Promotion of stem cell-like phenotype of lung adenocarcinoma by FAM83A via stabilization of ErbB2.

Lung cancer stands as the leading cause of mortality among all types of tumors, with over 40% of cases being lung adenocarcinoma (LUAD). Family with sequence similarity 83 member A (FAM83A) emerges as a notable focus due to its frequent overexpression in LUAD. Despite this, the precise role of FAM83A remains elusive. This study addresses this gap by unveiling the crucial involvement of FAM83A in maintaining the cancer stem cell-like (CSC-like) phenotype of LUAD. Through a global proteomics analysis, the study identifies human epidermal growth factor receptor 2 (HER2 or ErbB2) as a crucial target of FAM83A. Mechanistically, FAM83A facilitated ErbB2 expression at the posttranslational modification level via the E3 ubiquitin ligase STUB1 (STIP1-homologous U-Box containing protein 1). More importantly, the interaction between FAM83A and ErbB2 at Arg241 promotes calcineurin (CALN)-mediated dephosphorylation of ErbB2, followed by inhibition of STUB1-mediated ubiquitin-proteasomal ErbB2 degradation. The maintenance of the CSC-like phenotype by FAM83A, achieved through the posttranslational regulation of ErbB2, offers valuable insights for identifying potential therapeutic targets for LUAD.

Optical coherence tomography as a useful adjunct in the early detection of meningioma with optic nerve compression.

A 48-year-old woman presented with persistent clouding vision in her lower field in the right eye for 5 months. A small retinal hemorrhage was initially reported. Her visual acuity was 20/30 in the right eye and 20/20 in the left, with normal color vision and pupil response. Fundus examination did not reveal any retinal hemorrhage. Although optical coherence tomography (OCT) showed normal macula and retinal nerve fiber layers in both eyes, asymmetric thinning of the ganglion cell inner plexiform layer was found in the superior macula of the right eye in ganglion cell analysis (GCA). Visual field examination revealed a subtle inferonasal scotoma. Compressive optic neuropathy (CON) was suspected. The visual evoked potential test revealed delayed P100 latency. A tuberculum sellae meningioma was found with right medial optic canal extension. The visual acuity of the right eye returned to 20/25 after decompression surgery. OCT can be used to differentiate between retinopathy and optic neuropathy. GCA can help in the early detection of CON and achieve a good visual outcome after surgery.

Supratentorial hemangioblastoma: A rare case report and literature review.

Hemangioblastomas are rare and benign tumors of the central nervous system. They account for 1.5%-2.5% of all intracranial tumors and have an incidence of 3.2%. The resemblance of hemangioblastomas to other tumors renders preoperative diagnosis and management challenging. Herein, we report a case of a supratentorial hemangioblastoma accompanied by extensive reactive gliosis and diagnosed through magnetic resonance imaging. In addition, we review the relevant literature.

Electroencephalogram-Based Motor Imagery Classification Using Deep Residual Convolutional Networks.

The classification of electroencephalogram (EEG) signals is of significant importance in brain-computer interface (BCI) systems. Aiming to achieve intelligent classification of motor imagery EEG types with high accuracy, a classification methodology using the wavelet packet decomposition (WPD) and the proposed deep residual convolutional networks (DRes-CNN) is proposed. Firstly, EEG waveforms are segmented into sub-signals. Then the EEG signal features are obtained through the WPD algorithm, and some selected wavelet coefficients are retained and reconstructed into EEG signals in their respective frequency bands. Subsequently, the reconstructed EEG signals were utilized as input of the proposed deep residual convolutional networks to classify EEG signals. Finally, EEG types of motor imagination are classified by the DRes-CNN classifier intelligently. The datasets from BCI Competition were used to test the performance of the proposed deep learning classifier. Classification experiments show that the average recognition accuracy of this method reaches 98.76%. The proposed method can be further applied to the BCI system of motor imagination control.

An Intelligent EEG Classification Methodology Based on Sparse Representation Enhanced Deep Learning Networks.

The classification of electroencephalogram (EEG) signals is of significant importance in brain-computer interface (BCI) systems. Aiming to achieve intelligent classification of EEG types with high accuracy, a classification methodology using sparse representation (SR) and fast compression residual convolutional neural networks (FCRes-CNNs) is proposed. In the proposed methodology, EEG waveforms of classes 1 and 2 are segmented into subsignals, and 140 experimental samples were achieved for each type of EEG signal. The common spatial patterns algorithm is used to obtain the features of the EEG signal. Subsequently, the redundant dictionary with sparse representation is constructed based on these features. Finally, the samples of the EEG types were imported into the FCRes-CNN model having fast down-sampling module and residual block structural units to be identified and classified. The datasets from BCI Competition 2005 (dataset IVa) and BCI Competition 2003 (dataset III) were used to test the performance of the proposed deep learning classifier. The classification experiments show that the recognition averaged accuracy of the proposed method is 98.82%. The experimental results show that the classification method provides better classification performance compared with sparse representation classification (SRC) method. The method can be applied successfully to BCI systems where the amount of data is large due to daily recording.

MicroRNA-93-5p expression in tumor tissue and its tumor suppressor function via targeting programmed death ligand-1 in colorectal cancer.

This work aimed to investigate miR-93-5p expression in tumor tissue and its in vitro effects in colorectal cancer (CRC) by targeting programmed death ligand-1 (PD-L1). MiR-93-5p and PD-L1 expression was detected in CRC and adjacent normal tissues by quantitative real-time polymerase chain reaction and immunohistochemistry. The correlation between miR-93-5p and PD-L1 was validated by a dual-luciferase reporter assay. HCT116 and SW480 cells were divided into blank, miR-NC, miR-93-5p mimics, miR-93-5p inhibitor, PD-L1 small interfering RNA (siRNA) and miR-93-5p inhibitor + PD-L1 siRNA groups, and wound-healing and transwell assays were performed to detect cell migration and invasion, respectively. Protein expression was measured by western blotting. The secretion of cytokines was detected in the CRC cell/T coculture models. MiR-93-5p was downregulated in CRC tissues with upregulated PD-L1. In PD-L1-negative patients, miR-93-5p expression was increased compared with that in PD-L1-positive patients. MiR-93-5p and PD-L1 expression levels were associated with the tumor differentiation, lymphatic metastasis, TNM, Duke's stage, and prognosis of CRC. PD-L1 siRNA weakened the migration and invasion abilities via decreased expression of matrix metalloproteinase-1 (MMP-1), -2, and -9, and these effects were abolished by the miR-93-5p inhibitor. Additionally, anti-PD-L1 upregulated the expressions of interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α), and interferon γ (IFN-γ) in the coculture of T cells with CRC cells, but downregulated the expressions of IL-1ß, IL-10, and TGF-ß. However, these changes were partially reversed by miR-93-5p inhibition. miR-93-5p is expected to be a novel target for CRC treatment since it decreases the migration and invasion, as well as the immune evasion, of CRC cells via targeting PD-L1.

Transfemoral Approach for Intraoperative Angiography in the Prone or Three-quarter Prone Position : A Revisited Protocol for Intracranial Arteriovenous Malformation and Fistula Surgery.

PURPOSE: Among the different arterial accesses, the femoral access is the main approach for intraoperative angiography (IOA) performed in a prone position. Without a standardized protocol, however, the application of prone IOAs in intracranial arteriovenous malformation (AVM) or arteriovenous fistula (AVF) surgery remains limited by its procedural complexity. This study describes the detailed protocol for prone IOA through a transfemoral approach and highlights several refinements in preparing this procedure. METHODS: This study retrospectively reviewed the intracranial or high cervical AVM/AVF surgical cases in which both resection and IOA were performed in the prone or three-quarter prone position. Extended femoral sheath approaches and radiolucent head clamps were used in all cases. An aneurysm clip, serving as a localization landmark in IOA, was routinely placed within the surgical field. The IOA imaging, clinical impact of IOA, and complications related to the procedure were recorded. RESULTS: A total of six AVM and three AVF cases, operated on in the prone (n = 7) or three-quarter prone (n = 2) positions, were included. Multiple vessel injections were required in 66.7% of cases, and IOA was successfully performed in every intended vessel. All IOA images were adequate for interpretation, except for two cases in which the non-radiolucent component of the head clamp obscured the region of interest in the lateral views. Incomplete occlusion was identified in two patients, and the aneurysm clip provided precise guidance in localizing the residual nidus. Final IOA confirmed complete lesion removal in all cases, and there were no IOA-related complications. CONCLUSION: Three key steps in setting-up a prone IOA procedure for intracranial AVM/AVF surgery are proposed: (1) utilize an extended femoral sheath approach, (2) establish a localization landmark with an aneurysm clip and (3) avoid possible image interference from the non-radiolucent component of the head clamp.

Impact of Intraoperative 3-Dimensional Volume-Rendering Rotational Angiography on Clip Repositioning Rates in Aneurysmal Surgery.

OBJECTIVE: Three-dimensional (3D) rotational angiography (RA), a gold standard imaging tool for the evaluation of cerebral aneurysms after clipping, can currently be performed intraoperatively in a hybrid operating room (OR). However, its role in intraoperative aneurysmal surgery is unclear. We aimed to study the value of intraoperative 2-dimensional digital subtraction angiography (2D-DSA) and 3D-RA for the evaluation of aneurysms after clipping, in terms of clip repositioning. METHODS: We included patients with cerebral aneurysms who were treated with microsurgical clipping in a hybrid OR. After aneurysmal clipping and indocyanine green video angiography assessment, intraoperative 2D-DSA and 3D-RA with volume-rendering (VR) images of the clipped aneurysm were obtained. The incidence rate of clip repositioning was determined, and aneurysm-related factors associated with suboptimal clipping that required clip revision after intraoperative angiography evaluation were analyzed. RESULTS: Between September 2016 and August 2017, 24 consecutive patients with 35 aneurysms were treated with microsurgical clipping. A clip repositioning rate of 17.1% was revealed after intraoperative 3D-VR imaging and initial indocyanine green-video angiography. 3D-VR was able to demonstrate all aneurysmal remnants, whereas 2D-DSA helped confirm flow stagnation in compromised vessels. Challenging aneurysms of size >7 mm (P = 0.043) and neck width >4 mm (P = 0.012) were significantly associated with a higher incidence of suboptimal aneurysmal clipping. CONCLUSIONS: A hybrid OR, with angiography facilities for high-resolution 2D-DSA and 3D-VR images, allows neurosurgeons to perform high-quality surgery. The routine use of intraoperative 3D-RA may not be necessary; however, it is invaluable for treating challenging aneurysms.

The effect of an integrated education model on anxiety and uncertainty in patients undergoing cervical disc herniation surgery.

BACKGROUND: Educating patients about receiving surgical procedures is becoming an important issue, as it can reduce anxiety and uncertainty while helping to hasten decisions for undergoing time sensitive surgeries. We evaluated a new integrated education model for patients undergoing cervical disc herniation surgery using a quasi-experimental design. METHODS: The participants were grouped into either the new integrated educational model (n = 32) or the standard group (n = 32) on the basis of their ward numbers assigned at admission. Anxiety, uncertainty, and patient satisfaction were measured before (pre-test) and after the educational intervention (post-test-1) and post-surgery (post-test-2) to assess the effectiveness of the model in this intervention. RESULTS: We found that the generalized estimating equation modeling demonstrated this new integrated education model was more effective than the conventional model in reducing patients' anxiety and uncertainty (p <0.05). Patients were also more satisfied with our newly developed model as it takes a more holistic approach to individual health. CONCLUSION: This novel systemic educational model enhances patient's understanding of the medical condition and surgery while promoting patient-caregiver interaction for optimal patient health outcomes. We present a comprehensive and consistent platform for educational purposes in patients undergoing surgery as well as reducing the psychological burden from anxiety and uncertainty. Integrating medicine, nursing, and new technologies into an e-practice and e-learning platform offers the potential of easier understanding and usage. It could revolutionize patient education in the future.

Idiopathic spinal epidural lipomatosis - two cases report and review of literature.

Spinal epidural lipomatosis (SEL), an abnormal localized or tumor-like accumulation of fat in the epidural space, is an infrequent complication of chronic steroid usage and an uncommon cause of spinal cord compression. During the period of 1990 to 2006, we have two cases of medically heath SEL patients without history of steroid administration. Their initial clinical manifestations were low back pain, progressive lower extremities weakness, numbness, followed by rapid deterioration of neurogenic intermittent claudication. They were misdiagnosed and treated as degenerative spinal disease for a long time. Due to prominent neurological deficit, lumbar magnetic resonance image (MRI) was obtained and showed SEL. These 2 patients all underwent laminectomy and removal of epidural fat. Postoperatively, they both showed improvement. We reviewed the literature and discussed the current concept in the management of SEL.

A vitronectin M381T polymorphism increases risk of hemangioblastoma in patients with VHL gene defect.

Hemangioblastomas, highly vascular tumors, occur sporadically or associated with von Hippel-Lindau (VHL) disease. Diverse mutations in the VHL gene inactivate the VHL protein and constitute the molecular etiology of the disease. Changes in VHL gene were analyzed in patients with multiplex ligation-dependent probe amplification and single-strand conformation polymorphism analyses. We report here that other angiogenesis-related changes in vitronectin were identified with 2D electrophoresis of plasma samples and restriction fragment length polymorphisms. Our findings revealed that most patients (80.0%) with a familial VHL deletion carried the threonine (T) allele at vitronectin codon 381. Adults simultaneously carrying a VHL defect and the T allele were 5.0-fold more likely to be affected by VHL disease than were methionine/methionine (M/M) homozygotes carrying a VHL defect. Patients with sporadic hemangioblastoma, C-terminally truncated VHL protein or a large deletion in the VHL gene, and the T allele were 18.0-fold more likely to develop recurrent disease. Taken together, individuals with mutated VHL are more likely to be affected by familial or recurrent sporadic hemangioblastoma when carrying the M/T or T/T genotype at codon 381 of vitronectin.

Catheter migration after implantation of an intrathecal baclofen infusion pump for severe spasticity: a case report.

We report a case of intrathecal baclofen infusion pump implantation complicated by migration of the catheter tip. A 55-year-old man required an intrathecal baclofen infusion for severe spasticity 4 years after a cervical spinal cord injury with incomplete tetraparesis. Twelve months after initial implantation of the device, the patient began to experience a recurrence of trunk tightness and spasticity. Subsequent X-ray and computed tomography evaluations of the catheter system revealed pooling of contrast medium outside of the intrathecal distribution in the lumbar subcutaneous region of the back and therefore migration of the pump catheter tip. At surgical revision, emphasis was placed on minimizing the length of catheter outside of the spine and securing the catheter in the supraspinous fascia with a right-angled anchor. The distance between the anchors and the entry point of the catheter into the supraspinous fascia was also reduced to prevent slipping when the patient bends forward. After surgery, the patients spasticity improved and, 1 year later, he has experienced no further complications during follow-up, requiring an average baclofen dose of 150 microg/day. Here, we describe several surgical methods intended to secure the intrathecal catheter and prevent catheter migration. Other complications related to catheter failure are also highlighted.

Placenta-derived multipotent cells differentiate into neuronal and glial cells in vitro.

Stem cells have great potential for clinical application because of their self-renewal property and ability to differentiate into many types of cells, but because there are ethical and biological limitations with current sources of stem cells, the search continues for more suitable sources of multipotent cells. We have reported previously on a population of multipotent cells isolated from the human term placenta, an ethically unproblematic and easily available source of tissue. These placenta-derived multipotent cells (PDMCs) can differentiate into lineages of mesenchymal tissues, including osteoblasts and adipocytes, as well as non-mesenchymal tissue of neuron-like cells. We further examined the ability of PDMCs to differentiate into all 3 types of neural cells--neurons, astrocytes, and oligodendrocytes--under various induction conditions, including retinoic acid (RA), 1-methyl-3-isobutylxanthine (IBMX), and co-culture with neonatal rat brain cells. PDMCs exhibited outgrowth of processes and the expression of neuron-specific molecules such as neuron-specific enolase upon induction. Co-culture with neonatal rat brain cells also induced neural differentiation. Our results indicate that PDMCs can be differentiated into neural cell types of the human nervous system upon exposure to RA, IBMX, or primary rat brain cells.

Chronic subdural hematoma associated with arachnoid cyst in young adults: a case report.

Intracranial arachnoid cysts are believed to be congenital; they can become symptomatic in pediatric patients. Chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury a few months prior to the onset of symptoms. However, these two distinct clinical entities sporadically occur together in relatively young patients. We report a 29-year-old man who presented with headache and dizziness of 2 months' duration. Brain computed tomography revealed a huge chronic subdural hematoma over the left frontoparietal lobe, with an incidental finding of an arachnoid cyst over the left sylvian fissure. In light of a literature review, we discuss arachnoid cysts as a possible risk factor for subdural hematoma, especially in young adults.

An in vivo study of tricalcium phosphate and glutaraldehyde crosslinking gelatin conduits in peripheral nerve repair.

In order to modulate the mechanical properties of gelatin, we previously developed a biodegradable composite composed by tricalcium phosphate and glutaraldehyde crosslinking gelatin (GTG) feasible for surgical manipulation. In this study, we evaluated the in vivo applications of GTG conduit for peripheral nerve repair. The effect of sciatic nerve reconstruction was compared between resorbable permeable GTG conduits and durable impermeable silicone tubes. Traditional methods of assessing nerve recovery following peripheral nerve repair including histomorphometric and electrophysiologic features were conducted in our study. In addition, autotomy score and sciatic function index (SFI) in walking tract analysis were used as additional parameters for assessing the return of nerve function. Twenty-four weeks after sciatic nerve repair, the GTG conduits were harvested. Microscopically, regeneration of nerves was observed in the cross-section at the mid portion of all implanted GTG conduits. The cross-sectional area of regenerated nerve of the GTG group was significant larger than that of the silicone group. In the compound muscle action potentials (CMAP), the mean recovery index of CMAP amplitude was 0.24 +/- 0.02 for the silicone group, 0.41 +/- 0.07 for the GTG group. The mean SFI increased with time in the GTG group during the evaluation period until 24 weeks. Walking tract analysis showed a higher SFI score in the GTG group at both 12 and 24 weeks. The difference reached a significant level at 24 weeks. Thus, the histomorphometric, electrophysiologic, and functional assessments demonstrate that GTG can be a candidate for peripheral nerve repair.

Rational management of simple depressed skull fractures in infants.

OBJECT: The management regimen for depressed skull fractures in infants can be conservative or surgical. The aim of this study was to provide a rational principle of management for simple depressed skull fractures in infants. METHODS: A protocol of nonsurgical treatment for a simple depressed skull fracture was designed for all affected infants during the period from 1985 to 2001. Conservative management was used for those with a depressed fracture measuring less than 5 mm in depth, whereas vacuum extraction was applied for larger and deeper depressions. All of the patients were evaluated for initial results and later outcomes. Twenty-five infants suffering simple depressed skull fractures were consecutively enrolled. According to our protocol, 11 patients received conservative management by close observation only. Spontaneous restoration of the depression was observed in eight patients within a period of 1 to 6 months. For the remaining 14 patients, vacuum extraction was performed. A negative pressure of 0.3 to 0.8 kg/cm2 (mean 0.49 kg/cm2) was applied for a duration of 20 to 90 seconds (mean 43.6 seconds). All but one patient experienced complete recovery following extraction. The depressions of the four patients that were residual after initial management smoothed out with time. No neurological deficit or later epilepsy was noted in any patient. CONCLUSIONS: Nonsurgical management can be the treatment of choice for infants with simple depressed skull fractures, whereas vacuum extraction is one option for larger and deeper depressions to obtain prompt resolution and relieve major family anxiety, without taking additional risks.

Cervical subdural empyema following acupuncture.

A review of the literature reveals only a few cases of spinal subdural empyema. Etiologies of spinal subdural empyema include hematogenous spread from skin lesions, systemic sepsis, direct spread from spinal osteomyelitis and complications of discography. However, in this report, we describe a patient who developed spinal subdural empyema following several cervical acupuncture sessions. Operative treatment with adequate laminectomy, removal of abscess, and copious irrigation resulted in good recovery. Microbiologic culture study of pus obtained at surgery was positive for Staphylococcus aureus. The need for sterilization procedures for acupuncture is emphasized and a brief review of the relevant literature is presented.