The C5 root dermatome enlarges and modulates hand pain in total brachial plexus palsy

Hand pain is a major complaint in 80% of the patients with complete brachial plexus palsy; and, in 80% of these patients, the C5 root is ruptured and the C6‐T1 roots avulsed from the spinal cord. It has been suggested that pain in brachial plexus injuries may not arise from avulsed roots, but rather from ruptured roots. Traditionally the C5 root dermatome does not extend to the hand. We have hypothesized that in total lesions of the brachial plexus the C5 root dermatome expands, reaching the hand. In 20 patients with confirmed C5 root rupture and C6‐T1 root avulsion, we investigated the distribution of C5 root paresthesia six to eight weeks after grafting. After cervical percussion in search of Tinel's sign, maps related to reported paresthesia were drawn on the affected limb. We observed that paresthesia following C5 root percussion reached the hands and fingers, dermatomes linked to the C6 and C8 roots. Immediately after percussion, for a few seconds, 14 patients who complained of pain during examination reported the augmentation of numbness and pain resolution. After brachial plexus injury, the C5 root dermatome expands and modulates hand pain. © 2013 Wiley Periodicals, Inc. Microsurgery 34:292–295, 2014.     

Time in hemodialysis modulates the levels of genetic damage in hemodialysis patients

It is assumed that hemodialysis treatment can diminish the levels of genetic damage in circulating lymphocytes by cleaning the blood of uremic toxins that cause oxidative stress. However, the hemodialysis process by itself may also induce genomic damage by producing reactive oxygen species (ROS). We conducted a follow‐up study in a group of 70 hemodialysis patients followed for a mean time of 15 months. We investigated the effect of exposure time in hemodialysis on the levels of genetic damage in peripheral blood lymphocytes using the micronucleus assay. In addition, genetic damage after in vitro irradiation with 0.5 Gy was also analyzed to evaluate changes in radiosensitivity. Our results showed that, at the end of the study, there was a decrease in both the basal levels of genetic damage (9.9 ± 1.0 vs. 7.6 ± 0.7) and radiosensitivity values (38.5 ± 3.0 vs. 27.6 ± 2.4). We conclude that hemodialysis procedures may act as an ameliorating factor reducing the genetic damage present in chronic kidney disease patients. Environ. Mol. Mutagen. 55:363–368, 2014. © 2014 Wiley Periodicals, Inc.     

Genomic damage as a biomarker of chronic kidney disease status

Patients suffering from chronic kidney disease (CKD) exhibit a high incidence of cancer and cardiovascular diseases, as well as high levels of genomic damage. To confirm the association of CKD with genomic damage we have carried out the largest study to date addressing this issue, using a total of 602 subjects (187 controls, 206 pre‐dialysis CKD patients and 209 CKD patients in hemodialysis). DNA oxidative damage was measured in all individuals using the comet assay. Our results indicate that CKD patients have significantly higher levels of DNA damage than controls, but no significant differences were observed between pre‐hemodialysis (pre‐HD) and hemodialysis (HD) patients. When oxidative damage was measured, no differences were observed between patients and controls, although HD patients showed significantly higher levels of oxidative damage than pre‐HD patients. In addition, a positive relationship was demonstrated between genomic damage and all‐cause mortality. Our study confirms that genomic damage can be predictive of prognosis in CKD patients, with high levels of DNA damage indicating a poor prognosis in HD patients. Environ. Mol. Mutagen. 56:301–312, 2015. © 2014 Wiley Periodicals, Inc.     

How to Tailor Structural Colors for Extended Visibility and White Light Generation Employing Direct Laser Interference Patterning

The appearance of a surface can be controlled by creating periodic microstructures designed to diffract light and produce structural colors. Nevertheless, since structural coloration is based on diffraction, the produced colors have a strong dependence on the viewing angle and absence of coloration takes place while tilting the samples. In this work direct laser interference patterning is used to firstly provide transparent polymer sheets a structural coloration with a high‐range observation angle, and secondly to demonstrate the combination of structural colors, producing a white coloring effect. The employed approaches are based on the fabrication of micro‐gratings with multiple periods in the same structured area and on the engineering of the diffraction orders of the diffraction spectrum. The patterned surfaces are characterized by confocal microscopy and angular spectrometry in reflection mode. The morphological characterization shows homogeneous surface patterns, while the spectral results demonstrate that combining four spatial periods on a single patterned surface, a white appearance is obtained over an angular observation range higher than 30°. The experimental results are supported by theoretical predictions by means of generalized formulas based on the diffraction of light.     

Multiparametric Ultrasound Evaluation of the Thyroid: Elastography as a Key Tool in the Risk Prediction of Undetermined Nodules (Bethesda III and IV)—Histopathological Correlation

The purpose of this study was to select thyroid nodules most at risk for malignancy among those cytologically undetermined by fine-needle aspiration biopsy (FNAB), using B-mode, color duplex Doppler and 2-D shear wave shear wave elastography (2-D-SWE). This was a prospective diagnostic accuracy study with 62 Bethesda III/IV nodules according to FNAB (atypia/follicular lesion of undetermined significance or follicular neoplasia/Hürthle cell neoplasm). Ultrasonography (US) data were compared with resection histologic results, revealing 35 of 62 benign nodules (56.4%) and 27 of 62 carcinomas (43.6%). Conventional US was uses to evaluate nodule echogenicity, dimensions, contours, presence of halo and microcalcifications. Doppler US was used to assess the vascularization (exclusively or predominantly peripheral or central) and mean resistance index of three nodule arteries. Elastography was used to evaluate the nodule elastographic pattern; mean nodule deformation index; deformation ratio between nodule and adjacent thyroid parenchyma; and mean deformation ratio between nodule and pre-thyroid musculature (MDR). Statistical analysis included χ², Fisher's exact, Student's t, Mann–Whitney tests and multivariable analysis by multiple logistic regression. Areas under the receiver operating characteristic curves (AUC-ROCs) were used for accuracy analysis. Fifty-eight participants (54.7 ± 14.0 y, 51 women) were studied. The parameters that were statistically significant to the univariate analysis were hypo-echogenicity, nodule diameter greater than width and all parameters analyzed from Doppler and elastography. Multivariate analysis revealed that the MDR (in kPa) was the best parameter for risk analysis of indeterminate nodules. Nodules with MDRs >1.53 exhibited a greater chance of malignancy (AUC-ROC = 0.98). We conclude that 2-D-SWE is able to select malignant nodules among those cytologically indeterminate, thus avoiding unnecessary surgery in these cytologic groups.     

Geometrical Measurement of Central Tumor Location in cT1N0M0 NSCLC Predicts N1 but Not N2 Upstaging

1. Download : Download high-res image (252KB)
2. Download : Download full-size image