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BACKGROUNDS: Pilocytic astrocytomas (PAs) are World Health Organization (WHO) grade I tumors, which are relatively common, and are benign lesions in children. PAs could originate from the cerebellum, optic pathways, and third ventricular/hypothalamic region. Traditional various transcranial routes are used for hypothalamic PAs (HPAs). However, there are few studies on hypothalamic PAs treated through the endoscopic endonasal approach (EEA). This study reports the preliminary experience of the investigators and results with HPAs via expanded EEAs. METHODS: All patients with HPAs, undergone EEA in our hospital from 2017 to 2019, were retrospectively reviewed. The demographic data, clinical symptoms, complications, skull base reconstruction, prognosis, and endocrinological data were all recorded and analyzed in detail. RESULTS: Finally, five female patients were enrolled. The average age of patients was 28.6 ± 14.0. All patients had complaints about their menstrual disorder. One patient had severe bilateral visual impairment. Furthermore, only one patient suffered from severe headache due to acute hydrocephalus, although there were four patients with headache or dizziness. Four cases achieved gross-total resection, and one patient achieved subtotal resection. Furthermore, there was visual improvement in one patient (case 5), and postoperative worsening of vision in one patient (case 4). However, only one patient had postoperative intracranial infection. None of the patients experienced a postoperative CSF leak, and in situ bone flap (ISBF) techniques were used for two cases for skull base repair. In particular, ISBF combined with free middle turbinate mucosal flap was used for case 5. After three years of follow-up, three patients are still alive, two patients had no neurological or visual symptoms, or tumor recurrence, and one patient had severe hypothalamic dysfunction. Unfortunately, one patient died of severe postoperative hypothalamus reaction, which presented with coma, high fever, diabetes insipidus, hypernatremia and intracranial infection. The other patient died of recurrent severe pancreatitis at one year after the operation. CONCLUSION: Although the data is still very limited and preliminary, EEA provides a direct approach to HPAs with acceptable prognosis in terms of tumor resection, endocrinological and visual outcomes. ISBF technique is safe and reliable for skull base reconstruction.
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Astrocitoma , Hipotálamo , Cirugía Endoscópica por Orificios Naturales , Adulto , Astrocitoma/cirugía , Femenino , Humanos , Hipotálamo/cirugía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Parents confront multiple aspects of offspring demands and need to coordinate different parental care tasks. Biparental care is considered to evolve under circumstances where one parent is not competent for all tasks and cannot efficiently raise offspring. However, this hypothesis is difficult to test, as uniparental and biparental care rarely coexist. Chinese penduline tits (Remiz consobrinus) provide such a system where both parental care types occur. Here, we experimentally investigated whether parents in biparental nests are less capable of caring than parents in uniparental nests. We monitored parenting efforts at (1) naturally uniparental and biparental nests and (2) biparental nests before and during the temporary removal of a parent. Given the relatively small sample sizes, we have employed various statistical analyses confirming the robustness of our results. We found that total feeding frequency and brooding duration were similar for natural uniparental and biparental nests. Feeding frequency, but not brooding duration, contributed significantly to nestling mass. In line with this, a temporary parental removal revealed that the remaining parents at biparental nests fully compensated for the partner's feeding absence but not for brooding duration. This reflects that the manipulated parents are confronted with a trade-off between feeding and brooding and were selected to invest in the more influential one. However, such a trade-off may not occur in parents of natural uniparental care nests. The different capabilities of a parent independently coordinating feeding and brooding tasks suggest that parents from biparental and uniparental nests were exposed to different resource conditions, thereby foraging efficiency may differ between care types.
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OBJECTIVE: Diffuse large B-cell lymphoma (DLBCL) is the most common histopathological type of non-Hodgkin's lymphoma and might arise from various extranodal sites. Little is known about the clinical characteristics and survival outcomes of primary DLBCL of the brain, including the cerebrum, cerebellum, brain steam and ventricle (CCSV). Thus, we performed this study to explore the independent prognostic factors of CCSV-DLBCL using the Surveillance, Epidemiology, and End Results (SEER) database. MATERIALS AND METHODS: We extracted the data of patients diagnosed with CCSV-DLBCL between 1975 and 2016 from the SEER database. Variables including demographic characteristics, Ann Arbor stage and therapies, such as surgery, radiation and chemotherapy, were all collected. The prognostic factors on overall survival (OS) and disease-specific survival (DSS) were analysed using Kaplan-Meier curves. RESULTS: One thousand three hundred and twenty-eight patients were finally enrolled in the analysis. The median age was 62 years old. More than half of the cases of CCSV-DLBCL (54.22%) originated from the cerebrum. Patients older than 75 years had the worst OS and DSS. Moreover, black people had the worst survival outcomes compared with white and other people. Surgery, radiation and chemotherapy all significantly improved OS and DSS. CONCLUSION: To the best of our knowledge, this is the largest population-based study of CCSV-DLBCL. Advanced age, black race, lack of surgical resection, radiation or chemotherapy were all poor prognostic factors.
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Linfoma de Células B Grandes Difuso , Humanos , Persona de Mediana Edad , Pronóstico , Estadificación de Neoplasias , Programa de VERF , Linfoma de Células B Grandes Difuso/terapia , Linfoma de Células B Grandes Difuso/diagnóstico , Estudios Retrospectivos , Encéfalo/patologíaRESUMEN
Temperate-tropical comparisons of avian life history traits are helpful to understand the different selective pressures placed on birds by different climate zones. Although there have been many comparative studies targeting multiple species in different regions, there are few comparative studies on the reproductive successes of the same species between tropical and temperate regions. In this study, we monitored the breeding activities of the Barn Swallow (Hirundo rustica) simultaneously at a single tropical site and a single temperate site in China, compared the breeding performances of the two populations, and investigated the effects of weather conditions on reproductive success separately. The clutch and brood sizes of the Barn Swallow at the topical site were significantly smaller than those at the temperate site. Furthermore, the breeding success of the Barn Swallow at the tropical site was significantly lower than that at the temperate site. The mean daytime temperature had a negative effect on the clutch size and brood size at both sites; it had a negative effect on nestling survival at the tropical site, but not the temperate site. This study will help us understand the adaptation strategies of widely distributed bird species in different environments, and how climate change will affect birds in different climate zones.