Easy preoperative planning of deeply located brain lesions using external skin reference and 3-Dimensional surface MRI

Open skull surgery of deeply located intracerebral lesions requires precise determination of the treatment area in 3-dimensional (3-D) space. 3-D MRI can give important additional information in presurgical determination of the surgical approach to the target, taking into account highly functional brain areas and important vascular structures. The day before surgery, a grid composed of 9 tubings intersecting at 90° at 1 cm intervals and filled with a Q1SO4 solution is firmly attached to the skin of the patient’s head in the presumed region of the craniotomy. A 3-D turbo-FLASH sequence is then performed in the sagittal plane after intravenous Gd-DOTA injection on a IT Magnetom. 3-D surface reconstruction of the cortical gyri and sulci is performed. Once the gyri are identified, the 3-D program is then implemented in order to perform a color display of the cortical veins and of the tumor boundaries. The surgical access is then chosen by the surgeon, taking into account highly functional areas. Finally, the boundaries of the tumor are projected on the cortex reconstruction and on the external reference placed on the skin. The entry place for surgery as well as the size of craniotomy are drawn on the skin and the tubed grid is removed. The accuracy of this method tested in 9 patients with deeply located brain tumors or arteriovenous malformations was very satisfactory. In daily practice, this method is a valuable technique providing important clinical information in determining the shortest and safest way through the brain tissue, decreasing possible functional deficit and reducing craniotomy size in cases of difficult to access deep brain areas. Our method does not require a stereotactic frame permanently fixed to the head of the patient during surgery. © 1994 S. Karger AG, Basel.

CRYPTOSPORIDIUM RELATED TO MEASLES DIARRHOEA IN RWANDA

SCOPUS: le.j

Lymphatic porosity as a consequence of complex vitamin B deficiency in the rat

Lymphatic porosity was produced by feeding rats a diet, lacking from the vitamins of the B group. Coumarintroxerutin (Venalot®) treatment has been found to prevent this abnormality. Pathophysiologic and therapeutic implications of these findings are discussed. © 1973 S. Karger AG, Basel.

Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location

Background Correctly diagnosing basal cell carcinoma (BCC) clinical type is crucial for the therapeutic management. A systematic description of the variability of all reported BCC dermoscopic features according to clinical type and anatomic location is lacking. Objectives To describe the dermoscopic variability of BCC according to clinical type and anatomic location and to test the hypothesis of a clinical/dermoscopic continuum across superficial BCCs (sBCCs) with increasing palpability. Methods Clinical/dermoscopic images of nodular BCCs (nBCCs) and sBCCs with different degrees of palpability were retrospectively evaluated for the presence of dermoscopic criteria including degree of pigmentation, BCC-associated patterns, diverse vascular patterns, melanocytic patterns and polarized light patterns. Results We examined 501 histopathologically proven BCCs (66.9% sBCCs; 33.1% nBCCs), mainly located on trunk (46.7%; mostly sBCCs) and face (30.5%; mostly nBCCs). Short fine telangiectasias, leaf-like areas, spoke-wheel areas, small erosions and concentric structures were significantly associated with sBCC, whereas arborizing telangiectasias, blue-white veil-like structures, white shiny areas and rainbow pattern with nBCCs. Short fine telangiectasia, spoke-wheel areas and small erosions were independently associated with trunk location, whereas arborizing telangiectasias with facial location. Scalp BCCs had significantly more pigmentation and melanocytic criteria than BCCs located elsewhere. Multiple clinical/dermoscopic parameters displayed a significant linear trend across increasingly palpable sBCCs. Conclusions Particular dermoscopic criteria are independently associated with clinical type and anatomic location of BCC. Heavily pigmented, scalp BCCs are the most challenging to diagnose. A clinical/dermoscopic continuum across increasingly palpable sBCCs was detected and could be potentially important for the non-surgical management of the disease.

The diencephalic syndrome in infants: A review in relation to optic nerve glioma

A study of the diencephalic syndrome in cases so far collected from the literature was carried out on the clinical, macroscopic and histological brain findings found recorded in, respectively, 29, 25 and 34 cases. For comparison, 3 further cases with this syn- drome were described, in which a diagnosis of optic nerve glioma could be made. The review of the 39 cases with the diencephalic syndrome has shown that in 90°/o of these patients an extensive glioma of the 3rd ventricle had been present. 70% of these patients had additional glioma of optic nerves and/or chiasm with an equal amount of infants having diminished visual acuity in one or both eyes. From these, so far unreported, findings, strong suggestive evidence was thus presented that the ‘diencephalic syndrome’ described in infants was indeed a mor¬bid entity, namely, a hypothalamo-optic glioma. The further question whether this brain tumour was a primary optic nerve rather than a primary diencephalic glioma could presently not be firmly answered from the reviewed data of the literature. © 1972 S. Karger AG, Basel.

Exploring the safety of chemotherapy for treating breast cancer during pregnancy

Introduction: The diagnosis of breast cancer during pregnancy (BCP) represents a unique challenge to the patient, her family and the treating physician. The proper management of this critical clinical situation is crucial, and requires a multidisciplinary approach. A proper understanding of the safety of chemotherapy during pregnancy is a vital step to avoid detrimental consequences on the mother and the fetus.Areas covered: The aim of this article is to review the available evidence on the safety of chemotherapy administration in managing BCP.Expert opinion: The rule of thumb of chemotherapy - avoiding first trimester exposure and starting therapy in the second trimester - can be considered applicable for classic agents that are used in managing pregnant breast cancer patients. Anthracycline-based regimens are considered the standard of care in managing BCP. Recently, a growing amount of data suggests the safety of taxanes during pregnancy. Pregnancy in cancer patients should be considered as "high risk": once the systemic treatment is initiated, regular fetal monitoring is highly recommended. Emerging data are available on the relative long-term safety secondary to anthracycline exposure during pregnancy. A continued monitoring of the health of individuals with prenatal exposure to chemotherapy into adulthood is recommended for the possible occurrence of long-term side effects.

Has the time come for genomic tests to guide the use of adjuvant chemotherapy in node-positive breast cancer?

SCOPUS: ed.j

Insufficient Evidence of Jatropha curcas L. Invasiveness: Experimental Observations in Burkina Faso, West Africa

Biofuel plants such as Jatropha curcas L. have potential to support the livelihoods of rural communities and contribute to sustainable rural development in Africa, if risks and uncertainties are minimized. Yet, recent papers have warned of the risk of biological invasions in such tropical regions as a consequence of the introduction of exotic biofuel crops. We investigated the seed dispersal risk and invasiveness potential of both J. curcas monoculture plantations and live fences into adjacent cultivated and uncultivated land use systems in Sissili province, Burkina Faso. Invasiveness potential was assessed through (i) detecting evidence of natural regeneration in perimeters around J. curcas plantations and live fences, (ii) assessing seed dispersal mechanisms, and (iii) assessing seedling establishment potential through in situ direct seed sowing. Spontaneous regeneration around the plantation perimeters of the three sites was very low. Individual seedling density around J. curcas live fences was less than 0.01 m⁻² in all sites. Seventy percent of the seedlings were found close to the live fence and most of them derived from the same year (96 %), which indicates low seed-bank longevity and seedling survival. J. curcas can be dispersed by small mammals and arthropods, particularly rodents and ants. In some sites, such as in Onliassan, high secondary seed dispersal by animals (up to 98 %) was recorded. There were highly significant differences in germination rates between seeds at the soil surface (11 %) and those buried artificially at 1–2-cm depth (64 %). In conclusion, we failed to find convincing evidence of the spreading of J. curcas or any significant impact on the surrounding environment.

Identification of 1-methyloctyl butanoate as the major sex pheromone component from females of the saddle gall midge, Haplodiplosis marginata (Diptera: Cecidomyiidae)

The saddle gall midge, Haplodiplosis marginata (von Roser) (Diptera: Cecidomyiidae), has undergone a resurgence recently as a pest of cereals in Belgium and other European countries. An effective monitoring tool of saddle gall midge flights is needed to understand the enigmatic population dynamics of this pest, and to design an integrated management strategy. Therefore, volatile compounds emitted by females (alkan-2-ols and alk-2-yl butanoates) were identified, and the chirality of the emitted esters was determined to be the R absolute configuration. In field-trapping experiments, racemic non-2-yl butanoate attracted substantial numbers of H.marginata males. Thus, this compound will be useful in baited traps for monitoring seasonal flight patterns, and improving integrated management of the saddle gall midge in agricultural systems.

Learning environment, preparedness and satisfaction in osteopathy in Europe: The PreSS study

Objective: 1) to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2) to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3) to identify possible correlations between learning environment and preparedness to practice. Method: Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM), the Association of American Medical Colleges (AAMC) and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model. Results: Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands) and 243 (77%) of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66) whilst the AAMC was 17.58 (SEM:0.35). A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001). Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01). Discussion: A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a 'more positive than negative' result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students' preparedness and satisfaction were found across all institutions recruited.

Comments on: Static and dynamic source locations in undirected networks

SCOPUS: ed.j

Outer crust of a cold non-accreting magnetar

The outer-crust structure and composition of a cold, non-accreting magnetar are studied. We model the outer crust to be made of fully equilibrated matter where ionized nuclei form a Coulomb crystal embedded in an electron gas. The main effects of the strong magnetic field are those of quantizing the electron motion in Landau levels and of modifying the nuclear single-particle levels producing, on average, an increased binding of nucleons in nuclei present in the Coulomb lattice. The effect of a homogeneous and constant magnetic field on nuclear masses has been predicted by using a covariant density functional in which induced currents and axial deformation due to the presence of a magnetic field that breaks time-reversal symmetry have been included self-consistently in the nucleon and meson equations of motion. Although not yet observed, for Ba 1016 G both effects contribute to produce different compositions - odd-mass nuclei are frequently predicted - and to increase the neutron-drip pressure as compared to a typical neutron star. Specifically, in such a regime, the magnetic-field effects on nuclei favor the appearance of heavier nuclei at low pressures. As B increases, such heavier nuclei are also preferred up to larger pressures. For the most extreme magnetic field considered, B=1018 G, and for the models studied, almost the whole outer crust is made of 4092Zr52.

Participatory filmmaking with Qur’anic students in Kano, Nigeria: ‘speak good about us or keep quiet!’

‘Participatory’ research is often presented as a means to ‘empower’ stigmatised groups by addressing shame and by promoting attitude changes. Drawing on experiences producing a ‘participatory’ docudrama with traditional Qur’anic students (almajirai) in Kano, northern Nigeria, I reflect on the limits of ‘participatory’ research as a tool for ‘empowerment’. I describe the risks stigmatised groups may incur by participating, and consider to what extent, if at all, it can foster social change. The almajirai have attracted negative attention as presumed victims of child neglect and as ‘cannon fodder’ for Islamic radicalisation. Their participation in the filmmaking gave them an opportunity to voice their concerns and to rebuke those treating them heedlessly. At the same time, they became vulnerable to accusations and suspicions within their communities. To escape the negative connotations of poverty, they deemphasised its role for almajiri enrolment, thus concealing structural inequalities.

Asymmetric polygons with maximum area

We say that a polygon inscribed in the circle is asymmetric if it contains no two antipodal points being the endpoints of a diameter. Given n diameters of a circle and a positive integer k < n, this paper addresses the problem of computing a maximum area asymmetric k-gon having as vertices k < n endpoints of the given diameters. The study of this type of polygons is motivated by ethnomusiciological applications.

The complexity of Drosophila innate immunity

Metazoans rely on efficient mechanisms to oppose infections caused by pathogens. The immediate and first-line defense mechanism(s) in metazoans, referred to as the innate immune system, is initiated upon recognition of microbial intruders by germline encoded receptors and is executed by a set of rapid effector mechanisms. Adaptive immunity is restricted to vertebrate species and it is controlled and assisted by the innate immune system. Interestingly, most of the basic signaling cascades that regulate the primeval innate defense mechanism(s) have been well conserved during evolution, for instance between humans and the fruit fly, Drosophila melanogaster. Being devoid of adaptive signaling and effector systems, Drosophila has become an established model system for studying pristine innate immune cascades and reactions. In general, an immune response is evoked when microorganisms pass the fruit fly’s physical barriers (e.g. cuticle, epithelial lining of gut and trachea), and it is mainly executed in the hemolymph, the equivalent of the mammalian blood. Innate immunity in the fruit fly consists of a phenoloxidase (PO) response, a cellular response (hemocytes), an antiviral response, and the NF-κB dependent production of antimicrobial peptides referred to as the humoral response. The JAK/STAT and Jun kinase signaling cascades are also implicated in the defence against pathogens.