Magnetic Resonance Imaging of Kernohan\u27s Notch in Chronic Subdural Hematoma: Significance of Coronal Images for Preoperative Diagnosis

A 67-year-old man presented with headache and gait disturbance. On admission, he was mildly confused but aroused by verbal stimulus, with normal motor function. A CT scan showed bilateral subdural hematomas (right >> left) and a midline shift to the left. One hour after admission, he suddenly became somnolent and developed right hemiparesis. While repeated CT examinations failed to reveal new findings, coronal MRI clearly depicted the left cerebral peduncle pressed against the free edge of the tentorium. Craniotomy was immediately performed to remove the right chronic subdural hematoma. Soon after the operation, neurological functions were markedly improved. When paradoxical (ipsilateral to the lesion) motor deficit is observed in patients with head injuries, including cases of chronic subdural hematomas, coronal MR imaging and magnetic resonance angiography should be immediately performed to detect Kernohan\u27s notch and to rule out other possible complications, such as diffuse axonal injury or cerebral stroke

Extracellular nanomatrix-induced self-organization of neural stem cells into miniature substantia nigra-like structures with therapeutic effects on Parkinsonian rats

Substantia nigra (SN) is a complex and critical region of the brain wherein Parkinson's disease (PD) arises from the degeneration of dopaminergic neurons. Miniature SN‐like structures (mini‐SNLSs) constructed from novel combination of nanomaterials and cell technologies exhibit promise as potentially curative cell therapies for PD. In this work, a rapid self‐organization of mini‐SNLS, with an organizational structure and neuronal identities similar to those of the SN in vivo, is achieved by differentiating neural stem cells in vitro on biocompatible silica nanozigzags (NZs) sculptured by glancing angle deposition, without traditional chemical growth factors. The differentiated neurons exhibit electrophysiological activity in vitro. Diverse physical cues and signaling pathways that are determined by the nanomatrices and lead to the self‐organization of the mini‐SNLSs are clarified and elucidated. In vivo, transplantation of the neurons from a mini‐SNLS results in an early and progressive amelioration of PD in rats. The sculptured medical device reported here enables the rapid and specific self‐organization of region‐specific and functional brain‐like structures without an undesirable prognosis. This development provides promising and significant insights into the screening of potentially curative drugs and cell therapies for PD

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Impact of a see-and-treat melanoma clinic on patient experience

Background See-and-treat (‘one stop’) clinics for cutaneous and noncutaneous tumor streams have been shown to enhance patient experience, amongst other benefits, such as reduced waiting time to surgery if required. To date, there have been no studies assessing patient perception of one-stop clinics dedicated to the diagnosis and treatment of melanomas and pigmented lesions. Objective To perform a prospective survey study examining patient’s perception of a see-and-treat pigmented lesion clinic. Methods and materials Consenting patients were contacted by phone to complete a survey comprising 10 statements relating to different facets of the clinic, four weeks after their initial assessment. Reponses were documented on a 5-point Likert scale. Results A total of 107/142 (75.4%) patients consented to partake in the study. Compared to overall mean response, patients who underwent same-day biopsy reported higher satisfaction (4.9 vs. 4.5, p < .01) and perceived convenience (4.8 vs. 4.4, p < .01). Of those who received same-day procedures, no patient reported being given insufficient time to consider surgical treatment. Conclusion A see-and-treat model for pigmented lesions, incorporating same-day excisional biopsy for lesions suspicious for melanoma, is viewed upon favorably by patients

Oncogenic roles of PRL-3 in FLT3-ITD induced acute myeloid leukaemia

FLT3-ITD mutations are prevalent mutations in acute myeloid leukaemia (AML). PRL-3, a metastasis-associated phosphatase, is a downstream target of FLT3-ITD. This study investigates the regulation and function of PRL-3 in leukaemia cell lines and AML patients associated with FLT3-ITD mutations. PRL-3 expression is upregulated by the FLT3-STAT5 signalling pathway in leukaemia cells, leading an activation of AP-1 transcription factors via ERK and JNK pathways. PRL-3-depleted AML cells showed a significant decrease in cell growth. Clinically, high PRL-3 mRNA expression was associated with FLT3-ITD mutations in four independent AML datasets with 1158 patients. Multivariable Cox-regression analysis on our Cohort 1 with 221 patients identified PRL-3 as a novel prognostic marker independent of other clinical parameters. Kaplan-Meier analysis showed high PRL-3 mRNA expression was significantly associated with poorer survival among 491 patients with normal karyotype. Targeting PRL-3 reversed the oncogenic effects in FLT3-ITD AML models in vitro and in vivo. Herein, we suggest that PRL-3 could serve as a prognostic marker to predict poorer survival and as a promising novel therapeutic target for AML patients

Bleeding post-transplantation intrarenal pseudoaneurysms

We herein present a case of an intrarenal pseudoaneurysm developing 2 weeks after renal transplantation. The patient presented with hemorrhagic shock. Computed tomography confirmed an intrarenal pseudoaneurysm with extravasation of contrast and a large surrounding hematoma. Angiography confirmed the pseudoaneurysm, and embolization of the segmental graft renal artery was performed. In view of the uncertain etiology and the possibility of a mycotic pseudoaneurysm, we administered empiric antimicrobial therapy. The clinical course, investigations, and management are described. Finally, a review of the literature regarding post-transplantation pseudoaneurysms is presented. 以下是一宗於移植後 2 週出現的腎內僞動脈瘤個案，患者以出血性休克表現。當時為其安排緊急電腦斷層攝影 (CT)，發現有一個腎內僞動脈瘤，並呈現顯影劑溢出現象，且被一大型血腫圍繞。緊急血管攝影證實為植入腎之僞動脈瘤，同時我們對涉及的節段性動脈予以栓塞處置。基於病因並不明確，而且不能排除黴菌性僞動脈瘤的可能性，因此我們實施了經驗性抗微生物學療法。在本文中，我們描述了本個案的臨床歷程、相關檢查及後續處置，並指出我們在治療上所遭遇到的困難。最後，我們對移植後僞動脈瘤的相關文獻作出了回顧

Extracellular Nanomatrix‐Induced Self‐Organization of Neural Stem Cells into Miniature Substantia Nigra‐Like Structures with Therapeutic Effects on Parkinsonian Rats

Substantia nigra (SN) is a complex and critical region of the brain wherein Parkinson's disease (PD) arises from the degeneration of dopaminergic neurons. Miniature SN‐like structures (mini‐SNLSs) constructed from novel combination of nanomaterials and cell technologies exhibit promise as potentially curative cell therapies for PD. In this work, a rapid self‐organization of mini‐SNLS, with an organizational structure and neuronal identities similar to those of the SN in vivo, is achieved by differentiating neural stem cells in vitro on biocompatible silica nanozigzags (NZs) sculptured by glancing angle deposition, without traditional chemical growth factors. The differentiated neurons exhibit electrophysiological activity in vitro. Diverse physical cues and signaling pathways that are determined by the nanomatrices and lead to the self‐organization of the mini‐SNLSs are clarified and elucidated. In vivo, transplantation of the neurons from a mini‐SNLS results in an early and progressive amelioration of PD in rats. The sculptured medical device reported here enables the rapid and specific self‐organization of region‐specific and functional brain‐like structures without an undesirable prognosis. This development provides promising and significant insights into the screening of potentially curative drugs and cell therapies for PD

Table_1_Wrist accelerometry for monitoring dementia agitation behaviour in clinical settings: A scoping review.DOCX

Agitated behaviour among elderly people with dementia is a challenge in clinical management. Wrist accelerometry could be a versatile tool for making objective, quantitative, and long-term assessments. The objective of this review was to summarise the clinical application of wrist accelerometry to agitation assessments and ways of analysing the data. Two authors independently searched the electronic databases CINAHL, PubMed, PsycInfo, EMBASE, and Web of Science. Nine (n = 9) articles were eligible for a review. Our review found a significant association between the activity levels (frequency and entropy) measured by accelerometers and the benchmark instrument of agitated behaviour. However, the performance of wrist accelerometry in identifying the occurrence of agitation episodes was unsatisfactory. Elderly people with dementia have also been monitored in existing studies by investigating the at-risk time for their agitation episodes (daytime and evening). Consideration may be given in future studies on wrist accelerometry to unifying the parameters of interest and the cut-off and measurement periods, and to using a sampling window to standardise the protocol for assessing agitated behaviour through wrist accelerometry.</p