Seizure prediction : ready for a new era

Acknowledgements: The authors acknowledge colleagues in the international seizure prediction group for valuable discussions. L.K. acknowledges funding support from the National Health and Medical Research Council (APP1130468) and the James S. McDonnell Foundation (220020419) and acknowledges the contribution of Dean R. Freestone at the University of Melbourne, Australia, to the creation of Fig. 3.Peer reviewedPostprin

Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence

About one-third of people with major depressive disorder (MDD) fail at least two antidepressant drug trials at 1 year. Together with clinical and experimental evidence indicating that the pathophysiology of MDD is multifactorial, this observation underscores the importance of elucidating mechanisms beyond monoaminergic dysregulation that can contribute to the genesis and persistence of MDD. Oxidative stress and neuroinflammation are mechanistically linked to the presence of neurovascular dysfunction with blood-brain barrier (BBB) hyperpermeability in selected neurological disorders, such as stroke, epilepsy, multiple sclerosis, traumatic brain injury, and Alzheimer’s disease. In contrast to other major psychiatric disorders, MDD is frequently comorbid with such neurological disorders and constitutes an independent risk factor for morbidity and mortality in disorders characterized by vascular endothelial dysfunction (cardiovascular disease and diabetes mellitus). Oxidative stress and neuroinflammation are implicated in the neurobiology of MDD. More recent evidence links neurovascular dysfunction with BBB hyperpermeability to MDD without neurological comorbidity. We review this emerging literature and present a theoretical integration between these abnormalities to those involving oxidative stress and neuroinflammation in MDD. We discuss our hypothesis that alterations in endothelial nitric oxide levels and endothelial nitric oxide synthase uncoupling are central mechanistic links in this regard. Understanding the contribution of neurovascular dysfunction with BBB hyperpermeability to the pathophysiology of MDD may help to identify novel therapeutic and preventative approaches

Cartilage versus temporalis fascia in tympanplasty

Introduction: Retraction or perforation after reconstruction of the eardrum are well known problems in tympanoplasty. Different techniques and materials, including cartilage and temporalis fascia have been used in an attempt to prevent these problems.Today cartilage is more and more often used in middle ear surgery. It is therefore interesting to compare the outcomes in the short and long term with fascia grafting, which is still the most commonly used material.Methods: Between January 2002 and July 2009 a total of 182 patients aged 18 to 55 underwent surgery for noncholesteatomatous diseases of middle ear. The eardrum was reconstructed using cartilage palisades or cartilage composite grafts in 84 cases and temporalis fascia in 98 cases. The choice between the cartilage in both forms and fascia graft material was at random. Hearing was evaluated by two methods: absolute hearing( pure tone average ) and air-bone gap. For absolute hearing and air-bone gap, an average of thresholds at 500, 1000, 2000 and 4000 Hz was calculated. Hearing results were reported at 12 and 30 months.Results: All patients in the cartilage group attended the follow-up examinations for at least two years. In the fascia group there were 5 patients that did not attend the follow-up examinations. In the cartilage group the mean follow up period was 31 months and 35 months in the fascia group. We present and discuss our results regarding residual perforations, retractions and hearing.Conclusion: The results regarding the residual perforations and hearing are quite the same no matter the material used for the reconstruction. In poor ventilated ears cartilage seems to be a better option for eardrum reconstruction, but it requires a longer follow-up period

Titanium stapes protheses in otosclerosis surgery

Introduction: The main techniques used today in stapes surgery are: stapedectomy (under 10%), partial posterior stapedectomy (small fenestra technique) and stapedotomy (more than 90%). The advantages of stapedotomy are: less trauma to the inner ear and a better stability of the prosthesis. The stapedotomy opening can be made with manual perforators, diamond microburr, laser beam or skeeter drill.Materials and methods: Between January 2006 and October 2011 a total of 162 patients were operated in the ENT Department of the University of Medicine and Pharmacy Timisoara, performing 183 procedures. We used titanium stapes prostheses of 0,4-0,6 mm diameter and 4.5, 4.75 mm lengths. The stapedotomy was performed with the manual perforators (majority of the cases) or with diamond microdrill (sometimes). 17 out of 162 patients were bilateral operated (10,49%). 15 out of 183 procedures were surgical revisions (8,19%). Results: A postoperative air-bone gap of 0 -10 dB was obtained in approximatively 90% of the cases. A partial sensorineural hearing loss, only on high frequencies, occurred in one patient (0,62%). Postoperative vertigo was rare and of short duration.Conclusion: The stapedotomy technique produces little trauma to the inner ear and good functional results. Titanium stapes prostheses have maximum biocompatibility, small weight, the most superior mechanical properties, such as elasticity, stability and stiffness

Eye-Size Variability in Deep-Sea Lanternfishes (Myctophidae): An Ecological and Phylogenetic Study

One of the most common visual adaptations seen in the mesopelagic zone (200-1000 m), where the amount of light diminishes exponentially with depth and where bioluminescent organisms predominate, is the enlargement of the eye and pupil area. However, it remains unclear how eye size is influenced by depth, other environmental conditions and phylogeny. In this study, we determine the factors influencing variability in eye size and assess whether this variability is explained by ecological differences in habitat and lifestyle within a family of mesopelagic fishes characterized by broad intra-and interspecific variance in depth range and luminous patterns. We focus our study on the lanternfish family (Myctophidae) and hypothesise that lanternfishes with a deeper distribution and/or a reduction of bioluminescent emissions have smaller eyes and that ecological factors rather than phylogenetic relationships will drive the evolution of the visual system. Eye diameter and standard length were measured in 237 individuals from 61 species of lanternfishes representing all the recognised tribes within the family in addition to compiling an ecological dataset including depth distribution during night and day and the location and sexual dimorphism of luminous organs. Hypotheses were tested by investigating the relationship between the relative size of the eye (corrected for body size) and variations in depth and/or patterns of luminous-organs using phylogenetic comparative analyses. Results show a great variability in relative eye size within the Myctophidae at all taxonomic levels (from subfamily to genus), suggesting that this character may have evolved several times. However, variability in eye size within the family could not be explained by any of our ecological variables (bioluminescence and depth patterns), and appears to be driven solely by phylogenetic relationships