Comparison of temporal lobectomies of children and adults with intractable temporal lobe epilepsy

Introduction

The aim of the study was to assess the difference in clinical characteristics and postsurgical outcomes between children and adults who have undergone temporal lobectomy (TL).

Materials and methods

We retrospectively reviewed the medical records of 52 patients who had undergone TL between 2006 and 2008. Nineteen patients were classified as children (≤18 years old), and 33 patients were classified as adults (>18 years old) according to the age when TL had been performed.

Results

Twelve of 19 (63.2%) children and 24 of 33 (72.7%) adults became seizure free. Rapid secondary generalization such as generalized tonic or tonic–clonic seizures showed a tendency to be more prominent in children (four of 19, 21.1%) than in adults (three of 33, 9.1%). Patients in childhood had significantly more multifocal discharges on interictal electroencephalography (EEG) (42.1%) compared to adults (15.2%, p?=?0.014). The mean extent of surgical excision was 5.0 cm in children and 4.1 cm in adults (p?=?0.001). The incidence of hippocampal sclerosis, the most common pathologic finding in the two groups, was 57.9% (11 of 19) in children and 78.8% (26 of 33) in adults. Malformations of cortical development were significantly more frequent in children (nine of 19, 47.4%) than in adults (seven of 33, 21.2%). Dual pathology was found in 31.6% of children and in 12.1% of adults. The intelligence quotient and memory quotient values in children with temporal lobe resection remained nearly steady during follow-up period without significant decline.

Conclusion

Patients undergoing TL during childhood compared to during adulthood had distinctively different interictal EEG, resectional extents, and pathologic findings.     

Neuroprotective effects of Alpinia katsumadai against neuronal damage in the gerbil hippocampus induced by transient cerebral ischemia

Alpinia katsumadai, one of the family Zingiberaceae, contains chalcone, flavonoids, diarylheptanoids, monoterpenes, sesquiterpenoids, stilbenes, and labdanes. It has been reported that the extract of Alpinia katsumadai seed (EAKS) has antiinflammatory effects, and enhances antioxidant activities. We observed the neuroprotective effects of EAKS against ischemic damage in gerbils received oral administrations of EAKS (50 mg/kg) once a day for 7 days before transient cerebral ischemia. In the EAKS-treated ischemia group, neuronal nuclei (NeuN, a marker for neurons)-immunoreactive pyramidal neurons were abundant (68.3% of the sham group) in the hippocampal CA1 region (CA1) 4 days after ischemia/reperfusion (I/R) compared to those in the vehicle-treated ischemia group (13.18%). We also observed that EAKS treatment significantly decreased the activation of astrocytes and microglia in the CA1 compared with the vehicle-treated ischemia group 4 days postischemia. In addition, protein levels of GFAP and Iba-1 in the EAKS-treated ischemia group were much lower than those in the vehicle-treated ischemia group 4 days after I/P. Our findings indicate that the repeated supplements of EAKS could protect neurons from an ischemic damage, showing that glial activation is markedly decreased in the ischemic area.     

The Processing Time for Recanalization and Size of Ischemic Lesions on DWI is Related With Complete Reperfusion After Mechanical Thrombectomy

Recent studies demonstrated that modified thrombolysis in cerebral infarction (TICI) 3 reperfusion have better functional outcomes than modified TICI 2b after mechanical thrombectomy in acute ischemic stroke with large vessel occlusion. The purpose of this study was to determine significant factors to forecast the presence of complete reperfusion after mechanical thrombectomy based on multimodal magnetic resonance imaging (MRI). We investigated 96 consecutive patients with acute large intracranial artery occlusion of anterior circulation who based on multimodal MRI. Also, we compared clinical and radiologic parameters between patients with modified TICI 3 and those with modified TICI 0-2b. Among 96 eligible subjects received mechanical thrombectomy, 39 patients (40.6%) showed complete reperfusion and 57 partial or nonreperfusion (mTICI 2b-26, mTICI 2a-9, mTICI 1-8, and mTICI 0-14) after mechanical thrombectomy. Patients with mTICI 3 had significantly smaller initial Diffusion weighted images (DWI) lesion volume (P < .01) and much shorter time interval from onset to reperfusion (P < .01) than those patients with mTICI (0-2b). In multivariate analysis, smaller initial DWI volume (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.23-2.57; P < .01) and faster reperfusion time (OR, 1.07; 95% CI 1.01-1.14; P = .015) had an independence significance for complete reperfusion after mechanical thrombectomy. In this study, the ischemic lesion volume on DWI and faster processing time are critical factor to predict the state of complete reperfusion after mechanical thrombectomy.     

Roles of hydroxyl and carbonate radicals in bisphenol a degradation via a nanoscale zero-valent iron/percarbonate system: influencing factors and mechanisms

In this work, nanoscale-zero-valent iron (nZVI) was applied to activate sodium percarbonate (SPC) to eliminate bisphenol A (BPA), which poses a risk to ecological and human health as a typical endocrine disruptor. The influence of nZVI loading, SPC dosing, initial pH, and the presence of inorganic anions (including Cl⁻, HPO₄²⁻, NO₃⁻ and NO₂⁻) and humic acid on BPA removal by the nZVI/SPC system were investigated. Based on the scavenger test results, ˙OH and CO₃˙⁻ participated in the degradation of BPA, and ˙OH was illustrated to be the dominant radical. The X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analysis suggested that surface iron oxide generation, electron transfer and Fe²⁺ release were the main processes of the SPC activation by nZVI. Moreover, BPA transformation products were detected by LC-MS allowing the proposal of a possible degradation pathway of BPA. Along with the degradation of the parent compound BPA, the total organic carbon (TOC) gradually decreased, while the bio-toxicity increased at the initial stage of the reaction (0–3 min) and then decreased to a lower level rapidly at 20 min. Overall, this study evidenced the feasibility of the nZVI/SPC system to efficiently degrade BPA, broadening the applications of nZVI in wastewater treatment.

Both ˙OH and CO₃˙⁻ participated in the degradation of BPA in the nZVI/SPC system, and ˙OH was the main radical.     

Alteration of intramolecular electronic transition via deboronation of carbazole-based o-carboranyl compound and intriguing ‘turn-on’ emissive variation

The conversion of closo-o-carborane–containing compounds to the nido-o-species via deboronation causes photophysical changes that could be used for sensing applications. 9-Methyl-9H-carbazole–based closo- (closo-Cz) and nido-o-carboranyl (nido-Cz) compounds were prepared and fully characterised by multinuclear NMR spectroscopy and elemental analysis, and the solid-state molecular structure of closo-Cz was analysed by X-ray crystallography. Although the closo-compound exhibited an emissive pattern centred at λ_em = ca. 530 nm in the rigid state only (in THF at 77 K and as a film), nido-Cz demonstrated intense emission in the near-UV region (λ_em = ca. 380 nm) in both solution and film states at 298 K. The positive solvatochromic effect of nido-Cz and the results of theoretical calculations for both the o-carboranyl compounds supported that these emissive features originate from intramolecular charge transfer (ICT) corresponding to the o-carborane. Furthermore, the calculations verified that the electronic role of the o-carboranyl unit changed from acceptor to donor upon deboronation from closo-Cz to nido-Cz. Investigations of the radiative decay mechanisms of closo-Cz and nido-Cz according to their quantum efficiencies (Φ_em) and decay lifetimes (τ_obs) suggested that the ICT-based radiative decays of closo-Cz and nido-Cz readily occur in the film (solid) and solution state, respectively. These observations implied that the emission of closo-Cz in the solution state could be drastically enhanced by deboronation to nido-Cz upon exposure to an increasing concentration of fluoride anions. Indeed, turn-on emissive features in an aqueous solution were observed upon deboronation, strongly suggesting the potential of closo-Cz as a turn-on and visually detectable chemodosimeter for fluoride ion sensing.

Deboronation of a 9-methyl-9H-carbazole–based closo-o-carboranyl compound to the nido-o-carborane in an aqueous solution results in a ratiometric turn-on response in the deep-blue emission region with moderate reactivity.     

Effect of atorvastatin monotherapy and low-dose atorvastatin/ezetimibe combination on fasting and postprandial triglycerides in combined hyperlipedemia

Postprandial triglyceride (TG) levels are easy to measure and are associated with future cardiovascular risk. The aim of this study was to compare the effects of statin monotherapy and low-dose statin/ezetimibe on lipid parameters including fasting and postprandial TG. After a 4-week dietary run-in period, 78 patients with combined hyperlipidemia were randomized into 1 of 2 treatment groups for 8 weeks: atorvastatin 20 mg or atorvastatin/ezetimibe 5 mg/5 mg. An oral fat load test was performed before and after the drug-treatment period. The low-dose combination had a tendency to decrease fasting TG more than atorvastatin monotherapy. The combination regimen showed a greater reduction in postprandial TG (-13% ± 42% and -34% ± 30%, in the atorvastatin and combination groups, respectively, P = .03) and total cholesterol (TC; P = .03). The changes in low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) were not different between the 2 groups. The reduction in apo B/A1 was greater in the combination group (-32% ± 19% and -42% ± 13%, in the atorvastatin and combination groups, respectively, P = .02). In conclusion, these results demonstrated a potential beneficial effect of low-dose atorvastatin/ezetimibe combination treatment on postprandial TG control after comparable LDL-C lowering in patients with combined hyperlipidemia.     

Calorie restriction (CR) reduces age-dependent decline of non-homologous end joining (NHEJ) activity in rat tissues

Even though CR has shown to enhance base excision repair (BER) and nucleotide excision repair (NER) capacities, it has not been reported whether CR can enhance non-homologous end joining (NHEJ) activity. To examine the effect of CR on NHEJ activity, ad libitum (AL)- and calorie restricted (CR)-dieted rats were used. Age-dependent decline of NHEJ activity was apparent in the lung, liver, and kidney and appeared to be slightly decreased in spleen. CR reduced age-dependent decline of NHEJ activity in all tissues, even though the extent of recovery was variable among tissues. Moreover, CR appeared to reduce age-dependent decline of XRCC4 protein level. These results suggest that CR could reduce age-dependent decline of NHEJ activity in various tissues of rats possibly through up-regulation of XRCC4.     

Noninvasive photoacoustic measurement of the composite indicator dilution curve for cardiac output estimation

Recently, the measurement of indicator dilution curves using a photoacoustic (PA) technology was reported, which showed promising results on the noninvasive estimation of cardiac output (CO) that is an important hemodynamic parameter useful in various clinical situations. However, in clinical practice, measuring PA indicator dilution curves from an arterial blood vessel requires an ultrasound transducer array capable of focusing on the targeted artery. This causes several challenges on the clinical translation of the PA indicator dilution method, such as high sensor cost and complexity. In this paper, we theoretically derived that a composite PA indicator dilution curve simultaneously measured from both arterial and venous blood vessels can be used to estimate CO correctly. The ex-vivo and in-vivo experimental results with a flat ultrasound transducer verified the developed theory. We believe this new concept would overcome the main challenges on the clinical translation of the noninvasive PA indicator dilution technology.OCIS codes: (170.0170) Medical optics and biotechnology, (170.3890) Medical optics instrumentation, (170.5120) Photoacoustic imaging, (170.4580) Optical diagnostics for medicine, (170.3880) Medical and biological imaging