Impasse in the management of recurrent basal cell carcinoma of the skull with sagittal sinus erosion1

Abstract Basal cell carcinoma (BCC) is a non melanocytic skin cancer that arises from basal cells, affecting commonly fair-skinned human beings. Although the tumor is well known for local recurrences, extension into the intracranial space is reported. A case of a giant BCC of the scalp invading the middle and posterior third of the superior sagittal sinus (SSS) is reported. A 70-year-old male with a basal cell carcinoma history presented with a massive bleeding from the SSS invaded by the tumor. Since the patient refused surgery the bleeding was managed through direct compression by applying a thrombin-based hemostatic agents and sterile dressings. This procedure was performed daily in order to stimulate the spontaneous thrombosis of the dural sinus and development of collateral circle. BCC invading the SSS is rarely reported. A technical description of this case is provided. This case underscores the importance of early and appropriate treatment for high risk BCC, and whenever surgical procedure is not suitable appropriate conservative treatment may be efficacious

A rare case of extra-intramedullary dorsal tanycitic ependymoma, radically removed with intraoperative neurophysiological monitoring

Introduction: Tanycitic dorsal extra and intramedullary ependymoma is a rare form of tumor. From the histological point of view, these tumors show several aspects that make difficult the differential diagnosis from schwannomas and pilocytic astrocytomas. Tanycytic variant, often occurs in the thoracic tract of the spinal cord, and it is constituted by tanycites, that are typical elongated and bipolar cells that give to the tumor fibrillary aspects. Tanycitic variant has been recently characterized as a variant of ependymoma, since the 2000 World Health Organization (WHO) system. Case presentation: A 57 years old woman presented with intractable back pain often radiating to the left leg. Neurological exam revealed mild weakness in left tight flexion. No sensory or sphincterial disturbances were present. A dorso-lumbar Magnetic Resonance Imaging (MRI)with contrast medium showed a well-demarked T12 intradural extramedullary lesion, suggestive for schwannoma. The tumor was radically removed, with an excellent neurological outcome, and was then characterized as a grade II tanycitic ependymoma. Conclusion: To differentiate the diagnosis between extramedullary ependymomas and schwannomas, meningiomas or astrocytomas is necessary a histopathological examination and a close follow up period is recommended since the tumor could evolve into higher grade. Neurophysiological monitoring is necessary for a satisfactory neurological outcome

Case report: Personalized transcatheter approach to mid-aortic syndrome by in vitro simulation on a 3-dimensional printed model

An 8-year-old girl, diagnosed with mid-aortic syndrome (MAS) at the age of 2 months and under antihypertensive therapy, presented with severe systemic hypertension (>200/120 mmHg). Computed tomography (CT) examination revealed aortic aneurysm between severe stenoses at pre- and infra-renal segments, and occlusion of principal splanchnic arteries with peripheral collateral revascularization. Based on CT imaging, preoperative three-dimensional (3D) anatomy was reconstructed to assess aortic dimensions and a dedicated in vitro planning platform was designed to investigate the feasibility of a stenting procedure under fluoroscopic guidance. The in vitro system was designed to incorporate a translucent flexible 3D-printed patient-specific model filled with saline. A covered 8-zig 45-mm-long Cheatham-Platinum (CP) stent and a bare 8-zig, 34-mm-long CP stent were implanted with partial overlap to treat the stenoses (global peak-to-peak pressure gradient > 60 mmHg), excluding the aneurysm and avoiding risk of renal arteries occlusion. Percutaneous procedure was successfully performed with no residual pressure gradient and exactly replicating the strategy tested in vitro. Also, as investigated on the 3D-printed model, additional angioplasty was feasible across the frames of the stent to improve bilateral renal flow. Postoperative systemic pressure significantly reduced (130/70 mmHg) as well as dosage of antihypertensive therapy. This is the first report demonstrating the use of a 3D-printed model to effectively plan percutaneous intervention in a complex pediatric MAS case: taking full advantage of the combined use of a patient-specific 3D model and a dedicated in vitro platform, feasibility of the stenting procedure was successfully tested during pre-procedural assessment. Hence, use of patient-specific 3D-printed models and in vitro dedicated platforms is encouraged to assist pre-procedural planning and personalize treatment, thus enhancing intervention success

Unusual case of dorsal vertebral metastases from a male breast cancer

Introduction: Breast cancer is a malignant neoplasm arising from mammary glands and is a rare entity in the male patient. Spine is a common site for skeletal metastases. Case presentation: A 53-years-old male was admitted to our Neurosurgical unit because of an untreatable dorsal pain. He had been treated 3 years before for breast cancer. A dorsal Magnetic Resonance Imaging (MRI) evidenced pathological masses at T8 level. A total body Computed Tomography (CT) scan revealed lungs and liver metastases. After a multidisciplinary consult, a posterior T8 decompression, a radiofrequency thermoablation in T8 vertebral body followed by screws and rods fixation (T7-T9) was performed. Post-operative course was uneventful and the patient experienced a significant improvement of dorsal pain. Cycles of adjuvant chemo-radiotherapy followed. After 8 months, patient is still alive and in good general conditions but a spine MRI revealed a rapid and widespread diffusion of ostelytic metastases. Conclusion: Despite the high incidence of breast cancer metastases to the spine, very few clinical reports (just eight, whose only one treated surgically) in the literature deal specifically with metastases from male breast cancer, which is rarer and with a worst prognosis than female counterpart. In spite of the poor course, surgery still plays a role in treating these kind of malignancies and in improving quality of life

Thermal ionization of excitons in V-shaped quantum wires

The exciton-to-free-carrier transition in GaAs and In_xGa_{1-x}As V-shaped quantum wires is revealed by means of temperature-dependent magnetoluminescence experiments. The experimental results are in excellent agreement with the diamagnetic shift obtained from a solution of the full two-dimensional Schrödinger equation for electrons and holes including magnetic-field and excitonic effects. In the GaAs wires, the exciton-to-free-carrier transition is found to occur at temperature consistent with the exciton binding energies. In the In_xGa_{1-x}As wires the diamagnetic shift of the luminescence is found to be free-carrier-like, independent of temperature, due to the weakening of the exciton binding energy induced by the internal piezoelectric field

GraphFind: enhancing graph searching by low support data mining techniques

<p>Abstract</p> <p>Background</p> <p>Biomedical and chemical databases are large and rapidly growing in size. Graphs naturally model such kinds of data. To fully exploit the wealth of information in these graph databases, a key role is played by systems that search for all exact or approximate occurrences of a query graph. To deal efficiently with graph searching, advanced methods for indexing, representation and matching of graphs have been proposed.</p> <p>Results</p> <p>This paper presents GraphFind. The system implements efficient graph searching algorithms together with advanced filtering techniques that allow approximate search. It allows users to select candidate subgraphs rather than entire graphs. It implements an effective data storage based also on low-support data mining.</p> <p>Conclusions</p> <p>GraphFind is compared with Frowns, GraphGrep and gIndex. Experiments show that GraphFind outperforms the compared systems on a very large collection of small graphs. The proposed low-support mining technique which applies to any searching system also allows a significant index space reduction.</p

Sequence similarity is more relevant than species specificity in probabilistic backtranslation

BACKGROUND: Backtranslation is the process of decoding a sequence of amino acids into the corresponding codons. All synthetic gene design systems include a backtranslation module. The degeneracy of the genetic code makes backtranslation potentially ambiguous since most amino acids are encoded by multiple codons. The common approach to overcome this difficulty is based on imitation of codon usage within the target species. RESULTS: This paper describes EasyBack, a new parameter-free, fully-automated software for backtranslation using Hidden Markov Models. EasyBack is not based on imitation of codon usage within the target species, but instead uses a sequence-similarity criterion. The model is trained with a set of proteins with known cDNA coding sequences, constructed from the input protein by querying the NCBI databases with BLAST. Unlike existing software, the proposed method allows the quality of prediction to be estimated. When tested on a group of proteins that show different degrees of sequence conservation, EasyBack outperforms other published methods in terms of precision. CONCLUSION: The prediction quality of a protein backtranslation methis markedly increased by replacing the criterion of most used codon in the same species with a Hidden Markov Model trained with a set of most similar sequences from all species. Moreover, the proposed method allows the quality of prediction to be estimated probabilistically