A Case Study of Genomic Instability in an Industrial Strain of Saccharomyces cerevisiae

The Saccharomyces cerevisiae strain JAY270/PE2 is a highly efficient biocatalyst used in the production of bioethanol from sugarcane feedstock. This strain is heterothallic and diploid, and its genome is characterized by abundant structural and nucleotide polymorphisms between homologous chromosomes. One of the reasons it is favored by many distilleries is that its cells do not normally aggregate, a trait that facilitates cell recycling during batch-fed fermentations. However, long-term propagation makes the yeast population vulnerable to the effects of genomic instability, which may trigger the appearance of undesirable phenotypes such as cellular aggregation. In pure cultures of JAY270, we identified the recurrent appearance of mutants displaying a mother-daughter cell separation defect resulting in rough colonies in agar media and fast sedimentation in liquid culture. We investigated the genetic basis of the colony morphology phenotype and found that JAY270 is heterozygous for a frameshift mutation in the ACE2 gene (ACE2/ace2-A7), which encodes a transcriptional regulator of mother-daughter cell separation. All spontaneous rough colony JAY270-derived isolates analyzed carried copy-neutral loss-of-heterozygosity (LOH) at the region of chromosome XII where ACE2 is located (ace2-A7/ace2-A7). We specifically measured LOH rates at the ACE2 locus, and at three additional chromosomal regions in JAY270 and in a conventional homozygous diploid laboratory strain. This direct comparison showed that LOH rates at all sites were quite similar between the two strain backgrounds. In this case study of genomic instability in an industrial strain, we showed that the JAY270 genome is dynamic and that structural changes to its chromosomes can lead to new phenotypes. However, our analysis also indicated that the inherent level of genomic instability in this industrial strain is normal relative to a laboratory strain. Our work provides an important frame of reference to contextualize the interpretation of instability processes observed in the complex genomes of industrial yeast strains.

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HO Endonuclease-Initiated Recombination in Yeast Meiosis Fails To Promote Homologous Centromere Pairing and Is Not Constrained To Utilize the Dmc1 Recombinase

Crossover recombination during meiosis is accompanied by a dramatic chromosome reorganization. In Saccharomyces cerevisiae, the onset of meiotic recombination by the Spo11 transesterase leads to stable pairwise associations between previously unassociated homologous centromeres followed by the intimate alignment of homologous axes via synaptonemal complex (SC) assembly. However, the molecular relationship between recombination and global meiotic chromosome reorganization remains poorly understood. In budding yeast, one question is why SC assembly initiates earliest at centromere regions while the DNA double strand breaks (DSBs) that initiate recombination occur genome-wide. We targeted the site-specific HO endonuclease to various positions on S. cerevisiae's longest chromosome in order to ask whether a meiotic DSB's proximity to the centromere influences its capacity to promote homologous centromere pairing and SC assembly. We show that repair of an HO-mediated DSB does not promote homologous centromere pairing nor any extent of SC assembly in spo11 meiotic nuclei, regardless of its proximity to the centromere. DSBs induced en masse by phleomycin exposure likewise do not promote homologous centromere pairing nor robust SC assembly. Interestingly, in contrast to Spo11, HO-initiated interhomolog recombination is not affected by loss of the meiotic kinase, Mek1, and is not constrained to use the meiosis-specific Dmc1 recombinase. These results strengthen the previously proposed idea that (at least some) Spo11 DSBs may be specialized in activating mechanisms that both 1) reinforce homologous chromosome alignment via homologous centromere pairing and SC assembly, and 2) establish Dmc1 as the primary strand exchange enzyme.

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Evidence of Zip1 Promoting Sister Kinetochore Mono-orientation During Meiosis in Budding Yeast

Halving of the genome during meiosis I is achieved as the homologous chromosomes move to the opposite spindle poles whereas the sister chromatids stay together and move to the same pole. This requires that the sister kinetochores should take a side-by-side orientation in order to connect to the microtubules emanating from the same pole. Factors that constrain sister kinetochores to adopt such orientation are therefore crucial to achieve reductional chromosome segregation in meiosis I. In budding yeast, a protein complex, known as monopolin, is involved in conjoining of the sister kinetochores and thus facilitates their binding to the microtubules from the same pole. In this study, we report Zip1, a synaptonemal complex component, as another factor that might help the sister kinetochores to take the side-by-side orientation and promote their mono-orientation on the meiosis I spindle. From our results, we propose that the localization of Zip1 at the centromere may provide an additional constraining factor that promotes monopolin to cross-link the sister kinetochores enabling them to mono-orient.

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Poster 238: A Case Report: Ascending Paresis: An Atypical Presentation of Bannwarth Syndrome

Erin Beddows: I Have No Relevant Financial Relationships To Disclose

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Poster 232: Brachial Artery Pseudoaneurysm Causing Median Mononeuropathy: A Case Report

John Wallington: I Have No Relevant Financial Relationships To Disclose

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Poster 334: Delayed Diagnosis of Spinal Epidural Abscess in a Chronic Pain Patient: A Case Report

Matthew Moore: I Have No Relevant Financial Relationships To Disclose

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Poster 345: A 7-Year-Old Boy Developed Ataxic Gait: A Case Report

Jinpu Li: I Have No Relevant Financial Relationships To Disclose

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Poster 269: The Anti-Hu Syndrome: Anti-Hu Antibody Related Paraneoplastic Sensorimotor Polyneuropathy in a Patient with Poorly Differentiated Small Cell Carcinoma of the Lung: A Case Report

Vivek Sindhi: I Have No Relevant Financial Relationships To Disclose

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Poster 346: Spasticity Management in a Pediatric Patient with Co-morbid Duchenne Muscular Dystrophy and Cerebral Palsy: A Case Report

Mark Fisher: I Have No Relevant Financial Relationships To Disclose

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Poster 302: Multifocal Motor Neuropathy Due to Copper Deficiency. A Case Report

Ajaya Moturu: I Have No Relevant Financial Relationships To Disclose

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Poster 347: Fibrocartilaginous Embolism Causing Spinal Cord Injury in a Pediatric Patient

Brittni Micham: I Have No Relevant Financial Relationships To Disclose

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Poster 62: Subacute Systemic Inflammation Associated with Depression at 12 Months Post-Traumatic Brain Injury

Juliet Schulz: I Have No Relevant Financial Relationships To Disclose

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Poster 348: Recovery from Malignant Catatonia with Electroconvulsive Therapy in a Child with Anti-NMDA Receptor Encephalitis: A Case Report

Roger Wang: I Have No Relevant Financial Relationships To Disclose

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Poster 318: Treatment of Phantom Limb Pain in Recent Amputee with Virtual Reality Mirror Therapy: A Case Report

Phillip Ta: I Have No Relevant Financial Relationships To Disclose

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Poster 349: Aicardi-Goutieres Syndrome as a Rare Cause of Spastic Diplegia: A Case Report

Nan Wang: I Have No Relevant Financial Relationships To Disclose

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Poster 286: Central Pontine Myelinolysis in Refeeding Syndrome in Setting of Alcohol Abuse Without Hyponatremia: A Case Report

Richard Lau: I Have No Relevant Financial Relationships To Disclose

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Poster 350: Delayed Presentation of a Pediatric Traumatic Popliteal Artery Injury: A Case Report

Juliet Amene: I Have No Relevant Financial Relationships To Disclose

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Poster 253: A Rare Case of Purkinje Cell Cytoplasmic Antibody and P/Q-type Voltage-Gated Calcium Channel Antibody Positive Paraneoplastic Cerebellar Degeneration

Ashley Kakkanatt: I Have No Relevant Financial Relationships To Disclose

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Poster 351: Hydrocephalus Following Cervical Spinal Cord Injury: A Case Report

Elise Tran: I Have No Relevant Financial Relationships To Disclose

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Poster 342: Paraplegia After Thoracic Intercostal Chemical Nerve Ablation

Ehab Yasin: I Have No Relevant Financial Relationships To Disclose

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Poster 352: Back to School Woes: Hereditary Neuropathy with Liability to Pressure Palsies and Its Impact on Education

Michael Ibrahim: I Have No Relevant Financial Relationships To Disclose

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Poster 326: Multilevel Vertebral Compression Fractures Due to Pregnancy Induced Osteoporosis and Lovenox Use in a Post-Partum Patient: A Case Report

John Wallington: I Have No Relevant Financial Relationships To Disclose

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Poster 353: Intervertebral Disc Calcification: An Uncommon Cause of Acute Pediatric Cervical Pain

Joseph Seacrist: I Have No Relevant Financial Relationships To Disclose

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Dynamic Cerebral Autoregulation Is Maintained during High-Intensity Interval Exercise

Introduction High-intensity interval exercise (HIIE) is more effective at increasing metabolic and cardiovascular health compared to moderate-intensity continuous exercise for patients with cardiovascular disease, but exhaustive high-intensity continuous exercise (HICE) attenuates dynamic cerebral autoregulation (CA). This study assessed the effect of HIIE on dynamic CA. Methods Nine healthy men (age: 24 ± 3 years; mean ± SD) warmed up at 50%-60% maximal workload (Wmax) for 5 min before HIIE including four 4 min bouts of exercise at 80%-90% Wmax interspaced by four 3 min bouts at 50%-60% Wmax. Transcranial Doppler determined middle cerebral artery mean blood velocity (MCA Vmean), and brachial artery catheterization determined mean arterial pressure (MAP). Dynamic CA was evaluated by transfer function analysis of changes in MAP and MCA Vmean. Results The HIIE increased MAP (from 92 ± 9 to 104 ± 10 mmHg; P

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The Effect of Dietary Protein on Protein Metabolism and Performance in Endurance-trained Males

Recommendations for dietary protein are based primarily intakes that maintain nitrogen (i.e. protein) balance rather than optimize metabolism and/or performance. PURPOSE To determine how varying protein intakes, including a new tracer-derived safe intake, alter whole body protein metabolism and exercise performance during training. METHODS Using a double-blind randomized crossover design, 10 male endurance-trained runners (age, 32±8 yr; VO2peak, 65.9±7.9 ml O2·kg-1·min-1) performed 3 trials consisting of 4 days of controlled training (20, 5, 10, 20 km·d-1, respectively) while consuming diets providing 0.94 (LOW), 1.20 (MOD), and 1.83 (HIGH) g protein·kg-1·d-1. Whole body protein synthesis (S), breakdown (B), and net balance (NB) were determined by oral [15N]glycine on the first and last day of the 4-d controlled training period whereas exercise performance was determined from maximum voluntary isometric contraction (MVC), 5-km Time Trial (5kmTT), and countermovement jump Impulse (IMP) and peak force (PF) before and immediately after the 4-d intervention. RESULTS S and B were not affected by protein intake whereas NB showed a dose-response (HIGH > MOD > LOW, P

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Mutations of ARX and non-syndromic intellectual disability in Chinese population

Abstract

Mutations of Aristaless-related homeobox (ARX) gene were looked as the third cause of non-syndromic intellectual disability (NSID), while the boundary between true disease-causing mutations and non-disease-causing variants within this gene remains elusive. To investigate the relationship between ARX mutations and NSID, a panel comprising six reported causal mutations of the ARX was detected in 369 sporadic NSID patients and 550 random participants in Chinese. Two mutations, c.428_451 dup and p.G286S, may be disease-causing mutations for NSID, while p.Q163R and p.P353L showed a great predictive value in female NSID diagnosis with significant associations (X² = 19.60, p = 9.54e−6 for p.Q163R; X² = 25.70, p = 4.00e−07 for p.P353L), carriers of these mutations had an increased risk of NSID of more than fourfold. Detection of this panel also predicted significant associations between genetic variants of the ARX gene and NSID (p = 3.73e−4). The present study emphasized the higher genetic burden of the ARX gene on NSID in the Chinese population, molecular analysis of this gene should be considered for patients presenting NSID of unknown etiology.

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Bronchial Blocker Use in the Difficult Airway Patient Requiring Lung Isolation: Clarification as to What Blockers Are Actually Available

No abstract available

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Intraoperative Considerations for Transgender Patients

No abstract available

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In Response

No abstract available

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In Response

No abstract available

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Programmed Intermittent Bolus Regimen for Erector Spinae Plane Blocks in Children: A Retrospective Review of a Single-Institution Experience

With few published reports on erector spinae plane block use in children, limited guidance on perioperative local anesthetic dosing exists. We present a series of 22 patients who received erector spinae plane catheters with programmed intermittent bolus for various surgeries. Median loading dose of 0.4 mL/kg (interquartile range [IQR], 0.1 mL/kg) ropivacaine 0.5%, intraoperative bolus of 0.3 mL/kg/h (IQR, 0.1 mL/kg) ropivacaine 0.2%, and a postoperative programmed intermittent bolus regimen of maximum 0.6 mg/kg/h resulted in highest pain scores on postoperative day 1 with a median score of 1.7 of 10 (IQR, 1.8) and highest morphine equivalents consumed on postoperative day 2 with a median score of 0.16 mg/kg up to 120 hours after surgery. Accepted for publication August 22, 2018. Funding: None. Conflicts of Interest: See Disclosures at the end of the article. Reprints will not be available from the authors. Address correspondence to Ban C. H. Tsui, MD, FRCPC, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, 300 Pasteur Dr, 3rd Floor, Room H3584, MC 5640, Stanford, CA 94305. Address e-mail to bantsui@stanford.edu. © 2018 International Anesthesia Research Society

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Acute Stroke Management in the First 24 Hours: A Practical Guide for Clinicians

No abstract available

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Obstetric Anesthesiology in the United States: Current and Future Demand for Fellowship-Trained Subspecialists

No abstract available

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Lack of Bias Evaluation and Inadequate Study Selection May Produce Misleading Results

No abstract available

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Should We Always Continue β-Blocking Agents Preoperatively?

No abstract available

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Is Tube Thermosoftening Helpful for Videolaryngoscope-Guided Nasotracheal Intubation?: A Randomized Controlled Trial

BACKGROUND: Thermosoftening of the endotracheal tube (ETT) and telescoping the ETT into a rubber catheter have been suggested as a method for reducing epistaxis during nasotracheal intubation (NTI). However, thermosoftening technique is known to make it difficult to navigate the ETT into trachea without the use of Magill forceps during NTI. The cuff inflation technique has been suggested as an effective alternative to the use of Magill forceps to improve the oropharyngeal navigation of the ETT, irrespective of their stiffness, during direct laryngoscope-guided NTI. We evaluated whether thermosoftening of the ETT telescoped into rubber catheters has an additional benefit in reducing nasal injury. Simultaneously, we also evaluated whether thermosoftening of the ETT worsened orotracheal navigability during cuff inflation-supplemented videolaryngoscope-guided NTI. METHODS: One hundred forty patients were randomly assigned to 1 of the 2 groups depending on whether the ETT was softened by warming or not. The primary outcome was the incidence of epistaxis during NTI. The secondary outcome was nasotracheal navigability of the ETT, assessed by navigation grade and time required for insertion of ETT in each phase (from nose to oropharynx, from oropharynx to glottic inlet aided by cuff inflation if needed, and from glottic inlet to trachea). RESULTS: The ETTs were successfully inserted through the selected nostril of all 140 patients. In the thermosoftening group, the incidence and severity of epistaxis was significantly lower (7% vs 51%; difference of 44.2%; 95% confidence interval, 29.9%–56.2%; P .99 and P = .054, respectively) and from the glottic inlet to the trachea (P > .99 and P = .750, respectively) between the 2 groups. In both groups, all ETTs could be navigated into the trachea without the use of Magill forceps. CONCLUSIONS: Supplemented with cuff inflation during videolaryngoscope-guided NTI, thermosoftening of the ETT telescoped into rubber catheters has a substantial benefit because it significantly reduces the incidence of epistaxis without worsening the oropharyngeal navigability of the ETT. Accepted for publication August 17, 2018. Funding: None. The authors declare no conflicts of interest. This study was approved by the Institutional Ethics Committee (institutional review board [IRB] approval number 2017-03-020, IRB contact information: Institutional Review Board, Hallym University Kangnam Sacred Heart Hospital, B1, 12, Siheung-daero 187-gil, Yeongdeungpo-gu, Seoul 07441, Republic of Korea. E-mail: dandelionc@hallym.or.kr. Reprints will not be available from the authors. Address correspondence to Joo Hyun Jun, MD, PhD, Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea. Address e-mail to ilpleut@naver.com. © 2018 International Anesthesia Research Society

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Multimodal General Anesthesia: Theory and Practice

Balanced general anesthesia, the most common management strategy used in anesthesia care, entails the administration of different drugs together to create the anesthetic state. Anesthesiologists developed this approach to avoid sole reliance on ether for general anesthesia maintenance. Balanced general anesthesia uses less of each drug than if the drug were administered alone, thereby increasing the likelihood of its desired effects and reducing the likelihood of its side effects. To manage nociception intraoperatively and pain postoperatively, the current practice of balanced general anesthesia relies almost exclusively on opioids. While opioids are the most effective antinociceptive agents, they have undesirable side effects. Moreover, overreliance on opioids has contributed to the opioid epidemic in the United States. Spurred by concern of opioid overuse, balanced general anesthesia strategies are now using more agents to create the anesthetic state. Under these approaches, called "multimodal general anesthesia," the additional drugs may include agents with specific central nervous system targets such as dexmedetomidine and ones with less specific targets, such as magnesium. It is postulated that use of more agents at smaller doses further maximizes desired effects while minimizing side effects. Although this approach appears to maximize the benefit-to-side effect ratio, no rational strategy has been provided for choosing the drug combinations. Nociception induced by surgery is the primary reason for placing a patient in a state of general anesthesia. Hence, any rational strategy should focus on nociception control intraoperatively and pain control postoperatively. In this Special Article, we review the anatomy and physiology of the nociceptive and arousal circuits, and the mechanisms through which commonly used anesthetics and anesthetic adjuncts act in these systems. We propose a rational strategy for multimodal general anesthesia predicated on choosing a combination of agents that act at different targets in the nociceptive system to control nociception intraoperatively and pain postoperatively. Because these agents also decrease arousal, the doses of hypnotics and/or inhaled ethers needed to control unconsciousness are reduced. Effective use of this strategy requires simultaneous monitoring of antinociception and level of unconsciousness. We illustrate the application of this strategy by summarizing anesthetic management for 4 representative surgeries. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Accepted for publication June 11, 2018. Funding: This work was supported by the National Institutes of Health (Bethesda, MD): R01 GM104948 (to E.N.B.) and P01GM118269 (to E.N.B.); and by the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA. Conflicts of Interest: See Disclosures at the end of the article. A glossary of terms is available in the Appendix. Reprints will not be available from the authors. Address correspondence to Emery N. Brown, MD, PhD, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Grey-Jackson 444, Boston, MA 02114. Address e-mail to enb@neurostat.mit.edu. © 2018 International Anesthesia Research Society

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Performance of Air Seal of Flexible Reinforced Laryngeal Mask Airway in Thyroid Surgery Compared With Endotracheal Tube: A Randomized Controlled Trial

BACKGROUND: Flexible reinforced laryngeal mask airway (FLMA®) has gained popularity in thyroid surgery, but air leak and displacement are still concerns. METHODS: In this randomized, single-blinded, noninferiority, controlled trial, we randomized patients scheduled for elective radical thyroidectomy to an endotracheal tube (ETT) group or a FLMA group. The primary outcomes were ventilation leak volume, peak airway pressure, and partial pressure of end-tidal carbon dioxide (PetCO2). Data for primary outcomes were collected after insertion of ETT/FLMA, at incision, and at 10-minute intervals during surgery. Ten milliliters, 5 cm H2O, and 10 mm Hg were used as the noninferiority deltas for ventilation leak volume, peak airway pressure, and PetCO2, respectively. We assessed noninferiority of FLMA to ETT on the primary outcomes over time using the results of a linear mixed-effects model. The position of FLMA mask was evaluated before and after surgery, and the airway complications were recorded. RESULTS: A total of 132 patients were included: 65 in ETT group and 67 in FLMA group. Differences (FLMA group minus ETT group) of ventilation leak volume, peak airway pressure, and PetCO2 from the mixed-effects models were 2.09 mL (98.3% confidence interval [CI], –6.46 to 10.64), −0.60 cm H2O (98.3% CI, –2.15 to 0.96), and 1.02 mm Hg (98.3% CI, 0.04–1.99), respectively. Score of fiber-optic position of FLMA was significantly higher after surgery than before. There was no severe shift, loss of the mask seal, regurgitation, or aspiration in the FLMA group. One patient in the FLMA group experienced brief and easily controlled laryngospasm. CONCLUSIONS: In thyroid surgery, FLMA is noninferior to ETT in the peak airway pressure and PetCO2 although mild to moderate mask shift could occur during surgical manipulation. There is no evidence for a higher complication rate when FLMA is used. Accepted for publication July 27, 2018. Funding: None. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). Clinical Trial Number: ChiCTR-IOR-15006602. LMA Flexible and LMA Classic are registered trademarks of Teleflex Incorporated or its affiliates. Reprints will not be available from the authors. Address correspondence to Jie Yi, MD, Department of Anesthesiology, Peking Union Medical College Hospital, Beijing 100730, China. Address e-mail to easyue@163.com. © 2018 International Anesthesia Research Society

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Partial maintenance of organ-specific epigenetic marks during plant asexual reproduction leads to heritable phenotypic variation [Genetics]

Plants differ from animals in their capability to easily regenerate fertile adult individuals from terminally differentiated cells. This unique developmental plasticity is commonly observed in nature, where many species can reproduce asexually through the ectopic initiation of organogenic or embryogenic developmental programs. While organ-specific epigenetic marks are not passed on...

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A case of an elderly female with diffuse hepatic hemangiomatosis complicated with multiple organic dysfunction and Kasabach–Merritt syndrome

Abstract

Since diffuse hepatic hemangiomatosis (DHH) is an extremely rare disease especially in adults, the etiology and natural course of adult-onset DHH has not been well understood. We report a case of DHH complicated with multiple organic dysfunction and Kasabach–Merritt syndrome (KMS) in an 83-year-old female. She presented with mild abdominal distension and laboratory findings revealed thrombocytopenia and abnormal coagulation, indicating disseminated intravascular coagulation (DIC). Enhanced computed tomography revealed diffuse, hypodense hepatic nodules with delayed enhancement involving the whole liver, and multiple hypodense splenic legions. To obtain a definitive diagnosis, laparoscopic-guided biopsy was performed. Histological findings revealed irregularly dilated non-anastomotic vascular spaces, which were lined with flat endothelial cells without cellular atypia. We diagnosed this as DHH complicated with splenic lesions and KMS. Although the patient was treated with symptomatic treatment, such as anti-coagulation therapy, hemangiomatous lesions, especially in the spleen, progressed rapidly, leading to worsening of DIC. Finally, the patient died of multiple organ failure at 12 months after diagnosis. A postmortem examination demonstrated diffuse hemangiomatosis of not only the liver and spleen, but also the adrenal glands and bone marrow. Despite no malignant histologically, DHH can be fatal if it progresses rapidly within a short period of time.

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Ford creates system to alert drivers to oncoming emergency vehicles

The new system helps drivers give emergency vehicles a route through traffic by forming an "emergency corridor"

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Non‐carious cervical lesions and risk factors: a case‐control study

Journal of Oral Rehabilitation, Volume 0, Issue ja, -Not available-.


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A Rare Case of Enoxaparin Induced Skin Necrosis Without Thrombocytopenia

No abstract available

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Breaking bad news in genetic counseling—problems and communication tools

Abstract

Breaking bad news is a common problem for clinical geneticists in their daily work. Just like doctors of other specialties, e.g., oncologists, they can use proven communication tools instead of relying only on professional sense. The latter is, of course, always the most important for experienced doctors, but the use of protocols such as SPIKES and EMPATHY facilitates both the delineation of difficult information and the process of its transmission. The article gives an overview of the best tools of this type available to medical professionals dealing with genetic counseling.

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Passive Functional Mapping of Receptive Language Areas Using Electrocorticographic Signals

Publication date: Available online 25 September 2018

Source: Clinical Neurophysiology

Author(s): J.R. Swift, W.G. Coon, C. Guger, P. Brunner, M. Bunch, T. Lynch, B. Frawley, A.L. Ritaccio, G. Schalk

Abstract

Objective

To validate the use of passive functional mapping using electrocorticographic (ECoG) broadband gamma signals for identifying receptive language cortex.

Methods

We mapped language function in 23 patients using ECoG and using electrical cortical stimulation (ECS) in a subset of 15 subjects.

Results

The qualitative comparison between cortical sites identified by ECoG and ECS show a high concordance. A quantitative comparison indicates a high level of sensitivity (95%) and a lower level of specificity (59%). Detailed analysis reveals that 82% of all cortical sites identified by ECoG were within one contact of a site identified by ECS.

Conclusions

These results show that passive functional mapping reliably localizes receptive language areas, and that there is a substantial concordance between the ECoG- and ECS-based methods. They also point to a more refined understanding of the differences between ECoG- and ECS-based mappings. This refined understanding helps to clarify the instances in which the two methods disagree and can explain why neurosurgical practice has established the concept of a "safety margin."

Significance

Passive functional mapping using ECoG signals provides a fast, robust, and reliable method for identifying receptive language areas without many of the risks and limitations associated with ECS.

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Indications for Neuromuscular Ultrasound: Expert Opinion and Review of the Literature

Publication date: Available online 25 September 2018

Source: Clinical Neurophysiology

Author(s): Francis O. Walker, Michael S Cartwright, Katharine E Alter, Leo H Visser, Lisa D. Hobson-Webb, Luca Padua, Jeffery A Strakowski, David C Preston, Andrea J Boon, Hubertus Axer, Nens van Alfen, Eman A Tawfik, Einar Wilder-Smith, Joon Shik Yoon, Byung-Jo Kim, Ari Breiner, Jeremy DP Bland, Alexander Grimm, Craig M Zaidman

Abstract

Over the last two decades, dozens of applications have emerged for ultrasonography in neuromuscular disorders. We wanted to measure its impact on practice in laboratories where the technique is in frequent use.

After identifying experts in neuromuscular ultrasound and electrodiagnosis, we assessed their use of ultrasonography for different indications and their expectations for its future evolution. We then identified the earliest papers to provide convincing evidence of the utility of ultrasound for particular indications and analyzed the relationship of their date of publication with expert usage.

We found that experts use ultrasonography often for inflammatory, hereditary, traumatic, compressive and neoplastic neuropathies, and somewhat less often for neuronopathies and myopathies. Usage significantly correlated with the timing of key publications in the field. We review these findings and the extensive evidence supporting the value of neuromuscular ultrasound. Advancement of the field of clinical neurophysiology depends on widespread translation of these findings.

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Retroperitoneal choriocarcinoma diagnosed by endoscopic ultrasonography-guided fine needle aspiration biopsy

Publication date: Available online 24 September 2018

Source: Arab Journal of Gastroenterology

Author(s): Hiroyuki Matsubayashi, Ryo Yamashita, Keiko Sasaki, Tomohiro Iwai, Hirotoshi Ishiwatari, Kenichiro Imai, Hiroyuki Ono

Abstract

A 25-year-old man, with a retroperitoneal bulky mass invading the posterior pancreas head, was referred to investigate and treat his rapidly advancing disease. An endoscopic ultrasonography guided-fine needle aspiration biopsy (EUS-FNAB), performed the next day, and followed by immunostaining for human chorionic gonadotropin (hCG), led to a histological diagnosis of choriocarcinoma. An elevated level of serum hCG also supported the diagnosis. Systemic chemotherapy by etoposide and cisplatin was initiated within a week, with precautions taken to avoid tumour lysis syndrome and choriocarcinoma syndrome. EUS-FNAB enabled a prompt diagnosis and suitable treatment for choriocarcinoma and was considered as an effective diagnostic tool for rare tumours with rapid progression.

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Editorial Board

Publication date: October 2018

Source: Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms, Volume 1861, Issue 10

Author(s):

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Anti-tumor necrosis factor therapy decreases the risk of initial intestinal surgery after diagnosis of Crohn’s disease of inflammatory type

Journal of Gastroenterology

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Gastroesophageal reflux disease and its related factors among women of reproductive age: Korea Nurses’ Health Study

BMC Public Health

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Anti-RNPC3 (U11/U12) antibodies in systemic sclerosis are associated with moderate to severe gastrointestinal dysmotility

Arthritis Care & Research

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Extending the clinical phenotype associated with biallelic NTHL1 germline mutations

Clinical Genetics, EarlyView.


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Perioperative anesthetic management of children with congenital central hypoventilation syndrome and rapid‐onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation undergoing thoracoscopic phrenic nerve‐diaphragm pacemaker implantation

Pediatric Anesthesia, EarlyView.


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Description of typical personality factors and events that lead to anxiety at induction of anesthesia in French children

Pediatric Anesthesia, EarlyView.


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