Surgical treatment of epilepsy at the Russian Children’s Clinical Hospital: substrates and imaging aspects

2021 ◽  
Vol 2 (1) ◽  
pp. 29-37
Author(s):  
Maya V. Polyanskaya ◽  
Alisa A. Demushkina ◽  
Irina V. Rasskazchikova ◽  
Igor G. Vasilyev ◽  
Viktor A. Chadaev ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Neurological Status ◽  
Good Prognosis ◽  
Morphological Data ◽  
Presurgical Evaluation ◽  
Treatment Optimization ◽  
Russian State ◽  
Cortical Dysplasias ◽  
High Level ◽  
Epileptogenic Foci

Introduction. MRI revealing the epileptogenic foci is the central part of the presurgical evaluation of children with focal-resistant epilepsy. Besides that, MRI seems to be a reliable instrument of treatment optimization and good prognosis. Aim. To identify epileptogenic lesions in children with resistant focal epilepsy by high resolution (HR) MRI and comparing obtained data with postsurgical morphology. Materials and methods. We assessed the results of neuroimaging, EEG, clinical neurological status, and postsurgical morphological data in 65 children with focal epilepsy who had undergone antiepileptic surgery in Russian State Children Hospital, neurosurgery department (Moscow, Russia) from 2016 to 2020. Results. The broad spectrum of epileptogenic lesions was revealed by HR MRI, including focal and diffuse cortical dysplasias (44.6%), cortical post hypoxic gliosis (27.7%), glial tumors (7.7%), Rasmussen encephalitis (10.8%), tuberous sclerosis, and Sturge-Weber syndrome (3%), small angiodysplasias (4.6%) and other. Focal cerebral dysplasia had an obvious superiority as the main etiological factor in focal epilepsy and was approved in 33.8% of all patients. In all cases, epilepsy is characterized by frequent and resistant seizures, inflicting motor arrest, and psycho-emotional deterioration. Conclusion. HR MRI and multidisciplinary investigation have to be unchangeable standards in the presurgical evaluation of children with focal epilepsy. This approach’s effectiveness has reassuring confirmation by high level (95.2%) of total coincidence MRI and morphological results.

scholarly journals Role of contrast-free MR-perfusion in the diagnosis of potential epileptogenic foci in children with focal epilepsia

2018 ◽  
Vol 10 (2) ◽  
pp. 6-18
Author(s):  
M. V. Polyanskaya ◽  
A. A. Demushkina ◽  
I. G. Vasiliev ◽  
H. Sh. Gazdieva ◽  
A. A. Kholin ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Clinical Status ◽  
Brain Perfusion ◽  
Arterial Perfusion ◽  
Arterial Blood ◽  
Russian State ◽  
Epileptogenic Lesion ◽  
Mri Scans ◽  
Epileptogenic Foci

ASL (Arterial Spin Labeling) – a novel modality of MR angiography – is based on radio-frequency labeling of aqueous protons in the arterial blood; the method is used to monitor blood supply to  organs, including the brain. So far there has been little information on the use of ASL in children with focal epilepsy, especially in the pre-surgery period.Aim:to evaluate the perfusion patterns in seizure-free children with drug resistant focal epilepsy (FE) using the ASL mode of MRI.Materials and methods.We studied the ASL data of 54 (23-boys/31 girls) patients with FE  treated in the Dpt. of Neurology at the Russian State Children Hospital from 2015 to 2018. The  patients’ age varied from 4 months to 17 years. All images were produced with a 3T GE Discovery  750W system.Results. We found several brain perfusion patterns in children with FE; among other factors, those patterns depended on the clinical status of the patient, i. e. the interictal period or the early post- seizure period. The main pattern of the interictal period was characterized by a focal decrease in  perfusion located around a structural focus identified on MRI scans. In the early post-seizure  period, there was an increase in the arterial perfusion in the area of a structural epileptogenic lesion.Conclusion.ASL-MRI is an effective diagnostic method providing more information on children  with FE during their pre-surgery phase. The ASL modality needs further research to rationalize its wider use as a preferred diagnostic tool or as a combination with the more complex PET and SPECT.

scholarly journals GCT-10. CAN HIGH LEVEL SERUM hCG-β BE CONSIDERED EQUIVALENT TO A DIAGNOSIS OF CHORIOCARCINOMA IN PRIMARY CENTRAL NERVOUS SYSTEM GERM-CELL TUMOR?

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii329-iii330
Author(s):  
Hiroaki Motegi ◽  
Shigeru Yamaguchi ◽  
Yukitomo Ishi ◽  
Michinari Okamoto ◽  
Akihiro Iguchi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Good Prognosis ◽  
Cell Tumor ◽  
University Hospital ◽  
Kaplan Meier ◽  
Beta Human Chorionic Gonadotropin ◽  
High Level

Abstract BACKGROUND Primary central nervous system(CNS) choriocarcinoma(CC) is very rare and has the poorest prognosis among germ cell tumor (GCT). CC usually has extremely high level (HL) of serum beta-human chorionic gonadotropin (bhCG) over than 1,000 mIU/ml. Some studies assign HL bhCG cases to poor prognosis group even without biopsy. The purpose of this study was to find out if there was a good prognosis subset in the HL bh group. MATERIALS AND METHODS We analyzed 103 cases diagnosed with GCT from 1998 to 2019 in Hokkaido University Hospital and reviewed the literature of CNS CC and bhCG. Survival was assessed using Kaplan-Meier method and log-rank statistics between the group with CC component and that with no CC component but HL bhCG. RESULTS One out of 103 our cases was diagnosed as a mixed GCT with CC component and did not respond to treatment and died 9 months later. Two cases were treated as CC because of HL bhCG (1,226 and 2,739 mIU/ml) despite that the biopsy showed only germinomas and survived(105 and 37 months), that is, no CC component. Combining our cases with 69 cases in the literature, all 7 cases with no CC component but HL bhCG survived but the median survival of the other 65 cases with CC component was 38.2 months (P=0.02). CONCLUSION This study has a limitation of selection bias, however, it suggests that patients with no CC component but HL bhCG may have a better prognosis.

Arterial Spin Labeling is a Useful MRI Method for Presurgical Evaluation in MRI-Negative Focal Epilepsy

2021 ◽  
Author(s):  
Martin Kojan ◽  
Martin Gajdoš ◽  
Pavel Říha ◽  
Irena Doležalová ◽  
Zdeněk Řehák ◽  
...  
Keyword(s):  
Arterial Spin Labeling ◽  
Focal Epilepsy ◽  
Spin Labeling ◽  
Presurgical Evaluation

scholarly journals Indicators of occupational traumatism and mortality in employees of Russian State Fire Service (1996–2015)

2018 ◽  
pp. 05-25 ◽  
Author(s):  
S. S. Aleksanin ◽  
E. V. Bobrinev ◽  
V. I. Evdokimov ◽  
A. A. Kondashov ◽  
V. I. Sibirko ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Occupational Injuries ◽  
Fire Service ◽  
Annual Number ◽  
General Level ◽  
Respiratory Protection ◽  
Russian State ◽  
International Statistical Classification ◽  
Health Disorders ◽  
High Level

Relevance.Profession of firefighters is considered to refer to extreme activities, which have high risks of health disorders, injuries and even death.Intention– to analyze occupational traumatism and deaths from injuries in Russian State Fire Service (SFS) (1996–2004) and the Federal Fire Service of EMERCOM of Russia (2005–2015) employees for 20 years and to compare these data with the indicators of Russian workers.Methods.Information on occupational traumas and deaths of employees and response personnel of Russian SFS was gathered. The annual number of examined firefighters of special military ranks (officer, warrant officer, sergeant, common soldier) was (108.8 ± 6.2) thousand people, which was not less than 80 % of personnel of Russian SFS. The levels of occupational injuries, deaths from occupational injuries of Russian workers, mortality in the XIX Chapter of the International Statistical Classification of Diseases and Health Problems, 10th edition (ICD-10) of men of working age in Russia were received from the official website of the Federal Agency for Statistics. Database «FDB «Fires» was used for the distribution of fires in Russia over time periods. The dynamics of indicators of health disorders of firefighters and of fire distribution was evaluated by the method of time series analysis, which used a polynomial trend of the 2nd order.Results and Discussion.The average annual level of occupational traumatism in 20 years (1996–2015) in Russian SFS staff amounted to (3.795 ± 0.390)‰, in response staff for 1999–2015 – (5.295 ± 0.644)‰. The level of occupational traumatism among Russian workers during these periods was (3.410 ± 0.351) and (3.000 ± 0.318)‰ respectively, which is significantly less than that of the response personnel (p < 0.05). A positive statistically significant relationship between the number of injuries and combat performances (r = 0.51; p < 0.05), the number of injuries and accident rate in the staff of Russian SFS with the complexity of fire-fighting tasks and number of use of personal respiratory protection (r = 0.53 and r = 0.46, respectively, p < 0.05). The cyclical nature of risks of traumatism in response staff of Russian SFS, depending on hours of the day, days of the week and months of the year, due to the nature of combat performance and other professional factors was found. This phenomenon requires additional research. The mortality rate of SFS staff from occupational injuries in 1996–2015 was (0.125 ± 0.011)‰, response personnel – (0.149 ± 0.014)‰. The mortality rate of Russian workers was statistically significantly less (0.116 ± 0.007)‰ compared to the response personnel (p < 0.05). There are decreases in occupational traumatism and deaths from occupational injuries in SFS staff and Russian workers.Conclusion.In general, level of occupational traumatism and mortality from occupational injuries in employees and response personnel of the Russian SFS can be comparable with level revealed among the Russian workers. It indicates, on the one hand, the effective organizational and technological measures for the prevention of occupational injuries and the death of firefighters, and, on the other hand, high level of occupational traumatism of the Russian workers.

Ostatni będą pierwszymi? LNG w polityce energetycznej Rosji

2020 ◽  
Vol 18 (4) ◽  
pp. 97-120
Author(s):  
Szymon Kardaś
Keyword(s):  
Energy Markets ◽  
The State ◽  
External Energy ◽  
State Budget ◽  
Russian State ◽  
Internal Structures ◽  
Constant State ◽  
High Level ◽  
The Relationship

The purpose of the article is to analyze the current condition and development prospects for the Russian LNG sector. Taking into account the specifics of the functioning of the Russian state, the author chose the realistic paradigm (neoclassical realism), which is useful in the context of showing the relationship between internal structures and external activity of the state. The author argues that Russian expansion in the LNG sector is the result of the lobbying capacity of Novatek – the largest private gas producer in Russia. Although the state budget incurs significant costs related to the implementation of Novatek projects, in particular due to fiscal preferences, it also achieves the possibility of achieving the objectives in external and internal energy policy. Novatek’s expansion increases Russia’s share in external energy markets; at the same time LNG expansion, it is used for internal purposes. Novatek’s dominant position in the LNG sector is confirmed by both already implemented projects and plans for further expansion. The factors favoring Russian expansion are constant state support for Novatek projects, high level of internationalization of implemented projects and favorable forecasts on energy markets. The strong competition between currently dominant LNG producers and the risk of internal competition between Russian exporters are among the key long-term challenges.

scholarly journals Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation (SEEG-Guided RF-TC) in Patients with Drug-Resistant Focal Epilepsy

2017 ◽  
Vol 3 (1) ◽  
pp. 40-47
Author(s):  
Chengwei Xu ◽  
Wenjing Zhou
Keyword(s):  
Radio Frequency ◽  
Surgical Resection ◽  
Seizure Frequency ◽  
Palliative Treatment ◽  
Focal Epilepsy ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Functional Area ◽  
Presurgical Evaluation ◽  
Epileptic Patients

For some patients with drug-resistant focal epilepsy, we usually select conventional surgical resection, which has brought better outcomes. However, others are not eligible for a conventional open surgical resection of the epileptogenic zone because of the proximity of a functional area or the implication of a larger epileptogenic network. Initially, stereoelectroencephalography (SEEG) exploration was a method of electroencephalography recording that was used in the presurgical evaluation of epileptic patients with complex epilepsy. Later, intracerebral electrodes used for SEEG were applied to produce radio frequency thermocoagulation (RF-TC) in epileptic patients. SEEG-guided RF-TC has produced some promising results, especially in the last dacade. Now, it has become popular as a palliative treatment to reduce seizure frequency in patients with drug-resistant focal epilepsy. This article presents a review of SEEG-guided RF-TC.

scholarly journals P.048 Characterization of somatic mutations in mTOR pathway genes in focal cortical dysplasias

2019 ◽  
Vol 46 (s1) ◽  
pp. S26-S27
Author(s):  
E Krochmalnek ◽  
A Accogli ◽  
J St-Onge ◽  
N Addour ◽  
R Dudley ◽  
...  
Keyword(s):  
Somatic Mutations ◽  
Focal Epilepsy ◽  
Mtor Pathway ◽  
High Yield ◽  
Structural Abnormalities ◽  
Causal Variants ◽  
Cortical Dysplasias ◽  
Custom Panel ◽  
The Brain

Background: Focal cortical dysplasias (FCDs) are congenital structural abnormalities of the brain, and represent the most common cause of medication-resistant focal epilepsy in children and adults. Recent studies have shown that somatic mutations (i.e. mutations arising in the embryo) in mTOR pathway genes underlie some FCD cases. Specific therapies targeting the mTOR pathway are available. However, testing for somatic mTOR pathway mutations in FCD tissue is not performed on a clinical basis, and the contribution of such mutations to the pathogenesis of FCD remains unknown. Aim: To investigate the feasibility of screening for somatic mutations in resected FCD tissue and determine the proportion and spatial distribution of FCDs which are due to low-level somatic mTOR pathway mutations. Methods: We performed ultra-deep sequencing of 13 mTOR pathway genes using a custom HaloPlexHS target enrichment kit (Agilent Technologies) in 16 resected histologically-confirmed FCD specimens. Results: We identified causal variants in 62.5% (10/16) of patients at an alternate allele frequency of 0.75–33.7%. The spatial mutation frequency correlated with the FCD lesion’s size and severity. Conclusions: Screening FCD tissue using a custom panel results in a high yield, and should be considered clinically given the important potential implications regarding surgical resection, medical management and genetic counselling.

Genetic diversity of eight millet genera assessed by using molecular and morphological markers

2016 ◽  
Vol 67 (2) ◽  
pp. 181
Author(s):  
Zdislava Dvořáková ◽  
Petra Hlásná Čepková ◽  
Iva Viehmannová ◽  
Lenka Havlíčková ◽  
Dagmar Janovská
Keyword(s):  
Genetic Diversity ◽  
Morphological Variability ◽  
Aflp Markers ◽  
Morphological Data ◽  
Plant Materials ◽  
Morphological Attributes ◽  
Shannon’S Index ◽  
High Level ◽  
Close Relatedness ◽  
Nei's Genetic Distance

In this study, the genetic diversity and relationships among eight millet genera were investigated by molecular and morphological data analyses. Sixty-nine millet accessions were analysed by using amplified fragment length polymorphism (AFLP) markers, and evaluated for morphological traits. Eight AFLP primer pairs were amplified successfully and 779 bands were scored for all accessions, with a high level of polymorphism detected. Nei’s genetic distance among all accessions varied from 0.0123 to 0.4246 and the Shannon’s index was estimated at 0.9708. The neighbour joining tree, using the unweighted neighbour-joining method and Dice’s dissimilarity coefficient, was constructed. The AFLP markers revealed the close relatedness between the Eragrostis and Panicum genera, whereas the greatest distance was found the Pennisetum and Echinochloa genera. Cluster analysis based on the AFLP profiles revealed that the majority of accessions of a given millet genus tend to group together. Clustering from morphological data allocated individuals into three main clusters with high variation. The genetic variability found between the analysed accessions was weakly negatively correlated (r = –0.074) with their morphological attributes. However, high molecular and morphological variability indicated that this collection includes rich and valuable plant materials for millet breeding.

Novel non‐invasive modalities for presurgical evaluation in focal epilepsy

2019 ◽  
Vol 61 (3) ◽  
pp. 319-321
Author(s):  
Yuji Ito ◽  
Hiroyuki Yamamoto ◽  
Tohru Okanishi ◽  
Satoshi Maesawa ◽  
Jun Natsume
Keyword(s):  
Focal Epilepsy ◽  
Presurgical Evaluation ◽  
Non Invasive
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