3-D reconstructed magnetic resonance imaging in localization of subdural EEG electrodes. Case illustration

We report an illustrative case of presurgical evaluation for epilepsy surgery, where the three-dimensional reconstructed magnetic resonance imaging played a pivotal role in determining the exact location of the subdural strip electrodes in temporomesial area. The tip of one the frontal strip electrodes was actually recording the temporopolar ictal activity. This contributed conclusively to the decision for surgical treatment and to the excellent outcome.     

Day-case tonsillectomy in children: parental attitudes and consultation rates

OBJECTIVE: In Europe, the day-case tonsillectomy rate in children is slowly increasing, but whether parents really want this rapid discharge of their child is questionable. The fear is that aftercare might fall solely on community care. The aim of this prospective study was to introduce pediatric day-case tonsillectomy to our hospital and to determine parents' attitudes to this procedure. The other interest centered on consultation rates within the 2-week recovery period. METHODS: One hundred children aged 3-16 years had day-case tonsillectomy (38) or adenotonsillectomy (62). Peri-operative and post-operative complications were recorded. Parents were phoned the next day and 1-4 months after the operation. Parents' opinions of day-case surgery and consultations with healthcare professionals during the 2-week recovery period were recorded. RESULTS: Ninety children went home the day of the operation. Vomiting was the most frequent complication. No primary hemorrhages occurred. Called the next day, 100% of parents felt that their children were better served spending their first night at home as compared with staying in hospital. Called 1-4 months later, 94.5% of parents still thought this way. In the 2-week recovery period following the tonsillectomy, 13% of patients visited a physician and 17% called for information. These numbers include patients with secondary hemorrhage. If these are excluded, 5% of patients visited a physician and 13% called for advice. Children were taken back to hospital only due to secondary hemorrhage. CONCLUSIONS: Most parents considered day-case tonsillectomy to be suitable for their family. Consultation rates were low. Careful patient selection and adequate pre-operative information are prerequisites for day-case tonsillectomy.     

Candidate susceptibility variants for esophageal squamous cell carcinoma

Esophageal cancer is common worldwide, and often fatal. The major histological subtype is esophageal squamous cell carcinoma (ESCC). ESCC shows familial aggregation and high heritability. Mutations in RHBDF2 cause tylosis, a very rare disorder characterized by high life‐time risk of ESCC, but no other well‐established predisposition genes have been identified. To identify candidate susceptibility variants for ESCC we utilized the Population Information System and the Finnish cancer registry to find study materials by clustering ESCC patients by family name at birth and municipality at birth. We collected archival tissue material and exome sequenced a total of 30 ESCC cases. We prioritized shared, deleterious and rare variants that were significantly enriched in our sample set compared to Finnish and population subset specific controls. Six variants passed filtering, the most frequent being a nonsense mutation in DNAH9 (p.Tyr1573Ter) found in four unrelated patients. DNAH9 has been reported to be frequently lost in ESCC tumors. In this study, one patient's tumor showed loss of the wild type allele of DNAH9 suggesting a tumor suppressive function. A missense variant in GKAP1 was shared by three patients, and missense variants in BAG1, NFX1, FUK, and DDOST by two each. EP300 which has previously been implicated in the genesis of ESCC had a missense variant segregating in three affected individuals in a single family. If validated in independent patient sets, these variants could serve as a tool towards prevention and early diagnosis of ESCC.     

Synthesis of novel pyrazolobenzothiazine 5,5-dioxide derivatives as potent anti-HIV-1 agents

A new series of pyrazolobenzothiazine-based carbohydrazides was prepared in a facile way, starting with commercially available sodium saccharine. The final products were sufficiently characterized by spectroscopic techniques. In addition, compound 5k was confirmed with X-ray crystallography as well. All the compounds were screened for anti-HIV-1 and cytotoxicity activities. Overall, out of 15 compounds, seven exhibited good activity with EC₅₀ values <20 μM. Compounds 5c, 5d, 5g, 5j and 5k appeared as the potent anti-HIV-1 agents with EC₅₀ values <5.0 μM. The structure–activity relationship would facilitate the discovery of new molecules with better profile of HIV inhibition activity.     

Synthesis, antiviral activity, and stability of nucleoside analogs containing tricyclic bases

A series of 3,9-dihydro-9-oxo-5H-imidazo[1,2-A]purine nucleosides (tricylic nucleosides) were synthesized from 9-[4-α-(hydroxymethyl)cyclopent-2-ene-1-α-yl]guanine (CBV) 5, (−)-β-D-(2R,4R)-1,3-dioxolane-guanosine (DXG) 6, 3′-azido-3′-deoxy-guanosine (AZG) 7, and 2′-C-methylguanosine 8. Their in vitro activity against HIV and HCV was evaluated and correlated to their ability to degrade to their purine counterpart.     

Anti-HIV-1 and cytotoxicity studies of piperidyl-thienyl chalcones and their 2-pyrazoline derivatives

A series of 12 new pyrazoline derivatives was prepared from piperidyl chalcones, which in turn were synthesized by condensing 4-piperidin-1-ylbenzaldehyde with diverse acetylthiophenes. The target compounds were characterized by spectroscopic techniques (NMR, IR, MS) and elemental analysis. All the compounds were screened for cytotoxic and anti-HIV-1 activities. Compounds 1c, 1g, 1j, 2a, 2c, 2e, 2g, and 2k demonstrated potential anti-HIV activity but were cytotoxic except for 2e and 2k, which displayed no cytotoxicity in primary human cells. Bioassay results show that the type and positions of the substituents seem to be critical for their cytotoxic and anti-HIV-1 activities.     

Melkersson-Rosenthal syndrome.

OBJECTIVES: To study characteristics of Melkersson-Rosenthal syndrome (MRS) patients with facial palsy (FP) and differences in patients treated at the Departments of Otorhinolaryngology and Dermatology. METHODS: Clinical picture of MRS was studied from patient charts at two departments. Patients with FP received a questionnaire and were examined. Tissue biopsies were searched for non-necrotizing granulomatous infiltrations typical of MRS and blood DNA for UNC-93B1 gene mutations predisposing to herpesvirus infection. RESULTS: At the Department of Otorhinolaryngology, all 18 MRS patients had FP, 9 the triad form. Two patients revealed non-necrotizing granulomatous infiltrations during acute edema episodes; another two had association with uveitis. Edema was rarely persistent and did not dominate the clinical picture. No UNC-93B1 mutations were found. At the Department of Dermatology, 2 patients had triad MRS and 15 had monosymptomatic granulomatous cheilitis with persistent edema and typical MRS histology. CONCLUSION: The clinical picture of MRS with FP differed from the current knowledge of edema-dominated MRS. More studies focusing on MRS with FP would broaden our understanding of the syndrome.     

Effect of electrode cap on measured cortical motor threshold

We investigated the role of electrode cap use in the determination of the cortical motor threshold (MT), and the resulting changes in the recorded motor evoked potentials (MEPs). We also tested whether the induced changes in determined MT could be corrected via previously introduced correction method. Sixteen healthy subjects were studied. Navigated TMS was used for mapping the optimal representation area of the thenar musculature in the primary motor cortex and individual MTs were determined with and without the use of the electrode cap. A mathematical correction was utilized to compensate for the effect of electrode cap in the MTs. Individual MEPs were also measured. We observed a significant (p<0.05) increase in the determined MTs attributable to the use of the electrode cap. At the group level this difference was reduced significantly (p<0.01) by the use of the correction method. However, at the individual level the efficiency of the correction was poor. The MEP-amplitudes were not affected whether measured with or without the electrode cap. The electrode cap affects significantly the cortical MT measured as stimulation intensity making the comparison of MTs difficult with other studies not having used an electrode cap.