Characterizing the neurocognitive profiles of children with moyamoya disease using the Das Naglieri cognitive assessment system

Although cognitive impairment is well-documented in children with moyamoya disease (MMD), selective decline in specific neurocognitive domains remains controversial. The purpose of this study was to characterize the neurocognitive profile of children with MMD using the Das Naglieri Cognitive Assessment System (CAS) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). We analyzed the neurocognitive data of 30 children (median age, 7 years) with MMD who were assessed with the CAS and the WISC-IV before surgery. We focused on the comparison of standard scores and intraindividual differences across domains. The CAS scores significantly varied across four measures (standard scores, p < 0.001; intraindividual differences, p < 0.001). Post-hoc analyses revealed that the standard scores and intraindividual differences for successive processing were significantly lower than those for planning and attention. The WISC-IV scores did not significantly vary among the four measures, although the working memory index was the lowest among the four measures. The within-individual weakness in successive processing, a form of working memory function, may be a distinct characteristic of children with MMD. The CAS may be more sensitive than the WISC-IV for detecting this selective neurocognitive weakness in children with MMD

Metastatic Renal Cell Carcinoma to the Left Sphenoid Sinus: A Case Report in Light of the Literature

A 79-year-old Japanese woman presented with a rare case of metastatic renal cell carcinoma to the left sphenoid sinus with left nasal bleeding. She had previously had right radical nephrectomy for renal cell carcinoma at the age of 64 years and brain and spinal cord infarction at 74 years. Endoscopic examination revealed no mass in the nasal cavity. CT and MRI revealed a tumor in the left sphenoid sinus. The size of the tumor increased gradually from 12 to 15 years after the radical nephrectomy. Complete resection with endoscopic surgery was performed without preoperative embolization. The tumor cells had clear cytoplasm and were arranged in a trabecular pattern lined by a layer of endothelial cells. These findings were identical to the pathological findings of the surgical specimen of the renal cell carcinoma from 15 years previous. A pathological diagnosis of metastatic renal cell carcinoma of clear cell type (grade 1) was made. PET-CT demonstrated no metastasis. The patient’s condition was successfully managed with excision of the tumor, and she remains well with no evidence of recurrence and metastasis 36 months after treatment. Metastatic renal cell carcinoma to the sphenoid sinus is rare, but it might be considered in the differential diagnosis of masses in the paranasal sinus even long after initial treatment of renal cancer

Network analyses reveal shifts in transcript profiles and metabolites that accompany the expression of sun and an elongated tomato fruit

SUN controls elongated tomato (Solanum lycopersicum) shape early in fruit development through changes in cell number along the different axes of growth. The gene encodes a member of the IQ domain family characterized by a calmodulin binding motif. To gain insights into the role of SUN in regulating organ shape, we characterized genome-wide transcriptional changes and metabolite and hormone accumulation after pollination and fertilization in wild-type and SUN fruit tissues. Pericarp, seed/placenta, and columella tissues were collected at 4, 7, and 10 d post anthesis. Pairwise comparisons between SUN and the wild type identified 3,154 significant differentially expressed genes that cluster in distinct gene regulatory networks. Gene regulatory networks that were enriched for cell division, calcium/transport, lipid/hormone, cell wall, secondary metabolism, and patterning processes contributed to profound shifts in gene expression in the different fruit tissues as a consequence of high expression of SUN. Promoter motif searches identified putative cis-elements recognized by known transcription factors and motifs related to mitotic-specific activator sequences. Hormone levels did not change dramatically, but some metabolite levels were significantly altered, namely participants in glycolysis and the tricarboxylic acid cycle. Also, hormone and primary metabolite networks shifted in SUN compared with wild-type fruit. Our findings imply that SUN indirectly leads to changes in gene expression, most strongly those involved in cell division, cell wall, and patterningrelated processes. When evaluating global coregulation in SUN fruit, the main node represented genes involved in calcium-regulated processes, suggesting that SUN and its calmodulin binding domain impact fruit shape through calcium signaling.Fil: Clevenger, Josh P..Fil: Van Houten, Jason.Fil: Blackwood, Michelle.Fil: Rodríguez, Gustavo Rubén. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Jikumaru, Yusuke.Fil: Kamiya, Yuji.Fil: Kusano, Miyako.Fil: Saito, Kazuki.Fil: Visa, Sofia.Fil: Van Der Knaap, Esther

Development of a New Bioartificial Liver Support System Using a Radial-flow Bioreactor

There is an increasing number of patients with severe liver disease that requires whole organ transplantation or living-related split liver transplantation. This has resulted in a shortage of donor organs, which is particularly problematic and still awaits resolution. Bioartificial liver (BAL) support systems have been developed with the aim of supporting patients with life-threatening liver disease until their liver recovers. Here, we describe a high performance three-dimensional rat hepatocyte culture system using a radial-flow bioreactor (RFB) with a polyvinyl alcohol (PVA) membrane as a small-scale BAL support system. Hepatocytes from male Sprague-Dawley rat livers were isolated and divided into two groups as follows. Group A: isolated hepatocytes were maintained in culture medium as controls; and group B: isolated hepatocytes were injected into the medium chamber of the RFB-PVA culture system. Sampling was carried out every 48 h to analyze the concentrations of ammonia and albumin in the medium. Light and electron microscopic examination of hepatocytes explanted from the PVA membrane was also performed. Albumin production and urea synthesis by cells in group B were both significantly higher than in group A. Hematoxylin-Eosin staining of the cells in group B showed that three-dimensional cell masses were attached to the PVA membrane. It also showed that the cells were stably proliferating in the porous spaces of the PVA. Scanning electron microscopic images of group B also showed clusters of hepatocytes attached to the PVA membrane. Hepatocyte clusters growing in the RFB-PVA culture system retained their biological function and were stable in the porous spaces of the PVA membrane. This cell culture system may be useful for the development of new BAL support systems

Endoscopic Treatment of Sinonasal Glomangiopericytoma: A Case Report in Light of the Literature

A 71-year-old Japanese male patient presented with a rare case of Glomangiopericytoma (GPC) of the left nasal with obstruction. Complete resection with endoscopic surgery was performed. Immunohistochemical staining for smooth muscle actin, β catenin, cyclin D1, vimentin, and factor 13 were helpful in establishing a definitive diagnosis. Extranasal treatment has been traditionally performed for successful management. However, recent advances in endoscopic treatment have enabled complete endoscopic resection of GPC, minimizing morbidity and facilitating subsequent surveillance for recurrence. Endoscopic management should be considered in suitable cases

Immersive inclusivity at CHI: Design and creation of inclusive user interactions through immersive media

Immersive media is becoming increasingly common in day-to-day scenarios: from extended reality systems to multimodal interfaces. Such ubiquity opens an opportunity for building more inclusive environments for users with disabilities (permanent, temporary, or situational) by either introducing immersive and multimodal elements into existing applications, or designing and creating immersive applications with inclusivity in mind. Thus the aim of this workshop is to create a discussion platform on intersections between the fields of immersive media, accessibility, and human-computer interaction, outline the key current and future problems of immersive inclusive design, and define a set of methodologies for design and evaluation of immersive systems from inclusivity perspective

Feasibility of Precoagulation Without the Pringle Maneuver for Endoscopic Hepatectomy of Cirrhotic Liver

Various methods, devices, and techniques have been developed to improve safety during laparoscopic hepatectomy procedures. Among these, the Pringle maneuver （PM） is widely used to minimize blood loss during liver transections; however, the risk of ischemic injury associated with this technique is increased by poor hepatic reserve and regeneration dysfunction secondary to liver cirrhosis. This retrospective study evaluated the short-term outcomes and feasibility of precoagulation for endoscopic hepatectomy without PM in patients with liver cirrhosis. Eleven patients with liver cirrhosis who also underwent endoscopic hepatectomy for hepatocellular carcinoma were recruited to undergo either microwave tissue coagulation or radiofrequency ablation for precoagulation before liver transection. A wedge resection without the PM was performed in all patients, with seven patients selected for bipolar radiofrequency ablation and four patients for microwave coagulation therapy. The procedures included video-assisted thoracoscopic hepatectomy in two patients and laparoscopic hepatectomy in nine patients. One patient who underwent radiofrequency ablation developed postoperative bleeding （Clavien-Dindo grade Ⅲ）. In conclusion, precoagulation can help to minimize intraoperative blood loss without the PM, contributing to effective resection of liver tumors. We propose that precoagulation could serve as a standard technique for endoscopic hepatectomy in patients with cirrhosis

Efficacy and Safety of an Ultrasonically Activated Device for Sealing the Bile Ducts During Liver Resection

The use of ultrasonically activated devices (USADs) in hepatic resections may be associated with an increased rate of complications, such as postoperative bile leaks. Nonetheless, the safety of USADs for sealing bile ducts during liver surgery has not yet been established. The purpose of this study was to assess the efficacy of a USAD for sealing bile ducts. In animal experiments, the common bile duct of ten anesthetized dogs was individually occluded using a USAD. Additionally, using the prospective liver surgery database from a single institution, we identified 45 consecutive patients who underwent hepatic resection using a USAD (USAD group) and 45 similar patients who underwent hepatic resection without the use of a USAD (NUSAD group). In the occluded and harvested canine bile ducts, the mean burst pressure was 280mmHg, and the lumen of the bile duct was completely sealed morphologically. In the clinical study, there was no significant difference in postoperative mortality or complications between the two groups, and biliary leakage was observed in only one patient (0.7%) in the USAD group. These data demonstrate that the USAD is a safe, efficient, and practical instrument for use during liver surgery to achieve complete hemobiliary stasis