Pediatric Pterygopalatine Fossa Schwannoma Presenting as Vision Loss: A Case Report and Literature Review.

Neurosynovial tumors, originating from Schwann cells within nerve sheaths, are benign entities, with 25% to 45% manifesting in the head and neck region. However, occurrences in the pterygopalatine fossa (PPF) are exceptionally rare, and only a handful of cases have been documented. In this report, we present the unique case of a 6-year-old child exhibiting a sizable soft tissue mass in the left PPF, extending into the inferior orbital fissure. The patient underwent successful intranasal endoscopic removal of PPF schwannoma utilizing the prelacrimal recess approach, with postoperative pathology confirming the diagnosis of schwannoma. Schwannomas within the PPF are particularly uncommon, and instances of such tumors in pediatric patients are even more exceptional. This case highlights the diagnostic and therapeutic challenges associated with PPF schwannomas in children, emphasizing the significance of a multidisciplinary approach for optimal management. In addition, a comprehensive literature review is presented to provide insights into the existing knowledge on this rare entity, further contributing to the understanding of pediatric PPF schwannomas.

A Rare Case of Sinonasal Pleomorphic Adenoma.

Pleomorphic adenoma (PA) is the most prevalent benign tumor of the salivary glands, characterized by both epithelial and mesenchymal differentiation. It primarily originates within the parotid and submandibular glands, with only rare occurrences in the minor salivary glands. PA in the sinonasal area is extremely rare. Herein, we present a case of a 61-year-old female with a large soft tissue mass in the paranasal sinus and nasal cavity, as evidenced by computed tomography imaging. The patient suffered from repeated nasal congestion for more than 6 months. Eventually, the mass was completely resected using an endoscopic endonasal prelacrimal approach under general anesthesia. Postoperative pathological examination revealed the presence of PA in the nasal sinus.

Microscale Self-Assembly of Upconversion Nanoparticles Driven by Block Copolymer.

Lanthanide-based upconversion nanoparticles can convert low-energy excitation to high-energy emission. The self-assembled upconversion nanoparticles with unique structures have considerable promise in sensors and optical devices due to intriguing properties. However, the assembly of isotropic nanocrystals into anisotropic structures is a fundamental challenge caused by the difficulty in controlling interparticle interactions. Herein, we report a novel approach for the preparation of the chain-like assemblies of upconversion nanoparticles at different scales from nano-scale to micro-scale. The dimension of chain-like assembly can be fine-tuned using various incubation times. Our study observed Y-junction aggregate morphology due to the flexible nature of amphiphilic block copolymer. Furthermore, the prepared nanoparticle assemblies of upconversion nanoparticles with lengths up to several micrometers can serve as novel luminescent nanostructure and offer great opportunities in the fields of optical applications.

The association between non-motor symptoms in Parkinson's disease and age at onset.

OBJECTIVE: Age at onset is likely to be related to a wide range of problems in Parkinson's disease (PD), including cardinal motor features, motor complications and non-motor symptoms (NMS). This study investigated the effect of the age at onset on NMS. METHODS: Two hundred and thirty patients were examined and classified into one of three groups based on age at onset: early onset PD (EOPD) group (<45 years), middle-age onset group (45-64 years) and old-age onset group (≥65 years). The trends relating to NMS were compared across the three groups. The EOPD and old-age onset groups were separately studied to determine their association to the appearance of non-motor features using logistic regression analysis. RESULTS: There were upward trends in the occurrence of dribbling (P=0.009; all P values are stated for trend), impaired taste/smelling (P=0.016), constipation (P=0.006), urinary urgency (P=0.002), nocturia (P=0.018), hallucinations (P=0.016) and acting out during dreams (P=0.011) with the increase of age at onset. Older age at onset is an independent risk factor for dementia (OR=8.42, CI 3.16-22.44), dribbling (OR=4.14, CI 1.93-8.87), impaired taste/smelling (OR=2.23, CI 1.20-4.13), constipation (OR=3.42, CI 1.88-6.24), incomplete bowel emptying (OR=2.23, CI 1.19-4.20), urinary urgency (OR=2.58 CI 1.46-4.57), nocturia (OR=2.65, CI 1.49-4.71), hallucinations (OR=5.32, CI 1.78-15.97), dizziness (OR=3.03, CI 1.59-5.79), falling (OR=3.60, CI 1.67-7.77), insomnia (OR=2.29, CI 1.28-4.11), intense vivid dreaming (OR=2.10, CI 1.21-3.66) and acting out during dreams (OR=2.23, CI 1.24-4.01). CONCLUSIONS: PD patients with different ages at onset present clinically different symptoms in terms of NMS. Old-age onset PD is characterized by more olfactory and sensory symptoms, autonomic symptoms, sleep disorders, dementia and psychosis compared to EOPD.

[Burden and related factors among care-takers of patients with Parkinson's disease].

OBJECTIVE: To assess the impact on caretaker who looked after patients with Parkinson's disease (PD) and to identify the main factors related to their burden. METHODS: 115 consecutive pairs of PD patients and their caretakers were included. Caregiver Burden Inventory (CBI) was used to assess the burden of PD on the caretakers. Patients were evaluated by neurologists using the United Parkinson's Disease Rating Scale (UPDRS), the Hoehn and Yahr Scale (H-Y Scale), the Activity of Daily Living Scale (ADL), the Parkinson's Disease Questionnaire (PDQ-39), the Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), the Montreal Cognitive Assessment (MoCA) and the Mini-mental State Examination (MMSE). Multiple linear stepwise regression models were fitted to ascertain the factors linked to the CBI. RESULTS: Based on multiple linear stepwise regression analysis, ADL (ß = -0.813, t = -6.265, P = 0.000) and PDQ-39 (ß = 0.285, t = 4.256, P = 0.000) of patients and the age of caretakers (ß = 0.327, t = 3.107, P = 0.002) proved to be the main predictors of CBI. CONCLUSION: Many factors might comprehensively affect the burden of PD on caretakers of the patients. Attention needs to be given to the early identification of factors that generating stress on caretakers in order to improve their quality of life.

[Systematic evaluation on influence of dopaminergic therapy: on motor complications in Parkinson's disease].

OBJECTIVE: To investigate the impact of dopaminergic therapy on the onset of motor complications in Parkinson's disease (PD). METHODS: Two clinical questions were identified. (1) Whether levodopa (LD) dose, LD treatment duration, the time from disease onset to initiation of LD can predict the onset of motor complications in PD? and (2) whether dopamine agonists (DA) used in de novo patients can delay the onset of motor complications? Literatures on observation studies of factors associated with motor complications and randomized controlled trials (RCTs) of DA compared to LD in treatment of de novo patients published before May 2008 were retrieved from Pubmed, EMbase, and Cochrane Database. Methodology quality was critically assessed. RESULTS: 12 articles on the first question were selected, including one RCT, five cohort studies, six case-control studies. Six RCTs on the second question were selected. Because of clinical heterogeneity among the researches thus retrieved, meta-analysis was not conducted, and qualitative analysis showed that initial LD dose, LD dose per kilogram body weight, accumulated LD dose, and accumulated LD equivalent dose might be independent factors associated with motor complications. The time from disease onset to initiation of LD was not correlated with motor complications. DA as initial treatment was associated with later occurrence of dyskinesias (CALM-PD: HR = 0.37, 95% CI: 0.25 - 0.56, P < 0.001; PELMOPET: HR = 0.48, 95% CI = 0.29 - 0.80, P < 0.001; Ropinirole 056: HR = 0.4, 95% CI: 0.2 - 0.8, P = 0.007; REAL-PET: HR = 8.28, 95% CI: 2.46 - 27.93, P < 0.001). The relationship between LD treatment duration and motor complications could not be concluded from present evidence. CONCLUSION: Initial LD dose, LD dose per kilogram body weight, accumulated LD dose, and accumulated LD equivalent dose may be independent factors associated with motor complications. The time from disease onset to initiation of LD was not correlated with motor complications.

[Non-pharmacological influencing factors of motor complications in Parkinson's disease: a systematic review].

OBJECTIVE: To make a systematic review of risk factors associated with motor complications in Parkinson's disease (PD). METHODS: Medline, EMbase and Cochrane Database were used to search for prospective and retrospective studies on the factors associated with dyskinesia and motor fluctuations. Methodological quality was checked by two independent reviewers. RESULTS: Earlier age at onset, female gender and a long disease duration might be the risk factors of motor complications. CONCLUSION: More high-quality clinical trials are required to evaluate the factors associated with motor complications.

[Neuropsychiatric problems in patients with Parkinson's disease].

OBJECTIVE: To survey the prevalence and distribution of neuropsychiatric problems in patients with Parkinson's disease (PD), and to investigate their effects on life quality and the interactions among different neuropsychiatric problems. METHODS: Unified Parkinson's disease rating scale (UPDRS) part III, dyskinesia and motor fluctuation subscale of UPDRS part IV, mini-mental state examination (MMSE) ,Montreal Cognitive Assessment (MoCA), Hamilton rate scale of depression (HRSD), Hamilton anxiety scale (HAMA), digit span (DS), and 39 item Parkinson's disease questionnaire (PDQ-39) were used to assess the motor symptoms and neuropsychiatric problems in 116 PD patients, 66 males and 50 females, aged (67 +/- 9) (50-90), with the course of disease of 5 +/- 4 years (0.5--18 years). Spearman rank order correlation and hierarchical regressions of the major statistical procedures were employed. RESULTS: Various neuropsychiatric problems were found in the PD patients. The neuropsychiatric problems, such as depression, anxiety, apathy, attention deficit disorder, and cognitive deficits, were correlated with the UPDRS III score and Hoehn-Yahr stage, but not correlated with the course of disease ( all P > 0.05). Hallucination was not correlated with any factors (all P > 0.05). There were some correlations among different neuropsychiatric problems. Hierarchical regression revealed that different neuropsychiatric problems showed significant effects on the quality of life after controlling the motor symptoms. Depression (deltaR2 = 19.1%, P < 0.01) and apathy (deltaR2 = 17.0%, P < 0.01) exerted the most powerful influence in causing poor quality of life. CONCLUSION: Neuropsychiatric problems are common a in PD patients Their effects on the poor quality of life are no less than that of motor symptoms and should be recognized and treated well.

Evaluation of cirrhotic liver with perfusion-weighted magnetic resonance imaging: a preliminary experimental study in animal models with half-liver cirrhosis.

OBJECTIVE: To investigate the role of perfusion-weighted magnetic resonance imaging (MRI) in evaluation of cirrhotic liver. METHODS: With a 4F catheter, 1% diluted carbon tetrachloride (1 ml/kg) was selectively injected into right or left hepatic artery of 12 dogs fortnightly. The half liver into which carbon tetrachloride was injected was called as study side (SS), while the other half liver without carbon tetrachloride injection was called as study control side (SCS). Conventional and perfusion-weighted MRI were performed in every 4 weeks. Via a 4F catheter, 5ml gadolinium diethylentriamine pentaaceti acid (Gd-DTPA) dilution was injected into superior mesenteric artery at the 5th scan. The signal intensity-time curves of SS, SCS, and portal vein were completed in MR workstation. The maximal relative signal increase (MRSI), peak time (tp), and slope of the curves were measured. RESULTS: On conventional MR images, no abnormalities of externality and signal intensity were observed in both SS and SCS of liver at each stage. The mean tp, MRSI, and slope of intensity-time curves in normal liver were 10.56 seconds, 1.01, and 10.23 arbitrary unit (au)/s, respectively. Three parameters of curves didn't show obvious change in SCS of liver at every stage. Abnormal perfusion curves occurred in SS of liver at the 12th week after the 1st injection. The abnormality of perfusion curve in SS was more and more serious as the times of injection increased. The mean tp, MRSI, and slope intensity-time curves in SS of liver were 19.45 seconds, 0.43, and 3.60 au/s respectively at the 24th week. CONCLUSION: Perfusion-weighted imaging can potentially provide information about portal perfusion of hepatic parenchyma, and to some degree, reflect the severity of cirrhosis.