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1.
J Comp Pathol ; 170: 46-52, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31375158

RESUMO

Equine multinodular pulmonary fibrosis (EMPF) is a recently described form of interstitial pneumonia associated with equine herpesvirus type 5 (EHV-5). This disease has been reported in North and South America, Europe and Oceania but not, to our knowledge, in horses in Japan. We diagnosed EMPF in two Thoroughbred horses in Japan on the basis of gross and histopathological findings. In both cases, significant gross lesions, restricted to the lungs, consisted of numerous firm and coalescing nodules widely distributed throughout the lung. The nodules were <3 cm in diameter and pale white to tan in colour. Microscopically, they showed severe interstitial fibrosis and infiltration of macrophages, neutrophils, lymphocytes and a few eosinophils. The residual alveoli were lined by cuboidal epithelial cells (type II pneumocytes) and filled with many macrophages, which rarely displayed oval eosinophilic to amphophilic intranuclear inclusion bodies. Polymerase chain reaction and sequence analyses identified the glycoprotein H gene of EHV-5, and in-situ hybridization detected EHV-5 in the alveolar macrophages in the lesions. In one case, electron microscopy revealed herpesvirus-like particles and EHV-5 was isolated from pulmonary lesions.


Assuntos
Infecções por Herpesviridae/veterinária , Doenças dos Cavalos/patologia , Doenças dos Cavalos/virologia , Fibrose Pulmonar/veterinária , Animais , Gammaherpesvirinae , Cavalos , Japão
2.
AJNR Am J Neuroradiol ; 39(12): 2371-2377, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30442696

RESUMO

BACKGROUND AND PURPOSE: Abnormalities of oligodendrocytes have been reported in surgical specimens of patients with medically intractable epilepsy. The aim of this study was to compare the MR imaging, magnetoencephalography, and surgical outcome of children with oligodendrocytosis relative to focal cortical dysplasia I. MATERIALS AND METHODS: Oligodendrocytosis included oligodendroglial hyperplasia, oligodendrogliosis, and oligodendroglial-like cells in the white matter, gray matter, or both from children with medically intractable epilepsy. Focal cortical dysplasia I included radial and tangential cortical dyslamination. The MR imaging, magnetoencephalography, type of operation, location, and seizure outcome of oligodendrocytosis, focal cortical dysplasia I, and oligodendrocytosis + focal cortical dysplasia I were compared. RESULTS: Eighteen subjects (39.1%) had oligodendrocytosis, 21 (45.7%) had focal cortical dysplasia I, and 7 (15.2%) had oligodendrocytosis + focal cortical dysplasia I. There were no significant differences in the type of seizures, focal or nonfocal epileptiform discharges, magnetoencephalography, and MR imaging features, including high T1 signal in the cortex, high T2/FLAIR signal in the cortex or subcortical white matter, increased cortical thickness, blurring of the gray-white junction, or abnormal sulcation and gyration among those with oligodendrocytosis, focal cortical dysplasia I, or oligodendrocytosis + focal cortical dysplasia I (P > .01). There were no significant differences in the extent of resection (unilobar versus multilobar versus hemispherectomy), location of the operation (temporal versus extratemporal versus both), or seizure-free outcome of oligodendrocytosis, focal cortical dysplasia I, and oligodendrocytosis + focal cortical dysplasia I (P > .05). CONCLUSIONS: Oligodendrocytosis shared MR imaging and magnetoencephalography features with focal cortical dysplasia I, and multilobar resection was frequently required to achieve seizure freedom. In 15% of cases, concurrent oligodendrocytosis and focal cortical dysplasia I were identified. The findings suggest that oligodendrocytosis may represent a mild spectrum of malformations of cortical development.


Assuntos
Epilepsia Resistente a Medicamentos/etiologia , Malformações do Desenvolvimento Cortical/diagnóstico por imagem , Malformações do Desenvolvimento Cortical/cirurgia , Oligodendroglia/patologia , Adolescente , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/cirurgia , Criança , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Magnetoencefalografia , Masculino , Malformações do Desenvolvimento Cortical/complicações , Estudos Retrospectivos , Resultado do Tratamento
3.
Cell Death Dis ; 6: e1759, 2015 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-25950489

RESUMO

Necroptosis is a recently described Caspase 8-independent method of cell death that denotes organized cellular necrosis. The roles of RIP1 and RIP3 in mediating hepatocyte death from acute liver injury are incompletely defined. Effects of necroptosis blockade were studied by separately targeting RIP1 and RIP3 in diverse murine models of acute liver injury. Blockade of necroptosis had disparate effects on disease outcome depending on the precise etiology of liver injury and component of the necrosome targeted. In ConA-induced autoimmune hepatitis, RIP3 deletion was protective, whereas RIP1 inhibition exacerbated disease, accelerated animal death, and was associated with increased hepatocyte apoptosis. Conversely, in acetaminophen-mediated liver injury, blockade of either RIP1 or RIP3 was protective and was associated with lower NLRP3 inflammasome activation. Our work highlights the fact that diverse modes of acute liver injury have differing requirements for RIP1 and RIP3; moreover, within a single injury model, RIP1 and RIP3 blockade can have diametrically opposite effects on tissue damage, suggesting that interference with distinct components of the necrosome must be considered separately.


Assuntos
Apoptose/genética , Proteínas Ativadoras de GTPase/antagonistas & inibidores , Hepatite Autoimune/genética , Fígado/lesões , Proteína Serina-Treonina Quinases de Interação com Receptores/antagonistas & inibidores , Acetaminofen , Animais , Apoptose/efeitos dos fármacos , Apoptose/imunologia , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Caspase 8/metabolismo , Quimiocina CCL2/sangue , Concanavalina A , Modelos Animais de Doenças , Proteínas Ativadoras de GTPase/genética , Proteínas Ativadoras de GTPase/metabolismo , Hepatócitos/patologia , Interleucina-6/sangue , Fígado/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteína 3 que Contém Domínio de Pirina da Família NLR , Necrose/genética , Espécies Reativas de Oxigênio/metabolismo , Proteína Serina-Treonina Quinases de Interação com Receptores/genética , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismo , Fator de Necrose Tumoral alfa/sangue
4.
J Neurosurg Sci ; 59(2): 141-55, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25649065

RESUMO

The general principle of epilepsy surgery is to achieve seizure freedom without causing any neurological deficit that would outweigh the clinical benefit. To achieve this, the epileptogenic zone, which is the part of the brain responsible for seizure generation, as well as the anatomic location of the eloquent cortex must be precisely identified in order to spare those functions during excision of the epileptogenic tissue. Major technical advances over the last decade have continuously contributed to increase our ability to map the brain and identify these critical areas. These technologies and innovations that can be routinely used today include non-invasive studies such as magnetoencephalography (MEG), functional MRI (fMRI), simultaneous EEG-fMRI, and nuclear medicine based methods like PET and SPECT as well as invasive studies through chronically implanted electrodes. Electrodes can be either placed subdurally via burr holes and craniotomies or within the brain parenchima via frame-based and frameless stereotactic methods. Apart from a continuous change in these insertion techniques, the most valuable advances here include recordings on high frequency bandwidth (100-600 Hz EEG) that are capable to delineate high-frequency oscillations (HFOs). These HFOs have been recognized as a biomarker for epileptogenic tissue. All of these technical advances have made epilepsy surgery a truly multidisciplinary field and surgeons have to be able to understand and interpret all of the gathered data. Moreover, this development has influenced surgical approaches and techniques and epilepsy surgery today includes a wide variety of procedures. These can be subdivided into resective, disconnective and neuromodulation procedures and vary from a small, targeted lesionectomy to disconnection/resection of one entire hemisphere. This review will give an overview of the available surgical techniques today and will focus on how the technical advances enable us to map the brain and delineate the critical areas.


Assuntos
Mapeamento Encefálico/métodos , Epilepsia/cirurgia , Neuroimagem/métodos , Procedimentos Neurocirúrgicos/métodos , Mapeamento Encefálico/tendências , Humanos , Neuroimagem/tendências , Procedimentos Neurocirúrgicos/tendências
5.
J Comp Pathol ; 147(2-3): 386-90, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22520805

RESUMO

A 25-year-old female mandrill (Mandrillus sphinx) died after exhibiting weakness and recumbency with serosanguineous ascites. Gross findings included haemoperitoneum and multifocal to diffuse serosal thickening with petechiae and ecchymoses throughout the peritoneum. The uterus was covered entirely with large blood clots and was adherent to the ovaries and pelvic wall. Microscopical and immunohistochemical examination revealed extra- and intra-uterine growth of ectopic endometrial tissue with marked fibrosis. The ectopic endometrial tissues predominantly consisted of stromal cells expressing CD10 and progesterone receptor and variably-sized glands lined by the epithelium with occasional slight expression of oestrogen receptor α. A diagnosis of endometriosis was made. This is the first report of naturally occurring endometriosis in a mandrill.


Assuntos
Endometriose/veterinária , Mandrillus , Doenças dos Macacos/patologia , Animais , Endometriose/metabolismo , Endometriose/patologia , Evolução Fatal , Feminino , Doenças dos Macacos/metabolismo , Neprilisina/metabolismo , Receptores de Progesterona/metabolismo , Células Estromais/metabolismo , Células Estromais/patologia
6.
Vet Pathol ; 45(5): 685-9, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18725474

RESUMO

A 2-year-old, male Japanese native fowl (Gallus gallus domesticus) was presented with an inability to feed and torticollis. At a necropsy, there were cylindrical enlargements and yellow discoloration of multiple peripheral nerves, including nerves of the lumbosacral plexus, brachial plexus, and spinal ganglia. On histologic examination, these lesions consisted of diffuse proliferations of spindle cells with characteristic onion bulb-like structures around residual axons. The spindle cells were immunohistochemically positive for glucose transporter 1 (GLUT1) and negative for S-100 alpha/beta proteins. On the basis of microscopic, histologic, and immunohistochemical findings, the tumors were diagnosed as multiple perineuriomas.


Assuntos
Galinhas , Neoplasias de Bainha Neural/veterinária , Doenças das Aves Domésticas/patologia , Animais , Leucose Aviária/patologia , Leucose Aviária/virologia , Vírus da Leucose Aviária/genética , Vírus da Leucose Aviária/crescimento & desenvolvimento , Evolução Fatal , Imuno-Histoquímica/veterinária , Masculino , Neoplasias de Bainha Neural/patologia , Neoplasias de Bainha Neural/virologia , Doenças das Aves Domésticas/virologia , RNA Viral/química , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/veterinária
7.
Acta Neurol Scand Suppl ; 186: 29-36, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17784535

RESUMO

Magnetoencephalography (MEG) provides accurate localizing information of the epileptogenic zones in localization-related epilepsies. Refractory status epilepticus (RSE) is a life-threatening emergency that often requires prolonged high-dose suppressive therapy (HDST) to stop frequent and prolonged seizures. Surgical treatments for patients with RSE secondary to pre-existing epilepsy were reported. This article addresses the role of MEG in localizing the epileptogenic zone for the surgical treatment of patients with RSE. Five pediatric patients with RSE underwent epilepsy surgery using MEG, scalp video EEG and magnetic resonance imaging (MRI). Ictal MEG spike sources (MEGSSs) were localized in the clustered interictal MEGSSs in right Rolandic region (patient 3) and right temporal region (patient 5). Interictal MEG revealed unilateral clustered MEGSSs in four patients (patients 1, 2, 4, and 5) and bilateral (patient 3). Ictal-onset EEG findings were localized to one region in three patients (patients 1, 3, and 5) and two regions in the other two patients (patients 2 and 4). In all five patients, interictal discharges were widespread involving over two lobes (patients 2 and 4) or three lobes (patients 1, 3, and 5). Suppression burst pattern was obtained by HDST (patient 5). MRI showed cortical dysplasia in three patients (patients 1, 3, and 4). Patient 2 had a normal MRI. Patient 5 had normal MRI at the onset. Repeat MRI 5 days later showed diffusion restriction in the right hippocampus associated with increased signal intensity on T2 and FLAIR sequences. We performed cortical excision in two patients (patients 1 and 4), hemispherectotomy one (patient 3) and anterior temporal lobectomy two patients (patients 2 and 5). Two patients (patients 1 and 3) became seizure free, the other three patients experienced residual seizures. MEG showed clustered MEGSSs during the RSE in the pre-existing epilepsy patients and at an early time window in the acute symptomatic RSE patients. The complete resection of clustered MEGSSs can control RSE and possibly lead to a seizure free outcome.


Assuntos
Encéfalo/patologia , Encéfalo/cirurgia , Magnetoencefalografia/métodos , Cuidados Pré-Operatórios/métodos , Estado Epiléptico/diagnóstico , Estado Epiléptico/cirurgia , Potenciais de Ação , Adolescente , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Gadolínio , Humanos , Imageamento por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos/métodos , Valor Preditivo dos Testes , Estado Epiléptico/fisiopatologia , Lobo Temporal/patologia , Lobo Temporal/fisiopatologia , Lobo Temporal/cirurgia , Resultado do Tratamento
8.
Acta Neurol Scand ; 116(4): 263-7, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17824907

RESUMO

BACKGROUND: A child whose left temporal lobe contained mesial, anterior and basal structures but lacked superio-lateral cortex had intractable epilepsy secondary to a porencephalic cyst. Magnetoencephalography (MEG) shows equivalent current dipoles (ECDs) as dipole modeling for temporal lobe epilepsy rather than in an exact location. AIM: We hypothesized that the magnetic fields generated by the epileptic discharges in mesio-basal temporal areas could be detected by MEG without interference from the superio-lateral temporal cortices. METHODS: We analyzed MEG spikes using single dipole analysis and synthetic aperture magnetometry (SAM), and compared with EEG spike topography. RESULTS: Two MEG ECDs corresponding to T3 spikes localized to the anterior mesio-basal temporal region with vertical orientation. Sixteen MEG ECDs corresponding to T5 spikes localized to the middle to posterior mesio-basal temporal region with vertical orientation. SAM revealed maximum current density at hippocampus and anterior fusiform gyrus for T3 spikes, and at posterior hippocampus and fusiform gyrus for T5 spikes. CONCLUSION: Vertically oriented ECDs were obtained without superio-lateral temporal cortices because of temporo-parieto-occipital porencephalic cyst. The absence of superio-lateral temporal cortices, prominent temporal EEG spikes, less prominent MEG spikes, and mesio-basal SAM spikes indicated that the vertically oriented ECDs were projected directly from the mesio-basal temporal region.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico , Encefalopatias/complicações , Mapeamento Encefálico , Criança , Cistos/complicações , Eletroencefalografia , Epilepsia do Lobo Temporal/etiologia , Epilepsia do Lobo Temporal/fisiopatologia , Humanos , Magnetoencefalografia , Masculino , Lobo Temporal/fisiopatologia
9.
Acta Neurol Scand ; 116(1): 59-64, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17587257

RESUMO

AIM OF THE STUDY: To report benign epileptiform discharges (BEDs) in the Rolandic region, coexisting in a pediatric patient with intractable localization-related epilepsy, secondary to hippocampal sclerosis. METHODS: We describe the clinical features, MRI, scalp video EEG, magnetoencephalography (MEG) and intracranial video EEG findings, and surgical outcome in a 9-year-old boy with BEDs and intractable complex partial seizures. RESULTS: MRI showed left hippocampal sclerosis. Scalp video EEG interictally demonstrated left temporal spike and sharply contoured slow waves, and right fronto-centro-temporal spike and waves. Ictal scalp video EEG showed left temporal rhythmic sharp waves after the clinical onset of epigastric aura, followed by staring. MEG showed interictal dipoles in the bilateral Rolandic regions with a uniform orientation and right hemispheric predominance. Intracranial video EEG, with bilateral mesial temporal depth and fronto-temporo-parietal strip electrodes, interictally showed polyspikes and slow waves with superimposed low-amplitude fast waves in the left mesial and posterior lateral temporal regions, and spike and waves in the bilateral fronto-parietal regions. Ictal onset was marked by low-amplitude fast waves in the left mesial and posterior lateral temporal regions. He underwent left anterior temporal lobectomy with hippocampectomy. Pathology was hippocampal sclerosis. Predominant right fronto-centro-temporal spike and waves and MEG right Rolandic dipoles persisted after surgery. He was seizure-free 14 months after surgery. CONCLUSION: This is the first report on MEG and intracranial video EEG features of BEDs in the Rolandic region, coexisting with hippocampal sclerosis. Persistence of contralateral benign MEG Rolandic dipoles after surgery indicates that BEDs are coincidental in mesial temporal lobe epilepsy. MEG identified Rolandic dipoles, although was unable to localize the deep and focal epileptogenic dipoles from the hippocampal sclerosis.


Assuntos
Epilepsia Parcial Complexa/fisiopatologia , Córtex Motor/fisiopatologia , Criança , Eletroencefalografia , Epilepsia Parcial Complexa/etiologia , Epilepsia Parcial Complexa/patologia , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética , Magnetoencefalografia , Masculino , Córtex Motor/patologia , Esclerose/complicações
10.
Acta Neurol Scand ; 115(4 Suppl): 29-36, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17362274

RESUMO

Magnetoencephalography (MEG) provides accurate localizing information of the epileptogenic zones in localization-related epilepsies. Refractory status epilepticus (RSE) is a life-threatening emergency that often requires prolonged high-dose suppressive therapy (HDST) to stop frequent and prolonged seizures. Surgical treatments for patients with RSE secondary to pre-existing epilepsy were reported. This article addresses the role of MEG in localizing the epileptogenic zone for the surgical treatment of patients with RSE. Five pediatric patients with RSE underwent epilepsy surgery using MEG, scalp video EEG and magnetic resonance imaging (MRI). Ictal MEG spike sources (MEGSSs) were localized in the clustered interictal MEGSSs in right Rolandic region (patient 3) and right temporal region (patient 5). Interictal MEG revealed unilateral clustered MEGSSs in four patients (patients 1, 2, 4, and 5) and bilateral (patient 3). Ictal-onset EEG findings were localized to one region in three patients (patients 1, 3, and 5) and two regions in the other two patients (patients 2 and 4). In all five patients, interictal discharges were widespread involving over two lobes (patients 2 and 4) or three lobes (patients 1, 3, and 5). Suppression burst pattern was obtained by HDST (patient 5). MRI showed cortical dysplasia in three patients (patients 1, 3, and 4). Patient 2 had a normal MRI. Patient 5 had normal MRI at the onset. Repeat MRI 5 days later showed diffusion restriction in the right hippocampus associated with increased signal intensity on T2 and FLAIR sequences. We performed cortical excision in two patients (patients 1 and 4), hemispherectotomy one (patient 3) and anterior temporal lobectomy two patients (patients 2 and 5). Two patients (patients 1 and 3) became seizure free, the other three patients experienced residual seizures. MEG showed clustered MEGSSs during the RSE in the pre-existing epilepsy patients and at an early time window in the acute symptomatic RSE patients. The complete resection of clustered MEGSSs can control RSE and possibly lead to a seizure free outcome.


Assuntos
Magnetoencefalografia , Neurocirurgia/métodos , Estado Epiléptico/fisiopatologia , Estado Epiléptico/cirurgia , Adolescente , Mapeamento Encefálico , Criança , Pré-Escolar , Eletroencefalografia/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Fatores de Tempo , Resultado do Tratamento
11.
Neurology ; 57(4): 590-6, 2001 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-11524465

RESUMO

OBJECTIVE: To describe the diagnosis, treatment, and outcomes in children with malignant rolandic-sylvian epilepsy (MRSE), defined as a form of epilepsy characterized by sensorimotor seizures, medical refractoriness, normal MRI, frontocentrotemporal EEG spikes, rolandic-sylvian spike sources on magnetoencephalography (MEG), and cognitive problems. METHODS: A retrospective chart analysis of seven patients who had shown these characteristics and undergone extensive diagnostic testing, including MEG and intracranial video-EEG was performed. RESULTS: Interictal scalp EEG spikes were seen over the frontocentrotemporal regions bilaterally (6) and unilaterally (1). MEG showed spike sources in the perisylvian region in two patients (both bilateral) and in the perirolandic fissure in five (two bilateral). Three patients required bilateral subdural strips to lateralize seizures before electrocorticography. Final electrocorticograms showed an ictal onset zone around the rolandic (four cases) and rolandic-sylvian regions (three cases). Six patients showed neuropsychological deficits. After cortical excision and multiple subpial transection, three were seizure free and four had seizures rarely (30 months' mean follow-up). No child had a permanent deficit in sensorimotor or cognitive functions, although two showed exacerbation of preexisting attentional deficits. Tissue analysis showed definite evidence of neuronal migration disorders (3) and gliosis (2). CONCLUSIONS: MEG was helpful for localizing both malignant rolandic-sylvian neuronal activities and functional cortex. Successive neuropsychological assessments are necessary to detect cognitive deterioration and indicate remedial programming. If, after careful observation over at least 5 years, surgery is considered to control refractory seizures, intracranial video-EEG is needed to localize the epileptogenic zone.


Assuntos
Eletroencefalografia , Epilepsia Rolândica/diagnóstico , Magnetoencefalografia , Adolescente , Criança , Eletroencefalografia/métodos , Epilepsia Rolândica/psicologia , Epilepsia Rolândica/cirurgia , Potenciais Somatossensoriais Evocados/fisiologia , Feminino , Humanos , Magnetoencefalografia/métodos , Masculino , Testes Neuropsicológicos , Estudos Retrospectivos , Telemetria/métodos , Gravação em Vídeo/métodos
12.
Epilepsia ; 42(4): 483-90, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11440343

RESUMO

PURPOSE: We evaluated dipole localizations of independent neighboring interictal spike foci using scalp electroencephalogram (EEG) to identify neuronal generators of epileptic discharges. METHODS: Three pediatric patients with extratemporal lobe epilepsy who had two independent neighboring interictal spike foci on scalp EEG were studied. Prolonged video EEG was digitally recorded from 19 scalp electrodes, whose positions were registered using a three-dimensional digitizer. Interictal spikes were visually selected based on negative phase reversals on bipolar montages. We analyzed the dipole position and moment of each spike using a single moving dipole and three-shell spherical head model. The dipoles were overlaid onto magnetic resonance (MR) images and divided into two groups based on two spike foci. RESULTS: The dipoles of the two groups were oriented either tangentially or radially to the scalp in close proximity to each other. The dipoles oriented radially were located underneath the electrode with a negative peak; those oriented tangentially were between electrodes with a negative and positive peak. The positions of tangential dipoles were more concentrated than those of radial dipoles. The epileptogenic regions corresponded to the dipole localizations. Surgical excisions were performed based on the results of electrocorticography. After surgery, two patients were seizure free, and one had rare seizures (follow-up period, 13-31 months). CONCLUSIONS: We showed that dipoles in close proximity but with different orientations projected two negative maxima on scalp EEG in three patients with extratemporal localization-related epilepsy. Equivalent current dipole analysis of individual interictal spikes can provide useful information about the epileptogenic zone in these patients.


Assuntos
Córtex Cerebral/fisiopatologia , Eletroencefalografia/estatística & dados numéricos , Epilepsia/diagnóstico , Adolescente , Mapeamento Encefálico , Córtex Cerebral/cirurgia , Criança , Eletrodos Implantados , Eletroencefalografia/métodos , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/fisiopatologia , Epilepsia/fisiopatologia , Epilepsia/cirurgia , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/estatística & dados numéricos , Prognóstico , Estatística como Assunto , Resultado do Tratamento , Gravação de Videoteipe
13.
Epilepsia ; 42(12): 1523-30, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11879362

RESUMO

PURPOSE: To discover whether the spatial distribution of spike sources determined by magnetoencephalography (MEG) provides reliable information for planning surgery and predicting outcomes in pediatric patients with lesional extrahippocampal epilepsy. METHODS: We retrospectively studied 12 children with extrahippocampal epilepsy secondary to cortical dysplasia (CD), tumor, or porencephalic cyst. We compared interictal MEG spike source locations and somatosensory evoked fields derived from equivalent-current dipole modeling with intraoperative or extraoperative electrocorticography (ECoG). RESULTS: MEG spike sources were found in proximity to the lesion in all patients and extended from lesions in five patients with CD. Marginal spike sources were noted in three patients with tumors, one patient with a cyst, and one with CD, and extramarginal sources in three patients with tumors. Three patients with tumors underwent lesionectomy only; two had further cortical excisions. One patient with CD underwent lesionectomy only, three had lesionectomy and cortical excisions, and two had lesionectomy and multiple subpial transection. Asymmetric MEG spike sources correlated with ECoG findings in all patients. Residual epileptiform discharges on postexcisional ECoG corresponded to spike sources in three patients with tumors and one patient with a cyst. Eleven patients have been seizure free for 1-6 years (mean, 4 years). One patient had residual seizures after incomplete excision of right temporal CD. CONCLUSIONS: MEG delineated asymmetric epileptogenicity surrounding lesions and the eloquent cortex. Complete tumor resection produced favorable outcomes despite residual postexcisional ECoG spikes and extramarginal MEG spike sources. CD characterized by clusters of MEG spike sources within and extending from lesions seen on magnetic resonance imaging (MRI) should be removed to prevent seizures.


Assuntos
Córtex Cerebral/fisiopatologia , Córtex Cerebral/cirurgia , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/cirurgia , Magnetoencefalografia/estatística & dados numéricos , Adolescente , Fatores Etários , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/cirurgia , Córtex Cerebral/anormalidades , Criança , Pré-Escolar , Eletroencefalografia/estatística & dados numéricos , Epilepsias Parciais/fisiopatologia , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Monitorização Fisiológica , Gravação de Videoteipe
14.
Clin Neurophysiol ; 111(1): 161-8, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10656524

RESUMO

OBJECTIVES: To assess the reliability of dipole localization based on residual variances (RV), using equivalent current dipole analysis of interictal EEG spikes in children with extratemporal lobe epilepsy. METHODS: Four pediatric patients with extratemporal lobe epilepsy were studied. Digital EEG was recorded from 19 scalp electrodes. Computer programs for spike detection and clustering analysis were used to select spikes. Dipoles were calculated 5 times for each spike using different initial guesses by the moving dipole model. Standard deviation (SD) of the dipole positions was calculated at each time point in the 5 trials. RESULTS: We analyzed the dipoles at 1097 time points from 4 patients. Among 106 time points with RV < 2%, the SD was < 1 mm in 78 (74%), while in those with SD > 1 mm the dipole positions varied between 2.8 and 52.6 mm. Of dipoles with RV < 1%, 26 of 27 (96%) had an SD < 1 mm; the one dipole with SD > 1 mm varied within 2.5 mm. The dipole localizations with RV < 2% corresponded to the epileptogenic zones identified on intracranial invasive video EEG and intraoperative ECoG. CONCLUSIONS: The systematic approach of equivalent current dipole analysis using spike detection, clustering analysis, and an RV < 2% as a standard is useful for identifying extratemporal epileptic regions.


Assuntos
Eletroencefalografia , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/fisiopatologia , Epilepsia do Lobo Frontal/fisiopatologia , Adolescente , Encéfalo/fisiopatologia , Encefalopatias/complicações , Criança , Cistos/complicações , Epilepsias Parciais/etiologia , Epilepsia do Lobo Frontal/diagnóstico , Epilepsia Rolândica/diagnóstico , Epilepsia Rolândica/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Reprodutibilidade dos Testes , Couro Cabeludo , Software
15.
Neurosurgery ; 45(5): 1186-91, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10549936

RESUMO

OBJECTIVE: This study was undertaken to assess the utility of digital camera-derived intraoperative images in the planning of neurosurgery for children with epilepsy. METHODS: A hand-held digital camera was used to capture the exposed surgical field at the time of craniotomy for 11 children with medically intractable seizure disorders. Intraoperative somatosensory evoked potential recordings of phase reversals and direct cortical stimulation were used to map areas of eloquent brain tissue. Digital camera images were obtained to mark regions of functional brain tissue with respect to cortical surface landmarks and subdural grid placement. The digital camera images were then immediately downloaded, in the operating room, to a laptop computer, which was placed next to the electroencephalographic recording device. Using computer software, the epileptologist highlighted the primary and secondary zones of epileptogenesis, as well as the functional brain areas identified during the monitoring period, on the digital camera images on the computer screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and multiple subpial transections. RESULTS: With the images obtained using the digital camera, the epilepsy team was able to observe the contacts of the grid electrodes with the brain during the procedure. Color printouts of the images served as references during the period of invasive monitoring. Zones of primary and secondary epileptogenesis, as well as areas of functional brain tissue, were identified and plotted on the digital camera images. Other benefits of the digital camera-derived images included the ability to accurately reposition the grids or letters marking eloquent brain tissue if they were inadvertently shifted during the procedure, the ease with which the images could be obtained and manipulated, the ability to assess postresection epileptiform activity of the surrounding brain tissue with images obtained while an electrocorticographic array was in place, the ability to provide the entire epilepsy team with updated information on the neurosurgical field while minimizing movement in the operating room, and facilitation, with neurosurgical maps, of discussions with the patients and their families concerning proposed cortical resections. CONCLUSION: Digital camera images have become essential components for the planning of cortical resections for children with intractable epilepsy at our institution. We envision widespread application of this technology to other neurosurgical fields.


Assuntos
Epilepsia/cirurgia , Processamento de Imagem Assistida por Computador/instrumentação , Monitorização Intraoperatória/instrumentação , Planejamento de Assistência ao Paciente , Fotografação/instrumentação , Adolescente , Mapeamento Encefálico/instrumentação , Córtex Cerebral/fisiopatologia , Córtex Cerebral/cirurgia , Criança , Pré-Escolar , Eletroencefalografia/instrumentação , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Microcomputadores , Equipe de Assistência ao Paciente , Software
16.
J Immunol ; 161(6): 2716-22, 1998 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-9743328

RESUMO

Fc gamma RIIB1 (CD32) is a receptor that binds the Fc domain of Ag-complexed IgG. Coaggregation of B cell receptor (BCR) and Fc gamma RIIB1 generates a dominant negative signal that inhibits B cell activation. In Ag-specific Id-positive B cells, the co-cross-linking of BCR and Fc gamma RIIB1 by anti-Id Ab resulted in the association of both Src homology 2-containing protein tyrosine phosphatase (SHP-1) and Src homology 2-containing inositol phosphatase (SHIP) with the Fc gamma RIIB1; however, only SHIP activity was detected. "Superclustering" of the BCR and Fc gamma RIIB1 complex induced by stimulation with anti-Id Ab plus polyvalent Ag synergistically activated SHP-1. The degree of co-cross-linking between BCR and Fc gamma RIIB1 may determine the activation status of SHP-1 and SHIP.


Assuntos
Proteínas Tirosina Fosfatases/metabolismo , Agregação de Receptores/imunologia , Receptores de Antígenos de Linfócitos B/metabolismo , Receptores de IgG/metabolismo , Domínios de Homologia de src/imunologia , Animais , Anticorpos Anti-Idiotípicos/farmacologia , Ativação Enzimática/imunologia , Haptenos/genética , Peptídeos e Proteínas de Sinalização Intracelular , Linfoma de Células B/imunologia , Linfoma de Células B/metabolismo , Camundongos , Fosforilação , Proteína Fosfatase 1 , Proteína Tirosina Fosfatase não Receptora Tipo 11 , Proteína Tirosina Fosfatase não Receptora Tipo 6 , Proteínas Tirosina Fosfatases/antagonistas & inibidores , Receptores de Antígenos de Linfócitos B/genética , Receptores de Antígenos de Linfócitos B/fisiologia , Receptores de IgG/fisiologia , Proteínas Tirosina Fosfatases Contendo o Domínio SH2 , Soroalbumina Bovina/genética , Soroalbumina Bovina/imunologia , Transdução de Sinais/imunologia , Transfecção/imunologia , Trinitrobenzenos/imunologia , Células Tumorais Cultivadas
17.
J Immunol ; 161(3): 1390-8, 1998 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-9686602

RESUMO

This communication describes an extracellular signal-regulated kinase kinase (MEK)-dependent signal transduction pathway that prevents the terminal differentiation of a hemopoietic cell line. Both PMA and the cell-permeable ceramide, C2-ceramide, caused differentiation of U937 cells, but with distinct cell morphology and CD11b/CD14 surface expression. While PMA activated extracellular signal-regulated kinase (ERK), a downstream kinase of Raf-MEK signaling, C2-ceramide activated c-Jun NH2-terminal kinase (JNK), an anchor kinase of stress-induced signaling. Furthermore, only C2-ceramide stimulated an induction of cell cycle arrest that was associated with stable expression of p21CIP1 and retinoblastoma nuclear phosphoprotein dephosphorylation. Expression of p21CIP1 and JNK activation were also observed in sphingosine-treated cells, whereas sphingosine did not induce detectable differentiation. Concomitant stimulation with C2-ceramide and PMA resulted in the PMA phenotype, and cell cycle arrest was absent. ERK activation was enhanced by C2-ceramide plus PMA stimulation, whereas the activation of JNK was aborted. Strikingly, the inhibition of MEK with PD98059 altered the phenotype of C2-ceramide- and PMA-stimulated U937 cells to that of cells treated with C2-ceramide alone. Thus, ERK and JNK pathways deliver distinct signals, and the ERK pathway is dominant to the JNK cascade. Furthermore, differentiation and cell cycle arrest caused by C2-ceramide rely on independent signaling pathways, and JNK is an unlikely signaling element for this differentiation. Importantly, during C2-ceramide and PMA costimulation, the JNK pathway is not simply blocked by ERK activation; rather, cross-talk between these MAP kinase pathways acts to simultaneously augment ERK activity and down-regulate JNK activity.


Assuntos
Proteínas Quinases Dependentes de Cálcio-Calmodulina/metabolismo , Leucemia Monocítica Aguda/patologia , Quinases de Proteína Quinase Ativadas por Mitógeno , Esfingosina/análogos & derivados , Proteínas Quinases Dependentes de Cálcio-Calmodulina/efeitos dos fármacos , Proteínas Quinases Dependentes de Cálcio-Calmodulina/fisiologia , Ciclo Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Inibidor de Quinase Dependente de Ciclina p21 , Ciclinas/biossíntese , Ciclinas/efeitos dos fármacos , Ativação Enzimática/efeitos dos fármacos , Humanos , Leucemia Monocítica Aguda/enzimologia , MAP Quinase Quinase 1 , Fenótipo , Fosforilação/efeitos dos fármacos , Proteínas Serina-Treonina Quinases/antagonistas & inibidores , Proteínas Tirosina Quinases/antagonistas & inibidores , Proteína do Retinoblastoma/metabolismo , Transdução de Sinais/efeitos dos fármacos , Esfingosina/farmacologia , Acetato de Tetradecanoilforbol/farmacologia , Células Tumorais Cultivadas
18.
Immunol Lett ; 61(2-3): 135-43, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9657266

RESUMO

Membrane-expressed immunoglobulins are B-cell receptors (BCR) for specific antigens (Ag). Upon Ag engagement of the BCR, B-cells are activated to internalize Ag-BCR complexes, process Ag and subsequently present Ag-peptides loaded in class II MHC. Due to the specific nature of the BCR, the cognate interaction between T-cells expressing Ag-specific T-cell receptor and these Ag-presenting B-cells occur in a highly regulated and precise manner. Accordingly, efficient control of T-cell activation may be achieved through regulation of Ag presenting B-cells. A potent form of regulation of lymphocyte responses is mediated by Ig end-product and anti-idiotypic antibodies via Fc-dependent mechanisms. In this communication, the authors present data that an anti-idiotype (anti-Id) Ab inhibits BCR-mediated internalization of specific Ag. Coupling of BCR to the cytoskeleton was also abortive in anti-Id Ab-treated B-cells. Inhibition by anti-Id Ab was dependent upon the presence of FcgammaRIIB1 on B-cells. As a result of anti-Id Ab suppression, B-cells were unable to initiate Ca2+ responses in Ag-specific T-cells. The results suggest that co-crosslinking of FcgammaRIIB1 and BCR inhibits cytoskeletal coupling and internalization of the Ag-BCR complex thereby preventing specific Ag presentation by B-cells. Anti-Id Ab may mediate a negative regulatory mechanism that suppresses B-cell-mediated Ag-specific T-cell activation.


Assuntos
Antígenos CD/imunologia , Linfócitos B/imunologia , Receptores de Antígenos de Linfócitos B/imunologia , Receptores de IgG/imunologia , Transdução de Sinais , Animais , Anticorpos Anti-Idiotípicos/imunologia , Cálcio/metabolismo , Reagentes de Ligações Cruzadas , Citoesqueleto , Haptenos/imunologia , Camundongos , Linfócitos T/metabolismo , Células Tumorais Cultivadas
19.
J Synchrotron Radiat ; 5(Pt 3): 256-62, 1998 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-15263488

RESUMO

A two-dimensional microstrip gas chamber (MSGC) has been developed with a 10 cm-square detection area and an ultrafast read-out system. The MSGC was made using multi-chip module (MCM) technology, and has a very thin substrate of 17 micro m and many anodes and back strips, both with 200 micro m pitches. The new read-out system, in which the hit addresses of the electrodes were sequentially encoded to the hit positions by a synchronous clock, handles data rates of up to 10(7) events s(-1) from MSGCs. This enables the acquisition of fast and sequential digital images. Furthermore, since the MSGC is a real photon-counting detector, the timing of the photons, to an accuracy of a few tens of nanoseconds, and energy can be recorded. Here, the performance of the MSGC system as a real-time area detector is reported, and the abilities of this system are discussed.

20.
J Synchrotron Radiat ; 5(Pt 3): 857-9, 1998 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-15263676

RESUMO

A two-dimensional microstrip gas chamber (MSGC) with a 5 cm x 5 cm detection area has been developed. It has 254 anodes and 255 back strips, both with 200 micro m pitches. Using this MSGC, linear polarization of X-rays was successfully measured in the energy range 6-14 keV. In addition, the performance of the MSGC as an X-ray imaging polarimeter has been simulated using the EGS4 program (Electron Gamma Shower, Version 4) modified for this purpose. In this article, the results of both the polarization measurement and the simulation are reported.

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