Exclusive surgical treatment for vestibular schwannoma regrowth or recurrence: A meta-analysis of the literature

Vestibular schwannomas can be treated in different ways, but for symptomatic or growing tumors, the gold standard is surgical removal of the lesion. In order to preserve neurovascular structures, partial removal is often performed, leaving a residual that may grow in subsequent years. To date, there is no consensus with regard to surgical treatment of vestibular schwannoma residuals, and so this review focuses on this topic. A structured search was performed on PubMed searching for all articles discussing vestibular schwannoma residuals and recurrences. Only articles discussing surgical treatment were included, focusing on studies which also examined facial nerve outcomes. A total of 51 articles were eligible for review and these included 375 patients. Statistical analysis was performed by correlating the following parameters: patients' gender and age at first surgery, surgical approach adopted at first and subsequent surgeries, tumor and residual size, and extent of resection (gross total, near total, subtotal or others) at first and subsequent surgical procedures. Facial nerve function was also analyzed focusing on its performance when correlated with the different surgical approaches. The data were analyzed by linear regression but there were no correlations between any of the parameters chosen. There was a statistically significant difference between the first approach used (mainly the retrosigmoid route) compared with subsequent approaches (mainly the translabyrinthine route). In total, 8.5 % of patients needed further treatment due to residual regrowth. Facial nerve outcome was independent of the parameters chosen. Exclusive surgical treatment for vestibular schwannoma residuals had a very low failure rate in terms of requiring further treatment. The approach usually chosen for second surgery was the translabyrinthine technique, and this may be explained by the location of the residual, rather than its size. The choice of a particular surgical approach rather than another had no influence on facial nerve function. Complications rates are comparable to Gamma Knife Radiosurgery's as reported in the literature

Magnetic properties of GdT2T_2Zn20_{20} (T = Fe, Co) investigated by X-ray diffraction and spectroscopy

We investigate the magnetic and electronic properties of the Gd$T_2$Zn$_{20}$ ($T$ = Fe and Co) compounds using X-ray resonant magnetic scattering (XRMS), X-ray absorption near-edge structure (XANES) and X-ray magnetic circular dichroism (XMCD) techniques. The XRMS measurements reveal that the GdCo$_2$Zn$_{20}$ compound has a commensurate antiferromagnetic spin structure with a magnetic propagation vector $\vec{\tau}$ = $(\frac{1}{2},\frac{1}{2},\frac{1}{2})$ below the N\'eel temperature ($T_N \sim$ 5.7 K). Only the Gd ions carry a magnetic moment forming an antiferromagnetic structure with magnetic representation $\Gamma_6$. For the ferromagnetic GdFe$_2$Zn$_{20}$ compound, an extensive investigation was performed at low temperature and under magnetic field using XANES and XMCD techniques. A strong XMCD signal of about 12.5 $\%$ and 9.7 $\%$ is observed below the Curie temperature ($T_C \sim$ 85 K) at the Gd-$L_2$ and $L_3$ edges, respectively. In addition, a small magnetic signal of about 0.06 $\%$ of the jump is recorded at the Zn $K$-edge suggesting that the Zn 4$p$ states are spin polarized by the Gd 5$d$ extended orbitals

Electronic and structural ground state of heavy alkali metals at high pressure

Alkali metals display unexpected properties at high pressure, including emergence of low symmetry crystal structures, that appear to occur due to enhanced electronic correlations among the otherwise nearly-free conduction electrons. We investigate the high pressure electronic and structural ground state of K, Rb, and Cs using x-ray absorption spectroscopy and x-ray diffraction measurements together with ab initio theoretical calculations. The sequence of phase transitions under pressure observed at low temperature is similar in all three heavy alkalis except for the absence of the oC84 phase in Cs. Both the experimental and theoretical results point to pressure-enhanced localization of the valence electrons characterized by pseudo-gap formation near the Fermi level and strong spd hybridization. Although the crystal structures predicted to host magnetic order in K are not observed, the localization process appears to drive these alkalis closer to a strongly correlated electron state.Comment: 10 pages, 8 figure

Leiomyosarcoma of the Larynx: A Complex Diagnosis

An 84-year-old man was referred to our institution for dysphonia present for 2 months. Fiberoptic laryngoscopy demonstrated a polypoid lesion of the right true vocal fold with normal motility. Excisional biopsy of a submucosal thickening of the right vocal fold with vocal ligament calcification was performed. Histology revealed squamous cell epithelium without malignancy. Postoperative endoscopic follow-up was regular. Six months after surgery, dysphonia and dyspnea occurred. Flexible laryngoscopy demonstrated right hemilaryngeal paralysis, edema, and partial airway obstruction. Necrotic tissue and purulent secretions were visible at the anterior commissure, right vocal fold, and ipsilateral vestibule. A second microlaryngoscopic surgery included multiple biopsies and debridement of the necrotic tissue. Histological report was negative for malignancy, and purulent chondritis was diagnosed. Intravenous antibiotic therapy was administered with improvement of infection, inflammation, dysphonia, and dyspnea. The patient was discharged

Pressure and chemical substitution effects in the local atomic structure of BaFe2As2

The effects of K and Co substitutions and quasi-hydrostatic applied pressure (P<9 GPa) in the local atomic structure of BaFe2As2, Ba(Fe{0.937}Co{0.063})2As2 and Ba{0.85}K{0.15}Fe2As2 superconductors were investigated by extended x-ray absorption fine structure (EXAFS) measurements in the As K absorption edge. The As-Fe bond length is found to be slightly reduced (<~ 0.01 Angstroms) by both Co and K substitutions, without any observable increment in the corresponding Debye Waller factor. Also, this bond is shown to be compressible (k = 3.3(3)x10^{-3} GPa^{-1}). The observed contractions of As-Fe bond under pressure and chemical substitutions are likely related with a reduction of the local Fe magnetic moments, and should be an important tuning parameter in the phase diagrams of the Fe-based superconductors.Comment: 7 pages, 6 figure