Validation of a Novel Wearable Multistream Data Acquisition and Analysis System for Ergonomic Studies

Nowadays, the growing interest in gathering physiological data and human behavior in everyday life scenarios is paralleled by an increase in wireless devices recording brain and body signals. However, the technical issues that characterize these solutions often limit the full brain-related assessments in real-life scenarios. Here we introduce the Biohub platform, a hardware/software (HW/SW) integrated wearable system for multistream synchronized acquisitions. This system consists of off-the-shelf hardware and state-of-art open-source software components, which are highly integrated into a high-tech low-cost solution, complete, yet easy to use outside conventional labs. It flexibly cooperates with several devices, regardless of the manufacturer, and overcomes the possibly limited resources of recording devices. The Biohub was validated through the characterization of the quality of (i) multistream synchronization, (ii) in-lab electroencephalographic (EEG) recordings compared with a medical-grade high-density device, and (iii) a Brain-Computer-Interface (BCI) in a real driving condition. Results show that this system can reliably acquire multiple data streams with high time accuracy and record standard quality EEG signals, becoming a valid device to be used for advanced ergonomics studies such as driving, telerehabilitation, and occupational safety.

Minimal Sentinel Node Procedure for Staging Early Breast Cancer

Aims and Background

Sentinel lymph node dissection (SLND) has recently been evaluated as a new staging technique for early breast cancer. To minimize the extent of surgery, the feasibility of eradicating primary breast lesions and the relative sentinel lymph nodes (SLN) under regional anesthesia was evaluated in this study.

Methods and Study Design

A selected population of 76 patients with suspected operable breast cancer and no clinically palpable lymph nodes was enrolled in the study. Intra- and perilesional administration of a radiotracer was performed. Lymphoscintigraphy was carried out to confirm the drainage pathway and locate the SLN. The following day, after inducing a nervous block induction of the ipsilateral intercostal nerves, we performed the surgical procedure with the help of a hand-held gamma-detecting probe. In case the primary lesion was diagnosed as invasive carcinoma by frozen section, the SLN and the remaining axillary lymph nodes (non-SLNs) were removed. The status of SLN and non-SLNs was compared.

Results

The primary breast lesion was located and excised in all cases (identification rate: 100%). Lymphoscintigraphy positively identified SLNs in 40/45 (89%) patients; in five patients no lymphatic drainage was detected. In 38 cases an average of 1.5 SLNs and 14 non-SLNs per patient were removed and pathologically analyzed; the remaining two patients showed SLNs in the internal mammary chain, which were not excised. Twenty-nine percent of the patients showed metastatic disease in the lymph nodes examined. Of all patients with affected nodes, 55% had cancer cells only in the SLN. No false negatives (skip metastases) were found. No immediate or long-term anesthesia-related complications (eg pleural lesions, intravascular injection) were observed.

Conclusions

Our data confirm the feasibility of single radiotracer administration for both occult lesion and SLN localization as well as the usefulness of SLND in staging early breast cancer. Regional anesthesia resulted in easy management and good patient compliance. This time-saving procedure allowed the completion of the whole surgical plan, reducing the recovery time without modifying the effectiveness of surgery.

Advances in the anatomic study of the interscapular region of the cat

Background

New clinical oriented approaches are supported by the integration of advanced imaging techniques, e.g. computed tomography and magnetic resonance, with gross anatomy imaging. The interscapular region of the cat is a typical site of a highly invasive infiltrative pathology, i.e. Feline Injection-Site Sarcoma. Even if chemotherapy and radiotherapy have been considered as pre-surgical therapies, extensive surgery is still the recommended treatment. Evidence suggested that the relationships between muscles, infiltrative mass and adjacent musculoskeletal structures could change according to the forelimb positions: a fact to be duly considered while planning the surgical approach.

Anatomic and tomographic atlases provide only images of the interscapular region from cats positioned with their forelimbs extended cranially, which means that, they do not record musculoskeletal modifications due to the forelimb movements.

Aim of this study was to provide detailed images of the changes occurring in the musculoskeletal structures of the interscapular region of cats according to their forelimb position by comparing cross-sectional gross anatomy, computed tomography and magnetic resonance imaging.

Results

We provide an atlas of normal cross-sectional anatomy, computed tomography and magnetic resonance imaging of the interscapular region of the cat, from the fifth cervical vertebra to the fifth thoracic vertebra. We compare and couple the slices obtained both in flexed and extended forelimb positioning with the animal maintained in sternal recumbency.

Conclusion

This study shows a new and dynamic way to investigate the interscapular region of the cat and provides anatomical references for in vivo computed tomography and magnetic resonance imaging, considering changes in the muscular form according to the forelimb positioning. We believe that an in-depth anatomical knowledge of the interscapular region may be helpful to approach the study of any pathology located there and, in particular, to set up an appropriate therapy for the feline injection-site sarcoma.

[OCT and neovascular glaucoma]

INTRODUCTION

Neovascular glaucoma is a chronic and sight-threatening disease. Four different grades have been described. Anterior chamber optical coherence tomography (OCT) is a new imaging technique allowing the visualization of the anterior segment. The purpose of our study was to describe the appearance of the different neovascular glaucoma grades with the OCT in order to refine the clinical analysis of this disease.

PATIENTS AND METHODS

Eleven patients (nine men and two women) with different grades of neovascular glaucoma were analyzed in this study. Neovascular glaucoma complicated central retinal vein occlusion in seven patients and diabetic retinopathy in four patients. All patients had bilateral biomicroscopical examination and OCT analysis. OCT images and clinical examination were then compared.

RESULTS

No modifications could be observed using OCT in patients with grade 1 neovascular glaucoma. For grade 2, a slightly hyper-reflective linear iris secondary to neovascularization was observed. For grade 3, OCT images showed a thickened hyper-reflective iridocorneal angle with possible iridocorneal synechiae. For grade 4, the iridocorneal angle was closed and associated with iris contraction and uveae ectropion.

CONCLUSION

OCT is a new promising technique for the precise analysis of different grades of neovascular glaucoma. It certainly helps in the management of such cases.

Intracranial pressure patterns after endoscopic third ventriculostomy. Preliminary experience

BACKGROUND

Endoscopic Third Ventriculostomy (ETV) has become the treatment of choice for non-communicating hydrocephalus as it is able to couple high success rate (60-80%) with rare complications (about 5%). Nevertheless, which is the best postoperative care standard and whether or not it is possible to predict the success of the procedure is still discussed. Traditional neuro-imaging techniques show several limitations in the early postoperative period. Indeed, a decrease of the ventricular size is often minimal and not visible before three weeks, while, MRI visualization of a flow void signal through the third ventricle floor, seems to have a significant incidence of false positives. The use of postoperative ICP measurement after ETV has been suggested as a valid monitoring method, mostly in the early postoperative period. In previously unpublished data the authors observed the existence of different ICP patterns following ETV. This finding prompted the authors to search for a relationship among ICP patterns, stoma functioning and prediction of success.

METHOD

At our institution 26 consecutive patients affected by obstructive triventricular hydrocephalus underwent ETV. Among them there were 11 primitive aqueductal stenosis (AS), 5 shunt malfunctions, 2 third ventricle mass, 3 intraventricular cysts, and 5 patients with different lesions (1 quadrigeminal cistern arachnoidal cyst, 1 pineal region mass, 2 tectal tumours, and 1 supracerebellar abscess) compressing the aqueduct of Sylvius from outside named " ab estrinseco" aqueductal stenosis. All patients underwent postoperative Intra Cranial Pressure (ICP) monitoring by means of a ventricular catheter.

FINDINGS

Transient ICP rises of any grade, mostly responsive to periodical liquoral subtractions, occurred shortly after ETV in as many as 50% of our patients. No major complications occurred. The effect of ETV on ICP trend was found to be variable among groups of patients thus identifying different ICP patterns. Patients with ab estrinseco Sylvian aqueduct compression showed the best effect on ICP, whilst, patients with intraventricular mass lesions causing triventricular hydrocephalus and shunt-dependent patients, revealed a clear trend to develop a more severe intracranial hypertension after ETV.

CONCLUSIONS

Patients with shunt malfunction and patients with intraventricular mass lesions, showing a more pronounced trend to develop severe intracranial hypertension after ETV, should always be considered for postoperative ICP monitoring in order to detect and, eventually, treat any ICP rises which may occur. Unfortunately, it is still difficult to assign a predictive value to the different postoperative ICP patterns. The authors encourage postoperative ICP monitoring in all patients in order to define all the possible ICP patterns following ETV.

Exclusively intracranial and cranial fasciitis of the adult age

The unusual case of an exclusively intracranial localization of fasciitis (CF) in a man aged 47 is reported. The cystic lesion had been accidentally discovered 10 years before when the patient sustained a contralateral ischemic stroke; the cyst, being absolutely silent, was not operated on at that time. After 10 years, the patient complained of seizures and mild right-sided paresis. CT scan revealed a dramatic increase of the lesion whose mass effect caused an initial subfalcial herniation of the brain. The mass was grossly removed, the patient recovered and become seizure-free. CF, rare in childhood, is exceptional in the adult age. The importance of a correct histological diagnosis is hereby stressed, because CF is absolutely benign, self-limiting, and does not require further treatment, but may be misdiagnosed as sarcoma.

Intracranial pressure monitoring after endoscopic third ventriculostomy: an effective method to manage the 'adaptation period'

Endoscopic third ventriculostomy (ETV) has become the treatment of choice for non-communicating hydrocephalus. Nevertheless, which technique should be considered of choice to identify features correlating with the failure of an endoscopic procedure and which is the optimal postoperative period care standard are still a matter of debate. Traditional neuroimaging techniques have several limitations in assessing the success of the procedure mostly in the early postoperative period. Indeed, a decrease in the ventricular size is often minimal and not visible before 3-4 weeks. MRI, able to detect the presence of a flow void signal through the third ventricle floor, has been reported to have a significantly high incidence of false positives. In our experience, the continuous measuring of intracranial pressure (ICP) by means of a ventricular catheter has been of great help in verifying the correct functioning of the communication between the ventricle and the subarachnoidal spaces during the first postoperative days. Furthermore, ICP monitoring allowed us to safely deal with the intracranial hypertension that may occur shortly after ETV.

Traumatic subependymal hematoma during endoscopic third ventriculostomy in a patient with a third ventricle tumor: case report

Endoscopic third ventriculostomy has become a routine intervention for the treatment of non-communicating hydrocephalus. This technique is largely considered safe and a very low incidence of complications is reported. However, hemorrhage in the course of neuroendoscopy is still a problem difficult to manage. The authors present a case in which endoscopic third ventriculostomy and tumor biopsy were performed in a young patient with a huge tumor growing in the posterior part of the third ventricle. The surgical approach to realize the stoma was difficult because the tumor size reduced the third ventricle diameter. Surgical manipulation produced a traumatic subependymal hematoma. This hematoma drained spontaneously after few minutes into the ventricle and the blood was washed away. The postoperative neurological course was uneventful and the ventriculostomy showed to work well by reducing the size of the lateral ventricles and the intracranial pressure in three days. This complication during endoscopic third ventriculostomy has never been reported before. We emphasize the difficulty of endoscopic procedures in patients with huge tumors in the third ventricle. Where reduction in size of the third ventricle and of the foramen of Monro ist present we suggest a careful approach to the third ventricle.

Surgical approach to non-small cell lung cancer involving the chest wall

Treatment of NSCLC invading the chest wall (T3) remains controversial. Surgery is undoubtedly the only chance for these neoplasms, but its role regarding the T3N2 tumors is highly questionable. Between 1975 and 1994, 710 NSCLC patients underwent surgery in our department. Of these, 38 with tumor involvement of the chest wall underwent curative resection: en bloc resection or extrapleural resection, and 31 of these patients (19 with T3N0 tumors and 12 with T3N1-N2 tumors) were available for estimating long-term survival. The overall survival was 20.5% at 5 years and 15.4% at 10 years. Patients without lymph-node involvement had a survival rate of 26.2% at 5 years and 19.27% at 10 years. No patient with T3N2 tumor was alive 5 years after surgery. Patients with T3N1 tumor had a survival rate of 16.7% at both 5 and 10 years. The difference between T3N0 and T3N2 tumors was statistically significant. Neither histologic type nor depth of chest wall involvement had a significant impact on survival. En bloc or extrapleural resection, if curative, can be effective in T3N0-N1 tumors. Surgery is inadequate for the treatment of T3N2 tumors with chest wall involvement.

Biological studies on 2,1-benzisothiazole derivatives. II. Evaluation of antimicrobial and genotoxic properties of bz-nitro-, 3-ethylacetate-, 3-amino- and 3-substituted amino 2,1-benzisothiazoles

The in vitro antimicrobial activity of bz-nitro-, 3-ethylacetate-, 3-amino- and 3-substitutedamino 2,1-benzisothiazoles was evaluated. The compounds studied were found to display a very low activity against bacteria and fungi, with the exception of compound 61, which exhibited a relatively high activity against Bacillus subtilis, Escherichia coli and Saccharomyces cerevisiae. As for genotoxic properties, compounds 1-3, 5 and 6 showed DNA-damaging activity in the Bacillus subtilis rec-assay. The Salmonella-microsome assay confirmed the genotoxicity of these compounds and also revealed the mutagenicity of compounds 4, 7-12, 23, 24, 31, 33-35, 38, 39, 44, 49, 51, 53, 57-63. Structure-activity relationships showed all the compounds containing an aromatic nitro group or an unsubstituted amino group to possess genotoxic properties. Whereas most of the 3-acylamino-, 3-acylalkylamino- and 3-azomethynderivatives showed mutagenic activity, none of the 3-alkylamino-2,1-benzisothiazoles was active. None of the 1,2-isomers studied showed genotoxic properties.

Biological studies on 2,1-benzisothiazole derivatives. I. Evaluation of antibacterial, antifungal and genotoxic activities of 1-acyl-3-acylimino-2,1-benzisothiazolines

The in vitro evaluation of antibacterial, antifungal and genotoxic activities of some 1-acyl-3-acylimino-2,1-benzisothiazolines is described. Compounds 55, 58, 60 and 62 exhibited a selective antibacterial activity. Compounds 1, 2, 30, 59 and 63 were active against Botrytis cinerea, compounds 6, 20, 39 and 54 against Pythium irregulare. DNA-damaging activity in the Bacillus subtilis rec-assay was demonstrated for compounds 45, 46, 54, 55, 57 and 61. By the Salmonella-microsome assay, genotoxic activity was confirmed and demonstrated also for compounds 10, 28, 29, 40, 44, 47-53, 56, 58-60, 62 and 63. Relationships between structure and genotoxic activity showed that all compounds containing an aromatic -NO2 group, except compound 27, were active. Among derivatives containing a -CH2Cl group in the acylic chain, only compound 40 showed mutagenic activity.

Biological studies on 1,2-benzisothiazole derivatives. III. Evaluation of antibacterial, antifungal and DNA-damaging activities of 1,2-benzisothiazolin-3-ones

The in vitro evaluation of the antibacterial, antifungal and DNA-damaging properties of some 1,2-benzisothiazolin-3-one derivatives is described. Antibacterial activity against Gram+ microorganisms (Bacillus subtilis and Staphylococcus aureus) was demonstrated in some N-alkoxybenzyl, N-aryl and N-alkoxyphenyl derivatives. Antifungal activity turned out to be strongly affected by the substituents considered. Some derivatives exhibited selective activity against the fungi used. Poor antimicrobial activity was observed in the N-chlorocarbonylphenyl and N-carboxyamidophenyl derivatives. None of the compounds tested turned out to have any genotoxic properties.

Biological studies on 1,2-benzisothiazole derivatives. II. Evaluation of antibacterial, antifungal and DNA-damaging activities of 3-amino, 3-acylamino, 3-alkylaminoacylamino derivatives

The in vitro evaluation of antibacterial, antifungal and DNA-damaging properties of some 3-amino, 3-acylamino and 3-alkylaminoacylamino derivatives of 1,2-benzisothiazole is described. Compounds 1-8, 38 and 48 exhibited a selective antifungal activity while the other compounds did not show any significative activity. None of the compounds tested turned out to have any genotoxic properties.

Migration of distal catheter of the ventriculo-mitral shunt into the right atrium. Case report

A rare case of migration of a distal catheter from a ventriculo-atrial shunt into the right atrium is presented. The employed surgical procedure for the removal of the foreign body from the heart is briefly discussed.