Spontaneous fracture of a titanium mesh cranioplasty implant in a child: A case report

BACKGROUND Titanium mesh cranioplasty is often performed after decompressive craniectomy.Spontaneous fracture of the titanium prosthesis is an extremely rare postoperative complication.Here,we report a 10-year-old boy who presented with a spontaneous fracture of titanium mesh without antecedent head trauma.CASE SUMMARY A 10-year-old boy presented with a 1-wk history of a tender bulge over the left temporo-parieto-occipital scalp.He had undergone a temporo-parieto-occipital titanium mesh cranioplasty 26 mo previously.He denied antecedent head trauma.Computerized tomography disclosed a perpendicular fissure in the titanium mesh,suggesting a diagnosis of spontaneous titanium mesh fracture.He underwent a second temporo-parieto-occipital cranioplasty and made an uneventful recovery.Three-dimensional modeling and finite element analyses were used to explore potential risk factors of titanium mesh fracture.CONCLUSION We report a case of spontaneous fracture of a titanium mesh cranioplasty implant.The current case and literature review indicate that titanium mesh implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.

Processing Mechanism of Chinese Verbal Jokes:Evidence from ERP and Neural Oscillations

The cognitive processing mechanism of humor refers to how the system of neural circuitry and pathways in the brain deals with the incongruity in a humorous manner. The past research has revealed different stages and corresponding functional brain activities involved in humor-processing in terms of time and space dimensions, highlighting the effects of the time windows of about 400 ms, 600 ms, and 900 ms. However, much less is known about humor processing in light of the frequency dimension. A total of 36 Chinese participants were recruited in this experiment, with Chinese jokes, nonjokes, and nonsensical sentences used as the stimuli. The experimental results showed that there were significant differences among conditions in the P200 effect, which signified that the incongruity detection had already been integrated and perceived at about 200 ms, prior to the semantic integration at about 400 ms. This pre-processing is specific to Chinese verbal jokes due to the simultaneous involvement of both orthographic and phonologic parts in processing Chinese characters. The analysis on the frequency dimension indicated that beta’s power particularly reflected the characteristics of different stages in Chinese verbal humor processing. Jokes’ and nonsensical sentences’ relative power changes on the beta band ranked significantly higher than that of nonjokes at about 200 ms, which suggested the existence of more difficulties in meaning construction in pre-processing the incongruities. This indicated a continuity between the analysis of event related potential (ERP) components and neural oscillations and revealed the key role of the beta frequency band in Chinese verbal joke processing.

Decreased expression of HDAC8 indicates poor prognosis in patients with intrahepatic cholangiocarcinoma

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly malignant primary tumor in the liver, and the rates of incidence and mortality are rapidly increasing globally. Histone deacetylase 8 (HDAC8) is a transcriptional regulator and is associated with tumorigenesis of several tumor types. This study aimed to evaluate the correlation between HDAC8 expression and clinicopathological parameters in ICC patients. Methods: ICC tissues and corresponding nonmalignant bile duct tissues were obtained from 60 patients. HDAC8 and Ki-67 expression were evaluated by immunohistochemistry staining. HDAC8 expression and the clinicopathological features and prognosis of the patients were analyzed. The mRNA level of HDAC8 in ICC was further analyzed using data from The Cancer Genome Atlas (TCGA). Results: The expression of HDAC8 were lower in ICC tissues (39/60, 65%) than in the corresponding nonmalignant bile duct tissues (54/60, 90%)( P = 0.001). Low HDAC8 expression in ICC was significantly associated with lymph node metastases (47.6% vs. 17.9%, P = 0.015). In addition, the positive cells rate of HDAC8 was statistically and negatively correlated with the Ki-67 index in ICC lesions ( r =?0.7660, P < 0.001). Importantly, the overall survival rate and recurrence-free survival rate in ICC patients with low HDAC8 expression were lower than those with high HDAC8 expression ( P = 0.008 and P = 0.011, respectively). Conclusions: Decreased HDAC8 expression in ICC is related to poor prognosis, and HDAC8 may be an independent prognostic indicator of ICC patients after curative resection.