Expertise in surgical neuro-oncology. Results of a survey by the EANS neuro-oncology section.

Introduction: Technical advances and the increasing role of interdisciplinary decision-making may warrant formal definitions of expertise in surgical neuro-oncology. Research question: The EANS Neuro-oncology Section felt that a survey detailing the European neurosurgical perspective on the concept of expertise in surgical neuro-oncology might be helpful. Material and methods: The EANS Neuro-oncology Section panel developed an online survey asking questions regarding criteria for expertise in neuro-oncological surgery and sent it to all individual EANS members. Results: Our questionnaire was completed by 251 respondents (consultants: 80.1%) from 42 countries. 67.7% would accept a lifetime caseload of >200 cases and 86.7% an annual caseload of >50 as evidence of neuro-oncological surgical expertise. A majority felt that surgeons who do not treat children (56.2%), do not have experience with spinal fusion (78.1%) or peripheral nerve tumors (71.7%) may still be considered experts. Majorities believed that expertise requires the use of skull-base approaches (85.8%), intraoperative monitoring (83.4%), awake craniotomies (77.3%), and neuro-endoscopy (75.5%) as well as continuing education of at least 1/year (100.0%), a research background (80.0%) and teaching activities (78.7%), and formal interdisciplinary collaborations (e.g., tumor board: 93.0%). Academic vs. non-academic affiliation, career position, years of neurosurgical experience, country of practice, and primary clinical interest had a minor influence on the respondents' opinions. Discussion and conclusion: Opinions among neurosurgeons regarding the characteristics and features of expertise in neuro-oncology vary surprisingly little. Large majorities favoring certain thresholds and qualitative criteria suggest a consensus definition might be possible.

Acanthosis Nigricans Presenting as Skin Tags: A Case Report.

Acanthosis nigricans (AN) is a common chronic disorder that is characterized by velvety-like, hyperpigmented, hyperkeratotic plaques, typically in intertriginous areas. However, atypical presentations have been reported. Here we present a five-year-old boy presented with a one-year history of asymptomatic slowly progressing skin lesions. He is a known case of type 1 diabetes mellites on insulin treatment, otherwise healthy. The review of systems was unremarkable. No similar case was found in the family. Skin examination revealed multiple tiny non-scaly brownish papules on the medial aspects of the upper thighs, bilaterally. Differential diagnosis included skin tags, viral warts, and dermatosis papulose nigra (DPN). Dermoscopic findings revealed a velvety-like appearance on the papules and the normal skin surrounding the papules. A 2-mm punch skin biopsy of the papule revealed papillomatosis of the epidermis, and the granular layer was normal. The dermis was normal. On the basis of the above clinicopathological findings, specifically the velvety texture of the normal skin surrounding the papules, the patient was diagnosed with ANs. The parent was reassured, and we started the patient on daily tretinoin cream.

Transcription factor GATA3 expression is induced by GLS2 overexpression in a glioblastoma cell line but is GLS2-independent in patient-derived glioblastoma.

Phosphate-activated glutaminase (GA), a ubiquitous glutamine-metabolizing enzyme, is encoded by two genes, GLS and GLS2. In mammalian cancers, GLS isoforms are perceived as molecules promoting cell proliferation and invasion, whereas the role of GLS2 isoforms seems to be more complex and cell type-specific. Previous studies have shown abundance of GLS and lack of GLS2 transcripts in T98G human glioblastoma (GBM) cell line and patient-derived GBM. Transfection with GAB sequence, the whole GLS2 cDNA transcript, suppressed malignant phenotype of T98G cells. Microarray analysis revealed upregulation of GATA3, the product of which has been implicated in suppressing growth of some peripheral cancers. In this study we confirmed a significant upregulation of GATA3 expression in the transfected cells both at mRNA and protein level. Considerable expression of GATA3 was also observed in GBM tissues (previously shown as not expressing GLS2), while only traces or no GATA3 was detected in (GLS2-expressing) non-tumorigenic brain samples. In conclusion, while mechanistic relation between GAB and GATA3 expression is evident following in vitro manipulation of GBM cell line, it does not appear to be an intrinsic property of GBM nor non-tumorigenic brain tissue.

Effect of cyclic adenosine monophosphate on the G protein-dependent inward rectifier K(+)-like channel current in medial prefrontal cortex pyramidal neurons.

Cyclic adenosine monophosphate (cAMP) levels in medial prefrontal cortex (mPFC) pyramidal neurons are altered in neuropsychiatric disorders. cAMP is a component of the transduction pathways involved in the control of ionic channels by metabotropic receptors. The purpose of this study was to determine whether cAMP modifies the activity of the G protein-dependent inward rectifier K(+) (GIRK)-like channel current in the mPFC pyramidal neurons of 3-week-old rats. Channel currents were recorded in a patch clamp cell-attached configuration. Membrane-permeable adenylyl cyclase activator forskolin (10 µM) and membrane-permeable protein kinase A (PKA) activator 8-Br-cAMP (100 µM) were found to significantly decrease the open probability (Po) of the GIRK-like channels. Conversely, selective protein kinase A inhibitors: H-89 (10 µM) and KT5720 (0.5 µM) increased the open probability of the GIRK-like channels. Also, the effect of forskolin was tested after preincubation of the neurons with the PKA inhibitor (KT5720). The application of forskolin, despite PKA inhibition, significantly decreased the Po of the GIRK-like channels. This finding suggested that GIRK-like channel current activity might also be inhibited by cAMP in a PKA-independent manner. A compound, 8CPT-2Me-cAMP (10 µM), which is a specific activator of the Epac protein, which in turn is another intracellular target of cAMP, was also found to inhibit GIRK-like channel activity. We conclude that the constitutive activity of neuronal GIRK-like channel currents is inhibited by cAMP. We suggest that PKA and Epac might be components of the transduction pathway between cAMP and the GIRK channels.

Kinetic properties of voltage-gated Na+ currents in rat muscular sympathetic neurons with and without adenosine triphosphate and guanosine triphosphate in intracellular solution.

Voltage-gated Na+ currents were recorded from anatomically identified postganglionic muscular sympathetic neurons without and with ATP and GTP in the intracellular solution. The main findings of the study were that cells without ATP and GTP in the intracellular solution express a higher amplitude and greater density of voltage-gated Na+ current, and their Na+ current activates faster and also inactivates faster time dependently. The current is also steady-state inactivated to a lesser degree and recovers from inactivation more slowly in cells without added ATP and GTP. These findings suggest that the presence of ATP and GTP, substrates for channel phosphorylation, changes the kinetic properties of Na+ currents.

[Malonyldialdehyde and total antioxidant status in the peritoneal fluid of infertile women]. / Stezenie dialdehydu malonowego oraz calkowity potencjal antyoksydacyjny w plynie otrzewnowym nieplodnych kobiet.

OBJECTIVE: To estimate the concentration of malonyldialdehyde (MDA) and total antioxidant status in the peritoneal fluid (PF) of patients with unexplained infertility (UI) and infertile women with minimal and mild endometriosis. MATERIALS AND METHODS: PF was obtained during laparoscopy from 8 women with UI, 12 infertile women with endometriosis (I degree and II degrees rAFS) and 10 women with benign noninflammatory ovarian tumours. All laparoscopies were performed in the follicular phase of the cycle. MDA concentration was measured according to Ledwozyw method, TAS was measured spectrophotometrically using RANDOX diagnostic reagent system. RESULTS: We found significantly higher concentration of MDA in PF from both patients with UI (p = 0.03) and with endometriosis (p = 0.046) compared to the control group. TAS was significantly (p = 0.027) higher in PF of women with UI but did not differ significantly (p = 0.49) between patients with endometriosis and controls. CONCLUSIONS: Our results show that an imbalance between lipid peroxides and the antioxidant system in PF environment may be one of the main factors responsible for the UI. In the group with endometriosis a marginally significant difference in MDA levels, no significant differences in TAS and data from the literature, suggest that accelerated lipid peroxidation in PF doesn't appear to play a role in the endometriosis associated infertility.