and management of these patients.

Alcohol use disorder (AUD) affects nearly 5% of the world’s adult population. Despite treatment, AUD often manifests with relapse to binge drinking, which has been associated with corticostriatal hypersynchrony involving the nucleus accumbens (NAc).

A modified “Drinking in the Dark” protocol was used to provoke binge-like alcohol drinking. We implemented Coordinated Reset Stimulation (CRS), a computationally designed, spatio-temporal stimulation algorithm, to desynchronize abnormal neuronal activity via a deep brain stimulation (DBS) electrode in the NAc of mice exhibiting binge-like alcohol drinking. CD532 datasheet Integral CRS charge injected would be 2.5% of that of conventional high-frequency DBS.

NAc CRS delivery during only the initial phase of exposure to alcohol and prior to the exposure (but not during) significantly reduced binge-like drinking without interfering with social behavior or locomotor activity.

NAc CRS ameliorates binge-like alcohol drinking and preliminarily exhibits sustained aftereffects that are suggestive of an unlearning of hypersynchrony.

NAc CRS ameliorates binge-like alcohol drinking and preliminarily exhibits sustained aftereffects that are suggestive of an unlearning of hypersynchrony.

To present the outcomes of endoscopic endonasal surgery for giant pituitary adenomas and discuss the extent of resection to minimize morbidity and mortality.

We retrospectively reviewed medical records of 44 patients with giant pituitary adenomas who underwent endoscopic endonasal surgery. Clinical presentation, laboratory results, imaging studies, clinical outcomes, extent of resection, and complications were collected and analyzed. Factors affecting long-term outcome according to surgical technique were identified and analyzed.

Radical resection (RR) was defined as either gross total resection or near-total resection (90%-100% of the tumor). There were 28 patients (63.6%) who underwent RR, 10 patients (22.7%) who underwent subtotal resection, and 6 patients (13.6%) who underwent partial resection. Visual improvement was achieved in 27 patients (81.8%). Thirteen patients (72.2%) with pituitary dysfunction had improvement in at least 1 preoperative endocrinological dysfunction. RR rates for dumbbell and multilobular tumors were 44.4% and 28.6%, respectively. Surgical complications were observed in 14 (31.8%) patients. Major vascular injury occurred in 3 patients (6.8%). Mean follow-up period was 38.5 months (range, 1-70 months). No patients with RR had recurrence or residual tumor progression. Ten patients (22.7%) received adjuvant radiation therapy after resection. Two patients were reoperated on for tumor regrowth, and 3 patients (including the 2 patients with tumor regrowth) were lost to follow-up.

Long-term follow-up results and low recurrence rate of tumors indicate that RR is effective to decrease morbidity and mortality.

Long-term follow-up results and low recurrence rate of tumors indicate that RR is effective to decrease morbidity and mortality.Despite numerous clinical series, consistent karyotype-phenotype correlations for Turner syndrome have not been established, although a lower level of 45,X is generally thought to be associated with a milder phenotype. This limits personalized counseling for women with 45,X/46,XX mosaicism. To better understand the phenotypic spectrum associated with various levels of 45,X/46,XX mosaicism, we compared patients evaluated in the Massachusetts General Hospital Turner Syndrome Clinic to determine if cardiac, renal, and thyroid abnormalities correlated with the percentage of 45,X cells present in a peripheral blood karyotype. of the 118 patients included in the study, 78 (66%) patients had non-mosaic 45,X and 40 (34%) patients had varying levels of 45,X/46,XX mosaicism. Patients with ≤70% 45,X compared with those with >70% 45,X had a significantly lower frequency of cardiac and renal anomalies. The presence of hypothyroidism was somewhat lower for the ≤70% 45,X group, but was not statistically significant. Supplemental tissue testing on another tissue type, typically buccal mucosa, was often useful in counseling patients with 45,X mosaicism. Given the modest sample size of patients with varying levels of mosaicism and the variability of Turner syndrome abnormalities, we hope this preliminary study will inspire a multicenter collaboration, which may lead to modification of clinical guidelines. Because several patients with ≤70% 45,X were ascertained from perinatal care referrals, we still advise women with 45,X mosaicism pursuing pregnancy to receive standard Turner syndrome cardiac surveillance. There is an opportunity to personalize counseling and surveillance for patients based on percentage of 45,X cells on chromosome analysis.

Reporting a rare case of a teenage girl, with a bizarre clinical presentation of a benign breast condition, that too is uncommon at her age.

A 14-year-old pre-menarche girl presented with a rapidly progressing lump that involved the entire breast within 3 months. It was associated with ulceration of the overlying skin along with destruction of the nipple-areola complex.

During the pre- operative workup, a neoplastic etiology was suspected, but post- operative histopathology revealed it to be giant juvenile fibroadenoma.

This case emphasizes on the benign character of breast masses in the adolescent age group. Despite the massive volume and appearance, the opportunity of a conservative surgical approach should be sought.

This case emphasizes on the benign character of breast masses in the adolescent age group. Despite the massive volume and appearance, the opportunity of a conservative surgical approach should be sought.

Thickeners are frequently used in various foods, including ice cream and sauces, to impart viscosity. Generally, viscous foods have some flavor (smell and taste). In this study, we examined the effects of flavor on the oral perception and palatability of viscosity in humans.

Viscous fluids were prepared by adding the commercial thickener Tsururinko® (0.5 and 3.0%) to water and apple juice, which were used as the control and flavor fluids, respectively. The viscosity and palatability perception of the test fluids were evaluated in nine healthy volunteers using a visual analog scale. In the other seven volunteers, fluid viscosities were measured before and after spitting following retention in the mouth for 5s to investigate the dilution of viscous fluids by flavor-stimulated saliva.

With 1.5% Tsururinko®, there was no difference between the physical viscosity of water and apple juice, but the perceived viscosity of apple juice was significantly lower than that of water. With 3.0% Tsururinko®, the viscosity of apple juice was significantly higher than that of water, but the perceived viscosities did not differ significantly.