaneous AVNRT, while preserving AV node conduction intact.