In vivo microglia activation in very early dementia with Lewy bodies,comparison with Parkinson's disease

BackgroundReactive microgliosis, hallmark of neuroinflammation, may contribute to neuronal degeneration, as shown in several neurodegenerative diseases. We in vivo evaluated microglia activation in early dementia with Lewy bodies, still not reported, and compared with early Parkinson's disease, to assess possible differential pathological patterns.MethodsWe measured the [¹¹C]-PK11195 binding potentials with Positron Emission Tomography, using a simplified reference tissue model, as marker of microglia activation, and cerebral spinal fluid protein carbonylation levels, as marker of oxidative stress. Six dementia with Lewy bodies and 6 Parkinson's disease patients within a year from the onset, and eleven healthy controls were included. Clinical diagnosis was confirmed at a 4-year follow-up.ResultsIn dementia with Lewy bodies as well as in Parkinson's disease, we found significant (p < 0.001) [¹¹C]-PK11195 binding potential increases in the substantia nigra and putamen. Patients with Lewy bodies dementia had extensive additional microglia activation in several associative cortices. This was evident also at a single subject level. Significant increase of Cerebral Spinal Fluid protein carbonylation was shown in both patients' groups.Conclusions[¹¹C]-PK11195 Positron Emission Tomography imaging revealed neuroinflammation in dementia with Lewy bodies and Parkinson's disease, mirroring, even at a single subject level, the common and the different topographical distribution of neuropathological changes, yet in the earliest stages of the disease process. Focusing on those events that characterize parkinsonisms and Parkinson's disease may be the key to further advancing the understanding of pathogenesis and to taking these mechanisms forward as a means of defining targets for neuroprotection.     

Implantation of a completely subcutaneous ICD system: case report of a patient with Brugada syndrome and state of the art

Aims  

Complications of implantable cardioverter-defibrillator (ICD) therapy are often linked to transvenous lead insertion, lead failure, or infections. An entirely subcutaneous ICD system (S-ICD) avoids the need for the placement of electrodes within the heart and can provide clinical advantages.     

Epitaxial and large area Sb2Te3 thin films on silicon by MOCVD

Antimony telluride (Sb₂Te₃) thin films were prepared by a room temperature Metal–Organic Chemical Vapor Deposition (MOCVD) process using antimony chloride (SbCl₃) and bis(trimethylsilyl)telluride (Te(SiMe₃)₂) as precursors. Pre-growth and post-growth treatments were found to be pivotal in favoring out-of-plane and in-plane alignment of the crystallites composing the films. A comprehensive suite of characterization techniques were used to evaluate their composition, surface roughness, as well as to assess their morphology, crystallinity, and structural features, revealing that a quick post-growth annealing triggers the formation of epitaxial-quality Sb₂Te₃ films on Si(111).

Highly oriented antimony telluride thin films are prepared by room temperature metalorganic chemical vapor deposition on Si(111).     

Short- and long-term outcomes of intracorporeal versus extracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for colon cancer

Background

We assessed the short- and long-term outcomes of intracorporeal ileocolic anastomosis (IA) in laparoscopic right hemicolectomy for colon cancer compared with extracorporeal anastomosis (EA).

Methods

A retrospective chart review of 86 consecutive patients who underwent laparoscopic right hemicolectomy for colon cancer from March 2005 to June 2010 was performed.

Results

There were 51 and 35 patients who underwent intracorporeal and extracorporeal anastomosis, respectively. The two groups were demographically comparable. The conversion rate to open surgery was 8.6 % in the EA group, but none in the IA group (p = 0.064). There was no significant difference in operative time, estimated blood loss, complications (intra-abdominal abscess, anastomotic leak, ileus, and wound infection), and length of hospital stay between the groups. There was no perioperative mortality in both groups. There was no significant difference in median number of retrieved lymph node. The overall survival and the disease-free survival at 3 years were not different between the groups.

Conclusions

Compared with the extracorporeal anastomosis technique, intracorporeal ileocolic anastomosis produces comparable short- and long-term outcomes in laparoscopic right hemicolectomy for colon cancer.     

Reading disorders in a language with shallow orthography: A multiple single-case study in Italian

Background: This study aimed (i) to verify whether the classical word-naming models developed for English-speaking participants also account for the performance of patients who speak a shallow-orthography language such as Italian, and (ii) to study the effects of word frequency, concreteness, and grammatical class on word naming. Methods & Procedures: A total of 90 Italian aphasic patients participated in two reading tasks. The first task contained four sets of items: (i) concrete nouns (natural objects and artefacts), (ii) abstract nouns, (iii) function words, (iv) morphologically simple legal nonwords. The second task (trisyllabic words with unpredictable stress position) was designed to test reading ability along the lexical route (the position of the major word stress is the only opaque variable in the Italian reading system). The patients' performances on the two tasks were analysed for strong dissociations, and to test the effect of grammatical class, concreteness, word frequency, and item length. The effect of age of acquisition was tested in a subsequent analysis. Outcomes & Results: Reading scores were pathological for all patients. The present sample reflected the entire spectrum of reading impairments: phonological (49), surface (4), undifferentiated (32), and letter-by-letter (5) dyslexia, which is in line with data reported for English-speaking aphasic patients. Only one of the phonological dyslexic patients made semantic errors (a reading impairment compatible with the diagnosis of deep dyslexia). The vast majority of Broca's aphasic patients suffered from phonological dyslexia (76%), while fluent aphasic patients were distributed more evenly across dyslexia types; all four surface dyslexic patients belonged to the fluent aphasia group. Overall, grammatical class (concrete nouns vs function words) had a significant effect on 14 patients (15.6%), concreteness (concrete vs abstract nouns) on 15 (16.7%), and word frequency on 5 (5.6%). Grammatical class and concreteness affected the performance of phonological and undifferentiated dyslexic patients, and seemed not to influence the scores of the surface dyslexic patients. Age of acquisition turned out to have a highly significant effect and may account for most of the lexical effects emerging from the first analysis. Conclusions: The entire spectrum of reading impairments was observed in this group of Italian aphasic patients, thus confirming the validity of contemporary reading models also for shallow-orthography languages. Concreteness and grammatical class effects, present in deep dyslexia, also affected the performance of patients suffering from other types of dyslexia, although both phenomena might derive from a confounding effect of age of acquisition.     

Short- and long-term motor outcome of STN-DBS in Parkinson’s Disease: focus on sex differences

Neurological Sciences - Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for patients with Parkinson’s disease (PD) with motor complications; the contribution...     

<Superscript>11</Superscript>C-Choline PET/CT for restaging prostate cancer. Results from 4,426 scans in a single-centre patient series

Purpose

To evaluate ¹¹C-choline PET/CT as a diagnostic tool for restaging prostate cancer (PCa), in a large, homogeneous and clinically relevant population of patients with biochemical recurrence (BCR) of PCa after primary therapy. The secondary aim was to assess the best timing for performing ¹¹C-choline PET/CT during BCR.

Methods

We retrospectively analysed 9,632 ¹¹C-choline PET/CT scans performed in our institution for restaging PCa from January 2007 to June 2015. The inclusion criteria were: (1) proven PCa radically treated with radical prostatectomy (RP) or with primary external beam radiotherapy (EBRT); (2) PSA serum values available; (3) proven BCR (PSA >0.2 ng/mL after RP or PSA >2 ng/mL above the nadir after primary EBRT with rising PSA levels). Finally, 3,203 patients with recurrent PCa matching all the inclusion criteria were retrospectively enrolled and 4,426 scans were analysed.

Results

Overall, 52.8 % of the ¹¹C-choline PET/CT scans (2,337/4,426) and 54.8 % of the patients (1,755/3,203) were positive. In 29.4 % of the scans, at least one distant finding was observed. The mean and median PSA values were, respectively, 4.9 and 2.1 ng/mL at the time of the scan (range 0.2 – 50 ng/mL). In our series, 995 scans were performed in patients with PSA levels between 1 and 2 ng/mL. In this subpopulation the positivity rate in the 995 scans was 44.7 %, with an incidence of distant findings of 19.2 % and an incidence of oligometastatic disease (one to three lesions) of 37.7 %. The absolute PSA value at the time of the scan and ongoing androgen deprivation therapy were associated with an increased probability of a positive ¹¹C-choline PET/CT scan (p?<?0.0001). In the ROC analysis, a PSA value of 1.16 ng/mL was the optimal cut-off value. In patients with a PSA value <1.16 ng/mL, 26.8 % of 1,426 ¹¹C-choline PET/CT scans were positive, with oligometastatic disease in 84.7 % of positive scans.

Conclusion

In a large cohort of patients, the feasibility of ¹¹C-choline PET/CT for detecting the sites of metastatic disease in PCa patients with BCR was confirmed. The PSA level was the main predictor of a positive scan with 1.16 ng/mL as the optimal cut-off value. In the majority of positive scans oligometastatic disease, potentially treatable with salvage therapies, was observed.