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Objective: The identification of tumor infiltrated brain tissue during neurosurgical resection is still a major challenge in the field of neurooncology. The challenge is aggravated by the infiltrative growth of certain tumor types, like glioblastoma multiforme, which leads to ill-defined tumor borders. [for full text, please go to the a.m. URL]

Objective: Optical coherence tomography (OCT) is a non-invasive technique that can capture 3-dimensional images with micrometer resolution. Prior studies of several groups have shown that OCT has the potential to detect glial tumors by evaluating changes in tissue structure and/or optical properties[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

BackgroundTarget 3.2 of the United Nations Sustainable Development Goals (SDGs) is to reduce neonatal mortality. In low-income and middle-income countries (LMICs), the District Health Information Software, V.2 (DHIS2) is widely used to help improve indicator data reporting. There are few reports on its use for collecting neonatal hospital data that are of increasing importance as births within facilities increase. To address this gap, we investigated implementation experiences of DHIS2 in LMICs and mapped the information flow relevant for neonatal data reporting in Kenyan hospitals.MethodsA narrative review of published literature and policy documents from LMICs was conducted. Information gathered was used to identify the challenges around DHIS2 and to map information flows from healthcare facilities to the national level. Two use cases explore how newborn data collection and reporting happens in hospitals. The results were validated, adjusted and system challenges identified.ResultsLiterature and policy documents report that DHIS2 is a useful tool with strong technical capabilities, but significant challenges can emerge with the implementation. Visualisations of information flows highlight how a complex, people-based and paper-based subsystem for inpatient information capture precedes digitisation. Use cases point to major challenges in these subsystems in accurately identifying newborn deaths and appropriate data for the calculation of mortality even in hospitals.ConclusionsDHIS2 is a tool with potential to improve availability of health information that is key to health systems, but it critically depends on people-based and paper-based subsystems. In hospitals, the subsystems are subject to multiple micro level challenges. Work is needed to design and implement better standardised information processes, recording and reporting tools, and to strengthen the information system workforce. If the challenges are addressed and data quality improved, DHIS2 can support countries to track progress towards the SDG target of improving neonatal mortality.

Neurofibromatosis type 1 (NF1) is a tumor predisposition disease. Multiple neurofibromas are among the characteristic tumors of NF1. The report describes the diagnosis and treatment of a large spinal neurofibroma in a NF1 patient. The tumor showed a striking pigmentation and was diagnosed as pigmented (melanotic) neurofibroma. The distinction between this rare tumor variant and other pigmented tumors, especially malignant melanoma, is of primary importance. Die Neurofibromatose Typ 1 (NF1) ist eine Tumor-Prädispositionserkrankung. Multiple Neurofibrome zählen zu den charakteristischen Tumoren der NF1. Der Bericht beschreibt Diagnose und Behandlung eines ausgedehnten Neurofibroms des Rückens bei einem NF1 Patienten. Intraoperativ zeigte sich eine auffällige Pigmentierung des Tumors, der histologisch als pigmentiertes (melanotisches) Neurofibrom eingeordnet wurde. Die Unterscheidung dieser seltenen Variante des Neurofibroms von anderen pigmentbildenden Tumoren, insbesondere dem malignen Melanom, ist von vorrangiger Bedeutung.

Aim: Brain clusterin is known to be associated with the amyloid‐β deposits in Alzheimer's disease (AD). We assessed the distribution of clusterin immunoreactivity in cerebrovascular disorders, particularly focusing on white matter changes in small vessel diseases. Methods: Post‐mortem brain tissues from the frontal or temporal lobes of a total of 70 subjects with various disorders including cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cerebral amyloid angiopathy (CAA) and AD were examined using immunohistochemistry and immunofluorescence. We further used immunogold electron microscopy to study clusterin immunoreactivity in extracellular deposits in CADASIL. Results: Immunostaining with clusterin antibodies revealed strong localization in arterioles and capillaries, besides cortical neurones. We found that clusterin immunostaining was significantly increased in the frontal white matter of CADASIL and pontine autosomal dominant microangiopathy and leukoencephalopathy subjects. In addition, clusterin immunostaining correlated with white matter pathology severity scores. Immunostaining in axons ranged from fine punctate deposits in single axons to larger confluent areas with numerous swollen axon bulbs, similar to that observed with known axon damage markers such as non‐phosphorylated neurofilament H and the amyloid precursor protein. Immunofluorescence and immunogold electron microscopy experiments showed that whereas clusterin immunoreactivity was closely associated with vascular amyloid‐β in CAA, it was lacking within the granular osmiophilic material immunolabelled by NOTCH3 extracelluar domain aggregates found in CADASIL. Conclusions: Our results suggest a wider role for clusterin associated with white matter damage in addition to its ability to chaperone proteins for clearance via the perivascular drainage pathways in several disease states.

Neurofibromatosis type 1 (NF1) is an autosomal dominant disease that shows high penetrance with a wide variability in the phenotype. Prepubertal enlargement of the breast in male subjects affected by this condition is well known, but rarely reported. The present case report describes diagnosis and therapy of unilateral gynaecomastia in a toddler showing integumental stigmata of NF1. Furthermore, the report provides a brief review of the literature concerning this finding in NF1. According to this review, the present case appears to be one of the youngest NF1-affected males affected by gynaecomastia that has been reported. Die Neurofibromatose Typ 1 (NF1) ist eine autosomal dominante Erbkrankheit mit hoher Penetranz bei breiter Variabilität des Phänotyps. Präpubertäre Brustvergrößerungen bei männlichen NF1-erkrankten Patienten sind bekannt, aber sehr selten publiziert. Der vorliegende Fallbericht beschreibt Diagnose und Therapie der unilateralen Gynäkomastie eines Kleinkindes mit klinischen Stigmata der NF1 und bietet eine Übersicht bisheriger Fälle mit ähnlichem Erscheinungsbild. Nach Lage der bisher veröffentlichten Berichte handelt es sich in diesem Fall um eine der bisher frühesten Manifestationen einer Gynäkomastie bei NF1.

Introduction: Even though less than 1% of Alzheimer’s disease (AD) is of hereditary origin, FAD is used as a reference for its natural history and as a framework for the development of animal models and therapies for the disease. Given that all known mutations for FAD occur in proteins involved[for full text, please go to the a.m. URL], 60th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN)