Patient-reported change of sensibility and pain after parotid and labial gland biopsy applied for primary Sjogren's syndrome diagnostics: One-year follow-up study

Objective. To assess how patients perceived pain and change of sensibility of the biopsied area after having undergone parotid and labial gland biopsy as part of the diagnostic work-up of primary Sjogren's syndrome (pSS). Methods. Simultaneously, parotid and labial salivary gland biopsies were taken under local anesthesia. One week, 6 months and 12 months post-operatively, each patient was sent a postal questionnaire to quantify the severity of pain and change of sensibility in the biopsied areas with a visual analogue scale (VAS; range 0-100). Results. 110 patients were included. The median age of patients was 54 years (IQR=47-65) and 92% were female. Changes in sensibility and pain in the biopsied area were significantly higher after a parotid gland biopsy than after a labial gland biopsy at one week and 6 months post-operatively, but rather minor in both areas. At 12 months post-operatively, the change in sensibility and pain level was negligible in most patients and comparable for both biopsied areas. The duration of the technique, outcome of the biopsy, exposure of nerve branches during the biopsy and bleeding during the biopsy did not affect the reported change of sensibility or pain in the biopsied area. ESSPRI was not related to pain level or change of sensibility at any time point (r0.05). Conclusion. Patient-reported post-operative change of sensibility and pain in the area of the parotid and labial gland biopsy are minor and comparable. Parotid and labial gland biopsies are diagnostic techniques well tolerated by patients suspected with pSS

Reconstructing the stellar mass distributions of galaxies using S4G IRAC 3.6 and 4.5 μm images: the conversion from light to mass

We present a new approach for estimating the 3.6 μm stellar mass-to-light ratio Υ3.6 in terms of the [3.6]-[4.5] colors of old stellar populations. Our approach avoids several of the largest sources of uncertainty in existing techniques using population synthesis models. By focusing on mid-IR wavelengths, we gain a virtually dust extinction-free tracer of the old stars, avoiding the need to adopt a dust model to correctly interpret optical or optical/NIR colors normally leveraged to assign the mass-to-light ratio Υ. By calibrating a new relation between NIR and mid-IR colors of giant stars observed in GLIMPSE we also avoid the discrepancies in model predictions for the [3.6]-[4.5] colors of old stellar populations due to uncertainties in the molecular line opacities assumed in template spectra. We find that the [3.6]-[4.5] color, which is driven primarily by metallicity, provides a tight constraint on Υ3.6, which varies intrinsically less than at optical wavelengths. The uncertainty on Υ3.6 of ~0.07 dex due to unconstrained age variations marks a significant improvement on existing techniques for estimating the stellar M/L with shorter wavelength data. A single Υ3.6=0.6 (assuming a Chabrier IMF), independent of [3.6]-[4.5] color, is also feasible as it can be applied simultaneously to old, metal-rich and young, metal-poor populations, and still with comparable (or better) accuracy 0.1 dex) as alternatives. Our Υ3.6 is optimal for mapping stellar mass distributions in S4G/DAGAL, for which we are first constructing a new catalog of images using an Independent Component Analysis technique to isolate the old stellar light at 3.6 μm from non-stellar emission (e.g. hot dust and the 3.3 μm PAH feature). Our estimate should also be useful for determining the fractional contribution of non-stellar emission to global (rest-frame) 3.6 μm fluxes, e.g., in WISE imaging and establishes a reliable basis for exploring variations in the stellar IMF

The Utility of Transcranial Electrical Stimulation Motor Evoked Potential Monitoring in Predicting Post-operative Supplementary Motor Area Syndrome and Motor Function Recovery

Postoperative hemiparesis following frontal lobe lesion resection is alarming, and predicting motor function recovery is challenging. Supplementary motor area (SMA) syndrome following resection of frontal lobe lesions is often indistinguishable from post-operative motor deficit due to surgical injury of motor tracts. We aim to describe the use of intra-operative TES (transcranial-electrical stimulation) with MEP (motor evoked potential) monitoring data as a diagnostic tool in distinguishing between SMA syndrome and permanent motor deficit (PMD). A retrospective analysis of 235 patients undergoing craniotomy and resection with TES-MEP monitoring for a frontal lobe lesion was performed. Patients that developed immediate post-operative motor deficit were included in analysis. Motor deficit and TES-MEP findings were categorized by muscle group as left upper extremity (LUE), left lower extremity (LLE), right upper extremity (RUE), or right lower extremity (RLE). Statistical analysis was performed to determine the predictive value of stable TES-MEP for SMA syndrome versus PMD. Twenty patients comprising 29 cases of immediate post-operative motor deficit by muscle group were included. Of these, 27 cases resolved and were diagnosed as SMA syndrome while two cases progressed to PMD. TES-MEP stability was significantly associated with diagnosis of SMA syndrome (p=.015). TES-MEP showed excellent diagnostic utility with a sensitivity and positive-predictive value of 100% and 92.6% respectively. Negative predictive value was 100%. Temporary SMA syndrome versus PMD is difficult to distinguish immediately postoperatively. TES-MEP may be a useful intra-operative adjunct that may aid in distinguishing SMA syndrome from PMD secondary to surgical injury