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001) lower TLI in the VIM region than in the Zi region. CONCLUSION Zi DBS performed asleep appears to be safe and effective. LDF monitoring provides direct in vivomeasurement of the microvascular blood flow in front of the probe, which can help reduce the risk of hemorrhage. LDF can differentiate between the grey substance in the thalamus and the transmission border entering the posterior subthalamic area where the tissue consists of more white matter tracts. © 2020 S. Karger AG, Basel.INTRODUCTION The disadvantage of conventional armrests is the difficulty in adjusting its height and position during surgery. OBJECTIVES We investigated whether a freely movable armrest (FMA) that follows the surgeon's arm is useful for reducing surgeon fatigue and arm tremors and improving surgical accuracy. METHODS In the basic study, a corneal suture was placed in porcine eyes with FMA (FMA group) or without FMA (non-FMA group). The suture was intended to pass through two points. Tremor was quantified using motion tracking software when the needle was held. Subjective symptoms of arm-related fatigue were scored using a questionnaire. Suturing accuracy was compared between groups. In the clinical study, the same surgeon performed corneal transplantation, cataract surgery, and glaucoma surgery with or without FMA. Fatigue scores from the questionnaire were then compared. RESULTS In the basic study, hand tremor at rest was significantly improved with FMA (p less then 0.0001). The subjective arm fatigue score was significantly reduced (p = 0.0465), while the subjective tremor score was also significantly improved (p = 0.0453). There were no differences in the accuracy of corneal suturing with or without FMA. In the clinical study, the total and arm-related fatigue scores during corneal transplantation and glaucoma surgery tended to improve. CONCLUSIONS FMA is a useful tool for fixing the surgeon's arm in any position and may improve the quality of ophthalmic surgery by reducing hand tremor and fatigue. © 2020 S. Karger AG, Basel.Among actinopterygian fishes, holosteans are the phylogenetically closest group to teleosts but they have been much less studied, particularly regarding the neurochemical features of their central nervous system. The serotonergic system is one of the most important and conserved systems of neurotransmission in all vertebrates. By means of immunohistochemistry against serotonin (5-hydroxytryptamine), we have conducted a comprehensive and complete description of this system in the brain and retina of representative species of the 3 genera of holostean fishes, belonging to the only 2 extant orders, Amiiformes and Lepisosteiformes. Serotonin-immunoreactive cell groups were detected in the preoptic area, the hypothalamic paraventricular organ, the epiphysis, the pretectal region, the long and continuous column of the raphe, the spinal cord, and the inner nuclear layer of the retina. Specifically, the serotonergic cell groups in the preoptic area, the epiphysis, the pretectum, and the retina had never been identified in previous studies in this group of fishes. Widespread serotonergic innervation was observed in all main brain regions, but more abundantly in the subpallium, the hypothalamus, the habenula, the optic tectum, the so-called cerebellar nucleus, and the area postrema. The comparative analysis of these results with those in other groups of vertebrates reveals some extremely conserved features, such as the presence of serotonergic cells in the retina, the pineal organ, and the raphe column, while other characteristics, like the serotonergic populations in the preoptic area, the paraventricular organ, the pretectum, and the spinal cord are generally present in all fish groups, but have been lost in most amniotes. © 2020 S. Karger AG, Basel.INTRODUCTION Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. It has distinct molecular features and primarily affects the KIT and PDGFRA genes. OBJECTIVE We wanted to assess the molecular profile of 68 GIST patients who were sequenced consecutively between 2014 and 2019 at our institute of pathology. METHODS Our cohort comprised 60 primary and 8 metastatic GIST patients; 43 and 57% of the cases, respectively, were analyzed by Sanger sequencing or next-generation sequencing (NGS). RESULTS Of the 60 primary GIST patients, 47 (78%) showed a KIT mutation; 2 cases showed a double KIT mutation, and 1 of these was a therapy-naive GIST. Nine (15%) patients harbored a PDGFRA mutation, 2 (3%) had a BRAF mutation, 1 (2%) had a PIK3CA mutation, and 1 (2%) did not show any mutation. One BRAF and the PIK3CA mutation have not been described in GIST before. All metastatic GIST harbored exclusively KIT mutations. CONCLUSION A retrospective analysis of GIST sequenced at our institute revealed incidences of KIT and PDGFRA mutations comparable to those in other cohorts from Europe. Interestingly, we found 2 previously undescribed mutations in the BRAF and PIK3CA genes as well as 1 treatment-naive case with a double KIT mutation in exon 11. © 2020 S. Karger AG, Basel.BACKGROUND At present more attention is paid to the treatment of secretory otitis media in children, but there is also a high incidence of adult patients. The etiology of secretory otitis media in adults is complex and related to many factors. OBJECTIVES The aim of this study was to evaluate the correlation between the Reflux Symptom Index (RSI)/Reflux Finding Score (RFS) and secretory otitis media in adults, and to explore further treatment methods. MATERIAL AND METHODS Taking outpatients in the otology department from January 2017 to May 2019 as the object of study, acoustic immittance tests were performed and the results analyzed. Patients with secretory otitis media received tympanocentesis or tympanotomy and the related components were analyzed.The patients were followed up and the curative effects of different treatment schemes were compared. RESULTS There were 67 patients with secretory otitis media. The prevalence of secretory otitis media in patients with RSI >13 was significantly higher than that in patients with RSI 0.05). In type B patients, the detection rate of pepsin in the experimental group was significantly higher than that in the control group (p less then 0.05), and the scores of RSI/RFS in the pepsin-positive group were significantly higher than those in the negative group (p less then 0.05). Treatment with acid-suppressive drugs in patients with abnormal RSI/RFS achieved better results (p less then 0.05). CONCLUSIONS RSI/RFS may be related to the development of secretory otitis media in adults, and could play a guiding role in its treatment. © 2020 S. Karger AG, Basel.BACKGROUND Stroke is a leading cause of death and disability in globally and particularly in low- and middle-income countries, and this burden is increasing. The burden of stroke pathological subtypes varies in terms of incidence, disability and mortality. Previous Global Burden of Diseases, Injuries, and Risk Factors Studies (GBD) reports did not provide separate global burden and trends estimates for haemorrhagic stroke by primary intracerebral haemorrhage (PICH) and subarachnoid haemorrhage (SAH). AIM To summarise the GBD 2017 findings for the burden and 27-year trends for ischaemic stroke (IS), intracerebral haemorrhage and SAH by age, sex and country income level in 21 world regions and associated risk factors. METHODS Data on stroke incidence, prevalence, mortality and disability-adjusted life-years (DALY) lost and the burden of IS, PICH and SAH were derived from all available datasets from the GBD 2017 studies. Data were analysed in terms of absolute numbers and age-standardised rates per 100,000 (95% ous GBD stroke burden findings and provide most accurate data for stroke care planning and resource allocation globally, regionally and for 195 countries. Stroke remains the second leading cause of deaths and disability worldwide. The increased stroke burden continues to exacerbate a huge pressure on people affected by stroke, their families and societies. It is imperative to develop and implement more effective primary prevention strategies to reduce stroke burden and its impact. © 2020 S. Karger AG, Basel.BACKGROUND Malignant melanoma represents the deadliest form of skin cancer with a high tendency to metastasize during the early course of the disease. Radiation therapy has long played a key role in the management of both local and metastatic melanoma. Although local radiation therapy exerts antitumor effects by damaging the cellular DNA, it also induces an important out-of-field (distant) effect known as the "abscopal effect" in nonirradiated sites. Radiation therapy-induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. OBJECTIVE To provide a detailed overview of the current state of knowledge and clinical experience of radiation therapy-induced abscopal effects in patients with malignant melanoma. METHODS Using electronic databases such as MEDLINE via PubMed and Google Scholar, a systematic literature review was performed to find published clinical evidence for radiation therapy-induced abscopal effects in patients with malignant melanoma. The clinical data be optimally utilized clinically to achieve improved survival outcomes among patients with malignant melanoma. © 2020 S. Karger AG, Basel.It is projected that by 2020 there will be 8.7 million veterans over the age of 65 years, more than half (64%) of whom served during the Vietnam War. The effects of military service on mental health and well-being may be more pronounced later in life among those who served in Vietnam than prior cohorts of veterans. Many veterans confront and rework their wartime memories later in life in an attempt to find meaning and coherence, engaging in a process referred to as Later-Adulthood Trauma Reengagement (LATR). LATR often occurs in the context of other stressors that are a normative part of aging, such as role transitions (e.g., retirement), declines in physical health, and the death of close others (e.g., spouses), perhaps because these events trigger reminiscence. Importantly, LATR may result in either positive (e.g., acceptance) or negative (e.g., distress) psychological outcomes. It has been suggested that the presence of social/environmental resources, including socioemotional support, may aid veterans in successfully navigating LATR. We, therefore, review relevant areas of research to delineate the role that various layers of social context may play in -helping - or hindering - aging Vietnam veterans as they navigate LATR in the context of normative late-life stressors. We conclude by offering fruitful directions for future research and applied implications for intervention efforts. © 2019 S. Karger AG, Basel.INTRODUCTION Post-trabeculectomy scaring due to excessive proliferation of human Tenon's fibroblasts (HTFs) often led to operation failure. Developing a new anti-fibrosis drug with high efficacy to inhibit HTFs' cell growth will greatly improve the effectiveness of trabeculectomy. OBJECTIVE This study aims to investigate the effect of berbamine (BBM) treatment on the cell growth and survival of HTFs. METHODS Cultured human fetal Tenon's fibroblasts (HFTFs) were treated with or without different concentrations of BBM. Cell morphology was observed with a phase contrast microscope. A CCK-8 method and Ki67 immunofluorescence were used to determine cell viability and cell proliferation. A scratch test was used to study cell migration. Flow cytometry and TUNEL staining were performed to detect cell apoptosis. The expression of BAX/BCL-2, ERK and AKT/mTOR pathway components was determined by western blotting. RESULTS BBM treatment disrupted HFTF's normal morphology and inhibited its cell growth in a dose-dependent manner.