Neuronavigation and intraoperative imaging system in orbital tumor surgery: a review of recent literature

Orbit is a small complex anatomic space that contains important structures, ocular globe, extrinsic muscles, cranial nerves, blood vessels, fat, lacrimal gland. In presence of orbital tumors it is mandatory to use a surgical approach that allows to achieve an adequate surgical field while preserving neurological function. Neuronavigation is the set of computer-assisted technologies used to guide or "navigate” the edges of the tumor to allow the surgeon during resection or biopsy. This technology started with use of CT data to get some landmarks of human anatomy defined “targets” that could be readily used in surgery. Finally, the evolution of modern neuroimaging technologies such intraoperative CT and MRI boosted the surgery accuracy. In order to identify advantages and practical use of these technologies we performed a nonsystematic review of the current literature using the keywords “orbital tumor or orbital neoplasia or orbital mass or orbital lesion” and “neuronavigation or navigation” published in last 10 years. We evaluated 29 papers and we can conclude that navigation in orbital surgery helps to reduce surgical damage while at the same time, allowing a more radical tumor resection. CT and MRI scans are complementary in diagnosing and in intraoperative navigation allow the surgeon to avoid and preserve vital structures, particularly in a complex surgical procedure without real anatomical landmarks for intraoperative orientation. Future is going towards rapid changes and the integration with intraoperative procedures is carrying on to new technologies further our contemporary bounds

Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, "local" relapse was observed 5 months after surgery

The interaction of native calf thymus DNA with FeIII-dipyrido[3,2-a:2\u2019,3\u2019-c]phenazine

The mono and bis dipyrido[3,2-a:20,30-c]phenazine (dppz) adducts of iron(III) chloride, i.e. [Fe(dppz)]Cl3 and [Fe(dppz)2]Cl3, have been synthesized and characterized. The interaction of the FeIIIdppz hydrolyzed aquo complex with native calf thymus DNA has been monitored as a function of the metal complex\u2013DNA molar ratio, by variable temperature UV absorption spectrophotometry, circular dichroism (CD) and fluorescence spectroscopy. The results obtained in solution at various ionic strength values give support for a tight intercalative binding of the FeIIIdppz cation with DNA. In particular, the appearance of induced CD bands, caused by the addition of FeIIIdppz, indicate the existence of a rigid metal complex\u2013DNA-binding leading to dominating chiral organization of FeIIIdppz species within the DNA double helix. The trend of selected CD bands with the molar concentration of FeIIIdppz emphasizes that the presence of high amounts of metal complex induces also the formation of DNA\u2013FeIIIdppz supramolecular aggregates in solution. The analysis of fluorescence measurements allowed us to calculate a value of the intercalative binding constant comparable to that obtained by UV spectrophotometric titration. Finally, the temperature dependence of the absorbance at 258 nm shows that the metal complex strongly increases the DNA melting temperature already at metal complex\u2013DNA molar ratio equal to 0.25 suggesting that metal complex intercalation effectively hinders DNA denaturation. Overall, the results of the present study point out that the FeIIIdppz aquo complex has DNA-binding properties analogous to those previously reported for the tris-chelate FeII(phen)2dppz complex (phen = 1,10-phenantroline)

Analysis of 3 years of data from the gravitational wave detectors EXPLORER and NAUTILUS

We performed a search for short gravitational wave bursts using about 3 years of data of the resonant bar detectors Nautilus and Explorer. Two types of analysis were performed: a search for coincidences with a low background of accidentals (0.1 over the entire period), and the calculation of upper limits on the rate of gravitational wave bursts. Here we give a detailed account of the methodology and we report the results: a null search for coincident events and an upper limit that improves over all previous limits from resonant antennas, and is competitive, in the range h_rss ~1E-19, with limits from interferometric detectors. Some new methodological features are introduced that have proven successful in the upper limits evaluation.Comment: 12 pages, 12 figure

Natural products as novel scaffolds for the design of glycogen synthase kinase 3β inhibitors

Introduction: The different and relevant roles of GSK-3 are of critical importance since they deal with development, metabolic homeostasis, cell polarity and fate, neuronal growth and differentiation as well as modulation of apoptotic potential. Given their involvement with different diseases, many investigations have been undertaken with the aim of discovering new and promising inhibitors for this target. In this context, atural products represent an invaluable source of active molecules. Areas covered: In order to overcome issues such as poor pharmacokinetic properties or efficacy, frequently associated with natural compounds, different GSK-3β inhibitors belonging to alkaloid or flavonoid classes have been subjected to structural modifications in order to obtain more potent and safer compounds. Herein, the authors report the results obtained from studies where natural compounds have been used as hits with the aim of providing new kinase inhibitors endowed with a better inhibitory profile. Expert opinion: Structurally modification of natural scaffolds is a proven approach taking advantage of their pharmacological characteristics. Indeed, whatever the strategy adopted is and, despite the limitations associated with the structural complexity of natural products, the authors recommend the use of natural scaffolds as a promising strategy for the discovery of novel and potent GSK-3β inhibitors

The role of time-resolved imaging of contrast kinetics (TRICKS) magnetic resonance angiography (MRA) in the evaluation of head-neck vascular anomalies: A preliminary experience

Objectives: In this preliminary report, we describe our experience with time-resolved imaging of contrast kinetics-MR angiography (TRICKS-MRA) in the assessment of head-neck vascular anomalies (HNVAs). Methods: We prospectively studied six consecutive patients with clinically suspected or diagnosed HNVAs. All of them underwent TRICKS-MRA of the head and neck as part of the routine for treatment planning. A digital subtraction angiography (DSA) was also performed. Results: TRICKS-MRA could be achieved in all cases. Three subjects were treated based on TRICKS-MRA imaging findings and subsequent DSA examination. In all of them, DSA confirmed the vascular architecture of HNVAs shown by TRICKS-MRA. In the other three patients, a close follow up to assess the evolution of the suspected haemangioma was preferred. Conclusions: TRICKS sequences add important diagnostic information in cases of HNVAs, helpful for therapeutic decisions and post-treatment follow up. We recommend TRICKSMRA use (if technically possible) as part of routine MRI protocol for HNVAs, representing a possible alternative imaging tool to conventional DSA

Effect of cosmic rays on the resonant gravitational wave detector NAUTILUS at temperature T=1.5 K

The interaction between cosmic rays and the gravitational wave bar detector NAUTILUS is experimentally studied with the aluminum bar at temperature of T=1.5 K. The results are compared with those obtained in the previous runs when the bar was at T=0.14 K. The results of the run at T = 1.5 K are in agreement with the thermo-acoustic model; no large signals at unexpected rate are noticed, unlike the data taken in the run at T = 0.14 K. The observations suggest a larger efficiency in the mechanism of conversion of the particle energy into vibrational mode energy when the aluminum bar is in the superconductive status.Comment: 7 pages, 3 figures, 2 tables. Accepted by Physics Letters