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Proximal posterior inferior cerebellar artery (PICA) aneurysms are surgically challenging due to the high variability in the anatomy of the PICA origin, their deep-seated nature, and their entanglement with the lower cranial nerves. Direct or reconstructive clipping may not be achievable if the aneurysm is large, or dissecting, or exhibits atherosclerosis or calcification.

We present a case of a proximal PICA lateral medullary segment (P2) aneurysm that was successfully cured by trapping the aneurysm and reconstructing the PICA using the PICA-intracranial vertebral artery (PICA-V4) via end-to-side reimplantation bypass with the far lateral approach.

This case demonstrates the feasibility and safety of PICA-V4 reimplantation bypass, especially if the origin of the PICA is highly seated and the intracranial VA, or V4 segment, is long enough and well-exposed supra or under hypoglossal nerves.

This case demonstrates the feasibility and safety of PICA-V4 reimplantation bypass, especially if the origin of the PICA is highly seated and the intracranial VA, or V4 segment, is long enough and well-exposed supra or under hypoglossal nerves.Agaricus bitorquis (Quél.) Sacc. Chaidam (ABSC) is a wild edible fungus uniquely found in the Tibet Plateau. ABSC is rich in polysaccharides that are considered biologically active. This study aimed to determine the feasibility of enhancing exopolysaccharide (EPS) production by ABSC in shake flask culture by supplementing the fermentation medium with anthocyanin extract. Different concentrations of Lycium ruthenicum Murr. (LRM) anthocyanin crude extract were tested on ABSC fermentation. The activity of phosphoglucose isomerase (PGI), phosphoglucose mutase (PGM), and phosphomannose isomerase (PMI), enzymes presumably involved in EPS synthesis by ABSC, was determined. ABSC transcriptomic profile in response to the presence of anthocyanins during fermentation was also investigated. LRM anthocyanin crude extract (0.06 mg/mL) was most effective in increasing EPS content and mycelial biomass (by 208.10% and 105.30%, respectively, P  less then  0.01). The activity of PGI, PGM, and PMI was increased in a medium where LRM anthocyanin extract and its main components (proanthocyanidins and petunia anthocyanin) were added. RNA-Seq analysis showed that 349 genes of ABSC were differentially expressed during fermentation in the medium containing anthocyanin extract of LRM; 93 genes were up-regulated and 256 genes down-regulated. From gene ontology enrichment analysis, differentially expressed genes were mostly assigned to carbohydrate metabolism and signal transduction categories. Collectively, LRM anthocyanins extract positively affected EPS production and mycelial biomass during ABSC fermentation. Our study provides a novel strategy for improving EPS production and mycelial growth during ABSC liquid submerged fermentation.Thin-layer cascades (TLCs) enable algae cultivation at high cell densities, thus increasing biomass yields and facilitating the harvest process. This makes them a promising technology for industrial-scale algal fuel production. Using Life Cycle Assessment (LCA), we calculate the greenhouse gas (GHG) emissions of aviation fuel produced using algal biomass from TLCs. We find that the impact (81 g CO2e per MJ) is lower than that of fuel from algal biomass cultivated in open race way ponds (94 g CO2e). However, neither of the two cultivation systems achieve sufficient GHG savings for compliance with the Renewable Energy Directive II. Seawater desalination in particular dominates the TLC impact, indicating a trade-off between carbon and water footprint. In both cultivation systems, the mixing power and fertilizer consumption present further significant impacts. There is uncertainty in the correlation between mixing power and algal oil yield, which should be investigated by future experimental studies.This study determines the bulk surface water (BSW) dissolved inorganic nutrients of nitrogen (DINi) and phosphate (DIP) during the upwelling season off the east coast of Peninsular Malaysia, South China Sea. BSW samples were analysed for DINi and DIP by using a standard automated colorimetric method. BSW DINi and DIP concentrations varied between 0.11 and 2.55 μM (mean 1.12 ± 0.63 μM), and below detection limit, and 0.29 μM (mean 0.11 ± 0.08 μM), respectively. The spatial distribution of higher concentrations between DINi and DIP was distinct. However, the highest concentrations of DINi and DIP were mostly recorded in the month of peak upwelling (July and August), where colder BSW temperatures were also encountered during field sampling. This study provides new evidence on the presence of BSW nutrients of DINi and DIP during upwelling season peak in July and August before their decline in September.

To compare the characteristics and outcomes of rectal cancer patients with local recurrence at a perianastomotic site (PA), a surgical field (SF) site, or in lateral lymph nodes (LLN).

A total of 114 consecutive patients who underwent surgery for recurrent, non-metastatic rectal cancer at a single comprehensive cancer center between 1997 and 2012 were grouped on the basis of radiographic assessment of type of recurrence PA, 76 (67%) patients; SF, 25 (22%) patients; LLN, 13 (11%) patients. Demographic, clinical, and pathological features were compared between the three groups, as were disease-free survival (DFS) and overall survival (OS).

Recurrence type was associated with positive circumferential margin in the primary resection (PA, 4 [6%]; SF, 4 [19%]; LLN, 3 [25%]; P = 0.027), prior neoadjuvant therapy for the primary tumor (PA, 57 [75%]; SF, 18 [72%]; LLN, 4 [31%]; P = 0.007), and location of the primary tumor in the upper rectum (PA, 33 [45%]; SF, 5 [23%]; LLN, 1 [8%]; P < 0.001). buy AOA hemihydrochloride Patients with PA had longer median DFS (PA, 5.1years; SF, 1.5years; LLN, 1.2years; P = 0.036). There was a non-significant trend toward longer OS and higher rates of R0 resection for PA.

Type of recurrence after salvage surgery for locally recurrent rectal cancer is associated with longer DFS in patients with PA recurrence.

Type of recurrence after salvage surgery for locally recurrent rectal cancer is associated with longer DFS in patients with PA recurrence.