Cerebral processing of auditory stimuli in patients with irritable bowel syndrome

瞄准：用大脑决定功能的磁性的回声成像(fMRI ) 非内脏的刺激的服的处理是否在急躁的肠症候群(IBS ) 被改变病人与健康题目相比。围绕针的内脏躯体集中机制，并且识别心理因素的可能的影响，我们使用了听觉的刺激刺激在他们的感情的质量不同。方法：在 8 个 IBS 病人和 8 控制， fMRI 大小用不同感情的质量(钟声，讨厌的偷看(2000 Hz ) ，中立的词，和感情的词的愉快的声音) 的 4 听觉的刺激的一个块图案被执行。坡度回响 T2 * 加权的顺序被用于功能的扫描。统计地图用一般线性模型被构造。结果：到感情的听觉的刺激，，相对控制的 IBS 病人在感情的处理区域的一个更大的变化与更强壮的释放反应了反应模式，在控制不同，没在令人烦恼或愉快的声音之间区分。到中立听觉的刺激，由对比，仅仅 IBS 病人与大重要激活反应了。结论：到在感情的处理刺激的区域的听觉的刺激的改变的服的反应模式建议在 IBS 的改变的感觉处理不能为内脏的感觉是特定的，但是可能在感情的敏感和感情方面的反应反映概括变化，可能与经常在 IBS 病人发现的心理 comorbidity 联系了。

Multimodal Imaging to Delineate Tumor Heterogeneity in Cerebral Gliomas

Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.

Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique

Background and purpose The first-pass effect(FPE),defined as a first-pass Expanded Treatment in Cerebral Ischaemia(eTICI)2c/3 reperfusion,has emerged as a key metric of efficacy in mechanical thrombectomy(MT)for acute ischaemic stroke.The proximal balloon occlusion together with direct thrombus aspiration during stent retriever thrombectomy(PROTECT)-PLUS technique consists in the use of a balloon guide catheter and a combined MT approach involving contact aspiration and a stent retriever.The aim of this study is to assess the effectiveness and safety of the PROTECT-PLUS technique using distal aspiration catheters(DACs)with different inner diameters by comparing the large-bore DAC Catalyst 7 versus the use of medium-bore DACs.Methods Retrospective analysis of a prospectively maintained database of patients treated with PROTECT-PLUS using Catalyst 7,Catalyst 6 or Catalyst 5 with an occlusion of either the terminal carotid artery or the M1 or M2 segments of the middle cerebral artery from 2018 to 2020 in two comprehensive stroke centres.Baseline characteristics and procedural,safety and clinical outcomes were compared between groups.Multivariable logistic regression analysis was performed in order to find independent predictors of FPE.Results We identified 238 consecutive patients treated with PROTECT-PLUS as front-line approach using Catalyst 7(n=86),Catalyst 6(n=78)and Catalyst 5(n=76).The rate of FPE was higher with Catalyst 7(54%)than Catalyst 6(33%,p=0.009)and Catalyst 5(32%,p=0.005),in addition to higher final eTICI 2c/3 reperfusion rates,shorter procedural times,lower need of rescue therapy and fewer procedure-related complications.After multivariable analysis the sole independent factor associated to FPE was the use of Catalyst 7(OR 2.34;95%CI 1.19 to 4.58;p=0.014).Conclusion Further development of combined MT by incorporating larger-bore aspiration catheters is associated with higher reperfusion rates,shorter procedure times,and lower need of rescue therapy while reducing the complication rates.

Neoadjuvant stereotactic radiosurgery for intracerebral metastases of solid tumors(NepoMUC):a phase I dose escalation trial

Background:More than 25%of patients with solid cancers develop intracerebral metastases.Aside of surgery,radia-tion therapy(RT)is a mainstay in the treatment of intracerebral metastases.Postoperative fractionated stereotactic RT(FSRT)to the resection cavity of intracerebral metastases is a treatment of choice to reduce the risk of local recur-rence.However,FSRT has to be delayed until a sufficient wound healing is attained;hence systemic therapy might be postponed.Neoadjuvant stereotactic radiosurgery(SRS)might offer advantages over adjuvant FSRT in terms of better target delineation and an earlier start of systemic chemotherapy.Here,we conducted a study to find the maximum tolerated dose(MTD)of neoadjuvant SRS for intracerebral metastases.Methods:This is a single-center,phase I dose escalation study on neoadjuvant SRS for intracerebral metastases that will be conducted at the Klinikum rechts der Isar Hospital,Technical University of Munich.The rule-based traditional 3+3 design for this trial with 3 dose levels and 4 different cohorts depending on lesion size will be applied.The primary endpoint is the MTD for which no dose-limiting toxicities(DLT)occur.The adverse events of each participant will be evaluated according to the Common Terminology Criteria for Adverse Events(CTCAE)version 5.0 continuously during the study until the first follow-up visit(4-6 weeks after surgery).Secondary endpoints include local control rate,survival,immunological tumor characteristics,quality of life(QoL),CTCAE grade of late clinical,neurological,and neurocognitive toxicities.In addition to the intracerebral metastasis which is treated with neoadjuvant SRS and resection up to four additional intracerebral metastases can be treated with definitive SRS.Depending on the occurrence of DLT up to 72 patients will be enrolled.The recruitment phase will last for 24 months.Discussion:Neoadjuvant SRS for intracerebral metastases offers potential advantages over postoperative SRS to the resection cavity,such as better target volume definition with subsequent higher efficiency of eliminating tumor cells,and lower damage to surrounding healthy tissue,and much-needed systemic chemotherapy could be initiated more rapidly.