Fluctuations in EEG band power at subject‐specific timescales over minutes to days explain changes in seizure evolutions

Epilepsy is recognised as a dynamic disease, where both seizure susceptibility and seizure characteristics themselves change over time. Specifically, we recently quantified the variable electrographic spatio‐temporal seizure evolutions that exist within individual patients. This variability appears to follow subject‐specific circadian, or longer, timescale modulations. It is therefore important to know whether continuously recorded interictaliEEG features can capture signatures of these modulations over different timescales. In this study, we analyse continuous intracranial electroencephalographic (iEEG) recordings from video‐telemetry units and find fluctuations in iEEG band power over timescales ranging from minutes up to 12 days. As expected and in agreement with previous studies, we find that all subjects show a circadian fluctuation in their iEEG band power. We additionally detect other fluctuations of similar magnitude on subject‐specific timescales. Importantly, we find that a combination of these fluctuations on different timescales can explain changes in seizure evolutions in most subjects above chance level. These results suggest that subject‐specific fluctuations in iEEG band power over timescales of minutes to days may serve as markers of seizure modulating processes. We hope that future study can link these detected fluctuations to their biological driver(s). There is a critical need to better understand seizure modulating processes, as this will enable the development of novel treatment strategies that could minimise the seizure spread, duration or severity and therefore the clinical impact of seizures.     

Diaforodiagnostic dilemma of a breast tumor in a patient with known history of chest sarcoidosis: a diagnostic approach

Breast sarcoidosis is extremely rare, substantially less frequent than other extrapulmonary manifestations of sarcoidosis. It can mimic a benign or malignant tumor of the breast. We describe the case of a patient with a history of pulmonary sarcoidosis referred to our hospital for a screening mammography. Mammographic findings raised the suspicion for a breast mass. An additional breast ultrasound and fine -needle aspiration biopsy were performed. Finally, patient underwent a excisional biopsy of the left breast and the histopathological report revealed sarcoidosis.     

Balancing the spatial demands of the developing dentition with the mechanical demands of the catarrhine mandibular symphysis

The superior transverse torus of the catarrhine mandible has been shown to effectively reduce bending at the symphysis during unilateral postcanine biting. While the adult superior transverse torus contains trabecular bone, the juvenile one is almost entirely filled by developing permanent incisors until their eruption. This study uses finite elements analysis (FEA) to investigate whether the presence of developing incisors in the juvenile symphysis increases strains on the superior transverse torus. Two FE models of a juvenile Macaca fascicularis mandible were created: one included all the developing teeth; the second was modified to remove the incisor tooth crypts by filling them with trabecular bone. The models were loaded identically to simulate static physiological unilateral biting on dp(4) and strain magnitudes, patterns and distributions of the two FE models were compared. The FEA results show a notable increase in strain magnitudes by up to 40% when the developing incisors are present. The results indicate that, in order to maintain the same symphyseal strain magnitudes during chewing, the presence of the incisors in the symphysis necessitates a larger superior transverse torus in the juvenile than would be required if the superior transverse torus did not house the developing incisors. These results highlight the adaptational balance of the symphyseal morphology throughout ontogeny between biomechanics and the spatial demands of the developing dentition. Based on the findings we therefore propose that the spatial requirements of the developing incisors during ontogeny can act as a constraint on the functional adaptation and subsequent adult morphology observed in the catarrhine mandibular symphysis.     

A familial X/Y translocation in a boy with ichthyosis, hypogonadism and mental retardation

A 14-year-old boy is described with hypogonadism, ichthyosis and mental retardation. His karyotype was 46, Y, der (X), t(X;) (p22;q11). His mother's karyotype was 46, X, der (X), t(X; Y) (p22;ql 1). Thus the son is nullisomic for the region Xp22 → pter and the mother is monosomic for the same region.
The steroid sulfatase activity in this boy is discussed in relationship to the enzyme's locus on the X chromosome and the manifestation of ichthyosis.     

Image-guided lens extraction surgery: a systematic review

A systematic review of the recent literature regarding the current image-guided systems used for cataract surgery or refractive lens exchange was performed based on the PubMed and Google Scholar databases in March 2018. Literature review returned 21 eligible studies. These studies compared image-guided systems with other keratometric devices regarding their accuracy, repeatability and reproducibility in measurement of keratometric values, astigmatism magnitude and axis, as well as in IOL power calculation. Additionally, the image-guided systems were compared with conventional manual ink-marking techniques for the alignment of toric IOLs. In conclusion, image-guided systems seem to be an accurate and reliable technology with measurements of high repeatability and reproducibility regarding the keratometry and IOL power calculation, but not yet interchangeable with the current established and validated keratometric devices. However, they are superior over the conventional manual ink-marking techniques for toric IOL alignment.