The results reflected positively on the patients' awake and outpatient surgery experience, but there were some areas that require improvement, specifically perioperative pain control and postoperative care. These insights on patients' perspectives can lead to better delivery of care, and ultimately, improved health outcomes.

The acetyltransferase Tip60/Kat5 acetylates both histone and non-histone proteins, and is involved in a variety of biological processes. By acetylating p53, Tip60 controls p53-dependent transcriptional activity and so is implicated as a tumor suppressor. However, many breast cancers with low Tip60 also show p53 mutation, implying that Tip60 has a tumor suppressor function independent of its acetylation of p53. Here, we show in a p53-null mouse model of sporadic invasive breast adenocarcinoma that heterozygosity for Tip60 deletion promotes mammary tumorigenesis. Low Tip60 reduces DNA repair in normal and tumor mammary epithelial cells, both under resting conditions and following genotoxic stress. We demonstrate that Tip60 controls homologous recombination (HR)-directed DNA repair, and that Tip60 levels correlate inversely with a gene expression signature associated with defective HR-directed DNA repair. In human breast cancer data sets, Tip60 mRNA is downregulated, with low Tip60 levels correlating with p53 mutations in basal-like breast cancers. Our findings indicate that Tip60 is a novel breast tumor suppressor gene whose loss results in genomic instability leading to cancer formation.

Traumatic neuroma in continuity (NIC) results in profound neurological deficits, and its management poses the most challenging problem to peripheral nerve surgeons today. The absence of a clinically relevant experimental model continues to handicap our ability to investigate ways of better diagnosis and treatment for these disabling injuries. Various injury techniques were tested on Lewis rat sciatic nerves. Optimal experimental injuries that consistently resulted in NIC combined both intense focal compression and traction forces. Nerves were harvested at 0, 5, 13, 21, and 65 days for histological examination. Skilled locomotion and ground reaction force (GRF) analysis were performed up to 9 weeks on the experimental (n=6) and crush-control injuries (n=5). Focal widening, disruption of endoneurium and perineurium with aberrant intra- and extrafascicular axonal regeneration and progressive fibrosis was consistently demonstrated in 14 of 14 nerves with refined experimental injuries. At 8 weeks, experimental animals displayed a significantly greater slip ratio in both skilled locomotor assessments, compared to nerve crush animals (p<0.01). GRFs of the crush- injured animals showed earlier improvement compared to the experimental animals, whose overall GRF patterns failed to recover as well as the crush group. We have demonstrated histological features and poor functional recovery consistent with NIC formation in a rat model. The injury mechanism employed combines traction and compression forces akin to the physical forces at play in clinical nerve injuries. This model may serve as a tool to help diagnose this injury earlier and to develop intervention strategies to improve patient outcomes.

The median nerve in the sheep forelimb is a reproducible and reliable model for assessing regeneration through long peripheral nerve grafts.

Doctor–patient communication in the setting of a life-threatening illness poses considerable challenges. This study aimed to determine the information needs of a subset of neurosurgical patients. Qualitative case study methodology was used. Twenty-five semi-structured interviews were conducted with ambulatory adult patients who had undergone surgery for a benign brain tumor, arteriovenous malformation, or unruptured aneurysm. Interviews were digitally audio recorded and transcribed, and the data subjected to thematic analysis. Six overarching themes emerged from the data: (1) the amount of information patients want varies; (2) the type of information needed is not limited to information about treatment options and risks; (3) patients engage in independent information seeking for a variety of reasons; (4) patients consider compassion from their surgeon as important; (5) direct communication with the surgeon post-operatively is very important; and (6) patients’ information needs are greatest post-operatively. Many patients felt that the amount and quality of information they received was not sufficient, particularly regarding post-operative recovery and long-term life issues, leading many to do their own research. The findings from this study emphasize the need for improved communication with patients so they can participate meaningfully in choices about their treatment, give a truly informed consent, and effectively participate in their own recovery.

(2012) Volume specific response criteria for brain metastases following salvage stereotactic radiosurgery and associated predictors of response, Acta Oncologica, 51:5, 629-635,

Background Gamma Knife stereotactic radiosurgery (GKSRS) is an outpatient radiation therapy procedure in which a highly focused dose of radiation is delivered in a single fraction. It is used to treat a variety of well-demarcated intracranial lesions, including brain tumors. This study aims to explore patients' perspectives of the GKSRS process and the various stages involved. Methods Qualitative research methodology was used. Three semi-structured, open-ended interviews were conducted with 29 participants, who were ambulatory adult patients who underwent GKSRS between August 2007 and August 2008. Results Seven overarching themes emerged from the data: (1) patients were satisfied with the overall treatment experience; (2) the majority of patients had a good knowledge of GKSRS; (3) the quality and amount of patient education were adequate; (4) process expectations were largely met; (5) most patients prioritized outcome over process; (6) most patients had a realistic expectation of outcomes; and (7) pain and anxiety were important issues. Conclusions The study results reflected positively on the GKSRS process, but there were some areas identified that require improvement, specifically the referralconsultation process and the management of procedural pain. These insights on the patients' perspectives can lead to better delivery of care and ultimately, improved health outcomes.

268Carpal tunnel syndrome (CTS) and ulnar nerve entrapment at the elbow are two of the most common entrapment neuropathies seen in the adult population. These conditions are initially treated by conservative management but some patients eventually require surgery consisting of appropriate nerve decompression. Since these procedures are fast and safe, they are usually performed under local anesthesia and on an outpatient basis, with minimal morbidity. However, very few studies [1][2][3] have been done to explore patients' thoughts and feelings about their condition, the surgical procedure itself, and the postoperative results, including level of satisfaction and perceived disability. This study aimed to discover patients' perceptions about carpal tunnel and ulnar nerve decompression surgery by utilizing qualitative research methodology in the form of interviews with patients.Prior studies 4,5 have shown that there may be dissociation in the assessment of the severity of disease and functional outcome ABSTRACT: Background: Carpal tunnel syndrome and ulnar nerve entrapment at the elbow are the most common entrapment neuropathies seen in adults. Surgery for nerve decompression is a safe and effective treatment option, and is usually performed under local anesthesia and as an outpatient procedure. This study aimed to explore patients' satisfaction and other aspects of the overall experience with this type of surgery. Methods: Qualitative research methodology was used. Semi-structured, open-ended interviews were conducted with 30 adult patients who had undergone carpal tunnel release or ulnar nerve decompression at the elbow 6-24 months prior. Interviews were digitally audio recorded and transcribed, and the data subjected to thematic analysis. Results: Four overarching themes emerged from the data: (1) most patients did not perceive their condition to be serious; (2) patients were satisfied with the overall surgical experience; (3) the outcome was more important to patients than the process; and (4) majority of patients had a realistic expectation of outcomes. Conclusions: Patients had a positive experience with carpal tunnel and ulnar nerve decompression surgery, although their level of satisfaction was dependent on the surgical outcome. Areas requiring improvement, specifically information about post-operative care and expectations of recovery, will be implemented in the future care of patients. RÉSUMÉ: Les perceptions des patients concernant la chirurgie de décompression du canal carpien et du nerf cubital. Contexte : Le syndrome du canal carpien et le syndrome de compression du nerf cubital au niveau du coude sont les neuropathies de compression les plus fréquentes chez les adultes. La chirurgie de décompression nerveuse est une option de traitement sûre et efficace, habituellement effectuée sous anesthésie locale en externe. Le but de cette étude était d'explorer la satisfaction des patients ainsi que d'autres aspects de l'expérience globale concernant cette chirurgie. Méthode : Nous avons utilisé une méthode de...