Notes

Epigenetic therapies in ovarian cancers adjust recurring component expression in the TP53-dependent manner.
ascularized flap. However, each case must be assessed individually and lateral extension beyond the optic canals with internal carotid artery encasement must be considered before planning surgery.
Surgical revascularization is the mainstay of treatment in symptomatic patients of moyamoya disease (MMD).

The present study analyzed the postoperative angio-architecture in pediatric and adult patients of moyamoya disease.

Patients with MMD, both ischemic and hemorrhagic, were subjected to surgery. A superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis was attempted in all. It was augmented by an encephalo-duro-myo-synangiosis), this was labelled as the combined surgical group. In patients where a direct bypass was not possible encephalo-duro-arterio-myo-synangiosis (EDAMS) was performed and these patients were put in the indirect surgery group. In the postoperative period, MRA was performed in all patients to look for (a) graft patency, (b) regression of moyamoya vessels, and (c) degree of surgical neovascularization (as quantified on adapted Matsushima and Inaba grading system).

Eighty-two patients underwent 131 surgical revascularization procedures. A combined surgery (STA-MCA bypass and EDAMS) was performed in 100 hemispheres and indirect surgery (EDAMS) on 31 sides. In children less than 5 years of age, STA-MCA anastomosis was possible in more than 50% of patients. Clinical improvement was seen in 85.4% of patients. Postoperative MRA demonstrated a patent bypass graft in 97% of cases. Regression of moyamoya vessels was seen in half of the cases and good surgical revascularization (type A and B) was seen in more than 80% of hemispheres in the combined surgery and indirect surgery group.

Revascularization procedures led to a regression of moyamoya collaterals, appearance of surgical neo angiogenesis, and a graft patency rate of 97%. Surgical group with combined revascularization had a trend towards better collateral development.
Revascularization procedures led to a regression of moyamoya collaterals, appearance of surgical neo angiogenesis, and a graft patency rate of 97%. Surgical group with combined revascularization had a trend towards better collateral development.
Autologous bone is the most commonly used flap in cranioplasty to repair the defect; however, synthetic materials are available. Poly methyl methacrylate (PMMA) is an effective polymer owing to its thermoplastic and radiolucent properties comparable to bone strength. Three-dimensional (3D) printing combined with computer-assisted design (CAD) is a simple, low-cost method to print molds that ensure surgical success.

A total of 114 patients underwent cranioplasty (July 2015-April 2018), and 25 of them using 3D printed template molds due to unavailability of autologous bone. The clinical features, patient demographics, and surgical parameters were analyzed. The visual analog score for cosmesis (VASC) and Odom's score was obtained pre and post-op.

The mean age of the patients is 38.4 ± 14.6 years (Range, 9-66). The primary pathology for undergoing craniectomy is stroke (n = 13; 52%), traumatic brain injury (10; 40%) and tumor (2; 8%). The reason for nonavailability of flap was infection (n = 14;56%), flap resorption (4;16%), and trauma or tumor (7;28%). The mean time for manufacturing the 3D printed template is 13.2 ± 2.1 h. On follow-up, median Odom's score is excellent in 52% of cases, good in 40%, and fair in 8%. The mean VASC score on follow up is 8.2 ± 1.3. Three patients developed minor postoperative complications.

This is the first study from a single tertiary care center in India to systematically evaluate the outcomes in 3D cranioplasty using CAD and 3D printing technology. This method would be optimal especially in developing countries since PMMA is cost effective and also gives an ideal cosmetic effect.
This is the first study from a single tertiary care center in India to systematically evaluate the outcomes in 3D cranioplasty using CAD and 3D printing technology. This method would be optimal especially in developing countries since PMMA is cost effective and also gives an ideal cosmetic effect.
Parkinson's disease (PD) is characterized by bradykinesia, tremor, rigidity, postural instability and cognitive deficits in attention, executive functions, learning and memory. Motor speed, measured using Finger Tapping Test (FTT), is an important indicator and predictor of cognitive and motor functions. Deficits in motor speed have significant impact on performance on other neuropsychological tests.

This study aimed to understand and compare the cognitive profile of patients with and without deficits in motor speed as evaluated on the FTT.

A detailed neuropsychological evaluation using the NIMHANS Neuropsychological Battery was carried out on 70 PD patients. The PD patients were divided into patients with (n = 46) and without (n = 24) motor speed deficits. TAK243 The two groups were comparable with regard to age (P = 0.591), years of formal education (up to 10
- 24.3, above 10
- 75.7) duration of illness (P = 0.703) and age of onset (P = 0.721).

Across the various cognitive domains such as executive functions, verbal recognition, visuospatial functions, visual learning and memory, the group without deficits in motor speed performed significantly better in comparison to patients with motor symptoms.

A short and simple test such as FTT may be helpful in predicting the range and severity of cognitive deficits across other cognitive domains in patients with PD. Future studies on larger cohort examining the intricate role and association of FTT and other motor functions such as dexterity may be helpful in understanding the nature and severity of other cognitive functions in this clinical population.
A short and simple test such as FTT may be helpful in predicting the range and severity of cognitive deficits across other cognitive domains in patients with PD. Future studies on larger cohort examining the intricate role and association of FTT and other motor functions such as dexterity may be helpful in understanding the nature and severity of other cognitive functions in this clinical population.
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