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Herein, this review endeavored to collate and summarize the evidence of the unique characteristics and features of activated immune responses via mIgD-BCR and sIgD that revealed an unappreciated immune-regulatory function of IgD in the immune system via an amplifying loop of anti-inflammatory Th2 and tolerogenic responses, and highlighted a novel therapeutic paradigm in harnessing these immune responses to treat human autoimmune and allergic conditions.Nanocluster based drug delivery systems are very useful in modern medical treatment and interaction mechanism of desflurane (DES), isoflurane ISO), sevoflurane (SEV) over carboxyl substituted graphene-doped with O and S atoms were investigated in the present study. Different electronic and chemical properties of adsorbed desflurane, isoflurane and sevoflurane with nanoclusters are analyzed. To track the drugs, SERS is used as an efficient method and drug's detection was analyzed using SERS. DES's energy over GQD-S is greater than that over GQD-O nanocluster and for ISO and SEV, adsorption energies over the O/S nanoclusters are same. The title drugs work on the reactives sites and got adsorbed. For ISO, there is an increase in fluorine atom charges and for DES and SEV, the fluorine atom charge decreases due to adsorption in both O/S nanoclusters. Changes in chemical descriptors are identified for the sensing property of drug-nanoclusters. Communicated by Ramaswamy H. Sarma.

Cerebellopontine angle (CPA) epidermoids, although of benign nature, are of considerable neurosurgical interest because of their close proximity and adherence to the cranial nerves and brain stem. In this paper, we describe our experience and attempt to correlate the final outcomes with the extent of surgical removal. The main objectives were to study various modes of surgical management of CPA epidermoids with regard to removal and preservation of the cranial nerves and also to evaluate the role of endoscopic assisted microsurgical excision thereby minimizing recurrences. This case series is one of the largest series reported so far worldwide.

From 2006 to 2016, 139 patients with CPA epidermoids were operated at Grant Medical College and J. J. Hospital, Mumbai. All patients underwent detailed magnetic resonance imaging (MRI) of brain. Lesions were classified according Rogelio Revuelta-Gutiérrez

with respect to their anatomic extent grade I- within the boundaries of the CPA, grade II- extension to the tumor.

Epidermoid cysts are challenging entities in current neurosurgery practice due to tumor adhesions to neurovascular structures. Metabolism inhibitor Meticulous surgical technique with the aid of neurophysiological monitoring is crucial to achieve safe and effective total or subtotal removal of these lesions. A conservative approach is indicated for patients in whom the fragments of capsule is adhered closely to blood vessels, nerves, or the brainstem, in order to avoid risk of serious neurological deficits related to an inadvertent damage of these structures. link2 Use of angled views by endoscope at the conclusion of the surgery may assure the surgeon of total removal of the tumor.

Spinal meningeal melanocytoma is an extremely rare tumour with an estimated annual incidence of 1 per 10 million people. It usually arises from the intradural extramedullary compartment at the cervical levels. Although these tumours are histologically benign, they may behave aggressively. Local recurrence could occur even after total tumour excision.

We report a case of a 33-year-old Asian male who developed progressive weakness and numbness of the bilateral lower extremities as well as urinary retention five years after complete tumour resection of lumbar spinal meningeal melanocytoma. Magnetic resonance imaging of the lumbar spine revealed a mass with thecal sac compression which was hypointense on T2-weighted images and hyperintense on T1-weighted images. The patient underwent total tumour removal. Histologic examination was compatible with recurrent meningeal melanocytoma. After a 4-week inpatient rehabilitation programme, he was able to ambulate without assistance and to do clean intermittent catheterisation for micturition on a regular basis.

This is the first reported case of intradural extramedullary meningeal melanocytoma located at the lumbar region. Clinicians should consider the possibility of these rare tumours at any level of the spine, and be aware of sphincter dysfunction in addition to motor and sensory deficits of extremities.

This is the first reported case of intradural extramedullary meningeal melanocytoma located at the lumbar region. Clinicians should consider the possibility of these rare tumours at any level of the spine, and be aware of sphincter dysfunction in addition to motor and sensory deficits of extremities.Occlusion of foramen of Monro is an uncommon clinical entity that usually presents in children. Common causes are obstructing mass, infectious etiologies or vascular malformation. Rarely, it may be an idiopathic stricture or membrane. We report a case of idiopathic membranous obstruction of the foramen of Monro in a 45-year-old male with no past medical or surgical history. He presented with new intermittent dull and burning bifrontal severe headache for 2 d, which was alleviated slightly by non-steroidal anti-inflammatory medication. Imaging showed marked dilation of the lateral ventricles with normal third and fourth ventricles. The patient was discharged initially with conservative medical management and close follows up; however, the headache continued to progress and neurosurgical intervention was offered. The patient underwent endoscopic exploration, fenestration of the septum pellucidum, and right ventriculoperitoneal shunt placement. Bilateral membranous obstruction of foramina of Monro and an auto-fenestrated cavum septum pellucidum were identified intraoperatively. The patient reported resolution of headache post-operatively without recurrence on 1-month follow up. This case is unusual in that the patient presented without any known neurologic history or prior intracranial infections. It became apparent at the time of surgery that chronic obstruction of the bilateral foramina with collapse of the third ventricle had developed, and the safest durable treatment for him was septostomy and cerebrospinal fluid (CSF) shunt placement.Reports from various population-based studies indicate that the incidence of colorectal cancer may be strongly affected by dietary patterns of the respective populations. The nature of dietary patterns of specific Indonesia population on the risk of colorectal cancer might differ from previously published data with the global population. Therefore, we conducted a study where the dietary pattern in colorectal cancer patient cohorts was compared to age- and population-matched control. We documented 89 colorectal cancer cases and among 173 individuals from the South Sulawesi population. A series of logistic regression and Fisher's exact tests were utilized to test associations of dietary intakes and colorectal cancer risk as well as colorectal cancer staging. Our data demonstrate that vegetable (p-value = 8.70 × 10-26, OR = 0.49) and fruit (p-value = 7.59x10-5, OR = 0.70) intakes are associated with the reduced risk of colorectal cancer incidence. Conversely, acidic food, reheated food, meat, spicy food, and alcohol are associated with the increment case of cancer. Moreover, meat intake (p-value less then 0.01) shows a significant association with cancer staging progression. Common dietary pattern is a determinant aspect to the colorectal cancer incidence as well as its staging progression.

Primary intracranial Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is an extremely uncommon tumor. Care should be taken as it can be mistaken for a meningioma radiologically.

This paper reports a case of a 44-year-old male presenting with headache. A magnetic resonance imaging demonstrated a mass involving the tentorium, cerebrum and cerebellum with solid-cystic component. The solid component was hyperintense on T1-weighted images with significant enhancement. There was restriction in diffusion-weighted images and microhemorrhagic signal change in susceptibility weighted images. MR perfusion revealed increased relative cerebral blood volume and mean transit time values. Surgical pathology was reported as ES.

Intracranial ES/pPNET is a rare tumor that generally arises from the meninges. It must be distinguished from meningioma since it can be mistaken radiologically, because the treatment and prognosis are quite different. Localization and conventional MR signal characteristics of both lesions are similar. Whereas, MR perfusion findings may be helpful in discrimination.

Intracranial ES/pPNET is a rare tumor that generally arises from the meninges. It must be distinguished from meningioma since it can be mistaken radiologically, because the treatment and prognosis are quite different. Localization and conventional MR signal characteristics of both lesions are similar. Whereas, MR perfusion findings may be helpful in discrimination.

To assess the relationship between nutritional status and inflammatory markers of breast cancer patients, and to identify predictors of malnutrition in these patients.

This is a cross-sectional study of 45 patients with breast cancer assessed between January and June 2018. Nutritional status was evaluated by objective and subjective methods. The inflammatory markers and inflammation-based scores evaluated were C-reactive protein (CRP), albumin, erythrocyte sedimentation rate (ESR), Glasgow Prognostic Score (GPS), CRP/albumin ratio, and Albumin/CRP ratio.

A total of 45 patients were evaluated. Majority of the patients have high levels of both CRP and ESR (73.3% and 86.7% respectively). link3 More than 70% of the patients were well nourished. There was no significant association between CRP (

 = 0.067), ESR (

 = 0.094) and SGA (Subjective Global Assessment) categories. Albumin (

 < 0.001), Albumin/CRP ratio (

 = 0.002), CRP/albumin ratio (

= < 0.001), and GPS (

 < 0.001) were significantly associated with SGA categories. On multivariate analysis, albumin (

 < 0.001), Albumin/CRP ratio (

 = 0.004), CRP/albumin ratio (

 = 0.009), GPS (

 = 0.01), and ECOG (

 = 0.009) were the only markers independently related to malnutrition.

The inflammation-based scores were significantly associated with malnutrition and can be used as biochemical nutritional assessment tools in cancer patients.

The inflammation-based scores were significantly associated with malnutrition and can be used as biochemical nutritional assessment tools in cancer patients.Background and purpose - Several surgical approaches are used in primary total hip arthroplasty (THA). In this randomized controlled trial we compared gait, risk of fall, self-reported and clinical measurements between subjects after direct superior approach (DSA) versus posterolateral approach (PL) for THA.Patients and methods - Participants with DSA (n = 22; age 74 [SD 8.9]) and PL (n = 23; age 72 [7.7]) underwent gait analysis, risk of fall assessment and Timed Up and Go Test (TUG) before (PRE), 1 month (T1) and 3 months after (T3) surgery. Data on bleeding and surgical time was collected.Results - DSA resulted in longer surgical times (90 [14] vs. 77 [20] min) but lower blood loss (149 [66] vs. 225 [125] mL) than PL. DSA had lower risk of fall at T3 compared with T1 and higher TUG scores at T3 compared with T1 and PRE. PL improved balance at T3 compared with T1 and PRE. Spatiotemporal gait parameters improved over time for both DSA and PL with no inter-group differences, whereas DSA, regarding hip rotation range of motion, showed lower values at T3 and T1 compared with PRE and, furthermore, this group had lower values at T1 and T3 compared with PL.