Intracranial Neuro-Enteric Cyst.

An intracranial nerve-enteric cyst is a relatively rare benign disease, and the main clinical manifestations are related to the location and size of the cyst. The main symptoms are caused by cyst compression. When the cyst is small without compression, it may have no obvious symptoms, and when the cyst increases to a certain degree, it may cause corresponding clinical manifestations. The diagnosis of this disease is mainly based on clinical manifestations, imaging examinations, and pathological examinations. The authors present a 47-year-old woman who was admitted to the hospital with "dizziness". Imaging was performed and revealed a small round lesion in the posterior cranial fossa in front of the brainstem. It was surgically removed and the postoperative pathology revealed an intracranial neuro-enteric cyst. The patient's dizziness disappeared after surgery and was reviewed 1 year later without recurrence.

Slit Ventricle Syndrome.

Slit ventricle syndrome (SVS) is a complication after ventriculoperitoneal shunt (VPS) or cystoperitoneal shunt(CPS), mostly due to excessive drainage of cerebrospinal. The disease is most often seen in children and has a complex pathogenesis. Clinical manifestations are mainly intermittent headache, slow refilling of the shunt reservoir, and slit-like ventricles on imaging. Surgery is the main treatment. We present a 22-year-old female patient with a previous 14-year history of CPS. The patient recently presented with typical symptoms but her ventricular morphology was normal. We performed VPS after diagnosis of SVS. After the surgery, the patient's symptoms improved and her condition was stable.

IsoMaTrix: a framework to visualize the isoclines of matrix games and quantify uncertainty in structured populations.

SUMMARY: Evolutionary game theory describes frequency-dependent selection for fixed, heritable strategies in a population of competing individuals using a payoff matrix. We present a software package to aid in the construction, analysis and visualization of three-strategy matrix games. The IsoMaTrix package computes the isoclines (lines of zero growth) of matrix games, and facilitates direct comparison of well-mixed dynamics to structured populations on a lattice grid. IsoMaTrix computes fixed points, phase flow, trajectories, (sub)velocities and uncertainty quantification for stochastic effects in spatial matrix games. We describe a result obtained via IsoMaTrix's spatial games functionality, which shows that the timing of competitive release in a cancer model (under continuous treatment) critically depends on the initial spatial configuration of the tumor. AVAILABILITY AND IMPLEMENTATION: The code is available at: https://github.com/mathonco/isomatrix. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Capitalizing on competition: An evolutionary model of competitive release in metastatic castration resistant prostate cancer treatment.

The development of chemotherapeutic resistance resulting in tumor relapse is largely the consequence of the mechanism of competitive release of pre-existing resistant tumor cells selected for regrowth after chemotherapeutic agents attack the previously dominant chemo-sensitive population. We introduce a prisoner's dilemma game theoretic mathematical model based on the replicator of three competing cell populations: healthy (cooperators), sensitive (defectors), and resistant (defectors) cells. The model is shown to recapitulate prostate-specific antigen measurement data from three clinical trials for metastatic castration-resistant prostate cancer patients treated with 1) prednisone, 2) mitoxantrone and prednisone and 3) docetaxel and prednisone. Continuous maximum tolerated dose schedules reduce the sensitive cell population, initially shrinking tumor burden, but subsequently "release" the resistant cells from competition to re-populate and re-grow the tumor in a resistant form. The evolutionary model allows us to quantify responses to conventional (continuous) therapeutic strategies as well as to design adaptive strategies.These novel adaptive strategies are robust to small perturbations in timing and extend simulated time to relapse from continuous therapy administration.

Are Adaptive Chemotherapy Schedules Robust? A Three-Strategy Stochastic Evolutionary Game Theory Model.

We investigate the robustness of adaptive chemotherapy schedules over repeated cycles and a wide range of tumor sizes. Using a non-stationary stochastic three-component fitness-dependent Moran process model (to track frequencies), we quantify the variance of the response to treatment associated with multidrug adaptive schedules that are designed to mitigate chemotherapeutic resistance in an idealized (well-mixed) setting. The finite cell (N tumor cells) stochastic process consists of populations of chemosensitive cells, chemoresistant cells to drug 1, and chemoresistant cells to drug 2, and the drug interactions can be synergistic, additive, or antagonistic. Tumor growth rates in this model are proportional to the average fitness of the tumor as measured by the three populations of cancer cells compared to a background microenvironment average value. An adaptive chemoschedule is determined by using the N→∞ limit of the finite-cell process (i.e., the adjusted replicator equations) which is constructed by finding closed treatment response loops (which we call evolutionary cycles) in the three component phase-space. The schedules that give rise to these cycles are designed to manage chemoresistance by avoiding competitive release of the resistant cell populations. To address the question of how these cycles perform in practice over large patient populations with tumors across a range of sizes, we consider the variances associated with the approximate stochastic cycles for finite N, repeating the idealized adaptive schedule over multiple periods. For finite cell populations, the distributions remain approximately multi-Gaussian in the principal component coordinates through the first three cycles, with variances increasing exponentially with each cycle. As the number of cycles increases, the multi-Gaussian nature of the distribution breaks down due to the fact that one of the three sub-populations typically saturates the tumor (competitive release) resulting in treatment failure. This suggests that to design an effective and repeatable adaptive chemoschedule in practice will require a highly accurate tumor model and accurate measurements of the sub-population frequencies or the errors will quickly (exponentially) degrade its effectiveness, particularly when the drug interactions are synergistic. Possible ways to extend the efficacy of the stochastic cycles in light of the computational simulations are discussed.

Evaluation of Application Value of Transcranial Doppler (TCD) in the Inspection of Cerebral Vasospasm After the Treatment of Intracranial Aneurysm.

Objective This study aimed to explore the application value of transcranial doppler (TCD) in the inspection of cerebral vasospasm (CVS) after the treatment of intracranial aneurysm. METHODS: 105 cases of patients with confirmed intracranial aneurysm were divided into two groups based on the two different treatments - craniotomy and aneurysmal clipping or interventional emboli-zation therapy. TCD was applied to monitor the conditions of CVS of 105 cases, and case study re-search method was used to analyze and conclude the TCD inspection data of patients with intracrani-al aneurysm detected after operation. RESULTS: The sensitivity of TCD in the detection of CVS was 83% and the specificity was 88%. Fur-ther, the incidence rate of CVS in the group treated with interventional embolization therapy was higher than that of the group treated with aneurysm clipping. CONCLUSIONS: TCD, which can be used to guide the adjustment of treatment and avoid complications, is an effective method in monitoring CVS after the treatment of intracranial aneurysm.

Long noncoding RNA LINC00460 targets miR-539/MMP-9 to promote meningioma progression and metastasis.

Emerging evidence reveal that long noncoding RNAs (lncRNAs) participates in the epigenetic regulation of pathophysiological process. However, the deepgoing role of lncRNAs on meningioma is still unclear. In present study, we investigate the roles of lncRNA LINC00460 in meningeoma tissue and uncover its molecular mechanism. Results revealed that LINC00460 expression level was significantly up-regulated in meningeoma tissues and malignant meningeoma cell lines (IOMM-Lee, CH157-MN). Mechanically, loss-of-function assays showed that LINC00460 knockdown significantly suppressed the proliferation ability, increased the apoptosis and decreased the proteins (MMP-2, MMP-9, ZEB1) expression. Bioinformatics tools predicted that miR-539 both targeted with the 3'-UTR of LINC00460 and MMP-9 mRNA, which was confirmed by luciferase reporter assay and western blot analysis. In summary, our study reveals that LINC00460 promotes MMP-9 expression through targeting miR-539, acting as an oncogenic RNA in the meningeoma malignancy and accelerating the proliferation and metastasis of meningeoma.

Imaging characteristics and surgical treatment of invasive meningioma.

In order to provide an effective way to prevent or substantially delay the recurrence of invasive meningioma, and improve the curative effect of surgical treatment, we collected and analyzed the clinical manifestations, pathological features, preoperative imaging characteristics as well the data obtained during the surgical treatment of invasive meningioma. From February 2014 to February 2016, 59 patients with invasive meningioma were enrolled in this study. Invasive meningioma was confirmed in all patients by operation. Information about clinical manifestations, pathological features, preoperative imaging and surgical treatment were collected and analyzed. After surgery, pathological specimens were collected, and cases were confirmed as invasive meningioma by pathological examination. The course of disease ranged from 15 days to 7 years (average, 13.2 months). We used World Health Organization (WHO) criteria for classification of meningioma in the nervous system tumors as our reference. Symptoms were as follows: Intracranial hypertension (29 cases), cranial nerve dysfunction (10 cases), epilepsy (11 cases) and other symptoms (9 cases). We had 56 cases of WHO grade I; 6 cases of WHO grade II and 7 cases of WHO grade III. Surgical removal was: Simpson grade I (56 cases), Simpson grade II (2 cases), Simpson grade III and above (56 cases). We used before surgery imaging data to formulate our surgical plan. In general, during surgeries we did not proceed to complete resection, because in the majority of cases, some key structures were invaded and meningioma was very deep and any attempt for total resection could easily lead to significant damage to these structures.

Protection of Facial Nerves During Acoustic Neuroma Surgery.

The objective of this study was to summarize the experience about the protection of the facial nerve in surgery for acoustic neuroma surgery with the aim to improve the retention of facial nerve function and the quality of life. Forty-two patients with acoustic neuroma were recruited from the year 2010 to 2013. Using microsurgical techniques, the tumors were resected through the suboccipital approach over the posterior edge of the sigmoid sinus, and intraoperative electrophysiological monitoring of the facial nerve function was performed. The House-Brackmann (H-B) grading was used to evaluate the facial nerve function evaluation postoperatively. Total tumor resection was achieved in 32 cases, and partial resection in 10 cases, without any intraoperative deaths. Also facial nerves were retained in 35 of 42 cases (83.33 %). One week after surgery, the facial nerve H-B grading was grade I in 8 cases, grade II in 15 cases, grade III in 12 cases, grade IV in 6 cases, and grade V in 1 case. The key to improved protection of the facial nerve during acoustic neuroma surgery includes a complete understanding of the anatomy of the cerebellopontine angle, proper use of microsurgical techniques, and intraoperative electrophysiological monitoring of the status of facial nerve functions to avoid damage to the nerves.