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1.
Int J Mol Sci ; 21(16)2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32796723

RESUMO

Photosynthesis is not only a primary generator of reactive oxygen species (ROS) but also a component of plant defence. To determine the relationships among photosynthesis, ROS, and defence responses to powdery mildew in wheat, we compared the responses of the Pm40-expressing wheat line L658 and its susceptible sister line L958 at 0, 6, 12, 24, 48, and 72 h post-inoculation (hpi) with powdery mildew via analyses of transcriptomes, cytology, antioxidant activities, photosynthesis, and chlorophyll fluorescence parameters. The results showed that H2O2 accumulation in L658 was significantly greater than that in L958 at 6 and 48 hpi, and the enzymes activity and transcripts expression of peroxidase and catalase were suppressed in L658 compared with L958. In addition, the inhibition of photosynthesis in L658 paralleled the global downregulation of photosynthesis-related genes. Furthermore, the expression of the salicylic acid-related genes non-expressor of pathogenesis related genes 1 (NPR1), pathogenesis-related 1 (PR1), and pathogenesis-related 5 (PR5) was upregulated, while the expression of jasmonic acid- and ethylene-related genes was inhibited in L658 compared with L958. In conclusion, the downregulation of photosynthesis-related genes likely led to a decline in photosynthesis, which may be combined with the inhibition of peroxidase (POD) and catalase (CAT) to generate two stages of H2O2 accumulation. The high level of H2O2, salicylic acid and PR1 and PR5 in L658 possible initiated the hypersensitive response.

2.
Artif Intell Med ; 107: 101911, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32828450

RESUMO

Manual delineation of vestibular schwannoma (VS) by magnetic resonance (MR) imaging is required for diagnosis, radiosurgery dose planning, and follow-up tumor volume measurement. A rapid and objective automatic segmentation method is required, but problems have been encountered due to the low through-plane resolution of standard VS MR scan protocols and because some patients have non-homogeneous cystic areas within their tumors. In this study, we retrospectively collected multi-parametric MR images from 516 patients with VS; these were extracted from the Gamma Knife radiosurgery planning system and consisted of T1-weighted (T1W), T2-weighted (T2W), and T1W with contrast (T1W + C) images. We developed an end-to-end deep-learning-based method via an automatic preprocessing pipeline. A two-pathway U-Net model involving two sizes of convolution kernel (i.e., 3 × 3 × 1 and 1 × 1 × 3) was used to extract the in-plane and through-plane features of the anisotropic MR images. A single-pathway model that adopted the same architecture as the two-pathway model, but used a kernel size of 3 × 3 × 3, was also developed for comparison purposes. In addition, we used multi-parametric MR images with different image contrasts as the model training input in order to effectively segment tumors with solid as well as cystic parts. The results of the automatic segmentation demonstrated that (1) the two-pathway model outperformed single-pathway model in terms of dice scores (0.90 ± 0.05 versus 0.87 ± 0.07); both of them having been trained using the T1W, T1W + C and T2W anisotropic MR images, (2) the optimal single-parametric two-pathway model (dice score: 0.88 ± 0.06) was then trained using the T1W + C images, and (3) the two-pathway models trained using bi-parametric (T1W + C and T2W) and tri-parametric (T1W, T2W, and T1W + C) images outperformed the model trained using the single-parametric (T1W + C) images (dice scores: 0.89 ± 0.05 and 0.90 ± 0.05, respectively, larger than 0.88 ± 0.06) because it showed improved segmentation of the non-homogeneous parts of the tumors. The proposed two-pathway U-Net model outperformed the single-pathway U-Net model when segmenting VS using anisotropic MR images. The multi-parametric models effectively improved on the defective segmentation obtained using the single-parametric models by separating the non-homogeneous tumors into their solid and cystic parts.

3.
Pancreas ; 49(7): 967-974, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32658083

RESUMO

OBJECTIVE: The study concerns identifying risk factors and developing nomogram for pancreatic pseudocyst (PPC) in idiopathic chronic pancreatitis (ICP) to facilitate early diagnosis. METHODS: From January 2000 to December 2013, ICP patients admitted to our center were enrolled. Cumulative incidence of PPC was determined by Kaplan-Meier method. Patients were randomized into training group and validation group in a 2:1 ratio. Risk factors of PPC were determined through Cox proportional hazards regression model based on training cohort. The nomogram was constructed according to risk factors. RESULTS: Totally, 1633 ICP patients were included with a median follow-up duration of 9.8 years. Pancreatic pseudocyst was observed in 14.7% (240/1633) of patients after ICP onset. The cumulative incidences of PPC were 8.2%, 10.4%, and 12.9% at 3, 5, and 10 years after ICP onset, respectively. Male sex, smoking history, history of severe acute pancreatitis, and chronic pain at/before diagnosis of ICP and complex pathologic changes in main pancreatic duct were recognized as risk factors of PPC development. The nomogram constructed with these risk factors achieved good concordance indexes. CONCLUSIONS: Risk for PPC could be estimated through the nomogram. High-risk patients were suggested to be followed up closely to help early diagnosis of PPC.

5.
Nano Lett ; 20(8): 5699-5704, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32638594

RESUMO

Water purification by solar distillation is considered a promising technology for producing clean water from undrinkable water resources. A solar steam generator is a central part of a solar distillation process to separate water and contaminants. Here, we report an efficient and sustainable hierarchical solar steam generator (HSSG) with reduced vaporization enthalpy based on bacterial cellulose (BC) nanocomposites. The nanomaterials are assembled with BC nanofibers produced by bacteria in situ to form nanocomposites. Using this method, we construct functional BC nanocomposites inside and on the natural porous structure of wood. Our HSSG integrates solar-to-vapor efficiency improvement and vaporization enthalpy reduction by integrating the hierarchical multifunctional BC nanocomposites with the natural porous structure of wood. Because of the biomimetic design, hierarchical structure and reduced vaporization enthalpy of HSSG, a high evaporation rate of 2.9 kg m-2 h-1 and solar-to-vapor efficiency of 80% is achieved.

6.
Neurosurgery ; 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32687577

RESUMO

BACKGROUND: Facial nerve schwannomas are rare, challenging tumors to manage due to their nerve of origin. Functional outcomes after stereotactic radiosurgery (SRS) are incompletely defined. OBJECTIVE: To analyze the effect of facial nerve segment involvement on functional outcome for these tumors. METHODS: Patients who underwent single-session SRS for facial nerve schwannomas with at least 3 mo follow-up at 11 participating centers were included. Preoperative and treatment variables were recorded. Outcome measures included radiological tumor response and neurological function. RESULTS: A total of 63 patients (34 females) were included in the present study. In total, 75% had preoperative facial weakness. Mean tumor volume and margin dose were 2.0 ± 2.4 cm3 and 12.2 ± 0.54 Gy, respectively. Mean radiological follow-up was 45.5 ± 38.9 mo. Progression-free survival at 2, 5, and 10 yr was 98.1%, 87.2%, and 87.2%, respectively. The cumulative proportion of patients with regressing tumors at 2, 5, and 10 yr was 43.1%, 63.6%, and 63.6%, respectively. The number of involved facial nerve segments significantly predicted tumor progression (P = .04). Facial nerve function was stable or improved in 57 patients (90%). Patients with involvement of the labyrinthine segment of the facial nerve were significantly more likely to have an improvement in facial nerve function after SRS (P = .03). Hearing worsened in at least 6% of patients. Otherwise, adverse radiation effects included facial twitching (3 patients), facial numbness (2 patients), and dizziness (2 patients). CONCLUSION: SRS for facial nerve schwannomas is effective and spares facial nerve function in most patients. Some patients may have functional improvement after treatment, particularly if the labyrinthine segment is involved.

7.
JAMA Oncol ; 6(7): 1028-1037, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32496550

RESUMO

Importance: Although stereotactic radiosurgery (SRS) is preferred for limited brain metastases from most histologies, whole-brain radiotherapy (WBRT) has remained the standard of care for patients with small cell lung cancer. Data on SRS are limited. Objective: To characterize and compare first-line SRS outcomes (without prior WBRT or prophylactic cranial irradiation) with those of first-line WBRT. Design, Setting, and Participants: FIRE-SCLC (First-line Radiosurgery for Small-Cell Lung Cancer) was a multicenter cohort study that analyzed SRS outcomes from 28 centers and a single-arm trial and compared these data with outcomes from a first-line WBRT cohort. Data were collected from October 26, 2017, to August 15, 2019, and analyzed from August 16, 2019, to November 6, 2019. Interventions: SRS and WBRT for small cell lung cancer brain metastases. Main Outcomes and Measures: Overall survival, time to central nervous system progression (TTCP), and central nervous system (CNS) progression-free survival (PFS) after SRS were evaluated and compared with WBRT outcomes, with adjustment for performance status, number of brain metastases, synchronicity, age, sex, and treatment year in multivariable and propensity score-matched analyses. Results: In total, 710 patients (median [interquartile range] age, 68.5 [62-74] years; 531 men [74.8%]) who received SRS between 1994 and 2018 were analyzed. The median overall survival was 8.5 months, the median TTCP was 8.1 months, and the median CNS PFS was 5.0 months. When stratified by the number of brain metastases treated, the median overall survival was 11.0 months (95% CI, 8.9-13.4) for 1 lesion, 8.7 months (95% CI, 7.7-10.4) for 2 to 4 lesions, 8.0 months (95% CI, 6.4-9.6) for 5 to 10 lesions, and 5.5 months (95% CI, 4.3-7.6) for 11 or more lesions. Competing risk estimates were 7.0% (95% CI, 4.9%-9.2%) for local failures at 12 months and 41.6% (95% CI, 37.6%-45.7%) for distant CNS failures at 12 months. Leptomeningeal progression (46 of 425 patients [10.8%] with available data) and neurological mortality (80 of 647 patients [12.4%] with available data) were uncommon. On propensity score-matched analyses comparing SRS with WBRT, WBRT was associated with improved TTCP (hazard ratio, 0.38; 95% CI, 0.26-0.55; P < .001), without an improvement in overall survival (median, 6.5 months [95% CI, 5.5-8.0] for SRS vs 5.2 months [95% CI, 4.4-6.7] for WBRT; P = .003) or CNS PFS (median, 4.0 months for SRS vs 3.8 months for WBRT; P = .79). Multivariable analyses comparing SRS and WBRT, including subset analyses controlling for extracranial metastases and extracranial disease control status, demonstrated similar results. Conclusions and Relevance: Results of this study suggest that the primary trade-offs associated with SRS without WBRT, including a shorter TTCP without a decrease in overall survival, are similar to those observed in settings in which SRS is already established.

8.
J Neurosurg Pediatr ; : 1-8, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590353

RESUMO

OBJECTIVE: Stereotactic radiosurgery (SRS) is a treatment option for pediatric brain arteriovenous malformations (AVMs), and early obliteration could encourage SRS utilization for a subset of particularly radiosensitive lesions. The objective of this study was to determine predictors of early obliteration after SRS for pediatric AVMs. METHODS: The authors performed a retrospective review of the International Radiosurgery Research Foundation AVM database. Obliterated pediatric AVMs were sorted into early (obliteration ≤ 24 months after SRS) and late (obliteration > 24 months after SRS) responders. Predictors of early obliteration were identified, and the outcomes of each group were compared. RESULTS: The overall study cohort was composed of 345 pediatric patients with obliterated AVMs. The early and late obliteration cohorts were made up of 95 (28%) and 250 (72%) patients, respectively. Independent predictors of early obliteration were female sex, a single SRS treatment, a higher margin dose, a higher isodose line, a deep AVM location, and a smaller AVM volume. The crude rate of post-SRS hemorrhage was 50% lower in the early (3.2%) than in the late (6.4%) obliteration cohorts, but this difference was not statistically significant (p = 0.248). The other outcomes of the early versus late obliteration cohorts were similar, with respect to symptomatic radiation-induced changes (RICs), cyst formation, and tumor formation. CONCLUSIONS: Approximately one-quarter of pediatric AVMs that become obliterated after SRS will achieve this radiological endpoint within 24 months of initial SRS. The authors identified multiple factors associated with early obliteration, which may aid in prognostication and management. The overall risks of delayed hemorrhage, RICs, cyst formation, and tumor formation were not statistically different in patients with early versus late obliteration.

9.
Sci Rep ; 10(1): 10448, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32591619

RESUMO

Bimodal classification of idiopathic chronic pancreatitis (ICP) into early-onset (<35 years) and late-onset (>35 years) ICP was proposed in 1994 based on a study of 66 patients. However, bimodal distribution wasn't sufficiently demonstrated. Our objective was to examine the validity and relevance of the age-based bimodal classification of ICP. We analyzed the distribution of age at onset of ICP in our cohort of 1633 patients admitted to our center from January 2000 to December 2013. Classify ICP patients into early-onset ICP(a) and late-onset ICP(a) according to different cut-off values (cut-off value, a = 15, 25, 35, 45, 55, 65 years old) for age at onset. Compare clinical characteristics of early-onset ICP(a) and late-onset ICP(a). We found slightly right skewed distribution of age at onset for ICP in our cohort. There were differences between early-onset and late-onset ICP with respect to basic clinical characteristics and development of key clinical events regardless of the cut off age at onset i.e. 15, 25, 35, 45 or even higher. The validity of the bimodal classification of early-onset and late-onset ICP could not be established in our large patient cohort and therefore such a classification needs to be reconsidered.

10.
Adv Mater ; : e2001086, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32483868

RESUMO

As an abundant natural resource, wood has gained great attention for thousands of years, spanning from the primitive construction materials to the modern high-added-value engineering materials. The unique delicate microstructures and the wonderful properties (e.g., low-density, high strength and stiffness, good toughness, and environmental sustainability) have made wood a natural source of inspiration that guides researchers to invent various wood-inspired materials. Herein, as an emerging material system, bioinspired artificial wood, with similar cellular structures and comparable mechanical properties, is discussed in the view of the design concept, fabrication strategy, properties, and possible applications. The present challenges and further research opportunities are also presented for artificial woods to thrive. To achieve the final eco-friendly artificial wood, more endeavors should be made in biomaterials and biodegradable or recyclable engineering of polymers to gain high mechanical properties and environmental sustainability simultaneously.

11.
Acta Neurochir (Wien) ; 162(7): 1759-1766, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32385636

RESUMO

BACKGROUND: A significant difference exists between the published results reporting the clinical outcome following brain arteriovenous malformation (AVM) ruptures. Information about the outcome following hemorrhage in an AVM population treated with radiosurgery could provide additional information to assess the risk of mortality and morbidity following an AVM hemorrhage. METHODS: Clinical outcome was studied in 383 patients, the largest patient population yet studied, who suffered from a symptomatic hemorrhage after Gamma Knife® surgery (GKS) but before confirmed AVM obliteration. The impact of different patient, AVM, and treatment parameters on the clinical outcome was analyzed. The aim was to generate outcome predictions by comparing our data to and combining them with earlier published results. RESULTS: No relation was found between clinical outcome and treatment parameters, indicating that the results are applicable also on untreated AVMs. Twenty-one percent of the patients died, 45% developed or experienced worsening of neurological sequelae, and 35% recovered completely after the hemorrhage. Old age was a predictor of poor outcome. Sex, AVM location, AVM volume, and history of prior hemorrhage did not influence the outcome. The mortality rate was comparable to earlier published prospective data, but higher than that found in retrospective studies. CONCLUSIONS: The mortality rates in earlier published retrospective series as well as in studies focusing on clinical outcome following AVM hemorrhage significantly underestimate the risk for a mortal outcome following an AVM hemorrhage. Based on our findings, an AVM rupture has around 20% likelihood to result in mortality, 45% likelihood to result in a minor or major deficit, and 35% likelihood of complete recovery. The findings are probably applicable also for AVM ruptures in general. The cumulative mortality and morbidity rates 25 years after diagnosis were estimated to be around 40% in a patient with a patent AVM.

12.
J Neurooncol ; 148(2): 363-372, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32405998

RESUMO

PURPOSE: Stereotactic radiosurgery (SRS) is a potential re-irradiation treatment for recurrent intracranial ependymoma after prior radiation therapy. The purpose of this study was to examine the efficacy and safety of repeated SRS in the treatment of recurrent intracranial ependymomas. METHODS: This is a retrospective study of consecutive patients with residual or recurrent intracranial ependymomas who were treated with SRS between 1993 and 2018. Tumor progression was defined as a ≥ 10% increase in tumor volume. Tumor regression was defined as a ≥ 10% reduction in tumor volume. A tumor that remained within 10% of its original volume was defined as stable. Tumor control comprised tumor regression and stability. Time-dependent analyses were performed using two treatment failure endpoint definitions: (1) evidence of local tumor progression or distant metastasis (single SRS analysis), and (2) lack of tumor response to SRS (repeated SRS analysis). These analyses were adjusted for the competing risk of death. RESULTS: The study comprised 37 patients (65 intracranial ependymomas) who underwent multiple SRS sessions (range: 1-7). Median age was 10.2 years (range: 0.8-53.8 years), and median tumor volume was 1.5 mL (range: 0.01-22.5 mL). The median radiation dose was 13.3 Gy (range: 7.9-22.0 Gy) at a median isodose line of 57% (range: 50-90%). Overall tumor control rates in the single SRS analysis adjusting for the competing risk of death were 53.6%, 30.5%, and 23.6% at 1, 3, and 5 years, respectively. Overall tumor control rates in the repeated SRS analysis adjusting for the competing risk of death were 70.6%, 50.4%, and 43.1% at 1, 3, and 5 years, respectively. Prior gross total resection was the only independent predictor of overall tumor control after SRS (aHR = 25.62 (1.55-422.1), p = 0.02). CONCLUSIONS: Repeated GKRS appeared to be an effective treatment strategy for recurrent or residual intracranial ependymomas, with acceptable complication rates.

13.
J Dairy Sci ; 103(6): 4895-4906, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32229112

RESUMO

The objective of this study was to evaluate the protection conferred by lactoferrin, α-lactalbumin, and ß-lactoglobulin in cerebral ischemia reperfusion (I/R) injury. Rat pheochromocytoma (PC12) cells were used to construct an oxygen and glucose deprivation model in vitro, and ICR mice underwent carotid artery "ligation-relaxation" to construct a cerebral I/R injury model in vivo. The levels of toll-like receptor 4 (TLR4) and downstream factors including nuclear factor-κB, tumor necrosis factor-α, and IL-1ß were measured. Metabonomics detection and data mining were conducted to identify the specific metabolic sponsor of the 3 proteins. The results showed that lactoferrin, α-lactalbumin, and ß-lactoglobulin protected neurons from cerebral I/R injury by increasing the level of bopindolol and subsequently inhibiting the TLR4-related pathway to different degrees; ß-lactoglobulin had the strongest activity of the 3 proteins. In summary, this study is the first to investigate and compare the protective effects of lactoferrin, α-lactalbumin, and ß-lactoglobulin in a cerebral stroke model. The results implicate TLR4 as a novel target of the 3 bioactive proteins to prevent cerebral I/R injury.

14.
Artigo em Inglês | MEDLINE | ID: mdl-32227978

RESUMO

Perovskite light-emitting diodes (PeLEDs) exhibit high external quantum efficiencies (EQEs), emerging as a next-generation lighting and display technology. Nevertheless, they suffer from severe efficiency roll-off at high luminance, particularly in the case of blue and green emissions, which is one of the major bottlenecks in their industrial applications. Here, we attack this problem using a rare-earth metal, Yb, as cathode interface layer (CIL) for green PeLEDs. By adopting a new device configuration of ITO/TFB/FA-based quasi-2D perovskite/TPBi/Yb/Ag, we achieved a peak current efficiency (CE) of 22.3 cd/A with a corresponding EQE of 5.28% and a high maximum luminance of 19 160 cd/m2. Importantly, the maximum CE of 22.0 cd/A at 2000 cd/m2 slightly decreased to 16.8 cd/A at 5000 cd/m2 and maintained a still-decent value of 12.0 cd/A at a high luminance of 10 000 cd/m2, exhibiting a remarkably low efficiency roll-off. Our Yb-incorporated devices significantly outperformed the PeLEDs containing conventional CILs, including Mg and Liq, in terms of peak efficiency, efficiency roll-off, and operational lifetime. We attribute this encouraging performance to barrier-free, efficient electron injection enabled by the low work function of Yb (2.6 eV), which led to a high electron current, nearly approaching the hole current in hole-dominant PeLEDs, as confirmed by the single-carrier device measurements. In addition, we also present Yb-incorporated PeLEDs containing Cs-based quasi-2D perovskite as the emissive layer, which displayed an impressive CE of 51.3 cd/A with a corresponding EQE of 16.4% and a maximum luminance of 14 240 cd/m2, and still demonstrated a reduced efficiency roll-off comparing to that of the Liq-based equivalent. These results unveil the inspiring prospects of Yb as an efficient CIL for PeLEDs toward high efficiency with curtailed roll-off.

15.
J Neurosurg ; : 1-10, 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32244212

RESUMO

OBJECTIVE: Central neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors. METHODS: The authors retrospectively analyzed a cohort of patients with CNs treated with SRS at 10 centers between 1994 and 2018. Tumor recurrences were classified as local or distant. Adverse radiation effects (AREs) and the need for a CSF shunt were also evaluated. RESULTS: The study cohort comprised 60 patients (median age 30 years), 92% of whom had undergone prior resection or biopsy and 8% received their diagnosis based on imaging alone. The median tumor volume and margin dose were 5.9 cm3 and 13 Gy, respectively. After a median clinical follow-up of 61 months, post-SRS tumor recurrence occurred in 8 patients (13%). The 5- and 10-year local tumor control rates were 93% and 87%, respectively. The 5- and 10-year progression-free survival rates were 89% and 80%, respectively. AREs were observed in 4 patients (7%), but only 1 was symptomatic (2%). Two patients underwent post-SRS tumor resection (3%). Prior radiotherapy was a predictor of distant tumor recurrence (p = 0.044). Larger tumor volume was associated with pre-SRS shunt surgery (p = 0.022). CONCLUSIONS: Treatment of appropriately selected CNs with SRS achieves good tumor control rates with a reasonable complication profile. Distant tumor recurrence and dissemination were observed in a small proportion of patients, which underscores the importance of close post-SRS surveillance of CN patients. Patients with larger CNs are more likely to require shunt surgery before SRS.

16.
Biomed Res Int ; 2020: 8278943, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32076617

RESUMO

This research demonstrates the current use of air purification methods in the operating rooms (ORs) in China. 154 hospitals from 6 provinces were included in this survey to reflect the air purification methods of ORs in 2017. Air cleaning technology (ACT) is used in 124 (80.52%) hospitals. We find that the rates of using grade I, III, or IV clean operating room (COR) in tertiary hospitals are all higher than in lower level hospitals; the rate of using ACT in the ORs is higher, too. In addition, general hospitals have higher rate in using ACT in the ORs than specialized hospitals. The highest rate of using ACT in the ORs is in the eastern region of China. The number of hospitals using ACT, ultraviolet light disinfection, and air sterilizers (such as circulating air UV sterilizer) increased yearly. All grades of CORs can be maintained as required by more than 90% hospitals except grade II COR. In this research, we found air purification methods, especially the ACT, are widely used in hospitals' ORs. However, finding the way to select and use different air purification methods correctly is an urgent problem to be solved next.

17.
Eur J Radiol ; 125: 108866, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32065928

RESUMO

PURPOSE: MRI and MR angiography (MRA) are noninvasive methods for examining cavernous sinus dural arteriovenous fistulas (CSDAVFs) after radiosurgery. In this study, we investigated the accuracy of unenhanced MRI/3-dimensional time-of-flight (3D TOF) MRA in evaluating CSDAVF obliteration as compared with digital subtraction angiography (DSA). METHODS: From 1995-2012, 48 cases of CSDAVFs received Gamma Knife surgery (GKS) and had undergone both unenhanced MRI/3D TOF MRA and DSA for posttreatment evaluation. Two blinded observers independently interpreted the results of MRI/MRA. The results of MRI/MRA were compared with those of DSA. The sensitivity (the probability of MRI/MRA showing obliteration when DSA showed complete obliteration), specificity, positive predictive value, and negative predictive value for CSDAVF obliteration were reported. RESULTS: The median interval between the final MRI/MRA and the subsequent DSA was 2 months. Follow-up DSA revealed that 38 of 48 (79.2 %) CSDAVFs were completely obliterated. The results of interobserver agreement assessment showed almost perfect agreement between the 2 observers. For unenhanced MRI/3D TOF MRA, the observed sensitivity was 84.2 %, specificity was 100 %, positive predictive value was 100 %, and negative predictive value was 62.5 %. CONCLUSIONS: Unenhanced MRI/3D TOF MRA alone may be adequate to document the complete obliteration of CSDAVFs after GKS. Time-resolved MRA or DSA can be reserved for a suspected residual CSDAVF after a sufficient latency period after GKS.

18.
Adv Mater ; 32(14): e1906319, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32080919

RESUMO

Movement is one of the vital features of living systems, and remote control of bioinspired soft robotic systems in a precise, contactless and harmless way is extremely desirable but challenging. A near-infrared (NIR) photodriven polymeric oscillator is designed and fabricated by selectively coating a mussel-inspired polydopamine (PDA) polymer layer on the surface of splay-aligned liquid crystalline network (LCN) film. The oscillating motions of the LCN oscillators can be facilely manipulated by tuning light intensity and film thickness. More importantly, the programmability of the PDA coating enables the oscillating behaviors of LCN film to be predesignated and finely adjusted by coating the film with PDA locally and repeatedly. The self-oscillating movement mechanism can be attributed to the temperature oscillation at the PDA-coated LCN film since it is alternatively exposed and sheltered to the NIR-light irradiations. Owing to over 50% NIR irradiation in solar spectrum, PDA-coated film is found to oscillate upon exposure of focused sunlight, presenting great potential in fabrication of solar power generation devices. This provides a versatile strategy to fabricate NIR-light-actuated polymeric oscillators, providing inspirations in the development of biological soft robots and advanced biomimetic devices.

19.
J Neurooncol ; 146(3): 439-449, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32020474

RESUMO

PURPOSE: Gamma Knife radiosurgery (GKRS) is a non-invasive procedure for the treatment of brain metastases. This study sought to determine whether radiomic features of brain metastases derived from pre-GKRS magnetic resonance imaging (MRI) could be used in conjunction with clinical variables to predict the effectiveness of GKRS in achieving local tumor control. METHODS: We retrospectively analyzed 161 patients with non-small cell lung cancer (576 brain metastases) who underwent GKRS for brain metastases. The database included clinical data and pre-GKRS MRI. Brain metastases were demarcated by experienced neurosurgeons, and radiomic features of each brain metastasis were extracted. Consensus clustering was used for feature selection. Cox proportional hazards models and cause-specific proportional hazards models were used to correlate clinical variables and radiomic features with local control of brain metastases after GKRS. RESULTS: Multivariate Cox proportional hazards model revealed that higher zone percentage (hazard ratio, HR 0.712; P = .022) was independently associated with superior local tumor control. Similarly, multivariate cause-specific proportional hazards model revealed that higher zone percentage (HR 0.699; P = .014) was independently associated with superior local tumor control. CONCLUSIONS: The zone percentage of brain metastases, a radiomic feature derived from pre-GKRS contrast-enhanced T1-weighted MRIs, was found to be an independent prognostic factor of local tumor control following GKRS in patients with non-small cell lung cancer and brain metastases. Radiomic features indicate the biological basis and characteristics of tumors and could potentially be used as surrogate biomarkers for predicting tumor prognosis following GKRS.

20.
J Chin Med Assoc ; 83(2): 188-193, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31972830

RESUMO

BACKGROUND: Microelectrode recording (MER) for target refinement is widely used in deep brain stimulator insertion for Parkinson disease. Signals may be influenced by anesthetics when patients receive general anesthesia (GA). This study determined the inhibitory concentration (IC) of propofol on MER signals when it was coadministered with dexmedetomidine. METHODS: Patients were anesthetized with dexmedetomidine (0.5 µg·kg loading, followed by infusion at 0.4 µg·kgh) and propofol through target-controlled infusion for GA with tracheal intubation. The surgeon conducted the online scoring of the background signals, spiking frequency, amplitude, and pattern of single-unit activities by using a 0-10 verbal numerical rating scale (NRS; 0, maximal suppression; 10, minimal suppression), and responses were grouped into suppression (NRS ≤ 6) and nonsuppression (NRS > 6). The median inhibitory concentration (IC50) of propofol (as target effect-site concentrations: Ceprop) was determined using modified Dixon's up-and-down method. Probit regression analysis was further used to obtain the dose-response relationship, and IC05 and IC95 were calculated. RESULTS: Twenty-three adult patients participated in this study. Under the concomitant infusion of dexmedetomidine, the predicted IC50 value (95% CI) of Ceprop for neuronal suppression during MER was 1.29 (1.24-1.34) µg·mL as calculated using modified Dixon's up-and-down method. Using probit analysis, the estimated IC05, IC50, and IC95 values (95% CIs) were 1.17 (0.87-1.23), 1.28 (1.21-1.34), and 1.40 (1.33-1.85) µg·mL, respectively. CONCLUSION: Our data provided reference values of propofol for dosage adjustment to avoid interference on MER under GA when anesthetics have to be continuously infused during recording.

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