Pamidronic acid and cabergoline as effective long-term therapy in a 12-year-old girl with extended facial polyostotic fibrous dysplasia, prolactinoma and acromegaly in McCune-Albright syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>McCune-Albright syndrome is a complex inborn disorder due to early embryonal postzygotic somatic activating mutations in the <it>GNAS</it>1 gene. The phenotype is very heterogeneous and includes polyostotic fibrous dysplasia, typically involving the facial skull, numerous café-au-lait spots and autonomous hyperfunctions of several endocrine systems, leading to hyperthyroidism, hypercortisolism, precocious puberty and acromegaly.</p> <p>Case presentation</p> <p>Here, we describe a 12-year-old Caucasian girl with severe facial involvement of fibrous dysplasia, along with massive acromegaly due to growth hormone excess and precocious puberty, with a prolactinoma. Our patient was treated with a bisphosphonate and the prolactin antagonist, cabergoline, resulting in the inhibition of fibrous dysplasia and involution of both the prolactinoma and growth hormone excess. During a follow-up of more than two years, no severe side effects were noted.</p> <p>Conclusion</p> <p>Treatment with bisphosphonates in combination with cabergoline is a suitable option in patients with McCune-Albright syndrome, especially in order to circumvent surgical interventions in patients suffering from polyostotic fibrous dysplasia involving the skull base.</p

In Vivo Tissue Regeneration with Robotic Implants

Robots that reside inside the body to restore or enhance biological function have long been a staple of science fiction. Creating such robotic implants poses challenges both in signaling between the implant and the biological host as well as in implant design. To investigate these challenges, we created a robotic implant to perform in vivo tissue regeneration via mechano-stimulation. The robot is designed to induce lengthening of tubular organs, such as the esophagus and intestines, by computer-controlled application of traction forces. Esophageal testing in swine demonstrates that the applied forces can induce cell proliferation and lengthening of the organ without a reduction in diameter, while the animal is awake, mobile and able to eat normally. Such robots can serve as research tools for studying mechanotransduction-based signaling and can also be employed clinically for conditions such as long-gap esophageal atresia and short bowel syndrome

Fourth-generation bypass and flow reversal to treat a symptomatic giant dolichoectatic basilar trunk aneurysm

BACKGROUND: Giant dolichoectatic basilar trunk aneurysms have an unfavorable natural history and are associated with high morbidity, but their neurosurgical treatment is complex and challenging. METHODS: Flow reversal reconstruction with fourth-generation bypass and proximal vertebral artery clip occlusion is performed via orbitozygomatic craniotomy with the Kawase approach under rapid ventricular pacing. CONCLUSION: Fourth-generation bypass is an innovative, technically challenging, and clinically effective tool in the treatment armamentarium for giant dolichoectatic basilar trunk aneurysms

Short-term effects of tillage of long-term no-till on nitrous oxide emissions from two contrasting Canadian prairie soils

The reduction in net CO2 emissions from increased carbon sequestration in soil and slower decomposition of soil organic matter under most long-term no-till (NT) situations can potentially be offset by a concomitant increase in nitrous oxide (N2O) emissions after tillage reversal on long-term NT soils. The objective of this work was to quantify N2O emissions after tillage reversal on two contrasting western Canadian Prairie soils managed under long-term (∼30 yr) NT. We measured one growing season (2010) of soil N2O emissions on a Black Chernozem and Gray Luvisol at Ellerslie and Breton, AB, respectively, following 30 yr of NT and N fertilizer application at two rates (0 and 100 kg N ha−1) subjected to tillage reversal and no disturbance (i.e., continuing NT). Tillage reversal after long-term NT was associated with higher N2O emissions in both soils but was significant only in the Gray Luvisol with 0 kg N ha−1. Long-term N fertilizer applications of 100 kg N ha−1 were associated with higher growing season soil N2O emissions and higher levels of soil N (i.e., a positive, long-term soil N balance) at both sites. Regardless of tillage, the difference in growing season nitrous oxide emissions from the 0 and 100 kg N ha−1 plots on the Gray Luvisol were much greater than the Black Chernozem. A modest increase in N2O emissions upon tillage reversal on a long-term NT soils could translate to a significant increase to agricultural greenhouse gas inventories in the event of large-scale tillage reversal on agricultural land in western Canada.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

NSJ-Spine january 2004

ERCUTANEOUS vertebroplasty enables minimally invasive treatment of both vertebral tumors and compression fractures of the cervical spine. The injection of radiopaque cement across a cervical spine fracture increases the strength and stiffness of the VB and has been shown to provide pain control in up to 90% of patients. Surgical Technique General anesthesia is induced and an endotracheal tube is placed. The patient&apos;s neck is oriented in a neutral position. Fluoroscopy is used to identify and demarcate the level of C-4, and the skin on the lateral neck is opened through a 2-cm incision Department of Neurological Surgery, Wayne State University, Detroit, Michigan The authors describe a technique for minimally invasive anterior vertebroplasty for treating metastatic disease of the C-2 vertebra and discuss its application in 2 cases. After a 2-cm lateral neck incision is made, blunt dissection is performed toward the anterior inferior endplate of the C-2 vertebra. An 11-gauge needle is introduced through a tubular sheath and tapped into the inferior endplate of C-2, with biplanar fluoroscopy being performed to confirm position. The needle is subsequently advanced across the fracture line and into the odontoid process. Under fluoroscopic guidance, 2 ml of methylmethacrylate is injected into the odontoid process and vertebral body. This method is advantageous as 1) hyperextension of the neck is not performed, 2) the chance of inadvertent neurovascular or submandibular gland injury is minimized, 3) the possibility of cement leakage is decreased, and 4) hemostasis is better achieved under direct vision