Articles you may be interested inHigh-speed imaging upgrade for a standard sample scanning atomic force microscope using small cantilevers Rev. Sci. Instrum. 85, 093702 (2014); 10.1063/1.4895460Piezoelectric bimorph-based scanner in the tip-scan mode for high speed atomic force microscope Rev. Sci. Instrum. 84, 083706 (2013);Atomic force microscopy improved resolution employing large scanning speeds: Effects of the double relaxation time Rev.We have developed a new atomic force microscope ͑AFM͒, with a z scanner independent of the xy scanner. Unlike conventional AFM systems, our xy scanner moves only the sample in the xy plane, while the z scanner controls the AFM probe along the z axis. The xy scanner is a single module parallel-kinematics flexure stage that guarantees high orthogonality and minimum out-of-plane motion. The z scanner is a one-dimensional flexure stage with negligible out-of-axis motion. Separating the z scanner from the xy scanner practically eliminates the x -z cross coupling problem inherent in conventional AFMs. Furthermore, the z servo response is no longer limited by the xy scanner characteristics, allowing us to make full use of our high performance z scanner. Our system uses the laser beam bounce detection method, and only the cantilever and the photodetector are mounted on the z scanner to realize a lightweight probing unit. We have devised a unique design such that the photodetector signal measures only the cantilever deflection and not the z-scanner motion. Our new AFM provides fast z servo response and high scan accuracy.
Background Leptomeningeal carcinomatosis (LMC) is frequently associated with hydrocephalus, which quickly devastates the performance of the patient. Cerebrospinal fluid (CSF) shunt is a widely accepted treatment of choice, but the clinical outcomes in patients with LMC are not well studied. This study aimed to examine the efficacy of a CSF shunt in patients with LMC. Methods Seventy patients with LMC confirmed by cytology or magnetic resonance imaging (MRI) underwent ventriculoperitoneal (VP) or lumboperitoneal (LP) shunt surgery. We retrospectively analyzed the clinical characteristics of patients, symptom improvement after the shunt, rate of complications associated with the surgery, and overall survival. Results Fifty-five patients had systemic cancer as a preceding disease, including lung cancer (45), breast cancer (6), and others (4). Primary brain tumors were mainly glioma (7) and medulloblastoma (5). Fifty-one patients had VP shunt, and 19 had LP shunt. After surgery, preoperative symptoms “improved” in 35 patients (50%) and were “normalized” in 24 of those patients (34%). Shunt malfunction occurred in eight patients, and infection occurred in eight patients. Seventeen patients underwent revision due to infection, shunt malfunction, or over-drainage. There were no complications associated with peritoneal seeding during a median follow-up of 3.3 months after surgery. The median overall survival was 8.7 months (95% confidence interval, 6.0–11.4) from LMC diagnosis and 4.1 months from shunt surgery. Conclusion VP or LP shunt is effective for patients with hydrocephalus from LMC in terms of symptom improvement and prolonging of overall survival with an acceptable rate of procedure-related complications. Trial registration This study was approved by the Institutional Review Board (IRB) of the National Cancer Center (retrospectively registered, NCC2018-0051 ).
Pyogenic vertebral osteomyelitis (PVO) may result in neurological deficits and sequelae, so early diagnosis and appropriate treatment are critical. Many previous studies on PVO exist, but our paper has aimed to comprehensively summarize the clinical aspects of PVO. Through review of the vast literature on the clinical research of PVO an overview of the clinical characteristics, diagnostic methods, treatment and prognosis is provided.
Leptomeningeal metastasis (LM) has a poor prognosis and is difficult to diagnose and predict the response of treatment. In this study, we suggested that the monitoring of changes in the concentration of extracellular vesicles in cerebrospinal fluid could help diagnose or predict outcomes for LM. We measured nanoparticles in 472 human cerebrospinal fluid (CSF) from patients including LM with both Dynamic Light Scattering (DLS) and Nanoparticle Tracking Analysis (NTA) after two-step centrifugations. NTA revealed that the concentration of CSF nanoparticles was significantly increased in LM compared to other groups (2.80 × 108 /mL vs. 1.49 × 108 /mL, p < 0.01). Changes in NTA-measured nanoparticles concentration after intra-CSF chemotherapy were further examined in 33 non-small cell lung cancer patients with LM. Overall survival was longer for patients with increased EV than the others (442 vs. 165 days, p < 0.001). Markers of extracellular vesicles (CD9/CD63/CD81) significantly decreased in the EV-decreased group. MicroRNA-21 expression decreased in this favorable prognostic group, whereas it increased in the EV-decreased group. In conclusion, the elevated concentration of extracellular vesicles in cerebrospinal fluid in patients with LM may be a predictive marker for survival duration. Moreover, EV changes combined with microRNA-21 might be a biomarker for monitoring the efficacy of intracranial chemotherapy of LM in non-small cell lung cancer patients.
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