Radiological and Clinical Value of 7T MRI for Evaluating 3T-Visible Lesions in Pharmacoresistant Focal Epilepsies

Objective: The recent FDA approval of the first 7T MRI scanner for clinical diagnostic use in October 2017 will likely increase the utilization of 7T for epilepsy presurgical evaluation. This study aims at accessing the radiological and clinical value of 7T in patients with pharmacoresistant focal epilepsy and 3T-visible lesions.Methods: Patients with pharmacoresistant focal epilepsy were included if they had a lesion on pre-operative standard-of-care 3T MRI and also a 7T research MRI. An epilepsy protocol was used for the acquisition of the 7T MRI. Prospective visual analysis of 7T MRI was performed by an experienced board-certified neuroradiologist and communicated to the patient management team. The clinical significance of the additional 7T findings was assessed by intracranial EEG (ICEEG) ictal onset, surgical resection, post-operative seizure outcome and histopathology. A subset of lesions were demarked with arrows for subsequent, retrospective comparison between 3T and 7T by 7 neuroradiologists using a set of quantitative scales: lesion presence, conspicuity, boundary, gray-white tissue contrast, artifacts, and the most helpful sequence for diagnosis. Conger's kappa for multiple raters was performed for chance-adjusted agreement statistics.Results: A total of 47 patients were included, with the main pathology types of focal cortical dysplasia (FCD), hippocampal sclerosis, periventricular nodular heterotopia (PVNH), tumor and polymicrogyria (PMG). 7T detected additional smaller lesions in 19% (9/47) of patients, who had extensive abnormalities such as PMG and PVNH; however, these additional findings were not necessarily epileptogenic. 3T−7T comparison by the neuroradiologist team showed that lesion conspicuity and lesion boundary were significantly better at 7T (p < 0.001), particularly for FCD, PVNH and PMG. Chance-adjusted agreement was within the fair range for lesion presence, conspicuity and boundary. Gray-white contrast was significantly improved at 7T (p < 0.001). Significantly more artifacts were encountered at 7T (p < 0.001).Significance: For patients with 3T-visible lesions, 7T MRI may better elucidate the extent of multifocal abnormalities such as PVNH and PMG, providing potential targets to improve ICEEG implantation. Patients with FCD, PVNH and PMG would likely benefit the most from 7T due to improved lesion conspicuity and boundary. Pathologies in the antero–inferior temporal regions likely benefit less due to artifacts.

Laser treatment of the anterior capsulorhexis shrinkage syndrome in patients with pseudophakia

The article describes results of laser treatment applied in seven patients (eleven eyes) due to capsulorhexis margin shrinkage and the subsequent wrinkling of the anterior capsule in eyes with pseudophakia. Almost total loss of the anterior capsulorhexis aperture caused a significant decrease in visual acuity, to the level of counting fingers right in front of the eyes in three patients (four eyes). The laser cut of the anterior capsulorhexis margin using the Nd-Yag laser led to an immediate increase in the capsulorhexis size in each case. Visual acuity improved in the eyes with an extreme decrease in the capsulorhexis size. In the remaining eyes, where the decrease of the capsulorhexis size did not lead to the appearance of anterior capsule wrinkling, visual acuity did not change. The progressive decrease in the capsulorhexis size, accompanied by the appearance of white tissue on its margin, containing shrinking elements, constitutes an indication for the implementation of laser therapy.

Seagrass leaf reddening alters the microbiome of Zostera muelleri

Seagrasses host an extremely diverse microbiome that plays fundamental roles in seagrass health and productivity but may be sensitive to shifts in host physiology. Here, we observed a leaf reddening phenomenon in Zostera muelleri and characterized bacterial assemblages associated with green and reddened leaves to determine whether this change in leaf pigmentation stimulates shifts in the seagrass microbiome. Using 16S rRNA gene amplicon sequencing, we observed that the microbiome associated with 4 different leaf pigmentation categories (i.e. green, white, purple and black) differed significantly, with substantial changes in microbiome composition when the tissue is whitened (non-pigmented). Actinobacteria, Rhodobacteraceae, Erythrobacter, Sulfitobacter and Granulosicoccus were enriched in black and/or purple tissues and discriminated these microbiomes from those associated with green leaves. Contrastingly, all ‘discriminatory’ zero-radius operational taxonomic units (zOTUs) were depleted within the communities associated with white samples. While 40% of the abundant zOTUs identified were exclusively associated with a single pigmentation category, only 3% were shared across all categories, indicating partitioning of the phyllosphere microbiome. However, a significant proportion of the ‘normal’ (green) leaf core microbiome was also retained in the core communities associated with black (70%) and purple (70%) tissues. Contrastingly, no core zOTUs were maintained in the white tissues. These results indicate that environmentally driven physiological shifts in seagrasses, such as leaf reddening expressed in response to high irradiance, can impact the seagrass leaf microbiome, resulting in significant shifts in the microbiome of reddened leaves with the most extreme expression (in white tissue of reddened leaves).

Pericardial sarcoma

Pericardial sarcomas are extremely rare aggressive neoplasms. Non-specific symptoms and incidental discovery are usually the rule. Multimodality imaging is extremely important for diagnosis and tissue characterisation of all cardiac masses. Despite treatment, pericardial sarcomas are considered extremely fatal. We encountered a 27-year-old female patient who presented to our facility with progressive dyspnoea. On examination, clinical signs of cardiac tamponade were appreciated, transthoracic echocardiography revealed a tamponading pericardial effusion and a large heterogeneous pericardial mass. Pericardiocentesis revealed haemorrhagic fluid. Subsequently, CT revealed a pericardial mass compressing the right atrium. Excision biopsy showed a well-circumscribed mass, and cut sections showed friable grey–white tissue with areas of haemorrhage and necrosis. Pathological examination confirmed the diagnosis of high-grade undifferentiated sarcoma of the pericardium. The patient was started on adjuvant chemotherapy and radiotherapy. Follow-up after 1 year showed no relapse.

Isotopic evidence for nitrogen exchange between autotrophic and heterotrophic tissues in variegated leaves

Many plant species or cultivars form variegated leaves in which blades are made of green and white sectors. On the one hand, there is little photosynthetic CO2 assimilation in white tissue simply because of the lack of functional chloroplasts and thus, leaf white tissue is heterotrophic and fed by photosynthates exported by leaf green tissue. On the other hand, it has been previously shown that the white tissue is enriched in nitrogenous compounds such as amino acids and polyamines, which can, in turn, be remobilised upon nitrogen deficiency. However, the origin of organic nitrogen in leaf white tissue, including the possible requirement for N-reduction in leaf green tissue before export to white tissue, has not been examined. Here, we took advantage of isotopic methods to investigate the source of nitrogen in the white tissue. A survey of natural isotope abundance (δ15N) and elemental composition (%N) in various variegated species shows no visible difference between white and green tissues, suggesting a common N source. However, there is a tendency for N-rich white tissue to be naturally 15N-enriched whereas in the model species Pelargonium × hortorum, white sectors are naturally 15N-depleted, indicating that changes in metabolic composition and/or N-partitioning may occur. Isotopic labelling with 15N-nitrate on illuminated leaf discs clearly shows that the white tissue assimilates little nitrogen and thus relies on nitrate reduction and metabolism in the green tissue. The N-sink represented by the white tissue is considerable, accounting for nearly 50% of total assimilated nitrate.

Fallopian Tube Papilloma – Case Report of a Rare Tumor

Fallopian tube neoplasms are rare. We report a rare case of fallopian tube papilloma discovered incidentally in a 45 year old female, operated for procidentia. Right tube was dilated at the infundibular region, with friable grey white tissue in the lumen. Microscopy showed delicate branching papillae lined by a single layer of epithelium resembling tubal lining. There were no features to suggest a reactive hyperplasia in response to inflammation or of aggressive behaviour. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12515 Kathmandu Univ Med J 2013; 43(3):250-252

Comparison of Mangalica and Hungarian Large White pigs at identical bodyweight: 2. Fatty acid regiodistribution analysis of the triacylglycerols

At identical bodyweight values (130 kg) Mangalica and Hungarian Large White tissue (liver, kidney, heart and skeletal muscle, adipose tissue, spleen and lung) triacylglycerol (TAG) fatty acid distribution analysis was performed, to describe tissue types and possible genotype-associated differences. Tissue TAG was partially hydrolyzed with hog pancreatic lipase, and the fatty acid profile of 2-monoacylglycerols (2MAG) and TAGs was analyzed by gas-chromatography. All extrahepatic tissues provided marked central (sn-2) saturated fatty acid (SFA) (mostly palmitate) recruitment, while liver 2MAGs were mainly aclylated by unsaturated fatty acids (UFA). Inter-genotype differences were minor: in adipose tissue in Mangalica the total palmitate moiety was found in the 2MAGs, while in the liver docosapentaenoic and docosahexaenoic acids were only found in the Mangalica 2MAGs. In conclusion, the direct analysis results of the 2MAGs in six extrahepatic organs and in the liver provided evidence that the building-up of the characteristic porcine TAG structure is located at a post-hepatic site, being true for most of the organs in the pig body.