Proving cortical death after vascular coma: Evoked potentials,EEG and neuroimaging

Objectives

Several studies have shown that bilateral abolition of somatosensory evoked potentials after a nontraumatic coma has 100% specificity for nonawakening with ethical consequences for active care withdrawal. We propose to evaluate the prognostic value of bilateral abolished cortical components of SEPs in severe vascular coma.

Relevance of bi-functionalized polyelectrolyte multilayers for cell transfection

In an effort to develop new biomaterial coatings, it was shown that polyelectrolyte multilayers constitute a very powerful tool to render surfaces biologically active. The challenge is to multi-functionalize surfaces in a controlled way. We show here, for the first time, that it is possible to functionalize multilayer films simultaneously with two molecules acting in totally different ways on cells, namely plasmid DNA (pDNA), pre-complexed with poly(ethyleneimine) (PEI), and a peptide molecule, NDPMSH. This peptide, grafted to poly(L-glutamic acid) (PGA) was used as a signal molecule for melanoma cells B16-F1 and for its ability to enhance gene delivery in a receptor-independent manner. The PGA-NDPMSH chains are embedded in poly-(allylamine hydrochloride)/poly-(sodium 4-styrene sulfonate) multilayers and the pDNA-PEI complexes are deposited on top of the films. It is shown that melanoma cells (B16-F1) are efficiently transfected after 24h of contact with functionalized films. When brought in contact with Huh-7 cells that do not express the peptide receptors, these films trigger significantly the transfection rate, showing that it is possible to enhance the transfection process by incorporating specific peptides into multilayer films. Moreover, transfected cells sorted by flow cytometry produce melanin, demonstrating both activation via the peptide signaling pathway and cell transfection.     

Does proprioception contribute to the sense of verticality?

The representation of the vertical can be assessed by measuring the visual, tactile or perception of the postural vertical (PV). It is well accepted that visceral graviceptors and Golgi tendon receptors contribute to perception of the PV, whereas the role of muscular proprioception (Ia muscle spindles) remains to be clarified. The objective of this study was to analyze whether or not muscular proprioception contributes to the representation of verticality. We hypothesized that the modulation of proprioception by appropriate tendinomuscular vibration may tilt the PV. We present two experiments that explore this hypothesis. PV was firstly measured in the pitch plane in twelve healthy subjects in two conditions: baseline and vibration of both Achilles tendons during six minutes, according to a counterbalanced presentation. PV orientation (mean) and dispersion (standard deviation) were calculated on the six measurements per condition. Vibration of the Achilles tendons induced a systematic backward tilt of PV (2.7° ± 0.8° on average; P < 10⁻³), and no significant changes regarding PV dispersion. A clear post-effect was found for PV orientation in subjects who started the experiment with the condition vibration on. The possibility that PV could also be modulated by a much shorter duration of vibration (less than 8 s of vibration) was analyzed in a second experiment using a similar general procedure but a simplified experimental plane in other subjects. Again a backward PV tilt was induced by the vibration, but with a magnitude lower than that found in the first experiment, and with no post-effect. Since body geometry was unchanged, these two studies mean that proprioception contributes to the representation of the vertical. In conclusion, this study brings new insights to our understanding of the sense of verticality and contributes to the interpretation of backward falls induced by vibration. The induced backward fall is partly due to alignment of the erect posture with a backward-tilted referential of verticality.     

Surgical perspective on treatment of pediatric undifferentiated sarcoma of the liver

Surgical resection and chemotherapy are the mainstay of the treatment for undifferentiated embryonal sarcoma of the liver. Whether neoadjuvant chemotherapy shou...     

Construction and assessment of a 3-T MRI brain template

New MR imaging protocols enable visualization of brain structures. However, for dedicated clinical applications such as targeting deep brain stimulation (DBS), a more accurate localization requires the use of atlases. We developed a three-dimensional digitized mono-subject anatomical template of the human brain based on 3-T magnetic resonance images (MRI). By averaging 15 registered T1 image acquisitions, we have shown that the final image corresponds to an optimal image, limited by the performance of the 3-T MR machine. We compared different preprocessing workflows for template construction. With the optimal strategy, along with validated existing processing methods, one T1 template and one T1–T2 mixing template were created in order to improve visualization of spatially complex deep structures. Reduction of voxel size to 0.25 mm³ was also advantageous to observe fine structures and white matter/gray matter intensity crossings. Results demonstrated that such a template also improved inter-patient registration for population comparison in DBS. These MR templates are made freely available to our community (http://www.vmip.org/mritemplate) to serve as a reference for neuroimage processing methods.