Follow-up of intracranial aneurysms treated with stent-assisted coiling: Comparison of contrast-enhanced MRA, time-of-flight MRA, and digital subtraction angiography.

BACKGROUND AND PURPOSE: Data about non-invasive follow-up of aneurysm after stent-assisted coiling is scarce. We aimed to compare time-of-flight (TOF) magnetic resonance angiography (MRA) (3D-TOF-MRA) and contrast-enhanced MRA (CE-MRA) at 3-Tesla, with digital subtraction angiography (DSA) for evaluating aneurysm occlusion and parent artery patency after stent-assisted coiling. MATERIALS AND METHODS: In this retrospective single-center study, patients were included if they had an intracranial aneurysm treated by stent-assisted coiling between March 2008 and June 2015, followed with both MRA sequences (3D-TOF-MRA and CE-MRA) at 3-Tesla and DSA, performed in an interval<48hours. RESULTS: Thirty-five aneurysms were included. Regarding aneurysm occlusion evaluation, agreement with DSA was better for CE-MRA (K=0.53) than 3D-TOF-MRA (K=0.28). Diagnostic accuracies for aneurysm remnant depiction were similar for 3D-TOF-MRA and CE-MRA (P=1). Both 3D-TOF-MRA (K=0.05) and CE-MRA (K=-0.04) were unable to detect pathological vessel compared to DSA, without difference in accuracy (P=0.68). For parent artery occlusion detection, agreement with DSA was substantial for 3D-TOF-MRA (K=0.64) and moderate for CE-MRA (K=0.45), with similar good diagnostic accuracies (P=1). CONCLUSION: After stent-assisted coiling treatment, 3D-TOF-MRA and CE-MRA demonstrated good accuracy to detect aneurysm remnant (but tended to overestimation). Although CE-MRA agreement with DSA was better, there was no statistical difference between 3D-TOF-MRA and CE-MRA accuracies. Both MRAs were unable to provide a precise evaluation of in-stent status but could detect parent vessel occlusion.

Endovascular treatment of intracranial aneurysms with Barricade coils: Feasibility, procedural safety, and immediate postoperative anatomical results.

BACKGROUND AND PURPOSE: The safety of bare platinum coils has been widely described in the literature. This study aimed to report the first series of intracranial aneurysms treated with Barricade bare platinum coils with a comprehensive evaluation of their procedural safety and postprocedural anatomical results. METHODS: Patients with intracranial aneurysms treated between October 2013 and December 2015 by simple coiling or balloon-assisted coiling with Barricade coils (Blockade Medical, Irvine, California, USA) were prospectively included in a database and retrospectively studied. For all included patients, the patient and aneurysm characteristics, procedural complications, technical issues, postoperative anatomical results, and one-month clinical outcome (modified Rankin Scale) were evaluated by an independent interventional neuroradiologist. RESULTS: Eighty-eight patients harboring 97 aneurysms were included. Procedural complications and technical issues were encountered in 17 and 5 patients (19.3 and 5.7%, respectively), but clinical worsening in only 2 patients (2.2%). There was no treatment-related mortality. After one month, morbidity (mRS≥1) was observed in 19 patients (21.8%), 17 related to subarachnoid hemorrhage (SAH) in patients with ruptured aneurysms (19.4%) and 2 related to thromboembolic events in patients with unruptured aneurysms (2.3%). Nine patients initially presenting with a ruptured aneurysm were deceased at 1 month as a consequence of SAH (10.2%). Adequate occlusion was observed postoperatively in 94.8% of the aneurysms (complete occlusion in 81.4% and residual neck in 13.4%). CONCLUSION: Endovascular treatment of intracranial aneurysms with Barricade coils is feasible and the demonstrated overall safety results are within the ranges found in the literature for other coils. Immediate anatomical results are satisfying.

Colorectal cancer screening: Modalities and adherence.

In the last decade, several studies have explored various modalities and strategies for colorectal cancer (CRC) screening, taking into account epidemiological data, individual characteristics, and socioeconomic factors. In this editorial, we comment further on a retrospective study by Agatsuma et al published in the recent issue of the World Journal of Gastroenterology. Our focus is on screening trends, particularly in relation to efforts to improve the currently suboptimal uptake among the general population worldwide, aiming to enhance early diagnosis rates of CRC. There is a need to raise awareness through health edu-cation programs and to consider the use of readily available, non-invasive screening methods. These strategies are crucial for attracting screen-eligible populations to participate in first-line screening, especially those in high- or average-risk groups and in regions with limited resources. Liquid biopsies and biomarkers represent rapidly evolving trends in screening and diagnosis; however, their clinical relevance has yet to be standardized.

Calpain-mediated Mechanoptosis in Breast Adenocarcinoma.

Calpains belong to a family of important calcium-dependent cysteine proteases. They are involved in intracellular processes including cytoskeleton disorganization and substrate proteolysis. They also enhance apoptosis and cell to cell adhesion. Calpains demonstrate also a mechanosensory function in neoplastic and malignant cells due to their implication in mechanoptosis. This is a specific type of apoptotic death induced by strong external mechanical stimuli. Anti-cytoskeleton rigidity inhibition strategies based on calpain induction lead to increased apoptosis of tumor transformed cells. Elevated intracellular calcium concentration mediated by specific receptors and channels activates calpains. In the current molecular review, we explored the role of calpains in calcium-dependent signa transduction pathways in breast adenocarcinoma in conjunction with novel agents that activate their important anti-tumor functions.

DNA Mismatch Repair System Imbalances in Breast Adenocarcinoma.

DNA mismatch repair system (MMR) is considered a leading genetic mechanism in stabilizing DNA structure and maintaining its function. DNA MMR is a highly conserved system in bacteria, prokaryotic, and eukaryotic cells, and provides the highest protection to DNA by repairing micro-structural alterations. DNA MMR proteins are involved in the detection and repair of intra-nucleotide base-to-base errors inside the complementary DNA strand recognizing the recently synthesized strand from the parental template. During DNA replication, a spectrum of errors including base insertion, deletion, and miss-incorporation negatively affect the molecule's structure and its functional stability. A broad spectrum of genomic alterations such as promoter hyper methylation, mutation, and loss of heterozygosity (LOH) in MMR genes including predominantly hMLH1, hMSH2, hMSH3, hMSH6, hPMS1, and hPMS2 lead to their loss of base-to-base error repairing procedure. Microsatellite instability (MSI) refers to the DNA MMR gene alterations that are observed in a variety of malignancies of different histological origins. In the current review, we present the role of DNA MMR deficiency in breast adenocarcinoma, a leading cancer-based cause of death in females worldwide.

Epigenetic Mechanisms in Breast Adenocarcinoma: Novel DNA Methylation Patterns.

Breast adenocarcinoma is a leading cause of death in females worldwide. A broad spectrum of genetic and epigenetic alterations has been already identified and reported in millions of examined cancerous substrates, evidence of a high-level genomic heterogeneity that characterizes these malignancies. Concerning epigenetic changes and imbalances that critically affect progression and prognosis in the corresponding patients, DNA methylation, histone modifications (acetylation), micro-RNAs (miRs) alterations and chromatin re-organization represent the main mechanisms. Referring to DNA methylation, promoter hyper-hypo methylation in critical tumour suppressor and oncogenes is implicated in normal epithelia transformation to their neoplastic and finally malignant cyto-phenotypes. The current review is focused on the different methylation patterns and mechanisms detected in breast adenocarcinoma and their impact on the corresponding groups of patient response to specific chemotherapeutic regimens and life span prognosis.

A low-profile wideband compressed single-arm spiral antenna array for mid-band 5G beam steering applications.

A low profile wideband spiral antenna array is presented for global mid-band 5G beam steering applications. In the global rollout of mid-band 5G, different frequencies have been licensed within each region (e.g. 3.4-3.8 GHz in the EU and 3.7-5 GHz in the USA). Therefore, antenna arrays must be able to cover a bandwidth of 3.3 GHz to 5 GHz to provide true global coverage. Initially, this work presents the design of a wideband compressed spiral antenna that provides an axial beam throughout its operational bandwidth of 3.3 GHz to 5 GHz, enabling beam steering functionality. Then, this antenna has been placed in a 4 × 4 array with a triangular lattice. The proposed spiral antenna array can provide a scanning range of - 40° ≤ θ ≤ + 40° in all azimuth directions with an average back lobe level of less than - 9.5 dB. This development will allow for low-cost integration of 5G systems for global use, such as passenger aircraft, UAVs, drones, and marine and ground vehicles.

Mucinous cystic neoplasms of the mesentery: a case report and review of the literature.

BACKGROUND: Mucinous cystic neoplasms arise in the ovary and various extra-ovarian sites. While their pathogenesis remains conjectural, their similarities suggest a common pathway of development. There have been rare reports involving the mesentery as a primary tumour site. CASE PRESENTATION: A cystic mass of uncertain origin was demonstrated radiologically in a 22 year old female with chronic abdominal pain. At laparotomy, the mass was fixed within the colonic mesentery. Histology demonstrated a benign mucinous cystadenoma. METHODS AND RESULTS: We review the literature on mucinous cystic neoplasms of the mesentery and report on the pathogenesis, biologic behavior, diagnosis and treatment of similar extra-ovarian tumors. We propose an updated classification of mesenteric cysts and cystic tumors. CONCLUSION: Mucinous cystic neoplasms of the mesentery present almost exclusively in women and must be considered in the differential diagnosis of mesenteric tumors. Only full histological examination of a mucinous cystic neoplasm can exclude a borderline or malignant component. An updated classification of mesenteric cysts and cystic tumors is proposed.

MR imaging features and tumor biomarkers of screen-detected and non-screen detected breast cancers: preliminary results of a comparative study.

PURPOSE: To investigate differences in clinical features, MRI findings and tumor biomarker characteristics in screen-detected (SCD) and non-screendetected (NSCD) cancers. MATERIAL AND METHODS: A total of 62 women (mean age, 48.4 years; range, 33-68 years) with biopsy confirmed breast cancer who underwent preoperative breast MRI were retrospectively evaluated by two expert radiologists. The women were divided into two groups according to the mode of cancer detection (Group A: screen- detected, Group B: non-screen/symptomatic cancer) and clinical, histopathological, MRI characteristics and biomarker features in each group were evaluated. RESULTS: NSCD tumors had significantly greater size (3.5 cm vs. 2.1 cm) and Ki-67 expression (68.4% vs. 41.7%) in comparison to SCD cancers. NSCD cancers were less likely to have strongly positive progesterone receptors (Pr) and more likely to have Ki-67 > 15% or positive nodal status (47.4% vs. 8.3%). Increased breast density (ACR C and D: 78.9% vs. 50%ACR A and B) and intense background parenchymal enhancement (BPE, moderate/marked: 42.1% vs. 8.3% minimal/mild) were significantly more frequent in NSCD cases. CONCLUSION: NSCD cancers had higher prevalence of poor prognostic characteristics in comparison to SCD tumors, including larger tumor size, higher Ki-67 index, and positive nodes. Increased fibroglandular tissue and intense BPE were both strongly associated with NSCD cancers, supporting their use as potential MR biomarkers in breast cancer risk models.

Treatment of recurrent aneurysms using the Woven EndoBridge (WEB): anatomical and clinical results.

BACKGROUND: The safety and efficacy of the Woven EndoBridge (WEB) for the treatment of naïve intracranial aneurysms has been confirmed. PURPOSE: To analyze the safety and efficacy of the WEB in the treatment of recurrent aneurysms. METHODS: Anatomical and clinical results in consecutive patients with a recurrent aneurysm, who were treated using the WEB device in two French neurointerventional centers, were evaluated. RESULTS: Seventeen patients with 17 aneurysms were included. Treatment was feasible in 16 patients. In seven patients (41.2%), ancillary devices were used. Permanent morbidity due to a thromboembolic complication occurred in one patient (5.9%). There was no mortality. Follow-up angiographic studies were available for 15 patients after a mean of 12.1±6.1 months. Rates of complete occlusion, neck remnant, and aneurysm remnant were 33.3%, 40.0%, and 26.7%, respectively. CONCLUSIONS: Treatment of recurrent aneurysms using the WEB device may be reasonably safe and effective.