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Background: Radiation-induced spinal cord cavernous malformations (CMs) are rare pathologies compared with radiation-induced cerebral CMs. We present a case of a radiation-induced spinal cord CM developed 31 years after radiation therapy for medulloblastoma., Case Description: A 37-year-old man developed a symptomatic spinal hemorrhagic lesion 31 years after radiation therapy for medulloblastoma. Magnetic resonance imaging revealed an intramedullary cystic lesion with a fluid-fluid level in the C7 area. Surgery was performed leading to an unclear diagnosis. Two years later, the patient had a relapse and underwent a second operation, allowing a definitive diagnosis of radiation-induced spinal cord CM. This is believed to be the second case of de novo intramedullary CM formation following spinal radiation therapy for medulloblastoma., Conclusions: Radiation-induced spinal cord CMs should be recognized as a possible late adverse effect in patients treated with radiation therapy for medulloblastoma., (Copyright © 2020 Elsevier Inc. All rights reserved.)

An inexpensive, simple, and high-activity catalyst preparation method has been introduced in this work. Pt and RuO x catalysts were fabricated by soaking inexpensive graphite electrodes (pencil-lead graphite rod: PGR) in catalyst precursor solutions and using a simple flame-annealing method, which results in lower amount of Pt and RuO x catalyst layers. From X-ray photoelectron spectroscopy and near-edge X-ray absorption fine structure analysis, it has been found that platinum and ruthenium were deposited as zero-valence metal (Pt) and oxide (RuO x ), respectively. Catalytic activities of Pt/PGR and RuO x /PGR for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) were evaluated using neutral 1 M Na 2 SO 4 aqueous electrolyte, respectively. Although HER and OER currents using PGR without catalysts were -16 mA cm -2 (at -1.5 V vs Ag/AgCl) and +20 mA cm -2 (at +2.0 V vs Ag/AgCl), they were improved to -110 and +80 mA cm -2 with catalysts (Pt and RuO x ), respectively. Such an inexpensive and rapid catalyst electrode preparation method on PGR using flame-annealing is a very significant method in the initial catalyst activity evaluation requiring a large amount of trial and error., Competing Interests: The authors declare no competing financial interest., (Copyright © 2020 American Chemical Society.)

Background: Cerebral venous thrombosis is rare and an uncommon cause of stroke and has diverse etiologies and varied clinical presentations. Here, we report 2 cases of deep cerebral venous thrombosis., Case Description: A 64-year-old woman presented with cerebral venous thrombosis due to a hypercoagulable state associated with ovarian tumor. On initial fluid-attenuated inversion recovery and diffusion-weighted imaging, there was a diffuse high-intensity lesion in the bilateral thalamus. Computed tomography angiography showed occlusion of the straight sinus, vein of Galen, and internal cerebral vein. Single-photon emission computed tomography showed decreased cerebral blood flow in the bilateral thalamus. After 3 weeks of factor Xa inhibitor therapy, the patient's consciousness gradually improved and eventually became clear enough to leave the hospital. She had no neurological deficit. Another patient was a 47-year-old man who presented with splitting headache and drowsiness. Magnetic resonance venography confirmed deep thrombosis of the vein of Galen. He completely recovered after 4 weeks of factor Xa inhibitor therapy., Conclusions: This study reports on 2 rare cases of decreased cerebral blood flow in the bilateral thalamus on single-photon emission computed tomography, which improved following the administration of factor Xa inhibitor., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Multiple imputation (MI) is one of the most popular methods to deal with missing data, and its use has been rapidly increasing in medical studies. Although MI is rather appealing in practice since it is possible to use ordinary statistical methods for a complete data set once the missing values are fully imputed, the method of imputation is still problematic. If the missing values are imputed from some parametric model, the validity of imputation is not necessarily ensured, and the final estimate for a parameter of interest can be biased unless the parametric model is correctly specified. Nonparametric methods have been also proposed for MI, but it is not so straightforward as to produce imputation values from nonparametrically estimated distributions. In this paper, we propose a new method for MI to obtain a consistent (or asymptotically unbiased) final estimate even if the imputation model is misspecified. The key idea is to use an imputation model from which the imputation values are easily produced and to make a proper correction in the likelihood function after the imputation by using the density ratio between the imputation model and the true conditional density function for the missing variable as a weight. Although the conditional density must be nonparametrically estimated, it is not used for the imputation. The performance of our method is evaluated by both theory and simulation studies. A real data analysis is also conducted to illustrate our method by using the Duke Cardiac Catheterization Coronary Artery Disease Diagnostic Dataset., (Copyright © 2018 John Wiley & Sons, Ltd.)

The CH 3 NH 3 PbI 3 perovskite solar cells have been fabricated using three-porous-layered electrodes as, 〈glass/F-doped tin oxide (FTO)/dense TiO 2 /porous TiO 2 -perovskite/porous ZrO 2 -perovskite/porous carbon-perovskite〉 for light stability tests. Without encapsulation in air, the CH 3 NH 3 PbI 3 perovskite solar cells maintained 80% of photoenergy conversion efficiency from the initial value up to 100 h under light irradiation (AM 1.5, 100 mW cm -2 ). Considering the color variation of the CH 3 NH 3 PbI 3 perovskite layer, the significant improvement of light stability is due to the moisture-blocking effect of the porous carbon back electrodes. The strong interaction between carbon and CH 3 NH 3 PbI 3 perovskite was proposed by the measurements of X-ray photoelectron spectroscopy and X-ray diffraction of the porous carbon-perovskite layers.

Object: Of the intracranial germ cell tumors (IGCTs), 10% of germinomas and most nongerminomatous tumors remain refractory to multimodality therapy. The authors investigated the mutation of c-kit and the expression of its product KIT in IGCTs to identify tumors susceptible to imatinib mesylate, a synthetic agent targeting KIT., Methods: The authors investigated 26 IGCTs, including 13 germinomas, five mixed germ cell tumors (MGCTs), four immature teratomas (ITs), and two each of yolk sac tumors and choriocarcinomas. These tumors were examined for the expression of KIT and CD34 by immunohistochemical analysis, and for mutations in exons 2, 8 to 11, 13, and 17 of c-kit. Strong KIT expression was found in the cell membrane of germinomas (100%) and germinomatous cells of MGCTs (80%), as well as in the cytoplasm of epithelial and smooth-muscle cells of ITs. The membranous expression of CD34 was found in the nongerminomatous tumor cells and the chondrocytes of MGCTs (60%), ITs (100%), and a choriocarcinoma (50%), but not in germinomas and germinomatous cells. A total of five missense mutations distributed in exons 2, 11, 13, and 17 of c-kit were detected in three (23%) of the 13 germinomas. The novel mutations E73K, T96M (both in exon 2), and A636V (in exon 13) were detected in a single tumor. The presence or type of c-kit mutation was not correlated with patient prognosis., Conclusions: Immunohistochemical analysis of KIT expression is useful for the diagnosis of germinoma. This study may help in clarifying the pathogenesis of IGCTs and in identifying tumors susceptible to drugs targeting KIT.

Object: Medulloblastoma is a malignant cerebellar tumor of childhood and is difficult to cure due to frequent cerebrospinal fluid dissemination. Amplification of the c-myc gene (4%) and messenger (mRNA) overexpression (50%) are known to be adverse prognostic indicators. Because mRNA overexpression cannot be explained by gene amplification alone, mechanisms other than gene amplification are postulated. Molecules on the Wnt signal pathway in primary tumors were examined., Methods: Immunohistochemical and cytogenetic examinations of beta- and gamma-catenin, c-myc, N-myc, and cyclin D1 in 24 primary medulloblastomas were conducted, and their clinical relevance was evaluated. Cytoplasmic/membranous staining of beta- and gamma-catenin was detected in 19 (79%) and nine (37%) cases, respectively, and nuclear expression of cyclin D1 and c-myc was detected in six (25%) and 21 (83%) cases, respectively. The expression levels of gamma-catenin in Western blot analysis and immunohistochemistry were similar. By differential polymerase chain reaction, c-myc and N-myc were amplified separately in two large cell/anaplastic medulloblastomas. No cyclin D1 amplification, or beta- or gamma-catenin mutations were found. Kaplan-Meier analysis revealed no dissemination at diagnosis (Chang Grade M0) and gamma-catenin expression was correlated with good prognosis (p = 0.0002 and 0.003, respectively). Expression of gamma-catenin was also significant in the M0 group (p = 0.022). Expression of cyclin D1 showed a trend toward adverse outcome (p = 0.057) and all patients in whom cyclin D1 expression was found died of disease., Conclusions: Expression of gamma-catenin is of great prognostic value and its immunohistochemistry may be useful for further stratification of treatment. Cyclin D expression may have the potential to be an adverse prognostic indicator.

We report a case of Cushing disease whose microadenoma was not identified by MRI with dynamic study and whose sphenoid sinus was conchal in type. Venous sampling test in the bilateral inferior petrosal sinus demonstrated ACTH hypersecretion on the right side. The patient underwent transsphenoidal surgery. A poorly pneumatized sphenoid sinus was drilled effectively, guided by the STEALTH navigation system. After the first operation, the patient's serum ACTH concentration was still high, suggesting that tumor removal was incomplete. Then she underwent the second operation and the residual tumor was completely removed with the assistance of the STEALTH navigation system again. Postoperatively, her serum ACTH concentration dropped below 5 pg/ml. In this case, inferior petrosal sinus sampling was extremely helpful for the diagnosis of Cushing disease, and operations were able to be performed safely using the neuronavigation system in drilling of the incompletely pneumatized sphenoid sinus.

The authors report a case of the rhabdoid predisposition syndrome (RPS) secondary to a germline hSNF5/INI1 mutation, whose brain tumor was originally unclassified but finally diagnosed as an atypical teratoid/rhabdoid tumor (AT/RT) by molecular analysis. A 7-month-old infant presented with hydrocephalus secondary to a huge pineal tumor and subsequently developed a renal rhabdoid tumor. The histology of the brain tumor was initially undetermined; however, an AT/RT was strongly suspected because of her clinical course. Mutational screening of the hSNF5/INI1 gene by heteroduplex and direct sequence analysis detected a missense mutation at codon 53 (CGA --> TGA, arginine --> stop) in both tumors, as well as in normal tissue of the kidney. Polymerase chain reaction (PCR)-based microsatellite analysis showed in both tumors allelic loss on chromosome arm 22q to which the hSNF5/INI1 gene maps. c-myc amplification was examined by differential PCR but not detected. Histologic review of the brain tumor by immunohistochemistry confirmed focal expression of epithelial membrane antigen and smooth muscle actin. These findings suggest that the brain tumor was really an AT/RT as a component of RPS secondary to a germline hSNF5/INI1 mutation. The present mutation has never been reported in the literature.

Metastasis of systemic cancer to intracranial tumors is a rare event. The authors report a case of 49-year-old woman with such occurrence, whose breast cancer metastasized to a preexisting parasagittal meningioma at a postoperative interval of 1.5 years. She was admitted to our hospital because of progressive right hemiparesis. Magnetic resonance imaging revealed newly emerged perifocal edema and inhomogeneous contrast enhancement of the meningioma. High choline/creatine ratio and lactate/lipid peak on proton magnetic resonance spectroscopy suggested malignancy. She underwent a tumor resection, and pathologic examination revealed intratumoral metastasis of breast cancer in a transitional meningioma. Immunoreactivity of E-cadherin was detected in both meningioma and breast cancer cells. It is suggested that abrupt appearance of symptoms, inhomogeneous enhancement, and perifocal edema of meningioma is a sign of intratumoral metastasis from systemic cancers.