Multiformni glioblastom lokaliziran u motornom korteksu: specifičnosti u odnosu na gliome niskog stupnja iste lokalizacije - analiza serije od šezdeset bolesnika

The verified presence of a glioblastoma multiforme (GBM ) tumor in the motor area of the brain, in a patient lacking preoperative neurological deficit, offers no certainty that the tumor can be radically removed without the possibility of causing postoperative motor deficit. We present a series of 60 patients hospitalized at the Clinical Department of Neurosurgery, Clinical Center of Serbia in Belgrade between October 2011 and February 2015, harboring tumors located within and in the vicinity of the motor zone of the brain. By using Karnofsky‘s index (KI), the pre- and postoperative conditions of the patients were evaluated. Regarding electrical stimulation of the motor cortex, significantly lower values of the electrical current intensity, frequency, and pulse wave duration (p<0.01) were needed for triggering motor response in case of GBM tumor compared to a slowly growing tumor (low-grade). Patients with low-grade gliomas (LGG) had statistically significantly higher KI values pre- and postoperatively than patients with GBM (p<0.01). Using electrical stimulation of the cortex, a higher grade of resection of LGG could be achieved as compared with the group presenting with GBM (c2=5.281; df=1; p<0.05). Our findings and review of the results reported by other authors underline the necessity of routine application of electrical stimulation of the cerebral cortex in order to identify the primary motor field (M1).Jasna prezentacija tumora mozga u području motorne zone kod bolesnika koji prijeoperacijski nisu imali slabost ekstremiteta nije jamstvo da se on može radikalno odstraniti bez poslijeoperacijskog neurološkog deficita. Prikazujemo niz od 60 ispitanika sa supratentorijalnim tumorima lokaliziranim u i oko motorne zone mozga, koji su hospitalizirani na Institutu za neurokirurgiju KCS u Beogradu u razdoblju od listopada 2011. do veljače 2015. godine. Procjena prije- i poslijeoperacijskog stanja bolesnika je vrednovana ljestvicom Karnofski indeksa (KI). Iz serije su isključeni bolesnici s recidivom tumora i bolesnici čiji je KI kod prijma bio manji od 70. Tijekom procedure elektrostimulacije motornog korteksa potrebne su značajno manje vrijednosti jačine struje, frekvencije i pulsnog vala (p<0,01) za izazivanje motornog odgovora u slučaju postojanja tipa tumora multiformnog glioblastoma (glioblastoma multiforme, GBM ) u odnosu na spororastuće gliome (niskog stupnja) mozga. Nađena je statistički značajna razlika u prije- i poslijeoperacijskim vrijednostima KI (F=48,856; df=1; p<0,01; Eta2=0,457), naime, bolesnici s gliomima niskog stupnja imali su statistički značajno veću vrijednost KI prije- i poslijeoperacijski u odnosu na vrijednosti KI kod skupine bolesnika s GBM (p<0,01). Uporabom elektrostimulacije korteksa postignut je veći stupanj radikalnosti kirurške resekcije glioma niskog stupnja u odnosu na skupinu bolesnika s GBM (c2=5,281; df=1; p<0,05). Kirurgija tumora lokaliziranih u motornom korteksu predstavlja izazov zbog pratećeg rizika od de novo nastanka motornog deficita. Naši rezultati kao i rezultati drugih autora pokazuju neophodnost rutinske primjene direktne elektrostimulacije moždane kore radi identifikacije primarnog motornog polja (M1)

Structural transformation from titania nanoparticles to sodium titanate nanosheet exhibiting sensing properties

TiO2-based nanomaterials, such as titanium dioxide and layered titanates, are increasingly used in nanotechnology due to biological and photochemical stability, catalytic activity, non-toxicity and cost-effectiveness. In addition, it is known that some titanates can be used for humidity sensors regarding hydrophilic nature of their surface [1]. Nine TiO2-based products were obtained by the hydrothermal treatment of starting nanoanatase using NaOH solution (c = 5 mol cm–3) under different conditions (from 6 h at 110 °C to 18 h at 160 °C). Such optimization was necessary in order to obtain single sodium titanate phase allowing the testing of sensing properties but also long time waited distinction between titania and titanates in terms of structural and microstructural properties. The intensification of hydrothermal treatment notably increased the solubility of nanoanatase causing the phase and morphology transition from nearly spherical titania nanoparticles into elongated titanate nanosheets. According to XRPD and HRTEM/SAED, the single titanate phase was prepared after the most energy-intensive treatment, i.e. at 160 °C for 18 h. The Na0.4H1.6Ti2O5·H2O could be ascribed as its formula, based on EDS and TG. The phase composition and crystallite size were calculated in Jade software for all nine samples while unit cell parameters of single-phased sodium titanate were obtained by Rietveld refinement using FullProf software in Winplotr environment. The calculated unit cell parameters of sodium titanate, a = 18.16(7) Å, b = 3.754(7) Å, c = 2.99(1) Å, show the slight elongation along a‑axis comparing to H2Ti2O5·H2O (PDF card No. 47-0124) probably due to partial Na+–H+ ion exchange. The TG and FTIR analyses showed the hygroscopic nature of Na0.4H1.6Ti2O5·H2O nanosheets revealing the water adsorption on surface. Hence, the obtained Na0.4H1.6Ti2O5·H2O was for the first time used to produce a humidity sensor, which displayed remarkably rapid response and very fast recovery time

Divovska kavernozna malformacija s neuobičajeno agresivnim kliničkim tijekom: prikaz slučaja

Giant cavernomas (GC) are rare lesions, with less than 50 cases reported so far. Clinical presentation usually involves epileptic seizures and less typically focal neurological deficit, due to repeated hemorrhages and GC mass effect and consequentially increased intracranial pressure. Although individual cases have been reported, due to the rarity and variable imaging appearance, GCs are usually not considered in the differential diagnosis of large hemorrhagic lesions, especially when significant mass effect is present. A 17-year-old boy presented due to severe headache, right-sided weakness, and slurred speech. Symptoms started three days before with occasional headaches, which intensified gradually. Emergency computed tomography revealed a left frontal massive heterogeneous lesion. Soon after, right-sided hemiparesis and speech impairment progressed, and the patient became drowsy with the slightly dilated left pupil. Emergency surgery was performed, and the lobed grayish lesion was entirely removed. Based on the macroscopic appearance, the surgeon assumed it was a metastasis of melanoma. Histopathologic analysis result was cavernoma. GC should be considered as an option in hemorrhagic lesions, especially in the young age population. Emergency surgery for mass lesions is not uncommon in neurosurgery; however, bleeding cavernomas are usually planned for elective surgery due to the specific approach and complications.Divovski kavernomi (DK) su rijetke lezije s manje od 50 dosad opisanih slučajeva. Uobičajena simptomatologija su epileptični napadaji, a rjeđe se manifestiraju žarišnim neurološkim deficitom koji je uzrokovan ponavljanim hemoragijama i posljedičnim povećanjem intrakranijskog tlaka. Iako su objavljeni pojedini slučajevi, zbog rijetke pojavnosti i raznovrsne radiološke prezentacije DK se obično ne razmatraju u diferencijalnoj dijagnostici velikih hemoragičnih ekspanzivnih lezija, pogotovo kada je prisutan značajan kompresivni učinak. Sedamnaestogodišnji dječak se javio liječniku zbog jake glavobolje, blaže desnostrane slabosti i nerazgovijetnog govora. Simtpomi su se javili 3 dana ranije u vidu blagih glavobolja koje su se postupno pojačavale. Hitna kompjutorizirana tomografija je pokazala masivnu hemoragičnu leziju frontalno lijevo. Nedugo zatim desnostrana slabost i nerazgovijetan govor su se pogoršali i bolesnik je postao pospan s blago proširenom lijevom zjenicom. Učinjena je hitna operacija, kružna sivkasta lezija je u cijelosti uklonjena. Na osnovi makroskopskog izgleda kirurg je pomislio da se radi o metastazi melanoma. Histopatološka analiza je pokazala da se radi o kavernomu. DK bi trebalo razmatrati kao mogućnost kod hemoragičnih lezija, pogotovo kod mlađih bolesnika. Hitna operacija kod kompresivnih lezija nije rijetkost u neurokirurgiji, međutim, krvareći kavernomi se obično planiraju za elektivnu operaciju zbog specifičnog pristupa i mogućih komplikacija

Supplementary data for article: Villalta-Romero, F.; Borro, L.; Mandić, B.; Escalante, T.; Rucavado, A.; Gutierrez, J. M.; Neshich, G.; Tasic, L. Discovery of Small Molecule Inhibitors for the Snake Venom Metalloprotease BaP1 Using in Silico and in Vitro Tests. Bioorganic and Medicinal Chemistry Letters 2017, 27 (9), 2018–2022. https://doi.org/10.1016/j.bmcl.2017.03.007

Supplementary material for: [ https://doi.org/10.1016/j.bmcl.2017.03.007]Related to published version: [http://cherry.chem.bg.ac.rs/handle/123456789/2449]Related to accepted version: [http://cherry.chem.bg.ac.rs/handle/123456789/3001

Određivanje prediktivnih anatomskih parametara za krvarenje arteriovenskih malformacija mozga pomoću multidetektorske CT angiografije

Patients with brain arteriovenous malformation (AVM) have a certain risk to bleed, and the goal of this study was to examine the effect of radiological and clinical predictive characteristics of AVM hemorrhage using multidetector computed tomographic (MDCT) angiography. The study included a series of 57 patients, mean age 35.46 years, who were diagnosed during their hospitalization at Clinical Department of Neurosurgery, Clinical Center of Serbia, in the period from January 2008 to March 2016. In all patients, the diagnosis was made using MDCT angiography. Two groups of patients were observed. The first group included patients who did not initially present with hemorrhage, while the second group initially presented with hemorrhage. Both groups were treated with medical therapy or a combination of medical therapy with embolization/surgery/radiotherapy. Deep venous drainage (p60 mm, venous dilatation present in the drainage vein (p60 mm, the angle of the casting feeding arteries in the nidus ≥130° and dilatation and/or venous aneurysm of drainage vessel are predictive for clinical presenting by hemorrhage.Bolesnici s arteriovenskim malformacijama mozga (AVM) imaju određen rizik za krvarenje pa je cilj ove studije bio ­ispitati utjecaj radioloških i kliničkih prediktivnih karakteristika AVM za hemoragiju pomoću multidetektorske CT angiog-rafije (MDCTA). U studiju je bilo uključeno 57 bolesnika srednje dobi od 35,46 godina kojima je dijagnoza postavljena na Institutu za radiologiju i magnetskom rezonancijom dok su bili hospitalizirani na Klinici za neurologiju Kliničkog centra Srbije u razdoblju od siječnja 2008. do ožujka 2016. godine. Svim bolesnicima je dijagnoza postavljena pomoću MDCTA. Praćene su dvije skupine bolesnika. Jednu skupinu činili su bolesnici kod kojih se AVM u početku nije manifestirala krva-renjem, dok se druga skupina odmah prezentirala hemoragijom. Obje skupine su liječene medikamentnom terapijom ili kombinacijom medikamentne terapije s embolizacijom/kirurškom intervencijom/radioterapijom. Duboka venska drenaža (p60 mm, prisutna venska dilatacija na dre-nažnoj veni (p60 mm, kutom ulijevanja dovodne arterije u nidus ≥130° i dilatacijom i/ili aneurizmom drenažne vene su prediktivni model za kliničko prezentiranje hemoragijom

Assessing the quality of angiographic display of brain blood vessels aneurysms compared to intraoperative state

Background/Aim. Aneurysms in brain blood vessels are expanding bags composed of a neck, body and fundus. Clear visibility of the neck, the position of the aneurysm and surrounding structures are necessary for a proper choice of methods for excluding the aneurysm from the circulation. The aim of this study was to evaluate the reliability of spatial reconstruction of blood vessels of the brain based on the original software for 3D reconstruction of the equipment manufacturer and a personal computer model developed earlier in the Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, compared to intraoperative identification of these aneurysms. Methods. This study included 137 patients of both sexes. The presence of an aneurysm was verified by angiographic methods [computed tomographic angiography (CTA), multislice computed tomography angiography (MSCTA), magnetic resonance imaging angiography (MRA), or digital subtraction angiography (DSA)]. Results. The quality score (0 to 5) for CTA was 3.180 ± 0.961, MSCTA 4.062 ± 0.928, and for DSA 4.588 ± 0.758 (p < 0.01). The results of this study favorite conventional angiography as the gold standard for diagnostic of intracranial aneurysms. Conclusion. The results of this study are consistent with current publications review and clearly recognize the advantages and disadvantages of diagnostic neuroradiological procedures, with DSA of brain blood vessels as a binding preoperative diagnostic procedure in cases in who it is not possible to clearly visualize the supporting blood vessel and neck of the aneurysm by using the findings of CTA, MRA and MSCTA

Src Inhibitors Pyrazolo[3,4-d]pyrimidines, Si306 and Pro-Si306, Inhibit Focal Adhesion Kinase and Suppress Human Glioblastoma Invasion In Vitro and In Vivo

Glioblastoma (GBM), as the most aggressive brain tumor, displays a high expression of Src tyrosine kinase, which is involved in the survival, migration, and invasiveness of tumor cells. Thus, Src emerged as a potential target for GBM therapy. The effects of Src inhibitors pyrazolo[3,4-d]pyrimidines, Si306 and its prodrug pro-Si306 were investigated in human GBM cell lines (U87 and U87-TxR) and three primary GBM cell cultures. Primary GBM cells were more resistant to Si306 and pro-Si306 according to the 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. However, the ability of all GBM cells to degrade the extracellular matrix was considerably compromised after Si306 and pro-Si306 applications. Besides reducing the phosphorylation of Src and its downstream signaling pathway components, both compounds decreased the phosphorylated form of focal adhesion kinase (FAK) and epidermal growth factor receptor (EGFR) expression, showing the potential to suppress the aggressiveness of GBM. In vivo, Si306 and pro-Si306 displayed an anti-invasive effect against U87 xenografts in the zebrafish embryo model. Considering that Si306 and pro-Si306 are able to cross the blood-brain barrier and suppress the spread of GBM cells, we anticipate their clinical testing in the near future. Moreover, the prodrug showed similar efficacy to the drug, implying the rationality of its use in clinical settings

COMPARISON OF SENSING PROPERTIES OF SnO2/KIT-5 AND SnO2 HUMIDITY SENSORS

In this work, two different syntheses approaches – nanocasting and sol-gel technique were employed for the preparation of SnO2 powders for humidity sensors. Stock solution of SnCl2 in ethanol (0.5 M) was used as a Sn-precursor for both syntheses. In the first procedure, this solution was infiltrated by wet impregnation method into the hydrothermally prepared KIT-5 used as silica template. Mesoporous SnO2/KIT-5 hybrid was obtained after two step loading/calcination process. Calcination was performed at 550 C for 5 h. In the second procedure, silica template was excluded from synthetic path. Ethanol solution of SnCl2 was slowly heated to form the gel which was later submitted to the same calcination conditions resulting in the preparation of SnO2 nanopowder. By dispersing the as prepared powders in the ethyl-cellulose/α-terpineol solution and adding a few drops of acetic acid in the mixture, viscous pastes were prepared and further homogenized for 24 h with magnetic stirrer. Using doctor blade applicator a few micron thick films were deposited onto alumina substrates provided with interdigitated Pt/Ag electrodes. Sensors’ characteristics were compared by measuring the change of the complex impedance of the samples exposed to a humid climate chamber environment at different temperatures and RH values from 40 % to 90 % at 25 °C and from 30 % to 90 % at 50 °C. The value of impedance measured at 42 Hz and within the RH range of 40 % to 90 %, changes 53 times at 25 °C, and 96 times at 50 °C. In contrast, for the sensor prepared from chemically derived SnO2, the impedance changes in a moderate way – 8 times at 25 °C and 3 times at 50 °C. Fast response/recovery time of the SnO2/KIT-5 hybrid sensor exposed to humidity change from 40 % – 90 % at room temperature, confirmed superior potentials of this material for humidity sensing over the SnO2

CuO-based nanoplatelets for humidity sensing application

Determination and monitoring of humidity level is of great importance because water is one of essential components of the living organisms and materials used by people. Metal oxides are the most popular materials used as sensing elements for humidity sensors, due to their excellent thermal and environmental stability, high mechanical strength, wide range of working temperature, low fabrication cost and robustness in practical applications. Humidity sensing ability of metal oxide based ceramic materials can be enhanced by doping with metal cations. In this work, we present hydrothermal method for preparation of pure and Mgdoped CuO nanoplatelets and investigate their sensing properties towards humidity. The proposed method involves autoclaving of copper(II)-acetate solution under autogenous pressure in alkaline conditions, with different concentrations of Mgdopant (0, 2.5, 5 and 10 mol%). We have performed thorough structural and optical investigations of as synthesized material (TEM, XRD, SAED, UV-VIS-NIR). Furthermore, we have processed obtained powders into functional thick films using doctor blade technique, and their sensing properties were tested in wide range of temperatures (25, 50, 75 °C) and relative humidities (40–90%), resulting with strong response and promising response/recovery times

The application of the Kampala trauma Score for prehospital assessment of severity of injuries and prediction of outcome after severe trauma

Severe trauma is the main cause of mortality and disability in modern society. Emergency medical doctors are usually the first to establish contact with the injured person, and the extent of definitive care largely depends on their correct assessment of the severity of the injury, using an adequate pre-hospital trauma score. Injury severity scores are used to numerically categorize the type and extent of the injury. They represent an important additional instrument, which is used to enable faster triage, the categorization of injury severity, adequate care, treatment, and transport of patients with multiple injuries to the appropriate hospital. They are also important in research. This paper aims to suggest, using several case reports, the possibility of pre-hospital use of the Kampala Trauma Score (KTS) as an easily applicable and very suitable system for monitoring the condition and predicting the outcome of seriously injured patients. The patients were primarily assessed at the pre-hospital level and assigned a certain injury severity score according to the KTS, which later proved to reflect their definitive outcome. It can be concluded that the KTS is an effective scoring system that can be used during initial triage of the seriously injured for categorization of the severity of the injury, prediction of mortality and necessity of hospitalization. The possibility of its potential application during emergency care of the seriously injured, both for differentiating the severity of injuries and for predicting the definitive outcome, is indicated. However, due to the limited number of patients, original research should be conducted on a larger sample