Incidental finding of metastatic prostatic adenocarcinoma of cerebellopontine angle presenting as acoustic neuroma: A case report and review of literature.

INTRODUCTION: Brain metastases from carcinoma of prostate are rare and only few cases with brain metastases preceding the diagnosis of carcinoma of prostate have been reported in the literature. Lesions of brain metastasis from prostate cancer had a large variety of imaging presentations and it is very difficult to distinguish them from the other types of brain occupying lesions. We report one case of metastatic prostatic adenocarcinoma of cerebellopontine angle presenting as acoustic neuroma, as the first clinical evidence of metastatic carcinoma of the prostate. PRESENTATION OF CASE: The 57-year-old male presented to the neurology clinic complaining of dizziness accompanied by right tinnitus, he was proposed to be diagnosed with acoustic neuroma, and the tumor resection was performed later in our neurosurgery department. The postoperative histopathological and immunohistochemical (IHC) examinations revealed a cerebellar pontine angle metastatic adenocarcinoma, which was then confirmed as prostate cancer metastasis. The patient refused surgical castration and only agreed to conservative treatment. The patient's condition continued to deteriorate, and he died 12 months after the initial presentation. DISCUSSION: Brain metastasis is rare in prostate cancer, which accounts for only 0.2 % to 2 % of all brain metastases. Intracranial metastasis as the first clinical symptom of prostate cancer is extremely rare. In our article, we report the VIIIth and VIIth cranial nerves palsy for the first time, caused by brain metastases from prostate cancer, with symptoms similar to an acoustic neuroma. Prostate cancer most commonly spreads to the bones, including the skull, Cranial nerve palsy is caused by extensive invasion of the skull base. The serum PSA level is considered the most valuable tool to monitor the disease progression of patients with prostate cancer metastasis. A high PSA level significantly increases the tendency of prostate cancer to metastasize to the brain. A high Gleason score is believed to help determine the risk and likelihood of brain metastases in patients with prostatic carcinoma. CONCLUSION: In our case, we initially report the VIIIth and VIIth cranial nerve palsy, mimicking an acoustic neuroma, caused by metastatic prostate carcinoma. For early diagnosis, the prostate should not be neglected as a possible source of the metastases in male patients presenting with brain metastases. High prostate specific antigen (PSA) level and high Gleason score can be useful parameters for the prediction of brain metastasis from prostate cancer. The PSA should play a vital role in distinguishing metastatic prostate carcinoma in male patients.

The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials.

To conduct a systematic review and meta-analysis and evaluate the effect of tranexamic acid in patients with traumatic brain injury. PubMed, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched to identify randomized controlled trials and evaluate the effect of tranexamic acid in traumatic brain injury patients. The primary outcome was mortality. Two reviewers extracted the data independently. The random effect meta-analysis was used to estimate the aggregate effect size of 95% confidence intervals. Six randomized controlled trials investigating tranexamic acid versus placebo and 30073 patients were included. Compared with placebo, tranexamic acid decreased the mortality (RR = 0.92; 95% CI, 0.87-0.96; p < 0.001) and growth of hemorrhagic mass (RR = 0.78; 95% CI, 0.61-0.99; p = 0.04). However, tranexamic acid could not decrease disability or independent, neurosurgery, vascular embolism, and stroke. Current evidence suggested that compared with placebo, tranexamic acid could reduce mortality and growth of hemorrhagic mass. This finding indicated that patients with traumatic brain injury should be treated with tranexamic acid.

A novel model for predicting the outcome of intracerebral hemorrhage: Based on 1186 Patients.

OBJECTIVE: To establish a model for predicting the outcome according to the clinical and computed tomography(CT) image data of patients with intracerebral hemorrhage(ICH). METHODS: The clinical and CT image data of the patients with ICH in Qinghai Provincial People's Hospital and Xuzhou Central Hospital were collected. The risk factors related to the poor outcome of the patients were determined by univariate and multivariate logistic regression analysis. To determine the effect of factors related to poor outcome, the nomogram model was made by software of R 3.5.2 and the support vector machine operation was completed by software of SPSS Modelor. RESULTS: A total of 8265 patients were collected and 1186 patients met the criteria of the study. Age, hospitalization days, blend sign, intraventricular extension, subarachnoid hemorrhage, midline shift, diabetes and baseline hematoma volume were independent predictors of poor outcome. Among these factors, baseline hematoma volume๥20ml (odds ratio:13.706, 95% confidence interval:9.070-20.709, p < 0.001) was the most significant factor for poor outcome, followed by the volume among 10ml-20ml (odds ratio:11.834, 95% confidence interval:7.909-17.707, p < 0.001). It was concluded that the highest percentage of weight in outcome was baseline hematoma volume (25.0%), followed by intraventricular hemorrhage (23.0%). CONCLUSION: This predictive model might accurately predict the outcome of patients with ICH. It might have a wide range of application prospects in clinical.

Optimization of Melanin Extraction from the Wood Ear Medicinal Mushroom, Auricularia auricula-judae (Agaricomycetes), by Response Surface Methodology and Its Antioxidant Activities In Vitro.

The optimal conditions for melanin extraction from Auricularia auricula-judae (Hei 29) fruiting bodies was determined on the basis of the extract yield of melanin, calculated by using a single-factor experiment and response surface methodology. Its antioxidant activities were also studied in vitro. Various optimal process conditions for melanin extraction were determined by using Design-Expert software: incubation temperature, 69.11°C; incubation time, 58.66 minutes; and incubation pH, 12.81. Under these conditions, the melanin yield was 2.59%. We found that the antioxidant activities of A. auricula-judae melanin in vitro were strong against DPPH radicals and superoxide anions. The rate of DPPH radical scavenging was 63.04% when the A. auricula-judae melanin concentration was 0.36 mg/mL; the rate of superoxide anion scavenging reached 39.79% when the concentration was 0.375 mg/mL. However, the antioxidant activity against hydroxyl radicals was somewhat weak; the rate of scavenging reached only 7.47% when the A. auricula-judae melanin concentration was 0.06 mg/mL.

Identification of a New Fungal Pathogen Causing White Villous Disease on the Fruiting Body of the Culinary-Medicinal Mushroom Auricularia auricula-judae (Agaricomycetes) in China.

Auricularia auricula-judae is an edible and medicinal fungus ranking fourth in production among the edible fungi cultivated worldwide. White villous disease is rampant in Northeast China; it infects the fruiting bodies of A. auricula-judae by forming a white mycelial layer on its ventral side. The disease not only causes an unacceptable morphological appearance and a poor-quality product, but it also significantly reduces the yield. In this study, based on fungal morphology, ribosomal DNA internal transcribed spacer sequences, identification of species-specific primers, and the pathogenicity of the mycelia and spores, 2 fungal pathogens were isolated and identified as Fusarium equiseti and F. sporotrichioides.

Marginal and internal fit of two different zirconium copings fabricated on the implant abutment.

OBJECTIVE: To evaluate the accuracy of marginal and internal fit of the zirconium copings manufactured by two different computer-aided design(CAD)/computer-aided manufacturing(CAM)system on the implant abutment. METHODS: Using different scanning mode,five Procera(®) zirconium copings and five Lava zirconium copings were fabricated on the same implant abutment, and then compared with five precious metal copings fabricated by traditional method. Fifteen abutment replica were made with die-stone and the copings were randomly cemented on them, then they were sectioned and invested. The marginal, shoulder, occlusal, and axial fit of each sample was measured by scanning electron microscopy (SEM). RESULTS: There was no significant difference in marginal and axial fit among the three groups(P>0.05). Significant difference in occlusal fit was found among the three groups(P<0.05): Lava group showed better fit than the others(P<0.05)and Procera(®) group showed better fit than the control(P<0.05). CONCLUSIONS: These two types of zirconium coping have clinically acceptable marginal and internal fit. The internal fit of zirconium coping may be affected by different manufacturing techniques.