Acute hemichorea as unusual first multiple sclerosis presentation

Patient 1 was a 39-year-old woman with an unremarkable medical history who developed acute involuntary right arm and leg movements. Neurologic examination revealed moderate dysarthria and subcontinuous, choreic movements in her right limbs, prevailing in the arm, which worsened during postural tasks. She occasionally had ballistic movements in her right limbs and abnormal dystonic postures. Continuous peribuccal and tongue involuntary movements were noted. Moreover, bilateral upper limb ataxia, gait and trunk ataxia, and brisk right tendon reflexes were found. There was no strength or sensory loss (video 1 at Neurology.org/cp). Brain MRI revealed a tumefactive, T2/fluid-attenuated inversion recovery (FLAIR) hyperintense, T1 hypointense contrast-enhancing demyelinating lesion in the left cerebral peduncle, extending to the substantia nigra and subthalamic nucleus (STN) (figure, A-C). Multiple hyperintense T2/FLAIR, T1 hypointense, non-contrast-enhancing demyelinating lesions in the hemispheric and periventricular deep white matter, brainstem, and cerebellar hemispheres were also found. All serologic tests were within normal limits. Isoelectric focusing (IEF) revealed 9 CSF oligoclonal bands (OCBs). A diagnosis of multiple sclerosis (MS) was made and the patient was treated with high-dose methylprednisolone with improvement of symptoms

Ophiolites from the Grammos-Arrenes area, northern Greece:geological, paleontological and geochemical data

The Grammos-Arrenes ophiolites between the Pindos Flysch to the east and the Mesohellenic basin to the west represent the northernmost outcrop of the Pindos Ophiolite belt in Greece. The analyses on key outcrops of the Sub-ophiolitic Mélange allow adding new data on the age of the oceanization and on the geochemistry of the effusive products. Basalts samples show a N-MOR affinity and are associated with late Bajocian-early Bathonian radiolarian cherts. The emplacement of the ophiolites onto the sequences of the continental margin is preceded by mass flow deposition of ophiolitic material in the basins facing the advancing ophiolitic nappe. Ophiolite-bearing debris flow deposits and slide blocks are recognized in the Lower Cretaceous deep water sediments of the Beotian Unit and in the upper portion of the Tertiary Pindos Flysch. The intercalations of ophiolitic material in the Beotian flysch before, and in the Pindos Flysch later, are interpreted as the forerunners of the Ophiolitic Nappe which, coming from the Vardar Ocean located to the east, emplaced westward onto the continental margin of Adria. The collected data allow consolidating the constraints for the timing and mechanism of ophiolite emplacement in the Pindos-Grammos area. In addition, taking in consideration the geometry of tectonic stack in the Grammos-Arrenes and the ages of the involved sedimentary deposits it is possible to reconstruct a geodynamic history comparable to the other zones studied along the Dinaric-Hellenic chain

Bronchiolitis obliterans organizing pneumonia after radiation therapy for lung cancer. A case report

Bronchiolitis obliterans organizing pneumonia (BOOP), also known as cryptogenic organizing pneumonia, has mainly been described in patients with breast cancer who received radiotherapy after breast-conserving surgery. In this rare case, a 70-year-old man with left apical squamous lung cancer developed BOOP after radiotherapy and only one cycle of concomitant chemotherapy. This case report draws attention to the development of this syndrome in the unusual setting of lung cancer, advising prompt steroid treatment when diagnostic images reveal the characteristic signs of the disease

Surgical Training on Ex Vivo Ovine Model in Otolaryngology Head and Neck Surgery: A Comprehensive Review.

Background: Nowadays, head and neck surgical approaches need an increased level of anatomical knowledge and practical skills; therefore, the related learning curve is both flat and long. On such procedures, surgeons must decrease operating time as much as possible to reduce the time of general anesthesia and related stress factors for patients. Consequently, little time can be dedicated for training skills of students and young residents in the operating theater. Fresh human cadavers offer the most obvious surrogate for living patients, but they have several limitations, such as cost, availability, and local regulations. Recently, the feasibility of using ex vivo animal models, in particular ovine ones, have been considered as high-fidelity alternatives to cadaveric specimens. Methods: This comprehensive review explores all of head and neck otolaryngology applications with this sample. We analyzed studies about ear surgery, orbital procedures, parotid gland and facial nerve reanimation, open laryngeal and tracheal surgery, microlaryngoscopy procedures, laryngotracheal stenosis treatment, and diagnostic/operative pediatric endoscopy. For each different procedure, we underline the main applications, similarities, and limitations to human procedures so as to improve the knowledge of this model as a useful tool for surgical training. Results: An ovine model is easily available and relatively inexpensive, it has no limitations associated with religious or animal ethical issues, and it is reliable for head and neck surgery due to similar consistencies tissues and neurovascular structures with respect to humans. However, some other issues should be considered, such as differences about some anatomical features, the risk of zoonotic diseases, and the absence of bleeding during training. Conclusion: This comprehensive review highlights the potentials of an ex vivo ovine model and aims to stimulate the scientific and academic community to further develop it for other applications in surgical education

Novel blocked functionality copolymers as surface coatings in DNA microarray technology

AbstractNew copolymers made of 2-(dimethyl amino) ethyl methacrylate (DMAEM) and isocyanate ethyl methacrylate blocked with methyl ethyl ketoxime (IEMB) was synthesized in various composition ratios in order to obtain water reducible copolymers after acidification. They were characterized by infrared spectroscopy, chemical titration for the determination of amine equivalent weight, and by differential scanning calorimetry (DSC). Calorimetric analysis showed the presence of a former broad endothermal peak followed by a latter, stronger exothermal one, which can be respectively attributed to the deblocking of isocyanate groups and to their subsequent reactions. Some copolymer compositions were dip coated onto microscope glass slides and surfaces were characterized by static and dynamic contact angles, revealing a clear effect of the salifying agent and a likely surface rearrangement of polar groups while in contact with water. Finally, oligonucleotides surface immobilization and molecular recognition capability of the coated glass slides were positively assessed by hybridization tests with fluorescently labelled complementary probes

Kynurenine/Tryptophan Ratio as a Potential Blood-Based Biomarker in Non-Small Cell Lung Cancer

The enzyme indoleamine 2,3-dioxygenase 1 (IDO1) degrade tryptophan (Trp) into kynurenine (Kyn) at the initial step of an enzymatic pathway affecting T cell proliferation. IDO1 is highly expressed in various cancer types and associated with poor prognosis. Nevertheless, the serum Kyn/Trp concentration ratio has been suggested as a marker of cancer-associated immune suppression. We measured Kyn and Trp in blood samples of a wide cohort of non-small-cell lung cancer (NSCLC) patients, before they underwent surgery, and analyzed possible correlations of the Kyn/Trp ratio with either IDO1 expression or clinical-pathological parameters. Low Kyn/Trp significantly correlated with low IDO1 expression and never-smoker patients; while high Kyn/Trp was significantly associated with older (>= 68 years) patients, advanced tumor stage, and squamous cell carcinoma (Sqcc), rather than the adenocarcinoma (Adc) histotype. Moreover, high Kyn/Trp was associated, among the Adc group, with higher tumor stages (II and III), and, among the Sqcc group, with a high density of tumor-infiltrating lymphocytes. A trend correlating the high Kyn/Trp ratio with the probability of recurrences from NSCLC was also found. In conclusion, high serum Kyn/Trp ratio, associated with clinical and histopathological parameters, may serve as a serum biomarker to optimize risk stratification and therapy of NSCLC patients